Predictors of rate of cognitive decline in patients with amnestic mild cognitive impairment.

Objective: Amnestic mild cognitive impairment (MCI) is a known risk factor for conversion to Alzheimer's disease (AD). Although substantial research has been conducted on the general profile of amnestic MCI subjects and predictors of conversion to AD, research on predictors of rate of decline has been considerably less extensive. The present study sought to more systematically and comprehensively examine predictors of rate of cognitive decline in a longitudinal sample of individuals with MCI, including age, genetic vulnerability, baseline cognitive performance, and baseline neuropsychiatric severity.

Benefit of phonemic cueing on confrontation naming in Alzheimer's disease.

Deficits in confrontation naming vary among persons with Alzheimer's disease (AD), including the extent to which phonemic cueing is helpful in generating the target word. This study examined neuropsychological correlates of phonemic cueing benefit and the influential effects of AD severity, estimated premorbid intellectual functioning, and apolipoprotein E genotype status. Participants were 1104 individuals with mild to moderate AD who were administered the Boston Naming Test (BNT) as part of their initial neuropsychological evaluation.

Cognitive impairment and postural control deficit in adults with Type 2 diabetes.

Background: Diseases induced by metabolic disorders, eg, Type 2 diabetes, has recently been linked to both sensory and motor deficit in the absence of a formal clinical diagnosis of peripheral neuropathy. Studies have demonstrated mild cognitive impairment in diabetic patients, which also plays a role in one's loss of ability to successfully perform basic motor activities. This project focused on evaluating cognitive function while maintaining balance.

Frequency and Correlates of Subjective Cognitive Impairment in HIV Disease.

The increasing prevalence of older adults living with HIV has raised growing concerns about a possible rise in the incidence of neurocognitive disorders due to HIV and other age-related factors. In typical aging, subjective cognitive impairment (SCI) among individuals with normal neurocognitive functioning may be an early manifestation of an incipient neurocognitive disorder. The current study examined the frequency and correlates of SCI in 188 HIV-infected adults without performance-based neurocognitive deficits or a current psychiatric disorder and 133 HIV seronegative comparison participants.

Semantic Memory in HIV-associated Neurocognitive Disorders: An Evaluation of the "Cortical" Versus "Subcortical" Hypothesis.

Objective: HIV-associated neurocognitive disorders (HAND) have historically been characterized as a subcortical condition that does not affect semantic memory; however, recent evidence suggests that the cortical regions that support semantic memory may be affected in HIV.

Method: The current study examined the effects of HAND on semantic memory in 85 HIV+ individuals with HAND, 193 HIV+ individuals without HAND, and 181 HIV- individuals who completed the Boston Naming Test (BNT) and the Famous Faces subtest of the Kauffman Adolescent and Adult Intelligence Test (KAIT-FF).

Results: Linear regressions revealed a significant adverse effect of HAND on total scores on the BNT and the KAIT-FF (all ps < .

Prevalence and correlates of cognitive asymmetry in a large sample of Alzheimer's disease patients.

Previous research has suggested that a significant minority of patients with Alzheimer's disease (AD) exhibit asymmetric cognitive profiles (greater verbal than visuospatial impairment or vice versa) and that these patient subgroups may differ in demographic and other characteristics. Prior studies have been relatively small, and this investigation sought to examine correlates of asymmetry in a large patient sample (N = 438). Patients were classified into the following cognitive profile groups: low verbal, symmetric, and low visuospatial.

Rapidly Versus Slowly Progressing Patients With Alzheimer's Disease: Differences in Baseline Cognition.

Rate of progression of cognitive deficits is variable among patients with Alzheimer's disease (AD). The purpose of the current study was to compare demographic characteristics and performance on neuropsychological measures at baseline evaluation between rapidly and slowly progressing patients. Participants were divided into 2 groups based on change in Alzheimer's Disease Assessment Scale-Cognitive subscale score from baseline to 2-year follow-up, and baseline performance was compared between the groups.

Does Older Age Confer an Increased Risk of Incident Neurocognitive Disorders Among Persons Living with HIV Disease?

Objective: This study aimed to determine the combined effects of age and HIV infection on the risk of incident neurocognitive disorders.

Method: A total of 146 neurocognitively normal participants were enrolled at baseline into one of four groups based on age (≤ 40 years and ≥ 50 years) and HIV serostatus resulting in 24 younger HIV-, 27 younger HIV+, 39 older HIV-, and 56 older HIV+ individuals. All participants were administered a standardized clinical neuropsychological battery at baseline and 14.

Cognitive and Functional Correlates of NPI-Q Scores and Symptom Clusters in Mildly Demented Alzheimer Patients.

Previous research has demonstrated an association between the emotional and behavioral symptoms of dementia, known as neuropsychiatric symptoms, and cognitive and functional decline among patients with Alzheimer disease (AD). The present study aimed to identify associations between neuropsychiatric symptoms as measured by the Neuropsychiatric Inventory-Questionnaire (NPI-Q) and cognitive and functional performance. Participants were 256 AD patients enrolled in the Alzheimer's Disease and Memory Disorders Center at Baylor College of Medicine.

Elevated rates of mild cognitive impairment in HIV disease.

With the rising number of individuals in their 50s and 60s who are infected with HIV, concerns have emerged about possible increases in the rates of non-HIV-associated dementias. The current study examined the prevalence of mild cognitive impairment (MCI) in older HIV-infected adults, since MCI is an intermediate state between typical cognitive aging and dementia that emerges in this age range. Participants included 75 adults with HIV disease aged 50 years and older who were on combination antiretroviral therapy (cART) and had undetectable plasma viral loads and 80 demographically similar HIV-seronegative comparison subjects.

Relationships between testosterone levels and cognition in patients with Alzheimer disease and nondemented elderly men.

Background/aims: Previous research suggests that low levels of testosterone may be associated with the development of Alzheimer disease (AD), as well as poorer performance on certain neuropsychological tests and increased risk of depression.

Methods: This study utilized data from 61 nondemented older men and 68 men with probable AD.

Results: Testosterone levels did not differ between the groups.

Factor structure of the Geriatric Depression Scale and relationships with cognition and function in Alzheimer's disease.

Background/aims: No study to date has systematically explored whether the Geriatric Depression Scale (GDS) measures symptoms of apathy and dysphoria in patients with Alzheimer's disease (AD) or related these constructs to cognitive and functional status.

Methods: Exploratory factor analysis (EFA) was used to identify factors of the GDS in a sample of 569 patients with probable AD. Two-way ANOVAs were used to determine the relationship of apathy and dysphoria to neuropsychological and functional measures.

Binomial regression with a misclassified covariate and outcome.

Misclassification occurring in either outcome variables or categorical covariates or both is a common issue in medical science. It leads to biased results and distorted disease-exposure relationships. Moreover, it is often of clinical interest to obtain the estimates of sensitivity and specificity of some diagnostic methods even when neither gold standard nor prior knowledge about the parameters exists.

An examination of the Boston Naming Test: calculation of "estimated" 60-item score from 30- and 15-item scores in a cognitively impaired population.

Objective: Multiple versions of the Boston Naming Test (BNT) exist, which makes comparison of findings from different studies difficult. The current project sought to determine if estimated 60-item BNT scores could be reliably calculated from 30- and 15-item administrations with patients diagnosed with Alzheimer's disease (AD).

Methods: Estimated 60-item scores were created for 30-item (even and odd) and 15-item Consortium to Establish a Registry for Alzheimer's disease (CERAD) versions of the BNT from a database containing item-level responses for all BNT items.

Validation of the new interpretive guidelines for the clinical dementia rating scale sum of boxes score in the national Alzheimer's coordinating center database.

Background: It was recently demonstrated that the Clinical Dementia Rating scale Sum of Boxes (CDR-SB) score can be used to accurately stage severity of Alzheimer dementia and mild cognitive impairment (MCI). However, to our knowledge, the utility of those interpretive guidelines has not been cross-validated or applied to a heterogeneous sample of dementia cases.

Objective: To cross-validate the staging guidelines proposed in a previous study using the National Alzheimer's Coordinating Center (NACC) database.

Cognitive and affective sequelae of primary hyperparathyroidism and early response to parathyroidectomy.

Cognitive and affective complaints are common in patients with primary hyperparathyroidism (PHPT), but few studies have used psychometric testing to document these symptoms and their response to parathyroidectomy. The current study sought to clarify the nature of cognitive and affective impairments in PHPT and changes postparathyroidectomy. One hundred eleven patients with PHPT underwent neuropsychological evaluation prior to parathyroidectomy with 68 returning for an early postsurgical evaluation.

How well do the ADAS-cog and its subscales measure cognitive dysfunction in Alzheimer's disease?

Background/aims: The Alzheimer's Disease Assessment Scale-cognitive (ADAS-cog) is regularly used to assess cognitive dysfunction in Alzheimer's disease (AD) clinical trials. Yet, little is known about how the instrument and its subscales measure cognition across the spectrum of AD. The current investigation used item response theory (IRT) analyses to assess the measurement properties of the ADAS-cog across the range of cognitive dysfunction in AD.

Staging dementia using Clinical Dementia Rating Scale Sum of Boxes scores: a Texas Alzheimer's research consortium study.

Background: The Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) score is commonly used, although the utility regarding this score in staging dementia severity is not well established.

Objective: To investigate the effectiveness of CDR-SOB scores in staging dementia severity compared with the global CDR score.

Design: Retrospective study.

Baseline cognitive function predicts rate of decline in basic-care abilities of individuals with dementia of the Alzheimer's type.

Decline in basic self-care abilities is an important risk factor for institutionalization in individuals with dementia. The ability to predict such decline would be of clinical importance in working with families of dementia patients. Research has suggested that cognitive decline may precede loss of functional capacity.

Survival among patients with dementia from a large multi-ethnic population.

Survival among patients with dementia is critical information needed for planning and assessing the overall impact of dementia. Attrition from longitudinal cohorts often limits the confidence in survival estimates. For this study, we examined survival among dementia patients from a large multi-ethnic population with excellent longitudinal follow-up.

Individual growth curve analysis of APOE epsilon 4-associated cognitive decline in Alzheimer disease.

Background: The apolipoprotein E epsilon4 (APOE epsilon4) allele is associated with an increased risk of developing Alzheimer disease (AD). However, findings regarding an association between the APOE epsilon4 allele and the rate of decline in AD have been mixed.

Objective: To examine the relationship between the APOE epsilon4 allele and the rate of cognitive and functional decline in AD using individual growth curve analyses.

Investigation of profile difference between Alzheimer's disease patients declining at different rates: examination of baseline neuropsychological data.

The rate of cognitive decline in AD has been noted to vary significantly among patients. The ability to predict the probable rate of decline early in the disease process would be of great practical importance. Attempts to analyze early cognitive deficits to find patterns associated with rapid decline have met with limited success.

WAIS-R factor structure in Alzheimer's disease patients: a comparison of alternative models and an assessment of their generalizability.

The WAIS-R is often used in neuropsychological evaluations of individuals with probable Alzheimer's disease (AD), but its factor structure in this population is unknown. Moreover, theories and past research findings make competing predictions concerning its structure. Using confirmatory factor analysis, the authors compared 5 alternative WAIS-R factor models among 516 AD patients: 1-factor (Spearman's g) and 2-factor (Verbal IQ and Performance IQ) models; a 3-factor model including Verbal Comprehension (VC), Perceptual Organization (PO), and Freedom From Distractibility (FD) factors; a 3-factor model in which Digit Symbol loads on PO rather than FD; and a 3-factor model in which Digit Symbol loads on both PO and FD.

Effects of blood pressure on neuropsychological functioning in Alzheimer's disease.

Blood pressure is often lower among patients with Alzheimer's disease (AD) compared to nondemented older adults. Lower blood pressure in AD correlates with reduced cerebral blood flow and cortical atrophy, but its effect on neuropsychological functioning is unclear. We assessed the effects of blood pressure on tests of dementia severity, attention, memory, language, verbal and nonverbal reasoning, motor/psychomotor functioning, and activities of daily living (ADL) among probable AD patients (n=609).