Research Helps Clear Up Confusion About Cognition

Just-published research out of the University of California-San Francisco suggests that younger adults who struggle with higher levels of inflammation might suffer reduced cognition in midlife.

“We know from long-term studies that brain changes leading to Alzheimer’s disease and other dementias may take decades to develop,” first author Amber Bahorik, PhD, of the UCSF Department of Psychiatry and Behavioral Sciences said in a press release. “We wanted to see if health and lifestyle habits in early adulthood may play a part in cognitive skills in midlife, which in turn may influence the likelihood of dementia in later life.”

Cognitive challenges like these can be symptoms of several different psychiatric and neurological disorders. The Journal of Clinical Psychiatry typically offers insights into the complexities of cognition, from the gradual decline as we age to the effects of psychiatric medications on cognitive function.

We’ve spent years curating evidence-based and holistic content so readers can have a better understanding of cognition and its mental health implications.

A Systematic Review of How ECT Impacts Cognition

The hallmarks of schizophrenia run the gamut:  from hallucinations and delusions to apathy, and a lack of emotion. It can also reveal itself in cognitive impairments, notably in attention, memory, and executive functions. Cognitive deficits in schizophrenia vary, but they can generally predict functional outcomes.

Antipsychotic medications remain the best first-line treatment. But they don’t necessarily work for everyone. Caregivers rely on clozapine for treatment-resistant schizophrenia (TRS). But not everyone responds to it. Many consider non-pharmacologic treatment – such as electroconvulsive therapy (ECT). ECT, which induces brief seizures to tweak brain function, has shown efficacy, especially as an augmentation to antipsychotics.

But despite its effectiveness, ECT use has fallen off in Western countries, though it remains common in Asia and Africa. Major psychiatric associations recommend ECT for specific schizophrenia cases, including catatonia and clozapine resistance.

ECT concerns include potential cognitive impairment, particularly memory loss. Evidence from studies on major depressive disorder suggests no long-term cognitive deficits from ECT. And some studies even show cognitive improvements. However, less research has examined the cognitive effects of ECT in schizophrenia.

A systematic review of 17 studies from 2000 to 2022, primarily in Asian countries, investigated ECT’s cognitive impact on schizophrenia. These studies indicated that:

• ECT generally doesn’t impair global cognition, attention, language, visuospatial function, problem-solving, or executive function.
• The results on memory effects appear to be mixed, with one significant study showing short-term memory decline post-ECT.
• Others report no long-term memory impairments.

Overall, this review suggests that ECT doesn’t cause significant long-term cognitive deficits in schizophrenia patients, addressing a critical concern for this population where cognitive impairment is already prevalent.

The researchers add that larger, controlled trials would help further validate these findings and guide clinical practices.

Brief Cognitive Screener Detects Early Signs of Cognitive Decline in Some Patients

Analysts estimate that the number of Americans aged 65 and older – the most vulnerable demographic for neurocognitive disorders – will climb to 95 million by 2060. That translates into a total population share increase from 16 percent to 23 percent. Many of these aging Americans already show signs of cognitive dysfunction but haven’t received a dementia assessment, even if they’ve seen their GP recently. Rapid detection of cognitive decline remains essential for early intervention to mitigate functional decline, psychosocial hardship, and healthcare costs.

The researchers in this study used The South Florida Cognitive Screener (SFCS), an eight-item self-report tool. Scientists designed the survey to identify common cognitive, functional, and behavioral complaints early in cognitive decline. 

For this project, the team administered the SFCS to 1,676 patients aged 55 and older at an outpatient neurology practice in South Florida. The average participant age was 73.8 years. And nearly 59 percent were women. 

The SFCS – and its Spanish counterpart – proved effective in spotting early cognitive decline. The tool helps physicians quickly assess and discuss cognitive status, facilitating the early detection of emerging dementia.

Study Links MSK1 Methylation, Executive Function to Suicidal Ideation in Depressed Adolescents

Adolescent suicide persists as a critical global health issue, with roughly 12 percent of U.S. adolescents experiencing suicidal ideation, 4 percent planning to take their own life, and another 4 percent attempting it.

Suicidal ideation remains a strong predictor of suicide, particularly in those with major depressive disorder (MDD). Identifying risk factors such as executive dysfunction — a set of cognitive processes for goal-directed task s— could help guide evaluations and interventions to mitigate suicide risk. Disrupted executive function can affect emotional and cognitive processing, increasing one’s risk.

Research indicates an association between executive dysfunction and suicide risk in adults, but there’s a dearth of similar research on adolescents. Some studies link suicide risk to worse executive function. Others don’t. Additionally, altered gene methylation, such as in the brain-derived neurotrophic factor (BDNF) and mitogen- and stress-activated protein kinase 1 (MSK1) genes, has been linked to higher suicide risk and executive dysfunction.

This study explored the relationship between MSK1 methylation, executive function, and suicidal ideation in a longitudinal study of 66 adolescents with first-episode, drug-naïve MDD. Participants received antidepressant treatment for six weeks.

The study’s authors theorized that:

• Adolescents with suicidal ideation would show worse executive function and different MSK1 methylation.
• Pretreatment executive function and/or MSK1 methylation would predict suicide risk.
• Changes during treatment would correlate with changes in suicidal ideation.

And the study results confirmed that adolescents with suicidal ideation exhibited worse executive function and higher MSK1 methylation. MSK1 methylation predicted suicidal ideation before treatment.

Additionally, researchers noted that executive function improved during treatment, while suicidal ideation taped off. The findings appeared to be exclusive of any shifts in depression severity.

Overall, these results support the potential of MSK1 methylation as a biomarker and targeting executive function as a therapeutic approach for reducing suicidal ideation in depressive adolescents.

The study underscores the importance of further research on MSK1 methylation, executive function, and their interactions with antidepressant treatments.