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Welhaf MS, Wilks H, Aschenbrenner AJ, Balota DA, Schindler SE, Benzinger TLS, Gordon BA, Cruchaga C, Xiong C, Morris JC, Hassenstab J. Naturalistic assessment of reaction time variability in older adults at risk for Alzheimer's disease. J Int Neuropsychol Soc 2024; 30:428-438. [PMID: 38282413 PMCID: PMC11078617 DOI: 10.1017/s1355617723011475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Maintaining attention underlies many aspects of cognition and becomes compromised early in neurodegenerative diseases like Alzheimer's disease (AD). The consistency of maintaining attention can be measured with reaction time (RT) variability. Previous work has focused on measuring such fluctuations during in-clinic testing, but recent developments in remote, smartphone-based cognitive assessments can allow one to test if these fluctuations in attention are evident in naturalistic settings and if they are sensitive to traditional clinical and cognitive markers of AD. METHOD Three hundred and seventy older adults (aged 75.8 +/- 5.8 years) completed a week of remote daily testing on the Ambulatory Research in Cognition (ARC) smartphone platform and also completed clinical, genetic, and conventional in-clinic cognitive assessments. RT variability was assessed in a brief (20-40 seconds) processing speed task using two different measures of variability, the Coefficient of Variation (CoV) and the Root Mean Squared Successive Difference (RMSSD) of RTs on correct trials. RESULTS Symptomatic participants showed greater variability compared to cognitively normal participants. When restricted to cognitively normal participants, APOE ε4 carriers exhibited greater variability than noncarriers. Both CoV and RMSSD showed significant, and similar, correlations with several in-clinic cognitive composites. Finally, both RT variability measures significantly mediated the relationship between APOE ε4 status and several in-clinic cognition composites. CONCLUSIONS Attentional fluctuations over 20-40 seconds assessed in daily life, are sensitive to clinical status and genetic risk for AD. RT variability appears to be an important predictor of cognitive deficits during the preclinical disease stage.
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Affiliation(s)
- Matthew S Welhaf
- Department of Psychological & Brain Sciences, Washington University in St. Louis. St. Louis, MO, USA
| | - Hannah Wilks
- Department of Psychological & Brain Sciences, Washington University in St. Louis. St. Louis, MO, USA
| | - Andrew J Aschenbrenner
- Department of Neurology. Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - David A Balota
- Department of Psychological & Brain Sciences, Washington University in St. Louis. St. Louis, MO, USA
| | - Suzanne E Schindler
- Department of Neurology. Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian A Gordon
- Department of Psychological & Brain Sciences, Washington University in St. Louis. St. Louis, MO, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Department of Neurology. Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jason Hassenstab
- Department of Psychological & Brain Sciences, Washington University in St. Louis. St. Louis, MO, USA
- Department of Neurology. Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
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Kim J, Keye SA, Pascual-Abreu M, Khan NA. Effects of an acute bout of cycling on different domains of cognitive function. PROGRESS IN BRAIN RESEARCH 2024; 283:21-66. [PMID: 38538189 DOI: 10.1016/bs.pbr.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
The literature suggesting acute exercise benefits cognitive function has been largely confined to single cognitive domains and measures of reliant on measures of central tendencies. Furthermore, studies suggest cognitive intra-individual variability (IIV) to reflect cognitive efficiency and provide unique insights into cognitive function, but there is limited knowledge on the effects of acute exercise on IIV. To this end, this study examined the effects of acute exercise on three different cognitive domains, executive function, implicit learning, and hippocampal-dependent memory function using behavioral performance and event-related potentials (ERPs). Furthermore, this study also sought to explore the effects of an acute bout of exercise on IIV using the RIDE algorithm to separate signals into individuals components based on latency variability. Healthy adult participants (N=20; 26.3±4.8years) completed a randomized cross-over trial with seated rest or 30min of high intensity cycling. Before and after each condition, participants completed a cognitive battery consisting of the Eriksen Flanker task, implicit statistical learning task, and a spatial reconstruction task. While exercise did not affect Flanker or spatial reconstruction performance, there were exercise related decreases in accuracy (F=5.47; P=0.040), slowed reaction time (F=5.18; P=0.036), and decreased late parietal positivity (F=4.26; P=0.046). However, upon adjusting for performance and ERP variability, there were exercise related decreases in Flanker reaction time (F=24.00; P<0.001), and reduced N2 amplitudes (F=13.03; P=0.002), and slower P3 latencies (F=3.57; P=0.065) for incongruent trials. These findings suggest that acute exercise may impact cognitive IIV as an adaptation to maintain function following exercise.
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Affiliation(s)
- Jeongwoon Kim
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Shelby A Keye
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Melannie Pascual-Abreu
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | - Naiman A Khan
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana, IL, United States; Division of Nutritional Sciences, University of Illinois Urbana-Champaign, Urbana, IL, United States; Neuroscience Program, University of Illinois Urbana-Champaign, Urbana, IL, United States; Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, United States.
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Caballero HS, McFall GP, Gee M, MacDonald S, Phillips NA, Fogarty J, Montero-Odasso M, Camicioli R, Dixon RA. Cognitive Speed in Neurodegenerative Disease: Comparing Mean Rate and Inconsistency Within and Across the Alzheimer's and Lewy Body Spectra in the COMPASS-ND Study. J Alzheimers Dis 2024; 100:579-601. [PMID: 38875040 DOI: 10.3233/jad-240210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
Background Alzheimer's disease (AD) and Lewy body disease (LBD) are characterized by early and gradual worsening perturbations in speeded cognitive responses. Objective Using simple and choice reaction time tasks, we compared two indicators of cognitive speed within and across the AD and LBD spectra: mean rate (average reaction time across trials) and inconsistency (within person variability). Methods The AD spectrum cohorts included subjective cognitive impairment (SCI, n = 28), mild cognitive impairment (MCI, n = 121), and AD (n = 45) participants. The LBD spectrum included Parkinson's disease (PD, n = 32), mild cognitive impairment in PD (PD-MCI, n = 21), and LBD (n = 18) participants. A cognitively unimpaired (CU, n = 39) cohort served as common benchmark. We conducted multivariate analyses of variance and discrimination analyses. Results Within the AD spectrum, the AD cohort was slower and more inconsistent than the CU, SCI, and MCI cohorts. The MCI cohort was slower than the CU cohort. Within the LBD spectrum, the LBD cohort was slower and more inconsistent than the CU, PD, and PD-MCI cohorts. The PD-MCI cohort was slower than the CU and PD cohorts. In cross-spectra (corresponding cohort) comparisons, the LBD cohort was slower and more inconsistent than the AD cohort. The PD-MCI cohort was slower than the MCI cohort. Discrimination analyses clarified the group difference patterns. Conclusions For both speed tasks, mean rate and inconsistency demonstrated similar sensitivity to spectra-related comparisons. Both dementia cohorts were slower and more inconsistent than each of their respective non-dementia cohorts.
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Affiliation(s)
- H Sebastian Caballero
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
| | - G Peggy McFall
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
| | - Myrlene Gee
- Department of Medicine (Neurology), University of Alberta, Edmonton, AB, Canada
| | - Stuart MacDonald
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | | | | | | | - Richard Camicioli
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
- Department of Medicine (Neurology), University of Alberta, Edmonton, AB, Canada
| | - Roger A Dixon
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
- Department of Psychology, University of Alberta, Edmonton, AB, Canada
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Vance DE, Collette C, Frank JS, Billings R, Deaver J, Del Bene VA, Fazeli PL, Bail JR, Li W, Triebel K, Von Ah D, Wang HL. Cognitive intra-individual variability in breast cancer survivors: A systematic review. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-15. [PMID: 37878814 DOI: 10.1080/23279095.2023.2270097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Subjective and objective cognitive impairments in Breast Cancer Survivors (BCS) often do not correlate. One important contribution to the reported disparities may be the reliance on mean-based cognitive performance. Cognitive intra-individual variability (IIV) may provide important insights into these reported disparities. Cognitive IIV refers to the fluctuation in performance for an individual on either one cognitive task across a trial or dispersed across tasks within a neuropsychological test battery. The purpose of this systematic review was to search for and examine the literature on cognitive IIV in BCS. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach was used to search for all articles related to cognitive IIV in BCS. MEDLINE (via PubMed), Embase, and Scopus databases were searched using detailed search terms and strategies. Initially, 164 articles were retrieved but only 4 articles met the criteria for this systematic review. BCS differed from healthy controls in similar ways across the four studies, generally demonstrating similar performance but showing increased cognitive IIV for the more difficult tasks. Differences were enhanced later during chemotherapy. The four studies provide support for cognitive IIV as a useful measure to detect the subtle objective cognitive change often reported by BCS but frequently not detected by standard normed-based cognitive testing. Unexpectedly, measures of cognitive IIV were not consistently associated with self-reported measures of cognition.
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Affiliation(s)
- David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christopher Collette
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Rebecca Billings
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jill Deaver
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Victor A Del Bene
- UAB Libraries, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pariya L Fazeli
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jennifer R Bail
- College of Nursing, The University of Alabama in Huntsville, Huntsville, AL, USA
| | - Wei Li
- Department of Clinical and Diagnostic Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Diane Von Ah
- College of Nursing, Ohio State University, Columbus, OH, USA
| | - Hsiao-Lan Wang
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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Fituri S, Shi Z. Association between Dietary Patterns and Cognitive Function among Qatari Adults: A Cross-Sectional Analysis of the Qatar Biobank Study. Nutrients 2023; 15:4053. [PMID: 37764836 PMCID: PMC10537779 DOI: 10.3390/nu15184053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/11/2023] [Accepted: 09/16/2023] [Indexed: 09/29/2023] Open
Abstract
This study aimed to assess the association between dietary patterns and cognitive function among Qatari adults. In a cross-sectional analysis, data on 1000 Qatari adults attending the Qatar Biobank Study (QBB) aged ≥18 years were obtained. Using factor analysis, dietary patterns were constructed based on habitual dietary intake assessed by food frequency questionnaires (FFQs). The mean reaction time (MRT) derived from self-administered touch screen tests was used as an indicator of cognitive function. The association between dietary patterns and MRT was investigated using linear regression. The mean age of the participants was 35.8 (SD 10.3) years, and the mean MRT was 715.3 (SD 204.1) milliseconds. Three dietary patterns were identified. The "traditional" dietary pattern, characterized by high intakes of white rice, mixed dishes and soups/starters possibly high in saturated fat and sodium, was positively associated with MRT. In the multivariable model, comparing the highest to lowest quartiles of the traditional pattern, the regression coefficient for MRT was 50.0 (95% CI 16.9, 83.1; p for trend 0.001). There was an effect modification of diabetes and age on the association between the "modern" dietary pattern and MRT. The "convenient" dietary pattern was not associated with cognition. In conclusion, the traditional rice-based dietary pattern may be associated with poor cognitive function.
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Affiliation(s)
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar;
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Cheetham NJ, Penfold R, Giunchiglia V, Bowyer V, Sudre CH, Canas LS, Deng J, Murray B, Kerfoot E, Antonelli M, Rjoob K, Molteni E, Österdahl MF, Harvey NR, Trender WR, Malim MH, Doores KJ, Hellyer PJ, Modat M, Hammers A, Ourselin S, Duncan EL, Hampshire A, Steves CJ. The effects of COVID-19 on cognitive performance in a community-based cohort: a COVID symptom study biobank prospective cohort study. EClinicalMedicine 2023; 62:102086. [PMID: 37654669 PMCID: PMC10466229 DOI: 10.1016/j.eclinm.2023.102086] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 09/02/2023] Open
Abstract
Background Cognitive impairment has been reported after many types of infection, including SARS-CoV-2. Whether deficits following SARS-CoV-2 improve over time is unclear. Studies to date have focused on hospitalised individuals with up to a year follow-up. The presence, magnitude, persistence and correlations of effects in community-based cases remain relatively unexplored. Methods Cognitive performance (working memory, attention, reasoning, motor control) was assessed in a prospective cohort study of participants from the United Kingdom COVID Symptom Study Biobank between July 12, 2021 and August 27, 2021 (Round 1), and between April 28, 2022 and June 21, 2022 (Round 2). Participants, recruited from the COVID Symptom Study smartphone app, comprised individuals with and without SARS-CoV-2 infection and varying symptom duration. Effects of COVID-19 exposures on cognitive accuracy and reaction time scores were estimated using multivariable ordinary least squares linear regression models weighted for inverse probability of participation, adjusting for potential confounders and mediators. The role of ongoing symptoms after COVID-19 infection was examined stratifying for self-perceived recovery. Longitudinal analysis assessed change in cognitive performance between rounds. Findings 3335 individuals completed Round 1, of whom 1768 also completed Round 2. At Round 1, individuals with previous positive SARS-CoV-2 tests had lower cognitive accuracy (N = 1737, β = -0.14 standard deviations, SDs, 95% confidence intervals, CI: -0.21, -0.07) than negative controls. Deficits were largest for positive individuals with ≥12 weeks of symptoms (N = 495, β = -0.22 SDs, 95% CI: -0.35, -0.09). Effects were comparable to hospital presentation during illness (N = 281, β = -0.31 SDs, 95% CI: -0.44, -0.18), and 10 years age difference (60-70 years vs. 50-60 years, β = -0.21 SDs, 95% CI: -0.30, -0.13) in the whole study population. Stratification by self-reported recovery revealed that deficits were only detectable in SARS-CoV-2 positive individuals who did not feel recovered from COVID-19, whereas individuals who reported full recovery showed no deficits. Longitudinal analysis showed no evidence of cognitive change over time, suggesting that cognitive deficits for affected individuals persisted at almost 2 years since initial infection. Interpretation Cognitive deficits following SARS-CoV-2 infection were detectable nearly two years post infection, and largest for individuals with longer symptom durations, ongoing symptoms, and/or more severe infection. However, no such deficits were detected in individuals who reported full recovery from COVID-19. Further work is needed to monitor and develop understanding of recovery mechanisms for those with ongoing symptoms. Funding Chronic Disease Research Foundation, Wellcome Trust, National Institute for Health and Care Research, Medical Research Council, British Heart Foundation, Alzheimer's Society, European Union, COVID-19 Driver Relief Fund, French National Research Agency.
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Affiliation(s)
- Nathan J. Cheetham
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Rose Penfold
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Edinburgh Delirium Research Group, Ageing and Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Vicky Bowyer
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Carole H. Sudre
- MRC Unit for Lifelong Health and Ageing, Department of Population Health Sciences, University College London, London, United Kingdom
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Liane S. Canas
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Jie Deng
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Benjamin Murray
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Eric Kerfoot
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Michela Antonelli
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Khaled Rjoob
- MRC Unit for Lifelong Health and Ageing, Department of Population Health Sciences, University College London, London, United Kingdom
| | - Erika Molteni
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Marc F. Österdahl
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Nicholas R. Harvey
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | | | - Michael H. Malim
- Department of Infectious Diseases, King's College London, London, United Kingdom
| | - Katie J. Doores
- Department of Infectious Diseases, King's College London, London, United Kingdom
| | - Peter J. Hellyer
- Centre for Neuroimaging Sciences, King's College London, London, United Kingdom
| | - Marc Modat
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Alexander Hammers
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
- King's College London & Guy's and St Thomas' PET Centre, King's College London, London, United Kingdom
| | - Sebastien Ourselin
- School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom
| | - Emma L. Duncan
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Guy's & St Thomas's NHS Foundation Trust, London, United Kingdom
| | - Adam Hampshire
- Department of Brain Sciences, Imperial College London, United Kingdom
| | - Claire J. Steves
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
- Guy's & St Thomas's NHS Foundation Trust, London, United Kingdom
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Geer JH, Jeon S, O'Connell M, Linsky S, Conley S, Hollenbeak CS, Jacoby D, Yaggi HK, Redeker NS. Correlates of cognition among people with chronic heart failure and insomnia. Sleep Breath 2023; 27:1287-1296. [PMID: 36214945 PMCID: PMC10084469 DOI: 10.1007/s11325-022-02716-w] [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: 03/14/2022] [Revised: 08/09/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE This study aimed to describe cognitive characteristics and their associations with demographic and clinical factors among adults with chronic heart failure (HF) and insomnia. METHODS We performed a cross-sectional analysis of baseline data from the HeartSleep Study (NCT#02,660,385), a randomized controlled trial designed to evaluate the effects of cognitive-behavioral therapy for insomnia. Demographic characteristics and health history were obtained. We measured sleep characteristics with the Insomnia Severity Index, the PROMIS Sleep Disturbance Questionnaire, and wrist actigraphy. Sleepiness, stress, and quality of life were measured with validated questionnaires. Measures of cognition included frequency of lapses on the psychomotor vigilance test and the PROMIS cognitive abilities scale where ≥ 3 lapses and a score of ≤ 50, respectively, suggested impairment. These variables were combined into a composite score for multivariable analyses. RESULTS Of a sample that included 187 participants (58% male; mean age 63.1 [SD = 12.7]), 77% had New York Heart Association class I or II HF and 66% had HF with preserved ejection fraction. Common comorbidities were diabetes (35%), hypertension (64%), and sleep apnea (54%). Impaired vigilant attention was associated with non-White race, higher body mass index, less education, and more medical comorbidities. Self-reported cognitive impairment was associated with younger age, higher body mass index, and pulmonary disease. On adjusted analysis, significant risk factors for cognitive impairment included hypertension (OR 1.94), daytime sleepiness (OR 1.09), stress (OR 1.08), and quality of life (OR 0.12). CONCLUSIONS Impaired cognition is common among people with chronic HF and insomnia and associated with hypertension, daytime sleepiness, stress, and poor quality of life. TRIAL REGISTRATION ClinicalTrials.gov Identifier: Insomnia Self-management in Heart Failure; NCT#02,660,385.
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Affiliation(s)
- Jacqueline H Geer
- Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Sangchoon Jeon
- Yale School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
| | - Meghan O'Connell
- Schools of Nursing and Medicine, University of Connecticut, 231 Glenbrook Road, Unit 4026, Storrs Mansfield, CT, 06269, USA
| | - Sarah Linsky
- Yale School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA
| | | | | | - Daniel Jacoby
- Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - H Klar Yaggi
- Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Nancy S Redeker
- Yale School of Nursing, 400 West Campus Drive, Orange, CT, 06477, USA.
- Schools of Nursing and Medicine, University of Connecticut, 231 Glenbrook Road, Unit 4026, Storrs Mansfield, CT, 06269, USA.
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Nguyen TM, Leow AD, Ajilore O. A Review on Smartphone Keystroke Dynamics as a Digital Biomarker for Understanding Neurocognitive Functioning. Brain Sci 2023; 13:959. [PMID: 37371437 DOI: 10.3390/brainsci13060959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/07/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Can digital technologies provide a passive unobtrusive means to observe and study cognition outside of the laboratory? Previously, cognitive assessments and monitoring were conducted in a laboratory or clinical setting, allowing for a cross-sectional glimpse of cognitive states. In the last decade, researchers have been utilizing technological advances and devices to explore ways of assessing cognition in the real world. We propose that the virtual keyboard of smartphones, an increasingly ubiquitous digital device, can provide the ideal conduit for passive data collection to study cognition. Passive data collection occurs without the active engagement of a participant and allows for near-continuous, objective data collection. Most importantly, this data collection can occur in the real world, capturing authentic datapoints. This method of data collection and its analyses provide a more comprehensive and potentially more suitable insight into cognitive states, as intra-individual cognitive fluctuations over time have shown to be an early manifestation of cognitive decline. We review different ways passive data, centered around keystroke dynamics, collected from smartphones, have been used to assess and evaluate cognition. We also discuss gaps in the literature where future directions of utilizing passive data can continue to provide inferences into cognition and elaborate on the importance of digital data privacy and consent.
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Affiliation(s)
- Theresa M Nguyen
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Alex D Leow
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA
- Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, IL 60607, USA
- Department of Computer Science, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Olusola Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA
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9
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Schellenberg S, Straumann D, Green DA, Schuetz P, Zehnder Y, Swanenburg J. Earth-vertical motion perception assessment using an elevator: a feasibility study. Sci Rep 2023; 13:9450. [PMID: 37296287 PMCID: PMC10256722 DOI: 10.1038/s41598-023-36655-7] [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: 05/23/2022] [Accepted: 06/07/2023] [Indexed: 06/12/2023] Open
Abstract
A feasible, inexpensive, rapid, and easy-to-use method to measure vestibular vertical movement perception is needed to assess the sacculus-mediated low-frequency otolith function of dizzy patients. To evaluate the feasibility of reaction time assessment in response to vertical motion induced by an elevator in healthy young individuals. We recorded linear acceleration/deceleration reaction times (LA-RT/LD-RT) of 20 healthy (13 female) subjects (mean age: 22 years ± 1 SD) as a measure of vertical vestibular motion perception. LA-RT/LD-RT were defined as the time elapsed from the start of elevator acceleration or deceleration to the time at which subjects in a sitting position indicated perceiving a change in velocity by pushing a button with their thumb. The light reaction time was measured as a reference. All 20 subjects tolerated the assessment with repeated elevator rides and reported no adverse events. Over all experiments, one upward and four downward rides had to be excluded for technical reasons (2.5%). The fraction of premature button presses varied among the four conditions, possibly related to elevator vibration (upward rides: LA-RT-up 66%, LD-RT-up 0%; downward rides: LA-RT-down 12%, LD-RT-down 4%). Thus LD-RT-up yielded the most robust results. The reaction time to earth-vertical deceleration elicited by an elevator provides a consistent indicator of linear vestibular motion perception in healthy humans. The testing procedure is inexpensive and easy to use. Deceleration on upward rides yielded the most robust measurements.
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Affiliation(s)
- Simona Schellenberg
- Physiotherapy and Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland
| | - Dominik Straumann
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
- Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland
| | - David Andrew Green
- Space Medicine Team, HRE-OM, European Astronaut Centre, European Space Agency, Cologne, Germany
- KBRwyle Laboratories GmbH, Cologne, Germany
- Centre of Human & Applied Physiological Sciences, King's College London, London, UK
| | - Philipp Schuetz
- Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
| | - Yves Zehnder
- Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
| | - Jaap Swanenburg
- Physiotherapy and Occupational Therapy Research Center, Directorate of Research and Education, University Hospital Zurich, Zurich, Switzerland.
- Institute of Anatomy, Faculty of Medicine, University of Zurich, Winterthurerstrasse 190, 8057, Zurich, Switzerland.
- Air Force Center, Air Base Dübendorf, UZH Space Hub, Zurich, Switzerland.
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10
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Cho H, Pilloni G, Tahsin R, Best P, Krupp L, Oh C, Charvet L. Moving intra-individual variability (IIV) towards clinical utility: IIV measured using a commercial testing platform. J Neurol Sci 2023; 446:120586. [PMID: 36812823 DOI: 10.1016/j.jns.2023.120586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/29/2022] [Accepted: 02/09/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVES Intra-individual variability (IIV), measured across repeated response times (RT) during continuous psychomotor tasks, is an early marker of cognitive change in the context of neurodegeneration. To advance IIV towards broader application in clinical research, we evaluated IIV from a commercial cognitive testing platform and compared it to the calculation approaches used in experimental cognitive studies. METHODS Cognitive assessment was administered in participants with multiple sclerosis (MS) during the baseline of an unrelated study. Cogstate was used for computer-based measures providing three timed-trial tasks measuring simple (Detection; DET) and choice (Identification; IDN) RT and working memory (One-Back; ONB). IIV for each task was automatically output by the program (calculated as a log10-transformed standard deviation or "LSD"). We calculated IIV from the raw RTs using coefficient of variation (CoV), regression-based, and ex-Gaussian methods. The IIV from each calculation was then compared by rank across participants. RESULTS A total of n = 120 participants with MS aged 20-72 (Mean ± SD, 48.99 ± 12.09) completed the baseline cognitive measures. For each task, the interclass correlation coefficient was generated. Each ICC showed that LSD, CoV, ex-Gaussian, and regression methods clustered strongly (Average ICC for DET: 0.95 with 95% CI [0.93, 0.96]; Average ICC for IDN: 0.92 with 95% CI [0.88 to 0.93]; Average ICC for ONB: 0.93 with 95% CI [0.90 to 0.94]). Correlational analyses indicated the strongest correlation between LSD and CoV for all tasks (rs ≥ 0.94). CONCLUSION The LSD was consistent with research-based methods for IIV calculations. These findings support the use of LSD for the future measurement of IIV for clinical studies.
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Affiliation(s)
- Hyein Cho
- NYU Grossman School of Medicine, Department of Neurology, USA
| | - Giuseppina Pilloni
- NYU Grossman School of Medicine, Department of Neurology, USA; NYU Grossman School of Medicine, Parekh Center for Interdisciplinary Neurology, USA
| | - Raisa Tahsin
- NYU Grossman School of Medicine, Department of Neurology, USA
| | - Pamela Best
- NYU Grossman School of Medicine, Department of Neurology, USA
| | - Lauren Krupp
- NYU Grossman School of Medicine, Department of Neurology, USA; NYU Grossman School of Medicine, Parekh Center for Interdisciplinary Neurology, USA
| | - Cheongeun Oh
- NYU Grossman School of Medicine, Department of Population Health and Environmental Medicine, USA
| | - Leigh Charvet
- NYU Grossman School of Medicine, Department of Neurology, USA; NYU Grossman School of Medicine, Parekh Center for Interdisciplinary Neurology, USA.
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11
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Jin H, Junghaenel DU, Orriens B, Lee PJ, Schneider S. Developing Early Markers of Cognitive Decline and Dementia Derived From Survey Response Behaviors: Protocol for Analyses of Preexisting Large-scale Longitudinal Data. JMIR Res Protoc 2023; 12:e44627. [PMID: 36809337 PMCID: PMC9993229 DOI: 10.2196/44627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/10/2023] [Accepted: 01/24/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Accumulating evidence shows that subtle alterations in daily functioning are among the earliest and strongest signals that predict cognitive decline and dementia. A survey is a small slice of everyday functioning; nevertheless, completing a survey is a complex and cognitively demanding task that requires attention, working memory, executive functioning, and short- and long-term memory. Examining older people's survey response behaviors, which focus on how respondents complete surveys irrespective of the content being sought by the questions, may represent a valuable but often neglected resource that can be leveraged to develop behavior-based early markers of cognitive decline and dementia that are cost-effective, unobtrusive, and scalable for use in large population samples. OBJECTIVE This paper describes the protocol of a multiyear research project funded by the US National Institute on Aging to develop early markers of cognitive decline and dementia derived from survey response behaviors at older ages. METHODS Two types of indices summarizing different aspects of older adults' survey response behaviors are created. Indices of subtle reporting mistakes are derived from questionnaire answer patterns in a number of population-based longitudinal aging studies. In parallel, para-data indices are generated from computer use behaviors recorded on the backend server of a large web-based panel study known as the Understanding America Study (UAS). In-depth examinations of the properties of the created questionnaire answer pattern and para-data indices will be conducted for the purpose of evaluating their concurrent validity, sensitivity to change, and predictive validity. We will synthesize the indices using individual participant data meta-analysis and conduct feature selection to identify the optimal combination of indices for predicting cognitive decline and dementia. RESULTS As of October 2022, we have identified 15 longitudinal ageing studies as eligible data sources for creating questionnaire answer pattern indices and obtained para-data from 15 UAS surveys that were fielded from mid-2014 to 2015. A total of 20 questionnaire answer pattern indices and 20 para-data indices have also been identified. We have conducted a preliminary investigation to test the utility of the questionnaire answer patterns and para-data indices for the prediction of cognitive decline and dementia. These early results are based on only a subset of indices but are suggestive of the findings that we anticipate will emerge from the planned analyses of multiple behavioral indices derived from many diverse studies. CONCLUSIONS Survey response behaviors are a relatively inexpensive data source, but they are seldom used directly for epidemiological research on cognitive impairment at older ages. This study is anticipated to develop an innovative yet unconventional approach that may complement existing approaches aimed at the early detection of cognitive decline and dementia. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44627.
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Affiliation(s)
- Haomiao Jin
- School of Health Sciences, University of Surrey, Guildford, United Kingdom.,Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Doerte U Junghaenel
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States.,Center for Self-Report Sciences, University of Southern California, Los Angeles, CA, United States.,Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Bart Orriens
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Pey-Jiuan Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Stefan Schneider
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States.,Center for Self-Report Sciences, University of Southern California, Los Angeles, CA, United States.,Department of Psychology, University of Southern California, Los Angeles, CA, United States
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12
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DesRuisseaux LA, Suchy Y, Franchow EI. Intra-individual variability identifies individuals vulnerable to contextually induced executive lapses. Clin Neuropsychol 2023; 37:322-349. [PMID: 35392764 DOI: 10.1080/13854046.2022.2055651] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Contextual stressors, such as engagement in burdensome emotion regulation known as expressive suppression (ES), can result in transient but clinically meaningful decrement in performance on measures of executive functioning (EF). The goal of the present investigation was to examine whether intra-individual variability (IIV-I), which has been identified as an indicator of cognitive weakness, could serve as a marker of vulnerability to EF decrements due to both naturally-occurring and experimentally-manipulated ES. In Study 1, 180 cognitively healthy older adults completed the Push-Turn-Taptap (PTT) task to assess IIV-I, four Delis-Kaplan Executive Function System (D-KEFS) subtests to assess EF, and the Burden of State Emotion Regulation Questionnaire (B-SERQ) to assess naturally-occurring ES. In Study 2, a subset (n = 81) of participants underwent experimental manipulation to induce ES, followed by second administration of the D-KEFS to examine ES-induced decrements in EF. In Study 1, hierarchical linear regression yielded a significant interaction between ES and IIV-I as predictors of EF performance, demonstrating that high ES was associated with low EF only among individuals with high IIV-I. In Study 2, repeated measures ANOVA demonstrated an interaction between time (pre- vs. post- manipulation), group (ES vs. control), and IIV-I (high vs. low), such that only individuals who exhibited high IIV-I were negatively impacted by the ES manipulation. IIV-I moderates the association between ES and EF, such that only individuals with high IIV-I exhibit vulnerability to the impact of ES. Thus, IIV-I may act as a marker of vulnerability to temporary EF depletion.
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Affiliation(s)
| | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Emilie I Franchow
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.,Advocate Aurora Healthcare, Milwaukee, WI, USA
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13
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Relationship between Reaction Times and Post-COVID-19 Symptoms Assessed by a Web-Based Visual Detection Task. Healthcare (Basel) 2023; 11:healthcare11030284. [PMID: 36766859 PMCID: PMC9914750 DOI: 10.3390/healthcare11030284] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
Long-COVID is a clinical condition in which patients affected by SARS-CoV-2 usually report a wide range of physical and cognitive symptoms from 3 to 6 months after the infection recovery. The aim of the current study was to assess the link between self-reported long-COVID symptoms and reaction times (RTs) in a self-administered Visual Detection Task (VDT) in order to identify the predictor symptoms of the slowing in reaction times to determine attention impairment. In total, 362 participants (age (mean ± S.D.: 38.56 ± 13.14); sex (female-male: 73.76-26.24%)) responded to a web-based self-report questionnaire consisting of four sections: demographics, disease-related characteristics, and medical history questions. The final section consisted of a 23 item 5-point Likert-scale questionnaire related to long-term COVID-19 symptoms. After completing the questionnaire, subjects performed a VDT on a tablet screen to assess reaction times (RTs). An exploratory factorial analysis (EFA) was performed on the 23 long-COVID symptom questions, identifying 4 factors (cognition, behavior, physical condition, presence of anosmia and/or ageusia). The most important predictors of RTs were cognition and physical factors. By dissecting the cognitive and physical factors, learning, visual impairment, and headache were the top predictors of subjects' performance in the VDT. Long-COVID subjects showed higher RTs in the VDT after a considerable time post-disease, suggesting the presence of an attention deficit disorder. Attention impairment due to COVID-19 can be due to the presence of headaches, visual impairments, and the presence of cognitive problems related to the difficulty in learning new activities. The link between the slowing of reaction times and physical and cognitive symptoms post-COVID-19 suggests that attention deficit disorder is caused by a complex interaction between physical and cognitive symptoms. In addition, the study provides evidence that RTs in a VDT represent a reliable measure to detect the presence of long-COVID neurological sequelae.
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14
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Mascarenhas Fonseca L, Sage Chaytor N, Olufadi Y, Buchwald D, Galvin JE, Schmitter-Edgecombe M, Suchy-Dicey A. Intraindividual Cognitive Variability and Magnetic Resonance Imaging in Aging American Indians: Data from the Strong Heart Study. J Alzheimers Dis 2023; 91:1395-1407. [PMID: 36641671 PMCID: PMC9974814 DOI: 10.3233/jad-220825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND American Indians have high prevalence of risk factors for Alzheimer's disease and related dementias (ADRD) compared to the general population, yet dementia onset and frequency in this population are understudied. Intraindividual cognitive variability (IICV), a measure of variability in neuropsychological test performance within a person at a single timepoint, may be a novel, noninvasive biomarker of neurodegeneration and early dementia. OBJECTIVE To characterize the cross-sectional associations between IICV and hippocampal, total brain volume, and white matter disease measured by magnetic resonance imaging (MRI) among older American Indians. METHODS IICV measures for memory, executive function, and processing speed, and multidomain cognition were calculated for 746 American Indians (aged 64-95) who underwent MRI. Regression models were used to examine the associations of IICV score with hippocampal volume, total brain volume, and graded white matter disease, adjusting for age, sex, education, body mass index, intracranial volume, diabetes, stroke, hypertension, hypercholesterolemia, alcohol use, and smoking. RESULTS Higher memory IICV measure was associated with lower hippocampal volume (Beta = -0.076; 95% CI -0.499, -0.023; p = 0.031). After adjustment for Bonferroni or IICV mean scores in the same tests, the associations were no longer significant. No IICV measures were associated with white matter disease or total brain volume. CONCLUSION These findings suggest that the IICV measures used in this research cannot be robustly associated with cross-sectional neuroimaging features; nonetheless, the results encourage future studies investigating the associations between IICV and other brain regions, as well as its utility in the prediction of neurodegeneration and dementia in American Indians.
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Affiliation(s)
- Luciana Mascarenhas Fonseca
- Elson S Floyd College of Medicine, Washington State University, United States
- Programa Terceira Idade (PROTER, Old Age Research Group), Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Naomi Sage Chaytor
- Elson S Floyd College of Medicine, Washington State University, United States
| | - Yunusa Olufadi
- Elson S Floyd College of Medicine, Washington State University, United States
| | - Dedra Buchwald
- Elson S Floyd College of Medicine, Washington State University, United States
- Institute for Research and Education to Advance Community Health, Washington State University, United States
| | - James E. Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, United States
| | | | - Astrid Suchy-Dicey
- Elson S Floyd College of Medicine, Washington State University, United States
- Institute for Research and Education to Advance Community Health, Washington State University, United States
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15
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Wang P, Fang Y, Qi JY, Li HJ. FISHERMAN: A Serious Game for Executive Function Assessment of Older Adults. Assessment 2022:10731911221105648. [PMID: 35762827 DOI: 10.1177/10731911221105648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Executive functions (EFs) are essential for daily living activities but decline with age. Convenient assessment and timely intervention have particular significance for older adults. However, the traditional laboratory tasks of EFs are typically monotonous and inconvenient. The current study aimed to develop an interesting and convenient supplementary tool to assess EFs for older adults. According to the theory of EFs, we developed a serious game, FISHERMAN, to assess EFs. The game includes three subgames, Cautious Fisherman, Agile Fisherman, and Wise Fisherman, targeting core components of inhibition, shifting, and working memory, respectively. The current study aims to verify the reliability and validity of the game. One hundred and eight healthy older adults participated in this study and were tested through the FISHERMAN game and a battery of cognitive tests. The results show that the FISHERMAN game has high internal consistency reliability and good construct validity as well as criterion-related validity, suggesting that the game design is valid and can be used in EFs assessment for older adults. Future studies are warranted to establish the norm of the FISHERMAN game in older adults and investigate whether the FISHERMAN game can be generalized to other populations.
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Affiliation(s)
- Ping Wang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuan Fang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jing-Yi Qi
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Hui-Jie Li
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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16
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Weizenbaum EL, Fulford D, Torous J, Pinsky E, Kolachalama VB, Cronin-Golomb A. Smartphone-Based Neuropsychological Assessment in Parkinson's Disease: Feasibility, Validity, and Contextually Driven Variability in Cognition. J Int Neuropsychol Soc 2022; 28:401-413. [PMID: 33998438 PMCID: PMC10474573 DOI: 10.1017/s1355617721000503] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES The prevalence of neurodegenerative disorders demands methods of accessible assessment that reliably captures cognition in daily life contexts. We investigated the feasibility of smartphone cognitive assessment in people with Parkinson's disease (PD), who may have cognitive impairment in addition to motor-related problems that limit attending in-person clinics. We examined how daily-life factors predicted smartphone cognitive performance and examined the convergent validity of smartphone assessment with traditional neuropsychological tests. METHODS Twenty-seven nondemented individuals with mild-moderate PD attended one in-lab session and responded to smartphone notifications over 10 days. The smartphone app queried participants 5x/day about their location, mood, alertness, exercise, and medication state and administered mobile games of working memory and executive function. RESULTS Response rate to prompts was high, demonstrating feasibility of the approach. Between-subject reliability was high on both cognitive games. Within-subject variability was higher for working memory than executive function. Strong convergent validity was seen between traditional tests and smartphone working memory but not executive function, reflecting the latter's ceiling effects. Participants performed better on mobile working memory tasks when at home and after recent exercise. Less self-reported daytime sleepiness and lower PD symptom burden predicted a stronger association between later time of day and higher smartphone test performance. CONCLUSIONS These findings support feasibility and validity of repeat smartphone assessments of cognition and provide preliminary evidence of the effects of context on cognitive variability in PD. Further development of this accessible assessment method could increase sensitivity and specificity regarding daily cognitive dysfunction for PD and other clinical populations.
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Affiliation(s)
- Emma L. Weizenbaum
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Daniel Fulford
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
- Department of Occupational Therapy and Rehabilitation Sciences, Boston University, Boston, MA, USA
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Emma Pinsky
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
- Department of Psychology, Bryn Mawr College, Bryn Mawr, PA, USA
| | - Vijaya B. Kolachalama
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
- Department of Computer Science, and Faculty of Computing and Data Sciences, Boston University Alzheimer’s Disease Center; Boston University, Boston, MA, USA
| | - Alice Cronin-Golomb
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
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17
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Inoue T, Nagata K, Tateoka K, Seol J, Yoon J, Tsuji T, Okura T. [Relationship between performance on the Digital Trail Making Peg test and cognitive function in older adults]. Nihon Ronen Igakkai Zasshi 2022; 59:331-338. [PMID: 36070907 DOI: 10.3143/geriatrics.59.331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AIM To determine the relationship between performance on the Digital Trail Making Peg test (DTMP) and cognitive function in older adults. METHODS A total of 203 community-dwelling older adults (mean age: 76.4±5.1 years old) participated in this study. The five-cog test was used to assess the cognitive function. The DTMP measured completion time, number of errors and intra-individual variability for performance variability (coefficient of variation, CV; inter-elemental variability, IEV). Spearman's rank correlation coefficient (ρ) was calculated to examine the association between each variable. In addition, a multiple regression analysis was performed with the cognitive function score as the dependent variable and the DTMP completion time, number of errors, CV, and IEV as the independent variables, with adjusting for the sex, age, years of education, body mass index, medical history, depression, and physical function. RESULTS The rank correlation coefficients with cognitive function scores were as follows: completion time, ρ = -0.479 (P < 0.01), number of errors, ρ = -0.068 (P = 0.332), CV, ρ = 0.085 (P = 0.225), IEV, ρ = -0.316 (P < 0.01). The results of the multiple regression analysis showed that completion time (β = -0.566), CV (β = 0.164), IEV (β = 2.736) were significantly associated with cognitive function scores. CONCLUSIONS The shorter the DTMP completion time, the better the overall cognitive function. However, the intra-individual variability of CV and IEV did not show consistent results, with smaller values indicating less intra-individual variability.
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Affiliation(s)
- Taiki Inoue
- Department of Physical Therapy, Faculty of Health Sciences, Mejiro University
- Doctoral Program in Human Care Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Koki Nagata
- Doctoral Program in Public Health, Degree Programs in Comprehensive Human Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Korin Tateoka
- Doctoral Program in Health and Sports Sciences, Degree Programs in Comprehensive Human Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba
| | - Jaehoon Seol
- Faculty of Health and Sport Science, University of Tsukuba
- Japan Society for the Promotion of Science
- International Institute for Integrative Sleep Medicine, University of Tsukuba
| | - Jieun Yoon
- Open Innovation Laboratory for Food and Medicinal Resource Engineering
- R& D Center for Tailor-Made QOL, University of Tsukuba
| | - Taishi Tsuji
- Faculty of Health and Sport Science, University of Tsukuba
| | - Tomohiro Okura
- Faculty of Health and Sport Science, University of Tsukuba
- International Institute for Integrative Sleep Medicine, University of Tsukuba
- R& D Center for Tailor-Made QOL, University of Tsukuba
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18
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Heggy A, Masoumi A, Al-Yafei M, Al-Bader F, Al-Abdi T, Shi Z. Habitual Tea and Coffee Consumption and Mean Reaction Time Among Qatari Adults. J Alzheimers Dis 2021; 84:767-776. [PMID: 34602487 DOI: 10.3233/jad-215130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Tea and coffee consumption is associated with cognitive function in some studies. OBJECTIVE We aimed to identify tea and coffee drinking patterns and their association with mean reaction time among Qatari adults. METHOD The study included 1,000 adults aged 20 years and above attending the Qatar Biobank Study (QBB). Habitual tea and coffee consumption during the previous year was assessed by questionnaire. Tea and coffee drinking patterns were identified using factor analysis. In a computer-based self-administered touch screens test, mean reaction time (MRT) was used as an indicator of cognitive function. RESULTS The mean age of the participants was 35.8 (SD 10.3) years. Herbal tea and regular coffee consumption was inversely associated with MRT. In the multivariable model, compared with non-consumers, the regression coefficients for MRT were -34.3 (-65.4, -3.3) and -37.9 (-71.0, -4.7) for daily consumers of herbal tea and regular coffee, respectively. Of the two tea and coffee drinking patterns identified, pattern 1 (high consumption of tea, Arabic coffee, and herbal tea) was not associated with MRT but pattern 2 (high loadings of instant coffee, regular coffee, and Karak) was inversely associated with MRT in the unadjusted model. There was a significant interaction between pattern 2 and low-density lipoprotein (LDL) in relation to MRT. Pattern 2 was inversely associated with MRT among those with a low LDL. CONCLUSION There was an inverse association between regular coffee and herbal tea consumption with mean reaction time. There was an interaction between Western coffee pattern and LDL.
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Affiliation(s)
- Alaa Heggy
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Aisha Masoumi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Maryam Al-Yafei
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Fatima Al-Bader
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Tamara Al-Abdi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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19
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Lee JH, Lee TL, Kang N. Transcranial direct current stimulation decreased cognition-related reaction time in older adults: A systematic review and meta-analysis. Ageing Res Rev 2021; 70:101377. [PMID: 34089900 DOI: 10.1016/j.arr.2021.101377] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/18/2021] [Accepted: 05/31/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND This systematic review and meta-analysis investigated the effects of transcranial direct current stimulation (tDCS) on the cognitive functions of healthy older adults by focusing on the changes in reaction time during cognitive tasks. METHOD A total of 31 studies qualified for this meta-analysis, and we acquired 36 comparisons from the included studies for data synthesis. The individual effect sizes were calculated by comparing the altered reaction time during the performance of a specific cognitive task between the active tDCS and sham groups. In two moderator variable analyses, we examined the potentially different effects of the tDCS protocols on the cognition-related reaction time based on the tDCS protocol used (i.e., online vs. offline tDCS) and the five cognitive domains: (a) perceptual-motor function, (b) learning and memory, (c) executive function / complex attention, (d) language, and (e) social cognition. Meta-regression analyses were conducted to estimate the relationship between demographic and tDCS parameter characteristics and the changes in reaction time. RESULTS The random-effects model meta-analysis revealed significant small effects of tDCS on cognition-related reaction time. Specifically, providing online tDCS significantly reduced the reaction time, and these patterns were observed during learning and memory and executive function / complex attention tasks. However, applying offline tDCS failed to find any significant reduction of reaction time across various cognitive tasks. The meta-regression analysis revealed that the effects of tDCS on the reaction time during the performance of cognitive tasks increased for the older people. CONCLUSIONS These findings suggest that providing online tDCS may effectively improve the ageing-induced reaction time related to specific cognitive functions of elderly people.
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20
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Chow R, Rabi R, Paracha S, Vasquez BP, Hasher L, Alain C, Anderson ND. Reaction time intra-individual variability reveals inhibitory deficits in single- and multiple-domain amnestic mild cognitive impairment. J Gerontol B Psychol Sci Soc Sci 2021; 77:71-83. [PMID: 33770153 DOI: 10.1093/geronb/gbab051] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Amnestic mild cognitive impairment (aMCI), a prodromal stage of Alzheimer's disease and other dementias, is characterized by episodic memory impairment. Recent evidence has shown inhibitory control deficits in aMCI, but the extent of these deficits across inhibitory domains (i.e., response inhibition and interference control) and aMCI subtypes (i.e., single- versus multiple-domain) remains unclear. Few studies have included response time intra-individual variability (RT IIV) in these efforts. The aim of this study was to compare response inhibition and interference control between aMCI subtypes using measures of accuracy, mean RT, and RT IIV. METHOD We report data from 34 individuals with single-domain aMCI (sdaMCI, 66-86 years), 20 individuals with multiple-domain aMCI (mdaMCI, 68-88 years), and 52 healthy controls (64-88 years) who completed tasks of response inhibition (Go-NoGo) and interference control (Flanker). Group differences in accuracy, mean RT, and RT IIV were examined for both tasks. RESULTS Individuals with mdaMCI had higher RT IIV than the other groups on both tasks. In RT IIV, we observed an interference control deficit in mdaMCI and sdaMCI relative to healthy controls, a finding not observed through accuracy or mean RT. DISCUSSION RT IIV may detect subtle differences in inhibition deficits between aMCI subtypes that may not be evident with conventional behavioral measures. Findings support the supplementary use of RT IIV when assessing early executive function deficits.
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Affiliation(s)
- Ricky Chow
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
| | - Rahel Rabi
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
| | - Shahier Paracha
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada
| | - Brandon P Vasquez
- Neuropsychology & Cognitive Health, Baycrest Centre, Toronto, Ontario, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Ontario, Canada
| | - Lynn Hasher
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Ontario, Canada
| | - Claude Alain
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Ontario, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest Centre, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Ontario, Canada
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Moore RC, Paolillo EW, Sundermann EE, Campbell LM, Delgadillo J, Heaton A, Swendsen J, Depp CA. Validation of the mobile verbal learning test: Illustration of its use for age and disease-related cognitive deficits. Int J Methods Psychiatr Res 2021; 30:e1859. [PMID: 33159488 PMCID: PMC7992286 DOI: 10.1002/mpr.1859] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/30/2020] [Accepted: 10/06/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE We developed a mobile cognitive test of verbal learning and memory, the mobile verbal learning test (mVLT), to allow for brief, repeated and portable delivery of a 12-item list learning test through a smartphone. This study examined the psychometric properties of the mVLT among older persons with and without human immunodeficiency virus (HIV). METHODS Sixty-eight persons with HIV and 36 HIV-negative individuals (aged 50-74) completed three trials of the mVLT on a smartphone once daily for 14 days. A different word list was administered each day. RESULTS Participants completed 80% of the 14 mVLT administrations, equating to 1166 valid and complete mVLTs. Neither adherence nor mean mVLT total score (number correct in 3 recall trials) differed by HIV status. No practice effects from repeated mVLT administration were observed, and there were moderately strong correlations of mVLT performance with performance on the in-lab version of the task and with traditional cognitive assessments of cognitive processes contributing to memory. We found evidence of within-person learning across mVLT trials, with persons with HIV demonstrating less learning from trials 1 to 3 compared to HIV-negative participants. CONCLUSIONS The mVLT is a valid method to assess learning in the real world in older adults with and without HIV.
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Affiliation(s)
- Raeanne C Moore
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Emily W Paolillo
- Department of Psychiatry, University of California San Diego, San Diego, California, USA.,SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Erin E Sundermann
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Laura M Campbell
- Department of Psychiatry, University of California San Diego, San Diego, California, USA.,SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Jeremy Delgadillo
- Advancing Diversity in Aging Research (ADAR) Program, San Diego State University, San Diego, California, USA
| | - Anne Heaton
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Joel Swendsen
- National Center for Scientific Research, University of Bordeaux, EPHE PSL Research University, Bordeaux, France
| | - Colin A Depp
- Department of Psychiatry, University of California San Diego, San Diego, California, USA.,VA San Diego Healthcare System, San Diego, California, USA
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22
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Williams DR, Mulder J, Rouder JN, Rast P. Beneath the surface: Unearthing within-person variability and mean relations with Bayesian mixed models. Psychol Methods 2021; 26:74-89. [PMID: 32437184 PMCID: PMC8572133 DOI: 10.1037/met0000270] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mixed-effects models are becoming common in psychological science. Although they have many desirable features, there is still untapped potential. It is customary to view homogeneous variance as an assumption to satisfy. We argue to move beyond that perspective, and to view modeling within-person variance as an opportunity to gain a richer understanding of psychological processes. The technique to do so is based on the mixed-effects location scale model that can simultaneously estimate mixed-effects submodels to both the mean (location) and within-person variance (scale). We develop a framework that goes beyond assessing the submodels in isolation of one another and introduce a novel Bayesian hypothesis test for mean-variance correlations in the distribution of random effects. We first present a motivating example, which makes clear how the model can characterize mean-variance relations. We then apply the method to reaction times (RTs) gathered from 2 cognitive inhibition tasks. We find there are more individual differences in the within-person variance than the mean structure, as well as a complex web of structural mean-variance relations. This stands in contrast to the dominant view of within-person variance (i.e., "noise"). The results also point toward paradoxical within-person, as opposed to between-person, effects: several people had slower and less variable incongruent responses. This contradicts the typical pattern, wherein larger means tend to be associated with more variability. We conclude with future directions, spanning from methodological to theoretical inquires, that can be answered with the presented methodology. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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23
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Evaluation of the Reaction Time and Accuracy Rate in Normal Subjects, MCI, and Dementia Using Serious Games. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11020628] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The main purpose of this research is to evaluate the differences in the reaction time and accuracy rate of three categories of subjects using our serious games. Thirty-seven subjects were divided into three groups: normal (n1 = 16), MCI (Mild Cognitive Impairment) (n2 = 10), and dementia—moderate-to-severe (n3 = 11) groups based on the MMSE (Mini Mental State Examination). Two serious games were designed: (1) whack-a-mole and (2) hit-the-ball. Two dependent variables, reaction time and accuracy rate, were statistically analyzed to compare elders’ performances in the games among the three groups for three levels of speed: slow, medium, and fast. There were significance differences between the normal group, the MCI group, and the moderate-to-severe dementia group in both the reaction-time and accuracy-rate analyses. We determined that the reaction times of the MCI and dementia groups were shorter compared to those of the normal group, with poorer results also observed in accuracy rate. Therefore, we conclude that our serious games have the feasibility to evaluate reaction performance and could be used in the daily lives of elders followed by clinical treatment in the future.
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24
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Medina LD, Woo E, Rodriguez-Agudelo Y, Chaparro Maldonado H, Yi D, Coppola G, Zhou Y, Chui HC, Ringman JM. Reaction time and response inhibition in autosomal dominant Alzheimer's disease. Brain Cogn 2020; 147:105656. [PMID: 33310624 DOI: 10.1016/j.bandc.2020.105656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 10/22/2020] [Accepted: 11/15/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Subtle deficits in several cognitive domains characterize the neuropsychological profile of preclinical Alzheimer's disease (AD). Assessment of preclinical individuals with genes causing autosomal dominant AD (ADAD) provides a model for prodromal disease. We sought to sensitively evaluate attention and working memory using a computerized battery in non-demented persons carrying ADAD mutations. METHOD A total of 71 non-demented Latinos at-risk for ADAD mutations were recruited [40 mutation carriers (MCs), 31 non-mutation carriers (NCs)] and completed a Spanish language chronometric battery of speeded decision and working memory tasks. RESULTS On two complex reaction time (RT) tasks involving decision-making and response inhibition, MCs exhibited slower RTs than NCs as they approached their anticipated age of dementia diagnosis. Education moderated these effects, but only in younger MCs. APOE ε4 status was not associated with age-related slowing among NCs or MCs on any of the tests. CONCLUSIONS Our findings indicate MCs respond more slowly as they approach the age of dementia onset on tasks with greater demands on executive function. Our results also suggest these effects were not explained by APOE ε4 status independently of ADAD mutation status. Computerized reaction time tests can provide sensitive measures of the earliest cognitive changes in AD.
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Affiliation(s)
- Luis D Medina
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Ellen Woo
- Department of Psychology, California State University Fresno, Fresno, CA, United States; Department of Psychiatry, University of California San Francisco, San Francisco, CA, United States
| | | | | | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, South Korea
| | - Giovanni Coppola
- UCLA Department of Neurology, Los Angeles, CA, United States; Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
| | - Yan Zhou
- Mary S. Easton Center for Alzheimer's Disease Research at UCLA, Los Angeles, CA, United States; UCLA Department of Neurology, Los Angeles, CA, United States
| | - Helena C Chui
- Department of Neurology, Keck School of Medicine of USC, Los Angeles, CA, United States
| | - John M Ringman
- Department of Neurology, Keck School of Medicine of USC, Los Angeles, CA, United States.
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25
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Holtzer R, Ross D, Izzetoglu M. Intraindividual variability in neural activity in the prefrontal cortex during active walking in older adults. Psychol Aging 2020; 35:1201-1214. [PMID: 33180518 DOI: 10.1037/pag0000583] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Intraindividual variability in gait and cognitive performance is distinct from central-tendency measures and associated with clinical outcomes in aging. Knowledge concerning intraindividual variability in neural activity, however, has been relatively scarce, and no research to date has reported on such variability during active walking. The current study addressed this major gap in knowledge. Participants were community-residing older adults (n = 394; mean age = 76.29 ± 6.65 years; %female = 55). Functional near-infrared spectroscopy (fNIRS) was used to measure oxygenated hemoglobin (HbO2) in the prefrontal cortex under three experimental conditions: single-task-walk, single-task-alpha (cognitive task), and dual-task-walk, which required the participants to perform the two single tasks simultaneously. Intraindividual variability in neural activity was operationalized using the standard deviation of fNIRS-derived HbO2 observations assessed during a 30-s interval in each experimental condition. The increase in intraindividual variability in neural activity in the dual-task-walk condition compared to both single-task conditions was associated with the presence of cognitive impairments and being a male. Furthermore, measures of intraindividual variability in neural activity and gait performance were positively correlated only under the dual-task-walk condition. Intraindividual variability in the neural activity of gait may be a novel marker for age-related impairments in mobility and cognitive function. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Roee Holtzer
- Ferkauf Graduate School of Psychology, Yeshiva University
| | - Daliah Ross
- Ferkauf Graduate School of Psychology, Yeshiva University
| | - Meltem Izzetoglu
- Department of Electrical and Computer Engineering, Villanova University
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26
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Bočková M, Lamoš M, Klimeš P, Jurák P, Halámek J, Goldemundová S, Baláž M, Rektor I. Suboptimal response to STN-DBS in Parkinson’s disease can be identified via reaction times in a motor cognitive paradigm. J Neural Transm (Vienna) 2020; 127:1579-1588. [DOI: 10.1007/s00702-020-02254-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/14/2020] [Indexed: 12/17/2022]
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27
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Lu K, Nicholas JM, James S, Lane CA, Parker TD, Keshavan A, Keuss SE, Buchanan SM, Murray‐Smith H, Cash DM, Sudre CH, Malone IB, Coath W, Wong A, Henley SM, Fox NC, Richards M, Schott JM, Crutch SJ. Increased variability in reaction time is associated with amyloid beta pathology at age 70. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12076. [PMID: 32789161 PMCID: PMC7416668 DOI: 10.1002/dad2.12076] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/07/2020] [Indexed: 12/25/2022]
Abstract
INTRODUCTION We investigated whether life-course factors and neuroimaging biomarkers of Alzheimer's disease pathology predict reaction time (RT) performance in older adults. METHODS Insight 46 study participants, all born in the same week in 1946 (n = 501; ages at assessment = 69 to 71 years), completed a 2-choice RT task and amyloid beta (Aβ) positron emission tomography and MR imaging. We tested for associations between task outcomes (RT; error rate; intra-individual variability in RT) and life-course predictors including childhood cognitive ability and education. In a subsample of 406 cognitively normal participants, we investigated associations between task outcomes and biomarkers including Aβ-positivity. RESULTS Cognitively normal Aβ-positive participants had 10% more variable RTs than Aβ-negative participants, despite having similar mean RTs. Childhood cognitive ability and education independently predicted task performance. DISCUSSION This study provides novel evidence that Aβ pathology is associated with poorer consistency of RT in cognitively normal older adults, at an age when dementia prevalence is still very low.
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Affiliation(s)
- Kirsty Lu
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Jennifer M. Nicholas
- Department of Medical StatisticsLondon School of Hygiene and Tropical MedicineLondonUK
| | - Sarah‐Naomi James
- MRC Unit for Lifelong Health and Ageing at UCLUniversity College LondonLondonUK
| | - Christopher A. Lane
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Thomas D. Parker
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Ashvini Keshavan
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Sarah E. Keuss
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Sarah M. Buchanan
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Heidi Murray‐Smith
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - David M. Cash
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Carole H. Sudre
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
- School of Biomedical Engineering and Imaging SciencesKing's College LondonLondonUK
- Department of Medical PhysicsUniversity College LondonLondonUK
| | - Ian B. Malone
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - William Coath
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCLUniversity College LondonLondonUK
| | - Susie M.D. Henley
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Nick C. Fox
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
- UK Dementia Research Institute at University College LondonLondonUK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCLUniversity College LondonLondonUK
| | - Jonathan M. Schott
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
| | - Sebastian J. Crutch
- Dementia Research CentreUCL Queen Square Institute of Neurology, University College LondonLondonUK
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Weizenbaum E, Torous J, Fulford D. Cognition in Context: Understanding the Everyday Predictors of Cognitive Performance in a New Era of Measurement. JMIR Mhealth Uhealth 2020; 8:e14328. [PMID: 32706680 PMCID: PMC7413292 DOI: 10.2196/14328] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 03/02/2020] [Accepted: 03/26/2020] [Indexed: 01/07/2023] Open
Abstract
Background Research suggests that variability in attention and working memory scores, as seen across time points, may be a sensitive indicator of impairment compared with a singular score at one point in time. Given that fluctuation in cognitive performance is a meaningful metric of real-world function and trajectory, it is valuable to understand the internal state-based and environmental factors that could be driving these fluctuations in performance. Objective In this viewpoint, we argue for the use of repeated mobile assessment as a way to better understand how context shapes moment-to-moment cognitive performance. To elucidate potential factors that give rise to intraindividual variability, we highlight existing literature that has linked both internal and external modifying variables to a number of cognitive domains. We identify ways in which these variables could be measured using mobile assessment to capture them in ecologically meaningful settings (ie, in daily life). Finally, we describe a number of studies that have already begun to use mobile assessment to measure changes in real time cognitive performance in people’s daily environments and the ways in which this burgeoning methodology may continue to advance the field. Methods This paper describes selected literature on contextual factors that examined how experimentally induced or self-reported contextual variables (ie, affect, motivation, time of day, environmental noise, physical activity, and social activity) related to tests of cognitive performance. We also selected papers that used mobile assessment of cognition; these papers were chosen for their use of high-frequency time-series measurement of cognition using a mobile device. Results Upon review of the relevant literature, it is evident that contextual factors have the potential to meaningfully impact cognitive performance when measured in laboratory and daily life environments. Although this research has shed light on the question of what gives rise to real-life variability in cognitive function (eg, affect and activity), many of the studies were limited by traditional methods of data collection (eg, involving retrospective recall). Furthermore, cognition has often been measured in one domain or in one age group, which does not allow us to extrapolate results to other cognitive domains and across the life span. On the basis of the literature reviewed, mobile assessment of cognition shows high levels of feasibility and validity and could be a useful method for capturing individual cognitive variability in real-world contexts via passive and active measures. Conclusions We propose that, through the use of mobile assessment, there is an opportunity to combine multiple sources of contextual and cognitive data. These data have the potential to provide individualized digital signatures that could improve diagnostic precision and lead to meaningful clinical outcomes in a wide range of psychiatric and neurological disorders.
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Affiliation(s)
- Emma Weizenbaum
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Daniel Fulford
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, United States.,Department of Occupational Therapy and Rehabilitation Sciences, Boston University, Boston, MA, United States
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29
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Serra-Añó P, Pedrero-Sánchez JF, Hurtado-Abellán J, Inglés M, Espí-López GV, López-Pascual J. Mobility assessment in people with Alzheimer disease using smartphone sensors. J Neuroeng Rehabil 2019; 16:103. [PMID: 31412893 PMCID: PMC6694667 DOI: 10.1186/s12984-019-0576-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/08/2019] [Indexed: 01/20/2023] Open
Abstract
Background Understanding the functional status of people with Alzheimer Disease (AD), both in a single (ST) and cognitive dual task (DT) activities is essential for identifying signs of early-stage neurodegeneration. This study aims to compare the performance quality of several tasks using sensors embedded in an Android device, among people at different stages of Alzheimer and people without dementia. The secondary aim is to analyze the effect of cognitive task performance on mobility tasks. Methods This is a cross-sectional study including 22 participants in the control group (CG), 18 in the group with mild AD and 22 in the group with moderate AD. They performed two mobility tests, under ST and DT conditions, which were registered using an Android device. Postural control was measured by medial-lateral and anterior-posterior displacements of the COM (MLDisp and APDisp, respectively) and gait, with the vertical and medial-lateral range of the COM (Vrange and MLrange). Further, the sit-to-stand (PStand) and turning and sit power (PTurnSit), the total time required to complete the test and the reaction time were measured. Results There were no differences between the two AD stages either for ST or DT in any of the variables (p > 0.05). Nevertheless, people at both stages showed significantly lower values of PStand and PTurnSit and larger Total time and Reaction time compared to CG (p < 0.05). Further, Vrange is also lower in CDR1G than in CG (p < 0.05). The DT had a significant deleterious effect on MLDisp in all groups (p < 0.05) and on APDisp only in moderate AD for DT. Conclusions Our findings indicate that AD patients present impairments in some key functional abilities, such as gait, turning and sitting, sit to stand, and reaction time, both in mild and moderate AD. Nevertheless, an exclusively cognitive task only influences the postural control in people with AD.
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Affiliation(s)
- Pilar Serra-Añó
- UBIC, Departament de Fisioteràpia de la Universitat de València, C/ Gascó Oliag, 5, 46010, Valencia, Spain
| | - José Francisco Pedrero-Sánchez
- Instituto de Biomecánica de Valencia, Universidad Politécnica de Valencia, Edificio 9C. Camino de Vera, s/n, 46022, Valencia, Spain
| | - Juan Hurtado-Abellán
- UBIC, Departament de Fisioteràpia de la Universitat de València, C/ Gascó Oliag, 5, 46010, Valencia, Spain
| | - Marta Inglés
- UBIC, Departament de Fisioteràpia de la Universitat de València, C/ Gascó Oliag, 5, 46010, Valencia, Spain
| | - Gemma Victoria Espí-López
- UBIC, Departament de Fisioteràpia de la Universitat de València, C/ Gascó Oliag, 5, 46010, Valencia, Spain
| | - Juan López-Pascual
- Instituto de Biomecánica de Valencia, Universidad Politécnica de Valencia, Edificio 9C. Camino de Vera, s/n, 46022, Valencia, Spain.
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30
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Basoudan N, Torrens-Burton A, Jenkins A, Thornton IM, Hanley C, Tree JJ, Thomas S, Tales A. Sequential Information Processing: The "Elevated First Response Effect" Can Contribute to Exaggerated Intra-Individual Variability in Older Adults. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2019; 92:13-20. [PMID: 30923469 PMCID: PMC6430171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In this study we examined attention-related reaction time (RT) and intra-individual variability (IIV) in younger and older adults using an iPad-based visual search test, in which, for each trial, participants were required to sequentially press a series of on-screen stimuli numbered from 1 to 8. Although overall performance RT was significantly slower, with greater IIV for the older compared to the younger adult group, there was also a disproportionately slowed RT and greater IIV for the first item in the series compared to all other responses within the trial. When the response to the first stimulus was removed from statistical analysis, the significant age-related RT slowing effect remained, but IIV was no longer significantly greater for the older compared to the younger adults. This pattern of results reveals a dichotomy between the preservation of RT and IIV in aging, and one that is strongly related to research methodology. A finding that may account, at least in part, for the outcome heterogeneity in the study of IIV in aging.
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Affiliation(s)
- Nasreen Basoudan
- Department of Psychology, Swansea University, Swansea, Wales, UK
| | | | - Amy Jenkins
- Centre for Innovative Ageing, Swansea University, Swansea, Wales, UK
| | | | - Claire Hanley
- Department of Psychology, Swansea University, Swansea, Wales, UK
| | - Jeremy J. Tree
- Department of Psychology, Swansea University, Swansea, Wales, UK
| | | | - Andrea Tales
- Centre for Innovative Ageing, Swansea University, Swansea, Wales, UK
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