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Τhe pattern of relations between cognitive control and Theory of Mind in older adults having vascular risk factors and older adults with Mild Cognitive Impairment: are there any differences?

Glykeria Tsentidou1*, Despoina Moraitou1, Elvira Masoura1 and Georgia Papantoniou2
  • 1 Aristotle University of Thessaloniki, Greece
  • 2 University of Ioannina, Greece

Aim: The study aims at investigating the relationships among cognitive control (Cc) and Theory of Mind (ToM) in older adults experiencing very mild cognitive decline due to risk factors for vascular disease development (VRF), and older adults with Mild Cognitive Impairment (MCI). Method: The two groups (VRF, MCI) matched for gender, age, and educational level, are measured with tests assessing different dimensions of Cc and ToM. Results: Non-recursive and multi-group path analyses will be applied to the data, to find the relationships between Cc and ToM, for each group, and to reveal possible differences. Conclusion: A different pattern of relationships between ToM and Cc in each group would emerge, as a possible result of the progression of cognitive decline which may lead to a reconfiguration of the relations between these dimensions, due to the efforts of the cognitive system to adapt to the diminishing levels of brain functioning. Recently, several studies have linked non-diagnosed vascular pathology with cognitive impairment. It is reasonable to maintain that since vascular disease affects the brain, it also affects cognitive functioning (Lindeboom, Weinstein, 2004) and leads to some type of “cognitive frailty”. Indeed, the theoretical approach of the “vascular hypothesis of cognitive aging” (Anstey, 2008; Spiro, Brady, 2008) posits that basic risk factors for the emergence of vascular disease, such as hypertension, hyperlipidemia, and diabetes mellitus, affect cognitive functions that are supported by the frontal brain regions (Elias, Elias, D’Agostino, et al., 2005; Okusaga, Stewart, Butcher, et al., 2012). A step further in regards to cognitive decline, the term “Mild Cognitive Impairment (MCI)” was introduced to describe the trajectory of decline in cognition that is identified with dementia (Zheng, Sun, Dong, et al., 2014). Besides the well established memory deficits, many patients with MCI deal with problems in executive functions or cognitive control processes (Cc), namely, the higher-order cognitive processes that control thought and action (Ready, Ott, Grace, & Cahn-Weiner, 2003; Marshall, Rentz, Frey, Locascio, Johnson, Sperling, 2011; Mitchell & Shiri-Feshki M, 2009). In the more recent literature, we come across studies on Theory of Mind (ToM) in MCI. ToM is the most known dimension of social cognition that refers to the ability to understand other people’s intentions, beliefs, and desires. What is known till now is that, compared to cognitively healthy older adults, MCI patients seem to perform worse on complex ToM tasks. However, to our knowledge, there is not sufficient evidence regarding the pattern of the relationships between Cc and ToM in community dweller older adults having vascular risk factors (VRF group), and MCI patients. In this light, the present study aims to investigate the differences of older adults having vascular risk factors and MCI patients in regards to the pattern of the relations between cognitive control and Theory of Mind. The following hypothesis has been formulated: the pattern of the relations between Cc and ToM is expected to be more complex in MCI patients, compared to VRF group, given a possible increased recruitment of Cc, in order to complete a task, that MCI patients may follow as a compensatory mechanism against their more advanced level of cognitive decline. The sample consists of two groups of older adults, matched for gender, age and educational level. Each group is composed of 30 participants. All participants are at least 60 years old, with at least six years of schooling and Hellenic as their native language. The first group is composed of community dweller older adults having vascular risk factors (VRF), and the other of older adults diagnosed with MCI. All participants are informed about the procedure and the aim of the study, and their written consent is taken. The neuropsychological assessment is implemented with the administration of a battery of tests measuring Cc as inhibitory control, task switching, updating-monitoring, and planning, and assessing ToM as social mental verb understanding and indirect speech perception. Emotion recognition ability is also assessed, as an underlying construct for the development of ToM. The neuropsychological evaluation takes place over two sessions due to its long duration. The order in which the tests are administered to each participant differs, to avoid serial position effects. Assessment procedure is in progress and soon will be completed. In order to reveal differences in the pattern of relations among the different tasks, structural equation modeling (SEM) techniques will be conducted: using non-recursive path modeling, the direction of the relations between Cc and ToM would be revealed (Kline, 2005). Next, a series of multi-group path analyses will be performed to trace and compare any differentiated patterns of relations among variables (Kline, 2005), for each group. A different pattern of relationships between ToM and Cc in VRF and MCI groups would emerge. Specifically, MCI patients would display a more complex pattern of associations among Cc and ToM dimensions, compared to VRF group, as a possible result of the progression of cognitive decline which may lead to a reconfiguration of the relations between these dimensions, due to the effort of the cognitive system to adapt to the diminishing levels of brain functioning. If there wouldn't be any significant differences in Cc and ToM performance of the two groups, this might lead to the conclusion that the progression of mild cognitive decline in older adults may be reflected in a more complex pattern of associations among cognitive constructs.

References

Anstey, K. (2008). Cognitive aging and functional biomarkers. In S. Hofer and D. Alwin Eds. Handbook of cognitive aging: interdisciplinary perspectives Thousand Oaks, California: Sage;327 .

Elias, P., Elias, MF., D’Agostino, RB., et al. (2005). Serum cholesterol and cognitive performance in the Framingham Heart Study. J Biobehavioral Medical; 67(1): 24-30.

Kline, RB. (2005). Principles and practice of structural equation modeling; New York: Guilford Press

Lindeboom, J., Weinstein, H. (2004). Neuropsychology of cognitive ageing, minimal cognitive impairment, Alzheimer’s disease, and vascular cognitive impairment. European Journal of Pharmacology; 490: 83–6.

Marshall, A., Rentz, M., Frey, T., Locascio, J., Johnson, A., Sperling, A. (2011).Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer’s disease. Alzheimer’s & Dementia, 7, 300 - 308.

Mitchell, J. & Shiri-Feshki, M. (2009). Rate of progression of mild cognitive impairment to dementia meta-analysis of 41 robust inception cohort studies. Acta Psychiatrica Scandinavica, 119 (4), 252–265.

Okusaga, Ο., Stewart, ΜCW., Butcher, I., et al. (2012). Smoking, hypercholesterolaemia and hypertension as risk factors for cognitive impairment in older adults. Age Ageing; 42(3): 306-11.

Ready, E., Ott, R., Grace, J., & Cahn-Weiner, A. (2003). Apathy and executive dysfunction in mild cognitive impairment and Alzheimer disease. American Journal of Geriatric Psychiatry, 11(2), 222–228.

Spiro, A., Brady, C. (2008). Integrating health into cognitive aging research and theory. In S. Hofer and D. Alwin Eds. Handbook of cognitive aging: interdisciplinary perspectives Thousand Oaks, California: Sage: 260-83.

Zheng, D., Sun, H., Dong, X., Liu, B., Xu, Y., Chen, S., Song, L., Zhang, H., Wang, X. (2014). Executive dysfunction and gray matter atrophy in amnestic mild cognitive impairment. Neurobiology of Aging, 35, 548 - 555.

Keywords: vascular risk factors, Mild Cognitive Impairment, cognitive control, Theory of Mind, neuropsychological assessment

Conference: SAN2016 Meeting, Corfu, Greece, 6 Oct - 9 Oct, 2016.

Presentation Type: Poster Presentation in SAN2016 Conference

Topic: Posters

Citation: Tsentidou G, Moraitou D, Masoura E and Papantoniou G (2016). Τhe pattern of relations between cognitive control and Theory of Mind in older adults having vascular risk factors and older adults with Mild Cognitive Impairment: are there any differences?. Conference Abstract: SAN2016 Meeting. doi: 10.3389/conf.fnhum.2016.220.00123

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Received: 29 Jul 2016; Published Online: 01 Aug 2016.

* Correspondence: Mrs. Glykeria Tsentidou, Aristotle University of Thessaloniki, Thessaloniki, Greece, gltsentidou@gmail.com