Cerebral Microbleeds Were Related With Poor Cognitive Performances on the Dual Task Condition in Older Adults

Background: The dual task (DT) was commonly used to assess the risk of falls in older adults and patients with neurological disorders. However, the performance on DT conditions has not been well investigated in patients with cerebral microbleed (CMB). This study is aimed to compare the performance in DT tests between older adults with and without CMB, and to explore the association between CMB and cognitive performances of DT.Methods: This is a cross-sectional study. A total of 211 old adults participated, involving 68 CMB patients. The task protocol involved two global cognition tests, two single cognitive tests (serial 7 subtraction and semantic fluency), two single motor tasks [8-m walking and timed up and go test (TUG)], and three DT tests [walking and serial subtraction (WSS), walking and semantic fluency (WSF), and TUG and serial subtraction (TUGSS)]. The time taken to complete each task and the number of correct responses were recorded. For each DT condition, the correct response rate (CRR) and the dual-task effect (DTE) for the correct number were calculated.Results: Compared with subjects without CMB, CMB patients had worse cognitive performances on DT condition in CRR of WSS (p = 0.003), WSF (p = 0.030) and TUGSS (p = 0.006), and DTE of WSS (p = 0.017). Binary logistic regression analysis showed that the presence of CMB was an independent risk factor for the impairment group for CRR of TUGSS (OR, 2.54; 95% CI, 1.11–5.82; p = 0.027) with the adjustment for confounders, rather than CRR of WSS and WSF, or DTE of WSS. Multiple linear regression analysis showed that CRR of TUGSS decreased with the increase of CMB number grades (β, −0.144; 95% CI, −0.027, −0.002; p = 0.028).Conclusion: The present study indicated that CMBs were closely associated with poor cognitive performances on DT in the elderly. Strongest effect size was seen for CRR of TUGSS, where performance deficits increased in proportion to the degree of CMB burden.

Vascular burden and cognition: Mediating roles of neurodegeneration and amyloid-PET

INTRODUCTION: It remains unclear to which extent vascular burden promotes neurodegeneration and cognitive dysfunction in a cohort spanning low-to-severe small vessel disease (SVD) and amyloid-beta pathology. METHODS: In 120 subjects, we investigated 1) whether vascular burden, quantified as total or lobar white matter hyperintensity (WMH) volumes, is associated with different cognitive domains; and 2) whether the total WMH effect on cognition is mediated by amyloid (18F-AV45-PET), glucose metabolism (18F-FDG-PET), and/or cortical atrophy. RESULTS: Increased total WMH volume was associated with poorer performance in all cognitive domains tested, with the strongest effects observed for semantic fluency. These relationships were mediated mainly through cortical atrophy, particularly in the temporal lobe, and to a lesser extent through amyloid and metabolism. WMH volumes differentially impacted cognition depending on lobar location and amyloid status. DISCUSSION: Our study suggests mainly an amyloid-dependent pathway in which vascular burden affects cognitive impairment through temporal lobe atrophy.

Discussion of Issues Related to Assessing Signed or Spoken Language in Children with Developmental Language Disorder

Issues regarding assessment of the deaf and hard-of-hearing (D/HH) child with developmental language disorder (DLD) have implications for the assessment of the child with DLD who is not D/HH. Of note are suggestions regarding literacy, the potential for semantic fluency assessment to contribute to the identification of DLD, the use of standardized protocols to support assessment at the conversational level, and the necessary skills of those completing assessments. Similarly, issues in assessment and identification of children with DLD who are not D/HH have implications for practice with children who are D/HH. These include the shift from exclusionary approaches to identification and recognition of co-occurring conditions, addressing the impact of development over time and considering the contribution of dynamic assessment. This chapter is a joint discussion of key items related to the assessment of deaf and hearing children with a developmental language disorder that were presented in Chapters 5.1 and 5.2.

Neural Correlates of Letter and Semantic Fluency in Primary Progressive Aphasia

Verbal fluency (VF) is an informative cognitive task. Lesion and functional imaging studies implicate distinct cerebral areas that support letter versus semantic fluency and the understanding of neural and cognitive mechanisms underlying task performance. Most lesion studies include chronic stroke patients. People with primary progressive aphasia (PPA) provide complementary evidence for lesion-deficit associations, as different brain areas are affected in stroke versus PPA. In the present study we sought to determine imaging, clinical and demographic correlates of VF in PPA. Thirty-five patients with PPA underwent an assessment with letter and category VF tasks, evaluation of clinical features and an MRI scan for volumetric analysis. We used stepwise regression models to determine which brain areas are associated with VF performance while acknowledging the independent contribution of clinical and demographic factors. Letter fluency was predominantly associated with language severity (R2 = 38%), and correlated with the volume of the left superior temporal regions (R2 = 12%) and the right dorsolateral prefrontal area (R2 = 5%). Semantic fluency was predominantly associated with dementia severity (R2 = 47%) and correlated with the volume of the left inferior temporal gyrus (R2 = 7%). No other variables were significantly associated with performance in the two VF tasks. We concluded that, independently of disease severity, letter fluency is significantly associated with the volume of frontal and temporal areas whereas semantic fluency is associated mainly with the volume of temporal areas. Furthermore, our findings indicated that clinical severity plays a critical role in explaining VF performance in PPA, compared to the other clinical and demographic factors.

Is Old Age Just a Number in Language Skills? Language Performance and Its Relation to Age, Education, Gender, Cognitive Screening, and Dentition in Very Old Finnish Speakers

Purpose: This study reports on how very old (VO) Finnish people without dementia perform in the Western Aphasia Battery (WAB) and two verbal fluency tasks and which demographic factors predict the performance. Method: The study included fifty 80- to 100-year-old community-dwelling Finnish speakers with no dementing illnesses or speech-language disabilities, who completed the WAB and two verbal fluency tasks. Multifactorial statistical analyses with recursive partitioning were carried out to determine the significant predictors out of five predictor variables (age, gender, education, dentition, and Mini-Mental State Examination [MMSE]) for four response variables (WAB Aphasia Quotient [AQ], Language Quotient [LQ], semantic, and phonemic word fluencies). Results: Overall, individual variation was notable in VO speakers. All predictor variables were statistically significantly associated with one or more of the language skills. Age was the most significant predictor; the critical age of 85–86 years was associated with a decline in WAB-AQ and semantic fluency. Poor dentition and the MMSE score both predicted a decline in WAB-LQ and phonemic fluency. A high level of education was positively associated with the skills of the best-performing individuals in WAB-AQ, WAB-LQ, and semantic fluency. Conclusions: VO age is a significant factor contributing to language performance. However, a younger age, a good cognitive performance, intact teeth, and a higher educational level also seem to have a preservative power as regards language skills. Gender differences should be interpreted with caution. The results of this study provide culture- and language-specific normative data, which aids in differentiating typical aging from the signs of acute or degenerative neuropathology to ensure appropriate medical and therapeutic interventions.

Developing a Persian Verbal Fluency Test and Comparing the Results Between Healthy Persian Speakers and Persian Speakers Patients With Alzheimer Disease and Mild Cognitive Impairment

Objectives: Phonemic and semantic fluency tasks are used for verbal fluency (VF) evaluation. The present study aimed to select the most appropriate semantic categories and the most frequent phonemes of Persian as items for the VF test. Then, we determine the test results in differentiation between cognitively intact people and those with Mild Cognitive Impairment (MCI) and Alzheimer Disease (AD). Methods: A cross-sectional study was conducted on 120 people (60 cognitively intact, 30 with AD, and 30 with MCI) in two phases. In phase one, linguists determine the most frequent phonemes at the beginning of Persian words and the most frequent semantic categories based on a survey. In phase two, the verbal fluency test was administered to cognitively intact people and those with cognitive impairment (patients with AD and MCI). One-way ANOVA and multiple linear regression were used for statistical analysis. Results: The normal subjects scored significantly higher in all phonemic and semantic fluency tasks than the patients with AD and people with MCI (P<0.05). Regarding the phonemic VF task, the phonemes /sh/, /s/, and then /a/ were better in differentiating the MCI and AD groups from the normal group. Regarding the semantic VF task, the animals’ category was better differentiated the MCI and AD groups from the normal group. Discussion: Comparing frequent phonemes and semantic categories of Persian across three groups of normal, AD, and MCI showed that some phonemes and semantic categories can be more differentiating in the VF task. However, it is a preliminary validation study, and this topic needs more investigation in the future.

Qntifying and Examining Reserve in Symptomatic Former National Football League Players

Background: Repetitive head impacts (RHI) from contact sports have been associated with cognitive and neuropsychiatric disorders. However, not all individuals exposed to RHI develop such disorders. This may be explained by the reserve hypothesis. It remains unclear if the reserve hypothesis accounts for the heterogenous symptom presentation in RHI-exposed individuals. Moreover, optimal measurement of reserve in this population is unclear and likely unique from non-athlete populations. Objective: We examined the association between metrics of reserve and cognitive and neuropsychiatric functioning in 89 symptomatic former National Football League players. Methods: Individual-level proxies (e.g., education) defined reserve. We additionally quantified reserve as remaining residual variance in 1) episodic memory and 2) executive functioning performance, after accounting for demographics and brain pathology. Associations between reserve metrics and cognitive and neuropsychiatric functioning were examined. Results: Higher reading ability was associated with better attention/information processing (β=0.25; 95%CI, –0.13–0.64), episodic memory (β=0.27; 95%CI, 0.16–0.38), semantic fluency (β=0.24; 95%CI, 0.01–0.47; β=0.38; 95%CI, –0.14–0.90), and behavioral regulation (β=–0.26; 95%CI, –0.78–0.27) performance. There were no effects for other individual-level proxies. Residual episodic memory variance was associated with better attention/information processing (β=0.45; 95%CI, –0.34–1.24), executive functioning (β=0.36; 95%CI, –3.14–3.86), and semantic fluency (β=0.38; 95%CI, –0.08–0.84) performance. Residual executive functioning variance was associated with better attention/information processing (β=0.44; 95%CI, 0.39–0.49) and episodic memory (β=0.37; 95%CI, 0.36–0.39) performance. Conclusion: Traditional reserve proxies (e.g., years of education, occupational attainment) have limitations and may be unsuitable for use in elite athlete samples. Alternative approaches of reserve quantification may prove more suitable for this population.

Lexical-semantic Properties in Parkinson's Disease with and without Dementia

Dementia has important clinical consequences for patients with PD and their caregivers, which may negatively, affected their daily living activities and quality of life. Previous studies, have investigated the properties and characteristics of the words generated in semantic fluency task by patients with Alzheimer's disease, but this has not been investigated in PD patients yet. This study aimed to investigate if there are possible distinctive features that might differentiate between cognitive decline direct consequence of Idiopathic PD and that of Alzheimer’s type dementia associated with PD. There were six PD patients with dementia, six matched PD patients without dementia and six matched controls participated in this study. The present findings showed that although patients with dementia performed worse than those without dementia on all neuropsychological tests, significant differences were found only on the semantic fluency test and Frontal assessment battery. Furthermore, the present findings showed that patients with dementia produced fewer words in the semantic fluency task than healthy controls did. The words generated by demented patients were longer, less familiar, less typical and acquired later in life than the words produced by healthy controls. These findings might use for clinical application to distinct between PD patients with and without dementia.

Category Production Norms for 117 Concrete and Abstract Categories

We present a database of category production (aka semantic fluency) norms collected in the UK for 117 categories (67 concrete and 50 abstract). Participants verbally named as many category members as possible within 60 seconds, resulting in a large variety of over 2000 generated member concepts. The norms feature common measures of category production (production frequency, mean ordinal rank, first rank frequency), as well as response times for all first-named category members, and typicality ratings collected from a separate participant sample. We provide two versions of the dataset: a referential version that groups together responses that relate to the same referent (e.g., hippo, hippopotamus) and a full version that retains all original responses to enable future lexical analysis. Correlational analyses with previous norms from the US and UK demonstrate both consistencies and differences in English-language norms over time and between geographical regions. Further exploration of the norms reveals a number of structural and psycholinguistic differences between abstract and concrete categories. The data and analyses will be of use in the fields of cognitive psychology, neuropsychology, psycholinguistics, cognitive modelling, and to any researchers interested in semantic category structure. All data, including original participant recordings, are available at https://osf.io/jgcu6/.