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A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature264224
Source
Lancet. 2015 Jun 6;385(9984):2255-63
Publication Type
Article
Date
Jun-6-2015
Author
Tiia Ngandu
Jenni Lehtisalo
Alina Solomon
Esko Levälahti
Satu Ahtiluoto
Riitta Antikainen
Lars Bäckman
Tuomo Hänninen
Antti Jula
Tiina Laatikainen
Jaana Lindström
Francesca Mangialasche
Teemu Paajanen
Satu Pajala
Markku Peltonen
Rainer Rauramaa
Anna Stigsdotter-Neely
Timo Strandberg
Jaakko Tuomilehto
Hilkka Soininen
Miia Kivipelto
Source
Lancet. 2015 Jun 6;385(9984):2255-63
Date
Jun-6-2015
Language
English
Publication Type
Article
Keywords
Aged
Cognition Disorders - epidemiology - prevention & control
Diet
Double-Blind Method
Exercise
Exercise Therapy
Humans
Male
Middle Aged
Neuropsychological Tests
Risk assessment
Vascular Diseases - epidemiology - prevention & control
Abstract
Modifiable vascular and lifestyle-related risk factors have been associated with dementia risk in observational studies. In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), a proof-of-concept randomised controlled trial, we aimed to assess a multidomain approach to prevent cognitive decline in at-risk elderly people from the general population.
In a double-blind randomised controlled trial we enrolled individuals aged 60-77 years recruited from previous national surveys. Inclusion criteria were CAIDE (Cardiovascular Risk Factors, Aging and Dementia) Dementia Risk Score of at least 6 points and cognition at mean level or slightly lower than expected for age. We randomly assigned participants in a 1:1 ratio to a 2 year multidomain intervention (diet, exercise, cognitive training, vascular risk monitoring), or a control group (general health advice). Computer-generated allocation was done in blocks of four (two individuals randomly allocated to each group) at each site. Group allocation was not actively disclosed to participants and outcome assessors were masked to group allocation. The primary outcome was change in cognition as measured through comprehensive neuropsychological test battery (NTB) Z score. Analysis was by modified intention to treat (all participants with at least one post-baseline observation). This trial is registered at ClinicalTrials.gov, number NCT01041989.
Between Sept 7, 2009, and Nov 24, 2011, we screened 2654 individuals and randomly assigned 1260 to the intervention group (n=631) or control group (n=629). 591 (94%) participants in the intervention group and 599 (95%) in the control group had at least one post-baseline assessment and were included in the modified intention-to-treat analysis. Estimated mean change in NTB total Z score at 2 years was 0·20 (SE 0·02, SD 0·51) in the intervention group and 0·16 (0·01, 0·51) in the control group. Between-group difference in the change of NTB total score per year was 0·022 (95% CI 0·002-0·042, p=0·030). 153 (12%) individuals dropped out overall. Adverse events occurred in 46 (7%) participants in the intervention group compared with six (1%) participants in the control group; the most common adverse event was musculoskeletal pain (32 [5%] individuals for intervention vs no individuals for control).
Findings from this large, long-term, randomised controlled trial suggest that a multidomain intervention could improve or maintain cognitive functioning in at-risk elderly people from the general population.
Academy of Finland, La Carita Foundation, Alzheimer Association, Alzheimer's Research and Prevention Foundation, Juho Vainio Foundation, Novo Nordisk Foundation, Finnish Social Insurance Institution, Ministry of Education and Culture, Salama bint Hamdan Al Nahyan Foundation, Axa Research Fund, EVO funding for University Hospitals of Kuopio, Oulu, and Turku and for Seinäjoki Central Hospital and Oulu City Hospital, Swedish Research Council, Swedish Research Council for Health, Working Life and Welfare, and af Jochnick Foundation.
Notes
Comment In: Nat Rev Neurol. 2015 May;11(5):24825799934
PubMed ID
25771249 View in PubMed
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A 3-year clinical follow-up of adult patients with 3243A>G in mitochondrial DNA.

https://arctichealth.org/en/permalink/ahliterature82145
Source
Neurology. 2006 May 23;66(10):1470-5
Publication Type
Article
Date
May-23-2006
Author
Majamaa-Voltti K A M
Winqvist S.
Remes A M
Tolonen U.
Pyhtinen J.
Uimonen S.
Kärppä M.
Sorri M.
Peuhkurinen K.
Majamaa K.
Author Affiliation
Department of Internal Medicine, University of Oulu, Oulu, Finland. kirsi.majamaa-voltti@oulu.fi
Source
Neurology. 2006 May 23;66(10):1470-5
Date
May-23-2006
Language
English
Publication Type
Article
Keywords
Adult
Alleles
Blood Glucose - analysis
Cognition Disorders - genetics
DNA, Mitochondrial - genetics
Diabetes Mellitus - blood - genetics
Disease Progression
Electrocardiography, Ambulatory
Electroencephalography
Female
Finland - epidemiology
Follow-Up Studies
Hearing Loss, Sensorineural - genetics
Humans
Hypertrophy, Left Ventricular - genetics - ultrasonography
Lactates - blood
MELAS Syndrome - genetics - mortality
Male
Middle Aged
Mitochondria, Muscle - metabolism
Mosaicism
Neuropsychological Tests
Point Mutation
Pyruvates - blood
Abstract
OBJECTIVE: To follow the clinical course of patients with the mitochondrial DNA mutation 3243A>G for 3 years. METHODS: Thirty-three adult patients with the 3243A>G mutation entered a 3-year follow-up study. They were clinically evaluated annually, audiometry was performed, and samples were drawn for the analysis of blood chemistry and mutation heteroplasmy in leukocytes. Holter recording was performed three times during the follow-up and echocardiography, neuropsychological assessment, and quantitative EEG and brain imaging conducted at entry and after 3 years. RESULTS: The incidence of new neurologic events was low during the 3-year follow-up. Sensorineural hearing impairment (SNHI) progressed, left ventricular wall thickness increased, mean alpha frequency in the occipital and parietal regions decreased, and the severity of disease index (modified Rankin score) progressed significantly. The rate of SNHI progression correlated with mutation heteroplasmy in muscle. The increase in left ventricular wall thickness was seen almost exclusively in diabetic patients. Seven patients died during the follow-up, and they were generally more severely affected than those who survived. CONCLUSIONS: Significant changes in the severity of disease, sensorineural hearing impairment, left ventricular hypertrophy, and quantitative EEG were seen in adult patients with 3243A>G during the 3-year follow-up.
Notes
Comment In: Neurology. 2007 Jan 9;68(2):163-417210904
PubMed ID
16717204 View in PubMed
Less detail

15q11.2 CNV affects cognitive, structural and functional correlates of dyslexia and dyscalculia.

https://arctichealth.org/en/permalink/ahliterature287813
Source
Transl Psychiatry. 2017 Apr 25;7(4):e1109
Publication Type
Article
Date
Apr-25-2017
Author
M O Ulfarsson
G B Walters
O. Gustafsson
S. Steinberg
A. Silva
O M Doyle
M. Brammer
D F Gudbjartsson
S. Arnarsdottir
G A Jonsdottir
R S Gisladottir
G. Bjornsdottir
H. Helgason
L M Ellingsen
J G Halldorsson
E. Saemundsen
B. Stefansdottir
L. Jonsson
V K Eiriksdottir
G R Eiriksdottir
G H Johannesdottir
U. Unnsteinsdottir
B. Jonsdottir
B B Magnusdottir
P. Sulem
U. Thorsteinsdottir
E. Sigurdsson
D. Brandeis
A. Meyer-Lindenberg
H. Stefansson
K. Stefansson
Source
Transl Psychiatry. 2017 Apr 25;7(4):e1109
Date
Apr-25-2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Chromosome Aberrations
Chromosome Deletion
Chromosomes, Human, Pair 15 - genetics
Cognition - physiology
DNA Copy Number Variations - genetics
Developmental Disabilities - genetics
Dyscalculia - genetics
Dyslexia - genetics
Female
Functional Neuroimaging - methods - standards
Heterozygote
Humans
Iceland - epidemiology
Intellectual Disability - genetics
Magnetic Resonance Imaging - methods
Male
Middle Aged
Neuropsychological Tests - standards
Phenotype
Temporal Lobe - anatomy & histology - diagnostic imaging
Young Adult
Abstract
Several copy number variants have been associated with neuropsychiatric disorders and these variants have been shown to also influence cognitive abilities in carriers unaffected by psychiatric disorders. Previously, we associated the 15q11.2(BP1-BP2) deletion with specific learning disabilities and a larger corpus callosum. Here we investigate, in a much larger sample, the effect of the 15q11.2(BP1-BP2) deletion on cognitive, structural and functional correlates of dyslexia and dyscalculia. We report that the deletion confers greatest risk of the combined phenotype of dyslexia and dyscalculia. We also show that the deletion associates with a smaller left fusiform gyrus. Moreover, tailored functional magnetic resonance imaging experiments using phonological lexical decision and multiplication verification tasks demonstrate altered activation in the left fusiform and the left angular gyri in carriers. Thus, by using convergent evidence from neuropsychological testing, and structural and functional neuroimaging, we show that the 15q11.2(BP1-BP2) deletion affects cognitive, structural and functional correlates of both dyslexia and dyscalculia.
Notes
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PubMed ID
28440815 View in PubMed
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Abnormal brain processing in hepatic encephalopathy: evidence of cerebral reorganization?

https://arctichealth.org/en/permalink/ahliterature141910
Source
Eur J Gastroenterol Hepatol. 2010 Nov;22(11):1323-30
Publication Type
Article
Date
Nov-2010
Author
Rolf Ankerlund Blauenfeldt
Søren Schou Olesen
Jesper Bach Hansen
Carina Graversen
Asbjørn Mohr Drewes
Author Affiliation
Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg Hospital, Aarhus University Hospital, Denmark.
Source
Eur J Gastroenterol Hepatol. 2010 Nov;22(11):1323-30
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Acoustic Stimulation
Aged
Auditory Perception
Brain - physiopathology
Brain Mapping
Brain Waves
Case-Control Studies
Denmark
Electric Stimulation
Electroencephalography
Evoked Potentials, Somatosensory
Evoked Potentials, Visual
Female
Functional Laterality
Hepatic Encephalopathy - diagnosis - physiopathology
Humans
Male
Median Nerve - physiopathology
Middle Aged
Neural Conduction
Neuropsychological Tests
Photic Stimulation
Psychometrics
Reaction Time
Time Factors
Abstract
Hepatic encephalopathy (HE) is a severe and frequent complication of liver cirrhosis characterized by abnormal cerebral function. Little is known about the underlying neural mechanisms in HE and human data are sparse. Electrophysiological methods such as evoked brain potentials after somatic stimuli can be combined with inverse modeling of the underlying brain activity. Thereby, information on neuronal dynamics and brain activity can be studied in vivo. The aim of this study was to investigate the sensory brain processing in patients with HE.
Twelve patients with minimal or overt HE and 26 healthy volunteers were included in the study. Cerebral sensory processing was investigated as (i) an auditory reaction time task; (ii) visual and somatosensory evoked brain potentials, and (iii) reconstruction of the underlying brain activity.
Somatosensory evoked potentials were reproducible (all P>0.05), whereas flash evoked potentials were not reproducible (all P
PubMed ID
20661140 View in PubMed
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Aboriginal experiences of aging and dementia in a context of sociocultural change: qualitative analysis of key informant group interviews with Aboriginal seniors.

https://arctichealth.org/en/permalink/ahliterature137393
Source
J Cross Cult Gerontol. 2011 Mar;26(1):103-17
Publication Type
Article
Date
Mar-2011
Author
Shawnda Lanting
Margaret Crossley
Debra Morgan
Allison Cammer
Author Affiliation
Department of Psychology, University of Saskatchewan, Arts Building, 9 Campus Drive, S7N 5A5 Saskatoon, SK, Canada. shawnda.lanting@usask.ca
Source
J Cross Cult Gerontol. 2011 Mar;26(1):103-17
Date
Mar-2011
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging - ethnology - psychology
Cultural Evolution
Dementia - ethnology - psychology
Family
Female
Health Knowledge, Attitudes, Practice
Humans
Indians, North American - psychology
Interviews as Topic
Neuropsychological Tests
Qualitative Research
Saskatchewan
Abstract
Examining the role of culture and cultural perceptions of aging and dementia in the recognition, diagnosis, and treatment of age-related cognitive impairment remains an understudied area of clinical neuropsychology. This paper describes a qualitative study based on a series of key informant group interviews with an Aboriginal Grandmothers Group in the province of Saskatchewan. Thematic analysis was employed in an exploration of Aboriginal perceptions of normal aging and dementia and an investigation of issues related to the development of culturally appropriate assessment techniques. Three related themes were identified that highlighted Aboriginal experiences of aging, caregiving, and dementia within the healthcare system: (1) cognitive and behavioural changes were perceived as a normal expectation of the aging process and a circular conception of the lifespan was identified, with aging seen as going back "back to the baby stage", (2) a "big change in culture" was linked by Grandmothers to Aboriginal health, illness (including dementia), and changes in the normal aging process, and (3) the importance of culturally grounded healthcare both related to review of assessment tools, but also within the context of a more general discussion of experiences with the healthcare system. Themes of sociocultural changes leading to lifestyle changes and disruption of the family unit and community caregiving practices, and viewing memory loss and behavioural changes as a normal part of the aging process were consistent with previous work with ethnic minorities. This research points to the need to understand Aboriginal perceptions of aging and dementia in informing appropriate assessment and treatment of age-related cognitive impairment and dementia in Aboriginal seniors.
PubMed ID
21287400 View in PubMed
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Above-average intelligence and neuropsychological test score performance.

https://arctichealth.org/en/permalink/ahliterature200784
Source
Int J Neurosci. 1999 Aug;99(1-4):221-31
Publication Type
Article
Date
Aug-1999
Author
A M Horton
Author Affiliation
Psych Associates, Towson, Maryland, USA. drmachorton@hotmail.com
Source
Int J Neurosci. 1999 Aug;99(1-4):221-31
Date
Aug-1999
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Canada
Educational Status
Female
Humans
Intelligence
Male
Middle Aged
Neuropsychological Tests - statistics & numerical data
Predictive value of tests
Wechsler Scales - statistics & numerical data
Abstract
Recent studies regarding the effects of above average intelligence and neuropsychological performance have been mixed with Dodrill (1977) suggesting that above-average performances on neuropsychological test scores should not be expected when intellectual abilities are above average and Tremont, Hoffman, Scott and Adams (in press) clearly suggesting better neuropsychological skills in the higher IQ group. This paper described a reanalysis of a previously presented Canadian data-set assembled by Pauker (1980) of three hundred and sixty-three persons (152 males, 211 females) who were administered the core tests of the Halstead-Reitan Neuropsychological Test Battery (HRNTB) and the Wechsler Adult Intelligence Scale (WAIS). The results were that subjects with higher intelligence had better neuropsychological test score performances except for the Finger Tapping with the dominant hand test.
PubMed ID
10495218 View in PubMed
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Acceptability and concurrent validity of measures to predict older driver involvement in motor vehicle crashes: an Emergency Department pilot case-control study.

https://arctichealth.org/en/permalink/ahliterature161383
Source
Accid Anal Prev. 2007 Sep;39(5):1056-63
Publication Type
Article
Date
Sep-2007
Author
Frank J Molnar
Shawn C Marshall
Malcolm Man-Son-Hing
Keith G Wilson
Anna M Byszewski
Ian Stiell
Author Affiliation
CanDRIVE(1): a Canadian Institutes of Health Research (CIHR) Institute of Aging funded New Emerging Team, Elisabeth-Bruyère Research Institute, 43 Bruyère Street, Ottawa, ON, Canada K1N 5C8. fmolnar@ottawahospital.on.ca
Source
Accid Anal Prev. 2007 Sep;39(5):1056-63
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Accidents, Traffic - prevention & control - statistics & numerical data
Aged
Automobile Driver Examination - statistics & numerical data
Case-Control Studies
Chronic Disease - epidemiology
Dementia - diagnosis - epidemiology
Disability Evaluation
Female
Head Movements
Humans
Male
Mass Screening - statistics & numerical data
Mental Status Schedule - statistics & numerical data
Motor Skills
Neuropsychological Tests - statistics & numerical data
Ontario
Pilot Projects
Psychomotor Performance
Questionnaires
Reaction Time
Risk
Visual Fields
Wounds and injuries - epidemiology - prevention & control
Abstract
Older drivers have one of the highest motor vehicle crash (MVC) rates per kilometer driven, largely due to the functional effects of the accumulation, and progression of age-associated medical conditions that eventually impact on fitness-to-drive. Consequently, physicians in many jurisdictions are legally mandated to report to licensing authorities patients who are judged to be medically at risk for MVCs. Unfortunately, physicians lack evidence-based tools to assess the fitness-to-drive of their older patients. This paper reports on a pilot study that examines the acceptability and association with MVC of components of a comprehensive clinical assessment battery.
To evaluate the acceptability to participants of components of a comprehensive assessment battery, and to explore potential predictors of MVC that can be employed in front-line clinical settings.
Case-control study of 10 older drivers presenting to a tertiary care hospital emergency department after involvement in an MVC and 20 age-matched controls.
The measures tested were generally found to be acceptable to participants. Positive associations (p
PubMed ID
17854579 View in PubMed
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Access to neuropsychologic services after pediatric brain tumor.

https://arctichealth.org/en/permalink/ahliterature106864
Source
Pediatr Neurol. 2013 Dec;49(6):420-3
Publication Type
Article
Date
Dec-2013
Author
Ingrid Tonning Olsson
Sean Perrin
Johan Lundgren
Lars Hjorth
Aki Johanson
Author Affiliation
Department of Psychology, Lund University, Lund, Sweden; Department of Pediatrics, Skåne University Hospital, Lund, Sweden. Electronic address: ingrid.tonning-olsson@skane.se.
Source
Pediatr Neurol. 2013 Dec;49(6):420-3
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Brain Neoplasms - complications - psychology
Child
Child, Preschool
Cognition Disorders - etiology - rehabilitation
Female
Humans
Infant
Infant, Newborn
Male
Neoplasm Recurrence, Local - complications - psychology
Neuropsychological Tests
Pediatrics
Retrospective Studies
Risk factors
Sweden
Abstract
Increasing survival rates for children with brain tumors creates a greater need for neuropsychologic follow-up and intervention. The aim of this study was to evaluate rates of referral by medical doctors to neuropsychologic services and patient and treatment factors that differentiated referred and nonreferred patients.
Data were retrieved from medical records of all pediatric brain tumor patients in southern Sweden diagnosed between 1993 and 2004 who survived more than 1 year (n = 132). Characteristics of the patients, the cancer, and treatment received were then compared for patients who were and were not referred for neuropsychologic examination during that period.
Sixty-four (48%) of the pediatric brain tumor patients were referred for neuropsychologic evaluation. These patients had significantly larger tumors, more recurrences of cancer, and increased intracranial pressure at diagnosis when compared with the nonreferred group (n = 68). However, most of the patients in the nonreferred group either had significant risk factors for cognitive impairment or were reporting impairments that would suggest a referral was warranted.
Given the high rates of cognitive impairment in children with brain tumors, referral to neuropsychologic services should be considered in all survivors. In addition to improving long-term adjustment, systematic referral can provide data on cognitive impairments, making it possible to evaluate different cancer treatment protocols not only in terms of survival but also in terms of quality of survival. Greater efforts are needed to disseminate and raise awareness about published guidelines on the long-term care of pediatric brain tumor patients.
PubMed ID
24095573 View in PubMed
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Accuracy of CT scan measurements of the medial temporal lobe in routine dementia diagnostics.

https://arctichealth.org/en/permalink/ahliterature52157
Source
Int J Geriatr Psychiatry. 2003 Apr;18(4):308-12
Publication Type
Article
Date
Apr-2003
Author
A R Oksengaard
M. Haakonsen
R. Dullerud
K. Engedal
K. Laake
Author Affiliation
Department of Geriatric Medicine, Ullevaal University Hospital, Oslo, Norway. a.r.h.oksengard@ioks.uio.no
Source
Int J Geriatr Psychiatry. 2003 Apr;18(4):308-12
Date
Apr-2003
Language
English
Publication Type
Article
Keywords
Aged
Alzheimer Disease - diagnosis - pathology - radiography
England
Female
Humans
Linear Models
Male
Neuropsychological Tests
Norway
Observer Variation
Reproducibility of Results
Research Support, Non-U.S. Gov't
Temporal Lobe - pathology - radiography
Tomography, X-Ray Computed
Abstract
BACKGROUND: Atrophy of the medial part of the temporal lobe is seen in Alzheimer's disease (AD). We studied the usefulness of CT scan measurements of the medial temporal lobe (MTL) in elderly with suspected dementia. METHODS: MTL measurements were done with callipers by three raters, blinded to the diagnosis and to each other, on scans from 110 subjects with suspected dementia from a memory clinic in Oslo, Norway and 36 participants included in the OPTIMA study, Oxford, England. RESULTS: The correlation between the MTL and the Mini-Mental State Examination (MMSE) was very low, and there was a marked overlap between Alzheimer and cognitively unimpaired subjects. The inter-rater reliability was lower on the Norwegian than on the OPTIMA scans (R = 0.48 vs R = 0.68), but this was partly explained by larger MTL readings (4.5 mm after adjustment for age, gender and MMSE sumscore) on the OPTIMA scans as the reliability was confounded by MTL width and was higher at larger MTLs. A wider scan width (3 mm vs 2 mm in the OPTIMA scans) can also contribute to differences in reliability. CONCLUSIONS: The published threshold values regarding the CT scan MTL measurements for the diagnosis of AD may be invalid when applied by other radiology departments without a local standardisation and validation.
PubMed ID
12673606 View in PubMed
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1012 records – page 1 of 102.