Cristina Lojo-Seoane

Does tip-of-the-tongue for proper names discriminate amnestic mild cognitive impairment?

BACKGROUND Difficulty in retrieving peoples names is very common in the early stages of Alzheimers disease and mild cognitive impairment. Such difficulty is often observed as the tip-of-the-tongue (TOT) phenomenon. The main aim of this study was to explore whether a famous peoples naming task that elicited the TOT state can be used to discriminate between amnestic mild cognitive impairment (aMCI) patients and normal controls. METHODS Eighty-four patients with aMCI and 106 normal controls aged over 50 years performed a task involving naming 50 famous people shown in pictures. Univariate and multivariate regression analyses were used to study the relationships between aMCI and semantic and phonological measures in the TOT paradigm. RESULTS Univariate regression analyses revealed that all TOT measures significantly predicted aMCI. Multivariate analysis of all these measures correctly classified 70% of controls (specificity) and 71.6% of aMCI patients (sensitivity), with an AUC (area under curve ROC) value of 0.74, but only the phonological measure remained significant. This classification value was similar to that obtained with the Semantic verbal fluency test. CONCLUSIONS TOTs for proper names may effectively discriminate aMCI patients from normal controls through measures that represent one of the naming processes affected, that is, phonological access.

¿Previene la actividad intelectual el deterioro cognitivo? Relaciones entre reserva cognitiva y deterioro cognitivo ligero

An in-depth review is presented of the role that cognitive reserve plays in the emergence of (mild cognitive impairment (MCI), and its progression to dementia by using different indicators. The studies reviewed provide support to the hypothesis that the reserve influences the manifestation of symptoms of cognitive impairment and at least partially, in its progression to dementia. The role of indicators of reserve are discussed, such as educational level, work complexity and cognitive activity in these processes. A model is also presented that argues that people with MCI and low reserves show a steeper decline early in the process of deterioration, compared to the high level of reserve this marked deterioration would have at the end of the process, due to the protective role of this reserve. This raises the need for more empirical research to help consolidate this theoretical model.

Structural model for estimating the influence of cognitive reserve on cognitive performance in adults with subjective memory complaints.

Cognitive reserve (CR) is often operationally defined as a complex structure of latent variables. Here, we present a structural model that analyzes the effect of CR on three cognitive domains: episodic memory, working memory, and general cognitive performance. We developed and analyzed a structural equation model (SEM) to study CR and cognitive performance in 326 participants over 50 years old with subjective memory complaints. The CR construct was found to consist of two factors: (a) educational level and (b) lifestyle. The model revealed that CR had significant direct effects on episodic memory, working memory, and general cognitive performance, and indirect effects on episodic memory via working memory. As a latent construct, CR is related to cognitive performance in participants over 50 years with subjective memory complaints, and it should therefore be considered in the evaluation and diagnosis of such people.

Do the Cambridge Neuropsychological Test Automated Battery episodic memory measures discriminate amnestic mild cognitive impairment

Although visual recognition memory and visuospatial paired associates learning has been shown to be impaired in amnestic mild cognitive impairment (aMCI), the sensitivity and specificity of the visual memory tests used to identify aMCI are not well defined. The current study attempted to analyze the sensitivity and specificity of three visual episodic memory tests (Pattern Recognition Memory [PRM], Delayed Matching to Sample [DMS], and Paired Associated Learning [PAL]) from the CANTAB, in differentiating aMCI patients from control healthy participants.

Normative scores of the Cambridge Cognitive Examination-Revised in healthy Spanish population

BACKGROUND The Cambridge Cognitive Examination-Revised (CAMCOG) is widely used in clinical, epidemiological and research studies, but normative scores for age and educational level have not yet been established in the Spanish population. METHOD The CAMCOG-R was administered to 730 adult members ofthe community, aged between 50-97 years, living throughout the region of Galicia. Initial screening yielded provisional identification of cognitive impairment and depressive symptoms. The final sample consisted of 643 cognitively healthy adults. The following instruments were administered: a questionnaire concerning socio-demographic and clinical data, the Charlsons Comorbidity Index, the Mini-Mental State Examination, the Montreal Cognitive Assessment (MoCA), the Lawton and Brody Index, a short version of the Geriatric Depression Scale, and the CASP-19 quality of life scale. RESULTS Internal consistency values of the CAMCOG-R were similar to those obtained for the original scale. The convergent validity between MoCA and CAMCOG-R was good, and the divergent validity between CASP-19 and CAMCOG-R was higher than the recommended value. Percentiles and inter-quartile range for age and educational level were calculated. CONCLUSIONS Psychometric indexes showed that the CAMCOG-R is a reliable and valid instrument, which can generally avoid a ceiling effect. The study findings confirm the importance of specifying the normative data by age and educational level.

Working memory span in mild cognitive impairment. Influence of processing speed and cognitive reserve.

BACKGROUND Mild cognitive impairment (MCI) often includes episodic memory impairment, but can also involve other types of cognitive decline. Although previous studies have shown poorer performance of MCI patients in working memory (WM) span tasks, different MCI subgroups were not studied. METHODS In the present exploratory study, 145 participants underwent extensive cognitive evaluation, which included three different WM span tasks, and were classified into the following groups: multiple-domain amnestic MCI (mda-MCI), single-domain amnestic MCI (sda-MCI), and controls. General linear model was conducted by considering the WM span tasks as the within-subject factor; the group (mda-MCI, sda-MCI, and controls) as the inter-subject factor; and processing speed, vocabulary and age as covariates. Multiple linear regression models were also used to test the influence of processing speed, vocabulary, and other cognitive reserve (CR) proxies. RESULTS Results indicate different levels of impairment of WM, with more severe impairment in mda-MCI patients. The differences were still present when processing resources and CR were controlled. CONCLUSIONS Between-group differences can be understood as a manifestation of the greater severity and widespread memory impairment in mda-MCI patients and may contribute to a better understanding of continuum from normal controls to mda-MCI patients. Processing speed and CR have a limited influence on WM scores, reducing but not removing differences between groups.

Characterizing Magnitude and Selectivity of Attrition in a Study of Mild Cognitive Impairment.

ObjectivesAttrition is one of the greatest difficulties in longitudinal studies on cognitive ageing because of the associated risk of underestimating declines. The aims of this paper were to characterize the magnitude and selectivity of attrition in a study of mild cognitive impairment.DesignForty two patients with multiple-domain amnestic MCI, 71 with single-domain amnestic MCI, 35 with non-amnestic MCI and 318 healthy controls were recruited from primary care centers and assessed at baseline.MeasurementsAll participants underwent extensive neuropsychological evaluation, including the Mini-Mental State Examination, the Californian Verbal Learning Test, the CAMCOG-R battery, the Counting Span task and Listening Span task, and the Subjective Memory Complaints Questionnaire.Results21.5% of the participants at baseline did not participate in the follow-up assessment. Comparison between respondents and non-returners did not reveal differences in cognitive performance in the MCI group. Data obtained at the initial assessment regarding comorbidity, social activities and attention given to memory training enabled prediction of the status of the participants in the follow-up assessment.ConclusionIdentification of potential non- returners is relevant, especially in MCI studies, in order to develop retention strategies to minimize attrition.

Visual memory profiling with CANTAB in mild cognitive impairment (MCI) subtypes.

Although visual memory has been shown to be impaired in amnestic mild cognitive impairment (aMCI), the differences between MCI subtypes are not well defined. The current study attempted to investigate visual memory profiles in different MCI subtypes.

Longitudinal Assessment of Verbal Learning and Memory in Amnestic Mild Cognitive Impairment: Practice Effects and Meaningful Changes

Objectives: To identify learning effects and meaningful changes in amnestic mild cognitive impairment (aMCI) at a follow-up assessment. Method: The Spanish version of the California Verbal Learning Test (CVLT) was administered to a sample of 274 adults of age over 50 years with subjective memory complains (SMC), including single and multiple domain aMCI groups and participants with SMC but without cognitive impairment (SMC group). The Wilcoxon test was used to compare results at baseline and after 18 months in short and long recall, and standardized regression-based (SRB) methods were used to study meaningful changes. Results: Scores were significantly higher at follow-up for short and long-delayed recall in all groups indicating generalized practice effect. SRB scores indicated a significant decline in recall in a higher proportion of participants with aMCI than in SMC group. Discussion: Patients with multiple and single domain aMCI benefit from practice in a verbal learning memory test. The SRB approach revealed a higher incidence of meaningful decline in short and long-delay recall and recognition in the aMCI groups than in the SMC group. Specifically, compared to SMC participants, single-domain aMCI individuals declined in a higher proportion in all measures, and multiple-domain aMCI individuals in long delay free recall.

Tip-of-the-tongue for proper names in non-amnestic mild cognitive impairment

Abstract Difficulty in recalling peoples names is very common in the early stages of Alzheimers disease and in mild cognitive impairment (MCI). Recent studies using tip-of-the-tongue (TOT) tasks have shown that impaired naming of famous people by amnestic MCI patients is associated with difficulties in accessing the phonological representations of the names, but not with semantic breakdown. The aims of the present study were to investigate, by use of a TOT task, semantic and phonological access to famous peoples names in non-amnestic MCI and to test whether impairment in verbal episodic memory and other cognitive domains leads to difficulties in semantic and phonological access. We compared the performance of individuals with multiple domain amnestic MCI with that of individuals with multiple domain non-amnestic MCI and of healthy controls, and we studied the relationships between TOT production and the functioning of verbal episodic memory and other cognitive domains. In the multiple domain MCI groups (amnestic and non-amnestic), the main process affected was phonological access; failure in phonological access was related to deficits in general cognitive functioning and executive functioning. Semantic access was not impaired in either type of MCI. We interpret the findings in light of the transmission deficit hypothesis, as multiple domain MCI involves greater deficit in transmission from semantic to phonological representations than that produced by normal ageing, possibly because of reductions in cognitive resources and executive functions.