scholarly journals Fitness to drive in older drivers with cognitive impairment

2000 ◽  
Vol 6 (4) ◽  
pp. 480-490 ◽  
Author(s):  
FREDERIEC K. WITHAAR ◽  
WIEBO H. BROUWER ◽  
ADRIAAN H. VAN ZOMEREN
Keyword(s):  
Cognitive Impairment ◽  
Test Performance ◽  
Traffic Accidents ◽  
Neuropsychological Test ◽  
Driving Performance ◽  
Older Drivers ◽  
Cognitive Test ◽  
Cognitively Impaired ◽  
Fitness To Drive ◽  
Cognitive Test Performance

This paper is a literature review on assessment of fitness to drive in older drivers with cognitive impairment. Early studies on dementia and driving generally failed to distinguish between safe and unsafe drivers on the basis of cognitive test performance. Predictive studies demonstrated that cognitively impaired persons as a group perform significantly worse than controls on both neuropsychological and driving measures. A high prevalence of cognitive impairment was found in groups of older drivers involved in traffic accidents and crashes. However, a large range in neuropsychological test scores has been found. Low to moderate correlations could be established between neuropsychological test results and on-road driving performance, making it difficult to discriminate between cognitively impaired subjects who are fit or unfit to drive. The review concludes with a discussion of methodological difficulties in the field of dementia and driving, including participant selection, the choice of neuropsychological tests, and the operationalization of driving performance. (JINS, 2000, 6, 480–490.)

Disease-modifying treatments and cognition in relapsing-remitting multiple sclerosis

Neurology ◽  
2020 ◽  
Vol 94 (22) ◽  
pp. e2373-e2383 ◽  
Author(s):  
Nils C. Landmeyer ◽  
Paul-Christian Bürkner ◽  
Heinz Wiendl ◽  
Tobias Ruck ◽  
Hans-Peter Hartung ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Test Performance ◽  
Meta Analysis ◽  
Cognitive Test ◽  
Current Evidence ◽  
Relapsing Remitting ◽  
Disease Modifying ◽  
Cognitive Test Performance

ObjectiveDisease-modifying treatments (DMTs) are the gold standard for slowing disability progression in multiple sclerosis (MS), but their effects on cognitive impairment, a key symptom of the disease, are mostly unknown. We conducted a systematic review and meta-analysis to evaluate the differential effects of DMTs on cognitive test performance in relapsing-remitting MS (RRMS).MethodsPubMed, Scopus, and Cochrane Library were searched for studies reporting longitudinal cognitive performance data related to all major DMTs. The standardized mean difference (Hedges g) between baseline and follow-up cognitive assessment was used as the main effect size measure.ResultsForty-four studies, including 55 distinct MS patient samples, were found eligible for the systematic review. Twenty-five studies were related to platform therapies (mainly β-interferon [n = 17] and glatiramer acetate [n = 4]), whereas 22 studies were related to escalation therapies (mainly natalizumab [n = 14] and fingolimod [n = 6]). Reported data were mostly confined to the cognitive domain processing speed. A meta-analysis including 41 studies and 7,131 patients revealed a small to moderate positive effect on cognitive test performance of DMTs in general (g = 0.27, 95% confidence interval [CI] = [0.21–0.33]), but no statistically significant differences between platform (g = 0.27, 95% CI = [0.18–0.35]) and escalation therapies (g = 0.28, 95% CI = [0.19–0.37]) or between any single DMT and β-interferon.ConclusionsDMTs are effective in improving cognitive test performance in RRMS, but a treatment escalation mainly to amend cognition is not supported by the current evidence. Given the multitude of DMTs and their widespread use, the available data regarding differential treatment effects on cognitive impairment are remarkably scant. Clinical drug trials that use more extensive cognitive outcome measures are urgently needed.

Perceived Cognitive Difficulties and Cognitive Test Performance as Predictors of Employment Outcomes in People with Multiple Sclerosis

2015 ◽  
Vol 21 (2) ◽  
pp. 156-168 ◽  
Author(s):  
Cynthia A. Honan ◽  
Rhonda F. Brown ◽  
Jennifer Batchelor
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Prospective Memory ◽  
Test Performance ◽  
Work Hours ◽  
Work Outcomes ◽  
Cognitive Test ◽  
Cognitive Difficulties ◽  
Cognitive Test Performance ◽  
The Relationship

AbstractPerceived cognitive difficulties and cognitive impairment are important determinants of employment in people with multiple sclerosis (pwMS). However, it is not clear how they are related to adverse work outcomes and whether the relationship is influenced by depressive symptoms. Thus, this study examined perceived and actual general cognitive and prospective memory function, and cognitive appraisal accuracy, in relation to adverse work outcomes. The possible mediating and/or moderating role of depression was also examined. A cross-sectional community-based sample of 111 participants (33 males, 78 females) completed the Multiple Sclerosis Work Difficulties Questionnaire (MSWDQ), Beck Depression Inventory – Fast Screen (BDI-FS), and questions related to their current or past employment. They then underwent cognitive testing using the Screening Examination for Cognitive Impairment, Auditory Consonant Trigrams test, Zoo Map Test, and Cambridge Prospective Memory Test. Perceived general cognitive and prospective memory difficulties in the workplace and performance on the respective cognitive tests were found to predict unemployment and reduced work hours since MS diagnosis due to MS. Depression was also related to reduced work hours, but it did not explain the relationship between perceived cognitive difficulties and the work outcomes. Nor was it related to cognitive test performance. The results highlight a need to address the perceptions of cognitive difficulties together with cognitive impairment and levels of depression in vocational rehabilitation programs in pwMS. (JINS, 2015,21, 156–168)

Associations between Visual Acuity and Cognitive Decline in Older Adulthood: A 9-Year Longitudinal Study

2021 ◽  
pp. 1-11
Author(s):  
Ashlyn Runk ◽  
Yichen Jia ◽  
Anran Liu ◽  
Chung-Chou H. Chang ◽  
Mary Ganguli ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Risk Factor ◽  
Cognitive Decline ◽  
Test Performance ◽  
Cognitive Abilities ◽  
Neuropsychological Test ◽  
Joint Modeling ◽  
Modifiable Risk Factor ◽  
Cognitive Test ◽  
Cognitive Test Performance

Abstract Objective: Emerging evidence suggests low vision may be a modifiable risk factor for cognitive decline. We examined effects of baseline visual acuity (VA) on level of, and change in, cognitive test performance over 9 years. Method: A population-based sample of 1,621 participants (average age 77 years) completed a comprehensive neuropsychological evaluation and VA testing at baseline and reassessed at nine subsequent annual visits. Linear regression modeled the association between baseline VA and concurrent cognitive test performance. Joint modeling of a longitudinal sub-model and a survival sub-model to adjust for attrition were used to examine associations between baseline VA and repeated cognitive test performance over time. Results: Better baseline VA was associated cross-sectionally with younger age, male sex, greater than high school education, and higher baseline neuropsychological test scores on both vision-dependent (B coefficient range −0.163 to −0.375, p = .006 to <.001) and vision-independent tests (−0.187 to −0.215, p = .003 to .002). In longitudinal modeling, better baseline VA was associated with slower decline in vision-dependent tests (B coefficient range −0.092 to 0.111, p = .005 to <.001) and vision-independent tests (−0.107 to 0.067, p = .007 to <.001). Conclusions: Higher VA is associated with higher concurrent cognitive abilities and slower rates of decline over 9 years in both vision-dependent and vision-independent tests of memory, language, and executive functioning. Findings are consistent with emerging literature supporting vision impairment in aging as a potentially modifiable risk factor for cognitive decline. Clinicians should encourage patient utilization of vision assessment and correction with the added aim of protecting cognition.

scholarly journals Driving with Mild Cognitive Impairment or Dementia: Cognitive Test Performance and Proxy Report of Daily Life Function in Older Women

2015 ◽  
Vol 63 (9) ◽  
pp. 1774-1782 ◽  
Author(s):  
Leslie Vaughan ◽  
Patricia E. Hogan ◽  
Stephen R. Rapp ◽  
Elizabeth Dugan ◽  
Richard A. Marottoli ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Older Women ◽  
Test Performance ◽  
Daily Life ◽  
Cognitive Test ◽  
Proxy Report ◽  
Cognitive Test Performance ◽  
Life Function

How to Correct for Computer Experience in Online Cognitive Testing?

Assessment ◽  
2020 ◽  
pp. 107319112091109
Author(s):  
Philippe R. Lee Meeuw Kjoe ◽  
Joost A. Agelink van Rentergem ◽  
Ivar E. Vermeulen ◽  
Sanne B. Schagen
Keyword(s):  
Test Performance ◽  
Neuropsychological Test ◽  
Cognitive Testing ◽  
Self Report ◽  
Cognitive Test ◽  
Computer Experience ◽  
Cognitive Test Performance ◽  
Online Tests ◽  
Report Measure ◽  
A Performance

Objective: Since computerized cognitive test performance may be influenced by computer experience, correction for this measure might be needed. This study examined how to correct for computer experience by examining its influence on online and traditional tests. Method: 248 healthy adults completed an online neuropsychological test battery and 70 adults completed traditional equivalents of the tests. Computer experience was assessed by a performance-based and a self-report measure. Regression analyses were applied to examine their influence on the online and traditional tests. Results: After correction for demographics, the performance-based measure was associated with online and traditional, predominantly speed-based, tests. The self-report measure was also associated with speed-based online tests but not with most traditional tests. Conclusions: Correcting computerized neuropsychological tests using a performance-based measure of computer experience would be unwise, because this measure also seems to tap into cognitive functions. A correction using a self-report measure might be better and is appropriate.

scholarly journals Differential Impact of Cognitive Impairment in MCI Patients: A Case-Based Report

2020 ◽  
Vol 12 (2) ◽  
pp. 222-231
Author(s):  
Valentina Pergher ◽  
Birgitte Schoenmakers ◽  
Philippe Demaerel ◽  
Jos Tournoy ◽  
Marc M. Van Hulle
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Test Performance ◽  
Intermediate Stage ◽  
Cognitive Test ◽  
White Matter Volume ◽  
Matter Volume ◽  
Mri Scans ◽  
Cognitive Test Performance ◽  
The Impact

Mild cognitive impairment (MCI) traditionally refers to an intermediate stage between healthy individuals and early Alzheimer disease. Evidence shows grey and white matter volume changes and decrease in several executive functions, albeit the relation between cognitive performance and brain volume remains unclear. Here, we discuss 3 individual cases of MCI by investigating their MRI scans and cognitive test performance. We also recruited age-matched healthy older adults serving as gold standard for both grey and white matter volume and cognitive test outcomes. Our results show the impact of cognitive impairment on cognitive test performance and grey and white matter volumes, and the role played by cognitive and brain reserve on mitigating cognitive decline. Furthermore, we add evidence to previous studies by showing an increase in white matter volume compared to healthy controls, in all 3 patients. This pattern of increased white matter volume might help us to better understand the pathological mechanisms underlying MCI which in turn could contribute to future investigations.

scholarly journals Cognitive profile of mild behavioral impairment in Brain Health Registry participants

2021 ◽  
Author(s):  
Farzeen Kassam ◽  
Hung-Yu Chen ◽  
Rachel L Nosheny ◽  
Alexander McGirr ◽  
Tirzah Williams ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Test Performance ◽  
Test Scores ◽  
Neuropsychological Test ◽  
Behavioral Assessment ◽  
Cognitive Test ◽  
Brain Health ◽  
Behavioral Impairment ◽  
Cognitive Test Performance ◽  
Health Registry

INTRODUCTION: Dementia assessment includes cognitive and behavioral testing with informant validation. Conventional testing is resource intensive, with uneven access. Online unsupervised assessments could reduce barriers to risk assessment. We interrogated the relationship between informant-rated behavioral changes and neuropsychological test performance in older adults in the Brain Health Registry. METHODS: Participants completed online unsupervised cognitive tests, and informants completed the Mild Behavioral Impairment Checklist via a Study Partner portal. Cognitive performance was evaluated in MBI+/- individuals, as was the association between cognitive scores and MBI symptom severity. RESULTS: Mean age of the 499 participants was 67, 61% of which were female. MBI+ participants had lower working memory and executive function test scores. Lower cognitive test scores associated with greater MBI burden. DISCUSSION: Our findings support the feasibility of remote, informant-reported behavioral assessment and support its validity by demonstrating a relationship to cognitive test performance using online unsupervised assessments for dementia risk assessment.

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