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PURPOSE The purposes of this study were to determine if (1) certain demographic characteristics (potential predictors) of participants, and (2) clock-drawing test results (as a screening test for cognitive impairment) were associated with fecal immunochemical test (FIT) sample collection errors. METHODS Patients scheduled for an upcoming colonoscopy were asked to collect stool samples using 5 different FITs. Patients completed a questionnaire that included the clock-drawing test. Errors included mistakes or omissions in recording the stool collection date and errors in stool collection. Each clock drawing was scored by 2 reviewers using 2 established methods. RESULTS Of the 1,448 participants with a clock drawing, 63% were female with a mean age of 63 years. In this population there were 83% White, 6% Black, and 24% Hispanic persons. Cognitive impairment was found in 292 patients by the Mendes-Santos method. Kappa coefficient for the 2 clock-drawing scores was 0.79 (P CONCLUSION Among the participants who do not have dementia, FIT collection errors were made not only by those who had abnormal clock drawing, but also, by those with normal clock drawings. Subjects being female, having 8th grade education or less, and having an abnormal clock drawing scored by Mendes-Santos's method were associated with FIT collection errors. Key words: clock drawing test; cognitive impairment; colorectal cancer; fecal immunochemical test; occult blood, INTRODUCTION Approximately 16% to 20% of people ages 60 or more years have mild cognitive impairment. (1) Mild cognitive impairment is described as an intermediate state between cognitively intact persons [...]

Byline: Swati. Bajpai, Ashima. Nehra, R. Pandey, Hemchand. Sati, Rajesh. Singh, Venugopalan. Vishnu, Roopa. Rajan, Manmohan. Singh, Achal. Srivastava, Padma. Srivastava, Manjari. Tripathi Background: Disability evaluation as per World Health [...]

People infected with West Nile virus often experience cognitive side effects including memory loss through unknown mechanisms; mice and humans infected with the virus experience a loss in hippocampal presynaptic terminals, which can be reversed by disrupting complement or microglia in mice. Cognitive abnormalities associated with West Nile virus A majority of West Nile virus (WNV) sufferers experience cognitive signs and symptoms, including memory dysfunction, but the mechanisms driving these impairments are largely unknown. Robyn Klein and colleagues demonstrate an enhancement of complement-mediated synaptic pruning in the hippocampus following WNV infection. This pruning required microglia and resembled developmental pruning by the same mechanism. Disruption of complement or microglia during infection protected animals from the WNV-induced memory deficits. Over 50% of patients who survive neuroinvasive infection with West Nile virus (WNV) exhibit chronic cognitive sequelae.sup.1,2. Although thousands of cases of WNV-mediated memory dysfunction accrue annually.sup.3, the mechanisms responsible for these impairments are unknown. The classical complement cascade, a key component of innate immune pathogen defence, mediates synaptic pruning by microglia during early postnatal development.sup.4,5. Here we show that viral infection of adult hippocampal neurons induces complement-mediated elimination of presynaptic terminals in a murine WNV neuroinvasive disease model. Inoculation of WNV-NS5-E218A, a WNV with a mutant NS5(E218A) protein.sup.6,7 leads to survival rates and cognitive dysfunction that mirror human WNV neuroinvasive disease. WNV-NS5-E218A-recovered mice (recovery defined as survival after acute infection) display impaired spatial learning and persistence of phagocytic microglia without loss of hippocampal neurons or volume. Hippocampi from WNV-NS5-E218A-recovered mice with poor spatial learning show increased expression of genes that drive synaptic remodelling by microglia via complement. C1QA was upregulated and localized to microglia, infected neurons and presynaptic terminals during WNV neuroinvasive disease. Murine and human WNV neuroinvasive disease post-mortem samples exhibit loss of hippocampal CA3 presynaptic terminals, and murine studies revealed microglial engulfment of presynaptic terminals during acute infection and after recovery. Mice with fewer microglia (Il34.sup.-/- mice with a deficiency in IL-34 production) or deficiency in complement C3 or C3a receptor were protected from WNV-induced synaptic terminal loss. Our study provides a new murine model of WNV-induced spatial memory impairment, and identifies a potential mechanism underlying neurocognitive impairment in patients recovering from WNV neuroinvasive disease., Author(s): Michael J. Vasek [sup.1] , Charise Garber [sup.1] , Denise Dorsey [sup.1] , Douglas M. Durrant [sup.1] [sup.2] , Bryan Bollman [sup.1] , Allison Soung [sup.1] , Jinsheng Yu [...]

Aging is the major risk factor for the development of human neurodegenerative maladies such as Alzheimer's, Huntington's and Parkinson's diseases (PDs) and prion disorders, all of which stem from toxic protein aggregation. All of these diseases are correlated with cognitive decline. Cognitive Decline is a dynamic state from normal cognition of aging to dementia. According to the original criteria for Alzheimer's Disease (AD) (1984), a clinical diagnosis was possible only when someone was already demented. The prevalence rates of Cognitive Decline (mild cognitive impairment plus dementia) are very high now and will be higher in future because of the increasing survival time of people. Many neurological and psychiatric diseases are correlated with cognitive decline. Diagnosis of cognitive decline is mostly clinical (clinical criteria), but there are multiple biomarkers that could help us mostly in research programs such as short or long, paper and pencil or computerized neuropsychological batteries for cognition, activities of daily living and behavior, electroencephalograph, event-related potentials, and imaging--structural magnetic resonance imaging (MRI) and functional (fMRI, Pittsburgh bound positron emission tomography, FDG-PET, single photon emission computerized tomography and imaging of tau pathology)--cerebrospinal fluid proteins (Abeta, tau and phospho-tau in AD and α-synuclein (αSyn) for PD). Blood biomarkers need more studies to confirm their usefulness. Genetic markers are also studied but until now are not used in clinical praxis. Finally, in everyday clinical praxis and in research workout for early detection of cognitive decline, the combination of biomarkers is useful. European Journal of Clinical Nutrition (2014) 68, 1186-1191; doi:10.1038/ejcn.2014.189; published online 1 October 2014, DEFINITIONS AND CRITERIA Cognitive Decline is a dynamic state from normal cognition to dementia, where interventions can be taken to stop or delay the progression to dementia. At early stages, [...]

Background: Assessment of the musical ability of people with schizophrenia has attracted little interest despite the diverse and substantive findings of impairments in sound perception and processing and the therapeutic effect of music in people with the illness. The present study investigated the musical ability of people with schizophrenia and the association with psychiatric symptoms and cognition. Methods: We recruited patients with chronic schizophrenia and healthy controls for participation in our study. To measure musical ability and cognitive function, we used the Montreal Battery of Evaluation of Amusia (MBEA) and the Brief Assessment of Cognition in Schizophrenia (BACS). We carried out a mediation analysis to investigate a possible pathway to a deficit in musical ability. Results: We enrolled 50 patients and 58 controls in the study. The MBEA global score in patients with schizophrenia was significantly lower than that in controls (p < 0.001), and was strongly associated with both the composite cognitive function score (r = 0.645, p < 0.001) and the negative symptom score (r = -0.504, p < 0.001). Further analyses revealed direct and indirect effects of negative symptoms on musical ability. The indirect effects were mediated through cognitive impairment. Limitations: The relatively small sample size did not permit full evaluation of the possible effects of age, sex, education, medication and cultural influences on the results. Conclusion: Examining the associations between musical deficits, negative symptoms and cognitive impairment in patients with schizophrenia may identify shared biological mechanisms., Introduction Like language, music is a universal, human-specific cultural experience. Perception, interpretation and production of music are linked to language, emotion, cognitive function and social communication in everyday life. Neurocognitive [...]

Background. There is growing interest in determining the degree of anemia, which is clinically significant. The goal of this study was to determine the association between hemoglobin concentration and cognitive impairment in a large sample of U.S. adults. Methods. We used cross-sectional data from 19,701 adults participating in the REasons for Geographic And Racial Differences in Stroke study. Cognitive impairment was defined as a score of 4 or less on the six-item screener. Hemoglobin was analyzed in 1 g/dL increments relative to the World Health Organization (WHO) threshold l< 13 g/dL for men and < 12 g/dL for women). Results. The mean hemoglobin concentration was 13.7 [+ or -] 1.5 g/dL. The prevalence of cognitive impairment increased from 4.39; among individuals with a hemoglobin >3 g/dL above the WHO threshold to 16.8c/c for those with a hemoglobin [greater than or equal to] 2 g/dL below the WHO threshold. After adjustment for demographics, chronic health conditions, health status, and inflammation, the association between reduced hemoglobin and cognitive impairment was attenuated and no longer significant, including among those with hemoglobin [greater than or equal to] 2 g/dL below the WHO threshold (odds ratio 1.39, 95% confidence interval = 0.94 2.04). A test for linear trend way of borderline significance (p value = .06). For 94% of the sample within 2 g/dL of the WHO threshold, there way no relationship between hemoglobin concentration and the odds of cognitive impairment. The associations did not differ by sex and race. Conclusions. Within a large sample of community-dwelling adults, there v, as no significant association between hemoglobin concentration and cognitive impairment after multivariable adjustment. Key Words: Hemoglobin--Anemia--Cognitive impairment. doi: 10.1093/gerona/glq126

Objectives. Many analytical methods are not very sensitive to change because of the difficulty of distinguishing short-term fluctuation from the developmental change of primary interest. The current project investigated one possible solution to this problem in the form of a measurement-burst design in which research participants perform several versions of each test at each measurement occasion. Methods. Over 1,200 adults across a wide-age range performed different versions of cognitive tests on several sessions at each measurement occasion. Results. Four methods of incorporating short-term variability were compared with respect to the magnitude of the correlations of the ability measures with each other and with respect to the magnitude of their relations with age. Conclusions. The results revealed that more sensitive assessments of change can be obtained by taking short-term fluctuation into account with measurement-burst designs. In particular, capitalizing on the availability of multiple measures at each occasion to form latent constructs representing the level and change in cognitive performance may provide the most sensitive assessment of cognitive change. Key Words: Cognitive change--Intra-individual variability--Measurement burst. doi: 10.1093/geronb/gbq060.

Personal interviews were conducted with respondents using validated survey data to assess the presence of cognitive impairment and determine the change in cognitive impairment and physical functioning among patients who survived severe sepsis. Older populations with severe sepsis were found to be independently associated with substantial and persistent new cognitive impairment and functional disability among survivors to live independently.

Background. In community-dwelling older adults, global cognitive function predicts longitudinal gait speed decline. Few prospective studies have evaluated whether specific executive cognitive deficits in aging may account for gait slowing over time. Methods. Multiple cognitive tasks were administered at baseline in 909 participants in the Health, Aging, and Body Composition Study Cognitive Vitality Substudy (mean age 75.2 [+ or -] 2.8 years, 50.6% women, 48.4% black). Usual gait speed (m/s) over 20 minutes was assessed at baseline and over a 5-year follow-up. Results. Poorer performance in each cognitive task was cross-sectionally associated with slower gait independent of demographic and health characteristics. In longitudinal analyses, each 1 SD poorer performance in global function, verbal memory, and executive function was associated with 0.003-0.004 m/s greater gait speed decline per year (p =.03-.05) after adjustment for baseline gait speed, demographic, and health characteristics. Conclusions. In this well-functioning cohort, several cognitive tasks were associated with gait speed cross-sectionally and predicted longitudinal gait speed decline. These data are consistent with a shared pathology underlying cognitive and motor declines but do not suggest that specific executive cognitive deficits account for slowing of usual gait in aging. Key Words: Aging--Cognitive function--Gait speed. doi: 10.1093/gerona/glq111

Certain micronutrients are protective against cognitive decline. We examined whether there is any uniform pattern of circulating micronutrients cross--culturally that are associated with successful cognitive aging. For the U.S. sample, we used the stored serum/plasma of 115 participants, collected in Oregon, USA. The Okinawa sample consisted of 49 participants selected using similar inclusion criteria as the Oregon sample, from the Keys to Optimal Cognitive Aging Project. All participants were aged 85 years and older without cognitive impairment. We found that the Okinawan elders used fewer vitamin supplements but had similar levels of vitamin [B.sub.12] and [alpha]-tocopherol, lower folate and [gamma]-tocopherol, compared with Oregonian elders. That is, we did not find a uniform pattern of circulating micronutrients, suggesting that micronutrients other than those examined here or other lifestyle factors than nutrition could play an important role in achieving successful cognitive aging. Key Words: Oldest old--Circulating micronutrients--Healthy cognitive aging--Okinawa--Oregon. doi: 10.1093/gerona/glq124

The major purpose of this study was to determine the effects of procyanidins extracted from the lotus seedpod on cAMP-response element-binding protein phosphorylation in hippocampus and cerebral cortex in cognitively impaired aged rats. Based on Morris water maze, aged unimpaired and aged impaired rats were chosen from aged rats. Comparing with young and aged unimpaired animals, aged impaired rats exhibited significant reduction in hippocampal but not cortical cAMP-response element-binding phosphorylation states as well as brain-derived neurotrophic factor messenger RNA and protein expressions, which were accompanied by decreased phosphorylation states of hippocampal extracellular signal-related kinase (42/44) and calcium calmodulin kinase IV. Lotus seedpod supplementation (50 and 100 mg/kg body weight intragastric administration) for 7 weeks significantly reversed all these declines happened in hippocampus except calcium calmodulin kinase IV phosphorylation levels. These results suggested that lotus seedpod might enhance cAMP-response element-binding--dependent transcription through the activation of extracellular signal-related kinase signalling pathway, which might contribute to its ameliorative effects on cognitive deficits in aged impaired animals. Key Words: Procyanidins--Memory--CREB--BDNF--ERK--Hippocampus. doi: 10.1093/gerona/glq094

Background. The move from lying to standing is typically associated with a variety of physiological and neurohumoral changes, most especially a slight increase in systolic blood pressure (SBP). Decreased efficacy of the various mechanisms that control orthostatic blood pressure (BP) regulation may result in lightheadedness, dizziness, syncope, and cerebral hypoperfusion. The lack of effective orthostatic BP regulation is a symptom for various problems, including fatigue, depression, anxiety, and reduced attention. Methods. This study examined men and women (N = 74) who were aged 30 75 years and asymptomatic for clinical orthostatic hypotension. Results. Relatively poor BP regulation in response to orthostasis was associated with decreased verbal memory, decreased concentration, and higher hopelessness scores. Conclusions. Individuals who exhibited less effective SBP regulation even to a subsyndromal degree in response to an orthostatic challenge may be at increased risk for cognitive and affective problems. The relationship between orthostatic BP regulation is best described as curvilinear. Key Words: Subclinical orthostatic hypotension--Cognition--Hopelessness. doi: 10.1093/gerona/glq068

Background. Noncancer pain and cognitive impairment affect many older adults and each is associated with functional disability, but their combined impact has yet to be rigorously studied. Methods. This is a cross-sectional analysis of the Canadian Study of Health and Aging. Pain was collapsed from a 5-point to a dichotomous scale (no and very mild vs moderate and greater). Cognitive status was dichotomized from the Modified Mini-Mental State Examination (0-100) to no (>77) or mild-moderate (77-50) impairment. Five Instrumental Activities of Daily Living (IADL) and seven Activities of Daily Living (ADL) were self-rated as 'accomplished without any help' (0), 'with some help' (I), or 'completely unable to do oneself' (2) and then summed to create a composite score of 0-10 and 0-14, respectively. Multivariate linear regression analysis was conducted to determine the associations between self-reported functional status with moderate or greater pain, cognitive impairment, and the interaction of the two. Results. A total of 5,143 (90.2%) participants were eligible, 1,813 (35.6%) reported pain at a moderate intensity or greater and 727 (14.3%) were cognitively impaired. The median 1ADL and ADL summary scores increased among the pain and cognition categories in the following order: no pain and cognitively intact (0.63 SD 1.24, 0.23 SD 0.80), pain and cognitively intact (1.18 SD 1.69.0.57 SD 1.27), no pain and cognitively impaired (1.64 SD 2.22, 0.75 SD 1.57), and pain and cognitively impaired (2.27 SD 2.47, 1.35 SD 2.09), respectively. Multivariate linear regression found IADL summary scores were associated with pain, coefficient. 17 (95% confidence interval [CI] 0.07-0.26), p < .0l; cognitive impairment, coefficient .67 (95% CI 0.51-0.83), p < .01: and an interaction effect of pain with cognitive impairment, coefficient .24 (95% CI 0.01-0.49), p = .05. ADL summary scores were associated with pain coefficient .10 (95% CI 0.04-0.17), p < .01 and cognitive impairment, coefficient .29 (95% CI 0.19-0.39), p < .01, but had a nonsignificant interaction term, coefficient. 12 (95% CI-0.03 to 0.29), p = .12. Conclusions. Noncancer pain and cognitive impairment are independently associated with IADL and ADL impairment and IADL impairment is even greater when both conditions are present. Key Words: Noncancer pain--Cognitive impairment--Function--Dementia--Older adult. doi: 10.1093/gerona/glq039

Background. Due to the increasing longevity of human populations worldwide, there is need of a useful biomarker for the early detection of cognitive impairment in elderly persons. Both high blood pressure (BP) and inflammatory processes have been reported to be involved in cognitive impairment via cerebrovascular atherosclerosis or neuronal cell damage. Methods. In this cross-sectional study of 210 ambulatory elderly hypertensive patients without clinically evident dementia (mean age: 74 years; 44% men), we measured 24-hour BP, circulatory pentraxin 3 (PTX3) and high-sensitivity C-reactive protein (hs-CRP) levels, and cognitive function (Mini-Mental State Examination [MMSE]). Results. A high plasma PTX3 level was observed in lean subjects, especially in those whose current body weight was lower than that measured 5 years earlier, whereas a high hs-CRP level was associated with obesity (all p < .05). Both PTX3 and hs-CRP levels were significantly associated with the MMSE score (r = -.248, p Conclusions. A high plasma PTX3 level in elderly hypertensive patients, particularly in those with a high 24-hour BP level, could be a significant predictor of cognitive impairment. A high PTX3 level may be a marker of frailty in elderly hypertensive patients. Key Words: Pentraxin 3--High-sensitivity C-reactive protein--Cognitive impairment--Elderly hypertensive patients. doi: 10.1093/gerona/glq030

Demonstrating a specific cognitive deficit usually involves comparing patients' performance on 2 or more tests, The psychometric confound occurs if the psychometric properties of these tests lead patients to show greater cognitive deficits in 1 domain. One way to avoid the psychometric confound is to use tests with a similar level of discriminating power, which is a test's ability to index true individual differences in classic psychometric theory. One suggested way to measure discriminating power is to calculate true score variance (L. J. Chapman & J. P. Chapman, 1978). Despite the centrality of these formulations, there is no systematic examination of the relationship between the observable property of true score variance and the latent property of discriminating power. The authors simulated administrations of free response tests and forced choice tests by creating different replicable ability scores for 2 groups, across a wide range of various psychometric properties (i.e., difficulty, reliability, observed variance, and number of items), and computing an ideal index of discriminating power. Simulation results indicated that true score variance had only limited ability to predict discriminating power (explained about 10% of variance in replicable ability scores). Furthermore, the ability varied across tests with wide ranges of psychometric variables, such as difficulty, observed variance, reliability, and number of items. Discriminating power depends on a complicated interaction of psychometric properties that is not well estimated solely by a test's true score variance. Keywords: differential deficit, generalized deficit, psychometric confound, discriminating power, simu- lation study DOI: 10.1037/a0018400

The objective of this study was to examine the relationship between the Bicycle Drawing Task and a number of neuropsychological variables, including the Repeatable Battery for the Assessment of Neuropsychological Status, in a heterogeneous group of older adults referred for a dementia evaluation. The sample consisted of 91 participants with a mean age of 77.0 yr. (SD = 6.4). The correlations between scores on the Bicycle Drawing Task and the Repeatable Battery for the Assessment of Neuropsychological Status and supplemental cognitive measures were generally in the moderate range. The Bicycle Drawing Task was not significantly related to premorbid IQ or education. As a neuropsychological measure, the task is brief, easily explained, easily scored, and well-tolerated by patients. Results suggest the Bicycle Drawing Task may be a useful screening procedure for cognitive impairment that is not significantly related to education or premorbid ability. DOI: 10.2466/PMS.109.3.721-730

Cognitive impairment and depression were investigated in older Korean women. 143 Korean women (M age = 75.8) attending four senior service community centers in Seoul participated. 27% scored as possibly demented and 15% as demented on the Korean version of the Mini-Mental State Examination. 57% scored as depressed on the Korean Geriatric Depression Scale. Younger elderly women (ages 65-74 years) displayed less cognitive impairment than older women. Older elderly Korean women (>75 yr.) who lived with their spouses scored as more cognitively stable than those who lived without spouses. Those with inadequate income scored higher on Depression, which was inversely correlated with cognitive function in the entire sample. Dementia and depression were found to be more frequent in this elderly sample than previously reported by the Korean government. DOI 10.2466/PR0.105.2.569-574

A study was conducted to evaluate the accuracy of cerebrospinal fluid (CSF) biomarkers in predicting incipient Alzheimer disease among patients with mild cognitive impairment (MCI). Results indicated that such biomarkers were accurate in predicting Alzheimers but less accurately than those from single-center studies.

Mild cognitive impairment (MCI) refers to the clinical state of subjects who suffer from some degree of cognitive deterioration but do not meet clinical criteria for dementia. The aim of this study was to analyze the magnetoencephalogram (MEG) background activity in MCI subjects using two connectivity measures: coherence and synchronization likelihood (SL). Our results showed that coherence and SL mean values were lower in the MCI group than in control group at all frequency bands (delta, theta, alpha-l, alpha-2, beta, and gamma). Significant differences were found in the beta frequency band with both measures (p < 0.05, Mann-Whitney U-test). Coherence analysis also revealed significant differences between controls and MCIs in the gamma band. Additionally, coherence and SL mean values at each frequency band were analyzed by means of receiver operating characteristic curves. The highest accuracy (69.8%) was achieved in the beta band with both connectivity measures. Our results suggest that spontaneous MEG rhythms show disconnection problems in MCI, especially in the beta band. In conclusion, both coherence and SL may be useful measures for discriminating MCI patients from control subjects. Index Terms--Beta frequency band, coherence, functional connectivity, magnetoencephalogram, mild cognitive impairment (MCI), synchronization likelihood (SL).

BACKGROUND: Recent data indicate that chronic low-level exposure to lead is associated with accelerated declines in cognition in older age, but this has not been examined in women. OBJECTIVE: We [...]

BACKGROUND: Early-life exposure to p,p'-DDT [2,2-bis(p-chlorophenyl) -1, 1, 1 - trichloroethane] is associated with a decrease in cognitive skills among preschoolers at 4 years of age. We hypothesized that genetic [...]

BACKGROUND: Several epidemiologic studies have demonstrated relationships between prenatal exposure to polychlorinated biphenyls (PCBs) and modest cognitive impairments in infancy and early childhood. However, few studies have followed cohorts of [...]