Digit Symbol Substitution Test Test Research Articles

Association of vitamin B2 intake with cognitive performance in older adults: a cross-sectional study

BackgroundTo scrutinize the relationship between vitamin B2 consumption and cognitive function based on the NHANES database.MethodsThis cross-sectional study included eligible older adults from the NHANES 2011–2014. Vitamin B2 intake was determined from dietary interview data for two 24-h periods. Cognitive function was evaluated through the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). The regression analyses were used to evaluate the association of vitamin B2 intake with cognitive performance. Stratified analyses based on gender, race, and body mass index (BMI) were conducted.ResultsHigher vitamin B2 intake was correlated with higher scores on each test. As compared to the lowest quartile, the highest quartile of vitamin B2 intake was related to a 45.1-fold increase (P = 0.004) on the DSST test sores. Moreover, those who were males, non-Hispanic whites, or had a BMI of 18.5 to 30 kg/m2 had a stronger relationship between total vitamin B2 consumption and cognitive function.ConclusionIt's possible that older persons who consume more vitamin B2 have enhanced performance in some areas of cognitive function. To determine the causal link between vitamin B2 consumption and cognitive performance, further long-term research is required.

Association between Serum Iron, Blood Lead, Cadmium, Mercury, Selenium, Manganese and Low Cognitive Performance in Old Adults from National Health and Nutrition Examination Survey (NHANES): A Cross-Sectional Study.

Cognitive decline is a public health problem for the world's aging population. This study was to evaluate the relationships between serum iron, blood lead, cadmium, mercury, selenium, and manganese and cognitive decline in elderly Americans. Data of this cross-sectional study was extracted from the National Health and Nutritional Examination Survey (NHANES 2011-2014). Cognitive performance was measured by the consortium to establish a registry for Alzheimer's disease (CERAD), Animal fluency, and digit symbol substitution test (DSST) tests. Weighted univariable and multivariate logistic regression analyses were used to assess the associations between six trace elements and low cognitive performance, with odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses based on diabetes and hypertension history were further assess the associations. A total of 2,002 adults over 60 years old were included. After adjusting covariates, elevated serum iron levels were associated with the decreased risk of low cognitive performance (OR=0.995, 95%CI: 0.990-0.999), as well as in the elderly without diabetes history (OR=0.992, 95%CI: 0.988-0.997) and with hypertension history (OR=0.993, 95%CI: 0.988-0.997) in the Animal Fluency test. High blood cadmium and blood manganese levels were associated with the odds of low cognitive performance in old adults with diabetes (OR=2.900, 95%CI: 1.311-6.417) and hypertension (OR=1.037, 95%CI: 1.009-1.066) history, respectively. In the DSST test, high blood lead levels were related to the odds of low cognitive performance (OR=1.102, 95%CI: 1.019-1.192), as well as in the elderly without diabetes (OR=1.126, 95%CI: 1.026-1.235) and hypertension (OR=1.121, 95%CI: 1.002-1.255) history. Elevated blood cadmium levels were connected with low cognitive performance in diabetic (OR=3.177, 95%CI: 1.323-7.27) and hypertensive (OR=1.896, 95%CI: 1.056-3.403) old people. High blood selenium levels were linked to the decreased risk of low cognitive performance in all the elderly (OR=0.987, 95%CI: 0.981-0.993). Appropriate iron, selenium supplementation and iron-, selenium-rich foods intake, while reducing exposure to lead, cadmium and manganese may be beneficial for cognitive function in the elderly.

Relationships between urinary metals concentrations and cognitive performance among U.S. older people in NHANES 2011-2014.

BackgroundEpidemiological evidence on Urine metals and cognitive impairment in older individuals is sparse and limited. The goal of this study was to analyze if there was a link between urinary metal levels and cognitive performance in U.S. people aged 60 and up.MethodsThe National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2014 were utilized in this cross-sectional analysis. Memory function was quantified using the following methods: Established Consortium for Word Learning in Alzheimer's Disease (CERAD-WL) (immediate learning and recall and delayed recall), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). An inductively coupled plasma mass spectrometry (ICP-MS) was used to estimate urine metal concentrations. The connection of Urine metals level with cognitive function was investigated employing binary logistic regression and restricted cubic spline models.ResultsA total of 840 participants aged 60 years and over were enrolled in this study. After controlling for confounders, the association between cadmium, barium, cobalt, cesium, manganese, and thallium and poor cognitive performance showed significance in multiple logistic regression compared to the lowest quartile of metals. In the DSST test, the weighted multivariate adjusted ORs (95% CI) for cadmium in the highest quartile, barium and cesium in the third quartile were 2.444 (1.310–4.560), 0.412 (0.180–0.942) and 0.440 (0.198–0.979), respectively. There were L-shaped associations between urine cesium, barium, or manganese and low cognitive performance in DSST. Urine lead, molybdenum and uranium did not show any significant relationships with cognitive impairment, respectively, compared to the respective lowest quartile concentrations.ConclusionThe levels of barium (Ba), cobalt (Co), cesium (Cs), manganese (Mn), and thallium (Tl) in urine were found to be negatively related to the prevalence of impaired cognitive performance in our cross-sectional investigation. Higher cadmium (Cd) levels were associated with cognitive impairment.

Threshold effects and interactive effects of total zinc and selenium intake on cognitive function in older adults

The aim of this study was to assess threshold effects and interactive effects of total zinc and selenium intake on cognitive function in older adults. We used data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Zinc and selenium intake were obtained through two 24-h dietary recalls. Cognitive performance was evaluated by the Digit Symbol Substitution Test (DSST). Smooth curve fitting, two-piecewise multivariable linear regression models, binary logistic regression model, multiplicative interactions model, and additive interactions model were used to evaluate the association between zinc, selenium intake and their interactive effect on cognitive function. A total of 2450 participants aged 60 years or older were included. Zinc and selenium intake was non-linearly associated with cognitive function. The inflection point for zinc intake was 8.94mg/d in males and 7.58mg/d in females. When zinc intake was below inflection point, zinc intake was positively associated with the DSST test in males (β=1.02, 95% CI, 0.44 to 1.60) and females (β=0.94, 95% CI, 0.26 to 1.62). When zinc intake above inflection point, there is no association between zinc intake and the DSST test in both sexs. The inflection point for selenium intake was 186.33μg/d in males and 68.40μg/d in females. Among males, the β (95% CIs) was 0.03 (0.01,0.06) to the left side of the inflection point and-0.06 (-0.10,-0.02) to the right of the inflection point. Among females, the β (95% CIs) was 0.13 (0.04,0.22) to the left side of the inflection point and 0.01 (-0.01,0.04) to the right of the inflection point. Besides, zinc and selenium have significant interaction on DSST test only in females (P=0.028, RERI=0.418). The present study demonstrated that zinc and selenium intake was non-linearly associated with cognitive function in different sex. There was an interactive effect between zinc and selenium intake on improving cognitive function, especially in females.

Association between biological age, clinical and biochemical indicators, manifestation of cognitive disorders and health indicators in patients with arterial hypertension

The aim of this work was to determine the association between biological age (BA), clinical and biochemical parameters, cognitive functions and subjective health assessment in patients with arterial hypertension (AH) and low-grade cardiovascular risk (CVR).Materials and methods. The examinations involved 95 patients (50 men and 45 women) with the mean age of 43.8 years — from 25 to 59.8 years. All patients were divided into 2 groups: control group consisted of patients without hypertension (n = 24) and the second (main) group included patients with grade 1 — 2 stages 1 — 2 AH with low and moderate CVR (n = 71). Each group was dived into two subgroups:: 25 — 44 years old and 45 — 60 years old patients. Clinical, biochemical and anthropometric parameters were determined in patients. BA of patients was determined using the method named after A. G. Gorelkin and B. B. Pinkhasov, cognitive dysfunction was assessed based on the results of the questionnaires, namely Montreal Cognitive Assessment (MoCA) and Digit Symbol Substitution Test (DSS), and health status was estimated using European Quality of Life Questionnaire (EQ-5D).Results. Significant differences were found between patients of the main and control groups in terms of BA (p = 0.000), weight (p = 0.016), body mass index (BMI) (p = 0.02), waist circumference (WC) (p = 0.001) and thigh circumference (p = 0.013). Analysis of the parameter values distribution in patients aged from 25 to 45 years old with and without AH showed significant differences in BA (p = 0.025), weight (p = 0.009), BMI (p = 0.048), WC (p = 0.007), levels of triglyceride (TG) (p = 0.025), very low density lipoprotein cholesterol (VLDL-C) (p = 0.025), high-density lipoprotein cholesterol (HDL-C) (p = 0.000), atherogenic coefficient (AC) (p = 0.001), creatinine (p = 0.007) and MoCA results (p = 0.000). Patients in the main group aged 45 to 60 years had significant differences in the levels of total cholesterol (p = 0.002), TG (p = 0.015), VLDL-C (p = 0.042), AC (p = 0.010), and low-density lipoprotein cholesterol (LDL-C) (p = 0.042), increased alanine aminotransferase (p = 0.021), DSS (p = 0.000) compared with controls. Decrease in cognitive functions in patients with AH in comparison with controls (p < 0.05) was observed according to the results of the MoCA in young people and DSS in middle-aged people. BA assessment demonstrated a link with DSS test results and health indicators in both young and middle-aged patients.Conclusions. Not only can middle-aged patients with AH and low CVR have cognitive impairments, but also young patients. MoCA questionnaires can be effective for the identification of cognitive disorders in young patients, whereas DSS test can be useful in middle-aged people. BA can be used as an indicator of health disorders in patients with AH, both young and middle-aged.

Semi-supervised learning with the clustering and Decision Trees classifier for the task of cognitive workload study

The paper is focused on application of the clustering algorithm and Decision Tress classifier (DTs) as a semi-supervised method for the task of cognitive workload level classification. The analyzed data were collected during examination of Digit Symbol Substitution Test (DSST) with use of eye-tracker device. 26 participants took part in examination as volunteers. There were conducted three parts of DSST test with different levels of difficulty. As a results there were obtained three versions of data: low, middle and high level of cognitive workload. The case study covered clustering of collected data by using k-means algorithm to detect three clusters or more. The obtained clusters were evaluated by three internal indices to measure the quality of clustering. The David-Boudin index detected the best results in case of four clusters. Based on this information it is possible to formulate the hypothesis of the existence of four clusters. The obtained clusters were adopted as classes in supervised learning and have been subjected to classification. The DTs was applied in classification. There were obtained the 0.85 mean accuracy for three-class classification and 0.73 mean accuracy for four-class classification.

Association of dietary \u03c9-3 and \u03c9-6 fatty acids intake with cognitive performance in older adults: National Health and nutrition examination Survey (NHANES) 2011\u20132014

BackgroundCurrent evidence on the association of dietary ω-3 and ω-6 fatty acids intake with cognitive performance is inconsistent. Therefore, the aim is to explore the association of dietary ω-3 and ω-6 fatty acids intake with cognitive performance in the U.S. noninstitutionalized population of older adults.MethodsWe used data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Intakes of ω-3 and ω-6 fatty acids were obtained through two 24-h dietary recalls and were adjusted by energy. Cognitive performance was evaluated by the Consortium to Establish a Registry for Alzheimer’s disease (CERAD) Word Learning sub-test, Animal Fluency test and Digit Symbol Substitution Test (DSST). For each cognitive test, people who scored lower than the lowest quartile in each age group were defined as having low cognitive performance. Binary logistic regression and restricted cubic spline models were applied to evaluate the association of dietary ω-3 and ω-6 fatty acids intake with cognitive performance.ResultsA total of 2496 participants aged 60 years or older were included. In the full-adjusted model, the odds ratios (ORs) with 95% confidence interval (CI) of CERAD test score, Animal Fluency test score and DSST test score were 0.58 (0.38–0.88), 0.68 (0.47–0.99) and 0.59 (0.37–0.92) for the highest versus lowest tertile of dietary ω-3 fatty acids intake, respectively; the ORs with 95% CI of CERAD test score, Animal Fluency test score and DSST test score were 0.48 (0.31–0.75), 0.60 (0.40–0.92) and 0.50 (0.34–0.75) for the highest versus lowest tertile of dietary ω-6 fatty acids intake, respectively. The association between ω-6: ω-3 ratio and cognitive performance was not statistically significant in three tests. In dose-response relationship analysis, L-shaped associations were apparent for ω-3 and ω-6 fatty acids intake with CERAD test score, Animal Fluency test score and DSST test score.ConclusionsDietary ω-3 and ω-6 fatty acids intake might be inversely associated with low cognitive performance.

Association of Coffee, Decaffeinated Coffee and Caffeine Intake from Coffee with Cognitive Performance in Older Adults: National Health and Nutrition Examination Survey (NHANES) 2011-2014.

The aim of this study was to examine the association of coffee, caffeinated coffee, decaffeinated coffee and caffeine intake from coffee with cognitive performance in older adults. we used data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Coffee and caffeine intake were obtained through two 24-hour dietary recalls. Cognitive performance was evaluated by the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) test, Animal Fluency test and Digit Symbol Substitution Test (DSST). Binary logistic regression and restricted cubic spline models were applied to evaluate the association of coffee and caffeine intake with cognitive performance. A total of 2513 participants aged 60 years or older were included. In the fully adjusted model, compared to those reporting no coffee consumption, those who reported 266.4–495 (g/day) had a multivariate adjusted odd ratio (OR) with 95% confidence interval (CI) of 0.56(0.35–0.89) for DSST test score, compared to those reporting no caffeinated coffee consumption, those who reported ≥384.8 (g/day) had a multivariate-adjusted OR (95% CI) of 0.68(0.48–0.97) for DSST test score, compared to the lowest quartile of caffeine intake from coffee, the multivariate adjusted OR (95% CI) of the quartile (Q) three was 0.62(0.38–0.98) for the CERAD test score. L-shaped associations were apparent for coffee, caffeinated coffee and caffeine from coffee with the DSST test score and CERAD test score. No significant association was observed between decaffeinated coffee and different dimensions of cognitive performance. Our study suggests that coffee, caffeinated coffee and caffeine from coffee were associated with cognitive performance, while decaffeinated coffee was not associated with cognitive performance.

Associations between cognitions and functional decline in patients with major depressive disorder

Associations between cognitions and functional decline in patients with major depressive disorder

Effects of seafood consumption and toenail mercury and selenium levels on cognitive function among American adults: 25 y of follow up.

The aim of this study was to examine the longitudinal association between seafood and intake of long-chain ω-3 polyunsaturated fatty acids (LCω-3 PUFA) and cognitive function and to explore the possible effect modifications owing to mercury (Hg) and selenium (Se) levels. Participants (N = 3231) from the CARDIA (Coronary Artery Risk Development in Young Adults) study underwent baseline examination and were reexamined in eight follow-up visits. Diet was assessed at baseline and in exam years 7 and 20. Toenail Hg and Se were measured at exam year 2. Cognitive function was measured at exam year 25 using three tests: Rey Auditory Verbal Learning Test (RAVLT), Digit Symbol Substitution Test (DSST), and the Stroop test. The general linear regression model was used to examine cumulative average intakes of LCω-3 PUFA and seafood in relation to the cognitive test scores; and to explore the possible effect modifications caused by Hg and Se. LCω-3 PUFA intake was significantly associated with better performance in the DSST test (quintile 5 versus quintile 1; mean difference = 1.74; 95% confidence interval, 0.19-3.29; Ptrend, 0.048]), but not in the RAVLT and Stroop tests. Similar results were observed for intakes of eicosapentaenoic acid, docosahexaenoic acid, and non-fried seafood. The observed associations were more pronounced in participants with body mass index ≥25 kg/m2, but not significantly modified by toenail Hg or Se. This longitudinal study supported the hypothesis that LCω-3 PUFA or non-fried seafood intake is associated with better cognitive performance in psychomotor speed among US adults, especially those who are overweight or obese.

The Effects of Maximal Intensity Exercise on Cognitive Performance in Children.

High intensity physical exercise has previously been found to lead to a decline in cognitive performance of adults. The aim of this study was to determine the effects of maximal intensity exercise on cognitive performance of children. Using a repeated-measures design, 20 children and adolescents aged 8-17 years completed a battery of tests measuring memory and attention. Forward and Backward Digit Span tests, the Rey Auditory-Verbal Learning Test (RAVLT) and the Digit Symbol Substitution Test (DSST) were performed at baseline, immediately after, and one hour after a maximal cardiopulmonary exercise test. Forward and Backward Digit Span scores significantly improved post-recovery compared with baseline measurements. There was a significant decrease in RAVLT scores post-exercise, which returned to baseline values after recovery. The DSST test scores were mildly elevated from post-exercise to after recovery. Maximal intensity exercise in children and adolescents may result in both beneficial and detrimental cognitive effects, including transient impairment in verbal learning. Cognitive functions applying short term memory improve following a recovery period. Parents, educators and coaches should consider these changes in memory and attention following high-intensity exercise activities in children.

Composite Marker of Cognitive Dysfunction and Brain Atrophy is Highly Accurate in Discriminating Between Relapsing-Remitting and Secondary Progressive Multiple Sclerosis.

BackgroundWith the advent of numerous new-generation disease-modifying drugs for multiple sclerosis (MS), the discrimination between relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS) has become a problem of high importance. The aim of our study was to find a simple way to accurately discriminate between RRMS and SPMS that is applicable in clinical practice as a composite marker, using the linear measures of magnetic resonance imaging (MRI) and the results of cognitive tests.Material/MethodsWe included 88 MS patients in the study: 43 participants had RRMS and 45 had SPMS. A battery consisting of 11 tests was used to evaluate cognitive function. We used 11 linear MRI measures and 7 indexes to assess brain atrophy.ResultsFour cognitive tests and 3 linear MRI measures were able to distinguish RRMS from SPMS with the AUC >0.8 based on ROC analysis. Multiple logistic regression models were constructed to identify the best set of cognitive and MRI markers. The model, using the Rey Auditory Verbal Learning Test (RAVLT), Digit Symbol Substitution Test (DSST), and Huckman Index, showed the highest predictive ability: AUC=0.921 (p<0.001). We constructed a simple remission-progression index from the same 3 variables, which discriminated well between RRMS and SPMS: AUC=0.920 (p<0.001), maximal Youden Index=0.702, cut-off=1.68, sensitivity=79.1%, and specificity=91.1%.ConclusionsThe composite remission-progression index, using the RAVLT test, DSST test, and MRI Huckman Index, is highly accurate in discriminating between RRMS and SPMS.

P.1.j.025 Sensitivity of the tests measuring information processing in schizophrenia and bipolar disorder

Purpose: Schizophrenia and bipolar disorder are two major psychiatric illnesses that may have pathophysiological common points. Although the relationships between cognitive functions, symptoms and functionality differ for schizophrenia or bipolar disorder, and remain to be clarified, it’s known that cognitive dysfunction is a good candidate to be a predictor of functioning in both disorders [1]. The importance of the cognitive dysfunction in psychiatric disorders has been substantially increasing, but we still need more sensitive and appropriate assessment tools [2]. Most instruments or tests assess only one domain, representing a single task. This narrow span is useful when examining a specific domain that is heavily impaired. In psychiatric disorders, however, most subjects are only slightly impaired and those tools with low sensitivity lack reliability and sensitivity in determining slight impairments. This study aims to evaluate capabilities of cognitive tests used to evaluate information processing in schizophrenia and bipolar disorder. Methods: Thirty-five patients with bipolar disorder (age 34.74+ 8.71 years, m/f: 18/17) and 32 schizophrenia patients (age 39.97+9.43 years, m/f: 23/9) enrolled into the study. Clinical examinations were performed with Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS), Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HDRS) and the Abnormal Involuntary Movement Scale (AIMS). Cognitive evaluations included the Stroop Test (ST), Trail Making Test (TMT), Digit Span Test, Digit-Symbol Substitution Test (DSS), auditory and visual Reaction Time Test (RT) and Adult Memory and Intelligence Processing Battery (AMIPB). The AMIPB has raw scores and adjusted scores according to motor speed of subjects. The t test and Pearson’s correlation tests were used for statistical analyses. Results: Visual RT, TMT-B, digit span, DSS test and 1, 2, 3 and 5th subtests of the ST did not differ between groups. Auditory RT (p = 0.004), TMT-A (p = 0.024), ST 4 (p = 0.040) tests differed between groups. There was significant difference between groups in all subtests of the AMIPB. Motor (p = 0.001), total raw score (p< 0.001), and adjusted scores (p< 0.001) of the AMIPB-A and total raw score (p = 0.002), motor speed (p = 0.013) and adjusted (p = 0.001) scores differed between groups. The AMIPB showed correlations to all other cognitive measures, both in schizophrenia and bipolar disorder groups with strong significance. Discussion: The AMIPB discriminated the schizophrenia and bipolar disorder groups. These results suggest that among many different tests to measure information processing, the AMIPB is a sensitive test in quality and quantities of speed and accuracy for psychiatric disorders. The battery also include working memory demands, therefore it evaluates different aspects of information processing. Information processing is related to basic components of cognition including working memory and executive functions (judgment, decision making, etc.). Although all other tests include properties of one aspect of basic components of information processing, the AMIPB has interactions with different basic components of cognition. This wealthy of interactions may provide broader portfolio of capabilities and greater sensitivity for the battery. The AMIPB is a highly sensitive and consistent test for information processing evaluations in schizophrenia and bipolar disorder.