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Biomedical subjects

Jelle Jolles

Publications and source records attributed to Jelle Jolles.

At least 19 recordsLinked to original sources

The effect of perceived forgetfulness on quality of life in older adults; a qualitative review.

BACKGROUND: Approximately 50% of older individuals perceive themselves as being forgetful. OBJECTIVE: The objective of this review is to get an overview of previous research on the relation between perceived forgetfulness (in the absence of objective memory deficit) and quality of life in older individuals. Findings in previous research might be a starting point for further research and possible future interventions. METHODS: Scientific papers that investigated the relation between subjective memory complaints and quality of life were searched. Two independent raters scored the articles on their methodology. The methodological quality was taken into account when conclusions were drawn. RESULTS: The literature search resulted in 682 articles, of which five studies met the inclusion criteria. Although the five studies differed in their methodology, the findings of the methodologically adequate studies show a relation between memory complaints and a diminished quality of life in the elderly. CONCLUSIONS: The negative impact that subjective memory complaints can have on quality of life makes it important to acknowledge forgetfulness as a serious issue in the life of older individuals. However, more research is needed to explore the relationship between subjective memory complaints and quality of life, also with regard to the influence of depression and objective memory performance.

Aged↗

On the relative role of inhibition in age-related working memory decline.

In this cross-sectional study, the mediating role of inhibition relative to speed in age-related working memory decline on different tasks was investigated. It was hypothesized that the role of inhibition is marginal or absent in a relatively "passive" or simple working memory task, but present in a relatively "active" or complex task in which the processing, rather than the storage capacity of working memory, is addressed. This hypothesis was tested with a structural equation model that was fitted on a subsample (N = 213) of the Maastricht Aging Study (MAAS). The first trial of the Verbal Learning Test (VLT) served as the passive test and the Self-Paced Auditory Serial Addition Task (SPASAT) as the active test. Results showed that the role of inhibition was absent in predicting VLT performance, whereas it was comparable to the role of speed in predicting SPASAT performance. These findings suggest a relative, task-dependent role of inhibition in explaining age-related memory decline.

Adult↗

Methylphenidate improves reading performance in children with attention deficit hyperactivity disorder and comorbid dyslexia: an unblinded clinical trial.

Attention Deficit Hyperactivity Disorder (ADHD) and dyslexia are frequently co-occurring disorders. Although methylphenidate (MPH) is the primary treatment for ADHD, the effect on reading in children with these comorbid problems is not yet known. This study was an unblinded clinical trial to evaluate the reading performance before and after treatment with MPH. Reading performance was compared with General Linear Model repeated measures between three groups: (1) an experimental group of children with both ADHD and dyslexia (N = 24), (2) a control group of children with ADHD (N = 9) and (3) a control group of children with dyslexia (N = 10). MPH improved reading performance significantly stronger in the experimental group than in the control groups; the number of correctly read words increased to a larger extent. In conclusion, MPH proved to be an aid in the reading process of children with ADHD and comorbid dyslexia by improving the learning conditions, but MPH cannot cure the reading disorder. Future research should study the effect of MPH on reading in a double-blind clinical trial.

Adolescent↗

Mental performance in old age dependent on cortisol and genetic variance in the mineralocorticoid and glucocorticoid receptors.

Depression and cognitive decline have been associated with changes in circulating cortisol concentrations. Cortisol exerts its functions through mineralocorticoid (MR) and glucocorticoid (GR) receptors. However, data on the influence of variations in the MR and GR genes on depressive symptoms and cognitive functioning in older adults are scarce. Therefore, we explored the impact of MR-215G/C, MR-I180V, GR-ER22/23EK, GR-N363S, and GR-BclI polymorphisms on these end points in the population-based Leiden 85-plus Study. This prospective study includes 563 participants aged 85 years and older, with a mean follow-up of 4.2 years. In this study, high morning cortisol levels (per 1 SD cortisol) associated with impairments in global cognitive functioning (p=0.002) at baseline (age 85). These impairments were mainly attributable to lower attention (p=0.057) and slower processing speed (p=0.014). Similar effects were also observed during follow-up (age 85-90), where participants with higher cortisol levels (per 1 SD cortisol) had impaired global cognitive functioning (p=0.003), as well as impairments in attention (p=0.034) and processing speed (p=0.013). Changes in depressive symptoms were observed for the MR-I180V single-nucleotide polymorphism (SNP), where during follow-up the prevalence of depressive symptoms was higher in the 180V-allele carriers (p=0.049) compared to noncarriers. Dependent on these polymorphisms, no differences in overall and in specific domains of cognitive functioning were observed. In conclusion, the MR-I180V SNP has a specific effect on depressive symptoms, independent from cognitive functioning, and other polymorphisms in the MR and GR genes. In contrast, these genetic variants in the MR and GR genes do not influence cognitive functioning in old age.

Aged, 80 and over↗

Effect of a structured course involving goal management training in older adults: A randomised controlled trial.

OBJECTIVE: The objective of this study was to investigate the effects of a structured 6-week neuropsychological course on the executive functioning of older adults with cognitive complaints. METHODS: A randomised controlled design was used involving 69 community dwelling individuals aged 55 years and older. Both objective and subjective measures were included to assess executive functioning. General linear model with repeated measures analysis of variance was used to examine the intervention effects. RESULTS: After the intervention, the participants in the intervention group were significantly less annoyed by their cognitive failures, were better able to manage their executive failures and reported less anxiety symptoms than those in the waiting list control group. CONCLUSION: These findings indicate that a combination of psycho-education and training has the potential to change the attitude of older individuals towards their cognitive functioning. PRACTICE IMPLICATIONS: Because this training focussed on cognitive functions that are among the first to decline in older adults and the subjective evaluation of the people after training was quite favourable, the proposed intervention may be considered a valuable contribution to cognitive interventions for older adults.

Activities of Daily Living↗

Effects of aging on recognition of intentionally and incidentally stored words: an fMRI study.

Functional magnetic resonance imaging (fMRI) was used to gain more insight in the mechanism underlying a decline in recognition memory function with age. Twelve young (23-27 years) and 12 older (63-67 years) healthy men performed two types of word encoding tasks, in which words were either incidentally or intentionally encoded for storage in memory. After a 30min delay, participants performed a recognition task. Older participants were less accurate and slower than young on the recognition task. In the both groups, successful retrieval was accompanied by activation in the left inferior frontal gyrus, left precentral gyrus and right cerebellum. Older participants showed additional activity in the bilateral medial prefrontal gyrus and right parahippocampal gyrus. Correlational analyses showed that only the additional parahippocampal activation correlated positively with task performance in the older but not young participants, suggesting that activation in this area served the purpose of functional compensation. The additional activation in the medial prefrontal cortex, on the other hand, was explained in terms of increased conflict, that is, reduced distinction between target and distracter words leading to increased simultaneous activity of both response tendencies. In a comparison between incidentally and intentionally remembered words the young group showed additional activation in the right middle occipital gyrus. This last result was explained in terms of strategic differences between the young and older group.

Adult↗

Associations between lifestyle and depressed mood: longitudinal results from the Maastricht Aging Study.

OBJECTIVES: We examined whether healthy lifestyles are associated with absence of depressed mood. METHODS: A sample of 1169 adult participants in the Maastricht Aging Study provided baseline and 6-year follow-up data on smoking, alcohol use, physical exercise, body mass index, and mood. We examined associations between lifestyles and depressed mood using longitudinal analyses controlling for baseline depressive symptoms and covariates. RESULTS: Reports of excessive alcohol use at baseline predicted depressed mood at follow-up (relative risk [RR] = 2.48; 95% confidence interval [CI] = 1.08, 5.69), and reports of more than 30 minutes of physical exercise per day at baseline were associated with an absence of depressed mood at follow-up (RR=0.52; 95% CI=0.29, 0.92). Reports of being engaged in physical exercise throughout the 6-year follow-up period were also associated with absence of depressed mood (RR=0.56; 95% CI=0.34, 0.93). CONCLUSIONS: In this relatively healthy population sample, certain lifestyles either predicted or protected against depressed mood. Adopting or maintaining healthy lifestyles might be a starting point in preventing or treating depressed mood over time.

Adult↗

The effect of acute tryptophan depletion on the BOLD response during performance monitoring and response inhibition in healthy male volunteers.

RATIONALE: Serotonin (5-HT) was implicated in both clinical and experimental studies in flexible, goal-directed behavior. However, the way in which 5-HT manipulations affect brain activation patterns underlying different subprocesses of cognitive flexibility remains largely unknown. OBJECTIVES: The aim of this study was to investigate the effect of a transient lowering of 5-HT on brain activation during performance monitoring and response inhibition. MATERIALS AND METHODS: We used acute tryptophan depletion (ATD), a well-known method to reduce central 5-HT, to investigate the effect of a transient lowering of 5-HT on the blood-oxygen-level dependent (BOLD) response in an event-related functional MRI study. Thirteen healthy male volunteers performed a modified Go/NoGo task in a counterbalanced, placebo-controlled, within-subject design. RESULTS: ATD significantly lowered plasma tryptophan but did not affect mood and cognitive performance. ATD decreased the BOLD response in the dorsomedial prefrontal cortex (BA 8) during performance monitoring. ATD did not affect the BOLD response during response inhibition. CONCLUSIONS: This study provides more evidence for the suggested role of 5-HT in performance monitoring. Because ATD studies have revealed inconsistent effects of ATD on performance and on brain activation, it was suggested that gender and personality traits are important variables to take into account for future research.

Adult↗

Awareness and behavioral problems in dementia patients: a prospective study.

BACKGROUND: The results of studies of the association between awareness and clinical correlates in patients with dementia are inconclusive. The aims of this study were to investigate whether awareness changed during the course of dementia and to determine whether awareness was associated with certain behavioral symptoms. Specifically, it was hypothesized that relatively intact awareness was related to affective disorders. METHODS: One hundred and ninety-nine patients with dementia were included in a prospective 18-month follow-up study. Behavioral problems were assessed with the Neuropsychiatric Inventory and the Cornell Scale for Depression in Dementia. Awareness was assessed by means of the Guidelines for the Rating of Awareness Deficits. RESULTS: Cross-sectional analyses showed awareness to be positively associated with age, gender, education and socioeconomic status, and negatively associated with psychosis, apathy, and overall behavioral disorders at baseline. After 1 year, a higher level of awareness was related to depression and anxiety. The level of awareness at baseline also predicted depression and anxiety after 1 year. Awareness decreased during the study. CONCLUSIONS: A higher level of awareness is associated with subsyndromal depression and anxiety, whereas lack of awareness is associated with psychosis and apathy. The level of awareness decreases as dementia progresses. Clinicians should be more alert to changes in awareness in patients with dementia because psychosocial support might help to prevent the development of affective symptoms.

Aged↗

Do subjective memory complaints predict cognitive dysfunction over time? A six-year follow-up of the Maastricht Aging Study.

BACKGROUND: Middle-aged and older people often worry that their perceived diminishing memory function may indicate incipient dementia. OBJECTIVES: The present study addresses questions regarding subjective memory complaints as a predictor of lower performance on cognitive tasks. Also, in participants with subjective memory complaints it was investigated, whether trying to keep mentally active improved memory function. Characteristics of the participants who were and were not interested in an intervention to decrease worries and to improve memory in daily life were determined. METHODS: Data were obtained from a large longitudinal study: the Maastricht Aging Study, involving 557 participants aged 55 to 85 years. Follow-up measurement was performed after 6 years. Outcome variables were simple, complex and general information processing speed and immediate and delayed recall. RESULTS: At baseline, forgetfulness was associated with a slower general information processing and delayed recall. At the six-year follow-up, being forgetful was not associated with a significant change in cognitive performance. Taking steps to remain cognitively active was not a predictor of better performance on cognitive tasks at baseline or at the six-year follow-up. CONCLUSION: Being forgetful might be an indicator of slower general information processing speed and delayed recall at baseline but does not predict cognitive change over 6 years in older adults. However, the effects are rather small and cannot directly be generalized to applications in clinical settings. Other factors, such as depression and anxiety might also underlie the cause of the forgetfulness.

Aged↗

Normative data for the Animal, Profession and Letter M Naming verbal fluency tests for Dutch speaking participants and the effects of age, education, and sex.

Previous research has indicated that performance on verbal fluency tests (VFTs) is influenced by language and/or culture. Consequently, normative VFT data for English-speaking people cannot be used for people for whom English is not their first language. The aim of the present study was to provide normative data for the Animal Naming, Profession Naming, and Letter M Naming (four-letter words beginning with the letter M) VFTs for Dutch-speaking populations, based on a large sample (N = 1856) of healthy men and women aged 24-81 years of different educational levels. The results showed that age affected the performance of all VFTs profoundly, but the age effect was not uniform: in the Profession and Letter M Naming VFTs, performance was stable in young adulthood but declined strongly after age 50. In contrast, in the Animal Naming VFT, performance appeared to decline linearly, starting early in life. Furthermore, males had higher scores than females on the Profession Naming VFT, and higher educated participants outperformed their lower educated counterparts on all three VFTs. Regression-based normative data were prepared for the 3 VFTs, and the advantages of using a regression-based normative approach instead of a traditional normative approach are discussed.

Adult↗

Memory self-efficacy predicts memory performance: results from a 6-year follow-up study.

The purpose of this study was to examine the relationship between memory self-efficacy (MSE) and a 6-year follow-up assessment of memory functioning in a sample of Dutch older adults. MSE was assessed by a Dutch abridged version of the Metamemory in Adulthood questionnaire (MIA; R. A. Dixon, D. F. Hultsch, & C. Hertzog, 1988; C. Hertzog, D. F. Hultsch, & R. A. Dixon, 1989; R. W. H. M. Ponds & J. Jolles, 1996). The total MSE score predicted memory performance at 6 years, as measured by the Visual Verbal Learning Task (VVLT; N. Brand & J. Jolles, 1985). A separate analysis of the different MSE subscales indicated that the MIA Change score was the most salient domain-specific MSE predictor of subsequent memory performance after 6 years. An extreme groups analysis of the MIA Change score revealed a pattern of performance for those who perceived that their memory was worsening, performing less well on the 3 trials of the VVLT when these were readministered at the 6-year follow-up.

Age Factors↗

The Concept Shifting Test: adult normative data.

The Concept Shifting Test (CST) is a newly developed Trail Making Type test that measures concept shifting and executive functioning. The purpose of the present study was to determine whether CST performance was affected by age, gender, educational level, or handedness and to establish the normal range of test performance. The CST was administered to a large sample (N = 1,794) of cognitively intact adults (age range 24 to 81 years). The results showed that CST performance was superior in women, decreased with age, and increased with level of education. Handedness did not affect CST performance. Normative data that are corrected for the influences of these demographical variables were established with a regression-based normative approach.

Adult↗

Neurocognitive fitness in the sub-acute stage after mild TBI: the effect of age.

OBJECTIVE: Age is assumed to be a negative prognostic factor in recovery from moderate-to-severe traumatic brain injury (TBI). Little is known on cognitive performance after mild TBI in relation to age in the sub-acute stage after injury. METHOD: Ninety-nine mild TBI subjects (age 15-75) were compared with 91 healthy control subjects (age 14-74) in a case-control design. Patients were matched on age, sex and level of education, with control subjects. Mean interval between injury and cognitive assessment was 13 days. Neurocognitive test battery contained tests of verbal memory, selective attention, general speed of information processing and verbal fluency. RESULTS: An overall effect was found of a single mild TBI on neurocognitive performance in the sub-acute stage after injury. Age did not add significantly to the effect of mild TBI on cognitive functioning. CONCLUSION: Patients suffering from mild TBI are characterized by subtle neurocognitive deficits in the weeks directly following the trauma. The notion that elderly subjects have a worse outcome in the sub-acute period after mild TBI is at least not in line with the results of this study.

Adolescent↗

Transfer of training effects in stroke patients with apraxia: an exploratory study.

The goal of the present study was to examine the transfer of the effects of cognitive strategy training for stroke patients with apraxia from trained to non-trained tasks. In strategy training, the occurrence of transfer is expected as the training programme is aimed, not at relearning specific tasks, but at teaching patients new ways to handle the problems resulting from the impairment. Exploratory analyses were conducted on data previously collected in a randomised controlled trial on the efficacy of the strategy training. A total of 113 left hemisphere stroke patients were randomly assigned to a strategy training group and a group receiving occupational therapy as usual. Assessment of apraxia, motor functioning and activities of daily living (ADL) took place at baseline, after an eight-week treatment period, and five months after baseline. The primary outcome measure consisted of standardised ADL observations of trained and non-trained tasks. The analyses showed that in both treatment groups, the scores on the ADL observations for non-trained tasks improved significantly after eight weeks of training as compared with the baseline score. Change scores of non-trained activities were larger in the strategy training group as compared with the usual treatment group. By using previously collected data we are able to illustrate the potential transfer of treatment effects in a large sample of stroke patients. We found indications for the occurrence of transfer, although the study was not originally designed for the purpose of evaluating transfer. Therefore these results are worth exploring more profoundly. We will further investigate our preliminary conclusions in a new prospective study which is specifically designed to examine the transfer of training effects.

Aged↗

The Letter Digit Substitution Test: normative data for 1,858 healthy participants aged 24-81 from the Maastricht Aging Study (MAAS): influence of age, education, and sex.

The Letter Digit Substitution Test (LDST) is based on earlier developed substitution tests (e.g., Digit Symbol Substitution Test) but uses over-learned signs instead of the symbols used in other substitution tests. The written and oral versions of the LDST were administered to a large, cognitively screened sample (N = 1,858) of adults aged 24 to 81 years. Age was the most important predictor of LDST performance, and females outperformed males. A low level of education profoundly influenced LDST performance: the effect of a low versus high level of education on LDST performance was comparable to about 20 years of aging. Regression-based normative data were prepared for both the written and oral versions of the LDST.

Adult↗

Cognitive functioning in spousal caregivers of dementia patients: findings from the prospective MAASBED study.

BACKGROUND: Spousal caregivers are usually of the same age as the dementia patient and therefore at risk of age-related cognitive decline. Suboptimal cognitive functioning in caregivers may have profound implications. METHODS: Fifty-four spousal caregivers of dementia patients from the Memory Clinic of the Academic Hospital Maastricht and the Regional Institute for Community Mental Health Care in the Netherlands were compared with 108 non-caregiving controls. Data were collected on patient and caregiver characteristics and caregiver cognitive functioning. Repeated measures statistical analyses were carried out to investigate the relationship between caregiver cognitive functioning at baseline and patient behavioural problems and caregiver competence during 1 year of follow-up. RESULTS: Caregivers performed significantly worse on several cognitive domains compared with control subjects. Low performance on a verbal memory task was related to a decrease in caregiver subjective competence and an increase in patient hyperactivity. CONCLUSION: The results indicate that screening for cognitive impairment of spousal caregivers may be helpful, because suboptimal cognitive functioning may affect the ability to provide adequate care.

Aged↗

Verbal learning and aging: combined effects of irrelevant speech, interstimulus interval, and education.

Older or lower educated individuals may be less able than younger or higher educated individuals to inhibit irrelevant speech when learning new visual information. In Experiment 1, we investigated the effects of age (four groups), educational attainment (low or high), and verbal noise (spoken words or silence) on word-learning performance in 230 individuals aged 24 to 76 years. Performance was negatively affected by age, lower education, and irrelevant speech, but there were no interactions between age group and noise condition. In Experiment 2, we increased the difficulty of the word-learning task by using both irrelevant speech and a short interstimulus interval (2 or 0.5 s). Age differences became more pronounced as the result of the simultaneous occurrence of irrelevant speech and a short interstimulus interval. This suggests that older individuals may need more time than younger individuals to learn new information in noisy environments.

Adult↗