scholarly journals Profiles of Normal Cognition in Essential Tremor

2019 ◽  
Vol 26 (2) ◽  
pp. 197-209 ◽  
Author(s):  
Tess E. K. Cersonsky ◽  
Sarah Kellner ◽  
Silvia Chapman ◽  
Edward D. Huey ◽  
Elan D. Louis ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Functioning ◽  
Essential Tremor ◽  
High Performance ◽  
Elderly Subjects ◽  
Cross Sectional ◽  
Cognitively Normal ◽  
Increased Risk ◽  
Wide Range

AbstractObjectives:Patients with essential tremor exhibit heterogeneous cognitive functioning. Although the majority of patients fall under the broad classification of cognitively “normal,” essential tremor is associated with increased risk for mild cognitive impairment and dementia. It is possible that patterns of cognitive performance within the wide range of normal functioning have predictive utility for mild cognitive impairment or dementia. These cross-sectional analyses sought to determine whether cognitive patterns, or “clusters,” could be identified among individuals with essential tremor diagnosed as cognitively normal. We also determined whether such clusters, if identified, were associated with demographic or clinical characteristics of patients.Methods:Elderly subjects with essential tremor (age >55 years) underwent comprehensive neuropsychological testing. Domain means (memory, executive function, attention, visuospatial abilities, and language) from 148 individuals diagnosed as cognitively normal were partitioned using k-means cluster analysis. Individuals in each cluster were compared according to cognitive functioning (domain means and test scores), demographic factors, and clinical variables.Results:There were three clusters. Cluster 1 (n = 64) was characterized by comparatively low memory scores (p < .001), Cluster 2 (n = 39) had relatively low attention and visuospatial scores (p < .001), and Cluster 3 (n = 45) exhibited consistently high performance across all domains. Cluster 1 had lower Montreal Cognitive Assessment scores and reported more prescription medication use and lower balance confidence.Conclusions:Three patterns of cognitive functioning within the normal range were evident and tracked with certain clinical features. Future work will examine the extent to which such patterns predict conversion to mild cognitive impairment and/or dementia.

Association of Circulating Cholesterol Level with Cognitive Function and Mild Cognitive Impairment in the Elderly: A Community-based Population Study

2020 ◽  
Vol 17 (6) ◽  
pp. 556-565
Author(s):  
Yujie Guo ◽  
Pengfei Li ◽  
Xiaojun Ma ◽  
Xiaochen Huang ◽  
Zhuoheng Liu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Function ◽  
Cholesterol Level ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cross Sectional ◽  
Increased Risk ◽  
Aging Adults ◽  
Female Subjects

Background: The present study was designed to examine the association of circulating cholesterol with cognitive function in non-demented community aging adults. Methods: This was a cross-sectional study including 1754 Chinese adults aged 55-80 years. The association between serum cholesterol levels and cognitive function was examined. Participants were categorized into four groups according to the quartile of circulating TC (total cholesterol), High Density Lipoprotein Cholesterol (HDL-c), Low Density Lipoprotein Cholesterol (LDL-c) levels and HDLc/ LDL-c ratio. The difference in cognitive performance among the groups was compared. Logistic regression model was used to determine the association of circulating cholesterol level with the risk of Mild Cognitive Impairment (MCI). Results: Mild increase of serum LDL-c level correlated with better visual and executive, language, memory and delayed recall abilities. Higher circulating TC and HDL-c levels were found to be associated with poorer cognitive function, especially in aging female subjects. Higher circulating TC, HDL-c and HDL/LDL ratio indicated an increased risk of MCI, especially in female subjects. Conclusion: Slight increase in circulating LDL-c level might benefit cognitive function in aging adults. However, higher circulating TC and HDL-c levels might indicate a decline of cognitive function, especially in aging female subjects.

scholarly journals Depressive symptoms in relation to clinical symptom onset of mild cognitive impairment

2018 ◽  
Vol 31 (04) ◽  
pp. 561-569 ◽  
Author(s):  
Carol K. Chan ◽  
Anja Soldan ◽  
Corinne Pettigrew ◽  
Mei-Cheng Wang ◽  
Jiangxia Wang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Clinical Symptom ◽  
Symptom Onset ◽  
Symptom Severity ◽  
Hamilton Depression Scale ◽  
Cognitively Normal ◽  
Increased Risk ◽  
Time To Onset

ABSTRACTObjective:There is increasing evidence of an association between depressive symptoms and mild cognitive impairment (MCI) in cross-sectional studies, but the longitudinal association between depressive symptoms and risk of MCI onset is less clear. The authors investigated whether baseline symptom severity of depression was predictive of time to onset of symptoms of MCI.Method:These analyses included 300 participants from the BIOCARD study, a cohort of individuals who were cognitively normal at baseline (mean age = 57.4 years) and followed for up to 20 years (mean follow-up = 2.5 years). Depression symptom severity was measured using the Hamilton Depression Scale (HAM-D). The authors assessed the association between dichotomous and continuous HAM-D and time to onset of MCI within 7 years versus after 7 years from baseline (reflecting the mean time from baseline to onset of clinical symptoms in the cohort) using Cox regression models adjusted for gender, age, and education.Results:At baseline, subjects had a mean HAM-D score of 2.2 (SD = 2.8). Higher baseline HAM-D scores were associated with an increased risk of progression from normal cognition to clinical symptom onset ≤ 7 years from baseline (p= 0.043), but not with progression &gt; 7 years from baseline (p= 0.194). These findings remained significant after adjustment for baseline cognition.Conclusions:These results suggest that low levels of depressive symptoms may be predictive of clinical symptom onset within approximately 7 years among cognitively normal individuals and may be useful in identifying persons at risk for MCI due to Alzheimer’s disease.

Subjective Memory Complaints and Mild Cognitive Impairment

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
M. Simoes ◽  
L.C. Castro ◽  
O. Ribeiro ◽  
T. Salgado ◽  
C. Paz
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
The Elderly ◽  
Future Research ◽  
Older Individuals ◽  
Subjective Memory Complaints ◽  
Subjective Memory ◽  
Cross Sectional ◽  
Memory Complaints ◽  
Increased Risk

Background:Subjective Memory Complaints (SMC) are common in clinical practice. the clinical significance of these subjective complaints among older individuals is not well understood.Aim:To study and discuss the association between SMC and MCI, underlining the importance of an adequate clinical assessment of SMC in the elderly.Methods:Review of the literature.Results:There is no consistent definition of SMC in the literature. Some prospective studies showed an association with objective memory impairments, conceptualizing SMC as a Pre-Mild Cognitive Impairment. SMC are also currently considered to be a core feature of Mild Cognitive Impairment (MCI). Cross-sectional studies and longitudinal studies showed conflicting results concerning the association between SMC and MCI.Discussion:The understanding of the predictive value of SMC in cognitive decline is still poorly understood. It is important to define criteria aimed to increase specificity of memory complaints, allowing an earlier identification of populations with higher risk of MCI. Future research on this complex association is important to identify SMC individuals at increased risk of conversion to MCI and dementia.

scholarly journals Identifying the Factors Related to Depressive Symptoms Amongst Community-Dwelling Older Adults with Mild Cognitive Impairment

2019 ◽  
Vol 16 (18) ◽  
pp. 3449 ◽  
Author(s):  
Dan Song ◽  
Doris S.F. Yu ◽  
Polly W.C. Li ◽  
Qiuhua Sun
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Increased Risk ◽  
Community Dwelling Older Adults

High-level depressive symptoms have been reported in individuals with mild cognitive impairment (MCI), resulting in increased risk of progression to dementia. However, studies investigating the correlates of depressive symptoms among this population are scarce. This study aimed to investigate the significant socio-demographic, lifestyle-related and disease-related correlates of depressive symptoms among this cohort. Cross-sectional data were obtained from a sample of 154 Chinese community-dwelling older adults with MCI. MCI subjects were screened by the Montreal Cognitive Assessment. Depressive symptoms were measured by the Geriatric Depression Scale. Possible correlates of depressive symptoms in individuals with MCI were explored by multiple linear regressions. The prevalence of depressive symptoms among Chinese older adults with MCI was 31.8%. In multiple regression analysis, poor perceived positive social interaction, small social network, low level of physical activity, poor functional status, subjective memory complaint, and poor health perception were correlated with depressive symptoms. The findings highlight that depressive symptoms are sufficient to warrant evaluation and management in older adults with MCI. Addressing social isolation, assisting this vulnerable group in functional and physical activities, and cultivating a positive perception towards cognitive and physical health are highly prioritized treatment targets among individuals with MCI.

Evaluating Mild Cognitive Impairment in Essential Tremor: How Many and Which Neuropsychological Tests?

2018 ◽  
Vol 24 (10) ◽  
pp. 1084-1098 ◽  
Author(s):  
Tess E.K. Cersonsky ◽  
Sarah Morgan ◽  
Sarah Kellner ◽  
Daphne Robakis ◽  
Xinhua Liu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Essential Tremor ◽  
Neuropsychological Tests ◽  
Verbal Learning ◽  
Clinical Dementia Rating ◽  
Cognitive Changes ◽  
Increased Risk ◽  
Prospective Longitudinal

AbstractObjectives:Essential tremor (ET) confers an increased risk for developing both amnestic and non-amnestic mild cognitive impairment (MCI). Yet, the optimal measures for detecting mild cognitive changes in individuals with this movement disorder have not been established. We sought to identify the cognitive domains and specific motor-free neuropsychological tests that are most sensitive to mild deficits in cognition as defined by a Clinical Dementia Rating (CDR) of 0.5, which is generally associated with a clinical diagnosis of MCI.Methods:A total of 196 ET subjects enrolled in a prospective, longitudinal, clinical-pathological study underwent an extensive motor-free neuropsychological test battery and were assigned a CDR score. Logistic regression analyses were performed to identify the neuropsychological tests which best identified individuals with CDR of 0.5 (mild deficits in cognition)versus0 (normal cognition).Results:In regression models, we identified five tests in the domains of Memory and Executive Function which best discriminated subjects with CDR of 0.5versus0 (86.9% model classification accuracy). These tests were the California Verbal Learning Test II Total Recall, Logical Memory II, Verbal-Paired Associates I, Category Switching Fluency, and Color-Word Inhibition.Conclusions:Mild cognitive difficulty among ET subjects is best predicted by combined performance on five measures of memory and executive function. These results inform the nature of cognitive dysfunction in ET and the creation of a brief cognitive battery to assess patients with ET for cognitively driven dysfunction in life that could indicate the presence of MCI. (JINS, 2018,24, 1084–1098)

scholarly journals Informant-based hearing difficulties and the risk for mild cognitive impairment and dementia

2019 ◽  
Vol 48 (6) ◽  
pp. 888-894 ◽  
Author(s):  
Maria Vassilaki ◽  
Jeremiah A Aakre ◽  
David S Knopman ◽  
Walter K Kremers ◽  
Michelle M Mielke ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Daily Activities ◽  
Cross Sectional ◽  
Cox Proportional Hazards Models ◽  
Increased Risk ◽  
Hearing Difficulties

Abstract Background: hearing loss has been associated with mild cognitive impairment (MCI) and dementia. Studies have not assessed whether hearing difficulties (HD) that interfere with daily activities as reported by partners can be a marker for increased risk for cognitive decline and impairment. Objective: to assess the cross-sectional and longitudinal associations between informant-based HD, which interfere with daily activities and the risk for MCI and dementia. Methods: the study included 4812 participants without dementia, enrolled in the Mayo Clinic Study of Aging (mean age (SD) 73.7 (9.6) years) with cognitive evaluation and informant-based report on participant’s HD that interfere significantly with daily activities at baseline and for every 15 months. Cox proportional hazards models (utilising time-dependent HD status and age as the time scale) were used to examine HD and the risk for MCI or dementia, and mixed-effects models (allowing for random subject-specific intercepts and slopes) were used to examine the relationship between HD and cognitive decline. Results: about, 981 participants had HD and 612 (12.7%) had prevalent MCI at baseline; 759 participants developed incident MCI and 273 developed incident dementia. In cognitively unimpaired participants at baseline, those with HD had higher risk for MCI (hazard ratio [HR] = 1.29, 95% confidence interval [CI] (1.10, 1.51), P = 0.002; adjusting for sex, years of education). In participants without dementia, those with HD had higher risk for dementia (HR: 1.39, 95% CI, (1.08–1.79), P = 0.011; adjusting sex and education). In individuals with MCI, HD was associated with modestly greater cognitive decline. Conclusions: informant-based HD was associated with increased risk for MCI and dementia.

An abbreviated version of Silhouettes test: a brief validated mild cognitive impairment screening tool

2018 ◽  
Vol 31 (06) ◽  
pp. 849-856
Author(s):  
Lin Huang ◽  
Ke-Liang Chen ◽  
Bi-Ying Lin ◽  
Le Tang ◽  
Qian-Hua Zhao ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Space Perception ◽  
The Elderly ◽  
Cognitive Test ◽  
Visual Object ◽  
Neuropsychological Battery ◽  
Cross Sectional ◽  
Chinese Elderly ◽  
Cognitively Normal

ABSTRACTObjectives:To revise an abbreviated version of the Silhouettes subtest of the Visual Object and Space Perception (VOSP) battery in order to recognize mild cognitive impairment (MCI) and determine the optimal cutoffs to differentiate among cognitively normal controls (NC), MCI, and Alzheimer’s Disease (AD) in the Chinese elderly.Design:A cross-sectional validation study.Setting:Huashan Hospital, Shanghai, China.Subjects:A total of 591 participants: Individuals with MCI (n = 211), AD (n = 139) and NC (n = 241) were recruited from the Memory Clinic, Huashan Hospital, Shanghai, China.Methods:Baseline neuropsychological battery (including VOSP) scores were collected from firsthand data. An abbreviated version of silhouettes test (Silhouettes-A) was revised from the original English version more suitable for the elderly, including eight silhouettes of animals and seven silhouettes of inanimate objects, with a score ranging from 0 to 15.Results:Silhouettes-A was an effective test to screen MCI in the Chinese elderly with good sensitivity and specificity, similar to the Montreal cognitive assessment and superior to other single tests reflecting language, spatial, or executive function. However, it had no advantage in distinguishing MCI from AD. The corresponding optimal cutoff scores of Silhouettes-A were 10 for screening MCI and 8 for AD.Conclusion:Silhouettes-A is a quick, simple, sensitive, and dependable cognitive test to distinguish among NC, MCI, and AD patients.

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