Factors influencing routine cognitive impairment screening in older at-risk drinkers: Findings from a qualitative study in the United Kingdom

Cognitive Impairment (CI) screening is recommended for those engaged in harmful levels of alcohol use. However, there is a lack of evidence on implementation. This paper explores the barriers and facilitators to CI screening experienced across a service specifically for older drinkers. The findings draw on data gathered as part of an evaluation of a multilevel programme to reduce alcohol-related harm in adults aged 50 and over in five demonstration areas across the United Kingdom. It is based on qualitative interviews and focus groups with 14 service providers and 22 service users. Findings are presented thematically under the section headings: acceptability of screening, interpretation and making sense of screening and treatment options. It is suggested that engagement with CI screening is most likely when its fit with agency culture and its purpose is clear; where service providers have the technical skills to administer and discuss the results of screening with service users; and where those undertaking screening have had the opportunity to reflect on their own experience of being screened. Engagement with CI screening is also most likely where specific intervention pathways and engagement practices can be accessed to respond to assessed need.     

Mental Health of Mothers of Children with Juvenile Rheumatoid Arthritis: Appraisal as a Mediator

Examined direct and mediated relations between condition parametersand maternal mental health for 53 mothers of 2- to 11-year-oldchildren with juvenile rheumatoid arthritis (JRA). Multivariateanalyses revealed that when considered simultaneously, indicesof both biological severity and functional severity were associatedsignificantly with maternal mental health. Further, mother'sappraisals of the impact of the child's illness on the familypartially mediated the effects of medication type and child'sfunctional status on mother's mental health. Results providesupport for conceptual models that emphasize the cognitive mechanismsby which condition parameters such as biological and functionalseverity might affect maternal mental health. Explicating theprocesses by which a child's JRA might lead to psychologicaladjustment problems in the parent has implications for developingpreventive and treatment interventions.     

Phenotypic assortative mating vs. social homogamy among Japanese and Chinese parents in the Hawaii Family Study of Cognition

Among the subjects of Japanese and Chinese ancestries in the parent generation in the Hawaii Family Study of Cognition were 47 pairs of siblings. Since data were available on the spouses of these siblings, this allowed for tests of whether spouse correlations of educational and occupational attainment and cognitive abilities were due to active phenotypic assortment and/or shared social background (social homogamy). Comparisons of sibling correlations, spouse correlations, and correlations between the spouse of one sibling and the spouse of the other sibling, as well as the results of model-fitting analyses, suggest that spouse correlations for education are determined by both phenotypic assortment and social homogamy, spouse correlations for occupational attainment by phenotypic assortment, and spouse correlations for verbal ability mostly by social homogamy.The results reported here were made possible by a collaboration of a group of investigators (G. C. Ashton, R. C. Johnson, M. P. Mi, and M. N. Rashad at the University of Hawaii and J. C. DeFries, G.E. McClearn, S. G. Vandenberg, and J. R. Wilson at the University of Colorado) supported by NSF Grant GB-34720 and Grant HD-06669 from the National Institute of Child Health and Human Development.     

Cognitive impairment in Parkinson's disease: amyloid plaques, neurofibrillary tangles, and neuropil threads in the cerebral cortex

Summary Sensitive silver methods for extracellular amyloid and intraneuronal cytoskeleton abnormalities (neurofibrillary tangles and neuropil threads) were employed to examine the cortical pathology in Parkinson's disease. In cases with cognitive impairment many plaque-like amyloid deposits were found in the cerebral cortex. Neuritic plaques were rare or absent. Neither the Ammon's horn nor the isocortex revealed a sufficiently large number of tangles to permit the diagnosis of a coexisting fully developed Alzheimer's disease. Large numbers of neurofibrillary tangles and neuropil threads were only found in layer Pre- of the entorhinal cortex. This layer gives rise to major portions of the perforant tract, a pathway which serves as a link in the transmission of data from isocortical association areas to the hippocampal formation. During the course of Parkinson's disease the hippocampal formation is thus endangered to become disrupted from isocortical influences. It is concluded that the cognitive impairment shown by many individuals suffering from Parkinson's disease may partly be caused by cortical lesions.     

Post-stroke depression: Relationships with morphological damage and cognition over time

The aim of the present study was to investigate the relationships between poststroke depression (PSD), lesion location and cognitive deficits after stroke. We studied 20 patients within the first month after clinical onset (T1), and one year later (T2). PSD was observed in 55% of patients at T1 and 35% of patients at T2. At T1, depression was reliably correlated with dorsal lesions in the right-hemisphere and anterior lesions in the left hemisphere. Lesion location was no longer a significant factor determining PSD at T2. Changes in PSD, from T1 to T2, were inversely correlated with the performances in cognitive tests exploring the domains of attention, visuospatial learning, executive/motor functions, and with the global composite cognitive score. Our data suggest that: 1) in the mix of influences that may produce PSD, lesion location is the main factor determining mood changes after stroke in the first month; 2) PSD produces deficits in attention, learning, and executive/motor functions, without affecting language and other cognitive domains.

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Sommario Scopo di questo studio sono i rapporti tra la depressione post-stroke (PSD), la localizzazione della lesione cerebrovascolare e i disturbi cognitivi conseguenti alla lesione. Abbiamo studiato 20 pazienti entro il primo mese dall'episodio ictale (T1) ed un anno dopo (T2). La PSD era osservabile nel 55% dei pazienti a T1 e nel 35% dei pazienti a T2. A T1, la PSD era significativamente correlata con lesioni dorsali nell'emisfero di destra e con lesioni anteriori nell'emisfero di sinistra. Queste correlazioni non erano più significative a T2. Le variazioni della PSD da T1 a T2 erano inversamente correlate con le prestazioni dei pazienti a compiti cognitivi di attenzione, apprendimento visuospaziale, funzioni esecutivo/motorie, e con un punteggio cognitivo composito.Questi dati suggeriscono che: 1) tra le numerose cause che possono produrre la PSD, la localizzazione della lesione sembra essere il fattore principale nel primo mese dopo l'episodio cerebrovascolare; 2) la PSD produce disturbi attentivi, di apprendimento visuospaziale ed esecutivi/motori senza determinare disturbi nella sfera del linguaggio e di altre funzioni cognitive.

     

Sexual orientation and performance on sexually dimorphic motor tasks

Performance of homosexual and heterosexual men and women on two motor tasks which reliably demonstrate sex differences in opposite directions was examined. A Throw-to-Target Task and the Purdue Pegboard were administered to undergraduate students matched for age and program of study. A two-way ANOVA (Sex × Sexual Orientation) of the Throw data showed a significant interaction,F(1, 90) = 16.22,p 0.001, and a trend for an effect of sex,F(1, 90) = 3.72,p < 0.06. Heterosexual men outperformed heterosexual women, whereas gay men threw less accurately and lesbians tended to throw more accurately than their heterosexual counterparts. Differences in sports history or hand strength did not account for these effects. Analysis of the Pegboard scores found no interaction or main effect of sexual orientation, but the effect of sex was significant,F(1,63) = 7.01,p 0.02. Regardless of sexual orientation, women outperformed men and this difference remained significant even when a measure of finger size was partialed out. This study provides new evidence suggesting an association between sexual orientation and motor-performance profiles. As with cognitive tasks, the motor-performance profiles of homosexuals are composites of some male-typical and some female-typical abilities. To the extent that sociological factors have been controlled, the study suggests that both sexual orientation and motor/cognitive predispositions may have early biological contributions.This research was supported by a grant from the Medical Research Council, Ottawa, to D. Kimura.     

Problem solving,sense of coherence and instrumental ADL of elderly people with depression and normal control group

The purpose of this study was first, to explore the separate contribution and interaction between verbal and performance based problem solving and sense of coherence; and second, to examine the association of these variables with Instrumental Activities of Daily Living (IADL) function among elderly people with depression living in the commuinity and a normal control group. The participants included elders receiving ambulatory care for depression (n=31; mean age=73, SD=9.3); and normal elders (n=30; mean age=78, SD=5.8). Screening for general cognitive ability and level of depression was done using the Mini Mental Status Examination (MMSE) and the Geriatric Depression Scale (GDS). All participants underwent evaluation using the Large Allen Cognitive Level Test (LACL) (a measure of performance based problem solving); the Problem Solving Verbal Reaction to everyday problematic situations (PSVR); the Sense of Coherence questionnaire (SOC) and the Routine Task Inventory (RTI) (a measure of IADL from the cognitive perspective). Wilcoxon statistical analysis indicated highly significant differences between the two groups for all of the study variables. In the depressive group, significant correlations were found between the components of problem solving (LACL and PSVR) and IADL (r=0.70 and r=0.53), while the SOC did not correlate with IADL in either group. Results of ANCOVA controlling for LACL showed that it has a significant effect (F=13.63, p=0.001); however, beyond it verbal problem solving still has a significant effect on IADL (F=4.77, p=0.02), and SOC in interaction with verbal problem solving was significant (F=3.97, p=0.035). The findings suggest that depression in elderly people is associated with lower functioning in problem solving and IADL function, and lower sense of coherence; hence, attention to these factors should be integral to intervention with elderly people. However, it is recommended that further study be made of the relationships of variables found in this study with the current instruments, and also with additional tools because of confounding effects, in order to further support and validate the findings. As the sample size was small compared with the number of measures, it is important to replicate the study with larger groups to have more power. Copyright © 1999 Whurr Publishers Ltd.     

不同发育期铅暴露对大鼠空间认知能力的影响

用不同发育期大鼠的接铅史来探讨铅暴露的敏感期及铅对年轻大鼠空间认知能力的影响。结果发现,生前和生后持续接铅的染毒１组和经母体间接接铅的染毒３组,两者Ｍｏｒｉｓ水迷宫的测试成绩均显著低于对照组,而断乳后接铅的染毒２组,虽然血铅水平显著增高,但脑铅水平和水迷宫测试成绩却与对照组无差别,提示在神经发育早期（胎儿期和婴儿期）对铅更敏感。     

Sexual orientation and cognitive abilities

We asked whether homosexual and heterosexual men and women differ on standard measures of cognitive ability. Subjects were adults recruited for a family study of sexual orientation. They completed the Fy Scale of the California Psychological Inventory, a self-administered measure of psychological femininity, and were given subtests of the Wechsler Adult Intelligence Scale and the Primary Mental Abilities test which had been previously shown to discriminate between the sexes. We predicted that homosexual subjects would score significantly in the gender-atypical direction on the Fy scale. We also predicted that they would achieve scores on the tests of cognitive abilities significantly in the direction of the other gender. Comparisons were made between homosexual and heterosexual individuals within gender. Also, comparisons were made between heterosexual men and women to see if our results replicate differences typically found between the genders. As predicted, both homosexual men and women were strongly gender-atypical on the Fy scale relative to their heterosexual counterparts. However, neither differed from heterosexuals on any of the measures of cognitive abilities. Heterosexual men did better than women on the Primary Mental Abilities spatial relations test. We conclude that sexual orientation is not related to specific cognitive abilities.Supported in part by NIMH grant 32,170 to Dr. Pillard.