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Liu Y, Su N, Li W, Hong B, Yan F, Wang J, Li X, Chen J, Xiao S, Yue L. Associations between Informant-Reported Cognitive Complaint and Longitudinal Cognitive Decline in Subjective Cognitive Decline A 7-Year Longitudinal Study. Arch Clin Neuropsychol 2024; 39:409-417. [PMID: 38180808 DOI: 10.1093/arclin/acad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 11/21/2023] [Accepted: 12/07/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVE This study aimed to determine the predictive values of informant-reported memory decline (IMD) among subjective cognitive decline (SCD) older adults from a 7-year community-based cohort study. METHOD Ninety SCD participants were included. Demographic data and neuropsychological test scores at both baseline and 7-year follow-up were collected. Differences between SCD with IMD (+IMD) and SCD without IMD (-IMD) were compared. Logistic regression models were used to determine whether baseline IMD could predict diagnostic outcomes at 7-year follow-up. RESULTS Forty-one percent of SCD adults had IMD. At baseline, the +IMD group showed more depressive symptoms (p = 0.016) than the -IMD group. Furthermore, the Beijing-version Montreal Cognitive Assessment (MoCA), Digit Span Test-Forward, Visual Matching and Reasoning, and Wechsler Adult Intelligence Scale-RC Picture Completion (WAIS-PC) scores in the +IMD group were significantly lower than those in the -IMD group. Fifty-four percent of +IMD participants converted to mild cognitive impairment (MCI) or dementia at follow-up, and 22.6% of the -IMD participants converted to MCI. Follow-up Mini-Mental State Examination, MoCA, and Verbal Fluency Test scores of the +IMD group were significantly lower than those in the -IMD group. The +IMD group was more likely to progress to cognitive impairment at 7-year follow-up (OR = 3.361, p = 0.028). CONCLUSIONS SCD participants with +IMD may have poorer cognition and are more likely to convert to cognitive impairment over time. Our long-term follow-up study confirmed the importance of informants' perceptions of SCD, which can help clinicians identify individuals at risk of cognitive decline.
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Affiliation(s)
- Yuanyuan Liu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ning Su
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Bo Hong
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Yan
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Jinghua Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Jianhua Chen
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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Peichel S, Quante A. [Differentiation Between Alzheimer̓s Disease and Old Age Depression: Overview and Conception of a Questionnaire for Relatives]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2024; 92:186-193. [PMID: 38113905 DOI: 10.1055/a-2202-9622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND Differential diagnosis of Alzheimer's disease and major depression in the elderly is difficult because of overlapping and similar symptoms. A questionnaire for relatives may facilitate the diagnostic burden in clinical practice. MATERIALS AND METHODS Based on a selection of clinical criteria, an expert survey, and statistical analysis of the expert survey, a questionnaire for relatives was designed. RESULTS 18 out of 48 suggested clinical criteria were assessed by neuropsychologists as suitable for the differential diagnosis and were summarized in a questionnaire for relatives (ADAD). First results of the validation of the questionnaire gave an indication of the suitability of the clinical criteria. CONCLUSIONS The ADAD questionnaire could be simply implemented in clinical practice to differentiate between symptoms of Alzheimer's disease and major depression, but it needs to be evaluated in a larger group of patients.
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Affiliation(s)
- Sarah Peichel
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Friedrich von Bodelschwingh-Klinik, Berlin, Germany
| | - Arnim Quante
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Friedrich von Bodelschwingh-Klinik, Berlin, Germany
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin Campus Benjamin Franklin, Berlin, Germany
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Zimmerman KA, Hain JA, Graham NSN, Rooney EJ, Lee Y, Del-Giovane M, Parker TD, Friedland D, Cross MJ, Kemp S, Wilson MG, Sylvester RJ, Sharp DJ. Prospective cohort study of long-term neurological outcomes in retired elite athletes: the Advanced BiomaRker, Advanced Imaging and Neurocognitive (BRAIN) Health Study protocol. BMJ Open 2024; 14:e082902. [PMID: 38663922 PMCID: PMC11043776 DOI: 10.1136/bmjopen-2023-082902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Although limited, recent research suggests that contact sport participation might have an adverse long-term effect on brain health. Further work is required to determine whether this includes an increased risk of neurodegenerative disease and/or subsequent changes in cognition and behaviour. The Advanced BiomaRker, Advanced Imaging and Neurocognitive Health Study will prospectively examine the neurological, psychiatric, psychological and general health of retired elite-level rugby union and association football/soccer players. METHODS AND ANALYSIS 400 retired athletes will be recruited (200 rugby union and 200 association football players, male and female). Athletes will undergo a detailed clinical assessment, advanced neuroimaging, blood testing for a range of brain health outcomes and neuropsychological assessment longitudinally. Follow-up assessments will be completed at 2 and 4 years after baseline visit. 60 healthy volunteers will be recruited and undergo an aligned assessment protocol including advanced neuroimaging, blood testing and neuropsychological assessment. We will describe the previous exposure to head injuries across the cohort and investigate relationships between biomarkers of brain injury and clinical outcomes including cognitive performance, clinical diagnoses and psychiatric symptom burden. ETHICS AND DISSEMINATION Relevant ethical approvals have been granted by the Camberwell St Giles Research Ethics Committee (Ref: 17/LO/2066). The study findings will be disseminated through manuscripts in clinical/academic journals, presentations at professional conferences and through participant and stakeholder communications.
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Affiliation(s)
- Karl A Zimmerman
- Centre for Care, Research and Technology, UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
- Centre for Injury Studies, Imperial College London, London, UK
| | - Jessica A Hain
- Centre for Care, Research and Technology, UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Neil S N Graham
- Centre for Care, Research and Technology, UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
- Centre for Injury Studies, Imperial College London, London, UK
| | - Erin Jane Rooney
- Centre for Care, Research and Technology, UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
- Institute of Sport, Exercise and Health (ISEH), University College London, London, UK
| | - Ying Lee
- Centre for Care, Research and Technology, UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
- Institute of Sport, Exercise and Health (ISEH), University College London, London, UK
| | - Martina Del-Giovane
- Centre for Care, Research and Technology, UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
| | - Thomas D Parker
- Centre for Care, Research and Technology, UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
- Department of Neurodegenerative Disease, The Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Daniel Friedland
- Department of Brain Sciences, Imperial College London, London, UK
- Institute of Sport, Exercise and Health (ISEH), University College London, London, UK
| | - Matthew J Cross
- Carnegie Applied Rugby Research Centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- Premiership Rugby, London, UK
| | - Simon Kemp
- Rugby Football Union, Twickenham, UK
- London School of Hygiene & Tropical Medicine, London, UK
| | - Mathew G Wilson
- Institute of Sport, Exercise and Health (ISEH), University College London, London, UK
- HCA Healthcare Research Institute, London, UK
| | - Richard J Sylvester
- Institute of Sport, Exercise and Health (ISEH), University College London, London, UK
- Acute Stroke and Brain Injury Unit, National Hospital for Neurology and Neurosurgery, London, UK
| | - David J Sharp
- Centre for Care, Research and Technology, UK Dementia Research Institute, Imperial College London, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
- Centre for Injury Studies, Imperial College London, London, UK
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Bonfim LPF, Correa TR, Freire BCC, Pedroso TM, Pereira DN, Fernandes TB, Kopittke L, de Oliveira CRA, Teixeira AL, Marcolino MS. Post-COVID-19 cognitive symptoms in patients assisted by a teleassistance service: a retrospective cohort study. Front Public Health 2024; 12:1282067. [PMID: 38689777 PMCID: PMC11060150 DOI: 10.3389/fpubh.2024.1282067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 03/04/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Four years after the onset of the COVID-19 pandemic, the frequency of long-term post-COVID-19 cognitive symptoms is a matter of concern given the impact it may have on the work and quality of life of affected people. Objective To evaluate the incidence of post-acute COVID-19 cognitive symptoms, as well as the associated risk factors. Methods Retrospective cohort, including outpatients with laboratory-confirmed COVID-19 and who were assisted by a public telehealth service provided by the Telehealth Network of Minas Gerais (TNMG), during the acute phase of the disease, between December/2020 and March/2022. Data were collected through a structured questionnaire, applied via phone calls, regarding the persistence of COVID-19 symptoms after 12 weeks of the disease. Cognitive symptoms were defined as any of the following: memory loss, problems concentrating, word finding difficulties, and difficulty thinking clearly. Results From 630 patients who responded to the questionnaire, 23.7% presented cognitive symptoms at 12 weeks after infection. These patients had a higher median age (33 [IQR 25-46] vs. 30 [IQR 24-42] years-old, p = 0.042) with a higher prevalence in the female sex (80.5% vs. 62.2%, p < 0.001) when compared to those who did not present cognitive symptoms, as well as a lower prevalence of smoking (8.7% vs. 16.2%, p = 0.024). Furthermore, patients with persistent cognitive symptoms were more likely to have been infected during the second wave of COVID-19 rather than the third (31.0% vs. 21.3%, p = 0.014). Patients who needed to seek in-person care during the acute phase of the disease were more likely to report post-acute cognitive symptoms (21.5% vs. 9.3%, p < 0,001). In multivariate logistic regression analysis, cognitive symptoms were associated with female sex (OR 2.24, CI 95% 1.41-3.57), fatigue (OR 2.33, CI 95% 1.19-4.56), depression (OR 5.37, CI 95% 2.19-13.15) and the need for seek in-person care during acute COVID-19 (OR 2.23, CI 95% 1.30-3.81). Conclusion In this retrospective cohort of patients with mostly mild COVID-19, cognitive symptoms were present in 23.7% of patients with COVID-19 at 12 weeks after infection. Female sex, fatigue, depression and the need to seek in-person care during acute COVID-19 were the risk factors independently associated with this condition.
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Affiliation(s)
- Lívia Paula Freire Bonfim
- Tropical Medicine and Infectious Disease Program, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Rotsen Correa
- Statistics Department, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bruno Cabaleiro Cortizo Freire
- Tropical Medicine and Infectious Disease Program, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Thais Marques Pedroso
- Tropical Medicine and Infectious Disease Program, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Daniella Nunes Pereira
- Tropical Medicine and Infectious Disease Program, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Luciane Kopittke
- Hospital Nossa Senhora da Conceição, Porto Alegre, Rio Grande do Sul, Brazil
| | - Clara Rodrigues Alves de Oliveira
- Tropical Medicine and Infectious Disease Program, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Antonio Lucio Teixeira
- Tropical Medicine and Infectious Disease Program, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, UT Health Houston, Houston, TX, United States
| | - Milena Soriano Marcolino
- Tropical Medicine and Infectious Disease Program, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- National Institute for Health Technology Assessment (IATS), Porto Alegre, Rio Grande do Sul, Brazil
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Finley JCA, Cladek A, Gonzalez C, Brook M. Perceived cognitive impairment is related to internalizing psychopathology but unrelated to objective cognitive performance among nongeriatric adults presenting for outpatient neuropsychological evaluation. Clin Neuropsychol 2024; 38:644-667. [PMID: 37518890 DOI: 10.1080/13854046.2023.2241190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
Objective: This study investigated the relationship between perceived cognitive impairment, objective cognitive performance, and intrapersonal variables thought to influence ratings of perceived cognitive impairment. Method: Study sample comprised 194 nongeriatric adults who were seen in a general outpatient neuropsychology clinic for a variety of referral questions. The cognition subscale score from the WHO Disability Assessment Schedule served as the measure of perceived cognitive impairment. Objective cognitive performance was indexed via a composite score derived from a comprehensive neuropsychological battery. Internalizing psychopathology was indexed via a composite score derived from anxiety and depression measures. Medical and neuropsychiatric comorbidities were indexed by the number of different ICD diagnostic categories documented in medical records. Demographics included age, sex, race, and years of education. Results: Objective cognitive performance was unrelated to subjective concerns, explaining <1% of the variance in perceived cognitive impairment ratings. Conversely, internalizing psychopathology was significantly predictive, explaining nearly one-third of the variance in perceived cognitive impairment ratings, even after accounting for test performance, demographics, and number of comorbidities. Internalizing psychopathology was also highly associated with a greater discrepancy between scores on perceived and objective cognitive measures among participants with greater cognitive concerns. Clinically significant somatic symptoms uniquely contributed to the explained variance in perceived cognitive impairment (by ∼13%) when analyzed in a model with internalizing symptoms. Conclusions: These findings suggest that perceived cognitive impairment may be more indicative of the extent of internalizing psychopathology and somatic concerns than cognitive ability.
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Affiliation(s)
- John-Christopher A Finley
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Andrea Cladek
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Michael Brook
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Pawlaczyk NA, Milner R, Szmytke M, Kiljanek B, Bałaj B, Wypych A, Lewandowska M. Medial Temporal Lobe Atrophy in Older Adults With Subjective Cognitive Impairments Affects Gait Parameters in the Spatial Navigation Task. J Aging Phys Act 2024; 32:185-197. [PMID: 37989135 DOI: 10.1123/japa.2022-0335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 07/05/2023] [Accepted: 08/21/2023] [Indexed: 11/23/2023]
Abstract
Both navigation abilities and gait can be affected by the atrophy in the medial temporal cortex. This study aimed to determine whether navigation abilities could differentiate seniors with and without medial temporal lobe atrophy who complained about their cognitive status. The participants, classified to either the medial temporal atrophy group (n = 23) or the control group (n = 22) underwent neuropsychological assessment and performed a spatial navigation task while their gait parameters were recorded. The study showed no significant differences between the two groups in memory, fluency, and semantic knowledge or typical measures of navigating abilities. However, gait parameters, particularly the propulsion index during certain phases of the navigation task, distinguished between seniors with and without medial temporal lobe lesions. These findings suggest that the gait parameters in the navigation task may be a valuable tool for identifying seniors with cognitive complaints and subtle medial temporal atrophy.
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Affiliation(s)
- Natalia Anna Pawlaczyk
- Faculty of Philosophy and Social Sciences, Institute of Psychology, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Rafał Milner
- Faculty of Philosophy and Social Sciences, Institute of Psychology, Nicolaus Copernicus University in Torun, Torun, Poland
| | | | - Bartłomiej Kiljanek
- Faculty of Philosophy and Social Sciences, Institute of Psychology, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Bibianna Bałaj
- Faculty of Philosophy and Social Sciences, Institute of Psychology, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Aleksandra Wypych
- Center for Modern Interdisciplinary Technologies, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Monika Lewandowska
- Faculty of Philosophy and Social Sciences, Institute of Psychology, Nicolaus Copernicus University in Torun, Torun, Poland
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Perneczky R, Hansen N, Hofmann A, Laske C, Priller J, Grimmer T, Frölich L, Düzel E, Jessen F, Wiltfang J. Blood-Based Biomarkers for Early Alzheimer's Disease Diagnosis in Real-World Settings. Methods Mol Biol 2024; 2785:3-14. [PMID: 38427184 DOI: 10.1007/978-1-0716-3774-6_1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
As our knowledge about the biology of Alzheimer's disease (AD) expands and we recognize the significance of early intervention for effective treatment, there is a shift in focus toward detecting the disease at an early stage. AD is characterized by the accumulation of misfolded amyloid-β (Aβ) and phosphorylated tau proteins in the brain, leading to the formation of senile plaques and neurofibrillary tangles. While a definitive diagnosis of AD can only be confirmed through autopsy by examining these pathological features, there are now reliable methods available for diagnosing the disease in living individuals. These methods involve analyzing cerebrospinal fluid and using positron emission tomography to accurately assess the presence of Aβ and tau proteins. While these diagnostic markers have shown high accuracy in memory-clinic populations, they do have limitations such as the requirement for invasive lumbar puncture or exposure to ionizing radiation. Additionally, they are not easily accessible outside of specialized healthcare settings. Blood-based biomarkers of the core pathological features of AD are being developed, showing promise for less invasive, scalable identification of AD cases in the community. The advantages for the healthcare systems of this development are obvious, but the diagnostic performance of blood-based biomarkers in broader, non-selected populations outside of retrospective analyses and research cohorts still requires further investigation, including the combination with more effective neuropsychological assessments such as digital cognitive test solutions.
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Affiliation(s)
- Robert Perneczky
- Department of Psychiatry and Psychotherapy, LMU Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK.
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK.
| | - Niels Hansen
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Anna Hofmann
- Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- Department of Neurology, University Hospital Tuebingen, Tuebingen, Germany
- German Center for Neurodegenerative Diseases (DZNE) Tuebingen, Tuebingen, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE) Tuebingen, Tuebingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Josef Priller
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE) Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charite University Medicine, Berlin, Germany
- Dementia Research Institute, University of Edinburgh, Edinburgh, UK
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Emrah Düzel
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg, Magdeburg, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Cologne, Medical Faculty, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE) Bonn, Bonn, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE) Goettingen, Goettingen, Germany
- Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
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Chang KH, Wang C, Nester CO, Katz MJ, Byrd DA, Lipton RB, Rabin LA. Examining the role of participant and study partner report in widely-used classification approaches of mild cognitive impairment in demographically-diverse community dwelling individuals: results from the Einstein aging study. Front Aging Neurosci 2023; 15:1221768. [PMID: 38076542 PMCID: PMC10702963 DOI: 10.3389/fnagi.2023.1221768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/29/2023] [Indexed: 01/28/2024] Open
Abstract
Objective The role of subjective cognitive concerns (SCC) as a diagnostic criterion for MCI remains uncertain and limits the development of a universally (or widely)-accepted MCI definition. The optimal MCI definition should define an at-risk state and accurately predict the development of incident dementia. Questions remain about operationalization of definitions of self- and informant-reported SCCs and their individual and joint associations with incident dementia. Methods The present study included Einstein Aging Study participants who were non-Hispanic White or Black, free of dementia at enrollment, had follow-up, and completed neuropsychological tests and self-reported SCC at enrollment to determine MCI status. Informant-reported SCC at baseline were assessed via the CERAD clinical history questionnaire. Self-reported SCC were measured using the CERAD, items from the EAS Health Self-Assessment, and the single memory item from the Geriatric Depression Scale. Cox proportional hazards models examined the association of different operationalizations of SCC with Petersen and Jak/Bondi MCI definitions on the risk of dementia, further controlling for age, sex, education, and race/ethnicity. Time-dependent sensitivity and specificity at specific time points for each definition, and Youden's index were calculated as an accuracy measure. Cox proportional hazards models were also used to evaluate the associations of combinations of self- and informant-reported SCC with the risk of incident dementia. Results 91% of the sample endorsed at least one SCC. Youden's index showed that not including SCC in either Jak/Bondi or Petersen classifications had the best balance between sensitivity and specificity across follow-up. A subset of individuals with informants, on average, had a lower proportion of non-Hispanic Blacks and 94% endorsed at least one self-reported SCC. Both informant-reported and self-reported SCC were significantly associated with incident dementia. Conclusion Our findings suggest that the SCC criterion may not improve the predictive validity for dementia when included in widely-employed definitions of MCI. Consistent with some prior research, informant-reported SCC was more related to risk of incident dementia than self-reported SCC. Given that requiring informant report as a diagnostic criterion may unintentionally exclude health disparate groups, additional consideration is needed to determine how best to utilize informant-report in MCI diagnosis.
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Affiliation(s)
- Katherine H. Chang
- Department of Psychology, Queens College, City University of New York (CUNY), Queens, NY, United States
- Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, United States
| | - Cuiling Wang
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Caroline O. Nester
- Department of Psychology, Queens College, City University of New York (CUNY), Queens, NY, United States
- Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, United States
| | - Mindy J. Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Desiree A. Byrd
- Department of Psychology, Queens College, City University of New York (CUNY), Queens, NY, United States
- Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, United States
| | - Richard B. Lipton
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Laura A. Rabin
- Department of Psychology, Queens College, City University of New York (CUNY), Queens, NY, United States
- Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, United States
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Psychology, Brooklyn College, City University of New York (CUNY), Brooklyn, NY, United States
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9
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Lojo-Seoane C, Facal D, Delgado-Losada ML, Rubio-Valdehita S, López-Higes R, Frades-Payo B, Pereiro AX. Normative scores for attentional tests used by the Spanish consortium for ageing normative data (SCAND) study: Trail Making Test, Digit Symbol and Letter Cancellation. Clin Neuropsychol 2023; 37:1766-1786. [PMID: 36772821 DOI: 10.1080/13854046.2023.2173304] [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: 07/27/2022] [Accepted: 01/20/2023] [Indexed: 02/12/2023]
Abstract
Objective: This paper reports normative data for different attentional tests obtained from a sample of middle-aged and older native Spanish adults and considering effects of age, educational level and sex. Method: 2,597 cognitively intact participants, aged from 50 to 98 years old, participated voluntarily in the SCAND consortium studies. The statistical procedure included conversion of percentile ranges into scaled scores. The effects of age, education and sex were taken into account. Linear regressions were used to calculate adjusted scaled scores. Results: Scaled scores and percentiles corresponding to the TMT, Digit Symbol and Letter Cancellation Task are shown. Additional tables show the values to be added to or subtracted from the scaled scores, for age and education in the case of the TMT and Letter Cancellation Task measures, and for education in the case of the Digit Symbol subtest. Conclusions: The current norms provide clinically useful data for evaluating Spanish people aged 50 to 98 years old and contribute to improving detection of initial symptoms of cognitive impairment.
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Affiliation(s)
- Cristina Lojo-Seoane
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - David Facal
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María Luisa Delgado-Losada
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Susana Rubio-Valdehita
- Department of Social, Work and Differential Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Ramón López-Higes
- Department of Experimental Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | | | - Arturo X Pereiro
- Department of Developmental and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
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10
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Heikkinen AL, Hänninen T, Kuikka P, Akila R, Savolainen A, Valtonen T, Umer A, Lötjönen J, Hublin C, Remes AM, Paajanen T. The Cognitive Function at Work Questionnaire (CFWQ): A new scale for measuring cognitive complaints in occupational population. APPLIED NEUROPSYCHOLOGY. ADULT 2023; 30:649-660. [PMID: 34482772 DOI: 10.1080/23279095.2021.1970553] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Cognitive functioning is a relevant work and health related topic, however, validated methods to assess subjective cognitive complaints (SCC) at work are lacking. We introduce the Cognitive Function at Work Questionnaire (CFWQ) for measuring SCC in occupational settings. 1-year follow-up data of 418 employees from a Finnish public media service company was analyzed. Participants completed web-based CFWQ, cognitive tests and a broad set of questionnaires for evaluating depression, anxiety, insomnia, daytime sleepiness, burnout, stress, mental job burden, work ability, cognitive errors, and perceived health. The factor analysis yielded a model with the CFWQ subdomains: Memory, Language, Executive Function, Speed of Processing, Cognitive Control and Name Memory. The internal consistency (Cronbach's alpha = .87) and the test-retest constancy (ICC = .84) reflected good reliability. Correlation between the CFWQ and cognitive errors at work ranged from .25 to .64 indicating adequate concurrent validity. Employees with depression, insomnia and burnout symptoms had higher (p < .001) CFWQ scores than participants without these symptoms. Depression and burnout symptom severity as well as accumulation of mood, sleep, and psychosocial stressors were associated with higher CFWQ scores (p < .001 in all). The CFWQ appears psychometrically sound measure for the assessment of SCC in occupational population.
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Affiliation(s)
- Anna-Leena Heikkinen
- Research Unit of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
- MRC, Oulu University Hospital, Oulu, Finland
| | - Tuomo Hänninen
- Neurology, Neurocenter, Kuopio University Hospital, Kuopio, Finland
| | - Pekka Kuikka
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Ritva Akila
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Aslak Savolainen
- Occupational Health Services, Finnish Broadcasting Company, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Teppo Valtonen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Adil Umer
- VTT Technical Research Centre of Finland Ltd, Tampere, Finland
| | | | - Christer Hublin
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Anne M Remes
- Research Unit of Clinical Neuroscience, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
| | - Teemu Paajanen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
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11
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Nader MM, Cosarderelioglu C, Miao E, Whitson H, Xue QL, Grodstein F, Oh E, Ferrucci L, Bennett DA, Walston JD, George C, Abadir PM. Navigating and diagnosing cognitive frailty in research and clinical domains. NATURE AGING 2023; 3:1325-1333. [PMID: 37845509 DOI: 10.1038/s43587-023-00504-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/13/2023] [Indexed: 10/18/2023]
Abstract
While physical frailty has been recognized as a clinical entity for some time, the concept of cognitive frailty (CF) is now gaining increasing attention in the geriatrics research community. CF refers to the co-occurrence of physical frailty and cognitive impairment in older adults, which has been suggested as a potential precursor to both dementia and adverse physical outcomes. However, this condition represents a challenge for researchers and clinicians, as there remains a lack of consensus regarding the definition and diagnostic criteria for CF, which has limited its utility. Here, using insights from both the physical frailty literature and cognitive science research, we describe emerging research on CF. We highlight areas of agreement as well as areas of confusion and remaining knowledge gaps, and provide our perspective on fine-tuning the current construct, aiming to stimulate further discussion in this developing field.
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Affiliation(s)
- Monica M Nader
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
| | - Caglar Cosarderelioglu
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
- Ankara University School of Medicine, Department of Internal Medicine, Division of Geriatrics, Ankara, Turkey
| | - Emily Miao
- Albert Einstein College of Medicine/Montefiore Medical Center, Department of Medicine, Division of Geriatrics, New York, NY, USA
| | - Heather Whitson
- Duke University School of Medicine, Center for the Study of Aging, Durham, NC, USA
| | - Qian-Li Xue
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA
| | - Francine Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Esther Oh
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
| | | | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Jeremy D Walston
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
| | - Claudene George
- Albert Einstein College of Medicine/Montefiore Medical Center, Department of Medicine, Division of Geriatrics, New York, NY, USA
| | - Peter M Abadir
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA.
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12
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Park CJ, Kim SY, Kim JH, Son NH, Park JY, Jeong YH, Kim HJ, Park J, Kim WJ. Evaluation of glymphatic system activity using diffusion tensor image analysis along the perivascular space and amyloid PET in older adults with objectively normal cognition: a preliminary study. Front Aging Neurosci 2023; 15:1221667. [PMID: 37577357 PMCID: PMC10413261 DOI: 10.3389/fnagi.2023.1221667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Objectives Diffusion tensor image analysis along the perivascular space (DTI-ALPS) is a recently introduced method for the assessment of the glymphatic system without the need for contrast injection. The purpose of our study was to assess the glymphatic system in cognitively normal older adults with or without subjective cognitive decline (SCD) using DTI-ALPS, and correlating with amyloid PET. Design and participants To evaluate the glymphatic system in cognitively normal older adults using DTI-ALPS, we built a prospective cohort including a total of 123 objectively cognitively normal older adults with or without SCD. The ALPS index was calculated from DTI MRI and was assessed by correlating it with standardized uptake value ratios (SUVRs) from amyloid PET and clinically relevant variables. The study subjects were also divided into amyloid "positive" and "negative" groups based on the result of amyloid PET, and the ALPS indices between those two groups were compared. Results The ALPS index was not significantly different between the normal and SCD groups (P = 0.897). The mean ALPS index from the amyloid positive and amyloid negative group was 1.31 and 1.35, respectively, which showed no significant difference (P = 0.308). Among the SUVRs from variable cortices, that of the paracentral cortex was negatively correlated with the ALPS index (r = -0.218, P = 0.016). Multivariate linear regression revealed that older age (coefficient, -0.007) and higher SUVR from the paracentral cortex (coefficient, -0.101) were two independent variables with a significant association with a lower ALPS index (P = 0.015 and 0.045, respectively). Conclusion DTI-ALPS may not be useful for evaluation of the glymphatic system in subjects with SCD. Older age was significantly associated with lower ALPS index. Greater amyloid deposition in the paracentral cortex was significantly associated with lower glymphatic activity in cognitively normal older adults. These results should be validated in future studies on the relationships between ALPS index and other fundamental compartments in glymphatic system, such as perivenous space and the meningeal lymphatic vessels.
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Affiliation(s)
- Chae Jung Park
- Department of Radiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Sang-Young Kim
- MR Clinical Science, Philips Healthcare Korea, Seoul, Republic of Korea
| | - Jun Hwee Kim
- Department of Radiology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Nak-Hoon Son
- Department of Statistics, Keimyung University, Daegu, Republic of Korea
| | - Jin Young Park
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Republic of Korea
- Center for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Yong Hyu Jeong
- Department of Nuclear Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Hyun Jeong Kim
- Department of Nuclear Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Republic of Korea
| | - Jaesub Park
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Woo Jung Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Republic of Korea
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13
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Tsai CL, Chou KH, Lee PL, Liang CS, Kuo CY, Lin GY, Lin YK, Hsu YC, Ko CA, Yang FC, Lin CP. Shared alterations in hippocampal structural covariance in subjective cognitive decline and migraine. Front Aging Neurosci 2023; 15:1191991. [PMID: 37409010 PMCID: PMC10318340 DOI: 10.3389/fnagi.2023.1191991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/05/2023] [Indexed: 07/07/2023] Open
Abstract
Introduction Subjective cognitive decline (SCD) and migraine are often comorbid. Hippocampal structural abnormalities have been observed in individuals with both SCD and migraine. Given the known structural and functional heterogeneity along the long axis (anterior to posterior) of the hippocampus, we aimed to identify altered patterns of structural covariance within hippocampal subdivisions associated with SCD and migraine comorbidities. Methods A seed-based structural covariance network analysis was applied to examine large-scale anatomical network changes of the anterior and posterior hippocampus in individuals with SCD, migraine and healthy controls. Conjunction analyses were used to identify shared network-level alterations in the hippocampal subdivisions in individuals with both SCD and migraine. Results Altered structural covariance integrity of the anterior and posterior hippocampus was observed in the temporal, frontal, occipital, cingulate, precentral, and postcentral areas in individuals with SCD and migraine compared with healthy controls. Conjunction analysis revealed that, in both SCD and migraine, altered structural covariance integrity was shared between the anterior hippocampus and inferior temporal gyri and between the posterior hippocampus and precentral gyrus. Additionally, the structural covariance integrity of the posterior hippocampus-cerebellum axis was associated with the duration of SCD. Conclusion This study highlighted the specific role of hippocampal subdivisions and specific structural covariance alterations within these subdivisions in the pathophysiology of SCD and migraine. These network-level changes in structural covariance may serve as potential imaging signatures for individuals who have both SCD and migraine.
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Affiliation(s)
- Chia-Lin Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
| | - Kun-Hsien Chou
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei City, Taiwan
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Pei-Lin Lee
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
| | - Chen-Yuan Kuo
- Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Guan-Yu Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
| | - Yu-Kai Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei City, Taiwan
| | - Yi-Chih Hsu
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
| | - Chien-An Ko
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei City, Taiwan
| | - Ching-Po Lin
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei City, Taiwan
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei City, Taiwan
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei City, Taiwan
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14
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Soldevila-Domenech N, De Toma I, Forcano L, Diaz-Pellicer P, Cuenca-Royo A, Fagundo B, Lorenzo T, Gomis-Gonzalez M, Sánchez-Benavides G, Fauria K, Sastre C, Fernandez De Piérola Í, Molinuevo JL, Verdejo-Garcia A, de la Torre R. Intensive assessment of executive functions derived from performance in cognitive training games. iScience 2023; 26:106886. [PMID: 37260752 PMCID: PMC10227423 DOI: 10.1016/j.isci.2023.106886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/26/2023] [Accepted: 05/11/2023] [Indexed: 06/02/2023] Open
Abstract
Traditional neuropsychological tests accurately describe the current cognitive state but fall short to characterize cognitive change over multiple short time periods. We present an innovative approach to remote monitoring of executive functions on a monthly basis, which leverages the performance indicators from self-administered computerized cognitive training games (NUP-EXE). We evaluated the measurement properties of NUP-EXE in N = 56 individuals (59% women, 60-80 years) at increased risk of Alzheimer's disease (APOE-ϵ4 carriers with subjective cognitive decline) who completed a 12-month multimodal intervention for preventing cognitive decline. NUP-EXE presented good psychometric properties and greater sensitivity to change than traditional tests. Improvements in NUP-EXE correlated with improvements in functionality and were affected by participants' age and gender. This novel data collection methodology is expected to allow a more accurate characterization of an individual's response to a cognitive decline preventive intervention and to inform development of outcome measures for a new generation of intervention trials.
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Affiliation(s)
- Natalia Soldevila-Domenech
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Medicine and Life Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Ilario De Toma
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Laura Forcano
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Patrícia Diaz-Pellicer
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Medicine and Life Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Aida Cuenca-Royo
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Beatriz Fagundo
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Thais Lorenzo
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Medicine and Life Sciences, Pompeu Fabra University, Barcelona, Spain
| | - Maria Gomis-Gonzalez
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Karine Fauria
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | | | | | - José Luis Molinuevo
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Rafael de la Torre
- Neurosciences Research Programme, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Department of Medicine and Life Sciences, Pompeu Fabra University, Barcelona, Spain
- CIBER de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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15
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Matziorinis AM, Flo BK, Skouras S, Dahle K, Henriksen A, Hausmann F, Sudmann TT, Gold C, Koelsch S. A 12-month randomised pilot trial of the Alzheimer's and music therapy study: a feasibility assessment of music therapy and physical activity in patients with mild-to-moderate Alzheimer's disease. Pilot Feasibility Stud 2023; 9:61. [PMID: 37076884 PMCID: PMC10114372 DOI: 10.1186/s40814-023-01287-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/30/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND The Alzheimer's and Music Therapy (ALMUTH) study is the first randomised controlled trial (RCT) design with 12 months of active non-pharmacological therapy (NPT) implementing music therapy (MT) and physical activity (PA) for participants with Alzheimer's disease (AD). The aim of the present article is to retrospectively examine the inclusion of mild-to-moderate Alzheimer's Disease patients into the main ALMUTH study protocol and to determine if continued inclusion of AD patients is warranted. METHODS The randomised pilot trial was conducted as a parallel three-arm RCT, reflecting the experimental design of the ALMUTH study. The trial was conducted in Bergen, Norway, and randomisation (1:1:1) was performed by an external researcher. The study was open label and the experimental design features two active NPTs: MT and PA, and a passive control (no intervention, CON) in Norwegian speaking patients with AD who still live at home and could provide informed consent. Sessions were offered once per week (up to 90 min) up to 40 sessions over 12 months. Baseline and follow-up tests included a full neuropsychological test battery and three magnetic resonance imaging (MRI) measurements (structural, functional, and diffusion weighted imaging). Feasibility outcomes were assessed and were determined as feasible if they met the target criteria. RESULTS Eighteen participants with a diagnosis of mild-to-moderate AD were screened, randomised, and tested once at baseline and once after 12-months. Participants were divided into three groups: MT (n = 6), PA (n = 6), and CON (n = 6). Results of the study revealed that the ALMUTH protocol in patients with AD was not feasible. The adherence to the study protocol was poor (50% attended sessions), with attrition and retention rates at 50%. The recruitment was costly and there were difficulties acquiring participants who met the inclusion criteria. Issues with study fidelity and problems raised by staff were taken into consideration for the updated study protocol. No adverse events were reported by the patients or their caregivers. CONCLUSIONS The pilot trial was not deemed feasible in patients with mild-to-moderate AD. To mitigate this, the ALMUTH study has expanded the recruitment criteria to include participants with milder forms of memory impairment (pre-AD) in addition to expanding the neuropsychological test battery. The ALMUTH study is currently ongoing through 2023. TRIAL REGISTRATION Norsk Forskningsråd (NFR) funded. Regional Committees for Medical and Health Research Ethics (REC-WEST: reference number 2018/206). CLINICALTRIALS gov: NCT03444181 (registered retrospectively 23 February 2018, https://clinicaltrials.gov/ct2/show/NCT03444181 ).
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Affiliation(s)
- A M Matziorinis
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
| | - B K Flo
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - S Skouras
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - K Dahle
- Kompetansesenter for Demens, Bergen Kommune, Norway
| | - A Henriksen
- Department of Sport, Food, and Natural Sciences, Faculty of Education, Arts, and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - F Hausmann
- Department of Sport, Food, and Natural Sciences, Faculty of Education, Arts, and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - T T Sudmann
- Department of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
| | - C Gold
- NORCE Norwegian Research Centre AS, Bergen, Norway
- Grieg Academy Department of Music, University of Bergen, Bergen, Norway
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
| | - S Koelsch
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway.
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16
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Lee D, Park JY, Kim WJ. Altered functional connectivity of the default mode and dorsal attention network in subjective cognitive decline. J Psychiatr Res 2023; 159:165-171. [PMID: 36738647 DOI: 10.1016/j.jpsychires.2023.01.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/23/2022] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Subjective cognitive decline (SCD) is a clinical condition in which performance on standardized cognitive tests does not indicate impairment like mild cognitive impairment (MCI), but self-experienced cognitive capacity persistently declines. We aimed to explore the functional connectivity (FC) characteristics of SCD subjects compared to healthy controls and MCI patients. Resting-state functional MRI was performed on 152 elderly subjects: 65 normal controls, 62 SCD subjects, and 25 MCI patients. A seed-based FC analysis was performed to compare groups. The major brain regions of the default mode network (DMN) and dorsal attention network (DAN), large-scale brain networks disrupted in patients with dementia, were selected as seed regions. As a result, the SCD group showed stronger FC than the MCI group between DMN seeds and the supramarginal gyrus. Both the SCD and MCI groups showed stronger FC between the left lateral parietal cortex and right dorsolateral prefrontal cortex. In the FC analysis centred on DAN seeds, both the SCD and MCI groups showed weaker FC of the right posterior intraparietal sulcus in the left anterior cingulate cortex and the left insula, compared to those in the control group. Within the SCD group, hyperconnectivity between the right lateral parietal cortex and left supramarginal gyrus was significantly correlated with better performance on the Controlled Oral Word Association Test. In conclusion, the SCD group showed several DMN- and DAN-related FC alterations, similar to the MCI group, but with distinct hyperconnectivity between DMN seeds and the supramarginal gyrus. In particular, SCD has DMN-related FC patterns distinct from those of MCI that are associated with verbal fluency retention.
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Affiliation(s)
- Deokjong Lee
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Young Park
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea; Center for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea.
| | - Woo Jung Kim
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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17
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Lindberg M, Månsson Lexell E, Ranner M, Lund ML. Self-initiated management strategies in digitalized work and everyday life - experiences of people with cognitive difficulties due to neurological disorders. Scand J Occup Ther 2023; 30:559-571. [PMID: 36780367 DOI: 10.1080/11038128.2023.2175724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Background: Digitalized work life can increase cognitive demands and influence people's everyday life. This can be challenging for people with cognitive difficulties, yet there is scarce knowledge of how they manage these. It is essential to learn how self-initiated management strategies can be a resource to support sustainable work and everyday life.Aim: To describe how people with cognitive difficulties due to neurological disorders experience their use of self-initiated strategies to manage digitalized work and other activities of everyday life.Material and Methods: Eleven employees in digital work with cognitive difficulties and neurological disorders participated in qualitative interviews supported by a dialogue support tool. Data were analyzed using content analysis.Results: A complexity of strategies was used to manage digital work and other activities. Based on how strategies were applied, three different profiles were found. These reflected efforts to manage situations in everyday life and how these influenced strategies applied and their importance.Conclusion: This knowledge can support people with cognitive difficulties and professionals to become aware of the potential of strategies and acknowledge a person's own management resources. Reflections on how to manage situations can give perspectives on prevention or vocational rehabilitation to facilitate a sustainable work life.
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Affiliation(s)
- Monika Lindberg
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Eva Månsson Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology, Rehabilitation Medicine, Memory clinic and Geriatrics, Skane University Hospital, Lund-Malmö, Sweden
| | - Maria Ranner
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Maria Larsson Lund
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
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18
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Truong QC, Numbers K, Choo CC, Bentvelzen AC, Catts VS, Cervin M, Jorm AF, Kochan NA, Brodaty H, Sachdev PS, Medvedev ON. Establishing conversion of the 16-item Informant Questionnaire on Cognitive Decline in the Elderly scores into interval-level data across multiple samples using Rasch methodology. Psychogeriatrics 2023; 23:411-421. [PMID: 36781176 DOI: 10.1111/psyg.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/20/2023] [Accepted: 01/25/2023] [Indexed: 02/15/2023]
Abstract
BACKGROUND The 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16) is a well-validated and widely-used measure of cognitive changes (CCs) among older adults. This study aimed to use Rasch methodology to establish psychometric properties of the IQCODE-16 and validate the existing ordinal-to-interval transformation algorithms across multiple large samples. METHODS A Partial Credit Rasch model was employed to examine psychometric properties of the IQCODE-16 using data (n = 918) from two longitudinal studies of participants aged 57-99 years: the Older Australian Twins Study (n = 450) and the Canberra Longitudinal Study (n = 468), and reusing the Sydney Memory and Ageing Study (MAS) sample (n = 400). RESULTS Initial analyses indicated good reliability for the IQCODE-16 (Person Separation Index range: 0.82-0.90). However, local dependency was identified between items, with several items showing misfit to the model. Replicating the existing Rasch solution could not reproduce the best Rasch model fit for all samples. Combining locally dependent items into three testlets resolved all misfit and local dependency issues and resulted in the best Rasch model fit for all samples with evidence of unidimensionality, strong reliability, and invariance across person factors. Accordingly, new ordinal-to-interval transformation algorithms were produced to convert the IQCODE-16 ordinal scores into interval data to improve the accuracy of its scores. CONCLUSIONS The findings of this study support the reliability and validity of the IQCODE-16 in measuring CCs among older adults. New ordinal-to-interval conversion tables generated using samples from multiple independent datasets are more generalizable and can be used to enhance the precision of the IQCODE-16 without changing its original format. An easy-to-use converter has been made available for clinical and research use.
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Affiliation(s)
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Carol C Choo
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Adam C Bentvelzen
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Vibeke S Catts
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Matti Cervin
- Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Faculty of Medicine, Lund University, Lund, Sweden
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), University of New South Wales, Sydney, New South Wales, Australia
| | - Oleg N Medvedev
- School of Psychology, University of Waikato, Hamilton, New Zealand
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Poptsi E, Moraitou D, Tsardoulias E, Symeonidis AL, Papaliagkas V, Tsolaki M. R4Alz-Revised: A Tool Able to Strongly Discriminate 'Subjective Cognitive Decline' from Healthy Cognition and 'Minor Neurocognitive Disorder'. Diagnostics (Basel) 2023; 13:diagnostics13030338. [PMID: 36766444 PMCID: PMC9914647 DOI: 10.3390/diagnostics13030338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The diagnosis of the minor neurocognitive diseases in the clinical course of dementia before the clinical symptoms' appearance is the holy grail of neuropsychological research. The R4Alz battery is a novel and valid tool that was designed to assess cognitive control in people with minor cognitive disorders. The aim of the current study is the R4Alz battery's extension (namely R4Alz-R), enhanced by the design and administration of extra episodic memory tasks, as well as extra cognitive control tasks, towards improving the overall R4Alz discriminant validity. METHODS The study comprised 80 people: (a) 20 Healthy adults (HC), (b) 29 people with Subjective Cognitive Decline (SCD), and (c) 31 people with Mild Cognitive Impairment (MCI). The groups differed in age and educational level. RESULTS Updating, inhibition, attention switching, and cognitive flexibility tasks discriminated SCD from HC (p ≤ 0.003). Updating, switching, cognitive flexibility, and episodic memory tasks discriminated SCD from MCI (p ≤ 0.001). All the R4Alz-R's tasks discriminated HC from MCI (p ≤ 0.001). The R4Alz-R was free of age and educational level effects. The battery discriminated perfectly SCD from HC and HC from MCI (100% sensitivity-95% specificity and 100% sensitivity-90% specificity, respectively), whilst it discriminated excellently SCD from MCI (90.3% sensitivity-82.8% specificity). CONCLUSION SCD seems to be stage a of neurodegeneration since it can be objectively evaluated via the R4Alz-R battery, which seems to be a useful tool for early diagnosis.
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Affiliation(s)
- Eleni Poptsi
- School of Psychology, Faculty of Philosophy, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (CIRI—AUTh), 54124 Thessaloniki, Greece
- Day Center “Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD)”, 54643 Thessaloniki, Greece
- Correspondence:
| | - Despina Moraitou
- School of Psychology, Faculty of Philosophy, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (CIRI—AUTh), 54124 Thessaloniki, Greece
- Day Center “Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD)”, 54643 Thessaloniki, Greece
| | - Emmanouil Tsardoulias
- School of Electrical and Computer Engineering, Faculty of Engineering, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
| | - Andreas L. Symeonidis
- School of Electrical and Computer Engineering, Faculty of Engineering, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
| | - Vasileios Papaliagkas
- Department of Biomedical Sciences, International Hellenic University, 57001 Thessaloniki, Greece
| | - Magdalini Tsolaki
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation, Aristotle University of Thessaloniki (CIRI—AUTh), 54124 Thessaloniki, Greece
- Day Center “Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD)”, 54643 Thessaloniki, Greece
- 1st Department of Neurology, Medical School, Aristotle University of Thessaloniki (AUTh), 54124 Thessaloniki, Greece
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20
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Moret-Tatay C, Zharova I, Iborra-Marmolejo I, Bernabé-Valero G, Jorques-Infante MJ, Beneyto-Arrojo MJ. Psychometric Properties of the Subjective Cognitive Decline Questionnaire (SCD-Q) and Its Invariance across Age Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1220. [PMID: 36673996 PMCID: PMC9859323 DOI: 10.3390/ijerph20021220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
Considering that a good sense of subjective cognitive decline seems to be crucial to prevent decline before clinical impairment, the interest in examining tools on this front were raised in the last decade. The aim of the present study is to examine the psychometric properties of the Subjective Cognitive Decline Questionnaire (SCD-Q) across age in its Spanish adaptation. It should be noted that two constructs were proposed in this context: mnestic processes and executive function factors. For this reason, a sample of 750 individuals aged from 18 to 82 years participated in the study. They were divided into three different groups: young, middle, and older adults. A confirmatory factor analysis (CFA) and invariance analysis were carried out. Moreover, a logistic regression was employed to address the role of age. The results support a good goodness of fit for both uni- and bifactorial models. The invariance analysis reached the structural covariances levels. Last, age did not predict the recognition of cognitive decline in the last two years, while the SCD-Q bifactorial model did. These results are of interest both on a theoretical level, to provide more information on models of cognitive impairment, and on a practical level, for screening.
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Affiliation(s)
- Carmen Moret-Tatay
- MEB Laboratory, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la ilustración 2, 46100 Valencia, Spain
| | - Iryna Zharova
- MEB Laboratory, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la ilustración 2, 46100 Valencia, Spain
- Faculty of Psychology, National University of Ukraine on Physical Education and Sport, Kiev. Ukraine. St. Fizkul’tury, 1, 0315 Kyiv, Ukraine
| | - Isabel Iborra-Marmolejo
- MEB Laboratory, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la ilustración 2, 46100 Valencia, Spain
| | - Gloria Bernabé-Valero
- MEB Laboratory, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la ilustración 2, 46100 Valencia, Spain
| | - María José Jorques-Infante
- MEB Laboratory, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la ilustración 2, 46100 Valencia, Spain
| | - María José Beneyto-Arrojo
- MEB Laboratory, Faculty of Psychology, Universidad Católica de Valencia San Vicente Mártir, Avenida de la ilustración 2, 46100 Valencia, Spain
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21
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Hong JY, Lee PH. Subjective Cognitive Complaints in Cognitively Normal Patients With Parkinson's Disease: A Systematic Review. J Mov Disord 2023; 16:1-12. [PMID: 36353806 PMCID: PMC9978265 DOI: 10.14802/jmd.22059] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/15/2022] [Indexed: 11/11/2022] Open
Abstract
Subjective cognitive complaints (SCCs) refer to self-perceived cognitive decline and are related to objective cognitive decline. SCCs in cognitively normal individuals are considered a preclinical sign of subsequent cognitive impairment due to Alzheimer's disease, and SCCs in cognitively normal patients with Parkinson's disease (PD) are also gaining attention. The aim of this review was to provide an overview of the current research on SCCs in cognitively normal patients with PD. A systematic search found a lack of consistency in the methodologies used to define and measure SCCs. Although the association between SCCs and objective cognitive performance in cognitively normal patients with PD is controversial, SCCs appear to be predictive of subsequent cognitive decline. These findings support the clinical value of SCCs in cognitively normal status in PD; however, further convincing evidence from biomarker studies is needed to provide a pathophysiological basis for these findings. Additionally, a consensus on the definition and assessment of SCCs is needed for further investigations.
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Affiliation(s)
- Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea,Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea,Corresponding author: Phil Hyu Lee, MD, PhD Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea / Tel: +82-2-2228-1608 / Fax: +82-2-393-0705 / E-mail:
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22
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Matziorinis AM, Gaser C, Koelsch S. Is musical engagement enough to keep the brain young? Brain Struct Funct 2023; 228:577-588. [PMID: 36574049 PMCID: PMC9945036 DOI: 10.1007/s00429-022-02602-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/08/2022] [Indexed: 12/28/2022]
Abstract
Music-making and engagement in music-related activities have shown procognitive benefits for healthy and pathological populations, suggesting reductions in brain aging. A previous brain aging study, using Brain Age Gap Estimation (BrainAGE), showed that professional and amateur-musicians had younger appearing brains than non-musicians. Our study sought to replicate those findings and analyze if musical training or active musical engagement was necessary to produce an age-decelerating effect in a cohort of healthy individuals. We scanned 125 healthy controls and investigated if musician status, and if musical behaviors, namely active engagement (AE) and musical training (MT) [as measured using the Goldsmiths Musical Sophistication Index (Gold-MSI)], had effects on brain aging. Our findings suggest that musician status is not related to BrainAGE score, although involvement in current physical activity is. Although neither MT nor AE subscales of the Gold-MSI are predictive for BrainAGE scores, dispositional resilience, namely the ability to deal with challenge, is related to both musical behaviors and sensitivity to musical pleasure. While the study failed to replicate the findings in a previous brain aging study, musical training and active musical engagement are related to the resilience factor of challenge. This finding may reveal how such musical behaviors can potentially strengthen the brain's resilience to age, which may tap into a type of neurocognitive reserve.
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Affiliation(s)
- Anna Maria Matziorinis
- Department of Biological and Medical Psychology, University of Bergen, Jonas Lies Vei 91, 5009, Bergen, Norway.
| | - Christian Gaser
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Stefan Koelsch
- Department of Biological and Medical Psychology, University of Bergen, Jonas Lies Vei 91, 5009, Bergen, Norway
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23
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Kero K, Halter CM, Moll AC, Hanna SM, Woodard JL, Giordani B, Daugherty AM, Kavcic V. Metacognition in Community-Dwelling Older Black and African American Adults During the COVID-19 Pandemic. J Alzheimers Dis 2023; 96:301-311. [PMID: 37742635 PMCID: PMC10757653 DOI: 10.3233/jad-221140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
BACKGROUND Cognitive assessment of older adults typically includes symptom reports and objective evaluations. However, there is often poor agreement between these measures. Cultural norms, stress, and anxiety may also influence cognitive self-appraisal and performance. Little research describes how other factors affect the self-report/objective test discrepancies noted in the literature. OBJECTIVE This study investigated whether the disparity between subjective cognitive concerns and objective cognitive performance is related to measures of anxiety and stress in older Black and African American adults. METHODS Telephone screenings were administered to 206 older adults (ages 64-94) during the first year of the pandemic. Demographic data, objective memory (Telephone Interview for Cognitive Status [TICS-m]), an adaptation of the subjective memory measure, the Cognitive Change Questionnaire, emphasizing executive functioning in everyday life [CCQ-e]), Generalized Anxiety Disorder-7 (GAD-7), and Perceived Stress Scale-4 (PSS4) were measured. Metacognition Discrepancy Index (MDI) was calculated from the standardized residual after regressing TICS-m on CCQ-e scores to quantify the discrepancy between cognitive self-appraisal and objective cognitive functioning. RESULTS Neither GAD-7 nor PSS-4 moderated the relationship between TICS-m and CCQ-e, and TICS-m scores weakly predicted subjective CCQ-e scores (F(1, 197)=4.37, p = 0.038, R2 = 0.022). The MDI correlated with stress and anxiety (rs = 0.294, 0.396, ps < 0.001). CONCLUSION Discrepancies exist between objectively measured and self-evaluated cognition. Elevations in stress and anxiety are associated with greater overestimation of cognitive difficulties relative to objective performance. Pandemic-related stressors may have worsened anxiety and diminished self-appraisal of cognitive abilities for some individuals, while others may remain reluctant to acknowledge impairments. Social and emotional factors are meaningful considerations in assessing cognitive difficulties.
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Affiliation(s)
| | | | | | | | | | - Bruno Giordani
- Michigan Alzheimer’s Disease Research Center, Ann Arbor, MI, USA
- University of Michigan, Ann Arbor, MI, USA
| | | | - Voyko Kavcic
- Wayne State University, Detroit, MI, USA
- International Institute of Applied Gerontology, Ljubljana, Slovenia
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24
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Kim KY, Park J, Jeong YH, Kim HJ, Lee E, Park JY, Kim E, Kim WJ. Plasma amyloid-beta oligomer is related to subjective cognitive decline and brain amyloid status. Alzheimers Res Ther 2022; 14:162. [PMID: 36324157 PMCID: PMC9632136 DOI: 10.1186/s13195-022-01104-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
Background Subjective cognitive decline (SCD) is a target for Alzheimer’s disease prediction. Plasma amyloid-beta oligomer (AβO), the pathogenic form of Aβ in blood, has recently been proposed as a novel blood-based biomarker of AD prediction by representing brain Aβ deposition. The relationship between plasma AβO, brain Aβ deposition, and SCD in individuals with normal objective cognition has not been investigated. Methods In this cross-sectional study, we analyzed 126 participants with normal objective cognition. More SCD symptoms were expressed as higher scores of the Subjective Cognitive Decline Questionnaire (SCDQ) and Memory Age-associated Complaint Questionnaire (MACQ). The plasma AβO level of each participant was measured twice for validation and expressed as a concentration (ng/mL) and a ratio relative to the mean value of two internal standards. Brain Aβ deposition was assessed by [18F] flutemetamol positron emission tomography (PET) and expressed as standard uptake value ratio (SUVR). Associations of SCDQ and MACQ with plasma AβO levels or SUVR were analyzed in multiple linear regression models. The association between plasma AβO level and flutemetamol PET positivity was assessed in logistic regression and receiver operative characteristic analyses. Results Overall, participants were 73.3 years old with female predominance (69.0%). After adjustment for confounders, high SCDQ and MACQ scores were associated with the high plasma AβO levels as both concentrations and ratios (ratios: standardized coefficient = 0.246 and p = 0.023 for SCDQ, standardized coefficient = 0.209 and p = 0.029 for MACQ; concentrations: standardized coefficient = 0.257 and p = 0.015 for SCDQ, standardized coefficient = 0.217 and p = 0.021 for MACQ). In contrast, SCDQ and MACQ were not significantly associated with SUVRs (p = 0.134 for SCDQ, p = 0.079 for MACQ). High plasma AβO levels were associated with flutemetamol PET (+) with an area under the curve of 0.694 (ratio) or 0.662 (concentration). Combined with APOE e4, plasma AβO presented area under the curves of 0.789 (ratio) and 0.783 (concentration). Conclusions Our findings indicate that the high plasma AβO level could serve as a potential surrogate biomarker of severe SCD and the presence of brain Aβ deposition in individuals with normal objective cognition.
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Affiliation(s)
- Keun You Kim
- grid.15444.300000 0004 0470 5454Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea ,grid.412479.dDepartment of Psychiatry, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jaesub Park
- grid.15444.300000 0004 0470 5454Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea ,grid.416665.60000 0004 0647 2391Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Yong Hyu Jeong
- grid.15444.300000 0004 0470 5454Department of Nuclear Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Hyun Jeong Kim
- grid.15444.300000 0004 0470 5454Department of Nuclear Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Eun Lee
- grid.15444.300000 0004 0470 5454Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Young Park
- grid.15444.300000 0004 0470 5454Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, 363, Dongbaekjukjeon-daero, Giheung-gu, Gyeonggi Yongin, Republic of Korea
| | - Eosu Kim
- grid.15444.300000 0004 0470 5454Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Woo Jung Kim
- grid.15444.300000 0004 0470 5454Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, 363, Dongbaekjukjeon-daero, Giheung-gu, Gyeonggi Yongin, Republic of Korea
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25
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Yang Q, Wang Y, Yang M, Ge S, Cheng S, Wang C, Zhang W, Tian C, Mao J. Apathy co-occurs with subjective cognitive decline among community-dwelling older adults. Geriatr Nurs 2022; 48:177-182. [PMID: 36257223 DOI: 10.1016/j.gerinurse.2022.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To investigate the relationship between apathy and subjective cognitive decline (SCD) in community-dwelling older adults. METHODS A total of 211 participants without objective cognitive impairment were included in this study. Their SCD, apathy, sleep quality, depression, and anxiety were assessed by face-to-face interviews. Multivariate logistic regression was constructed to examine the independent relationship between apathy and SCD with adjustment for confounders. RESULTS The participants' average SCD-questionnaire and apathy evaluation scale-self scores were 7.13 and 30.65, respectively. Nearly half of the participants were categorized as having SCD. A quarter of participants were identified as apathetic. The apathy score was significantly associated with an increased risk of SCD (odds ratio 1.05, 95% confidence interval 1.01-1.10) after controlling for covariates. CONCLUSION Apathy was independently and significantly associated with SCD in community-dwelling older adults without objective cognitive impairment. Thus early intervention on apathy is important to protect elderly cognitive functioning.
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Affiliation(s)
- Qing Yang
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuxin Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Mengshu Yang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Song Ge
- Department of Natural Sciences, University of Houston-Downtown, Houston, TX, US
| | - Shiyao Cheng
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chuwen Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenya Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chong Tian
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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26
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Akinci M, Sánchez-Benavides G, Brugulat-Serrat A, Peña-Gómez C, Palpatzis E, Shekari M, Deulofeu C, Fuentes-Julian S, Salvadó G, González-de-Echávarri JM, Suárez-Calvet M, Minguillón C, Fauria K, Molinuevo JL, Gispert JD, Grau-Rivera O, Arenaza-Urquijo EM, Beteta A, Cacciaglia R, Cañas A, Cumplido I, Dominguez R, Emilio M, Falcon C, Hernandez L, Huesa G, Huguet J, Marne P, Menchón T, Operto G, Polo A, Rodríguez-Fernández B, Pradas S, Sadeghi I, Soteras A, Stankeviciute L, Vilanova M, Vilor-Tejedor N. Subjective cognitive decline and anxious/depressive symptoms during the COVID-19 pandemic: what is the role of stress perception, stress resilience, and β-amyloid? Alzheimers Res Ther 2022; 14:126. [PMID: 36068641 PMCID: PMC9446623 DOI: 10.1186/s13195-022-01068-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 08/28/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
The COVID-19 pandemic may worsen the mental health of people reporting subjective cognitive decline (SCD) and therefore their clinical prognosis. We aimed to investigate the association between the intensity of SCD and anxious/depressive symptoms during confinement and the underlying mechanisms.
Methods
Two hundred fifty cognitively unimpaired participants completed the Hospital Anxiety and Depression Scale (HADS) and SCD-Questionnaire (SCD-Q) and underwent amyloid-β positron emission tomography imaging with [18F] flutemetamol (N = 205) on average 2.4 (± 0.8) years before the COVID-19 confinement. During the confinement, participants completed the HADS, Perceived Stress Scale (PSS), Brief Resilience Scale (BRS), and an ad hoc questionnaire on worries (access to primary products, self-protection materials, economic situation) and lifestyle changes (sleep duration, sleep quality, eating habits). We investigated stress-related measurements, worries, and lifestyle changes in relation to SCD. We then conducted an analysis of covariance to investigate the association of SCD-Q with HADS scores during the confinement while controlling for pre-confinement anxiety/depression scores and demographics. Furthermore, we introduced amyloid-β positivity, PSS, and BRS in the models and performed mediation analyses to explore the mechanisms explaining the association between SCD and anxiety/depression.
Results
In the whole sample, the average SCD-Q score was 4.1 (± 4.4); 70 (28%) participants were classified as SCD, and 26 (12.7%) were amyloid-β-positive. During the confinement, participants reporting SCD showed higher PSS (p = 0.035) but not BRS scores (p = 0.65) than those that did not report SCD. No differences in worries or lifestyle changes were observed. Higher SCD-Q scores showed an association with greater anxiety/depression scores irrespective of pre-confinement anxiety/depression levels (p = 0.002). This association was not significant after introducing amyloid-β positivity and stress-related variables in the model (p = 0.069). Amyloid-β positivity and PSS were associated with greater HADS irrespective of pre-confinement anxiety/depression scores (p = 0.023; p < 0.001). The association of SCD-Q with HADS was mediated by PSS (p = 0.01).
Conclusions
Higher intensity of SCD, amyloid-β positivity, and stress perception showed independent associations with anxious/depressive symptoms during the COVID-19 confinement irrespective of pre-confinement anxiety/depression levels. The association of SCD intensity with anxiety/depression was mediated by stress perception, suggesting stress regulation as a potential intervention to reduce affective symptomatology in the SCD population in the face of stressors.
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Ibnidris A, Robinson JN, Stubbs M, Piumatti G, Govia I, Albanese E. Evaluating measurement properties of subjective cognitive decline self-reported outcome measures: a systematic review. Syst Rev 2022; 11:144. [PMID: 35850915 PMCID: PMC9290248 DOI: 10.1186/s13643-022-02018-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 07/04/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Subjective cognitive decline (SCD) is present in the early stage of preclinical Alzheimer's disease (AD) and is associated with an increased risk of further cognitive decline and AD dementia later in life. Early detection of at-risk groups with subjective complaints is critical for targeted dementia prevention at the earliest. Accurate assessment of SCD is crucial. However, current measures lack important psychometric evaluations and or reporting. OBJECTIVES To systematically evaluate measurement properties of self-reported outcome measures (PROMs) used to assess SCD in the older adult population with or at risk of AD. METHODS AND ANALYSIS We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols 2015 Checklist for reporting. We conducted a literature search, screened, and included validation studies of SCD based on self-reported questionnaires from both population-based and clinical studies, conducted in older adults (≥ 55). We critically appraised the included primary studies using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. RESULTS Sixteen studies met the inclusion criteria. The included studies reported psychometric properties of 17 SCD self-reported questionnaires. We extracted data on the structural validity, internal consistency, test-retest reliability, and cross-cultural validity and found a widespread proneness to bias across studies, and a marked heterogeneity is assessed and reported measurement properties that prevented the consolidation of results. CONCLUSION Our findings suggest that available SCD questionnaires lack content validity evaluation. Currently available measurements of SCD lack development and validation standards. Further work is needed to develop and validate SCD self-reported measurement with good quality measurement properties.
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Affiliation(s)
- Aliaa Ibnidris
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland. .,Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - Janelle N Robinson
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Marissa Stubbs
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | | | - Ishtar Govia
- Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona Campus, Kingston, Jamaica
| | - Emiliano Albanese
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
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From Subjective Cognitive Decline to Mild Cognitive Impairment to Dementia: Clinical and Capacity Assessment Considerations. PSYCHOLOGICAL INJURY & LAW 2022. [DOI: 10.1007/s12207-022-09456-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Flo BK, Matziorinis AM, Skouras S, Sudmann TT, Gold C, Koelsch S. Study protocol for the Alzheimer and music therapy study: An RCT to compare the efficacy of music therapy and physical activity on brain plasticity, depressive symptoms, and cognitive decline, in a population with and at risk for Alzheimer’s disease. PLoS One 2022; 17:e0270682. [PMID: 35771851 PMCID: PMC9246122 DOI: 10.1371/journal.pone.0270682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 06/13/2022] [Indexed: 11/28/2022] Open
Abstract
Background There is anecdotal evidence for beneficial effects of music therapy in patients with Alzheimer’s Disease (AD). However, there is a lack of rigorous research investigating this issue. The aim of this study is to evaluate the effects of music therapy and physical activity on brain plasticity, mood, and cognition in a population with AD and at risk for AD. Methods One-hundred and thirty-five participants with memory complaints will be recruited for a parallel, three-arm Randomized Controlled Trial (RCT). Inclusion criteria are a diagnosis of mild (early) AD or mild cognitive impairment (MCI), or memory complaints without other neuropsychiatric pathology. Participants are randomised into either a music therapy intervention (singing lessons), an active control group (physical activity) or a passive control group (no intervention) for 12 months. The primary outcomes are the brain age gap, measured via magnetic resonance imaging (MRI), and depressive symptoms. Secondary outcomes include cognitive performance, activities of daily living, brain structure (voxel-based morphometry and diffusion tensor imaging), and brain function (resting-state functional MRI). Trial status Screening of participants began in April 2018. A total of 84 participants have been recruited and started intervention, out of which 48 participants have completed 12 months of intervention and post-intervention assessment. Discussion Addressing the need for rigorous longitudinal data for the effectiveness of music therapy in people with and at risk for developing AD, this trial aims to enhance knowledge regarding cost-effective interventions with potentially high clinical applicability. Trial registration ClinicalTrials.gov identifier: NCT03444181, registered on February 23, 2018.
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Affiliation(s)
- Birthe K. Flo
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- * E-mail: (BKF); (SK)
| | | | - Stavros Skouras
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | | | - Christian Gold
- NORCE Norwegian Research Centre AS, Bergen, Norway
- Grieg Academy Department of Music, University of Bergen, Bergen, Norway
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
| | - Stefan Koelsch
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- * E-mail: (BKF); (SK)
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Yeh PK, Liang CS, Tsai CL, Lin YK, Lin GY, Tsai CK, Tsai MC, Liu Y, Tai YM, Hung KS, Yang FC. Genetic Variants Associated With Subjective Cognitive Decline in Patients With Migraine. Front Aging Neurosci 2022; 14:860604. [PMID: 35783123 PMCID: PMC9248861 DOI: 10.3389/fnagi.2022.860604] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
The genetic association between subjective cognitive decline (SCD) and migraine comorbidity remains unclear. Furthermore, single nucleotide polymorphisms (SNP) associated with SCD have not been identified previously. Migraineurs were genotyped using an Affymetrix array. The correlation between different SNP variants in migraineurs with or without SCD and non-migraine controls was investigated. Migraineurs with or without SCD were further divided for the analysis of relevant SNP variants linked to migraine with aura (MA), migraine without aura (MoA), episodic migraine (EM), and chronic migraine (CM). Significant connectivity between SNPs and clinical indices in migraineurs and non-migraine controls with SCD were assessed using multivariate regression analysis. The rs144191744 SNP was found in migraineurs (p = 3.19E-08), EM (p = 1.34E-07), and MoA(p = 7.69E-07) with and without SCD. The T allele frequency for rs144191744 in TGFBR3 was 0.0054 and 0.0445 in migraineurs with and without SCD (odds ratio, 0.12), respectively. rs2352564, rs6089473 in CDH4, rs112400385 in ST18, rs4488224 and rs17111203 in ARHGAP29 SNPs were found, respectively, in non-migraineurs (p = 4.85E-06, p = 8.28E-06), MoA (p = 3.13E-07), and CM subgroups (p = 1.05E-07, 6.24E-07) with and without SCD. Rs144191744 closely relates to SCD with the all-migraine group and the EM and MoA subgroups. In conclusion, rs144191744 in TGFBR3 was significantly associated with SCD in migraineurs, especially in the EM, MoA, and female patient subgroups. Furthermore, three SNPs (rs112400385, rs4488224, and rs17111203) were associated with SCD in migraineurs but not in non-migraine controls.
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Affiliation(s)
- Po-Kuan Yeh
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Lin Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Kai Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Guan-Yu Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Neurology, Songshan Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Kuang Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ming-Chen Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi Liu
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yueh-Ming Tai
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kuo-Sheng Hung
- Center for Precision Medicine and Genomics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- *Correspondence: Fu-Chi Yang
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Wang T, Yan X, Zhou Q. Effect of acupuncture on gut microbiota in participants with subjective cognitive decline. Medicine (Baltimore) 2022; 101:e27743. [PMID: 35550457 PMCID: PMC9276146 DOI: 10.1097/md.0000000000027743] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 10/24/2021] [Indexed: 12/18/2022] Open
Abstract
A close relationship has recently been described between subjective cognitive decline (SCD) and gut microbiota disorders. Herein, we aim to investigate the effect of electroacupuncture (EA) on gut microbiota in participants with SCD.We conducted a study of 60 participants with SCD. Sixty participants were allocated to either EA group (n = 30) or sham acupuncture group (n = 30). Both groups received 24 sessions of real acupuncture treatment or identical treatment sessions using the placebo needle. Global cognitive change based on a comprehensive neuropsychological test battery was evaluated to detect the clinical efficacy of acupuncture treatment at the baseline and the end of treatment. Faecal microbial analyses were carried out after collecting stools at T0 and T12 weeks. Microbiomes were analyzed by 16S ribosomal RNA gene sequencing. Correlation analyses were performed to investigate the relationships between the changes in gut microbiota and symptom improvement.Age is a particularly important factor leading to the severity of dementia. Compared with sham acupuncture group, the number of Escherichia-Shigella in EA group decreased after treatment. The number of Escherichia-Shigella in EA group decreased after treatment compared with EA group before treatment. Bifidobacterium is positively correlated with clinical efficacy Z-score and Montreal Cognitive Assessment Scale (both P < .005).Acupuncture could improve global cognitive change among SCD participants by regulating the intestinal flora. Dysbiosis was found in the gut microbiome in SCD and partially relieved by acupuncture. Our study suggests that gut microbiota could be a potential therapeutic target and diagnostic biomarker for SCD.
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Affiliation(s)
- Tianqi Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaoying Yan
- Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qi Zhou
- Department of Obstetrics and Gynecology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Frias JR, Nogueira J, Gerardo B, Afonso RM, Freitas S. Cognitive decline complaints scale (CDCS): validation and normative studies for the adults and older adults Portuguese population. Aging Ment Health 2022; 27:721-728. [PMID: 35470707 DOI: 10.1080/13607863.2022.2068130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Subjective Cognitive Complaints, which result from the self-perception of Subjective Cognitive Decline, are frequently reported by older adults. The Cognitive Decline Complaints Scale (CDCS) assesses subjective complaints of cognitive decline in several cognitive domains through three levels of severity. This study aims to psychometrically validate this instrument considering the Classical Test Theory, and to establish preliminary normative data of the CDCS for adults and older adults of the Portuguese population. METHODS The community-based sample consisted of 199 cognitively healthy Portuguese participants, aged 50 years or older, stratified according to several sociodemographic variables. In addition to the CDCS, all participants responded to an extensive neuropsychological assessment protocol. RESULTS The psychometric characteristics of the CDCS were generally adequate for this community sample (e.g. Cronbach's alpha = .936). As for the sociodemographic variables analyzed, only the geographic region showed differences in the CDCS scores, which were more significant in the Azores. There were no significant correlations or differences between the CDCS scores and age and educational level and, therefore, normative data were explored considering the total sample. CONCLUSION As a scale, the CDCS allows for the detailed assessment of subjective cognitive complaints and the determination of whether or not such complaints are considered normative, which will facilitate an empirically based understanding of this dimension of psychological functioning and also provide indications as to the need for a more extensive neuropsychological assessment.
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Affiliation(s)
- Joana Rita Frias
- Department of Psychology and Education, University of Beira Interior, Covilhã, Portugal
| | - Joana Nogueira
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences (FPCEUC), University of Coimbra, Coimbra, Portugal.,Psychological Assessment and Psychometrics Laboratory (PsyAssessmentLab), Faculty of Psychology and Educational Sciences (FPCEUC), University of Coimbra, Coimbra, Portugal
| | - Bianca Gerardo
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences (FPCEUC), University of Coimbra, Coimbra, Portugal.,Psychological Assessment and Psychometrics Laboratory (PsyAssessmentLab), Faculty of Psychology and Educational Sciences (FPCEUC), University of Coimbra, Coimbra, Portugal
| | - Rosa Marina Afonso
- Department of Psychology and Education, University of Beira Interior, Covilhã, Portugal.,CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - Sandra Freitas
- Department of Psychology and Education, University of Beira Interior, Covilhã, Portugal.,Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences (FPCEUC), University of Coimbra, Coimbra, Portugal.,Psychological Assessment and Psychometrics Laboratory (PsyAssessmentLab), Faculty of Psychology and Educational Sciences (FPCEUC), University of Coimbra, Coimbra, Portugal
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Splonskowski M, Jacova C. Older Adults' Likelihood of Participating in Home-Based Cognitive Assessment. Dement Geriatr Cogn Disord 2022; 51:32-41. [PMID: 35193138 DOI: 10.1159/000521903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/05/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Timely detection of cognitive impairment among older adults has shown to lead to better health and financial outcomes but is hampered by psychological, financial, and physical barriers to participation in cognitive assessment. Home-based cognitive assessment (HBCA) could help overcome some of these barriers. This study aimed to examine older adults' likelihood of participation in HBCA and identify factors predicting this likelihood. MATERIALS AND METHODS A cross-sectional online survey distributed through Amazon Mechanical Turk, was used to collect data from adults aged 50 years or older residing in the USA The survey was designed to gauge attitudes toward technology and cognitive assessment and to measure psychological variables including subjective cognitive decline (SCD), depression, and anxiety. Information on income and geographic location (rural vs. suburban and urban) was also collected. Univariate and hierarchical regression analyses were conducted to examine the contributions of these variables to a composite measure of likelihood of participation in HBCA. RESULTS Complete data were obtained on n = 483 (age 50-79). Approximately, two-thirds of respondents described themselves as likely or very likely to participate in HBCA. In univariate analyses, younger age, higher income, higher technology assessment acceptance scores, and higher SCD burden were associated with higher likelihood of participation. Hierarchical regression revealed significant stepwise increments in explained variance: demographic variables 4.1%, technology acceptance 25.2%, assessment acceptance 15.4%, and SCD burden 1.6%. The contribution of SCD was moderated by sex and found for women but not for men. DISCUSSION/CONCLUSION A large proportion of adults aged 50 and above described themselves likely to participate in HBCA. Middle-aged, technology-savvy, higher income adults expressed the most positive attitudes toward this type of service. Of interest is that HBCA may be particularly acceptable among older women with SCD, a group known to be at risk of cognitive decline. Our findings support the expansion of cognitive assessment services to the home setting.
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Affiliation(s)
| | - Claudia Jacova
- School of Graduate Psychology, Pacific University, Hillsboro, Oregon, USA
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Ko J, Ha J, Lee JJ, Jin S, Lee J, Baek MS, Hong JY. Reliability and Validity of the Subjective Cognitive Complaints Questionnaire for Parkinson’s Disease (SCCQ-PD). J Clin Neurol 2022; 18:171-178. [PMID: 35196748 PMCID: PMC8926760 DOI: 10.3988/jcn.2022.18.2.171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 11/19/2022] Open
Abstract
Background and Purpose Subjective cognitive complaints (SCCs) are gaining attention as a self-perceived symptom for cognitive impairment in patients with Parkinson’s disease (PD), but there are few suitable tools for assessing SCCs in PD. This study aimed to develop and validate a questionnaire for assessing SCCs in PD, called the Subjective Cognitive Complaints Questionnaire for Parkinson’s Disease (SCCQ-PD). Methods The SCCQ-PD consists of 12 yes/no questions on subjective cognitive function, and the questionnaire was completed by patients with PD (score-P) and their caregivers (score-C). The cognitive function of patients was examined using comprehensive neuropsychological tests. Results This study included 73 patients (38 cognitively normal, 25 with mild cognitive impairment [MCI], and 10 demented) and their caregivers. Score-P and score-C had excellent reliability (Kuder-Richardson formula 20 coefficients of 0.893 and 0.931, respectively), and the scores exhibited a strong intercorrelation. Both score-P and score-C were negatively correlated with cognitive performance, and both were excellent in discriminating demented patients from those with normal cognition or MCI (areas under the receiver operating characteristic curve of 0.83 and 0.88, respectively). Conclusions The SCCQ-PD is a reliable tool for assessing SCCs in patients with PD. SCCs measured using the SCCQ-PD are correlated with objective cognitive decline and useful for discriminating demented patients from nondemented patients.
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Affiliation(s)
- Jeongmin Ko
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Joonyoung Ha
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jae Jung Lee
- Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sunjin Jin
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jongwoo Lee
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Min Seok Baek
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Jin Yong Hong
- Department of Neurology, Yonsei University Wonju College of Medicine, Wonju, Korea
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Pacifico D, Sabatini S, Fiordelli M, Albanese E. The role of disability and depressive symptoms in the relation between objective cognitive performance and subjective cognitive decline. Front Psychiatry 2022; 13:963703. [PMID: 36506437 PMCID: PMC9729556 DOI: 10.3389/fpsyt.2022.963703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Subjective cognitive decline (SCD) and subjective memory decline (SMD) are common among older people. Evidence linking SCD and SMD with cognitive and memory impairment is inconsistent. Moreover, little is known about the associations of SCD and SMD with disability. We aimed to explore the associations of SCD and SMD with objective cognitive and memory performance, disability, and depressive symptoms. MATERIALS AND METHODS In a cross-sectional study we conducted face to face interviews in a randomized sample of people aged ≥65 years living in the Canton of Ticino, southern Switzerland, between May 2021 and April 2022. We measured subjective cognitive decline with the MyCog, a subsection of the Subjective Cognitive Decline Questionnaire (SCD-Q); cognitive functioning with the Community Screening Instrument for Dementia; memory with the consortium to establish a registry for alzheimer's disease (CERAD) 10-word list learning task; and disability and depressive symptoms with the world health organization disability assessment schedule 2.0 (WHO-DAS 2.0) and the Euro-Depression (EURO-D) scales, respectively. RESULTS Of the 250 participants 93.6% reported at least one cognitive difficulty, and 40.0% SMD. Both SCD and SMD were associated with poorer objective cognitive/memory performance, and independently with greater disability, and more depressive symptoms. But in participants with high disability and depressive symptoms subjective and objective cognition were no longer associated. Disability fully mediated the associations of poorer objective cognitive and memory performance with subjective cognitive and memory decline. CONCLUSION Routine clinical assessments of cognitive function should include formal enquires about SCD and SMD, and also account for disability and depressive symptoms.
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Affiliation(s)
- Deborah Pacifico
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Serena Sabatini
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Maddalena Fiordelli
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Faculty of Biomedical Sciences, Institute of Public Health, Università della Svizzera Italiana, Lugano, Switzerland
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Rabin LA, Guayara-Quinn CG, Nester CO, Ellis L, Paré N. Informant report of practical judgment ability in a clinical sample of older adults with subjective cognitive decline, mild cognitive impairment, and dementia. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 29:139-157. [PMID: 33618617 PMCID: PMC8380745 DOI: 10.1080/13825585.2020.1859081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 11/29/2020] [Indexed: 01/03/2023]
Abstract
Despite the importance of capturing problems with judgment and decision-making during neuropsychological evaluations of older adults, there are a limited number of validated measures and no informant rating scales. We developed an informant measure that captures compromised judgment related to safety, medical, financial, and social-ethical issues After item refinement and piloting in a memory disorders clinic, we utilized the Test of Practical Judgment-Informant (TOP-J-Informant) at two clinics in the Midwestern U.S., including 189 patient/informant dyads (mean age = 79.0, median years of education = 13, % female = 67.7) with various preclinical and clinical dementia conditions. We found psychometric support, including evidence for convergent, divergent, and criterion-related validity, and internal consistency. Importantly, we were able to discriminate between diagnostic groups in the expected direction. The TOP-J-Informant is brief (<5 minutes), easy to administer, and can reveal areas of concern related to poor judgment when administered in the context of a neuropsychological evaluation or clinic visit.
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Affiliation(s)
- Laura A Rabin
- Department of Psychology, Brooklyn College and the Graduate Center of CUNY, Brooklyn, NY, USA
- Department of Psychology, Queens College and the Graduate Center of CUNY, New York, NY, USA
| | | | - Caroline O Nester
- Department of Psychology, Queens College and the Graduate Center of CUNY, New York, NY, USA
| | - Liam Ellis
- Neuropsychology Division, Department of Neurological Sciences, Nebraska Medicine, Omaha, NE, USA
| | - Nadia Paré
- Neuropsychology Division, Department of Neurological Sciences, Nebraska Medicine, Omaha, NE, USA
- Department of Neurology, University of Nebraska Medical Center, Omaha, NE, USA
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Measurement of Subjective Cognitive Decline (SCD) Using Korean-Everyday Cognition (K-ECog) as a Screening Tool: a Feasibility Study. Dement Neurocogn Disord 2021; 20:80-88. [PMID: 34795771 PMCID: PMC8585529 DOI: 10.12779/dnd.2021.20.4.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/15/2021] [Accepted: 10/15/2021] [Indexed: 11/27/2022] Open
Abstract
Background and Purpose Everyday Cognition (ECog) has been widely used to differentiate individuals with mild cognitive impairment (MCI) and dementia from normal elderly individuals. It has also been used to assess subjective cognitive decline (SCD). This study investigated the feasibility of using ECog as a screening measure for SCD in community-dwelling elderly individuals. Methods The participants included 84 older adults with and 93 without SCD living in the community. These 2 groups were classified based on their response (“yes” or “no”) to the question “Do you perceive memory or cognitive difficulties?” All participants were evaluated using the Korean-Mini Mental State Examination (K-MMSE), Short form of the Geriatric Depression Scale (SGDS), and the Korean version of Everyday Cognition (K-ECog). Results The scores of all participants were within the normal range on the K-MMSE and SGDS. The total K-MMSE score did not differ significantly between the 2 groups after controlling for age, education, and depression. The scores of SCD group were significantly higher than those of the non-SCD group for memory, language, and executive function: planning domains, as well as K-ECog total score. Receiver operating characteristic curve analysis revealed that the K-ECog total score was effective in moderately differentiating between subjects with and without SCD (area under the curve: 0.73). Conclusions ECog is a feasible and useful screening measure for SCD in older adults living in the community, and can be used to assess the full spectrum of cognitive and functional deficits, ranging from SCD to MCI and dementia.
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Chi SY, Chua EF, Kieschnick DW, Rabin LA. Prospective Metamemory Monitoring of Episodic Visual Memory in Community-Dwelling Older Adults with Subjective Cognitive Decline and Mild Cognitive Impairment. Arch Clin Neuropsychol 2021; 36:1404–1425. [PMID: 33893475 DOI: 10.1093/arclin/acab008] [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] [Accepted: 01/24/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE Metamemory tasks have been utilized to investigate anosognosia in older adults with dementia, though previous research has not systematically compared memory self-awareness in prodromal dementia groups. This represents an important oversight given that remedial and interventional efforts may be most beneficial before individuals' transition to clinical dementia. We examine differences in memory self-awareness and memory self-monitoring between cognitively healthy elderly controls and prodromal dementia groups. METHODS Participants with subjective cognitive decline despite intact objective neuropsychological functioning (SCD; n = 82), amnestic mild cognitive impairment (aMCI; n = 18), nonamnestic mild cognitive impairment (naMCI; n = 38), and normal cognitive functioning (HC; n = 120) were recruited from the Einstein Aging Study for a cross-sectional study. Participants completed an experimental visual memory-based global metamemory prediction task and subjective assessments of memory/cognition and self-awareness. RESULTS While, relative to HC, memory self-awareness and memory self-monitoring were preserved for delayed memory performance in SCD and aMCI, these processes were impaired in naMCI. Furthermore, results suggest that poor metamemory accuracy captured by our experimental task can be generalized to everyday memory problems. CONCLUSIONS Within the framework of the Cognitive Awareness Model, our findings provide preliminary evidence that poor memory self-awareness/self-monitoring in naMCI may reflect an executive or primary anosognosia, with implications for tailored rehabilitative interventions.
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Affiliation(s)
- Susan Y Chi
- Queens College, City University of New York, Queens, NY, USA
- Graduate Center, City University of New York, New York, NY, USA
- University of California at San Francisco, Weill Institute for Neurosciences, San Francisco, CA, USA
- Framework Associates, Santa Monica, CA, USA
| | - Elizabeth F Chua
- Graduate Center, City University of New York, New York, NY, USA
- Brooklyn College, City University of New York, Brooklyn, NY, USA
| | - Dustin W Kieschnick
- University of California at San Francisco, Weill Institute for Neurosciences, San Francisco, CA, USA
| | - Laura A Rabin
- Queens College, City University of New York, Queens, NY, USA
- Graduate Center, City University of New York, New York, NY, USA
- Brooklyn College, City University of New York, Brooklyn, NY, USA
- Albert Einstein College of Medicine, Einstein Aging Study, Bronx, NY, USA
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Xu WQ, Lin LH, Ding KR, Ke YF, Huang JH, Hou CL, Jia FJ, Wang SB. The role of depression and anxiety in the relationship between poor sleep quality and subjective cognitive decline in Chinese elderly: Exploring parallel, serial, and moderated mediation. J Affect Disord 2021; 294:464-471. [PMID: 34325166 DOI: 10.1016/j.jad.2021.07.063] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/20/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Poor sleep quality exacerbates subjective cognitive decline (SCD). Mental health may play an important role in the relationship, but the potential underlying mechanisms remain unknown. METHODS A cross-sectional study was conducted on older adult residents in Guangdong province, south China from November 2020 to March 2021. A total of 717 adults aged 60 years and over were recruited for a face-to-face investigation on a range of socio-demographic factors, lifestyle behaviors, sleep quality, SCD, depressive and anxiety symptoms. Parallel, serial and moderated mediation models were used to examine whether depression and anxiety mediated in the poor sleep quality-SCD linkage. RESULTS Both direct and indirect effects of poor sleep quality on SCD symptoms were found. Anxiety and depressive symptoms mediated the relationship between poor sleep quality and SCD symptoms(βAnxiety = 0.123, 95%CI: 0.079 to 0.173; βDepression=0.274, 95%CI: 0.200 to 0.348), respectively. Serial mediation analyses indicated that depressive and anxiety symptoms co-play a serial mediating role in the association of poor sleep quality and SCD symptoms (βa=0.052, 95% CI: 0.026 to 0.084; βb=0.077, 95% CI: 0.033 to 0.128). Moderated mediation model revealed that the mediation of depressive symptoms on the relationship between poor sleep quality and SCD symptoms was moderated by anxiety symptoms(β=0.318, 95% CI: 0.164 to 0.472). LIMITATIONS The study is the cross-sectional design, which limits the causal inference ability. CONCLUSIONS These findings provided new insights into possible avenues for prevention and intervention on SCD through sleep-based treatments with a multi-faceted approach on psychiatric disorders.
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Affiliation(s)
- Wen-Qi Xu
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Li-Hua Lin
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong province, China
| | - Kai-Rong Ding
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China; Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yun-Fei Ke
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China
| | - Jia-Hao Huang
- Yuexiu District Center for Disease Control, Guangzhou, Guangdong Province, China
| | - Cai-Lan Hou
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong province, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Fu-Jun Jia
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China; School of Medicine, South China University of Technology, Guangzhou, Guangdong province, China; Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China; The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong Province, China.
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Pavisic IM, Lu K, Keuss SE, James SN, Lane CA, Parker TD, Keshavan A, Buchanan SM, Murray-Smith H, Cash DM, Coath W, Wong A, Fox NC, Crutch SJ, Richards M, Schott JM. Subjective cognitive complaints at age 70: associations with amyloid and mental health. J Neurol Neurosurg Psychiatry 2021; 92:1215-1221. [PMID: 34035132 PMCID: PMC8522456 DOI: 10.1136/jnnp-2020-325620] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/08/2021] [Accepted: 04/28/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate subjective cognitive decline (SCD) in relation to β-amyloid pathology and to test for associations with anxiety, depression, objective cognition and family history of dementia in the Insight 46 study. METHODS Cognitively unimpaired ~70-year-old participants, all born in the same week in 1946 (n=460, 49% female, 18% amyloid-positive), underwent assessments including the SCD-Questionnaire (MyCog). MyCog scores were evaluated with respect to 18F-Florbetapir-PET amyloid status (positive/negative). Associations with anxiety, depression, objective cognition (measured by the Preclinical Alzheimer Cognitive Composite, PACC) and family history of dementia were also investigated. The informant's perspective on SCD was evaluated in relation to MyCog score. RESULTS Anxiety (mean (SD) trait anxiety score: 4.4 (3.9)) was associated with higher MyCog scores, especially in women. MyCog scores were higher in amyloid-positive compared with amyloid-negative individuals (adjusted means (95% CIs): 5.3 (4.4 to 6.1) vs 4.3 (3.9 to 4.7), p=0.044), after accounting for differences in anxiety. PACC (mean (SD) -0.05 (0.68)) and family history of dementia (prevalence: 23.9%) were not independently associated with MyCog scores. The informant's perception of SCD was generally in accordance with that of the participant. CONCLUSIONS This cross-sectional study demonstrates that symptoms of SCD are associated with both β-amyloid pathology, and more consistently, trait anxiety in a population-based cohort of older adults, at an age when those who are destined to develop dementia are still likely to be some years away from symptoms. This highlights the necessity of considering anxiety symptoms when assessing Alzheimer's disease pathology and SCD.
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Affiliation(s)
- Ivanna M Pavisic
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - Kirsty Lu
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah E Keuss
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah-Naomi James
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Christopher A Lane
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Thomas D Parker
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Ashvini Keshavan
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah M Buchanan
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Heidi Murray-Smith
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - David M Cash
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - William Coath
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Andrew Wong
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Marcus Richards
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Jonathan M Schott
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
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Lazarou I, Moraitou D, Papatheodorou M, Vavouras I, Lokantidou C, Agogiatou C, Gialaoutzis M, Nikolopoulos S, Stavropoulos TG, Kompatsiaris I, Tsolaki M. Adaptation and Validation of the Memory Alteration Test (M@T) in Greek Middle-Aged, Older, and Older-Old Population with Subjective Cognitive Decline and Mild Cognitive Impairment. J Alzheimers Dis 2021; 84:1219-1232. [PMID: 34657882 DOI: 10.3233/jad-210558] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Memory Alteration Test (M@T) is a verbal episodic and semantic memory screening test able to detect subjective cognitive decline (SCD) and Mild Cognitive Impairment (MCI). OBJECTIVE To adapt M@T, creating a Greek version of the Memory Alteration Test (M@T-GR), and to validate M@T-GR compared to the Mini-Mental State Examination (MMSE), and Subjective Cognitive Decline- Questionnaire (SCD-Q) MyCog and TheirCog. METHODS 232 people over 55 years old participated in the study and they were classified as healthy controls (HC, n = 65), SCD (n = 78), or MCI (n = 89). RESULTS The ANCOVA showed that the M@T-GR's total score was significantly different in HC and SCD (I-J = 2.26, p = 0.032), HC and MCI (I-J = 6.16, p < 0.0001), and SCD compared to MCI (I-J = 3.90, p < 0.0001). In particular, a cut-off score of 46.50 points had an 81%sensitivity and 61%specificity for discriminating HC from SCD (AUC = 0.76, p < 0.0001), while a cut-off score of 45.50 had a sensitivity of 92%and a specificity of 73%for discriminating MCI (AUC = 0.88, p < 0.0001), and a cut-off score of 45.50 points had a sensitivity of 63%and a specificity of 73%for discriminating SCD from those with MCI (AUC = 0.69, p < 0.0021). Exploratory factor analysis indicated that there was one factor explaining 38.46%of the total variance. Internal consistency was adequate (α= 0.75), while convergent validity was found between M@T-GR and MMSE (r = 0.37, p < 0.0001) and SCD-Q TheirCog (r = -0.32, p < 0.0001). CONCLUSION The M@T-GR is a good to fair screening tool with adequate discriminant validity for administration in people with SCD and MCI in Greece.
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Affiliation(s)
- Ioulietta Lazarou
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece.,1st Department of Neurology, G.H. "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Despina Moraitou
- Laboratory of Psychology, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marianna Papatheodorou
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Isaak Vavouras
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Chrysanthi Lokantidou
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Christina Agogiatou
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Moses Gialaoutzis
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Spiros Nikolopoulos
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Thanos G Stavropoulos
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Ioannis Kompatsiaris
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece
| | - Magda Tsolaki
- Information Technologies Institute, Centre for Research and Technology Hellas, Thessaloniki, Greece.,1st Department of Neurology, G.H. "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
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42
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Chapman S, Sunderaraman P, Joyce JL, Azar M, Colvin LE, Barker MS, McKeague I, Kreisl WC, Cosentino S. Optimizing Subjective Cognitive Decline to Detect Early Cognitive Dysfunction. J Alzheimers Dis 2021; 80:1185-1196. [PMID: 33646159 DOI: 10.3233/jad-201322] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The utility of subjective cognitive decline (SCD) as an indicator of preclinical AD is overshadowed by its inconsistent association with objective cognition. OBJECTIVE This study examines if manipulations of SCD measurement affect its association with early cognitive dysfunction characteristic of preclinical AD. METHODS Cognitively healthy older adults (n = 110) completed SCD questionnaires that elicited complaints in general, compared to 5 years ago (retrospective SCD) and compared to their peers (age-anchored SCD) in binary and Likert scales. Outcome cognitive tasks included an associative memory task (Face-Name Test), a visual short-term memory binding task (STMB test), and a clinical neuropsychological list learning test (Selective Reminder Test). RESULTS SCD complaints, when compared to age-matched peers (age-anchored SCD) were endorsed less frequently than complaints compared to 5 years ago (retrospective SCD) (p < 0.01). In demographically adjusted regressions, age-anchored ordinal-rated SCD was associated with short term memory binding (β= -0.22, p = 0.040, CI = -0.45, -0.01), associative memory (β= -0.26, p = 0.018, CI = -0.45, -0.06), and list learning (β= -0.31, p = 0.002, CI = -0.51, -0.12). Retrospective and general ordinal-rated SCD was associated with associative memory (β= -0.25, p = 0.012, CI = -0.44, -0.06; β= -0.29, p = 0.003, CI = -0.47, -0.10) and list learning only (β= -0.25, p = 0.014, CI = -0.45, -0.05; β= -0.28, p = 0.004, CI = -0.48, -0.09). CONCLUSION Ordinal age-anchored SCD appears better suited than other SCD measurements to detect early cognitive dysfunction characteristic of preclinical AD.
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Affiliation(s)
- Silvia Chapman
- Cognitive Neuroscience Division, Columbia University Medical Center, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Preeti Sunderaraman
- Cognitive Neuroscience Division, Columbia University Medical Center, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA.,Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Jillian L Joyce
- Cognitive Neuroscience Division, Columbia University Medical Center, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA
| | - Martina Azar
- Department of Psychology, Drexel University, Philadelphia, PA, USA.,VA Boston Health Care System, Boston, MA, USA
| | | | - Megan S Barker
- Cognitive Neuroscience Division, Columbia University Medical Center, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Ian McKeague
- Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - William C Kreisl
- Cognitive Neuroscience Division, Columbia University Medical Center, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA.,Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Stephanie Cosentino
- Cognitive Neuroscience Division, Columbia University Medical Center, New York, NY, USA.,Gertrude H. Sergievsky Center, Columbia University Medical Center, New York, NY, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA.,Department of Neurology, Columbia University Medical Center, New York, NY, USA
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43
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Tsolaki M, Tsatali M, Gkioka M, Poptsi E, Tsolaki A, Papaliagkas V, Tabakis IM, Lazarou I, Makri M, Kazis D, Papagiannopoulos S, Kiryttopoulos A, Koutsouraki E, Tegos T. Memory Clinics and Day Care Centers in Thessaloniki, Northern Greece: 30 Years of Clinical Practice and Experience. Front Neurol 2021; 12:683131. [PMID: 34512506 PMCID: PMC8425245 DOI: 10.3389/fneur.2021.683131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background: This review describes the diagnostic and interventional procedures conducted in two university memory clinics (established network of G. Papanikolaou Hospital: 1988–2017 and AHEPA hospital: 2017–today) and 2 day care centers (established network of DCCs: 2005–today) in North Greece and their contribution in the scientific field of dementia. The aims of this work are (1) to provide a diagnosis and treatment protocol established in the network of memory clinics and DCCs and (2) to present further research conducted in the aforementioned network during the last 30 years of clinical practice. Methods: The guidelines to set a protocol demand a series of actions as follows: (1) set the diagnosis criteria, neuropsychological assessment, laboratory examinations, and examination of neurophysiological, neuroimaging, cerebrospinal fluid, blood, and genetic markers; and (2) apply non-pharmacological interventions according to the needs and specialized psychosocial interventions of the patient to the caregivers of the patient. Results: In addition to the guidelines followed in memory clinics at the 1st and 3rd Department of Neurology and two DCCs, a database of patients, educational programs, and further participation in international research programs, including clinical trials, make our contribution in the dementia field strong. Conclusion: In the current paper, we provide useful guidelines on how major and minor neurocognitive disorders are being treated in Thessaloniki, Greece, describing successful practices which have been adapted in the last 30 years.
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Affiliation(s)
- Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh) Balkan Center, Buildings A & B, Aristotle University of Thessaloniki, Thessaloniki, Greece.,3rd University Department of Neurology "G. Papanikolaou" Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marianna Tsatali
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Mara Gkioka
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Poptsi
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Anthoula Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Papaliagkas
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,Department of Biomedical Sciences International Hellenic University, Thessaloniki, Greece
| | - Irene-Maria Tabakis
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Ioulietta Lazarou
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marina Makri
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Kazis
- 3rd University Department of Neurology "G. Papanikolaou" Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sotirios Papagiannopoulos
- 3rd University Department of Neurology "G. Papanikolaou" Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Kiryttopoulos
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efrosyni Koutsouraki
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Thomas Tegos
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Nakhla MZ, Cohen L, Salmon DP, Smirnov DS, Marquine MJ, Moore AA, Schiehser DM, Zlatar ZZ. Self-reported subjective cognitive decline is associated with global cognition in a community sample of Latinos/as/x living in the United States. J Clin Exp Neuropsychol 2021; 43:663-676. [PMID: 34709141 PMCID: PMC8720066 DOI: 10.1080/13803395.2021.1989381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Although subjective cognitive decline (SCD) may be an early risk marker of Alzheimer's Disease (AD), research on SCD among Hispanics/Latinos/as/x (henceforth Latinos/as) living in the U.S. is lacking. We investigated if the cross-sectional relationship of self-reported SCD with objective cognition varies as a function of ethnic background (Latinos/as versus Non-Hispanic Whites [NHWs]). Secondary analyses conducted solely within the Latino/a group investigated if informant reported SCD is associated with objective cognition and whether self-reported SCD is related to markers of brain health in a sub-sample of Latinos/as with available MRI data. METHODS Eighty-three participants (≥60 years of age) without dementia (35 Latinos/as; 48 NHWs) completed the Mattis Dementia Rating Scale (MDRS) and the Subjective Cognitive Decline-Questionnaire (SCD-Q). Additionally, 22 Latino/a informants completed the informant-version of the SCD-Q. Hierarchical regression models investigated if ethnicity moderates the association of MDRS and SCD-Q scores after adjusting for demographics and depressive symptoms. Correlational analyses within the Latino/a group investigated self- and informant-reported associations of SCD-Q scores with objective cognition, and associations of self-reported SCD-Q scores with medial temporal lobe volume and thickness. RESULTS Latinos/as had lower education and MDRS scores than NHWs. Higher SCD-Q scores were associated with lower MDRS scores only in Latinos/as. Within the Latino/a group, self, but not informant reported SCD was related to objective cognition. Medium to large effect sizes were found whereby higher self-reported SCD was associated with lower entorhinal cortex thickness and left hippocampal volume in Latinos/as. CONCLUSIONS The association of SCD and concurrent objectively measured global cognition varied by ethnic background and was only significant in Latinos/as. Self-reported SCD may be an indicator of cognitive and brain health in Latinos/as without dementia, prompting clinicians to monitor cognition. Future studies should explore if SCD predicts objective cognitive decline in diverse groups of Latinos/as living in the U.S.
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Affiliation(s)
- Marina Z. Nakhla
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct, San Diego, CA
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Research Service, VA San Diego Healthcare System, La Jolla, California, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Lynn Cohen
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
| | - David P. Salmon
- Department of Neurosciences; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
| | - Denis S. Smirnov
- Department of Neurosciences; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
| | - María J. Marquine
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Department of Medicine, Division of Geriatrics, Gerontology and Palliative Care; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
| | - Alison A. Moore
- Department of Medicine, Division of Geriatrics, Gerontology and Palliative Care; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
| | - Dawn M. Schiehser
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
- Research Service, VA San Diego Healthcare System, La Jolla, California, 3350 La Jolla Village Dr., San Diego, CA 92161
| | - Zvinka Z. Zlatar
- Department of Psychiatry; University of California, San Diego, 9500 Gilman Dr, La Jolla, CA 92093
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Narbutas J, Van Egroo M, Chylinski D, Bahri MA, Koshmanova E, Talwar P, Besson G, Muto V, Schmidt C, Luxen A, Balteau E, Phillips C, Maquet P, Salmon E, Bastin C, Vandewalle G, Collette F. Associations Between Cognitive Complaints, Memory Performance, Mood, and Amyloid-β Accumulation in Healthy Amyloid Negative Late-Midlife Individuals. J Alzheimers Dis 2021; 83:127-141. [PMID: 34275899 DOI: 10.3233/jad-210332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cognitive complaints are gaining more attention as they may represent an early marker of increased risk for AD in individuals without objective decline at standard neuropsychological examination. OBJECTIVE Our aim was to assess whether cognitive complaints in late middle-aged individuals not seeking medical help are related to objective cognitive outcomes known as early markers for AD risk, concomitant affective state, and amyloid-β (Aβ) burden. METHODS Eighty-seven community-based cognitively normal individuals aged 50-69 years underwent neuropsychological assessment for global cognition, using Preclinical Alzheimer's Cognitive Composite 5 (PACC5) score, and a more specific episodic memory measure. Affective state was based on self-assessment questionnaires for depression and anxiety. Aβ PET burden was assessed via [18F]Flutemetamol (N = 84) and [18F]Florbetapir (N = 3) uptake. Cognitive complaints were evaluated using Cognitive Difficulties Scale. RESULTS Higher cognitive complaints were significantly associated with lower episodic memory performance and worse affective state. Moreover, higher level of cognitive complaints was related to higher (but still sub-clinical) global Aβ accumulation (at uncorrected significance level). Importantly, all three aspects remained significant when taken together in the same statistical model, indicating that they explained distinct parts of variance. CONCLUSION In healthy Aβ negative late middle-aged individuals, a higher degree of cognitive complaints is associated with lower episodic memory efficiency, more anxiety and depression, as well as, potentially, with higher Aβ burden, suggesting that complaints might signal subtle decline. Future studies should untangle how cognitive complaints in healthy aging populations are related to longitudinal changes in objective cognition and AD biomarker correlates.
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Affiliation(s)
- Justinas Narbutas
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium.,Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Maxime Van Egroo
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Daphne Chylinski
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Mohamed Ali Bahri
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Ekaterina Koshmanova
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Puneet Talwar
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Gabriel Besson
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Vincenzo Muto
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Christina Schmidt
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium.,Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - André Luxen
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Evelyne Balteau
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Christophe Phillips
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Pierre Maquet
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium.,Department of Neurology, CHU Liège, Liège, Belgium
| | - Eric Salmon
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium.,Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium.,Department of Neurology, CHU Liège, Liège, Belgium
| | - Christine Bastin
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium.,Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
| | - Gilles Vandewalle
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium
| | - Fabienne Collette
- GIGA-Institute, Cyclotron Research Centre/In Vivo Imaging, University of Liège, Liège, Belgium.,Psychology and Neuroscience of Cognition Research Unit, Faculty of Psychology and Educational Sciences, University of Liège, Liège, Belgium
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Effects of Smartphone-Based Compensatory Cognitive Training and Physical Activity on Cognition, Depression, and Self-Esteem in Women with Subjective Cognitive Decline. Brain Sci 2021; 11:brainsci11081029. [PMID: 34439648 PMCID: PMC8392206 DOI: 10.3390/brainsci11081029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 11/17/2022] Open
Abstract
Subjective cognitive decline is a symptom that may appear in the early stages of Alzheimer’s disease. This study examined the effects of smartphone-based calendar training and walking exercise regimen on postmenopausal women experiencing subjective cognitive decline. Experimental group 1 participated in both calendar training and walking exercise, group 2 participated in calendar training only, and the control group did not receive either intervention. Forty-two participants completed a cognitive function test and questionnaire upon entering the study and 12 weeks later. The controlled oral word association score increased in experimental groups 1 and 2 and decreased in the control group. Memory contentment increased in experimental group 1, maintained in experimental group 2, and decreased in the control group. Smartphone-based calendar training and a walking exercise regimen improved executive function and memory contentment in everyday life, but the effects on depressive symptoms and self-esteem were not significant. Our findings demonstrate that smartphone-based calendar training and walking exercise improved cognitive function and have potential as nonpharmacologic interventions to strengthen cognitive function in women experiencing subjective cognitive decline.
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Tort-Merino A, Valech N, Laine M, Olives J, León M, Ecay-Torres M, Estanga A, Martínez-Lage P, Fortea J, Molinuevo JL, Sánchez-Valle R, Rodriguez-Fornells A, Rami L. Accelerated long-term forgetting in individuals with subjective cognitive decline and amyloid-β positivity. Int J Geriatr Psychiatry 2021; 36:1037-1049. [PMID: 33792089 DOI: 10.1002/gps.5539] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 03/21/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We studied a sample of cognitively unimpaired individuals, with and without subjective cognitive decline (SCD), in order to investigate accelerated long-term forgetting (ALF) and to explore the relationships between objective and subjective cognitive performance and cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers. METHODS Fifty-two individuals were included and SCD was quantified through the Subjective Cognitive Decline Questionnaire (SCD-Q), using its validated cutoff to classify participants as Low SCD-Q (n = 21) or High SCD-Q (n = 31). These groups were further subdivided according to the presence or absence of abnormal levels of CSF Aβ42 . Objective cognitive performance was assessed with the Ancient Farming Equipment Test (AFE-T), a new highly-demanding test that calls for acquisition and retention of novel object/name pairs and allows measuring ALF over a 6-month period. RESULTS The High SCD-Q group showed a significantly higher free forgetting rate at 3 months compared to the Low SCD-Q (F [1,44] = 4.72; p < 0.05). When stratifying by amyloid status, High SCD-Q/Aβ+ showed a significantly lower performance than High SCD-Q/Aβ-on the final free and cued learning scores (F [1,27] = 6.44, p < 0.05 and F [1,27] = 7.51, p < 0.05, respectively), the 1-week free and cued recall (F [1,24] = 4.49; p < 0.05 and F [1,24] = 7.10; p < 0.01, respectively), the 1-week cued forgetting rate (F [1,24] = 5.13; p < 0.05), and the 3-month cued recall (F [1,24] = 4.27; p < 0.05). Linear regression analyses showed that higher SCD-Q scores were associated with higher forgetting rates on the AFE-T (β = -0.212; p < 0.05). CONCLUSIONS It is possible to detect ALF in individuals with high SCD ratings, appearing especially in those with abnormal CSF Aβ42 levels. Both in research and the clinical field, there is an increasing need of using more demanding cognitive measures, such as the AFE-T, for identifying and tracking the earliest cognitive changes in these populations.
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Affiliation(s)
- Adrià Tort-Merino
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Natalia Valech
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Matti Laine
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Jaume Olives
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - María León
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain
| | - Mirian Ecay-Torres
- Neurología, Fundación CITA-Alzhéimer Fundazioa, Centro de Investigación y Terapias Avanzadas, San Sebastián, Guipúzcoa, Spain
| | - Ainara Estanga
- Neurología, Fundación CITA-Alzhéimer Fundazioa, Centro de Investigación y Terapias Avanzadas, San Sebastián, Guipúzcoa, Spain
| | - Pablo Martínez-Lage
- Neurología, Fundación CITA-Alzhéimer Fundazioa, Centro de Investigación y Terapias Avanzadas, San Sebastián, Guipúzcoa, Spain
| | - Juan Fortea
- Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau and Institute of Biomedical Research, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - José Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain.,Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Antoni Rodriguez-Fornells
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain.,Department of Cognition, Development and Education Psychology, University of Barcelona, L'Hospitalet de Llobregat, Spain
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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Yang J, Kong C, Jia L, Li T, Quan M, Li Y, Lyu D, Li F, Jin H, Li Y, Wang Q, Jia J. Association of accelerated long-term forgetting and senescence-related blood-borne factors in asymptomatic individuals from families with autosomal dominant Alzheimer's disease. ALZHEIMERS RESEARCH & THERAPY 2021; 13:107. [PMID: 34044860 PMCID: PMC8157428 DOI: 10.1186/s13195-021-00845-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/10/2021] [Indexed: 12/11/2022]
Abstract
Background Accelerated long-term forgetting has been identified in preclinical Alzheimer’s disease (AD) and is attributed to a selective impairment of memory consolidation in which the hippocampus plays a key role. As blood may contain multiple senescence-related factors that involved in neurogenesis and synaptic plasticity in the hippocampus, we tested whether there is an association between blood-borne factors and accelerated long-term forgetting in asymptomatic individuals from families with autosomal dominant AD (ADAD). Methods We analyzed data of 39 asymptomatic participants (n = 18 ADAD mutation carriers, n = 21 non-carriers) from the Chinese Familial Alzheimer’s Disease Network (CFAN) study. Long-term forgetting rates were calculated based on recall or recognition of two materials (word list and complex figure) at three delays comprising immediate, 30 min, and 7 days. Peripheral blood concentrations of candidate pro-aging factors (CC chemokine ligand 11 [CCL11] and monocyte chemotactic protein 1 [MCP1]) and rejuvenation factors (growth differentiation factor 11 [GDF11], thrombospondin-4 [THBS4], and secreted protein acidic and rich in cysteine like 1 [SPARCL1]) were evaluated in all participants. Results Despite normal performance on standard 30-min delayed testing, mutation carriers exhibited accelerated forgetting of verbal and visual material over 7 days in comparison with matched non-carriers. In the whole sample, lower plasma THBS4 was associated with accelerated long-term forgetting in list recall (β = −0.46, p = 0.002), figure recall (β = −0.44, p = 0.004), and list recognition (β = −0.37, p = 0.010). Additionally, higher plasma GDF11 and CCL11 were both associated with accelerated long-term forgetting (GDF11 versus figure recall: β = 0.39, p = 0.007; CCL11 versus list recognition: β = 0.44, p = 0.002). Conclusions Accelerated long-term forgetting is a cognitive feature of presymptomatic AD. Senescence-related blood-borne factors, especially THBS4, GDF11, and CCL11, may be promising biomarkers for the prediction of accelerated long-term forgetting. Supplementary Information The online version contains supplementary material available at 10.1186/s13195-021-00845-0.
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Affiliation(s)
- Jianwei Yang
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun St, Beijing, China
| | - Chaojun Kong
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun St, Beijing, China
| | - Longfei Jia
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun St, Beijing, China. .,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China. .,Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China. .,Center of Alzheimer's Disease, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.
| | - Tingting Li
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun St, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Meina Quan
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun St, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Yan Li
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun St, Beijing, China
| | - Diyang Lyu
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun St, Beijing, China
| | - Fangyu Li
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun St, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Hongmei Jin
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun St, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Ying Li
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun St, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Qigeng Wang
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun St, Beijing, China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China.,Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China.,Center of Alzheimer's Disease, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China
| | - Jianping Jia
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, 45 Changchun St, Beijing, China. .,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China. .,Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China. .,Center of Alzheimer's Disease, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.
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Ruan Q, Zhang W, Ruan J, Chen J, Yu Z. Clinical and Objective Cognitive Measures for the Diagnosis of Cognitive Frailty Subtypes: A Comparative Study. Front Psychol 2021; 12:603974. [PMID: 34108904 PMCID: PMC8182758 DOI: 10.3389/fpsyg.2021.603974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 04/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background Cognitive frailty (CF) includes reversible and potentially reversible subtypes; the former is known as concurrent physical frailty (PF) and pre-mild cognitive impairment subjective cognitive decline (pre-MCI SCD), whereas the latter is known as concurrent PF and MCI. The diagnoses of pre-MCI SCD and MCI are based on clinical criteria and various subjective cognitive decline questionnaires. Heterogeneous assessment of cognitive impairment (CI) results in significant variability of CI, CF, and their subtype prevalence in various population-based studies. Objective This study aimed to compare the classification differences in CI and CF subtypes from PF and normal cognition by applying clinical and objective cognitive criteria. Clinical criteria comprised Fried PF and clinical MCI criteria combined with the SCD questionnaire, whereas objective criteria comprised Fried PF and objective cognitive criteria based on the norm-adjusted six neuropsychological test scores. Methods Of the 335 volunteers (age ≥ 60 years) in this study, 191 were diagnosed with CI based on clinical cognitive diagnosis criteria, and 144 were identified as robust normal based on objective cognitive assessment from the community-dwelling older adult cohort. Individuals with clinical CI, including 94 with MCI and 97 with pre-MCI SCD, were reclassified into different z-score-derived MCI, pre-MCI SCD, and normal subgroups based on objective cognitive criteria. The classification diagnostic accuracy of normal cognition, PF, pre-MCI, MCI, CF, and CF subtypes based on clinical and objective criteria was compared before and after adjusting for age, sex, and education level. Results The reclassification of objective assessments indicated better performance than that of clinical assessments in terms of discerning CI severity among different subgroups before adjusting for demographic factors. After covariate adjustment, clinical assessments significantly improved the ability to cognitively discriminate normal individuals from those with pre-MCI SCD and MCI but not the z-score-derived pre-MCI SCD and MCI groups from the robust normal group. Furthermore, the adjustment did not improve the ability to discriminate among individuals with reversible CF from those with potentially reversible CF and pre-MCI only SCD from MCI only SCD. Conclusions Objective criteria showed better performance than clinical criteria in the diagnosis of individuals with CI or CF subtypes. Rapid clinical cognitive screening in combination with normative z-scores criteria is cost effective and sustainable in clinical practice.
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Affiliation(s)
- Qingwei Ruan
- Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, Research Center of Aging and Medicine, Shanghai Institute of Geriatrics and Gerontology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Weibin Zhang
- Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, Research Center of Aging and Medicine, Shanghai Institute of Geriatrics and Gerontology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jian Ruan
- Molecular and Cellular Biology Core Facility, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Jie Chen
- Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, Research Center of Aging and Medicine, Shanghai Institute of Geriatrics and Gerontology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Geriatrics, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhuowei Yu
- Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, Research Center of Aging and Medicine, Shanghai Institute of Geriatrics and Gerontology, Shanghai Medical College, Fudan University, Shanghai, China.,Department of Geriatrics, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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50
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Ruan Q, Xiao F, Gong K, Zhang W, Zhang M, Ruan J, Zhang X, Chen Q, Yu Z. Demographically Corrected Normative Z Scores on the Neuropsychological Test Battery in Cognitively Normal Older Chinese Adults. Dement Geriatr Cogn Disord 2021; 49:375-383. [PMID: 33176318 DOI: 10.1159/000505618] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/24/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Subjective questionnaires used for the diagnosis of pre-mild cognitive impairment (pre-MCI) and conventional criteria for MCI might mainly result in false-positive diagnostic errors. The integrated criteria based on demographically adjusted total and process Z scores on neuropsychological tests have been validated to be sensitive for measuring pre-MCI, MCI, and MCI subtypes. However, the underrepresentativity of Chinese populations and the complexity in some tests limit the use of the established Z scores in the elderly Chinese population. OBJECTIVE The aim of this study was to develop a useful Z score calculator to assess individual cognitive performance after adjustment of the scores on each of the neuropsychological tests according to sex, age, and education and to establish preliminary norms for the objective assessment of cognition function in elderly Chinese individuals. METHODS The neuropsychological test battery consists of measures of performance on different cognitive domains, including episodic memory, language, executive function, processing speed, and attention. Data were obtained from 220 clinically cognitively normal Chinese volunteers aged 60 years or older from the cohort of the Shanghai study of health promotion among frail elderly individuals. Regression models were used to investigate the impact of age, education, and sex on test scores. Z scores were estimated for the different scores by subtracting the predicted mean from the raw score and dividing it by the root mean square error term for any given linear regression model. RESULTS Preliminary analyses indicated that age, sex, or level of education significantly affected test scores. A series of linear regression models was constructed for all instruments, i.e.: the Trail-Making Test A and B, to assess executive function or attention; the Boston Naming Test and animal list generation, to assess language; delayed free correct responses and the Hopkins Verbal Learning Test-Revised (HVLT-R) recognition, as well as three process scores, i.e., intrusion errors, learning slope, and retroactive interference, from the HVLT-R, to assess memory, by adjusting for the covariates of age, sex, and level of education concurrently. The Z scores on all neuropsychological tests were estimated based on the corresponding regression coefficients. CONCLUSIONS We constructed a multivariable regression-based normative Z score method for the measurement of cognition among older Chinese individuals in the community. The normative score will be useful for the accurate diagnosis of different subtypes of pre-MCI and MCI after preliminary rapid screening in the community.
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Affiliation(s)
- Qingwei Ruan
- Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Department of Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Shanghai Medical College, Fudan University, Shanghai, China,
| | - Feng Xiao
- Zhoujiaqiao Primary Health Service Centre, Shanghai, China
| | - Ke Gong
- Department of Social Work, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Weibin Zhang
- Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Department of Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Shanghai Medical College, Fudan University, Shanghai, China
| | - Min Zhang
- Zhoujiaqiao Primary Health Service Centre, Shanghai, China
| | - Jian Ruan
- Molecular and Cellular Biology Core Facility, Institute of Neuroscience, Chinese Academy of Science, Shanghai, China
| | - Xuefeng Zhang
- Department of Social Work, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qingru Chen
- Department of Social Work, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhuowei Yu
- Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Department of Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Shanghai Medical College, Fudan University, Shanghai, China
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