Current limitations of neuropsychological tests and assessment procedures.

Objective: Neuropsychological tests are used for a wide variety of purposes: assessing basic cognitive abilities or disabilities; determining cognitive patterns associated with brain disorders or injury; exploring brain-behavior relationships; and, in some cases, addressing psycho-legal issues. This paper will focus on the limitations of current neuropsychological tests for these purposes.

Method: Current limits of neuropsychological tests and assessment procedures are reviewed and recommendations for improvements are made.

Pathologies Underlying Longitudinal Cognitive Decline in the Oldest Old.

Background: Understanding contributions of different brain pathologies to domain-specific cognitive trajectories in the oldest old is crucial to guide future intervention studies.

Methods: Two-hundred-twenty Oregon Alzheimer's Disease Center research participants who were cognitively intact at entry were followed on average for 7.3 years with annual neuropsychological testing until death (mean age, 93.

Cognitive Skills and the Aging Brain: What to Expect.

Whether it's a special episode on the PBS series, "The Secret Life of the Brain" or an entire issue dedicated to the topic in the journal Science, a better understanding of the aging brain is viewed as a key to an improved quality of life in a world where people live longer. Despite dementia and other neurobiological disorders that are associated with aging, improved imaging has revealed that even into our seventies, our brains continue producing new neurons. Our author writes about how mental health functions react to the normal aging process, including why an aging brain may even form the basis for wisdom.

Computer mouse movement patterns: A potential marker of mild cognitive impairment.

Introduction: Subtle changes in cognitively demanding activities occur in MCI but are difficult to assess with conventional methods. In an exploratory study, we examined whether patterns of computer mouse movements obtained from routine home computer use discriminated between older adults with and without MCI.

Methods: Participants were 42 cognitively intact and 20 older adults with MCI enrolled in a longitudinal study of in-home monitoring technologies.

Embedded Online Questionnaire Measures Are Sensitive to Identifying Mild Cognitive Impairment.

Background/aims: Early changes in cognitively demanding daily activities occur between normal cognition and the development of mild cognitive impairment (MCI). These real-world functional changes as early signals of cognitive change form a prime target for meaningful early detection of dementia. We examined whether passive aspects of responding to a remotely monitored weekly online questionnaire discriminated between older adults with and without MCI.

Memory Complaints in Older Adults: Prognostic Value and Stability in Reporting over Time.

Objective: The purpose of this longitudinal study was to examine the prognostic value of subjective memory complaints in 156 cognitively intact community-dwelling older adults with a mean age of 83 years.

Methods: Participants were assessed for subjective memory complaints, cognitive performance, functional status, and mood at annual evaluations with a mean follow-up of 4.5 years.

The impact of sleep on neuropsychological performance in cognitively intact older adults using a novel in-home sensor-based sleep assessment approach.

The relationship between recent episodes of poor sleep and cognitive testing performance in healthy cognitively intact older adults is not well understood. In this exploratory study we examined the impact of recent sleep disturbance, sleep duration, and sleep variability on cognitive performance in 63 cognitively intact older adults using a novel unobtrusive in-home sensor-based sleep assessment methodology. Specifically, we examined the impact of sleep the night prior, the week prior, and the month prior to a neuropsychological evaluation on cognitive performance.

Plasma omega-3 PUFA and white matter mediated executive decline in older adults.

Introduction: Cross-sectional studies have identified long chain omega-3 polyunsaturated fatty acids (eicosapentaenoic acid 20:5n-3 and docosahexaenoic acid 22:6n-3 (O3PUFA) in association with fewer white matter lesions and better executive function in older adults. We hypothesized that O3PUFA are associated with less executive decline over time and that total white matter hyperintensity volume (WMH) mediates this association.

Methods: Eighty-six non-demented older adults were followed over 4 years after measurement of plasma O3PUFA with annual evaluations of cognitive function.

Neuropathologic basis of white matter hyperintensity accumulation with advanced age.

Objective: To determine which vascular pathology measure most strongly correlates with white matter hyperintensity (WMH) accumulation over time, and whether Alzheimer disease (AD) neuropathology correlates with WMH accumulation.

Methods: Sixty-six older persons longitudinally followed as part of an aging study were included for having an autopsy and >1 MRI scan, with last MRI scan within 36 months of death. Mixed-effects models were used to examine the associations between longitudinal WMH accumulation and the following neuropathologic measures: myelin pallor, arteriolosclerosis, microvascular disease, microinfarcts, lacunar infarcts, large-vessel infarcts, atherosclerosis, neurofibrillary tangle rating, and neuritic plaque score.

Neuropathologic basis of age-associated brain atrophy.

Importance: While brain volume changes are used as surrogate markers for Alzheimer disease neuropathology in clinical studies, the extent to which these changes are due to pathologic features of Alzheimer disease in the aging brain is not well established. This study aims to clarify the neuropathologic correlates of longitudinal brain atrophy.

Objective: To examine the association between brain atrophy during life and neuropathology in an elderly population.

Ginkgo biloba does not improve cognitive function in MS: a randomized placebo-controlled trial.

Objective: To determine whether Ginkgo biloba extract (ginkgo) improves cognitive function in persons with multiple sclerosis (MS).

Methods: Persons with MS from the Seattle and Portland VA clinics and adjacent communities who scored 1 SD or more below the mean on one of 4 neuropsychological tests (Stroop Test, California Verbal Learning Test II [CVLT-II], Controlled Oral Word Association Test [COWAT], and Paced Auditory Serial Addition Task [PASAT]) were randomly assigned to receive either one 120-mg tablet of ginkgo (EGb-761; Willmar Schwabe GmbH & Co, Germany) or one placebo tablet twice a day for 12 weeks. As the primary outcome, we compared the performance of the 2 groups on the 4 tests at exit after adjusting for baseline performance.

Executive function predicts risk of falls in older adults without balance impairment.

Background: Executive dysfunction has previously been found to be a risk factor for falls. The aim of this study is to investigate the association between executive dysfunction and risk of falling and to determine if this association is independent of balance.

Methods: Participants were 188 community-dwelling individuals aged 65 and older.

Measurement of reaction time in the home for people with dementia: a feasibility study.

Background: Cognitive decline is the cardinal symptom of dementia. Accurate measurement of changes in cognition, while essential for testing interventions to slow cognitive decline, can be challenging in people with dementia (PWD). For example, the laboratory environment may cause anxiety and negatively affect performance.

Serial position effects in mild cognitive impairment.

Mild cognitive impairment (MCI) is often associated with the preclinical phase of Alzheimer's disease (AD). Special scoring of word-list recall data for serial position has been suggested to improve discrimination of normal aging from dementia. We examined serial position effects in word-list recall for MCI participants compared to Alzheimer patients and controls.

The trajectory of gait speed preceding mild cognitive impairment.

Objectives: To compare the trajectory of motor decline, as measured by gait speed and finger-tapping speed, between elderly people who developed mild cognitive impairment (MCI) and those who remained cognitively intact. We also sought to determine the approximate time at which the decline in motor function accelerated in persons who developed MCI.

Design: Longitudinal cohort study.

Cognitive impairment risk: white matter hyperintensity progression matters.

Objective: To determine whether white matter hyperintensity (WMH) progression rate is a better predictor of cognitive impairment risk than baseline WMH volume in healthy elderly individuals.

Method: Ninety-eight cognitively intact elderly subjects were followed in the Oregon Brain Aging Study. Forty-nine had at least 3 brain MRIs and annual cognitive and neurologic assessments until diagnosed with persistent cognitive impairment (PCI).

Wechsler Memory Scale-III Faces test performance in patients with mild cognitive impairment and mild Alzheimer's disease.

Little is known about the sensitivity of the Wechsler Memory Scale-Third Edition (WMS-III) Faces subtest to memory impairment associated with mild cognitive impairment (MCI). In this study, Faces performance was examined in 24 MCI patients, 46 mild Alzheimer's disease (AD) patients, and 98 elderly controls. We hypothesized that participants with diagnoses of MCI or AD would be impaired relative to controls on Faces.

Status of computerized cognitive testing in aging: a systematic review.

Background: Early detection of cognitive decline in the elderly has become of heightened importance in parallel with the recent advances in therapeutics. Computerized assessment might be uniquely suited to early detection of changes in cognition in the elderly. We present here a systematic review of the status of computer-based cognitive testing, focusing on detection of cognitive decline in the aging population.

Trajectory of mild cognitive impairment onset.

The objective was to identify the trajectories of onset of memory and other cognitive loss in persons destined to develop mild cognitive impairment (MCI) or dementia. Healthy, community dwelling, cognitively intact elders (n = 156, mean age at entry = 83 years) were examined annually for an average of greater than 7 years. Those who developed at least two consecutive Clinical Dementia Ratings >or= 0.

Physical activity and the risk of dementia in oldest old.

Objective: This study evaluated the protective role of physical activity (PA) against cognitive impairment (CI) in the oldest old (age >/= 85).

Method: Prospective data on 66 optimally healthy, oldest old adults (mean age 88.5) were analyzed using survival analysis.

Effects of sex on object recognition and spatial navigation in humans.

Human tests designed to mirror rodent tests of object recognition and spatial navigation were administered to adult cognitively healthy humans. Facial recognition was also assessed. There was no sex difference in facial recognition, consistent with earlier studies.

Independent predictors of cognitive decline in healthy elderly persons.

Background: Several studies have shown that individually memory, hippocampal volume, and motor measures presage the onset of dementia. It is unclear if these independently contribute to the prediction of mild cognitive impairment.

Objective: To determine the ability of memory, hippocampal volume, and a gait speed to independently predict cognitive decline in healthy elderly persons.