The Effect of Diabetes Medication on Cognitive Function: Evidence from the PATH Through Life Study

Objective. To examine the effect of diabetes treatment on change of measures of specific cognitive domains over 4 years.Research Design and Methods. The sample was drawn from a population-based cohort study in Australia (the PATH Through Life Study) and comprised 1814 individuals aged 65–69 years at first measurement, of whom 211 were diagnosed with diabetes. Cognitive function was measured using 10 neuropsychological tests. The effect of type of diabetes treatment (diet, oral hypoglycemic agents, and insulin) on measures of specific cognitive domains was assessed using Generalized Linear Models adjusted for age, sex, education, smoking, physical activity level, BMI, and hypertension.Results. Comparison of cognitive function between diabetes treatment groups showed no significant effect of type of pharmacological treatment on cognitive function compared to diet only group or no diabetes group. Of those on oral hypoglycaemic treatment only, participants who used metformin alone had better cognitive function at baseline for the domains of verbal learning, working memory, and executive function compared to participants on other forms of diabetic treatment.Conclusion. This study did not observe significant effect from type of pharmacological treatment for diabetes on cognitive function except that participants who only used metformin showed significant protective effect from metformin on domain of verbal learning, working memory, and executive function.

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Speech Perception in Noise Is Associated With Different Cognitive Abilities in Chinese-Speaking Older Adults With and Without Hearing Aids

Frontiers in Psychology ◽

10.3389/fpsyg.2021.640300 ◽

2022 ◽

Vol 12 ◽

Author(s):

Yuan Chen ◽

Lena L. N. Wong ◽

Shaina Shing Chan ◽

Joannie Yu

Keyword(s):

Older Adults ◽

Working Memory ◽

Executive Function ◽

Speech Perception ◽

Cognitive Function ◽

Verbal Learning ◽

Chinese Adults ◽

Speech Perception In Noise ◽

Older Chinese ◽

Older Chinese Adults

Chinese-speaking older adults usually do not perceive a hearing problem until audiometric thresholds exceed 45 dB HL, and the audiometric thresholds of the average hearing-aid (HA) user often exceed 60 dB HL. The purpose of this study was to examine the relationships between cognitive and hearing functions (measured as audiometric or speech reception thresholds) in older Chinese adults with HAs and with untreated hearing loss (HL). Participants were 49 Chinese older adults who used HAs and had moderate to severe HL (HA group), and 46 older Chinese who had mild to moderately severe HL but did not use HAs (untreated; or UT group). Multiple linear regression analysis was employed to evaluate how well age, education level, audiometric thresholds, and speech perception in noise were related to performance on general cognitive function, working memory, executive function, attention, and verbal learning tests. Results showed that speech perception in noise alone accounted for 13–25% of the variance in general cognitive function, working memory, and executive function in the UT group, and 9–21% of the variance in general cognitive function and verbal learning in the HA group (i.e., medium effect sizes). Audiometric thresholds did not explain any proportion of the variance in cognitive functioning in the HA or UT group. Thus, speech perception in noise accounts for more variance in cognitive performance than audiometric thresholds, and is significantly associated with different cognitive functions in older Chinese adults with HAs and with untreated HL.

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Abstract 2718: Cognitive Function is Poorer in Heart Failure

Circulation ◽

10.1161/circ.118.suppl_18.s_768-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Susan J Pressler ◽

Usha Subramanian ◽

David Kareken ◽

Susan M Perkins ◽

Irmina Gradus-Pizlo ◽

...

Keyword(s):

Heart Failure ◽

Working Memory ◽

Executive Function ◽

Cognitive Function ◽

Cognitive Deficits ◽

Verbal Learning ◽

Small Samples ◽

Psychomotor Speed ◽

Delayed Recall ◽

Comparison Groups

Background: Heart failure (HF) patients have been found to have cognitive deficits but studies have been limited by small samples and lack of comparison groups. Objective: To determine the types, frequency, and severity of cognitive deficits among patients (pts) with chronic HF compared to age- and education-matched healthy (HC) participants and participants with major medical conditions but not HF (MC). Methods: In this comparative study, face-to-face interviews were completed by 414 participants (249 HF pts, 63 HC, 102 MC) to assess function in cognitive domains of language, working memory, memory (verbal learning total and delayed recall), psychomotor speed, and executive function. Characteristics of HF pts were: mean age 62.9 yrs; 63% men; mean education 12.9 yrs; mean LVEF 28%; NYHA I-15%; II-34%; III-39%; IV-12%). HC and MC groups were matched on education and premorbid intellect, but HC were younger than HF and MC groups. Comparisons among the 3 groups were made using ANCOVA adjusting for intellect, age, and education. Family members of all participants were interviewed separately to validate cognitive deficits. Results: No differences were found among HF, HC and MC participants in language or working memory. In verbal learning total recall, HF pts had poorer scores than HC and MC participants (p<.0001). In delayed recall, HF pts had poorer scores than MC participants (p=.0152). In psychomotor speed, HF pts had poorer scores than HC and MC participants (p<.0001) on 1 test and poorer scores than MC (p=.0177) on the 2 nd . In executive function (verbal fluency and mental flexibility), HF pts had poorer scores than MC participants (p = .0022; p = .0428). Family member reported more difficulty in memory among HF pts (p< .0001) than HC ((p< .0001) and more negative behavior changes than HC (p=.0025) and MC participants (p=.0291). Conclusions: This carefully characterized sample of HF pts had poorer cognitive function than HC and MC participants. Domains most affected were memory, psychomotor speed processing, and executive function. Studies are needed to 1) evaluate the trajectory of cognitive function across the trajectory of HF; and 2) test novel interventions to improve cognitive function in HF.

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Cognitive dysfunction in adolescents with chronic fatigue: a cross-sectional study

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-306764 ◽

2015 ◽

Vol 100 (9) ◽

pp. 838-844 ◽

Cited By ~ 14

Author(s):

Dag Sulheim ◽

Even Fagermoen ◽

Øyvind Stople Sivertsen ◽

Anette Winger ◽

Vegard Bruun Wyller ◽

...

Keyword(s):

Working Memory ◽

Cognitive Function ◽

Processing Speed ◽

Sleep Problems ◽

Verbal Learning ◽

Chronic Fatigue ◽

Cross Sectional Study ◽

Cognitive Inhibition ◽

Sectional Study ◽

Cross Sectional

ObjectiveTo compare cognitive function in adolescents with chronic fatigue with cognitive function in healthy controls (HC).Study designCross-sectional study.SettingPaediatric department at Oslo University Hospital, Norway.Participants120 adolescents with chronic fatigue (average age 15.4 years; range 12–18) and 39 HC (average age 15.2 years; range 12–18).MethodsThe adolescents completed a neurocognitive test battery measuring processing speed, working memory, cognitive inhibition, cognitive flexibility, verbal learning and verbal memory, and questionnaires addressing demographic data, depression symptoms, anxiety traits, fatigue and sleep problems. Parents completed the Behaviour Rating Inventory of Executive Function (BRIEF), which measures the everyday executive functions of children.ResultsAdolescents with chronic fatigue had impaired cognitive function compared to HC regarding processing speed (mean difference 3.3, 95% CI 1.1 to 5.5, p=0.003), working memory (−2.4, −3.7 to −1.1, p<0.001), cognitive inhibition response time (6.2, 0.8 to 11.7, p=0.025) and verbal learning (−1.7, −3.2 to −0.3, p=0.022). The BRIEF results indicated that everyday executive functions were significantly worse in the chronic fatigue group compared to the HC (11.2, 8.2 to 14.3, p<0.001). Group differences remained largely unaffected when adjusted for symptoms of depression, anxiety traits and sleep problems.ConclusionsAdolescents with chronic fatigue had impaired cognitive function of clinical relevance, measured by objective cognitive tests, in comparison to HC. Working memory and processing speed may represent core difficulties.

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Association of AKAP6 and MIR2113 with cognitive performance in a population based sample of older adults

10.1101/070409 ◽

2016 ◽

Author(s):

Shea J. Andrews ◽

Debjani Das ◽

Kaarin J. Anstey ◽

Simon Easteal

Keyword(s):

Older Adults ◽

Working Memory ◽

Cognitive Function ◽

Episodic Memory ◽

Cognitive Performance ◽

Cognitive Change ◽

European Ancestry ◽

Substantial Contribution ◽

Perceptual Speed ◽

Cognitive Domains

AbstractGenetic factors make a substantial contribution to inter-individual variability in cognitive function. A recent meta-analysis of genome-wide association studies identified two loci, AKAP6 and MIR2113 that are associated with general cognitive function. Here, we extend this previous research by investigating the association of MIR2113 and AKAP6 with baseline and longitudinal nonlinear change across a broad spectrum of cognitive domains in community-based cohort of 1,570 older adults without dementia. Two SNPs, MIR211-rs10457441 and AKAP6-rs17522122 were genotyped in 1,570 non-demented older Australians of European ancestry, who were examined up to 4 times over 12 years. Linear mixed effects models were used to examine the association between AKAP6 and MIR2113 with cognitive performance in episodic memory, working memory, vocabulary, perceptual speed and reaction time at baseline and with linear and quadratic rates of change. AKAP6-rs17522122*T was associated with worse baseline performance in episodic memory, working memory, vocabulary and perceptual speed, but it was not associated with cognitive change in any domain. MIR2113-rs10457441*T was associated with accelerated decline in episodic memory. No other associations with baseline cognitive performance or with linear or quadratic rate or cognitive changes was observed for this SNP. These results confirm the previous finding that, AKAP6 is associated with performance across multiple cognitive domains at baseline but not with cognitive decline, while MIR2113 primarily affects the rate at which memory declines over time.

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Meta-Analysis on Cognitive Benefit of Exercise after Stroke

Complexity ◽

10.1155/2021/5569346 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Bo Yang ◽

Shuming Wang

Keyword(s):

Working Memory ◽

Executive Function ◽

Exercise Intervention ◽

Combined Therapy ◽

Meta Analysis ◽

Cochrane Library ◽

Treatment Protocols ◽

Cognitive Domains ◽

Chi Squared ◽

Cognitive Benefit

ObjectiveThe objective of this paper is to evaluate the cognitive benefit of exercise after stroke, so as to provide more accurate and reliable guidance for targeted exercise intervention. Methods. Randomized controlled trials of the relationship between exercise and cognition after stroke were identified in Cochrane Library and PubMed. Methodological quality was assessed using the Cochrane tool of bias. SMD and 95% confidence intervals were calculated, and Chi-squared test (Q) was adopted to estimate the heterogeneity. Results. (a) Twenty-three studies met inclusion criteria, including 1528 participants. Heterogeneity was from low to high such as attention (I2 = 0.00%), executive function (I2 = 0.00%), cognition (I2 = 64%), and working memory (I2 = 77%). (b) The overall effect on cognition was small (SMD = 0.16 [0.04, 0.28]) but significant and there is a difference between cognitive domains in attention (SMD = −0.35 [−0.57, −0.14]), executive function (SMD = −0.24 [−0.40, −0.08]), and working memory (SMD = 0.36 [0.20, 0.53]). (c) Exercise training was less effective before the 18th month after stroke. Higher benefits on cognition were found after combined therapy compared with other exercise programs, and the older the stroke survivors, the less the cognitive benefit of exercise. Conclusion. Small-to-moderate effect of exercise on cognitive benefit after stroke was found, and the effect was moderated by treatment protocols and sample characteristics.

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Association between plasma homocysteine levels and cognitive deficits in Han Chinese patients with schizophrenia across age groups

Scientific Reports ◽

10.1038/s41598-021-99239-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Sumiao Zhou ◽

Yuanyuan Huang ◽

Yangdong Feng ◽

Hehua Li ◽

Kai Wu ◽

...

Keyword(s):

Working Memory ◽

Cognitive Function ◽

Learning And Memory ◽

Cognitive Deficits ◽

Visual Learning ◽

Verbal Learning ◽

Age Groups ◽

Speed Of Processing ◽

Function Score ◽

Cognitive Function Score

AbstractIt was still unclear how homocysteine (Hcy) levels and cognitive deficits change in patients with schizophrenia of various ages. The present article attempts to assess the relationship between Hcy levels and cognitive deficits in patients with schizophrenia across age groups, especially in young people. Totals of 103 patients and 122 healthy controls were included. All participants were stratified into four groups according to their age: 18–29 years, 30–39 years, 40–49 years, and 50–59 years. Clinical data, plasma Hcy levels, and cognitive function score were collected. Cognitive function was evaluated using the MATRICS Consensus Cognitive Battery of tests assessing speed of processing, verbal learning and memory, visual learning and memory, working memory, and attention/vigilance. Compared with the healthy group, Hcy levels increased significantly, and all the measured cognitive function score were significantly lower in all age groups of patients with schizophrenia (p < 0.001). Hcy levels were negatively associated with speed of processing (SoP), working memory (WM), and visual learning and memory (Vis Lrng) score in 18–29 years. Further multiple regression analysis showed that SoP were independently associated with Hcy levels in patients with schizophrenia aged 18–29 years (B = 0.74, t = 3.12, p = 0.008). Based on our results, patients with schizophrenia performed worse on cognitive assessments and Hcy levels were more closely related to cognition in young patients.

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Effect of N-methyl-D-aspartate-receptor-enhancing agents on cognition in patients with schizophrenia: A systematic review and meta-analysis of double-blind randomised controlled trials

Journal of Psychopharmacology ◽

10.1177/0269881118822157 ◽

2019 ◽

Vol 33 (4) ◽

pp. 436-448 ◽

Cited By ~ 8

Author(s):

Chun-Hung Chang ◽

Hsien-Yuan Lane ◽

Ping-Tao Tseng ◽

Shaw-Ji Chen ◽

Chieh-Yu Liu ◽

...

Keyword(s):

Working Memory ◽

Cognitive Function ◽

Nmda Receptor ◽

Rating Scales ◽

Meta Analysis ◽

Random Effect Model ◽

Double Blind ◽

Cognitive Domains ◽

Positive Effects ◽

Statistical Heterogeneity

Background: Multiple N-methyl-d-aspartate (NMDA)-receptor-enhancing agents have demonstrated promising effects for cognition in schizophrenia. However, the results of studies have been conflicting. This updated meta-analysis explored the effect of NMDA-receptor-enhancing agents on cognitive function. Methods: We searched PubMed, the Cochrane Collaboration Central Register of Controlled Clinical Trials and Cochrane Systematic Reviews for studies on the effect of NMDA-receptor-enhancing agents on cognitive function in patients with schizophrenia up to September 2018. Double-blind randomised placebo trials with cognition rating scales were included. We pooled studies by using a random-effect model for comparisons with add-on NMDA-receptor-enhancing agents. Cognitive function scores were compared between baseline and subsequent levels, and NMDA-receptor-positive modulators were assessed using the standardised mean difference (SMD) with 95% confidence intervals (CIs). We evaluated statistical heterogeneity through visual inspection of funnel plots and by using the I2 statistic. Results: We identified 25 trials with 1951 participants meeting the inclusion criteria. NMDA-receptor-enhancing agents had a small but nonsignificant effect compared with the placebo on overall cognitive function (SMD = 0.068, CI = −0.056 to 0.193, P = 0.283). We identified trials enrolling patients aged between 30 and 39 years old, which reported significant positive effects (SMD: 0.163, 95% CI: 0.016–0.310, P = 0.030). Men were associated with a smaller effect of NMDA-receptor-positive modulators on overall cognitive function. Moreover, subgroup meta-analysis of cognitive domains revealed that N-acetyl cysteine (NAC) had a significant effect on working memory ( P-value for interaction = 0.038; SMD = 0.679, CI = 0.397–0.961, P < 0.001). Conclusions: Our meta-analysis revealed no significant effect of NMDA-enhancing agents on overall cognition. However, subgroup analysis suggested that NMDAR-enhancing agents may benefit young patients with schizophrenia, and NAC may have an effect on working memory. Additional trials with larger samples are suggested to evaluate these cognitive domains and ascertain the possible mechanisms.

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Correlating cognitive functions to symptom domains and insight in Egyptian patients with schizophrenia

International Journal of Social Psychiatry ◽

10.1177/0020764019897697 ◽

2020 ◽

Vol 66 (3) ◽

pp. 240-248 ◽

Cited By ~ 1

Author(s):

Afaf Hamed Khalil ◽

Marwa Abd el-Meguid ◽

Mostafa Bastawy ◽

Samah Rabei ◽

Ramy Ali ◽

...

Keyword(s):

Working Memory ◽

Cognitive Impairment ◽

Problem Solving ◽

Cognitive Functions ◽

Visual Learning ◽

Verbal Learning ◽

General Psychopathology ◽

Cognitive Domains ◽

Reasoning Problem ◽

Egyptian Patients

Introduction: Cognitive impairment is one of the fundamental features among patients with schizophrenia. The relationship between schizophrenia symptoms, insight and cognitive domains remains controversial. We aimed to study these relations in a sample of Egyptian patients with schizophrenia. Methods: A total of 109 patients with schizophrenia were assessed using Structured Clinical Interview for DSM-IV ( Diagnostic and Statistical Manual of Mental Disorders (4th ed.)) Axis I diagnosis (SCID-I), Positive and Negative Syndrome Scale (PANSS) and Scale to Assess Unawareness of Medical Disorder (SUMD). Cognitive functions were assessed using the Wechsler Adult Intelligence Scale (WAIS), the Wisconsin Card Sorting Test (WCST) and the Wechsler Memory Scale (WMS). The cognitive functions would be distributed to cover six cognitive domains: attention/vigilance speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. Results: There was a significant correlation between all cognitive domains (except attention) and PANSS subscales. PANSS negative and general psychopathology subscales were significantly correlated with five cognitive domains: speed of processing, verbal learning, visual learning, working memory and reasoning/problem solving. PANSS negative subscale was significantly correlated with verbal learning (verbal paired association 1) and visual learning (visual paired association 1). There was a significant correlation between all cognitive domains and SUMD, except verbal and visual learning domains assessed by verbal and visual paired association 1 subtests, as well as attention assessed by failure to maintain set subtest. Only visual learning (trials administered), working memory (percentage error), and processing speed (perseverative responses, and trials to complete first category) were significantly negatively correlated to SUMD. Conclusion: Cognitive impairment in patients with schizophrenia is most likely to underlie negative symptoms, general psychopathology symptoms and poor insight, suggesting that treatment strategies minimizing these symptoms would improve cognitive impairment.

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Efficacy of non-invasive brain stimulation on cognitive functioning in brain disorders: a meta-analysis

Psychological Medicine ◽

10.1017/s0033291720003670 ◽

2020 ◽

Vol 50 (15) ◽

pp. 2465-2486

Author(s):

Marieke J. Begemann ◽

Bodyl A. Brand ◽

Branislava Ćurčić-Blake ◽

André Aleman ◽

Iris E. Sommer

Keyword(s):

Working Memory ◽

Brain Stimulation ◽

Meta Analysis ◽

Verbal Learning ◽

The Other ◽

Brain Disorders ◽

Brain Disorder ◽

Cognitive Domains ◽

Domain Specific ◽

Non Invasive

AbstractBackgroundCognition is commonly affected in brain disorders. Non-invasive brain stimulation (NIBS) may have procognitive effects, with high tolerability. This meta-analysis evaluates the efficacy of transcranial magnetic stimulation (TMS) and transcranial Direct Current Stimulation (tDCS) in improving cognition, in schizophrenia, depression, dementia, Parkinson's disease, stroke, traumatic brain injury, and multiple sclerosis.MethodsA PRISMA systematic search was conducted for randomized controlled trials. Hedges' g was used to quantify effect sizes (ES) for changes in cognition after TMS/tDCS v. sham. As different cognitive functions may have unequal susceptibility to TMS/tDCS, we separately evaluated the effects on: attention/vigilance, working memory, executive functioning, processing speed, verbal fluency, verbal learning, and social cognition.ResultsWe included 82 studies (n = 2784). For working memory, both TMS (ES = 0.17, p = 0.015) and tDCS (ES = 0.17, p = 0.021) showed small but significant effects. Age positively moderated the effect of TMS. TDCS was superior to sham for attention/vigilance (ES = 0.20, p = 0.020). These significant effects did not differ across the type of brain disorder. Results were not significant for the other five cognitive domains.ConclusionsOur results revealed that both TMS and tDCS elicit a small trans-diagnostic effect on working memory, tDCS also improved attention/vigilance across diagnoses. Effects on the other domains were not significant. Observed ES were small, yet even slight cognitive improvements may facilitate daily functioning. While NIBS can be a well-tolerated treatment, its effects appear domain specific and should be applied only for realistic indications (i.e. to induce a small improvement in working memory or attention).

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Corpus callosal atrophy and associations with cognitive impairment in Parkinson disease

Neurology ◽

10.1212/wnl.0000000000003764 ◽

2017 ◽

Vol 88 (13) ◽

pp. 1265-1272 ◽

Cited By ~ 37

Author(s):

Jennifer G. Goldman ◽

Ian O. Bledsoe ◽

Doug Merkitch ◽

Vy Dinh ◽

Bryan Bernard ◽

...

Keyword(s):

Working Memory ◽

Cognitive Impairment ◽

Executive Function ◽

Corpus Callosum ◽

Parkinson Disease ◽

Clinical Manifestations ◽

Cognitive Domain ◽

Intracranial Volume ◽

Volume Loss ◽

Cognitive Domains

Objective:To investigate atrophy of the corpus callosum on MRI in Parkinson disease (PD) and its relationship to cognitive impairment.Methods:One hundred patients with PD and 24 healthy control participants underwent clinical and neuropsychological evaluations and structural MRI brain scans. Participants with PD were classified as cognitively normal (PD-NC; n = 28), having mild cognitive impairment (PD-MCI; n = 47), or having dementia (PDD; n = 25) by Movement Disorder Society criteria. Cognitive domain (attention/working memory, executive function, memory, language, visuospatial function) z scores were calculated. With the use of FreeSurfer image processing, volumes for total corpus callosum and its subsections (anterior, midanterior, central, midposterior, posterior) were computed and normalized by total intracranial volume. Callosal volumes were compared between participants with PD and controls and among PD cognitive groups, covarying for age, sex, and PD duration and with multiple comparison corrections. Regression analyses were performed to evaluate relationships between callosal volumes and performance in cognitive domains.Results:Participants with PD had reduced corpus callosum volumes in midanterior and central regions compared to healthy controls. Participants with PDD demonstrated decreased callosal volumes involving multiple subsections spanning anterior to posterior compared to participants with PD-MCI and PD-NC. Regional callosal atrophy predicted cognitive domain performance such that central volumes were associated with the attention/working memory domain; midposterior volumes with executive function, language, and memory domains; and posterior volumes with memory and visuospatial domains.Conclusions:Notable volume loss occurs in the corpus callosum in PD, with specific neuroanatomic distributions in PDD and relationships of regional atrophy to different cognitive domains. Callosal volume loss may contribute to clinical manifestations of PD cognitive impairment.

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