Cognitive Set Research Articles

Microfluidic and Computational Tools for Neurodegeneration Studies.

Understanding the molecular, cellular, and physiological components of neurodegenerative diseases (NDs) is paramount for developing accurate diagnostics and efficacious therapies. However, the complexity of ND pathology and the limitations associated with conventional analytical methods undermine research. Fortunately, microfluidic technology can facilitate discoveries through improved biomarker quantification, brain organoid culture, and small animal model manipulation. Because this technology can increase experimental throughput and the number of metrics that can be studied in concert, it demands more sophisticated computational tools to process and analyze results. Advanced analytical algorithms and machine learning platforms can address this challenge in data generated from microfluidic systems, but they can also be used outside of devices to discern patterns in genomic, proteomic, anatomical, and cognitive data sets. We discuss these approaches and their potential to expedite research discoveries and improve clinical outcomes through ND characterization, diagnosis, and treatment platforms.

Heart rate during moderate exercise and attention among adolescents: An experimental study.

Existing studies on the effects of physical activity on cognitive function have predominantly focused on pre- or post-exercise effects, leaving a gap in understanding the immediate cognitive impacts during physical exertion. Understanding cognitive performance during activity could have significant implications for improving productivity and therapeutic strategies. This study examined the relationship between heart rate and cognitive performance, specifically attention, using the D2 attention test among 32 adolescents aged 12-18years. Participants underwent attention assessments at rest and while moving at target heart rates of 100bpm, 120bpm, and 140bpm. The influence of body mass index (BMI) and sleep quality on attention has been analysed too. A significant positive correlation between heart rate and attention was observed (r = 0.39, P < .005), indicating enhanced cognitive performance with increased heart rate. Furthermore, a significant negative correlation was found between BMI and attention (r = -0.37, P = .039) and a significant positive correlation was found between sleep quality and attention (r = 0.66, P = .014). These findings suggest that moderate physical activity can enhance attention, which could inform the design of educational, therapeutic, and occupational strategies. Future research should explore the generalizability of these effects across different cognitive domains, age groups, and settings.

Sparsity of Population Activity in the Hippocampus Is Task‐Invariant Across the Trisynaptic Circuit and Dorsoventral Axis

ABSTRACTEvidence from neurophysiological and genetic studies demonstrates that activity sparsity—the proportion of neurons that are active at a given time in a population—systematically varies across the canonical trisynaptic circuit of the hippocampus. Recent work has also shown that sparsity varies across the hippocampal dorsoventral (long) axis, wherein activity is sparser in ventral than dorsal regions. While the hippocampus has a critical role in long‐term memory (LTM), whether sparsity across the trisynaptic circuit and hippocampal long axis is task‐dependent or invariant remains unknown. Importantly, representational sparsity has significant implications for neural computation and theoretical models of learning and memory within and beyond the hippocampus. Here we used functional molecular imaging to quantify sparsity in the rat hippocampus during performance of the Morris water task (MWT) and contextual fear discrimination (CFD) – two popular and distinct assays of LTM. We found that activity sparsity is highly reliable across memory tasks, wherein activity increases sequentially across the trisynaptic circuit (DG &lt; CA3 &lt; CA1) and decreases across the long axis (ventral&lt;dorsal). These results have important implications for models of hippocampal function and suggest that activity sparsity is a preserved property in the hippocampal system across cognitive settings.

Protocol for the creation of a core outcome set for clinical trials of interventions to improve sleep in people with cognitive impairment: The Sleep in Cognitive Impairment Core Outcome Set (SCICOS) study.

Background While sleep disturbance is common in dementia, leading to negative outcomes, there is growing evidence that sleep disturbance begins early in prodromal dementia and may contribute to cognitive decline. Sleep is therefore an important treatment target throughout the natural history of dementia and there is increasing interest in sleep as a modifiable risk factor. Clinical trials of interventions to improve sleep in people with cognitive impairment are beset by wide heterogeneity in the outcome measures reported. A core outcome set (COS) is urgently required to improve the coherence and comparability of data. Aim To produce a COS for clinical trials of interventions to improve sleep in people with cognitive impairment: the Sleep in Cognitive Impairment Core Outcome Set (SCICOS). Methods The Core Outcome Set-STAndards for Development: the COS-STAD recommendations will be followed. A systematic review (Registration: CRD42024556750) will identify outcome measures used in relevant clinical trials. Qualitative interviews involving people living with cognitive impairment and their caregivers will ascertain the outcome measures important to them. Finally, a modified Delphi process, involving people living with cognitive impairment and their caregivers as well as expert clinicians and researchers, will be conducted to reach consensus regarding the final composition of the SCICOS. Conclusion Interventions to improve sleep in people with cognitive impairment may reduce distress associated with sleep disturbance and, potentially, slow progression of cognitive decline. Creating the SCICOS will facilitate development of more meaningful and coherent data to drive progress in this emerging field.

The identification and analysis of pivotal factors influencing the corrosion of natural gas pipelines using fuzzy cognitive map

Corrosion presents the gas industry with the formidable challenge of sustaining natural gas energy resources. Given the intricate nature of corrosion, it is imperative to devise a comprehensive model and formulate cognitive sets to effectively manage the risks associated with corrosion in the gas industry. Therefore, the present research was conducted with the objective of identifying and presenting a fuzzy cognitive map delineating the critical factors of corrosion. The statistical population of the research comprises corrosion experts. The statistical sample for this study encompasses 30 experts possessing requisite knowledge and experience, with a minimum of 10 years of expertise in engineering disciplines such as materials science and metallurgy. The findings revealed that the cathodic protection factor exerts the most significant influence on corrosion. The fuzzy cognitive mapping structure of the study comprises 19 edges. The factors “CO2″, ”H2S“, and ”Pipeline Age“ exhibit the highest susceptibility with input degrees of 0.895 and 0.6, respectively. Additionally, ”Cathodic Protection“ ranks highest in terms of influence with a degree of 0.895, whereas ”Working Temperature“ has the least impact with an output degree of − 0.895. The reliability of expert opinions using the Z-number theory has been assessed, yielding fuzzy numbers (0.47, 0.7, 0.93), indicating a reliable and highly certain relationship. The identified factors furnish essential insights to bolster evidence-based policy formulation, facilitating effective monitoring and evaluation of policies within the gas industry.

Cardiac-Sympathetic Contractility and Neural Alpha-Band Power: Cross-Modal Collaboration during Approach-Avoidance Conflict.

As evidence mounts that the cardiac-sympathetic nervous system reacts to challenging cognitive settings, we ask if these responses are epiphenomenal companions or if there is evidence suggesting a more intertwined role of this system with cognitive function. Healthy male and female human participants performed an approach-avoidance paradigm, trading off monetary reward for painful electric shock, while we recorded simultaneous electroencephalographic and cardiac-sympathetic signals. Participants were reward sensitive but also experienced approach-avoidance "conflict" when the subjective appeal of the reward was near equivalent to the revulsion of the cost. Drift-diffusion model parameters suggested that participants managed conflict in part by integrating larger volumes of evidence into choices (wider decision boundaries). Late alpha-band (neural) dynamics were consistent with widening decision boundaries serving to combat reward sensitivity and spread attention more fairly to all dimensions of available information. Independently, wider boundaries were also associated with cardiac "contractility" (an index of sympathetically mediated positive inotropy). We also saw evidence of conflict-specific "collaboration" between the neural and cardiac-sympathetic signals. In states of high conflict, the alignment (i.e., product) of alpha dynamics and contractility were associated with a further widening of the boundary, independent of either signal's singular association. Cross-trial coherence analyses provided additional evidence that the autonomic systems controlling cardiac-sympathetics might influence the assessment of information streams during conflict by disrupting or overriding reward processing. We conclude that cardiac-sympathetic control might play a critical role, in collaboration with cognitive processes, during the approach-avoidance conflict in humans.

Social norms and cooperation in higher-order networks

Recent research has been focused on understanding how cooperation is fostered through various mechanisms in cognitive settings, particularly through pairwise interactions. However, real-world interactions often extend beyond simple dyads, including multiple cliques with both pairwise and higher-order interactions. These complex interactions influence how individuals perceive and adapt their strategies based on social norms. We here introduce a model that explores the evolution of collective strategies and social norms within a heterogeneous environment, encompassing both dyadic and three-body interactions. We find that social norms play a crucial role in promoting cooperation in comparison with simply imitating the most successful neighbour. We also show that the rise of prosocial norms leads to increased cooperation across various social dilemmas, often resulting in shifts from defective to cooperative behaviour. Additionally, we observe that a moderate level of information privacy helps sustaining prosocial norms and curtails antisocial tendencies, even in situations where mutual defection might seem advantageous. Our research thus offers insights into the evolution of cooperation through the lens of social norm diffusion in higher-order networks.

Semantic and Morphosyntactic Differences among Nouns: A Template-Based and Modular Cognitive Model

The noun category exhibits diverse dissimilarities, characterised at the semantic (e.g., countable/uncountable) or/and morphosyntactic (e.g., determined/determinerless) level, which may be more or less important depending on languages. In this paper, we would like to discuss those differences, which we named inter-word and inter-process morphosyntactic variations. The Riffian language served us as a reference in our enquiries, before referring to other languages to show how our discoveries could be applied to them. By putting in perspective those aspects, this led us to propose a formal mathematical model denoted as a Template-Based and Modular Cognitive model. The latter is able to predict the nonlinear dynamic mapping of lexical items onto morphological templates. The aims of this article are thus manifold and cover theoretical issues. We demonstrate that nouns are organised and distributed in modular cognitive sets, having their own morphological template and unmarked forms. The extent of these sets and their number as well as the template, are specific to each language. All sorts of markers can compose with the template, but some, namely countability markers, are prevalent among several languages with no relationship. This approach allows us to explain the marking discrepancies existing between different kinds of nouns (borrowed, proper, countable and uncountable nouns) for a given linguistic variety or between languages. The main assumption of this model is that these irregular markings are caused by a template shift, occurring when items undergo a process of word and meaning formation. Our contribution represents an initial stride toward understanding the fundamental patterns of morphosyntax and opens venues for applying this mathematical model with other behavioural and natural phenomena.

Between-task transfer of item-specific control is replicable and extends to novel conditions.

Learning-guided control refers to adjustments of cognitive control settings based on learned associations between predictive cues and the likelihood of conflict. In three preregistered experiments, we examined transfer of item-specific control settings beyond conditions under which they were learned. In Experiment 1, an item-specific proportion congruence (ISPC) manipulation was applied in a training phase in which target color in a Flanker task was biased (mostly congruent or mostly incongruent). In a subsequent transfer phase, participants performed a color-word Stroop task in which the same target colors were unbiased (50% congruent). The same design was implemented in Experiment 2, but training and transfer tasks were intermixed within blocks. Between-task transfer was evidenced in both experiments, suggesting learned control settings associated with the predictive cues were retrieved when encountering unbiased transfer items. In Experiment 3, we investigated a farther version of between-task transfer by using training (color-word Stroop) and transfer (picture-word Stroop) tasks that did not share the relevant (to-be-named) dimension or response sets. Despite the stronger, between-task boundary, we observed an ISPC effect for the transfer items, but it did not emerge until the second half of the experiment. The results provided converging evidence for the flexibility and automaticity of item-specific control. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Long-lasting negativity in the left motoric brain structures during word memory inhibition in the Think/No-Think paradigm

In this study, we investigated the electrical brain responses in a high-density EEG array (64 electrodes) elicited specifically by the word memory cue in the Think/No-Think paradigm in 46 participants. In a first step, we corroborated previous findings demonstrating sustained and reduced brain electrical frontal and parietal late potentials elicited by memory cues following the No-Think (NT) instructions as compared to the Think (T) instructions. The topographical analysis revealed that such reduction was significant 1000 ms after memory cue onset and that it was long-lasting for 1000 ms. In a second step, we estimated the underlying brain generators with a distributed method (swLORETA) which does not preconceive any localization in the gray matter. This method revealed that the cognitive process related to the inhibition of memory retrieval involved classical motoric cerebral structures with the left primary motor cortex (M1, BA4), thalamus, and premotor cortex (BA6). Also, the right frontal-polar cortex was involved in the T condition which we interpreted as an indication of its role in the maintaining of a cognitive set during remembering, by the selection of one cognitive mode of processing, Think, over the other, No-Think, across extended periods of time, as it might be necessary for the successful execution of the Think/No-Think task.

Effective mathematics learning through APOS theory by dint of cognitive abilities

The paper dwells on the contributions of APOS theory to the development of teaching and learning of mathematics in school. APOS is an acronym for &lt;i&gt;action&lt;/i&gt;, &lt;i&gt;process&lt;/i&gt;, &lt;i&gt;object&lt;/i&gt;, and &lt;i&gt;schema&lt;/i&gt;. The theory emerges as an extension to constructivism but with a more focused and robust learner-centered approach to the teaching and learning of mathematics. Proponents of the theory believed that learning occurs initially as an &lt;i&gt;action &lt;/i&gt;or &lt;i&gt;activity &lt;/i&gt;in learners’ cognitive settings, independent of learners’ environment, triggered by cognitive coherence, then it is transformed to &lt;i&gt;process&lt;/i&gt;,&lt;i&gt; &lt;/i&gt;where learner now waits for internalization of the earlier &lt;i&gt;activity&lt;/i&gt;, preparatory to the occurrence of learning. At &lt;i&gt;object &lt;/i&gt;level, learner now considers what has been learnt earlier to have been fully internalized into mathematical &lt;i&gt;object(s)&lt;/i&gt;. Lastly, at &lt;i&gt;schema &lt;/i&gt;level, the &lt;i&gt;object&lt;/i&gt; learnt is assumed to have been embedded in the learners’ &lt;i&gt;schema&lt;/i&gt;–a cognitive structure formed as a result of accumulated learning experience, and a complete mental image of what has been learnt is said to have been formed. Against the backdrop of this, the paper looks at how this theory had changed the narrative about teaching and learning of mathematics vis-à-vis the bearing of the theory to other cognitive abilities of the learner such as intelligence and creativity. In the end, the paper suggests the application of APOS theory in teaching and learning mathematics at all levels of learning in Nigeria and beyond.

A novel automatic detection and classification algorithm for elderly cognitive impairment using CSVM

Alzheimer’s disease (AD) is a degenerative disease with insidious onset and chronic nervous system, which can be roughly classified into three stages: preclinical AD, mild cognitive impairment (MCI), and clinical AD. Given that timely treatment of MCI can delay the course of AD, identifying what stage of the disease is at the time of early diagnosis is critical in clinical practice. Based on the survey data of elderly residents in Changsha community, this paper constructs the cognitive impairment data set and explores the application of the emerging classification algorithm Convolutional Support Vector Machine(CSVM) in identifying elderly cognitive impairment, a small data classification problem. CSVM is an improved Support Vector Machine classification(SVC) algorithm, which uses the convolution filtering idea of the Convolutional Neural Networks(CNN) algorithm to preprocess the nonlinearly separable sample set to improve the classification ability of SVM. In addition, the optimal convolution filter (solution) is found by the Simplified Swarm Optimization(SSO) algorithm and orthogonal array experimental design. A variable update amplitude method is also proposed to optimize the SSO update strategy further. Aiming at the problem of an unbalanced sample set, a stratified sampling method is used to divide and cross-validate the sample data, and a variety of evaluation indicators are used to evaluate the performance of the model. Experimental results show that the data set processed by a specific convolution filter can significantly improve the classification performance of linear SVM. The accurate differentiation of normal cognition(NC), MCI, and AD helps intervene in adjuvant treatment for potential patients timely.

Building Communication Ethics in the Leadership of the Junior State 2 High School in Gorontalo, OSIS Management for the 2022-2023 Period

This article investigates the significance of communication ethics in shaping the leadership dynamics among OSIS (Organization of Islamic Students) administrators within educational institutions. Through empirical analysis, it is revealed that adherence to communication ethics profoundly influences the effectiveness of OSIS administrators, facilitating smooth execution of diverse OSIS activities and fostering strong interpersonal bonds among administrators and members alike. Moreover, the integration of communication ethics fosters harmonious collaboration between OSIS supervisors, teachers, parents, and administrators, thereby cultivating a conducive environment for organizational growth and development. Furthermore, the application of communication ethics within the leadership framework of OSIS administration augments administrators' cognitive capacities, skill sets, and overall achievements, both academically and in extracurricular endeavors. This study underscores the pivotal role of communication ethics in enhancing leadership efficacy and fostering holistic development within the OSIS management milieu.

Abstract TP78: Characteristics of Verbal and Non-Verbal Cognitive Function in Post-Stroke Aphasia Based on Language-Cognition Neuropsychological Processing Model

Introduction: Post-stroke aphasia (PSA) patients have different levels of phonetic, lexical, semantic, syntactic, and other linguistic domain impairment, and accompanied by non-verbal cognitive impairment. However, the association between verbal and non-verbal cognitive functions is not fully understood.In this study, we used the Chinese Aphasia Language Battery (CALB) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) to fully evaluate the characteristics of verbal and non-verbal cognitive function impairment in PSA patients. Methods: A total of 105 stroke patients were recruited in this study. Language and non-linguistic cognitive impairments were evaluated by CALB and LOTCA, respectively. Patients in the PSA group were subdivided into the fluent aphasia group (FAG) and the non-FAG group. Potential confounders were adjusted in the analysis of covariance. Partial correlation analysis between the subscores of CALB and LOTCA was also performed. Results: This study showed that PSA patients had worse speech analysis ability, vocabulary processing ability, semantic processing ability, syntactic structure conversion ability, and non-verbal cognitive performance(P&lt;0.001). Moreover, the scores of phonetic decoding, phonetic vocabulary production, noun category classification, total LOTCA, orientation, visual perception, motor use, and thinking operation were lower in the non-FAG compared with the FAG (p&lt;0.05). The total score of LOTCA was positively correlated with the aphasia quotient (r=0.637, P&lt;0.001) and scores of speech analysis ability, vocabulary processing ability, semantic processing ability, and syntactic structure conversion ability (r&gt;0; P&lt;0.0005). Conclusions: Based on the language-cognition neuropsychological processing model, this study adopted a comprehensive verbal and non-verbal cognitive assessment set of tests, and found that PSA patients have extensive phonological, lexical, semantic, syntactic, and grammatical processing disorders. Moreover, PSA patients often have more extensive and serious non-verbal cognitive impairments, and the severity of aphasia is significantly positively correlated with the degree of nonverbal cognitive impairment.

Theoretical Considerations of Resilience in Caregivers

Resilience requires a dynamic interaction between the physical, emotional, cognitive and social dimensions of self, marshaled to confront adversity, meet specific associated challenges, recover and rebound to achieve personal growth. Caregivers encounter adversity repeatedly over time such that these experiences become routine creating an unusual circumstance for personal growth. Oversights in methodologies such as failing to evaluate subtle differences in intra-personal domains and adversity ratings prior to encountering the impact of stressors during a care giving assignment, at targeted intervals over the course of the assignment and sometime after completion may result in missed opportunities to appreciate valuable data that reveals the complexity of the resilience construct. Components of motivation, socialization, cognition, emotion and physical domains in caregiver research have not been clearly explicated. There has been no unifying qualitative or quantitative theory of resilience proposed addressing the dynamic interaction within and between the intra-personal dimensions and the environmental stress over the care giving assignment that considers underlying caregivers’ motivations. This article attempts to identify the intrinsic and extrinsic factors involved in understanding and measuring resilience among caregivers. A hypothetical model is proposed conceptualizing resilience as a continuous experience in care giving measured by intrinsic and extrinsic components incorporated in to a newly developed dependent measure to be administered at specified intervals before, during and after subjects accept new assignments. The factor structure of this new instrument may serve to capture subtle individual differences based on demographic factors, motivation, physical, emotional, and/or cognitive set, recovery, rebound, and personal growth. In this way, resilience may be considered a continuous factor capturing both positive and negative impact of the care giving experience.

Supporting Argumentation in a Service-Oriented Hypertext System

Systems supporting argumentation exist for a long time and have appeared with many different forms, ranging from online forums, to mind maps and decision support systems. These systems are used daily by teams that collaborate in data intensive and cognitive complex settings, such as teams involved in DNA analysis and social media research. However, current argumentation support systems do not offer the required functionalities for the meaningful analysis and aggregation of the associated complex data, thus not properly serving requirements related to gaining of insights and decision making. Aiming to address these issues, this paper presents an approach that integrates argumentation support services with data mining and natural language processing services to augment collaboration and decision making in the above teams. The proposed approach builds on well-tried principles of hypertext systems and adopts a service-oriented architecture to enable the contextualization of the foreseen services, as well as their execution and integration of their results in the argumentative discourse, hence facilitating its monitoring and understanding.

Emotional activation in a cognitive behavioral setting: extending the tradition with embodiment.

The neuroscience-based concept of "embodied cognition" or "embodiment" highlights that body and psyche are closely intertwined, i.e., effects of body and psyche are bidirectional and reciprocal. This represents the view that cognitive processes are not possible without the direct participation of the body. Traditional Cognitive Behavioral Therapy (CBT) addresses emotional processes on a conceptual level (dysfunctional thoughts, beliefs, attributions, etc.). However recent findings suggest that these processes already start at the level of bodily sensations. This opens up a way of working in therapy that includes the level of bodily sensations, where the development of emotional meaning is supported by bottom-up processes. Bidirectionality of embodiment can be effectively exploited by using body postures and movements associated with certain emotions, which we refer to as embodiment techniques, to deepen the physical experience of poorly felt emotions and support the valid construction of emotional meaning. This embodied approach offers several advantages: Prelinguistic or hard-to-grasp aspects can be identified more easily before being processed verbally. It is also easier to work with clients who have limited access to their emotions. Thus, in this paper we describe a new embodied CBT approach to working on the dysfunctional schema, which is based on three modules: body focus, emotional field, and interaction focus. In addition, using specific zones in the space of the therapy-room allows the embodiment of problematic interactions, as well as of power and powerlessness, closeness and distance, etc. Directly experiencing these processes on one's own body in the protected space of therapy allows faster and deeper insights than would be possible with conversations alone. Finally, the vitalizing power of emotions is used to create coherent action plans and successful interactions. This working method is illustrated by means of a case from practice.

The future of neuropsychology is digital, theory-driven, and Bayesian: a paradigmatic study of cognitive flexibility.

This study explores the transformative potential of digital, theory-driven, and Bayesian paradigms in neuropsychology by combining digital technologies, a commitment to evaluating theoretical frameworks, and Bayesian statistics. The study also examines theories of executive function and cognitive flexibility in a large sample of neurotypical individuals (N = 489). We developed an internet-based Wisconsin Card-Sorting Task (iWCST) optimized for online assessment of perseveration errors (PE). Predictions of the percentage of PE, PE (%), in non-repetitive versus repetitive situations were derived from the established supervisory attention system (SAS) theory, non-repetitive PE (%) < repetitive PE (%), and the novel goal-directed instrumental control (GIC) theory, non-repetitive PE (%) > repetitive PE (%). Bayesian t-tests revealed the presence of a robust error suppression effect (ESE) indicating that PE are less likely in repetitive situations than in non-repetitive situations, contradicting SAS theory with posterior model probability p < 0.001 and confirming GIC theory with posterior model probability p > 0.999. We conclude that repetitive situations support cognitive set switching in the iWCST by facilitating the retrieval of goal-directed, instrumental memory that associates stimulus features, actions, and outcomes, thereby generating the ESE in neurotypical individuals. We also report exploratory data analyses, including a Bayesian network analysis of relationships between iWCST measures. Overall, this study serves as a paradigmatic model for combining digital technologies, theory-driven research, and Bayesian statistics in neuropsychology. It also provides insight into how this integrative, innovative approach can advance the understanding of executive function and cognitive flexibility and inform future research and clinical applications.

Cost‐effectiveness of amyloid‐targeting therapies: modelling based on 5724 biomarker positive AD patients in the Swedish Registry of Cognitive Disorders

AbstractBackgroundLecanemab is an amyloid‐targeting therapy recently approved by the U.S. FDA for treatment of early Alzheimer’s disease. A phase III trial (Clarity AD) demonstrated a reduction of disease progression, however uncertainty remains around the long‐term health outcomes and implications for cost‐effectiveness. Previous economic evaluations have been limited by lack of long‐term follow‐up data on health outcomes and resource utilization in AD patients with biomarker‐confirmed amyloid pathology.Method5724 patients with longitudinal follow‐up data were included from the Swedish Registry of Cognitive Disorders (SveDem), linked to other data sources. Amyloid positivity was determined from the CSF beta amyloid 1‐42/p‐Tau ratio, with optimal cut‐off levels determined from Abeta 40/42 ratios. Patients were followed up to 12.9 years from diagnosis (mean 4.9 years). A disease model model was constructed with states defined by cognitive status (MCI/dementia, MMSE score) and care setting (community/institution). The semi‐Markov design allows transition probabilities to vary with time spend in individual states. Hazard rates for disease progression, institutionalization and mortality were estimated using semiparametric survival models based on SveDem linked to the municipal care and death registries. Costs by disease state were estimated from resource utilization data from the national patient and prescription drug registries on formal medical and community care. Health utility values by disease state were derived from previous observational studies in Sweden.ResultA therapy reducing disease progression to more severe cognitive states by 31% over a treatment period of 18 months (as in Clarity AD) was associated with savings in formal care costs of 41,000 SEK and 0.140 quality‐adjusted life‐years (QALYs) gained. At 1 million SEK per QALY, treatment would be cost‐effective at an annual cost of 121,000 SEK, including costs for diagnosis and monitoring. Almost half of estimated QALY gains were due to reduced mortality; setting survival equal in treated and untreated patients resulted in fewer QALYs gained but higher cost savings.ConclusionThis is the first study to report on the cost‐effectiveness of amyloid‐targeting therapy based on integrated disease progression and cost data from a large, representative cohort of amyloid‐positive early AD patients. Such data is of critical importance to enable cost‐effective introduction of lecanemab.

Clinical Assessment Tools for the Detection of Cognitive Impairment and Hearing Loss in the Ageing Population: A Scoping Review.

There is a strong association between cognitive impairment and hearing loss, both highly prevalent in the ageing population. Early detection of both hearing loss and cognitive impairment is essential in the management of these conditions to ensure effective and informed decisions on healthcare. The main objective was to identify existing and emerging cognitive and auditory assessment tools used in clinical settings (eg, memory clinics, audiology clinics), which manage the ageing population. A scoping review of peer-reviewed publications and results were reported according to the PRISMA-ScR guidelines. A total of 289 articles were selected for data extraction. The majority of studies (76.1%) were conducted in 2017 or later. Tests of global cognitive function (ie, Mini-Mental State Exam, Montreal Cognitive Assessment) were the most commonly used method to detect cognitive impairment in hearing healthcare settings. Behavioral hearing testing (ie, pure-tone audiometry) was the most commonly used method to detect hearing loss in cognitive healthcare settings. Objective, physiological measures were seldom used across disciplines. Preferences among clinicians for short, accessible tests likely explain the use of tests of global cognitive function and behavioral hearing tests. Rapidly evolving literature has identified inherent limitations of administering global cognitive function tests and pure-tone testing in an ageing population. Using electrophysiological measures as an adjunct to standard methods of assessment may provide more reliable information for clinical recommendations in those with cognitive and hearing impairment, and subsequently achieve better healthcare outcomes.