Kirk Daffner - Profile on Academia.edu (original) (raw)

Papers by Kirk Daffner

Managing Neuropsychiatric Symptoms of Neurodegenerative Diseases

Springer eBooks, 2016

Many neurodegenerative conditions are associated with neuropsychiatric symptoms. The origin of th... more Many neurodegenerative conditions are associated with neuropsychiatric symptoms. The origin of these symptoms is complex, and includes neuroanatomical, neurochemical, psychological, and social factors. Management of neuropsychiatric symptoms in neurologic disease is challenging, as there is a dearth of evidence-based data. This chapter explores the neurobiology of the most common neuropsychiatric symptoms encountered in clinical practice, and outlines current approaches toward their pharmacological and behavioral management.

Case Study 2: A 60-Year-Old Man With Progressive Deficits in Language Output

Journal of Neuropsychiatry and Clinical Neurosciences, Jul 1, 2022

Alzheimers & Dementia, Jul 1, 2019

Memory and emotions for the 9/11/01 terrorist attacks in patients with Alzheimer’s disease, mild cognitive impairment, and healthy older adults

Neuropsychology (journal), 2004

Psychiatric and Behavioral Problems

Neurologic Clinics, May 1, 1998

In an emergency setting, many neurologic conditions present with psychiatric and behavioral sympt... more In an emergency setting, many neurologic conditions present with psychiatric and behavioral symptoms. These symptoms may either be the first manifestation of the neurologic illness or a later occurrence in the progression of the disease. It is important for clinicians evaluating patients with psychiatric symptoms to identify the signs indicating associated neurologic illness and to have strategies for managing the acute, potentially dangerous, neuropsychiatric manifestations of the disease. This article addresses emergency evaluation and management of depression, anxiety, psychosis, mania, suicide attempts, neuroleptic malignant syndrome and other hypermetabolic and amnestic syndromes, somatoform disorders, aggression, and legal issues, such as capacity to accept or refuse treatment.

The brain health champion study: A health coaching intervention with mobile technology in older adults with mild cognitive impairment or risk factors for dementia – An update

Alzheimers & Dementia, Jun 1, 2023

Alzheimer's & Dementia

BackgroundThere is growing evidence that adherence to brain‐healthy behaviors can reduce the risk... more BackgroundThere is growing evidence that adherence to brain‐healthy behaviors can reduce the risk of dementia and rate of decline. Current standard of care, however, does not systematically promote or monitor adherence to brain health guidelines. We recently demonstrated that a health coaching intervention, which included weekly phone calls, facilitated greater adherence to lifestyle recommendations and improved quality of life. The current study is investigating the impact of supplementing health coaching with digital health technology, including a mobile platform and wearable fitness trackers.MethodIn an ongoing six‐month trial, we are measuring the effect of a clinic‐embedded, technology‐augmented health coaching program on adherence to brain health recommendations. Forty patients with mild cognitive impairment (MCI) or risk factors for dementia are being randomized to the Brain Health Champion (BHC) intervention or a counseling and education (CE) control. In BHC, participants wo...

ALZ‐NET: Using Real World Evidence to Inform the Future of Alzheimer’s Treatment and Care

Alzheimer's & Dementia

Advances in Understanding Dysexecutive Syndromes

NEJM Journal Watch, 2003

Godefroy briefly reviews dysexecutive syndromes as they relate to disorders of frontal systems, w... more Godefroy briefly reviews dysexecutive syndromes as they relate to disorders of frontal systems, with emphasis on the clinical implications of ongoing

Cognitive Changes after Working Memory Training in Healthy Older Adults: Evidence From a Multi-Site, Randomized Controlled Trial (P6.107)

Neurology, 2017

Objective: To evaluate the efficacy of computerized cognitive training (CCT) focused on working m... more Objective: To evaluate the efficacy of computerized cognitive training (CCT) focused on working memory (WM) compared to an active control condition in healthy older adults. Background: Developing effective interventions to attenuate age-related cognitive decline is a major public health goal. CCT has been marketed increasingly to older adults, but its efficacy remains unclear. WM, a key determinant of higher order cognitive abilities, is susceptible to age-related decline, which makes WM a relevant target for CCT in elders. Design/Methods: Seventy-six cognitively normal adults, 65 years and older, from two sites (US and Sweden) were randomly assigned to Cogmed Adaptive or Non-Adaptive (active control) CCT groups. Training was performed in participants’ homes during sessions lasting ~ 40 minutes, 5 days per week over 5 weeks. In Adaptive CCT, difficulty level was continually adjusted, while for the Non-Adaptive group, difficulty level remained the same. At baseline, subjects underwen...

The Heuristic Power of Clinical Case Conferences: A New Section in the Journal of Neuropsychiatry and Clinical Neurosciences

The Journal of Neuropsychiatry and Clinical Neurosciences, 2021

Cognitive Disorders Other than Alzheimer Disease

DeckerMed Psychiatry, 2016

Higher cognitive functions, such as abstract reasoning, complex decision making, and language, ar... more Higher cognitive functions, such as abstract reasoning, complex decision making, and language, are the mental faculties that separate our species from other animals. When these faculties become impaired as a result of neurologic disease, striking and devastating behavioral changes result. Many neurologic diseases are associated with impaired cognition and behavior, and their etiologies are as varied as their clinical presentations. In this review, the focus is on dementia with Lewy bodies (DLB), the frontotemporal dementias (FTDs), and vascular cognitive impairment (VCI). The review covers the epidemiology and diagnosis of DBB, FTDs, and VCIs, as well as the etiology and genetics. Figures show neuroimaging in DLB, management of DLB, FTLD clinical syndromes, FTLD clinicopathologic correlations: approximate distribution of pathotypes for behavioral-variant FTD and primary progressive aphasia (PPA) variants, PPA-semantic subtype, PPA-logopenic subtype, post-stroke VCI, and subcortical...

Neurology: Clinical Practice, 2020

Aging physicians are at a higher risk of cognitive impairment, undermining patient safety and unr... more Aging physicians are at a higher risk of cognitive impairment, undermining patient safety and unraveling physicians' careers. Neurologists, occupational health physicians, and psychiatrists will participate in both health system policy decisions and individual patient evaluations. We address cognitive impairment in aging physicians and attendant risks and benefits. If significant cognitive impairment is found after an appropriate evaluation, precautions to confidentially support physicians' practicing safely for as long as possible should be instituted. Understanding that there is heterogeneity and variability in the course of cognitive disorders is crucial to supporting cognitively impaired, practicing physicians. Physicians who are no longer able to practice clinically have other meaningful options.

P2‐537: The Brain Health Champion Study: Promoting Nonpharmacological Interventions in Patients with Cognitive Disorders

Alzheimer's & Dementia, 2018

B-11Effects of Physical, Cognitive, or Mindfulness Training Interventions on Gait Under Dual-Task Conditions

Archives of Clinical Neuropsychology, 2015

Faculty Opinions recommendation of Association between CSF biomarkers and incipient Alzheimer's disease in patients with mild cognitive impairment: a follow-up study

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature, 2006

F1000 - Post-publication peer review of the biomedical literature, 2011

To examine the impact of age and cognitive reserve on cognitive functioning in patients with brea... more To examine the impact of age and cognitive reserve on cognitive functioning in patients with breast cancer who are receiving adjuvant treatments. Patients with breast cancer exposed to chemotherapy (n ϭ 60; mean age, 51.7 years) were evaluated with a battery of neuropsychological and psychological tests before treatment and at 1, 6, and 18 months after treatment. Patients not exposed to chemotherapy (n ϭ 72; mean age, 56.6 years) and healthy controls (n ϭ 45; mean age, 52.9 years) were assessed at matched intervals. Mixed-effects modeling revealed significant effects for the Processing Speed and Verbal Ability domains. For Processing Speed, a three-way interaction among treatment group, age, and baseline cognitive reserve (P Ͻ .001) revealed that older patients with lower baseline cognitive reserve who were exposed to chemotherapy had lower performance on Processing Speed compared with patients not exposed to chemotherapy (P ϭ .003) and controls (P Ͻ .001). A significant group by time interaction for Verbal Ability (P ϭ .01) suggested that the healthy controls and no chemotherapy groups improved over time. The chemotherapy group failed to improve at 1 month after treatment but improved during the last two follow-up assessments. Exploratory analyses suggested a negative effect of tamoxifen on Processing Speed (P ϭ .036) and Verbal Memory (P ϭ .05) in the no-chemotherapy group. These data demonstrated that age and pretreatment cognitive reserve were related to posttreatment decline in Processing Speed in women exposed to chemotherapy and that chemotherapy had a short-term impact on Verbal Ability. Exploratory analysis of the impact of tamoxifen suggests that this pattern of results may be due to a combination of chemotherapy and tamoxifen.

Faculty of 1000 evaluation for Cognitive impairment in hemodialysis patients is common

F1000 - Post-publication peer review of the biomedical literature, 2006

F1000 - Post-publication peer review of the biomedical literature, 2008

Managing Neuropsychiatric Symptoms of Neurodegenerative Diseases

Springer eBooks, 2016

Many neurodegenerative conditions are associated with neuropsychiatric symptoms. The origin of th... more Many neurodegenerative conditions are associated with neuropsychiatric symptoms. The origin of these symptoms is complex, and includes neuroanatomical, neurochemical, psychological, and social factors. Management of neuropsychiatric symptoms in neurologic disease is challenging, as there is a dearth of evidence-based data. This chapter explores the neurobiology of the most common neuropsychiatric symptoms encountered in clinical practice, and outlines current approaches toward their pharmacological and behavioral management.

Case Study 2: A 60-Year-Old Man With Progressive Deficits in Language Output

Journal of Neuropsychiatry and Clinical Neurosciences, Jul 1, 2022

Alzheimers & Dementia, Jul 1, 2019

Memory and emotions for the 9/11/01 terrorist attacks in patients with Alzheimer’s disease, mild cognitive impairment, and healthy older adults

Neuropsychology (journal), 2004

Psychiatric and Behavioral Problems

Neurologic Clinics, May 1, 1998

In an emergency setting, many neurologic conditions present with psychiatric and behavioral sympt... more In an emergency setting, many neurologic conditions present with psychiatric and behavioral symptoms. These symptoms may either be the first manifestation of the neurologic illness or a later occurrence in the progression of the disease. It is important for clinicians evaluating patients with psychiatric symptoms to identify the signs indicating associated neurologic illness and to have strategies for managing the acute, potentially dangerous, neuropsychiatric manifestations of the disease. This article addresses emergency evaluation and management of depression, anxiety, psychosis, mania, suicide attempts, neuroleptic malignant syndrome and other hypermetabolic and amnestic syndromes, somatoform disorders, aggression, and legal issues, such as capacity to accept or refuse treatment.

The brain health champion study: A health coaching intervention with mobile technology in older adults with mild cognitive impairment or risk factors for dementia – An update

Alzheimers & Dementia, Jun 1, 2023

Alzheimer's & Dementia

BackgroundThere is growing evidence that adherence to brain‐healthy behaviors can reduce the risk... more BackgroundThere is growing evidence that adherence to brain‐healthy behaviors can reduce the risk of dementia and rate of decline. Current standard of care, however, does not systematically promote or monitor adherence to brain health guidelines. We recently demonstrated that a health coaching intervention, which included weekly phone calls, facilitated greater adherence to lifestyle recommendations and improved quality of life. The current study is investigating the impact of supplementing health coaching with digital health technology, including a mobile platform and wearable fitness trackers.MethodIn an ongoing six‐month trial, we are measuring the effect of a clinic‐embedded, technology‐augmented health coaching program on adherence to brain health recommendations. Forty patients with mild cognitive impairment (MCI) or risk factors for dementia are being randomized to the Brain Health Champion (BHC) intervention or a counseling and education (CE) control. In BHC, participants wo...

ALZ‐NET: Using Real World Evidence to Inform the Future of Alzheimer’s Treatment and Care

Alzheimer's & Dementia

Advances in Understanding Dysexecutive Syndromes

NEJM Journal Watch, 2003

Godefroy briefly reviews dysexecutive syndromes as they relate to disorders of frontal systems, w... more Godefroy briefly reviews dysexecutive syndromes as they relate to disorders of frontal systems, with emphasis on the clinical implications of ongoing

Cognitive Changes after Working Memory Training in Healthy Older Adults: Evidence From a Multi-Site, Randomized Controlled Trial (P6.107)

Neurology, 2017

Objective: To evaluate the efficacy of computerized cognitive training (CCT) focused on working m... more Objective: To evaluate the efficacy of computerized cognitive training (CCT) focused on working memory (WM) compared to an active control condition in healthy older adults. Background: Developing effective interventions to attenuate age-related cognitive decline is a major public health goal. CCT has been marketed increasingly to older adults, but its efficacy remains unclear. WM, a key determinant of higher order cognitive abilities, is susceptible to age-related decline, which makes WM a relevant target for CCT in elders. Design/Methods: Seventy-six cognitively normal adults, 65 years and older, from two sites (US and Sweden) were randomly assigned to Cogmed Adaptive or Non-Adaptive (active control) CCT groups. Training was performed in participants’ homes during sessions lasting ~ 40 minutes, 5 days per week over 5 weeks. In Adaptive CCT, difficulty level was continually adjusted, while for the Non-Adaptive group, difficulty level remained the same. At baseline, subjects underwen...

The Heuristic Power of Clinical Case Conferences: A New Section in the Journal of Neuropsychiatry and Clinical Neurosciences

The Journal of Neuropsychiatry and Clinical Neurosciences, 2021

Cognitive Disorders Other than Alzheimer Disease

DeckerMed Psychiatry, 2016

Higher cognitive functions, such as abstract reasoning, complex decision making, and language, ar... more Higher cognitive functions, such as abstract reasoning, complex decision making, and language, are the mental faculties that separate our species from other animals. When these faculties become impaired as a result of neurologic disease, striking and devastating behavioral changes result. Many neurologic diseases are associated with impaired cognition and behavior, and their etiologies are as varied as their clinical presentations. In this review, the focus is on dementia with Lewy bodies (DLB), the frontotemporal dementias (FTDs), and vascular cognitive impairment (VCI). The review covers the epidemiology and diagnosis of DBB, FTDs, and VCIs, as well as the etiology and genetics. Figures show neuroimaging in DLB, management of DLB, FTLD clinical syndromes, FTLD clinicopathologic correlations: approximate distribution of pathotypes for behavioral-variant FTD and primary progressive aphasia (PPA) variants, PPA-semantic subtype, PPA-logopenic subtype, post-stroke VCI, and subcortical...

Neurology: Clinical Practice, 2020

Aging physicians are at a higher risk of cognitive impairment, undermining patient safety and unr... more Aging physicians are at a higher risk of cognitive impairment, undermining patient safety and unraveling physicians' careers. Neurologists, occupational health physicians, and psychiatrists will participate in both health system policy decisions and individual patient evaluations. We address cognitive impairment in aging physicians and attendant risks and benefits. If significant cognitive impairment is found after an appropriate evaluation, precautions to confidentially support physicians' practicing safely for as long as possible should be instituted. Understanding that there is heterogeneity and variability in the course of cognitive disorders is crucial to supporting cognitively impaired, practicing physicians. Physicians who are no longer able to practice clinically have other meaningful options.

P2‐537: The Brain Health Champion Study: Promoting Nonpharmacological Interventions in Patients with Cognitive Disorders

Alzheimer's & Dementia, 2018

B-11Effects of Physical, Cognitive, or Mindfulness Training Interventions on Gait Under Dual-Task Conditions

Archives of Clinical Neuropsychology, 2015

Faculty Opinions recommendation of Association between CSF biomarkers and incipient Alzheimer's disease in patients with mild cognitive impairment: a follow-up study

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature, 2006

F1000 - Post-publication peer review of the biomedical literature, 2011

To examine the impact of age and cognitive reserve on cognitive functioning in patients with brea... more To examine the impact of age and cognitive reserve on cognitive functioning in patients with breast cancer who are receiving adjuvant treatments. Patients with breast cancer exposed to chemotherapy (n ϭ 60; mean age, 51.7 years) were evaluated with a battery of neuropsychological and psychological tests before treatment and at 1, 6, and 18 months after treatment. Patients not exposed to chemotherapy (n ϭ 72; mean age, 56.6 years) and healthy controls (n ϭ 45; mean age, 52.9 years) were assessed at matched intervals. Mixed-effects modeling revealed significant effects for the Processing Speed and Verbal Ability domains. For Processing Speed, a three-way interaction among treatment group, age, and baseline cognitive reserve (P Ͻ .001) revealed that older patients with lower baseline cognitive reserve who were exposed to chemotherapy had lower performance on Processing Speed compared with patients not exposed to chemotherapy (P ϭ .003) and controls (P Ͻ .001). A significant group by time interaction for Verbal Ability (P ϭ .01) suggested that the healthy controls and no chemotherapy groups improved over time. The chemotherapy group failed to improve at 1 month after treatment but improved during the last two follow-up assessments. Exploratory analyses suggested a negative effect of tamoxifen on Processing Speed (P ϭ .036) and Verbal Memory (P ϭ .05) in the no-chemotherapy group. These data demonstrated that age and pretreatment cognitive reserve were related to posttreatment decline in Processing Speed in women exposed to chemotherapy and that chemotherapy had a short-term impact on Verbal Ability. Exploratory analysis of the impact of tamoxifen suggests that this pattern of results may be due to a combination of chemotherapy and tamoxifen.

Faculty of 1000 evaluation for Cognitive impairment in hemodialysis patients is common

F1000 - Post-publication peer review of the biomedical literature, 2006

F1000 - Post-publication peer review of the biomedical literature, 2008