Neuropsychological Tests Of Executive Function Research Articles

Executive functions and ADHD symptoms predict educational functioning in children with ADHD: A two-year longitudinal study

The aim of this two-year longitudinal study was to investigate whether deficits in executive functions (EF) predict impaired everyday functioning after two years in children and adolescents with ADHD. A sample of 135 participants with and without ADHD were assessed with neuropsychological tests of EF and parent ratings of everyday functioning with the Child Behavior Checklist at baseline (Mage = 11.6, SD = 2.0), and after two years (Mage = 13.6, SD = 2.1). Results showed that ADHD symptoms and impaired EF at baseline predicted lower educational functioning when controlling for general cognitive ability (i.e. “IQ”) at two-year follow-up. Furthermore, the results indicated that increased ADHD symptoms predicted problems both with social functioning and functioning in leisure activities (i.e. sport/hobbies/chores/jobs), whereas higher IQ predicted better functioning in leisure activities. The current study primarily highlights the importance of detecting and treating ADHD symptoms in order to prevent reduced functional outcomes, and that EF tests may contribute to identify children in need of educational interventions targeting EF deficits.

1 Executive Functioning and Anxiety/Depressive Symptoms as Mediators Between ADHD and Quality of Life: A 10-year Longitudinal Study

Objective:Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with impaired executive functioning and anxiety/depressive symptoms, which may contribute to reduced quality of life. We tested the hypotheses that (1) a childhood diagnosis of ADHD is related to reduced quality of life in emerging adulthood and that (2) this relationship is mediated by impaired executive functioning and anxiety/depressive symptoms.Participants and Methods:We assessed 85 children and adolescents with ADHD and 50 typically developing peers at baseline (Mean age = 11.6 years, 58% males), two-year follow-up, and 10-year follow-up with neuropsychological tests of executive functioning, the Behavioral Rating Inventory of Executive Function (BRIEF), the Short Moods and Feelings Questionnaire (SMFQ), and the Revised Children’s Manifest Anxiety Scale, second edition (RCMAS-2), as well as the Perceived Quality of Life scale (PQoL) at the 10-year follow-up. Four neuropsychological tests of executive functioning, the Letter-Number Sequencing test (working memory), the Color-Word Interference test condition 3 (response inhibition), the Color-Word Interference test condition 4 (shifting), and the trail making test condition 4 (cognitive flexibility) were combined into a neuropsychological executive functioning composite score based on high factor loadings (> .73). the parent-reported BRIEF indexes, the behavioral regulation index, and the metacognition index were used as measures of everyday executive functioning. We conducted independent samples t-tests to compare the groups and simple and parallel mediation analyses with full information maximum likelihood estimation to examine whether the different executive functioning measures and anxiety/depressive symptoms at two-year follow-up mediated the relationship between baseline ADHD and self-reported quality of life at 10-year follow-up.Results:Baseline ADHD was associated with more difficulties with executive functioning on a composite measure of neuropsychological tests (p < .001, Hedges g = .79) and parent-reported everyday metacognitive (p < .001, Hedges g = 2.37) and behavioral regulation executive functioning (p < .001, Hedges g = 1.55), as well as self-reported anxiety (p < .001, Hedges g = 1.05) and depressive symptoms (p < .001, Hedges g = 1.00) at two-year follow-up. Baseline ADHD was associated with lower self-reported quality of life (p = .001, Hedges g = -.67) at 10-year follow-up. The mediation analysis showed that everyday metacognitive executive functioning (p = .011, ß = -.497) and an anxiety/depressive symptoms composite (p < .001, ß = -.404) parallelly mediated the relationship between ADHD and quality of life.Conclusions:Impaired everyday executive functioning and anxiety/depressive symptoms may represent two distinct pathways to reduced quality of life in emerging adults with a childhood diagnosis of ADHD. These findings stress the importance of targeting both cognitive and emotional aspects in interventions for children and adolescents with ADHD to improve later quality of life.

Regional differences in the link between water exchange rate across the blood–brain barrier and cognitive performance in normal aging

The blood–brain barrier (BBB) undergoes functional changes with aging which may contribute to cognitive decline. A novel, diffusion prepared arterial spin labeling-based MRI technique can measure the rate of water exchange across the BBB (kw) and may thus be sensitive to age-related alterations in water exchange at the BBB. However, studies investigating relationships between kw and cognition have reported different directions of association. Here, we begin to investigate the direction of associations between kw and cognition in different brain regions, and their possible underpinnings, by evaluating links between kw, cognitive performance, and MRI markers of cerebrovascular dysfunction and/or damage. Forty-seven healthy older adults (age range 61–84) underwent neuroimaging to obtain whole-brain measures of kw, cerebrovascular reactivity (CVR), and white matter hyperintensity (WMH) volumes. Additionally, participants completed uniform data set (Version 3) neuropsychological tests of executive function (EF) and episodic memory (MEM). Voxel-wise linear regressions were conducted to test associations between kw and cognitive performance, CVR, and WMH volumes. We found that kw in the frontoparietal brain regions was positively associated with cognitive performance but not with CVR or WMH volumes. Conversely, kw in the basal ganglia was negatively associated with cognitive performance and CVR and positively associated with regional, periventricular WMH volume. These regionally dependent associations may relate to different physiological underpinnings in the relationships between kw and cognition in neocortical versus subcortical brain regions in older adults.

Validating Rating Scales for Executive Functioning across Education Levels and Informants

AbstractThe goal of the study was to deliver and validate a new solution-focused instrument, the Focus Skills Questionnaire (FSQ), to assess the degree of executive functioning skills in the school context, for three different education levels (elementary, secondary, and tertiary education) and informant groups (students, teachers and parents) on a sample of 1109 students from Dutch and Belgian schools. The factor structure was evaluated by confirmative factor analysis (CFA) and the study examined how students’ self-reports of executive functioning skills related to outcomes of neuro-psychological tests of executive functions (EF). The CFA results showed a parsimonious model with a four-factor structure of the FSQ that was equivalent for all education levels and informant groups, but that does not correspond with the generally assumed executive functioning factors. There are differences in the perception of executive functioning skills by different informant groups and also differences per education level. Student perceptions of executive functioning skills do not correspond with EF test outcomes and in some subgroups clearly diverge from teacher or parent perceptions of the students’ executive functioning skills. Although the new instrument does not converge with laboratory assessments of EF’s, the new instrument could be useful in everyday school practice.

Childhood Executive Function Predicts Internalizing and Externalizing Symptoms in Emerging Adults With and Without Autism: A 10-Year Longitudinal Study

ABSTRACT Individuals with autism spectrum disorder (ASD) and typically developing individuals were assessed on three neuropsychological tests of executive function (EF) and on scales of autism symptoms and co-occurring internalizing and externalizing symptoms at baseline (T1; N = 88, Mage = 11.8 years, 73% males), 2-year (T2; 99% retention, Mage = 13.9 years), and 10-year follow-ups (T3; 75% retention, Mage = 21.4 years). An EF composite score from T1 significantly predicted internalizing symptoms at T2 (β = .228) and internalizing and externalizing symptoms at T3 (β = .431 and .478, respectively), when controlling for age and autism symptoms. OThe findings suggest that EF difficulties are a long-term risk factor for more co-occurring symptoms. .

Predictors of Quality of Life and Functional Impairments in Emerging Adults With and Without ADHD: A 10-Year Longitudinal Study

Objective: We tested the hypotheses that (1) a diagnosis of ADHD in childhood or adolescence is associated with reduced quality of life (QoL) and everyday functioning in emerging adulthood, and (2) executive function (EF) deficits, internalizing difficulties, and ADHD symptoms predict reduced QoL and more functional impairments. Method: We assessed 85 children and adolescents with ADHD and 50 typically developing (TD) peers at baseline (Mage = 11.6 years, 58% males), 2-year follow-up, and 10-year follow-up with neuropsychological tests of EF and self-reports. Results: Individuals with ADHD reported lower QoL and functional impairments in emerging adulthood compared to TD peers. More internalizing difficulties and ADHD symptoms at baseline and 2-year follow-up significantly predicted lower QoL and more functional impairments at the 10-year follow-up. Conclusion ADHD and internalizing difficulties in childhood or adolescence have a negative impact on QoL and everyday functioning in emerging adulthood.

Childhood executive functions and ADHD symptoms predict psychopathology symptoms in emerging adults with and without ADHD: a 10-year longitudinal study

Deficits in executive functions (EFs) are theorized to play an important role in causing functional impairment and associated psychopathology in individuals with ADHD. The objective of this study was to examine the role of EFs and ADHD symptoms as longitudinal predictors of psychopathology symptoms in individuals with ADHD and typically developing individuals. We assessed individuals with and without ADHD (N = 135) with neuropsychological tests of EFs and scales of ADHD symptoms and psychopathology symptoms at baseline (T1; Mage = 11.59, 57.8% boys), 2-year follow-up (T2; Mage = 13.63, 97% retention), and 10-year follow-up (Mage = 21.18, 75% retention). Baseline EFs predicted psychopathology symptoms at the 2- and the 10-year follow-up, explaining 17% and 12% of the variance, respectively. Baseline EFs predicted both internalizing and externalizing symptoms, and the predictive value of EFs on psychopathology symptoms at 10-year follow-up was accounted for by cognitive flexibility. Baseline ADHD symptoms were a significant predictor of all symptom domains at all time points. Thus, childhood EFs, in particular cognitive flexibility, can predict psychopathology symptoms in emerging adulthood beyond the effect of ADHD symptoms. This supports dominating theories of ADHD stating that executive dysfunction contributes to the observed phenotype, including associated psychopathology symptoms, and suggests that EFs are important targets of interventional efforts.

Effects of Coordinative Exercise on Sustained Attention and Perceptual Discrimination in Elementary School Physical Education

ABSTRACTPurpose: This study examined the effects of coordinative exercise on children’s sustained attention and perceptual discrimination in a school-based physical education (SBPE) setting. Methods: Seventy-three children received an intervention of moderate-to-vigorous intensity coordinative exercise, and 75 children participated in a moderate-to-vigorous intensity physical activity as part of a regular physical education class. Two neuropsychological tests of executive function (EF) were used to assess attention and perceptual discrimination functions before and after each treatment. Results: The results found that coordinative exercise significantly improved the performances on sustained attention and perceptual discrimination, as evidenced by enhanced response accuracy and improved speed of responding. Specifically, higher progressions in task performance were seen following coordinative exercise relative to regular physical activity. Conclusion: These findings suggest that coordinative exercise could enable more robust improvements in sustained attention and perceptual discrimination among children. Overall, we conclude that structured coordinative exercise, implemented in SBPE settings, may be a promising alternative to promote children’s cognitive abilities.

Reliability and validity of composite scores from the timed subtests of the D-KEFS battery.

Many neuropsychological tests of executive functioning (EF) have test-retest reliabilities below what is considered acceptable. Combining several tests into a composite can improve reliability, although due to concerns about the multifaceted nature of the EF construct, this practice is rarely applied. The present study (a) examined internal consistencies and test-retest reliabilities of two composites of four EF tests (EF-Speed from timed scores and EF-Accuracy from error scores), and (b) preliminarily examined the criterion validity of the composites as a first step toward construct validation. Participants were 576 adults aged 18-93. Participants completed timed subtests of the Delis-Kaplan Executive Function System (D-KEFS) at baseline. A subset of participants was retested twice (at 30 min and 1 year), or once (at 6 weeks). An additional subsample completed Timed Instrumental Activities of Daily Living (TIADLs), which was used to preliminarily examine the composites' criterion validity. Internal consistency and test-retest reliabilities ranged from good to excellent for the EF-Speed composite (.809-.901) but were poor to acceptable for the EF-Accuracy composite (.510-.736). Both composites surpassed reliabilities of individual test or condition scores; one third of the examined individual speed-based scores and none of the individual error-based scores met the acceptable reliability threshold (i.e., < .7). The EF-Speed composite accounted for more variance in TIADL speed, and the EF-Accuracy in TIADL accuracy, than did any of the individual test scores, providing preliminary evidence of clinical utility and criterion validity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Cerebellar and Prefrontal Structures Associated With Executive Functioning in Pediatric Patients With Congenital Heart Defects.

ObjectiveChildren, adolescents, and young adults with congenital heart defects (CHD) often display executive dysfunction. We consider the prefrontal and cerebellar brain structures as mechanisms for executive dysfunction among those with CHD.Methods55 participants with CHD (M age = 13.93) and 95 healthy controls (M age = 13.13) completed magnetic resonance imaging (MRI) of the brain, from which we extracted volumetric data on prefrontal and cerebellar regions. Participants also completed neuropsychological tests of executive functioning; their parents completed ratings of their executive functions.ResultsCompared to healthy controls, those with CHD had smaller cerebellums and lateral, medial, and orbital prefrontal regions, they performed more poorly on tests of working memory, inhibitory control, and mental flexibility, and their parents rated them as having poorer executive functions across several indices. Across both groups, there were significant correlations for cerebellar and/or prefrontal volumes with cognitive assessments of working memory, mental flexibility, and inhibitory control and with parent-completed ratings of task initiation, working memory, and planning/organization. Greater prefrontal volumes were associated with better working memory, among those with larger cerebellums (with group differences based on the measure and the prefrontal region). Greater prefrontal volumes were related to better emotional regulation only among participants with CHD with smaller cerebellar volumes, and with poorer inhibition and emotional regulation only among healthy controls with larger cerebellar volumes.ConclusionThe cerebellum not only contributes to executive functioning among young individuals with CHD but may also modulate the relationships between prefrontal regions and executive functioning differently for pediatric patients with CHD vs. health controls.

Validity of the Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C) in children and adolescents with pediatric acquired brain injury

ABSTRACT The Behavioural Assessment of the Dysexecutive Syndrome for Children (BADS-C) was developed to address the need for a standardized ecologically valid test of executive function (EF) in the pediatric population. Our study aimed to investigate the discriminant, concurrent, and ecological validity of BADS-C in a sample with pediatric acquired brain injury (pABI). Seventy-four participants with pABI aged 10–17 years were included to a pre-registered randomized controlled trial, and baseline assessment was used for the current study. Controls consisted of 60 participants aged 10–17 years. Participants with pABI were assessed with neuropsychological tests and questionnaires of EF, and measurements of general intellectual ability (IQ). Results showed that all BADS-C subtests discriminated between participants with pABI and controls, except for the Playing Cards Test. Concurrent and ecological validity was demonstrated through associations between BADS-C total score, Key Search Test, and Zoo Map Test 1, and neuropsychological tests and teacher questionnaire ratings of EF. Key Search Test and Zoo Map Test 1 predicted teacher ratings of EF, beyond IQ and other neuropsychological test of EF. These findings provide support for BADS-C as a valid clinical assessment tool that can detect everyday executive dysfunction in the pABI population, and guide rehabilitation and treatment decisions.

208 Association between cardiovascular data and the development and progression of mild cognitive impairment: results from the retrospective cohort study

Abstract Aims Mild cognitive impairment (MCI) is characterized by objective evidence of cognitive impairment in one or more cognitive domains in the absence of significant interference in daily-life activities. Anyway, people with MCI are considered to be at heightened risk of further cognitive decline and progression to dementia. To date, few evidence regarding the association between cardiovascular data and MCI are present in the literature. To investigate the association between various cardiovascular data (traditional risk factors and outcomes) and the development and progression of MCI. Methods and results The study included 127 patients referred to the Neurological Unit of the Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico of Milan for subjective memory complaints and/or clinical suspect of cognitive impairment. Neuropsychological tests evaluating executive functions and cardiovascular data were collected at baseline and 2-year follow-up. Visit reports and medical records were reviewed to extrapolate the data. The study was conducted between 2012 and 2020. The 51 (40.2%) patients on antiplatelet therapy (94% on aspirin) had a worse baseline degree of cognitive impairment on neuropsychological tests of executive functions and had greater worsening of MCI at 2 years (Table 1). Patients on antiplatelet therapy were significantly older (75.85 vs. 71.7; P = 0.009), more ischaemic (21.6% vs. 1.3%; P &amp;lt; 0.001), hypertensive (90.2% vs. 60.5%; P &amp;lt; 0.001), and dyslipidaemic (62.7% vs. 19.7%; P &amp;lt; 0.001) than patients without antiplatelet therapy. No other single cardiovascular data analysed (presence of hypertension, dyslipidaemia, ischaemic heart disease, diabetes, atrial fibrillation, and anticoagulation therapy) showed a statistical significant association with MCI presence or progression. Conclusions The present study suggests that the prevalence and progression of MCI is significantly higher among patients on antiplatelet therapy, who carry a greater cardiovascular burden. Although patients on antiplatelet therapy were older, more ischaemic, hypertensive, and dyslipidaemic than patients without antiplatelet therapy, none of these parameters were associated with MCI presence and/or progression and can therefore be considered a confounding factor.

Attaining the recesses of the cognitive space.

Existing neuropsychological tests of executive function often manifest a difficulty pinpointing cognitive deficits when these are intermittent and come in the form of omissions. We discuss the hypothesis that two partially interrelated reasons for this failure stem from relative inability of neuropsychological tests to explore the cognitive space and to explicitly take into account strategic and opportunistic resource allocation decisions, and to address the temporal aspects of both behaviour and task-related brain function in data analysis. Criteria for tasks suitable for neuropsychological assessment of executive function, as well as appropriate ways to analyse and interpret observed behavioural data are suggested. It is proposed that experimental tasks should be devised which emphasize typical rather than optimal performance, and that analyses should quantify path-dependent fluctuations in performance levels rather than averaged behaviour. Some implications for experimental neuropsychology are illustrated for the case of planning and problem-solving abilities and with particular reference to cognitive impairment in closed-head injury.

Measures of executive functions predicting Attention-Deficit/Hyperactivity Disorder core symptoms

Attention-deficit/hyperactivity disorder (ADHD) is a common childhood disorder, and in many children, ADHD is thought to be aggravated by a deficit in executive functions (EFs). This study tried to establish whether commonly used neuropsychological tests of EF also predicted the core symptoms of ADHD, namely hyperactivity/impulsiveness (H/I) and inattention, as well as total ADHD symptomatology, according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR). The participants were children from the Limpopo province, South Africa, aged from 6 to 15 years (M = 11.7 years; SD = 1.7). One hundred and fifty-six children (51.3% girls) were assessed by neuropsychological tests of EFs: the Tower of London (ToL), Digits Forward and Digits Backward, Trails-A and Trails-B and Wisconsin Card Sorting Test (WCST). Forward stepwise regression analysis was employed to predict H/I and inattention, as well as total ADHD symptomatology, based on DSM-IV-TR criteria. All the tests, except Trails-A, were found to predict ADHD symptomatology. The WCST (total errors) was the best predictor of all the ADHD symptoms and also for H/I and inattention separately, followed by Trails-B and Digits Backwards, which were found to predict more symptoms of inattention than H/I. Perseverative errors on the WCST predicted more H/I symptomatology, whilst non-perseverating errors were more associated with inattention. The ToL and Digits Forward predicted fewer ADHD symptoms. The ToL seemed more sensitive to inattention, whilst Digits Forward showed a stronger association with H/I. The WCST, Digits Backwards and Trails-B may be used to measure EF to support the diagnosis of ADHD in a clinical setting and to indicate cognitive impairment.

Regression-based norms for the FAS phonemic fluency test for ages 40–84 based on a Norwegian sample

The FAS phonemic fluency test is a commonly used neuropsychological test of executive function and processing speed. Although Norwegian discrete norms have been developed for the FAS test, American regression-based norms are frequently used by clinicians in Norway. However, language and cultural differences impact performance on the FAS test, and using foreign norms may not be appropriate. Moreover, while discrete norming relies on stratified subgroups of demographics, regression-based norming uses the entire sample to estimate the influence of demographics on performance and may thus improve normative estimates. Here we develop regression-based norms for the FAS phonemic fluency test based on n = 204 healthy Norwegian controls between the ages 40−84 from the Norwegian Dementia Disease Initiation cohort (DDI). We compare the proposed regression norms to published Norwegian discrete norms and American regression-based norms in an independent sample of n = 182 cognitively healthy adults reporting subjective cognitive decline (SCD). We found that years of education was the only significant predictor of FAS performance in our normative sample, accounting for 14.9% of the variance. Both the proposed regression-based norms and previously published discrete norms adequately adjusted for demographics in the independent sample. In contrast, the American norms underestimated the effect of education and overestimated the effect of age. While both the proposed Norwegian regression norms and the previously published discrete norms are suitable for use in Norway, the proposed regression norms may be less vulnerable to sub-stratification sample characteristics posed by discrete norming procedures, and thereby improve normative estimation.

Theory of Mind and Executive Functions in Children With Attention Deficit Hyperactivity Disorder and Specific Learning Disorder.

Background:Children with attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD) generally have difficulties in social cognition and display impairments involving emotion and face and prosody perception and reduced empathy, indicating theory of mind (ToM) impairment. The objective of this work was to assess and compare the executive functions and ToM in children with ADHD and SLD.Methods:Twenty children diagnosed with ADHD, 20 children diagnosed with SLD, and 20 normal healthy children in the age group of 7 to 15 years, IQ between 90 and 110 (average intelligence) of any gender, were recruited. All participants were assessed using neuropsychological tests of executive functions and ToM.Results:Significant differences were found on early ToM, basic ToM, advanced ToM, and mean scores on ToM inventory between ADHD and control groups (P ≤ 0.001). Similarly, significant differences were found between ADHD and SLD groups on early, basic, advanced, and mean ToM inventory scores (P < 0.001). No significant differences were found between the control and SLD groups on ToM measures. Further, in the ToM task battery, on task D and task G, significant differences were found between the SLD and control groups at P = 0.04 and P = 0.03 respectively. Differences between ADHD and control groups were also statistically significant on task D and task G at P < 0.001 and P = 0.033. Executive functions in the form of set-shifting and response inhibition were significantly poor in the ADHD group and SLD group at P < 0.001 and P < 0.05 levels, respectively, when compared to the control group.Conclusion:Children with ADHD displayed more deficits in the ToM inventory and tasks than children having SLD and healthy children of their similar age and educational background. Executive functions (set-shifting and response inhibition) were poorer in children with ADHD and children with SLD when compared to healthy children of their similar age and educational background.

Functional Connectivity and Response Inhibition: A Secondary Analysis of an 8-Week Randomized Controlled Trial of Computerized Cognitive Training

Background: Evidence suggests that computerized cognitive training (CCT) can improve cognitive function in older adults, particularly executive functions. However, the underlying mechanisms by which CCT may improve executive functions are not well established. Objective: To determine: 1) inter-network functional connectivity correlates of changes in executive functions; and 2) the effect of CCT on these functional connectivity correlates. Methods: This secondary analysis included a subset of 124 adults aged 65–85 years enrolled in an 8-week randomized controlled trial of CCT. Participants were randomized to either: 1) group-based CCT 3x/week for 1 hour plus 3x/week home-based training; 2) group-based CCT preceded by brisk walking (Ex+CCT) 3x/week for 1 hour plus 3x/week home-based training; or 3) group-based balanced and toned (BAT) classes 3x/week for 1 hour (control). At baseline and trial completion, 65 of the 124 participants completed resting-state functional magnetic resonance imaging and neuropsychological tests of executive functions, specifically the Stroop Colour-Word Test and Flanker Test. Results: Improved performance on the Stroop Colour-Word Test and Flanker Test were associated with decreased correlation between the default mode network (DMN) and the fronto-parietal network (FPN) (p &lt; 0.05). Compared with BAT, CCT alone significantly decreased correlation between the left dorsolateral prefrontal cortex and both the left and right medial temporal gyrus (–0.143, 95%CI [–0.256,–0.030], p = 0.014, and –0.123, 95%CI [–0.242,–0.004], p = 0.043, respectively). Conclusion: Decreased correlation between DMN and FPN, indicating less connection between these networks, may be an underlying mechanism by which CCT improves executive functions. Future studies are needed to replicate this finding.

Dementia Worry and Neuropsychological Performance in Healthy Older Adults.

Dementia is one of the most feared diseases in American society. However, limited research exists regarding how worrying about dementia may influence peoples' cognitive abilities. The current study examines how dementia worry affects performance on neuropsychological domains of executive function, memory, attention, and processing speed in a healthy older adult population. Participants (n=40) were screened for depression using the Patient Health Questionnaire-8 (PHQ-8, scores > 10 were excluded) and for mild cognitive impairment using the Telephone Interview for Cognitive Status (TICS, scores < 32 were excluded). All participants were administered common neuropsychological tests of executive function, memory, attention, and processing speed. Participants were also asked to complete the Dementia Worry Scale (DWS), a measure assessing the level of dementia worry individuals experience in daily life. A multivariate effect of dementia worry on neuropsychological measures of executive function was supported. Specifically, higher levels of dementia worry were significantly related to poorer performance on combined measures of executive function (Wilk's Lambda=0.821, F (2, 36)=3.934, p=.028). Dementia worry significantly affects scores on specific neuropsychological measures. Inasmuch, dementia worry may have both functional implications for older adults, as well as assessment implications for practicing neuropsychologists. Further research is necessary to parse apart whether dementia worry represents a psychological variable affecting cognitive performance and/or serves as an early marker of cognitive decline.

The effect of cardiorespiratory fitness and physical activity levels on cognitive functions in survivors of childhood acute lymphoblastic leukemia

Introduction. Most childhood acute lymphoblastic leukemia (ALL) survivors develop chronic treatment-related adverse effects several years after the end of the treatment. Regular physical activity and a good cardiorespiratory fitness can decrease the risks of neurological disturbances and increase cognitive function scores. The aim of this study was to examine the effect of good cardiorespiratory fitness and physical activity levels on cognitive functions.Methods. We enrolled 219 survivors of childhood ALL. The participants underwent a cardiopulmonary exercise test, neuropsychological tests of executive functions (i.e. verbal fluency, cognitive flexibility, working memory, processing speed) and completed a physical activity questionnaire. We calculated the odds ratio to obtain the preventive fraction of physical activity and cardiorespiratory fitness levels on cognitive functions.Results. The cohort is 52% male and 48% female. A total of 182 survivors (83%) have a cardiorespiratory fitness below their predicted (<100%). Our analyses show that there is an association between good cardiorespiratory fitness and processing speed (preventive fraction of 70% for dominant hand (p < 0.01) and 65% for non-dominant hand (p < 0.01)) and with cognitive flexibility identified as the category switching measure of the D-KEFS verbal fluency (preventive fraction of 61%; p < 0.05).Conclusion. Good cardiorespiratory fitness and good levels of physical activity were associated to a preventive fraction for most cognitive function parameters measured. Good cardiorespiratory fitness levels were significantly associated with a lower prevalence of deficits in processing speed (i.e., dominant hand and non-dominant hand) and in cognitive flexibility (i.e., category switching) in childhood acute lymphoblastic leukemia survivors.

The oblique effect: The relationship between profiles of visuospatial preference, cognition, and brain connectomics in older adults

The oblique effect (OE) describes the visuospatial advantage for identifying stimuli oriented horizontally or vertically rather than diagonally; little is known about brain aging and the OE. We investigated this relationship using the Judgment of Line Orientation (JLO) in 107 older adults (∼age = 67.8 ± 6.6; 51% female) together with neuropsychological tests of executive functioning (EF), attention/information processing (AIP), and neuroimaging. Only JLO lines falling between 36-54° or 126–144° were considered oblique. To quantify the oblique effect, we calculated z-scores for oblique errors (zOblique = #oblique errors/#oblique lines), and similarly, horizontal + vertical line errors (zHV), and a composite measure of oblique relative to HV errors (zOE). Composite z-scores of EF and AIP reflected domains associated with JLO performance. Graph theory analysis integrated T1-derived volumetry and diffusion MRI-derived white matter tractography into connectivity matrices analyzed for select network properties. Participants produced more zOblique than zHV errors (p < 0.001). Age was not associated with zOE adjusting for sex, education, and MMSE. Similarly adjusted linear regression models revealed that lower EF was associated with a larger oblique effect (p < 0.001). Modular analyses of neural connectivity revealed a differential patterns of network affiliation that varied by high versus low group status determined via median split of zOblique and zHV errors, separately. Older adults exhibit the oblique effect and it is associated with specific cognitive processes and regional brain networks that may facilitate future investigations of visuospatial preference in aging.