Decreased emotional creativity and its relationship with cognitive functions in Parkinson's disease: A preliminary study.

Patients with Parkinson's disease (PD) suffer from a wide range of non-motor symptoms, including cognitive deficits and impairment of emotional processing. The present study aimed to explore in PD patients compared to healthy adults the relationship between cognitive performance and emotional creativity (EC), defined as a set of cognitive abilities and personality traits related to originality and appropriateness of emotional experience. PD patients (n = 22) and healthy controls (n = 40) underwent a complex neuropsychological assessment and were administrated with the self-reported Emotional Creativity Inventory (ECI) questionnaire. To explore the relationship between cognitive tests and the ECI, a regression analysis was conducted. PD patients and healthy controls differed significantly in the EC component Preparedness as well as in the neuropsychological test battery scores. PD patients showed lower scores in cognitive tests and a lower score in Preparedness compared to healthy adults. The output of the regression analysis showed that the extent to which the neuropsychological tests relate to the ECI components is low.

Determining a Short Form Montreal Cognitive Assessment (s-MoCA) Czech Version: Validity in Mild Cognitive Impairment Parkinson's Disease and Cross-Cultural Comparison.

The Montreal Cognitive Assessment (MoCA) is one of the most common screening instruments for mild cognitive impairment. However, the standard MoCA is approximately two times longer to administer than the Mini-Mental State Examination. A total of 699 Czech and 175 American participants received the standard MoCA Czech and English versions and in the clinical part, a sample of 102 nondemented patients with Parkinson's disease (PD). We created a validated Czech short version (s-MoCA-CZ) from the original using item response theory. As expected, s-MoCA-CZ scores were highly correlated with the standard version (Pearson r = .94, p < .001). s-MoCA-CZ also had 80% classification accuracy in the differentiation of PD mild cognitive impairment from PD without impairment. The s-MoCA-CZ, a brief screening tool, is shorter to administer than the standard MoCA. It provides high-classification accuracy for PD mild cognitive impairment and is equivalent to that of the standard MoCA-CZ.

Young-Old City-Dwellers Outperform Village Counterparts in Attention and Verbal Control Tasks.

Cognitive performance is dynamic and shaped by individual biological and environmental factors throughout life. In psychology, besides the effects of age, education, and other often studied factors, the complexity of the lived-in environment and urbanicity in that context are yet to be elucidated. In this observational cross-sectional study, we compare cognitive performance in standard neuropsychological tests in healthy older persons from three different types of settlements in the Czechia: the capital city of Prague, towns, and villages. The groups were equal in terms of the age-band (60-74 years), the distribution of gender, education, past and current leisure activities, and cognitive health status (MMSE score). The results showed that Prague citizens had consistently better performance in all verbal tests (for memory and verbal control, i.e., executive function) and attention than persons from other areas. The groups did not differ in timed visuo-graphomotor performance. The conclusion is that the complex environment of a city may promote, in the long-term, certain cognitive abilities, distinguishable even in a developed, culturally homogenous country. The implications are: (a) the description of samples used in normative studies should include information on the lived-in environment for the reference of researchers and clinicians; and (b) individual clinical assessment should reflect the role of the patient's environment where appropriate. The exact mechanisms and causes of the differences need further investigation.

The Uniform Data Set, Czech Version: Normative Data in Older Adults from an International Perspective.

BACKGROUND: Outside of the United States, international perspectives on normative data for neuropsychological test performance, within diverse populations, have been scarce. The neuropsychological test battery from the Uniform Data Set (UDS) of the Alzheimer's Disease Centers (ADC) program of the United States National Institute on Aging (NIA) is one of the most sensitive batteries for the evaluation of both normal cognitive aging and pathological cognitive decline. OBJECTIVE: This study aimed to determine the feasibility of the Czech Neuropsychological Test Battery from the Uniform Data Set (UDS-Cz 2.0), while also evaluating the results obtained from an international perspective. METHODS: This paper describes data from 520 cognitively normal participants. Regression analyses were used to describe the influence of demographic variables on UDS-Cz test performance. RESULTS: Cognitive performance on all measures declined with age, with patient education level serving as a protective factor. Therefore, the present study provides normative data for the UDS-Cz, adjusted for the demographic variables of age and education. CONCLUSION: The present study determines the psychometric properties of the UDS-Cz and establishes normative values in the aging Czech population, which can be used in clinical settings.

Clinimetric validity of the Trail Making Test Czech version in Parkinson's disease and normative data for older adults.

OBJECTIVE: The influence of demographic variables on the Trail Making Test (TMT) performance in older individuals and empirical findings on clinical validity in predementia states, such as Parkinson's disease mild cognitive impairment (PD-MCI), are limited. The principal aim of this study was to add normative data for the Czech population of older adults and explore the clinimetric properties between PD-MCI and PD patients with normal cognition (PD-NC). METHOD: The study included 125 PD patients classified as 77 PD-MCI and 48 PD-NC and 528 older individuals (60-74 years, further subdivided for normative tables into 60-64, 65-69 and 70-74 age groups) and very old individuals (aged 75-96, further subdivided into 75-79, 80-84, 85-96) cognitively intact Czech adults. RESULTS: Mostly age, to a lesser extent education but not gender, was associated with most TMT basic and derived indices (TMT-B - A). However, the ratio of TMT-B/TMT-A was independent of both age and education. We provide corresponding T-scores that minimize the effect of demographic variables. The results showed a high discriminative validity of TMT basic and derived indices for the differentiation of PD-MCI from PD-NC (all p < .05). The classification accuracy for the differentiation of PD-MCI from controls was optimal for the TMT-B only (80% area under the curve) based on norm adjusted scores. The classification accuracy of the TMT for PD-MCI vs. PD-NC was suboptimal. CONCLUSIONS: The cut-offs and normative standards are useful in clinical practice for those working with PD patients and very old adults.

A parsimonious scoring and normative calculator for the Parkinson's disease mild cognitive impairment battery.

OBJECTIVE: The aim of the present study was to provide a regression-based calculator that takes premorbid functioning into account to detect subtle cognitive decline, as is often present in pre-dementia states, especially mild cognitive impairment in Parkinson's disease (PD-MCI). METHOD: We used demographic adjustments based on sex, age, and education of 699 normative participants that fulfilled exclusion criteria for ascertaining the diagnostic accuracy of the Movement Disorders Society PD-MCI battery at Level II. We examined the clinical validity of the battery on 36 PD patients. RESULTS: An estimated z-score was calculated for any raw score based on different models that adjust for the demographic predictors of gender, age, and education, either concurrently, individually or without covariates. We provide a useful online z-score, SD, and percentile calculator that yields estimates of cognitive impairment based on normative sample for each of the ten neuropsychological tests and enables actuarial decision-making regarding its level and profile (number of domains impaired). We document the clinical utility and applicability of the calculator on a patient with PD-MCI and show the discriminative validity of all measures in the battery by comparing PD-MCI and PD without cognitive impairment with the highest area under the curve (.94) for Tower of London at -2 SD threshold. CONCLUSIONS: Our normative calculator introduces a practical web-based psychometric tool for the evaluation of PD-MCI status in clinical settings. We show the detection potential of each of ten measures included in the battery and delineate the diagnostic precision of the PD-MCI battery.

Montreal Cognitive Assessment and Mini-Mental State Examination reliable change indices in healthy older adults.

OBJECTIVE: Cognitive tests are used repeatedly to assess the treatment response or progression of cognitive disorders. The Montreal Cognitive Assessment (MoCA) is a valid screening test for mild cognitive impairment. The aim of our study was to establish 90% reliable change indices (RCI) for the MoCA together with the Mini-Mental State Examination (MMSE) in cognitively healthy older adults. METHOD: We analyzed 197 cognitively healthy and functional independent volunteers aged 60-94 years, who met strict inclusion criteria for four consecutive years. The RCI methods by Chelune and Hsu were used. RESULTS: For 1, 2, and 3 years, the 90% RCI for MoCA using Chelune's formula were -4 ≤, ≥4; -4 ≤, ≥4 and -5 ≤, ≥4 points, respectively, and -3 ≤, ≥3 for the MMSE each year. Ninety percent RCI for MoCA using Hsu's formula ranged from -6 to 0, respectively, and +3 to +8 dependent on the baseline MoCA. CONCLUSION: Our study demonstrated RCI for the MoCA and MMSE in a 3-year time period that can be used for the estimation of cognitive decline or improvement in clinical settings. Copyright © 2016 John Wiley & Sons, Ltd.