Neurological soft signs (NSS) comprise subtle deficits in sensory integration, motor coordination, and sequencing of complex motor acts, which are typically observed in the majority of schizophrenia patients, including chronic cases and neuroleptic-naïve first-episode patients. However, recent studies clearly demonstrate that NSS are not a static feature of schizophrenia but vary in the clinical course of the disorder. This effect was investigated in a meta-analysis based on 17 longitudinal studies published between 1992 and 2012. Studies included between 10 and 93 patients with schizophrenia spectrum disorders (total number 787) with follow-up periods between 2 and 208 weeks. Beside the Neurological Examination Scale, the Cambridge Neurological Inventory and the Heidelberg NSS Scale were used to assess NSS. All but three studies found NSS to decrease in parallel with remission of psychopathological symptoms. This effect was more pronounced in patients with a remitting compared to a non-remitting, chronic course (Cohen’s d 0.81 vs. 0.15) and was significantly correlated with length of the follow-up period (r = −0.64) but not with age (r = 0.28). NSS scores did not decrease to the level typically observed in healthy controls. From a clinical perspective, NSS may therefore be used to identify subjects at risk to develop schizophrenia and to monitor disease progression.
Previous research has demonstrated the harmful impact of subjective aging processes (e.g., negative age self-stereotyping) on normal cognitive aging in different domains of cognitive functioning, such as memory, executive function, and fluid abilities. Recently, subjective aging has also been linked to important biomarkers of Alzheimer's disease (AD) and dementia-related outcomes, indicating associations with pathological cognitive aging. With data from the Interdisciplinary Longitudinal Study of Adult Development and Aging (ILSE), the present study extends this research by examining the long-term effect of attitude toward own aging (ATOA) on expert-based clinical diagnosis of mild cognitive impairment (MCI) and AD in old age. In the study, 260 initially cognitively healthy participants with a mean age of 62.5 years were followed for 12 years. In the course of the study, 103 participants developed MCI and 14 received diagnosis of AD. Logistic regression models showed that baseline ATOA predicted future clinical diagnoses of MCI and AD 12 years later, while controlling for sociodemographic, genetic, and health variables. Although theoretically suggested, evidence for a mediating role of leisure-activity level and control beliefs was scarce. Our findings add to the emerging literature supporting negative views of aging as a risk factor for cognitive disorder in old age. (PsycINFO Database Record
Objectives: Neurological soft signs (NSS), i.e., minor motor and sensory changes, are a common feature in severe psychiatric disorders. We sought to establish the frequency of NSS in patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD) on basis of a large population-based sample and to identify their neuropsychological correlates including cognitive reserve.Methods: Neurological soft signs were examined using an abbreviated version of the Heidelberg NSS Scale in 221 “old” participants born between 1930 and 1932 (63 with MCI, 15 with AD, 143 healthy old controls) and 256 healthy “young” participants (born between 1950 and 1952) of the population-based interdisciplinary longitudinal study of aging. Subjects received thorough neuropsychological testing; years of school education were used as a proxy for cognitive reserve.Results: Neurological soft signs scores were significantly (p < 0.001) higher in the AD patients (5.6 ± 3.11) than in the healthy old controls (2.8 ± 1.90) and in the MCI patients (3.0 ± 1.96). This result was confirmed after years of school education, which were inversely correlated (r = −0.25; p < 0.001) with NSS were entered as a covariate. In the patients, but not in the controls, NSS were significantly correlated with deficits in executive functioning and visuospatial functioning. Comparison of NSS scores between “old” (2.84 ± 1.9) and “young” (2.46 ± 1.97) controls yielded only minor, non-significant differences after education (13.86 ± 3.0 vs. 14.61 ± 2.48 years, respectively) was controlled for.Conclusion: Our results demonstrate that NSS are frequently found in mild AD, but not in MCI. NSS refer to frontal-executive deficits and visuospatial dysfunction rather than age per se and can be partly compensated for by cognitive reserve.
Bilingualism is associated with enhanced executive functioning and delayed onset of mild cognitive impairment (MCI) and Alzheimer's disease (AD). Here, we investigated neuropsychological differences between mono- and bilingual patients with MCI and AD as well as the respective effects of dementia on the dominant and non-dominant language of bilinguals. 69 patients with MCI (n = 22) or AD (n = 47) and 17 healthy controls were included. 41 subjects were classified as lifelong bilinguals (mean age: 73.6; SD = 11.5) and 45 as monolinguals (mean age: 78.1; SD = 10.9). Neuropsychological performance was assessed on the CERAD-NP, the clock-drawing test, and the logical memory subscale of the Wechsler Memory Scale. Neuropsychological profiles showed only minor nonsignificant differences between mono- and bilingual subjects when compared between diagnostic groups. Bilingual MCI patients scored significantly lower on the verbal fluency and picture naming task in their dominant language than bilingual controls. Bilingual AD patients showed a reduced performance in their nondominant language when compared to bilingual MCI patients and bilingual controls (main effect language dominance: verbal fluency task p < 0.001; BNT p < 0.001). Bilingual MCI and AD patients show a similar pattern of neuropsychological deficits as monolingual patients do. The dominant language appears to be compromised first in bilingual MCI patients, while severe deficits of the nondominant language develop later in the course with manifestation of AD. These findings are important for the diagnostic work up of bilingual patients and the development of improved care concepts for bilingual patients such as migrant populations.
Aims: We examined the ‘positivity effect' on memory performance in mild cognitive impairment (MCI) and dementia patients. Methods: In 109 subjects (28 controls, 32 with MCI, 27 with mild and 32 with moderate dementia), we investigated free recalls (immediate and delayed) and recognition of 12 pictures. Moreover, the emotional valence of the pictures perceived and the emotions evoked in the subjects were evaluated. Results: Patients with mild and moderate dementia recalled fewer pictures than those with MCI or the healthy controls. Across the groups, the positive pictures were better memorized and induced a higher arousal than the negative or neutral ones. Conclusions: Our findings indicate a positivity effect on memory performance and intensity of experience not only in healthy elderly patients but also in those with MCI or mild and moderate dementia. This effect does not refer to the compliance of the patients investigated since they perceived and experienced the pictures in the expected way.
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