Cognitive Assessment Research Articles

Association of CSF α-Synuclein Seeding Amplification Assay Results With Clinical Features of Possible and Probable Dementia With Lewy Bodies.

The clinical diagnosis of dementia with Lewy bodies (DLB) depends on identifying significant cognitive decline accompanied by core features of parkinsonism, visual hallucinations, cognitive fluctuations, and REM sleep behavior disorder (RBD). Hyposmia is one of the several supportive features. α-Synuclein seeding amplification assays (αSyn-SAAs) may enhance diagnostic accuracy by detecting pathologic αSyn seeds in CSF. In this study, we examine how different clinical features associate with CSF αSyn-SAA positivity in a large group of clinically diagnosed participants with DLB. Cross-sectional and longitudinal CSF samples from the multicentered observational cohort study of the DLB Consortium and similar studies within the Parkinson's Disease Biomarker Program, contributed by academic medical centers in the United States, underwent αSyn-SAA testing. Participants included those clinically diagnosed with DLB and 2 control cohorts. Associations between core DLB features and olfaction with αSyn-SAA positivity were evaluated using logistic regression. CSF samples from 191 participants diagnosed with DLB (mean age 69.9 ± 6.8, 15% female), 50 age-matched and sex-matched clinical control participants, and 49 younger analytical control participants were analyzed. Seventy-two percent (137/191) of participants with DLB had positive αSyn-SAAs vs 4% of the control groups. Among participants with DLB, those who were αSyn-SAA-positive had lower Montreal Cognitive Assessment scores (18.8 ± 5.7 vs 21.2 ± 5.2, p = 0.01), had worse parkinsonism on the Movement Disorders Society Unified Parkinson's Disease Rating Scale part III (33.8 ± 15.1 vs 25.6 ± 16.4, p = 0.001), were more likely to report RBD (114/133 [86%] vs 33/53 [62%], p < 0.0001), and had worse hyposmia on the University of Pennsylvania Smell Identification Test (UPSIT) (94/105 [90%] below 15th percentile vs 14/44 [32%], p < 0.0001). UPSIT percentile had the highest area under the curve (0.87, 95% CI 0.81-0.94) in predicting αSyn-SAA positivity and participants scoring at or below the 15th percentile of age and sex normative values had 18.3 times higher odds (95% CI 7.52-44.6) of having a positive αSyn-SAA test. Among 82 participants with longitudinal CSF samples, 81 (99%) had the same αSyn-SAA result for initial and follow-up specimens. A substantial proportion of clinically diagnosed participants with DLB had negative αSyn-SAA results. Hyposmia was the strongest clinical predictor of αSyn-SAA positivity. Hyposmia and αSyn-SAA may have utility in improving the diagnostic assessment of individuals with potential DLB. This study provided Class III evidence that CSF αSyn-SAA distinguishes patients with clinically diagnosed DLB from normal controls.

HindiPersonalityNet: Personality Detection in Hindi Conversational Data Using Deep Learning with Static Embedding

Personality detection along with other behavioral and cognitive assessment can essentially explain why people act the way they do and can be useful to various online applications such as recommender systems, job screening, matchmaking, and counseling. Additionally, psychometric natural language processing relying on textual cues and distinctive markers in writing style within conversational utterances reveals signs of individual personalities. This work demonstrates a text-based deep neural model, HindiPersonalityNet, of classifying conversations into three personality categories (ambivert, extrovert, introvert) for detecting personality in Hindi conversational data. The model utilizes a gated recurrent unit with BioWordVec embeddings for text classification and is trained/tested on a novel dataset, शख्सियत (pronounced as Shakhsiyat) curated using dialogues from an Indian crime-thriller drama series, Aarya . The model achieves an F1-score of 0.701 and shows the potential for leveraging conversational data from various sources to understand and predict a person's personality traits. It exhibits the ability to capture both semantic and long-distance dependencies in conversations and establishes the effectiveness of our dataset as a benchmark for personality detection in Hindi dialogue data. Further, a comprehensive comparison of various static and dynamic word embedding is done on our standardized dataset to ascertain the most suitable embedding method for personality detection.

Urinary AD7c -NTP is Associated With Cognitive Recovery After Ischemic Stroke.

Urinary Alzheimer-associated neuronal thread protein (AD7c-NTP) is regarded as a biomarker for β-amyloid protein deposition in Alzheimer disease (AD). The value of AD7c-NTP in predicting post-stroke cognitive recovery was worth exploring. In total, 224 patients with first-ever stroke were enrolled in this retrospective study. Cognitive assessment was evaluated by Mini-Mental State Examination (MMSE), and cognitive improvement was defined as MMSE scores ≥27 or 4-score elevation at 3-month follow-up after stroke. The AD7c-NTP level was 0.68±0.40ng/mL in the 135 patients with cognitive improvement, while the AD7c-NTP level was 1.49±0.99ng/mL in the 89 patients without improvement (P<0.001). Those displaying better cognitive recovery also had younger ages, higher MMSE scores, and lower NIHSS scores on admission. In multivariable logistic regression analysis, AD7c-NTP concentration (OR=9.14, 95% CI: 4.52-18.49, P<0.001), age (OR=1.04, 95% CI: 1.01-1.08, P=0.012), and NIHSS score on admission (OR=1.17, 95% CI: 1.07-1.28, P<0.001) remained the independent risk factors affecting cognitive recovery. The area under the receiver operating characteristics curve for AD7c-NTP in predicting unfavorable cognitive function was 0.80 (sensitivity: 0.73 and specificity: 0.84). Urinary AD7c-NTP is a valuable biomarker associated with post-stroke cognitive recovery. It might be adopted to discriminate coexisting AD pathology from vascular cognitive impairment.

A Comparative Study of Cognitive and Motor Performance in Liver Recipients.

Introduction: Neurocognitive and motor impairments are often observed both before and after liver transplantation, resulting in inefficiencies in dual-task performance. Specific aim: The aim of this study was to evaluate the motor-cognitive dual-task performance in liver recipients, with a particular emphasis on cognition, performance status, and the impact of the COVID-19 pandemic. Design: A prospective, cross-sectional, web-based design with a control group was used. The study included 22 liver transplant recipients and 23 controls. Participants completed a motor-cognitive dual-task test (timed up and go test, TUG), a cognitive assessment (mini mental state examination), and a physical performance test (5-repetition sit-to-stand test). The study also used a functional performance status scale (The Karnofsky performance status) and assessed fear of coronavirus disease (fear of COVID-19 scale). Dual-task interference was assessed and the rate of correct responses per second was calculated to assess cognitive performance. Results: The results indicated no statistically significant difference in TUG time and TUG correct responses per second between the groups (group × condition interactions; P > 0.05). There was no significant difference in cognitive and motor dual-task interference during the TUG test between the two groups (P > 0.05). The Karnofsky Performance Status score was significantly correlated with TUG motor dual-task interference (r = -0.424 and P = 0.049). Conclusion: This study suggests that dual-task performance does not differ in cognitive or motor performance between liver recipients and healthy controls under the same dual-task condition. However, further controlled studies are needed to improve the generalizability of these findings.

Longitudinal association of adverse childhood experiences with cognitive function trajectories among middle-aged and older adults: group-based trajectory modeling

IntroductionAdverse childhood experiences (ACEs) impact cognitive function, but the relationship remains unclear. We aim to identify cognitive function trajectories and scrutinize the correlation between ACEs and cognitive function.MethodsTo identify cognitive trajectories, we employed a group-based trajectory model, and influential factors were determined using multinomial unordered logistic regression analysis.ResultsThree cognitive decline subgroups emerged: low-start decline, high-start stability, and mid-start decline. There is no dose-response relationship between cumulative adverse childhood experiences and cognitive function. The high-start stability group had specific residence and education traits, while sibling death affected them. The mid-start decline group was vulnerable to parental death, physical abuse, and domestic violence. The low-start decline group should consider age structure and childhood friendships.ConclusionsNo dose-response association between cumulative ACEs and cognitive decline. Still, specific ACE metrics are correlated with cognitive trajectories. We can incorporate patients’ ACEs into cognitive function assessments for early risk factor identification and tailored interventions. Moreover, recognizing the influence of early-life experiences on cognitive function, we can advocate for nurturing positive family and societal environments to optimize cognitive function.

PASS Theory of Intelligence and Its Measurement Using the Cognitive Assessment System, 2nd Edition

The goal of this paper was to describe the context within which the PASS theory of intelligence was conceived and the reasons why this theory was used to guide the construction of the Cognitive Assessment System and the several versions of the Cognitive Assessment System, 2nd Edition. We also discuss validity issues such as equitable assessment of intelligence, using PASS scores to examine a pattern of strengths and weaknesses related to academic variability and diagnosis, and the utility of PASS scores for intervention. We provide summaries of the research that informs our suggestions that intelligence testing should be theory-based, not constrained by the seminal work of test developers in the early 1900s, and neurocognitive processes should be measured based on brain function.

IL-6 LEVELS AND COGNITIVE COMPLICATIONS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A CROSS SECTIONAL STUDY

Objective: It is important to monitor and manage macrovascular and microvascular complications, which are significant causes of mortality and morbidity in type 2 diabetes (T2DM). Diabetes-related cognitive impairment is an important complication that has recently attracted more attention, but its pathophysiology and clinical features are not known. The aim of this study was to evaluate the potential role of inflammation in diabetes-related cognitive impairment. Material and Method: A total of 122 participants (67 patients with T2DM and 55 controls) took part in this cross-sectional observational clinical study. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) test. IL-6 levels were measured using the ELISA method on blood samples obtained from the participants. Result and Discussion: Although IL-6 levels increased with diabetes and cognitive impairment, there was no significant difference between the groups (p&amp;gt;0.05). Except for attention and orientation, we observed significantly more impaired cognitive performance in T2DM patients. The MoCA total score was significantly correlated with age, education level, fasting glucose, HbA1c, and vitamin D levels (p&amp;lt;0.05). Our results found no evidence that IL-6 is involved in the pathophysiology of cognitive impairment in T2DM, but these findings the importance of cognitive screening in monitoring complications associated with diabetes.

Stroke Severity, Caregiver Feedback, and Cognition in the REGARDS-CARES Study.

Cognitive impairment after stroke is common and is present in up to 60% of survivors. Stroke severity, indicated by both volume and location, is the most consequential predictor of cognitive impairment, with severe strokes predicting higher chances of cognitive impairment. The current investigation examines the associations of 2 stroke severity ratings and a caregiver-report of poststroke functioning with longitudinal cognitive outcomes. One hundred fifty-seven caregivers and stroke survivor dyads participated in the CARES (Caring for Adults Recovering From the Effects of Stroke) project, an ancillary study of the REGARDS (Reasons for Geographic and Racial Differences in Stroke) national cohort study. The Glasgow Outcome Scale and modified Rankin Scale scores collected at hospitalization discharge were included as 2 primary predictors of cognitive impairment. The number of caregiver-reported problems and impairments at 9 months following stroke were included as a third predictor. Cognition was measured using a biennial telephone battery and included the domains of learning, memory, and executive functioning. Multiple cognitive assessments were analyzed up to 5 years poststroke, controlling for prestroke cognition and demographic variables of the stroke survivor. Separate mixed models showed significant main effects of the Glasgow Outcome Scale (b=0.3380 [95% CI, 0.14-0.5]; P=0.0009), modified Rankin Scale (b=-0.2119 [95% CI, -0.32 to -0.10]; P=0.0002), and caregiver-reported problems (b=-0.0671 [95% CI, -0.09 to -0.04]; P<0.0001) on longitudinal cognitive scores. In a combined model including all 3 predictors, only caregiver-reported problems significantly predicted cognition (b=-0.0480 [95% CI, -0.08 to -0.03]; P<0.0001). These findings emphasize the importance of caregiver feedback in predicting cognitive consequences of stroke.

Stakeholder-informed pragmatic trial protocol of the TabCAT-BHA for the detection of cognitive impairment in primary care

BackgroundCognitive impairment and dementia are frequently under-recognized. Health system strategies anchored in primary care are essential to address gaps in timely, comprehensive diagnosis. The goal of this paper is to describe the adaptation of a tablet-based brain health assessment (TabCAT-BHA) intervention and the study protocol to test its effectiveness in improving the detection of cognitive impairment, including dementia.MethodsThis mixed-methods, pragmatic, cluster randomized, hybrid effectiveness-implementation trial is being conducted in two 18-month waves with 26 Kaiser Permanente Southern California primary care clinics, with 13 serving as intervention clinics and 13 as usual care clinics. Patients 65 years and older with memory concerns (n ~ 180,000) receiving care at the 26 clinics will be included in the analyses. Primary care clinics are provided the following practice supports as part of the TabCAT-BHA intervention: brief education and training on neurocognitive disorders and study workflows; digital tools to assess cognitive function and support clinician decision making and documentation; and registered nurse support during the work-up and post-diagnosis periods for primary care providers, patients, and families. The intervention was adapted based on engagement with multiple levels of clinical and operational leaders in the healthcare system. Effectiveness outcomes include rates of cognitive impairment diagnosis in primary care and rates of completed standardized cognitive assessments and specialist referrals with incident diagnoses. Implementation outcomes include acceptability-appropriateness-feasibility, adoption, and fidelity.ResultsWe identified seven themes organized by system-, provider-, and patient-level domains that were used to adapt the TabCAT-BHA intervention. Accordingly, changes were made to the provider education, diagnostic work-up, and post-diagnostic support. Results will be reported in fall of 2027.ConclusionsOur engagement with multiple primary and specialty care clinical and operational leaders to adapt the TabCAT-BHA intervention to these primary care clinics has informed the protocol to evaluate the intervention’s effectiveness for improving the detection of cognitive impairment, including dementia, in an integrated healthcare system.Trial RegistationClinicaltrials.gov: NCT06090578 (registered 10/24/23).

How Do Nurses Assess Cognition in Adults With Neurological Conditions? A Scoping Review.

According to epidemiological studies, neurological cognitive problems are increasingly prevalent in the aging population, with estimates that the number of people living with cognitive impairment will triple by 2050. Therefore, early detection in rehabilitation settings is needed to manage cognitive changes to ensure that individuals living with these conditions receive care and support that addresses their needs. This scoping review, based on the Arksey and O'Malley method, aims to investigate the cognitive assessments used for patients with neurological conditions in current nursing practice. PubMed, Ovid Medline, and CINAHL databases were searched to identify relevant articles published from 2017 to 2023 in English. Twenty-four articles met the inclusion criteria. Cognitive assessments were evaluated across acute care/hospital, outpatient/clinic, community, and long-term care/nursing home settings. The Mini-Mental State Examination is the most frequently used tool across all settings except for long-term care. Cognition includes many different domains such as executive functioning and speed of processing information; however, most tools only capture memory. The nursing profession must expand its standardized nursing vocabulary to capture cognition better. As rehabilitation nurses navigate diverse clinical environments, recognition of contextual nuances is important in selecting cognitive function measurement tools most suitable for their setting.

Arterial Oxygen Desaturation Hinders Gamified Working Memory Performance.

Hypoxia presents a physiological challenge to the Warfighters during military aviation and subterranean warfare operations by decreasing the supply of oxygen to the brain, which results in a reduced cognitive function depending on the magnitude and duration of hypoxic exposure. Moderate hypoxic exposures, fractions of inspired oxygen (FiO2) of 0.11 to 0.14, show no effects on simple tasks, but complex tasks like working memory may be hindered. Unfortunately, people often cannot recognize their own symptoms of hypoxemia, which are individualistic at moderate hypoxic exposure. Thus, screening tools, like gamified cognitive assessments, during moderate hypoxia may provide personnel objective feedback to initiate safety protocols before a possible accident. However, whether gamified assessments of working memory are sensitive to moderate hypoxia is unknown. Therefore, we tested the hypothesis which moderate normobaric hypoxia decreases gamified working memory performance when accounting for the individualistic responses of arterial blood oxygen saturations. Following 3 consecutive days of 2 practice sessions per day, 30 healthy adults (25 ± 5 years, 10 women) completed three 1-min rounds of the tablet-based working memory game (Backtracker, Statespace Labs, Inc.) at baseline and 60 and 90 min after exposure to FiO2 (= 0.138 ± 0.002 [hypoxia] and 0.201± 0.004 [normoxia] oxygen). Both conditions were completed on the same day and administered in a single-blind, block randomized manner. Arterial oxyhemoglobin saturation was estimated via forehead pulse oximetry (SpO2). Data were analyzed using linear mixed effects modeling. Compared to normoxia (99 ± 1%), SpO2 was lower (P < .001) at 60 (90 ± 2%) and 90 (90 ± 2%) min of hypoxia. A decrease in SpO2 was associated with a statistically significant decrease in the proportion of both tiles with the correct location (P < .02; -0.016) and correct order of appearance recalled (P < .01; -0.016). A decrease in SpO2 was associated with a statistically significant decrease in median time to first tap (P < .01; -0.041s) and median time between taps (P<.01; -0.030s). A significant interaction effect between the SpO2 decrease and baseline performance was found for proportion of tiles with the correct location recalled (P < .05; -0.014), median time to first tap (P <.01; -0.070s), and median time between taps (P < .01; -0.037s). A significant interaction effect between the SpO2 decrease and the path length was found for the proportion of tiles with the correct location recalled (P < .01; +0.021), median time to first tap (P < .01; -0.036s), and median time between taps (P < .01; -0.043s). These findings indicate that greater decreases in SpO2 during moderate hypoxic exposure hinder performance on a gamified assessment of working memory as measured by the proportion of correctly identified order and location of tiles. Considering the statistically significant decrease in both median time to first tap and median time between taps associated with the decrease in SpO2, participants are taking less time to plan or execute movements, which may compound or independently contribute to spatial and temporal memory mistakes.

Enhancing Outcomes in Alzheimer's Disease: Exploring the Effects of a Diversified Rehabilitation Program Combined with Donepezil on Apathy, Cognitive Function, and Family Caregiver Burden

Background and objective: Alzheimer's disease is a progressive neurodegenerative disorder characterized by cognitive decline, behavioral changes, and functional impairments. Apathy, a common symptom in Alzheimer's disease, refers to a lack of motivation, interest, and emotional responsiveness. It can significantly impact patients' quality of life and increase caregiver burden. This study aimed to determine the effects of a diversified rehabilitation program combined with donepezil on apathy, cognitive function, and family caregiver burden of Alzheimer's disease patients. Methods: A total of 105 Alzheimer's disease patients treated at our hospital between January 2020 and January 2023 were selected and analyzed retrospectively. They were assigned to the control group (n = 50) or the observation group (n = 55). The two groups did not differ in terms of general data such as age and sex. All patients were treated with donepezil orally. The control group was given routine nursing, whereas the observation group was given a diversified rehabilitation program intervention, including cognitive training and emotional support. The Hasegawa's dementia scale, mini-mental state examination, and Montreal cognitive assessment scale were adopted to evaluate the cognitive function of the two groups before and after treatment. A caregiver burden scale, the Zarit Burden Interview (ZBI) and the Apathy Evaluation Scale Informant version (AES-I) were used to evaluate the caregiver burden and apathy of the two groups. Results: A significantly higher overall response rate to treatment was found in the observation group (94.55%) than in the control group (80.00%) (p = 0.024). After treatment, scores on the Hasegawa's dementia scale, mini-mental state examination, and Montreal cognitive assessment scale of the two groups increased to varying degrees, with greater increases in the observation group than in the control group (p &lt; 0.05). The ZBI and AES-I scores of the two groups decreased to different degrees after treatment, with greater decreases in the observation group than in the control group (p &lt; 0.05). Conclusion: A diversified rehabilitation program combined with donepezil can substantially alleviate the apathy of Alzheimer's disease patients, improve their cognitive function, and reduce the burden on their families.

The Impact of Combined Application of Donepezil and Nimodipine on Patients with Comorbid Cerebral Small Vessel Disease and Cognitive Dysfunction: Efficacy and Influence on Nutritional Status

Background and objective: Cerebral small vessel disease (CSVD) often coexists with cognitive dysfunction in patients, leading to significant challenges in treatment and management. This study aimed to examine the efficacy of combined application of donepezil and nimodipine on patients with comorbid CSVD and cognitive dysfunction and the effects on patients' albumin and prealbumin levels. Methods: The records of 112 patients with comorbid CSVD and cognitive dysfunction treated at the People's Hospital of Suzhou New District from January 2019 to December 2022 were analysed retrospectively. A total of 50 patients receiving donepezil were allocated to the control group, and 62 patients receiving both nimodipine and donepezil to the study group. Outcomes compared between the two groups included serum homocysteine (Hcy), high sensitivity C-reactive protein (hs-CRP), albumin, and prealbumin before and after therapy, efficacy, and adverse reactions. Additionally, logistic regression was performed to analyze the risk factors impacting patient prognosis. Results: Prior to therapy, the two groups did not differ significantly in Hcy and hs-CRP levels (p &gt; 0.05), whereas after therapy, the levels in both groups dropped significantly (p &lt; 0.01), with more obvious lower levels in the study group (p &lt; 0.05). After treatment, the study group presented significantly higher albumin and prealbumin levels than the control group (p &lt; 0.001). An obvious higher overall response rate was observed in the study group compared to the control group (p = 0.012). No significant inter-group discrepancy was found regarding the total incidence of adverse reactions (p = 0.752). Univariate analysis identified age, course of disease, heart rate (HR), Montreal Cognitive Assessment (MoCA) score, diastolic blood pressure (DBP), systolic blood pressure (SBP), drinking history, as well as medication regimen as risk factors impacting patient prognosis. Multivariate logistic regression analysis identified SBP, DBP, and medication regimen as the independent risk factors. Conclusion: Combined application of donepezil and nimodipine can effectively treat patients with comorbid CSVD and cognitive dysfunction. It can significantly lower the Hcy and hs-CRP levels and improve the nutritional status without increasing the frequency of adverse reactions. In addition, for CSVD patients with cognitive dysfunction, age, course of disease, MoCA score, HR, SBP, DBP, drinking history, and medication regimen are risk factors impacting patient prognosis, while SBP, DBP, and medication regimen are independent risk factors.

The Protective Role of Cognitive Reserve: A Preliminary Study on Parkinsonian Patients Undergoing Deep Brain Stimulation

Background/Objectives: High cognitive reserve (CR) has been shown to have beneficial effects on global cognition, cognitive decline, and risk of dementia in Parkinson’s disease (PD). We evaluated the influence of CR on the long-term cognitive outcomes of patients with PD who underwent subthalamic nucleus deep brain stimulation (STN-DBS). Methods: Twenty-five patients with PD underwent neuropsychological screening using the Montreal Cognitive Assessment (MoCA) at baseline, 1 year, and 5 years after bilateral STN-DBS. CR was assessed using the Cognitive Reserve Index questionnaire. According to CR score, patients were assigned to two different groups (LowCR group ≤ 130, HighCR group &gt; 130). Results: Our data showed that patients in the HighCR group obtained a better performance with the MoCA total score at long-term follow-up compared to those in the LowCR group ([mean ± SE] LowCR group: 21.4 ± 1.2 vs. HighCR group: 24.5 ± 1.3, p = 0.05). The cognitive profile of the HighCR group remained unchanged over time. Conversely, the LowCR group had worse global cognition 5 years after surgery (T0: 25.3 ± 0.6 vs. T2: 21.4 ± 1.2, p = 0.02). Cognitive decline was not associated with mood, demographics, or clinical variables. Conclusions: These preliminary findings suggest that higher CR may be protective in PD cognition after STN-DBS. Specifically, a high CR may help cope with long-term decline in the context of surgical treatment. Quantifying a patient’s CR could lead to more personalized medical care, tailoring postoperative support and monitoring for those at higher risk of cognitive decline.

Age-Related Hearing Loss, Cognitive Decline, and Social Interaction: Testing a Framework.

Aging increases risk for hearing loss, cognitive decline, and social isolation; however, the nature of their interconnection remains unclear. This study examined the interplay between age-related hearing loss, cognitive decline, and social isolation in adults by testing the ability to understand speech in background noise, a challenge frequently reported by many older adults. We analyzed data collected from 128 adults (20-79 years of age, Mage = 51 years) recruited as part of the Aging Brain Cohort at the University of South Carolina repository. The participants underwent testing for hearing, cognition, and social interaction, which included pure-tone audiometry, a words-in-noise (WIN) test, a hearing questionnaire (Speech, Spatial and Qualities of Hearing Scale [SSQ12]), a social questionnaire (Patient-Reported Outcomes Measurement Information System-57 Social), and the Montreal Cognitive Assessment. We used a single pure-tone average (PTA) threshold value and a single WIN threshold value for each participant because there were no differences on average between the left and right ears. Poorer hearing was significantly associated with cognitive decline, through both PTA and WIN thresholds, with a stronger association observed for WIN threshold. Adults with poorer hearing also exhibited greater social isolation, as evidenced by their WIN threshold and SSQ12 score, although not through PTA. This connection was more pronounced with the WIN threshold than with the SSQ12 score. Cognition was not related to social isolation, suggesting that social isolation is affected more by the ability to understand words in noise than by cognition in a nondemented population. Understanding speech in challenging auditory environments rather than mere threshold detection is strongly linked to social isolation and cognitive decline. Thus, inclusion of a word-recognition-in-noise test and a social isolation survey in clinical settings is warranted. https://doi.org/10.23641/asha.26237060.

Changes of cerebral structure and perfusion in subtypes of systemic sclerosis: a brain magnetic resonance imaging study.

The characteristics of brain impairment in different subtypes of systemic sclerosis (SSc) (dcSSc, diffuse cutaneous SSc; lcSSc, limited cutaneous SSc) remain unclear. This study aimed to characterize cerebral structure and perfusion changes in different subtype of SSc patients using magnetic resonance (MR) imaging. Seventy SSc patients (46.0 ± 11.7 years, 62 females) and 30 healthy volunteers (44.8 ± 13.7 years, 24 females) were recruited and underwent brain MR imaging and Montreal Cognitive Assessment (MoCA) test. Gray matter (GM) volumes were measured using voxel-based morphometry analysis on T1-weighted images. Voxel-based and regional cerebral blood flow (CBF) was calculated on arterial spin labelling images. The cerebral structural and perfusion measurements by MR imaging were compared among dcSSc, lcSSc and healthy subjects using one-way ANOVA. The correlations between clinical characteristics and MR imaging measurements were also analyzed. The dcSSc patients exhibited a significant reduction in GM volume in the para-hippocampal region (cluster p < 0.01, FWE corrected) compared with healthy volunteers. Whereas, SSc patients, particularly lcSSc patients, showed elevated CBF in cerebellum, insula, cerebral cortex, and subcortical structures (regional analyses: all p < 0.05; voxel-based analyses: cluster p < 0.01, FWE corrected). Furthermore, clinical characteristics of modified Rodnan skin score (mRSS) (r value ranged from -0.29 to -0.45), MoCA scores (r = 0.40) and antinuclear antibody (ANA) positivity (r=-0.33) were significantly associated with CBF in some regions (all p < 0.05). The manifestations of brain involvement vary among different subtypes of SSc. In addition, severe skin sclerosis may indicate higher risk of brain involvement in SSc patients.

Development and assessment of analytic methods to improve the measurement of cognition in longitudinal studies of aging through the use of substudies with comprehensive neuropsychological testing.

The Health and Retirement Study International Partner Surveys (HRS IPS) have rich longitudinal data, but the brevity of cognitive batteries is a limitation. We used data from a substudy of the English Longitudinal Study of Ageing (ELSA) administering detailed cognitive assessments with the Harmonized Cognitive Assessment Protocol (ELSA-HCAP) (N=1273) to inform approaches for estimating cognition in ELSA (N=11,213). We compared two novel approaches: confirmatory factor analysis (CFA)- and regression-based prediction. Compared to estimates from the full HCAP battery, estimated cognitive functioning derived using regression models or CFA had high correlations (regression: r=0.85 [95% confidence interval [CI]: 0.83 to 0.87]; CFA: r=0.83 [95% CI: 0.81 to 0.85]) and reasonable mean squared error (regression: 0.25 [0.22 to 0.27]; CFA: 0.29 [0.26 to 0.32]) in held-out data. The use of additional items from waves 7 to 9 improved performance. Both approaches are recommended for future research; the similarity in approaches may be due to the brevity of available cognitive assessments in ELSA. Estimates of cognitive functioning informed by English Longitudinal Study of Ageing-Harmonized Cognitive Assessment Protocol (ELSA-HCAP) data had an adequate performance. Standard errors were smaller for associations with example risks when using measures informed by ELSA-HCAP. Performance was better when including additional cognitive measures available in waves 7 to 9. Conceptual advantages to the confirmatory factor analysis (CFA) approach were not important in practice due to the brevity of the ELSA cognitive battery.

Developing and validating the charismatic leadership tactics scale: evidence from multi-source questionnaire studies, cognitive and behavioral assessments and a leadership training evaluation

Developing and validating the charismatic leadership tactics scale: evidence from multi-source questionnaire studies, cognitive and behavioral assessments and a leadership training evaluation

Monoaminergic degeneration, cognition, and autonomic symptom trajectory in early Parkinson's disease

IntroductionParkinson's disease (PD) encompasses a range of non-motor symptoms attributed to deficits in various neurotransmitter systems. This study aimed to investigate the associations between cognitive and autonomic symptoms and the degeneration of brainstem monoaminergic nuclei, particularly the serotonergic and noradrenergic nuclei, in a prospective cohort of early PD patients. MethodsTwenty-eight early PD patients (with an average disease duration of approximately three years) underwent baseline [18F]FP-CIT positron emission tomography (PET) scans, Montreal Cognitive Assessment (MoCA), and Composite Autonomic Symptom Scale-31 (COMPASS-31) evaluations, followed by repeat MoCA and COMPASS-31 assessments three years later. Regression models were utilized to analyze both cross-sectional and longitudinal changes in non-motor symptoms relative to baseline degeneration of the noradrenergic locus coeruleus (LC) and serotonergic raphe, normalized by striatal dopaminergic terminal loss. ResultsBaseline LC and raphe degeneration in early PD was cross-sectionally associated with poorer MoCA performances. Over the three-year follow-up, gastrointestinal symptoms exhibited progression, while cognitive scores remained stable. Profound baseline degeneration of the LC and raphe, relative to nigrostriatal terminal loss, were predictive of subsequent accelerated deterioration in gastrointestinal symptoms. ConclusionBrainstem non-dopaminergic dysfunction in early PD is linked to cognitive dysfunction and predicts progression in gastrointestinal symptoms, offering potential indicators for worsening non-motor trajectories.

Peripheral insulin resistance attenuates cerebral glucose metabolism and impairs working memory in healthy adults

People with insulin resistance are at increased risk for cognitive decline. Insulin resistance has previously been considered primarily a condition of ageing but it is increasingly seen in younger adults. It is possible that impaired insulin function in early adulthood has both proximal effects and moderates or even accelerates changes in cerebral metabolism in ageing. Thirty-six younger (mean 27.8 years) and 43 older (mean 75.5) participants completed a battery of tests, including blood sampling, cognitive assessment and a simultaneous PET/MR scan. Cortical thickness and cerebral metabolic rates of glucose were derived for 100 regions and 17 functional networks. Older adults had lower rates of regional cerebral glucose metabolism than younger adults across the brain even after adjusting for lower cortical thickness in older adults. Higher fasting blood glucose was also associated with lower regional cerebral glucose metabolism in older adults. In younger adults, higher insulin resistance was associated with lower rates of regional cerebral glucose metabolism but this was not seen in older adults. The largest effects of insulin resistance in younger adults were in prefrontal, parietal and temporal regions; and in the control, salience ventral attention, default and somatomotor networks. Higher rates of network glucose metabolism were associated with lower reaction time and psychomotor speed. Higher levels of insulin resistance were associated with lower working memory. Our results underscore the importance of insulin sensitivity and glycaemic control to brain health and cognitive function across the adult lifespan, even in early adulthood.