Cognitive functioning in Alzheimer’s and vascular dementia: A meta-analysis.

Differentiating between Alzheimer’s disease (AD) and vascular dementia (VaD) remains difficult but important if existing pharmacological treatments are to provide symptomatic relief in the case of AD or to alter disease progression in the case of VaD. Cognitive assessments play an important role in aiding diagnosis, despite a lack of clear evidence defining the cognitive abilities and tests that best distinguish between the two types of dementia. The current study therefore completed a meta-analysis of research comparing the cognitive abilities of persons diagnosed with AD and VaD. A comprehensive search was undertaken of the PubMed and PsychInfo databases, with 81 studies being eligible for inclusion. Weighted Cohen’s d effect sizes, percentage overlap statistics, fail-safe Ns, and confidence intervals were calculated for all cognitive tests. Of the tests that were examined by more than one study, there was one test of perception and one test of verbal memory that showed large and significant group differences. There were an additional 12 tests that may prove useful. However, all cognitive tests were limited in their ability to discriminate between AD and VaD, suggesting that they should be used cautiously and only in conjunction with other information (imaging, medical history) when diagnosing patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression as a risk factor or prodromal feature for dementia? Findings in a population-based sample of Swedish twins.

This study tested whether history of depression is associated with an increased likelihood of dementia, and whether a first depressive episode earlier in life is associated with increased dementia risk, or whether only depressive episodes close in time to dementia onset are related to dementia. Depression information came from national hospital discharge registries, medical history, and medical records. Dementia was diagnosed clinically. In case–control results, individuals with recent registry-identified depression were 3.9 times more likely than those with no registry-identified depression history to have dementia, whereas registry-identified depression earlier in life was not associated with dementia risk. Each 1-year increase in time between depression onset and dementia onset or equivalent age decreased the likelihood of dementia by 8.4%. In co-twin control analyses, twins with prior depression were 3.0 times more likely to have dementia than their nondepressed twin partners, with a similar age of depression gradient. These findings suggest that after partially controlling for genetic influences, late-life depression for many individuals may be a prodrome rather than a risk factor for dementia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Language decline across the life span: Findings from the nun study.

The present study examines language samples from the Nun Study. Measures of grammatical complexity and idea density were obtained from autobiographies written over a 60-year span. Participants who had met criteria for dementia were contrasted with those who did not. Grammatical complexity initially averaged 4.78 ( on a 0-to-7-point scale) for participants who did not meet criteria for dementia and declined .04 units per year; grammatical complexity for participants who met criteria for dementia initially averaged 3.86 and declined .03 units per year. Idea density averaged 5.35 propositions per 10 words initially for participants who did not meet criteria for dementia and declined an average of .03 units per year, whereas idea density averaged 4.34 propositions per 10 words initially for participants who met criteria for dementia and declined .02 units per year. Adult experiences, in general, did not moderate these declines. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrative cognitive–behavioral and spiritual counseling for rural dementia caregivers with depression.

Objective: Discuss initial evaluation of a program for training faith community nurses (FCNs) to conduct cognitive–behavioral and spiritual counseling (CBSC) for rural dementia caregivers (CGs), and present 2 case studies on the use of CBSC for treating depression in this population. Study Design: Pre–post evaluation of the effectiveness of CBSC training and a case study analysis of the effectiveness of CBSC on CG problem improvement and depression. Outcome Measures: For FCN training, we used the FCN Counseling Comfort Scale, FCN Counseling Efficacy Scale, and the FCN Counseling Workshop Satisfaction Survey. The Problem Severity Scale and Center for Epidemiologic Studies Depression Scale were used in the case studies. Results: Significant post-training increases in FCN counseling comfort and perceived counseling efficacy were obtained. Case study findings provided evidence of substantial improvement in caregiving problems and reductions in depression. Conclusions: Preliminary outcomes of FCN training and CBSC for dementia CGs were promising. However, replication across the sample is required to evaluate the overall effectiveness of CBSC for reducing CG depression. Specific competencies and ethical considerations in supervising this form of intervention are also addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Musical structural determinants of emotional judgments in dementia of the Alzheimer type.

People with dementia of the Alzheimer type (DAT) may well be emotionally soothed by listening to music. However, very few systematic studies have been conducted to support the anecdotal evidence. DAT does damage certain cerebral structures that subsume emotional processing, and some studies have demonstrated deficits affecting emotional judgments of facial expression and prosody in DAT. Accordingly, this study addressed the question of whether DAT might leave musical emotional judgment intact. Twelve early DAT participants and 12 healthy elderly participants took part in this study. Emotional judgments were examined in relation to mode and tempo, two important structural properties that contribute to the happy-sad distinction in music. Their respective contributions were assessed in four different experimental conditions. The DAT participants' responses were similar to those of healthy elderly participants, showing spared ability to employ tempo and mode as cues for emotional interpretation. The DAT participants' performance was not correlated with their global cognitive functioning. These results constitute a preliminary empirical demonstration that, in early DAT, musical emotional judgments appear to be based on normal structural analysis of musical input. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological decline in frontotemporal lobar degeneration: A longitudinal analysis.

Few studies have assessed whether the patterns of neuropsychological impairment in patients with different frontotemporal lobar degeneration (FTLD) subtypes remain distinct over the duration of their illness or devolve into a common, undifferentiated neuropsychological state. A longitudinal neuropsychological analysis was obtained over 100 months assessing executive control, language/naming, and visuoconstruction in 441 patients diagnosed with Alzheimer’s disease (AD) and four FTLD subtypes, i.e., a social comportment/dysexecutive (SOC/EXEC) disorder; progressive non-fluent aphasia (PNFA); semantic dementia (SemD); and corticobasal degeneration (CBD). Initial group differences on each measure were maintained over the duration of illness, including several double dissociations. For example, AD patients exhibited a decline in 'animal' fluency; PNFA patients had difficulty on tests of executive control, SemD maintained their impairment on tests of naming, and CBD had presented with performance on visuoconstructional tests. None of the group by neuropsychological task interactions evaluating longitudinal decline was significant, suggesting that performance does not converge onto a common subtype over time. These data indicate that distinct patterns of neuropsychological impairment are maintained longitudinally, reflecting the unique anatomic distribution of relative disease burden in AD and FTLD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

人参皂苷Rg2 对拟血管性痴呆大鼠学习记忆的影响

目的 研究人参皂苷Rg2 对拟血管性痴呆大鼠学习记忆的影响, 并探讨其与谷氨酸离子型受体基因表达的关系。 方法 双侧颈总动脉永久性结扎制备拟血管性痴呆大鼠模型, 人参皂苷Rg2 治疗后, 检测大鼠自发性活动变化并用水迷宫法检测大鼠学习记忆变化;采用RT-PCR 方法检测海马NR1 、NR2A 、NR2B 和GluR2 基因表达的变化。 结果 拟血管性痴呆大鼠自发性活动显著减少, 学习记忆能力明显下降, 表现为信息游泳时间和选择游泳时间延长;人参皂苷Rg2 2.5 、5.0 、10.0 mg kg 能剂量依赖性地增加大鼠自发性活动, 缩短信息游泳时间和选择游泳时间, 提高选择正确率, 显著改善大鼠学习记忆障碍。拟血管性痴呆大鼠海马谷氨酸离子型受体亚基NR1 mRNA表达显著增加, 而NR2A 、NR2B 和GluR2 mRNA 的表达均显著降低, 人参皂苷Rg2 能逆转此变化。 结论 人参皂苷Rg2 能显著改善大鼠学习记忆障碍,机制可能与其有效调节脑内谷氨酸受体亚基基因的表达有关。     

Object categorization: Reversals and explanations of the basic-level advantage.

People are generally faster and more accurate to name or categorize objects at the basic level (e.g., dog) relative to more general (animal) or specific (collie) levels, an effect replicated in Experiment 1 for categorization of object pictures. To some, this pattern suggests a dual-process mechanism, in which objects first activate basic-level categories directly and later engage more general or specific categories through the spread of activation in a processing hierarchy. This account is, however, challenged by data from Experiment 2 showing that neuropsychological patients with impairments of conceptual knowledge categorize more accurately at superordinate levels than at the basic level--suggesting that knowledge about an object's general nature does not depend on prior basic-level categorization. The authors consider how a parallel distributed processing theory of conceptual knowledge can reconcile the apparent discrepancy. This theory predicts that if healthy individuals are encouraged to make rapid categorization responses, the usual basic > general advantage should also reverse, a prediction tested and confirmed in Experiment 3. Implications for theories of visual object recognition are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

我国典型失智老人照护单元公共空间疗愈性目标设计研究

选择广州市老人院慈慧楼失智老人照护单元为研究对象,就其公共空间疗愈性目标（TGs）设计开展循证研究。首先采用定点观察与行为跟踪的方法,记录长者在圆形大厅、环状走廊、康复治疗室等公共空间的行为特征;结合医护人员及家属问卷调查,分析公共空间中群体活动与个体行为潜在的疗愈性目标需求。结合我国医护与患者比例低、床位数量大的失智老人照护单元现状,提出通过室内外空间的互动联系融合大自然健康绩效,同时结合特定照护方法形成面向疗愈性目标的整体解决方案,并从室内空间、户外场地和护理方法三个层,对慈慧楼公共空间疗愈性目标设计提出自己的思考。