Mean Cognitive Scores Research Articles

Genetics education program to help public health nurses improve their knowledge and enhance communities\u2019 genetic literacy: a pilot study

BackgroundAs human genetics knowledge develops, public genetic literacy needs to be increased, though the educational capacity for this purpose has not yet been fully developed. Under this circumstance, the daily work of public health nurses can be viewed as an opportunity to enhance public genetic literacy. However, in Japan, there is not only a lack of public knowledge of human genomics but also a lack of public health nurses’ recognition about genomic literacy. A short-term education program was implemented as a pilot study. This study aimed to examine the effectiveness of the program to support public health nurses’ activity aimed at promoting health services-related genetic literacy.MethodsThe genetics education program was implemented in December 2019, in Kagoshima, Japan. Twenty-three public health nurses cooperated with the research. The program was composed of a case study on consultation, a lecture on hereditary diseases, and a discussion on the role of public health nurses. Familial hypercholesterolemia was used as the topic of the case study. We evaluated scores for cognition, affect, and psychomotor characteristics related to their learning goals before and after the program using Wilcoxon signed-rank tests. Answers in the consultation were qualitatively analyzed.ResultsThe mean cognitive score, capturing provision of explanations of hereditary disease, was 6.3 before the program but increased significantly to 9.3 after the program (p < 0.001). For the affective score, the goal of which was deepening interest in human genetics, the mean score increased significantly from 8.5 before to 11.0 after (p < 0.001). For the psychomotor score, addressing the need for genetic consultation, the mean score increased significantly from 4.4 before to 8.1 after (p < 0.001). Prominent themes extracted from descriptions on the worksheet post training included, “providing advice and accurate information on genetic disorders” and “referral to a specialized organization.”ConclusionsOur findings indicated that this education program helps public health nurses be positively involved in human genetic disorders. Thus, they may connect to their local community to provide accurate genetics knowledge and advice for health management and promoting genetic literacy.

Progesterone for prevention of preterm birth in women with short cervical length: 2-year infant outcomes.

ABSTRACTObjectiveTo evaluate the long‐term outcomes of children born to women with a short cervix and otherwise low risk for preterm birth, after antenatal exposure to vaginal progesterone vs placebo.MethodsThis was a follow‐up study of the Triple P trial, which randomized 80 low‐risk women with a short cervix (≤ 30 mm) at 18–22 weeks' gestation to progesterone (n = 41) or placebo (n = 39). At 2 years of corrected age, children were invited for a neurodevelopmental assessment, using the Bayley Scales of Infant and Toddler Development, third edition (BSID‐III), and a neurological and physical examination by an assessor blinded to the allocated treatment. Parents filled out the Ages and Stages Questionnaire, the Child Behavior Checklist (CBCL) and a general‐health questionnaire. The main outcome of interest was mean BSID‐III cognitive and motor scores. Additionally, a composite score of mortality and abnormal developmental outcome, including BSID‐III ≤–1 SD, CBCL score in the clinical range and/or parental reported physical problems (at least two operations or at least two hospital admissions in the previous 2 years), was evaluated. Our sample size, dictated by the original sample of the Triple P trial, provided 80% power to detect a mean difference (MD) of 15 points (1 SD) between groups for the BSID‐III tests.ResultsOf the 80 children born to the randomized women, one in the progesterone group and two in the placebo group died in the neonatal period. Follow‐up data were obtained for 59/77 (77%) children and BSID‐III outcomes in 57 children (n = 28 in the progesterone group and n = 29 in the placebo group) born at a median gestational age of 38 + 6 weeks (interquartile range (IQR), 37 + 3 to 40 + 1 weeks) with a median birth weight of 3240 g (IQR, 2785–3620 g). In the progesterone vs placebo groups, mean BSID‐III cognitive development scores were 101.6 vs 105.0 (MD, –3.4 (95% CI, –9.3 to 2.6); P = 0.29) while mean motor scores were 102.4 vs 107.3 (MD, –4.9 (95% CI, –11.2 to 1.4); P = 0.13). No differences were seen between the two groups in physical (including genital and neurological examination), behavioral and health‐related outcomes.ConclusionIn this sample of children born to low‐risk women with a short cervix at screening, no relevant differences in neurodevelopmental, behavioral, health‐related and physical outcomes were found between offspring exposed to vaginal progesterone and those exposed to placebo. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Associations between newborn thyroid-stimulating hormone concentration and neurodevelopment and growth of children at 18 months.

The study aimed to assess the associations between newborn thyroid-stimulating hormone (TSH) concentration, a marker of iodine nutrition in early life, and childhood neurodevelopment and growth using data collected from two pregnancy studies, one in a borderline iodine-deficient setting (DHA to Optimize Mother Infant Outcome (DOMInO) Study) and one in an iodine-sufficient setting (Pregnancy Iodine and Neurodevelopment in Kids (PINK) Study). TSH data were obtained from routine newborn screening. Neurodevelopment was assessed at 18 months using the Bayley Scales of Infant and Toddler Development, third edition (Bayley-III). Weight, height and head circumference were measured at 18 months. In total, 1467 children were included in the analysis. Comparing the highest with the lowest TSH quartile, the mean differences (MD) in the Bayley-III scores ranged from -2·0 (95 % CI -4·7, 0·7) to -2·2 (95 % CI -5·8, 1·3) points in DOMInO and 1·0 (95 % CI -1·6, 3·6) to 2·0 (95 % CI -0·4, 4·4) points in PINK in the cognitive, language and motor scales; the MD in the anthropometric z scores ranged from -0·01 (95 % CI -0·5, 0·5) to -0·5 (95 % CI -0·9, -0·1) in both studies. A 1 mIU/l increase in TSH was associated with -0·3 (95 % CI -0·9, 0·2) point and 0·2 (95 % CI -0·3, 0·7) point changes in the mean cognitive score in the DOMInO and PINK, respectively. A null association between TSH and growth was also observed in both studies. Longitudinal studies that utilise newborn TSH data and examine neurodevelopmental outcomes at later ages are warranted, as neurodevelopmental assessments in older children are more predictive of later achievement.

Transfusions and neurodevelopmental outcomes in extremely low gestation neonates enrolled in the PENUT Trial: a randomized clinical trial.

BackgroundOutcomes of extremely low gestational age neonates (ELGANs) may be adversely impacted by packed red blood cell (pRBC) transfusions. We investigated the impact of transfusions on neurodevelopmental outcome in the Preterm Erythropoietin (Epo) Neuroprotection (PENUT) Trial population.MethodsThis is a post hoc analysis of 936 infants 24-0/6 to 27-6/7 weeks’ gestation enrolled in the PENUT Trial. Epo 1000 U/kg or placebo was given every 48 h × 6 doses, followed by 400 U/kg or sham injections 3 times a week through 32 weeks postmenstrual age. Six hundred and twenty-eight (315 placebo, 313 Epo) survived and were assessed at 2 years of age. We evaluated associations between BSID-III scores and the number and volume of pRBC transfusions.ResultsEach transfusion was associated with a decrease in mean cognitive score of 0.96 (95% CI of [−1.34, −0.57]), a decrease in mean motor score of 1.51 (−1.91, −1.12), and a decrease in mean language score of 1.10 (−1.54, −0.66). Significant negative associations between BSID-III score and transfusion volume and donor exposure were observed in the placebo group but not in the Epo group.ConclusionsTransfusions in ELGANs were associated with worse outcomes. We speculate that strategies to minimize the need for transfusions may improve outcomes.Impact Transfusion number, volume, and donor exposure in the neonatal period are associated with worse neurodevelopmental (ND) outcome at 2 years of age, as assessed by the Bayley Infant Scales of Development, Third Edition (BSID-III).The impact of neonatal packed red blood cell transfusions on the neurodevelopmental outcome of preterm infants is unknown.We speculate that strategies to minimize the need for transfusions may improve neurodevelopmental outcomes.

Nutritional Status and Its Association with Cognitive Function among School Aged Children at Soddo Town and Soddo Zuriya District, Southern Ethiopia: Institution Based Comparative Study

About 1 billion stunted school-aged children are growing up with impaired mental development which can lead to low cognitive performance, reduced school achievement, and low productivity. But there is scarce evidence on cognitive function, school performance and their associated factors among school aged children. The main aim of this study was to assess cognitive function, school performance and determine their association with nutritional status among school children aged 7 to 10 years at Soddo Town and Soddo Zuriya Woreda, Wolaita Zone, Southern Ethiopia. Institutional comparative cross-sectional study was conducted on a total sample of 178 primary school children. The Raven’s Color Progressive Matrices (RCPM) and selected tests from Kaufman assessment battery for children second edition were used. Mid-year average students’ examination result was also used. Data were analyzed by using SPSS version 25, WHO Anthro plus, and independent sample t-test. Bivariate and multivariate linear regression analyses were also used. Mean (±SD) cognitive test scores of urban study participants was 18.7 ± 3.4 for RCPM which was higher (P < .001) as compared to rural (16.5 ± 3.3). The urban mean cognitive test scores was also higher for both pattern reasoning and visual processing with (P < .001) as compared to rural counterparts. School performance was higher (P < .001) for urban. Maternal education (P < .002) and wealth index (P < .006) were positively predicted while stunting (P < .001) negatively predicted cognitive function test scores and school performance. Cognitive function and school performance of study participants were associated with their nutritional status and rural participants had significantly lower mean scores as compared to urban counterparts. Further study should be done to community level.

Cognitive, motor, and visual development in healthy children in the first 42 months of life.

The Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) is a tool for measuring the developmental status of children, including cognitive and motor functioning, in the first three years of life. This study aims to evaluate the correlation between grating visual acuity and visual functionality in healthy children using the Bayley-III. Binocular grating visual acuity was measured using Teller Acuity Cards followed by the Bayley-III in healthy children aged 1-42 months. Visual acuity (logMAR) and Bayley-III scores for both cognitive and motor (gross and fine) skills were compared. Forty children (20 boys) aged 1.2-42.1 months were tested. Their mean visual acuity was 0.39 ± 0.27 logMAR, which was within the normal age limits for all children. There was a strong and significant negative correlation between visual acuity and age (r=-0.83, p<0.001). The mean cognitive raw data score was 49.92 ± 18.93 points, with a strong and significant positive correlation between cognitive score and age (r=0.81, p<0.001). The mean gross motor score was 41.72 ± 16.23 points, with a strong and significant positive correlation between gross motor score and age (r=0.75, p<0.001). The mean fine motor score was 39.75 ± 14.63 points, with a strong and significant positive correlation between fine motor score and age (r=0.77, p<0.001). Multiple linear regression demonstrated that older age and better visual acuity were significantly associated with higher Bayley-III scores. This study found a high correlation between grating visual acuity measured using Teller Acuity Cards and cognitive and motor scores measured using the Bayley-III in healthy children, demonstrating that the Bayley-III might be a useful tool for assessing the repercussions of visual impairment on the cognitive and motor development of young children.

Genetic Ancestry and General Cognitive Ability in a Sample of American Youths

Black and Hispanic children in the United States have lower mean cognitive test scores than White children. The reasons for this are contested. The test score gap may be caused by socio-cultural factors, but the high heritability of g suggests that genetic variance might play a role. Differences between self-identified race or ethnicity (SIRE) groups could be the product of ancestral genetic differences. This genetic hypothesis predicts that genetic ancestry will predict g within these admixed groups. To investigate this hypothesis, we performed admixture-regression analyses with data from the Adolescent Brain Cognitive Development Cohort. Consistent with predictions from the genetic hypothesis, African and Amerindian ancestry were both found to be negatively associated with g. The association was robust to controls for multiple cultural, socioeconomic, and phenotypic factors. In the models with all controls the effects were as follows: (a) Blacks, African ancestry: b = -0.89, N = 1690; (b) Hispanics, African ancestry: b = -0.58, Amerindian ancestry: b = -0.86, N = 2021), and (c) a largely African-European mixed Other group, African ancestry: b = -1.08, N = 748). These coefficients indicate how many standard deviations g is predicted to change when an individual's African or Amerindian ancestry proportion changes from 0% to 100%. Genetic ancestry statistically explained the self-identified race and ethnicity (SIRE) differences found in the full sample. Lastly, within all samples, the relation between genetic ancestry and g was partially accounted for by cognitive ability and educational polygenic scores (eduPGS). These eduPGS were found to be significantly predictive of g within all SIRE groups, even when controlling for ancestry. The results are supportive of the genetic model. Keywords: Ancestry, Admixture, education, Intelligence, ABCD cohort

The Utilization of History Module in the Development of Multiculturalism-Based Team Games Tournament Model to Improve the Bhineka Attitudes on 10th Grade Students in SMA Erlangga Pematangsiantar

This research is a development research that aims to produce alternative teaching materials in the form of a multiculturalism-based TGT model in increasing the diversity attitudes of students at Erlangga Pematangsiantar High School. The making of this module also aims to increase learning resources in the classroom and innovate learning media. The validation results of the module where the results of the material expert validation showed that the results of the material expert validation for the content component got an average score of 8.8 and 8.6 for the language component. The total average score for the two components was 8.7 in the “Highly Valid” category. The model's effectiveness test used a parametric statistical test, including the independent sample t test and paired sample t test. The results of the independent sample t test show that the value of tcount&gt; ttable (3.101&gt; 1.711) so that H0 is rejected and H1 is accepted, which indicates that there is a difference in the mean cognitive scores of the experimental and control groups. In addition, the results of the independent sample t test for the attitude scale show that the value of t count&gt; t table (2.527&gt; 1.711) so that H0 is rejected and H1 is accepted, which indicates that the diversity attitudes of students who use the history module are higher than students who use conventional models. The results of the calculation of the paired sample t test for the cognitive domain show that the value-tcount (-6,271) &lt;-ttable (-1,711). H0 is rejected and H1 is accepted, so it can be seen that there is a difference in the mean score of the experimental group students before and after being treated. While the results of the calculation of the paired sample t test for the affective domain show that the value-tcount (-3,698) &lt;-ttable (-1,711). H0 is rejected and H1 is accepted, so it can be seen that there is a difference in the level of awareness of the diversity of the experimental group students between before and after treatment. Developing a multiculturalism-based TGT model history module is able to develop students' diversity attitudes.

Use of Fundamentals of Laparoscopic Surgery Testing to Assess Gynecologic Surgeons: A Retrospective Cohort Study of 10-Years Experience

To compare the Fundamentals of Laparoscopic Surgery (FLS) exam scores between obstetrics and gynecology (OBGYN) and general surgery (GS) providers. This is a retrospective cohort study at a single institution from July 2007 to May 2018. Categorical and continuous variables were analyzed with χ2 test, t test, and Wilcoxon rank sum test. Beth Israel Deaconess Medical Center (BIDMC), Boston, MA, a tertiary care academic medical center. All providers who took the FLS exam at the Carl J. Shapiro Simulation and Skills Center at BIDMC. FLS certification. A total of 205 BIDMC trainees and faculty took the FLS exam between July 2007 and May 2018, of which 176 were identified to be OBGYN or GS providers. The FLS certification pass rate was high for both specialties (97.0% OBGYN vs 96.1% sGS, p = .76). When comparing all providers, no significant difference was found in the mean manual skill test scores between surgical specialties (594.9 OBGYN vs 601.0 GS, p = .59); whereas, a significant difference was noted in the mean cognitive scores, with GS providers scoring higher than OBGYN providers (533.8 OBGYN vs 583.4 GS, p <.001). However, when adjusting for several variables in a multivariate linear regression model, surgical specialty was not a predictor for cognitive scores. In the multivariate analysis, age, sex, and test year were predictors for cognitive scores, with higher scores associated with younger age, male sex, and advancing calendar year. None of the variables were significant predictors of manual scores. Both OBGYN and GS providers had extremely high FLS pass rates. In the multivariate analysis, surgical specialty was not a predictor for higher FLS test scores for either manual or cognitive test scores. Although OBGYN residency programs offer fewer years of training, OBGYN trainees demonstrate the capacity to perform well on the FLS exam.

Fetal Umbilical Arterial Pulsatility Correlates With 2-Year Growth and Neurodevelopmental Outcomes in Congenital Heart Disease

BackgroundChildren with congenital heart disease (CHD) are at risk of adverse long-term neurodevelopmental outcomes, believed to be, in part, secondary to prenatal insults. Placental pathology and altered fetal middle cerebral arterial (MCA) flow suggestive of brain sparing have been documented in fetal CHD. In the present study we investigated the relationship between MCA and umbilical arterial (UA) flow patterns in fetal transposition of the great arteries (d-TGA) and hypoplastic left heart syndrome (HLHS) and growth and 2-year neurodevelopmental outcomes. MethodsWe included children with d-TGA and HLHS who had third-trimester fetal echocardiograms between 2004 and 2014, at which time umbilical artery (UA) and MCA pulsatility indices (PIs) were measured, and who underwent 2-year growth and neurodevelopmental assessments. ResultsWe identified 24 children with d-TGA and 36 with HLHS. Mean age at fetal echocardiography was 33.8 ± 3.5 weeks. At 2-year follow-up, head circumference z score (standard deviation [SD]) was –0.09 (1.07) and 0.17 (1.7) for the d-TGA and HLHS groups, respectively. Bayley III mean (SD) cognitive, language, and motor scores were 97.7 (10.8), 94.7 (13.4), and 98.6 (8.6) for the d-TGA group and 90.3 (13.9), 87.2 (17.5), and 85.3 (16.2) for the HLHS group. On multivariate linear regression analysis, UA-PI was associated (effect sizes [95% CI]) with length (–1.45 [–2.7, –0.17], P = 0.027), weight (–1.46 [–2.6 to –0.30], P = 0.015) and cognitive scores (–14.86 [–29.95 to 0.23], P = 0.05) at 2 years of age. MCA PI showed no statistically significant correlation. ConclusionsIn fetal d-TGA and HLHS, a higher UA-PI in the third trimester, suggestive of placental insufficiency—but not MCA-PI—is associated with worse 2-year growth and neurodevelopment.

Comparison of postoperative cognitive dysfunction with the use of propofol versus desflurane in patients undergoing surgery for clipping of aneurysm after subarachnoid hemorrhage.

Background: Cerebral aneurysm rupture is a distinct entity among various causes of cerebrovascular accident. Despite the current concept of early surgical clipping to prevent consequences of ruptured aneurysm in good grade subarachnoid hemorrhage patients, 40–50% have postoperative cognitive dysfunction (POCD) on a long- term basis. Here, we compared the effect of two commonly used anesthetic agents on cognitive function following cerebral aneurysmal surgery, i.e., propofol and desflurane.Methods: We conducted a prospective double-blind clinical study in 70 patients who were randomized to receive maintenance anesthetic agents either propofol or desflurane. The cognitive functions of patients were studied at the time of the discharge from a hospital or at 2 weeks following surgery whichever was early using the Hindi version of the Montreal Cognitive Assessment scale. The hemodynamic parameters, brain relaxation score at the different time intervals, were also studied.Results: There was no difference between the two anesthetic agents in terms of incidence of POCD (65.4% vs. 82.6%, P > 0.05) at the time of discharge or at 2 weeks following surgery. The mean POCD score in propofol and desflurane group was 22.81 ± 4.45 and 19.09 ± 5.66 which was statistically significant (P-value-0.01). The scores for domains of executive function, attention, and orientation were better with propofol group than desflurane group. Intraoperative hemodynamics and brain relaxation scores were similar in both groups.Conclusion: A significant number of patients undergoing aneurysmal neck surgery experienced POCD although incidence remained similar in both groups. However, it appears that mean cognitive score and certain domains of cognitive functions especially the executive function, attention, and orientation were better preserved with the use of propofol when compared to desflurane at the time of discharge or on 2 weeks following surgery whichever was early.

Idosas e prática de atividade física: correlação entre estado cognitivo e níveis de escolaridade

Este estudo teve objetivo de verificar a possível relação entre o nível de escolaridade e o estado cognitivo de idosas ativas e insuficientemente ativas. A amostra foi composta por 544 idosas brasileiras, com média de idade de 68,9 (±6,64), média do tempo de estudo, em anos, foi 5,17 (±4,1). Foram classificadas como ativas 74,4% das idosas e 54,6% da amostra apresentou déficit cognitivo. Os questionários utilizados foram: Sociodemográfico, IPAQ e o Mini Mental State. Foram apresentadas as frequências relativa e acumulada, coeficiente de correlação de Pearson, análise de variância Two Way e o teste t de Student, adotando como significância p&lt;0,05.Verificou-se associação entre o escore cognitivo e o tempo de escolaridade, sendo mais forte em idosas ativas. A ANOVA de dois fatores demonstrou diferença nas médias do escore cognitivo com as categorias de escolaridade (F=14,287; p&lt;0,000) e entre o nível de atividade física (F=4,709; p&lt;0,030), tendo o teste de Bonferroni indicado que apenas no grupo de idosas ativas existe diferença de médias do escore cognitivo em relação as categorias de escolaridade. Na análise do teste t para amostras independentes, as idosas do nível fundamental ativas fisicamente demonstram ter melhor média do escore cognitivo (t=24,20; p&lt;0,04) em comparação às idosas insuficientemente ativas. A escolaridade e atividade física revelaram-se importantes fatores relacionados com superávit cognitivo na amostra. Conclui-se que a atividade física parece exercer papel relevante na cognição, e pode colaborar na manutenção cognitiva em idosos. Assim como, a escolaridade pode ter função importante perante a cognição.

Association of Intrauterine Growth Restriction and Small for Gestational Age Status With Childhood Cognitive Outcomes

The magnitude of the association of intrauterine growth restriction (IUGR) and small for gestational age (SGA) status with cognitive outcomes in preterm and term-born children has not been established. To examine cognitive outcomes of preterm and term-born children who had IUGR and were SGA compared with children who were appropriate for gestational age (AGA) during the first 12 years of life. For this systematic review and meta-analysis, the Scopus, PubMed, Web of Science, Science Direct, PsycInfo, and ERIC databases were searched for English-language, peer-reviewed literature published between January 1, 2000, and February 20, 2020. The following Medical Subject Heading terms for IUGR and SGA and cognitive outcomes were used: intrauterine growth restriction, intrauterine growth retardation, small for gestational age AND neurodevelopment, neurodevelopmental outcome, developmental outcomes, and cognitive development. Inclusion criteria were assessment of cognitive outcomes (full-scale IQ or a cognitive subscale), inclusion of an AGA group as comparison group, and inclusion of gestational age at birth and completion of cognitive assessment up to 12 years of age. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines were followed. Data were double screened for full-text articles, and a subset were independently coded by 2 authors. Standardized mean differences (SMDs) and odd ratios from individual studies were pooled by applying random-effects models. Cognitive outcomes, defined as mental, cognitive, or IQ scores, estimated with standardized practitioner-based cognitive tests or as borderline intellectual impairment (BII), defined as mental, cognitive, or IQ scores at least 1 SD below the mean cognitive score. In this study of 89 samples from 60 studies including 52 822 children, children who had IUGR and were SGA had significantly poorer cognitive outcomes (eg, cognitive scores and BII) than children with AGA in childhood. For cognitive scores, associations are consistent for preterm (SMD, -0.27; 95% CI, -0.38 to -0.17) and term-born children (SMD, -0.39; 95% CI, -0.50 to -0.28), with higher effect sizes reported for term-born IUGR and AGA group comparisons (SMD, -0.58; 95% CI, -0.82 to -0.35). Analyses on BII revealed a significantly increased risk in the preterm children who had IUGR and were SGA (odds ratio, 1.57; 95% CI, 1.40-1.77) compared with the children with AGA. Growth vulnerabilities assessed antenatally (IUGR) and at the time of birth (SGA) are significantly associated with lower childhood cognitive outcomes in preterm and term-born children compared with children with AGA. These findings highlight the need to develop interventions that boost cognitive functions in these high-risk groups.

Comparison of neurocognitive changes among newly diagnosed tuberculosis patients with and without dysglycaemia

BackgroundDiabetes often occurs together with tuberculosis (TB) and both may affect each other negatively. Diabetes may be associated with neurocognitive dysfunctioning in affected patients and may negatively impact treatment adherence and outcomes. This study compared the neurocognitive status between newly diagnosed smear positive tuberculosis patients with dysglycaemia and those with normoglycaemia.MethodsThe current study was a cross-sectional study involving one hundred and forty-six (146) newly diagnosed smear positive TB patients. Oral glucose tolerance test (OGTT) was performed and the results were categorized as either normoglycaemia, impaired glucose tolerance (IGT), impaired fasting glucose (IFG) or diabetes.Neurocognitive functioning among study participants was assessed at the time of TB diagnosis using Cognitive Failure Questionnaire (CFQ), Montreal Cognitive Assessment tool (MoCA), California Verbal Learning Test (CVLT), Brief Symptom Inventory (BSI) and the Spitzer Quality of Life Index (QLI).ResultsThe mean age of the participants (n = 146) was 38.7 years with 78.8% being males and 21.2% females. Using the fasting blood glucose test, the prevalence of impaired fasting glucose and diabetes were 5.5 and 3.4% respectively, both representing a total of 13 out of the 146 participants; whilst the prevalence of impaired glucose tolerance and diabetes using 2-h post-glucose values were 28.8 and 11.6% respectively, both representing a total of 59 out of the 146 participants.There were no significant differences in the mean scores on the neurocognitive measures between the dysglaycaemia and normoglycamic groups using fasting plasma glucose (FPG). However, there were significant differences in the mean scores between the dysglycaemia and normal groups using 2-h postprandial (2HPP) glucose values on Phobic Anxiety (Normal, Mean = 0.38 ± 0.603; dysglycaemia, Mean = 0.23 ± 0.356; p = 0.045), and Montreal Cognitive Assessment (MoCA) scores (17.26 ± 5.981 vs. 15.04 ± 5.834, p = 0.037).ConclusionNewly diagnosed smear positive patients with dysglycaemia were associated with significantly lower mean cognitive scores and scores on phobic anxiety than those with normoglyacaemia. The latter finding must be further explored.

Abstract P423: Lactation Duration is Associated With Favorable Cognitive Function in Women During Midlife: The 30-year Cardia Study

Introduction: Lactation has been associated with lower incidence of the metabolic syndrome, type 2 diabetes, hypertension, and early atherosclerosis in women across the childbearing years. The lower risk of cardiometabolic diseases related to higher lifetime lactation may also extend to levels of cognitive function during midlife. Hypothesis: We tested the hypothesis that lactation duration is associated with better cognitive function in women during midlife independent of antecedent risk factors, as well as obesity, diabetes, and hypertension. Methods: We included 904 women aged 18-30 years at baseline (1985-86) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study without no diabetes before ≥1 birth(s) after baseline, reported lactation duration for each post-baseline birth, and had 6 measures of cognitive function assessed at Year 30 (2015-16) including the Rey Auditory Verbal Learning Test (RAVLT), Digit Symbol Substitution Test (DSST), Stroop Test, Montreal Cognitive Assessment (MoCA), Letter Fluency Test, and Category Fluency Test. Linear regression models estimated mean (95%CI) cognition scores by lactation duration (none, &gt;0 to 6 mos, &gt; 6 to &lt;12 mos, ≥12 mos) adjusted for race, age, BMI, blood pressure, parity, and follow up covariates (Table 1). Results: Among parous women (46% black, 54% white) at 30-year follow up, average age was 54 yrs and 47% had obesity, 61% delivered ≥2 births since baseline, 29% used anti-hypertensive medications and 16% developed overt diabetes. Black women were less likely to report &gt;6 mos of total lactation for all births than white women (23% vs. 58%). Unadjusted and fully adjusted mean scores for 3 cognitive function measures had graded direct associations with increasing lactation duration; specifically, the RAVLT, MoCA and Category Fluency Test scores (all p-trend &lt; 0.01). Conclusions: In this prospective study, longer lactation duration was associated with more favorable cognition scores among women during midlife.

Abstract TP483: Transcatheter Aortic Valve Replacement (TAVR) Does Not Improve Cerebral Hemodynamics or Neurocognition in Patients With Severe Aortic Stenosis

Objective: To determine if aortic stenosis (AS) is associated with altered cerebral hemodynamics and impaired neurocognition, and whether TAVR improves hemodynamics and cognition. Background: AS results in higher systolic pressure to overcome resistance from the stenotic valve, leading to heart failure and decline in cardiac output. There has been no baseline assessment of CBF with neurocognition in AS, or the effects of valve replacement. Methods: In 40 patients with planned TAVR, transcranial Doppler (TCD) assessed bilateral MCA mean flow velocity (MFV); abnormality was &lt; 30cc/sec. The neurocognitive battery assessed memory, language, attention, visual-spatial skills, and executive function, yielding an average Z-score. Impairment was &lt; 1.5 SD’s below the normative mean. Results: The mean age was 78 years, 59% male, and the mean valve gradient was 46.87%. Mean follow-up was 36 days post-TAVR (range 27 - 55). Before TAVR, the average MFV was 42 cc/sec (SD=10.22), and the mean cognitive score was -0.22 SD’s (range -1.99 to 1.08) below the normative mean. Of the 5 with abnormal MFV’s, none had abnormal cognition (average=0.19 SD’s above the normative mean). After TAVR, the MFV was 43 cc/sec, not different from baseline (p=0.56). The post-TAVR average Z-score was 0.01 SD’s above the normative mean, also not different from baseline (p=0.29). There was no correlation between the change scores in MFV and in neurocognition (r = 0.08, p= 0.69). Conclusions: Among patients with severe AS, there was no correlation at baseline between abnormal MFV’s on TCD and abnormal neurocognition. It was therefore unsurprising that there was little impact of valve replacement on these measures of cerebral blood flow and brain function. Prior assumptions about diminished CBF and the relationship to cognitive function may not be supported.

Cognitive Function Assessment in Patients on Moderate- or High-Intensity Statin Therapy.

BackgroundCardiovascular diseases are the leading cause of death in the USA. Statin therapy reduces cardiovascular events significantly. Cognitive impairment has been reported with statin therapy but there is a lack of consensus. We analyzed the cognitive functions of adult patients who were on moderate-intensity statin therapy (MIST) or high-intensity statin therapy (HIST).MethodsA total of 213 patients underwent cognitive assessment testing. Cognitive function scores were correlated with the durations of statin therapy, age, and level of education by using Pearson correlation. Independent t-test was used to compare the mean cognitive function score to the gender, race, type of statin therapy, and comorbid conditions.ResultsMean age of all the patients was 55.4 years. Majority of the patients (66.2%) were on MIST while the rest (33.8%) were on HIST. Cognitive impairment was observed in 17.8% of the studied patients. A total of 41.7% of the patients in the HIST group and 5.7% in the MIST group had cognitive impairment (P < 0.001). There was no correlation between cognitive function score and age (r = -0.106), weakly positive correlation between the level of education and cognitive function score (r = 0.252), and weakly negative correlation between the duration of statin therapy and cognitive function score (r = -0.283). In the group of patients on HIST with cognitive impairment, the proportion of patients on atorvastatin 40 - 80 mg was significantly higher than the proportion of patients on rosuvastatin 20 - 40 mg (66.7% vs. 33.3%; P < 0.05). In the group of patients on MIST with cognitive impairment, atorvastatin 10 - 20 mg was the most commonly used statin therapy (50%), followed by rosuvastatin 10 mg (25%), simvastatin 20 - 40 mg (12.5%) and pravastatin 40 - 80 mg (12.5%).ConclusionsWe found a significantly higher association of cognitive impairment in patients who were on MIST or HIST compared to the general population. We found no correlation between cognitive function score and age, weakly positive correlation between the level of education and cognitive function score, and weakly negative correlation between the duration of statin therapy and cognitive function score. HIST was associated with a higher frequency of cognitive impairment compared to the MIST.

Protective Lifestyle Factors and Cognitive Function in a Middle- to Older-Aged Population: A Cross-Sectional Analysis

AbstractBackground and ObjectivesCognitive impairment among the elderly is an important concern worldwide. Evidence suggests that certain lifestyle behaviours may have a protective effect against cognitive decline. In this study we examined the relationship between a 5-component protective lifestyle behaviour score and cognitive function to determine whether the number of protective lifestyle behaviours is related to cognitive decline.Materials and MethodsThis was a cross-sectional analysis of the Mitchelstown Cohort Rescreen study, a random sample of men and women aged 51–77 years recruited from a single primary care centre. Cognitive function was assessed using the Mini Mental State Exam (MMSE) and cognitive data were available for 1,022 participants. Cognitive impairment was classified as an upper 75th percentile reversed MMSE score value for the study sample. We defined 5 low-risk protective lifestyle behaviours as never smoking, moderate alcohol intake, moderate to vigorous physical activity, a high-quality diet score (upper 40%) and a body mass index between 18.5 to 24.9 kg/m2. Linear and logistic regression analyses were used to test associations between a protective factor score and the MMSE.ResultsThere was a linear relationship between the number of protective lifestyle behaviours and mean cognitive score values and a significant inverse association was observed between a protective lifestyle score and the MMSE cognitive score (β = -0.20, 95% CI: -0.30, -0.10). Logistic regression suggested a dose-response relationship, with odds ratios of having poorer cognitive functioning being noticeably increased in subjects with 0 or 1 PLBs (OR = 2.18, 95% CI: 1.06, 4.52) when compared to participants with 4 or 5 PLBs in multivariable analysis.ConclusionsThese data imply that a combination of healthy lifestyle behaviours protects against cognitive impairment. As all of the examined factors are modifiable, small behavioural changes may help in preventing cognitive decline in an elderly population.

Relationship Between PET-Assessed Amyloid Burden and Visual and Verbal Episodic Memory Performance in Elderly Subjects.

Studies of elderly subjects using biomarkers that are proxies for Alzheimer's disease (AD) pathology have the potential to document meaningful relationships between cognitive performance and biomarker changes along the AD continuum. To document cognitive performance differences across distinct AD stages using a categorization based on the presence of PET-assessed amyloid-β (Aβ) burden and neurodegeneration. Patients with mild dementia compatible with AD (n = 38) or amnestic mild cognitive impairment (aMCI; n = 43) and a cognitively unimpaired group (n = 27) underwent PET with Pittsburgh compound-B (PiB) assessing Aβ aggregation (A+) and [18F]FDG-PET assessing neurodegeneration ((N)+). Cognitive performance was assessed with verbal and visual episodic memory tests and the Mini-Mental State Examination. The A+(N)+ subgroup (n = 32) showed decreased (p < 0.001) cognitive test scores compared to both A+(N)-(n = 18) and A-(N)-(n = 49) subjects, who presented highly similar mean cognitive scores. Despite its modest size (n = 9), the A-(N)+ subgroup showed lower (p < 0.043) verbal memory scores relative to A-(N)-subjects, and trend lower (p = 0.096) scores relative to A+(N)-subjects. Continuous Aβ measures (standard uptake value ratios of PiB uptake) were correlated most significantly with visual memory scores both in the overall sample and when analyses were restricted to dementia or (N)+ subjects, but not in non-dementia or (N)-groups. These results demonstrate that significant Aβ-cognition relationships are highly salient at disease stages involving neurodegeneration. The fact that findings relating Aβ burden to memory performance were detected only at (N)+ stages, together with the similarity of test scores between A+(N)-and A-(N)-subjects, reinforce the view that Aβ-cognition relationships during early AD stages may remain undetectable unless substantially large samples are evaluated.

The most useful cranial ultrasound predictor of neurodevelopmental outcome at 2 years for preterm infants

To determine the most important cranial ultrasound predictors of abnormality associated with neurodevelopmental outcome at 2 years of age in preterm infants. A total of 343 preterm infants born between 2005 and 2010 and cared for in KK Women's and Children's Hospital, a tertiary paediatric hospital, with birth weight ≤1,250 g were assessed in this retrospective study. Serial cranial ultrasound examinations were examined for intraventricular haemorrhage and cystic periventricular leukomalacia. Ventricular-brain ratio on term equivalent cranial ultrasound was measured. Neurodevelopmental outcome was assessed by the performance on Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-III) at 2 years corrected age. Mental delay was defined as having a combined Bayley-III score (the average of cognitive and language scores) <80. The mean cognitive, language, and motor scores on Bayley-III in this cohort were 93±15, 83±18, and 92±15, respectively. Twenty-six percent of the preterm infants had mental delay and 4% had cerebral palsy. Ventricular-brain ratio >0.35 was the most significant factor associated with mental delay (odds ratio 5.28, 95% CI: 1.49-18.71, p=0.01). Other significant risk factors for mental delay were male gender, postnatal steroids, and necrotising enterocolitis, whereas maternal tertiary education was a protective factor against adverse outcome. Ventricular-brain ratio >0.35 on term-equivalent cranial ultrasound in preterm infants is the strongest predictor for mental delay on Bayley score at 2 years of age.