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  • 1
    Online Resource
    Online Resource
    Are Empirically-Derived Subtypes of Mild Cognitive Impairment Consistent with Conventional Subtypes?
    Cambridge University Press (CUP) ; 2013
    In:  Journal of the International Neuropsychological Society Vol. 19, No. 6 ( 2013-07), p. 635-645
    Details
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 19, No. 6 ( 2013-07), p. 635-645
    Abstract: Given the importance of identifying dementia prodromes for future treatment efforts, we examined two methods of diagnosing mild cognitive impairment (MCI) and determined whether empirically-derived MCI subtypes of these diagnostic methods were consistent with one another as well as with conventional MCI subtypes (i.e., amnestic, non-amnestic, single-domain, multi-domain). Participants were diagnosed with MCI using either conventional Petersen/Winblad criteria ( n = 134; 〉 1.5 SD s below normal on one test within a cognitive domain) or comprehensive neuropsychological criteria developed by Jak et al. (2009) ( n = 80; 〉 1 SD below normal on two tests within a domain), and the resulting samples were examined via hierarchical cluster and discriminant function analyses. Results showed that neuropsychological profiles varied depending on the criteria used to define MCI. Both criteria revealed an Amnestic subtype, consistent with prodromal Alzheimer's disease (AD), and a Mixed subtype that may capture individuals in advanced stages of MCI. The comprehensive criteria uniquely yielded Dysexecutive and Visuospatial subtypes, whereas the conventional criteria produced a subtype that performed within normal limits, suggesting its susceptibility to false positive diagnostic errors. Whether these empirically-derived MCI subtypes correspond to dissociable neuropathologic substrates and represent reliable prodromes of dementia will require additional follow-up. ( JINS , 2013, 19 , 1–11)
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    URL: Article
    DOI: 10.1017/S1355617713000313
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2013
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  • 2
    Online Resource
    Online Resource
    Complex activities of daily living vary by mild cognitive impairment subtype
    Cambridge University Press (CUP) ; 2010
    In:  Journal of the International Neuropsychological Society Vol. 16, No. 4 ( 2010-07), p. 630-639
    Details
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 16, No. 4 ( 2010-07), p. 630-639
    Abstract: There is increasing consensus regarding the importance of operationally defining and measuring functional decline in mild cognitive impairment (MCI). However, few studies have directly examined functional abilities in MCI or its presumed subtypes and, to date, reported findings have been discrepant. Nondemented older adults ( n = 120) were administered a comprehensive cognitive battery measuring multiple domains as well as a performance-based functional ability measure. Participants were characterized as either cognitively normal, amnestic MCI, or non-amnestic MCI. MCI individuals demonstrated decrements in instrumental activities of daily living (IADL) relative to their cognitively normal counterparts. Specifically, participants with amnestic MCI demonstrated significant decrements in financial management, whereas those with non-amnestic MCI showed poorer performance in abilities related to health and safety. Moreover, decreased functional abilities were associated with decrements in global cognitive functioning but not memory or executive functions in the MCI participants. Finally, logistic regression demonstrated that functional abilities accurately predicted MCI subtype. Results support the need for better delineation of functional decline in MCI. Given the implications of functional status for MCI diagnosis and treatment, the direct assessment of functional abilities is recommended. Results further suggest performance-based IADL assessment may have utility in distinguishing MCI subtypes. ( JINS , 2010, 16 , 630–639.)
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    URL: Article
    DOI: 10.1017/S1355617710000330
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2010
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  • 3
    Online Resource
    Online Resource
    Heterogeneity in mild cognitive impairment: Differences in neuropsychological profile and associated white matter lesion pathology
    Cambridge University Press (CUP) ; 2009
    In:  Journal of the International Neuropsychological Society Vol. 15, No. 6 ( 2009-11), p. 906-914
    Details
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 15, No. 6 ( 2009-11), p. 906-914
    Abstract: This study examined whether distinct neuropsychological profiles could be delineated in a sample with Mild Cognitive Impairment (MCI) and whether white matter lesion (WML) burden contributed to MCI group differences. A heterogeneous, clinical sample of 70 older adults diagnosed with MCI was assessed using cognitive scores, and WML was quantified using a semi-automated, volumetric approach on T 2 -weighted fluid-attenuated inversion recovery (FLAIR) images. Using cluster and discriminant analyses, three distinct groups (Memory/Language, Executive/Processing Speed, and Pure Memory) were empirically derived based on cognitive scores. Results also showed a dose dependent relationship of WML burden to MCI subgroup, with the Executive/Processing Speed subgroup demonstrating significantly higher levels of WML pathology when compared to the other subgroups. In addition, there was a dissociation of lesion type by the two most impaired subgroups (Memory/Language and Executive/Processing Speed) such that the Memory/Language subgroup showed higher periventricular lesion (PVL) and lower deep white matter lesion (DWML) volumes, whereas the Executive/Processing Speed demonstrated higher DWML and lower PVL volumes. Results demonstrate that distinct MCI subgroups can be empirically derived and reliably differentiated from a heterogeneous MCI sample, and that these profiles differ according to WML burden. Overall, findings suggest different underlying pathologies within MCI and contribute to our understanding of MCI subtypes. ( JINS , 2009, 15 , 906–914.)
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    URL: Article
    DOI: 10.1017/S1355617709990257
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2009
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  • 4
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    Online Resource
    Profile of hippocampal volumes and stroke risk varies by neuropsychological definition of mild cognitive impairment
    Cambridge University Press (CUP) ; 2009
    In:  Journal of the International Neuropsychological Society Vol. 15, No. 6 ( 2009-11), p. 890-897
    Details
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 15, No. 6 ( 2009-11), p. 890-897
    Abstract: Wide-ranging conceptual and diagnostic approaches to defining mild cognitive impairment (MCI) have led to highly variable prevalence and progression rates. We sought to examine whether bilateral hippocampal volumes and cerebrovascular risk factors in individuals characterized by two different neuropsychological definitions of MCI subtypes would also differ. Participants were 65 nondemented, community-dwelling, older adults, ages 62–91 years, drawn from a larger group of individuals enrolled in a longitudinal study of normal aging. A comprehensive neuropsychological definition of MCI that required the presence of more than one impaired score in a cognitive domain resulted in expected anatomical results; hippocampal volumes were significantly smaller in the aMCI group as compared to cognitively normal or nonamnestic MCI participants. However, a typical definitional scheme for classifying MCI based only on the presence of one impaired score within a cognitive domain did not result in hippocampal differences between groups. Global stroke risk factors did not differ between the two definitional schemes, although the relationship between stroke risk variables and neuropsychological performance did vary by diagnostic approach. The comprehensive approach demonstrated associations between stroke risk and cognition, whereas the typical approach did not. Use of more sophisticated clinical decision-making and diagnostic approaches that incorporate comprehensive neuropsychological assessment techniques is supported by this convergence of neuropsychological, neuropathological, and stroke risk findings. ( JINS , 2009, 15 , 890–897.)
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    URL: Article
    DOI: 10.1017/S1355617709090638
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2009
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  • 5
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    Online Resource
    Associations Between Depression and Cardiometabolic Health: A 27-Year Longitudinal Study – Corrigendum
    Cambridge University Press (CUP) ; 2022
    In:  Psychological Medicine Vol. 52, No. 14 ( 2022-10), p. 3018-3018
    Details
    In: Psychological Medicine, Cambridge University Press (CUP), Vol. 52, No. 14 ( 2022-10), p. 3018-3018
    Type of Medium: Online Resource
    ISSN: 0033-2917 , 1469-8978
    URL: Article
    DOI: 10.1017/S0033291722003105
    RVK:
    XA 10000
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2022
    detail.hit.zdb_id: 1470300-2
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  • 6
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    Online Resource
    Associations between depression and cardiometabolic health: A 27-year longitudinal study
    Cambridge University Press (CUP) ; 2022
    In:  Psychological Medicine Vol. 52, No. 14 ( 2022-10), p. 3007-3017
    Details
    In: Psychological Medicine, Cambridge University Press (CUP), Vol. 52, No. 14 ( 2022-10), p. 3007-3017
    Abstract: Clarifying the relationship between depression symptoms and cardiometabolic and related health could clarify risk factors and treatment targets. The objective of this study was to assess whether depression symptoms in midlife are associated with the subsequent onset of cardiometabolic health problems. Methods The study sample comprised 787 male twin veterans with polygenic risk score data who participated in the Harvard Twin Study of Substance Abuse (‘baseline’) and the longitudinal Vietnam Era Twin Study of Aging (‘follow-up’). Depression symptoms were assessed at baseline [mean age 41.42 years ( s.d. = 2.34)] using the Diagnostic Interview Schedule, Version III, Revised. The onset of eight cardiometabolic conditions (atrial fibrillation, diabetes, erectile dysfunction, hypercholesterolemia, hypertension, myocardial infarction, sleep apnea, and stroke) was assessed via self-reported doctor diagnosis at follow-up [mean age 67.59 years ( s.d. = 2.41)]. Results Total depression symptoms were longitudinally associated with incident diabetes (OR 1.29, 95% CI 1.07–1.57), erectile dysfunction (OR 1.32, 95% CI 1.10–1.59), hypercholesterolemia (OR 1.26, 95% CI 1.04–1.53), and sleep apnea (OR 1.40, 95% CI 1.13–1.74) over 27 years after controlling for age, alcohol consumption, smoking, body mass index, C-reactive protein, and polygenic risk for specific health conditions. In sensitivity analyses that excluded somatic depression symptoms, only the association with sleep apnea remained significant (OR 1.32, 95% CI 1.09–1.60). Conclusions A history of depression symptoms by early midlife is associated with an elevated risk for subsequent development of several self-reported health conditions. When isolated, non-somatic depression symptoms are associated with incident self-reported sleep apnea. Depression symptom history may be a predictor or marker of cardiometabolic risk over decades.
    Type of Medium: Online Resource
    ISSN: 0033-2917 , 1469-8978
    URL: Article
    DOI: 10.1017/S003329172000505X
    RVK:
    XA 10000
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2022
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  • 7
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    Online Resource
    Mild Traumatic Brain Injury Burden Moderates the Relationship Between Cognitive Functioning and Suicidality in Iraq/Afghanistan-Era Veterans
    Cambridge University Press (CUP) ; 2019
    In:  Journal of the International Neuropsychological Society Vol. 25, No. 1 ( 2019-01), p. 79-89
    Details
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 25, No. 1 ( 2019-01), p. 79-89
    Abstract: Objectives: Suicidal ideation (SI) is highly prevalent in Iraq/Afghanistan-era veterans with a history of mild traumatic brain injury (mTBI), and multiple mTBIs impart even greater risk for poorer neuropsychological functioning and suicidality. However, little is known about the cognitive mechanisms that may confer increased risk of suicidality in this population. Thus, we examined relationships between neuropsychological functioning and suicidality and specifically whether lifetime mTBI burden would moderate relationships between cognitive functioning and suicidal ideation. Methods: Iraq/Afghanistan-era Veterans with a history of mTBI seeking outpatient services ( N = 282) completed a clinical neuropsychological assessment and psychiatric and postconcussive symptom questionnaires. Results: Individuals who endorsed SI reported more severe post-traumatic stress disorder (PTSD), depression, and postconcussive symptoms and exhibited significantly worse memory performance compared to those who denied SI. Furthermore, mTBI burden interacted with both attention/processing speed and memory, such that poorer performance in these domains was associated with greater likelihood of SI in individuals with a history of three or more mTBIs. The pattern of results remained consistent when controlling for PTSD, depression, and postconcussive symptoms. Conclusions: Slowed processing speed and/or memory difficulties may make it challenging to access and use past experiences to solve current problems and imagine future outcomes, leading to increases in hopelessness and SI in veterans with three or more mTBIs. Results have the potential to better inform treatment decisions for veterans with history of multiple mTBIs. ( JINS , 2019, 25, 79–89)
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    URL: Article
    DOI: 10.1017/S1355617718000851
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2019
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  • 8
    Online Resource
    Online Resource
    Hierarchical cognitive and psychosocial predictors of amnestic mild cognitive impairment
    Cambridge University Press (CUP) ; 2010
    In:  Journal of the International Neuropsychological Society Vol. 16, No. 4 ( 2010-07), p. 721-729
    Details
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 16, No. 4 ( 2010-07), p. 721-729
    Abstract: To identify neuropsychological and psychosocial factors predictive of amnestic Mild Cognitive Impairment (aMCI) among a group of 94 nondemented older adults, we employed a novel nonlinear multivariate classification statistical method called Optimal Data Analysis (ODA) in a dataset collected annually for 3 years. Performance on measures of memory and visuomotor processing speed or symptoms of depression in year 1 predicted aMCI status by year 2. Performance on a measure of learning at year 1 predicted aMCI status at year 3. No other measures significantly predicted incidence of aMCI at years 2 and 3. Results support the utility of multiple neuropsychological and psychosocial measures in the diagnosis of aMCI, and the present model may serve as a testable hypothesis for prospective investigations of the development of aMCI. ( JINS , 2010, 16 , 721–729.)
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    URL: Article
    DOI: 10.1017/S1355617710000512
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2010
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  • 9
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    Online Resource
    Neuropsychological Criteria for Mild Cognitive Impairment and Dementia Risk in the Framingham Heart Study
    Cambridge University Press (CUP) ; 2016
    In:  Journal of the International Neuropsychological Society Vol. 22, No. 9 ( 2016-10), p. 937-943
    Details
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 22, No. 9 ( 2016-10), p. 937-943
    Abstract: Objectives: To refine mild cognitive impairment (MCI) diagnostic criteria, we examined progression to dementia using two approaches to identifying MCI. Methods: A total of 1203 Framingham Heart Study participants were classified at baseline as cognitively normal or MCI (overall and four MCI subtypes) via conventional Petersen/Winblad criteria (single cognitive test impaired per domain, 〉 1.5 SD below expectations) or Jak/Bondi criteria (two tests impaired per domain, 〉 1 SD below norms). Cox proportional hazards models were constructed to examine the association between each MCI definition and incident dementia. Results: The Petersen/Winblad criteria classified 34% of participants as having MCI while the Jak/Bondi criteria classified 24% as MCI. Over a mean follow-up of 9.7 years, 58 participants (5%) developed incident dementia. Both MCI criteria were associated with incident dementia [Petersen/Winblad: hazards ratio (HR) = 2.64; p -value=.0002; Jak/Bondi: HR=3.30; p -value 〈 .0001]. When both MCI definitions were included in the same model, only the Jak/Bondi definition remained statistically significantly associated with incident dementia (HR=2.47; p -value=.008). Multi-domain amnestic and single domain non-amnestic MCI subtypes were significantly associated with incident dementia for both diagnostic approaches (all p -values 〈 .01). Conclusions: The Jak/Bondi MCI criteria had a similar association with dementia as the conventional Petersen/Winblad MCI criteria, despite classifying ~30% fewer participants as having MCI. Further exploration of alternative methods to conventional MCI diagnostic criteria is warranted. ( JINS , 2016, 22 , 937–943)
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    URL: Article
    DOI: 10.1017/S1355617716000199
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2016
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  • 10
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    Online Resource
    Psychological Symptoms and Rates of Performance Validity Improve Following Trauma-Focused Treatment in Veterans with PTSD and History of Mild-to-Moderate TBI
    Cambridge University Press (CUP) ; 2020
    In:  Journal of the International Neuropsychological Society Vol. 26, No. 1 ( 2020-01), p. 108-118
    Details
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 26, No. 1 ( 2020-01), p. 108-118
    Abstract: Iraq and Afghanistan Veterans with posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) history have high rates of performance validity test (PVT) failure. The study aimed to determine whether those with scores in the invalid versus valid range on PVTs show similar benefit from psychotherapy and if psychotherapy improves PVT performance. Method: Veterans ( N = 100) with PTSD, mild-to-moderate TBI history, and cognitive complaints underwent neuropsychological testing at baseline, post-treatment, and 3-month post-treatment. Veterans were randomly assigned to cognitive processing therapy (CPT) or a novel hybrid intervention integrating CPT with TBI psychoeducation and cognitive rehabilitation strategies from Cognitive Symptom Management and Rehabilitation Therapy (CogSMART). Performance below standard cutoffs on any PVT trial across three different PVT measures was considered invalid (PVT-Fail), whereas performance above cutoffs on all measures was considered valid (PVT-Pass). Results: Although both PVT groups exhibited clinically significant improvement in PTSD symptoms, the PVT-Pass group demonstrated greater symptom reduction than the PVT-Fail group. Measures of post-concussive and depressive symptoms improved to a similar degree across groups. Treatment condition did not moderate these results. Rate of valid test performance increased from baseline to follow-up across conditions, with a stronger effect in the SMART-CPT compared to CPT condition. Conclusion: Both PVT groups experienced improved psychological symptoms following treatment. Veterans who failed PVTs at baseline demonstrated better test engagement following treatment, resulting in higher rates of valid PVTs at follow-up. Veterans with invalid PVTs should be enrolled in trauma-focused treatment and may benefit from neuropsychological assessment after, rather than before, treatment.
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    URL: Article
    DOI: 10.1017/S1355617719000997
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2020
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