Differential effects of age at illness onset on verbal memory functions in antipsychotic-naïve schizophrenia patients aged 12–43 years

2020 ◽  
pp. 1-11 ◽  
Author(s):  
Birgitte Fagerlund ◽  
Christos Pantelis ◽  
Jens Richardt Møllegaard Jepsen ◽  
Jayachandra Mitta Raghava ◽  
Egill Rostrup ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Late Onset ◽  
Significant Proportion ◽  
Verbal Working Memory ◽  
Analysis Of Covariance ◽  
First Episode ◽  
Significant Group ◽  
Illness Onset ◽  
Age Related ◽  
The Impact

Abstract Background The typical onset of schizophrenia coincides with the maturational peak in cognition; however, for a significant proportion of patients the onset is before age 18 and after age 30 years. While cognitive deficits are considered core features of schizophrenia, few studies have directly examined the impact of age of illness onset on cognition. Methods The aim of the study was to examine if the effects of age on cognition differ between healthy controls (HCs) and patients with schizophrenia at illness onset. We examined 156 first-episode antipsychotic-naïve patients across a wide age span (12–43 years), and 161 age- and sex-matched HCs. Diagnoses were made according to ICD-10 criteria. Cognition was assessed using the Brief Assessment of Cognition in Schizophrenia (BACS), and IQ was estimated using subtests from the Wechsler adult- or child-intelligence scales. Multivariate analysis of covariance (MANCOVA) was used to examine linear and quadratic effects of age on cognitive scores and interactions by group, including sex and parental socioeconomic status as covariates. Results There was a significant overall effect of age on BACS and IQ (p < 0.001). Significant group-by-age interactions for verbal memory (for age-squared, p = 0.009), and digit sequencing (for age, p = 0.01; age-squared, p < 0.001), indicated differential age-related trajectories between patients and HCs. Conclusions Cognitive functions showing protracted maturation into adulthood, such as verbal memory and verbal working memory, may be particularly impaired in both early- and late-schizophrenia onset. Our findings indicate a potential interaction between the timing of neurodevelopmental maturation and a possible premature age effect in late-onset schizophrenia.

Fractionation of Verbal Memory Impairment in Schizophrenia and Schizophreniform Psychosis

2007 ◽  
Vol 41 (9) ◽  
pp. 732-739 ◽  
Author(s):  
Stephen J. Wood ◽  
Aleks U. Tarnawski ◽  
Tina M. Proffitt ◽  
Warrick J. Brewer ◽  
Greg R. Savage ◽  
...  
Keyword(s):  
Working Memory ◽  
Associative Learning ◽  
Verbal Memory ◽  
Memory Performance ◽  
Memory Function ◽  
Verbal Working Memory ◽  
First Episode ◽  
Story Recall ◽  
Associate Learning ◽  
The Impact

Objectives: The characterization, aetiology, and course of verbal memory deficits in schizophrenia remain ill defined. The impact of antipsychotic medications is also unclear. The purpose of the present paper was to investigate verbal memory performance in established schizophrenia (SZ) and first-episode schizophreniform psychosis (FE). Method: Performances of 32 SZ and 33 FE patients were compared to those of 47 healthy volunteers on measures of verbal working memory, verbal associative learning and story recall. Results: Story recall deficits, but not deficits in working memory or paired associate learning, were demonstrated by both patient groups. Patients treated with typical neuroleptics had more impairment in associative learning with arbitrary word pairings than those treated with atypicals, regardless of patient group. Conclusions: The results are consistent with the notion that some neuropsychological impairment is present at the time of psychosis onset and that this impairment is non-progressive. However, deficits may be specific to subclasses of memory function.

scholarly journals Childhood Cognition and Age-Related Change in Standing Balance Performance From Mid to Later Life: Findings From a British Birth Cohort

2018 ◽  
Vol 75 (1) ◽  
pp. 155-161 ◽  
Author(s):  
Joanna M Blodgett ◽  
Diana Kuh ◽  
Rebecca Hardy ◽  
Daniel H J Davis ◽  
Rachel Cooper
Keyword(s):  
Cognitive Processing ◽  
Verbal Memory ◽  
Repeated Measures ◽  
Later Life ◽  
Standing Balance ◽  
Balance Performance ◽  
Standard Deviation Increase ◽  
Eyes Closed ◽  
Age Related ◽  
The Impact

Abstract Background Cognitive processing plays a crucial role in the integration of sensory input and motor output that facilitates balance. However, whether balance ability in adulthood is influenced by cognitive pathways established in childhood is unclear, especially as no study has examined if these relationships change with age. We aimed to investigate associations between childhood cognition and age-related change in standing balance between mid and later life. Methods Data on 2,380 participants from the MRC National Survey of Health and Development were included in analyses. Repeated measures multilevel models estimated the association between childhood cognition, assessed at age 15, and log-transformed balance time, assessed at ages 53, 60–64, and 69 using the one-legged stand with eyes closed. Adjustments were made for sex, death, attrition, anthropometric measures, health conditions, health behaviors, education, other indicators of socioeconomic position (SEP), and adult verbal memory. Results In a sex-adjusted model, 1 standard deviation increase in childhood cognition was associated with a 13% (95% confidence interval: 10, 16; p &lt; .001) increase in balance time at age 53, and this association got smaller with age (cognition × age interaction: p &lt; .001). Adjustments for education, adult verbal memory, and SEP largely explained these associations. Conclusions Higher childhood cognition was associated with better balance performance in midlife, with diminishing associations with increasing age. The impact of adjustment for education, cognition and other indicators of SEP suggested a common pathway through which cognition is associated with balance across life. Further research is needed to understand underlying mechanisms, which may have important implications for falls risk and maintenance of physical capability.

scholarly journals B-14 Differences in Performance of Memory Tasks in HIV + Cocaine and Methamphetamine Users

2019 ◽  
Vol 34 (6) ◽  
pp. 958-958
Author(s):  
N Nemanim ◽  
C Hinkin ◽  
E Singer
Keyword(s):  
Verbal Memory ◽  
Visual Memory ◽  
Verbal Learning ◽  
Memory Task ◽  
Verbal Working Memory ◽  
Or Education ◽  
Chi Square ◽  
Cocaine Use ◽  
Cocaine Users ◽  
The Impact

Abstract Objective Approximately 1.2 million people in the U.S. are infected with HIV (HIV+), many of whom use stimulants. Recent meta-analytical work supports differing neurocognitive profiles associated with methamphetamine and cocaine use in seronegative individuals, especially in the domain of memory. Both substances are associated with deficits in verbal working memory, while only methamphetamine is associated with deficits in delayed contextual verbal memory and delayed visual memory. This study serves to replicate these findings amongst an HIV+ sample. Methods The performance of 88 HIV+ cocaine users and 49 HIV+ methamphetamine users were compared on the Hopkins Verbal Learning Test–Revised and Brief Visuospatial Memory Test–Revised. Participants were actively enrolled in National Neurological AIDS Bank and over the age of 18. Chi-square and Analysis of Variance (ANOVA) were used to compare group equivalence. Groups differed on gender and race but not on age, virologic variables, or education. ANOVA and Independent T-tests were used to compare performance. Results Both groups exhibited deficits on visual, verbal, and delayed verbal memory tasks but differences between the two groups were not significant (p>.05). Methamphetamine users performed significantly worse than cocaine users on the delayed visual memory task (F (1,131) = 9.27, p = .003, η² = .066). Conclusions Consistent with findings in seronegative individuals, HIV+ methamphetamine users performed more poorly than cocaine users on tasks involving delayed visual memory. However, this study did not replicate findings involving delayed verbal memory. Further work is necessary to understand the impact of methamphetamine and cocaine use in HIV+ individuals.

Trajectory of neurological examination abnormalities in antipsychotic-naïve first-episode psychosis population: a 1 year follow-up study

2019 ◽  
Vol 50 (12) ◽  
pp. 2057-2065 ◽  
Author(s):  
Paulo Lizano ◽  
Kiranpreet Dhaliwal ◽  
Olivia Lutz ◽  
Suraj Sarvode Mothi ◽  
Jean Miewald ◽  
...  
Keyword(s):  
Neurological Examination ◽  
Motor Coordination ◽  
First Episode Psychosis ◽  
Analysis Of Covariance ◽  
First Episode ◽  
Clinical Tool ◽  
Significant Group ◽  
Clinical Variables ◽  
Episode Psychosis ◽  
Response Groups

AbstractBackgroundNeurological Examination Abnormalities (NES) are quantified by measuring subtle, partially localizable (cerebello-thalamo-prefrontal cortical circuit) and heritable neurological signs comprising sensory integration, motor coordination and complex motor sequencing that are associated with first-episode psychosis (FEP). A few studies have evaluated NES longitudinally and as a predictor for diagnostic and response classification, but these studies have been confounded, underpowered and divergent. We examined (1) baseline and longitudinal NES differences between diagnostic and year 1 response groups; (2) if NES predicts diagnostic and response groups and (3) relationships between clinical variables and NES measures in antipsychotic-naïve FEP.MethodsNES and clinical measures were obtained for FEP-schizophrenia (FEP-SZ, n = 232), FEP non-schizophrenia (FEP-NSZ, n = 117) and healthy controls (HC, n = 204). Response groups with >25% improvement in average year 1 positive and negative symptomatology scores were classified as responsive (n = 97) and <25% improvement as non-responsive (n = 95). Analysis of covariance, NES trajectory analysis and logistic regression models assessed diagnostic and response group differences. Baseline and longitudinal NES relationships with clinical variables were performed with Spearman correlations. Data were adjusted for age, sex, race, socioeconomic status and handedness.ResultsCognitive perceptual (COGPER) score was better than repetitive motor (REPMOT) at differentiating FEP-SZ from FEP-NSZ and distinguishing responders from non-responders. We identified significant group-specific associations between COGPER and worse GAF, positive and negative symptomatology and some of these findings persisted at 1-year assessment.ConclusionNES are an easy to administer, bedside-elicited, endophenotypic measure and could be a cost-effective clinical tool in antipsychotic-naïve FEP.

416 The impact of Obstructive Sleep Apnea severity on age-related comorbities: a population-based study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A165-A165
Author(s):  
Mayra Silva ◽  
Dalva Poyares ◽  
Luciana Oliveira ◽  
Monica Andersen ◽  
Sergio Tufik ◽  
...  
Keyword(s):  
Older Adults ◽  
Late Onset ◽  
Clinical Manifestations ◽  
Population Based ◽  
Baseline Survey ◽  
Older Individuals ◽  
Blood Tests ◽  
Age Related ◽  
Obstructive Sleep ◽  
The Impact

Abstract Introduction Although age per se has been considered a risk factor for OSA, evidence suggest OSA in older adults may be less severe and OSA diagnostic criteria might be adjusted for this age group. Concurrently, it is likely the late-onset OSA is a distinct phenotype having different pathophysiological mechanisms, as well as clinical manifestations and consequences. We sought to investigate the clinical consequences of OSA severity in older adults from a representative sample of the older population living in the São Paulo city. Methods From the baseline survey including 1042 participants in 2007, 715 were reassessed in 2016 completing full in-lab PSG, health-related questionnaires, blood tests, and blood pressure measurements. Individuals &gt; 60 y.o. (n=199) of both genders were included in the analysis. Participants were stratified according to OSA presence and severity in 3 groups G1 (non and mild OSA n=83); G2 (moderate OSA n=56); G3 (severe OSA n=60). General Linear Model (GLM) tests and Chi-square were carried out. Results Participants mean age was 70.02±7.31 and mean body mass index (BMI) 28.61±5.39, 40.71% of men. The only comorbidity associated with OSA severity was arterial hypertension occurring in 61.7% of G3, 46.4% of G4 and 41% of G1 (p=0.04). Severe OSA participants were more likely to use a higher (&gt;2/day) number of medications (p=0.03). Finally, out of all blood tests only cortisol was significantly higher in severe OSA group (p&lt;0.001) Conclusion Severe OSA in older individuals of the general population is not associated with metabolic conditions, such as diabetes, but it was associated with hypertension. Severe OSA may be a stressful condition, since it was associated with higher cortisol in this population. Support (if any) Associaçao Fundo Incentivo a Pesquisa (AFIP)

The impact of cognitive reserve, cognition and clinical symptoms on psychosocial functioning in first-episode psychoses

2020 ◽  
pp. 1-12 ◽  
Author(s):  
Silvia Amoretti ◽  
Adriane R Rosa ◽  
Gisela Mezquida ◽  
Bibiana Cabrera ◽  
María Ribeiro ◽  
...  
Keyword(s):  
Cognitive Performance ◽  
Verbal Memory ◽  
Negative Symptoms ◽  
Cognitive Reserve ◽  
Clinical Symptoms ◽  
First Episode ◽  
Cognitive Domains ◽  
The Impact ◽  
The Relationship

Abstract Background Functional impairment is a defining feature of psychotic disorders. A range of factors has been shown to influence functioning, including negative symptoms, cognitive performance and cognitive reserve (CR). However, it is not clear how these variables may affect functioning in first-episode psychosis (FEP) patients. This 2-year follow-up study aimed to explore the possible mediating effects of CR on the relationship between cognitive performance or specific clinical symptoms and functional outcome. Methods A prospective study of non-affective FEP patients was performed (211 at baseline and 139 at follow-up). CR was entered in a path analysis model as potential mediators between cognitive domains or clinical symptoms and functioning. Results At baseline, the relationship between clinical variables or cognitive performance and functioning was not mediated by CR. At follow-up, the effect of attention (p = 0.003) and negative symptoms (p = 0.012) assessed at baseline on functioning was partially mediated by CR (p = 0.032 and 0.016), whereas the relationship between verbal memory (p = 0.057) and functioning was mediated by CR (p = 0.014). Verbal memory and positive and total subscales of PANSS assessed at follow-up were partially mediated by CR and the effect of working memory on functioning was totally mediated by CR. Conclusions Our results showed the influence of CR in mediating the relationship between cognitive domains or clinical symptoms and functioning in FEP. In particular, CR partially mediated the relationship between some cognitive domains or clinical symptoms and functioning at follow-up. Therefore, CR could improve our understanding of the long-term functioning of patients with a non-affective FEP.

The impact of a support centre for people with sensory impairment living in rural Scotland

2015 ◽  
Vol 17 (02) ◽  
pp. 138-148 ◽  
Author(s):  
Annetta Smith ◽  
Ashley Shepherd ◽  
Ruth Jepson ◽  
Seonaid Mackay
Keyword(s):  
Sense Of Self ◽  
Significant Proportion ◽  
Functional Independence ◽  
Sensory Loss ◽  
Service Access ◽  
Sensory Impairment ◽  
Individual Interviews ◽  
Age Related ◽  
Sensory Impairments ◽  
The Impact

AimThe overall aim of this study was to evaluate whether attendance at a Sensory Support Centre for people with a sensory impairment living in the Western Isles of Scotland had an impact on their lives.BackgroundDemographic forecasts show that the prevalence of sensory impairment in the population will increase, as a significant proportion of sensory loss is age related. People with sensory impairments are more likely to experience social exclusion, and are more at risk of injury and physical and mental illness. Therefore, strategies to improve service access and provision for people with sensory impairments are important to reduce the disability associated with sight and/or hearing loss.MethodsAll clients who accessed the service during a six-month period were invited to complete a postal questionnaire about their service experience. Semi-structured individual interviews with clients (n=12) described their experience of living with a sensory impairment and the impact (if any) that access to the Sensory Centre had on their lives. Individual interviews were also conducted with healthcare and social-care professionals (n=7) to ascertain their level of service awareness.FindingsClients who experienced sensory impairment described how the impairment negatively impacted on their activities of living, safety and independence. Following Sensory Centre assessment and support, some clients were able to identify ways in which interventions had reduced their sense of social isolation, impacted positively on self-confidence and sense of self-esteem and safety. Importantly, interventions had supported greater functional independence in their own homes.ConclusionThis study provides evidence that access to sensory services are important to people with sensory impairments living in remote areas, and should be considered when planning healthcare services, as they are one way of ameliorating health inequalities in this population group.

scholarly journals Hippocampal Sclerosis in Older Patients: Practical Examples and Guidance With a Focus on Cerebral Age-Related TDP-43 With Sclerosis

2017 ◽  
Vol 141 (8) ◽  
pp. 1113-1126 ◽  
Author(s):  
Matthew D. Cykowski ◽  
Suzanne Z. Powell ◽  
Paul E. Schulz ◽  
Hidehiro Takei ◽  
Andreana L. Rivera ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Alzheimer Disease ◽  
Frontotemporal Lobar Degeneration ◽  
Late Onset ◽  
Hippocampal Sclerosis ◽  
Oldest Old ◽  
Significant Proportion ◽  
Lewy Body Disease ◽  
Older Population ◽  
Age Related

Context.— Autopsy studies of the older population (≥65 years of age), and particularly of the “oldest-old” (≥85 years of age), have identified a significant proportion (∼20%) of cognitively impaired patients in which hippocampal sclerosis is the major substrate of an amnestic syndrome. Hippocampal sclerosis may also be comorbid with frontotemporal lobar degeneration, Alzheimer disease, and Lewy body disease. Until recently, the terms hippocampal sclerosis of aging or hippocampal sclerosis dementia were applied in this context. Recent discoveries have prompted a conceptual expansion of hippocampal sclerosis of aging because (1) cellular inclusions of TAR DNA-binding protein 43 kDa (TDP-43) are frequent; (2) TDP-43 pathology may be found outside hippocampus; and (3) brain arteriolosclerosis is a common, possibly pathogenic, component. Objective.— To aid pathologists with recent recommendations for diagnoses of common neuropathologies in older persons, particularly hippocampal sclerosis, and highlight the recent shift in diagnostic terminology from HS-aging to cerebral age-related TDP-43 with sclerosis (CARTS). Data Sources.— Peer-reviewed literature and 5 autopsy examples that illustrate common age-related neuropathologies, including CARTS, and emphasize the importance of distinguishing CARTS from late-onset frontotemporal lobar degeneration with TDP-43 pathology and from advanced Alzheimer disease with TDP-43 pathology. Conclusions.— In advanced old age, the substrates of cognitive impairment are often multifactorial. This article demonstrates common and frequently comorbid neuropathologic substrates of cognitive impairment in the older population, including CARTS, to aid those practicing in this area of pathology.

scholarly journals Impact of depressive episodes on cognitive deficits in early bipolar disorder: data from the Systematic Treatment Optimization Programme for Early Mania (STOP-EM)

2014 ◽  
Vol 205 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Kesavan Muralidharan ◽  
Ivan J. Torres ◽  
Leonardo E. Silveira ◽  
Jan-Marie Kozicky ◽  
Joana Bücker ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Cognitive Deficits ◽  
Verbal Memory ◽  
First Episode ◽  
Treatment Optimization ◽  
Systematic Treatment ◽  
Cross Sectional ◽  
Sectional Analysis ◽  
Depressive Episodes ◽  
The Impact

BackgroundAlthough manic episodes reportedly contribute to cognitive deficits in bipolar I disorder, the contribution of depressive episodes is poorly researched.AimsWe investigated the impact of depressive episodes on cognitive function early in the course of bipolar I disorder.MethodA total of 68 patients and 38 controls from the Systematic Treatment Optimization Programme for Early Mania (STOP-EM) first-episode mania programme were examined. We conducted (a) a cross-sectional analysis of the impact of prior depressive episodes on baseline cognitive function and (b) a prospective analysis assessing the contribution of depression recurrence within 1 year following a first episode of mania on cognitive functioning.ResultsThe cross-sectional analysis showed no significant differences between patients with past depressive episodes compared with those without, on overall or individual domains of cognitive function (allP>0.09). The prospective analysis failed to reveal a significant group×time interaction for cognitive decline from baseline to 1 year (P= 0.99) in patients with a recurrence of depressive episodes compared with those with no recurrence. However, impaired verbal memory at baseline was associated with a depression recurrence within 1 year.ConclusionsAlthough deficits in all domains of cognitive function are seen in patients early in the course of bipolar disorder, depressive episodes do not confer additional burden on cognitive function. However, poorer verbal memory may serve as a marker for increased susceptibility to depression recurrence early in the course of illness.

The influence of gender on clinical and social characteristics of patients at psychosis onset: a report from the Psychosis Incident Cohort Outcome Study (PICOS)

2011 ◽  
Vol 42 (4) ◽  
pp. 769-780 ◽  
Author(s):  
M. Bertani ◽  
A. Lasalvia ◽  
C. Bonetto ◽  
S. Tosato ◽  
D. Cristofalo ◽  
...  
Keyword(s):  
Unmet Needs ◽  
Social Characteristics ◽  
First Episode ◽  
Outcome Study ◽  
Social Disability ◽  
Illness Onset ◽  
Male Patients ◽  
Incident Cohort ◽  
Incident Cases ◽  
The Impact

BackgroundThis paper examined the hypothesis that males with first-episode psychosis (FEP) experience lower pre-morbid adjustment, greater social disability and more self-perceived needs at illness onset than females (by controlling for duration of untreated psychosis, diagnosis, age and symptoms at onset). Results disconfirming this hypothesis were thought to suggest the potentially mediating role of social context in determining the impact of symptoms and disability on the everyday lives of male patients in the early phase of psychosis.MethodA large epidemiologically representative cohort of FEP patients (n=517) was assessed within the Psychosis Incident Cohort Outcome Study (PICOS) framework – a multi-site research project examining incident cases of psychosis in Italy's Veneto region.ResultsDespite poorer pre-morbid functioning and higher social disability at illness onset, males reported fewer unmet needs in the functioning domain than females did. An analysis of help provided by informal caregivers showed that males received more help from their families than females did. This finding led us to disconfirm the second part of the hypothesis and suggest that the impact of poorer social performance and unmet needs on everyday life observed in male patients might be hampered by higher tolerance and more support within the family context.ConclusionsThese findings shed new light on rarely investigated sociocultural and contextual factors that may account for the observed discrepancy between social disability and needs for care in FEP patients. They also point to a need for further research on gender differences, with the ultimate aim of delivering gender-sensitive effective mental health care.

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