Individual Cognitive Function Research Articles

GBA moderates cognitive reserve's effect on cognitive function in patients with Parkinson's disease.

Cognitive reserve (CR) involves an individual's ability to maintain cognitive vitality over their lifespan. Glucocerebrosidase (GBA) gene mutations contribute to additional effects on cognitive function in Parkinson's disease (PD) patients, but the interplay between GBA mutations and CR remains unclear. We investigated the interactions among CR, GBA, and diseases, aiming to examine whether the CR established at different stages interacts with specific genotypes to affect cognitive function. Three hundred and eighteen participants' CR indicators (i.e., education, occupation, and social function) and comprehensive neuropsychological function (i.e., tests for executive function, attention/working memory, visuospatial function, memory, and language) were evaluated. We found that CR established in a specific life stage influences the individual's cognitive function, particularly in PD, based on their distinct GBA rs9628662 genotypes. Attention/working memory and memory performance are affected by occupational complexity in midlife in PD patients with the GG genotype (q < 0.0001; q < 0.0001) and healthy adults with the T genotype (q = 0.0440; q < 0.0001). Language is influenced by early education and occupation, and the effects of occupation are also observed in PD patients with the GG genotype (q = 0.0040) and in healthy adults carrying the T genotype (q = 0.0040). CR, established at different life stages, can be influenced by the GBA rs9628662 genotype, impacting later-life cognition. Validating genotypes and incorporating genotype information when assessing cognitive reserve effects is crucial and can enhance targeted cognitive training.

423 Innovation in MS Patient Care: Linking Cognitive Health and Myelin Integrity

OBJECTIVES/GOALS: Our objective is to develop a patient-friendly application addressing the progression of cognitive impairments in multiple sclerosis (MS) patients. This initiative aims to augment individualized care and precision management of a major MS comorbidity by generating a cognitive health brain map for each patient. METHODS/STUDY POPULATION: Using the UAMS COMS Database, featuring high-resolution multi-contrast MRIs, and a comprehensive clinical, behavioral, and demographic dataset, we are developing a hierarchical learning-based software tool to compute maps correlating brain structure-function and individual cognitive function. Our MRI analysis employs a three-compartment model (NNLS&gt;0.96). Functional scores are defined by individualized accuracy during the modified information processing speed task (e.g., m-SDMT). We utilize a Bayesian classifier with explicit Pearson’s correlation for tissue classification (BF10&gt;100) to compute an index of the likelihood of correlation with cognitive impairment throughout brain tissue. RESULTS/ANTICIPATED RESULTS: This approach allows us to reveal subtle cognitive changes and their potential links to myelin integrity, offering vital insights into disease progression and management. The m-SDMT strongly correlates with the standard SDMT (r=0.79, p&lt;0.001), confirming reliability as a cognitive assessment tool in clinical and research contexts. Analysis of the COMS dataset emphasized insights into the role of fine myelin structure in MS patients' cognitive functionality. Our findings heightened the pivotal significance of myelin integrity in preserving cognitive abilities and identify disruptions in myelin synthesis and homeostasis as primary contributors to cognitive decline. This discovery stresses the critical role that specialized brain pathways, influenced by myelin integrity, play in the pathology of MS. DISCUSSION/SIGNIFICANCE: This development bridges advanced neuroimaging techniques with practical clinical applications, emphasizing the nuanced role of myelin integrity in MS-related cognitive deficits. Our findings advocate for a multidisciplinary approach to MS management, demanding collaborative workforce development and education in translational science.

Occupational therapy intervention for people with movement disorders and cognitive impairment

The article deals with the use of occupational therapy intervention for people with movement disorders and cognitive impairment. The relevance of the research lies in the fact that for many people with movement disorders and cognitive impairment, self-care and limited household activity are difficult even in the conditions of their own home, and it is extremely difficult to visit various institutions for domestic purposes. Therefore, the aim of the study was to substantiate the effectiveness of occupational therapy intervention to avoid pathological and pre-pathological changes in people with movement disorders and cognitive impairment. The research methods used were the analysis of literary sources, occupational therapy observation, questionnaires and conversations with people with movement disorders and cognitive impairment. The sequence of actions of ergotherapeutic intervention in the correction or compensation of movement disorders and cognitive insufficiency of the patient is determined. Recommendations are provided for an ergotherapeutic program, regarding the use of means of rehabilitation for people with movement disorders and cognitive impairment, which includes: treatment of position, joint play, restoration of balance and gait, cardio training, physical exercises, research of individual cognitive functions such as memory, attention, spatial perception etc. The importance of using special technical devices for people with severe diseases of the upper limbs and leg joints who cannot perform self-care is shown. The goal of occupational therapy intervention for cognitive impairment is outlined, which includes achieving maximum self-sufficiency and independence of a person in everyday activities (in the home, work and social environment). The use of occupational therapy intervention in practical activities will help to avoid pathological and pre-pathological changes in people with movement disorders and cognitive impairment and will speed up recovery.

Biological screening to identify hits the Therapeutic Targets of Alzheimer's disease and their role in the pathogenesis

Alzheimer's disease (AD) is a major problem in today's societies. More than five million Americans are living with Alzheimer's disease in the United States, with the majority being 65 and older. According to the Alzheimer's Association Report, the number of persons affected by Alzheimer's disease in the United States would rise to fourteen million by 2060. The disease, which is the most prevalent form of dementia, is a progressive and irreversible brain disorder that gradually deteriorates an individual's cognitive function. It advances from preclinical to early- to moderate- to late-stage disease. Early symptoms primarily include cognitive impairment, particularly memory loss. Current Alzheimer's disease treatment can be divided into two categories based on the disease's stage. Galantamine, rivastigmine, and donepezil as acetylcholinesterase inhibitors are suitable for mild to moderate cases to provide transient symptomatic relief among patients. Memantine, an N-methyl D-aspartate (NMDA) antagonist, is used as monotherapy to treat symptoms of moderate to severe Alzheimer's disease. These medications are typically selective molecules that target certain proteins ("one compound-one target" method), and their main goal is to restore physiological acetylcholine levels. Nonetheless, multiple pathways of Alzheimer's disease pathogenesis have been hypothesized to far, and they have been proven to overlap and influence one another.

A Single-Stage Population-Based Study of the Relationship between Cognitive and Somatic Health Parameters in Children of Secondary School Age

Background. One of the four important components of the formation of cognitive functions is somatic health. But to date, there are no population studies that consider the relationship with cognitive functions and school performance of a large range of somatic factors, which allows us to compare the strength of their hypothetical contribution to cognitive functioning with each other. This study is the second part of a population-based study, the first part of which is presented in the previous publication "A Single-Stage Population-Based Study of the Prevalence of Mild Cognitive Impairment in Children of Secondary School Age". Aims — to determine the main patterns in the relationship between cognitive-academic and somatic factors in a cohort of Russian children, 5th grade students at school. Methods. In Russian schoolchildren of the 5th grades of municipalities representing cities of all federal districts of the Russian Federation, the links with integrative cognitive success, the number of subtests performed at the level of mild cognitive impairment, the results of individual cognitive subtests, academic performance and the leading hand factor were analyzed — the following somatic factors: the presence of skin pathology, bronchial asthma, orthopedic, ophthalmological disorders, visual acuity, body mass index, parameters of the study of the function of external respiration, electrocardiography, ultrasound examination of the thyroid gland, laboratory blood tests. Results. The results of the survey of 1036 participants, 51% of them girls, were admitted to the analysis. It has been established that iron content is directly related to integrative cognitive success and school performance, the relationship is especially strong between subgroups of iron content above and below 26.4 mmol/l. Clinical levels of erythrocytes are more strongly associated with integrative cognitive success and individual cognitive functions than other factors: in erythropenia cognitive parameters are worse. The presence of thyroid cysts directly correlates with some of the worst parameters of cognitive activity. High body mass index and low hemoglobin are associated with poorer academic performance. Conclusions. The results of the study for the first time on a cohort of Russian schoolchildren showed a connection with cognitive activity and school performance of a number of somatic factors, including iron content, which requires further in-depth study.

Cognitive functioning of a patient with herpes simplex virus encephalitis – a case study. An exemplary paper for the State Examination in the field of clinical psychology – neuropsychology

This paper is an example of a case report for a state examination in the field of clinical psychology – neuropsychology. The case report was used during the examination in 2023 and received a positive rating. Its publication is an attempt to respond to the still reported difficulties in accessing exemplary works of this type. Due to publication limitations, some elements of the description have been shortened. The article can also be treated as a case study on the cognitive functioning of a person with active herpes encephalitis. Both screening scales, such as Addenbrooke’s Cognitive Examination III and Frenchay Aphasia Screening Test, as well as other scales to measure individual cognitive functions were used in order to assess the patient.

Cognitive functioning in untreated glioma patients: The limited predictive value of clinical variables.

Previous research identified many clinical variables that are significantly related to cognitive functioning before surgery. It is not clear whether such variables enable accurate prediction for individual patients' cognitive functioning because statistical significance does not guarantee predictive value. Previous studies did not test how well cognitive functioning can be predicted for (yet) untested patients. Furthermore, previous research is limited in that only linear or rank-based methods with small numbers of variables were used. We used various machine learning models to predict preoperative cognitive functioning for 340 patients with glioma across 18 outcome measures. Predictions were made using a comprehensive set of clinical variables as identified from the literature. Model performances and optimized hyperparameters were interpreted. Moreover, Shapley additive explanations were calculated to determine variable importance and explore interaction effects. Best-performing models generally demonstrated above-random performance. Performance, however, was unreliable for 14 out of 18 outcome measures with predictions worse than baseline models for a substantial number of train-test splits. Best-performing models were relatively simple and used most variables for prediction while not relying strongly on any variable. Preoperative cognitive functioning could not be reliably predicted across cognitive tests using the comprehensive set of clinical variables included in the current study. Our results show that a holistic view of an individual patient likely is necessary to explain differences in cognitive functioning. Moreover, they emphasize the need to collect larger cross-center and multimodal data sets.

26 To 'Proxy’ or Not to 'Proxy’: The Differential Effects of Cognitive Reserve on Late-Life Neuropsychological Functioning

Objective:As the population continues to age at a rapid pace, an important question that has been raised by clinicians and researchers alike, is “how can we preserve our cognitive abilities as older adults?” Cognitive reserve (CR) is thought to account for inter-individual differences in the cognitive trajectories of older people experiencing similar levels of brain pathology. Being a hypothetical construct, CR cannot be measured directly and therefore, must be operationalized through a combination of demographic and lifestyle variables. While there is sufficient empirical evidence supporting the relationship between individual CR proxies and cognitive functioning, few studies to date have explored which CR proxy is most important in predicting aspects of late-life cognitive functioning and whether composite measure of CR accurately predict cognitive functioning, above and beyond variables traditionally associated with late-life cognitive ability (e.g., age, gender, cardiovascular risk, depression). The present cross-sectional study sought to examine the relationship between three well-established CR proxies—educational attainment, mental workplace demands, crystallized intelligence—and baseline neuropsychological functioning in a clinical sample of older adults without dementia.Participants and Methods:Using archival data from 248 older adult patients seen at geriatric specialist hospital in Ontario, Canada, we examined the cumulative and independent effects of educational attainment (years of formal education), mental workplace demands (mean analyst rating for 10 O*NET variables measuring cognitively complex work activities), and crystallized intelligence (score on WASI-I Vocabulary subtest) on performance across several neuropsychological tests assessing i.) verbal memory, ii.) visual memory, iii.) attention, concentration, and working memory, iv.) executive functioning, v.) visuospatial processing, and vi.) language. Composite scores for all six cognitive domains were calculated by averaging converted z-scores on domain-specific tests of neuropsychological functioning. A series of regression models were then constructed to evaluate the relationship between CR and late-life cognitive functioning. To determine the relative importance of each CR proxy, a follow-up relative weight analysis (RWA) was performed for each regression model.Results:After controlling for age, gender, cardiovascular risk, and depression, our composite measure of CR (average z-score of educational attainment, mental workplace demands, crystallized intelligence) proved to be a significant predictor across all domains of cognitive functioning. Of the six cognitive domains assessed, CR was the most important in predicting higher-order cognitive functions, such as working memory and executive functioning. Out of the three CR proxies, crystallized intelligence was the only CR proxy that significantly predicted performance across all six cognitive domains. RWA revealed that crystallized intelligence was the most important in predicting neuropsychological functioning, followed by educational attainment, and mental workplace demands.Conclusions:Despite being closely related, all three CR proxies demonstrated differential effects on late-life cognitive functioning. Overall, our findings suggest that the effects of CR are not generalizable across all cognitive domains and appears to be somewhat dependent on the CR proxy used. This study supports the existing literature in demonstrating the robustness of crystallized intelligence as a CR proxy and provides preliminary evidence supporting the idea that tasks that require higher levels of cognitive processing are the most influenced by CR.

Rethinking epilepsy diagnosis and medical fitness to drive laws

Driving is an essential aspect of an individual's autonomy and ability to function as an active member of the community, travel to work, and participate in social functions. A variety of neurological conditions such as epilepsy, dementia, and Parkinson's disease can impact an individual's ability to safely operate a motor vehicle. These medical conditions and associated clinical symptoms can influence an individual's cognitive functioning, attention, thinking, and motor function. All states have laws that govern drivers' licensure and medical fitness to drive. However, many states specify granular reporting and mandatory prescriptive restrictions related to epilepsy, but not for other conditions. This article provides an overview of state laws governing medical conditions and drivers' licensure, why current laws may not accurately measure driver's ability or impairment, and suggestions for physicians and transportation professionals to balance the importance of driving while managing public safety risks.

Influence of visual acuity, manual dexterity and handgrip strength on oral and denture hygiene ability of non-frail older people: Development of the Gerostomatological Assessment Battery.

Due to the heterogeneity of older people, it is difficult to identify reliable factors influencing oral health. The aim was to illustrate the influence of visual acuity, manual dexterity, and handgrip strength on the oral and denture hygiene ability of older non-frail people. In a cross-sectional study, conducted at a specialized dental clinic, at baseline, all participants received professional prophylaxis and instruction on daily oral and denture hygiene regimes for a 6-week intervention period. Data on the Quigley and Hein modified plaque index (QHI), respectively, the Denture Hygiene Index (DHI), visual acuity, manual dexterity and handgrip strength in non-frail participants (≥ 65 years) were collected. Recruitment was done within the clinic's patient clientele and within the staff (control cohort). Women showed significantly better manual dexterity than men (Mann-Whitney U, p = .01), while women's mean handgrip strength was significantly lower (Mann-Whitney U, p < .01). Manual dexterity (Mann-Whitney U, p = .003) and handgrip strength (Mann-Whitney U, p = .052) were associated with age. However, visual acuity, manual dexterity and handgrip strength had no influence on oral or denture hygiene. Visual acuity, manual dexterity and handgrip strength have no influence on oral and denture hygiene ability in older non-frail people. Further studies should investigate whether these factors also have no influence on oral and denture hygiene in vulnerable older patients. Therefore, an assessment tool for the evaluation of potential influencing factors of oral and denture hygiene is proposed in a dental context. This Gerostomatological Assessment Battery (G-AB) can be used as a helpful tool to check the individual cognitive function and comprehension, dental therapy approaches and their individual adaption.

Coffee consumption and all-cause and cardiovascular mortality in older adults: should we consider cognitive function?

BackgroundThe association between coffee and mortality risk has been found in most previous studies, and recent studies have found an association between coffee consumption and cognition. However, there is still a lack of research exploring whether the association between coffee and mortality is influenced by cognitive function.ObjectiveThe purpose of this study was to explore the association of coffee, caffeine intake in coffee and decaffeinated coffee with all-cause mortality and cardiovascular disease (CVD) mortality in older adults with different cognitive performances.MethodsThe study was based on data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Coffee and caffeine consumption data were obtained from two 24-h dietary recalls. Individual cognitive functions were assessed by CERAD-word learning test (CERAD-WLT), animal fluency test (AFT), and digit symbol substitution test (DSST). In addition, principal component analysis (PCA) was performed with the above test scores to create global cognitive score. The lowest quartile of scores was used to classify cognitive performance. Cox regression and restricted cubic spline (RCS) were applied to assess the relationship between coffee and caffeine consumption and mortality.ResultsIn the joint effects analysis, we found that those with cognitive impairment and who reported without drinking coffee had the highest risk of all-cause and cardiovascular mortality compared with others. In the analysis of population with cognitive impairment, for all-cause mortality, those who showed cognitive impairment in the AFT displayed a significant negative association between their total coffee consumption and mortality {T3 (HR [95% CI]), 0.495 [0.291–0.840], p = 0.021 (trend analysis)}. For DSST and global cognition, similar results were observed. Whereas for CERAD-WLT, restricted cubic spline (RCS) showed a “U-shaped” association between coffee consumption and mortality. For CVD mortality, a significant negative trend in coffee consumption and death was observed only in people with cognitive impairment in AFT or DSST. In addition, we observed that decaffeinated coffee was associated with reduced mortality in people with cognitive impairment.ConclusionOur study suggested that the association between coffee consumption and mortality is influenced by cognition and varies with cognitive impairment in different cognitive domains.

Neighborhood Features and Cognitive Function: Moderating Roles of Individual Socioeconomic Status

Introduction: There is an interest in exploring the associations between neighborhood characteristics and individual cognitive function; however, little is known about whether these relationships can be modified by individual socioeconomic status, such as educational attainment and income. Methods: Drawing from the 2010-2018 Health and Retirement Study (HRS), this study analyzed 10,621 older respondents (aged 65+) with a total of 33,931 person-waves. These respondents did not have dementia in 2010 and stayed in the same neighborhood throughout the study period. Cognitive function was measured with a 27-point indicator biennially, and neighborhood characteristics (i.e., walkability, concentrated disadvantage, and social isolation) were assessed in 2010. All analyses were performed in 2023. Results: Cognitive function is positively associated with neighborhood walkability and negatively related to concentrated disadvantage, suggesting that exposures to these neighborhood characteristics have long-lasting impacts on cognitive function. Furthermore, individual socioeconomic status modifies the relationship between neighborhood characteristics and cognitive function. Compared with those graduating from college, respondents without a bachelor's degree consistently have lower cognitive function but the educational gap in cognitive function narrows with increases in walkability (b=-0.152, SE=0.092), and widens when neighborhood concentrated disadvantage (b=0.212, SE=0.070) or social isolation (b=0.315, SE=0.125) rises. The income gap in cognitive function shrinks with increases in walkability (b=-0.063, SE=0.027). Conclusions: The moderating role of socioeconomic status indicates that low-socioeconomic status older adults who also live in disadvantaged neighborhoods face a higher risk of poor cognitive function. Low-education and low-income aging adults may have the most to gain from investments to improve neighborhood characteristics.

Glycogen Synthase Kinase-3β, NLRP3 Inflammasome, and Alzheimer's Disease.

Alzheimer's disease (AD) is the most prevalent cause of dementia worldwide. Because of the progressive neurodegeneration, individual cognitive and behavioral functions are impaired, affecting the quality of life of millions of people. Although the exact pathogenesis of AD has not been fully elucidated, amyloid plaques, neurofibrillary tangles (NFTs), and sustaining neuroinflammation dominate its characteristics. As one of the major tau kinases leading to hyperphosphorylation and aggregation of tau, glycogen synthase kinase-3β (GSK-3β) has been drawing great attention in various AD studies. Another research focus of AD in recent years is the inflammasome, a multiprotein complex acting as a regulator in immunological reactions to exogenous and endogenous danger signals, of which the Nod-like receptor (NLR) family, pyrin domain-containing 3 (NLRP3) inflammasome has been studied mostly in AD and proven to play a significant role in AD development by its activation and downstream effects such as caspase-1 maturation and interleukin (IL)-1β release. Studies have shown that the NLRP3 inflammasome is activated in a GSK-3β-dependent way and that inhibition of the NLRP3 inflammasome downregulates GSK-3β, suggesting that these two important proteins are closely related. This article reviews the respective roles of GSK-3β and the NLRP3 inflammasome in AD as well as their relationship and interaction.

Which executive functions affect text comprehension and writing in paper and digital mode? An investigation in primary school children

The scientific literature supports the hypothesis of a disadvantage in students' performances when learning tasks are conducted in the digital mode in comparison to the paper one. Some studies suggest the need of investigating the role of individual cognitive functioning in digital reading and writing with special attention to those cognitive processes, such as Executive Functions (EF), which are acknowledged to control and affect learning and school adaptation. The present study aimed to: 1) investigate the differences in performances between paper and digital modalities in text reading and text writing in primary grade students; 2) analyse whether EF predict performances in paper and digital modalities; 3) explore whether any differences between paper and digital text comprehension or writing can be differently explained by EF depending on the children's learning performances. 175 typically developing Grades 3–5 students performed text comprehension and text writing tasks on computer and on paper and were assessed with EF tasks tapping inhibitory control, working memory and cognitive flexibility. The results showed no performance differences between digital and paper tasks at the group level apart from a higher text length in the digital than paper mode. However, children with low performances at the comprehension and writing tasks benefited more from the digital than the paper mode, in comparison to high performers that showed the opposite pattern. Additionally, low performers scored worse than high performers in most of the EF tasks. Lastly, working memory explained the digital-paper difference in text comprehension among low comprehenders as well as cognitive flexibility explained the difference in level of narrative complexity and number of words among low writers.The results suggest the benefit of the digital mode for low readers and writers and highlight the role of the main components of EF in reading and writing in both paper and digital modes in primary school.

Structural Fingerprinting of the Frontal Aslant Tract: Predicting Cognitive Control Capacity and Obsessive-Compulsive Symptoms.

White matter of the human brain is influenced by common genetic variations and shaped by neural activity-dependent experiences. Variations in microstructure of cerebral white matter across individuals and even across fiber tracts might underlie differences in cognitive capacity and vulnerabilities to mental disorders. The frontoparietal and cingulo-opercular networks of the brain constitute the central system supporting cognitive functions, and functional connectivity of these networks has been used to distinguish individuals known as "functional fingerprinting." The frontal aslant tract (FAT) that passes through the two networks has been implicated in executive functions. However, whether FAT can be used as a "structural fingerprint" to distinguish individuals and predict an individual's cognitive function and dysfunction is unknown. Here we investigated the fingerprinting property of FAT microstructural profiles using three independent diffusion MRI datasets with repeated scans on human participants including both females and males. We found that diffusion and geometric profiles of FAT can be used to distinguish individuals with a high accuracy. Next, we demonstrated that fractional anisotropy in different FAT segments predicted distinct cognitive functions, including working memory, inhibitory control, and relational reasoning. Finally, we assessed the contribution of altered FAT microstructural profiles to cognitive dysfunction in unmedicated patients with obsessive-compulsive disorders. We found that the altered microstructure in FAT was associated with the severity of obsessive-compulsive symptoms. Collectively, our findings suggest that the microstructural profiles of FAT can identify individuals with a high accuracy and may serve as an imaging marker for predicting an individual's cognitive capacity and disease severity.SIGNIFICANCE STATEMENT The frontoparietal network and cingulo-opercular network of the brain constitute a dual-network architecture for human cognitive functions, and functional connectivity of these two networks can be used as a "functional fingerprint" to distinguish individuals. However, the structural underpinnings of these networks subserving individual heterogeneities in their functional connectivity and cognitive ability remain unknown. We show here that the frontal aslant tract (FAT) that passes through the two networks distinguishes individuals with a high accuracy. Further, we demonstrate that the diffusion profiles of FAT predict distinct cognitive functions in healthy subjects and are associated with the clinical symptoms in patients with obsessive-compulsive disorders. Our findings suggest that the FAT may serve as a unique structural fingerprint underlying individual cognitive capability.

Face Recognition Using Raspberry PI for Mentally Retarded Person

The face recognition system described in this paper focuses on addressing the needs of individuals with intellectual disabilities. Intellectual disabilities often affect an individual's cognitive and adaptive functioning, making it challenging for them to perform everyday tasks independently. This system utilizes the capabilities of Raspberry Pi , a low cost single-board computer, to create an accessible and user-friendly solution for face recognition. The main objective of this system is to assist mentally challenged individuals in recognizing and identifying familiar faces. By utilizing face recognition technology, the system aims to enhance their independence, social interactions, and overall quality of life. The Raspberry Pi platform provides a flexible and affordable hardware foundation for implementing this system. The system leverages a pre-trained deep learning model for face recognition, such as OpenCV or dlib, to perform face detection and identification tasks. The model is trained on a dataset containing facial images of familiar individuals to ensure accurate recognition. Raspberry Pi's computational capabilities enable real-time processing of the captured video feed, facilitating prompt recognition and response.

[The old person in road traffic].

Due to the demographic change and the rising mobility of older adults in comparison with former generations, the number of old persons involved in road traffic has been continuously growing. The safety of all participating parties in road traffic necessitates asuccessful interaction of each individual's visual, motor and cognitive functions. These might be negatively affected by age-related physiological changes with alarge individual variation. In addition, old age is affected to varying degrees by multimorbidity and the resulting medication can further influence the ability to drive. There are, however, several options to compensate for potential functional losses in road traffic. Maintaining the mobility of old people for as long as possible and at the same time maintaining traffic safety for all participants represents a challenge for society and medicine when dealing with older adults. This article discusses the old person in road traffic from ageriatrics point of view.

Statistical Approaches for the Analysis of Combined Health-Related Factors in Association with Adult Cognitive Outcomes: A Scoping Review.

Dementia prevention is a global health priority, and there is emerging evidence to support associations between individual modifiable health behaviors and cognitive function and dementia risk. However, a key property of these behaviors is they often co-occur or cluster, highlighting the importance of examining them in combination. To identify and characterize the statistical approaches used to aggregate multiple health-related behaviors/modifiable risk factors and assess associations with cognitive outcomes in adults. Eight electronic databases were searched to identify observational studies exploring the association between two or more aggregated health-related behaviors and cognitive outcomes in adults. Sixty-two articles were included in this review. Fifty articles employed co-occurrence approaches alone to aggregate health behaviors/other modifiable risk factors, eight studies used solely clustering-based approaches, and four studies used a combination of both. Co-occurrence methods include additive index-based approaches and presenting specific health combinations, and whilst simple to construct and interpret, do not consider the underlying associations between co-occurring behaviors/risk factors. Clustering-based approaches do focus on underlying associations, and further work in this area may aid in identifying at-risk subgroups and understanding specific combinations of health-related behaviors/risk factors of particular importance in the scope of cognitive function and neurocognitive decline. A co-occurrence approach to aggregating health-related behaviors/risk factors and exploring associations with adult cognitive outcomes has been the predominant statistical approach used to date, with a lack of research employing more advanced statistical methods to explore clustering-based approaches.

Hub structure in functional network of EEG signals supporting high cognitive functions in older individuals.

Maintaining high cognitive functions is desirable for "wellbeing" in old age and is particularly relevant to a super-aging society. According to their individual cognitive functions, optimal intervention for older individuals facilitates the maintenance of cognitive functions. Cognitive function is a result of whole-brain interactions. These interactions are reflected in several measures in graph theory analysis for the topological characteristics of functional connectivity. Betweenness centrality (BC), which can identify the "hub" node, i.e., the most important node affecting whole-brain network activity, may be appropriate for capturing whole-brain interactions. During the past decade, BC has been applied to capture changes in brain networks related to cognitive deficits arising from pathological conditions. In this study, we hypothesized that the hub structure of functional networks would reflect cognitive function, even in healthy elderly individuals. To test this hypothesis, based on the BC value of the functional connectivity obtained using the phase lag index from the electroencephalogram under the eyes closed resting state, we examined the relationship between the BC value and cognitive function measured using the Five Cognitive Functions test total score. We found a significant positive correlation of BC with cognitive functioning and a significant enhancement in the BC value of individuals with high cognitive functioning, particularly in the frontal theta network. The hub structure may reflect the sophisticated integration and transmission of information in whole-brain networks to support high-level cognitive function. Our findings may contribute to the development of biomarkers for assessing cognitive function, enabling optimal interventions for maintaining cognitive function in older individuals.

Abnormal cerebral micro-structures in end-stage renal disease patients related to mild cognitive impairment

PurposeTo investigate the mediating effect of abnormal brain micro-structures on the relationship between clinical risk factors and mild cognitive impairment (MCI), and further predict individual cognitive function in end-stage renal disease (ESRD) patients undergoing maintenance hemodialysis. MethodsIn total, 40 ESRD patients and 30 healthy controls were prospectively enrolled in our study. All subjects completed diffusion kurtosis imaging (DKI) examinations and Montreal cognitive assessment (MoCA) test. Between-group differences in the DKI metrics were analyzed. In addition, the mediating effects of altered brain micro-structures on the association between clinical risk factors and MCI were determined by mediation analysis. Finally, cognitive function was predicted based on DKI metrics and clinical characteristics by applying the optimized least squares support vector regression machine. ResultsWe observed disrupted brain micro-structures in ESRD patients with MCI, as indicated by significantly altered DKI parameters. Significant correlations were found between the DKI metrics, clinical characteristics, and MoCA scores. In ESRD patients, low hemoglobin level and high serum creatine level were clinical risk factors for MCI. A decreased axial kurtosis value in the left hippocampus may partially mediate the impact of serum creatine on MCI. Furthermore, the prediction model could predict cognitive scores associated with ESRD with relatively high accuracy. ConclusionAberrant micro-structures partially mediated the association between clinical risk factors and MCI, which is a novel insight into the progression of cognitive dysfunction in ESRD patients. Combined DKI metrics and clinical characteristics could be used as features to efficiently predict cognitive function associated with ESRD.