Executive Function Performance Research Articles

Executive Functioning, Family Accommodation, and Treatment Response in Youth with OCD and Comorbid ADHD in a Partial Hospital Program.

Few studies have examined differential treatment response, rates of familial accommodation (FA), and executive functioning (EF) in youth with OCD vs. OCD + ADHD, particularly in a partial hospital program (PHP). The current study includes 138 youth diagnosed with OCD only and 102 youth diagnosed with OCD + ADHD in a PHP setting for a total sample of 240 youth (and their families). Families and clinicians completed several measures assessing child and parent variables of interest. Findings of ANCOVA analyses suggest poorer treatment response and EF in children with comorbid OCD + ADHD compared to their counterparts with OCD only. No significant differences emerged between groups in baseline levels of symptom severity, functional impairment, or FA. Given the high rate of comorbidity between OCD + ADHD, clinicians and researchers should be aware of the need to modify treatment approaches for children with comorbid OCD + ADHD and/or weaker EF performance.

The contribution of cerebral small vessel disease in idiopathic normal pressure hydrocephalus: Insights from a prospective cohort study.

Idiopathic normal pressure hydrocephalus (iNPH) and cerebral small vessel disease (CVSD) are age-related diseases, but their prevalence and clinical relationship are unclear. This prospective cohort study enrolled 95 patients with probable iNPH in China and evaluated their CSVD burden using magnetic resonance imaging. Linear regression models were used to analyze the association between CSVD scores and clinical outcomes. The results showed 78% of the patients had at least one CSVD imaging marker, and higher total CSVD scores were significantly associated with declines in attention, executive function, psychomotor speed, and gait performance after multivariate adjustments. However, the preoperative CSVD score did not affect the post-shunt improvement in modified Rankin scale or iNPH grading scale scores. Our findings suggest that CSVD is prevalent in patients with iNPH and is associated with more severe symptoms, but it may not affect shunt outcomes. Future studies are needed to elucidate the underlying mechanisms. We found that 78% of the patients with idiopathic normal pressure hydrocephalus (iNPH) had at least one type of cerebral small vessel disease (CSVD) imaging marker. The CSVD burden aggravates cognitive and gait impairments in patients with iNPH but may not affect shunt outcomes. The effects of different imaging markers of CSVD on cognition and gait are different and worthy of further investigation.

Affect and executive function dynamics in primary school classrooms: an intensive longitudinal study

ABSTRACT This study investigates the temporal dynamics and affective associations related to executive function (EF) performance in primary school classrooms using an intensive longitudinal design. Data were collected from 35 students aged 8.9 to 11.4 years. Participants reported their affective experiences and completed EF measures three times daily following a fixed sampling schedule. The data collection spanned two consecutive school weeks across three primary school classrooms. Utilising Dynamic Structural Equation Modeling (DSEM), we examined 505 measurements of EF tasks and self-reported affective states over two weeks. The findings reveal significant within-person variability in EF, accounting for 52% of the observed variance, with performance declining later in the day and week. At the within-person level, positive affect was associated with improved EF performance, while negative affect was associated with poorer EF. No significant between-person relationships were found. These results underscore the importance of considering within-person processes and affective experiences in educational settings and highlight the need for further research employing intensive longitudinal methods to better understand the nuanced dynamics of affect and EF in real-world classroom environments.

Abstract 4126628: Worse Cardiac Structure and Function is Associated with Decline in Multiple Domains of Cognitive Function: the Atherosclerosis Risk in Communities (ARIC) Study

Background: Cognitive impairment is cross-sectionally associated with worse cardiac structure/function. However, limited data exist regarding cardiac structure/function and longitudinal changes in cognitive function. Objective: Determine the association of cardiac structure and function with longitudinal changes in cognitive performance in late life. Methods: Among HF- and dementia-free participants in the community-based ARIC study who attended the 5th study visit (V5; 2011-2013), underwent protocol echocardiography, and completed a neurocognitive test battery at both V5 and study Visit 6 (V6; 2015-17), we assessed associations of cardiac structure and function measures with changes in both domain-specific and global cognitive scores between V5 and V6 using multivariable linear regression. Models were initially adjusted for demographics and education level, with additional models further adjusting for cardiovascular risk factors and disease at both V5 and V6. The neuropsychological test battery consisted of 10 neuropsychological tests that covered 3 domains of cognitive function: memory, executive functioning, and language. Factor scores were constructed for each cognitive domain, and their average represented a global composite score. Results: Among 2,988 included participants, mean age was 74±5 years, 60% were female, 20% reported Black race, and mean LVEF was 66±6%. Over a mean of 4.9±0.6 years (the V5 to V6 interval), raw scores declined for all neuropsychological tests. In fully adjusted models, worse diastolic function (larger LAVi) and LV remodeling (greater LV mass index) were associated with decline in executive function. Lower LVEF was associated with decline in language function, while worse LV longitudinal strain – a more sensitive measure of systolic dysfunction – was associated with decline in executive function, language function, and global cognition performance (all p<0.05; Table). Conclusion: Subclinical LV remodeling and dysfunction is associated with greater declines in cognitive function over 5 years in late life. Differential associations were observed by cognitive domains, with executive function decline most uniformly associated with impairments in cardiac structure/function.

A meta-analysis of data-driven cognitive subgroups in bipolar disorder

The delineation of cognitive subgroups of bipolar disorder (BD) might be helpful for identifying biologically valid subtypes of this disorder. This meta-analysis identified peer-reviewed literature on studies investigating cognitive subgroups of BD with data-driven clustering methods. Relevant studies were searched in PubMed, Scopus, and Web of Science. Random-effects meta-analysis was performed using R software. A total of 14 cross-sectional studies including euthymic or mildly symptomatic patients with BD were included in the current meta-analysis. The available studies have consistently supported a 3-cluster solution. The pooled prevalence of the severe-impairment, moderate-impairment, and major good-functioning groups were 23.1 % (95%CI, 18.5 %–27.7 %), 42.5 % (95%CI, 36.3 %–48.8 %), and 33.5 % (95%CI, 25.9 %–41.1 %) respectively. Compared to healthy controls, both the severe-impairment (g=−1.40 to −1.73) and moderate-impairment groups (g=−0.59 to −0.96) had significant deficits in all six cognitive domains (verbal memory, visual memory, executive functions, working memory, attention and processing speed). The good-performance subgroup had a small increase in the performance of executive functions (g=0.23) and normal functioning in all other domains. Compared to the good-performance subgroup, the severe-impairment subgroup was characterized by more severe functional impairment, more hospital admissions, a higher percentage of type I BD and antipsychotic use. The characteristics of the moderate-impairment subgroup were lying between the other two subgroups for most of the measures. The current findings support the existence of 3 cognitive subgroups in BD including severe-impairment and moderate-impairment groups which are associated with a more severe course of illness.

Attention and executive delays in early childhood: a meta-analysis of neurodevelopmental conditions.

The objective of this review was to evaluate attention and executive function performance in children with neurodevelopmental conditions across the first 5 years of life, compared to neurotypical peers. MEDLINE, EMBASE, and PsycINFO databases were searched until June 30, 2023, and studies comparing attention or executive function between children with (or at risk for) neurodevelopmental conditions and neurotypical (or low risk) peers, 0 to 5 years old, were included. Of the 4338 studies identified, 111 studies with 12292 participants were included in the meta-analysis. The qualitative analysis of brain development included 5 studies. Primary outcomes were the standardised mean difference (Hedges' g) in attention and executive function between groups. Meta-regressions examined moderating effects of age, biological sex, diagnosis, and measure type. Children with neurodevelopmental conditions showed small delays in attention (n = 49 studies, k = 251 outcomes, g = 0.36, 95% CI 0.23-0.48, p < 0.001) and moderate delays in executive function (n = 64 studies, k = 368 outcomes, g = 0.64,95% CI 0.53-0.76, p < 0.001). Attention and executive function delays could not be identified in the first year (equivalence tests, p < 0.001), small to moderate delays were found in toddlerhood and moderate delays by preschool. Delays identified were largely transdiagnostic, although there was some evidence of diagnosis-specific delays for attention and moderation by measure type (informant rating vs performance-based vs physiological). Qualitative analysis described how delays were underpinned by a divergence of brain development in medial prefrontal regions. These findings highlight the potential of using attention and executive measures to detect delay and to intervene in neurodevelopmental conditions early in life.

Manifestation of Psychosis and Impairments of Executive Functions Emphasize the Interaction of Psychological and Neurological Dysfunctions in People Who Use Methamphetamine

Aim: Cumulative evidence has demonstrated the neurotoxic effect of methamphetamine (Meth) on the central nervous system. Meth can induce psychotic symptoms and impairments of cognitive abilities, including executive function (EF). Method: In this study, we hypothesized the interaction of the neurotoxic effects of Meth on psychotic symptoms and EF performances. The Stroop test evaluated the EF performances, Go/No-Go task, one-back test (OBT), and Wisconsin Card Sorting Test (WCST) in people who use Meth with psychosis (MWP) and without psychosis (MWOP) compared with healthy control participants. Result: The results showed that MWOP and MWP exhibited EF deficits in attention, working memory, and initial conceptualization. Moreover, a deficit in inhibition was observed in MWOP, while poorer processing speed and cognitive flexibility were found in MWP. Conclusion: The correlation between psychotic symptoms and poor EF performances was observed in MWP. These findings underline the interaction of the mechanistic neurotoxic effect of Meth to induce psychological and neurological dysfunctions in people who use Meth.

Lifespan longitudinal changes in mesocortical thickness and executive function: Role of dopaminergic genetic predisposition

Dopamine (DA) signaling is critical for optimal cognitive aging, especially in prefrontal-parietal and fronto-striatal networks. Single nucleotide polymorphisms associated with dopamine regulation, COMTVal158Met and DRD2C957T, stand to exert influence on executive function performance via neural properties. The current study investigated whether longitudinal thinning of mesocortical regions is related to COMT and DRD2 genetic predisposition and associated with decline in executive function over four-years. N=235 healthy adults aged 20–94 years were recruited, with n=124 returning 4-years later. Latent mixed effects modeling revealed dopamine-related thinning in several frontal, parietal, and cingulate regions as well as decline in verbal fluency category switching across 4-years. Mesocortical thinning was also related to switching performance. Greater cortical thinning interacted with DA-genotype risk for lower DA-availability to predict poorer switching performance in parietal and posterior cingulate cortex. These findings lend support to the notion that early-life factors, such as genetic influence on neurotransmitter function, play a role in cognitive and brain aging and their linked association.

Physical Fitness, Executive Functions, and Academic Performance in Children and Youth: A Cross-Sectional Study.

The aim of this cross-sectional study was to investigate the relationship between physical fitness, executive function, and academic performance in children and adolescents. A total of 131 students (49% female) aged 10-15 years from a public school in Rio de Janeiro were assessed in executive functions (hearts and flowers, Corsi's block, and digit span tasks), academic performance (Portuguese, reading, math, and overall school grade), physical tests (touch test disc, agility, lower limb and upper limb explosive strength), and anthropometric measurements. Regression results showed that the composite of sports-related fitness measures was the best predictor of executive functions (β = 0.472; t = -6.075 p < 0.001). Decision tree classifier analysis showed that the combination of factors that discriminated better and worse executive function groups were better performance in hand-eye coordination (TTD), math, and upper limb strength (ULEST). Sports-related fitness is significantly correlated with executive function. Hand-eye motor coordination has been identified as the most important predictor of improved cognitive outcomes, surpassing even academic skills. These findings should be considered in the design of physical activity programs in school settings, which may have a positive impact on child development, reflected in the reduction of academic and socioeconomic disparities.

Executive function is associated with the development of math performance in children born at

To describe associations between executive function (EF) domains (attentional control, information processing, cognitive flexibility, and goal setting) and concurrent math computation performance at age 7 and 13 years in children born <30 weeks' gestation or weighing <1,250 g, and second, to examine the impact of 7-year EF on math performance at 13 years. In a prospective, longitudinal cohort of children born <30 weeks' gestation or with a birthweight <1,250 g, assessment of EF and math performance was undertaken at 7 (n = 187) and 13 years (n = 174). Linear regression models were used to describe associations between EF domains with math performance at both time points, as well as to examine the impact of EF at 7 years on math performance at 13 years. At 7 and 13 years, all EF domains were positively and strongly associated with concurrent math performance (β = 11.35, 95% CI [9.28, 13.41] to β = 13.79, 95% CI [11.59, 15.98]). All EF domains at age 7 years were positively associated with math performance at 13 years, with the strongest associations observed for cognitive flexibility (β = 10.79 [8.64, 12.94]) and goal setting (β = 10.37 [8.08, 12.67]). This study provides evidence that EF is strongly associated with math performance in children born <30 weeks' gestation or with a birthweight <1,250 g and highlights the importance of early cognitive flexibility and goal setting performance for future math performance. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Neurocognitive correlates of cerebral mitochondrial function and energy metabolism using phosphorus magnetic resonance spectroscopy in older adults.

The goal of the current study was to learn about the role of cerebral mitochondrial function on cognition. Based on established cognitive neuroscience, clinical neuropsychology, and cognitive aging literature, we hypothesized mitochondrial function within a focal brain region would map onto cognitive behaviors linked to that brain region. To test this hypothesis, we used phosphorous (31P) magnetic resonance spectroscopy (MRS) to derive indirect markers of mitochondrial function and energy metabolism across two regions of the brain (bifrontal, left temporal). We administered cognitive tasks sensitive to frontal-executive or temporal-hippocampal systems to a sample of 70 cognitively unimpaired older adults with subjective memory complaints and a first-degree family history of Alzheimer's disease and predicted better executive function and recent memory performance would be related to greater frontal and temporal 31P MRS indirect markers, respectively. Results of separate hierarchical linear regressions indicated better recent memory scores were related to 31P MRS indirect markers of lower static energy and higher energy reserve within the left temporal voxel; these findings were associated with moderate effect sizes. Contrary to predictions, executive function performance was unrelated to 31P MRS indirect markers within the bilateral frontal voxel, which may reflect a combination of theoretical and/or methodological issues. Findings represent a snapshot of the relationship between cognition and 31P MRS indirect markers of mitochondrial function, providing potential avenues for future work investigating mitochondrial underpinnings of cognition. 31P MRS may provide a sensitive neuroimaging marker for differences in aspects of memory among persons at-risk for mild cognitive impairment or dementia.

Executive functions and theory of mind development in preschoolers: Insights from NIRS data

Numerous studies have highlighted the importance of executive functions (EFs) in the development of Theory of Mind (ToM) in preschoolers. However, research focusing on young children at the neural level has been limited. This study examined the relationship between EFs and ToM in twenty-nine healthy Japanese preschoolers aged 5–7 years, focusing on neural responses during EF and ToM tasks using near-infrared spectroscopy (NIRS) to monitor prefrontal cortex (PFC) activity. The study utilized EF tasks and the Sally-Anne scenario to assess false- and true-belief understanding, aiming to provide a comprehensive analysis of ToM capabilities. Results indicated that despite advanced EF capabilities and a ceiling effect across all EF tasks, there were no significant correlations between EF performance or verbal ability and ToM task performance. NIRS data revealed no PFC activation during the Stroop task. However, activation was observed in the left and right lateral PFC in the control false belief condition, the left lateral PFC in the false belief condition, and across all PFC regions in the true belief condition during ToM tasks. Significant relationships were found between behavioral performance in ToM tasks and neural activity in key brain regions. The study also identified a complex relationship between false and true belief reasoning, suggesting a nuanced developmental trajectory for ToM. These findings underscore the crucial role of early childhood in the development of ToM and the complex interplay between cognitive functions and neural efficiency in understanding others' mental states.

Dissecting neural correlates of theory of mind and executive functions in behavioral variant frontotemporal dementia

Behavioral variant frontotemporal dementia (bvFTD) is characterized by profound and early deficits in social cognition (SC) and executive functions (EF). To date it remains unclear whether deficits of the respective cognitive domains are based on the degeneration of distinct brain regions. In 103 patients with a diagnosis of bvFTD (possible/probable/definite: N = 40/58/5) from the frontotemporal lobar degeneration (FTLD) consortium Germany cohort (age 62.5±9.4 years, gender 38 female/65 male) we applied multimodal structural imaging, i.e. voxel-based morphometry, cortical thickness (CTH) and networks of structural covariance via source based morphometry. We cross-sectionally investigated associations with performance in a modified Reading the Mind in the Eyes Test (RMET; reflective of theory of mind - ToM) and five different tests reflective of EF (i.e. Hamasch-Five-Point Test, semantic and phonemic Fluency, Trail Making Test, Stroop interference). Finally, we investigated the conjunction of RMET correlates with functional networks commonly associated with SC respectively ToM and EF as extracted meta-analytically within the Neurosynth database. RMET performance was mainly associated with gray matter volume (GMV) and CTH within temporal and insular cortical regions and less within the prefrontal cortex (PFC), whereas EF performance was mainly associated with prefrontal regions (GMV and CTH). Overlap of RMET and EF associations was primarily located within the insula, adjacent subcortical structures (i.e. putamen) and the dorsolateral PFC (dlPFC). These patterns were more pronounced after adjustment for the respective other cognitive domain. Corroborative results were obtained in analyses of structural covariance networks. Overlap of RMET with meta-analytically extracted functional networks commonly associated with SC, ToM and EF was again primarily located within the temporal and insular region and the dlPFC. In addition, on a meta-analytical level, strong associations were found for temporal cortical RMET correlates with SC and ToM in particular. These data indicate a temporo-frontal dissociation of bvFTD related disturbances of ToM and EF, with atrophy of the anterior temporal lobe being critically involved in ToM deficits. The consistent overlap within the insular cortex may be attributable to the multimodal and integrative role of this region in socioemotional and cognitive processing.

Exploring the links among brain iron accumulation, cognitive performance, and dietary intake in older adults: A longitudinal MRI study

This study evaluated longitudinal brain iron accumulation in older adults, its association with cognition, and the role of specific nutrients in mitigating iron accumulation. MRI-based, quantitative susceptibility mapping estimates of brain iron concentration were acquired from seventy-two healthy older adults (47 women, ages 60–86) at a baseline timepoint (TP1) and a follow-up timepoint (TP2) 2.5–3.0 years later. Dietary intake was evaluated at baseline using a validated questionnaire. Cognitive performance was assessed at TP2 using the uniform data set (Version 3) neuropsychological tests of episodic memory (MEM) and executive function (EF). Voxel-wise, linear mixed-effects models, adjusted for longitudinal gray matter volume alterations, age, and several non-dietary lifestyle factors revealed brain iron accumulation in multiple subcortical and cortical brain regions, which was negatively associated with both MEM and EF performance at T2. However, consumption of specific dietary nutrients at TP1 was associated with reduced brain iron accumulation. Our study provides a map of brain regions showing iron accumulation in older adults over a short 2.5-year follow-up and indicates that certain dietary nutrients may slow brain iron accumulation.

The cumulative impact of clinical risk on brain networks and associations with executive function impairments in adolescents with congenital heart disease.

Patients with congenital heart disease (CHD) demonstrate altered structural brain network connectivity. However, there is large variability between reported results and little information is available to identify those patients at highest risk for brain alterations. Thus, we aimed to investigate if network connectivity measures were associated with the individual patient's cumulative load of clinical risk factors and with family-environmental factors in a cohort of adolescents with CHD. Further, we investigated associations with executive function impairments. In 53 adolescents with CHD who underwent open-heart surgery during infancy, and 75 healthy controls, diffusion magnetic resonance imaging and neuropsychological assessment was conducted at a mean age of 13.2 ± 1.3 years. Structural connectomes were constructed using constrained spherical deconvolution tractography. Graph theory and network-based statistics were applied to investigate network connectivity measures. A cumulative clinical risk (CCR) score was built by summing up binary risk factors (neonatal, cardiac, neurologic) based on clinically relevant thresholds. The role of family-environmental factors (parental education, parental mental health, and family function) was investigated. An age-adjusted executive function summary score was built from nine neuropsychological tests. While network integration and segregation were preserved in adolescents with CHD, they showed lower edge strength in a dense subnetwork. A higher CCR score was associated with lower network segregation, edge strength, and executive function performance. Edge strength was particularly reduced in a subnetwork including inter-frontal and fronto-parietal-thalamic connections. There was no association with family-environmental factors. Poorer executive functioning was associated with lower network integration and segregation. We demonstrated evidence for alterations of network connectivity strength in adolescents with CHD - particularly in those patients who face a cumulative exposure to multiple clinical risk factors over time. Quantifying the cumulative load of risk early in life may help to better predict trajectories of brain development in order to identify and support the most vulnerable patients as early as possible.

Associations Between Hydration Status and Executive Function in Middle-Aged and Older Adults: Findings from the Nationally Representative Health and Retirement Study

The purpose of the current study is to examine the association between hydration status and cognitive function in middle-aged and older adults, drawing from a large, nationally representative sample in the United States and using a comprehensive set of executive function performance measures. We utilized data from the Health and Retirement Study to conduct twelve, three-stage hierarchical regressions on hydration status and executive function performance of older adults. Cognitive performance scores on the Trail Making A, Symbol Digit Modalities, and Letter Cancellation tests significantly differed by hydration status, and these outcomes follow a curvilinear pattern, such that performance scores are lower for those who are hyper-hydrated or dehydrated relative to those who are euhydrated or near-dehydration. Our study’s findings are consistent with prior studies examining the impact of serum osmolarity on cognitive performance. Specifically, a curvilinear pattern was associated with speed of processing tests of executive function. Overall, hydration status is associated with curvilinear patterns of performance on executive function measures, specifically Trail Making A, Symbol Digit Modalities, and Letter Cancellation Tests.

Associations Between Cognitive Performance and Self-Efficacy for Pain Management in Older Adults With Chronic Pain

BackgroundSelf-efficacy for pain management is the key to successful pain management, yet little is known about the effect of cognitive performance on self-efficacy for pain management. This study aimed to examine to what extent cognitive performance is related to self-efficacy for pain management in older adults with chronic pain. MethodsThe analyses utilized data from the baseline assessment of the MOBILIZE Boston Study. Five neuropsychological tests—the Clock in the Box Test, Letter Fluency Test, Trail-making Test, Hopkins Verbal Learning Test, and WORLD Test—were performed to measure the cognitive performance domains of 458 participants, aged 70 years and reporting chronic pain and self-efficacy for pain management. We measured self-efficacy for pain management using the Chronic Pain Self-Efficacy Scale. Statistical analyses were done using multiple linear regression analysis. ResultsAfter adjusting for sociodemographic factors, general cognitive performance, executive function, as measured by the Clock in the Box Test, and attention, as measured by the Trail-Making Test Part A, were significantly associated with self-efficacy for pain management in older adults with chronic pain. However, after controlling for sociodemographic factors, chronic conditions, pain interference, and physical performance, the associations between cognitive performance measures and self-efficacy for pain management weakened. ConclusionGreater cognitive performance in attention and executive function might be associated with better self-efficacy for pain management. Future longitudinal research is required to investigate the long-term implications of cognitive performance changes on the progress of self-efficacy for pain management in community-dwelling older adults.

Marital dissolution and cognition: The mediating effect of Aβ neuropathology

AbstractINTRODUCTIONWidowhood and divorce are extremely stressful life events that are associated with dementia, but the neurobiological underpinnings of this risk remain unknown. Amyloid beta (Aβ) load may explain influences of chronic stress, commonly seen in disruptive marital transitions, on cognitive decline.METHODSWe examined whether Aβ quantified by tracer uptake on positron emission tomography mediates associations between marital dissolution and executive functioning and episodic memory performance using data from 543 cognitively normal (CN) participants from the Alzheimer's Disease Neuroimaging Initiative.RESULTSMarriage dissolution was associated with increased Aβ burden (β = 0.56; P = 0.015) and worse memory performance (β = –0.09; P = 0.003). Aβ levels were a significant mediator for the relationship between marriage dissolution and memory (average causal mediation effect = –0.007; P = 0.029).DISCUSSIONFindings suggest that stressful life events, such as the dissolution of one's marriage, might exert an effect on Alzheimer's disease proteinopathy, which may subsequently influence poor cognition.Highlights Marital dissolution was associated with increased amyloid beta (Aβ) and memory declines. Aβ burden mediated associations between marital dissolution and memory. Findings were robust to potential non‐linear influences of age. Mediation results were not observed when stratifying marital groups by sex.

Retinal Microvasculature Changes Linked to Executive Function Impairment after COVID-19

Background/Objectives: Studies using optical coherence tomography angiography (OCTA) have revealed that individuals recovering from COVID-19 have a reduced retinal vascular density (VD) and larger foveal avascular zones (FAZs) than healthy individuals, with more severe cases showing greater reductions. We aimed to examine aspects of the retinal microvascularization in patients with post-COVID-19 condition (PCC) classified by COVID-19 severity and how these aspects relate to cognitive performance. Methods: This observational cross-sectional study included 104 PCC participants from the NAUTILUS Project, divided into severe (n = 59) and mild (n = 45) COVID-19 groups. Participants underwent cognitive assessments and OCTA to measure VD and perfusion density (PD) in the superficial capillary plexus (SVP) and FAZ. Analysis of covariance and partial Pearson and Spearman correlations were used to study intergroup differences and the relationships between cognitive and OCTA variables. Results: Severe PCC participants had significantly lower central (p = 0.03) and total (p = 0.03) VD, lower central (p = 0.02) PD measurements, and larger FAZ areas (p = 0.02) and perimeters (p = 0.02) than mild cases. Severe cases showed more cognitive impairment, particularly in speed processing (p = 0.003) and executive functions (p = 0.03). Lower central VD, lower central PD, and larger FAZ areas and perimeters were associated with worse executive function performance in the entire PCC sample and in the mild COVID-19 group. Conclusions: Retinal microvascular alterations, characterized by reduced VD and PD in the SVP and larger FAZ areas, were associated with cognitive impairments in PCC individuals. These findings suggest that severe COVID-19 leads to long-lasting microvascular damage, impacting retinal and cognitive health.

Coping patterns associations with cognitive function in older adults.

Cognitive function may contribute to variability in older adults' ability to cope with chronic stress; however, limited research has evaluated this relationship. This study investigated the relationship between theoretically derived coping domains and cognitive function in 165 middle-to-older adults during the Omicron stage of COVID-19. Participants completed a clinical interview and self-report measures of health. The National Alzheimer's Coordinating Center Uniform Data Set neuropsychological battery was used to evaluate memory, language, executive function/speed, and working memory. Structural equation modeling evaluated the underlying factor structure of the Brief COPE adapted for COVID-19. The data supported the proposed second-order Approach factor comprised of Problem-Solving and Emotion Regulation (ER) strategies and a first-order Avoidance factor. Higher Avoidance was associated with greater depression symptoms, lower income and worse memory, executive function, working memory, and verbal fluency performance. Higher Problem-Solving was associated with better verbal fluency performance. ER strategies were not significantly associated with cognitive function. The use of Problem-Solving was not associated with less Avoidance. Greater use of Problem-Solving, ER, and Avoidance were all associated with higher levels of stress. Post-hoc analyses found that higher Acceptance was the only coping strategy associated with less stress. These findings demonstrate that older adults with worse cognitive function were more likely to use Avoidance during the pandemic, which could result in prolonged stress and adverse health consequences. Future research is warranted to investigate whether acceptance-based interventions reduce the avoidance and impact of stress on health in vulnerable older adults.