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At least 433 records · Page 24Linked to original sources

PubMed2000

Basal activity of the hypothalamic-pituitary-adrenal axis and cognitive function in anorexia nervosa.

Anorexia nervosa is associated with abnormalities in neuroendocrine function including sustained hypercortisolism, which has been shown elsewhere to be associated with impairment of function in learning, memory and attention. Cognitive impairment has also been observed in anorexia nervosa. These effects may be mediated in part through cortisol effects on the hippocampus, which is dense with glucocorticoid receptors. We investigated the association between cortisol levels and cognitive function in anorexia nervosa by measuring both 24-hour urinary cortisol counts and performance on tasks of learning, memory and attention in patients suffering from the disorder. Cortisol secretion was shown to be significantly higher in the patient group than in a matched control group and patients were also shown to be impaired in memory and attention. However, no correlations were found between the cognitive deficits and cortisol measures. It is suggested that more sensitive profiling of cortisol levels throughout the circadian cycle may be useful in future studies of cognitive function in anorexia nervosa.

Adult↗

PubMed1996

The impact of inadequate sleep on children's daytime cognitive function.

This report describes the relationship between sleep and cognitive function in children. As reviewed, the empiric data to directly address the effects of sleep loss or disruption on children's cognitive function are quite sparse. However, a wide range of clinical and observational data support a general picture that inadequate sleep results in tiredness, difficulties with focussed attention, low threshold to express negative affect (irritability and easy frustration), and difficulty modulating impulses and emotions. In some cases these symptoms may resemble attention deficit hyperactivity disorder. These findings are discussed in relation to a model of sleep loss influencing prefrontal cortex including executive functions involved in the control of attention and emotions.

Adolescent↗

PubMed2003

[Cognitive functions and cerebral oxygenation of older patients after general and regional anaesthesia].

OBJECTIVE: The aim of the present study was to show the influence of cerebral oxygenation (regional cerebral oxygen saturation rSO(2) by near infrared spectroscopy) and of the nocturnal arterial oxygen saturation (SatO(2) by pulse oximetry) on the restitution of cognitive functions in patients aged between 40 and 85 years scheduled for elective hip arthroplasty. METHODS: A total of 40 patients (ASA II) were randomized to be operated either in general anaesthesia or regional anaesthesia. The patients were additionally classified by age (40-64 years and 65-85 years). Cognitive functions were tested 14-16 h pre-operatively (t0), 1.5 h post-operatively (t1) and at the first and third postoperative days (t2 and t3). During testing, as well as during surgery and postoperatively until t1, rSO(2) was continuously measured. SatO(2) was measured in the night before surgery (N0) and for 3 nights after surgery (N1, N2, N3) between 22.00 p.m. and 5.00 a.m. These measurements were divided into interval groups (80-83%, 84-87%, 88-91%, 92-95%, 96-100%). RESULTS: Almost all cognitive functions were significantly reduced at t1 in all groups compared to t0, but recovered up to the third postoperative day (t3). RSO(2) in contrast was significantly reduced in all groups compared to t0 at the third postoperative day (t3). The relative proportion of the intervals compared to the total measurement time for SatO(2) shifted in both anaesthesia procedures: before surgery (N0) the most frequented interval was 96-100%, after surgery (N1, N2) it was 88-91%. There was no correlation between rSO(2), the restitution of the tested cognitive functions and SatO(2). CONCLUSIONS: Cognitive functions recovered completely during the first 3 postoperative days in patients scheduled for elective hip surgery under general or regional anaesthesia regardless of age and type of anaesthesia. This restitution of cognition occurred despite a significant decrease of cerebral oxygenation (rSO(2)) and despite an increase of nocturnal hypoxaemic intervals. Changes of the rsO(2) up to 3% below the baseline values (measured by NIRS) do not predict cognitive restitution. A minimal limiting value of the rSO(2) could not be defined.

Adult↗

PubMed2006

Effect of oral vitamin B-12 with or without folic acid on cognitive function in older people with mild vitamin B-12 deficiency: a randomized, placebo-controlled trial.

BACKGROUND: Vitamin B-12 deficiency is associated with cognitive impairment in older people. However, evidence from randomized trials of the effects of vitamin B-12 supplementation on cognitive function is limited and inconclusive. OBJECTIVE: The objective was to investigate whether daily supplementation with high doses of oral vitamin B-12 alone or in combination with folic acid has any beneficial effects on cognitive function in persons aged >/=70 y with mild vitamin B-12 deficiency. DESIGN: In a double-blind, placebo-controlled trial, 195 subjects were randomly assigned to receive 1000 microg vitamin B-12, 1000 microg vitamin B-12 + 400 microg folic acid, or placebo for 24 wk. Vitamin B-12 status was assessed on the basis of methylmalonic acid, total homocysteine (tHcy), and holotranscobalamin (holoTC) concentrations before and after 12 and 24 wk of treatment. Cognitive function was assessed before and after 24 wk of treatment with the use of an extensive neuropsychologic test battery that included the domains of attention, construction, sensomotor speed, memory, and executive function. RESULTS: Vitamin B-12 status did not change significantly after treatment in the placebo group; however, oral vitamin B-12 supplementation corrected mild vitamin B-12 deficiency. Vitamin B-12 + folic acid supplementation increased red blood cell folate concentrations and decreased tHcy concentrations by 36%. Improvement in memory function was greater in the placebo group than in the group who received vitamin B-12 alone (P = 0.0036). Neither supplementation with vitamin B-12 alone nor that in combination with folic acid was accompanied by any improvement in other cognitive domains. CONCLUSION: Oral supplementation with vitamin B-12 alone or in combination with folic acid for 24 wk does not improve cognitive function.

Administration, Oral↗

PubMed1999

[Anesthesia in geriatric patients. The determination of physiological variables for cognitive function in geriatric patients after regional or general anesthesia].

OBJECTIVE: The aim of the present study was to show the influence of the parameters of gas exchange (arterial oxygen pressure paO2, arterial oxygen saturation SatO2) and haemodynamics (arterial systolic and mean blood pressure RRs and MAP) on the restitution of cognitive functions in geriatric patients scheduled for elective hip arthroplasty. METHODS: A total of 30 patients (70 years, ASA II) were randomized to be operated either in regional anaesthesia (n = 15) or general anaesthesia (n = 15). PaO2 (by capillary blood gas analysis), RRs and MAP (by oscillometry) were measured 15 and 90 minutes after arrival in the recovery unit (t1 and t2), 24 and 72 hours postoperatively (t3 and t4), and cognitive functions were tested. Intraoperatively, throughout the day and the first night after surgery we measured satO2 by continuous pulse oximetry. We recorded MAP and RRs by oscillometry every 3 minutes during the operation and every 15 minutes for the rest of that day and night. RESULTS: The parameters of gas exchange and haemodynamics did not differ among the groups. PaO2 was significantly reduced in both groups compared to baseline 24 hours postoperatively (t3) and remained low until 72 hours postoperatively (t4). Nearly all cognitive functions were significantly reduced in both groups compared to baseline 15 and 90 minutes after arrival in the recovery unit (t1 and t2), but recovered on the first postoperative day (t3). Both groups kept deficits in verbal memory and reading capacity up to the third postoperative day (t4). There was no correlation between the physiological parameters and the restitution of the tested cognitive functions. CONCLUSION: The restitution of cognitive functions during the first three postoperative days in geriatric patients scheduled for elective hip surgery does not depend on the anaesthetic technique. According to our results regional anaesthesia does not show any advantage for geriatric patients undergoing elective hip arthroplasty.

Aged↗

PubMedDate not supplied

The course of functional decline in geriatric patients with schizophrenia: cognitive-functional and clinical symptoms as determinants of change.

OBJECTIVE: Authors sought to use a cognitive assessment instrument validated for assessing low-functioning patients to broaden knowledge about the rate and correlates of functional decline. METHODS: Patients were examined across a wide range of baseline cognitive and functional status, and changes in cognitive and functional status were examined. A group of 424 elderly patients with schizophrenia were followed up over a 6-year period; 280 of these manifested severe cognitive impairment at baseline. Patients were examined with an instrument designed for cognitive and functional assessment of severe cognitive impairment: the Alzheimer's Disease Assessment Scale-Late (ADAS-L). RESULTS: Patients with higher and lower baseline scores manifested equivalent declines in the ADAS-L cognitive subscale, but differences in decline on basic activities of daily living. Random-effects regression analysis indicated that functional changes were significantly correlated with cognitive changes for the sample as whole and that cognitive changes were the best predictor of changes in functional status over time. Baseline cognitive status was not a statistically significant covariate for functional change, nor was the course of negative symptoms over the follow-up period. CONCLUSIONS: Cognitive change appears very similar in magnitude across older, poor-outcome patients with different baselines of cognitive impairment. In contrast, functional decline was limited to patients with lower levels of functioning at baseline. These findings suggest that cognitive thresholds for impairments in different aspects of functional status may exist in patients with schizophrenia. Basic activities of daily living decline only in patients with very low levels of baseline cognitive functioning.

Aged↗

PubMed1999

A comparison of the effect of clozapine with typical neuroleptics on cognitive function in neuroleptic-responsive schizophrenia.

Clozapine has been reported to improve selected aspects of cognitive function in neuroleptic-resistant schizophrenia. In this study, we report the first direct comparison of the effect of clozapine and typical neuroleptic drugs on cognitive function in neuroleptic-responsive schizophrenia. Sixty-four patients with recent onset, neuroleptic-responsive schizophrenia or schizoaffective disorder were randomly assigned to either clozapine (n = 35) or typical neuroleptics (n = 29) and followed for 12 months. They were administered a comprehensive cognitive test battery at baseline and at 6 weeks, 6 months and 12 months after initiating drug treatment. Treatment with clozapine improved psychomotor speed and attention [Digit Symbol Substitution Test (DSST)] and verbal fluency [Category Instance Generation and Controlled Word Association Test (CWAT)] at 6 weeks. The improvement in these measures was maintained throughout the 12-month period. Treatment with typical neuroleptics produced no sustained improvement in any cognitive measure, except for a tendency to improve delayed recall memory (Verbal List Learning Test). The improvement in the DSST and CWAT was significantly greater with clozapine treatment compared to that with typical neuroleptics. These improvements were not related to improvement in psychopathology. These results suggest that clozapine is superior to typical neuroleptics in improving specific types of cognitive function in recent onset, neuroleptic-responsive schizophrenia.

Adult↗

PubMed2006

Estrogen, cognitive function and negative symptoms in female schizophrenia.

The aim of this study was to evaluate the relationship of serum reproductive hormone levels with cognitive function and negative symptoms in schizophrenic women during the follicular phase of the menstrual cycle. Thirty-five women with chronic schizophrenia who had minimal positive symptoms participated in this study. We evaluated the correlation of serum reproductive hormone levels with the Scale for the Assessment of Negative Symptoms (SANS) and cognitive function tests such as the Immediate Visual Recognition Scale, Oral Fluency Test, List Recall Scale with List Acquisition Scale, Trail Making Tests A and B, and Digit Symbol Test. The patients were divided into two subgroups (low estradiol group and normal estradiol group) using the normal serum reference range for estradiol. Significant correlation between SANS subcategories, such as Alogia and Attention Impairment, and estradiol were found. Moreover, significant relationships between the estradiol level and the Oral Fluency Test, List Recall Scale with List Acquisition Scale, Trail Making Test B and Digit Symbol Test were observed. In the low estradiol group, the SANS scores, except for Anhedonia-Asociality and Avolition-Apathy, were significantly higher than those in the normal estradiol group. Patients in the low estradiol group had a significantly lower performance in the cognitive function tests, except Visual Recognition Scale, when compared to patients in the normal estradiol group. These results suggest that for schizophrenic women of reproductive age, lower levels of estrogen are associated with more severe negative symptomatology as well as reduced performance in cognitive function, especially verbal performance and executive functioning.

Adult↗

PubMed2000

Postmenopausal hormone therapy and cognitive function in healthy older women.

OBJECTIVE: Accumulating biologic evidence suggests that estrogen is related to cognitive function. Several epidemiologic investigations have reported that hormone therapy may reduce the risk of Alzheimer's disease. However, fewer studies have examined the relation of postmenopausal hormone use to general cognitive function in nondemented older women. Thus, we examined the association of hormone therapy to performance on four cognitive tests among healthy participants of the Nurses' Health Study. DESIGN: Cohort study. SETTING: The Nurses' Health Study, an ongoing prospective cohort study begun in 1976. PARTICIPANTS: From the Nurses' Health Study, 2138 women aged 70-78 years. MEASUREMENTS: From 1995-1999 we administered four cognitive tests (Telephone Interview for Cognitive Status (TICS), immediate and delayed recall of the East Boston Memory Test (EBMT), and verbal fluency) by telephone. Hormone use was ascertained from biennial questionnaires beginning in 1976. Linear and logistic regression models were used to calculate multivariate-adjusted differences in scores and relative risks of a low score for never users compared to current and past hormone users. RESULTS: After adjustment for confounders, neither current nor long-term hormone users demonstrated better performance on an overall measure of cognition (TICS), or on three tests of verbal memory (immediate and delayed recall of the EBMT, immediate recall of the TICS 10-word list) than never users. On the test of verbal fluency, current hormone users scored significantly better than never users (linear regression estimate of the difference in score = 0.78 points, 95% confidence interval (CI) 0.19-0.38, P = .01 for any current use; and 0.91 points, 95% CI 0.28-1.54, P = .005 for > or = 5 years current use). Current hormone users also had a 30% decrease (RR = 0.70, 95% CI 0.45-1.09) in their risk of a low score on the test of verbal fluency. These results were similar for women taking estrogen alone and estrogen combined with a progestin. CONCLUSIONS: Verbal fluency may be enhanced among women taking postmenopausal hormones, however, there is little support for better overall cognitive function in hormone users than nonusers.

Aged↗

PubMed1996

The effects of amantadine and pemoline on cognitive functioning in multiple sclerosis.

BACKGROUND: Amantadine hydrochloride and pemoline, both frequently used to treat the fatigue of multiple sclerosis (MS), may also improve attention and other cognitive functions in MS. To our knowledge, these agents have never been compared in a placebo-controlled trial of patients with MS. OBJECTIVE: To evaluate the effects of amantadine and pemoline on cognitive functioning in MS. METHODS: A total of 45 ambulatory patients with MS and severe fatigue were treated for 6 weeks with amantadine, pemoline, or placebo using a parallel group design. They underwent comprehensive neuropsychological testing to determine treatment effects on cognitive functioning. Primary outcome measures were tests of attention (Digit Span, Trail Making Test, and Symbol Digit Modalities Test), verbal memory (Selective Reminding Test), nonverbal memory (Benton Visual Retention Test), and motor speed (Finger Tapping Test). RESULTS: Fatigue did not significantly correlate with any of the neuropsychological outcome measures at baseline or after treatment. All three treatment groups improved on tests of attention (P < .003), verbal memory (P < .001), and motor speed (P < .002). There were no significant differences between amantadine, pemoline, and placebo. CONCLUSIONS: Cognitive functioning in MS is independent of fatigue. Neither amantadine nor pemoline enhances cognitive performance in MS compared with placebo.

Adolescent↗

PubMed2026

Social support and cognitive function in postmenopausal women.

OBJECTIVE: An active social lifestyle may protect against cognitive decline in older adults, but few studies have examined specific social support dimensions in relation to specific cognitive domains. This study examines associations between social support dimensions and cognitive function in older women. METHODS: The Early versus Late Intervention Trial with Estradiol (ELITE) was a randomized, double-blinded, placebo-controlled trial of oral 17β-estradiol versus placebo in postmenopausal women, designed primarily to evaluate the timing hypothesis on atherosclerosis progression and cognitive decline; the present analysis is a secondary, hypothesis-generating examination of the psychosocial substudy data (2009-2012). A total of 448 women completed psychosocial assessments every 6 months. Cognitive function was assessed at baseline, 2.5, and 5 years using composite scores for executive function, verbal memory, visual memory, and global cognition derived from 14 standardized tests. Perceived social support was assessed using the Medical Outcomes Study-Social Support Survey (MOS-SSS; 0-100 scale). Paired cognitive-psychosocial assessments were analyzed using linear mixed-effects models adjusted for age, marital status, blood pressure medication, BMI, education, income, race, and randomized treatment (hormone therapy or placebo). RESULTS: A total of 298 women (mean age 60.3 y) provided 322 paired visits. Positive associations were observed between instrumental social support and visual memory (β(SE)=0.0044(0.0022), 95% CI: -0.00002 to 0.0088, P=0.051) and between positive social interaction and global cognition (β(SE)=0.0092(0.0046), 95% CI: 0.0001-0.0182, P=0.047). In age-stratified analyses, the positive social interaction-global cognition association was significant among women <65 years (P=0.042) but not women ≥65 years (P=0.34). No association survived false discovery rate (FDR) correction for multiple comparisons. CONCLUSIONS: In this sample of healthy middle- to older-aged women, no association between specific dimensions of social support and cognitive domains was statistically significant after correction for multiple comparisons. These hypothesis-generating findings suggest any association is modest at best and warrant confirmation in studies designed specifically for this question.

Cognitive function↗

PubMed1992

The MRC Multicentre Study of Cognitive Function and Ageing: a EURODEM incidence study in progress.

The purpose of this paper is to describe the design and methodology of this multicentre study of cognitive function and ageing, which is currently funded by the Medical Research Council (MRC) and the Department of Health for a period of 5 years. The study is designed to estimate and compare the prevalence and incidence of dementia in five centres in the United Kingdom, to examine the natural history of cognitive decline and dementia in the population and to evaluate the degree of disability associated with any decline. This will be achieved by the examination, twice, of the cognitive function of individuals aged 65 and over, with an interval of 2 years between the examinations. A 20% subsample, taken across the full range of cognitive function will be reviewed annually in more detail to chart the level of cognitive function and to ascertain a diagnosis of dementia. This represents the first systematic examination of different populations using a common methodology in the United Kingdom.

Aged↗

PubMed1988

Conduct disorder and cognitive functioning: testing three causal hypotheses.

The sample consisted of black adolescents who were members of the Columbia-Presbyterian chapter of the Collaborative Perinatal Project from birth to age 7. At age 17, subjects and their parents were administered a battery of instruments that included standardized psychiatric diagnostic interviews as part of a call-back study. Results from least-squares and logistic regression analyses were compatible with the hypothesis that deficiencies in cognitive functioning are causally related to adolescent conduct disorder as defined by DSM III. The results suggested that the relation of cognitive functioning to psychiatric status appears to be specific to conduct disorders. The results were incompatible with a "third" variable hypothesis (third factors included neurological status and environmental disadvantage) and the hypothesis that conduct problems lead to deficits in cognitive functioning. The 3 most (and equally) important factors in accounting for age-17 conduct disorder were cognitive functioning, parent psychopathology, and early aggression. A closer look at the data tentatively suggested that a broad deficiency in acculturational learning, rather than narrowly focused social cognitive differences or native endowment, constitutes a key element in the link between cognitive functioning and conduct disorder. Test bias was ruled out as a possible explanation for the results.

Adolescent↗

PubMed2002

Preservation of cognitive function with antihypertensive medications: a longitudinal analysis of a community-based sample of African Americans.

BACKGROUND: Results of previous studies of white older adults suggest that antihypertensive medications preserve cognition. We assessed the long-term effect of antihypertensive medications on cognitive function in a community sample of African American older adults. METHODS: We conducted longitudinal surveys and clinical assessment of cognitive function in a random sample of 2212 community-dwelling African Americans 65 years and older. We identified 1900 participants without evidence of cognitive impairment at baseline, 1617 of whom had subsequent follow-up information, and 946 of whom had blood pressure measurements. Cognitive function was measured at baseline and at 2 and 5 years by means of scores on the Community Screening Instrument for Dementia and neuropsychological and clinical assessment for dementia and cognitive impairment. Prescription and nonprescription medication use was derived from in-home inspection of medications and participant and informant reports. RESULTS: Of 1900 participants, 288 (15.2%) developed incident cognitive impairment. Using logistic regression to control for the effects of age, sex, education, baseline cognitive scores, and hypertension and angina or myocardial infarction, we found that antihypertensive medications reduced the odds of incident cognitive impairment by 38% (odds ratio, 0.62; 95% confidence interval, 0.45-0.84). Corresponding analysis using blood pressure measurements on the subset of participants was inconclusive. CONCLUSION: Antihypertensive medication use is associated with preservation of cognitive function in older African American adults.

Black or African American↗

PubMed1993

[Hypertension and disorders of cognitive function].

In the treatment of hypertension, the aspect of cognitive function is now becoming ever more important. In recent years, the influence of hypertension itself--as well as that of anti-hypertensive treatment--on cognitive functioning has repeatedly been investigated. The results obtained differ too widely to permit any final statement to be made on the relationships involved. The reasons for these differences seem to be due in particular to differences in the methods of investigation and random sampling involved in the studies. More recent studies, however, seem to support a relationship between hypertension and decreased cognitive performance. Improved investigations are expected to produce more detailed results in the future.

Antihypertensive Agents↗

PubMed2005

Physical health, depression and cognitive function as correlates of disability in an older Korean population.

BACKGROUND: The World Health Organisation Disability Assessment Schedule II (WHODAS II) measures functioning and disability in concordance with the bio-psycho-social model of the WHO's International Classification of Functioning, Disability, and Health. Our objectives were to investigate the independent associations of physical health, depression and cognitive function with WHODAS II disability in an older Korean population. METHODS: The WHODAS II was administered to a community sample of 1204 residents age 65 or over. Data on demographic characteristics (age, gender, living area, marital state, and religion), socio-economic state (education, type of accommodation, number of rooms, previous occupation, current employment, monthly income), social support, number of physical illness, depression (GMS), and cognitive function (MMSE) was gathered. A subsample (n = 746) received a clinical examination for dementia. RESULTS: Scores on the WHODAS II were significantly and independently associated with worse physical health, depression, and lower cognitive function. Associations with other factors were no longer apparent after adjustment for these. These associations persisted in the absence of dementia. In participants with dementia (n = 110), WHODAS II scores were principally associated with physical health and accommodation type. CONCLUSIONS: Level of disability, as measured by the WHODAS II, was principally associated with physical health, depression and cognitive function, rather than socio-demographic factors.

Aged↗

PubMed1997

Cognitive functions in the informed consent evaluation process: a pilot study.

Assessment of capacity to give informed consent in the general hospital setting usually rests on a clinical judgment made of a patient's understanding and appreciation of his or her illness, a process limited by its subjective nature, interexaminer variability, and relative deficiency of quantitative instruments available to provide collateral information. Inasmuch as identification of associated variables could strengthen this process, this study examines the association of cognitive functions to the capacity to give informed consent. Over a one-year period, 65 patients were evaluated independent of medical or psychiatric diagnoses. The study population consisted of medical and neurology inpatients seen for neuropsychiatric evaluation. All evaluations included assessment of capacity to give informed consent as it related to the reason for the admission to the hospital, followed by administration of the Hopkins Competency Assessment Test, the Mini-Mental Status Examination, the Trail-Making Test, Parts A and B, and the Executive Interview. Of 65 patients, 34 were excluded based on preset criteria. The remaining patients were assigned to either a "competent" or "noncompetent" group based on clinical evaluation. Number of patients, gender, and handedness distributions between groups were similar. The groups did not differ significantly in terms of age or education. Significant between-group differences were found on an empirical measure of competency, a general mental state measure, and on measures of attentional and executive cognitive functions. An analysis of classification rates indicated that a measure of executive cognitive functioning (Executive Interview) had the best sensitivity and specificity in correctly classifying competent and noncompetent patients. The results of this study support the association between the capacity to give informed consent in the hospital setting and measures of cognitive functioning, suggesting that utilization of cognitive function measures may strengthen the competency assessment process.

Adult↗

PubMed1997

Cognitive functioning of 75- and 80-year-old people and changes during a 5-year follow-up.

The aim of the study was to analyze cognitive functioning among two cohorts of elderly people, aged 75 and 80 years at baseline, and changes in the functioning during a five-year period. Cognitive functioning was assessed using psychometric tests, neuropsychological tasks, metacognitive self-evaluations, cognitive screening tests and reaction time tasks. The objective methods correlated significantly with each other, and only one general factor was clearly produced by the factor analyses. However, the speed of cognitive processing was concluded to have a central meaning in the kind of assessments used in this study. Selective attrition affected the results of psychometric and neuropsychological methods; subjects with better cognitive functioning participating in the follow-up assessments. Among those retested, the cognitive level decreased significantly, but the magnitude of the decline was usually low. Differences between the men and the women were mostly nonsignificant. The retest correlations were high in the psychometric tests but lower in many of the neuropsychological and metacognitive methods. Connections between the metamemory scores and the objective test scores were variable.

Aged↗