Aerobic Exercise Improves Mood, Cognition, and Language Function in Parkinson's Disease: Results of a Controlled Study. Cognitive outcomes of TMS treatment in bipolar depression: Safety data from a randomized controlled trial. Relative lack of cognitive effects of methylphenidate in elderly male volunteers One-year repeated cycles of cognitive training (CT) for Alzheimer’s disease Dose-dependent changes in cognitive function with exercise augmentation for major depression: Results from the TREAD study Cognitive training in affective disorders improves memory: a preliminary study using the NEAR approach. Effect of resistance-type exercise training with or without protein supplementation on cognitive functioning in frail and pre-frail elderly: Secondary analysis of a randomized, double-blind, placebo-controlled trial Executive decline and dysfunction precedes declines in memory: the Women's Health and Aging Study II. Memory enhancement training for older adults with mild cognitive impairment: A preliminary study The Study of Mental and Resistance Training (SMART) study—resistance training and/or cognitive training in mild cognitive impairment: a randomized, double-blind, double-sham controlled trial. Effect of antidepressant treatment on cognitive impairments associated with depression: a randomised longitudinal study. Integrative group-based cognitive rehabilitation efficacy in multiple sclerosis: a randomized clinical trial A preliminary, randomized, double-blind, placebo-controlled trial of l-carnosine to improve cognition in schizophrenia Cognitive determinants of social functioning after a first ever mild to moderate stroke at vocational age A study of donepezil in female breast cancer survivors with self-reported cognitive dysfunction 1 to 5 years following adjuvant chemotherapy The effects of cognitive speed of processing training among older adults with psychometrically- defined mild cognitive impairment. Body mass index and neurocognitive functioning across the adult lifespan. Memory training (MT) in mild cognitive impairment (MCI) generates change in cognitive performance. Enhancing dentate gyrus function with dietary flavanols improves cognition in older adults Working memory functioning in schizophrenia patients and their first-degree relatives: cognitive functioning shedding light on etiology Neuropsychological predictors of functional outcome in Cognitive Behavioral Social Skills Training for older people with schizophrenia Comparison of domain-specific cognitive function after carotid endarterectomy and stenting. A randomized, controlled trial of computer-assisted cognitive remediation for schizophrenia Longitudinal associations between late-life depression dimensions and cognitive functioning: a cross-domain latent growth curve analysis Aerobic exercise increases hippocampal volume and improves memory in multiple sclerosis: Preliminary findings Profiles of neuropsychological impairment in autopsy-defined Alzheimer's disease and cerebrovascular disease. Sydney Memory and Ageing Study: An epidemiological cohort study of brain ageing and dementia Acupressure as a non-pharmacological intervention for traumatic brain injury (TBI). Subarachnoid haemorrhage (SAH): long-term cognitive outcome in patients treated with surgical clipping or endovascular coiling The effects of rasagiline on cognitive deficits in Parkinson's disease patients without dementia: a randomized, double-blind, placebo-controlled, multicenter study. The relationship of subcortical MRI hyperintensities and brain volume to cognitive function in vascular dementia. Effect of Sahaj Yoga on neuro-cognitive functions in patients suffering from major depression. Short-term effects of glucose and sucrose on cognitive performance and mood in elderly people Persistence of cognitive impairment in geriatric patients following antidepressant treatment: a randomized, double-blind clinical trial with nortriptyline and paroxetine. Donepezil for Irradiated Brain Tumor Survivors: A Phase III Randomized Placebo-Controlled Clinical Trial. Distinct Brain and Behavioral Benefits from Cognitive vs. Physical Training: A Randomized Trial in Aging Adults The nature and staging of attention dysfunction in early (minimal and mild) Alzheimer’s disease: relationship to episodic and semantic memory impairment Apathy, but Not Depression, Reflects Inefficient Cognitive Strategies in Parkinson's Disease Cognitive effects of very low nicotine content cigarettes, with and without nicotine replacement, in smokers with schizophrenia and controls. Lisdexamfetamine dimesylate improves processing speed and memory in cognitively impaired MS patients: a phase II study
OBJECTIVES Parkinson 's disease ( PD ) results in a range of non-motor deficits that can affect mood , cognition , and language , and many of these issues are unresponsive to pharmacological intervention . Aerobic exercise can improve mood and cognition in healthy older adults , although only a few studies have examined exercise effects on these domains in PD . The current study assesses the effects of aerobic exercise on aspects of cognition , mood , and language production in people with PD . METHODS This study compares the effects of aerobic exercise to stretch-balance training and a no-contact control group in participants with idiopathic PD . The aerobic and stretch-balance groups trained three times a week for 16 weeks , while controls continued normal activities . Outcome measures included disease severity , mood , cognition ( speed of processing , memory , and executive function ) , and language production ( picture descriptions ) . Cognition and language were assessed in single and dual task conditions . RESULTS Depressive symptoms increased only in the control group ( p<.02 ) . Executive function improved in the aerobic exercise group only in the single task ( p=.007 ) and declined in controls in the dual task . Completeness of picture descriptions improved significantly more in the aerobic group than in the stretch-balance group ( p<.02 ) . CONCLUSIONS Aerobic exercise is a viable intervention for PD that can be protective against increased depressive symptoms , and can improve several non-motor domains , including executive dysfunction and related aspects of language production . ( JINS , 2016 , 22 , 878 - 889 ) BACKGROUND Bipolar depression ( BD ) is a highly prevalent condition associated with marked cognitive deficits that persist even in the euthymic phase of the illness . Pharmacological treatments for BD might further aggravate cognitive impairment , highlighting the need of developing interventions that present cognitive safety . In this study , we evaluated the cognitive effects of H1-coil ( deep ) transcranial magnetic stimulation ( TMS ) in patients with treatment-resistant bipolar depression . METHODS Fourty-three patients were r and omized to receive 20 sessions of active ( 55 trains , 18 Hz , 120 % resting motor threshold intensity ) or sham rTMS within a double-blind , sham-controlled trial . A battery of 20 neuropsychological assessment s , grouped in 6 domains ( attention and processing speed , working memory and executive function , inhibitory control , language , immediate verbal memory , and long-term verbal memory ) was performed at baseline and after 4 and 8 weeks of trial onset . Depressive symptoms were assessed with the 17-item Hamilton Rating Scale for Depression . RESULTS Cognitive improvement was shown for all cognitive domains . It occurred regardless of intervention group and depression improvement . For the language domain , greater improvement was observed in the sham group over time . No correlations between depression ( at baseline or during treatment ) and cognitive improvement were found . LIMITATIONS Absence of healthy control group . CONCLUSION The results of this exploratory study provide evidence on the cognitive safety of H1-coil TMS for BD patients . Putative pro-cognitive effects of rTMS in BD were not observed and thus should be further investigated Rationale Methylpheni date , a dopaminergic and noradrenergic reuptake inhibitor , has been shown in young , healthy adult volunteers to produce pronounced effects on working memory and sustained attention . We were interested in assessing whether similar improvements could be conferred upon elderly volunteers in order to gain a more complete underst and ing of the effects of age on monoaminergic manipulations of working memory and attention , as well as to explore the potential for pharmacological intervention in attention and executive dysfunction disorders in this age group . Objectives The main aim of the study was to characterise the dose-related effects of methylpheni date on a range of neuropsychological functions in elderly healthy volunteers . Methods Sixty healthy elderly adult male volunteers received either a single oral dose of placebo , 20 mg or 40 mg methylpheni date prior to performing a variety of tasks design ed to assess memory , attention and executive function . A r and omised double-blind , between-subjects design was used . Results Methylpheni date had significant cardiovascular and subjective effects . However , unlike in younger volunteers , no significant effects of drug on working memory ( spatial span and spatial working memory ) , response inhibition ( stop-signal ) or sustained attention ( rapid visual information processing ) were seen . Subtle effects on latency similar to those in younger volunteers were identified : both doses of methylpheni date result ed in a slowing in response time during set-shifting and decision-making . Conclusions The results of this study demonstrate that , in elderly subjects , the cognitive effects of methylpheni date are grossly attenuated and distinct from the profile previously described in younger volunteers . It is suggested that methylpheni date may not be appropriate as a pharmacological intervention in elderly patient groups , such as those reporting age-related cognitive decline Background Recent research suggests that a combination of both pharmacological and psychosocial treatments targeting cognitive functions improves cognition in patients with Alzheimer ’s disease ( AD ) . The present study evaluated the effectiveness of a 1-year cognitive training ( CT ) by comparing the cognitive performance of 16 patients with AD treated with CT and cholinesterase inhibitors ( ChEIs ) ( experimental group ) with the performance of 16 patients treated with a non-specific cognitive treatment and ChEIs ( control group ) . Methods This study was a single-blind r and omized controlled trial . The patients in the experimental group received pharmacological treatment and repeated cycles of CT for 1 year , whereas the control group received pharmacological treatment and repeated cycles of non-specific cognitive exercises . The patients in the two groups were administered a variety of neuropsychological tests measuring several cognitive functions ( i.e. memory , language , reasoning , executive function , working memory and apraxia ) , activities of daily living , and depression . Results After 1 year of training , the experimental group scored significantly higher on the Mini Mental State Examination , the Milan Overall Dementia Assessment battery and in other five neuropsychological tests , compared to the control group . Conclusions Present results suggest that repeated cycles of CT in patients with AD treated with ChEIs are associated with benefits in several areas of cognitive function Cognitive dysfunction has been repeatedly observed in major depressive disorder ( MDD ) , particularly in areas of attention , verbal and nonverbal learning and memory , and executive functioning . Exercise has been shown to improve cognitive outcomes in other population s , including age-associated cognitive decline , but has not to our knowledge been investigated as an augmentation strategy in depression . This study evaluated the effectiveness of exercise augmentation on cognitive performance in persons with MDD and residual symptoms that included cognitive complaints following initial treatment with a selective  serotonin reuptake  inhibitor ( SSRI ) . Participants enrolled in the Treatment with Exercise Augmentation for Depression ( TREAD ) study were r and omized to receive either a low or high dose exercise regimen . TREAD participants who provided informed consent for the current study completed Cambridge Neuropsychological Test Automated Battery measures assessing Attention , Visual Memory , Executive Function/Set-shifting and Working Memory , and Executive Function/Spatial Planning domains . Data were analyzed for 39 participants completing both baseline and Week 12 cognitive testing . Overall tests indicated a significant task × group × time interaction for the Executive Function/Set-shifting and Working Memory domain . Post-hoc tests indicated improvements in high dose exercisers ' spatial working memory , but decreases in spatial working memory and set-shifting outcomes in low dose exercisers . Both groups improved on measures of psychomotor speed , attention , visual memory and spatial planning . This study suggests a dose-response effect of exercise in specific executive function and working memory tasks among depressed persons with a partial response to SSRI and cognitive complaints , with some cognitive functions improving regardless of exercise dose BACKGROUND Neuropsychological deficits in depression include difficulties with psychomotor speed , executive functions and memory . Some of these changes persist despite antidepressant treatment . While research in other areas of psychiatry has shown cognitive training techniques to be effective , only one study has evaluated this approach in depression . METHODS Sixteen patients ( mean age=33.5years ) with a lifetime diagnosis of major depressive disorder were administered a st and ardised battery of neuropsychological tests and allocated to treatment ( n=8 ) or waitlist control ( n=8 ) conditions . The treatment consisted of 10-weeks of twice weekly cognitive training using the Neuropsychological Educational Approach to Remediation . All participants were re-assessed after 10-weeks by interviewers blinded to group allocation . RESULTS Participants in the treatment condition demonstrated greater improvements on tests of memory encoding and memory retention than the waitlist control group . There were no observable benefits in terms of psychomotor speed or executive functions or in self-reported levels of disability . Affective symptoms also remained stable . LIMITATIONS This study included a small sample of participants and treatment allocation was not r and omised . CONCLUSIONS Cognitive training in affective disorders improves memory performance . It may be an effective non-pharmacological treatment option for improving cognitive functions , which in turn , may improve psychosocial functioning and reduce disability . This study supports theories suggesting cognitive training may promote neuroplasticity Physical activity has been proposed as one of the most effective strategies to prevent cognitive decline .  Protein supplementation may exert an additive effect . The effect of resistance-type exercise training with or without protein supplementation on cognitive functioning in frail and pre-frail elderly people was assessed in a secondary analysis . Two 24-week , double-blind , r and omized , placebo-controlled intervention studies were carried out in parallel . Subjects performed a  resistance-type exercise program of two sessions per week ( n=62 ) or no exercise program ( n=65 ) . In both studies , subjects were r and omly allocated to either a protein ( 2 × 15 g daily ) or a placebo drink . Cognitive functioning was assessed with a neuropsychological test battery focusing on the cognitive domains episodic memory , attention and working memory , information processing speed , and executive functioning . In frail and pre-frail elderly  , resistance-type exercise training in combination with protein supplementation  improved information processing speed ( changes in domain score 0.08±0.51 versus -0.23±0.19 in the non-exercise group , p=0.04 ) . Exercise training without protein supplementation was beneficial for attention and working memory ( changes in domain scores 0.35±0.70 versus -0.12±0.69 in the non-exercise group , p=0.02 ) . There were no significant differences among the intervention groups on the other cognitive tests or domain scores BACKGROUND Underst and ing pre clinical transitions to impairment in cognitive abilities associated with risks for functional difficulty and dementia . This study characterized in the Women 's Health and Aging Study ( WHAS ) II 9-year declines and transitions to impairment across domains of cognition . METHODS The WHAS II is an observational study of initially high-functioning , community-dwelling women aged 70 - 80 years at baseline . R and om-effects models jointly compared rates of decline , and discrete-time Cox models estimated hierarchies of incident clinical impairment on measures of psychomotor speed and  executive function  ( EF ) using the Trail Making Test and in immediate and delayed verbal recall using the Hopkins Verbal Learning Test . Patterns of transition were related to incidence of global cognitive impairment on the Mini-Mental State Exam ( MMSE ) . RESULTS Mean decline and impairment occurred first in EF and preceded declines in memory by about 3 years . Thereafter , memory decline was equivalent to that for EF . Over 9 years , 49 % developed domain-specific impairments . Risk of incident EF impairment occurred in 37 % of the sample and was often the first impairment observed ( 23.7 % ) , at triple the rate for psychomotor speed ( p < .01 ) . Risk of immediate and delayed recall impairments was nearly double that for psychomotor speed ( p values < .01 ) . Incident impairment in EF and delayed recall was associated with greater risk for MMSE impairment . CONCLUSIONS Executive dysfunction developed first among nearly one quarter of older women and was associated with elevated risk for global cognitive impairment . Because EF declines preceded memory declines and are important to efficient storage and retrieval EF represents an important target for interventions to prevent declines in memory and MMSE both of which are associated with progression to dementia ' Mild cognitive impairment ' ( MCI ) in older adults refers to a significant decline in memory function but not other cognitive functions . Pharmacological and non-pharmacological treatments for MCI are needed . The present r and omized clinical trial tests the efficacy of a cognitive and behavioral treatment to improve memory performance and participants ' attitudes about their memory .  A multi-faceted intervention that included education about memory loss , relaxation training , memory skills training , and cognitive restructuring for memory-related beliefs was compared to a no-treatment control condition . Outcomes included memory performance and appraisal s of memory function and control . Results indicate that the treated group had significantly better memory appraisal s than controls at the end of treatment and at a six-month follow-up . There were no differences between groups on memory performance at post-test but at follow-up the trained individuals showed a trend toward better word list recall than controls . Findings suggest that individuals with MCI can benefit from multi-component memory enhancement training . Further development of such training programs and tests of their efficacy alone and in combination with medications are needed BACKGROUND Mild cognitive impairment ( MCI ) increases dementia risk with no pharmacologic treatment available . METHODS The Study of Mental and Resistance Training was a r and omized , double-blind , double-sham controlled trial of adults with MCI . Participants were r and omized to 2 supervised interventions : active or sham physical training ( high intensity progressive resistance training vs seated calisthenics ) plus active or sham cognitive training ( computerized , multidomain cognitive training vs watching videos/quizzes ) , 2 - 3 days/week for 6 months with 18-month follow-up . Primary outcomes were global cognitive function ( Alzheimer 's Disease Assessment Scale-cognitive subscale ; ADAS-Cog ) and functional independence ( Bayer Activities of Daily Living ) . Secondary outcomes included executive function , memory , and speed/attention tests , and cognitive domain scores . RESULTS One hundred adults with MCI [ 70.1 ( 6.7 ) years ; 68 % women ] were enrolled and analyzed . Resistance training significantly improved the primary outcome ADAS-Cog ; [ relative effect size ( 95 % confidence interval ) -0.33 ( -0.73 , 0.06 ) ; P < .05 ] at 6 months and executive function ( Wechsler Adult Intelligence Scale Matrices ; P = .016 ) across 18 months . Normal ADAS-Cog scores occurred in 48 % ( 24/49 ) after resistance training vs 27 % ( 14/51 ) without resistance training [ P < .03 ; odds ratio ( 95 % confidence interval ) 3.50 ( 1.18 , 10.48 ) ] . Cognitive training only attenuated decline in Memory Domain at 6 months ( P < .02 ) . Resistance training 18-month benefit was 74 % higher ( P = .02 ) for Executive Domain compared with combined training [ z-score change = 0.42 ( 0.22 , 0.63 ) resistance training vs 0.11 ( -0.60 , 0.28 ) combined ] and 48 % higher ( P < .04 ) for Global Domain [ z-score change = .0.45 ( 0.29 , 0.61 ) resistance training vs 0.23 ( 0.10 , 0.36 ) combined ] . CONCLUSIONS Resistance training significantly improved global cognitive function , with maintenance of executive and global benefits over 18 months BACKGROUND Antidepressant treatment failure is a common problem worldwide . In this study , we assess whether or not an important aspect of depression , cognitive impairment , is untreated by antidepressants by study ing the effect of acute antidepressant treatment on a range of cognitive domains . METHODS In this r and omised longitudinal study , which is part of the International Study to Predict Optimized Treatment in Depression ( iSPOT-D ) trial , we assessed the effects of acute antidepressant treatment in a large patient population , across clinical remission outcomes , on a range of cognitive domains : attention , response inhibition , executive function during visuospatial navigation , cognitive flexibility , verbal memory , working memory , decision speed , information processing speed , and psychomotor response speed . We enrolled patients from primary or specialty care clinics in a multicentre , international , open-label , r and omised , prospect i ve trial . Eligible patients ( aged 18 - 65 years ) were previously untreated or were willing to undergo a 1-week medication washout before the study start , and could not have had inadequate response to study medications in the past . We enrolled a large population of medication-free ( ie , untreated ) out patients in a depressive episode and assessed them for cognitive function at enrolment ( pre-treatment ) , and again after 8 weeks of treatment with one of three antidepressant drugs ( escitalopram , sertraline , or venlafaxine extended-release ) . Patients were r and omly assigned ( 1:1:1 ) to one of the three antidepressants using a blocked r and omisation procedure ( block size of 12 ) . As a comparison group , we also simultaneously enrolled matched healthy participants . Healthy participants received no medication or intervention , but were assessed for change in cognitive and clinical measures during the same interval and testing protocol . Therefore , this group acts as a test-retest control for the primary outcome measure examined in this study , change in cognitive measures over 8 weeks of treatment in depressed patients . This study is registered with Clinical Trials.gov , number NCT00693849 . FINDINGS Between Dec 8 , 2008 , and Sept 30 , 2011 , we enrolled 1008 eligible people into the study .  Impairment in five domains-attention , response inhibition , verbal memory , decision speed , and information processing-showed no relative improvement with acute treatment ( controlling for time or repeated testing ) , irrespective of antidepressant treatment group , even in patients whose depression remitted acutely according to clinical measures . Broader cognitive impairment was associated with greater illness chronicity ( earlier illness onset ) but not with symptom severity or previous antidepressant failures . INTERPRETATION Depression is associated with impairments in higher-order cognitive functions and information processing , which persist independently of clinical symptom change with treatment . We recorded no difference between the three antidepressants tested , with none showing efficacy for these impairments . Although the 8-week treatment period limits interpretation to acute treatment effects , it does highlight cognitive impairment as an untargeted contributor to incomplete treatment success . FUNDING Brain Re source Company Operations Pty Ltd and NIH Abstract Purpose : This study aim ed to determine the efficacy of the integrative group-based cognitive rehabilitation programme , REHACOP , on improving cognitive functions in multiple sclerosis ( MS ) . Methods : Fourty-two MS patients were r and omized to the treatment programme REHACOP  ( n = 21 ) or waiting list control condition ( n = 21 ) . The REHACOP group received cognitive rehabilitation in group format for three months focused on attention , processing speed , learning and memory , language , executive functioning , and social cognition . Patients completed a neuropsychological assessment at baseline and follow-up , which included tests of attention , processing speed , working memory , verbal memory , verbal fluency , and executive functioning . Repeated measures multivariate analysis of covariance ( MANCOVA ) was used to determine the efficacy of the cognitive rehabilitation programme . Results : Group × Time interactions revealed significant improvements in the REHACOP group as compared with the control group for processing speed ( p = 0.011 , np2 = 0.16 ) , working memory ( p = 0.014 , np2 = 0.15 ) , verbal memory ( p = 0.025 , np2 = 0.13 ) , and executive functioning ( p = 0.024 , np2 = 0.13 ) , showing medium – large effect sizes . Conclusions : Patients receiving REHACOP  showed improvements in several cognitive domains . This preliminary study thus provides evidence supporting the efficacy of this integrative group-based cognitive rehabilitation intervention in MS . Future research should confirm these findings , examine the impact of the treatment on everyday life functioning and explore the presence of brain changes associated with cognitive rehabilitation . Implication s for rehabilitation This study provides initial evidence for integrative group-based cognitive rehabilitation efficacy in MS patients through the implementation of the REHACOP cognitive rehabilitation programme . Patients received cognitive rehabilitation for three months ( 3 one-hour-sessions per week ) focused on training attention , learning and memory , language , executive functioning , and social cognition . Patients attending REHACOP sessions showed medium to large and statistically significant improvements in processing speed , working memory , verbal memory , and executive functioning BACKGROUND Targeting glutamatergic dysfunction provides an exciting opportunity to improve cognitive impairment in schizophrenia . One treatment approach has targeted inadequate antioxidant defenses at glutamatergic synapses . Animal and human data suggest NMDA antagonists worsen executive cognitive controls -- e.g . increase perseverative responses and impair set-shifting . We conducted a preliminary study to test the hypothesis that L-carnosine , an antioxidant and anti-glycation agent which is co-localized and released with glutamate would improve executive dysfunction , a cognitive domain associated with glutamate . METHODS Seventy-five symptomatically stable adults with chronic schizophrenia were r and omly assigned to L-carnosine as adjunctive treatment ( 2 g/day ) or a matched placebo in a double-blind manner for 3 months . Cognitive domains ( executive dysfunction , memory , attention and motor speed ) were assessed using a computerized battery at baseline , 4 and 12 weeks , along with psychopathology ratings and safety parameters . RESULTS The L-carnosine group performed significantly faster on non-reversal condition trials of the set-shifting test compared with placebo but reversal reaction times and errors were not significantly different between treatments . On the strategic target detection test , the L-carnosine group displayed significantly improved strategic efficiency and made fewer perseverative errors compared with placebo . Other cognitive tests showed no significant differences between treatments . Psychopathology scores remained stable . The carnosine group reported more adverse events ( 30 % ) compared with the placebo group ( 14 % ) . Laboratory indices remained within acceptable ranges . CONCLUSIONS These preliminary findings suggest that L-carnosine merits further consideration as adjunctive treatment to improve executive dysfunction in persons with schizophrenia Background and aim : Social functioning is impaired in approximately two-thirds of stroke patients of vocational age , even several months after a first ever mild to moderate stroke . The known predictors of social functioning are initial stroke severity , anxiety and depression , and the Mini-Mental State Evaluation , suggesting that cognitive deficits contribute to post-stroke social dysfunctioning . The aim of this study was to evaluate whether cognitive domains correlated with social functioning and to determine the cognitive predictors of social dysfunctioning . Methods : 74 patients were prospect ively included 6 months after a first ever stroke . National Institutes of Health Stroke Scale ( NIHSS ) , modified Rankin scale , depression and anxiety were recorded . Social functioning was recorded using the Work and Social Adjustment Scale  ( WSAS ) . An extensive neuropsychological test battery explored general cognitive functioning , episodic memory , instrumental functions , executive functions and working memory . Univariate comparisons assessed the relationships between the neuropsychological tests and scores on the WSAS . Predicting factors for WSAS were determined using ordinal logistic regression . Results : 52 patients ( 70 % ; 95 % confidence interval 58 % to 80 % ) complained of significant perturbations in work and social functioning . In univariate comparisons , general cognitive functioning , memory , instrumental functions , executive functions and working memory significantly correlated with social functioning . Working memory was the most affected domain . With multivariate modelling , the NIHSS at admission , Hospital Anxiety Depression scale and Owen ’s Spatial Working Memory test were independent predictors of WSAS . Conclusions : All cognitive domains were associated with social functioning , working memory being the main cognitive determinant . Our results suggest that cognitive impairment impacts on social dysfunctioning , which is known to be a component of quality of life Purpose Some breast cancer survivors report cognitive difficulties greater than 1 year after chemotherapy .  Acetylcholinesterase inhibitors ( AChEI ) may improve cognitive impairment . We conducted a r and omized , placebo-controlled , pilot study to assess the feasibility of using the AChEI , donepezil , to improve subjective and objective measures of cognitive function in breast cancer survivors . Methods Women who received adjuvant chemotherapy 1–5 years prior with current cognitive dysfunction symptoms were r and omized to  5 mg of donepezil/day vs placebo for 6 weeks and if tolerated 10 mg/day for 18 weeks for a total of 24 weeks . A battery of vali date d measures of attention , memory , language , visuomotor skills , processing speed , executive function , and motor dexterity and speed was administered at baseline and at 24 and 36 weeks . Subjective cognitive function , fatigue , sleep , mood , and health-related quality of life were evaluated at baseline and at 12 , 24 , and 36 weeks . Results Sixty-two patients were enrolled , 76 % completed the study , self-reported compliance was 98 % , and toxicities were minimal . At the end of treatment , the donepezil group performed significantly better than the control group on two parameters of memory — the Hopkins Verbal Learning Test -Revised ( HVLT-R ) Total Recall ( p = 0.033 ) and HVLT-R Discrimination ( p = 0.036 ) . There were no significant differences on other cognitive variables or in subjective cognitive function or quality of life . Conclusion Accrual to this feasibility trial was robust , retention was good , compliance was excellent , and toxicities were minimal . Implication s for Cancer SurvivorsR and omized clinical trials in breast cancer survivors to improve cognitive dysfunction are feasible . A phase III trial testing the efficacy of donepezil is warranted given these pilot results Despite the growing interest in cognitive training programs as a potential non-pharmacological approach to slowing cognitive decline in mild cognitive impairment ( MCI ) , there has been little research on the differential effectiveness of training among subtypes of MCI ( i.e. , amnestic , single non-amnestic , and multi-domain ) . The current study examined the longitudinal effects of  cognitive speed of processing training ( SOPT )  among older adults with psychometricallydefined MCI from the Advanced Cognitive Training for Independent and Vital Elderly ( ACTIVE ) trial . Mixed model ANOVAs examined the effectiveness of SOPT in participants with MCI relative to controls and also compared training effectiveness in MCI subgroups to appropriate controls . A mixed effects model compared SOPT training effects longitudinally across five years relative to controls . A second mixed effects model compared the durability of training gains between the MCI subtypes across 5 years . All subtypes of MCI showed immediate improvement post-training relative to controls , with the single non-amnestic subtype showing the most benefit . Additionally , all subtypes showed similar trajectories across five years . There were no significant changes in performance across time , indicating initial training gains were maintained . These results provide support for the effectiveness and potential durability of SOPT among persons with MCI regardless of subtype . Future research should investigate if SOPT transfers to improvements in the everyday functioning of those with MCI OBJECTIVE Cognitive dysfunction and structural brain abnormalities have been observed in obese versus lean individuals , but with variability across age and weight groups . The current study was design ed to clarify the cognitive profile of obesity by examining performance across multiple cognitive domains in adults with wide-ranging age and weight status . METHOD Participants ( N = 732 ; 61 % women ; ages 18 - 88 ; BMI range 19 - 75 ) underwent assessment of cognitive functioning and relevant medical/demographic covariates .  Neuropsychological tests  were grouped by cognitive domain ( via confirmatory factor analysis ) , and st and ardized scores were averaged into composite variables . RESULTS Hierarchical linear regression analyses revealed main effects for BMI on motor ( ΔR2 = .02 , β = -.15 ) and attention/processing speed ( ΔR2 = .01 , β = -.07 ) , whereas a significant interaction between BMI and age was observed ( ΔR2 = .01 , β = -.08 ) for predicting executive functioning ( p < .05 ) . BMI was not independently associated with memory or language functioning and no interaction effects were observed for these variables . Although BMI was not independently related to executive dysfunction , a significant age × BMI interaction suggests that obesity-related executive deficits may increase with age . CONCLUSIONS Overall , these findings may support an independent association between obesity and a frontal-subcortical pathology , though prospect i ve studies are needed to further clarify this possibility BACKGROUND Longevity can be accompanied by several challenges , among them cognitive decline . The early identification of cognitive impairment offers the opportunity to act with the aim of preventing or delaying dementia . One potential intervention measure is MT . OBJECTIVES To test the effect of MT  in a sample of older individuals previously identified as having MCI . METHODS A r and omized controlled clinical trial was carried out . Subjects were recruited by the local media for a memory study and were su bmi tted to a battery of cognitive tests . Subjects meeting inclusion criteria ( n=112 ) were classified as normal controls ( n=65 ) and MCI ( n=47 ) , according to Gauthier and Touchon 's criteria ( Gauthier & Touchon , 2005 ) . The study sample was r and omly assigned to three different intervention groups : MT group , educational intervention ( EI ) group , and control group ( CG ) . The MT group received eight training sessions to learn mnemonic strategies based on ecological tasks . They also completed tasks which recruited attention and executive functions .  Educational content on  memory and aging was also offered . The EI participated in the same number of sessions , yet , only the educational content was offered . The CG completed pre- and post-test evaluations , and received training afterwards . RESULTS Training effects were modest and for certain variables they were equivalent to retest effects . However , after training , individuals with MCI in the MT group exhibited cognitive performance typical of individuals without cognitive impairment , suggesting cognitive plasticity . CONCLUSION MT is a feasible non-pharmacological intervention which might bring positive performance change in older adults facing cognitive impairment The dentate gyrus ( DG ) is a region in the hippocampal formation whose function declines in association with human aging and is therefore considered to be a possible source of age-related memory decline . Causal evidence is needed , however , to show that DG-associated memory decline in otherwise healthy elders can be improved by interventions that enhance DG function . We addressed this issue by first using a high-resolution variant of functional magnetic resonance imaging ( fMRI ) to map the precise site of age-related DG dysfunction and to develop a cognitive task whose function localized to this anatomical site . Then , in a controlled r and omized trial , we applied these tools to study healthy 50–69-year-old subjects who consumed either a high or low cocoa flavanol – containing diet for 3 months . A high-flavanol intervention was found to enhance DG function , as measured by fMRI and by cognitive testing . Our findings establish that DG dysfunction is a driver of age-related cognitive decline and suggest non-pharmacological means for its amelioration There is accumulating evidence for involvement of the prefrontal cortex ( PFC ) in the pathophysiology of schizophrenia . A primary function supported by the PFC is working memory ( WM ) . Findings from WM studies in schizophrenia can provide insight into the nature of clinical symptoms and cognitive deficits associated with this disorder , as well as begin to suggest areas of underlying neuropathology . To date , studies have not adequately investigated different WM domains ( e.g. , verbal , spatial , or object ) or processing requirements ( e.g. , maintenance , monitoring , or manipulation ) , shown to be associated with distinct patterns of neural activation , in schizophrenia patients and their well relatives . Accordingly , this study evaluated the performance of schizophrenia patients , their first-degree biological relatives , and nonpsychiatric controls on a comprehensive battery of WM tasks and investigated the association among WM deficits and  schizophrenia-spectrum psychopathology . The findings indicate that schizophrenia patients are consistently impaired on WM tasks  , irrespective of WM domain or processing requirements . In contrast , their unaffected relatives are only impaired on  WM tasks with higher central executive processing requirements . This pattern of WM performance may further implicate DLPFC dysfunction in the liability for schizophrenia and has implication s for future cognitive , genetic , and neurodevelopmental research Cognitive Behavioral Social Skills Training ( CBSST ) is a 24-session weekly group therapy intervention to improve functioning in people with schizophrenia . In our prior r and omized clinical trial comparing treatment as usual ( TAU ) with TAU plus group CBSST ( Granholm , E. , McQuaid , J.R. , McClure , F.S. , Ausl and er , L. , Perivoliotis , D. , Pedrelli , P. , Patterson , T. , Jeste , D.V. , 2005 . A r and omized controlled trial of cognitive behavioral social skills training for middle-aged and older out patients with chronic schizophrenia . Am . J. Psychiatry 162 , 520 - 529 . ) , participants with schizophrenia in CBSST  showed significantly better functional outcome than participants in TAU . The present study was a secondary analysis of neuropsychological predictors of functional outcome in our prior CBSST trial . We examined ( 1 ) whether neuropsychological impairment at baseline moderated functional outcome in CBSST relative to TAU , and ( 2 ) whether improvement in neuropsychological abilities mediated improvement in functional outcome in CBSST .  Attention , verbal learning/memory , speed of processing , and executive functions were assessed at baseline , end of treatment , and 12-month follow-up . Greater severity of neuropsychological impairment at baseline predicted poorer functional outcome for both treatment groups ( nonspecific predictor ) , but the interaction between severity of neuropsychological impairment and treatment group was not significant ( no moderation ) . Effect sizes for the difference between treatment groups on functional outcome measures at 12-month follow-up were similar for participants with relatively mild ( d=.44-.64 ) and severe ( d=.29-.60 ) neuropsychological impairment . Results also did not support the hypothesis that improvement in neuropsychological abilities mediated improvement in functioning in CBSST . Adding CBSST to st and ard pharmacologic care , therefore , improved functioning relative to st and ard care alone , even for participants with severe neuropsychological impairment , and this improvement in functioning was not related to improvement in neuropsychological abilities in CBSST BACKGROUND Observational data indicate that carotid artery stenting ( CAS ) is associated with higher incidence of sub clinical cerebral microemboli than carotid endarterectomy ( CEA ) . We hypothesized that CEA would be associated with superior performance on detailed domain-specific cognitive testing compared with CAS . METHODS Patients with > 80 % asymptomatic carotid artery stenosis were r and omized to CEA or CAS  with side of stenosis balanced across condition . A robust battery of tests was used to assess the cognitive domains of attention , memory , mood , visual-spatial skills , motor ability , processing speed , and executive functioning ≤10 days preoperatively and postoperatively at 6 weeks and 6 months . Tests were administered using st and ardized conditions and were scored by individuals blinded to treatment allocation . RESULTS Baseline cognitive performance was similar between CAS ( n = 29 ) and CEA ( n = 31 ) groups ( P > .05 ) . Relative to baseline , verbal and visual memory and attention functions substantially improved in the CAS and CEA groups at 6 months ( multiple cognitive tests achieved statistical significance ) . Compared with  CEA , cognitive processing speed ( Stroop Color test : 9.0 vs 7.3 , P = .04 ; and Stroop Word test : 9.0 vs 7.4 , P = .05 ) was superior in the CAS group at 6 weeks . Executive functioning ( phonemic verbal fluency : 10.6 vs 8.4 , P = .043 ) and motor function ( Grooved Pegboard of nondominant extremity : 45.7 vs 38.9 , P = .022 ) were also superior in the CAS group at 6 months . Tests of attention , memory , and visual-spatial skills were similar between CAS and CEA patients at 6 weeks and 6 months . CONCLUSIONS Carotid revascularization improves memory and attention within the first 6 postoperative months . Compared with CEA , CAS produces improvements in cognitive processing speed , executive functioning , and motor function OBJECTIVE There is considerable interest in cognitive remediation for schizophrenia . Our study aim ed to evaluate , in a large sample of patients with schizophrenia , the interest of a computer-assisted cognitive remediation program on cognitive performances of patients as well as in clinical and functional outcome . METHOD Seventy-seven patients with remitted schizophrenia were r and omly assigned to 14 2-hours individual sessions of computer-assisted cognitive remediation ( n=39 ) or a control condition ( n=38 ) . Remediation was performed using RehaCom ® software . Four procedures were chosen to train four cognitive functions involved in different stages of the information processing : attention/concentration , working memory , logic , and executive functions . Primary outcomes were remediation exercise metrics , neuropsychological composites ( episodic memory , working memory , attention , executive functioning , and processing speed ) , clinical and community functioning measures . RESULTS Cognitive performances concerning Attention/vigilance , verbal working memory and verbal learning memory and reasoning/problem solving improved significantly in the remediation condition when no difference was reported in the control condition between the 2 assessment s. However , there were no significant benefits of cognitive remediation on non-verbal working memory and learning and speed of processing or functional outcome measures . CONCLUSIONS Cognitive remediation for people with schizophrenia was effective in improving performance , but the benefits of training did not generalize to functional outcome measures . Long term follow-up studies are needed to confirm the maintenance of such improvements Background Cognitive impairment and depression often co-occur in older adults , but it is not clear whether depression is a risk factor for cognitive decline , a psychological reaction to cognitive decline , or whether changes in depressive symptoms correlate with changes in cognitive performance over time . The co-morbid manifestation of depression and cognitive impairment may reflect either a causal effect or a common cause , depending on the specific symptoms experienced and the cognitive functions affected . Method The study sample comprised 1506 community-dwelling older adults aged ⩾65 years from the Longitudinal Aging Study Amsterdam ( LASA ) . We conducted cross-domain latent growth curve analyses to examine longitudinal associations between late-life depression dimensions ( i.e. depressed affect , positive affect , and somatic symptoms ) and specific domains of cognitive functioning ( i.e. processing speed , inductive reasoning , immediate recall , and delayed recall ) . Results Poorer delayed recall performance at baseline predicted a steeper increase in depressed affect over time . Steeper decline in processing speed correlated with a steeper increase in somatic symptoms of depression over time . Conclusions Our findings suggest a prospect i ve association between memory function and depressed affect , whereby older adults may experience an increase in depressed affect in reaction to poor memory function . Somatic symptoms of depression increased concurrently with declining processing speed , which may reflect common neurodegenerative processes . Our findings do not support the hypothesis that depression symptoms may be a risk factor for cognitive decline in the general population . These findings have potential implication s for the treatment of late-life depression and for the prognosis of cognitive outcomes Multiple sclerosis leads to prominent hippocampal atrophy , which is linked to memory deficits . Indeed , 50 % of multiple sclerosis patients suffer memory impairment , with negative consequences for quality of life . There are currently no effective memory treatments for multiple sclerosis either pharmacological or behavioral . Aerobic exercise improves memory and promotes hippocampal neurogenesis in nonhuman animals . Here , we investigate the benefits of aerobic exercise in memory-impaired multiple sclerosis patients . Pilot data were collected from two ambulatory , memory-impaired multiple sclerosis participants r and omized to non-aerobic ( stretching ) and aerobic ( stationary cycling ) conditions . The following baseline/follow-up measurements were taken : high-resolution MRI ( neuroanatomical volumes ) , fMRI ( functional connectivity ) , and memory assessment . Intervention was 30-minute sessions 3 times per week for 3 months . Aerobic exercise result ed in 16.5 % increase in hippocampal volume and 53.7 % increase in memory , as well as increased hippocampal resting-state functional connectivity . Improvements were specific , with no comparable changes in overall cerebral gray matter ( + 2.4 % ) , non-hippocampal deep gray matter structures ( thalamus , cau date : −4.0 % ) , or in non-memory cognitive functioning ( executive functions , processing speed , working memory : changes ranged from −11 % to + 4 % ) . Non-aerobic exercise result ed in relatively no change in hippocampal volume ( 2.8 % ) or memory ( 0.0 % ) , and no changes in hippocampal functional connectivity  . This is the first evidence for aerobic exercise to increase hippocampal volume and connectivity and improve memory in multiple sclerosis . Aerobic exercise represents a cost-effective , widely available , natural , and self-administered treatment with no adverse side effects that may be the first effective memory treatment for multiple sclerosis patients Differentiating the cognitive effects of cerebrovascular disease , particularly small vessel disease , from those of Alzheimer 's disease is a difficult clinical challenge . An influential model of how subcortical cerebrovascular disease causes cognitive dysfunction posits that damage to frontostriatal loops impairs frontal lobe function , leading to predominant impairment of executive function and secondary impairments of associated cognitive functions such as memory . Consistent with this , neuropsychological studies of clinical ly diagnosed patients have reported that individuals with vascular dementia do better on memory tests and worse on executive function tests compared with patients with Alzheimer 's disease . This observation has led to the suggestion that predominant cognitive executive dysfunction might serve as a useful diagnostic marker for vascular dementia . We sought to test this idea in a series of cases with autopsy-defined pathologies . Subjects were 62 autopsied cases from a prospect i ve study of vascular contributions to dementia . Using neuropathological features alone , 23 were diagnosed with Alzheimer 's disease ( AD ) , 11 with cerebrovascular disease ( CVD ) , 9 with both ( mixed pathology ) and 19 with normal elderly brain ( NEB ) . Three psychometrically matched composite scales of different cognitive abilities were used : Verbal Memory , Nonverbal Memory and Executive Function . Analysis of group data showed that for Alzheimer 's disease memory scores were lower than Executive Function by nearly a st and ard deviation on average . In contrast , and contrary to the model , CVD was rather equally impaired on Executive Function , Verbal Memory and Nonverbal Memory . Individual patterns of cognitive impairment were examined by defining three profiles based on reliable differences between neuropsychological scores to characterize cases with predominant memory impairment , predominant executive dysfunction , and ' other ' patterns . Analysis of individual impairment profiles showed that predominant memory impairment was present in 71 % of Alzheimer 's disease while predominant executive dysfunction described only 45 % of CVD . A stronger pattern emerged when cognitively normal cases were excluded ; among the six cognitively impaired CVD patients four had predominant executive dysfunction and none had predominant memory impairment . This report , comprised of a substantial sample of autopsy confirmed cases , delineates the patterns of neuropsychological impairment associated with small vessel cerebrovascular disease and Alzheimer 's disease While the findings show that memory loss usually exceeds executive dysfunction in patients with Alzheimer 's disease , the reverse is not the case in CVD . Taken as a whole , the results indicate that the cognitive effects of the small vessel cerebrovascular disease are variable and not especially distinct , thus raising question about the utility of executive impairment as a diagnostic marker for vascular dementia Abstract Non-demented community-dwelling older adults aged 70–90 years ( n = 1,037 ) r and omly recruited from the electoral roll completed neuropsychological and medical assessment s over six years . The overall prevalence of mild cognitive impairment ( MCI ) at baseline was 36.7 % . Risk factors for MCI include APOE ϵ4 allele carrier status , high homocysteine , heart disease , poor odour identification , low visual acuity and low mental activity , but notable age and sex differences were observed . Neuropsychiatric symptoms were rare ; depression was the most common and was associated with cognitive impairment in at least one domain as well as subsequent dementia 2 years later . Poorer cognitively dem and ing functional abilities were associated with cognitive impairment . Biomarkers for cognitive impairment and decline were identified . Inflammatory markers and plasma apolipoprotein levels were associated with poorer performance in the attention/processing speed domain . Measures of white matter lesions , white matter integrity , sulcal morphology and tractography were identified as novel biomarkers of early cognitive decline . Stronger deactivation in the posteromedial cortex with increasing memory load on functional MRI predicted future decline . Compared to previous reports , our prevalence rates of MCI were higher but rates of progression to dementia and reversion to normal were similar , as were risk factors for progression to dementia Acupressure is a complementary and alternative medicine ( CAM ) treatment using fingertips to stimulate acupoints on the skin . Although suggested to improve cognitive function , acupressure has not been previously investigated with a controlled design in traumatic brain injury ( TBI ) survivors , who could particularly benefit from a non-pharmacological intervention for cognitive impairment . A r and omized , placebo-controlled , single-blind design assessed the effects of acupressure ( eight treatments over 4 weeks ) on cognitive impairment and state of being following TBI , including assessment of event-related potentials ( ERPs ) during Stroop and auditory oddball tasks . It was hypothesized that active acupressure treatments would confer greater cognitive improvement than placebo treatments , perhaps because of enhanced relaxation response induction and result ing stress reduction . Significant treatment effects were found comparing pre- to post-treatment change between groups . During the Stroop task , the active-treatment group showed greater reduction in both P300 latency ( p = 0.010 , partial η² = 0.26 ) and amplitude ( p = 0.011 , partial η² = 0.26 ) , as well as a reduced Stroop effect on accuracy ( p = 0.008 , partial η² = 0.21 ) than did the placebo group . Additionally , the active-treatment group improved more than did the placebo group on the digit span test ( p = 0.043 , Cohen 's d = 0.68 ) . Together , these results suggest an enhancement in working memory function associated with active treatments . Because acupressure emphasizes self-care and can be taught to novice individuals , it warrants further study as an adjunct treatment for TBI Purpose : To compare long-term cognitive outcomes of patients treated with surgical clipping or endovascular coiling after subarachnoid haemorrhage ( SAH ) . Method : Retrospective matched cohort study assessed neuropsychological functioning at least 12 months after aneurysmal SAH treatment . Fourteen patients treated by endovascular coiling and nine patients treated by surgical clipping participated . After gaining written consent , a comprehensive neuropsychological battery was completed . St and ardised tests were employed to assess pre-morbid and current intellectual functioning ( IQ ) , attention , speed of information processing , memory and executive function as well as psychosocial functioning and affect . Results : Treatment groups were not significantly different in terms of age , pre-morbid IQ , time from injury to treatment or time since injury . A significant effect of treatment on full-scale IQ score ( p = 0.025 ) , performance IQ ( p = 0.045 ) and verbal IQ score ( p = 0.029 ) , all favouring the coiled group was observed . A medium effect size between groups difference in immediate memory ( p = 0.19 , partial η2 = 0.08 ) was also observed . No significant between group differences on attention , executive functioning and speed of information processing measures or mood and psychosocial functioning were noted . Both groups reported increased anxiety and memory , attention and speed of information processing deficits relative to normative data . Conclusions : Study findings indicate fewer cognitive deficits following endovascular coiling . Cognitive deficits in the clipped group may be due in part to the invasive nature of neurosurgical clipping . Further prospect i ve research with regard to long-term cognitive and emotional outcomes is warranted . Implication s of Rehabilitation Treatment of ruptured intracranial aneurysms by either endovascualar coiling or neurosurgical clipping can result in significant long-term physical disability as well as cognitive impairment . Observed cognitive impairment(s ) tend to be less in patients following endovascular coiling . Following ruptured aneurysm , patients with cognitive impairment report reduced health related quality of life and increased anxiety . Those with identified cognitive impairment(s ) may benefit from cognitive remediation Cognitive impairment can occur at all stages of Parkinson 's disease . Rasagiline is a selective monoamine oxidase type-B inhibitor that enhances central dopaminergic transmission . Dopamine is thought to be involved in certain cognitive processes such as working memory . We assessed the effects of rasagiline on cognitive deficits in cognitively impaired , nondemented patients with Parkinson 's disease . This was a r and omized , double-blind , placebo-controlled prospect i ve study . Patients with Parkinson 's disease receiving stable dopaminergic treatment were assigned to receive rasagiline 1 mg/day or placebo for 3 months . Patients were eligible if they had impairment in 2 of 4 cognitive domains ( attention , executive functions , memory , visuospatial functions ) in the screening neuropsychological tests , yet did not fulfill criteria for Parkinson 's disease dementia . Fifty-five patients were r and omized ; 48 patients completed the study . Patients in the rasagiline group showed significant improvement in digit span-backward compared with the placebo group ( P = .04 ) , with trends favoring rasagiline in digit span total and digit-ordering tests . Verbal fluency total score showed a significant difference in favor of rasagiline ( P = .038 ) , with trends favoring rasagiline in semantic fluency test and Stroop spontaneous corrections . The composite cognitive domain Z scores revealed a significant difference in favor of rasagiline compared with placebo in the attentional Z score ( P < .005 ) . There were no significant differences between the 2 groups in the other cognitive tests or cognitive domain Z scores . The monoamine oxidase type-B inhibitor rasagiline may exert beneficial effects on certain aspects of attention and executive functions in nondemented patients with Parkinson 's disease with cognitive impairment The relationship between MRI findings ( i.e. , subcortical hyperintensities ; SH , whole brain volume ) and the cognitive dysfunction of vascular dementia ( VaD ) was examined . Participants included 24 persons that met NINDS-AIREN criteria for VaD ( MMSE = 19.9 + /- 4.2 ) and underwent comprehensive neuropsychological assessment and MRI brain imaging .  The volume of subcortical hyperintensities ( SH ) was strongly associated with executive-psychomotor performance , but not with performance across other cognitive domains or global cognitive functional level . Conversely , WBV was strongly associated with global cognitive functioning and performance across most cognitive domains ( memory , language , visual integration ) , but not with executive-psychomotor functioning . The failure of SH to account for either the global dementia evident in these VaD patients or impairments across most cognitive domains suggests that deep subcortical white matter disease may only indirectly contribute to the global cognitive dysfunction of VaD. That WBV emerged as a stronger correlate of dementia raises further questions regarding the cerebral mechanisms that contribute to the development of Cognitive functions are impaired in Major Depression . Studies on the effects of Yoga on cognitive functions have shown improvement in memory , vigilance and anxiety levels . 30 patients suffering from Major depression ( age 18 to 45 years ) were r and omly divided into two groups : Group 1 : ( 10 males and 5 Females ) Patients who practised Sahaj Yoga meditation and also received conventional anti-depressant medication . Group 2 : ( 9 males and 6 Females ) Patients who only received conventional antidepressant medication .  Group 1 patients were administered Sahaj Yoga practice for 8 weeks . Neuro-cognitive test battery consisting of Letter cancellation test ( LCT ) , Trail making test ' A ' ( TTA ) , Trail making test ' B ' ( TTB ) , Ruff figural fluency test ( RFFT ) , Forward digit span ( FDS ) & Reverse digit span test ( RDS ) was used to assess following cognitive domains : Attention span , visuo-motor speed , short-term memory , working memory and executive functions . After 8 weeks , both Group 1 and Group 2 subjects showed significant improvement in LCT , TTA & TTB but improvement in LCT was more marked in Group 1 subjects . Also , there was significant improvement in RDS scores in only Group 1 subjects ( P < 0.05 ) . The results thereby , demonstrate that Sahaj Yoga practice in addition to the improvement in various other cognitive domains seen with conventional anti-depressants , can lead to additional improvement in executive functions like manipulation of information in the verbal working memory and added improvement in attention span and visuo-motor speed of the depressives In this study we determined the short-term effects of a glucose drink and a sucrose drink compared to a placebo on cognitive performance and mood in elderly people with subjective , mild memory complaints using a r and omized crossover study design . In total , 43 nondiabetic older adults with self-reported memory complaints were included .  Drinks consisted of 250 ml with dissolved glucose ( 50 g ) , sucrose ( 100 g ) , or a mixture of artificial sweeteners ( placebo ) .  Multiple neuropsychological tests were performed and were combined by means of z scores into four cognitive domains : episodic memory , working memory , attention and information ( processing speed ) , and executive functioning . Mood was assessed with the short Profile of Mood Status ( s-POMS ) question naire . Blood glucose concentrations were measured at five time points to divide participants into those with a better or poorer blood glucose recovery . Performance on the domain of attention and information processing speed was significantly better after consuming the sucrose drink ( domain score of 0.06 , SD = 0.91 ) than after the placebo drink ( –0.08 , SD = 0.92 , p = .04 ) . Sucrose had no effect on the other three domains , and glucose had no effect on any of the domains compared to the placebo . When dividing participants into poorer or better glucose recoverers , the beneficial effect of sucrose on attention and information processing speed was only seen in participants with a poorer recovery . After sucrose consumption , depressive feelings and tension were slightly higher than after the placebo . To conclude , 100 g sucrose , but not 50 g glucose , optimized attention and information processing speed in the short term in this study in elderly people with subjective , mild memory complaints Cognitive dysfunction is common in older persons suffering from a major depression . However , the degree to which this dysfunction is reversible with successful treatment of the depression remains uncertain . The present study examined the effects that treatment ( r and omized double-blind design ) with either an SSRI ( paroxetine ) or a tricyclic antidepressant ( nortriptyline ) had on cognition in older depressed patients . The patients ' performance was compared to that of a group of normal controls of similar age and education . Patients and controls were administered measures of working memory , information-processing speed , episodic memory and attention five times over the course of a 12 week trial . At baseline , the patients performed more poorly than the elderly controls on all cognitive measures . While the patients ' performance did improve over the course of their treatment , the magnitude of this improvement did not exceed that produced in the elderly controls by practice alone . The same pattern of results was evident in both intent-to-treat and responder analyses . Thus , there was no evidence that the depressed patients ' cognitive performance normalized after response to antidepressant therapy . Neither the patients ' age at onset nor their baseline level of cognitive functioning influenced the amount by which their performance improved over the 12 week trial . There was no difference between paroxetine and nortriptyline in the amount of cognitive change associated with treatment . The present results suggest that cognitive dysfunction persists in older depressed patients even after their mood disorder has responded to antidepressant medications PURPOSE Neurotoxic effects of brain irradiation include cognitive impairment in 50 % to 90 % of patients . Prior studies have suggested that donepezil , a neurotransmitter modulator , may improve cognitive function . PATIENTS AND METHODS A total of 198 adult brain tumor survivors ≥ 6 months after partial- or whole-brain irradiation were r and omly assigned to receive a single daily dose ( 5 mg for 6 weeks , 10 mg for 18 weeks ) of donepezil or placebo . A cognitive test battery assessing memory , attention , language , visuomotor , verbal fluency , and executive functions was administered before r and om assignment and at 12 and 24 weeks . A cognitive composite score ( primary outcome ) and individual cognitive domains were evaluated . RESULTS Of this mostly middle-age , married , non-Hispanic white sample , 66 % had primary brain tumors , 27 % had brain metastases , and 8 % underwent prophylactic cranial irradiation . After 24 weeks of treatment , the composite scores did not differ significantly between groups ( P = .48 ) ; however , significant differences favoring donepezil were observed for memory ( recognition , P = .027 ; discrimination , P = .007 ) and motor speed and dexterity ( P = .016 ) . Significant interactions between pretreatment cognitive function and treatment were found for cognitive composite ( P = .01 ) , immediate recall ( P = .05 ) , delayed recall ( P = .004 ) , attention ( P = .01 ) , visuomotor skills ( P = .02 ) , and motor speed and dexterity ( P < .001 ) , with the benefits of donepezil greater for those who were more cognitively impaired before study treatment . CONCLUSION Treatment with donepezil did not significantly improve the overall composite score , but it did result in modest improvements in several cognitive functions , especially among patients with greater pretreatment impairments Insidious declines in normal aging are well-established . Emerging evidence suggests that non-pharmacological interventions , specifically cognitive and physical training , may counter diminishing age-related cognitive and brain functions . This r and omized trial compared effects of two training protocol s : cognitive training ( CT ) vs. physical training ( PT ) on cognition and brain function in adults 56–75 years . Sedentary participants ( N = 36 ) were r and omized to either CT or PT group for 3 h/week over 12 weeks . They were assessed at baseline- , mid- , and post-training using neurocognitive , MRI , and physiological measures . The CT group improved on executive function whereas PT group 's memory was enhanced . Uniquely deploying cerebral blood flow ( CBF ) and cerebral vascular reactivity ( CVR ) MRI , the CT cohort showed increased CBF within the prefrontal and middle/posterior cingulate cortex ( PCC ) without change to CVR compared to PT group . Improvements in complex abstract ion were positively associated with increased resting CBF in dorsal anterior cingulate cortex ( dACC ) . Exercisers with higher CBF in hippocampi bilaterally showed better immediate memory . The preliminary evidence indicates that increased cognitive and physical activity improves brain health in distinct ways . Reasoning training enhanced frontal networks shown to be integral to top-down cognitive control and brain resilience . Evidence of increased resting CBF without changes to CVR implicates increased neural health rather than improved vascular response . Exercise did not improve cerebrovascular response , although CBF increased in hippocampi of those with memory gains . Distinct benefits incentivize testing effectiveness of combined protocol s to strengthen brain health The development of cholinergic therapies for Alzheimer 's disease ( AD ) has highlighted the importance of underst and ing the role of attentional deficits and the relationship between attention and memory in the earliest stages of the disease . Variability in the tasks used to examine aspects of attention , and in the disease severity , between studies makes it difficult to determine which aspects of attention are affected earliest in AD , and how attentional impairment is related to other cognitive modules . We tested 27 patients in the early stages of the disease on the basis of the MMSE ( minimal 24 - 30 corresponding to minimal cognitive impairment , very mild or possible AD in other classifications ; and mild 18 - 23 ) on a battery of attentional tests aim ed to assess sustained , divided , and selective attention , plus tests of episodic memory , semantic memory , visuoperceptual and visuospatial function , and verbal short-term memory . Although the mildly demented group were impaired on all attentional tests , the minimally impaired group showed a preserved ability to sustain attention , and to divide attention based on a dual-task paradigm . The minimally demented group had particular problems with response inhibition and speed of attentional switching . Examination of the relationship between attention and other cognitive domains showed impaired episodic memory in all patients . Deficits in attention were more prevalent than deficits in semantic memory suggesting that they occur at an earlier stage and the two were partially independent . Impairment in visuoperceptual and visuospatial functions and verbal short-term memory were the least common . Although attention is impaired early in AD , 40 % of our patients showed deficits in episodic memory alone , confirming that amnesia may be the only cognitive deficit in the earliest stages of sporadic AD Background The relationship between apathy , depression and cognitive impairment in Parkinson 's disease ( PD ) is still controversial . The objective of this study is to investigate whether apathy and depression are associated with inefficient cognitive strategies in PD . Methods In this prospect i ve clinical cohort study conducted in a university-based clinical and research movement disorders center we studied 48 PD patients . Based on clinical evaluation , they were classified in two groups : PD with apathy ( PD-A group , n = 23 ) and PD without apathy ( PD-NA group , n = 25 ) . Patients received clinical and neuropsychological evaluations . The clinical evaluation included :  Apathy Evaluation Scale-patient version , Hamilton Depression Rating Scale-17 items , the Unified Parkinson 's Disease Rating Scale and the Hoehn and Yahr staging system ; the neuropsychological evaluation explored speed information processing , attention , working memory , executive function , learning abilities and memory , which included several measures of recall ( immediate free , short delay free , long delay free and cued , and total recall ) . Findings PD-A and PD-NA groups did not differ in age , disease duration , treatment , and motor condition , but differed in recall ( p<0.001 ) and executive tasks ( p<0.001 ) . Immediate free recall had the highest predictive value for apathy ( F = 10.94 ; p = 0.002 ) . Depression and apathy had a weak correlation ( Pearson index = 0.3 ; p<0.07 ) , with three items of the depression scale correlating with apathy ( Pearson index between .3 and .4 ; p<0.04 ) . The depressed and non-depressed PD patients within the non-apathetic group did not differ . Conclusion Apathy , but not depression , is associated with deficit in implementing efficient cognitive strategies . As the implementation of efficient strategies relies on the fronto-striatal circuit , we conclude that apathy , unlike depression , is an early expression of executive impairment in PD INTRODUCTION Beneficial effects of nicotine on cognitive functioning may contribute to the markedly high rates of smoking among people with schizophrenia . A reduction in the nicotine content of cigarettes to non-addictive levels is being considered as a regulatory strategy for reducing tobacco dependence in the United States . We examined whether switching to very low nicotine content ( VLNC ) cigarettes impairs cognitive functioning in smokers with and without schizophrenia , and whether nicotine replacement reverses these effects . METHODS Smokers with schizophrenia ( SS , n = 29 ) and control smokers matched on smoking rate but without psychiatric illness ( CS , n = 28 ) smoked usual-br and cigarettes , VLNC cigarettes while wearing 2 placebo patches ( PLA ) , or VLNC cigarettes while wearing 2 nicotine patches totaling 42 mg ( NIC ) for 5hr , and then completed computerized assessment s of visual sustained attention , motor speed , visual working memory , processing speed , inhibitory control , and response variability . RESULTS Across conditions , SS were slower than CS in tasks of motor speed and visual working memory , and had poorer target detectability on a visual sustained attention task . Across groups , functioning in domains of visual sustained attention , inhibitory control , processing speed , and response variability was impaired in the VLNC + PLA condition relative to the usual-br and and VLNC + NIC conditions . CONCLUSIONS Dramatically reducing the nicotine content of cigarettes may impair cognitive functioning in heavy smokers with and without schizophrenia , but the use of nicotine replacement while smoking VLNC cigarettes may preserve cognitive functioning in these smokers Multiple sclerosis ( MS ) causes cognitive impairment including slowed processing speed and problems with learning and memory . Stimulants are attractive c and i date s for improving mental speed but carry risk of addiction and other adverse behavioral effects . Lisdexamfetamine dimesylate ( LDX ) is a d-amphetamine prodrug currently approved for attention deficit ( hyperactivity ) disorder with the potential to be better tolerated due to its prolonged clinical effect . This phase II placebo-controlled , double-blind study aim ed to assess the safety and efficacy of LDX in cognitively impaired MS patients . Subjects were patients with clinical ly definite MS , aged 18–56 years , and impaired on either of two primary outcomes : the Symbol Digit Modalities Test ( SDMT ) or the  Paced Auditory Serial Addition Test ( PASAT ) . Both SDMT and PASAT are measures of cognitive processing speed . Of 174 MS patients screened , 63 were r and omized to 30 mg of LDX or placebo in a 2:1 fashion ; the dose was increased as tolerated to 70 mg over 4 weeks and then maintained for another 4 weeks . Secondary outcomes were the Brief Visuospatial Memory Test Revised ( BVMTR ) , the California Verbal Learning Test 2nd edition ( CVLT2 ) , both measures of episodic memory , and the Behavioral Rating Inventory of Executive Function for adults ( BRIEF-A ) , a self-report measure of executive function . Fatigue and depression were also evaluated . There was significant improvement in the SDMT score ( + 4.6 vs. + 1.3 ) and CVLT2 score ( + 4.7 vs. −0.9 ) in the LDX group compared with the placebo group among the 49 completers . There was no change on the other outcomes . A high proportion of both LDX-treated and placebo-treated subjects reported adverse events ( 73.5 % vs. 68.4 % ) . However , there were no serious adverse events noted in the study . These preliminary data indicate that LDX has the potential to be an efficacious treatment for MS patients with cognitive impairment
Results show that various classes of antidepressants exert improving effects on cognitive function across several cognitive domains .
Specifically , studies suggest that SSRIs , the SSRE tianeptine , the SNRI duloxetine , vortioxetine and other antidepressants such as bupropion and moclobemide may exert certain improving effects on cognitive function in depression , such as in learning and memory and executive function .
The few non-pharmacological studies conducted employing cognitive orientated treatments and cognitive remediation therapy show promising results for the improvement of cognitive impairment in depression .
Cognitive dysfunction is of clinical significance and exerts longst and ing implication on patients ׳ function .
Pharmacological and non-pharmacological treatments of cognitive dysfunction are emerging .
This review evaluates pharmacological and non-pharmacological treatments of cognitive impairment primarily in the domains of memory , attention , processing speed and executive function in clinical depression .