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Shaikh KT, Bolton K, Shaikh U, Troyer AK, Rich JB, Vandermorris S. Evaluating functional abilities within the context of memory assessment: A practice survey of neuropsychologists. Clin Neuropsychol 2024; 38:557-587. [PMID: 37649186 DOI: 10.1080/13854046.2023.2249178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/12/2023] [Indexed: 09/01/2023]
Abstract
Objective: Functioning in daily life is an important consideration when differentiating between individuals with normal cognition, mild neurocognitive disorder, and major neurocognitive disorder. Despite this, there is no gold standard measurement approach for assessing functional abilities and few guidelines on how to do so. The objective of this study was to examine neuropsychologists' practices regarding the assessment of functional abilities across the spectrum of memory ability. Method: A total of 278 psychologists who routinely conduct neuropsychological assessments completed an online survey (estimated 15% response rate) querying their practices and perspectives with respect to the assessment of functional abilities. Results: Respondents identified that changes to several components of daily functioning, including activities of daily living, were important when evaluating functional abilities. Respondents reported utilizing a variety of instruments to assess functioning, with an overwhelming majority indicating the use of semi-structured interviews. Although most respondents are satisfied with existing tools, a quarter of respondents felt strongly that there was a need for more instruments of everyday functioning. Respondents further indicated that their recommendations to patients, particularly regarding compensatory strategies and follow-up with other professionals, were informed by results of their functional assessment. Conclusions: Overall, our survey results indicate that neuropsychologists perceive multiple factors of daily life to be important considerations when evaluating functioning, use a variety of techniques to assess functioning, and perceive a need for more measures of functional abilities.
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Affiliation(s)
- Komal T Shaikh
- Department of Psychology, York University, Toronto, Canada
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Kathryn Bolton
- Department of Psychology, York University, Toronto, Canada
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
- Department of Psychology, Toronto Metropolitan University
| | - Umar Shaikh
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Jill B Rich
- Department of Psychology, York University, Toronto, Canada
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Susan Vandermorris
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
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2
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Sanchez E, Wilkinson T, Coughlan G, Mirza S, Baril A, Ramirez J, Binns MA, Black SE, Borrie M, Dilliott AA, Dixon RA, Dowlatshahi D, Farhan S, Finger E, Fischer CE, Frank A, Freedman M, Goncalves RA, Grimes DA, Hassan A, Hegele RA, Kumar S, Lang AE, Marras C, McLaughlin PM, Orange JB, Pasternak SH, Pollock BG, Rajji TK, Roberts AC, Robinson JF, Rogaeva E, Sahlas DJ, Saposnik G, Strong MJ, Swartz RH, Tang‐Wai DF, Tartaglia MC, Troyer AK, Kvartsberg H, Zetterberg H, Munoz DP, Masellis M. Association of plasma biomarkers with cognition, cognitive decline, and daily function across and within neurodegenerative diseases: Results from the Ontario Neurodegenerative Disease Research Initiative. Alzheimers Dement 2024; 20:1753-1770. [PMID: 38105605 PMCID: PMC10984487 DOI: 10.1002/alz.13560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/02/2023] [Accepted: 10/29/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION We investigated whether novel plasma biomarkers are associated with cognition, cognitive decline, and functional independence in activities of daily living across and within neurodegenerative diseases. METHODS Glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), phosphorylated tau (p-tau)181 and amyloid beta (Aβ)42/40 were measured using ultra-sensitive Simoa immunoassays in 44 healthy controls and 480 participants diagnosed with Alzheimer's disease/mild cognitive impairment (AD/MCI), Parkinson's disease (PD), frontotemporal dementia (FTD) spectrum disorders, or cerebrovascular disease (CVD). RESULTS GFAP, NfL, and/or p-tau181 were elevated among all diseases compared to controls, and were broadly associated with worse baseline cognitive performance, greater cognitive decline, and/or lower functional independence. While GFAP, NfL, and p-tau181 were highly predictive across diseases, p-tau181 was more specific to the AD/MCI cohort. Sparse associations were found in the FTD and CVD cohorts and for Aβ42/40 . DISCUSSION GFAP, NfL, and p-tau181 are valuable predictors of cognition and function across common neurodegenerative diseases, and may be useful in specialized clinics and clinical trials.
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DAmico D, Yusupov I, Zhu L, Lass JW, Plunkett C, Levine B, Troyer AK, Vandermorris S. Feasibility, Acceptability, and Impact of a self-guided e-learning Memory and Brain Health Promotion Program for Healthy Older Adults. Clin Gerontol 2024; 47:4-16. [PMID: 35713408 DOI: 10.1080/07317115.2022.2088325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To examine the feasibility (e.g., completion rate), acceptability (e.g., satisfaction), and participant-reported impact (e.g., memory concerns, behavior change, goal attainment) of a self-guided, e-learning adaptation of a validated, facilitator-guided, in-person memory intervention for older adults. METHODS Participants were 139 healthy older adults (mean age: 73 ± 7, 73% women). Participation tracking and pre/post questionnaires embedded within the e-learning program were used to assess feasibility, acceptability, and impact. RESULTS Sixty-eight percent of participants completed the program. Anonymous feedback data indicated a high level of satisfaction with the program, the pace and clarity of the learning modules, and the user interface. Suggested improvements included offering more interaction with others and addressing minor platform glitches. There was a 41% decrease in the prevalence of concern about memory changes from baseline to posttest. The majority of participants reported an increase in use of memory strategies and uptake of health-promoting lifestyle behaviors. All participants reported moderate-to-high satisfaction with personal goal attainment. CONCLUSIONS The program demonstrated good feasibility, acceptability, and lead to reduction in age-related memory concerns. CLINICAL IMPLICATIONS Self-guided, e-learning programming shows promise for fostering positive adaptation to age-related memory changes and improving the uptake of evidence-based strategies to promote brain health among older adults.
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Affiliation(s)
- Danielle DAmico
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Iris Yusupov
- Department of Psychology, York University, Toronto, Ontario, Canada
- Neuropsychology and Cognitive Health Program, Baycrest, Toronto, Ontario, Canada
| | - Lynn Zhu
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
| | - Jordan W Lass
- Kunin-Lunenfeld Centre for Applied Research and Evaluation (KL-CARE), Baycrest, Toronto, Ontario, Canada
| | - Cindy Plunkett
- Centre for Aging and Brain Health Innovation (CABHI), Baycrest, Toronto, Ontario, Canada
| | - Brian Levine
- Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Susan Vandermorris
- Neuropsychology and Cognitive Health Program, Baycrest, Toronto, Ontario, Canada
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4
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Carvalho de Abreu DC, Pieruccini-Faria F, Sarquis-Adamson Y, Black A, Fraser J, Van Ooteghem K, Cornish B, Grimes D, Jog M, Masellis M, Steeves T, Nanayakkara N, Ramirez J, Scott C, Holmes M, Ozzoude M, Berezuk C, Symons S, Mohammad Hassan Haddad S, Arnott SR, Binns M, Strother S, Beaton D, Sunderland K, Theyers A, Tan B, Zamyadi M, Levine B, Orange JB, Roberts AC, Lou W, Sujanthan S, Breen DP, Marras C, Kwan D, Adamo S, Peltsch A, Troyer AK, Black SE, McLaughlin PM, Lang AE, McIlroy W, Bartha R, Montero-Odasso M. White matter hyperintensity burden predicts cognitive but not motor decline in Parkinson's disease: results from the Ontario Neurodegenerative Diseases Research Initiative. Eur J Neurol 2023; 30:920-933. [PMID: 36692250 DOI: 10.1111/ene.15692] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 12/29/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE The pathophysiology of Parkinson's disease (PD) negatively affects brain network connectivity, and in the presence of brain white matter hyperintensities (WMHs) cognitive and motor impairments seem to be aggravated. However, the role of WMHs in predicting accelerating symptom worsening remains controversial. The objective was to investigate whether location and segmental brain WMH burden at baseline predict cognitive and motor declines in PD after 2 years. METHODS Ninety-eight older adults followed longitudinally from Ontario Neurodegenerative Diseases Research Initiative with PD of 3-8 years in duration were included. Percentages of WMH volumes at baseline were calculated by location (deep and periventricular) and by brain region (frontal, temporal, parietal, occipital lobes and basal ganglia + thalamus). Cognitive and motor changes were assessed from baseline to 2-year follow-up. Specifically, global cognition, attention, executive function, memory, visuospatial abilities and language were assessed as were motor symptoms evaluated using the Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III, spatial-temporal gait variables, Freezing of Gait Questionnaire and Activities Specific Balance Confidence Scale. RESULTS Regression analysis adjusted for potential confounders showed that total and periventricular WMHs at baseline predicted decline in global cognition (p < 0.05). Also, total WMH burden predicted the decline of executive function (p < 0.05). Occipital WMH volumes also predicted decline in global cognition, visuomotor attention and visuospatial memory declines (p < 0.05). WMH volumes at baseline did not predict motor decline. CONCLUSION White matter hyperintensity burden at baseline predicted cognitive but not motor decline in early to mid-stage PD. The motor decline observed after 2 years in these older adults with PD is probably related to the primary neurodegenerative process than comorbid white matter pathology.
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Affiliation(s)
- Daniela Cristina Carvalho de Abreu
- Gait and Brain Lab, Division of Geriatric Medicine, and Lawson Health Research Institute, Parkwood Institute, University of Western Ontario, Ontario, London, Canada
- Department of Physical Therapy, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Frederico Pieruccini-Faria
- Gait and Brain Lab, Division of Geriatric Medicine, and Lawson Health Research Institute, Parkwood Institute, University of Western Ontario, Ontario, London, Canada
- Gait and Brain Laboratory, Lawson Health Research Institute, London, Ontario, Canada
| | | | - Alanna Black
- Gait and Brain Laboratory, Lawson Health Research Institute, London, Ontario, Canada
| | - Julia Fraser
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Karen Van Ooteghem
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Benjamin Cornish
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - David Grimes
- Department of Medicine (Neurology), Ottawa Hospital Research Institute, University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada
| | - Mandar Jog
- Division of Neurology, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Mario Masellis
- Cognitive and Movement Disorders Clinic, Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Thomas Steeves
- Division of Neurology, Department of Medicine, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Nuwan Nanayakkara
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Joel Ramirez
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Christopher Scott
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Melissa Holmes
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Miracle Ozzoude
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Courtney Berezuk
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | - Sean Symons
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | | | - Stephen R Arnott
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Malcolm Binns
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Stephen Strother
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Derek Beaton
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Kelly Sunderland
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Athena Theyers
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Brian Tan
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Mojdeh Zamyadi
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Brian Levine
- Rotman Research Institute at Baycrest Hospital University of Toronto, Toronto, Ontario, Canada
| | - Joseph B Orange
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Canadian Centre for Activity and Aging, Western University, London, Ontario, Canada
| | - Angela C Roberts
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Canadian Centre for Activity and Aging, Western University, London, Ontario, Canada
- Department of Computer Science, Western University, London, Ontario, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sujeevini Sujanthan
- Department of Ophthalmology and Visual Sciences, Research Institute of the McGill University Health Center, Montreal, Quebec, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Connie Marras
- Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Sabrina Adamo
- Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, Ontario, Canada
| | - Alicia Peltsch
- Faculty of Engineering and Applied Science, Queen's University, Kingston, Ontario, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Sandra E Black
- L.C. Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Program, Department of Medicine (Neurology), Sunnybrook Research Institute, Sunnybrook HSC, University of Toronto, Toronto, Ontario, Canada
| | | | - Anthony E Lang
- Division of Neurology, Department of Medicine, Edmond J Safra Program in Parkinson's Disease and Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - William McIlroy
- Neuroscience, Mobility and Balance Laboratory, Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Robert Bartha
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Robarts Research Institute, Western University, London, Canada
| | | | - Manuel Montero-Odasso
- Gait and Brain Lab, Division of Geriatric Medicine, and Lawson Health Research Institute, Parkwood Institute, University of Western Ontario, Ontario, London, Canada
- Gait and Brain Laboratory, Lawson Health Research Institute, London, Ontario, Canada
- Division of Geriatric Medicine, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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5
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Rowe G, Troyer AK, Murphy KJ, Biss R, Hasher L. Implicit processes enhance cognitive abilities in mild cognitive impairment. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2023; 30:172-180. [PMID: 34724878 DOI: 10.1080/13825585.2021.1998320] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Previous work has shown that older adults with typical age-related memory changes (i.e., without cognitive impairment) pick up irrelevant information implicitly, and unknowingly use that information when it becomes relevant to a later task. Here, we address the possibility that implicit processes play a similarly beneficial role in the cognitive abilities of individuals with amnestic mild cognitive impairment (aMCI). Twenty-two individuals with aMCI and 22 matched controls participated in a picture judgment task while instructed to ignore distractions in the form of word/non-word letter strings. Memory for the distracting words was later tested with a word-fragment completion task. Both groups showed a priming effect, that is, they were significantly more likely to solve fragments of previously presented than non-presented words. However, the aMCI group had significantly higher scores than the older adults without cognitive impairment, t(42) = 2.16, p < .05, Cohen's d = 0.67. Our findings suggest that individuals with aMCI can enhance their performance on an explicit cognitive task, in this case, word-fragment completion, if previously exposed to the relevant information implicitly, opening up possible interventions aimed at this population.
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Affiliation(s)
- Gillian Rowe
- Neuropsychology and Cognitive Health, Baycrest Health Sciences, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health, Baycrest Health Sciences, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
| | - Kelly J Murphy
- Neuropsychology and Cognitive Health, Baycrest Health Sciences, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
| | - Renee Biss
- Department of Psychology, University of Windsor, Windsor, Canada
| | - Lynn Hasher
- Rotman Research Institute of Baycrest Centre, Toronto, Canada
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6
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Sunderland KM, Beaton D, Arnott SR, Kleinstiver P, Kwan D, Lawrence-Dewar JM, Ramirez J, Tan B, Bartha R, Black SE, Borrie M, Brien D, Casaubon LK, Coe BC, Cornish B, Dilliott AA, Dowlatshahi D, Finger E, Fischer C, Frank A, Fraser J, Freedman M, Greenberg B, Grimes DA, Hassan A, Hatch W, Hegele RA, Hudson C, Jog M, Kumar S, Lang A, Levine B, Lou W, Mandzia J, Marras C, McIlroy W, Montero-Odasso M, Munoz DG, Munoz DP, Orange JB, Park DS, Pasternak SH, Pieruccini-Faria F, Rajji TK, Roberts AC, Robinson JF, Rogaeva E, Sahlas DJ, Saposnik G, Scott CJM, Seitz D, Shoesmith C, Steeves TDL, Strong MJ, Strother SC, Swartz RH, Symons S, Tang-Wai DF, Tartaglia MC, Troyer AK, Turnbull J, Zinman L, McLaughlin PM, Masellis M, Binns MA, Adamo S, Berezuk C, Black A, Breen DP, Bulman D, Chen Y, El‐Defrawy S, Farhan S, Ghani M, Gonder J, Haddad SMH, Holmes M, Huang J, Leontieva E, Mandelcorn E, Margolin E, Nanayakkara N, Ozzoude M, Peltsch AJ, Pollock B, Raamana P, Rashkovan N, Yanina, Southwell A, Sujanthan S, Tayyari F, Van Ooteghem K, Woulfe J, Zamyadi M, Zou G. Characteristics of the Ontario Neurodegenerative Disease Research Initiative cohort. Alzheimers Dement 2023; 19:226-243. [PMID: 36318754 DOI: 10.1002/alz.12632] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 12/01/2021] [Accepted: 12/17/2021] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Understanding synergies between neurodegenerative and cerebrovascular pathologies that modify dementia presentation represents an important knowledge gap. METHODS This multi-site, longitudinal, observational cohort study recruited participants across prevalent neurodegenerative diseases and cerebrovascular disease and assessed participants comprehensively across modalities. We describe univariate and multivariate baseline features of the cohort and summarize recruitment, data collection, and curation processes. RESULTS We enrolled 520 participants across five neurodegenerative and cerebrovascular diseases. Median age was 69 years, median Montreal Cognitive Assessment score was 25, median independence in activities of daily living was 100% for basic and 93% for instrumental activities. Spousal study partners predominated; participants were often male, White, and more educated. Milder disease stages predominated, yet cohorts reflect clinical presentation. DISCUSSION Data will be shared with the global scientific community. Within-disease and disease-agnostic approaches are expected to identify markers of severity, progression, and therapy targets. Sampling characteristics also provide guidance for future study design.
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Affiliation(s)
- Kelly M Sunderland
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Derek Beaton
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Stephen R Arnott
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Peter Kleinstiver
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | | | - Joel Ramirez
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Robert Bartha
- Robarts Research Institute, Western University, London, Ontario, Canada.,Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Sandra E Black
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Michael Borrie
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,St. Joseph's Healthcare Centre, London, Ontario, Canada
| | - Donald Brien
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Leanne K Casaubon
- Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,Toronto Western Hospital, Toronto, Ontario, Canada
| | - Brian C Coe
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Benjamin Cornish
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Allison A Dilliott
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Robarts Research Institute, Western University, London, Ontario, Canada
| | - Dar Dowlatshahi
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Elizabeth Finger
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Corinne Fischer
- Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Andrew Frank
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Julia Fraser
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Morris Freedman
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,Division of Neurology, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Barry Greenberg
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David A Grimes
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ayman Hassan
- Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada
| | - Wendy Hatch
- Kensington Eye Institute, Toronto, Ontario, Canada.,Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Robert A Hegele
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Robarts Research Institute, Western University, London, Ontario, Canada
| | - Christopher Hudson
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Mandar Jog
- London Health Sciences Centre, London, Ontario, Canada
| | - Sanjeev Kumar
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Anthony Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Brian Levine
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Wendy Lou
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Mandzia
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Clinical Neurological Sciences, London Health Sciences Centre, London, Ontario, Canada
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, Toronto, Ontario, Canada
| | - William McIlroy
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Manuel Montero-Odasso
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Gait and Brain Lab, Parkwood Institute, London, Ontario, Canada
| | - David G Munoz
- Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
| | - Joseph B Orange
- School of Communication Sciences and Disorders, Elborn College, Western University, London, Ontario, Canada
| | - David S Park
- Hotchkiss Brain Institute, Calgary, Alberta, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Stephen H Pasternak
- St. Joseph's Healthcare Centre, London, Ontario, Canada.,Cognitive Neurology and Alzheimer's Disease Research Centre, Parkwood Institute, London, Ontario, Canada
| | - Frederico Pieruccini-Faria
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada.,Gait and Brain Lab, Parkwood Institute, London, Ontario, Canada
| | - Tarek K Rajji
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Angela C Roberts
- School of Communication Sciences and Disorders, Elborn College, Western University, London, Ontario, Canada.,Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, Illinois, USA
| | - John F Robinson
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Robarts Research Institute, Western University, London, Ontario, Canada
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | | | - Gustavo Saposnik
- Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,Keenan Research Centre for Biomedical Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Christopher J M Scott
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Dallas Seitz
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | | | - Michael J Strong
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Canadian Institutes for Health Research, Ottawa, Ontario, Canada
| | - Stephen C Strother
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Richard H Swartz
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Sean Symons
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - David F Tang-Wai
- Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada.,Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Angela K Troyer
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada.,Neuropsychology and Cognitive Health, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - John Turnbull
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lorne Zinman
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Paula M McLaughlin
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada.,Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Mario Masellis
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Ontario, Canada
| | - Malcolm A Binns
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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LaPlume AA, McKetton L, Levine B, Troyer AK, Anderson ND. The adverse effect of modifiable dementia risk factors on cognition amplifies across the adult lifespan. Alzheimers Dement (Amst) 2022; 14:e12337. [PMID: 35845262 PMCID: PMC9277708 DOI: 10.1002/dad2.12337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/28/2022] [Accepted: 05/21/2022] [Indexed: 11/09/2022]
Abstract
Background Reversible lifestyle behaviors (modifiable risk factors) can reduce dementia risk by 40%, but their prevalence and association with cognition throughout the adult lifespan is less well understood. Methods The associations between the number of modifiable risk factors for dementia (low education, hypertension, hearing loss, traumatic brain injury, alcohol or substance abuse, diabetes, smoking, and depression) and cognition were examined in an online sample (N = 22,117, ages 18–89). Findings Older adults (ages 66–89) had more risk factors than middle‐aged (ages 45–65) and younger adults (ages 18–44). Polynomial regression revealed that each additional risk factor was associated with lower cognitive performance (equivalent to 3 years of aging), with a larger association as age increased. People with no risk factors in their forties to seventies showed similar cognitive performance to people 10 or 20 years younger with many risk factors. Interpretation Modifiable dementia risk factors amplify lifespan age differences in cognitive performance.
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Affiliation(s)
| | - Larissa McKetton
- Rotman Research Institute Baycrest Health Sciences Toronto Canada
| | - Brian Levine
- Rotman Research Institute Baycrest Health Sciences Toronto Canada.,Department of Psychology University of Toronto Toronto Canada.,Department of Medicine (Neurology) University of Toronto Toronto Canada
| | - Angela K Troyer
- Department of Psychology University of Toronto Toronto Canada.,Neuropsychology and Cognitive Health Program Baycrest Health Sciences Toronto Canada
| | - Nicole D Anderson
- Rotman Research Institute Baycrest Health Sciences Toronto Canada.,Department of Psychology University of Toronto Toronto Canada.,Department of Psychiatry University of Toronto Toronto Canada
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8
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Beaton D, McLaughlin PM, Orange JB, Munoz DP, Mandzia J, Abrahao A, Binns MA, Black SE, Borrie M, Dowlatshahi D, Freedman M, Fischer CE, Finger EC, Frank A, Grimes D, Hassan A, Kumar S, Lang AE, Levine B, Marras C, Masellis M, Pollock BG, Rajji TK, Ramirez J, Sahlas DJ, Saposnik G, Scott CJM, Seitz DP, Strother SC, Sunderland KM, Tan B, Tang-Wai DF, Troyer AK, Turnbull J, Zinman L, Swartz RH, Tartaglia MC, Breen DP, Kwan D, Roberts AC, The Ondri Investigators. Caregiving concerns and clinical characteristics across neurodegenerative and cerebrovascular disorders in the Ontario neurodegenerative disease research initiative. Int J Geriatr Psychiatry 2022; 37. [PMID: 35633037 DOI: 10.1002/gps.5727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 04/20/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Caregiving burdens are a substantial concern in the clinical care of persons with neurodegenerative disorders. In the Ontario Neurodegenerative Disease Research Initiative, we used the Zarit's Burden Interview (ZBI) to examine: (1) the types of burdens captured by the ZBI in a cross-disorder sample of neurodegenerative conditions (2) whether there are categorical or disorder-specific effects on caregiving burdens, and (3) which demographic, clinical, and cognitive measures are related to burden(s) in neurodegenerative disorders? METHODS/DESIGN N = 504 participants and their study partners (e.g., family, friends) across: Alzheimer's disease/mild cognitive impairment (AD/MCI; n = 120), Parkinson's disease (PD; n = 136), amyotrophic lateral sclerosis (ALS; n = 38), frontotemporal dementia (FTD; n = 53), and cerebrovascular disease (CVD; n = 157). Study partners provided information about themselves, and information about the clinical participants (e.g., activities of daily living (ADL)). We used Correspondence Analysis to identify types of caregiving concerns in the ZBI. We then identified relationships between those concerns and demographic and clinical measures, and a cognitive battery. RESULTS We found three components in the ZBI. The first was "overall burden" and was (1) strongly related to increased neuropsychiatric symptoms (NPI severity r = 0.586, NPI distress r = 0.587) and decreased independence in ADL (instrumental ADLs r = -0.566, basic ADLs r = -0.43), (2) moderately related to cognition (MoCA r = -0.268), and (3) showed little-to-no differences between disorders. The second and third components together showed four types of caregiving concerns: current care of the person with the neurodegenerative disease, future care of the person with the neurodegenerative disease, personal concerns of study partners, and social concerns of study partners. CONCLUSIONS Our results suggest that the experience of caregiving in neurodegenerative and cerebrovascular diseases is individualized and is not defined by diagnostic categories. Our findings highlight the importance of targeting ADL and neuropsychiatric symptoms with caregiver-personalized solutions.
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Affiliation(s)
- Derek Beaton
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Paula M McLaughlin
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada.,Nova Scotia Health Authority, Halifax, NS, Canada.,Department of Medicine - Geriatrics, Dalhousie University, Halifax, NS, Canada
| | - Joseph B Orange
- School of Communication Sciences and Disorders, Western University, London, ON, Canada.,Canadian Centre for Activity and Aging, Western University, London, ON, Canada.,Faculty of Health Sciences, Western University, London, ON, Canada
| | - Douglas P Munoz
- Department of Biomedical and Molecular Sciences, Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Jennifer Mandzia
- Department of Clinical Neurological Sciences, London Health Sciences Center, Western University, London, ON, Canada
| | - Agessandro Abrahao
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Malcolm A Binns
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Sandra E Black
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Michael Borrie
- Department of Medicine, Division of Geriatric Medicine, Western University, Toronto, ON, Canada
| | - Dar Dowlatshahi
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Morris Freedman
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada.,Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Elizabeth C Finger
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Andrew Frank
- Bruyere Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - David Grimes
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Ayman Hassan
- Northern Ontario School of Medicine, Clinical Science Division, Depart of Internal Medicine, Thunder Bay, ON, Canada
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Anthony Edward Lang
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Brian Levine
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada.,Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, ON, Canada
| | - Mario Masellis
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Bruce G Pollock
- Centre for Addiction and Mental Health, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Tarek K Rajji
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Joel Ramirez
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,LC Campbell Cognitive Neurology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Demetrios J Sahlas
- Department of Medicine (Division of Neurology), McMaster University, Hamilton, ON, Canada
| | - Gustavo Saposnik
- Outcomes and Decision Neuroscience Research Unit, Toronto, ON, Canada
| | - Christopher J M Scott
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada.,LC Campbell Cognitive Neurology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Dallas P Seitz
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Stephen C Strother
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Kelly M Sunderland
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, ON, Canada
| | - David F Tang-Wai
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Department of Medicine (Geriatric Medicine), University of Toronto, Toronto, ON, Canada.,University Hospital Network Memory Clinic, Toronto, ON, Canada
| | - Angela K Troyer
- Department of Psychology, University of Toronto, Toronto, ON, Canada.,Neuropsychology & Cognitive Health Program, Baycrest Health Sciences, Toronto, ON, Canada
| | - John Turnbull
- Department of Medicine (Division of Neurology), McMaster University, Hamilton, ON, Canada
| | - Lorne Zinman
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Richard H Swartz
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Maria Carmela Tartaglia
- Department of Medicine (Division of Neurology), University of Toronto, Toronto, ON, Canada.,Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.,Division of Neurology, Krembil Neuroscience Centre Memory Clinic, Toronto, ON, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.,Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK.,Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Donna Kwan
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Angela C Roberts
- School of Communication Sciences and Disorders, Western University, London, ON, Canada.,Roxelyn and Richard Pepper Department of Communication Sciences and Disorders and Department of Computer Science, Northwestern University, Evanston, Illinois, USA
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LaPlume AA, McKetton L, Anderson ND, Troyer AK. Sex differences and modifiable dementia risk factors synergistically influence memory over the adult lifespan. Alzheimers Dement (Amst) 2022; 14:e12301. [PMID: 35386471 PMCID: PMC8973898 DOI: 10.1002/dad2.12301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 11/12/2022]
Abstract
Introduction More women than men develop Alzheimer's disease, yet women perform better and show less decline on episodic memory measures, a contradiction that may be accounted for by modifiable risk factors for dementia. Methods Associations among age, sex, modifiable dementia risk factors, and cognition were measured in a cross‐sectional online sample (n = 21,840, ages 18 to 89). Results Across four tests of associative memory and executive functions, only a Face‐Name Association task revealed sex differences in associative memory that varied by age. Men had worse memory than women (the equivalent of performing similar to someone 4 years older) across ages. Men had larger age differences than women (ie, worse memory in older ages) among people with no to one risk factor, but not those with multiple risk factors. Discussion Because the relationship between dementia risk factors and age‐related memory differences varies between men and women, sex‐specific dementia prevention approaches are warranted.
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Affiliation(s)
- Annalise A LaPlume
- Rotman Research Institute Baycrest Health Sciences (fully affiliated with the University of Toronto) Toronto Canada
| | - Larissa McKetton
- Rotman Research Institute Baycrest Health Sciences (fully affiliated with the University of Toronto) Toronto Canada
| | - Nicole D Anderson
- Rotman Research Institute Baycrest Health Sciences (fully affiliated with the University of Toronto) Toronto Canada.,Department of Psychology University of Toronto Toronto Canada.,Department of Psychiatry University of Toronto Toronto Canada
| | - Angela K Troyer
- Department of Psychology University of Toronto Toronto Canada.,Neuropsychology and Cognitive Health Program Baycrest Health Sciences Toronto Canada
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10
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Hudes R, Baptist-Mohseni N, Dimech C, Rich JB, Troyer AK, Vandermorris S. Evaluating the effectiveness of compensatory memory interventions in adults with acquired brain injury: A systematic review and meta-analysis of memory and everyday outcomes. Neuropsychology 2022; 36:243-265. [PMID: 35238602 DOI: 10.1037/neu0000799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Adults with acquired brain injury (ABI) often experience memory impairments that are persistent and difficult to treat. Although evidence has shown that rehabilitation programs may improve cognitive performance in persons with ABI, there is an opportunity to look more closely at the benefits provided by specific interventions. We conducted a systematic review and meta-analysis to evaluate whether compensation-based memory programs improve memory or everyday outcomes (e.g., mood, quality of life, community integration, everyday functioning). METHOD The review was limited to published, English-language controlled trials that evaluated compensatory memory interventions for adults (18 +) with ABI using at least one memory or everyday outcome. The final search was conducted in April 2021 using PsychINFO, Medline, EMBASE, the Cochrane Review database, Google Scholar, and the reference lists of relevant articles. RESULTS Of 2,817 identified articles, 22 controlled trials met inclusion criteria, of which 12 provided sufficient data to include in the meta-analyses. Risk of bias assessment identified problems with recruitment and masking procedures. Results indicate that compared to controls, these interventions produce positive effects on outcomes of immediate verbal recall (g = 0.43), participant-reported memory (g = 0.28), and strategy use (g = 0.39) and that these improvements are maintained at follow-up. CONCLUSIONS Compensatory memory programs produce meaningful memory improvements and are a promising avenue for reducing ABI-related memory impairment. Future research focusing on specific subsets of ABI populations and a broader range of participant-reported outcomes is needed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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11
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LaPlume AA, Anderson ND, McKetton L, Levine B, Troyer AK. Corrigendum to: When I'm 64: Age-Related Variability in Over 40,000 Online Cognitive Test Takers. J Gerontol B Psychol Sci Soc Sci 2022; 77:130. [PMID: 35022778 PMCID: PMC8755902 DOI: 10.1093/geronb/gbab207] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Annalise A LaPlume
- Rotman Research Institute, Baycrest Health Sciences (fully affiliated with the University of Toronto), Ontario, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest Health Sciences (fully affiliated with the University of Toronto), Ontario, Canada.,Departments of Psychology & Psychiatry, University of Toronto, Ontario, Canada
| | - Larissa McKetton
- Rotman Research Institute, Baycrest Health Sciences (fully affiliated with the University of Toronto), Ontario, Canada
| | - Brian Levine
- Rotman Research Institute, Baycrest Health Sciences (fully affiliated with the University of Toronto), Ontario, Canada.,Departments of Psychology & Medicine (Neurology), University of Toronto, Ontario, Canada
| | - Angela K Troyer
- Department of Psychology, University of Toronto, Ontario, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Ontario, Canada
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12
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LaPlume AA, Paterson TSE, Gardner S, Stokes KA, Freedman M, Levine B, Troyer AK, Anderson ND. Interindividual and intraindividual variability in amnestic mild cognitive impairment (aMCI) measured with an online cognitive assessment. J Clin Exp Neuropsychol 2021; 43:796-812. [PMID: 34556008 DOI: 10.1080/13803395.2021.1982867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Mean cognitive performance is worse in amnestic mild cognitive impairment (aMCI) compared to control groups. However, studies on variability of cognitive performance in aMCI have yielded inconclusive results, with many differences in variability measures and samples from one study to another. METHODS We examined variability in aMCI using an existing older adult sample (n = 91; 51 with aMCI, 40 with normal cognition for age), measured with an online self-administered computerized cognitive assessment (Cogniciti's Brain Health Assessment). Our methodology extended past findings by using pure measures of variability (controlling for confounding effects of group performance or practice), and a clinically representative aMCI sample (reflecting the continuum of cognitive performance between normal cognition and aMCI). RESULTS Between-group t-tests showed significantly greater between-person variability (interindividual variability or diversity) in overall cognitive performance in aMCI than controls, although the effect size was with a small to moderate effect size, d = 0.44. No significant group differences were found in within-person variability (intraindividual variability) across cognitive tasks (dispersion) or across trials of a response time task (inconsistency), which may be because we used a sample measuring the continuum of cognitive performance. Exploratory correlation analyses showed that a worse overall score was associated with greater inter- and intraindividual variability, and that variability measures were correlated with each other, indicating people with worse cognitive performance were more variable. DISCUSSION The current study demonstrates that self-administered online tests can be used to remotely assess different types of variability in people at risk of Alzheimer`s. Our findings show small but significantly more interindividual differences in people with aMCI. This diversity is considered as "noise" in standard assessments of mean performance, but offers an interesting and cognitively informative "signal" in itself.
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Affiliation(s)
- Annalise A LaPlume
- Rotman Research Institute, Baycrest (Fully Affiliated with the University of Toronto), Toronto, Canada
| | - Theone S E Paterson
- Department of Psychology, University of Victoria, Victoria, Canada.,Neuropsychology and Cognitive Health Program, Baycrest, Toronto, Canada
| | - Sandra Gardner
- Rotman Research Institute, Baycrest (Fully Affiliated with the University of Toronto), Toronto, Canada.,Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Kathryn A Stokes
- Neuropsychology and Cognitive Health Program, Baycrest, Toronto, Canada
| | - Morris Freedman
- Rotman Research Institute, Baycrest (Fully Affiliated with the University of Toronto), Toronto, Canada.,Division of Neurology, Baycrest, Toronto, Canada.,Department of Medicine, Division of Neurology, Mt. Sinai Hospital, Toronto, ON, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Canada
| | - Brian Levine
- Rotman Research Institute, Baycrest (Fully Affiliated with the University of Toronto), Toronto, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest (Fully Affiliated with the University of Toronto), Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
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13
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Paterson TSE, Sivajohan B, Gardner S, Binns MA, Stokes KA, Freedman M, Levine B, Troyer AK. Accuracy of a Self-Administered Online Cognitive Assessment in Detecting Amnestic Mild Cognitive Impairment. J Gerontol B Psychol Sci Soc Sci 2021; 77:341-350. [PMID: 34333629 PMCID: PMC8824689 DOI: 10.1093/geronb/gbab097] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives Our aim was to validate the online Brain Health Assessment (BHA) for detection of amnestic mild cognitive impairment (aMCI) compared to gold-standard neuropsychological assessment. We compared the diagnostic accuracy of the BHA to the Montreal Cognitive Assessment (MoCA). Methods Using a cross-sectional design, community-dwelling older adults completed a neuropsychological assessment, were diagnosed as normal cognition (NC) or aMCI, and completed the BHA and MoCA. Both logistic regression (LR) and penalized logistic regression (PLR) analyses determined BHA and demographic variables predicting aMCI; MoCA variables were similarly modeled. Diagnostic accuracy was compared using area under the receiver operating characteristic curve (ROC AUC) analyses. Results Ninety-one participants met inclusion criteria (51 aMCI, 40 NC). PLR modeling for the BHA indicated Face–Name Association, Spatial Working Memory, and age-predicted aMCI (ROC AUC = 0.76; 95% confidence interval [CI]: 0.66–0.86). Optimal cut-points resulted in 21% classified as aMCI (positive), 23% negative, and 56% inconclusive. For the MoCA, digits, abstraction, delayed recall, orientation, and age predicted aMCI (ROC AUC = 0.71; 95% CI: 0.61–0.82). Optimal cut-points resulted in 22% classified positive, 8% negative, and 70% inconclusive (LR results presented within). The BHA model classified fewer participants into the inconclusive category and more as negative for aMCI, compared to the MoCA model (Stuart–Maxwell p = .004). Discussion The self-administered BHA provides similar detection of aMCI as a clinician-administered screener (MoCA), with fewer participants classified inconclusively. The BHA has the potential to save practitioners time and decrease unnecessary referrals for a comprehensive assessment to determine the presence of aMCI.
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Affiliation(s)
- Theone S E Paterson
- Baycrest Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychology, University of Victoria, British Columbia, Canada
| | | | - Sandra Gardner
- Baycrest Health Sciences Centre, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Malcolm A Binns
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.,Rotman Research Institute, Toronto, Ontario, Canada
| | | | - Morris Freedman
- Baycrest Health Sciences Centre, Toronto, Ontario, Canada.,Rotman Research Institute, Toronto, Ontario, Canada
| | - Brian Levine
- Rotman Research Institute, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Ontario, Canada
| | - Angela K Troyer
- Baycrest Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Ontario, Canada
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14
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LaPlume A, Anderson ND, McKetton L, Levine B, Troyer AK. When I'm 64: Age-related variability in over 40,000 online cognitive test takers. J Gerontol B Psychol Sci Soc Sci 2021; 77:104-117. [PMID: 34329440 PMCID: PMC8755911 DOI: 10.1093/geronb/gbab143] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives Age-related differences in cognition are typically assessed by comparing groups of older to younger participants, but little is known about the continuous trajectory of cognitive changes across age, or when a shift to older adulthood occurs. We examined the pattern of mean age differences and variability on episodic memory and executive function measures over the adult life span, in a more fine-grained way than past group or life-span comparisons. Method We used a sample of over 40,000 people aged 18–90 who completed psychometrically validated online tests measuring episodic memory and executive functions (the Cogniciti Brain Health Assessment). Results Cognitive performance declined gradually over adulthood, and rapidly later in life on spatial working memory, processing speed, facilitation (but not interference), associative recognition, and set shifting. Both polynomial and segmented regression fit the data well, indicating a nonlinear pattern. Segmented regression revealed a shift from gradual to rapid decline that occurred in the early 60s. Variability between people (interindividual variability or diversity) and variability within a person across tasks (intraindividual variability or dispersion) also increased gradually until the 60s, and rapidly after. Confirmatory factor analysis revealed a single general factor (of variance shared between tasks) offered a good fit for performance across tasks. Discussion Life-span cognitive performance shows a nonlinear pattern, with gradual decline over early and mid-adulthood, followed by a transition in the 60s to notably accelerated, but more variable, decline. Some people show less decline than others, and some cognitive abilities show less within-person decline than others.
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Affiliation(s)
- Annalise LaPlume
- Rotman Research Institute, Baycrest Health Sciences (fully affiliated with the University of Toronto), Toronto, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest Health Sciences (fully affiliated with the University of Toronto), Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Larissa McKetton
- Rotman Research Institute, Baycrest Health Sciences (fully affiliated with the University of Toronto), Toronto, Canada
| | - Brian Levine
- Rotman Research Institute, Baycrest Health Sciences (fully affiliated with the University of Toronto), Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada.,Department of Medicine (Neurology), University of Toronto, Toronto, Canada
| | - Angela K Troyer
- Department of Psychology, University of Toronto, Toronto, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
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15
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Kotsopoulos J, Kim SJ, Armel S, Bordeleau L, Foulkes WD, McKinnon W, Panchal S, Cohen SA, Sun S, Sun P, McKetton L, Troyer AK, Narod SA. An evaluation of memory and attention in BRCA mutation carriers using an online cognitive assessment tool. Cancer 2021; 127:3183-3193. [PMID: 34077552 DOI: 10.1002/cncr.33654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The objective of this study was to evaluate the impact of various surgical, hormonal, and lifestyle factors on memory and attention in women with a BRCA1 or BRCA2 mutation. METHODS BRCA mutation carriers enrolled in a longitudinal study were invited to complete an online brain health assessment tool designed to screen for cognitive deficits. Four measures of memory and executive attention were assessed individually, and an overall score was compiled adjusting for age. Exposures, including preventive surgery, hormone use, and lifestyle factors, were captured by questionnaire. Performance on each of the 5 subtasks was analyzed according to various exposures. Analysis of covariance was used to compare overall scores. RESULTS In total, 880 women completed the online cognitive assessment. The average age of the participants was 54 years (range, 23-86 years). The mean overall test score was 54.4 (range, 0-93). The individual subtask scores declined with age at test completion (P < .0001) and increased with level of education (P ≤ .01). Women who underwent a preventive oophorectomy had a significantly higher overall score compared with women who did not undergo this surgery (55.5 vs 50.5; P = .01). Reconstructive breast surgery was also associated with a higher overall score (56.5 vs 52.3; P = .005). Chemotherapy and hormone-replacement therapy were not predictive of the overall score. CONCLUSIONS These findings are reassuring to high-risk women who undergo early surgical menopause for their cancer predisposition. Further studies are needed to evaluate cognitive function over time when memory deficits become more prevalent.
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Affiliation(s)
- Joanne Kotsopoulos
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Shana J Kim
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Susan Armel
- Division of Gynecologic Oncology, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Louise Bordeleau
- Division of Medical Oncology, Juravinski Cancer Center, Hamilton, Ontario, Canada
| | - William D Foulkes
- Program in Cancer Genetics, Department of Oncology and Human Genetics, McGill University, Montreal, Quebec, Canada
| | - Wendy McKinnon
- Familial Cancer Program, University of Vermont Medical Center, Burlington, Vermont
| | - Seema Panchal
- Marvelle Koffler Breast Center, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Stephanie A Cohen
- Cancer Genetics Risk Assessment Program, St Vincent Health, Indianapolis, Indiana
| | - Sophie Sun
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Ping Sun
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | | | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest Center for Geriatric Care, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Steven A Narod
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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16
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Vandermorris S, Cochrane M, Troyer AK. Understanding the client and family experience of neuropsychological evaluation. Professional Psychology: Research and Practice 2021. [DOI: 10.1037/pro0000385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Fishman KN, Roberts AC, Orange JB, Sunderland KM, Marras C, Tan B, Steeves T, Kwan D, Lang AE, Grimes D, Levine B, Masellis M, Binns MA, Jog M, Strother SC, Investigators O, McLaughlin PM, Troyer AK. Bilingualism in Parkinson's disease: Relationship to cognition and quality of life. J Clin Exp Neuropsychol 2021; 43:199-212. [PMID: 33827353 DOI: 10.1080/13803395.2021.1902946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Some studies have found that bilingualism promotes cognitive reserve. OBJECTIVE We aimed to determine whether bilingualism, defined as regularly (i.e. daily) using at least two languages at least since early adulthood, is associated with cognitive advantages in Parkinson's disease (PD) or whether the possible benefits of bilingualism are lost in the context of PD, possibly affecting quality of life (QoL) and independence. METHOD Participants with idiopathic PD (n = 140, mean age = 67.9 [SD = 6.4], 78% men) completed standard neuropsychological tasks evaluating attention/working memory, language, executive function, memory, and visuospatial ability, as well as measures of wellbeing and functional independence. RESULTS Bilinguals with PD (n = 21) performed worse than monolinguals with PD (n = 92) on attention/working memory and language measures. The between-group differences in attention/working memory were restricted to verbally-based measures. When measured along a continuum, a higher degree of bilingualism was correlated with lower scores on measures of attention/working memory and language. There were no group differences in self- or informant-reported cognitive decline, PD health-related QoL, or functional independence. CONCLUSIONS Bilingualism in PD was not associated with better cognitive performance. Lower scores on language-based measures may reflect a distributed fund of linguistic information across more than one language, lower language proficiency in English, and/or other cultural artifacts. Furthermore, using normative data specific to the dominant language spoken or conducting neuropsychological testing in participants' self-reported most proficient language may enhance additional studies addressing this topic. Future research may also examine the roles of bilingualism over time and across other neurodegenerative diseases with and without EF impairment to illuminate further the impact of bilingualism on cognition and QoL, and shape culturally and linguistically diverse research and clinical care.
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Affiliation(s)
- Keera N Fishman
- University of Ottawa, Ottawa, Ontario, Canada.,Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Angela C Roberts
- Northwestern University, Evanston, Illinois, USA.,, Western University, London, Ontario, Canada
| | - J B Orange
- , Western University, London, Ontario, Canada
| | | | - Connie Marras
- , University of Toronto, Toronto, Ontario, Canada.,Toronto Western Hospital, Toronto, Ontario, Canada
| | - Brian Tan
- Baycrest Health Sciences, Toronto, Ontario, Canada
| | | | - Donna Kwan
- Queen's University, Toronto, Ontario, Canada
| | - Anthony E Lang
- , University of Toronto, Toronto, Ontario, Canada.,Toronto Western Hospital, Toronto, Ontario, Canada
| | - David Grimes
- University of Ottawa, Ottawa, Ontario, Canada.,The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Brian Levine
- Baycrest Health Sciences, Toronto, Ontario, Canada.,, University of Toronto, Toronto, Ontario, Canada
| | - Mario Masellis
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Malcolm A Binns
- Baycrest Health Sciences, Toronto, Ontario, Canada.,, University of Toronto, Toronto, Ontario, Canada
| | - Mandar Jog
- , Western University, London, Ontario, Canada
| | - Stephen C Strother
- Baycrest Health Sciences, Toronto, Ontario, Canada.,, University of Toronto, Toronto, Ontario, Canada
| | | | - Paula M McLaughlin
- Queen's University, Toronto, Ontario, Canada.,Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
| | - Angela K Troyer
- Baycrest Health Sciences, Toronto, Ontario, Canada.,, University of Toronto, Toronto, Ontario, Canada
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18
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Abstract
OBJECTIVES Individuals facing a personal challenge, such as age-related memory changes, may feel that their experiences are abnormal or pathological. Previous qualitative research on a group intervention that focuses on memory changes in older adulthood revealed that one of the greatest benefits derived by participants was the realization that their experience with memory changes was normal. In order to quantify this experience, we developed and validated a new measure, the 26-item Subjective Normalcy Inventory (SNI). METHOD Reliability and validity were assessed with a sample of 167 community-dwelling adults between the ages of 55 and 90. Questionnaire responsiveness was assessed with an additional sample of 29 older adults who completed a 5-session memory intervention program known to cultivate normalization. RESULTS The SNI exhibited a two-factor structure, excellent test-retest reliability, ICC = .79, excellent internal consistency, Cronbach's α = .91, and good convergent, |rs| = .46-.58, and discriminant, rs = .02-.06, validity. The measure was also responsive to change, as participants who completed the memory intervention program reported a greater sense of normalcy relative to nonintervention controls, η2p = 0.17. CONCLUSION The SNI has the potential to provide novel and useful outcome information for interventions designed to improve one's sense of normalcy and may be applied in both clinical and research settings. The SNI can also be modified, validated, and used to assess subjective normalcy with respect to other personal challenges outside of memory and attention changes.
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Affiliation(s)
- Erica L Tatham
- Department of Psychology, York University, Toronto, ON, Canada.,Neuropsychology and Cognitive Health, Baycrest Health Sciences, Toronto, ON, Canada
| | - Komal T Shaikh
- Department of Psychology, York University, Toronto, ON, Canada.,Neuropsychology and Cognitive Health, Baycrest Health Sciences, Toronto, ON, Canada
| | - Susan Vandermorris
- Neuropsychology and Cognitive Health, Baycrest Health Sciences, Toronto, ON, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health, Baycrest Health Sciences, Toronto, ON, Canada.,Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Jill B Rich
- Department of Psychology, York University, Toronto, ON, Canada.,Neuropsychology and Cognitive Health, Baycrest Health Sciences, Toronto, ON, Canada
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19
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Abstract
Many adults report memory changes as they age. The Multifactorial Memory Questionnaire (MMQ) measures different aspects of self-reported memory, including satisfaction with one's memory, self-appraisal of memory ability, and compensatory strategy use. This questionnaire has been extensively used for clinical and research purposes, with studies reporting differences in the factor structure (three or four factors) underlying this measure. The current study evaluates previously reported factor configurations of the MMQ using best measurement practices. Confirmatory factor analyses were conducted on data from 560 cognitively - normal adults, ranging in age from 50 to 90 years old. Our results demonstrate support for both 3-factor model (with Satisfaction, Ability and Strategy scales) and 4-factor model structure (with Satisfaction, Ability, Internal Strategy and External Strategy scales) of this instrument. These results harmonise the existing literature which, in separate studies using exploratory analyses, supports the validity of one model or the other. The confirmation of multiple Strategy scales will provide clinicians and researchers with additional relevant information about how older adults compensate for their memory changes, enabling a broader understanding of the experience of age-related memory change. We contextualise these results within existing research identifying conceptual differences between internal and external strategy implementation.
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Affiliation(s)
- Komal T Shaikh
- Department of Psychology, York University, Toronto, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Erica L Tatham
- Department of Psychology, York University, Toronto, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Jill B Rich
- Department of Psychology, York University, Toronto, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
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20
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Vandermorris S, Au A, Gardner S, Troyer AK. Initiation and maintenance of behaviour change to support memory and brain health in older adults: A randomized controlled trial. Neuropsychol Rehabil 2020; 32:611-628. [PMID: 33203317 DOI: 10.1080/09602011.2020.1841656] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02087137.
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Affiliation(s)
| | - April Au
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Sandra Gardner
- Kunin-Lunenfeld Centre for Applied Research and Evaluation, Baycrest, Toronto, Canada.,Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Baycrest, Toronto, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
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21
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Murphy KJ, Hodges TE, Sheppard PAS, Troyer AK, Hampson E, Galea LAM. Sex differences in cortisol and memory following acute social stress in amnestic mild cognitive impairment. J Clin Exp Neuropsychol 2020; 42:881-901. [PMID: 33023371 DOI: 10.1080/13803395.2020.1825633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Older adults with amnestic mild cognitive impairment (aMCI) develop Alzheimer's type dementia approximately 10 times faster annually than the normal population. Adrenal hormones are associated with aging and cognition. We investigated the relationship between acute stress, cortisol, and memory function in aMCI with an exploratory analysis of sex. METHOD Salivary cortisol was sampled diurnally and during two test sessions, one session with the Trier Social Stress Test (TSST), to explore differences in the relationship between cortisol and memory function in age-normal cognition (NA) and aMCI. Participants with aMCI (n = 6 women, 9 men; mean age = 75) or similarly aged NA (n = 9 women, 7 men, mean age = 75) were given tests of episodic, associative, and spatial working memory with a psychosocial stressor (TSST) in the second session. RESULTS The aMCI group performed worse on the memory tests than NA as expected, and males with aMCI had elevated cortisol levels on test days. Immediate episodic memory was enhanced by social stress in NA but not in the aMCI group, indicating that stress-induced alterations in memory are different in individuals with aMCI. High cortisol was associated with impaired performance on episodic memory in aMCI males only. Cortisol in Session 1 moderated the relationship with spatial working memory, whereby higher cortisol was associated with worse performance in NA, but better spatial working memory in aMCI. In addition, effects of aMCI on perceived anxiety in response to stress exposure were moderated by stress-induced cortisol in a sex-specific manner. CONCLUSIONS We show effects of aMCI on Test Session cortisol levels and effects on perceived anxiety, and stress-induced impairments in memory in males with aMCI in our exploratory sample. Future studies should explore sex as a biological variable as our findings suggest that effects at the confluence of aMCI and stress can be obfuscated without sex as a consideration.
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Affiliation(s)
- Kelly J Murphy
- Neuropsychology and Cognitive Health Program, Baycrest , Toronto, ON, Canada.,Psychology Department, University of Toronto , Toronto, ON, Canada
| | - Travis E Hodges
- Djavad Mowafaghian Centre for Brain Health, Department of Psychology, University of British Columbia , Vancouver, BC, Canada
| | - Paul A S Sheppard
- Djavad Mowafaghian Centre for Brain Health, Department of Psychology, University of British Columbia , Vancouver, BC, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest , Toronto, ON, Canada.,Psychology Department, University of Toronto , Toronto, ON, Canada
| | | | - Liisa A M Galea
- Djavad Mowafaghian Centre for Brain Health, Department of Psychology, University of British Columbia , Vancouver, BC, Canada
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22
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Seixas-Lima B, Murphy K, Troyer AK, Levine B, Graham NL, Leonard C, Rochon E. Episodic memory decline is associated with deficits in coherence of discourse. Cogn Neuropsychol 2020; 37:511-522. [PMID: 32490725 DOI: 10.1080/02643294.2020.1770207] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study investigates coherence of discourse in the production of autobiographical narratives by individuals with aMCI. Autobiographical interviews were analyzed to determine whether reduced episodic recall was related to deficits in discourse coherence. A coherence rating scale was used to evaluate relatedness of the autobiographical details produced by participants to the topic of discourse. Interviews were transcribed, segmented into details, and divided into sets of episodic, semantic, or supplementary information, which were subsequently analysed with the coherence rating scale. We predicted that the known episodic deficits observed in aMCI could also affect the retrieval of coherent episodic information. The results revealed deficits in coherence could be found in both episodic and semantic information in the aMCI group. These results suggest that the cognitive deficits experienced by individuals with aMCI may go beyond their known difficulty in recalling episodic details, as they also affect the controlled retrieval of both episodic and semantic information.
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Affiliation(s)
- Bruna Seixas-Lima
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Speech-Language Pathology, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Kelly Murphy
- Department of Psychology, University of Toronto, Toronto, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Angela K Troyer
- Department of Psychology, University of Toronto, Toronto, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Brian Levine
- Department of Psychology, University of Toronto, Toronto, Canada.,Rotman Research Institute - Baycrest Centre, Toronto, Canada
| | - Naida L Graham
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Speech-Language Pathology, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Carol Leonard
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Speech-Language Pathology, University of Toronto, Toronto, Canada.,Audiology and Speech-Language Pathology Program, University of Ottawa, Ottawa, Canada
| | - Elizabeth Rochon
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Department of Speech-Language Pathology, University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
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23
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McLaughlin PM, Sunderland KM, Beaton D, Binns MA, Kwan D, Levine B, Orange JB, Peltsch AJ, Roberts AC, Strother SC, Troyer AK. The Quality Assurance and Quality Control Protocol for Neuropsychological Data Collection and Curation in the Ontario Neurodegenerative Disease Research Initiative (ONDRI) Study. Assessment 2020; 28:1267-1286. [PMID: 32321297 DOI: 10.1177/1073191120913933] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As large research initiatives designed to generate big data on clinical cohorts become more common, there is an increasing need to establish standard quality assurance (QA; preventing errors) and quality control (QC; identifying and correcting errors) procedures for critical outcome measures. The present article describes the QA and QC approach developed and implemented for the neuropsychology data collected as part of the Ontario Neurodegenerative Disease Research Initiative study. We report on the efficacy of our approach and provide data quality metrics. Our findings demonstrate that even with a comprehensive QA protocol, the proportion of data errors still can be high. Additionally, we show that several widely used neuropsychological measures are particularly susceptible to error. These findings highlight the need for large research programs to put into place active, comprehensive, and separate QA and QC procedures before, during, and after protocol deployment. Detailed recommendations and considerations for future studies are provided.
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Affiliation(s)
- Paula M McLaughlin
- Queen's University, Kingston, Ontario, Canada.,Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Derek Beaton
- Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Malcolm A Binns
- Baycrest Health Sciences, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Donna Kwan
- Queen's University, Kingston, Ontario, Canada
| | - Brian Levine
- Baycrest Health Sciences, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | | | | | - Angela C Roberts
- Western University, London, Ontario, Canada.,Northwestern University, Evanston, IL, USA
| | - Stephen C Strother
- Baycrest Health Sciences, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Angela K Troyer
- Baycrest Health Sciences, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
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24
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Shaikh KT, Tatham EL, Parikh PK, McCreath GA, Rich JB, Troyer AK. Development and Psychometric Validation of a Questionnaire Assessing the Impact of Memory Changes in Older Adults. Gerontologist 2020. [PMID: 29522122 DOI: 10.1093/geront/gny011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Many healthy older adults experience age-related memory changes that can impact their day-to-day functioning. Qualitative interviews have been useful in gaining insight into the experience of older adults who are facing memory difficulties. To enhance this insight, there is a need for a reliable and valid measure that quantifies the impact of normal memory changes on daily living. The primary objective of this study was to develop and validate a new instrument, the Memory Impact Questionnaire (MIQ). RESEARCH DESIGN AND METHODS We examined the underlying component structure and psychometric properties of the MIQ in a sample of 205 community-dwelling older adults. RESULTS Principal component analysis revealed three clusters: (a) Lifestyle Restrictions, (b) Positive Coping, and (c) Negative Emotion. Comparisons of the corresponding subscale scores with scores on other instruments revealed good convergent and discriminant validity. In addition, the MIQ subscales and the total score showed good test-retest reliability (rs = 0.65-0.91) and internal consistency (αs = 0.87-0.93). DISCUSSION AND IMPLICATIONS This novel questionnaire can be used in both clinical and research settings to better understand the impact of memory changes on the day-to-day functioning of older adults and to monitor outcomes of support programs for this population.
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Affiliation(s)
- Komal T Shaikh
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Erica L Tatham
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Preeyam K Parikh
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Canada
| | | | - Jill B Rich
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Ontario, Canada
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25
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Hudes R, Rich JB, Troyer AK, Yusupov I, Vandermorris S. The impact of memory-strategy training interventions on participant-reported outcomes in healthy older adults: A systematic review and meta-analysis. Psychol Aging 2019; 34:587-597. [DOI: 10.1037/pag0000340] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Belleville S, Moussard A, Ansaldo AI, Belchior P, Bherer L, Bier N, Bohbot VD, Bruneau MA, Cuddy LL, Gilbert B, Jokel R, Mahalingam K, McGilton K, Murphy KJ, Naglie G, Rochon E, Troyer AK, Anderson ND. Rationale and protocol of the ENGAGE study: a double-blind randomized controlled preference trial using a comprehensive cohort design to measure the effect of a cognitive and leisure-based intervention in older adults with a memory complaint. Trials 2019; 20:282. [PMID: 31118095 PMCID: PMC6532200 DOI: 10.1186/s13063-019-3250-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 02/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Leisure activities can be both enjoyable and cognitively stimulating, and participation in such activities has been associated with reduced age-related cognitive decline. Thus, integrating stimulating leisure activities in cognitive training programs may represent a powerful and innovative approach to promote cognition in older adults at risk of dementia. The ENGAGE study is a randomized controlled, double-blind preference trial with a comprehensive cohort design that will test the efficacy and long-term impact of an intervention that combines cognitive training and cognitively stimulating leisure activities. METHODS One hundred and forty-four older adults with a memory complaint will be recruited in Montreal and Toronto. A particular effort will be made to reach persons with low cognitive reserve. Participants will be randomly assigned to one of two conditions: cognitive + leisure training (ENGAGE-MUSIC/SPANISH) or active control (ENGAGE-DISCOVERY). The ENGAGE-MUSIC/SPANISH training will include teaching of mnemonic and attentional control strategies, casual videogames selected to train attention, and classes in music or Spanish as a second language. The ENGAGE-DISCOVERY condition will comprise psychoeducation on cognition and the brain, low-stimulating casual videogames and documentary viewing with discussions. To retain the leisure aspect of the activities, participants will be allowed to exclude either music or Spanish at study entry if they strongly dislike one of these activities. Participants randomized to ENGAGE-MUSIC/SPANISH who did not exclude any activity will be assigned to music or Spanish based on a second random assignment. Training will be provided in 24 2-h sessions over 4 months. Outcomes will be measured at baseline, at 4-month follow-up, and at 24-month follow-up. The primary outcome will be cognitive performance on a composite measure of episodic memory (delayed recall scores for words and face-name associations) measured at baseline and at the 4-month follow-up. Secondary outcomes will include a composite measure of attention (speed of processing, inhibition, dual tasking, and shifting), psychological health, activities of daily living, and brain structure and function and long-term maintenance measured at the 24-month follow-up. Information on cognitive reserve proxies (education and lifestyle questionnaires), sex and genotype (apolipoprotein (Apo)E4, brain-derived neurotrophic factor (BDNF), and catechol-O-methyltransferase (COMT)) will be collected and considered as moderators of training efficacy. DISCUSSION This study will test whether a program combining cognitive training with stimulating leisure activities can increase cognition and reduce cognitive decline in persons at risk of dementia. TRIAL REGISTRATION NCT03271190 . Registered on 5 September 2017.
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Affiliation(s)
- S Belleville
- Université de Montréal, Montreal, Canada. .,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada.
| | - A Moussard
- Université de Montréal, Montreal, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - A I Ansaldo
- Université de Montréal, Montreal, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - P Belchior
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada.,McGill University, Montreal, Canada
| | - L Bherer
- Université de Montréal, Montreal, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - N Bier
- Université de Montréal, Montreal, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - V D Bohbot
- McGill University, Montreal, Canada.,Douglas Mental Health University Institute, Montreal, Canada
| | - M-A Bruneau
- Université de Montréal, Montreal, Canada.,Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - L L Cuddy
- Queen's University, Kingston, Canada
| | - B Gilbert
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - R Jokel
- University of Toronto, Toronto, Canada.,Baycrest Health Sciences, Toronto, Canada
| | | | - K McGilton
- University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute - the University Health Network, Toronto, Canada
| | - K J Murphy
- University of Toronto, Toronto, Canada.,Baycrest Health Sciences, Toronto, Canada
| | - G Naglie
- University of Toronto, Toronto, Canada.,Baycrest Health Sciences, Toronto, Canada
| | - E Rochon
- University of Toronto, Toronto, Canada.,Toronto Rehabilitation Institute - the University Health Network, Toronto, Canada
| | - A K Troyer
- University of Toronto, Toronto, Canada.,Baycrest Health Sciences, Toronto, Canada
| | - N D Anderson
- University of Toronto, Toronto, Canada.,Baycrest Health Sciences, Toronto, Canada
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27
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Troyer AK, Leach L, Vandermorris S, Rich JB. The measurement of participant-reported memory across diverse populations and settings: a systematic review and meta-analysis of the Multifactorial Memory Questionnaire. Memory 2019; 27:931-942. [PMID: 31020904 DOI: 10.1080/09658211.2019.1608255] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Multifactorial Memory Questionnaire (MMQ) is a participant-reported measure of memory satisfaction, ability, and strategy use. Initially validated with healthy older adults, it has since been used in many different populations and settings for a variety of purposes. We conducted a systematic review and meta-analysis of the measurement properties of the MMQ across multiple, diverse studies. METHODS The study was designed using the Consensus-Based Standards for the Selection of Health Measurement Instruments and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We calculated aggregate statistics and evaluated the methodological quality of 29 studies retrieved from PsycINFO, MEDLINE, EMBASE, and Web of Science. RESULTS Analyses revealed high-quality evidence for internal consistency, stability, measurement error, convergent validity, and known-groups validity of the three MMQ scales. There was moderate-quality evidence for responsiveness and structural validity, with some studies identifying separate factors for internal and external memory strategy use. Measurement properties were similar across languages, participant samples, and study designs. CONCLUSIONS The MMQ is a valid, reliable, and responsive measure across diverse settings and populations. Future research is needed to determine whether more detailed information can be obtained from the scales, specifically, internal versus external strategy use.
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Affiliation(s)
- Angela K Troyer
- a Neuropsychology and Cognitive Health Program, Baycrest Health Sciences , Toronto , Canada.,b Department of Psychology , University of Toronto , Toronto , Canada
| | - Larry Leach
- c Department of Psychology , Glendon College, York University , Toronto , Canada
| | - Susan Vandermorris
- a Neuropsychology and Cognitive Health Program, Baycrest Health Sciences , Toronto , Canada
| | - Jill B Rich
- a Neuropsychology and Cognitive Health Program, Baycrest Health Sciences , Toronto , Canada.,d Department of Psychology , York University , Toronto , Canada
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Herdman KA, Vandermorris S, Davidson S, Au A, Troyer AK. Comparable achievement of client-identified, self-rated goals in intervention and no-intervention groups: reevaluating the use of Goal Attainment Scaling as an outcome measure. Neuropsychol Rehabil 2018; 29:1600-1610. [DOI: 10.1080/09602011.2018.1432490] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Susan Vandermorris
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Sylvia Davidson
- Occupational Therapy, Baycrest Health Sciences, Toronto, Canada
- Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - April Au
- Department of Psychology, University of Toronto, Toronto, Canada
| | - Angela K. Troyer
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
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Vandermorris S, Davidson S, Au A, Sue J, Fallah S, Troyer AK. 'Accepting where I'm at' - a qualitative study of the mechanisms, benefits, and impact of a behavioral memory intervention for community-dwelling older adults. Aging Ment Health 2017; 21:895-901. [PMID: 27376167 DOI: 10.1080/13607863.2016.1181709] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Gain novel, in-depth insight into therapeutic mechanisms, benefits, and impact of a multi-modal behavioral memory intervention for older adults with concerns about memory. METHODS Participants were11 community-dwelling older adults (aged 63-88) who completed the Memory and Aging Program, an evidence-based multi-modal group intervention for normal age-related memory change. Semi-structured interviews were administered post-intervention. Responses were analyzed using qualitative content analysis until meaningful themes were agreed upon. RESULTS Analyses revealed a main theme of normalization as the overarching benefit of participation. The mechanism for this comprised both specific intervention content and the process of participating with others. A positive impact of the intervention was demonstrated at emotional (feelings of reassurance, hope, and confidence) and functional (increasing motivation for lifestyle change) levels; for some, there was a direct link between emotion and function. CONCLUSION This study highlighted a single, prominent therapeutic benefit of normalization, illustrated a dual mechanism for achieving this, and characterized a nuanced inter-relationship of the emotional and functional impact of the intervention for participants. Results support the notion that group behavioral interventions can educate, empower, and promote psychological well-being in older adults and may be an effective avenue to reduce risk of disease and promote sustained functional independence.
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Affiliation(s)
- Susan Vandermorris
- a Neuropsychology and Cognitive Health Program, Baycrest Health Sciences , Toronto , Canada
| | - Sylvia Davidson
- b Occupational Therapy, Baycrest Health Sciences , Toronto , Canada.,c Occupational Science & Occupational Therapy , University of Toronto , Toronto , Canada
| | - April Au
- d Department of Psychology , University of Toronto , Toronto , Canada
| | - Joanna Sue
- a Neuropsychology and Cognitive Health Program, Baycrest Health Sciences , Toronto , Canada.,e Department of Psychology , Queen's University , Kingston , Canada
| | - Shafagh Fallah
- f Kunin-Lunenfeld Applied and Evaluative Research Unit, Baycrest Health Sciences , Toronto , Canada
| | - Angela K Troyer
- a Neuropsychology and Cognitive Health Program, Baycrest Health Sciences , Toronto , Canada.,d Department of Psychology , University of Toronto , Toronto , Canada
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Au A, Vandermorris S, Rendell PG, Craik FIM, Troyer AK. Psychometric properties of the Actual Week test: a naturalistic prospective memory task. Clin Neuropsychol 2017; 32:1068-1083. [PMID: 28829248 DOI: 10.1080/13854046.2017.1360946] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Prospective memory is the ability to 'remember to remember' and a facet of memory important to everyday functioning. For older adults, prospective memory slips are a common concern. In the present study, we conducted an initial validation of a paper-and-pencil adaptation of the Actual Week test, and reported on internal consistency, inter-rater and test-retest reliability, convergent and divergent validity, as well as veridicality of the task. METHOD Fifty-eight healthy, community-dwelling older adults were recruited from a larger randomized controlled trial and tested at baseline. The Actual Week test was a naturalistic five-day prospective memory task where participants were assigned eight hypothetical tasks to remember per day for five days. Tasks were either time-cued or event-cued and regular (i.e. occurring daily) or irregular (i.e. varied each day). The proportion of tasks that were recorded as on time and accurate was used as the primary measure of performance. RESULTS The Actual Week test had good internal consistency (Kuder-Richardson: r > .8), intra-test (intraclass correlation: α > .9) and test-retest reliability (r = .76). There was also evidence for convergent and divergent validity. Task performance was associated with age, but not years of education or sex. CONCLUSION The Actual Week test demonstrated strong psychometric qualities and promising evidence for validity as a performance-based measure of everyday prospective memory in older adults. Avenues for future studies include extending the evidence for convergent validity and evaluating feasibility and utility with other clinical populations.
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Affiliation(s)
- April Au
- a Department of Psychology , University of Toronto , Toronto , Canada
| | - Susan Vandermorris
- b Neuropsychology and Cognitive Health Program , Baycrest Health Sciences , Toronto , Canada
| | - Peter G Rendell
- c Cognition and Emotion Research Centre, Australian Catholic University , Melbourne , Australia
| | - Fergus I M Craik
- a Department of Psychology , University of Toronto , Toronto , Canada.,d Rotman Research Institute, Baycrest Health Sciences , Toronto , Canada
| | - Angela K Troyer
- a Department of Psychology , University of Toronto , Toronto , Canada.,b Neuropsychology and Cognitive Health Program , Baycrest Health Sciences , Toronto , Canada
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Parikh PK, Troyer AK, Maione AM, Murphy KJ. The Impact of Memory Change on Daily Life in Normal Aging and Mild Cognitive Impairment. Gerontologist 2015; 56:877-85. [PMID: 26035897 DOI: 10.1093/geront/gnv030] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 02/07/2015] [Indexed: 02/04/2023] Open
Abstract
PURPOSE OF THE STUDY Older adults with age-normal memory changes and those with amnestic mild cognitive impairment (aMCI) report mild memory difficulties with everyday problems such as learning new names or remembering past events. Although the type and extent of memory changes in these populations have been well documented, little is known about how memory changes impact their everyday lives. DESIGN AND METHODS Using a qualitative research design, data were collected from three focus groups of older adults with normal memory changes (n = 23) and two focus groups of older adults with aMCI (n = 14). A thematic analysis using the constant comparative method was used to identify the impacts of memory change on key life domains. RESULTS Four major themes emerged from the two groups, including changes in feelings and views of the self, changes in relationships and social interactions, changes in work and leisure activities, and deliberate increases in compensatory behaviors. Participants described both positive and negative consequences of memory change, and these were more substantial and generally more adverse for individuals with aMCI than for those with age-normal memory changes. IMPLICATIONS There are similarities and important differences in the impact of mild memory change on the everyday lives of older adults with age-normal memory changes and those with aMCI. Findings underscore the need for clinical interventions that aim to minimize the emotional impact of memory changes and that increase leisure and social activity in individuals with aMCI.
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Affiliation(s)
- Preeyam K Parikh
- Department of Psychology, University of Toronto, Ontario, Canada
| | - Angela K Troyer
- Department of Psychology, University of Toronto, Ontario, Canada. Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Ontario, Canada.
| | - Andrea M Maione
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Kelly J Murphy
- Department of Psychology, University of Toronto, Ontario, Canada. Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Ontario, Canada
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Troyer AK, Rowe G, Murphy KJ, Levine B, Leach L, Hasher L. Development and evaluation of a self-administered on-line test of memory and attention for middle-aged and older adults. Front Aging Neurosci 2014; 6:335. [PMID: 25540620 PMCID: PMC4261807 DOI: 10.3389/fnagi.2014.00335] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 11/27/2014] [Indexed: 11/17/2022] Open
Abstract
There is a need for rapid and reliable Internet-based screening tools for cognitive assessment in middle-aged and older adults. We report the psychometric properties of an on-line tool designed to screen for cognitive deficits that require further investigation. The tool is composed of measures of memory and executive attention processes known to be sensitive to brain changes associated with aging and with cognitive disorders that become more prevalent with age. Measures included a Spatial Working Memory task, Stroop Interference task, Face-Name Association task, and Number-Letter Alternation task. Normative data were collected from 361 healthy adults age 50–79 who scored in the normal range on a standardized measure of general cognitive ability. Participants took the 20-minute on-line test on their home computers, and a subset of 288 participants repeated the test 1 week later. Analyses of the individual tasks indicated adequate internal consistency, construct validity, test-retest reliability, and alternate version reliability. As expected, scores were correlated with age. The four tasks loaded on the same principle component. Demographically-corrected z-scores from the individual tasks were combined to create an overall score, which showed good reliability and classification consistency. These results indicate the tool may be useful for identifying middle-aged and older adults with lower than expected scores who may benefit from clinical evaluation of their cognition by a health care professional.
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Affiliation(s)
- Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest Centre for Geriatric Care Toronto, ON, Canada ; Department of Psychology, University of Toronto Toronto, ON, Canada
| | - Gillian Rowe
- Neuropsychology and Cognitive Health Program, Baycrest Centre for Geriatric Care Toronto, ON, Canada ; Department of Psychology, University of Toronto Toronto, ON, Canada
| | - Kelly J Murphy
- Neuropsychology and Cognitive Health Program, Baycrest Centre for Geriatric Care Toronto, ON, Canada ; Department of Psychology, University of Toronto Toronto, ON, Canada
| | - Brian Levine
- Department of Psychology, University of Toronto Toronto, ON, Canada ; Rotman Research Institute, Baycrest Centre for Geriatric Care Toronto, ON, Canada
| | - Larry Leach
- Neuropsychology and Cognitive Health Program, Baycrest Centre for Geriatric Care Toronto, ON, Canada
| | - Lynn Hasher
- Department of Psychology, University of Toronto Toronto, ON, Canada ; Rotman Research Institute, Baycrest Centre for Geriatric Care Toronto, ON, Canada
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Wiegand MA, Troyer AK, Gojmerac C, Murphy KJ. Facilitating change in health-related behaviors and intentions: a randomized controlled trial of a multidimensional memory program for older adults. Aging Ment Health 2014; 17:806-15. [PMID: 23611105 DOI: 10.1080/13607863.2013.789000] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Many older adults are concerned about memory changes with age and consequently seek ways to optimize their memory function. Memory programs are known to be variably effective in improving memory knowledge, other aspects of metamemory, and/or objective memory, but little is known about their impact on implementing and sustaining lifestyle and healthcare-seeking intentions and behaviors. METHODS We evaluated a multidimensional, evidence-based intervention, the Memory and Aging Program, that provides education about memory and memory change, training in the use of practical memory strategies, and support for implementation of healthy lifestyle behavior changes. In a randomized controlled trial, 42 healthy older adults participated in a program (n = 21) or a waitlist control (n = 21) group. RESULTS Relative to the control group, participants in the program implemented more healthy lifestyle behaviors by the end of the program and maintained these changes 1 month later. Similarly, program participants reported a decreased intention to seek unnecessary medical attention for their memory immediately after the program and 1 month later. CONCLUSIONS Findings support the use of multidimensional memory programs to promote healthy lifestyles and influence healthcare-seeking behaviors. Discussion focuses on implications of these changes for maximizing cognitive health and minimizing impact on healthcare resources.
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Vandermorris S, Murphy KJ, Troyer AK. Age-related elevations in intraindividual variability on associative memory tasks. Aging, Neuropsychology, and Cognition 2013; 20:722-34. [DOI: 10.1080/13825585.2013.772557] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abstract
PRIMARY OBJECTIVE This study set out to examine the sensitivity of verbal fluency component scores in severe traumatic brain injury (TBI). RESEARCH DESIGN A retrospective cross-sectional design was used, with control participants chosen at random from the community and TBI patients from litigation cases. METHODS AND PROCEDURES Fifty-four healthy controls and 28 patients who had incurred a severe TBI were included in the study. The Controlled Oral Word Association test was rescored to include clustering and switching scores for phonemic and semantic fluency separately. The scores were compared between controls and TBI patients using independent samples t-tests. MAIN OUTCOMES AND RESULTS The findings demonstrate that component scores for semantic fluency yielded the largest effect sizes overall (d = 1.32 and d = 1.53), but not phonemic fluency. Total words generated in phonemic fluency yielded the largest effect size, although still modest (d = 0.62). CONCLUSIONS While verbal fluency may be a useful test tool to elicit evidence of neuropsychological impairment after TBI, these findings are consistent with previous research demonstrating that component scores are more sensitive indices. There is potential clinical utility in using component scores for examining the specific severity of verbal fluency impairment in TBI and guiding rehabilitation efforts.
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Troyer AK, Murphy KJ, Anderson ND, Craik FI, Moscovitch M, Maione A, Gao F. Associative recognition in mild cognitive impairment: Relationship to hippocampal volume and apolipoprotein E. Neuropsychologia 2012; 50:3721-8. [PMID: 23103838 DOI: 10.1016/j.neuropsychologia.2012.10.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 10/16/2012] [Accepted: 10/19/2012] [Indexed: 10/27/2022]
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Ossher L, Bialystok E, Craik FIM, Murphy KJ, Troyer AK. The effect of bilingualism on amnestic mild cognitive impairment. J Gerontol B Psychol Sci Soc Sci 2012; 68:8-12. [PMID: 22454387 DOI: 10.1093/geronb/gbs038] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Previous reports have found that lifelong bilingualism is associated with a delay in the onset of dementia, including Dementia of the Alzheimer's Type (DAT). Because amnestic mild cognitive impairment (aMCI) is often a transition stage between normal aging and DAT, our aim in this paper was to establish whether this delay in symptom onset for bilinguals would also be seen in the onset of symptoms of aMCI and whether this delay would be consistent in different subtypes of aMCI. METHOD We examined the effect of bilingualism on the age of diagnosis in individuals with single- or multiple-domain aMCI who were administered a battery of neuropsychological tests and questionnaires about their language and social background. RESULTS Our results showed an interaction between aMCI type and language history. Only individuals diagnosed with single-domain aMCI demonstrated a later age of diagnosis for bilinguals (M = 79.4 years) than monolinguals (M = 74.9 years). DISCUSSION This preliminary evidence suggests that the early protective advantage of bilingualism may be specific to single-domain aMCI, which is the type of aMCI most specifically associated with progression to DAT.
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Affiliation(s)
- Lynn Ossher
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, MI 48109, USA.
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Abstract
We set out to examine the sensitivity of switching and clustering component scores of verbal fluency in patients with mild traumatic brain injury (mTBI). Clustering and switching scores were compared between patients with mTBI and healthy normal controls as well as those with moderate TBI and severe TBI. Fifty-four healthy controls along with 20 mild TBI, 8 moderate TBI, and 12 severe TBI patients were included in the study. Our findings demonstrate that component score effect sizes were larger than those of total words generated for both phonemic and semantic fluency. This pattern of finding held true regardless of comparison group. In addition, semantic fluency component scores were found to correspond to larger component score effect sizes than did phonemic fluency component scores. Our findings demonstrate that component scores derived from the Controlled Oral Word Association Test may be sufficient to reliably capture the effects of unremitting injury (i.e., more than 3 months post status) to the frontal and temporal brain as evinced in cases of unremitting mTBI. This differential pattern of performance provides preliminary evidence for the potential usefulness of switching and clustering in the assessment of mTBI. Given the small sample sizes employed in our study, however, future studies are needed to determine whether component measures of verbal fluency have discriminative ability.
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Troyer AK, D'Souza* NA, Vandermorris S, Murphy KJ. Age-related differences in associative memory depend on the types of associations that are formed. Aging, Neuropsychology, and Cognition 2011; 18:340-52. [DOI: 10.1080/13825585.2011.553273] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Troyer AK. Improving Memory Knowledge, Satisfaction, and Functioning Via an Education and Intervention Program for Older Adults. Aging, Neuropsychology, and Cognition 2010. [DOI: 10.1076/anec.8.4.256.5642] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Murphy KJ, Troyer AK, Levine B, Moscovitch M. Episodic, but not semantic, autobiographical memory is reduced in amnestic mild cognitive impairment. Neuropsychologia 2008; 46:3116-23. [PMID: 18675285 PMCID: PMC2629588 DOI: 10.1016/j.neuropsychologia.2008.07.004] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Revised: 06/25/2008] [Accepted: 07/07/2008] [Indexed: 11/24/2022]
Abstract
Amnestic mild cognitive impairment (aMCI) is characterized by decline in anterograde memory as measured by the ability to learn and remember new information. We investigated whether retrograde memory for autobiographical information was affected by aMCI. Eighteen control (age 66-84 years) and 17 aMCI (age 66-84 years) participants described a personal event from each of the five periods across the lifespan. These events were transcribed and scored according to procedures that separate episodic (specific happenings) from semantic (general knowledge) elements of autobiographical memory. Although both groups generated protocols of similar length, the composition of autobiographical recall differentiated the groups. The aMCI group protocols were characterized by reduced episodic and increased semantic information relative to the control group. Both groups showed a similar pattern of recall across time periods, with no evidence that the aMCI group had more difficulty recalling recent, rather than remote, life events. These results indicate that episodic and semantic autobiographical memories are differentially affected by the early brain changes associated with aMCI. Reduced autobiographical episodic memories in aMCI may be the result of medial temporal lobe dysfunction, consistent with multiple trace theory, or alternatively, could be related to dysfunction of a wider related network of neocortical structures. In contrast, the preservation of autobiographical semantic memories in aMCI suggests neural systems, such as lateral temporal cortex, that support these memories, may remain relatively intact.
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Affiliation(s)
- Kelly J Murphy
- Department of Psychology, Baycrest, 3560 Bathurst Street, Toronto, Ontario, Canada, M6A 2E1.
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Davidson PSR, Anaki D, Ciaramelli E, Cohn M, Kim ASN, Murphy KJ, Troyer AK, Moscovitch M, Levine B. Does lateral parietal cortex support episodic memory? Evidence from focal lesion patients. Neuropsychologia 2008; 46:1743-55. [PMID: 18313699 PMCID: PMC2806230 DOI: 10.1016/j.neuropsychologia.2008.01.011] [Citation(s) in RCA: 163] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Revised: 01/05/2008] [Accepted: 01/08/2008] [Indexed: 11/18/2022]
Abstract
Although neuroimaging and human lesion studies agree that the medial parietal region plays a critical role in episodic memory, many neuroimaging studies have also implicated lateral parietal cortex, leading some researchers to suggest that the lateral region plays a heretofore underappreciated role in episodic memory. Because there are very few extant lesion data on this matter, we examined memory in six cases of focal lateral parietal damage, using both clinical and experimental measures, in which we distinguished between recollection and familiarity. The patients did not have amnesia, but they did show evidence of disrupted recollection on an anterograde memory task. Although the exact mechanisms remain to be elucidated, lateral parietal damage appears to impair some aspects of episodic memory.
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Troyer AK, Murphy KJ, Anderson ND, Moscovitch M, Craik FIM. Changing everyday memory behaviour in amnestic mild cognitive impairment: A randomised controlled trial. Neuropsychol Rehabil 2008; 18:65-88. [DOI: 10.1080/09602010701409684] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Troyer AK, Murphy KJ, Anderson ND, Hayman-Abello BA, Craik FIM, Moscovitch M. Item and associative memory in amnestic mild cognitive impairment: Performance on standardized memory tests. Neuropsychology 2008; 22:10-6. [PMID: 18211151 DOI: 10.1037/0894-4105.22.1.10] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Angela K Troyer
- Department of Psychology, Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada.
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Troyer AK, Graves RE, Cullum CM. Executive functioning as a mediator of the relationship between age and episodic memory in healthy aging. Aging, Neuropsychology, and Cognition 2007. [DOI: 10.1080/09289919408251449] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Troyer AK, Murphy KJ. Memory for intentions in amnestic mild cognitive impairment: time- and event-based prospective memory. J Int Neuropsychol Soc 2007; 13:365-9. [PMID: 17286894 DOI: 10.1017/s1355617707070452] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2006] [Revised: 10/16/2006] [Accepted: 10/20/2006] [Indexed: 11/05/2022]
Abstract
Amnestic mild cognitive impairment (aMCI) is associated with neuropathological changes in medial-temporal and frontal-system structures. By definition, retrospective memory is mildly impaired in aMCI. We examined whether prospective memory (PM) is also impaired, in particular time-based PM, which requires considerable self-initiation and inhibition. We administered time- and event-based PM tasks to 42 healthy older adults, 45 individuals with aMCI, and 24 individuals with Alzheimer's disease (AD). The healthy group performed better than the aMCI group, and the aMCI group performed better than the AD group on both PM tasks. Importantly, the aMCI group performed more poorly on the time- than event-based task, whereas the other groups performed comparably on both tasks. Findings suggest that PM, particularly time-based PM, is sensitive to the earliest cognitive changes associated with aMCI, possibly reflecting decreased self-initiation, attention switching, and/or inhibition on memory tasks because of early involvement of the frontal system.
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Affiliation(s)
- Angela K Troyer
- Psychology Department, Baycrest Centre for Geriatric Care, Toronto, Ontario.
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Troyer AK, Leach L, Strauss E. Aging and response inhibition: Normative data for the Victoria Stroop Test. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2006; 13:20-35. [PMID: 16766341 DOI: 10.1080/138255890968187] [Citation(s) in RCA: 139] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Increased difficulty with response inhibition occurs with age, although there is some controversy as to whether increased interference on Stroop tasks reflects difficulties with response inhibition or simply reflects generalized cognitive slowing. The Victoria Stroop Test (VST) is a brief, easily administered, psychometrically sound version of Stroop's original task. Performance on the VST by adults across a wide age span was examined to determine the association between age and various measures of interference. In addition, normative data for the VST were calculated. Participants were 272 healthy, community-dwelling adults age 18 to 94. Age and speed were negatively correlated on all trials of the VST. Importantly, however, interference scores that were corrected for baseline slowing remained highly correlated with age. Similarly, age and error scores on the interference trial were positively correlated, indicating decreased accuracy with age. These findings suggest that increased interference on Stroop tasks with age is not accounted for by simple cognitive slowing and more likely reflects other cognitive changes, such as decreased response inhibition. The VST has a number of administrative and psychometric strengths, and the provision of normative data should enhance its potential for clinical and research applications.
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Affiliation(s)
- Angela K Troyer
- Psychology Department, Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada.
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Abstract
Amnestic mild cognitive impairment (aMCI) represents a high-risk factor for Alzheimer's disease (AD) and is characterized by a selective decline in episodic memory. Although by definition aMCI is not associated with impaired verbal fluency performance, we examined relative differences between fluency tasks because AD is characterized by poorer semantic than phonemic fluency. Phonemic and semantic fluency trials were administered to 46 healthy controls, 33 patients with aMCI, and 33 patients with AD. Results revealed a progressive advantage (controls > aMCI > AD) in semantic, relative to phonemic fluency. Difference scores between tasks distinguished each group from the others with medium to large effect sizes (d) ranging from 0.49 to 1.07. Semantic fluency relies more on semantic associations between category exemplars than does phonemic fluency. This aMCI fluency pattern reflects degradation of semantic networks demonstrating that initial neuropathology may extend beyond known early changes in hippocampal regions.
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Affiliation(s)
- Kelly J Murphy
- Psychology Department, Baycrest Centre for Geriatric Care, Toronto, Ontario, Canada.
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49
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Davidson PSR, Troyer AK, Moscovitch M. Frontal lobe contributions to recognition and recall: linking basic research with clinical evaluation and remediation. J Int Neuropsychol Soc 2006; 12:210-23. [PMID: 16573855 DOI: 10.1017/s1355617706060334] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2005] [Revised: 07/19/2005] [Accepted: 07/19/2005] [Indexed: 11/05/2022]
Abstract
The role of the human frontal lobes in episodic memory is becoming better understood, thanks mainly to focal lesion and neuroimaging studies. Here we review some recent findings from basic research on the frontal lobes in memory encoding, search, and decision-making at retrieval. For each of these processes, researchers have uncovered cases in which frontal memory impairments can be attenuated by various task manipulations. We suggest ways in which these findings may inform clinical evaluation and rehabilitation of memory problems following frontal damage.
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Affiliation(s)
- Patrick S R Davidson
- The Rotman Research Institute, Baycrest Centre for Geriatric Care, 3560 Bathurst Street, Toronto, Ontario M6A 2E1, Canada.
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50
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Troyer AK, Häfliger A, Cadieux MJ, Craik FIM. Name and Face Learning in Older Adults: Effects of Level of Processing, Self-Generation, and Intention to Learn. J Gerontol B Psychol Sci Soc Sci 2006; 61:P67-74. [PMID: 16497956 DOI: 10.1093/geronb/61.2.p67] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Many older adults are interested in strategies to help them learn new names. We examined the learning conditions that provide maximal benefit to name and face learning. In Experiment 1, consistent with levels-of-processing theory, name recall and recognition by 20 younger and 20 older adults was poorest with physical processing, intermediate with phonemic processing, and best with semantic processing. In Experiment 2, name and face learning in 20 younger and 20 older adults was maximized with semantic processing of names and physical processing of faces. Experiment 3 showed a benefit of self-generation and of intentional learning of name-face pairs in 24 older adults. Findings suggest that memory interventions should emphasize processing names semantically, processing faces physically, self-generating this information, and keeping in mind that memory for the names will be needed in the future.
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Affiliation(s)
- Angela K Troyer
- Psychology Department, Baycrest Centre for Geriatric Care, 3560 Bathurst Street, Toronto, Ontario M6A 2E1, Canada.
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