Browsing by Subject "Cognitive Impairment"

Now showing 1 - 3 of 3
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    Cognitive impairment in older patients with breast cancer before systemic therapy: is there an interaction between cancer and comorbidity?
    (American Society of Clinical Oncology, 2014-06-20) Mandelblatt, Jeanne S.; Stern, Robert A.; Luta, Gheorghe; McGuckin, Meghan; Clapp, Jonathan D.; Hurria, Arti; Jacobsen, Paul B.; Faul, Leigh Anne; Isaacs, Claudine; Denduluri, Neelima; Gavett, Brandon; Traina, Tiffany A.; Johnson, Patricia; Silliman, Rebecca A.; Turner, R. Scott; Howard, Darlene; Van Meter, John W.; Saykin, Andrew J.; Ahles, Tim; Department of Medicine, IU School of Medicine
    PURPOSE: To determine if older patients with breast cancer have cognitive impairment before systemic therapy. PATIENTS AND METHODS: Participants were patients with newly diagnosed nonmetastatic breast cancer and matched friend or community controls age > 60 years without prior systemic treatment, dementia, or neurologic disease. Participants completed surveys and a 55-minute battery of 17 neuropsychological tests. Biospecimens were obtained for APOE genotyping, and clinical data were abstracted. Neuropsychological test scores were standardized using control means and standard deviations (SDs) and grouped into five domain z scores. Cognitive impairment was defined as any domain z score two SDs below or ≥ two z scores 1.5 SDs below the control mean. Multivariable analyses evaluated pretreatment differences considering age, race, education, and site; comparisons between patient cases also controlled for surgery. RESULTS: The 164 patient cases and 182 controls had similar neuropsychological domain scores. However, among patient cases, those with stage II to III cancers had lower executive function compared with those with stage 0 to I disease, after adjustment (P = .05). The odds of impairment were significantly higher among older, nonwhite, less educated women and those with greater comorbidity, after adjustment. Patient case or control status, anxiety, depression, fatigue, and surgery were not associated with impairment. However, there was an interaction between comorbidity and patient case or control status; comorbidity was strongly associated with impairment among patient cases (adjusted odds ratio, 8.77; 95% CI, 2.06 to 37.4; P = .003) but not among controls (P = .97). Only diabetes and cardiovascular disease were associated with impairment among patient cases. CONCLUSION: There were no overall differences between patients with breast cancer and controls before systemic treatment, but there may be pretreatment cognitive impairment within subgroups of patient cases with greater tumor or comorbidity burden.
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    Depressive Symptoms Mediate Associations between Subjective Memory Complaints, Cognitive Ability, and Instrumental Activities of Daily Living
    (Taylor & Francis, 2023-04-10) Lee, Chang Dae; Foster, Erin R.; Goverover, Yael
    Objectives: Cognitive ability (CA) and instrumental activities of daily living (IADL) performance are essential for productive aging. Therefore, it is important to understand if other common issues such as subjective memory complaints (SMCs) and depressive symptoms are related to CA and IADLs, and explore the nature of those relationships. This study aims to explore 1) the associations between SMCs, depressive symptoms, CA, and IADL performance and 2) the role of depressive symptoms in these associations. Method: The study sample included 1,621 community-dwelling oldest-old from the Health and Retirement Study. Results: SMCs were significantly and positively associated with cognitive decline and limitations in IADL performance. Additionally, depressive symptoms mediated the associations between SMCs and cognitive decline and between SMCs and limitations in IADL performance. Conclusion: Depressive symptoms associated with SMCs negatively affect CA and IADL performance. Therefore, healthcare providers should consider and assess SMCs and depressive symptoms in the oldest-old.
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    The Structural and Functional Connectome and Prediction of Risk for Cognitive Impairment in Older Adults
    (Springer-Verlag, 2015-12) Contreras, Joey A.; Goñi, Joaquín; Risacher, Shannon L.; Sporns, Olaf; Saykin, Andrew J.; Department of Radiology and Imaging Sciences, IU School of Medicine
    The human connectome refers to a comprehensive description of the brain's structural and functional connections in terms of brain networks. As the field of brain connectomics has developed, data acquisition, subsequent processing and modeling, and ultimately the representation of the connectome have become better defined and integrated with network science approaches. In this way, the human connectome has provided a way to elucidate key features of not only the healthy brain but also diseased brains. The field has quickly evolved, offering insights into network disruptions that are characteristic for specific neurodegenerative disorders. In this paper, we provide a brief review of the field of brain connectomics, as well as a more in-depth survey of recent studies that have provided new insights into brain network pathologies, including those found in Alzheimer's disease (AD), patients with mild cognitive impairment (MCI), and finally in people classified as being "at risk". Until the emergence of brain connectomics, most previous studies had assessed neurodegenerative diseases mainly by focusing on specific and dispersed locales in the brain. Connectomics-based approaches allow us to model the brain as a network, which allows for inferences about how dynamic changes in brain function would be affected in relation to structural changes. In fact, looking at diseases using network theory gives rise to new hypotheses on mechanisms of pathophysiology and clinical symptoms. Finally, we discuss the future of this field and how understanding both the functional and structural connectome can aid in gaining sharper insight into changes in biological brain networks associated with cognitive impairment and dementia.