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Royall DR, Palmer RF. The effects of CNS atrophy and ICVD on tests of executive function and functional status are mediated by intelligence. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100184. [PMID: 37811522 PMCID: PMC10550593 DOI: 10.1016/j.cccb.2023.100184] [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: 01/26/2023] [Revised: 09/05/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023]
Abstract
Background Impairments in executive function (EF) are often attributed to ischemic cerebrovascular disease (ICVD) and frontal circuit pathology. However, EF can be distinguished from general intelligence and the latter is likely to manifest in "executive" measures. We aimed to distinguish the effects of imaging biomarkers on these constructs. Methods We tested neuroimaging biomarkers as independent predictors of observed 12 month-prospective cognitive performance by a Multiple Indicators Multiple Causes (MIMIC) model in the Alzheimer's Disease Neuroimaging Initiative (ADNI) (N ≅ 1750). Results ICVD was associated with ''Organization" (ORG) and "Planning" (PLAN) domain scores from the test of Every Day Cognition. Left anterior cingulate (LAC) atrophy was independently associated with Trail-Making part B and Animal Naming. The MIMIC model had excellent fit and tests additional latent variables i.e., EF and dEF (a latent δ homolog derived from Spearman's general intelligence factor, g). Only dEF was associated with instrumental activities of daily living (IADL). ICVD and LAC were both associated with observed executive measures through dEF. ICVD was independently associated with those same measures through EF. Conclusions Observed EF is independently determined by multiple factors. The effects of EF-associated MRI biomarkers can be related to disability and dementia only via their effects on g. Because g /δ are unlikely to be located within the frontal lobes, the dementia-specific variance in executive measures may have little to do with either frontal structure or function. Conversely, domain-specific variance in EF may have little to do with either IADL-impairment or dementia.
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Affiliation(s)
- Donald R. Royall
- Department of Psychiatry, the University of Texas Health Science Center, San Antonio, TX, United States of America
- Department of Medicine, the University of Texas Health Science Center, San Antonio, TX, United States of America
- Department of Family and Community Medicine, the University of Texas Health Science Center, San Antonio, TX, United States of America
- The Glenn Biggs Institute for Alzheimer's and Neurodegenerative Disease, the University of Texas Health Science Center, San Antonio, TX, United States of America
| | - Raymond F. Palmer
- Department of Family and Community Medicine, the University of Texas Health Science Center, San Antonio, TX, United States of America
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Perepelkina OV, Poletaeva II. Selection of Mice for Object Permanence Cognitive Task Solution. Neurol Int 2022; 14:696-706. [PMID: 36135993 PMCID: PMC9502561 DOI: 10.3390/neurolint14030058] [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: 08/01/2022] [Revised: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
The selection of mice for high (“plus”) and low (“minus”) scores in the puzzle-box test was performed over five generations. This test evaluates the success (or failure) in finding the underpass, leading to the dark part of the box, when it is blocked. This means that the mouse is either able or unable to operate the “object permanence rule” (one of the index’s cognitive abilities). For the “+” strain, animals were bred who solved the test when the underpass test blocked with a plug; the “−” strain comprised those who were unable to solve this task. In mice of the “+” strain, the proportion of animals that was able to solve “plug” stages of the test was higher than in the “−” strain and in the non-selected genetically heterogeneous population. The “+” mice ate significantly more new food in the hyponeophagia test. Animals of both strains demonstrated the ability to “manipulate” the plug blocking the underpass, touching the plug with their paws and muzzle, although the majority of “−” mice were unable to open the underpass effectively. Thus, mice of both selected strains demonstrated that they were able to understand that the underpass does exist, but only “+”-strain animals (at least the majority of them) were able to realize the solution. The selection for plug-stage solution success affected the mouse’s ability to open the hidden underpass.
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Kiselica AM, Kaser AN, Webber TA, Small BJ, Benge JF. Development and Preliminary Validation of Standardized Regression-Based Change Scores as Measures of Transitional Cognitive Decline. Arch Clin Neuropsychol 2020; 35:1168–1181. [PMID: 32710607 DOI: 10.1093/arclin/acaa042] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2020] [Indexed: 02/28/2024] Open
Abstract
OBJECTIVE An increasing focus in Alzheimer's disease and aging research is to identify transitional cognitive decline. One means of indexing change over time in serial cognitive evaluations is to calculate standardized regression-based (SRB) change indices. This paper includes the development and preliminary validation of SRB indices for the Uniform Data Set 3.0 Neuropsychological Battery, as well as base rate data to aid in their interpretation. METHOD The sample included 1,341 cognitively intact older adults with serial assessments over 0.5-2 years in the National Alzheimer's Coordinating Center Database. SRB change scores were calculated in half of the sample and then validated in the other half of the sample. Base rates of SRB decline were evaluated at z-score cut-points, corresponding to two-tailed p-values of .20 (z = -1.282), .10 (z = -1.645), and .05 (z = -1.96). We examined convergent associations of SRB indices for each cognitive measure with each other as well as concurrent associations of SRB indices with clinical dementia rating sum of box scores (CDR-SB). RESULTS SRB equations were able to significantly predict the selected cognitive variables. The base rate of at least one significant SRB decline across the entire battery ranged from 26.70% to 58.10%. SRB indices for cognitive measures demonstrated theoretically expected significant positive associations with each other. Additionally, CDR-SB impairment was associated with an increasing number of significantly declined test scores. CONCLUSIONS This paper provides preliminary validation of SRB indices in a large sample, and we present a user-friendly tool for calculating SRB values.
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Affiliation(s)
- Andrew M Kiselica
- Division of Neuropsychology, Baylor Scott and White Health, Temple, TX, USA
| | - Alyssa N Kaser
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | | | - Brent J Small
- School of Aging Studies, University of South Florida, Tampa, FL, USA
| | - Jared F Benge
- Division of Neuropsychology, Baylor Scott and White Health, Temple, TX, USA
- Plummer Movement Disorders Center, Temple, TX, USA
- Texas A&M College of Medicine, Bryan, TX, USA
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Do executive functions mediate the link between socioeconomic status and numeracy skills? A cross-site comparison of Hong Kong and the United Kingdom. J Exp Child Psychol 2020; 194:104734. [DOI: 10.1016/j.jecp.2019.104734] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 11/21/2022]
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Royall DR, Bishnoi RJ, Palmer RF. Blood-based protein predictors of dementia severity as measured by δ: Replication across biofluids and cohorts. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2019; 11:763-774. [PMID: 31909176 PMCID: PMC6939046 DOI: 10.1016/j.dadm.2019.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Dementia severity can be empirically described by the latent dementia phenotype "δ" and its various composite "homologs". We have explored δ's blood-based protein biomarkers in the Texas Alzheimer's Research and Care Consortium (TARCC) study. However, it would be convenient to replicate those associations in the Alzheimer's Disease Neuroimaging Initiative (ADNI). To this end, we recently engineered a δ homolog from observed cognitive performance measures common to both projects (i.e., "dT2A"). METHODS We used nine rationally chosen peripheral blood-based protein biomarkers as indicators of a latent variable "INFLAMMATION". We then associated that construct with dT2A in structural equation models adjusted for age, gender, depressive symptoms, and apolipoprotein E (APOE) ε4 allelic burden. Significant factor loadings and INFLAMMATION's association with dT2A were confirmed in random splits of TARCC's relatively large sample, and across biofluids in the ADNI. RESULTS Nine proteins measured in serum (TARCC) or plasma (ADNI) explained ≅10% of dT2A's variance in both samples, independently of age, APOE, education, and gender. All loaded significantly on INFLAMMATION, and positively or negatively, depending on their known roles are PRO- or ANTI-inflammatory proteins, respectively. The parameters of interest were confirmed across random 50% splits of the TARCC's sample, and replicated across biofluids in the ADNI. DISCUSSION These results suggest that SEM can be used to replicate biomarker findings across samples and biofluids, and that a substantial fraction of dementia's variance is attributable to peripheral blood-based protein levels.
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Affiliation(s)
- Donald R. Royall
- Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX, USA
- Department of Medicine, the University of Texas Health Science Center, San Antonio, TX, USA
- Family and Community Medicine, the University of Texas Health Science Center, San Antonio, TX, USA
- The Biggs Institute for Alzheimer's and Neurodegenerative Disease, the University of Texas Health Science Center, San Antonio, TX, USA
| | - Ram J. Bishnoi
- The Department of Psychiatry, The Medical College of Georgia, Augusta, GA, USA
| | - Raymond F. Palmer
- Family and Community Medicine, the University of Texas Health Science Center, San Antonio, TX, USA
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Royall DR, Palmer RF. Blood-based protein mediators of senility with replications across biofluids and cohorts. Brain Commun 2019; 2:fcz036. [PMID: 32954311 PMCID: PMC7425523 DOI: 10.1093/braincomms/fcz036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/25/2019] [Accepted: 10/07/2019] [Indexed: 01/08/2023] Open
Abstract
Dementia severity can be quantitatively described by the latent dementia phenotype 'δ' and its various composite 'homologues'. We have explored δ's blood-based protein biomarkers in the Texas Alzheimer's Research and Care Consortium. However, it would be convenient to replicate them in the Alzheimer's Disease Neuroimaging Initiative. To that end, we have engineered a δ homologue from the observed cognitive performance measures common to both projects [i.e. 'd:Texas Alzheimer's Research and Care Consortium to Alzheimer's Disease Neuroimaging Initiative' (dT2A)]. In this analysis, we confirm 13/22 serum proteins as partial mediators of age's effect on dementia severity as measured by dT2A in the Texas Alzheimer's Research and Care Consortium and then replicate 4/13 in the Alzheimer's Disease Neuroimaging Initiative's plasma data. The replicated mediators of age-specific effects on dementia severity are adiponectin, follicle-stimulating hormone, pancreatic polypeptide and resistin. In their aggregate, the 13 confirmed age-specific mediators suggest that 'cognitive frailty' pays a role in dementia severity as measured by δ. We provide both discriminant and concordant support for that hypothesis. Weight, calculated low-density lipoprotein and body mass index are partial mediators of age's effect in the Texas Alzheimer's Research and Care Consortium. Biomarkers related to other disease processes (e.g. cerebrospinal fluid Alzheimer's disease-specific biomarkers in the Alzheimer's Disease Neuroimaging Initiative) are not. It now appears that dementia severity is the sum of multiple independent processes impacting δ. Each may have a unique set of mediating biomarkers. Age's unique effect appears to be at least partially mediated through proteins related to frailty. Age-specific mediation effects can be replicated across cohorts and biofluids. These proteins may offer targets for the remediation of age-specific cognitive decline (aka 'senility'), help distinguish it from other determinants of dementia severity and/or provide clues to the biology of Aging Proper.
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Affiliation(s)
- Donald R Royall
- Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX 78229-3900, USA
- Department of Medicine, The University of Texas Health Science Center, San Antonio, TX 78229-3900, USA
- Department of Family and Community Medicine, The University of Texas Health Science Center, San Antonio, TX 78229-3900, USA
- The Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, The University of Texas Health Science Center, San Antonio, TX 78229-3900, USA
| | - Raymond F Palmer
- Department of Family and Community Medicine, The University of Texas Health Science Center, San Antonio, TX 78229-3900, USA
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Saari T, Hallikainen I, Hänninen T, Räty H, Koivisto A. Relationships between Cognition and Activities of Daily Living in Alzheimer's Disease During a 5-Year Follow-Up: ALSOVA Study. J Alzheimers Dis 2019; 64:269-279. [PMID: 29889073 DOI: 10.3233/jad-171059] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Impaired cognition and activities of daily living (ADL) are core symptoms of Alzheimer's disease (AD), but their relationship is unclear. OBJECTIVES To explore relationships between cognitive domains and functional ability during 5-year follow-up in persons with AD. METHODS We analyzed ALSOVA study data from 236 individuals with very mild or mild AD at baseline. The CERAD Neuropsychological Battery (CERAD-NB) was used as a cognitive measure and Alzheimer's Disease Cooperative Study ADL (ADCS-ADL) as a functional measure, analyzing the IADL and BADL sub-scores separately. Annual regression models and linear mixed-effect models (LMMs) covering a 5-year follow-up period were used. RESULTS Annually, the CERAD-NB total and especially Verbal Fluency, Clock Drawing, and Constructional Praxis were associated with the total ADCS-ADL and IADL scores increasingly yet modestly, and to a lesser extent the BADL score. In the LMMs, the same measures and MMSE were associated with ADL. CONCLUSION Measures of executive function and visuoconstructive skills appear to be associated with caregiver-interview based ADL measure during the progression of AD.
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Affiliation(s)
- Toni Saari
- Department of Education and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Ilona Hallikainen
- Institute of Clinical Medicine, Neurology, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Tuomo Hänninen
- NeuroCenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Hannu Räty
- Department of Education and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Anne Koivisto
- Institute of Clinical Medicine, Neurology, School of Medicine, University of Eastern Finland, Kuopio, Finland.,NeuroCenter, Neurology, Kuopio University Hospital, Kuopio, Finland
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Royall DR, Palmer RF. Selection for depression-specific dementia cases with replication in two cohorts. PLoS One 2019; 14:e0216413. [PMID: 31150419 PMCID: PMC6544211 DOI: 10.1371/journal.pone.0216413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 04/21/2019] [Indexed: 01/01/2023] Open
Abstract
The latent variable "δ" (for "dementia") provides an etiologically "agnostic" omnibus dementia severity metric capable of recognizing the dementing potential of any condition. Depressive symptoms are independent predictors of δ and are thereby implicated as "dementing". Serum resistin levels partially mediate the association between depressive symptoms and δ. We use a novel "off-diagonal" CHI SQ algorithm to demonstrate our ability to select individuals demented solely by depression's effect in both the Texas Alzheimer's Research and Care Consortium (TARCC) (N ≌ 3,500), and the Alzheimer's Disease Neuroimaging Initiative (ADNI (N ≌ 1,750), and demonstrate the higher resistin levels of such cases in TARCC. This approach can be adapted to any δ-related dementia risk factor or biomarker and used identify individuals who might revert back to non-demented states after its successful treatment.
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Affiliation(s)
- Donald R. Royall
- Department of Psychiatry, the University of Texas Health Science Center, San Antonio, Texas, United States of America
- Department of Medicine, the University of Texas Health Science Center, San Antonio, Texas, United States of America
- Department of Family and Community Medicine, the University of Texas Health Science Center, San Antonio, Texas, United States of America
- South Texas Veterans’ Health System Audie L. Murphy Division Geriatric Research Education and Clinical Care Center, San Antonio, Texas, United States of America
| | - Raymond F. Palmer
- Department of Family and Community Medicine, the University of Texas Health Science Center, San Antonio, Texas, United States of America
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Royall DR, Palmer RF. A δ Homolog for Dementia Case Finding with Replication in the Alzheimer's Disease Neuroimaging Initiative. J Alzheimers Dis 2018; 67:67-79. [PMID: 30507569 DOI: 10.3233/jad-171053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Dementia can be empirically described by the latent dementia phenotype "δ" and its various composite "homologs". We have explored δ's blood-based protein biomarkers in the Texas Alzheimer's Research and Care Consortium (TARCC) study. However, it would be convenient to replicate those associations in the Alzheimer's Disease Neuroimaging Initiative (ADNI). To this end, we have engineered a δ homolog from observed cognitive performance measures common to both projects. Our findings were replicated in randomly selected 50% splits of TARCC data (Group 1, N = 1,747; Group 2, N = 1,755), and then independently in ADNI (N = 1,737). The new δ homolog, i.e., "dT2A" (d-TARCC to ADNI), fit the data of both studies well, and was strongly correlated with dementia severity, as rated by the Clinical Dementia Rating Scale "sum of boxes" (TARCC: r = 0.99, p < 0.001; ADNI: r = 0.96, p < 0.001). dT2A achieved an area under the receiver operating characteristic curve of 0.981 (0.976-0.985) for the discrimination of Alzheimer's disease from normal controls in TARCC, and 0.988 (0.983-0.993) in ADNI. dT2A is the 12th δ homolog published to date, and opens the door to independent replications across these and similar studies.
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Affiliation(s)
- Donald R Royall
- Department of Psychiatry, The University of Texas Health Science Center, San Antonio, TX, USA.,Department of Medicine, The University of Texas Health Science Center, San Antonio, TX, USA.,Department of Family and Community Medicine, The University of Texas Health Science Center, San Antonio, TX, USA.,South Texas Veterans' Health System Audie L. Murphy Division GRECC, San Antonio, TX, USA
| | - Raymond F Palmer
- Department of Family and Community Medicine, The University of Texas Health Science Center, San Antonio, TX, USA
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General Intelligence (g), ACT Scores, and Theory of Mind: (ACT)g Predicts Limited Variance Among Theory of Mind Tests. INTELLIGENCE 2018. [DOI: 10.1016/j.intell.2018.10.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Karr JE, Areshenkoff CN, Rast P, Hofer SM, Iverson GL, Garcia-Barrera MA. The unity and diversity of executive functions: A systematic review and re-analysis of latent variable studies. Psychol Bull 2018; 144:1147-1185. [PMID: 30080055 DOI: 10.1037/bul0000160] [Citation(s) in RCA: 252] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Confirmatory factor analysis (CFA) has been frequently applied to executive function measurement since first used to identify a three-factor model of inhibition, updating, and shifting; however, subsequent CFAs have supported inconsistent models across the life span, ranging from unidimensional to nested-factor models (i.e., bifactor without inhibition). This systematic review summarized CFAs on performance-based tests of executive functions and reanalyzed summary data to identify best-fitting models. Eligible CFAs involved 46 samples (N = 9,756). The most frequently accepted models varied by age (i.e., preschool = one/two-factor; school-age = three-factor; adolescent/adult = three/nested-factor; older adult = two/three-factor), and most often included updating/working memory, inhibition, and shifting factors. A bootstrap reanalysis simulated 5,000 samples from 21 correlation matrices (11 child/adolescent; 10 adult) from studies including the three most common factors, fitting seven competing models. Model results were summarized as the mean percent accepted (i.e., average rate at which models converged and met fit thresholds: CFI ≥ .90/RMSEA ≤ .08) and mean percent selected (i.e., average rate at which a model showed superior fit to other models: ΔCFI ≥ .005/.010/ΔRMSEA ≤ -.010/-.015). No model consistently converged and met fit criteria in all samples. Among adult samples, the nested-factor was accepted (41-42%) and selected (8-30%) most often. Among child/adolescent samples, the unidimensional model was accepted (32-36%) and selected (21-53%) most often, with some support for two-factor models without a differentiated shifting factor. Results show some evidence for greater unidimensionality of executive function among child/adolescent samples and both unity and diversity among adult samples. However, low rates of model acceptance/selection suggest possible bias toward the publication of well-fitting but potentially nonreplicable models with underpowered samples. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Matsuoka T, Kato Y, Imai A, Fujimoto H, Shibata K, Nakamura K, Yamada K, Narumoto J. Differences in the neural correlates of frontal lobe tests. Psychogeriatrics 2018; 18:42-48. [PMID: 29372597 DOI: 10.1111/psyg.12285] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 06/03/2017] [Accepted: 07/17/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND The Executive Interview (EXIT25), the executive clock-drawing task (CLOX1), and the Frontal Assessment Battery (FAB) are used to assess executive function at the bedside. These tests assess distinct psychometric properties. The aim of this study was to examine differences in the neural correlates of the EXIT25, CLOX1, and FAB based on magnetic resonance imaging. METHODS Fifty-eight subjects (30 with Alzheimer's disease, 10 with mild cognitive impairment, and 18 healthy controls) participated in this study. Multiple regression analyses were performed to examine the brain regions correlated with the EXIT25, CLOX1, and FAB scores. Age, gender, and years of education were included as covariates. Statistical thresholds were set to uncorrected P-values of 0.001 at the voxel level and 0.05 at the cluster level. RESULTS The EXIT25 score correlated inversely with the regional grey matter volume in the left lateral frontal lobe (Brodmann areas 6, 9, 44, and 45). The CLOX1 score correlated positively with the regional grey matter volume in the right orbitofrontal cortex (Brodmann area 11) and the left supramarginal gyrus (Brodmann area 40). The FAB score correlated positively with the regional grey matter volume in the right precentral gyrus (Brodmann area 6). The left lateral frontal lobe (Brodmann area 9) and the right lateral frontal lobe (Brodmann area 46) were identified as common brain regions that showed association with EXIT25, CLOX1, and FAB based only a voxel-level threshold. CONCLUSIONS The results of this study suggest that the EXIT25, CLOX1, and FAB may be associated with the distinct neural correlates of the frontal cortex.
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Affiliation(s)
- Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuka Kato
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ayu Imai
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Hiroshi Fujimoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Keisuke Shibata
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kaeko Nakamura
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Royall DR, Al-Rubaye S, Bishnoi R, Palmer RF. Serum proteins mediate depression's association with dementia. PLoS One 2017; 12:e0175790. [PMID: 28594820 PMCID: PMC5464526 DOI: 10.1371/journal.pone.0175790] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/31/2017] [Indexed: 01/08/2023] Open
Abstract
The latent variable "δ" (for "dementia") uniquely explains dementia severity. Depressive symptoms are independent predictors of δ. We explored 115 serum proteins as potential causal mediators of the effect of depressive symptoms on δ in a large, ethnically diverse, longitudinal cohort. All models were adjusted for age, apolipoprotein E, education, ethnicity, gender, hemoglobin A1c, and homocysteine, and replicated in randomly selected 50% subsets. Alpha1-antitrypsin (A1AT), FAS, Heparin-binding EGF-like Growth Factor (HB-EGF), Insulin-like Growth Factor-1 (IGF-1), Luteinizing Hormone (LH), Macrophage Inflammatory Protein type 1 alpha (MIP-1α), Resitin, S100b, Tissue Inhibitor of Metalloproteinase type 1 (TIMP-1), and Vascular Cell Adhesion Molecule type 1 (VCAM-1) each were partial mediators of depression's association with δ. These proteins may offer targets for the treatment of depression's specific effect on dementia severity and Alzheimer's Disease (AD) conversion risk.
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Affiliation(s)
- Donald R. Royall
- Department of Psychiatry, the University of Texas Health Science Center, San Antonio, Texas, United States of America
- Department of Medicine, the University of Texas Health Science Center, San Antonio, Texas, United States of America
- Department of Family and Community Medicine, the University of Texas Health Science Center, San Antonio, Texas, United States of America
- South Texas Veterans’ Health System Audie L. Murphy Division Geriatric Research Education and Clinical Care Center, San Antonio, Texas, United States of America
| | - Safa Al-Rubaye
- Department of Psychiatry, the University of Texas Health Science Center, San Antonio, Texas, United States of America
| | - Ram Bishnoi
- Department of Psychiatry, the Medical College of Georgia, Augusta, Georgia, United States of America
| | - Raymond F. Palmer
- Department of Family and Community Medicine, the University of Texas Health Science Center, San Antonio, Texas, United States of America
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Peh CX, Abdin E, Vaingankar JA, Verma S, Chua BY, Sagayadevan V, Seow E, Zhang Y, Shahwan S, Ng LL, Prince M, Chong SA, Subramaniam M. Validation of a Latent Construct for Dementia in a Population-Wide Dataset from Singapore. J Alzheimers Dis 2016; 55:823-833. [PMID: 27802230 DOI: 10.3233/jad-160575] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The latent variable δ has been proposed as a proxy for dementia. Previous validation studies have been conducted using convenience samples. It is currently unknown how δ performs in population-wide data. OBJECTIVE To validate δ in Singapore using population-wide epidemiological study data on persons aged 60 and above. METHODS δ was constructed using items from the Community Screening Instrument for Dementia (CSI'D) and World Health Organization Disability Assessment Schedule (WHODAS II). Confirmatory factor analysis (CFA) was conducted to examine δ model fit. Convergent validity was examined with the Clinical Dementia Rating scale (CDR) and GMS-AGECAT dementia. Divergent validity was examined with GMS-AGECAT depression. RESULTS The δ model demonstrated fit to the data, χ2(df) = 249.71(55), p < 0.001, CFI = 0.990, TLI = 0.997, RMSEA = 0.037. Latent variable δ was significantly associated with CDR and GMS-AGECAT dementia (range: β= 0.32 to 0.63), and was not associated with GMS-AGECAT depression. Compared to unadjusted models, δ model fit was poor when adjusted for age, gender, ethnicity, and education. CONCLUSION The study found some support for δ as a proxy for dementia in Singapore based on population data. Both convergent and divergent validity were established. In addition, the δ model structure appeared to be influenced by age, gender, ethnicity, and education covariates.
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Affiliation(s)
- Chao Xu Peh
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Swapna Verma
- Early Psychosis Intervention Programme, Institute of Mental Health, Singapore, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Esmond Seow
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - YunJue Zhang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore
| | - Martin Prince
- Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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15
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Gavett BE, John SE, Gurnani AS, Bussell CA, Saurman JL. The Role of Alzheimer's and Cerebrovascular Pathology in Mediating the Effects of Age, Race, and Apolipoprotein E Genotype on Dementia Severity in Pathologically-Confirmed Alzheimer's Disease. J Alzheimers Dis 2016; 49:531-45. [PMID: 26444761 DOI: 10.3233/jad-150252] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Dementia severity can be modeled as the construct δ, representing the "cognitive correlates of functional status." OBJECTIVE We recently validated a model for estimating δ in the National Alzheimer's Coordinating Center's Uniform Data Set; however, the association of δ with neuropathology remains untested. METHODS We used data from 727 decedents evaluated at Alzheimer's Disease (AD) Centers nationwide. Participants spoke English, had no genetic abnormalities, and were pathologically diagnosed with AD as a primary or contributing etiology. Clinical data from participants' last visit prior to death were used to estimate dementia severity (δ). RESULTS A structural equation model using age, education, race, and apolipoprotein E (APOE) genotype (number of ɛ2 and ɛ4 alleles) as predictors and latent AD pathology and cerebrovascular disease (CVD) pathology as mediators fit the data well (RMSEA = 0.031; CFI = 0.957). AD pathology mediated the effects of age and APOE genotype on dementia severity. An older age at death and more ɛ2 alleles were associated with less AD pathology and, in turn, with less severe dementia. In contrast, more ɛ4 alleles were associated with more pathology and more severe dementia. Although age and race contributed to differences in CVD pathology, CVD pathology was not related to dementia severity in this sample of decedents with pathologically-confirmed AD. CONCLUSIONS Using δ as an estimate of dementia severity fits well within a structural model in which AD pathology directly affects dementia severity and mediates the relationship between age and APOE genotype on dementia severity.
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16
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Koppara A, Wolfsgruber S, Kleineidam L, Schmidtke K, Frölich L, Kurz A, Schulz S, Hampel H, Heuser I, Peters O, Reischies FM, Jahn H, Luckhaus C, Hüll M, Gertz HJ, Schröder J, Pantel J, Rienhoff O, Rüther E, Henn F, Wiltfang J, Maier W, Jessen F, Kornhuber J, Wagner M. The Latent Dementia Phenotype δ is Associated with Cerebrospinal Fluid Biomarkers of Alzheimer's Disease and Predicts Conversion to Dementia in Subjects with Mild Cognitive Impairment. J Alzheimers Dis 2016; 49:547-60. [PMID: 26484902 DOI: 10.3233/jad-150257] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The recently proposed latent variable δ is a new tool for dementia case finding. It is built in a structural equation modeling framework of cognitive and functional data and constitutes a novel endophenotype for Alzheimer's disease (AD) research and clinical trials. OBJECTIVE To investigate the association of δ with AD biomarkers and to compare the prediction of δ with established scales for conversion to dementia in patients with mild cognitive impairment (MCI). METHODS Using data from a multicenter memory clinic study, we examined the external associations of the latent variable δ and compared δ with well-established cognitive and functional scales and cognitive-functional composite scores. For that purpose, logistic regressions with cerebrospinal fluid (CSF) biomarkers and conversion to dementia as dependent variables were performed with the investigated scores. The models were tested for significant differences. RESULTS In patients with MCI, δ based on a broad range of cognitive scales (including the ADAS-cog, the MMSE, and the CERAD neuropsychological battery) predicted an abnormal CSF Aβ42/tau ratio indicative of AD (n = 340, AUC = 0.78, p < 0.001), and predicted incident dementia within 1-3 years of follow-up (n = 525, AUC = 0.84, p < 0.001). These associations were generally stronger than for any other scale or cognitive-functional composite examined. Homologs of δ based on reduced test batteries yielded somewhat lower effects. CONCLUSION These findings support the interpretation of δ as a construct capturing the disease-related "essence" of cognitive and functional impairments in patients with MCI and dementia, and suggest that δ might become an analytical tool for dementia research.
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Affiliation(s)
- Alexander Koppara
- Department of Psychiatry, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Steffen Wolfsgruber
- Department of Psychiatry, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Luca Kleineidam
- Department of Psychiatry, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Klaus Schmidtke
- Center for Geriatric Medicine, Ortenau Klinikum, Offenburg-Gengenbach, Germany
| | - Lutz Frölich
- Department of Gerontopsychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - Alexander Kurz
- Department of Psychiatry, Technical University of Munich, Germany
| | | | - Harald Hampel
- Department of Neurology, Université Pierre et Marie Curie (Sorbonne), and AXA Research Fund & UPMC Chair, Paris, France
| | - Isabella Heuser
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Friedel M Reischies
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Holger Jahn
- Department of Psychiatry, University of Hamburg, Germany
| | | | - Michael Hüll
- Center for Psychiatry, Clinic for Geronto- and Neuropsychiatry Emmendingen and Dep. of Psychiatry, University of Freiburg, Germany
| | | | - Johannes Schröder
- Section for Geriatric Psychiatry/Institute of Gerontology, University of Heidelberg, Germany
| | - Johannes Pantel
- Institute of General Medicine University of Frankfurt, Frankfurt am Main, Germany
| | - Otto Rienhoff
- Department of Medical Informatics, University of Göttingen, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Germany
| | - Fritz Henn
- Ichan School of Medicine at Mt. Sinai, New York, USA
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University of Göttingen, Germany
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Frank Jessen
- Department of Psychiatry, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany.,Department of Psychiatry, Medical Faculty University of Cologne, Germany
| | - Johannes Kornhuber
- Department of Psychiatry, Friedrich-Alexander-University Erlangen, Germany
| | - Michael Wagner
- Department of Psychiatry, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
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Abstract
The presence of general intelligence poses a major evolutionary puzzle, which has led to increased interest in its presence in nonhuman animals. The aim of this review is to critically evaluate this question and to explore the implications for current theories about the evolution of cognition. We first review domain-general and domain-specific accounts of human cognition in order to situate attempts to identify general intelligence in nonhuman animals. Recent studies are consistent with the presence of general intelligence in mammals (rodents and primates). However, the interpretation of a psychometric g factor as general intelligence needs to be validated, in particular in primates, and we propose a range of such tests. We then evaluate the implications of general intelligence in nonhuman animals for current theories about its evolution and find support for the cultural intelligence approach, which stresses the critical importance of social inputs during the ontogenetic construction of survival-relevant skills. The presence of general intelligence in nonhumans implies that modular abilities can arise in two ways, primarily through automatic development with fixed content and secondarily through learning and automatization with more variable content. The currently best-supported model, for humans and nonhuman vertebrates alike, thus construes the mind as a mix of skills based on primary and secondary modules. The relative importance of these two components is expected to vary widely among species, and we formulate tests to quantify their strength.
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18
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Roh HW, Hong CH, Lee S, Lee Y, Lee KS, Chang KJ, Oh BH, Choi SH, Kim SY, Back JH, Chung YK, Lim KY, Noh JS, Son SJ. Frontal Lobe Function and Risk of Hip Fracture in Patient With Alzheimer Disease: An Analysis of Linked Data. Medicine (Baltimore) 2015; 94:e1918. [PMID: 26559259 PMCID: PMC4912253 DOI: 10.1097/md.0000000000001918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To determine the association between frontal lobe function and risk of hip fracture in patients with Alzheimer disease (AD).Retrospective cohort study using multicenter hospital-based dementia registry and national health insurance claim data was done. Participants who had available data of neuropsychological test, national health insurance claim, and other covariates were included. A total of 1660 patients with AD were included based on Stroop Test results. A total of 1563 patients with AD were included based on the Controlled Oral Word Association Test (COWAT) results. Hip fracture was measured by validated identification criteria using national health insurance claim data. Frontal lobe function was measured by Stroop Test and COWAT at baseline.After adjusting for potential covariates, including cognitive function in other domains (language, verbal and nonverbal memory, and attention), the Cox proportional hazard regression analysis revealed that risk of a hip fracture was decreased with a hazard ratio (HR) of 0.98 per one point of increase in the Stroop Test (adjusted HR = 0.98, 95% confidence interval [CI]: 0.97-1.00) and 0.93 per one point increase in COWAT (adjusted HR = 0.93, 95% CI: 0.88-0.99).The risk of hip fracture in AD patients was associated with baseline frontal lobe function. The result of this research presents evidence of association between frontal lobe function and risk of hip fracture in patients with AD.
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Affiliation(s)
- Hyun Woong Roh
- From the Department of Psychiatry, Ajou University School of Medicine, Suwon (HWR, CHH, KJC, YKC, KYL, JSN, SJS); Health Administration, Department of Management & Administration, Backseok Arts University, Seoul (SJL); Department of Preventive Medicine and Public Health, Ajou University School of Medicine (YL); Institute on Aging, Ajou University Medical Center, Suwon (HWR, CHH, YL, KJC, SJS); Department of Psychiatry, CHA University College of Medicine, Gangnam Medical Center and CHAUM Life Center (KSL); Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul (BHO); Department of Neurology, Inha University School of Medicine, Incheon (SHC); Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul (SYK); and Health Insurance Police Research Institute, National Health Insurance Service, Seoul, Republic of Korea (JHB)
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Doherty TA, Barker LA, Denniss R, Jalil A, Beer MD. The cooking task: making a meal of executive functions. Front Behav Neurosci 2015; 9:22. [PMID: 25717294 PMCID: PMC4324235 DOI: 10.3389/fnbeh.2015.00022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 01/20/2015] [Indexed: 11/17/2022] Open
Abstract
Current standardized neuropsychological tests may fail to accurately capture real-world executive deficits. We developed a computer-based Cooking Task (CT) assessment of executive functions and trialed the measure with a normative group before use with a head-injured population. Forty-six participants completed the computerized CT and subtests from standardized neuropsychological tasks, including the Tower and Sorting Tests of executive function from the Delis-Kaplan Executive Function System (D-KEFS) and the Cambridge prospective memory test (CAMPROMPT), in order to examine whether standardized executive function tasks, predicted performance on measurement indices from the CT. Findings showed that verbal comprehension, rule detection and prospective memory contributed to measures of prospective planning accuracy and strategy implementation of the CT. Results also showed that functions necessary for cooking efficacy differ as an effect of task demands (difficulty levels). Performance on rule detection, strategy implementation and flexible thinking executive function measures contributed to accuracy on the CT. These findings raise questions about the functions captured by present standardized tasks particularly at varying levels of difficulty and during dual-task performance. Our preliminary findings also indicate that CT measures can effectively distinguish between executive function and Full Scale IQ abilities. Results of the present study indicate that the CT shows promise as an ecologically valid measure of executive function for future use with a head-injured population and indexes selective executive function’s captured by standardized tests.
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Affiliation(s)
- T A Doherty
- Brain Behaviour and Cognition Group, Department of Psychology, Sociology and Politics, Sheffield Hallam University Sheffield, UK
| | - L A Barker
- Brain Behaviour and Cognition Group, Department of Psychology, Sociology and Politics, Sheffield Hallam University Sheffield, UK
| | - R Denniss
- Brain Behaviour and Cognition Group, Department of Psychology, Sociology and Politics, Sheffield Hallam University Sheffield, UK
| | - A Jalil
- Communication and Computing Research Centre (CCRC), Sheffield Hallam University Sheffield, UK
| | - M D Beer
- Communication and Computing Research Centre (CCRC), Sheffield Hallam University Sheffield, UK
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