Diabetes, obesity-associated comorbidities and NIH-Toolbox neurocognitive performance

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Ronald A Cohen

Background/Objectives: Severe obesity is associated with cognitive deficits in adults without current or past neurological brain disturbances. This study examined the relationship between specific metabolic and vascular risk factors and cognitive performance on a computerized neurocognitive assessment battery in adults with BMI > 35. Subjects/Methods: 123 adults with Class II or III obesity, ages 20-75, were enrolled in a study of the cognitive and brain effects of reduced BMI and improved diabetes mellitus (DM) following bariatric surgery. Baseline clinical/cognitive assessments were conducted with the NIH Toolbox (NIH-TB) cognitive module prior to surgery, and in severely obese controls recruited from the community. Global, Fluid and Crystallized indices were derived from performance across nine tasks. Hierarchical regression analyses examined six obesity-associated clinical factors (BMI, HbA1c, and DM, hypertension, sleep apnea, and osteoarthritis diagnoses) relative to NIH-TB performance. Results: Fluid Cognition deficits were observed, greatest on attention-executive and cognitive processing speed tasks (Flanker and Pattern Comparison). DM diagnosis was most strongly associated with weaker cognitive performance (Global and Fluid Cognition), and with poorer performance on the Flanker, Pattern Comparison, Picture Sequencing, Verbal Learning, and Symbol Coding tasks. Elevated HbA1c was associated with weaker Card Sorting and Symbol Coding performance, hypertension with poorer Fluid Cognition, and osteoarthritis with lower List Sorting performance. Elevated BMI was only associated with Flanker performance, though DM was more strongly associated with this measure. Conclusion: Deficits of fluid cognitive functions (attention-executive, processing speed) exist among adults with Class II and III obesity. DM was most consistently associated with weaker NIH-TB performance. BMI was not as strongly associated with NIH-TB performance, perhaps reflecting the elevated BMI of the entire sample. That cognitive deficits were linked to specific obesity-associated comorbidities support the validity and potential clinical utility of the NIH-TB for the assessment and management of adults with severe obesity.

2013 ◽  
Vol 44 (5) ◽  
pp. 937-947 ◽  
Author(s):  
A. Pantzar ◽  
E. J. Laukka ◽  
A. R. Atti ◽  
J. Fastbom ◽  
L. Fratiglioni ◽  
...  

BackgroundThere is substantial variability in the degree of cognitive impairment among older depressed persons. Inconsistencies in previous findings may be due to differences in clinical and demographic characteristics across study samples. We assessed the influence of unipolar depression and severity of depression on cognitive performance in a population-based sample of elderly persons aged ⩾60 years.MethodEighty-nine persons fulfilled ICD-10 criteria for unipolar depression (mild, n = 48; moderate, n = 38; severe, n = 3) after thorough screening for dementia (DSM-IV criteria), psychiatric co-morbidities and antidepressant pharmacotherapy. Participants (n = 2486) were administered an extensive cognitive test battery.ResultsModerate/severe unipolar depression was associated with poorer performance on tasks assessing processing speed, attention, executive function, verbal fluency, episodic memory and vocabulary. Mild depression was associated with poorer performance in processing speed, and few differences between mild and moderate/severe depression were observed. No association between depression and short-term memory, general knowledge or spatial ability was observed. Increasing age did not exacerbate the depression-related cognitive deficits, and the deficits remained largely unchanged after excluding persons in a preclinical phase of dementia. Furthermore, depression-related cognitive deficits were not associated with other pharmacological treatments that may affect cognitive performance.ConclusionsCognitive deficits in unipolar old-age depression involve a range of domains and the cognitive deficits seem to follow the spectrum of depression severity. The finding that mild depression was also associated with poorer cognitive functioning underscores the importance of detecting mild depression in elderly persons.


2019 ◽  
Vol 29 (4) ◽  
pp. 421-449 ◽  
Author(s):  
Eric L. A. Fonseca Wald ◽  
Jos G. M. Hendriksen ◽  
Gerald S. Drenthen ◽  
Sander M. J. V. Kuijk ◽  
Albert P. Aldenkamp ◽  
...  

AbstractCognition in absence epilepsy (AE) is generally considered undisturbed. However, reports on cognitive deficits in AE in recent years have suggested otherwise. This review systematically assesses current literature on cognitive performance in children with AE. A systematic literature search was performed in Pubmed, Embase, Cochrane and Web of Science. All studies reporting on cognitive performance in children with AE were considered. In total 33 studies were eligible for inclusion. Neuropsychological tests were classified into the following domains: intelligence; executive function; attention; language; motor & sensory-perceptual examinations; visuoperceptual/visuospatial/visuoconstructional function; memory and learning; achievement. Random-effect meta-analyses were conducted by estimating the pooled mean and/or pooling the mean difference in case-control studies. Full-scale IQ in children with AE was estimated at 96.78 (95%CI:94.46–99.10) across all available studies and in case-control studies IQ was on average 8.03 (95%CI:-10.45- -5.61) lower. Verbal IQ was estimated at 97.98 (95%CI:95.80–100.16) for all studies and 9.01 (95%CI:12.11- -5.90) points lower in case-control studies. Performance IQ was estimated at 97.23 (93.24–101.22) for all available studies and 5.32 (95%CI:-8.27–2.36) points lower in case-control studies. Lower performance was most often reported in executive function (cognitive flexibility, planning, and verbal fluency) and attention (sustained, selective and divided attention). Reports on school difficulties, neurodevelopmental problems, and attentional problems were high. In conclusion, in contrast to common beliefs, lower than average neurocognitive performance was noted in multiple cognitive domains, which may influence academic and psychosocial development.


2020 ◽  
Vol 35 (5) ◽  
pp. 630-630
Author(s):  
C Quintana ◽  
M A Kelly ◽  
N R Heebner ◽  
D Y Han ◽  
J P Abt ◽  
...  

Abstract Objective Understanding sex and sport-related differences in baseline neurocognitive scores may aid in interpreting post-injury performance. Sex and sport-related differences in neurocognitive performance for collegiate athletes have not been examined on the NIH Toolbox® Cognition Battery (NIHTB-CB). Therefore, this study sought to determine if baseline scores on the NIHTB-CB differ between sex or sport in collegiate athletes. It was hypothesized that sex, but not sport-related differences would exist in CB baseline performance. Method 107 Division-I athletes (47 females, 60 males) that participated in soccer (n = 45), football (n = 30), or cheerleading (n = 32) volunteered to participate. Participants completed tablet-based NIHTB-CB assessments including the Flanker Inhibitory Control & Attention (FICA), Dimensional Change Card Sort (DCCS), Picture Sequence Memory (PSM), and Pattern Comparison Processing Speed (PCPS) tests. These assessments measured visual attention, cognitive flexibility, memory recall, and processing speed, respectively. Fully corrected t-scores were used for analyses. Parametric and non-parametric tests compared scores based on sex and sport. Results Females demonstrated greater performance on the PCPS (Females: 64.72 ± 9.84, Males: 61.08 ± 8.85; p = 0.006). Males exhibited better performance on the FICA (Females: 45.72 ± 10.12, Males: 51.03 ± 10.70; p = 0.009). After controlling for sex, a significant difference across sports was identified in the FICA (p = 0.007) with cheerleading (43.81 ± 9.28) exhibiting poorer performance than football (54.33 ± 10.44; p = 0.002) and soccer (48.42 ± 10.28; p = 0.047). No sex or sport differences were identified for the DCCS or PSM. Conclusions Baseline differences in neurocognitive performance exist on the NIHTB-CB based on sex and sport suggesting these variables be taken into consideration when interpreting post-concussion scores in collegiate athletes.


2020 ◽  
Vol 26 (8) ◽  
pp. 739-748 ◽  
Author(s):  
Sarah E. MacPherson ◽  
Michael Allerhand ◽  
Sarah Gharooni ◽  
Daniela Smirni ◽  
Tim Shallice ◽  
...  

AbstractObjective:Cognitive reserve (CR) suggests that premorbid efficacy, aptitude, and flexibility of cognitive processing can aid the brain’s ability to cope with change or damage. Our previous work has shown that age and literacy attainment predict the cognitive performance of frontal patients on frontal-executive tests. However, it remains unknown whether CR also predicts the cognitive performance of non-frontal patients.Method:We investigated the independent effect of a CR proxy, National Adult Reading Test (NART) IQ, as well as age and lesion group (frontal vs. non-frontal) on measures of executive function, intelligence, processing speed, and naming in 166 patients with focal, unilateral frontal lesions; 91 patients with focal, unilateral non-frontal lesions; and 136 healthy controls.Results:Fitting multiple linear regression models for each cognitive measure revealed that NART IQ predicted executive, intelligence, and naming performance. Age also significantly predicted performance on the executive and processing speed tests. Finally, belonging to the frontal group predicted executive and naming performance, while membership of the non-frontal group predicted intelligence.Conclusions:These findings suggest that age, lesion group, and literacy attainment play independent roles in predicting cognitive performance following stroke or brain tumour. However, the relationship between CR and focal brain damage does not differ in the context of frontal and non-frontal lesions.


2014 ◽  
Vol 94 (6) ◽  
pp. 757-766 ◽  
Author(s):  
Elizabeth L. Stegemöller ◽  
Jonathan P. Wilson ◽  
Audrey Hazamy ◽  
Mack C. Shelley ◽  
Michael S. Okun ◽  
...  

Background Cognitive impairments in Parkinson disease (PD) manifest as deficits in speed of processing, working memory, and executive function and attention abilities. The gait impairment in PD is well documented to include reduced speed, shortened step lengths, and increased step-to-step variability. However, there is a paucity of research examining the relationship between overground walking and cognitive performance in people with PD. Objective This study sought to examine the relationship between both the mean and variability of gait spatiotemporal parameters and cognitive performance across a broad range of cognitive domains. Design A cross-sectional design was used. Methods Thirty-five participants with no dementia and diagnosed with idiopathic PD completed a battery of 12 cognitive tests that yielded 3 orthogonal factors: processing speed, working memory, and executive function and attention. Participants completed 10 trials of overground walking (single-task walking) and 5 trials of overground walking while counting backward by 3's (dual-task walking). Results All gait measures were impaired by the dual task. Cognitive processing speed correlated with stride length and walking speed. Executive function correlated with step width variability. There were no significant associations with working memory. Regression models relating speed of processing to gait spatiotemporal variables revealed that including dual-task costs in the model significantly improved the fit of the model. Limitations Participants with PD were tested only in the on-medication state. Conclusions Different characteristics of gait are related to distinct types of cognitive processing, which may be differentially affected by dual-task walking due to the pathology of PD.


2016 ◽  
Vol 35 ◽  
pp. 32-38 ◽  
Author(s):  
A. James ◽  
E. Joyce ◽  
D. Lunn ◽  
M. Hough ◽  
L. Kenny ◽  
...  

AbstractBackgroundAdolescent-onset schizophrenia (AOS) is associated with cognitive impairment and poor clinical outcome. Cognitive dysfunction is hypothesised, in part, to reflect functional dysconnectivity between the frontal cortex and the striatum, although structural abnormalities consistent with this hypothesis have not yet been demonstrated in adolescence.ObjectiveTo characterise frontostriatal white matter (WM) tracts in relation to cognition in AOS.DesignA MRI volumetric and diffusion tensor imaging study.ParticipantsThirty-seven AOS subjects and 24 age and sex-matched healthy subjects.Outcome measuresUsing probabilistic tractography, cortical regions with the highest connection probability for each striatal voxel were determined, and correlated with IQ and specific cognitive functions after co-varying for age and sex. Fractional anisotropy (FA) from individual tracts was a secondary measure.ResultsBayesian Structural Equation modeling of FA from 12 frontostriatal tracts showed processing speed to be an intermediary variable for cognition. AOS patients demonstrated generalised cognitive impairment with specific deficits in verbal learning and memory and in processing speed after correction for IQ. Dorsolateral prefrontal cortex connectivity with the striatum correlated positively with these measures and with IQ. DTI voxel-wise comparisons showed lower connectivity between striatum and the motor and lateral orbitofrontal cortices bilaterally, the left amygdalohippocampal complex, right anterior cingulate cortex, left medial orbitofrontal cortex and right dorsolateral prefrontal cortex.ConclusionsFrontostriatal dysconnectivity in large WM tracts that can explain core cognitive deficits are evident during adolescence. Processing speed, which is affected by alterations in WM connectivity, appears an intermediary variable in the cognitive deficits seen in schizophrenia.


2001 ◽  
Vol 17 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Karl H. Wiedl ◽  
Henning Schöttke ◽  
M. Dolores Calero Garcia

Summary: Dynamic assessment is a diagnostic approach in which specific interventions are integrated into assessment procedures to estimate cognitive modifiability. The study investigates the utility of this approach in persons with compelling rehabilitational needs. Samples of schizophrenic patients and of elderly with and without dementia were assessed with dynamic versions of the Wisconsin Card Sorting Test and the Auditory Verbal Learning Test. Both tests were administered by applying specific procedures of verbal mediation designed to increase performance. Results demonstrated superior predictive validity with regard to proficiency in a clinical training in schizophrenic subjects and better discrimination of nondemented and demented elderly with the help of dynamic measures compared to static test scores. Subsequent correlational analyses indicated that, for both tests, performance change following intervention is related to the processing of verbal context information. Results are discussed with respect to the concept of verbal working memory as one component of the patients' rehabilitation potential.


2020 ◽  
Vol 91 (6) ◽  
pp. 532-534
Author(s):  
Nicola Mammarella

INTRODUCTION: In recent decades, there has been investigation into the effects of microgravity and microgravity-like environments on cognition and emotion separately. Here we highlight the need of focusing on emotion-cognition interactions as a framework for explaining cognitive performance in space. In particular, by referring to the affective cognition hypothesis, the significant interplay between emotional variables and cognitive processing in space is briefly analyzed. Altogether, this approach shows an interesting pattern of data pointing to a dynamic relation that may be sensitive to microgravity. The importance of examining interactions between emotion and cognition for space performance remains fundamental (e.g., stress-related disorders) and deserves further attention. This approach is ultimately interesting considering the potential effects that microgravity may play on human performance during long-term space missions and on return to Earth.Mammarella N. Towards the affective cognition approach to human performance in space. Aerosp Med Hum Perform. 2020; 91(6):532–534.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A15-A15
Author(s):  
Andrea Ricciardiello ◽  
Sharon Naismith ◽  
Angela D’Rozario ◽  
Fiona Kumfor ◽  
Rick Wassing

Abstract Introduction Late-life depression is the most common psychiatric disorder in older adults and is associated with cognitive deficits, however, the role of sleep disturbance in cognitive deficits is poorly defined. In the current study we aimed to examine sleep macro and micro-architecture differences between those with late-life depression and controls. Secondly, we sought to determine how sleep changes relate to clinical memory and executive function measures in those with late-life depression and controls. Methods Using prior clinical data, this retrospective study assessed adults >50 years who had completed an overnight PSG study and comprehensive psychiatric, neuropsychological, and medical assessment. Memory performance was measured using the Weschler Memory Scale logical Memory 1 and 2 components, Rey Auditory Verbal Learning Test (Senior) 30-minute recall and Rey Complex Figure 3-minute recall. Executive function was defined by z scores from Trail Making Test, D-KEFS Stroop Test and Controlled Oral Word Association Test. The sample comprised of 71 depressed participants, defined by a Geriatric Depression Scale score ≥6, and 101 non-depressed participants (GDS <6 and no lifetime history of depression using DSM-IV criteria). Results Contrary to our hypothesis no significant macroarchitectural differences were observed between the groups. Less time spent in slow-wave sleep (SWS) was associated with worse delayed memory recall scores in the depression group (z=.342, p=0.008) although this was not seen in the control group. SWS and slow wave activity (SWA) were not related to measures of executive function performance. Depressed participants demonstrated a reduced level of sleep spindles (Dep= 159 ±142.8, con= 213±163, p=.03) although there were no associations with memory outcomes. Conclusion Compared to younger adults with depression, macroarchitectural differences in those with late-life depression are not as pronounced, due to a reduction of SWS and SWA power as a function of ageing. The efficiency of SWS hippocampal dependent memory processes in depression may be reduced, therefore, more time spent in SWS is related to better memory performance. This study assessed the density of sleep spindles but not spindle and slow wave oscillation coupling which may be more important for hippocampal dependent memory. Support (if any):


2020 ◽  
pp. 1-12
Author(s):  
Kimberly H. Wood ◽  
Adeel A. Memon ◽  
Raima A. Memon ◽  
Allen Joop ◽  
Jennifer Pilkington ◽  
...  

Background: Cognitive and sleep dysfunction are common non-motor symptoms in Parkinson’s disease (PD). Objective: Determine the relationship between slow wave sleep (SWS) and cognitive performance in PD. Methods: Thirty-two PD participants were evaluated with polysomnography and a comprehensive level II neurocognitive battery, as defined by the Movement Disorders Society Task Force for diagnosis of PD-mild cognitive impairment. Raw scores for each test were transformed into z-scores using normative data. Z-scores were averaged to obtain domain scores, and domain scores were averaged to determine the Composite Cognitive Score (CCS), the primary outcome. Participants were grouped by percent of SWS into High SWS and Low SWS groups and compared on CCS and other outcomes using 2-sided t-tests or Mann-Whitney U. Correlations of cognitive outcomes with sleep architecture and EEG spectral power were performed. Results: Participants in the High SWS group demonstrated better global cognitive function (CCS) (p = 0.01, effect size: r = 0.45). In exploratory analyses, the High SWS group showed better performance in domains of executive function (effect size: Cohen’s d = 1.05), language (d = 0.95), and processing speed (d = 1.12). Percentage of SWS was correlated with global cognition and executive function, language, and processing speed. Frontal EEG delta power during N3 was correlated with the CCS and executive function. Cognition was not correlated with subjective sleep quality. Conclusion: Increased SWS and higher delta spectral power are associated with better cognitive performance in PD. This demonstrates the significant relationship between sleep and cognitive function and suggests that interventions to improve sleep might improve cognition in individuals with PD.


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