Katherine G. Denny

Progression from normal cognition to mild cognitive impairment in a diverse clinic-based and community-based elderly cohort

Investigation of the conversion rates from normal cognition (NC) to mild cognitive impairment (MCI) is important, as effective early intervention could potentially prevent or substantially delay the onset of dementia. However, reported conversion rates differ across studies and recruitment source. Our study examined predictors of conversion from NC to MCI in a racially and ethnically diverse sample drawn both from community and clinic recruitment sources.

Therapeutic temperature modulation is associated with pulmonary complications in patients with severe traumatic brain injury.

AIM To examine complications associated with the use of therapeutic temperature modulation (mild hypothermia and normothermia) in patients with severe traumatic brain injury (TBI). METHODS One hundred and fourteen charts were reviewed. Inclusion criteria were: severe TBI with Glasgow Coma Scale (GCS) < 9, intensive care unit (ICU) stay > 24 h and non-penetrating TBI. Patients were divided into two cohorts: the treatment group received therapeutic temperature modulation (TTM) with continuous surface cooling and indwelling bladder temperature probes. The control group received standard treatment with intermittent acetaminophen for fever. Information regarding complications during the time in the ICU was collected as follows: Pneumonia was identified using a combination of clinical and laboratory data. Pulmonary embolism, pneumothorax and deep venous thrombosis were identified based on imaging results. Cardiac arrhythmias and renal failure were extracted from the clinical documentation. acute respiratory distress syndrome and acute lung injury were determined based on chest imaging and arterial blood gas results. A logistic regression was conducted to predict hospital mortality and a multiple regression was used to assess number and type of clinical complications. RESULTS One hundred and fourteen patients were included in the analysis (mean age = 41.4, SD = 19.1, 93 males), admitted to the Jackson Memorial Hospital Neuroscience ICU and Ryder Trauma Center (mean GCS = 4.67, range 3-9), were identified and included in the analysis. Method of injury included motor vehicle accident (n = 29), motor cycle crash (n = 220), blunt head trauma (n = 212), fall (n = 229), pedestrian hit by car (n = 216), and gunshot wound to the head (n = 27). Ethnicity was primarily Caucasian (n = 260), as well as Hispanic (n = 227) and African American (n = 223); four patients had unknown ethnicity. Patients received either TTM (43) or standard therapy (71). Within the TTM group eight patients were treated with normothermia after TBI and 35 patients were treated with hypothermia. A logistic regression predicting in hospital mortality with age, GCS, and TM demonstrated that GCS (Beta = 0.572, P < 0.01) and age (Beta = -0.029) but not temperature modulation (Beta = 0.797, ns) were significant predictors of in-hospital mortality [χ(2) (3) = 22.27, P < 0.01] A multiple regression predicting number of complications demonstrated that receiving TTM was the main contributor and was associated with a higher number of pulmonary complications (t = -3.425, P = 0.001). CONCLUSION Exposure to TTM is associated with an increase in pulmonary complications. These findings support more attention to these complications in studies of TTM in TBI patients.

Early Functional Limitations in Cognitively Normal Older Adults Predict Diagnostic Conversion to Mild Cognitive Impairment

To examine whether specific types of early functional limitations in cognitively normal older adults are associated with subsequent development of mild cognitive impairment (MCI), as well as the relative predictive value of self versus informant report in predicting diagnostic conversion to MCI.

Compensation Strategies in Older Adults: Association With Cognition and Everyday Function:

Background/Rationale: Compensation strategies may contribute to greater resilience among older adults, even in the face of cognitive decline. This study sought to better understand how compensation strategy use among older adults with varying degrees of cognitive impairment impacts everyday functioning. Methods: In all, 125 older adults (normal cognition, mild cognitive impairment, dementia) underwent neuropsychological testing, and their informants completed questionnaires regarding everyday compensation and cognitive and functional abilities. Results: Cognitively normal and mild cognitive impairment older adults had greater levels of compensation use than those with dementia. Higher levels of neuropsychological functioning were associated with more frequent compensation use. Most importantly, greater frequency of compensation strategy use was associated with higher levels of independence in everyday function, even after accounting for cognition. Conclusion: Use of compensation strategies is associated with higher levels of functioning in daily life among older adults. Findings provide strong rational for development of interventions that directly target such strategies.

A MULTI-MODAL INTERVENTION TO ENHANCE COGNITIVE COMPENSATION STRATEGIES AND PROMOTE BRAIN HEALTH ACTIVITIES

registration trial) especially because of better memory registration and had many more false positives on CVLT recognition memory testing. In comparison, the non-amnestic AD patients were worse on Forward Digit Span, Trailmaking B time, Boston Naming Test (uncued), CVLT memory registration, and the Southern California Figure-Ground Test. 17 of the 19 non-amnestic EOAD patients were abnormal on all 6 tests, and the Trailmaking B added the highest specificity at 0.92. Conclusions:These results reveal significantly different neuropsychological profiles for the non-amnestic variants of AD, as a group, from typical AD. The findings suggest neuropsychological measure for differentiation of these variants that including measures of early impairment in mental control and executive abilities, uncued naming, memory registration, and midlevel visuospatial processing.

USEFULNESS OF SELF- AND INFORMANT-REPORTED FUNCTIONAL ABILITIES IN PREDICTING RISK OF TRANSITIONING FROM NORMAL COGNITION TO MCI

Age, Mean Years (SD) 72.1 (4.7) Gender (Male %) 50.9 Education, Mean Years (SD) 16.8 (2.5) % APOE ε4, 0/1/2 allele(s) 77.8/20.8/1.4 Age of Symptom Onset, Mean Years (SD) N/A Disease Duration, Mean Years (SD) N/A Baseline CDR Score, Mean (SD) 0.03 (0.12) Baseline MMSE Score, Mean (SD) 29.0 (1.2) SUVR, Mean 1.02 (0.06) % of N with MRI/FDG/Amyloid Scans 95.3/99.5/100.0 Poster Presentations: Wednesday, July 19, 2017 P1441