Cognitive Heterogeneity Research Articles

Cognitive profiles in perimenopause: hormonal and menopausal symptom correlates

Objective Perimenopause is associated with declines in attention, working memory and verbal memory; however, there are significant individual differences. Further, the contributions of hormones and menopausal symptoms to domain-specific cognitive functions remain unknown. This longitudinal study aimed to determine whether there were distinct cognitive profiles in perimenopause and to identify factors associated with each profile. Design In a sample of 85 women evaluated over 400 bi-annual visits, we administered a comprehensive neuropsychological battery, assessed menopausal symptoms and measured 17β-estradiol and follicle stimulating hormone. Multilevel latent profile analysis was used to identify cognitive profiles. Regressions were conducted to determine differences in hormones and symptoms by profile after adjusting for Stages of Reproductive Aging Workshop + 10 (STRAW + 10) stage and demographic factors. Results Perimenopausal cognitive profiles consisted of cognitively normal (Profile 1; n = 162), weaknesses in verbal learning and memory (Profile 2; n = 94), strengths in verbal learning and memory (Profile 3; n = 98) and strengths in attention and executive function (Profile 4; n = 61). Profile 2 was differentiated by less hormonal variability and more sleep disturbance than Profile 1 (p < 0.05). Conclusions There is significant heterogeneity in cognition during perimenopause. While most women do not develop impairments, a significant minority experience weaknesses in verbal learning and memory. Profile analysis may identify at-risk populations and inform interventions.

Cognitive heterogeneity in first-episode psychosis and its relationship with premorbid developmental adjustment.

Patients with schizophrenia spectrum disorders have been increasingly recognised to form cognitive subgroups with differential levels of impairment. Using cluster analytical techniques, this study sought to identify cognitive clusters in a sample of first-episode psychosis (FEP) patients and examine clinical and developmental differences across the resultant groups. In total, 105 FEP patients in the University of California Los Angeles Aftercare Research Program were assessed for cognition, symptoms and premorbid developmental adjustment. Hierarchical cluster analysis with Ward's method and squared Euclidean distance was conducted, confirmed by discriminant function analysis and optimised with k-means clustering. The stability of the solution was evaluated through split-sample (random, 80 and 70% samples) and alternate method (average linkage method) replication via Cohen's κ analysis. Controlling for multiple comparisons, one-way analysis of variances examined group differences in symptom severity and premorbid adjustment. Three groups were identified: severely impaired (n = 27), moderately impaired (n = 41) and relatively intact (n = 37). There were no significant differences in symptom severity across the groups. Significant differences were observed for scholastic performance at three different developmental stages: childhood, early adolescence and late adolescence, with the relatively intact group demonstrating significantly better scholastic performance at all three stages than both the moderately impaired and severely impaired groups (who did not significantly differ from each other). The findings add to growing evidence that cognitive clusters in FEP mirror that of later-stage schizophrenia. They also suggest that premorbid scholastic performance may not just be a risk factor for developing schizophrenia, but is also related to cognitive impairment severity and potentially to prognosis.

Empirical evidence for cognitive subgroups in body dysmorphic disorder.

Current understanding of cognitive functioning in body dysmorphic disorder is limited, owing to few studies, small sample sizes and assessment across only limited cognitive domains. Existing research has also shown inconsistent findings, with both intact and impaired cognition reported in body dysmorphic disorder, which might point towards cognitive heterogeneity in the disorder. This study aimed to examine the cognitive profile of body dysmorphic disorder in a large sample across eight cognitive domains, and to explore whether cognitive subgroups might be identified within body dysmorphic disorder. Cognitive domains of inhibition/flexibility, working memory, speed of processing, reasoning and problem-solving, visual and verbal learning, attention/vigilance and social cognition were assessed and compared between 65 body dysmorphic disorder patients and 70 healthy controls. Then, hierarchical clustering analysis was conducted on the body dysmorphic disorder group's cognitive data. Group-average comparisons demonstrated significantly poorer cognitive functioning in body dysmorphic disorder than healthy controls in all domains except for attention/vigilance and social cognition. Cluster analysis identified two divergent cognitive subgroups within our body dysmorphic disorder cohort characterised by (1) broadly intact cognitive function with mild selective impairments (72.3%), and (2) broadly impaired cognitive function (27.7%). However, the clusters did not significantly differ on clinical parameters or most sociodemographic characteristics. Our findings demonstrate considerable cognitive heterogeneity among persons with body dysmorphic disorder, rather than uniform deficits. Poor performances in the broadly impaired subgroup may have driven group-level differences. However, our findings also suggest a dissociation between cognitive functioning and clinical characteristics in body dysmorphic disorder that has implications for current aetiological models. Additional research is needed to clarify why some people with body dysmorphic disorder demonstrate cognitive deficits while others do not.

Heterogeneity of social cognitive and language functions in children at familial high-risk of severe mental illness; The Danish High Risk and Resilience Study VIA 7.

Cognitive heterogeneity characterizes individuals with schizophrenia and bipolar disorder; however, little is known of cognitive heterogeneity within young children at familial high-risk of schizophrenia or bipolar disorder. This study aimed to investigate heterogeneity across social cognitive and language functions in children at familial high-risk of schizophrenia or bipolar disorder, i.e. severe mental illness (FHR-SMI). This may help designate subgroups in need of intervention initiatives. A data-driven, hierarchical cluster analysis was applied across a sample of 322 children at FHR-SMI (FHR-SZ, n = 200; FHR-BP, n = 120) on measures of Theory of Mind, facial emotion recognition, social cognitive processing speed, receptive and pragmatic language. We examined differences between subgroups as well as differences between subgroups and a control group. Exploratively, the subgroups were compared in terms of social responsiveness and global functioning. A Typical-High Functioning Subgroup with intact social cognitive and language functioning (34.5%), a Mildly Impaired Subgroup with selective impairments in explicit Theory of Mind and language functioning (58.7%), and a Significantly Impaired Subgroup with social cognitive and language functioning impairments (6.8%) were identified. The subgroups differed significantly from each other and overall compares to the controls. The Significantly and Mildly Impaired Subgroups presented with poorer social responsiveness and global functioning than the Typical-High Functioning Subgroup. In young children with FHR-SMI, three subgroups with relatively homogeneous social cognitive and language functioning profiles were observed. Only a small proportion of children at FHR-SMI displayed large social cognitive and language functioning impairments in middle childhood.

Neurocognitive functioning in bipolar disorder: What we know and what we don't.

Introduction: This narrative review of systematic reviews and meta-analyses aims at compiling available evidence in various aspects of neurocognitive functioning in Bipolar Disorder (BD).Methods: We conducted a MEDLINE literature search and identified 38 relevant systematic reviews and metaanalyses.Results: Current evidence suggests that BD is associated with cognitive impairment across multiple domains and during all clinical states. However, there is a considerable cognitive heterogeneity within BD, which cannot be explained by clinical subtypes, and the pattern of neurocognitive impairment in BD overlaps with other psychiatric conditions such as major depression and schizophrenia. Residual depressive symptoms, poor clinical course and higher number of manic episodes may negatively impact cognitive performance, which is a major predictor of general functioning in BD. Evidence from available prospective studies does not support the notion of progressive cognitive decline in BD while some evidence exists to suggest patients may show some improvements in cognitive functioning following the first manic episode. Furthermore, a subset of patients may show premorbid cognitive abnormalities that could signal an early neurodevelopmental aetiology. Preliminary findings from small studies identify potential pro-cognitive effects of Cognitive Remediation, erythropoietin, intranasal insulin, lurasidone, mifepristone, repetitive Transcranial Magnetic Stimulation and transcranial Direct Current Stimulation in BD.Discussion: Longitudinal studies in high-risk individuals can provide a better understanding of the development and progression of neurocognitive impairment in BD. Largescale randomised control trials are needed to compare the pro-cognitive efficacy of various pharmacological and non-pharmacological interventions in different cognitive subgroups of patients at different stages of BD.

Зборка полісуб’єкта спільного створення інноваційних цінностей

The fundamental prerequisite for the harmonization of socio-economic processes is the development and implementation of an internally coordinated system of views that can set up responsible innovation activities that are implemented on the principles of sustainable development. Achievements in cognitive sciences and postnonclassical management indicate that the paradigm of co-creativity can make a significant contribution to the formation of a new system of views on innovation. The purpose of the article is to analyze and substantiate the theoretical and empirical foundations of the assembly of a polysubject focused on co-creation and expanding the cognitive heterogeneity of the subjects of innovative development to activate the innovative processes of the enterprise and increase the relevance of the created innovations. The article examines the main stages of the assembly of the polysubject of the joint creation of innovative values with their filling in the reference points with indicative signs of group dynamics, fixing the qualitative changes in the community. The constellation of the factor of the effective functioning of polysubject environments for the joint creation of innovative values, which are localized according to the main stages of assembly, is presented. The paper shows that the polysubject of cocreation of innovations is able to generate relevant values to the extent that it is able to reproduce the main spectrum of consumer constructs in the properties of the objects being created. A prerequisite for relevant results of innovation activity is the co-creation of subjects with high cognitive complexity, which together form a cognitively heterogeneous poly-subject, capable of leveling the complexity and uncertainty of market and innovation processes with its own variety of constructs. The conditions for effective interaction of a cognitively heterogeneous polysubject is the prerogative of the moderator of co-creativity, who should be focused on maintaining a high level of diversity of subjects – on the one hand, and on the other, to provide semantic and communication connectivity of actors for effective intersubjective interactions.

«Соединить телескоп и мелкоскоп»: об одной попытке разрешения методологических и источниковедческих проблем изучения истории российского крестьянского рода Епифанского уезда XVI – XX веков

The article assesses source and archival studies aspects of the V. P. Kozlov’s book “Remove to history ...”: The Peasant Family and Settlement of the Tula Region in the 16th – 20th Centuries. It is the first volume of the study, covering the period up to 1917. The work is devoted to the history and culture of the Yepifan uezd. This uezd is considered in two ways: as a territory, including the villages where the author’s ancestors lived, and as a part of its surroundings. The state of the territory is described for several periods. Via stepwise immersion accompanied by detailing of material, the author advances the restoration of the history of villages and their inhabitants. In the Russian scientific literature, an experience of large-scale and consistent implementation of this approach is a unique case. The author analyzes it theoretically, bringing it into correlation with trends of modern historical science and demonstrating its effectiveness. To study the history of the Yepifan uezd, a significant amount of documents, both published and stored in the archives, has been involved for the first time. V.P. Kozlov divides sources into three classes. In line with his approach used in his works on archeography, he characterizes eight types of sources. Among sources of personal provenance, he underscores oral history documents — records of his relatives’ memoirs collected over the years. He points to the cognitive heterogeneity of these sources: he emphasizes the need to take into account the “author's angles,” notes high reliability of correspondence, especially between relatives. Isolation by V. P. Kozlov of a special class of sacred documentary sources is new. The author refers to these documents as reflecting “relations with the sacred ... beliefs, convictions and symbols” and capturing “the sacrament of human communication with... extrahuman authority.” As an example, he cites his grandmother’s nightly prayers and recordings of miracles of St. Matrona of Moscow. V. P. Kozlov notes an abundance of such sources in the Russian archives. Identifying gaps in sources, he explains the reasons for different preservation of documentary complexes. He dwells on research methods that can partially compensate for the insufficiency of sources. He took some risk in choosing the inhabitants of a small village as main characters of his research. The analysis of source study and archival aspects of his research proves that such work can be successfully carried out even with insufficient sources.

Cognitive heterogeneity in the offspring of patients with schizophrenia or bipolar disorder: a cluster analysis across family risk

BackgroundNeurocognitive impairment is considered to lie on a continuum of severity across schizophrenia (SZ) and bipolar disorder (BP), possibly reflecting a gradient of neurodevelopmental load. Cluster analyses have identified different levels of impairment across the two disorders, from none to widespread and severe. We for the first time used this approach to examine cognitive function pooling together children and adolescents at familial risk of SZ or BP. Methods220 participants, 49 offspring of individuals with schizophrenia (SZO), 90 offspring of individuals with bipolar disorder (BPO) and 81 offspring of healthy control parents (HC), aged 6 to 17 years, underwent a comprehensive clinical and cognitive assessment. Cognitive measures were used to group SZO and BPO using K-means clustering. Cognitive performance within each of the clusters was compared to that of HC and clinical variables were compared between clusters. ResultsWe identified three cognitive subgroups: a moderate impairment group, a mild impairment group, and a cognitively intact group. Both SZO and BPO were represented in each of the clusters, yet not evenly, with a larger proportion of the SZO in the moderately impaired cluster, but also a subgroup of BPO showing moderate cognitive dysfunction. LimitationsParticipants have yet to reach the age of onset for the examined disorders. ConclusionsThe findings point to a range of neurodevelopmental loadings across youth at familial risk of both SZ and BP. They have therefore important implications for the stratification of cognitive functioning and the possibility to tailor interventions to individual levels of impairment.

Heterogeneity of Executive Function Abilities in Recently Detoxified Patients with Alcohol Use Disorder: Evidence from a Cluster Analysis.

Impairments of executive functions (EF) have been consistently reported in patients with alcohol use disorder (AUD), mostly in studies which were based on comparisons of means between groups. However, given the high heterogeneity in AUD patients, this approach could actually cover a wide range of EF patterns. In the present study, we addressed the paucity of the literature about cognitive heterogeneity in AUD by applying a cluster analytical approach on EF measures. Seventy-eight withdrawn AUD patients and 77 healthy Control participants completed measures targeting a variety of EF components. We then used cluster analysis to identify subgroups of AUD patients. Furthermore, the AUD subgroups were compared to the Control group to establish their specific EF patterns. Findings showed that AUD patients could be divided into 3 clusters based on their EF performances. A first cluster accounting for half of the AUD sample was characterized by unimpaired EF (Cluster 1). The 2 other clusters displayed major EF deficits but differed regarding the deficient EF component. While Cluster 2 was mainly impaired on measures of rule deduction and mental flexibility, Cluster 3 was mainly characterized by a lower processing speed and impaired inhibition of an ongoing motor response. Differences in EF performances of AUD patients could be related to differences in premorbid cognitive reserve, impulsiveness patterns, and withdrawal complications. This study highlights the importance of the cognitive heterogeneity in AUD by showing that AUD patients display substantially different EF patterns. Future studies should try to go beyond mere group comparisons to further deepen our understanding about cognitive differences between AUD patients. In the long run, this could lead to more personalized prevention and treatment programs specifically tailored to the patient's impairments.

Pediatric bipolar disorder: Executive, linguistic, mnemonic, and cognitive efficiency mapping

Neuropsychological assessment can enrich our understanding of Pediatric Bipolar Disorder (PB). This study aimed to: (1) analyze the occurrence of neuropsychological frequency of deficits and difficulties in children with PB; (2) verify whether there is a performance difference between PB type I (PB-I) and PB type II (PB-II)/unspecified, and between PB with and without ADHD; and (3) verify the cognitive efficiency differences within the PB group and control groups, and among clinical subgroups. Participants in the study were 16 children diagnosed with PB and 40 children with typical development (6–12 years old). The results indicated a high frequency of deficits/difficulties in verbal fluency, cognitive efficiency in performing basic abilities, inhibitory control, cognitive flexibility, and working memory, with emphasis on verbal and executive losses. There were indications that type PB-I and comorbidity with ADHD negatively impact a child’s neuropsychological development. The clinical group showed more cognitive efficiency losses compared with the control group, and greater losses were observed in PB-I and in PB with ADHD. The role of neuropsychological evaluation in multidomain and nonlinear statistical analysis is critical to gaining an understanding of the clinical and cognitive heterogeneity of PB.

Colocalization of atrophy and tau improves AI classification of Alzheimer phenotypical variants

AbstractBackgroundThe high cognitive and anatomical heterogeneity in phenotypical variants of Alzheimer’s Disease imposes a formidable challenge for biomarker‐based discriminatory models. Motivated by recent findings (La Joie, 2020) suggesting a causal relationship between regional tau accumulation and future atrophy development, we used Machine Learning techniques to test whether colocalization of these two biomarkers could improve clinical differentiation of AD phenotypical variants.MethodWe investigated 85 amyloid‐positive patients with a clinical diagnosis of AD (MCI or dementia stage), including 17 patients with PCA, 16 with lvPPA, and 52 typical cases (tAD, Table 1). Patients received 3‐tesla MRI and PET with [11C]PIB and [18F]Flortaucipir. Thickness measurements were turned into age and sex adjusted z‐scores (Potvin, 2017). Standardized Uptake Value Ratio (SUVR) images were created using reference regions. Mean SUVR or cortical thickness values were extracted from 72 FreeSurfer regions (Figure 1). Random Forest (RF) and Support Vector Machines (SVM) were used for supervised classification of patients into one of the three diagnosis above. Four distinct models were compared: based on amyloid, atrophy, tau, or on the product between atrophy and tau (hence capturing the colocalization of these two biomarkers). Selected ROIs were acquired using SVM feature importance and used in a second SVM method (SVM‐ROIs).ResultFigure 2a shows the accuracy of the classification models as a function of the used input features. As a general trend: i) amyloid‐based models had the poorest classification accuracy; ii) tau‐based SVM models outperformed atrophy‐based predictions; iii) the product of atrophy and tau significantly improved accuracy; and iv) in SVM models, selection of a subset of regions consistently improved classifications over those models using all brain regions. Figure 2b shows the confusion matrix for the most accurate model (SVM on selected ROIs).ConclusionIn the cohort used in this study, the product of atrophy and tau provides a better classification feature than each feature considered in isolation. Our results suggest that the colocalization of these two biomarkers represent a valuable instrument for clinical decision‐making in phenotypical variants of AD.

Surface‐based amyloid and tau correlates of digital clock drawing performance

AbstractBackgroundUsing a digital pen to record performance on neuropsychological tasks allows for the capture of much more subtle and nuanced aspects of cognitive performance. Previous research showed that lower DCTClock summary score was associated with greater entorhinal tau in clinically‐normal older adults (CN) (Rentz, AAIC 2019). Additionally, spatial reasoning was related to elevated entorhinal tau, inferior temporal tau, and neocortical amyloid. Given the observed cognitive heterogeneity in early stages of AD, we explored the relationship between different aspects of digital clock performance and amyloid and tau pathology across the cortical surface.MethodCN from the Harvard Aging Brain Study completed both a spontaneous (COM) and copy (COP) clock drawing test using a digital pen. We used a summary score (DCTScore) and four main composite scores (drawing efficiency, simple motor, information processing and spatial reasoning) calculated by Digital Cognition Technologies. Participants also underwent [11C]PiB‐PET (n = 112) and [18F]T807‐PET (n = 116) acquisition within one year of cognitive testing. We utilized a vertex‐wise analysis with a cluster‐wise multiple comparison correction (minimum cluster extent=100mm2) and a threshold of ‐log(p)&gt;2 to analyze relationships with clock scores across the vertices, adjusting for age, sex, and education.ResultLower DCTScore strongly correlated with greater amyloid signal in the frontal lobe, with some significant clusters also observed within the lateral temporal and inferior parietal cortices (Figure 1). Lower DCTScore also related to elevated tau signal in the right lateral temporal and inferior parietal lobes. Tau was most strongly associated with COM spatial reasoning score in the right lateral temporal lobe (Figure 2), reflecting known functional associations with this region; this was not reflected with COP spatial reasoning scores.ConclusionIn clinically‐normal older adults, lower scores on clock drawing were associated with greater cortical amyloid and tau. Lower spatial reasoning scores were related to tauopathy, but only in spontaneous clock drawing, supporting the notion that more complex cognitive tasks are compromised earlier in the clinical continuum. More fine‐grained measurements of cognition using digital tasks in relation to neuroimaging markers has the potential to improve our understanding of the pathogenesis of early AD.

Cognitive subgroups in first episode bipolar I disorder: Relation to clinical and brain volumetric variables.

Distinct cognitive subgroups are seen in patients with long duration bipolar I disorder (BDI), possibly reflective of underlying pathophysiological differences. It is unknown whether such cognitive heterogeneity is present at illness onset. We applied latent class analysis (LCA) to cognitive test scores in first episode BDI patients. Exploratory analysis elucidated whether impaired subgroups were characterized by 'early neurodevelopmental' (low premorbid IQ and intracranial volume) versus 'later neurodevelopmental' (decline from premorbid to current IQ, changes in relative grey (GM)/white (WM) matter volumes) pathology. Recently recovered first manic episode BDI patients (n=91) and healthy controls (HC, n=63) comprised the study sample. LCA identified subgroups based on processing speed, verbal memory, non-verbal memory, executive functioning, attention and working memory scores. Subgroups were compared amongst each other and HC on premorbid/current IQ, intracranial (ICV), total brain and regional volumes. Three cognitive subgroups emerged: (i) globally impaired (GI, n=31), scoring 0.5-1 SD below demographically corrected norms across domains, (ii) selectively impaired (SI, n=47), with predominant processing speed deficits and (iii) high performing (HP, n=13), with above-average cognitive performance. GI patients showed a 'later neurodevelopmental' pattern, with normal ICV, significant decline from premorbid to current IQ, higher total GM and lower total WM (with respect to total brain volume) versus SI and HC (p=0.003). GI patients had higher left frontal pole GM versus HC (p<0.05, FWE corrected). A globally impaired patient subgroup is identifiable in first episode BDI, possibly characterized by unique neurodevelopmental pathologic processes proximal to illness onset.

Role of cognitive reserve in cognitive variability in euthymic individuals with bipolar disorder: cross-sectional cluster analysis.

People with bipolar disorder have moderate cognitive difficulties that tend to be more pronounced during mood episodes but persist after clinical remission and affect recovery. Recent evidence suggests heterogeneity in these difficulties, but the factors underlying cognitive heterogeneity are unclear. To examine whether distinct cognitive profiles can be identified in a sample of euthymic individuals with bipolar disorder and examine potential differences between subgroups. Cognitive performance was assessed across four domains (i.e. processing speed, verbal learning/memory, working memory, executive functioning) in 80 participants. We conducted a hierarchical cluster analysis and a discriminant function analysis to identify cognitive profiles and considered differences in cognitive reserve, estimated cognitive decline from premorbid cognitive functioning, and clinical characteristics among subgroups. Four discrete cognitive profiles were identified: cognitively intact (n = 25; 31.3%); selective deficits in verbal learning and memory (n = 15; 18.8%); intermediate deficits across all cognitive domains (n = 30; 37.5%); and severe deficits across all domains (n = 10; 12.5%). Cognitive decline after illness onset was greater for the intermediate and severe subgroups. Cognitive reserve scores were increasingly lower for subgroups with greater impairments. A smaller proportion of cognitively intact participants were using antipsychotic medications compared with all other subgroups. Our findings suggest that individuals with cognitively impaired profiles demonstrate more cognitive decline after illness onset. Cognitive reserve may be one of the factors underlying cognitive variability across people with bipolar disorder. Patients in the intermediate and severe subgroups may be in greater need of interventions targeting cognitive difficulties.

A theory of information overload applied to perfectly efficient financial markets

PurposeIn the era of big data investors deal every day with a huge flow of information. Given a model populated by economic agents with limited computational capacity, the paper shows how “too much” information could cause financial markets to depart from the assumption of informational efficiency. The purpose of the paper is to show that as information increases, at some point the efficient market hypothesis ceases to be true. In general, the hypothesis cannot be maintained if the use of the maximum amount of information is not optimal for investors.Design/methodology/approachThe authors use a model of cognitive heterogeneity to show the inadequacy of the notion of market efficiency in the modern society of big data.FindingsTheorem 1 proves that as information grows, agents' processing capacities do not, so at some point there will be an amount of information that no one can fully use. The introduction of computer-based processing techniques can restore efficiency, however, also machines are bounded. This means that as the amount of information increases, even in the presence of non-human techniques, at some point it will no longer be possible to process further information.Practical implicationsThis paper explains why investors very often prefer heuristics to complex strategies.Originality/valueThis is, to the authors’ knowledge, the first model that uses information overload to prove informational inefficiency. This paper links big data to informational efficiency, whereas Theorem 1 proves that the old notion of efficiency is not well-founded because it relies on unlimited processing capacities of economic agents.

Factors Predicting Detrimental Change in Declarative Memory Among Women With HIV: A Study of Heterogeneity in Cognition.

ObjectiveStatistical techniques used to study cognitive function in HIV typically yield normative estimates and can mask the heterogeneity in cognitive trajectories over time. We applied a novel statistical approach to identify clusters of individuals with distinct patterns of change in declarative memory in HIV-seropositive (HIV+) and HIV-seronegative (HIV−) women.Methods1731 women from the Women’s Interagency HIV Study, a multi-center, prospective cohort study, completed the Hopkins Verbal Learning Test-Revised (HLVT-R) at >2 visits. To derive subgroups with similar patterns of decline by HIV-serostatus, we used a mixed-effects framework that modeled the trajectory of multiple declarative memory outcomes over time, while simultaneously clustering individuals.ResultsOf the 1731 participants, 1149 were HIV+ (70% Black/African American [AA]; 30% White/Other [W/O]) and 582 were HIV− (68% AA; 32% W/O). Race stratification was necessary to optimize clustering. Among HIV+AA’s, four subgroups emerged: a subgroup with minimal decline, two with accelerated decline, and one with stable but low performance. In HIV− AA, three subgroups emerged: one with minimal decline and two with accelerated decline. In multivariable-adjusted models among HIV+, individuals with accelerated decline were less educated (P < 0.001) and more likely to have a history of depression (P < 0.001) versus those with minimal decline. Similar subgroups were identified in W/O HIV+ and W/O HIV− participants.ConclusionWe identified clinically meaningful subgroups of women with distinct phenotypes of declarative memory decline, which depend on race and HIV-serostatus using a data driven approach. Identification of underlying mechanisms and risk factors contributing to the observed differences are warranted. More broadly our modeling approach could be other populations to identify risk factors for accelerated cognitive decline and to personalize interventions.

A Relationship Model between Top Management Team Cognitive Heterogeneity and Strategic Decision Quality and Its Implications for Sustainability

To achieve sustainable development, a top management team (TMT) and the quality of its strategic decisions on sustainability are critical. This paper builds a relationship model between top management team (TMT) cognitive heterogeneity and the quality of strategic decisions. This research is important because TMT cognitive heterogeneity can comport decision-making schemes with complex and changing environments. Specifically, this paper explores the intermediary role of the team fusion process composed of different shareholders’ agents in integrating TMT heterogeneous cognition to improve the quality of strategic decisions. It adopts the upper echelon theory, which proposes that decision-makers have limited rationality and face difficulty in collecting and analyzing information in complex and changing environments. A questionnaire survey of 107 Chinese enterprises was conducted. Through the research framework of “cognitive heterogeneity–team fusion–strategic decision quality,” this paper constructs a moderated mediator model with entrepreneurial spirit as the moderating variable. Based on statistical analysis, the following results and contributions are obtained. First, TMT cognitive heterogeneity positively affected strategic decision quality. Second, two dimensions of team fusion—information integration and emotional fusion—mediated the relationship between TMT cognitive heterogeneity and strategic decision quality. Third, entrepreneurial spirit positively moderated the relationship between information integration and strategic decision quality, as well as the relationship between emotional fusion and strategic decision quality. The implications of our results related to sustainability are also discussed.

Varieties of Cognitive Profiles in Poor Readers: Evidence for a VAS-Impaired Subtype

A wide share of secondary school children does not reach the expected competence level in reading. These children could benefit from more efficient intervention responses, providing a better understanding of their cognitive weaknesses/deficits. Our aim was to explore the cognitive heterogeneity of a population of poor readers identified from a large sample of 948 sixth-grade children. We first assessed the contribution of phoneme awareness (PA), rapid automatized naming (RAN), and visual attention span (VAS) to reading performance in a subset of 281 children including poor and average readers/spellers. We show that all three skills are unique and significant predictors of reading fluency. We then restricted the analysis to participants with normal Raven’s score (IQ) and oral language skills to focus on 110 children with more specific reading difficulties. A unique VAS deficit was found in 18% of these poor readers while 20% and 15.5% showed a unique PA or RAN deficit. Children with multiple or no deficit were further identified. The overall findings provide evidence for a variety of cognitive profiles in poor readers. They suggest that, in addition to PA interventions, training programs targeting VAS might be useful for the nontrivial share of poor readers who exhibit a VAS deficit.

Effects of integrated interventions on growth and development of young children: A meta-analysis

Abstract Background We did a systematic review to understand: (a) the effects of integrated versus usual care on the developmental outcomes and nutritional status of children under five years; and (b) which intervention characteristics are associated with positive effects. Methods We searched eight electronic databases for studies published between January 2013 and September 2019. Eligible studies were Randomised Controlled Trials (RCTs) and non-randomised controlled studies of integrated nutrition and stimulation interventions with child growth and developmental outcomes. We extracted data on intervention characteristics including delivery strategies, behaviour change techniques, intervention intensity and delivery personnel. We meta-analysed data for Length-for-age/Height-for-age Z scores (LAZ/HAZ) and cognitive, motor and language development scores, and conducted subgroup analyses by main intervention characteristics. Results Twenty-two unique RCTs met the inclusion criteria, of which 16 were included in the meta-analysis. Compared to the usual care, pooled Effect Sizes (ES) showed small to medium benefits of integrated interventions on cognitive (n = 15, ES 0.64; 95% CI: 0.39, 0.88) and language development scores (n = 10, ES 0.47, 95% CI: 0.21, 0.73) but heterogeneity was high (I2&amp;gt;75%). We found no significant effects of interventions on motor development scores (n = 12, ES 0.31, 95% CI: -0.02, 0.64) or LAZ/HAZ scores (n = 8, ES -0.03, 95% CI: -0.11, 0.03). The effects of interventions on developmental outcomes did not differ by intervention characteristics, and heterogeneity remained high in sub-group analyses. Conclusions Integrated nutrition and stimulation interventions had significant effects on cognitive and language development, but no detectable effect on motor development or linear growth. Our ability to identify intervention characteristics linked to positive effects can be improved by standardising the reporting of implementation processes. Key messages More high-quality trials with longer follow-up duration are needed to examine the role of integrated nutrition and stimulation interventions on growth and developmental outcomes. Future research should map the characteristics of integrated nutrition and stimulation interventions following standardised guidelines to understand their influence on the outcomes reported.

Cognitive abilities in Williams syndrome

The current study utilized a comprehensive neuropsychological test battery to investigate cognitive abilities in a sample of 49 WS individuals (25 male) aged 6–39 years. Age effects were also investigated by splitting the sample into child and adult groups. Cognitive heterogeneity was found on the Woodcock Johnson III Tests of Cognitive Abilities, Australian Adaptation (WJ-III COG) (Woodcock, McGrew, & Mather, 2001), with cognitive abilities ranging from profoundly impaired to superior and individualized profiles of strength and weakness varying considerably. Overall, findings supported previous research showing strengths in auditory processing and phonemic awareness. The weakest performance, on average, was in processing speed, attention, delayed associative learning and executive functioning capabilities. Visual-spatial functioning was not a weakness overall, neither was nonverbal reasoning. Chronological age did not relate significantly to cognitive abilities. Findings highlight the need for individual assessment and management of WS individuals.