Serial Sevens Research Articles

Systolic blood pressure dipping may be associated with mobility impairment and brain volume in community-dwelling older adults: An exploratory study

We investigated whether systolic blood pressure (SBP) dipping is associated with mobility outcomes and brain volume in older adults without dementia. We conducted an exploratory analysis of data from 345 community-dwelling older adults (mean age [SD]: 69.9 [7.1], 60% women) who underwent 24-h BP measurement and mobility assessment. Mobility measures included usual and dual-task (DT) gait velocity, step length, and variability. For DT assessment, participants performed naming animals (NA) and serial sevens (S7) tasks. A subsample of participants (N=32) also underwent magnetic resonance imaging to estimate total grey matter, white matter, and hippocampal brain volumes. We conducted hierarchical regression models to examine the association between SBP dipping and mobility outcomes, after adjusting for age, years of education, sex, Montreal Cognitive Assessment score, body mass index, hypertension, diabetes, other cardiovascular diseases, musculoskeletal conditions, and study cohort. Similar models were conducted to investigate associations between SBP dipping and brain volumes. SBP dipping significantly predicted gait velocity and step length under usual and both DT conditions. The R2 change was the highest for usual gait velocity (Fchange=7.8, p=0.005, R2change=0.019), and lowest for step length during the NA task (Fchange=4.4, p=0.037, R2change=0.01), suggesting a deleterious effect of SBP dipping on gait regardless of task complexity. For brain volumes, SBP dipping significantly predicted right hippocampal volume (Fchange=5.4, p=0.029, R2change=0.12), and total hippocampal volume (Fchange=5.1, p=0.033, R2change=0.1). Our findings suggest that SBP dipping, as a marker of cardiovascular disease in older adults, impacts mobility performance and hippocampal volume. SBP dipping could be targeted in future therapeutic interventions in older adults at risk for mobility and cognitive impairment.

Association Between Sleep Duration and Cognitive Decline

An association between sleep duration and the trajectory of cognitive decline has not been conclusively demonstrated. To investigate the association between sleep duration and cognitive decline by a pooled analysis of 2 nationally representative aging cohorts. A pooled cohort study using data from waves 4 to 8 (2008-2009 to 2016-2017) in the English Longitudinal Study of Ageing and waves 1 to 3 (2011 to 2015) in the China Health and Retirement Longitudinal Study in a population-based setting. Participants were 2 randomly enrolled cohorts comprising 28 756 individuals living in England who were 50 years or older and those living in China who were 45 years or older. Self-reported sleep duration per night according to face-to-face interviews. Global cognitive z scores were calculated according to immediate and delayed recall test, an animal fluency test, the serial sevens test, an intersecting pentagon copying test, and a date orientation test. Data were analyzed from 20 065 participants, including 9254 from the English Longitudinal Study of Ageing (mean [SD] age, 64.6 [9.8] years; 55.9% [5174 of 9254] women; median follow-up duration, 8 [interquartile range, 6-8] years) and 10 811 from the China Health and Retirement Longitudinal Study (mean [SD] age, 57.8 [9.0] years; 50.2% [5425 of 10 811] men; median follow-up duration, 4 [interquartile range, 4-4] years). During 100 000 person-years of follow-up, global cognitive z scores in individuals with 4 hours or less (pooled β = -0.022; 95% CI, -0.035 to -0.009 SD per year; P = .001) and 10 hours or more (pooled β = -0.033; 95% CI, -0.054 to -0.011 SD per year; P = .003) of sleep per night declined faster than in the reference group (7 hours per night) after adjusting for a number of covariates. An inverted U-shaped association between sleep duration and global cognitive decline was also observed. In this pooled cohort study, an inverted U-shaped association between sleep duration and global cognitive decline was found, indicating that cognitive function should be monitored in individuals with insufficient (≤4 hours per night) or excessive (≥10 hours per night) sleep duration. Future studies are needed to examine the mechanisms of the association between sleep duration and cognitive decline.

Novel information processing at work across time is associated with cognitive change in later life: A 14-year longitudinal study.

This study examined whether the degree of novel information processing at work (NPW) attenuates cognitive aging across 14 years for adults 50+ in the United States and how NPW links with job complexity. To answer these questions, we used data (N = 4,252) from the Health and Retirement Study. Detailed information on occupational characteristics from O*Net between 2000 and 2014 was used to assess NPW and matched with participants' occupational codes across time. Multilevel transition models were employed to estimate the relationship between NPW and cognitive functioning across time and to explore the moderating effect of cognitive level. Our results showed that exposure to more NPW across time attenuates cognitive decline as indicated by immediate word recall and serial 7s performance, while adjusting for baseline age, leisure, volunteering activities, cognition at previous wave, and other covariates. This buffering effect of NPW is reduced but sustained when controlling for change in job complexity, indicating that, as expected, NPW and job complexity are linked. We also found that particularly for workers with lower levels of cognitive performance, exposure to NPW across 14 years was linked with less decline in serial 7s performance (controlling for job complexity). This, however, was not the case for immediate word recall performance, which asks for further study. Overall, our findings suggest that mental stimulation through NPW is one mechanism (in the work context) that buffers cognitive decline. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Arabic translation and cross-cultural adaptation of the Sport Concussion Assessment Tool 5 (SCAT5).

The aim was to create a Modern Standard Arabic SCAT5 version for different Arabic dialects. This translation and cross-cultural adaptation was performed in eight stages: initial translations, reconciliation of translations and cultural adaptation, back translation, appraisal of back translations, validation of the translation, review and adjustment by reconciliation committee, pretesting in 12 football players and document finalisation. As an alternative to the problematic Months In Reverse Order Test (MIROT) in Arabic, the Serial 3s test (32 Arabic and 30 English participants), the Days of the Week Backwards test (DWBT), and the ‘Adding Serial 3s’ test were tested (30 English and 30 Arabic participants) for accuracy, difficulty and time of completion. The Arabic SCAT5 was similar and comparable to the original English version (7-point Likert scales =< 2). Testing of the pre-final version of the Arabic SCAT5 took 20.4 (SD 3.4) and 17.7 (SD 3.0) minutes respectively to complete and was found acceptable in terms of clarity, understandability, grammatical correctness and coherence. The Arabic Serial 3s test (subtraction version) was unsuitable due to high completion time, low pass rate and high difficulty perception [time = 47.2 (SD 28.0) s; accuracy = 55.2%; difficulty = 3.2 (SD 1.1)]. The Arabic DWBT was too fast and undemanding for concentration testing [time = 4.6 (SD 1.5) s; accuracy = 90%; difficulty = 1.1 (SD 0.3)]. The Adding Serial 3s tests produced similar completion times [18.4 (SD 6.8) vs. 21.1 (SD 5.3), p = 0.088], accuracy (100%) and self-rated difficulty [English = 2.0 (SD 0.7) vs. Arabic-speaking participants = 2.1 (SD 0.8), p = 0.512] and was therefore adopted to replace the MIROT. This culturally adapted Arabic-SCAT5 questionnaire is the first concussion assessment tool available for Arabic-speaking healthcare providers and athletes. Sport Concussion Assessment Tool 5 (SCAT5). Biol Sport. 2021;38(1):129–144.

Acute Effects of a Polyphenol-Rich Leaf Extract of Mangifera indica L. (Zynamite) on Cognitive Function in Healthy Adults: A Double-Blind, Placebo-Controlled Crossover Study.

Extracts made from the leaves of the mango food plant (Mangifera indica L., Anacardiaceae) have a long history of medicinal usage, most likely due to particularly high levels of the polyphenol mangiferin. In rodent models, oral mangiferin protects cognitive function and brain tissue from a number of challenges and modulates cerebro-electrical activity. Recent evidence has confirmed the latter effect in healthy humans following a mangiferin-rich mango leaf extract using quantitative electroencephalography (EEG). The current study therefore investigated the effects of a single dose of mango leaf extract, standardised to contain >60% mangiferin (Zynamite®), on cognitive function and mood. This study adopted a double-blind, placebo-controlled cross-over design in which 70 healthy young adults (18 to 45 years) received 300 mg mango leaf extract and a matched placebo, on separate occasions, separated by at least 7 days. On each occasion, cognitive/mood assessments were undertaken pre-dose and at 30 min, 3 h and 5 h post-dose using the Computerised Mental Performance Assessment System (COMPASS) assessment battery and the Profile of Mood States (POMS). The results showed that a single dose of 300 mg mango leaf extract significantly improved performance accuracy across the tasks in the battery, with domain-specific effects seen in terms of enhanced performance on an ‘Accuracy of Attention’ factor and an ‘Episodic Memory’ factor. Performance was also improved across all three tasks (Rapid Visual Information Processing, Serial 3s and Serial 7s subtraction tasks) that make up the Cognitive Demand Battery sub-section of the assessment. All of these cognitive benefits were seen across the post-dose assessments (30 min, 3 h, 5 h). There were no interpretable treatment related effects on mood. These results provide the first demonstration of cognition enhancement following consumption of mango leaf extract and add to previous research showing that polyphenols and polyphenol rich extracts can improve brain function.

Sport-related Concussions Have A More Conservative Stepping Pattern During Instrumented Tandem Gait Performance

Tandem gait has emerged as a dynamic and clinically viable test of dynamic motor control following sport-related concussion (SRC). A myriad of tools are available to objectively assess gait kinematics. One piece of equipment, the Tekscan Strideway, uses individual load cells on a series of connected force platform tiles to quantify gait. No data exists that examines the performance of SRC using this device. PURPOSE: The purpose of this study was to evaluate the differences in center of pressure (CoP) performance during single-task (ST) and dual-task (DT) tandem gait within 24-48 hours post-SRC. METHODS: 18 Division I [SRC (age: 19 ± 1.00 yr. Male=7, Female=11)] and 18 nearly matched controls [CON (age: 19.88 ± 1.05 yr. Male=7, Female=11)] completed the vestibular ocular motor screening test (VOMS) and 3 trials of ST and 1 trial of DT (serial 7s) using the Tekscan Strideway (30Hz, Boston, MA). The raw CoP trajectory for the best tandem gait trial of each condition (fastest overall) was exported and further analyzed using a custom MATLAB code. All turns during the tandem gait trials were removed and each straight path walking was composed together. The raw CoP data in the AP and ML directions were smoothed using empirical mode decomposition and then excursion and velocity data were calculated. T-tests compared the time to complete ST and DT while two multivariate ANOVAs compared CoP in the AP and ML directions. RESULTS: SRC took significantly longer to complete the ST trial (p=.006; SRC=14.2±4.4s, CON=10.8±2.1s) but not the DT trial (p=.279). The SRC group had a larger VOMS near-point convergence (NPC) (p=.007; SRC=9.5±5.5cm, CON=5.2±2.9cm) and a higher VOMS change score (p<.001; SRC=19.7±6.4, CON=0±0). A significant omnibus effect was noted in AP direction (p=.015) but not in the ML direction (p=.996) for the tandem gait CoP data. Follow-up comparisons noted that in the AP direction during ST, SRC had slower CoP excursion (p=.003; SRC=1.6±0.2cm, CON=1.9±0.4cm) and lower CoP velocity (p=.004; SRC=54.2±7.7cm/s, CON=66.1±14.2cm/s) but no differences during DT. CONCLUSIONS: These results suggest that during instrumented ST tandem gait, SRC have a more conservative and slower heel-to-toe stepping pattern.

Further Evidence of Benefits to Mood and Working Memory from Lipidated Curcumin in Healthy Older People: A 12-Week, Double-Blind, Placebo-Controlled, Partial Replication Study.

Curcumin (a flavonoid isolated from turmeric) affects several processes involved in neurocognitive aging. We have previously reported that short term (4-weeks) administration of a highly bioavailable curcumin preparation (Longvida©) improved working memory and reduced fatigue and stress reactivity in a healthy older cohort. The present trial (ACTRN12616000484448) was a partial replication study, evaluating similar effects at 4 and 12-weeks Longvida© supplementation. A double-blind, placebo-controlled, parallel-groups trial was conducted. Eighty participants aged 50–80 years (mean = 68.1, SD = 6.34) were randomised to receive Longvida© (400 mg daily containing 80 mg curcumin) or a matching placebo. Assessment took place at baseline then following 4 and 12 weeks treatment. Outcome measures included cognitive performance, mood and biomarkers. Compared with placebo, curcumin was associated with several significant effects. These included better working memory performance at 12-weeks (Serial Threes, Serial Sevens and performance on a virtual Morris Water Maze), and lower fatigue scores on the Profile of Mood States (POMS) at both 4 and 12-weeks, and of tension, anger, confusion and total mood disturbance at 4-weeks only. The curcumin group had significantly elevated blood glucose. These results confirm that Longvida© improves aspects of mood and working memory in a healthy older cohort. The pattern of results is consistent with improvements in hippocampal function and may hold promise for alleviating cognitive decline in some populations.

Effects of Polyphenol-Rich Interventions on Cognition and Brain Health in Healthy Young and Middle-Aged Adults: Systematic Review and Meta-Analysis.

Context: Affecting older and even some younger adults, neurodegenerative disease represents a global public health concern and has been identified as a research priority. To date, most anti-aging interventions have examined older adults, but little is known about the effects of polyphenol interventions on brain-related aging processes in healthy young and middle-aged adults. Objective: This systematic review and meta-analysis aimed to evaluate the acute and chronic effects of (poly)phenol-rich diet supplementation on cognitive function and brain health in young and middle-aged adults. In July 2019, two electronic databases (PubMed and Web of Science) were used to search for relevant trials examining the effect of acute or chronic (poly)phenol-rich supplementation on cognitive function and neuroprotective measures in young and middle-aged adults (<60 years old). A total of 4303 records were screened by two researchers using the PICOS criteria. Fifteen high quality (mean PEDro score = 8.8 ± 0.58) trials with 401 total participants were included in the final analyses. Information on treatment, study design, characteristics of participants, outcomes and used tools were extracted following PRISMA guidelines. When items were shown to be sufficiently comparable, a random-effects meta-analysis was used to pool estimates across studies. Effect size (ES) and its 95% confidence interval (CI) was calculated. The meta-analysis indicated that (poly)phenol supplementation significantly increased brain-derived neurotrophic factor (ES = 3.259, p = 0.033), which was accompanied by higher performance in serial (7s) subtraction (ES = 1.467, p = 0.001) and decreases in simple reaction time (ES = −0.926, p = 0.015) and mental fatigue (ES = −3.521, p = 0.010). Data related to cognitive function were skewed towards an effect from acute compared to chronic polyphenol intervention; data related to BDNF were skewed toward an effect from higher bioavailability phenolic components. Conclusion: This meta-analysis provides promising findings regarding the usefulness of polyphenol-rich intervention as an inexpensive approach for enhancing circulation of pro-cognitive neurotrophic factors. These beneficial effects appear to depend on the supplementation protocols. An early acute and/or chronic application of low- to high-dose phenolic components with high bioavailability rates (≥30%) at a younger age appear to provide more promising effects.

The association between dual-task walking and counting responses and cognitive function and disability after severe head injury: A preliminary study

ABSTRACT Adverse outcomes after severe head injury (SHI) can be difficult to detect in primary care and other settings where there is not specialist expertise for interpretation. Walking and counting dual-task (DT) measures are strongly associated with cognitive impairment and dementia and this preliminary study investigates whether performance on DT walking and counting tasks are associated with cognitive function and disability in 125 participants who sustained a SHI on average 26 years before. Single Task (ST) walking (speed over 6 metres) and ST counting (Serial 3s) and DT performance of concurrent walking and Serial 3s were compared with neuropsychological, wellbeing and disability tests for strength of association. The strongest correlations were between ST Correct Cognitive Responses (CCRs) and MMSE (rho = 0.435), DT CCRs and Short-term Memory Binding Tests (STMBT) binding accuracy (rho = 0,409) and DT CCRs and STROOP (rho = 0.420), but associations were less strong with disability. Developing this test, as a cost-efficient screening tool for triage to onward referral for neuropsychological assessment, holds promise, but requires further research.

The Two Minute Walk Test Overground and on a Self-Paced Treadmill Detects Dual Task Deficits in Individuals With Parkinson's Disease.

The aim of this project was to 1) evaluate the potential of the Two Minute Walk Test (2MWT) to detect declines in gait velocity under dual task conditions, and 2) compare gait velocity overground and on a self-paced treadmill in Parkinson's disease (PD). Twenty-three individuals with PD completed the 2MWT under single and dual task (serial 7s) conditions overground and on a self-paced treadmill. There was a significant decrease in gait velocity from single to dual task conditions overground (1.32±.22 m/sec to 1.10±.25 m/sec, p <.001) and on the self-paced treadmill (1.24±.21 m/sec to 1.05±.25 m/sec, p <.001). Overground and treadmill velocities were not statistically different from each other; however, differences approached or exceeded the minimal clinical important difference. The 2MWT coupled with a cognitive task provides an effective model of identifying dual task declines in individuals with PD. Further studies comparing overground and self-paced treadmill velocity is warranted in PD.

Neuro-autonomic changes induced by remote ischemic preconditioning (RIPC) in healthy young adults: Implications for stress

The mechanisms underlying the protective effects of remote ischemic preconditioning (RIPC) are not presently clear. Recent studies in experimental models suggest the involvement of the autonomic nervous system (ANS) in cardioprotection. The aim of this study was to investigate the changes in ANS in healthy young volunteers divided into RIPC (n = 22) or SHAM (n = 18) groups. RIPC was induced by 1 cycle of 4 min inflation/5 min deflation followed by 2 cycles of 5 min inflation/5 min deflation of a cuff placed on the upper left limb. The study included analysis of heart rate (HR), blood pressure (BP), heart rate variability (HRV), measurements of microcirculation and porphyrin fluorescence in the limb before and after the RIPC. RIPC caused reactive hyperemia in the limb and reduced blood porphyrin level. A mental load (serial sevens test) and mild motor stress (hyperventilation) were performed on all subjects before and after RIPC or corresponding rest in the SHAM group. Reduction of HR occurred during the experiments in both RIPC and SHAM groups reflecting RIPC-independent adaptation of the subjects to the experimental procedure. However, in contrast to the SHAM group, RIPC altered several of the spectral indices of HRV during the serial sevens test and hyperventilation. This was expressed predominantly as an increase in power of the very low-frequency band of the spectrum, increased values of detrended fluctuation analysis and weakening of correlation between the HRV parameters and HR. In conclusion, RIPC induces changes in the activity of ANS that are linked to stress resistance.

Multimorbidity and Cognitive Decline Over 14 Years in Older Americans.

Multimorbidity is associated with greater disability and accelerated declines in physical functioning over time in older adults. However, less is known about its effect on cognitive decline. Participants without dementia from the Health and Retirement Study were interviewed about physician-diagnosed conditions, from which their multimorbidity-weighted index (MWI) that weights diseases to physical functioning was computed. We used linear mixed-effects models to examine the predictor MWI with the modified Telephone Interview for Cognitive Status (TICSm, global cognition), 10-word immediate recall and delayed recall, and serial 7s outcomes biennially after adjusting for baseline cognition and covariates. Fourteen thousand two hundred sixty-five participants, 60% female, contributed 73,700 observations. Participants had a mean ± SD age 67 ± 9.3 years and MWI 4.4 ± 3.9 at baseline. Each point increase in MWI was associated with declines in global cognition (0.04, 95% CI: 0.03-0.04 TICSm), immediate recall (0.01, 95% CI: 0.01-0.02 words), delayed recall (0.01, 95% CI: 0.01-0.02 words), and working memory (0.01, 95% CI: 0.01-0.02 serial 7s; all p < .001). Multimorbidity was associated with faster declines in global cognition (0.003 points/year faster, 95% CI: 0.002-0.004), immediate recall (0.001 words/year faster, 95% CI: 0.001-0.002), and working memory (0.006 incorrect serial 7s/year faster, 95% CI: 0.004-0.009; all p < .001), but not delayed recall compared with premorbid slopes. Multimorbidity using a validated index weighted to physical functioning was associated with acute decline in cognition and accelerated and persistent cognitive decline over 14 years. This study supports an ongoing geriatric syndrome of coexisting physical and cognitive impairment in adults with multimorbidity. Clinicians should monitor and address both domains in older multimorbid adults.

A Highly Bioavailable Curcumin Extract Improves Neurocognitive Function and Mood in Healthy Older People: A 12-Week Randomised, Double-Blind, Placebo-Controlled Trial (OR32-05-19)

ObjectivesCurcumin (a flavonoid isolated from the spice turmeric) affects several processes involved in neurocognitive aging. We have previously reported that 4 weeks administration of a highly bioavailable curcumin extract (Longvida™) improved working memory and reduced fatigue and stress reactivity in older Australians. This follow-up study (ACTRN12616000484448) was aimed at determining if similar effects were evident following 12 weeks administration of the same extract. MethodsA double-blind, placebo-controlled, parallel-groups trial was conducted. Eighty participants aged 50–80 years (mean = 68.1, SD 6.34) were randomised to receive administration of Longvida™ (400 mg daily containing 80 mg curcumin) or a matching placebo. Assessment took place at baseline then at 4 and 12 weeks. Outcomes included measures of cognitive performance focusing on memory processes relevant to hippocampal function. Participants also underwent neuroimaging and measures of mood, cardiovascular function and other blood biomarkers were collected. ResultsCompared with placebo, there were a number of improvements in the curcumin group. The curcumin group had significantly better working memory performance at 12 weeks, as measured by Serial Threes, Serial Sevens and performance on a virtual Morris Water Maze. Curcumin was also associated with better performance on a pattern separation task. Curcumin was also associated with significantly lower fatigue scores on the Profile of Mood States (POMS) at both 4 and 12 weeks, and of tension, anger, confusion and total mood disturbance at 4 weeks only. There were no group differences in biomarker levels. ConclusionsThese results confirm that Longvida™ improves aspects of mood and working memory in a healthy older cohort. The pattern of results is consistent with improvements in hippocampal function and may hold promise for alleviating cognitive decline in some populations. Funding SourcesThis study was funded by a grant from Verdure Sciences.KC was supported by an Australian Government Research Training Program Scholarship Supporting Tables, Images and/or Graphs▪

Exploring the Roles of Central and Peripheral Nervous System Function in Gait Stability: Preliminary Insights from Cancer Survivors

BackgroundImpairments in central and/or peripheral nervous systems are known to be associated with altered gait; however, the interplay between cognitive function, peripheral sensation, and orbital gait stability remains largely unclear. Elucidating these relationships is expected to provide a clearer understanding of potential fall risk factors across various populations and targets for novel interventions. Many patients diagnosed with cancer are treated with chemotherapy agents known to be neurotoxic to the central and/or peripheral nervous systems that can contribute to movement deficiencies, making this population a novel model to investigate these relationships. Research QuestionThe purpose of this exploratory study was to investigate how central and peripheral nervous system impairments associate with orbital stability during single- and dual-task gait. MethodsTwenty cancer survivors were enrolled and separated into three groups: no prior chemotherapy exposure (CON, n = 6), and prior treatment with chemotherapy and having no/mild chemotherapy-induced peripheral neuropathy (CIPN) symptoms (-CIPN, n = 8) or moderate/severe CIPN symptoms (+CIPN, n = 6). Testing included single- and dual-task (i.e., serial sevens) treadmill walking as well as a computerized test of executive function. Maximum Floquet multipliers were calculated to assess orbital stability during gait. ResultsWorse executive function was associated with decreased orbital stability during the dual-task condition in the +CIPN group (Spearman’s ρ = 0.94, P = 0.017). Additionally, decreased orbital stability during dual-task gait was observed for the -CIPN group compared to the CON group (ES = 1.96, P = 0.019). SignificanceExecutive dysfunction was associated with decreased gait stability during challenging dual-task gait in survivors with sensory symptoms of CIPN. The association between combined central and peripheral nervous system impairments and decreased gait stability in cancer survivors provides a novel demonstration of potential compensatory strategies that accompany deficiencies in these functions. Future work is needed to confirm these relationships and whether they hold in other populations.

Cognitive decline reduces household spending among older people.

The purpose of the present study was to investigate the effect of cognitive decline on household spending. The panel data covered the years 2007-2009 and were taken from the Japanese Study of Aging and Retirement, with data extracted for 253 participants aged 65 years and over. Sociodemographic characteristics, functional status, depressive symptoms, and monthly household spending excluding spending for shelter (e.g. mortgage) were used in the analysis. Cognitive function was evaluated by delayed recall and serial 7s and represented by the sum of both scores. Changes in spending and cognitive function scores were calculated by subtracting 2007 scores from 2009 scores. Participants were divided into two groups: cognitive decline and no cognitive decline. The effect of cognitive decline on changes in household spending was estimated. Although the cognitive decline group had more severe depressive symptoms than the no cognitive decline group in 2009, cognitive decline was the only factor related to change in household spending. The results imply that cognitive decline may cause a decline in household spending in older people. Focusing on changes in household spending behaviour might help detect cognitive impairment in older people.

Attentional and working memory performance following alcohol and energy drink: A randomised, double-blind, placebo-controlled, factorial design laboratory study.

Alcohol mixed with energy drinks (AMED) studies have typically not shown antagonism of acute alcohol effects by energy drink (ED), particularly over relatively short time frames. This study investigated the effects of alcohol, ED, and AMED on attentional and working memory processes over a 3 h period. Twenty-four young adults took part in a randomised, double-blind, placebo-controlled, factorial, 4-arm study. They were administered 0.6g/kg alcohol and 250 ml ED (containing 80 mg caffeine), and matching placebos alone and in combination. A battery of attentional and working memory measures was completed at baseline then 45, 90 and 180 min post-treatment. Alcohol produced a characteristic shift in speed/accuracy trade-off, having little effect on reaction times while increasing errors on all attentional measures (4-choice Reaction Time, Number Pairs and Visual Search), as well as a composite Attentional error score and one working memory task (Serial Sevens). ED alone improved two working memory measures (Memory Scanning accuracy and Digit–Symbol reaction times) and improved speed of responding on a composite Working Memory score. There was no consistent pattern of AMED vs. alcohol effects; AMED produced more errors than alcohol alone on one attentional measure (Visual Search errors) at 45 min only whereas AMED resulted in fewer errors on the Serial Sevens task at 90 min and better Digit-Symbol accuracy and reaction time at 45 min. Alcohol consumption increases error rate across several attentional and working memory processes. Mutual antagonism between alcohol and ED showed no consistent pattern and likely reflects a complex interaction between caffeine and alcohol levels, phase of the blood alcohol limb, task domain and cognitive load.

Association between circulating inflammatory markers and marksmanship following intense military training

IntroductionIntense military operations during deployment or training are associated with elevations in inflammatory cytokine markers. However, the influence of an inflammatory response on military-specific skills is unclear. This study examined...

Which cognitive dual-task walking causes most interference on the Timed Up and Go test in Parkinson's disease: a controlled study.

There is evidence that cognitive load has a negative effect on the gait of patients with Parkinson's disease (PD). However, it is not clear which type of cognitive activities are more likely to affect dual-task abilities in this patient group. To compare the cognitive dual-task abilities in patients with PD and control subjects and to analyze the effect of different cognitive activities on the walking ability of patients with PD. The Hoehn and Yahr scale, the Freezing of Gait Questionnaire (FOGQ), Montreal Cognitive Assessment (MoCA), and the Functional Reach Test were used to include and exclude the patients. The Timed Up and Go (TUG) test was applied under single and dual-task conditions. The completion time of TUG was found to be increased in the PD group compared with the healthy controls under single- and dual-task conditions (p < 0.05). The completion time of TUG was significantly increased in dual-task conditions with complex attention activity (serial subtractions test) compared with other dual-task conditions in patients with PD (p < 0.001). The gait performance of both healthy subjects and patients with PD was impaired with cognitive activity during walking, and patients with PD showed more impairment under different cognitive dual tasks. Among the other cognitive tasks, the 'serial sevens' test, a measure of complex attention, significantly increased the completion time of TUG. While assessing the dual-task ability of patients with early-stage PD, tasks that increase the demand for complex attention seem to be more sensitive to showing impaired dual-task ability.

The Cone Evasion Walk test: Reliability and validity in acute stroke.

To estimate the reliability and validity of the Cone Evasion Walk test (CEW), a new test assessing the ability to evade obstacles, in people with acute stroke. To estimate the reliability of the CEW, video recordings of 20 people with acute stroke performing the test were assessed by 10 physiotherapists on two occasions, resulting in a total of 400 ratings. Patients performed the CEW (n=221), functional ambulation classification (FAC; n=204), Timed Up and Go (TUG; n=173), TUG cognitive (TUG-cog; n=139), Serial 7s attention task from the Montreal Cognitive Assessment (MoCA-S7; n=127), and the Star Cancellation Test (SCT; n=151). These tests and side of lesion (n=143) were used to examine construct validity. The predictive validity was evaluated in relation to falls during the following 6months (n=203). The intraclass correlation coefficients for intrarater and interrater reliability were 0.88-0.98. For validity, there were significant correlations between the CEW and FAC (rs =-0.67), TUG (rs =0.45), MoCA-S7 (rs =-0.36), and SCT total score (rs =-0.36). There was a significant correlation between the number of cones touched on the left side and the proportion of cancelled stars on the left (rs =-0.23) and right (rs =0.23) side in the SCT. Among right hemisphere stroke participants (n=79), significantly more persons hit cones on the left side (n=25) than the right side (n=8), whereas among those with a left hemisphere stroke (n=64) significantly more persons hit cones on the right side (n=11) than the left (n=3). Cox regression showed that participants who touched four to eight cones had an increased risk of falls over time (hazard ratio 2.11, 95% CI [1.07, 4.17]) compared with those who touched none. The new CEW test was reliable and valid in assessing the ability to evade obstacles while walking and to predict falls in patients with acute stroke.

Cognitive Assessment of Surgeons During Surgical Procedures: Influence of Time and Intraoperative Complications.

Surgeon's performance may be influenced by several factors that may affect skills and judgement, which ultimately represents surgeon´s cognition. Cognition refers to all forms of knowing and awareness, such as perceiving, conceiving, remembering, reasoning, judging, imagining, and problem solving. This report aims to evaluate the effect of operative time and operative complications on surgeon´s cognition. Forty-six surgeons (mean age 31years, 78% males) assigned to an operation expected to last for at least 2h, volunteered for the study. All participants underwent 3 cognitive tests at the beginning of the operation and hourly, until the end of the procedure: (a) concentration (serial sevens, counting down from 100 by sevens); (b) visual (fast counting, counting the number of circles with the same color among a series of circles); and (c) motor (trail making, connecting a set of numbered dots). Intraoperative complications were recorded. The visual test had a stable behavior along time. Concentration and motor tests tend to be performed faster. Intraoperative complications occurred in 5 (11%) cases (3 hemorrhage and 2 organ injuries). Performance time was stable for concentration and motor tests but visual test tends to be performed faster in cases with an intraoperative complication. Our results showed that (1) time does not jeopardize surgeons' cognition, but rather surgeons learned to perform the tests faster, and (2) complications do not decrease surgeons' cognition.