INTRODUCTION: While Latin America (LatAm) is facing an increasing burden of dementia due to the r... more INTRODUCTION: While Latin America (LatAm) is facing an increasing burden of dementia due to the rapid aging of the population, it remains underrepresented in dementia research, diagnostics, and care. METHODS: In 2023, the Alzheimer's Association hosted its eighth satellite symposium in Mexico, highlighting emerging dementia research, priorities, and challenges within LatAm. RESULTS: Significant initiatives in the region, including intracountry support, showcased their efforts in fostering national and international collaborations; genetic † shared first authorship This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Journal of the International Neuropsychological Society, Oct 31, 2023
Prospective memory (PM) is the ability to remember to produce an action at a specific moment in t... more Prospective memory (PM) is the ability to remember to produce an action at a specific moment in the future signaled by the occurrence of a specific event (EB condition), a time or a time interval (TB condition). Detection of the appropriate moment corresponds to the prospective component (PC), while production of the appropriate action corresponds to the retrospective (RC) component. Although PM difficulties have been reported in healthy aging and in association with Multiple Sclerosis (MS), PM has not been examined in elderly people with MS (PwMS), which is particularly relevant since their life expectancy has improved significantly in recent years due to available treatments, and PM is essential to daily functioning. The main objective of this study was to investigate whether the decline in PM performance with advancing age is influenced by the presence of multiple sclerosis (MS). This study also aimed to clarify the type of PM impairment (PC vs RC in TB and EB conditions) in MS as a function of age. Participants and Methods: A total of 80 participants were recruited and separated into four groups: elderly PwMS (n = 20), young PwMS (n = 20), elderly healthy controls (HC) (n = 20) and young HC (n = 20). PM and its components were measured using the TEMP, an experimental ecological tool developed by our laboratory that has been validated in previous studies. In addition, all participants underwent a series of neuropsychological tests specific to MS (MACIFMS) and aging (Boston Naming Test, Clock Drawing Test, Towers of London, Trail making Test, Stroop, MoCA). Results: On the TEMP total score, a two-way ANOVA showed a main effect of age (F[1,75]=47.4, p<0.001, η2 = .40), a main effect of the presence of MS (F[1,75]=19.51, p<0.001, η2 = .21) as well as a significant Age X Disease interaction (F[2,74] =5.40, p=0.023, η2 = .07). Direct comparison between EB and TB conditions revealed that for the PC, only elderly PwMS had more difficulty in the TB than in the EB condition (Z =-2.51, p = 0.012), whereas RC score was significantly lower in the TB than in the EB condition in all groups except in younger controls (younger PwMS : Z =-2.56, p = 0.01; elderly HC : Z =-3.31, p < 0.001; elderly PwMS :Z =-3.04, p = 0.002). Conclusions: The TEMP revealed a marked impairment in PM in elderly PwMS compared to elderly HC and young PwMS. This impairment was particularly evident on the PC component in the TB condition. RC difficulties noted in the TB condition in all but younger controls reflect the arbitrary nature of the cue-action link that is particularly sensitive to episodic memory difficulties often observed in aging and MS.
Journal of the International Neuropsychological Society, Oct 31, 2023
Objective: Mild cognitive impairment (MCI) is common in Parkinson's disease (PD). Recent scientif... more Objective: Mild cognitive impairment (MCI) is common in Parkinson's disease (PD). Recent scientific advances show that MCI in PD could also be impacted by neuropsychiatric symptoms (such as apathy, anxiety, depression), dopaminergic deficiency (more striatal denervation associated with MCI) and certain genotypes such as in APOE E4, MAPT H1 or SNCA C/C carriers. We used a python-based random forest machine-learning algorithm (scikit-learn) in order to evaluate the factors that are mostly involved in the MCI conversion over a 5-year follow-up period. Participants and Methods: Baseline data of healthy individuals and participants with Parkinson's disease were extracted from the PPMI dataset. All participants also had the evaluations of their cognitive status, neuropsychiatric symptoms (hallucinations, anxiety, apathy, depression, sleepiness , impulse control disorders and rapid eye movement behaviors), dopaminergic uptake (DaT-Scan) and genetic status (APOE, MAPT and SNCA) at baseline and after 5 years. Baseline demographic (age, sex, education years) and clinical values (duration of disease, age of onset) were also included in the model. The algorithm defined (1) the most important variables in predicting MCI, (2) the threshold values to distinguish "converting" vs. "nonconverting" subgroups. Results: The algorithm showed that (1) age onset of disease, (2) dopaminergic uptake, (3) Categories: MCI (Mild Cognitive Impairment)
Journal of the International Neuropsychological Society, Oct 31, 2023
Assessing one's functional capacity-in addition to neuropsychological performance-is essential fo... more Assessing one's functional capacity-in addition to neuropsychological performance-is essential for determining neurocognitive status, and functional assessment is often provided via informant report. While informant characteristics have been shown to influence reports of participant functioning, the degree to which they moderate relationships between reported functioning and participant performance on neuropsychological testing is unclear. Moreover, associations among informant characteristics, reported functioning, and neuropsychological performance have not been directly examined with non-Hispanic Black (NHB) samples, despite this population's disproportionately high risk for dementia. Participants and Methods: In this crosssectional observational study, we examined the influence of informant characteristics on (1) informant reports of participant functioning (assessed via the Functional Activity Questionnaire [FAQ]), and (2) associations between reported functioning and participant performance on neuropsychological testing, among NHB adult participants in the National Alzheimer's Coordinating Center cohort (n=1024). Results: Younger age, female sex/gender, higher education, longer relationships with participants, and cohabitation were informant characteristics associated with poorer reported functioning (ps<.01). Moreover, poorer reported functioning was associated with poorer performance on (1) memory and language tests, particularly for participants with male (versus female) informants, and (2) the Multilingual Naming Test, particularly for participants with cohabitating (versus non-cohabitating) informants (ps<.01). Conclusions: Within the context of neurocognitive evaluation of NHB adults, informant age, sex/gender, education, relationship length, and cohabitation status influence informant reports of participant functioning, and informant sex/gender and cohabitation status in turn moderate associations between reported functioning and participant performance on comprehensive neuropsychological testing.
Background: Multiple sclerosis (MS) is commonly associated with decision-making, neurocognitive i... more Background: Multiple sclerosis (MS) is commonly associated with decision-making, neurocognitive impairments, and mood and motivational symptoms. However, their relationship may be obscured by traditional scoring methods. Objectives: To study the computational basis underlying decision-making impairments in MS and their interaction with neurocognitive and neuropsychiatric measures. Methods: Twenty-nine MS patients and 26 matched control subjects completed a computer version of the Iowa Gambling Task (IGT). Participants underwent neurocognitive evaluation using an expanded version of the Brief Repeatable Battery. Hierarchical Bayesian Analysis was used to estimate three established computational models to compare parameters between groups. Results: Patients showed increased learning rate and reduced lossaversion during decision-making relative to control subjects. These alterations were associated with: (1) reduced net gains in the IGT; (2) processing speed, executive functioning and memory impairments; and (3) higher levels of depression and current apathy. Conclusion: Decision-making deficits in MS patients could be described by the interplay between latent computational processes, neurocognitive impairments, and mood/motivational symptoms.
The COVID-19 pandemic has affected the continuity of cognitive rehabilitation worldwide. However,... more The COVID-19 pandemic has affected the continuity of cognitive rehabilitation worldwide. However, the use of teleneuropsychology to provide cognitive rehabilitation has contributed significantly to the continuity of the treatment. Objectives: To measure the effects of cognitive telerehabilitation on cognition, neuropsychiatric symptoms, and memory strategies in a cohort of patients with mild cognitive impairment. Methods: A sample of 60 patients with mild cognitive impairment according to Petersen’s criteria was randomly divided into two groups: 30 treatment cases and 30 controls (waiting list group). Subjects were matched by age, sex, and Montreal Cognitive Assessment. The treatment group received ten cognitive telerehabilitation sessions of 45 minutes duration once a week. Pre-treatment (week 0) and post-treatment (week 10) measures were assessed for both groups. Different linear mixed models were estimated to test treatment effect (cognitive telerehabilitation vs. controls) on ea...
We evaluated the effect of the antidiabetic drug metformin on patients enrolled in the ADNI study... more We evaluated the effect of the antidiabetic drug metformin on patients enrolled in the ADNI study considering patients with mild cognitive impairment (MCI) due to Alzheimer's disease (AD). Employing data from this observational study, we performed a principal component analysis focusing on the cognitive sphere by evaluating data from neuropsychological tests included in a modified version of the Alzheimer's Disease Cooperative Study-Preclinical Alzheimer Cognitive Composite (ADCS-PACC). Second, we included the levels of amyloid-β, tau, and phosphorylated tau in CSF. We found that MCI metformin-treated patients were globally characterized as subjects with a better cognitive performance and CSF biomarkers profile than the mean population of MCI patients. On the other hand, control subjects and type 2 diabetes patients (T2D) were paired by age, gender, ApoE allele, and years of education, defining three groups: MCI, MCI + T2D, and MCI + T2D + metformin. We evaluated the effect of T2D and metformin treatment employing the PACC score and composites defined from standardized ADNI variables to evaluate the memory and learning function. We found that MCI + T2D patients had a worse cognitive performance than MCI patients, but this deleterious effect was not observed in MCI + T2D + metformin patients. These cognitive variations were associated with changes in cortical thickness and hippocampal volume. Finally, no differences were found in metabolic plasmatic parameters (glycemia, cholesterol, triglycerides). Our study-employing different strategies for data analysis from the global study ADNI-shows a beneficial effect of metformin treatment on cognitive performance, CSF biomarkers profile, and neuroanatomical measures in MCI due to AD patients.
INTRODUCTION AND OBJECTIVE The Mini-SEA is a quick and brief cognitive assessment test developed ... more INTRODUCTION AND OBJECTIVE The Mini-SEA is a quick and brief cognitive assessment test developed to study social cognition. It consists of a modified version of the faux pas Test and an emotional recognition test based on Ekman's faces. The objective of this work was to obtain the first Spanish Speaking norms for the Mini-SEA test. MATERIAL AND METHODS 64 healthy volunteers, between 35 and 80 years old, were recruited and evaluated with the Mini-SEA by specialized neuropsychologists from the Cities of Buenos Aires and La Plata, both in the Province of Buenos Aires, Argentina. RESULTS The total mean (M) of the Mini-SEA was 25 +/- 4. The M of the faux pas Score was 12.5 +/- 2.4 and the M of the Emotional Recognition Score was 12.8 +/- 1.5. The sample was divided into 4 age groups: Group 1 (<50 years), Group 2 (50-59 years), Group 3 (60-69 years) and Group 4 (more than 70 years). Differences were found in the age continuum in the Emotional Recognition score between group 1 and 4...
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
World‐Wide FINGERS (WW‐FINGERS) is a global network of multidomain lifestyle intervention trials ... more World‐Wide FINGERS (WW‐FINGERS) is a global network of multidomain lifestyle intervention trials for dementia risk reduction and prevention (Kivipelto et al., 2020). With over 30 countries conducting studies within the network, harmonizing interventions and data collection wherever possible is a priority. However, study‐specific adaptations are inevitable to accommodate differences in language, culture, and environment. Thus, a single data collection system is not feasible across WW‐FINGERS and opportunities for synergies between study‐specific systems should be explored.
En los ultimos anos han incrementado las consultas por fallas de memoria, dado que ha aumentado l... more En los ultimos anos han incrementado las consultas por fallas de memoria, dado que ha aumentado la expectativa de vida. La prevalencia de trastornos mnesicos en la edad adulta, requiere instrumentos de rastrillaje sensibles, especificos y de rapida administracion para la deteccion del deterioro cognitivo. El fin de dichos instrumentos es que puedan ser administrados por medicos generales y aun otros profesionales de la salud siendo de facil interpretacion, para la discriminacion entre olvidos patologicos y olvidos asociados al envejecimiento normal. Permitiendo la derivacion o el estudio mas exhaustivo de aquellos sujetos que presenten indicios de deterioro cognitivo. Objetivo: Establecer la validacion de la Escala de Deteccion de Olvidos (EDO-10), un breve cuestionario para ser completado por el informante del paciente, que sirve detectar sujetos con deterioro cognitivo leve. Es un instrumento que puede ser administrado de manera sencilla y posee la ventaja de no necesitar la prese...
Introduction: The MoCa (Montreal Cognitive Assessment) Screening test has become relevant in rece... more Introduction: The MoCa (Montreal Cognitive Assessment) Screening test has become relevant in recent years in the screening of patients with Mild Cognitive Impairment (MCI). It is important to seek and study simple and reliable tools in clinical practices that correlate with biological markers that have been used to predict conversion from MCI to AD. Objective: To analyze the MOCA and its cognitive sub-scores and the relationship with Amyloid pathophysiology in Alzheimer’s Disease. Methodology: 32 patients with MCI were studied, they were separated according positive (n: 20) and negative (n: 12) underlying amyloid pathology. The patients performed a extensive cognitive assessment that included MoCa Test. Results: MoCa Total Scores showed significantly different results between groups (p <0.001) as well as the Memory Score (MoCa MIS), the Executive (MoCa EIS), the Attentional Score (MoCa AIS)) (p < 0.001) and the Orientation Score (MoCa OIS)) (p < 0.05) with worse performance...
Reducing the risk of dementia can halt the worldwide increase of affected people. The multifactor... more Reducing the risk of dementia can halt the worldwide increase of affected people. The multifactorial and heterogeneous nature of late‐onset dementia, including Alzheimer's disease (AD), indicates a potential impact of multidomain lifestyle interventions on risk reduction. The positive results of the landmark multidomain Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) support such an approach. The World‐Wide FINGERS (WW‐FINGERS), launched in 2017 and including over 25 countries, is the first global network of multidomain lifestyle intervention trials for dementia risk reduction and prevention. WW‐FINGERS aims to adapt, test, and optimize the FINGER model to reduce risk across the spectrum of cognitive decline—from at‐risk asymptomatic states to early symptomatic stages—in different geographical, cultural, and economic settings. WW‐FINGERS aims to harmonize and adapt multidomain interventions across various countries and settings, to fa...
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, 2020
Purpose: To describe results of the Amyloid, Tau, Neurodegeneration (ATN) research framework clas... more Purpose: To describe results of the Amyloid, Tau, Neurodegeneration (ATN) research framework classification in the Argentine-Alzheimer's Disease Neuroimaging Initiative (arg-ADNI) cohort. Methods: Twenty-three patients with mild cognitive impairment (MCI), 12 dementia of Alzheimer's type (DAT), and 14 normal controls were studied following the ADNI2 protocol. Patients were categorized according to presence or absence of the biomarkers for amyloid beta (A ; A: amyloid positron emission tomography [PET] scan or cerebrospinal fluid [CSF] A 42), tau (T: CSF phosphorylated-tau), and neurodegeneration (N: CSF total-tau, fluorodeoxyglucose [FDG]-PET scan, or structural magnetic resonance imaging [MRI] scan). Results: A+T+N+ biomarker profile was identified at baseline in 91% of mild dementia patients, 20% of early MCI patients, 46% of late MCI patients, and 14% of control subjects. Suspected non-AD pathophysiology (SNAP, AT -N+) was found in 8% of mild dementia, 20% of early MCI, 15% of late MCI, and 7% of control subjects. Conversion rates to dementia after 5-year follow-up were 85% in A+T+N+ MCI patients and 50% in AT -N+ patients. Conclusions: We present initial 5-year follow-up results of a regional ADNI based on AD biomarkers and the ATN classification.
Objective: Increased life expectancy and exponential growth of adults suffering from Alzheimer's ... more Objective: Increased life expectancy and exponential growth of adults suffering from Alzheimer's disease (AD) worldwide, has led to biomarkers incorporation for diagnosis in early stages. Use of neuropsychological testing remains limited. This study aimed to identify which neuropsychological tests best indicated underlying AD pathophysiology.Methods: One hundred and forty-one patients with MCI (Mild Cognitive Impairment) were studied. A neuropsychological test battery based on the Uniform Data Set (UDS) from the Alzheimer's Disease Centers program of the National Institute on Aging (NIA) was performed and amyloid markers recorded; according to presence or absence of amyloid identified by positive PIB-PET findings, or low CSF Aβ42 levels, patients were separated into MCI amyloid-(n:58) and MCI amyloid + (n = 83) cases.Results: Statistical differences were found in all memory tests between groups. Delayed recall score at thirty minutes on the Rey Auditory Verbal Learning Test (AVLT) was the best predictor of amyloid pathology presence (AUC 0.68), followed by AVLT total learning (AUC 0.66) and AVLT Recognition (AUC 0.59) scores, providing useful cut off values in the clinical setting.Conclusions: Use of neuropsychological testing, specifically AVLT scores with cutoff values, contributed to the correct diagnosis of MCI due to AD in this SouthAmerican cohort.
As life expectancy increases, there is a marked increase in the elderly population eager to conti... more As life expectancy increases, there is a marked increase in the elderly population eager to continue driving. A large proportion of these elderly drive safely, however, patients with mild dementia are high-risk drivers. Objective: to identify the cognitive tests that best predict driving ability in subjects with mild dementia. Methods: 28 drivers with mild dementia and 28 healthy elderly subjects underwent an extensive cognitive assessment (NACC Uniform Data Set Neuropsychological Battery), completed an adapted On Road Driving Test (ORDT) and a Driving Simulator assessment. Results: drivers with mild dementia made more mistakes on the ORDT and had slower responses in the simulator tasks. Cognitive tests correlated strongly with on road and simulator driving performance. Age, the Digit Symbol Modalities Test and Boston Naming Test scores were the variables that best predicted performance on the ORDT and were included in a logistic regression model. Conclusion: the strong correlation ...
Introducción: Los pacientes con demencia son considerados conductores de alto riesgo. Sin embargo... more Introducción: Los pacientes con demencia son considerados conductores de alto riesgo. Sin embargo, un gran porcentaje de ellos todavía puede conducir adecuadamente. Objetivo: Identificar las pruebas cognitivas que mejor predicen las habilidades de conducción vehicular en personas mayores de 65 años. Pacientes y métodos: 28 sujetos mayores de 65 años con demencia leve y 28 controles sanos fueron evaluados con una extensa batería neuropsicológica y pruebas ecológicas de manejo vehicular que incluyeron una evaluación en un simulador de manejo y la conducción en un circuito controlado de manejo. Resultados: Los pacientes con demencia se desempeñaron peor que los controles en el manejo vehicular y tenían respuestas de frenado más lentas en el simulador. Las pruebas cognitivas que mejor correlacionaron con la evaluación de manejo vehicular fueron la
INTRODUCTION: While Latin America (LatAm) is facing an increasing burden of dementia due to the r... more INTRODUCTION: While Latin America (LatAm) is facing an increasing burden of dementia due to the rapid aging of the population, it remains underrepresented in dementia research, diagnostics, and care. METHODS: In 2023, the Alzheimer&#39;s Association hosted its eighth satellite symposium in Mexico, highlighting emerging dementia research, priorities, and challenges within LatAm. RESULTS: Significant initiatives in the region, including intracountry support, showcased their efforts in fostering national and international collaborations; genetic † shared first authorship This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Journal of the International Neuropsychological Society, Oct 31, 2023
Prospective memory (PM) is the ability to remember to produce an action at a specific moment in t... more Prospective memory (PM) is the ability to remember to produce an action at a specific moment in the future signaled by the occurrence of a specific event (EB condition), a time or a time interval (TB condition). Detection of the appropriate moment corresponds to the prospective component (PC), while production of the appropriate action corresponds to the retrospective (RC) component. Although PM difficulties have been reported in healthy aging and in association with Multiple Sclerosis (MS), PM has not been examined in elderly people with MS (PwMS), which is particularly relevant since their life expectancy has improved significantly in recent years due to available treatments, and PM is essential to daily functioning. The main objective of this study was to investigate whether the decline in PM performance with advancing age is influenced by the presence of multiple sclerosis (MS). This study also aimed to clarify the type of PM impairment (PC vs RC in TB and EB conditions) in MS as a function of age. Participants and Methods: A total of 80 participants were recruited and separated into four groups: elderly PwMS (n = 20), young PwMS (n = 20), elderly healthy controls (HC) (n = 20) and young HC (n = 20). PM and its components were measured using the TEMP, an experimental ecological tool developed by our laboratory that has been validated in previous studies. In addition, all participants underwent a series of neuropsychological tests specific to MS (MACIFMS) and aging (Boston Naming Test, Clock Drawing Test, Towers of London, Trail making Test, Stroop, MoCA). Results: On the TEMP total score, a two-way ANOVA showed a main effect of age (F[1,75]=47.4, p<0.001, η2 = .40), a main effect of the presence of MS (F[1,75]=19.51, p<0.001, η2 = .21) as well as a significant Age X Disease interaction (F[2,74] =5.40, p=0.023, η2 = .07). Direct comparison between EB and TB conditions revealed that for the PC, only elderly PwMS had more difficulty in the TB than in the EB condition (Z =-2.51, p = 0.012), whereas RC score was significantly lower in the TB than in the EB condition in all groups except in younger controls (younger PwMS : Z =-2.56, p = 0.01; elderly HC : Z =-3.31, p < 0.001; elderly PwMS :Z =-3.04, p = 0.002). Conclusions: The TEMP revealed a marked impairment in PM in elderly PwMS compared to elderly HC and young PwMS. This impairment was particularly evident on the PC component in the TB condition. RC difficulties noted in the TB condition in all but younger controls reflect the arbitrary nature of the cue-action link that is particularly sensitive to episodic memory difficulties often observed in aging and MS.
Journal of the International Neuropsychological Society, Oct 31, 2023
Objective: Mild cognitive impairment (MCI) is common in Parkinson's disease (PD). Recent scientif... more Objective: Mild cognitive impairment (MCI) is common in Parkinson's disease (PD). Recent scientific advances show that MCI in PD could also be impacted by neuropsychiatric symptoms (such as apathy, anxiety, depression), dopaminergic deficiency (more striatal denervation associated with MCI) and certain genotypes such as in APOE E4, MAPT H1 or SNCA C/C carriers. We used a python-based random forest machine-learning algorithm (scikit-learn) in order to evaluate the factors that are mostly involved in the MCI conversion over a 5-year follow-up period. Participants and Methods: Baseline data of healthy individuals and participants with Parkinson's disease were extracted from the PPMI dataset. All participants also had the evaluations of their cognitive status, neuropsychiatric symptoms (hallucinations, anxiety, apathy, depression, sleepiness , impulse control disorders and rapid eye movement behaviors), dopaminergic uptake (DaT-Scan) and genetic status (APOE, MAPT and SNCA) at baseline and after 5 years. Baseline demographic (age, sex, education years) and clinical values (duration of disease, age of onset) were also included in the model. The algorithm defined (1) the most important variables in predicting MCI, (2) the threshold values to distinguish "converting" vs. "nonconverting" subgroups. Results: The algorithm showed that (1) age onset of disease, (2) dopaminergic uptake, (3) Categories: MCI (Mild Cognitive Impairment)
Journal of the International Neuropsychological Society, Oct 31, 2023
Assessing one's functional capacity-in addition to neuropsychological performance-is essential fo... more Assessing one's functional capacity-in addition to neuropsychological performance-is essential for determining neurocognitive status, and functional assessment is often provided via informant report. While informant characteristics have been shown to influence reports of participant functioning, the degree to which they moderate relationships between reported functioning and participant performance on neuropsychological testing is unclear. Moreover, associations among informant characteristics, reported functioning, and neuropsychological performance have not been directly examined with non-Hispanic Black (NHB) samples, despite this population's disproportionately high risk for dementia. Participants and Methods: In this crosssectional observational study, we examined the influence of informant characteristics on (1) informant reports of participant functioning (assessed via the Functional Activity Questionnaire [FAQ]), and (2) associations between reported functioning and participant performance on neuropsychological testing, among NHB adult participants in the National Alzheimer's Coordinating Center cohort (n=1024). Results: Younger age, female sex/gender, higher education, longer relationships with participants, and cohabitation were informant characteristics associated with poorer reported functioning (ps<.01). Moreover, poorer reported functioning was associated with poorer performance on (1) memory and language tests, particularly for participants with male (versus female) informants, and (2) the Multilingual Naming Test, particularly for participants with cohabitating (versus non-cohabitating) informants (ps<.01). Conclusions: Within the context of neurocognitive evaluation of NHB adults, informant age, sex/gender, education, relationship length, and cohabitation status influence informant reports of participant functioning, and informant sex/gender and cohabitation status in turn moderate associations between reported functioning and participant performance on comprehensive neuropsychological testing.
Background: Multiple sclerosis (MS) is commonly associated with decision-making, neurocognitive i... more Background: Multiple sclerosis (MS) is commonly associated with decision-making, neurocognitive impairments, and mood and motivational symptoms. However, their relationship may be obscured by traditional scoring methods. Objectives: To study the computational basis underlying decision-making impairments in MS and their interaction with neurocognitive and neuropsychiatric measures. Methods: Twenty-nine MS patients and 26 matched control subjects completed a computer version of the Iowa Gambling Task (IGT). Participants underwent neurocognitive evaluation using an expanded version of the Brief Repeatable Battery. Hierarchical Bayesian Analysis was used to estimate three established computational models to compare parameters between groups. Results: Patients showed increased learning rate and reduced lossaversion during decision-making relative to control subjects. These alterations were associated with: (1) reduced net gains in the IGT; (2) processing speed, executive functioning and memory impairments; and (3) higher levels of depression and current apathy. Conclusion: Decision-making deficits in MS patients could be described by the interplay between latent computational processes, neurocognitive impairments, and mood/motivational symptoms.
The COVID-19 pandemic has affected the continuity of cognitive rehabilitation worldwide. However,... more The COVID-19 pandemic has affected the continuity of cognitive rehabilitation worldwide. However, the use of teleneuropsychology to provide cognitive rehabilitation has contributed significantly to the continuity of the treatment. Objectives: To measure the effects of cognitive telerehabilitation on cognition, neuropsychiatric symptoms, and memory strategies in a cohort of patients with mild cognitive impairment. Methods: A sample of 60 patients with mild cognitive impairment according to Petersen’s criteria was randomly divided into two groups: 30 treatment cases and 30 controls (waiting list group). Subjects were matched by age, sex, and Montreal Cognitive Assessment. The treatment group received ten cognitive telerehabilitation sessions of 45 minutes duration once a week. Pre-treatment (week 0) and post-treatment (week 10) measures were assessed for both groups. Different linear mixed models were estimated to test treatment effect (cognitive telerehabilitation vs. controls) on ea...
We evaluated the effect of the antidiabetic drug metformin on patients enrolled in the ADNI study... more We evaluated the effect of the antidiabetic drug metformin on patients enrolled in the ADNI study considering patients with mild cognitive impairment (MCI) due to Alzheimer's disease (AD). Employing data from this observational study, we performed a principal component analysis focusing on the cognitive sphere by evaluating data from neuropsychological tests included in a modified version of the Alzheimer's Disease Cooperative Study-Preclinical Alzheimer Cognitive Composite (ADCS-PACC). Second, we included the levels of amyloid-β, tau, and phosphorylated tau in CSF. We found that MCI metformin-treated patients were globally characterized as subjects with a better cognitive performance and CSF biomarkers profile than the mean population of MCI patients. On the other hand, control subjects and type 2 diabetes patients (T2D) were paired by age, gender, ApoE allele, and years of education, defining three groups: MCI, MCI + T2D, and MCI + T2D + metformin. We evaluated the effect of T2D and metformin treatment employing the PACC score and composites defined from standardized ADNI variables to evaluate the memory and learning function. We found that MCI + T2D patients had a worse cognitive performance than MCI patients, but this deleterious effect was not observed in MCI + T2D + metformin patients. These cognitive variations were associated with changes in cortical thickness and hippocampal volume. Finally, no differences were found in metabolic plasmatic parameters (glycemia, cholesterol, triglycerides). Our study-employing different strategies for data analysis from the global study ADNI-shows a beneficial effect of metformin treatment on cognitive performance, CSF biomarkers profile, and neuroanatomical measures in MCI due to AD patients.
INTRODUCTION AND OBJECTIVE The Mini-SEA is a quick and brief cognitive assessment test developed ... more INTRODUCTION AND OBJECTIVE The Mini-SEA is a quick and brief cognitive assessment test developed to study social cognition. It consists of a modified version of the faux pas Test and an emotional recognition test based on Ekman's faces. The objective of this work was to obtain the first Spanish Speaking norms for the Mini-SEA test. MATERIAL AND METHODS 64 healthy volunteers, between 35 and 80 years old, were recruited and evaluated with the Mini-SEA by specialized neuropsychologists from the Cities of Buenos Aires and La Plata, both in the Province of Buenos Aires, Argentina. RESULTS The total mean (M) of the Mini-SEA was 25 +/- 4. The M of the faux pas Score was 12.5 +/- 2.4 and the M of the Emotional Recognition Score was 12.8 +/- 1.5. The sample was divided into 4 age groups: Group 1 (<50 years), Group 2 (50-59 years), Group 3 (60-69 years) and Group 4 (more than 70 years). Differences were found in the age continuum in the Emotional Recognition score between group 1 and 4...
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
World‐Wide FINGERS (WW‐FINGERS) is a global network of multidomain lifestyle intervention trials ... more World‐Wide FINGERS (WW‐FINGERS) is a global network of multidomain lifestyle intervention trials for dementia risk reduction and prevention (Kivipelto et al., 2020). With over 30 countries conducting studies within the network, harmonizing interventions and data collection wherever possible is a priority. However, study‐specific adaptations are inevitable to accommodate differences in language, culture, and environment. Thus, a single data collection system is not feasible across WW‐FINGERS and opportunities for synergies between study‐specific systems should be explored.
En los ultimos anos han incrementado las consultas por fallas de memoria, dado que ha aumentado l... more En los ultimos anos han incrementado las consultas por fallas de memoria, dado que ha aumentado la expectativa de vida. La prevalencia de trastornos mnesicos en la edad adulta, requiere instrumentos de rastrillaje sensibles, especificos y de rapida administracion para la deteccion del deterioro cognitivo. El fin de dichos instrumentos es que puedan ser administrados por medicos generales y aun otros profesionales de la salud siendo de facil interpretacion, para la discriminacion entre olvidos patologicos y olvidos asociados al envejecimiento normal. Permitiendo la derivacion o el estudio mas exhaustivo de aquellos sujetos que presenten indicios de deterioro cognitivo. Objetivo: Establecer la validacion de la Escala de Deteccion de Olvidos (EDO-10), un breve cuestionario para ser completado por el informante del paciente, que sirve detectar sujetos con deterioro cognitivo leve. Es un instrumento que puede ser administrado de manera sencilla y posee la ventaja de no necesitar la prese...
Introduction: The MoCa (Montreal Cognitive Assessment) Screening test has become relevant in rece... more Introduction: The MoCa (Montreal Cognitive Assessment) Screening test has become relevant in recent years in the screening of patients with Mild Cognitive Impairment (MCI). It is important to seek and study simple and reliable tools in clinical practices that correlate with biological markers that have been used to predict conversion from MCI to AD. Objective: To analyze the MOCA and its cognitive sub-scores and the relationship with Amyloid pathophysiology in Alzheimer’s Disease. Methodology: 32 patients with MCI were studied, they were separated according positive (n: 20) and negative (n: 12) underlying amyloid pathology. The patients performed a extensive cognitive assessment that included MoCa Test. Results: MoCa Total Scores showed significantly different results between groups (p <0.001) as well as the Memory Score (MoCa MIS), the Executive (MoCa EIS), the Attentional Score (MoCa AIS)) (p < 0.001) and the Orientation Score (MoCa OIS)) (p < 0.05) with worse performance...
Reducing the risk of dementia can halt the worldwide increase of affected people. The multifactor... more Reducing the risk of dementia can halt the worldwide increase of affected people. The multifactorial and heterogeneous nature of late‐onset dementia, including Alzheimer's disease (AD), indicates a potential impact of multidomain lifestyle interventions on risk reduction. The positive results of the landmark multidomain Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) support such an approach. The World‐Wide FINGERS (WW‐FINGERS), launched in 2017 and including over 25 countries, is the first global network of multidomain lifestyle intervention trials for dementia risk reduction and prevention. WW‐FINGERS aims to adapt, test, and optimize the FINGER model to reduce risk across the spectrum of cognitive decline—from at‐risk asymptomatic states to early symptomatic stages—in different geographical, cultural, and economic settings. WW‐FINGERS aims to harmonize and adapt multidomain interventions across various countries and settings, to fa...
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, 2020
Purpose: To describe results of the Amyloid, Tau, Neurodegeneration (ATN) research framework clas... more Purpose: To describe results of the Amyloid, Tau, Neurodegeneration (ATN) research framework classification in the Argentine-Alzheimer's Disease Neuroimaging Initiative (arg-ADNI) cohort. Methods: Twenty-three patients with mild cognitive impairment (MCI), 12 dementia of Alzheimer's type (DAT), and 14 normal controls were studied following the ADNI2 protocol. Patients were categorized according to presence or absence of the biomarkers for amyloid beta (A ; A: amyloid positron emission tomography [PET] scan or cerebrospinal fluid [CSF] A 42), tau (T: CSF phosphorylated-tau), and neurodegeneration (N: CSF total-tau, fluorodeoxyglucose [FDG]-PET scan, or structural magnetic resonance imaging [MRI] scan). Results: A+T+N+ biomarker profile was identified at baseline in 91% of mild dementia patients, 20% of early MCI patients, 46% of late MCI patients, and 14% of control subjects. Suspected non-AD pathophysiology (SNAP, AT -N+) was found in 8% of mild dementia, 20% of early MCI, 15% of late MCI, and 7% of control subjects. Conversion rates to dementia after 5-year follow-up were 85% in A+T+N+ MCI patients and 50% in AT -N+ patients. Conclusions: We present initial 5-year follow-up results of a regional ADNI based on AD biomarkers and the ATN classification.
Objective: Increased life expectancy and exponential growth of adults suffering from Alzheimer's ... more Objective: Increased life expectancy and exponential growth of adults suffering from Alzheimer's disease (AD) worldwide, has led to biomarkers incorporation for diagnosis in early stages. Use of neuropsychological testing remains limited. This study aimed to identify which neuropsychological tests best indicated underlying AD pathophysiology.Methods: One hundred and forty-one patients with MCI (Mild Cognitive Impairment) were studied. A neuropsychological test battery based on the Uniform Data Set (UDS) from the Alzheimer's Disease Centers program of the National Institute on Aging (NIA) was performed and amyloid markers recorded; according to presence or absence of amyloid identified by positive PIB-PET findings, or low CSF Aβ42 levels, patients were separated into MCI amyloid-(n:58) and MCI amyloid + (n = 83) cases.Results: Statistical differences were found in all memory tests between groups. Delayed recall score at thirty minutes on the Rey Auditory Verbal Learning Test (AVLT) was the best predictor of amyloid pathology presence (AUC 0.68), followed by AVLT total learning (AUC 0.66) and AVLT Recognition (AUC 0.59) scores, providing useful cut off values in the clinical setting.Conclusions: Use of neuropsychological testing, specifically AVLT scores with cutoff values, contributed to the correct diagnosis of MCI due to AD in this SouthAmerican cohort.
As life expectancy increases, there is a marked increase in the elderly population eager to conti... more As life expectancy increases, there is a marked increase in the elderly population eager to continue driving. A large proportion of these elderly drive safely, however, patients with mild dementia are high-risk drivers. Objective: to identify the cognitive tests that best predict driving ability in subjects with mild dementia. Methods: 28 drivers with mild dementia and 28 healthy elderly subjects underwent an extensive cognitive assessment (NACC Uniform Data Set Neuropsychological Battery), completed an adapted On Road Driving Test (ORDT) and a Driving Simulator assessment. Results: drivers with mild dementia made more mistakes on the ORDT and had slower responses in the simulator tasks. Cognitive tests correlated strongly with on road and simulator driving performance. Age, the Digit Symbol Modalities Test and Boston Naming Test scores were the variables that best predicted performance on the ORDT and were included in a logistic regression model. Conclusion: the strong correlation ...
Introducción: Los pacientes con demencia son considerados conductores de alto riesgo. Sin embargo... more Introducción: Los pacientes con demencia son considerados conductores de alto riesgo. Sin embargo, un gran porcentaje de ellos todavía puede conducir adecuadamente. Objetivo: Identificar las pruebas cognitivas que mejor predicen las habilidades de conducción vehicular en personas mayores de 65 años. Pacientes y métodos: 28 sujetos mayores de 65 años con demencia leve y 28 controles sanos fueron evaluados con una extensa batería neuropsicológica y pruebas ecológicas de manejo vehicular que incluyeron una evaluación en un simulador de manejo y la conducción en un circuito controlado de manejo. Resultados: Los pacientes con demencia se desempeñaron peor que los controles en el manejo vehicular y tenían respuestas de frenado más lentas en el simulador. Las pruebas cognitivas que mejor correlacionaron con la evaluación de manejo vehicular fueron la
Uploads
Papers by Lucía Crivelli