Cognitive Trajectories Research Articles

Associations of Amyloid Burden, White Matter Hyperintensities, and Hippocampal Volume With Cognitive Trajectories in the 90+ Study.

Associations of Amyloid Burden, White Matter Hyperintensities, and Hippocampal Volume With Cognitive Trajectories in the 90+ Study.

Role of Cardiovascular Risk in Associations of Brain-Derived Neurotrophic Factor with Longitudinal Brain and Cognitive Trajectories in Older Adults

ABSTRACT Background Higher levels of brain-derived neurotrophic factor (BDNF) have been associated with better neurocognitive outcomes. BDNF is present in cardiovascular tissue, and some evidence suggests it may benefit cardiovascular function. The current study assessed whether there is a mediating and/or moderating role of cardiovascular health in the relationship between BDNF and brain and cognitive outcomes. Method We examined longitudinal data from 397 older adults (aged 54–89;164 females, 233 males) enrolled in the Alzheimer’s Disease Neuroimaging Initiative with available plasma BDNF, medical, neuroimaging, and cognitive assessments. We used path analysis and linear regression to estimate the mediating and moderating roles of two measures of cardiovascular health, the Framingham Risk Score (FRS) and pulse pressure, in the relationships between BDNF and longitudinal changes in brain structure (white matter hyperintensity volume, hippocampal volume, and primary visual cortex volume) and cognitive function (executive function, episodic memory, and language). Results There was no significant association of plasma BDNF with FRS or pulse pressure (ps > 0.31), precluding mediation. There were no robust associations between BDNF and longitudinal change in any brain structural or cognitive measures (ps > .12). Higher FRS was significantly associated with greater increases in WMH volume (ps < .01). FRS and pulse pressure were not associated with any other brain structural or cognitive outcomes (ps > .07). Conclusion These results suggest that cardiovascular health may not play an important role in the influence of BDNF on neurocognitive health in older adults.

Distinct brain and neurocognitive transformations after bariatric surgery: a pilot study

BackgroundObese patients have worse outcomes after surgery and are at increased risk for perioperative neurocognitive disorders (PND). Our aim was to detail the cognitive trajectories of patients undergoing bariatric surgery (BS) and map distinct structural brain changes using magnetic resonance imaging (MRI) to better understand the association between the vulnerable brain, surgery, and the arc of PND.MethodsProspective pilot study with longitudinal comprehensive cognitive assessments and MRI were performed on obese patients scheduled for BS. We analyzed baseline cognitive function and high-resolution T1-/T2-weighted brain images on 19 obese patients [age, 54 (9) years, BMI, 40 (36, 42) kg m−2] and compared with 50 healthy control subjects [age, 52 (6) years; BMI, 25 (24, 27) kg m−2]. Patients were evaluated within five days of BS (baseline), immediately after (within 48h), and follow up at six months.ResultsAt baseline, obese patients had significant brain tissue changes seen in MRI and decreased cognitive scores compared to controls (MoCA 26 vs 28, P = 0.017). Surgery induced further gray matter volume and brain tissue changes along with reduced cognitive scores within the immediate postoperative period (MoCA 26 vs 24, P &amp;lt; 0.001). At six months, we observed reversal of brain alterations for most patients and a concomitant rebound of cognitive scores to patient’s baseline status.ConclusionsBariatric surgery resulted in worsening of preexisting brain structural integrity and lower cognitive function for obese patients compared to baseline. These distinct brain lesions are consistent with specific domains of cognition. Most of these changes reverted to patient’s baseline condition within six months after surgery.

Relationship between MRI brain-age heterogeneity, cognition, genetics and Alzheimer’s disease neuropathology

Brain ageing is highly heterogeneous, as it is driven by a variety of normal and neuropathological processes. These processes may differentially affect structural and functional brain ageing across individuals, with more pronounced ageing (older brain age) during midlife being indicative of later development of dementia. Here, we examined whether brain-ageing heterogeneity in unimpaired older adults related to neurodegeneration, different cognitive trajectories, genetic and amyloid-beta (Aβ) profiles, and to predicted progression to Alzheimer's disease (AD). Functional and structural brain age measures were obtained for resting-state functional MRI and structural MRI, respectively, in 3460 cognitively normal individuals across an age range spanning 42-85 years. Participants were categorised into four groups based on the difference between their chronological and predicted age in each modality: advanced age in both (n=291), resilient in both (n=260) or advanced in one/resilient in the other (n=163/153). With the resilient group as the reference, brain-age groups were compared across neuroimaging features of neuropathology (white matter hyperintensity volume, neuronal loss measured with Neurite Orientation Dispersion and Density Imaging, AD-specific atrophy patterns measured with the Spatial Patterns of Abnormality for Recognition of Early Alzheimer's Disease index, amyloid burden using amyloid positron emission tomography (PET), progression to mild cognitive impairment and baseline and longitudinal cognitive measures (trail making task, mini mental state examination, digit symbol substitution task). Individuals with advanced structural and functional brain-ages had more features indicative of neurodegeneration and they had poor cognition. Individuals with a resilient brain-age in both modalities had a genetic variant that has been shown to be associated with age of onset of AD. Mixed brain-age was associated with selective cognitive deficits. The advanced group displayed evidence of increased atrophy across all neuroimaging features that was not found in either of the mixed groups. This is in line with biomarkers of preclinical AD and cerebrovascular disease. These findings suggest that the variation in structural and functional brain ageing across individuals reflects the degree of underlying neuropathological processes and may indicate the propensity to develop dementia in later life. The National Institute on Aging, the National Institutes of Health, the Swiss National Science Foundation, the Kaiser Foundation Research Institute and the National Heart, Lung, and Blood Institute.

Predictive ability of the Cancer and Aging Research Group chemotherapy toxicity calculator in hematologic malignancy

IntroductionChemotherapy toxicity tools are rarely studied in patients with hematologic malignancy (HM). The primary aim of this pilot study was to determine the predictive ability of the Cancer and Aging Research Group (CARG) chemo-toxicity calculator in estimating grade 3–5 toxicity in patients with HM. Materials and MethodsPatients 60 years and older with HM were prospectively evaluated using the CARG chemo-toxicity calculator. Discrimination and calibration were checked by applying the published model in our data. Additionally, a full geriatric assessment (GA), the Short Physical Performance Battery (SPPB), and health related quality of life (HRQoL) were captured longitudinally at the start of treatment and at end of study. Secondary aims explored the association of GA metrics with chemo-related toxicities and survival. ResultsOne hundred forty-five patients were approached, 118 patients consented, and 97 patients were evaluable. Most patients were newly diagnosed (n = 91). The median CARG score was 9 (range 4–18). The CARG score was not validated in our cohort of older patients with HM, with area under the receiver operation characteristic curve being 0.53 (95 % CI: 0.41–0.65). In multivariable analysis, after controlling for disease type, risk factors associated with grade 3–5 toxicity included living alone (hazard ratio [HR] 4.24, 95 %CI: 2.07–8.68, p < 0.001), increase in body mass index (HR 1.06, 95 %CI: 1.01–1.12, p = 0.03) and a higher social activities score (HR 1.27, 95 %CI: 1.06–1.51, p = 0.01). In multivariable analysis of overall survival, the only prognostic factor was an objective marker of physical function (SPPB score HR = 0.85, 95 %CI:0.78–0.93, p < 0.001). DiscussionThe CARG chemo-toxicity calculator was not predictive of grade 3–5 toxicity in patients with hematologic malignancy. The SPPB was associated with overall survival in multivariable analysis, suggesting future use as an objective biomarker in HM. We also report a comprehensive trajectory of function, QoL, psychosocial well-being, and cognition among older adults with HM. The predictive accuracy of the CARG chemo-toxicity calculator may be affected by the diverse range of HM treatment options that are not traditional chemotherapy.

Cognitive, adaptive and daily life functioning in adults with 22q11.2 deletion syndrome.

22q11.2 deletion syndrome (22q11.2DS) is associated with cognitive impairments and an increased risk of psychopathology. Most of the research has been conducted in children and adolescents, although the majority of affected individuals live well into adulthood. Hence, limited data are available on functional outcomes in adults. To provide more insight in cognitive and adaptive abilities, and daily life functioning (marital status, living situation and work situation) in adults with 22q11.2DS. This retrospective study included 250 Dutch-speaking adults (16-69 years) with 22q11.2DS from three sites in The Netherlands and Belgium. Data on full-scale IQ (FSIQ) scores (assessed with the Wechsler Adult Intelligence Scale), adaptive functioning (assessed with the Vineland Adaptive Behavior Scale II), and functional outcomes including marital status, living and work situation were systematically collected from clinical files. In addition, we examined predictors of adaptive functioning. The majority of individuals in our adult sample demonstrated a low level of adaptive functioning (65%). In contrast to previous findings in children and adolescents, the majority functioned at an intellectual disability level (56%). Male sex, lower FSIQ and autism spectrum disorder were predictors of lower adaptive functioning (P = 0.016, P < 0.001 and P = 0.16, respectively). These results suggest that low levels of cognitive and adaptive functioning are common in adults with 22q11.2DS. Future longitudinal and multicentre studies including older patients (>40 years) are needed to further investigate cognitive and adaptive trajectories and their interactions with physical and psychiatric comorbidities.

Using interpretable deep learning radiomics model to diagnose and predict progression of early AD disease spectrum: a preliminary [18F]FDG PET study.

In this study, we propose an interpretable deep learning radiomics (IDLR) model based on [18F]FDG PET images to diagnose the clinical spectrum of Alzheimer's disease (AD) and predict the progression from mild cognitive impairment (MCI) to AD. This multicentre study included 1962 subjects from two ethnically diverse, independent cohorts (a Caucasian cohort from ADNI and an Asian cohort merged from two hospitals in China). The IDLR model involved feature extraction, feature selection, and classification/prediction. We evaluated the IDLR model's ability to distinguish between subjects with different cognitive statuses and MCI trajectories (sMCI and pMCI) and compared results with radiomic and deep learning (DL) models. A Cox model tested the IDLR signature's predictive capability for MCI to AD progression. Correlation analyses identified critical IDLR features and verified their clinical diagnostic value. The IDLR model achieved the best classification results for subjects with different cognitive statuses as well as in those with MCI with distinct trajectories, with an accuracy of 76.51% [72.88%, 79.60%], (95% confidence interval, CI) while those of radiomic and DL models were 69.13% [66.28%, 73.12%] and 73.89% [68.99%, 77.89%], respectively. According to the Cox model, the hazard ratio (HR) of the IDLR model was 1.465 (95% CI: 1.236-1.737, p < 0.001). Moreover, three crucial IDLR features were significantly different across cognitive stages and were significantly correlated with cognitive scale scores (p < 0.01). Preliminary results demonstrated that the IDLR model based on [18F]FDG PET images enhanced accuracy in diagnosing the clinical spectrum of AD. Question The study addresses the lack of interpretability in existing DL classification models for diagnosing the AD spectrum. Findings The proposed interpretable DL radiomics model, using radiomics-supervised DL features, enhances interpretability from traditional DL models and improves classification accuracy. Clinical relevance The IDLR model interprets DL features through radiomics supervision, potentially advancing the application of DL in clinical classification tasks.

Effects of brain microRNAs in cognitive trajectory and Alzheimer’s disease

microRNAs (miRNAs) have a broad influence on gene expression; however, we have limited insights into their contribution to rate of cognitive decline over time or Alzheimer’s disease (AD). Given this, we tested associations of 528 miRNAs with cognitive trajectory, AD hallmark pathologies, and AD clinical diagnosis using small RNA sequencing from the dorsolateral prefrontal cortex of 641 community-based donors. We found 311 miRNAs differentially expressed in AD or its endophenotypes after adjusting for technical and sociodemographic variables. Among these, 137 miRNAs remained differentially expressed after additionally adjusting for several co-occurring age-related cerebral pathologies, suggesting that some miRNAs are associated with the traits through co-occurring pathologies while others through mechanisms independent from pathologies. Pathway enrichment analysis of downstream targets of these differentially expressed miRNAs found enrichment in transcription, postsynaptic signalling, cellular senescence, and lipoproteins. In sex-stratified analyses, five miRNAs showed sex-biased differential expression for one or more AD endophenotypes, highlighting the role that sex has in AD. Lastly, we used Mendelian randomization to test whether the identified differentially expressed miRNAs contribute to the cause or are the consequence of the traits. Remarkably, 15 differentially expressed miRNAs had evidence consistent with a causal role, laying the groundwork for future mechanistic studies of miRNAs in AD and its endophenotypes.

Dual group-based trajectories of physical activity and cognitive function in aged over 55: a nationally representative cohort study.

As individuals age, they commonly experience reduced physical activity and cognitive decline. While evidence, there is limited trajectory research on their concurrent progression and interrelation in individuals over 55 years old. The data was collected from 5,765 individuals aged over 55 years who participated in the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2020. Physical activity was measured by IPAQ, cognitive function by episodic memory, and mental intactness score. Separate sets of group-based trajectory models were fitted to identify physical activity trajectories and cognitive function trajectories. Multivariate logistic regression was used to estimate the association between baseline characteristics and each set of trajectories. Group-based dual trajectory modeling (GBDTM) was applied to quantify these associations. GBDTM identified three distinct trajectory groups for physical activity and cognitive outcomes. The physical activity trajectories were classified as "Persistently low physical activity" (74.2%), "Decreasing physical activity" (13.7%), and "Rising physical activity" (12.1%). Similarly, cognitive function trajectories were categorized as "Persistently low cognitive function" (22.2%), "Persistently moderate cognitive function" (37.9%), and "Persistently high cognitive function" (39.9%). Notably, 15.6% of participants followed the trajectories of "Persistently low physical activity" and "Persistently low cognitive function." The presence of a severe decline in physical activity was associated with an increased likelihood of poor cognitive function and vice versa. Age, sex, education, residential status, BMI, and visual impairment were identified as significant predictors for physical activity and cognitive decline. This study found that the GBDTM can determine the consistent trajectories of physical activity and cognitive function trajectories that persistently decline in individuals over 55 years. Analyses of predictive factors can be instrumental in promoting physical activity and delaying cognitive decline.

Subjective memory complaints and the effect of a multidomain lifestyle intervention on cognition - the FINGER trial.

Older people reporting subjective memory complaints (SMCs) may have greater risk of cognitive decline. Multidomain lifestyle interventions are a promising strategy for the prevention of cognitive decline. The aim of this study was to investigate whether the presence of SMCs affects the efficacy of a 2-year multidomain lifestyle intervention on cognition. This study is part of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) project. Participants (a sub-sample of 568 individuals, baseline age 60 to 77 years) were randomized (1:1) to receive a 2-year multidomain lifestyle intervention group including dietary advice, exercise, cognitive training, and vascular risk management, or regular health advice control group. Cognitive performance was assessed at baseline and at 1- and 2-year visits, using a neuropsychological test battery, including tests assessing memory, executive functions, and processing speed. Participants rated the frequency of SMCs using the Prospective and Retrospective Memory Questionnaire. Having more retrospective SMCs was linked to a less favorable cognitive trajectory over 2 years. The difference between the intervention and control groups in annual change in tested memory performance was 0.077 (95 % CI 0.008-0.146) among those reporting more retrospective SMCs and -0.011 (-0.074-0.053) among those with less SMCs; interaction effect p=0.019. No other interactions between SMCs and intervention allocation were observed. A lifestyle intervention may be beneficial for older adults with and without SMCs. Persons having more retrospective SMCs may benefit more from the intervention regarding memory functioning.

Motor and Cognitive Trajectories in Infants and Toddlers with and at Risk of Cerebral Palsy Following a Community-Based Intervention

Motor and Cognitive Trajectories in Infants and Toddlers with and at Risk of Cerebral Palsy Following a Community-Based Intervention

Autoantibodies to BACE1 promote Aβ accumulation and neurodegeneration in Alzheimer's disease.

The profile of autoantibodies is dysregulated in patients with Alzheimer's disease (AD). Autoantibodies to beta-site amyloid precursor protein (APP)-cleaving enzyme 1 (BACE1) are present in human blood. This study aims to investigate the clinical relevance and pathophysiological roles of autoantibodies to BACE1 in AD. Clinical investigations were conducted in two independent cohorts, the Chongqing cohort, and the Australian Imaging, Biomarkers, and Lifestyle (AIBL) cohort. The Chongqing cohort included 55 AD patients, 28 patients with non-AD dementia, and 70 cognitively normal subjects (CN). The AIBL cohort included 162 Aβ-PET- CN, 169 Aβ-PET+ cognitively normal subjects (preclinical AD), and 31 Aβ-PET+ cognitively impaired subjects (ClinicalAD). Plasma autoantibodies to BACE1 were determined by one-site Elisa. The associations of plasma autoantibodies to BACE1 with brain Aβ load and cognitive trajectory were investigated. The effects of autoantibodies to BACE1 on AD-type pathologies and underlying mechanisms were investigated in APP/PS1 mice and SH/APPswe/PS1wt cell lines. In the Chongqing cohort, plasma autoantibodies to BACE1 were higher in AD patients, in comparison with CN and non-AD dementia patients. In the AIBL cohort, plasma autoantibodies to BACE1 were highest in clinical AD patients, followed by preclinical AD and CN subjects. Higher autoantibodies to BACE1 were associated with an increased incidence of brain amyloid positivity conversion during follow-up. Autoantibodies to BACE1 exacerbated brain amyloid deposition and subsequent AD-type pathologies, including Tau hyperphosphorylation, neuroinflammation, and neurodegeneration in APP/PS1 mice. Autoantibodies to BACE1 increased Aβ production by promoting BACE1 expression through inhibiting PPARγ signaling. These findings suggest that autoantibodies to BACE1 are pathogenic in AD and the upregulation of these autoantibodies may promote the development of the disease. This study offers new insights into the mechanism of AD from an autoimmune perspective.

Pre-COVID-19 cognitive social capital trajectories and peri-COVID-19 depression in China, 2014–2020: A longitudinal study

BackgroundSocial capital is dynamic; however, little is known about the association of its dynamics with peri-pandemic health. We examined the longitudinal association of pre-COVID-19 cognitive social capital trajectories with peri-COVID-19 depressive symptoms and the moderating effect of province-level COVID-19 severity on the association in China. MethodsWe employed four-wave data from China Family Panel Studies between 2014 and 2020. Depressive symptoms in 2020 were measured by the 8-item Center for Epidemiological Studies-Depression Scale. Pre-COVID-19 cognitive social capital from 2014 to 2018 included dichotomized (high/low) generalized trust, trust in neighbors, trust in local government officials, and reciprocity, each of which included five trajectories: persistently low, decreased, fluctuated, increased, and persistently high. Province-level COVID-19 severity in 2020 was a factor score constructed by the number of provincial COVID-19 cases and deaths. We conducted mixed-effects linear regression to answer our research question. ResultsPersistently low generalized trust (β: 0.46; 95 % CI: 0.15,0.78), persistently low (β: 0.57; 95 % CI: 0.22, 0.92), decreased (β: 0.36; 95 % CI: 0.07, 0.65) and increased (β: 0.40; 95 % CI: 0.12, 0.68) trust in neighbors, and persistently low (β: 0.39; 95 % CI: 0.02, 0.77) and decreased (β: 0.68; 95 % CI: 0.38, 0.97) reciprocity, compared with their persistently high trajectories, were associated with a higher level of peri-COVID-19 depressive symptoms. We did not find robust evidence to support the moderating effect of province-level COVID-19 severity. ConclusionsLong-term strategies to increase cognitive social capital and prevent cognitive social capital decline are needed to protect mental health against a pandemic.

Pathway enrichment in genome-wide analysis of longitudinal Alzheimer's disease biomarker endophenotypes.

The genetic pathways that influence longitudinal heterogeneous changes in Alzheimer's disease (AD) may provide insight into disease mechanisms and potential therapeutic targets. Longitudinal endophenotypes from the Alzheimer's Disease Neuroimaging Initiative (ADNI) representing amyloid, tau, neurodegeneration (A/T/N), and cognition were selected. Genome-wide association analysis was performed using a linear mixed model (LMM) approach, followed by gene and pathway enrichment with significant and functionally relevant SNPs. A total of 33 and 19 statistically significant pathways were identified associating with the intercept and longitudinal trajectory, respectively. The longitudinal intercept pathways represent eight groups: immune, metabolic, cell growth and survival, DNA maintenance, neuronal signaling, RAS/MAPK/ERKsignalingpathways, vesicle and lysosomal transport, and transcription modification. Longitudinal trajectory pathways represented six groups: Immune, metabolic, cell signaling, cytoskeleton, and glycosylation. Longitudinal enrichment identified pathways that uniquely associate with trajectories of key AD biomarkers and cognition, providing new insight into AD course-related mechanisms and potential new therapeutic targets. A systematic genome-wide analysis with longitudinal AD biomarker endophenotypes was performed. Enriched pathways were identified with functionally derived SNP to gene analysis. Fifty-two pathways were associated with longitudinal trajectory and intercept. Many of the identified pathways are specific steps in larger pathways implicated in AD. The identified pathways may provide therapeutic targets and areas for further study.

Association of Adherence to a MIND-Style Diet With the Risk of Cognitive Impairment and Decline in the REGARDS Cohort.

Diet may influence the development of cognitive impairment and affect cognitive decline, but whether this relationship varies between Black American and White American people is unclear. This study examined the association of Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) and incident cognitive impairment and cognitive trajectories in a biracial prospective cohort study. Using data derived from the Food Frequency Questionnaire in the REasons for Geographic and Racial Differences in Stroke study, we compared MIND diet adherence with incident cognitive impairment and cognitive trajectory in Black participants and White participants. Logistic regression was used to model MIND diet score (continuous variable and using tertiles) and incident cognitive impairment after adjusting for age, sex, race, region, education, income, total energy, hypertension history, dyslipidemia, diabetes, estimated glomerular filtration rate, ischemic heart conditions, atrial fibrillation, and lifestyle factors including sedentary, obesity, and smoking. Mixed-effects models were used to examine the association between cognitive trajectory and MIND diet adherence. Dietary data to calculate the MIND diet score and cognitive data were available on 14,145 participants with a mean age of 64 years (SD 9.0 years) that was 56.7% female. Greater MIND diet adherence was associated with a decreased incidence of cognitive impairment (odds ratio [OR] 0.96, 95% CI 0.93-0.99, p = 0.02) after adjusting for all covariates. In the fully adjusted model, greater MIND diet adherence was associated with decreased risk of cognitive impairment in female participants (OR 0.92, 95% CI 0.89-0.96, p < 0.001) but not in male participants (OR 1.01, 95% CI 0.97-1.06, p = 0.64). In all models, greater MIND diet adherence was associated with decreased risk of cognitive decline. MIND diet adherence was a better predictor of cognitive decline in Black participants (β = 0.04, SE = 0.007, p < 0.001) than in White participants (β = 0.03, SE = 0.004, p < 0.001). Greater MIND diet adherence was associated with decreased risk of cognitive impairment in female participants but not male participants, with no difference between Black participants and White participants. However, MIND diet adherence was a better predictor of cognitive trajectory in Black participants than in White participants.

Innovations and challenges in predicting cognitive trajectories after stroke.

This scientific commentary refers to 'Deep learning disconnectomes to accelerate and improve long-term predictions for post-stroke symptoms', by Matsulevits et al. (https://doi.org/10.1093/braincomms/fcae338).

Cognitive Trajectories and Associated Social and Behavioral Determinants Among Racial/Ethnic Minority Older Adults in the United States.

Despite higher risks of developing Alzheimer's disease and Alzheimer's disease-related dementias (AD/ADRD) among racial/ethnic minority populations, some maintain good cognition until old age. This study aimed to investigate heterogeneous cognitive trajectories among non-Hispanic Black and Hispanic older adults, examine cognitive impairment prevalence across trajectory classes, and identify associated social and behavioral determinants. Using 11 waves of data from the Health and Retirement Study (1996-2016), 1,322 non-Hispanic Black and 747 Hispanic adults aged 50 + with normal cognition in 1996 were included. Latent class growth modeling and multinomial logistic regressions were performed to examine cognitive trajectories and associated determinants. For both racial/ethnic groups, three trajectory classes were identified: high, medium, and low cognition. In the low cognition class, 87% and 100% of non-Hispanic Black and Hispanic participants developed cognitive impairment. For both racial/ethnic groups, older age and living in rural areas during school time increased the likelihood of being in the low cognition class, while more education was associated with a lower likelihood. Unique risk and protective determinants for non-Hispanic Black and Hispanic participants were also identified. This study reveals the heterogeneity of cognitive trajectories among racial/ethnic minority older adults and various associated social and behavioral determinants. More prevention interventions and accessible, affordable diagnosis and treatment should be provided to older racial/ethnic minorities with these characteristics to reduce disparities. More research is needed to further explore associations between unique determinants and cognition in racial/ethnic minority populations to better inform interventions.

Becoming a "Hungry Mind": Stability and Change in Need for Cognition across Adolescence.

Need for Cognition has been established as a key intellectual investment trait shaping students' academic development. However, little is yet known about its malleability, particularly in youth. This study investigated stability and change in Need for Cognition in a large longitudinal sample of 3409 adolescents from 166 classes in 27 schools in Flanders. Participants reported on their Need for Cognition in Grades 7, 8, 11 and 12. First, the latent rank-order stability of Need for Cognition between Grades 7 and 11 was found to be r = 0.50. This stability was of a similar magnitude to that of the Big Five personality traits observed in the same sample and larger than that of academic intrinsic motivation. Second, trajectories of Need for Cognition over time were found to vary between individuals. In particular, three trajectory classes could be identified, differentiated mainly by the initial level of Need for Cognition (i.e., a low, medium, and high trajectory). Finally, cognitive ability, cognitive stimulation at home, and parental autonomy support, but not parental educational level, were associated with higher odds of belonging to the high Need for Cognition trajectory and lower odds of belonging to the low Need for Cognition trajectory.

Age differences in the change in cognition after stroke

ObjectiveTo compare changes in cognitive trajectories after stroke between younger (18-64) and older (65+) adults, accounting for pre-stroke cognitive trajectories. Materials and methodsPooled cohort study using individual participant data from 3 US cohorts (1971-2019), the Atherosclerosis Risk In Communities Study (ARIC), Framingham Offspring Study (FOS), and REasons for Geographic And Racial Differences in Stroke Study (REGARDS). Linear mixed effect models evaluated the association between age and the initial change (intercept) and rate of change (slope) in cognition after compared to before stroke. Outcomes were global cognition (primary), memory and executive function. ResultsWe included 1,292 participants with stroke; 197 younger (47.2 % female, 32.5 % Black race) and 1,095 older (50.2 % female, 46.4 % Black race). Median (IQR) age at stroke was 59.7 (56.6-61.7) (younger group) and 75.2 (70.5-80.2) years (older group). Compared to the young, older participants had greater declines in global cognition (-1.69 point [95 % CI, -2.82 to -0.55] greater), memory (-1.05 point [95 % CI, -1.92 to -0.17] greater), and executive function (-3.72 point [95 % CI, -5.23 to -2.21] greater) initially after stroke. Older age was associated with faster declines in global cognition (-0.18 points per year [95 % CI, -0.36 to -0.01] faster) and executive function (-0.16 [95 % CI, -0.26 to -0.06] points per year for every 10 years of higher age), but not memory (-0.006 [95 % CI, -0.15 to 0.14]), after compared to before stroke. ConclusionOlder age was associated with greater post-stroke cognitive declines, accounting for differences in pre-stroke cognitive trajectories between the old and the young.

Distinct Cognitive Trajectories According to Amyloid Positivity in Non-Alzheimer Disease Dementias.

The clinical effects of β-amyloid positivity (Aβ+) on copathologies in various dementias remain relatively underexamined. Thus, the present study was conducted to investigate the prevalence and clinical effects of Aβ+ in subcortical vascular cognitive impairment (SVCI) and frontotemporal dementia (FTD). We enrolled SVCI (n = 583), FTD (n = 152), and cognitively unimpaired (CU) participants (n = 1,249) who underwent Aβ PET scans. The odds of having Aβ+ were subsequently compared among the diagnostic groups (CU, SVCI, and FTD) according to age and apolipoprotein E genotype. Additionally, a linear mixed-effects model was used to investigate the effects of Aβ+ on cognitive trajectories in SVCI and FTD. Compared with CU, the SVCI group had a higher prevalence of Aβ+ in the 75 to 90 years age group (adjusted odds ratio, 1.97; 95% confidence interval, 1.36-2.85; P < 0.001), as well as within the apolipoprotein E ε3/ε3 group (adjusted odds ratio, 1.78; 95% confidence interval, 1.20-2.63; P = 0.001), whereas the FTD group showed no difference in Aβ+ prevalence. Aβ+ was associated with a worse cognitive trajectory in SVCI (adjusted β-coefficient = -0.6424; P < 0.001), but not in FTD. These findings contribute to our understanding of Aβ biomarker traits in various dementias in Korea.