The Clinical neuropsychologist
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In the last five years, a consensus has developed that Alzheimer's disease (AD) may begin years before overt cognitive impairment. Accordingly, the focus has shifted to identifying preclinical disease in order to match treatments to those most likely to benefit. Subtle cognitive changes, including reduced benefit from practice, may be one such preclinical sign. In this study, we explore cognitive aging trajectories within a large cohort of clinically intact late middle-aged adults. ⋯ Reduced practice effects have previously been observed in clinical groups. These results in middle-aged adults suggest that they may also indicate preclinical changes on the path to AD.
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Comparative Study
The Role of Baseline Cognitive Function in the Neurocognitive Effects of Electroconvulsive Therapy in Depressed Elderly Patients.
Electroconvulsive therapy (ECT) is an effective biological treatment option for severely depressed elderly patients; however, it can cause cognitive side effects, including anterograde and retrograde amnesia. Elderly patients with "cognitive impairment no dementia" (CIND) are reported as being more vulnerable to the cognitive side effects of ECT compared with patients with "no cognitive impairment" (NCI). The few studies that have reached this conclusion can be criticized for using insensitive outcome measures. ⋯ CIND patients were not more vulnerable to amnesia than were NCI patients. Long-term cognitive side effects of ECT were not detected.
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The current survey updated professional practice and income information pertaining to clinical neuropsychology. ⋯ Professional practice survey information continues to provide valuable perspectives regarding consistency and change in the activities, beliefs, and incomes of US clinical neuropsychologists.
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The Standardized Assessment of Concussion (SAC) is a standardized mental status screening instrument initially developed for assessment and tracking of concussion symptoms in athletes. The purpose of the current study was to validate the utility of the SAC as an embedded screening measure for insufficient effort in independent medical examinations (IME) and personal injury cases. ⋯ While optimal cut-off scores depend upon intended use, our data suggest that the SAC is useful as a potential screener for insufficient effort, after which one can employ additional measures to rule out false-positives. Further research is required before cut-off scores can be recommended for clinical use.
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Comparative Study
The relationship between suboptimal effort and post-concussion symptoms in children and adolescents with mild traumatic brain injury.
This retrospective chart review study explored the relationship between suboptimal effort and post-concussion symptoms in pediatric mild traumatic brain injury (mTBI). Participants were 382 clinically referred children and adolescents between 8 and 16 years of age who sustained an mTBI. Suboptimal effort was identified using reliable digit span and age-corrected scaled scores from the Numbers subtest of the Children's Memory Scale (CMS); 20% of the sample were classified as non-credible performers. ⋯ Additionally, non-credible performers demonstrated comparatively poorer performance on neuropsychological tests of focused attention and processing speed. These results suggest that children and adolescents with mTBI who fail effort testing might have a greater tendency to exaggerate post-concussion symptoms and cognitive impairment. The clinical implications of these findings are discussed.