Estimated pre-morbid IQ effects on cognitive and functional outcomes in Alzheimer disease: a longitudinal study in a treated cohort

Abstract Background Cognitive reserve is thought to influence the degree of neuropathology needed for diagnosis of Alzheimer disease (AD). Cognitive reserve can be operationally defined as the hypothesized capacity of the mature adult brain to sustain the effects of disease or injury without manifesting clinical symptoms of AD, but sufficient to cause clinical dementia in an individual possessing less cognitive reserve. Its effect on the subsequent course of AD is less clear. Pre-morbid IQ is a useful measure of cognitive reserve. Methods We studied 659 consecutive patients with AD at a tertiary referral memory clinic. Patients were assessed on six cognitive tests at baseline. Activities of Daily Living (ADL) were measured on the Instrumental Activities of Daily Living (IADL) scale and Physical Self-Maintenance Scale (PSMS). The National Adult Reading Test (NART) was used to estimate pre-morbid IQ. Patients were followed up after starting a cholinesterase inhibitor over 78 weeks. Mixed general linear models estimated the effects of NART on cognition and ADL. Results Three hundred and fifty-five patients had NART scored with a mean estimated pre-morbid IQ of 104.7 (standard deviation 18.5). NART increased overall cognitive ability by 2.7% for every 10 IQ points (p Conclusion Our data support the hypothesis that cognitive reserve continues to have a limited influence on cognition after AD has been diagnosed and thus, indirectly, has an impact on ADL.</p

A machine learning approach to model interdependencies between dynamic response and crack propagation

Accurate damage detection in engineering structures is a critical part of structural health monitoring. A variety of non-destructive inspection methods has been employed to detect the presence and severity of the damage. In this research, machine learning (ML) algorithms are used to assess the dynamic response of the system. It can predict the damage severity, damage location, and fundamental behaviour of the system. Fatigue damage data of aluminium and ABS under coupled mechanical loads at different temperatures are used to train the model. The model shows that natural frequency and temperature appear to be the most important predictive features for aluminium. It appears to be dominated by natural frequency and tip amplitude for ABS. The results also show that the position of the crack along the specimen appears to be of little importance for either material, allowing simultaneous prediction of location and damage severit

A practical demonstration of autonomous ultrasonic testing for rail flaws inspection

This study established the viability of autonomous ultrasonic inspections at the technology readiness level 5 (TRL 5). An autonomous ultrasonic rail inspection prototype was developed using commercially available ultrasonic instruments and an unmanned on-track vehicle platform consisting of a Clearpath's Warthog and a road-rail vehicle (RRV) trolley. The prototype was designed to travel back and forth on a segment of the test track during the test programme. Repeated fault checks were able to discover seeded artificial flaws at depths of 23 and 27 mm. The detection was indicated by an audio alarm triggered when the ultrasonic emissions exceeded the threshold of the detector gate. A plain text message sent over local area network (LAN) WIFI to a virtual server was also used to demonstrate the transmission of detection messages. The repeatability of the inspection prototype's positioning relative to the problem was confirmed using odometry, global navigation satellite system (GNSS), and positional measurements. The results of the three measurement methods were in good agreement, and the positioning inaccuracy varied between 3 and 7 cm. This study demonstrated the potential of autonomous ultrasonic checks and gave recommendations for further work and limitations

Childhood socioeconomic position and objectively measured physical capability levels in adulthood: a systematic review and meta-analysis

&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Grip strength, walking speed, chair rising and standing balance time are objective measures of physical capability that characterise current health and predict survival in older populations. Socioeconomic position (SEP) in childhood may influence the peak level of physical capability achieved in early adulthood, thereby affecting levels in later adulthood. We have undertaken a systematic review with meta-analyses to test the hypothesis that adverse childhood SEP is associated with lower levels of objectively measured physical capability in adulthood.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Methods and Findings:&lt;/b&gt; Relevant studies published by May 2010 were identified through literature searches using EMBASE and MEDLINE. Unpublished results were obtained from study investigators. Results were provided by all study investigators in a standard format and pooled using random-effects meta-analyses. 19 studies were included in the review. Total sample sizes in meta-analyses ranged from N = 17,215 for chair rise time to N = 1,061,855 for grip strength. Although heterogeneity was detected, there was consistent evidence in age adjusted models that lower childhood SEP was associated with modest reductions in physical capability levels in adulthood: comparing the lowest with the highest childhood SEP there was a reduction in grip strength of 0.13 standard deviations (95% CI: 0.06, 0.21), a reduction in mean walking speed of 0.07 m/s (0.05, 0.10), an increase in mean chair rise time of 6% (4%, 8%) and an odds ratio of an inability to balance for 5s of 1.26 (1.02, 1.55). Adjustment for the potential mediating factors, adult SEP and body size attenuated associations greatly. However, despite this attenuation, for walking speed and chair rise time, there was still evidence of moderate associations.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; Policies targeting socioeconomic inequalities in childhood may have additional benefits in promoting the maintenance of independence in later life.&lt;/p&gt

Barriers to early detection of cognitive impairment in the elderly despite the availability of simple cognitive screening tools and the pharmacist’s role in early detection and referral

Aim The aim of this review is to identify a suitable cognitive screening tool that can be used by the pharmacist during home medication review in addition to calculating the medications’ total anticholinergic burden (ACB). Data sources A search of the literature was conducted using PubMed, Embase, Medline and Google Scholar databases to identify relevant studies using the following keywords: ‘cognitive impairment’, ‘cognitive impairment AND diagnosis’, ‘cognitive scales’, ‘dementia’, ‘delirium’, ‘pharmacist role’, ‘mini-mental state examination (MMSE)’, ‘the Rowland dementia assessment scale (RUDAS)’, ‘the Alzheimer's Disease Assessment Scale - Cognition (ADAS-Cog)’ and ‘barriers and problems’. Only informational websites, clinical trials and review articles were included. Results The MMSE, RUDAS, ADAS-Cog, Psychogeriatric Assessment Scale (PAS) and Kimberley Indigenous Cognitive Assessment (KICA-Cog) require specialist training. The anxiety and depression checklist (K10) and ‘worried about your memory’ (WAYM) can be self-administered without prior training. The ACB scoring system can also be used to determine the total medications ACB. Conclusion The K10 and WAYM can be used by the pharmacist during medication reviews to detect cognitive impairment early and refer the elderly for further medical care supported by the calculated score for the patient‘s total medications‘ ACB

Profiles of physical, emotional and psychosocial wellbeing in the Lothian birth cohort 1936

<p>Abstract</p> <p>Background</p> <p>Physical, emotional, and psychosocial wellbeing are important domains of function. The aims of this study were to explore the existence of separable groups among 70-year olds with scores representing physical function, perceived quality of life, and emotional wellbeing, and to characterise any resulting groups using demographic, personality, cognition, health and lifestyle variables.</p> <p>Methods</p> <p>We used latent class analysis (LCA) to identify possible groups.</p> <p>Results</p> <p>Results suggested there were 5 groups. These included High (n = 515, 47.2% of the sample), Average (n = 417, 38.3%), and Poor Wellbeing (n = 37, 3.4%) groups. The two other groups had contrasting patterns of wellbeing: one group scored relatively well on physical function, but low on emotional wellbeing (Good Fitness/ Low Spirits,n = 60, 5.5%), whereas the other group showed low physical function but relatively well emotional wellbeing (Low Fitness/Good Spirits, n = 62, 5.7%). Salient characteristics that distinguished all the groups included smoking and drinking behaviours, personality, and illness.</p> <p>Conclusions</p> <p>Despite there being some evidence of these groups, the results also support a largely one-dimensional construct of wellbeing in old age—for the domains assessed here—though with some evidence that some individuals have uneven profiles.</p

Coreceptor gene imprinting governs thymocyte lineage fate

Double-positive (CD4+CD8+) thymocytes differentiate into CD4+ helper T cells and CD8+ cytotoxic T cells. A knock-in approach replacing CD8-coding sequences with CD4 cDNA shows that it is the expression kinetics of CD8, and not the identity of the coreceptor, that governs thymocyte-lineage fate