Large Sample Of Persons Research Articles

Profiling cognitive-motor interference in a large sample of persons with progressive multiple sclerosis and impaired processing speed: results from the CogEx study.

Performing cognitive-motor dual tasks (DTs) may result in reduced walking speed and cognitive performance. The effect in persons with progressive multiple sclerosis (pwPMS) having cognitive dysfunction is unknown. To profile DT-performance during walking in cognitively impaired pwPMS and examine DT-performance by disability level. Secondary analyses were conducted on baseline data from the CogEx-study. Participants, enrolled with Symbol Digit Modalities Test 1.282 standard deviations below normative value, performed a cognitive single task ([ST], alternating alphabet), motor ST (walking) and DT (both). Outcomes were number of correct answers on the alternating alphabet task, walking speed, and DT-cost (DTC: decline in performance relative to the ST). Outcomes were compared between EDSS subgroups (≤ 4, 4.5-5.5, ≥ 6). Spearman correlations were conducted between the DTCmotor with clinical measures. Adjusted significance level was 0.01. Overall, participants (n = 307) walked slower and had fewer correct answers on the DT versus ST (both p < 0.001), with a DTCmotor of 15.8% and DTCcognitive of 2.7%. All three subgroups walked slower during the DT versus ST, with DTCmotor different from zero (p's < 0.001). Only the EDSS ≥ 6 group had fewer correct answers on the DT versus ST (p < 0.001), but the DTCcognitive did not differ from zero for any of the groups (p ≥ 0.039). Dual tasking substantially affects walking performance in cognitively impaired pwPMS, to a similar degree for EDSS subgroups.

Changes in Apathy, Depression, and Anxiety in Parkinson's Disease from before to during the COVID-19 Era.

Apathy, depression, and anxiety are common non-motor symptoms of Parkinson's disease (PD). Tracking the changes in such symptoms over time would be valuable not only to determine their natural course during the disease, but also to establish the effects of unusual historical events interacting with the natural course. Having collected data on apathy (Apathy Scale), depression (Beck Depression Inventory-II), and anxiety (Parkinson's Anxiety Scale) in a large sample of persons with PD (PwPD) before the beginning of the COVID-19 era, we followed up with these individuals to investigate the changes in their prevalence of apathy, depression, and anxiety across two timepoints (T1 and T2). Of the original 347 participants, 111 responded and provided complete data at T2. The data collection at T1, before COVID-19, occurred between 2017-2018. The data collection at T2 occurred in 2021 and included the same measures, with the addition of the Coronavirus Impact Scale to assess the effects of the pandemic on the individual participants. Over this period, there was a significant increase in apathy, but not in depression or anxiety. Anxiety and depression, but not apathy, were correlated with the impact of COVID-19.

Genomics and human diversity

The sequencing of the human genome (2003) has been followed by a number of technical developments that allow detailed characterization (including complete sequencing) of the DNA of thousands of individuals. This has provided an estimate of human genetic diversity: approx. 3 million base substitutions within our genome that includes 3,000 million bases. Although the divergence between any two individuals is small, it is responsible for much of the phenotypic diversity observed within the human population, and current techniques make it possible to measure genetic distances between any two individuals whose genome has been analysed. When results from a large sample of persons are analysed by sophisticated multi-dimensional representation, fairly distinct clusters appear in the population, indicating groups of individuals that are more similar to each other than to persons from other groups. Although these groups are defined by genome analysis, without any a priori information on their origin, it turns out that they largely correspond to so-called “ethnic” categories that reflect genetic ancestry (e.g. Europeans, Africans and Asians). Every group is internally quite diverse, but analysis of thousands of genetic markers does indeed differentiate between them. “Race”, as commonly defined, is a very imperfect proxy for these ancestry groups, as it suggests high homogeneity within each group, implies assumptions about behaviour and “character” that have no scientific basis, and is heavily tainted by past uses in support of oppression and even genocide. Thus “ancestry” or “ancestry group” is a highly preferable term, especially now that more and more people are of mixed ancestry. These methods have been widely applied to current populations and to “ancient DNA” from historical samples, and have made possible great strides in understanding the history of our species.

La génomique et la diversité humaine

The sequencing of the human genome (2003) has been followed by a number of technical developments that allow detailed characterization (including complete sequencing) of the DNA of thousands of individuals. This has provided an estimate of human genetic diversity: approx. 3 million base substitutions within our genome that includes 3,000 million bases. Although the divergence between any two individuals is small, it is responsible for much of the phenotypic diversity observed within the human population, and current techniques make it possible to measure genetic distances between any two individuals whose genome has been analysed. When results from a large sample of persons are analysed by sophisticated multi-dimensional representation, fairly distinct clusters appear in the population, indicating groups of individuals that are more similar to each other than to persons from other groups. Although these groups are defined by genome analysis, without any a priori information on their origin, it turns out that they largely correspond to so-called “ethnic” categories that reflect genetic ancestry (e.g. Europeans, Africans and Asians). Every group is internally quite diverse, but analysis of thousands of genetic markers does indeed differentiate between them. “Race”, as commonly defined, is a very imperfect proxy for these ancestry groups, as it suggests high homogeneity within each group, implies assumptions about behaviour and “character” that have no scientific basis, and is heavily tainted by past uses in support of oppression and even genocide. Thus “ancestry” or “ancestry group” is a highly preferable term, especially now that more and more people are of mixed ancestry. These methods have been widely applied to current populations and to “ancient DNA” from historical samples, and have made possible great strides in understanding the history of our species.

Genomics and human diversity

The sequencing of the human genome (2003) has been followed by a number of technical developments that allow detailed characterization (including complete sequencing) of the DNA of thousands of individuals. This has provided an estimate of human genetic diversity: approx. 3 million base substitutions within our genome that includes 3,000 million bases. Although the divergence between any two individuals is small, it is responsible for much of the phenotypic diversity observed within the human population, and current techniques make it possible to measure genetic distances between any two individuals whose genome has been analysed. When results from a large sample of persons are analysed by sophisticated multi-dimensional representation, fairly distinct clusters appear in the population, indicating groups of individuals that are more similar to each other than to persons from other groups. Although these groups are defined by genome analysis, without any a priori information on their origin, it turns out that they largely correspond to so-called “ethnic” categories that reflect genetic ancestry (e.g. Europeans, Africans and Asians). Every group is internally quite diverse, but analysis of thousands of genetic markers does indeed differentiate between them. “Race”, as commonly defined, is a very imperfect proxy for these ancestry groups, as it suggests high homogeneity within each group, implies assumptions about behaviour and “character” that have no scientific basis, and is heavily tainted by past uses in support of oppression and even genocide. Thus “ancestry” or “ancestry group” is a highly preferable term, especially now that more and more people are of mixed ancestry. These methods have been widely applied to current populations and to “ancient DNA” from historical samples, and have made possible great strides in understanding the history of our species.

La génomique et la diversité humaine

The sequencing of the human genome (2003) has been followed by a number of technical developments that allow detailed characterization (including complete sequencing) of the DNA of thousands of individuals. This has provided an estimate of human genetic diversity: approx. 3 million base substitutions within our genome that includes 3,000 million bases. Although the divergence between any two individuals is small, it is responsible for much of the phenotypic diversity observed within the human population, and current techniques make it possible to measure genetic distances between any two individuals whose genome has been analysed. When results from a large sample of persons are analysed by sophisticated multi-dimensional representation, fairly distinct clusters appear in the population, indicating groups of individuals that are more similar to each other than to persons from other groups. Although these groups are defined by genome analysis, without any a priori information on their origin, it turns out that they largely correspond to so-called “ethnic” categories that reflect genetic ancestry (e.g. Europeans, Africans and Asians). Every group is internally quite diverse, but analysis of thousands of genetic markers does indeed differentiate between them. “Race”, as commonly defined, is a very imperfect proxy for these ancestry groups, as it suggests high homogeneity within each group, implies assumptions about behaviour and “character” that have no scientific basis, and is heavily tainted by past uses in support of oppression and even genocide. Thus “ancestry” or “ancestry group” is a highly preferable term, especially now that more and more people are of mixed ancestry. These methods have been widely applied to current populations and to “ancient DNA” from historical samples, and have made possible great strides in understanding the history of our species.

Associations Between Acculturation, Depressive Symptoms, and Life Satisfaction Among Migrants of Turkish Origin in Germany: Gender- and Generation-Related Aspects

ObjectiveThe aim of the present study was to investigate the degree of depressive symptoms and life satisfaction (LS) as well as the association between acculturation and depressive symptoms among a large sample of persons with Turkish migration background in Germany, taking into account gender- and migration-related differences.MethodsThis study was part of a pretest for a large national epidemiological cohort study in Germany. Acculturation was measured using the Frankfurt Acculturation Scale (FRACC). Based on the median split of the two subscales, four acculturative styles according to Berry (integration, assimilation, separation and marginalization) were determined. Depressive symptoms were assessed with the depression module (PHQ-9) from the Patient Health Questionnaire. LS was assessed with a single item on a scale from 1 = bad to 5 = excellent. Differences in levels of depressive symptoms and LS in relation to gender and generation of migration were tested with analysis of covariance, controlling for age. Gender-stratified multiple linear regression analyses were also conducted for depressive symptoms as criterion variable.Results328 Turkish migrants participated (61.3% women). The cut-off-value of ≥10 for the PHQ-9 was achieved by 33.2% of the women and 26.4% of the men (p=0.209, φ=0.071). In female migrants, the age-adjusted mean score for depressive symptoms was 7.81 (SD=6.42), in males 6.70 (SD=6.41) (p=0.137, η2=0.007). After controlling for unemployment status, women showed a trend for being more frequently depressed than men (p=0.055, φ=0.117) and also demonstrated a trend for higher levels of depressive symptoms (p=0.072, η2=0.012). No significant gender-specific difference was found concerning age-adjusted mean score for LS (p=0.547, η2=0.001), also when controlled for unemployment status (p=0.322, η2=0.004). In both sexes, the second generation demonstrated a significantly higher age-adjusted mean score for LS of small/medium effect size than the first generation. In women, separation as acculturation style (linear regression coefficient (B=4.42, 95% CI=1.68, 7.17, p=0.002; reference: integration), having no partnership (B=2.56, 95% CI=0.26, 4.86, p=0.03) and lower education (B=-2.28, 95% CI=-4.54, -0.02, p=0.048) were associated with higher severity of depressive symptoms; in men, separation as acculturation style (B=4.01, 95% CI=0.70, 7.31, p=0.018; reference: integration) and employment status (B=-3.32, 95% CI=-5.71, -0.92, p=0.007) were related to depression levels.ConclusionsSeparation as acculturation style is associated with higher levels of depressive symptoms (for both genders). Gender-sensitive health promotion programs should target separated migrants to improve their integration into the German society.

Device-Measured Physical Activity and Cognitive Processing Speed Impairment in a Large Sample of Persons with Multiple Sclerosis.

There is accumulating evidence regarding the beneficial effects of physical activity (PA) on cognitive processing speed in persons with multiple sclerosis (MS). However, one overarching limitation of this research is that researchers have not recruited samples who have the actual problem of being studied (i.e., cognitive processing speed impairment). This study examined associations between device-measured PA and cognitive processing speed in a large sample of persons with MS overall and between those with and without cognitive processing speed impairment. Three hundred eighty-five persons with MS underwent the oral Symbol Digit Modalities Test (SDMT) and wore an accelerometer for 7 days for PA measurement. We divided the overall sample into subsamples with (n = 140) and without (n = 245) cognitive processing speed impairment based on age, sex, and education-adjusted SDMT Z-scores. After controlling for age and disability status, higher levels of device-measured PA were significantly associated with faster cognitive processing speed overall, and the association was significantly stronger among persons with MS who presented with cognitive processing speed impairment. This examination provides initial cross-sectional support for informing the development of PA interventions as a possible approach for managing MS-related cognitive processing speed impairment. This highlights the importance of developing purposefully designed trials involving PA interventions for targeting cognitive processing speed as a primary end point among persons with MS with impaired cognitive processing speed.

Metformin Is Associated With Reduced Odds for Colorectal Cancer Among Persons With Diabetes.

INTRODUCTION:Metformin may be associated with reduced colorectal cancer (CRC) risk, but findings from previous studies have been inconsistent and had insufficient sample sizes to examine whether the association differs by anatomic site. This study examined whether metformin was associated with reduced CRC risk, both overall and stratified by anatomic site, in a large sample of persons with diabetes who underwent colonoscopy.METHODS:We performed a case-control study of US Veterans with prevalent diabetes who underwent colonoscopy between 1999 and 2014 using Department of Veterans Affairs electronic health record data. Cases were defined by presence of CRC at colonoscopy, while controls had normal colonoscopy. The primary exposure was metformin use at time of colonoscopy (yes/no). Association of metformin exposure with CRC (further stratified by proximal, distal, or rectal subsite) was examined using multivariable and multinomial logistic regression and summarized by odds ratios (ORs) with 95% confidence intervals (CIs).RESULTS:We included 6,650 CRC patients and 454,507 normal colonoscopy patients. CRC cases were older and had lower metformin exposure. Metformin was associated with 8% relative reduction in CRC odds (OR: 0.92, 95% CI: 0.87–0.96). By subsite, metformin was associated with a 14% statistically significant reduced rectal cancer odds (OR: 0.86, 95% CI: 0.78–0.94) but no reduced distal or proximal cancer odds.DISCUSSION:Metformin was associated with reduced CRC odds—particularly rectal cancer—in a large sample of persons with diabetes undergoing colonoscopy.

Predictors of hospital-based multidisciplinary rehabilitation effects in persons with multiple sclerosis: a large-scale, single-centre study.

BackgroundPersons with multiple sclerosis may benefit from hospital-based multidisciplinary rehabilitation.ObjectivesTo investigate the effects of hospital-based multidisciplinary rehabilitation and to identify their potential predictors in a large sample of persons with multiple sclerosis.MethodsFrom the charts of 655 persons with multiple sclerosis consecutively admitted to our unit, disease profiles, modified Barthel index, Expanded Disability Status Scale (EDSS), pain numerical rating score and type of interventions were retrospectively collected. We defined an improvement at discharge as follows: modified Barthel index increase of at least 5 points, EDSS decrease of 1.0 if baseline score was 5.5 or less and of 0.5 if baseline score was greater than 5.5; any numerical rating score decrease.ResultsAfter a median admission period of 36 days, at discharge 65%, 22% and 89% of persons with multiple sclerosis improved for modified Barthel index, EDSS and numerical rating score, respectively. The modified Barthel index improvement was associated with shorter disease duration, lower EDSS at baseline and with access to psychological counselling. EDSS improvement was associated with shorter disease duration, relapsing–remitting course, female gender and longer duration of the admission period.ConclusionsInpatient multidisciplinary rehabilitation was associated with improved autonomy in activities of daily living in a relevant proportion of persons with multiple sclerosis. The effect seems to be more evident in individuals with shorter multiple sclerosis duration and relapsing–remitting disease course.

O5.5. SLEEP IN MAJOR PSYCHIATRIC DISORDERS: RESULTS FROM NATIONWIDE SUPER FINLAND STUDY

BackgroundPeople with psychotic disorders demonstrate a wide spectrum of sleep abnormalities. Abnormalities include changes in total sleep time, increased sleep onset latency, increased wake-up time after sleep onset and abnormalities in sleep architecture. The study aimed to characterize the sleep difficulties in a large sample of persons with psychotic disorders and to examine association with age and gender.MethodsAltogether, 5046 persons with a major psychiatric disorder (schizophrenia: 2972, schizoaffective disorder: 640, bipolar disorder: 1097 and psychotic depression: 330) and aged 18–80 participated in a nationwide Super project. The Finnish SUPER (Finnish acronym for “Finnish study on genetic mechanisms of psychotic disorders”) study is a part of the international Stanley Global Neuropsychiatric Genomics Initiative. The results were compared with a representative general population sample of 8018 adults (Health 2000). Sleep was assessed in a self-report questionnaire. In the present study we used total sleep time, tiredness (defined as feeling more tired than other people of the same age during day time at least weakly, yes/no), difficulties in getting sleep without sleep medication often or almost daily (yes/no) and early morning or night awakenings occurring either often or nearly every night (yes/no).ResultsLong sleep (> 10h) was most common in persons with schizophrenia or schizoaffective disorder reported by approximately 30% when age was 18–40. The corresponding proportion was approximately 15% in persons with bipolar disorder or psychotic depression and less than 1% in the general population. Tiredness, difficulties in getting sleep and early morning or night awakenings were reported most by persons with bipolar disorder and psychotic depression, but also persons with schizophrenia reported those more than the general population in people with under 60 years of age. Schizoaffective disorder was between schizophrenia and affective psychoses in the sleep variables. In persons over 60, the difference between the groups was smaller than in persons under 60 years of age, because sleeping long and tiredness decreased in all patient groups, and difficulties getting sleep and awakenings increased in the general population sample more than in psychosis patients.DiscussionSleep disorders seem to be prominent in persons with major psychiatric disorders. Tiredness was common in all diagnosis groups. Long sleep was most common in schizophrenia and difficulties in getting sleep and early morning or night awakenings in affective psychoses. More research is needed on possibilities to prevent and treat sleep disorders in major psychiatric disorders.

Association between housing, personal capacity factors and community participation among persons with psychiatric disabilities

There is a need to understand which housing and personal capacity factors facilitate and hinder maximum community participation among people with psychiatric disabilities. The present study examined housing and personal capacity factors associated with community participation in a large sample of persons with psychiatric disabilities living in the same neighborhoods (defined by specified zip codes). Three hundred and forty-three persons with psychiatric disabilities were recruited from congregate and independent scatter-site housing programs in 3 New York City-area neighborhoods with high concentrations of housing for persons with psychiatric disabilities. Participants completed measures of community participation, psychiatric symptoms, substance use, independent living-skill, self-efficacy, and coping style. Community participation measures grouped into 3 factors: social community participation, physical community participation, and vocational involvement. Social community participation was associated with negative symptoms and active coping, but not by housing. Independent living-skill moderated the relationship between independent scatter-site housing and social community participation. Physical community participation was associated with negative symptoms, active coping, independent living-skill, and residence in independent scatter-site housing. Vocational involvement was only associated with negative symptoms. Findings suggest that a complex array of personal capacity and housing factors are associated with community participation among persons with psychiatric disabilities.

Upper limb impairment is associated with use of assistive devices and unemployment in multiple sclerosis

BackgroundIndividuals with multiple sclerosis (MS) frequently suffer from impaired sensory function, reduced strength and tremor in the upper limbs, which may interfere with upper limb function. However, upper limb impairment in MS is under-recognized and understudied. We aimed to evaluate the prevalence of upper limb impairment in a large sample of persons with MS; the association between upper limb function and employment status in MS; and the frequency of use of assistive devices aimed at addressing upper limb impairments. MethodsWe surveyed participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry regarding upper limb function using the ABILHAND questionnaire, and asked about use of assistive devices intended to improve the performance on upper limb activities. We evaluated the association between ABILHAND scores and current employment status using multivariable logistic regression analysis, and the association between ABILHAND scores and the use of an assistive device. ResultsOf 7463 eligible respondents, 5846 (78.3%) were female and mean (SD) age of 57.4 (10.2) years. The median (IQR) score on the ABILHAND was 45 (39–46). Higher levels of disability, as measured by the PDDS, correlated moderately with lower (worse) scores on the ABILHAND (r=−0.50; 95%CI: −0.48, −0.52). Over half of participants reported that they possessed an assistive device to aid upper limb function (3914, 56.0%). Older age, female sex, greater ambulatory disability, higher levels of fatigue, sensory impairment, spasticity and cognitive impairment, and visiting an occupational therapist were independently associated with increased odds of using an assistive device. After accounting for disability, perceived cognitive impairment, and fatigue, impaired upper limb function was associated with decreased odds of being employed (OR/1 point rise in ABILHAND 0.97; 95%CI: 0.96, 0.98). ConclusionsUpper limb impairment is common in older MS patients, and adversely affects the ability to perform many common daily activities.

THE ECONOMIC THEORY OF UTILITY APPLIED TO A WEB-BASED SEARCH FOR A ROMANTIC PARTNER

There are a few published studies that address the actual behavior of people in scenarios where the subjects must conduct searches of the kind typical of online dating sites. The consensus of the empirical findings seems to be that people tend to stop searching too soon. On the other hand, a very common psychological attitude among those who use online dating sites is a refusal to “settle” for anything less than their ideal partner, or someone very close to it. This paper addresses the question of how a man or a woman should apply the criterion of economic efficiency to choosing a person to pursue for a romantic relationship. The paper applies the mathematical theory of optimal stopping to a situation where a user of a dating website has identified a finite but perhaps very large sample of persons who are potential romantic partners. The paper applies the economic theory of a consumer’s utility function to establish a stopping rule which maximizes the likelihood that the searcher will meet the candidate who maximizes the searcher’s idiosyncratic attitudes.

Depressive and Anxiety Disorders Predicting First Incidence of Alcohol Use Disorders

Depressive and anxiety disorders may predict first incidence of alcohol abuse and alcohol dependence. This study aims to identify those persons who are at an increased risk of developing alcohols abuse or alcohol dependence by considering the heterogeneity of depressive and anxiety disorders and exploring the role of other risk factors. In a large sample of persons with and without baseline DSM-IV depressive or anxiety disorders (n = 2,676; 18-65 years; assessed in 2004-2007), the first incidences of DSM-IV alcohol abuse and alcohol dependence during a 4-year follow-up were considered as primary outcomes. Status (remitted or current disorder), severity, and type (specific disorders) of depressive and anxiety disorders were assessed, as well as other risk factors, such as sociodemographic, vulnerability, and addiction-related factors. Cumulative first-incidence rates of alcohol abuse and alcohol dependence were 2.0% and 3.0%, respectively. Persons with current, but not remitted, depressive or anxiety disorders were at an increased risk of a first incidence of alcohol dependence (hazard ratio [HR] = 2.69; 95% CI, 1.37-5.29), but not first incidence of alcohol abuse (HR = 0.55; 95% CI, 0.28-1.09). Although this association was not conditional on the type of disorder, first-incidence rates of alcohol dependence gradually increased with the number of depressive and anxiety disorders (HR per SD increase = 1.65; 95% CI, 1.37-2.00). Subthreshold alcohol problems especially (P < .001), but also recent negative life events (P = .06), were additional independent predictors of first incidence of alcohol dependence. Current depressive disorder, anxiety disorder, or both significantly predicted first incidence of alcohol dependence, which stresses the importance of addiction prevention strategies for depressed and anxious patients in mental health settings. Subthreshold alcohol problems and recent negative life events may help to identify persons at an increased risk for developing alcohol dependence.

Objectively Quantified Physical Activity in Persons With Multiple Sclerosis

ObjectivesTo investigate levels of moderate-to-vigorous physical activity (MVPA) in a large sample of persons with multiple sclerosis (MS) and controls using accelerometry as a measure of physical activity, and to compare the rates of meeting public health guidelines for MVPA (ie, 30min/d) between persons with MS and controls. DesignSecondary analysis of a combined data set of persons with MS and healthy controls from 13 previous investigations of physical activity over a 8-year period (2005–2013). SettingUniversity. ParticipantsParticipants with MS (n=800) were recruited primarily within Illinois through multiple sources, including print and e-mail flyers and an online advertisement on the National Multiple Sclerosis Society website. Healthy controls (n=137) were recruited via public e-mail postings delivered across the university community. InterventionsNot applicable. Main Outcome MeasuresLevels of MVPA and meeting public health guidelines for MVPA between persons with MS and controls. ResultsAfter controlling for covariates (ie, age, sex, education, race, income), there was a moderate (d=.68) and statistically significant (F=47.2, P<.001) difference of 13.1 minutes of MVPA per day (95% confidence interval, 9.4–16.8) between MS and controls. There was a difference in the rates of meeting public health guidelines for MVPA (χ2=50.7, P<.001) between MS patients (20%) and controls (47%). Among those with MS, minutes of MVPA significantly differed as a function of education, employment status, clinical course, disease duration, and disability status. ConclusionsWe provide data using an objective physical activity measure and a large sample to indicate that only a small proportion of persons with MS are achieving adequate amounts of daily MVPA.

Physical activity is associated with cognitive processing speed in persons with multiple sclerosis

The impairment of cognitive processing speed is common, disabling, and poorly managed in multiple sclerosis (MS). This study examined the association between objectively-measured physical activity and cognitive processing speed (CPS) in a large sample of persons with MS. Patients (N=212) underwent two valid neuropsychological tests of CPS, completed the Timed 25-Foot Walk (T25FW), and wore an ActiGraph model GT3X accelerometer during the waking hours of a 7-day period for objectively measuring physical activity as steps/day. Physical activity was significantly associated with CPS (r=.39, p<.01), even when controlling for age, sex, and education (pr=.26, p<.01). This association was attenuated, but still significant after further controlling for T25FW performance (pr=.13, p=.03). Physical activity behavior is positively and independently, albeit weakly, associated with CPS in persons with MS, and may play an important role in managing this aspect of cognition as it does in other outcomes in MS.

Steps Per Day Among Persons With Multiple Sclerosis: Variation by Demographic, Clinical, and Device Characteristics

ObjectivesTo identify steps per day in a large sample of persons with multiple sclerosis (MS) and to describe variation by demographic and clinical characteristics and device type. DesignCross-sectional design. SettingGeneral community. ParticipantsConvenience sample of persons with multiple sclerosis (N=645) recruited from the general community who were ambulatory and relapse free for 30 days. Mean age ± SD of the participants was 46.3±10.6 years old. Participants were mostly women (85%), white (93%), and employed (64%). InterventionsNot applicable. Main Outcome MeasureStep counts measured by a motion sensor during a 7-day period. ResultsThe average value for the entire sample was 5903±3185 steps per day. This value varied by demographic and clinical characteristics, but not device type, and indicated that men, participants who were unemployed, had a high school education or less, progressive MS, a longer disease duration, and higher disability were less physically active based on the metric of steps per day. ConclusionsThis study provides an expected value for average steps per day among persons with MS. Such an expected value for this population is an important first step to help researchers and clinicians interested in improving the overall health of persons with MS through physical activity promotion.

Accelerometry as a measure of walking behavior in multiple sclerosis.

Accelerometry has been identified as a possible ecologically valid and objective approach for measuring community ambulation in multiple sclerosis (MS). This study provides a validation of accelerometer output based on associations with Expanded Disability Status Scale (EDSS), Patient Determined Disease Steps (PDDS) Scale, and Multiple Sclerosis Walking Scale-12 (MSWS-12) scores, timed 25-foot walk (T25FW) and 6-min walk (6MW) performance, oxygen cost (O(2) cost) of walking, and spatial and temporal parameters of gait. 256 persons with MS completed the PDDS and MSWS-12, underwent an examination for the generation of an EDSS score, undertook two T25FW tests and a 6MW while wearing a portable metabolic unit for measuring the O(2) cost of walking, completed two trials of comfortable walking on a GAITRite electronic walkway for measuring spatial and temporal parameters of gait, and then wore an Actigraph accelerometer during the waking hours of a 7-day period. The accelerometer output was significantly correlated with EDSS (ρ = -0.522), PDDS (ρ = -0.551), and MSWS-12 (ρ = -0.617) scores, T25FW (ρ = -0.595) and 6MW (ρ = 0.630) performance, and O(2) cost of walking (ρ = -0.457). Regarding gait parameters, the accelerometer output was significantly correlated with velocity (ρ = 0.420), cadence (ρ = 0.349), step time (ρ = -0.353), step length (ρ = 0.395), double support (ρ = -0.424), and single support (ρ = 0.400). We provide comprehensive evidence from a large sample of persons with MS that further supports accelerometry as a measure of walking behavior.

Neuropsychological variability, symptoms, and brain imaging in chronic schizophrenia

We examined variability in performance on widely-used neuropsychological Wechsler tests of intelligence and memory in a large sample of persons with chronic schizophrenia, a subset of whom had also undergone prior studies of magnetic resonance imaging (MRI) of the orbital frontal cortex (OFC) gray matter and diffusion tensor imaging (DTI) of the cingulum bundle (CB) and the uncinate fasiculus (UF) white matter. In comparison to controls, persons with schizophrenia showed lower scores across neuropsychological tests, with most pronounced drops in processing speed and immediate memory, in relation to oral reading. For patients, greater declines in intelligence and memory each correlated with reduced CB white matter fractional anisotropy and reduced OFC gray matter, respectively. However, only memory decline correlated with severity of negative symptoms. Taken together, these data raise the intriguing question as to whether communication and motivational deficits expressed in negative symptoms may contribute to the relationship of auditory memory decline and OFC volume observed in this patient sample.