OBJECTIVE: This study assessed the relationship between speech and language impairment and outcome in a multicenter cohort of isolated/idiopathic rapid eye movement (REM) sleep behavior disorder (iRBD). METHODS: Patients with iRBD from 7 centers speaking Czech, English, German, French, and Italian languages underwent a detailed speech assessment at baseline. Story-tale narratives were transcribed and linguistically annotated using fully automated methods based on automatic speech recognition and natural language processing algorithms, leading to the 3 distinctive linguistic and 2 acoustic patterns of language deterioration and associated composite indexes of their overall severity. Patients were then prospectively followed and received assessments for parkinsonism or dementia during follow-up. The Cox proportional hazard was performed to evaluate the predictive value of language patterns for phenoconversion over a follow-up period of 5 years. RESULTS: Of 180 patients free of parkinsonism or dementia, 156 provided follow-up information. After a mean follow-up of 2.7 years, 42 (26.9%) patients developed neurodegenerative disease. Patients with higher severity of linguistic abnormalities (hazard ratio [HR = 2.35]) and acoustic abnormalities (HR = 1.92) were more likely to develop a defined neurodegenerative disease, with converters having lower content richness (HR = 1.74), slower articulation rate (HR = 1.58), and prolonged pauses (HR = 1.46). Dementia-first (n = 16) and parkinsonism-first with mild cognitive impairment (n = 9) converters had higher severity of linguistic abnormalities than parkinsonism-first with normal cognition converters (n = 17). INTERPRETATION: Automated language analysis might provide a predictor of phenoconversion from iRBD into synucleinopathy subtypes with cognitive impairment, and thus can be used to stratify patients for neuroprotective trials. ANN NEUROL 2024;95:530-543.
OBJECTIVE: This study examined associations between physical activity (PA) and neuropsychiatric symptoms (NPS) in older adults free of dementia. METHODS: This cross-sectional study included 3,222 individuals ≥70 years of age (1,655 men; mean±SD age=79.2±5.6; cognitively unimpaired, N=2,723; mild cognitive impairment, N=499) from the population-based Mayo Clinic Study of Aging. PA (taken as a presumed predictor) in midlife (i.e., when participants were 50-65 years of age) and late life (i.e., the year prior to assessment) was assessed with a self-reported, validated questionnaire; PA intensity and frequency were used to calculate composite scores. NPS (taken as presumed outcomes) were assessed with the Neuropsychiatric Inventory Questionnaire, Beck Depression Inventory (BDI-II), and Beck Anxiety Inventory (BAI). Regression analyses included midlife and late-life PA in each model, which were adjusted for age, sex, education, apolipoprotein E ɛ4 status, and medical comorbidity. RESULTS: Higher late-life PA was associated with lower odds of having apathy (OR=0.89, 95% CI=0.84-0.93), appetite changes (OR=0.92, 95% CI=0.87-0.98), nighttime disturbances (OR=0.95, 95% CI=0.91-0.99), depression (OR=0.94, 95% CI=0.90-0.97), irritability (OR=0.93, 95% CI=0.89-0.97), clinical depression (OR=0.92, 95% CI=0.88-0.97), and clinical anxiety (OR=0.90, 95% CI=0.86-0.94), as well as lower BDI-II (β estimate=-0.042, 95% CI=-0.051 to -0.033) and BAI (β estimate=-0.030, 95% CI=-0.040 to -0.021) scores. Higher midlife PA was associated only with higher BDI-II scores (β estimate=0.011, 95% CI=0.004 to 0.019). Sex modified the associations between PA and NPS. CONCLUSIONS: Late-life PA was associated with a lower likelihood of clinical depression or anxiety and subclinical NPS. These findings need to be confirmed in a cohort study.
- MeSH
- cvičení MeSH
- deprese * psychologie MeSH
- kognitivní dysfunkce * diagnóza MeSH
- kohortové studie MeSH
- lidé MeSH
- neuropsychologické testy MeSH
- průřezové studie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stárnutí MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Cancer-related cognitive impairment (CRCI) is one of the most serious side effects of cancer that negatively impacts the quality of life of cancer patients and survivors. There is evidence of CRCI in Hodgkin lymphoma patients (HL); however, there is a lack of studies examining the presence of cognitive deficits before starting any treatment in HL patients. METHODS: Forty adult patients (N = 40) newly diagnosed with HL (with no previous cancer diagnoses) and 40 healthy controls (N = 40) matched for age, sex, education, and premorbid intellect completed the neuropsychological battery and subjective and objective measures of affective distress and quality of life. RESULTS: The results showed impairment in three out of six cognitive domains: verbal memory and learning, speed of processing/psychomotor speed, and abstraction/executive functions in the HL patients before the initiation of any treatment. The speed of processing/psychomotor speed domain is negatively correlated with depression. CONCLUSION: Cognitive deterioration in verbal memory and learning and abstraction/executive functions domains in HL patients seems to occur before the initiation of treatment independently of anxiety, depression, or physical symptoms. This suggests that HL itself may cause cognitive deficits in these cognitive domains. However, the underlying causes of CRCI still remain unclear.
- MeSH
- COVID-19 * komplikace MeSH
- dospělí MeSH
- kognitivní dysfunkce * diagnóza farmakoterapie komplikace MeSH
- lidé středního věku MeSH
- lidé MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
OBJECTIVES: Examine cognitive changes over time among nursing home residents and develop a risk model for identifying predictors of cognitive decline. DESIGN: Using secondary analysis design with Minimum Data Set data, cognitive status was based on the Cognitive Performance Scale (CPS). SETTING AND PARTICIPANTS: Baseline and 7 quarterly follow-up analyses of US and Canadian interRAI data (N = 1,257,832) were completed. METHODS: Logistic regression analyses identified predictors of decline to form the CogRisk-NH scale. RESULTS: At baseline, about 15% of residents were cognitively intact (CPS = 0), and 11.2% borderline intact (CPS = 1). The remaining more intact, with mild impairment (CPS = 2), included 15.0%. Approximately 59% residents fell into CPS categories 3 to 6 (moderate to severe impairment). Over time, increasing proportions of residents declined: 17.1% at 6 months, 21.6% at 9 months, and 34.0% at 21 months. Baseline CPS score was a strong predictor of decline. Categories 0 to 2 had 3-month decline rates in midteens, and categories 3 to 5 had an average decline rate about 9%. Consequently, a 2-submodel construction was employed-one for CPS categories 0 to 2 and the other for categories 3 to 5. Both models were integrated into a 6-category risk scale (CogRisk-NH). CogRisk-NH scale score distribution had 15.9% in category 1, 26.84% in category 2, and 36.7% in category 3. Three higher-risk categories (ie, 4-6) represented 20.6% of residents. Mean decline rates at the 3-month assessment ranged from 4.4% to 28.3%. Over time, differentiation among risk categories continued: 6.9% to 38.4.% at 6 months, 11.0% to 51.0% at 1 year, and 16.2% to 61.4% at 21 months, providing internal validation of the prediction model. CONCLUSIONS AND IMPLICATIONS: Cognitive decline rates were higher among residents in less-impaired CPS categories. CogRisk-NH scale differentiates those with low likelihood of decline from those with moderate likelihood and, finally, much higher likelihood of decline. Knowledge of resident risk for cognitive decline enables allocation of resources targeting amenable factors and potential interventions to mitigate continuing decline.
- MeSH
- kognice MeSH
- kognitivní dysfunkce * diagnóza MeSH
- lidé MeSH
- pečovatelské domovy * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Kanada MeSH
Cíl: Nedávno byla vyvinuta možnost elektronického vyšetření paměti testem ALBAV. Cílem práce bylo zjistit jeho diskriminační a souběžnou validitu a další charakteristiky. Metody: Vyplňování elektronického testu ALBAV probíhalo v domácím prostředí účastníků, u některých pacientů s asistencí blízké osoby při obsluze počítače. Celkový skór ALBAV 0–40 vzniká jako součet výsledků ze čtyř úloh vždy s rozmezím 0–10 bodů: vybavení počtu správných 1) názvů obrázků; 2) gest; 3) slov věty a 4) pojmenování obtížnějších obrázků pro pacienty s kognitivní poruchou. Test ALBAV si samo provedlo 108 osob starších 55 let rozdělených na skupinu 34 pacientů s mírnými poruchami kognitivních funkcí (KOPO) a 74 osob vyšetřených neuropsychologickými testy kvůli souběžné validitě, z nichž byla vybrána podskupina 45 osob s normálními kognitivními funkcemi (NOS) a podobnými sociodemografickými charakteristikami jako pacienti. Výsledky: Pacienti KOPO měli významně nižší skóry v jednotlivých úlohách i celkovém skóru ALBAV (21 ± 6 vs. 30 ± 3) než NOS. Podle analýzy receiver operating characteristic je optimálním hraničním skórem 27 bodů se senzitivitou 82 % a specificitou 82 % a vysokou plochou pod křivkou 0,9 pro detekci mírných poruch kognitivních funkcí. Celkový skór testu ALBAV významně koreluje pozitivně se skóry v Reyově paměťovém testu učení a negativně s trváním v Testech cesty A a B. Dále významně koreluje s výsledky osobního vyšetření – paměťovým skórem ALBA a s počtem vybavených obrázků v testu POBAV. Hodnota Cronbachova alfa pro test ALBAV je 0,77. Závěr: Elektronický test ALBAV jako nástroj k samovyšetření paměti má potvrzenou dostatečnou diskriminační a souběžnou validitu. Budoucím plánem je zavedení automatického vyhodnocení testu a přizpůsobení testu různým elektronickým zařízením.
Aim: Electronic memory assessment has been recently developed using the ALBAV test. The aim of the study was to find out its discriminant and concurrent validity and other characteristics. Methods: The ALBAV electronic tests were completed at home of the participants with computer assistance of a nearby person in some patients. The total ALBAV score of 0–40 is a sum of the results of four tasks each with a range of 0–10 points: the number of correctly recalled 1) picture names; 2) gestures; 3) words of a sentence and 4) naming more difficult pictures for patients with cognitive impairment. The ALBAV test was self-administered by 108 persons over the age of 55. They were divided into a group of 34 patients with mild impairment of cognitive functions (MIC) and 74 individuals assessed with neuropsychological tests for concurrent validity from whom a subgroup of 45 persons with normal cognitive functions (NE) and similar sociodemographic characteristics as patients was selected. Results: MIC patients had significantly lower scores in individual tasks and the total ALBAV score (21 ± 6 vs. 30 ± 3 points) than those in the NE group. Based on the receiver operating characteristic analysis, the optimal cut-off score is 27 points with a sensitivity of 82%, a specificity of 82%, and a high area under the curve of 0.9 for detection of mild impairment of cognitive functions. The total score of the ALBAV test is significantly positively correlated with scores of the Rey Auditory Verbal Learning Test and negatively correlated with the duration of the Trail Making Tests A and B. It is also significantly correlated with the results of the in-person evaluation – the ALBA memory score and the number of recalled picture names in the PICNIR test. A Cronbach‘s alpha value for the ALBAV test is 0.77. Conclusion: The ALBAV electronic test is a possible valid tool for memory self-examination. The future plan is to implement an automatic evaluation of the test and adaptation of the test to different electronic devices.
- Klíčová slova
- testy ALBAV,
- MeSH
- klinická studie jako téma MeSH
- kognitivní dysfunkce * diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- neuropsychologické testy * MeSH
- poruchy paměti diagnóza MeSH
- reprodukovatelnost výsledků MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- telemedicína * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- práce podpořená grantem MeSH
INTRODUCTION: We examined the association between cerebrospinal fluid (CSF)-derived biomarkers of Alzheimer's disease and neuropsychiatric symptoms (NPS) in older non-demented adults. METHODS: We included 784 persons (699 cognitively unimpaired, 85 with mild cognitive impairment) aged ≥ 50 years who underwent CSF amyloid beta (Aβ42), hyperphosphorylated tau 181 (p-tau), and total tau (t-tau) as well as NPS assessment using Beck Depression and Anxiety Inventories (BDI-II, BAI), and Neuropsychiatric Inventory Questionnaire (NPI-Q). RESULTS: Lower CSF Aβ42, and higher t-tau/Aβ42 and p-tau/Aβ42 ratios were associated with BDI-II and BAI total scores, clinical depression (BDI-II ≥ 13), and clinical anxiety (BAI ≥ 10), as well as NPI-Q-assessed anxiety, apathy, and nighttime behavior. DISCUSSION: CSF Aβ42, t-tau/Aβ42, and p-tau/Aβ42 ratios were associated with NPS in community-dwelling individuals free of dementia. If confirmed by a longitudinal cohort study, the findings have clinical relevance of taking into account the NPS status of individuals with abnormal CSF biomarkers.
- MeSH
- Alzheimerova nemoc * mozkomíšní mok MeSH
- amyloidní beta-protein mozkomíšní mok MeSH
- biologické markery mozkomíšní mok MeSH
- kognitivní dysfunkce * diagnóza MeSH
- lidé MeSH
- longitudinální studie MeSH
- peptidové fragmenty mozkomíšní mok MeSH
- proteiny tau mozkomíšní mok MeSH
- senioři MeSH
- stárnutí MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- MeSH
- antitumorózní látky škodlivé účinky MeSH
- centrální nervový systém patologie účinky léků účinky záření MeSH
- kognitivní dysfunkce * chemicky indukované diagnóza terapie MeSH
- kognitivní porucha po chemoterapii diagnóza terapie MeSH
- látky ovlivňující centrální nervový systém terapeutické užití MeSH
- lidé MeSH
- nežádoucí účinky léčiv * diagnóza terapie MeSH
- radioterapie škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
