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At least 217 records · Page 12Linked to original sources
PubMed2005

Protocol for Project FACT: a randomised controlled trial on the effect of a walking program and vitamin B supplementation on the rate of cognitive decline and psychosocial wellbeing in older adults with mild cognitive impairment [ISRCTN19227688].

BACKGROUND: The prevalence of individuals with cognitive decline is increasing since the number of elderly adults is growing considerably. The literature provides promising results on the beneficial effect of exercise and vitamin supplementation on cognitive function both in cognitively healthy as well as in the demented elderly. METHODS/DESIGN: The design is a two-by-two factorial randomised controlled trial. The study population consists of independently living elderly, between 70 and 80 years old, with mild cognitive impairment (MCI). In the RCT the effect of two interventions, a walking program and vitamin supplementation, is examined. The walking program (WP) is a group-based program aimed at improving cardiovascular endurance; frequency two lessons a week; lesson duration one hour; program duration one year. Non-walking groups receive a placebo activity program (PAP) (i.e. low intensive non-aerobic group exercises, like stretching) with the same frequency, lesson and program duration. Vitamin supplementation consists of a single daily vitamin supplement containing 50 mg B6, 5 mg folic acid and 0,4 mg B12 for one year. Subjects not receiving vitamin supplements are daily taking an identically looking placebo pill, also for a year. Participants are randomised to four groups 1) WP and vitamin supplements; 2) WP and placebo supplements; 3) PAP and vitamin supplements; 4) PAP and placebo supplements. Primary outcome measures are measures of cognitive function. Secondary outcomes include psychosocial wellbeing, physical activity, cardiovascular endurance and blood vitamin levels. DISCUSSION: No large intervention study has been conducted yet on the effect of physical activity and vitamin supplementation in a population-based sample of adults with MCI. The objective of the present article is to describe the design of a randomised controlled trial examining the effect of a walking program and vitamin B supplementation on the rate of cognitive decline in older adults with MCI.

Aged↗
PubMed2004

The Women's Health Initiative Study of Cognitive Aging (WHISCA): a randomized clinical trial of the effects of hormone therapy on age-associated cognitive decline.

The Women's Health Initiative Study of Cognitive Aging (WHISCA) was a two armed, randomized, placebo controlled, clinical trial designed to assess the efficacy of postmenopausal hormone therapy on age related changes in specific cognitive functions. WHISCA was an ancillary study to the Women's Health Initiative (WHI) and the WHI Memory Study (WHIMS) and enrolled 2302 women aged 66 to 84 years (mean 73.9; standard deviation 3.8) who did not meet criteria for dementia. Women were randomly assigned by the WHI to hormone treatment (unopposed conjugated estrogens (CEE) 0.625 mg/day if they were without a uterus; CEE combined with medroxyprogesterone acetate (MPA) 2.5 mg/day otherwise) or placebo for an average of three years before the first WHISCA assessment. WHISCA investigated the effects of hormone therapy on rates of change over time in memory, other aspects of cognition (language, attention, spatial ability), motor function, and mood. In this paper, we present the study rationale and design, including specific cognitive measures, and the challenges of incorporating WHISCA into an ongoing randomized trial. WHISCA provided a unique opportunity to investigate the potential of hormone therapy to modify age related changes in specific cognitive functions. WHISCA also demonstrated the feasibility of adding a detailed cognitive assessment into an ongoing clinical trial to address an important issue in women's health, despite the challenges of maintaining the integrity of the parent studies, ensuring high retention, and achieving high quality assurance across sites.

Age Factors↗
PubMed1998

A randomized, double-blind, placebo-controlled trial of deprenyl and thioctic acid in human immunodeficiency virus-associated cognitive impairment. Dana Consortium on the Therapy of HIV Dementia and Related Cognitive Disorders.

Cognitive impairment is a frequent manifestation of advanced human immunodeficiency virus (HIV) infection. The response to antiretroviral medication is often partial and poorly sustained. Recent studies suggest that free radical production within the CNS and neuronal apoptosis may play important roles in the pathogenesis of HIV dementia. We conducted a randomized double-blind, placebo-controlled trial using a parallel group, 2 x 2 factorial design evaluating deprenyl, a monoamine oxidase B inhibitor and putative anti-apoptotic agent, and thioctic acid, an antioxidant, in 36 patients with HIV-associated cognitive impairment. Both deprenyl and thioctic acid were well tolerated with few adverse events. Deprenyl recipients showed significant improvement on tests of verbal memory compared with patients not taking deprenyl. Thioctic acid treatment did not improve cognitive function. These results suggest that deprenyl treatment is associated with cognitive improvement in subjects with mild HIV-associated cognitive impairment, whereas thioctic acid has no benefit. A larger efficacy trial is needed to assess the long-term effect of deprenyl on cognitive performance in patients with HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Cognitive processes and cognitive behavior therapy in the treatment of problem drinking.

Cognitive behavior Therapy has been shown to be an effective therapy for a wide range of clinical problems. However, the efficacy of CBT on addictive behavior is still unknown. This paper reviews the evidence for the efficacy of cognitive behavior therapy treatment for problem drinkers and examines its relationship with cognitive models of problem drinking. A computer search of the literature showed that only 13 studies met the criteria for inclusion in this review. This review indicated that there is evidence to show that cognitive behavior therapy can be successfully applied to addictive behaviors, in particular, problem drinking. However, there is lack of evidence to show that cognitive behavior therapy supports cognitive models of problem drinking. Future direction for research in this area is suggested.

Alcoholism↗
PubMed2005

[Cognitive and Cognitive-Behavioral Therapy for substance abuse disorders].

This article describes the current status of Cognitive and Behavioral Therapy as well Relapse Prevention and Coping Skill approaches applied in drug abuse treatments. The objective is show a review about theories and technique used by Cognitive Therapy and others approaches derived that, specifically Relapse Prevention and Coping Skill Treatments. Cognitive and Behavioral Therapy, Coping Skill, and Relapse Prevention are a short-time, goal-oriented and structured treatments. Thus, they assume a posture directive and active. We pointed out some difference between the theories about Cognitive Therapy, Relapse Prevention and Coping Skill. The Cognitive Therapy accentuated the focus in patients thought, feeling and circumstances that get in a dysfunctional behavioral. Relapse Prevention and Coping Skill are based in behavioral theories besides of the Cognitive. We, finally, look forward to introduce the lasted scientific finding to helpful the general psychiatric to improve the assistance in drug abuse treatment.

Adaptation, Psychological↗
PubMed1979

Prediction of later cognitive behavior from early school perceptual-motor, perceptual, and cognitive performances.

Multiple regression equations were generated to predict cognitive achievement for 189 young children (ages 57 to 92 mo.) 1 yr. after original administration of a battery of perceptual-motor, perceptual, and cognitive tests. Regression equations generated from maximum R2 improvement techniques indicated that a battery of perceptual and perceptual-motor performances at pre-kindergarten is useful for prediction of cognitive performance 1 yr. later at kindergarten level. This battery included one fine and two gross perceptual-motor tasks, and one visual and two auditory perceptual tasks. Inclusion of original cognitive performances did not improve the optimal prediction equation for this age group. In contrast, cognitive achievement at first grade and, particularly, at second grade levels was best predicted from knowledge of earlier cognitive performances.

Achievement↗
PubMed1989

Psychological coping and the management of pain with cognitive restructuring and biofeedback: a case study and variation of cognitive experiential therapy.

Pain is generally recognized as being influenced by multiple psychological factors. Cognitive experiential therapy may use cognitive restructuring with imagery and hypnosis. The restructuring of negative cognitive, affective, behavioral, and physiological states occurs through six stages. This case study illustrates the use of cognitive restructuring and biofeedback with a woman hospitalized for depression and a chronic pain syndrome consisting of tension headache pain. Measures of headache pain (frequency, intensity), skin temperature, and assessment with the Millon Behavioral Health Inventory consisting of broad categories and scales were taken at pretest, posttest and follow-up. The biofeedback treatment alone showed some physiological improvement. Cognitive restructuring and biofeedback resulted in improvements on the Millon, and reduction of headache symptoms at the posttest. Gains on the Millon broad categories of personality coping styles and psychosomatic correlates were maintained at follow-up and chronic headache pain was not reported. Self-report headache frequency and intensity decreased over time with the cognitive restructuring and biofeedback approach.

Adaptation, Psychological↗
PubMed2002

[The cognitive variations among non-dementia elders: from successful aging to mild cognitive impairment].

OBJECTIVE: To study the heterogeneity of cognitive function in the non-demented elderly population with complaint of memory decline. METHODS: Neuropsychological tests were carried out in 34 subjects by using clinical memory scales including 17 variables and Q-type cluster analysis was performed. RESULTS: Fifteen subjects (44%) were diagnosed as mild cognitive impairment (MCI). Six new clusters were produced by cluster analysis. CONCLUSION: In the transitional period from normal aging to early Alzheimer's disease, the cognitive function of elders are heterogeneous, there may be cognition of successful aging, cognition of normal aging and even cognitive impairment with potential risk of dementia.

Aged↗
PubMed1995

Symposium: Cognitive processes and sleep disturbances: Sleep/wake patterns in Alzheimer's disease: relationships with cognition and function.

Alzheimer's disease (AD), the most common dementing disorder of aging, is a progressive neurodegenerative disease of unknown etiology. Two of the common clinical features of AD are progressive cognitive and functional impairment, and disturbed sleep/wake patterns. We examined sleep/wake patterns and cognitive and functional status measures in a large sample of AD subjects ranging from mild to moderate-severe in impairment. All subjects survived at least 2 years after initial diagnosis. Regression analyses revealed that sleep/wake variables were highly correlated with and explained significant variance in cognitive and functional measures. More wakefulness during the night and longer REM latencies were associated with impaired cognition and function while more REM and slow-wave sleep were associated with preserved cognition and function. These results indicate that with advancing severity of the disease, sleep/wake patterns are disrupted in parallel with the disturbances in cognition and function that are the hallmarks of AD. Further, they suggest that the neural substrates underlying each process degenerate at somewhat comparable rates.

Journal Article↗
PubMed2003

Validity of a novel computerized cognitive battery for mild cognitive impairment.

BACKGROUND: 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 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. METHODS: A 2-center study was designed to assess 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. RESULTS: Mindstreams outcome parameters across multiple cognitive domains significantly discriminated among MCI and healthy elderly 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. CONCLUSIONS: 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 elderly at high risk for dementia.

Journal Article↗
PubMed1990

The relationship of the Allen Cognitive Level Test to cognitive abilities and psychopathology.

The cognitive factors measured by the Allen Cognitive Level Test (ACL) (Allen, 1982) as well as the test's relationship to level of psychopathology were examined through a retrospective study of 71 patients from a general hospital psychiatry unit. Pearson correlations, computed for the ACL score with the Shipley Institute of Living Scale (Shipley, 1940), a general measure of intellectual functioning, were significant. A strong correlation was found between the ACL and the Symbol-Digit Modalities Test (Smith, 1982), a measure of motor speed and concentration often used as a neurological screening instrument. This suggests the potential usefulness of the ACL to screen for cognitive dysfunctions associated with organicity. Contrary to hypothesis, there was no significant correlation between the ACL and measures of psychopathology such as the Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961) and the Minnesota Multiphasic Personality Inventory (Hathaway & McKinley, 1940). The relationship of the ACL to other recognized measures of cognitive functioning increases its usefulness as a valid measure of day-to-day limitations in the functioning of psychiatric patients. Effective communication of the implications of these cognitive levels to a multidisciplinary treatment team is enhanced by knowledge of the relationship of the ACL to measures of cognitive functioning and psychopathology used by other disciplines.

Adult↗
PubMed2026

Effect of a PROtein-enriched MEDiterranean diet and EXercise (PROMED-EX) on nutritional status and cognitive performance in older adults at risk of undernutrition and cognitive decline: the PROMED-EX randomized controlled trial.

BACKGROUND: Undernutrition in older adults is associated with adverse health outcomes including cognitive decline, yet evidence for effective preventive strategies is limited. OBJECTIVES: The objective of this study was to investigate effects of a protein-enriched Mediterranean diet, with and without exercise, on nutritional status and cognitive performance in "at risk" community-dwelling older adults. METHODS: A total of 105 participants (69% female; aged 67.7 &#xb1; 6.1 y) at risk of undernutrition and cognitive decline were randomized to 1 of 3 groups: 1) PROMED-EX (personalized dietary counseling plus home-based exercise); 2) PROMED (personalized dietary counseling only); or 3) CON (healthy eating leaflet). The primary outcome was change in nutritional status at 6 mo, measured by the Mini Nutritional Assessment (MNA; 0-30 points). Secondary outcomes included neurocognitive test battery (NTB) z-score, PROMED diet quality score (0-14), physical performance, and health-related quality of life. Analyses followed an intention-to-treat approach using linear regression to assess between-group differences in 6-mo outcomes. RESULTS: At baseline, the mean MNA score was 22.5 &#xb1; 2.3. After 6 mo, nutritional status improved significantly in both intervention groups compared with CON: mean differences in MNA were 2.7 [95% confidence interval (CI): 1.3, 4.2] for PROMED and 2.9 (95% CI: 1.5, 4.3) for PROMED-EX (both P < 0.001). Cognitive function also improved, with NTB z-score differences of 0.3 (95% CI: 0.1, 0.5; P = 0.01) in PROMED and 0.2 (95% CI: 0.0, 0.4; P = 0.02) in PROMED-EX compared with CON. Diet quality scores significantly increased with mean differences of 4.0 (95% CI: 2.9, 5.0) for PROMED and 3.9 (95% CI: 2.8, 4.9) for PROMED-EX compared with CON (both P < 0.001). Despite low adherence to exercise, additional benefits were observed for physical performance and quality of life. CONCLUSIONS: Dietary intervention improved nutritional status in community-dwelling older adults at risk of undernutrition. Correcting undernutrition could help to slow cognitive decline and promote physical health and quality of life during aging. This study was registered at clinicaltrials.gov as NCT05166564.

Humans↗
PubMed2005

Cognitions in cognitive-behavioral psychotherapies; toward an integrative model.

There seems to be a lack of a coherent and integrative theory and theoretically informed manuals in cognitive behavioral therapies that could negatively impact both the program of CBT as a platform for psychotherapy integration, as well as its efficacy and effectiveness. Although CBT is the golden psychological treatment for various disorders, overall, about 30-40% of the patients are still non-responsive to these interventions and various schools debate their status as promoters of the best theoretical view. The objective of the present paper is to use cognitive psychology/science as a tool to clarify several theoretical confusions in CBT, with impact on a coherent science and practice of CBT. As a general conclusion, we believe that CBT has reached preeminence in the clinical field betting on cold cognitions. Despite obvious advantages and accomplishments, this approach seems to loose its heuristic value. We believe that the next phase of CBT development lies in the construct of hot cognitions (which would increase its effectiveness) and in cognitive psychology (which would contribute to a coherent science of CBT beyond various schools). These developments could offer CBT the chance to be a platform for the integration of psychotherapy.

Autobiographies as Topic↗
PubMed2003

Cognitive change and enhanced coping: missing mediational links in cognitive behavior therapy with anxiety-disordered children.

In this review, we examine the recent cognitive behavior therapy (CBT) outcome literature with anxiety-disordered children and, specifically, explore the status of cognitive change and increased coping ability as (1) specific treatment effects, and (2) possible mediators of the efficacy of CBT. In the past decade, the number of controlled CBT studies with clinically diagnosed anxiety-disordered children has increased substantially. CBT aims to restructure distorted or maladaptive cognitions and teach the anxious child to effectively use diverse coping strategies. Our review shows that in recent CBT research with anxiety-disordered children the use of domain-specific measures like cognitive and coping measures is, unfortunately, not common practice. Furthermore, only one study examined the issue of treatment mediation. Generally, recent CBT research has not been designed to test mediational issues and does not clarify whether cognitive change and enhanced coping--the presumed central components of CBT--are in fact responsible for its efficacy. Implications for the direction of future CBT research with anxiety-disordered children are discussed.

Adaptation, Psychological↗
PubMed1999

Differential cognitive response to a mood challenge following successful cognitive therapy or pharmacotherapy for unipolar depression.

This study examined the nature of cognitive reactivity to mood changes in formerly depressed patients. Patients who recovered either through cognitive-behavior therapy (CBT; N = 25) or through pharmacotherapy (PT; N = 29) completed self-reported ratings of dysfunctional attitudes before and after a negative mood induction procedure. In response to similar levels of induced sad mood, PT patients showed a significant increase in dysfunctional cognitions compared with patients in the CBT group. To evaluate the effects of such cognitive reactivity on the subsequent course of depression, follow-up analyses reassessed 30 patients several years after initial testing. Results indicated that patients' reactions to the mood induction procedure were predictive of depressive relapse. These findings argue for differential effects of treatment on cognitive reactivity to mood induction and for the link between such reactivity and risk for later depressive relapse.

Adult↗
PubMed2006

Cognitive predictors of social functioning improvements following cognitive remediation for schizophrenia.

A greater understanding of the links between cognitive and social functioning changes is needed to refine cognitive treatments for schizophrenia. To date, studies have been cross-sectional, and few have investigated the impact of cognitive change. This single-blind randomized controlled trial explored the links between changes in executive/memory functions and social behavior, as well as the moderating effect of cognitive remediation therapy (CRT). A total of 85 participants with schizophrenia received 40 sessions of CRT (an individual psychological therapy aiming to improve attention, memory, and problem solving) or treatment-as-usual. At baseline, social functioning was significantly associated with "verbal working memory," "response inhibition," "verbal long-term memory," and "visuo-spatial long-term memory," but not "schema generation," factors. However, only improvement in "schema generation" predicted improved social functioning. This was true whether or not participants had received CRT. These results suggest that cross-sectional associations between cognitive functions and social functioning may not offer the best means for identifying good targets for intervention. Improvement in the ability to generate new schemas has a beneficial impact on social functioning.

Adolescent↗