Level Of Cognitive Functioning Research Articles

Determinants of successful cognitive aging over 15 years: a population‐based study

AbstractBackgroundAlthough aging is related to loss in cognitive function, some individuals maintain high levels of cognitive performance also in late life. However, studies mapping longitudinal cognitive trajectories are scarce and little is known about the factors that may promote successful cognitive aging (SCA). We sought to identify predictors of SCA, based on latent profiles derived from interindividual differences in rate of change across several cognitive domains.MethodWe followed 1,966 individuals from the Swedish National Study on Aging and Care in Kungsholmen (SNAC‐K) over 15 years (mean baseline age = 71.6 years; 62.9% female). Participants were free from dementia at baseline and had undergone at least two cognitive assessments during follow‐up. Cognition was assessed with a comprehensive battery, including tests of semantic memory, episodic recall and recognition, letter and verbal fluency, and executive function. We estimated level and change within each of the cognitive domains with linear mixed effect models, based on which we classified participants into successful, normal, or decline groups. These groups were used to derive profiles of overall cognitive change trajectories, through latent class analysis. We then investigated demographic, health, lifestyle, and genetic predictors of profile membership.ResultWe obtained three latent cognitive profiles. 31.6% of the sample was classified as successful, 50.6% as normal, and 17.8% as decliner. In multi‐adjusted multinomial logistic regression analysis, membership in the successful profile was predicted by female sex, higher education, and a faster walking speed (ps < 0.003). Current smoking, feelings of loneliness, and carrying the Apolipoprotein ԑ4‐allele were associated with a lower likelihood of being classified as successful (ps < 0.037). Higher age, diagnosis of diabetes or depression, and being an ԑ4‐carrier increased the likelihood of being classified into the decline profile (ps < 0.026).ConclusionWe identified several demographic, lifestyle, health, and genetic factors of SCA. Of note, these factors were different from those that predicted accelerated cognitive decline. Although some cognitive loss may be an inevitable part of aging, our results suggest certain modifiable factors (i.e. smoking and quality of social interactions) to be related to maintained cognitive function in older age.

Combining working memory and speech data in a digital app for early detection of cognitive impairment in primary care

AbstractBackgroundCognitive screening to detect mild cognitive impairment (MCI) and dementia in primary care settings has proven to be a challenging task. The ideal solution would be a brief, low‐burden assessment tool appropriate for use with individuals from diverse educational and cultural backgrounds that requires limited time and expertise from primary care providers. The purpose of this project was to develop a digital cognitive screening app derived from widely used cognitive and speech tasks using machine learning techniques.MethodParticipants were 104 old adults, 53 who were cognitively normal (CN) and 51 who were cognitively impaired (CI). All participants completed a working memory task (WM), followed by four speech‐language tasks, followed by a second administration of WM (WM2) to investigate the added utility of practice effects. Participants also completed the Quick Mild Cognitive Impairment (Qmci) screen. Bayesian adaptive regression trees were used to test 11 models. All models contained sex, age, education, and marital status. One model contained WM and the WM2‐WM difference. Four models contained 26 acoustic and 34 linguistic variables derived from each of the four speech tasks, and four more models were identical, except with the two WM variables added. For comparison, two models with Qmci were fitted: one with and one without the two WM variables.ResultThree models achieved cross‐validated classification accuracy of c≥0.90: WM by itself (estimated c = 0.91; Figure 1), WM and a personal narrative task (c = 0.94; Figure 2), and WM and a counting backwards task (c = 0.90). Models with picture description and procedural discourse tasks performed the worst. The QMCI‐only model yielded c = 0.91.ConclusionCombining WM, acoustic and linguistic variables involved in recounting personal memories, and the ability to benefit from prior exposure to a task discriminated CN from CI groups with a high degree of accuracy. This unique combination assesses key cognitive abilities known to be affected early in neurodegenerative diseases, executive functioning and memory, and includes both verbal and nonverbal tasks. Importantly, individuals with varying levels of cognitive functioning, including mild dementia, were able to use the app successfully, and the automated nature of the tool required minimal staff time or expertise.

Association of periodontal condition with cognitive impairment and the mediating role of accelerated biological aging among US older adults

AbstractBackgroundIncreasing evidence has shown the associations between periodontitis and cognitive impairment or dementia; however, few studies have explored the role of accelerated biological aging that affects this association. Biological aging is the gradual and progressive decline in system integrity that occurs with advancing age. In this study, we examined the mediating effect of biological aging on the association between periodontal conditions and cognitive impairment in US older adults.MethodWe analyzed data from 2,186 participants aged 60 and older from the US National Health and Nutrition Examination Survey 2011‐2014. Data included sociodemographic, behavioral, and health‐related characteristics, periodontal status (measured by mean clinical attachment loss and pocket depth), blood‐chemistry measures of biological age (using KDM‐biological age and PhenoAge algorithms), and cognitive functioning (measured by Digit Symbol Substitution Test). We created an accelerated biological aging measure using residuals from regressing each blood‐chemistry measure on chronological age. The biological ages’ residual discrepancies with chronological age were defined as the biological age accelerations (BAA). Mediation analysis, weighted for complex survey design, assessed the effect of BAA on the association between periodontal conditions and cognitive functioning.ResultAfter adjusting for covariates, participants with periodontitis exhibited greater KDM BAA (β [SE] = ‐0.40 [0.17]), PhenoAge BAA (β [SE] = ‐0.57 [0.21]), and lower level of cognitive function (β [SE] = ‐1.50 [0.33]) than those without periodontitis. Both KDM and PhenoAge BAA were significantly associated with lower cognitive functioning (β [SE] = ‐0.27 [0.10] and β [SE] = ‐0.29 [0.07]), mediating 11.0% and 9.7% of the total effects of periodontitis on cognitive functioning, respectively. Furthermore, KDM and PhenoAge BAA mediated 11.7% and 5.8% of the association between mean pocket depth and DSST, respectively.ConclusionOur findings suggest that periodontitis is partially associated with worse cognitive functioning through accelerating the biological aging process. Efforts to improve oral health or slow biological aging have the potential to help reserve cognitive health in later life.

중 고령자 자원봉사와 인지기능의 종단관계 및 교육과 연령의 조절

This study investigates the longitudinal associations between volunteering among older adults and the cognitive functioning for the purpose of preventing the cognitive decline, examining how volunteerism of older persons affects the cognitive functioning. For the purpose, the study analyzes about 8,688 older subjects who are observed six times with intervals of two years, using statistical analysis model of linear multilevel mixed regression. The results show that volunteering is associated with higher level of cognitive function over time, and the education moderates the association, with volunteering benefiting the most differentially least-educated elderly among four higher-educated groups. Also age weakens the effect size of volunteering, but volunteering effects work in all ages. Volunteering is lifestyle behaviors that enhance cognitive functioning of older persons. The results suggests that cognition-strengthened volunteer programs are beneficial to older persons at the population level.

The Look AHEAD Aging Study: design, cohort characteristics, and cognitive function

AbstractBackgroundData on cognitive trajectories and characteristics associated with cognitive resilience among older individuals with type 2 diabetes and overweight or obesity are scant. To date, the NIA‐funded Action for Health in Diabetes (Look AHEAD) Aging Study has enrolled 1245 individuals, ages 64 to 95 years, who have been richly characterized over 18 years of prior follow‐up with factors associated with cognitive aging.MethodVolunteers from the Look AHEAD clinical trial of a multidomain lifestyle intervention and its subsequent clinic‐based post‐trial observational phase were invited to join a 4‐year telephone‐based observational study that includes annual cognitive assessments to assess memory, attention/processing speed, executive function, and global cognitive function. A composite measure of cognitive function based on the average standardized cognitive function tests was used to capture global cognitive function. Mild cognitive impairment and probable dementia will be centrally adjudicated. Additional measures include depressive symptoms, physical function and abilities, medical events, medication use, and health related quality of life. Recruitment will be completed in early 2023.ResultThe enrolled cohort to date (N = 1590) includes 62% women, 32% individuals from traditionally under‐represented racial/ethnic minorities, 49% without college education, and 52% who had been randomly assigned to the lifestyle intervention. The mean (SD) age is 76.3 (5.6) and years of diabetes is 25.5 (5.5). When last measured, the mean BMI was 33.8 (6.3) kg/m2 and 4 m walk speed was 0.86 (0.22) m/sec. Of 1060 who were tested, 20.6% have one apoE‐e4 allele and 1.1% have two apoE‐e4 alleles. Modified Telephone Interview for Cognitive Status (TICSm) scores ranged from 12 to 48, with mean 34.7 (4.7), with no difference between intervention groups (p = 0.66). While TICSm scores tended to be lower for older participants, many still demonstrated relatively high levels of cognitive functioning, even into the 8th decade of life (attached figure).ConclusionThe Look AHEAD Aging study holds great promise to identify factors across two decades of follow‐up that are associated with cognitive resilience in a large cohort with type 2 diabetes and overweight or obesity. Our presentation will provide data on the full cohort and cognitive battery.

Combining working memory and speech data in a digital app for early detection of cognitive impairment in primary care

AbstractBackgroundCognitive screening to detect mild cognitive impairment (MCI) and dementia in primary care settings has proven to be a challenging task. The ideal solution would be a brief, low‐burden assessment tool appropriate for use with individuals from diverse educational and cultural backgrounds that requires limited time and expertise from primary care providers. The purpose of this project was to develop a digital cognitive screening app derived from widely used cognitive and speech tasks using machine learning techniques.MethodParticipants were 104 old adults, 53 who were cognitively normal (CN) and 51 who were cognitively impaired (CI). All participants completed a working memory task (WM), followed by four speech‐language tasks, followed by a second administration of WM (WM2) to investigate the added utility of practice effects. Participants also completed the Quick Mild Cognitive Impairment (Qmci) screen. Bayesian adaptive regression trees were used to test 11 models. All models contained sex, age, education, and marital status. One model contained WM and the WM2‐WM difference. Four models contained 26 acoustic and 34 linguistic variables derived from each of the four speech tasks, and four more models were identical, except with the two WM variables added. For comparison, two models with Qmci were fitted: one with and one without the two WM variables.ResultThree models achieved cross‐validated classification accuracy of c = 0.90: WM by itself (estimated c = 0.91; Figure 1), WM and a personal narrative task (c = 0.94; Figure 2), and WM and a counting backwards task (c = 0.90). Models with picture description and procedural discourse tasks performed the worst. The QMCI‐only model yielded c = 0.91.ConclusionCombining WM, acoustic and linguistic variables involved in recounting personal memories, and the ability to benefit from prior exposure to a task discriminated CN from CI groups with a high degree of accuracy. This unique combination assesses key cognitive abilities known to be affected early in neurodegenerative diseases, executive functioning and memory, and includes both verbal and nonverbal tasks. Importantly, individuals with varying levels of cognitive functioning, including mild dementia, were able to use the app successfully, and the automated nature of the tool required minimal staff time or expertise.

Cognitive Improvement through Breathing Exercises in Post-Stroke Respiratory Sarcopenia: A Review

PURPOSE: The first purpose of this study is to investigate the relationship between Post-Stroke Respiratory Sarcopenia (PSRS) and Cognitive Impairment (CI) through Breathing Exercise (BE) as a respiratory rehabilitation after stroke (ST). The second purpose is to introduce a pilot study design set to investigate and compare the acute effects of each BE to develop a BE protocol for further studies.METHODS: Pubmed, Scopus, Web of Science and Google Scholar search engines were used to identify the definition and mechanism of ST, CI and respiratory sarcopenia (RS), and to find cases of application of BE in such conditions.RESULTS: Review; BEs that improve ST, RS, and CI symptoms are Box Breathing (Tactical Breathing), Fast-Breathing, Slow-paced Breathing, Inspiratory Diaphragmatic Breathing+Expiratory Pursed-lip Breathing Exercise. However, the effect is still unclear as post-stroke patients undergo multiple medical treatments other than BE. Pilot Study Prospective results; Inspiratory Diaphragmatic Breathing+Expiratory Pursed-lip Breathing Exercise, Slow-paced Breathing, Box Breathing (Tactical Breathing) and Fast-Breathing will be performed by 40 healthy college students through a randomized controlled trial for 4 weeks. Respiratory functions, exercise intensity, active oxygen level, blood lactate level, cerebral oxygen saturation and cognitive function will be measured pre- and post-intervention along with acute and 2 week mid-intervention. BEs are expected to improve respiratory function, cognitive performance and energy levels while reducing HR, BP, and stress. However, individual response to BE may vary according to health, physical fitness and life styles. All BE will be conducted in an evenly controlled and supervised environment for accurate data collection.CONCLUSIONS: Further study will be done to develop an appropriate BE protocol for PSRS patients per this review. Follow-up studies may also use this review as a reference for the application of BEs in PSRS patients with CI.

Association of cognitive and adaptive skills with internalizing and externalizing problems in autistic children and adolescents.

The presence of an intellectual disability (ID) alongside autism is considered to increase the risk for mental health and behavior problems in children and adolescents. Existing evidence is restricted by looking at ID as a categorical classification. The study aimed to examine the association of cognitive and adaptive behavior skills with internalizing and externalizing problems in a large sample of autistic children and adolescents, across a wide range of cognitive skills. Participants were 2759 children and adolescents aged between 4 and 18 years recruited as part of the Simons Simplex Collection (SSC), of whom 709 (approximately 25%) had ID. Multiple regression models examined associations of internalizing and externalizing problems with cognitive and adaptive skills (communication, daily living, and socialization skills). Cognitive skills were not associated with externalizing problems but were associated with more internalizing problems in autistic children without ID (Cog β: 0.126). All adaptive skill domains were inversely associated with externalizing (Communication β: -0.145; Daily-Living β: -0.132; Socialization β: -0.289) and internalizing problems (Communication β: -0.074; Daily-Living β: -0.064; Socialization β: -0.213) in those without ID. Daily living (β: -0.158) and socialization skills (β: -0.104) were inversely correlated with externalizing problems in autistic children with ID, while only socialization problems (β: -0.099) were associated with internalizing problems in this group. Socialization skills were systematically associated with internalizing and externalizing problems across all levels of cognitive functioning. Supporting social skills development may benefit all aspects of child mental health, while recognizing that children with higher cognitive skills are more vulnerable to internalizing problems might assist with earlier identification of these problems.

Associations of sleep duration and daytime sleepiness with plasma amyloid beta and cognitive performance in cognitively unimpaired, middle-aged and older African Americans.

Given the established racial disparities in both sleep health and dementia risk for African American populations, we assess cross-sectional and longitudinal associations of self-report sleep duration (SRSD) and daytime sleepiness with plasma amyloid beta (Aβ) and cognition in an African American (AA) cohort. In a cognitively unimpaired sample drawn from the African Americans Fighting Alzheimer's in Midlife (AA-FAiM) study, data on SRSD, Epworth Sleepiness Scale, demographics, and cognitive performance were analyzed. Aβ40, Aβ42, and the Aβ42/40 ratio were quantified from plasma samples. Cross-sectional analyses explored associations between baseline predictors and outcome measures. Linear mixed-effect regression models estimated associations of SRSD and daytime sleepiness with plasma Aβ and cognitive performance levels and change over time. One hundred and forty-seven participants comprised the cross-sectional sample. Baseline age was 63.2 ± 8.51 years. 69.6% self-identified as female. SRSD was 6.4 ± 1.1 hours and 22.4% reported excessive daytime sleepiness. The longitudinal dataset included 57 participants. In fully adjusted models, neither SRSD nor daytime sleepiness is associated with cross-sectional or longitudinal Aβ. Associations with level and trajectory of cognitive test performance varied by measure of sleep health. SRSD was below National Sleep Foundation recommendations and daytime sleepiness was prevalent in this cohort. In the absence of observed associations with plasma Aβ, poorer self-reported sleep health broadly predicted poorer cognitive function but not accelerated decline. Future research is necessary to understand and address modifiable sleep mechanisms as they relate to cognitive aging in AA at disproportionate risk for dementia. Not applicable.

Association of bone turnover markers and cognitive function in Chinese chronic schizophrenia patients with or without vitamin D insufficiency

BackgroundIncreasing evidence shows that bone turnover markers (BTMs) and vitamin D can affect human cognitive function. However, there are few studies that have investigated the association between BTMs and cognitive function in chronic schizophrenia patients. The aim of this study was to investigate the relationship between BTMs and cognitive function in chronic schizophrenia patients with or without vitamin D insufficiency (VDI).MethodsIn all, 118 chronic schizophrenia patients were enrolled in this cross-sectional study. Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was applied to evaluate the cognitive function of the subjects. Blood analysis included bone turnover markers, vitamin D levels, and glycolipid levels.ResultsRelative to 72 vitamin D-sufficient (VDS) patients, 46 VDI patients had higher bone resorption markers levels and lower bone formation markers levels. Regression analysis showed that, in the total sample, CTX and language function exhibited independent positive correlation (p = 0.027, R2 change = 0.042), and in the VDS group, procollagen type I N-terminal propeptide (PINP) was independently negatively correlated with language function (p = 0.031, R2 change = 0.065), while the positive correlation between osteopontin (OPN) and delayed memory remained in the VDI group (p = 0.036, R2 change = 0.083).ConclusionOur study showed an association between the levels of BTMs and cognitive function among chronic schizophrenia patients. This correlation may have different mechanisms of action at different vitamin D levels.

Polygenic risk scores for Alzheimer's disease in relation to cognitive change: A representative sample from the general population followed over 16 years.

BackgroundPolygenic risk scores for Alzheimer's disease (AD-PRSs) have been associated with cognition. However, few studies have examined the effect of AD-PRS beyond the APOE gene, and the influence of genetic variants related to level of cognitive ability (COG-PRS) on cognitive performance over time in the general older population. MethodA population-based sample of 965 individuals born in 1930, with genetic and standardized cognitive data on six psychometric tests (Thurstone's picture memory, immediate recall of 10 words, Block design, word fluency, figure identification, delayed recall of 12 items), were examined at age 70, 75, 79, and 85 years. Non-APOE AD-PRSs and COG-PRSs (P < 5e−8, P < 1e−5, P < 1e−3, P < 1e−1) were generated from recent genome-wide association studies. Linear mixed effect models with random intercepts and slope were used to analyze the effect of APOE ε4 allele, AD-PRSs, and COG-PRSs, on cognitive performance and rate of change. Analyses were repeated in samples excluding dementia. ResultsAPOE ε4 and AD-PRS predicted change in cognitive performance (APOE ε4*age: β = −0.03, P < 0.0001 and AD-PRS *age: β = −0.01, P = 0.02). The results remained similar in the sample excluding those with dementia. COG-PRS predicted level of cognitive performance, while APOE ε4 and AD-PRS did not. COG-PRSs did not predict change in cognitive performance. ConclusionWe found that genetic predisposition of AD predicted cognitive decline among 70-year-olds followed over 16 years, regardless of dementia status, while polygenic risk for general cognitive performance did not.

Abstract 18644: Disparities in Inpatients’ Perceptions, Evaluation, and Responses to Worsening Heart Failure Symptoms- Racial and Financial Status

Background: Most patients with heart failure (HF) exhibit a broad symptom profile, sporadically marked by periods of acute exacerbation and readmission that can be prevented by symptom monitoring and adequate self-care. Yet, patients are frequently unable to adhere to appropriate self-care measures. Reasons for non-adherence are multifactorial including disparities related to race and financial status, and are insufficiently investigated. Thus, a secondary analysis study was conducted to 1) compare HF inpatients’ knowledge, cognitive function and HF self-care based on their race (Black and White), and financial status (higher if they reported having “enough or more than enough to make ends meet” and lower if they “did not have enough to make ends meet”), and 2) investigate disparities in patients’ perception and evaluation of symptoms, and actions taken during HF exacerbation based on their race and financial status. Methods: A total of 185 patients (62 years ±13, 49 % female, 76% white) admitted for acute HF exacerbation completed standardized instruments measuring cognitive function, HF knowledge, HF self-care, perception of, and responses to HF symptoms. Chi-square and independent samples t-test analyses were used. Results: Black patient with HF had lower levels of HF knowledge, cognitive function, and engagement in self-care maintenance behaviors than White patients (p &lt;.05). Black patients believed medication nonadherence, excessive fluid intake, hypertension, and overeating were causes of their worsening symptoms (p &lt;.05). Black patients tended to call an ambulance in response to worsening symptoms while White patients took their water pill (p = 0.03). Patients with lower financial status reported higher body mass index than those with higher financial status (p = .03). Patients with lower financial status linked their symptoms to depression and lung problems (p =.02), but they did nothing to manage symptoms and hoped their symptoms would go away (p &lt; .05). Conclusions: Interventions that take into account culture and financial status are needed to mitigate racial disparities, improve symptom perception, and promote appropriate responses in HF patients.

Feasibility and Acceptability of a Group Music Creativity Intervention for Adults with Varying Cognitive Function

ABSTRACT Maintaining healthy cognitive functioning and delaying cognitive decline in cognitively intact and cognitively impaired adults are major research initiatives for addressing dementia disease burden. Music interventions are promising, non-pharmaceutical treatment options for preserving cognitive function and psychological health in older adults with varying levels of cognitive function. While passive, music interventions have attracted considerable attention in the abnormal cognitive aging literature, active, music interventions such as music creativity are less well-studied. Among 58 older adults with different levels of cognitive function (cognitively healthy to mild cognitive impairment), we examined the feasibility and acceptability of Project CHROMA, a Stage 1 clinical trial developed to assess the effects of a novel, music creativity curriculum on various health outcomes. Music intervention participation (93%), overall study retention (78%), and intervention satisfaction (100%) rates were comparable to other similarly designed clinical trials. Exploratory analyses using mixed-level modeling tested the efficacy of the intervention on cognitive and psychological outcomes. Compared to those in the control condition, participants in the music condition showed some improvements in cognitive functioning and socioemotional well-being. Findings suggest that a 6-week music creativity clinical trial with several multi-modal health assessments can be feasibly implemented within a sample of varying cognitive ability.

Feasibility of a remotely-delivered yoga intervention on cognitive function in breast cancer survivors: a mixed-methods study

BackgroundCancer-related cognitive impairment (CRCI) is a common, persistent quality of life complaint among breast cancer survivors (BCS), however there remain no proven treatments. There is emerging evidence that aerobic exercise and yoga may improve CRCI. There remains limited research on the safety and feasibility of virtually-supervised, remotely-delivered yoga interventions among cancer survivors, and no yoga studies to date have assessed cognitive function as a primary outcome in BCS. The purpose of this study was to explore the feasibility of an 8-week, remotely-delivered yoga intervention and examine its impact on cognitive function, fatigue, and exercise levels in BCS using a concurrent mixed-methods design.MethodsParticipants completed objective and self-report cognitive function measures (NIH Toolbox remote cognitive battery, PsyToolkit Task Switch test, Functional Assessment of Cancer Therapy-Cognitive Function [FACT-Cog3]); fatigue (Revised-Piper Fatigue Scale); and exercise activity level (modified Godin Leisure Time Exercise Questionnaire) before and after the yoga intervention. Semi-structured qualitative interviews were conducted post-intervention to understand participants' experiences with the yoga intervention, CRCI, and fatigue.ResultsThe intervention surpassed a priori feasibility indicators (adherence rate = 83.7%, attrition rate = 5.4%, no adverse events). Participants (n = 18, Mage= 52.2 ± 10.1) had significant improvements in objective memory, fatigue, and weekly minutes of moderate-to-vigorous exercise post-intervention. Qualitative themes indicated that participants found the remote intervention to be enjoyable and beneficial.ConclusionsIn this small proof-of-concept study, remotely-delivered yoga appears safe and effective at improving CRCI. Future randomized controlled trials examining the impact of remotely-delivered yoga interventions on cognitive function in BCS are warranted.

The Relationship Between Level of Education, Cognitive Function and Medication Adherence in Patients with Schizophrenia.

Several studies have explored the relationship between level of education and medication adherence, as well as the relationship between level of education and cognitive function. However, there have been few studies on the relationships between level of education, cognitive function, and medication adherence. This study aimed to explore whether cognitive function has a mediating effect between level of education and medication adherence in patients with schizophrenia. A total of 329 participants were included in this study. Cognitive function was assessed using the Brief Assessment of Cognition in Schizophrenia, and medication adherence using the Medication Adherence Questionnaire. The relationships between the clinical factors and cognitive function that contributed to medication adherence were tested through multivariable linear regression analysis. The mediatingeffect of medication adherence was tested using the bootstrapping approach with the PROCESS macro. Family history, insight and executive function were associated with medication adherence in individuals with schizophrenia, and executive function had a mediating effect between level of education and medication adherence. Adopting specific education programs that promote cognitive development as well as actively intervening in executive function might be conducive to improve medication adherence in patients with schizophrenia.

Literature Review of Burnout Syndrome in Intensive Care Unit (ICU) Staffs During The COVID-19 Pandemic

Introductions: Burnout syndrome becomes a special concern for health workers during COVID-19 pandemic that has been exposed to increased workload and intense working hours with COVID-19 patients, stating having a high risk of getting infected with COVID-19 as well. Methods: This literature review paper reviewed scientific journals with prevalence and burnout syndrome profile data. The journals were obtained through the search engines GoogleScholar, the MEDLINE (PubMed) database and PsychINFO. From the search, there are 13 articles in total that meet the required data criteria. Results: Prevalence of burnout syndrome were found severely high in ICU settings, it reached more than 50% from most of the survey. Burnout syndrome rate can be influenced by working conditions, age and gender, time of work and working experience. Burnout syndrome can manifest as higher fatigue level and decrease of cognitive function that can increase the risk of medical mistake. Conclusions: High prevalence and severity of burnout syndrome oblige us to pay attention to symptoms that can affect professional intensive care unit staff and its service to patients. Further research should review prevention therapy and how to apply to health workers and also the prevalence of prevention that has been done in other studies.

Childhood maltreatment and midlife cognitive functioning: A longitudinal study of the roles of social support and social isolation.

Negative consequences of childhood maltreatment have been well-documented, including poorer executive functioning and nonverbal reasoning in midlife. However, not all adults with a history of childhood maltreatment manifest these outcomes, suggesting the presence of risk and protective factors. Based on growing empirical support for the importance of social variables in understanding neuropsychological development and functioning, we examined whether social support and social isolation mediate or moderate the effects of childhood maltreatment on cognitive functioning in midlife. In the context of a prospective cohort design study, individuals with documented histories of childhood maltreatment (ages 0-11 years) and demographically matched controls were followed up and interviewed in adulthood. Social support and isolation were assessed in young adulthood (Mage = 29), and cognitive functioning was assessed in midlife (Mage = 41). Structural equation modeling was used for mediation and linear regressions for moderation. Childhood maltreatment predicted higher levels of social isolation and lower levels of social support and cognitive functioning. Only social isolation mediated the relationship between childhood maltreatment and midlife cognitive functioning, whereas childhood maltreatment interacted with social support to predict Matrix Reasoning in midlife. Social support was protective for the control group but not for those maltreated. Social isolation and social support play different roles in understanding how childhood maltreatment impacts midlife cognitive functioning. Greater social isolation predicts greater deficits in cognitive functioning overall, whereas the protective effects of social support are limited to those without a documented history of childhood maltreatment. Clinical implications are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

20 The Relationship Between Quality of Life, Cognitive Functioning, and Tumor Grade Level in Brain Tumor Patients

Objective:The goal of the current study is to compare QoL between tumor grade levels (i.e., low vs high) as well as the relationship between QoL, cognition, and tumor grade.Participants and Methods:Participants were 156 individuals diagnosed with a brain tumor who completed neuropsychological evaluation within an interdisciplinary brain tumor clinic (mean age=51.67; SD=15.0; mean education=13.98; SD=2.6; 59% male). Independent samples T-Test was utilized to review participants’ reported overall quality of life (QoL) on the FACT-Br in relation to tumor grade level (i.e., high vs low). Linear regression analysis was utilized to determine which cognitive variable may be most predictive of QoL.Results:Results of the Independent T-test demonstrated that low and high tumor grade level groups did not significantly differ in total or individual sub-domain QoL. With regard to the regression analysis, cognitive variables as measured by TMT B, HVLT delayed recall, and FAS accounted for significant variance in quality of life in both low grade and high grade tumor groups (low tumor grade level effect size R2 =0.21; high tumor grade level effect size R2 = 0.19). However, TMT B emerged as a significant predictor of QoL in only the low grade group, while cognitive performance within these same tasks did not significantly predict QoL for the high tumor grade level group.Conclusions:Our findings did not significantly differ in the overall impact tumor grade level (i.e., low vs., high) has on QoL. Notably, cognitive performance on TMT B significantly predicts QoL for the low but not high tumor grade level group.

The impact of automation on the safety of drug dispensing in nursing homes

ObjectiveTo compare the rate and severity of reported dispensing errors in nursing homes using manual medication dispensation vs automated dispensation with a specifically selected Automated Dispensing System. MethodA pre-post retrospective observational study conducted in 7 nursing homes. Comparison of voluntarily reported dispensing errors in 2 periods under a manual dispensing system of weekly pill boxes (data from 2013) and an Automated drug dispensing and Packaging System Xana 4001U2 Tosho® for oral solid medications used in combination with a manual system for other drug forms (data from 2015). We analysed patient function, cognition, and pharmacological data from both periods. ResultsThe residents’ mean age (83.9 vs 83.6 years; P> .05) and physical functioning (Barthel index 41.8 vs 44.2; P> .05) were similar, but not their level of cognitive functioning (MMSE 20.3 vs 21.7; P < .05). During 2013 (manual system) 408 errors were detected, whereas in 2015 (automated system) only 36 were detected. This represents a reduction of 91% in dispensing errors. A total of 43 errors reached the patient in 2013 vs 6 errors in 2015. Of these, 5 errors vs 1 error, respectively, required monitoring. ConclusionsThe introduction of an Automated drug dispensing and Packaging System significantly improves safety in the dispensing and administration of solid medications in nursing homes. The voluntary reporting of errors facilitated comparisons of safety during the 2 periods under different dispensing systems.

Epigenetic Age Acceleration and Chronological Age: Associations With Cognitive Performance in Daily Life.

DNA methylation-derived epigenetic clocks offer the opportunity to examine aspects of age acceleration (ie, the difference between an individual's biological age and chronological age), which vary among individuals and may better account for age-related changes in cognitive function than chronological age. Leveraging existing ambulatory cognitive assessments in daily life from a genetically diverse sample of 142 adults in midlife, we examined associations between 5 measures of epigenetic age acceleration and performance on tasks of processing speed and working memory. Covarying for chronological age, we used multilevel models to examine associations of epigenetic age acceleration (Horvath 1, Horvath 2, Hannum, PhenoAge, and GrimAge clocks) with both average level and variability of cognitive performance. Positive age acceleration (ie, epigenetic age greater than chronological age) was associated with poorer mean processing speed (Horvath 1 and 2) and working memory (GrimAge). Higher chronological age was also associated with poorer mean processing speed and working memory performance. Further, positive age acceleration was generally associated with greater intraindividual variability in working memory and processing speed tasks, whereas being chronologically older was associated with less intraindividual variability. Although further work is needed, our results indicate age acceleration effects have comparable or greater size as those for chronological age differences, suggesting that epigenetic age acceleration may account for additional risk and interindividual variation in cognitive performance above chronological age.