Global Cognitive Assessment Research Articles

Sarcopenia and Its Relationships with Depression, Cognition, and Physical Activity in Thai Community-Dwelling Older Adults.

Background Age-related sarcopenia is associated with physical decline, including poor functional capacity, lack of physical activity, problems with activities of daily living, and disability. However, little is known about the association between mental health problems and cognitive function in older adults with sarcopenia. Therefore, this study explored community-dwelling older adults' sarcopenia prevalence and related associations with depression, cognitive performance, and physical activity. Methods This cross-sectional study included 330 community-dwelling older adults (66.85 ± 5.54 years, 76.06% female). Based on the Asian Working Group for Sarcopenia guidelines, gait speed, muscle mass, and handgrip were assessed. All participants responded to a set of questionnaires (e.g., Global Physical Activity Questionnaire, cognitive assessment, and depression scale). Logistic regression analysis and multivariate logistic regression were used to determine independent predictors for sarcopenia. Results Overall, 16.1% of the participants were identified as having sarcopenia. Further, advanced age (i.e., mean age ≥ 70 years; odds ratio: 4.67), high depression scores (odds ratio: 2.09), mild cognitive impairment (odds ratio: 0.22), and low physical activity levels (odds ratio: 1.96) were significant associated risk factors for sarcopenia after adjusting for age, sex, and educational level. Conclusions Sarcopenia can lead to adverse health outcomes (i.e., depressive symptoms, cognitive decline, and low physical activity) in older adults.

Abstract 16628: Cognitive Dysfunction, Instrumental Activities of Daily Living, and Health-related Quality of Life in Heart Failure

Introduction: Cognitive dysfunction is common in heart failure (HF), but relationships are unclear among cognitive dysfunction, performance-based instrumental activities of daily living (IADL), and health-related quality life (HRQL). Objectives: Guided by HRQL and IADL theories, hypotheses were: 1) worse cognitive function in global cognition, memory, executive function is associated with worse performance in IADL; 2) worse performance in IADL is associated with worse HRQL; and 3) IADL mediates the relationship between cognitive dysfunction and HRQL. Methods: In a cross-sectional analysis, baseline data were used from a randomized controlled trial of cognitive training in HF (N=256, mean age 66; 54% women; EF 49%; NYHA Class I=9%, II=36%, III=55%). Measures were: global cognition-Montreal Cognitive Assessment; memory-Hopkins Verbal Learning Test; executive function-Category fluency; IADL-Everyday Problem Test; and HRQL-Living with Heart Failure Questionnaire. Higher scores of cognitive and IADL measures indicate better performance. Higher scores of HRQL indicate worse HRQL. Covariates were age, gender, education, NYHA, and depressive symptoms. Multiple linear regressions were used to test hypotheses. Results: Hypothesis 1 was supported. Worse cognitive function in global cognition, memory, executive function was associated with worse IADL (β=0.38~0.45, p<.001, R 2 =0.19~0.22). Age and education were significant covariates. Hypothesis 2 was supported. Worse IADL was associated with worse HRQL (β =0.79, p <.001, R 2 =0.55). Gender, NYHA Class, and depressive symptoms were significant covariates. Hypothesis 3 was not tested because cognitive function was not significantly related to HRQL. Conclusions: Cognitive dysfunction was associated with worse performance in IADL. Worse performance in IADL was associated with worse HRQL. Interventions to improve HRQL may need to target improving performances in both cognitive function and IADL.

Decline in kidney function over the course of adulthood and cognitive function in midlife.

To test the hypothesis that end-stage renal disease (ESRD) risk exposure during young adulthood is related to worse cognitive performance in midlife. We included 2,604 participants from the population-based Coronary Artery Risk Development in Young Adults (CARDIA) Study (mean age 35 years, 54% women, 45% Black). Estimated glomerular filtration rate and albumin-to-creatinine ratio were measured every 5 years at year (Y) 10 through Y30. At each visit, moderate/high risk of ESRD according to the Kidney Disease: Improving Global Outcomes guidelines (estimated glomerular filtration rate <60 mL/min/1.73 m2 or albumin-to-creatinine ratio >30 mg/g) was defined, totaled over examinations, and categorized into 0 episodes, 1 episode, and >1 episodes of ESRD risk. At Y30, participants underwent global and multidomain cognitive assessment. We used analysis of covariance to assess the association of ESRD risk categories with cognitive function, controlling for cardiovascular risk factors. Over the course of 20 years, 427 participants (16% of the study population) had ≥1 episodes of ESRD risk exposure. Individuals with more risk episodes had lower composite cognitive function (p < 0.001), psychomotor speed (p < 0.001), and executive function (p = 0.007). All these associations were independent of sociodemographic status and cardiovascular risk factors. In this population-based longitudinal study, we show that episodes of decline in kidney function over the young-adulthood course are associated with worse cognitive performance at midlife. Preserving kidney function in young age needs to be investigated as a potential strategy to preserve cognitive function in midlife.

Associations Between Neuroanatomic Patterns of Cerebral Infarctions and Vascular Dementia.

A history of multiple cerebral infarctions is generally regarded as an important risk factor for vascular dementia. The authors examined the risk of vascular dementia in patients with multiple acute ischemic lesions. The authors conducted a hospital-based prospective study of 11,200 patients with first-time stroke who underwent 1.5 or 3-T MRI and a global cognitive assessment. Univariate and multivariate logistic regression analyses estimated the risk of dementia associated with multiple lesions versus a single lesion. Having multiple lesions, compared with having a single lesion, was significantly associated with dementia in patients with stroke (odds ratio=5.83, 95% CI=5.08, 6.70; p<0.001). The apoliproprotein ε4 allele was more frequent in patients with multiple lesions than in those with a single lesion (odds ratio=1.70, 95% CI=1.39, 2.07; p<0.001). Severe leukoaraiosis (odds ratio=15.77, 95% CI=8.38, 29.68; p<0.001) and microbleedings (odds ratio=1.31, 95% CI=1.06, 1.63; p<0.01) were strong confounders for dementia in the multivariate analysis. Multiple logistic regression analysis showed that multiple lesions in one hemisphere versus a single lesion (odds ratio=2.14, 95% CI=1.83, 2.51; p<0.001), involvement of strategic regions (odds ratio=4.73, 95% CI=4.07, 5.49; p<0.001), and stroke lesion volume (odds ratio=1.31, 95% CI=1.03, 1.66; p=0.03) were significantly associated with dementia. There was a preponderance of lesions on the left side in patients with dementia (odds ratio=2.56, 95% CI=2.11, 3.11; p<0.001). Multiple spontaneous anterior or posterior circulation lesions after stroke increase a patient's risk of developing dementia. Recognition of multiple ischemic lesions after stroke may allow targeted rapid therapeutic interventions to prevent subsequent cognitive deterioration.

Iron leakage owing to blood-brain barrier disruption in small vessel disease CADASIL.

To assess the relationship among iron accumulation, blood-brain barrier (BBB) damage, and cognitive function in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). We enrolled 21 patients with NOTCH3 mutations and 21 age-matched healthy controls in this cross-sectional study. All participants underwent global physical and cognitive assessments and brain MRI using voxel-based quantitative susceptibility mapping (QSM; iron deposition measure) and dynamic contrast-enhanced MRI (BBB permeability measure). We compared behavioral and imaging data between the groups and analyzed the correlations in each group. Among 21 NOTCH3 mutation carriers, 10 were symptomatic and 11 asymptomatic. Montreal Cognitive Assessment scores were significantly different among the groups (symptomatic < asymptomatic < control participants). Voxel-based QSM analysis revealed that the symptomatic group had higher QSM values than did the asymptomatic group in the putamen, caudate nucleus, temporal pole, and centrum semiovale. These QSM values were positively correlated with regional BBB permeabilities (putamen: r = 0.57, p = 0.006; caudate nucleus: r = 0.51, p = 0.019; temporal pole: r = 0.48, p = 0.030; centrum semiovale: r = 0.45, p = 0.044) and negatively correlated with Montreal Cognitive Assessment scores (caudate nucleus: r = -0.53, p = 0.012; temporal pole: r = -0.56, p = 0.008). This study showed that cerebral iron burden was associated with regional BBB permeability and cognitive dysfunction in patients with CADASIL, highlighting the potential of these imaging techniques as auxiliary biomarkers to monitor the course of small vessel disease.

Telmisartan and Rosuvastatin Synergistically Ameliorate Dementia and Cognitive Impairment in Older Hypertensive Patients With Apolipoprotein E Genotype.

Objective: To investigate the effect of telmisartan, rosuvastatin, or their combination on dementia and to understand the impact of apolipoprotein E (APOE) genotype on the effect of the medications in older patients with hypertension.Methods: This is a double-blind, randomized, and placebo-controlled trial using a 2 × 2 factorial design. Between April 2008 and November 2010, 1,244 hypertensive patients aged ≥60 years without cognitive impairment were recruited from communities in six cities in Shandong area, China. Patients were randomized into telmisartan and rosuvastatin administration after a 2-week washout period. APOE genotype was identified at the baseline. Possible dementia was determined using the combination of the global cognitive function and Assessment of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE).Results: Over an average follow-up of 7 [interquartile range (IQR): 6.7–7.2] years, telmisartan and rosuvastatin significantly reduced the cognitive impairment progression and the incidence of dementia. There was a synergistic interaction between telmisartan and rosuvastatin to reduce the cognitive impairment and the incidence of dementia (Padjusted < 0.001). The cognitive impairment progression and the risk of dementia were higher in the hypertensive patients with APOE ε4 allele than in those without APOE ε4 allele. Rosuvastatin medication significantly alleviated the cognitive impairment progression and the risks of dementia in patients with APOE ε4 allele.Conclusion: The combination of telmisartan and rosuvastatin might be an effective prevention and/or treatment strategy for cognitive impairment and dementia, especially in hypertensive patients with the APOE ε4 allele.Clinical Trial Registration: www.ClinicalTrials.gov, ChiCTR.org.cn, identifier ChiCTR-IOR-17013557. Registered on April 12, 2017 – Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=23121

Global Cognitive Performance and Assessment of Memory Functions in Obstructive Sleep Apnea.

Cognitive problems in patients with obstructive sleep apnea have been suspected since the 1980s. Several studies have investigated different cognitive domains. A similar widespread survey has not been done in the Bulgarian population. This study aimed to evaluate global cognitive functioning and memory function in patients with obstructive sleep apnea and to examine the potential influence of comorbidities on cognitive functions. The study examined the neurocognitive profile of 103 consecutive patients newly diagnosed with OSA and 31 healthy controls. A list of inclusion and exclusion criteria was developed. Sleep breathing was examined in both groups. The other methods were: a medical history of patients, clinical examination, neuropsychological assessment, statistical analysis. The study found that the global cognitive functioning of patients with OSA and the memory function was impaired. Short-term memory has been found affected predominantly. Only obesity was distinguished as a major factor relevant to the severity of cognitive changes in the study group. A statistically significant difference between the groups with and without obesity was found for the applied memory tests, except for the delayed recall and word recognition. The duration of exposure to hypoxia and sleep fragmentation is important for the severity of cognitive deficits. The results confirmed this theory showing that this factor is among the major severity factors. The study found that the global cognitive functioning of patients with OSA, as well as memory function, were impaired. The role of comorbidities is complex and far from clear.

Magnetic Susceptibility Associates With Dopaminergic Deficits and Cognition in Parkinson's Disease.

The objective of this study was to assess the relationship between nigrostriatal magnetic susceptibility and dopamine transporter abnormality and their associations with behavioral and cognitive impairments in patients with Parkinson's disease (PD). For this case-control study, we enrolled 41 patients with PD and 20 age-matched healthy controls. All participants underwent global physical and cognitive assessments, 3-Tesla brain magnetic resonance imaging including quantitative susceptibility mapping (QSM; iron deposition measure), and 123 I-N-v-fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl) nortropane single-photon emission computed tomography (dopamine transporter measure). We subdivided the striatum into the putamen, caudate nucleus, and nucleus accumbens and measured the nigrostriatal QSM values and dopamine transporter-specific binding ratios using an atlas-based approach. The patients with PD had higher QSM values in the substantia nigra and subdivisions of the striatum than did the healthy controls. The striatal dopamine transporter-specific binding ratios were not correlated with the QSM values of the substantia nigra but were inversely correlated with those of the striatum (putamen, r = -0.478, P = 0.009; caudate nucleus, r = -0.462, P = 0.011). The QSM values of the putamen were positively correlated with motor parkinsonism scores (Movement Disorder Society Unified Parkinson's Disease Rating Scale, r = 0.505, P = 0.003), and those of the caudate nucleus were negatively correlated with cognitive impairment scores (Montreal Cognitive Assessment, r = -0.525, P < 0.001). This study showed that striatal iron accumulations were correlated with dopaminergic deficits and neurophysiological signs in patients with PD, highlighting the potential of QSM as an auxiliary biomarker for parkinsonism and cognitive dysfunction. © 2020 International Parkinson and Movement Disorder Society.

Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging

PurposeTo investigate cerebral blood flow (CBF) characteristics before and after hemodialysis initiation and their longitudinal associations with global cognitive function in older adults. MethodsA cohort of 17 older end-stage renal disease patients anticipating standard thrice-weekly hemodialysis and a group of 11 age- and sex-matched healthy control volunteers were recruited for brain perfusion imaging studies using arterial spin labeling. Hemodialysis patients participated in a prospective longitudinal study using brain magnetic resonance imaging and global cognitive assessment using the Modified Mini-Mental State Examination (3MS) at two time points: baseline, 2.9 ± 0.9 months before, and follow-up, 6.4 ± 2.4 months after hemodialysis initiation. Healthy controls were imaged once using the same protocol. CBF analyses were performed globally in grey and white matter and regionally in the hippocampus and orbitofrontal cortex. Covariate-adjusted linear mixed-effects models were used for statistical analyses (significance: p < 0.05; marginal significance: p < 0.1). ResultsAt baseline, global and regional CBF was significantly higher in hemodialysis patients than in healthy controls. However, after approximately 6 months of hemodialysis, CBF declined substantially in hemodialysis patients, and became comparable to those in healthy controls. Specifically, in the hemodialysis patients, CBF declined non-significantly globally for grey and white matter and significantly regionally in the hippocampus and orbitofrontal cortex. Marginally significant associations were observed between 3MS scores and regional CBF measurements in the hippocampus and orbitofrontal cortex at baseline and follow-up, and between longitudinal changes. ConclusionThe significant decline in CBF after hemodialysis initiation and the observed association between longitudinal changes in regional CBF and 3MS scores suggest that decreased brain perfusion may contribute to the observed cognitive decline.

Nutritional Interventions for the Prevention of Cognitive Impairment and Dementia in Developing Economies of East Asia: Systematic Review and Meta-analysis

AbstractIntroductionDementia represents one of the impending global health challenges, and low and middle-income countries (LMICs) are projected to greatly contribute to the rising dementia global burden. Currently, there is a lack of pharmacological treatment for dementia and therefore research efforts have focused on prevention, with the identification of early lifestyle, demographic and nutritional risk factors. In particular, diet may be an important modifiable risk factor for maintenance of cognitive health in later life. There are plausible suggestions to support the synergistic effects of certain nutrients, such as polyphenols, unsaturated fats and antioxidant vitamins, in having a beneficial role in the modulation of oxidative stress and neuro-inflammation – processes associated with cognitive decline. Therefore, the aim of this systematic review was to evaluate the current evidence on nutritional interventions for the prevention of dementia in developing economies in East Asia.Materials and MethodsFour comprehensive medical databases were searched from inception until February 2019: MEDLINE, EMBASE, PsycINFO and Scopus. The literature search was restricted to randomised clinical trials [RCTs], conducted in adult humans [ ≥ 18 years], assessing the effect of nutritional interventions on cognitive performance, and / or incidence of mild cognitive impairment [MCI] or dementia. The outcome of interest for the meta-analysis was: [1] global cognitive performance and [2] domain specific cognitive performance. Data was pooled by random model analysis and estimates of effect size were given for each domain and sub-categorised according to the type of nutritional intervention.ResultsTwenty-two RCTs were included, of which, sixteen studies showed significant beneficial effects in favor of the nutritional intervention based on single neuropsychological test scores and / or scores of global cognitive assessment tools. Sixteen studies had sufficient data reported for meta-analysis, and marginally significant beneficial effects were found on global cognitive performance in elderly for micro-nutrient supplementation [n = 4 studies, n = 451 participants, std mean difference: 0.41 [-0.03; 0.84], p = 0.07], and EPA / DHA supplementation [n = 4 studies, n = 373 participants, std mean difference 0.57 [-0.01; 1.14], p = 0.06].DiscussionSeveral promising strategies, such as B-vitamin supplementation, EPA / DHA supplementation and nutrition and lifestyle counselling interventions, seem to be able to decrease age-related cognitive decline in East Asia. Large, good quality, long term trials are needed to confirm these findings, to further evaluate the role of nutritional interventions on cognitive function and to identify if these interventions are feasible and effective to decrease dementia incidence in developing economies, like East Asia.

REAL-WORLD REPRESENTATIVENESS OF CANADIAN RESEARCH SUBJECTS WITH MILD COGNITIVE IMPAIRMENT

Studies of mild cognitive impairment (MCI) utilize stringent inclusion/exclusion criteria which may impact the generalizability of findings to the broader clinical population. We compared characteristics of MCI patients in a Canadian memory clinic in Calgary to MCI research participants in published Canadian studies to assess the representativeness of research samples. Clinic participants included 555 MCI patients from the Prospective Study for Persons with Memory Symptoms registry. Research participants included 4,981 individuals with MCI retained from a systematic literature review of 112 peer-reviewed empirical Canadian studies. Clinic patients and research participants were diagnosed with MCI using similar diagnostic criteria (i.e., from the NIA-AA, or Petersen criteria). Both samples were compared on baseline demographic variables, medical and psychiatric comorbidities, and global cognitive performance using chi-square tests and t-tests with weighted means. Diverse presumed causes were noted among clinic patients. Clinic patients were younger, more likely to be male, and more educated than research participants (ds: 0.22-0.98). Psychiatric disorders, traumatic brain injury, and sensory impairments were common in clinic patients (up to 83%), but participants with these conditions were excluded from approximately 80% of studies in the systematic review. Clinic patients performed significantly worse on two global cognitive assessments (ds: 0.53 – 1.27). Stringent eligibility criteria such as used in Canadian MCI research studies would exclude a considerable subset of MCI patients seen in our referral clinic. This may have contributed to the disparities between the clinical and research cohorts in the cognitive measures examined. The implications of these findings will be discussed.

Voxel-based quantitative susceptibility mapping in Parkinson's disease with mild cognitive impairment.

Brain iron accumulation has been proposed as one of the pathomechanisms in Parkinson's disease (PD). This study aimed to examine the whole-brain pattern of iron accumulation associated with cognitive impairment in patients with PD using voxel-based quantitative susceptibility mapping analysis. We enrolled 24 patients with PD and mild cognitive impairment, 22 patients with PD and normal cognition, and 20 age-matched healthy controls in this cross-sectional study. All participants underwent global cognitive and physical assessments and brain MRI. Using a combined method of voxel-based morphometry and quantitative susceptibility mapping, we compared the voxel-wise magnetic susceptibility of the whole brain between the groups and analyzed its correlation with the cognitive and behavioral data. The PD and mild cognitive impairment group had lower Montreal Cognitive Assessment (MoCA) score than the PD and normal cognition and healthy control groups. There were no gray matter volumetric differences between the groups. In contrast, the voxel-based quantitative susceptibility mapping analysis showed that the PD and mild cognitive impairment group had significantly higher quantitative susceptibility mapping values in the cuneus, precuneus, caudate head, fusiform gyrus, and orbitofrontal cortex than did the PD and normal cognition group. These quantitative susceptibility mapping values were negatively correlated with the MoCA scores in the PD patients (cuneus: r = -0.510, P < .001; caudate head: r = -0.458, P = 0.002). This study suggests that cognitive impairment in PD is associated with cerebral iron burden and highlights the potential of quantitative susceptibility mapping as an auxiliary biomarker for early evaluation of cognitive decline in patients with PD. © 2019 International Parkinson and Movement Disorder Society.

Effect of Vitamin D on Cognitive Functions in Older Adults: 24-Week Follow-Up Study.

The purpose of this study is to assess the effect of vitamin D replacement on cognitive function in older adults. A total of 560 patients who underwent comprehensive geriatric assessment including Global cognitive assessment, Basic Activities of Daily Living (BADL), and Instrumental Activities of Daily Living (IADL) twice in 6-month period were retrospectively reviewed. Oral cholecalciferol was replaced to patients with vitamin D deficiency routinely. In baseline cognitive scores, BADL-IADL scores were lower in the severe deficiency group than in the deficiency and adequate groups (P < .05). With regard to the relation between changes in cognitive functions, BADL-IADL scores on the 6-month versus baseline, no difference was determined in patients with and without dementia (P > .05). Vitamin D replacement may not improve cognitive performance in older adults, even if vitamin D is raised to adequate level, suggesting that longer term replacement therapy may be needed to improve cognitive function.

Comparative sensitivity of the MoCA and Mattis Dementia Rating Scale‐2 in Parkinson's disease

Clinicians and researchers commonly use global cognitive assessments to screen for impairment. Currently there are no published studies directly comparing the sensitivity and specificity of the Montreal Cognitive Assessment and Mattis Dementia Rating Scale-2 in PD. The objective of this study was to identify the relative sensitivity and specificity of the Montreal Cognitive Assessment and Mattis Dementia Rating Scale-2 in PD. The Montreal Cognitive Assessment and Mattis Dementia Rating Scale-2 were administered to training and validation cohorts. Cutoff scores were determined within the training cohort (n = 85) to optimize sensitivity and specificity for cognitive impairment and were applied to an independent validation cohort (n = 521). The Montreal Cognitive Assessment was consistently sensitive across training and validation cohorts (90.0% and 80.3%, respectively), whereas the Mattis Dementia Rating Scale-2 was not (87.5% and 60.3%, respectively). In individual domains, the Montreal Cognitive Assessment remained sensitive to memory and visuospatial impairments (91.9% and 87.8%, respectively), whereas the Mattis Dementia Rating Scale-2 was sensitive to executive impairments (86.2%). The Montreal Cognitive Assessment and Mattis Dementia Rating Scale-2 demonstrated individual strengths. Future work should focus on developing domain-specific cognitive screening tools for PD. © 2018 International Parkinson and Movement Disorder Society.

Muscle profile and cognition in patients with Alzheimer's disease dementia.

Neurodegenerative disease is one of the main contributing factors affecting muscle atrophy. However, this intriguing brain-muscle axis has been explained by the unsubstantial mechanisms. Although there have been several studies that have evaluated the muscle profile and its relation to cognition in patients with dementia, there is still lack of data using standardized methods and only few published studies on Korean populations. The objective of this study is to evaluate the relationship of muscle mass and strength to cognition in patients with Alzheimer's disease dementia (AD). We recruited 91 patients with probable AD without weakness. We assessed patients' basic demographic characteristics, vascular risk, body mass index, and global cognitive assessment scores. Muscle mass was measured using body dual-energy X-ray absorptiometry. Muscle strength was assessed by isokinetic knee extensor using an isokinetic device at an angular velocity of 60°/s in nm/kg. The muscle mass and strength were not related to each other in both male and female groups. Only muscle strength, but not muscle mass, was negatively related to cognition. After adjusting for covariates, the relationship between muscle strength and cognition still remained in the male group, however, was attenuated in the female group. In patients with AD dementia, abundant muscle mass did not mean strong power. The simple lower-extremity muscle strength assessment is more effective in predicting cognition than a muscle mass measure in male patients.

Cognitive and functional connectivity alterations in Friedreich's ataxia.

ObjectiveThe aim of this study was to perform the first resting‐state functional MRI (RS‐fMRI) analysis in Friedreich's ataxia (FRDA) patients to assess possible brain functional connectivity (FC) differences in these patients, and test their correlations with neuropsychological performances.MethodsIn total, 24 FRDA patients (M/F: 15/9, mean age 31.3 ± 15.0) and 24 healthy controls (HC; M/F: 15/9, mean age 30.7 ± 15.5) were enrolled in this cross‐sectional study. All patients underwent a thorough neuropsychological battery, investigating different cognitive domains. RS‐fMRI data were analyzed using a seed‐based approach, probing the FC of cortical areas potentially referable to specific executive and cognitive functions compromised in FRDA.ResultsCompared to HC, FRDA patients showed overall worse neuropsychological scores in several domains, including global cognitive assessment, spatial memory, visuoperception and visuospatial functions, and executive functions. Analysis of RS‐fMRI data showed a higher FC in FRDA patients compared to HC between paracingulate gyri and the medial frontal gryrus, between the superior frontal gyrus and bilateral angular gyri, and between the middle temporal gyrus and the cingulate gyrus, with a reduced FC between the medial frontal gryrus and the cerebellum.InterpretationWe found a reduction in FC between frontal areas and the contralateral cerebellar cortex in FRDA, in line with the known alteration in cerebello‐cortical pathway in this condition. On the other hand, a higher FC between different cortical areas was shown, possibly reflecting a compensatory phenomenon. These results, in conjunction with clinical findings, may shed new light on the pattern of supratentorial and infratentorial involvement, and on dynamics of brain plasticity in this disease.

Effects of tai chi on cognition and instrumental activities of daily living in community dwelling older people with mild cognitive impairment

BackgroundCognitive impairment places older adults at high risk of functional disability in their daily-life activities, and thus affecting their quality of life. This study aimed to examine the effects of Tai Chi on general cognitive functions and instrumental activities of daily living (IADL) in community-dwelling older people with mild cognitive impairment (MCI) in Hong Kong.MethodsThe study adopted a multi-site nonequivalent control-group pretest-posttest design. 160 community-dwelling older people, aged ≥60, with MCI, from four community elderly centers participated in the study. The intervention group (IG, n = 80) received training in the Yang-style simple form of Tai Chi, at a frequency of two lessons per week for 16 weeks. Each lesson lasted for one hour. The control group (CG, n = 80) had no treatment regime and joined different recreational activity groups in community centers as usual within the study period. Outcome measures included measures of global cognitive status and IADL. The Chinese version of the Mini-Mental State Examination (CMMSE) was used for global cognitive assessment. The Hong Kong Chinese version of Lawton’s Instrumental Activities of Daily Living (IADL-CV) was used to assess the participants’ IADL levels. General Estimating Equations (GEE) was used to examine each of the outcome variables for the two groups at the two study time points (the baseline and at the end of the study). Meanwhile, minimum detectable change (MDC) was calculated to estimate the magnitude of changes required to eradicate the possibility of measurement error of outcome measures.ResultsSeventy four participants in the IG and 71 participants in the CG completed the study. With adjustments for differences in age, education, marital status and living conditions, the findings revealed that the participants in the IG scored significantly better on the CMMSE test (P = 0.001), and the instrumental ADL questionnaire (P = 0.004). However, those scores changes did not exceed the limits of the respective MDCs in the study, the possibility of measurement variation due to error could not be excluded.ConclusionTai Chi may be an effective strategy to enhance cognitive health and maintain functional abilities in instrumental ADL in older people with MCI.Trial registrationNCT03404765 (Retrospectively registered January 19, 2018)

Trajectories of Cognitive Aging in Older Women: Role of Fine Particulate Matter

Background/Aim: Cross-sectional studies have found associations of cognitive deficits with long-term exposure to particulate matter. Few longitudinal studies have shown inconsistent associations, and their analyses with limited neuropsychological assessments could not separate learning effects from trajectories of cognitive decline in late life. Methods: We examined how fine particulate matter (PM2.5: PM with aerodynamic diameters &lt;2.5µm) was associated with cognitive declines in a geographically-diverse US population of older women (N=7064; aged 65-80) from the Women’s Health Initiative Memory Study, with up to 9 annual global cognitive assessments (in 6.3±2.1 visits) using the Modified Mini-Mental State (3MS) Exam. Given residential histories and ambient monitoring data coupled with air quality model simulation, the Bayesian Maximum Entropy method was used to estimate long-term (3-year average) PM2.5 exposures preceding each visit. We fit longitudinal linear mixed-effects models to standardized 3MS z-scores and assessed how cognitive trajectories were influenced by PM2.5 exposures, adjusting for socio-demographic (age; residential geography; race/ethnicity; education; income; employment status), lifestyle (smoking; alcohol use), and clinical factors (body mass index; hypertension; cardiovascular diseases). Results: Two concurrent processes of cognitive aging were identifiable. The first trajectory showed 3MS scores increased with visit numbers (p&lt;0.001), likely reflecting a systematic difference that included the learning effect. The second trajectory was defined by the age-related decrease in 3MS, incrementally with faster declines during the extended follow-up (interaction p&lt;0.0001). For the first trajectory, we found no appreciable differences by PM2.5 exposure (interaction p=0.88). The effect of aging on 3MS was accelerated by increased PM2.5 (interaction p&lt;0.0001); this apparent neurotoxic effect was masked when the second trajectory was ignored in the mixed-effect model. Conclusions: This longitudinal study provides further evidence that late-life exposure to PM2.5 accelerates age-related cognitive decline. Our analyses also demonstrate the importance of accounting for the underlying trajectories of cognitive aging in community-dwelling populations.

GANDRA-BARTA FOR THE ASSESSMENT OF FACIAL EMOTION RECOGNITION IN ACQUIRED BRAIN INJURY

[b]Background[/b][b]:[/b] Patients with acquired brain injury (ABI) may experience social difficulties more specifically in the emotional recognition of faces. The present research aims to test the discriminative validity of Gandra-BARTA to the changes in the emotional recognition of faces after ABI and to perceive its connection with the general cognitive functioning, executive functioning and other variables associated with ABI. [b]Material/ Methods: [/b]The sample consists of two groups, the Clinical Group (n=20, ABI participants) and the Control Group (n=16, healthy participants). All participants underwent a global cognitive assessment through the Montreal Cognitive Assessment (MoCA), executive functioning was measured by INECO Frontal Screening and the evaluation of emotional recognition of faces through Gandra-BARTA.[b]Results: [/b]The results demonstrate that Gandra-BARTA presents discriminative capacity for the evaluation of the emotional recognition of faces in patients with acquired brain injury. We observed differences between the two groups in the capacity of emotional recognition especially in the identification of emotions such as anger, disgust, happiness and surprise. The study also shows the existence of a decline in the identification of emotions with age, in the recognition of the disgusting stimuli presents a deficit related to the age and executive functioning, while with the rage the decline is related to the age and schooling. The emotional recognition of faces presents improvements with time after injury. Identification of the neutral expression demonstrates an improvement over time after injury.[b]Conclusions:[/b]The discriminative ability of Gandra-BARTA allows it to be an instrument to be used in the evaluation of the emotional recognition of faces in patients with acquired brain injury. Individuals with brain injury have difficulties in identifying anger, disgust, happiness and surprise. Emotional recognition differs in relation to age, executive functioning, schooling, and time after injury.

A Comparison Study of Cognitive and Neuropsychiatric Features of Essential Tremor and Parkinson's Disease.

BackgroundEssential tremor (ET) and Parkinson’s disease (PD) are two of the most common movement disorders. Leaving aside their motor features, these two conditions share several non-motor features, including cognitive dysfunction and personality changes. However, there are few data comparing the cognitive and personality profiles of ET with PD. Here we compare the cognitive and personality profiles of the two diseases.MethodsThirty-two consecutive non-demented ET patients (13 females and 19 males) (67.7±9.8 years), 32 non-demented PD patients (13 females and 19 males) (67.7±9.5 years), and 32 healthy matched controls (14 females and 18 males) (67.9±10.1 years) underwent a neuropsychological test battery, including a global cognitive assessment and tests of attention, executive function, memory, language, and visuospatial function, as well as the Personality Assessment Inventory. Multivariable linear regression analyses were performed, adjusted for age, sex, years of education, medications that potentially affect cognitive function, number of medications, and the 17-item Hamilton Depression Rating Scale Total Score.ResultsNeuropsychological scores were similar in PD and ET patients, but patients with disease performed more poorly than control subjects in cognitive tasks such as attention, executive function, memory, and naming.DiscussionET and PD exhibited similar deficits in specific aspects of neuropsychological functioning, particularly those thought to rely on the integrity of the prefrontal cortex, and this suggests involvement of frontocerebellar circuits. These findings further challenge the traditional view of ET as a benign and monosymptomatic disorder.