scholarly journals Contemporary approaches to correction of cognitive impairment in endogenous depression

2020 ◽  
pp. 82-93
Author(s):  
I. V. Oleichik ◽  
T. I. Shishkovskaia ◽  
P. A. Baranov
Keyword(s):  
Cognitive Impairment ◽  
Verbal Learning ◽  
Endogenous Depression ◽  
Pharmacological Agents ◽  
Delayed Recall ◽  
Basic Symptoms ◽  
Peak Intensity ◽  
Initial Stage ◽  
Subjective Importance ◽  
Reaction Speed

Cognitive dysfunction is one of the basic symptoms of endogenous depression, gaining much of the researchers’ interest lately. It is observed at the initial stage, at the peak intensity of depressive symptoms and even after their reduction, which leads to the persistence of residual depressive state. Cognitive impairment during the depressive episode can be detected by objective methods (clinical and neuropsychological), and their subjective importance is being revealed by standardized questionnaires. Depressed patients show lower results in executive functions, working memory, reaction speed, verbal learning, immediate and delayed recall subtests of neuropsychological batteries. There are few pharmacological agents (mostly antidepressants) with well-proven procognitive activity in depression. Besides, some new pharmacological and non-pharmacological approaches for treatment of cognitive impairment in depression have appeared lately and are described in literature as promising.

scholarly journals Cognitive impairment, health literacy, secondary prevention capacity and behaviours in acute coronary syndrome patients at early discharge: a prospective observational study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
E Zhao ◽  
NL Lowres ◽  
JT Tofler ◽  
SN Naismith ◽  
AB Baumman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Acute Coronary Syndrome ◽  
Cognitive Impairment ◽  
Health Literacy ◽  
Secondary Prevention ◽  
Learning And Memory ◽  
Verbal Learning ◽  
Post Discharge ◽  
Delayed Recall ◽  
Coronary Syndrome

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): the Vanguard Grant, Heart Foundation Background Cognitive impairment (CI) following acute coronary syndrome (ACS) is poorly understood. Purpose We aimed to explore the prevalence of CI in ACS patients four weeks post hospitalisation, the association with secondary prevention capacity and behaviours. Methods ACS inpatients who were free from visual deficits and dementia diagnoses were recruited. The post four weeks hospitalisation assessments included cognitive screening (Montreal Cognitive Assessment [MoCA], and Hopkins Verbal Learning Test [HVLT]), health literacy (Newest Vital Sign), depression (Patient Health Questionnaire-9), physical activity (Physical Activity Scale for the Elderly and Fitbit-Flex activity tracker), medication knowledge and adherence, sociodemographic and clinical factors. Results Participants (n = 45) had an average age of 65.07 ± 11.21 years, 82.2% were male, 64.4% were married/partnered and 82.2% had high school education or higher. CI occurred in 28.9% using either instrument, 20% using MoCA only and 15.6% using HVLT ­only. Cognitive domains affected were delayed recall (median = 5, range = 0-6) and new verbal learning and memory (15.6%). Adequate health literacy was less common in patients with CI (61.4%) than patients with normal cognition (90.3%, p = 0.024). Furthermore, patients with CI had trends for lower levels of secondary prevention capacity and behaviours, including fewer patients with high medication adherence, unlikely to be married or have an intimate partner, more depressive symptoms and lower levels of physical activity. Conclusions CI occurs in almost 30% of ACS patients four weeks post discharge, however a single screening tool is not sufficient to identify all cases. CI affected delayed recall, new verbal learning and memory; was associated with worse health literacy and may have potential implications for secondary prevention capacity.

scholarly journals Cognitive Impairment in Heart Failure: Issues of Measurement and Etiology

2002 ◽  
Vol 11 (6) ◽  
pp. 520-528 ◽  
Author(s):  
Barbara Riegel ◽  
Jill A. Bennett ◽  
Andra Davis ◽  
Beverly Carlson ◽  
John Montague ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cognitive Impairment ◽  
Fluid Overload ◽  
Verbal Learning ◽  
Screening Method ◽  
Serum Osmolality ◽  
Screening Tests ◽  
Delayed Recall ◽  
Correlational Design ◽  
Patients With Heart Failure

• Background Clinicians need easy methods of screening for cognitive impairment in patients with heart failure. If correlates of cognitive impairment could be identified, more patients with early cognitive impairment could be treated before the problem interfered with adherence to treatment. • Objectives To describe cognitive impairment in patients with heart failure, to explore the usefulness of 4 measures of cognitive impairment, and to assess correlates of cognitive impairment. • Methods A descriptive, correlational design was used. Four screening measures of cognition were assessed in 42 patients with heart failure: Commands subtest and Complex Ideational Material subtest of the Boston Diagnostic Aphasia Examination, Mini-Mental State Examination, and Draw-a-Clock Test. Cognitive impairment was defined as performance less than the standardized (T-score) cutoff point on at least 1 of the 4 measures. Possible correlates of cognitive impairment included age, education, hypotension, fluid overload (serum osmolality <269 mOsm/kg), and dehydration (serum osmolality ≥295 mOsm/kg). • Results Cognitive impairment was detected in 12 (28.6%) of 42 participants. The 4 screening tests varied in effectiveness, but the Draw-a-Clock Test indicated impairment in 50% of the 12 impaired patients. A summed standardized score for the 4 measures was not significantly associated with age, education, hypotension, fluid overload, or dehydration in this sample. • Conclusions Cognitive impairment is relatively common in patients with heart failure. The Draw-a-Clock Test was most useful in detecting cognitive impairment, although it cannot be used to detect problems with verbal learning or delayed recall and should not be used as the sole screening method for patients with heart failure. Correlates of cognitive impairment require further study.

Usefulness of Discriminability and Response Bias Indices for the Evaluation of Recognition Memory in Mild Cognitive Impairment and Alzheimer Disease

2016 ◽  
Vol 43 (1-2) ◽  
pp. 1-14 ◽  
Author(s):  
María Julieta Russo ◽  
Gabriela Cohen ◽  
Jorge Campos ◽  
Maria Eugenia Martin ◽  
María Florencia Clarens ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Alzheimer Disease ◽  
Recognition Memory ◽  
Response Bias ◽  
Memory Performance ◽  
Verbal Learning ◽  
False Alarms ◽  
Significant Group ◽  
Delayed Recall

Background: Most studies examining episodic memory in Alzheimer disease (AD) have focused on patients' impaired ability to remember information. This approach provides only a partial picture of memory deficits since other factors involved are not considered. Objective: To evaluate the recognition memory performance by using a yes/no procedure to examine the effect of discriminability and response bias measures in amnestic mild cognitive impairment (a-MCI), AD dementia, and normal-aging subjects. Methods: We included 43 controls and 45 a-MCI and 51 mild AD dementia patients. Based on the proportions of correct responses (hits) and false alarms from the Rey Auditory Verbal Learning Test (RAVLT), discriminability (d′) and response bias (C) indices from signal detection theory (SDT) were calculated. Results: Results showed significant group differences for d′ (F (2) = 83.26, p < 0.001), and C (F (2) = 6.05, p = 0.00). The best predictors of group membership were delayed recall and d′ scores. The d′ measure correctly classified subjects with 82.98% sensitivity and 91.11% specificity. Conclusions: a-MCI and AD dementia subjects exhibit less discrimination accuracy and more liberal response bias than controls. Furthermore, combined indices of delayed recall and discriminability from the RAVLT are effective in defining early AD. SDT may help enhance diagnostic specificity.

Being married/having an intimate partner/being has protective effects for mild cognitive impairment in acute coronary syndrome patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Gallagher ◽  
E Zhao ◽  
S Naismith ◽  
G Tofler ◽  
A Bauman
Keyword(s):  
Acute Coronary Syndrome ◽  
Cognitive Impairment ◽  
Verbal Learning ◽  
Intimate Partner ◽  
Funding Source ◽  
Protective Effects ◽  
Z Score ◽  
Delayed Recall ◽  
Coronary Syndrome ◽  
The Mean

Abstract Background Cardiovascular disease (CVD) is a leading cause of mortality and morbidity and is known to contribute to cognitive impairment, a condition common in CVD patients. Cognitive impairment (CI) is important to detect, manage and accommodate because it limits the capacity of CVD patients to learn about secondary prevention and engage in appropriate self-care including lifestyle change. Purpose Therefore this study aimed to determine the prevalence and predictors of cognitive impairment in acute coronary syndrome (ACS) patients during hospital admission. Methods ACS (myocardial infarction, unstable angina) inpatients (n=81) who did not have a neurocognitive diagnosis were recruited to a prospective descriptive study in 2019. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) and the Hopkins Verbal Learning Test (HVLT). Results The sample had an age mean of 63.49±10.86 (range 40–89) years, was mostly male (82.7%) and 50.6% were university educated. MI occurred in 56.8%, equally STEMI (28.4%) and nSTEMI (28.4%) with 70.4% treated by coronary intervention. The mean education adjusted MOCA score was 25.73±3.05 (range 18–31) and 48.1% were classified as having mild CI (18–26). The domain with the worst performance was delayed recall/memory domain at mean 2.58±1.77 (of potential 0–5 points). The mean unadjusted recall score on HVLT was 19.56±6.18 (range 0–32), the mean z-score −0.69±1.21 (range −4.59–1.87) and 40.7% were classified as having mild CI (age and education adjusted Z-score ≥−1). Mild CI was classified by both MOCA and HVLT (both adjusted) in 24.7%. Patients classified as having mild CI (MOCA) were significantly older (66.87 versus 60.36 years, p=0.006) and less likely and to be married or have an intimate partner (21% versus 32% p=0.039). When all factors were taken into account using multiple linear regression, higher MOCA scores in patients who were married/partnered (B=1.6) and lower scores with advancing age (B=−0.08). Conclusions Mild CI and decreased delayed recall is prevalent in ACS patients and patient education strategies need to be accommodate this. Being married/partnered may have protective effects, therefore additional support may need to be directed to single patients. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Heart Foundation of Australia Vanguard Award

scholarly journals Normative Data that Does Not Exclude Participants with Mild Cognitive Impairment Results in Lower Than Expected Memory Impairment Rates, Particularly in Females

2019 ◽  
Vol 34 (6) ◽  
pp. 848-848
Author(s):  
N Stricker ◽  
E Lundt ◽  
T Christianson ◽  
M Machulda ◽  
W Kremers ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Aging ◽  
Normative Data ◽  
Verbal Learning ◽  
Population Based ◽  
Delayed Recall ◽  
Impaired Performance ◽  
Auditory Verbal Learning ◽  
Learning Test

Abstract Objective Mayo’s Older Adult Normative Studies (MOANS) have served as an important resource for clinicians for three decades. Data collection was completed prior to the development and widespread use of Mild Cognitive Impairment (MCI) as a construct. Therefore, a portion of individuals included in the MOANS normative studies likely had undetected cognitive impairment. Method The Mayo Clinic Study of Aging (MCSA) is a population-based study of cognitive aging among Olmsted County, Minnesota, residents that began in October 2004. We applied age-adjusted MOANS norms (Ivnik et al., 1992) for the Auditory Verbal Learning Test (AVLT) long delay recall to cognitively unimpaired participants age 56 or older in the MCSA (N = 3,603). We used 1-sample tests of proportions comparing observed impairment rates to impairment rates expected based on a normal distribution of performance. Results Results showed that a significantly lower than expected number of participants demonstrated impaired delayed recall based on MOANS norms (all p’s < .001). Using a lenient cut-off (< -1 SD), only 7.3% of participants demonstrated impaired performance (vs. 15.9% expected), and this was more pronounced for females (3.5% impaired) relative to males (11.1% impaired). Further, only 0.6% of participants demonstrated impaired performance at a cut-off of < -2 SD, and no participants aged 80-91 reached this cut-off (2.3% expected). Conclusions Results suggest that the sensitivity of the original MOANS norms is lowered by likely inclusion of individuals with MCI, particularly in females. Updated normative data for the AVLT that exclude individuals with MCI and adjust for sex are needed.

scholarly journals Event-related potential and EEG oscillatory predictors of verbal memory in mild cognitive impairment

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Jiangyi Xia ◽  
Ali Mazaheri ◽  
Katrien Segaert ◽  
David P Salmon ◽  
Danielle Harvey ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Verbal Memory ◽  
Verbal Learning ◽  
Event Related Potential ◽  
Single Trial ◽  
Prodromal Alzheimer’S Disease ◽  
Alpha Beta

Abstract Reliable biomarkers of memory decline are critical for the early detection of Alzheimer’s disease. Previous work has found three EEG measures, namely the event-related brain potential P600, suppression of oscillatory activity in the alpha frequency range (∼10 Hz) and cross-frequency coupling between low theta/high delta and alpha/beta activity, each of which correlates strongly with verbal learning and memory abilities in healthy elderly and patients with mild cognitive impairment or prodromal Alzheimer’s disease. In the present study, we address the question of whether event-related or oscillatory measures, or a combination thereof, best predict the decline of verbal memory in mild cognitive impairment and Alzheimer’s disease. Single-trial correlation analyses show that despite a similarity in their time courses and sensitivities to word repetition, the P600 and the alpha suppression components are minimally correlated with each other on a trial-by-trial basis (generally |rs| &lt; 0.10). This suggests that they are unlikely to stem from the same neural mechanism. Furthermore, event-related brain potentials constructed from bandpass filtered (delta, theta, alpha, beta or gamma bands) single-trial data indicate that only delta band activity (1–4 Hz) is strongly correlated (r = 0.94, P &lt; 0.001) with the canonical P600 repetition effect; event-related potentials in higher frequency bands are not. Importantly, stepwise multiple regression analyses reveal that the three event-related brain potential/oscillatory measures are complementary in predicting California Verbal Learning Test scores (overall R2’s in 0.45–0.63 range). The present study highlights the importance of combining EEG event-related potential and oscillatory measures to better characterize the multiple mechanisms of memory failure in individuals with mild cognitive impairment or prodromal Alzheimer’s disease.

scholarly journals Paraoxonase 1, B Vitamins Supplementation, and Mild Cognitive Impairment

2021 ◽  
pp. 1-19
Author(s):  
Joanna Perła-Kaján ◽  
Olga Włoczkowska ◽  
Anetta Zioła-Frankowska ◽  
Marcin Frankowski ◽  
A. David Smith ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Controlled Trial ◽  
Verbal Learning ◽  
Cognitive Status ◽  
B Vitamins ◽  
Paraoxonase 1 ◽  
Phenyl Acetate ◽  
Double Blind ◽  
Trail Making

Background: Identification of modifiable risk factors that affect cognitive decline is important for the development of preventive and treatment strategies. Status of paraoxonase 1 (PON1), a high-density lipoprotein-associated enzyme, may play a role in the development of neurological diseases, including Alzheimer’s disease. Objective: We tested a hypothesis that PON1 status predicts cognition in individuals with mild cognitive impairment (MCI). Methods: Individuals with MCI (n = 196, 76.8-years-old, 60% women) participating in a randomized, double-blind placebo-controlled trial (VITACOG) were assigned to receive a daily dose of folic acid (0.8 mg), vitamin B12 (0.5 mg) and B6 (20 mg) (n = 95) or placebo (n = 101) for 2 years. Cognition was analyzed by neuropsychological tests. Brain atrophy was quantified in a subset of participants (n = 168) by MRI. PON1 status, including PON1 Q192R genotype, was determined by quantifying enzymatic activity of PON1 using paraoxon and phenyl acetate as substrates. Results: In the placebo group, baseline phenylacetate hydrolase (PhAcase) activity of PON1 (but not paraoxonase activity or PON1 Q192R genotype) was significantly associated with global cognition (Mini-Mental State Examination, MMSE; Telephone Inventory for Cognitive Status-modified, TICS-m), verbal episodic memory (Hopkins Verbal Learning Test-revised: Total Recall, HVLT-TR; Delayed Recall, HVLT-DR), and attention/processing speed (Trail Making A and Symbol Digits Modalities Test, SDMT) at the end of study. In addition to PhAcase, baseline iron and triglycerides predicted MMSE, baseline fatty acids predicted SDMT, baseline anti-N-Hcy-protein autoantibodies predicted TICS-m, SDMT, Trail Making A, while BDNF V66M genotype predicted HVLT-TR and HVLT-DR scores at the end of study. B-vitamins abrogated associations of PON1 and other variables with cognition. Conclusion: PON1 is a new factor associated with impaired cognition that can be ameliorated by B-vitamins in individuals with MCI.

scholarly journals CTNI-51. NEUROCOGNITIVE FUNCTION (NCF) OUTCOMES OF RTOG FOUNDATION 3508: A PHASE 3 TRIAL OF ABT-414 WITH CONCURRENT CHEMORADIATION AND ADJUVANT TEMOZOLOMIDE IN PATIENTS WITH EGFR-AMPLIFIED NEWLY DIAGNOSED GBM

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii54-ii54
Author(s):  
Jeffrey S Wefel ◽  
Minhee Won ◽  
Andrew Lassman ◽  
Yaakov Stern ◽  
Tony Wang ◽  
...  
Keyword(s):  
Learning And Memory ◽  
Verbal Learning ◽  
Concurrent Chemoradiation ◽  
Reliable Change Index ◽  
Newly Diagnosed ◽  
Total Recall ◽  
Phase 3 ◽  
Delayed Recall ◽  
Adjuvant Temozolomide ◽  
Over Time

Abstract RTOG 3508/AbbVie M13-813/INTELLANCE-1 was a phase 3 trial of depatuximab-mafodotin (depatux-m, formerly ABT-414) that accrued 639 patients with EGFR-amplified newly diagnosed GBM. At the pre-specified interim OS analysis, the futility criteria were met and there was no survival benefit from adding depatux-m to SOC. Pre-specified secondary NCF analyses included time to decline in verbal learning and memory as assessed by the HVLT-R Total Recall based on the reliable change index. Exploratory NCF analyses examined changes in other HVLT-R outcomes over time. As corneal epitheliopathy causing visual impairment is a known toxicity of depatux-m, NCF tests that did not depend on visual acuity were employed. NCF testing occurred at baseline, day 1 of the first cycle of adjuvant depatux-m, every other cycle (i.e., 8 weeks) thereafter, and at progression. Compliance with test completion was 95% at screening and 80%, 70%, 58%, 51%, 47% thereafter through cycle 9. The most common reasons for missing data was site error. Time to HVLT-R Total Recall decline trended worse in the depatux-m arm compared to placebo but the difference was not significant (12 month deterioration: 41.2%, 95% CI: 3.50–47.2 vs 32.4%, 95% CI: 26.6- 38.4, p=0.052). The depatux-m arm, in comparison to the placebo arm, showed greater decline from baseline on the HVLT-R at the following time points: cycle 3 (Total Recall: mean= -1.8, SD=5.7 vs mean= -0.5, SD=5.5, respectively, p=0.046; Delayed Recall: mean= -1.1, SD=3.0 vs. mean= -0.2, SD=2.7, respectively, p=0.01), cycle 7 (Total Recall: mean= -0.6, SD=5.1 vs mean= 1.4, SD=5.0, respectively, p=0.009; Delayed Recall: mean -0.6, SD=3.0 vs. mean= 0.5, SD=2.7, respectively, p=0.01), and cycle 9 (Delayed Recall: mean=-0.4, SD=2.7 vs. mean= 0.8, SD=2.4, respectively, p=0.003). Depatux-m added to concurrent chemoradiation and adjuvant temozolomide was associated with faster time to deterioration and worse episodic learning and memory over time than placebo.

scholarly journals A score based on screening tests to differentiate mild cognitive impairment from subjective memory complaints

2013 ◽  
Vol 5 (3) ◽  
pp. 16 ◽  
Author(s):  
Fábio Henrique De Gobbi Porto ◽  
Lívia Spíndola ◽  
Maira Okada De Oliveira ◽  
Patrícia Helena Figuerêdo Do Vale ◽  
Marco Orsini ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Characteristic Curve ◽  
Neuropsychological Testing ◽  
Area Under The Curve ◽  
Screening Tests ◽  
Elderly Subjects ◽  
Subjective Memory ◽  
Delayed Recall ◽  
Memory Complaints

It is not easy to differentiate patients with mild cognitive impairment (MCI) from subjective memory complainers (SMC). Assessments with screening cognitive tools are essential, particularly in primary care where most patients are seen. The objective of this study was to evaluate the diagnostic accuracy of screening cognitive tests and to propose a score derived from screening tests. Elderly subjects with memory complaints were evaluated using the Mini Mental State Examination (MMSE) and the Brief Cognitive Battery (BCB). We added two delayed recalls in the MMSE (a delayed recall and a late-delayed recall, LDR), and also a phonemic fluency test of letter P fluency (LPF). A score was created based on these tests. The diagnoses were made on the basis of clinical consensus and neuropsychological testing. Receiver operating characteristic curve analyses were used to determine area under the curve (AUC), the sensitivity and specificity for each test separately and for the final proposed score. MMSE, LDR, LPF and delayed recall of BCB scores reach statistically significant differences between groups (P=0.000, 0.03, 0.001 and 0.01, respectively). Sensitivity, specificity and AUC were MMSE: 64%, 79% and 0.75 (cut off &lt;29); LDR: 56%, 62% and 0.62 (cut off &lt;3); LPF: 71%, 71% and 0.71 (cut off &lt;14); delayed recall of BCB: 56%, 82% and 0.68 (cut off &lt;9). The proposed score reached a sensitivity of 88% and 76% and specificity of 62% and 75% for cut off over 1 and over 2, respectively. AUC were 0.81. In conclusion, a score created from screening tests is capable of discriminating MCI from SMC with moderate to good accurancy.

Sign in / Sign up

Export Citation Format

Share Document