Executive Function In Older Adults Research Articles

Executive functions in male and female older adults with aligned levels of VO2max.

Studies have shown a positive relationship between cardiorespiratory fitness (CRF) and executive functioning in older adults. Although this relationship has been well established, there seems to be a gap in the literature on the role of sex differences concerning CRF and executive functions. The current study aimed to assess the effect of sex in the relationship between CRF and cognition in older adults by stratifying the results to examine effects in males and females. Ninety-six older adults (61 females) gave their written, informed consent to participate in this cross-sectional study. All participants underwent a maximal continuous graded exercise test on a cycle ergometer to assess their maximal oxygen uptake (VO<inf>2max</inf>) and a computerized Stroop task (naming, inhibition, and switching) to assess their executive functions. According to VO<inf>2max</inf> test results and the American College of Sports Medicine's guidelines, females and males were classified into higher-fit and lower-fit groups. A general linear model and estimated marginal means analyses were applied. Results showed no significant differences in the naming, inhibition and switching performance tests between male and female older adults (P>0.05). Based on the observed positive relationship between CRF and executive functioning, the data of the current study supports the idea that aerobic exercise, which typically increases CRF, is well-situated to improve executive functioning in older adults, irrespective of sex.

Effects of Second Language Acquisition on Executive Functioning in Older Adults in France

Purpose: The aim of the study was to analyze the effects of second language acquisition on executive functioning in older adults in France. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Research on second language acquisition in older adults in France indicates that learning a new language can boost cognitive abilities like problem-solving and multitasking. It enhances memory retention and cognitive flexibility, vital for maintaining mental acuity. Language learning stimulates brain regions linked to executive functions, potentially reducing cognitive decline and offering protective benefits against neurodegenerative diseases in aging populations. These findings highlight the cognitive advantages of bilingualism among older adults in France. Unique Contribution to Theory, Practice and Policy: Bilingual advantage hypothesis, cognitive reserve theory &amp; neuroplasticity theory may be used to anchor future studies on the effects of second language acquisition on executive functioning in older adults in France. Encourage lifelong learning programs that include SLA courses for older adults in France. Advocate for the inclusion of SLA programs in public health initiatives aimed at promoting cognitive health among older adults. Policy frameworks should support funding and infrastructure for community-based language learning initiatives.

Moderate intensity intermittent lifestyle physical activity is associated with better executive function in older adults.

Executive functions are among the first cognitive abilities to decline with age and age-related executive function slowing predisposes older adults to cognitive disorders and disease. Intermittent Lifestyle Physical Activity (ILPA) reflects brief, unplanned activity that occurs during routine daily activities and is operationalized as activity bouts <60s. Our understanding of short bouts of habitual physical activity and executive functions is limited. We tested the hypothesis that greater amounts of ILPA in moderate and vigorous intensity domains would be associated with better executive function in older adults. Forty older adults (26 females, 68 ± 6, >55 years; body mass index: 26.6 ± 4.3 kg/m2) completed a Trail-Making-Task and wore an activPAL 24-hr/day for 6.2 ± 1.8-days. For each intensity, total time and time spent in bouts <60 s were determined. Trail A (processing speed) and Trail B (cognitive flexibility) were completed in 25.8 ± 8.2 s and 63.2 ± 26.2 s, respectively. Non-parametric Spearman's rank correlations report that moderate ILPA (3.2 ± 3.2 min/day) and total-moderate physical activity (20.1 ± 16.0 min/day) were associated with faster Trail A (total-moderate physical activity: ρ=-0.48; moderate-ILPA: ρ = -0.50; both, p < 0.003) and Trail B time (total-moderate physical activity: ρ = 0.36; moderate-ILPA: ρ = -0.46; both, p < 0.020). However, the results show no evidence of an association with either vigorous physical activity or light physical activity (total time or ILPA bouts: all, p > 0.180). Moderate physical activity accumulated in longer bouts (>60 s) was not associated with Trail B time (p = 0.201). Therefore, more total moderate physical activity and shorter bouts (<60 s) may result in better executive functions in older adults.

Clinical Utility of the Neuropsychological Assessment Battery Judgment Subtest in the Evaluation of Older Adults.

The purpose of this retrospective archival study was to explore the clinical utility of the Judgment subtest of the Neuropsychological Assessment Battery (NAB) in older adults who were referred because of cognitive concerns. Specifically, we were interested in how NAB Judgment covaried with other measures of executive functioning. 226 adults, aged 61-89years (48% dementia, 35% mild cognitive impairment, 18% cognitively intact) completed NAB Judgment. They also completed Trail Making Test (TMT) A and B. In addition, Behavior Rating Inventory of Executive Function (BRIEF-A) informant and self-reports were obtained to measure executive functioning in daily life. Scores on NAB Judgment did not correlate significantly with BRIEF-A informant ratings. However, there was a statistically significant correlation between BRIEF-A informant ratings and TMT B. Better performance on TMT B was associated with fewer informant concerns. Furthermore, subgroups with versus without informant BRIEF-A Metacognition indices in the range of impairment demonstrated a statistically significant difference on TMT B but not on Judgment. Executive functioning in older adults should not be assessed using NAB Judgment alone. Such an evaluation should be supplemented with other in-person tests as well as informant ratings of daily functioning.

Effects of different types of physical exercise on executive function of older adults: a scoping review.

This scoping review examined the impact of physical exercise on executive function (EF) in older adults and investigated the moderating effects of exercise types. We systematically searched four electronic databases for randomized controlled trials (RCTs) investigating the effects of exercise on EF, published until November 26, 2023. The proportions of positive and null/negative effects across all studies were calculated. In total, 91 studies were included in the analysis. Among these, 27 (29.7%) studies employed aerobic exercise interventions for older adults' EF, with 19 (70.4%) studies reporting positive effects. Additionally, 18 (19.8%) studies utilized strength exercise interventions for older adults' EF, with 15 (83.3%) studies demonstrating positive benefits. Furthermore, 32 (35.2%) studies employed coordination exercise interventions for older adults' EF, with 25 (78.1%) studies showing positive benefits. Similarly, 30 (33%) studies applied mixed exercise interventions for older adults' EF, with 25 (83.3%) studies indicating positive benefits. Overall, all four types of physical exercise enhance EF in older adults, with mixed exercises being the most effective.

Neural mechanisms and digital promotion of executive function in older adults with amnestic mild cognitive impairment

Neural mechanisms and digital promotion of executive function in older adults with amnestic mild cognitive impairment

Effect of Baduanjin exercise on executive function in older adults with cognitive frailty: A randomized controlled trial

Objective To investigate the effectiveness of Baduanjin exercise on executive function in community-dwelling older adults with cognitive frailty. Design Randomized controlled trial. Setting Community residential centers. Subjects 120 eligible older adults. Interventions Baduanjin training group received supervised Baduanjin training, 60 min sessions three times per week for 24 weeks. The control group did not receive any exercise intervention. Main measures Primary outcome was executive function, assessed using Clock Drawing Test. Secondary outcomes included the subcomponents of executive function (working memory, inhibitory control and cognitive flexibility), attention and cognitive frailty (global cognitive function, physical frailty) assessed using Verbal Fluency Test, Trail Making Test-A/B, Stroop Test, Montreal Cognitive Assessment and Edmonton Frailty Scale, respectively, at baseline and 24 weeks after intervention. Results After the 24-week intervention, the scores of Clock Drawing Test and Verbal Fluency Test, the Trail Making Test-B time and the Card correct numbers of Stroop Test in Baduanjin training group showed significant improvement compared with control group (all P < 0.05) with small to moderate effect sizes and the significant interaction effect of group by time in the Clock Drawing Test and Trail Making Test-B test (P = 0.003 and P = 0.043); cognitive frailty variables, including Montreal Cognitive Assessment and Edmonton Frail Scale scores, also showed significant improvement (P = 0.002 and P = 0.004) with a moderate effect sizes and a significant interaction effect (P < 0.001, P = 0.013). No adverse events were reported. Conclusion Regular Baduanjin training may be an effective and safe intervention to improve cognitive frailty and executive function in community-dwelling older adults with cognitive frailty. Trial registration Chinese Clinical Trial Registry, ChiCTR2100050857. Data of registration: 8/5/2020, https://www.chictr.org.cn/showproj.html?proj = 133037.

Exercise training mitigates the deleterious effects of experimental bed rest on intraindividual variability of executive functioning in older adults: A randomised controlled trial

AbstractBackgroundIn older adults, bed rest can occur because of chronic conditions, injury, surgery, or hospitalization. Extreme levels of physical inactivity due to bed rest initiate a downward spiral in several body systems. Exercise is a countermeasure to many of these changes; nonetheless, little is known about the effect of exercise on older adults’ cognition during bed rest. We thus examined the effects of exercise on the intraindividual variability (IIV) of cognitive performance in older adults exposed to 14 days of experimental 6° head‐down bed rest (HDBR) and whether sex moderates its effects. We chose IIV as our outcome measure because it is more sensitive than traditional summary scores of cognitive performance, albeit no studies have explored exercise effects on older adults’ IIV submitted to bed rest.MethodA non‐blinded, parallel‐group, randomised controlled trial. Twenty‐three healthy older adults aged 55‐65 were randomised to: 1) 14 days of HDBR (CON); or 2) 14 days of HDBR with daily aerobic and strength exercise (EX). Data were collected at baseline, HDBR completion, and end of seven‐day‐recovery. The National Institutes of Health Toolbox Cognitive Battery assessed executive function (Flanker Incongruent and Congruent and Dimensional Change Card Sort) and processing speed (Pattern Comparison). IIV was indexed by intraindividual coefficient of variation (ICV) and residual intraindividual standard deviation (R‐ISD), with R‐ISD as our primary measure of interest. Linear mixed models assessed group differences and the moderator role of sex.ResultAt HDBR completion, EX had significantly lower (better) Flanker incongruent ICV (Estimated mean difference = ‐0.10, 95%CI ‐0.19;‐0.003, p = 0.022) and R‐ISD (Estimated mean difference = ‐3.63, 95%CI ‐6.10;‐1.17, p = 0.005) vs. CON. Sex moderated the effect of exercise; females in EX had significantly lower Flanker incongruent ICV vs. CON (Estimated mean difference = ‐0.23; 95%CI ‐0.34;‐0.12, p&lt;0.001). At the end of the seven‐day recovery, EX had significantly lower Flanker incongruent R‐ISD vs. CON (Estimated mean difference = ‐3.11, 95%CI ‐5.70;‐0.052, p = 0.019). Summary scores and processing speed IIV changes were not statistically significant (ps&gt;0.05).ConclusionExercise during HDBR preserved executive functioning, especially in females. Our findings support the delivery of exercises to older adults during bed rest to preserve their cognitive function.

SARS-CoV-2 infection and cognition in community-dwelling and nursing home residents in southern Switzerland

BackgroundCOVID-19 patients can report ‘brain fog’ and may exhibit cognitive symptoms for months after recovery (Cognitive COVID). However, evidence on whether and the extent to which SARS-CoV-2 infection impacts cognition irrespective of COVID-19 course and severity is limited to clinical samples and mainly comes from prognostic studies. We aimed to explore the association between serologically confirmed SARS-CoV-2 infection and cognitive functioning in community-based and institutionalized older adults, irrespective of COVID-19 symptoms. MethodsWe conducted a case-control study nested into two cohorts in Southern Switzerland. Eligible subjects were Italian speaking older adults, without a previous diagnosis of dementia, who underwent serological testing for anti-SARS-CoV-2 antibodies between November 2020 and July 2021. We manually selected age-, sex- and education-matched cases (i.e., individuals with a serologically confirmed SARS-CoV-2 infection), with seronegative controls, and we conducted in-person neuropsychological assessments using validated, highly sensitive cognitive tests. ResultsWe completed 38 neuropsychological assessments in a mostly female sample of older adults (Mean age: 83.13 ± 8.95; 86.8% women). 17 were community dwelling individuals while 21 lived in a nursing home. As expected, socio-demographic characteristics of age, gender and educational level were similarly distributed between cases (n = 14) and controls (n = 24). In linear regression models, cases had significantly lower scores in cognitive tasks of memory (β = −0.367, p = 0.023), attention (β = 0.428, p = 0.008) and executive functions (β = 0.326, p = 0.046). We found no significant difference in tests of language and spatial-temporal orientation (all p values > 0.05). ConclusionsSARS-CoV-2 infection was associated with cognitive impairment in memory, attention, and executive functions in older adults. Our findings are consistent with mechanistic evidence of the neurotropism of the virus and provide empirical support for the “Cognitive COVID” construct also in non-clinical samples. With nearly 800 million COVID-19 cases (in April 2023), and many more infections worldwide, the clinical and public health implications of Cognitive COVID due to SARS-CoV-2 infection may be massive and warrant further epidemiological investigations.

32 Elevated Plasma pTau-181 is Associated with Lower Global Cognition and Executive Function in Older Adults

Objective:Aggregation of phosphorylated tau (pTau) is a hallmark feature of Alzheimer’s disease (AD). Novel assays now allow pTau to be measured in plasma. Elevated plasma pTau predicts subsequent development of AD, cortical atrophy and AD-related pathologies in the brain. We aimed to determine whether elevated pTau is associated with cognitive functioning in older adults prior to the development of dementia.Participants and Methods:Independently living older adults (N = 48, mean age = 70.0 years; SD = 7.7; age range 55-88 years; 35.4% male) free of dementia or clinical stroke were recruited from the community and underwent blood draw and neuropsychological assessment. Plasma was assayed using the Quanterix Simoa® pTau-181 V2 Advantage Kit to quantify pTau-181 levels and APOE genotyping was conducted on the blood cell pellet fraction obtained from plasma separation. Global cognition was assessed using the Dementia Rating Scale-2 (DRS-2) and executive function was assessed using the Stroop, D-KEFS-2 Fluency, and Trails Making Test. Diagnosis of mild cognitive impairment (MCI) was determined based on overall neuropsychological performance. Participants were diagnosed as MCI if they scored &gt;1 SD below norm-referenced values on 2 or more tests within a domain (language, executive, memory) or on 3 tests across domains.Results:Multiple linear regression analysis revealed a significant negative association between plasma pTau-181 levels and DRS-2 (B = -2.57, 95% CI (-3.68, -1.47), p &lt;.001), Stroop Color-Word score (B = -2.64, 95% CI (-4.56, - 0.71), p = .009) and Fruits and Vegetables Fluency (B = -1.67, 95% CI (-2.84, -0.49), p = .007), adjusting for age, sex, education and APOE4 status. MCI diagnosis was determined for 43 participants, of which 8 (18.6%) met criteria. Logistic regression analysis revealed that pTau-181 levels are associated with increased odds of MCI diagnosis (OR = 2.18, 95% CI (1.01, 4.68), p = .046), after accounting for age, sex, education and APOE4 status.Conclusions:Elevated plasma pTau-181 is associated with worse cognition, particularly executive function, and predicts MCI diagnosis in older adults. Higher plasma pTau-181 was associated with increased odds of MCI diagnosis. Detection of pTau-181 in plasma allows a novel, non-invasive method to detect burden of one form of AD pathology. These findings lend support to the use of plasma pTau-181 as a valuable marker in detecting even early cognitive changes prior to the development of AD. Additional longitudinal studies are warranted to explore the prognostic value of plasma pTau-181 over time.

29 Vascular Burden Mediates the Relationship Between ADHD and Cognition in Older Adults

Objective:Accumulating evidence from case-control and population studies suggests attention-deficit/hyperactivity disorder (ADHD) confers a 2- to 5-fold risk of all-cause dementia later in life. Here, we investigate vascular burden as a potential mediator of this relationship, because vascular integrity is well known to be compromised in ADHD (due to chronic obesity, diabetes, and hypertension) and is also a robust risk factor for neurodegeneration (due to reduced cerebral blood flow). We use brain white matter hyperintensities (WMH) as a measure of vascular burden.Participants and Methods:Thirty-nine adults aged 48-81 years with clinical ADHD, and 37 matched controls, completed neuropsychological testing and 1.5 T structural neuroimaging. None had stroke. Cognitive tests were demographically-adjusted to Z scores using regression-based norms generated from the control group, and averaged across tests within domains of short- and long-term verbal memory (forward digit span, California Verbal Learning Test, Logical Memory), visual memory (Visual Recognition, Rey Complex Figure), processing speed (coding, trails A, Stroop word-reading and color-naming), language (Boston Naming Test, semantic fluency), visuoconstruction (clock drawing, Rey Complex Figure copy), and executive function (backward digit span, trails B, phonemic fluency, Stroop inhibition, Wisconsin Card Sorting Test). Total WMH volumes (i.e., combined periventricular and deep) within subcortical, temporal, frontal, parietal, and occipital regions were individually divided by regional volumes to produce a proportion of each region representing WMH, then log-transformed to correct for skew. Age-corrected linear regression quantified total effects of ADHD on cognition; when these were significant, mediation models quantified the direct effects of ADHD on WMH volumes and the direct effect of WMH volumes on cognition. Sobel’s test estimated indirect effects of ADHD on cognition via WMH.Results:Group had a significant total effect on Processing Speed (ß=-1.154, p&lt;.001) and on Executive Functioning (ß=-0.587, p=.004), where ADHD participants had lower composite scores (M=-1.10, SD=1.76 and M=-0.54, SD=1.14 respectively) than controls (M=0.02, SD=0.74; M=0.00, SD=0.49). Only frontal-lobe WMH had direct effects on Processing Speed (ß=-0.315, p=.012) and Executive Functioning (ß=-0.273, p&lt;.001). The direct effect of ADHD on frontal WMH was significant (ß=-0.734, p=.016), and Sobel’s tests supported an indirect effect of ADHD on Executive Functioning (z=2.079, p=.038) but not Processing Speed (z=1.785, p=.074) via WMH. Because the effect of ADHD on WMH was negative (i.e., fewer WMH in ADHD) despite worse cognition than controls, we tested the a posteriori hypothesis that WMH burden may be relatively more deleterious for ADHD than controls. We found considerably stronger negative correlations between total WMH volumes and Processing Speed (r=-.423, p=.009) and Executive Functioning (r=-.528, p&lt;.001) in the ADHD group than in controls (r=-.231, p=.175 and r=-.162, p=.346, respectively), even though total whole-brain proportion of WMH (M=0.15%, SD=0.27; Mann-Whitney l/=430.0, p=.002) and frontal-lobe proportion of WMH volumes (M=0.33%, SD=0.51; Mann-Whitney U=464.0, p=.007) were lower in ADHD than in controls (M=0.29%, SD=0.42 and M=0.66%, SD=0.88, respectively).Conclusions:WMH burden contributes significantly to the relationship between ADHD and cognition, but ADHD remains an independent contributor to worse processing speed and executive functioning in older adults. Vascular burden may have relatively more deleterious effects on cognition in ADHD, potentially due to decades of accumulated allostatic load, whereas healthy controls can accumulate greater amounts of WMH before cognition is impacted.

90 Self-Rated Executive Dysfunction in Older Adults with Subjective Cognitive Dysfunction and Mild Cognitive Impairment

Objective:Mild cognitive impairment (MCI) is characterized by subjective and objective memory concerns, though additional cognitive concerns are commonly reported, including changes in executive functions (EF). Rabin et al. (2006) showed that a sample of research participants with MCI endorsed problems with their EFs, especially working memory. Similarly, those with subjective cognitive dysfunction (SCD) also reported greater difficulty with aspects of their EF than a healthy comparison sample of older adults (HC). In the present study, we investigated subjective EF in clinical samples of older adults with MCI or SCD, which represents a more naturalistic sample relative to a research sample. Furthermore, we evaluated whether subjective EF varied in these groups depending on whether patients were "young-old" versus "old-old" given prior research indicating objective cognitive differences between these age groups.Participants and Methods:Participants were 135 older adults (53 MCI, 52 SCD, and 30 HC) matched for age (p = .116) and education (p = .863). Dichotomous categorization of age used the sample median (72 years) as cutoff score with 72 participants in the young-old group (mean age = 65.8 ± 4.7 years) and 63 in the old-old group (mean age = 78.1 ± 3.7 years). Participants completed the Behavior Rating Inventory of Executive Function-Adult (BRIEF-A), assessing executive functions in everyday life over the past month. The BRIEF-A yields an overall score (Global Executive Composite [GEC]) composed of two index scores (Behavioral Regulation Index [BRI] and Metacognition Index [MI]) and nine clinical scales (Inhibit, Shift, Emotional Control, Self-Monitor, Initiate, Working Memory, Plan/Organize, Task Monitor, and Organization of Materials). A diagnosis by age-group multivariate analysis of variance (MANOVA) with post-hoc comparisons for diagnosis using a Tukey HSD correction was conducted using SPSS Version 24.Results:MCI and SCD groups endorsed worse EF on all three index scores (ps &lt; .005) and all nine clinical scales (ps &lt; .05) relative to the HC group, and the MCI group reported worse initiation relative to the SCD group. Additionally, worse executive functions on all three index scores (ps &lt; .05) and four clinical scales (ps &lt; .05; emotional control, self-monitoring, planning/organization, and task monitoring) were reported by the young-old group relative to the old-old group. No diagnosis by age-group interactions were observed.Conclusions:Problems with aspects of EF were endorsed by older adults with MCI and SCD compared to HCs across all indices and clinical scales; however, only initiation was reported to be worse in MCI than those with SCD. Additionally, the young-old group endorsed having worse EF than the old-old group across BRIEF-A indices and several more specific aspects of EF, without a moderating effect of diagnosis. These findings highlight the importance of assessing subjective EF in older adults, as they may be early indicators of cognitive change, prior to objective evidence of cognitive decline. Furthermore, results also point to differences in how the young-old and old-old perceive their EF in everyday life.

3 Body Mass Index Partially Mediates Gait Speed and Executive Functioning in Older Adults

Objective:Gait speed is associated with poorer executive functioning performance in older adults such that individuals with slower gait speed have shown declines in cognitive flexibility and set-shifting. Body mass index (BMI) is associated with sedentary lifestyles and slower gait speed, and has demonstrated negative effects on executive set-shifting in this population. However, the interaction between gait speed, BMI, and executive functioning has yet to be examined. The purpose of this study is to investigate the potential mediating effect of BMI on the negative relationship between gait speed and executive functioning in older adults.Participants and Methods:The sample included 154 community-dwelling older adults drawn from two clinical trials. Participants were recruited from the VA Palo Alto Health Care System and Stanford/VA Alzheimer’s Disease Research Center. Gait speed was measured using the six-minute walk test, with longer distances representing faster gait speeds. Weight and height were used to calculate BMI. Each participant completed the Trail Making Test Part B (TMTB), which was used to measure executive functioning. A simple mediation analysis was performed using SPSS PROCESS Macro version 3.5. The outcome variable for the analysis was TMTB completion times. The predictor variable was gait speed, and the mediator variable was BMI. Age was entered as a covariate. We hypothesized that gait speed will negatively predict time to completion on the executive functioning task. We also hypothesized that BMI will mediate this relationship.Results:The analysis found that gait speed negatively predicted executive functioning scores (b = -.12, p = .02). The overall mediation model was statistically significant (F(3,150) =9.17, p &lt; .001). Gait speed and age negatively predicted BMI (p &lt; .001). BMI was a significant predictor of executive functioning (p = .001). The direct effect of gait speed on executive functioning remained significant after including BMI in the model (p &lt; .001), which suggests that BMI partially mediated the relationship between gait speed and executive functioning. The indirect effect of the model when including BMI was tested using the bootstrap estimation approach with 5,000 samples, and was found to be significant (95% CI [.03,.11]), indicating that mediation did occur in the analysis.Conclusions:BMI partially mediated the relationship between gait speed and executive set-shifting. Thus, the path by which gait speed predicted executive functioning abilities was partially attributable to BMI, one measure of obesity. This finding suggests that older adults with slower gait speeds may have poorer executive function partially due to greater BMI. Given the importance of executive functions on independence and well-being in older adulthood, management of BMI could lead to improved functioning and quality of life. Interventions to decrease weight in older adults is likely to result in several positive health outcomes, and these results suggest that they may also promote important cognitive processes.

B - 63 Relationship between Executive Functioning and Trauma Symptom Report in Healthy Older Adults.

The study investigated the relationship between trauma symptoms and executive functioning (EF) in healthy older adults, emphasizing the importance of assessing the trauma history of those with subclinical trauma and stressor-related disorders in neuropsychological evaluations. It was hypothesized that age is negatively correlated with trauma symptoms, and trauma symptoms are negatively correlated with EF performance. This cross-sectional investigation included 520 adults ages 50-85 (67.9% Female; Education: 15.95(2.31); 87.9% White, 7.7% Black, 3.3% Asian, 0.6% Native American, 0.6% Other) from the Nathan Kline Institute's Rockland Sample. Trauma was measured by the total raw score of the Trauma Symptom Checklist-40 (TSC-40) and six subscale scores. EF was measured by performance on selected D-KEFS measures. Separate Pearson correlations were used to compare age to trauma scores, and EF performance to trauma scores. The anxiety subscale of TSC-40 showed a significant weak correlation with age, r (518) = -0.138, p = 0.001. Age was not correlated with any other TSC-40 subscales. The TSC-40 sexual abuse (SA) subscale showed a significant weak correlation with Color-Word Inhibition r(518) = -0.096, p = 0.031 and Trail Making-Switching r(518) = -0.106, p = 0.016. The remaining TSC-40 subscales were not correlated with other EF measures. The study demonstrated that the overall severity of trauma symptoms is not associated with age in older adults. Older adults with fewer symptoms associated with SA showed higher EF abilities. Future investigations will assess how gender and socioeconomic status affect the association between trauma and EF in older adults.

B - 56 Effects of rTMS Treatment on Executive Function Measured by the CANTAB Spatial Working Memory Subtest.

Traumatic Brain Injury (TBI) presents with deficits in executive function (Krawczyk et al., 2019). Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation treatment, may help improve cognitive outcomes. However, it remains unclear in which cognitive domains (Clark & Parasuraman, 2014; Donaldson et al., 2015). This study investigates executive function using the Spatial Working Memory subtest of the Cambridge Neuropsychological Test Automated Battery, a computerized card-matching task in which participants match up to 12 cards to matched pairs based on memory (CDC). Veterans and civilians were enrolled (n = 31; mild and moderate TBI; mean age = 62.25) and placed into active or sham groups. Participants received neuropsychological assessment at baseline, after 20 rTMS treatments, and at six-month follow-up. This study compared means between the active and sham groups (n = 16 & 15, respectively). Participants in the active group had fewer errors than the sham group on the 12-box trial (M = 24.19, SD = 11.20; M = 34.27, SD = 18.16; respectively), 8-box trial (M = 6.75, SD = 5.447; M = 8.27, SD = 6.11; respectively), 6-box trial (M = 2.06, SD = 3.00; M = 3.60, SD = 4.03; respectively) and across the 4, 6 and 8-box trials (M = 9.75, SD = 8.57; M = 12.47, SD = 10.04; respectively). Effect sizes were small to large (d = 0.28-0.67). The results suggest that rTMS treatment potentially enhances executive functioning in older adults with TBI. Further research on the impacts of rTMS in executive function domains is warranted.

The Role of Physical Exercise in Cognitive Preservation: A Systematic Review

Dementia, or major neurocognitive disorder, is one of the most common causes of disability and dependency in older adults with far-reaching social, physical, and economic impacts. In the absence of adequate treatment, much research has been directed towards prevention. Physical exercise has been shown to increase cerebral blood flow, amplify production of neurotrophic factors, and enhance brain volume. Whether these changes on a structural and cellular level result in cognitive preservation is less clear. This systematic review synthesizes findings from seventeen randomized controlled trials that examine the effects of physical activity on global cognition, memory, and executive function in older adults. Cognitive benefits of exercise are strongest for those who are cognitively intact or with mild cognitive impairment. In studies with long-term follow up, cognitive gains tended to decay after cessation of physical intervention suggesting that sustained physical exercise may be required to preserve cognitive function in older adults prior to onset of dementia.

Cognitive reserve counteracts typical neural activity changes related to ageing

Studies have shown that older adults with high Cognitive Reserve (HCR) exhibit better executive functioning than their low CR (LCR) counterparts. However, the neural processes linked to those differences are unclear. This study investigates (1) the neural processes underlying executive functions in older adults with HCR compared to older adults with LCR and (2) how executive control differences between HCR and LCR groups are modulated by increased task difficulty. We recruited 74 participants (37 in each group) with diverse CR levels, as determined by a standardised CR questionnaire. Participants performed two executive control tasks with lower and higher difficulty levels (i.e., Simon and spatial Stroop tasks, respectively) while recording the electroencephalogram. The accuracy on both tasks requiring inhibition of irrelevant information was better in the HCR than the LCR group. Also, in the task with higher difficulty level (i.e., the spatial Stroop task), event-related potential (ERP) latencies associated with inhibition (i.e., frontal N200) and updating of working memory (i.e., P300) were earlier in HCR than LCR. Moreover, the HCR, but not the LCR group, showed larger P300 amplitude in parietal than frontal regions and in the left than right hemisphere, suggesting a posterior to anterior shift of activity and loss of inter-hemispheric asymmetries in LCR participants. These results suggest that high CR counteracts neural activity changes related to ageing. Thus, high levels of CR may be related to maintenance of neural activity patterns typically observed in young adults rather than to deployment of neural compensatory mechanisms.

The connectome-based prediction of trust propensity in older adults: A resting-state functional magnetic resonance imaging study.

A recent neuropsychoeconomic model of trust propensity argues that an individual uses economic (executive functions) and social (social cognition) rationality strategies to transform the risk of treachery (affect) into positive expectations of reciprocity, promoting trust in another person. Previous studies have shown that the trust of older adults is associated with affect and social cognition. However, little is known about the intrinsic functional connectivity correlated with trust propensity or whether trust propensity is associated with executive functions in older adults. In this study, we examined the association between trust propensity (measured by a one-shot trust game [TG]), social preference (measured by a one-shot dictator game), and executive functions (measured by a battery of neuropsychological tests). We also performed connectome-based predictive modeling (CPM) and computational lesion analysis to identify the key large-scale resting-state functional connectivity (RSFC) underlying the prediction of trust propensity. Our behavioral results showed a lower trust propensity in older adults in our study than in younger adults in a previous meta-analysis. Furthermore, trust propensity was associated with social preference, but there was no significant relationship between trust propensity and executive functions. The neuroimaging results showed that the cingulo-opercular network (CON) and the default mode network (DMN), rather than the frontoparietal network (FPN), significantly contributed to the prediction of trust propensity in older adults. Our findings suggest that older adults rely less on economic rationality (executive functions, associated with FPN) in trust games. Rather, they are likely to depend more on social rationality (social cognition, associated with social preference and DMN) to resolve the risk of treachery (affect, associated with CON) in trust dilemmas. This study contributes to a better understanding of the neural underpinnings of older adults' trust propensity.

The effect of virtual reality on executive function in older adults with mild cognitive impairment: A systematic review and meta‐analysis

AbstractBackgroundVirtual reality (VR) ‐ a computer simulation of a real or imagined three‐dimensional (3‐D) environment, which allows users to have the same experiences they would get in a similar real situation, has stimulated the interest of researchers and clinicians since its first use in 1994. Compared to traditional pen‐and‐paper training, it is symbolized as a systematic and controllable intervention that makes use of data visualization and provides immediate feedback based on the participants’ performance. VR is usually categorized into three types according to the form of connection with the physical world, and includes non‐immersive, semi‐immersive, and full‐immersive VR.MethodThis review aimed to summarize the currently available premium evidence to determine the effect of virtual reality (VR) on executive function (EF) in older adults with mild cognitive impairment (MCI), and to detect what level of immersive VR would be the most beneficial. Five electronic databases, namely, PubMed, Embase, PsycINFO, CINAHL and Cochrane Library were searched. Our research team screened the studies and extracted data according to our inclusion criteria. The methodological quality of each study was rated using the PEDro scale. When three or more studies reported the same outcome, a meta‐analysis was conducted using Review manager 5.4.1ResultFinally, 14 randomized controlled trials with a total of 518 participants were included. VR training had an overall positive effect on cognitive flexibility, global cognitive function, attention, and short‐term memory compared to the control groups. Additionally, semi‐immersive VR was more effective in improving cognitive flexibility compared to the other two types of VR. The application of non‐immersive level of VR had a significant effect on global cognitive function, attention, short‐term memory, and cognitive flexibility.ConclusionVR may be effective in improving EF in older adults with MCI. However, the level of immersive VR that would be the most beneficial on EF still needs to be investigated with a greater number of well‐designed studies.

A narrative video game for adults with subjective and objective cognitive impairment. Design and preliminary results on user-interaction and efficacy

ABSTRACT The design of a narrative video game for cognitive training of memory and executive functions in older adults with subjective and objective cognitive impairment is reported along with preliminary results on preferences (Study 1), user interaction experience (Study 2), and efficacy of the game (Study 3). A study of aesthetic preferences in backgrounds and avatars was implemented in 13 older adults, who were asked for their opinion on the acceptability of the plot. After completion of the design, a user interaction study was conducted in a sample of 19 older adults. In addition, a Matched Paired Experimental Design (MPED) was implemented as a preliminary test of the efficacy of the narrative video game in a sample of 22 participants with Subjective Cognitive Decline (SCD) and Mild Cognitive Impairment (MCI). Preferences for free violence content in videogames was supported in our sample of low-frequency adult gamers and acceptability of the plot was high. The video game was rated favourably by the older adults in terms of user preferences and acceptability. The results of the preliminary MPED study suggest that the video game could be a useful tool for cognitive training in SCD and MCI older adults.