Aspects Of Executive Function Research Articles

Evaluating the Pattern of Relationships of Speech and Language Deficits with Executive Functions, Attention Deficit/Hyperactivity Disorder (ADHD), and Facets of Giftedness in Greek Preschool Children. A Preliminary Analysis

Speech and language deficits often occur in preschool children, and empirical studies have indicated an association between language impairments and challenges in different cognitive domains. The primary aim of the current study was to evaluate the associations between speech and language deficits, executive function (EF) impairments, Attention Deficit/Hyperactivity Disorder (ADHD), and aspects of giftedness in Greek preschoolers based on assessments from their teachers. Investigating the associations between aspects of EFs, ADHD, and giftedness was another objective of the current study. Finally, we examined on a sample of Greek preschool children the convergent validity of the LAMP screening test in relation to the following questionnaires: the Childhood Executive Functioning Inventory (CHEXI), the ADHD-IV Questionnaire, the Gifted Rating Scales-Preschool/Kindergarten Form (GRS-P), and the Scales for Rating the Behavioral Characteristics of Superior Students (SRBCSS). For the purpose of the present study, 20 kindergarten teachers and 71 Greek preschoolers (41 boys and 30 girls) were included in the sample. Data analysis revealed that according to teachers’ estimations, speech and language deficits are positively associated to a statistically significant degree with ADHD and with deficits in working memory (WM) and inhibition. On the other hand, aspects of preschool-aged creativity and giftedness were significantly correlated negatively with speech and language deficits. Additionally, the findings demonstrated a negative correlation between aspects of giftedness and ADHD symptoms as well as poor achievement on working memory (WM) and inhibition assessment tests. Furthermore, there was no association between hyperactivity/inhibition deficit and creativity, which is an aspect of giftedness. The moderate positive associations of the LAMP screening test with the psychometric tools of measurement of ADHD and executive function (EF) deficits, and the negative associations with the scales of giftedness showed the good convergent and distinct validity of the LAMP assessment test.

Exploring Music-Based Interventions for Executive Functioning and Emotional Well-Being in Stroke Rehabilitation: A Scoping Review.

Stroke is one of the leading causes of disability with life-long implications requiring assessment and treatment of several functional domains. This review identifies the results from research into music-based interventions (MBIs), including music therapy (MT), for executive functions (EFs) and emotional well-being (EWB) in adults with stroke and highlights opportunities for clinical practice and future research. APA PsycInfo (EBSCOhost), and CINAHL (EBSCOhost) were searched, in addition to grey literature. A total of 49 studies were included and encompassed experimental, analytic, and descriptive observational studies, and case reports, involving a total of 1663 participants. In total, 32 studies included MT interventions, and 17 were MBIs. EFs were an outcome in 20.41%, and EWB in 61.22% of studies, for which active interventions were the most utilized. Overall, 73.47% of the studies reported positive results. This scoping review indicates that music interventions can be beneficial for the improvement of different aspects of EFs and EWB at different stages of stroke recovery. Further research may benefit clinical practice by including standardized protocols, outcome and self-reported measures, and brain imaging data to determine the effects of interventions and support evidence-based decisions for treatment policies for stroke survivors.

Longitudinal associations between autistic children's anxiety and social communication differences: The moderating role of executive function behaviours.

Anxiety is a mental health concern affecting many autistic children, and has been linked to greater differences in social communication and interaction style. Executive functioning (i.e. the ability to direct and regulate attention and behaviour) plays an important role in autistic children's and social-emotional development. We tested whether anxiety (reported by parents) predicts social communication and interaction differences (reported by teachers) over time or vice versa among autistic preadolescents. We also investigated whether the link between anxiety and social communication and interaction differed depending on children's EF abilities (reported by teachers). We found less parent-reported anxiety predicted more teacher-reported social communication and interaction differences a year later - but only for children who had heightened behavioural dysregulation (an aspect of executive functioning that includes impulse and emotion control). Our work suggests autistic preadolescents with behavioural dysregulation and limited anxiety may be at greater risk for social difficulties, and may need more support in this area. Executive functioning may be a useful mechanism to target in treatment for this group of children.

Inferring Word Class and Meaning From Spoken and Written Texts: A Comparison of Children With and Without Developmental Language Disorder.

The aim of the study was to determine the ability of children with developmental language disorder (DLD) to infer word class and meaning from text and to document variations by word class (noun, verb, adjective) and modality (listening, reading). We also asked whether the children could integrate global cues across the entire passage as well as local cues from the immediate sentence frame to support inferences. Fourth graders with DLD (n = 28) and typical language development (TLD; n = 41) read and listened to expository texts and guessed the noun, verb, and adjective removed from each. Adults (n = 20) completed the task to establish a baseline of correct responses. We used latent semantic analysis (LSA) to determine the semantic fit of the responses to the texts and to determine whether global cues were more difficult for children with DLD than local cues. The DLD group was 24% less accurate than the TLD group. In both diagnostic groups, accuracy varied by word class (nouns > adjectives > verbs) but not modality (reading = listening). Word class errors were rare, and errors of semantic fit were frequent. LSA cosines were higher for correct responses relative to the passage as a whole than the immediate sentence frame, suggesting that both groups mined the more extensive information in the global cues to support inferences. Compared to the TLD group, the DLD group tended to make "worse" errors: repeating words from the sentence frame or coming up with no response at all. Accuracy in the DLD group, but not the TLD group, was related to vocabulary knowledge. When the two groups were collapsed, scores on verbal short-term/working memory and sustained attention also predicted performance, but weaknesses in these aspects of executive function on the part of individuals with DLD did not fully explain the difference between the performance of the DLD and TLD groups. Whether listening or reading, fourth graders with DLD are less able to infer word meaning from texts than their age-mates. The problem reflects, in part, deficits in executive function and lexical semantic knowledge.

Temperament and executive functioning correlates of ADHD symptom severity during early versus middle childhood.

This study investigated associations among temperament, executive functioning (EF), and attention-deficit/hyperactivity disorder (ADHD) symptom severity at two developmental stages. Participants were 61 4-year-old children and 165 8-11-year-old children (126 ADHD, 39 typically developing [TD]). Caregivers reported on temperament (effortful control [EC], negative affect, and surgency), and ADHD symptoms. Three aspects of EF (working memory, inhibitory control, and processing speed) were measured with neuropsychological tests. Among 4-year-olds, variance in ADHD symptom severity was only explained by the temperament variables. EC was not significantly correlated with any of the EFs in this cohort. Among school-aged children, low EC, high surgency, high negative affect, and reduced working memory were associated with greater ADHD symptom severity. EC was significantly and positively correlated with processing speed in the school-aged children. Results are consistent with a neurodevelopmental model of ADHD, wherein dysregulated temperament is associated with ADHD in young children, while both dysregulated temperament and cognitive skills are associated with ADHD in middle childhood. Results could inform the selection of clinical tools for diagnostic evaluation of pediatric ADHD symptoms and clinical follow-up.

Executive functioning is associated to everyday interference of pain in patients with chronic pain.

Dysfunction in executive functions is common among patients with chronic pain. However, the relationships between executive functioning and pain management have not been extensively studied. In this study, 189 outpatients (160 women, 29 men; mean age 33.15) with chronic pain underwent an extensive neuropsychological assessment, including several tests of executive functions. In addition, all participants completed self-assessment questionnaires regarding pain and interference of pain in everyday life. After adjusting for effects of age, education, and depression, several aspects of executive functioning were significantly associated with self-assessed everyday interference of pain (rs = 0.13-0.22, all ps < 0.05). This indicates that lower performance on tests of executive functioning was significantly associated with a higher degree of pain interference and a lower degree of life control. Pain characteristics such as pain intensity, pain duration, and pain spreading were not associated with executive functioning. These results suggest that preserved executive functions are related to better coping with pain, but not directly to the pain itself, in patients with chronic pain. Depression was also associated with self-management of pain, indicating that patients with lower executive functioning in combination with depression may need special attention during rehabilitation.

Influence of acute and chronic therapeutic cooling on cognitive performance and well-being

PurposeResearch regarding the effect cold-water immersion (CWI) has on cognitive performance often uses excessive cooling protocols (>1-hour) to measure the detrimental impact prolonged cold exposure has on cognition. Previous studies have not considered shorter CWI protocols, similar to that used in recovery and wellness practices (∼10 min). AimsTo investigate a more ecologically valid CWI protocol on cognition, well-being and sleep in an acute and chronic manner. It was hypothesised that a therapeutic CWI protocol would improve well-being, and sleep and have no detrimental effect on cognition. MethodsThirteen healthy participants (20.85±2.15 years), (169.96±7.77 cm), (72.03±14.92 kg), (27.67±9.55 BF%) volunteered to complete a 4-week CWI protocol. Participants were immersed in cold water (10.42±0.59 °C) 3-times a week for 4-weeks. Cognitive performance (Stroop & TMT), well-being (WEMWBS, PSWQ, GAD-7, SHS) and sleep (PSQI) were measured acutely and chronically over the 4-week protocol along with thermoregulatory measures (Tsk, Tco, thermal comfort). ResultsResults show that CWI had no detrimental impact on cognitive performance, with Stroop performance & well-being seeing no differences acutely or chronically. Alternatively, the trail making test showed significant improvement from baseline (TMT-A 15.17±4.81-seconds, TMT-B 39.68±15.12-seconds) to week-3 (TMT-A 11.06±3.29-seconds, TMT-B 26.18±10.23-seconds). A reduction in sleep disturbances was seen from baseline scores of 7.85±3.44 AU to the end of week-3 measures 5.75±3.77 AU. ConclusionTherapeutic cooling can improve sleep quality when utilised in short frequent doses (3 times per week, for 4-weeks) and is not detrimental to cognitive performance, improving certain aspects of executive function.

Effects of executive function on age-related emotion recognition decline varied by sex

This study delves into the criticality of Emotion recognition (ER) as a pivotal component of social functionality and psychological well-being, focusing on its susceptibility to aging and sex-related differences. Underpinned by the 'frontal aging hypothesis,' which posits a particular vulnerability of executive functions to the aging process, this study aims to unravel the intricate dynamics of how aging influences ER in both sexes, emphasizing the mediating role of executive functions. A cohort of 127 healthy adults underwent the Multi-Modality Emotion Recognition Test mobile application to assess facial ER and cross-modal matching abilities. Comprehensive neuropsychological assessments supplemented this to evaluate various facets of executive function. The analysis indicated a pronounced decline in ER performance among older adults, with no significant sex differences across age groups. However, gender-specific patterns emerged in the aging-ER relationship. For males, cognitive flexibility (β = 0.399, p < 0.001) and inhibition (β = 0.329, p = 0.020) were partial mediators. In females, working memory (β = −0.297, p = 0.023) and selective attention (β = 0.290, p = 0.042) moderated the aging-facial ER link, with inhibition (β = 0.284, p = 0.015) also playing a partial mediating role. Additionally, inhibition (β = 0.194, p = 0.043) moderated the relationship between aging and the female's cross-modal matching. The findings highlight a gender-differentiated impact of executive functions on age-related ER decline. This underscores the need for gender-tailored approaches in enhancing ER, particularly in an aging population.

The connection between articulatory skill and higher-level executive function in monolinguals and bilinguals

While the existence of a bilingual advantage in higher-level executive function remains controversial, recent studies showed bilinguals consistently outperform monolinguals in learning new patterns of pronunciation (in both natural or artificially constructed novel dialects). Since audition and articulatory control are involved in this type of learning, the question arises to what extent these lower-level functions are enhanced in people with superior performance on phonetic learning tasks. Dugaillard &amp; Spinu (2019) found that sequential bilinguals outperformed monolinguals and simultaneous bilinguals on a tongue-twister task (Goldrick &amp; Blumstein 2006, McMillan&amp;Corley 2010), suggesting an advantage in articulatory skill. In the current study, we aim to replicate the original findings with a new group of bilinguals and further explore the connection of articulatory skill with one aspect of executive function (i.e. interference/conflict resolution). The experimental tasks include (1) reading artificially constructed tongue-twisters such as “kifkivkivkif” three times in succession, matching a 150 bps rhythm on a metronome, and (2) a classic Simon task asking participants to react or inhibit their response to congruent and incongruent stimuli. We expect the findings to shed more light on the bilingual advantage phenomenon and the connection between lower- and higher-level cognitive functions in both populations.

Assessing the effect of anthocyanins through diet and supplementation on cognitive function in older adults at risk for dementia: protocol for a randomised controlled trial

IntroductionPromising evidence is emerging for the procognitive, anti-inflammatory and neuroprotective properties of dietary flavonoids, particularly anthocyanins that provide red, purple and blue plant pigments.Methods and analysisThe ‘Food for Thought’ study...

Executive deficits after SARS-CoV-2 infection: A cross-sectional population study

ImportanceDespite the major implications of executive deficits in day-to-day functioning, few studies have investigated this in post-acute sequelae of SARS-CoV-2 infection using standardized measures that differentiate between aspects of executive function. ObjectiveExamine whether SARS-CoV-2 infection is associated with deficits in executive functions and if so, investigate the duration of this association. Design, Setting, and ParticipantsThe present research has a cross-sectional design and uses data from the Norwegian Covid-19 Cohort study. The current cohort (n = 8102) completed the Behavior Rating Inventory of Executive Function- Adult Version (BRIEF-A) electronically between April 2021 and September 2021. During the assessment, 4183 of the included participants had a prior positive polymerase chain reaction test (PCR) for SARS-CoV-2 and 3919 were untested or had a confirmed negative PCR test. ExposureLaboratory-confirmed SARS-CoV-2 infection. Main outcomes and measuresExecutive functions were measured using the BRIEF-A, a self-report questionnaire comprising 75 items within nine theoretically and empirically distinct clinical scales. All participants self-reported on demographical variables and comorbidity. Information on sex and age was derived from the personal identification number, and vaccination status was obtained from the Norwegian Immunization Registry (SYSVAK). ResultsParticipants with a positive SARS-CoV-2 status reported executive deficits in everyday life above the clinical threshold (T-score ≥65) more often than non-infected controls (383 vs. 225). Specifically, the SARS-CoV-2 positive status group indicated significantly more deficits related to metacognition, with the greatest difference demonstrated for working memory. This difference remained when adjusting for various demographic factors and comorbidities, with significantly greater odds of reporting above the clinical threshold following SARS-CoV-2 infection, as observed on the global executive composite score 6–12 months after infection (OR 1.97; 95% CI 1.51 to 2.55). ConclusionsOur study confirms more perceived executive deficits following SARS-CoV-2 infection compared to non-infected controls, with metacognitive aspects being the most affected. These findings shed light on the potential functional difficulties that individuals may encounter during the post-acute phase of SARS-CoV-2 infection and may guide further development of targeted interventions addressing metacognitive domains of executive functioning.

A meta-analysis on the relationship between subjective cognitive failures as measured by thecognitive failures questionnaire (CFQ) and objective performance on executive function tasks.

The Cognitive Failures Questionnaire (CFQ) has been widely used as a measure of subjective cognitive function in everyday life for decades. However, the evidence on how it relates to objective performance on executive function tasks is mixed. One possible reason for these mixed results is that the CFQ has selective relationships with some aspects of executive function and not others. Here, therefore, we classified tasks according to an influential framework of executive functions-switching, updating, inhibition, and we also considered the Sustained Attention to Response Task (SART) as a category because it was custom designed to gauge cognitive failures. We synthesized a large body of available evidence and performed four Bayesian meta-analyses on the relationship between CFQ scores and objective performance on executive function tasks in these four categories. Results suggested that CFQ scores were associated with objective performance on SART (18 effect sizes, μ = -.19, BF10 = 18.03, i.e., 18.03 times more evidence of a relationship versus no relationship), updating working memory (49 effect sizes, μ = -.06, BF10 = 17.80), and inhibition tasks (41 effect sizes, μ = -.07, BF10 = 15.40), whereas there was not definitive evidence regarding switching (34 effect sizes, μ = -.06, BF10 = .50, i.e., two times greater evidence for no relationship). This suggests that subjective cognitive function can predict objective performance on at least some executive function tasks. We discuss methodological and theoretical factors that constrain the maximum observable correlation and consider the relative insights that subjective measures versus task performance provide.

On executive functioning and childcare: The moderating role of parent-child interactions.

Childcare services are widely used by families and thereby exert an important influence on many young children. Yet, little research has examined whether childcare may impact the development of child executive functioning (EF), one of the pillars of cognitive development in early childhood. Furthermore, despite persisting hypotheses that childcare may be particularly beneficial for children who have less access to optimal developmental resources at home, research has yet to address the possibility that putative associations between childcare and EF may vary as a function of family factors. Among a sample of 180 mostly White middle-class families (91 girls), we examined if childcare participation in infancy was related to two aspects of EF (Delay and Conflict) at 3 years, and whether two aspects of maternal parenting behavior (sensitivity and autonomy support) moderated these associations. The results showed positive associations between participation in group-based childcare and Delay EF specifically among children of relatively less autonomy-supportive mothers. These findings suggest that out-of-home childcare services may play a protective role for children exposed to parenting that is less conducive to their executive development. RESEARCH HIGHLIGHTS: Little research has considered effects of childcare in infancy on executive functioning (EF). Long-standing hypothesis that childcare is more beneficial for children exposed to less sensitive and supportive parenting. We test interactions between maternal parenting and childcare participation in infancy in relation to EF at age 3 years. We find positive associations between participation in group-based childcare and Delay EF specifically among children of relatively less autonomy-supportive mothers.

Identifying conflict monitoring as a specific executive component that contributes to impaired self-awareness in patients with acquired brain injury

ABSTRACT Objective Impaired self-awareness (SA) after acquired brain injury (ABI) has traditionally been linked to deficits in executive functions. However, conflicting findings about this relationship have been reported in the literature. This inconsistency is probably due to the multicomponent nature of both constructs, as not all aspects of executive functions may be equally relevant to all components of self-awareness. This study explored whether offline SA (i.e. metacognitive knowledge) and online SA (i.e. error detection) relate to a less studied executive component, conflict monitoring/resolution. Method Twenty-six patients with ABI performed the Three-Conflict Cognitive Control Task (3CCT), an experimental task that allowed to measure the ability to monitor and solve three different types of conflicts (Distractors-filtering, Spatial Stroop and Simon). Measures of SA were collected: offline SA was based on self-informant discrepancy about patient’s everyday functional difficulties, and online SA was based on error detection abilities during a performance-based naturalistic task (The Breakfast Conflict Task). Results After controlling for global cognition, the conflict monitoring measure of 3CCT demonstarted incremental validity in predicting offline and online SA measured in naturalistic tasks. Conclusions Conflict monitoring/resolution seems to be an important component of SA. This finding contributes to further understand the relationship between executive functions and SA. In addition, conflict monitoring/resolution is an executive component that should be considered when designing assessment and intervention strategies to deal with ISA.

Online Group Cognitive Rehabilitation Program for Prostate Cancer Survivors: Development Using Codesign and the Theoretical Domains Framework

ObjectivesThis study aimed to describe the adaptation of a group cognitive rehabilitation program for prostate cancer survivors (PCS) via telehealth delivery using a codesign approach with PCS experiencing cancer-related cognitive impairment. The Theoretical Domains Framework (TDF) also informed the intervention development. MethodsIntervention development consisted of three steps: 1) Adapting an existing cancer-related cognitive rehabilitation program for PCS; 2) Conducting a codesign focus group workshop to gather feedback that was analyzed using a template approach; and 3) Incorporation of consumer feedback to refine the program for future piloting in PCS. Components of the finalized intervention were mapped onto the TDF domains. ResultsSix PCS were involved in the codesign focus group workshop, providing feedback on program structure, the topics and its order, and rehabilitation activities. A manualized four-week online group cognitive rehabilitation program titled “Promoting Cognitive Wellbeing in Prostate Cancer Survivors (ProCog)” was developed. Four sessions of 2-hours’ duration were designed exploring: cognitive/brain functions; the impact of cancer treatments and ageing; the relationship between thoughts, feelings and behaviors; values-based goal-setting; and skills/strategies to manage fatigue and improve attention, memory, aspects of executive functioning, and emotional functioning. ConclusionsConsumer input and guidance from the TDF ensures a robust development process for the online ProCog intervention, designed for and with PCS experiencing cognitive difficulties. As an important initial step before piloting, this adaptation and development process ensures that ProCog addresses consumer needs and preferences and targets factors increasing behavior change. Implications for Nursing PracticeThis research raises awareness of possible cancer-related cognitive impairments in prostate cancer survivors and strategies for rehabilitation. ProCog is an accessible online intervention that nurses can use to refer patients needing cognitive rehabilitation.

The relationship between personality and cognition in older adults with and without early-onset depression.

It is well established that personality traits impact cognition, as certain personality factors are associated with performance in specific cognitive domains. However, the findings on the relationships between the Big Five traits and cognition are mixed. Additionally, few studies have explored these relationships in older adults with a history of depression. The present study aimed to (a) evaluate the impact of the Big Five personality traits in older adults with and without a lifetime history of depression; and (b) test the hypotheses that higher trait neuroticism would correlate negatively with cognitive performance, while openness to experience would correlate positively with cognition. The sample consisted of 138 participants between the ages of 55 and 78 (M = 65.56, SD = 6.36). Sixty-two participants met criteria for current or remitted Major Depressive Disorder, while 76 had no history of depression or other mental health disorders. Participants underwent comprehensive neuropsychological testing. Personality was assessed using the NEO Personality Inventory-Revised (NEO-PI-R), while depression status was determined using the Structured Clinical Interview for DSM-5 (SCID-5). Following a series of Pearson correlations of cognitive variables and the five personality factors, linear regression models were estimated for each significant correlation. Demographic variables (i.e., age, education and sex) were entered in block 1, depression status (never vs. ever) was entered in block 2, and the personality factor score, or sub-facet was entered in block 3. Neuroticism was not associated with cognitive performance on any outcome measure. The facets Openness to Feelings and Openness to Values were positively related to phonemic fluency. Further Openness to Values was positively related to cognitive flexibility. Our results suggest that older people who are (a) more capable of identifying and understanding their feelings and the feelings of others, and (b) who are more willing to re-examine social, political, and religious values perform stronger on tasks measuring verbal fluency and cognitive flexibility, which are aspects of executive functioning. Interventions that aim to enhance open mindedness in older adults may have a parallel impact on improving executive functioning, though this would need to be examined prospectively.

Effects of a cognitive rehabilitation training program in school-aged children with specific learning disorder

ABSTRACT Objective This study investigated the effect of Cognitive Rehabilitation Training (CRT) on executive functions, problem solving, and attention in students with a specific learning disorder (SLD). Method Forty-two SLD students from the third to sixth grade (8–12 years old) were randomly assigned to 16 sessions of CRT (n = 21) or to a control (n = 21) group. Executive functions were assessed by the Behavior Rating Inventory of Executive Function (2nd ed.), problem solving by the Tower of London test, and attention by the Stroop test. Results Analyses of variance and post-hoc analyses revealed that there were significant improvements in the CRT group in most aspects of executive functions, problem solving, and attention, and these improvements were maintained over a two-month follow-up. Conclusion These findings suggest that a CRT program may have positive implications for cognitive functioning and may provide preliminary support for alternative therapeutic interventions for use in children with SLD.

Conceptualizing avoidant/restrictive food intake disorder via an executive functioning lens.

Avoidant/restrictive food intake disorder (ARFID) is a heterogeneous disorder wherein restrictive eating is primarily attributed to non-shape/weight-based reasons (e.g., sensory sensitivity) that empirical research continues to explore. Mounting evidence suggests that ARFID often presents alongside neurodevelopmental diagnoses (NDs) or divergent neurodevelopment broadly. Executive functioning (EF) differences often characterize divergent neurodevelopmental trajectories. Additionally, restrictive eating in anorexia nervosa has been conceptualized as related to EF factors (e.g., set shifting). Given the neurodevelopmental phenotype that may be associated with ARFID and the role of EF in anorexia nervosa, this paper proposes EF as a potentially important, yet understudied factor in ARFID pathology. We posit that various observed ARFID behavioral/cognitive tendencies can be conceptualized in relation to EF differences. We contextualize commonly observed ARFID presentations within "core" EF components (i.e., cognitive flexibility, working memory, inhibitory control), leading to hypotheses about EF in ARFID. Finally, we offer additional considerations/directions for future research on EF in ARFID. Increased research on EF in ARFID is needed to consider this potential common factor in the etiology and maintenance of this heterogeneous disorder. We aim to promote further consideration of EF in ARFID etiology, maintenance, and treatment-outcome research. PUBLIC SIGNIFICANCE: This article proposes that aspects of executive functioning (EF) may play a role in the onset and maintenance of avoidant/restrictive food intake disorder (ARFID), although this notion is largely untested by existing research. Further research on the role of EF in ARFID may assist with refining models and treatments for this heterogeneous disorder.

Executive function, perceived stress and eating behaviours among Chinese young adults.

Young adults in a transitional period may experience more stress and, hence, suffer from an increased risk of unhealthy eating. Executive function (EF) involves not only inhibitory control and mental flexibility (the 'cool' facet) to facilitate resistance to immediate temptations, but also affective decision making (the 'hot' facet) that helps to regulate emotional eating. The effects of different facets of EF and their interactions with perceived stress on eating behaviours remained underexplored. In this study, 594 young adults in their graduation year of post-secondary education were included. We used latent profile analysis to identify major patterns of eating behaviours and analysed their associations with perceived stress, and both the 'cool' and 'hot' facets of EF using multinominal logistic regression models. Latent profile analysis identified three clusters of eating patterns: non-approaching moderate eaters (N=312, 52.5%), approaching eaters (N=229, 38.6%), and approaching-and-avoidant eaters (N=53, 8.9%). Logistic regression models found that the approaching-and-avoidant eating pattern was associated with higher perceived stress (OR=3.16, p value=0.007) and poorer affective decision-making (OR=0.97, p value=0.006). Stratified analysis further revealed that higher perceived stress was significantly associated with approaching-and-avoidant eating only among individuals with poorer affective decision-making. These findings suggest that individuals with poorer emotional regulation may face greater difficulties in regulating eating behaviours when experiencing higher stress. Interventions for people with a mixed pattern of approaching-and-avoidance eating should focus on providing support to regulate emotion-related eating.

Development of a new computer simulated environment to screen cognition: assessing the feasibility and acceptability of Leaf Café in younger and older adults

BackgroundExisting traditional cognitive screening tools for dementia have various limitations, including overreliance on tests assessing verbal memory and, to a lesser extent, on some aspects of executive functioning. Comprehensive neuropsychological assessment is sensitive to impairment but time-intensive and expensive. Virtual reality may provide a dynamic and unique understanding of cognitive performance and increase the ecological validity of cognitive assessment. The use of virtual reality in screening for cognitive function in older persons is promising, but evidence for its use remains sparse.ObjectiveOur primary aim was to examine the feasibility and acceptability of a newly developed, virtual reality assessment module, ‘Leaf Café’, a computer-based program that assesses cognition in an engaging, efficient, and ecologically relevant way. The secondary aim was to assess the ability of the module to discriminate between performances of younger and older adults.MethodsA cross-sectional study was carried out in Sydney, Australia, targeting adults aged 18 years and above. Participants completed a traditional cognitive screening tool (Telephone Interview for Cognitive Status-Modified, TICS-M) and Leaf Café, a low-immersive virtual reality module designed to evaluate learning and memory, perceptual-motor function, and executive functioning. The total performance score for each participant, ranging from 0 to 180, was correlated with their cognitive performance assessed by TICS-M, using Pearson’s correlation coefficient. Following module completion, participants were presented with an open and closed-question survey to capture their perceptions, attitudes, and feedback on the module, encompassing practicality, acceptability, and enjoyment. Both descriptive and content analyses were employed to interpret the obtained data.ResultsA sample of 131 participants (mean age 54.9 years, SD = 20.8, range 20–85) took part. The majority were female (71.8%) and born in an English-speaking country (75.8%). The mean amount of time spent in the module was 32.8 min (SD = 13.3) with a mean module score of 107.6 (SD = 38.7). Most participants completed the highest level (5; 80.5%). There was a significant correlation between Leaf Café total scores with TICS-M cognitive scores overall, and for both younger (aged 18–64 years) and older adult (aged 65 + years) groups. No significant difference was found on performance between age groups on TICS-M performance, however, younger adults had significantly better performance on the Leaf Café module than older adults (M = 124.1 vs 95.9; p < .001). Participants had similar response proportions regarding user experience with most agreeing that the module was easy to use (84%) and to navigate (85%). Compared with younger adults, older adults had lower rates of agreement on the module’s design (36.8% vs 64.3%; p = .020) and support experienced (20.5% vs 53.6%; p = .007). Participants highlighted the significance of practicality and the cognitive challenges presented by the module, in terms of memory strain and user interface concerns. Feedback encompassed different opinions on the usefulness of music, with suggestions for improvements centred around clearer instructions, varied game dynamics, and considerations for diverse user needs.ConclusionsLeaf Café is a feasible and acceptable tool to be used for screening for cognitive impairment in older adults and has real-world assessment value. Further verification on the game’s utility in detecting cognitive impairment is required.