Measures Of Cognitive Processing Speed Research Articles

Morphosyntactic Abilities and Cognitive Performance in Multiple Sclerosis.

While cognitive abilities in people with multiple sclerosis (PwMS) have been studied in detail, little is known about linguistic abilities in PwMS and their relation to cognitive impairment. In this cross-sectional explorative study, we aim to investigate the morphosyntactic abilities of PwMS alongside their cognitive performance. Furthermore, we explore the effect of clinical factors, namely, the disease duration and MS type, on the linguistic and cognitive performance of PwMS. By so doing, we aim to shed light on neurocognitive and clinical correlates of linguistic performance in PwMS. We included 78 patients and 78 age-, sex- and education-matched healthy individuals. All participants were additionally administered the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) battery, a verbal short-term memory task (non-word repetition) and questionnaires about mood, fatigue and quality of life. In addition, they underwent examinations with morphology and syntax tasks. PwMS were found to be impaired in morphology (past tense) and selectively impaired in syntax alongside cognitive impairments. Disease duration had the main impact on cognitive abilities. The MS type selectively impacted linguistic abilities, as shown by the remarkably deficient performance of the MS individuals with the progressive disease subtype. Linguistic impairments were predicted by only one measure of the BICAM test, namely, the Symbol Digit Modalities Test (SDMT), a measure of cognitive processing speed. Overall, this study contributes to the better understanding of the linguistic profile of PwMS by reporting selective deficits in their morphological and syntactical abilities. Furthermore, it provides insights into the clinical and cognitive correlates of linguistic performance. By so doing, it suggests clinical implications for the development of intervention programs for PwMS.

Cerebrovascular reactivity in amnestic and non‐amnestic mild cognitive impairment

AbstractBackgroundCerebrovascular disease (CVD) is implicated in the pathogenesis and clinical presentation of Alzheimer’s Disease. Cerebrovascular reactivity (CVR) is considered a more direct estimate of cerebrovascular integrity. CVR is a potential promising biomarker for examining pathological cognitive decline in older adults though, to date, findings have been inconclusive, possibly partly due to variability in methodological approaches. In this study, we add to the limited literature on CVR in mild cognitive impairment (MCI). We provide preliminary evidence for CVR differences in MCI phenotypes compared to older adult cognitively normal controls. We hypothesized that they amnestic phenotype (aMCI) will have lower CVR than non‐amnestic (naMCI) and both groups will show lower CVR compared to controls. We also performed exploratory correlational analyses between CVR and neuropsychological test scores.MethodCVR was assessed in 22 controls, 11 aMCI, 9 naMCI cohorts using a breath‐holding task functional magnetic resonance imaging (fMRI). fMRI data were preprocessed and analyzed using AFNI. All participants underwent neuropsychological testing. T‐tests and ANOVA/ANCOVA analyses were conducted to compare controls to MCI groups on CVR metrics and cognitive tests of memory, language, processing speed, and executive functioning. Partial correlation analyses between CVR derived from regions‐of‐interest (Yeo 1‐7 ROIs) and different cognitive functions were conducted.ResultsCVR was found to be significantly lower in MCI compared to controls across all Yeo functional networks, ps < .001, which was mostly driven by the aMCI phenotype. naMCI showed intermediate patterns between aMCI and controls, though results were not significant, ps > .05. Regional CVR values along Yeo networks were positively correlated with cognitive measures of processing speed, executive functioning, and memory.ConclusionThis is the first study to evaluate CVR differences in MCI phenotypes. Consistent with previous research, we found that CVR is lower in MCI compared to controls. While group differences between naMCI and controls (also between naMCI and aMCI) did not reach statistical significance, visual inspection of CVR mean values showed preliminary evidence that naMCI had lower mean values across all ROIs compared to controls and higher mean values compared to aMCI. Future research is needed to examine differences in CVR between MCI phenotypes.

3 Associations Between Exercise Type, Fluid Intelligence, and Processing Speed in the Oldest-Old

Objective:Exercise elicits a variety of physiological responses in the body. In the brain, exercise can modulate levels of neurotransmitters and other neurochemicals as well as sparking neurogenesis and structural changes. Downstream psychological effects of exercise include changes in mood and cognition. These changes vary depending on the type of exercise conducted (e.g., running versus strength training). While much is known about the effects of exercise in animals and adult humans, literature on the oldest-old (>= 85 years old) is sparse. The present cross-sectional study explores the relationship between exercise and cognition in the oldest-old.Participants and Methods:The final sample includes 194 cognitively healthy participants (106 females, MoCA mean score = 24.75) aged 85 to 99 years old (mean = 88.48). Each participant completed the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire and a cognitive battery comprising of the NIH Toolbox, digit coding, symbol search, verbal fluency, and Stroop task. Three groups (sedentary, cardio, and cardio plus strength training) were derived from responses on CHAMPS.Results:The cardio plus strength training group performed significantly better on the cognitive measures compared to the sedentary group. For two measures, digit coding and symbol search, the cardio plus strength training group also performed significantly better than the cardio group. Cardio group did not significantly differ from the sedentary group on the cognitive measures. All at p < 0.05 and adjusted for multiple comparisons.Conclusions:Our findings suggest exercise in the oldest-old is linked with higher fluid intelligence and better performance on cognitive measures of processing speed and that there may be an additive effect of exercise types on cognition.

A - 174 The Clinical Utility of RBANS Coding Compared to WAIS-IV PSI in Community Dwelling Older Adults.

Fatigue and cognitive performance are important considerations in assessment with older adults. Utilization of a shorter cognitive battery may provide similar results to lengthier batteries in older adults diagnosed with various degenerative diseases (Mooney et al., 2007). Studies have identified implications for both normative and abnormal cognitive decline with regard to task-related fatigue (Campbell et al., 2022; Hess & Knight, 2021). When examining processing speed and mental fatigue, research has identified strong associations in clinical populations (Andreasen et al., 2010; Hess & Knight, 2021; Banerjee et al., 2020). The current study compares longer and shorter measures of cognitive processing speed in a community dwelling older adult sample. bThe current sample consists of 60 community dwelling participants (female n = 54; Caucasian n = 52); mean education 13.83years; mean age = 76years. Measures: Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Coding; Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV) Symbol Search (SS) and Coding (CD) subtests. Linear regression identified that 82.7% of the variance in RBANS Coding was accounted for by WAIS-IV SS and CD (Adjusted R Squared = 0.827). The specific correlations for RBANS Coding were strong for SS (r = 0.794, p < 0.001) and CD (r = 0.907, p < 0.001). RBANS Coding appears to map on strongly to the WAIS PSI in community dwelling older adult populations. RBANS Coding may be considered as an alternative to longer measures of processing speed due to the strong correlation to better established PSI measures on the WAIS.

SARS-CoV-2-Specific Immune Responses in Patients With Postviral Syndrome After Suspected COVID-19.

Millions of Americans were exposed to SARS-CoV-2 early in the pandemic but could not get diagnosed with COVID-19 due to testing limitations. Many have developed a postviral syndrome (PVS) including neurologic manifestations similar to those with postacute sequelae of SARS-CoV-2 infection (Neuro-PASC). Owing to those circumstances, proof of SARS-CoV-2 infection was not required for evaluation at Northwestern Medicine's Neuro COVID-19 clinic. We sought to investigate clinical and immunologic findings suggestive of SARS-CoV-2 exposure in patients with PVS. We measured SARS-CoV-2-specific humoral and cell-mediated immune responses against Nucleocapsid and Spike proteins in 29 patients with PVS after suspected COVID-19, 32 confirmed age-matched/sex-matched Neuro-PASC (NP) patients, and 18 unexposed healthy controls. Neurologic symptoms and signs, comorbidities, quality of life, and cognitive testing data collected during clinic visits were studied retrospectively. Of 29 patients with PVS, 12 (41%) had detectable humoral or cellular immune responses consistent with prior exposure to SARS-CoV-2. Of 12 PVS responders (PVS+), 75% harbored anti-Nucleocapsid and 50% harbored anti-Spike responses. Patients with PVS+ had similar neurologic symptoms as patients with NP, but clinic evaluation occurred 5.3 months later from the time of symptom onset (10.7 vs 5.4 months; p = 0.0006). Patients with PVS+ and NP had similar subjective impairments in quality of life measures including cognitive function and fatigue. Patients with PVS+ had similar results in objective cognitive measures of processing speed, attention, and executive function and better results in working memory than patients with NP. Antibody and T-cell assays showed evidence of prior SARS-CoV-2 exposure in approximately 40% of the PVS group. Three-quarters of patients with PVS+ had detectable anti-Nucleocapsid and one-half anti-Spike responses, highlighting the importance of multitargeted COVID-19 immunologic evaluation and the limitations of commercially available diagnostic tests. Despite their persistent symptoms, lack of COVID-19 diagnosis likely delayed clinical care in patients with PVS. Our data suggest that millions of Americans presenting with PVS resembling Neuro-PASC were indeed exposed to SARS-CoV-2 at the beginning of the pandemic, and they deserve the same access to care and inclusion in research studies as patients with NP with confirmed COVID-19 diagnosis.

What lies beneath: White matter microstructure in pediatric myalgic encephalomyelitis/chronic fatigue syndrome using diffusion MRI.

Recent studies in adults with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) suggest that changes in brain white matter microstructural organization may correlate with core ME/CFS symptoms, and represent a potential biomarker of disease. However, this has yet to be investigated in the pediatric ME/CFS population. We examined group differences in macrostructural and microstructural white matter properties, and their relationship with clinical measures, between adolescents recently diagnosed with ME/CFS and healthy controls. Forty-eight adolescents (25 ME/CFS, 23 controls, mean age 16 years) underwent brain diffusion MRI, and a robust multi-analytic approach was used to evaluate white and gray matter volume, regional brain volume, cortical thickness, fractional anisotropy, mean/axial/radial diffusivity, neurite dispersion and density, fiber density, and fiber cross section. From a clinical perspective, adolescents with ME/CFS showed greater fatigue and pain, poorer sleep quality, and poorer performance on cognitive measures of processing speed and sustained attention compared with controls. However, no significant group differences in white matter properties were observed, with the exception of greater white matter fiber cross section of the left inferior longitudinal fasciculus in the ME/CFS group compared with controls, which did not survive correction for intracranial volume. Overall, our findings suggest that white matter abnormalities may not be predominant in pediatric ME/CFS in the early stages following diagnosis. The discrepancy between our null findings and white matter abnormalities identified in the adult ME/CFS literature could suggest that older age and/or longer illness duration influence changes in brain structure and brain-behavior relationships that are not yet established in adolescence.

Race and Social Determinants of Health in Performance Outcomes among Relapsing Remitting Multiple Sclerosis Patients (P13-3.017)

Race and Social Determinants of Health in Performance Outcomes among Relapsing Remitting Multiple Sclerosis Patients (P13-3.017)

The recognition of time-compressed speech as a function of age in listeners with cochlear implants or normal hearing.

Speech recognition is diminished when a listener has an auditory temporal processing deficit. Such deficits occur in listeners over 65 years old with normal hearing (NH) and with age-related hearing loss, but their source is still unclear. These deficits may be especially apparent when speech occurs at a rapid rate and when a listener is mostly reliant on temporal information to recognize speech, such as when listening with a cochlear implant (CI) or to vocoded speech (a CI simulation). Assessment of the auditory temporal processing abilities of adults with CIs across a wide range of ages should better reveal central or cognitive sources of age-related deficits with rapid speech because CI stimulation bypasses much of the cochlear encoding that is affected by age-related peripheral hearing loss. This study used time-compressed speech at four different degrees of time compression (0, 20, 40, and 60%) to challenge the auditory temporal processing abilities of younger, middle-aged, and older listeners with CIs or with NH. Listeners with NH were presented vocoded speech at four degrees of spectral resolution (unprocessed, 16, 8, and 4 channels). Results showed an interaction between age and degree of time compression. The reduction in speech recognition associated with faster rates of speech was greater for older adults than younger adults. The performance of the middle-aged listeners was more similar to that of the older listeners than to that of the younger listeners, especially at higher degrees of time compression. A measure of cognitive processing speed did not predict the effects of time compression. These results suggest that central auditory changes related to the aging process are at least partially responsible for the auditory temporal processing deficits seen in older listeners, rather than solely peripheral age-related changes.

Disentangling the cognitive, physical, and mental health sequelae of COVID-19

SummaryAs COVID-19 cases exceed hundreds of millions globally, many survivors face cognitive challenges and prolonged symptoms. However, important questions about the cognitive effects of COVID-19 remain unresolved. In this cross-sectional online study, 478 adult volunteers who self-reported a positive test for COVID-19 (mean = 30 days since most recent test) perform significantly worse than pre-pandemic norms on cognitive measures of processing speed, reasoning, verbal, and overall performance, but not short-term memory, suggesting domain-specific deficits. Cognitive differences are even observed in participants who did not require hospitalization. Factor analysis of health- and COVID-related questionnaires reveals two clusters of symptoms—one that varies mostly with physical symptoms and illness severity, and one with mental health. Cognitive performance is positively correlated with the global measure encompassing physical symptoms, but not the one that broadly describes mental health, suggesting that the subjective experience of “long COVID” relates to physical symptoms and cognitive deficits, especially executive dysfunction.

Improvements in Cognitive Processing Speed, Disability, and Patient-Reported Outcomes in Patients with Early Relapsing-Remitting Multiple Sclerosis Treated with Natalizumab: Results of a 4-year, Real-World, Open-Label Study.

STRIVE was a prospective, 4-year, multicenter, observational, open-label, single-arm study of natalizumab treatment in anti-JC virus antibody-negative patients with early relapsing-remitting multiple sclerosis (RRMS). Study objectives examined the effects of natalizumab on cognitive processing speed, confirmed disability improvement (CDI), and patient-reported outcomes (PROs). Clinical and PRO secondary endpoints were assessed annually over 4 years in STRIVE. The Symbol Digit Modalities Test (SDMT) was used as a measure of cognitive processing speed. PROs were assessed using the Multiple Sclerosis Impact Score (MSIS-29) and the Work Productivity and Activity Impairment Questionnaire (WPAI). At all four annual assessments, the proportion of patients in the intent-to-treat (ITT) population (N = 222) who exhibited clinically meaningful improvement in their SDMT score from baseline (i.e., change ≥4 points) ranged from 41.9 to 54.0%. The cumulative probability of CDI at 4 years in patients in the ITT population with a baseline Expanded Disability Status Scale score ≥2 (N = 133) was 43.9%. Statistically significant reductions in the mean change from screening in the MSIS-29 physical and psychological scores, indicating improved quality of life, were observed over all 4 years (P ≤0.0012 for all). A statistically significant decrease from screening in the impact of MS on regular activities, signifying an improvement in this WPAI measure, was also observed over all 4 years of the study. These results further extend our knowledge of the effectiveness, specifically regarding improvements in cognitive processing speed, disability and PROs, of long-term natalizumab treatment in early RRMS patients. GOV: NCT01485003 (5 December 2011).

Working Memory Phenotypes in Early Multiple Sclerosis: Appraisal of Phenotype Frequency, Progression and Test Sensitivity.

Working memory (WM) impairments are common and debilitating symptoms of multiple sclerosis (MS), often emerging early in the disease. Predominantly, WM impairments are considered in a binary manner, with patients considered either impaired or not based on a single test. However, WM is comprised of different activated subcomponents depending upon the type of information (auditory, visual) and integration requirements. As such, unique WM impairment phenotypes occur. We aimed to determine the most frequent WM phenotypes in early MS, how they progress and which WM test(s) provide the best measure of WM impairment. A total of 88 participants (63 early relapsing–remitting MS: RRMS, 25 healthy controls) completed five WM tests (visual–spatial, auditory, episodic, executive) as well as the symbol digit modalities test as a measure of processing speed. RRMS patients were followed-up for two years. Factors affecting WM (age/gender/intelligence/mood) and MS factors (disease duration/disability) were also evaluated. Some 61.9% of RRMS patients were impaired on at least one WM subcomponent. The most subcomponents impaired were visual,–spatial and auditory WM. The most common WM phenotypes were; (1) visual–spatial sketchpad + episodic buffer + phonological loop + central executive, (2) visual–spatial sketchpad + central executive. The test of visual–spatial WM provided the best diagnostic accuracy for detecting WM impairment and progression. The SDMT did not achieve diagnostic accuracy greater than chance. Although this may be unsurprising, given that the SDMT is a measure of cognitive processing speed in MS, this does highlight the limitation of the SDMT as a general screening tool for cognitive impairment in early MS.

Cognitive Fatigue and Processing Speed in Children Treated for Brain Tumours.

The relationship between fatigue and cognition has not been fully elucidated in children and adolescent survivors of brain tumours. The aim of the present study was to investigate the potential relationship between fatigue and cognitive impairments in these survivors, as this group is at risk for both types of deficits. Survivors of paediatric brain tumours (n = 45) underwent a neuropsychological testing on average 4 years after diagnosis. Mean age at follow-up was 13.41 years. Cognition was assessed with neuropsychological tests, and fatigue with the Pediatric Quality of Life (PedsQL™) Multidimensional Fatigue Scale. Regression analysis, adjusted for cranial radiotherapy and age at diagnosis, was used to investigate the associations between cognitive variables and fatigue subscales. Cognitive variables associated with fatigue were subsequently exploratively assessed. Significant associations were found for cognitive fatigue and measures of cognitive processing speed; Coding: p = .003, r = .583, 95% CI [9.61; 22.83] and Symbol Search: p = .001, r = .585, 95% CI [10.54; 24.87]. Slower processing speed was associated with poorer results for cognitive fatigue. Survivors with the largest decrease in processing speed from baseline to follow-up also experienced the most cognitive fatigue. Survivors expressed more cognitive fatigue compared to other types of fatigue. The association between cognitive fatigue and cognitive processing speed in children and adolescents treated for brain tumours is in concordance with the results previously reported in adults. Some survivors experience fatigue without impairment in processing speed, indicating the need for comprehensive assessments. Moreover, the study supports that fatigue is a multidimensional concept which should be measured accordingly.

Questionnaire-Based Everyday Reaction Time: Reliable, Valid, and Unobtrusive Measure of Cognition

Experience sampling paradigms provide new opportunity for early identification of mild cognitive impairment (MCI). We investigated two research questions: (1) is time to complete a repeatedly administered survey (i.e., questionnaire-based everyday reaction time, q*bert) a reliable and valid measure of cognition? (2) does this measure distinguish MCI status? To answer these questions, we leveraged ecological momentary assessment (EMA) data from the Einstein Aging Study, where older adults (N=240) completed six daily surveys and cognitive assessments on smartphones over 14 days. Q*bert had good between-person reliability after two days (~11 EMAs) and excellent reliability from three to fourteen days. Q*bert moderately correlated with ambulatory cognitive measures of processing speed and memory binding (p’s < .001) and was significantly slower in those with MCI (p < .001). We propose q*bert as a reliable, valid, and unobtrusive measure of cognition when ambulatory cognitive assessments are not feasible.

Persistent alterations in cerebrovascular reactivity in response to hypercapnia following pediatric mild traumatic brain injury

Much attention has been paid to the effects of mild traumatic brain injury (mTBI) on cerebrovascular reactivity in adult populations, yet it remains understudied in pediatric injury. In this study, 30 adolescents (12–18 years old) with pediatric mTBI (pmTBI) and 35 age- and sex-matched healthy controls (HC) underwent clinical and neuroimaging assessments during sub-acute (6.9 ± 2.2 days) and early chronic (120.4 ± 11.7 days) phases of injury. Relative to controls, pmTBI reported greater initial post-concussion symptoms, headache, pain, and anxiety, resolving by four months post-injury. Patients reported increased sleep issues and exhibited deficits in processing speed and attention across both visits. In grey-white matter interface areas throughout the brain, pmTBI displayed increased maximal fit/amplitude of a time-shifted end-tidal CO2 regressor to blood oxygen-level dependent response relative to HC, as well as increased latency to maximal fit. The alterations persisted through the early chronic phase of injury, with maximal fit being associated with complaints of ongoing sleep disturbances during post hoc analyses but not cognitive measures of processing speed or attention. Collectively, these findings suggest that deficits in the speed and degree of cerebrovascular reactivity may persist longer than current conceptualizations about clinical recovery within 30 days.

Piano training enhances Stroop performance and musical self-efficacy in older adults with Parkinson’s disease

Parkinson’s disease (PD) is commonly associated with motor symptoms; however, many patients with PD exhibit decline in executive functions. Executive functions refer to a broad array of generalized cognitive abilities such as cognitive control and working memory. The purpose of this research was to evaluate the impact of a novel intense group piano training program on executive functions in patients with PD. Forty-five patients with PD were assigned to an intense group piano training program or a waitlist control group. Group intensive piano training consisted of basic piano technique, finger dexterity exercises, basic piano repertoire, and music theory, presented over a 10-day period (30 hrs of training). Participants completed a battery of standardized cognitive measures of processing speed, cognitive control, and verbal fluency, pre- and post-training. Results of an independent samples Mann–Whitney test on composite cognitive and psychosocial variables revealed significantly enhanced Stroop performance and musical self-efficacy. Intensive piano training may serve as an effective cognitive and psychosocial intervention for those with PD.

Resting-state functional connectivity, cognition, and fatigue in response to cognitive exertion: a novel study in adolescents with chronic fatigue syndrome.

Emerging evidence suggests that central nervous system dysfunction may underlie the core symptoms of Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) in adults, such as cognitive disturbance, fatigue and post-exertional malaise. Research into brain dysfunction in the pediatric CFS/ME context, however, is severely lacking. It is unclear whether the adolescent CFS/ME brain functions differently compared with healthy peers, particularly in situations where significant mental effort is required. This study used resting-state functional MRI in a novel repeated-measures design to evaluate intrinsic connectivity, cognitive function, and subjective fatigue, before and after a period of cognitive exertion in 48 adolescents (25 CFS/ME, 23 healthy controls). Results revealed little evidence for a differential effect of cognitive exertion in CFS/ME compared with controls. Both groups demonstrated a similar rate of reduced intrinsic functional connectivity within the default mode network (DMN), reduced sustained attentional performance, slower processing speed, and increased subjective fatigue as a result of cognitive exertion. However, CFS/ME adolescents consistently displayed higher subjective fatigue, and controls outperformed the CFS/ME group overall on cognitive measures of processing speed, sustained attention and new learning. No brain-behavior relationships were observed between DMN connectivity, cognitive function, and fatigue over time. These findings suggest that effortful cognitive tasks may elicit similar levels of energy expenditure across all individuals in the form of reduced brain functioning and associated fatigue. However, CFS/ME may confer a lower starting threshold from which to access energy reserves and cognitive resources when cognitive effort is required.

Chronic Pain, Sleep, and Cognition in Older Adults With Insomnia: A Daily Multilevel Analysis.

The goal of this study was to examine daily associations between sleep and cognition in older adults suffering from insomnia, with or without a history of chronic pain. Sixty older adults with insomnia and a history of chronic pain (HxCP; n = 33, mean age = 69.5 years, standard deviation = 7.8) or no history of chronic pain (NCP; n = 27, mean age = 69.7 years, standard deviation = 7.9) completed 14 days of diaries and actigraphy, measuring sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), and sleep quality. Participants completed daily cognitive measures of processing speed (ie, symbol digit modalities test, SDMT), reasoning (ie, letter series), and verbal memory (ie, word list delayed recall). For HxCP and NCP, associations between sleep parameters, daily pain, depressive symptoms (ie, Beck Depression Inventory, Second Edition scores), and daily cognition, controlling for age, and global cognition were examined through multilevel modeling. For HxCP, greater self-reported WASO was associated with worse next-day SDMT performance, whereas greater actigraphic WASO was associated with better next-day SDMT performance. Greater depression was associated with worse daily letter series performance. Greater self-reported WASO and SE were associated with better next-day delayed recall. For NCP, greater self-reported WASO and depression were associated with better daily SDMT performance, whereas worse daily pain was associated with worse SDMT and delayed recall performance. In older adults with HxCP, improving sleep may benefit lower level cognition, whereas reducing depression may affect higher level cognition. Discrepancies in sleep parameters promote assessment of objective and subjective sleep outcomes when investigating effects of insomnia on cognition. Title: Intraindividual Variability in Sleep and Cognitive Performance in Older Adults (REST), Registry: ClinicalTrials.gov, Identifier: NCT02967185, URL: https://clinicaltrials.gov/ct2/show/NCT02967185.

Relationships among clinic, home, and ambulatory blood pressures with small vessel disease of the brain and functional status in older people with hypertension

Subcortical small vessel disease, represented as white matter hyperintensity (WMH) on magnetic resonance images (MRI) is associated with functional decline in older people with hypertension. We evaluated the relationships of clinic and out-of-office blood pressures (BP) with WMH and functional status in older persons. Using cross-sectional data from 199 older study participants enrolled in the INFINITY trial, we analyzed the clinic, 24-hour ambulatory, and home BPs and their relationships with WMH burden and mobility and cognitive outcomes. Volume of WMH was associated with clinic and 24-hour ambulatory systolic BP but not home systolic BP. The mobility measure, supine-to-sit time, had a significant association with 24-hour systolic BP and pulse pressure but not with diastolic BP or values obtained by home BP. Cognitive measures of processing speed (Trails Making Test Part A and the Stroop Word Test) were significantly associated with 24-hour systolic BP, but not clinic and home BPs. These data demonstrate that ambulatory BP measurements in older people are more strongly associated with WMH and certain measures of functional status compared to home BP measurements. Hence, home BP may not be a useful substitute for ambulatory BP for assessing subcortical small vessel disease and its consequences. Further longitudinal analyses comparing clinic and various types of out-of-office BP measures with small vessel brain disease are needed. Clinicaltrials.gov identifier: NCT01650402.

Media multitasking in adolescence

Media use has been on the rise in adolescents overall, and in particular, the amount of media multitasking-multiple media consumed simultaneously, such as having a text message conversation while watching TV-has been increasing. In adults, heavy media multitasking has been linked with poorer performance on a number of laboratory measures of cognition, but no relationship has yet been established between media-multitasking behavior and real-world outcomes. Examining individual differences across a group of adolescents, we found that more frequent media multitasking in daily life was associated with poorer performance on statewide standardized achievement tests of math and English in the classroom, poorer performance on behavioral measures of executive function (working memory capacity) in the laboratory, and traits of greater impulsivity and lesser growth mindset. Greater media multitasking had a relatively circumscribed set of associations, and was not related to behavioral measures of cognitive processing speed, implicit learning, or manual dexterity, or to traits of grit and conscientiousness. Thus, individual differences in adolescent media multitasking were related to specific differences in executive function and in performance on real-world academic achievement measures: More media multitasking was associated with poorer executive function ability, worse academic achievement, and a reduced growth mindset.

Cognitive and psychomotor effects of three months of escitalopram treatment in elderly patients with major depressive disorder

BackgroundAlthough psychomotor retardation (PR) and cognitive disfunctioning are essential symptoms of elderly depressed patients, the differential effect of treatment with an SSRI in the elderly on these symptoms has hardly got any attention in studies with objective experimental measures. Since effects appear relatively slower in elderly, this study evaluates the effect on cognitive and psychomotor functioning as compared to mood, on four points during a twelve week follow up of monotreatment with escitalopram. Method28 non-demented elderly unipolar depressive patients on 5–20mg escitalopram were compared to 20 matched healthy elderly. All participants underwent a test battery containing clinical depression measures, cognitive measures of processing speed, executive function and memory, clinical ratings of PR, and objective computerized fine motor skill-tests at the start and after 2, 6 and 12 weeks. Statistical analysis consisted of a General Linear Model (GLM) repeated measures multivariate analysis of variance of completers to compare the psychomotor and cognitive outcomes of the two groups. ResultsAlthough, apart from the significant mood effect, no interaction effects were found for the psychomotor and cognitive tasks, the means in general show a trend of differential effects in cognitive and psychomotor functions, with smaller effects and delayed timeframes and with presence of subgroups compared to mood effects. LimitationLonger follow up studies are necessary to evaluate differential long term effects. ConclusionIn elderly, moderate effects of SSRI treatment on mood precede slow or limited effects on cognition and psychomotor retardation.