Change in cognitive capabilities in the oldest old: the effects of proximity to death in genetically related individuals over a 6-year period

Change in cognitive abilities was assessed over a 6-year period in a sample of monozygotic and same-sex dizygotic twin pairs (N = 507 individuals), aged 80 and older (mean age = 83.3 years: SD = 3.1). who remained nondemented over the course of the study. Latent growth models (LGMs) show that chronological age and time to death are consistent predictors of decline in measures of memory, reasoning, speed, and verbal abilities. Multivariate LGM analysis resulted in weak and often negative correlations among rates of change between individuals within twin pairs, indicating greater differential change within twin pairs than occurs on average across twin pairs. These findings highlight several challenges for estimating genetic sources of variance in the context of compromised health and mortality-related change.     

Latent growth curve analyses of accelerating decline in cognitive abilities in late adulthood

Latent growth models were applied to data from the Swedish Adoption/Twin Study of Aging to discover if the rate of change in cognitive performance increased from middle age to later adulthood. The sample included 590 participants aged 44 to 88 years at first measurement. Data were gathered at 2 follow-up occasions at intervals of 3 years. Cognitive ability was assessed through 11 tests that tapped crystallized, fluid, memory, and spatial abilities and perceptual speed. Results indicated stability for measures of crystallized ability, linear age changes for many cognitive abilities, and a significant acceleration in linear decline after age 65 for measures with a large speed component. Gender differences were found only in mean level, not in rate of decline.     

Selective deficit of motor imagery as tapped by a left-right decision of visually presented hands

This paper presents the case of MT, a patient suffering from apraxia with left-hemisphere damage who showed a selective deficit in mentally rotating images of hands whereas he was still able to mentally rotate other visual stimuli. The deficit was particularly evident when MT was asked to decide which hand (left or right) was represented in a picture. suggested that in order to carry out this task, participants would mentally rotate a representation of their own body part until it aligns with the stimulus and it does appear that MT's ability to mentally simulate movements is impaired. In contrast, he was able to mentally rotate other forms of bi- and three-dimensional stimuli. Our findings are also consistent with proposal that there are at least two ways in which objects can be mentally rotated, one that recruits processes devoted to motor preparation (e.g., hands), and another that does not.     

Cultural Difference in Hand Preference: Evidence from India and Japan

Indian (N = 400) and Japanese (N = 502) adult subjects were examined for their hand preference on a 7-point scale (1 = left always, 7 = right always) of the 32-item Waterloo Handedness Questionnaire (Steenhuis & Bryden, 1989). Factor analyses of the data yielded a two-factorial structure of hand preference: skilled and unskilled. Interaction of Culture × Hand preference indicated that Indians had more right-hand preference for unskilled activities whereas Japanese subjects had more right-hand preference for skilled activities. Further analyses revealed that the frequency of middle category responses was more common in Japanese subjects. Indian subjects were found to give more extreme responses for either right- or left-hand preference. Findings are discussed in the light of cultural training given to the individuals in these two societies, which are essentially collective in nature.     

Day treatment of patients with personality disorders: experiences from a Norwegian treatment research network

This study sought to investigate the following research questions: Are time-limited day treatment programs for patients with personality disorder (PD) effective outside resourceful university settings, and what are the overall treatment results when the program is implemented on a larger scale? Do all categories and subtypes of PDs respond favorably to such treatment? How intensive should such day treatment programs be? All patients (n = 1,244) were consecutively admitted to eight different treatment programs in the Norwegian Network of Psychotherapeutic Day Hospitals from 1993 to 2000. Altogether, 1,010 patients were diagnosed with PD. Avoidant, borderline, not otherwise specified (NOS), and paranoid PD were the most common conditions. SCID-II and MINI were used as diagnostic instruments. Outcome measures included GAF Global Assessment of Functioning, (GAF; American Psychiatric Association, 1994), SCL-90R, CIP, Quality of Life, work functioning and parasuicidal behavior, measured at admittance, discharge and 1-year follow up. The attrition rate was 24%. The number of dropouts did not improve over time. As a group, completers with PD improved significantly on all outcome variables from admittance to discharge and improvement was maintained or increased at follow up. Treatment results were best for borderline PD, cluster C patients, PD NOS and No PD, and poorer for cluster A patients. Units with a high treatment dosage did not experience better outcomes than those with a low treatment dosage (10 hours per week). Results from the University unit were not better than those from units at local hospitals or mental health centers.     

Cardiac morbidity risk and depression and anxiety: a disorder, symptom and trait analysis among cardiac surgery patients

The aim of this study was to examine depression and anxiety disorders and their characteristic symptoms (anhedonia/low positive affect and anxious arousal, respectively), along with measures of state negative affect (NA) and Type D personality, in relation to cardiac surgery related morbidity. Patients awaiting elective coronary artery bypass graft surgery (n=158; 20.9% female; 11.4% concomitant valve surgery; age M=64.7, SD=10.6) underwent the structured MINI International Neuropsychiatric Interview to determine current affective disorders. Patients also completed the Mood and Anxiety Symptom Questionnaire and a measure of Type D personality traits. Postoperative cardiac morbidity was confirmed after surgery during the index hospitalization and included stroke,renal failure, ventilation>24 h, deep sternal wound infection, reoperation, arrhythmia and 30-day mortality at any location (n=59, 37.3% of total). After adjustment for age, recent myocardial infarction, heart failure, hypertension, urgency of surgery and time spent on cardiopulmonary bypass generalized anxiety disorder was associated with cardiac morbidity (odds ratio [OR]=3.26, 95% confidence interval [CI] 1.10-9.67, p=0.03). Adjusted analysis of personality traits revealed the NA component of Type D personality was associated with cardiac morbidity (OR=1.07, 95% CI 1.01-1.14, p=0.03). The Mood and Anxiety Symptom Questionnaire subscales were not associated with increased morbidity risk. Affective disorders, affective phenotypes, and personality traits were differentially associated with post-cardiac surgery morbidity outcomes independent of cardiac surgery morbidity risk factors. Concurrent investigation of depression and anxiety with respect to cardiac outcomes warrants further research.     

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.     

Neuropsychological Functioning in Early Hydrocephalus: Review From a Developmental Perspective

Children with hydrocephalus have deficits in several neuropsychological domains. The most notable are motor, visuoperceptual, and visuomotor function. These deficits are multiply determined and depend on the etiology and severity of the hydrocephalus to a large extent. Corpus callosum abnormalities resulting from stretching of callosal fibers and other cortical white matter tracts are implicated as contributory to these deficits. Enlarged ventricles and associated compression of posterior cortical areas also correlate with cognitive impairment. Distinguishing which cognitive domain negatively impacts on the child’s functioning and which domains influence behavior in isolation or in combination has been the subject of numerous studies. Developmentally, we know little about the emergence of neuropsychological functioning in children with hydrocephalus. Study of the effects of hydrocephalus at different stages of development is useful to clinicians and researchers interested in the impact of diffuse neurophysiological damage on cognition in the developing brain. The medical and neuropsychological literature have begun to inform about these effects. The core deficits in hydrocephalus have yet to be explicated and a focus on investigations that answer these questions is required. This review summarizes the current knowledge about neurocognitive sequelae of hydrocephalus.