Evaluation Of Cognitive Function Research Articles

Visualization of “Subclinical Consequence” After Successful and Uneventful Surgical Intervention for Unruptured Cerebral Aneurysms

There are many studies on post-operative cognitive function after surgical clipping (SC) and endovascular coiling (EC) for unruptured cerebral aneurysms, but few reports focusing on possible subclinical damage. The aim of the present study was to detect the subclinical damage after surgical intervention. Patients with anterior circulation aneurysms who underwent either SC (SC group) or EC (EC group) were recruited. Imaging studies and evaluation of cognitive function were performed within 1 month preoperatively and at 6 months and 2 years postoperatively. The ipsilateral/contralateral cerebral blood flow (CBF) ratio (I/C ratio) calculated from values in four regions of interest (ROIs) placed on N-isopropyl-p-[123I] iodoamphetamine (123I-IMP)-single photon emission computed tomography (SPECT) was used to detect "subclinical consequence". "Subclinical consequence" was defined as post-operative CBF reduction without abnormality in other radiological examinations and cognitive tests. There were 14 patients in the SC group (mean age, 60.6±11.7 years) and 33 patients in the EC group (mean age, 67.5±7.2 years). All cognitive assessment results showed no significant reduction through the survey period. However, I/C ratios were restored by 2 years in the EC group not but in the SC group. I/C ratios at 6 months and 2 years were significantly lower in the SC group than the EC group (P<0.01). 123IMP-SPECT revealed a statistically significant reduction in ipsilateral CBF in patients who had an uneventful clinical course and no cognitive problems. The subclinical consequence could persist for at least 2 years following SC, and was less pronounced following EC.

Associations between cardiac rehabilitation and clinical outcomes in patients with heart failure and cognitive frailty

Abstract Introduction Patients with heart failure (HF) often contend with various comorbidities, including cognitive impairment. Cognitive impairment has been increasingly recognised as cognitive frailty, which is reportedly associated with poor outcomes. On the other hand, cardiac rehabilitation (CR) for HF contributes to improved clinical outcomes. However, very few reports have examined whether CR is effective in patients with HF who have cognitive frailty. Purpose The present study aimed to investigate whether CR is associated with clinical outcomes in patients with HF, even in the presence of cognitive frailty. Methods This observational study analysed 1404 consecutive patients who admitted to a university hospital for the treatment of HF and received CR during hospitalisation. Patients who had dementia, did not perform the cognitive function evaluation, or died during hospitalisation were excluded from this study. All patients were encouraged to continue outpatient CR after hospital discharge. Cognitive function was assessed using the Mini-Cog© and a score ≤2 points was defined as the cognitive frailty. As physical function, quadriceps isometric strength (QIS) and 6-min walking distance (6MWD) were measured at the discharge and at the end of outpatient CR. The primary outcome was composite events, comprising all-cause death and re-admission due to HF. The secondary outcome was the change in physical function (ΔQIS and Δ6MWD) following outpatient CR. The association between participation in outpatient CR and composite events was assessed using the multivariate Cox proportional hazard models. We also compared the physical function changes between the presence or absence of cognitive frailty using analysis of covariance. Results The median age of the patients was 75 (interquartile range [IQR]: 66–81) years and 62.3% were males. Among them, 23.4% were identified as cognitive frailty. While 45.1% of overall population participated in outpatient CR, the cognitive frailty was relevant to a lower participation rate (P &amp;lt;0.001). Over a median follow-up period of 1.0 years (IQR: 0.3–2.4 years), a total of 544 composite events occurred. Participation in outpatient CR was associated with a reduced incidence of composite events in both the cognitive frailty and non-cognitive frailty, as well as in the overall patient population (Figure 1). Additionally, ΔQIS and Δ6MWD did not significantly differ between the cognitive frailty status (P = 0.655 and 0.573, respectively). Conclusions Participating in outpatient CR was linked to reduced rates of composite events and improved physical function in patients with HF, regardless of the presence or absence of cognitive frailty. Encouraging active participation in outpatient CR, even among patients with cognitive frailty, is essential as it is associated with favourable clinical outcomes.Survival analysisANCOVA

Inter- and intra-rater reliability of cognitive assessment conducted by assistive robot for older adults living in the community: a preliminary study.

The purpose of this study was to reveal inter- and intra-rater reliability of the detailed evaluation of cognitive function by assistive robot for older adults. We investigated the inter-rater and test-retest reliability. Neurobehavioral Cognitive Status Examination was conducted twice for each participant using an assistive robot and the examiner respectively (Experiment 1). The order of these two tests was randomly selected and the interval between them was 1 week. In Experiment 2, we investigated the test-retest reliability of the first robot test and this additional robot test was conducted approximately 6 weeks after Experiment 1. Fifty-one (13 men and 38 women, mean age: 80.5 ± 5.6 years) participants went through Experiment 1 and 29 of those (eight men and 21 women, mean age: 80.4 ± 4.8 years) completed Experiment 2. In Experiment 1, the interclass coefficient (ICC) in orientation was in the high range and its Cronbach's α was 0.919, rated as excellent internal consistency. On the other hand, other items did not show positive results. In Experiment 2, the ICCs in orientation, attention, and repetition were in the adequate range, while other items showed marginal or low range. Orientation was supposed to be utilised for figuring out initial symptoms of dementia. In the future, as robot functions become more high-tech, a partner robot might be able to measure the symptoms and severity of dementia.

The Association Between Inflammatory Dietary Pattern and Risk of Cognitive Impairment Among Older Adults with Chronic Diseases and Its Multimorbidity: A Cross-Sectional Study.

The present study aimed to explore the association between the inflammatory potential of diet, assessed by energy-adjusted dietary inflammatory index (E-DII) and reduced rank regression (RRR)-derived inflammatory dietary pattern, and the risk for cognitive impairment (CI) in community-dwelling older adults, especially in older adults with chronic diseases and multimorbidity. A total of 549 older adults from Taiyuan city were included in the present cross-sectional study. The Chinese Version of the Mini-Mental State Examination (CMMSE) was used for the evaluation of cognitive function. E-DII score was calculated based on semi-quantitative food frequency questionnaire (FFQ). Blood samples, including interleukin (IL)-1β, interleukin (IL)-18, tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP), were tested for calculating RRR-derived inflammatory dietary pattern. Logistic regression was used to assess the association between inflammatory dietary pattern and risk of CI. In addition, patients with diabetes, hypertension, hyperlipidemia and multimorbidity were screened for further analysis among 549 older adults. In those 549 older adults, adjusting for demographic characteristics and chronic disease status, there was no association between E-DII score tertile (OR T3VST1 : 1.357, 95%CI:0.813~2.265, P trend = 0.267), RRR-derived inflammatory dietary pattern score tertile (OR T3VST1 : 1.092, 95%CI:0.679~ 1.758, P trend = 0.737) and risk of CI. However, in older adults with diabetes and multimorbidity, the score tertile of E-DII and RRR-derived inflammatory dietary pattern were positively correlated with risk of CI in a dose-responsive manner (All P trend < 0.05). There is insufficient evidence to reach similar conclusion in patients with hypertension and hyperlipidemia (All P trend > 0.05). In the present study, pro-inflammatory diet contributed to the increased risk of CI in older adults with diabetes and multimorbidity. These results supplemented vital evidence for the prevention and treatment of CI in older adults with chronic diseases.

The relationship between cognitive function and functional capacity, and cognitive reserve and reaction time in patients with multiple sclerosis.

Cognitive dysfunction is frequently seen in multiple sclerosis (MS). However, there are conflicting findings regarding the factors it is associated with. To investigate the relationship between aerobic capacity, strength, disability, depression, fatigue, and cognitive reserve and function. The mobile applications Trail Making Test (TMT A-B), Digit Span Test (DST), Visuospatial Memory Test (VSMT), and Tap Fast were used in the cognitive function evaluation. Functional performance was assessed with the 6-minute walk test (6MWT), 5-Time Sit-to-Sand (5STS) test, and grip strength. Cognitive Reserve Index (CRI), Beck Depression Inventory, Fatigue Severity Scale (FSS), and Nottingham Health Profile were also used. A significant difference was found between the MS and control groups only in the 6MWT, STS-5, grip strength, TMT, VSMT, and Tap Fast. Good correlation was found between the TMT-A and 6MWT and physical mobility. A fair correlation was shown between grip strength, energy, and pain status. A good correlation was found between TMT-B and 6MWT, and a fair relationship with disability, cognitive reserve, and pain. Good correlation was observed between the DST and 6MWT, left grip strength, pain, and energy status; fair correlations were found between right grip strength, cognitive reserve, and physical mobility. Good correlation was found between the VSMT and energy. A fair relationship between disability, cognitive reserve, and pain was demonstrated. Good correlation was observed between the Tap Fast score and disability, 5STS, FSS, energy, and physical mobility. A fair relationship was found between pain and social isolation. It has been shown that cognitive performance in MS is related to disability, functional performance, cognitive reserve, fatigue, and general health. NCT06084182.

Evaluation of sensomotor development, behavioral reactions and cognitive functions of the second generation of rats with hyperhomocysteinemia

The adverse maternal exposure during pregnancy leads to developmental disorders in the offspring that can be passed on to later generations. Epigenetic regulation of DNA transcription may mediate inherited metabolic diseases. An increase in homocysteine concentration in the blood is associated with epigenetic modifications of the genome, which can alter the fetal brain’s development program and cause cognitive impairment. The aim of our work was to identify changes in sensomotor development, behavioral reactions and cognitive functions of offspring of second generation rats (HcyF2) of hyperhomocysteinemia. Our results indicate that unconditioned reflexes and physical parameters are delayed in HcyF2 rats. In “open field”, HcyF2 rats showed higher levels of anxiety and decreased exploratory and motor activity, while coordination of movements studied in “rotarod” test was not impaired. Decreased limb muscle strength was shown in the “grip strength” test. Additionally, HcyF2 rats demonstrated an impaired learning and longterm memory in the Morris water maze. Biochemical analysis revealed an imbalance in the antioxidant systems, which was attributed to decreased activity of glutathione peroxidases and H2S synthesis enzymes. It was suggested that elevated homocysteine levels during pregnancy may result in epigenetic modifications of the genome, which can impact the metabolism of offspring and be inherited by future generations.

Evaluation of cognitive function in elderly patients hospitalized for heart failure with and without diabetes mellitus

Pacientes idosos com diabetes melitus (DM) hospitalizados por insuficiência cardíaca (IC) apresentam frequentemente sinais de comprometimento cognitivo (CC). Objetivo: Avaliar a função cognitiva de idosos portadores de IC com e sem DM. Métodos: Pacientes hospitalizados (≥ 65 anos) por IC foram avaliados através de testes cognitivos: Montreal Cognitive Assessment (MoCA) e Mini-Cog. Resultados:196 pacientes, com média de idade de 73,04 ± 6,04. Segundo o Mini-cog, 77% tinham CC. O escore médio do MoCA foi de 14,60 ± 5,79. De acordo com presença ou ausência de DM, foi observado associação significativa com o sexo, feminino 54,7% vs masculino 45,3% (p=0,04) e cintura abdominal, aumentada 81,3% vs normal 18,8% (p=0,02). No cenário de cognição normal pelo Mini-cog, pacientes com pré-diabetes tinham maior probabilidade de ter fração de ejeção do ventrículo esquerdo (FEVE) normal (60,75 ± 11,15) em comparação com pacientes com diabetes (47,00 ± 14,42) e pacientes euglicêmicos (44,50 ± 19,92), p = 0,035. Conclusão: Foi encontrado elevada frequência de CC em pacientes idosos hospitalizados por IC. Pacientes com pré-diabetes sem CC tiveram maior probabilidade de apresentar FEVE preservada.

Mobile Application Applied for Cognitive Rehabilitation: A Systematic Review.

The COVID-19 pandemic has increased the demand for home rehabilitation services, leading to the development and rising demand for cognitive rehabilitation apps. However, a comprehensive analysis of the content and effectiveness of these apps is needed. This study systematically reviewed and analyzed the literature on mobile apps for cognitive rehabilitation. One researcher and an external expert conducted the study selection, data extraction, and quality assessment following the PRISMA Checklist 2020 guidelines. Our review of 18 studies identified 8 randomized controlled trials (RCTs) (44.44%) of high quality and 10 non-RCT studies (55.56%) of moderate quality. Overall, 16 of the 18 studies (88.88%) demonstrated positive clinical implications for cognitive function after using cognitive rehabilitation apps. Eight studies showed a correlation between app use and improved cognitive function, and four highlighted the potential for cognitive function evaluation through apps. All studies employed various occupational therapy (OT) intervention approaches, with prevention being the most common (100%), followed by establishment and restoration (83.33%), maintenance (77.77%), and creation and promotion (38.88%). This study clinically validates the effectiveness of cognitive rehabilitation mobile applications from an occupational therapy perspective.

Evaluation of Cognitive Functions in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: A Prospective Pilot Study.

It is not clear whether cognitive functions are impaired in young patients with acute coronary syndrome (ACS). This study aims to detect whether or not there is cognitive impairment and cerebral changes in young patients with ACS undergoing percutaneous coronary intervention (PCI). All 50 patients with ACS who were treated with primary PCI were eligible for this prospective study. All participants had normal cognitive function before ACS. Brain magnetic resonance imaging (MRI) was performed to quantify changes in brain white and gray matter. Cognitive functions (CFs) were evaluated by seven cognitive tests. Patients were categorized by MRI findings and test scores were compared from the first day to after the first month. We determined 25 patients with impaired CFs on the first day. After the first month, we identified 18 patients with transient impaired CFs. No structural difference was observed between impaired CF and normal CF. While 25 patients had a score of 1 according to Fazekas, 10 patients had a score of 1 according to MTLA. While the mean Stroop test completion time and Stroop test error rate scores were significantly higher on the first day than after the first month in the Fazekas+ group (p = 0.003, p < 0.001, respectively), other cognitive test scores-except clock drawing test, digital span forwards, and backwards-were significantly lower on the first day compared to after the first month in the Fazekas+ group (p < 0.05). Patients with ACS have transient impairment in cognitive functions. Acute coronary syndrome is not associated with structural changes in the brain.

Evaluation of frailty, cognitive function, and age as prognostic factors for survival in patients with IDH1wild-type high-grade glioma

Abstract INTRODUCTION: High-grade gliomas without isocitrate dehydrogenase (IDH) mutations are associated with poor survival and have been poorly studied. Our aim was to investigate the prognostic factors for survival in this group, focusing on frailty, age, and cognition. METHODS: This study included Slovenian patients with high-grade IDH1 wild-type gliomas. Frailty and cognitive functioning were measured postoperatively using the Clinical Frailty Scale and neuropsychological test battery. Descriptive statistics were used to analyze the demographic and clinical data. Univariate and multivariate Cox proportional hazard regression models were used to examine the clinical predictors and prognostic value of the cognitive test scores. Kaplan-Meier curves were generated, and the log-rank test was used. RESULTS: Data from 75 patients were analyzed. The median time to progression was 11.0 months, and the median survival was 12.8 months. Multivariate analysis revealed that frailty, sex, O6-methylguanine-DNA methyltransferase methylation, and verbal fluency, but not the global cognitive functioning, were significant prognostic factors for survival. Age was a statistically significant prognostic factor in the univariate regression model; when other factors were controlled for in the multivariate model, age lost its prognostic value. CONCLUSION: Frailty is an important prognostic factor for survival of patients with high-grade IDH1 wild-type gliomas. Cognitive functioning in the domain of verbal fluency remained an independent prognostic factor for survival after controlling for other factors.

Evaluation of mental performance and cognitive functions of children and adolescents diagnosed with radiologically isolated syndrome

BackgroundRadiologically isolated syndrome (RIS) is a condition characterized by asymptomatic, incidentally detected demyelinating plaques in the CNS in a patient without typical clinical findings of multiple sclerosis (MS). This study aimed to compare the mental status and cognitive functions of child and adolescent RIS cases with healthy controls and to investigate the relationship between psychometric test results and the demyelinating lesion characteristics. MethodsThe mental status and cognitive functions of 12 RIS cases and 12 healthy controls were compared. Semi-structured interviews, behavioral evaluations, depression and anxiety scales, neuropsychological test battery, and an intelligence test were applied for the evaluation of mental state and cognitive functions. These results were compared with the number and localization of demyelinating lesions. ResultsSustained attention, visual-motor coordination, short-term memory skills, and ability to use visual-spatial information were found worse in the RIS group. There was no correlation between mental state and cognitive functions, and the number and localization of demyelinating lesions. ConclusionOur study showed that pediatric RIS cases may have worse cognitive performance than healthy controls, but no correlation was found between the number and location of demyelinating lesions and psychiatric findings. Although it is controversial whether psychiatric disorders and cognitive disabilities have predictive value in terms of MS conversion in pediatric RIS cases, these subjects were not included in the scope of this study.

A psychometric study of validation and cross-cultural adaptation of the Holden Communication Scale for elderly with dementia in care homes

Purpose This paper aims to validate and adapt the Arabic version of Holden Communication Scale (HCS) for assessing communication skills among old people with dementia in care home. Design/methodology/approach A study involving 210 elderly residents from Jordanian care homes was conducted, where they completed the Arabic version of the HCS. Internal consistency and factor analysis techniques were precisely used to assess the scale's reliability. Additionally, cognitive function evaluation used the Arabic iteration of the Saint Louis University Mental Status (SLUMS) questionnaire, while communication skills were comprehensively appraised using the HCS. Findings The Arabic HCS has strong content validity, with a one-component structure accounting for 60% of the variation and a three-factor structure accounting for 77.2% of the variance. The original three-subgroup structure of the scale was recreated, and internal consistency varied from 0.85 to 0.87, indicating good reliability. Originality/value This study aimed to assess the reliability and validity of the Arabic version of the HCS among old people with dementia residing in care homes. The authors conducted examination of its psychometric properties within this unique population.

From Hospital to Home: Validating a Cognitive-Functional Evaluation of Elders (COFEE-HD).

Background. Increase in hospitalizations of older adults emphasizes the need for efficient hospital discharge planning to enable optimal reentry upon returning home. Yet few assessments offer an extensive picture of the older adult's functional-cognitive state. A comprehensive assessment for discharge planning together with a written summary can be beneficial to the older adult and family. Purpose. This quantitative study compared a modified version of a previously validated tool COFEE (cognitive OT functional evaluation of elders), for use in the hospital, HD (hospital discharge) with standard hospitals assessments. Methods. Of the 77 participants recruited in hospital, home assessments were conducted 4 months later on 64 participants. Findings. The COFEE-HD scores (physical functioning, personal and environmental safety and meta cognitive functioning) were significantly correlated with standard hospital measures and with the home assessment. Implications. The COFEE-HD was found to have a high level of validity in a hospital setting, and the resulting evaluation can provide important insights into function, safety and cognitive function for post-discharge behaviors.

Cortical Lesions as an Early Hallmark of Multiple Sclerosis: Visualization by 7 T MRI.

Compelling evidence indicates a significant involvement of cortical lesions in the progressive phase of multiple sclerosis (MS), significantly contributing to late-stage disability. Despite the promise of ultra-high-field magnetic resonance imaging (MRI) in detecting cortical lesions, current evidence falls short in providing insights into the existence of such lesions during the early stages of MS or their underlying cause. This study delineated, at the early stage of MS, (1) the prevalence and spatial distribution of cortical lesions identified by 7 T MRI, (2) their relationship with white matter lesions, and (3) their clinical implications. Twenty individuals with early-stage relapsing-remitting MS (disease duration <1 year) underwent a 7 T MRI session involving T1-weighted MP2RAGE, T2*-weighted multiGRE, and T2-weighted FLAIR sequences for cortical and white matter segmentation. Disability assessments included the Expanded Disability Status Scale, the Multiple Sclerosis Functional Composite, and an extensive evaluation of cognitive function. Cortical lesions were detected in 15 of 20 patients (75%). MP2RAGE revealed a total of 190 intracortical lesions (median, 4 lesions/case [range, 0-44]) and 216 leukocortical lesions (median, 2 lesions/case [range, 0-75]). Although the number of white matter lesions correlated with the total number of leukocortical lesions (r = 0.91, P < 0.001), no correlation was observed between the number of white matter or leukocortical lesions and the number of intracortical lesions. Furthermore, the number of leukocortical lesions but not intracortical or white-matter lesions was significantly correlated with cognitive impairment (r = 0.63, P = 0.04, corrected for multiple comparisons). This study highlights the notable prevalence of cortical lesions at the early stage of MS identified by 7 T MRI. There may be a potential divergence in the underlying pathophysiological mechanisms driving distinct lesion types, notably between intracortical lesions and white matter/leukocortical lesions. Moreover, during the early disease phase, leukocortical lesions more effectively accounted for cognitive deficits.

Cognitive Functions and Subjective Hearing in Cochlear Implant Users.

A cochlear implant (CI) is an effective prosthetic device used to treat severe-to-profound hearing loss. The present study examined cognitive function in CI users by employing a web-based cognitive testing platform, i.e., BrainCheck, and explored the correlation between cognitive function and subjective evaluation of hearing. Forty-two CI users (mean age: 58.90 years) were surveyed in the subjective evaluation of hearing, and 20/42 participated in the BrainCheck cognitive tests (immediate recognition, Trail Making A, Trail Making B, Stroop, digit symbol substitution, and delayed recognition). As controls for cognitive function, young normal-hearing (YNH, mean age=23.83 years) and older normal-hearing (ONH, mean age=52.67 years) listener groups were subjected to Brain-Check testing. CI users exhibited poorer cognitive function than the normal hearing groups in all tasks except for immediate and delayed recognition. The highest percentage of CI users who had "possible" and "likely" cognitive impairment, based on BrainCheck scores (ranging from 0-200), was observed in tests assessing executive function. The composite cognitive score across domains tended to be related to subjective hearing (p=0.07). The findings of the current study suggest that CI users had a higher likelihood of cognitive impairment in the executive function domain than in lower-level domains. BrianCheck online cognitive testing affords a convenient and effective tool to self-evaluate cognitive function in CI users.

Brain vital sign monitoring of sleep deprivation detects situational cognitive impairment.

Objective, rapid evaluation of cognitive function is critical for identifying situational impairment due to sleep deprivation. The present study used brain vital sign monitoring to evaluate acute changes in cognitive function for healthy adults. Thirty (30) participants were scanned using portable electroencephalography before and after either a night of regular sleep or a night of total sleep deprivation. Brain vital signs were extracted from three established event-related potential components: (1) the N100 (Auditory sensation); (2) the P300 (Basic attention); and (3) the N400 (Cognitive processing) for all time points. As predicted, the P300 amplitude was significantly reduced in the sleep deprivation group. The findings indicate that it is possible to detect situational cognitive impairment due to sleep deprivation using objective, rapid brain vital sign monitoring.

Independent effects of early life adversity on social cognitive function in patients with schizophrenia.

The aim of this study was to investigate the impact of early life adversity on cognitive function in patients with schizophrenia, with a focus on social cognition (SC). Two groups of patients with schizophrenia were recruited and matched on sociodemographic and clinical characteristics. One group consisted of 32 patients with a history of childhood trauma (SCZ-ct), and the other group consisted of 30 patients without a history of childhood trauma (SCZ-nct). In addition, 39 healthy controls without a history of childhood trauma (HC-nct) were also recruited. The intelligence of the three groups was assessed using the Wechsler Abbreviated Scale of Intelligence (WAIS-RC) short version. The cognitive function evaluation was conducted using the MATRICS Consensus Cognitive Battery (MCCB), and early life adversity was measured using the Childhood Trauma Questionnaire-Short Form (CTQ) and Bullying Scale for Adults (BSA). Patients with schizophrenia endosed significantly higher scores on the CTQ (F=67.61, p<0.001) and BSA (F=9.84, p<0.001) compared to the HC-nct. Analysis of covariance (ANCOVA) and post-hoc analyses revealed that SCZ-ct (F=11.20, p<0.001) exhibited the most pronounced cognitive impairment among the three groups, as indicated in MCCB total scores and in the domain score of SC. CTQ exhibited a negative correlation with MCCB (r=-0.405, p< 0.001); SC was negatively correlated with physical abuse (PA) of CTQ (r=-0.271, p=0.030) and emotional abuse (EA) of BSA (r=-0.265, p=0.034) in the whole patient sample. Higher SC performance was significantly predicted by CT_total (Beta =-0.582, p<0.001, 95% CI -0.96-0.46), and years of education (Beta=0.260, p =0.014, 95% CI 0.20-1.75) in schizophrenia. Besides familial trauma, schizophrenia patients appear to have a higher likelihood of experiencing bullying in their early life. These experiences seem to contribute significantly to their severe impairments in SC.

Evaluation of cognitive functions and dementia two years after COVID-19 infection

Background: The Coronavirus disease 2019 (COVID-19) causes high morbidity and mortality in the acute period. Some patients with COVID-19 continue to have symptoms for a long time. However, data on the long-term effects of COVID-19, particularly on cognitive disorders is scarce. We aimed to evaluate cognitive functions and dementia in patients who survived two years after discharge from hospital due to acute covid-19 infection. Methods: Two hundred and five patients who had neurological symptoms during index hospitalization for COVID-19 infection were evaluated two years after discharge, and 64 patients were included in the study. According to cognitive assessments, patients were grouped as having normal cognitive levels (48 patients) or impaired cognitive levels (16 patients). Results: The impaired cognitive level was found in 16 (25.0%) of patients who underwent cognitive tests. Age, the pre-existence of neurological comorbidity, mean intensive care unit day, and Beck’s Anxiety Inventory and Beck’s Depression Inventory scores in the impaired cognitive level group were significantly higher than the normal cognitive level group (p:0.001, p:0.013, p:0.015, p:0.004 and p:0.008). The frequency of cognitive impairment in patients who developed altered mental state during hospitalization was 36.0%, while it was 17.9% in patients with normal mental state. Age, the pre-existence of neurological comorbidity, and anxiety were determined as independent risk factors for impaired cognitive level. In addition, we detected new-onset dementia in 8 patients (12.5%). Conclusion: We found a high frequency of cognitive impairment and new-onset dementia among COVID-19 survivors who developed neurological manifestations during the acute infection phase.

Translation and Adaptation of Cognistat in Hindi Language: For Computerized Evaluation of Cognitive Functioning.

Cognitive assessment is a crucial element of the mental health screening process. However, there is a lack of culturally appropriate cognitive screening tools for the Hindi-speaking aging population in India. We aimed to translate and culturally tailor the English version of the computerized Cognistat test for the Hindi-speaking aging population. The computer-based Cognistat Assessment System was culturally adapted for the North Indian Hindi-speaking population. Participants with mild cognitive impairment (MCI) (n =30), depression (n =30), and healthy control (n =30) groups between the age range of 50 and 83years were assessed using the translated version of the tool. The group differences were analyzed using analysis of variance, multivariate analysis of variance, Tukey's post hoc analysis for continuous variables, and Fisher's exact test for categorical variables. The correlation between the Cognistat domains was analyzed using Pearson's correlation, and test reliability was assessed using Cronbach's alpha. The MCI group had significantly lower scores as compared with the depression and control groups on orientation, language, repetition, and calculation domain tasks. For attention and construction tasks, the MCI group had lower scores than the control group. MCI group scores were significantly lower than the control group on naming domain. The Hindi version of the test was reliable for the Hindi-speaking aging population. Cognistat Hindi can be used by trained healthcare professionals with Hindi-speaking populations for culturally tailored primary evaluation of cognitive difficulties. Future research should focus on further validation and assessment of its properties.

In patients with mild disability NMOSD: is the alteration in the cortical morphological or functional network topological properties more significant.

To assess the alteration of individual brain morphological and functional network topological properties and their clinical significance in patients with neuromyelitis optica spectrum disorder (NMOSD). Eighteen patients with NMOSD and twenty-two healthy controls (HCs) were included. The clinical assessment of NMOSD patients involved evaluations of disability status, cognitive function, and fatigue impact. For each participant, brain images, including high-resolution T1-weighted images for individual morphological brain networks (MBNs) and resting-state functional MR images for functional brain networks (FBNs) were obtained. Topological properties were calculated and compared for both MBNs and FBNs. Then, partial correlation analysis was performed to investigate the relationships between the altered network properties and clinical variables. Finally, the altered network topological properties were used to classify NMOSD patients from HCs and to analyses time- to-progression of the patients. The average Expanded Disability Status Scale score of NMOSD patients was 1.05 (range from 0 to 2), indicating mild disability. Compared to HCs, NMOSD patients exhibited a higher normalized characteristic path length (λ) in their MBNs (P = 0.0118, FDR corrected) but showed no significant differences in the global properties of FBNs (p: 0.405-0.488). Network-based statistical analysis revealed that MBNs had more significantly altered connections (P< 0.01, NBS corrected) than FBNs. Altered nodal properties of MBNs were correlated with disease duration or fatigue scores (P< 0.05/6 with Bonferroni correction). Using the altered nodal properties of MBNs, the accuracy of classification of NMOSD patients versus HCs was 96.4%, with a sensitivity of 93.3% and a specificity of 100%. This accuracy was better than that achieved using the altered nodal properties of FBNs. Nodal properties of MBN significantly predicted Expanded Disability Status Scale worsening in patients with NMOSD. The results indicated that patients with mild disability NMOSD exhibited compensatory increases in local network properties to maintain overall stability. Furthermore, the alterations in the morphological network nodal properties of NMOSD patients not only had better relevance for clinical assessments compared with functional network nodal properties, but also exhibited predictive values of EDSS worsening.