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Cognitive impairment appears to be common in ALS patients
March 14, 2006In a study of 40 patients with amyotrophic lateral sclerosis (ALS), about one-third showed evidence of cognitive impairment, but these deficits did not appear to be related to survival, according to a study in the March issue of Archives of Neurology, one of the JAMA/Archives journals.
ALS, commonly referred to as Lou Gehrig disease, is a progressive disorder characterized by the loss of muscle function and the atrophy (wasting away) of muscle tissue. ALS is primarily a disorder involving the motor neurons, which control muscles and movement in the body, but new evidence suggests it also may have an impact on cognition (thinking, learning and memory), according to background information in the article. Previous research has estimated that anywhere from 2 to 52 percent of patients with ALS also experience cognitive impairment.
Gregory A. Rippon, M.D., M.S., and colleagues at the Columbia University College of Physicians and Surgeons, New York, analyzed 40 consecutive patients with ALS who were evaluated at neurologists' offices between August 1991 and August 1992. Participants underwent examinations and testing to gauge their cognitive functioning and verify the diagnosis and history of their disease, including whether symptoms were first detected in muscles of the throat, jaw, tongue or face (bulbar onset) or those in the arms (limb onset). The researchers selected a control group of 80 individuals without ALS, matched to the ALS patients by age, gender and education, from a series of patients referred to a memory disorder clinic from 1992 to 2003.
Of the 40 patients with ALS, 12 (30 percent) showed evidence of cognitive impairment, including nine (23 percent) who met criteria for dementia. There were no significant differences between ALS patients who had dementia and those who did not in terms of age, sex, education, site of onset, memory loss, emotional stability, severity of the disease or family history. ALS patients and control participants had similar results on cognitive tests, although patients with more severe ALS showed a decline in verbal skills beyond what would be associated with motor difficulties affecting speech muscles. Survival data from public and medical records were available in January 2004 for 38 of 40 patients with ALS, who lived an average of 3.4 years after testing. Cognitive impairment and dementia did not appear to be associated with survival.
"In conclusion, using a conventional test battery, 30 percent of a consecutive series of patients with ALS demonstrated cognitive impairment, and nearly a quarter qualified for a neuropsychologic diagnosis of dementia," the authors write. "Free recall, executive function and naming were most impaired in ALS patients with dementia." Future studies using testing and diagnostic criteria specific to frontotemporal lobar dementia, the type believed to be associated with ALS and other motor neuron diseases, may find that the percentage of ALS patients with cognitive impairment or dementia is even higher, they conclude.
JAMA and Archives Journals
Of the 40 patients with ALS, 12 (30 percent) showed evidence of cognitive impairment, including nine (23 percent) who met criteria for dementia. There were no significant differences between ALS patients who had dementia and those who did not in terms of age, sex, education, site of onset, memory loss, emotional stability, severity of the disease or family history. ALS patients and control participants had similar results on cognitive tests, although patients with more severe ALS showed a decline in verbal skills beyond what would be associated with motor difficulties affecting speech muscles. Survival data from public and medical records were available in January 2004 for 38 of 40 patients with ALS, who lived an average of 3.4 years after testing. Cognitive impairment and dementia did not appear to be associated with survival.
"In conclusion, using a conventional test battery, 30 percent of a consecutive series of patients with ALS demonstrated cognitive impairment, and nearly a quarter qualified for a neuropsychologic diagnosis of dementia," the authors write. "Free recall, executive function and naming were most impaired in ALS patients with dementia." Future studies using testing and diagnostic criteria specific to frontotemporal lobar dementia, the type believed to be associated with ALS and other motor neuron diseases, may find that the percentage of ALS patients with cognitive impairment or dementia is even higher, they conclude.
JAMA and Archives Journals
Cognitive Impairment Current Events and Cognitive Impairment News RSSSurgery not linked to memory problems in older patients
For years, it has been widely assumed that older adults may experience memory loss and other cognitive problems following surgery. But a new study from researchers at Washington University School of Medicine in St. Louis questions those assumptions.
Reduced muscle strength associated with risk for Alzheimer's
Individuals with weaker muscles appear to have a higher risk for Alzheimer's disease and declines in cognitive function over time, according to a report in the November issue of Archives of Neurology, one of the JAMA/Archives journals.
Clinical tests begin on medication to correct Fragile X defect
NIH-supported scientists at Seaside Therapeutics in Cambridge, Mass., are beginning a clinical trial of a potential medication designed to correct a central neurochemical defect underlying Fragile X syndrome, the most common inherited cause of intellectual disability.
Statins show dramatic drug and cell dependent effects in the brain
Besides their tremendous value in treating high cholesterol and lowering the risk of heart disease, statins have also been reported to potentially lower the risks of other diseases, such as dementia.
Older Patients with Dementia at Increased Risk for Flu Mortality
An epidemiological study on pneumonia and influenza (P&I) in adults age 65 and over reports that patients with dementia are diagnosed with flu less frequently, have shorter hospital stays, and have a fifty percent higher rate of death than those without dementia.
Fighting Sleep, Penn Researchers Reverse the Cognitive Impairment Caused By Sleep Deprivation
A research collaboration led by biologists and neuroscientists at the University of Pennsylvania has found a molecular pathway in the brain that is the cause of cognitive impairment due to sleep deprivation.
Chemobrain - the flip side of surviving cancer
One of the most problematic side effects of cancer treatment, chemobrain - a range of symptoms including memory loss, inability to concentrate, difficulty thinking and other subtle cognitive changes following chemotherapy - seriously diminishes women's quality of life and daily functioning.
Mount Sinai researchers find phone assessment effective for evaluating cognition in the elderly
Cognitive testing by telephone in elderly individuals is generally as effective as in-person testing, according to a new study by Effie M. Mitsis, PhD, Assistant Professor of Psychiatry at Mount Sinai School of Medicine and part of Mount Sinai's Alzheimer's Disease Research Center. The study will appear in the International Journal of Geriatric Psychiatry.
The future of schizophrenia
Schizophrenia is a major public health problem. Affecting almost 1% of the world's population, it takes an enormous economic and social toll in addition to the distress, dysfunction, disability and mortality for those afflicted with this disease.
High fruit and vegetable intake positively correlated with antioxidant status, cognitive performance
Researchers at the Institute of Biochemistry and Molecular Biology I of the Heinrich-Heine University, Düsseldorf, Germany, investigated the relationship between fruit and vegetable intake, plasma antioxidant micronutrient status and cognitive performance in healthy subjects aged 45 to 102 years.
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