Five-year change scores in old age for six neuropsychological tests and normative data for the Useful Field of View (UFOV) test: The influence of physical health

Introduction: Neuropsychological assessment of cognitive change over time is often conducted in clinical settings, but whether neuropsychological change scores are influenced by physical health has, as far as we know, not been examined previously.

Method: In a sample of 153 older Swedish adults (age range, 72–86 years), we evaluated the influence of common age-related diseases, terminal decline pathology, age, education, and gender, to provide (a) preliminary test-specific regression weights and 90% confidence intervals to assess significant change in performance after five years on tests of visual scanning, mental shifting, visual spatial ability, memory, reaction time, and selective attention, and (b) normative data for the Useful Field of View test (UFOV) from a single testing occasion.

Results: Multiple regression analyses showed that test–retest changes were affected by physical health for mental shifting, visual spatial ability, memory, and reaction time, by age for mental shifting and visual reaction time, by education for visual spatial ability, and by Age × Education for auditory reaction time. Gender did not affect any of the change scores. The overall average of variance explained was 2.5%: up to 8.1% for physical health, 4.4% for age, and 3.6% for education. The UFOV scores were mostly influenced by age, but also by physical health and education.

Conclusions: The findings indicate that considering the influence of health on normative change scores in old age in addition to demographic factors leads to more accurate predictions of whether true change has occurred.     

Mild cognitive impairment in Parkinson’s disease: Diagnosis and progression to dementia

Introduction: Mild cognitive impairment is common in nondemented Parkinson disease patients (PD-MCI) and is considered as a risk factor for dementia (PDD). Recently, the Movement Disorder Society (MDS) published guidelines for PD-MCI, although the studies available are still limited. The aim of this work was to characterize PD-MCI and its progression to dementia. Moreover, the study variables could be considered as predictors for the progression of cognitive impairment. Method: The study included 43 patients with idiopathic PD (mean age = 59.19 years, SD = 9.64) and 20 healthy and neurologically normal controls (mean age = 60.85 years, SD = 12.26). The criteria proposed by the MDS Task Force were applied for the PD-MCI diagnosis. Follow-up assessments were conducted within six to eight years after the diagnosis of PD-MCI. Results: The results showed that 60.5% of the patients were diagnosed with PD-MCI when a comprehensive assessment was performed (MDS criteria Level 2), while 23.3% of the patients met MCI criteria when a brief assessment was used (MDS criteria Level 1). Multiple domain impairment was the most frequent impairment (96.2%). A total of 42.3% of PD-MCI patients had dementia in the follow-up study. Logistic regression showed that the Hoehn and Yahr stage and education significantly contributed to the prediction of PD-MCI. Moreover, the Hoehn and Yahr stage and memory domain significantly contributed to the prediction of dementia. Conclusions: The results of the study: (a) provide relevant data about the process of validation of the MDS PD-MCI criteria, (b) reinforce the hypothesis that PD-MCI is more frequent than previous studies showed without applying MDS criteria, and (c) confirm that PD-MCI is a risk factor for the onset of dementia. Finally, the study shows that neurological impairment, educational level and memory impairment were predictors for the progression of cognitive impairment.     

Cognition of the mothers of patients with Duchenne muscular dystrophy

Duchenne muscular dystrophy (DMD) has been found to be associated with cognitive impairment. However, few studies have addressed cognitive impairment among mothers of children with DMD. In the present study, the neuropsychological profiles of both carrier mothers (C-Ms) and noncarrier mothers (NC-Ms) were examined, and the findings were compared with healthy control mothers (HC-Ms). There were 90 participants, consisting of 31 C-Ms, 24 NC-Ms, and 35 HC-Ms, each of whom completed a neuropsychological test battery. C-Ms had poorer cognition performance in attention, working memory, immediate verbal memory, visuospatial skills, and executive functions than NC-Ms, and HC-Ms. This study provides evidence that there may be cognitive impairment in mothers of patients with DMD. The cognitive impairment of C-Ms has similarities to that seen in children with DMD.     

老龄化对错误记忆影响的神经心理学研究

目的探讨老龄化对错误记忆的神经心理学影响,并对产生老年人错误记忆的神经心理学机制进行研究。方法将60名教育程度相匹配的受试者分为青年组人(44岁及以下)、中年组(45～59岁)、老年组(60岁及以上),每组20名;采用图片诱发的和词汇诱发的错误记忆的实验范式(DRM范式)进行研究。结果老年组图片诱发的错误记忆高于青年组、中年组,差异有统计学意义(P=0. 000,P=0. 000)。中年组词汇诱发的关键诱饵错误再认高于青年组、老年组,差异有统计学意义(P=0. 001,P=0. 000)。老年组词汇诱发的无关项目的错误再认高于中年组、青年组,中年组的高于青年组,这三组之间两两比较差异均有统计学意义(P=0. 032,P=0. 000,P=0. 005);且无关项目的错误再认和学习项目正确再认呈负相关(P=0. 000)。结论老龄化错误记忆的增加不仅与其本身记忆编码和提取功能减退有关,还可能与记忆监测的障碍有关。     

早期干预对早产小于胎龄儿体格发育及神经心理发育的影响

目的 研究在新生儿重症监护病房(NICU)住院期间及出院后行早期干预对早产小于胎龄儿的体格发育及神经心理发育的影响, 为早产高危儿的干预提供参考。方法 选取2016年10月-2019年2月在温州市中西医结合医院NICU住院的早产小于胎龄儿做为观察组(n=103), 分别在住院期间及出院后给予早期干预, 将此前在本院住院的早产小于胎龄儿但并未实行早期干预措施的患儿做为对照组(n=89), 记录两组患儿体格发育指标, 并于关键年龄行0~1岁20项神经运动评估(INMA)及贝利婴幼儿发育(BSIDⅡ)评估, 将两组患儿上述检查指标进行对照分析。结果 观察组和对照组矫正年龄6、12月龄时, 体重、身长比较差异无统计学意义, 但12月龄时两组间头围比较差异有统计学意义(t=-2.260, P=0.032)。矫正年龄18月龄时, 体重、身长及头围在两组间比较差异均有统计学意义(t=-2.652, -3.381, -2.627, P<0.05)。矫正年龄6月龄时体重及头围的追赶率观察组较对照组高(χ² =3.891、4.444, P<0.05), 矫正年龄18月龄身长的追赶率观察组亦较对照组高, 差异有统计学意义(χ² =4.516, P=0.034);矫正年龄6月龄前行INMA提示观察组矫正年龄4月、5月时INMA异常率较对照组低(χ² =4.401、4.786, P<0.05), 矫正年龄12月龄及18月龄时运动发展指数(PDI)及智力发育指数(MDI)比较观察组均明显高于对照组(t=2.645、3.492、2.427、2.437, P<0.05)。结论 对早产小于胎龄儿进行早期干预, 可以促进其体格发育及神经心理发育, 有利于早期实现追赶生长, 减少神经系统后遗症, 实现此类高危儿健康生长轨迹的发展。