1
|
Furneri G, Varrasi S, Guerrera CS, Platania GA, Torre V, Boccaccio FM, Testa MF, Martelli F, Privitera A, Razza G, Santagati M, Di Nuovo S, Pirrone C, Castellano S, Caraci F, Monastero R. Combining Mini-Mental State Examination and Montreal Cognitive Assessment for assessing the clinical efficacy of cholinesterase inhibitors in mild Alzheimer's disease: a pilot study. Aging Clin Exp Res 2024; 36:95. [PMID: 38630416 PMCID: PMC11023996 DOI: 10.1007/s40520-024-02744-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
Current drugs for Alzheimer's Disease (AD), such as cholinesterase inhibitors (ChEIs), exert only symptomatic activity. Different psychometric tools are needed to assess cognitive and non-cognitive dimensions during pharmacological treatment. In this pilot study, we monitored 33 mild-AD patients treated with ChEIs. Specifically, we evaluated the effects of 6 months (Group 1 = 17 patients) and 9 months (Group 2 = 16 patients) of ChEIs administration on cognition with the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Frontal Assessment Battery (FAB), while depressive symptoms were measured with the Hamilton Depression Rating Scale (HDRS). After 6 months (Group 1), a significant decrease in MoCA performance was detected. After 9 months (Group 2), a significant decrease in MMSE, MoCA, and FAB performance was observed. ChEIs did not modify depressive symptoms. Overall, our data suggest MoCA is a potentially useful tool for evaluating the effectiveness of ChEIs.
Collapse
Affiliation(s)
- Giovanna Furneri
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Simone Varrasi
- Department of Educational Sciences, University of Catania, Catania, Italy
| | | | | | - Vittoria Torre
- Department of Educational Sciences, University of Catania, Catania, Italy
| | | | | | - Federica Martelli
- Department of Educational Sciences, University of Catania, Catania, Italy
| | | | - Grazia Razza
- Department of Mental Health, ASP3 Catania, Alzheimer Psychogeriatric Center, Catania, Italy
| | - Mario Santagati
- Department of Mental Health, ASP3 Catania, Alzheimer Psychogeriatric Center, Catania, Italy
| | - Santo Di Nuovo
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Concetta Pirrone
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, Catania, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, Catania, Italy.
- Oasi Research Institute - IRCCS, Troina, Italy.
| | - Roberto Monastero
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy.
| |
Collapse
|
2
|
Ryoo SW, Choi BY, Son SY, Oh KH, Min JY, Min KB. Association between Multiple Trace Elements, Executive Function, and Cognitive Impairment with No Dementia in Older Adults. Nutrients 2024; 16:1001. [PMID: 38613034 PMCID: PMC11013674 DOI: 10.3390/nu16071001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
Many studies suggest a significant association between individual essential trace elements (ETEs) and cognitive impairment in older adults, but evidence of the synchronized effect of multiple ETEs on cognitive function is lacking. We investigated the association between multiple ETEs, cognitive impairment with no dementia (CIND), and executive function in older Korean adults, using the Bayesian kernel machine regression (BKMR) model. Three hundred and thirty-six older adults were included as the study population and classified as the CIND and control groups. Blood manganese (Mn), copper (Cu), zinc (Zn), selenium (Se), and molybdenum (Mo) were measured as relevant ETEs. The frontal/executive tests included digit symbol coding (DSC), the Korean color word Stroop test (K-CWST), a controlled oral word association test (COWAT), and a trial-making test (TMT). Overall, the BKMR showed a negative association between multiple ETEs and the odds of CIND. Mn was designated as the most dominant element associated with the CIND (PIP = 0.6184), with a U-shaped relationship. Cu and Se levels were positively associated with the K-CWST percentiles (β = 31.78; 95% CI: 13.51, 50.06) and DSC percentiles (β = 25.10; 95% CI: 7.66, 42.53), respectively. Our results suggest that exposure to multiple ETEs may be linked to a protective mechanism against cognitive impairment in older adults.
Collapse
Affiliation(s)
- Seung-Woo Ryoo
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea; (S.-W.R.)
| | - Baek-Yong Choi
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea; (S.-W.R.)
| | - Seok-Yoon Son
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea; (S.-W.R.)
| | - Kun-Hee Oh
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea; (S.-W.R.)
| | - Jin-Young Min
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul 05368, Republic of Korea
| | - Kyoung-Bok Min
- Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea; (S.-W.R.)
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea
| |
Collapse
|
3
|
Che J, Cheng N, Jiang B, Liu Y, Liu H, Li Y, Liu H. Executive function measures of participants with mild cognitive impairment: Systematic review and meta-analysis of event-related potential studies. Int J Psychophysiol 2024; 197:112295. [PMID: 38266685 DOI: 10.1016/j.ijpsycho.2023.112295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/19/2023] [Accepted: 12/30/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVE Objective measurements of executive functions using event-related potential (ERP) may be used as markers for differentiating healthy controls (HC) from patients with mild cognitive impairment (MCI). ERP is non-invasive, cost-effective, and affordable. Older adults with MCI demonstrate deteriorated executive function, serving as a potentially valid neurophysiological marker for identifying MCI. We aimed to review published ERP studies on executive function in older adults with MCI and summarize the performance differences by component between healthy older adults and older adults with MCI. METHODS Eight electronic databases (Web of Science, PubMed, ScienceDirect, American Psychological Association PsycNet, Cochrane Library, Scopus, Embase, and Ovid) were searched for the study. Articles published from January 1 to December 31, 2022, were considered for this review. A random-effects meta-analysis and between-study heterogeneity analysis were conducted using Comprehensive Meta-Analysis V3.0 software. RESULTS We identified 7829 articles of which 28 met the full inclusion criteria and were included in the systematic review and analyses. Our pooled analysis suggested that participants with MCI can be differentiated from HC by significant P200, P300, and N200 latencies. The P100 and P300 amplitudes were significantly smaller in participants with MCI when compared with those in the HCs, and the patients with MCI showed increased N200 amplitudes. Our findings provide new insights into potential electrophysiological biomarkers for diagnosing MCI.
Collapse
Affiliation(s)
- Jiajun Che
- Department of Psychology, Chengde Medical University, Chengde 067000, China
| | - Nan Cheng
- Department of Psychology, Chengde Medical University, Chengde 067000, China
| | - Bicong Jiang
- Department of Psychology, Chengde Medical University, Chengde 067000, China
| | - Yanli Liu
- Department of Biomedical Engineering, Chengde Medical University, Chengde 067000, China
| | - Haihong Liu
- Department of Psychology, Chengde Medical University, Chengde 067000, China; Natural University of Malaysia, Faculty of Social Sciences and Humanities, Centre for Psychology and Human Welfare, Bangui, Malaysia
| | - Yutong Li
- Department of Psychology, Chengde Medical University, Chengde 067000, China
| | - Haining Liu
- Department of Psychology, Chengde Medical University, Chengde 067000, China; Hebei Key Laboratory of Nerve Injury and Repair, Chengde Medical University, Chengde 067000, China.
| |
Collapse
|
4
|
Cheung MC, Sze SL, Chan AS. Chanwuyi Lifestyle Medicine Program Improves Memory and Executive Functions of Older Adults With Mild Cognitive Impairment. Am J Alzheimers Dis Other Demen 2024; 39:15333175241255744. [PMID: 38764310 PMCID: PMC11104026 DOI: 10.1177/15333175241255744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
The Chanwuyi Lifestyle Medicine Program (CLMP) was found to enhance the memory and executive functions of older adults with or without subjective memory complaints. The present study investigated whether similar beneficial effects can be extended to mild cognitive impairment (MCI). Twenty-four older adults with MCI were randomly assigned to receive the CLMP (the experimental group) or strategic memory training (SMT; the active control group) for 10 weeks. They were assessed by neuropsychological tests at baseline and post-intervention. Older adults showed similar visual and verbal memory improvements after receiving the CLMP and SMT. Yet, only those who received the CLMP showed distinct improvements in planning/organization, working memory, and attention in terms of accuracy, with greater cognitive gains associated with older age and lower levels of education and baseline cognitive functions. This study provides preliminary evidence for the effects of the CLMP on improving memory, attention, and executive functions in MCI.
Collapse
Affiliation(s)
- Mei-Chun Cheung
- Department of Social Work, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Sophia L. Sze
- Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| | - Agnes S. Chan
- Research Center for Neuropsychological Well-Being, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China
| |
Collapse
|
5
|
Trtica LM, Volarić M, Kurevija T, Mihaljević S, Dupan ZK, Wittlinger T. Psycho-social and health predictors of loneliness in older primary care patients and mediating mechanisms linking comorbidities and loneliness. BMC Geriatr 2023; 23:801. [PMID: 38049734 PMCID: PMC10696735 DOI: 10.1186/s12877-023-04436-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 10/28/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Aging is associated with many personal, social, and environmental challenges that increase the risk of loneliness. Loneliness is a painful emotional experience associated with a perceived lack of connection and intimacy. Loneliness accelerates health deterioration, but the presence of chronic health conditions (comorbidities) in older individuals may potentiate the feeling of loneliness. The relationships between health status and loneliness in older individuals have not been assessed in an integrated manner, although it is necessary for planning efficient interventions. The aim of this study was to fill in this knowledge gap, by attempting to create an integrated model of loneliness in older individuals. METHODS The sample consisted of 189 (58% F) older individuals (> 60 years) (mean ± SD, 78.47 ± 6.65), attendees in Primary Health Care. Different factors associated with loneliness in the older population were assessed, and classified as demographic, environmental, physical (health-related), and psychological, in addition to functional abilities. A set of standard questionnaires was used to assess psychological factors and functional abilities. The hierarchical regression model assessed the effect of particular blocks of factors on status loneliness. The second aim was to analyze how psychological factors mediate associations between health status (comorbidity level) and loneliness. RESULTS Indicated that increasing comorbidity, anxiety, lack of positive moods, not having hobbies/activities, low perception of social support, impaired cognitive function, and suppression of emotion expression, are significant predictors of loneliness. Mediation analysis informed us of how to help patients with comorbidities feel less lonely. Interventions that were suggested were those that can reduce anxiety and depression, improve cognitive abilities and emotional regulation control, and enhance social support. CONCLUSIONS Results can help understand the pathophysiology loops linking poor health status (comorbidity level) of older individuals and loneliness, and have significant potentials from the translational perspectives, as a decision-support tool.
Collapse
Affiliation(s)
- Ljiljana Majnarić Trtica
- Department of Family Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Mile Volarić
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia
- School of Medicine, University of Mostar, University Hospital Mostar, Mostar, Bosnia and Herzegovina
| | - Tomislav Kurevija
- Department of Family Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Silvio Mihaljević
- Department of Internal Medicine and the History of Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Zdravka Krivdić Dupan
- Department of Radiology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Thomas Wittlinger
- Department of Cardiology, Asklepios Hospital, 38642, Goslar, Germany.
| |
Collapse
|
6
|
Feter N, Schaun GZ, Smith EC, Cassuriaga J, Alt R, Redig L, Alberton CL, Coombes JS, Rombaldi AJ. High-velocity resistance training improves executive function in mobility-limited older adults. Arch Gerontol Geriatr 2023; 114:105081. [PMID: 37269697 DOI: 10.1016/j.archger.2023.105081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/16/2023] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVES To examine the effect of high-velocity resistance training (HVRT) on the executive function of middle-aged and older adults with and without mobility limitations. METHODS Participants (n = 41, female: 48.9%) completed a supervised 12-week HVRT intervention (2 sessions/week; at 40-60% of one-repetition maximum). The sample included 17 middle-aged adults (40-55 years); 16 older adults (>60 years) and 8 mobility-limited older adults (LIM). Executive function was assessed before and after the intervention period and was reported as z-scores. Maximal dynamic strength, peak power, quadriceps muscle thickness, maximal isometric voluntary contraction (MVIC), and functional performance were also measured pre and post intervention. Training-related adaptations in cognitive measures were calculated using a Generalized Estimating Equation model. RESULTS HVRT improved executive function in LIM (adjusted marginal mean differences [AMMD]: 0.21; 95%CI: 0.04, 0.38; p = 0.040) although no effect on middle-aged (AMMD: 0.04; 95%CI: -0.09; 0.17; p = 0.533) and older (AMMD: -0.11; 95%CI: -0.25; 0.02; p = 0.107) participants was observed. Improvements in maximal dynamic strength, peak power, MVIC, quadriceps muscle thickness, and functional performance were all associated with changes in executive function, and changes in the first four also seem to mediate the association between changes in functional performance and executive function. CONCLUSIONS HVRT-induced improvement in executive function of mobility-limited older adults were mediated by changes in lower-body muscle strength, power, and muscle thickness. Our findings reinforce the relevance of muscle-strengthening exercises to preserve cognition and mobility in older adults.
Collapse
Affiliation(s)
- Natan Feter
- Postgraduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
| | - Gustavo Z Schaun
- Neuromuscular Assessment Laboratory, Federal University of Pelotas, Pelotas, Brazil; Centre for Sport Science and University Sports, University of Vienna, 1150 Vienna, Austria
| | - Emily C Smith
- Centre of Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, Australia
| | - Júlia Cassuriaga
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Ricardo Alt
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Larissa Redig
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Cristine Lima Alberton
- Neuromuscular Assessment Laboratory, Federal University of Pelotas, Pelotas, Brazil; Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Jeff S Coombes
- Centre of Research on Exercise, Physical Activity and Health, The University of Queensland, Brisbane, Australia
| | - Airton J Rombaldi
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| |
Collapse
|
7
|
Taylor J, Wu JG, Kunkel D, Parker M, Rivera C, Casey C, Naismith S, Teixeira-Pinto A, Maze M, Pearce RA, Lennertz R, Sanders RD. Resolution of elevated interleukin-6 after surgery is associated with return of normal cognitive function. Br J Anaesth 2023; 131:694-704. [PMID: 37385855 PMCID: PMC10925892 DOI: 10.1016/j.bja.2023.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/02/2023] [Accepted: 05/24/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Unresolved surgical inflammation might induce chronic cognitive decline in older adults. Although inflammatory biomarkers have been correlated with perioperative cognitive impairment and delirium, the effects of prolonged inflammation on cognition are not well studied. This prospective cohort study investigated 1-yr dynamics in plasma interleukin-6 levels and executive function. METHODS Patients undergoing major surgery (n=170) aged ≥65 yr completed Trail Making Test B and other neuropsychological assessments with plasma interleukin-6 levels collected on postoperative days 1-9 and 90, and at 1-yr. Mixed-effects analyses were conducted for Trail Making Test B (and other assessments), including interleukin-6 levels, time, and additional confounders (fixed effects), and a random effect for participant. RESULTS Changes in interleukin-6 levels were associated with changes in Trail Making Test B over 1 yr in a generalised additive model (β=0.074, P<0.001) supporting that unresolved inflammation impaired executive function. This result was robust to confounders, outlier rejection, and fitting to non-linear models. Changes in interleukin-6 levels also correlated with changes in Trail Making Test A and Controlled Oral Word Association Test. Sensitivity analyses conducted on binary definitions of cognitive decline (>1, >1.5, or >2 standard deviations from baseline) were also associated with interleukin-6 changes. CONCLUSIONS Delayed resolution of inflammation is associated with cognitive impairment after surgery. Monitoring interleukin-6 might provide an opportunity to intervene with anti-inflammatory therapies in vulnerable patients. CLINICAL TRIAL REGISTRATION NCT01980511, NCT03124303.
Collapse
Affiliation(s)
- Jennifer Taylor
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Justin G Wu
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - David Kunkel
- Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Margaret Parker
- Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Cameron Rivera
- Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Cameron Casey
- Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Sharon Naismith
- Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia; School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | | | - Mervyn Maze
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USA
| | - Robert A Pearce
- Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Richard Lennertz
- Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Robert D Sanders
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia.
| |
Collapse
|
8
|
Reiter K, Butts AM, Janecek JK, Correro AN, Nencka A, Agarwal M, Franczak M, Glass Umfleet L. Relationship between cognitive reserve, brain volume, and neuropsychological performance in amnestic and nonamnestic MCI. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn 2023; 30:940-956. [PMID: 36573001 DOI: 10.1080/13825585.2022.2161462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022]
Abstract
Cognitive Reserve (CR) is a theoretical construct that influences the onset and course of cognitive and structural changes that occur with aging and mild cognitive impairment (MCI). There is a paucity of research that examines the relationship of CR and brain volumes in amnestic (aMCI) and nonamnestic (naMCI) separately. This study is a retrospective chart review of MCI patients who underwent neuropsychological evaluation and brain MRI with NeuroReader™ (NR). NR is an FDA-cleared software that standardizes MRI volumes to a control sample. Classifications of aMCI and naMCI were based on Petersen criteria. CR was measured as education, occupation, and word reading. Data analysis included bivariate correlations between CR, neuropsychological test scores, and NR-brain volumes by MCI subtype. The Benjamini-Hochberg method corrected for multiple comparisons. The sample included 91 participants with aMCI and 41 with naMCI. Within naMCI, positive correlations were observed between CR and whole brain volume, total gray matter, bifrontal, left parietal, left occipital, and bilateral cerebellum. Within aMCI, no significant correlations were observed between CR and brain volumes. Positive correlations with CR were observed in language, attention, and visual learning in both aMCI and naMCI groups. The current study adds to the minimal literature on CR and naMCI. Results revealed that CR is associated with volumetrics in naMCI only, though cognitive findings were similar in both MCI groups. Possible explanations include heterogeneous disease pathologies, disease stage, or a differential influence of CR on volumetrics in MCI. Additional longitudinal and biomarker studies will better elucidate this relationship.
Collapse
Affiliation(s)
- K Reiter
- Cleveland Clinic, Neurological Institute, Cleveland, OH, USA
| | - A M Butts
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - J K Janecek
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - A N Correro
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - A Nencka
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Agarwal
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M Franczak
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - L Glass Umfleet
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| |
Collapse
|
9
|
Fu X, Qin M, Liu X, Cheng L, Zhang L, Zhang X, Lei Y, Zhou Q, Sun P, Lin L, Su Y, Wang J. Decreased GABA levels of the anterior and posterior cingulate cortex are associated with executive dysfunction in mild cognitive impairment. Front Neurosci 2023; 17:1220122. [PMID: 37638325 PMCID: PMC10450953 DOI: 10.3389/fnins.2023.1220122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023] Open
Abstract
Background and purpose Executive function impairment, a slight but noticeable cognitive deficit in mild cognitive impairment (MCI) patients, is influenced by gamma-aminobutyric acid (GABA) levels. Reduced cognitive function is accompanied by thinning of the cerebral cortex, which has higher GABA levels than white matter. However, the relationships among GABA levels, cortical thickness, and executive function in MCI patients have not yet been elucidated. We investigated the relationships among GABA levels, cortical thickness, and executive function in MCI patients. Methods In this study, a total of 36 MCI patients and 36 sex-, age-, and education-matched healthy controls (HC) were recruited. But 33 MCI patients and 35 HC were included because of head motion or poor data quality for three MCI patients and one HC. The levels of gamma-aminobutyric acid plus relative to creatine (GABA+/Cr) and glutamate-glutamine relative to creatine (Glx/Cr) in the anterior cingulate cortex (ACC) and posterior cingulate cortex (PCC) were measured using the Meshcher-Garwood point resolved spectroscopy (MEGA-PRESS) sequence. Metabolite ratios, cortical thickness, and executive function and their interrelationships were determined in the MCI and HC groups. Results Patients with MCI showed lower GABA+/Cr levels in the ACC and PCC. Combined levels of GABA+ and Glx in the ACC and GABA+ in the PCC showed good diagnostic efficacy for MCI (AUC: 0.82). But no differences in cortical thickness were found between the two groups. In the MCI group, lower GABA+/Cr level was correlated to worse performance on the digit span test backward, and the shape trail test-B. The cortical thickness was not associated with GABA+ levels and executive function in patients. Conclusion These results implied that decreased GABA levels in the ACC and PCC had a critical role in the early diagnosis of impaired executive function of MCI. Therefore, GABA in the ACC and PCC could be a potential diagnostic marker of the executive function decline of MCI.
Collapse
Affiliation(s)
- Xiaona Fu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Mengting Qin
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoming Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Lan Cheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Lan Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Xinli Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Yu Lei
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| | - Qidong Zhou
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Peng Sun
- Clinical & Technical Solutions, Philips Healthcare, Beijing, China
| | - Liangjie Lin
- Clinical & Technical Solutions, Philips Healthcare, Beijing, China
| | - Ying Su
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, China
| |
Collapse
|
10
|
Tuena C, Maestri S, Serino S, Pedroli E, Stramba-Badiale M, Riva G. Prognostic relevance of gait-related cognitive functions for dementia conversion in amnestic mild cognitive impairment. BMC Geriatr 2023; 23:462. [PMID: 37525134 PMCID: PMC10388514 DOI: 10.1186/s12877-023-04175-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/15/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Increasing research suggests that gait abnormalities can be a risk factor for Alzheimer's Disease (AD). Notably, there is growing evidence highlighting this risk factor in individuals with amnestic Mild Cognitive Impairment (aMCI), however further studies are needed. The aim of this study is to analyze cognitive tests results and brain-related measures over time in aMCI and examine how the presence of gait abnormalities (neurological or orthopedic) or normal gait affects these trends. Additionally, we sought to assess the significance of gait and gait-related measures as prognostic indicators for the progression from aMCI to AD dementia, comparing those who converted to AD with those who remained with a stable aMCI diagnosis during the follow-up. METHODS Four hundred two individuals with aMCI from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database were included. Robust linear mixed-effects models were used to study the impact of gait abnormalities on a comprehensive neuropsychological battery over 36 months while controlling for relevant medical variables at baseline. The impact of gait on brain measures was also investigated. Lastly, the Cox proportional-hazards model was used to explore the prognostic relevance of abnormal gait and neuropsychological associated tests. RESULTS While controlling for relevant covariates, we found that gait abnormalities led to a greater decline over time in attention (DSST) and global cognition (MMSE). Intriguingly, psychomotor speed (TMT-A) and divided attention (TMT-B) declined uniquely in the abnormal gait group. Conversely, specific AD global cognition tests (ADAS-13) and auditory-verbal memory (RAVLT immediate recall) declined over time independently of gait profile. All the other cognitive tests were not significantly affected by time or by gait profile. In addition, we found that ventricles size increased faster in the abnormal gait group compared to the normal gait group. In terms of prognosis, abnormal gait (HR = 1.7), MMSE (HR = 1.09), and DSST (HR = 1.03) covariates showed a higher impact on AD dementia conversion. CONCLUSIONS The importance of the link between gait and related cognitive functions in terms of diagnosis, prognosis, and rehabilitation in aMCI is critical. We showed that in aMCI gait abnormalities lead to executive functions/attention deterioration and conversion to AD dementia.
Collapse
Affiliation(s)
- Cosimo Tuena
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy.
| | - Sara Maestri
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Silvia Serino
- Department of Psychology, Università degli Studi Milano-Bicocca, Milan, Italy
| | - Elisa Pedroli
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Faculty of Psychology, Università eCampus, Novedrate, Italy
| | - Marco Stramba-Badiale
- Department of Geriatrics and Cardiovascular Medicine, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Giuseppe Riva
- Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, Milan, Italy
- Humane Technology Lab, Università Cattolica del Sacro Cuore, Milan, Italy
| |
Collapse
|
11
|
Ribas MZ, Paticcié GF, Noleto FM, Ramanzini LG, Veras ADO, Dall'Oglio R, Filho LBDA, Martins da Silva JG, Lima MPP, Teixeira BE, Nunes de Sousa G, Alves AFC, Vieira Lima LMF, Sallem CC, Garcia TFM, Ponte de Oliveira IM, Rocha RSDC, Jucá MDS, Barroso ST, Claudino Dos Santos JC. Impact of dysexecutive syndrome in quality of life in Alzheimer disease: What we know now and where we are headed. Ageing Res Rev 2023; 86:101866. [PMID: 36709886 DOI: 10.1016/j.arr.2023.101866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/18/2023] [Accepted: 01/25/2023] [Indexed: 01/27/2023]
Abstract
Alzheimer's disease (AD) is a common form of dementia that leads to multiple repercussions in the patient's life. This condition's clinical characteristics include loss of memory, temporal and spatial disorientation, language or executive dysfunction, and subsequent decline of social function. Dysexecutive syndrome (DS), the second most frequent neuropsychological dysfunction in AD, affects multiple brain areas and causes cognitive, behavioral, and emotional difficulties. We aimed to analyze the association between DS and AD and elucidate possible lack of evidence that may urge further research on this theme. Especially when dealing with such a disabling disease, where new findings can directly imply a better prognosis.
Collapse
Affiliation(s)
| | | | - Felipe Micelli Noleto
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil
| | | | - Arthur de Oliveira Veras
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, USP, Ribeirão Preto, SP, Brazil
| | - Renato Dall'Oglio
- Faculdade Evangélica Mackenzie do Paraná (FEMPAR), Curitiba, PR, Brazil
| | | | | | | | | | | | | | | | - Camilla Costa Sallem
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil
| | - Tulia Fernanda Meira Garcia
- Escola Multicampi de Ciências Médicas do RN, Universidade Federal do Rio Grande do Norte (EMCM-UFRN), Caicó, RN, Brazil
| | | | | | - Mikaio de Sousa Jucá
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil
| | - Sarah Távora Barroso
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil
| | - Júlio César Claudino Dos Santos
- Faculdade de Medicina, Centro Universitário Christus, UNICHRISTUS, Fortaleza, CE, Brazil; Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| |
Collapse
|
12
|
Huang Y, Pan FF, Huang L, Guo Q. The Value of Clock Drawing Process Assessment in Screening for Mild Cognitive Impairment and Alzheimer's Dementia. Assessment 2023; 30:364-374. [PMID: 34704455 DOI: 10.1177/10731911211053851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Many clock drawing test (CDT) scoring systems focus on drawing results and lack drawing process assessments. This study created a CDT scoring procedure with drawing process assessment and explored its diagnostic value in screening for mild cognitive impairment (MCI) and early Alzheimer's disease (AD) from normal control (NC). We used logistic regression and receiver operating characteristic (ROC) curves to determine a new, sensitive scoring system for AD and MCI patients in a derivation cohort. The new scoring method was then compared to two common scoring systems and externally validated in a second cohort. We developed a new scoring system named CDT5, which contained one process assessment item: remember setting time without asking. Compared with two published scoring systems, CDT5 had better discriminatory power in distinguishing AD patients from NCs in derivation (area under the ROC curve [area under the curve, AUC] = .890) and validation (AUC = .867) cohorts. Three scoring systems had poor diagnostic accuracy at discriminating MCI patients from controls, with CDT5 being the most sensitive (78.57%). Adding the drawing process in CDT helps accurately detect patients with early AD, but its role in identifying patients with MCI needs to be further explored.
Collapse
Affiliation(s)
- Yanlu Huang
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Feng-Feng Pan
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Lin Huang
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Qihao Guo
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| |
Collapse
|
13
|
James CE, Stucker C, Junker-Tschopp C, Fernandes AM, Revol A, Mili ID, Kliegel M, Frisoni GB, Brioschi Guevara A, Marie D. Musical and psychomotor interventions for cognitive, sensorimotor, and cerebral decline in patients with Mild Cognitive Impairment (COPE): a study protocol for a multicentric randomized controlled study. BMC Geriatr 2023; 23:76. [PMID: 36747142 PMCID: PMC9900212 DOI: 10.1186/s12877-022-03678-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/03/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Regular cognitive training can boost or maintain cognitive and brain functions known to decline with age. Most studies administered such cognitive training on a computer and in a lab setting. However, everyday life activities, like musical practice or physical exercise that are complex and variable, might be more successful at inducing transfer effects to different cognitive domains and maintaining motivation. "Body-mind exercises", like Tai Chi or psychomotor exercise, may also positively affect cognitive functioning in the elderly. We will compare the influence of active music practice and psychomotor training over 6 months in Mild Cognitive Impairment patients from university hospital memory clinics on cognitive and sensorimotor performance and brain plasticity. The acronym of the study is COPE (Countervail cOgnitive imPairmEnt), illustrating the aim of the study: learning to better "cope" with cognitive decline. METHODS We aim to conduct a randomized controlled multicenter intervention study on 32 Mild Cognitive Impairment (MCI) patients (60-80 years), divided over 2 experimental groups: 1) Music practice; 2) Psychomotor treatment. Controls will consist of a passive test-retest group of 16 age, gender and education level matched healthy volunteers. The training regimens take place twice a week for 45 min over 6 months in small groups, provided by professionals, and patients should exercise daily at home. Data collection takes place at baseline (before the interventions), 3, and 6 months after training onset, on cognitive and sensorimotor capacities, subjective well-being, daily living activities, and via functional and structural neuroimaging. Considering the current constraints of the COVID-19 pandemic, recruitment and data collection takes place in 3 waves. DISCUSSION We will investigate whether musical practice contrasted to psychomotor exercise in small groups can improve cognitive, sensorimotor and brain functioning in MCI patients, and therefore provoke specific benefits for their daily life functioning and well-being. TRIAL REGISTRATION The full protocol was approved by the Commission cantonale d'éthique de la recherche sur l'être humain de Genève (CCER, no. 2020-00510) on 04.05.2020, and an amendment by the CCER and the Commission cantonale d'éthique de la recherche sur l'être humain de Vaud (CER-VD) on 03.08.2021. The protocol was registered at clinicaltrials.gov (20.09.2020, no. NCT04546451).
Collapse
Affiliation(s)
- CE. James
- grid.5681.a0000 0001 0943 1999Geneva School of Health Sciences, Geneva Musical Minds Lab (GEMMI lab), University of Applied Sciences and Arts Western Switzerland HES-SO, Avenue de Champel 47, 1206 Geneva, Switzerland ,grid.8591.50000 0001 2322 4988Faculty of Psychology and Educational Sciences, University of Geneva, Boulevard Carl-Vogt 101, 1205 Geneva, Switzerland
| | - C. Stucker
- grid.5681.a0000 0001 0943 1999Geneva School of Health Sciences, Geneva Musical Minds Lab (GEMMI lab), University of Applied Sciences and Arts Western Switzerland HES-SO, Avenue de Champel 47, 1206 Geneva, Switzerland
| | - C. Junker-Tschopp
- grid.5681.a0000 0001 0943 1999Geneva School of Social Work, Department of Psychomotricity, University of Applied Sciences and Arts Western Switzerland HES-SO, Rue Prévost-Martin 28, 1205 Geneva, Switzerland
| | - AM. Fernandes
- grid.5681.a0000 0001 0943 1999Geneva School of Health Sciences, Geneva Musical Minds Lab (GEMMI lab), University of Applied Sciences and Arts Western Switzerland HES-SO, Avenue de Champel 47, 1206 Geneva, Switzerland
| | - A. Revol
- grid.5681.a0000 0001 0943 1999Geneva School of Social Work, Department of Psychomotricity, University of Applied Sciences and Arts Western Switzerland HES-SO, Rue Prévost-Martin 28, 1205 Geneva, Switzerland
| | - ID. Mili
- grid.8591.50000 0001 2322 4988Faculty of Psychology and Educational Sciences, Didactics of Arts and Movement Laboratory, University of Geneva, Switzerland. Boulevard Carl-Vogt 101, 1205 Geneva, Switzerland
| | - M. Kliegel
- grid.8591.50000 0001 2322 4988Faculty of Psychology and Educational Sciences, Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Switzerland, Boulevard du Pont d’Arve 28, 1205 Geneva, Switzerland
| | - GB. Frisoni
- grid.8591.50000 0001 2322 4988University Hospitals and University of Geneva, Memory Center, Rue Gabrielle-Perret-Gentil 6, 1205 Geneva, Switzerland
| | - A. Brioschi Guevara
- grid.8515.90000 0001 0423 4662Leenaards Memory Center, Lausanne University Hospital, Chemin de Mont-Paisible 16, 1011 Lausanne, Switzerland
| | - D. Marie
- grid.5681.a0000 0001 0943 1999Geneva School of Health Sciences, Geneva Musical Minds Lab (GEMMI lab), University of Applied Sciences and Arts Western Switzerland HES-SO, Avenue de Champel 47, 1206 Geneva, Switzerland ,grid.8591.50000 0001 2322 4988CIBM Center for Biomedical Imaging, MRI HUG-UNIGE, University of Geneva, Geneva, Switzerland
| |
Collapse
|
14
|
Gustavson DE, Reynolds CA, Hohman TJ, Jefferson AL, Elman JA, Panizzon MS, Neale MC, Logue MW, Lyons MJ, Franz CE, Kremen WS. Alzheimer's Disease Polygenic Scores Predict Changes in Episodic Memory and Executive Function Across 12 Years in Late Middle Age. J Int Neuropsychol Soc 2023; 29:136-47. [PMID: 35184795 DOI: 10.1017/S1355617722000108] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Alzheimer's disease (AD) is highly heritable, and AD polygenic risk scores (AD-PRSs) have been derived from genome-wide association studies. However, the nature of genetic influences very early in the disease process is still not well known. Here we tested the hypothesis that an AD-PRSs would be associated with changes in episodic memory and executive function across late midlife in men who were cognitively unimpaired at their baseline midlife assessment.. METHOD We examined 1168 men in the Vietnam Era Twin Study of Aging (VETSA) who were cognitively normal (CN) at their first of up to three assessments across 12 years (mean ages 56, 62, and 68). Latent growth models of episodic memory and executive function were based on 6-7 tests/subtests. AD-PRSs were based on Kunkle et al. (Nature Genetics, 51, 414-430, 2019), p < 5×10-8 threshold. RESULTS AD-PRSs were correlated with linear slopes of change for both cognitive abilities. Men with higher AD-PRSs had steeper declines in both memory (r = -.19, 95% CI [-.35, -.03]) and executive functioning (r = -.27, 95% CI [-.49, -.05]). Associations appeared driven by a combination of APOE and non-APOE genetic influences. CONCLUSIONS Memory is most characteristically impaired in AD, but executive functions are one of the first cognitive abilities to decline in midlife in normal aging. This study is among the first to demonstrate that this early decline also relates to AD genetic influences, even in men CN at baseline.
Collapse
|
15
|
Tung YE, Kuo LM, Chen MC, Hsu WC, Shyu YL. An Outpatient-Based Training Program Improves Family Caregivers' Preparedness in Caring for Persons With Mild Cognitive Impairment: A Randomized Controlled Trial. J Nurs Res 2023; 31:e252. [PMID: 36692834 DOI: 10.1097/jnr.0000000000000541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Little is known regarding the effects of training programs on family caregivers of older persons with mild cognitive impairment because of the significant differences in outcome variables measured in the various studies in the literature. PURPOSE This study was designed to examine the effects of an outpatient-based caregiver training program on the preparedness, health-related quality of life, and depressive symptoms of participants responsible for caring for older persons with mild cognitive impairment. METHODS A randomized clinical trial was implemented. Of the 54 family caregiver participants who provided complete and valid data, 28 and 26 were assigned to the experimental and control groups, respectively. The experimental group participated in a researcher-developed training program that provided information on mild cognitive impairment, strategies for maintaining and promoting cognitive function in persons with mild cognitive impairment, managing their own and their care recipients' healthcare, and managing their own emotional support and stress. Outcomes (caregiver preparedness, health-related quality of life, and depressive symptoms) were assessed before the start of the training program (baseline) and at 1, 3, and 6 months after completion of the program. RESULTS After controlling for baseline cognitive function of the care recipients and of caregiver preparedness, the experimental group was shown to be significantly less prepared than the control group at baseline (β = -1.41, p = .031) and better prepared than the control group at all three posttests (group differences: 1.3, 1.53, and 4.24, respectively), with the difference at the third posttest (6 months) reaching statistical significance (p = .008). No impact of the intervention on caregiver depressive symptoms or health-related quality of life was found at posttest. CONCLUSIONS The training intervention in this study was found to increase the perceived preparedness of the family caregiver participants to handle various aspects of providing care to persons with mild cognitive impairment. However, no changes were found in depressive symptoms or health-related quality of life.
Collapse
|
16
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
17
|
Franz CE, Gustavson DE, Elman JA, Fennema-Notestine C, Hagler DJ, Baraff A, Tu XM, Wu TC, DeAnda J, Beck A, Kaufman JD, Whitsel N, Finch CE, Chen JC, Lyons MJ, Kremen WS. Associations Between Ambient Air Pollution and Cognitive Abilities from Midlife to Early Old Age: Modification by APOE Genotype. J Alzheimers Dis 2023; 93:193-209. [PMID: 36970897 PMCID: PMC10827529 DOI: 10.3233/jad-221054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Fine particulate matter (PM2.5) and nitrogen dioxide (NO2) measures of ambient air pollution are associated with accelerated age-related cognitive impairment, and Alzheimer's disease and related dementias (ADRD). OBJECTIVE We examined associations between air pollution, four cognitive factors, and the moderating role of apolipoprotein E (APOE) genotype in the understudied period of midlife. METHODS Participants were ∼1,100 men in the Vietnam Era Twin Study of Aging. Baseline cognitive assessments were from 2003 to 2007. Measures included past (1993-1999) and recent (3 years prior to baseline assessment) PM2.5 and NO2 exposure, in-person assessment of episodic memory, executive function, verbal fluency, and processing speed, and APOE genotype. Average baseline age was 56 years with a 12-year follow-up. Analyses adjusted for health and lifestyle covariates. RESULTS Performance in all cognitive domains declined from age 56 to 68. Higher PM2.5 exposures were associated with worse general verbal fluency. We found significant exposure-by-APOE genotype interactions for specific cognitive domains: PM2.5 with executive function and NO2 with episodic memory. Higher PM2.5 exposure was related to worse executive function in APOE ɛ4 carriers, but not in non-carriers. There were no associations with processing speed. CONCLUSION These results indicate negative effects of ambient air pollution exposure on fluency alongside intriguing differential modifications of cognitive performance by APOE genotype. APOE ɛ4 carriers appeared more sensitive to environmental differences. The process by which air pollution and its interaction with genetic risk for ADRD affects risk for later life cognitive decline or progression to dementia may begin in midlife.
Collapse
Affiliation(s)
- Carol E. Franz
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
| | - Daniel E. Gustavson
- Institute for Behavior Genetics, University of Colorado Boulder, Boulder, CO
| | - Jeremy A. Elman
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
| | - Christine Fennema-Notestine
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
- Department of Radiology, University of California, San Diego, La Jolla, CA
| | - Donald J. Hagler
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
- Department of Radiology, University of California, San Diego, La Jolla, CA
- Department of Neurosciences, University of California, San Diego, La Jolla, CA
| | - Aaron Baraff
- Vietnam Era Twin Registry, VA Puget Sound Health Care, Seattle, WA
| | - Xin M. Tu
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, CA
| | - Tsung-Chin Wu
- Herbert Wertheim School of Public Health & Human Longevity Science, University of California San Diego, CA
| | - Jaden DeAnda
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
- Department of Psychology, San Diego State University, San Diego, CA
| | - Asad Beck
- Graduate Program in Neuroscience, University of Washington, Seattle, WA
| | - Joel D. Kaufman
- Epidemiology, Environmental and Occupational Health Sciences, and General Internal Medicine, University of Washington, Seattle, WA
| | - Nathan Whitsel
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
| | - Caleb E. Finch
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA
| | - Jiu-Chiuan Chen
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA
| | - Michael J. Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA
| | - William S. Kremen
- Department of Psychiatry and Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA
| |
Collapse
|
18
|
Tsentidou G, Moraitou D, Tsolaki M, Masoura E, Papaliagkas V. Trajectories of Cognitive Impairment in Adults Bearing Vascular Risk Factors, with or without Diagnosis of Mild Cognitive Impairment: Findings from a Longitudinal Study Assessing Executive Functions, Memory, and Social Cognition. Diagnostics (Basel) 2022; 12:diagnostics12123017. [PMID: 36553024 PMCID: PMC9777412 DOI: 10.3390/diagnostics12123017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022] Open
Abstract
With the aging of the population, a key concern of both societies and health services is to keep the population cognitively healthy until the maximum age limit. It is a well-known fact that vascular aging has a negative effect on the cognitive skills of adults, putting them at greater risk of developing dementia. The present longitudinal study aimed to evaluate the main dimensions of cognition in two pathological groups with different health profiles: a group of adults with vascular risk factors (VRF) (n = 35) and a group of adults with vascular risk factors and mild cognitive impairment (VRF + MCI) (n = 35). The two groups were matched in age, education, and gender. They were assessed with extensive neuropsychological testing at three different times with a distance of about 8 months between them; the assessment regarded executive functions, memory capacity, and Theory of Mind abilities. The analyses carried out were (a) mixed-measures ANOVA, (b) repeated measures ANOVA, and (c) ANOVA. The findings showed that global cognitive status and short-term memory are the main cognitive abilities that decline in community dwelling people bearing VRF. Hence, this group of adults should be examined at least every 2 years for this decline. As regards people with both VRF and MCI, it seems that the assessment of Theory of Mind abilities can better capture their further impairment. Global cognitive status, task/rule switching function, and long-term memory (delayed verbal recall) were revealed as the abilities that clearly and steadily differentiate VRF people with and without MCI.
Collapse
Affiliation(s)
- Glykeria Tsentidou
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, 541 24 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-6983140302
| | - Despina Moraitou
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, 541 24 Thessaloniki, Greece
- Greek Association of Alzheimer’s Disease and Related Disorders, 546 43 Thessaloniki, Greece
| | - Magdalini Tsolaki
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI), AUTh, 541 24 Thessaloniki, Greece
- Greek Association of Alzheimer’s Disease and Related Disorders, 546 43 Thessaloniki, Greece
| | - Elvira Masoura
- Laboratoty of Psychology, Department of Experimental and Cognitive Psychology, School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Vasileios Papaliagkas
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 574 00 Sindos, Greece
| |
Collapse
|
19
|
Lin M, Ma C, Zhu J, Gao J, Huang L, Huang J, Liu Z, Tao J, Chen L. Effects of exercise interventions on executive function in old adults with mild cognitive impairment: A systematic review and meta-analysis of randomized controlled trials. Ageing Res Rev 2022; 82:101776. [PMID: 36332758 DOI: 10.1016/j.arr.2022.101776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
AIMS To assess the effect of exercise interventions on subdomains of executive function (EF) in older adults with mild cognitive impairment (MCI). METHODS Nine electronic databases were comprehensively searched from their inception to February 2021. Randomized controlled trials examining the effect of exercise training on EF in MCI were included. RESULTS Twenty-four eligible articles involving 2278 participants were identified. The results showed that exercise interventions had positive benefits on working memory, switching and inhibition in MCI. Subgroup analysis based on exercise prescriptions revealed that both aerobatic exercise and mind-body exercise had similar positive effect size on working memory. However, only mind-body exercise had significant effect on switching. Exercise training with moderate frequency (3-4 times/week) had larger effect size than low frequency (1-2 times/week) and only moderate frequency had positive benefits on switching. Both short (4-12 weeks), medium (13-24 weeks) and long (more than 24 weeks) exercise duration significantly ameliorate working memory and switching, however with short duration having slight larger effect sizes than medium and long. CONCLUSION Exercise significantly improves three subdomains of EF in MCI, especially mind-body exercise. Exercise training sticking to at least 4 weeks with 3-4 times a week tends to have larger effect size.
Collapse
Affiliation(s)
- Miaoran Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Chuyi Ma
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Jingfang Zhu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Jiahui Gao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Li Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Jia Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of Traditional Chinese Medicine), Ministry of Education, China.
| | - Zhizhen Liu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of Traditional Chinese Medicine), Ministry of Education, China.
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of Traditional Chinese Medicine), Ministry of Education, China.
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China; Fujian Key Laboratory of Rehabilitation Technology, Fuzhou, Fujian, China; Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation (Fujian University of Traditional Chinese Medicine), Ministry of Education, China.
| |
Collapse
|
20
|
Gustavson DE, Archer DB, Elman JA, Puckett OK, Fennema-Notestine C, Panizzon MS, Shashikumar N, Hohman TJ, Jefferson AL, Eyler LT, McEvoy LK, Lyons MJ, Franz CE, Kremen WS. Associations among executive function Abilities, free Water, and white matter microstructure in early old age. Neuroimage Clin 2022; 37:103279. [PMID: 36493704 PMCID: PMC9731853 DOI: 10.1016/j.nicl.2022.103279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/26/2022] [Accepted: 11/30/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Studies have investigated white matter microstructure in relation to late-life cognitive impairments, with fractional anisotropy (FA) and mean diffusivity (MD) measures thought to capture demyelination and axonal degradation. However, new post-processing methods allow isolation of free water (FW), which captures extracellular fluid contributions such as atrophy and neuroinflammation, from tissue components. FW also appears to be highly relevant to late-life cognitive impairment. Here, we evaluated whether executive functions are associated with FW, and FA and MD corrected for FW (FAFWcorr and MDFWcorr). METHOD We examined 489 non-demented men in the Vietnam Era Twin Study of Aging (VETSA) at mean age 68. Two latent factors capturing 'common executive function' and 'working-memory specific' processes were estimated based on 6 tasks. Analyses focused on 11 cortical white matter tracts across three metrics: FW, FAFWcorr, and MDFWcorr. RESULTS Better 'common executive function' was associated with lower FW across 9 of the 11 tracts. There were no significant associations with intracellular metrics after false discovery rate correction. Effects also appeared driven by individuals with MCI (13.7% of the sample). Working memory-specific tasks showed some associations with FAFWcorr, including the triangularis portion of the inferior frontal gyrus. There was no evidence that cognitive reserve (i.e., general cognitive ability assessed in early adulthood) moderated these associations between executive function and FW or FA. DISCUSSION Executive function abilities in early old age are associated primarily with extracellular fluid (FW) as opposed to white matter (FAFWcorr or MDFWcorr). Moderation analyses suggested cognitive reserve does not play a strong role in these associations, at least in this sample of non-demented men.
Collapse
Affiliation(s)
- Daniel E Gustavson
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA; Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Derek B Archer
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Jeremy A Elman
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA
| | - Olivia K Puckett
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA
| | - Christine Fennema-Notestine
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA; Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Matthew S Panizzon
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA
| | - Niranjana Shashikumar
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Timothy J Hohman
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Angela L Jefferson
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA
| | - Linda K McEvoy
- Department of Radiology, University of California San Diego, La Jolla, CA, USA; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Michael J Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Carol E Franz
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA
| | - William S Kremen
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA, USA
| |
Collapse
|
21
|
Parra MA, Calia C, Pattan V, Della Sala S. Memory markers in the continuum of the Alzheimer's clinical syndrome. Alzheimers Res Ther 2022; 14:142. [PMID: 36180965 PMCID: PMC9526252 DOI: 10.1186/s13195-022-01082-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/14/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND The individual and complementary value of the Visual Short-Term Memory Binding Test (VSTMBT) and the Free and Cued Selective Reminding Test (FCSRT) as markers to trace the AD continuum was investigated. It was hypothesised that the VSTMBT would be an early indicator while the FCSRT would inform on imminent progression. METHODS Healthy older adults (n=70) and patients with mild cognitive impairment (MCI) (n=80) were recruited and followed up between 2012 and 2017. Participants with at least two assessment points entered the study. Using baseline and follow-up assessments four groups were defined: Older adults who were healthy (HOA), with very mild cognitive but not functional impairment (eMCI), and with MCI who did and did not convert to dementia (MCI converters and non-converters). RESULTS Only the VSTMBT predicted group membership in the very early stages (HOA vs eMCI). As the disease progressed, the FCSRT became a strong predictor excluding the VSTMB from the models. Their complementary value was high during the mid-prodromal stages and decreased in stages closer to dementia. DISCUSSION The study supports the notion that neuropsychological assessment for AD needs to abandon the notion of one-size-fits-all. A memory toolkit for AD needs to consider tools that are early indicators and tools that suggest imminent progression. The VSTMBT and the FSCRT are such tools.
Collapse
Affiliation(s)
- Mario A Parra
- School of Psychological Sciences and Health, University of Strathclyde, Graham Hills Building, 40 George Street, Glasgow, G1 1QE, UK.
| | - Clara Calia
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Vivek Pattan
- NHS Forth Valley, Stirling Community Hospital, Stirling, UK
| | - Sergio Della Sala
- Human Cognitive Neuroscience, Psychology Department, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
22
|
Rivas-Fernández MÁ, Lindín M, Zurrón M, Díaz F, Aldrey-Vázquez JM, Pías-Peleteiro JM, Vázquez-Vázquez L, Pereiro AX, Lojo-Seoane C, Nieto-Vieites A, Galdo-Álvarez S. Brain Atrophy and Clinical Characterization of Adults With Mild Cognitive Impairment and Different Cerebrospinal Fluid Biomarker Profiles According to the AT(N) Research Framework of Alzheimer’s Disease. Front Hum Neurosci 2022; 16:799347. [PMID: 35280203 PMCID: PMC8914376 DOI: 10.3389/fnhum.2022.799347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/10/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction This study aimed to evaluate, in adults with mild cognitive impairment (MCI), the brain atrophy that may distinguish between three AT(N) biomarker-based profiles, and to determine its clinical value. Methods Structural MRI (sMRI) was employed to evaluate the volume and cortical thickness differences in MCI patients with different AT(N) profiles, namely, A−T−(N)−: normal AD biomarkers; A+T−(N)−: AD pathologic change; and A+T+(N)+: prodromal AD. Sensitivity and specificity of these changes were also estimated. Results An initial atrophy in medial temporal lobe (MTL) areas was found in the A+T−(N)− and A+T+(N)+ groups, spreading toward the parietal and frontal regions in A+T+(N)+ patients. These structural changes allowed distinguishing AT(N) profiles within the AD continuum; however, the profiles and their pattern of neurodegeneration were unsuccessful to determine the current clinical status. Conclusion sMRI is useful in the determination of the specific brain structural changes of AT(N) profiles along the AD continuum, allowing differentiation between MCI adults with or without pathological AD biomarkers.
Collapse
Affiliation(s)
- Miguel Ángel Rivas-Fernández
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- *Correspondence: Miguel Ángel Rivas-Fernández,
| | - Mónica Lindín
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Montserrat Zurrón
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Fernando Díaz
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - José Manuel Aldrey-Vázquez
- Neurology Service, Santiago Clinic Hospital (CHUS), Santiago de Compostela, Spain
- NeuroAging Group (NEURAL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Juan Manuel Pías-Peleteiro
- Neurology Service, Santiago Clinic Hospital (CHUS), Santiago de Compostela, Spain
- NeuroAging Group (NEURAL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Laura Vázquez-Vázquez
- NeuroAging Group (NEURAL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Arturo Xosé Pereiro
- Department of Developmental and Educational Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Cristina Lojo-Seoane
- Department of Developmental and Educational Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ana Nieto-Vieites
- Department of Developmental and Educational Psychology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Santiago Galdo-Álvarez
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| |
Collapse
|
23
|
Corbo I, Casagrande M. Higher-Level Executive Functions in Healthy Elderly and Mild Cognitive Impairment: A Systematic Review. J Clin Med 2022; 11:jcm11051204. [PMID: 35268294 PMCID: PMC8911402 DOI: 10.3390/jcm11051204] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/27/2022] [Accepted: 02/21/2022] [Indexed: 02/04/2023] Open
Abstract
Mild Cognitive Impairment (MCI) is a clinical syndrome characterized by a moderate decline in one or more cognitive functions with a preserved autonomy in daily life activities. MCI exhibits cognitive, behavioral, psychological symptoms. The executive functions (EFs) are key functions for everyday life and physical and mental health and allow for the behavior to adapt to external changes. Higher-level executive functions develop from basic EFs (inhibition, working memory, attentional control, and cognitive flexibility). They are planning, reasoning, problem solving, and fluid intelligence (Gf). This systematic review investigates the relationship between higher-level executive functions and healthy and pathological aging, assuming the role of executive functions deficits as a predictor of cognitive decline. The systematic review was conducted according to the PRISMA Statement. A total of 73 studies were identified. The results indicate that 65.8% of the studies confirm significant EFs alterations in MCI (56.8% planning, 50% reasoning, 100% problem solving, 71.4% fluid intelligence). These results seem to highlight a strong prevalence of higher-level executive functions deficits in MCI elderly than in healthy elderly.
Collapse
Affiliation(s)
- Ilaria Corbo
- Dipartimento di Psicologia, Università di Roma Sapienza, 00185 Roma, Italy;
| | - Maria Casagrande
- Dipartimento di Psicologia Dinamica, Clinica e Salute, Università di Roma Sapienza, 00185 Roma, Italy
- Correspondence:
| |
Collapse
|
24
|
Herold F, Labott BK, Grässler B, Halfpaap N, Langhans C, Müller P, Ammar A, Dordevic M, Hökelmann A, Müller NG. A Link between Handgrip Strength and Executive Functioning: A Cross-Sectional Study in Older Adults with Mild Cognitive Impairment and Healthy Controls. Healthcare (Basel) 2022; 10:healthcare10020230. [PMID: 35206845 PMCID: PMC8872145 DOI: 10.3390/healthcare10020230] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 01/16/2023] Open
Abstract
Older adults with amnestic mild cognitive impairment (aMCI) who in addition to their memory deficits also suffer from frontal-executive dysfunctions have a higher risk of developing dementia later in their lives than older adults with aMCI without executive deficits and older adults with non-amnestic MCI (naMCI). Handgrip strength (HGS) is also correlated with the risk of cognitive decline in the elderly. Hence, the current study aimed to investigate the associations between HGS and executive functioning in individuals with aMCI, naMCI and healthy controls. Older, right-handed adults with amnestic MCI (aMCI), non-amnestic MCI (naMCI), and healthy controls (HC) conducted a handgrip strength measurement via a handheld dynamometer. Executive functions were assessed with the Trail Making Test (TMT A&B). Normalized handgrip strength (nHGS, normalized to Body Mass Index (BMI)) was calculated and its associations with executive functions (operationalized through z-scores of TMT B/A ratio) were investigated through partial correlation analyses (i.e., accounting for age, sex, and severity of depressive symptoms). A positive and low-to-moderate correlation between right nHGS (rp (22) = 0.364; p = 0.063) and left nHGS (rp (22) = 0.420; p = 0.037) and executive functioning in older adults with aMCI but not in naMCI or HC was observed. Our results suggest that higher levels of nHGS are linked to better executive functioning in aMCI but not naMCI and HC. This relationship is perhaps driven by alterations in the integrity of the hippocampal-prefrontal network occurring in older adults with aMCI. Further research is needed to provide empirical evidence for this assumption.
Collapse
Affiliation(s)
- Fabian Herold
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.K.L.); (P.M.); (M.D.); (N.G.M.)
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476 Potsdam, Germany
- Correspondence:
| | - Berit K. Labott
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.K.L.); (P.M.); (M.D.); (N.G.M.)
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; (B.G.); (N.H.); (C.L.); (A.A.); (A.H.)
| | - Bernhard Grässler
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; (B.G.); (N.H.); (C.L.); (A.A.); (A.H.)
| | - Nicole Halfpaap
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; (B.G.); (N.H.); (C.L.); (A.A.); (A.H.)
| | - Corinna Langhans
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; (B.G.); (N.H.); (C.L.); (A.A.); (A.H.)
| | - Patrick Müller
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.K.L.); (P.M.); (M.D.); (N.G.M.)
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Achraf Ammar
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; (B.G.); (N.H.); (C.L.); (A.A.); (A.H.)
| | - Milos Dordevic
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.K.L.); (P.M.); (M.D.); (N.G.M.)
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476 Potsdam, Germany
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Anita Hökelmann
- Institute III, Department of Sport Science, Otto von Guericke University Magdeburg, 39104 Magdeburg, Germany; (B.G.); (N.H.); (C.L.); (A.A.); (A.H.)
| | - Notger G. Müller
- Department of Neurology, Medical Faculty, Otto von Guericke University, 39120 Magdeburg, Germany; (B.K.L.); (P.M.); (M.D.); (N.G.M.)
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, 14476 Potsdam, Germany
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), 39118 Magdeburg, Germany
| |
Collapse
|
25
|
Grandi F, Martínez-Pernía D, Parra M, Olavarria L, Huepe D, Alegria P, Aliaga Á, Lillo P, Delgado C, Tenorio M, Rosas R, López O, Becker J, Slachevsky A. Standardization and diagnostic utility of the Frontal Assessment Battery for healthy people and patients with dementia in the Chilean population. Dement Neuropsychol 2022; 16:69-78. [PMID: 35719260 PMCID: PMC9170265 DOI: 10.1590/1980-5764-dn-2021-0059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/06/2021] [Accepted: 09/17/2021] [Indexed: 11/22/2022] Open
Abstract
The Frontal Assessment Battery (FAB) is a screening test that measures executive functions. Although this instrument has been validated in several countries, its diagnostic utility in a Chilean population has not been studied yet. Objectives This study aimed to (1) adapt FAB in a Chilean population; (2) study the psychometric properties of the FAB in a Chilean population; (3) assess the sociodemographic influence in the performance of the FAB in a sample of healthy controls (HC); and (4) develop normative data for this healthy group. Methods A HC (n=344) and a group of patients with dementia (n=156) were assessed with the Chilean version of FAB. Results FAB showed good internal consistency (Cronbach's alpha=0.79) and acceptable validity based on the relationship with other variables. Factor analysis showed the unidimensionality of the instrument. Significant differences were found in the total FAB value between the HC and dementia groups. With the matched sample, the established cutoff point was 13.5, showing a sensitivity of 80.8% and a specificity of 90.4%. Regression analysis showed that education and age significantly predicted FAB performance in the healthy group. Finally, normative data are provided. Conclusions This study shows that FAB is a useful tool to discriminate between healthy people and people with dementia. However, further studies are needed to explore the capacity of the instrument to characterize the dysexecutive syndrome in people with dementia in the Chilean population.
Collapse
Affiliation(s)
- Fabrissio Grandi
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador, Memory and Neuropsychiatric Clinic, Neurology Department, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Neuroscience and East Neuroscience Departments, Santiago, Chile
- Universidad de los Andes, School of Psychology, Santiago, Chile
| | - David Martínez-Pernía
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador, Memory and Neuropsychiatric Clinic, Neurology Department, Santiago, Chile
- Universidad Adolfo Ibañez, School of Psychology, Center for Social and Cognitive Neuroscience, Santiago, Chile
| | - Mario Parra
- University of Strathclyde, School of Psychological Sciences and Health, Glasgow, Scotland
| | - Loreto Olavarria
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador, Memory and Neuropsychiatric Clinic, Neurology Department, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Neuroscience and East Neuroscience Departments, Santiago, Chile
| | - David Huepe
- Universidad Adolfo Ibañez, School of Psychology, Center for Social and Cognitive Neuroscience, Santiago, Chile
| | - Patricia Alegria
- Clínica Alemana, Physical Medicine and Rehabilitation Service, Santiago, Chile
| | - Álvaro Aliaga
- Diego Portales Universidad, School of Psychology, Santiago, Chile
| | - Patricia Lillo
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, South Neuroscience Department, Santiago, Chile
- Complejo Hospitalario San José, Neurology Unit, Santiago, Chile
| | - Carolina Delgado
- Universidad de Chile, School of Medicine, Department of Neuroscience, Santiago, Chile
- Universidad de Chile, Hospital Clínico, Department of Neurology and Neurosurgery, Healthy Brain Unit, Santiago, Chile
| | - Marcela Tenorio
- Universidad de los Andes, School of Psychology, Santiago, Chile
- Millennium Institute for Caregiving Research, Santiago, Chile
| | - Ricardo Rosas
- Pontificia Universidad Católica de Chile, Center for the Development of Inclusion Technologies, Santiago, Chile
| | - Oscar López
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA
- University of Pittsburgh, Department of Neurology, Pittsburgh, PA, USA
| | - James Becker
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA
- University of Pittsburgh, Department of Neurology, Pittsburgh, PA, USA
- University of Pittsburgh, Department of Psychology, Pittsburgh, PA, USA
| | - Andrea Slachevsky
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador, Memory and Neuropsychiatric Clinic, Neurology Department, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Neuroscience and East Neuroscience Departments, Santiago, Chile
- Universidad del Desarrollo, Clínica Alemana, Department of Medicine, Neurology Unit, Santiago, Chile
| |
Collapse
|
26
|
Serra L, D'Amelio M, Esposito S, Di Domenico C, Koch G, Marra C, Mercuri NB, Caltagirone C, Artusi CA, Lopiano L, Cercignani M, Bozzali M. Ventral Tegmental Area Disconnection Contributes Two Years Early to Correctly Classify Patients Converted to Alzheimer's Disease: Implications for Treatment. J Alzheimers Dis 2021; 82:985-1000. [PMID: 34120905 DOI: 10.3233/jad-210171] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recent cross-sectional studies highlighted the loss of dopaminergic neurons in the ventral tegmental area (VTA) as an early pathophysiological event in Alzheimer's disease (AD). OBJECTIVE In this study, we longitudinally investigated by resting-state fMRI (rs-fMRI) a cohort of patients with mild cognitive impairment (MCI) due to AD to evaluate the impact of VTA disconnection in predicting the conversion to AD. METHODS A cohort of 35 patients with MCI due to AD were recruited and followed-up for 24 months. They underwent cognitive evaluation and rs-fMRI to assess VTA connectivity at baseline and at follow-up. RESULTS At 24-month follow-up, 16 out of 35 patients converted to AD. Although converters and non-converters to AD did not differ in demographic and behavioral characteristics at baseline, the first group showed a significant reduction of VTA-driven connectivity in the posterior cingulate and precentral cortex. This pattern of additional disconnection in MCI-Converters compared to non-converters remained substantially unchanged at 24-month follow-up. CONCLUSION This study reinforces the hypothesis of an early contribution of dopaminergic dysfunction to AD evolution by targeting the default-mode network. These results have potential implications for AD staging and prognosis and support new opportunities for therapeutic interventions to slow down disease progression.
Collapse
Affiliation(s)
- Laura Serra
- Neuroimaging Laboratory, Fondazione Santa Lucia, IRCCS, Rome, Italy
| | - Marcello D'Amelio
- Laboratory Molecular Neurosciences, Fondazione Santa Lucia, IRCCS, Rome, Italy.,Unit of Molecular Neurosciences, Department of Medicine, University Campus-Biomedico, Rome, Italy
| | - Sharon Esposito
- Neuroimaging Laboratory, Fondazione Santa Lucia, IRCCS, Rome, Italy
| | | | - Giacomo Koch
- Non Invasive Brain Stimulation Unit/Department of Behavioral and Clinical Neurology, Fondazione Santa Lucia, IRCCS, Rome, Italy.,Section of Human Physiology, University of Ferrara, Ferrara, Italy
| | - Camillo Marra
- Institute of Neurology, Catholic University, Rome, Italy
| | - Nicola Biagio Mercuri
- Laboratory of Experimental Neurology, Fondazione Santa Lucia, IRCCS, Rome, Italy.,Department of Systems Medicine, University of Rome 'Tor Vergata', Rome, Italy
| | - Carlo Caltagirone
- Department of Clinical and Behavioural Neurology, Fondazione Santa Lucia, IRCCS, Rome, Italy
| | - Carlo Alberto Artusi
- 'Rita Levi Montalcini' Department of Neuroscience University of Torino, Turin, Italy
| | - Leonardo Lopiano
- 'Rita Levi Montalcini' Department of Neuroscience University of Torino, Turin, Italy
| | - Mara Cercignani
- Neuroimaging Laboratory, Fondazione Santa Lucia, IRCCS, Rome, Italy.,Cardiff University Brain Imaging Centre, School of Psychology, Cardiff University, Cardiff, Wales, United Kingdom
| | - Marco Bozzali
- 'Rita Levi Montalcini' Department of Neuroscience University of Torino, Turin, Italy.,Department of Neuroscience, Brighton & Sussex Medical School, University of Sussex, Brighton, East Sussex, United Kingdom
| |
Collapse
|
27
|
Oliveira CRD, Lima MMBMPD, Barroso SM, Argimon IIDL. Psychometric properties of the Dysexecutive Questionnaire (DEX): a study with Brazilian older adults. Psico-USF 2021. [DOI: 10.1590/1413-8271202126nesp10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract This study aimed to verify the psychometric properties of the Dysexecutive Questionnaire (DEX) through exploratory factor analysis (EFA), evidence of reliability, and convergent validity, in a sample of neurologically preserved older adults. Participants were 345 older adults who answered, in addition to DEX, a sociodemographic and clinical questionnaire, the Mini-Mental State Examination (MMSE), and two verbal fluency tasks. The EFA was conducted through Parallel Analysis based on the generation of a polychoric correlation matrix, as well as Pearson’s correlation between the DEX scores, age, education, MMSE, and verbal fluency tasks. According to the EFA, the extraction of two factors (“Inhibition” and “Social Regulation and Planning”) was suggested and DEX was negatively associated with age and MMSE. In conclusion, DEX presented a satisfactory factorial structure for older adults, which can be considered a reliable self-report measure for complaints of executive functions.
Collapse
|