Research has demonstrated that cancer patients report problems with cognitive functioning related to their cancer and their cancer treatments. Cognitive complaints refer to subjective reports of problems such as decreased memory, attention, concentration, and language skills. These problems with cognitive functioning can interfere with a person’s quality of life. The current measures of cognitive complaints have poor or unknown psychometric properties. Therefore, the present study sought to examine the psychometric properties of a newly developed measure of cognitive complaints for cancer patients, the Functional Assessment of Cancer Therapy Cognitive Scale (FACT-Cog). Eighty-two patients were administered a comprehensive battery of neuropsychological tests assessing memory, executive functioning, motor, and attention, as well as a battery of psychosocial measures six months or twelve months after receiving a bone marrow transplant. Results indicated that the internal consistency reliability of the FACT-Cog was high. Concurrent validity was evidenced by the significant relationship of the FACT-Cog to another measure of cognitive complaints. Convergent validity is evidenced by the significant relationship of the FACT-Cog to measures of depression, fatigue, anxiety, mental well-being, and physical well-being. Divergent validity was evidenced by the lack of significant relationship of the FACT-Cog to a measure of extroversion. In contrast, there was limited support for the criterion validity of the FACT-Cog as evidenced by the limited significant relationships with neuropsychological test scores. The FACT-Cog did not demonstrate superior psychometric properties to an existing measure of cognitive complaints (EORTC-CF). Future research should investigate the relationship of cognitive complaints to cognitive performance utilizing longitudinal designs, other clinical populations, and neuropsychological tests that require sustained effort.

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Cognitive functioning is important for managing work and life in general. However, subjective cognitive complaints (SCC), involving self-perceived difficulties with concentration, memory, decision making, and clear thinking are common in the general and in the working population and can be coupled with both lowered well-being and work ability. The present thesis investigated the extent to which SCC among people in the work force can be explained by objective cognitive functioning (study I &amp; II) and working conditions (study III), utilizing samples from the working population. The potential roles of other common psychological problems which often co-occur with SCC were also investigated in studies I-III. In Study I, high levels of SCC were associated with significantly poorer episodic memory performance during high executive demands and a trend was found towards poorer episodic memory, while not being associated with semantic memory. In Study II, high levels of SCC were associated with significantly poorer executive cognitive performance on all three executive cognitive tests used. Symptoms of depression, chronic stress and sleeping problems were found to play an important role in the relations between SCC and episodic memory during divided attention in study I and executive cognitive functioning in study II. In Study III, in all cross-sectional data analyses, high quantitative demands, information and communication technology (ICT) demands, underqualification in the work situation and inter-personal conflicts were positively associated with SCC, whereas social support, good resources at work and overqualification in the work situation were negatively associated with SCC. In all prospective data analyses, quantitative job demands, ICT demands and underqualification were positively associated with future SCC, including when adjusted for baseline cognitive complaints. The findings may guide prevention of and interventions for SCC among people in the work force. / <p>At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 1: Submitted. Paper 2: Accepted.</p>

The diagnosis of neurodegenerative diseases leading to dementia is increasingly moving to the earlier stages in an effort to find the disease-modifying treatment for these diseases. Prodromal and preclinical stages of the diseases have become the primary research interests. Neuropsychology is specifically focused on early cognitive markers and development of methods that would be able to reliably assess these markers and to evaluate the risk of progression of cognitive decline in individual cases. The theoretical part of the thesis presents the current knowledge in the field of neurodegenerative diseases, it is specifically focused on Alzheimer's disease (AD) as the most common cause of dementia. We also present the current trends in neuropsychological diagnostics of early AD and the approach to subjective and objective evaluation of cognitive functioning. Building on that, we present the rationale for the empirical part of the thesis. The empirical part of the thesis extends the existing knowledge in the field of AD. We present and discuss seven original publications that follow three basic objectives: first, to characterize subjective cognitive complaints of individuals at risk of AD, second, to evaluate the potential of selected standard and experimental neuropsychological methods to detect...

Indiana University-Purdue University Indianapolis (IUPUI) / Alzheimer’s disease (AD) is the most common age-related neurodegenerative disease. Many researchers believe that an effective AD treatment will prevent the development of disease rather than treat the disease after a diagnosis. Therefore, the development of tools to detect AD-related pathology in early stages is an important goal. In this report, MRI-based markers of neurodegeneration are explored as biomarkers of AD. In the first chapter, the sensitivity of cross-sectional MRI biomarkers to neurodegenerative changes is evaluated in AD patients and in patients with a diagnosis of mild cognitive impairment (MCI), a prodromal stage of AD. The results in Chapter 1 suggest that cross-sectional MRI biomarkers effectively measure neurodegeneration in AD and MCI patients and are sensitive to atrophic changes in patients who convert from MCI to AD up to 1 year before clinical conversion. Chapter 2 investigates longitudinal MRI-based measures of neurodegeneration as biomarkers of AD. In Chapter 2a, measures of brain atrophy rate in a cohort of AD and MCI patients are evaluated; whereas in Chapter 2b, these measures are assessed in a pre-MCI stage, namely older adults with cognitive complaints (CC) but no significant deficits. The results from Chapter 2 suggest that dynamic MRI-based measures of neurodegeneration are sensitive biomarkers for measuring progressive atrophy associated with the development of AD. In the final chapter, a novel biomarker for AD, visual contrast sensitivity, was evaluated. The results demonstrated contrast sensitivity impairments in AD and MCI patients, as well as slightly in CC participants. Impaired contrast sensitivity was also shown to be significantly associated with known markers of AD, including cognitive impairments and temporal lobe atrophy on MRI-based measures. The results of Chapter 3 support contrast sensitivity as a potential novel biomarker for AD and suggest that future studies are warranted. Overall, the results of this report support MRI-based measures of neurodegeneration as effective biomarkers for AD, even in early clinical and preclinical disease stages. Future therapeutic trials may consider utilizing these measures to evaluate potential treatment efficacy and mechanism of action, as well as for sample enrichment with patients most likely to rapidly progress towards AD.