Sherri Hayden

Response biases as a confound to expressed burden among spousal caregivers of suspected dementia patients.

Burden among family caregivers has yet to be adequately assessed relative to social desirability response sets. This study examined the impact of two different response biases relative to expressed burden among spousal caregivers of suspected dementia patients. In addition to individual social desirability, it was hypothesized that a distinct social desirability construct exists as a function of ones perception of self within relationships. As predicted, a significant inverse association was apparent between expressed burden and this systemic response bias (as measured by the Edmonds Marital Conventionality Scale), whereas this association was not apparent with a measure of individual social desirability (the Marlowe-Crowne Social Desirability Scale). This finding suggests that systemic social desirability may exist as a significant response bias.

Sustained attention abnormalities in breast cancer survivors with cognitive deficits post chemotherapy: An electrophysiological study

OBJECTIVE Many breast cancer survivors (BCS) report cognitive problems following chemotherapy, yet controversy remains concerning which cognitive domains are affected. This study investigated a domain crucial to daily function: the ability to maintain attention over time. METHODS We examined whether BCS who self-reported cognitive problems up to 3 years following cancer treatment (n=19) performed differently from healthy controls (HC, n=12) in a task that required sustained attention. Participants performed a target detection task while periodically being asked to report their attentional state. Electroencephalogram was recorded during this task and at rest. RESULTS BCS were less likely to maintain sustained attention during the task compared to HC. Further, the P3 event-related potential component elicited by visual targets during the task was smaller in BCS relative to HC. BCS also displayed greater neural activity at rest. CONCLUSIONS BCS demonstrated an abnormal pattern of sustained attention and resource allocation compared to HC, suggesting that attentional deficits can be objectively observed in breast cancer survivors who self-report concentration problems. SIGNIFICANCE These data underscore the value of EEG combined with a less traditional measure of sustained attention, or attentional states, as objective laboratory tools that are sensitive to subjective complaints of chemotherapy-related attentional impairments.

Neuropsychological Subgroups of Cognitively-Impaired-Not-Demented (CIND) Individuals: Delineation, Reliability, and Predictive Validity

The objectives of the present investigation were to determine whether subgroups of Cognitively-Impaired-Not-Demented (CIND) individuals with distinct neuropsychological profiles exist in two independent samples, and whether subgroup membership is related to diagnostic outcome over periods of 2 to 5 years. A series of cluster analyses was performed on ipsative factor z-scores derived from principal component analyses. Five subgroups were identified in the Base Sample (n = 461): Verbal Dysfunction,Verbal/Visuospatial Dysfunction,Memory/Verbal Dysfunction,Memory Dysfunction, and Visuospatial Dysfunction. This five-cluster solution was replicated in an independent sample of CIND individuals (n = 166). The highest rates of conversion to dementia were observed in the Memory Dysfunction and Memory/Verbal Dysfunction subgroups. The Verbal Dysfunction subgroup was most likely to show improvement in cognitive status. The cognitive heterogeneity of the CIND condition must be taken into account in future research focusing on the early identification of dementia. The research described herein was conducted as part of a doctoral dissertation by the first author (K.R.P.). While conducting this research, the first author (K.R.P.) received support from a Doctoral Training Award jointly funded by the Alzheimer Society of Canada and the Canadian Institutes of Health Research and by a Postgraduate Scholarship funded by the Natural Sciences and Engineering Research Council of Canada. The CSHA was supported through the National Health Research and Development program grant # 6606-3954-MC[S]. The ACCORD study was supported through the MRC PMAC program grant # PA14197 awarded to H.F. We would like to express our sincerest gratitude to the participants and their families for their commitment to both the CSHA and ACCORD studies. We would also like to acknowledge the hard work performed by each centre that participated in each of these two studies.

Scientific and ethical features of English-language online tests for Alzheimer's disease

Freely accessible online tests for the diagnosis of Alzheimers disease (AD) are widely available. The objective of this study was to evaluate these tests along three dimensions as follows: (1) scientific validity; (2) human‐computer interaction (HCI) features; and (3) ethics features.

Neuropsychological characterization of cognitively-impaired-not-demented (CIND) individuals: clinical comparison data.

The primary objective of the present investigation was to characterize the neuropsychological test performance of a large sample of clinic-referred individuals diagnosed as Cognitively-Impaired-Not-Demented(CIND). Participants classified as Not-Cognitively-Impaired(NCI;n = 68)differed from CIND individuals(n = 205)on a number of demographic, clinical, and neuropsychological measures. A backward stepwise logistic regression analysis revealed that measures of learning and memory, visuoconstruction abilities, and cognitive flexibility provided the best discrimination between NCI and CIND participants. Clinical comparison data for CIND participants were generated for various demographically defined groups. The amount of inter-test scatter(highest minus lowest sample-basedz-score)and the overall number of cognitive impairments(impairment being defined as performance equal to or greater than 1 standard deviation below the sample mean)in CIND individuals are reported. The results support the impression that CIND is a cognitively heterogeneous condition.

Effect of aerobic exercise on cancer-associated cognitive impairment: A proof-of-concept RCT.

Change in cognitive ability is a commonly reported adverse effect by breast cancer survivors. The underlying etiology of cognitive complaints is unclear and to date, there is limited evidence for effective intervention strategies. Exercise has been shown to improve cognitive function in older adults and animal models treated with chemotherapy. This proof‐of‐concept randomized controlled trial tested the effect of aerobic exercise versus usual lifestyle on cognitive function in postmenopausal breast cancer survivors.

UTILITY OF COGNIGRAM IN TRIAGING PATIENTS FOR NEUROPSYCHOLOGICAL TESTING IN A TERTIARY MEMORY CLINIC

ering around 16 features. The study consisted of selection of feature subsets, fishers score method was employed for identifying the most prominent features. Features were fed to the Support Vector Machines classifier and Particle Swarm Optimization method was used for optimizing the parameters to design a CDSS for the diagnosis of AD. The results were compared with SVM based on the grid search technique and principle component analysis (PCAGrid-SVM) in terms of their classification accuracy. We also propose a unique model to monitor the daily activities of dementia patient by using IoT, Machine learning and Artificial intelligence. Methods: 850 subjects and 62 features from eight modalities were extracted from various Neuro imaging centers and hospitals across Karnataka. All features were obtained from the baseline visits of the Patients. AD image and corresponding binary lesion mask. Axial T2 weighted image (left), and proton density (PD) weighted image (At the centre), showing hyper intense white matter lesions; the corresponding binary lesion mask (right) was used to obtain the lesion features entered into the Support Vector Machine analysis using ensemble approach. Results: 850 subject details were put into the CDSS using different ML algorithms the below results were found. ML Algorithms j Number of Runs jClassification Accuracy (%) j Sensitivity j Specificity Rough sets Approach j10 j93.2329 j 0.941 j 0.937 Classification Tree (C4.5) j 10 j 91.0262 j 0.901 j 0.924 Random Forest j 10 j 85.3421 j 0.908 j 0.9165 SVM with PCA j 10 j 94.753 j 0.936 j 0.939. Conclusions:Experimental results on Neuropsychological tests, Laboratory investigations and image data set have proved to be efficient, resulting in an accuracy of 99.08%. The models are validated using 168 test cases the results proved to be efficient in Investigating and classifying stages of AD. The study proposes Different Machine Learning models for the classifying various stages of Alzheimer’s disease. Wearable sensors, particularly those equipped with IoT intelligence, offer attractive options for enabling observation and recording of data of the patients.

Patient perspectives of the experience of a computerized cognitive assessment in a clinical setting

Computerized assessments are becoming widely accepted in the clinical setting and as a potential outcome measure in clinical trials. To gain patient perspectives of this experience, the aim of the present study was to investigate patient attitudes and perceptions of the Cognigram [Cogstate], a computerized cognitive assessment.

Neurobehavioral characterization of adult-onset Alexander disease A family study

Alexander disease is a clinically heterogeneous condition associated with glial fibrillary acidic protein ( GFAP ) gene mutations initially described in infants, but juvenile and adult forms exist. Adult-onset Alexander disease (AOAD) has an insidious onset of symptoms localized largely to brainstem, but may also include cognitive dysfunction.

Cognitive testing on computer (C-TOC): Design, usability evaluation and validation of a novel computerized testing tool

evaluation of early dementia. Batteries that include a language test fail to assess spontaneous speech production and comprehension. Yet, deficits in these functions can be the earliest presenting symptoms in Frontotemporal dementia (FTD) and Alzheimer Disease (AD). We designed Sentence Production (SP) as a subtest for our new computerized battery, Cognitive Testing on Computer (C-TOC), with the aim of simulating as closely as possible on computer the production of speech. In this study we tested SP’s sensitivity to speech and language difficulties characteristic of aphasia syndromes. Methods: C-TOC was designed to combine a highly usable test platform with valid test paradigms in the detection of dementia prodromes. C-TOC records clicking-and-moving mouse responses, and therefore allows for the assessment of productive behaviours. The SP subtest requires the description of pictures by selecting words from an array that includes phonemic and semantic lures, and by ordering the selected words into sentences on the screen. For two items, the production of non-canonical sentence structures is forced. SP is scored for semantic units, phrases, word count, time per word, and syntax. The entire C-TOC battery including SP, and neuropsychological tests (NPT) of language were given to subjects with aphasia and cognitively normal controls. Results: Participants included 9 subjects with aphasia, M age1⁄466, SD1⁄411.1; 4 females/5 males, and a mix of etiologies: 5 FTD (1 behavioural-variant, 4 semantic dementia), 1 AD and 3 stroke, and 12 cognitively normal controls, M age1⁄467.5, SD1⁄46.6, 6 females/6 males. As a group, subjects with aphasia performed poorly on all SP measures, on the NPT language tests and on other verbal C-TOC subtests. Their performance was near normal on non-verbal C-TOC subtests. Performance differences were larger and overlap with controls smaller, on SP and NPT than on all other measures. SP performance patterns were qualitatively different for aphasia related to semantic dementia and stroke.Conclusions: The computerized sentence production paradigm that is part of the C-TOC battery is sensitive to a number of aphasia deficits. The paradigm may have utility in screening for different dementia prodromes.