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At least 181 records · Page 10Linked to original sources
PubMed2001

Do self-help interventions in health education lead to cognitive changes, and do cognitive changes lead to behavioural change?

OBJECTIVES: The present study examined the extent to which self-help interventions change specific cognitions and the extent to which changes in such cognitions are related to behavioural changes. DESIGN: A randomized field experiment with follow-ups after 2 weeks and 3 months. METHOD: Smokers (N = 1546) were randomly assigned to one of four conditions offering smoking cessation self-help materials containing (1) outcome information, (2) self-efficacy enhancing information, (3) both sorts of information, or (4) no information. RESULTS: First, with regard to behavioural effects, only self-help interventions that included self-efficacy enhancing information were more effective than no information. Second, with regard to the cognitive changes, the data showed that outcome information led to increase in expected positive outcomes but also to increases in self-efficacy expectations. Further, self-efficacy-enhancing information led to increases in self-efficacy. Third, different cognitive changes between T1 and T2 were related to different types of quitting activity at T3 in different groups of smokers. CONCLUSIONS: Some types of information lead to specific cognitive changes, while other types have more generalized cognitive effects. Further, cognitive changes produced by a self-help intervention predict future quitting activity.

Clinical Trial↗
PubMed2000

Measurement of cognitive performance in computer programming concept acquisition: interactive effects of visual metaphors and the cognitive style construct.

An innovative research program was devised to investigate the interactive effect of instructional strategies enhanced with text-plus-textual metaphors or text-plus-graphical metaphors, and cognitive style on the acquisition of programming concepts. The Cognitive Styles Analysis (CSA) program (Riding,1991) was used to establish the participants' cognitive style. The QUEST Interactive Test Analysis System (Adams and Khoo,1996) provided the cognitive performance measuring tool, which ensured an absence of error measurement in the programming knowledge testing instruments. Therefore, reliability of the instrumentation was assured through the calibration techniques utilized by the QUEST estimate; providing predictability of the research design. A means analysis of the QUEST data, using the Cohen (1977) approach to size effect and statistical power further quantified the significance of the findings. The experimental methodology adopted for this research links the disciplines of instructional science, cognitive psychology, and objective measurement to provide reliable mechanisms for beneficial use in the evaluation of cognitive performance by the education, training and development sectors. Furthermore, the research outcomes will be of interest to educators, cognitive psychologists, communications engineers, and computer scientists specializing in computer-human interactions.

Aptitude Tests↗
PubMed2002

Low cholesterol, cognitive function and Alzheimer s disease in a community population with cognitive impairment.

BACKGROUND: The association between cholesterol levels, cognitive impairment and dementia is controversial. OBJECTIVES: To investigate differences in serum total cholesterol levels between mild and moderate cognitive impairment and between dementia syndromes. To investigate the association between cholesterol level and progression of Alzheimer s disease (AD). DESIGN: Non-fasting cholesterol levels were measured in two groups: a) 291 participants in a community study in South Korea, aged 65 or over, and scoring below 25 on the Mini-Mental State Examination (Korean version: MMSE-K); and b) 79 patients with AD attending a local hospital. In the community sample, associations were investigated between cholesterol level and both cognitive function and dementia (DSM-IV). For the hospital sample, associations were investigated between cholesterol level and decline in cognitive function (MMSE-K) and/or functional activities of daily living (ADL, Blessed Dementia Scale) over one year. RESULTS: Lower serum cholesterol level was associated with worse cognitive function in the community sample. Associations with dementia were specific to AD rather than other subtypes. No cross-sectional association was found between cholesterol levels and cognitive function in AD groups from either sample. No prospective associations were found between cholesterol level and decline of cognitive function or functional ADL in hospital attenders with AD. Adjustment for age, gender, education, past occupation, disablement, duration of dementia, and the presence of APOE e4 made little difference to the associations in the hospital sample. CONCLUSION: Lower serum cholesterol level may be a state marker of AD but does not appear to influence its rate of progression.

Journal Article↗
PubMed1996

Informant ratings of cognitive decline of elderly people: relationship to longitudinal change on cognitive tests

Formal assessment of cognitive decline with cognitive tests can be difficult, requiring either two measurement points or a comparison of 'hold' with 'don't hold' tests. Informant-based assessment provides an alternative approach because informants can adopt a longitudinal perspective and directly rate cognitive change. A study was carried out to assess the validity of informant ratings collected by means of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). A community sample of 500 subjects aged 74 or over underwent four cognitive tests on two occasions 3½ years apart. On the second occasion, informants filled out the IQCODE. Subjects rated as having moderate or severe decline were found to have greater change on the cognitive tests. These findings support the validity of informant ratings of cognitive decline.

Journal Article↗
PubMed2001

Depressive symptoms among cognitively normal versus cognitively impaired elderly subjects.

OBJECTIVES: The present cross-sectional study analyzed the prevalence and severity of depressive symptoms among patients with Alzheimer's disease (DAT), vascular dementia (VAD), and among the cognitively normal elderly. Putative risk factors contributing to depression were likewise evaluated. METHODS: Seventy-six DAT patients, 51 VAD patients, and 121 cognitively normal subjects were admitted to the study. Questionnaires concerning demography and their vascular and familial risk factors together with results of neuropsychological testing by combined Mini-Mental Status Examinations (MMSE), Cognitive Capacity Screening Examinations (CCSE), and Hamilton Depression Rating Scales (HDRS) were obtained so that resulting data would be statistically analyzed. RESULTS: Prevalence of depressive symptoms among VAD, DAT, and cognitively normal elderly were 31.4%, 19.9%, and 13.2%, respectively. 25.5% of VAD and 13.2% of DAT patients had depression of mild to moderate degrees. Regression analysis revealed that diagnosis of VAD and DAT, heart disease, and past history of depression was significantly associated with high HDRS scores. There was no correlation between degree of depression and severity of cognitive impairments. CONCLUSION: Mild to moderate depression is a common comorbidity with organic dementia, especially VAD, but associated depression is independent of severity of cognitive impairments.

Aged↗
PubMed2007

Cognitive-behavioral management of chemotherapy-related cognitive change.

Adjuvant chemotherapy can produce mild cognitive decline among breast cancer survivors which adversely effects function and quality of life. However, no treatment to date has been proposed or developed for this problem despite large numbers of cancer patients who report post-treatment memory dysfunction. This paper presents data from a single arm pilot study of a brief cognitive-behavioral treatment aimed at helping breast cancer survivors manage cognitive dysfunction associated with adjuvant chemotherapy (Memory and Attention Adaptation Training; MAAT). Participants were twenty-nine women who were an average of 8 years post-chemotherapy for stage I and II breast cancer. All had reported complaints regarding memory and attention. Improvements in self-report of cognitive function, quality of life and standard neuropsychological test performance were observed at post-treatment, 2-month and 6-month follow-up. Participants also reported high treatment satisfaction and rated MAAT as helpful in improving ability to compensate for memory problems. Given these results, the treatment appears to be a feasible and practical cognitive-behavioral program that warrants continued evaluation among cancer survivors who experience persistent cognitive dysfunction.

Adult↗
PubMed2006

Outcomes of a computer-based cognitive rehabilitation program on Alzheimer's disease patients compared with those on patients affected by mild cognitive impairment.

The aim of the present study is to evaluate the outcomes of a computer-based cognitive training on patients affected by Alzheimer's disease (AD) compared with the outcomes on patients affected by mild cognitive impairment (MCI), multiple system atrophy (MSA). Ten AD patients aged 74.1+/-5.6 years, with mini-mental state examination (MMSE) score at baseline of 23.9+/-2.4, and 10 MCI patients aged 70.6+/-6.0 years, with MMSE score of 28.0+/-1.4, attending our day-hospital of neurorehabilitation were selected for the study. Three MSA patients aged 69.0+/-9.5 years, MMSE scores 26.7+/-2.3 were selected from the same setting in order to have a different control group. Each patient attended two training programs and was evaluated according to cognitive and non-cognitive functions at baseline at the end of the second training program. The AD group showed a significant MMSE score improvement (p=0.010). On the contrary, MMSE scores at baseline and at follow-up remained quite stable in the other two groups. AD patients also showed significant improvement in the areas of verbal production (p=0.036) and executive functions (p=0.050). MCI patients significantly improved in behavioral memory (p=0.017; p=0.011). No significant improvement was observed in MSA group. Our data seem to indicate that the same individualized rehabilitative intervention could have different effects according to patient's diagnosis. MCI and AD patients had significant improvements in global cognitive status and/or in specific cognitive areas. On the contrary, MSA patients did not benefit at all.

Aged↗
PubMed2005

Focus on "cognition" in cognitive behavior therapy for ocd: is it really necessary?

The past decade has witnessed a significant shift toward a more cognitive emphasis in our understanding and treatment of obsessive-compulsive disorders (OCD). This article discusses the shortcomings in more standard behavioral treatment of OCD, which despite its demonstrated efficacy, led to the recent cognitive-behavioral approaches to the disorder. Current cognitive behavior therapy for OCD is described and a short critical review of the comparative treatment outcome literature on cognitive behavior therapy vs exposure and response prevention is provided. The article concludes that although the clinical utility of a more cognitive approach to OCD has not been consistently demonstrated, it would be premature to abandon cognitive formulations until some key research questions have been addressed.

Cognition↗
PubMed2005

Is cognitive reserve applicable to epilepsy? The effect of educational level on the cognitive decline after onset of epilepsy.

PURPOSE: The aim of this study was to know the effect of education level (EL) on the cognitive change after onset of epilepsy. The rationale is that people with high EL may have more cognitive reserve and show resistance to damage brought about by epilepsy. METHODS: Patients were from an outpatient epilepsy clinic of a national university hospital. All received initial and repeated neuropsychological tests and the Cognitive Ability Screening Instrument (CASI), at an interval of 12 months. CASI consists of nine items, with a total score of 100. We compared the differences between the two tests, in terms of z-scores. The EL was divided into high and low with a cut-off at 12 years, and age at entry was divided with a cut-off at 38 years. Epilepsy severity was divided into intractable and nonintractable. RESULTS: A total of 64 patients completed the study, including 31 with high EL and 33 with low EL, with no differences in gender and epilepsy severity between groups. In general, patients had cognitive impairment in multiple domains. At the baseline, the effect of EL was found for all items except remote memory and orientation, whereas the effect of age was observed for remote and recent memory. At the 12-month follow-up, subjects with high EL showed deterioration in mental manipulation, whereas subjects with low EL showed improvement in verbal fluency but deterioration in attention. CONCLUSIONS: Patients with high EL have better cognitive functioning than those with low EL after epilepsy has developed, which supports the cognitive reserve theory. However, 1-year follow-up might be too short to see significant changes between groups.

Adult↗
PubMed2006

Investigating cognitive genetics and its implications for the treatment of cognitive deficit.

Cognitive impairment in the elderly, caused by either normal ageing process or dementia, is an increasing problem in developed countries that has enormous social and economic considerations. Research investigating the genetic basis of cognition is a new and rapidly developing field that may aid in the development of new treatments for age-related cognitive deficit. Over the past 6 years, a number of quantitative trait loci (QTLs) have been associated with cognitive functioning in humans including loci within the genes catechol-o-methyltransferase, brain-derived neurotrophic factor, muscle segment homeobox 1, serotonin transporter 2A (HTR2A), cholinergic muscarinic receptor 2, cathepsin D, metabotrophic glutamate receptor and most recently the class II human leukocyte antigens. Unfortunately, inconsistency within the literature, which is a hallmark of almost all association studies investigating complex diseases and traits, is casting doubt as to which genes are truly associated with cognition and which are a result of Type 2 error. This review will highlight implicated intelligence QTLs, examine the probable reasons for the current discrepancies between reports and discuss the potential advantages that may be procured from the study of cognitive genetics.

Aging↗
PubMed2004

Validity of the Mindstreams computerized cognitive battery for mild cognitive impairment.

The NeuroTrax Mindstreams computerized cognitive assessment system was designed for widespread clinical and research use in detecting mild cognitive impairment (MCI). However, the capability of Mindstreams tests to discriminate the elderly with MCI from those who are cognitively healthy has yet to be evaluated. Moreover, the comparability between these tests and traditional neuropsychological tests in detecting MCI has not been examined. A two-center study was designed to assess the discriminant validity of tests in the Mindstreams Mild Impairment Battery. Participants were 30 individuals diagnosed with MCI, 29 with mild Alzheimer's disease (AD), and 39 healthy elderly. Testing was with the Mindstreams battery and traditional neuropsychological tests. Receiver operating characteristic (ROC) analysis was used to examine the ability of Mindstreams and traditional measures to discriminate those with MCI from cognitively healthy elderly. Between-group comparisons were made (Mann-Whitney U test) between MCI and healthy elderly and between MCI and mild AD groups. Mindstreams outcome parameters across multiple cognitive domains significantly discriminated between MCI and healthy elders with considerable effect sizes (p < 0.05). Measures of memory, executive function, visual spatial skills, and verbal fluency discriminated best, and discriminability was at least comparable to that of traditional neuropsychological tests in these domains. Mindstreams tests are effective in detecting MCI, providing a comprehensive profile of cognitive function. Further, the enhanced precision and ease of use of these computerized tests make the NeuroTrax system a valuable clinical tool in the identification of elders at high risk for dementia.

Aged↗
PubMedDate not supplied

[Position test: an instrument for measuring the cognitive plasticity in the elderly with mild cognitive impairment].

INTRODUCTION: The search for variables that mediate in the shift from mild cognitive impairment (MCI) to dementia is currently a very active field of research. In this area, the term cognitive plasticity or modifiability can be of great interest. Proof of the existence of plasticity in the elderly with MCI and its possible value as an indicator of the shift from this condition to dementia have aroused an interest in investigating evaluation tools that enable the evaluation of plasticity in old age. AIMS. In this study we assess the validity of the position test (PT) as a measure of cognitive plasticity in the elderly and we examine its existence in people with MCI. PATIENTS AND METHODS: A total of 117 elderly subjects were evaluated with the Spanish version of the MMSE (Minimental State Examination) as a screening test for cognitive impairment, the AVLT LP (Auditory Verbal Learning Test Learning Potential), a test that is frequently used to evaluate plasticity, and the PT. RESULTS: Findings show that the PT evaluates cognitive plasticity in the elderly suffering from MCI, that it is possible to shorten the test without losing its evaluative properties and that performance in the test is not affected by educational level. Furthermore, it also reveals the fact that some elderly people with MCI show plasticity. CONCLUSION: The data obtained allow us to state that the PT is ideal for evaluating plasticity in the elderly, and we also recommend further research into plasticity and its possible relation with the cognitive progress of people with MCI.

Aged↗
PubMed2006

Perspectives on depression, mild cognitive impairment, and cognitive decline.

CONTEXT: The public health implications of depression and cognitive impairment in late life are enormous. Cognitive impairment and late-life depression are associated with increased risk for subsequent dementia; however, investigations of these phenomena appear to be proceeding along separate tracks. OBJECTIVES AND DATA SOURCE: The National Institute of Mental Health organized the conference "Perspectives on Depression, Mild Cognitive Impairment, and Cognitive Decline" to consider how the varied perspectives might be better integrated to examine the associations among depression, mild cognitive impairment, and cognitive decline and to illuminate the common or distinct mechanisms involved in these associations. DATA SYNTHESIS: The following 2 broad questions were addressed: (1) What gaps in our knowledge have the greatest public health significance? (2) Can we more efficiently use our research dollars and participant resources to fill these gaps? Meeting participants included grantees from the National Institute of Mental Health and the National Institute on Aging and program staff from the National Institute of Mental Health, the National Institute on Aging, and the National Institute of Neurological Disorders and Stroke. CONCLUSIONS: One of the most important recommendations to emerge from the meeting discussions is for increased collaboration among clinical and epidemiological investigators whose work focuses in the area of depression with those working primarily in the area of memory disorders. Directions for future research were identified.

Aged↗
PubMed2007

Efficacy of cognitive rehabilitation in patients with mild cognitive impairment treated with cholinesterase inhibitors.

BACKGROUND: Individuals who have Mild Cognitive Impairment (MCI) may be in a transitional stage between aging and Alzheimer's disease (AD). The high rate of conversion from MCI to AD makes early treatment an important clinical issue. Recent evidence suggests that cognitive training intervention may reduce the rate of progression to AD. OBJECTIVES: To evaluate the efficacy of a NeuroPsychological Training (TNP) in patients with MCI who are treated with cholinesterase inhibitors (ChEIs), compared with patients MCI treated only with ChEIs and patients not treated, in a longitudinal, one year follow-up study. METHODS: One year longitudinal and retrospective comparison study of neuropsychological performances in 59 subjects affected by Mild Cognitive Impairment (MCI) according to Petersen's criteria. Fifteen subjects were randomised to receive TNP plus cholinesterase inhibitors; 22 subjects cholinesterase inhibitors alone and 22 subjects no treatment. All the subjects referring memory complaints, corroborated by an informant, underwent a multidimensional assessment concerning neuropsychological, behavioural and functional characteristics, at baseline and after one year follow-up. RESULTS: Subjects without treatment maintained their cognitive, functional and behavioural status after one year; patients treated only with ChEIs improved in depressive symptoms whereas subjects treated with TNP and ChEIs showed significant improvements in different cognitive areas, such as memory, abstract reasoning and in behavioural disturbances, particularly depressive symptoms. CONCLUSIONS: A long-term TNP in ChEIs-treated MCI subjects induces additional cognitive and mood benefits.

Activities of Daily Living↗
PubMed2002

Screening for mild cognitive impairment (MCI) utilizing combined mini-mental-cognitive capacity examinations for identifying dementia prodromes.

OBJECTIVE: To test correctness of results when combining Mini-Mental State Examination (MMSE) and Cognitive Capacity Screening Examination (CCSE) for identifying mild cognitive impairment (MCI) among non-demented elderly subjects at risk for developing dementia. METHODS: A retrospective study was conducted among consecutively referred volunteers with memory complaints to a research out-patient clinic. Two cognitive screening tests (MMSE and CCSE) were performed according to established protocol. Resulting combined screening test (termed by acronym as CMC) combined the non-overlapping test items derived from both MMSE and CCSE. Conversion to dementia at follow-up served as the 'gold-standard' for evaluating correctness of CMC for identifying MCI. RESULTS: Of 351 subjects completing cognitive assessments and meeting requirements for study protocol, 84 (23.9%) developed dementia of different types within 3-6 years (3.89 +/- 2.17) of follow-up. Among these, 47 met criteria for probable Alzheimer disease (AD), 22 for probable vascular dementia (VaD), 12 for mixed AD/VaD and three for probable frontotemporal dementia. When final diagnosis of AD was used as the 'gold standard' for testing correctness of MCI identified by cognitive screening tests, sensitivities of MMSE, CCSE and CMC for identifying MCI were relatively 61.0%, 74.3% and 83.1% with minimum specificity set at 80%. When diagnosis of all types of dementia was used as the standard for testing predictive correctness of MCI, CCSE emerged as an optimal MCI screening test. CONCLUSION: Combining the CCSE and MMSE screening tests resulted in higher sensitivity than was achieved by MMSE alone and maintained specificity at comparable levels for identifying MCI. The results confirmed that CMC has optimal correctness and utility as a brief cognitive test for screening MCI as a prodrome for dementia among non-demented elderly populations.

Aged↗
PubMed1984

Cognitive versus behavioral procedures in cognitive-behavior therapy: a critical review of the evidence.

During the past decade there has been an increasing emphasis on cognition in psychology and behavior therapy. This movement has spawned several distinctive cognitive therapies. While those therapies do employ innovative cognitive treatment procedures, they often do so in the context of well-established behavioral treatment procedures which may or may not be acknowledged by the label "cognitive-behavior therapy". This paper addresses the question of whether cognitive therapy is an evolutionary or revolutionary development from behavior therapy and critically evaluates the evidence for the efficacy of procedures specific to cognitive therapy.

Agoraphobia↗
PubMed1995

One-session cognitive treatment of dental phobia: preparing dental phobics for treatment by restructuring negative cognitions.

The purpose of this study was to investigate the effectiveness of a single session of cognitive restructuring in a sample of phobic dental patients. Fifty-two patients were randomly assigned to one of three conditions: cognitive restructuring (modification of negative cognitions), provision of information (about oral health and dental treatment), and a waiting list control condition. Both interventions maximally lasted one hour. In comparison with the waiting list control condition and the information intervention condition, the cognitive intervention condition not only showed a large decrease in frequency and believability of negative cognitions, but also exhibited a clear decline in dental trait anxiety. Analysis at a follow-up of one year demonstrated a further, drastic reduction in dental anxiety in both intervention conditions, wherein the difference among these conditions was not maintained. It is concluded that it is possible to obtain substantial reductions of dental trait anxiety through a single session of cognitive restructuring. Nevertheless, repeated exposure to the dental situation seems necessary for a further reduction of anxiety.

Adolescent↗
PubMed1982

Cognitive and cognitive-behavioral methods for pain control: a selective review.

The literature on cognitive and cognitive-behavioral methods for pain control is selectively reviewed, with particular focus on controlled studies. Such methods include the provision of preparatory information, cognitive coping skills or strategies, the provision of preparatory information plus some form of coping skills instructions or training, prepared childbirth techniques, multifaceted cognitive-behavioral treatment regimens, and stress-inoculation training. Overall, the scientific evidence for the efficacy of cognitive and cognitive-behavioral methods for clinical pain attenuation is somewhat meager, although some encouraging but still tentative results have been obtained. There has been much work on the psychological elements involved in such strategies in the laboratory but there is still little sound information on their use for clinical pain. Several issues emerging from the literature review are discussed, with the need for further controlled evaluations being obvious.

Behavior Therapy↗