| 1. |
- Eckerström, Carl, et al.
(författare)
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Characteristic Biomarker and Cognitive Profile in Incipient Mixed Dementia.
- 2020
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Ingår i: Journal of Alzheimer's disease : JAD. - 1875-8908. ; 73:2, s. 597-607
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Tidskriftsartikel (refereegranskat)abstract
- Research has shown that mixed dementia is more common than previously believed but little is known of its early stages.To examine if incipient mixed dementia can be differentiated from incipient Alzheimer's disease (AD) and subcortical ischemic vascular dementia (SVD) using neuropsychological tests, cerebrospinal fluid (CSF) markers, and magnetic resonance imaging markers.We included 493 patients and controls from the Gothenburg MCI study and used the dementia groups for marker selection (CSF total-tau (T-tau), phospho-tau (P-tau), and amyloid-β42 (Aβ42), 11 neuropsychological tests, and 92 regional brain volumes) and to obtain cut-off values which were then applied to the MCI groups.Incipient mixed dementia was best differentiated from incipient AD by the Word fluency F-A-S test and the Trail making test A. CSF T-tau, P-tau, and Aβ42 differentiated incipient mixed dementia from incipient SVD.Incipient mixed dementia is characterized by an AD-like biomarker profile and an SVD-like cognitive profile. Incipient mixed dementia can be separated from incipient AD and incipient SVD using CSF markers and cognitive testing.
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| 2. |
- Eckerström, Carl, et al.
(författare)
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Evaluation of the ATN model in a longitudinal memory clinic sample with different underlying disorders.
- 2021
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Ingår i: Alzheimer's & dementia. - : Wiley. - 2352-8729. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- To evaluate the usefulness of the 2018 NIA-AA (National Institute on Aging and Alzheimer's Association) research framework in a longitudinal memory clinic study with different clinical outcomes and underlying disorders.We included 420 patients with mild cognitive impairment or subjective cognitive impairment. During the follow up, 27% of the patients converted to dementia, with the majority converting to Alzheimer's disease (AD) or mixed dementia. Based on the baseline values of the cerebrospinal fluid biomarkers, the patients were classified into one of the eight possible ATN groups (amyloid beta [Aβ] aggregation [A], tau aggregation reflecting neurofibrillary tangles [T], and neurodegeneration [N]).The majority of the patients converting to AD and mixed dementia were in ATN groups positive for A (71%). The A+T+N+ group was highly overrepresented among converters to AD and mixed dementia. Patients converting to dementias other than AD or mixed dementia were evenly distributed across the ATN groups.Our findings provide support for the usefulness of the ATN system to detect incipient AD or mixed dementia.
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| 3. |
- Eckerström, Marie, 1981, et al.
(författare)
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Longitudinal evaluation of criteria for subjective cognitive decline and preclinical Alzheimer's disease in a memory clinic sample.
- 2017
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Ingår i: Alzheimer's & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 16:8, s. 96-107
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Tidskriftsartikel (refereegranskat)abstract
- Subjective cognitive decline (SCD) and biomarker-based "at-risk" concepts such as "preclinical" Alzheimer's disease (AD) have been developed to predict AD dementia before objective cognitive impairment is detectable. We longitudinally evaluated cognitive outcome when using these classifications.Memory clinic patients (n=235) were classified as SCD (n=122): subtle cognitive decline (n=36) and mild cognitive impairment (n=77) and subsequently subclassified into SCDplus and National Institute on Aging-Alzheimer's Association (NIA-AA) stages 0 to 3. Mean (standard deviation) follow-up time was 48 (35) months. Proportion declining cognitively and prognostic accuracy for cognitive decline was calculated for all classifications.Among SCDplus patients, 43% to 48% declined cognitively. Among NIA-AA stage 1 to 3 patients, 50% to 100% declined cognitively. The highest positive likelihood ratios (+LRs) for subsequent cognitive decline (+LR 6.3), dementia (+LR 3.4), and AD dementia (+LR 6.5) were found for NIA-AA stage2.In a memory clinic setting, NIA-AA stage 2 seems to be the most successful classification in predicting objective cognitive decline, dementia, and AD dementia.
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| 4. |
- Ellbin, S., et al.
(författare)
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Self-reported cognitive impairment and daily life functioning 7-12 years after seeking care for stress-related exhaustion
- 2021
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Ingår i: Scandinavian Journal of Psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 62:4, s. 484-492
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Tidskriftsartikel (refereegranskat)abstract
- The overall aim of this study was to investigate self-reported cognitive difficulties, daily life activities, and health/sleep factors in former patients with exhaustion disorder (ED) who still fulfill the clinical criteria for exhaustion 7-12 years after seeking care. The Sahlgrenska Self-reported Cognitive Impairment Questionnaire (SASCI-Q) was used to measure cognitive difficulties, daily life activities, and health/sleep factors. Three groups were compared: previous patients still judged to be clinically exhausted seven years or more after seeking care (n = 51); previous patients considered clinically recovered (n = 98); and healthy controls (n = 50). Patients who still fulfilled the diagnostic criteria for ED reported widespread problems related to cognition, fatigue, and daily life functioning compared to the clinically recovered group. Furthermore, despite no longer fulfilling the clinical criteria, the recovered patients still reported more problems related to cognitive functioning and fatigue compared to healthy controls. Thus, this group appeared intermediary between the non-recovered group and healthy controls regarding self-reported cognitive functioning. To conclude, ED may have considerable negative long-term effects, and it is possible that some of these residual symptoms, particularly the cognitive problems and persistent fatigue, are permanent in some patients. Preventive measures should be the primary focus for all stakeholders, since the consequences of stress-related mental health problems seem to be extensive and long-lasting.
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| 5. |
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| 6. |
- Hessen, Erik, et al.
(författare)
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Subjective Cognitive Impairment Is a Predominantly Benign Condition in Memory Clinic Patients Followed for 6 Years: The Gothenburg-Oslo MCI Study.
- 2017
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Ingår i: Dementia and geriatric cognitive disorders extra. - : S. Karger AG. - 1664-5464. ; 7:1, s. 1-14
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Tidskriftsartikel (refereegranskat)abstract
- In the quest for prevention or treatment, there is a need to find early markers for preclinical dementia. This study observed memory clinic patients with subjective cognitive impairment (SCI) and normal cognitive function at baseline. The primary aim was to address SCI as a potential risk factor for cognitive decline. The secondary aim was to address a potential relation between (1) baseline cerebrospinal fluid biomarkers and (2) a decline in memory performance over the first 2 years of follow-up, with a possible cognitive decline after 6 years.Eighty-one patients (mean age 61 years) were recruited from university memory clinics and followed up for 6 years.Eighty-six percent of the cohort remained cognitively stable or improved, 9% developed mild cognitive impairment, and only 5% (n = 4) developed dementia. Regression analysis revealed that low levels of Aβ42 at baseline and memory decline during the first 2 years predicted dementia. When combined, these variables were associated with a 50% risk of developing dementia.Cognitive stability for 86% of the cohort suggests that SCI is predominantly a benign condition with regard to neuropathology. The low number of individuals who developed dementia limits the generalizability of the results and discussion of progression factors.
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| 7. |
- Hessen, E., et al.
(författare)
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T-Tau is Associated with Objective Memory Decline over Two Years in Persons Seeking Help for Subjective Cognitive Decline: A Report from the Gothenburg-Oslo MCI Study
- 2015
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Ingår i: Journal of Alzheimer's Disease. - 1387-2877 .- 1875-8908. ; 47:3, s. 619-628
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Tidskriftsartikel (refereegranskat)abstract
- © 2015 - IOS Press and the authors. All rights reserved. Background: There is a need to find very early markers for pre-clinical Alzheimer's disease as interventions early in the disease process are thought to be most effective. Objective: The present study aimed to address the potential relation between cerebrospinal fluid (CSF) biomarkers and reduced cognitive function in a relatively young cohort of memory clinic patients with subjective cognitive decline. Methods: 122 patients (mean age 63 years) with subjective cognitive decline were recruited from two university memory clinics and followed for two years. Results: The main finding was that the subgroup with objective memory decline during the study period had significantly higher T-tau at baseline than the group with improved memory. Baseline CSF variables showed a trend toward more pathological values in the patients with memory decline compared to those who improved or remained stable.Tthe baseline memory score of those who declined was significantly better than the baseline score of those who improved over two years.Tthe general trend for the whole group was improved memory and executive test scores.Tthere were no differences in cognitive scores based on CSF quartiles at baseline, nor were there differences in cognitive outcome for patients with early amnestic mild cognitive impairment versus average cognitive function at baseline. Conclusions: The main finding that T-tau rather than amyloid-β was associated with memory decline do not support the prevailing opinion about the chain of events assumed to take place in Alzheimer's disease. In addition, memory decline was not associated with poor baseline memory score. Thus, a memory cut-off indicating low baseline memory would not would have identified the declining group.
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| 8. |
- Jansen, Willemijn J, et al.
(författare)
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Prevalence Estimates of Amyloid Abnormality Across the Alzheimer Disease Clinical Spectrum.
- 2022
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Ingår i: JAMA neurology. - : American Medical Association (AMA). - 2168-6157 .- 2168-6149. ; 79:3, s. 228-243
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Tidskriftsartikel (refereegranskat)abstract
- One characteristic histopathological event in Alzheimer disease (AD) is cerebral amyloid aggregation, which can be detected by biomarkers in cerebrospinal fluid (CSF) and on positron emission tomography (PET) scans. Prevalence estimates of amyloid pathology are important for health care planning and clinical trial design.To estimate the prevalence of amyloid abnormality in persons with normal cognition, subjective cognitive decline, mild cognitive impairment, or clinical AD dementia and to examine the potential implications of cutoff methods, biomarker modality (CSF or PET), age, sex, APOE genotype, educational level, geographical region, and dementia severity for these estimates.This cross-sectional, individual-participant pooled study included participants from 85 Amyloid Biomarker Study cohorts. Data collection was performed from January 1, 2013, to December 31, 2020. Participants had normal cognition, subjective cognitive decline, mild cognitive impairment, or clinical AD dementia. Normal cognition and subjective cognitive decline were defined by normal scores on cognitive tests, with the presence of cognitive complaints defining subjective cognitive decline. Mild cognitive impairment and clinical AD dementia were diagnosed according to published criteria.Alzheimer disease biomarkers detected on PET or in CSF.Amyloid measurements were dichotomized as normal or abnormal using cohort-provided cutoffs for CSF or PET or by visual reading for PET. Adjusted data-driven cutoffs for abnormal amyloid were calculated using gaussian mixture modeling. Prevalence of amyloid abnormality was estimated according to age, sex, cognitive status, biomarker modality, APOE carrier status, educational level, geographical location, and dementia severity using generalized estimating equations.Among the 19097 participants (mean [SD] age, 69.1 [9.8] years; 10148 women [53.1%]) included, 10139 (53.1%) underwent an amyloid PET scan and 8958 (46.9%) had an amyloid CSF measurement. Using cohort-provided cutoffs, amyloid abnormality prevalences were similar to 2015 estimates for individuals without dementia and were similar across PET- and CSF-based estimates (24%; 95% CI, 21%-28%) in participants with normal cognition, 27% (95% CI, 21%-33%) in participants with subjective cognitive decline, and 51% (95% CI, 46%-56%) in participants with mild cognitive impairment, whereas for clinical AD dementia the estimates were higher for PET than CSF (87% vs 79%; mean difference, 8%; 95% CI, 0%-16%; P=.04). Gaussian mixture modeling-based cutoffs for amyloid measures on PET scans were similar to cohort-provided cutoffs and were not adjusted. Adjusted CSF cutoffs resulted in a 10% higher amyloid abnormality prevalence than PET-based estimates in persons with normal cognition (mean difference, 9%; 95% CI, 3%-15%; P=.004), subjective cognitive decline (9%; 95% CI, 3%-15%; P=.005), and mild cognitive impairment (10%; 95% CI, 3%-17%; P=.004), whereas the estimates were comparable in persons with clinical AD dementia (mean difference, 4%; 95% CI, -2% to 9%; P=.18).This study found that CSF-based estimates using adjusted data-driven cutoffs were up to 10% higher than PET-based estimates in people without dementia, whereas the results were similar among people with dementia. This finding suggests that preclinical and prodromal AD may be more prevalent than previously estimated, which has important implications for clinical trial recruitment strategies and health care planning policies.
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| 9. |
- Wallin, Anders, 1950, et al.
(författare)
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Alzheimer's disease-subcortical vascular disease spectrum in a hospital-based setting: overview of results from the Gothenburg MCI and dementia studies.
- 2016
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Ingår i: Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism. - : SAGE Publications. - 1559-7016. ; 36:1, s. 95-113
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Forskningsöversikt (refereegranskat)abstract
- The ability to discriminate between Alzheimer's disease (AD), subcortical vascular disease, and other cognitive disorders is crucial for diagnostic purposes and clinical trial outcomes. Patients with primarily subcortical vascular disease are unlikely to benefit from treatments targeting the AD pathogenic mechanisms and vice versa. The Gothenburg mild cognitive impairment (MCI) and dementia studies are prospective, observational, single-center cohort studies suitable for both cross-sectional and longitudinal analysis that outline the cognitive profiles and biomarker characteristics of patients with AD, subcortical vascular disease, and other cognitive disorders. The studies, the first of which started in 1987, comprise inpatients with manifest dementia and patients seeking care for cognitive disorders at an outpatient memory clinic. This article gives an overview of the major published papers (neuropsychological, imaging/physiology, and neurochemical) of the studies including the ongoing Gothenburg MCI study. The main findings suggest that subcortical vascular disease with or without dementia exhibit a characteristic neuropsychological pattern of mental slowness and executive dysfunction and neurochemical deviations typical of white matter changes and disturbed blood-brain barrier function. Our findings may contribute to better healthcare for this underrecognized group of patients. The Gothenburg MCI study has also published papers on multimodal prediction of dementia, and cognitive reserve.Journal of Cerebral Blood Flow & Metabolism advance online publication, 29 July 2015; doi:10.1038/jcbfm.2015.148.
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| 10. |
- Wallin, Anders, 1950, et al.
(författare)
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The Gothenburg MCI study: design and distribution of Alzheimer's disease and subcortical vascular disease diagnoses from baseline to 6-year follow-up.
- 2016
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Ingår i: Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism. - : SAGE Publications. - 1559-7016. ; 36:1, s. 114-131
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Tidskriftsartikel (refereegranskat)abstract
- There is a need for increased nosological knowledge to enable rational trials in Alzheimer's disease (AD) and related disorders. The ongoing Gothenburg mild cognitive impairment (MCI) study is an attempt to conduct longitudinal in-depth phenotyping of patients with different forms and degrees of cognitive impairment using neuropsychological, neuroimaging, and neurochemical tools. Particular attention is paid to the interplay between AD and subcortical vascular disease, the latter representing a disease entity that may cause or contribute to cognitive impairment with an effect size that may be comparable to AD. Of 664 patients enrolled between 1999 and 2013, 195 were diagnosed with subjective cognitive impairment (SCI), 274 with mild cognitive impairment (MCI), and 195 with dementia, at baseline. Of the 195 (29%) patients with dementia at baseline, 81 (42%) had AD, 27 (14%) SVD, 41 (21%) mixed type dementia (=AD+SVD=MixD), and 46 (23%) other etiologies. After 6 years, 292 SCI/MCI patients were eligible for follow-up. Of these 292, 69 (24%) had converted to dementia (29 (42%) AD, 16 (23%) SVD, 15 (22%) MixD, 9 (13%) other etiologies). The study has shown that it is possible to identify not only AD but also incipient and manifest MixD/SVD in a memory clinic setting. These conditions should be taken into account in clinical trials.Journal of Cerebral Blood Flow & Metabolism advance online publication, 15 July 2015; doi:10.1038/jcbfm.2015.147.
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| 11. |
- Antonsson, Malin, 1986, et al.
(författare)
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Using a Discourse Task to Explore Semantic Ability in Persons With Cognitive Impairment.
- 2021
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Ingår i: Frontiers in aging neuroscience. - : Frontiers Media SA. - 1663-4365. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- This paper uses a discourse task to explore aspects of semantic production in persons with various degree of cognitive impairment and healthy controls. The purpose of the study was to test if an in-depth semantic analysis of a cognitive-linguistic challenging discourse task could differentiate persons with a cognitive decline from those with a stable cognitive impairment. Both quantitative measures of semantic ability, using tests of oral lexical retrieval, and qualitative analysis of a narrative were used to detect semantic difficulties. Besides group comparisons a classification experiment was performed to investigate if the discourse features could be used to improve classification of the participants who had a stable cognitive impairment from those who had cognitively declined. In sum, both types of assessment methods captured difficulties between the groups, but tests of oral lexical retrieval most successfully differentiated between the cognitively stable and the cognitively declined group. Discourse features improved classification accuracy and the best combination of features discriminated between participants with a stable cognitive impairment and those who had cognitively declined with an area under the curve (AUC) of 0.93.
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| 12. |
- Eckerström, Marie, 1981, et al.
(författare)
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Cognitive impairment without altered levels of cerebrospinal fluid biomarkers in patients with encephalitis caused by varicella-zoster virus: a pilot study.
- 2020
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Ingår i: Scientific reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- Varicella-zoster virus (VZV) is one of the most common agents causing viral infections of the central nervous system (CNS). VZV encephalitis is associated with severe neurological sequelae, despite antiviral treatment. Cognitive impairment has been reported and VZV has been associated with dementia. Our aim was to investigate the cognitive impairment and cerebrospinal fluid biomarkers in a follow-up study of patients with VZV encephalitis. Thirteen patients with VZV encephalitis, diagnosed by detection of VZV DNA in cerebrospinal fluid (CSF) by PCR and concomitant symptoms of encephalitis, were included. Neuropsychological assessment in parallel with a lumbar puncture to obtain CSF was performed 1.5-7years after acute disease. The CSF biomarkers neurofilament light chain (NFL), S100B, glial fibrillary acidic protein (GFAP), amyloid-β (Aβ) 40 and Aβ42, total tau (t-tau) and phosphorylated tau (p-tau) were analysed and compared to controls (n=24). Cognitive impairment was shown in the domains of executive functions and speed/attention and to a minor degree in the domains of learning/memory and language, indicated by a significantly poorer performance on seven neuropsychological test variables. No convincing evidence of alterations in concentrations of biomarkers in the CSF were shown. Our results indicate that patients with VZV encephalitis suffer from cognitive impairment long time after acute disease. Importantly, these impairments do not seem to be accompanied by biomarker evidence of ongoing neuronal or astrocytic injury/activation or induction of dementia-related brain pathologies by the infection.
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| 13. |
- Eckerström, Marie, 1981, et al.
(författare)
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High Prevalence of Stress and Low Prevalence of Alzheimer Disease CSF Biomarkers in a Clinical Sample with Subjective Cognitive Impairment
- 2016
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Ingår i: Dementia and Geriatric Cognitive Disorders. - : S. Karger AG. - 1420-8008 .- 1421-9824. ; 42:1-2, s. 93-105
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims: Subjective cognitive impairment (SCI) is a trigger for seeking health care in a possible preclinical phase of Alzheimer's disease (AD), although the characteristics of SCI need clarification. We investigated the prevalence of psychosocial stress, depressive symptoms and CSF AD biomarkers in SCI and MCI (mild cognitive impairment). Methods: Memory clinic patients (SCI: n = 90; age: 59.8 ± 7.6 years; MCI: n = 160; age: 63.7 ± 7.0 years) included in the Gothenburg MCI study were examined at baseline. Variables were analyzed using logistic regression with SCI as dependent variable. Results: Stress was more prevalent in SCI (51.1%) than MCI (23.1%); p < 0.0005. SCI patients had more previous depressive symptoms (p = 0.006), but showed no difference compared to MCI patients considering current depressive symptoms. A positive CSF AD profile was present in 14.4% of SCI patients and 35.0% of MCI patients (p = 0.001). Stress (p = 0.002), previous stress/depressive symptoms (p = 0.006) and a negative CSF AD profile (p = 0.036) predicted allocation to the SCI group. Conclusion: Psychosocial stress is more prevalent in SCI than previously acknowledged. The high prevalence and long-term occurrence of stress/depressive symptoms in SCI in combination with a low prevalence of altered CSF AD biomarkers strengthens the notion that AD is not the most likely etiology of SCI.
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| 14. |
- Eckerström, Marie, 1981, et al.
(författare)
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Neurodegeneration and the Gothenburg MCI study – a background to the linguistic and extralinguistic parameters for early detection of cognitive impairment-project.
- 2019
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Ingår i: Proceedings of the 10th International Conference of Experimental Linguistics, 25-27 September 2019, Lisbon, Portugal / edited by Antonis Botinis. - : ExLing Society. - 2529-1092. - 9786188458505
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Konferensbidrag (refereegranskat)abstract
- Mild cognitive impairment (MCI) is the stage between the expected cognitive decline of a normal aging population and the more serious decline of dementia. Typically, the performance of a cognitive test is considered impaired if it is =>1.5 standard deviations below normal controls. The ongoing Gothenburg mild cognitive impairment (MCI) study is an attempt to conduct longitudinal in-depth phenotyping of patients with different forms and degrees of cognitive impairment using various assessment tools. This paper presents the background of the linguistic and extralinguistic parameters for early detection of cognitive impairment-project, a research which is partly based on data acquired at the Gothenburg MCI-study.
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| 15. |
- Eckerström, Marie, 1981, et al.
(författare)
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Sahlgrenska Academy Self-reported Cognitive Impairment Questionnaire (SASCI-Q) - a research tool discriminating between subjectively cognitively impaired patients and healthy controls.
- 2013
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Ingår i: International psychogeriatrics / IPA. - 1741-203X. ; 25:3, s. 420-430
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT Background: Subjective cognitive impairment (SCI) is a potential early marker for actual cognitive decline. The cognitive manifestation of the SCI stage is, however, largely unknown. Self-report instruments developed especially for use in the SCI population are lacking, and many SCI studies have not excluded mild cognitive impairment and dementia. We developed and tested a patient-based questionnaire on everyday cognitive function aiming to discriminate between patients with subjective, but not objective, cognitive impairment and healthy controls. Methods: Individuals experiencing cognitive impairment were interviewed to generate a pool of items. After condensing to 97 items, we tested the questionnaire in 93 SCI patients seeking care at a memory clinic (age M = 64.5 years, Mini-Mental State Examination (MMSE) M = 29.0) and 50 healthy controls (age M = 69.6 years, MMSE M = 29.3). Further item reduction was conducted to maximize that remaining items would discriminate between SCI patients and controls, using a conservative α level and requiring medium to high effect sizes. Internal consistency reliability and convergent validity was subsequently examined. Results: Forty-five items discriminated between the groups, resulting in the Sahlgrenska Academy Self-reported Cognitive Impairment Questionnaire (SASCI-Q). Internal consistency was high and correlations to a single question on memory functioning were of medium to large sizes. Most remaining items were related to the memory domain. Conclusion: The SASCI-Q discriminates between SCI patients and healthy controls and demonstrates satisfying psychometric properties. The instrument provides a research method for examining SCI and forms a foundation for future examining which SCI symptoms predict objective cognitive decline. The cognitive manifestation of the SCI stage is mostly related to experiences of memory deficits.
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| 16. |
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| 17. |
- Eckerström, Marie, 1981
(författare)
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Subjective cognitive decline in memory clinic patients - characteristics and clinical relevance : Results from Sahlgrenska University Hospital Memory Clinic in Mölndal
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Subjective cognitive decline (SCD) refers to concerns – symptoms - regarding one’s cognitive functioning, in the absence of objective evidence of impairment. SCD has been described as a possible stage preceding mild cognitive impairment (MCI) and dementia. The characteristics and clinical relevance in relation to subsequent objective cognitive decline is however still unclear. We developed a patient-based comprehensive questionnaire on everyday cognitive difficulties. Patients with SCD were followed over time, to analyze the associations between SCD and cognitive outcome. Furthermore, we investigated the associations between SCD and stress, depressive symptoms and CSF AD profiles, and evaluated newly published international criteria for SCD, ‘preclinical AD’ and subcategories, involving both clinical features and neurochemical biomarkers. All participants in the current thesis were patients or healthy volunteers at the Sahlgrenska memory clinic in Mölndal. We identified specific SCD symptoms that were more frequently reported by subjectively impaired patients seeking help for cognitive problems, compared to healthy elderly. The self-report instrument SASCI-Q is a useful research tool to investigate cognitive symptoms further. SCD patients were characterized by relatively young age, high educational attainment, high prevalence of stress conditions and depressive symptoms, and a family history of dementia. About 40 % of patients with SCD declined cognitively over 4±2.9 years – one fourth of them converted to dementia. When CSF biomarkers were added, the ability to predict MCI, dementia and AD dementia clearly increased. A specific profile of subjective cognitive symptoms could not be associated with cognitive decline in a mixed SCD+MCI patient sample. However, when groups were analysed separately, reporting more symptoms was associated with subsequent decline in the SCD group whilst reporting less symptoms was associated with subsequent decline in the MCI group. Cognitive symptoms reported by the patient may signify many different conditions, and their associations with subsequent dementia should not be overstated when there are no objective signs present.
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| 18. |
- Eliassen, I. V., et al.
(författare)
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Predictive and diagnostic utility of brief neuropsychological assessment in detecting Alzheimer's pathology and progression to dementia
- 2020
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Ingår i: Neuropsychology. - : American Psychological Association (APA). - 1931-1559 .- 0894-4105. ; 34:8, s. 851-861
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the role of brief neuropsychological assessments in prediction and identification of Alzheimer's disease (AD) pathology and progression to AD dementia. Method: Adults (N = 255; range = 40-81 years) with self-reported cognitive decline underwent baseline and 2-year follow-up clinical assessment, including a brief neuropsychological screening and lumbar puncture. Five different mild cognitive impairment (MCI) algorithms were applied on baseline cognitive test results: one conventional, three amnestic (lenient, stringent, multidomain), and one comprehensive criterion. We compared predictive and diagnostic accuracy of these MCI criteria by performing logistic regression analyses and calculating diagnostic accuracy measures for 2-year outcomes of (1) clinical diagnosis of AD dementia and (2) cerebrospinal fluid biomarkers in the Alzheimer's continuum. Results: The lenient amnestic MCI criterion showed the largest effect size for predicting progression to AD dementia (OR = 13.762, 99% CI = 1.969-96.194, p = .001) and AD biomarkers (OR = 4.855, 99% CI = 1.974-11.924, p < .001) after 2 years. This criterion was sensitive for progression to dementia (sensitivity = 92.0%, specificity = 54.8%, positive likelihood ratio [LR+] = 2.03, LR- = 0.15) and showed the highest overall diagnostic accuracy for AD biomarkers (sensitivity = 72.7%, specificity = 59.1%, LR+ = 1.78, negative likelihood ratio [LR-] = 0.46). The multidomain amnestic MCI criterion produced the highest specificity for dementia (sensitivity = 76.0%, specificity = 73.0%, LR+ = 2.82, LR- = 0.33) and AD biomarkers (sensitivity = 46.8% specificity = 70.9% LR+ = 1.61, LR- = 0.75). Conclusions: Defining MCI using a brief neuropsychological battery provided limited accuracy for progression to AD dementia and cerebrospinal fluid Aβ. The lenient amnestic MCI criterion identified the highest number of individuals who progressed to clinical AD or showed biomarker pathology, but this approach included a substantial number of false positives. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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| 19. |
- Eliassen, Ingvild Vøllo, et al.
(författare)
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Regression-Based Cognitive Change Norms Applied in Biochemically Defined Predementia Alzheimer’s Disease
- 2023
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Ingår i: Neuropsychology. - : American Psychological Association (APA). - 0894-4105 .- 1931-1559. ; 37:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: We aim to develop 2-year cognitive change norms for adults ages 41–84 for six cognitive tests, and to evaluate these norms in groups with AD biomarkers. Background: Practice effects are common in repeated neuropsychological testing. Not accounting for practice effects may obscure cognitive decline in early Alzheimer’s disease (AD). Method: We developed standardized regression-based change norms from normative samples consisting of healthy controls from the Dementia Disease Initiation study (n = 125), the Trønderbrain study (n = 57), and the Gothenburg mild cognitive impairment (MCI) study (n = 65). Norms were applied in a sample with cognitive symptoms (subjective cognitive decline or MCI) and AD cerebrospinal fluid (CSF) biomarkers (n = 246), classified according to the A/T/N system. Results: The change norms adjusted for pertinent demographics and practice effects. The group with cognitive complaints displayed a trend toward cognitive decline compared to the normative group, with the A+T/N+ subgroup showing the most marked decline. This was observed in tests of episodic memory and cognitive flexibility/divided attention. Conclusions: We present 2-year cognitive change norms for adults between 41 and 84 years, adjusted for practice and demographics. A web-based change norm calculator is provided.
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| 20. |
- Espenes, J., et al.
(författare)
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Demographically adjusted trail making test norms in a Scandinavian sample from 41 to 84 years
- 2020
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Ingår i: Clinical Neuropsychologist. - : Informa UK Limited. - 1385-4046 .- 1744-4144. ; 34:suppl. 1, s. 110-126
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Tidskriftsartikel (refereegranskat)abstract
- Objective The trail making test (TMT) is one of the most widely used neuropsychological tests. TMT-A provides measures of visual scanning/visuomotor speed and TMT-B involves additional demands on executive functions. Derived scores TMT B-A and TMT B/A enhance measures of executive functioning. However, simple B-A subtraction may lead to false estimates of executive dysfunction in clinical samples. Norms for TMT have been published in several countries but are currently lacking for Scandinavia. Methods A total of 292 healthy controls between age 41 and 84 years were included from the Norwegian "Dementia Disease Initiation" (DDI) study (n = 170) and the Gothenburg Mild Cognitive Impairment (MCI) study (n = 122). We used a regression-based procedure to develop demographically adjusted norms for basic (TMT-A and TMT-B) and derived measures (TMT B-A and B/A). We also propose a regression-based alternative to the TMT B-A measure named "TMT-beta". The proposed norms were compared to norms from Heaton et al. and Tombaugh. Results Due to differences in the estimated normative effects of demographics on performance, the proposed norms for TMT were better suited in the Scandinavian sample compared with published non-Scandinavian norms. The proposed TMT-beta measure was highly correlated to TMT B-A (r = 0.969,p < 0.001). Conclusion We here propose demographically adjusted norms for the TMT for ages 41 through 84 years based on a Scandinavian sample. We also present the regression-based derived measure TMT-beta which may resolve issues with the conventional TMT B-A measure.
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| 21. |
- Espenes, J., et al.
(författare)
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Regression-based normative data for the Rey Auditory Verbal Learning Test in Norwegian and Swedish adults aged 49-79 and comparison with published norms
- 2023
-
Ingår i: Clinical Neuropsychologist. - : Informa UK Limited. - 1385-4046 .- 1744-4144. ; 37:6, s. 1276-1301
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The Rey Auditory Verbal Learning Test (RAVLT) is a widely used measure of episodic verbal memory. To our knowledge, culturally adapted and demographically adjusted norms for the RAVLT are currently not available for Norwegian and Swedish adults, and imported North American norms are often used. We here develop regression-based norms for Norwegian and Swedish adults and compare our norms to North American norms in an independent sample of cognitively healthy adults. Method: Participants were 244 healthy adults from Norway and Sweden between the aged 49 and 79 years, with between 6 and 24 years of education. Using a multiple multivariate regression-based norming procedure, we estimated effects of age, sex, and years of education on basic and derived RAVLT test scores. The newly developed norms were assessed in an independent comparison group of cognitively healthy adults (n = 145) and compared to recently published North American regression-based norms. Results: Lower age, female sex and more years of education predicted higher performance on the RAVLT. The new norms adequately adjusted for age, education, and sex in the independent comparison group. The American norms corrected for demographics on all RAVLT trials except trials 4, 7, list B, and trials 1-5 total. Test-retest (M = 2.55 years) reliability varied from poor to good. Conclusion: We propose regression-based norms for the RAVLT adjusting for pertinent demographics. The norms may be used for assessment of Norwegian and Swedish adults between the aged of 49 and 79 years, with between 6 and 24 years of education.
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| 22. |
- Fraser, Kathleen, 1984, et al.
(författare)
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Improving the Sensitivity and Specificity of MCI Screening with Linguistic Information.
- 2018
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Ingår i: Proceedings of the LREC workshop: Resources and ProcessIng of linguistic, para-linguistic and extra-linguistic Data from people with various forms of cognitive/psychiatric impairments (RaPID-2). 8th of May 2018, Miyazaki, Japan / Dimitrios Kokkinakis (ed.). - 9791095546269
-
Konferensbidrag (refereegranskat)abstract
- The Mini-Mental State Exam (MMSE) is a screening tool for cognitive impairment. It has been extensively validated and is widely used, but has been criticized as not being effective in detecting mild cognitive impairment (MCI). In this study, we examine the utility of augmenting MMSE scores with automatically extracted linguistic information from a narrative speech task to better differentiate between individuals with MCI and healthy controls in a Swedish population. We find that with the addition of just four linguistic features, the F score (measuring a trade-off between sensitivity and specificity) is improved from 0.67 to 0.81 in logistic regression classification. These preliminary results suggest that the accuracy of traditional screening tools may be improved through the addition of computerized language analysis.
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| 23. |
- Fraser, Kathleen, 1984, et al.
(författare)
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Predicting MCI Status From Multimodal Language Data Using Cascaded Classifiers
- 2019
-
Ingår i: Frontiers in Aging Neuroscience. - : Frontiers Media SA. - 1663-4365. ; 11:205
-
Tidskriftsartikel (refereegranskat)abstract
- Recent work has indicated the potential utility of automated language analysis for the detection of mild cognitive impairment (MCI). Most studies combining language processing and machine learning for the prediction of MCI focus on a single language task; here, we consider a cascaded approach to combine data from multiple language tasks. A cohort of 26 MCI participants and 29 healthy controls completed three language tasks: picture description, reading silently, and reading aloud. Information from each task is captured through different modes (audio, text, eye-tracking, and comprehension questions). Features are extracted from each mode, and used to train a series of cascaded classifiers which output predictions at the level of features, modes, tasks, and finally at the overall session level. The best classification result is achieved through combining the data at the task level (AUC = 0.88, accuracy = 0.83). This outperforms a classifier trained on neuropsychological test scores (AUC = 0.75, accuracy = 0.65) as well as the "early fusion" approach to multimodal classification (AUC = 0.79, accuracy = 0.70). By combining the predictions from the multimodal language classifier and the neuropsychological classifier, this result can be further improved to AUC = 0.90 and accuracy = 0.84. In a correlation analysis, language classifier predictions are found to be moderately correlated (rho = 0.42) with participant scores on the Rey Auditory Verbal Learning Test (RAVLT). The cascaded approach for multimodal classification improves both system performance and interpretability. This modular architecture can be easily generalized to incorporate different types of classifiers as well as other heterogeneous sources of data (imaging, metabolic, etc.).
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| 24. |
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| 25. |
- Göthlin, Mattias, 1978, et al.
(författare)
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Prognostic Accuracy of Mild Cognitive Impairment Subtypes at Different Cut-Off Levels.
- 2017
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 43:5-6, s. 330-341
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Tidskriftsartikel (refereegranskat)abstract
- The prognostic accuracy of mild cognitive impairment (MCI) in clinical settings is debated, variable across criteria, cut-offs, subtypes, and follow-up time. We aimed to estimate the prognostic accuracy of MCI and the MCI subtypes for dementia using three different cut-off levels.Memory clinic patients were followed for 2 (n = 317, age 63.7 ± 7.8) and 4-6 (n = 168, age 62.6 ± 7.4) years. We used 2.0, 1.5, and 1.0 standard deviations (SD) below the mean of normal controls (n = 120, age 64.1 ± 6.6) to categorize MCI and the MCI subtypes. Prognostic accuracy for dementia syndrome at follow-up was estimated.Amnestic multi-domain MCI (aMCI-md) significantly predicted dementia under all conditions, most markedly when speed/attention, language, or executive function was impaired alongside memory. For aMCI-md, sensitivity increased and specificity decreased when the cut-off was lowered from 2.0 to 1.5 and 1.0 SD. Non-subtyped MCI had a high sensitivity and a low specificity.Our results suggest that aMCI-md is the only viable subtype for predicting dementia for both follow-up times. Lowering the cut-off decreases the positive predictive value and increases the negative predictive value of aMCI-md. The results are important for understanding the clinical prognostic utility of MCI, and MCI as a non-progressive disorder.
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| 26. |
- Janssen, O., et al.
(författare)
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Characteristics of subjective cognitive decline associated with amyloid positivity
- 2022
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Ingår i: Alzheimers & Dementia. - : Wiley. - 1552-5260 .- 1552-5279. ; 18:10, s. 1832-1845
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Tidskriftsartikel (refereegranskat)abstract
- Introduction The evidence for characteristics of persons with subjective cognitive decline (SCD) associated with amyloid positivity is limited. Methods In 1640 persons with SCD from 20 Amyloid Biomarker Study cohort, we investigated the associations of SCD-specific characteristics (informant confirmation, domain-specific complaints, concerns, feelings of worse performance) demographics, setting, apolipoprotein E gene (APOE) epsilon 4 carriership, and neuropsychiatric symptoms with amyloid positivity. Results Between cohorts, amyloid positivity in 70-year-olds varied from 10% to 76%. Only older age, clinical setting, and APOE epsilon 4 carriership showed univariate associations with increased amyloid positivity. After adjusting for these, lower education was also associated with increased amyloid positivity. Only within a research setting, informant-confirmed complaints, memory complaints, attention/concentration complaints, and no depressive symptoms were associated with increased amyloid positivity. Feelings of worse performance were associated with less amyloid positivity at younger ages and more at older ages. Discussion Next to age, setting, and APOE epsilon 4 carriership, SCD-specific characteristics may facilitate the identification of amyloid-positive individuals.
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| 27. |
- Juhlin, F., et al.
(författare)
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Rey auditory verbal learning test in idiopathic normal pressure hydrocephalus and Alzheimer's disease
- 2023
-
Ingår i: Clinical Neuropsychologist. - 1385-4046. ; 38:1, s. 202-18
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aims to evaluate the ability of the Rey Auditory Verbal Learning Test (RAVLT), to separate the early stages of idiopathic normal pressure hydrocephalus (iNPH) from Alzheimer's disease (AD), both in comparison to each other and to healthy individuals (HI). Method: The RAVLT performance regarding learning, recall and recognition, was analyzed in three matched samples comprising 30 HI, 84 participants with AD and 84 with iNPH. The clinical samples were divided into two subgroups based on scores on the MMSE, High performers (27-30 points, n = 30) and Medium performers (18-26 points, n = 54). Results: Memory performance was significantly impaired in both clinical samples relative to HI, even in the comparisons with the subgroups consisting of only High-MMSE performers. Despite similar results on measures capturing learning, the iNPH patients outperformed AD patients on measures of recall and recognition. Conclusions: Learning impairment occurs early in iNPH and AD alike, when MMSE performance is still within normal limits. RAVLT measures of delayed recall and recognition are less affected in iNPH than in AD and may serve as differential diagnostic neuropsychological markers.
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| 28. |
- Kokkinakis, Dimitrios, 1965, et al.
(författare)
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A Multifaceted Corpus for the Study of Cognitive Decline in a Swedish Population
- 2019
-
Ingår i: CLARe4 : Corpora for Language and Aging Research, 27 February – 1 March 2019, Helsinki, Finland.
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- A potential, early-stage diagnostic marker for neurodegenerative diseases, such as Alzheimer’s disease, is the onset of language disturbances which is often characterized by subtle word-finding difficulties, impaired spontaneous speech, slight speech hesitancy, object naming difficulties and phonemic errors. Connected speech provides valuable information in a non-invasive and easy-to-assess way for determining aspects of the severity of language impairment. Data elicitation is an established method of obtaining highly constrained samples of connected speech that allows us to study the intricate interactions between various linguistic levels and cognition. In the paper, we describe the collection and content of a corpus consisting of spontaneous Swedish speech from individuals with Mild Cognitive Impairment (MCI), with Subjective Cognitive Impairment SCI) and healthy, age-matched controls (HC). The subjects were pooled across homogeneous subgroups for age and education, a sub-cohort from the Gothenburg-MCI study. The corpus consists of high quality audio recordings (including transcriptions) of several tasks, namely: (i)a picture description task – the Cookie-theft picture, an ecologically valid approximation to spontaneous discourse that has been widely used to elicitate speech from speakers with different types of language and communication disorders; (ii)a read aloud task (including registration of eye movements) – where participants read a text from the IREST collection twice, both on a computer screen (while eye movements are registered), and the same text on paper; (iii)a complex planning task – a subset of executive functioning that tests the ability to identify, organize and carry out (complex) steps and elements that are required to achieve a goal; (iv)a map task – a spontaneous speech production/semi-structured conversation in which the participants are encouraged to talk about a predefined, cooperative task-oriented topic; (v)a semantic verbal fluency task – category animals: where participants have to produce as many words as possible from a category in a given time (60 seconds). The fluency tests require an elaborate retrieval of words from conceptual (semantic) and lexical (phonetic) memory involving specific areas of the brain in a restricted timeframe. All samples are produced by Swedish speakers after obtaining written consent approved by the local ethics committee. Tasks (i) and (ii) have been collected twice in a diachronically apart period of 18 months between 2016 and 2018. The corpus represents an approximation to speech in a natural setting: The material for elicitation is controlled in the sense that the speakers are given specific tasks to talk about, and they do so in front of a microphone. The corpus may serve as a basis for many linguistic and/or speech technological investigations and has being already used for various investigations of language features.
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| 29. |
- Kokkinakis, Dimitrios, 1965, et al.
(författare)
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Kan textforskning bidra till tidigare och säkrare demensdiagnostik?
- 2018
-
Ingår i: Forum för textforskning 13 , Lund 7 – 8 juni 2018.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Tidigare forskning har visat att subtila språkstörningar kan finnas vid de tidigaste förstadierna till demens, flera år innan en klinisk diagnos kan ställas. Inom ramen för projektet ”Språkliga och extra-lingvistiska parametrar för tidig upptäckt av kognitiv svikt” (finansierat av Riksbankens Jubileumsutlysning, 2016-19) undersöker vi med hjälp av språkteknologi och språkanalysstudier hur dessa språkstörningar yttrar sig. Kan språkteknologi användas för att upptäcka dessa tidiga språkrelaterade symtom och därmed bidra med nyanserad, komplementär och användbar kunskap? Kan användning av språkteknologi särskilja personer med de allra tidigaste kognitiva avvikelserna från personer med mer godartad, åldersrelaterad kognitiv svikt? Vilka språkliga förmågor drabbas? Hur yttrar sig dessa förändringar och vilka slags empiriska material finns att tillgå? Dessa är några av de frågor vi söker svar på. Vi gör inspelningar som vi analyserar för att kunna ta fram ny kunskap om subtila språkliga kännetecken som kan föregå demensutveckling. Denna kunskap kan användas för att eventuellt kunna förutsäga vilka individer som befinner sig i riskzonen för att utveckla demens, och kan vara användbar som komplementerande beslutsunderlag till domänexperter. Vi utvinner, analyserar och undersöker om det finns samband mellan olika språkrelaterade parametrar från spontan talinteraktion, transkriptioner men även ögonrörelser och neuropsykologiska tester från personer med subjektiv eller lindrig kognitiv nedsättning och friska kontrollpersoner. Många gånger är det svårt att avgöra huruvida lindriga kognitiva symtom är en del av det normala åldrandet eller början på en neurodegenerativ process. Vi förväntar oss inte heller att varje enskild person med kognitiv nedsättning kommer att uttrycka sig eller läsa på samma sätt utan snarare att dessa personer tidigt i sjukdomsförloppet kommer att börja uppvisa olika slags avvikande läsmönster, eller göra fonologiska, lexikala, syntaktiska eller semantiska fel. I studien utvecklar vi verktyg för att automatiskt hitta dessa avvikelser, och målet är att detta sedan ska kunna användas som komplement till tidig diagnostik samt som prognostiskt eller screeningverktyg. Deltagarna i vår studie har rekryterats från en pågående longitudinell studie, ”Demens i Tidigt Skede”, (eng. ”The Gothenburg MCI study”) på Minnesmottagningen i Göteborg, och vårt projekt har godkänts av den lokala etiknämnden. Alla deltagare i studien (kontrollgruppen [HC], personer med subjektiv kognitiv nedsättning [SCI] och personer med mild kognitiv nedsättning [MCI]) har genomgått baslinjeundersökning och gett informerat skriftligt samtycke (demografisk information finns i tabell 1). Vårt projekt är f.n. pågående och vi kommer presentera resultat baserade på inspelningstillfälle nr ett (aug. 2016-mars 2017). En ny inspelningsomgång, med samma deltagare, började i februari 2018 och förväntas vara avslutat i december 2018. Under presentationen kommer vi ge exempel på olika tal-, text- och ögonrörelseanalyser vi har genomfört och diskutera metodval och resultat baserade på studiens första fas. Vi kommer vidare ge en kort inblick i den nya, pågående inspelningsomgången och de nya testmoment vi använder. Vi vill med vårt arbete visa hur språkteknologisk analys kan bidra till att utöka vår kunskap inom området så att den kan vara användbar för tidig diagnostik och optimal omvårdnad. Enligt Socialstyrelsen (2017) finns det i Sverige över 160 000 personer med någon demenssjukdom. Våra resultat kan ha en betydelse för vårdpersonal som snabbare vill diagnostisera och identifiera individer med olika former av kognitiv funktionsnedsättning innan allvarliga symtom blir påtagliga. Utvecklingsmöjligheterna är många: nya eller förbättrade kognitiva screeningtester som skulle kunna användas inom primär- och specialistvården, samt utveckling och tillämpning av insatser som kan påverka beteendemönster och träna upp individens kommunikativa förmåga, kan på sikt leda till positiva konsekvenser som minskade vårdköer samt effektivare behandling avseende kostnader och behandlingsutfall.
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| 30. |
- Lindkvist, Rose-Marie, et al.
(författare)
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Brief admission by self-referral for individuals with self-harm and suicidal ideation : a qualitative study based on focus groups exploring relatives' experiences
- 2024
-
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - 1748-2631. ; 19:1
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Brief Admission by self-referral (BA) is a standardized crisis-management intervention for individuals with self-harm and risk for suicide. This study explored relatives' experiences of BA. Relatives' perspectives may contribute to an increased understanding of the effects of BA given the relatives' role as support and informal caregivers as well as being co-sufferers.METHODS: Fourteen relatives to adults with access to BA within one Swedish region participated in focus groups analysed with reflexive thematic analysis.RESULTS: We generated themes evolving around three meaning-based concepts: access (A low threshold to a safe back-up is crucial and obstacles may easily break faith), independence (Trust in their ability with care and respect), and recovery (The rest and relational recovery we all get are needed and invaluable).CONCLUSIONS: BA brings considerable value to users and relatives, by supporting them to take care of themselves and each other. Communication and involvement of relatives may enhance users' ability to overcome obstacles to accessing BA. Implementation and adherence may be strengthened by supervision of BA staff and education of emergency care staff. Resources are needed to improve access. Mapping hurdles to BA, support through peers and targeted psychoeducation may improve recovery for BA users and their relatives.
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| 31. |
- Linz, Nicklas, et al.
(författare)
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Temporal Analysis of Semantic Verbal Fluency Tasks in Persons with Subjective and Mild Cognitive Impairment.
- 2019
-
Ingår i: Sixth Workshop on Computational Linguistics and Clinical Psychology: Reconciling Outcomes. Minneapolis, Minnesota, USA, June 6, 2019 / Kate Niederhoffer, Kristy Hollingshead, Philip Resnik, Rebecca Resnik, Kate Loveys (Editors). - Stroudsburg, PA : Association for Computational Linguistics. - 9781948087957
-
Konferensbidrag (refereegranskat)abstract
- The Semantic Verbal Fluency (SVF) task is a classical neuropsychological assessment where persons are asked to produce words belonging to a semantic category (e.g., animals) in a given time. This paper introduces a novel method of temporal analysis for SVF tasks utilizing time intervals and applies it to a corpus of elderly Swedish subjects (mild cognitive impairment, subjective cognitive impairment and healthy controls). A general decline in word count and lexical frequency over the course of the task is revealed, as well as an increase in word transition times. Persons with subjective cognitive impairment had a higher word count during the last intervals, but produced words of the same lexical frequencies. Persons with MCI had a steeper decline in both word count and lexical frequencies during the third interval. Additional correlations with neuropsychological scores suggest these findings are linked to a person’s overall vocabulary size and processing speed, respectively. Classification results improved when adding the novel features (AUC = 0.72), supporting their diagnostic value.
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| 32. |
-
Proceedings of the LREC 2020. Workshop on: Resources and Processing of Linguistic, Para-linguistic and Extra-linguistic Data from People with Various Forms of Cognitive/Psychiatric/Developmental Impairments (RaPID-3), May 11-16, 2020, Marseille, France
- 2020
-
Proceedings (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- RaPID-3 aims to be an interdisciplinary forum for researchers to share information, findings, methods, models and experience on the collection and processing of data produced by people with various forms of mental, cognitive, neuropsychiatric, or neurodegenerative impairments, such as aphasia, dementia, autism, bipolar disorder, Parkinson’s disease or schizophrenia. Particularly, the workshop’s focus is on creation, processing and application of data resources from individuals at various stages of these impairments and with varying degrees of severity. Creation of resources includes e.g. annotation, description, analysis and interpretation of linguistic, paralinguistic and extra-linguistic data (such as spontaneous spoken language, transcripts, eyetracking measurements, wearable and sensor data, etc). Processing is done to identify, extract, correlate, evaluate and disseminate various linguistic or multimodal phenotypes and measurements, which then can be applied to aid diagnosis, monitor the progression or predict individuals at risk. A central aim is to facilitate the study of the relationships among various levels of linguistic, paralinguistic and extra-linguistic observations (e.g., acoustic measures; phonological, syntactic and semantic features; eye tracking measurements; sensors, signs and multimodal signals). Submission of papers are invited in all of the aforementioned areas, particularly emphasizing multidisciplinary aspects of processing such data and the interplay between clinical/nursing/medical sciences, language technology, computational linguistics, natural language processing (NLP) and computer science. The workshop will act as a stimulus for the discussion of several ongoing research questions driving current and future research by bringing together researchers from various research communities.
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| 33. |
- Rolstad, Sindre, 1976, et al.
(författare)
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Biomarkers in relation to cognitive reserve in patients with mild cognitive impairment--proof of concept.
- 2009
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 27:2, s. 194-200
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The concept of the cognitive reserve (CR) posits that factors such as education enable compensation for the effect of brain pathology. Consequently, pathology should be more pronounced in individuals with higher CR before becoming clinically apparent. Biomarkers such as total tau (t-tau) and beta-amyloid 42 (Abeta42) may be surrogates for pathology in relation to CR in patients with neurodegenerative disease. OBJECTIVE: To examine the applicability of biomarkers as surrogates for pathology in relation to the CR in patients with mild cognitive impairment (MCI) either converting to dementia or remaining stable at follow-up. METHOD: Comparisons of baseline t-tau, Abeta42, educational years and global cognition for MCI patients either converting to dementia (n = 57) or remaining stable (n = 91) were made. Patients converting to dementia were grouped on the basis of educational level and compared considering biomarkers and neuropsychological tests. RESULTS: Stable MCI patients were better educated, performed better cognitively, had higher Abeta42 levels and lower levels of t-tau. Converting MCI patients with higher education had lower levels of Abeta42 and performed equally in neuropsychological tests compared to those with lower education. CONCLUSION: Our results suggest that highly educated MCI patients subsequently converting to dementia display more amyloid pathology.
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| 34. |
- Rolstad, Sindre, 1976, et al.
(författare)
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Cognitive reserve in relation to abeta42 in patients converting from MCI to dementia - a follow-up report.
- 2009
-
Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 28:2, s. 110-5
-
Tidskriftsartikel (refereegranskat)abstract
- The concept of the cognitive reserve (CR) hypothesizes that premorbid factors such as education enable compensation for the manifestation of brain pathology. Accordingly, pathology should be more prominent in individuals with higher CR before becoming clinically apparent. Previously, we found that patients subsequently converting to dementia with higher CR had lower concentrations of amyloid beta 42 (abeta42) as compared to patients with lower CR. However, the interaction between time, biomarkers, neuropsychological performance and CR is yet to be established. OBJECTIVE: To study the relation between biomarkers, neuropsychological performance and CR longitudinally. METHOD: A mixed between-within subject analysis of variance was performed for longitudinal analysis. Paired t tests were used for within group comparisons. RESULTS: Patients with higher CR (n = 15) had significantly lower concentrations of abeta42 at both time points compared to those with medium (n = 23) and lower CR (n = 28). Also, abeta42 concentrations decreased significantly from baseline to follow-up in patients with higher and medium CR. Groups performed comparably on neuropsychological tests. CONCLUSION: This study provides further support for the applicability of abeta42 as a substitute for pathology in relation to CR. Also, abeta42 reflects the disease progression in patients with higher and medium CR.
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| 35. |
- Rolstad, Sindre, 1976, et al.
(författare)
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High Education May Offer Protection Against Tauopathy in Patients with Mild Cognitive Impairment.
- 2010
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Ingår i: Journal of Alzheimer's disease : JAD. - 1875-8908. ; 21:1, s. 221-8
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Tidskriftsartikel (refereegranskat)abstract
- The concepts of brain and cognitive reserve stem from the observation that premorbid factors (e.g., education) result in variation in the response to brain pathology. Potential early influence of reserve on pathology, as assessed using the cerebrospinal fluid biomarkers total tau and amyloid-beta{42}, and cognition was explored in mild cognitive impairment (MCI) patients who remained stable over a two-year period. A total of 102 patients with stable MCI grouped on the basis of educational level were compared with regard to biomarker concentrations and cognitive performance. Stable MCI patients with higher education had lower concentrations of t-tau as compared to those with lower education. Also, educational level predicted a significant proportion of the total variance in t-tau concentrations. Our results suggest that higher education may offer protection against tauopathy.
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| 36. |
- Rolstad, Sindre, 1976, et al.
(författare)
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The Swedish National Adult Reading Test (NART-SWE): a test of premorbid IQ.
- 2008
-
Ingår i: Scandinavian journal of psychology. - : Wiley. - 0036-5564 .- 1467-9450. ; 49:6, s. 577-82
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to construct a Swedish version of the National Adult Reading Test (NART-SWE), a test for assessment of premorbid IQ, and to investigate its validity and reliability on healthy controls and patients with mild Alzheimer's disease. As Swedish pronunciation rules are fixed, NART-SWE was constructed using loan words. NART-SWE has satisfactory psychometric properties: Inter-rater and retest reliability as well as internal consistency are very high. The NART-SWE demonstrates face validity. In addition, high correlation with IQ was obtained. A significant model emerged when using NART-SWE to predict IQ. Furthermore, no significant differences were observed when comparing performance for healthy controls' with that of patients with Alzheimer's disease on NART-SWE. It does appear that reading of irregular words is intact in mild Alzheimer's disease.
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| 37. |
- Sacuiu, Simona, 1971, et al.
(författare)
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Increased risk of dementia in subjective cognitive decline if CT brain changes are present
- 2018
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Ingår i: Journal of Alzheimer's Disease. - 1387-2877. ; 66:2, s. 483-495
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Tidskriftsartikel (refereegranskat)abstract
- Background: Subjective cognitive decline (SCD) has low predictive value for incident dementia. Objectives: We examined whether CT detectable brain changes add predictive value to SCD in a population sample with high scores on the Mini-Mental State Examination. Methods: Subjective reports of memory and executive function were gathered in a non-demented population sample ≥70 years (n=921). CT-brain was performed at baseline (n=626). Brain atrophy, infarcts, and white matter lesions (WMLs) were classified using visual ratings. Dementia incidence was evaluated periodically during 12 years. Results: The prevalence of SCD was 32.5% among individuals without dementia. During follow-up, 151 individuals (16.4%) developed dementia. The risk of dementia was increased in SCD, and increased further with WMLs and cortical atrophy present. However, the positive predictive values for incident dementia were low, 25% in SCD and 41% in SCD with WMLs and cortical atrophy. Conclusion: Our observations add clinical value to the use of SCD and CT to select relevant populations for interventions against dementia, but more stringent screening methods are necessary to reach individuals at risk. © 2018 - IOS Press and the authors. All rights reserved.
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| 38. |
- Themistocleous, Charalambos, 1980, et al.
(författare)
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Automated speech analysis improves MCI diagnosis
- 2020
-
Ingår i: Proceedings of the 11th Experimental Linguistics Conference (ExLing). - 2529-1092.
-
Konferensbidrag (refereegranskat)abstract
- Mild Cognitive Impairment (MCI) is a condition characterized by cognitive decline greater than expected for an individual's age and education level. In this study, we are investigating whether acoustic properties of speech production can improve the classification of individuals with MCI from healthy controls augmenting the Mini Mental State Examination, a traditional screening tool, with automatically extracted acoustic information. We found that just one acoustic feature, can improve the AUC score (measuring a trade-off between sensitivity and specificity) from 0.77 to 0.89 in a boosting classification task. These preliminary results suggest that computerized language analysis can improve the accuracy of traditional screening tools
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| 39. |
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| 40. |
- Themistocleous, Charalambos, 1980, et al.
(författare)
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Effects of Mild Cognitive Impairment on vowel duration
- 2018
-
Ingår i: Proceedings of the 9th Tutorial & Research Workshop on Experimental Linguistics, 28 - 30 August 2018, Paris, France / edited by Antonis Botinis. - 2529-1092. - 9789604661626
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Konferensbidrag (refereegranskat)abstract
- Mild cognitive impairment (MCI) is a neurological condition, which is characterized by a noticeable decline of cognitive abilities, including communicative and linguistic skills. In this study, we have measured the duration of vowels produced in a reading task by 55 speakers— 30 healthy controls and 25 MCI—. The main results showed that MCI speakers differed significantly from HC in vowel duration as MCI speakers produced overall longer vowels. Also, we found that gender effects on vowel duration were different in MCI and HC. One significant aspect of this finding is that they highlight the contribution of vowel acoustic features as markers of MCI.
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| 41. |
- Themistocleous, Charalambos, 1980, et al.
(författare)
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Identification of Mild Cognitive Impairment From Speech in Swedish Using Deep Sequential Neural Networks
- 2018
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Ingår i: Frontiers in Neurology. - : Frontiers Media SA. - 1664-2295. ; 9, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- While people with mild cognitive impairment (MCI) portray noticeably incipient memory difficulty in remembering events and situations along with problems in decision making, planning, and finding their way in familiar environments, detailed neuropsychological assessments also indicate deficits in language performance. To this day, there is no cure for dementia but early-stage treatment can delay the progression of MCI; thus, the development of valid tools for identifying early cognitive changes is of great importance. In this study, we provide an automated machine learning method, using Deep Neural Network Architectures, that aims to identify MCI. Speech materials were obtained using a reading task during evaluation sessions, as part of the Gothenburg MCI research study. Measures of vowel duration, vowel formants (F1 to F5), and fundamental frequency were calculated from speech signals. To learn the acoustic characteristics associated with MCI vs. healthy controls, we have trained and evaluated ten Deep Neural Network Architectures and measured how accurately they can diagnose participants that are unknown to the model. We evaluated the models using two evaluation tasks: a 5-fold crossvalidation and by splitting the data into 90% training and 10% evaluation set. The findings suggest first, that the acoustic features provide significant information for the identification of MCI; second, the best Deep Neural Network Architectures can classify MCI and healthy controls with high classification accuracy (M = 83%); and third, the model has the potential to offer higher accuracy than 84% if trained with more data (cf., SD≈15%). The Deep Neural Network Architecture proposed here constitutes a method that contributes to the early diagnosis of cognitive decline, quantify the progression of the condition, and enable suitable therapeutics.
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| 42. |
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| 43. |
- Themistocleous, Charalambos, et al.
(författare)
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Voice quality and speech fluency distinguish individuals with Mild Cognitive Impairment from Healthy Controls
- 2020
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Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 15:7
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Tidskriftsartikel (refereegranskat)abstract
- Mild Cognitive Impairment (MCI) is a syndrome characterized by cognitive decline greater than expected for an individual's age and education level. This study aims to determine whether voice quality and speech fluency distinguish patients with MCI from healthy individuals to improve diagnosis of patients with MCI. We analyzed recordings of the Cookie Theft picture description task produced by 26 patients with MCI and 29 healthy controls from Sweden and calculated measures of voice quality and speech fluency. The results show that patients with MCI differ significantly from HC with respect to acoustic aspects of voice quality, namely H1-A3, cepstral peak prominence, center of gravity, and shimmer; and speech fluency, namely articulation rate and averaged speaking time. The method proposed along with the obtainability of connected speech productions can enable quick and easy analysis of speech fluency and voice quality, providing accessible and objective diagnostic markers of patients with MCI.
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| 44. |
- Waggestad, T. H., et al.
(författare)
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Improving validity of the trail making test with alphabet support
- 2023
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Ingår i: Frontiers in Psychology. - 1664-1078. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveThe Trail Making Test (TMT) is commonly used worldwide to evaluate cognitive decline and car driving ability. However, it has received critique for its dependence on the Latin alphabet and thus, the risk of misclassifying some participants. Alphabet support potentially increases test validity by avoiding misclassification of executive dysfunction in participants with dyslexia and those with insufficient automatization of the Latin alphabet. However, Alphabet support might render the test less sensitive to set-shifting, thus compromising the validity of the test. This study compares two versions of the TMT: with and without alphabet support. MethodsWe compared the TMT-A, TMT-B, and TMT-B:A ratios in two independent normative samples with (n = 220) and without (n = 64) alphabet support using multiple regression analysis adjusted for age and education. The sample comprised Scandinavians aged 70-84 years. Alphabet support was included by adding the Latin alphabet A-L on top of the page on the TMT-B. We hypothesized that alphabet support would not change the TMT-B:A ratio. ResultsAfter adjusting for age and years of education, there were no significant differences between the two samples in the TMT-A, TMT-B, or the ratio score (TMT-B:A). ConclusionOur results suggest that the inclusion of alphabet support does not alter TMT's ability to measure set-shifting in a sample of older Scandinavian adults.
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| 45. |
- Wallin, Anders, 1950, et al.
(författare)
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Cognitive medicine - a new approach in health care science.
- 2018
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Ingår i: BMC psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- The challenges of today's society call for more knowledge about how to maintain all aspects of cognitive health, such as speed/attention, memory/learning, visuospatial ability, language, executive capacity and social cognition during the life course.Medical advances have improved treatments of numerous diseases, but the cognitive implications have not been sufficiently addressed. Disability induced by cognitive dysfunction is also a major issue in groups of patients not suffering from Alzheimer's disease or related disorders. Recent studies indicate that several negative lifestyle factors can contribute to the development of cognitive impairment, but intervention and prevention strategies have not been implemented. Disability due to cognitive failure among the workforce has become a major challenge. Globally, the changing aging pyramid results in increased prevalence of cognitive disorders, and the diversity of cultures influences the expression, manifestation and consequences of cognitive dysfunction.Major tasks in the field of cognitive medicine are basic neuroscience research to uncover diverse disease mechanisms, determinations of the prevalence of cognitive dysfunction, health-economical evaluations, and intervention studies. Raising awareness for cognitive medicine as a clinical topic would also highlight the importance of specialized health care units for an integrative approach to the treatment of cognitive dysfunctions.
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| 46. |
- Wallin, Anders, 1950, et al.
(författare)
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Progression from mild to pronounced MCI is not associated with cerebrospinal fluid biomarker deviations.
- 2011
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Ingår i: Dementia and geriatric cognitive disorders. - : S. Karger AG. - 1421-9824 .- 1420-8008. ; 32:3, s. 193-7
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aim: Detection of cerebrospinal fluid (CSF) biomarker deviations improve prediction of progression from mild cognitive impairment (MCI) to dementia. However, it is not settled whether the same pattern exists in patients progressing from very mild to more pronounced MCI. Given that neurodegenerative processes occur very early in the disease course, we also expected to find biomarker deviations in these patients. Methods: A total of 246 memory clinic patients with non-progressive (n = 161), progressive (n = 19), or converting (n = 66) MCI, 67 with stable dementia, and 80 controls were followed for 24 months. At baseline, CSF total tau (T-tau), β-amyloid 1–42 (Aβ42) and the light subunit of neurofilament protein (NFL) were determined. Results: Patients with converting MCI and stable dementia had lower CSF Aβ42 concentrations and higher T-tau concentrations and NFL in comparison with controls and non-progressive/progressive MCI (p < 0.0005). No differences were found between progressive and non-progressive MCI. Conclusion: As expected, biomarker deviations predicted progression from MCI to dementia. Contrary to our hypothesis, progression from very mild MCI to more pronounced MCI was not reflected by biomarker deviations. The results suggest that the measured biomarkers are not early disease markers, or alternatively Alzheimer or vascular pathology is not the underlying cause in this patient group.
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| 47. |
- Öhman, Fredrik, et al.
(författare)
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Demographically adjusted Rey-Osterrieth Complex Figure Test norms in a Swedish and Norwegian cohort aged 49-77years and comparison with North American norms.
- 2024
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Ingår i: Scandinavian journal of psychology. - 1467-9450. ; 65:2, s. 168-178
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Tidskriftsartikel (refereegranskat)abstract
- The Rey-Osterrieth Complex Figure Test (RCFT) is one of the most commonly used neuropsychological tests in Sweden and Norway. However, no publications provide normative data for this population. The objective of this study was to present demographically adjusted norms for a Swedish and Norwegian population and to evaluate these in an independent comparison group.The RCFT was administrated to 344 healthy controls recruited from the Swedish Gothenburg MCI study, the Norwegian Dementia Disease Initiation study, and the Swedish Cardiopulmonary Bioimage Study. Age ranged from 49 to 77years (mean=62.4years, SD=5.0years), and education ranged from 6 to 24years (mean=13.3years, SD=3.0years). Using a regression-based procedure, we investigated the effects of age, sex, and years of education on test performance. We compared and evaluated our Swedish and Norwegian norms with North American norms in an independent comparison group of 145 individuals.In healthy controls, age and education were associated with performance on the RCFT. When comparing normative RCFT performance in an independent comparison group, North American norms generally overestimated immediate and delayed recall performance. In contrast, our Swedish and Norwegian norms appear to better take into account factors of age and education.We presented demographically adjusted norms for the RCFT in a Swedish and Norwegian sample. This is the first normative study of the RCFT that presents normative data for this population. In addition, we showed that North American norms might produce inaccurate normative estimations in an independent comparison group.
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