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PubMed2004

Relationship between plasticity, mild cognitive impairment and cognitive decline.

A topic of great interest in gerontology research is the prediction of cognitive deterioration which marks the transition from mild cognitive impairment (MCI) to dementia. In this area the term plasticity is a construct of prime importance. Previous studies have demonstrated the existence of plasticity in healthy older persons, and it is thought that this is what discriminates between healthy individuals and those at risk for dementia. The aim of the present study is to demonstrate that plasticity exists in persons with MCI, and that a lack of plasticity may be one of the risk factors related to cognitive decline. An adapted version of the Auditory Verbal Learning Test-the AVLT of Learning Potential-was used to assess plasticity. Participants in the research were 203 older persons whose cognitive status had previously been determined using a cognitive screening test. The results show that plasticity exists in persons with MCI and that its presence is associated with less marked cognitive decline.

Aged↗
PubMed2006

Cognitive flexibility but not cognitive coordination is affected in rats with toxic liver failure.

Hepatic encephalopathy (HE), a consequence of liver damage, is associated with cognitive deficits. In this study, behavioral activity, non-associative learning, associative memory, cognitive coordination and flexibility were investigated in rats with subclinical HE evoked by thioacetamide treatment. Non-associative learning was studied in the open field (OF) set up in 12 HE and 8 saline-injected control rats (C). Memory was examined in spatial place avoidance tasks in 10 HE and 10 C rats. The Room+ Arena- task involved the selection of distal room stimuli from irrelevant arena stimuli (i.e. intramaze cues and/or self-motion information), which engages processes of cognitive coordination. Following the Room+ Arena- training, cognitive flexibility of rats was tested in the Arena+ place avoidance condition, which demands the previously ignored stimuli from arena. In the OF test HE and control rats behaved similar. They displayed high activity in the first block of each session and this pattern was stable. In both groups of rats darkness enhanced locomotor activity in comparison to light only in the first block. The HE and C rats avoided the to-be-avoided place in the Room+ Arena- task, whereas only HE rats were affected in the Arena+ task. In conclusion, these results demonstrate cognitive inflexibility in HE rats. We suggest that (1) the behavioral changes in the TAA model are typical of subclinical HE and (2) test for cognitive flexibility may be modified towards a routine use in patients with subclinical HE.

Adaptation, Psychological↗
PubMed1998

Long-term postoperative cognitive dysfunction in the elderly ISPOCD1 study. ISPOCD investigators. International Study of Post-Operative Cognitive Dysfunction.

BACKGROUND: Long-term postoperative cognitive dysfunction may occur in the elderly. Age may be a risk factor and hypoxaemia and arterial hypotension causative factors. We investigated these hypotheses in an international multicentre study. METHODS: 1218 patients aged at least 60 years completed neuropsychological tests before and 1 week and 3 months after major non-cardiac surgery. We measured oxygen saturation by continuous pulse oximetry before surgery and throughout the day of and the first 3 nights after surgery. We recorded blood pressure every 3 min by oscillometry during the operation and every 15-30 min for the rest of that day and night. We identified postoperative cognitive dysfunction with neuropsychological tests compared with controls recruited from the UK (n=176) and the same countries as study centres (n=145). FINDINGS: Postoperative cognitive dysfunction was present in 266 (25.8% [95% CI 23.1-28.5]) of patients 1 week after surgery and in 94 (9.9% [8.1-12.0]) 3 months after surgery, compared with 3.4% and 2.8%, respectively, of UK controls (p<0.0001 and p=0.0037, respectively). Increasing age and duration of anaesthesia, little education, a second operation, postoperative infections, and respiratory complications were risk factors for early postoperative cognitive dysfunction, but only age was a risk factor for late postoperative cognitive dysfunction. Hypoxaemia and hypotension were not significant risk factors at any time. INTERPRETATION: Our findings have implications for studies of the causes of cognitive decline and, in clinical practice, for the information given to patients before surgery.

Abdomen↗
PubMed2005

Socioeconomic status does not moderate the familiality of cognitive abilities in the Hawaii family study of cognition.

Data from 949 families of Caucasian and 400 families of Japanese ancestry who took part in the Hawaii Family Study of Cognition were used to ascertain the associations of parental cognitive ability, parental education and paternal occupation with offspring cognitive ability. In particular, analyses were focused on testing the possible moderating effects of parental socioeconomic status on the familial transmission of cognitive abilities. Parental cognitive ability was substantially associated and parental education and paternal occupation only trivially associated with offspring performance. In contrast to the findings of Turkheimer et al. (2003), there was no evidence in these data that familiality for cognitive abilities was lower in the lower as opposed to upper levels of socioeconomic status. These results were consistent across measures, ethnicity and sex of offspring.

Cognition↗
PubMed2001

The strong connection between sensory and cognitive performance in old age: not due to sensory acuity reductions operating during cognitive assessment.

Cognitive aging research has documented a strong increase in the covariation between sensory and cognitive functioning with advancing age. In part, this finding may reflect sensory acuity reductions operating during cognitive assessment. To examine this possibility, the authors administered cognitive tasks used in prior studies (e.g., Lindenberger & Baltes, 1994) to middle-aged adults under age-simulation conditions of reduced visual acuity, auditory acuity, or both. Visual acuity was lowered through partial occlusion filters, and auditory acuity through headphone-shaped noise protectors. Acuity manipulations reduced visual acuity and auditory acuity in the speech range to values reaching or approximating old-age acuity levels, respectively, but did not lower cognitive performance relative to control conditions. Results speak against assessment-related sensory acuity accounts of the age-related increase in the connection between sensory and cognitive functioning and underscore the need to explore alternative explanations, including a focus on general aspects of brain aging.

Adult↗
PubMed2006

Cognitive cladistics and cultural override in Hominid spatial cognition.

Current approaches to human cognition often take a strong nativist stance based on Western adult performance, backed up where possible by neonate and infant research and almost never by comparative research across the Hominidae. Recent research suggests considerable cross-cultural differences in cognitive strategies, including relational thinking, a domain where infant research is impossible because of lack of cognitive maturation. Here, we apply the same paradigm across children and adults of different cultures and across all nonhuman great ape genera. We find that both child and adult spatial cognition systematically varies with language and culture but that, nevertheless, there is a clear inherited bias for one spatial strategy in the great apes. It is reasonable to conclude, we argue, that language and culture mask the native tendencies in our species. This cladistic approach suggests that the correct perspective on human cognition is neither nativist uniformitarian nor "blank slate" but recognizes the powerful impact that language and culture can have on our shared primate cognitive biases.

Adolescent↗
PubMed2005

FDG-PET measurement is more accurate than neuropsychological assessments to predict global cognitive deterioration in patients with mild cognitive impairment.

The accurate prediction, at a pre-dementia stage of Alzheimer's disease (AD), of the subsequent clinical evolution of patients would be a major breakthrough from both therapeutic and research standpoints. Amnestic mild cognitive impairment (MCI) is presently the most common reference to address the pre-dementia stage of AD. However, previous longitudinal studies on patients with MCI assessing neuropsychological and PET markers of future conversion to AD are sparse and yield discrepant findings, while a comprehensive comparison of the relative accuracy of these two categories of measure is still lacking. In the present study, we assessed the global cognitive decline as measured by the Mattis scale in 18 patients with amnestic MCI over an 18-month follow-up period, studying which subtest of this scale showed significant deterioration over time. Using baseline measurements from neuropsychological evaluation of memory and PET, we then assessed significant markers of global cognitive change, that is, percent annual change in the Mattis scale total score, and searched for the best predictor of this global cognitive decline. Altogether, our results revealed significant decline over the 18-month follow-up period in the total score and the verbal initiation and memory-recall subscores of the Mattis scale. The percent annual change in the total Mattis score significantly correlated with age and baseline performances in delayed episodic memory recall as well as semantic autobiographical and category word fluencies. Regarding functional imaging, significant correlations were also found with baseline PET values in the right temporo-parietal and medial frontal areas. Age and right temporo-parietal PET values were the most significant predictors of subsequent global cognitive decline, and the only ones to survive stepwise regression analyses. Our findings are consistent with previous works showing predominant delayed recall and semantic memory impairment at a pre-dementia stage of AD, as well as early metabolic defects in the temporo-parietal associative cortex. However, they suggest that only the latter predictor is specifically and accurately associated with subsequent cognitive decline in patients with MCI within 18 months of first assessment.

Aged↗
PubMed2002

Activity in older adults: cause or consequence of cognitive functioning? A longitudinal study on everyday activities and cognitive performance in older adults.

The impact of three types of everyday activities (i.e., social, experiential, and developmental) on four cognitive functions (i.e., immediate recall, learning, fluid intelligence, and information-processing speed) and one global indicator of cognitive functioning (Mini-Mental State Exam score) over a period of 6 years was studied in a large 55--85 year-old population-based sample (N = 2,076). A cross-lagged regression model with latent variables was applied to each combination of 1 cognitive function and 1 type of activity, resulting in 15 (3 x 5) different models. None of the activities were found to enhance cognitive functioning 6 years later when controlling for age, gender, level of education, and health, as well as for unknown confounding variables. Conversely, one cognitive function (i.e., information-processing speed) appeared to affect developmental activity. It is suggested that no specific activity, but rather socioeconomic status to which activities are closely connected, contributes to maintenance of cognitive functions.

Activities of Daily Living↗
PubMed2005

General lifestyle activities as a predictor of current cognition and cognitive change in older adults: a cross-sectional and longitudinal examination.

General lifestyle activities were examined as a predictor of current cognition and cognitive change over a 6-year interval in older adults. Participants were drawn from a population-based longitudinal study, and they completed the Adelaide Activities Profile and a battery of tests measuring cognition and sensory functioning. Hierarchical regression analyses revealed that, after sensory functioning was controlled for, activity was a significant predictor of current levels of speed, picture naming, incidental recall, and verbal fluency, and of cognitive change in speed, picture naming, and incidental recall. Commonality analyses demonstrated that activity accounted for a notable amount of the total variance in cognition, and that there was prominent overlap in shared variance between activity and age, and between sensory functioning and age. These findings suggest that engaging in general lifestyle activities may help to promote successful cognitive aging.

Activities of Daily Living↗
PubMed1992

Nursing home case-mix classification and residents suffering from cognitive impairment: RUG-II and cognition in the Texas case-mix data base.

Case-mix reimbursement systems for nursing home care are now in use or under consideration in over 20 states. Though many in the long-term care field still debate the relative merits of the various systems, those systems based on the Resource Utilization Groups-II (RUG-II) system used in New York seem to be increasingly popular. However, one of the more serious questions raised concerning RUG-like systems is whether they fully acknowledge the role played by cognitive deficits in determining nursing home residents' care needs. The results of this research indicate: 1) that resource provision and cognitive status are correlated, 2) that residents with higher levels of cognitive impairment appear most frequently in RUG-II categories that have higher case-mix weights, 3) that simply adding some measure of cognitive function does not significantly increase the power of these models, and 4) that the RUG-II model predicts the level of care resources provided to the cognitively intact much better than it predicts those provided to residents suffering from relatively severe disorientation. These results imply that such classification systems may create disincentives for the admission of the most cognitively impaired residents and that the care of these individuals, more than others, may be dependent on facility-to-facility variation.

Activities of Daily Living↗
PubMedDate not supplied

Changes in cognitive coping skills and social support during cognitive behavioral stress management intervention and distress outcomes in symptomatic human immunodeficiency virus (HIV)-seropositive gay men.

OBJECTIVE: We have previously reported decreases in dysphoria, anxiety, and total mood disturbance in symptomatic HIV seropositive gay men after a 10-week cognitive behavioral stress management (CBSM) group intervention. This structured intervention was designed a) to increase cognitive and behavioral coping skills related to managing the distress of symptomatic HIV, and b) to increase social support among group members. Here we examine the relative contribution of changes in coping skills and social support during the intervention period to reductions in dysphoria, anxiety, and distress-related symptoms in this sample. METHODS: Participants were randomized to a 10-week CBSM group intervention or to a wait-list control condition. Coping, social supports, and mood were measured before and after the intervention period. RESULTS: Members of the CBSM group (N = 22) showed significant improvement in cognitive coping strategies involving positive reframing and acceptance, and in social supports involving attachment, alliances, and guidance at the end of the 10-week CBSM program compared with controls (N = 18) who showed decrements in these coping abilities and no changes in social support. Improved cognitive coping, specifically acceptance of the HIV infection, was strongly related to lower dysphoria, anxiety, and total mood disturbance in both conditions. Changes in social support and in cognitive coping skills seem to mediate the effects of the experimental condition on the changes in distress noted during the intervention. CONCLUSIONS: These results suggest that cognitive coping and social support factors can be modified by psychosocial interventions and may be important determinants of the changes in psychological well-being and quality of life during symptomatic HIV infection that can be achieved through this form of intervention.

Adaptation, Psychological↗
PubMed2003

Cognitive-behavioral therapy for children with anxiety disorders in a clinical setting: no additional effect of a cognitive parent training.

OBJECTIVE: To evaluate a 12-week cognitive-behavioral treatment program for children with anxiety disorders and the additional value of a seven-session cognitive parent training program. METHOD: Seventy-nine children with an anxiety disorder (aged 7-18 years) were randomly assigned to a cognitive behavioral treatment condition or a wait-list control condition. Families in the active treatment condition were randomly assigned to an additional seven-session cognitive parent training program. Semistructured diagnostic interviews were conducted with parents and children separately, before and after treatment and at 3 months follow-up. Questionnaires included child self-reports on anxiety and depression and parent reports on child's anxiety and behavioral problems. RESULTS: Children with anxiety disorders showed more treatment gains from cognitive-behavioral therapy than from a wait-list control condition. These results were substantial and significant in parent measures and with regard to diagnostic status, but not in child self-reports. In the active treatment condition, children improved on self-reported anxiety and depression, as well as on parent reports on their child's anxiety problems. These results were equal for clinically referred and recruited children. Child self-reports decreased to the normal mean, whereas parents reported scores that were lower than before treatment but were still elevated from the normal means. No significant outcome differences were found between families with or without additional parent training. CONCLUSIONS: Children with anxiety disorders profited from cognitive-behavioral therapy. Children improved equally whether or not additional parent training was offered.

Adolescent↗
PubMed2005

Relationship of leukoaraiosis to cognitive decline and cognitive aging.

OBJECTIVE: Leukoaraiosis (LA) is a common finding on MRI scans of the elderly. However, its exact relationship to cognitive decline and dementia is in dispute. Because LA involves the paracallosal white matter, we sought to determine if LA, uncomplicated by ischemic lesions or complaints of cognitive impairment, is associated with cognitive loss or difficulties with interhemispheric integration of behavioral functions. METHODS: Two hundred fifty-seven MRI scans with deep white matter changes were screened. After a chart review, 38 patients had uncomplicated LA, and 31 gave informed consent to undergo cognitive and behavioral testing. RESULTS: LA severity was not related to any of the cognitive or behavioral assessments. However, some dependent measures showed medium effect sizes that were in keeping with published findings, indicating that LA has a marginal impact on cognition. In comparison, robust relationships with age were found for certain tasks, suggesting that our cohort size was sufficient to detect meaningful clinical relationships. CONCLUSION: Based on statistical interpretations using effect sizes, LA severity may be better viewed as a biomarker for physiological brain aging that is in advance of chronological age, leaving the elderly individual at greater risk for developing dementia.

Aged↗
PubMed2007

Does fluoxetine have any effect on the cognition of patients with mild cognitive impairment? A double-blind, placebo-controlled, clinical trial.

OBJECTIVES: Mild cognitive impairment (MCI) may be a prodromal state for Alzheimer disease. Recent research suggest a role for other neuronal systems such as monoaminergic hypofunction beside cholinergic dysfunction in age-related cognitive decline. In several studies, selective serotonin reuptake inhibitors demonstrated promotion of neurogenesis in the hippocampus. In this study, the effects of fluoxetine, a selective serotonin reuptake inhibitor, on memory and cognition of patients with mild cognitive impairment has been studied. METHOD: Fifty-eight nondepressed patients with MCI were randomly assigned to take fluoxetine or placebo. The patients were administered the Structured Clinical Interview for DSM-IV (Diagnosis and Statistical Manual for Mental Disorders, Fourth Edition) Disorders, the Mini-Mental Status Examination (MMSE), subtests from the Persian standardized Wechsler Memory Scale III (WMS-III) preintervention. Forty-four patients completed the 8-week trial. Treatment response was defined as improvement in the scores of MMSE, subtests of WMS-III, and Clinical Global Impression. RESULT: The patients in the fluoxetine group showed improvement in MMSE and immediate and delayed logical memory scores of WMS-III. The placebo group had no significant changes in the cognitive measurements. CONCLUSION: Fluoxetine enhanced memory and cognition in the patients. This was consistent with previous studies that emphasized the role of fluoxetine in improving memory and promoting neurogenesis in the hippocampus. However, this is a preliminary study with small sample size, and larger double-blind placebo-controlled studies are needed to confirm these findings.

Aged↗
PubMed2005

Cognitive coping with the threat of rape: vigilance and cognitive avoidance.

Individual differences in women's avoidant and vigilant style in coping with the threat of rape were explored in four studies. In the first study, 97 women read a rape scenario and completed measures of cognitive vigilance and avoidance. They also provided ratings of fear of rape and anticipated coping problems in case of sexual assault. Vigilance was associated with significantly higher levels of fear of rape and anticipation of more severe coping problems. No effects were found for cognitive avoidance. Study 2 replicated these findings with a sample of 275 women. In addition, it showed that high vigilance was associated with significantly more rape-preventive behaviors. Study 3, including 172 women, was an online study on the effect of cognitive coping style on fear of rape, anticipated coping problems, and two behavioral measures of rape avoidance. High vigilance was related to higher levels of fear of rape, anticipation of more severe coping problems, and more rape-preventive behaviors. Finally, Study 4 (N=210) showed that individual differences in cognitive coping style affected rape-related affect and behavior in the absence of a rape scenario, underlining the chronic salience of the threat of rape for women. Vigilance was positively related to fear of rape, rape-avoidance behavior, and anticipated coping problems. In contrast, a negative relationship was found between cognitive avoidance and fear of rape, rape-avoidance strategies, and anticipated coping problems. Across the four studies, no evidence was found for an interactive effect of cognitive avoidance and vigilance, as suggested by the construct of repression versus sensitization. The findings are discussed in the light of previous research on repression-sensitization in coping with threatening information.

Adaptation, Psychological↗
PubMed2006

Cognitive correlates of financial abilities in mild cognitive impairment.

OBJECTIVES: To investigate the cognitive correlates of financial abilities in mild cognitive impairment (MCI). DESIGN: Controlled, matched-sample, cross-sectional analysis regressing five cognitive composites on financial performance measures. SETTING: University medical and research centers. PARTICIPANTS: Forty-three persons with MCI and 43 normal controls. MEASUREMENTS: The Financial Capacity Instrument (FCI) and a comprehensive neurocognitive battery. RESULTS: Patients with MCI performed significantly worse than controls on cognitive domains of executive function, memory, and language and on FCI domains of financial conceptual knowledge, bank statement management, and bill payment. Patients with MCI also needed significantly more time to complete a multistep financial task and were significantly more likely than controls to make errors on this task. Stepwise regression models revealed that, within the MCI group, attention and executive function were significant correlates of FCI performance. CONCLUSION: Although impaired memory is the cardinal deficit in MCI, the neurocognitive basis of lower functional performance in MCI appears to be emergent declines in abilities to selectively attend, self-monitor, and temporally integrate information. Compromised performance on cognitive measures of attention and executive function may constitute clinical markers of lower financial abilities and should be evaluated for its relationship to functional ability in general. These cognitive domains may be appropriate targets of future intervention studies aimed at preservation of functional independence in people with MCI.

Aged↗
PubMed1996

Apolipoprotein E: non-cognitive symptoms and cognitive decline in late onset Alzheimer's disease.

OBJECTIVES: To determine the association between the epsilon2 and epsilon4 alleles of apolipoprotein E (ApoE) and independent measures of cognitive decline and non-cognitive symptomatology in late onset Alzheimer's disease. METHODS: The frequency of the epsilon2 and epsilon4 alleles of ApoE and their association with measures of cognitive decline and non-cognitive symptomatology were assessed in a population based case register study of 164 patients with late onset Alzheimer's disease from the east Lambeth and south Southwark districts of south London. RESULTS: Analysis of a wide range of non-cognitive symptoms against ApoE epsilon4 genotype showed no significant association but a positive relation was found between ApoE epsilon2 genotype and depressive symptomatology (P = 0.004). No relation was found between measurements of cognitive decline and the presence of the ApoE epsilon4 allele. A trend for decreasing age at onset of 3 to 4 years in carriers of the ApoE epsilon4 allele was found, confirming earlier studies. CONCLUSION: Presence of the epsilon4 allele of ApoE is associated with an earlier age at onset but does not seem to be related to either a more severe psychopathology or a more rapid progression of the illness. The epsilon2 allele of ApoE is associated with depressive symptomatology in late onset Alzheimer's disease.

Age of Onset↗
PubMed2005

The impact of change in cognitive functioning and cognitive decline on disability, well-being, and the use of healthcare services in older persons. Results of Longitudinal Aging Study Amsterdam.

The study investigated the impact of change in cognitive functioning and cognitive decline on disability, well-being, and the use of healthcare services among older persons in the Longitudinal Aging Study Amsterdam (LASA). Data were collected from 1,349 subjects, aged 65-85 years, who had scores of 24 and higher on the Mini-Mental State Examination (MMSE) at baseline, over a period of 6 years in three waves. The results indicate that cognitive decline and changes in cognitive functioning in older persons who were either not impaired or only mildly cognitively impaired at baseline have an impact on disability, well-being, and the use of healthcare services. With the aging of the population, the number of persons with cognitive impairment is likely to increase, and appropriate services should be available to them.

Aged↗