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PubMed2006

An exploratory study of the effect of mahjong on the cognitive functioning of persons with dementia.

OBJECTIVE: To explore the effect of an activity treatment-mahjong-on the cognitive functioning of persons with mild-to-moderate dementia. METHOD: Participants were 62 older persons (M(age) = 83.94, SD = 7.58) who met DSM-IV diagnosis of any dementia condition, had an initial Mini-Mental State Examination (MMSE) score < or = 24, and were able to play, yet not having played mahjong for the past six months. They were randomly assigned to play either twice (n = 33) or four times (n = 29) a week over a 16-week duration. Digit forward span, digit forward sequence, verbal memory and MMSE were measured at baseline, post-test and 1-month follow-up. RESULTS: Regardless of frequency of playing, mahjong produced consistent gains across all cognitive performance measures. It had large effect sizes on digit forward memory (1.0-1.4 for both span and sequence), moderate-to-large effect sizes on verbal memory (0.5-0.9), and a moderate effect size on MMSE (around 0.6). The effects lasted after mahjong had been withdrawn for a month, suggesting that constant practice is not necessary to achieve therapeutic effect once an initial threshold is attained. CONCLUSION: Mahjong is a viable treatment option for dementia. Because mahjong therapy basically does not require professional supervision and can be implemented as widely as space allows at a given time, the potential benefits of integrating mahjong into the daily routines of an institution are enormous vis-à-vis minimal, if any, cost to the institution.

Aged, 80 and over↗

PubMed2004

Associations between dietary intake of folate and vitamins B-12 and B-6 and self-reported cognitive function and psychological well-being in Australian men and women in midlife.

OBJECTIVES: To assess dietary intake status of folate and vitamins B-12 and B-6 in 1183 middle-aged men and women, and to examine associations between dietary intake of these vitamins and self-reported cognitive function and psychological well-being. METHODS: A population-based sample of urban and rural South Australians completed questionnaires assessing demographics, background, health, and self-reported cognitive and memory functioning and psychological well-being. Usual dietary intake status was estimated using a retrospective, self-report, quantified food frequency questionnaire. RESULTS: About 20% of both men and women had intakes of folate that were below the Recommended Daily Intake for Australia. Vitamins B-12 and B-6 were positively related to memory functioning in men, and moderate dietary intake of folate and B-6 was associated with better memory functioning in women. CONCLUSIONS: Vitamin B-12 and B-6 intakes may be positively related to the memory performance of middle-aged men and intakes at around the RDI are associated with better memory functioning for women. The investigation of the dose-response effects of B vitamin supplementation on cognition and mood in middle-aged men and women using objective measures of cognition and accounting for the influence of confounding factors such age and education would be informative.

Adult↗

PubMed1996

Relation between executive cognitive functioning and the adverse consequences of alcohol use in social drinkers.

The purpose of this study was to assess the relation between Executive Cognitive Functioning (ECF) and the adverse consequences of alcohol consumption. ECF encompasses "higher order" cognitive abilities involved in goal-directed behavior, such as attentional control, mental flexibility, planning, and self-monitoring. Impaired ECF has been shown to result in a variety of negative consequences, including excessive drug and alcohol use. Subjects were 79 nonalcoholic male social drinkers between 17 to 30 years of age. ECF was measured using three neuropsychological tests: the Wisconsin Card Sorting Test (WCST), the Conditional Associative Learning Test (CAT), and the Sequential Matching Memory Test (SMMT). Adverse drinking consequences were measured using the Drinker Inventory of Consequences (DrInC). The DrInC assesses drinking consequences in five domains: Physical, Intrapersonal, Interpersonal, Social Responsibility, and Impulse Control. Scores from the neuropsychological tests were reduced into two latent variables: one representing the WCST and the other representing the CAT and SMMT. The results indicated that errors on the CAT/SMMT variable were positively related to adverse consequences in each domain, except for physical consequences. A similar association was found between the WCST variable and impulse control consequences. These findings indicate that performance on tests measuring ECF is related to the severity of drinking consequences. Therefore, prevention and treatment outcomes may be improved by incorporating cognitive habilitation into current interventions.

Adolescent↗

PubMed1996

Hormones, mood, and cognitive functioning in postmenopausal women.

Findings from basic neuroscience have provided information on the effects of estrogen on brain morphology and chemistry that explain how this sex steroid may influence brain function. The clinical literature shows that estrogen enhances mood and specific aspects of cognitive functioning in postmenopausal women. There is also evidence that estrogenic effects on various psychological functions are dissociable and specific. Although several recent epidemiologic case-control studies have suggested a protective effect of estrogen against Alzheimer disease, these findings need to be verified by prospective, controlled investigations.

Affect↗

PubMed1986

Effects of D-Met2, Pro5-enkephalinamide on pain tolerance and some cognitive functions in man.

The effects of D-Met2, Pro5-enkephalinamide (EA) on pain tolerance and some cognitive functions have been examined in healthy male volunteers. Dihydrocodeine (DC) was used as reference substance. Applying the submaximum effort tourniquet technique EA (10 mg SC) was found to elevate the pain threshold similarly to DC (20 mg SC). Neither DC nor EA impaired the performance in the symbol cancellation test, which quantitates the intensity of attention. In this assay rather a slight improvement was detected. in addition the short-term memory performance (Wechsler test) was also improved by EA and DC. No alteration was seen in the word fluency test, an indicator of long-term (semantic) memory. The data show that EA not only improves pain tolerance but some of its mental effects are similar to those of a classical morphine congener DC.

Adult↗

PubMedDate not supplied

Executive cognitive functions as mediators of alcohol-related aggression.

A large body of literature has documented a relation between executive cognitive functioning (ECF) and aggression. ECF encompasses 'higher-order' mental abilities such as attention, planning, organization, abstract reasoning, and self-monitoring. ECF has been defined as the ability to utilize these functions to self-regulate goal-directed behaviour. The prefrontal cortex represents the primary neurological substrate that subserves ECF. Acute alcohol consumption has been shown to disrupt ECF/prefrontal cortical functioning. Literature is reviewed linking ECF/prefrontal cortical functioning, alcohol consumption, and aggressive behaviour. A hypothetical model, based on empirical data, is presented, suggesting that ECF/prefrontal cortical functioning is an underlying aetiological mechanism for the relation between acute alcohol consumption and aggressive behaviour.

Aggression↗

PubMed2003

Affective, behavioral, and cognitive functioning in adolescents with multiple suicide attempts.

The purpose of this study was to examine affective, behavioral, and cognitive functioning in adolescents with multiple suicide attempts. Forty-seven adolescents with a history of multiple suicide attempts (MA) were compared to 74 single suicide attempters (SA) on psychiatric diagnosis, depressive symptoms, affect regulation, self-mutilation, alcohol use, and hopelessness. Results revealed that the MA group was more likely to be diagnosed with a mood disorder, and reported more severe depressive symptoms and anger, in comparison to the SA group. Behaviorally, the MA group had higher rates of disruptive behavior disorders and higher levels of affect dysregulation and serious self-mutilation than the SA group. Further, greater levels of hopelessness were reported by the MA than the SA group. After controlling for a mood disorder diagnosis, only differences in anger, affect dysregulation, and serious self-mutilation remained significant. Overall, results suggest that treatment with adolescent suicide attempters might specifically target anger and affect dysregulation to reduce risk for future suicidal behavior.

Adolescent↗

PubMed1987

Reliability and validity of the Disability Rating Scale and the Levels of Cognitive Functioning Scale in monitoring recovery from severe head injury.

The Disability Rating Scale (DRS) and the Levels of Cognitive Functioning Scale (LCFS) are both widely used to monitor recovery from head injury, despite the total lack of published research on the reliability and validity of the LCFS, and the fragmented and incomplete reports on these characteristics of the DRS. Forty head-injured inpatients were evaluated with the DRS and LCFS four times weekly throughout their rehabilitation hospitalization. The DRS and LCFS were compared in terms of how consistently ratings could be made by different raters, how stable those ratings were from day to day, their relative correlation with Stover Zeiger (S-Z) ratings collected concurrently at admission, and with S-Z, Glasgow Outcome Scale (GOS), and Expanded GOS (EGOS) ratings collected concurrently at discharge, and finally in the ability of admission DRS and LCFS scores to predict discharge ratings on the S-Z, GOS, and EGOS. Results suggest that both scales possess significant degrees of test-retest and interrater reliabilities, and of concurrent and predictive validities, but the DRS surpasses the LCFS in nearly every regard. These results offer psychometric justification favoring the use of the DRS for monitoring recovery from head injury.

Adult↗

PubMedDate not supplied

Schizophrenic individuals' cognitive functioning and performance in interpersonal interactions and skills training procedures.

The purpose of this research was to determine the relationship between schizophrenic individuals' cognitive functioning and their performance in interpersonal interactions and skills training procedures. Thirty schizophrenic individuals and 15 non-mentally ill individuals were administered two versions of the Continuous Performance Test, the Span of Apprehension Test, the Digit Span Distractibility Test, the Assessment of Interpersonal Problem Solving Skills, and three elemental skills training tasks. Vigilance level as measured by the Continuous Performance Test was substantially correlated with performance in both roleplayed interactions and skills training tasks, while recall memory as measured by the Digit Span Distractibility Test was correlated with performance in the skills training tasks independently of vigilance level. Thus, the results indicated that the cognitive dysfunctions of schizophrenia are associated with poorer social functioning and with reduced performance in the elemental procedures that constitute efforts to improve that functioning.

Activities of Daily Living↗

PubMed2001

Pathological correlates of late-onset dementia in a multicentre, community-based population in England and Wales. Neuropathology Group of the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS).

BACKGROUND: We have undertaken a large unselected, community-based neuropathology study in an elderly (70-103 years) UK population in relation to prospectively evaluated dementia status. The study tests the assumption that dementing disorders as defined by current diagnostic protocols underlie this syndrome in the community at large. METHODS: Respondents in the Medical Research Council Cognitive Function and Ageing Study were approached for consent to examine the brain at necropsy. Dementia status was assigned by use of the automated geriatric examination for computer-assisted taxonomy algorithm. Neuropathological features were standardised by use of the protocol of the Consortium to Establish a Registry of Alzheimer's Disease, which assesses the severity and distribution of Alzheimer-type pathology, vascular lesions, and other potential causes of dementia. A statistical model of dementia risk related predominantly to Alzheimer-type and vascular pathology was developed by multivariate logistic regression. FINDINGS: We report on the first 209 individuals who have come to necropsy. The median age at death was 85 years for men, and 86 years for women. Cerebrovascular (78%) and Alzheimer-type (70%) pathology were common. Dementia was present in 100 (48%), of whom 64% had features indicating probable or definite Alzheimer's disease. However, 33% of the 109 non-demented people had equivalent densities of neocortical neuritic plaques. Some degree of neocortical neurofibrillary pathology was found in 61% of demented and 34% of non-demented individuals. Vascular lesions were equally common in both groups, although the proportion with multiple vascular pathology was higher in the demented group (46% vs 33%). INTERPRETATION: Alzheimer-type and vascular pathology were the major pathological correlates of cognitive decline in this elderly sample, as expected, but most patients had mixed disease. There were no clear thresholds of these features that predicted dementia status. The findings therefore challenge conventional dementia diagnostic criteria in this setting. Additional factors must determine whether moderate burdens of cerebral Alzheimer-type pathology and vascular lesions are associated with cognitive failure.

Aged↗

PubMed1996

Comparison of antiepileptic drugs on cognitive function in newly diagnosed epileptic children: a psychometric and neurophysiological study.

Using a randomized parallel group study design, we compared the cognit ive effects of carbamazepine (CBZ), phenobarbital (PB), and valproate (VPA) in children with epilepsy. Seventy-three children with newly diagnosed epilepsy were tested with the Wechsler Intelligence Scale for Children-Revised (WISC-R), Bender-Gestalt test, and auditory event-related potentials (P 300) before and 6 and 12 months after antiepileptic drug (AED) treatment. There were no significant differences in WISC-R IQs and Bender-Gestalt scores for children in any group at any of the three sessions. P 300 latencies were increased in the children receiving PB but not in children receiving CBZ and VPA. P 300 amplitudes were significantly reduced in treated children in all three groups, but amplitudes were not significantly different among the three groups. These findings suggest that PB may affect cognitive function of epileptic children and that the P 300 may be a sensitive additional procedure that can be used to assess the cognitive effect of AEDs.

Adolescent↗

PubMed1997

Physical illness and disability among elderly people in England and Wales: the Medical Research Council Cognitive Function and Ageing Study. The Analysis Group.

STUDY OBJECTIVE: This study was conducted as part of the MRC cognitive function and ageing study. It aimed to estimate the lifetime prevalence of self reported physical illnesses and other health related events, and the prevalence of limiting disability in people over 65 in six areas of England and Wales. DESIGN: Screening phase of a two stage prevalence study. SETTING: Geographically delimited areas in four urban and two rural areas including institutions. PARTICIPANTS: Random population samples of people in their 65th year and above on the sample definition date, interviewed between 1989 and 1994. In Newcastle, Nottingham, and Oxford (urban) and in Cambridgeshire and Gwynedd(rural), the sample was stratified to provide equal numbers in the 65-74 and 75 years and over age groups. In Liverpool (urban), equal numbers in the five year age groups were taken. MAIN RESULTS: Age standardised prevalences were calculated for each geographical area, sex, and age group (65-74, 75+). Many conditions were more prevalent in the older age group including stroke, Parkinson's disease, arthritis, diabetes, and shingles but hypertension was more common in the younger age group. Conditions that were more prevalent in men included angina, heart attack, stroke, head injury, and peptic ulcers while hypertension, shingles, pernicious anaemia, and thyroid disease were more common in women. There was a complex pattern of area differences for individual conditions. Cambridgeshire had generally low prevalences for many diseases, including vascular problems, Gwynedd and Newcastle had less healthy elderly populations, and Nottingham and Newcastle had the highest percentages of housebound. CONCLUSIONS: This study provides the most robust available estimates for life-time prevalence of a variety of health conditions on a regional and national basis. It shows the greatly increased prevalence of disability in the very old population, particularly women.

Age Distribution↗

PubMed1997

Profiles of cognitive functioning in subjects with neurological disorders.

This report completes a four-year funded project designed to develop a data bank of Neurobehavioral Cognitive Status Examinations (NCSE) profiles of patients with neurological based disorders. Seven facilities participated in the study. Twenty categories of neurological/ psychological disorders were obtained from the NCSE profiles of 804 patients. Four categories had a sample large enough to permit inferences about the cognitive deficits related to the specific neurologic diagnosis. Including all diagnoses, the major areas of cognitive decline were auditory memory, visual memory and construction. Subjects with dementia had similar profiles but the severity varied depending upon the diagnoses of multi-infarct dementia, dementia of unknown origin or Alzheimer's disease. Profiles of cognitive functioning appear to differ among patients with different neurological/psychological disorders. The study also illustrated unique cognitive deficits that occur with different neurologic disorders, and how NCSE profiles were able to identify specific areas of cognitive deficits in population of patients with similar neurologic insults.

Central Nervous System Diseases↗

PubMed2004

Disparities in cognitive functioning by race/ethnicity in the Baltimore Memory Study.

The Baltimore Memory Study is a cohort study of the multilevel determinants of cognitive decline in 50-70-year-old randomly selected residents of specific city neighborhoods. Prior studies have demonstrated that cognitive function differs by race/ethnicity, with lower scores in minorities than in whites, but the underlying basis for these differences is not understood. Studies have differed in the rigor with which they evaluated and controlled for such important confounding variables as socioeconomic status (SES), health-related behaviors, comorbid illnesses, and factors in the physical environment. The goal of this study was to describe differences in neurobehavioral test scores by race/ethnicity, before and after control for a four-dimensional measure of SES and health-related behaviors and health conditions, in a cross-sectional analysis of first visit data. Random samples of households in the study area were selected until enrollment goals were reached. Among the 2,351 persons on whom eligibility was determined, 60.8% were scheduled for an enrollment visit; of these, 1,140 (81.3%) were enrolled and tested. These study participants were 34.3% male and 65.7% female and were from 65 Baltimore, Maryland, neighborhoods. After adjustment for age, sex, and testing technician, there were large and statistically significant differences in neurobehavioral test scores by race/ethnicity, with African-American scores lower than those for whites, for both men and women. After adjustment for individual SES (educational status, household income, household assets, and occupational status), the average difference declined by 25.8%. After additional adjustment for SES, health-related behaviors and health conditions, and blood lead, the average difference declined another 10%, but large differences persisted; African Americans had test scores that averaged 0.43 standard deviation lower than those for whites across all neurobehavioral tests. These differences were present in all cognitive domains, including tests that would not be characterized as susceptible to differential item functioning by race/ethnicity, suggesting that the results are not due to race/ethnicity-associated measurement error.

Black or African American↗

PubMed2005

Schizophrenia patients with a history of severe violence differ from nonviolent schizophrenia patients in perception of emotions but not cognitive function.

BACKGROUND: Impaired processing of emotions may relate to violent behavior in schizophrenia patients. We compared emotional function in schizophrenia patients with and without a history of severe violent behavior. METHOD: Tests of identification and differentiation of facial emotions were performed to compare 35 patients with chronic schizophrenia or schizoaffective disorder (DSM-IV criteria) and a history of severe violent behavior with 35 non-violent schizophrenia patients and 46 healthy controls. Tests of executive function, attention, visual orientation, working memory, memory for faces and objects, and motor function were also administered. RESULTS: Violent and nonviolent schizophrenia patients showed impaired emotional and cognitive function compared with controls. Violent patients showed a significantly better ability to identify facial emotional expressions but a poorer ability to discriminate between intensity of emotions than nonviolent schizophrenia patients. There was no difference in cognitive performance between the 2 patient groups. CONCLUSION: Violent schizophrenia patients may have a better ability to identify facial emotional cues than nonviolent schizophrenia patients but may be less able to assess the intensity of these cues. This trait may contribute to conflict generation and failure to recognize resolution signals, leading to conflict escalation and violence in violence-prone schizophrenia patients.

Adult↗

PubMed1998

Cognitive function in 70-year-old men and women. A 16-year cohort difference population study.

Cohort differences in cognitive functioning were studied in two 70-year-old samples born 16 years apart, 1906/07 and 1922, and living in Göteborg, Sweden. Psychometric tests measuring verbal ability, inductive reasoning, spatial ability, perceptual speed, secondary memory, and primary memory were used. All tests showed significantly better results in the latter 70-year-old cohort. Longer education and better living conditions in this cohort help to explain the results. Differences in somatic health could not explain the cognitive differences in this population. If biological age is defined as inversely related to the remainder of an individual's life span, the increasing life expectancy also means that the 70-year olds in 1992 are biologically younger than their 1976/77 counterparts.

Aged↗

PubMed2002

Effects of acute tryptophan depletion on cognitive function in euthymic bipolar patients.

Decreasing brain 5-HT levels by acute tryptophan depletion has been shown to selectively impair cognition in healthy volunteers. In bipolar disorder, ATD causes measurable neurophysiological effects without altering mood. The purpose of this study was to examine the effects of ATD on neuropsychological performance in 14 euthymic bipolar patients. Cognitive function was evaluated 4-6 h after ingestion of a control or depleting amino-acid drink. Plasma tryptophan levels fell significantly following the depleting drink, however there were no main effects on the ID/ED set-shift task, Paired Associates Learning or Vigil. A trend towards a decrease in the proportion of perfect solutions on the Tower of London task was observed when depleted. While ATD reduces 5-HT levels in the brain, it does not appear to alter neuropsychological performance on tests of sustained attention or associative learning. Effects on specific 'executive' functions are less clear, and should be the focus for future research.

Adult↗

PubMed1995

Calculation abilities in young children with different patterns of cognitive functioning.

This study examined the arithmetic calculation abilities of kindergarten and first-grade children with different patterns of cognitive functioning: children with low language but adequate spatial abilities (Low Language; n = 33, male = 42%); children with low spatial but adequate language abilities (Low Spatial; n = 21, male = 42%); children with general delays (Delayed; n = 21, male = 48%); and children with no language or spatial impairments (Nonimpaired; n = 33, male = 48%). Each child was given a series of addition and subtraction calculations presented as nonverbal problems, story problems, and number-fact problems. Story problems and number-fact problems require mastery of conventional verbal symbols, whereas nonverbal problems do not. The findings show that nonverbal, story, and number-fact problem formats are differentially sensitive to variation in cognitive ability. The Low Language group performed significantly worse than the Nonimpaired group on story problems but not on nonverbal problems or number-fact problems. The Delayed group performed significantly worse than the Nonimpaired group on nonverbal problems as well as on story problems but not on number-fact problems. The Low Spatial group did not differ significantly from the Nonimpaired group on any of the three problem types, although the overall performance of these children was weaker. When we adjusted for finger use on number-fact problems, the Nonimpaired group outperformed both the Low Language and the Delayed groups but not the Low Spatial group. Thus, the finding that the Low Language and Delayed groups perform as well as the Nonimpaired group on number-fact problems is attributable to their greater finger use.

Child↗