Assessment Of Cognitive Function Research Articles

Assessment of Cognitive Functions in Patients Accidentally Exposed to Radiation

Assessment of Cognitive Functions in Patients Accidentally Exposed to Radiation

Correlation between cognitive assessment scores and circulating cerebral biomarkers in women with pre-eclampsia and eclampsia.

The cerebral injury biomarkers neurofilament light chain (NfL) and tau and the glial activation biomarker glial fibrillary acidic protein (GFAP) may reflect neurological injury in pre-eclampsia. We assessed if there was a correlation between cognitive function assessment scores and plasma concentrations of these biomarkers in pre-eclampsia. Women with eclampsia, pre-eclampsia and normotensive pregnancies from the South African PROVE biobank were included. Blood samples were taken at inclusion. The Montreal Cognitive Assessment was performed after delivery at the time of discharge. The correlation between cognitive assessment scores and plasma concentrations of cerebral biomarkers was analysed using Spearman correlation adjusted for time from eclamptic seizure. We included 49 women with eclampsia, 16 women with pre-eclampsia complicated by pulmonary oedema, 22 women with pre-eclampsia without pulmonary oedema, HELLP or neurological complications and 18 women with normotensive pregnancies. There was a correlation between impaired cognitive function and increased plasma concentrations of NfL in women with eclampsia and women with pre-eclampsia and pulmonary oedema (r=-0.37, p=0.009 and r=-0.56, p=0.025 respectively). No correlation between impaired cognitive function and NfL in pre-eclampsia cases without pulmonary oedema, HELLP or neurological complications or normotensive pregnancies was found. No correlation with cognitive impairment was found in any groups for tau or GFAP. We found a correlation between impaired cognitive function assessment and plasma NfL concentrations in women with eclampsia and pre-eclampsia complicated by pulmonary oedema. These findings suggest that acute neuroaxonal injury may cause or contribute to cognitive impairment in these women.

Cognitive performance on a neuropsychological battery with accommodations for hearing loss by listeners with cochlear implants

A relationship between hearing loss and cognitive decline has emerged across multiple studies. Hearing aids and cochlear implants (CIs) may slow down the progression of cognitive decline. Cognitive factors may also influence performance with a CI. However, cognitive tests often assume perfect sensory perception, underestimating performance in individuals with hearing loss. The purpose of this study is to determine how CI listeners perform on a cognitive battery when accommodations for hearing loss are provided. Twenty-eight older adults with CIs completed a neuropsychological test battery created by an interdisciplinary team which assessed six cognitive domains and included accommodations for hearing loss. Participants also completed sentence recognition tests in quiet and in noise, and several subjective questionnaires. Preliminary data revealed that the performance of CI listeners with accommodations on tests of processing speed (p < 0.001) and visuospatial ability (p = 0.002) was significantly poorer compared to the normative sample. Performance on measures assessing memory, executive function, attention, and language was not significantly different. In conclusion, when neuropsychological test instructions and stimuli are adapted for hearing loss and functional speech performance is accounted for, individuals with CIs perform similarly to normal-hearing peers but not in all domains, suggesting a more accurate assessment of cognitive functioning.

Abstract P504: Prospective Associations of Midlife C3, C4 and Their Changes Since Midlife With Future Cognitive Performance: The Study of Women’s Health Across the Nation HDL Ancillary Study

Objective: Almost two-thirds of Americans over 65 with Alzheimer’s disease (AD) are women. The menopause transition is characterized by a systemic inflammatory state which increases atherosclerosis risk predisposing to dementia. Complement system was inappropriately activated in the brain of AD patients, which may contribute to local inflammation correlated with cognitive dysfunction. Complement factor 3 (C3) and 4 (C4) are the most clinically used complement components. Increased serum C3 and the presence of C4 null genes producing less C4 are risk factors of cardiovascular disease (CVD), indicating the necessity of analyzing the ratio of C3 and C4. Since serum C3 and C4 markedly increase over the menopause transition, we aimed to assess the associations of midlife C3, C4, and C3/C4 ratio and their changes since midlife with future cognitive function in women. Design: Repeated measures of serum C3, C4, and measures of working memory (digit span backward test), processing speed (symbol digit modality test), episodic memory immediate and delayed recall (East Boston memory test) were evaluated among midlife women traversing menopause. Mixed effect models were applied to assess the associations. Results: We included 305 women (706 observations) with mean age of 51 (SD=3) and 72% of them being pre- or perimenopausal at baseline. C3 and C4 were measured a median of 1.07 (Q1: 0.94, Q3: 1.81) years before cognitive performance assessment. In final models, higher C4 measured at midlife (baseline) was associated with better future episodic memory levels, and higher midlife C3/C4 ratio was associated with worse future episodic memory ( Table ). Changes in the complement factors were not associated with cognitive measures. Conclusion: Among women, higher midlife C4 and lower midlife C3/C4 ratio, but not changes in C4 or C3/C4 ratio since midlife, were associated with better future episodic memory levels. Midlife complement protein levels could be early markers of cognitive impairment known to be linked with CVD.

Corneal nerve loss predicts dementia in patients with mild cognitive impairment.

This study compared the utility of corneal nerve measures with brain volumetry for predicting progression to dementia in individuals with mild cognitive impairment (MCI). Participants with no cognitive impairment (NCI) and MCI underwent assessment of cognitive function, brain volumetry of thirteen brain structures, including the hippocampus and corneal confocal microscopy (CCM). Participants with MCI were followed up in the clinic to identify progression to dementia. Of 107 participants with MCI aged 68.4 ± 7.7 years, 33 (30.8%) progressed to dementia over 2.6-years offollow-up. Compared to participants with NCI (n=12), participants who remained with MCI (n=74) or progressed to dementia had lower cornealnerve measures (p < 0.0001). Progressors had lower cornealnerve measures, hippocampal, and whole brain volume (all p < 0.0001).However, CCM had a higher prognostic accuracy (72%-75% vs 68%-69%) for identifying individuals who progressed to dementia compared to hippocampus and whole brain volume. The adjusted odds ratio for progression to dementia was 6.1 (95% CI: 1.6-23.8) and 4.1 (95% CI: 1.2-14.2) higher with abnormal CCM measures, but was not significant for abnormal brain volume. Abnormal CCM measures have a higher prognostic accuracy than brain volumetry for predicting progression from MCI to dementia.Further work isrequiredto validate the predictive ability of CCM compared to other established biomarkers of dementia.

Mind the Mood: Momentary Depression and Anxiety Moderate the Correspondence Between Subjective and Objective Cognitive Functioning in Fibromyalgia.

Subjective cognitive dysfunction (SCD) affects 55-75% of individuals with fibromyalgia (FM), but those reporting cognitive difficulties often lack corresponding objective deficits. Symptoms of depression and anxiety are prevalent in FM and may account for part of this discrepancy. This study was undertaken to investigate whether momentary (within-day, across 7 days) changes in mood moderate the relationship between within-the-moment SCD and mental processing speed performance. A total of 50 individuals with FM (mean age 44.8 years, mean education 15.7 years, 88% female, 86% White) completed momentary assessments of subjective cognitive functioning, depressive and anxious symptoms, and a test of processing speed. Assessments were completed 5 times per day for 8 consecutive days on a study-specific smartphone application. Momentary ratings of SCD were positively associated with mean reaction time (P <0.001) and variability of processing speed (P=0.02). Depressive symptoms moderated the relationship between SCD and processing speed, with lower correspondence when depressive symptoms were higher (P=0.03). A similar moderating effect was demonstrated for both depression (P=0.02) and anxiety (P=0.03) on the association between SCD and variability in processing speed performance. Individuals with FM may have more accurate self-perception of momentary changes in mental processing speed during periods of less pronounced mood symptoms based on their corresponding objective processing speed performance. However, during moments of heightened depression and anxiety, we found increasingly less correspondence between SCD and objective performance, suggesting that psychological symptoms may play an important role in self-perception of cognitive dysfunction in FM as it relates to mental processing speed.

Clinical and Demographic Determinants of Cognitive Disorders in Multiple Sclerosis Patients

Multiple sclerosis (MS) is a chronic, inflammatory, (auto) immune disease of the central nervous system (CNS). The aim of the study was to determine the distribution of cognitive disorders in MS in relation to demographic parameters, degree of clinical disability and depression. The prospective study included 135 subjects with MS in the Clinic of Neurology of the University Clinical Center in Tuzla. The first group consisted of women (101 respondents) and the second of men (34 respondents). Clinical assessment instruments were: Expanded Disability Status Scale Score, Mini Mental Status, Beck Depression Scale, Battery of Cognitive Function Assessment Tests: Wechsler Intelligence Scale, Revised Beta Test, Raven Coloured Progressive Matrix, Wechsler Memory Verification Scale, Audio Memory Test learning, Rey-Osterriecht complex character test, verbal fluency test. There were no significant differences between the mentioned groups in age, level of education, duration of the disease, severity of disease symptoms or in the prevalence of certain forms of MS. Cognitive disorders are present in 40-60 % of subjects with MS. Visuospatial, visuoconstructive, visuoperceptive functions, mnestic functions were most affected in both groups of respondents. There was no difference in the level of depression in relation to sex. Poor results of cognitive parameters in 32.7 % can be considered the cause of high scores of EDSS in female patients and in 29.2 % in patients, which is not statistically significant. The correlation between depression and EDSS is positive but not statistically significant in both sexes. Cognitive disorders are heterogeneous regardless of sex. Cognitive impairment in MS patients is related to impairment of working ability and memory, executive functions and attention. Subjects with a more severe degree of clinical disability had poorer cognitive functions.

Cross-Cultural Adaptation and Validation of the Serbian Version of the Brief Assessment of Cognition in Schizophrenia Scale.

The Brief Assessment of Cognition in Schizophrenia (BACS) scale was developed for the assessment of cognitive function in patients with schizophrenia. The objective of this study was to cross-culturally adapt and validate the BACS in to the Serbian language. The study was conducted at the Laza Lazarevic Clinic for Mental Disorders and the Clinic for Psychiatry of the University Clinical Center of Serbia from March 2021 to January 2022. The study enrolled 61 inpatients diagnosed with schizophrenia and 61 healthy controls matched for age and sex. Compared with the healthy control group, the schizophrenia patient group had worse cognitive function in all dimensions measured using BACS (p < 0.001 for all measures). The mean standardized composite BACS score was z = -2.46, and symbol coding (z = -2.54) was the most deficient function. Principal component analysis suggests a two-factor structure, where the first factor consisted of loading the measures of verbal and working memory, attention, speed of information processing, and executive function, while the second factor regarded the loading of motor speed. Cronbach's alpha coefficient demonstrated an excellent level of internal consistency (0.798). These outcomes suggest that the Serbian BACS neurocognitive battery's psychometric properties are satisfactory, with good overall discriminant validity and high internal consistency. The Serbian BACS appears to be a quick and reliable neuropsychological instrument for evaluating global cognition in schizophrenia patients in Serbia.

Efficacy of a combination of non-drug therapies in patients with non-dementia vascular cognitive impairment

Objective : to study the effectiveness of a combination of non-drug methods in the treatment of non-dementia cognitive impairment of vascular etiology. Material and methods . The study involved 60 patients with moderate cognitive impairment of vascular etiology. The patients were divided into two groups: group 1 (n=30, mean age 63.7±8.8 years) received a combination of non-drug methods in the form of cognitive training, physical activity and meal planning for 1 month; patients of the 2nd group (n=30, mean age 64.2±10.7 years) were once informed about the advisability of a healthy diet and maintenance of mental and physical activity. Neuropsychological testing was done at the inclusion stage of the study, immediately after 1 month course of treatment, 6 months and a year after the start of the study. There were no significant differences between the groups in terms of cognitive functions at baseline. Results . After a month of treatment, in the 1st group the results of neuropsychological testing significantly (p&lt;0.05) improved compared to the first visit: Montreal Cognitive Function Assessment Scale (MoCA-test) – from 22.5±2.4 to 23.7±2.8, Trail making test part A – from 56.9±20.1, up to 49.3±21.7; Trail making test part B – from 116.8±47.8 to 93.5±36.3; the Digit Symbol Substitution test (DSST) scores increased from 26.6±9.0 to 28.8±9.0. Categorical and literal fluency increased from 14.9±4.1 to 16.5±4.6 and from 10.0±1.7 to 11.6±1.9, respectively. In the 2nd group, 1 month after the start of the study, there were no significant differences from the baseline in neuropsychological tests. Differences between the groups at the second visit were statistically significant (p&lt;0.05) according to the MoCA test, Trail making tests (parts A, B), DSST, and association tests. Significant differences between groups persisted during the first 6 months, but disappeared after 12 months of follow-up. Conclusion . Multimodal non-drug therapy in patients with moderate cognitive impairment of vascular etiology improves the main cognitive parameters.

Incremental validity of brief and abbreviated neuropsychological tests toward predicting functional outcomes in multiple sclerosis

Objective This study examined the relationships among functional outcomes and performance on standard-length and abbreviated cognitive screening measures for multiple sclerosis (MS). Method 72 adults with MS underwent neurological examination and cognitive screening. They completed standard-length and abbreviated versions of tests from the Minimal Assessment of Cognitive Function in MS (MACFIMS), the abbreviated aMACFIMS, and the Brief International Cognitive Assessment for MS (BICAMS). Functional outcomes included neurological disability, physical and psychological dysfunction, and employment status. Results Concordance of impairment classifications was examined between standard-length and abbreviated tests using logistic regression and ROC curve analyses. Overall, the abbreviated test versions showed a broad range of concordance with impairment classifications made using the full-length tests. Processing speed was the strongest correlate of neurological disability and employment status; immediate recall was the strongest predictor of subjective physical dysfunction. Test performance provided unique value toward predicting neurological disability and employment status, but not physical and psychological dysfunction. Conclusions The findings replicate some support for abbreviated tests in MS assessment, although caveats regarding loss of validity associated with abbreviation remain. The findings extend prior research showing that abbreviated tests of processing speed and immediate recall can provide unique predictive information regarding objective functional outcomes.

Neuropsychiatric Status of Patients With Multiple Sclerosis Across Disease Duration Intervals.

The neuropsychiatric sequelae of multiple sclerosis (MS) are important predictors of morbidity and mortality. The authors examined how symptoms of depression, anxiety, fatigue, subjective cognitive impairment, and objective cognitive dysfunction varied with disease duration. They also explored changes in the use of disease-modifying therapies, psychotropic medications, and psychotherapies in relation to disease duration. A retrospective sample of 464 people with MS was stratified into three groups based on disease duration: <5 years (N=129), 5-10 years (N=101), and >10 years (N=234). Symptoms of depression and anxiety were recorded with the Hospital Anxiety and Depression Scale (HADS); fatigue, with the five-item version of the Modified Fatigue Impact Scale (MFIS-5); subjective cognitive impairment, with the five-item version of the Perceived Deficits Questionnaire (PDQ-5); and cognition, with the Minimal Assessment of Cognitive Function in MS (MACFIMS). There were between-group differences in anxiety symptoms (p<0.01) and degree of cognitive impairment (p=0.03), but there were no differences in depressive symptoms, fatigue, or subjective cognitive difficulties. Anxiety was higher during the first 5 years after diagnosis, and cognitive dysfunction was higher when assessed more than 10 years after diagnosis. With longer disease duration, a greater proportion of participants received psychotropic medications (p<0.01), and lower proportions received disease-modifying therapies (p<0.01) or psychotherapies (p<0.01). Findings indicated that rates of some neuropsychiatric symptoms, such as anxiety and cognitive dysfunction, may shift with disease duration, whereas other symptoms, such as fatigue and depression, may not. These findings highlight the importance of closely monitoring the mental state of people with MS over time.

Personalized Computerized Training for Cognitive Dysfunction after COVID-19: A Before-and-After Feasibility Pilot Study.

The current pilot study was set to evaluate the feasibility and potential benefit of a personalized computerized cognitive training (CCT) intervention to improve cognitive function among people living with post-acute sequelae of COVID-19 (PASC). Seventy three adults who self-reported cognitive dysfunction more than 3 months after a diagnosis of COVID-19 took part in an 8-week training study. Participants' general cognitive function was assessed before they completed as many cognitive daily training sessions as they wished during an 8-week period, using a personalized CCT application at home. At the end of this period, participants repeated the general cognitive function assessment. The differences between the scores at 8 weeks and baseline in five cognitive domains (attention, memory, coordination, perception, reasoning), complemented with analyses of the changes based on the participants' age, training time, self-reported health level at baseline and time since the initial COVID-19 infection. Participants had significant cognitive dysfunction and self-reported negative health levels at baseline. Most of the participants obtained higher scores after CCT in each of the domains as compared with baseline. The magnitude of this score increase was high across domains. It is concluded that a self-administered CCT based on gamified cognitive tasks could be an effective way to ameliorate cognitive dysfunction in persons with PASC. The ClinicalTrials.gov identifier is NCT05571852.

Correlation of Brain-Derived Neurotrophin Factor Levels in Epilepsy Patients Treated with Valproic Acid and Phenytoin with Cognitive Function

BACKGROUND: Epilepsy cases requiring OAE multitherapy are found in 40% of total epilepsy cases. Many epilepsy patients are referred to Dr. Kariadi Hospital Semarang because of the occurrence of intractable epilepsy. Valproic acid is one of the OAEs that are widely used in the BPJS era in Indonesia as a combination of phenytoin. Seizures increase the expression of BDNF mRNA and protein. METHODS: This study is a cross-sectional study that took place from January to May 2022. The subjects of this study were epilepsy patients who used a combination of phenytoin-valproic acid who met the inclusion criteria. Patient data were obtained from medical records and filling out questionnaires. Patients were asked to fast for ± 8−10 h. Furthermore, blood sampling (±5 ml) of BDNF was carried out at 08.00−10.00 WIB. Cognitive function assessments were performed using MoCA-Ina and the Hamilton depression rating scale at the same time. Data were analyzed by Spearman correlation test and partial correlation test. The results are said to be meaningful if p &lt; 0.05. RESULTS: Thirty-two study subjects used a combination of phenytoin-valproic acid. The Spearman correlation test between the relationship between BDNF levels and cognitive function in epilepsy patients treated with valproic acid and phenytoin showed a significant relationship with the direction and strength of which was strongly positive (r = 0.676 and p ≤ 0.001). The partial correlation test between the relationship between BDNF levels and cognitive function after controlling for age (r = 0.692), seizure frequency (r = 0.641), duration of combination therapy (r = 0.700), and age of seizure onset (r = 0.693) remained the same, while after controlling for the level of education (r = 0.812) and the type of seizure (r = 0.747) increased. CONCLUSION: There is a strong correlation between BDNF levels and cognitive function in epilepsy patients treated with valproic acid and phenytoin. The relationship between BDNF levels and cognitive function remained the same after controlling for age, frequency of seizures, duration of combination therapy, and age of onset of epilepsy.

Efficacy, Safety, and Health-Related Quality of Life With Camrelizumab Plus Pemetrexed and Carboplatin as First-Line Treatment for Advanced Nonsquamous NSCLC With Brain Metastases (CAP-BRAIN): A Multicenter, Open-Label, Single-Arm, Phase 2 Study

IntroductionSystemic treatment options for NSCLC with brain metastases (BMs) are scarce. We evaluated the activity and safety of camrelizumab plus chemotherapy as first-line therapy in patients with advanced nonsquamous NSCLC with BMs. MethodsThis was a multicenter, single-arm, phase 2 trial (NCT04211090) conducted at seven hospitals in China. Eligible patients had treatment-naive metastatic nonsquamous NSCLC and BMs that were asymptomatic or symptoms controlled with dehydration therapy and no previous systemic treatment or local therapy for the target brain lesion. Patients received camrelizumab (200 mg) plus pemetrexed (500 mg/m2) and carboplatin (area under the curve 5) intravenously on day 1 of each 21-day cycle for four cycles, followed by maintenance with camrelizumab (200 mg) and pemetrexed (500 mg/m2) every 21 days until disease progression, unacceptable toxicity, or death. The primary end point was confirmed intracranial objective response rate according to modified Response Evaluation Criteria in Solid Tumors version 1.1, which was primarily analyzed in the efficacy analysis set (EAS). ResultsA total of 45 patients were enrolled and treated (full analysis set), with 40 patients having at least one post-baseline tumor assessment (EAS). As of August 30, 2022, median follow-up duration was 12.5 months (95% confidence interval [CI]: 9.2–17.3). The confirmed intracranial objective response rate was 52.5% (95% CI: 36.1–68.5) in EAS and 46.7% (95% CI: 31.7–62.1) in full analysis set. The extracranial objective response rate was 47.5% (95% CI: 31.5–63.9) and 42.2% (95% CI: 27.7–57.8), respectively. Median intracranial progression-free survival was 7.6 months (95% CI: 4.6–not reached [NR]), median overall progression-free survival was 7.4 months (95% CI: 4.4–NR), and median overall survival was 21.0 months (95% CI: 15.9–NR). The most common treatment-related adverse events of grade 3 or higher were neutrophil count decrease (six [13.3%]) and anemia (four [8.9%]). One treatment-related death occurred owing to immune-related pneumonia. Linear mixed-effects model displayed that a positive trend for improvement in cognitive function and quality of life was observed based on Montreal Cognitive Assessment and Functional Assessment of Cancer Therapy—Lung scores (p = 0.025, p < 0.001). ConclusionsCamrelizumab plus pemetrexed and carboplatin was found to have an activity with manageable toxicity and to improve cognitive function and quality of life for patients with nonsquamous NSCLC with BMs in the first-line setting.

Measured and Perceived Exercise Intensity During the Performance of Single-Task, Cognitive-Motor Dual-Task, and Exergame Training: Transversal Study

The physical and cognitive loads borne during exergaming may differ from more conventional cognitive-motor dual-task trainings. The aim of this pilot transversal study was to compare objectively measured and perceived exercise intensity during exergame, cognitive-motor dual-task, and single-task training sessions. We recruited apparently healthy young adults who carried out one session of each type of training: exergaming, cognitive-motor dual-tasking, and single-tasking. We used a custom-made exergame as support. The sessions lasted 30 minutes, were spaced at least 24 hours apart, and took place in random order for each group of 4 participants. We used heart rates to assess exercise intensity and the modified Borg scale to assess perception of intensity. In all, 16 apparently healthy young participants carried out all sessions. There was no difference between the different types of training in mean heart rates (P=.27), peak heart rates (P=.50), or Borg scale scores (P=.40). Our custom-made exergame's objectively measured and perceived physical load did not differ between cognitive-motor dual-task and single-task training. As a result, our exergame can be considered to be as challenging as more traditional physical training. Future studies should be conducted in older adults with or without cognitive impairments and incorporate an assessment of cognitive performance.

In multiple sclerosis, a Functional Independence Measure ≥ 107 is the best predictor of outcome after clean intermittent catheterization training.

Assessment of motor and cognitive functions is recommended before clean intermittent catheterization training. Two validated instruments, the Functional Independence Measure (FIM) and the Pencil and Paper Test (PP-Test), are associated with the ability to learn self-catheterization in people with multiple sclerosis. We aimed to compare the performance of these tools in predicting the outcome of clean intermittent catheterization training in multiple sclerosis. All people with multiple sclerosis attending a tertiary neuro-urology department between 2011 and 2019 and eligible for clean intermittent catheterization were included in this retrospective study. The reference standard was the ability to perform at least 2 trials of self-catheterization at the end of the training session. The 2 index tests, the FIM and PP-Test, were administered before the teaching session. Their diagnostic performance was estimated by calculating sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). The AUC values were compared by a two-sided DeLong test. We included 395 individuals (mean [SD] age 49.8 [12] years; 70% women). At the end of the session, 87% of the patients succeeded in learning self-catheterization. The optimal cut-offs for the FIM (107) and PP-Test (13) were estimated, resulting in sensitivity of 73% (95% confidence interval [68-77) and 73% (67-77) and specificity 73% (59-84) and 63% (49-76), respectively. The AUC values for the FIM and PP-Test were significantly different (0.79vs 0.73, p=0.049). The effect size was large for both the FIM (Cohen's d=1.14) and PP-Test (Cohen's d=0.87). An FIM value ≥107 has the best specificity to predict outcome after clean intermittent catheterization training for people with multiple sclerosis. The sensitivity of the FIM and PP-Test is similar, and both have a large effect size for the outcome of self-catheterization training in multiple sclerosis.

Abstract WP57: Large-scale Reliability/Validity Assessments And Quantification Of Cognition Within The Imperial College Comprehensive Assessment For Cerebrovascular Disease (IC3): A Novel In-depth, Self-administered, Online Cognitive Tool

Background: Cognitive difficulties occur in up to 86% of acute stroke cases and persist in a third. There is a growing need for a scalable, cost-effective and in-depth assessment of cognitive function in patients, that enables longitudinal tracking of recovery and better understanding of predictors of long-term cognitive outcomes. This study aims to address this gap by presenting reliability and validity data on a novel self-administered online assessment tool that assesses cognition after stroke. Method: This self-administered web-based tool offers an in-depth cognitive profiling through 22 tasks spanning both domain-general (e.g. attention) and domain-specific deficits (e.g. memory, language, visual neglect), together with neuropsychiatric questionnaires. In light of these specifications, the battery has been named IC3 (Imperial College Comprehensive assessment for Cerebrovascular disease; https://ic3study.co.uk/ ) Results: We present results outlining the normative ranges for the assessment in 1000+ gender, age and education matched controls and in a modest sample of patients following stroke. Furthermore, we present results showcasing the reliability and validity of the assessment through specificity, sensitivity and test-retest analyses. Finally, we present a novel statistical approach that allows one to tease out motor-driven deficits during response selection, from true cognitive deficits, allowing for a more precise phenotyping of cognition in stroke. Conclusion: IC3 is the first assessment to offer in-depth unsupervised cognitive phenotyping of patients following stroke, while also allowing scalable and cost-efficient longitudinal monitoring. It fares well against various reliability/validation metrics and is able to capture cognition in a more precise and scalable manner than currently available assessments, making it an attractive tool for understanding the mechanisms of recovery in a plethora of vascular disorders.

Preliminary study of assessing cognitive impairment in older patients with chronic obstructive pulmonary disease by using a cognitive functional assessment tool via a touchscreen personal computer.

Unique cognitive impairments related to chronic obstructive pulmonary diseases (COPD) have been increasingly reported. Considering the dementia risk and medication management, older patients with COPD should be evaluated for cognitive impairment. This study aimed to examine whether specific cognitive impairments related to COPD could be detected by an assessment tool using a touchscreen personal computer (PC) in older patients with COPD. This study included 28 older male patients with COPD and 30 healthy older male individuals. A touchscreen PC-based cognitive assessment application called CogEvo was used to assess and compare the cognitive function according to five domains: spatial cognition, orientation, working memory, executive function, and attention. Analysis of variance showed an interaction effect on the indices of cognitive function based on five domains between the two groups, indicating differences in the characteristics of cognitive function in such groups. Betweengroup comparisons as a subtest showed that attention, executive function, and working memory were significantly lower in the COPD group than in the healthy group. CogEvo can detect specific cognitive impairments associated with COPD, suggesting that it can be potentially used as a screening tool for cognitive impairment in older patients with COPD.

Cognitive and Mood Effect of Alpha-Lipoic Acid Supplementation in a Nonclinical Elder Sample: An Open-Label Pilot Study.

Memory disorders are common among elder people, and nonclinical cognitive decline is commonly experienced with age. Preclinical investigations have explored the possible role of alpha-lipoic acid (ALA), a known antioxidant compound abundant in vegetables and animal tissues, in reducing oxidative stress in the aging brain and preventing cognitive decline. However, clinical evidence is limited, and the few existing results are contrasting. In addition, while most of the existing trials have been focused on the effects of ALA administration in Alzheimer's disease (AD) or other types of dementia, studies evaluating its effects on nonclinical elder population are still missing. In the present open-label, pilot study, fifteen elder patients (mean age: 84.5 ± 5.77) received ALA at a daily dose of 600 mg/day for 12 weeks. General cognitive function, executive function, and mood symptom assessment were carried out at baseline and at the endpoint. Overall, ALA administration was generally well-tolerated (only one dropout due to gastrointestinal side effects). However, no statistically significant effects either on cognitive function, executive function, or mood were found. Despite several limitations, our study found no evidence of positive effects on cognition and mood after ALA administration in elder people without the diagnosis of AD or cognitive impairment. Further clinical trials are needed to better investigate ALA effectiveness on cognition and mood in elder subjects.

Relationship between glycemic control and cognitive impairment: A systematic review and meta-analysis.

Diabetes mellitus, or hyperglycemia, is an independent risk factor for cognitive impairment. Here we systematically analyzed whether glycemic control could improve cognitive impairment in patients with diabetes mellitus (DM), hyperglycemia, or insulin resistance. Three databases (PubMed, EMBASE, and Cochrane Library) and ClinicalTrials.gov were searched for randomized controlled trials analyzing the relationship between glycemic control and cognitive function assessments, published from database inception to June 2022. Patients in experimental groups were treated with antidiabetic drugs, while control groups were treated with a placebo or alternative antidiabetic drugs. Data analysis was conducted using RevMan 5.3 and StataSE-64, and standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated. Thirteen studies comprising 19,314 participants were included. Analysis revealed that glycemic control significantly attenuated the degree of decline in cognitive function assessment scores (SMD = 0.15; 95% CI 0.05, 0.26; p < 0.00001), and funnel plots confirmed no publication bias. Seven studies used Mini-Mental State Examination as the primary cognitive function assessment, showing that glycemic control significantly delayed the degree of decline in cognitive function assessment scores (SMD = 0.18; 95% CI 0.03, 0.34; p = 0.02). Similar results were seen in two studies using the Montreal Cognitive Assessment scale, but without significant difference (SMD = 0.05; 95% CI-0.10, 0.21; p = 0.51). One study using Auditory Word Learning Test (AVLT) showed that glycemic control significantly delayed the decline in cognitive function assessment scores (SMD = 0.52; 95% CI 0.11,0.93; p = 0.01), and another used Wechsler Memory Scale Revised, showing similar results (SMD = 1.45; 95% CI 0.86, 2.04; p < 0.00001). Likewise, a study that used Modified Mini-Mental State scale showed that glycemic control significantly delayed the decline in cognitive function assessment scores (SMD = -0.10; 95% CI-0.16, -0.03; p = 0.005). Lastly, one study used AVLT subtests to show that glycemic control delayed the decline in cognitive function assessment scores, although not statistically significant (SMD = 0.09; 95% CI-0.53, 0.71; p = 0.78). Glycemic control through antidiabetic treatment correlates with the improvement of cognitive impairment in patients with DM, hyperglycemia or insulin resistance. However, further studies are needed to validate the results of this study. PROSPERO, identifier CRD42022342260.