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Objective Dementia is one of the most feared diseases in American society. However, limited research exists regarding how worrying about dementia may influence peoples' cognitive abilities. The current study examines how dementia worry affects performance on neuropsychological domains of executive function, memory, attention, and processing speed in a healthy older adult population. Method Participants (n  = 40) were screened for depression using the Patient Health Questionnaire-8 (PHQ-8, scores > 10 were excluded) and for mild cognitive impairment using the Telephone Interview for Cognitive Status (TICS, scores < 32 were excluded). All participants were administered common neuropsychological tests of executive function, memory, attention, and processing speed. Participants were also asked to complete the Dementia Worry Scale (DWS), a measure assessing the level of dementia worry individuals experience in daily life. Results A multivariate effect of dementia worry on neuropsychological measures of executive function was supported. Specifically, higher levels of dementia worry were significantly related to poorer performance on combined measures of executive function (Wilk's Lambda = 0.821, F (2, 36) = 3.934, p  = .028). Conclusions Dementia worry significantly affects scores on specific neuropsychological measures. Inasmuch, dementia worry may have both functional implications for older adults, as well as assessment implications for practicing neuropsychologists. Further research is necessary to parse apart whether dementia worry represents a psychological variable affecting cognitive performance and/or serves as an early marker of cognitive decline. [ABSTRACT FROM AUTHOR]

Individuals who carry the apolipoprotein E &varepsilon;4 polymorphism have an increased risk of late-onset Alzheimer’s disease. However, because possession of the &varepsilon;4 allele confers an increased risk for the diagnosis of dementia, it has proven problematic in older individuals to dissociate the influence of &varepsilon;4 on cognitive capacity per se as distinct from its influence on clinical diagnostic status. We report a statistical approach that attempts to partial out the influence of diagnostic group membership (Alzheimer’s disease, mild cognitive impairment, healthy control) from the influence of apolipoprotein &varepsilon;4 genetic status on cognitive functioning. The cognitive phenotype hypothesis predicts that &varepsilon;4-positive individuals will show cognitive deficits (relative to matched &varepsilon;4-negative individuals) independent of the development of Alzheimer’s disease. By contrast, the prodromal/preclinical Alzheimer’s disease hypothesis proposes that the effect of apolipoprotein E status on cognitive performance is a function of the increased risk of dementia in individuals with the &varepsilon;4 allele. We evaluated these hypotheses in the Australian Imaging, Biomarkers and Lifestyle cohort (n = 1112). We first determined whether previously reported findings concerning &varepsilon;4 status and age-related neuropsychological performance could be explained by the inadvertent recruitment of people with mild cognitive impairment into the healthy control group. We then tested each diagnostic group in isolation to identify any neuropsychological patterns that may be attributed to the &varepsilon;4 allele. Finally, as interactions between the &varepsilon;4 allele and age have previously been reported in cognitive functioning within healthy elderly populations, we attempted to determine whether the inclusion of mild cognitively impaired individuals in the sample may drive this relationship. An extensive battery of standardized, well-validated neuropsychological tasks was administered to a final sample of 764 healthy control subjects, 131 individuals with mild cognitive impairment and 168 individuals with Alzheimer’s disease. The effect of the &varepsilon;4 allele on cognitive performance was assessed using a statistical mediation analysis and supplemented with Bayesian methods to address a number of the limitations associated with Fisherian/Neyman-Pearsonian significance testing. Our findings support the prodromal/preclinical Alzheimer’s disease hypothesis and do not support the concept of a distinctive &varepsilon;4-related cognitive phenotype. [ABSTRACT FROM PUBLISHER]

Executive functions (EFs) are vulnerable to disruption in pediatric-onset multiple sclerosis (MS) patients. We describe the pattern and correlates of executive dysfunction in 34 adolescents with MS on neuropsychological tests and the parent version of the Behavior Rating Inventory of Executive Function (BRIEF). The adolescents with MS performed lower than age-matched controls in several areas of executive functioning, with 44% of patients being impaired on the Trail Making Test–Part B. On the BRIEF, problems in working memory and planning/organization were identified in the patient group compared with controls, particularly in patients with a younger age at disease onset. Task performance and parent-ratings of EF skills were strongly related to whole brain and regional brain volume metrics and, to a lesser extent, T2-weighted lesion volume. Working memory and attention switching are at greatest risk of impairment. Results support the inclusion of neuropsychological assessment alongside parent-report measures of EF skills in childhood-onset MS. [ABSTRACT FROM AUTHOR]

Research has shown conflicting results with regard to the influence of depression and anxiety on neuropsychological performance following coronary artery bypass graft (CABG) surgery. Notably, the independent effects of depression and anxiety have not been examined among CABG candidates in the longer term where it is has been suggested that these patients show marked cognitive deterioration. A neuropsychological test battery and measures of psychological distress were completed by 86 CABG patients and 50 nonsurgical control participants at baseline and 6 months, whereas 75 patients and 36 controls, respectively, completed a 5-year follow-up. In CABG patients, cognitive and affective depressive symptoms were independently associated with lower and worse performance on the Boston Naming Test, Purdue Peg Board, and Digit Symbol Coding 6 months after surgery, whereas at 5-year follow-up an effect for Digit Symbol persisted, and an association was also observed for the Trail Making Test (TMT). On average, CABG patients performed worse on TMT and Digit Symbol at 6 months, whereas at 5-year follow-up their performance was worse on short-term delayed verbal recall. The results among the CABG patients did not show a consistent pattern of association between psychological distress and those neuropsychological domains that were on average significantly lower than a nonsurgical control group. The results here also support the use of nonbiased statistical methodology to document dysfunction among heterogeneous cognitive domains after CABG surgery. [ABSTRACT FROM PUBLISHER]

Abstract: This study examined postconcussion-like symptoms in a group of university students and explored their relationships to neuropsychological function performance. A sample of 124 students was recruited. All of the participants received the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) and completed a comprehensive set of neuropsychological tests. They reported a relatively high base rate of postconcussion-like symptoms. The most frequently endorsed items were “fatigue” (76.9%), “longer time to think” (60.3%), “poor concentration” (58.7%), “sleep disturbance” (50.4%), and “frustration” (46.3%). There were no significant differences between low symptom reporters and high symptom reporters, except for self-reported dysexecutive problems. A comparison of the healthy high symptom reporters and a convenient sample of traumatic brain injury patients revealed that the patients performed significantly worse on neuropsychological functions than the high symptom reporters, despite non-significant differences between symptom endorsement. Our findings demonstrate that: (a) the base rate of postconcussion-like symptoms in a group of healthy university students is relatively high and (b) postconcussion symptom (PCS) is not related to neuropsychological functions in normal people. [Copyright &y& Elsevier]

Objective. Chronic pain and cognitive impairment are prevalent and disabling in older adults (OA), but their interrelationship has not been rigorously tested. We did so in OA with chronic low back pain (CLBP). Design. A total of 323 OA (160 pain-free, 163 CLBP; mean age 73.5 years, 45% female) had neuropsychological (NP) testing with the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test, and the Grooved Pegboard Test. Pain intensity was measured with the McGill Pain Questionnaire Short Form. Physical performance (gait speed, functional reach, chair rise, trunk rotation, and static/dynamic lifting), psychosocial disruption (Geriatric Depression Scale, the Short Form-36 Mental Health and Role Limitations-Emotional Composite scale), and self-reported disability (Functional Status Index, the Short From-36 Physical Functioning/Role-Physical Composite scale) were also measured. Setting. Outpatient research laboratory. Results. There were no group differences in age, gender, or educational level, but significant differences in NP scores ( P = 0.01) were found. Five scales accounted for the differences: immediate memory ( P = 0.002), language ( P = 0.004), delayed memory ( P = 0.04), mental flexibility (Trails B [ P = 0.02]), and Grooved Pegboard ( P = 0.05). NP scores were significantly correlated with physical performance ( R2 = 0.30, P < 0.001), but not self-reported disability ( R2 = 0.04, P = 0.52) or psychosocial disruption ( R2 = 0.05, P = 0.46). NP function was correlated with pain intensity ( R2 = 0.17, P < 0.001), and NP function mediated the relationship between pain and physical performance. Conclusions. OA with CLBP demonstrated impaired NP performance as compared with pain-free OA. Further, pain severity was inversely correlated with NP performance, and NP performance mediated the relationship between pain and physical performance. Future research should examine whether cognitive function and impaired physical performance can be improved with pain reduction. [ABSTRACT FROM AUTHOR]

Abstract: The effect of depression and anxiety upon neuropsychological test scores of candidates for coronary artery bypass graft (CABG) surgery was examined. Sixty patients were administered the Beck Depression Inventory II and the State-Trait Anxiety Inventory, along with a battery of neuropsychological tests. Regression analyses were conducted in which the neuropsychological test scores were predicted using age, education, depression, anxiety, and combined depression-anxiety scores. While age and education were significant predictors of several neuropsychological test measures, no significant regression analysis results were obtained for the depression, anxiety and combined depression-anxiety scores. Similarities and discrepancies between this research and previous studies are discussed. It appears that low levels of preoperative depression and anxiety states do not affect neuropsychological functioning among CABG candidates. [Copyright &y& Elsevier]