Rapid eye movement sleep behavior disorder (RBD) affects 33-46% of patients with Parkinson's disease (PD) and may be a risk factor for neuropsychological and functional deficits. However, the role of ...RBD on neuropsychological functioning in PD has yet to be fully determined. We, therefore, examined differences in neurocognitive performance, functional capacity, and psychiatric symptoms among nondemented PD patients with probable RBD (PD/pRBD+) and without (PD/pRBD-), and healthy comparison participants (HC).
Totally, 172 participants (58 PD/pRBD+; 65 PD/pRBD-; 49 HC) completed an RBD sleep questionnaire, psychiatric/clinical questionnaires, performance-based and self-reported functional capacity measures, and underwent a comprehensive neuropsychological battery assessing attention/working memory, language, visuospatial function, verbal and visual learning and memory, and executive function.
Controlling for psychiatric symptom severity, the PD/pRBD+ group had poorer executive functioning and learning performance than the PD/pRBD- group and poorer neuropsychological functioning across all individual cognitive domains than the HCs. In contrast, PD/pRBD- patients had significantly lower scores than HCs only in the language domain. Moreover, PD/pRBD+ patients demonstrated significantly poorer medication management skills compared to HCs. Both PD groups reported greater depressive and anxiety severity compared to HCs; PD/pRBD+ group also endorsed greater severity of apathy compared to HCs.
The presence of pRBD is associated with poorer neuropsychological functioning in PD such that PD patients with pRBD have poorer cognitive, functional, and emotional outcomes compared to HC participants and/or PD patients without pRBD. Our findings underscore the importance of RBD assessment for improved detection and treatment of neuropsychological deficits (e.g., targeted cognitive interventions).
ABSTRACTObjectives:To show enhanced psychometric properties and clinical utility of the modified Mini-Mental State Examination (3MS) compared to the Mini-Mental State Examination (MMSE) in mild ...cognitive impairment (MCI).
Psychometric and clinical comparison of the 3MS and MMSE.
Neuropsychological clinic in the northeastern USA.
Older adults referred for cognitive concerns, 87 of whom were cognitively intact (CI) and 206 of whom were diagnosed with MCI.
The MMSE, the 3MS, and comprehensive neuropsychological evaluations.
Both instruments were significant predictors of diagnostic outcome (CI or MCI), with comparable odds ratios, but the 3MS explained more variance and showed improved classification accuracies relative to the MMSE. The 3MS also demonstrated greater receiver operating characteristic area under the curve values (0.85, SE = 0.02) compared to the MMSE (0.74, SE = 0.03). Scoring lower than 95/100 on the 3MS suggested MCI, while scoring lower than 28/30 on the MMSE suggested MCI. Additionally, compared to the MMSE, the 3MS shared more variance with neuropsychological composite scores in Language and Memory domains but not in Attention, Visuospatial, and Executive domains. Finally, 65.5% MCI patients were classified as impaired (scoring ≤1 SD below the mean) using 3MS normative data, compared to only 11.7% of patients who were classified as impaired using MMSE normative data.
Broadly speaking, our data strongly favor the widespread substitution of the MMSE with the 3MS in older adults with concerns for cognitive decline.
There exists a need for more sensitive measures capable of detecting subtle cognitive decline due to Alzheimer's disease.
To advance the literature in Alzheimer's disease by demonstrating that ...performance on a cued-Stroop task is impacted by preclinical Alzheimer's disease neuropathology.
Twenty-nine cognitively asymptomatic older adults completed a computerized, cued-Stroop task in which accuracy rates and intraindividual variability in reaction times were the outcomes of interest. Cerebrospinal fluid biomarkers of Aβ42 and tau were measured and participants were then grouped according to a published p-tau/Aβ42 cutoff reflecting risk for Alzheimer's disease (preclinical Alzheimer's disease = 14; control = 15).
ANOVAs indicated that accuracy rates did not differ between the groups but 4-second delay incongruent color-naming Stroop coefficient of variation reaction times were higher in the preclinical Alzheimer's disease group compared to the control group, reflecting increased within-person variability. Moreover, partial correlations showed no relationships between cerebrospinal fluid biomarkers and accuracy rates. However, increases in coefficient of variation reaction times correlated with decreased Aβ42 and increases in p-tau and the p-tau/Aβ42 ratio.
Results supported the ability of the computerized, cued-Stroop task to detect subtle Alzheimer's disease neuropathology using a small cohort of cognitively asymptomatic older adults. The ongoing measurement of cued-Stroop coefficient of variation reaction times has both scientific and clinical utility in preclinical Alzheimer's disease.
Impulsivity reflects a pattern of rapid behavioral responses to internal or external cues with little planning or consideration of consequences. Impulsive personality is purported to be a largely ...stable, trait-based quality, while impulsive choice has been shown to respond to interventions aimed at reducing impulsivity. We sought to evaluate the stability of impulsive personality and examine reductions in impulsivity during short-term residential substance use disorder (SUD) treatment. The temporal stability of the UPPS-P Impulsive Behavior Scale (UPPS-P) and discounting rates on a measure of impulsive choice (i.e., Monetary Choice Questionnaire-27 MCQ-27) were assessed over a brief 10-day period in a sample of individuals engaged in 14-day residential SUD treatment (N = 28). Although all five UPPS-P scales exhibited adequate to good test-retest reliability (rs > .78), Negative Urgency and (lack of) Premeditation decreased over time with large and moderate effects, respectively. Discounting rates on the MCQ-27 also declined (i.e., reduced impulsivity) during treatment. While impulsive personality is broadly understood to be trait-like and largely resistant to treatment effects, our results add to emerging evidence that two scales on the UPPS-P (i.e., Negative Urgency and lack of Premeditation) measure aspects of impulsive personality that respond to treatment. These findings have significant implications for understanding and conceptualizing impulsivity during initial SUD treatment and suggest opportunities for additional interventions targeting aspects of impulsive personality.
Public Heath Significance
This study contributes to emerging evidence that aspects of impulsive personality may be more responsive to acute treatment effects than previously believed. We evaluated changes in impulsive personality and impulsive choice for individuals completing 14-day residential substance use disorder treatment. While impulsive personality was largely stable over the treatment period, certain aspects of impulsive personality declined over the brief treatment period.
To investigate predictors of return to work (RTW) in a poststroke sample.
Retrospective investigation of archival data from an inception cohort; acute care records and 6-month follow-up telephone ...interview data were obtained for analysis.
The Brain Recovery Core, a collaborative interinstitutional endeavor among an academic medical center, an acute care hospital, and a rehabilitation center.
Data from patients with stroke from the Brain Recovery Core (N=298). Excluded cases included those with nontraditional and/or nonpaid job status, no National Institute of Health Stroke Scale (NIHSS) score, and an NIHSS score >16. Our final sample included 244 individuals (age range, 25-87y).
Not applicable.
Sociodemographic variables, stroke severity (NIHSS), and physical and neurocognitive measures.
Adding predictor variables to our logistic regression model increased accuracy by approximately 18%. Greater independence in the FIM sit-to-stand movement predicted improved RTW rates (odds ratio OR, 1.8; 95% confidence interval CI, 1.0-3.1), whereas nonwhite race (OR, 2.52; 95% CI, 1.16-5.47) and greater impairment on the NIHSS (OR, .88; 95% CI, .77-.99) predicted attenuated RTW rates.
Valid measures of stroke severity and a clinician-rated sit-to-stand movement have utility in the acute prediction of later RTW in patients with mild to moderate stroke. Given the complexity of the RTW construct and the acute measurement of these variables, we believe that our findings can be used to inform clinical decisions and appropriately tailor rehabilitative strategies that improve quality of life for stroke survivors.
PDF
