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1.
Zh Nevrol Psikhiatr Im S S Korsakova ; 120(10. Vyp. 2): 39-45, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33205929

RESUMO

Cognitive impairment or delirium occurs in about 40% of elderly patients after surgery. The increasing number of elderly people has led to a significant increase in the number of cases of postoperative cognitive dysfunction (POCD). This is one of the most important medical and social problems, the analysis of which is especially difficult, since it requires the coordination of a large number of specialties: anesthesiology, surgery, neurology, psychiatry, neuropsychology, as well as fundamental neurosciences. Thus, a systematic multidisciplinary approach that takes into account all possible factors affecting the condition of patients should be considered. The article is devoted to the main aspects of the pathogenesis, prevention and treatment of POCD.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Delírio , Idoso , Cognição , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/etiologia , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia , Humanos , Complicações Pós-Operatórias/epidemiologia , Período Pós-Operatório
2.
Rev Med Suisse ; 16(714): 2160-2164, 2020 Nov 11.
Artigo em Francês | MEDLINE | ID: mdl-33174697

RESUMO

What are the criteria for admitting an elderly polymorbid patient to intensive care ? The multidimensional geriatric evaluation is a tool to screen for geriatric syndromes, with the division of elderly patients into 3 categories: robust, vulnerable and dependent. Targeting certain co-morbidities such as cognitive disorders, delirium, frailty, polymedication and malnutrition, allows clinicians to estimate the risks of mortality and functional and cognitive handicaps during a stay in intensive care. Based on a review of the literature, this article offers some guidelines for triage of older patients for admission to intensive care, using an ethical, multidisciplinary approach that takes into account the patient's fears and preferences.


Assuntos
Cuidados Críticos/estatística & dados numéricos , Idoso Fragilizado , Fragilidade/diagnóstico , Avaliação Geriátrica , Idoso , Transtornos Cognitivos/diagnóstico , Delírio/diagnóstico , Idoso Fragilizado/psicologia , Humanos , Desnutrição/diagnóstico
3.
PLoS One ; 15(11): e0241599, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33137145

RESUMO

INTRODUCTION: Electronic cigarette use (vaping) has become popular in recent years. The number of Americans with a variety of cognitive deficits has been increasing dramatically. This study aimed to examine the potential association of vaping with subjective cognitive complaints in US adults. METHODS: A combined 2016 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) national survey dataset yielded 886,603 adults who indicated their smoking and vaping status, as well as whether they had subjective cognitive complaints. With this dataset, the cross-sectional association of electronic cigarette use with subjective cognitive complaints was examined using multivariable weighted logistic regression models. RESULTS: Both dual users (adjusted Odds Ratio [aOR] = 2.07; 95% Confidence Interval [CI] = 1.66 to 2.60) and current vapers who were either ex-smokers (aOR = 1.94; 95% CI = 1.40 to 2.71) or never smoked (aOR = 1.96; 95% CI = 1.16 to 3.30) showed a significantly higher association with subjective cognitive complaints than never users. Current smokers (aOR = 1.49; 95% CI = 1.32 to 1.69) and ex-smokers (aOR = 1.25; 95% CI = 1.11 to 1.41) had a significantly higher association with subjective cognitive complaints compared to never users. Compared to current smokers, the ex-smokers showed a lower association with subjective cognitive complaints (aOR = 0.84; 95% CI = 0.73 to 0.96). Finally, the association of vaping with subjective cognitive complaints was not statistically significant in individual age group. CONCLUSION: Similar to smoking, vaping is associated with subjective cognitive complaints in US adults. These results provide preliminary evidence for a cross-sectional association of vaping with potential cognitive health effects in adults.


Assuntos
Transtornos Cognitivos/epidemiologia , Cognição , Vaping/epidemiologia , Adolescente , Adulto , Idoso , Transtornos Cognitivos/diagnóstico , Autoavaliação Diagnóstica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
4.
Z Gerontol Geriatr ; 53(8): 797-806, 2020 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-33146740

RESUMO

Older people often report a decline in their cognitive functions - memory problems and difficulty finding words are frequently mentioned. In this context it is essential to differentiate between age-related cognitive decline and pathological processes as they occur in the context of dementia. Neuropsychological diagnostics make an important contribution to this distinction. Using cognitive tests, the quality and quantity of cognitive deficits can be determined. Moreover, the cognitive profile can be used to generate hypotheses about the etiology of the cognitive impairment. In order to avoid a misdiagnosis, factors such as drug side effects, loss of vision and hearing, the presence of depressive symptoms or states of delirium should be taken into account.


Assuntos
Transtornos Cognitivos , Disfunção Cognitiva , Demência , Idoso , Idoso de 80 Anos ou mais , Cognição , Transtornos Cognitivos/diagnóstico , Disfunção Cognitiva/diagnóstico , Demência/diagnóstico , Humanos , Testes Neuropsicológicos
5.
Seizure ; 83: 223-231, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33172763

RESUMO

This is the second of two narrative reviews on cognitive disorders in epilepsy (companion manuscript: Cognitive disorders in epilepsy I: Clinical experience, real-world evidence and recommendations). Its focus is on the clinical targets, indications, and the selection of neuropsychological test instruments. Cognitive assessment has become an essential tool for the diagnosis and outcome control in the clinical management of epilepsy. The diagnostics of basic and higher brain functions can provide valuable information on lateralized and localized brain dysfunctions associated with epilepsy, its underlying pathologies and treatment. In addition to the detection or verification of deficits, neuropsychology reveals the patient's cognitive strengths and, thus, information about the patient reserve capacities for functional restitution and compensation. Neuropsychology is an integral part of diagnostic evaluations mainly in the context of epilepsy surgery to avoid new or additional damage to preexisting neurocognitive impairments. In addition and increasingly, neuropsychology is being used as a tool for monitoring of the disease and its underlying pathologies, and it is suited for the quality and outcome control of pharmacological or other non-invasive medical intervention. This narrative review summarizes the present state of neuropsychological assessments in epilepsy, reveals diagnostic gaps, and shows the great need for education, homogenization, translation and standardization of instruments.


Assuntos
Anticonvulsivantes/uso terapêutico , Transtornos Cognitivos/tratamento farmacológico , Cognição/efeitos dos fármacos , Epilepsia/tratamento farmacológico , Neuropsicologia , Transtornos Cognitivos/diagnóstico , Epilepsia/complicações , Humanos , Testes Neuropsicológicos , Neuropsicologia/instrumentação , Neuropsicologia/métodos
6.
Artigo em Inglês | MEDLINE | ID: mdl-33050599

RESUMO

The ecological validity of neuropsychological testing (NT) has been questioned in the sports environment. A frequent criticism is that NT, mostly consisting of pen and paper or digital assessments, lacks relevant bodily movement. This study aimed to identify the determinants of a newly developed testing battery integrating both cognitive and motor demands. Twenty active individuals (25 ± 3 years, 11 males) completed the new motor-cognitive testing battery (MC), traditional NT (Stroop test, Trail Making test, Digit Span test) and isolated assessments of motor function (MF; Y-balance test, 20m-sprint, counter-movement jump). Kendal's tau and partial Spearman correlations were used to detect associations between MC and NT/MF. Except for two items (Reactive Agility A and counter-movement jump; Run-Decide and sprint time; r = 0.37, p < 0.05), MC was not related to MF. Similarly, MC and NT were mostly unrelated, even when controlling for the two significant motor covariates (p > 0.05). The only MC item with (weak to moderate) associations to NT was the Memory Span test (Digit Span backwards and composite; r = 0.43-0.54, p < 0.05). In sum, motor-cognitive function appears to be largely independent from its two assumed components NT and MF and may represent a new parameter in performance diagnostics.


Assuntos
Desempenho Atlético/fisiologia , Transtornos Cognitivos/diagnóstico , Cognição/fisiologia , Testes Neuropsicológicos/estatística & dados numéricos , Transtornos Cognitivos/psicologia , Humanos , Masculino , Movimento , Psicometria , Reprodutibilidade dos Testes , Esportes , Análise e Desempenho de Tarefas
7.
Khirurgiia (Mosk) ; (8): 69-74, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32869618

RESUMO

OBJECTIVE: To substantiate the advisability of using cytoflavin to correct postoperative cognitive dysfunction (POCD) in patients undergoing video laparoscopic cholecystectomy (VLCE) under conditions of inhalation anesthesia with sevoflurane. MATERIAL AND METHODS: The data of two representative groups of patients (n=60) who underwent video-laparoscopic cholecystectomy under the conditions of inhalation anesthesia with sevoflurane were analyzed. At the stages of the perioperative period, in order to monitor the state of higher mental functions, neuropsychological testing was performed: anxiety and depression scales (HADS), the Montreal scale of cognitive dysfunction (MoCA), and frontal dysfunction batteries (FAB). Patients of the first group (n=19) were not corrected for POKD. For the correction of cognitive impairment, patients of the second group (n=41) were treated with Cytoflavin according to the 20 ml regimen per 250 ml of 0.9% sodium chloride solution intravenously once before the operation, then within 4 days of the postoperative period. RESULTS: Neuropsychological testing in group I patients revealed the development of moderate POCD. The inclusion of Cytoflavin in the treatment regimen in the II group of patients contributed to an improvement in the state of HMF, accompanied by a decrease in the level of anxiety and depression. CONCLUSION: The inclusion of Cytoflavin in treatment regimens helps prevent the development of POKD and is accompanied by an improvement in the state of higher mental functions, which is manifested by a decrease in the level of anxiety and depression, favorably affecting the emotional background of patients.


Assuntos
Anestésicos Inalatórios/efeitos adversos , Colecistectomia Laparoscópica , Transtornos Cognitivos/terapia , Mononucleotídeo de Flavina/administração & dosagem , Inosina Difosfato/administração & dosagem , Fármacos Neuroprotetores/administração & dosagem , Niacinamida/administração & dosagem , Sevoflurano/efeitos adversos , Succinatos/administração & dosagem , Anestesia por Inalação/efeitos adversos , Anestesia por Inalação/métodos , Colecistectomia Laparoscópica/efeitos adversos , Colecistectomia Laparoscópica/métodos , Transtornos Cognitivos/induzido quimicamente , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Combinação de Medicamentos , Humanos , Cirurgia Vídeoassistida
8.
J Stroke Cerebrovasc Dis ; 29(10): 105119, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32912505

RESUMO

BACKGROUND: While both motor and cognitive impairment are common after stroke, the focus of (early) treatment has always been on motor deficit. AIMS: The objective of the current study was to explore the link between motor and cognitive performance in stroke patients and to examine whether motor performance is associated with cognitive functioning at three months post stroke. METHODS: In both stroke patients (n = 142) and controls (n = 135), with the groups matched on age, gender and premorbid IQ, motor functioning was evaluated using both objective (Purdue Pegboard Test) and subjective measures (specific items from the Frenchay Activities Index and Barthel Index). Cognition, specifically information processing speed, working memory and cognitive flexibility, was assessed using objective tasks. The data were analyzed using Pearson product-moment correlation coefficients and logistic regression. RESULTS: Significant correlations between motor and cognitive functioning were found in stroke patients. The objective motor task was stronger than subjective measures in statistically explaining and predicting cognitive deficit, irrespective of stroke severity. CONCLUSIONS: We conclude that motor impairment at three months post-stroke should serve as a 'red flag' for professionals: cognitive impairment is likely and should also be evaluated.


Assuntos
Transtornos Cognitivos/etiologia , Cognição , Atividade Motora , Acidente Vascular Cerebral/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/psicologia , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/fisiopatologia , Acidente Vascular Cerebral/psicologia , Fatores de Tempo
9.
Pediatr Blood Cancer ; 67(11): e28575, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32813316

RESUMO

PURPOSE: Brain tumor (BT) survivors are at risk for difficulties with adaptive functioning (AF). Recent work has associated neurological risk with poorer AF outcomes using the Neurological Predictor Scale (NPS), a quantification of neurological risk factors. Survivors also have poorer attention, processing speed, and working memory, which are all important for AF. The current study examined whether these cognitive constructs explain the relationship between the NPS and AF in survivors. METHODS: Ninety-five adult BT survivors and 135 healthy controls were recruited from the Atlanta area. The Oral Symbol Digits Modalities test was used to measure processing speed, Digit Span Backward assessed working memory, and Digit Span Forward measured attention. Informants completed the Scales of Independent Behavior (SIB-R) to measure AF. Group differences and correlations were assessed, and the PROCESS macro for SPSS tested indirect effects. RESULTS: Survivors were significantly lower on AF and cognitive measures compared with controls. Attention span and processing speed had significant indirect effects in relationship between NPS and AF individually, but processing speed was the only variable with a significant indirect effect when all cognitive variables were included in the model. The NPS and processing speed together account for approximately 39% of variance in AF outcomes. CONCLUSIONS: BT survivors in our sample have lower AF than controls, and processing speed appears to be particularly important in explaining the relationship between neurological risk and AF. In the future, the development of interventions aimed at increasing young adult independence should target both cognitive processing speed and AF skills.


Assuntos
Atenção , Neoplasias Encefálicas/complicações , Sobreviventes de Câncer/psicologia , Transtornos Cognitivos/diagnóstico , Mastigação , Memória de Curto Prazo , Adolescente , Adulto , Neoplasias Encefálicas/terapia , Estudos de Casos e Controles , Transtornos Cognitivos/etiologia , Terapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Testes Neuropsicológicos , Prognóstico , Fatores de Risco , Taxa de Sobrevida , Adulto Jovem
10.
J Stroke Cerebrovasc Dis ; 29(9): 105063, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807468

RESUMO

BACKGROUND AND OBJECTIVE: After cerebral hemorrhage, cognitive functions and activities of daily living (ADL) are affected by various factors, including hematoma volume and patient age. In the present study, we investigated the effect of age and hematoma volume on cognitive functions and on ADL. METHODS: The sample comprised 274 patients (183 men and 91 women; mean age 58.2 ± 12.5 years) with putaminal hemorrhage who were hospitalized in a convalescent rehabilitation ward. Hematoma volume was estimated from computed tomography imaging at stroke onset. Cognitive functions were evaluated using Raven's Colored Progressive Matrices test (RCPM) and the Mini-Mental State Examination (MMSE) at hospital admission, while ADL score was assessed at discharge using the Functional Independence Measure motor subscale (FIM-M). In the present study, we classified the patients into six groups according to whether they were non-elderly or elderly (cutoff age, 60 years) and whether their hematoma was small, medium, or large (cutoff volumes, 20 and 40 mL, respectively). Subsequently, the scores on the RCPM, MMSE, and FIM-M were compared among the groups. RESULTS: In both age groups, patients with a larger hematoma volume had lower RCPM and MMSE scores. Patients <60 years old exhibited different trends in their RCPM and MMSE scores, such that the RCPM score showed a step-wise decrease according to hematoma volume, while a difference in the MMSE score was only observed at the 20 mL boundary. Most of the younger patients (<60 years of age) attained high FIM-M scores at discharge, as long as their hematoma volume was either medium or small (<40 mL). This age group had higher RCPM scores on admission, which may have contributed to their higher FIM-M scores on discharge. CONCLUSIONS: In the present study, we demonstrated that advancing age increases the effect of hematoma volume on RCPM and MMSE scores and identified differences in the effects observed on these two scores. Thus, it may be important to use the RCPM alongside the MMSE for patient assessment.


Assuntos
Atividades Cotidianas , Transtornos Cognitivos/etiologia , Cognição , Envelhecimento Cognitivo , Hemorragia/diagnóstico por imagem , Hemorragia Putaminal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Fatores Etários , Idoso , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/fisiopatologia , Transtornos Cognitivos/psicologia , Feminino , Hemorragia/complicações , Hemorragia/fisiopatologia , Hemorragia/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Valor Preditivo dos Testes , Prognóstico , Hemorragia Putaminal/complicações , Hemorragia Putaminal/fisiopatologia , Hemorragia Putaminal/psicologia , Fatores de Risco
11.
BMC Cardiovasc Disord ; 20(1): 381, 2020 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-32819289

RESUMO

BACKGROUND: Evidence has shown that serum uric acid (UA) is associated with cognitive function, but this finding remains debatable. Serum UA is commonly elevated in patients with chronic heart failure (CHF), especially in men. However, the relationship between serum UA and cognitive function in CHF populations and stratified by sex are unclear. We aimed to examine whether serum UA was independently associated with cognitive function in CHF populations after controlling for demographic, medical and psychological variables and whether there was a sex difference in the association between serum UA and cognitive function among male and female CHF patients. METHODS: One hundred ninety-two hospitalized patients with CHF underwent an assessment of cognitive function using the Montreal Cognitive Assessment (MoCA) and the determination of serum UA. Hyperuricemia was defined as serum UA ≥7 mg/dl in men and ≥ 6 mg/dl in women. Multiple linear hierarchical regression analyses were conducted to examine the independent association between serum UA and cognitive function in CHF populations and stratified by sex. RESULTS: The mean serum UA concentration of participants was 7.3 ± 2.6 mg/dL. The prevalence of hyperuricemia was 54.7% (105 of 192) in CHF patients, 52.9% (64 of 121) in men, and 57.7% (41 of 71) in women. In the total sample, higher serum UA was associated with poorer cognitive function independent of demographic, medical and psychological variables (ß = - 0.130, ΔR2 = 0.014, p = 0.015). In sex-stratified groups, elevated serum UA was independently associated with worse cognitive function in men (ß = - 0.247, ΔR2 = 0.049, p = 0.001) but not in women (ß = - 0.005, ΔR2 = 0.000, p = 0.955). CONCLUSIONS: Higher serum UA is independently associated with poorer cognitive function in CHF populations after adjusting for confounding variables. Furthermore, elevated serum UA is independently related to worse performance on cognitive function in men but not in women. More longitudinal studies are needed to examine the association between serum UA and cognitive function in CHF populations and stratified by sex.


Assuntos
Transtornos Cognitivos/etiologia , Cognição , Insuficiência Cardíaca/complicações , Hiperuricemia/complicações , Ácido Úrico/sangue , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Doença Crônica , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/psicologia , Estudos Transversais , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/fisiopatologia , Hospitalização , Humanos , Hiperuricemia/sangue , Hiperuricemia/diagnóstico , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Fatores Sexuais , Volume Sistólico , Função Ventricular Esquerda
12.
J Stroke Cerebrovasc Dis ; 29(8): 104923, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32689613

RESUMO

OBJECTIVE: In this prospective study, we aimed to investigate the presence and evolution of cerebellar cognitive affective syndrome in a cohort of isolated cerebellar stroke with no known cognitive or psychiatric impairment. We tried to distinguish the unconfounded effect of cerebellar lesions on neuropsychological processing. METHODS: After a meticulous exclusion procedure based on possible confounders, we recruited 14 patients and 13 age-matched healthy controls to the study, prospectively. All of the patients had a detailed initial neuropsychological assessment at the first week and a follow-up assessment at the 4th month after stroke. RESULTS: The prevalence of cognitive or behavioral-affective abnormalities in our cohort were 86% and 64% respectively. The patients exhibited mild and transient affective-behavioral abnormalities except for depressive symptoms that persisted in the subacute stage. They scored lower in general cognitive performance as revealed by mini mental test (p=0.001). Memory, executive functions, attention and working memory, central processing speed, and linguistic abilities were impaired (p<0.001; p=0.001; p=0.007; p=0.05; p<0.001 respectively). Improvement was evident only in memory domain of the cognitive functions in the subacute stage. Cognitive impairment was more likely with a medial or posterolateral infarct (p=0.014). Behavioral-affective abnormalities were not associated with a specific location in our cohort. Age seemed to negatively correlate with the recovery in general cognitive performance on the follow-up. CONCLUSIONS: These findings show that acute denervation of cerebellocortical projections leads to mild affective-behavioral abnormalities, and full-blown cerebellar cognitive affective syndrome is rare. However, cognition was significantly affected after an acute cerebellar infarct even in a previously healthy, non-demented pure population.


Assuntos
Afeto , Infartos do Tronco Encefálico/psicologia , Doenças Cerebelares/psicologia , Cerebelo/irrigação sanguínea , Transtornos Cognitivos/psicologia , Cognição , Transtornos do Humor/fisiopatologia , Doença Aguda , Atenção , Infartos do Tronco Encefálico/diagnóstico , Infartos do Tronco Encefálico/epidemiologia , Infartos do Tronco Encefálico/fisiopatologia , Estudos de Casos e Controles , Doenças Cerebelares/diagnóstico , Doenças Cerebelares/epidemiologia , Doenças Cerebelares/fisiopatologia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/fisiopatologia , Função Executiva , Feminino , Humanos , Idioma , Masculino , Memória , Pessoa de Meia-Idade , Transtornos do Humor/diagnóstico , Transtornos do Humor/epidemiologia , Transtornos do Humor/psicologia , Prevalência , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo , Turquia/epidemiologia
13.
Internist (Berl) ; 61(9): 929-938, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32666209

RESUMO

Approximately 40% of patients with heart failure show cognitive deficits, such as concentration difficulties, attention deficits, and memory impairment. Affected patients have a higher rate of rehospitalization and an increased mortality. This could be due to low adherence mediated by a lack of disease-specific knowledge and strategies to deal with symptom exacerbation. The pathogenesis of cognitive deficits in heart failure is multifactorial. In this respect the heart failure itself as well as cardiovascular risk factors and comorbidities play a role. Orientating neuropsychological screening tests can show a first indication of the presence of cognitive impairment. When identified, the causes can be specifically treated and care can be optimized through certain measures, such as the involvement of caregivers and healthcare providers.


Assuntos
Transtornos Cognitivos/etiologia , Disfunção Cognitiva/etiologia , Insuficiência Cardíaca/complicações , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/psicologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/epidemiologia , Comorbidade , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/psicologia , Humanos , Adesão à Medicação , Testes Neuropsicológicos
14.
Maturitas ; 138: 51-57, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32631588

RESUMO

BACKGROUND: Motoric Cognitive Risk syndrome (MCR), which combines Subjective Cognitive Complaint (SCC) and slow gait speed in individuals free of dementia and gait disability, is associated with cardiovascular risk factors and diseases as well as incident cognitive impairment. Little information on MCR exists in the Canadian population. This study aims to examine these associations in community-dwelling elderly people living in Quebec, which is a Canadian province. METHODS: Data was collected from the"Nutrition as a determinant of successful aging: The Quebec longitudinal study" (NuAge), which is a Quebec population-based observational cohort study with 3 years of follow-up. A subset of 1113 participants (age 73.8 ±â€¯4.1 and 51.9% female; 63.5% of the initial NuAge sample) was selected. MCR, cardiovascular risk factors and disease were recorded at baseline. Incident cognitive impairment was considered if the Modified Mini-Mental State Examination (3MS) score was ≤79/100 at subsequent annual visits. RESULTS: The prevalence of MCR was 4.2% at baseline and was significantly associated with diabetes (P < 0.032), cerebrovascular disease (P < 0.043) and incident cognitive impairment (P ≤ 0.001). The overall incidence of cognitive impairment during the 3-year follow-up period was 4.6%. A greater decrease of the 3MS score was observed in participants with MCR compared to those without MCR, at each annual assessment (P ≤ 0.001). CONCLUSION: MCR was associated with diabetes and cerebrovascular diseases at baseline, and incident cognitive impairment in NuAge study participants.


Assuntos
Doenças Cardiovasculares/epidemiologia , Transtornos Cognitivos/epidemiologia , Diabetes Mellitus/epidemiologia , Idoso , Transtornos Cognitivos/diagnóstico , Feminino , Humanos , Incidência , Vida Independente , Masculino , Testes Neuropsicológicos , Prevalência , Quebeque/epidemiologia , Fatores de Risco , Síndrome , Velocidade de Caminhada
15.
Epidemiol Psychiatr Sci ; 29: e144, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32684190

RESUMO

AIMS: Establishing the minimum clinically important difference (MCID) in functioning and cognition is essential to the interpretation of the research and clinical work conducted in bipolar disorders (BD). The present study aimed to estimate the MCID for the Functioning Assessment Short Test (FAST) and a battery of neuropsychological tests in BD. METHODS: Anchor-based and distributive methods were used to estimate the MCID for the FAST and cognition using data from a large, multicentre, observational cohort of individuals with BD. The FAST and cognition were linked with the Clinical Global Impressions Scale-Severity (CGI-S) and Global Assessment of Functioning (GAF) using an equipercentile method. The magnitude of the standard error measurement (s.e.m.) provided another estimate of the MCID. RESULTS: In total, 570 participants were followed for 2 years. Cross-sectional CGI-S and GAF scores were linked to a threshold ⩽7 on the FAST for functional remission. The MCID for the FAST equalled 8- or 9-points change from baseline using the CGI-S and GAF. One s.e.m. on the FAST corresponded to 7.6-points change from baseline. Cognitive variables insufficiently correlated with anchor variables (all ρ <0.3). One s.e.m. for cognitive variables corresponded to a range of 0.45 to 0.93-s.d. change from baseline. CONCLUSIONS: These findings support the value of the estimated MCID for the FAST and cognition and may be a useful tool to evaluate cognitive and functional remediation effects and improve patient functional outcomes in BD. The CGI-S and GAF were inappropriate anchors for cognition. Further studies may use performance-based measures of functioning instead.


Assuntos
Transtorno Bipolar/diagnóstico , Transtornos Cognitivos/diagnóstico , Cognição/fisiologia , Testes Neuropsicológicos/estatística & dados numéricos , Transtorno Bipolar/psicologia , Transtornos Cognitivos/psicologia , Estudos Transversais , Função Executiva , Feminino , Humanos , Masculino , Memória de Curto Prazo , Avaliação de Resultados em Cuidados de Saúde , Tempo de Reação , Comportamento Social
16.
Neuropsychiatr ; 34(3): 140-147, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32608011

RESUMO

BACKGROUND: Due to the increase of dementia diagnoses and individuals interested in monitoring their cognitive status, practical new neuropsychological tests are needed. Tablet-based tests offer a good alternative to traditional paper-pencil tests, as they can be completed remotely and independently. This study assessed two semantic memory tests (verbal and visual memory), in the scope of the creation of a new tablet-based battery-the International Neurocognitive Profil (INCP)-on the influences of demographic variables. METHODS: In all, 46 cognitively healthy participants who recruited at the memory clinic of the Medical University of Vienna were included in this study. They were asked to complete two tests of semantic memory and implicit learning: Capital Knowledge (CK) using verbal input and Flag Knowledge (FK) using visual input. Performance on the two tests was analysed according to influences of gender and age using two analyses of variance. Post hoc comparisons between age and gender groups were performed. In addition, correlational analyses were computed to assess strengths of association with age, gender and education. RESULTS: FK- and CK-based measures were found to be influenced by demographic variables with semantic memory measures being significantly influenced by gender and education while incidental memory measures were influenced by age. Performances differed between FK and CK showing that the mode of testing (visual, verbal) affected participant's performance. CONCLUSION: These findings are important for the creation of normative samples for both CK and FK. Furthermore, this study underlines the importance of using different testing modes when assessing individuals' semantic memory.


Assuntos
Transtornos Cognitivos , Memória , Semântica , Cognição , Transtornos Cognitivos/diagnóstico , Humanos , Testes Neuropsicológicos , Projetos Piloto
17.
Rev. logop. foniatr. audiol. (Ed. impr.) ; 40(2): 67-76, abr.-jun. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193699

RESUMO

ANTECEDENTES Y OBJETIVO: Investigaciones recientes señalan que el análisis acústico de la voz es una herramienta valiosa tanto para la evaluación objetiva del deterioro cognitivo como para la monitorización de la progresión de la enfermedad. El objetivo de este estudio es determinar si el análisis automático de la voz es también útil en el diagnóstico del deterioro cognitivo. MATERIALES Y MÉTODOS: Se trata de un estudio descriptivo correlacional transversal en el que se hace una comparativa entre un grupo experimental compuesto por 10 participantes con deterioro cognitivo y un grupo control con 10 participantes asintomáticos. Se recogieron grabaciones de voz de ambos grupos mientras realizaban 4 tareas cognitivas: conteo hacia atrás (desde el 305 hasta el 285), descripción de una lámina y 2 tareas de fluidez verbal (fonológica y semántica). Las muestras de voz fueron analizadas acústicamente para extraer de ellas variables predictoras del estado cognitivo del sujeto. RESULTADOS: Los resultados muestran que las variables acústicas analizadas son eficaces para la detección precoz del deterioro cognitivo, al lograr una tasa de clasificación del 100% al predecir el estado cognitivo de los sujetos de la muestra. Parece que las tareas de fluidez verbal presentan mayor eficacia que las de conteo hacia atrás y descripción de una imagen. CONCLUSIONES: A la luz de los resultados encontrados consideramos que el análisis automático de la voz podría ser una herramienta de evaluación objetiva adicional para mayores con deterioro cognitivo. Se discuten las implicaciones de los resultados encontrados


BACKGROUND AND AIM: Recent research has shown that acoustic voice analysis is a valuable tool for both the objective assessment of cognitive impairment and the monitoring of disease progression. The aim of this study is to determine whether automatic voice analysis is also useful for diagnosis of cognitive impairment. MATERIALS AND METHODS: This is a descriptive cross-sectional correlational study in which a comparison is made between an experimental group composed of 10 participants with cognitive impairment and a control group with 10 healthy participants. Voice recordings were collected from both groups while they performed 4 tasks: counting backwards (from 305 to 285), description of an image and two tasks of verbal fluency (phonological and semantic). The voice samples were later acoustically analyzed to extract from them variables predictive of the cognitive state of the subject. RESULTS: The results show that the acoustic variables are effective for early detection of cognitive impairment, achieving a classification rate of 100% when predicting the cognitive status of the subjects in our sample. From the results it is clear that verbal fluency tasks are more effective than counting backwards and describing an image. CONCLUSIONS: In light of our results, we consider that automatic voice analysis could be an additional objective assessment tool for elderly people with cognitive impairment. The implications of the results found are discussed


Assuntos
Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Transtornos Cognitivos/diagnóstico , Acústica da Fala , Estudos de Casos e Controles , Estudos Transversais
18.
Clin Interv Aging ; 15: 691-693, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32546987

RESUMO

Chemobrain is one of the problems that may arise during or after treatment and there is currently no specific treatment for this condition. Our case was a 76-year-old female patient who presented to our clinic with complaints of forgetfulness that did not affect daily living activities for the last year. Breast cancer was diagnosed in 2013 and she has been receiving anastrozole treatment for 6 years after local mass excision surgery and radiotherapy. After a comprehensive geriatric evaluation, cognitive impairment due to systemic cancer therapy was detected and treatment was started with Theracurmin 90 mg twice a day therapy. After 3-months of Theracurmin therapy, she had no cognitive improvement during the follow-up. This case report demonstrated that Theracurmin treatment may be a new option for chemobrain.


Assuntos
Anastrozol , Neoplasias da Mama/terapia , Transtornos Cognitivos , Cognição/efeitos dos fármacos , Curcumina/administração & dosagem , Radioterapia , Idoso , Anastrozol/administração & dosagem , Anastrozol/efeitos adversos , Antineoplásicos Hormonais/administração & dosagem , Antineoplásicos Hormonais/efeitos adversos , Neoplasias da Mama/patologia , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/tratamento farmacológico , Transtornos Cognitivos/etiologia , Feminino , Avaliação Geriátrica/métodos , Humanos , Mastectomia Segmentar/métodos , Nootrópicos/administração & dosagem , Radioterapia/efeitos adversos , Radioterapia/métodos , Resultado do Tratamento
19.
Psychiatry Res ; 290: 113051, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32474065

RESUMO

Differences in cognitive function have been suggested in people with late-life depression between those with early- (EOD) and late-onset (LOD), possibly reflecting different etiologies. The cutoff point for EOD and LOD was the first depressive episode before age 60 or later. However, depressive symptoms at the time of disorder are important confounders. The study aimed to compare cognitive function in older people with EOD and LOD in the euthymic state. A sample of 135 participants aged 60+ with a history of major depressive disorder in remission, received neuropsychological evaluation including tests of memory, attention, processing speed, visuospatial function, language, and executive function. Individual test scores and a derived composite score were investigated as dependent variables against age of onset using multiple linear regressions adjusted for potential confounders, including residual depressive symptoms. We found EOD (N = 67) and LOD (N = 68) groups did not differ significantly in overall composite cognitive scores after adjustment. Of individual test scores, only those for immediate recall were significantly lower in participants with EOD compared to LOD. In conclusion, the study found no associations between cognitive function and age of onset in this sample of people with depressive disorder in remission. Active or residual depressive symptoms might have confounded this relationship in previous research.


Assuntos
Cognição/fisiologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Testes Neuropsicológicos , Idade de Início , Idoso , Idoso de 80 Anos ou mais , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/psicologia , Transtorno Depressivo Maior/epidemiologia , Função Executiva/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Indução de Remissão
20.
Cogn Behav Neurol ; 33(2): 77-89, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32496293

RESUMO

Functional neurological (conversion) disorder (FND) is a neuropsychiatric condition characterized by sensorimotor symptoms exhibiting features incompatible with other neurologic diseases. Individuals with motor FND (mFND) typically present with limb weakness, nonepileptic seizures, and/or abnormal movements. However, this population also frequently reports clouded thinking, inattention, and memory difficulties. Cognitive complaints in individuals with mFND are important to evaluate as they may negatively impact quality of life and impede treatment engagement. We provide a narrative review of the neuropsychological testing literature detailing neurocognitive profiles of individuals with mFND. We also present three illustrative clinical cases at the intersection of mFND and cognitive concerns. Several studies and our case examples highlight that generally normal cognitive performance can be observed concurrently with subjective cognitive complaints in some individuals with mFND; this mismatch may be a possible "rule-in" sign of functional cognitive symptoms. Other studies have reported impairments in attention, memory, language, visuospatial, and executive functioning in individuals with mFND. These impairments could be related to medical-psychiatric comorbidities, psychotropic medication side effects, and intrinsic disease mechanisms. When evaluating individuals with mFND and their cognitive complaints, clinicians can use performance validity test and psychopathology findings to help them interpret the neuropsychological test results. Perceptual mismatches between intact objective cognitive performance and subjective cognitive complaints may reflect a negative attentional bias for cognitive abilities that can be targeted with cognitive retraining and cognitive behavioral therapy. Neuropsychological evaluations may provide a useful adjunctive tool clinicians can use to help assess individuals with mFND and cognitive concerns.


Assuntos
Transtornos Cognitivos/diagnóstico , Transtorno Conversivo/diagnóstico , Testes Neuropsicológicos/normas , Qualidade de Vida/psicologia , Adulto , Transtorno Conversivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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