Predictors Of Cognitive Dysfunction Research Articles

Predictors of the dynamics of changes in cognitive functions in patients 6 months after carotid endarterectomy

Background. Carotid atherosclerosis is one of the urgent problems due to the high risk of developing ischemic stroke and cognitive impairment. The dynamics of clinical disorders in patients with carotid stenosis is determined by a complex of neurophysiological, angiological, tissue and biomolecular reactions, the characteristics of which can act as predictors of the course of the pathology.The aim of the work. To determine the neurophysiological parameters and predictors of cognitive dysfunction in patients who underwent carotid endarterectomy.Materials and methods. The study included 59 people with carotid atherosclerotic disease. All included patients underwent carotid endarterectomy. We assessed the degree of stenosis of the internal carotid artery and cognitive status using the FAB (Frontal Assessment Battery) scale and MoCA (Montreal Cognitive Assessment) Test and recorded electroencephalogram (EEG), P300 cognitive evoked potentials and heart rate variability in patients at various terms (before surgery, 6 months after the surgery). Patients were divided into groups based on the dynamics of cognitive tests using cluster analysis (k-means) with identification of elements included in the clusters: patients of cluster 1 had a “preserved” profile of cognitive status; patients of cluster 2 – moderate cognitive dysfunction.Results. Patients of cluster 1 had a higher power of beta oscillations in the frontal lead, a higher amplitude of the P3 component of the P300 potential, and a greater variability of R-R intervals in terms of the total indicator and high-frequency power. We proposed a model that allows us to classify patients into groups according to the dynamics of cognitive function scores. According to the data obtained, the most significant predictors of the dynamics of cognitive status were the initial characteristics of the EEG and the P300 cognitive evoked potential.Conclusions. We determined the clinical and neurophysiological correlates of cognitive dysfunction: an association with greater preservation of activating effects on the EEG, processes of recognition and decision-making in the associative zones of the cortex, and less pronounced activity of stress-implementing mechanisms. Indicators of EEG spectral analysis and characteristics of the P300 cognitive evoked potential are predictors of the cognitive status dynamics.

Association between Cerebral Small Vessel Disease and Plasma Levels of LDL Cholesterol and Homocysteine: Implications for Cognitive Function

Background: Investigate the correlation between low-density lipoprotein (LDL) cholesterol, homocysteine and cognitive function in patients with cerebral small vessel disease (CSVD). Methods: 240 patients with CSVD confirmed by head MRI in the Department of Neurology from January 2020 to December 2023 were retrospectively included in the study. All the patients had complete blood biochemical examination, and their cognitive function was evaluated by Montreal Cognitive Assessment Scale (MoCA), and after correcting for the factor of years of education, the patients were divided into a group of normal cognition (MoCA ≥26, 70 patients) and a group of cognitive function (MoCA ≥26, 70 patients) according to the scores. After correcting for the factor of years of education, the patients were divided into the normal cognitive function group (70 cases with MoCA ≥26) and the cognitive dysfunction group (170 cases with MoCA <26) according to their scores. The general information of the two groups and the patients' cognitive function characteristics, including visuospatial and executive ability, naming, attention and calculation, language, abstraction, delayed memory, and orientation, were compared, and the independent influences on the occurrence of cognitive dysfunction in patients with CSVD were analyzed by two-category multifactorial logistic regression. Results: Compared with the group with normal cognitive function, the cognitive dysfunction group had lower years of education and higher homocysteine, and the differences were statistically significant (P < 0.05). Compared with the group with normal cognitive functioning, the cognitive dysfunction group had lower MoCA total scores, lower visuospatial and executive ability, naming, attention and calculation, language, abstraction, delayed memory, and orientation scores, and the differences were statistically significant (P < 0.05). Two-category multifactorial logistic regression analysis showed that low-density lipoprotein cholesterol (OR=2.756, 95% CI:0.673-0.938, P=0.012) and homocysteine (OR=1.859, 95% CI: 1.024-1.324, P=0.016) were the independent factors influencing cognitive dysfunction in CSVD patients. The lower the risk of cognitive impairment in CSVD patients, the higher the plasma LDL cholesterol and homocysteine levels, the higher the risk of cognitive impairment in CSVD patients. Conclusion: Plasma LDL cholesterol and homocysteine levels are associated with and may be predictors of cognitive dysfunction in patients with CSVD.

Cognitive impairment, childhood trauma, sedentary behaviour, and elevated C-reactive protein levels in major affective disorders

Elevated C-reactive protein (CRP) levels were associated with cognitive decline, sedentary behaviour, and childhood trauma in patients with major affective disorders. This study aims to examine the association of peripheral CRP levels, cognitive function, childhood trauma, sedentary behaviour, and quality of life in individuals with major affective disorders, including bipolar disorder (BD), major depressive disorder (MDD), and individuals without mood disorders (controls). We included outpatients with BD (n = 42), MDD (n = 27), and healthy controls (n = 40). All participants were assessed by a questionnaire, structured clinical interview, and the following scales: international physical activity questionnaire, childhood trauma questionnaire, 17-item Hamilton Depression Rating Scale (HDRS17), and World Health Organization Quality of Life instrument, brief version (WHOQOL-BREF). Other measures were included: hs-CRP levels, anthropometric measures, and cognitive tests (Trail-making test part A and part B, Stroop test, phonemic verbal fluency test, and semantic verbal fluency test). Our results indicated that BD outpatients were less significantly physically active on leisure domain than controls. Levels of hs-CRP ≥ 5 mg/L were significantly linked with a history of childhood sexual abuse and childhood physical abuse, as well as worse neurocognitive performance in major depressive disorders, mainly in BD. There was a significant negative correlation between Trail-making part B score and WHOQOL-BREF total score. The findings support the hypothesis that levels of hs-CRP ≥ 5 mg/L may be a possible predictor of cognitive dysfunction, childhood sexual abuse and sedentary behaviour in major affective disorders.

Impact of cisplatin-induced hearing loss (CIHL) on patient-reported social and emotional functioning.

12120 Background: Cisplatin is one of the most commonly used ototoxic drugs, but no study has quantified the handicap imposed by CIHL in U.S. adult-onset cancer survivors. Identification of survivors with high degrees of handicap and related risk factors is vital, as hearing loss (HL) in the general population is strongly related to adverse health outcomes, including cognitive decline, dementia, and poor mental health and social well-being. Methods: Eligible testicular cancer survivors (TCS) (age < 60 y at diagnosis, given first line cisplatin) completed comprehensive health surveys, including the validated 25-item Hearing Handicap Inventory for Adults (HHIA). HHIA quantifies emotional (13 items) and social difficulties (12 items) related to HL; for each scale (0-100%), based on their responses, TCS were grouped into 3 handicap levels: 0-16% (none/minimal), 17-42% (mild/moderate), and 43-100% (significant) following HHIA recommendations. A Spearman correlation evaluated the associations between increasing HL severity and HHIA group. The association between HL and reported cognitive dysfunction was evaluated by a logistic regression analysis adjusted for age, income, education, yrs since therapy, cisplatin dose, BMI, smoking, and hypertension, with results presented as OR[CI], p-value. Results: Among 213 TCS [median age at evaluation, 46 y (IQR: 38-52 y); median time since cisplatin completion, 10.6 y (IQR: 6.8-16.6 y)], CIHL was reported by 127 TCS (60%). Of TCS with CIHL, 31% reported some degree of related handicap (for total HHIA scale: 13% TCS and 18% TCS reporting mild/moderate and significant handicap, respectively). HL severity was significantly correlated with handicap level in all domains (social, ρ = 0.85, p <.001; emotional, ρ = 0.72, p <.001; and total, ρ = 0.81, p <.001). Cognitive dysfunction was more commonly reported by TCS with CIHL than TCS without (35% and 22%, p =.049). HL was a significant independent predictor of cognitive dysfunction, 2.20 [1.09-4.47], p =.028. Since many patients with HL in the general population report tinnitus (TINN), and TINN may suggest a worse HL phenotype, we additionally adjusted for TINN severity and found a significant independent association for TINN and cognitive dysfunction, 1.49 [1.05-2.11], p = 0.027. Despite these outcomes, only 10% of TCS with HL used hearing aids (n = 13). Conclusions: After cisplatin chemotherapy, 60% TCS report CIHL, and TCS with CIHL report poorer social and emotional function. One in 5 TCS with CIHL reported significant overall handicap. Despite these outcomes, the low prevalence of hearing aid use suggests a potential clinical intervention that could improve social and emotional well-being. If confirmed, the possible association between CIHL with TINN and cognitive dysfunction may be of particular interest, as the Lancet Commission on Dementia Prevention (2020) identified untreated HL as a key modifiable risk factor.

Cognitive Dysfunction among U.S. High School Students and Its Association with Time Spent on Digital Devices: A Population-Based Study

Introduction: Cognitive dysfunction is a hallmark feature of many psychiatric disorders. We aimed to study the prevalence and predictors of cognitive dysfunction (CD) among U.S. high school students and its association with time spent on digital devices. Methods: We performed a cross-sectional survey study using YRBSS 2019 data of U.S. high school students in grades 9–12. Cognitive dysfunction was defined by difficulties with remembering, concentrating, and making decisions due to emotional, physical, or mental problems. Digital screen time was described by daily time spent on TV, computers, tablets, and phone. We performed univariate and multivariable survey logistic regression analysis to identify the prevalence of cognitive dysfunction and its association with time spent on digital devices. Results: Out of 10,317 total participants, 3914 (37.9%) reported CD. The prevalence of CD was higher in females compared to males (46.0% vs. 29.9%). Compared to participants with no CD, participants with CD reported substance abuse, such as alcohol (35.8% vs. 26.6%), marijuana (28.3% vs. 17.6%), cigarette (8.1% vs. 4.7%), and illicit drugs (18.9% vs. 9.0%) and they reported a higher prevalence (p < 0.0001 for all substances). Participants who felt sad and hopeless (62.8 vs. 22.1%) reported a high prevalence of CD, whereas participants with adequate sleep reported low prevalence (15.7% vs. 25.6%). In a regression, daily video game/internet use for non-work-related activities for 4 h (aOR:1.27; p = 0.03) and ≥5 h (aOR:1.70; p < 0.0001) demonstrated higher odds of CD, compared to participants with no daily use. Female sex, substance use, and depressed mood were additional predictors of CD. Conclusion: The prevalence of CD is high in U.S. high-school students. Female sex, substance abuse, depressed mood, and excessive VG/PC use is associated with high odds of cognitive dysfunction. Further research is needed to explore the complex relationship between screen time and cognitive dysfunction.

Biomarkers of Prevalent and Incident Cognitive Dysfunction in People with Dysglycemia: Data from the ORIGIN Trial

Background: Diabetes and cardiovascular disease increase the risk of incident cognitive dysfunction. Identification of novel biochemical markers for cognitive dysfunction may identify people at the highest risk while yielding insights regarding the pathophysiology of cognitive dysfunction. Objective: To identify cardiovascular biomarkers in serum that are independent predictors of cognitive dysfunction in individuals with dysglycemia. Methods: This analysis was conducted in 8,365 participants in the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial whose stored serum was analyzed for 238 cardio-metabolic biomarkers and completed a baseline Mini-Mental State Examination (MMSE). Fine and Gray sub distribution hazard models accounting for the competing risk of death accounting for clinical risk factors and the baseline MMSE were used to identify biomarkers that predicted incident cognitive dysfunction (MMSE < 24 or dementia) using forward selection with an inclusion p-value < 0.0002 to account for multiplicity. Results: During a median follow-up period of 6.2 years, 939 individuals developed cognitive dysfunction. After accounting for 17 clinical risk factors, glargine allocation, and the baseline MMSE, three biomarkers (α-2 Macroglobulin, HR 1.19; 95% CI 1.12, 1.27; Macrophage Inflammatory Protein 1α, HR 1.11; 95% CI 1.06, 1.16; and Growth Hormone, HR 0.91; 95% CI 0.87, 0.96) independently predicted incident cognitive dysfunction (p < 0.0002). Addition of these biomarkers to a model that included clinical risk factors, however, did not improve the ability to predict cognitive dysfunction. Conclusion: Addition of independent biomarkers to clinical risk factors for cognitive dysfunction in people with dysglycemia did not predict incident cognitive dysfunction better than clinical risk factors alone.

Increased Serum Neuropeptide Galanin Level Is a Predictor of Cognitive Dysfunction in Patients with Hip Fracture.

Background Hip fracture is a common occurrence in elderly populations and is frequently followed by various levels of cognitive dysfunction, leading to adverse functional outcomes. Risk stratification of hip fracture patients to identify high-risk subsets can enable improved strategies to mitigate cognitive complications. The neuropeptide galanin has multiple neurological functions, and altered levels are documented in dementia-type and depression disorders. The present study investigated the association of serum neuropeptide galanin levels in hip fracture patients with the occurrence of cognitive dysfunction during the first week of admission. Methods 276 hip fracture patients without preexisting delirium, cognitive impairment, or severe mental disorders were included in a cross-sectional study. Serum galanin levels were assessed by ELISA on the second day of admission. Routine clinical and laboratory variables were documented. MoCA was performed within 1 week, and those with a score < 26 were categorized with “cognitive decline.” Inferential statistics including multiple linear regression analysis were applied to determine the association of serum galanin level and cognitive status. Results 141 patients were categorized with “cognitive decline,” and 135 patients were categorized as “cognitively normal.” Serum galanin was highly significantly increased in the “cognitive decline” group (34.2 ± 4.8, pg/ml) compared to the “cognitively normal” group (28.9 ± 3.7, pg/ml) and showed significant negative correlation with MoCA scores (r = −0.229, p = 0.016). Regression analysis showed serum galanin as the sole significant independent predictor of lower MoCA scores (β = 0.231, p = 0.035) while age, gender, blood pressure, cholesterol, and blood glucose levels had no significant association. Conclusion Higher serum galanin predicted the development of cognitive dysfunction and worse MoCA scores in a cohort of hip fracture patients without preexisting cognitive impairment or delirium at admission, thus warranting large-scale studies investigating galanin as a candidate biomarker to identify hip fracture patients at risk of cognitive decline.

PREDICTING VISUAL PERCEPTION AND WORKING MEMORY DEFICITS AMONG PATIENTS WITH TYPE 1 DIABETES: THE IMPLICATION OF EATING ATTITUDE AND MENTAL HEALTH STATUS

Several recent studies designate that individuals with type-1-diabetes (T1D) are at higher risk for cognitive impairment than their peers without T1D. The aim of this study was to determine whether socio-demographic and clinical characteristics, eating attitude and psycho-emotional characteristics can predict visual perception (VP) and working memory (WM) impairment in the Moroccan population with T1D. A cross-sectional analysis was carried out in adult T1D patients (N=140). The Rey-Osterrieth Complex Figure test (electronical version) was used to evaluate the VP and WM. Moreover, patients also completed the 21-item Depression, Anxiety, and Stress Scale to assess their mental health state. In order to evaluate the risk of eating disorders the Eating attitudes Test-26 were used. Finally, anthropometric properties and clinical characteristics were evaluated. Predictors of cognitive dysfunction were determined using the hierarchical regression analysis. The major result was that age, long diabetes duration, glycemia, HbA1c, dieting and bulimia were the potential predictors of low scores in VP and WM. Other significant predictors were cholesterol, triglycerides for visual perception. Although psych-emotional symptoms including stress, anxiety, and depression were not a significant predictors of VP and WM impairment. Furthermore, our findings showed that the more the level of stress increases, the VP and WM scores significantly decrease. This study suggests that it can be helpful for medical practitioners to screen for disordered eating behaviors and emotional symptoms as a supplemental risk factor for cognitive impairment in T1D.

Myelin imaging measures as predictors of cognitive impairment in MS patients: A hybrid PET-MRI study

BackgroundCognitive impairment is one of the concerns of Multiple Sclerosis (MS) and has been related to myelin loss. Different neuroimaging methods have been used to quantify myelin and relate it to cognitive dysfunctions, among them Magnetization Transfer Ratio (MTR), Diffusion Tensor Imaging (DTI), and, more recently, Positron Emission Tomography (PET) with 11C-PIB. ObjectiveTo investigate different myelin imaging modalities as predictors of cognitive dysfunction. MethodsFifty-one MS patients and 24 healthy controls underwent clinical and neuropsychological assessment and MTR, DTI (Axial Diffusion-AD and Fractional Anisotropy-FA maps), and 11C-PIB PET images in a PET/MR hybrid system. ResultsMTR and DTI(FA) differed in patients with or without cognitive impairment. There was an association of DTI(FA) and DTI(AD) with cognition and psychomotor speed for progressive MS, and of 11C-PIB uptake and MTR for relapsing-remitting MS. MTR in the Thalamus (β= -0.51, p = 0.021) and Corpus Callosum (β= -0.24, p = 0.033) were predictive of cognitive impairment. DTI-FA in the Caudate (β= -26.93, p = 0.006) presented abnormal predictive result. ConclusionLower myelin content by 11C-PIB uptake was associated with worse cognitive status. MTR was predictive of cognitive impairment in MS.

Detection of Cognitive Impairment by Choice Auditory Reaction Time (ART) and Visual Reaction Time (VRT)s during Acute Mental Stress in Young Hypertensives: A Case Control Study.

Acute stress is known to be associated with both negative and positive influences on cognitive performance. Hypertension is one of the risk factors for lowered cognitive performance. Mental stress testing is easier to administer and can be regulated by the investigator. Mental arithmetic using serial subtraction is the most widely used method to administer stress. Reaction time (RT) is widely used to assess cognitive domains like attention, execution and psychomotor speed. Researchers have shown choice reaction times are delayed in hypertension. It is not known whether acute mental stress improves or deteriorates attention, execution and psychomotor speed in hypertension. We hypothesized in the present study that acute mental stress deteriorates cognitive function in hypertensives without overt cerebrovascular disease or other vascular risk factors. After getting medical ethical clearance from our institution, this case-control study was carried out over eight months (January 2017 to September 2017). 60 subjects between the age group of 35 to 55 years were included in the study. They were divided into 2 groups. Group 1 consisted of 30 diagnosed cases of hypertension at least two years of duration. Group 2 consisted of 30 sex and age-matched controls. MMSE was performed to assess the cognitive function in these groups. Simple (S) and choice (C) auditory reaction time (ART) and visual reaction time (VRT)s were measured at rest and acute mental stress in these groups to assess cognitive function. Predictive value of VRTC resting and VRTC during acute mental stress among hypertensives for cognitive dysfunction was calculated using the receiver operating characteristic (ROC) curve. There was significant difference ART and VRT, both simple and choice, in hypertensive and nonhypertensive subjects and these reaction times further increased during mental stress (P<0.001). VRTC can be a predictor of cognitive dysfunction in hypertensives and during acute mental stress. A significant difference in cognitive functions in hypertensive and nonhypertensive subjects exists and this further deteriorates with acute mental stress.

Prevalence, involved domains, and predictor of cognitive dysfunction in systemic lupus erythematosus

Cognitive Dysfunction (CD) can occur in Systemic Lupus Erythematosus (SLE) before the occurrence of Neuropsychiatric Lupus Erythematosus (NPSLE). Given the reversibility and fluctuation of SLE-related CD, the research for possible predictors is of great significance for early detection and intervention. We sought to determine the prevalence, involved domains, and possible predictors of CD in SLE patients. We conducted a retrospective cross-sectional study at Nanfang Hospital from 2018 to 2019. A total of 78 SLE patients were recruited. The Montreal Cognitive Assessment (MoCA) scale was used to screen cognitive function. Demographic, clinical, and laboratory characteristics were collected. The serum anti-methyl-d-aspartate receptor (anti-NMDAR) antibody and S100β were measured by enzyme-linked immunosorbent assay (ELISA). Multivariate logistic regression analysis and ROC curve were used to assess the predictor of SLE-related CD. Of 78 recruited patients,53 (67.9%) had CD. It mainly involved delayed recall, abstract generalization, verbal repetition, and fluency. The disease activity index (SLEDAI) was not associated with SLE-related CD (p > 0.05). Multivariate logistic regression showed that an increase in each year of education there was a decrease in the likelihood of CD (OR 0.261, CI 0.080-0.857, p = 0.027) whereas with each unit increase in serum anti-NMDAR antibody there was an increased likelihood of SLE-related CD (OR 1.568, CI 1.073-2.292, p = 0.020). The prevalence of SLE-related CD was 67.9% in our study and SLE-related CD was not associated with disease activity. Serum anti-NMDAR antibody can be used as a predictor for SLE-related CD.

Self-reported memory problems in adult-onset cancer survivors in the United States with or without: Type 2 diabetes mellitus, hypertension and hyperlipidemia.

e24062 Background: Cancer and chronic diseases (CD) are independent predictors of cognitive dysfunction, especially memory problems that can impact patients’ psychosocial functioning and quality of life. We examined the prevalence of memory problems in cancer patients with or without CD, including Type 2 Diabetes mellitus (DM), hypertension (HTN) and hyperlipidemia (HLD). Methods: We examined data from people who completed the US National Health and Nutrition Examination Survey from 2009 to 2016 to determine the prevalence of memory problems in cancer survivors vs. non-cancer survivors with and without a history of CD. Participants answered the ‘yes’ or ‘no’ question: “Are you limited in any way because of difficulty remembering or because you experience periods of confusion?” History of Cancer, DM, HTN and HLD were self-reported. We used Rao-Scott Modified Chi-Square Test (X2test) for cross-classified categorical data from complex sample survey. Age, sex, race-ethnicity, education, poverty, and general health were controlled using logistic regression. Results: The sample included 21813 adults, ³ 20 years old, and ≈52% female. There were 40% Whites, 22% Blacks, 25% Mexican American/Other Hispanics, and 13% other race/multi-racial. About 46% graduated high School/had a GED (21.2%) or completed less than high school (24.4%). Of those with cancer ( N= 2025), memory problems were associated with DM (17.72%; X2test, p= 0.003) and (HTN, 13.42%; X2test, p= 0.007), but not HLD (11.66%; X2test, p= 0.786). Of those without cancer, memory problems were associated with DM, HTN and HLD (all p&lt; 0.0001). Prevalence of CD was much greater in cancer survivors with memory problems ( p&lt; .05). Conclusions: Strategies to mitigate memory problems in cancer survivors should consider the implications of DM, HTN and HLD, particularly given the prevalence of these chronic morbidities in cancer populations.

Frontal dynamic activity as a predictor of cognitive dysfunction after pontine ischemia.

BACKGROUNDThere is a tendency to pay little attention to cognitive dysfunction after a subcortical stroke, resulting in this condition being overlooked. Damage to the brainstem may affect cognition, probably originating from the fronto-cerebellar circuit, but details remain obscure.OBJECTIVETo investigate the effect of damage to pons on frontal function via the fronto-cerebellar circuit.METHODSWe measured frontal dynamic responses in patients with acute pontine ischemia during phonemic verbal fluency task using near-infrared spectroscopy (NIRS). Furthermore, to determine whether the fronto-cerebellar circuit is affected by pontine ischemia, 99mTc-ECD single photon emission computed tomography (SPECT) was performed.RESULTSTwenty-five patients with pontine isolated infarction met the criteria. Especially, 80 percent of the pontine lesioned patients affected cognition. The patients exhibited hyper-frontal activity according to the neuropsychological tests. Follow-up NIRS showed increased frontal activity as being linked to improved cognition. This may indicate the involvement of frontal activity in cognitive recovery. The SPECT showed consistently hyper-frontal perfusion as well as hypo-cerebellar perfusion.CONCLUSIONSThis suggested that hyper-frontal activity might contribute to compensation for cognitive dysfunction after pontine ischemia and that recovery from the cognitive deficits is attributable to frontal activity.

Prediction of cognitive dysfunction after resuscitation - a systematic review.

Cardiac arrest (CA) due to cardiovascular disease is the leading cause of death in developed countries. It is estimated that over 350,000 people in Europe suffer from out-of-hospital cardiac arrest. According to the literature, the longer the episode of cardiac arrest, the greater the risk of cognitive impairment, especially short-term memory, as well as immediate and delayed recall. Other common dysfunctions include attention deficits and executive function disorders. The aim of this systematic review was to summarize current research on cognitive impairment in patients after sudden cardiac arrest. The electronic databases PubMed/MEDLINE, OVID, Web of Science, and EBSCO were searched using the following key words: ‘sudden cardiac arrest’, ‘out-of-hospital cardiac arrest’, ‘cognitive function’, ‘cognitive impairment’, ‘functional outcome’, ‘cardiopulmonary resuscitation’. The most recent studies from the last 7 years (2011–2018) were included. Cognitive disorders occurred in a broad range of cases: from 13% to even 100%. In one study, cognitive deficits did not occur at all. Amongst the reviewed articles only two studies were carried out on a large group of patients. The remaining studies were conducted on a small group of respondents; therefore there was no possibility to generalize the results to the entire population. The areas in which the most cognitive impairment occurred were memory, executive functions and visual–motor skills. One of the conclusions derived from the reviewed literature is the importance of continuous training of cognitive functions, especially for people with cardiovascular risk.

Cognitive dysfunction among newly diagnosed older patients with hematological malignancy: frequency, clinical indicators and predictors.

Medical staff often overlook or underestimate the presence or severity of cognitive dysfunction. The purpose of this study was to clarify the frequency, clinical indicators and predictors of cognitive dysfunction among newly diagnosed older patients with hematologic malignancy receiving first-line chemotherapy. Patients aged 65 years or over with a primary diagnosis of malignant lymphoma or multiple myeloma were consecutively recruited. Cognitive dysfunction was evaluated using the Mini-Mental State Examination (MMSE) twice: before starting chemotherapy (T1) and 1 month later (T2). Participants also underwent a comprehensive geriatric assessment at T1. Potential clinical indicators that were associated with cognitive dysfunction were explored via cross-sectional analysis at T1. Predictors of cognitive dysfunction at T2 were also investigated among patients without cognitive dysfunction at T1. A total of 145 participants participated in the study; cognitive dysfunction at T1 was present in 20%. Multivariate analysis demonstrated that lower educational attainment and poorer instrumental activities of daily living were significant clinical indicators of cognitive dysfunction. Among 99 patients who did not have cognitive dysfunction at T1 and underwent cognitive assessment at T2, 7% developed dysfunction. Subjective perception of difficulty remembering at T1 was the only factor which significantly predicted new-onset cognitive dysfunction at T2. The prevalence rate of cognitive dysfunction was non-negligible among older patients with hematologic malignancy before and immediately after initial chemotherapy. Attention to the clinical indicators and predictors found in this study may provide facilitate the identification of cognitive dysfunction in patients with cancer.

Related factors and predictors of cognitive dysfunction in Chronic Kidney Disease Patients on maintenance haemodialysis in Nigeria (P6.219)

Related factors and predictors of cognitive dysfunction in Chronic Kidney Disease Patients on maintenance haemodialysis in Nigeria (P6.219)

OP31 - Serum copeptin levels as predictor of cognitive dysfunction after carotid endarterectomy

OP31 - Serum copeptin levels as predictor of cognitive dysfunction after carotid endarterectomy

Related Factors and Predictors of Cognitive Dysfunction in Chronic Kidney Disease on Maintenance Hemodialysis in Nigeria.

Background:Previous studies suggest a high frequency of cognitive impairment (CI) in persons with chronic kidney disease (CKD); however, factors associated with CI and predictors of CI in persons with CKD remain largely unclear. The aim of this study was to determine the factors associated with CI and predictors of CI in CKD patients on maintenance hemodialysis.Materials and Methods:The first stage of the study included recruitment of 100 apparently healthy participants aimed at determining the reference values. The second stage of the study included eighty CKD patients on maintenance hemodialysis. The iron psychology (FEPSY) was used to assess the memory, psychomotor speed, concentration, and attention using simple auditory reaction time (ART) and visual reaction time (VRT) tasks, recognition memory tests (RMT), finger tapping task (FTT), and binary choice task (BCT).Results:Using normative values generated in this study, 41 (51.3%) and 43 (53.8%) CKD patients had abnormal scores on ART dominant (D) and nondominant (ND) sides, respectively. Forty (50%) and 42 (52.5%) patients had abnormal scores on VRT D and ND sides, respectively. Twenty-one (26.3%) and 68 (85%) had abnormal scores on BCT and computer-assisted visual scanning task, respectively. Sixty-four (80%) and 65 (81.3%) had abnormal scores on RMT (words) and RMT, respectively. Fifty-two (65%) and 48 (60%) patients had abnormal scores on D and ND sides of (FTT), respectively. Factors associated with psychomotor speed impairment were duration of CKD from diagnosis (P = 0.0001 and 0.043 in D and ND ART, respectively), duration on dialysis (P = 0.0001 across board in D and ND ART as well as in D and ND VRT, respectively), and plasma urea (PU) and plasma creatinine (PCr) (P < 0.05). Factors found to be associated with memory impairment included age (P = 0.045 and 0.025 on words and figures RMT, respectively), PU (P = 0.002 and 0.005 on words and figures RMT, respectively), and PCr (P = 0.012 and 0.040 on words and figures RMT, respectively). Duration on dialysis (P = 0.032) and PCr (P = 0.001) were associated with attention and concentration. Only psychomotor speed was independently predicted by duration of CKD.Conclusion:Factors associated with psychomotor speed impairment were duration of CKD, duration on dialysis, and PU and PCr while age, PU, and PCr were associated with memory. Duration on dialysis and PCr were associated with attention and concentration. Only psychomotor speed was independently predicted by duration of CKD.

S100B protein and neuron-specific enolase as predictors of cognitive dysfunction after coronary artery bypass graft surgery: A prospective observational study.

Postoperative cognitive dysfunction (POCD) may be related to the systemic inflammatory response and an increase in serum markers of brain injury such as S100B protein and neuron-specific enolase (NSE). The study aims to evaluate the association between POCD and serum levels of S100B and NSE after coronary artery bypass grafting surgery (CABG). Prospective observational study. Single university teaching hospital. We investigated 88 patients undergoing CABG. Cognitive function was measured preoperatively, and at the 21st and 180th postoperative days (i.e. 6 months after surgery). S100B protein and NSE serum levels were evaluated preoperatively, after induction of anaesthesia, at the end of surgery and at 6 and 24 h after surgery. The incidence of POCD was 26.1% at 21 days after surgery and 22.7% at 6 months after surgery. Increased serum levels of S100B protein and NSE were observed postoperatively and may indicate brain damage. Although serum levels of S100B protein and NSE are both significantly increased postoperatively, our findings indicate that serum levels of S100B protein may be more accurate than NSE in the detection of POCD after CABG. NCT01550159.

Radiographic absence of the posterior communicating arteries and the prediction of cognitive dysfunction after carotid endarterectomy.

Approximately 25% of patients exhibit cognitive dysfunction 24 hours after carotid endarterectomy (CEA). One of the purported mechanisms of early cognitive dysfunction (eCD) is hypoperfusion due to inadequate collateral circulation during cross-clamping of the carotid artery. The authors assessed whether poor collateral circulation within the circle of Willis, as determined by preoperative CT angiography (CTA) or MR angiography (MRA), could predict eCD. Patients who underwent CEA after preoperative MRA or CTA imaging and full neuropsychometric evaluation were included in this study (n = 42); 4 patients were excluded due to intraoperative electroencephalographic changes and subsequent shunt placement. Thirty-eight patients were included in the statistical analyses. Patients were stratified according to posterior communicating artery (PCoA) status (radiographic visualization of at least 1 PCoA vs of no PCoAs). Variables with p < 0.20 in univariate analyses were included in a stepwise multivariate logistic regression model to identify predictors of eCD after CEA. Overall, 23.7% of patients exhibited eCD. In the final multivariate logistic regression model, radiographic absence of both PCoAs was the only independent predictor of eCD (OR 9.64, 95% CI 1.43-64.92, p = 0.02). The absence of both PCoAs on preoperative radiographic imaging is predictive of eCD after CEA. This finding supports the evidence for an underlying ischemic etiology of eCD. Larger studies are justified to verify the findings of this study. Clinical trial registration no.: NCT00597883 ( http://www.clinicaltrials.gov ).