The Saint Louis University Mental Status (SLUMS) Examination is a relatively new brief cognitive screening measure developed for use with veterans. To date, there has been a paucity of research on its psychometric properties. Using a sample of 148 male veterans referred to a VA Mild Cognitive Impairment (MCI) Clinic for evaluation, the SLUMS’ ability to discriminate between MCI versus other diagnoses or no diagnosis was compared to results from a more comprehensive neuropsychological battery. Approximately 51% of the sample was diagnosed with MCI, 16% with Major Depressive Disorder (MDD), 17% did not meet criteria for a diagnosis, and 16% were given some other DSM-IV-TR diagnosis. The SLUMS demonstrated poor internal consistency (Cronbach’s alpha = .57), but scores were significantly correlated with scores on every neuropsychological measure, except for Trails B. Diagnostic discriminability was comparable to that of the more time intensive neuropsychological battery for discriminating between MCI and no diagnosis, and MCI and MDD. In the current sample, a cutoff score of 25 was optimal for discriminating between MCI and no diagnosis, whereas a slightly lower cutoff score of 24 is recommended for discriminating between MCI and those with MDD. Diagnostic indicators were poor for the SLUMS and the battery when discriminating between MCI and a heterogeneous group of other disorders. Possible reasons for low reliability in such a screening measure in the context of convergent validity are discussed. It is concluded that the SLUMS may be a viable brief cognitive screening measure in such veteran populations, particularly when discriminating between MCI and MDD; however, additional studies should be completed to evaluate other forms of consistency, such as test-retest reliability.

Cognitive impairment in Parkinson’s disease (PD) can impact negatively on caregivers and is associated with carer distress and feelings of burden. To investigate this relationship we examined level of burden, coping strategies, depression, anxiety and potential positive aspects of caregiving in the caregivers of 104 PD patients. The PD patients were classified as either showing normal cognition (PD-N; n=57), with mild cognitive impairment (PD-MCI; n=31) or with dementia (PD-D; n=16). The key finding was that mean Zarit burden score increased between carers of PD-N (M=14.1, SD=12.0) through to PD-MCI (M=21.1, SD=9.86) and PD-D (M=27.8, SD=10.61); F (2,101) =9.96, p<0.001. Post hoc tests (Newman-Keuls) identified significantly higher Zarit burden scores in PD-D caregivers compared to both PD-N (p<.001) and PD-MCI patients (p<.05), but carers of PD-MCI patients also showed increased burden scores relative to those of PD-N patients (p<.05). The proportion of carers showing significant levels of burden (Zarit burden score ≥21) also increased as cognition declined (21% for PD-N; 58% for PD-MCI; and 81% for PD-D). Time spent providing care and problem-focused, emotion-focused and dysfunctional coping strategies also increased with worsening cognition. While caregiver use of problem-focused coping mediated the association between patient cognitive status and caregiver burden, we could not be confident about this relationship as the inverse model was also significant. Caregiver Zarit burden was independent of caregiver depression, anxiety and positive attributions of caregiving. The study highlights the impact of Parkinson’s disease on those providing care when the patients’ cognition is poor, including those with MCI. Caregiver well-being has important implications for nursing home placement and disease course.

This study was an attempt to combine two research literatures on hyperactivity: the behaviour genetic research and the studies testing psychological theories of hyperactivity. We obtained behavioural ratings from the teachers of 1316 twin pairs, aged 7-12, from the general population. For a subsample of 268 twin pairs we obtained ratings also from their parents. Forty-six hyperactive twin pairs (pairs in which at least one twin was pervasively hyperactive) and 47 control twin pairs were then assessed on tests relating to three theories of hyperactivity, those of response inhibition deficit, working memory impairment and delay aversion. Confirming previous findings, genetic factors accounted for 50-70% of the variance in hyperactivity when considered as a continuous dimension. There was also significant evidence of genetic effects on extreme hyperactivity, although the present group heritability estimates were somewhat lower than previous estimates. The hyperactive group performed worse than the control group on the delay aversion measure and some of the working memory tasks. Controlling for IQ removed the significant group differences on the working memory measures, however. Although there were no significant group differences on the inhibition variables, the inhibition measure, stop task, produced evidence of a pattern of responding that was strongly characteristic of hyperactivity: hyperactive children were variable in their speed, generally slow and inaccurate. This pattern of responding may indicate a non-optimal effort/activation state. To investigate the possibility that the cognitive impairments or task engagement factors associated with hyperactivity mediate the genetic effects on the condition, bivariate group heritability analyses were carried out. There was significant evidence of shared genetic effects only on extreme hyperactivity and the variability of speed. The findings are interpreted as supporting the state regulation theory of hyperactivity. Although delay aversion is a characteristic of hyperactivity, it seems to have an environmental rather than a genetic origin.

Indiana University-Purdue University Indianapolis (IUPUI) / Chronic consumption of a high-fat diet is a lifestyle factor that increases the risk for cognitive impairment (Granholm et al., 2008; Greenwood & Winocur, 2005; Mattson, 2004; Winocur & Greenwood, 2005). A high-fat diet appears to facilitate cognitive impairment through the promotion of insulin resistance (Greenwood & Winocur, 2005; Stranahan et al., 2008; Winocur & Greenwood, 2005). A gap in the literature is an established timeframe of the progression and underlying mechanism, which study in animals would better afford. Furthermore, A limited number of studies have investigated the relationship between a high-fat diet and behavioral dysregulation such as anxiety and depression. The 1st aim of the study was to determine if consumption of a high-fat diet leads to cognitive impairment and behavioral dysfunction at 3, 8, or 13 weeks of consumption. The 2nd aim was to determine if cholesterol levels and HBP activity are aberrantly increased in specific regions in mice that display feeding induced cognitive/behavioral dysfunction. Consumption of the experimental specialty diets produced a number of significant behavioral effects. These significant effects began to emerge after only 3 weeks of low-and high-fat feeding with increased anxiety-like behavior displayed higher in the high-fat diet group for the Elevated Plus Maze and Open Field Test. There was increased thigmotactic behavior and floating in the low-fat diet group in the Morris Water Maze (MWM) task, therefore making cognitive assessment uninterpretable. This pattern in the behavioral tasks were more robust in the 8 week group and alleviated in the 13 week group. There was only a significant difference in depression-like symptoms in the Forced Swim (FS) Task in the 3 week group. Cholesterol analysis is still under review in Dr. Elmendorf’s lab to correlate cholesterol levels and cognitive/behavioral impairment.

No description available.

Introduction: Classifications such as Mild Cognitive Impairment (MCI) and Cognitive Impairment, No Dementia (CIND) are thought to represent the transitory, pre-clinical phase of dementia. However, increasing research demonstrates that MCI and CIND represent nonlinear and unstable entities that do not always lead to imminent dementia. Despite an increase in research examining patterns and predictors of cognitive impairment classification stability, this concept is still poorly understood, and the research remains limited. The present study was designed to address the existing limitations within the literature by utilizing a longitudinal repeated measures design to gain a more thorough understanding of CIND classification stability patterns, as well as identify predictors of future stability. Objectives: The objectives were to i) explore patterns of longitudinal stability in cognitive status across multiple assessments, and ii) investigate whether select baseline variables could predict 6-year cognitive status stability patterns. Methods: Participants included 259 older adults from Project MIND, a six-year longitudinal repeated measures design in which participants were classified as either Normal Cognition (NC) or CIND at each assessment. A latent transition analysis approach was adapted in order to identify and characterize transitions in CIND status across annual assessments. Participants were classified as either Stable NC, Stable CIND, Progressers, Reverters, or Fluctuaters. Multinomial logistic regression was then employed to test whether baseline predictors were associated with cognitive status stability patterns. Results: The sample demonstrated high rates of reversion and fluctuation in CIND status across years of study. Additionally, premorbid IQ, total number of medications, presence of arthritis, and CIND severity at baseline were all significantly associated with select CIND stability outcomes. Conclusion: CIND status was unstable for several years following baseline assessment, and factors such as cognitive reserve may delay or protect against demonstrable cognitive impairment. Further, considering cognitive impairment severity (i.e., single versus multidomain impairment) at the time of initial classification may improve CIND classifications. Continued research on CIND stability is recommended to improve classification methodology and provide a framework for future identification and prevention. / Graduate

No description available.

Mild cognitive impairment (MCI) is a medical diagnosis that is conceptualized as existing on a continuum between normal cognitive aging and dementia. While a growing body of research has established the impact of this condition on family members' emotional well-being, as well as the quality of family relationships, the reciprocal impact of family dynamics and the family environment on illness course has received much less attention. Expressed emotion (EE) is a measure of the family emotional climate that has been established as being highly predictive of relapse and symptom exacerbation for a variety of mental health disorders. The recent integration of attribution theory with EE has offered new insights into the underlying attitudes and beliefs that give rise to it. This mixed methods study applied the attribution model of EE to test the validity of EE in predicting the illness course of MCI, and to identify family members' attributions regarding MCI-related behaviors and symptoms that underlie their EE status. The study sample included 57 family dyads consisting of a person with MCI and a family member providing primary care or assistance. The results of the ANCOVA did not support the hypothesis that EE status would predict changes in the non-cognitive features of MCI over time. However, methods of thematic analysis revealed four major themes, or care partner attributional stances: (a) non-blaming, (b) blaming, (c) variable, and (d) no identified. The analysis also revealed three subthemes, or attributional styles, within the variable stance: (a) ambivalent, (b) mixed, and (c) complex. These attributional stances and styles intersected with family EE status in notable ways and form the basis for future research in this area, as well as clinical interventions with these families that promote adaptation to the illness. / Ph. D.

No / Person-centred care can improve the well-being of patients and is therefore a key driver in healthcare developments in the UK. The current study aims to investigate the complex relationship between cognitive impairment, dependency and well-being in people with a wide range of acquired brain and spinal injuries. Sixty-five participants, with varied acquired brain and spinal injuries, were selected by convenience sampling from six inpatient clinical neuroscience settings. Participants were observed using Dementia Care Mapping – Neurorehabilitation (DCM-NR) and categorised based on severity of cognitive impairment. A significant difference in the behaviours participants engaged in, their well-being and dependency was found between the severe cognitive impairment group and the mild, moderate or no cognitive impairment groups. Dependency and cognitive impairment accounted for 23.9% of the variance in well–ill-being scores and 17.2% of the variance in potential for positive engagement. The current study highlights the impact of severe cognitive impairment and dependency on the behaviours patients engaged in and their well-being. It also affirms the utility of DCM-NR in providing insights into patient experience. Consideration is given to developing DCM-NR as a process that may improve person-centred care in neuroscience settings.

La difficulté de la plainte mnésique est son aspect subjectif et son évaluation. Le concept de Subjective Cognitive Impairment (SCI) est une réalité épidémiologique. Nous rapportons ici notre expérience, au sein du service de neurologie Comportementale des Hôpitaux sud de MARSEILLE d'une cohorte de sujets consultants sur une période de plus de 6 ans, sur le plan neurologique, neuropsychologique et de la neuroimagerie. Le SCI représente un état anatomo-clinique défini, qu'on peut séparer à la fois des Contrôles Normaux (CN) et des Mild Cognitive Impairment-Amnésiques (MCI-A), sur le plan neuropsychologique, anatomique en IRM. Un suivi, sur une relativement courte période, permet de noter le passage de SCI en MCI-A, voir beaucoup plus rarement de SCI en Maladie d'Alzheimer-Légère (MA-L). Ces sujets évolutifs peuvent être repérés dès le premier bilan, par un test de mémoire épisodique verbale, comme le RAVLT RD. Ce test permet de prédire l'évolutivité des SCI et de caractériser les sujets susceptibles d'évoluer vers un MCI-A à 1 an. Pour améliorer l'étude de la plainte cognitive, il est important d'avoir un outil adapté. Le Memory Functioning Questionnaire (MFQ) est incomparablement plus efficace et plus précis que le Subjective Cognitive Deficit (SCD), dans l'approche diagnostique CN / SCI. L'atteinte directe de l'aire 10, qui sous-tendrait la métamémoire, à ce stade n'est pas prouvée mais pourrait être dû à une dysconnexion par atteinte de la substance blanche du faisceau cingulaire, dans sa partie antérieure. A ce stade, les sujets vont donc se plaindre du fonctionnement de leur mémoire, à cause des mauvaises informations reçues et traitées par l'aire 10. / The difficulty of the memory complaint is its subjective expression and its evaluation. The concept of Subjective Cognitive Impairment (SCI) is an epidemiological reality. We report our experience in the neurology department of Behavioral Hôpitaux Sud in Marseille a cohort of subjects over a period of more than 6 years, neurologically, neuropsychological and neuroimaging. SCI is a clinicopathological state defined wich can be separated from both Normal Controls (NC) and amnestic Mild Cognitive Impairment (A-MCI). MRI does not distinguish between CN and SCI. The SCI are different from the MCI-A, in terms of cognitive-behavioral and neuropsychological tests. Anatomically, MRI, differ A-MCI from SCI, by lesions of cerebral diffuse atrophy of hippocampal atrophy, anterior cingulated and atrophy, indicating a more intense underlying neurobiological processes. We can observe on a relatively short period, allows you to note the passing of SCI in A-MCI, or more rarely in Alzheimer‟s Disease (AD). These evolutionary topics can be identified as the first assessment, a test of verbal episodic memory, as RAVLT DR. This test predicts the scalability of SCI and characterizes subjects likely to progress to A-MCI to 1 year. To improve the study of cognitive complaint, it is important to have a suitable tool. The Memory Functioning Questionnaire (MFQ) is incomparably more efficient and accurate than the Subjective Cognitive Deficit (SCD) in the diagnostic CN / SCI approach. The direct interference of area 10, wich underlies metamemory, at this point is not proven but could be due to a disconnection by reaching the white matter of the cingulated bundle in its anterior region.