scholarly journals Role of cognitive reserve in cognitive variability in euthymic individuals with bipolar disorder: cross-sectional cluster analysis

BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Dimosthenis Tsapekos ◽  
Rebecca Strawbridge ◽  
Tim Mantingh ◽  
Matteo Cella ◽  
Til Wykes ◽  
...  

Background People with bipolar disorder have moderate cognitive difficulties that tend to be more pronounced during mood episodes but persist after clinical remission and affect recovery. Recent evidence suggests heterogeneity in these difficulties, but the factors underlying cognitive heterogeneity are unclear. Aims To examine whether distinct cognitive profiles can be identified in a sample of euthymic individuals with bipolar disorder and examine potential differences between subgroups. Method Cognitive performance was assessed across four domains (i.e. processing speed, verbal learning/memory, working memory, executive functioning) in 80 participants. We conducted a hierarchical cluster analysis and a discriminant function analysis to identify cognitive profiles and considered differences in cognitive reserve, estimated cognitive decline from premorbid cognitive functioning, and clinical characteristics among subgroups. Results Four discrete cognitive profiles were identified: cognitively intact (n = 25; 31.3%); selective deficits in verbal learning and memory (n = 15; 18.8%); intermediate deficits across all cognitive domains (n = 30; 37.5%); and severe deficits across all domains (n = 10; 12.5%). Cognitive decline after illness onset was greater for the intermediate and severe subgroups. Cognitive reserve scores were increasingly lower for subgroups with greater impairments. A smaller proportion of cognitively intact participants were using antipsychotic medications compared with all other subgroups. Conclusions Our findings suggest that individuals with cognitively impaired profiles demonstrate more cognitive decline after illness onset. Cognitive reserve may be one of the factors underlying cognitive variability across people with bipolar disorder. Patients in the intermediate and severe subgroups may be in greater need of interventions targeting cognitive difficulties.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xinyu Liu ◽  
Xiaojuan Ma ◽  
Wenchen Wang ◽  
Jian Zhang ◽  
Xia Sun ◽  
...  

Abstract Background The aim was to explore the associations between clinical symptoms, demographic variables, social and neurocognitive functioning in euthymic patients with bipolar disorder (BD) stratified by subgroups of DSM-IV BD (type I (BD-I) and type II (BD-II)) and occupational status (employed/unemployed), and to highlight the significance of occupational status when assessing social and neurocognitive functioning in euthymic BD patients. Methods A total of 81 euthymic BD patients were participated in the study. The severity of the depressive and manic/hypomanic symptoms was measured using the 17-item Hamilton Depression Rating Scale (HDRS-17) and the Young Mania Rating Scale (YMRS), respectively. Social functioning and neurocognitive functioning were evaluated by the Functioning Assessment Short Test (FAST) and neurocognitive measures, respectively. Results Employed BD patients displayed greater social functioning (autonomy, occupational functioning, interpersonal relationship domain) and better verbal learning performance and speed of processing than unemployed BD patients. The correlation between neurocognitive functioning and social functioning was stronger in the employed group than in the unemployed group. There were no significant differences in neurocognitive and social functioning between the BD-I and BD-II groups, and the correlation between neurocognitive functioning and social functioning was similar between the BD-I and BD-II groups. Conclusion Employed BD patients may present greater occupational functioning and interpersonal relationships, as well as better verbal learning performance and speed of processing.


2021 ◽  
pp. 073194872198997
Author(s):  
Philip Capin ◽  
Eunsoo Cho ◽  
Jeremy Miciak ◽  
Greg Roberts ◽  
Sharon Vaughn

This study investigated the word reading and listening comprehension difficulties of fourth-grade students with significant reading comprehension deficits and the cognitive difficulties that underlie these weaknesses. Latent profile analysis was used to classify a sample of fourth-grade students ( n = 446) who scored below the 16th percentile on a measure of reading comprehension into subgroups based on their performance in word reading (WR) and listening comprehension (LC). Three latent profiles emerged: (a) moderate deficits in both WR and LC of similar severity (91%), (b) severe deficit in WR paired with moderate LC deficit (5%), and (c) severe deficit in LC with moderate WR difficulties (4%). Analyses examining the associations between cognitive attributes and group membership indicated students with lower performance on cognitive predictors were more likely to be in a severe subgroup. Implications for educators targeting improved reading performance for upper elementary students with significant reading difficulties were discussed.


2021 ◽  
Vol 11 (4) ◽  
pp. 442
Author(s):  
Emilio Portaccio ◽  
Ermelinda De Meo ◽  
Angelo Bellinvia ◽  
Maria Pia Amato

Multiple sclerosis (MS) is one of the leading causes of disability in young adults. The onset of MS during developmental age makes pediatric patients particularly susceptible to cognitive impairment, resulting from both disease-related damage and failure of age-expected brain growth. Despite different test batteries and definitions, cognitive impairment has been consistently reported in approximately one-third of pediatric patients with MS. However, the lack of a uniform definition of cognitive impairment and the adoption of different test batteries have led to divergent results in terms of cognitive domains more frequently affected across the cohorts explored. This heterogeneity has hampered large international collaborative studies. Moreover, research aimed at the identification of risk factors (e.g., demographic, clinical, and radiological features) or protective factors (e.g., cognitive reserve, leisure activities) for cognitive decline is still scanty. Mood disorders, such as depression and anxiety, can be detected in these patients alongside cognitive decline or in isolation, and can negatively affect quality of life scores as well as academic performances. By using MRI, cognitive impairment was attributed to damage to specific brain compartments as well as to abnormal network activation patterns. However, multimodal MRI studies are still needed in order to assess the contribution of each MRI metric to cognitive impairment. Importantly, longitudinal studies have recently demonstrated failure of age-expected brain growth and of white matter (WM) and gray matter (GM) maturation plays a relevant role in determining cognitive dysfunction, in addition to MS-related direct damage. Whether these growth retardations might result in specific cognitive profiles according to the age at disease onset has not been studied, yet. A better characterization of cognitive profiles in pediatric MS patients, as well as the definition of neuroanatomical substrates of cognitive impairment and their longitudinal evolution are needed to develop efficient therapeutic strategies against cognitive impairment in this patient population.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 559-559
Author(s):  
W Quin Yow ◽  
Hui-Ching Chen ◽  
Tharshini Lokanathan ◽  
Attila Achenbach ◽  
Lucienne Blessing

Abstract Although cognitive training in healthy older adults (OA) has been controversial, specific and isolated cognitive skills such as semantic memory can be improved with appropriate designs. Semantic memory has been considered as a clinical marker for cognitive decline in dementia. The current study, as part of a larger touch-screen dual-language intervention program with cognitive training tools, aims to slow down the rate of cognitive decline in OA with dementia (OwD). A set of neuropsychological tests was conducted before and after the training program. After 24 training sessions over 8-12 weeks, OwD (11 females, 1 male, mean=85.8yo) improved significantly in their verbal working memory (Rey Auditory Verbal Learning Test; RAVLT) while performance of the cognitive-healthy OA (5 females, 3 males, mean=76.3yo) remained the same post-intervention. Our findings suggest that touch-screen technology can help OwD improve their semantic memory. The strengths and limitations of our game design and intervention will be discussed. Part of a symposium sponsored by Technology and Aging Interest Group.


2021 ◽  
pp. jnnp-2020-324992
Author(s):  
Emmet Costello ◽  
James Rooney ◽  
Marta Pinto-Grau ◽  
Tom Burke ◽  
Marwa Elamin ◽  
...  

BackgroundAmyotrophic lateral sclerosis (ALS) is often associated with cognitive and/or behavioural impairment. Cognitive reserve (CR) may play a protective role in offsetting cognitive impairment. This study examined the relationship between CR and longitudinal change in cognition in an Irish ALS cohort.MethodsLongitudinal neuropsychological assessment was carried out on 189 patients over 16 months using the Edinburgh cognitive and behavioural ALS screen (ECAS) and an additional battery of neuropsychological tests. CR was measured by combining education, occupation and physical activity data. Joint longitudinal and time-to-event models were fitted to investigate the associations between CR, performance at baseline and decline over time while controlling for non-random drop-out.ResultsCR was a significant predictor of baseline neuropsychological performance, with high CR patients performing better than those with medium or low CR. Better cognitive performance in high CR individuals was maintained longitudinally for ECAS, social cognition, executive functioning and confrontational naming. Patients displayed little cognitive decline over the course of the study, despite controlling for non-random drop-out.ConclusionsThese findings suggest that CR plays a role in the presentation of cognitive impairment at diagnosis but is not protective against cognitive decline. However, further research is needed to examine the interaction between CR and other objective correlates of cognitive impairment in ALS.


2021 ◽  
Vol 11 (2) ◽  
pp. 135
Author(s):  
Ariela Gigi ◽  
Merav Papirovitz

Studies demonstrate that anxiety is a risk factor for cognitive decline. However, there are also study findings regarding anxiety incidence among people with mild cognitive impairment (MCI), which mostly examined general anxiety evaluated by subjective questionnaires. This study aimed to compare subjective and objective anxiety (using autonomic measures) and anxiety as a general tendency and anxiety as a reaction to memory examination. Participants were 50 adults aged 59–82 years who were divided into two groups: MCI group and control group, according to their objective cognitive performance in the Rey Auditory Verbal Learning Test. Objective changes in the anxiety response were measured by skin conductivity in all tests and questionnaires. To evaluate subjective anxiety as a reaction to memory loss, a questionnaire on “state-anxiety” was used immediately after completing memory tests. Our main finding was that although both healthy and memory-impaired participants exhibited elevations in physiological arousal during the memory test, only healthy participants reported an enhanced state anxiety (p = 0.025). Our results suggest that people with MCI have impaired awareness of their emotional state.


2016 ◽  
Vol 12 ◽  
pp. P806-P806
Author(s):  
Matthew D. Parrott ◽  
Alexandra J. Fiocco ◽  
Pierre-Hugues Carmichael ◽  
Nicole D. Anderson ◽  
Danielle Laurin ◽  
...  

2006 ◽  
Vol 36 (8) ◽  
pp. 1053-1064 ◽  
Author(s):  
J. H. BARNETT ◽  
C. H. SALMOND ◽  
P. B. JONES ◽  
B. J. SAHAKIAN

Background. The idea that superior cognitive function acts as a protective factor against dementia and the consequences of head injury is well established. Here we suggest the hypothesis that cognitive reserve is also important in neuropsychiatric disorders including schizophrenia, bipolar disorder and depression.Method. We review the history of passive and active models of reserve, and apply the concept to neuropsychiatric disorders. Schizophrenia is used as an exemplar because the effects of premorbid IQ and cognitive function in this disorder have been extensively studied.Results. Cognitive reserve may impact on neuropsychiatric disorders in three ways: by affecting the risk for developing the disorder, in the expression of symptoms within disorders, and in patients' functional outcome. Cognitive failure below a certain threshold may alone, or in combination with common psychiatric symptoms, produce neuropsychiatric syndromes.Conclusions. Consideration of cognitive reserve may considerably improve our understanding of individual differences in the causes and consequences of neuropsychiatric disorders. For these reasons, the concept of cognitive reserve should be incorporated in future studies of neuropsychiatric disorder. It may be possible to enhance cognitive reserve through pharmacological or non-pharmacological means, such as education, neurocognitive activation or other treatment programmes.


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