Fluid Cognitive Abilities Research Articles

Relationship between subjective cognitive functioning and fluid and crystallized cognitive abilities in bipolar disorder.

People with bipolar disorder (BD) often show inaccurate subjective ratings of their objective cognitive function. However, it is unclear what information individuals use to formulate their subjective ratings. This study evaluated whether people with BD are likely using information about their crystallized cognitive abilities (which involve an accumulated store of verbal knowledge and skills and are typically preserved in BD) or their fluid cognitive abilities (which involve the capacity for new learning and information processing in novel situations and are typically impaired in BD) to formulate their subjective cognitive ratings. Eighty participants diagnosed with BD and 55 control volunteers were administered cognitive tests assessing crystallized and fluid cognitive abilities. Subjective cognitive functioning was assessed with the Cognitive Failures Questionnaire (CFQ), daily functioning was rated using the Multidimensional Scale of Independent Functioning (MSIF) and the Global Assessment of Functioning Scale (GAF), and quality of life was assessed with the Quality of Life in Bipolar Disorder scale (QoL.BD). The BD group exhibited considerably elevated subjective cognitive complaints relative to controls. Among participants with BD, CFQ scores were associated with fluid cognitive abilities including measures of memory and executive function, but not to crystallized abilities. After controlling for objective cognition and depression, higher cognitive complaints predicted poorer psychosocial outcomes. Cognitive self-reports in BD may represent a metacognitive difficulty whereby cognitive self-appraisals are distorted by a person's focus on their cognitive weaknesses rather than strengths. Moreover, negative cognitive self-assessments are associated with poorer daily functioning and diminished quality of life.

PURPOSE IN LIFE ACROSS THE COVID-19 PANDEMIC: THE EFFECTS OF COGNITIVE ABILITY, AGE, AND GENDER

Abstract In March of 2020, the World Health Organization declared COVID-19 a pandemic. Almost immediately, 95% of the US population was under stay-at-home orders, resulting in widespread uncertainty about the future, low community engagement, and social isolation. These effects may have been detrimental to maintaining a sense of purpose in life across this period, which has been linked to several health and wellness factors, including cognitive ability. Although previous work has indicated that higher cognitive ability predicts a stronger sense of purpose in life, the relationship between cognitive ability and changes in purpose across this universal, chronic stressor is unknown. The present study, therefore, examined the effects of cognitive ability, age, and gender on trajectories of purpose in life across the COVID-19 pandemic. Participants included 206 individuals (Age Range=45-88, M=69.04, SD=9.29) who participated in a cognitive assessment before the pandemic, as well as the multi-wave Notre Dame Study of Health & Well-being-COVID Study (NDHWB-CS) from September 2020-February 2022. Two-level, multilevel modeling tested the effects of total, fluid, and crystalized cognitive abilities, as well as age and gender, on trajectories of purpose in life. Results indicated that greater total and fluid cognitive abilities were associated with higher initial levels of purpose in life. Furthermore, although crystalized, fluid, and total cognitive abilities were each associated with change in purpose across the pandemic, there were age and gender differences in these effects. Theoretical and practical implications regarding the relationship between cognitive ability and sense of purpose in the context of stress will be discussed.

57 Financial Literacy in Older Adults: Cognitive, Demographic, and Personality Factors Related to Discrepancies between Objective Financial Knowledge and Subjective Financial Confidence

Objective:Management of finances is one of the earliest domains of daily living to decline in the neurodegenerative disease process, and poorer financial literacy is associated with worse cognition even in healthy, normative aging. However, some studies have demonstrated that cognitively normal older adults demonstrate preserved real-world financial outcomes despite the presence of age-related cognitive decline. One account for this discordance posits that older adults rely on intact financial knowledge to circumvent negative effects of declining fluid cognitive abilities. Also important to real-world financial behavior is insight into one’s level of financial knowledge and expertise (i.e., subjective financial confidence), which in some studies has been shown to have an equal or stronger influence on real-world financial behaviors compared to objective financial knowledge. This study investigated older adults’ financial abilities by identifying groups of individuals with discrepancies between objective financial knowledge and subjective financial confidence and exploring cognitive and non-cognitive (demographic, personality) factors associated with discrepancy group membership.Participants and Methods:Participants were 4,610 older adults (M age 71.18 ± .91) from the Wisconsin Longitudinal Study who answered 12 true-false questions on financial concepts (accuracy) and rated their confidence on each response. Standardized scores of accuracy and confidence were used to classify participants into three discrepancy groups (1) Overconfident (confidence >1 SD above accuracy), (2) Underconfident (accuracy >1 SD above confidence), and (3) Equal (accuracy and confidence within 1 SD). Logistic regression examined factors associated with discrepancy group membership.Results:Higher financial accuracy was moderately correlated with greater confidence (r=.42, p<.001). Approximately 29% of participants had standardized accuracy and confidence scores that differed by one standard deviation or more, with 14% of participants belonging to an “Overconfident” group and 15% to an “Underconfident” group. Lower likelihood of Overconfidence group membership was associated with higher levels of education (OR = .87, 95% CI [.82, .93], p<.001) and better cognitive performance on tests of delayed recall (OR = .90, 95% CI [.84, .97], p=.006) and numerical reasoning (OR = .94, 95% CI [.91, .97], p<.001), while higher extraversion was associated with increased likelihood of Overconfidence (OR = 1.03, 95% CI [1.00, 1.05], p=.04). Lower likelihood of Underconfident group membership was associated with better performance on cognitive tests of delayed recall (OR = .90, 95% CI [.84, .96], p=.002), male sex (OR = .60, 95% CI [.47, .77], p<.001), and lower levels of conscientiousness (OR = .95, 95% CI [.92, .99], p<.001), while better letter fluency performance was associated with increased likelihood of Underconfidence (OR = 1.03, 95% CI [1.00, 1.06], p=.04).Conclusions:Objective financial knowledge and subjective financial confidence are related yet distinct aspects of financial literacy. Discrepancies between financial knowledge and confidence are related to both cognitive and non-cognitive factors, such as personality and differing life experiences associated with educational attainment and sex-related social roles. Results may help clinicians identify profiles of older adults (e.g., high confidence and low knowledge/"Overconfident”) at risk for dysfunctional financial behaviors, including susceptibility to fraud and/or irresponsible financial decision-making.

Simultaneous Decisions to Undertake Off-Farm Work and Straw Return: The Role of Cognitive Ability

Using a sample of 1166 maize-planting farmers from Liaoning province in China, in this paper, we provide a new explanation for the slow-proliferation situation of straw return. Both our theoretical and empirical results indicate that the low rate of adoption of straw return can be partly attributed to the farmers’ choice to undertake off-farm work. Probit, PSM, IV-probit, and bivariate probit models are utilized to estimate the interdependent nature of these two simultaneous decisions, with an identified causal effect ranging from −0.115 to −0.287. Instead of the “income-increasing effect”, our research supports the dominant existence of the “lost-labor effect”. Furthermore, intelligent and risk-tolerant farmers undertaking off-farm work are found to have additional negative impacts on the likelihood of straw return adoption. With regard to the mediating mechanisms, we find that the choice of off-farm work may decrease the probability of raising cattle and also downscale arable land, thereby reducing the likelihood of straw return adoption. In line with our proposed model, fluid cognitive ability contributes to the farmers’ adoption of straw return by increasing their learning and updating efficiency. In contrast, crystal cognitive ability deters the undertaking of nonfarm work by establishing a comparative advantage in agricultural production, thus indirectly promoting the proliferation of straw incorporation. According to our theoretical and empirical findings, the proper policy interventions proposed mainly include three points. First, governments should endeavor to increase agricultural specialization by further promoting arable land transfer and human capital accumulation in farming. Second, it is beneficial to facilitate the process of learning by doing and social learning by enhancing the human capital levels of farmers. Last, it is necessary to cultivate farmers’ inclination towards long-term investment by explaining the concrete benefits of straw return to farmers on a timely basis.

Functional Cognition: Distinct From Fluid and Crystallized Cognition?

Functional cognition is emerging as a professional priority for occupational therapy practice. It is important to understand how it relates to other established cognitive constructs, so that occupational therapists can demonstrate their unique contributions. To examine whether functional cognition is a construct that is distinct from crystallized and fluid cognitive abilities. Secondary analysis of data collected from a cross-sectional study. Community. Adults with spinal cord injury, traumatic brain injury, or stroke (N = 493). The National Institutes of Health Toolbox Cognition Battery and the Executive Function Performance Test. We used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to investigate the factor structure of cognition. EFA identified three factors representing crystallized, fluid, and functional cognition. CFA revealed a second-order model in which the three cognitive constructs contribute hierarchically to a general cognitive factor. This study provides important and timely evidence for establishing functional cognition as a unique construct that is distinct from executive function as well as from fluid and crystallized cognition. Functional cognition is central to performance in daily activities, and its use will ensure that occupational therapy services support continued recovery and community reintegration. What This Article Adds: This study supports occupational therapy professionals in establishing the profession's role in evaluating and treating deficits of functional cognition to support patients' return to desired occupations in the family, workplace, and community.

No Appreciable Effect of Education on Aging-Associated Declines in Cognition: A 20-Year Follow-Up Study

Education has been claimed to reduce aging-associated declines in cognitive function. Given its societal relevance, considerable resources have been devoted to this research. However, because of the difficulty of detecting modest rates of change, findings have been mixed. These discrepancies may stem from methodological shortcomings such as short time spans, few waves, and small samples. The present study overcame these limitations (N = 1,892, nine waves over a period of 20 years). We tested the effect of education level on baseline performance (intercept) and the rate of change (slope) in crystallized and fluid cognitive abilities (gc and gf, respectively) in a sample of Japanese adults. Albeit positively related to both intercepts, education had no impact on either the gc or the gf slope. Furthermore, neither intercept exhibited any appreciable correlation with either slope. These results thus suggest that education has no substantial role (direct or mediated) in aging-related changes in cognition.

Age and Cognitive Ability Predict Emotion Regulation Strategy Use.

This study examines how age and cognitive ability predict use of different emotion regulation strategies in a laboratory task eliciting emotions varying in valence and arousal. Participants (N = 287) aged 25-85 completed the NIH Toolbox Cognitive Battery and an emotion regulation task in a laboratory setting. They watched a series of emotional clips (disgust, sadness, amusement, and contentment) under instructions to increase positive emotions or decrease negative emotions. After each clip, they rated the extent to which they used emotion regulation strategies that involve different types of engagement with emotional stimuli and disengagement from emotional stimuli. Older age was predictive of greater use of immersive-engagement strategies (e.g., perspective taking) and less use of disengagement strategies (e.g., distraction). Fluid cognitive ability was positively associated with immersive-engagement strategy use, particularly for high-arousal clips. For older adults, fluid cognitive ability was also associated with using positive-engagement strategies (e.g., positive reappraisal) to a greater extent to regulate negative emotions. Patterns of emotion regulation strategy use varied by age, even when accounting for differences in reactivity. Findings suggest that older adults may not necessarily prefer strategies that are lower in cognitive demands or that focus on enhancing positivity. Results support the idea that strategy preferences are driven by a combination of characteristics of the regulator and the regulation context. The relevance of cognitive resources likely varies across situations, perhaps being most consequential for deeper processing of high-arousal stimuli and for older adults' engagement with positive aspects of an otherwise negative situation.

The role of phenylalanine levels in the neuropsychological and neuroanatomical status of adult patients with phenylketonuria: The impact of fluctuations.

We aimed to evaluate the role of plasma phenylalanine (Phe) levels and its fluctuations in some neurocognitive domains and brain magnetic resonance imaging (MRI) findings in adult patients with phenylketonuria (PKU). It was an observational study that included patients older than 18 years with early-treated classical PKU. Plasma Phe levels were measured every other month throughout 2 years and predictor variables were the mean, maximum (max), minimum (min), range (min-max), and plasma Phe levels at the time of cognitive testing. Patients were evaluated for executive function, processing speed, visual attention, and fluid cognitive abilities using the Trail Making Test (TMT) and for the presence of brain MRI abnormalities. In all, 22 patients with a mean age of 34 years were included, of which 18 (81%) were women. Patients with higher range and maximum Phe levels had a poorer time-based performance on TMT form A and form B. Patients with brain MRI abnormalities had higher range, maximum, and mean Phe levels. Range of Phe levels showed a good performance for MRI abnormalities (area under the curve (AUC): 0.881, standard error (SE): 0.095, 95% CI: 0.695-0.999, p = 0.044) and for the poorest time-based performances on TMT form A (AUC: 0.822, SE: 0.092, 95% CI: 0.641-0.999, p = 0.024) and B (AUC: 0.816, SE: 0.094, 95% CI: 0.632-0.999, p = 0.021). Greater Phe variability may have a negative impact on some neurocognitive domains and could be related to the severity of brain structural damage in adult patients with PKU.

Are EQ and IQ Negatively Related? The Relationship between Trait Emotional Intelligence and Fluid Cognitive Ability

Are EQ and IQ Negatively Related? The Relationship between Trait Emotional Intelligence and Fluid Cognitive Ability

AGE AND COGNITIVE ABILITY AS PREDICTORS OF EMOTION REGULATION STRATEGY USE

Abstract Emotion regulation (ER) is viewed as a cognitively demanding process and involves selecting and implementing specific strategies in support of one’s emotional goals. Older adults are theorized to maintain emotional wellbeing by selecting ER strategies that are consistent with their available resources, which may involve engaging more with lower-arousal stimuli and less with higher-arousal stimuli, especially when cognitive resources are limited. The aim of this study was to examine relationships between age, cognitive ability, and use of different types of ER strategies. Participants (N = 287) aged 25-85 (M = 54.33, SD = 17.19) completed assessments of cognitive ability from the NIH Toolbox Cognitive Battery. In a laboratory task, participants viewed a series of film clips eliciting low-arousal emotions (sadness, contentment) and high-arousal emotions (disgust, amusement) under instructions to regulate pro-hedonically using any available strategy. They reported their use of disengagement (e.g., distraction, suppression), engagement (e.g., perspective-taking, awareness), and positive-focus strategies (e.g., savoring, positive reappraisal). Results from multilevel models revealed that with low-arousal stimuli, age was associated with higher engagement and lower disengagement, regardless of fluid cognitive ability. With high-arousal stimuli, a fluid cognition X age interaction indicated that there was an age-related increase in engagement among individuals with higher fluid cognitive ability, but not lower fluid cognitive ability. Findings support the idea that older adults tend to engage with emotional stimuli, which may aid with processing and support emotional memory for future regulation attempts. Fluid cognitive ability may be an important resource supporting older adults’ engagement with high-arousal stimuli.

Age-related differences in Default Mode Network resting-state functional connectivity but not gray matter volume relate to sacrificial moral decision-making and working memory performance

Older adults make fewer utilitarian decisions than younger adults during sacrificial moral dilemmas, which are associated with age-related reductions in Default Mode Network resting-state functional connectivity. Decreases on tasks associated with fluid cognitive abilities, such as working memory capacity, are also associated with age-related Default Mode Network changes. Regions within this network demonstrate some of the greatest age-related gray matter atrophy. Age-related changes in structure and function of the Default Mode Network may be associated with poorer working memory capacity and reduced utilitarian moral decision-making. Alternatively, recent theories suggest that age-related changes to Default Mode Network function may be adaptive in the context of tasks that include socioemotional components. As such, reduced within-network resting-state functional connectivity of the Default Mode Network may be associated with differential outcomes in moral decision-making for younger and older adults. In the present study, there were no age-related differences in working memory capacity. Older adults were less likely than younger adults to indicate the utilitarian option when trials involved Instrumental harm. Generally, increased within-network resting-state functional connectivity of the Default Mode Network was associated with better working memory performance in both groups, and reduced bias to endorse the utilitarian option during Incidental dilemmas compared to Instrumental dilemmas in younger adults. Older adults with similar moral decision-making behavior to younger adults demonstrated increased coupling between Default Mode Network and Salience Network regions. These findings suggest that Default Mode Network functional integrity may be differentially associated with age-related changes to working memory capacity and sacrificial moral decision-making.

Emotion regulation in old and very old age.

Prominent life span theories have suggested that the ability to downregulate negative emotions remains stable or even increases well into old age. However, past evidence for continued growth during old age is mixed. In this laboratory study, 130 young old individuals (Mage = 66.72 years, SD = 1.03, range = 65 to 69 years, 48% female) and 59 very old individuals (Mage = 86.03 years, SD = 1.44, range = 83 to 89 years, 58% female) watched negative emotion evoking film clips under different emotion regulation instructions. Subjective feelings, cardiovascular reactions, and facial behavioral expressions were assessed in response to each film. Emotion regulation competence was operationalized as difference in the intensity of negative emotions during a trial with no regulation instruction versus three trials with regulation instruction, asking participants to engage in detached reappraisal, behavioral suppression, or positive reappraisal. In comparison to young old individuals, very old individuals were less able to regulate their self-reported negative feelings. These age-related deficits were partly associated with age differences in fluid cognitive abilities. Notably, however, emotion regulation deficits in very old individuals observed in self-reports of emotions were not evident at the levels of cardiovascular arousal and facial expressivity. Together this evidence speaks against one-sided views on emotional aging as uniform process of either growth or decline, even in old and very old age. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Assessment of cross-cultural measurement invariance of the NIH toolbox fluid cognition measures between Jamaicans and African-Americans

The NIH Toolbox Cognitive Battery (NIHTB-CB) was developed as a common-metric, computerized cognitive screener for research. Although extensively normed and validated in Americans of different ethnicities, there is little data on how generalizable such results would be when used outside of the United States. The objective of this study was to assess measurement invariance (MI) of the NIHTB-CB across Jamaican and African-American samples and determine appropriateness of comparisons across groups. Multi-group confirmatory factor analyses using a single-factor model were conducted using five tests of fluid cognitive abilities from the NIHTB-CB, which assess working memory, episodic memory, processing speed, and executive function. MI was tested sequentially for configural, metric and scalar invariance. 125 Jamaican and 154 American adults of African descent were included. The Jamaican mean age was 31.6 ± 8.6 years (57% males) compared to 43.5 ± 15.5 years (25% males) for the African-American group. The Jamaicans had on average 11.3 ± 2.7 years of education compared to 13.9 ± 2.6 years for the African-Americans. We found metric and configural invariance across both samples but not scalar invariance. These findings suggest that the single factor emerging from the NIHTB-CB measures the same construct, i.e. fluid cognitive ability, in both groups and hence the battery is appropriate for assessments within cultures. However, lack of scalar invariance indicates that direct cross-cultural comparisons of performance levels should be interpreted with caution, also suggesting that U.S. normative standards are not generalizable to the Jamaican population.

Age declines in numeracy: An analysis of longitudinal data.

Numeracy, the ability to understand and use basic probability and numerical concepts, is associated with diverse positive outcomes across the lifespan. Prior cross-sectional research on numeracy has generally found a negative association with age, but positive correlations with male gender, education attainment, and measures of fluid and crystallized intelligence have been more robust. Age effects on cognitive functioning are well established, but little is known about longitudinal trends of numeracy into older age. The present study investigates longitudinal age effects on numeracy using a sample of 524 adults (2008 Agerange = 20-78) from the RAND American Life Panel. Participants completed a numeracy measure in both 2008 and 2019, a span of 11 years. Using a linear mixed-effect model to predict numeracy scores, a significant interaction between the year of testing and the quadric age term shows a decline in numeracy scores beginning in later middle age, a trend that falls in between those previously found for crystallized and fluid cognitive abilities. Numeracy declines are somewhat mitigated for males and those with higher education, but the interaction of the two variables did not return a clear pattern of results. Prior research has shown that numeracy is positively related to the quality of health and financial decisions and, ultimately, more positive health and economic outcomes. The implications of age declines in numeracy are discussed in relation to health and financial decision-making, tasks that remain relevant into old age. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Digital Neuropsychological Assessment of Cognitive Functions in Patients with Epilepsy.

Cognitive impairment often occurs secondary to epilepsy. This study aims to evaluate the cognitive functions of patients with idiopathic generalized epilepsy (IGE) by using the digital neuropsychological assessment. Seventy-nine patients diagnosed with IGE in the last 10 years in our clinic, who completed at least eight years of education were recruited. Participants who met the criteria were 36 individuals with IGE syndrome as well as 36 healthy individuals between the ages of 18-48. All volunteer participants were administered the standardized mini mental test (SMMT) and the Beck depression scale (BDS). For the neurocognitive assessment, participants completed five tasks in TestMyBrain digital neuropsychology test battery (TMB) which are TMB digit span, TMB choice reaction time test, TMB visual paired associates test, TMB matrix reasoning, and TMB digit symbol matching assessing a variety of cognitive domains. IGE patients showed lower cognitive performance in attention, short-term memory, working memory, visual memory, episodic memory, cognitive processing speed, response selection/inhibition, fluid cognitive ability, and perceptual reasoning domains. The results show that IGE patients have cognitive dysfunction in many cognitive domains. IGE patients performed significantly worse outcomes in some tests of the TMB. In this study, it is aimed to emphasize the necessity of evaluating the cognitive aspects of epilepsy patients, which will be of great importance in their functionality, in addition to providing symptomatic treatment in order to control their seizures.

Effects of covid-19 on cognitive functioning

Abstract We were interested in whether the covid-19 pandemic affects cognitive functioning in addition to emotional responses. To this end, we applied four questions related to everyday activities that inevitably involve fluid cognitive abilities, e.g., problems concentrating, remembering, and switching between different mental activities. Respondents self-assessed their cognitive abilities during the covid-19 pandemic compared to the period before the pandemic on a 7-point scale (1 - much easier than before, .. 4 - the same as earlier, .. and 7 - much harder than before). The results showed that, on average, respondents estimated slightly more cognitive problems during the covid-19 pandemic period than before the pandemic (4.21, where 4 means that the respondent does not notice changes). Nearly three-quarters of the respondents(72%) did not report changes in cognitive abilities. In comparison, 7% reported improved cognitive abilities, and as many as 21% of respondents self-assessed that their cognitive abilities deteriorated during the covid-19 pandemic. There were no differences between men and women in terms of self-assessment of cognitive abilities. More significant problems with their cognitive abilities during covid-19 pandemic reported younger as compared to older respondents, students as compared to other employment groups, less educated as compared to more educated, those living alone as compared to those living in the family, those whose financial situation had deteriorated, and, as expected, those with chronic illnesses, and those who also reported depressive and mental health symptoms. The results of the survey indicate the interdependence between different demographic factors, mood and mental health problems, and self-assessed changes in cognition. Therefore, interventions to mitigate the covid-19 pandemic should include peoples' emotional response and their cognitive problems.

Age-related differences in strategic competition

Understanding how people of different ages decide in competition is a question of theoretical and practical importance. Using an experimental laboratory approach, this research investigates the ability of younger and older adults to think and act strategically with equal or unequal resources. In zero-sum games of resource allocation, younger adults (19–35 years) and older adults (65–81 years) made strategic decisions in competition against opponents of a similar age (Study 1; N = 120) or different age (Study 2; N = 120). The findings highlight people’s ability to make good interpersonal decisions in complex scenarios: Both younger and older adults were aware of their relative strength (in terms of material resources) and allocated their resources adaptively. When competing against opponents of a similar age, people’s gains were in line with game-theoretic predictions. However, younger adults made superior strategic allocations and won more frequently when competing against older adults. Measures of fluid cognitive and numerical abilities correlated with strategic behavior in interpersonal competition.

Distinct functional and structural connections predict crystallised and fluid cognition in healthy adults.

White matter pathways between neurons facilitate neuronal coactivation patterns in the brain. Insight into how these structural and functional connections underlie complex cognitive functions provides an important foundation with which to delineate disease‐related changes in cognitive functioning. Here, we integrate neuroimaging, connectomics, and machine learning approaches to explore how functional and structural brain connectivity relate to cognition. Specifically, we evaluate the extent to which functional and structural connectivity predict individual crystallised and fluid cognitive abilities in 415 unrelated healthy young adults (202 females) from the Human Connectome Project. We report three main findings. First, we demonstrate functional connectivity is more predictive of cognitive scores than structural connectivity, and, furthermore, integrating the two modalities does not increase explained variance. Second, we show the quality of cognitive prediction from connectome measures is influenced by the choice of grey matter parcellation, and, possibly, how that parcellation is derived. Third, we find that distinct functional and structural connections predict crystallised and fluid abilities. Taken together, our results suggest that functional and structural connectivity have unique relationships with crystallised and fluid cognition and, furthermore, studying both modalities provides a more comprehensive insight into the neural correlates of cognition.

Sex Differences in the Outcomes of Mild Traumatic Brain Injury in Children Presenting to the Emergency Department.

Sex differences after concussion have been studied largely in high school and college athletes, often without reference to comparison groups without concussion. This study sought to evaluate sex differences in outcomes among all children and adolescents presenting to the Emergency Department (ED) for either mild traumatic brain injury (TBI) or orthopedic injury (OI), regardless of mechanism of injury. The study involved a concurrent cohort, prospective study design with longitudinal follow-up. Participants were eight to 16 years old with mild TBI (n = 143) or OI (n = 73). They were recruited and completed an initial assessment at EDs at two children's hospitals. They returned for a post-acute assessment within two weeks of injury and for follow-up assessments at three and six months. Outcomes included child and parent proxy ratings of somatic and cognitive symptoms, and standardized tests of cognitive functioning and balance. Sex did not moderate group differences in balance, fluid or crystallized cognitive ability, or child or parent proxy ratings of somatic or cognitive symptoms. Both parents and children reported more somatic symptoms in girls than boys, but in both groups. Compared with the OI group, the mild TBI group showed significantly lower fluid cognitive ability at the post-acute assessment and significantly higher somatic and cognitive symptoms according to both child and parent proxy ratings across the first two weeks post-injury. The results suggest that sex does not moderate the outcomes of mild TBI in a pediatric ED population. Previous research pointing to sex differences after concussion may reflect the lack of comparison groups, as well as a focus on adolescents and young adults and sport-related concussion. Future research should investigate whether sex moderates the outcomes of pediatric mild TBI in adolescents but not in pre-adolescent children.

Fluid Cognitive Abilities Are Important for Learning and Retention of a New, Explicitly Learned Walking Pattern in Individuals After Stroke

Background There is significant variability in poststroke locomotor learning that is poorly understood and affects individual responses to rehabilitation interventions. Cognitive abilities relate to upper extremity motor learning in neurologically intact adults, but have not been studied in poststroke locomotor learning. Objective To understand the relationship between locomotor learning and retention and cognition after stroke. Methods Participants with chronic (>6 months) stroke participated in 3 testing sessions. During the first session, participants walked on a treadmill and learned a new walking pattern through visual feedback about their step length. During the second session, participants walked on a treadmill and 24-hour retention was assessed. Physical and cognitive tests, including the Fugl-Meyer-Lower Extremity (FM-LE), Fluid Cognition Composite Score (FCCS) from the NIH Toolbox -Cognition Battery, and Spatial Addition from the Wechsler Memory Scale-IV, were completed in the third session. Two sequential regression models were completed: one with learning and one with retention as the dependent variables. Age, physical impairment (ie, FM-LE), and cognitive measures (ie, FCCS and Spatial Addition) were the independent variables. Results Forty-nine and 34 participants were included in the learning and retention models, respectively. After accounting for age and FM-LE, cognitive measures explained a significant portion of variability in learning (R2 = 0.17, P = .008; overall model R2 = 0.31, P = .002) and retention (ΔR2 = 0.17, P = .023; overall model R2 = 0.44, P = .002). Conclusions Cognitive abilities appear to be an important factor for understanding locomotor learning and retention after stroke. This has significant implications for incorporating locomotor learning principles into the development of personalized rehabilitation interventions after stroke.