Verbal Learning as a predictor of risks of accidents in elderly drivers / Aprendizado verbal como preditor de risco de acidentes em idosos

ABSTRACT Background: Age-related cognitive decline impacts cognitive abilities essential for driving. Objective: We aimed to measure main cognitive functions associated with a high number of traffic violations in different driving settings. Methods: Thirty-four elderly individuals, aged between 65 and 90 years, were evaluated with a driving simulator in four different settings (Intersection, Overtaking, Rain, and Malfunction tasks) and underwent a battery of cognitive tests, including memory, attention, visuospatial, and cognitive screening tests. Individuals were divided into two groups: High-risk driving (HR, top 20% of penalty points) and normal-risk driving (NR). Non-parametric group comparison and regression analysis were performed. Results: The HR group showed higher total driving penalty score compared to the NR group (median=29, range= 9-44 vs. median=61, range= 47-97, p<0.001). The HR group showed higher penalty scores in the Intersection task (p<0.001) and the Overtaking and Rain tasks (p<0.05 both). The verbal learning score was significantly lower in the HR group (median=33, range=12-57) compared with the NR group (median=38, range=23-57, p<0.05), and it was observed that this score had the best predictive value for worse driving performance in the regression model. General cognitive screening tests (Mini-Mental State Examination and Addenbrooke's Cognitive Evaluation) were similar between the groups (p>0.05), with a small effect size (Cohen's d=0.3 both). Conclusion: The verbal learning score may be a better predictor of driving risk than cognitive screening tests. High-risk drivers also showed significantly higher traffic driving penalty scores in the Intersection, Overtaking, and Rain tests.

RESUMO Antecedentes: O declínio cognitivo relacionado à idade impacta as habilidades cognitivas essenciais para direção. Objetivos: Nosso objetivo foi medir as funções cognitivas associadas ao alto número de violações de trânsito em diferentes contextos de direção. Métodos: Trinta e quatro idosos entre 65 e 90 anos foram avaliados em simulador de direção em quatro diferentes contextos (Travessia, Ultrapassagem, Chuva e Mal-funcionamento) e realizaram uma série de testes cognitivos, incluindo memória, atenção, visuoespacial e rastreamento. Indivíduos foram então divididos em dois grupos: Alto Risco de condução (HR, top 20% de pontos de penalidades de condução), e Risco Normal (NR). Comparações não-paramétricas e análise de regressão foram realizadas. Resultados: O grupo HR mostrou aumento no escore total de penalidades de condução quando comparado com o grupo NR (mediana=29, limites=9-44 vs. mediana=61, limites=47-97, p<0.001). O grupo HR mostrou maiores escores de penalidade na tarefa de Travessia (p<0.001), Ultrapassagem e Chuva (p<0.05 ambos). O escore de aprendizado verbal foi significativamente menor no grupo HR (mediana=33, limite=12-57) comparado com o grupo NR (mediana=38, limite=23-57, p<0.05), e foi observado que este escore foi o melhor preditor de pior performance de condução no modelo de regressão. Testes de rastreio cognitivo (Mini-exame do estado mental e Avaliação Cognitiva de Addenbroke) foram similar entre os grupos (p>0.05), com pequena magnitude de efeito (Cohen's d=0.3). Conclusões: O escore de aprendizado verbal pode ser o melhor preditor de risco de condução do que os testes de rastreio cognitivos. Motoristas de alto risco também mostraram maior escores de penalidade de trânsito nos testes de Travessia, Ultrapassagem e Chuva.

Impacto de la dislalia y disglosia en la comprensión verbal en escolares con necesidades especiales; Cuenca, Ecuador / The impact of dyslalia and dysglossia on verbal comprehension in schoolchildren with special needs; Cuenca, Equator

Este estudio analiza la relación entre los trastornos del lenguaje y la comprensión verbal en estudiantes que fueron evaluados como parte del pilotaje desarrollado por el proyecto de investigación "Efectividad del programa integral escalonado en pacientes con necesidades educativas especiales por trastornos del lenguaje y articulación", en la Unidad de Diagnóstico, Investigación Psicopedagógica y Apoyo a la Inclusión (UDIPSAI), Centro de Práctica y Relación con la Sociedad de la Universidad Católica de Cuenca. Se trata de un estudio observacional de tipo descriptivo y analítico; la técnica utilizada fue la psicometría y los instrumentos fueron pruebas para evaluar los trastornos del lenguaje y la inteligencia. Se aplicó la Prueba de Funciones Prelinguísticas y órganos fonoarticuladores, la Prueba de Articulación y la Prueba de Evaluación Clínica de los Fundamentos del Lenguaje. Para calificar la comprensión verbal se utilizó Weschler para niños -V (WISC-V) que investiga la capacidad individual dividida en escalas primarias. Para la investigación se consideró el Indice de Comprensión Verbal con las subescalas de similitudes, vocabulario, comprensión, información y acertijos. Se concluyó que la comprensión verbal es un factor importante para la presencia de trastornos del lenguaje y articulación en niños (AU)

Characterizacion of objectal actions and verbal production in pre-school age / Caracterizacion de acciones objetales y la producción verbal en la edad preescolar menor / Caracterização das ações objetais e da produção verbal na idade pré-escolar

RESUMEN El tema de las condiciones óptimas para el desarrollo verbal del niño preescolar menor aún sigue abierto en psicología, y surge la pregunta acerca de la naturaleza de dichas condiciones. Desde la teoría de la actividad se plantea la posibilidad de análisis de fenómenos del desarrollo no como procesos aislados, sino como elementos de la actividad que predomina en el desarrollo del niño en una u otra etapa. El objetivo de este estudio fue establecer una relación entre la adquisición de las acciones objetales y la producción verbal en niños preescolares menores.En el estudio se valoraron los niveles de adquisición de la acción objetal, comunicación verbal en el juego y la forma de interacción entre niño y adultos que predomina en familia. Para las interacciones con los niños se utilizó el Protocolo para Evaluación del desarrollo para niños preescolares menores (Solovieva & Quintanar, 2014), mientras que con los cuidadores se aplicó una entrevista para precisar el tipo de acciones y orientaciones predominantes en familia. Se identificó una relación entre ambos fenómenos estudiados y una correlación significativa entre el nivel de adquisición de las acciones con objetos, expresiones verbales y orientación parental. Se precisaron las etapas de adquisición de acciones con objetos y el paso al inicio de la adquisición de la función simbólica con el rol específico de uso de juguetes animados. Se discute la utilidad del protocolo para diagnóstico e interacción con niños preescolares, así como para la formulación de programas de intervención y desarrollo en esta edad.

RESUMO O tema das condições ótimas para o desenvolvimento verbal da criança pré-escolar ainda está em aberto na psicologia, trazendo questões sobre a natureza destas condições. A partir da teoria da atividade, se apresenta a possibilidade da análise dos fenômenos do desenvolvimento não como processos isolados, mas sim como elementos da atividade que predomina no desenvolvimento da criança em uma ou outra etapa. O objetivo do presente estudo foi estabelecer uma relação entre a aquisição das ações objetais e a produção verbal em crianças pré-escolares. Neste estudo se consideraram os níveis de aquisição da ação objetal, a comunicação verbal no jogo e a forma de interação predominante na família entre a criança e os adultos. Para as interações com as crianças utilizou-se o protocolo para Evaluación del desarrollo para niños preescolares menores (Solovieva & Quintanar, 2014), ao passo que uma entrevista foi aplicada aos cuidadores para precisar o tipo de ações e orientações predominantes na família. Foi identificada uma relação entre ambos os fenômenos estudados e uma correlação significativa entre o nível de aquisição de ações com objetos, expressões verbais e orientação parental. Foram especificadas as etapas de aquisição de ações com objetos e a passagem ao início da aquisição da função simbólica, com a necessidade particular do uso de brinquedos animados. Por fim, se discute a utilidade do protocolo para o diagnóstico e interação com crianças pré-escolares, assim como para a formulação de programas de intervenção e desenvolvimento nesta idade.

ABSTRACT The topic of favorable conditions for verbal development is opened in psychology. The question about the nature of such conditions hasn't been solved. According to activity theory, it is possible to study aspects of psychological development no as isolated functions, but in relation to the main activity at each stage of development. The objective of the study was to establish a relationship between stages of play with objects using symbols and verbal production in preschool children. For the interactions with children, the Protocol for Evaluación del desarrollo para niños preescolares menores (Solovieva & Quintanar, 2014) was used, and a semi-structured interview was applied with the caregivers in order to specify the type of actions and orientations Predominant in family. We identified a relationship between studied phenomena and a significant correlation between the variables of actions with objects, verbal expressions and parental orientation. The stages of acquisition of actions with objects were determined together with the specific necessity of use of animated toys for verbal development. We discuss the usefulness of the protocol for diagnosis and interaction with preschool children, as well as for the formulation of intervention and development programs at this age.

Marijuana use associated with worse verbal learning and delayed recall in a sample of young adults / El consumo de marihuana se asocia a una menor capacidad de aprendizaje verbal y memoria tardía en adultos jóvenes

ABSTRACT Background: There is concern about the cognitive consequences of marijuana consumption. Aim: To assess the influence of current and past marijuana use and frequency on verbal learning and memory in a sample of adults aged 21 years old. Material and Methods: Marijuana use was assessed using a clinician administered interview in 654 participants (56% females), who reported frequency of use, age of first use and whether its use led to problems in their lives. The CogState International Shopping List was administered to assess learning and memory. Results: Seventy percent reported ever using marijuana, 46% consuming during the past year and 27% during the past 30 days. The latter scored significantly lower on delayed recall. Current and frequent use were significantly associated with lower accuracy in verbal learning and memory. Conclusions: In this cohort of adults aged 21 years old, marijuana use was prevalent and related to worse verbal memory.

Antecedentes: Existe preocupación acerca de los efectos cognitivos del consumo de marihuana. Objetivo: Estudiar el efecto de consumo de marihuana presente o pasado en la capacidad de aprendizaje verbal y memoria en una muestra de adultos de 21 años. Material y Métodos: El consumo de marihuana fue evaluado mediante una entrevista médica en 654 adultos de 21 años (56% mujeres), quienes informaron acerca de la frecuencia de consumo, edad de comienzo y si el consumo les ha causado problemas en sus vidas. Se les administró el Cogstate International Shopping List para evaluar aprendizaje y memoria. Resultados: El 70% informó haber consumido marihuana alguna vez, 46% la usó durante el último año y el 27% en los últimos 30 días. Estos últimos tuvieron un menor puntaje en memoria tardía. El consumo actual y frecuente se asoció a una menor precisión en la capacidad de aprendizaje verbal y memoria. Conclusiones: En esta cohorte de adultos de 21 años, el consumo de marihuana fue prevalente y relacionado a una menor memoria verbal.

Development and Validation of the Full Version of Story Memory in the Korean-Mini Mental State Examination, 2nd Edition: Expanded Version (K-MMSE-2: EV)

BACKGROUND AND PURPOSE: The Korean version of Story Memory (SM) in the Korean-Mini Mental State Examination, 2nd Edition: Expanded Version (K-MMSE-2: EV) was developed. Based on the SM, we additionally developed a full version of SM including delayed recall (DR) and recognition adding to immediate recall (IR). This study aimed to examine the reliabilities and validities of the newly developed SM in the K-MMSE-2: EV and its full version. METHODS: Ninety-five healthy elderly individuals (HE), 90 patients with amnestic mild cognitive impairment (aMCI), and 53 patients with dementia of the Alzheimer's type (DAT) participated in the study. They were administered the full version of SM with the Seoul Verbal Learning Test-Elderly's version (SVLT-E) and Rey Complex Figure Test (RCFT). In addition, the SM was re-administered to 51 participants after a 5-week interval. Two clinical neuropsychologists independently rated the performance of 50 participants. RESULTS: The test-retest reliabilities of the IR, DR, and recognition of the SM were statistically significant. The inter-rater reliabilities (Cohen's kappa) were high (0.87–1.00) for all the measures. The IR, DR, and recognition of SM had significant positive correlations with those of the SVLT-E and RCFT. Significant group differences in IR and DR of SM were found among the HE, aMCI, and DAT groups. The recognition scores were significantly different between the aMCI and DAT groups, but not between the HE and aMCI groups. CONCLUSIONS: The newly developed full version of SM in the K-MMSE-2: EV was proven to be a reliable and valid memory measure for clinical use.

Learning of Pseudowords by Children of Different Ages in a Shared Book Reading Context / Aprendizagem de Pseudopalavras por Crianças de Diferentes Idades em Contexto de Leitura Compartilhada de Livros / Aprendizaje de Pseudopalabras en Niños de Diferentes Edades en Contexto de Lectura Compartida de Libros

Abstract Shared book reading favors incidental learning of vocabulary; however, studies indicate that the previous vocabulary level of the child interferes with learning. The aim of this study was to compare the learning relations between pseudowords and figures of children aged 3 and 7 years in a shared book reading situation and to investigate the possible occurrence of the Matthew Effect. A book with four pseudowords developed for this study was read three consecutive times to 10 children of each age group. Matching-to-sample, exclusion, naming, and description of the use probes were applied immediately after the reading and one week later. No significant differences were found between the performances of both groups, except for the exclusion probes, without incidence of the Matthew Effect. Learning words is a continuous process that involves frequency and contexts of exposure to the words.

Resumo A leitura compartilhada de histórias favorece a aprendizagem incidental de vocabulário, mas estudos indicam que o nível de vocabulário prévio da criança interfere nessa aprendizagem. O objetivo deste estudo foi comparar a aprendizagem de relações entre pseudopalavras e figuras por crianças de 3 e 7 anos em situação de leitura compartilhada de histórias e a possível ocorrência do Matthew Effect. Um livro especialmente elaborado para esta pesquisa foi lido por três vezes consecutivas para 10 crianças de cada grupo etário, apresentando quatro pseudopalavras. Sondas de emparelhamento ao modelo, exclusão, nomeação e descrição da utilidade foram aplicadas logo após a leitura e uma semana depois. Não foram encontradas diferenças significativas entre os desempenhos dos dois grupos, exceto nas sondas de exclusão, sem o registro de ocorrência do Matthew Effect. A aprendizagem de palavras é um processo contínuo e envolve condições como a frequência e os contextos de exposição às palavras.

Resumen La lectura compartida de libros favorece el aprendizaje incidental de vocabulario; sin embargo, los estudios apuntan que el nivel de vocabulario previo del niño interfiere en este aprendizaje. El presente estudio buscó comparar el aprendizaje de relaciones entre pseudopalabras y figuras en niños de entre 3 y 7 años en situación de lectura compartida de cuentos, así como la posible ocurrencia del Matthew Effect. Un libro no comercial se leyó tres veces consecutivas a 10 niños de cada grupo de edad, presentándoles cuatro pseudopalabras. Se aplicaron pruebas de igualación a la muestra, exclusión y denominación inmediatamente después de la lectura y una semana después de la misma. No se hallaron diferencias significativas en los desempeños de ambos grupos, a excepción de las pruebas de exclusión, y no se registró la ocurrencia del Matthew Effect. El aprendizaje de palabras es un proceso continuo e involucra condiciones como la frecuencia y los contextos de exposición a las palabras.

Ensino por múltiplos exemplares e integração de comportamentos de ouvinte e falante com unidades sintáticas substantivo-adjetivo em crianças com DENA e IC / Multiple exemplar instruction and integration of listening and speaking behaviors with substantive-adjective syntactic units in children with ANSD and CI

RESUMO Objetivo Verificar o efeito do ensino por múltiplos exemplares na aquisição e integração dos comportamentos de ouvinte e falante, com substantivos e combinações substantivo-adjetivo, em crianças com Desordem do Espectro da Neuropatia Auditiva (DENA) e implante coclear (IC). Método Participaram duas crianças com DENA que usavam IC. Foram adotados estímulos ditados e figuras que correspondiam a palavras (substantivo) e unidades sintáticas substantivo+adjetivo. O estudo foi organizado em passos de ensino que foram intercalados por avaliações dos comportamentos de ouvinte e falante, com todos os estímulos. O ensino por múltiplos exemplares apresentou tarefas de imitação oral (ecoico), reconhecimento auditivo (ouvinte) e nomeação de figuras (tato) de maneira rotativa; os substantivos foram ensinados primeiro e, em seguida, as combinações substantivo-adjetivo. Resultados No pré-teste, os participantes mostraram variabilidade e discrepância nas porcentagens de acertos de ouvinte e de falante. Todos alcançaram primeiro 100% de acertos nas tarefas de ouvinte e os desempenhos de falante ficaram próximos aos de ouvinte após o ensino. Todos estenderam a aprendizagem dos substantivos para as unidades sintáticas substantivo-adjetivo. Conclusão Crianças com DENA e IC podem aprender e integrar comportamentos de ouvinte e de falante por meio do ensino por múltiplos exemplares, de palavras a unidades sintáticas.

ABSTRACT Purpose To verify the effect of the multiple exemplar instruction at the acquisition and integration of listening and speaking behaviors, with substantives and substantive-adjective combinations, in children with Auditory Neuropathy Spectrum Disorder (ANSD) and cochlear implant (CI). Methods Participants were two children with ANSD that were users of CI. We adopted dictated stimulus and pictures that corresponded to words (substantive) and substantive-adjective syntactic units. The study was arranged in teaching steps that were intercalated with listening and speaking behaviors probes, with all stimuli. The multiple exemplar instruction presented oral imitation (echoic), auditory recognition (listening) and pictures naming (touch) tasks, on a rotating way; the substantives were taught first and, after that, the substantive-adjective combinations. Results In the pre-test, the participants showed variability and discrepancy in the correct responses percentages of listening and speaking. All achieved firstly 100% correct responses in the listening task and the speaking performances were close to listening after the teaching. All extended substantive learning to substantive-adjective syntactic units. Conclusion Children with ANSD and CI can learn and integrate listening and speaking behaviors by multiple exemplar instruction, from words to syntactic units.

Neurophysiological and Psychological Predictors of Social Functioning in Patients with Schizophrenia and Bipolar Disorder

OBJECTIVE: The aim of this study is to examine social functioning in patients with schizophrenia and bipolar disorder and explore the psychological and neurophysiological predictors of social functioning. METHODS: Twenty-seven patients with schizophrenia and thirty patients with bipolar disorder, as well as twenty-five healthy controls, completed measures of social functioning (questionnaire of social functioning), neurocognition (Verbal fluency, Korean-Auditory Verbal Learning Test), and social cognition (basic empathy scale and Social Attribution Task-Multiple Choice), and the childhood trauma questionnaire (CTQ). For neurophysiological measurements, mismatch negativity and heart rate variability (HRV) were recorded from all participants. Multiple hierarchical regression was performed to explore the impact of factors on social functioning. RESULTS: The results showed that CTQ-emotional neglect significantly predicted social functioning in schizophrenia group, while HRV-high frequency significantly predicted social functioning in bipolar disorder patients. Furthermore, emotional neglect and HRV-HF still predicted social functioning in all of the subjects after controlling for the diagnostic criteria. CONCLUSION: Our results implicated that even though each group has different predictors of social functioning, early traumatic events and HRV could be important indicators of functional outcome irrespective of what group they are.

Naming and verbal learning in adults with Alzheimer's disease, mild cognitive impairment and in healthy aging, with low educational levels / Nomeação e aprendizagem verbal na doença de Alzheimer, no comprometimento cognitivo leve e no envelhecimento sadio com baixa escolaridade

ABSTRACT Language assessment seems to be an effective tool to differentiate healthy and cognitively impaired aging groups. This article discusses the impact of educational level on a naming task, on a verbal learning with semantic cues task and on the MMSE in healthy aging adults at three educational levels (very low, low and high) as well as comparing two clinical groups of very low (0-3 years) and low education (4-7 years) patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI) with healthy controls. The participants comprised 101 healthy controls, 17 patients with MCI and 19 with AD. Comparisons between the healthy groups showed an education effect on the MMSE, but not on naming and verbal learning. However, the clinical groups were differentiated in both the naming and verbal learning assessment. The results support the assumption that the verbal learning with semantic cues task is a valid tool to diagnose MCI and AD patients, with no influence from education.

RESUMO A linguagem tem se mostrado uma ferramenta eficiente para diferenciar grupos de idosos saudáveis dos com deficiências cognitivas. O artigo objetiva discutir o impacto do nível educacional na nomeação, na aprendizagem verbal (AV) com pistas semânticas e no MEEM no envelhecimento saudável em três níveis de escolaridade (muito baixa: 0-3 anos, baixa: 4-7 anos e alta: >8 anos) e em dois grupos clínicos de escolaridade muito baixa e baixa (Doença de Alzheimer - DA - e Comprometimento Cognitivo Leve - CCL), comparados a controles saudáveis. Participaram 101 controles, 17 CCL e 19 DA. Comparações entre grupos saudáveis demonstraram um efeito da escolaridade no MEEM, mas não nas tarefas de nomeação e de AV. Considerando as comparações entre os grupos clínicos, tanto a nomeação quanto a AV os diferenciaram. Os resultados corroboram a pressuposição de que a tarefa de AV com pistas semânticas é válida para diagnosticar CCL e DA, não sendo influenciada pela escolaridade.

Change in Cognitive Function after Antipsychotics Treatment : A Pilot Study of Long-Acting Injectable versus Oral Form / 대한정신분열병학회지

OBJECTIVES: This study investigated whether long-acting injectable (LAI) paliperidone is different from its oral form in terms of the effect on cognitive function in schizophrenia spectrum and other psychotic disorders. METHODS: We reviewed the medical records of patients in Seoul National University Bundang Hospital who were diagnosed as having schizophrenia and/or other psychotic disorders based on DSM-5 from 2016 to 2017. Seven patients were treated with oral paliperidone and 11 were treated with paliperidone palmitate. All patients underwent clinical and neuropsychological assessment, including the Korean version of the MATRICS Consensus Cognitive Battery (MCCB) at their first visit or within one month of their initial treatment. MCCB was repeated within three to 12 months after the initial assessment. RESULTS: There was no significant difference between the two groups in most cognitive domains including speed of processing, attention and vigilance, working memory, verbal learning, visual learning and reasoning and problem solving domain. However, patients treated with paliperidone palmitate showed better improvement in social cognition domain than those taking oral paliperidone. The standardized values of social cognition domain scores had significantly improved over time in patients under paliperidone palmitate, demonstrating a significant time-by-group interaction. CONCLUSION: Our results show that long-acting injectable paliperidone could be helpful in some aspects of improving cognitive function in schizophrenia spectrum and other psychotic disorders. Further studies with other antipsychotics are necessary to generalize the results.

The Correlations among Depressive Symptoms, Cognitive Performance and Serum BDNF Levels in the Patients with Chronic Kidney Disease

OBJECTIVE: In the current study, we investigated whether there are relations among depressive symptoms, cognitive performance and serum BDNF levels in the patients with chronic kidney disease (CKD). METHODS: Sixty patients with CKD and 65 healthy controls participated. Depressive symptoms were evaluated with Beck depression inventory (BDI) and Hamilton Depression Rating Scale (HDRS). Mini-Mental State Examination included in the Korean version of the Consortium to Establish a Registry for Alzheimer’s disease (MMSE-KC) assessment packet was used for the evaluation of overall cognitive function. To assess memory function, the Korean version of the Hopkins Verbal Learning Test (K-HVLT) was used. BDNF levels were measured using an enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: The CKD patients showed more depressive symptoms when compared with controls. The depressive symptoms and cognitive function were not associated with serum BDNF levels in the CKD patients. CONCLUSION: In the current study, CKD patients had more depressive symptoms when compared controls. However, the serum BDNF levels of CKD patients were not associated with depressive symptoms and cognitive functions. These findings suggested that the serum BDNF levels may not be reflect the cognitive function and depressive mood state in the CKD patients.

Education as a Protective Factor Moderating the Effect of Depression on Memory Impairment in Elderly Women

OBJECTIVE: The cognitive reserve theory explicates individual differences observed in the clinical manifestation of dementia despite similar brain pathology. Education, a popular proxy of the cognitive reserve, has been shown to have protective effects delaying the onset of clinical symptoms including memory. This study was conducted to test whether education can moderate the negative effect of depressive mood on memory performance in elderly women residing in the community. METHODS: 29 elderly “unschooled” female (less than 6 years of formal education) and 49 “schooled” female (6 or more years) people were compared with regard to association between depressive mood and verbal memory functioning, which were measured by the Geriatric Depression Scale and the Elderly Verbal Learning Test, respectively. RESULTS: The results showed that completing or receiving more than primary school education significantly reduced the negative association between depressive mood and memory performance. Participants who did not complete primary schooling showed a decline in memory test scores depending on the level of depressive mood; whereas participants who have completed or received more than primary education displayed relatively stable memory function despite varying level of depressive mood. CONCLUSION: Our findings imply that education in early life may have protective effects against memory impairment related to elderly depression.

Subjective Age and Cognitive Functioning in Old Age

OBJECTIVE: The present study has examined whether subjective age would be associated with cognitive functioning in older adults. METHODS: Data from the third wave of Korean Social Life, Health, and Aging Project were used. This study was conducted with 152 older adults aged 60–89 years (mean=72.26, standard deviation=6.41) who completed measures of subjective age, Mini-Mental State Examination for Dementia Screening, Elderly Verbal Learning Test, Digit Span Test, Korean-Color Word Stroop Test, Trail Making Test, Verbal Fluency Test, Korean Boston Naming Test-Short form. The association of subjective age and cognitive functioning was analyzed using hierarchical regression analysis. Sex, depression, and chronological age were included as control variables. RESULTS: Hierarchical regression analysis revealed that a younger subjective age was associated with better processing speed, immediate memory, and executive function respectively. Even after controlling for chronological age, depression, and sex, the subjective age was associated with cognitive functioning in old age. CONCLUSION: Beyond chronological age, the subjective experience of age was associated with cognitive aging.

Modified Criteria for Diagnosing “Cognitive Frailty”

The concept of cognitive frailty has recently been proposed by an International Consensus Group as the presence of physical frailty and cognitive impairment [defined using the Clinical Dementia Ratings (CDR)=0.5], without concurrent dementia. However, CDR is difficult to implement and not often available in epidemiologic studies or busy clinical settings, and an alternative to CDR is required. We suggest an alternative definition of cognitive frailty as: 1) physical frailty, 2) more than 1.5 standard deviation below the mean for age-, gender-, and education-adjusted norms on any cognitive function test (e.g., the Montreal Cognitive assessment test, the Alzheimer’s disease assessment scale-cognitive subscale, verbal learning test, Digit Span, Boston Naming Test, Trail Making Test, and Frontal Assessment Battery), and 3) no dependency in instrumental activities of daily living. The redefined criteria for cognitive frailty would be more feasible to implement and thus more applicable in epidemiologic studies and busy clinical settings.

Influence of the Short-term Intake of High Doses of Solifenacin and Trospium on Cognitive Function and Health-Related Quality of Life in Older Women With Urinary Incontinence / 대한배뇨장애요실금학회지

PURPOSE: The aim of this study was to investigate the safety and the effects of elevated doses of solifenacin and trospium on cognitive function and health-related quality of life (HRQoL) in elderly women receiving treatment for urinary incontinence. METHODS: The study included 312 women aged 60–83 years (mean age, 69.4 years). All participants had scored at least 24 points on the Mini-Mental State Examination (MMSE) scale, and all of them had been diagnosed with urge urinary incontinence (UUI) or mixed urinary incontinence (MUI). The women were randomly assigned to 3 groups: group A, individuals who were simultaneously administered solifenacin at a high dosage of 20 mg per day and trospium at a high dosage of 60 mg per day; group B, persons taking solifenacin and trospium at the usual dosage of 10 and 30 mg per day, respectively; and group C, persons who received a placebo. Participants’ cognitive status was assessed by the MMSE, Controlled Oral Word Association Test, Wechsler Adult Intelligence Scale-Revised, Wechsler Memory Scale III, Colour Trails Test, and California Verbal Learning Test scales. The HRQoL assessment was performed using the Medical Outcomes Study 36-Item Health Survey. RESULTS: The cognitive function parameters did not differ at the start and end of the study across the groups (P>0.05). Additionally, the cognitive function parameters did not differ significantly within each group between the start and end of the study (P>0.05). The values of most HRQoL parameters regarding the functional state of the lower urinary tract (LUT) after the termination of treatment significantly improved in groups A and B (P < 0.05). A significant correlation between cognitive status and HRQoL or LUT parameters was absent (r < 0.3), while the correlations between HRQoL and LUT parameters were r=0.31–0.83, P < 0.05. CONCLUSIONS: The use of elevated doses of solifenacin and trospium did not increase the risk of cognitive impairment in women with UUI and MUI. The combination of solifenacin and trospium at a double dosage may be recommended to elderly women with treatment-resistant symptoms of UUI and MUI. However, the safety of combining antimuscarinic drugs in women with an increased volume of residual urine requires further study.

Neurocognitive Dysfunction According to Hypoperfusion Territory in Patients With Moyamoya Disease

OBJECTIVE: To demonstrate the prevalence of cerebral hypoperfusion without focal cerebral lesions in patients with Moyamoya disease (MMD), and the relationship between areas of hypoperfusion and cognitive impairment. METHODS: Twenty-six MMD patients were included. Patients were categorized according to the presence/absence of hypoperfusion in the frontal, parietal, temporal, and occipital lobes on brain single-photon-emission computed tomography (SPECT) after acetazolamide challenge. Computerized neuropsychological test (CNT) results were compared between groups. RESULTS: Only 3 patients showed normal cerebral perfusion. Baseline characteristics were similar between groups. Patients with frontal lobe hypoperfusion showed lower scores in visual continuous performance test (CPT), auditory CPT, forward digit span test, backward digit span test, verbal learning test, and trail-making test. Patients with parietal lobe hypoperfusion showed lower backward digit span test, visual learning test, and trail-making test scores. Related to temporal and occipital lobes, there were no significant differences in CNT results between the hypoperfusion and normal groups. CONCLUSION: MMD patients without focal cerebral lesion frequently exhibit cerebral hypoperfusion. MMD patients with frontal and parietal hypoperfusion had abnormal CNT profiles, similar to those with frontal and parietal lesions. It is suggested that the hypoperfusion territory on brain SPECT without focal lesion may affect the characteristics of neurocognitive dysfunction in MMD patients.

Predicting Prognosis in Patients with First Episode Psychosis Using Mismatch Negativity : A 1 Year Follow-up Study / 대한정신분열병학회지

OBJECTIVES: It has been shown that early intervention is crucial for favorable outcome in patients with schizophrenia. However, development of biomarkers for predicting prognosis of psychotic disorder still requires more research. In this study, we aimed to investigate whether baseline mismatch negativity (MMN) predict prognosis in patients with first episode psychosis (FEP). METHODS: Twenty-four patients with FEP and matched healthy controls (HCs) were examined with MMN at baseline, and their clinical status were re-assessed after 1 year. Repeated-measures analysis of variance was performed to compare baseline MMN between the two groups. Multiple regression analysis was used to identify factors predicting prognosis in FEP patients during the follow-up period. RESULTS: MMN amplitudes at baseline were significantly reduced in patients with FEP compared to healthy controls. In the multiple regression analysis, baseline MMN amplitude significantly predicted later improvement of performances on digit span and delayed recall of California Verbal Learning Test. However, baseline MMN did not predicted improvement of clinical symptoms. CONCLUSION: These results indicate that MMN may be a possible predictor of improvement in cognitive functioning in patients with FEP. Future study with larger sample and longer follow-up period would be needed to confirm the findings of the current study.

Neuropsicología del lenguaje de niños entre 6 y 10 años de edad con antecedente de nacimiento prematuro / Neuropsychology of language in children between 6 and 10 years old with a premature birth condition

En esta investigación se caracterizó el estado neuropsicológico de los componentes del lenguaje en niños entre 6 y 10 años de edad con antecedente de nacimiento prematuro. Para la evaluación se utilizaron los test, clasificación semántica y fluidez verbal (BANFE), lenguaje, denominación de imágenes, seguimiento de instrucciones, comprensión del discurso y coherencia narrativa (ENI), en una muestra de 80 niños prematuros y 80 niños en condición par y nacidos a término. Los datos obtenidos se analizaron mediante estadística descriptiva-correlacional. Se encontró que a nivel de la acción verbal las estructuras gramaticales y narrativas se ven comprometidas, así como los elementos sintácticos que involucran aspectos fonológicos de imitación verbal, con tendencia a que estas dificultades mejoren con el paso de los años.

This research focused on the neuropsychological status of the language components in children between 6-10 years of age with a history of premature birth. Several research tools were used like tests, semantic classification and verbal fluency (BANFE), language, image labeling, following directions, discourse comprehension, understanding speech and narrative coherence (ENI). The research tools were used in 80 premature and 80 non-premature infants. The data obtained was analyzed using descriptive and correlational statistics. It was found that the grammatical and narrative structures can be compromised as well as syntactic elements that involve phonological aspects at the level of verbal action. It was also found that these difficultie scan be overcome over the years.

Cognitive performance and psychosocial functioning in patients with bipolar disorder, unaffected siblings, and healthy controls

Objective: To assess cognitive performance and psychosocial functioning in patients with bipolar disorder (BD), in unaffected siblings, and in healthy controls. Methods: Subjects were patients with BD (n=36), unaffected siblings (n=35), and healthy controls (n=44). Psychosocial functioning was accessed using the Functioning Assessment Short Test (FAST). A sub-group of patients with BD (n=21), unaffected siblings (n=14), and healthy controls (n=22) also underwent a battery of neuropsychological tests: California Verbal Learning Test (CVLT), Stroop Color and Word Test, and Wisconsin Card Sorting Test (WCST). Clinical and sociodemographic characteristics were analyzed using one-way analysis of variance or the chi-square test; multivariate analysis of covariance was used to examine differences in neuropsychological variables. Results: Patients with BD showed higher FAST total scores (23.90±11.35) than healthy controls (5.86±5.47; p < 0.001) and siblings (12.60±11.83; p 0.001). Siblings and healthy controls also showed statistically significant differences in FAST total scores (p = 0.008). Patients performed worse than healthy controls on all CVLT sub-tests (p < 0.030) and in the number of correctly completed categories on WCST (p = 0.030). Siblings did not differ from healthy controls in cognitive tests. Conclusion: Unaffected siblings of patients with BD may show poorer functional performance compared to healthy controls. FAST scores may contribute to the development of markers of vulnerability and endophenotypic traits in at-risk populations.

Correlações entre aquisição do vocabulário e da fonologia: número de palavras produzidas versus consoantes adquiridas / Correlations between vocabulary and phonological acquisition: number of words produced versus acquired consonants

RESUMO Objetivo Verificar as possíveis correlações entre o número de tipos lexicais e o número de consoantes no sistema fonológico geral em crianças com desenvolvimento típico de linguagem. Métodos 186 crianças entre um ano e seis meses e cinco anos, 11 meses e 29 dias, falantes monolíngues do Português Brasileiro, com desenvolvimento típico de linguagem, participaram do estudo. A coleta de dados envolveu avaliações fonoaudiológicas e gravação da fala espontânea. Analisou-se a fonologia quanto ao número de consoantes adquiridas no sistema fonológico geral, em cada estrutura silábica e nos níveis do Modelo Implicacional de Complexidade de Traços (MICT). O vocabulário foi analisado quanto ao número de tipos de itens lexicais produzidos. Estes dados foram comparados entre as faixas etárias. A seguir, foram analisadas as correlações entre os tipos lexicais produzidos e as variáveis estabelecidas para o sistema fonológico. O nível de significância adotado foi de 5%. Resultados Todos os aspectos da fonologia avaliados apresentaram crescimento gradual. Os tipos lexicais apresentaram comportamento semelhante, porém com uma pequena regressão na idade de cinco anos. Houve diferentes correlações positivas entre os tipos lexicais produzidos e as variáveis analisadas no sistema fonológico. Houve apenas uma correlação negativa, referente à produção dos tipos lexicais com o onset complexo na última faixa etária analisada. Conclusão A fonologia e o vocabulário apresentam comportamentos semelhantes. Há diversas correlações positivas entre os tipos lexicais produzidos e diferentes aspectos da fonologia, exceto em relação ao onset complexo.

ABSTRACT Purpose To verify the probable correlations between the number of word types and the number of consonants in the general phonological system in children with typical language development. Methods Study participants were 186 children aged one year and six months to five years, 11 months and 29 days who were monolingual Brazilian Portuguese speakers with typical language development. Data collection involved speech, language and hearing assessments and spontaneous speech recordings. Phonology was assessed with regard to the number of acquired consonants in the general phonological system, in each syllable structure and in Implicational Model of Feature Complexity (IMFC) levels. Vocabulary was assessed with regard to number of word types produced. These data were compared across age groups. After that, correlations between the word types produced and the variables established for the phonological system were analyzed. The significance level adopted was 5%. Results All phonological aspects evaluated presented gradual growth. Word types produced showed a similar behavior, though with a small regression at the age of five years. Different positive correlations occurred between the spoken word types and the variables analyzed in the phonological system. Only one negative correlation occurred with respect to the production of complex onset in the last age group analyzed. Conclusion The phonology and vocabulary of the study participants present similar behaviors. There are many positive correlations between the word types produced and the different aspects of phonology, except regarding complex onset.