Diferenças de fatores ambientais entre normais e superidosos em uma coorte argentina

Normal aging usually brings age-related cognitive decline. However, there is a group of aged individuals who have exceptional memory performance: the superagers. Objective: Our aim was to identify the environmental factors that could influence exceptional memory performance in a cohort of Argentine individuals. Methods: Forty healthy volunteers >80 years of age were classified into two groups, superagers (SA, n=20) and normal agers (NA, n=20), according to the Northwestern SuperAging Program criteria. Participants were neuropsychologically tested and evaluated on environmental aspects: working status, education, bilingualism, cognitive reserve, physical activity, social networking, clinical comorbidities, and longevity of parents and siblings. Results: Both groups were highly educated (NA=16.3±3 years; SA 15.85±2.6; p=0.6), 11.8% of the sample was still working without differences between groups. There were no differences in cognitive reserve inventory (p=0.7), physical activity engagement (p=0.423), or social network index (p=0.73). As for longevity, 44% of the siblings lived longer than 80 years of age (p=0.432) and maternal longevity was linked to SA (NA=46.7%; SA=80%; p=0.045). Conclusions: This study is a pilot approximation to the superaging population in Argentina. Our results suggest that environmental factors related to successful aging do not differentiate superaging. SA may depend on variables yet to be identified, probably of a genetic/metabolic order

Evaluación teleneuropsicológica en América del Sur: Una perspectiva desde los pacientes y los neuropsicólogos

Teleneuropsychology (teleNP) in Argentina was promoted by the COVID-19 pandemic. This investigation aimed to evaluate patients’ and neuropsychologists’ satisfaction with teleNP and to identify the advantages and disadvantages of its use. 41 patients with mild cognitive impairment and 35 neuropsychologists from Argentina were surveyed. Both groups were sent a questionnaire by e-mail to evaluate their satisfaction and preferences regarding teleNP. Patients were sent the survey after being cognitively evaluated by teleNP. Outcomes reflected a 91% degree of satisfaction with teleNP, with no differences between patients and specialists (p = 0.112). Regarding patients, 50% had no predilection regarding evaluation modality, and 35.7% preferred teleNP. The main benefits identified were accessibility to remote areas (72.4%), and comfort of performing the assessment at home (57.14%). Moreover, 74.3% of practitioners reported that the principal difficulty was the patient’s lack of familiarity with the technology, and 60% a deficiency in environmental control. TeleNP cognitive evaluation has a high degree of acceptability for practitioners and patients. The main obstacles identified are network connection problems and the lack of familiarity with technology. The principal advantages come from accessing isolated areas. This suggests that this practice will remain relevant beyond the pandemic context.La teleneuropsicología (teleNP) en Argentina fue promovida por la pandemia del COVID-19. Esta investigación se propuso evaluar la satisfacción de pacientes y neuropsicólogos con la teleNP e identificar las ventajas y desventajas de su uso. Se encuestaron 41 pacientes con deterioro cognitivo leve y 35 neuropsicólogos de Argentina. A ambos grupos se les envió un cuestionario por correo electrónico para evaluar su satisfacción y preferencias respecto a la teleNP. A los pacientes se les envió la encuesta después de ser evaluados cognitivamente mediante teleNP. Los resultados reflejaron un grado de satisfacción con la teleNP del 91%, sin diferencias entre pacientes y especialistas (p = 0.112). En cuanto a los pacientes, el 50% no tenía predilección por ninguna modalidad de evaluación, y el 35.7% prefería la telePN. Los principales beneficios identificados fueron la accesibilidad a zonas remotas (72.4%), y la comodidad de realizar la evaluación en casa (57.14%). Por otra parte, el 74.3% de los profesionales informaron de que la principal dificultad era la falta de familiaridad del paciente con la tecnología, y el 60% una deficiencia en el control del entorno. La evaluación cognitiva TeleNP tiene un alto grado de aceptabilidad para los profesionales y los pacientes. Los principales obstáculos identificados son los problemas de conexión a la red y la falta de familiaridad con la tecnología. Las principales ventajas provienen del acceso a zonas aisladas. Esto sugiere que esta práctica seguirá siendo relevante más allá del contexto pandémico

La Cognición Social en la Esclerosis Múltiple Temprana: Enfoque neuropsicológico y anatómico

Cognitive impairment and deficits in social cognition (SC) are frequent in patients with multiple sclerosis (MS). The aim of the present work is to study SC in patients with early MS and to analyze its neuroanatomical correlation. Thirty-four patients with relapsing remitting MS, with ≤ 2 years of disease progression and EDSS and ≤2, and 30 healthy control subjects matched for age, sex, and educational level were recruited. Subjects performed a comprehensive neuropsychological assessment (Rao BRB). SC was assessed using the International Affective Picture System IAPS, The Eyes in the Mind Test, the Empathy Quotient, and the Faux Pas Test. The anatomical correlation of patients with deficits in social cognition was studied through brain MRI and voxel-based morphometric for which cortical reconstruction and volumetric segmentation were performed using Freesurfer processing software. Patients showed significant deficits in executive functions, verbal memory and language tests. SC assessment showed that patients presented greater difficulties in the Faux Pas Test (p = 0.023), The Mind in the Eyes Test (p = 0.014), and presented a positive bias in the interpretation of neutral images of the IAPS (P = 0.023). Furthermore, patients with CS deficits presented less cortical thickness in areas of the right supramarginal gyrus, pars opercularis, and anterior cingulum

Neuropsychological profile of Alzheimer's disease based on amyloid biomarker findings results from a South American cohort.

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 cohor

CONDUÇÃO E DOENÇA DE ALZHEIMER: UMA BATERIA DE TRIAGEM NEUROPSICOLÓGICA PARA IDOSOS

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 between driving performance and performance on specific cognitive tests supports the importance of cognitive assessment as a useful tool for deciding whether patients with mild dementia can drive safely. The algorithm including these three variables could be used as a screening tool for the detection of unsafe driving in elderly subjects with cognitive decline

Does Culture Shape Our Understanding of Others’ Thoughts and Emotions? An Investigation Across 12 Countries

Q2Q2Measures of social cognition have now become central in neuropsychology, being essential for early and differential diagnoses, follow-up, and rehabilitation in a wide range of conditions. With the scientific world becoming increasingly interconnected, international neuropsychological and medical collaborations are burgeoning to tackle the global challenges that are mental health conditions. These initiatives commonly merge data across a diversity of populations and countries, while ignoring their specificity. Objective: In this context, we aimed to estimate the influence of participants’ nationality on social cognition evaluation. This issue is of particular importance as most cognitive tasks are developed in highly specific contexts, not representative of that encountered by the world’s population. Method: Through a large international study across 18 sites, neuropsychologists assessed core aspects of social cognition in 587 participants from 12 countries using traditional and widely used tasks. Results: Age, gender, and education were found to impact measures of mentalizing and emotion recognition. After controlling for these factors, differences between countries accounted for more than 20% of the variance on both measures. Importantly, it was possible to isolate participants’ nationality from potential translation issues, which classically constitute a major limitation. Conclusions: Overall, these findings highlight the need for important methodological shifts to better represent social cognition in both fundamental research and clinical practice, especially within emerging international networks and consortia.https://orcid.org/0000-0001-9422-3579https://orcid.org/0000-0001-6529-7077Revista Internacional - IndexadaA2N

Alteraciones conductuales y cognitivas en un paciente con leucoencefalopatía debida a linfomatosis cerebri

A 59 years old female with a prior history of facial hemangioma, with a three-month progressive cognitive impairment (MoCA score 15/30) combined with abulia, unmotivated crying, non-fluent language, limb paratonia, bilateral Hoffman and palmomental reflex; and apraxic gait

Biomarcadores de enfermedad de Alzheimer en deterioro cognitivo leve: experiencia en una clínica de memoria de Latinoamérica

Objective: This study aimed to investigate the role and prognosis of Alzheimer disease biomarkers in patients with mild cognitive impairment (MCI) at a memory clinic in Latin America. Methods: We studied 89 patients with MCI, 43 with Alzheimer-type dementia, and 18 healthy controls (matched for age, sex, and educational level) at our memory clinic (Instituto FLENI) in Buenos Aires, Argentina. Patients and controls underwent an extensive demographic, neurological, and neuropsychological assessment. All subjects underwent a brain MRI scan; FDG-PET scan; amyloid PET scan; apolipoprotein E genotyping; and cerebrospinal fluid concentrations of Aβ1-42, tau, and phosphorylated tau. Patients were categorised as positive or negative for the presence of amyloid pathology and neurodegeneration. Results: Amyloid pathology was observed in cerebrospinal fluid results in 18% of controls, 64% of patients with MCI, and 92% of patients with Alzheimer-type dementia. Suspected non–Alzheimer disease pathophysiology was found in 11% of controls, 6% of patients with MCI, and 8% of patients with Alzheimer-type dementia. At 30 months of follow-up, 45% of amyloid-positive patients with MCI and 20% of amyloid-negative patients with MCI showed progression to dementia. Conclusions: This study demonstrates biomarker-based MCI prognosis and supports its role in clinical decision-making in daily practice.Objetivo: este estudio tuvo como objetivo investigar el papel y el pronóstico de los biomarcadores de la enfermedad de Alzheimer en pacientes con deterioro cognitivo leve (MCI) en una clínica de memoria en América Latina. Métodos: Estudiamos 89 pacientes con LM, 43 con demencia de tipo Alzheimer y 18 controles sanos (emparejados por edad, sexo y nivel educativo) en nuestra clínica de memoria (Instituto FLENI) en Buenos Aires, Argentina. Los pacientes y los controles se sometieron a una extensa evaluación demográfica, neurológica y neuropsicológica. Todos los sujetos se sometieron a una resonancia magnética cerebral; FDG-PET scan; tomografía PET amiloide; apolipoproteína E genotipado; y concentraciones de líquido cefalorraquídeo de Aβ1-42, tau y tau fosforilada. Los pacientes fueron categorizados como positivos o negativos por la presencia de patología amiloide y neurodegeneración. Resultados: se observó patología de amiloide en los resultados del líquido cefalorraquídeo en el 18% de los controles, el 64% de los pacientes con LM y el 92% de los pacientes con demencia de tipo Alzheimer. La sospecha de fisiopatología no relacionada con la enfermedad de Alzheimer se encontró en el 11% de los controles, el 6% de los pacientes con MCI y el 8% de los pacientes con demencia de tipo Alzheimer. A los 30 meses de seguimiento, el 45% de los pacientes con amiloide positivo con MCI y el 20% de los pacientes con amiloide negativo con MCI mostraron progresión a demencia. Conclusiones: este estudio demuestra el pronóstico de MCI basado en biomarcadores y apoya su papel en la toma de decisiones clínicas en la práctica diaria

Effectiveness of cognitive rehabilitation on mild cognitive impairment using teleneuropsychology

ABSTRACT 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 each outcome of interest over time (pre/post-intervention). Results: A significant group (control/treatment) x time (pre/post) interaction revealed that the treatment group at week 10 had better scores in cognitive variables: memory (RAVLT learning trials p=0.030; RAVLT delayed recall p=0.029), phonological fluency (p=0.001), activities of daily living (FAQ p=0.001), satisfaction with memory performance (MMQ satisfaction p=0.004) and use of memory strategies (MMQ strategy p=0.000), as well as, and a significant reduction of affective symptomatology: depression (GDS p=0.000), neuropsychiatric symptoms (NPI-Q p=0.045), forgetfulness (EDO-10 p=0.000), and stress (DAS stress p=0.000). Conclusions: Our study suggests that CTR is an effective intervention

Long-term (6 months) neurological and psychiatric consequences in mild COVID community patients

Las complicaciones neurológicas a largo plazo de la infección por coronavirus han sido descriptas en los pacientes hospitalizados en el episodio agudo. De ellos el 63% presentaron fatiga y debilidad muscular, el 26% trastornos del sueño; 24% trastornos en la marcha y 23% ansiedad y depresión. A mayor severidad del episodio agudo mayor probabilidad de sintomatología neurológica a largo plazo. El objetivo de este trabajo fue estudiar la prevalencia de síntomas neurológicos y psiquiátricos a los 6 meses en una cohorte de pacientes adultos, principalmente ambulatorios. Fueron evaluados mediante una entrevista telefónica 96 sujetos con una media de edad de 48 años, 54% mujeres, y el 86 % ambulatorios leves. De ellos a los 6 meses el 32% de la población presentaba aun síntomas neurológicos o psiquiátricos. Ansiedad (31%), fatiga (26%), niebla mental (24%), insomnio (22%), depresión (21%), y cefalea (19%) entre otros. Conclusiones: en el presente trabajo con sujetos que sufrieron COVID leve los síntomas neurológicos y psiquiátricos post COVID continuaron prominentes como lo reportado en otros trabajos en las formas agudas más gravesLong-term neurological complications of coronavirus infection have been described in the acute episode in hospitalized patients. 63% had fatigue and muscle weakness, 26% sleep disorders; 24% gait disorders and 23% anxiety and depression. The greater the severity of the acute episode, the greater the probability of long-term neurological symptoms. The objective of this work was to study the prevalence at 6 months in a cohort of mostly mild outpatients. 96 subjects with a mean age of 48 years, 54% women, and 86% mild outpatients were evaluated by means of a telephone interview. Of these, at 6 months, 32% of the population presented neurological or psychiatric symptoms. Anxiety (31%), Fatigue (26%), Mental fog (24%), Insomnia (22%), Depression (21%), Headache (19%) among others. Conclusions: In this work with subjects who suffered from mild COVID, neurological and psychiatric symptoms were still prominent as reported in acute severs one