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PubMed1993

Level of education and change in cognitive function in a community population of older persons.

In a community population of persons over the age of 65, cognitive function was assessed using brief performance tests on two occasions 3 years apart. Those with fewer years of formal education consistently had greater declines in cognitive function, independently of age, birthplace, language of interview, occupation, and income. These prospective findings suggest that low educational attainment or a correlate predicts cognitive decline. It is not clear, however, whether this relation represents a direct effect of education on future cognition, whether education might be related to occurrence of a disease leading to cognitive decline in older persons, or whether education might be a surrogate for some variable not included in the study.

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PubMed2006

The select action of hippocampal calcium calmodulin protein kinase II in mediating exercise-enhanced cognitive function.

We found that a single week of exercise enhanced cognitive function on the Morris water maze (MWM), such that exercise animals were significantly better than sedentary controls at learning and recalling the location of the platform. In order to elucidate the role that calcium calmodulin protein kinase II (CAMKII) holds in mediating the exercise-induced enhancement in learning and memory, a specific antagonist of CAMKII, KN-62, was used to block CAMKII in the rat hippocampus during a 1-week voluntary exercise period. Following, a two-trial-per-day MWM was performed for five consecutive days, succeeded by a probe trial 2 days later. Inhibiting CAMKII action during exercise blocked the ability of exercise to enhance memory retention on the MWM; the recall abilities of exercise animals receiving the CAMKII blocker were significantly worse than those of both sedentary and exercise controls. Conversely, CAMKII may not play a significant role in mediating the effects of exercise on learning acquisition as inhibiting CAMKII failed to block the exercise-induced enhancement in learning acquisition. Our results also show that CAMKII activation early during MWM learning may be counterproductive to learning acquisition, as exercising animals given the CAMKII inhibitor performed significantly (P<0.001) better than exercising control animals and sedentary controls only on day 2 of the MWM. Inhibiting CAMKII also blocked the exercise-induced upregulation of molecules critical for learning and memory, brain-derived neurotrophic factor (BDNF) and the transcription activator cAMP response-element-binding protein, which is regulated by and downstream to BDNF action. These findings indicate that hippocampal CAMKII may have a refined role in mediating the effects of exercise on cognition, selectively functioning to regulate memory retention.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗

PubMed1992

[A multi-stage cognitive training program for improving cognitive functions of chronic alcoholic patients].

In accordance with neuropsychological findings, that chronic alcohol abuse can lead to cognitive impairment, a multi-phased cognitive training program (MKT) developed by Sagstetter was conducted with a group of chronic alcoholic patients. In this article this program is introduced and evaluated with regard to chronic alcoholic patients and their improvement in certain cognitive functions. The study group consisted of 11 chronic alcoholics, who regularly took part in the program. The control group consisted of 11 patients who took part on a behavior therapy program offered by the clinic and had similar social and pathological histories to those of the study group. The two groups were compared with each other with the help of a follow-up study design after approximately seven weeks. The results reveal that this present cognitive training program promotes, above all, cognitive functions such as visual short-time memory, concentration, form perception as well as combination and organisation ability.

Adult↗

PubMed1989

Effects of missing breakfast on the cognitive functions of school children of differing nutritional status.

We examined the effects of omitting breakfast on the cognitive functions of three groups of children: stunted, nonstunted controls, and previously severely malnourished. They were admitted to a metabolic ward twice. After an overnight fast half the children received breakfast on their first visit and a cup of tea the second time. The treatment order was reversed for the other half. When breakfast was omitted, both the stunted and previously malnourished groups responded similarly. The malnourished groups had lower scores in fluency and coding whereas the control group had higher scores in arithmetic. The children were divided into wasted and nonwasted groups. Wasted children were adversely affected in the digit span backwards tests, and wasted members of the malnourished groups were adversely affected in efficiency of problem solving and those in the control group in digit span forwards. These results indicate that cognitive functions are more vulnerable to missing breakfast in poorly nourished children.

Child↗

PubMed2000

[A six year follow-up study on the influence of silent ischemic brain lesions on cognitive function and brain atrophy in elderly people].

METHODS: To investigate the influence of silent ischemic brain lesions (silent brain infarction (SBI) and periventricular hyperintensity (PVH) on cognitive function and brain atrophy, we studied MRI and cognitive tests in 27 healthy elderly people (above 65 years old) for 6 years. We examined Okabe's Scale for verbal intelligence, Koh's Block Design Test for performance intelligence and Zung's Self-rating Depression Scale (SDS). On MRI, lesions with high intensity on T2-weighted image and low intensity on T1-weighted image, and which were larger than 3 mm were diagnosed as SBI. The PVH was classified into 5 grades (0-4), and we divided the subjects into the PVH 0-1 group and the PVH 2-4 group. We evaluated brain atrophy using the ventricular area index (VAI) (the ratio of ventricular area to intracranial area at the level of lateral ventricle) on MRI by NIH image 1.55 (Macintosh). RESULTS: The SBI group and the PVH 2-4 group showed significant decline in Okabe's Score, and Koh's IQ, increase in SDS and VAI during six years. On the other hand, the non-SBI and the PVH 0-1 group showed a decline only in Okabe's score, and an increase in VAI. The rate of change in VAI was significantly higher in the subjects with SBI than those without it. However, there was no significant difference in the VAI change rate between the PVH 2-4 group and the PVH 0-1 group. CONCLUSION: Silent ischemic brain lesions such as SBI and PVH may have significant influence on decline of cognitive functions and progression of brain atrophy even in healthy elderly people.

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PubMedDate not supplied

[Environment and cognitive functions in a population 60 years and older].

AIM: The aim of the study was the evaluation of cognitive functions of town and village inhabitants. METHOD: One thousand people who were more than 60 years old were randomized from the list of inhabitants of Pruszcz Gdański city and another thousand from the communes: Pruszcz Gdański, Tratbki Wielkie i Pszczółki. The cognitive functions were assessed according to the MMSE (Mini Mental State Examination) which were next calculated according to an algorithm proposed by Mungas et al. RESULTS: Village inhabitants presented more severe cognitive impairment. The possible influence of education, sex and age are discussed.

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PubMed1993

Risk factors for cerebrovascular disease as correlates of cognitive function in a stroke-free cohort.

We investigated the relationship between risk factors for cerebrovascular disease and cognitive function in 249 stroke-free community volunteers (age, 70.8 +/- 6.7 years; education, 12.3 +/- 4.6 years) who were given tests of memory, language, visuospatial, abstract reasoning, and attentional skills. Using logistic regression analyses, we examined hypertension, diabetes mellitus, myocardial infarction, angina, hypercholesterolemia, and cigarette smoking as potential correlates of performance within these cognitive domains. Controlling for demographic factors within the logistic models, diabetes mellitus was a significant independent correlate of abstract reasoning deficits (odds ratio, 10.9; 95% confidence interval, 2.2 to 54.9) and visuospatial dysfunction (odds ratio, 3.5; confidence interval, 1.2 to 10.7), while hypercholesterolemia was a significant independent correlate of memory dysfunction (odds ratio, 3.0; confidence interval, 1.4 to 6.6). Prolonged exposure to vascular risk factors such as diabetes mellitus and hypercholesterolemia may lead to atherosclerotic disease, possibly resulting in "silent" infarctions or impaired cerebral blood flow and a decline in cognitive functioning.

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PubMed2006

Neprilysin-sensitive synapse-associated amyloid-beta peptide oligomers impair neuronal plasticity and cognitive function.

A subtle but chronic alteration in metabolic balance between amyloid-beta peptide (Abeta) anabolic and catabolic activities is thought to cause Abeta accumulation, leading to a decade-long pathological cascade of Alzheimer disease. However, it is still unclear whether a reduction of the catabolic activity of Abeta in the brain causes neuronal dysfunction in vivo. In the present study, to clarify a possible connection between a reduction in neprilysin activity and impairment of synaptic and cognitive functions, we cross-bred amyloid precursor protein (APP) transgenic mice (APP23) with neprilysin-deficient mice and biochemically and immunoelectron-microscopically analyzed Abeta accumulation in the brain. We also examined hippocampal synaptic plasticity using an in vivo recording technique and cognitive function using a battery of learning and memory behavior tests, including Y-maze, novel-object recognition, Morris water maze, and contextual fear conditioning tests at the age of 13-16 weeks. We present direct experimental evidence that reduced activity of neprilysin, the major Abeta-degrading enzyme, in the brain elevates oligomeric forms of Abeta at the synapses and leads to impaired hippocampal synaptic plasticity and cognitive function before the appearance of amyloid plaque load. Thus, reduced neprilysin activity appears to be a causative event that is at least partly responsible for the memory-associated symptoms of Alzheimer disease. This supports the idea that a strategy to reduce Abeta oligomers in the brain by up-regulating neprilysin activity would contribute to alleviation of these symptoms.

Alzheimer Disease↗

PubMed1996

[Awakening from anesthesia and recovery of cognitive function after desflurane or isoflurane].

UNLABELLED: Desflurane is a new volatile anaesthetic with an extremely low blood/gas partition coefficient of 0.42. This should provide a rapid recovery from anaesthesia. METHODS: We studied 100 adult patients, ASA class I or II, undergoing elective orthopaedic surgery randomly assigned to anaesthesia with desflurane (n = 50) or isoflurane (n = 50) supplemented by nitrous oxide in oxygen. Clorazepat was given for premedication, fentanyl and thiopental for induction of anaesthesia, followed by maintenance with desflurane or isoflurane as clinically appropriate. Emergence from anaesthesia was measured as well as return of cognitive functions (extended Aldrete score, digit symbol substitution test, and visual analogue scales [VAS]). RESULTS: While the demographic characteristics and administrated doses of fentanyl and thiopental were comparable, the recovery profiles in both groups were different. After discontinuation of the volatile anaesthetics, times to extubation and ability to follow simple commands were significantly shorter after desflurane than after isoflurane. Extended Aldrete scores, estimation of the patients' physical condition, results of the digit symbol substitution test, measuring cognitive functions, and rates of drowsiness and weakness on VAS showed better recovery with less impairment of cognitive function in the desflurane group than in isoflurane patients even 120 min after anaesthesia. VAS pain scores and doses of analgesic drugs given within the first 2 postoperative hours, however, showed no significant differences. Desflurane patients were also judged fit for discharge from the recovery room significantly faster. CONCLUSIONS: Our results demonstrate that desflurane anaesthesia, even when supplemented by premedication, intraoperative opioids, and nitrous oxide may offer clinical advantages over isoflurane as far as the post-anaesthetic recovery profile is concerned.

Adult↗

PubMedDate not supplied

The relationship of cognitive functioning to amount of recent and lifetime alcohol consumption in outpatient alcoholics.

Previous investigations of the relationship between drinking patterns and cognitive functioning have generally studied severely alcoholic patients, in whom the neurocognitive effects of alcohol consumption can be obscured by other medical or psychosocial factors. In the present study, cognitive functioning was examined after a minimum of 4 days of abstinence in 69 mildly to moderately alcohol-dependent outpatients without comorbid psychiatric, neurologic, or systemic medical illness. Circumscribed decrements in reaction time and verbal memory were associated with higher amounts of alcohol consumption in the 90 days prior to enrollment in the study, and amount of recent consumption was correlated with scores on numerous cognitive tests. In contrast, longer drinking history was not associated with poorer performance on any neuropsychological measures. Thus, in this group of high-functioning, mildly to moderately alcohol-dependent outpatients, mild cognitive deficits were related to the amount of recent, but not lifetime, alcohol consumption.

Adult↗

PubMed2001

Activational effects of testosterone on cognitive function in men.

OBJECTIVES: The effect of testosterone (T) on sexual function in men is well established. However, less is known about its effects on cognitive function. The aim of this study is to investigate the relationship between T levels and sex-typed cognitive abilities in both eugonadal and hypogonadal men. DESIGN: A single-blind placebo-controlled design was employed in this study. METHODS: Thirty healthy eugonadal men and seven hypogonadal men participated in the study. Eugonadal men were randomised into one of two treatment regimens: (1) active group--receiving 200 mg of T enanthate i.m. weekly for 8 weeks (raising T levels into the supraphysiological range) or (2) placebo group--receiving 200 mg of sodium chloride i.m. weekly for 8 weeks. The hypogonadal group received the physiological replacement dose of 200 mg T enanthate i.m. bi-weekly for 8 weeks. All groups underwent a battery of neuropsychological tests and had circulating T measured at baseline, and at weeks 4 and 8 during treatment. RESULTS: A significant time by group interaction effect was found in the measure of spatial ability (i.e., block design test) indicating that the active group's performance declined significantly at week 4, compared to placebo group (F(4,64)=3.78, P<0.01). Conversely, the active group performed significantly better than the placebo group in the measure of verbal fluency (i.e., the Controlled Oral Word Association Test) at week 4 (F(4,64)=2.54, P<0.05). No significant changes were found on any of the other tests. Generally, the hypogonadal group performed less well than the eugonadal groups on all tests. CONCLUSIONS: These results offer support to the notion that increased T has a differential effect on cognitive function, inhibiting spatial abilities while improving verbal fluency in eugonadal men.

Adult↗

PubMed1995

Health and social characteristics and children's cognitive functioning: results from a national cohort.

OBJECTIVES: The purpose of this study was to examine the associations between cognitive functioning in children and sociodemographic, family, and health characteristics. METHODS: Data from phase 1 of the third National Health and Nutrition Examination Survey were used to evaluate performance on standardized cognitive tests in a representative sample of 2531 children 6 to 16 years of age. Multivariate analyses were used to assess independent associations between covariates and test performance. RESULTS: Lower income, minority status, and lower education of an adult reference person (one of the persons in the household who owned or rented the home) were independently associated with poorer performance on all cognitive subtests. To a lesser degree, general health status, history of birth complications, and sex also were independent predictors of performance for some of the subtests. CONCLUSIONS: These findings illustrate disparities in cognitive functioning across sociodemographic and health characteristics of children in the US population. They suggest the need for public health policies to take a multifaceted approach to optimizing childhood environments in order to overcome the effects of socioeconomic and minority status.

Adolescent↗

PubMed2006

Cognitive functions in carotid artery disease before endarterectomy.

Restorative effects of carotid endarterectomy (CEA) on cognitive functioning in patients with severe atherosclerotic disease presuppose the existence of cognitive deficits prior to the intervention. Thorough examination of this premise received only minor attention. The present study assessed symptomatic and asymptomatic patients with severe unilateral or bilateral stenosis of the carotid arteries one day before CEA. Healthy volunteers with similar demographic characteristics served as control subjects. Patients overall showed decreased functioning on tests of attention, verbal and visual memory, verbal fluency, and psychomotor speed and executive functioning, even after correction for the effects of mood. Simple motor skills and visuospatial functioning were not affected. Patients grouped according to presence and type of previous clinical symptoms and severity of contralateral stenosis only slightly differed from each other. The findings leave open the potential of improving cognitive function after CEA.

Aged↗

PubMed1999

Vascular surgical society of great britain and ireland: impact of spontaneous embolization on cognitive function

BACKGROUND: Although microembolization may not be associated with focal neurological events following carotid endarterectomy (CEA), it might contribute towards cognitive impairment. METHODS: Forty-nine patients undergoing CEA underwent 30 min of preoperative ipsilateral transcranial Doppler (TCD) monitoring and a battery of tests of cognitive function, and the results were compared with those of age-matched normal controls. RESULTS: Seven patients who were spontaneously embolizing had significantly worse preoperative cognitive function scores than 42 patients with no recorded emboli (P = 0.03). Overall, patients undergoing CEA had a significant cognitive deficit compared with age-matched normal controls. CONCLUSION: Patients who have evidence of spontaneous preoperative embolization on TCD monitoring have a greater degree of preoperative cognitive impairment. This finding underlines the potential clinical importance of microembolization and suggests that this phenomenon should be investigated further.

Journal Article↗

PubMed1998

Height as a marker of childhood development and late-life cognitive function: the Honolulu-Asia Aging Study.

OBJECTIVE: Growing evidence suggests that structural and functional brain reserves, thought to develop in childhood and adolescence, may be crucial in determining when cognitive impairment begins. The purpose of this report is to examine the relationship of height, as a marker of childhood development, to late-life cognitive function in a sample of elderly Japanese-American men. METHOD: Cognitive performance was assessed from 1991 to 1993 in the Honolulu-Asia Aging Study in 3733 men aged 71 to 93 years and related to height that was measured 25 years earlier. RESULTS: Among the study sample, shorter men were older, leaner, and less educated than taller men. Shorter men also spent more years of their childhood living in Japan and were more likely to have had fathers in unskilled professions. After adjustment for age, the prevalence of poor cognitive performance declined consistently with increasing height from 25% in men shorter than 154 cm (61 in) to 9% in those taller than 174 cm (69 in). Excluding men with stroke or dementia did not alter the association between height and cognitive performance. Apolipoprotein E4 was unrelated to height and did not effect the association between height and cognitive function. The prevalence of Alzheimer's disease was higher in men who were 154 cm (61 in) or shorter as compared with men who were taller (4.7% vs 2.9%, respectively). There was no association between height and vascular dementia. CONCLUSION: Efforts to improve prenatal and early life conditions to maximize growth in childhood and adolescence could diminish or delay the expression of cognitive impairments that occur later in life. Prevention of some late-life cognitive impairments may have pediatric origins.

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PubMed2006

Effect of adjuvant breast cancer chemotherapy on cognitive function from the older patient's perspective.

PURPOSE: This longitudinal prospective study describes the older breast cancer patient's perception of the cognitive impact of adjuvant chemotherapy. METHODS: A total of 50 patients > or =age 65 with stage I to III breast cancer enrolled in this IRB-approved prospective study. Of the 50, 3 refused postchemotherapy testing and 2 had a cerebrovascular accident (CVA) during therapy, leaving 45 evaluable patients. The Squire Memory Self-Rating Questionnaire, given before and 6 months after chemotherapy, measured patients' perceptions of the ability to learn new information, of working memory, and of remote learning capabilities. RESULTS: Mean age was 70 years (range 65-84). Breast cancer stages were: I (33%), II (64%), III (2%). A 51% (23/45) of study participants perceived a decline in memory from before to 6 months after completion of chemotherapy. Patients who perceived a poorer memory than average before chemotherapy were more likely to report further memory deterioration after chemotherapy (19/30, 63%) than patients who perceived that their memory was average or better than average prior to chemotherapy (4/15, 27%). The memory domain most likely to be perceived as affected was the ability to learn new information (22/45, 49%) compared to remote memory (9/45, 20%) or working memory (13/45, 29%) capabilities. CONCLUSION: Approximately half of these older women perceived a decline in cognitive function from before to 6 months after chemotherapy. This perceived decline in cognitive function was most pronounced in patients with preexisting memory complaints. Further prospective study is needed to confirm these observations, correlate perceived memory changes with objective findings, and identify subgroups at special risk.

Aged↗

PubMedDate not supplied

Association between blood pressure and cognitive function in a biracial community population of older persons.

We examined whether or not blood pressure is related to cognitive function in a cross-sectional study of a biracial community of 5,816 persons aged 65 years and older. Blood pressure had a curvilinear association with cognitive performance in linear regression models adjusted for age, sex, race and education. Scores were lower by 2-5 percentiles at 100 mm Hg systolic pressure compared to scores at the mean of 140 mm Hg and lower by <1 percentile at 180 mm Hg. For diastolic pressure, scores were lower by 2-3 percentiles at 60 mm Hg and by 1-2 percentiles at 100 mm Hg compared to scores at the mean (77 mm Hg). The differences in the scores with low blood pressure were reduced with further adjustment for body mass index, self-perceived health status, depressive symptoms, alcohol use and smoking. The curvilinear associations were stronger among persons with histories of stroke, myocardial infarction and hypertension. The cross-sectional association between blood pressure and cognitive functions is small and curvilinear and more apparent in persons with cardiovascular conditions.

Black or African American↗

PubMed2003

Education, other socioeconomic indicators, and cognitive function.

The authors investigated the relation of educational attainment, husband's education, household income, and childhood socioeconomic status to cognitive function and decline among community-dwelling women aged 70-79 years. Information on exposures was self-reported, except for income (which was derived from census tract data). Between 1995 and 2000, six cognitive tests were administered to 19,319 Nurses' Health Study participants. Second assessments began in 2001 and are ongoing; as of April 2002, information was complete for 15,594 women. The authors used logistic regression to calculate multivariate-adjusted odds of a low baseline score (bottom 10%) and substantial decline (worst 10%), and linear regression was used to estimate adjusted mean differences in score and in decline across various levels of education and socioeconomic status. On a global score combining the results of all tests, women with a graduate degree had significantly decreased odds of a low baseline score (odds ratio = 0.49, 95% confidence interval: 0.36, 0.66) and decline (odds ratio = 0.65, 95% confidence interval: 0.50, 0.86) in comparison with women with a Registered Nurse diploma. Significantly lower mean scores and less mean decline were observed among women with a bachelor's or graduate degree than among women with a Registered Nurse diploma. Much weaker associations were evident for other socioeconomic variables. Thus, among well-educated women, educational attainment predicted cognitive function and decline, although other measures of socioeconomic status had little relation.

Aged↗