Lack of cognitive recovery following withdrawal from long-term benzodiazepine use

1994 ◽  
Vol 24 (1) ◽  
pp. 203-213 ◽  
Author(s):  
P. R. Tata ◽  
J. Rollings ◽  
M. Collins ◽  
A. Pickering ◽  
R. R. Jacobson
Keyword(s):  
Cognitive Function ◽  
Cognitive Deficits ◽  
Verbal Learning ◽  
Immediate Recovery ◽  
Benzodiazepine Use ◽  
Significant Impairment ◽  
Equivalent Control ◽  
Normal Controls

SynopsisTwenty-one patients with significant long-term therapeutic benzodiazepine (BZ) use, who remained abstinent at 6 months follow-up after successfully completing a standardized inpatient BZ withdrawal regime, and 21 normal controls matched for age and IQ but not for anxiety, were repeatedly tested on a simple battery of routine psychometric tests of cognitive function, pre- and post-withdrawal and at 6 months follow-up. The results demonstrated significant impairment in patients in verbal learning and memory, psychomotor, visuo-motor and visuo-conceptual abilities, compared with controls, at all three time points. Despite practice effects, no evidence of immediate recovery of cognitive function following BZ withdrawal was found. Modest recovery of certain deficits emerged at 6 months follow-up in the BZ group, but this remained significantly below the equivalent control performance. The implications of persisting cognitive deficits after withdrawal from long-term BZ use are discussed.

scholarly journals Long-term dietary flavonoid intake and change in cognitive function in the Framingham Offspring cohort

2020 ◽  
Vol 23 (9) ◽  
pp. 1576-1588 ◽  
Author(s):  
Esra Shishtar ◽  
Gail T Rogers ◽  
Jeffrey B Blumberg ◽  
Rhoda Au ◽  
Paul F Jacques
Keyword(s):  
Cohort Study ◽  
Cognitive Function ◽  
Visual Memory ◽  
Verbal Learning ◽  
Cognitive Domain ◽  
Offspring Cohort ◽  
Global Function ◽  
Flavonoid Intake

AbstractObjective:To examine the association between long-term intake of total and the six classes of dietary flavonoids and decline in cognitive function over a follow-up period of up to 15 years.Design:In this longitudinal study, we evaluated change in eight cognitive domain scores (verbal and visual memory, verbal learning, attention and concentration, abstract reasoning, language, visuoperceptual organisation and the global function) based on three neuropsychological exams and characterised the annualised change between consecutive exams. Long-term intakes of total and six flavonoid classes were assessed up to four times by a validated FFQ. Repeated-measures regression models were used to examine the longitudinal association between total and six flavonoid classes and annualised change in the eight cognitive domains.Setting:The Framingham Heart Study (FHS), a prospective cohort study.Participants:One thousand seven hundred and seventy-nine subjects who were free of dementia, aged ≥45 years and had attended at least two of the last three FHS Offspring cohort study exams.Results:Over a median follow-up of 11·8 years with 1779 participants, nominally significant trends towards a slower decline in cognitive function were observed among those with higher flavanol and flavan-3-ol intakes for global function, verbal and visual memory; higher total flavonoids and flavonoid polymers for visual memory; and higher flavanols for verbal learning.Conclusions:In spite of modest nominal trends, overall, our findings do not support a clear association between higher long-term flavonoid intake and slowing age-related cognitive decline.

scholarly journals Association between plasma homocysteine levels and cognitive deficits in Han Chinese patients with schizophrenia across age groups

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sumiao Zhou ◽  
Yuanyuan Huang ◽  
Yangdong Feng ◽  
Hehua Li ◽  
Kai Wu ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Function ◽  
Learning And Memory ◽  
Cognitive Deficits ◽  
Visual Learning ◽  
Verbal Learning ◽  
Age Groups ◽  
Speed Of Processing ◽  
Function Score ◽  
Cognitive Function Score

AbstractIt was still unclear how homocysteine (Hcy) levels and cognitive deficits change in patients with schizophrenia of various ages. The present article attempts to assess the relationship between Hcy levels and cognitive deficits in patients with schizophrenia across age groups, especially in young people. Totals of 103 patients and 122 healthy controls were included. All participants were stratified into four groups according to their age: 18–29 years, 30–39 years, 40–49 years, and 50–59 years. Clinical data, plasma Hcy levels, and cognitive function score were collected. Cognitive function was evaluated using the MATRICS Consensus Cognitive Battery of tests assessing speed of processing, verbal learning and memory, visual learning and memory, working memory, and attention/vigilance. Compared with the healthy group, Hcy levels increased significantly, and all the measured cognitive function score were significantly lower in all age groups of patients with schizophrenia (p < 0.001). Hcy levels were negatively associated with speed of processing (SoP), working memory (WM), and visual learning and memory (Vis Lrng) score in 18–29 years. Further multiple regression analysis showed that SoP were independently associated with Hcy levels in patients with schizophrenia aged 18–29 years (B = 0.74, t = 3.12, p = 0.008). Based on our results, patients with schizophrenia performed worse on cognitive assessments and Hcy levels were more closely related to cognition in young patients.

Abstract P423: Lactation Duration is Associated With Favorable Cognitive Function in Women During Midlife: The 30-year Cardia Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Erica P Gunderson ◽  
Cora E Lewis ◽  
Jennifer Lui ◽  
Kristine Yaffe ◽  
Stephen Sidney
Keyword(s):  
Cognitive Function ◽  
White Women ◽  
Verbal Learning ◽  
Digit Symbol Substitution Test ◽  
Linear Regression Models ◽  
The Metabolic Syndrome ◽  
Category Fluency ◽  
Lactation Duration ◽  
Fluency Test

Introduction: Lactation has been associated with lower incidence of the metabolic syndrome, type 2 diabetes, hypertension, and early atherosclerosis in women across the childbearing years. The lower risk of cardiometabolic diseases related to higher lifetime lactation may also extend to levels of cognitive function during midlife. Hypothesis: We tested the hypothesis that lactation duration is associated with better cognitive function in women during midlife independent of antecedent risk factors, as well as obesity, diabetes, and hypertension. Methods: We included 904 women aged 18-30 years at baseline (1985-86) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study without no diabetes before ≥1 birth(s) after baseline, reported lactation duration for each post-baseline birth, and had 6 measures of cognitive function assessed at Year 30 (2015-16) including the Rey Auditory Verbal Learning Test (RAVLT), Digit Symbol Substitution Test (DSST), Stroop Test, Montreal Cognitive Assessment (MoCA), Letter Fluency Test, and Category Fluency Test. Linear regression models estimated mean (95%CI) cognition scores by lactation duration (none, >0 to 6 mos, > 6 to <12 mos, ≥12 mos) adjusted for race, age, BMI, blood pressure, parity, and follow up covariates (Table 1). Results: Among parous women (46% black, 54% white) at 30-year follow up, average age was 54 yrs and 47% had obesity, 61% delivered ≥2 births since baseline, 29% used anti-hypertensive medications and 16% developed overt diabetes. Black women were less likely to report >6 mos of total lactation for all births than white women (23% vs. 58%). Unadjusted and fully adjusted mean scores for 3 cognitive function measures had graded direct associations with increasing lactation duration; specifically, the RAVLT, MoCA and Category Fluency Test scores (all p-trend < 0.01). Conclusions: In this prospective study, longer lactation duration was associated with more favorable cognition scores among women during midlife.

scholarly journals Subtle Cognitive Impairments in Patients with Long-Term Cure of Cushing’s Disease

2010 ◽  
Vol 95 (6) ◽  
pp. 2699-2714 ◽  
Author(s):  
Jitske Tiemensma ◽  
Nieke E. Kokshoorn ◽  
Nienke R. Biermasz ◽  
Bart-Jan S. A. Keijser ◽  
Moniek J. E. Wassenaar ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Functioning ◽  
Cushing’S Disease ◽  
Cognitive Impairments ◽  
Verbal Learning ◽  
Cushing's Disease ◽  
High Dose ◽  
Gender And Education ◽  
Irreversible Effects

Abstract Context and Objective: Active Cushing’s disease is associated with cognitive impairments. We hypothesized that previous hypercortisolism in patients with Cushing’s disease results in irreversible impairments in cognitive functioning. Therefore, our aim was to assess cognitive functioning after long-term cure of Cushing’s disease. Design: Cognitive assessment consisted of 11 tests, which evaluated global cognitive functioning, memory, and executive functioning. Patients and Control Subjects: We included 74 patients cured of Cushing’s disease and 74 controls matched for age, gender, and education. Furthermore, we included 54 patients previously treated for nonfunctioning pituitary macroadenomas (NFMA) and 54 controls matched for age, gender, and education. Results: Compared with NFMA patients, patients cured from Cushing’s disease had lower scores on the Mini Mental State Examination (P = 0.001), and on the memory quotient of the Wechsler Memory Scale (P = 0.050). Furthermore, patients cured from Cushing’s disease tended to recall fewer words on the imprinting (P = 0.013), immediate recall (P = 0.012), and delayed recall (P = 0.003) trials of the Verbal Learning Test of Rey. On the Rey Complex Figure Test, patients cured from Cushing’s disease had lower scores on both trials (P = 0.002 and P = 0.007) compared with NFMA patients. Patients cured from Cushing’s disease also made fewer correct substitutions on the Letter-Digit Substitution Test (P = 0.039) and came up with fewer correct patterns on the Figure Fluency Test (P = 0.003) compared with treated NFMA patients. Conclusions: Cognitive function, reflecting memory and executive functions, is impaired in patients despite long-term cure of Cushing’s disease. These observations indicate irreversible effects of previous hypercortisolism on cognitive function and, thus, on the central nervous system. These observations may also be of relevance for patients treated with high-dose exogenous glucocorticoids.

scholarly journals Intake of Vegetables and Fruits Through Young Adulthood Is Associated with Better Cognitive Function in Midlife in the US General Population

2019 ◽  
Vol 149 (8) ◽  
pp. 1424-1433
Author(s):  
Xuanxia Mao ◽  
Cheng Chen ◽  
Pengcheng Xun ◽  
Martha L Daviglus ◽  
Lyn M Steffen ◽  
...  
Keyword(s):  
Cognitive Function ◽  
General Population ◽  
Cognitive Performance ◽  
Young Adulthood ◽  
Verbal Learning ◽  
Stroop Test ◽  
Fruit Juices ◽  
Digit Symbol Substitution Test ◽  
Vegetables And Fruits

ABSTRACT Background Vegetables and fruits (VF) may differentially affect cognitive functions, presumably due to their various nutrient contents, but evidence from epidemiologic studies is limited. Objectives The aim of this study was to examine the long-term association between VF intakes, including VF subgroups, in young adulthood and cognitive function in midlife. Methods A biracial cohort of 3231 men and women aged 18–30 y at baseline in 1985–1986 were followed up for 25 y in the Coronary Artery Risk Development in Young Adults Study. Diet was measured at baseline, and in examination years 7 and 20. Cognitive function was assessed at examination year 25 through the use of 3 tests: the Rey Auditory Verbal Learning Test (RAVLT), the Digit Symbol Substitution Test (DSST), and the Stroop test. The mean differences (MDs) with 95% CIs in cognitive scores across intake categories were estimated through the use of the multivariable-adjusted general linear regression model. Results Excluding potatoes, intake of whole vegetables was significantly associated with a better cognitive performance after adjustment for potential confounders in all 3 cognitive tests (quintile 5 compared with quintile 1—RAVLT, MD: 0.33; 95% CI: 0.01, 0.64; P-trend = 0.08; DSST, MD: 2.84; 95% CI: 0.93, 4.75; P-trend < 0.01; Stroop test, MD: −2.87; 95% CI: −4.24, −1.50; P-trend < 0.01]. Similarly, intake of fruits, except fruit juices, was significantly related to a better cognitive performance (quintile 5 compared with quintile 1—DSST, MD: 2.41; 95% CI: 0.70, 4.12; P-trend = 0.03). Conclusions This study supports the long-term benefits of VF consumption on cognitive performance, except those VF with relatively low fiber content such as potatoes and fruit juices, among the middle-aged US general population.

Long-term cognitive deficits following posterior fossa tumor resection: A neuropsychological and functional neuroimaging follow-up study.

2009 ◽  
Vol 23 (6) ◽  
pp. 694-704 ◽  
Author(s):  
Hyo Jung De Smet ◽  
Hanne Baillieux ◽  
Peggy Wackenier ◽  
Mania De Praeter ◽  
Sebastiaan Engelborghs ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Cognitive Deficits ◽  
Functional Neuroimaging ◽  
Tumor Resection ◽  
Posterior Fossa Tumor ◽  
Follow Up Study

Is benzodiazepine use a risk factor for cognitive decline and dementia? A literature review of epidemiological studies

2004 ◽  
Vol 35 (3) ◽  
pp. 307-315 ◽  
Author(s):  
HELENE VERDOUX ◽  
RAJAA LAGNAOUI ◽  
BERNARD BEGAUD
Keyword(s):  
General Population ◽  
Cognitive Decline ◽  
Epidemiological Studies ◽  
Cognitive Outcome ◽  
Public Health Issue ◽  
Hand Search ◽  
Increased Risk ◽  
Benzodiazepine Use

Background. A major public health issue is to determine whether long-term benzodiazepine use may induce cognitive deficits persisting after withdrawal. The aim of the present review was to examine findings from prospective studies carried out in general population samples exploring whether exposure to benzodiazepines is associated with an increased risk of incident cognitive decline.Method. Using a MEDLINE search and a hand-search of related references in selected papers, we retrieved original studies published in peer-reviewed journals that explored in general population samples the association between benzodiazepine exposure and change in cognitive performance between baseline and follow-up assessment.Results. Six papers met the inclusion criteria. Two studies reported a lower risk of cognitive decline in former or ever users, two found no association whatever the category of user, and three found an increased risk of cognitive decline in benzodiazepine users.Conclusions. The discrepant findings obtained by studies examining the link between benzodiazepine exposure and risk of cognitive decline may be due to methodological differences, especially regarding the definitions of exposure and cognitive outcome. As a large proportion of subjects are exposed to benzodiazepines, a small increase in the risk of cognitive decline may have marked deleterious consequences for the health of the general population. This issue needs to be explored further by pharmaco-epidemiological studies.

scholarly journals Health-related quality of life of COVID-19 survivors at 6 months after hospital discharge: a cohort study

2021 ◽  
Author(s):  
MeiXuan Lin ◽  
Liqun Huang ◽  
Danwen Zheng ◽  
Linjie Zhang ◽  
Bing Feng ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Cognitive Function ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

Abstract Background: COVID-19 is a multi-systemic disease that is highly contagious and pathogenic. The long-term consequences of it are not yet clear, as is whether society and life can return to a healthy state. Long-term assessment of their health-related quality of life (HRQoL) is essential. This study aimed to investigate HRQoL and its risk factors in COVID-19 survivors at a follow-up of 6-month. Methods: A multicenter cross-sectional survey was conducted among 192 COVID-19 patients with confirmed age ≥ 18 years who were discharged from various hospitals in Wuhan from January to April 2020. The demographic characteristics, clinical characteristics, and laboratory results of the study subjects were obtained from the hospital's medical records. Survivors' HRQoL was assessed using the Short Form 36 (SF-36), cognition was assessed using the ascertain dementia eight-item informant questionnaire (AD8), and survivors' pulmonary function were examined. All participants in this study completed the survey and testing at Hubei Provincial Hospital of Chinese and Western Medicine. SF-36 scores were compared with the Chinese norm, and logistic regression and multivariate analysis were used to investigate the factors affecting HRQoL in COVID-19 survivors. Results: SF-36 showed significant differences in HRQoL between COVID-19 survivors and the general Chinese population ( P< 0.05).Multiple linear regression demonstrated that age was negatively correlated with physical functioning (PF), role-physical limitation (RP) and social functioning (SF) ( P <0.05). Bodily pain (BP), vitality (VT), SF and role-emotional limitation (RE) were negatively correlated with females ( P <0.05). Length from discharge to follow‐up was positively correlated with PF and RP ( P <0.05). Abnormal cognitive function was negatively correlated with PF, RP, general health (GH), VT, SF, RE and mental health (MH) ( P <0.05). Abnormal Carbon Monoxide Diffusing Capacity (DLCO%<80%) was significantly negatively correlated with PF and SF ( P <0.05).In addition, there was a significant negative correlation between Coronary heart disease and RP, GH, VT and RE ( P <0.05).Logistic regression analysis demonstrated that age(OR 1.032) and AD8 scores (OR 1.203)were risk factors associated with a low physical component summary (PCS) score. Length from discharge to follow‐up (OR 0.971) was the protective factor for PCS score. Abnormal cognitive function (OR 1.543) was a significant determinant associated with a mental component summary (MCS)<50 in COVID-19 patients. Conclusions: The HRQoL of COVID-19 survivors remains to be improved at six-month follow-up. Future studies should track HRQoL in older adults, women, patients with abnormal DLCO, and abnormal cognitive function for a long time and provide them with rehabilitation advice and guidance.

Long-Term Functional Outcomes after Blunt Cerebrovascular Injury: A 20-Year Experience

2018 ◽  
Vol 84 (4) ◽  
pp. 551-556 ◽  
Author(s):  
Charles P. Shahan ◽  
Taylor C. Stavely ◽  
Martin A. Croce ◽  
Timothy C. Fabian ◽  
Louis J. Magnotti
Keyword(s):  
Cognitive Function ◽  
Injury Severity Score ◽  
Acute Care ◽  
Functional Outcomes ◽  
Injury Severity ◽  
Blunt Cerebrovascular Injury ◽  
Cerebrovascular Injury ◽  
Activity Measure

Since blunt cerebrovascular injury (BCVI) became increasingly recognized more than 20 years ago, significant improvements have been made in both diagnosis and treatment. Little is known regarding long-term functional outcomes in BCVI. The purpose of this study was to evaluate the impact of BCVI on those long-term outcomes. All patients with BCVI from 1996 to 2014 were identified from the trauma registry. Functional outcome was measured using the Boston University Activity Measure for Post-Acute Care. Multiple regression analysis was performed to identify potential predictors of outcomes. A total of 509 patients were identified. Overall mortality was 18 per cent (BCVI-related = 1%). Of the 415 survivors, follow-up was obtained in 77 (19%). Mean follow-up was five years, with a maximum of 19 years. Mean age and injury severity score were 47 and 25, respectively. Six (8%) patients suffered strokes. Mean Activity Measure for Post-Acute Care scores were 59 (mobility), 58 (activity), and 44 (cognitive function), each indicating significant impairment compared with normal. Multiple regression models identified 1) age as a predictor of decreased mobility, 2) injury severity score as a predictor of decreased mobility, activity, and cognitive function, and 3) stroke as a predictor of decreased activity, cognitive function, and likely mobility. Development of stroke and increased injury severity resulted in worse long-term functional outcomes after BCVI. Thus, stroke prevention with optimal diagnostic and treatment algorithms remains critical in the successful treatment of BCVI because it has significant impact on long-term functional outcomes and is the only modifiable predictor of outcomes in patients after BCVI.

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