Search Results (109)

Background/Objectives: Fibromyalgia syndrome (FMS) is a chronic pain condition in which executive function (EF) alterations have been reported, though strikingly, relationships between simple executive functions (EFs) (updating, inhibition, and mental flexibility) and high-order ones, such as planning and problem-solving, have not been addressed yet in this population. This research aimed to firstly explore how low-level EFs play a role in planning and problem-solving performances. Methods: Thirty FMS patients and thirty healthy participants completed a series of neuropsychological tests evaluating low- and high-order EFs. Clinical and emotional symptoms were assessed with self-report questionnaires, while pain and fatigue levels were measured with numerical scales. Importantly, specific drug restrictions were accounted for. Results: Patients scored lower in most neurocognitive tests, with statistical significance noted only for visuospatial working memory (WM) and two planning and problem-solving tests. Pain, fatigue, and sleep disturbances showed important effects on most of the cognitive outcomes. Multiple regression analyses reflected that planning and problem-solving were successfully and partially predicted by updating, inhibition, and mental flexibility (though differences emerged between tasks). Conclusions: Our study confirms the presence of cognitive impairments in FMS, especially in high-order EFs, supporting patients’ complaints. Clinical symptoms play a role in FMS dyscognition but do not explain it completely. For the first time, as far as the authors know, simple EF influences on planning and problem-solving tests have been described for FMS patients. These results might help in unraveling the dysexecutive profile in FMS to design more adjusted treatment options. Full article

Background: In light of increasing breast cancer survival rates, it is essential to address cancer-related cognitive impairment (CRCI), a common yet often underestimated symptom. Methods: A randomised controlled trial is proposed involving 50 newly diagnosed participants, divided into a control group (CG) and an intervention group (IG). Both groups will receive an educational leaflet, while the IG will also take part in an individualised cognitive training programme based on everyday cognition (80 sessions distributed across four periods, compiled in a training dossier). Cognitive, emotional, and functional variables will be assessed before and after the intervention: cognitive function (MoCA test), everyday cognition (PECC), anxiety (Hamilton), functionality (LB), sleep quality (PSQI), quality of life (ECOG), and subjective memory complaints (FACT-COG). Expected results: Findings may guide future interventions and tailored protocols to alleviate CRCI in breast cancer patients undergoing active treatment. Ethics and dissemination: This study was approved by the Ethics Committee of the University of Salamanca (PI 2023 12 1478-TD). Full article

Over the past three turbulent decades, research has profoundly reshaped our understanding of chronic Toxoplasma gondii infection—traditionally regarded as harmless in immunocompetent individuals—unveiling its surprising impact on human health, performance, and behavior. This review emphasizes the effects of chronic Toxoplasma infection on physical and mental health, cognitive performance, and behavioral changes, highlighting key findings from studies investigating these domains, with a particular focus on both ultimate and proximate mechanisms underlying the observed effects. To this end, the primary focus will be on human studies; however, animal model studies will also be thoroughly considered when necessary and appropriate, to provide context and additional important information. Research demonstrates that chronic Toxoplasma infection may contribute to a broad spectrum of physical health issues. Ecological studies have revealed correlations between toxoplasmosis prevalence and increased morbidity and mortality from various conditions, including cardiovascular diseases, neurological disorders, and certain cancers. Large-scale cross-sectional studies have further shown that infected individuals report a higher incidence of numerous health complaints and diagnosed diseases, suggesting a significant impact on overall physical well-being. In addition to physical health, lifelong Toxoplasma infection (subclinical toxoplasmosis) has been implicated in cognitive impairments and behavioral changes. Studies have reported associations between infection and poorer performance in areas such as reaction time, processing speed, working memory, and executive function. Many of these behavioral changes likely relate to worsened health and a shift towards a “fast life history strategy.” These cognitive deficits can have significant implications for daily functioning and performance. Furthermore, the role of Toxoplasma infection in the development or exacerbation of mental health disorders has been extensively investigated. Meta-analyses, ecological studies, and large-scale observational studies have demonstrated associations between Toxoplasma infection and an increased risk of disorders such as schizophrenia and obsessive–compulsive disorder. While the precise mechanisms underlying these associations remain under investigation, research suggests that neuroinflammation and alterations in neurotransmitter systems are likely to play a role. Far from being harmless, subclinical toxoplasmosis is increasingly recognized as a hidden factor influencing human health, behavior, and cognitive performance—with implications that extend well beyond the individual to public health at large. Further research is warranted to elucidate the complex interplay between Toxoplasma infection, host physiology, and the development of various physical, cognitive, behavioral, and mental health conditions. Full article

Background and Objectives: Early detection of cognitive decline (CD) is crucial for managing dementia risk factors and preventing disease progression. This study pursues two main objectives: (1) to review existing cognitive screening practices implemented in community pharmacy settings and (2) to characterize the cognitive profile of individuals eligible for screening in this context. Materials and Methods: This study was conducted in two phases. First, a scoping review of cognitive screening tools used in community pharmacies was carried out following PRISMA-ScR guidelines. Second, a cross-sectional study was performed to design and implement a CD screening protocol, assessing cognitive function. Data collection included demographic and clinical variables commonly associated with dementia risk. Decision tree analysis was applied to identify key variables contributing to the cognitive profile of patients eligible for screening. Results: The scoping review revealed that screening approaches differed by country and population, with limited pharmacy involvement suggesting implementation barriers. Cognitive screening was conducted in 18 pharmacies in Valencia, Spain (1.45%), involving 286 regular users reporting Subjective Memory Complaints (SMC). The average age of participants was 71 years, and 74.8% were women. According to the unbiased Gini impurity index, the most relevant predictors of CD—based on the corrected mean decrease in corrected impurity (MDcI), a bias-adjusted measure of variable importance—were age (MDcI: 2.60), internet and social media use (MDcI: 2.43), sleep patterns (MDcI: 1.83), and educational attainment (MDcI: 0.96). Simple decision trees can reduce the need for full screening by 53.6% while maintaining an average sensitivity of 0.707. These factors are essential for defining the profile of individuals who would benefit most from CD screening services. Conclusions: Community pharmacy-based detection of CD shows potential, though its implementation remains limited by issues of consistency and feasibility. Enhancing early dementia detection in primary care settings may be achieved by prioritizing individuals with limited internet and social media use, irregular sleep patterns, and lower education levels. Targeting these groups could significantly improve the effectiveness of CD screening programs. Full article

Background: Since the pathophysiology of long COVID is not yet fully understood, there are no specific methods for its treatment; however, its individual symptoms can currently be treated. Long COVID is characterized by symptoms that persist at least 2 to 3 months after contracting COVID-19, although it is difficult to predict how long such symptoms may persist. Methods: In the present study, 774 patients who first visited our outpatient clinic during the Omicron period from February 2022 to October 2024 were divided into two groups: the early recovery (ER) group (370 cases; 47.8%), who recovered in less than 180 days (median 33 days), and the persistent-symptom (PS) group (404 cases; 52.2%), who had symptoms that persisted for more than 180 days (median 437 days). The differences in clinical characteristics between these two groups were evaluated. Results: Although the median age of the two groups did not significantly differ (40 and 42 in ER and PS groups, respectively), the ratio of female patients was significantly higher in the PS group than the ER group (59.4% vs. 47.3%). There were no significant differences between the two groups in terms of the period after infection, habits, BMI, severity of COVID-19, and vaccination history. Notably, at the first visit, female patients in the PS group had a significantly higher rate of complaints of fatigue, insomnia, memory disturbance, and paresthesia, while male patients in the PS group showed significantly higher rates of fatigue and headache complaints. Patients with more than three symptoms at the first visit were predominant in the PS groups in both genders. Notably, one to two symptoms were predominant in the male ER group, while two to three symptoms were mostly reported in the female PS group. Moreover, the patients in the PS group had significantly higher scores for physical and mental fatigue and for depressive symptoms. Conclusions: Collectively, these results suggest that long-lasting long COVID is related to the number of symptoms and presents gender-dependent differences. Full article

Ergothioneine is a diet-derived antioxidant with emerging evidence of neuroprotective benefits, but no dose-ranging study has evaluated its effects in healthy older adults. In this 16-week randomized, double-blind, placebo-controlled trial, 147 adults aged 55–79 with subjective memory complaints received ergothioneine (10 mg or 25 mg/day ErgoActive^®) or placebo. The primary outcome was the change in composite memory (CNS Vital Signs). Secondary outcomes included other cognitive domains, subjective memory and sleep quality, and blood biomarkers. At baseline, participants showed slightly above-average cognitive function (neurocognitive index median = 105), with plasma ergothioneine levels of median = 1154 nM (interquartile range = 889.9). Plasma ergothioneine increased by ~3- and ~6-fold for 10 mg, and ~6- and ~16-fold for 25 mg, at weeks 4 and 16, respectively (p < 0.001). 25 mg ergothioneine showed a within-group improvement in composite memory at week 4 (p < 0.05), although this was not sustained. Reaction time improved in both groups, dependent on time. Other domains showed null or limited effects. Subjective prospective memory and sleep initiation improved dose-dependently, with significant effects at 25 mg (p < 0.05). Liver function improved and a within-group increase in telomere length was noted. In conclusion, ergothioneine supplementation was safe and well tolerated, with evidence suggesting some benefits in this cohort of healthy older adults. Longer trials in individuals with lower baseline ergothioneine or cognitive function are warranted. Full article

Background: Prior studies have shown an association between jugular venous reflux and age-related neurological conditions, including cognitive decline and potentially incident dementia. However, a relationship between internal jugular vein (IJV) outflow disturbance and cognitive impairment has yet to be elucidated. This study evaluates the relationship between impaired IJV drainage and cognitive function. Methods: We recruited a prospective sample of 106 participants with subjective memory complaints. Subjects underwent neuropsychological assessments and ultrasound examination of IJV, including time-averaged mean velocity (TAMV) and the cross-sectional area of the IJV at the middle (J2) and distal (J3) segments. Impaired IJV drainage was defined by either of the following: (1) TAMV < 4 cm/s at the J2 or J3 segment on either side, or (2) IJV lumen collapse during inspiration at the J2 segment on either side. Results: The impaired cognition group had a significantly higher prevalence of both impaired flow velocity and impaired IJV drainage compared to the normal cognition group (34% vs. 16%, p = 0.032; 68% vs. 30%, p < 0.001). Furthermore, the impaired IJV drainage group demonstrated lower scores across all neuropsychological tests, with statistical significance observed in the Mini-Mental State Examination (median (IQR) 27 vs. 29, p = 0.013), Montreal Cognitive Assessment (median (IQR) 23 vs. 26, p < 0.001) and Chinese Version of the Verbal Learning Test (median (IQR) 23.5 vs. 27, p = 0.024). Notably, incorporating IJV lumen collapse during deep inspiration into the definition of impaired IJV drainage further increased its prevalence in the impaired cognition group. Conclusions: Our results revealed that the impaired cognition group exhibited a higher prevalence of impaired outflow in the bilateral IJV, while the impaired IJV drainage group scored lower on all neuropsychological tests compared to the normal group. These findings support the hypothesis that impaired IJV drainage is correlated with global cognitive decline. Full article

Background/Objectives: Subjective cognitive decline (SCD) is a common symptom experienced by individuals in the preclinical stage of dementia. However, traditional neuropsychological tests often fail to detect subtle cognitive changes associated with SCD. People with SCD may appear to have intact cognitive function (as measured by traditional tests), but they themselves subjectively feel that their cognition is becoming impaired. Methods: This preliminary study investigated the relationship between SCD and antisaccade performance as a potential early marker of dementia risk in a community-based sample of older adults (N = 17, mean age = 77.71 years). SCD was also explored by calculating the dissociation between objective and subjective memory performance, with SCD implied if there was a large dissociation between perceived memory performance but intact objective performance. Results: Participants with evidence of SCD exhibited significantly increased antisaccade latency compared to healthy controls, even when standard cognitive tests were normal. Antisaccade latency showed a significant correlation with self-reported cognitive complaints (r = 0.57, p = 0.018), while traditional cognitive measures did not. Conclusions: These compelling but preliminary findings suggest that antisaccade performance may be a more sensitive indicator of early cognitive decline than traditional cognitive measures, even in the preclinical stage of dementia. The results have implications for early dementia diagnosis, as antisaccade tasks could be incorporated into routine assessments to identify individuals at risk for dementia, potentially enabling earlier therapeutic intervention. Full article

Background: Motoric Cognitive Risk Syndrome (MCR), defined by the co-occurrence of subjective cognitive complaints and slow gait, is recognized as a preclinical risk state for cognitive decline. However, not all individuals with MCR experience cognitive deterioration, making early and individualized prediction critical. Methods: This study included 80 participants aged 60 and older with MCR who underwent baseline assessments including plasma biomarkers (β-amyloid, tau), dual-task gait measurements, and neuropsychological tests. Participants were followed for one year to monitor cognitive changes. Support Vector Machine (SVM) classifiers with different kernel functions were trained to predict cognitive decline. Feature importance was evaluated using the weight coefficients of a linear SVM. Results: Key predictors of cognitive decline included plasma β-amyloid and tau concentrations, gait features from dual-task conditions, and memory performance scores (e.g., California Verbal Learning Test). The best-performing model used a linear kernel with 30 selected features, achieving 88.2% accuracy and an AUC of 83.7% on the test set. Cross-validation yielded an average accuracy of 95.3% and an AUC of 99.6%. Conclusions: This study demonstrates the feasibility of combining biomarker, motor, and cognitive assessments in a machine learning framework to predict short-term cognitive decline in individuals with MCR. The findings support the potential clinical utility of such models but also underscore the need for external validation. Full article

Background/Objectives: Neuropsychological testing is key in defining cognitive profiles at early stages of dementia. More importantly, the detection of subtle cognitive changes, such as subjective cognitive complaints (SCCs), an understudied phenomenon, is critical for early detection and preventive interventions. Methods: This systematic review analyzes the empirical data on the cognitive domains and neuropsychological tests used in studies addressing SCC in the last 15 years (2009–2024). Results: A selection of 15 papers with exploratory, cross-sectional, and prospective scope in this field was obtained from PubMed and Embase databases. They used screening tests (17%) and a broad spectrum of neurocognitive domains. Yet, we identified three main targeted cognitive domains: executive functions (28%), language (17%), and memory (17%). Myriad assessment tools were also applied, but the most commonly used was a set of eight tests: Mini-mental Scale Examination (MMSE), Trail Making Test (A-B), Stroop test, Digit span test (DST), Semantic and Phonological fluency test, Rey Auditory Verbal Learning Test (RAVLT), Weschler Memory Scale (WMS), and Boston Naming Test (BNT). New approaches involved including the Geriatric Depression Scale (GDS) and self/informant reports. Conclusions: Despite scarce agreement in the assessment protocols, the identification of early neurocognitive symptoms to objectivate the SCC phenomenon envisions a broad field of research. Full article

Fragile-X-associated tremor/ataxia syndrome (FXTAS) is a progressive neurodegenerative disorder associated with the FMR1 gene premutation, characterized by the presence of 55 to 200 CGG triplet repeat expansions. Although the initial symptoms of FXTAS typically manifest in males around the age of 60 with motor symptoms and cognitive deficits, the presentation and progression in females differ. Women, in fact, exhibit a higher prevalence of neuropsychiatric symptoms, with an earlier onset compared to the motor symptoms observed in men. The following article reports on ten cases of women with a diagnosis of FMR1 gene premutation, originating from two medical centers. All the women in the study exhibited neuropsychiatric symptoms and subtle neurological signs as common features. Symptoms typically observed in the male population, such as tremors and cerebellar ataxia, were either absent or significantly reduced in the female cohort. Conversely, there was a higher prevalence of neuropsychiatric symptoms among the women. Neurocognitive impairment was only minimally evident, with mild executive dysfunction and memory complaints noted in a subset of cases. For this reason, we propose the terminology preFXTAS or prodromic FXTAS to define a clinical presentation in women characterized by early manifestations of FXTAS that do not entirely fulfill the established diagnostic criteria but exhibit MRI evidence of white matter alterations suggesting the initiation of the disease process. The study underscores the importance of establishing new diagnostic criteria for FXTAS and, at the same time, developing new biomarkers and interview checklists/assessment scales dedicated to females. Full article

Few studies have investigated the possibility of offering outreach from hospital-based memory clinic services to primary care. Such models could potentially improve access to specialised mental healthcare. We report on the reliability and validity of a pilot cognitive screening pathway in general practice (GP) in Ireland. Consecutive patients with memory complaints attending two primary care clinics were screened and diagnosed clinically by a physician-run memory clinic in GP. Follow-up in secondary care confirmed the diagnosis. Inter-rater reliability (IRR) and diagnostic validity of the Quick Mild Cognitive Impairment (Qmci) screen was compared to the Montreal Cognitive Assessment (MoCA) and General Practitioner Assessment of Cognition (GPCOG). In all, 63 patients, 31 with subjective memory complaints (SMC), 16 with mild cognitive impairment and 16 with dementia were screened. Their median age was 73 and 67% were female. The IRR of the Qmci screen between GP and clinic was excellent (r = 0.89). The Qmci was more accurate than the GPCOG in identifying cognitive impairment; the area under the curve (AUC) was 0.95 versus 0.80 (p = 0.008). The Qmci and MoCA had similar accuracy, with an AUC of 0.95 versus 0.91 (p = 0.117), respectively, but was significantly shorter (p < 0.001), suggesting it may be a useful instrument in this setting. Based on these results, a definitive study is now planned to examine the benefits and challenges of utilizing these instruments as part of establishing an outreach memory clinic service in primary care. Full article

This study examined the nature, severity, and predictors of cognitive complaints in patients referred for suspected obstructive sleep apnea (OSA). The sample included 127 patients classified as no OSA (AHI, apnea/hypopnea index < 5, N = 32), mild OSA (AHI 5–15, N = 46), moderate OSA (AHI 15–30, N = 25), or severe OSA (AHI > 30, N = 24), and 53 healthy controls (HCs), matched for age, sex, education, and IQ. Cognitive complaints were assessed using the Cognitive Failure Questionnaire (CFQ) and the Behavioral Rating Inventory of Executive Functioning Adult Version (BRIEF-A). Regression analyses examined predictors of cognitive complaints including AHI, sleepiness, anxiety, depression, fatigue, and neuropsychological performance. Compared to HCs, those with mild OSA reported more forgetfulness, distractibility, and working memory issues, while those with severe OSA reported more difficulties with initiative, both with large effect sizes. Cognitive complaints were linked to sleepiness, anxiety, and fatigue (ß’s 0.29–0.37), but not AHI or cognitive performance. Cognitive complaints were not specific to subjects with OSA but were also common among individuals with sleep complaints suspected for OSA. In conclusion, cognitive complaints were associated with anxiety, fatigue, and sleepiness rather than objective cognitive performance or impairment. Full article

Background: Current research on Alzheimer’s Disease has progressively focused on Mild Cognitive Impairment (MCI) as a pre-dementia state, as well as on Subjective Memory Complaint (SMC), as a potential early indicator of cognitive change. Consequently, timely interventions to prevent cognitive decline are essential and are most effective when combined with motor training. Nevertheless, motor-cognitive dual-task training often employs non-ecological tasks and is confined to clinical contexts lacking generalizability to daily life. The integration of 360° media could overcome these limitations. Therefore, the aim of the current work is twofold: (a) to present a dual-task training using 360° technology for its interactivity, versatility, and ecological validity, and (b) to propose a protocol to test its efficacy through a randomized clinical trial. Methods: This study will recruit 90 older adults (MCI and SMC). Participants will follow two phases of training: in-hospital rehabilitation and at-home rehabilitation. The experimental design will follow a 2 × 3 × 2 structure with 3 factors: type of treatment (360° training vs. traditional rehabilitation), time (baseline, post in-hospital training, and post at-home training), and group (SMC vs. MCI). Results: The expected outcome is an improvement in cognitive and motor functioning after the experimental training. Conclusion: This study will advance the literature on non-pharmacological interventions and innovative technological tools for cognitive trainings in the early stages of cognitive decline. Full article

The present study aimed to translate, culturally adapt, and present a psychometric validation for the Everyday Memory Questionnaire—Revised (EMQ-R) to the Portuguese population. The study involved 267 participants aged between 18 and 75 years (M = 39.32; SD = 14.8), recruited online. Self-report measures of anxiety and depression symptoms were administered to assess the instrument’s convergent validity. To examine the factorial structure of the measure, a two-step validation process was employed. Given the uncertainty about the optimal measurement model, the sample was randomly divided into two independent subsamples. First, a principal component analysis (PCA) was conducted to explore the factorial structure. Next, a confirmatory factor analysis (CFA) was performed to validate the identified structure. The results supported a unidimensional structure consisting of 12 items, suggesting that perceived memory difficulties are best represented as a single overarching factor. High reliability was observed for this structure (Cronbach’s alpha and McDonald’s omega values ≥ 0.90). The results also indicated that general memory complaints were moderately correlated with symptoms of anxiety and depression. Furthermore, the study highlighted the promising potential of the measure as a screening tool for detecting subjective memory complaints, with an optimal cut-off score of 16 points. Future studies should focus on validating the EMQ-R with clinical samples, exploring its discriminative ability, and examining the stability of the cut-off score across different populations and contexts. Full article