scholarly journals Digital Technology Differentiates Graphomotor and Information Processing Speed Patterns of Behavior

2021 ◽  
Vol 82 (1) ◽  
pp. 17-32 ◽  
Author(s):  
Stacy L. Andersen ◽  
Benjamin Sweigart ◽  
Nancy W. Glynn ◽  
Mary K. Wojczynski ◽  
Bharat Thyagarajan ◽  
...  
Keyword(s):  
Information Processing ◽  
Physical Function ◽  
Digital Technology ◽  
Test Scores ◽  
Neuropsychological Test ◽  
Apoe Genotype ◽  
Digital Data ◽  
Cognitive Test ◽  
Digit Symbol Substitution Test ◽  
Information Processing Speed

Background: Coupling digital technology with traditional neuropsychological test performance allows collection of high-precision metrics that can clarify and/or define underlying constructs related to brain and cognition. Objective: To identify graphomotor and information processing trajectories using a digitally administered version of the Digit Symbol Substitution Test (DSST). Methods: A subset of Long Life Family Study participants (n = 1,594) completed the DSST. Total time to draw each symbol was divided into ‘writing’ and non-writing or ‘thinking’ time. Bayesian clustering grouped participants by change in median time over intervals of eight consecutively drawn symbols across the 90 s test. Clusters were characterized based on sociodemographic characteristics, health and physical function data, APOE genotype, and neuropsychological test scores. Results: Clustering revealed four ‘thinking’ time trajectories, with two clusters showing significant changes within the test. Participants in these clusters obtained lower episodic memory scores but were similar in other health and functional characteristics. Clustering of ‘writing’ time also revealed four performance trajectories where one cluster of participants showed progressively slower writing time. These participants had weaker grip strength, slower gait speed, and greater perceived physical fatigability, but no differences in cognitive test scores. Conclusion: Digital data identified previously unrecognized patterns of ‘writing’ and ‘thinking’ time that cannot be detected without digital technology. These patterns of performance were differentially associated with measures of cognitive and physical function and may constitute specific neurocognitive biomarkers signaling the presence of subtle to mild dysfunction. Such information could inform the selection and timing of in-depth neuropsychological assessments and help target interventions.

A new computerised cognitive test for the detection of information processing speed impairment in multiple sclerosis

2013 ◽  
Vol 19 (12) ◽  
pp. 1665-1672 ◽  
Author(s):  
Aurélie Ruet ◽  
Mathilde SA Deloire ◽  
Julie Charré-Morin ◽  
Delphine Hamel ◽  
Bruno Brochet
Keyword(s):  
Multiple Sclerosis ◽  
Information Processing ◽  
Processing Speed ◽  
Cognitive Test ◽  
Digit Symbol Substitution Test ◽  
Digit Symbol ◽  
Information Processing Speed ◽  
Good Reliability ◽  
Digit Symbol Substitution ◽  
Symbol Substitution

Background: Cognitive impairment in multiple sclerosis (MS) primarily applies to information processing speed (IPS). Objective: To evaluate psychometric properties of a new digit/symbol substitution test in healthy subjects and patients with MS, and assess its ability to detect IPS impairment in patients with MS. Methods: A sample of MS patients, 60 relapsing–remitting (RRMS) and 41 primary progressive MS (PPMS), and 415 healthy controls (HCs) underwent an IPS battery, including assessment of reaction times of subtests of the Test of Attentional Performance battery and a newly developed in-house digit/symbol substitution task, the Computerised Speed Cognitive Test (CSCT). The CSCT was additionally evaluated in a second cohort of 31 RRMS and 12 progressive MS patients, for comparison with the Symbol Digit Modalities Test (SDMT). Results: The CSCT had good reliability in both HCs and patients with MS. It showed a weak practice effect at the 6-month time point. This test had good ecological validity in MS patients. There was a strong correlation between the CSCT with the SDMT and with other IPS tests in patients with MS. The CSCT had the best sensitivity for predicting IPS impairment and was one of the most accurate tests among the IPS battery. Conclusion: The CSCT appeared as a good candidate for detecting IPS impairment in MS patients.

scholarly journals Stroop performance in multiple sclerosis: Information processing, selective attention, or executive functioning?

2008 ◽  
Vol 14 (5) ◽  
pp. 805-814 ◽  
Author(s):  
J.A.B. MACNIVEN ◽  
C. DAVIS ◽  
M.-Y. HO ◽  
C.M. BRADSHAW ◽  
E. SZABADI ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Information Processing ◽  
Executive Functioning ◽  
Patient Group ◽  
Processing Speed ◽  
Neuropsychological Test ◽  
Stroop Test ◽  
Control Group ◽  
Information Processing Speed ◽  
Impaired Performance

Cognitive impairments in information processing speed, attention and executive functioning are widely reported in patients with multiple sclerosis (MS). Several studies have identified impaired performance on the Stroop test in people with MS, yet uncertainty remains over the cause of this phenomenon. In this study, 25 patients with MS were assessed with a neuropsychological test battery including a computerized Stroop test and a computerized test of information processing speed, the Graded Conditional Discrimination Tasks (GCDT). The patient group was compared with an individually age, sex and estimated premorbid IQ-matched healthy control group. The patients' reaction times (RTs) were significantly longer than those of the controls on all Stroop test trials and there was a significantly enhanced absolute (RTincongruent-RTneutral) and relative (100·[RTincongruent-RTneutral]/RTneutral) Stroop interference effect for the MS group. The linear function relating RT to stimulus complexity in the GCDT was significantly steeper in the patient group, indicating slowed information processing. The results are discussed with reference to the difference engine model, a theory of diversity in speeded cognition. It is concluded that, in the assessment of people with MS, great caution must be used in the interpretation of performance on neuropsychological tests which rely on RT as the primary measure. (JINS, 2008, 14, 805–814.)

scholarly journals Association of low-frequency and rare coding variants with information processing speed

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jan Bressler ◽  
Gail Davies ◽  
Albert V. Smith ◽  
Yasaman Saba ◽  
Joshua C. Bis ◽  
...  
Keyword(s):  
Information Processing ◽  
Processing Speed ◽  
African Ancestry ◽  
Functional Characterization ◽  
Community Dwelling ◽  
26S Proteasome ◽  
European Ancestry ◽  
Digit Symbol Substitution Test ◽  
Information Processing Speed ◽  
Coding Variants

AbstractMeasures of information processing speed vary between individuals and decline with age. Studies of aging twins suggest heritability may be as high as 67%. The Illumina HumanExome Bead Chip genotyping array was used to examine the association of rare coding variants with performance on the Digit-Symbol Substitution Test (DSST) in community-dwelling adults participating in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. DSST scores were available for 30,576 individuals of European ancestry from nine cohorts and for 5758 individuals of African ancestry from four cohorts who were older than 45 years and free of dementia and clinical stroke. Linear regression models adjusted for age and gender were used for analysis of single genetic variants, and the T5, T1, and T01 burden tests that aggregate the number of rare alleles by gene were also applied. Secondary analyses included further adjustment for education. Meta-analyses to combine cohort-specific results were carried out separately for each ancestry group. Variants in RNF19A reached the threshold for statistical significance (p = 2.01 × 10−6) using the T01 test in individuals of European descent. RNF19A belongs to the class of E3 ubiquitin ligases that confer substrate specificity when proteins are ubiquitinated and targeted for degradation through the 26S proteasome. Variants in SLC22A7 and OR51A7 were suggestively associated with DSST scores after adjustment for education for African-American participants and in the European cohorts, respectively. Further functional characterization of its substrates will be required to confirm the role of RNF19A in cognitive function.

scholarly journals Association Between APOE Alleles and Change of Neuropsychological Tests in the Long Life Family Study

2021 ◽  
Vol 79 (1) ◽  
pp. 117-125
Author(s):  
Mengtian Du ◽  
Stacy L. Andersen ◽  
Nicole Schupf ◽  
Mary F. Feitosa ◽  
Megan S. Barker ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Test Scores ◽  
Healthy Aging ◽  
Family Study ◽  
Apoe Genotype ◽  
Cognitive Test ◽  
Cross Sectional ◽  
Long Life ◽  
E4 Allele

Background: The Long Life Family Study (LLFS) is a family based, prospective study of healthy aging and familial longevity. The study includes two assessments of cognitive function that were administered approximately 8 years apart. Objective: To test whether APOE genotype is associated with change of cognitive function in older adults. Methods: We used Bayesian hierarchical models to test the association between APOE alleles and change of cognitive function. Six longitudinally collected neuropsychological test scores were modelled as a function of age at enrollment, follow-up time, gender, education, field center, birth cohort indicator (≤1935, or >1935), and the number of copies of ɛ2 or ɛ4 alleles. Results: Out of 4,587 eligible participants, 2,064 were male (45.0%), and age at enrollment ranged from 25 to 110 years, with mean of 70.85 years (SD: 15.75). We detected a significant cross-sectional effect of the APOE ɛ4 allele on Logical Memory. Participants carrying at least one copy of the ɛ4 allele had lower scores in both immediate (–0.31 points, 95% CI: –0.57, –0.05) and delayed (–0.37 points, 95% CI: –0.64, –0.10) recall comparing to non-ɛ4 allele carriers. We did not detect any significant longitudinal effect of the ɛ4 allele. There was no cross-sectional or longitudinal effect of the ɛ2 allele. Conclusion: The APOE ɛ4 allele was identified as a risk factor for poorer episodic memory in older adults, while the APOE ɛ2 allele was not significantly associated with any of the cognitive test scores.

Cognitive impairment in patients with multiple sclerosis predicts worse caregiver’s health-related quality of life

2014 ◽  
Vol 20 (13) ◽  
pp. 1769-1779 ◽  
Author(s):  
Andrés Labiano-Fontcuberta ◽  
Alex J Mitchell ◽  
Sara Moreno-García ◽  
Julián Benito-León
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Processing Speed ◽  
Neuropsychological Test ◽  
Health Related Quality ◽  
Information Processing Speed ◽  
Related Quality ◽  
Health Related

Background: Little information exists about how cognitive impairment in multiple sclerosis (MS) patients impacts on their caregivers’ health-related quality of life (HRQoL). Background: The objective of this paper is to examine the extent to which cognitive impairment in MS patients contributes to caregivers’ HRQoL. Methods: A total of 63 MS patients, 63 caregivers and 59 matched controls were recruited. Patients and controls underwent a neuropsychological assessment, including tests of working memory, speed of information processing, executive function, and verbal fluency. HRQoL of the caregivers was assessed by CAREQOL-MS. In logistic regression models, we adjusted for the effects of confounding variables. In these models, the dependent variable was the CAREQOL-MS (higher median of CAREQOL-MS (worse HRQoL) vs. lower median of CAREQOL-MS (better HRQoL) (reference)), and the independent variable was the impairment on each neuropsychological test vs. its integrity (reference). Results: Cognitive impairment in MS patients was significantly associated with worse caregiver HRQoL (adjusted odds ratio (OR) = 3.10, 95% confidence interval (CI) = 1.07–11.55, p = 0.04). In secondary analyses in which each neuropsychological test was entered in the analyses separately, only Symbol Digit Modalities Test (a measurement of information processing speed) impairment (OR = 4.22, 95%, CI = 1.16–14.53, p = 0.03) was significantly associated with worse caregiver HRQoL. Conclusions: MS patients’ caregivers’ HRQoL is significantly influenced by information processing speed impairment of MS patients.

Validity of a Novel Touch Screen Tablet-Based Assessment for Mild Cognitive Impairment and Probable AD in Older Adults

Assessment ◽  
2017 ◽  
Vol 26 (8) ◽  
pp. 1540-1553 ◽  
Author(s):  
Yo-Ping Huang ◽  
Avichandra Singh ◽  
Sheng Chen ◽  
Fang-Ju Sun ◽  
Chiu-Ron Huang ◽  
...  
Keyword(s):  
Older Adults ◽  
Motor Control ◽  
Cognitive Impairment ◽  
Information Processing ◽  
Mild Cognitive Impairment ◽  
Processing Speed ◽  
Touch Screen ◽  
Cognitive Test ◽  
Information Processing Speed ◽  
Visuospatial Perception

This study aimed to develop a psychometrically valid touch screen tablet-based cognitive test battery to identify early cognitive impairment due to dementia in older adults. The battery includes eight tests with 13 subscores, evaluating visual attention, auditory attention, information processing speed, visual memory, motor control, and visuospatial perception. Among the participants, 43 had been diagnosed with mild cognitive impairment (MCI) and 36 with probable Alzheimer’s disease (AD); 41 had no cognitive impairment. The average time to administer the tablet-based tests was 10 minutes. Significant correlations with the Mini-Mental State Examination were found in 9 out of 13 subscores. Patients with probable AD scored significantly lower than controls in 8 out of 13 subscores, whereas those with MCI scored significantly lower in 4 out of 13 subscores. Confirmatory factor analysis using Promax rotation showed that four factors caused lower subscores in the MCI group compared with the controls: information processing speed, memory, visuospatial perception, and motor control. All four factors significantly discriminated the controls from the MCI and probable AD groups, and in the expected direction. The touch screen tablet-based cognitive test battery is psychometrically valid for evaluating cognition in older adults.

scholarly journals Cognitive profile of mild behavioral impairment in Brain Health Registry participants

2021 ◽  
Author(s):  
Farzeen Kassam ◽  
Hung-Yu Chen ◽  
Rachel L Nosheny ◽  
Alexander McGirr ◽  
Tirzah Williams ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Test Performance ◽  
Test Scores ◽  
Neuropsychological Test ◽  
Behavioral Assessment ◽  
Cognitive Test ◽  
Brain Health ◽  
Behavioral Impairment ◽  
Cognitive Test Performance ◽  
Health Registry

INTRODUCTION: Dementia assessment includes cognitive and behavioral testing with informant validation. Conventional testing is resource intensive, with uneven access. Online unsupervised assessments could reduce barriers to risk assessment. We interrogated the relationship between informant-rated behavioral changes and neuropsychological test performance in older adults in the Brain Health Registry. METHODS: Participants completed online unsupervised cognitive tests, and informants completed the Mild Behavioral Impairment Checklist via a Study Partner portal. Cognitive performance was evaluated in MBI+/- individuals, as was the association between cognitive scores and MBI symptom severity. RESULTS: Mean age of the 499 participants was 67, 61% of which were female. MBI+ participants had lower working memory and executive function test scores. Lower cognitive test scores associated with greater MBI burden. DISCUSSION: Our findings support the feasibility of remote, informant-reported behavioral assessment and support its validity by demonstrating a relationship to cognitive test performance using online unsupervised assessments for dementia risk assessment.

Relative Trajectories of Gait and Cognitive Decline in Aging

2021 ◽  
Author(s):  
Oshadi Jayakody ◽  
Monique Breslin ◽  
Emmeline Ayers ◽  
Joe Verghese ◽  
Nir Barzilai ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Sex Education ◽  
Test Scores ◽  
Neuropsychological Test ◽  
Cognitive Test ◽  
Language Functions ◽  
Cognitive Risk ◽  
Study Participants ◽  
Aging People ◽  
Jewish Descent

Abstract Background Gait and cognition decline with advancing age, and presage the onset of dementia. Yet, the relative trajectories of gait and cognitive decline in aging are poorly understood – particularly among those with the Motoric Cognitive Risk (MCR) syndrome. This study compared changes in simple and complex gait performance and cognition, as a function of age and MCR. Methods We examined gait and cognitive functions of 1,095 LonGenity study participants (mean age = 75.4±6.7 years) with up to 12 years of annual follow-up. Participants were of Ashkenazi Jewish descent, free of dementia, ambulatory, and had a 12.2 % MCR prevalence at baseline. Gait speed was measured at usual pace walking (single-task walking, STW-speed) and walking while talking (WWT-speed). Eleven neuropsychological test scores were examined separately, and as a global cognition composite. Linear mixed-effects models adjusted for baseline sex, education, parental longevity, cognitive impairment and global health were used to estimate changes in gait and cognition, as a function of age and MCR. Results STW-speed, WWT-speed, and cognitive tests performance declined in a non-linear (accelerating) fashion with age. STW-speed declined faster than WWT-speed and cognitive test scores. People with MCR showed faster rates of decline on figure copy and phonemic fluency. Conclusions Gait declines at a faster rate than cognition in aging. People with MCR are susceptible to faster decline in visuospatial, executive, and language functions. This study adds important knowledge of trajectories of gait and cognitive decline in aging, and identifies MCR as a risk factor for accelerated cognitive decline.

scholarly journals Association of Drug Burden Index With Measures of Cognitive Function Among Older Adults

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 11-11
Author(s):  
Janie DiNatale ◽  
Kristi Crowe-White ◽  
Amy Ellis ◽  
Joy Douglas ◽  
Ian McDonough ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Apoe Genotype ◽  
Community Dwelling ◽  
Cognitive Test ◽  
Digit Symbol Substitution Test ◽  
Full Cohort ◽  
Cross Sectional ◽  
Drug Burden Index ◽  
Daily Dose

Abstract Objectives Many conditions associated with aging result in polypharmacy, and certain medications may impact cognition. One way to assess exposure to such medications is through the use of the drug burden index (DBI)- a validated measure of exposure to anticholinergic and sedative medications, with a higher DBI score indicating a higher drug burden. The objective of this cross-sectional analysis was to investigate the association between DBI and cognitive function assessed by two widely utilized cognitive tests among older adults. Methods The Health, Aging, and Body Composition Study was a prospective study of community-dwelling adults ages 70–79 years at enrollment. Using baseline data, DBI was calculated by dividing the daily dose of the medication taken by the sum of the daily dose taken and the minimum efficacious dose as approved by the Food and Drug Association. After adjusting for biological sex, race, education, and APOE genotype, the association between DBI and the Digit Symbol Substitution Test (DSST) and Modified Mini-Mental Status Exam (3MS) score was assessed by partial Spearman's rank correlation. Kruskal-Wallis tests were employed to assess significance among DBI scores by tertile. Results Among those with completed measures (n = 790, 52.4% male, 63.3% white), mean scores were as follows: DBI 0.84 ± 0.48, 3MS 90.12 ± 7.9, and DSST 34.7 ± 14.6. Results suggest that DBI was not significantly associated with either 3MS or DSST. However, DBI scores by tertile were significantly associated with DSST scores. Compared to tertile 2, participants in the lowest tertile had significantly lower DBI scores along with significantly higher DSST scores. Mean differences between tertile 1 and 2 were as follows: DBI = 0.1666 and DSST = 3.39. Conclusions Analyses among the full cohort suggest that DBI was not associated with slower processing speed as assessed by the DSST or with global cognition as assessed by 3MS. Yet with expanded analysis by tertile, results suggest that DBI scores were significantly associated with DSST scores. Future investigations on cognitive function among older adults may benefit from including the DBI analysis by tertile to explain some variance in cognitive test scores. Funding Sources This is an ancillary analysis, there is no funding applicable.

scholarly journals Scores Obtained from a Simple Cognitive Test of Visuospatial Episodic Memory Performed Decades before Death Are Associated with the Ultimate Presence of Alzheimer Disease Pathology

2018 ◽  
Vol 45 (1-2) ◽  
pp. 79-90 ◽  
Author(s):  
Andrew C. Robinson ◽  
Roseanne McNamee ◽  
Yvonne S. Davidson ◽  
Michael A. Horan ◽  
Julie S. Snowden ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Test Scores ◽  
Apoe Genotype ◽  
Population Based ◽  
Cognitive Test ◽  
Cognitive State ◽  
Early Interventions ◽  
Braak Stage ◽  
The University ◽  
University Of Manchester

Background: Community- or population-based longitudinal studies of cognitive ability with a brain donation end point offer an opportunity to examine relationships between pathology and cognitive state prior to death. Discriminating the earliest signs of dementing disorders, such as Alzheimer disease (AD), is necessary to undertake early interventions and treatments. Methods: The neuropathological profile of brains donated from The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age, including CERAD (Consortium to Establish a Registry for Alzheimer’s Disease) and Braak stage, was assessed by immunohistochemistry. Cognitive test scores collected 20 years prior to death were correlated with the extent of AD pathology present at death. Results: Baseline scores from the Memory Circle test had the ability to distinguish between individuals who developed substantial AD pathology and those with no, or low, AD pathology. Predicted test scores at the age of 65 years also discriminated between these pathology groups. The addition of APOE genotype further improved the discriminatory ability of the model. Conclusions: The results raise the possibility of identifying individuals at future risk of the neuropathological changes associated with AD over 20 years before death using a simple cognitive test. This work may facilitate early interventions, therapeutics and treatments for AD by identifying at-risk and minimally affected (in pathological terms) individuals.

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