Perception Of Cognitive Functioning Research Articles

The evolution of subjective cognition after meditation training in older people: a secondary analysis of the three-arm age-well randomized controlled trial

ABSTRACT Aging is associated with cognitive changes, even in the absence of brain pathology. This study aimed to determine if meditation training, by comparison to active and passive control groups, is linked to changes in the perception of cognitive functioning in older adults. One hundred thirty-four healthy older participants from the Age-Well Randomized Clinical Trial were included: 45 followed a meditation training, 45 a non-native language training and 44 had no intervention. Subjective cognition was assessed at baseline and following the 18-month intervention period. Perception of attentional efficiency was assessed using internal and external Attentional Style Questionnaire (ASQ) subscale scores. Perception of global cognitive capacities was measured via the total score of Cognitive Difficulties Scale (CDS). Deltas ([posttest minus pretest scores]/standard deviation at pretest) were calculated for the analyses. Generalized mixed effects models controlling for age, sex, education and baseline scores revealed that meditation training decreased the vulnerability score toward external distractors measured by the ASQ compared to non-native language training. However, no between-groups differences on ASQ internal or CDS total scores were observed. Results suggest a beneficial effect of meditation practice on perceived management of external distracting information in daily life. Meditation training may cultivate the ability to focus on specific information (e.g., breath) and ignore stimulation from other kinds of stimuli (e.g., noise).

Relationships Among Perception of Cognitive Function, Diabetes Self-Management, and Glucose Variability in Older Adults: A Mixed Methods Study.

The aim of the current study was to explore relationships among perceived cognitive function, glucose variability, and self-management in older adults with type 2 diabetes mellitus (T2DM). A mixed methods design was used with data from: (a) questionnaires on perceived cognitive function and diabetes self-management; (b) continuous glucose monitoring (CGM) reports; and (c) semi-structured interviews. Thirty adults with T2DM (47% female; mean age = 68.5 [SD = 5.2] years) participated. Those who exercised more days per week had more stable glucose. Those who reported fewer days of diet adherence had more hypoglycemia. Participants who reported higher levels of memory dissatisfaction exhibited higher levels of glucose variability. Findings point to the potential of glucose variability as a target to reduce the effect of diabetes on cognitive function. Instruction in recognition of glucose patterns found via CGM can be integrated into self-management education to improve self-management and subsequent glucose control and cognitive function. [Research in Gerontological Nursing, 15(4), 203-212.].

Cognitive function in long-term lymphoma survivors: relationship between subjective reports and objective assessments and with quality of life

ABSTRACT Cognitive functioning plays a fundamental role in people's life and quality of life (QoL), and anti-cancer chemotherapy may provoke long-lasting cognitive problems. This study investigated the subjective perception of cognitive functioning in long-term lynfoma survivors and its associations with objectively assessed cognitive functioning and QoL. 198 long-term lynfoma survivors were administered the Cognitive Functioning Self-Assessment Scale (CFSS), the Esame Neuropsicologico Breve 2 (ENB2) and the Short Form 36 Health Survey Questionnaire (SF-36). Subjectively reported cognitive functioning was worse than the norm for the general population (p<0.001). Difficulty in recalling recent information (22%), using of periphrases or generic terms (16.7%) and tip-of-the-tongue phenomena (14.7%) were the cognitive difficulties most frequently reported. CFSS overall score correlated positively with the number of impaired performances (p<0.001) and borderline performances (p=0.014) on the ENB2. Both subjectively and objectively assessed cognitive measures correlated negatively with most assessed QoL domains, indicating that QoL is worse when cognitive functioning is poor. Subjective concerns about one's own cognitive functioning are a reality for long-term lynphoma survivors, who experience these worries more than the general population does. Since improving QoL is a priority in oncology, this study supports the use of interventions to improve cognitive functioning in cancer survivors.

Discrepancies between Self- and Clinical Staff Members' Perception of Cognitive Functioning among Patients with Schizophrenia Undergoing Long-Term Hospitalization.

In Japan, long-term hospitalization of patients with schizophrenia is still prevalent, even though the focus of psychiatric care is shifting from hospitals to the community. Difficulties in discharge planning often arise because clinical staff members' functional assessment differs from that of patients' self-assessment. Therefore, we attempted to identify characteristics related to these perceptual differences to promote the development of more effective approaches toward the discharge and societal reintegration of patients with schizophrenia undergoing prolonged hospitalization. Forty-eight long-term inpatients (23 men and 25 women with a mean age of 60.72 years) with schizophrenia were examined using the Schizophrenia Cognition Rating Scale Japanese version (SCoRS-J), Life Skills Profile (LSP), and Profile of Mood States- (POMS-) Brief Form. Differences between patients' self-ratings and clinical staff members' ratings on the SCoRS-J were used to divide patients into overestimators, underestimators, and accurate raters. These groups were then comparatively analyzed. Accordingly, overestimators displayed significantly severe cognitive dysfunction on the SCoRS-J objective ratings (p = .001) and significantly less difficulty on the SCoRS-J subjective ratings (p = .002) as compared to underestimators. Overestimators also scored significantly lower on the communication (p = .012) and responsibility (p = .021) LSP subscales compared to underestimators, and the total LSP score for overestimators was significantly lower compared to accurate raters (p = .036) and underestimators (p = .009). However, underestimators displayed significantly higher confusion on the titular POMS subscale than did overestimators (p = .021). These findings indicate that, among the three groups, overestimators scored lowest for objectively rated functioning. In contrast, underestimators attained the highest functioning; however, they were also confused. Clinical staff should examine how patients' self-perceptions deviate from the perceptions of staff and implement an appropriate approach considering the patient characteristics revealed from the results of this study.

Abstract 5275: Comparing self-reported cognitive function among Caucasian and African American breast cancer survivors

Abstract Approximately 35% of breast cancer survivors (BCS) report changes in cognitive function after cancer treatment. The purpose of this abstract is to compare self-reported cognitive changes between Caucasian (CAU) and African American (AA) BCS who participated in the Think Well program. Think Well is an educational program to increase awareness of cognitive function and promote healthy living. Sixteen Think Well seminars were delivered in-person to urban and rural counties throughout North Central Alabama. Following each seminar, participants completed an evaluation of demographic information and cognitive changes. Descriptive statistics and chi-squared tests were used. Data were analyzed using SPSS v23. Among BCS who completed the evaluation, 82 (54%) were CAU, and 62 (41%) were AA. Many BCS were employed (32%) or disabled/retired (51%). CAU were more likely to be married than AA BCS (p&amp;lt;0.01). More CAU self-reported “poor/below average” in domains of memory, ability to think, speed of problem solving, and ability to pay attention than AA BCS (p&amp;lt;0.01). CAU were more likely than AA BCS to report “moderately” or “very much/extremely” in changes in ability to think (p&amp;lt;0.01), speed of problem solving (p=0.02), and ability to pay attention (p=0.01) since completion of breast cancer treatment. CAU BCS self-reported poorer cognitive function and changes since cancer treatment. Differences in self-reported changes between AA and CAU may be contributed to geographic location, racial differences in perception of cognitive function, or marital status. Race-related stigmas may affect self-reporting of cognitive function. Future research is warranted to examine factors that contribute to racial differences in cognitive function and interventions aimed at improving cognitive function among both AA and CAU BCS. Acknowledgement: Think Well is supported by a grant from the North Central Alabama Affiliate of Susan G. Komen. Authors are also supported by funding: Susan G. Komen Graduate Traineeship in Disparities Research, Robert Wood Johnson Foundation Future of Nursing Scholarship, and American Cancer Society Doctoral Degree Scholarship in Cancer Nursing (DSCN-17-076-01). Citation Format: Kayla A. Lewis, Jacqueline B. Vo, Kendra J. Royston, Silvia Gisiger-Camata, Karen Meneses. Comparing self-reported cognitive function among Caucasian and African American breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5275.

Do values placed on cognitive abilities shift with age?

Despite age-associated decreases in cognitive and physical abilities, age is not associated with a decrease in ratings of well-being; this phenomenon is termed the ‘paradox of well-being.’ One potential explanation for this paradox may be that older adults place less value on cognitive abilities that have been shown to decrease with age (e.g., memory) and more value on cognitive abilities shown to increase with age (e.g., knowledge). Using online methods, 358 individuals between the ages of 18 and 88 completed a survey assessing the values placed on everyday cognitive abilities, self-ratings for those same abilities, and life satisfaction. Results indicated that there were minimal age-related differences in values placed on everyday cognitive abilities and that values generally did not moderate the relationship between perceptions of cognitive functioning and life satisfaction. Of note, values placed on cognition significantly predicted life satisfaction in younger adults, but not in middle-aged and older adults.

A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients

Evidence for chemotherapy-induced cognitive impairment remains inconclusive. This study was designed to determine the trajectory of cognitive function over time in women with breast cancer, who received doxorubicin and cyclophosphamide (AC) alone or followed by a taxane. Associations between changes in cognitive function and potential covariates including anxiety, depression, fatigue, hemoglobin level, menopausal status, and perception of cognitive function were evaluated. The Repeatable Battery for the Assessment of Neuropsychological Status, Stroop Test, and Grooved Pegboard were used to assess cognitive function in a group of 71 women prior to chemotherapy, a week after completing the last cycle of AC, as well as 1 week and 6 months after the completion of all chemotherapy. Cognitive impairment was found in 23% of women prior to chemotherapy. Hierarchical linear modeling showed significant decreases after receiving chemotherapy followed by improvements 6 months after the completion of chemotherapy in the cognitive domains of visuospatial skill (p < 0.001), attention (p = 0.022), delayed memory (p = 0.006), and motor function (p = 0.043). In contrast, immediate memory, language, and executive function scores did not change over time. These results suggest that having a breast cancer diagnosis may be associated with cognitive impairment. While chemotherapy may have a negative impact on cognitive function, chemotherapy-related impairments appear to be more acute than chronic side effects of therapy. Further studies are needed to provide insight into the clinical significance and potential mechanisms of cancer and treatment-related cognitive impairments.

Cognitive function and fatigue in cancer patients after chemotherapy: A longitudinal cohort study in patients with colorectal cancer (CRC)

9099 Background: There is growing evidence that fatigue and cognitive dysfunction can affect cancer survivors. Here we evaluated these symptoms in patients with CRC in a longitudinal prospective study. Methods: Patients with localized CRC were evaluated for cognitive function and fatigue at baseline (mean 8 weeks post-surgery or before neoadjuvant therapy), 6 &amp; 12 months. Group A (Stage III/high risk II) received chemotherapy (CT) and group B (Stage I/II) received no CT. Pts had neuropsychological (NP) assessment with traditional tests and CANTAB, a computerized NP battery. They completed concurrent questionnaires for fatigue &amp; QOL (FACT-F), anxiety/depression (GHQ), and perception of cognitive function (FACT-COG). Blood tests evaluated cytokine levels, blood clotting factors, sex hormones and apolipoprotein genotyping as potential causal factors. Primary endpoints were cognitive function (traditional NP tests) and fatigue. Associations between test results, demographic and disease-related factors were sought. Results: Baseline data are available for 182 pts: 127 group A, and 55 group B, with follow-up at 6 and 12 months for 71 and 39 pts. Mean age was 57 years and 62% were male. At baseline (pre CT): 30% had cognitive impairment on traditional NP tests &amp; 20% on CANTAB; 25% reported moderate fatigue and 10% extreme fatigue. At 6 months there was no significant difference on objective NP testing between the groups or in perceived cognitive impairment (median FACT- COG 82 vs 88, p=0.34). CT pts had more fatigue (median FACT-F 75 vs 91, p&lt;0.001). At 12 months CT pts tend to have more cognitive impairment on traditional NP tests (26% vs 0%, p=.09), more perceived cognitive impairment (13.5% vs 0%, p=.57) &amp; greater fatigue (16% vs 0%). Cytokine levels were elevated in all groups at all time points compared to healthy volunteers. There was a trend to higher cytokine levels with greater fatigue and worse cognitive impairment. Fatigue, QOL and anxiety and depression were highly correlated. Conclusions: Cognitive impairment is present in some pts prior to CT and there is a trend for CT pts to have worse cognitive impairment at 12 but not at 6 months. Fatigue is associated with CT. Cytokine levels remained elevated in all groups compared to healthy volunteers. No significant financial relationships to disclose.

Relationship between optimism, disease variables, and health perception and quality of life in individuals with epilepsy

Epilepsy is a relatively frequent chronic condition with an important impact on the health perception and quality of life (QOL) of patients. The aim of the present study was to identify variables related to health status perception and QOL in persons with epilepsy. Participants were 200 persons with epilepsy, 53.5% of whom were males. The mean age was 39.6; 95% had seizures, and 99% were taking antiepileptic medication. The self-report questionnaire administered assessed four types of variables: demographic, disease, epilepsy-specific optimistic attitude, and outcome variables. Results demonstrated that an optimistic orientation is related to better perception of physical and mental health status and better perception of QOL. The variables that best predict positive outcomes are optimistic orientation, perception of cognitive functioning, and perception of seizure control. These results question the importance attributed to seizure characteristics for everyday functioning and everyday life of individuals with epilepsy, and stress the importance of facilitating an epilepsy-specific optimistic orientation.

Neuropsychological Changes Following Military Service in Iraq

SINCE THE 1990-1991 PERSIAN GULF WAR, THE IDEA that the health of military personnel returning from major deployments should be monitored proactively has been established. Major studies are under way on both sides of the Atlantic on the health of personnel deployed to Iraq. The research that has emerged so far on US veterans of Operation Iraqi Freedom indicates that there have indeed been many psychiatric casualties, with high prevalence rates of symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety. Up to 20% of soldiers and marines returning from deployment to Iraq and Afghanistan met criteria for PTSD. Similar findings have been documented by routine screening performed by the US Army. The situation for UK personnel returning from Operation TELIC in the 2003 Iraq War is—with the exception of reservists—rather different, with a prevalence of PTSD (measured using identical measures to the US studies) and depressive symptoms similar to those of nondeployed personnel. These international differences may in part be explained by the nature of deployments, with US personnel on longer tours of duty in more dangerous parts of Iraq. It also may relate to the populations deployed—the deployed US military personnel are younger and have considerably less experience of active deployment than their British counterparts. Whatever the reasons, some of the most significant health effects for returning personnel seem to have been on mental health, and, thus far, there is no evidence of a repeat of the multiple physical symptoms that characterized Persian Gulf War illness. Most studies on military personnel have not been able to study changes in health before and after deployment. The nature of military operations means that making prior ratings of health is logistically difficult. The study by Vasterling and colleagues in this issue of JAMA is a noteworthy exception. The authors measured neuropsychological function in a cohort of military personnel prior to and following deployment to Operation Iraqi Freedom, and compared these findings with those of a cohort of nondeployed soldiers. The authors report that significant neurocognitive changes occurred after deployment, with a worsening of performance on tasks requiring sustained attention, verbal learning, and visual-spatial memory but an improvement in reaction time. Vasterling et al conclude that these results are not explained by the most likely possibilities: head injury, PTSD, and depression. One of the most consistent groups of symptoms reported following the 1991 Persian Gulf War were what might broadly be described as cognitive. Many veterans of that conflict continue to complain of difficulties in memory, word finding, concentration, and other cognitive impairments. This led to speculation that these symptoms were the result of exposure to neurotoxic agents such as organophosphate pesticides and even sarin nerve gas. As a result, a series of neuropsychological studies of Gulf War veterans was undertaken some considerable time after deployment. A review of the results of these studies did not find a consistent pattern of significant deficits, and although certain subgroups (those who reported multiple symptoms and those who selfreported greater exposure to pesticides) had more deficits, again, there was no consistent pattern. Instead, the authors of the review concluded that these deficits were only mild and that “performance on objective tasks of neuropsychological function showed little correspondence to subjective perceptions of cognitive functioning.” Nevertheless, the rationale for the present study by Vasterling et al was to use neuropsychological testing as a means of assessing possible neural dysfunction, but this time to do so before so many years had elapsed. This study is the first of its kind to follow and reassess representative samples of deployed personnel 2 to 3 months following their return home from war. Whether veterans should be concerned about the findings of Vasterling et al depends on the answers to several other questions. First, are the reported effects clinically significant? The authors emphasize that the neuropsychological changes are “mild” and “subtle.” Although data on the dis-

Cytokine levels in patients (pts) with localized colorectal cancer (CRC) after surgery and their relationship to fatigue and cognitive function

3623 Background: Cytokines have been associated with fatigue and cognitive dysfunction. Here we evaluate cytokine levels in pts with CRC as part of a longitudinal study evaluating these symptoms. Methods: Serum levels of 12 cytokines were measured using a LiquiChip assay on pts with localized CRC at baseline (mean 7 weeks post-surgery or before neoadjuvant therapy), 6 and 12 months. Group A (Stage III/high risk II) received chemotherapy (CT) and group B (Stage I/II) received no CT. Pts completed concurrent questionnaires for fatigue &amp; QOL (FACT-F), anxiety/depression (GHQ), and perception of cognitive function (FACT-COG); they had neuropsychological (NP) assessment with traditional tests and CANTAB, a computerized NP battery. Associations between cytokine levels, test results, demographic and disease-related factors were sought. Results: Baseline data are available for 82 pts: 65 group A and 17 group B, with follow-up at 6 and 12 months for 32 and 15 pts. Mean age was 58 years and 68% were male. Cytokine levels were elevated in all groups with larger ranges after surgery (selected data in table ); in healthy people they are generally undetectable. There was cognitive impairment at baseline in 28% on traditional NP tests. At 6 months CT pts had more fatigue (median FACT-F 43 vs 47), perceived more cognitive impairment (median FACT-COG 127 vs 138), and had more cognitive impairment on CANTAB (42% vs 17%), but not on traditional NP tests (32% vs 33%). At 6 months, elevated cytokines (IL-1,-6,-8,-12, TNF, IFN) were associated with greater deficit on CANTAB (p&lt;0.06); there was no association of cytokines with time from surgery, traditional NP test score, FACT-COG, fatigue, QOL or anxiety &amp; depression. Conclusions: Cytokine levels were elevated in most pts. Cognitive impairment is present in some pts prior to chemotherapy and CT pts have worse impairment on computerized NP tests than non-CT pts. Elevated cytokines may be associated with worse cognitive function. [Table: see text] No significant financial relationships to disclose.

Perception of cognitive function in older adults following coronary artery bypass surgery.

This study examined the effects of coronary artery bypass grafting (CABG) on objective and subjective measures of neurocognitive functioning. Participants were 170 older patients (127 men and 43 women; mean age = 61 years) undergoing CABG. Measures of neurocognitive function, depression, anxiety, and perceived cognitive abilities were administered immediately prior to and 6 weeks following surgery. Although objective measures of impaired cognitive performance following CABG were not related to perceived cognitive difficulties, the presence of anxiety and depression was related to the perception of cognitive functioning. Patients who reported high levels of anxiety and depression 6 weeks after surgery perceived themselves as having poorer cognitive function. Interventions designed to reduce emotional distress could improve patient's perceived cognitive abilities following CABG.

Perception of cognitive function in older adults following coronary artery bypass surgery.

Perception of cognitive function in older adults following coronary artery bypass surgery.

Relationships among cognitive functioning, perceptions of cognitive functioning, and psychological functioning in patients with Eosinophilia Myalgia Syndrome (EMS)

Relationships among cognitive functioning, perceptions of cognitive functioning, and psychological functioning in patients with Eosinophilia Myalgia Syndrome (EMS)

Relationships among cognitive functioning, perceptions of cognitive functioning, and psychological functioning in patients with Eosinophilia Myalgia Syndrome (EMS)

Relationships among cognitive functioning, perceptions of cognitive functioning, and psychological functioning in patients with Eosinophilia Myalgia Syndrome (EMS)