Categories Of Cognitive Function Research Articles

Cognitive performance predictors of incident motoric cognitive risk syndrome

AbstractBackgroundMotoric cognitive risk syndrome (MCR) is a gait based pre‐dementia syndrome that builds on operational definitions of mild cognitive impairment (MCI), and is associated with increased risk for Alzheimer’s Disease and other types of dementia. Declines in cognitive function associated with risk of developing MCR have not been established. We aimed to examine the association between cognitive performance on tests of memory and executive function (EF) and related processes and risk of incident MCR.MethodOf the 541 non‐demented participants (aged 65+) in a community‐based cohort, at baseline 22 met criteria for MCR, 58 for MCI, and 17 met criteria for both MCR and MCI, and were excluded from the analyses. Cognitive performance was measured using seven tests: the free recall score from the Free and Cued Selective Reminding Test, Figure Recall from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Story Recall from the RBANS, Category Fluency, Controlled Oral Word Association Test, Digit Symbol Substitution test and Trail Making Test part B. A confirmatory factor analysis indicated that these cognitive tests fell into two categories of cognitive function: memory and EF and related processes. Cox proportional hazard models adjusted for age, sex and education was used to examine the association between cognitive test performance and incident MCR in 444 participants. For the purpose of comparison, we also examined the association between cognitive performance and MCI.ResultOver a mean follow‐up of 3.0 years, 37 participants developed incident MCR and 69 incident MCI. Performance on tests of EF and related processes was associated with risk for MCR (adjusted hazard ratios (aHR) ranging from 0.96 to 0.99). One memory test (free recall) was associated with risk of MCR (aHR: 0.94, 95% Confidence Interval: 0.89‐0.99). Performance on all tests of memory (aHR ranging from 0.81 to 0.92) and EF and related processes (HR ranging from 0.94 to 0.99) was associated with increased risk of MCI.ConclusionCognitive performance on tests of EF and related processes are associated with increased risk of MCR. This may be indicative of a distinct underlying pathology in patients who are at risk of MCR.

Development and Testing of the Pain Assessment Tool in Cognitively Impaired Elders (PATCIE): Nonverbal Pain Behaviors in African American and Caucasian Nursing Home Residents with Dementia

BackgroundPeople with dementia experience a decline in language skills required to self-report pain; researchers thus recommend the use of nonverbal behaviors to assess pain. Although multiple instruments exist for assessing nonverbal pain behaviors, psychometric data are lacking for African American nursing home residents with dementia. Aims and DesignThe purpose of this methodological study was to describe the development and testing of the Pain Assessment Tool in Cognitively Impaired Elders (PATCIE) in African American and Caucasian nursing home residents with dementia. Settings/ParticipantsThe convenience sample included 56 African American and 69 Caucasian residents with dementia in multiple nursing homes from three states. The research staff completed the pain assessments when the nursing home staff transferred the residents. Results/ConclusionsInitially, 15 nonverbal pain behaviors were evaluated. Based on the alpha scores and additional literature review, the 15 nonverbal pain behaviors were expanded to 28 behaviors. The PATCIE had a Cronbach's alpha of .73 during movement. Construct validity for the pain behaviors was demonstrated because higher scores were noted during movement, and scores before movement were significantly higher than those obtained after movement. For movement over time, there was a significant difference in the PATCIE score, regardless of ethnicity or time (p < .0001). There were no significant differences found between ethnic groups, either overall or in change over time between movements or between the categories of cognitive function. African Americans were more likely to display frowning, and Caucasians to display irritability. The PATCIE demonstrates preliminary reliability and validity in assessing pain in African American and Caucasian nursing home residents with dementia.

Study on changes in cognitive function of elderly individuals certified for long-term care insurance.

Objectives To elucidate the changes in cognitive function in elderly individuals as observed in the results of a long-term care certification survey.Methods The data were obtained from the long-term care insurance of 121 subjects who applied for benefit renewal between 2010 and 2011, in a city in Japan. The subjects were grouped into one of three groups (improved, maintained, or worsened) according to the change in status of overall cognitive function. Analyses were completed with this grouping as the main dependent variable and with sex, age, degree of independence at the initial insurance application in 2006, and levels of seven categories of cognitive function as independent variables.Results There was a statistically significant association between age and deterioration of various cognitive functions. Sex had no significant effect on the rate of deterioration. The initial degree of independence was positively associated with the cognitive function change. Multivariate analysis (logistic regression analysis) incorporating age, sex, and initial degree of dependence as independent variables revealed that sex does not significantly influence the prognosis of cognitive function. Changes in the score of each of the seven cognitive functions were analyzed with ANOVA, with categories of functions and individuals as sources of variance. Both function category and individuals were significantly associated with deterioration. Among the seven categories of functions, "understanding daily activities" had the greatest deterioration, while "calling him/herself by his/her own name" had the least.Conclusion Cognitive function, as observed in the long-term care certification survey, is more likely to deteriorate in elderly individuals and in those who were at higher levels of dependency index at the time of initial certification, and this effect is observed equally in men and women. Our results suggest that, in providing long-term care for elderly people, it may be useful to call the clients by their names and ask them to name themselves, as well as to try to improve their understanding regarding the daily activities by articulating the components of each activity.

Effect of Folic Acid, with or without Other B Vitamins, on Cognitive Decline: Meta-Analysis of Randomized Trials

Purpose We aimed to quantify the effect of folic acid supplementation on the prevention of cognitive decline. Methods We conducted a meta-analysis of 9 placebo-controlled randomized trials (2835 participants, median duration 6 months) of folic acid, with or without other B vitamins, on cognitive function. Standardized mean differences in cognitive function test scores were calculated between folic acid and placebo-treated groups. Results The standardized mean difference in cognitive function test scores was 0.01 (95% confidence interval [95% CI], −0.08 to 0.10), or an increase of 1% (95% CI, −8% to 10%) of 1 standard deviation. The results were similar within each of the 4 categories of cognitive function (memory, speed, language, and executive function); standardized mean differences were 0.01 (95% CI, −0.08 to 0.09), −0.01 (95% CI, −0.10 to 0.13), −0.05 (95% CI, −0.15 to 0.04), and 0.03 (95% CI, −0.13 to 0.19), respectively. Conclusion Randomized trials show no effect of folic acid, with or without other B vitamins, on cognitive function within 3 years of the start of treatment. Trials of longer duration, recording the incidence of dementia, as well as cognitive decline, are needed.

Behavioral Characterization of Quinolinate-Induced Lesions of the Medial Striatum: Relevance for Huntington's Disease

Huntington’s disease (HD) is an inherited neurodegenerative disorder in which the striatum undergoes marked atrophic changes. Patients with HD typically have impaired cognitive function, including deficient visuospatial skills, lack of cognitive flexibility and poor recall of memories. The relationship between these cognitive abnormalities and the striatal degeneration of HD is incompletely understood. In order to explore this issue, we studied the behavior of rats with histologically confirmed bilateral quinolinate (QUIN)-induced lesions of the medial striatum. In a series of Morris Water Maze (MWM) experiments and Delayed Alternation (DA) tests, QUIN-lesioned animals exhibited: (i) impaired acquisition of visuospatial skills; (ii) impaired “transfer of learning”; (iii) perseverative behavior; (iv) deficient retrieval or retention of stored memories. The lesioned rats were unimpaired when swimming to a visible platform, while moving spontaneously in behavior boxes, and when performing various specialized tests of motor function. These results indicate that QUIN-induced lesions of the medial striatum can produce impairments of visuospatial skills, cognitive flexibility, and recall. These are the categories of cognitive function that are disturbed in HD. This suggests that the striatal degeneration of HD could be a sufficient explanation for the cognitive abnormalities associated with the illness.