Beneficial Effect of Multidomain Cognitive Training on the Neuropsychological Performance of Patients with Early-Stage Alzheimer’s Disease

Background and Purpose. There is an increasing interest in the effect of nonpharmacological interventions on the course of patients with Alzheimer’s disease (AD). The objective of the present study is to determine the benefits of a structured, multidomain, mostly computer-based, cognitive training (MCT) οn the cognitive performance of patients with early-stage AD. Method. Fifty patients with early-stage AD participated in the study. Patients were randomly allocated either to the training program group (n=25) or to a wait list control group (n=25). The training program group received computer-assisted MCT and linguistic exercises utilizing pen and paper supplemented by cognitive-linguistic exercises for homework. The duration of the MCT intervention program was 15 weeks, and it was administered twice a week. Each session lasted for approximately one hour. Objective measures of episodic memory, delayed memory, word recognition, attention, executive function, processing speed, semantic fluency, and naming were assessed at baseline and after the completion of the program in both groups. Results. Analysis showed that in controls, delayed memory and executive function had deteriorated over the observation period of 15 weeks, while the training group improved their performance in word recognition, Boston Naming Test (BNT), semantic fluency (SF), clock-drawing test (CDT), digit span forward (DSF), digit span backward (DSB), trail-making test A (TMT A), and trail-making test B (TMT B). Comparison between the training group and the controls showed that MCT had a significant beneficial effect in delayed memory, naming, semantic fluency, visuospatial ability, executive functions, attention, and processing speed. Conclusions. The study provides evidence of a beneficial effect of MCT with an emphasis on cognitive-language performance of patients with early-stage AD. Considering the limited efficacy of current pharmacological therapies in AD, concurrent computer-based MCT may represent an additional enhancing treatment option in early-stage AD patients.

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S47. A MULTICENTER STUDY OF COGNITIVE RESERVE IN FIRST-EPISODE PYCHOSIS

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa031.113 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S50-S50

Author(s):

Silvia Amoretti ◽

Gerard Anmella ◽

Ana Meseguer ◽

Cristina Saiz ◽

Sonia Canals ◽

...

Keyword(s):

Working Memory ◽

Executive Function ◽

Processing Speed ◽

Cognitive Reserve ◽

Leisure Activities ◽

First Episode ◽

Trail Making Test ◽

Neurocognitive Performance ◽

Adult Intelligence Scale ◽

Trail Making

Abstract Background The cognitive reserve (CR) refers to the brain’s capacity to cope with pathology in order to minimize the symptoms. In the field of first episode psychosis (FEP), the CR was able to predict functional and neurocognitive performance. Nevertheless, CR has been estimated using heterogeneous methods, which, in term, difficult to compare studies. Therefore, there is a need to create a specific scale for the assessment of this relevant construct. The Cognitive Reserve Assessment Scale in Health (CRASH) is the first measure developed specifically for patients with severe mental illness with optimal psychometric properties, facilitating reliable and valid measurement of CR. The study of the internal structure of the CRASH determined a four-factor structure (Education, Occupation, Leisure activities and Sociability) that can be analyzed separately to know what kind of relationship they might have with other variables. The aim of this study was to analyze the effects of CR measured with CRASH scale on functioning and neurocognitive performance and to explore the relationship of each factor with the outcome in an adult sample of subjects with FEP. Methods The sample of this study came from a multicentre, naturalistic and longitudinal research project financed by a catalan grant (“Pla Estratègic de Recerca i Innovació en Salut” - PERIS 2016–2018). Expedient Nº: SLT006/17/00345; entitled “Identificación y caracterización del valor predictivo de la reserva cognitiva en el curso evolutivo y respuesta en terapéutica en personas con un primer episodio psicótico”. 23 FEP patients and 72 healthy control (HC) were enrolled. The premorbid IQ was estimated with the Wechsler Adult Intelligence Scale (WAIS-IV) vocabulary subtest. To assess processing speed, Trail Making Test-part A was used. Sustained attention was tested with the Continuous Performance Test–II. The working memory was assessed with the Letters and Numbers Subtest of the WAIS-IV. Finally, the executive functions tested set shifting, planning and cognitive flexibility using the Tower of London task and the Trail Making Test (TMT) part B. Results Significant differences between the total CRASH score of patients and HC groups have been found. The patient group obtained lower scores compared to the HC group (36.66±16.01 vs 49.83±11.08, p<0.001). After performing a logistic regression to assess the predictive power of CRASH for each group, the model correctly classified 83.2% of the cases (B=0.091; p<0.001; Exp(B)=1.095). In FEP patients, the CRASH score was associated with premorbid IQ (p<0.001), processing speed (p=0.005), executive function (TMT-B, p=0.005; London Tower task, p=0.039) and attention (CPT Hit SE ISI change, p=0.004). Specifically, the Education factor was associated with premorbid IQ, processing speed, working memory and executive function. The Occupation was only associated with executive function. Leisure activities factor was correlated with premorbid IQ and functioning. Finally, Sociability was correlated with psychosocial functioning and duration of untreated psychosis. In HC, CRASH was associated with premorbid IQ (p<0.001) and attention (p=0.015). Education and Occupation factors were associated with premorbid IQ and attention; Leisure activities with processing speed; and sociability with attention. Discussion FEP patients were shown to have lower CR than HC, and CRASH correctly classified 83.2% of the sample. Each CRASH factor was associated with different outcome, which is why it can be interesting to analyze the total CRASH score and each factor separately. Patients with higher CR showed a better cognitive performance. Therefore, enhancing each factor involved in cognitive reserve may improve outcomes in FEP.

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Neuropsychological Impairments and Their Cognitive Architecture in Mild Cognitive Impairment (MCI) with Lewy Bodies and MCI-Alzheimer’s Disease

Journal of the International Neuropsychological Society ◽

10.1017/s1355617721001181 ◽

2021 ◽

pp. 1-11

Author(s):

Joanna Ciafone ◽

Alan Thomas ◽

Rory Durcan ◽

Paul C Donaghy ◽

Calum A Hamilton ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Processing Speed ◽

Lewy Bodies ◽

Trail Making Test ◽

Neuropsychological Profile ◽

Trail Making

Abstract Objective: The present study aimed to clarify the neuropsychological profile of the emergent diagnostic category of Mild Cognitive Impairment with Lewy bodies (MCI-LB) and determine whether domain-specific impairments such as in memory were related to deficits in domain-general cognitive processes (executive function or processing speed). Method: Patients (n = 83) and healthy age- and sex-matched controls (n = 34) underwent clinical and imaging assessments. Probable MCI-LB (n = 44) and MCI-Alzheimer’s disease (AD) (n = 39) were diagnosed following National Institute on Aging-Alzheimer’s Association (NIA-AA) and dementia with Lewy bodies (DLB) consortium criteria. Neuropsychological measures included cognitive and psychomotor speed, executive function, working memory, and verbal and visuospatial recall. Results: MCI-LB scored significantly lower than MCI-AD on processing speed [Trail Making Test B: p = .03, g = .45; Digit Symbol Substitution Test (DSST): p = .04, g = .47; DSST Error Check: p < .001, g = .68] and executive function [Trail Making Test Ratio (A/B): p = .04, g = .52] tasks. MCI-AD performed worse than MCI-LB on memory tasks, specifically visuospatial (Modified Taylor Complex Figure: p = .01, g = .46) and verbal (Rey Auditory Verbal Learning Test: p = .04, g = .42) delayed recall measures. Stepwise discriminant analysis correctly classified the subtype in 65.1% of MCI patients (72.7% specificity, 56.4% sensitivity). Processing speed accounted for more group-associated variance in visuospatial and verbal memory in both MCI subtypes than executive function, while no significant relationships between measures were observed in controls (all ps > .05) Conclusions: MCI-LB was characterized by executive dysfunction and slowed processing speed but did not show the visuospatial dysfunction expected, while MCI-AD displayed an amnestic profile. However, there was considerable neuropsychological profile overlap and processing speed mediated performance in both MCI subtypes.

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Natural Is Not Always Better: The Varied Effects of a Natural Environment and Exercise on Affect and Cognition

Frontiers in Psychology ◽

10.3389/fpsyg.2020.575245 ◽

2021 ◽

Vol 11 ◽

Author(s):

Janet P. Trammell ◽

Shaya C. Aguilar

Keyword(s):

Executive Function ◽

Natural Environment ◽

Indoor Environment ◽

Digit Span ◽

Natural Environments ◽

Trail Making Test ◽

Beneficial Effects ◽

Before And After ◽

Affect And Cognition ◽

Trail Making

The Attention Restoration Theory (ART) has been widely cited to account for beneficial effects of natural environments on affect and attention. However, the effects of environment and exercise are not consistent. In a within-subjects design, participants completed affective and cognitive measures that varied in attentional demands (memory, working memory, and executive function) both before and after exercise in a natural and indoor environment. Contrary to the hypotheses, a natural environment resulted in lower positive affect and no difference in negative affect compared to an indoor environment. A natural environment resulted in the most improvement for cognitive tasks that required moderate attentional demand: Trail Making Test A and Digit Span Forwards. As predicted, exercise resulted in improved affect and improved executive function (Trail Making Test B). There were no interactions between environment and exercise. These results suggest that ART cannot fully explain the influence of environment on affect and cognition.

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Imagen corporal en universitarios mexicanos: diferencias entre hombres y mujeres (Effects of a small sided games program on executive function in a sample of adolescent girls)

Retos ◽

10.47197/retos.v0i30.50217 ◽

2016 ◽

pp. 171-176 ◽

Cited By ~ 1

Author(s):

María Del Carmen Zueck Enríquez ◽

Natalia Solano-Pinto ◽

Elia Verónica Benavides Pando ◽

Julio César Guedea Delgado

Keyword(s):

Physical Activity ◽

Executive Function ◽

Cognitive Skills ◽

Intervention Program ◽

Digit Span ◽

Physical Activity Program ◽

Trail Making Test ◽

Activity Program ◽

Trail Making ◽

The Impact

El objetivo de este trabajo fue analizar los efectos de un programa de actividad física, con una duración de 8 semanas y basados en juegos reducidos, sobre la función ejecutiva en un grupo de chicas. Las participantes fueron 39 adolescentes del municipio de Priego (Córdoba, España), con edades entre los 15 y 16 años (M= 15.41, DT= .50), que eran físicamente inactivas. Se empleó un diseño cuasi-experimental pre-post con dos grupos aleatorizados, control y experimental. Las herramientas empleadas para medir las habilidades cognitivas fueron el test Dígitos y el test Letras y Números, de la Escala de Inteligencia de Wechsler para Niños (WISC-IV), el Trail Making Test (A y B) y el Test Stroop. Se realizó un análisis de la varianza bifactorial para determinar los efectos de la intervención. Los datos hallados en el estudio pusieron de manifiesto efectos significativos del programa de actividad física sobre la memoria de trabajo y la flexibilidad cognitiva. Este trabajo contribuye a elevar el número de evidencias existentes sobre los beneficios de la actividad física en el funcionamiento cognitivo de los adolescentes. Abstract. The aim of this paper was to analyze the impact of an eight-week physical activity program based on small-sided games on the executive function of a group of teenage girls. The sample comprised 39 physically inactive girls from Priego (Cordoba, Spain) aged 15 and 16 years old (M= 15.41, SD= .50). The research was based on a quasi-experimental pre-post study design with two randomized groups: control and experimental. The Digit Span and the Letter-Number Sequencing subtests from the Wechsler Intelligence Scale for Children (WISC-IV), the Trail Making Test (A and B), and the Stroop Test were used to measure cognitive skills. A bi-factorial analysis of variance was carried out to ascertain the effects of the intervention program. The findings revealed significant effects of the physical activity program on working memory and cognitive flexibility. This paper helps to increase the amount of existing evidence on the benefit that physical activity provides to adolescents’ cognitive functioning.

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Structural and functional changes related to memory deficit in non-demential elderly individuals

Medicina (Ribeirao Preto Online) ◽

10.11606/issn.2176-7262.v49i6p533-548 ◽

2016 ◽

Vol 49 (6) ◽

pp. 533

Author(s):

Nísea De A. Corrêa ◽

Maria P. Foss ◽

Paula R. B. Diniz

Keyword(s):

Systematic Review ◽

Web Of Science ◽

Digit Span ◽

Meta Analysis ◽

Memory Deficit ◽

Trail Making Test ◽

Elderly Individuals ◽

Functional Changes ◽

Wechsler Memory Scale ◽

Trail Making

Objetivo: Verificar as alterações estruturais e funcionais, evidenciadas através da imagem por ressonância magnética, relacionadas aos déficits de memória identificados em idosos normais, quando comparados a adultos jovens. Metodologia: Procedeu-se à revisão sistemática, cujo protocolo obedeceu ao fluxograma do Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Foram investigadas as bases de dados PubMed, Scopus, EBSCO, utilizando o gerenciador de referências JabRef, na versão 2.10, e o Web of Science, pelo website. Foram incluídos artigos de estudos quase experimentais, transversais, em coorte ou tipo caso-controle, publicados entre 2005 e 2014, em periódicos indexados nacionais e internacionais, cuja amostra incluísse idosos a partir de 60 anos, não dementes, submetidos à investigação de alterações estruturais e funcionais do sistema nervoso central, por ressonância magnética e sua associação com déficits de memória avaliados por testes neuropsicológicos. Resultados: Quanto à técnica de imagem empregada, identificaram-se dois estudos com imagem por ressonância magnética estrutural, seis estudos com utilização de imagem por ressonância magnética funcional, e quatro estudos que empregaram ambas as técnicas. Nos 12 estudos foi identificado o emprego de 38 testes neuropsicológicos distintos, com uma média de cinco testes por estudo, com variação de um a 12 testes. Dentre os testes mais usados, estiveram o WAIS Digit Span Backwards (em sete estudos), o Trail Making Test A and B (em quatro estudos) e o Wechsler Memory Scale (em quatro estudos). Conclusão: Os estudos demonstraram que no envelhecimento normal, ocorre redução do volume de substância branca para-hipocampal, do volume do hipocampo e do córtex entorrinal com redução de memória verbal, possivelmente por desmielinização das fibras; redução das vias que ligam o lobo temporal e frontal, contribuindo para a redução da memória episódica, da memória de trabalho e da fluência verbal; redução da supressão de informações irrelevantes, o que contribui para menor registro de informação; alterações das áreas frontal e parietal que comprometem a memória de reconhecimento; modificações na atividade e na conectividade do default mode network; reorganização das funções cognitivas, bem como alentecimento de resposta por provável redução de ativação do córtex pré- frontal

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A-11 Investigating Gene–Gene Interactions by Cognitive Domain in Healthy Older Adults

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.29 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1051-1051

Author(s):

Kendra L Pizzonia ◽

Andrew M Bryant ◽

Leatha A Clark ◽

Brian C Clark ◽

Julie A Suhr

Keyword(s):

Executive Functioning ◽

Cognitive Functioning ◽

Verbal Fluency ◽

Community Dwelling ◽

Gene Interactions ◽

Trail Making Test ◽

Semantic Fluency ◽

Immediate Memory ◽

Trail Making ◽

Main Effects

Abstract Objective ApoE is a well-known gene carrying risk for Alzheimer’s disease and is associated with memory performance while the COMT gene is associated with executive functioning but is understudied. The present study investigated these gene interactions across cognitive domains. Method A larger study on gait and aging recruited 89 healthy community-dwelling adults over the age of 60. The primary analyses included 82 participants (67% female, mean age = 74.61, SD = 6.71). The analyses on executive functioning included 72 participants (65% female, mean age = 73.02, SD = 4.99) who completed all measures of interest. ApoE status was defined as presence/absence of Ɛ4. The rs4680 gene on the COMT allele was classified into Val/Met, Val/Val, and Met/Met genotypes. Biological sex was included as a binary term (i.e., male/female). Index variables and age corrected standard scores on the Repeatable Battery for the Assessment of Neuropsychological Status, verbal fluency, and Trail Making Test were included. Results Gene–gene interactions were found for overall cognitive functioning, immediate memory, and semantic fluency. There were main effects of sex for overall cognitive functioning, immediate memory, delayed memory, and semantic fluency. There were main effects for COMT for delayed memory and a main effect for both COMT and ApoE for visuospatial functioning, coding, and verbal fluency (all p’s < 0.05). There were no ApoE x COMT x Sex interactions and Trail Making Test B was not related to either gene or sex. Conclusion(s) Our findings suggest that both COMT and ApoE (and their interaction) influence cognition. Future research should investigate gene–gene interactions in larger samples with more comprehensive cognitive batteries.

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Alteração na atenção e o tratamento da dor do câncer

Revista da Escola de Enfermagem da USP ◽

10.1590/s0080-62342008000100019 ◽

2008 ◽

Vol 42 (1) ◽

pp. 143-151 ◽

Cited By ~ 2

Author(s):

Geana Paula Kurita ◽

Cibele Andrucioli de Mattos Pimenta ◽

José Oswaldo de Oliveira Júnior ◽

Ricardo Caponeiro

Keyword(s):

Digit Span ◽

Trail Making Test ◽

Digit Span Test ◽

Span Test ◽

Trail Making

Os danos à vida diária que a alteração cognitiva pode provocar motivaram a elaboração deste estudo, cujo objetivo foi analisar o impacto do tratamento da dor com opióides sobre a atenção. Os doentes foram divididos em grupos que recebiam (n=14) e não recebiam opióides (n=12). Foram feitas três entrevistas, utilizando-se o Trail Making Test e o Digit Span Test, que avaliam a atenção. Os grupos foram homogêneos nas variáveis sociodemográficas, dor e depressão; não foram homogêneos no índice de Karnofsky e no recebimento de analgésicos adjuvantes. Os doentes sem opióides tiveram melhor desempenho no Digit Span Test - ordem inversa, na segunda avaliação (p=0,29) e não foram observadas diferenças no Trail Making Test. As alterações observadas foram limitadas, mas, enquanto novos estudos não confirmem os achados, doentes, profissionais e cuidadores devem ser alertados dos possíveis efeitos deletérios dos opióides sobre a função cognitiva.

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Applicability of the Test of Variables of Attention – T.O.V.A in Brazilian adults

Dementia & Neuropsychologia ◽

10.1590/1980-57642018dn12-040009 ◽

2018 ◽

Vol 12 (4) ◽

pp. 394-401 ◽

Cited By ~ 4

Author(s):

Cláudia M. Memória ◽

Henrique C.S. Muela ◽

Natália C. Moraes ◽

Valéria A. Costa-Hong ◽

Michel F. Machado ◽

...

Keyword(s):

Performance Test ◽

Digit Span ◽

Screening Tests ◽

Trail Making Test ◽

Digit Symbol ◽

Cognitive Screening ◽

Or Education ◽

Attentional Processes ◽

Trail Making ◽

State Examination

ABSTRACT The functioning of attention is complex, a primordial function in several cognitive processes and of great interest to neuropsychology. The Test of Variables of Attention (T.O.V.A) is a continuous computerized performance test that evaluates some attention components such as response time to a stimulus and errors due to inattention and impulsivity. Objective: 1) To evaluate the applicability of T.O.V.A in Brazilian adults; 2) To analyze the differences in performance between genders, age ranges, and levels of education; 3) To examine the association between T.O.V.A variables and other attention and cognitive screening tests. Methods: The T.O.V.A was applied to 63 healthy adults (24 to 78 years of age) who also underwent the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Digit Span and Digit Symbol (Wechsler Intelligence Scale for Adults – WAIS-III) and the Trail Making Test. Results: the T.O.V.A was little influenced by age or education, but was influenced by gender. The correlations between some T.O.V.A variables and the Digit Symbol and Trail Making test were weak (r-values between 0.2 and 0.4), but significant (p<0.05). There was no correlation with the Digit Span test. Conclusion: The T.O.V.A showed good applicability and proved adequate for evaluating attentional processes in adults.

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Effects of dance on cognitive function in older adults: a systematic review and meta-analysis

Age and Ageing ◽

10.1093/ageing/afaa270 ◽

2020 ◽

Author(s):

Patricia Hewston ◽

Courtney Clare Kennedy ◽

Sayem Borhan ◽

Dafna Merom ◽

Pasqualina Santaguida ◽

...

Keyword(s):

Older Adults ◽

Executive Function ◽

Cognitive Function ◽

Learning And Memory ◽

Optimal Dose ◽

Future Research ◽

Trail Making Test ◽

Global Cognitive Function ◽

Trail Making ◽

Complex Attention

Abstract Background dance is a mind–body activity that stimulates neuroplasticity. We explored the effect of dance on cognitive function in older adults. Methods we searched MEDLINE, EMBASE, CENTRAL and PsycInfo databases from inception to August 2020 (PROSPERO:CRD42017057138). Inclusion criteria were (i) randomised controlled trials (ii) older adults (aged ≥ 55 years), (iii) intervention—dance and (iv) outcome—cognitive function. Cognitive domains were classified with the Diagnostic and Statistical Manual of Mental Disorders-5 Neurocognitive Framework. Meta-analyses were performed in RevMan5.3 and certainty of evidence with GradePro. Results we reviewed 3,997 records and included 11 studies (N = 1,412 participants). Seven studies included only healthy older adults and four included those with mild cognitive impairment (MCI). Dance interventions varied in frequency (1–3×/week), time (35–60 minutes), duration (3–12 months) and type. We found a mean difference (MD) = 1.58 (95% confidence interval [CI) = 0.21–2.95) on the Mini Mental State Examination for global cognitive function (moderate-certainty evidence), and the Wechsler Memory Test for learning and memory had an MD = 3.02 (95% CI = 1.38–4.65; low-certainty evidence). On the Trail Making Test-A for complex attention, MD = 3.07 (95% CI = −0.81 to 6.95; high-certainty evidence) and on the Trail Making Test-B for executive function, MD = −4.12 (95% CI = −21.28 to 13.03; moderate-certainty evidence). Subgroup analyses did not suggest consistently greater effects in older adults with MCI. Evidence is uncertain for language, and no studies evaluated social cognition or perceptual–motor function. Conclusions dance probably improves global cognitive function and executive function. However, there is little difference in complex attention, and evidence also suggests little effect on learning and memory. Future research is needed to determine the optimal dose and if dance results in greater cognitive benefits than other types of physical activity and exercise.

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Questioning the Effort Hypothesis That Depressed Patients Perform Disproportionately Worse on Effortful Cognitive Tasks

Perceptual and Motor Skills ◽

10.1177/0031512519898356 ◽

2020 ◽

Vol 127 (2) ◽

pp. 401-414

Author(s):

Dustin B. Hammers ◽

Sara Weisenbach

Keyword(s):

Digit Span ◽

Severe Depression ◽

Clinical Settings ◽

Trail Making Test ◽

Moderate Depression ◽

Self Reports ◽

Trail Making ◽

Neuropsychological Evaluations ◽

Accuracy Indices ◽

Effort Hypothesis

The debate over Hasher and Zacks’ effort hypothesis—that performance on effortful tasks by patients with depression will be disproportionately worse than their performance on automatic tasks—shows a need for additional research to settle whether or not this notion is “clinical lore.” In this study, we categorized 285 outpatient recipients of neuropsychological evaluations into three groups—No Depression, Mild-to-Moderate Depression, and Severe Depression—based on their Beck Depression Inventory-2 self-reports. We then compared these groups’ performances on both “automatic” and “effortful” versions of the Ruff 2 & 7 Selective Attention Test Total Speed and Total Accuracy Indices, the Digit Span subtest from the Wechsler Adult Intellectual Scale—Fourth Edition, and Trail Making Test Parts A and B, using a two-way (3 × 2) mixed multivariate analysis of variance. Patients with Mild-to-Moderate Depression or Severe Depression performed disproportionately worse than patients with No Depression in our sample on more effortful versions of only one of the four attention or executive functioning measures (Trail Making Test). Thus, these data failed to fully support a hypothesis of disproportionately worse performance on more effortful tasks. While this study failed to negate the effort hypothesis in some specific instances, particularly for use in the Trail Making Test, there is cause for caution in routinely applying the effort hypothesis when interpreting test findings in most clinical settings and for most measures.

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