Baseline Cognitive Functions Research Articles

Eye movements as predictor of cognitive improvement after cognitive remediation therapy in patients with schizophrenia.

Baseline cognitive functions of patients predicted the efficacy of cognitive remediation therapy (CRT), but results are mixed. Eye movement is a more objective and advanced assessment of cognitive functions than neuropsychological testing. We aimed to investigate the applicability of eye movements in predicting cognitive improvement after patients with schizophrenia were treated with CRT. We recruited 79 patients with schizophrenia to complete 8 weeks of CRT and assessed their cognitive improvement outcomes. Eye movements were assessed by prosaccades, antisaccades, and free-viewing tasks at baseline, and neuropsychological tests in four cognitive domains were assessed before and after treatment to calculate treatment outcomes. Predictors of demographic information, clinical characteristics, and eye movement measures at baseline on cognitive improvement outcomes were analyzed using logistic regression analysis. We further compared the predictive performance between eye movement measurements and neuropsychological test regarding the effect of CRT on cognitive improvement, and explored factors that could be affect the treatment outcomes in different cognitive domains. As operationally defined, 33 patients showed improved in cognition (improved group) and 46 patients did not (non-improved group) after CRT. Patients with schizophrenia being employed, lower directional error rate in antisaccade task, and lower the gap effect (i.e., the difference in saccadic latency between the gap condition and overlap condition) in prosaccade task at baseline predicted cognitive improvement in CRT. However, performance in the free-viewing task not associated with cognitive improvement in patients in CRT. Our results show that eye-movement prediction model predicted the effect of CRT on cognitive improvement in patients with schizophrenia better than neuropsychological prediction model in CRT. In addition, baseline eye-movements, cognitive reserve, antipsychotic medication dose, anticholinergic cognitive burden change, and number of training sessions were associated with improvements in four cognitive domains. Eye movements as a non-invasiveness, objective, and sensitive method of evaluating cognitive function, and combined saccadic measurements in pro- and anti-saccades tasks could be more beneficial than free-viewing task in predicting the effect of CRT on cognitive improvement in patients with schizophrenia.

Chanwuyi Lifestyle Medicine Program Improves Memory and Executive Functions of Older Adults With Mild Cognitive Impairment.

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.

A new approach for cognitive impairment pattern in chronic kidney disease.

Chronic kidney disease (CKD) is associated with an elevated risk of neurocognitive disorders (NCDs). It remains unclear whether CKD-related NCDs have a specific cognitive pattern or are earlier-onset phenotypes of the main NCDs (vascular NCDs and Alzheimer's disease). We used the Mini Mental State Examination score (MMSE) to assess cognitive patterns in 3003 CKD patients (stage 3-4) followed up over 5 years in the Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) cohort. After normalizing MMSE scores to a 0-to-100 scale, the associations between the baseline estimated glomerular filtration rate (eGFR, using the Chronic Kidney Disease Epidemiology Collaboration creatinine formula) and changes in each MMSE domain score were assessed in linear mixed models. Patients (age: 67±13years old; males: 65%, mean eGFR: 33± 12mL/min/1.73m2) had a good baseline cognitive functions: the mean MMSE score was 26.9/30±2.9. After adjustment for age, sex, educational level, depression (past or present), cardiovascular risk factors and cerebrovascular disease, a lower baseline eGFR (per 10mL/min/1.73m2) was associated with a 0.53-point decrement [P<.001; 95% confidence interval (CI) (-0.98, -0.08)] for orientation, a 1.04-point decrement [P=.03; 95% CI (-1.96, -0.13)] for attention and calculation, a 0.78-point decrement [P=.003; 95% CI (-1.30, -0.27)] for language, and a 0.94-point decrement [P=.02; 95% CI (-1.75, -0.13)] for praxis. Baseline eGFR was not, however, associated with significant changes over time in MMSE domain scores. A lower eGFR in CKD patients was associated with early impairments in certain cognitive domains: praxis, language and attention domains before an obvious cognitive decline. Early detection of NCD in CKD patients must be performed before clinically cognitive decline using preferably tests assessing executive, attentional functions and language, rather than memory tests. This early cognitive screening could lead to a better management of cognitive impairment and their consequences on CKD management.

A systematic review and meta-analysis of the effect of clozapine on cognitive functions in patients with treatment-resistant schizophrenia

BackgroundThis study aimed to conduct a systematic review and meta-analysis on cognitive performances of patients with treatment-resistant schizophrenia (TRS) after clozapine treatment and to examine the potential effect of follow-up duration and clozapine dosage. MethodsFive electronic databases were searched and studies were included if treatment-resistant schizophrenia patients were treated with clozapine and with baseline and follow-up cognitive functions assessments. Cognitive measures were categorised into six domains based on DSM-5-TR. Random-effect model analysis was used to pool the effect estimates. Moderator effects of clozapine dosage, follow up duration, duration of illness, age, years of education and change in positive symptoms severity were examined with meta-regression. FindingsNineteen articles were included with 50 cognitive measures reported. Systematic review found inconsistent results. Twelve cognitive measures were included for meta-analysis and found overall improvement of cognitive performances after clozapine treatment SMD = 0.11 [95 % CI 0.02, 0.20] (p = 0.021). Patients with younger age, more years of education and improvements in positive symptoms are more likely to improve in cognitive performances. Subgroup analysis found significant improvement in studies with follow-up periods of 6-months or longer but not for studies with shorter follow-up periods. ConclusionClozapine may improve some domains of cognitive function, particularly over a longer period. However, the overall inconsistent results suggest that more studies with larger sample size and standard cognitive function assessments would be needed to enhance our understanding of the impact of clozapine on the cognitive functions in the TRS patients.

Longitudinal changes of cognitive function and its relationship with subdomains of negative symptoms in patients with adult-onset first-episode schizophrenia: A 4-year follow up study

BackgroundsThis study explores the longitudinal changes and trajectories of cognitive functions in patients with adult-onset first-episode schizophrenia (FES) over four years and their relationships with the baseline subdomains of negative symptoms. MethodsA total of 177 patients of age 25–55 with FES were recruited. Baseline demographics, clinical, social and cognitive functions were assessed. Diminished expression and diminished motivation of negative symptoms were assessed with Scale for the Assessment of Negative Symptoms (SANS). Patients had yearly follow-up of cognitive function assessments over four years. Latent class growth analysis (LCGA) and mixed linear regression model were used to explore the longitudinal changes of cognitive functions and the effect of baseline negative symptoms on the longitudinal cognitive function changes. Relationships of baseline negative symptoms subdomains and cognitive functions were also explored. ResultsTwo trajectories of cognitive functions were identified. Longitudinal improvements were found in most cognitive functions apart from the logical memory. One trajectory of patients had significant deterioration of logical memory while the other group had significant improvement. Baseline diminished expression was associated with baseline and longitudinal changes of processing speed and verbal fluency while diminished motivation was associated with baseline and longitudinal changes of processing speed. ConclusionsAdult-onset FES patients had a homogeneous longitudinal improvement in most cognitive functions but not for logical memory suggesting the unique nature of verbal memory. The distinct relationship between baseline subdomains of negative symptoms with baseline and longitudinal cognitive functions suggesting the presence of differential overlapping etiology between negative symptom subdomains and cognitive functions.

Abstract TMP84: Baseline Cerebral Blood Flow Association With Cognitive Functions: Prospective Cohort Study.

Introduction: Carotid occlusive disease is reported to impact cognitive function. Reduced cerebral blood flow is considered a culprit in carotid disease-related cognitive impairment. However, the association is not consistent. Aim: To investigate the relationship between baseline cerebral blood flow (BCBF) and cognitive functions in a well-defined cohort of patients with severe occlusive extracranial carotid disease. Methods: Patients undergoing carotid intervention for occlusive diseases were prospectively recruited from two academic institutions. All patients received neurocognitive testing and MRI scanning pre-intervention. For neurocognitive testing, raw scores were normalized against age, education, and standard scores as appropriate. The cognitive domain-specific normalized scores were derived using principal component analysis. Univariate and multiple linear regression models were fitted to evaluate predictors of various cognitive domains including memory, executive function and language. Variables with P&lt;0.1 in the univariate analysis were included in the multiple models. Results: A total of 140 patients were included in our analysis. Most patients were males (96%) with a mean age of 69.9 years. Almost half of the cohort (50.8%) were symptomatic. Most patients were smokers (78.1%) and hypertensive (86.4%). Diabetes was prevalent (39.4%). In the multiple regression model, BCBF was independently associated with Trail Making Test (TMT) [regression coefficient(B)=-0.015, Standard Error (SE):0.008, p=0.04]. Other significant predictors of TMT were prior stroke and diabetes. BCBF was also associated with scores on the Stroop test (B=0.023, SE=0.009), albeit nonsignificant, in the multiple regression model (P=0.06). Age, renal insufficiency, and prior stroke were independently associated with Stroop test, p&lt;0.5. Conclusion: Our study showed an association between BCBF and baseline executive function measured by TMT in patients with severe carotid occlusive disease. BCBF was also associated with Stroop test in a trend that did not reach statistical significance. Inconsistency in the association between CBF and cognitive function may be due to diverse cognitive measures and patient-related comorbidities.

Predictive value of baseline cognitive functioning on health-related quality of life in individuals with coronary artery disease: a 5-year longitudinal study.

Emerging studies suggest an association exists between coronary artery disease (CAD) and the development of neurodegenerative diseases, with CAD acting as a precursor. Our study aimed to investigate the relationship between baseline measures of cognitive functioning and long-term health-related quality of life (HRQoL) in individuals with CAD with specification to Type D personality traits and sex. This prospective observational cohort study consisted of 864 participants (mean age 58 SD = 9 years, 74.0% men) with CAD after acute coronary syndrome. Baseline characteristics included comprehensive cognitive testing, measures of sociodemographic and clinical factors, and psychological assessment scales, such as Type D personality scale and the Hospital Anxiety and Depression scale. The Minnesota Living with Heart Failure Questionnaire assessed participants' HRQoL, conducted through phone interviews at baseline, every 6 months for up to 2 years, and after 5 years. Cognitive functioning correlated with HRQoL at all time intervals over the 5-year follow-up. Regarding sex and Type D personality, significant differences emerged in associations between impaired cognitive functioning at baseline and HRQoL measured over the period of 5 years. Men participants with characteristics of Type D personality were especially vulnerable to impaired cognitive functioning affecting the 5-year quality of life. Men with CAD who obtained scores indicating characteristics of Type D personality were significantly more likely to have lower baseline cognitive functions and long-term HRQoL outcomes. This information could inform healthcare practitioners to screen for personality characteristics and closely follow-up those at a greater risk.

Sodium nitroprusside treatment for psychotic symptoms and cognitive deficits of schizophrenia: A randomized, double-blind, placebo-controlled trial

Schizophrenia presents with a broad range of negative, positive, and cognitive symptoms, and comprehensive treatment is still a challenge. Sodium nitroprusside (SNP) has been reported to rapidly reduce psychotic symptoms and improve cognitive functions in patients with schizophrenia, providing a new possible direction for treatment. In this study, we tested whether SNP can improve psychotic symptoms and cognitive function in schizophrenia patients with longer disease history. This was a randomized, double-blind, placebo-controlled trial conducted between May 2016 and April 2017. Forty-two schizophrenia patients aged 18–45 years were recruited from Henan Province Mental Hospital. Baseline psychiatric symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), and baseline cognitive functions were measured using the Wechsler Adult Intelligence Scale. Patients received two SNP or placebo infusions (0.5 μg/kg per min for 4 h) at a one-week interval. We reassessed psychiatric symptoms and cognitive functions using the same tests shortly after the first and second infusions and 4 weeks after the second infusion. We did not find any significant effect of SNP over placebo on psychotic symptoms or cognitive functions, although SNP was relatively well tolerated with a good safety profile.

A longitudinal study of computerized cognitive training in stroke patients – effects on cognitive function and white matter

ABSTRACTBackground Computerized cognitive training is suggested to enhance attention and working memory functioning following stroke, but effects on brain and behavior are not sufficiently studied and longitudinal studies assessing brain and behavior relationships are scarce.Objective The study objectives were to investigate relations between neuropsychological performance post-stroke and white matter microstructure measures derived from diffusion tensor imaging (DTI), including changes after 6 weeks of working memory training.Methods In this experimental training study, 26 stroke patients underwent DTI and neuropsychological tests at 3 time points – before and after a passive phase of 6 weeks, and again after 6 weeks of working memory training (Cogmed QM). Fractional anisotropy (FA) was extracted from stroke-free brain areas to assess the white matter microstructure. Twenty-two participants completed the majority of training (≥18/25 sessions) and were entered into longitudinal analyses.Results Significant correlations between FA and baseline cognitive functions were observed (r = 0.58, p = 0.004), however, no evidence was found of generally improved cognitive functions following training or of changes in white matter microstructure.Conclusions While white matter microstructure related to baseline cognitive function in stroke patients, the study revealed no effect on cognitive functions or microstructural changes in white matter in relation to computerized working memory training.

The Effects of Cortical Hypometabolism and Hippocampal Atrophy on Clinical Trajectories in Mild Cognitive Impairment with Suspected Non-Alzheimer's Pathology: A Brief Report.

The clinical and structural trajectories of suspected non-Alzheimer' pathology (SNAP) remain elusive due to its heterogeneous etiology. Baseline and longitudinal clinical (global cognition, daily functioning, symptoms of dementia, and learning memory) and hippocampal volume trajectories over two years were compared between patients with amnestic mild cognitive impairment (aMCI) with SNAP with reduced hippocampal volumes (SNAP+HIPPO) and aMCI patients with SNAP without reduced hippocampal volumes. SNAP+HIPPO showed overall worse baseline cognitive functions. Longitudinally, SNAP+HIPPO showed faster deterioration of clinical symptoms of dementia. Having both hippocampal atrophy and cortical hypometabolism without amyloid pathology may exacerbate symptoms of dementia in aMCI.

Clinical Benefits of Memantine Treatment for Alzheimer's Disease in the Okayama Memantine Study II (OMS II).

The clinical benefits of memantine, depending on the baseline cognitive and affective conditions in real world dementia clinics, have not been completely examined. We performed the "Okayama Memantine Study II (OMS II)" to retrospectively evaluate the clinical effects of memantine monotherapy (n = 38) in Alzheimer's disease (AD) patients using seven batteries to assess dementia at the baseline, at 3, 6, and 12 months. Additionally, we divided 163 AD patients treated with memantine into two subgroups depending on the baseline cognitive score of the Mini-Mental State Examination (MMSE): the MMSE <15 group (n = 36) and the baseline MMSE ≥15 group (n = 127). We also analyzed 71 AD patients based on the baseline behavioral and psychological symptoms of dementia (BPSD) severity using Abe's BPSD score (ABS). Memantine monotherapy maintained cognitive functions until 6 months of treatment, but showed a decrease at 12 months (*p < 0.05 versus baseline). However, memantine monotherapy greatly improved BPSD symptoms until 12 months (*p < 0.05, **p < 0.01) and maintained other affective functions as well as the activity of daily living. Memantine treatment showed similar effects, regardless of the baseline cognitive functions, but showed better effects on ABS for higher baseline cognitive functions. Memantine treatment greatly improved ABS depending on baseline BPSD severity. Our present OMS II showed that memantine monotherapy improved BPSD until 12 months. The higher baseline cognitive subgroup (MMSE ≥15) and the worse baseline BPSD subgroup were expected to show better effects with memantine.

Baseline cognitive functions among elderly patients with localised breast cancer

PurposeCognitive deficits (CD) are reported among cancer patients receiving chemotherapy, but may also be observed before treatment. Though elderly patients are expected to be more prone to present age-related CD, poor information is available regarding the impact of cancer and chemotherapy on this population. This study assessed baseline cognitive functions (before adjuvant treatment) in elderly early stage breast cancer (EBC) patients. MethodsWomen >65years-old with newly diagnosed EBC were included in this prospective study. Episodic memory, working memory, executive functions and information processing speed were assessed by neuropsychological tests. Questionnaires were used to assess subjective CD, anxiety, depression, fatigue, quality of life and geriatric profile. Objective CD were defined using International Cognition and Cancer Task Force criteria. A group of elderly women without cancer coupled with published data related to healthy women were used for comparison (respectively to subjective and objective CD). ResultsAmong the 123 elderly EBC patients (70±4years) included, 41% presented objective CD, which is greater than expected in healthy population norms (binomial test P<.0001). Verbal episodic memory was mainly impaired (21% of patients). No correlation was observed between objective CD and cancer stage or geriatric assessment. Subjective CD only correlated with verbal episodic memory (P=.01). ConclusionsThis is the first large series assessing baseline cognitive functions in elderly EBC patients. More than 40% presented objective CD before any adjuvant therapy, which is higher than what is reported among younger patients. Our results reinforce the hypothesis that age is a risk factor for CD in EBC patients.

Baseline cognitive functions among elderly patients with localized breast cancer.

9510 Background: Cognitive deficits (CD) were reported among patients receiving chemotherapy (CT) for cancer, but could also be observed before treatment. Elderly patients were poorly studied although they are more prone to present age-related CD and CD onset or enhancement during CT. This study assessed baseline cognitive functions among elderly localized breast cancer (LBC) patients before adjuvant treatment therapy. Methods: Episodic memory, working memory, executive functions and information processing speed were assessed with neuropsychological tests. Validated questionnaires were used to assess subjective CD, anxiety, depression and fatigue before adjuvant treatment. Geriatric assessment was also realized. Objective CD were defined as a score less than 1.5 standard deviation (SD) of normative data on &gt;2 tests, or less than two SDs on &gt;1 test. Significant subjective CD (evaluated by the FACT-Cog) were defined when the 4 subscales below the first tercile distribution. Results: Results concern 123 elderly LBC (71±4 years): planned treatment included CT and radiotherapy (RT) for 61 patients and RT only for 62 patients. Characteristics are as follows: mastectomy (28%), stage (I: 60%, II: 27%, III: 13%), positive hormonal receptor (88%) and positive Her2 (17%). Before any adjuvant treatment, objective CD were observed in 40% of patients (46% in CT group, episodic memory mainly impaired and 37% in RT group, executive functions and information processing speed mainly impaired). No relation was observed between cancer stage, geriatric frailty and objective CD. Twenty nine percents of patients presented fatigue, 6% anxiety and 10% depression. These variables were not related to objective CD but they were related to subjective CD. Conclusions: More than 40% of elderly LBC patients presented objective CD before any adjuvant therapy that is higher than observed among younger patients. It is important to take account in the decision making of adjuvant treatment in elderly patients. Clinical trial information: NCT01333735.

Neural correlates of executive functions in healthy G2019S LRRK2 mutation carriers

IntroductionThe G2019S mutation in the leucine rich repeat kinase 2 (LRRK2) gene is prevalent among Ashkenazi Jewish patients with Parkinson's disease (PD). Cognitive deficits are common in early stage PD. We aimed to characterize the effect of the G2019S mutation on neural mechanisms of executive function processing by testing whether healthy mutation carriers who are an “at risk” population for the future development of PD differed from non-carriers on an functional magnetic resonance imaging (fMRI) Stroop interference task. MethodsCognitive performance and task related cerebral activity were measured in 40 healthy first-degree relatives of Ashkenazi PD patients (19 carriers and 21 non-carriers of the G2019S mutation). Both regional differences in neural activity and seed region driven functional connectivity methods were performed using fMRI. ResultsCompared to non-carriers, mutation carriers had greater baseline deactivation and increased task related activity in the right inferior parietal lobe, right precuneus and right fusiform gyrus. Whole brain functional connectivity analysis revealed stronger coupling between these regions and both basal ganglia structures as well as cortical regions in the carrier group. Non-manifesting G2019S mutation carriers and non-carriers performed similarly on the task and on all other assessed measures, so behavioral differences in task performance and baseline cognitive functions cannot explain the observed imaging differences. ConclusionsG2019S carriers, at risk for developing PD, had similar behavioral performance as non-carriers during the Stroop task, but increased activity in brain regions that have previously been found to be part of the ventral attention system together with stronger coupling between task related areas and structures that make up the ventral and dorsal attention system as well as the basal ganglia-thalamocortical network. This suggests a neural compensatory mechanism that enables intact cognitive performance in asymptomatic mutation carriers.

Role of piracetam on cognitive function in epilepsy and with antiepileptics in rats

Background: To study extent of cognitive impairment by epilepsy & antiepileptic treatment and evaluate the role of piracetam on it. Methods: 48 animals were divided into 6 groups: I-Control, II- Topiramate, III-Topiramate+Piracetam, IV-Valproate, V-Valproate+Piracetam, VI-Piracetam. Baseline cognitive functions were measured using Cook’s pole climbing apparatus (CPCA) and Elevated plus maze (EPM). In CPCA, on completion of training, number of avoidances (NOA) out of 10 trials were noted while in EPM, transfer latency (TL) was measured. Kindling was induced by 30mg/kg Pentylenetetrazol (PTZ), i.p. to all groups (except Group I) on alternate days till seizures developed. Groups were treated with respective drugs orally for 21 days and cognitive functions measured again. Results: Significant decrease in NOA & increase in TL was observed after PTZ kindling. Topiramate further significantly impaired NOA and TL whereas Valproate significantly reduced NOA in CPCA but increase in TL was not significant. Treatment with Piracetam significantly increased Topiramate, Valproate and PTZ kindling induced decrease in NOA as also significantly reduced Topiramate and PTZ kindling induced increase in TL. Conclusion: Seizures are associated with cognitive impairment. Cognitive impairment caused by Sodium valproate differs from Topiramate. Piracetam, a known nootropic can be used in alleviating cognitive impairment associated with epilepsy & chronic antiepileptic therapy.

Health-Related Cognitive and Quality of Life Outcomes in Acute Leukemia Patients During Chemotherapy

Abstract 2063 Background:Chemotherapy for acute leukemia can have an effect on cognitive functions and health-related quality of life measures. Cognitive impairment and fatigue have been described in patients with AML/MDS, even before the initiation of treatment. Objective:To assess baseline cognitive functions, short-term cognitive evolution, and to measure both depression and health-related quality of life outcomes in adult acute leukemia patients, before and after induction treatment. Methods:Current longitudinal-prospective study of adult acute leukemia patients treated with aggressive chemotherapy. The current study has been approved by the Institutional Ethical Committee and each patient has signed an informed consent before inclusion. Eligible patients are enrolled and are administered a comprehensive cognitive test battery, within five days after admission (T0) and after completion of induction treatment (T1). Cognitive functions assessed are attention, executive functions, motor dexterity, and verbal memory (with AVLT, COWA, PPT, SCWT, TMT). Both depression and health-related quality of life outcomes are assessed with self-report questionnaires (with CES-D and EORTC-QLQ-C30). Results:Thirty adult acute leukemia patients were included between 01/2009 and 07/2011. The median age was 46 years, 53% were male. The median duration of education was 13 years. 87% had AML and 13% had ALL. Baseline mean hematological values were: WBC count (8,2 10E3/uL), RBC count (3,1 10E6/uL), and HgB (9,8 g/dL). Induction treatment used in AML patients was the AML 2/95 protocol (n=22) or the HOVON 102 AML protocol (n=4), and in ALL patients the GMALL 7/03 protocol (n=4) was used. Baseline cognitive functions were normal in different cognitive domains, mainly in attention and executive functions (COWA and SCWT), except for mild cognitive deficits in verbal learning (AVLT A1–5), and especially in motor dexterity (PPT). These deficits were heterogeneous, ranging from severely impaired to good, within a specific cognitive domain. Short-term evolution on cognitive functions was observed in executive functions and verbal learning. Baseline levels of distress or depression were clinically significant, and adult acute leukemia patients showed problems on all function scales, except cognitive function, and on only two symptom scales, namely fatigue and pain. Short-term changes were found in depression, global health scale, functional scale emotional function, and symptom scale pain (also see Table). Conclusions:At baseline, adult acute leukemia patients had normal cognitive functions, except for verbal learning and especially motor dexterity. Cognitive impairment and fatigue were found similar to a previous reported research. However, our data showed less impaired motor dexterity, and we also noted a partial cognitive improvement. Depression and problems on the health-related quality of life outcomes were observed at baseline, whereas at follow-up only role and social function, and fatigue were still problematic.TableShort-term changes in cognitive and HRQoL outcomes.T0T1pCognitionExecutive function SCWT IV-II5750.004 TMT B9377.000Verbal learning AVLT A1-A54954.001Depression2114.004Global health3660.000Emotional function5676.000Fatigue6348.062Pain4919.000 Disclosures:No relevant conflicts of interest to declare.

Cognitive Impairment In Adult De Novo Acute Leukemia Patients

AbstractAbstract 4746 Introduction:A significant percentage of cancer patients develop or have chemotherapy-induced cognitive impairment, during and even long after completion of aggressive treatment. Cognitive deficits are usually subtle and mild, and can occur in various cognitive domains. In AML/MDS patients, impaired cognitive functions, even prior to initiation of chemotherapy, have been described. Objective:To assess baseline cognitive functions and short-term cognitive evolution in de novo acute leukemia patients during induction treatment, and to compare our data with previous research. Methods:Current longitudinal-prospective study of adult de novo AML/ALL patients, treated with induction chemotherapy at the Hematology Department, UZ Ghent, Belgium. Eligible patients are enrolled and investigated with a comprehensive cognitive test battery, within on average five days after admission (pre-induction) and after completion of induction chemotherapy, on average after two months (pre-consolidation). Cognitive functions are assessed across various domains, including attention, executive functions, motor dexterity, and verbal/visual memory. Patients' psychological functions and quality of life are assessed simultaneously. Results:Twenty adult patients were enrolled between 01/2009 and 06/2010. The median age was 43 years, 50% were male, 80% had AML (20% ALL), and median years of education was 12 years. Baseline hematological values were assessed, with WBC count (mean: 10,4 10E3/uL), RBC count (mean: 3,1 10E6/uL), and HgB (mean: 9,8 g/dL). Adult patients had normal cognitive functions (range: 1,0 SD below normative mean) in different cognitive domains, and mainly in attention and executive functions (COWA letter fluency & semantic fluency, and SCWT mental flexibility), except for mild cognitive deficits in verbal learning (AVLT A1-5), but especially in motor dexterity (PPT left and right hand). These functions were heterogeneous at baseline, ranging from severely impaired to good within a cognitive domain. At follow-up, attention, executive functions, motor dexterity, and verbal learning had all improved significantly (p<0.02). Conclusion:Adult de novo AML/ALL patients exhibit at baseline normal cognitive functions, except for verbal learning and motor dexterity. Cognitive deficits in attention, executive functions, and verbal learning were found similar to previous reported research in AML/MDS. However, our data showed less impaired motor dexterity. Moreover, cognitive functions improved at follow-up. Disclosures:No relevant conflicts of interest to declare.

Effect of antihypertensive therapy on some cognitive functions of patients of hypertension.

Aim- Hypertension associated with the decline in cognitive functions. There are certain studies which revealed that antihypertensive therapy improves the cognitive functions in patients of hypertension. Some other studies do not support this conclusion. So this study was done to see the effect of antihypertensive therapy on cognitive functions in patients of hypertension in our setting.Material and methods: Cases of hypertensions were recruited from the OPD of private physician. Baseline cognitive function tests were administered before starting the antihypertensive therapy and after three months of treatment. To see the effect of hypertension on cognitive functions baseline cognitive functions of cases were compared with healthy volunteers.Results: During comparison of cases and controls, it was found that there is decline in cognitive functions as indicated by Immediate recall test, Mental balance test, Forward digit span test, Word list memory test, Recognition test and Six letter cancellation test. Out of these tests, Immediate recall test, Word list memory test, Recognition and Six letter cancellation test showed improvement after three months of antihypertensive therapy. Some tests like Remote memory test, Recent memory

Ankle Brachial Index as a Predictor of Cognitive Impairment in the General Population: Ten‐Year Follow‐Up of the Edinburgh Artery Study

To determine whether the ankle brachial index (ABI, a marker of generalized atherosclerosis) is associated with cognitive impairment after 10 years in older people. Cohort study (Edinburgh Artery Study). Eleven general practices in Edinburgh, Scotland. Seven hundred seventeen men and women aged 55 to 74 from the general population, followed for 10 years. ABI measured at baseline and major cognitive functions (including premorbid function using the National Adult Reading Test, NART) tested after 10 years. After adjustment for age and sex, a low ABI was associated with lower scoring (bottom tertile vs top tertile) on Raven's Matrices (odds ratio (OR)=1.6, 95% confidence interval (CI) =1.0-2.6), Verbal Fluency (OR =1.8, 95% CI =1.1-3.0), and Digit Symbol Test (OR =2.3, 95% CI =1.3-4.2), suggesting that the ABI is predictive of poorer performance in nonverbal reasoning, verbal fluency, and information processing speed. The association between ABI and the Digit Symbol Test remained significant after further adjustment for premorbid cognitive function (tested using the NART), suggesting that the ABI is also predictive of decline in information processing speed (from premorbid ability to that measured here in older age). The ABI may be useful in identifying older individuals at higher risk of cognitive impairment. In the future, preventive measures developed to target individuals with a low ABI should consider measures to reduce vascular-related cognitive decline as well as cardiovascular events, in an effort to reduce the incidence and consequences of subsequent cognitive impairment and dementia.

Cognitive Change After Elective Surgery in Nondemented Older Adults

The authors report the results of repeated cognitive function tests administered over 10 months to 82 patients between the ages of 55 and 82 who underwent elective surgery. The Mini-Mental State Exam (MMSE) score, 10 months after surgery, was modeled by a multivariate linear regression that included the baseline demographics, baseline cognitive functions, and immediate postoperative MMSE scores. Immediate postoperative MMSE scores were highly significant to 10-month postoperative MMSE scores not explained by baseline variables. The results suggest that immediate postoperative cognitive change may predict later postoperative cognitive decline.