Enhanced Vocational Rehabilitation: A Pilot for Veterans With Cognitive Impairment and a History of Mild TBI

2012 ◽  
Author(s):  
Maureen K. O'Connor ◽  
Lisa Mueller ◽  
Alicia Semiatin ◽  
Charles E. Drebing ◽  
Shihwe Wang
Keyword(s):  
Cognitive Impairment ◽  
Vocational Rehabilitation ◽  
Mild Tbi ◽  
History Of

Voltage-gated potassium channel limbic encephalitis presenting as functional cognitive impairment

2020 ◽  
Vol 13 (12) ◽  
pp. e233179
Author(s):  
Eric Garrels ◽  
Fawziya Huq ◽  
Gavin McKay
Keyword(s):  
Cognitive Impairment ◽  
Case Report ◽  
Potassium Channel ◽  
Limbic Encephalitis ◽  
Psychiatric Symptoms ◽  
Differential Diagnoses ◽  
Visual Hallucinations ◽  
Voltage Gated ◽  
History Of ◽  
Impaired Cognition

Limbic encephalitis is often reported to present as seizures and impaired cognition with little focus on psychiatric presentations. In this case report, we present a 49-year-old man who initially presented to the Psychiatric Liaison Service with a several month history of confusion with the additional emergence of visual hallucinations and delusions. Due to the inconsistent nature of the symptoms in the context of a major financial stressor, a provisional functional cognitive impairment diagnosis was made. Investigations later revealed a positive titre of voltage-gated potassium channel (VGKC) antibodies, subtype leucine-rich glioma inactivated 1 accounting for his symptoms which dramatically resolved with steroids and immunoglobulins. This case highlighted the need for maintaining broad differential diagnoses in a patient presenting with unusual psychiatric symptoms.

Unemployment Status Is Associated With Greater Cognitive Intraindividual Variability in Veterans With a History of Remote Mild TBI

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
McKenna S. Sakamoto ◽  
Lisa Delano-Wood ◽  
Scott F. Sorg ◽  
Dawn M. Schiehser ◽  
Victoria C. Merritt
Keyword(s):  
Intraindividual Variability ◽  
Mild Tbi ◽  
History Of

OBJECTIVE COGNITIVE IMPAIRMENT AND PROGRESSION TO DEMENTIA IN WOMEN: THE PROSPECTIVE EPIDEMIOLOGICAL RISK FACTOR STUDY

2017 ◽  
pp. 1-7
Author(s):  
J. Skov Neergaard ◽  
K. Dragsbæk ◽  
C. Christiansen ◽  
M. Asser Karsdal ◽  
S. Brix ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Elderly Women ◽  
Population Based ◽  
Risk Factor Study ◽  
Factor Study ◽  
Epidemiological Risk ◽  
Epidemiological Risk Factor ◽  
History Of

Background: Identification of subjects with a progressive disease phenotype is an urgent need in the pharmaceutical industry where most of the recent clinical trials in Alzheimer’s disease have failed. Objectives: The objective of this study was to identify subgroups of individuals with objective cognitive impairment (OCI), who were most likely to progress to dementia and to identify the risk factors associated with progression. Design: Prospective cohort study. Setting: Population-based. Participants: 5,380 elderly women from Denmark. Measurements: The Short Blessed Test and a category fluency test with animal naming, was used to assess cognitive function, and to classify them into different groups of OCI. Results: OCI was identified in 852 subjects at baseline. The risk of dementia was elevated for OCI subjects as compared to subjects with normal cognition (HR 1.46[1.19-1.79]). The courses of OCI were studied in a sub-cohort who completed the cognitive assessment at both the baseline and the follow-up visit (n = 1,933). Of these subjects 203 had OCI at baseline. The multi-domain subtypes of OCI were associated with progressive OCI. Subjects most likely to progress were older, physically inactive, had a higher level of total cholesterol (>6.5 mmol/L) and had a history of depression as compared to subjects with a non-progressive course of OCI. Conclusions: In this cohort we identified a risk profile associated with progression from OCI in older women. The degree of impairment at baseline was an important predictor of conversion to dementia, additionally several modifiable risk factors were associated with progression.

scholarly journals Association of Diabetes With Atrial Fibrillation Phenotype and Cardiac and Neurological Comorbidities: Insights From the Swiss‐AF Study

2021 ◽  
Author(s):  
Arjola Bano ◽  
Nicolas Rodondi ◽  
Jürg H. Beer ◽  
Giorgio Moschovitis ◽  
Richard Kobza ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cognitive Impairment ◽  
Unique Identifier ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
History Of

Background Diabetes is a major risk factor for atrial fibrillation (AF). However, it remains unclear whether individual AF phenotype and related comorbidities differ between patients who have AF with and without diabetes. This study investigated the association of diabetes with AF phenotype and cardiac and neurological comorbidities in patients with documented AF. Methods and Results Participants in the multicenter Swiss‐AF (Swiss Atrial Fibrillation) study with data on diabetes and AF phenotype were eligible. Primary outcomes were parameters of AF phenotype, including AF type, AF symptoms, and quality of life (assessed by the European Quality of Life‐5 Dimensions Questionnaire [EQ‐5D]). Secondary outcomes were cardiac (ie, history of hypertension, myocardial infarction, and heart failure) and neurological (ie, history of stroke and cognitive impairment) comorbidities. The cross‐sectional association of diabetes with these outcomes was assessed using logistic and linear regression, adjusted for age, sex, and cardiovascular risk factors. We included 2411 patients with AF (27.4% women; median age, 73.6 years). Diabetes was not associated with nonparoxysmal AF (odds ratio [OR], 1.01; 95% CI, 0.81–1.27). Patients with diabetes less often perceived AF symptoms (OR, 0.74; 95% CI, 0.59–0.92) but had worse quality of life (β=−4.54; 95% CI, −6.40 to −2.68) than those without diabetes. Patients with diabetes were more likely to have cardiac (hypertension [OR, 3.04; 95% CI, 2.19–4.22], myocardial infarction [OR, 1.55; 95% CI, 1.18–2.03], heart failure [OR, 1.99; 95% CI, 1.57–2.51]) and neurological (stroke [OR, 1.39, 95% CI, 1.03–1.87], cognitive impairment [OR, 1.75, 95% CI, 1.39–2.21]) comorbidities. Conclusions Patients who have AF with diabetes less often perceive AF symptoms but have worse quality of life and more cardiac and neurological comorbidities than those without diabetes. This raises the question of whether patients with diabetes should be systematically screened for silent AF. Registration URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT02105844.

scholarly journals PENGARUH PENYAKIT KRONIS DAN GAYA HIDUP TERHADAP KINERJA VERBAL FLUENCY KATEGORIK PADA LANSIA

2019 ◽  
Vol 37 (1) ◽  
Author(s):  
Jessica Alysia ◽  
Yvonne Suzy Handajani ◽  
Nelly Tina Widjaja ◽  
Yuda Turana
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cognitive Impairment ◽  
Chronic Illness ◽  
Chronic Diseases ◽  
Verbal Fluency ◽  
Cross Sectional Study ◽  
Education Level ◽  
Cross Sectional ◽  
History Of

CHRONIC DISEASES AND LIFESTYLE IMPACT TO CATEGORY VERBAL FLUENCY PERFORMANCE IN ELDERLYABSTRACTIntroduction: In recent studies, chronic illness and sedentary lifestyle were found to bea risk factors for cognitive impairment. Verbal fluency (VF) is one of the most used instruments.Aim: To determine cognitive impairment using VF and its correlation with risk factors (chronic illness and lifestyle) in elderly.Method: This cross-sectional study was conducted toward 121 elderly respondents in August–September 2017 at Pusaka, West Jakarta. Cognitive impariment was assessesed using VF. VF otherwise disturbed if the value <16.03. Heart disease and stroke were determined by anamnesis. Blood pressure was determined using Riester tensimeter. that has been calibrated. Cholesterol and blood sugar were determined using laboratory result by CHOD-PAP method. Smoking was determined by asking the history of smoking. Physical activity was determined by 24-hour activity recall. Nutrition Intake was determined by food record.Results: There were 63.6% subjects wno had VF impairment. Most respondent were over 65 years old (71.9%), female (66.1%) and education level more than 6 years (72.7%). VF had a significant assosiation with education level (p=0.020; OR=3.792), and without cardiovascular disease (p=0.023; OR=0.111).Discussion: The mayority of respondents had VF impairment, lower education was consistenly as a risk factors while no history of cardiovascular disease as a protective factors of language impairment.Keywords: Chronic diseases, cognitive impairment, lifestyle, verbal fluencyABSTRAKPendahuluan: Pada beberapa penelitian terbaru ditemukan bahwa faktor risiko seperti penyakit kronis dan gaya hidup buruk meningkatkan risiko terkena gangguan fungsi kognitif. Salah satu instrumen yang sering digunakan adalah verbal fluency (VF).Tujuan: Mengetahui gambaran fungsi kognitif dengan instrumen VF dan hubungannya dengan faktor risiko (penyakit kronis dan gaya hidup) pada lansia.Metode: Penelitian potong lintang ini dilaksanakan pada 121 responden lansia pada bulan Agustus-September 2017 di Pusaka Jakarta Barat. Gangguan fungsi kognitif dinilai menggunakan instrumen VF. Verbal fluency dikatakan terganggu dengan nilai <16,03. Penyakit jantung dan stroke didapatkan dari anamnesis. Tekanan darah dari hasil pengukuran menggunakan tensimeter yang telah dikalibrasi sebelumnya. Pengukuran kolesterol dan gula darah didapatkan dari hasil laboratorium dengan metode CHOD-PAP. Merokok didapat dari anamnesis. Aktivitas fisik dinilai dari 24-hour activity recall. Asupan nutrisi dinilai dari kuisioner food record.Hasil: Hasil penelitian ini menunjukkan subjek dengan gangguan VF sebanyak 63,6%. Mayoritas responden berusia diatas 65 tahun (71,9%), dengan jenis kelamin wanita (66,1%) dan tingkat pendidikan diatas 6 tahun (72,7%). Hasil analisis menunjukan bahwa instrumen VF memiliki hubungan bermakna dengan tingkat pendidikan rendah (p=0,020; RO=3,792), dan tidak berpenyakit jantung (p=0,023; RO=0,111).Diskusi: Mayoritas responden memiliki gangguan bahasa, pendidikan rendah diketahui secara konsisten sebagai faktor risiko sementara tidak ada riwayat penyakit jantung sebagai faktor protektif untuk gangguan fungsi bahasa.Kata kunci: Gangguan fungsi kognitif, gaya hidup, penyakit kronis, verbal fluency

The Heterogeneity and Natural History of Mild Cognitive Impairment of Visual Memory Predominant Type

2014 ◽  
Vol 43 (1) ◽  
pp. 143-152 ◽  
Author(s):  
Byoung Seok Ye ◽  
Juhee Chin ◽  
Seong Yoon Kim ◽  
Jung-Sun Lee ◽  
Eun-Joo Kim ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Natural History ◽  
Visual Memory ◽  
Predominant Type ◽  
History Of

Abstract TP439: Temporary Cognitive Impairment in Transient Ischemic Attack and Minor Stroke Patients is Predicted by Chronic White Matter Hyperintensity Volume

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Leka Sivakumar ◽  
Thomas Jeerakathil ◽  
Negar Asdaghi ◽  
Richard Camicioli ◽  
Christian Beaulieu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
White Matter ◽  
White Matter Hyperintensity ◽  
Minor Stroke ◽  
Lesion Volume ◽  
Cognitive Changes ◽  
Mini Mental Status Examination ◽  
History Of ◽  
Ischemic Attack ◽  
Patients Experience

Background: Cognitive changes have been described in subacute TIA/minor stroke (TIA/MIS), but the temporal profile is unknown. We tested the hypothesis that TIA/MIS patients experience transient cognitive impairment, and that this can be predicted by Diffusion-Weighted Imaging (DWI) lesion volume. Methods: Acute TIA/MIS stroke (NIH stroke scale score ≤3) patients with no history of cognitive impairment were prospectively recruited within 72 h of onset. Patients underwent Montreal Cognitive Assessment (MoCA), Mini-Mental Status Examination (MMSE) and MRI, including DWI and Fluid-Attenuated Inverse Recovery (FLAIR) sequences, at baseline, days 7 and 30. DWI lesion and FLAIR chronic white matter hyperintensity (WMH) volumes were measured planimetrically. Results: Fifty patients (mean age 68 ±15.1 years) were imaged at a median (IQR) of 26.5 (28.5) h after onset. Cognitive impairment (scores ≤26) was detected more frequently with MoCA (31/50, 62%) than MMSE (13/50, 26%, p=0.009). Acute ischemic lesions (DWI) were present in 33 (66%) patients. Mean DWI volume at baseline was 4.5 ± 11.1ml. Patients with DWI lesions (22/33, 67%) had similar impairment rates as those without (9/17, 53%; p=0.34). Linear regression indicated no relationship between acute DWI lesion volume (log transformed) and baseline MoCA scores (β=0.028, 95% CI [-2.09, 2.44]). Impaired patients had larger WMH volumes (13.6 ± 21.9 ml) than unaffected patients (2.6 ± 3.2 ml, p=0.01). Log transformed WMH volumes were inversely predictive of baseline MoCA scores (β=-0.54, 95% CI [-7.84, -2.28]). Median MoCA scores improved over time (27(5) at day 7 and 28(5) at day 30). Patients with baseline impairment and an increase of ≥2 points on MoCA by day 30 were defined as reverters (N=20). DWI lesion frequency was similar in reverters and those with persisting impairment (75% vs 64%, p= 0.50), as was DWI (6.9 ±14.3 ml vs 1.2 ±1.9 ml; p= 0.113) and WMH lesion volume (17.0 ± 26.2 ml vs 8.1 ± 8.1 ml; p= 0.18). Conclusions: Most TIA/MIS patients have evidence of temporary acute cognitive impairment when assessed with MoCA. Deficits are correlated with chronic WMH, suggesting an unmasking of subclinical cognitive impairment. Temporary cognitive deficits should be considered in the management of TIA/MIS patients.

Clinical diagnosis of LGI1 antibody encephalitis in an 83-year-old woman

2021 ◽  
Vol 14 (1) ◽  
pp. e237398
Author(s):  
Jonathan E Attwood ◽  
Saniya Naseer ◽  
Sophia Michael ◽  
Josie Riley
Keyword(s):  
Cognitive Impairment ◽  
Clinical Diagnosis ◽  
Memory Impairment ◽  
Short Term Memory ◽  
Autoimmune Encephalitis ◽  
Short Term ◽  
Term Memory ◽  
Blood Tests ◽  
Abnormal Movements ◽  
History Of

An 83-year-old woman was referred to hospital with a 2-week history of short-lived episodic unpleasant sensations in her head and running down her body. This was accompanied by new short-term memory impairment and arm spasms. Initial investigations including blood tests and brain imaging did not reveal the diagnosis. The patient developed an increasing frequency of abnormal movements of her face and arm. These were clinically recognised as faciobrachial dystonic seizures (FBDS). FBDS are pathognomonic of an autoimmune encephalitis caused by an antibody directed against leucine-rich glioma-inactivated 1 (LGI1). The clinical diagnosis resulted in treatment with immunotherapy, leading to cessation of seizures and rapid cognitive recovery. Later, the predicted serology was confirmed. This reversible and under-recognised cause of cognitive impairment, typically affecting elderly patients, can be diagnosed clinically to enable early and effective treatment.

scholarly journals Association Between Atrial Fibrillation and Cognitive Impairment in Individuals With Prior Stroke

Stroke ◽  
2020 ◽  
Vol 51 (6) ◽  
pp. 1662-1666 ◽  
Author(s):  
Damianos G. Kokkinidis ◽  
Nikos Zareifopoulos ◽  
Christina A. Theochari ◽  
Angelos Arfaras-Melainis ◽  
Christos A. Papanastasiou ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cognitive Impairment ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Adjusted Analysis ◽  
End Point ◽  
History Of ◽  
The Impact ◽  
Prior Stroke ◽  
Unadjusted Analysis

Background and Purpose— Atrial fibrillation (AF) is the most common chronic arrhythmia. Dementia and cognitive impairment (CI) are major burdens to public health. The prevalence of all 3 entities is projected to increase due to population aging. Previous reports have linked AF with a higher risk of CI and dementia in patients without prior stroke. Stroke is known to increase the risk for dementia and CI. It is unclear if AF in patients with history of stroke can further increase the risk for dementia or CI. Our purpose was to evaluate the impact of AF on risk for dementia or CI among patients with history of stroke. Methods— Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines were followed. Pubmed, Scopus, and Cochrane central were searched. The outcomes of interest were dementia, CI, and the composite end point of dementia or CI. A random-effect model meta-analysis was performed. Meta-regression analysis was also performed. Publication bias was assessed with the Egger test and with funnel plots. Results— Fourteen studies and 14 360 patients (1363 with AF) were included in the meta-analysis. In the meta-analysis of adjusted odds ratio, AF was associated with increased risk of CI (odds ratio, 1.60 [95% CI, 1.20–2.14]), dementia (odds ratio, 3.11 [95% CI, 2.05–4.73]), and the composite end point of CI or dementia (odds ratio, 2.26 [95% CI, 1.61–3.19]). The heterogeneity for the composite end point of dementia or CI was moderate (adjusted analysis). The heterogeneity for the analysis of the end point of CI only was substantial in the unadjusted analysis and moderate in the adjusted analysis. The heterogeneity for the end point of dementia only was moderate in the unadjusted analysis and zero in the adjusted analysis. Conclusions— Our results indicate that an association between AF and CI or dementia is patients with prior strokes is possible given the persistent positive associations we noticed in the unadjusted and adjusted analyses. The heterogeneity levels limit the certainty of our findings.

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