Nikolaos Andronas

Self-awareness of cognitive efficiency: Differences between healthy elderly and patients with mild cognitive impairment (MCI)

ABSTRACT Introduction: Self-estimation of performance implies the ability to understand one’s own performance with relatively objective terms. Up to date, few studies have addressed this topic in mild cognitive impairment (MCI) patients. The aim of the present study was to compare objective measures of performance with subjective perception of specific performance on cognitive tests and investigate differences in assessment between MCI patients and healthy elderly. Method: Thirty-five participants diagnosed with MCI (women = 16, men = 19, mean age = 65.09 years ±SD = 7.81, mean education = 12.83 years ±SD = 4.32) and 35 control subjects similar in terms of age and education (women = 20, men = 15, mean age = 62.46 years ± SD = 9.35, mean education = 14.26 ± SD = 2.84) were examined with an extended battery of neuropsychological tests. After every test they were asked to self-evaluate their performance by comparing it to what they considered as average for people of their age and educational level. This self-evaluation was reported on a scale ranging from –100 to +100. Results: Significant differences were found in the self-assessment patterns of the two groups in memory measures of verbal and visual delayed recall, visuospatial perception, and tests of attention. MCI patients overestimated their performance on every cognitive domain while control participants underestimated their performance on measures of verbal memory. Conclusions: The present results indicate that accuracy of self-report is not uniform across groups and functional areas. The discrepancies in the MCI patients indicate unawareness of their memory deficits, which is contradictory to subjective memory complaints as being an important component for clinical diagnosis.

Clinical Reasoning: A 51-year-old man with cervical pain and progressively deteriorating gait

A 51-year-old Caucasian man presented with cervical pain, right hand weakness, and progressively deteriorating gait. Onset of symptoms occurred 1 month before admission with cervical pain that worsened during neck flexion. A few days later he noticed reduced dexterity and numbness of his right hand. During the following 3 weeks, his gait became increasingly unstable. Additionally, he reported erectile dysfunction and urinary hesitancy. No previous trauma was recalled. His medical and family history was unremarkable except for hypertension that was treated with angiotensin-converting enzyme inhibitors.

THE ASSESSMENT OF INCIDENTAL AND INTENTIONAL MEMORY IN PATIENTS WITH AMNESTIC MILD COGNITIVE IMPAIRMENT (AMCI) AND PATIENTS WITH DEPRESSION

represents an entity with specific executive (Delrieu et al, 2016) and motor impairments. Recently, two subtypes have been established: potentially-reversible and reversible cognitive-frailty (Ruan et al, 2015), related to mild cognitive impairment and subjective cognitive decline respectively. Recommendation for cognitive assessment includes screening (i.e. clock-drawing) and neuropsychological tests (i.e. verbal learning, processing speed and verbal fluency tasks). Conclusions:The conceptual and operational definition of Cognitive Frailty present implications for the study of neuropsychological profiles; the study of vascular, inflammatory, nutritional, and metabolic mechanisms involved; the role of the cognitive reserve construct; and its potential reversibility. Implications for cognitive screening and preventive interventions are discussed. Funding: This work was supported by the Xunta de Galicia, FrailNet network IN607C 2016/08.

SELF-EVALUATION OF DRIVING ABILITY THROUGH A DRIVING SIMULATOR EXPERIMENT: DIFFERENCES BETWEEN PATIENTS WITH MILD COGNITIVE IMPAIRMENT (MCI) AND HEALTHY ELDERLY DRIVERS

assumed without an adequate analysis, especially in Old Adults (OA). Among the “weak” stationarity tests, the Priestley-Subba Rao (PSR) test calculates a “local” spectra that is “valid” only for punctual moments in time. A series of “smoothed” frequency filters give information of the time the local spectra is calculated. In here, weak REM sleep stationarity by the PSR test was compared to that from Wakefulness (W) and Non-REM (NREM) sleep. Methods: 8 Old Adults (OA) (age: 67.6 6 5.7; education: 8.8 6 2.6) without depression neither anxiety and with intact daily living activities were selected. Also, evaluations with the Mini-Mental State Examination (MMSE, 28.1 6 1.8) and a one night polysomnography were performed. 30 second epochs were classified according to the AASM and every epoch of W, NREM and REM sleep was subjected to PSR tests. Percentages of stationary epochs were obtained with respect to the total number of epochs of each stage and Student t-tests were used to compare them. Results: The PSR effectively showed different proportions of stationarity according to the classification of stages in each subject. In Figure 1, in one OA, epochs with stationarity are shown in black and the classification of REM sleep is shown in green. Clearly, a lower proportion of stationarity was found in REM sleep vs the other stages. These differences reached significance in F7, Fp2, LOG and ROG (p < 0.05, Figure 2). Conclusions: In OA, REM sleep showed lower proportions of epochs with stationarity vs. W and NREM sleep at anterior areas, a result that could be explained by the tonic and phasic REM sleep. When stationarity measurements are planned, it is recommended to differentiate anterior from lateral and posterior areas.