Cognitive test to forecast unsafe driving in older drivers: Meta-analysis

2014 ◽  
Vol 35 (4) ◽  
pp. 771-778 ◽  
Author(s):  
Seong-Youl Choi ◽  
Jae-Shin Lee ◽  
A-Young Song
Keyword(s):  
Meta Analysis ◽  
Older Drivers ◽  
Cognitive Test

scholarly journals A Comparative Meta-Analysis of the Effects of Concussion on a Computerized Neurocognitive Test and Self-Reported Symptoms

2017 ◽  
Vol 52 (9) ◽  
pp. 834-846 ◽  
Author(s):  
Bara Alsalaheen ◽  
Kayla Stockdale ◽  
Dana Pechumer ◽  
Steven P. Broglio ◽  
Gregory F. Marchetti
Keyword(s):  
Test Performance ◽  
Fixed Effects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cognitive Testing ◽  
Cognitive Test ◽  
Fixed Effects Model ◽  
Symptom Scale ◽  
Additional Information ◽  
Neurocognitive Test

Context:  Meta-analyses examining construct-specific cognitive impairment concurrently with self-reported symptoms postconcussion are sparse. Objective:  To review the literature on the effects of concussion on construct-specific neurocognitive declines and to compare them with self-reported symptoms before 1 week and between 1 and 3 weeks postconcussion. Data Sources:  Relevant studies in PubMed, CINAHL, and PsycINFO published from January 1, 1999 through November 30, 2015. Study Selection:  Studies were included if participants completed the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) before and after concussion and if test performance and Postconcussion Symptom Scale (PCSS) scores were reported at both times. Data Extraction:  After reviewing the full texts, we extracted data from 17 studies consisting of 29 independent samples; therefore, this meta-analysis consisted of 1777 unique participants. Data Synthesis:  The Hedges g effect size (ES) was estimated. A random-effects or fixed-effects model was used based on heterogeneity findings. When heterogeneity was present, we used meta-regression to assess unexplained between-studies variance. Within the first week of injury, the ESs were small to moderate for cognitive declines, ranging from −0.43 (95% confidence interval [CI] = −0.52, −0.35) to −0.67 (95% CI = −0.77, −0.58), and large for the PCSS score (Hedges g = −0.81; 95% CI = −0.91, −0.71). After 1 week, the ESs for cognitive declines (Hedges g range = −0.25 [95% CI = −0.35, −0.15] to −0.37 [95% CI = −0.55, −0.19]) and PCSS score (Hedges g = −0.38; 95% CI = −0.53, −0.22) were also small. Within 2 weeks of injury, PCSS score and time since injury weakly moderated the cognitive ES. Conclusions:  When a neurocognitive test was administered within 1 week of injury, the ES was larger for self-reported symptoms than for ImPACT scores generated at the same session. After 1 week of injury, the ESs for ImPACT and PCSS scores were comparable. If the athlete reports symptoms within 1 week of injury, administering a cognitive test does not appear to offer additional information to the clinician. However, if the athlete does not report symptoms postconcussion, cognitive testing may inform the clinical management of the injury.

Disease-modifying treatments and cognition in relapsing-remitting multiple sclerosis

Neurology ◽  
2020 ◽  
Vol 94 (22) ◽  
pp. e2373-e2383 ◽  
Author(s):  
Nils C. Landmeyer ◽  
Paul-Christian Bürkner ◽  
Heinz Wiendl ◽  
Tobias Ruck ◽  
Hans-Peter Hartung ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Test Performance ◽  
Meta Analysis ◽  
Cognitive Test ◽  
Current Evidence ◽  
Relapsing Remitting ◽  
Disease Modifying ◽  
Cognitive Test Performance

ObjectiveDisease-modifying treatments (DMTs) are the gold standard for slowing disability progression in multiple sclerosis (MS), but their effects on cognitive impairment, a key symptom of the disease, are mostly unknown. We conducted a systematic review and meta-analysis to evaluate the differential effects of DMTs on cognitive test performance in relapsing-remitting MS (RRMS).MethodsPubMed, Scopus, and Cochrane Library were searched for studies reporting longitudinal cognitive performance data related to all major DMTs. The standardized mean difference (Hedges g) between baseline and follow-up cognitive assessment was used as the main effect size measure.ResultsForty-four studies, including 55 distinct MS patient samples, were found eligible for the systematic review. Twenty-five studies were related to platform therapies (mainly β-interferon [n = 17] and glatiramer acetate [n = 4]), whereas 22 studies were related to escalation therapies (mainly natalizumab [n = 14] and fingolimod [n = 6]). Reported data were mostly confined to the cognitive domain processing speed. A meta-analysis including 41 studies and 7,131 patients revealed a small to moderate positive effect on cognitive test performance of DMTs in general (g = 0.27, 95% confidence interval [CI] = [0.21–0.33]), but no statistically significant differences between platform (g = 0.27, 95% CI = [0.18–0.35]) and escalation therapies (g = 0.28, 95% CI = [0.19–0.37]) or between any single DMT and β-interferon.ConclusionsDMTs are effective in improving cognitive test performance in RRMS, but a treatment escalation mainly to amend cognition is not supported by the current evidence. Given the multitude of DMTs and their widespread use, the available data regarding differential treatment effects on cognitive impairment are remarkably scant. Clinical drug trials that use more extensive cognitive outcome measures are urgently needed.

Abstract 17058: Does Intensive Glucose Control Prevent Cognitive Decline in Diabetes? a Meta-analysis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Carlos A Peñaherrera Oviedo ◽  
María C Duarte Martinez ◽  
Daniel A Moreno Zambrano ◽  
Michael Palacios Mendoza ◽  
María B Jurado ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Decline ◽  
Median Duration ◽  
Glucose Control ◽  
Meta Analysis ◽  
Cognitive Test ◽  
Intensive Glucose Control ◽  
Duration Of Diabetes ◽  
Patients With Diabetes

Background: Long term diabetes is associated with cognitive decline. Blood glucose control improves outcomes in patients with diabetes, it is unclear if intensive glucose control prevents cognitive decline. The aim of this study is to conduct a meta-analysis to determine the effects of intensive glucose control on cognitive decline in patients with diabetes. Methods: We searched the MEDLINE database (1966 to December 2013) and supplemented the search with manual searches of bibliographies of key relevant articles. Keywords used for the search were: diabetes mellitus, cognitive decline, cognitive function, cognitive impairment, and glucose control. We selected all randomized studies where a measurement of cognitive decline and the level of glucose control were reported in patients with diabetes. We calculated the weighted standardized mean difference (SMD) of the measurement of cognitive decline between the intensive and standard glucose control arm. We also conducted meta-regression to evaluate the effect of the type of diabetes had on the results and stratified the analysis by type of diabetes. Results: The search strategy yielded 260 studies, of which only 7 met our eligibility criteria. Only three studies included subjects with type 2 diabetes, patients with type 2 diabetes had a median age of 62(59-63), 48(42-60) were female, the median HbA1c was 8% and the median duration of diabetes was 9 years. We included four studies with type 1 diabetes with a median age of 27(16-29) years, 49(49-50) % were female, the median Hba1c was 9% and the median duration of diabetes was 6(5-18) years. The weighted SMD of each cognitive test is shown in Table 1. Conclusions: Intensive glucose control prevents cognitive decline. The largest improvements were seen in the memory and speed processing domains. This was seen mostly in middle-aged type 2 diabetics with diabetes for 9 years and slightly out of control HbA1c.

scholarly journals An evidence-based method for examining and reporting cognitive processes in nutrition research

2014 ◽  
Vol 27 (2) ◽  
pp. 232-241 ◽  
Author(s):  
Matthew P. Pase ◽  
Con Stough
Keyword(s):  
Cognitive Processes ◽  
Cognitive Abilities ◽  
Meta Analysis ◽  
Cognitive Outcomes ◽  
Human Cognition ◽  
Cognitive Test ◽  
Evidence Based ◽  
Test Results ◽  
Nutrition Research ◽  
Composite Scores

Cognitive outcomes are frequently implemented as endpoints in nutrition research. To reduce the number of statistical comparisons it is commonplace for nutrition researchers to combine cognitive test results into a smaller number of broad cognitive abilities. However, there is a clear lack of understanding and consensus as to how best execute this practice. The present paper reviews contemporary models of human cognition and proposes a standardised, evidence-based method for grouping cognitive test data into broader cognitive abilities. Both Carroll's model of human cognitive ability and the Cattell–Horn–Carroll (CHC) model of intelligence provide empirically based taxonomies of human cognition. These models provide a cognitive ‘map’ that can be used to guide the handling and analysis of cognitive outcomes in nutrition research. Making use of a valid cognitive nomenclature can provide the field of clinical nutrition with a common cognitive language enabling efficient comparisons of cognitive outcomes across studies. This will make it easier for researchers, policymakers and readers to interpret and compare cognitive outcomes for different interventions. Using an empirically derived cognitive nomenclature to guide the creation of cognitive composite scores will ensure that cognitive endpoints are theoretically valid and meaningful. This will increase the generalisability of trial results to the general population. The present review also discusses how the CHC model of cognition can also guide the synthesis of cognitive outcomes in systematic reviews and meta-analysis.

scholarly journals Fitness to drive in older drivers with cognitive impairment

2000 ◽  
Vol 6 (4) ◽  
pp. 480-490 ◽  
Author(s):  
FREDERIEC K. WITHAAR ◽  
WIEBO H. BROUWER ◽  
ADRIAAN H. VAN ZOMEREN
Keyword(s):  
Cognitive Impairment ◽  
Test Performance ◽  
Traffic Accidents ◽  
Neuropsychological Test ◽  
Driving Performance ◽  
Older Drivers ◽  
Cognitive Test ◽  
Cognitively Impaired ◽  
Fitness To Drive ◽  
Cognitive Test Performance

This paper is a literature review on assessment of fitness to drive in older drivers with cognitive impairment. Early studies on dementia and driving generally failed to distinguish between safe and unsafe drivers on the basis of cognitive test performance. Predictive studies demonstrated that cognitively impaired persons as a group perform significantly worse than controls on both neuropsychological and driving measures. A high prevalence of cognitive impairment was found in groups of older drivers involved in traffic accidents and crashes. However, a large range in neuropsychological test scores has been found. Low to moderate correlations could be established between neuropsychological test results and on-road driving performance, making it difficult to discriminate between cognitively impaired subjects who are fit or unfit to drive. The review concludes with a discussion of methodological difficulties in the field of dementia and driving, including participant selection, the choice of neuropsychological tests, and the operationalization of driving performance. (JINS, 2000, 6, 480–490.)

Differences in the Performance of Children With Specific Language Impairment and Their Typically Developing Peers on Nonverbal Cognitive Tests: A Meta-Analysis

2014 ◽  
Vol 57 (4) ◽  
pp. 1363-1382 ◽  
Author(s):  
Erica Gallinat ◽  
Tammie J. Spaulding
Keyword(s):  
Language Impairment ◽  
Test Performance ◽  
Specific Language Impairment ◽  
Meta Analysis ◽  
Cognitive Test ◽  
Size Analysis ◽  
Cognitive Tests ◽  
Typically Developing ◽  
Specific Language ◽  
Iq Tests

PurposeThis study used meta-analysis to investigate the difference in nonverbal cognitive test performance of children with specific language impairment (SLI) and their typically developing (TD) peers.MethodThe meta-analysis included studies (a) that were published between 1995 and 2012 of children with SLI who were age matched (and not nonverbal cognitive matched) to TD peers and given a norm-referenced nonverbal cognitive test and (b) that reported sufficient data for an effect size analysis. Multilevel modeling was used to examine the performance of children with SLI relative to their typically developing, age-matched peers on nonverbal IQ tests.ResultsAcross 138 samples from 131 studies, on average children with SLI scored 0.69 standard deviations below their TD peers on nonverbal cognitive tests after adjusting for the differences in the tests used, the low-boundary cutoff scores, the age of the participants, and whether studies matched the two groups on socioeconomic status.DiscussionThe lower performance of children with SLI relative to TD children on nonverbal IQ tests has theoretical implications for the characterization of SLI and clinical and political implications regarding how nonverbal cognitive tests are used and interpreted for children with this disorder.

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