Cognitive Index Research Articles

Prevalence of mental disorders and related risk factors in refugees and asylum seekers in Campania.

In recent years, the increasing presence of refugees and asylum seekers displaced from their country of origin, determined significant social, economic, humanitarian and public health implications in host countries, including Italy. These populations are exposed to several potential stressful experiences which make them vulnerable to psychological distress. In fact, the majority of studies addressing the topic found a higher prevalence of mental disorders, especially post-traumatic stress disorder and major depressive disorder, in refugees and asylum seekers with respect to the general population. However, heterogeneous prevalence rates have been reported among studies, due to methodological factor as well as to the impact of a variety of risk factors related to stressful experiences lived in the country of origin, during the migration journey and in the host country. The aim of the present study was to assess the prevalence of the main psychiatric diagnoses in a large group of adult refugees and asylum seekers (N=303) in the reception centers of two provinces of the Campania region, as well as to investigate the impact of potential risk factors on the occurrence of psychiatric disorders. The diagnosis of psychiatric disorders and the identification of subjects at high risk to develop psychosis were carried out by means of structured diagnostic interviews. The following variables were explored as potential risk/protective factors to the occurrence of psychiatric disorders: socio-demographic variables, migration status (refugees/asylum seekers) and characteristics of the reception center,assessed by means of an ad hoc questionnaire; cognitive indices assessed by using standardized neuropsychological tests; traumatic experiences and level of political terror in the country of origin, assessed by means of reliable and valid self-report questionnaires. At least one mental disorder was found in 29.7% of the sample. Most prevalent diagnoses were depressive disorders, anxiety disorders and PTSD. Women showed, with respect to men, a higher prevalence of anxiety disorders, higher trauma levels, and came from more at-risk countries. Higher trauma levels, better cognitive abilities and unemployment and refugee status were associated to the presence of a current psychiatric disorder in the whole sample. Our findings showed a higher prevalence of depressive disorders and PTSD in the sample of refugees and asylum seekers with respect to the general population and highlighted the role of potential risk factors whose identification may guide the implementation of preventive strategies and early treatments in these people.

Adaptation, construct validity, and test-retest reliability of the Cognitive Reserve Index Questionnaire for the Israeli multiple sclerosis population

IntroductionA common tool used to measure cognitive reserve is the Cognitive Reserve Index questionnaire (CRIq). In the present study, we aimed to adapt and determine the psychometric properties (validity and intra-rater test-retest reliability) of the Hebrew version of the CRIq in a cohort of people with multiple sclerosis (pwMS). MethodsFifty pwMS (30 women aged 48.3 (SD=10.2)) completed the CRIq and the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), which were used for validation. Secondary outcome measures included the evaluation of depression, anxiety, and perceived fatigue. Twenty-five (of the 50) pwMS were randomly selected and participated in the CRIq intra-rater test-retest reproducibility study based on a 7–12-day interval between tests. ResultsThe mean CRIq total was 101.8 (S.D.=13.04), which is considered at the medium level. The CRIq section scores were at a similar medium level. According to Pearson's Rho correlation analysis, the CRIq total score and sections of education, work, and leisure were significantly correlated at a medium level (Rho ranging between 0.282 to 0.415) with the SDMT score, a measurement of cognitive information processing speed. The intraclass correlation coefficient (ICC) values of the CRIq total and CRIq sections ranged between 0.942 to 0.998, indicating a strong correlation. ConclusionsThe Hebrew version of the CRIq is a reliable and valid tool for assessing cognitive reserve in pwMS, hence enabling clinicians and researchers to effectively monitor cognitive reserve in this population.

Development and validation of the Fall Risk Assessment Scale for patients in rehabilitation hospitals: A methodological study.

Falling is a serious threat for patient safety in hospitals. This study aimed to identify the risk factors of fall amongst rehabilitation patients and to use them for developing and validating the Persian version of Fall Risk Assessment Scale (FRAS). The current methodological study was conducted in two phases. In the first phase, based on the review of the literature and investigation of the medical records of 251 patients selected via purposive sampling, the risk factors of fall were extracted and the FRAS was developed accordingly. In the second phase, the face and content validities of the designed scale were determined by cognitive interview and Content Validity Index (CVI) and to evaluate the construct validity, known-groups comparison was performed. Its inter-rater reliability was analyzed using the weighted Kappa Coefficient (κ*). The study adhered to COSMIN guidelines. Fall was significantly associated with disease diagnosis, used medications, history of fall, cognitive impairments, and three items of the Functional Independence Measure (toilet transfer, bed transfer, and shoer transfer). The CVI of the scale was 0.94. The risk for falls group had a significantly higher perceived fall risk than the no risk for falls group, thus establishing known-group validity. Its weighted kappa coefficient was >0.85, its sensitivity was 73%, and its specificity was 82%. The valid and reliable FRAS may accurately assess the level of Fall Risk patients in Rehabilitation wards, helping to predict fall during hospitalization. So, enabling the planning and implementation of effective caring interventions.

Neural network cognitive analysis of accumulation metals by marigold

The article presents the results of studies to assess the effect of humic acids, taken at a concentration of 250 ppm, on the process of induced phytoextraction of heavy metals from soils selected near Norilsk. Phytoxtraction was carried out by different types of marigold plants: Tagetes patula and Tagetes erecta. The studies were carried out in greenhouse conditions under controlled spectral illumination (light culture). The duration of the experiment was 21 days. A short vegetation period was chosen based on the conditions of a short summer period typical for this region, where it is more rational to keep records of the systemic removal of toxicants from contaminated soils by several cycles of their sowing/cutting per season, already at the juvenile phase of ontogenesis. For elemental analysis, the method of atomic emission spectrometry with inductively coupled plasma was used. To assess the level of efficiency of metal accumulation, the authors developed and used the original computing neural network CompNN, which allows calculating the cognitive significance index (CSI) based on empirical data on the accumulation of toxicants, both in shoots and roots of plants. The results of the study showed that the introduction of an organic additive in the form of humic acids into the soil led to inhibition of the growth of the above-ground part of T. patula. As for T. erecta, the rate of accumulation of green plant biomass did not change when humic acids were added. The decrease in the biomass of shoots of T. patula plants is explained by an increase in the accumulation of metals in them by an average of 91.6% for the variants. The content of metals in the shoots of T. erecta under the influence of humic acids, on the contrary, decreased by 17.3% on average. A similar result was observed in relation to the root zone: the trend of change in the fixation of metals for both plant species here was 40.8 and 10.8%, respectively. Calculation of CSI indices also showed that the addition of humic acids in T. patula increases the intensity of metal accumulation from the soil in its biomass in all variants, while in T. erecta, on the contrary, it decreases. The performed cluster analysis demonstrated the fixation of metals in the main buffer zone of plants, and also made it possible to isolate nickel into a separate homogeneous series. With regard to the distribution of this element in the shoots by variants, experience has shown that it has demonstrated here the proximity of convergence with copper. The correlation coefficients of their accumulation with the CSI index in the shoots of both plants were r = 0.82; 0.87 for Cu and r = 0.87; 0.83 for Ni. The proximity of these values indicates the priority nature of the accumulation of these metals in the plant biomass of marigolds, and also characterizes the manifestation of certain interactions between them in contaminated soil by the type of antagonism or synergism.

Association between patient-reported frailty and nonhome discharge among older patients with acute stroke: A prospective study

Objective To investigate the association between prestroke frailty and nonhome discharge, prolonged length of stay as well as functional outcomes. Design Prospective observational study. Setting Single urban teaching hospital in Guangzhou, China. Participants Consecutive sample of 271 older patients admitted with acute stroke. Intervention N/A. Main measures A five-item FRAIL scale (0∼5 points) and the stroke severity at onset were measured. The primary outcome of interest was nonhome discharge, with secondary outcomes including prolonged length of stay and worse short-term prognosis. Multivariable logistic regression adjusting for confounding factors was used to determine the association between patient-reported frailty and nonhome discharge, prolonged length of stay, worse short-term prognosis. Results The population had a median age of 68 [interquartile range (IQR), 64∼74)]years, with 50 individuals (18.5%) identified as frail. After adjusting for age, sex, Barthel index, National Institutes of Health Stroke Scale, and Mini-Mental Status Exam score at admission, patients with self-reported frailty were significantly likely to experience nonhome discharge (Odds Ratio [OR] = 4.788; 95% confidence interval [CI] = 1.272∼18.017; p = .021), prolonged length of stay (OR = 4.76; 95% CI = 1.80∼12.56; p = .002), mRS scores at 30 days (OR = 6.72;95% CI = 1.79∼25.20; p = .005) and three months postdischarge and three-month (OR = 8.94; 95% CI = 2.10∼38.08; p = .003). Conclusions In older adults with stroke, frailty is associated with nonhome discharge, prolonged length of stay, and worse short-term prognosis, regardless of the stroke severity, cognition, and Barthel index score at admission. FRAIL scale can be used as a practical screening tool in acute care setting by multidisciplinary team in supporting discharge process.

Relationship of anthropometric indices of obesity with the Big Five personality traits and cognition among undergraduate students

Background: Obesity is associated with personality and cognition. The association remains to be investigated in the African population. In this study, we aimed to determine the prevalence of obesity and the relationship between anthropometric indices of obesity, personality traits, and cognition among undergraduate students in Kano, Nigeria. Methods: Two hundred and fifty-five (males = 94 and females = 161) undergraduates (17–30 years old) were recruited for the study. Anthropometric indices were measured according to the STEPwise protocol of the World Health Organization. Personality traits were assessed using the Big Five Personality Inventory, whereas cognition was assessed using the Montreal Cognitive Assessment (MoCA) tool. Results: The mean age of the patients was 23 years. The prevalence rates of central obesity and general obesity were 26.3% and 1.6%, respectively. Waist circumference (WC) (r = 0.14, P = 0.025) and hip circumference (HC) (r = 0.126, P = 0.045) were positively correlated with neuroticism. However, WC (r = −0.138, P = 0.028), HC (r = −0.138, P = 0.028), and waist-to-height ratio (WHtR) (r = −0.156, P = 0.011) were negatively correlated with naming (a component of MoCA) while WHtR was negatively correlated with MoCA (r = −0.126, P = 0.044). After adjusting for age, sex, and marital status, WC (odds ratio [OR] = 0.679 [95% confidence interval (CI): 0.456–1.011]; P = 0.050), HC (OR = 1.414 [95% CI: 1.007–1.986]; P = 0.045), and waist-to-hip ratio (OR = 1357 [95% CI: 6.524–28248]; P = 0.039) were significant predictors of low MoCA score. Conclusion: The prevalence of central obesity among our participants was high and associated with neuroticism and poor cognition.

Gestational organophosphate esters (OPEs) and executive function in adolescence: The HOME Study

BackgroundEvidence from toxicological studies indicate organophosphate esters (OPEs) are neurotoxic, but few epidemiological studies investigated associations between gestational OPEs and executive function. ObjectiveTo examine the associations between gestational concentrations of OPE urinary metabolites and executive function at 12 years. MethodsWe used data from 223 mother-adolescent dyads from the Health Outcomes of Measures of the Environment (HOME) Study. Women provided spot urine samples at 16 weeks gestation, 26 weeks gestation, and at delivery for quantification of bis(1,3-dichloro-2-propyl) phosphate, bis-2-chloroethyl phosphate (BCEP), diphenyl phosphate (DPHP), and di-n-butyl phosphate (DNBP). Executive function was assessed at age 12 years using the parent- and self-report Behavior Rating Inventory of Executive Function (BRIEF2). Covariate-adjusted associations between specific gravity-corrected OPEs and BRIEF2 scores were estimated using multiple informant models. Bayesian Kernel Machine Regression (BKMR) was used to assess the impact of all OPEs simultaneously. ResultsParent- and self-report BRIEF2 indices and composite scores were weakly to moderately correlated (rs = 0.32–0.41). A natural-log unit increase in BCEP at 26 weeks was associated with approximately a 1-point increase on the self-report Cognitive Regulation Index [CRI] (95% CI 0.4, 2.3), the Emotion Regulation Index [ERI] (95% CI 0.3, 2.2), and the Global Executive Composite [GEC] (95% CI 0.4, 2.2), indicating poorer performance. Higher DPHP at 16 weeks was associated with lower parent-report GEC score (β = −1.1, 95% CI -2.3, −0.003). BKMR identified BCEP and DNBP at 26 weeks as important contributors to CRI and ERI, respectively. ConclusionOPE metabolites during gestational development, particularly BCEP, may influence adolescent executive function. However, since the FDR p-values failed to reach statistical significance, additional studies would benefit from using larger cohorts.

Comparing self-other distinction across motor, cognitive and affective domains.

The self-other distinction (SOD) is a process by which humans disentangle self from other-related mental representations. This online study investigated two unresolved questions: (i) whether partially the same processes underpin SOD for motor, cognitive and affective representations, and (ii) whether SOD overlaps with domain-general cognitive control processes. Participants (N = 243) performed three SOD tasks (motor: automatic imitation inhibition (AIT); cognitive: visual perspective-taking (VPT); affective: emotional egocentricity bias (av-EEB) tasks) and two cognitive control tasks (Stroop and stop-signal reaction time (SSRT) tasks). Correlation analyses showed no associations among the motor, cognitive and affective SOD indexes. Similarly, distinct SOD clusters emerged in the hierarchical clustering dendrogram, indicating clear separations among SODs. However, the results of multidimensional scaling suggested a tendency towards two clusters, as evidenced by the proximity of AIT and VPT indexes in relation to EEB indexes. AIT spatial laterality and Stroop domain-general cognitive control confounded AIT and VPT indexes, albeit slightly differently depending on the analysis method used. SSRT showed neither associations with SODs nor with other domain-general indexes. These findings underscore the complexity of SOD processes and have notable implications for basic and applied research, e.g. in the domain of clinical disorders affected by deficiencies in SOD.

The Semantics of Happiness and Joy in the Italian Language

Abstract A number of contemporary researchers have proposed considering happiness and joy as distinct phenomena and theoretical constructs. However, there is as yet insufficient information regarding whether the theoretical and empirical arguments for distinguishing happiness from joy also apply to folk representations of these concepts. This work presents two studies in which Italian speakers performed a free-listing task asking them to list words semantically equivalent to the Italian words felicità (happiness) (Study 1) and gioia (joy) (Study 2). A comparison between the two studies revealed that the Italian concepts of happiness and joy had 49 lexical items in common, 32 of which related to emotions. Interestingly, 11 of the latter ranked in the top 10 cognitive salience indexes obtained from both Study 1 and Study 2. It is argued that the semantic similarities between the two words examined – felicità and gioia – should not overshadow the meaning nuances distinguishing them.

Exploring the Relationship Between Amyloid Burden and Depression in Pre-clinical Alzheimer's Disease.

Background Alzheimer's disease (AD) is a form of dementia, marked by amyloid-β plaques, neurofibrillary tangles, and neuronal loss. The amyloid burden has been associated with cognitive impairment and depression, suggesting a potential link between these conditions. Objective This study investigates the relationships between amyloid burden, cognitive impairment, and depression in the preclinical stages of AD. Methods Data from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) study, involving 4486 cognitively unimpaired individuals aged 65-85, was analyzed. The amyloid burden was assessed using positron emission tomography (PET) standardized uptake value ratio (SUVR), cognitive function viacognitive function index (CFI) and tests, and depression via the short-form geriatric depression scale. Mediation analyses, adjusted for age, sex, and education, were employed to measure the impact of amyloid deposition on depression into direct and cognition-mediated indirect effects. Results No significant direct correlation between amyloid burden and depression was found (p=0.2935). Significant indirect effects were observed in cognition measures: CFI (0.3203, 95% CI: (0.2382, 0.4010)), digit symbol substitution test (0.0401, 95% CI: (0.0180, 0.0683)), and immediate recall (0.0169, 95% CI: (0.0014, 0.0354)). However, free and cued selective reminding (0.0056, 95% CI: (-0.0078, 0.0268)) and delayed recall (0.0105, 95% CI: (-0.0009, 0.0259)) showed no significant indirect effects. Conclusions The findings indicate significant mediation by CFI, digit symbol substitution test, and immediate recall in the relationship between amyloid burden and depression while free and cued selective reminding and delayed recall showed no significant mediation. These results underscore the importance of further research using longitudinal data and a broader range of confounders to fully understand cognition's mediating role.

B - 1 Cognitive Flexibility Moderates the Relationship between Trauma Symptoms and Cognitive Proficiency

Abstract Objective This study aims to lend additional empirical support for the relationship between cognitive proficiency and trauma. Importantly, the study seeks to advance our understanding of this relationship by investigating the possible moderating role of cognitive flexibility (CF). It was hypothesized that the relationship between trauma and cognitive proficiency would be stronger for individuals with less CF. Method Data were collected from 75 adult participants in a private practice. The sample was predominantly White and female, and all consented to a comprehensive neuropsychological assessment following referral for inattention and personal trauma. Relevant measures included the focused anxiety-trauma subscale of the Personality Assessment Inventory, the Cognitive Processing Index of the Weschler Adult Intelligence Scale, and Trails B to determine the correlation between trauma symptoms and cognitive proficiency and to evaluate whether CF moderated the relationship. Results Results indicated that greater trauma symptoms were associated with lower cognitive proficiency (B = −0.448, SE = 0.090, β = −0.554, p < 0.001). The interaction between trauma symptoms and CF was also significant (B = 0.007, SE = 0.002, β = 0.506, p < 0.001), suggesting the effect of trauma on cognitive proficiency depended upon the level of CF. Together, the variables accounted for approximately 30% of the variance in cognitive proficiency (R2 = 0.299, F(2, 73) = 15.574, p < 0.001). Conclusion This study supports the hypothesis that the impact of psychological trauma on cerebral efficiency is partially dependent on CF. These findings spotlight CF as a potential target for intervention to mitigate the cognitive effects of trauma.

Is the Term "Food Consistency" Used Consistently in Consumer Science? An Exploratory Study of Consumer Association and Conceptualization.

The post-pandemic context has changed the modes for collecting data in sensory and consumer science. The objectives of this research were to analyze consumers' associations of food consistency and to study two virtual modes of the Free Word Association test (FWA). This test was administered to 209 consumers (180 women, 29 men, 18-45 years old) asynchronously (i.e. self-administered) and synchronously (i.e. face to face interviews). The Cognitive Salience Index (CSI) was calculated, and the structure of the social representation was analyzed. Correspondence analysis showed that food consistency was a mixture of concepts related to structure, hardness and several aspects of auditory (e.g., Crunchy, Crispy), tactile (e.g. Smooth, Spreadable) and oral texture (e.g., Creamy, Gummy). Slightly consistent food was associated with something soft, liquid or semisolid, and very consistent food to something hard and resistant. Consistent food was more related to "very" than to "slightly consistent." The CSI depended on the stimulus presented (p < 0.05). Regarding the social representation structure, the central core had the highest CSI for all stimuli (CSI ≥ 0.13, p < 0.05). Consumers defined "very consistent, consistent and slightly consistent food" by naming more foods in the synchronous mode than in the asynchronous one. In the asynchronous mode, consumers took more time to complete the test. The virtual FWA test (asynchronous or synchronous) showed some differences in the associations of term consistency, due to the lack of spontaneity in the first minute. It is important to adjust the methodologies to standardize the times in both modes.

How sleep duration impacts cognitive status among Indian population aged ≥45 years: Evidence from Longitudinal Aging Study India (LASI).

An aging population is associated with an increased risk of cognitive decline. Sleep duration, both excess and deficiency, is a risk factor for cognitive impairment. Therefore, this study was conducted to assess the relationship between sleep duration and cognition in the Indian population. This study was a secondary analysis of the first wave of the Longitudinal Aging Study in India (LASI) conducted across India in all 34 states and union territories. Sleep duration was calculated using sleep and wake times, whereas cognition was measured as a composite cognitive index. Both univariable and multivariable linear regressions were performed on the composite cognitive score. Subgroup analyses were conducted based on sex and age groups (45-59 years and ≥60 years). The median (IQR) cognition score was 25 (20-30). A sleep duration of ≤4 hours was associated with a decrease in cognition status of 1.15 points (1.57-0.72), and a sleep duration of ≥9 hours was associated with a decrease of 0.93 points (1.25-0.60). Subgroup analysis revealed that this relationship remained consistent across both genders and both age groups. Both long and short durations of sleep were seen to be associated with a decrease in cognition scores among Indian adults, in both sexes and both age groups. Thus, proper sleep duration can help in the prevention of declining cognition as one ages and the development of dementia.

Cognitive Intraindividual variability in injection drug use among Hispanic residents of Puerto Rico

Despite a high prevalence of injection drug use (IDU) in Puerto Rico, little is known about how it affects neuropsychological functioning in this population. Investigations of intra-individual variability (IIV) have alluded to its utility as a potential indicator of neural decline. The purpose of this study was to characterize IIV among Hispanic residents of Puerto Rico who engage in IDU. Injectors and non-injectors completed the Neuropsí Atención y Memoria battery. Measures of IIV were calculated for the overall test battery (OTB), the three battery indices, and three domains of attention, memory, and executive functioning. The injector group showed significantly greater IIV than the non-injector group on all measures (OTB, indices, and individual domains). Additionally, injectors showed significantly higher IIV in the domain of executive functioning compared to other cognitive domains and battery indices. In contrast, non-injectors did not show any significant within-group differences on any IIV measures. The higher performance variability observed in the IDU group suggests a negative influence of IDU on cognition, with executive functioning being more susceptible to these effects. These findings support the need for continued investigations into the clinical application of IIV for diagnostic and prognostic purposes in the Hispanic IDU population.

Cognitive Polygenic Index is Associated with Occupational Complexity over and above Brain Morphometry.

Although the impact of occupation on cognitive skills has been extensively studied, there is limited research examining if genetically predicted cognitive score may influence occupation. We examined the association between Cognitive Polygenic Index (PGI) and occupation, including the role of brain measures. Participants were recruited for the Reference Ability Neural Network and the Cognitive Reserve studies. Occupational complexity ratings for Data, People, or Things came from the Dictionary of Occupational Titles. A previously-created Cognitive PGI and linear regression models were used for the analyses. Age, sex, education, and the first 20 genetic Principal Components (PCs) of the sample were covariates. Total cortical thickness and total gray matter volume were further covariates. We included 168 white-ethnicity participants, 20-80 years old. After initial adjustment, higher Cognitive PGI was associated with higher Data complexity (B=-0.526, SE = 0.227, Beta= -0.526 p = 0.022, R2 = 0.259) (lower score implies higher complexity). Associations for People or Things were not significant. After adding brain measures, association for Data remained significant (B=-0.496, SE: 0.245, Beta= -0.422, p = 0.045, R2 = 0.254). Similarly, for a further, fully-adjusted analysis including all the three occupational complexity measures (B=-0.568, SE = 0.237, Beta= -0.483, p = 0.018, R2 = 0.327). Cognitive genes were associated with occupational complexity over and above brain morphometry. Working with Data occupational complexity probably acquires higher cognitive status, which can be significantly genetically predetermined.

Dose–response relationship between computerized cognitive training and cognitive improvement

Although computerized cognitive training (CCT) is an effective digital intervention for cognitive impairment, its dose-response relationship is understudied. This retrospective cohort study explores the association between training dose and cognitive improvement to find the optimal CCT dose. From 2017 to 2022, 8,709 participants with subjective cognitive decline, mild cognitive impairment, and mild dementia were analyzed. CCT exposure varied in daily dose and frequency, with cognitive improvement measured weekly using Cognitive Index. A mixed-effects model revealed significant Cognitive Index increases across most dose groups before reaching the optimal dose. For participants under 60 years, the optimal dose was 25 to <30 min per day for 6 days a week. For those 60 years or older, it was 50 to <55 min per day for 6 days a week. These findings highlight a dose-dependent effect in CCT, suggesting age-specific optimal dosing for cognitive improvement.

Longitudinal Associations Between Cognition and Grip Strength, Differentiated by Sex and Physical Activity: A Population-Based Study in Older Adults From 17 European Countries.

Objectives (1) To investigate longitudinal associations between grip strength (GS) and cognition over 4 years in European older adults, (2) to examine differences in temporal associations between men and women and between levels of physical activity, (3) to explore in each year 2015 and 2019 associations between GS quartiles and cognitive performance, and (4) to explore longitudinal associations between GS quartiles (year 2015) and cognitive performance (year 2019). Methods: 25,281 individuals (14,200 women) from 17 European countries aged ≥50 years responded to waves 6th and 8th of the SHARE project. We analyzed GS, a general cognition index, and physical activity level. Results: Panel analyses revealed a bidirectional relationship over 4 years between GS and cognition, with differences between sex, as well as between participants with moderate-to-vigorous and low physical activity levels. Conclusion: Women and participants with low physical activity were more likely to experience cognitive performance deficits 4 years later.

Factors Associated With Physical Activity and Sedentary Behavior in People With Parkinson Disease: A Systematic Review and Meta-Analysis.

The goal of this review was to investigate factors associated with physical activity and sedentary behavior in people with Parkinson disease (PD). The magnitude of these associations were investigated in line with the International Classification of Functioning, Disability and Health components. A systematic literature review was conducted until February 2023, searching 4 databases (PubMed, EMBASE, Web of Science, and Scopus) for original articles investigating associations with physical activity or sedentary behavior in people with PD. Two independent researchers performed data extraction, and the risk of bias in the included studies was assessed using the Quality in Prognosis Studies tool. Meta-analyses were conducted to determine the magnitude of the associations, and significant regression models from the included studies were described. Forty-two studies were included. Twenty-one factors associated with overall physical activity were identified. Higher levels of physical activity had small association with cognition and body mass index, and fair association with 17 factors related to self-efficacy, physical function, mobility, quality of life, age, PD symptoms, and more. Better manual dexterity and functional gait had moderate to good association with higher levels of physical activity. The regression model with the higher magnitude was composed mostly of contextual factors, except for the body max index. The magnitude of factors associated with physical activity intensity or sedentary behavior could not be identified. Functional gait and manual dexterity were the strongest factors related to physical activity in people with PD. Further investigation is needed to understand the factors associated with physical activity intensity and sedentary behavior. This study emphasizes the significance of considering contextual factors alongside body function and structure, activity and participation, and the health condition to enhance physical activity improvement during the rehabilitation process. By adopting such holistic approach, rehabilitation professionals can optimize the overall health and wellbeing of individuals with Parkinson disease.

Cognitive reserve as a modulator of cognitive decline and of behavioral symptoms in patients with amyotrophic lateral sclerosis

Introduction: Amyotrophic lateral sclerosis (ALS) has heterogeneous manifestations ranging from motor neuron degeneration to cognitive and behavioral impairment. This study aims to clarify the interactions between cognition and behavioral symptoms with relevant disease predictors and with cognitive reserve (CR), quantified through education, physical activity, and occupation proxies. Methods: A prospective sample of 162 ALS patients and 61 controls were evaluated with the Edinburgh Cognitive and Behavioral ALS Screen (ECAS) (dependent variable), a Cognitive Reserve Index questionnaire (CRIq) and demographic data (age and sex), and, for patients, clinical variables: disease duration, site of onset, the ALS Functional Rating Scale (ALSFRS), forced vital capacity (FVC), and gene mutation chromosome 9 open reading frame 72 (C9orf72) (independent variables). Multiple regression and mediation analyses were performed to predict cognitive and behavioral symptoms. Results: For the ALS group, the statistical model explained 38.8% of variance in ECAS total (p < 0.001), 59.4% of executive functions (p < 0.001), and 55% of behavioral symptoms (p < 0.001). For controls, it accounted for 52.8% of variance in ECAS total (p < 0.001). Interaction effects and mediation analysis showed CR is an ECAS total modulator, with a differential effect within groups (p < 0.001). Verbal fluency was the single best cognitive score to differentiate patients from controls (p = 0.004), and the gene mutation C9orf72 was found to be a behavioral symptom’ predictor in patients (p = 0.009). Conclusion: This study supports the proposed concept that CR acts as a cognitive modulator in ALS patients and healthy individuals. Moreover, CR also modulates behavioral manifestations in ALS.

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 > 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.