Reliable change in neuropsychological test scores is associated with brain atrophy in older adults

2020 ◽  
Author(s):  
Shayne S.‐H. Lin ◽  
Evan Fletcher ◽  
Brandon E. Gavett ◽  
Keyword(s):  
Older Adults ◽  
Test Scores ◽  
Brain Atrophy ◽  
Neuropsychological Test ◽  
Reliable Change

Associations between Benzodiazepine Use and Neuropsychological Test Scores in Older Adults

2015 ◽  
Vol 34 (2) ◽  
pp. 207-214 ◽  
Author(s):  
Edward Helmes ◽  
Truls Østbye
Keyword(s):  
Older Adults ◽  
Test Scores ◽  
Neuropsychological Test ◽  
Benzodiazepine Use

RÉSUMÉLes benzodiazépines sont largement prescrits pour l'anxiété, bien que l'utilisation de cette classe de médicaments fût associée à la dépendance et les changements cognitifs. Cet article décrit une étude dans laquelle j'ai examiné la relation entre une* classe des benzodiazépines disponibles pour l'utilisation et le rendement lié aux tests neuro-psychologiques dans un échantillon de communauté de 1 754 Canadiens âgés de l'Etude canadienne sur la santé et le vieillissement. Les benzodiazépines ont été classés comme ayant une action de courte durée, intermédiare ou longue. À l'aide d'une analyse de régression multiple, et tenant compte de variables démographiques, les associations ont été calculées entre chaque catégorie de benzodiazépine et huit mesures neuro-psychologiques. Les résultats ont révélé des effets différents au sein des classes des trois médicaments; les benzodiazépines avec une courte demi-vie n'etaient associées à aucune mesure neuro-psychologique. Chacune des benzodiazépines à demi-vie intermédiare et à longue demi-vie ont été associée à deux mesures. Afin d'améliorer notre compréhension de la façon dont l'utilisation des benzodiazépines influence la cognition, une concentration accrue sur des domaines spécifiques de la fonction cognitive est requise.

scholarly journals Reliable Change on Neuropsychological Tests in the Uniform Data Set

2015 ◽  
Vol 21 (7) ◽  
pp. 558-567 ◽  
Author(s):  
Brandon E. Gavett ◽  
Lee Ashendorf ◽  
Ashita S. Gurnani
Keyword(s):  
Older Adults ◽  
Test Scores ◽  
Test Score ◽  
The United States ◽  
Cognitive Test ◽  
Data Set ◽  
Reliable Change ◽  
Base Rates ◽  
Baseline Test

AbstractLongitudinal normative data obtained from a robust elderly sample (i.e., believed to be free from neurodegenerative disease) are sparse. The purpose of the present study was to develop reliable change indices (RCIs) that can assist with interpretation of test score changes relative to a healthy sample of older adults (ages 50+). Participants were 4217 individuals who completed at least three annual evaluations at one of 34 past and present Alzheimer’s Disease Centers throughout the United States. All participants were diagnosed as cognitively normal at every study visit, which ranged from three to nine approximately annual evaluations. One-year RCIs were calculated for 11 neuropsychological variables in the Uniform Data Set by regressing follow-up test scores onto baseline test scores, age, education, visit number, post-baseline assessment interval, race, and sex in a linear mixed effects regression framework. In addition, the cumulative frequency distributions of raw score changes were examined to describe the base rates of test score changes. Baseline test score, age, education, and race were robust predictors of follow-up test scores across most tests. The effects of maturation (aging) were more pronounced on tests related to attention and executive functioning, whereas practice effects were more pronounced on tests of episodic and semantic memory. Interpretation of longitudinal changes on 11 cognitive test variables can be facilitated through the use of reliable change intervals and base rates of score changes in this robust sample of older adults. A Web-based calculator is provided to assist neuropsychologists with interpretation of longitudinal change. (JINS, 2015, 21, 558–567)

Educational intervention to improve palliative care knowledge among informal caregivers of cognitively impaired older adults

2020 ◽  
pp. 1-9
Author(s):  
Hyunjin Noh ◽  
Lewis H. Lee ◽  
Chorong Won
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Cognitive Impairment ◽  
Educational Intervention ◽  
Test Scores ◽  
Informal Caregivers ◽  
Cognitively Impaired ◽  
Significant Difference ◽  
Post Test ◽  
Seriously Ill

Abstract Objective Lack of palliative care knowledge among caregivers may pose an access barrier for cognitively impaired older adults, who may benefit from the specialized care. Therefore, this study aims to examine the effectiveness of an educational intervention in improving palliative care knowledge among informal caregivers of cognitively impaired older adults. Method Using a one-group, pre- and post-test intervention design, this study implemented an individual, face-to-face educational intervention with an informational brochure for 43 informal caregivers of chronically or seriously ill older adults (50+) with cognitive impairment, recruited from communities in West Alabama. Their level of knowledge about palliative care was assessed by the Palliative Care Knowledge Scale (PaCKS). The pre- and post-test scores were compared by the Wilcoxon signed-ranks test, and the racial subgroup (Whites vs. Blacks) comparison was made by the Mann–Whitney U test. Results There was a statistically significant difference between the pre- and post-test scores (z = 5.38, p < 0.001), indicating a statistically significant effect of the educational intervention in improving palliative care knowledge among participants. There was a significant difference (U = 143, p < 0.05) between Whites and Blacks in the pre-test, which, however, disappeared in the post-test (U = 173.50, p > 0.05), suggesting that the amount of increased PaCKS scores were significantly greater for Blacks (Mdn = 9.50) than for Whites (Mdn = 4.00, U = 130.50, p < 0.05). Significance of results This study demonstrated that a one-time educational intervention can improve the level of palliative care knowledge among informal caregivers of chronically or seriously ill older adults with cognitive impairment, particularly among Black caregivers. Therefore, further educational efforts can be made to promote palliative care knowledge and reduce racial disparities in palliative care knowledge and its use.

scholarly journals Digital Technology Differentiates Graphomotor and Information Processing Speed Patterns of Behavior

2021 ◽  
Vol 82 (1) ◽  
pp. 17-32 ◽  
Author(s):  
Stacy L. Andersen ◽  
Benjamin Sweigart ◽  
Nancy W. Glynn ◽  
Mary K. Wojczynski ◽  
Bharat Thyagarajan ◽  
...  
Keyword(s):  
Information Processing ◽  
Physical Function ◽  
Digital Technology ◽  
Test Scores ◽  
Neuropsychological Test ◽  
Apoe Genotype ◽  
Digital Data ◽  
Cognitive Test ◽  
Digit Symbol Substitution Test ◽  
Information Processing Speed

Background: Coupling digital technology with traditional neuropsychological test performance allows collection of high-precision metrics that can clarify and/or define underlying constructs related to brain and cognition. Objective: To identify graphomotor and information processing trajectories using a digitally administered version of the Digit Symbol Substitution Test (DSST). Methods: A subset of Long Life Family Study participants (n = 1,594) completed the DSST. Total time to draw each symbol was divided into ‘writing’ and non-writing or ‘thinking’ time. Bayesian clustering grouped participants by change in median time over intervals of eight consecutively drawn symbols across the 90 s test. Clusters were characterized based on sociodemographic characteristics, health and physical function data, APOE genotype, and neuropsychological test scores. Results: Clustering revealed four ‘thinking’ time trajectories, with two clusters showing significant changes within the test. Participants in these clusters obtained lower episodic memory scores but were similar in other health and functional characteristics. Clustering of ‘writing’ time also revealed four performance trajectories where one cluster of participants showed progressively slower writing time. These participants had weaker grip strength, slower gait speed, and greater perceived physical fatigability, but no differences in cognitive test scores. Conclusion: Digital data identified previously unrecognized patterns of ‘writing’ and ‘thinking’ time that cannot be detected without digital technology. These patterns of performance were differentially associated with measures of cognitive and physical function and may constitute specific neurocognitive biomarkers signaling the presence of subtle to mild dysfunction. Such information could inform the selection and timing of in-depth neuropsychological assessments and help target interventions.

Synergistic Effect of Serum Homocysteine and Diabetes Mellitus on Brain Alterations

2021 ◽  
pp. 1-9
Author(s):  
Gihwan Byeon ◽  
Min Soo Byun ◽  
Dahyun Yi ◽  
Jun Ho Lee ◽  
So Yeon Jeon ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Older Adults ◽  
Cognitive Decline ◽  
Brain Atrophy ◽  
Homocysteine Level ◽  
Cognitive Impairments ◽  
Interactive Effect ◽  
Brain Mri ◽  
Amyloid Β ◽  
Serum Homocysteine

Background: Both elevated blood homocysteine and diabetes mellitus (DM) are related to cognitive impairments or dementia. A previous study also demonstrated that the association between homocysteine and cognitive decline was much stronger in individuals with DM than in those without DM. Objective: This study aimed to examine the interactive effect of blood homocysteine and DM on brain pathological changes including brain atrophy, amyloid-β and tau deposition, and small vessel disease (SVD) related to cognitive impairments. Methods: A total of 430 non-demented older adults underwent comprehensive clinical assessment, measurement of serum homocysteine level, [11C] Pittsburgh Compound B (PiB) PET, [18F] AV-1451 PET, and brain MRI. Results: The interactive effect of homocysteine with the presence of DM on brain atrophy, especially in aging-related brain regions, was significant. Higher homocysteine concentration was associated with more prominent brain atrophy in individuals with DM, but not in those without DM. In contrast, interaction effect of homocysteine and DM was found neither on Alzheimer’s disease (AD) pathologies, including amyloid-β and tau deposition, nor white matter hyperintensity volume as a measure of SVD. Conclusion: The present findings suggest that high blood homocysteine level and DM synergistically aggravate brain damage independently of AD and cerebrovascular disease. With regard to preventing dementia or cognitive decline in older adults, these results support the importance of strictly controlling blood glucose in individuals with hyperhomocysteinemia and lowering blood homocysteine level in those with DM.

scholarly journals Effects of cerebrospinal fluid proteins on brain atrophy rates in cognitively healthy older adults

2014 ◽  
Vol 35 (3) ◽  
pp. 614-622 ◽  
Author(s):  
Niklas Mattsson ◽  
Philip Insel ◽  
Rachel Nosheny ◽  
John Q. Trojanowski ◽  
Leslie M. Shaw ◽  
...  
Keyword(s):  
Older Adults ◽  
Cerebrospinal Fluid ◽  
Brain Atrophy ◽  
Healthy Older Adults ◽  
Cerebrospinal Fluid Proteins
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