Executive Function Skills Research Articles

Theory of mind and text comprehension across the lifespan: A meta-analysis.

Researchers argue that theory of mind (ToM) abilities are needed for text (listening or reading) comprehension. Although many studies have supported this claim, findings are mixed and researchers have disagreed on how fundamental this relation is-for example, whether ToM and text comprehension are related merely because of shared variance with verbal and executive function skills. To address these issues more definitively, we conducted a meta-analysis examining ToM and text comprehension, which included 47 independent samples with 5,123 participants ranging in age from 3 to 70 years of age (M = 10.53 years). We found a statistically significant association (r = .33) between ToM and text comprehension across 157 effect sizes. This relation did not differ based on whether data were cross-sectional or longitudinal, the age of participants, or most characteristics of the ToM or comprehension tasks (e.g., the degree to which they were narrative or inferential). However, the effect size was stronger in some languages and for listening comprehension rather than reading comprehension tasks. In longitudinal designs, the effect size did not differ depending on whether ToM was assessed before text comprehension or the reverse. Finally, we conducted meta-analyses controlling for verbal and/or executive function abilities and found that the relation between ToM and text comprehension was significant when controlling for each as well as both abilities (r = .22-.32). The current findings provide the strongest evidence to date that there is a fundamental relation between ToM and text comprehension. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Multilingualism impacts children's executive function and core autism symptoms.

Autism spectrum disorder (ASD) is associated with marked heterogeneity in executive function (EF) abilities. EF components including inhibition and shifting are related to ASD core symptoms such as perspective taking, social communication, and repetitive behavior. Recent research suggests that multilingualism may have a beneficial impact on EF abilities, especially in children with ASD. However, there remains a lack of comprehensive understanding regarding the relationships between multilingualism, EF, and core symptoms in children with ASD. Here, we examined these associations in 7-12-year-old children with and without ASD (N = 116; 53 ASD, Mean age = 9.94 years). Results suggest that multilingual children have stronger parent-reported inhibition, shifting, and perspective-taking skills than monolingual children. Furthermore, we found a significant interaction between diagnosis and multilingual status on inhibition, such that the effects of multilingualism were stronger for children with ASD than typically developing (TD) children. Finally, we found indirect effects of multilingualism on perspective taking, social communication, and repetitive behaviors mediated by EF skills. These results demonstrate the supportive influences multilingual experience might have on bolstering EF and reducing ASD-related symptoms.

Relations Between Academic and Behavioral Adaptations: The Antecedent Effects of Executive Function.

Using a large sample (n = 1163) from the National Institute of Child Health and Development Study of Early Child Care and Youth Development, the Random Intercept Cross-Lagged Panel Model was employed to unpack the between-person and within-person aspects in the relations between children's academic performance and externalizing/internalizing behaviors during primary school and examined the predictive role of early executive function. Results showed that the reciprocal relations between state-level fluctuations in children's behavioral problems and academic performance were largely unsupported. Children with more advanced early executive function were found to have better academic performance and fewer behavioral problems throughout primary school, supporting the antecedent role of early executive function. These findings suggest that fostering executive function skills early on could be a key strategy for improving both academic outcomes and behavioral adjustment in children.

The role of parenting in autonomy and executive function development among young children experiencing homelessness

A large body of research has shown homelessness is a risk factor for academic difficulties. However, some children experiencing homelessness begin kindergarten well-prepared and continue to succeed; this variability has motivated a search for protective factors supporting academic achievement in the context of homelessness. Two such factors might be children’s autonomy and executive function (EF), which allow children to take control of their own learning. The current study examined links between autonomy and EF skills, as well as the role of parenting in their development among young children experiencing homelessness. Participants included 78 parents and their children (Mage = 53 months) residing in emergency housing. Children were given an autonomy assessment and both cool and hot EF tasks; parent–child dyads completed a problem-solving task to measure autonomy-supportive parenting. Results indicated that child autonomy was significantly correlated with both cool and hot EF. Cool EF was related to academic skills. Autonomy-supportive parenting was significantly linked only to children’s cool EF above and beyond parental warmth, suggesting this dimension of parenting may play a unique role in the development of cool EF in the context of homelessness.

Effects of the Tools for Getting Along Curriculum on Teachers’ Reports of Elementary Students’ Executive Functions, Social-Emotional Skills, and Behavior Problems

In this study, we examined the effectiveness of Tools for Getting Along (TFGA) on teachers’ reports of executive functioning (EF), social-emotional, and behavioral skills of upper elementary school students. TFGA is a classroom-level prevention curriculum that teaches students a sequence of empirically based problem-solving steps to apply in emotionally charged situations. We randomly assigned 52 elementary schools in California, Oklahoma, and Kentucky to the treatment (n = 26) or comparison (n = 26) condition, with study participants including 135 grade 4 teachers and their 1,713 students. Multilevel analyses revealed that relative to those in the comparison group, students who participated in TFGA had significantly better social skills (effect size = 0.12) and higher levels of behaviors associated with EFs (effect size = 0.11), as reported by their teachers. Further, students whose teachers reported as having higher internalizing and externalizing behaviors, lower competence, and weaker behaviors associated with EFs at baseline experienced greater improvements in these skills after participating in TFGA than their counterparts with relatively stronger skills in the comparison group. We discuss educational implications of this study to promote and scale evidence-based, social-emotional practices in elementary school classrooms.

Back to school: Teachers’ initial perceptions of students’ executive function behaviors are important for teacher–student relationships and executive function development

The transition to upper-elementary school marks an important shift when students are expected to independently manage their behaviors, attention, and engagement. The current study used a socioeconomically- and racially/ethnically-diverse sample of upper-elementary school students (N = 336, M age = 9.85 years). Results showed that teachers’ initial perceptions of students’ executive function (EF) behaviors as indexed by how well students adjusted to new situations, remembered multi-step activities, and stayed focused were related to their reports of conflict with students in the spring. Furthermore, teacher–student conflict was linked with teacher-reported EF behaviors in the spring, controlling for EF behaviors in the fall. Finally, teachers’ initial perceptions of students’ EF behaviors were associated with children’s performance on EF tasks in the spring, controlling for direct assessment of EF skills in the fall. Our findings emphasize the role of early teacher perceptions for the development of teacher–student relationships and children’s self-regulation skills during the school year.

Prenatal risk factors for child executive function at 3–5 years of age: the roles of maternal mood, substance use, and socioeconomic adversity in a prospective cohort study

BackgroundA growing body of literature links prenatal mood and substance use to children's cognitive and behavioral development. The relative contribution of these risk factors on children's executive function (EF) in the context of socioeconomic adversities needs further evaluation. To address this gap, we investigated the role of prenatal maternal anxiety and depression on childhood EF, specifically inhibitory control and working memory, within the context of socioeconomic adversities and prenatal substance use. We hypothesized that higher maternal mood symptoms, higher persistent prenatal drinking and smoking, and lower socioeconomic status would be associated with lower EF skills during early childhood.MethodsWe used data from 334 mother–child dyads followed prospectively through pregnancy and the offspring’s childhood. Prenatal maternal depression and anxiety were assessed via standardized questionnaires. Prenatal alcohol and tobacco consumption were assessed via a timeline follow-back interview. The EF touch battery assessed child inhibitory control and working memory at 3–5 years of age (4.76 ± 0.58 years, 171 females). Separate linear regression models were used to estimate the association of prenatal tobacco, alcohol, anxiety, and depression exposure with our two components of child EF, inhibitory control and working memory, while adjusting for gestational age, sex, and age at assessment. The following variables were also included as covariates: maternal educational achievement, employment status, parity, and household crowding index.ResultsChildren of mothers with high trait anxiety scores had reduced inhibitory control compared to children of mothers without trait anxiety or depression (β = -0.12, 95% CI:-0.22,-0.01). Children of mothers in the moderate to high continuous smoking group showed lower inhibitory control (β = − 0.19, 95% CI:-0.38,-0.01) compared to children of mothers in the none smoking group. Additionally, lower maternal education and higher household crowding were each associated with reduced inhibitory control. We found no significant association between prenatal maternal depression, anxiety, or socioeconomic factors with working memory.ConclusionsThese results underscore the need for comprehensive context-specific intervention packages, including mental health support for women to promote healthy inhibitory control development in children.

Integrating the ideas of mindful meditation into physical activities to improve executive function skills of kindergarten children

This study aimed to examine whether physical activities based on mindful meditation can significantly enhance executive function (EF) skills in kindergarten children. A pre-experimental design was used, and purposive sampling was conducted to recruit the participants. A total of 87 kindergarten children were recruited, including 66 regular children and 21 who were screened as having a risk of Attention Deficit Hyperactivity Disorder (ADHD) based on a t-score of ≥ 1.5 on the Swanson, Nolan, and Pelham Rating Scale-IV (SNAP-IV). The participants received one hour of training every day, four days per week, for eight weeks. The modified Thai version of the Behavior Rating Inventory of Executive Function-Preschool (BRIEF-P) was administered before and after the intervention. Paired t-tests were conducted to determine if there were any significant differences between the pre- and post-tests for children with and without a risk of ADHD. Independent t-tests were also conducted to determine if there were any significant differences between children with and without a risk of ADHD. The intervention significantly enhanced the participants' performance on the full BRIEF scale and all subscales (inhibition, cognitive flexibility, emotion control, working memory, and planning). Additionally, significant differences in cognitive flexibility, inhibition, and emotion management were found between children with and without a risk of ADHD in the pre- and post-tests. Overall, the intervention effectively enhanced the executive function of kindergarten students at risk of ADHD. However, interpretation of the study’s results should be done with caution due to the lack of a control group and random sampling. A true experimental design is suggested to overcome these limitations.

Within-Person Effects of Executive Functioning on Anxiety and Depressive Symptoms in Youth with Neurodevelopmental Disorders: A Longitudinal Study

Abstract Objectives The objective was to disentangle the role of between- and within-person variation in executive functioning (EF) in the development of anxiety and depressive symptoms among youth with neurodevelopmental disorders. Methods We assessed 85 youth with ADHD, 38 youth with autism spectrum disorder (ASD), and 50 typically developing (TD) youth at baseline (Mage = 11.7 years, 64% males), 2-year follow-up, and 10-year follow-up with neuropsychological tests of EF and anxiety and depressive symptoms scales. Results Across groups, depressive symptoms increased with age, whereas anxiety symptoms were stable. Greater within-person improvement in overall EF from baseline to 2-year follow-up predicted reduced anxiety symptoms. Greater within-person improvement in cognitive flexibility predicted reduced depressive symptoms from baseline to 2-year follow-up. Conclusions We conclude that improvement in EF skills in youth may lessen the severity of anxiety and depressive symptoms over time. Thus, EF could be an intervention target to prevent anxiety and depressive symptoms.

Executive functioning and nonverbal cognitive factors associated with response to technology-assisted language intervention

ObjectiveTo explore potential differences in the relationship between executive function (EF) skills and language development when integrating augmentative and alternative communication technology into speech-language therapy for deaf/hard of hearing (DHH) children. MethodRandomized trial data were analysed to investigate this relationship among children who participated in a Technology-Assisted Language Intervention (TALI) compared to treatment as usual (TAU). Language samples were assessed for pre-post-intervention changes, including mean length of utterance in morphemes (MLU), mean turn length (MTL), and number of different words spoken (NDW). EF skills were measured with standardized parent-report assessment. ResultsThirty-seven DHH children were included (TALI n = 19 and TAU n = 18). Results of regression models indicated that higher EF skills were significantly (p < 0.05) associated with improvements in MLU, MTL, and NDW among children who received TAU. No significant associations between EF skills and any of the measures (MLU, MTL, NDW) were seen in children who received TALI. ConclusionThese results suggest that TALI may offer language learning support, particularly for DHH children with EF difficulties. Future research should investigate the direct relationship between EF measurements and language outcomes in TALI recipients. Establishing baseline EF measurements in DHH children could inform personalized strategies within language interventions and therapy.

Enhancing Computational Thinking, Spatial Reasoning, and Executive Function Skills: The Impact of Tangible Programming Tools in Early Childhood and Across Different Learner Stages

Enhancing Computational Thinking, Spatial Reasoning, and Executive Function Skills: The Impact of Tangible Programming Tools in Early Childhood and Across Different Learner Stages

Research Review: Pharmacological and non-pharmacological treatments for adolescents with attention deficit/hyperactivity disorder - a systematic review of the literature.

Attention Deficit/Hyperactivity Disorder (ADHD) demonstrates unique developmental manifestations in adolescence with implications for optimized, age-appropriate treatment. This 10-year update is the third in a series of systematic reviews examining the efficacy and safety of adolescent ADHD treatments. We broadly examined efficacy on ADHD symptoms, impairments, and other reported outcomes. Acute and long-term efficacy, and treatment moderators, were considered. We performed PubMed, EMBASE, and PsycINFO searches for articles published or in press from 2013 to 2024, integrated with hand search and randomized controlled trials (RCTs) identified in this series' earlier reviews. RCTs examining the safety or efficacy of interventions delivered to adolescents (ages 10.0-19.9) with a diagnosis of ADHD were included. Study characteristics were extracted and reviewed, quality of evidence was assessed using GRADE, and effect sizes were calculated for individual studies and illustrated using forest plots. Sixty-three RCTs were identified. Quality of evidence ranged from high (medication; k = 29) to very low (nutrient supplementation, neurofeedback, occupational therapy; k = 1 each). Medications demonstrated consistent strong impact on ADHD symptoms and inconsistent impact on impairment. Diverse cognitive/behavioral treatments (C/BTs) demonstrated inconsistent impact on ADHD symptoms but strong and consistent impact on impairment and executive function skills, plus moderate benefits on internalizing symptoms. No interventions demonstrated significant safety concerns. Long-term maintenance (up to 3 years post-treatment) was demonstrated for C/BTs, though moderate quality of evidence was noted because participants cannot be fully blinded to receipt of treatment. The effects of C/BTs and medication appear complementary, not duplicative. Combining medication and C/BT is advised at treatment outset to maximize engagement, maintenance, and response breadth (i.e. improving both ADHD symptoms/cognitive performance and coping skills/functional impairments). Engagement strategies (e.g. motivational interviewing) may facilitate uptake. Novel treatments do not yet demonstrate effects on ADHD symptoms or impairments in adolescents but remain a promising area for research.

Three-Year Effects of Motivational Interviewing–Enhanced Behavior Therapy for Adolescents With ADHD: A Randomized Community-Based Trial

This study reports 3-year effects of a parent-teen cognitive/behavioral treatment for adolescent attention-deficit/hyperactivity disorder (ADHD), blended with Motivational Interviewing (Supporting Teens' Autonomy Daily [STAND]), vs Usual Care (UC) in 4 community clinics. This was a randomized clinical trial with double randomization of adolescents and therapists to STAND vs UC. Participants were 278 culturally diverse adolescents diagnosed with DSM-5 ADHD and 82 community therapists. Long-term effects on outcomes and theorized mechanisms were assessed at approximately 3 years post baseline (mean age= 16.94 years, SD= 1.69): ADHD severity (parent-rated), parent-teen conflict (parent/adolescent-rated), organization, time management, and planning skills (OTP; parent-rated), treatment and school enrollment (parent/adolescent-reported), and ADHD diagnostic persistence (clinician-determined). Therapist licensure was examined as a treatment moderator. Intent-to-treat (ITT) and per protocol analyses (n = 225; participants initiating treatment after agency intake) were conducted. As in the original trial, ITT analyses indicated no long-term group by time effects. However, STAND (vs UC) led to superior long-term outcomes when therapists were licensed (22% of sample) vs unlicensed for parent-rated hyperactivity/impulsivity (d= 0.39; adolescent-rated parent-teen conflict: d= 0.27, and parent-rated OTP skills: d= 0.79). Previously reported post-treatment group differences on medication engagement were non-significant at the 3-year follow-up. Although STAND did not outperform UC overall, group by licensure interactions indicate specific long-term impacts on ADHD symptoms, executive function skills such as OTP, and parent-teen conflict, extending this trial's acute effects and replicating previous findings. Clinicians in community settings might recommend adjunctive cognitive/behavioral treatment to adolescents with ADHD to maximize long-term outcomes. However, additional efforts are needed to facilitate effective implementation by unlicensed clinicians. STAND Community Trial (STAND); https://clinicaltrials.gov; NCT02694939. Long-term Follow-up of MI-based Behavioral Intervention Delivered in Community Mental Health; https://osf.io; h5w6f. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.

Early childhood executive function predicts concurrent and later social and behavioral outcomes: A review and meta-analysis.

Executive function (EF), the set of mental processes and skills involved in goal-oriented planning, organizing, and controlling behavior, is believed to support child development across many domains of life. However, although ample evidence suggests a relation between childhood EF and academic skills, it is less clear what its role is in domains beyond academics. We report a meta-analysis of relations between early childhood EF (assessed at 36-60 months of age) and social, health, and behavioral outcomes assessed concurrently and longitudinally (1,459 effect sizes, 158 studies, n = 144,642). No significant relations were found between EF and health outcomes. EF was concurrently associated with emotion understanding and regulation, prosocial skills, peer acceptance, and skill at lying. Both concurrently and longitudinally, EF was positively associated with peer acceptance, adaptive classroom behavior, and social competence, and negatively associated with internalizing and externalizing problems, and inattention and hyperactivity. For adolescent outcomes, only the relation between EF and internalizing could be meta-analyzed, and no significant relation was found between these variables. The magnitude of effect sizes varied, with absolute values ranging from r = .02 to .30. Moderator analyses indicated the relation between EF and behavioral outcomes varied by outcome, but there was no such finding for EF and social or health outcomes. EF was more strongly associated with teacher- versus parent-reported behavioral problems. There was little evidence that quality indicators affected effect sizes. There was also little evidence of publication bias. Overall, our results are consistent with the possibility of broad relevance of EF for child development; yet, future research should provide stronger causal tests of hypothesized relations between EF and outcomes to better understand the nature of EF and whether fostering it can promote healthy development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Maternal Depressive Symptoms and Risk for Childhood Depression: Role of Executive Functions

Offspring of mothers with depression are at increased risk for executive function (EF) deficits and later depressive symptoms, but limited studies examined EF as an intermediary pathway. This study examined the role of EF in mediating the association between maternal and child depressive symptoms. Data were from a longitudinal birth cohort consisting of 739 participants followed from the antenatal period for 12 years. Mothers completed the Edinburgh Perinatal Depression Scale at 26-28 weeks' gestation, at 3 months, and 24 months postpartum. At 8.5-10 years, children self-reported the Children's Depression Inventory-2. Task-based and parent-reported EF measures were collected at four timepoints between 3.5 and 8.5 years. Latent growth curve models examined antenatal depressive symptoms and its trajectory in contributing to cold (i.e., cognitive) and hot (i.e., affective) EF. We then assessed the extent to which EF mediated this association. Maternal depressive symptoms did not directly predict depressive symptoms in late childhood. Antenatal depressive symptoms predicted lower cold (ß = -0.13, 95% CI= -0.25, -0.004) and hot EF (ß = -0.26, 95% CI= -0.38, -0.15). Deficits in cold EF (ß = -0.26, 95% CI = -0.41, -0.11) acted as an intermediary path to depressive symptoms, while hot EF mediated the association between maternal and child depressive symptoms, forming an indirect path that accounted for 37.5% of the association. Deficits in hot EF may be a pathway in explaining the intergenerational transmission of depression. The finding suggests fostering EF skills as a potential strategy for at-risk children.

Anterior and posterior thalamic volumes differentially correlate with memory, attention, and motor processes in HIV infection and alcohol use disorder comorbidity

The thalamus, with its reciprocal connections to and from cortical, subcortical, and cerebellar regions, is a central active participant in multiple functional brain networks. Structural MRI studies measuring the entire thalamus without respect to its regional or nuclear divisions report volume shrinkage in diseases including HIV infection, alcohol use disorder (AUD), and their comorbidity (HIV+AUD). Here, we examined relations between thalamic subregions (anterior, ventral, medial, and posterior) and neuropsychological functions (attention/working memory, executive functioning, episodic memory, and motor skills). Volumes of thalamic subregions were derived from automatic segmentations of standard T1 weighted MRIs of 65 individuals with HIV, 189 with AUD, 80 with HIV+AUD comorbidity, and 141 healthy controls (CTRL). Total thalamic volume was smaller and cognitive and motor composite scores were lower in the three diagnostic groups relative to the CTRL group. The AUD and HIV+AUD groups had significantly smaller thalamic subregional volumes than the CTRL group. The HIV+AUD group had smaller anterior thalamic volume than the HIV-only group and smaller ventral thalamic volume than the AUD-only group. In the HIV+AUD group, memory scores correlated with anterior thalamic volumes, attention/working memory scores correlated with posterior and medial thalamic volumes, and motor skill scores correlated with posterior thalamic volumes. Exploratory analyses focused on the HIV+AUD group indicated that within the posterior thalamic region, the pulvinar and medial geniculate nuclei were related to attention/working memory scores, and the pulvinar was related to motor skills scores. This study is novel in locating volume deficits in specific thalamic subregions, in addition to the thalamus as a whole, in HIV, AUD, and their comorbidity and in identifying functional ramifications of these deficits. Taken together, this study highlights the relevance of thalamic subregional volume deficits to dissociable cognitive and motor processes.

The international study of movement behaviours in the early years: A pilot study from Bosnia and Herzegovina

The World Health Organization (WHO) released guidelines for physical activity (PA), sedentary behavior, and sleep for children under 5 years of age in 2019, but there are no reports on the adherence to the guidelines in southeastern Europe. This study aimed to: (i) determine the proportion of preschool children (aged 3-5 years) who met the WHO guidelines and examine the feasibility of the proposed protocol for the SUNRISE study in Bosnia and Herzegovina (B&amp;H), and (ii) define sex-, and urban/rural-living-specifics in movement-behaviors, anthropometrics, gross-motor-skills, fine-motor- skills, and cognitive-skills. The sample comprised 115 preschool children (63 girls and 52 boys), residing in urban (n = 66) and rural areas (n = 49) from B&amp;H. Participants were tested on movement behaviors (PA, sleep time, screen time) by accelerometry and comprehensive questionnaires. Body height, weight, body mass index, executive function, fine-, and gross-motor skill, and cognitive function were also measured. The results showed that PA-, sleep duration-, and screen time guidelines were met by 64%, 74% and 53% of children, respectively, while only 23% of the children met all three guidelines on movement behaviors. Boys exhibited higher PA than girls, but no differences in gross- and fine motor skills and cognitive functioning were recorded between the sexes. Children living in urban and rural environments did not differ in any of the studied variables. Results evidenced preschool children from B&amp;H being in line with other samples globally about study variables. Although PA was higher in boys than in girls it was not translated to differences in motor skills. Further studies on larger samples and other environments are warranted.

Bridging the Connection between Fluency in Reading and Arithmetic.

This study examines the contribution of early executive functions (EFs) in the association between fluency in reading and arithmetic. Kindergarten children (N = 1185) were assessed on executive functions skills and on reading and arithmetic fluency in Grade 1 and Grade 3. The analysis revealed that beyond the connection within each domain there is a unidirectional effect between fluency measures, with Grade 1 reading fluency significantly influencing the development of arithmetic fluency in Grade 3. Furthermore, the findings indicate that kindergarten EFs significantly contribute to arithmetic fluency at both time points and to reading fluency in the first grade. Early EF skills also emerged as significant contributors to the associations between fluency performance in reading and arithmetic, suggesting that the influence of EFs extends beyond individual academic domains. These findings have implications for understanding the cognitive mechanisms that underlie the relations between these academic skills.

Free-water: A promising structural biomarker for cognitive decline in aging and mild cognitive impairment.

Diffusion MRI derived free-water (FW) metrics show promise in predicting cognitive impairment and decline in aging and Alzheimer's disease (AD). FW is sensitive to subtle changes in brain microstructure, so it is possible these measures may be more sensitive than traditional structural neuroimaging biomarkers. In this study, we examined the associations among FW metrics (measured in the hippocampus and two AD signature meta-ROIs) with cognitive performance, and compared FW findings to those from more traditional neuroimaging biomarkers of AD. We leveraged data from a longitudinal cohort (nparticipants = 296, nobservations = 870, age at baseline: 73 ± 7 years, 40% mild cognitive impairment [MCI]) of older adults who underwent serial neuropsychological assessment (episodic memory, information processing speed, executive function, language, and visuospatial skills) and brain MRI over a maximum of four time points, including baseline (n = 284), 18-month (n = 246), 3-year (n = 215), and 5-year (n = 125) visits. The mean follow-up period was 2.8 ± 1.3 years. Structural MRI was used to quantify hippocampal volume, in addition to Schwarz and McEvoy AD Signatures. FW and FW-corrected fractional anisotropy (FAFWcorr) were quantified in the hippocampus (hippocampal FW) and the AD signature areas (SchwarzFW, McEvoyFW) from diffusion-weighted (dMRI) images using bi-tensor modeling (FW elimination and mapping method). Linear regression assessed the association of each biomarker with baseline cognitive performance. Additionally, linear mixed-effects regression assessed the association between baseline biomarker values and longitudinal cognitive performance. A subsequent competitive model analysis was conducted on both baseline and longitudinal data to determine how much additional variance in cognitive performance was explained by each biomarker compared to the covariate only model, which included age, sex, race/ethnicity, apolipoprotein-ε4 status, cognitive status, and modified Framingham Stroke Risk Profile scores. All analyses were corrected for multiple comparisons using an FDR procedure. Cross-sectional results indicate that hippocampal volume, hippocampal FW, Schwarz and McEvoy AD Signatures, and the SchwarzFW and McEvoyFW metrics are all significantly associated with memory performance. Baseline competitive model analyses showed that the McEvoy AD Signature and SchwarzFW explain the most unique variance beyond covariates for memory (ΔRadj 2 = 3.47 ± 1.65%) and executive function (ΔRadj 2 = 2.43 ± 1.63%), respectively. Longitudinal models revealed that hippocampal FW explained substantial unique variance for memory performance (ΔRadj 2 = 8.13 ± 1.25%), and outperformed all other biomarkers examined in predicting memory decline (pFDR = 1.95 x 10-11). This study shows that hippocampal FW is a sensitive biomarker for cognitive impairment and decline, and provides strong evidence for further exploration of this measure in aging and AD.

The Relationship Between Executive Functioning and Narrative Language Abilities in Aphasia.

Although individuals with aphasia commonly exhibit challenges in executive functioning (EF) and spoken discourse, there is limited research exploring connections between these abilities within this specific population. Therefore, this study investigated the relationship between verbal and nonverbal EF and narrative productions in aphasia using a multilevel linguistic approach. Participants included 22 persons with aphasia (PWA) and 24 age- and education-matched, neurologically healthy controls (NHC). All participants completed assessments for EF and a story retelling task. Narrative samples were analyzed for microlinguistic (productivity, lexical and syntactic features, semantic content, word and sentence errors) and macrolinguistic (coherence, informational content, organization, and language use) characteristics. Correlational analyses were employed to explore the relationships among narrative variables. EF factors, extracted from principal component analysis, were used as predictive variables in hierarchical stepwise regression analyses to evaluate their role in predicting narrative performances of PWA and NHC. Relative to NHC, PWA exhibited impaired narrative performance affecting both microlinguistic and macrolinguistic levels. Breakdowns at the structural level (i.e., reduced productivity, syntax, lexical retrieval, and diversity) correlated with impaired story completeness, organization, and connectedness; this relationship was more prominent for PWA. Three EF factors representing (1) verbal EF, (2) verbal and nonverbal fluency, and (3) nonverbal EF were extracted. Factors 1 and 2 largely predicted narrative performance, whereas Factor 3 (i.e., nonverbal EF) contributed prominently to predicting macrolinguistic discourse performance in both groups although accounting for less variance in the data. Overall, lower EF scores, particularly verbal EF variables, predicted poor narrative performance in both groups. Our results indicate that both linguistic and extralinguistic cognitive abilities play a role in story retelling performances among PWA. Notably, both verbal and nonverbal EF skills were found to be correlated with narrative abilities. However, the extent of their contributions varied depending on the discourse levels assessed. These findings provide a significant contribution to our understanding of the cognitive factors associated with breakdowns in discourse among PWA and highlight the importance of comprehensive assessment of EF and discourse within this population. https://doi.org/10.23641/asha.26485627.