中年Ⅱ型糖尿病人记忆损伤特点

本研究主要探讨中年Ⅱ型糖尿病人的记忆损伤特征。研究选取病人和对照各30人,控制年龄(65岁以下。病人组平均53岁,正常组52岁)、教育水平和相关疾病等因素。测试数字符号、数字工作记忆广度、动作记忆和无意义图形再认4项认知任务。结果发现：(1)病人组数字符号测试显著低于正常组;(2)在支持性条件记忆自由回忆中,病人组在有动作演练的高语义关联和无动作演练的低语义关联项目上显著低于对照组。出现分离现象;(3)在线索回忆中,病人组与对照组差异不显著;(4)两组数字工作记忆广度、无意义图形再认的成绩无差异。根据SPT(subject—performed task)研究理论对结果进行了分析,得出结论：中年Ⅱ型糖尿病人记忆的一般性信息加工能力未表现出受损,但特异信息加工受到损伤,并可能预测随年龄及病程进行而表现出一般性信息加工能力受损。     

3~6岁儿童执行功能子成分发展的研究

执行功能是对目标指向活动进行信息整合和控制调节的一系列认知能力,在学前期发展迅速。研究使用执行功能任务组软件考察了210名3~6岁儿童（6组,组间年龄跨度6个月）执行功能各子成分（工作记忆、抑制控制和认知灵活性）的发展特征。结果表明：（1）随年龄增长,3~6岁儿童执行功能呈上升趋势发展,4岁左右为抑制控制与认知灵活性的高速发展期;（2）执行功能各子成分发展不同步,抑制控制最快,工作记忆最慢;（3）各子成分间呈中度正相关。结论：3~6岁执行功能能力发展迅速,但各子成分的发展进程并不一致;幼儿阶段执行功能测试的年龄分组最好精确到6个月。     

教育水平对老年人认知能力的影响模式

来自北京三个社区的217位60~85岁的老年人接受了五项基本心理能力测验、感觉功能测查、加工速度和工作记忆容量的测试。运用相关分析、方差分析以及结构方程模型考察了教育水平对老年人基本心理能力的影响。研究得到：（1）从整体上看,教育水平对老年人基本心理能力的积极作用是普遍存在的,不依赖于具体的领域;分水平看,教育水平对认知功能的积极作用随教育水平的高低表现出领域间的差异。（2）教育水平与年龄各自独立地对老年人的认知能力产生影响,教育水平的作用是积极的,年龄的影响是极性的。（3）教育水平对老年人基本心理能力的影响不是直接的,而是以加工速度和工作记忆为中介的。     

4~8岁儿童认知风格的发展及其对问题解决的影响

认知风格是个体获取和加工信息的一贯模式,影响诸多认知活动。本研究测量了98名4-8岁儿童的认知风格和积木拼图中的问题解决行为,主要发现:（1）4-8岁儿童总体上表现为整体型认知风格,但分析型认知风格随着年龄增长在逐渐发展;（2）认知风格影响问题解决策略：越偏整体型认知风格的儿童越多使用主体参照策略（即先拼主体图形再补充其他部分）,并且越少使用线索推断策略（按照行/列的线索顺序依次拼图）和局部定位策略（根据某一局部图案的具体位置摆放积木）。本实验首次探索了低龄儿童认知风格的年龄差异,发现认知风格在发展早期就已影响问题解决行为。研究结果有助于理解儿童认知风格的发展及其作用,为儿童问题解决能力的培养实践提供一定的理论依据。     

运动习惯与社区老年人认知功能的关系

为评估社区老年人运动习惯与认知功能的关系,在北京市通过分层、方便取样的方法选取60岁以上的老年人732名,采用自编调查表收集一般人口学资料及运动习惯情况（包括有无运动习惯,运动频率,运动持续时间）,使用简明精神状态评估量表（MMSE）和北京版蒙特利尔认知评估量表（MoCA-BJ）评估认知功能。结果发现：（1）运动组整体认知功能及视空间定向能力得分均高于无运动组;（2）有无运动习惯可正向预测整体认知功能及视空间定向能力得分;（3）运动持续10年及以上组整体认知功能得分高于运动持续10年以下组。结果表明：相对于无运动习惯的社区老年人,有运动习惯的社区老年人的整体认知功能及视空间定向能力更好;运动持续年数较长,对社区老年人的认知功能起到促进作用。     

3～6岁儿童情绪伪装认知能力发展及其与错误信念理解的关系

个体的情绪伪装能力是其情绪社会化发展极为重要的方面,选取某幼儿园123名3～6岁儿童为被试,通过“区分外表-真实情绪”任务和“错误信念”任务考察3～6岁儿童情绪伪装认知能力的发展特点,进而探讨情绪伪装认知与错误信念理解的关系.结果表明：（1）儿童情绪伪装认知能力随年龄增长而提高,3～5岁为儿童情绪伪装认知能力的快速发展期;（2）儿童在消极情境下区分内外情绪的能力显著高于在积极情境中的表现;同时,对两种情绪伪装动机（社会适应、自我保护）的认知能力无显著差异;（3）儿童情绪伪装认知和错误信念理解能力显著相关,两种错误信念（意外内容、意外地点）理解都能很好地预测情绪伪装认知能力.     

创伤后应激障碍的认知功能缺陷与执行控制 ——5·12震后创伤恢复的认知基础

创伤后应激障碍（Posttraumatic stress disorder,PTSD）患者通常伴随着明显的认知功能损伤。例如,存在注意保持缺陷,对与创伤相关的信息表现出更多的注意偏向和应激反应;并存在对创伤信息的记忆偏向,在陈述性记忆和自传体记忆中表现出一定的缺陷。近年的研究积累了更多类似的证据,表明PTSD的认知损伤可能与执行功能缺陷密切相关,但这一解释是否正确仍有待进一步的研究。本综述对5·12汶川大地震后长期的心理干预工作,尤其是认知功能损伤人群的筛选、恢复以及相关科学研究具有现实意义和理论启发作用     

食管癌术后心律失常相关因素分析

为了探讨影响食管癌术后心律失常的相关因素,观察了术后心律失常的发生与患者年龄（≥65岁）、性别、吸烟、术前合并症、肺功能、心电图（EKG）改变、低血钾、术后24小时失血量及手术方式的关系。结果显示,318例食管癌术后心律失常发生率为47．48％。年龄（≥65岁）、FEV1／FVC≤70%和／或MVV％≤60％、术前ECG异常、术前血钾≤4．0mmol／L、术后24小时失血≥500ml及手术方式与术后心律失常的发生相关。提示术前改善低心肺功能、纠正低血钾、减少术中出血,高龄患者和多切口手术方式者术后加强监护,可预防和减少术后心律失常发生。     

与年龄及认知功能相关的成人脑波功率涨落图特点

对１２０名２０－７９岁正常受试者完成了与年龄及认知功能相关的脑涨落图特点的研究。结果表明：（１）脑波优势涨落功率空间构型额低枕高梯度的随龄减小过程,在认知测验差组较好组明显;（２）脑波优势涨落功率受年龄与认知因素的交互影响集中于左前右后脑轴上;（３）脑波优势涨落功率前后梯度和左右不对称性变化表明,脑波活动的前后和左右调控可能在不同层次上发挥作用,并且,前后脑和左右脑的协调活动与认知功能有密切关系。上述结果说明,脑波功率涨落与认知功能及其老化过程有密切关系。     

2～3.5岁儿童执行功能发展特点及其言语能力的影响

2~3.5岁是婴儿成长到幼儿的重要发展转折期,也是儿童执行功能及言语能力的发展萌芽期。研究通过测查北京市81名2~3.5岁儿童在固定盒子任务、搭积木任务、A非B任务和皮博迪图片词汇测验上的表现,探究了该年龄段儿童执行功能的发展特点、各成分间的内部关系、以及言语能力对执行功能的影响。结果发现:(1)在2~3.5岁期间,除认知灵活性外,儿童的工作记忆与抑制控制均快速发展,其中,2.5岁前后是工作记忆与抑制控制的重要发展时期;(2)在2~3岁期间,认知灵活性与工作记忆之间相关密切,在3~3.5岁期间,认知灵活性与抑制控制的相关密切,3岁是儿童执行功能内部成分关系的重要发展转折期;(3)在2~3.5岁期间,儿童言语能力呈现快速发展,并且言语能力对该年龄段执行功能各成分间关系产生一定的影响,但不同言语能力的儿童在执行功能各成分的表现并没有显著差异。     

进行中任务变化对轻度认知功能障碍者基于事件前瞻记忆的影响

本实验采用2被试组别(MCI组、正常老年组) × 3进行中任务变化(无变化、顺序变化、随机变化)被试间设计探究进行中任务变化对轻度认知功能障碍者基于事件前瞻记忆的影响。结果表明：(1)轻度认知功能障碍者的前瞻记忆成绩显著低于正常老年人的前瞻记忆成绩; (2)进行中任务变化对两组被试前瞻记忆和进行中任务的反应时影响存在显著差异。进行中任务变化越大, 轻度认知功能障碍者完成前瞻记忆和进行中任务的反应速度越慢; 而正常老年被试则不受影响。研究支持前瞻记忆策略加工的理论观点, 认为执行功能损伤可能是导致轻度认知功能障碍者前瞻记忆失败的主要原因。     

The Association Between Delirium and Cognitive Decline: A Review of the Empirical Literature

Delirium is a common neurobehavioral syndrome that occurs across health care settings which is associated with adverse outcomes, including death. There are limited data on long-term cognitive outcomes following delirium. This report reviews the literature regarding relationships between delirium and cognitive impairment. Psych Info and Medline searches and investigation of secondary references for all English language articles on delirium and subsequent cognitive impairment were carried out. Nine papers met inclusion criteria and documented cognitive impairment in patients following delirium. Four papers reported greater cognitive impairment among patients with delirium than matched controls. Four papers reported higher incidence of dementia in patients with a history of delirium. One study found 1 of 3 survivors of critical illness with delirium developed cognitive impairment. The evidence suggests a relationship between delirium and cognitive impairment, although significant questions remain regarding the nature of this association. Additional research on delirium-related effects on long-term cognitive outcome is needed.     

The nature and severity of cognitive impairment associated with adjuvant chemotherapy in women with breast cancer: a meta-analysis of the current literature

OBJECTIVE: Several studies have identified that adjuvant chemotherapy for breast cancer is associated with cognitive impairment; however, the magnitude of this impairment is unclear. This study assessed the severity and nature of cognitive impairment associated with adjuvant chemotherapy by conducting a meta-analysis of the published literature to date. METHOD: Six studies (five cross-sectional and one prospective) meeting the inclusion criteria provided a total of 208 breast cancer patients who had undergone adjuvant chemotherapy, 122 control participants and 122 effect sizes (Cohen's d) falling into six cognitive domains. First, the mean of all the effect sizes within each cognitive domain was calculated (separately for cross-sectional and prospective studies); second, a mean effect size was calculated for all of the effect sizes in each cross-sectional study; and third, regression analyses were conducted to determine any relationships between effect size for each study and four different variables. RESULTS: For the cross-sectional studies, each of the cognitive domains assessed (besides attention) showed small to moderate effect sizes (-0.18 to -0.51). The effect sizes for each study were small to moderate (-0.07 to -0.50) and regression analysis detected a significant negative logarithmic relationship (R2 = .63) between study effect size and the time since last receiving chemotherapy. For the prospective study, effect sizes ranged from small to large (0.11-1.09) and indicated improvements in cognitive function from the beginning of chemotherapy treatment to 3 weeks and even 1 year following treatment. CONCLUSION: This meta-analysis suggests that cognitive impairment occurs reliably in women who have undergone adjuvant chemotherapy for breast cancer but that the magnitude of this impairment depends on the type of design that was used (i.e., cross-sectional or prospective). Thus, more prospective studies are required before definite conclusions about the effects of adjuvant chemotherapy on cognition can be made.     

Vers une prise en charge des troubles cognitifs des patients atteints de cancer

Cancer and its treatments can have deleterious effects on cognitive function and a negative impact on the patient's quality of life. This work proposed a review of the different studies that have been implemented to deal with or prevent cognitive impairment in patients suffering from cancer. Two dissociated but complementary approaches emerge in patients support: a pharmacological approach and a psychological approach, in the form of cognitive rehabilitation. Despite a growing interest of researchers in this issue, we note that many practical and methodological problems persist; results remain therefore difficult to generalize. We hope that our reflections on the support of cognitive disorders in oncology will help the development of new research in this field considered very important by patients.     

Type 2 Diabetes Mellitus and Cognitive Performance in a Population-Based Sample of the Oldest Old: Impact of Comorbid Dementia

We examined the relationship between type 2 diabetes mellitus and cognitive function in a population-based sample of very old people. The sample comprised 338 persons, aged 80-93 years (mean age 83.5 years), of whom 70 persons had type 2 diabetes mellitus. Measures of cognitive functioning included tests of perceptual speed, visuo-spatial ability, inductive reasoning, short-term memory, semantic memory, episodic memory, and the Mini-Mental State Examination. Regression analyses showed that type 2 diabetes mellitus duration was related to test performance across all cognitive domains, with the exception of short-term memory, such that longer duration was associated with lower test performance. When cases with dementia were excluded from the sample, further analyses showed that diabetes duration was not associated with cognitive test performance. This indicates that diabetes is not related to lower cognitive function in the general population of non-demented old people. Diabetes, however, increases the risk for cerebrovascular incidents, like stroke, that may contribute to vascular dementia.     

Changing behaviors: Using norms to promote physical activity for type 2 diabetes patients

IntroductionGiven that diabetes is a major public heath issue around the world, it is vital that we find effective means to change behaviors, especially levels of physical activity among type 2 diabetes patients.ObjectiveThis study aims to provide proof of the effectiveness of programs promoting physical activity, based on cognitive dissonance and normative focus theories which are designed to produce behavioral changes in persons with type 2 diabetes.MethodNinety-six type 2 diabetes patients were assigned to one of three programs: a traditional information program, a norm-based program, and a dissonance-based program. The participants filled out a short French version of the International Physical Activity Questionnaire (IPAQ) one week before and one week after the program.ResultsThe results showed that the participants in the norm-based program made progress compared to those in the traditional information program. No significant difference was observed between the traditional information program and dissonance-based program.ConclusionsThese findings are consistent with both the focus normative theory and previous studies showing that recalling the norm increases compliance. The procedure to be used in diabetes prevention programs should focus on the normative dimensions of the desired behaviors in order to improve patients’ quality of life.     

Reprint of: 'Brain insulin signaling: A key component of cognitive processes and a potential basis for cognitive impairment in type 2 diabetes'

Understanding of the role of insulin in the brain has gradually expanded, from initial conceptions of the brain as insulin-insensitive through identification of a role in regulation of feeding, to recent demonstration of insulin as a key component of hippocampal memory processes. Conversely, systemic insulin resistance such as that seen in type 2 diabetes is associated with a range of cognitive and neural deficits. Here we review the evidence for insulin as a cognitive and neural modulator, including potential effector mechanisms, and examine the impact that type 2 diabetes has on these mechanisms in order to identify likely bases for the cognitive impairments seen in type 2 diabetic patients.     

Brain insulin signaling: a key component of cognitive processes and a potential basis for cognitive impairment in type 2 diabetes

Understanding of the role of insulin in the brain has gradually expanded, from initial conceptions of the brain as insulin-insensitive through identification of a role in regulation of feeding, to recent demonstration of insulin as a key component of hippocampal memory processes. Conversely, systemic insulin resistance such as that seen in type 2 diabetes is associated with a range of cognitive and neural deficits. Here we review the evidence for insulin as a cognitive and neural modulator, including potential effector mechanisms, and examine the impact that type 2 diabetes has on these mechanisms in order to identify likely bases for the cognitive impairments seen in type 2 diabetic patients.     

Social Cognition in Multiple Sclerosis: a Meta-Analysis

Multiple sclerosis (MS) is associated with cognitive decline and impairment in social functioning. Accumulating evidence suggests that patients with MS are impaired in social cognition, including theory of mind (ToM) and emotion recognition. In this meta-analysis of 24 studies, facial emotion recognition and ToM performances of 989 patients with MS and 836 healthy controls were compared. MS was associated with significant impairments with medium effect sizes in ToM (d?=?0.57) and facial emotion recognition (d?=?0.61). Among individual emotions recognition of fear and anger were particularly impaired. The severity of social cognitive deficits was significantly associated with non-social cognitive impairment. These deficits in social cognition may underpin difficulties in social functioning in MS. However, there is a need for further studies investigating the longitudinal evolution of social cognitive deficits and their neural correlates in MS.