Cognitive impairment in patients with bipolar disorder alone versus those with bipolar disorder comorbid with borderline personality disorder

BACKGROUND Bipolar disorder(BD)is a severe mental illness.BD often coexists with borderline personality disorders,making the condition more complex.AIM To explore the differences in cognitive impairment between patients with BD and those with BD comorbid with borderline personality disorder.METHODS Eighty patients with BD and comorbid borderline personality disorder and 80 patients with BD alone were included in groups A and B,respectively,and 80 healthy volunteers were included as controls.Cognitive function in each group was evaluated using the Chinese version of the repeatable battery for the assess-ment of neuropsychological status(RBANS),the Stroop color-word test,and the Wechsler intelligence scale-revised(WAIS-RC).RESULTS The indices of the RBANS,Stroop color-word test,and WAIS-RC in groups A and B were significantly lower than those of the control group(P<0.05).Group A had significantly longer Stroop color-word test times for single-character,single-color,double-character,and double-color,lower scores of immediate memory,visual breadth,verbal function dimensions and total score of the RBANS,as well as lower scores of verbal IQ,performance IQ,and overall IQ of the WAIS-RC compared with group B(P<0.05).Compared to group B,group A exhibited significantly longer single-character time,single-color time,double-character time,and double-color time in the Stroop color-word test(P<0.05).CONCLUSION The cognitive function of patients with BD complicated with borderline personality disorder is lower than that of patients with BD.

Impact of early refined nursing program on prognosis of middleaged and elderly patients with cognitive dysfunction combined with cerebral infarction

BACKGROUND Cerebral infarction is a local or extensive necrosis of brain tissue.Subsequently,the corresponding neurological deficits appear.The incidence of cerebrovascular diseases in China is increasing gradually.After the onset of cerebrovascular disease,the most common sequelae include movement disorders,language disorders,and cognitive dysfunction.AIM To investigate the effect of early refined nursing program on the prognosis of middle-aged and elderly patients with cerebral infarction combined with cognitive dysfunction.METHODS A retrospective study was conducted to divide 60 patients with cerebral infarction and cognitive impairment into an experimental group(n=32)and a control group(n=28).The experimental group received early intensive care every day,and the control group received daily routine care.The scores of the Mini-Mental State Examination(MMSE)and the Trail Making Test(TMT),as well as the latency and amplitude of the event-related potential P300,were used as main indicators to evaluate changes in cognitive function,and changes in BDNF,TGF-β,and GDNF expression were used as secondary indicators.RESULTS Both groups experienced notable enhancements in MMSE scores,with the experi-mental group demonstrating higher scores than the control group(experimental:28.75±2.31;control:25.84±2.87).Moreover,reductions in TMT-A and TMT-B scores were observed in both groups(experimental:TMT-A 52.36±6.18,TMT-B 98.47±10.23;control:TMT-A 61.48±7.92,TMT-B 112.63±12.55),with the experimental group displaying lower scores.P300 Latency decreased(experimental:270.63 ms±14.28 ms;control:285.72 ms±16.45 ms),while amplitude increased(experimental:7.82μV±1.05μV;control:6.35μV±0.98μV)significantly in both groups,with superior outcomes in the experimental cohort.Additionally,the levels of the growth factors BDNF,TGF-β1,and GDNF surged(experimental:BDNF 48.37 ng/mL±5.62 ng/mL,TGF-β152.14 pg/mL±4.28 pg/mL,GDNF 34.76 ng/mL±3.89 ng/mL;control:BDNF 42.58 ng/mL±4.73 ng/mL,TGF-β146.23 pg/mL±3.94 pg/mL,GDNF 30.25 ng/mL±2.98 ng/mL)in both groups,with higher levels in the experimental group.CONCLUSION For middle-aged and elderly patients with cerebral infarction and cognitive dysfunction,early refined nursing can significantly improve their cognitive function and prognosis.

Death-associated protein kinase 1 is associated with cognitive dysfunction in major depressive disorder

We previously showed that death-associated protein kinase 1(DAPK1)expression is increased in hippocampal tissue in a mouse model of major depressive disorde and is related to cognitive dysfunction in Alzheimer's disease.In addition,depression is a risk factor for developing Alzheimer's disease,as well as an early clinical manifestation of Alzheimer's disease.Meanwhile,cognitive dysfunction is a distinctive feature of major depressive disorder.Therefore,DAPK1 may be related to cognitive dysfunction in major depressive disorder.In this study,we established a mouse model of major depressive disorder by housing mice individually and exposing them to chronic,mild,unpredictable stressors.We found that DAPK1 and tau protein levels were increased in the hippocampal CA3 area,and tau was hyperphosphorylated at Thr231,Ser262,and Ser396 in these mice.Furthermore,DAPK1 shifted from axonal expression to overexpression on the cell membrane.Exercise and treatment with the antidepressant drug citalopram decreased DAPK1 expression and tau protein phosphorylation in hippocampal tissue and improved both depressive symptoms and cognitive dysfunction.These results indicate that DAPK1 may be a potential reason and therapeutic target of cognitive dysfunction in major depressive disorder.

Chronic Kidney Disease Induces Cognitive Impairment in the Early Stage

Objective Previous research indicates a link between cognitive impairment and chronic kidney disease(CKD),but the underlying factors are not fully understood.This study aimed to investigate the progression of CKD-induced cognitive impairment and the involvement of cognition-related proteins by developing early-and late-stage CKD models in Sprague-Dawley rats.Methods The Morris water maze test and the step-down passive avoidance task were performed to evaluate the cognitive abilities of the rats at 24 weeks after surgery.Histopathologic examinations were conducted to examine renal and hippocampal damage.Real-time PCR,Western blotting analysis,and immunohistochemical staining were carried out to determine the hippocampal expression of brain-derived neurotrophic factor(BDNF),choline acetyltransferase(ChAT),and synaptophysin(SYP).Results Compared with the control rats,the rats with early-stage CKD exhibited mild renal damage,while those with late-stage CKD showed significantly increased serum creatinine levels as well as apparent renal and brain damage.The rats with early-stage CKD also demonstrated significantly impaired learning abilities and memory compared with the control rats,with further deterioration observed in the rats with late-stage CKD.Additionally,we observed a significant downregulation of cognition-related proteins in the hippocampus of rats with early-stage CKD,which was further exacerbated with declining renal function as well as worsening brain and renal damage in rats with late-stage CKD.Conclusion These results suggest the importance of early screening to identify CKD-induced cognitive dysfunction promptly.In addition,the downregulation of cognition-related proteins may play a role in the progression of cognitive dysfunction.

Validity,reliability,and psychometric properties of a computerized,cognitive assessment test(Cognivue^®)Validity,reliability,and psychometric properties of a computerized,cognitive assessment test(Cognivue^®)

BACKGROUND Cognitive issues such as Alzheimer’s disease and other dementias confer a substantial negative impact.Problems relating to sensitivity,subjectivity,and inherent bias can limit the usefulness of many traditional methods of assessing cognitive impairment.AIM To determine cut-off scores for classification of cognitive impairment,and assess Cognivue®safety and efficacy in a large validation study.METHODS Adults(age 55-95 years)at risk for age-related cognitive decline or dementia were invited via posters and email to participate in two cohort studies conducted at various outpatient clinics and assisted-and independent-living facilities.In the cut-off score determination study(n=92),optimization analyses by positive percent agreement(PPA)and negative percent agreement(NPA),and by accuracy and error bias were conducted.In the clinical validation study(n=401),regression,rank linear regression,and factor analyses were conducted.Participants in the clinical validation study also completed other neuropsychological tests.RESULTS For the cut-off score determination study,92 participants completed St.Louis University Mental Status(SLUMS,reference standard)and Cognivue^®tests.Analyses showed that SLUMS cut-off scores of<21(impairment)and>26(no impairment)corresponded to Cognivue^®scores of 54.5(NPA=0.92;PPA=0.64)and 78.5(NPA=0.5;PPA=0.79),respectively.Therefore,conservatively,Cognivue^®scores of 55-64 corresponded to impairment,and 74-79 to no impairment.For the clinical validation study,401 participants completed≥1 testing session,and 358 completed 2 sessions 1-2 wk apart.Cognivue^®classification scores were validated,demonstrating good agreement with SLUMS scores(weightedκ0.57;95%CI:0.50-0.63).Reliability analyses showed similar scores across repeated testing for Cognivue^®(R2=0.81;r=0.90)and SLUMS(R2=0.67;r=0.82).Psychometric validity of Cognivue^®was demonstrated vs.traditional neuropsychological tests.Scores were most closely correlated with measures of verbal processing,manual dexterity/speed,visual contrast sensitivity,visuospatial/executive function,and speed/sequencing.CONCLUSION Cognivue^®scores≤50 avoid misclassification of impairment,and scores≥75 avoid misclassification of unimpairment.The validation study demonstrates good agreement between Cognivue^®and SLUMS;superior reliability;and good psychometric validity.

Spanish Version of Test MIS (*) with Delayed Memory Recall Normative Values and Results in a Population with Mild Cognitive Impairment

Background: Cognitive impairment becomes more common with ageing and may benefit from intervention. In a Spanish speaking population, detection of cognitive impairment by a general practitioner in Primary Care can be a problem, as many of the standard tests target English speaking populations. The Memory Impairment Screen (MIS-A) is a validated test using English words to detect Alzheimer’s Disease (AD) and other dementias. We have modified this test to suit a Spanish speaking population and added a new component, delayed recall. We have called our new test the Memory Impairment Screen with Delayed Recall (MIS-D). Objectives: 1) To test a Spanish version of MIS-A and MIS-D. 2) To assess the discriminative validity of MIS-D as a screening tool for the amnestic variant of Mild Cognitive Impairment (aMCI) in a group of Spanish speaking people aged 65 years old and over. Methods: A case-control study of a cohort of 739 native Spanish speaking residents of Buenos Aires aged 65 years old and over, of whom 436 were healthy controls and 303 had a diagnosis of aMCI. Measurements: Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NVP) were estimated for MIS-D and MIS-A. Results: Normative values for MIS-A and MIS-D were obtained from the control population. Both age and education significantly affected these values (p < 0.0001). Control participants showed significant differences for both modalities, MIS-A and MIS-D. The cut-off for MIS-A should be 7.5 and for MIS-D, 5.5. Comparison between control population and aMCI population using ROC curve gave a result of 5.5 in MIS-D, with 97% specificity and 76% sensitivity. Conclusion: MIS-D was positively predictive of aMCI, with 97% specificity and 76% sensitivity in a sample of Spanish speaking patients aged 65 years old and over in Buenos Aires.

Usefulness of the Japanese version of Rapid Dementia Screening Test for mild cognitive impairment in older patients with cardiovascular disease:a cross-sectional study

BACKGROUND Cognitive decline is common among older patients with cardiovascular disease(CVD) and can decrease their self-management abilities. However, the instruments for identifying mild cognitive impairment(MCI) are not always feasible in clinical practice. Therefore, this study evaluated whether MCI could be detected using the Japanese version of the Rapid Dementia Screening Test(RDST-J), which is a simple screening tool for identifying cognitive decline.METHODS This retrospective single-center study included patients who were ≥ 65 years old and hospitalized because of CVD.Patients with a pre-hospitalization diagnosis of dementia were excluded. Each patient's cognitive function had been measured at discharge using the RDST-J and the Japanese version of the Montreal Cognitive Assessment(Mo CA-J), which is a standard tool for MCI screening. The correlation between the two scores was evaluated using Spearman's rank correlation coefficient. Receiver operating characteristic(ROC) analysis was also to evaluate whether the RDST-J could identify MCI, which was defined as a Mo CA-J score of ≤ 25 points.RESULTS The study included 78 patients(mean age: 77.2 ± 8.9 years). The RDST-J and Mo CA-J scores were strongly correlated(r = 0.835, P < 0.001). The ROC analysis revealed that an RDST-J score of ≤ 9 points provided 75.4% sensitivity and 95.2% specificity for identifying MCI, with an area under the curve of 0.899(95% CI: 0.835-0.964). The same cut-off value was identified when excluding patients with a high probability of dementia(RDST-J score of ≤ 4 points).CONCLUSIONS The RDST-J may be a simple and effective tool for identifying MCI in older patients with CVD.

Designing of A Computerized Cognitive Adaptive Testing Model

Therecouldbenoscienceasweknowitwithoutmeasurement.Testing,includingallformsoflanguagetestingandpsychometricsitself,isoneformofmeasurement.Alanguagetestmaybedefinedasaprocedureforelicitinglanguageperformanceandaprocedureforassessingthatperformance.How...

Does Cognitive Interference Induce Measurement Bias in Cognitive Ability Tests?

The aim of this paper was to test for measurement bias, due to cognitive interference on cognitive ability tests, using a structural equation modeling technique. The sample consisted of 231 undergraduate students who were examined with three tests addressed to numerical ability, space visualization and inductive ability, respectively. They were also asked to respond to the Cognitive Interference Questionnaire tapping task-oriented worries while working on the aforementioned tests. In comparing two nested models, one hypothesizing measurement bias due to cognitive interference and one not, results show that the test tapping inductive ability displays measurement bias due to cognitive interference.

Performance of the walking trail making test in older adults with white matter hyperintensities

BACKGROUND Several studies have reported that the walking trail making test(WTMT)completion time is significantly higher in patients with developmental coordination disorders and mild cognitive impairments.We hypothesized that WTMT performance would be altered in older adults with white matter hyperintensities(WMH).AIM To explore the performance in the WTMT in older people with WMH.METHODS In this single-center,observational study,25 elderly WMH patients admitted to our hospital from June 2019 to June 2020 served as the WMH group and 20 participants matched for age,gender,and educational level who were undergoing physical examination in our hospital during the same period served as the control group.The participants completed the WTMT-A and WTMT-B to obtain their gait parameters,including WTMT-A completion time,WTMT-B completion time,speed,step length,cadence,and stance phase percent.White matter lesions were scored according to the Fazekas scale.Multiple neuropsychological assessments were carried out to assess cognitive function.The relationships between WTMT performance and cognition and motion in elderly patients with WMH were analyzed by partial Pearson correlation analysis.RESULTS Patients with WMH performed significantly worse on the choice reaction test(CRT)(0.51±0.09 s vs 0.44±0.06 s,P=0.007),verbal fluency test(VFT,14.2±2.75 vs 16.65±3.54,P=0.012),and digit symbol substitution test(16.00±2.75 vs 18.40±3.27,P=0.010)than participants in the control group.The WMH group also required significantly more time to complete the WTMT-A(93.00±10.76 s vs 70.55±11.28 s,P<0.001)and WTMT-B(109.72±12.26 s vs 82.85±7.90 s,P<0.001).WTMT-A completion time was positively correlated with CRT time(r=0.460,P=0.001),while WTMT-B completion time was negatively correlated with VFT(r=-0.391,P=0.008).On the WTMT-A,only speed was found to statistically differ between the WMH and control groups(0.803±0.096 vs 0.975±0.050 m/s,P<0.001),whereas on the WTMT-B,the WMH group exhibited a significantly lower speed(0.778±0.111 vs 0.970±0.053 m/s,P<0.001)and cadence(82.600±4.140 vs 85.500±5.020 steps/m,P=0.039),as well as a higher stance phase percentage(65.061±1.813%vs 63.513±2.465%,P=0.019)relative to controls.CONCLUSION Older adults with WMH showed obviously poorer WTMT performance.WTMT could be a potential indicator for cognitive and motor deficits in patients with WMH.

Population Normative Data of the Moroccan Arabic Version of Three Components of the 10/66 Dementia Research Group Cognitive Test Battery;with Moroccan Illiterate and Semi-Illiterate Subjects

The aim of this study was to provide normative data of the Moroccan Arabic version of the 10/66 Dementia Research Group cognitive test battery and to explore the effects of age, education/illiteracy, and gender on the performance of these tests. One hundred healthy subjects (67 illiterates and 33 semi-illiterates) participated in this study. None of the participants had serious medical, psychiatric, or neurological disorders including dementia. The protocol included the administration of three components of the 10/66 Dementia Research Group cognitive test battery;Community Screening Instrument for Dementia (CSI “D”, generating the COGSCORE measure of global function), and the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) verbal fluency (VF), word list memory (WLM, immediate recall) tests. All the test scores were not significantly influenced by sex and age. There was no significant effect of education/illiteracy on the CERAD verbal fluency (VF) and Word List Memory (immediate recall) test scores, but a weakly significant (p < 0.05) effect on the CSI “D” COGSCORE performance. These normative data will be useful for clinical interpretations of the three components of the 10/66 Dementia Research Program protocol in illiterate and semi-illiterate Moroccan subjects with cognitive disorders.

Subjective Cognitive Concerns and Attitudes toward Genetic Testing Are Associated with Depressive Symptoms and Quality of Life after Genetic Testing for the Cerebral Cavernous Malformation Common Hispanic Mutation (CCM1)

Purpose: This study aimed to characterize mood and quality of life and to examine the associations of these areas with subjective cognitive concerns and attitudes toward genetic testing for the Common Hispanic Mutation, a gene that has been associated with increased risk for CCM1. Method: Fifty-four adults with previous genetic testing for the Common Hispanic Mutation completed a mail survey that included assessments of the above identified areas. Results: Self-reported depressive symptoms and quality of life did not differ between those with positive and negative genetic test results. The negative group expressed a more favorable attitude toward genetic testing (p p = 0.06). Using generalized linear regression, more subjective cognitive concerns were associated with poorer quality of life and more depressive symptoms (p p Conclusions: Subjective cognitive concerns and negative attitudes toward genetic testing may influence emotional well-being after genetic testing for the Common Hispanic Mutation. Additional research is needed that uses objective neuropsychological measures to understand the associations of subjective cognitive concerns, emotional well-being, and cognitive test performance in individuals with CCM1. There is also a need for research that focuses on protective factors and resiliency following genetic testing for CCM1 and the development of mental health interventions to preempt psychosocial difficulties.

Validation of the Trail Making Test B for the Cognitive Assessment of Patients with Cancer in Palliative Care

Introduction: Cognitive impairment is common in patients with cancer;however, studies examining the adaptation and validation of instruments for use in patients with cancer are scarce. Purpose: The purpose of this study was to validate the Trail Making Test B (TMT-B) for use in patients with cancer. Methods: Ninety-four outpatients receiving palliative treatment and 39 healthy companions were assessed. Patients were tested with the TMT-B and answered questions regarding the presence and intensity of pain, fatigue, quality of sleep, anxiety, and depression, at two time points with a 7-day inter-assessment interval. Results: The instrument discriminated between patients, who were slower, and healthy companions with respect to the time required to complete the test, but not in terms of the number of errors. The test was stable for the healthy companions across the two assessments in terms of time to complete the TMT-B and the number of errors;for patients, the instrument was stable only for the number of errors. Performance on the TMT-B did not correlate with pain, fatigue, depression, anxiety, or sensation of rest. Conclusions: TMT-B cannot be considered fully validated. Further studies incorporating and comparing other instruments evaluating executive function and mental flexibility are needed.

Does a combined intervention program of repetitive transcranial magnetic stimulation and intensive occupational therapy affect cognitive function in patients with post-stroke upper limb hemiparesis?

Low-frequency repetitive transcranial magnetic stimulation（LF-r TMS） to the contralesional hemisphere and intensive occupational therapy（i OT） have been shown to contribute to a significant improvement in upper limb hemiparesis in patients with chronic stroke. However, the effect of the combined intervention program of LF-r TMS and i OT on cognitive function is unknown. We retrospectively investigated whether the combined treatment influence patient＇s Trail-Making Test part B（TMT-B） performance, which is a group of easy and inexpensive neuropsychological tests that evaluate several cognitive functions. Twenty-five patients received 11 sessions of LF-r TMS to the contralesional hemisphere and 2 sessions of i OT per day over 15 successive days. Patients with right- and left-sided hemiparesis demonstrated significant improvements in upper limb motor function following the combined intervention program. Only patients with right-sided hemiparesis exhibited improved TMT-B performance following the combined intervention program, and there was a significant negative correlation between Fugl-Meyer Assessment scale total score change and TMT-B performance. The results indicate the possibility that LF-r TMS to the contralesional hemisphere combined with i OT improves the upper limb motor function and cognitive function of patients with right-sided hemiparesis. However, further studies are necessary to elucidate the mechanism of improved cognitive function.

Modeling and Simulation for Complex Repairable System with Built-in Test Equipment

In order to research the effects of built-in test(BIT) on the system and select BITand test strategy,the complex repairable systems with BITequipment are modeled and simulated by using Simulink.Based on the model,the influences of different built-in test equipments,maintenance time and error probabilities on the system usability are evaluated.The simulation results showthat they effect on the system differently.The simulation method of complex system based on Simulink provides a technique approach to research the effects of BITon the system and select BITand test strategy.

Cognitive screening for adult psychiatric outpatients: Comparison of the Cognivue® to the Montreal Cognitive Assessment

In this editorial we comment on the article by Cahn-Hidalgo D published in a recent issue of the World Journal of Psychiatry 2020;10(1);1-11.We focus on the importance of utilizing psychometrically valid cognitive screening tools when assessing for cognitive decline in older adults in a psychiatric outpatient setting.We compared the use of Cognivue®to use of the montreal cognitive assessment(MoCA)as a cognitive screening tool.A total of 58 patients aged 55 and over participated in this comparison study.Patients completed cognitive screening on Cognivue®,a new Food and Drug Administration-cleared computer screening device,and the MoCA.The results of patient performance using these two instruments were analyzed.Sixteen(28%)patients screened negative for cognitive impairment on both assessments.Forty-two(72%)patients screened positive on one or both of the assessments.There was 43%agreement between Cognivue®and the MoCA in identifying patients with cognitive impairment,and individual subtests were weakly correlated.The MoCA was determined to be the preferred instrument due to its high sensitivity and specificity(100%and 87%,respectively)when screening for cognitive impairment.We propose that the use of Cognivue®cognitive screening tool be closely reviewed until more research proves that the test meets the standards for reliability and validity.It is important for clinicians to remember that screeners should not be used to diagnosis patients with neurocognitive disorders;instead,they should be used to determine whether further evaluation is warranted.Additionally,misdiagnosing of neurocognitive disorders can pose unnecessary psychological and emotional harm to patients and their families and also lead to incorrect treatment and undue healthcare costs.

Active video games in fully immersive virtual reality elicit moderate-to-vigorous physical activity and improve cognitive performance in sedentary college students

Background:Active video games are a new method for increasing physical activity(PA).Fully immersive virtual reality(VR)is a hardware device on which an active video game can run.Active(video games in)VR(AVR),might increase immersion,game engagement,and moderate-to-vigorous PA(MVPA),thereby yielding greater exercise-related benefits,e.g.,cognitive performance.Methods:We examined the induction of MVPA via an AVR and a sedentary VR(SVR)as well as the effects of VR play on cognitive performance,which was monitored using 2 different methods.Each of 29 sedentary college students attended three 20-min laboratory sessions(AVR,SVR,or control)in a randomized order;during the control session,they sat quietly doing nothing.A fully immersive headset was used for the 2 video game sessions.We monitored and computed participants’PA using hip-wom accelerometers(wGT3 x-bt;ActiGraph,Pensacola,FL,USA)and a heart rate band(Polar H7;Polar,Kempele,Finland).After each session,the participants completed a mnemonic similarity test(MST)to measure recognition memory.They also filled out a motion sickness questionnaire and an abbreviated game experience questionnaire.Results:The AVR session induced a significantly greater heart rate and more time spent in MVPA than did either of the other 2 sessions regardless of the PA monitoring method.AVR elicited greater game experience questionnaire-assessed sensory and imaginative immersion,challenge,and positive affect than did SVR.The mnemonic similarity test recognition score was marginally higher post-AVR session than it was post-SVR session.Conclusion:AVR elicited MVPA without a significant increase in motion sickness and induced a better game experience and better borderline cognitive performance than did SVR.

Cognitive Functional Impairment and Hemodynamic Changes in Patients with Symptomatic Leukoaraiosis

Objective: The pathogenesis of leukoaraiosis is still unclear. Many studies have determined that changes in the hemodynamics associated with leukoaraiosis, impaired cerebrovascular reserve, and intracranial hypoperfusion can lead to various clinical manifestations such as motor or cognitive impairment. The purpose of this study was to investigate the relationship between cognitive functional changes and imaging characteristics in patients with symptomatic leukoaraiosis, and to observe the corresponding changes in hemodynamics. Methods: A total of 203 Han patients (aged 43 - 93 years) with symptomatic leukoaraiosis were included in this study. Head magnetic resonance imaging was semi-quantified according to the Fazekas grading standard. Then, each patient was evaluated in terms of cognitive (Montreal scale) and executive function (trail-making test A [TMTA] and TMTB). Specifically, the TMTA asks patients to connect points on a piece of paper numbered from 1 to 25 in order and the TMTB asks patients to arrange numbers and letters in alternating order. In the current work, revised versions of these tests used are to include numbers in square and circular shapes where the shapes needed to be arranged in alternating order. The time required to complete the TMTA and TMTB was recorded. The changes in the blood flow velocity of the middle cerebral artery were also observed using routine Transcranial Doppler ultrasound and the breath-holding test. The dynamic curves of blood flow velocity during the breath-holding test were examined. Results: The cognitive and executive functions of patients with leukoaraiosis are related to the classification of image-based disease characteristics. In this sense, the more serious the leukoaraiosis is, the larger the impairment of cognitive and executive function is. According to the breath-holding test, the peak pattern of the blood flow velocity in the middle cerebral artery was significantly different between the various grades of leukoaraiosis. The peak type of Fazekas grade 0 and I was in the same direction, while the peak type of Fazekas grade II and III was significantly opposed (both p Conclusions: The impairment of cognitive and executive functions in patients with leukoaraiosis correlates with the severity of image-based disease manifestations, which are generally depicted as intracranial hypoperfusion.

Cognitive Effects of Late Life Depression: Review of Neuropsychological Findings

Normal aging and depression both slow information processing speed which leads to poorer attentional control, shallower inhibition monitoring, poorer encoding, poorer updating of short term memory, and subsequent poorer learning, set-shifting, error monitoring, inhibition control, and cognitive planning. A combination of aging and depression amplifies these cognitive effects. Deterioration in frontal brain functioning in normal aging is irreversible, but altering of frontal brain function due to depression may be reversible. Since the symptoms are indistinguishable, it is difficult to separate effects of depression and aging with use of neuropsychological tests, even when premorbid history is known. Statistical group effects show more severe cognitive effects in late life depression than in normal aging or depression in younger persons, but no particular cognitive markers of depression in older subjects have been identified. Attention and inhibition are closely related, but their relationship needs to be studied further. It is not clear, whether a problem with inhibition of irrelevant stimuli occurs because of attentional deficits due to late life depression, or if it is a primary consequence of the depression. Further studies on the relationship between inhibition, attention and processing speed involving homogeneous depressed and non-depressed groups of different age may help disentangle this relationship.