Cognitive aging in migraine sufferers is associated with more subjective complaints but similar age-related decline: a 5-year longitudinal study.

OBJECTIVES AND BACKGROUND: The effect of headache on cognitive performance is controversial, due to conflicting results obtained from studies in clinical or population settings. We aimed to understand if migraine and other headaches modify the rates of decline on different cognitive measures, during a 5-year interval. DESIGN AND METHOD: A cohort of community dwelling adults (> 50 years) with migraine (MH), non-migraine headaches (NMH) and controls without headache (WoH), was assessed by a comprehensive neuropsychological battery with tests of memory, language and executive functions, repeated 5 years apart. Change in performance between baseline and reevaluation was compared between groups, and controlled for age, gender, literacy and depressive symptoms. RESULTS: A total of 275 participants (78.5% WoH, 12.7% MH, 8.7% NMH) were reevaluated (average age 70.40 + 8.34 years, 64% females). Cognitive decline or dementia occurred in 11.4%, with a similar proportion among the three groups. Although MH participants had significantly more subjective cognitive complaints (p = 0.030, 95%CI:]-3.929,-0.014[), both MH and NMH subjects showed an age-associated decline identical to controls. Furthermore, migraine features (disease and attack duration, frequency and aura) were unrelated with cognitive performance. CONCLUSION: Migraine and non-migraine headache are not associated with increasing risk of dementia or cognitive decline at an older age although subjects with migraine have more cognitive complaints. Longer longitudinal studies are necessary to understand if this pattern persists for more than 5 years.

Predictors of cognitive stability or decline during aging: A longitudinal study in primary care.

We aimed to identify the early predictors of cognitive decline, and primary care physicians' (PCP) ability to diagnose cognitively impaired subjects, in a cohort of individuals recruited in primary care centers. Independent adults, aged ≥50 years at inception, with an overall low level of education, undertook a prospective clinical and cognitive evaluation targeting memory, attention and executive functions. At follow-up subjects were classified as cognitively normal (CN) or impaired (CI). Of 275 subjects (70.4 ± 8.3 years old, 176 females, 7.5 ± 4.4 education, 162 with MRI), 31 (11.2%) presented CI 4.9 years later, the majority (64.5%) presenting subjective cognitive complaints. PCP could correctly identify 40% of CI individuals, particularly if they presented current cognitive complaints. Male sex (OR = 3.117; CI95%: 1.007-9.645), age (OR = 1.063; CI95%: 1.004-1.126) and baseline scores on TMT-B (OR = 0.225; CI95%: 0.073-0.688) and Vocabulary (OR = 0.940; 95% CI: 0.894-0.986) predicted CI. This study shows that measures indicating poor cognitive reserve and low executive performance (as shown by low vocabulary and executive test scores, respectively) can be early indicators of the risk of decline, stressing the role of cognitive assessment as part of prevention/early intervention programs. The results also underline the need to help PCP to improve the detection of subjects with cognitive decline.

Nivel educativo y la autonomía funcional en adultos que residen en Quito (Ecuador) / Educational level and functional autonomy in adults of Quito-Ecuador

Resumen La incapacidad funcional del adulto asociada al envejecimiento poblacional genera un problema de salud pública. El objetivo de este artículo es estudiar la asociación existente entre el nivel educativo y la autonomía funcional de los adultos del Distrito Metropolitano de Quito (DMQ) en Ecuador. Para ello se realizó un análisis secundario con la información de la base de datos del estudio "Montreal Cognitive Assessment (MoCA): datos normativos para la población ecuatoriana", que tiene un diseño transversal con adultos de 45 a 85 años. Se utilizó un modelo multivariado de regresión logística. El tamaño muestral fue de 328 participantes, de los cuales 301 fueron incluidos. Los resultados muestran diferencias significativas en cuanto al nivel educativo y la autonomía funcional: primero, permiten observar que un nivel educativo igual o mayor a los 12 años de instrucción es un factor de prevención de la pérdida de la autonomía funcional; segundo, muestran que hay una mayor posibilidad de pérdida de autonomía en función de la edad. Esta asociación existente entre el nivel educativo y la preservación de la autonomía funcional en el adulto en el DMQ muestra la importancia de promover el acceso a prácticas educativas permanentes en la población como parte de un programa de prevención de la pérdida de la autonomía mencionada.

Abstract The functional disability of the adult associated with population aging generates a public health problem due to the impact on the health and social care systems. The objective of this investigation was to study the association between educational level and functional autonomy of adults of the Metropolitan District of Quito (DMQ) in Ecuador. For this, a secondary analysis was done with the information from the database of the study "Montreal cognitive assesment (MOCA): normative data for the Ecuadorian population", the same one that has a cross-sectional study design with adults from 45 to 85 years old. A multivariate logistic regression model was used. The sample number was 328 participants of which 301 were included. The results show the significant differences in terms of educational level and functional autonomy, being a factor of prevention an educational level equal to or greater than 12 years of instruction. In addition, showing greater possibility of loss of autonomy based on age. This existing association between educational level and the preservation of functional autonomy in adults in the DMQ demonstrates the importance of promoting access to permanent educational practices in the population as part of a program to prevent the loss of functional autonomy.

Application of Matrix Scoring Techniques to evaluate marine debris sources in the remote islands of the Azores Archipelago.

Three-quarters of all marine debris (MD) consists of plastic, a reflection of their worldwide use, production and waste mismanagement. Data on MD distributions can improve our ability to effectively reduce debris that escapes onto shorelines and the ocean. In this study, the Matrix Scoring Technique (Marine Strategy Framework Directive Technical Group on Marine Litter) was applied as an approach to calculate the likelihood of single debris items originating from a series of potential sources. Factors considered were: identity and function of debris, beach location, influential activities, "mix" of debris found, presence of indicator items, and quantity of MD. The standing-stock (abundance and composition) of MD was investigated in two sandy beaches (Conceição and Porto Pim) of the Azores Archipelago (NE Atlantic) for the period 2012-2018. The results of this study show promise towards the implementation of a new classification method to determine beach debris sources in remote open-ocean areas.

Uso del test de evaluación cognitiva de Montreal (MoCA) en América Latina: revisión sistemática / Use of the Montreal Cognitive Assessment (MoCA) in Latin America: a systematic review

Objetivo. Analizar la frecuencia del uso del test de evaluación cognitiva de Montreal (MoCA) como instrumento de cribado cognitivo, su adaptación transcultural, la existencia de baremos y estudios de validación clínica en países de habla hispana en América Latina. Sujetos y métodos. Se ha realizado una revisión sistemática de todos los estudios desarrollados en América Latina, con referencia al MoCA, que incluyan datos normativos, datos psicométricos y estudios de baremación o de validación clínica. Fueron consultadas sistemáticamente, entre abril y junio de 2017, las bases de datos Medline, PsycINFO, Web of Science, Scopus y Scielo, conforme a la metodología PRISMA. Resultados. De los 80 estudios encontrados, 19 cumplieron los criterios de inclusión. La mayoría de los estudios menciona el uso de la versión española y comunica un efecto significativo del sexo, la edad y la escolaridad. El punto de corte adoptado por la mayoría de los autores para el diagnóstico de deterioro cognitivo es el mismo del estudio original. Conclusiones. El reducido número de artículos identificados refleja posiblemente un inicio tardío de la utilización del MoCA en América Latina. Esto pone de manifiesto una tendencia en la región a utilizar la prueba sin hacer una adaptación transcultural de la versión original y sin recurrir a normas internacionales para el diagnóstico. La presente revisión sistemática demuestra la necesidad de trabajos futuros de investigación que puedan ofrecer una versión lingüísticamente adaptada del MoCA para América Latina y un estudio de sus propiedades psicométricas, con miras a una evaluación cognitiva de mayor calidad

Aim. To analyze the frequency of use of the Montreal Cognitive Assessment (MoCA) as a cognitive screening instrument, cross-cultural adaptation, the existence of normative data and clinical validation studies in Latin America Hispanic countries. Subjects and methods. The Medline, PsycINFO, Web of Science, Scopus and Scielo databases were consulted between April and June 2017 according to the PRISMA methodology. We included all studies referencing the MoCA as an instrument to evaluate cognitive deterioration conducted in Latin America and that included normative and psychometric data, as well as its clinical validation. Results. Of the 80 studies identified, 19 met the inclusion criteria. Most of the studies mentioned the use of the Spanish version of the MoCA and reported a statistically significant effect of gender, age and, most of all, education on the performance of this test. Only five studies presented with a detailed analysis of the psychometric characteristics of the test, and in most articles cut-off scores for the diagnosis of cognitive impairment were the same as the original study. Conclusions. The small number of articles identified may reflect a late start of the use of MoCA in Latin America. A tendency towards the use of this test without making a cross-cultural adaptation and the use of international norms was observed in this region. The present systematic review demonstrates the need for future research tackling the development of a linguistically adapted version of the MoCA to Latin America and the study of its psychometric properties, with the aim of improving cognitive assessment

Importance of N2-Fixation on the Productivity at the North-Western Azores Current/Front System, and the Abundance of Diazotrophic Unicellular Cyanobacteria.

To understand the impact of the northwestern Azores Current Front (NW-AzC/AzF) system on HCO3--and N2-fixation activities and unicellular diazotrophic cyanobacteria (UCYN) distribution, we combined geochemical and biological approaches from the oligotrophic surface to upper mesopelagic waters. N2-fixation was observed to sustain 45-85% of the HCO3--fixation in the picoplanktonic fraction performing 47% of the total C-fixation at the deep chlorophyll maximum north and south of the AzF. N2-fixation rates as high as 10.9 µmol N m-3 d-1 and surface nitrate δ15N as low as 2.7‰ were found in the warm (18-24°C), most saline (36.5-37.0) and least productive waters south of the AzF, where UCYN were the least abundant. However, picoplanktonic UCYN abundances up to 55 cells mL-1 were found at 45-200m depths in the coolest nutrient-rich waters north of the AzF. In this area, N2-fixation rates up to 4.5 µmol N m-3 d-1 were detected, associated with depth-integrated H13CO3--fixation rates at least 50% higher than observed south of the AzF. The numerous eddies generated at the NW-AzC/AzF seem to enhance exchanges of plankton between water masses, as well as vertical and horizontal diapycnal diffusion of nutrients, whose increase probably enhances the growth of diazotrophs and the productivity of C-fixers.

The ocean sampling day consortium.

Ocean Sampling Day was initiated by the EU-funded Micro B3 (Marine Microbial Biodiversity, Bioinformatics, Biotechnology) project to obtain a snapshot of the marine microbial biodiversity and function of the world's oceans. It is a simultaneous global mega-sequencing campaign aiming to generate the largest standardized microbial data set in a single day. This will be achievable only through the coordinated efforts of an Ocean Sampling Day Consortium, supportive partnerships and networks between sites. This commentary outlines the establishment, function and aims of the Consortium and describes our vision for a sustainable study of marine microbial communities and their embedded functional traits.

Factors affecting the retrieval of famous names.

Tests of famous faces are used to study language and memory. Yet, the effect of stimulus properties on performance has not been fully investigated. To identify factors influencing proper name retrieval and to probe stimulus-specific parameters within proper name lexicon, we analysed the results obtained by 300 healthy participants on a test of famous faces that includes 74 personalities. A factor analysis yielded five main factors that were characterized by language (national or foreign names), epoch of peak popularity (current, recent or past) and occupation (politicians, entertainment and sports) of the personalities. Multiple regression analysis showed that participants' education, age and gender accounted for 10-32% of the variance in factor scores. These results indicate that there are variables of the stimulus and participants' that must be taken into account in proper name testing and in designing tests aimed to differentiate age-associated difficulties from cognitive decline.

Grammatical dissociation during acquired childhood aphasia.

AIM: We report the case of a 6-year-old female who suffered a left hemisphere stroke attributed to a genetically determined prothrombotic state. She presented a fluent speech pattern with selective difficulty in retrieving names but not verbs. An evaluation was designed to clarify whether her symptoms represented a specific impairment of name retrieval. METHOD: The child undertook an experimental battery of visual naming tasks requiring the production of 52 nouns (belonging to nine different semantic categories) and 44 verbs. Her performance was compared with that of 12 healthy children, matched for age and IQ, attending a local kindergarten. RESULTS: The child retrieved significantly more verbs than nouns (chi(2)=16.27, p<0.01) and had a significantly lower score in noun (t=-7.2, p<0.005), but not in verb retrieval than the comparison group. This pattern persisted when verbs and nouns were matched for oral word frequency, showing that the results could not be explained by stimuli difficulty. INTERPRETATION: To our knowledge, this is the first report of a grammatical dissociation in a child. It suggests that nouns and verbs are subject to different processing early in development, at least before the formal acquisition of grammar. It contradicts theories that postulate a common processing of different grammatical categories early in life.

Effect of lesion site on serial position during list learning: a study with the CVLT.

Successful learning of supraspan word lists such as the California Verbal Learning Test (CVLT) relies more on clustering strategies than rote learning, subserved by the frontal and temporal lobes. The authors studied the effect of word sequence in CVLT learning, in 15 patients with frontal (FLL) and 15 temporal (TLL) lesions, and 33 controls. Experimental measures were: number of clusters, number of first (FI), middle (MI) and last items (LI), in learning trials and in total immediate recall. FLL disclosed significantly lower FI along learning. Clusters were similar among groups. This difficulty is discussed according to the role of frontal lobes in learning and memory.

Speech rate and fluency in children and adolescents.

Reduced speech fluency is frequent in clinical paediatric populations, an unexplained finding. To investigate age related effects on speech fluency variables, we analysed samples of narrative speech (picture description) of 308 healthy children, aged 5 to 17 years, and studied its relation with verbal fluency tasks. All studied measures showed significant developmental effects. Speech rate and verbal fluency scores increased, while pauses, repetitions and locution time declined with age. Speech rate correlated with semantic fluency tasks suggesting that it also depends upon the efficacy of lexical retrieval. These results indicate that the interpretation of disorders of speech fluency in childhood must incorporate age appropriate norms.

Degree of illiteracy and phonological and metaphonological skills in unschooled adults.

Phonological and metaphonological skills are explored in 97 Brazilian illiterate and semiliterate adults. A simple letter- and word-reading task was used to define the degree of illiteracy. Phonemic awareness was strongly dependent on the level of letter and word reading ability. Phonological memory was very low in illiterates and unrelated to letter knowledge. Rhyme identification was relatively preserved in illiterates and semiliterates, and unrelated to letter and word reading level. Phonetic discrimination (minimal pairs) was fairly good and marginally related to reading ability. These results suggest that phonological sensitivity, phonological memory, rhyme identification, and phonemic awareness are distinctive cognitive processes, and that only phonemic awareness is clearly and strongly dependent on the alphabetical acquisition.