scholarly journals A-73 Neurocognitive Profiles in Patients Following Covid-19 Infection

2021 ◽  
Vol 36 (6) ◽  
pp. 1115-1115
Author(s):  
Kamini Krishnan ◽  
Ashley K Miller ◽  
Aaron Bonner Jackson

Abstract Objective Little is known about neurocognitive function in patients with persisting cognitive complaints following Covid-19 infection. Initial studies, utilizing cognitive screening measures or case reports, suggest presence of deficits in attention and executive function. This study investigated cognitive functioning among individuals with Covid-19 infection. Methods The sample included 20 individuals referred to an outpatient Covid-19 recovery clinic at the Cleveland Clinic. At the time of Covid-19 diagnosis, 45% required hospitalization, 15% were in an intensive care unit, 10% needed mechanical ventilation, and 10% had delirium. Patients underwent neuropsychological evaluation on average 157 days after a Covid-19 positive PCR test. Results This sample (n = 20) was predominately female (85%), White non-Hispanic (70%), with a mean education of 15 years. For the majority of patients, neurocognitive test results were interpreted as within expectation compared to normative samples. Cognitive deficits, when present, were largely seen on isolated tests involving attention or executive function. Seventy percent of patients were treated for a mood disorder prior to Covid-19. At the time of testing, 45% of the sample endorsed moderate to severe symptoms of depression and/or anxiety and 92% noted significant fatigue as measured by the Fatigue Severity Scale. Conclusions Cognitive deficits, when observed, are consistent with prior research. These findings suggest that in patients with similar presentations, psychological implications of Covid-19 and other persisting symptoms (e.g., fatigue) may play a significant role in subjective cognitive complaints. These patients would likely benefit from resources to manage persisting or new mood symptoms and compensatory strategies for cognitive inefficiencies they experience.

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A15-A15
Author(s):  
Andrea Ricciardiello ◽  
Sharon Naismith ◽  
Angela D’Rozario ◽  
Fiona Kumfor ◽  
Rick Wassing

Abstract Introduction Late-life depression is the most common psychiatric disorder in older adults and is associated with cognitive deficits, however, the role of sleep disturbance in cognitive deficits is poorly defined. In the current study we aimed to examine sleep macro and micro-architecture differences between those with late-life depression and controls. Secondly, we sought to determine how sleep changes relate to clinical memory and executive function measures in those with late-life depression and controls. Methods Using prior clinical data, this retrospective study assessed adults >50 years who had completed an overnight PSG study and comprehensive psychiatric, neuropsychological, and medical assessment. Memory performance was measured using the Weschler Memory Scale logical Memory 1 and 2 components, Rey Auditory Verbal Learning Test (Senior) 30-minute recall and Rey Complex Figure 3-minute recall. Executive function was defined by z scores from Trail Making Test, D-KEFS Stroop Test and Controlled Oral Word Association Test. The sample comprised of 71 depressed participants, defined by a Geriatric Depression Scale score ≥6, and 101 non-depressed participants (GDS <6 and no lifetime history of depression using DSM-IV criteria). Results Contrary to our hypothesis no significant macroarchitectural differences were observed between the groups. Less time spent in slow-wave sleep (SWS) was associated with worse delayed memory recall scores in the depression group (z=.342, p=0.008) although this was not seen in the control group. SWS and slow wave activity (SWA) were not related to measures of executive function performance. Depressed participants demonstrated a reduced level of sleep spindles (Dep= 159 ±142.8, con= 213±163, p=.03) although there were no associations with memory outcomes. Conclusion Compared to younger adults with depression, macroarchitectural differences in those with late-life depression are not as pronounced, due to a reduction of SWS and SWA power as a function of ageing. The efficiency of SWS hippocampal dependent memory processes in depression may be reduced, therefore, more time spent in SWS is related to better memory performance. This study assessed the density of sleep spindles but not spindle and slow wave oscillation coupling which may be more important for hippocampal dependent memory. Support (if any):


Author(s):  
Nadja Cristina Furtado Back ◽  
Ana Chrystina de Souza Crippa ◽  
Tatiana Izabelle Jaworski de Sá Riechi ◽  
Liliane Desgualdo Pereira

Abstract Introduction Nowadays, there is no consensus on whether central auditory processing disorder is a primary or a secondary deficit to other cognitive deficits. A better understanding of the association between cognitive functions and central auditory skills may help elucidate this dilemma. Objective To investigate possible associations between auditory abilities and cognitive functions in schoolchildren. Methods Fifty-eight schoolchildren, aged between 8 years and 0 months old and 11 years and 11 months old, who underwent the following tests: masking level difference, gaps in noise, pitch pattern sequence test, dichotic digits test, sustained auditory attention ability test, Wechsler intelligence scale for children – IV, junior Hayling test, five digits test, and behavior rating inventory of executive function. Results Significant correlations were found between the hearing ability of temporal resolution and executive functions, temporal ordering/sequencing, binaural integration and separation, and sustained auditory attention, operational memory, inhibitory control, and cognitive flexibility; binaural integration was also associated with intelligence. The statistically significant positive correlation found between the ability of binaural interaction and the components of emotional control and behavior regulation of the behavior rating inventory of executive function was unexpected. Conclusion The associations identified reinforce the complexity of the tasks involved in the evaluation of central auditory processing and the need for multidisciplinary evaluation for the differential diagnosis of auditory processing disorder. Confirmation of the presence or absence of comorbidities between different disorders allows directing the therapeutic behaviors and reducing the impact of possible auditory and/or cognitive deficits in the different daily life situations of children.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Emily J. Henderson ◽  
Howard Chu ◽  
Daisy M. Gaunt ◽  
Alan L. Whone ◽  
Yoav Ben-Shlomo ◽  
...  

Background.MoCA is widely used in Parkinson’s disease (PD) to assess cognition. The Test Your Memory (TYM) test is a cognitive screening tool that is self-administered.Objectives.We sought to determine (a) the optimal value of TYM to discriminate between PD patients with and without cognitive deficits on MoCA testing, (b) equivalent MoCA and TYM scores, and (c) interrater reliability in TYM testing.Methods.We assessed the discriminant ability of TYM and the equivalence between TYM and MoCA scores and measured the interrater reliability between three raters.Results.Of the 135 subjects that completed both tests, 55% had cognitive impairment according to MoCA. A MoCA score of 25 was equivalent to a TYM score of 43-44. The area under the receiver operator characteristic (ROC) curve for TYM to differentiate between PD-normal and PD-cognitive impairment was 0.82 (95% CI 0.75 to 0.89). The optimal cutoff to distinguish PD-cognitive impairment from PD-normal was ≤45 (sensitivity 90.5%, specificity 59%) thereby correctly classifying 76.3% of patients with PD-cognitive impairment. Interrater agreement was high (0.97) and TYM was completed in under 7 minutes (interquartile range 5.33 to 8.52 minutes).Conclusions.The TYM test is a useful and less resource intensive screening test for cognitive deficits in PD.


2016 ◽  
Vol 8 (3) ◽  
pp. 11
Author(s):  
Fereshteh Heydari ◽  
Shohreh Farahani

<p>This study was conducted to compare with the executive function of ADHD versus normal male and female children. To obtain this objective, 30 ADHD children referring a private psychological center for the first time who had taken no medication for this disorder, and 30 normal children from one of the schools of District 14 in Tehran were selected randomly who were of the same age and gender of ADHD children. Wisconsin test was used as a measurement tool. Results showed that there is a significant difference between the average scores of the executive function of normal and ADHD children as well as average scores of the executive function of normal boys and ADHD children at the 0.01 level. In addition, there was a significant difference between the average scores of the executive function of normal girls and ADHD girls at the 0.05 level according to which null hypothesis is rejected. Therefore, ADHD children are of lower executive and cognitive function compared to normal children and have extensive cognitive deficits. Therefore, they require medications along with special training and rehabilitation.</p>


2013 ◽  
Vol 14 ◽  
pp. e131-e132
Author(s):  
M. Fortin ◽  
K. Gagnon ◽  
A. Baril ◽  
C. D’Aragon ◽  
J. Gagnon ◽  
...  

Author(s):  
R.-Y. Chao ◽  
T.-F. Chen ◽  
Y.-L. Chang

Background: Although evidence suggests that subjective memory complaints (SMCs) could be a risk factor for dementia, the relationship between SMCs and objective memory performance remains controversial. Old adults with or without mild cognitive impairment (MCI) may represent a highly heterogeneous group, based partly on the demonstrated variability in the level of executive function among those individuals. It is reasonable to speculate that the accuracy of the memory-monitoring ability could be affected by the level of executive function in old adults. Objective: This study investigated the effects of executive function level on the consistency between SMCs and objective memory performance while simultaneously considering demographic and clinical variables in nondemented older adults. Setting: Participants were recruited from both the memory clinics and local communities. Participants: Participants comprised 65 cognitively normal (CN) older adults and 54 patients with MCI. Measurements: Discrepancy scores between subjective memory evaluation and objective memory performance were calculated to determine the degree and directionality of the concordance between subjective and objective measures. Demographic, emotional, genetic, and clinical information as well as several executive function measurements were collected. Results: The CN and MCI groups exhibited similar degrees of SMC; however, the patients with MCI were more likely to overestimate their objective memory ability, whereas the CN adults were more likely to underestimate their objective memory ability. The results also revealed that symptoms of depression, group membership, and the executive function level together predicted the discrepancy between the subjective and objective measures of memory function; however, the executive function level retained its unique predictive ability even after the symptoms of depression, group membership, and other factors were controlled for. Conclusion: Although both noncognitive and cognitive factors were necessary for consideration, the level of executive function may play a unique role in understanding the equivocal relationship of the concurrence between subjective complaints and objective function measures. Through a comprehensive evaluation, high-risk individuals (i.e., CN individuals heightened self-awareness of memory changes) may possibly be identified or provided with the necessary intervention during stages at which objective cognitive impairment remains clinically unapparent.


Author(s):  
A. Koyanagi ◽  
B. Stubbs ◽  
E. Lara ◽  
N. Veronese ◽  
D. Vancampfort ◽  
...  

Abstract Aims Cognitive deficits are an important factor in the pathogenesis of psychosis. Subjective cognitive complaints (SCCs) are often considered to be a precursor of objective cognitive deficits, but there are no studies specifically on SCC and psychotic experiences (PE). Thus, we assessed the association between SCC and PE using data from 48 low- and middle-income countries. Methods Community-based cross-sectional data of the World Health Survey were analysed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 to 10 with higher scores representing more severe SCC. The Composite International Diagnostic Interview was used to identify past 12-month PE. Multivariable logistic regression and mediation analyses were performed. Results The final sample consisted of 224 842 adults aged ⩾18 years [mean (SD) age 38.3 (16.0) years; 49.3% males]. After adjustment for sociodemographic factors, a one-unit increase in the SCC scale was associated with a 1.17 (95% CI 1.16–1.18) times higher odds for PE in the overall sample, with this association being more pronounced in younger individuals: age 18–44 years OR = 1.19 (95% CI 1.17–1.20); 45–64 years OR = 1.15 (95% CI 1.12–1.17); ⩾65 years OR = 1.14 (95% CI 1.09–1.19). Collectively, other mental health conditions (perceived stress, depression, anxiety, sleep problems) explained 43.4% of this association, and chronic physical conditions partially explained the association but to a lesser extent (11.8%). Conclusions SCC were associated with PE. Future longitudinal studies are needed to understand temporal associations and causal inferences, while the utility of SCC as a risk marker for psychosis especially for young adults should be scrutinised.


Author(s):  
Kim Charest ◽  
Alexandra Tremblay ◽  
Roxane Langlois ◽  
Élaine Roger ◽  
Pierre Duquette ◽  
...  

ABSTRACT:Background:Although cognitive deficits are frequent in multiple sclerosis (MS), screening for them with tools such as the Montreal Cognitive Assessment (MoCA) test is usually not performed unless there is a subjective complaint. The Multiple Sclerosis Neuropsychological Questionnaire (MSNQ) is among the instruments most commonly used to assess self-reported subjective complaints in MS. Nonetheless, it does not always accurately reflect cognitive status; many patients with cognitive deficits thus fail to receive appropriate referral for detailed neuropsychological evaluation. The objective of this study was to examine the validity of the MoCA test to detect the presence of objective cognitive deficits among patients with MS without subjective complaints using the Minimal Assessment of Cognitive Function in MS (MACFIMS) as the gold standard.Methods:The sample included 98 patients who were recruited from a university hospital MS clinic. The MSNQ was used to select patients without subjective cognitive complaints who also completed the MACFIMS, MoCA test and MSQOL-54.Results:23.5% of patients without subjective cognitive complaints had evidence of objective cognitive impairment on the MACFIMS (z score < -1.5 on two or more tests). The MoCA had a sensitivity of 87% and a specificity of 68% for detecting objective cognitive impairment in this patient population using a cut-off score of 27.Conclusion:A significant proportion of patients without self-reported cognitive impairment do have evidence of cognitive deficits on more exhaustive cognitive assessment. The MoCA is a rapid screening test that could be used to target patients for whom a more detailed neuropsychological assessment would be recommended.


2020 ◽  
Vol 40 (3) ◽  
pp. 183-189
Author(s):  
Orit Lahav ◽  
Noomi Katz

Participation in Instrumental Activities of Daily Living (IADL) is essential in occupational therapy aiming to improve the life situation of elderly. Effective executive function (EF) is important to successful functioning in IADL. The purpose of this study was to examine EF and IADL performance differences according to cognitive levels as measured by the Montreal Cognitive Assessment (MoCA), age, and gender. In all, 80 elderly (49% female; age M = 73.4) were assessed at home, with Weekly Calendar Planning Activity (WCPA-10), IADL scale, and MoCA as a cognitive screening tool for dividing into normal cognitive (NC) level and mild cognitive impairment (MCI). The comparison between the MoCA groups on the WCPA-10 and IADL shows significant differences between the groups; gender and age differed only in IADL. IADL and WCPA-10 performance among independent elderly relates to their cognitive level. We suggest that intervention that will focus on EF may assist in improving performance and maintaining participation in occupation.


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