Domains Of Fluency Research Articles

Depressive symptoms are linked to age-specific neuroanatomical and cognitive variations

Depression is a heterogeneous disorder, both in terms of patient symptomatology and in patient sociodemographic factors. Here, we examine the contribution of age to this heterogeneity, by characterizing the associations of depressive symptoms with cognitive performance and brain structure across the lifespan. We analyzed data from the Cambridge Centre for Aging Neuroscience (Cam-CAN) cohort (N = 2591, age 18–99). A subset of this cohort (N = 647) underwent structural MRI. Depressive symptoms were measured using the Hospital Anxiety and Depression Scale. Cognitive assessments were performed using The Addenbrooke's Cognitive Examination Revised. Generalized linear models were employed to examine the relationship between depressive symptoms and cognitive performance. Statistical parametric mapping explored age-dependent associations between depressive symptoms and grey matter volume. Cognitive performance was associated with a significant age by depression by cognitive domain interaction, indicating that older individuals with more depressive symptoms had a lower cognitive performance, particularly in the fluency domain. Structural MRI revealed preferential depression-related reduction in grey matter volume in the left and right hippocampi in older adults. By contrast, in younger adults, depressive symptoms were more strongly associated with grey matter volume reduction in the left superior frontal gyrus and left middle frontal gyrus. Collectively, these findings indicate that the associations of depression with cognitive performance and brain structure are age-dependent, suggesting that the pathophysiological mechanisms underlying depression may differ between young and older adults. Recognizing these differences will support the development of better diagnostic tools and therapeutic interventions for depression across the lifespan.

The Impact of COVID-19 on Neuropsychological and Emotional-Behavioural Development in a Group of 8- and 9-Year-Old Children.

Introduction: The rapid spread of the COVID-19 pandemic has had a significant impact on the psychological well-being of millions of people around the world, and even more so among children. Contracting SARS-CoV-2, resulting in home confinement and restrictions on daily and school activities, led to negative effects on the mental health of the paediatric population. Although children suffering from COVID-19 had milder general symptoms compared to adults, impairments in cognitive, neuropsychological, and emotional-behavioural development were noted. Objective: The main aim of the present study was to detect possible changes in the neuropsychological and emotional-behavioural development of children after infection with the SARS-CoV-2 virus. The second aim was to investigate possible relationships between cognitive abilities and psychosocial characteristics. Methods: A total of 40 patients aged 8-9 years were recruited and divided into two groups: children who contracted (CG) and did not contract (NCG) SARS-CoV-2. The BVN 5-11 (Neuropsychological evaluation battery for developmental age from 5 to 11 years) instrument was administered to assess attention, memory, verbal recall, planning, phonemics, and categorical fluency domains in the paediatric population. Data on changes in emotional-behavioural profile and daily activities were collected through a questionnaire to parents. Results: The Wilcoxon signed-rank test revealed a significant change in mood after the COVID-19 period only in the CG participants (p = 0.019). However, the neuropsychological performance of the two identified groups on BVN 5-11 sub-items was below the cutoff of clinical significance. Correlations were found between sub-items of the BVN 5-11 battery, extracurricular activities, and children's psycho-motor development. Significant positive correlations were observed between Naming on visual presentation and Reading time (p = 0.006), backward digit span and time of motor activity (p = 0.009), Visual attention and Reading time (p = 0.048), and Phonemic fluency and time observed using devices (p = 0.030). Positive statistically significant correlations were also found between Mood and Free behaviour (p = 0.000), between Mood and Structured behaviour (p = 0.005), and between Mood and peer Interaction (p = 0.013). Conclusions: SARS-CoV-2 infection negatively affected the emotional development of children contracting the virus. The neuropsychological functioning of the paediatric population was influenced by psychosocial variables and time spent on daily activities, which played a protective role in children's cognitive development.

Association of Moderate and Vigorous Physical Activity With Cognitive Performance: Evidence From Brazil.

It is estimated that 2% of dementia cases worldwide could be prevented with increases in physical activity. However, there is little evidence of the association between vigorous physical activity (VPA) and cognitive performance. This study aimed to investigate the association of moderate physical activity (MPA) and VPA with cognitive performance in older adults from the Brazilian Longitudinal Study of Aging (ELSI-Brasil). Data from 7954 participants were analyzed. Mean age was 61.8 ± 9.2 years, 61.8% were women, and 44.3% were mixed races. Cognitive performance evaluated the memory, temporal orientation, and verbal fluency domains. A global composite z-score was derived from the tests. Physical activity was assessed by self-report. We used linear regression models to verify the association of MPA and VPA with cognitive performance. Compared with participants who did not meet the guidelines for MPA (<150 min/wk), those who met the guidelines (150 to 299 min/wk) and those who performed more than 2x the recommended amount of MPA (300 min or more/wk) had better global cognitive performance (β = 0.163, 95% CI = 0.086, 0.241; P < 0.001; β = 0.180, 95% CI = 0.107, 0.253, P < 0.001, respectively). We found no association between VPA and cognitive performance. There was no additional benefit of VPA for cognitive performance.

COVID-19 and Cognitive Decline in Older Adults with High-Cardiovascular Risk: A Post Hoc Analysis.

Cognitive decline has been reported as a short-term sequela in patients hospitalized for coronavirus disease-19 (COVID-19). Whether COVID-19 is associated with late cognitive impairment in older free-living individuals with high cardiovascular risk, a group at greater risk of cognitive decline, is unknown. We determined this association of COVID-19 through a longitudinal evaluation of post-COVID-19 cognitive performance and impairment as post hoc analysis in 5,179 older adults (48% female) with mean (SD) age 68.5 (5.0) years, body mass index 31.7 (3.7) kg/m2, harboring ≥ 3 criteria for metabolic syndrome (e.g., hypertension, hyperlipidemia, hyperglycemia etc.) enrolled in PREDIMED-Plus trial. Pre- and post-COVID-19 cognitive performance was ascertained from scheduled assessments conducted using a battery of neuropsychological tests, including 5 domains: Global Cognitive Function, General Cognitive Function, Execution Function, Verbal Fluency and Attention domains, which were standardized for the cohort. Cognitive impairment was defined as the bottom 10 percentile of the sample. Multivariable linear and logistic regression models assessed the association of COVID-19 with cognitive decline and impairment, respectively. After a mean 50-week follow-up, no significant associations were observed between COVID-19 status and post-COVID-19 scores of all tapped neuropsychological domains, except Global Cognitive Function (GCF). When fully adjusted, COVID-19 was marginally associated with higher (better) post-pandemic GCF score (βadj (95% CI): 0.06 (0.00, 0.13) p=.05). However, the odds for post-COVID-19 cognitive impairment in GCF domain were not associated with the disease (ORadj (95% CI): 0.90 (0.53, 1.51) p=.68). In the PREDIMED-Plus cohort, COVID-19 status and cognitive impairment determined 50 weeks post-infection showed no association in older adults at high cardiovascular risk. This suggests that cognitive changes observed shortly after COVID-19 revert over time. However, cautious interpretation is warranted as these data were obtained within the framework of a clinical trial encouraging a healthy lifestyle.

The Effects of Paraeducator-Implemented Interventions on Student Literacy Skill Acquisition: A Review

Paraeducators are increasingly tasked with delivering early literacy instruction to students with disabilities in elementary schools. This review synthesized findings from 19 studies that examined paraeducator-implemented early literacy instruction and reported the included studies’ descriptive characteristics, methodological quality, and treatment outcomes. Studies were rated for methodological quality using the Council for Exceptional Children’s quality indicators. This systematic review was the first to describe paraeducator-implemented early literacy instruction in elementary school settings across single-case research designs and between-group research designs and the first to apply a set of quality indicators to rate study quality. The synthesized evidence suggests that, with the appropriate training and supervision, paraeducators were able to facilitate student acquisition in phonological knowledge, word reading, fluency, comprehension, and spelling domains. Implications for research and practice are discussed.

The Cerebellar Cognitive Affective/Schmahmann Syndrome Scale in Spinocerebellar Ataxias.

The Cerebellar Cognitive Affective/Schmahmann Syndrome (CCAS) manifests as impaired executive control, linguistic processing, visual spatial function, and affect regulation. The CCAS has been described in the spinocerebellar ataxias (SCAs), but its prevalence is unknown. We analyzed results of the CCAS/Schmahmann Scale (CCAS-S), developed to detect and quantify CCAS, in two natural history studies of 309 individuals Symptomatic for SCA1, SCA2, SCA3, SCA6, SCA7, or SCA8, 26 individuals Pre-symptomatic for SCA1 or SCA3, and 37 Controls. We compared total raw scores, domain scores, and total fail scores between Symptomatic, Pre-symptomatic, and Control cohorts, and between SCA types. We calculated scale sensitivity and selectivity based on CCAS category designation among Symptomatic individuals and Controls, and correlated CCAS-S performance against age and education, and in Symptomatic patients, against genetic repeat length, onset age, disease duration, motor ataxia, depression, and fatigue. Definite CCAS was identified in 46% of the Symptomatic group. False positive rate among Controls was 5.4%. Symptomatic individuals had poorer global CCAS-S performance than Controls, accounting for age and education. The domains of semantic fluency, phonemic fluency, and category switching that tap executive function and linguistic processing consistently separated Symptomatic individuals from Controls. CCAS-S scores correlated most closely with motor ataxia. Controls were similar to Pre-symptomatic individuals whose nearness to symptom onset was unknown. The use of the CCAS-S identifies a high CCAS prevalence in a large cohort of SCA patients, underscoring the utility of the scale and the notion that the CCAS is the third cornerstone of clinical ataxiology.

Efeitos da Dança Sênior® modalidade sentada nas funções cognitivas em pessoas idosas com e sem declínio cognitivo: ensaio clínico controlado

Abstract Objective To analyze the effects of Senior Dance® (SD) on cognitive aspects in older adults aged 60 to 85 years. Method Non-randomized controlled clinical trial consisting of two groups: (G1) institutionalized older adults with cognitive decline and (G2) non-institutionalized older adults without cognitive decline. Assessments were conducted using the Mini-Mental State Examination (MMSE), Brief Cognitive Screening Battery (BCSB), and Clinical Dementia Rating (CDR). The SD sessions were conducted in a seated format, for 12 weeks, twice a week, with a duration of 60 minutes each. The Mann-Whitney and Wilcoxon non-parametric tests were used for pre-intervention and post-intervention comparisons. Results G1 consisted of 15 older adults with mild cognitive impairment (MCI) and mild dementia, while G2 consisted of 32 older adults. The Wilcoxon test showed a statistically significant difference (p value ≤0.050) in various cognitive domains assessed by the MMSE and BCSB in both groups. Specifically, significant improvements were observed in the domains of attention, calculation, and language in G1, as well as in language in G2, according to the MMSE. Additionally, significant changes were noted in the domains of incidental memory, recognition, and verbal fluency in G1, and in incidental memory, immediate memory, delayed memory, recognition, and clock drawing in G2, as assessed by the BCSB. Conclusion It is concluded that SD had positive impacts on the cognitive functions of participants in both groups, contributing to prevention and health promotion.

98 Cognitive Outcomes Following Bilateral Focused Ultrasound Thalamotomy for Tremor

Objective:Essential tremor (ET) is the most common movement disorder, characterized by bilateral action tremors of the upper extremities. Surgical interventions can be considered for severe cases that are refractory to medication. Magnetic resonance-guided focused ultrasound (MRgFUS) of the ventral intermediate nucleus of the thalamus (Vim) is a recently approved, minimally invasive treatment for unilateral tremor. While patients are generally pleased with unilateral treatment, many patients are bothered by tremor on the untreated side. Historically, bilateral thalamotomy has been associated with a higher rate of adverse events, including cognitive impairment. MRgFUS Vim thalamotomy for bilateral tremor is currently being investigated. The goal of the present study was to evaluate the effect of bilateral MRgFUS Vim thalamotomy on cognition.Participants and Methods:Twelve patients with medication-refractory essential tremor (mean age = 68.77 +/- 11.78 years, mean education = 14.34 +/- 2.71 years, 8 male) were included in the present study. Three of the 12 patients met criteria for mild cognitive impairment (MCI). All patients successfully underwent unilateral MRgFUS thalamotomy at least 48 weeks before the second thalamotomy. A battery of neuropsychological tests was administered to patients before (considered baseline in the present study) and three months following the second thalamotomy. Baseline evaluations occurred on average 144.64 +/- 91.53 weeks (range: 55.00 - 346.58) after the first thalamotomy. The neuropsychological battery assessed domains of processing speed (Oral Symbol Digit Modalities Test, D-KEFS Color-Word Naming and Reading), attention (WAIS-IV Digit Span Forward), executive function (D-KEFS Color-Word Inhibition and Inhibition/Switching), working memory (WAIS-IV Digit Span Backward and Sequencing), verbal fluency (D-KEFS Letter Fluency and Animal Fluency), confrontation naming (Boston Naming Test), verbal memory (Hopkins Verbal Learning Test-Revised), and visuospatial perception (Judgment of Line Orientation). Alternate versions of tests were used when possible. Cognitive changes were analyzed at the group and individual level. Group level changes were assessed with paired sample t-tests (corrected for multiple comparisons). At the individual level, postoperative declines &gt; 1.5 SD from baseline were considered clinically significant.Results:Participants’ baseline intellectual functioning ranged from low average to superior (as measured by the WTAR). The mean baseline score on the Montreal Cognitive Assessment was 24.58 (range: 17 - 30). At the group level, there were no significant changes in cognitive scores from baseline to follow-up (all p values &gt; 0.635). At the individual level, one patient with MCI declined &gt; 1.5 SD on the verbal memory composite. No other patients showed declines &gt; 1.5 SD.Conclusions:Our preliminary findings suggest that bilateral MRgFUS Vim thalamotomy is relatively safe from a cognitive perspective. However, a single patient with MCI exhibited clinically significant postoperative decline in verbal memory. Future studies with larger sample sizes are needed to investigate the factors that increase the risk of postoperative cognitive decline, including pre-existing cognitive impairment, older age, and lesion size.

19 Auditory and Cognitive Function in Adults Living With and Without HIV

Objective:Hearing consists of peripheral components (outer and middle ear, cochlea) and the central auditory system (cochlear nuclei to the auditory cortex). Speech perception relies on peripheral hearing abilities (i.e., pure-tone thresholds) and central auditory processing (CAP) and cognitive functioning. Specifically, working memory, executive function, attention, and verbal functioning allow for speech understanding. As a result, CAP deficits are also influenced by peripheral hearing sensitivity and cognitive functioning. Assessing CAP deficits can be difficult because of these complex interactions. Prior work has shown persons living with HIV (PWH) are at higher risk for sensorineural hearing loss compared to persons living without HIV (PWOH) after adjusting for age, sex, and noise exposure. Further, HIV is a risk factor for cognitive impairment, one example being Alzheimer's disease (AD) and its precursor, Mild Cognitive Impairment (MCI), with auditory dysfunction occurring in earlier stages of AD. Therefore, the purpose of this study was to evaluate: 1) the peripheral hearing sensitivity and CAP in PWH and PWOH; and 2) the association between cognitive function measures and CAP in PWH and PWOH.Participants and Methods:Participants included 59 PWH (39 men and 20 women, mean age=66.7 years [SD=4.4 years]) and 27 PWOH (13 men and 14 women, mean age=71.9 years [SD=7.1 years]). Participants completed a standard neuropsychological battery assessing the domains of learning, recall, executive function, working memory, verbal fluency, processing speed and motor. Raw scores were transformed to demographically corrected, domain T-scores. Cognitive function was normal for 39 (66.1%) PWH and 16 (59.3%) PWOH while 43 (72.9%) PWH and 17 (63.0%) PWOH were determined to have MCI. Participants with dementia were excluded. Participants also completed a hearing assessment, a portion of which consisted of pure-tone thresholds, peripheral hearing measure, and dichotic digits testing (DDT), a CAP measure. Pure-tone air-conduction thresholds were obtained at octave frequencies from 0.25 through 8 kHz, including 3 and 6 kHz. A pure-tone average (PTA) was calculated from 0.5, 1, 2, and 4 kHz thresholds for each ear. The DDT involves the presentation of numbers from 1 to 10, excluding 7, in which two different digits are presented to one ear while two other digits are simultaneously presented to the opposite ear. The outcome of DDT is percent correct.Results:PWH had slightly lower (i.e., better) mean PTAs in both ears compared to PWOH, but this was not statistically significant. Conversely, PWH had lower percent correct DDT results compared to PWOH, but this difference was also not statistically significant. Participants with impairment in verbal fluency, executive functioning, and working memory had significantly worse DDT results by approximately 10%, but only for right ear data.Conclusions:PWH in our sample had better hearing than PWOH, which can be explained by PWH having a lower mean age. PWH had poorer DDT results, however, indicative of CAP deficits rather than peripheral hearing problems. Poor right ear DDT was associated with impairments specifically in frontal-based cognitive processes with an executive component.

GLIOMA-16 EARLY NEUROCOGNITIVE OUTCOME POST RESECTION OF ADULT SUPRATENTORIAL GLIOMAS AT THE KENYATTA NATIONAL HOSPITAL

Abstract Gliomas are the commonest brain tumors in our setting. Traditionally; Overall Survival, progression free survival and Extent of resection are used to define oncologic outcome in gliomas. These measures don’t reflect the complete patient status and hence the need for functional outcome determination. Cognitive outcome, is a key functional measure in gliomas. This was a prospective Cohort Study whose objective was to determine the Early Neurocognitive outcome post-resection of adult supratentorial gliomas at the Kenyatta National Hospital. Our study population was adult patients with supratentorial gliomas. We examined twenty patients who met the inclusion criteria. Data collection was by an interviewer-based questionnaire incorporating the ACE III (Addenbrooke Cognitive Examination III) tool administered at three instances as follows: - Within two weeks Preoperatively (T0), at one week postoperatively (T1) and at four weeks postoperatively (T2). The pre and post operative cognitive scores were then analyzed to determine the cognitive outcome. Statistical significance was considered where the p-value was &amp;lt;0.05. Ninety five percent of patients had cognitive impairment at baseline. Mean age of presentation was 34.3 years for Low grade glioma (LGG) and 43.8 years for High Grade Glioma (HGG). 55% of patients had LGG while 45% had HGG. Overall, there was transient decline in cognition from T0-T1 and a gradual improvement beyond the baseline from T1-T2. This improvement was across all domains but was significant in the total ACE score, memory and fluency. LGG showed the greatest improvement in cognition especially in the fluency domain. Sixty percent of the tumors were subtotally resected and showed significant cognitive change in the domains of Attention, fluency and Visuospatial association. Glioma surgery in our setting results in a transient decline in cognition one week postoperatively after which improvement in cognition beyond baseline is noted one month post operatively.

Spirituality and creativity in the early childhood context

ABSTRACT This article reports a study on the impact of a customised spiritual education programme (SEP) on improving creativity for kindergarteners. The SEP was effective, and participants (n = 529) scored higher on creativity domains of figural fluency, originality, elaboration, abstractness of titles, and resistance to premature closure, compared to the waitlist control group. Girls, kindergarteners whose primary caregiver parents had higher formal education (postgraduate degree or professional degree), and who attended at least 80% of the SEP sessions (10–12 sessions), scored higher on all creativity parameters. Results suggest that spirituality, whose core is abstract and nonmaterial thinking, can be linked to nurturing creativity as a developmental asset among young children. The SEP may need some refining for young boys by including more externalising activities and simpler, relatable instructions for kindergarteners whose primary caregiver parents have lower formal education. Findings generally suggest that spiritual training can potentially bolster kindergarteners’ creativity.

Cognitive Performance and Incident Alzheimer’s Dementia in Men Versus Women

BackgroundThe utility of neuropsychological measurements as forerunners of Alzheimer’s Disease Dementia (AD) in individuals with normal cognition or mild cognitive impairment (MCI) is undeniable.ObjectivesTo assess the differential prognostic value of cognitive performance in older men versus women.DesignLongitudinal analysis of data acquired from the National Alzheimer’s Coordinating Center Uniform Data Set.SettingsData on older adults (≥60 years) were derived from 43 National Institute on Aging - funded Alzheimer’s Disease Research Centers.Participants10,073 cognitively unimpaired (CU) older adults followed for 5.5±3.8 years and 3,925 participants with amnestic MCI monitored for 3.5±2.8 years.MeasurementsThe domains of episodic memory, verbal fluency, naming, attention, processing speed and executive function were assessed. Cox proportional hazards models examined associations between individual cognitive domains and AD incidence separately for each participant set. CU and MCI. These predictive models featured individual neuropsychological measures, sex, neuropsychological measure by sex interactions, as well as a number of crucial covariates.ResultsEpisodic memory and verbal fluency were differentially related to future AD among CU individuals, explaining a larger proportion of risk variance in women compared to men. On the other hand, naming, attention and executive function were differentially related to future AD among participants with MCI, accounting for a greater fraction of risk variance in men than women.ConclusionCognitive performance is differentially related to risk of progressing to AD in men versus women without dementia.

Longitudinal trajectories of dietary quality and cognitive functions in Chinese older adults: The Taiwan Initiative for Geriatric Epidemiological Research (TIGER) cohort study

AbstractBackgroundDietary factors influence cognitive functions, but most previous studies were conducted in Western settings and assessed diet only once. Trajectory analysis of diet measured at multiple timepoints can track changes in diet and identify subpopulations requiring more intervention efforts. We thus assessed associations between dietary trajectories and cognitive functions in an understudied Asian elderly population.MethodThe TIGER study involves non‐demented community‐dwelling participants aged ≥65 years recruited between 2011‐2013. Dietary intakes were assessed using a food frequency questionnaire during baseline and 4th‐ and 6th‐year follow‐ups. Modified Alternative Healthy Eating Index (mAHEI) scores (energy‐adjusted using the residual method) were generated at each timepoint to reflect diet quality. Longitudinal trajectories of dietary quality were derived using latent growth mixture modelling. The Montreal Cognitive Assessment—Taiwanese version was used to assess global cognition for outcomes. Cognitive functions (baseline‐normalized z‐scores) of four cognitive domains, i.e., memory, attention, executive function, and verbal fluency, were also assessed. Associations between trajectories of dietary quality and cognitive functions were assessed using linear regressions, adjusting for important covariates including sex, apolipoprotein (APOE) e4 status, baseline age, body mass index (BMI), and depressive symptoms.ResultIncluded participants (n = 356) were 54.2% female, had a mean age of 71.6 years, and a mean BMI of 23.8 kg/m2 at baseline. The overall mean mAHEI scores were close to 37 (out of 70 possible) at all three time points. Three trajectories of dietary quality, namely 1) ‘increasing’, 2) ‘decreasing’, and 3) ‘stable‐high’ were identified and deemed optimal considering fit indices and interpretability. Compared with ‘stable‐high’ dietary quality trajectory, the ‘increasing’ trajectory was associated with worse memory performance (adjusted‐β = ‐0.424; 95% CI: ‐0.679, ‐0.169; P = 0.001) whereas the ‘decreasing’ trajectory was associated with worse performance for the verbal fluency domain (adjusted‐β = ‐0.342; 95% CI: ‐0.653, ‐0.030; P = 0.031). No other significant associations were observed.ConclusionMaintaining a stable‐high dietary quality trajectory over time is associated with better cognitive functions among Taiwanese older adults. Since there is much room for dietary improvement in this Taiwanese population, interventions to promote and sustain better dietary quality over time can have substantial impacts on their cognitive functions.

Longitudinal trajectories of dietary quality and cognitive performance in older adults: Results from a 6-year cohort study

Diet affects cognitive performance, but most previous studies only assessed diet once. Trajectory analysis of diet measured at multiple timepoints can identify subpopulations requiring more interventional efforts. We thus assessed associations between dietary trajectories and cognitive performance in older adults. This was a 6-year prospective cohort study involving 356 ethnically Chinese, non-demented, community-dwelling older adults recruited between 2011 and 2013. At baseline and at 4th- and 6th-year follow-ups, dietary intakes of the participants were assessed using food frequency questionnaires. Dietary quality was graded using the modified Alternative Healthy Eating Index (mAHEI) with seven components; longitudinal trajectories of dietary quality were derived using latent growth mixture modelling. Outcomes were global- and domain-specific cognitive performance (attention, memory, executive functions, and verbal fluency). Multivariable regressions adjusting for important covariates (sex, age, energy intake, APOE risk alleles, depressive symptoms, and body mass index (BMI)) assessed associations between the dietary trajectories and cognitive outcomes. Included participants had a mean age of 71.6 years and a mean BMI of 23.8kg/m2. Three mutually exclusive dietary quality trajectories, namely "deteriorating", "improving", and "stable-high", were derived. Compared with the stable-high trajectory, the improving trajectory was associated with a lower z-score for the memory domain (β:-0.403; 95% CI:-0.656,-0.151; P=0.002), which was consistently observed for the four individual tests of the domain (β range:-0.324 to-0.448; all P<0.05). In unadjusted analysis, the deteriorating trajectory was associated with a 0.369 lower z-score for the verbal fluency domain (95% CI:-0.700,-0.039 P=0.028), though attenuated to borderline significance with adjustment for covariates. Sex and BMI modified some of these associations. No other associations were observed for global cognition or other cognitive domains. In Taiwanese older adults, consistently high dietary quality is associated with better cognitive performance. Interventions to promote and sustain better dietary quality over time can have substantial impacts on cognitive function.

Patterns and prevalence of cognitive dysfunction in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease, in which cognitive dysfunction is common, but poorly understood. This study aims to characterize the prevalence and patterns of cognitive dysfunction in SLE. SLE patients (n = 95) and demographically matched healthy controls (n = 48) underwent cross-sectional cognitive testing using the 1-hr conventional neuropsychological test battery recommended by the American College of Rheumatology for use in SLE. We used standard deviations (SD) from the healthy control group to define impairment. For each cognitive test we compared SLE and control groups using independent samples t-tests (or alternatives when needed). We performed cluster analysis using a machine learning algorithm to look for patterns of cognitive dysfunction. The SLE group performed significantly worse than healthy controls on every cognitive test. The largest differences were in the domains of verbal fluency, working memory and attention, while fine motor and psychomotor speed were the least affected domains. As expected, the prevalence of cognitive dysfunction varied depending on the SD cut-off used, with 49% of participants being >1.5 SD below the healthy control mean in at least two cognitive domains. Heat mapping showed variability in the pattern of dysfunction between individual patients and cluster analysis confirmed the presence of two clusters of patients, which were those significantly impaired versus those having preserved cognition. Cognitive dysfunction is common in SLE but markedly heterogeneous across both cognitive domains and across the SLE group. Cluster analysis supports the use of a binary definition of cognitive dysfunction in SLE.

Efficacy of Institution-wide RTI Reading Intervention in Disadvantaged Suburbs of South Korea: 3-Year Analysis on Elementary Students with Reading Difficulties

The study examined the efficacy of reading intervention based on the Response to Intervention implementation (RTI) with public elementary school students and students from childcare centers in Gyeonggi province of South Korea. After the institution-wide screening and selecting process, reading intervention programs were provided at either Tier 2 or Tier 3 of the RTI in reading domains of fluency, vocabulary acquisition, reading comprehension, or phonological awareness as needed. For each year, approximately 69 participants were selected and the grade ranges were between 1st and 6th grade. Pre-and post-test results in all intervention domains were analyzed both by year and grade, and between-grade comparison was further conducted. Significances relating to the middle grades were discussed from the findings. The need for the institution-wide RTI approach to successful intervention and educational implications are discussed.

Association of apolipoprotein E epsilon 4 and cognitive impairment in adults living with human immunodeficiency virus: a meta-analysis.

It is controversial whether the apolipoprotein E epsilon 4 allele (APOE ε4) is a risk gene for human immunodeficiency virus (HIV)-related neurocognitive impairment. This meta-analysis aimed to summarize evidence of the associations between APOE ε4 and cognitive impairment in people living with HIV (PLWH). Our study conducted a systematic literature search of PubMed, Web of Science, Embase, Google Scholar, and ProQuest for studies published before April 11, 2022 that evaluated associations between APOE ε4 and cognitive impairment in adult PLWH (aged ≥18 years). We calculated pooled odds ratios (ORs) of global cognitive impairment and 95% confidence intervals (CIs) and standardized mean differences (SMDs) for specific cognitive domains between APOE ε4 carriers and non-carriers. Subgroup meta-analyses were used to evaluate the result profiles across different categorical variables. Twenty studies met the inclusion criteria, including 19 that evaluated global cognitive impairment. APOE ε4 was significantly associated with global cognitive impairment in PLWH (OR = 1.36, 95% CI = [1.05, 1.78], number of estimates [k] = 19, P = 0.02, random effects). Subgroup meta-analysis based percentage of females showed evident intergroup differences in global cognitive performance between ε4 carriers and non-carriers (P = 0.015). APOE ε4 carriers had lower cognitive test scores than non-carriers in all seven cognitive domains, including fluency (SMD = -0.51, 95% CI = [-0.76, -0.25], P < 0.001, k = 4, I2 = 0%), learning (SMD = -0.52, 95% CI = [-0.75, -0.28], P < 0.001, k = 5, I2 = 0%), executive function (SMD = -0.41, 95% CI = [-0.59, -0.23], P < 0.001, k = 8, I2 = 0%), memory (SMD = -0.41, 95% CI = [-0.61, -0.20], P < 0.001, k = 10, I2 = 36%), attention/working memory (SMD = -0.34, 95% CI = [-0.54, -0.14], P = 0.001, k = 6, I2 = 0%), speed of information processing (SMD = -0.34, 95% CI = [-0.53, -0.16], P < 0.001, k = 8, I2 = 0%), and motor function (SMD = -0.19, 95% CI = [-0.38, -0.01], P = 0.04, k = 7, I2 = 0%). Our meta-analysis provides significant evidence that APOE ε4 is a risk genotype for HIV-associated cognitive impairment, especially in cognitive domains of fluency, learning, executive function, and memory. Moreover, the impairment is sex specific. PROSPERO, CRD 42021257775.

CHARACTERIZING PERFORMANCE VARIABILITY ACROSS COGNITIVE TASKS IN OLDER ADULTS WITH AND WITHOUT ADHD

Abstract Most research on cognitive performance among individuals with Attention Deficit/Hyperactivity Disorder (ADHD) focuses on younger persons and on cognitive variability within speeded response-time tasks. Dispersion, i.e., variability across a range of cognitive domains, is emerging as a promising indicator of age-related and pathological cognitive impairment. However, there has yet to be an evaluation of differences in dispersion among older adults with and without ADHD. We address this gap by assessing associations of age and ADHD status with dispersion. We hypothesize older adults will exhibit greater dispersion than comparatively younger adults and explore whether individuals with ADHD exhibit greater dispersion than individuals without ADHD. In a sample of 231 adults from the Longitudinal Aging Study Amsterdam (Average age=71.64 years, SD=7.7, 59% female), 23 individuals met DSM-IV criteria for ADHD and 208 were classified as neurotypically functioning. Participants completed 13 tasks spanning domains of attention, fluency, memory, processing speed, and reasoning. Dispersion across the tasks was calculated as an intraindividual standard deviation. We regressed dispersion on age and ADHD status and adjusted for sex. Older age was significantly associated with greater dispersion (Est =0.06, SE=0.03, p=0.01). However, dispersion profiles did not vary as a function of ADHD status (Est.=-0.25, SE=0.67, p&amp;gt;05). Preliminary results suggest that dispersion across cognitive tasks may not be a sensitive marker of ADHD in older adults, although statistical power to detect differences was relatively low in the current study. As expected, age was a significant predictor of increased dispersion, consistent with accounts of age-related changes in neurological integrity.

Clinical and Metabolic Signature of UNC13A rs12608932 Variant in Amyotrophic Lateral Sclerosis.

Background and ObjectivesTo characterize the clinical and cognitive behavioral phenotype and brain 18F-2-fluoro-2-deoxy-d-glucose-PET (18F-FDG-PET) metabolism of patients with amyotrophic lateral sclerosis (ALS) carrying the rs12608932 variant of the UNC13A gene.MethodsThe study population included 1,409 patients with ALS without C9orf72, SOD1, TARDBP, and FUS mutations identified through a prospective epidemiologic ALS register. Control participants included 1,012 geographically matched, age-matched, and sex-matched participants. Clinical and cognitive differences between patients carrying the C/C rs12608932 genotype and those carrying the A/A + A/C genotype were assessed. A subset of patients underwent 18F-FDG-PET.ResultsThe C/C genotype was associated with an increased risk of ALS (odds ratio: 1.54, 95% confidence interval 1.18–2.01, p = 0.001). Patients with the C/C genotype were older, had more frequent bulbar onset, and manifested a higher rate of weight loss. In addition, they showed significantly reduced performance in the letter fluency test, fluency domain of Edinburgh Cognitive and Behavioural ALS Screen (ECAS) and story-based empathy task (reflecting social cognition). Patients with the C/C genotype had a shorter survival (median survival time, C/C 2.25 years, interquartile range [IQR] 1.33–3.92; A/A + C/C: 2.90 years, IQR 1.74–5.41; p = 0.0001). In Cox multivariable analysis, C/C genotype resulted to be an independent prognostic factor. Finally, patients with a C/C genotype had a specific pattern of hypometabolism on brain 18F-FDG-PET extending to frontal and precentral areas of the right hemisphere.DiscussionC/C rs12608932 genotype of UNC13A is associated with a specific motor and cognitive/behavioral phenotype, which reflects on 18F-FDG-PET findings. Our observations highlight the importance of adding the rs12608932 variant in UNC13A to the ALS genetic panel to refine the individual prognostic prediction and reduce heterogeneity in clinical trials.

Effects of Tempeh Probiotics on Elderly With Cognitive Impairment.

IntroductionOral consumption of probiotics can alter Gut Microbiota by causing changes in the production of probiotic derivatives. Therefore, by utilizing Gut-Brain-Axis (GBA), probiotics could provide an opportunity for central nervous system (CNS) modulation, including cognitive function. Tempeh is a traditional Indonesian food rich in probiotics and beneficial for cognitive function. However, the type of probiotics that play a role in cognitive improvement and the number of probiotics needed for the benefits of increasing cognitive function was unknown.MethodThis experimental study involved a total of 93 subjects, divided into 3 groups: A, B and C/control (n: 33, 32, and 28), who were provided with probiotic supplementation isolated from tempeh for 12 weeks intervention. Inclusion criteria were age > 60 years, and memory impairment with the third repetition value of Word List Memory Immediate Recall (WLMIR) < 7. Subjects with diabetes were excluded. Cognitive function examinations were carried out before and after treatment. The tempeh-derived probiotics were prepared trough several processes. Genomic isolation, detection of GABA-encoding genes, and species identification using the 16S-rRNA gene encoding were performed.ResultsThe probiotics isolate used in the intervention was identified as Limosilactobacillus fermentum. We assigned this isolate as L. fermentum A2.8. The presence of the gene encoding GABA was found on this isolate. There was an increase in the cognitive domains of memory, learning process, and verbal fluency (p < 0.05) in group A (probiotics at concentration of 108 CFU/mL). Memory function, visuospatial, and verbal fluency improved (p < 0.05) in group B (probiotics at concentration of 107 CFU/mL). Only an increase in the memory domain was observed in the control group. Improvement of the learning process occurred only in group A (p = 0.006).ConclusionAdministration of probiotics derived from L. fermentum A2.8 increased the cognitive domains of memory, language and visuospatial function. However, probiotic supplementation at a concentration of 108 CFU/mL was better in improving the learning process. This study succeeded in detecting Lactic Acid Bacterial isolates L. fermentum A2.8 that enclosed gene encoding glutamate decarboxylase (gad) which is involved in the synthesis of -aminobutyric acid (GABA), a neurotransmitter vital for cognitive function.