Journal of clinical and experimental neuropsychology
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J Clin Exp Neuropsychol · Nov 2017
The relationship between olfactory dysfunction and executive function in children with traumatic brain injury.
Olfactory dysfunction (OD) has been suggested as a possible marker of executive function (EF) deficits after traumatic brain injury (TBI) in adults. Little is known about the relationship between EF and OD in pediatric TBI (pTBI). This study aimed to investigate EF, explore the relationship between OD and EF, and determine the utility of olfactory performance as a marker of later EF in pTBI. It was hypothesized that (i) children with TBI would perform more poorly on EF measures relative to normative expectation; (ii) children with OD would perform more poorly on tests of EF than those with normal olfaction after TBI; and (iii) acute olfactory function would predict later EF for children with TBI. ⋯ Overall our findings provide little support for a significant relationship between EF and OD in pTBI. In particular, there was no strong evidence that acute olfactory function is an accurate predictor of later EF in pTBI. Given the dearth of pediatric research, the limitations of our study and the potential significance of acute olfactory performance as an early marker of later EF deficits in children, further investigation is warranted.
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J Clin Exp Neuropsychol · Nov 2017
Screening for neurocognitive impairment in HIV-positive adults aged 50 years and older: Montreal Cognitive Assessment relates to self-reported and clinician-rated everyday functioning.
As the HIV+ population ages, the risk for and need to screen for HIV-associated neurocognitive disorders (HAND) increases. The aim of this study is to determine the utility and ecological validity of the Montreal Cognitive Assessment (MoCA) among older HIV+ adults. A total of 100 HIV+ older adults aged 50 years or over completed a comprehensive neuromedical and neurocognitive battery, including the MoCA and several everyday functioning measures. ⋯ Higher MoCA total scores are also significantly (p <.01) associated with fewer instrumental activities of daily living declines (r = -0.28), fewer everyday cognitive symptoms (r = -0.25), and better clinician-rated functional status (i.e., Karnofsky scores; r = 0.28); these associations remain when controlling for depressive symptoms. HIV+ individuals who are neurocognitively normal demonstrate medium-to-large effect size differences in their MoCA performance compared to those with asymptomatic neurocognitive impairment (d = 0.85) or syndromic HAND (mild neurocognitive disorder or HIV-associated dementia; d = 0.78), while the latter two categories do not differ. Although limited by less than optimal specificity, the MoCA demonstrates good sensitivity and ecological validity, which lends support to its psychometric integrity as a brief cognitive screening tool among older HIV+ adults.