The Validity of a Parent-based Assessment of Cognitive Abilities in Three-year Olds*

The purpose of the present study was to validate a parent-based assessment of cognitive abilities of three-year-old children against a standard tester-administered measure. The cognitive abilities of 85 children (50 boys and 35 girls, members of 43 twin pairs) were assessed using a measure of non-verbal abilities called the Parent Report of Children's Abilities for three-year-olds (PARCA3), a vocabulary checklist, and the McCarthy Scales of Children's Abilities (McCarthy, 1972). Correlations indicated that both components of the PARCA3 (parent-report and parent-administered) were significantly associated with the McCarthy scales, as was the vocabulary measure. Most importantly, the PARCA3 and vocabulary measure in combination significantly and substantially predict the McCarthy General Cognitive Index (Total R =0.63). We conclude that the PARCA3, with the vocabulary measure, provides a valid, inexpensive, reliable measure of cognitive ability for very young children.     

The Validity of a Parent-based Assessment of Cognitive Abilities in Three-year Olds

The purpose of the present study was to validate a parent-based assessment of cognitive abilities of three-year-old children against a standard tester-administered measure. The cognitive abilities of 85 children (50 boys and 35 girls, members of 43 twin pairs) were assessed using a measure of non-verbal abilities called the Parent Report of Children's Abilities for three-year-olds (PARCA3), a vocabulary checklist, and the McCarthy Scales of Children's Abilities (McCarthy, 1972). Correlations indicated that both components of the PARCA3 (parent-report and parent-administered) were significantly associated with the McCarthy scales, as was the vocabulary measure. Most importantly, the PARCA3 and vocabulary measure in combination significantly and substantially predict the McCarthy General Cognitive Index (Total R =0.63). We conclude that the PARCA3, with the vocabulary measure, provides a valid, inexpensive, reliable measure of cognitive ability for very young children.     

无症状性脑梗死与认知功能障碍关系临床观察

目的探讨无症状性脑梗死与认知功能障碍的关系。方法对40例无症状脑梗死患者和40例对照者进行蒙特利尔认知评估量表评估,并分析梗死灶数量、位置等不同因素对认知功能的影响。结果无症状脑梗死患者的认知功能障碍发生率（25％）显著高于对照组（5％,P〈0．05）;皮质梗死患者的认知功能障碍发病率高于皮质下梗死（P〈0．05）;多发梗死患者的认知功能障碍发病率高于单病灶患者（P〈0．05）。结论无症状性脑梗死可能引起认知功能障碍;皮质及多发病灶患者更易出现认知功能障碍。     

激素替代治疗对老年甲减认知功能影响的研究

目的:研究甲状腺激素替代治疗对老年甲状腺功能减退患者认知功能的影响。方法:选择90例老年甲状腺功能减退患者为前瞻性研究的对象,在给予甲状腺激素替代治疗后检测外周血甲状腺相关激素FT3、FT4及TSH水平,观察认知功能的变化。结果:患者外周血中FT3、FT4水平及MMSE总评分及定向力、记忆力、注意力和计算力、回忆能力、语言能力评分均呈现治疗后6个月>治疗后3个月>治疗前,TSH水平呈现治疗后6个月<治疗后3个月<治疗前。结论:甲状腺激素替代治疗能够有效改善老年甲状腺功能减退患者的认知功能,具有积极的临床价值。     

Physical activity and cognitive functioning in aging

Aging is associated with decline in a multitude of cognitive processes and brain functions. A growing body of literature suggests that decline in cognitive functioning of older adults can be reduced through memory training and physical activity. The purpose of this article was to examine the hypothesis that physical activity enhances cognitive functioning, to summarize the cross-sectional and intervention research in this area, and to discuss potential mechanisms underlying the cognitive improvement. Finally, some suggestions for future research are outlined.     

Pretesting survey instruments: An overview of cognitive methods

This article puts forward the case that survey questionnaires, which are a type of measuring instrument, can and should be tested to ensure they meet their purpose. Traditionally survey researchers have been pre-occupied with standardising data collection instruments and procedures such as question wording and have assumed that experience in questionnaire design, coupled with pilot testing of questionnaires, will then ensure valid and reliable results. However, implicit in the notion of standardisation are the assumptions that respondents are able to understand the questions being asked, that questions are understood in the same way by all respondents, and that respondents are willing and able to answer such questions. The development of cognitive question testing methods has provided social researchers with a number of theories and tools to test these assumptions, and to develop better survey instruments and questionnaires. This paper describes some of these theories and tools, and argues that cognitive testing should be a standard part of the development process of any survey instrument.     

我国老年人认知衰弱转移规律及其影响因素研究

目的:了解我国老年人认知衰弱转移规律及其影响因素,为制定认知衰弱早期干预措施提供科学依据。方法:利用中国健康与养老追踪调查2011、2013和2015年3期数据,将个体健康状态划分为健壮-认知正常、认知障碍、躯体衰弱、认知衰弱4种,构建多状态Markov模型,探索认知衰弱转移规律及其影响因素。结果:共纳入3 470例老...     

以轻度认知功能障碍为主要表现的甲状腺功能减退症40例分析

目的 探讨轻度认知功能障碍(MCI)与甲状腺功能减退症(甲减)的关系,减少对甲减的误诊.方法 对于12 000例MCI患者常规测定甲状腺功能,对其中确诊为甲减40例患者,常规行韦氏量表测智商(IQ)、蒙特利尔认知评估量表(MoCA)、简易智能状态检查表(MMSE)评定,并行甲状腺功能测定,确诊后给予甲状腺素补充,3月后再次行甲状腺功能测定及MoCA、MMSE评定,并与治疗前比较.结果 以MCI为主要改变的甲减患者治疗前促甲状腺激素(TSH)为(12.25±4.25) mU/L,总三碘甲状腺原氨酸(TT3)为(1.60±0.25) nmol/L,总甲状腺素(TT4)为(80.25±10.38) nmoL/L;血清游离三碘甲状腺原氨酸(FT3)为(3.85±0.45) pmol/L,游离甲状腺素(FT4)为(7.12±1.25) pmol/L;治疗后TSH为(4.63±1.25m) U/L,TT3(1.80 ±0.35 nmol)/L,TT4(87.25±12.58) nmol/L;FT3 (4.05±0.52) pmol/L,FT4(10.15±1.158) pmol/L,治疗前后TSH、FT4差异有统计学意义,TT3、TT4、FT3差异无统计学意义(P＞0.05),治疗前后IQ均60～90,差异无统计学意义.治疗前MoCA、MMSE评分为19.20±3.55和21.30±4.52,经给予左旋甲状腺素3个月后分别为25.20±4.38和25.52±3.78,差异有统计学意义.结论 对于MCI患者应常规监测甲状腺功能并尽早干预,避免漏诊误诊.     

中国老年人丧子情况与认知障碍发病的关联性研究

目的 探讨65岁及以上老年人丧子情况和认知障碍发病的关联性。方法 数据来自2011/2012—2014年中国老年健康影响因素跟踪调查（CLHLS）。以基线时无认知障碍的老年人作为研究对象。使用SAS PROC MI过程步对缺失变量进行填补,采用多因素cox比例风险回归模型比较老人丧子情况与认知障碍发病的关系。结果 本研究共纳入5 044人, 平均年龄（81.11±9.71）岁,平均随访时间（2.61± 0.37）年,非丧子组发病密度为10.30/100人年,丧子组发病密度为20.82/100人年,多因素cox回归结果显示,丧子老年人的认知障碍发病风险显著增高（HR:1.26,95%CI:1.06～1.50）。进一步分层分析发现,年龄75岁以上、男性、居住在城镇、当前独居的丧子老人有更高的认知障碍发病风险。结论 丧子老年人的认知障碍的发病风险显著增加,尤其是75岁以上、男性、居住在城镇、当前独居的丧子老年人应注意保护认知功能。     

Glucoregulation has Greater Impact on Cognitive Performance than Macro-vascular Disease in Men with type 2 Diabetes: Data from the Caerphilly Study

Objective To compare vascular and glucose related mechanisms of type 2 diabetes on cognitive performance.Research design and methods: A cross-sectional observational study of type 2 diabetes defined by non insulin dependant self-report diabetes or fasting blood glucose ≤ 7.0 mmol/l of 2205 men eligible for the third phase of the Caerphilly Collaborative Heart Disease Study. Men were aged 55–69 years at time of testing. Tests of cognitive function included NART (crystallised IQ), AH4 (fluid IQ), verbal fluency (executive function) Cambridge Cognitive Examination (CAMCOG) and Mini Mental State Examination (MMSE) (global function), four choice serial reaction time (psychomotor function) and memory. Men with prior stroke were omitted from the analysis.Results: Men with diabetes showed cognitive deficits for verbal fluency, National Adult Reacting Test (NART) and AH4. Adjusting for vascular risk factors had minimal effect. Including blood glucose removed the deficit for verbal fluency and NART but the effect on AH4 score (−2.58; 95% CI: −5.0, −0.1, p = 0.039) was retained. More detailed analyses of AH4 score on men with diabetes showed a curvilinear relationship indicating that men with both low and high glucose levels had worse performance (AH4 = −66 + 80 log_e glucose – 18 log_e glucose²; 95% CI: −29, −6; p=0.002).Conclusions: These data identify a direct effect of glucose regulation on cognitive performance associated with diabetes in a population sample. These data suggest that an effect of glucose regulation on cognitive performance in diabetes is distinct from any effect of macro-vascular disease.     

Clarifying quality of life assessment: do theoretical models capture the underlying cognitive processes?

Objective  To develop an analysis scheme capturing the cognitive processes underlying QoL assessment to increase our understanding on how to interpret responses to QoL items. Tourangeau et al.’s (The psychology of survey response, 2000) and Rapkin and Schwartz’ (Health Qual Life Outcomes 2:14, 2004) cognitive process models form the basis for this analysis scheme. Methods  We conducted think aloud interviews with six cancer patients prior to and following radiotherapy to elicit the cognitive processes underlying the assessment of 7 EORTC QLQ-C30 items. Content analysis was carried out by two to four researchers independently. Eighty text fragments were analyzed inductively and combined in an iterative process with deductive analyses based on both models. Results  We have developed a comprehensive analysis scheme feasible for analyzing the cognitive processes underlying QoL assessment qualitatively. All cognitive components of both models could be distinguished in our data. The cognitive component ‘reporting and response selection’ needed extension to fully capture the cognitive processes used. Conclusion  The two models combined are useful in describing the cognitive processes cancer patients use in answering QoL items, and as such facilitate insight into patients’ self-reported QoL assessments. Interestingly, the content of the cognitive processes not only differed between patients but also between items within patients and over time.

贵州省农村低教育程度老年人认知储备的评价

目的 构建低教育水平老年人认知储备的评价方法,并分析其与认知功能的关联,为预防低教育程度老年人认知功能下降提供参考。 方法 采用多阶段整群抽样方法,选取贵州省2个县（区）内12个村庄共1 654名60岁及以上老年人为对象,收集对象人口学、生活方式、社会支持、简易精神状态评价量表（MMSE）评估等资料,采用探索性因子分析构建评价工具,验证性因子分析其结构效度,Spearman相关分析、多重线性回归分析认知储备与认知功能的关系。结果 通过探索性因子分析和验证性因子分析,低教育程度老年人认知储备可由“获得帮助”“解决烦恼”“获得支持”“认知刺激”四个维度构成,其拟合度较好。基于本次构建的认知储备工具进行测量,其认知储备评分与整体认知功能及各领域之间存在相关性（P＜0.001）;调整相关协变量后,认知储备与认知功能之间仍存在关联（β = 0.190,95%CI:0.123～0.257）;年龄和教育程度分层后,除80岁及以上人群组外,认知储备评分与MMSE仍存在相关性（P＜0.05）;在不同年龄组中,认知储备高的个体其MMSE评分也较高。 结论 本次构建的认知储备评分与认知功能存在关联,工具能较好反映低教育水平老年人的认知储备,但其对认知功能下降的保护作用仍需要随访研究进一步证实。     

患者过度医疗相关知识认知度调查

目的通过调查患者对过度医疗相关知识的认知和态度,从医疗服务需方的角度,探讨过度医疗产生的背景及原因。方法按照分层随机抽样的方法,选择江苏省某三级甲等综合医院作为研究现场,共对500名患者进行匿名问卷调查,并采取统计描述、多因素 Logistic 回归分析的方法进行结果的分析。结果本次调查中,回收有效问卷486份,回收率为97.2%,包括314名（64.6%）门诊及医技科室患者与172名（35.4%）住院患者。患者对过度医疗的知晓率仅为7.7%,对辅助检查的效果满意的比例为30.8%,会主动要求做医嘱之外检查的比例为26.7%,向医生送过钱物或贵重物品的比例为19.9%。在“主动要求做医嘱之外检查暠的原因中,所占比例由高到低依次为：“对医生不信任暠、“听信网上或者其他医生的建议暠、“可以报销暠、“不相信检查结果暠。结论“收入水平暠和“对辅助检查效果是否满意暠是影响患者是否会主动要求做医嘱之外检查的主要因素,“婚姻状况暠和“收入水平暠是影响患者是否向医生送过钱物或贵重物品的主要因素。目前患者对过度医疗的认知度较低,应有针对性地对患者开展过度医疗知识的健康教育,旨在从医疗服务需方的角度减少过度医疗的产生。     

西安市帕金森病患者认知障碍特征调查

目的 研究西安市帕金森病(PD)患者认知功能障碍特征及其影响因素.方法 采用连续入组的方法 ,对2007年1-4月在西安市7家综合医院神经内科就诊的PD患者,应用简易精神状态量表(MMSE)和蒙特利尔认知评估(MOCA)评定整体认知功能,Fuld物体记忆测验评价延迟记忆,快速词汇测验评价语言流畅性,数字广度试验评价注意功能,积木试验评价视空间功能.结果共入选PD患者100例,其中男52例,女48例;年龄43～86(65.6±17.1)岁.以MMSE作为判断有无认知障碍的标准,16%的PD患者存在认知障碍;以MOCA作为判断有无认知障碍的标准,83%的PD患者存在认知障碍.PD患者MMSE或MOCA亚项评分下降幅度最大,低分率较高的认知域为计算力、短时记忆、视空间功能、抽象能力、注意和语言流畅性.logistic逐步回归分析发现与PD认知障碍相关的因素有文化程度(P=0.000)、发病年龄(P=0.039)和性别(P=0.018).结论 PD常合并认知障碍,且以计算、短时记忆、视空间、抽象、注意和语言流畅性障碍为主.高龄发病、低文化程度和女性PD患者更容易发生认知功能障碍.     

Low 25-Hydroxyvitamin D Concentrations and Risk of Incident Cognitive Impairment in Black and White Older Adults: The Health ABC Study

Using data from the Health, Aging, and Body Composition study, we examined whether low 25-hydroxyvitamin D (25[OH]D) concentrations were associated with prevalent or incident cognitive impairment. Serum 25(OH)D concentrations were measured in 2,786 older adults and categorized as <20?ng/mL, 20 to <30?ng/mL, or ≥30?ng/mL. Cognitive impairment was defined as a score >1.5 standard deviations below race and education specific means on either digit symbol substitution test or modified mini-mental state test. Logistic regression determined the odds of cognitive impairment at baseline and year 5 by 25(OH)D category. 25(OH)D concentrations were <30?ng/mL in 57.3% of whites and 84.6% of blacks. After excluding participants with baseline cognitive impairment (n?=?340), 13% of whites and 13% of blacks developed cognitive impairment by year 5. In whites, 25(OH)D concentrations <30?ng/mL were not associated with prevalent or incident cognitive impairment. Black participants with 25(OH)D concentrations <20?ng/mL had a higher odds of prevalent, but not incident cognitive impairment (OR (95% CI): 2.05 (1.08–3.91), p?=?0.03) compared to participants with 25(OH)D concentrations ≥30?ng/mL. Low 25(OH)D concentrations were associated with twofold higher odds of prevalent cognitive impairment in blacks.     

医生过度医疗相关知识认知度调查

目的 通过调查医生对过度医疗相关知识的认知和态度,从医疗服务供方的角度,探讨过度医疗产生的背景及原因.方法 按照分层随机抽样的方法,选择江苏省某三级甲等综合医院作为研究现场,共对54名不同科室的医生进行匿名问卷调查,并采取统计描述、多因素Logistic回归分析的方法进行结果分析.结果 调查对象平均年龄（33.9±6.8）岁,对“过度医疗”这个概念的知晓率为57.4%,但具体到其表现形式及特征,大多数医生均能清晰识别;只有16.7%的医生在患者要求医嘱之外的检查和治疗时会坚决拒绝,其余医生均会尊重患者意见为其检查和治疗.过度医疗产生的原因排前3位的分别是医院、医生、患者,改善措施排前3位的依次为：建立完善的医疗保险制度（83.5%）、国家增加对卫生事业的支出（83.4%）、提高患者的就医素质（70.4%）.结论 “学历”和“职称”是影响医生在面对患者医嘱之外要求抉择的主要因素.应通过加强医德教育,提高医务人员的职业素质,同时有针对性地对患者开展过度医疗知识的健康教育,采取综合措施减少过度医疗的产生.     

On the dissimilar effects of alcohol and aging on the perception of cognitive failings

The effects of age and duration of alcoholism on self-report of cognitive errors were examined in detoxified alcoholic outpatients and normal controls. Among alcoholics, longer duration of alcohol abuse was associated with report of more frequent cognitive errors. Among both groups, aging was associated with report of less frequent errors. Thus, data from self-assessment of cognitive performance suggests that alcoholism and aging have dissimilar effects.     

Asthma medication and the role of serotonin in the development of cognitive and psychological difficulties

This literature review will focus on the discussion of asthma and how it affects the sufferer. The role of serotonin and its physiological working at a neural level will follow, as well as the effects of corticosteroids on the brain and how low serotonin levels are linked to depression and corticosteroid use.