scholarly journals Trail Making Test errors in normal aging, mild cognitive impairment, and dementia

Author(s):  
L ASHENDORF ◽  
A JEFFERSON ◽  
M OCONNOR ◽  
C CHAISSON ◽  
R GREEN ◽  
...  
Author(s):  
Joanna Ciafone ◽  
Alan Thomas ◽  
Rory Durcan ◽  
Paul C Donaghy ◽  
Calum A Hamilton ◽  
...  

Abstract Objective: The present study aimed to clarify the neuropsychological profile of the emergent diagnostic category of Mild Cognitive Impairment with Lewy bodies (MCI-LB) and determine whether domain-specific impairments such as in memory were related to deficits in domain-general cognitive processes (executive function or processing speed). Method: Patients (n = 83) and healthy age- and sex-matched controls (n = 34) underwent clinical and imaging assessments. Probable MCI-LB (n = 44) and MCI-Alzheimer’s disease (AD) (n = 39) were diagnosed following National Institute on Aging-Alzheimer’s Association (NIA-AA) and dementia with Lewy bodies (DLB) consortium criteria. Neuropsychological measures included cognitive and psychomotor speed, executive function, working memory, and verbal and visuospatial recall. Results: MCI-LB scored significantly lower than MCI-AD on processing speed [Trail Making Test B: p = .03, g = .45; Digit Symbol Substitution Test (DSST): p = .04, g = .47; DSST Error Check: p < .001, g = .68] and executive function [Trail Making Test Ratio (A/B): p = .04, g = .52] tasks. MCI-AD performed worse than MCI-LB on memory tasks, specifically visuospatial (Modified Taylor Complex Figure: p = .01, g = .46) and verbal (Rey Auditory Verbal Learning Test: p = .04, g = .42) delayed recall measures. Stepwise discriminant analysis correctly classified the subtype in 65.1% of MCI patients (72.7% specificity, 56.4% sensitivity). Processing speed accounted for more group-associated variance in visuospatial and verbal memory in both MCI subtypes than executive function, while no significant relationships between measures were observed in controls (all ps > .05) Conclusions: MCI-LB was characterized by executive dysfunction and slowed processing speed but did not show the visuospatial dysfunction expected, while MCI-AD displayed an amnestic profile. However, there was considerable neuropsychological profile overlap and processing speed mediated performance in both MCI subtypes.


2019 ◽  
Vol 26 (2) ◽  
pp. 210-225 ◽  
Author(s):  
Joanna Ciafone ◽  
Bethany Little ◽  
Alan J. Thomas ◽  
Peter Gallagher

AbstractObjectives:Dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD) have substantial clinical and biological overlap, with cognitive deficits typically observed in the executive and visuospatial domains. However, the neuropsychological profiles of mild cognitive impairment (MCI) associated with these disorders are not well understood.Methods:This systematic review examined existing literature on cognition in MCI due to LB disease (MCI-LB) and PD (PD-MCI) using an electronic search of seven databases (Medline, Embase, Psychinfo, PubMed, ProQuest, Scopus, and ScienceDirect). MCI-LB results were reviewed narratively given the small number of resulting papers (n = 7). Outcome variables from PD-MCI studies (n = 13) were extracted for meta-analysis of standardised mean differences (SMD).Results:In MCI-LB, executive dysfunction and slowed processing speed were the most prominent impairments, while visuospatial and working memory (WM) functions were also poor. MCI-LB scored significantly lower on verbal memory tests relative to controls, but significantly higher than patients with MCI due to Alzheimer’s disease. Quantitative analysis of studies in PD-MCI showed a similar profile of impairment, with the largest deficits in visuospatial function (Benton Judgement of Line Orientation, SMD g = −2.09), executive function (Trail Making Test B, SMD g = −1.65), verbal ability (Naming Tests, SMD g = −0.140), and WM (Trail Making Test A, SMD g = −1.20). In both MCI-LB and PD-MCI, verbal and visuospatial memory retrieval was impaired, while encoding and storage appeared relatively intact.Conclusions:The findings of this systematic review indicate similar neuropsychological profiles in the MCI stages of DLB and PDD. Executive impairment may at least partially explain poor performance in other domains.


Author(s):  
Nathalie Sanchia ◽  
Magdalena Surjaningsih Halim

 COGNITIVE STIMULATION THERAPY FOR ELDERLY WITH MILD COGNITIVE IMPAIRMENT: AN EXPERIMENTAL STUDY IN NURSING HOMEABSTRACTIntroduction: Mild cognitive impairment (MCI) is a transitional stage between the elderly’s normal (expected) cognitive decline and the more serious decline caused by dementia that needs interventions. One of the non-pharmacological interventions that can be done is cognitive stimulation therapy (CST). Research has shown that CST can stabilize and/ improve cognitive function in the elderly with MCI.Aims: To find out the differences in cognitive functions in the elderly with MCI and given CST intervention and elderly with MCI not given CST intervention.Methods: This was an experimental study that included elderly aged 60 years old divided into experimental and control group, each consists of four subjects. The experimental group was given CST twice a week with a total of fifteen meetings, but not on the control group. All subjects were subjected to cognitive examinations using neuropsychological instruments before, after, and one month after CST was completed. The statistical analysis performed in this study was Mann-Whitney U Test.Results: There was a significant difference in cognitive function in the attention domain with the trail making test sub-test and the memory domain with the digit pan sub-test after the CST is finished. One month after CST is completed, there were significant differences in cognitive function, in the memory domain.Discussion: The elderly group with MCI given CST has a different cognitive function than elderly group who are not given CST.Keywords: Cognitive function, elderly, mild cognitive impairment, nursing houseABSTRAKPendahuluan: Gangguan kognitif ringan atau mild cognitive impairment (MCI) merupakan proses transisi antara penurunan kognitif normal dan demensia yang perlu diintervensi. Salah satu intervensi non-farmakologis yang dapat dilakukan adalah cognitive stimulation therapy (CST). Banyak penelitian menunjukkan bahwa CST dapat menstabilkan dan/meningkatkan fungsi kognitif pada lansia dengan MCI.Tujuan: Untuk mengetahui pengaruh intervensi CST terhadap fungsi kognitif lansia dengan MCI.Metode: Studi eksperimental pada subjek lansia usia 60 tahun yang dibagi menjadi kelompok eksperimen dan kontrol yang masing-masing terdiri dari 4 subjek. Kelompok eksperimen dilakukan CST dua kali seminggu sebanyak lima belas kali pertemuan, tidak pada kelompok kontrol. Seluruh subjek dilakukan pemeriksaan kognitif dengan menggunakan instrumen neuropsikologi sebelum, sesudah, dan satu bulan setelah CST selesai. Analisis statistik menggunakan Mann- Whitney U test.Hasil: Terdapat perbedaan fungsi kognitif yang signifikan pada domain atensi dengan subtes Trail Making Test dan domain memori dengan subtes digit span setelah CST selesai. Satu bulan setelah CST selesai, terdapat perbedaan fungsi kognitif yang signifikan pada domain memori.Diskusi: Kelompok lansia dengan MCI yang diberikan CST memiliki fungsi kognitif yang berbeda dengan kelompok lansia yang tidak diberikan CST.Kata kunci: Fungsi kognitif, gangguan kognitif ringan, lansia, panti wreda  


2021 ◽  
pp. 1-19
Author(s):  
Joanna Perła-Kaján ◽  
Olga Włoczkowska ◽  
Anetta Zioła-Frankowska ◽  
Marcin Frankowski ◽  
A. David Smith ◽  
...  

Background: Identification of modifiable risk factors that affect cognitive decline is important for the development of preventive and treatment strategies. Status of paraoxonase 1 (PON1), a high-density lipoprotein-associated enzyme, may play a role in the development of neurological diseases, including Alzheimer’s disease. Objective: We tested a hypothesis that PON1 status predicts cognition in individuals with mild cognitive impairment (MCI). Methods: Individuals with MCI (n = 196, 76.8-years-old, 60% women) participating in a randomized, double-blind placebo-controlled trial (VITACOG) were assigned to receive a daily dose of folic acid (0.8 mg), vitamin B12 (0.5 mg) and B6 (20 mg) (n = 95) or placebo (n = 101) for 2 years. Cognition was analyzed by neuropsychological tests. Brain atrophy was quantified in a subset of participants (n = 168) by MRI. PON1 status, including PON1 Q192R genotype, was determined by quantifying enzymatic activity of PON1 using paraoxon and phenyl acetate as substrates. Results: In the placebo group, baseline phenylacetate hydrolase (PhAcase) activity of PON1 (but not paraoxonase activity or PON1 Q192R genotype) was significantly associated with global cognition (Mini-Mental State Examination, MMSE; Telephone Inventory for Cognitive Status-modified, TICS-m), verbal episodic memory (Hopkins Verbal Learning Test-revised: Total Recall, HVLT-TR; Delayed Recall, HVLT-DR), and attention/processing speed (Trail Making A and Symbol Digits Modalities Test, SDMT) at the end of study. In addition to PhAcase, baseline iron and triglycerides predicted MMSE, baseline fatty acids predicted SDMT, baseline anti-N-Hcy-protein autoantibodies predicted TICS-m, SDMT, Trail Making A, while BDNF V66M genotype predicted HVLT-TR and HVLT-DR scores at the end of study. B-vitamins abrogated associations of PON1 and other variables with cognition. Conclusion: PON1 is a new factor associated with impaired cognition that can be ameliorated by B-vitamins in individuals with MCI.


2011 ◽  
Vol 5 (2) ◽  
pp. 126-136 ◽  
Author(s):  
Mehul A. Trivedi ◽  
Travis R. Stoub ◽  
Christopher M. Murphy ◽  
Sarah George ◽  
Leyla deToledo-Morrell ◽  
...  

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