Traumatic Brain Injury (TBI) often leads to cognitive impairments, particularly regarding working memory (WM). This meta-analysis aims to examine the impact of TBI on WM, taking into account moderating factors which has received little attention in previous research, such as severity of injury, the different domains of Baddeley’s multi-component model, and the interaction between these two factors, as well as the interaction with other domains of executive functions.

Following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, a systematic review and meta-analysis searched Google Scholar, PubMed, and PsycNET for studies with objective WM measures. Multiple meta-analyses were performed to compare the effects of TBI severity on different WM components. Twenty-four English, peer-reviewed articles, mostly cross-sectional were included.

TBI significantly impairs general WM and all Baddeley’s model components, most notably the Central Executive (d’ = 0.74). Severity categories, mild-moderate and moderate-severe, were identified. Impairment was found across severities, with “moderate-severe” demonstrating the largest effect size (d’ = 0.81). Individuals with moderate-severe TBI showed greater impairments in the Central Executive and Episodic Buffer compared to those with mild-moderate injury, whereas no such differences were found for the Phonological Loop and Visuospatial Sketchpad.

These findings enhance our understanding of WM deficits in varying severities of TBI, highlighting the importance of assessing and treating WM in clinical practice and intervention planning.

The aim of this systematic review is to examine the cognitive impact of psychotropic medications including benzodiazepines, antidepressants, mood stabilizers, antipsychotics, or a combination of these drugs on older adults.

Systematic review.

We searched Medline, PsycINFO, and Embase through the Ovid platform, CINAHL through EBSCO, and Web of Science.

Randomized control trials (RCTs) and cohort studies that used a validated scale to measure cognition with a follow-up period of at least six months were included.

The primary outcome of interest was cognitive change associated with psychotropic medication use.

A total of 7551 articles were identified from the primary electronic literature search across the five databases after eliminating duplicates. Based on full-text analysis, 27 articles (two RCTs, 25 cohorts) met the inclusion criteria. Of these, nine each examined the impact of benzodiazepines and antidepressants, five examined psychotropic combinations, three on antipsychotic drugs, and one on the effects of mood stabilizers.

This is the first systematic review to examine the cognitive impact of multiple psychotropic drug classes in older adults over an extended follow-up period (six months or more) using robust sample sizes, drug-free control groups, and validated cognitive instruments. We found evidence to indicate cognitive decline with the cumulative use of benzodiazepines and the use of antidepressants, especially those with anticholinergic properties among older adults without cognitive impairment at baseline. Further, the use of antipsychotics and psychotropic combinations is also associated with cognitive decline in older adults.

We examined longitudinal changes in cognitive and physical function and associations between change in function and falls in people with and without mild cognitive impairment (MCI).

Prospective cohort study with assessments every 2 years (for up to 6 years).

Community, Sydney, Australia.

Four hundred and eighty one people were classified into three groups: those with MCI at baseline and MCI or dementia at follow-up assessments (n = 92); those who fluctuated between cognitively normal and MCI throughout follow-up (cognitively fluctuating) (n = 157), and those who were cognitively normal at baseline and all reassessments (n = 232).

Cognitive and physical function measured over 2–6 years follow-up. Falls in the year following participants’ final assessment.

In summary, 27.4%, 38.5%, and 34.1% of participants completed 2, 4, and 6 years follow-up of cognitive and physical performance, respectively. The MCI and cognitive fluctuating groups demonstrated cognitive decline, whereas the cognitively normal group did not. The MCI group had worse physical function than the cognitively normal group at baseline but decline over time in physical performance was similar across all groups. Decline in global cognitive function and sensorimotor performance were associated with multiple falls in the cognitively normal group and decline in mobility (timed-up-and-go test) was associated with multiple falls across the whole sample.

Cognitive declines were not associated with falls in people with MCI and fluctuating cognition. Declines in physical function were similar between groups and decline in mobility was associated with falls in the whole sample. As exercise has multiple health benefits including maintaining physical function, it should be recommended for all older people. Programs aimed at mitigating cognitive decline should be encouraged in people with MCI.

Postoperative cognitive disorders are an emerging public health problem because of its related socio-economic impact.: Postoperative cognitive disorders are an emerging public health problem because of its related socio-economic impact.

To determine the incidence and risk factors of cognitive disorders after endoscopic resection in urology.

This is an observational, descriptive and analytical study carried out in the urology department of Sahloul University Hospital during a 3 month period, and enrolling patients scheduled for endoscopic resections. Collected data included socio-demographic characteristics and parameters related to the operative management. Cognitive disorders were assessed by the MOCA Test one day before the intervention, then, during the first postoperative day. Patients developing TURP syndrome were excluded.

During the study period, 104 patients were enrolled with a mean age of 67.76 years. The sex ratio was 33.6. Main interventions were transurethral resection of bladder tumor and transurethral resection of the prostate.The incidence of cognitive disorders was 45.2% after endoscopic resection. Main Risk factors in multivariate analysis were age (p <10-3), low educational level (p <0.001), sedentary (p <0.001), smoking (p = 0.029), an age gap with spouse> 10 years (p <0.001), high blood pressure (p <0.001), myocardial infarction (p = 0.005); chronic bronchitis (p = 0.002), sleep disorders (p <0.001), preoperative concentration disturbances (p = 0.005), poor quality of patient information (p <0.05), and the type of anesthesia (p = 0.012).

The incidence of cognitive disorders after urologic endoscopic surgery is considerable. Patients with risk factors require preventive measures, regular screening and optimal management.

No significant relationships.

Early diagnostics of neurodegenerative disease and their comorbidities is linked to better treatment outcome and improved quality of life. The first patient assessment should lay strong foundations for the direction of the upcoming diagnostic procedure. Clock Drawing Test (CDT) is often used as an early screening instrument in geriatric patients presenting with cognitive disorders.

The goal of the present study was to evaluate diagnostic accuracy of the CDT in a geriatric cohort with mild cognitive difficulties.

Out of a pool of in- and outpatient data presenting with subjective cognitive difficulties three diagnostic groups were formed – mild cognitive impairment, depressive disorder and healthy controls. CDT was scored using a quantitative scoring system with each aspect of the clock evaluated separately. CDT data was analysed for its discriminative value in early diagnostics of AD and DD.

Logistic regression produced a significant model with a low percentage of explained variance in both DD and AD groups. Same CDT items were significant predictors for DD and AD pathology. ROC curve inspection allowed only a poor discrimination capability for the significant predictors.

Despite being a popular screening test, CDT is a poor choice for individuals presenting with a mild cognitive impairment. Using CDT alone might result in initial stages of neurodegeneration going undetected, thus depriving patients of early treatment options. Same error types were significant predictors in DD and AD. This indicates that CDT can detect a general impairment; however, an in-depth neuropsychological assessment is needed for differential diagnostics.

No significant relationships.

Cognitive impairments have a considerable impact on the functioning of patients, their socialization and level of disability. Cognitive deficits significantly deteriorate the quality of patients’ life. Currently, the possibilities of pharmacological correction of cognitive disorders in patients with epilepsy are limited.

Study of non-pharmacological program of cognitive disorder correction in patients with epilepsy and the assessment of its efficiency.

We have studied the features of clinical and psychopathological manifestations in patients suffering from epilepsy. The study included 146 patients with epilepsy (85 men and 61 women) who were receiving inpatient care. The following psychodiagnostic techniques were used: MOCA test, Mini Mult test, Münsterberg test, depression and Hamilton anxiety scale, quality of life scale. 63 patients received cognitive training online, of which 30 patients also used psychoeducation methods.

According to the MoCA findings, patients with epilepsy showed cognitive decline, the average score was 20.72, whereas healthy persons’ average score was 27.36. The Quality of Life Scale: the average rate among all examined persons was 69.45 out of 100, 78.60 were the results of healthy persons. In patients with PG1, who used cognitive training and psychoeducation the results of the MoCA test showed an improvement in cognitive functions (1.4, p <0.001) and increased subjective assessment of quality of life (2.77, p <0.05).

The study of the use of cognitive training and psychoeducation in patients with epilepsy for cognitive functions, quality of life resulted in a positive outcome. Cognitive online training is an encouraging area in the rehabilitation of patients with cognitive decline.

No significant relationships.

The relationships among depression, personality factors, and cognitive decline in the elderly are complex. Depressed elders score higher in neuroticism than nondepressed older individuals. Presence of neuroticism worsens cognitive decline in depressed older adults. Yet little is known about changes in neuroticism among older adults being treated for depression and the impact of these changes on cognitive decline.

Longitudinal observational study.

Academic Health Center.

We examined 68 participants in the neurobiology of late-life depression (LLD) study to test the hypothesis that older depressed subjects with more improvement in neuroticism would experience less cognitive decline compared with those with less change in neuroticism.

We measured neuroticism using the NEO-Personality Inventory-Revised at baseline and 1 year. Study psychiatrists measured depression using the Montgomery–Åsberg depression rating scale (MADRS). Global cognitive performance was measured using the Consortium to Establish a Registry for Alzheimer’s disease (CERAD) battery at baseline and annually over 3 years. Regression models of 1-year change in neuroticism and 3-year change in CERAD included sex, age, race, education, and 1-year change in MADRS score as covariates.

We found that among older adults, 1-year change in neuroticism was inversely associated with 3-year change in CERAD total score.

Our findings challenge the notion of longitudinal stability of measures of personality, especially among older depressed individuals. They highlight the importance of repeated personality assessment, especially of neuroticism, in the management of LLD. Future studies in larger samples followed for longer periods are needed to confirm our results and to extend them to examine both cognitive change and development of dementia.

Functional cognitive disorders (FCD) are an important differential diagnosis of neurodegenerative disease. The utility of suggested diagnostic features has not been prospectively explored in “real world” clinical populations. This study aimed to identify positive clinical markers of FCD.

Adults with cognitive complaints but not dementia were recruited from memory, neurology, and neuropsychiatry clinics. Participants underwent structured interview, Mini International Neuropsychiatric Interview, Montreal Cognitive Assessment, Luria 3-step, interlocking fingers, digit span and Medical Symptom Validity Test, Patient Health Questionnaire 15, Hospital Anxiety and Depression Scale, Multifactorial Memory Questionnaire, and Pittsburgh Sleep Quality Inventory. Potential diagnostic variables were tested against expert consensus diagnosis using logistic regression.

FCD were identified in 31/49 participants. Participants with FCD were younger, spoke for longer when prompted “Tell me about the problems you’ve been having,” and had more anxiety and depression symptoms and psychiatric diagnoses than those without FCD. There were no significant differences in sex, education, or cognitive scores. Younger age and longer spoken response predicted FCD diagnosis in a model which explained 74% of diagnostic variability and had an area under the curve (AUC) of 94%.

A detailed description of cognitive failure is a sensitive and specific positive feature of FCD, demonstrating internal inconsistency between experienced and observed function. Cognitive and performance validity tests appear less helpful in FCD diagnosis. People with FCD are not “worried well” but often perform poorly on tests, and have more anxiety, depression, and physical symptoms than people with other cognitive disorders. Identifying diagnostic profiles is an important step toward parity of esteem for FCDs, as differential diagnoses of neurodegenerative disease and an independent target for clinical trials.

The quality of life of patients with epilepsy, their social activity and functioning depends not only on the presence of epileptic seizures, but also on the level of cognitive decline.

The object of our study is impact of non-pharmacological methods on cognitive functions, decreasing of which deteriorates social activity in patients with epilepsy.

We have studied the features of clinical and psychopathological manifestations in patients suffering from epilepsy. The study covered 27 patients who were in inpatient care. The following psychodiagnostic techniques were used: the Toronto Cognitive Assessment TorCA, the MOCA and the MiniMult tests, Patient Social Functioning Questionnaire. Currently, a group of patients with cognitive decline cause by epilepsy is undergoing remote cognitive training on one of an online platforms, under our observation. Correction occurs throughout regular daily performance, assessment of cognitive functions is carried out on three indicators: attention, memory and thinking

The following results of the study were observed: initially decreased memory in 88,8 % patients and the level of cognitive decline were directly proportional to the duration of the illness, this category of patients has reduced activity and limited social contacts.The result of the use of cognitive training is an increase in all three indicators.

The results of the study indicate the need for further study of the features of cognitive disorders in epilepsy and the use of methods of psychotherapeutic correction.

The most common psychiatric conditions in epilepsy are depression, anxiety, behavioral, psychotic disorders and cognitive disorders as well as those which can be caused by convulsive seizures.

The aims of the research were to define cognitive and affective impairments in patients with epilepsy and their quality of life. Since the presents of cognitive impairments and affective disorders have a considerable impact on the functioning of patients, their socialization and the level of their disability.

We studied the features of clinical and psychopathological manifestations in patients suffering from epilepsy. The study covered 100 patients (47 men and 53 women) who were in inpatient care. The following psychodiagnostic techniques were used: the test of 10 words of Luria, the MOCA test, the Münsterberg test, Mini-Mult test, the quality of life scale, the Hamilton scale of depression and anxiety.

The following data of the study were observed: 88 % patients had decreased memory, 38% had symptoms of depression, 28% had mild situational or neurotic depression, 8% had moderate depression, 2% had severe depression, 20% had a state of severe anxiety, 16% had symptoms of anxiety. The average rate of quality of life among all examined people was 67.5 out of 100.

The results of the conducted research indicate the need for further study of the features of the comorbid pathology in epilepsy and development and implementation pharmacological and nonpharmacological methods for treatments of epilepsy.

Alcohol amnesia and palimpsests belong to understudied areas in addictology concerning the pathogenesis, risk factors, and development of effective integrated, targeted modalities of therapy, prevention, and after-treatment care.

Development of a new integrated, pathogenetically grounded approach to the emergency and routine therapy for immediate and long-term consequences of amnestic alcohol intoxication.

Modern complex clinical-psychopathological, pathopsychological, laboratory, electrophysiological, biochemical examination; method of analogues and prototype analytical examination.

Integrated anti-amnestic pharmacotherapeutic triad: Noobut IC (Phenibut) orally, before meals, for 6 days, twice a day: 250 mg in the morning, 500 mg at night, within days 7-14 250 mg twice: in the morning and at night; Vitaxon 2.0 ml daily, intramuscularly, No10 totally; ozone therapy for 10 days (ozone dissolved in olive oil, 6 mg/100 ml concentration), 5 ml orally 3 times a day. Complex therapy is concurrent with synergistic psychotherapeutic potentiation. Supportive anti-relapse prevention of alcohol-induced amnesia, palimpsests with Noobut IC: 1 tablet (250 mg) orally in the morning for 2 months. The pathogenetic support of the pharmacotherapeutic triad in treatment for alcohol addiction, comorbid with amnestic disorders, is pathogenetically focused on pharmacological properties of each component of the triad and their potentiating effects, involving most pathogenetic mechanisms of this disease.

Relieving and prophylactic efficacy of the proposed pharmacological triad (Noobut, Vitaxon, ozone and concurrent psychotherapeutic potentiation) is proven by the statistical reliability method and illustrated by clinical examples of patient-specific research.

To evaluate the association between neuropsychiatric symptoms and apolipoprotein E (APOE) ϵ4 allele among older people in Central African Republic (CAR) and the Republic of Congo (ROC).

Multicenter population-based study following a two-phase design.

From 2011 to 2012, rural and urban areas of CAR and ROC.

People aged 65 and over.

Following screening using the Community Screening Interview for Dementia, participants with low cognitive scores (CSI-D ≤ 24.5) underwent clinical assessment. Dementia diagnosis followed the DSM-IV criteria and Peterson’s criteria were considered for Mild Cognitive Impairment (MCI). Neuropsychiatric symptoms were evaluated through the brief version of the Neuropsychiatric Inventory (NPI-Q). Blood samples were taken from all consenting participants before APOE genotyping was performed by polymerase chain reaction (PCR). Logistic regression models were used to evaluate the association between the APOE ϵ4 allele and neuropsychiatric symptoms.

Overall, 322 participants had complete information on both neuropsychiatric symptoms and APOE status. Median age was 75.0 years and 81.1% were female. Neuropsychiatric symptoms were reported by 192 participants (59.8%) and at least 1 APOE ϵ4 allele was present in 135 (41.9%). APOE ϵ4 allele was not significantly associated with neuropsychiatric symptoms but showed a trend toward a protective effect in some models.

This study is the first one investigating the association between APOE ϵ4 and neuropsychiatric symptoms among older people in sub-Saharan Africa (SSA). Preliminary findings indicate that the APOE ϵ4 allele was not associated with neuropsychiatric symptoms. Further research seems, however, needed to investigate the protective trend found in this study.

Assistive technology is advocated as a key solution to the need for support among people living with dementia. There is growing awareness of the benefits of user involvement in the design and test of these technologies and the need to identifying applicable and effective methods for implementation. The aim of this review was to explore and synthesize research addressing assistive technology designed to be used by people with dementia for self-management. Further research aims were to explore if and how user involvement, dissemination, and adoption of assistive technology were addressed.

Electronic databases were searched using specified search terms. Key publications and grey literature sources were hand-searched. Materials published until year end 2018 were included. The results were summarized according to the research aims.

Eleven papers derived from eight studies were included. The studies presented data from prototype design and testing, and the review showed great variation in study scope, design, and methodology. User involvement varied from extensive involvement to no user involvement. Methods for adoption also varied widely and only targeted prototype testing. None of the studies addressed dissemination.

The results of this review underline the need for well-designed high-quality research into all the aspects that are essential to deliver applicable, effective, and sustainable assistive technology to support self-management of people with dementia. There is a need for evidence-based methods to promote and qualify user involvement, dissemination, and adoption. The results also point to the need for standardized outcome measures and standards for conducting and reporting research to improve its quality and impact.

Our objective was to examine and describe the common socio-demographic and clinical characteristics of first time older sex offenders.

Research papers published in MEDLINE, PsycINFO, and EMBASE were searched systematically. Following removal of duplicates and irrelevant papers, a total of 423 papers were reviewed to determine whether the selection criteria were met. A total of seven publications were included and evaluated by two researchers.

Of the seven publications, there were two retrospective research studies and five case reports. There was a higher proportion of neurocognitive disorder in this offender group and the victims were usually vulnerable individuals. Yet, cognitive assessments were rarely done or reported. Two subtypes of older sex offenders were identified: (i) offenders who had offended in the past but were not previously detected; (ii) first-time offenders with a high proportion of neurocognitive disorder.

There is a paucity of research in first time sex offending by older people. This review has highlighted a need for better designed studies to explore the characteristics of older sex offenders. Better collaboration between forensic and old-age psychiatric services is required for improved assessment and management of older sex offenders.

New onset of mood and behavioral changes in middle-aged patients are frequently the first manifestations of an unrecognized neurocognitive disorder. Impairment of social cognition, the cognitive ability to process social information coming from others, such as emotions, to attribute mental states to others, and to respond appropriately to them, is often at the origin of behavioral manifestations in neurodegenerative disorders.

This paper reviews the current literature on social cognition impairment in neurocognitive disorders, particularly in prodromal stages of behavioral-variant frontotemporal dementia (bvFTD), Alzheimer's disease (AD), idiopathic Parkinson's disease (IPD), and Lewy body dementia (LBD). The concepts of social cognition will be reviewed, including its impairment and neural basis, its clinical assessment, and the different therapeutic interventions available clinically.

Socially inappropriate behaviors, such as loss of empathy, inappropriateness of affect, and disinhibition are frequently reported in prodromal bvFTD and in prodromal AD. Lack of self-control, reduced perception of social cues, such as recognition of facial emotions and sarcastic speech, and impaired Theory of Mind all contribute to the neuropsychiatric symptoms and are secondary to neurodegeneration in specific brain regions. In contrasts to bvFTD and AD, deficits in social cognition in IPD occur later in the course of the disease and are often multifactorial in origin.

Through various manifestations, social inappropriateness is frequently the first clinical sign of a neurodegenerative process, especially in AD and bvFTD, years before noticeable impairment on classical neuropsychological assessment and brain atrophy on imaging.

Studies using acute tryptophan depletion (ATD) to examine the effects of a rapid reduction in serotonin function have shown a reduction in global cognitive status during ATD in Alzheimer's disease (AD) and Parkinson's disease (PD). Based on the severe cholinergic loss evident in dementia with Lewy bodies (DLB) and Parkinson's disease and dementia (PDD), we predicted that a reduction of global cognitive status during ATD would be greater in these conditions than in AD.

Patients having DLB or PDD underwent ATD in a double-blind, placebo-controlled, randomized, counterbalanced, crossover design.

While the study intended to test 20 patients, the protocol was poorly tolerated and terminated after six patients attempted, but only four patients – three with DLB and one with PDD – completed the protocol. The Modified Mini-Mental State Examination (3MSE) score was reduced in all three DLB patients and unchanged in the PDD and dementia patient during ATD compared with placebo.

This reduction in global cognitive function and the poor tolerability may fit with the hypothesis that people with dementia with Lewy bodies have sensitivity to the effects of reduced serotonin function.