scholarly journals Sensory Impairment and Algorithmic Classification of Early Cognitive Impairment in Middle-Aged and Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 438-438
Author(s):  
Yuri Agrawal ◽  
Jennifer Schrack ◽  
Alden Gross ◽  
Nicole Armstrong ◽  
Eleanor Simonsick ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Verbal Learning ◽  
Vision Impairment ◽  
Sensory Function ◽  
California Verbal Learning Test ◽  
Sensory Impairment ◽  
Immediate Recall ◽  
Sensory Impairments ◽  
Cox Proportional Hazard Models ◽  
Learning Test

Abstract Sensory function has been linked to cognitive impairment and dementia, but the link between multiple sensory impairments and early cognitive impairment (ECI) is unclear. Sensory function (vision, hearing, vestibular, proprioception, and olfaction) was measured in 390 BLSA participants (age=75±8 years; 57% women; 69% white) from 2012 to 2018 over a mean 3.6 years. ECI was defined based on 1 standard deviation below age-and race-specific means in Card Rotations or California Verbal Learning Test immediate recall. Cox proportional hazard models examined the risk of ECI for each sensory impairment and across categories of impairments. Vision impairment (vs. no vision impairment) was associated with a 70% greater risk of ECI (HR=1.70, p=0.05). Participants with 1 or ≥2 sensory impairments had triple the risk of ECI (HR=3.74 and 3.44, p=0.008 and 0.02, respectively) compared to those without impairment. Future studies are needed to examine whether treatment for sensory impairments can modify these risks.

scholarly journals Derivation and Validation of an Algorithmic Classification of Early Cognitive Impairment

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 438-438
Author(s):  
Yang An ◽  
Frank Lin ◽  
Luigi Ferrucci ◽  
Jennifer Schrack ◽  
Yuri Agrawal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Longitudinal Data ◽  
Verbal Learning ◽  
California Verbal Learning Test ◽  
Prior Work ◽  
Immediate Recall ◽  
Learning Test ◽  
Dementia Onset

Abstract The long prodromal period for dementia pathology demands valid and reliable approaches to detect cases before clinically recognizable symptoms emerge, by which time it may be too late to effectively intervene. We derived and compared several algorithms for early cognitive impairment (ECI) using longitudinal data on 1704 BLSA participants. Algorithms were based on cognitive impairment in various combinations of memory and non-memory tests, and the CDR. The best-performing algorithm was defined based on 1SD below age-and race-specific means in Card Rotations or California Verbal Learning Test immediate recall, two tests that in prior work show the earliest declines prior to dementia onset. While this ECI algorithm showed low concordance with concurrent adjudicated MCI/dementia (AUC: 0.63, sensitivity: 0.54, specificity: 0.73), it was among the best predictors of progression to MCI/dementia (HR: 3.65, 95% CI: 1.69,7.87). This algorithm may be useful in epidemiologic work to evaluate risk factors for early cognitive impairment.

Memantine for cognitive impairment in multiple sclerosis: a randomized placebo-controlled trial

2010 ◽  
Vol 16 (6) ◽  
pp. 715-723 ◽  
Author(s):  
JF Lovera ◽  
E. Frohman ◽  
TR Brown ◽  
D. Bandari ◽  
L. Nguyen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Free Recall ◽  
Controlled Trial ◽  
Neuropsychiatric Symptoms ◽  
Verbal Learning ◽  
Self Report ◽  
California Verbal Learning Test ◽  
Cognitive Improvement ◽  
Learning Test

Background: Memantine, an NMDA antagonist, is effective for moderate to severe Alzheimer’s disease. Objective: Determine whether memantine improves cognitive performance (CP) among subjects with multiple sclerosis (MS) and cognitive impairment (CI). Methods: This double-blind, randomized, placebo-controlled trial (Clinicaltrials.gov NCT00300716) compared memantine 10 mg twice a day (4 week titration followed by 12 weeks on the highest tolerated dose) with placebo. The primary outcome was the change from baseline to exit on the Paced Auditory Serial Addition Test (PASAT) and the California Verbal Learning Test-II (CVLT-II) Long Delay Free Recall (LDFR). Secondary outcomes included additional neuropsychological tests; self-report measures of quality of life, fatigue, and depression; and family/caregiver reports of subjects’ CI and neuropsychiatric symptoms. Results: The differences between the groups on the change on the PASAT (placebo—memantine = 0.0 correct responses, 95% CI 3.4, 3.4; p = 0.9) and on CVLT-II LDFR (placebo—memantine =—0.6 words, 95% CI —2.1, 0.8; p = 0.4) as well as on the other cognitive tests were not significant. Subjects on memantine had no serious adverse events (AEs) but had more fatigue and neurological AEs as well as, per family members’ reports, less cognitive improvement and greater neuropsychiatric symptoms than subjects on placebo. Conclusion: Memantine 10 mg twice a day does not improve CP in subjects with MS, ages 18—65, without major depression, who have subjective cognitive complaints and perform worse than one SD below the mean on the PASAT or on the California Verbal Learning Test-II (total recall or delayed free recall).

White Matter Changes and Cognitive Decline in a Ten-Year Follow-Up Period: A Pilot Study on a Single-Center Cohort from the Leukoaraiosis and Disability Study

2016 ◽  
Vol 41 (5-6) ◽  
pp. 303-313
Author(s):  
Sofia Madureira ◽  
Ana Verdelho ◽  
Carla Moleiro ◽  
Catarina Santos ◽  
Philip Scheltens ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
Verbal Learning ◽  
White Matter Lesions ◽  
Disease Assessment ◽  
California Verbal Learning Test ◽  
Clinical Diagnoses ◽  
Neuropsychological Predictors ◽  
Learning Test

Aims: To describe the contribution of white matter lesions to the long-term neuropsychological profiles of different groups of clinical diagnoses, and to identify neuropsychological predictors of cognitive impairment in a 10-year follow-up. Methods: The Lisbon subcohort of the Leukoaraiosis and Disability (LADIS) study was re-evaluated performing a clinical, functional and cognitive evaluation [including Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale - Cognition (ADAS-Cog) and ADAS-Cog with the extension for vascular impairment (VADAS-Cog), the 9-word version of the California Verbal Learning Test (CVLT-9), the Trail-Making test and the Stroop test] as well as an MRI scan. Using clinical diagnostic criteria, participants were identified as having no cognitive impairment (NI), cognitive impairment but no dementia (CIND) or dementia (DEM), and the effect of time on clinical diagnosis and neuropsychological profiles was analyzed. Results: From the initial group of 66 participants, 37 out of 41 survivors (90%) were re-evaluated (mean age 81.40 years, 57% women). Fifteen patients (41%) had DEM, 12 (32%) CIND and 10 (27%) NI. Over time, the three groups presented distinct profiles in the MMSE [F2, 62 = 15.85, p = 0.000], ADAS [F2, 62 = 15.85, p = 0.000] and VADAS [F2, 48 = 5.87, p = 0.008]. Logistic regression analysis identified higher scores on MMSE (β = 1.14, p = 0.03, OR = 3.13, 95% CI 1.09-8.97) as predictors of NI after 10 years of follow-up. Conclusion: Higher scores on baseline MMSE were the only neuropsychological predictors of NI after 10 years.

scholarly journals The correlation between EDSS and cognitive impairment in MS patients. Assessment of a Brazilian population using a BICAMS version

2016 ◽  
Vol 74 (12) ◽  
pp. 974-981 ◽  
Author(s):  
Marco A. G. de Caneda ◽  
Maria Cecília A. de Vecino
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Neuropsychological Tests ◽  
Verbal Learning ◽  
Therapeutic Interventions ◽  
California Verbal Learning Test ◽  
Cognitive Evaluation ◽  
Disability Status ◽  
Learning Test

ABSTRACT Multiple sclerosis (MS) may present with a cognitive impairment as disabling as the physical disabilities. Therefore, routine cognitive evaluation is pivotal. Valid and reliable neuropsychological tests are essential in follow-up and to define future therapeutic interventions. Objectives To investigate the correlation between the disabilities of MS patients and their cognitive impairment assessed by the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS). Methods Forty patients with definitive diagnoses of MS were selected. The correlation coefficient (r) between the Expanded Disability Status Scale (EDSS) and the neuropsychological tests of BICAMS were calculated. Results The correlation was clinically substantial and significant with r = 0.55 (p < 0.01) in the Symbol Digit Modalities Test (SDMT), 0.54 (p < 0.01) in the Brief Visuospacial Memory Test (BVMT) and 0.40 (p < 0.05) in the California Verbal Learning Test (CVLT). Conclusion BICAMS has easy and satisfactory application and evaluation for routine visits and presents a significant correlation with the EDSS. Its use may be indicated for screening and monitoring of cognitive impairment in patients with MS.

Assessment of Alcohol-related Memory Deficits: A Comparison between the Rivermead Behavioural Memory Test and the California Verbal Learning Test

2014 ◽  
Vol 15 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Arie J. Wester ◽  
Renée L. Roelofs ◽  
Jos I.M. Egger ◽  
Roy P.C. Kessels
Keyword(s):  
Cognitive Impairment ◽  
Memory Performance ◽  
Verbal Learning ◽  
Cognitive Disorders ◽  
Memory Test ◽  
Cued Recall ◽  
California Verbal Learning Test ◽  
Everyday Memory ◽  
Rivermead Behavioural Memory Test ◽  
Learning Test

Objectives: Neuropsychological assessment of memory disorders is an important prerequisite in the treatment of patients with alcohol-related cognitive disorders. Although many memory tests are available in clinical practice, a question remains regarding which test is most appropriate for this purpose. Our study's goal was to evaluate the discriminative power of indices of a standard memory test (the California Verbal Learning Test; CVLT) versus the subtests of an ecologically valid everyday memory test (the Rivermead Behavioural Memory Test; RBMT) in patients with alcohol-use disorder.Method: The patients included 136 with Korsakoff's syndrome (KS), 73 alcoholics with cognitive impairment (CI) not fulfilling the criteria for KS, and 24 cognitively unimpaired alcoholics (ALC).Results: KS patients performed significantly lower on all RBMT and CVLT variables than CI patients. ALC patients performed significantly better than CI patients on only one RBMT subtest, and had a significantly lower rate of forgetting and higher scores on free recall on CVLT. A combination of RBMT subtests and CVLT indices was able to discriminate KS patients from CI and ALC patients. The RBMT subtests could not significantly distinguish ALC from CI patients. Both rate of forgetting and a comparison between free and cued recall testing on the CVLT showed the largest between-group differences.Conclusion: Although the RBMT provides information about everyday memory performance, the CVLT indices are better able to distinguish between uncomplicated alcoholics and those with cognitive impairment or KS.

scholarly journals Differentiating Functional Cognitive Disorder from Early Neurodegeneration: A Clinic-Based Study

2021 ◽  
Vol 11 (6) ◽  
pp. 800
Author(s):  
Harriet A. Ball ◽  
Marta Swirski ◽  
Margaret Newson ◽  
Elizabeth J. Coulthard ◽  
Catherine M. Pennington
Keyword(s):  
Cognitive Abilities ◽  
Minnesota Multiphasic Personality Inventory ◽  
Verbal Learning ◽  
Cognitive Disorder ◽  
Control Group ◽  
Performance Validity ◽  
Immediate Recall ◽  
Trail Making ◽  
Learning Test ◽  
Validity Tests

Functional cognitive disorder (FCD) is a relatively common cause of cognitive symptoms, characterised by inconsistency between symptoms and observed or self-reported cognitive functioning. We aimed to improve the clinical characterisation of FCD, in particular its differentiation from early neurodegeneration. Two patient cohorts were recruited from a UK-based tertiary cognitive clinic, diagnosed following clinical assessment, investigation and expert multidisciplinary team review: FCD, (n = 21), and neurodegenerative Mild Cognitive Impairment (nMCI, n = 17). We separately recruited a healthy control group (n = 25). All participants completed an assessment battery including: Hopkins Verbal Learning Test-Revised (HVLT-R), Trail Making Test Part B (TMT-B); Depression Anxiety and Stress Scale (DASS) and Minnesota Multiphasic Personality Inventory (MMPI-2RF). In comparison to healthy controls, the FCD and nMCI groups were equally impaired on trail making, immediate recall, and recognition tasks; had equally elevated mood symptoms; showed similar aberration on a range of personality measures; and had similar difficulties on inbuilt performance validity tests. However, participants with FCD performed significantly better than nMCI on HVLT-R delayed free recall and retention (regression coefficient −10.34, p = 0.01). Mood, personality and certain cognitive abilities were similarly altered across nMCI and FCD groups. However, those with FCD displayed spared delayed recall and retention, in comparison to impaired immediate recall and recognition. This pattern, which is distinct from that seen in prodromal neurodegeneration, is a marker of internal inconsistency. Differentiating FCD from nMCI is challenging, and the identification of positive neuropsychometric features of FCD is an important contribution to this emerging area of cognitive neurology.

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