ABSTRACT
Alzheimer's disease (AD) imposes a major burden on affected individuals, their caregivers and health-care systems alike. Though quite many risk factors for disease progression have been identified, there is a lack of prospective studies investigating the interplay and predictive value of a wide variety of patient variables associated with cognitive deterioration (defined as key feature of AD progression). Study participants were patients with probable and possible AD, that were assessed at four time points over a period of two years (T1-T4). The main results were threefold: (i) over time, significant changes were observed regarding patients' cognitive functioning, activities of daily living and caregiver load (but not depression, pain, neuropsychiatric symptoms); (ii) intercorrelations between caregiver load and patients' cognitive and functional variables were high, correlation patterns remaining rather stable across time; (iii) cognitive functioning at T4 was best predicted by patients' age, sex, atrial fibrillation and activities of daily living at T1; and (iv) across all four assessment points, cognitive functioning was best predicted by time (i.e., disease duration), age, sex, activities of daily living and depression. Overall, even in early stages of AD and during a short two-year period, functional changes were significant and tightly intertwined with caregiver load, thus stressing the need to consider caregiver load when diagnosing and treating patients with AD. A novel and clinically relevant finding is that even in early stages of AD, cognitive deterioration was best predicted by a combination of patients' demographic, somatic and functional variables.
Subject(s)
Activities of Daily Living , Alzheimer Disease , Caregivers , Disease Progression , Humans , Alzheimer Disease/physiopathology , Alzheimer Disease/psychology , Male , Female , Aged , Prospective Studies , Caregivers/psychology , Aged, 80 and over , Cognition/physiology , Registries , Cognitive Dysfunction/physiopathology , Neuropsychological Tests , Middle Aged , Depression , Risk FactorsABSTRACT
In the present study, we conducted a Stroop-like task in which the participants were required to decide whether the presented stimulus, which could be either a colored digit or a colored rectangle, consisted of more or less than five colors. Like other Stroop-like tasks, the stimuli could be congruent (the stimulus was a digit that was equal to the presented number of colors), incongruent (the stimulus was a digit that was different than the presented number of colors), or neutral (a colored rectangle). We utilized a two-to-one response setting so that in some incongruent trials the digit and the number of colors would elicit the same response (e.g., the digit 3 containing two colors; both are smaller than 5), while in some incongruent trials, the digit and the number of colors would elicit different responses (e.g., the digit 3 containing 6 colors). This enabled us to measure both conflicts arising from stimulus-stimulus and stimulus-response compatibilities. Our results indicated the existence of stimulus-stimulus compatibility (SSC), stimulus-response compatibility (SRC), and task conflict. Interestingly, these effects were in interaction with the number of colors, so that in small numbers, SSC and SRC were found, and in large numbers, SRC and task conflict were found. Moreover, the results suggest that our task includes two types of task conflict that are raised due to three different tasks: processing the meaning of the digit vs. estimating the number of colors and counting the number of colors vs. estimating the number of colors.
ABSTRACT
Living in our information- and technology-driven society at the beginning of the 21st century requires the ability to understand and handle numbers not only for a successful career but also for coping with everyday life tasks [...].
ABSTRACT
Developmental dyscalculia (DD) is a developmental disorder characterized by arithmetic difficulties. Recently, it has been suggested that the neural networks supporting procedure-based calculation (e.g., in subtraction) and left-hemispheric verbal arithmetic fact retrieval (e.g., in multiplication) are partially distinct. Here we compared the neurofunctional correlates of subtraction and multiplication in a 19-year-old student (RM) with DD to 18 age-matched controls. Behaviorally, RM performed significantly worse than controls in multiplication, while subtraction was unaffected. Neurofunctional differences were most pronounced regarding multiplication: RM showed significantly stronger activation than controls not only in left angular gyrus but also in a fronto-parietal network (including left intraparietal sulcus and inferior frontal gyrus) typically activated during procedure-based calculation. Region-of-interest analyses indicated group differences in multiplication only, which, however, did not survive correction for multiple comparisons. Our results are consistent with dissociable and processing-specific, but not operation-specific neurofunctional networks. Procedure-based calculation is not only associated with subtraction but also with (untrained) multiplication facts. Only after rote learning, facts can be retrieved quasi automatically from memory. We suggest that this learning process and the associated shift in activation patterns has not fully occurred in RM, as reflected in her need to resort to procedure-based strategies to solve multiplication facts.
ABSTRACT
Statistical knowledge is a key competency for psychologists in order to correctly interpret assessment outcomes. Importantly, when learning statistics (and its mathematical foundations), self-efficacy (defined as an individual's belief to successfully accomplish specific performance attainments) is a central predictor of students' motivation to learn, learning engagement, and actual achievement. Therefore, it is crucial to gain a better understanding of students' self-efficacy for statistics and its interrelations with statistics anxiety and students' belief in the relevance of statistics. Here, we present results showing development and validation of a self-assessment questionnaire for examining self-efficacy for statistics in psychology students (Self-Efficacy for Learning Statistics for Psychologists, SES-Psy). Upon using different methodological approaches, we demonstrate that the SES-Psy questionnaire has (1) sound psychometric properties, and within our sample of university students, (2) a robust latent structure disclosing three clearly distinctive profiles that are characterized by a complex and nonlinear interplay between perceived self-efficacy (for basic and advanced statistics), statistics anxiety, and students' belief in the relevance of statistics. Implications for educational settings and future research are discussed.
Subject(s)
Self Efficacy , Students , Achievement , Anxiety/psychology , Humans , Learning , Students/psychologyABSTRACT
Old age is critically associated with multi-morbidity, chronic pain, and high risk for dementia. Recognizing and treating pain is very much dependent on language comprehension and production. Both may be impaired in dementia. Moreover, neuropsychiatric symptoms may interact with pain perception. The main aims of the present article were 1) to identify key areas for future research to elucidate the relation between pain and associated neuropsychiatric symptoms in dementia, and 2) to provide a conceptual framework for ameliorating the clinical process of recognizing, assessing, and managing pain in non-communicating patients with advanced dementia.
Subject(s)
Chronic Pain , Comprehension , Dementia , Pain Measurement , Aging , Chronic Pain/diagnosis , Chronic Pain/psychology , Dementia/complications , Dementia/psychology , Humans , LanguageABSTRACT
BACKGROUND: The present study aimed at investigating loneliness and burden experienced by family members caring for relatives diagnosed with Alzheimer disease. METHODS: Participants were 40 caregivers of inpatients with Alzheimer disease. Correlation and multiple regression analyses were conducted to investigate whether caregivers' loneliness (uni- and multidimensional) and burden are associated with and predicted by (1) specific caregiver characteristics and/or (2) patients' dementia severity and neuropsychiatric symptoms. RESULTS: Loneliness was significantly correlated with caregivers' sex, age, and living circumstances, while burden was significantly correlated with caregivers' education solely. Regression analyses revealed that caregivers' sex and living circumstances contributed significantly to variance explanation of loneliness (but not burden), while the additional consideration of patient variables did not improve model fit. CONCLUSIONS: Loneliness reported by caregivers of relatives diagnosed with dementia is significantly modulated by caregiver (but not patient) characteristics. Notably, both uni- and multidimensional loneliness scales seem to be sensitive diagnostic tools.
Subject(s)
Alzheimer Disease/psychology , Caregivers/psychology , Loneliness/psychology , Adaptation, Psychological , Aged, 80 and over , Female , Humans , Male , Middle Aged , Severity of Illness Index , Sex FactorsABSTRACT
Premature birth is a significant risk factor for learning disabilities in general and mathematics learning difficulties in particular. However, the exact reasons for this relation are still unknown. While typical numerical development is associated with a frontal-to-parietal shift of brain activation with increasing age, influences of gestational age have hardly been considered so far. Therefore, we investigated the influence of gestational age on the neural correlates of number processing in 6- and 7-year-old children born prematurely (n=16). Only the numerical distance effect - as a measure of intentional number magnitude processing - elicited the fronto-parietal activation pattern typically observed for numerical cognition. On the other hand, the size congruity effect - as a measure of automatic number magnitude processing - was associated with activation of brain areas typically attributed to cognitive control. Most importantly, however, we observed that gestational age reliably predicted the frontal-to-parietal shift of activation observed for the numerical distance effect. Our findings seem to indicate that human numerical development may start even before birth and prematurity might hamper neural facilitation of the brain circuitry subserving numerical cognition. In turn, this might contribute to the high risk of premature children to develop mathematical learning difficulties.
Subject(s)
Brain Mapping , Brain/physiology , Cognition/physiology , Gestational Age , Infant, Premature/physiology , Intention , Age Factors , Brain/diagnostic imaging , Child , Female , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Male , Mathematics , Oxygen/blood , Problem Solving/physiology , Reaction Time/physiologyABSTRACT
OBJECTIVES: Adverse effects of heavy drinking on cognition have frequently been reported. In the present study, we systematically examined for the first time whether clinical neuropsychological assessments may be sensitive to alcohol abuse in elderly patients with suspected minor neurocognitive disorder. METHODS: A total of 144 elderly with and without alcohol abuse (each group n=72; mean age 66.7 years) were selected from a patient pool of n=738 by applying propensity score matching (a statistical method allowing to match participants in experimental and control group by balancing various covariates to reduce selection bias). Accordingly, study groups were almost perfectly matched regarding age, education, gender, and Mini Mental State Examination score. Neuropsychological performance was measured using the CERAD (Consortium to Establish a Registry for Alzheimer's Disease). Classification analyses (i.e., decision tree and boosted trees models) were conducted to examine whether CERAD variables or total score contributed to group classification. RESULTS: Decision tree models disclosed that groups could be reliably classified based on the CERAD variables "Word List Discriminability" (tapping verbal recognition memory, 64% classification accuracy) and "Trail Making Test A" (measuring visuo-motor speed, 59% classification accuracy). Boosted tree analyses further indicated the sensitivity of "Word List Recall" (measuring free verbal recall) for discriminating elderly with versus without a history of alcohol abuse. CONCLUSIONS: This indicates that specific CERAD variables seem to be sensitive to alcohol-related cognitive dysfunctions in elderly patients with suspected minor neurocognitive disorder. (JINS, 2018, 24, 360-371).
Subject(s)
Alcohol-Related Disorders/complications , Cognitive Dysfunction/diagnosis , Cognitive Dysfunction/etiology , Neuropsychological Tests/standards , Aged , Alcohol-Related Disorders/classification , Case-Control Studies , Cognitive Dysfunction/classification , Female , Humans , Male , Middle Aged , Retrospective Studies , Sensitivity and SpecificityABSTRACT
There is accumulating evidence suggesting an association of numbers with physical space. However, the origin of such spatial-numerical associations (SNAs) is still debated. In the present study we investigated the development of two SNAs in a cross-sectional study involving children, young and middle-aged adults as well as the elderly: (1) the SNARC (spatial-numerical association of response codes) effect, reflecting a directional SNA; and (2) the numerical bisection bias in a line bisection task with numerical flankers. Results revealed a consistent SNARC effect in all age groups that continuously increased with age. In contrast, a numerical bisection bias was only observed for children and elderly participants, implying an U-shaped distribution of this bias across age groups. Additionally, individual SNARC effects and numerical bisection biases did not correlate significantly. We argue that the SNARC effect seems to be influenced by longer-lasting experiences of cultural constraints such as reading and writing direction and may thus reflect embodied representations. Contrarily, the numerical bisection bias may originate from insufficient inhibition of the semantic influence of irrelevant numerical flankers, which should be more pronounced in children and elderly people due to development and decline of cognitive control, respectively. As there is an ongoing debate on the origins of SNAs in general and the SNARC effect in particular, the present results are discussed in light of these differing accounts in an integrative approach. However, taken together, the present pattern of results suggests that different cognitive mechanisms underlie the SNARC effect and the numerical bisection bias.
ABSTRACT
Deficits in specific executive domains are highly prevalent in autism spectrum disorder; however, age-related improvements in executive functions (reflecting prefrontal maturational changes) have been reported even in individuals diagnosed with autism. The current study examined two components of cognitive flexibility (inhibition of prepotent responses and memory monitoring/updating) by using a random-motor-generation task (MPT) in a group of 23 boys with Asperger syndrome (AS) and 23 matched healthy controls. We found poorer inhibition and more repetitive responses in younger AS children solely, but comparable memory monitoring/updating skills across groups. Overall, our findings correspond well with previous studies and reveal that even in AS specific EFs may improve with age and, thus, call for a more differentiated view of executive (dys) function profiles in children diagnosed with AS. Tests such as the random-motor-generation task may help to disentangle more specific processes of executive deficits in autism spectrum disorder as compared to the more classical tests.
Subject(s)
Aging , Asperger Syndrome/complications , Asperger Syndrome/psychology , Inhibition, Psychological , Memory Disorders/etiology , Adolescent , Age Factors , Attention/physiology , Child , Humans , Male , Neuropsychological TestsABSTRACT
BACKGROUND: Very preterm birth is often associated with executive function deficits later in life. The transition to adolescence increases personal autonomy, independence and, in parallel, the demands placed on executive functions at home and in school. AIM: To assess the impact of increasing demands on executive function performance in very preterm children and adolescents with normal intellectual and motor functions. METHODS: Forty-one very preterm children and adolescents with normal intellectual and motor functions and 43 healthy term-born peers were assessed at a mean age of 13.0 years (SD: 1.9; range: 10.0-16.9). A comprehensive battery of performance-based executive function measures with different demand levels as well as a parent-rating questionnaire evaluating executive functions relevant for everyday life was applied. Standardized mean differences between groups of d ≥ .41 were regarded as clinically relevant. RESULTS: No group differences were found at the lowest demand levels of working memory (d=.09), planning (d=-.01), cognitive flexibility (d=-.21) and verbal fluency (d=-.14) tasks, but very preterm participants scored significantly below their term-born peers in the most demanding levels (d=-.50, -.59, -.43 and -.55, respectively). These differences were clinically relevant. Executive functions relevant for everyday life were strongly impaired in very preterm participants, e.g., global executive composite (d=-.66). CONCLUSION: Very preterm children and adolescents with normal intellectual and motor functions are at high risk for executive function deficits that may only become apparent with increasing demands, potentially leading to academic and other deficits.
Subject(s)
Adolescent Development , Executive Function , Infant, Extremely Premature/growth & development , Activities of Daily Living , Adolescent , Case-Control Studies , Child , Female , Humans , Infant, Newborn , Male , Memory, Short-Term , Motor SkillsABSTRACT
AIM: This study assesses whether previously reported performance deficiencies in visuo-constructional and executive functions, using the Rey-Osterrieth Complex Figure Test (ROCFT) in pediatric patients with congenital heart disease (CHD), persist into adolescence. METHODS: 53 adolescent CHD patients (mean age 13.7) and 39 healthy controls (mean age 14.1) participated. ROCFT performance was measured by three different scoring methods, focusing either on quantitative (Meyers & Meyers, 1995), qualitative (Wallon & Mesmin, 2009), or both performance aspects (Bernstein & Waber, 1996). Potential confounders (i.e., intelligence and visuomotor integration) and surgery-related risk factors were included in the data analysis. RESULTS: Adolescents with CHD demonstrated immature copy and recall approaches on the ROCFT using the qualitative system by Wallon and Mesmin (p<.001). Memory performance was also predicted by Bernstein and Waber scores (p<.03), whereas group differences were not significant according to the other scoring methods. Intelligence and visuomotor skills, but not surgery-related risk factors, were positively correlated with ROCFT performance (each p<.02). Interpretation: Visuoconstructional and executive deficiencies could be found in adolescent patients with CHD. However, not all ROCFT scoring methods were equally apt to detect group differences: especially the qualitative scoring method developed by Wallon and Mesmin seems sufficiently sensitive to detect long-lasting visuo-constructional and executive deficiencies in CHD patients.
ABSTRACT
This study examined the neural correlates of intentional and automatic number processing (indexed by number comparison and physical Stroop task, respectively) in 6- and 7-year-old children born prematurely. Behavioral results revealed significant numerical distance and size congruity effects. Imaging results disclosed (1) largely overlapping fronto-parietal activation for intentional and automatic number processing, (2) a frontal to parietal shift of activation upon considering the risk factors gestational age and birth weight, and (3) a task-specific link between math proficiency and functional magnetic resonance imaging (fMRI) signal within distinct regions of the parietal lobes-indicating commonalities but also specificities of intentional and automatic number processing.
Subject(s)
Brain Mapping , Infant, Premature/psychology , Intention , Magnetic Resonance Imaging , Mathematics , Prenatal Exposure Delayed Effects , Child , Female , Frontal Lobe/physiopathology , Humans , Infant, Premature/physiology , Learning/physiology , Male , Parietal Lobe/physiopathology , Pregnancy , Stroop TestABSTRACT
Specific language influences have been observed in basic numerical tasks such as magnitude comparison, transcoding, and the number line estimation task. However, so far language influences in more complex calculations have not been reported in children. In this translingual study, 7- to 9-year-old German- and Italian-speaking children were tested on a symbolic addition task. Whereas the order of tens and units in Italian number words follows the order of the Arabic notation, the order is inverted in German number words. For both language groups, addition problems were more difficult when a carry operation was needed, that is, when a manipulation within the place-value structure of the Arabic number system was particularly important. Most important, this carry effect was more pronounced in response latencies for children speaking German, a language with inverted verbal mapping of the place-value structure. In addition, independent of language group, the size of the carry effect was significantly related to verbal working memory. The current study indicates that symbolic arithmetic and the carry effect in particular are modulated by language-specific characteristics. Our results underline the fact that the structure of the language of instruction is an important factor in children's mathematical education and needs to be taken into account even for seemingly nonverbal symbolic Arabic tasks.
Subject(s)
Language , Mathematics , Symbolism , Austria , Child , Cross-Cultural Comparison , Female , Humans , Italy , Longitudinal Studies , Male , Memory, Short-Term/physiology , Psycholinguistics/methods , Semantics , Task Performance and AnalysisABSTRACT
The aim of the present voxel-based morphometry study was to examine the link between brain structure and number skills in a group of 6-7-year-old children born prematurely, which are considered to be an at-risk population for mathematical learning disabilities. Therefore, gray and white matter density values were extracted from brain areas previously reported to be relevant for number processing in developing brain systems and, thereafter, correlated with response time results tapping semantic number knowledge [i.e. numerical distance effect (NDE) derived from a number comparison task] as well as with general math proficiency (as indexed by a standardized calculation test). Behavioral results disclosed a significant NDE, thus indicating well-established number magnitude representations for one-digit numerals in our study group. Significant positive correlations between gray matter and NDE emerged in parietal regions (including the right anterior inferior and the left superior parietal lobe) and in the right superior temporal gyrus. Moreover, white matter and NDE were negatively correlated in the right anterior inferior parietal lobe and the right inferior frontal gyrus. Overall, our results are novel insofar as they show that in 6-7-year-old children born prematurely, individual differences in gray and white matter structures are associated with numerical skills. Importantly, in our study group the observed link between brain structure and behavioral performance emerges only regarding an experimental task tapping semantic number knowledge, whereas general math proficiency does not seem to be related to individual differences in brain structure in our study group.
Subject(s)
Brain Mapping , Frontal Lobe/physiopathology , Parietal Lobe/physiopathology , Premature Birth , Psychomotor Performance/physiology , Temporal Lobe/physiopathology , Child , Humans , Image Processing, Computer-Assisted , Mathematics , Reaction Time , SemanticsABSTRACT
By merging neuropsychological (CANTAB/cambridge neuropsychological test automated battery) and structural brain imaging data (voxel-based-morphometry) the present study sought to identify the neurocognitive correlates of executive functions in individuals with Asperger syndrome (AS) compared to healthy controls. Results disclosed subtle group differences regarding response speed on only one CANTAB subtest that is thought to tap fronto-executive network functions (SWM/spatial working memory). Across all participants, SWM performance was significantly associated with two brain regions (precentral gyrus white matter, precuneus grey matter), thus suggesting a close link between fronto-executive functions (SWM) and circumscribed fronto-parietal brain structures. Finally, symptom severity (ADOS total score) was best predicted by response speed on a set-shifting task (IES) thought to tap fronto-striatal functions (corrected R2 56%).
Subject(s)
Asperger Syndrome/physiopathology , Brain/physiopathology , Executive Function/physiology , Memory, Short-Term/physiology , Space Perception/physiology , Adolescent , Asperger Syndrome/pathology , Brain/pathology , Child , Female , Frontal Lobe/pathology , Frontal Lobe/physiopathology , Humans , Male , Parietal Lobe/pathology , Parietal Lobe/physiopathology , Psychiatric Status Rating Scales , Psychomotor Performance/physiology , Severity of Illness IndexABSTRACT
BACKGROUND: Dyscalculia is defined as difficulty acquiring basic arithmetic skills that is not explained by low intelligence or inadequate schooling. About 5% of children in primary schools are affected. Dyscalculia does not improve without treatment. METHODS: In this article, we selectively review publications on dyscalculia from multiple disciplines (medicine, psychology, neuroscience, education/special education). RESULTS: Many children and adolescents with dyscalculia have associated cognitive dysfunction (e.g., impairment of working memory and visuospatial skills), and 20% to 60% of those affected have comorbid disorders such as dyslexia or attention deficit disorder. The few interventional studies that have been published to date document the efficacy of pedagogic-therapeutic interventions directed toward specific problem areas. The treatment is tailored to the individual patient's cognitive functional profile and severity of manifestations. Psychotherapy and/or medication are sometimes necessary as well. CONCLUSION: The early identification and treatment of dyscalculia are very important in view of its frequent association with mental disorders. Sufferers need a thorough, neuropsychologically oriented diagnostic evaluation that takes account of the complexity of dyscalculia and its multiple phenotypes and can thus provide a basis for the planning of effective treatment.