This study was performed to examine cognitive function in patients with end-stage heart failure, to identify possible cardiovascular factors associated with cognitive function, and to evaluate changes in cognitive function in a subgroup of patients who received heart transplantation. An extensive battery of neuropsychological tests were given to 62 patients with end-stage cardiac failure as part of their evaluation for cardiac transplantation. Most patients were consecutive referrals, not selected because of cognitive complaints. A small subgroup of transplanted (n = 7) and non-transplanted (n = 4) patients received a repeat neuropsychological examination. At initial examination, approximately 50% of the patients met criteria for impairment in reference to normal control values. Higher stroke volume index and cardiac index and lower right atrial pressure were correlated with better cognitive function. In the subgroup of patients re-examined, the transplanted patients demonstrated significantly improved cognitive function, whereas the non-transplanted subjects were unchanged. These data indicate that in patients with end-stage heart failure there is a high prevalence of impaired cognitive function which is related to measures of cardiovascular efficiency. Preliminary evidence suggests that these impairments may be partially ameliorated by cardiac transplantation.

No abstract

The question of whether Parkinson's disease (PD) patients who have left (LPD) or right (RPD) motor predominance also exhibit cognitive differences is controversial. We examined this issue using a neuropsychological battery designed to provide a balanced sampling of both right- and left-hemispheric functions. RPD patients were impaired relative to LPD patients on verbally mediated tasks (left hemisphere function), but there was no group difference for visuospatial tasks (right-hemispheric function). In addition, there was a significant correlation between the extent of right side motor predominance and performance on verbal tasks, but there was no relationship between left side motor symptoms and performance on visuospatial tasks. The controversy related to cognitive differences in hemiparkinsonism may be due to the balance of the assessment procedure, the severity of motor asymmetry, or both.

No abstract

This study explored the factor structure of Zarit's Memory and Behavior Problem Checklist (MBPC), a 29-item inventory that samples negative behavior changes associated with dementia (e.g., incontinence and destroying property). Family caregivers for 185 progressive-dementia patients provided information on their affected relatives. A principal-components factor analysis with an oblique (nonorthogonal) rotation produced an 8-factor solution that accounted for 62.9% of the variance. A second-order factor analysis of the first 5 factors produced a 3-factor solution that accounted for 74.7% of the variance. The 3 factors were (a) self-care and self-maintenance functions, (b) memory problems and psychiatric symptoms associated with dementia, and (c) communication problems and agitation. Correlations between MBPC frequency scores and measures of adaptive ability and level of dementia were high and positive. Potential clinical and research applications of the scale in other related populations are discussed.