Cognitive Stages Research Articles

Clinically Relevant Changes for Cognitive Outcomes in Preclinical and Prodromal Cognitive Stages: Implications for Clinical Alzheimer Trials.

Clinically Relevant Changes for Cognitive Outcomes in Preclinical and Prodromal Cognitive Stages: Implications for Clinical Alzheimer Trials.

Application of artificial intelligence to the public health education.

With the global outbreak of coronavirus disease 2019 (COVID-19), public health has received unprecedented attention. The cultivation of emergency and compound professionals is the general trend through public health education. However, current public health education is limited to traditional teaching models that struggle to balance theory and practice. Fortunately, the development of artificial intelligence (AI) has entered the stage of intelligent cognition. The introduction of AI in education has opened a new era of computer-assisted education, which brought new possibilities for teaching and learning in public health education. AI-based on big data not only provides abundant resources for public health research and management but also brings convenience for students to obtain public health data and information, which is conducive to the construction of introductory professional courses for students. In this review, we elaborated on the current status and limitations of public health education, summarized the application of AI in public health practice, and further proposed a framework for how to integrate AI into public health education curriculum. With the rapid technological advancements, we believe that AI will revolutionize the education paradigm of public health and help respond to public health emergencies.

Retinal Vascular Changes in Alzheimer's Dementia and Mild Cognitive Impairment: A Pilot Study Using Ultra-Widefield Imaging.

Retinal microvascular abnormalities measured on retinal images are a potential source of prognostic biomarkers of vascular changes in the neurodegenerating brain. We assessed the presence of these abnormalities in Alzheimer's dementia and mild cognitive impairment (MCI) using ultra-widefield (UWF) retinal imaging. UWF images from 103 participants (28 with Alzheimer's dementia, 30 with MCI, and 45 with normal cognition) underwent analysis to quantify measures of retinal vascular branching complexity, width, and tortuosity. Participants with Alzheimer's dementia displayed increased vessel branching in the midperipheral retina and increased arteriolar thinning. Participants with MCI displayed increased rates of arteriolar and venular thinning and a trend for decreased vessel branching. Statistically significant differences in the retinal vasculature in peripheral regions of the retina were observed among the distinct cognitive stages. However, larger studies are required to establish the clinical importance of our findings. UWF imaging may be a promising modality to assess a larger view of the retinal vasculature to uncover retinal changes in Alzheimer's disease. This pilot work reports an investigation into which retinal vasculature measurements may be useful surrogate measures of cognitive decline, as well as technical developments (e.g., measurement standardization), that are first required to establish their recommended use and translational potential.

Russia’s domestic and international politics. No explanation without the cognitive-developmental approach

Russia’s war on Ukraine is not a failure by accident but reflects the mentality and stance of the Kremlin and greater parts of the Russian people. Russia’s international politics pursue imperial dreams, conducted by the most brutal methods. Obviously, the political consciousness of Russians has not progressed to the rates and standards that shape the minds and behavior of politicians and the electorate in the most advanced nations of our time. It is argued that political science must consider research conducted by the cognitive-developmental approach. Contemporary nations operate on differently developed stages of mind and cognition with far-reaching effects on moral reasoning, social understanding, and humanitarian standards. There is evidence that a weaker development of the fourth stage of human cognition, the stage of formal operations, accounts for backwardness concerning the process of civilization. This seems to be the main cause of the chasm between the “Russian World” and the “Free World”.

Crowdfunding as a Tool to Spread Good Attitudes in the Media and Support in Shaping Values in Human Life on the Example of the Production of the Film ABP Lefebvre – Why?

Goal – the research goal was to demonstrate the role of crowdfunding in the production of the analyzed film. Two theses result directly from the research goal and were formulated as follows: 1) Crowdfunding in the production of the film ABP Lefebvre – Why? is not the main source of financing; 2) The benefit of crowdfunding is the spread of good attitudes in the media and support in shaping values in human life and proclaiming the Catholic truth. Research methodology – the study uses descriptive research, which is an important stage of cognition because it creates an objective picture. The meaning of crowdfunding was preceded by a characterization of values in human life. As a part of the research methodology, the author of the article used the following research techniques as data collection methods: desk research, case study and an individual in-depth interview conducted with the film producers as part of the Filmowe Życiorysy PL project. Score/results – presentation of the importance of crowdfunding on the example of the production of the film ABP Lefebvre – Why? Crowdfunding can result in realizing many valuable and substantive projects, e.g. obtaining funds necessary for the production of a film, while engaging the community for which the subject of the film is important. However, crowdfunding was not the main source of financing in the case of the film ABP Lefebvre – Why?, it did not even constitute the majority share in the costs. Originality/value – the film about the archbishop is undoubtedly entering into the center of the hottest disputes in the Church, but also an opportunity to understand them better. This topic is rarely discussed in the literature. The paper covers both advantages and benefits and disadvantages and threats of crowdfunding as a tool to spread good attitudes in the media and the support in shaping values in human life. Crowdfunding, which enables partial financing of the film production of an important biography, has the potential to become a specific tool that brings people closer to God.

Constructivist Perspective on Developing a Multidimensional Blended Teaching Model Fostering Deep Learning

To promote high-quality development of higher education, it is imperative to facilitate students’ transition from surface learning to deep learning. Compared with surface learning that focuses on rote memorization, deep learning emphasizes meaningful learning based on understanding and transfer. It involves three progressively advanced cognitive stages of knowing: "learning for understanding," "learning for application," and "learning for innovation," which ultimately enable the internalization, transfer, and creative application of knowledge. How to foster deep learning in students has been an urgent issue of higher education. This study, grounded in constructivist learning theory, explores a multidimensional blended teaching model fostering deep learning. It also develops an evaluation system assessing learning outcomes from the perspectives of ideological, political and moral education, knowledge, and competencies. We conducted an empirical study to test the effectiveness of this multidimensional blended teaching model. Findings will provide theoretical and practical implications for teaching reforms of similar courses.

Opportunity (in)equity affects outcome evaluation at an early cognitive stage: Evidence from event-related potentials

Opportunity (in)equity affects outcome evaluation at an early cognitive stage: Evidence from event-related potentials

Dialectical Materialism and its Theory of Knowledge

This article explores the basic tenets of dialectical materialism and its theory of knowledge. Itis relevant to identifying the basics of dialectical materialistic philosophy and its cognitive theory. The article addresses the research problems concerning the primacy of thought or matter, the acceptance of the concept of the immutability of the cosmos or motion of matter,the source of knowledge, the validity of truth and morals, stages of cognition, and the utility of knowledge in changing the world.The article deals with the research problems through the review-based analysis of Marxist criticismsof the dialectical materialist philosophy and its cognitive theory. The article reveals that dialectical materialist philosophy believes in the primacy of matter and the motion of matter. The dialectical materialist theory of knowledge regards the objective world as the primary source of knowledge, rejects the idea of absolute and immutable truths and morals, believes in the dialectical relationship between perceptual and logical knowledge, and gives high priority to the application of the gained knowledge in changing the existing world.

Listen up! ADHD slows spoken-word processing in adverse listening conditions: Evidence from eye movements

BackgroundCognitive skills such as sustained attention, inhibition and working memory are essential for speech processing, yet are often impaired in people with ADHD. Offline measures have indicated difficulties in speech recognition on multi-talker babble (MTB) background for young adults with ADHD (yaADHD). However, to-date no study has directly tested online speech processing in adverse conditions for yaADHD. AimsGauging the effects of ADHD on segregating the spoken target-word from its sound-sharing competitor, in MTB and working-memory (WM) load. Methods and proceduresTwenty-four yaADHD and 22 matched controls that differ in sustained attention (SA) but not in WM were asked to follow spoken instructions presented on MTB to touch a named object, while retaining one (low-load) or four (high-load) digit/s for later recall. Their eye fixations were tracked. Outcomes and resultsIn the high-load condition, speech processing was less accurate and slowed by 140ms for yaADHD. In the low-load condition, the processing advantage shifted from early perceptual to later cognitive stages. Fixation transitions (hesitations) were inflated for yaADHD. Conclusions and implicationsADHD slows speech processing in adverse listening conditions and increases hesitation, as speech unfolds in time. These effects, detected only by online eyetracking, relate to attentional difficulties. We suggest online speech processing as a novel purview on ADHD. What this paper adds?We suggest speech processing in adverse listening conditions as a novel vantage point on ADHD. Successful speech recognition in noise is essential for performance across daily settings: academic, employment and social interactions. It involves several executive functions, such as inhibition and sustained attention. Impaired performance in these functions is characteristic of ADHD. However, to date there is only scant research on speech processing in ADHD. The current study is the first to investigate online speech processing as the word unfolds in time using eyetracking for young adults with ADHD (yaADHD). This method uncovered slower speech processing in multi-talker babble noise for yaADHD compared to matched controls. The performance of yaADHD indicated increased hesitation between the spoken word and sound-sharing alternatives (e.g., CANdle-CANdy). These delays and hesitations, on the single word level, could accumulate in continuous speech to significantly impair communication in ADHD, with severe implications on their quality of life and academic success. Interestingly, whereas yaADHD and controls were matched on WM standardized tests, WM load appears to affect speech processing for yaADHD more than for controls. This suggests that ADHD may lead to inefficient deployment of WM resources that may not be detected when WM is tested alone. Note that these intricate differences could not be detected using traditional offline accuracy measures, further supporting the use of eyetracking in speech tasks. Finally, communication is vital for active living and wellbeing. We suggest paying attention to speech processing in ADHD in treatment and when considering accessibility and inclusion.

Biblical and Anthropocentric Phraseologisms in Dmytro Dontsov’s Works: A Cognitive Aspect

The paper deals with Dontsov’s “phraseological speech” in the framework of cognitive linguistics. The ways of creating partially-authorial (biblical) and authorial (anthropocentric) phraseologisms are discussed and their assignment to different phraseological-semantic microfields is suggested. A number of Dontsov’s phraseologisms are viewed as linguomental pictures of the world that are potentially acceptable for a wider use.Methodologically, the research presents a cluster of general scholarly methods and those used in cognitive linguistics as well as special approaches developed in modern anthropocentric research. Methods of cognitive linguistics are of the utmost importance and include categorizing the phenomena of the objective reality and the interdisciplinary method of interpretation related to the correlation of language data with cultural studies, political science, ethnopsychology and other disciplines. Semantic and contextual analyses are also used as supplementary methods. The potential value of the research is ensured by its contribution to the modern anthropocentric linguistics that aims at studying language through its speaker.Structural-and-logical scheme illustrating the cognitive stages of generating a phraseologism is suggested and the importance of categorization of lingual phenomena is emphasized. Dontsov’s phraseologisms are claimed to be means of exposure of the national Ukrainian lingual picture, symbols of the national worldview, and the prism of the world perception and understanding.

Impact of Automation at Different Cognitive Stages on High-Speed Train Driving Performance

In the process of intelligent driving technology development, the performance of human–machine systems for high-speed train driving tasks has been scrutinized and challenged. The human cognitive process can be divided into several stages. Within each of these stages, automation can be applied across different levels. However, the impact of different automation levels at different cognitive stages on high-speed train driving performance is still unclear. In this study, different level of automation (LOA) of high-speed train driving functions at different cognitive stages are designed, and 30 participants are recruited to execute orthogonal Latin square experiments. The experimental results show that driving automation in the decision-making stage significantly improved performance in a speed control task but also increased the mental workload and reaction time for monitoring train signals. However, this effect did not occur in a track obstacle observation response time. These results show that driving automation not only improves the performance of primary driving tasks but also has a negative impact on secondary driving-related tasks. This study evaluates the influence of high-speed train driving automation on the performance of human–machine systems and analyzes the advantages and costs of different LOA at different cognitive stages. It provides a theoretical basis for the design of intelligent high-speed train driving systems from the perspective of human–machine collaboration.

Circadian age, chronological age, and Alzheimer’s dementia

AbstractBackgroundIn older adults, circadian rhythms show alterations in multiple dimensions with aging and during Alzheimer’s dementia progression. We propose that circadian function may serve as a unique gauge of biological age (i.e., circadian age), and that individuals with greater circadian age than chronological age have increased risk of Alzheimer’s dementia.MethodWe constructed a regression model with chronological age as the predicting target. The model prediction was termed circadian age. A softplus activation function was used to ensure positivity. The model was optimized to minimize the mean‐squared prediction error while penalizing the covariance between chronological age and prediction error. Cosinor analysis, nonparametric analysis, uniform phase empirical mode decomposition, and detrended fluctuation analysis were performed on baseline actigraphy data of 882 participants (age: 80.1±7.3; female/male: 692/190) from the Rush Memory and Aging Project who were cognitively intact and were not taking sleep medications. These analyses resulted in 23 features for circadian daily activity patterns as model inputs. The optimal model was trained through cross‐validation for the penalization parameter and applied to follow‐up actigraphy data. We compared circadian age among participants at different cognitive stages, evaluated the longitudinal change of circadian age, and examined the association of circadian age with incident Alzheimer’s dementia.ResultChronological age explained 24.8% of the variance in circadian age. At analytical baseline, participants with Alzheimer’s dementia had significantly greater circadian–chronological age deviation (CCD) than cognitively normal participants (2.98±1.43 vs. ‐0.13±0.42 years, p=0.04). For each 1‐year increase in chronological age, circadian age increased by 1.05±0.06 years (p<0.001), suggesting accelerated circadian aging. Among baseline cognitively normal participants, greater CCD was associated with an increased risk of Alzheimer’s dementia independent from chronological age, sex, total daily activity, sleep fragmentation, vascular disease and risk factors, and depressive symptoms. For a 10‐year increase in CCD, the hazard ratio was 1.23 (95% CI: 1.06‐1.42).ConclusionCircadian daily patterns can be integrated to predict chronological age. Older circadian age than chronological age is an independent risk factor for Alzheimer’s dementia. Future work should refine the determination of health status for training dataset and examine whether circadian age links with endogenous circadian function.

Different criteria modify Alzheimer’s disease diagnosis and prognosis

AbstractBackgroundAlzheimer’s disease (AD) has recently been reconceptualized into a dual entity, a biological disease, and a clinical syndrome. Following these advances, the National Institute on Aging – Alzheimer’s Association (NIA‐AA) and the International Working Group (IWG) released four updated diagnostic guidelines for AD diagnosis: NIA‐AA 2011, IWG 2016, NIA‐AA 2018, and IWG 2021. Although many studies still rely solely on a clinical diagnosis of AD, and a consensus on diagnostic criteria is still lacking. Here, we aim to elucidate how the aforementioned AD guidelines affect the individuals’ diagnostic label.MethodClinical, demographic and biomarker data were extracted from ADNI (n = 1215), and used to build classification algorithms according to diagnostic criteria from NIA‐AA 2011, IWG 2016, NIA‐AA 2018, and IWG 2021. Subjects then were labeled as Not AD (NA), At Risk of Developing AD (AR), or AD. Results were compared according to cognitive stage, cognitively unimpaired (CU) or cognitively impaired (CI), and to AD biomarkers profile. Kaplan‐Meier curves were used to evaluate conversion to CI in CU individuals using each diagnostic guideline. All analyses were performed in R (v 4.0.3).ResultIndividuals were diagnosed using criteria from the NIA‐AA 2011 [NA = 36.8%, AR = 23.2%, AD = 40%], IWG 2016 [NA = 37.9%, AR = 28.8%, AD = 33.3%], NIA‐AA 2018 [NA = 40.5%, AR = 11.1%, AD = 48.4%], and the IWG 2021 [NA = 51.3%, AR = 8.7%, AD = 40%] (Figure 1). Diagnoses were discordant between criteria in 39.8% of the individuals, with 69.4% of those being in the A+T‐ or A‐T+ biomarker groups. Conversion to CI of CU individuals AR compared to NA were calculated for the NIA‐AA 2011 [log‐rank 0,001], IWG 2016 [log‐rank 0,000], NIA‐AA 2018 [log‐rank 0,24], and IWG 2021 [log‐rank 0,000].ConclusionOur findings indicated that almost 40% of the studied population presented discordant diagnoses using different AD criteria. Most of these had only one positive biomarker (amyloid or tau). All guidelines except for the NIA‐AA 2018 managed to differentiate asymptomatic individuals at risk of developing cognitive impairment. Our findings have important implications in clinical practice and the design of future clinical trials.

Effects of Augmented Reality-Based Dual-Task Program on Physical Ability by Cognitive Stage with Developmental Disabilities.

People diagnosed with developmental disabilities are less likely to participate in physical activities even if they are provided opportunities. This study aimed to examine the effects of dual-task exercise-based augmented reality (AR) on muscle strength, muscle endurance, balance ability, and flexibility among people with developmental disabilities. Twenty-seven patients with developmental disabilities were included in the study. The intervention was based on an AR-based rehabilitation program and lasted for 8 weeks. The results showed a statistically significant improvement in muscle strength, muscle endurance, balance ability, and flexibility after the intervention (p < 0.05). The AR-based dual-task program increased interest and motivation in the high-cognitive-stage groups, while less interest and motivation were observed in the low-cognitive-stage groups. Our results suggest that an AR-based dual-task program can be an effective method to improve physical ability in patients with high cognitive levels.

A Head-to-Head Comparison Between Plasma pTau181 and Tau PET Along the Alzheimer's Disease Continuum.

Both plasma tau phosphorylated at threonine-181 (pTau181) and tau PET show potential for detecting Alzheimer's disease (AD) pathology and predicting clinical progression. In this study, we performed a head-to-head comparison between plasma pTau181 and tau PET along the AD continuum. Methods: We included participants from the Amsterdam Dementia Cohort who underwent 18F-flortaucipir (tau) PET and had a plasma sample biobanked within 12 mo from tau PET. Fifty subjective cognitive decline (SCD) participants (31 Aβ-negative and 19 Aβ-positive) and 60 Aβ-positive participants with mild cognitive impairment (MCI) or dementia due to AD were included. A subset had 2-y longitudinal plasma pTau181 and tau PET available (n = 40). Longitudinal neuropsychological test data covering 3.2 ± 2.7 y from both before and after tau PET were available. Plasma pTau181 and tau PET were compared in their accuracies in discriminating between cognitive stage (MCI/AD vs. SCD) and preclinical Aβ status (SCD Aβ-positive vs. SCD Aβ-negative), their associations with cross-sectional and longitudinal neuropsychological test performance, and their longitudinal changes over time. Results: When discriminating between preclinical Aβ status, the area under the curve (AUC) for plasma pTau181 (0.83) and tau PET (entorhinal, 0.87; temporal, 0.85; neocortical, 0.67) were equally high (all DeLong P > 0.05), but tau PET outperformed plasma pTau181 in discriminating MCI/AD from SCD (AUC for plasma pTau181: 0.74; AUCs for tau PET: entorhinal, 0.89; temporal, 0.92; neocortical, 0.89) (all P < 0.01). Overall, tau PET showed stronger associations with cognitive decline and was associated with a wider variety of cognitive tests than plasma pTau181 (plasma pTau181, -0.02 > β < -0.12; tau PET, -0.01 > β < -0.22). Both plasma pTau181 and tau PET increased more steeply over time in MCI/AD than in SCD (P < 0.05), but only tau PET annual changes were associated with cognitive decline. Conclusion: Our results suggest that plasma pTau181 and tau PET perform equally well in identifying Aβ pathology but that tau PET better monitors disease stage and clinical progression.

PELATIHAN ORIGAMI DAN POP-UP BAGI GURU TK DIAN PERTIWI UNTUK MEMPERKENALKAN HEWAN PELIHARAAN

&lt;p&gt;&lt;em&gt;Early Child Education (ECE) students, who are 3-6 years old, are in Pre-Operation cognitive stage, that trying to recognize all their surroundings. ECE schools manage to introduce them simple objects, animals, their families and others. Furthermore, school also train students to be ready for reading, writing and counting. Art lesson can be one method to introduce objects and their environment, also to practice their fine motor skills. TK Dian Pertiwi as one of ECE school also implement art lesson in their curriculum. However, since the teachers are having more concern on other skills development and not all of teachers are having interest and skill on art either, it is necessary to execute a training to upgrade teacher’s ability on developing and delivering the art lesson to the students in attractive and educative method, that it may expand students’ cognitive ability as well. Therefore, in January 10, 2022 Visual Communication Design Department of Bunda Mulia University executed a training for TK Dian Pertiwi Teachers as community service activity. The training titled“Creative Origami and Pop Up to Introduce Pet Animals for ECE Students”, was executed online using Gmeet platform, due to Large Scale Social Restriction Policy announced by Republic of Indonesia government caused by Covid-19 Pandemic. The training was divided into two sessions to explain about origami and pop up. Both sessions presented information such as history, benefit, types, basic technic, materials, and demonstration about how to make origami and pop-up forming pet animals, such as cat, dog, rabbit, and other pets. The participant followed both demonstration by doing the instruction and making their own origami and pop up. After the training participants are able to create pet animals using origami and pop-up technics, choosing appropriate materials, recognize the benefit of both technics and having inspiration to develop the art lessons.&lt;/em&gt;&lt;/p&gt;

건축의 표면의 특성이 날카로운 조형의 위협성 인지에 미치는 영향에 관한 연구

Designers express diverse opinions on how to apply sharp shapes in buildings. Sharply-changed contour of sharp shapes is one visual primitive that can be quickly extracted by people1). As a critical part of architectural design, architectural surface boasts of some characteristics that affect brain to recognize threat of sharp contours. In this day with diversified aesthetics, aesthetics rests with audience’s visual perception and cognition of objective objects, as well as their professional knowledge, life experience, thoughts and culture. In the course of evolution, general aesthetic awareness acquired by the brain is minimally impacted by subjective factors. Under the background, this study, on neuroscience view, adopts interdisciplinary approach to explain brain’s perception mechanism to threats and selective attention mechanism by applying interdisciplinary approach. Starting with analyzing five stages of aesthetic cognition, it exposes brain’s preference for characteristics in line with survival instinct, such as “transparency” and “reflection”, in accordance with viewpoint of evolutionary aesthetics. Aesthetic preference can be triggered by both materials, and permeability of architectural shape structures. In summary, this study aims to reveal reasons of threat perception and attraction of sharp shapes, so as to determine influence of surface characteristics on cognition and aesthetic effects of sharp shapes. It is hoped to provide scientific references and proposals for applying surface characteristics in buildings with sharp shapes.

EEG reveals deficits in sensory gating and cognitive processing in asymptomatic adults with a history of concussion

ABSTRACT Objective Individuals with a concussion history tend to perform worse on dual-tasks compared controls but the underlying neural mechanisms contributing to these deficits are not understood. This study used event-related potentials (ERPs) to investigate sensory gating and cognitive processing in athletes with and without a history of concussion while they performed a challenging dual-task. Methods We recorded sensory (P50, N100) and cognitive (P300) ERPs in 30 athletes (18 no previous concussion; 12 history of concussion) while they simultaneously performed an auditory oddball task and a working memory task that progressively increased in difficulty. Results The concussion group had reduced auditory performance as workload increased compared to the no-concussion group. Sensory gating and cognitive processing were reduced in the concussion group indicating problems with filtering relevant from irrelevant information and appropriately allocating resources. Sensory gating (N100) was positively correlated with cognitive processing (P300) at the hardest workload in the no-concussion group but negatively correlated in the concussion group. Conclusion Concussions result in long-term problems in behavioral performance, which may be due to poorer sensory gating that impacts cognitive processing. Significance Problems effectively gating sensory information may influence the availability or allocation of attention at the cognitive stage in those with a concussion.

Stage-dependent differential influence of metabolic and structural networks on memory across Alzheimer's disease continuum.

Large-scale neuronal network breakdown underlies memory impairment in Alzheimer's disease (AD). However, the differential trajectories of the relationships between network organisation and memory across pathology and cognitive stages in AD remain elusive. We determined whether and how the influences of individual-level structural and metabolic covariance network integrity on memory varied with amyloid pathology across clinical stages without assuming a constant relationship. Seven hundred and eight participants from the Alzheimer's Disease Neuroimaging Initiative were studied. Individual-level structural and metabolic covariance scores in higher-level cognitive and hippocampal networks were derived from magnetic resonance imaging and [18F] fluorodeoxyglucose positron emission tomography using seed-based partial least square analyses. The non-linear associations between network scores and memory across cognitive stages in each pathology group were examined using sparse varying coefficient modelling. We showed that the associations of memory with structural and metabolic networks in the hippocampal and default mode regions exhibited pathology-dependent differential trajectories across cognitive stages using sparse varying coefficient modelling. In amyloid pathology group, there was an early influence of hippocampal structural network deterioration on memory impairment in the preclinical stage, and a biphasic influence of the angular gyrus-seeded default mode metabolic network on memory in both preclinical and dementia stages. In non-amyloid pathology groups, in contrast, the trajectory of the hippocampus-memory association was opposite and weaker overall, while no metabolism covariance networks were related to memory. Key findings were replicated in a larger cohort of 1280 participants. Our findings highlight potential windows of early intervention targeting network breakdown at the preclinical AD stage. Data collection and sharing for this project was funded by the Alzheimer's Disease Neuroimaging Initiative (ADNI) (National Institutes of Health Grant U01 AG024904) and DOD ADNI (Department of Defense award number W81XWH-12-2-0012). We also acknowledge the funding support from the Duke NUS/Khoo Bridge Funding Award (KBrFA/2019-0020) and NMRC Open Fund Large Collaborative Grant (OFLCG09May0035).

Which Test Is the Best to Assess Visuo-Cognitive Impairment in Patients with Parkinson’s Disease with Mild Cognitive Impairment and Dementia? A Systematic Review and Meta-Analysis

Visuo-cognitive impairment is common in patients with Parkinson's disease with mild cognitive impairment (PD-MCI) and constitutes a prognostic factor for the conversion to Parkinson's disease dementia (PDD). However, systematic analyses on which neuropsychological tests are most suitable to assess visuo-cognition in PD-MCI and PDD and to differentiate these cognitive stages are lacking. To review neuropsychological tests used to assess visuo-cognition including visuo-perceptual and visuo-spatial processing, visuo-constructive copying and drawing on command abilities; and to identify the visuo-cognitive subdomain as well as tests most suitable to discriminate between PD-MCI and PDD. MEDLINE, PsycINFO, Web of Science Core Collection, and CENTRAL were systematically searched for relevant studies assessing visuo-cognitive outcomes in patients with PD-MCI and PDD. Risk of bias was assessed using a customized form based on well-established tools. Random-effect meta-analyses were conducted. 33 studies were included in the systematic review. Data of 19 studies were entered in meta-analyses. Considerable heterogeneity regarding applied tests, test versions, and scoring systems exists. Data indicate that visuo-constructive command tasks are the subdomain best suited to discriminate between PD-MCI and PDD. Furthermore, they indicate that the Rey-Osterrieth-Complex-Figure Test (ROCF), Corsi Block-Tapping Test, Judgment of Line Orientation (JLO), and Clock Drawing Test (CDT) are tests able to differentiate between the two stages. We provide suggestions for suitable visuo-cognitive tests (Corsi Block-Tapping Test, or JLO, ROCF, CDT) to improve diagnostic accuracy. Methodological challenges (e.g., heterogeneity of definitions, tests) are discussed and suggestions for future research are provided. https://www.crd.york.ac.uk/prospero/, ID: CRD42018088244.