Rey Auditory Verbal Learning Test Research Articles

Longitudinal Cognitive Screening Findings in Pediatric MS vs. Pediatric Controls and Adult MS in a Multi-center Cohort (S31.008)

Longitudinal Cognitive Screening Findings in Pediatric MS vs. Pediatric Controls and Adult MS in a Multi-center Cohort (S31.008)

Klinikai neuropszichológiai tesztek magyarországi normatív adatai II.

One basis of clinical neuropsychology is the application of objective, standardized measurements. Several internationally widespread measurements of memory and learning do not have normative data of the Hungarian population, hence it is crucial to provide a basis for future reference. The purpose of this study was to provide normative data about neuropsychological instruments measuring executive functions, memory and verbal learning skills in relation to demographic factors. Rey Auditory Verbal Learning Test (RAVLT), Montreal Cognitive Assessment (MoCA) and Prospective and Retrospective Memory Questionnaire (PRMQ) were administered to an adult, Hungarian representative sample (age, sex, education). Higher educated participants performed better on PRMQ, MoCA and RAVLT. Participants with primary education were identified as a risk group for poor verbal learning skills, executive functions and they committed more memory errors. Age had no significant effect on the results of PRMQ, while on MoCA and RAVLT a significant decline in performance was observed with the passage of lifetime. Females performed better in immediate and delayed recall on RAVLT. Application of the presented neuropsychological tests is recommended in clinical practice and scientific research as well. The presented normative data could be a valuable reference point for future studies and practical application, furthermore a basis for early identification of neurocognitive deficits. Orv Hetil. 2023; 164(16) 618-629.

Steeper memory decline after COVID-19 lockdown measures

BackgroundDuring COVID-19 lockdown measures, memory clinic patients reported worries for faster cognitive decline, due to loss of structure and feelings of loneliness and depression. We aimed to investigate the impact of the COVID-19 lockdown on rate of cognitive decline in a mixed memory clinic population, compared to matched historical controls.MethodsWe included patients who visited Alzheimer Center Amsterdam 6 months to 1 week before the first Dutch COVID-19 lockdown, and had a second visit 1 year later, after this lockdown period (n = 113; 66 ± 7 years old; 30% female; n = 55 dementia, n = 31 mild cognitive impairment (MCI), n = 18 subjective cognitive decline (SCD), n = 9 postponed diagnosis). Historical controls (visit in 2016/2017 and second visit 1 year later (n = 640)) were matched 1:1 to lockdown patients by optimal Mahalanobis distance matching (both groups n = 113). Groups were well matched. Differences between lockdown patients and historical controls over time in Mini-Mental State Examination, Trail Making Test part A and B, Rey-Auditory Verbal Learning Test (RAVLT) immediate and delayed recall, and category fluency scores were analyzed using linear mixed effect models with random intercepts. We examined differences in rate of cognitive decline between whole groups, and after stratification in SCD, MCI, and dementia separately.ResultsLockdown patients had a faster rate of memory decline compared to controls on both RAVLT immediate [B(SE) = − 2.62 (1.07), p = 0.015] and delayed recall [B(SE) = − 1.07 (0.34), p = 0.002]. Stratification by syndrome diagnosis showed that this effect was largely attributable to non-demented participants, as we observed faster memory decline during lockdown in SCD and MCI (RAVLT immediate [SCD: B(SE) = − 6.85 (2.97), p = 0.027; MCI: B(SE) = − 6.14 (1.78), p = 0.001] and delayed recall [SCD: B(SE) = − 2.45 (1.11), p = 0.035; MCI: B(SE) = − 1.50 (0.51), p = 0.005]), but not in dementia.ConclusionMemory clinic patients, specifically in pre-dementia stages, showed faster memory decline during COVID-19 lockdown, providing evidence that lockdown regulations had a deleterious effect on brain health. In individuals that may have been able to deal with accumulating, subclinical neuropathology under normal and structured circumstances, the additional stress of lockdown regulations may have acted as a “second hit,” resulting in less beneficial disease trajectory.

Rey Auditory Verbal Learning Test in idiopathic normal pressure hydrocephalus and Alzheimer’s disease

Objective: This study aims to evaluate the ability of the Rey Auditory Verbal Learning Test (RAVLT), to separate the early stages of idiopathic normal pressure hydrocephalus (iNPH) from Alzheimer’s disease (AD), both in comparison to each other and to healthy individuals (HI). Method: The RAVLT performance regarding learning, recall and recognition, was analyzed in three matched samples comprising 30 HI, 84 participants with AD and 84 with iNPH. The clinical samples were divided into two subgroups based on scores on the MMSE, High performers (27–30 points, n = 30) and Medium performers (18–26 points, n = 54). Results: Memory performance was significantly impaired in both clinical samples relative to HI, even in the comparisons with the subgroups consisting of only High-MMSE performers. Despite similar results on measures capturing learning, the iNPH patients outperformed AD patients on measures of recall and recognition. Conclusions: Learning impairment occurs early in iNPH and AD alike, when MMSE performance is still within normal limits. RAVLT measures of delayed recall and recognition are less affected in iNPH than in AD and may serve as differential diagnostic neuropsychological markers.

Landmark Model-based Individual Dynamic Prediction of Conversion from Mild Cognitive Impairment to Alzheimer's Disease using Cognitive Screening.

Identifying individuals with mild cognitive impairment (MCI) who are at increased risk of Alzheimer's Disease (AD) in cognitive screening is important for early diagnosis and prevention of AD. This study aimed at proposing a screening strategy based on landmark models to provide dynamic predictive probabilities of MCI-to-AD conversion according to longitudinal neurocognitive tests. Participants were 312 individuals who had MCI at baseline. The longitudinal neurocognitive tests were the Mini-Mental State Examination, Alzheimer Disease Assessment Scale-Cognitive 13 items, Rey Auditory Verbal Learning Test immediate, learning, and forgetting, and Functional Assessment Questionnaire. We constructed three types of landmark models and selected the optimal landmark model to dynamically predict 2-year probabilities of conversion. The dataset was randomly divided into training set and validation set at a ratio of 7:3. The FAQ, RAVLT-immediate, and RAVLT-forgetting were significant longitudinal neurocognitive tests for MCI-to-AD conversion in all three landmark models. We considered Model 3 as the final landmark model (C-index = 0.894, Brier score = 0.040) and selected Model 3c (FAQ and RAVLT-forgetting as neurocognitive tests) as the optimal landmark model (C-index = 0.898, Brier score = 0.027). Our study shows that the optimal landmark model with a combination FAQ and RAVLTforgetting is feasible to identify the risk of MCI-to-AD conversion, which can be implemented in cognitive screening.

A Cross-sectional Study on the Association of KIBRA Genetic Polymorphism with Episodic Memory in North Jordanian Adults

One of the cognitive processes most damaged by aging and thought to be the system most susceptible to neurodegenerative illnesses is episodic memory. Recently, episodic memory function has been linked to a single nucleotide polymorphism (rs17070145) in the ninth intron of the KIBRA gene (kidney and brain expressed gene). This study looked at the relationship between the KIBRA polymorphism (rs17070145) and the episodic memory abilities assessed by the Rey Auditory Verbal Learning Test and Rey Complex Figure Test at various time points (20-minute, 30-minute, 24-hours and 6-month). 112 healthy adult Jordanians between the ages of 18 and 45 were included in the study, and the genotypes at the KIBRA (rs17070145) polymorphic site were identified using the PCR-RFLP method. The outcomes did not reveal any statistically significant any assessment of verbal and visual episodic memory tests and the KIBRA polymorphism. The findings also indicated that KIBRA polymorphism had no statistically significant impact on short-term memory or learning capacity, indicating that KIBRA had no effect on a person's ability to pay attention or concentrate. Additionally, in the Jordanian population, the genotype percentages for KIBRA rs17070145 were: 10.7% for TT, 43.8% for TC, and 45.5% for CC, and the percentage of the T allele was 0.326. The current investigation discovered no statistically significant differences between the Jordanian population and either the European or the South Asian populations in terms of the percentages of alleles and genotypes of the KIBRA rs17070145 gene.

500 Non-Verbal Memory Decline is Greater Following Anterior Temporal Lobectomy Than Mesial Temporal Laser Ablation in Non-Dominant Temporal Lobe Epilepsy

INTRODUCTION: Although it has been shown for dominant temporal lobe epilepsy that stereotactic laser amygdalohippocampectomy (SLAH) results in less verbal memory decline than anterior temporal lobectomy (ATL), the relative cognitive effects of these surgeries in non-dominant temporal lobe epilepsy have not been directly studied. METHODS: A retrospective review of SLAH or ATL surgeries at the University of Washington from 2014 to 2020 was conducted. Hemisphere dominance was determined using WADA testing or functional MRI. Patients that received non-dominant SLAH or ATL and pre- and post-operative neuropsychological testing were analyzed. A composite non-verbal visuospatial memory variable was created using Z-score normalization of the Visual Reproduction (VR) and Rey Complex Figure Test (RCFT) tasks. The Rey Auditory Verbal Learning Test (RAVLT) was used for verbal memory analysis. Paired t-test analysis was used to compare cognitive score distributions. Two-way ANOVA was used to assess the effects of seizure freedom (Engel score 1) and surgical intervention factors on cognitive improvement. RESULTS: Pre- and post-operative neuropsychological testing was available for 26 patients (14 SLAH, 12 ATL). Non-verbal visuospatial memory significantly decreased after ATL (mean -0.18 to -0.82, p = 0.025, n = 11) but not after SLAH (mean -0.55 to -0.57, p = 0.96, n = 14). There were no observed changes in verbal memory after ATL (mean -0.41 to -0.07, p = 0.22, n = 11) or SLAH (mean -0.13 to 0.-42, p = 0.26, n = 13). Seizure freedom was a significant factor in explaining non-verbal memory improvement, even when modeled with surgical intervention interaction term (ANOVA, p = 0.04). CONCLUSIONS: Patients undergoing non-dominant ATL experience a greater reduction in visuospatial memory metrics compared to patients undergoing SLAH. Independent of surgery type, seizure freedom is associated with improved non-verbal memory outcome.

Electroconvulsive Therapy Impact on Memory Performance in Patients With Depression

IntroductionThe safety of electroconvulsive therapy has improved greatly over the last decades, making the potentially adverse effects on memory and other neurocognitive functions the main clinical aspect of concern in the present. In Colombia, the general population and healthcare professionals (even some psychiatrists) seem to have mostly negative opinions towards electroconvulsive therapy treatment, but maybe this could be reconsidered if more information is provided; therefore, the aim of the present study was to evaluate the changes in memory and the severity of the symptoms in a group of patients with severe depression before and after electroconvulsive therapy. MethodsTwenty-three patients ranging in age from 23 to 70 years from the electroconvulsive therapy service at the San Juan de Dios Clinic (Manizales, Colombia) were recruited in order to assess the effect of electroconvulsive therapy on memory in patients with severe depression. Depressive symptoms and memory were assessed with the Hamilton Depression Scale (HAMD) and Rey Auditory Verbal Learning Test (RAVLT), respectively. The assessment was administered to participants before the initial treatment of electroconvulsive therapy series (0-1 day) and 2 days after their last treatment. ResultsElectroconvulsive therapy resulted in significant improvement in the rating of depression. There were no significant differences in the five learning trials, delayed recall, learning and forgetting scores from pre-treatment to post-treatment. Significant pre-treatment/post-treatment differences were found in the delayed recognition trial. ConclusionsPre- and post- electroconvulsive therapy cognitive assessment is a feasible and useful procedure. In general, memory performance does not worsen after electroconvulsive therapy in patients with depression. Only delayed recognition is affected a few days following electroconvulsive therapy, particularly in patients with low educational level and bitemporal (BT) electrode placement.

Effect of including a dietary supplement of raisins, a food rich in polyphenols, on cognitive function in healthy older adults; a study protocol for a randomized clinical trial

BackgroundPolyphenols have been shown to be effective against many chronic diseases, including neurodegenerative diseases. Specifically, the consumption of raisins, being a food rich in polyphenols, has been attributed with neuroprotective benefits. Therefore, our main objective is to evaluate the effect of including 50 g of raisins in the diet daily for 6 months, on the improvement of cognitive performance, cardiovascular risk factors and markers of inflammation in a population of older adults without cognitive impairment.MethodsDesign and intervention: This study will be a randomized controlled clinical trial of two parallel groups. Each subject included in the study will be randomly assigned to one of two study groups: control group (no supplement), intervention group (50 g of raisins daily during 6 months).Study population: The participants will be selected by consecutive sampling in the Primary Care consultations of urban health centers in Salamanca and Zamora (Spain), taking into account the selection criteria.Study variables: Two visits will be made, baseline and at 6 months. Cognitive performance will be evaluated (Mini-Mental State Examination test, Rey Auditory Verbal Learning Test, verbal fluency and montreal cognitive assessment (Moca)). It will also be analyzed the level of physical activity, quality of life, activities of daily living, energy and nutritional composition of the diet, body composition, blood pressure, heart rate, markers of inflammation and other laboratory tests of clinical relevance (glycaemia, total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides). In addition, sociodemographic data, personal and family history, medication use and alcohol and tobacco consumption will be collected.DiscussionIn this project, it is intended to contribute to minimize the problems derived from cognitive deterioration in older people.Trial registrationClincalTrials.gov Identifier: NCT04966455 Registration date: July 1, 2021.

Neuropsychological evaluation of phenoconversion risk in REM sleep behaviour disorder: A scoping review.

The objective of this study was to assess the role of cognitive evaluation in the prediction of phenoconversion in polysomnography-confirmed idiopathic or isolated rapid eye movement sleep behaviour disorder, through a scoping review focussing on a longitudinal comprehensive neuropsychological assessment of patients with idiopathic REM sleep behaviour disorder. A literature search (2006-2022) yielded 1034 records, and 20 were selected for analysis. The sample included 899 patients from eight different cohorts and five countries. We extracted data on clinical evolution, mild cognitive impairment diagnosis, neuropsychological tests used, and classification of cognitive domains. Tests, cognitive domains, and mild cognitive impairment definitions were heterogeneous across the studies, precluding a meta-analysis. Ten studies (50%) evaluated the presence of mild cognitive impairment; 14 studies (70%) grouped neuropsychological tests into between three (6 studies, 21.4%) and seven (1 study, 7.1%) cognitive domains. The most frequently used tests were semantic fluency, Stroop colour word test, trail making test A and B, digit span, Rey auditory verbal learning test, and Rey-Osterrieth figure. All except digit span showed a role in predicting phenoconversion. The authors did not consistently assign tests to specific cognitive domains. In conclusion, we discuss methodological differences between the studies and highlight the need for a standardised framework for neuropsychological data acquisition and presentation, based on a multilevel approach covering test selection, domain assignment, and mild cognitive impairment diagnostic criteria.

The use of hippocampal grading as a biomarker for preclinical and prodromal Alzheimer's disease.

Hippocampal changes are associated with increased age and cognitive decline due to mild cognitive impairment (MCI) and Alzheimer's disease (AD). These associations are often observed only in the later stages of decline. This study examined if hippocampal grading, a method measuring local morphological similarity of the hippocampus to cognitively normal controls (NCs) and AD participants, is associated with cognition in NCs, subjective cognitive decline (SCD), early (eMCI), late (lMCI), and AD. A total of 1620 Alzheimer's Disease Neuroimaging Initiative participants were examined (495 NC, 262 eMCI, 545 lMCI, and 318AD) because they had baseline MRIs and Alzheimer's disease Assessment Scale (ADAS-13) and Clinical Dementia Rating-Sum of Boxes (CDR-SB) scores. In a sub-analysis, NCs with episodic memory scores (as measured by Rey Auditory Verbal Learning Test, RAVLT) were divided into those with subjective cognitive decline (SCD+; 103) and those without (SCD-; 390). Linear regressions evaluated the influence of hippocampal grading on cognition in preclinical and prodromal AD. Lower global cognition, as measured by increased ADAS-13, was associated with hippocampal grading: NC (p < .001), eMCI (p < .05), lMCI (p < .05), and AD (p=.01). Lower global cognition as measured increased CDR-SB was associated with hippocampal grading in lMCI (p <.05) and AD (p < .001). Lower RAVLT performance was associated with hippocampal grading in SCD- (p < .05) and SCD+ (p < .05). These findings suggest that hippocampal grading is associated with global cognition in NC, eMCI, lMCI, and AD. Early changes in episodic memory during pre-clinical AD are associated with changes in hippocampal grading. Hippocampal grading may be sensitive to progressive changes early in the disease course.

Methylation of BDNF gene in association with episodic memory in women.

Brain-derived neurotrophic factor (BDNF) gene regulation plays an important role in long-term memory formation, and the DNA methylation (DNAm) level of BDNF promoters has been associated with episodic memory deficits. Our aim was to explore the association between DNAm levels in BDNF promoter IV with verbal learning and memory performance in healthy women. We conducted a cross-sectional study by recruiting 53 individuals. Episodic memory was assessed by using the Rey Auditory Verbal Learning Test (RAVLT). Clinical interviews, RAVLT, and blood sample collection were assessed in all participants. DNAm was measured on DNA from whole peripheral blood using pyrosequencing. According to generalized linear model (GzLM) analyses, cytosine guanine dinucleotide (CpG) site 5 showed significant associations between learning capacity (LC, p < 0.035), that is, every 1% of DNA methylation at CpG site 5 results in a 0.068 reduction in verbal learning performance. To the best of our knowledge, the current study is the first to show that BDNF DNAm plays an important role in episodic memory.

Altered static and dynamic spontaneous neural activity in patients with ischemic pontine stroke.

The purpose of the study was to investigate the abnormality both of static spontaneous brain activity and dynamic temporal variances following a pontine infarction. Forty-six patients with chronic left pontine infarction (LPI), thirty-two patients with chronic right pontine infarction (RPI), and fifty healthy controls (HCs) were recruited for the study. The static amplitude of low-frequency fluctuations (sALFF), static regional homogeneity (sReHo), dynamic ALFF (dALFF), and dynamic ReHo (dReHo) were employed to detect the alterations in brain activity induced by an infarction. The Rey Auditory Verbal Learning Test and Flanker task were used to evaluate the verbal memory and visual attention function, respectively. Receiver operating characteristic curve analysis was used to reveal the potential capacity of these metrics to distinguish the patients from HCs. There were significant variations of these static and dynamic metrics in patients with chronic pontine infarction. The altered regions involved the supratentorial regions, including cortex and subcortical. Moreover, the altered metrics were significantly correlated with verbal memory and visual attention. In addition, these static and dynamic metrics also showed potential in distinguishing stroke patients with behavior deficits from HCs. The pontine infarction-induced cerebral activation changes are observed in both motor and cognitive systems, indicating the functional damage and reorganization across the global cerebral level in these patients with subtentorial infarction, and there is a reciprocal effect between motor and cognitive impairment and repair.

APOE4 Status and Cognitive Function in Middle-aged and Elderly People.

APOE is one of the prominent genes involved in the increased risk of developing Alzheimer's disease, but its effect on cognition in patients who are not yet diagnosed with dementia or mild cognitive impairment is relatively understudied. We aimed to examine the effect of ApoE4 on cognitive performance in unimpaired middle-aged and elderly persons. Our study included 51 cognitively unimpaired participants divided into ApoE4 positive patients and controls by APOE genotyping. The following clinical and demographic characteristics were collected: age, gender, education, social status, BMI, history of medical or psychiatric disorders. Patients with current anxiety or depressive disorders were excluded. Cognitive function was evaluated using MMSE, Rey Auditory-Verbal Learning Test, Rey Complex Figure test, TMT A and B and verbal fluency test. The two groups were matched for age, sex, and education. Categorial data was analyzed using Chi-Square and continuous data using Student-T test (parametric variables) or Mann-Whitney test (non-parametric variables). Statistical significance was considered at p≤.05. There were 11 (21.6%) ApoE4 positive patients and 40 (78.4%) controls. There were no significant differences between the groups regarding socio-demographic and clinical characteristics. The ApoE4 positive group performed slightly worse on cognitive evaluations compared to controls but only the mean scores of the Rey Complex Figure Test - Memory reached statistical significance (p=.019). Cognitive evaluation generally rendered lower scores in the ApoE4 group compared to the control group. However, only visual memory impairment scores were significantly lower in the ApoE4 positive individuals than in controls.

Abstract P505: Midlife Cognitive Function is Associated With Gut Microbial Species and Metabolic Pathways: Coronary Artery Risk Development in Young Adults (CARDIA) Study

Background: The gut microbiota may play a role in cognitive function and decline. Animal models support mechanisms involving short-chain fatty acid production, amino acid metabolism, and purine metabolism. There is need to replicate these findings in population-based human studies. Methods: Data were from 570 participants who attended the Yr. 30 follow-up exam (2015-16, ages 48-60 y, 45%:55% Black:White race, 45%:55% M:F sex), provided a fecal sample, and completed a cognitive battery of 6 assessments: Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSST), Rey-Auditory Verbal Learning Test (RAVLT), Stroop, and Letter and Category Fluency. A global cognition score was derived from the 6 assessments using principal components analysis. Species and metabolic pathways were assigned to whole-metagenomics sequence data using standard reference databases. Multivariable-adjusted linear regression was used to test associations between distinct microbial features and measures of cognition, controlling for false discovery rate (FDR). Results: Sequence data mapped to 106 species and 312 metabolic pathways. In multivariable-adjusted regression analysis, adjusted for socio-demographics, health behaviors, and BMI, 5 species and 5 metabolic pathways were significantly associated with measures of cognitive function, FDR &lt; 0.20 (Figure) . These species/pathways are involved in purine and pyrimidine metabolism and short-chain fatty acid production. Conclusion: Identified pathways play a role in neurodevelopment and in the gut-brain axis of physiologic communications. Our findings suggest long-term relationships between gut microbiota composition and cognitive function.

Cognition in COVID-19 infected patients undergoing invasive ventilation: results from a multicenter retrospective study

A growing number of scientific contributions suggest that COVID-19 infection can lead to impairment of cognition, mainly in executive functions and memory domains, even in the absence of frank neurological pathologies. The primary objective of this retrospective study is to evaluate the frequency and type of inefficiencies in a selection of cognitive tests administered to a sample of subjects who, following infection, required invasive assisted ventilation and were admitted to rehabilitation wards for the treatment of functional impairment. Fifty-seven subjects were enrolled. The recruited patients undergone an assessment of verbal and visuospatial memory and executive functions, upon entry into the rehabilitation department, after discharge from intensive care. The following tests were administered: Rey Auditory Verbal Learning Test (AVLT) (immediate and delayed recall), Rey-Osterrieth Complex Figure Test (ROCFT) (copy and delayed recall), Stroop Color-Word Test, and Trail Making Test (TMT, A and B). Deficient scores, in beyond 25% of subjects, were found in the copy of the ROCFT (32.1% of subjects), and in the delayed recall of ROCFT (27.2%). Between 10 and 20% of patients presented an abnormal result in delayed recall of AVLT (16.07%), and Stroop Test (time, 15.6%, error, 11.5%). Less than 10% of the sample had abnormal performances on TMT (A, 3.5%, and B, 9.4%), and in AVLT immediate recall (8.9%). Correlations of the performances with age, sex, and education were also found. This paper highlights the high incidence of abnormal cognitive performances in this specific subpopulation of patients with COVID-19 infection.

Subclinical memory impairment in unaffected siblings of patients with dementia

Objective: Family history of dementia is a known risk factor for dementia. The cognitive performance of unaffected siblings of dementia patients has been poorly studied. We aimed to determine whether clinically unaffected siblings of dementia patients have significant cognitive impairment compared to individuals who do not have first-degree relatives with dementia. Methods: We compared the cognitive performance of 67 patients with dementia (24 males; mean age 69.5), 90 healthy siblings of those patients (34 males; mean age 61.56) and 92 healthy adults (35 males; mean age 60.96) who have no first-degree relatives with dementia. We assessed learning and memory (Rey Auditory Verbal Learning Test (RAVLT)), short-term/working memory (Digit Span) executive functions (Stroop Test) and general intelligence (Raven Progressive Matrices). Test scores were compared among three groups, with regression-based adjustments for age, sex, and education. Results: As expected, the patients with dementia were impaired in all cognitive domains. In the Sibling Group, RAVLT total learning was significantly lower compared to controls (B = −3.192, p = .005). In a subgroup analysis, compared to controls, RAVLT delayed recall was poorer in the siblings of patients with early-onset (<65 years) dementia. No significant differences were observed in other cognitive domains. Conclusion: Clinically unaffected siblings of dementia patients seem to have a selective subclinical impairment in memory encoding. This impairment seems to be more prominent in siblings of patients with early-onset dementia who also have deficits in delayed recall. Future studies are needed to determine if the observed cognitive impairment deteriorates to dementia.

Efficacy of Souvenaid® Combined with Acetylcholinesterase Inhibitors in the Treatment of Mild Alzheimer's Disease.

Souvenaid® is a medical food that contains nutrients that can help synapse synthesis in Alzheimer's disease (AD). The potential effectiveness of combination therapy of Souvenaid with cholinesterase inhibitors (AChEI) is currently not well-known. To look into the effect of combination therapy with Souvenaid plus AChEI in people with mild AD in the real-world. We carried out a retrospective analysis in mild AD patients attending a memory clinic. Three groups were studied according to the treatment they received: Souvenaid alone (n = 66), AChEI alone (n = 84), and Souvenaid+AChEI (n = 70). Treatment effects were evaluated at baseline, 6 and 12 months. Cognitive functioning was assessed by Mini-Mental State Examination (MMSE), Rey Auditory Verbal Learning Test (RAVLT), Symbol Digit Modalities Test (SDMT), Boston Naming Test (BNT), Trail Making Test (TMT/A-B), Phonemic and Semantic Verbal Fluency Test (PVFT/SVFT); neuropsychiatric symptoms were evaluated by the Neuropsychiatric Inventory (NPI); functional capacity was assessed by the Bayer Activities Daily Living Scale (BAYER-S). A Mixed Model for Repeated Measures analysis was carried out to evaluate changes in outcome scores. After 12 months Souvenaid+AChEI showed significant improvement in MMSE (p < 0.001), RAVLT (p < 0.0001), SVFT (p = 0.002), PVFT (p = 0.007), TMTA (p = 0.039), TMTB (p = 0.001), and NPI (p < 0.0001) compared to AChEI alone. Souvenaid showed cognitive and behavioral benefits in mild AD patients. These effects increased when Souvenaid and AChEI were used in combination. This study can serve as a model for the design of prospective controlled trials that help to support the combined use of Souvenaid and antidementia drugs in AD.

The role of gender in cognitive outcomes from stroke.

Stroke can cause cognitive impairment, which can lead to challenges returning to day-to-day activities. Knowing what factors are associated with cognitive impairment post-stroke can be useful for predicting outcomes and guiding rehabilitation. One such factor is gender: previous studies are inconclusive as to whether gender influences cognitive outcomes post-stroke. Accounting for key variables, we examined whether there are gender differences in cognitive outcomes after stroke. We analyzed data from neuropsychological assessments of 237 individuals tested in the chronic epoch (≥ 3 months) following ischemic stroke. Using ANCOVA and linear mixed modeling, we examined gender as a predictor of cognition as measured by general cognitive ability (g), Full-Scale IQ, and 18 cognitive tests, controlling for age at stroke onset, education, premorbid intelligence, and lesion volume. There were no significant gender differences in overall cognitive outcomes as measured by g (p = .887) or Full-Scale IQ (p = .801). There were some significant gender differences on specific cognitive tests, with women outperforming men on scores from the Rey Auditory Verbal Learning Test (ps < .01) and men outperforming women on the Wechsler Adult Intelligence Scale Arithmetic and Information subtests (ps < .01). Our findings indicate that men and women have similar overall cognitive outcomes after stroke, when demographic and lesion factors are accounted for. Although men and women differed in their performance on some individual cognitive tests, neither gender performed systematically better or worse. However, for learning, working memory, and verbal knowledge/comprehension, gender may be an important predictor of outcome post-stroke.

Cognitive and behavioral abnormalities in individuals with Alzheimer’s disease, mild cognitive impairment, and subjective memory complaints

AbstractIn this study, we investigated the ability of commonly used neuropsychological tests to detect cognitive and functional decline across the Alzheimer’s disease (AD) continuum. Moreover, as preclinical AD is a key area of investigation, we focused on the ability of neuropsychological tests to distinguish the early stages of the disease, such as individuals with Subjective Memory Complaints (SMC). This study included 595 participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) dataset who were cognitively normal (CN), SMC, mild cognitive impairment (MCI; early or late stage), or AD. Our cognitive measures included the Rey Auditory Verbal Learning Test (RAVLT), the Everyday Cognition Questionnaire (ECog), the Functional Abilities Questionnaire (FAQ), the Alzheimer’s Disease Assessment Scale–Cognitive Subscale (ADAS-Cog), the Montreal Cognitive Assessment scale (MoCA), and the Trail Making test (TMT-B). Overall, our results indicated that the ADAS-13, RAVLT (learning), FAQ, ECog, and MoCA were all predictive of the AD progression continuum. However, TMT-B and the RAVLT (immediate and forgetting) were not significant predictors of the AD continuum. Indeed, contrary to our expectations ECog self-report (partner and patient) were the two strongest predictors in the model to detect the progression from CN to AD. Accordingly, we suggest using the ECog (both versions), RAVLT (learning), ADAS-13, and the MoCA to screen all stages of the AD continuum. In conclusion, we infer that these tests could help clinicians effectively detect the early stages of the disease (e.g., SMC) and distinguish the different stages of AD.