BrainBlog

Exergaming and older adult cognition a cluster randomized clinical trial Am J Prev Med. 2012 Feb;42(2):109-19 Anderson-Hanley C, Arciero PJ, Brickman AM, Nimon JP, Okuma N, Westen SC, Merz ME, Pence BD, Woods JA, Kramer AF, Zimmerman EA Abstract BACKGROUND: Dementia cases may reach 100 million by 2050. Interventions are sought to curb or prevent cognitive decline. Exercise yields cognitive benefits, but few older adults exercise. Virtual reality-enhanced exercise or "exergames" may elicit greater participation. PURPOSE: To test the following hypotheses: (1) stationary cycling with virtual reality tours ("cybercycle") will enhance executive function and clinical status more than traditional exercise; (2) exercise effort will explain improvement; and (3) brain-derived neurotrophic growth factor (BDNF) will increase. DESIGN: Multi-site cluster randomized clinical trial (RCT) of the impact of 3 months of cybercycling versus traditional exercise, on cognitive function i...

Subjective Cognitive Complaints of Older Adults at the Population Level: An Item Response Theory Analysis Alzheimers Disease and Associated Disorders. 2011 Dec 20; Snitz BE, Yu L, Crane PK, Chang CC, Hughes TF, Ganguli M Abstract Subjective cognitive complaints (SCCs) are increasingly a focus in studies on prodromal Alzheimer disease (AD) and risk for dementia. Little is known about the optimal approach to measure SCCs. We used item response theory (IRT) to examine the characteristics of 24 SCC items in a sample of 3495 older adults pooled from 4 community-based studies. We investigated the potential advantages of IRT scoring over conventional scoring on the basis of participants' item response patterns. Items most likely endorsed by individuals low in SCC severity relate to word retrieval and general subjective memory decline. Items likely endorsed only by individuals high in SCC severity relate to nonepisodic memory changes, such as decline in comprehension, judgment and executi...

A new post at the New York Times blog, "The New Old Age": November 23, 2011, 12:18 PM It’s Mild Cognitive Impairment. Now What? By PAULA SPAN "How would you react to a diagnosis of mild cognitive impairment — memory problems that allow you to continue normal daily activities, but presage an increased likelihood of developing Alzheimer’s disease within a few years?" Read the full post

Hippocampal Subregions are Differentially Affected in the Progression to Alzheimer's Disease Anat Rec (Hoboken). 2011 Nov 18; Greene SJ, Killiany RJ, Abstract Atrophy within the hippocampus (HP) as measured by magnetic resonance imaging (MRI) is a promising biomarker for the progression to Alzheimer's disease (AD). Subregions of the HP along the longitudinal axis have been found to demonstrate unique function, as well as undergo differential changes in the progression to AD. Little is known of relationships between such HP subregions and other potential biomarkers, such as neuropsychological (NP), genetic, and cerebral spinal fluid (CSF) beta amyloid and tau measures. The purpose of this study was to subdivide the hippocampus to determine how the head, body, and tail were affected in normal control, mild cognitively impaired, and AD subjects, and investigate relationships with HP subregions and other potential biomarkers. MRI scans of 120 participants of the Alzheimer's Di...

Predictive value of APOE-ε4 allele for progression from MCI to AD-type dementia: A meta-analysis Journal of Neurology Neurosurgery and Psychiatry. 2011 Oct; 82(10): 1149-1156. Elias-Sonnenschein LS, Viechtbauer W, Ramakers IH, Verhey FR, Visser PJ Abstract BACKGROUND: The identification of subjects with mild cognitive impairment (MCI) at high risk for Alzheimer's disease (AD) is important for prognosis and early intervention. The APOE-ε4 allele is the strongest known genetic risk factor for AD. The authors performed a meta-analysis to establish the predictive accuracy of the APOE-ε4 allele for progression from MCI to AD-type dementia. METHODS: The authors included 35 prospective cohort studies of subjects with MCI, including 6095 subjects, of whom 1236 progressed to AD-type dementia after 2.9 years of follow-up. Pooled estimates of the OR, sensitivity, specificity, positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (LR+ and LR-) were ...

There have been a number of excellent papers published over the past month in a number of different journals on the topic of Mild Cognitive Impairment (MCI). Looking forward to reading this new paper: An exploration of subgroups of mild cognitive impairment based on cognitive, neuropsychiatric and functional features: analysis of data from the national Alzheimer's coordinating center American Journal of Geriatric Psychiatry . 2011 Nov; 19(11): 940-950. Hanfelt JJ, Wuu J, Sollinger AB, Greenaway MC, Lah JJ, Levey AI, Goldstein FC Abstract OBJECTIVES: : To empirically expand the existing subtypes of mild cognitive impairment (MCI) by incorporating information on neuropsychiatric and functional features, and to assess whether cerebrovascular disease (CVD) risk factors are associated with any of these subgroups. DESIGN: : Latent class analysis using 1,655 patients with MCI. SETTING: : Participants in the Uniform Data Set (UDS) from 29 National Institutes of Health-supported Alzheimer...

Outcome of Mild Cognitive Impairment Comparing Early Memory Profiles. American Journal of Geriatric Psychiatry . 2011 Sep 19; Authors: Gómez-Tortosa E, Mahillo-Fernández I, Guerrero R, Montoya J, Alonso A, Sainz MJ Abstract BACKGROUND:: Finding variables that predict decline or stability in persons with amnestic mild cognitive impairment (aMCI) is an important step in identifying subjects in prodromal stages of dementia. This study tests a clinical observation suggesting that aMCI cases with better-preserved recognition skills, despite similar delayed recall deficits, are more likely to remain functionally stable. METHODS:: A cohort of 210 cases with aMCI, diagnosed with standardized criteria that had been followed up for 48 ± 12 months (range: 36-100), were divided into two groups according to their initial recognition memory discrimination index (DI) on the Hopkins Verbal Learning Test (DI ≥ or PMID: 21934475 [PubMed - as supplied by publisher]

The 9th Annual Mild Cognitive Impairment Symposium will take place in late April in Miami Beach, Florida. The theme of the meeting is "New Criteria for Prodromal and Preclinical Alzheimer's Disease" The website for the conference can be found at: mcisymposium.org . The Twitter voice of the conference is @mcisymposium

Elfgren C, Gustafson L, Vestberg S, & Passant U. Subjective memory complaints, neuropsychological performance and psychiatric variables in memory clinic attendees: A 3-year follow-up study. Archives of Gerontology and Geriatrics. 2010 Mar 6. [Epub ahead of print] Department of Geriatric Psychiatry, Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden. The aims were to evaluate the cognitive performance and clinical diagnosis in patients ( PMID: 20211500 [PubMed - as supplied by publisher]

Today's recommended read deals with an important neuropsychological assessment issue in the domain of aging and the potential to identify the presence of cognitive problems that might (emphasis on "might" - such findings in a screen are not definitive) be part of the onset of a dementing disease process. The issue has implications, as well, for applications in CNS clinical trials. Scharre DW, Chang SI, Murden RA, Lamb J, Beversdorf DQ, Kataki M, Nagaraja HN, & Bornstein RA. Self-administered Gerocognitive Examination (SAGE): A Brief Cognitive Assessment Instrument for Mild Cognitive Impairment (MCI) and Early Dementia. Alzheimer Disease and Associate Disorders. 2010 January/March; 24(1), 64-71. OBJECTIVES: To develop a self-administered cognitive assessment instrument to facilitate the screening of mild cognitive impairment (MCI) and early dementia and determine its association with gold standard clinical assessments including neuropsychologic evaluation. METHODS: A...

The Alzheimer's Association ICAD 2008 conference begins today and continues through the 31st of July. The conference takes place in Chicago at McCormick Place. Details available at the conference website: ICAD website .

Nutter-Upham KE, Saykin AJ, Rabin LA, Roth RM, Wishart HA, Pare N, Flashman LA. Verbal fluency performance in amnestic MCI and older adults with cognitive complaints. Archives of Clinical Neuropsychology . 2008 May; 23(3): 229-241. Neuropsychology Program, Department of Psychiatry, Dartmouth Medical School/DHMC, Lebanon, NH, USA. Verbal fluency tests are employed regularly during neuropsychological assessments of older adults, and deficits are a common finding in patients with Alzheimer's disease (AD). Little extant research, however, has investigated verbal fluency ability and subtypes in preclinical stages of neurodegenerative disease. We examined verbal fluency performance in 107 older adults with amnestic mild cognitive impairment (MCI, n=37), cognitive complaints (CC, n=37) despite intact neuropsychological functioning, and demographically matched healthy controls (HC, n=33). Participants completed fluency tasks with letter, semantic category, and semantic switching constrain...

Bondi MW, Jak AJ, Delano-Wood L, Jacobson MW, Delis DC, & Salmon DP. Neuropsychological Contributions to the Early Identification of Alzheimer's Disease. Neuropsychological Review. 2008 Mar 18. A wealth of evidence demonstrates that a prodromal period of Alzheimer's disease (AD) exists for some years prior to the appearance of significant cognitive and functional declines required for the clinical diagnosis. This prodromal period of decline is characterized by a number of different neuropsychological and brain changes, and reliable identification of individuals prior to the development of significant clinical symptoms remains a top priority of research. In this review we provide an overview of those neuropsychological changes. In particular, we examine specific domains of cognition that appear to be negatively affected during the prodromal period of AD, and we review newer analytic strategies designed to examine cognitive asymmetries or discrepancies between higher-order ...

Karas G, Sluimer J, Goekoop R, van der Flier W, Rombouts S, Vrenken H, Scheltens P, Fox N, & Barkhof F. Amnestic Mild Cognitive Impairment: Structural MR Imaging Findings Predictive of Conversion to Alzheimer Disease. American Journal of Neuroradiology. 2008 Feb 22 [Epub ahead of print]. Department of Diagnostic Radiology, Image Analysis Center, Alzheimer Center, and Department of Clinical Neurology, VU University Medical Center, Amsterdam, the Netherlands; Dementia Research Group, Department of Clinical Neurology, Institute of Neurology, London, UK; Department of Physics and Medical Technology, Alzheimer Center, VU University Medical Center and Leiden Institute for Brain and Cognition, Leiden, the Netherlands; Department of Psychology, Leiden University, Leiden, the Netherlands; and Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands. BACKGROUND AND PURPOSE: Mild cognitive impairment (MCI) is considered by many to be a prodromal phase of Alzheime...

Unverzagt FW, Sujuan Gao , Lane KA, Callahan C, Ogunniyi A, Baiyewu O, Gureje O, Hall KS, & Hendrie HC. Mild cognitive dysfunction: An epidemiological perspective with an emphasis on African Americans. Geriatrics Psychiatry & Neurology. 2007 Dec; 20(4): 215-226. Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, USA. This review begins with a historical accounting of the evolution of the concept of mild cognitive dysfunction, including nomenclature and criteria from Kral to Petersen. A critical analysis of the main elements relating to assessment and diagnosis of mild cognitive dysfunction is provided. Methodological limitations in design, measurement, and characterization, especially as they relate to older African Americans, are identified. Data from a 15-year longitudinal study of community-dwelling African Americans in Indianapolis, Indiana, indicate a 23% prevalence of all-cause mild cognitive dysfunction, with approximately 25% pr...

Fleisher AS, Sun S, Taylor C, Ward CP, Gamst AC, Petersen RC, Jack CR, Aisen PS, & Thal LJ. Volumetric MRI vs clinical predictors of Alzheimer disease in mild cognitive impairment. Neurology. 2008 Jan 15; 70(3): 191-199. OBJECTIVE: To compare volumetric MRI of whole brain and medial temporal lobe structures to clinical measures for predicting progression from amnestic mild cognitive impairment (MCI) to Alzheimer disease (AD). METHODS: Baseline MRI scans from 129 subjects with amnestic MCI were obtained from participants in the Alzheimer's Disease Cooperative Study group's randomized, placebo-controlled clinical drug trial of donepezil, vitamin E, or placebo. Measures of whole brain, ventricular, hippocampal, and entorhinal cortex volumes were acquired. Participants were followed with clinical and cognitive evaluations until formal criteria for AD were met, or completion of 36 months of follow-up. Logistic regression modeling was done to assess the predictive value of all ...