Emotion and Executive Functioning: The Effect of Normal Mood States on Fluency Tasks

EEG activation studies suggest cerebral lateralization of emotions with greater left than right prefrontal activation during positive mood states and greater right than left prefrontal activation during negative mood states (Davidson et al., 1990). Cerebral lateralization is also observed in cognitive tasks, with verbal fluency associated with left frontal activation and design fluency associated with right frontal activation (Baldo et al., 2001). Further, there are lateralized associations between emotion and cognition; that is, verbal fluency is positively associated with induced positive mood, whereas design fluency is positively associated with induced negative mood (Bartolic et al., 1999). The current study expected naturally occurring mood states to be differentially associated with performance on executive function fluency tasks, and based on previous findings (Cabeza, 2002), that age would moderate the association between emotion and fluency. Results suggest a trend for a positive association between positive affect (PA) and verbal fluency. Age did not moderate associations between emotion and cognitive tasks, although greater interdependence between cognitive and emotion variables in older relative to middle-aged adults suggests decreased lateralization in older adults; however differences in interdependence between older and younger adults were negligible. These results suggest that PA may positively influence some areas of cognition, although age may not moderate these results. Sample and measurement limitations may have contributed to this finding

Reliability and validity of the geriatric depression scale in a sample of portuguese older adults with mild-to-moderate cognitive impairment

Although the Geriatric Depression Scale (GDS) is a well-established instrument for the assessment of depressive symptoms in older adults, this has not been validated specifically for Portuguese older adults with cognitive impairment. The objective of this study was to analyze the psychometric properties of two Portuguese versions of the GDS (GDS-27 and GDS-15) in a sample of Portuguese older adults with mild-to-moderate cognitive impairment. Clinicians assessed for major depressive disorder and cognitive functioning in 117 participants with mild-to-moderate cognitive decline (76.9% female, Mage = 83.66 years). The internal consistency of GDS-27 and GDS-15 were 0.874 and 0.812, respectively. There was a significant correlation between GDS-27 and GDS- 15 with the Beck Depression Inventory-II (GDS-27: rho = 0.738, p < 0.001; GDS-15: rho = 0.760, p < 0.001), suggesting good validity. A cutoff point of 15/16 in GDS-27 and 8/9 in GDS-15 resulted in the identification of persons with depression (GDS-27: sensitivity 100%, specificity 63%; GDS-15: sensitivity 90%, specificity 62%). Overall, the GDS-27 and GDS-15 are reliable and valid instruments for the assessment of depression in Portuguese-speaking older adults with cognitive impairmentS

Clinical Medicina

With notable increases in older adult populations, as well as with the associated cognitive impairments that can accompany aging, there is significant importance in identifying strategies to promote cognitive health. The current study explored the implementation of a positive reminiscence program (REMPOS), a non-pharmacological cognitive therapy that has been previously structured, defined, and tested in a Spanish sample. We sought to improve the quality of life of institutionalized older adults with healthy aging, mild cognitive impairment, and Alzheimer’s disease by utilizing this protocol in these samples. A randomized design with a pre-post measure was conducted over a three-month period. Two types of interventions were used: the experimental groups received REMPOS, and the control groups underwent their regular daily institutional programming with cognitive stimulation techniques. After the intervention, the three experimental groups showed higher cognitive functioning, decreased depressive symptomatology (except for the MCI group) and higher evocation of specific positive memories (except for the MCI group). This study supports the effectiveness of REMPOS and reminiscence therapy, with regard to both cognitive and mood factors in cognitively impaired older adults.https://www.mdpi.com/2077-0383/10/14/3168/ht

Revision of the frontal systems behavior scale (FrSBe)

The Frontal Systems Behavior Scale (FrSBe) is a 46-item questionnaire that measures behavioral dysfunction associated with frontal subcortical dysfunctions; specifically, apathy, disinhibition, and executive dysfunction, in adult neurologic populations (Grace & Malloy, 2001). The current study aimed to revise the FrSBe to improve the reliability and validity of the measure. Scale revision was determined by the best fitting model using confirmatory factor analysis (CFA), results from a previous EFA on a separate dataset (Stout et al., 2001), and cognitive interviewing (Knafl et al., 2007). Improvement in reliability was measured by comparing the internal consistency reliability of the revised to the original scale and change in validity was determined by comparing the classification accuracy of patient groups (Parkinson’s disease, Alzheimer’s disease, and patients with frontal dysfunction) in the original and revised models. The best fitting model removed 10 items from the original measure, and improved model fit over the original FrSBe. Significant differences were not observed between the reliability and validity of the original compared to the revised scale, although the reliabilities and validities in both versions were strong. Revising the FrSBe resulted in a briefer, more concise tool (with less potentially confusing items) measuring behavioral abilities in various adult neurologic samples

Neuropsychologic profile of a high-functioning family with a mitochondrial cytopathy

Objective: To examine the neuropsychologic profile of 3 family members diagnosed with the same mitochondrial cytopathy corresponding to a defect in the respiratory chain. Background: The neuropsychologic functioning of patients with mitochondrial cytopathies has been largely unexamined in the literature. These mitochondrial defects often result in cell death and the failure of whole systems, including the brain. There are over 40 known types of mitochondrial cytopathies, which vary greatly in their genetic, clinical, and behavioral manifestations. Method: The following project describes the neuropsychologic profiles of a family (a mother and her 2 children) afflicted by the same mitochondrial cytopathy possibly associated with nucleotide 15,924. Standardized tests of premorbid intelligence estimation, attention, executive function, language, verbal and visual memory, visuospatial functioning, motor functioning, visual acuity, mood, and activities of daily living were administered. Results: Participants\u27 profiles were characterized by estimated intellectual ability in the average to superior range with marked variability on a number of assessments, making it difficult to identify a distinct pattern. General trends, however, were reflective of executive function impairment associated with dysfunction of frontal-subcortical systems. Conclusions: Mitochondrial disorders are extremely complicated and variable in their presentation. A multifactor approach should be adopted when examining neuropsychologic profiles

Psychometrics of the AAN Caregiver Driving Safety Questionnaire and Contributors to Caregiver Concern about Driving Safety in Older Adults

The American Academy of Neurology (AAN) updated their practice parameters in the evaluation of driving risk in dementia and developed a Caregiver Driving Safety Questionnaire, detailed in their original manuscript (Iverson Gronseth, Reger, Classen, Dubinsky, & Rizzo, 2010). They described four factors associated with decreased driving ability in dementia patients: history of crashes or citations, informant-reported concerns, reduced mileage, and aggressive driving. An informant-reported AAN Caregiver Driving Safety Questionnaire was designed with these elements, and the current study was the first to explore the factor structure of this questionnaire. Additionally, we examined associations between these factors and cognitive and behavioral measures in patients with mild cognitive impairment or early Alzheimer\u27s disease and their informants. Exploratory factor analysis revealed a four-component structure, consistent with the theory behind the AAN scale composition. These four factor scores also were significantly associated with performance on cognitive screening instruments and informant reported behavioral dysfunction. Regressions revealed that behavioral dysfunction predicted caregiver concerns about driving safety beyond objective patient cognitive dysfunction. In this first known quantitative exploration of the scale, our results support continued use of this scale in office driving safety assessments. Additionally, patient behavioral changes predicted caregiver concerns about driving safety over and above cognitive status, which suggests that caregivers may benefit from psychoeducation about cognitive factors that may negatively impact driving safety

Associations Between Original and a Reduced Frontal Systems Behavior Scale (FrSBe), Cognition, and Activities of Daily Living in a Large Neurologic Sample

A recent confirmatory factor analysis (CFA) on the Frontal Systems Behavior Scale (FrSBe) indicated that the basic structure of the FrSBe subscales held after removal of 8 weak items. In a replication of previous studies using the original FrSBe, the present study explored associations between a reduced version of the FrSBe, cognition, and activities of daily living (ADLs) in a large mixed outpatient neurologic sample. Consistent with previous findings with the original FrSBe, significant associations existed between reduced FrSBe scores and the Mattis Dementia Rating Scale-Second Edition. Additionally, after controlling for age, gender, and education, reduced FrSBe Apathy was associated with basic ADLs, and reduced FrSBe Disinhibition was associated with instrumental ADLs. These results offer replication in a larger sample of previous findings and statistical support for a reduced FrSBe beyond CFA results alone

Effectiveness of a Randomized Controlled Trial of Individual Reminiscence Therapy on Cognition, Mood and Quality of Life in Azorean Older Adults with Neurocognitive Disorders

Reminiscence therapy (RT) is a form of cognitive stimulation therapy that incorporates discussion of past activities, events, and experiences to stimulate individual memories; it has had some success in treating persons with neurocognitive disorders. This research aims to evaluate the ability of individual RT, using a simple reminiscence format, to improve the overall cognitive function, memory, executive functions, emotional status, and quality of life in older adults with neurocognitive disorders who received social care and support services. A multicenter randomized controlled trial was completed in the Azores archipelago (an independent region of Portugal) using repeated measures (pre-intervention, post-intervention, and follow-up). The intervention group underwent individual RT sessions, twice weekly for 13 weeks, while the control group completed regular activities administered as part of their program. Results did not reveal any significant differences between the intervention and control groups. While results did not reveal significant effects, a number of historical and contextual factors are considered as possible explanations for the lack of effects—namely, data collection occurring during the COVID-19 global pandemic, participant cohort effects, and therapist heterogeneity