scholarly journals Goal Setting Improves Cognitive Performance in a Randomized Trial of Chronic Stroke Survivors

Stroke ◽  
2021 ◽  
Vol 52 (2) ◽  
pp. 458-470
Author(s):  
Keera N. Fishman ◽  
Andrea R. Ashbaugh ◽  
Richard H. Swartz
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Cognitive Performance ◽  
Goal Setting ◽  
Verbal Learning ◽  
Chronic Phase ◽  
Vascular Cognitive Impairment ◽  
Stroke Survivors ◽  
Verbal Recall

Background and Purpose: Cognitive impairment after stroke, especially executive and attention dysfunction, is common, negatively affects daily functioning, and has limited treatment options. A single-blind, parallel-design, randomized controlled trial was used to examine the impact of goal setting on poststroke cognitive performance. Methods: Stroke survivors (n=72; mean age, 68.38 [SD=11.84] years; 69.4% men) in the chronic phase (≥3 months) after stroke from an academic stroke prevention clinic were randomly assigned to receive goal-setting instructions (n=36) or standard instructions (n=36) after completing baseline cognitive measures of executive function (primary outcome), attention/working memory, verbal learning, and verbal recall. Results: A one-way mixed multivariate analysis of covariance (MANCOVA) found a group by instructional manipulation interaction effect for executive function (Wilks λ=0.66; F [3,66]=11.30; P ≤0.001; η 2 p =0.34), after adjusting for age and years of education. After similar adjustment, attention/working memory (Wilks λ=0.86; F [5,63]=2.10; P =0.043; η 2 p =0.16) and verbal learning ( F [1,60]=5.81; P =0.019; η 2 p =0.09) also showed improvement after instruction but not verbal recall (Wilks λ=0.95; F [1,56]=2.82; P =0.099; η 2 p =0.05). There were no adverse events. Conclusions: Goal setting improved executive function, attention/working memory, and learning in a heterogeneous sample in the chronic phase after stroke. This suggests that >3 months after stroke, vascular cognitive impairment is not a fixed deficit; there is a motivational contributor. Brief treatments targeting goal-oriented behavior and motivation may serve as a novel approach or adjunct treatment to improve cognitive outcomes after stroke. Future research should investigate the use of goal setting on functional outcomes (eg, instrumental activities of daily living and vocational function) in this population, highlighting new potential avenues for treatment for vascular cognitive impairment. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT03511300.

scholarly journals Do Cognitive Performance and Physical Function Differ between Individuals with Motoric Cognitive Risk Syndrome and those with Mild Cognitive Impairment?

2020 ◽  
Author(s):  
Fang-Yu Cheng ◽  
Yuanmay Chang ◽  
Shih-Jung Cheng ◽  
Jin-Siang Shaw ◽  
Chuo-Yu Lee ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Physical Function ◽  
Cognitive Performance ◽  
Assessment Scale ◽  
Timed Up And Go ◽  
Cognitive Risk ◽  
Cognitive Complaint

Abstract Background Motoric cognitive risk syndrome (MCR) is defined by slow gait speed combined with subjective cognitive complaint. MCR is a predementia syndrome, similar to mild cognitive impairment (MCI). However, there is currently no study comparing the differences in cognitive performance and physical function between these two types of cognitive impairment. Thus, the aim of this study is to compare cognitive performance and physical function in individuals with MCR versus MCI. Methods A total of 77 participants, free of dementia, were recruited from the neurological outpatient clinic of a medical center in Taiwan. Participants were separated into two groups, MCR (n=33) and MCI (n=44) groups, based on definition criteria from previous studies. The priority was to assign a diagnosis of MCR first, followed by MCI. Hence, “pure” MCI had no overlap with MCR syndrome. Cognitive performance, including executive function, attention, working memory, episode memory, visuospatial function, and language, were measured. Physical functions such as activities in daily living, the Tinetti Assessment Scale, and the Timed Up and Go test were also measured. Results Executive function, attention, working memory, episodic memory and language were all significantly lower in the MCR group than the MCI group. Abilities related to physical function, including those measured by the Tinetti Assessment Scale and the Timed Up and Go test, were significantly lower in the MCR group than the MCI group. Conclusions We noted that cognitive performance and physical function were lower in MCR individuals than MCI but without MCR syndrome. However, the conclusions were based on the enrollment procedure of participants prioritizes the MCR syndrome. Because of the overlap of MCR and MCI, future studies should use different enrollment strategies to further clarify the status of these two populations.

scholarly journals Soya isoflavone supplementation enhances spatial working memory in men

2009 ◽  
Vol 102 (9) ◽  
pp. 1348-1354 ◽  
Author(s):  
Alicia A. Thorp ◽  
Natalie Sinn ◽  
Jonathan D. Buckley ◽  
Alison M. Coates ◽  
Peter R. C. Howe
Keyword(s):  
Working Memory ◽  
Executive Function ◽  
Cognitive Performance ◽  
Spatial Working Memory ◽  
Digit Span ◽  
Verbal Learning ◽  
Spatial Processing ◽  
Initial Letter ◽  
Visual Spatial ◽  
Visual Spatial Processing

Females perform better in certain memory-related tasks than males. Sex differences in cognitive performance may be attributable to differences in circulating oestrogen acting on oestrogen β receptors (ERβ) which are prevalent in brain regions such as the hippocampus, frontal lobe and cortex that mediate cognitive functions. Since soya isoflavones are known to activate ERβ, chronic isoflavone supplementation in males may improve cognitive performance in memory-related tasks. A 12-week double-blind, placebo-controlled cross-over trial was conducted in thirty-four healthy men to investigate the effect of isoflavone supplementation on cognitive function. Volunteers were randomised to take four capsules/d containing soya isoflavones (116 mg isoflavone equivalents/d: 68 mg daidzein, 12 mg genistein, 36 mg glycitin) or placebo for 6 weeks, and the alternate treatment during the following 6 weeks. Assessments of memory (verbal episodic, auditory and working), executive function (planning, attention, mental flexibility) and visual-spatial processing were performed at baseline and after each treatment period. Isoflavone supplementation significantly improved spatial working memory (P = 0·01), a test in which females consistently perform better than males. Compared with placebo supplementation, there were 18 % fewer attempts (P = 0·01), 23 % fewer errors (P = 0·02) and 17 % less time (P = 0·03) required to correctly identify the requisite information. Isoflavones did not affect auditory and episodic memory (Paired Associate Learning, Rey's Auditory Verbal Learning Task, Backward Digit Span and Letter-Number Sequencing), executive function (Trail Making and Initial Letter Fluency Task) or visual-spatial processing (Mental Rotation Task). Isoflavone supplementation in healthy males may enhance cognitive processes which appear dependent on oestrogen activation.

scholarly journals Do Cognitive Performance and Physical Function Differ between Individuals with Motoric Cognitive Risk Syndrome and those with Mild Cognitive Impairment?

2020 ◽  
Author(s):  
Fang-Yu Cheng ◽  
Yuanmay Chang ◽  
Shih-Jung Cheng ◽  
Jin-Siang Shaw ◽  
Chuo-Yu Lee ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Physical Function ◽  
Cognitive Performance ◽  
Assessment Scale ◽  
Timed Up And Go ◽  
Cognitive Risk ◽  
Cognitive Complaint

Abstract Background Motoric cognitive risk syndrome (MCR) is defined by slow gait speed combined with subjective cognitive complaint. MCR is a predementia syndrome, similar to mild cognitive impairment (MCI). However, there is currently no study comparing the differences in cognitive performance and physical function between these two types of cognitive impairment. Thus, the aim of this study is to compare cognitive performance and physical function in individuals with MCR versus MCI. Methods A total of 77 participants, free of dementia, were recruited from the neurological outpatient clinic of a medical center in Taiwan. Participants were separated into two groups, MCR (n = 33) and MCI (n = 44) groups, based on definition criteria from previous studies. Cognitive performance, including executive function, attention, working memory, episode memory, visuospatial function, and language, were measured. Physical functions such as activities in daily living, the Tinetti Assessment Scale, and the Timed Up and Go test were also measured. Results Executive function, attention, working memory, episodic memory and language were all significantly lower in the MCR group than the MCI group. Abilities related to physical function, including those measured by the Tinetti Assessment Scale and the Timed Up and Go test, were significantly lower in the MCR group than the MCI group. Conclusions We noted that cognitive performance and physical function were lower in MCR individuals than MCI individuals. The significant differences between those two groups may provide insight that MCR might lead to more severe overall functional deterioration in older adults than MCI patients.

scholarly journals Do Cognitive Performance and Physical Function Differ between Individuals with Motoric Cognitive Risk Syndrome and those with Mild Cognitive Impairment?

2020 ◽  
Author(s):  
Fang-Yu Cheng ◽  
Yuanmay Chang ◽  
Shih-Jung Cheng ◽  
Jin-Siang Shaw ◽  
Chuo-Yu Lee ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Physical Function ◽  
Cognitive Performance ◽  
Assessment Scale ◽  
Timed Up And Go ◽  
Cognitive Risk ◽  
Cognitive Complaint

Abstract Background Motoric cognitive risk syndrome (MCR) is defined by slow gait speed combined with subjective cognitive complaint. MCR is a predementia syndrome, similar to mild cognitive impairment (MCI). However, there is currently no study comparing the differences in cognitive performance and physical function between these two types of cognitive impairment. Thus, the aim of this study is to compare cognitive performance and physical function in individuals with MCR versus MCI. Methods A total of 77 participants, free of dementia, were recruited from the neurological outpatient clinic of a medical center in Taiwan. Participants were separated into two groups, MCR (n=33) and MCI (n=44) groups, based on definition criteria from previous studies. The priority was to assign a diagnosis of MCR first, followed by MCI. Hence, “pure” MCI has no overlap with MCR syndrome. Cognitive performance, including executive function, attention, working memory, episode memory, visuospatial function, and language, were measured. Physical functions such as activities in daily living, the Tinetti Assessment Scale, and the Timed Up and Go test were also measured. Results Executive function, attention, working memory, episodic memory and language were all significantly lower in the MCR group than the MCI group. Abilities related to physical function, including those measured by the Tinetti Assessment Scale and the Timed Up and Go test, were significantly lower in the MCR group than the MCI group. Conclusions We noted that cognitive performance and physical function were lower in MCR individuals than MCI but without MCR syndrome. However, the conclusions were based on the enrollment procedure of participants prioritizes the MCR syndrome. Because of the overlap of MCR and MCI, future studies should use different enrollment strategies to further clarify the status of these two populations.

Cerebral Vasomotor Reactivity in Amnestic Mild Cognitive Impairment

2020 ◽  
Vol 77 (1) ◽  
pp. 191-202
Author(s):  
Tsubasa Tomoto ◽  
Takashi Tarumi ◽  
Jason Chen ◽  
Evan P. Pasha ◽  
C. Munro Cullum ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Cognitive Performance ◽  
Verbal Learning ◽  
Normal Subjects ◽  
Amnestic Mild Cognitive Impairment ◽  
Logical Memory ◽  
Vasomotor Reactivity ◽  
Cerebral Vasomotor Reactivity

Background: Cerebral blood flow (CBF) is sensitive to changes in arterial CO2, referred to as cerebral vasomotor reactivity (CVMR). Whether CVMR is altered in patients with amnestic mild cognitive impairment (aMCI), a prodromal stage of Alzheimer disease (AD), is unclear. Objective: To determine whether CVMR is altered in aMCI and is associated with cognitive performance. Methods: Fifty-three aMCI patients aged 55 to 80 and 22 cognitively normal subjects (CN) of similar age, sex, and education underwent measurements of CBF velocity (CBFV) with transcranial Doppler and end-tidal CO2 (EtCO2) with capnography during hypocapnia (hyperventilation) and hypercapnia (rebreathing). Arterial pressure (BP) was measured to calculate cerebrovascular conductance (CVCi) to normalize the effect of changes in BP on CVMR assessment. Cognitive function was assessed with Mini-Mental State Examination (MMSE) and neuropsychological tests focused on memory (Logical Memory, California Verbal Learning Test) and executive function (Delis-Kaplan Executive Function Scale; DKEFS). Results: At rest, CBFV and MMSE did not differ between groups. CVMR was reduced by 13% in CBFV% and 21% in CVCi% during hypocapnia and increased by 22% in CBFV% and 20% in CVCi% during hypercapnia in aMCI when compared to CN (all p < 0.05). Logical Memory recall scores were positively correlated with hypocapnia (r = 0.283, r = 0.322, p < 0.05) and negatively correlated with hypercapnic CVMR measured in CVCi% (r = –0.347, r = –0.446, p < 0.01). Similar correlations were observed in D-KEFS Trail Making scores. Conclusion: Altered CVMR in aMCI and its associations with cognitive performance suggests the presence of cerebrovascular dysfunction in older adults who have high risks for AD.

General Measures of Cognition

2003 ◽  
Vol 15 (S1) ◽  
pp. 215-217 ◽  
Author(s):  
Steven H. Ferris
Keyword(s):  
Working Memory ◽  
Clinical Trials ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Vascular Dementia ◽  
Cognitive Performance ◽  
Verbal Fluency ◽  
Primary Outcome ◽  
Cognitive Domains ◽  
Reasonable Approach

A general cognitive performance battery is needed as a primary outcome in vascular dementia clinical trials. Because there is considerable overlap between vascular dementia and Alzheimer's disease (AD) in the pattern of cognitive impairment, a reasonable approach to developing an optimal vascular dementia battery is to begin with a widely used AD measure and improve its sensitivity to the cognitive domains that are more prominent in vascular dementia. Thus the VaDAS-cog has evolved, which comprises the ADAS-cog with additional frontal lobe subtests covering attention, working memory, executive function, and verbal fluency. Validation of this new cognitive instrument will be supported by its successful use in vascular dementia clinical trials.

scholarly journals Do cognitive performance and physical function differ between individuals with motoric cognitive risk syndrome and those with mild cognitive impairment?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fang-Yu Cheng ◽  
Yuanmay Chang ◽  
Shih-Jung Cheng ◽  
Jin-Siang Shaw ◽  
Chuo-Yu Lee ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Physical Function ◽  
Cognitive Performance ◽  
Assessment Scale ◽  
Timed Up And Go ◽  
Cognitive Risk ◽  
Cognitive Complaint

Abstract Background Motoric cognitive risk syndrome (MCR) is defined by slow gait speed combined with subjective cognitive complaint. MCR is a predementia syndrome, similar to mild cognitive impairment (MCI). However, there is currently no study comparing the differences in cognitive performance and physical function between these two types of cognitive impairment. Thus, the aim of this study is to compare cognitive performance and physical function in individuals with MCR versus MCI. Methods A total of 77 participants, free of dementia, were recruited from the neurological outpatient clinic of a medical center in Taiwan. Participants were separated into 2 groups, MCR (n = 33) and MCI (n = 44) groups, based on definition criteria from previous studies. The priority was to assign a diagnosis of MCR first, followed by MCI. Hence, “pure” MCI had no overlap with MCR syndrome. Cognitive performance, including executive function, attention, working memory, episode memory, visuospatial function, and language, were measured. Physical functions such as activities in daily living, the Tinetti Assessment Scale, and the Timed Up and Go test were also measured. Results Executive function, attention, working memory, episodic memory and language were all significantly lower in the MCR group than the MCI group. Abilities related to physical function, including those measured by the Tinetti Assessment Scale and the Timed Up and Go test, were significantly lower in the MCR group than the MCI group. Conclusions We noted that cognitive performance and physical function were lower in MCR individuals than MCI but without MCR syndrome. However, the conclusions were based on the enrollment procedure of participants prioritizes the MCR syndrome. Because of the overlap of MCR and MCI, future studies should use different enrollment strategies to further clarify the status of these two populations.

scholarly journals Working Memory and Executive Function Decline across Normal Aging, Mild Cognitive Impairment, and Alzheimer’s Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Anna-Mariya Kirova ◽  
Rebecca B. Bays ◽  
Sarita Lagalwar
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Working Memory ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Executive Dysfunction ◽  
Normal Aging ◽  
Future Research ◽  
Neurological Differences

Alzheimer’s disease (AD) is a progressive neurodegenerative disease marked by deficits in episodic memory, working memory (WM), and executive function. Examples of executive dysfunction in AD include poor selective and divided attention, failed inhibition of interfering stimuli, and poor manipulation skills. Although episodic deficits during disease progression have been widely studied and are the benchmark of a probable AD diagnosis, more recent research has investigated WM and executive function decline during mild cognitive impairment (MCI), also referred to as the preclinical stage of AD. MCI is a critical period during which cognitive restructuring and neuroplasticity such as compensation still occur; therefore, cognitive therapies could have a beneficial effect on decreasing the likelihood of AD progression during MCI. Monitoring performance on working memory and executive function tasks to track cognitive function may signal progression from normal cognition to MCI to AD. The present review tracks WM decline through normal aging, MCI, and AD to highlight the behavioral and neurological differences that distinguish these three stages in an effort to guide future research on MCI diagnosis, cognitive therapy, and AD prevention.

Abstract TP442: Periventricular Not Deep White Matter Hyperintensities Are Associated With Vascular Cognitive Impairment

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Yan Chen ◽  
Renyuan Liu ◽  
Shuwei Qiu ◽  
Yun Xu
Keyword(s):  
Regression Analysis ◽  
Cognitive Impairment ◽  
White Matter ◽  
Linear Regression ◽  
Cognitive Performance ◽  
White Matter Hyperintensities ◽  
Rating Scale ◽  
Linear Regression Analysis ◽  
Vascular Cognitive Impairment ◽  
Cerebral White Matter

Introduction: Cerebral White matter hyperintensities(WMH) are frequent findings on MRI scan. They are well known to correlate with vascular cognitive impairment(VCI). However, controversies still remain about the relationship between WMH locations and cognitive function across studies. Hypothesis: Periventricular WMHs(PWH) rather than deep WMHs(DWH) are associated with cognitive decline in VCI. Methods: Fifty-nine subjects with WMHs on MRI were divided into three groups, normal control(NC), mild cognitive impairment(MCI) and vascular dementia(VaD), according to clinical manifestation and neuropsychological performance. WMH volumes were evaluated by Fazekas rating scale and segmental volumetric. Correlations between cognitive performance and WMH volumes were determined in virtue of Spearman correlation analysis. Receiver operator characteristic (ROC) curves were generated to define the classification cut-off value of WMH volumes for distinguishing VCI versus normal controls. Multiple linear regression analysis was used to predict cognitive performance with WMH volumes and locations after adjusting for sex ,age and education level. Results: Cognitive capacities were gradually declined from NC through MCI to VaD patients while WMH volumes and Fazekas scores altered oppositely. Both PWH and DWH volumes and Fazekas scores were correlated with cognitive performance, and moreover, WMH volumes were correlated with Fazekas scores. ROC analysis showed a cut-off value of PWH rather than DWH to distinguish VCI from NC(AUC=0.745 and 0.635, p =0.001 and 0.076, respectively). Linear regression analysis demonstrated that only PWH volumes were associated with cognitive performance( p < 0.001). Conclusion: Our study demonstrate that PWHs are independent predictors for vascular contribution in white matter lesions and suggest clinicians that PWH should be emphasized on evaluating vascular cognitive impairment related with white matter load.

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

2020 ◽  
Vol 66 (3) ◽  
pp. 240-248 ◽  
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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