1
|
Corney KB, Pasco JA, Stuart AL, Kavanagh BE, Mohebbi M, Sui SX, Williams LJ. Social determinants of health and cognitive function: A cross-sectional study among men without dementia. Brain Behav 2023; 13:e3235. [PMID: 37652752 PMCID: PMC10636419 DOI: 10.1002/brb3.3235] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/09/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Certain age-related and medical factors have been associated with cognitive dysfunction; however, less is known regarding social determinants of health. The current study aimed to investigate associations between social determinants of health and cognitive function in a population-based sample of men without dementia. METHODS Data were drawn from the ongoing Geelong Osteoporosis Study (n = 536). Cognitive function was determined using the Cog-State Brief Battery. Area-based socioeconomic status (SES) was determined using the Index of Relative Socioeconomic Advantage and Disadvantage, marital status by self-report, and social support by the Multidimensional Scale of Perceived Social Support, which considers family, friends, and significant others. RESULTS Belonging to a higher SES group, being in a relationship (married/de-facto) and perceived social support from a significant other and friends were each associated with better overall cognitive function. In regard to the specific cognitive domains, higher SES was associated with better psychomotor function and visual learning, being in a relationship was associated with better working memory, and perceived social support from a significant other was associated with better attention and working memory, with perceived social support from friends associated with better psychomotor function. There were no associations detected between social support from family and any of the cognitive domains. CONCLUSION Higher SES, being in a relationship, and greater perceived social support from a significant other and friends were associated with better cognitive function. Further studies identifying underlying mechanisms linking social factors with cognition are needed to establish prevention strategies and enhance cognitive health.
Collapse
Affiliation(s)
- Kayla B. Corney
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
| | - Julie A. Pasco
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
- Barwon HealthUniversity Hospital GeelongGeelongAustralia
- Department of Medicine‐Western HealthThe University of MelbourneSt AlbansAustralia
| | - Amanda L. Stuart
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
| | - Bianca E. Kavanagh
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
- Deakin Rural Health, School of MedicineDeakin UniversityWarrnamboolAustralia
| | - Mohammadreza Mohebbi
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
- Faculty of Health, Biostatistics UnitDeakin UniversityGeelongAustralia
| | - Sophia X. Sui
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
| | - Lana J. Williams
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, School of MedicineDeakin UniversityGeelongAustralia
- Barwon HealthUniversity Hospital GeelongGeelongAustralia
| |
Collapse
|
2
|
Pilato IB, Beezhold B, Radnitz C. Diet and lifestyle factors associated with cognitive performance in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:2230-2236. [PMID: 33320776 DOI: 10.1080/07448481.2020.1847118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/18/2020] [Accepted: 10/25/2020] [Indexed: 06/12/2023]
Abstract
ObjectiveEngaging in a healthy diet and positive lifestyle behaviors have been shown to improve cognitive functioning in children and older adults, however, few have examined these factors in college-aged students. Participants: A diverse sample of 115 college students were recruited on two university campuses. Method: Completed computerized cognitive testing and an online survey about diet and lifestyle behaviors. Results: All analyses were conducted with Pearson's correlations. Higher fruit consumption was correlated with better visual memory scores. Higher seafood consumption was correlated with better learning performance. Increased fast food consumption was correlated with poorer executive functioning in resident students and poorer visual memory performance in commuter students. Increased fluid intake on testing day was correlated with better visual memory and better verbal memory performance. Conclusions: Behavioral changes such as increasing hydration, eating more fruit and fish, and eating less fast food may improve cognitive performance in college students.
Collapse
Affiliation(s)
- Ilana B Pilato
- Department of Psychology, Fairleigh Dickinson University, Teaneck, New Jersey, USA
| | - Bonnie Beezhold
- Department of Nutrition, Benedictine University, Lisle, Illinois, USA
| | - Cynthia Radnitz
- Department of Psychology, Fairleigh Dickinson University, Teaneck, New Jersey, USA
| |
Collapse
|
3
|
Dingwall KM, Delima JF, Binks P, Batey R, Bowden SC. What is the optimum thiamine dose to treat or prevent Wernicke's encephalopathy or Wernicke-Korsakoff syndrome? Results of a randomized controlled trial. Alcohol Clin Exp Res 2022; 46:1133-1147. [PMID: 35428992 PMCID: PMC9321884 DOI: 10.1111/acer.14843] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 04/06/2022] [Accepted: 04/12/2022] [Indexed: 01/14/2023]
Abstract
Background The primary cause of Wernicke–Korsakoff syndrome (WKS) is thiamine deficiency, and more than 90% of cases are reported in alcohol‐dependent patients. While observational studies show parenteral thiamine administration drastically reduced WKS‐related mortality, relevant treatment trials have never been conducted to determine the optimum thiamine dose. Methods Two double‐blind, parallel groups, randomized controlled trials (RCTs) were conducted to determine the optimal thiamine dose required for (1) the prevention of Wernicke's encephalopathy (WE), the acute phase of WKS, in asymptomatic but “at‐risk” alcohol misuse patients (Study 1) and (2) the treatment of WE in symptomatic alcohol misuse patients (Study 2). Each study had a dosage regimen comprising three parenteral thiamine doses that were allocated at a ratio of 1:1:1. Study 1: Asymptomatic At‐Risk patients (N = 393) received either 100 mg daily, 100 mg thrice daily, or 300 mg thrice daily, for 3 days. Study 2: Symptomatic patients (N = 127) received either 100 mg thrice daily, 300 mg thrice daily, or 500 mg thrice daily, for 5 days. Cognitive function was the primary outcome, assessed using the Rowland Universal Dementia Assessment Scale, two Cogstate subtests, and an adapted Story Memory Recall test. Secondary analyses examined differences in neurological function (ataxia, oculomotor abnormalities, and confusion) at follow‐up. Results No significant differences were observed between any of the dosage conditions for either Study 1 or Study 2 on cognition or neurological functioning. This real‐world study found that having a clinically unwell target population with high comorbidity and multiple presentations, coupled with challenges in cross‐cultural assessment is likely to complicate RCT findings. Conclusions The results of this study showed no clear benefit of high dose thiamine over intermediate or lower doses of thiamine, over the time intervals examined, for the treatment and prevention of cognitive and neurological abnormalities related to WKS. Several study limitations temper the interpretation of these findings. Nevertheless, the absence of conclusive evidence for the superiority of high‐dose thiamine supports a recommendation for patient‐specific treatment, while ensuring that the potential impact of other biochemical factors (e.g., magnesium and other B vitamin deficiencies) are considered and corrected if necessary.
Collapse
Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Charles Darwin University, Alice Springs, Northern Territory, Australia
| | - Jennifer F Delima
- Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Paula Binks
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Robert Batey
- Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Stephen C Bowden
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.,Centre for Clinical Neuroscience and Neurological Research, St Vincent's Hospital, Fitzroy, Victoria, Australia
| |
Collapse
|
4
|
Thompson F, Harriss LR, Russell S, Taylor S, Cysique LA, Strivens E, Maruff P, McDermott R. Using health check data to investigate cognitive function in Aboriginal and Torres Strait Islanders living with diabetes in the Torres Strait, Australia. ENDOCRINOLOGY DIABETES & METABOLISM 2021; 5:e00297. [PMID: 34559471 PMCID: PMC8754245 DOI: 10.1002/edm2.297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/11/2021] [Accepted: 08/14/2021] [Indexed: 12/03/2022]
Abstract
Background Type 2 Diabetes (T2DM) has a subtle deleterious effect on cognition and imposes a higher lifetime risk of cognitive impairment and dementia. In populations where both T2DM and dementia are highly prevalent, understanding more about the early effects of T2DM on cognition may provide insights into the lifetime risks of this disease. Methods In 2016, 186 Australian Aboriginal and/or Torres Strait Islander residents of the Torres Strait (54% female, mean age =38.9 years, SD =15.9, range =15–74) participated in a community health check. The effect of diabetes (Type 1 or Type 2) on speed of thinking and working memory was assessed with the Cogstate Brief Battery (CBB) during the health check. Results One third of participants had diabetes (n = 56, 30.1%). After adjusting for age, education and previous iPad/Tablet experience, participants with diabetes had a small, yet significant reduction in accuracy on the One Back working memory task (β = −.076, p = .010, r2 = .042). The effect was most pronounced among participants with diabetes aged 20–49 years (n = 20), who also had evidence of poorer diabetes control (eg HbA1c% ≥6.5, 76.6%), relative to participants with diabetes aged 50 years and over (n = 31) (HbA1c% ≥6.5, 32.0%, p = .005). Conclusions Early and subtle decrements in working memory may be a potential complication of diabetes among Aboriginal and Torres Strait Islander residents of the Torres Strait. Several potentially influential variables were not captured in this study (eg medication and diabetes duration). Greater preventative health resources are required for this population, particularly given the emerging elevated dementia rates linked to chronic disease.
Collapse
Affiliation(s)
- Fintan Thompson
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Qld, Australia
| | - Linton R Harriss
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Qld, Australia.,College of Medicine and Dentistry, James Cook University, Cairns, Qld, Australia
| | - Sarah Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Qld, Australia.,Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Qld, Australia
| | - Sean Taylor
- Top End Health Service, Northern Territory Government, Darwin, NT, Australia
| | - Lucette A Cysique
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Qld, Australia.,Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Qld, Australia
| | | | | |
Collapse
|
5
|
Coffman CA, Harrison AT, Kay JJM, Holloway JP, LaFountaine MF, Moore RD. The Influence of Family History of Neurodegenerative Disease on Adolescent Concussion Outcomes. J Clin Med 2021; 10:528. [PMID: 33540525 PMCID: PMC7867167 DOI: 10.3390/jcm10030528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/21/2021] [Accepted: 01/28/2021] [Indexed: 12/04/2022] Open
Abstract
Evidence suggests that factors associated with a family history of neurodegenerative disease (fhNDD) may influence outcomes following a concussion. However, the relevance of these findings in adolescent populations has not been fully explored. Therefore, the present study sought to evaluate the relationship between fhNDD and neurological outcomes following an adolescent concussion. Data from a local pediatric concussion clinic were used to compare adolescents with (n = 22) and without (n = 44) an fhNDD. Clinical symptom burden, emotional health, cardio-autonomic function, and cognitive performance were assessed at initial (~2 weeks) and follow-up (~5 weeks) post-injury evaluations. Cardio-autonomic function was assessed at rest and during isometric handgrip contraction (IHGC). Results indicated no significant group differences in emotional health or cognitive performance. Across evaluations, those with an fhNDD exhibited greater somatic symptom severity, alterations in HRV at rest, and early blunted cardio-autonomic reactivity during IHGC compared to those without an fhNDD. These findings suggest that positive fhNDD is negatively associated with clinical symptomology and cardio-autonomic functioning following an adolescent concussion. Further, these findings encourage clinicians to utilize a comprehensive neurological evaluation to monitor concussion recovery. Future studies should look into exploring the role of specific neurodegenerative processes and conditions on concussion outcomes in adolescents.
Collapse
Affiliation(s)
- Colt A. Coffman
- Concussion Health and Neuroscience Lab, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (A.T.H.); (J.J.M.K.)
| | - Adam T. Harrison
- Concussion Health and Neuroscience Lab, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (A.T.H.); (J.J.M.K.)
| | - Jacob J. M. Kay
- Concussion Health and Neuroscience Lab, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (A.T.H.); (J.J.M.K.)
| | - Jeffrey P. Holloway
- Department of Pediatrics—School of Medicine, University of South Carolina, Columbia, SC 29209, USA;
| | - Michael F. LaFountaine
- Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ 07110, USA;
- Departments of Medical Sciences and Neurology, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Robert Davis Moore
- Concussion Health and Neuroscience Lab, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (A.T.H.); (J.J.M.K.)
| |
Collapse
|
6
|
Lupu T, Braw Y, Sacher Y, Ratmansky M. Cogstate Brief Battery: Cognition and the feigning of cognitive impairment in chronic pain. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1332-1343. [PMID: 33492175 DOI: 10.1080/23279095.2021.1873138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Chronic pain (CP) is often associated with cognitive impairment. The Cogstate Brief Battery (CBB), a computerized assessment battery, has been studied in several neuropsychiatric disorders but not in CP. Since feigning of cognitive impairment is common in CP, the current study aimed to assess the CBB's utility in differentiating CP patients (n = 64) from healthy participants (n = 33), as well as to assess the effect of simulating cognitive impairment by CP patients on performance in the battery. CP outpatients were randomly assigned to one of two groups: (a) Patients performing the CBB to the best of their ability. (b) Patients simulating cognitive impairment. Independent-samples t-tests indicated that three of four CBB tasks successfully differentiated CP patients from matched healthy controls. Additionally, an analysis of covariance (ANCOVA) indicated that CP patients who simulated cognitive impairment performed more poorly in all four CBB tasks, with the detection task having the strongest discrimination capacity. This is the first study to point toward the usefulness and sensitivity of the CBB for assessment of cognition and detection of feigned cognitive impairment in CP. Further studies are required to validate these preliminary findings and assess the CBB's utility in daily clinical practice.
Collapse
Affiliation(s)
- Tamar Lupu
- Department of Psychology, Ariel University, Ariel, Israel
| | - Yoram Braw
- Department of Psychology, Ariel University, Ariel, Israel
| | - Yaron Sacher
- Traumatic Brain Injury Rehabilitation Department, Loewenstein Rehabilitative Hospital, Ra'anana, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Motti Ratmansky
- Pain Unit, Loewenstein Hospital Rehabilitation Center, Ra'anana, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
7
|
Coffman CA, Kay JJM, Saba KM, Harrison AT, Holloway JP, LaFountaine MF, Moore RD. Predictive Value of Subacute Heart Rate Variability for Determining Outcome Following Adolescent Concussion. J Clin Med 2021; 10:jcm10010161. [PMID: 33466532 PMCID: PMC7796512 DOI: 10.3390/jcm10010161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/21/2020] [Accepted: 12/30/2020] [Indexed: 01/28/2023] Open
Abstract
Objective assessments of concussion recovery are crucial for facilitating effective clinical management. However, predictive tools for determining adolescent concussion outcomes are currently limited. Research suggests that heart rate variability (HRV) represents an indirect and objective marker of central and peripheral nervous system integration. Therefore, it may effectively identify underlying deficits and reliably predict the symptomology following concussion. Thus, the present study sought to evaluate the relationship between HRV and adolescent concussion outcomes. Furthermore, we sought to examine its predictive value for assessing outcomes. Fifty-five concussed adolescents (12–17 years old) recruited from a local sports medicine clinic were assessed during the initial subacute evaluation (within 15 days postinjury) and instructed to follow up for a post-acute evaluation. Self-reported clinical and depressive symptoms, neurobehavioral function, and cognitive performance were collected at each timepoint. Short-term HRV metrics via photoplethysmography were obtained under resting conditions and physiological stress. Regression analyses demonstrated significant associations between HRV metrics, clinical symptoms, neurobehavioral function, and cognitive performance at the subacute evaluation. Importantly, the analyses illustrated that subacute HRV metrics significantly predicted diminished post-acute neurobehavioral function and cognitive performance. These findings indicate that subacute HRV metrics may serve as a viable predictive biomarker for identifying underlying neurological dysfunction following concussion and predict late cognitive outcomes.
Collapse
Affiliation(s)
- Colt A. Coffman
- Concussion Health and Neuroscience Lab, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (J.J.M.K.); (K.M.S.); (A.T.H.)
- Correspondence: (C.A.C.); (R.D.M.); Tel.: +1-(803)-777-3278 (C.A.C. & R.D.M.)
| | - Jacob J. M. Kay
- Concussion Health and Neuroscience Lab, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (J.J.M.K.); (K.M.S.); (A.T.H.)
| | - Kat M. Saba
- Concussion Health and Neuroscience Lab, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (J.J.M.K.); (K.M.S.); (A.T.H.)
| | - Adam T. Harrison
- Concussion Health and Neuroscience Lab, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (J.J.M.K.); (K.M.S.); (A.T.H.)
| | - Jeffrey P. Holloway
- Department of Pediatrics, School of Medicine, University of South Carolina, Columbia, SC 29209, USA;
| | - Michael F. LaFountaine
- Department of Physical Therapy, School of Health and Medical Sciences, Seton Hall University, South Orange, NJ 07110, USA;
- Departments of Medical Sciences and Neurology, Hackensack Meridian School of Medicine, Nutley, NJ 07110, USA
| | - Robert Davis Moore
- Concussion Health and Neuroscience Lab, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; (J.J.M.K.); (K.M.S.); (A.T.H.)
- Correspondence: (C.A.C.); (R.D.M.); Tel.: +1-(803)-777-3278 (C.A.C. & R.D.M.)
| |
Collapse
|
8
|
Thompson F, Cysique LA, Harriss LR, Taylor S, Savage G, Maruff P, Mcdermott R. Acceptability and Usability of Computerized Cognitive Assessment Among Australian Indigenous Residents of the Torres Strait Islands. Arch Clin Neuropsychol 2020; 35:1288-1302. [PMID: 32647858 DOI: 10.1093/arclin/acaa037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 04/23/2020] [Accepted: 05/29/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This cross-sectional study aimed to investigate the acceptability and usability of the Cogstate Brief Battery (CBB) in a community-based sample of Australian Indigenous people from the Torres Strait region, based on a user experience framework of human-computer interaction. METHODS Two-hundred community participants completed the four subtests of the CBB on an iPad platform, during a free adult health check on two islands in the region, between October and December 2016. Acceptability was defined as completing the learning trial of a task and usability as continuing a task through to completion, determined by examiner acumen and internal Cogstate completion and integrity criteria. These were combined into a single dichotomous completion measure for logistic regression analyses. Performance-measured as reaction times and accuracy of responses-was analyzed using linear regression analyses. RESULTS CBB completion ranged from 82.0% to 91.5% across the four tasks and the odds of completing decreased with age. After adjusting for age, iPad/tablet familiarity increased the odds of completion for all tasks while level of education and employment increased the odds for some tasks only. These variables accounted for 18.0%-23.8% of the variance in reaction times on speeded tasks. Age and education had the most effect, although semipartial correlations were modest. CONCLUSIONS When administered in a health-screening context, the acceptability and usability of the CBB were greatest in young- to middle-aged participants with some education and iPad/tablet experience. Older and more vulnerable participants may have benefited from additional time and practice on the CBB prior to administration.
Collapse
Affiliation(s)
- Fintan Thompson
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Lucette A Cysique
- Neurosciences Research Australia, Psychology Department, University of New South Wales, Sydney, New South Wales, Australia
| | - Linton R Harriss
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| | - Sean Taylor
- Top End Health Service, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Greg Savage
- Department of Psychology, Macquarie University, Sydney, New South Wales, Australia
| | | | - Robyn Mcdermott
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
| |
Collapse
|
9
|
Carey TA, Dudgeon P, Hammond SW, Hirvonen T, Kyrios M, Roufeil L, Smith P. The Australian Psychological Society's Apology to Aboriginal and Torres Strait Islander People. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12300] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Pat Dudgeon
- School of Indigenous Studies, University of Western Australia,
| | - Sabine W Hammond
- Science, Education and Membership, Australian Psychological Society and School of Psychology, Australian Catholic University,
| | | | - Michael Kyrios
- Research School of Psychology, Australian National University,
| | - Louise Roufeil
- Professional Practice, Australian Psychological Society,
| | - Peter Smith
- Quirindi Health Centre,
- Walhallow Aboriginal Health Service,
| |
Collapse
|
10
|
Stolwyk RJ, Evans L, O'Halloran C, Evans J, Gooden JR. Comparing cognitive assessment service provision between Aboriginal and Torres Strait Islanders and non-Indigenous Australians at a metropolitan health service. Health Promot J Austr 2020; 32:541-547. [PMID: 32686249 DOI: 10.1002/hpja.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 07/14/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Aboriginal and Torres Strait Islander populations are at a significantly higher risk of neurological and cognitive impairment from a range of aetiologies. In order to better identify and support Indigenous Australians with cognitive impairment, culturally appropriate screening, management and referral processes are critical. The primary aim of this study was to investigate the frequency of presentations and type of cognitive screening conducted with Indigenous Australians presenting to health services. METHODS Hospital data for 30 Indigenous Australians presenting with neurological symptoms to Emergency Departments within a large metropolitan health service were compared with a group of 30 non-Indigenous, Australian-born, English-speaking, age-, gender- and diagnosis-matched individuals. RESULTS Only two individuals, one from each group, received cognitive screening. This was likely related to a surprisingly large proportion of Indigenous Australians presenting to hospital with headache and migraine. Significantly more Indigenous Australians (36.7%) were consulted by a member of the multidisciplinary team compared to 10% of the non-Indigenous group. No differences in follow-up referrals were observed. CONCLUSIONS Results indicated a lack of cognitive screening practices being undertaken in both groups. It was encouraging to see Indigenous Australians receiving consultations from multidisciplinary team members at a higher rate, with a similar follow-up pathway being observed. This study further highlights the need for adoption of screening practices in primary health care settings and the development and use of culturally appropriate cognitive screening measures. SO WHAT?: This study investigates the cognitive screening practices of a metropolitan health service and highlights the need for culturally appropriate cognitive screening methods to be developed and implemented to facilitate the identification of cognitive impairment in Indigenous Australians presenting for treatment.
Collapse
Affiliation(s)
- Renerus J Stolwyk
- Turner Institute for Brain and Mental, School of Psychological Sciences, Monash University, Clayton, VIC, Australia.,Monash-Epworth Rehabilitation Research Centre, Richmond, VIC, Australia
| | | | | | | | - James R Gooden
- Turner Institute for Brain and Mental, School of Psychological Sciences, Monash University, Clayton, VIC, Australia.,Monash-Epworth Rehabilitation Research Centre, Richmond, VIC, Australia.,Eastern Health, Box Hill, VIC, Australia
| |
Collapse
|
11
|
De Meijer L, Merlo D, Skibina O, Grobbee EJ, Gale J, Haartsen J, Maruff P, Darby D, Butzkueven H, Van der Walt A. Monitoring cognitive change in multiple sclerosis using a computerized cognitive battery. Mult Scler J Exp Transl Clin 2018; 4:2055217318815513. [PMID: 30559973 PMCID: PMC6293367 DOI: 10.1177/2055217318815513] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 10/11/2018] [Accepted: 11/01/2018] [Indexed: 11/15/2022] Open
Abstract
Background Cognitive monitoring that can detect short-term change in multiple sclerosis is challenging. Computerized cognitive batteries such as the CogState Brief Battery can rapidly assess commonly affected cognitive domains. Objectives The purpose of this study was to establish the acceptability and sensitivity of the CogState Brief Battery in multiple sclerosis patients compared to controls. We compared the sensitivity of the CogState Brief Battery to that of the Paced Auditory Serial Addition Test over 12 months. Methods Demographics, Expanded Disability Status Scale scores, depression and anxiety scores were compared with CogState Brief Battery and Paced Auditory Serial Addition Test performances of 51 patients with relapsing-remitting multiple sclerosis, 19 with secondary progressive multiple sclerosis and 40 healthy controls. Longitudinal data in 37 relapsing-remitting multiple sclerosis patients were evaluated using linear mixed models. Results Both the CogState Brief Battery and the Paced Auditory Serial Addition Test discriminated between multiple sclerosis and healthy controls at baseline (p<0.001). CogState Brief Battery tasks were more acceptable and caused less anxiety than the Paced Auditory Serial Addition Test (p<0.001). In relapsing-remitting multiple sclerosis patients, reaction time slowed over 12 months (p<0.001) for the CogState Brief Battery Detection (mean change -34.23 ms) and Identification (-25.31 ms) tasks. Paced Auditory Serial Addition Test scores did not change over this time. Conclusions The CogState Brief Battery is highly acceptable and better able to detect cognitive change than the Paced Auditory Serial Addition Test. The CogState Brief Battery could potentially be used as a practical cognitive monitoring tool in the multiple sclerosis clinic setting.
Collapse
Affiliation(s)
- L De Meijer
- Rijksuniversiteit, The Netherlands.,Erasmus MC Medical Center, The Netherlands
| | - D Merlo
- Eastern Health Clinical Research Unit, Monash University, Australia.,Department of Neuroscience, Monash University, Australia
| | - O Skibina
- Eastern Health Clinical Research Unit, Monash University, Australia.,Department of Neurology, Eastern Health, Australia.,Department of Neurology, Alfred Health, Australia
| | | | | | - J Haartsen
- Eastern Health Clinical Research Unit, Monash University, Australia.,Department of Neurology, Eastern Health, Australia
| | - P Maruff
- Department of Neuroscience, Monash University, Australia
| | - D Darby
- Department of Neurology, Eastern Health, Australia.,Florey Institute for Neuroscience and Mental Health, University of Melbourne, Australia
| | - H Butzkueven
- Eastern Health Clinical Research Unit, Monash University, Australia.,Department of Neuroscience, Monash University, Australia.,Department of Neurology, Eastern Health, Australia.,Department of Neurology, Alfred Health, Australia
| | - A Van der Walt
- Eastern Health Clinical Research Unit, Monash University, Australia.,Department of Neuroscience, Monash University, Australia.,Department of Neurology, Eastern Health, Australia.,Department of Neurology, Alfred Health, Australia.,These authors contributed equally
| |
Collapse
|
12
|
Response Time Reduction Due to Retesting in Mental Speed Tests: A Meta-Analysis. J Intell 2018; 6:jintelligence6010006. [PMID: 31162433 PMCID: PMC6480749 DOI: 10.3390/jintelligence6010006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/09/2018] [Accepted: 02/23/2018] [Indexed: 01/08/2023] Open
Abstract
As retest effects in cognitive ability tests have been investigated by various primary and meta-analytic studies, most studies from this area focus on score gains as a result of retesting. To the best of our knowledge, no meta-analytic study has been reported that provides sizable estimates of response time (RT) reductions due to retesting. This multilevel meta-analysis focuses on mental speed tasks, for which outcome measures often consist of RTs. The size of RT reduction due to retesting in mental speed tasks for up to four test administrations was analyzed based on 36 studies including 49 samples and 212 outcomes for a total sample size of 21,810. Significant RT reductions were found, which increased with the number of test administrations, without reaching a plateau. Larger RT reductions were observed in more complex mental speed tasks compared to simple ones, whereas age and test-retest interval mostly did not moderate the size of the effect. Although a high heterogeneity of effects exists, retest effects were shown to occur for mental speed tasks regarding RT outcomes and should thus be more thoroughly accounted for in applied and research settings.
Collapse
|
13
|
Dingwall KM, Gray AO, McCarthy AR, Delima JF, Bowden SC. Exploring the reliability and acceptability of cognitive tests for Indigenous Australians: a pilot study. BMC Psychol 2017; 5:26. [PMID: 28768522 PMCID: PMC5541699 DOI: 10.1186/s40359-017-0195-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 07/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reliable cognitive assessment for Indigenous Australians is difficult given that mainstream tests typically rely on Western concepts, content and values. A test's psychometric properties should therefore be assessed prior to use in other cultures. The aim of this pilot study was to examine the reliability and acceptability of four cognitive tests for Australian Aboriginal people. METHODS Participants were 40 male and 44 female (N = 84) Aboriginal patients from Alice Springs Hospital. Four tests were assessed for reliability and acceptability - Rowland Universal Dementia Assessment Screen (RUDAS) (n = 19), PEBL Corsi Blocks (Corsi) (n = 19), Story Memory Recall Test (SMRT) (n = 17) and a CogState battery (n = 18). Participants performed one to three of the tests with repeated assessment to determine test-retest reliability. Qualitative interviews were conducted and analysed based on an adapted phenomenological approach to explore test acceptability. An Indigenous Reference Group gave advice and guidance. RESULTS Intra-class correlations (ICC) for test retest reliability ranged from r = 0.58 (CogState One Back accuracy) to 0.86 (RUDAS). Themes emerged relating to general impressions, impacts on understanding and performance, appropriateness, task preferences and suggested improvements. CONCLUSIONS RUDAS, CogState Identification task, and SMRT showed the highest reliabilities. Overall the tests were viewed as a positive challenge and an opportunity to learn about the brain despite provoking some anxiety in the patients. Caveats for test acceptability included issues related to language, impacts of convalescence and cultural relevance.
Collapse
Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, PO Box 4066, Alice Springs, NT, 0871, Australia.
| | - Allison O Gray
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, PO Box 4066, Alice Springs, NT, 0871, Australia
| | - Annette R McCarthy
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, PO Box 4066, Alice Springs, NT, 0871, Australia
| | - Jennifer F Delima
- Alice Springs Hospital, PO Box 2234, Alice Springs, NT, 0871, Australia
| | | |
Collapse
|
14
|
|
15
|
MacDonald LA, Minahan CL. Indices of cognitive function measured in rugby union players using a computer-based test battery. J Sports Sci 2016; 34:1669-74. [DOI: 10.1080/02640414.2015.1132003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
16
|
Performance of the CogState computerized battery in the Mayo Clinic Study on Aging. Alzheimers Dement 2015; 11:1367-76. [PMID: 25858683 DOI: 10.1016/j.jalz.2015.01.008] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 12/13/2014] [Accepted: 01/19/2015] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The feasibility and validity of brief computerized cognitive batteries at the population-level are unknown. METHODS Nondemented participants (n = 1660, age 50-97 years) in the Mayo Clinic Study on Aging completed the computerized CogState battery and standard neuropsychological battery. The correlation between tests was examined and comparisons between CogState performance on the personal computer (PC) and iPad (n = 331), and in the clinic vs. at home (n = 194), were assessed. RESULTS We obtained valid data on greater than 97% of participants on each test. Correlations between the CogState and neuropsychological tests ranged from -0.462 to 0.531. Although absolute differences between the PC and iPad were small and participants preferred the iPad, performance on the PC was faster. Participants performed faster on Detection, One Card Learning, and One Back at home compared with the clinic. DISCUSSION The computerized CogState battery, especially the iPad, was feasible, acceptable, and valid in the population.
Collapse
|
17
|
Mielke MM, Weigand SD, Wiste HJ, Vemuri P, Machulda MM, Knopman DS, Lowe V, Roberts RO, Kantarci K, Rocca WA, Jack CR, Petersen RC. Independent comparison of CogState computerized testing and a standard cognitive battery with neuroimaging. Alzheimers Dement 2014; 10:779-89. [PMID: 25458308 PMCID: PMC4273919 DOI: 10.1016/j.jalz.2014.09.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 08/19/2014] [Accepted: 09/18/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Inexpensive, non-invasive tools for assessing Alzheimer-type pathophysiologies are needed. Computerized cognitive assessments are prime candidates. METHODS Cognitively normal participants, aged 51-71, with magnetic resonance imaging, fluorodeoxyglucose-positron emission tomography (FDG-PET), amyloid PET, CogState computerized cognitive assessment, and standard neuropsychological tests were included. We first examined the association between the CogState battery and neuroimaging measures. We then compared that association to the one between standard neuropsychological z-scores and neuroimaging. RESULTS Slower reaction times for CogState Identification and One Back, and lower memory and attention z-scores, were associated (P < .05) with FDG-PET hypometabolism. Slower time on the Groton Maze Learning Task and worse One Card Learning accuracy were associated (P < .05) with smaller hippocampal volumes. There were no associations with amyloid PET. Associations of CogState and neuropsychological Z-scores with neuroimaging were small and of a similar magnitude. CONCLUSIONS CogState subtests were cross-sectionally comparable to standard neuropsychological tests in their relatively weak associations with neurodegeneration imaging markers.
Collapse
Affiliation(s)
- Michelle M Mielke
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA.
| | - Stephen D Weigand
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Heather J Wiste
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | | | - Val Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Rosebud O Roberts
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Walter A Rocca
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Ronald C Petersen
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
18
|
Nyaradi A, Foster JK, Hickling S, Li J, Ambrosini GL, Jacques A, Oddy WH. Prospective associations between dietary patterns and cognitive performance during adolescence. J Child Psychol Psychiatry 2014; 55:1017-24. [PMID: 24673485 DOI: 10.1111/jcpp.12209] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/28/2013] [Indexed: 12/28/2022]
Abstract
BACKGROUND The aim of the study was to investigate prospective associations between dietary patterns and cognitive performance during adolescence. METHODS Participants were sourced from the Western Australian Pregnancy Cohort (Raine) Study that includes 2868 children born between 1989 and 1992 in Perth, Western Australia. When the children were 17 years old (2006-2009), cognitive performance was assessed using a computerized cognitive battery of tests (CogState) that included six tasks. Using a food frequency questionnaire administered when the children were 14 years old (2003-2006), 'Healthy' and 'Western' dietary patterns were identified by factor analysis. Associations between dietary patterns at 14 years of age and cognitive performance at 17 years of age were assessed prospectively using multivariate regression models. RESULTS Dietary and cognitive performance data were available for 602 participants. Following adjustment for the 'Healthy' dietary pattern, total energy intake, maternal education, family income, father's presence in the family, family functioning and gender, we found that a longer reaction time in the detection task (β = .016; 95% CI: 0.004; 0.028; p = .009) and a higher number of total errors in the Groton Maze Learning Test - delayed recall task (β = .060; 95% CI: 0.006; 0.114; p = .029) were significantly associated with higher scores on the 'Western' dietary pattern. The 'Western' dietary pattern was characterized by high intakes of take-away food, red and processed meat, soft drink, fried and refined food. We also found that within the dietary patterns, high intake of fried potato, crisps and red meat had negative associations, while increased fruit and leafy green vegetable intake had positive associations with some aspects of cognitive performance. CONCLUSION Higher dietary intake of the 'Western' dietary pattern at age 14 is associated with diminished cognitive performance 3 years later, at 17 years.
Collapse
Affiliation(s)
- Anett Nyaradi
- School of Population Health, The University of Western Australia, Perth, WA, Australia; Telethon Institute for Child Health Research, The University of Western Australia, Perth, WA, Australia
| | | | | | | | | | | | | |
Collapse
|
19
|
“You’ve got to make it relevant”: barriers and ways forward for assessing cognition in Aboriginal clients. BMC Psychol 2014. [DOI: 10.1186/2050-7283-2-13] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
20
|
Dingwall KM, Pinkerton J, Lindeman MA. "People like numbers": a descriptive study of cognitive assessment methods in clinical practice for Aboriginal Australians in the Northern Territory. BMC Psychiatry 2013; 13:42. [PMID: 23368850 PMCID: PMC3598474 DOI: 10.1186/1471-244x-13-42] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 01/29/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Achieving culturally fair assessments of cognitive functioning for Aboriginal people is difficult due to a scarcity of appropriately validated tools for use with this group. As a result, some Aboriginal people with cognitive impairments may lack fair and equitable access to services. The objective of this study was to examine current clinical practice in the Northern Territory regarding cognitive assessment for Aboriginal people thereby providing some guidance for clinicians new to this practice setting. METHOD Qualitative enquiry was used to describe practice context, reasons for assessment, and current practices in assessing cognition for Aboriginal Australians. Semi-structured interviews were conducted with 22 clinicians working with Aboriginal clients in central and northern Australia. Results pertaining to assessment methods are reported. RESULTS A range of standardised tests were utilised with little consistency across clinical practice. Nevertheless, it was recognised that such tests bear severe limitations, requiring some modification and significant caution in their interpretation. Clinicians relied heavily on informal assessment or observations, contextual information and clinical judgement. CONCLUSIONS Cognitive tests developed specifically for Aboriginal people are urgently needed. In the absence of appropriate, validated tests, clinicians have relied on and modified a range of standardised and informal assessments, whilst recognising the severe limitations of these. Past clinical training has not prepared clinicians adequately for assessing Aboriginal clients, and experience and clinical judgment were considered crucial for fair interpretation of test scores. Interpretation guidelines may assist inexperienced clinicians to consider whether they are achieving fair assessments of cognition for Aboriginal clients.
Collapse
Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, Australia.
| | - Jennifer Pinkerton
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, Australia
| | | |
Collapse
|
21
|
Darby DG, Pietrzak RH, Fredrickson J, Woodward M, Moore L, Fredrickson A, Sach J, Maruff P. Intraindividual cognitive decline using a brief computerized cognitive screening test. Alzheimers Dement 2012; 8:95-104. [PMID: 22404851 DOI: 10.1016/j.jalz.2010.12.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Revised: 11/23/2010] [Accepted: 12/15/2010] [Indexed: 10/28/2022]
Abstract
BACKGROUND Progressive intraindividual decline in memory and cognition is characteristic of dementia and may be useful in detecting very early Alzheimer's disease pathology. METHODS This study evaluated the slopes of cognitive performance over a 12-month period in 263 healthy, community-dwelling, adult volunteers aged ≥50 years. Participants completed a brief computerized battery of cognitive tests (CogState) at baseline and during 3-, 6-, 9-, and 12-month follow-up assessments. Linear mixed models were used to estimate age-adjusted mean slopes and 95% confidence intervals of change for each of the cognitive measures. RESULTS By defining age-adjusted mean slopes, and 95% confidence intervals for a measure of episodic memory, individuals with greater than expected decline (equal to or lower than the fifth percentile level of decline) were identified. From these, four individuals completed a full medical, neurologic, and neuropsychological evaluation, with none of them fulfilling criteria for mild cognitive impairment, but three (75%) having positive amyloid-positron emission tomographic scans. CONCLUSIONS Intraindividual decline in cognitive performance can be detected in otherwise healthy, community-dwelling, older persons, and this may deserve further study as a potential indicator of early Alzheimer's disease pathology.
Collapse
|
22
|
Dingwall KM, Maruff P, Fredrickson A, Cairney S. Cognitive recovery during and after treatment for volatile solvent abuse. Drug Alcohol Depend 2011; 118:180-5. [PMID: 21497458 DOI: 10.1016/j.drugalcdep.2011.03.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 03/09/2011] [Accepted: 03/21/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Cognitive impairment reflecting CNS disruption in chronic solvent abusers can resolve within two years of abstinence. However, the specific time course for recovery has yet to be determined empirically. This study monitored cognition among solvent (i.e., gasoline) abusers throughout 8 weeks of residential treatment. It also investigated the extent to which solvent-related cognitive impairments persisted following discharge. METHODS Non-drug using healthy controls (n=33) and solvent abusers (n=29) who had inhaled gasoline, regularly or episodically, for an average of 4.3 years (SD=2.7) were assessed. Using linear mixed model analyses, solvent abusers were compared to healthy controls throughout treatment at baseline, two weeks, four weeks and six weeks, on visual motor, attention, learning, memory, and executive function tasks. Ten users who maintained abstinence were reassessed an average of 12 months later (SD=2.8) and were compared to healthy controls (n=12) retested at the same time interval using ANCOVA while controlling for age and baseline performance. RESULTS At baseline, solvent abusers showed cognitive deficits on visual motor, learning and memory, paired associate learning, and executive functions. Paired associate learning performance improved within 6 weeks of abstinence, however, impairments in visual motor speed, learning and memory, and executive function persisted throughout and in some cases beyond treatment. CONCLUSIONS Cognitive deficits exist for solvent abusers upon treatment entry. Some impairments resolve within weeks of abstinence, while memory and executive function improves gradually over months to years of abstinence, and might never fully recover.
Collapse
Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Australia.
| | | | | | | |
Collapse
|
23
|
Dingwall KM, Maruff P, Cairney S. Similar profile of cognitive impairment and recovery for Aboriginal Australians in treatment for episodic or chronic alcohol use. Addiction 2011; 106:1419-26. [PMID: 21438935 DOI: 10.1111/j.1360-0443.2011.03434.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS The cognitive impairment and recovery associated with chronic alcohol abuse and subsequent abstinence is well understood. However, the recovery profile following heavy episodic or 'binge' use, which is common among some Australian Aboriginal users, has not been investigated thoroughly and no empirical studies have examined chronic use in this population. The aim of this study was to identify and compare cognitive impairment and recovery associated with chronic and episodic alcohol use among Aboriginal Australians. DESIGN Longitudinal case-control design. SETTING Residential alcohol treatment programmes in northern Australia. PARTICIPANTS Forty chronic alcohol users, 24 episodic users and 41 healthy controls [mean age = 34.24; standard deviation (SD) = 9.73]. MEASUREMENTS Cognitive assessments of visual motor, attention, memory, learning and executive functions at baseline (start of treatment), then 4 weeks and 8 weeks later. Reassessment of 31% of participants an average of 11 months later (SD = 4.4) comparing those who remained abstinent (n = 5), those who relapsed (n = 11) and healthy controls (n = 19). FINDINGS At baseline, chronic and episodic alcohol users showed impaired visual motor, learning, memory and executive functions. With the exception of visual motor impairment, all deficits had improved to normal levels within 4 weeks. Visual motor deficits had normalized within 11 months. Performances did not differ at any time between chronic and episodic alcohol groups. CONCLUSIONS In Aboriginal Australians, episodic drinking is associated with similar patterns of impairment and recovery as chronic alcohol use. Most cognitive deficits appear to recover within the first month of abstinence, while persisting visual motor problems recover within 1 year.
Collapse
Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Australia.
| | | | | |
Collapse
|
24
|
Hammers D, Spurgeon E, Ryan K, Persad C, Heidebrink J, Barbas N, Albin R, Frey K, Darby D, Giordani B. Reliability of repeated cognitive assessment of dementia using a brief computerized battery. Am J Alzheimers Dis Other Demen 2011; 26:326-33. [PMID: 21636581 DOI: 10.1177/1533317511411907] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the short-term stability and reliability of a brief computerized cognitive battery in established dementia types. METHOD Patients were administered the computerized battery twice with administrations approximately 2 hours apart, with intervening conventional neuropsychological tests. Patients were classified clinically, via consensus conference, as healthy controls (n = 23), mild cognitive impairment (n = 20), Alzheimer's disease (n = 52), dementia with Lewy Bodies ([DLB], n = 10), or frontotemporal dementia (n = 9). RESULTS Minimal practice effects were evident across Cog-State test administrations. Small magnitude improvements were seen across all groups on a working memory task, and healthy controls showed a mild practice effect on the accuracy of associative learning. CONCLUSIONS In established dementia, administration of the CogState tasks appears sensitive to cognitive impairment in dementia. Repeat administration also provided acceptable stability and test-retest reliability with minimal practice effects at short test-retest intervals despite intervening cognitive challenges.
Collapse
Affiliation(s)
- Dustin Hammers
- Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
DINGWALL KYLIEM, MARUFF PAUL, CLOUGH ALANR, CAIRNEY SHEREE. Factors associated with continued solvent use in Indigenous petrol sniffers following treatment. Drug Alcohol Rev 2011; 31:40-6. [DOI: 10.1111/j.1465-3362.2010.00279.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
26
|
Dingwall KM, Maruff P, Cairney S. Neuropsychological problems and alcohol availability appear to be key factors in continued heavy alcohol use by Aboriginal Australians. Med J Aust 2011; 194:50-1. [DOI: 10.5694/j.1326-5377.2011.tb04152.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Accepted: 10/27/2010] [Indexed: 11/17/2022]
Affiliation(s)
- Kylie M Dingwall
- Division of Healing and Resilience, Menzies School of Health Research, Alice Springs, NT
| | - Paul Maruff
- Centre for Neuroscience, University of Melbourne, Melbourne VIC
| | - Sheree Cairney
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT
| |
Collapse
|
27
|
Abstract
BACKGROUND Chronic petrol inhalation can be associated with significant cognitive impairment. While rehabilitation programs can rely on such skills to educate clients and achieve treatment outcomes, cognitive function is rarely assessed on admission. This is particularly true for Indigenous populations where standard assessments are not appropriate. This paper describes a process for assessing cognition in Indigenous Australians. Two studies investigate firstly the demographic factors impacting on cognition for healthy Indigenous Australians and secondly the utility of the assessment process for detecting petrol sniffing related cognitive impairments. METHODS Study One assessed a naturalistic sample of healthy Indigenous Australians from the Northern Territory (N = 206; mean age = 28.03) on computerised tests of psychomotor speed, visual attention, memory, learning, spatial awareness and executive functions. Multiple regression analyses determined the unique contributions of six factors (age, education, gender, familiarity with computers, regular long term cannabis use and locality) to the variance in performance for this group. Study Two examined group differences in cognitive performance on the same tests between healthy Indigenous Australians (N = 96) and Indigenous petrol sniffers (N = 50; both age restricted to < 26 years) while controlling those factors found to impact on performance from Study One. RESULTS Age, computer familiarity, and education significantly contributed to the variance in performance measures. While controlling these factors, petrol abuse was associated with poorer performance on complex tasks of psychomotor, visual attention, memory, learning, spatial awareness and executive function. CONCLUSIONS This assessment process is useful for detecting substance abuse related impairments in Indigenous Australians and when using this assessment process, age and computer familiarity in particular should be controlled for.
Collapse
|
28
|
Lewis MS, Dingwall KM, Berkhout N, Sayers S, Maruff P, Cairney S. Assessment of cognition in an adolescent Indigenous population. AUSTRALIAN PSYCHOLOGIST 2010. [DOI: 10.1080/00050060903352998] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Nicole Berkhout
- Menzies School of Health Research, Darwin, Northern Territory
| | - Susan Sayers
- Menzies School of Health Research, Darwin, Northern Territory
| | - Paul Maruff
- Centre for Neuroscience, University of Melbourne
- CogState, Melbourne, Victoria, Australia
| | - Sheree Cairney
- Menzies School of Health Research, Darwin, Northern Territory
| |
Collapse
|
29
|
Abstract
OBJECTIVE The aim of the present review was to evaluate the psychological and cognitive assessments that have been considered suitable for Indigenous Australians. This will provide a basis from which future developments can occur, leading to improved mental health services for Indigenous Australians. METHOD Literature searches of key health science databases were conducted using the following search terms in various combinations: Indigenous, Aboriginal, cognitive, assessment, mental health, social emotional well-being, psychological, Australian. Psychological, mental health or social and emotional well-being assessments as well as cognitive assessments that have been utilized and found suitable in Indigenous Australian populations were reviewed. RESULTS A limited number of assessments were found and discussed and these varied in their applications. CONCLUSIONS Further research and development is necessary to establish a national approach to assessing or screening mental health and cognitive function among Indigenous Australians. This is an important and necessary step to improve mental health and related services for Indigenous Australians.
Collapse
Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, PO Box 41096, Casuarina, NT 0811, Australia.
| | | |
Collapse
|
30
|
Dingwall K, Cairney S. The importance and challenges of assessing cognition in Indigenous Australians. Australas Psychiatry 2009; 17 Suppl 1:S47-50. [PMID: 19579106 DOI: 10.1080/10398560902948670] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The aim of this paper was to investigate the importance and challenges involved in conducting serial cognitive assessments among healthy Indigenous adolescents. METHOD Cognitive assessments were conducted at fortnightly intervals for 2 months and again at 6 and 12 months among a group of Indigenous students from a boarding school in the Northern Territory. These students were to be the healthy control group in a long-term study of substance abuse. Recruitment and attrition rates were reviewed and related challenges for assessing participants were identified. RESULTS From the recruited sample (n=49), 18% reported heavy or frequent use of alcohol, cannabis or petrol. Males were more likely to have used these substances compared to females. Attrition increased as the follow-up interval increased with 49 recruits reducing to 32 in the first 2 months and only 15 and 13 of the initial group remaining for the 6 and 12 month follow-ups respectively. CONCLUSIONS Main challenges included (i) appropriateness of tests and assessment processes, (ii) high rates of substance abuse and other illness in the control group and (iii) high attrition rates. The importance of assessing cognition appropriately is highlighted by a lack of information regarding mental health issues in Indigenous populations.
Collapse
Affiliation(s)
- Kylie Dingwall
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, NT, Australia.
| | | |
Collapse
|