Syndromes of Cognitive Dysfunction

2021 ◽  
pp. 655-661
Author(s):  
Shivram Kumar ◽  
Kelly D. Flemming
Keyword(s):  
Executive Function ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Executive Dysfunction ◽  
Memory Disorders ◽  
Mental Process ◽  
Level Of Consciousness ◽  
High Level ◽  
Confusional States ◽  
Attention Dysfunction

Cognitive function refers to the mental process of knowing things. It includes high-level cortical functions such as memory, language, perception, and executive function (planning, initiating, and reasoning) that generally depend on the alert state and focused attention. Dysfunction of cognition without a change in consciousness may result in various disorders, including aphasia, apraxia, agnosia, executive dysfunction, and memory disorders such as dementia and amnesia. Transient dysfunction of cognition associated with a change in level of consciousness or attention may be due to delirium or confusional states. This chapter broadly introduces the specific definitions of cognitive dysfunction and the overall differential diagnoses.

scholarly journals Efficacy of Different Types of Exercise on Cognitive Function in People With MCI or Dementia: A Network Meta-Analysis

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 293-293
Author(s):  
Qiaoqin Wan ◽  
Xiuxiu Huang ◽  
Xiaoyan Zhao ◽  
Bei Li ◽  
Ying Cai ◽  
...  
Keyword(s):  
Executive Function ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Meta Analysis ◽  
Memory Function ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Exercise Treatment ◽  
Different Types ◽  
Global Cognition

Abstract With the accelerating progress of population aging, cognitive dysfunction is becoming increasingly prevalent. Exercise, as a promising non-pharmaceutical therapy, showed favorable effects on cognitive function. But which type is the most effective exercise treatment is still unclear. This study compared the efficacy of different types of exercise interventions based on network meta-analysis and aimed to explore the optimal exercise treatment for cognitive decline. The electronic databases of PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials, SPORTDiscus, PsycInfoy, and OpenGrey were searched from inception to September 2019. We only included randomized controlled trials that examined the effectiveness of exercise interventions in people with MCI or dementia. Primary outcomes were global cognition, executive function and memory function. Standard mean difference (SMD) and its 95% confidence interval (CI) were calculated to estimate the effect sizes. Finally, 73 articles with 5748 participants were included. The results showed all kinds of exercise interventions were effective on global cognition and resistance exercise was probably the most effective exercise treatment to prevent the decrease of global cognition (SMD=1.05, 95%CI 0.56-1.54), executive function (SMD=0.85, 95%CI 0.21-1.49) and memory function (SMD=0.32, 95%CI 0.01-0.63) for people with cognitive dysfunction. Subgroup analysis revealed multi-component exercise showed more favorable effects on global cognition (SMD=0.99, 95%CI 0.44-1.54) and executive function (SMD=0.72, 95%CI 0.06-1.38) in people with MCI. In conclusion, resistance exercise tended to be the optimal exercise type for people with cognitive dysfunction, especially for people with dementia. And multi-component exercise also should be recommended for people with MCI.

Abstract 16628: Cognitive Dysfunction, Instrumental Activities of Daily Living, and Health-related Quality of Life in Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Miyeon Jung ◽  
Bruno Giordani ◽  
Sujuan Gao ◽  
Heather Burney ◽  
Marita G Titler ◽  
...  
Keyword(s):  
Heart Failure ◽  
Executive Function ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Daily Living ◽  
Nyha Class ◽  
Related Quality ◽  
Health Related ◽  
Global Cognition ◽  
Significant Covariates

Introduction: Cognitive dysfunction is common in heart failure (HF), but relationships are unclear among cognitive dysfunction, performance-based instrumental activities of daily living (IADL), and health-related quality life (HRQL). Objectives: Guided by HRQL and IADL theories, hypotheses were: 1) worse cognitive function in global cognition, memory, executive function is associated with worse performance in IADL; 2) worse performance in IADL is associated with worse HRQL; and 3) IADL mediates the relationship between cognitive dysfunction and HRQL. Methods: In a cross-sectional analysis, baseline data were used from a randomized controlled trial of cognitive training in HF (N=256, mean age 66; 54% women; EF 49%; NYHA Class I=9%, II=36%, III=55%). Measures were: global cognition-Montreal Cognitive Assessment; memory-Hopkins Verbal Learning Test; executive function-Category fluency; IADL-Everyday Problem Test; and HRQL-Living with Heart Failure Questionnaire. Higher scores of cognitive and IADL measures indicate better performance. Higher scores of HRQL indicate worse HRQL. Covariates were age, gender, education, NYHA, and depressive symptoms. Multiple linear regressions were used to test hypotheses. Results: Hypothesis 1 was supported. Worse cognitive function in global cognition, memory, executive function was associated with worse IADL (β=0.38~0.45, p<.001, R 2 =0.19~0.22). Age and education were significant covariates. Hypothesis 2 was supported. Worse IADL was associated with worse HRQL (β =0.79, p <.001, R 2 =0.55). Gender, NYHA Class, and depressive symptoms were significant covariates. Hypothesis 3 was not tested because cognitive function was not significantly related to HRQL. Conclusions: Cognitive dysfunction was associated with worse performance in IADL. Worse performance in IADL was associated with worse HRQL. Interventions to improve HRQL may need to target improving performances in both cognitive function and IADL.

Medial temporal lobe atrophy relates to executive dysfunction in Alzheimer's disease

2012 ◽  
Vol 24 (9) ◽  
pp. 1474-1482 ◽  
Author(s):  
Joukje M. Oosterman ◽  
Saskia Oosterveld ◽  
Marcel G. Olde Rikkert ◽  
Jurgen A. Claassen ◽  
Roy P. C. Kessels
Keyword(s):  
Alzheimer’S Disease ◽  
Executive Function ◽  
Cognitive Function ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Executive Dysfunction ◽  
Threshold Effect ◽  
Hippocampal Atrophy ◽  
Medial Temporal Lobe Atrophy ◽  
Lobe Atrophy

ABSTRACTBackground: White matter hyperintensities (WMH) have frequently been associated with lower executive function performance. Little is known, however, about the effects of hippocampal atrophy on executive control in Alzheimer's disease (AD). The present study focused on the association of hippocampal atrophy with executive function in AD patients and examined whether a threshold effect is present, indicating that a certain amount of brain damage must be present before cognitive function becomes impaired. Finally, we examined the combined effect of hippocampal atrophy and WMH on cognitive task performance.Methods: We retrospectively collected neuropsychological and neuroimaging data of 94 AD patients. These patients completed tasks of general cognitive function, executive function, memory, and processing speed. With magnetic resonance imaging (MRI), hippocampal atrophy was rated as medial temporal lobe atrophy (MTA) and cerebrovascular disease was rated as WMH using validated visual rating scales.Results: Medial temporal lobe atrophy (MTA) was associated with lower executive function, general cognitive function, and episodic memory performance. A threshold effect was present, indicating that severe to very severe, but not moderate, MTA was associated with lower executive function. WMH were significantly associated with a single executive test only, whereas the interaction between WMH and MTA was not significantly related to any of the cognitive tasks.Conclusions: Our findings suggest that AD neuropathology in itself may be responsible for executive dysfunction. Potential explanations for these findings are discussed, focusing on the role of the hippocampus in executive function tests and reduced frontal-posterior connectivity in this patient sample.

Cerebral Microbleeds are Associated with Impairments in Executive Function and Processing Speed

2021 ◽  
pp. 1-8
Author(s):  
Xuanting Li ◽  
Junliang Yuan ◽  
Wei Qin ◽  
Lei Yang ◽  
Shuna Yang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Executive Function ◽  
Cognitive Function ◽  
Processing Speed ◽  
Population Aging ◽  
Brain Magnetic Resonance Imaging ◽  
Executive Dysfunction ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Global Cognitive Function

Background: Cerebral microbleed (CMB) is an increasingly important risk factor for cognitive impairment due to population aging. Controversies, however, remain regarding the exact association between CMB and cognitive dysfunction. Objective: We aimed to determine the relationship between CMB burden and cognitive impairment, and also explore the characteristics of cognitive decline in CMB patients for middle-aged and elderly people. Methods: The present cross-sectional study included 174 participants (87 CMB patients and 87 controls) who underwent brain magnetic resonance imaging and a battery of neuropsychological test. Global cognitive function was measured using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Compound z-scores were calculated for three cognitive subdomains: memory, executive function and processing speed. Results: CMB patients had lower scores of MMSE (p <  0.001) and MoCA (p <  0.001). Patients at each category of CMB count had worse performance in global cognitive function and all three cognitive subdomains (p <  0.001). In multiple linear regression models, CMB patients had significantly greater declines in executive function (p <  0.001), processing speed (p <  0.001), and MoCA (p = 0.003) with increasing number of CMB. We found no relationship between CMB location and cognition (p <  0.05). Conclusion: CMB is associated with impairment in global cognition as well as for all tested subdomains. Strongest effect sizes were seen for tests which rely on executive functioning, where performance deficits increased in proportion to degree of CMB burden. Prospective studies are needed to evaluate whether the association between CMB and executive dysfunction is causal.

Cognitive Syndrome(s) in Preclinical and Clinical Vascular Dementia

2003 ◽  
Vol 15 (S1) ◽  
pp. 127-131 ◽  
Author(s):  
Ove Almkvist
Keyword(s):  
Executive Function ◽  
Cognitive Function ◽  
Executive Functions ◽  
Cognitive Decline ◽  
Vascular Dementia ◽  
Cognitive Dysfunction ◽  
Stroke Survivors ◽  
Clinical Stages

It is still a challenge to identify typical features of cognitive function in vascular dementia (VaD) in clinical as well as in preclinical stages. Selective empirical findings are described to illuminate degrees of cognitive decline. In predementia stages, speeded performance (motor and mental) and executive functions may be affected as demonstrated by CADASIL subjects and stroke survivors. In dementia stages, motor and mental speed as well as executive functions is commonly affected in addition to typical cognitive dysfunction in dementia (memory, verbal, and visuospatial). To summarize characteristics during preclinical and clinical stages, VaD appears to be associated with impairment in motor and mental speed as well as in executive function.

Abstract 53: Frontal Functional Connectivity Networks and Executive Function Following Perinatal Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Suraya Meghji ◽  
Alicia Hilderley ◽  
Adam Kirton ◽  
Helen Carlson
Keyword(s):  
Executive Function ◽  
Cognitive Function ◽  
Functional Connectivity ◽  
Resting State ◽  
Developmental Plasticity ◽  
Rating Scale ◽  
Executive Dysfunction ◽  
Mri Imaging ◽  
Arterial Ischemic Stroke ◽  
Perinatal Stroke

Perinatal stroke causes most hemiparetic cerebral palsy and a lifetime of disability with no known prevention strategies. Two types of perinatal stroke predominate, arterial ischemic stroke (AIS) and periventricular venous infarction (PVI), dictating lesion-specific differences in outcomes. Executive functioning challenges and attention deficit hyperactivity disorder (ADHD) are more common in children with perinatal stroke (19-35%) than peers (5-7%). Resting state (RS) functional magnetic resonance imaging (fMRI) measures fluctuations in the blood-oxygen level dependent (BOLD) signal that may estimate network functional connectivity (FC). We evaluated relationships between FC in relevant frontal circuits, ADHD and executive function in children with perinatal stroke compared to typically developing controls (TDC). Participant recruitment was from a population-based research cohort (AIS N=32; PVI N=30; TDC N=59). MRI imaging included T1-weighted anatomical and resting state fMRI sequences. Subsequent seed-to-seed analyses quantified FC within frontoparietal (FPN), dorsal attention (DAN) and default mode networks (DMN). Parent questionnaires quantified executive function (Behavior Rating Inventory of Executive Function (BRIEF)) and ADHD symptoms (ADHD Rating Scale-5). Large group FC differences were observed within FPN, DAN and DMN networks where AIS had lower FC compared to both PVI and TDC. For stroke participants, higher FC within the DAN and FPN was associated with poorer cognitive function (BRIEF). By contrast, higher FC within the DMN was associated with better ADHD ratings. Differences within frontal functional networks appear to be related to poorer cognitive function such that increased FC between the lesioned and nonlesioned hemisphere is associated with symptoms of executive dysfunction and ADHD suggesting that developmental plasticity leads to complex network changes following early unilateral brain injury.

Testing Cognitive Function at the Bedside

2017 ◽  
Author(s):  
John R. Hodges
Keyword(s):  
Executive Function ◽  
Cognitive Function ◽  
Semantic Memory ◽  
Cognitive Dysfunction ◽  
Response Inhibition ◽  
Cognitive Functions ◽  
Verbal Fluency ◽  
Right Hemisphere ◽  
Spoken Language ◽  
Set Shifting

This chapter explores the second component of assessment in patients with suspected cognitive dysfunction: testing cognitive function at the bedside. The first part of the examination should assess distributed cognitive functions, notably orientation and attention, episodic and semantic memory, and frontal executive function (initiation in the form of verbal fluency, abstraction, response inhibition, and set shifting); deficits in these indicate damage to particular brain systems, but not to focal areas of one hemisphere. The second part of the assessment deals with localized functions, divided into those associated with the dominant (i.e. the left side, in right-handers) and non-dominant hemispheres. The former relates largely to tests of spoken language with supplementary tests of reading, writing, calculation, and praxis when applicable. Testing right hemisphere function focuses on neglect (personal and extrapersonal), visuospatial and constructional abilities, and the agnosias including object and face agnosia.

Abstract 248: Baseline Cognitive Impairment a Predictor of Mortality in Cardiovascular Disease

2012 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
Antonio D Lassaletta ◽  
Frank W Sellke ◽  
Ronald A Cohen
Keyword(s):  
Cardiovascular Disease ◽  
Executive Function ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Independent Living ◽  
Cognitive Domains ◽  
The Relationship

Objective: Few longitudinal studies have examined outcomes of patients with cardiovascular disease (CVD) in relation to earlier, baseline cognitive function, or examined the relationship between specific cognitive domains and mortality. This study attempted to clarify the relationship between cognitive function and long-term outcomes, particularly mortality, in patients with cardiovascular disease. Methods: One hundred seventy seven participants between 55 and 85 years of age with an established history CVD were recruited from healthcare institutions. A comprehensive neurophysiological test battery was administered to all patients at baseline assessing 4 cognitive domains: language, visual-spatial, memory, and attention-executive function. Composite scores were calculated by averaging z-scores of all component measures. At 6-year the follow-up, of the 136 patients who were still enrolled, the 116 who were still alive were contacted by phone for assessment of level of independent living, and subjective assessment of cognitive function, and quality of life.Results were corrected for age. Results: At follow-up, participants who were deceased had significantly lower baseline attention-executive function (M=-0.51, SD=0.78 vs. M=0.06, SD=0.54 in survivors, p < 0.01). Poorer memory performance at baseline was associated with a greater degree of cognitive dysfunction at follow-up (p = 0.085). No significant relationships were found between baseline cognitive performance and independent living status or quality of life. Conclusion: Impaired executive function was predictive of poorer outcomes, specifically, 6-year mortality. This finding reinforces the frontal nature of vascular cognitive impairments, especially in regard to the long term sequelae of cognitive dysfunction in patients with CVD. The higher mortality observed in patients with baseline executive domain impairment may be due to behaviors such as impaired self-care, treatment adherence and rehab participation or functional impairments that exacerbate health problems, resulting in death. Patients with cardiovascular disease and executive function impairment should be identified and measures taken to address these potential problems.

scholarly journals DOMAINS OF AWARENESS WITH COMPLEX JUDGEMENTS ARE ASSOCIATED TO EXECUTIVE FUNCTION IN ALZHEIMER’ DISEASE

2021 ◽  
Author(s):  
Isabel Lacerda ◽  
Raquel Santos ◽  
Tatiana Belfort ◽  
José Neto ◽  
Marcia Dourado
Keyword(s):  
Executive Function ◽  
Cognitive Function ◽  
Alzheimer Disease ◽  
Emotional State ◽  
Neuropsychiatric Symptoms ◽  
Primary Caregivers ◽  
Executive Dysfunction ◽  
Health Condition ◽  
Multidimensional Construct ◽  
Global Cognitive Function

Background: Awareness is a multidimensional construct and there is a lack of research investigating the association between awareness domains and other deficits than cognition. Objective: Our aim is to investigate the influence of executive dysfunction in awareness domains. Methods: 75 people with mild-to-moderate AD completed assessments about global cognitive function, executive functioning, and their awareness of disease. Their primary caregivers’ dyad provided information about demographics, awareness of disease, dementia severity, neuropsychiatric symptoms, and functional status. Results: Executive dysfunction was predictor for more complex domains of awareness: awareness of disease, of emotional state and of social functioning and relationships. Awareness of cognitive functioning and health condition and of functional activity impairments exhibit only global cognitive function as a predictor. Conclusions: Findings confirm some degree of independence between awareness domains and identify the more complexity of some domains beside others. These results suggest that different interventions are necessary in domains of awareness.

Arterial Stiffness, Cognitive Dysfunction and Adherence to Antihypertensive Agents. Is there a Link to Hypertensive Patients?

2020 ◽  
Vol 18 (4) ◽  
pp. 410-417 ◽  
Author(s):  
Rigas G. Kalaitzidis ◽  
Thalia Panagiotopoulou ◽  
Dimitrios Stagikas ◽  
Kosmas Pappas ◽  
Olga Balafa ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Arterial Stiffness ◽  
Cognitive Dysfunction ◽  
Antihypertensive Drugs ◽  
Patient Adherence ◽  
Antihypertensive Agents ◽  
Treatment Compliance ◽  
Poor Adherence ◽  
Large Artery ◽  
Adherence To Medication

:The incidence of hypertension (HTN) and its cardiovascular (CV) complications are increasing throughout the world. Blood pressure (BP) control remains unsatisfactory worldwide. Medical inertia and poor adherence to treatment are among the factors that can partially explain, why BP control rate remains low. The introduction of a method for measuring the degree of adherence to a given medication is now a prerequisite. Complex treatment regimes, inadequate tolerance and frequent replacements of pharmaceutical formulations are the most common causes of poor adherence. In contrast, the use of stable combinations of antihypertensive drugs leads to improved patient adherence.:We aim to review the relationships between arterial stiffness, cognitive function and adherence to medication in patients with HTN.:Large artery stiffening can lead to HTN. In turn, arterial stiffness induced by HTN is associated with an increased CV and stroke risk. In addition, HTN can induce disorders of brain microcirculation resulting in cognitive dysfunction. Interestingly, memory cognitive dysfunction leads to a reduced adherence to drug treatment. Compliance with antihypertensive treatment improves BP control and arterial stiffness indices. Early treatment of arterial stiffness is strongly recommended for enhanced cognitive function and increased adherence.

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