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PubMed1999

Insulin-like growth factor-I and cognitive function in healthy older men.

The GH/insulin-like growth factor-I (GH/IGF-I) axis is known to be involved in aging of physiological functions. Recent studies indicate that the GH/IGF-I axis may be associated with cognitive functioning. The aim of the present study was to determine whether the age-related decline in circulating levels of IGF-I, as an index of anabolic status, is associated with cognitive functions that are known to decline with aging, but not with cognitive functions not sensitive to aging. Twenty five healthy older men with well-preserved functional ability participated in the study. We also administered neuropsychological tests of general knowledge, vocabulary, basic visual perception, reading ability, visuoconstructive ability, perceptual-motor speed, mental tracking, and verbal long-term memory. Performance on the last four tests decline with aging, whereas the first four of these tests have been shown not to be sensitive to cognitive aging. Mean age of the subjects was 69.1 +/- 3.4 (SD) yr (range 65-76 yr), their mean body mass index was 27.0 +/- 2.4 kg/m2, and their mean IGF-I level was 122 ng/mL (range: 50-220). We found IGF-I levels to be significantly associated with the performances (controlled for education) on the Digit Symbol Substitution test (r = 0.52, P = 0.009) and the Concept Shifting Task (r = -0.55, P = 0.005), which measure perceptual-motor and mental processing speed. Subjects with higher IGF-I levels performed better on these tests, performance on which is known to decline with aging. In conclusion, the results of this study support the hypothesis that circulating IGF-I may play a role in the age-related reduction of certain cognitive functions, specifically speed of information processing.

Aged↗

PubMed1999

A prospective analysis of cognitive function and anticardiolipin antibodies in systemic lupus erythematosus.

OBJECTIVE: To prospectively analyze the association between changes in cognitive function and circulating anticardiolipin antibodies (aCL) over a period of 5 years in patients with systemic lupus erythematosus (SLE). METHODS: Cognitive function was assessed in 51 unselected female SLE patients at baseline and after a mean followup of 64.5 months (range 52-71 months), using standardized tests of cognitive function, i.e., the Wechsler Adult Intelligence Scale-Revised, the Wechsler Memory Scale-Revised, and the California Verbal Learning Test. Circulating IgG, IgA, and IgM aCL and anti-double-stranded DNA (anti-dsDNA) antibody levels were determined by enzyme-linked immunosorbent assay on 4-7 occasions over the same time period. Persistent antibody reactivity was defined as levels more than 2 standard deviations (moderately positive) and more than 5 standard deviations (highly positive) above the mean for normal controls over the duration of the study. Changes in overall cognitive performance and in raw scores on individual cognitive tests were compared in patients who were persistently positive or negative for aCL. RESULTS: At baseline 11 patients (22%) were cognitively impaired, compared with 7 (14%) at followup. Between 16% and 37% of patients had persistently elevated aCL levels of different isotypes. There was no significant difference in the prevalence of overall cognitive impairment in patients who were persistently positive for aCL compared with those who were not. In contrast, over the period of study, patients who had persistent IgG aCL positivity had a reduction in psychomotor speed, and patients who had persistent IgA aCL positivity had a reduction in conceptual reasoning and executive ability. Similar associations with anti-dsDNA antibodies were not found. CONCLUSION: These results suggest that IgG and IgA aCL may be responsible for long-term subtle deterioration in cognitive function in patients with SLE.

Adult↗

PubMed2007

Evolution of cognitive function via redeployment of brain areas.

The creative reuse of existing neural components may have played a significant role in the evolutionary development of cognition. There are obvious evolutionary advantages to such redeployment, and the data presented here confirm three important empirical predictions of this account of the development of cognition: 1) A typical brain area will be used by many cognitive functions in diverse task categories, (2) evolutionarily older brain areas will be deployed in more cognitive functions, and (3) more recent cognitive functions will use more, and more widely scattered, brain areas. These findings have implications not just for our understanding of the evolutionary origins of cognitive function but also for the practice of both clinical and experimental neuroscience.

Animals↗

PubMed1999

Cognitive functioning moderates the relation between hyperactivity and drinking habits.

Previous research reveals an inconsistent link between hyperactivity and drinking (Weiss and Hechtman, 1993). This study sought to investigate whether cognitive functioning moderates the relation between these two variables. One hundred participants completed three measures of drinking habits, two measures of hyperactivity, and four measures of cognitive functioning. Confirmatory factor analysis showed that a three-factor model of hyperactivity, cognitive functioning, and drinking habits provided an excellent fit to the data. Stacked two-group analyses revealed that cognitive functioning moderated the association between hyperactivity and drinking habits. Drinking habits and hyperactivity correlated 0.408 (p < 0.05) for individuals low on cognitive performance; the correlation between these constructs was only 0.120 (NS) for individuals high on cognitive performance. Higher levels of cognitive functioning may buffer individuals from drinking alcohol in accordance with their hyperactive symptoms.

Adolescent↗

PubMed1988

Estrogen and/or androgen replacement therapy and cognitive functioning in surgically menopausal women.

The effect of estrogen and/or androgen replacement therapy on several aspects of cognitive functioning in surgically menopausal women was tested in a prospective, crossover design. Women who received either a combined estrogen-androgen preparation, estrogen alone, or androgen alone had scores on two tests of short-term memory, a test of long-term memory and a test of logical reasoning that were not different during the postoperative treatment phase compared to their preoperative performance. However, oophorectomized women who received placebo had lower scores on all four measures of cognitive functioning postoperatively, coincident with their significantly lower concentrations of plasma estradiol and testosterone. Patients who had a hysterectomy but whose ovaries were retained showed stability both in cognitive performance and in circulating sex steroid concentrations. These findings suggest that the drastic change in endocrine milieu following surgical menopause may have a direct, albeit modest, effect on aspects of cognitive functioning. Possible mechanisms of action of the sex hormones on cognitive functioning in women are discussed.

Adult↗

PubMed1998

Improvements in cognitive functioning following intensive behavioural rehabilitation.

Serial evaluation of intelligence tests performed with long-term patients in psychiatric hospitals frequently reveal deterioration in cognitive functioning. Despite early success in the amelioration of cognitive symptoms of schizophrenia, little effort at cognitive remediation is currently directed to long-term psychiatric patients. In contrast, in the brain injury rehabilitation community, cognitive remediation is strongly supported despite mixed results in clinical literature. Within this context, individuals with brain injury in psychiatric hospitals may have little prospect of receiving cognitive remediation services. Utilizing performance on intelligence testing spanning 20 years, the following study evaluates changes in cognitive functioning of a severely brain injured individual, who had been replaced in a long-term psychiatric hospital and treated in an intensive behavioural rehabilitation programme. Results found that the patient demonstrated a significant improvement in overall verbal and nonverbal cognitive functioning during treatment. These improvements were maintained for a 1-year period. It was suggested that the use of 'low tech', small group interventions, within intensive behavioural rehabilitation programmes, may lead to the recovery of cognitive functioning for individuals who are significantly post-injury.

Adult↗

PubMed2006

Reading words with irregular decoding rules: a test of premorbid cognitive function?

The present study investigated the relation between level of general cognitive function and the oral reading of irregular words in Swedish. Swedish is an orthographically regular language, so many irregular words are loan words from other languages. A test comprising such words (irregularly spelled words (ISW)) was designed, and tested on a sample of 48 healthy Swedish adults, stratified according to age, gender, and level of education. The results confirmed that the ability to read words that do not follow the regular rules for decoding in Swedish was positively related to general cognitive level. ISW in combination with demographic variables gave a good estimate of general cognitive function and a better estimate than demographic variables alone. Exposure to written and spoken vocabulary during the lifespan may be indexed by ISW performance, for factor analysis suggested that this may constitute a discrete factor contributing to cognitive function.

Adult↗

PubMed1997

Cognitive function in amyotrophic lateral sclerosis.

Cognitive function in patients with amyotrophic lateral sclerosis (ALS) has drawn recent attention. However, the pathogenesis of cognitive dysfunction in patients with ALS remains uncertain. To explore the underlying mechanism for cognitive dysfunction further, we studied 26 patients with ALS (15 male and 11 female; age from 36 to 67 years) by using neuropsychological batteries, magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT). We also evaluated these patients and an additional 26 age- and sex-matched normal controls using neuropsychological batteries with special attention to the frontal lobe function. On the basis of neuropsychological examination, we classified patients into three groups using cluster analysis. Age, education level and severity were comparable across these subgroups. Neuropathologic examination was subsequently carried out in six patients. Patients in Group 1 and 2 had low scores on all measures compared to patients in Group 3 and normal controls. Patients in Group 1 and 2 had frontal atrophy on MRI and reduced isotope uptake in the frontal region on SPECT, which was more evident in patients in Group 1. On neuropathologic examination, patients in Group 1 showed spongy degeneration and neuronal loss in the frontal lobe. Patients in Group 3 showed no notable pathology in the frontal region. The gradient distribution of the scores for attention and executive function, as well as SPECT findings suggested the presence of a continuum of cognitive disability in patients with ALS corresponding to the pathologic process in the frontal lobe ranging from significant impairment to normality. We, therefore, believe that inattention and executive dysfunction alternatives may evolve in patients with ALS corresponding to the pathologic process in the frontal lobe.

Adult↗

PubMed2003

Double blind study of melatonin effects on the sleep-wake rhythm, cognitive and non-cognitive functions in Alzheimer type dementia.

Previously, we reported that morning bright light therapy improved sleep time and cognitive function in Alzheimer type of dementia. We conducted a double blind study to examine the effects of melatonin on the sleep-wake rhythm, cognitive and non-cognitive functions in Alzheimer type of dementia. The subjects were 9 persons given a placebo (PLA), and 11 given melatonin ( 3 mg)(MLT). The mean age was 79.2+/-6.4 (17 females and 3 males). The drugs were given at 20: 30 each day for 4 weeks. We checked sleep time and activity by Actigraph through one week before and the 4th week after drug administration. Cognitive and non-cognitive functions were evaluated with the clinical dementia rating scale (CDR), and Mini Mental State Examination (MMSE), and the Alzheimer's Disease Assessment Scale (ADAS). We successfully recorded Actigraph data from 18 patients (PLA8, MLT10). The mean sleep time change ratio and SD of the administration of PLA in the night was-0.2+/-13.7%, and MLT was 33.2+/-37.6%. The mean activity counts and SD of the administration of PLA in the night was 29.8+/-77.0%; in MLT it was-44.9+/-21.9%. Melatonin significantly prolonged the sleep time (p=0.017) and decreased activity (p=0.014) in the night (21: 00-6: 00) in the MLT group, although no significant difference in sleep time or activity in the daytime (6: 00-21: 00) was recognized between the two groups. In comparison with ADAS cognition score changes, the mean change and SD in the PLA was 0.3+/-3.7; in MLT it was-4.3+/-3.6 points. In comparison with ADAS non-cognition score, the mean change and SD in the PLA group was-0.8+/-1.0, in the MLT group it was-4.1+/-2.2 points. There were also significant differences between the PLA and the MLT groups in the comparison with the score improvement of ADAS cognition (p=0.017) and non-cognition (p=0.002), otherwise there was no significant difference in improvement of MMSE between both groups. Melatonin administration had effect to improve sleep time and night activity, but no significant effect to improve daytime naps and activity. Although melatonin administration might has less strong effect on circadian rhythm than morning bright light therapy we previously reported, cognitive and non-cognitive functions were improved. Melatonin seemed to be useful for care of the Alzheimer type of dementia patients.

Aged↗

PubMed1987

The relationship between neuroleptic dosage and cognitive functioning in chronic schizophrenic patients.

A review of the effects of phenothiazines on cognitive function suggests that phenothiazine derivatives facilitate performance on tests of cognitive function, at least in subjects who are thought disordered. Drug effects frequently depend on the dose administered, however, and the response to various doses of some drugs (e.g., antidepressants) is frequently nonlinear. In our study, 23 hospitalized males with chronic psychotic disorders, and stabilized on dosages of neuroleptics with chlorpromazine equivalents of from 50 to 7,200 milligrams daily, were tested in the morning and in the evening of the same day with the Mini-Mental State examination [1]. Cognitive functioning was positively correlated (+0.49) with dosage, but the relationship was curvilinear. Functioning improved with increasing dose up to a dose of about 2,000 milligrams daily; beyond that dosage (and up to 7,200 milligrams daily) functioning plateaued. Scores on same-day retest were essentially unchanged regardless of dose. The implication of these findings for the management of chronic psychotic patients is discussed.

Adult↗

PubMed2006

Cognitive function in Stage 5 chronic kidney disease patients on hemodialysis: no adverse effects of lanthanum carbonate compared with standard phosphate-binder therapy.

Patients with Stage 5 chronic kidney disease who have hyperphosphatemia require treatment with phosphate binders to lower serum phosphorus levels. Existing binders are effective but may be associated with important safety disadvantages. Lanthanum carbonate is a phosphate binder with demonstrated efficacy, safety, and tolerability in clinical trials. Changes in cognitive function were evaluated over time using the Cognitive Drug Research computerized cognitive assessment system (Simple Reaction Time, Digit Vigilance Task, Choice Reaction Time, Numeric Working Memory, and Delayed Picture Recognition) in 360 hemodialysis patients who were enrolled in a 2-year, multicenter, comparative study of lanthanum carbonate versus standard therapy. A decline in cognitive function from baseline was observed in both groups. The deterioration in cognitive function was similar in both the lanthanum carbonate and standard therapy groups. One parameter - Numeric Working Memory - showed a statistically significant between-group difference in favor of lanthanum carbonate (P=0.02). Given the magnitude of the changes, however, and the differences that were observed at baseline between treatment groups, the clinical significance of this difference is doubtful. This study demonstrates that cognitive function deteriorates in hemodialysis patients over a 2-year time period. Use of lanthanum carbonate as a phosphate binder does not adversely affect cognitive function compared with standard therapy.

Adult↗

PubMed2005

Association between physical and cognitive function in healthy elderly: the health, aging and body composition study.

Performance measures of physical function (gait speed, chair stands, standing balance) and cognitive function [Teng-modified Mini-Mental Status Exam (3MS) and digit symbol substitution test (DSST)] were assessed at baseline in 3,075 participants in the Health, Aging and Body Composition Study. Each physical function measure was examined for the strength and magnitude of association with cognitive function. All physical function measures were associated with both the 3MS and DSST scores (p < 0.001), and in multivariate analysis each relationship was independent of demographic characteristics, weight, physical activity and comorbid health conditions of participants. The association of motor performance was consistently greater for the DSST than the 3MS and, among the motor tests, gait speed retained a significant association with both cognitive measures independent of demographic, weight, physical activity and comorbid health conditions. In this large cohort of high-functioning older adults, the correlation between physical and cognitive function was not entirely explained by demographics. Longitudinal studies are needed to determine the direction of causality in this relationship.

Aged↗

PubMed1997

Cognitive function 5 years after randomization to coronary angioplasty or coronary artery bypass graft surgery.

BACKGROUND: Coronary bypass surgery often leads to short-term cognitive dysfunction, whereas coronary angioplasty does not. Perioperative cognitive dysfunction usually resolves, although a subgroup of surgical patients may continue to exhibit long-term cognitive dysfunction. The purpose of this study was to compare cognitive function 5 years after randomization to a strategy of either initial coronary surgery or initial angioplasty. METHODS AND RESULTS: Five centers in the Bypass Angioplasty Revascularization Investigation participated in this ancillary study. Patients with multivessel coronary disease randomized to angioplasty or surgery were eligible at the time of their 5-year clinic visit. A battery of five measures previously shown to be sensitive to perioperative changes in cognitive function was administered, including the Logical and Figural Memory Scales from the Wechsler Memory Scale, the Digit Symbol and Digit Span subtests from the Wechsler Adult Intelligence Scale, and Part B of the Reitan Trail Making Test. The 125 study patients were generally similar to the 133 patients who were eligible but did not participate, although study participants were significantly younger (P=.003). The 64 patients randomly assigned to angioplasty had baseline characteristics similar to those of 61 patients randomly assigned to surgery. Cognitive function scores were not significantly different between angioplasty or surgery patients in an intention-to-treat analysis (P=.57). There also was no difference in cognitive function scores when the data were analyzed according to whether the patient had ever undergone bypass surgery (P=.59). CONCLUSIONS: Long-term cognitive function is similar after coronary bypass surgery and coronary angioplasty in the majority of patients.

Adult↗

PubMed1994

Measuring the effect of the duration of problem drinking on cognitive functions in alcoholics.

Although research has been conducted to determine the effects of the duration of problem drinking on cognitive functioning, the findings are inconclusive. The duration of problem drinking does not seem to be in a linear relation to the cognitive functions of alcoholics. This study tested the hypothesis according to which the duration of problem drinking is connected with cognitive functioning only at the beginning of abstinence, when withdrawal symptoms are present and when the spontaneous recovery of cognitive functions has hardly started. Once the withdrawal symptoms have gone, between-subjects variation in spontaneous recovery probably hides the effect of the duration of problem drinking. A total of 179 Finnish male alcoholics took part in the study. Randomly assigned to three groups, the subjects were tested during the first, second or fourth week of abstinence. The hypothesis was supported by the data.

Adult↗

PubMed2006

Mexican-American ethnicity and cognitive function: findings from an elderly southwestern sample.

Relatively little is known about late-life patterns of cognitive function among Hispanics of Mexican heritage who reside in the United States. The authors designed a study to assess the association between Mexican-American ethnicity (defined in terms of childhood and adolescent developmental history) and cognitive function among elderly Mexican-American and non-Hispanic white residents of El Paso County, Texas. Our findings indicate significant associations between the degree of Mexican-American ethnicity and cognitive impairment on all three measures of cognitive function. These statistically significant findings remain after effects of education, age, and gender have been removed from the multiple regression equation. The authors conclude that a dependable and clinically meaningful negative association exists between Mexican-American ethnicity and late-life cognitive function in this region that is mediated by as yet unmeasured variables.

Aged↗

PubMed2004

[Effect of soybean isoflavone on the cognitive function in ovariectomized mice].

OBJECTIVE: To explore the effect of soybean isoflavone on the cognitive function in ovariectomized mice and to study the cognitive function mechanism of soybean isoflavone. METHODS: Forty-five Kunming female mice were randomly assigned into 5 groups: A (sham operated); B (ovariectomized, OVX); C (OVX + low dose soybean isoflavone); D (OVX + moderate dose soybean isoflavone); and E (OVX + high dose soybean isoflavone). The experiment lasted 60 days. RESULTS: Ovariectomy significantly elongated the destination time of water maze, shortened the latent time of step-down test, decreased SOD of serum and Na+ K+ -ATPase and Ca2+ Mg2+ -ATPase of brain, and increased malonaldehyde of serum and monoamine oxidase of brain, which-could be inhibited by soybean isoflavone consumption. CONCLUSION: The continuous oral administration of soybean isoflavone can improve the cognitive function of ovariectomized mice.

Animals↗

PubMed2002

Relationship of race/ethnicity and blood pressure to change in cognitive function.

OBJECTIVES: To determine whether there are racial/ethnic differences regarding the relationship of level of blood pressure to change in cognitive function in older people. DESIGN: Longitudinal data 1986 to 1989 on representative, older, community-residing African Americans and whites. Blood pressure levels were assessed and a brief screen of cognitive functioning, the Short Portable Mental Status Questionnaire (SPMSQ), was performed at baseline and 3 years later. SETTING: Five contiguous counties in the Piedmont area of North Carolina. PARTICIPANTS: African-American (n = 2,260) and white(n = 1,876) participants in the Duke Established Populations for Epidemiologic Studies of the Elderly, aged 65 to 105 at baseline. MEASUREMENTS: The outcome measure was change in SPMSQ score over 3 years. Covariates included age; education; gender; self-reported diabetes mellitus, stroke, heart attack, current smoking, and depressive symptomatology;and use of antihypertensive medication. The primary independent variable was measured blood pressure. RESULTS: In unadjusted analyses, a statistically significant U-shaped relationship was found between systolic (but not diastolic) blood pressure levels and change in SPMSQ score over a 3-year period for older white men and women. No such relationships were found between these blood pressure measurements and change in SPMSQ score in older African Americans. These findings remained after adjustment for initial SPMSQ score, demographic characteristics, and use of antihypertensive medication. There were no significant interactions between race and blood pressure on change in cognitive function. CONCLUSION: Decline in cognitive function was associated with extremes of systolic blood pressure in older white people. Although a similar but muted nonsignificant association was found in older African Americans, the curves for the two groups were not significantly different. Further studies in older African Americans are needed.

Aged↗

PubMed1996

Linguistic ability in early life and cognitive function and Alzheimer's disease in late life. Findings from the Nun Study.

OBJECTIVE: To determine if linguistic ability in early life is associated with cognitive function and Alzheimer's disease in late life. DESIGN: Two measures of linguistic ability in early life, idea density and grammatical complexity, were derived from autobiographies written at a mean age of 22 years. Approximately 58 years later, the women who wrote these autobiographies participated in an assessment of cognitive function, and those who subsequently died were evaluated neuropathologically. SETTING: Convents in the United States participating in the Nun Study; primarily convents in the Milwaukee, Wis, area. PARTICIPANTS: Cognitive function was investigated in 93 participants who were aged 75 to 95 years at the time of their assessments, and Alzheimer's disease was investigated in the 14 participants who died at 79 to 96 years of age. MAIN OUTCOME MEASURES: Seven neuropsychological tests and neuropathologically confirmed Alzheimer's disease. RESULTS: Low idea density and low grammatical complexity in autobiographies written in early life were associated with low cognitive test scores in late life. Low idea density in early life had stronger and more consistent associations with poor cognitive function than did low grammatical complexity. Among the 14 sisters who died, neuropathologically confirmed Alzheimer's disease was present in all of those with low idea density in early life and in none of those with high idea density. CONCLUSIONS: Low linguistic ability in early life was a strong predictor of poor cognitive function and Alzheimer's disease in late life.

Adult↗