Cerebral microbleeds and cognitive decline in a hemodialysis patient: Case report and review of literature

Cerebral microbleeds (CMBs) are small hemosiderin deposits indicative of prior cerebral microscopic hemorrhage and previously thought to be clinically silent. Recent population‐based cross‐sectional studies and prospective longitudinal cohort studies have revealed association between CMB and cognitive dysfunction. In the general population, CMBs are associated with age, hypertension, and cerebral amyloid angiopathy. In the chronic kidney disease (CKD) population, diminished estimated glomerular filtration rate has been found to be an independent risk factor for CMB, raising the possibility that a uremic milieu may predispose to microbleeds. In the end‐stage renal disease (ESRD) population on hemodialysis, the incidence of microbleeds is significantly higher compared with a control group without history of CKD or stroke. We present an ESRD patient on chronic hemodialysis with a history of gradual cognitive decline and progressive CMBs. Through this case and literature review, we illustrate the need to develop detection and prediction models to treat this frequent development in ESRD patients.     

Skeletal Muscle Health and Cognitive Function: A Narrative Review

Sarcopenia is the loss of skeletal muscle mass and function with advancing age. It involves both complex genetic and modifiable risk factors, such as lack of exercise, malnutrition and reduced neurological drive. Cognitive decline refers to diminished or impaired mental and/or intellectual functioning. Contracting skeletal muscle is a major source of neurotrophic factors, including brain-derived neurotrophic factor, which regulate synapses in the brain. Furthermore, skeletal muscle activity has important immune and redox effects that modify brain function and reduce muscle catabolism. The identification of common risk factors and underlying mechanisms for sarcopenia and cognition may allow the development of targeted interventions that slow or reverse sarcopenia and also certain forms of cognitive decline. However, the links between cognition and skeletal muscle have not been elucidated fully. This review provides a critical appraisal of the literature on the relationship between skeletal muscle health and cognition. The literature suggests that sarcopenia and cognitive decline share pathophysiological pathways. Ageing plays a role in both skeletal muscle deterioration and cognitive decline. Furthermore, lifestyle risk factors, such as physical inactivity, poor diet and smoking, are common to both disorders, so their potential role in the muscle–brain relationship warrants investigation.     

Preschool Competency in Context: An Investigation of the Unique Contribution of Child Competencies to Early Academic Success.

The present concurrent study combined developmental and ecological considerations to examine the unique contribution of multiple preschool competencies to an indicator of early academic success. Participants included 195 Head Start children from 32 classrooms representative of a large, urban Head Start program. Dimensional (variable-centered) analyses revealed 3 distinct classroom competency dimensions (i.e., General Classroom Competencies, Specific Approaches to Learning, and Interpersonal Classroom Behavioral Problems). The first 2 of these dimensions were found to be uniquely associated with early academic success. Findings from typological (person-centered) analyses supported the dimensional findings. Typological analyses revealed 7 profiles of classroom competency distinguished by high scores on the dimensions of General Competencies and Approaches to Learning, and these profiles were found to relate differentially to the indicator of early academic success. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuroticism and depressive symptoms among spouse caregivers: Do health behaviors mediate this relationship?

This study examined the mediating role of health behaviors in the relationship between neuroticism and depressive symptoms among spouse caregivers. Path analysis was used to test a model of the caregiver stress process among 233 caregivers of people with dementia. Results indicate that neuroticism has a significant direct effect on depressive symptoms and also indirectly influences depressive symptoms through health behaviors and perceived stress. When individual health behaviors were examined in the path model, only physical activity served a significant mediating role. These findings suggest that neuroticism may lead to depressive symptoms among caregivers partly through declines in physical activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective investigation of the impact of childhood sexual abuse on the development of sexuality.

The sexual attitudes and activities of 77 sexually abused and 89 comparison women (mean age=20.41, SD=3.38) were assessed 10 years after disclosure in a longitudinal, prospective study of the long-term effects of childhood sexual abuse. Abused participants were more preoccupied with sex, younger at first voluntary intercourse, more likely to have been teen mothers, and endorsed lower birth control efficacy than comparison participants. When psychological functioning earlier in development was examined, sexual preoccupation was predicted by anxiety, sexual aversion was predicted by childhood sexual behavior problems, and sexual ambivalence (simultaneous sexual preoccupation and sexual aversion) was predicted by pathological dissociation. Findings also indicate that biological father abuse may be associated with greater sexual aversion and sexual ambivalence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Temperament in Childhood Predicts Body Mass in Adulthood: The Cardiovascular Risk in Young Finns Study.

This study examined associations of temperament at ages 6 to 12 with body-mass index (BMI) and waist circumference (WC) at ages 24 to 30 years. The participants were 619 men and women derived from the population-based Cardiovascular Risk in Young Finns Study. Temperament was operationalized as (negative) emotionality, sociability, and activity. High emotionality predicted increased BMI, independently of WC, and independently of childhood and adulthood risk factors for adult obesity. None of the temperament dimensions had any associations with WC after controlling for BMI. The findings suggest that temperamental difficulty in childhood may be a useful risk indicator for general body mass in adulthood, and the mechanisms relating temperament with body mass should be further explored. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What does the object decision task measure? Reflections on the basis of evidence from semantic dementia.

The authors investigated the impact of semantic knowledge on visual object analysis by assessing the performance of patients with semantic dementia on a different-views object matching test and on 2 object decision tests differing, for example, in whether the nonreal items were nonsense objects or chimeras of 2 real objects. On average, the patients scored normally on both the object matching and the object decision test including nonsense objects but were impaired on the object decision test including chimeras; this latter was also the only visual object test that correlated significantly with degree of semantic impairment. These findings demonstrate that object decision is not a single task or ability and that it is not necessarily independent of conceptual knowledge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Question hard, answer simply: A comment on Storms et al. (2003).

It seems clear that, for whatever reasons, the dementia of the Alzheimer type patient group (as well as other patient groups) exhibits behavior that is different from the normal control group. G. Storms, T. Dirikx, J. Saerens, S. Verstraeten, and P. P. De Deyn (2003) rightfully argue that the observed behavior (similarity judgments) does not tell us the source (cause) of the differences between the 2 groups. Rather, the focus of the study should be placed more on finding the ways the 2 groups are different. They also point out various methodological problems in some of the previous attempts to characterize the nature of the differences. Further methodological issues in G. Storms et al.'s study are examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trajectories leading to school-age conduct problems.

The present study applied a semiparametric mixture model to a sample of 284 low-income boys to model developmental trajectories of overt conduct problems from ages 2 to 8. As in research on older children, 4 developmental trajectories were identified: a persistent problem trajectory, a high-level desister trajectory, a moderate-level desister trajectory, and a persistent low trajectory. Follow-up analyses indicated that initially high and low groups were differentiated in early childhood by high child fearlessness and elevated maternal depressive symptomatology. Persistent problem and high desister trajectories were differentiated by high child fearlessness and maternal rejecting parenting. The implications of the results for early intervention research are discussed, with an emphasis on the identification of at-risk parent-child dyads. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Structure of Working Memory From 4 to 15 Years of Age.

The structure of working memory and its development across the childhood years were investigated in children 4-15 years of age. The children were given multiple assessments of each component of the A. D. Baddeley and G. Hitch (1974) working memory model. Broadly similar linear functions characterized performance on all measures as a function of age. From 6 years onward, a model consisting of 3 distinct but correlated factors corresponding to the working memory model provided a good fit to the data. The results indicate that the basic modular structure of working memory is present from 6 years of age and possibly earlier, with each component undergoing sizable expansion in functional capacity throughout the early and middle school years to adolescence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)