Cognitive reserve (CR) has been conceptualized as an individual's ability to optimize or maximize performance through differential recruitment of brain networks. As such, CR may contribute to the heterogeneity of cognitive deficits observed in schizophrenia. This study aimed to assess the relationships between CR, cognition and quality of life in first-episode (FES) patients. A total of 137 patients with either ICD-10 schizophrenia or "acute and transient psychotic disorders" diagnosis, and 62 healthy controls had completed a comprehensive assessment of six cognitive domains: speed of processing, attention, working memory/flexibility, verbal memory, visual memory, and abstraction/executive functioning. CR was calculated from the participants' education, premorbid IQ, and socioeconomic status. The results suggested that in patients, CR was positively related to cognitive performance in all domains, explaining 42.6% of the variance observed in cognition overall. Effects of CR in the control group were limited to three domains: speed of processing, abstraction/executive function and working memory/flexibility. These results suggest that CR largely contributes to cognitive variations present in FES patients. In addition, CR was negatively related to the social construct of patients' quality of life, and positively to symptom severity and general functioning.
- Keywords
- Cognitive deficit, Cognitive domains, Cognitive reserve, First episode, Quality of life, Schizophrenia,
- MeSH
- Cognition MeSH
- Cognitive Reserve * MeSH
- Memory, Short-Term MeSH
- Quality of Life MeSH
- Humans MeSH
- Neuropsychological Tests MeSH
- Schizophrenia * complications diagnosis MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
OBJECTIVE: The aim of these secondary analyses was to examine cognitive speed of processing training (SPT) gains in cognitive and everyday functioning among older adults with psychometrically defined mild cognitive impairment (MCI). METHOD: A subgroup of participants from the Staying Keen in Later Life (SKILL) study with psychometrically defined MCI ( N = 49) were randomized to either the SPT intervention or an active control group of cognitive stimulation. Outcome measures included the Useful Field of View (UFOV), Road Sign Test, and Timed Instrumental Activities of Daily Living (IADL) Test. A 2 × 2 repeated-measures MANOVA revealed an overall effect of training, indicated by a significant group (SPT vs. control) by time (baseline vs. posttest) interaction. RESULTS: Effect sizes were large for improved UFOV, small for the Road Sign test, and medium for Timed IADL. DISCUSSION: Results indicate that further investigation of cognitive intervention strategies to improve everyday functioning in patients with MCI is warranted.
- Keywords
- activities of daily living, cognitive training, mild cognitive impairment,
- MeSH
- Activities of Daily Living MeSH
- Cognitive Behavioral Therapy methods MeSH
- Cognitive Dysfunction therapy MeSH
- Humans MeSH
- Neuropsychological Tests MeSH
- Aged MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial, Phase II MeSH
- Randomized Controlled Trial MeSH
- Research Support, N.I.H., Extramural MeSH
OBJECTIVES: The present study examines the associations between mental, social, and physical demands of work and cognitive functioning among older adults in the United States. METHOD: Data from 3,176 respondents in the Health and Retirement Study were analyzed using growth curve modeling (2004-2014). The study investigated differences by gender, race, ethnicity, and education. RESULTS: Higher mental and social demands of work were associated with higher levels of initial cognitive functioning, but were not significantly associated with slower cognitive decline over time. Physical demands of work were negatively associated with initial cognitive functioning and were also marginally associated with a slower rate of decline in cognitive functioning going into older adulthood. In stratified analyses, results varied by sociodemographic characteristics. DISCUSSION: The results partially support the environmental complexity hypothesis and the productive aging framework in that higher mental and social demands and lower physical demands relate to better cognitive functioning at baseline, with the differences appearing stable throughout older adulthood. The stratified results shed light on addressing disparities in cognitive aging and work environments.
- Keywords
- Cognition, Employment and older workers, Quantitative methods, Work complexity,
- MeSH
- Intelligence MeSH
- Cognition MeSH
- Cognitive Dysfunction * physiopathology psychology MeSH
- Cognitive Aging physiology MeSH
- Humans MeSH
- Job Description * MeSH
- Work Performance MeSH
- Aged MeSH
- Social Interaction * MeSH
- Sociodemographic Factors MeSH
- Aging psychology MeSH
- Educational Status MeSH
- Physical Functional Performance * MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
PURPOSE: The current study aimed to (1) examine the sociodemographic, clinical and psychological factors related to subjective cognitive functioning (SCF); (2) analyze the complex mutual interconnections between SCFs; and (3) address patients' perspectives on SCF and supportive care. METHOD: A heterogeneous sample of oncological patients (N = 566) was recruited.Items inquiring about the senses, attention, memory, spatial functions, decision-making and speech were administered. A network of subjectively perceived changes in cognitive functions was estimated while three open-ended questions addressed patients' perspectives on SCF. RESULTS: Within the network, deficits in spatial perception, attention focus and problem-solving ability had the highest strength index while the deficits related to the senses were the least influential. CONCLUSION: The findings indicate that psychological-based interventions focused on higher cognitive functions could improve patients' quality of life. The presence of supportive care and available information could strengthen SCF intervention and prevention for patients with cancer.
- Keywords
- Cognitive functioning, network analysis, patients with cancer, self-evaluation, supportive care,
- Publication type
- Journal Article MeSH
BACKGROUND: An association between lipid measures and cognitive decline in patients with multiple sclerosis (MS) has been suggested. OBJECTIVES: This study aimed to investigate relationships between lipid profile and cognitive performance in a large observational cohort of MS patients. MATERIALS AND METHODS: We included 211 patients with 316 available pairs of lipid and cognitive measures performed over follow-up. The time between lipid and cognitive measures did not exceed 90 days. Baseline data were analyzed by non-parametric Spearman rank correlation test. Repeated measures were analyzed using linear mixed models adjusted for sex, age, education level, disease-modifying therapy status, and depression. RESULTS: Baseline analyses showed a correlation between higher low-density lipoprotein cholesterol (LDL-C) and lower Categorical Verbal Learning Test (CVLT) (rho=-0.15; p = 0.04), lower Symbol Digit Modalities Test (SDMT) (rho=-0.16; p = 0.02) and lower Brief Visuospatial Memory Test-Revised (BVMT-R) scores (rho=-0.12; p = 0.04). Higher high-density lipoprotein cholesterol (HDL-C) was negatively correlated with lower SDMT scores (rho=-0.16; p = 0.02) and lower Paced Auditory Serial Addition Test-3 (PASAT-3) scores (rho=-0.24; p = 0.03). Mixed model analyses of repeated measures showed a negative association between higher LDL-C and lower CVLT (B=-0.02; p < 0.001, Cohen´s d = 0.08) and lower BVMT-R (B=-0.01; p = 0.03, Cohen´s d=-0.12). Also, the negative association between HDL-C and PASAT-3 was confirmed in the mixed model analysis (B=-0.18; p = 0.01, Cohen´s d = 0.07). Additional adjustments of the models for disability assessed by Expanded Disability Status Scale or Normalized Brain Volume did not change the results of the models substantially. CONCLUSIONS: Our results suggest a mild negative impact of dyslipidemia on cognitive performance in patients with MS. We propose that dyslipidemia contributes, at least in part, to cognitive decline in MS patients, independent of brain atrophy.
- Keywords
- Cognition, HDL, LDL, Multiple sclerosis,
- MeSH
- Adult MeSH
- Cholesterol, HDL blood MeSH
- Cognition physiology MeSH
- Cognitive Dysfunction * etiology blood physiopathology MeSH
- Cholesterol, LDL * blood MeSH
- Middle Aged MeSH
- Humans MeSH
- Neuropsychological Tests MeSH
- Multiple Sclerosis * blood complications MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Names of Substances
- Cholesterol, HDL MeSH
- Cholesterol, LDL * MeSH
Spatial navigation (SN) impairment is present early in Alzheimer's disease (AD). We tested whether SN performance, self-centered (egocentric) and world-centered (allocentric), was distinguishable from performance on established cognitive functions-verbal and nonverbal memory, executive and visuospatial function, attention/working memory, and language function. 108 older adults (53 cognitively normal [CN] and 55 with amnestic mild cognitive impairment [aMCI]) underwent neuropsychological examination and real-space navigation testing. Subset (n = 63) had automated hippocampal volumetry. In a factor analysis, allocentric and egocentric navigation tasks loaded highly onto the same factor with low loadings on other factors comprising other cognitive functions. In linear regression, performance on other cognitive functions was not, or was only marginally, associated with spatial navigation performance in CN or aMCI groups. After adjustment for age, gender, and education, right hippocampal volume explained 26% of the variance in allocentric navigation in aMCI group. In conclusion, spatial navigation, a known cognitive marker of early AD, may be distinguished from other cognitive functions. Therefore, its assessment along with other major cognitive functions may be highly beneficial in terms of obtaining a comprehensive neuropsychological profile.
- Keywords
- Alzheimer's disease, Hippocampus, Mild cognitive impairment, Morris Water Maze, Neuropsychology, Spatial navigation,
- MeSH
- Hippocampus diagnostic imaging pathology MeSH
- Cognition physiology MeSH
- Middle Aged MeSH
- Humans MeSH
- Magnetic Resonance Imaging MeSH
- Memory physiology MeSH
- Spatial Navigation physiology MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Aging pathology psychology MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
BACKGROUND: Subjective cognitive complaints (SCCs) may be an early marker of prodromal Alzheimer's disease. OBJECTIVES: Using a 10-item yes/no SCCs questionnaire (Le Questionnaire de Plainte Cognitive [QPC]), we evaluated the prevalence and distribution of SCCs in cognitively healthy Czech older adults and examined total score and specific QPC items in relation to depressive symptomology and cognitive performance. METHODS: A sample of 340 cognitively healthy older community-dwelling volunteers aged 60 or older from the third wave of the longitudinal project National Normative Study of Cognitive Determinants of Healthy Aging, who underwent a comprehensive neuropsychological assessment and completed the QPC and the 15-item Geriatric Depression Scale (GDS-15). Regression analysis was controlled for age when GDS-15 was the outcome and for age and GDS-15 with cognitive domains as the outcome. RESULTS: 71% reported 1 + SCCs, with prevalence of individual complaints ranging from 4% to 40%. The number of SCCs was associated with GDS-15 (p < 0.001). Personality change (p < 0.001) and Limitation in daily activities (p = 0.002) were significantly associated with higher GDS-15 score and Spatial orientation difficulties (p = 0.019) and Impression of worse memory in comparison to peers (p = 0.012) were significantly associated with lower memory performance. CONCLUSIONS: We identified some cognitive complaints that were very common in our sample. Overall, a higher number of SCCs in well cognitively functioning individuals was most closely related to depressive symptomatology, while some specific complaints reflected lower memory performance and should be considered when screening for people at risk of cognitive decline.
- Keywords
- Aging, cognitive functioning, depressive symptoms, prodromal Alzheimer’s disease, subjective cognitive complaints,
- MeSH
- Depression epidemiology physiopathology psychology MeSH
- Cognition Disorders epidemiology physiopathology psychology MeSH
- Middle Aged MeSH
- Humans MeSH
- Longitudinal Studies MeSH
- Neuropsychological Tests MeSH
- Personality MeSH
- Surveys and Questionnaires MeSH
- Independent Living MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Aging psychology MeSH
- Mental Status Schedule MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
OBJECTIVE: To compare cognitive phenotypes of participants with subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI), estimate progression to MCI/dementia by phenotype and assess classification error with machine learning. METHOD: Dataset consisted of 163 participants with SCD and 282 participants with aMCI from the Czech Brain Aging Study. Cognitive assessment included the Uniform Data Set battery and additional tests to ascertain executive function, language, immediate and delayed memory, visuospatial skills, and processing speed. Latent profile analyses were used to develop cognitive profiles, and Cox proportional hazards models were used to estimate risk of progression. Random forest machine learning algorithms reported cognitive phenotype classification error. RESULTS: Latent profile analysis identified three phenotypes for SCD, with one phenotype performing worse across all domains but not progressing more quickly to MCI/dementia after controlling for age, sex, and education. Three aMCI phenotypes were characterized by mild deficits, memory and language impairment (dysnomic aMCI), and severe multi-domain aMCI (i.e., deficits across all domains). A dose-response relationship between baseline level of impairment and subsequent risk of progression to dementia was evident for aMCI profiles after controlling for age, sex, and education. Machine learning more easily classified participants with aMCI in comparison to SCD (8% vs. 21% misclassified). CONCLUSIONS: Cognitive performance follows distinct patterns, especially within aMCI. The patterns map onto risk of progression to dementia.
- Keywords
- Machine learning, Mild cognitive impairment, Neuropsychological performance, Prospective cohort study, Subjective cognitive complaints, Transition to dementia,
- MeSH
- Phenotype MeSH
- Cognition MeSH
- Cognitive Dysfunction * complications MeSH
- Humans MeSH
- Brain MeSH
- Neuropsychological Tests MeSH
- Aged MeSH
- Aging MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Czech Republic MeSH
BACKGROUND: Older adults with subjective cognitive decline (SCD) are at an increased risk of progression to mild cognitive impairment (MCI) or dementia. However, few have examined the specific cognitive tests that are associated with progression. OBJECTIVE: This study examined performance on 18 neuropsychological tests among participants with SCD who later progressed to MCI or dementia. METHODS: We included 131 participants from the Czech Brain Aging Study that had SCD at baseline. They completed a comprehensive neuropsychological battery including cognitive tests from the Uniform Data Set 2.0 enriched by the verbal memory test Rey Auditory Verbal Learning Test (RAVLT) and Rey-Osterrieth Complex Figure Test (ROCFT). RESULTS: Fifty-five participants progressed: 53% to non-amnestic MCI (naMCI), 44% to amnestic MCI (aMCI), and 4% to dementia. Scoring one SD below the mean at baseline on the RAVLT 1 and RAVLT 1-5 was associated with 133% (RAVLT 1; HR: 2.33 [1.50, 3.62]) and 122% (RAVLT 1-5; HR: 2.22 [1.55, 3.16]) greater risk of progression to MCI or dementia over 3.84 years on average. Worse performance on the RAVLT 5, RAVLT 1-5, RAVLT 30, and ROCFT-Recall was associated with progression to aMCI whereas worse performance on the RAVLT 1, TMT B, and Boston Naming Test was associated with progression to naMCI. CONCLUSION: At baseline, lower verbal memory performance was most strongly associated with progression to aMCI whereas lower executive or language performance was most strongly associated with progression to naMCI.
- Keywords
- Cognitive aging, immediate recall, subjective memory complaints, verbal memory,
- MeSH
- Dementia * diagnosis MeSH
- Cognition MeSH
- Cognitive Dysfunction * diagnosis psychology MeSH
- Humans MeSH
- Neuropsychological Tests MeSH
- Aged MeSH
- Memory and Learning Tests MeSH
- Check Tag
- Humans MeSH
- Aged MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
Patients with unipolar depressive disorder and in the depressive phase of bipolar disorder often manifest psychological distress and cognitive deficits, notably in executive control. We used computerized cognitive training in an attempt to reduce psychological affliction, improve everyday coping, and cognitive function. We asked one group of patients (intervention group) to engage in cognitive training three times a week, for 20 min each time, for eight consecutive weeks. A second group of patients (control group) received standard care only. Before the onset of training we administered to all patients self-report questionnaires of mood, mental and psychological health, and everyday coping. We also assessed executive control using a broad computerized neurocognitive battery of tests which yielded, among others, scores in Working Memory, Shifting, Inhibition, Visuomotor Vigilance, Divided Attention, Memory Span, and a Global Executive Function score. All questionnaires and tests were re-administered to the patients who adhered to the study at the end of training. When we compared the groups (between-group comparisons) on the amount of change that had taken place from baseline to post-training, we found significantly reduced depression level for the intervention group. This group also displayed significant improvements in Shifting, Divided Attention, and in the Global executive control score. Further exploration of the data showed that the cognitive improvement did not predict the improvements in mood. Single-group data (within-group comparisons) show that patients in the intervention group were reporting fewer cognitive failures, fewer dysexecutive incidents, and less difficulty in everyday coping. This group had also improved significantly on the six executive control tests and on the Global executive control score. By contrast, the control group improved only on the reports of cognitive failure and on working memory.
- Keywords
- bipolar disorder, cognitive training, computer assisted training, personalized medicine, plasticity, unipolar depressive disorder,
- Publication type
- Journal Article MeSH