Search Results (35)

Idiopathic normal-pressure hydrocephalus (iNPH) is clinically characterized by the Hakim–Adams triad: gait disturbance, cognitive decline, and urinary incontinence. Cognitive impairment in iNPH predominates as a subcortical syndrome, with deficits in executive functions, psychomotor slowing, and memory inefficiency. However, the cognitive profile is heterogeneous and often overlaps with other neurodegenerative conditions, complicating differential diagnosis. This study investigated the cognitive features of iNPH using the Rey Auditory Verbal Learning Test (RAVLT), comparing 29 iNPH patients to 28 healthy controls. Demographic and neuroimaging parameters—such as Evans Index and Callosal Angle—were assessed. Results indicated significantly lower Montreal Cognitive Assessment (MoCA) and RAVLT scores in iNPH patients compared to controls. Analysis of serial position effects revealed that, whereas healthy individuals exhibited typical primacy and recency effects in verbal memory, iNPH patients demonstrated a selective impairment of the primacy effect, likely reflecting hippocampal dysfunction. These findings underline the importance of detailed neuropsychological evaluation in differentiating iNPH from other dementias and suggest that damage to medial temporal lobe structures plays a prominent role in the verbal memory deficit observed in iNPH. Full article

Background: The timely detection of cognitive decline in highly educated adults is challenging due to their resilient cognitive abilities and the limited sensitivity of neuropsychological tests for this group. Therefore, evaluating subjective facets such as subjective cognitive decline (SCD) becomes imperative, potentially enabling the early identification of cognitive decline. Objective: Our primary objective was to identify effective methods, both objective and subjective, for the early detection of cognitive decline in highly educated older adults. A secondary objective was to translate and validate a Hebrew adaptation of the SCD questionnaire. Methods: Initially (T0), the study included 28 highly educated participants (mean age = 72.6, SD = 4.54; mean education 17.6, SD = 3.41). By the final evaluation (T7), 20 participants remained. Annual assessments involved objective neuropsychological tests and self-report questionnaires evaluating depression, anxiety, and SCD with changes analyzed over time using repeated measures ANOVA. Results: Significant declines were observed in the following objective neuropsychological tests: Rey–Osterrieth Complex Figure Test (ROCFT) copy, F(3,57) = 9.05, p < 0.001, ηp2 = 0.32, and Rey Auditory Verbal Learning Test (RAVLT) trial six, F(1,19) = 7.32, p < 0.05, ηp2 = 0.28, which is consistent with previous findings. The Hebrew SCD questionnaire demonstrated high reliability and validity and was highly correlated with cognitive decline. Conclusions: The ROCFT copy and the Hebrew SCD questionnaire can serve as valuable indicators for the early detection of cognitive decline in highly educated older adults. Full article

Background/Objectives: Neuropsychological testing is key in defining cognitive profiles at early stages of dementia. More importantly, the detection of subtle cognitive changes, such as subjective cognitive complaints (SCCs), an understudied phenomenon, is critical for early detection and preventive interventions. Methods: This systematic review analyzes the empirical data on the cognitive domains and neuropsychological tests used in studies addressing SCC in the last 15 years (2009–2024). Results: A selection of 15 papers with exploratory, cross-sectional, and prospective scope in this field was obtained from PubMed and Embase databases. They used screening tests (17%) and a broad spectrum of neurocognitive domains. Yet, we identified three main targeted cognitive domains: executive functions (28%), language (17%), and memory (17%). Myriad assessment tools were also applied, but the most commonly used was a set of eight tests: Mini-mental Scale Examination (MMSE), Trail Making Test (A-B), Stroop test, Digit span test (DST), Semantic and Phonological fluency test, Rey Auditory Verbal Learning Test (RAVLT), Weschler Memory Scale (WMS), and Boston Naming Test (BNT). New approaches involved including the Geriatric Depression Scale (GDS) and self/informant reports. Conclusions: Despite scarce agreement in the assessment protocols, the identification of early neurocognitive symptoms to objectivate the SCC phenomenon envisions a broad field of research. Full article

Background/Objectives: A mango (Mangifera indica) leaf extract (Zynamite^®), rich in the polyphenol mangiferin, has been demonstrated to modulate brain activity, boost cognitive function, and reduce mental fatigue. Research evidence supports that improving the solubility of this extract could significantly enhance its efficacy as an active ingredient. This study examined the effects of a soluble version of Zynamite^®, Zynamite^® S (Zyn-S), on cognitive function and mood in young adults at low doses. Methods: A total of 119 university students were enrolled in the study. Participants were randomly assigned to receive either 100 mg, 150 mg, or placebo in a double-blind crossover design. Short- and long-term memory were evaluated using the Rey Auditory Verbal Learning Test (RAVLT), executive functions with the Trail Making Test (TMT), processing speed with the Digit Symbol Substitution Test (DSST), and selective attention with the Stroop Color and Word Test. Additionally, mood was assessed using the Spanish short version of the Profile of Mood States (POMS). All these assessments were conducted before taking the product and at 30 min, 3 h, and 5 h post-intake. Results: The results demonstrated that participants who received Zynamite^® S experienced significant improvements in reduced tension, depression, and confusion, suggesting an enhancement in mental clarity and overall emotional well-being. Both interventions also improved processing speed and cognitive flexibility. However, no significant differences were observed in short- and long-term verbal memory. Conclusions: In summary, these findings support Zynamite^® S as a natural nootropic capable of acutely improving key cognitive functions and emotional balance at low doses in young adults, with sustained efficacy for at least five hours. Full article

Background/objectives: Cognitive decline and loss of physical function are common concerns in older adults, with limited effective interventions available. This study aimed to assess the impact of pomegranate extract (PE) supplementation on cognitive and physical function in older adults aged 55–70 years. Methods: A randomised, double-blind placebo-controlled trial was conducted with 86 participants, who were assigned to receive either PE (740 mg) or a placebo (maltodextrin) daily for 12 weeks. Cognitive function was assessed using computerised tests (Corsi, digit span, Wisconsin Card Sorting Test (WCST), Tower of Hanoi, Stroop test and Rey auditory verbal learning test). Physical function was measured through assessments of standing balance, gait speed, chair sit to stand and grip strength. Results: There was a significant effect of treatment and time on WCST performance (F (1,2) = 2.718, p = 0.05), while trends towards better outcomes in the PE group were noted for digit span, Tower of Hanoi and Stroop tests. Physical function did not seem to be affected by the intervention, but results may have been limited by the high baseline physical activity levels and full mobility of the older adults. Conclusions: This was the first study to examine the effect of PE on cognitive and physical function over a duration of 12 weeks. Findings suggest that PE supplementation has potential in improving cognitive function and may offer a promising approach to preventing cognitive decline in ageing adults. Further controlled and well-designed long-term studies are needed to establish the long-term effects of PE on cognitive and physical health, along with the mechanisms of action involved. Full article

Background: The Improved Health Care in Neurology and Psychiatry—Longer Life (IHCNP) study was an 18-month prospective, observational, non-interventional research study focused on patients with mild cognitive impairment (MCI) following ischemic stroke. Objectives: Our secondary analysis of the IHCNP data aimed to document the progression of MCI in this patient group. Methods: A total of 100 patients from Romania were recruited, all of whom underwent cognitive assessments using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Rey Auditory Verbal Learning Test (RAVLT). Clinical evaluations were also conducted as part of the study. Baseline cognitive scores were recorded, and subsequent follow-ups documented cognitive changes over time. Results: At baseline, cognitive scores indicated mild impairment, with averages of MMSE 25.41, MoCA 23.27, and RAVLT 33.63. By the end of the study, patients exhibited a significant cognitive decline, with MMSE scores dropping by 8.7%, MoCA by 10.0%, and RAVLT by 29.5% (p < 0.0001 for all measures), reflecting the progressive nature of MCI post-stroke. Conclusions: These findings highlight the importance of early diagnosis and intervention to mitigate cognitive decline in post-stroke patients. The study underscores the need for ongoing cognitive monitoring to improve patient outcomes and manage MCI progression effectively. Full article

This study aimed to assess the effectiveness of vortioxetine for improving depressive symptoms, cognitive performance, daily and global functioning in patients with Alzheimer’s disease (AD) and major depressive disorder (MDD) in real-world clinical practice. We retrospectively identified 46 AD patients who had received treatment for 12 months with vortioxetine. Drug effects were evaluated at baseline, 4, 8, and 12 months. The primary endpoint was change from baseline in the Hamilton Depression Rating Scale (HDRS) and in the Cornell Scale for Depression in Dementia (CSDD) to month 12. Cognitive and daily and global functioning changes were also evaluated. Significant baseline-to-endpoint improvement in depressive symptom severity was observed (p < 0.0001). At month 12, the least-square mean (standard error) change score from baseline was −10.48 (±0.42) on the HDRS and −9.04 (±0.62) on the CSDD. Significant improvements in cognitive performance were observed for the Rey Auditory Verbal Learning Test, the Symbol Digit Modalities Test, the Letter Fluency Test, the Category Fluency Test, and the Trail Making Test-A. Patients also experienced significant improvements in daily and global functioning. Vortioxetine was safe and well tolerated. Patients with AD and MDD receiving vortioxetine showed meaningful improvements in depressive symptoms, cognitive performance, and daily and global functioning over the 12-month treatment period. Full article

Few randomized controlled trials have reported that repetitive transcranial magnetic stimulation (rTMS) has controversial results for managing multiple domains of fibromyalgia-related symptoms. This work aimed to evaluate the effect of low-frequency rTMS over the right dorsolateral prefrontal area (DLPFC) on the Fibromyalgia Impact Questionnaire (FIQ) concerning psychiatric and cognitive disorders. Forty-two eligible patients with fibromyalgia (FM) were randomized to have 20 sessions of active or sham rTMS (1 Hz, 120% of resting motor threshold with a total of 1200 pules/session) over the right DLPFC. All participants were evaluated at baseline, post sessions, and 3 months after sessions with the FIQ, Hamilton depression, and anxiety rating scales (HDRS and HARS), Montreal Cognitive Assessment (MoCA), Rey Auditory Verbal Learning Test (RAVLT), Tower of London test (TOL), the Trail Making, and Digit Span Tests. Both groups showed improvement in most rating scales at 1 and 3 months follow-up, with greater improvement in the active group, with significant correlation between FIQ cognitive rating scales, including RAVLT and TOL. Twenty sessions of low-frequency rTMS over the right DLPFC can improve FIQ scores regarding the psychiatric and cognitive symptoms of medicated patients with FM to a greater extent than sham. Changes in RAVLT and TOL correlated with changes in FIQ results. Full article

Background: Inorganic nitrate found in beetroot and green leafy vegetables has been demonstrated to reduce cardiovascular disease risk factors, including reducing blood pressure (BP) and the stiffness of blood vessels by increasing levels of nitric oxide (NO). The most beneficial effects of inorganic nitrate have been observed in young, healthy populations, whereas its impact on at-risk populations, such as postmenopausal women, is currently unknown. Objective: the primary aim of the trial is to evaluate the effectiveness of nitrate-rich beetroot juice in enhancing microvascular blood flow and cognitive function in postmenopausal women. Methods: We conducted a double-blind, three-armed, randomised, and controlled crossover trial with 24 postmenopausal women (aged 45 or older and having not had a period for over one year). The interventions were beetroot juice (BJ), nitrate-depleted BJ (NDJB), or NDBJ supplemented with potassium nitrate (0.4 g) to concurrently test if betalains, as well as nitrate, play a role in the vascular and cognitive effects. Cognitive tasks (episodic memory: Rey auditory verbal learning test; executive function: Stroop task, digit span backward and forward) and microvascular function (Laser Doppler Imaging (LDI) with iontophoresis; endothelium-independent and -dependent) were measured in participants before and 2.5 h after ingestion of the intervention. In addition, BP was measured in triplicate every 15 min from the baseline for 2.5 h. Results: The baseline characteristics of the participants recruited to date are as follows (mean and standard deviation)—age (years): 60 ± 5, BMI (kg/ m²): 23.8 ± 3.1, systolic BP (mmHg): 120 ± 14, and diastolic BP (mmHg): 75 ± 8. Early results indicated no significant difference between the groups with respect to SBP or DBP. A statistical analysis of the full data set, including endothelium-dependent and -independent microvascular function and cognitive tests, will be presented. Discussion: the results of this trial will help shed further light on the impact of dietary nitrate and the phytochemicals present in beetroot on human vascular and cognitive function. Full article

Background: The majority of previous studies showed that older adults with mild cognitive impairment (MCI) as well as Alzheimer’s disease dementia (ADD) had impaired cognition and mood status, as well as increased behavioral disturbances after the first wave of the COVID-19 pandemic. However, there are still controversial data as regards the multifactorial impact of the restrictive measures on cognition, mood and daily function in older adults with MCI and ADD. Aim: In the current study, the scope is to identify possible deterioration by means of cognitive and functional level due to mood and behavioral alterations during the second quarantine imposed in Greece between November 2020 and May 2021, as well as one year after the second quarantine, in May 2022. Methods: Participants were recruited from the two day centers of the Greek Association of Alzheimer Disease and Related Disorders (GAADRD). They underwent three yearly follow up assessments from May 2020 to May 2022 and participated in cognitive training interventions (through digital online means) during the aforementioned period. Mixed measures analyses of variance as well as path models were used for the study’s purposes. Results: The study sample comprised 210 participants (175 people with MCI and 35 people with ADD). The mean age was 71.59 and 77.94 for people with MCI and mild ADD, respectively, whereas the average number of years of education was 12.65 for those with MCI and 9.83 for people with mild ADD. The results show that participants’ deterioration rate (D), calculated by means of their performance in neuropsychological and functional assessments between 2020 and 2021 (D1) and 2021 and 2022 (D2), did not change significantly, except for the Rey Auditory Verbal Learning Test (RAVLT), since both groups displayed a larger D2 across the test conditions (immediate recall, fifth trial and delayed recall). Trail Making Test-B (TMT-B) performance, applied only in the MCI group, decreased more in relation to the deterioration rate D2. Additionally, two path models were applied to measure the direct relationships between diagnosis, performance in tests measuring mood and neuropsychiatric disturbances (NPI) and cognition, as measured by the RAVLT, in the 2020–2022 assessments. TMT-B was administered only in the MCI population, and therefore was not included in path models. The results show that participants’ scores in RAVLT conditions were related to diagnosis and NPI performance, which was positively affected by diagnosis. No other relationships between RAVLT with mood tests were observed. Conclusions: Our results show that after the second lockdown period, the neuropsychological performance of people with MCI and ADD, calculated by means of their D2, did not change, except from their verbal memory, as well as visual scanning and information processing, measured using the TMT-B. Therefore, it can be assumed that those who were enrolled in digital non-pharmacological interventions during the COVID-19 pandemic home restrictions did not experience increased cognitive and functional deterioration due to mood and behavioral alterations after the pandemic. Full article

The objective of this study was to evaluate the effects of consuming 50 g of raisins on cognitive performance, quality of life, and functional activities in healthy older adults. This is a parallel randomized controlled clinical trial, in which 80 subjects over 70 years of age participated. For 6 months, the intervention group (IG; n = 40) consumed 50 g of raisins per day added to their usual diet, whereas the control group (CG; n = 40) received no supplement. All variables were measured at baseline and at 6 months. Cognitive performance assessed with the Montreal Cognitive Assessment (MOCA) test shows a difference of 3.27 points (95% CI 1.59 to 4.96), p ≤ 0.001, favorable to the IG, after the intervention. Among the cognitive performances, an improvement is observed in the IG in orientation, assessed both with the MOCA test 0.49 (95% CI 0.10 to 0.87), p = 0.014, and with the Mini-Mental State Examination (MMSE) test, 0.36 (95% CI 0.02 to 0.70), p = 0.038. In visuospatial/executive capacity and in language, improvements were also observed in the IG, 1.36 (95% CI 0.77 to 1.95), p = 0.001, and 0.54 points (95% CI 0.12 to 0.96), p = 0.014, respectively. Immediate and delayed recall, assessed with the Rey Auditory Verbal Learning Test, improved in the IG. In addition, the IG showed a better quality of life and greater autonomy in instrumental activities of daily living after 6 months. No significant changes were observed in the rest of the variables analyzed. Therefore, the consumption of 50 g of raisins produces a slight improvement in cognitive performance, quality of life, and functional activities in the elderly. Full article

Associations between pathophysiological events and cognitive measures provide insights regarding brain networks affected during the clinical progression of Alzheimer’s disease (AD). In this study, we assessed patients’ scores in two delayed episodic memory tests, and investigated their associations with regional amyloid deposition and brain metabolism across the clinical spectrum of AD. We assessed the clinical, neuropsychological, structural, and positron emission tomography (PET) baseline measures of participants from the Alzheimer’s Disease Neuroimaging Initiative. Subjects were classified as cognitively normal (CN), or with early (EMCI) or late (LMCI) mild cognitive impairment, or AD dementia. The memory outcome measures of interest were logical memory 30 min delayed recall (LM30) and Rey Auditory Verbal Learning Test 30 min delayed recall (RAVLT30). Voxel-based [¹⁸F]florbetapir and [¹⁸F]FDG uptake-ratio maps were constructed and correlations between PET images and cognitive scores were calculated. We found that EMCI individuals had LM30 scores negatively correlated with [¹⁸F]florbetapir uptake on the right parieto-occipital region. LMCI individuals had LM30 scores positively associated with left lateral temporal lobe [¹⁸F]FDG uptake, and RAVLT30 scores positively associated with [¹⁸F]FDG uptake in the left parietal lobe and in the right enthorhinal cortex. Additionally, LMCI individuals had LM30 scores negatively correlated with [¹⁸F]florbetapir uptake in the right frontal lobe. For the AD group, [¹⁸F]FDG uptake was positively correlated with LM30 in the left temporal lobe and with RAVLT30 in the right frontal lobe, and [¹⁸F]florbetapir uptake was negatively correlated with LM30 scores in the right parietal and left frontal lobes. The results show that the association between regional brain metabolism and the severity of episodic memory deficits is dependent on the clinical disease stage, suggesting a dynamic relationship between verbal episodic memory deficits, AD pathophysiology, and clinical disease stages. Full article

A small number of robust studies have explored the association between cognitive tests and marital status levels of mild cognitive impairment (MCI) patients using the TADPOLE dataset. Rey Auditory Verbal Learning Test (RAVLT) cognition performance combined with marital status levels is associated with increased odds of MCI than either RAVLT in isolation. The cross-sectional association between RAVLT performance in immediate response, learning, forgetting, and perception of forgetting with marital status and MCI was evaluated using TADPOLE data. We included participants with MCI and normal cognition in our study. Based on our logistic regression model, four RAVLT subgroups are associated with MCI (low and high response performance, immediate response with learning, immediate response with learning and forgetting, immediate response with learning, forgetting, and perception of forgetting). We adjusted models for sex, age, race, marital status, education, ethnicity, APOE4 genotype, hippocampus, whole brain, ventricles, and ICV. A mean age of 77/67 years was observed in the sample (n = 6560), 44% of participants were females, and 58% had mild cognitive impairment. Subgroups whose ages are 61 to 70 (OR 0.26, 95% CI 0.15–0.45) and older (OR 0.07, 95% CI 0.04–0.12), as well as race: black/African American (OR 0.13, 95% CI 0.03–0.52), multiple races (OR 0.05, 95% CI 0.01–0.24), and never married (OR 0.2, 95% CI 0.12–0.34) were negatively associated with immediate response and forgetting subgroup tests. There is a need for studies that evaluate other cognitive tests in the TADPOLE dataset with missing data as a predictive tool that aligns with the factors associated with MCI. Full article

Although disturbed functional connectivity is known to be a factor influencing cognitive impairment, the neuropathological mechanisms underlying the cognitive impairment caused by type 2 diabetes mellitus (T2DM) remain unclear. To characterize the neural mechanisms underlying T2DM-related brain damage, we explored the altered functional architecture patterns in different cognitive states in T2DM patients. Thirty-seven T2DM patients with normal cognitive function (DMCN), 40 T2DM patients with mild cognitive impairment (MCI) (DMCI), and 40 healthy controls underwent neuropsychological assessments and resting-state functional MRI examinations. Functional connectivity density (FCD) analysis was performed, and the relationship between abnormal FCD and clinical/cognitive variables was assessed. The regions showing abnormal FCD in T2DM patients were mainly located in the temporal lobe and cerebellum, but the abnormal functional architecture was more extensive in DMCI patients. Moreover, in comparison with the DMCN group, DMCI patients showed reduced long-range FCD in the left superior temporal gyrus (STG), which was correlated with the Rey auditory verbal learning test score in all T2DM patients. Thus, DMCI patients show functional architecture abnormalities in more brain regions involved in higher-level cognitive function (executive function and auditory memory function), and the left STG may be involved in the neuropathology of auditory memory in T2DM patients. These findings provide some new insights into understanding the neural mechanisms underlying T2DM-related cognitive impairment. Full article

Objective: To explore the characteristics and dynamic evolution of cognitive impairment in patients with neuromyelitis optica spectrum disorder (NMOSD). Methods: Twenty-five patients with acute NMOSD and 30 age-matched healthy individuals were consecutively recruited in this study. The Montreal Cognitive Assessment (MoCA), Chinese Version of Rey Auditory Vocabulary Learning Test (CRAVLT), Verbal Fluency Test (VFT), Digital Span Test (DST), Paced Auditory Serial Addition Task 3/2s version (PASAT-3/2), Rey–Osterrieth Complex Figure Test (ROCF) and Stroop Color and Word Test (CWT) were used to evaluate cognitive function. The correlations between cognitive function and serum aquaporin-4 (AQP-4) antibody titer were analyzed. Results: Sixty-four percent of patients with acute NMOSD had cognitive dysfunction. MoCA (p < 0.001), CRAVLT-N7 (p = 0.004), CRAVLT-N8 (p = 0.011), ROCF-C (p = 0.005), ROCF-R (p < 0.001), PASAT-3 (p = 0.013), PASAT-2 (p = 0.001) and CWT-A (p = 0.017) were significantly worse in patients with acute NMOSD than those in control group. During follow-up visits, significant differences of serum AQP-4 antibody titers were still noted in NMOSD patients (p < 0.001), while no significant differences were found by MoCA. Conclusion: A high number of patients with acute NMOSD suffer from cognitive dysfunction. Serum AQP-4 antibody titers can decrease during disease remission, while obvious cognitive decline in these patients still exists. Full article