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Impairment of incidental memory for frequency in patients with obsessive-compulsive disorder.

The aim of our study was to investigate whether patients with obsessive-compulsive disorder (OCD) have impaired incidental memory for frequency. Fifty-four subjects (27 OCD patients and 27 matched control subjects) performed a task assessing estimation of occurrence of previously heard words. Performance on this task was compared with other intentional verbal memory tasks (recognition, recall and learning of common words). We also correlated memory for frequency with frontal lobe tests (Wisconsin Card Sorting Test, Trail Making Tests A and B, and verbal fluency). Performance on incidental learning of frequency was significantly worse in the OCD group than in control subjects. Other verbal memory measures did not show significant differences. Performance in the frequency task correlated with verbal fluency. Although intentional verbal memories are normal in OCD patients, incidental memory for frequency is impaired, suggesting that prefrontal systems are involved in OCD.

Adolescent↗

Changes in cognitive functioning following comprehensive treatment for first episode patients with schizophrenia spectrum disorders.

The course of cognitive functioning over a 1-year period was examined among a community cohort of individuals presenting with first episode schizophrenia spectrum psychosis. Data were obtained for 83 outpatients at entry to an early intervention program and 12 months later on the National Adult Reading Test, Wechsler Adult Intelligence Scales-Third Edition, Wechsler Memory Scales-Third Edition, Paced Auditory Serial Addition Task, Wisconsin Card Sorting Test, Stroop Colour and Word Test, Trail Making Test, Continuous Performance Task and Thurstone Word Fluency Test. Paired sample t-tests indicated significant and positive changes in verbal and non-verbal intelligence, auditory and visual memory, working memory and some aspects of executive functioning. Processing speed also improved though remained an area of relative weakness for this sample. Findings indicated generally average performance at both assessment periods. Neither gender nor duration of untreated psychosis were related to the degree of change in cognitive functioning for this sample. The implications of these findings and the impact of early intervention with this population are discussed.

Adult↗

Does risperidone act better in schizophrenic patients who have a family or obstetric history?

PURPOSE: The aim of the study was to assess the effect of treatment with risperidone on psychopathological symptoms and cognitive deficits in schizophrenic patients, in relation to family history, obstetric complications and duration of the illness. METHODS: Fifty schizophrenic inpatients (29 males, 21 females), aged 16-50 (mean 28 years), with duration of the illness 1-15 (mean 4 years) who successfully completed a 3-month risperidone treatment were included into the study. Family history of psychiatric illness and the presence of obstetric complications were estimated by a semistructured questionnaire. Schizophrenic symptoms were assessed using the Positive and Negative Symptoms Scale (PANSS). Cognitive abilities were measured by neuropsychological "frontal lobe" tests: Trail Making Test (TMT), part B, Stroop Color Word Interference Test, part B, and Wisconsin Card Sorting Test (WCST). The clinical and neuropsychological evaluation was performed before and after 3 months of risperidone treatment, in doses 2-6 mg (mean 4.2 mg/day). RESULTS: Before treatment, patients with family history had significantly higher intensity of negative symptoms, and obtained worse results on WCST perseverative errors (PE) and correct categories (CC). These measures were also impaired in subjects with obstetric complications. Additionally, in patients with obstetric complications, total and general PANSS psychopathology was higher and the results of Stroop B were worse. After a 3-month treatment with risperidone, no difference between respective groups was observed both in psychopathology and in neuropsychological tests. Patients with obstetric complications had higher degree of improvement on positive and negative symptoms and on TMT-B than the remaining ones. Patients with longer duration of the illness had less improvement on positive symptoms with risperidone treatment. CONCLUSIONS: The results of this study show that treatment with risperidone results in better compensation of psychopathological (negative symptoms) and neuropsychological (working memory) deficits in patients who have a family history and/or obstetric complications. This may be due to a favourable effect of risperidone on the prefrontal cortex dysfunction mediating these deficits.

Adolescent↗

Event-related potentials and neuropsychological tests in obsessive-compulsive disorder.

OBJECTIVE: Previous studies have provided evidence from event-related potentials (ERPs) and neuropsychological testing of abnormal cognitive processing in obsessive-compulsive disorder (OCD). The aim of this study was to further characterize the cognitive functions of the patients with OCD by utilizing ERPs and neuropsychological tests. METHODS: ERPs were recorded in a group of 31 drug-free OCD patients without depression and 30 normal controls following verbal auditory stimuli using an oddball paradigm. The specific neuropsychological tests administered to assess cognitive functions in all participants were the Stroop Test, Trail Making Test, Design Fluency Test, Controlled Word Association Test (Verbal Fluency test). RESULTS: The patient group showed shorter P300 duration compared to normal controls. In neuropsychological tests, no significant differences were found between the two groups. Negative correlations between Stroop duration and P300 amplitudes in occipital, parietal, and temporal anterior regions were observed. CONCLUSION: Shorter P300 duration may indicate an acceleration in the P300 process, and speeding of cognitive processing, dysfunction of cortico-subcortical circuits, or some combination of all of the above.

Adolescent↗

The relationship between parental report on the BRIEF and performance-based measures of executive function in children with moderate to severe traumatic brain injury.

The Behavior Rating Inventory of Executive Function (BRIEF) is a questionnaire that assesses parental observations of behaviors associated with executive function in children in the home environment. The current investigation examines the relationship between the BRIEF and individually-administered neuropsychological tests in children with traumatic brain injury. Forty-eight children with moderate to severe traumatic brain injury were administered the WISC-III and several performance-based tests of executive function (the Wisconsin Card Sorting Test, Trail Making Test Part B, verbal fluency), and a parent completed the BRIEF. Results indicate that the Metacognition Index from the BRIEF correlates with Verbal IQ, but none of the index scores from the BRIEF correlate with any of the performance-based tests of executive function. Results are discussed with respect to the ecological validity of standardized clinical neuropsychological tests of executive function.

Brain Injuries↗

Game changer? Cognitive-motor effects of VR exergaming compared to video-based training.

BACKGROUND/OBJECTIVE: Virtual reality (VR) exergaming enhances several cognitive domains through multisensory engagement. Acute cognitive benefits of VR are established, but evidence for direct comparisons with non-immersive controls is limited. This study aimed to determine whether VR exercise provides additional cognitive and cognitive-motor benefits beyond a matched non-immersive active stick-fight video (SFV) intervention, and whether effects persist after training. METHODS: In this randomized quasi-experimental study, N&#x2009;=&#x2009;55 healthy adults (VR: n&#x2009;=&#x2009;30; SFV: n&#x2009;=&#x2009;25; 25.5&#x2009;&#xb1;&#x2009;7.1&#x2009;years; 41.8% female) completed an 8-week program (2&#x2009;&#xd7;&#x2009;30&#x2009;min/week), of VR or SFV matched in movement patterns, frequency, intensity and duration. Measurements included reaction time (RT), Stroop Test (versions 1-3), Letter Cancellation Test (LCT), Trail Making Test (TMT), Trail Walking Test (TWT) and Fitts task (difficulty level 1-4). Data were analyzed using mixed-design ANOVAs. RESULTS: Improvements were observed in Stroop reading (F(1,53) = 14.84, p < .001, &#x3b7;2 = 0.219), Stroop inhibition (F(1,53) = 10.99, p = .002, &#x3b7;2 = 0.172), and LCT (F(1,53) = 4.57, p = .037, &#x3b7;2 = 0.079). A time&#x2009;&#xd7;&#x2009;group interaction was found for TMT (F(1,53) = 6.55, p = .031, &#x3b7;2 = 0.110), indicating greater changes following VR training. Both groups improved cognitive-motor performance (TWT: F(1,25) = 55.32, p < .001, &#x3b7;2 = 0.689; Fitts3: F(1,53) = 44.97, p < .001, &#x3b7;2 = 0.459), with greater gains for VR in Fitts3 (p = .006). CONCLUSION(S): Eight weeks of VR and SFV enhanced cognitive and cognitive-motor performance. VR provided domain-specific advantages in executive function, but these effects were not uniformly persistent. SFV sustained more improvements in real-world-relevant cognitive-motor tasks.

Humans↗

Very-low-birthweight and term small-for-gestational-age adolescents: attention revisited.

AIM: To assess whether adolescents with very low birthweight (VLBW) and peers born small for gestational age (SGA) at term are at a disadvantage when attending to or executing tasks. METHODS: Cohorts of 54 VLBW (<or=1,500 g), 60 SGA and 83 controls were tested with the Knox Cube Test, Conners' Continuous Performance Test (CPT II), Stroop Colour-Word Test, Trail Making Test (TMT) A & B, and Wisconsin Card Sorting Test (WCST). IQ was estimated using the subtests vocabulary and picture arrangement of WISC III. RESULTS: VLBW adolescents scored worse than controls on Knox Cube Test, Stroop Colour-Word Test, TMT A & B and WCST, whereas term SGA adolescents only made more non-perseverative errors in WCST and more errors in the interference condition of the Stroop Colour-Word Test. Thirty-two (38.6%) adolescents in the control group had poor performance (< 2 SD) on at least one of the tests compared with 40 (74.1%) VLBW (p<0.01) and 32 (53.3%) SGA adolescents (not significant). CONCLUSION: VLBW adolescents are at risk of disadvantage in aspects of attention and/or executive functions. The adverse effects of being born SGA at term appear to be few in these domains of cognitive function.

Adolescent↗

The prevalence of "cognitive impairment no dementia" in community-dwelling elderly: a pilot study.

OBJECTIVE: To determine the prevalence of "cognitive impairment no dementia" (CIND) and "amnestic mild cognitive impairment" (aMCI) in a population sample of 70-79-year-olds and the risk factors for CIND. METHOD: Cross sectional population survey. SETTING: Sutherland Shire, Sydney, Australia. SUBJECTS: 150 community-dwelling 70-79-year-olds were screened by telephone, 42 of whom were assessed at home. MEASURES: Demographics, subjective ratings of physical and emotional health and memory, cardiovascular risk factors, medications, the Mini-Mental State Examination, Boston Naming Test, Trail Making Tests A and B, Block Design, Rey Auditory Verbal Learning Test (RAVLT), Visual Reproduction, Logical Memory, letter and category fluency, the National Adult Reading Test (NART), the Geriatric Depression Scale (GDS) and the "state" section of the State-Trait Anxiety Inventory (STAI-S). RESULTS: From the 400 subjects contacted initially, 150 consented to be interviewed and 131 eligible subjects were recruited. Of a 1-in-3 random sample of 42 subjects assessed at home, 14 (33.3%) subjects met criteria for CIND, 1 (2.4%) had possible dementia and the 27 remaining (64.3%) were cognitively normal. Four (9.5%) met criteria for aMCI. Subjects with CIND were older, had lower ranking occupations and were less likely to be currently working than those classified as cognitively normal. Ten subjects with CIND did not meet criteria for aMCI because they lacked subjective memory impairment (n = 3) or had cognitive deficits other than memory (n = 7). All subjects with aMCI met criteria for CIND. CONCLUSIONS: One-third of individuals in this population sample met criteria for CIND. CIND is a broader definition than aMCI. Further research is needed to determine the longitudinal course and clinical utility of these definitions of cognitive impairment.

Aged↗

Neuropsychological disturbances and cerebral blood flow in bipolar disorder.

OBJECTIVE: To determine and correlate alterations in neuropsychological function and cerebral blood flow in bipolar patients. METHOD: Assessments included the Positive and Negative Symptom Scale, Global Assessment Functioning, Wechsler Adult Intelligence Scale (WAIS), Wisconsin Card Sorting Test (WCST), Stroop test, Trail Making Test (TMT), California Verbal Learning Test (CVLT), Wechsler Memory Scale (WMS) and phonetic verbal fluency/controlled oral word association tests. Single photon emission computed tomography (SPECT) was carried out with the administration of 99mTc-HMPAO. Forty-three outpatients out of 85 fulfilling RDC diagnostic criteria for bipolar disorder and six healthy subjects were included in the study. SPECT and neuropsychological assessments were performed in 30 patients in manic (n = 7), hypomanic (n = 8), depressed (n = 12) or euthymic (n = 3) states. All assessments were carried out before starting treatment. RESULT: Several corrected correlations between neuropsychological function and cerebral blood flow (CBF) were identified: executive function (WCST) and striatal, frontal, temporal, cerebellum, parietal and cingulate CBF; memory (WMS, WAIS-Digits) and striatal, frontal, temporal and parietal CBF; attentional tasks (Stroop) and striatal, temporo-medial and parietal CBF; verbal learning (CVLT) and frontal, posterior temporal, cingulate and occipital CBF; psychomotor disturbances (TMT) and anterior temporal CBF; poorer intelligence performance scores (WAIS-Vocabulary) and cerebellum and parietal CBF. CONCLUSIONS: This study confirms the presence of functional disturbances in fronto-subcortical structures, the cerebellum and limbic system in bipolar patients.

Adult↗

Does the SCL 90-R obsessive-compulsive dimension identify cognitive impairments?

OBJECTIVE: To investigate the relevance of the Symptom Checklist 90-R Obsessive-Compulsive subscale to cognition in individuals with brain tumor. DESIGN: A prospective study of patients assessed with a neuropsychological test battery. SETTING: A university medical center. PATIENTS: Nineteen adults with biopsy-confirmed diagnoses of malignant brain tumors were assessed prior to aggressive chemotherapy. MAIN OUTCOME MEASURES: Included in the assessment were the Mattis Dementia Rating Scale, California Verbal Learning Test, Trail Making Test B, Symptom Checklist 90-R, Mood Assessment Scale, Beck Anxiety Inventory, and Chronic Illness Problem Inventory. RESULTS: The SCL 90-R Obsessive-Compulsive subscale was not related to objective measures of attention, verbal memory, or age. It was related significantly to symptoms of depression (r = .81, P < .005), anxiety (r = .66, P < .005), and subjective complaints of memory problems (r = .75, P < .005). Multivariate analyses indicated that reported symptoms of depression contributed 66% of the variance in predicting SCL 90-R Obsessive-Compulsive Scores, whereas symptoms of anxiety contributed an additional 6% (P < .0001). CONCLUSIONS: Our data suggest that the SCL 90-R is best viewed as an indicator of unidimensional emotional distress and somatic effects of structural brain injury.

Adult↗

Long-term neuropsychological outcome after traumatic brain injury.

OBJECTIVE: To describe neuropsychological outcome 5 years after injury in persons with traumatic brain injury (TBI) who received inpatient medical rehabilitation. To determine the magnitude and pattern neuropsychological recovery from 1 year to 5 years after injury. DESIGN: Longitudinal cohort study with inclusion based on the availability of neuropsychological data at 1 year and 5 years after injury. SETTING: National Institute on Disability and Rehabilitation Research Traumatic Brain Injury Model Systems of Care. PARTICIPANTS: One hundred eighty-two persons with complicated mild to severe traumatic brain injury. PRIMARY OUTCOME MEASURES: Digits Forward and Backward, Logical Memory I and II, Token Test, Controlled Oral Word Association Test, Symbol Digit Modalities Test, Trail Making Test, Rey Auditory Verbal Learning Test, Visual Form Discrimination, Block Design, Wisconsin Card Sorting Test, and Grooved Pegboard. RESULTS: Significant variability in outcome was found 5 years after TBI, ranging from no measurable impairment to severe impairment on neuropsychological tests. Improvement from 1 year after injury to 5 years was also variable. Using the Reliable Change Index, 22.2% improved, 15.2% declined, and 62.6% were unchanged on test measures. CONCLUSIONS: Neuropsychological recovery after TBI is not uniform across individuals and neuropsychological domains. For a subset of persons with moderate to severe TBI, neuropsychological recovery may continue several years after injury with substantial recovery. For other persons, measurable impairment remains 5 years after injury. Improvement was most apparent on measures of cognitive speed, visuoconstruction, and verbal memory.

Adult↗

Alternative approaches to the assessment of mild head injury in athletes.

OBJECTIVES: Athletic trainers and team physicians are often faced with decisions concerning the severity and timing of an athletes return to play following mild head injury (MHI). These decisions can be the most difficult ones facing clinicians because of the limited amount of quantitative information indicating injury severity. Several authors have published guidelines for return to play following MHI, however these guidelines are based on limited scientific data. The purpose of this paper was to examine the effects of MHI on two objective measures, postural stability and cognitive function, to determine their usefulness in MHI assessment. The data gathered from these two measures has the potential to establish recovery curves based on objective data. METHODS: Eleven Division I collegiate athletes who sustained a MHI and eleven matched control subjects were assessed for postural stability and cognitive function at four intervals following injury. Postural stability was assessed using the Sensory Organization Test on the NeuroCom Smart Balance Master. Cognitive functioning was measured through the use of four neuropsychological tests: Stroop Test, Trail Making Test, Digits Span and Hopkins Verbal Learning Test. Separate mixed model repeated measures ANOVAs were calculated for the composite score and three ratio (vestibular, visual and somato-sensory) scores from the Sensory Organization Test and the scores from the neuropsychological test to reveal significant differences between groups and across days postinjury. RESULTS: A significant group by day interaction for overall postural stability (composite score) revealed that MHI athletes displayed increased postural instability for the first few days following MHI (p < .05). Analysis of the ratio scores revealed a significant interaction for the visual ratio. No significant group differences were revealed for any of the neuropsychological tests (p > .05), however significant day differences were revealed (p < .05). CONCLUSIONS: The results from this study indicate that athletes demonstrate decreased stability until 3 days postinjury. It appears this deficit is related to a sensory interaction problem, whereby the injured athlete fails to use their visual system effectively. These findings suggest that measures of postural stability may provide clinicians with a useful clinical tool for determining when an athlete may safely return to competition, although these findings need to be confirmed in larger groups of athletes.

Adolescent↗

Neuropsychological test performance prior to and following sports-related mild traumatic brain injury.

OBJECTIVE: To examine the utility of neuropsychological tests in assessing college athletes prior to and following a sports-related mild Traumatic Brain Injury (mTBI). DESIGN: A prospective study of college athletes who sustained mTBI while engaged in sport. Preinjury baseline neuropsychological test data were obtained for athletes at risk for mTBI. Following an mTBI, the athlete and his or her matched noninjured control were evaluated at 2 hours, 48 hours, 1 week, and I month postinjury. SETTING: Male and female athletes from a Division I college. PARTICIPANTS: Male and female athletes from the football, men's ice hockey, men's and women's soccer, and men's and women's basketball teams at Penn State University. A total of 29 injured and 20 noninjured athletes participated in the study. INTERVENTIONS: Neuropsychological test batteries were administered at baseline and serially following mTBI. MAIN OUTCOME MEASURES: Post-Concussion Symptom Checklist, Hopkins Verbal Learning Test, Symbol Digit Modalities Test, Stroop Color-Word Test, Trail Making Test, VIGIL/W, List Learning, Digit Span, Penn State Cancellation Test, and Controlled Oral Word Association. RESULTS: Neuropsychological test data yielded significant differences between injured athletes and controls at 2 hours and 48 hours following cerebral concussion; injured athletes performing significantly worse than controls. Injured athletes reported a significantly greater number of postconcussion symptoms 2 hours following injury but not at the 48-hour assessment. No multivariate group differences were found at 1 week, but univariate analyses suggested significant differences on a few measures. At 1 month postinjury, a statistically significant difference was found on one measure with injured athletes marginally outperforming controls. CONCLUSIONS: Neuropsychological tests are useful in the detection of cognitive impairment following mTBI. The test data appear to be more effective than subjective report of symptoms in differentiating between injured and noninjured athletes at 48 hours postinjury. Although significant individual variability existed, most injured athletes recovered within 1 week of injury. A battery of tests, rather than any single test, is necessary to capture the variability that exists among injured athletes.

Adolescent↗

Anosognosia in Alzheimer's disease: association with patient characteristics, psychiatric symptoms and cognitive deficits.

Anosognosia is one of the major problems in the treatment and care of Alzheimer's disease (AD) patients. The aim of the study was to determine the patient characteristics, psychiatric symptoms, and cognitive deficits associated with anosognosia, because these are currently poorly understood. Eighty-four patients who met the National Institute of Neurological and Communicative Disease and Stroke-Alzheimer's Disease and Related Disorders Association criteria for probable AD were examined for anosognosia based on the difference between questionnaire scores of the patient and their caregiver. The relationship of anosognosia with patient characteristics (age, age at onset, duration of illness, education, Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Hyogo Activities of Daily Living Scale (HADLS)), psychiatric symptoms (Neuropsychiatric Inventory (NPI), Geriatric Depression Scale (GDS)), and cognitive function (Digit Span, Word Fluency Test, Trail Making Test, Stroop Test, Raven's Coloured Progressive Matrices Test) were studied. Anosognosia showed positive correlations with age, age at onset, duration of illness, CDR, HADLS, and NPI disinhibition, and negative correlations with MMSE and GDS. Regarding cognitive function, only Part III of the Stroop Test was a predictor of anosognosia. The severity of anosognosia increased with disease progression and with a later age at onset. Subjective complaints of depression requiring self-monitoring of mood tended to decrease and, in contrast, inhibition of socially unsuitable behavior became more difficult as anosognosia worsened. Regarding cognitive function, anosognosia appeared to be associated with response inhibition impairment. Both disinhibition, as a psychiatric symptom, and response inhibition impairment are known to be correlated with disturbance of orbitofrontal function, which therefore may be associated with anosognosia.

Aged↗

Course of attention and memory after common whiplash: a two-years prospective study with age, education and gender pair-matched patients.

Attentional functioning and memory of common whiplash patients were evaluated during the first two years after experiencing injury. The study was based on a non-selected sample of 117 whiplash patients referred from primary care and recruited according to a strict injury definition. All patients had a similar socioeconomic background, all being injured in automobile accidents and fully covered by insurance plans. Two years following initial trauma, 21 patients remained symptomatic. For each of these 21 patients, a counterpart matched by age, educational attainment and gender was selected from the group of patients who had fully recovered during the follow-up period. Symptomatic patients and matched controls were compared with regard to baseline, six-months and two-years findings. Examinations included testing of different aspects of attention (i.e. Digit Span, Corsi Block-Tapping Test, Trail Making Test, Number Connection Test, Paced Auditory Serial Addition Task) and memory functioning (California Verbal Learning Test). Cognitive functioning was assessed in conjunction with self-ratings of cognitive abilities (Cognitive Failures Questionnaire), well-being (Well-being Scale), headache and neckpain intensity, utilized medication and subjective complaints. Results show no impairment of memory in symptomatic patients. In attentional functioning, different levels of improvement were found for symptomatic patients and matched counterparts, with the former showing difficulty at follow-up with tasks of divided attention. Utilized medication and pain intensity could not explain this difference in recovery of attentional functioning between the groups. These findings suggest problems in selective aspects of attentional functioning after common whiplash, which under real life circumstances may explain these patients' cognitive complaints and cause adaptational problems in daily life.

Accidents, Traffic↗

Pallidal stimulation in dystonia: effects on cognition, mood, and quality of life.

Bilateral deep brain stimulation (DBS) of the globus pallidus internus (GPi) alleviates symptoms in patients with dystonia but its effects on cognition, neuropsychiatric status, and quality of life have not been examined. This is a case series report of 15 consecutive patients with different forms of dystonia who underwent bilateral implantation of DBS electrodes in the GPi. The patients were evaluated preoperatively and after 3-12 months of DBS with tests of cognition (Mattis Dementia Rating Scale, Stroop Test, Trail Making Test, Phonemic and Category Word Fluency, Digit Span, Rey Auditory Verbal Learning Test, Tonic and Phasic Alertness), neuropsychiatric status (Beck Depression and Anxiety Inventories, Montgomery Asberg Depression Rating Scale, Snaith-Hamilton Pleasure Scale, Brief Psychiatric Rating Scale), quality of life, and motor functions. GPi DBS significantly improved dystonic symptoms, functional abilities, and quality of life allowing for a significant reduction of antidystonic medications. No deterioration was observed in cognitive scores and neuropsychiatric measures. The present case series report thus provides preliminary evidence for the safety of GPi DBS regarding cognitive and neuropsychiatric functions in patients with dystonia.

Adolescent↗

Extrapyramidalism in Alzheimer's disease: prevalence, psychiatric, and neuropsychological correlates.

The prevalence and clinical correlates of extrapyramidal signs in a consecutive series of 78 patients with Alzheimer's disease attending a neurology clinic, and 20 age comparable normal controls, were examined. Based on the unified Parkinson's disease rating scale (UPDRS) findings, 18 patients (23%) met criteria for parkinsonism, 44 (56%) had isolated extrapyramidal signs, and 16 (21%) had no extrapyramidal signs. Whereas the control group showed a similar prevalence of isolated extrapyramidal signs (57%), none of them showed parkinsonism. No significant differences were found for age, sex, duration of illness, and severity of dementia among the three Alzheimer's disease groups. Patients with Alzheimer's disease-parkinsonism, however, showed a significantly higher frequency of major depression and dysthymia and significantly higher Hamilton depression scores than patients with isolated or no extrapyramidal signs. Patients with Alzheimer's disease-parkinsonism also showed significantly more deficits on frontal lobe related tasks such as the Wisconsin card sorting test, trail making test, and verbal fluency, as well as on tests of constructional praxis and abstract reasoning than patients with Alzheimer's disease but no extrapyramidal signs. In conclusion, the study showed a specific association between Alzheimer's disease and parkinsonism, as well as significant relations between parkinsonism, deficits in executive functions, and depression among patients with Alzheimer's disease.

Aged↗

[Cognitive assessment in the elderly. Normative data of a Spanish population sample older than 70 years].

BACKGROUND AND OBJECTIVE: To define the parameters of normal cognitive performance in an easy to administer neuropsychological battery of a Spanish population sample of elderly over 70 years. SUBJECTS AND METHOD: We examined 527 home dwelling elderly from the longitudinal study Envejecer en Leganés, 71 to 99 years old (mean age [SD] 79 [6.2] years, 51.8% women, 38.7% without formal education), with an extensive clinical survey, a neurological exam and the following neuropsychological battery: Short Portable Mental Status Questionnaire, Mini Mental State Examination, Benton Orientation Test, Bell Test, Verbal Fluency, Clock Drawing Test, Trail Making Test, Free and Cued Figures Recall, Logic Memory, Naming, incidental Recall, Delayed Recall, Similarities, IQCODE Questionnaire Of Jorm and Depression Questionnaire CES-D. 111 cases who rejected the assessment or had sensomotor limitations were excluded. 368 non demented subjects (according to DSM-IV criteria; 88.5% of the de 416 remaining cases) were selected to establish the normative data of every test. RESULTS: The analyzed subsample was representative of the total sample. The normative data for every neuropsychological test were obtained in the total group of non demented subjects and in the subgroups stratified by four age levels and two cultural levels. The mean values, standard deviations, range and percentiles for every test and subgroup are presented. CONCLUSIONS: The normative data obtained in this population sample for a neuropsychological battery easy to administer to poorly educated elderly can be useful to rigourously apply the criteria of dementia and mild cognitive impairment in future clinical and population studies.

Aged↗