Predictors Of Cognitive Performance Research Articles

A-256 Literacy Level May Mediate the Relationship Between an Individual’s Ethnicity and Letter Fluency Ability

Abstract Objective: Previous research suggests that literacy level may be a better predictor of cognitive performance than years of education in minoritized groups. Although literacy tests remain a mainstay in the context of neuropsychological evaluations due to their role in the estimation of premorbid intellectual functioning, there is relatively little research examining the role of literacy in the relationship between ethnicity and cognitive performance. This study examined whether literacy level influences the relationship between ethnicity and letter fluency ability. Method: This cross-sectional study included 64 adult patients consecutively referred for outpatient neuropsychological evaluation within a large, Midwestern academic medical center. The sample was 54.7% male, 43.8% White, 56.3% Black, with Mage of 57.8 years (SD=11.7) and Meducation of 12.6 years (SD=2.5). A mediation analysis was performed using Hayes’ PROCESS macro within SPSS to evaluate whether literacy, as measured by the Test of Premorbid Functioning (TOPF), mediated the association between ethnicity (dichotomized as Black/White) and letter fluency via raw scores from the F/A/S trials. Results: The main model of the mediation analysis was significant, F (4, 51) = 13.89, p <.001, R2 = .521. After accounting for age and years of education, there was a significant mediation effect of literacy on the relationship between ethnicity and letter fluency (B = .740, SE = .143, t = 5.19, p <.001). Conclusion(s): In sum, this study provided evidence that literacy level helps explain the letter fluency performance differences observed between Black and White patients.

Childhood maltreatment and cognitive functioning in middle adulthood

BackgroundChildhood maltreatment (physical abuse, sexual abuse, and/or neglect) is associated with cognitive deficits in adulthood. Little is known about how childhood maltreatment affects the trajectory of cognitive functioning during early to middle adulthood. ObjectiveTo explore the relationship between childhood maltreatment and change in cognitive functioning over a 10-year period in adulthood. MethodsUtilizing a prospective cohort design, a large group of court-substantiated cases of childhood maltreatment (ages 0–11) and demographically matched controls were followed into adulthood (N = 1196). Verbal intelligence and reading ability were assessed at age 29, and executive functioning was assessed at age 41. Linear, mixed-effects modeling was used to evaluate childhood maltreatment as a predictor of cognitive functioning and change in cognitive functioning over time. ResultsChildhood maltreatment was associated with lower cognitive functioning at age 29 compared to controls (β = −0.28, p < .001), and this association was stronger for childhood neglect (β = −0.33, p < .001). Controls declined in cognitive functioning over the 10-year period (β = −0.12, p = .039), whereas childhood maltreatment overall was associated with no change. Adults with histories of neglect demonstrated an increase in cognitive functioning (β = 0.13, p = .021). ConclusionsOur results demonstrate that childhood maltreatment is associated with cognitive functioning deficits in adulthood and suggest that cognitive change in adulthood may be differentially impacted by type of maltreatment. The initial deficit demonstrated by adults with childhood neglect was largely erased by a subsequent increase in cognitive functioning over 10 years.

Association between physical and cognitive function in post menopause: a cross-sectional study

Functional tests have been performed to predict cognitive decline in postmenopausal women and may be an important tool to identify early reductions in cognitive performance in this population. However, it is still unclear which functional test is more sensitive for detecting cognitive decline in the investigated sample. The aim of this study was to verify the association between functional performance and cognitive function in postmenopausal women and to analyze whether the gait speed of 400 meters (400wt) and Timed Up and Go (TUG) tests are predictors of cognitive function in this sample. One hundred and twenty eight postmenopausal women (60.8 ± 7.9 years) participated in this cross-sectional study. Body composition was assessed using Dual Energy X-ray Absorptiometry (DXA), functional performance by the TUG and 400wt tests, cognitive performance by the Montreal Cognitive Assessment (MoCA) test and muscle strength by maximum voluntary isometric contraction (MVIC) in lower limbs. An association between functional performance and cognitive function was observed in middle-aged postmenopausal women. The TUG test was associated with the MoCA test (B = -0.79; SE = 0.29; p = 0.008). However, no association was observed between 400wt with the MoCA test (B = 3.03; SE = 1.92; p = 0.117). These results show that the TUG test is a good predictor of cognitive decline in postmenopausal middle-aged women.

Race, Childhood Socioeconomic Status, and Region of Childhood Residence as Intersectional Life-Course Predictors of Cognitive Aging in the United States.

Background and ObjectivesRace, childhood socioeconomic status (cSES), and region of childhood residence are each associated with later-life cognition, but no studies have examined how the confluence of these factors influences later-life cognitive performance. Guided by intersectionality theory, we examined individuals’ social positionality across these dimensions as a predictor of cognitive performance in later life among non-Hispanic White (NHW) and non-Hispanic Black (NHB) older adults.Research Design and MethodsWe used data from the 2010–2016 waves of the Health and Retirement Study with participants aged 65 and older in 2010. We employed growth curve modeling to estimate associations among race, cSES, and region of childhood residence, as well as their interactions, and cognitive performance at baseline and over time.ResultsIdentifying as NHB, residing in the South, and having lower cSES each were associated with poorer later-life cognition at baseline. Childhood residence in the South was an especially strong risk factor for poorer cognition among NHBs. Among NHWs, higher cSES was associated with better baseline cognitive performance, especially among those from the South. NHBs from the South demonstrated a small advantage of higher cSES, but regardless of cSES, NHBs from the South had lower levels of baseline cognitive scores compared to all other subgroups. We observed steeper declines in cognitive performance over the 6-year study period among participants who lived in the South as children.Discussion and ImplicationsOur findings suggest that intersectional social positions across race, cSES, and region of childhood residence primarily influence baseline cognition in later life. Results implicate the importance of attention to multiple life-course social positions in the context of racism within social policies and other initiatives to promote equity in later-life brain health.

Relationship between physiological tremor and cognitive function in physically active older women.

[Purpose]This study aimed to compare the physiological tremor, grip strength, and cognitive function of sedentary and physically active older adults.[Methods]Twenty-four older adults aged ≥65 years participated in this study and were divided into the sedentary (76.5±4.4 years, n=12) and physically active (73.5±3.3 years, n=12) groups. Each group completed the Mini-Mental State Examination (MMSE) for cognitive function assessment. Physiological tremor was measured using an accelerometer for both hands at rest and the left/right hand with a 1,000 g dumbbell on the palm in neutral positions and the elbow flexed at 90°. Physical fitness was measured by grip strength and completion of the Short Physical Performance Battery (SPPB) and the 6-min walk test.[Results]The physically active group showed a significantly lower level of physiological tremor in both hands at rest and the left/right hand with a 1,000 g dumbbell on the palm (P<0.05) than that in the sedentary group. For cognitive function, the physically active group showed significantly higher scores than those in the sedentary group (P<0.001). No significant correlation was found between cognitive function and left/right grip strength (left: r = 0.117, P = 0.585; right: r = 0.230, P = 0.279), physiological tremor in both hands at rest (left: r = -0.524, P < 0.001; right: r = -0.508, P < 0.05), and the left/right hand with a 1,000 g dumbbell on the palm (left: r = -0.505, P < 0.05; right: r = -0.458, P < 0.05).[Conclusion]Physiological tremor of the hands has the potential to be a useful predictor of cognitive function in older adults.

Examining the impact of socioeconomic status, demographic characteristics, lifestyle and other risk factors on adults' cognitive functioning in developing countries: an analysis of five selected WHO SAGE Wave 1 Countries

BackgroundThough extensive studies have been conducted on assessing the predictors of cognitive functioning among older adults in small community-based samples, very few studies have focused on understanding the impact of socioeconomic status (SES), demographic characteristics and other risk factors such as lifestyle and chronic diseases on the cognitive functioning among adults of all ages in a nationally representative population-based sample across low- and middle-income countries. This study, therefore, seeks to evaluate the impact of SES, demographic characteristics and risk factors on the cognitive functioning of adults across all ages in five selected developing countries.MethodsData from 12,430 observations obtained from the WHO Study on Global AGEing and Adult Health (SAGE) Wave 1; consisting of 2,486 observations each for China, Ghana, India, the Russian Federation, and South Africa, were used for the study. A meta-regression and a five-step hierarchical linear regression were used to analyze the data, with cognitive functioning as the dependent variable. Independent variables used in this study include SES; assessed by household income and education, demographic characteristics, other risk factors such as lifestyle, self-reported memory difficulty and chronic diseases.ResultsThis study found that SES and lifestyle significantly predicted cognitive functioning in all the five selected countries as obtained by the pooled results of the meta-regression analysis. The hierarchical linear regression results also revealed that demographic characteristics such as age, type of residency, and self-reported memory difficulty significantly impact cognitive functioning in China, Ghana, Russia, and South Africa.ConclusionThe findings in this study provide new insights for policymakers, caregivers, parents, and individuals, especially those in developing countries, to implement policies and actions targeted at improving SES and eliminating risk factors associated with cognitive decline, as these measures could help improve the cognitive functioning among their populations.

Association of β-Amyloid Accumulation With Executive Function in Adults With Unimpaired Cognition.

Background and ObjectivesThe neuropathologic changes underlying Alzheimer disease (AD) start before overt cognitive symptoms arise, but it is not well-known how they relate to the first subtle cognitive changes. The objective for this study was to examine the independent associations of the AD hallmarks β-amyloid (Aβ), tau, and neurodegeneration with different cognitive domains in cognitively unimpaired (CU) individuals.MethodsIn this cross-sectional study, CU participants from the prospective BioFINDER-2 study were included. All had CSF biomarkers (Aβ42 and phosphorylated tau [p-tau]181), MRI (cortical thickness of AD-susceptible regions), Aβ-PET (neocortical uptake), tau-PET (entorhinal uptake), and cognitive test data for memory, executive function, verbal function, and visuospatial function. Multivariable linear regression models were performed using either CSF Aβ42, p-tau181, and cortical thickness or Aβ-PET, tau-PET, and cortical thickness as predictors of cognitive function. The results were validated in an independent cohort (Alzheimer’s Disease Neuroimaging Initiative [ADNI]).ResultsA total of 316 CU participants were included from the BioFINDER-2 study. Abnormal Aβ status was independently associated with the executive measure, regardless of modality (CSF Aβ42, β = 0.128, p = 0.024; Aβ-PET, β = 0.124, p = 0.049), while tau was independently associated with memory (CSF p-tau181, β = 0.132, p = 0.018; tau-PET, β = 0.189, p = 0.002). Cortical thickness was independently associated with the executive measure and verbal fluency in both models (p = 0.005–0.018). To examine the relationships in the earliest stage of preclinical AD, only participants with normal biomarkers of tau and neurodegeneration were included (n = 217 CSF-based; n = 246 PET-based). Again, Aβ status was associated with executive function (CSF Aβ42, β = 0.189, p = 0.005; Aβ-PET, β = 0.146, p = 0.023), but not with other cognitive domains. The results were overall replicated in the ADNI cohort (n = 361).DiscussionThese findings suggest that Aβ is independently associated with worse performance on an executive measure but not with memory performance, which instead is associated with tau pathology. This may have implications for early preclinical AD screening and outcome measures in AD trials targeting Aβ pathology.

Factors affecting executive function performance of Brazilian elderly in the Stroop test.

Aging is related to a decrease in physiological abilities, especially cognitive functions. To unravel further evidence of age-related cognitive decline, we analyzed which physical and functional variables are predictors of cognitive performance in a sample of 498 Brazilian elderly (67.26% women). To do so, we used the Stroop test as a tool to evaluate executive functions and the General functional fitness index (GFFI) to evaluate the functional fitness of the participants. A linear regression analysis revealed that female sex (β=-0.097; t=-2.286; P=0.023), younger age (β=0.205; t=4.606; P<0.0001), more years of education (β=-0.280; t=-6.358; P<0.0001), and higher GFFI (β=-0.101; t=-2.347; P<0.02) were predictors of better cognitive performance. Body mass index (kg/m2) and nutritional status (underweight, eutrophic, overweight, or obese) were not predictors of cognitive performance. Interestingly, among the GFFI tasks, muscle strength influenced the test execution time, both in upper and lower limbs (elbow flexion: β=-0.201; t=-4.672; P<0.0001; sit-to-stand: β=-0.125; t=-2.580; P<0.01). Our findings showed that: 1) women performed the Stroop test faster than men; 2) the older the person, the lower was the cognitive performance; 3) the higher the education, the better the test execution time; and 4) higher scores in the GFFI were associated with a better performance in the Stroop test. Therefore, gender, age, education, and functional fitness and capacity were predictors of cognitive performance in the elderly.

Exploring biomarkers of processing speed and executive function: The role of the anterior thalamic radiations

IntroductionProcessing speed and executive function are often impaired after stroke and in typical aging. However, there are no reliable neurological markers of these cognitive impairments. The trail making test (TMT) is a common index of processing speed and executive function. Here, we tested candidate MRI markers of TMT performance in a cohort of older adults and individuals with chronic stroke. MethodsIn 61 older adults and 32 individuals with chronic stroke, we indexed white matter structure with region-specific lesion load (of white matter hyperintensities (WMHs) and stroke lesions) and diffusion tensor imaging (DTI) from four regions related to TMT performance: the anterior thalamic radiations (ATR), superior longitudinal fasciculus (SLF), forceps minor, and cholinergic pathways. Regression modelling was used to identify the marker(s) that explained the most variance in TMT performance. ResultsDTI metrics of the ATR related to processing speed in both the older adult (TMT A: β = -3.431, p < 0.001) and chronic stroke (TMT A: β = 11.282, p < 0.001) groups. In the chronic stroke group executive function was best predicted by a combination of ATR and forceps minor DTI metrics (TMT B: adjustedR2 = 0.438, p < 0.001); no significant predictors of executive function (TMT B) emerged in the older adult group. No imaging metrics related to set shifting (TMT B-A). Regional DTI metrics predicted TMT performance above and beyond whole-brain stroke and WMH volumes and removing whole-brain lesion volumes improved model fits. ConclusionsIn this comprehensive assessment of candidate imaging markers, we demonstrate an association between ATR microstructure and processing speed and executive function performance. Regional DTI metrics provided better predictors of cognitive performance than whole-brain lesion volumes or regional lesion load, emphasizing the importance of lesion location in understanding cognition. We propose ATR DTI metrics as novel candidate imaging biomarker of post-stroke cognitive impairment.

Abstract PO-090: The impacts of depression and socioeconomic factors on cognitive function among low-income Asian and African American elderly aged 65 and above

Abstract Background: Alzheimer's disease (AD) and Alzheimer's disease and related dementias (ADRD) have been a public health problem in the United States for a long time, and its adverse impact on the health of minority elderly population has been increasing since 2000. Nearly 40% of ADRD patients suffer from depression. However, the burden of ADRD and depression comorbidity among Asian and African Americans elderly was understudied. Methods: Participants aged 65 and older were recruited from Chinese, Vietnamese, and African American community-based organizations in the Greater Philadelphia Region and New York City. We conducted a cross sectional survey to assess their ADRD-related knowledge, depression symptoms, sociodemographic and health related factors. Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA), depression severity was tested with Patient Health Questionnaire (PHQ-9), and stressful life events (SLE) impact score was measured with a 6-item scale with excellent internal consistency (Cronbach's alpha=0.94). A p value that is smaller than 0.05 is considered statistically significant, while a p value that is smaller than 0.1 indicates marginally significant level. Results: Overall, the participants (n=306, 12.21% African Americans, 54.79% Chinese Americans, and 33% Vietnamese Americans) had an average age of 73.57; 89.56% of them had &amp;lt; $20k annual household income, and 62.13% did not have a college degree. The average MoCA score was 21.24, which was significantly lower than the normal criteria 26, indicating mild cognitive impairment. Bivariate analysis showed that depression (r=-0.51, p&amp;lt;0.001) and SLE impact (r=-0.33, p&amp;lt;0.001) were significantly negatively correlated to MoCA scores. After controlling for demographics, depression severity (Coef. =-0.42, p&amp;lt;0.001) remained a significant predictor of cognitive function. Multivariate analysis also found that age (Coef. =-0.15, p=0.016) and education levels (Coef. =2.11, p&amp;lt;0.001) were significant predictors of MoCA score. Compared with those who did not speak English at all, participants who speak some English (Coef. =3.10, p&amp;lt;0.001) and good at English speaking (Coef. =4.54, p=0.034) were more likely to have higher cognitive scores. Moreover, being retired (Coef. =-3.23, p=0.054) and having &amp;gt;$40k annual household income (Coef. =-3.73, p=0.091) showed marginally negative associations with cognitive function level. Conclusion: The preliminary findings demonstrate an association between depression and mild cognitive impairment among Asian and African American elderly. With the remaining experimental work, targeted interventions will be identified in improving ADRD knowledge, cognitive performance, and mental health among understudied older Asian and African Americans. Citation Format: Wenyue Lu, Lin Zhu, Michael Coronado, Guercie E. Guerrier, Yin Tan, Grace X. Ma. The impacts of depression and socioeconomic factors on cognitive function among low-income Asian and African American elderly aged 65 and above [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-090.

Predicting quality of life with physical and cognitive functioning among older adults with cognitive impairment

Purpose: Older adults experience abnormal declines in physical and cognitive functioning that increase their risk of dependence, subsequently quality of life. This study aims to explore the relationship between physical and cognitive functioning, and to predict quality of life among older adults with mild cognitive impairment. Methods: Survey was conducted with older adults registered at dementia support centers. Seventy-four older adults signed the consent form and participated in the study. physical functioning consisted of grip strength, balance (OLS), Timed up and go, and activities of daily living. Cognitive functioning was measured by K-MOCA. SF-12 was used to assess quality of life. Results: The participants was 76 years old on average, more women (75.4%), and mostly elementary or less education level (60.9%). Physical functioning explained 22.1% of variance in cognitive functioning after controlling for age and gender (F change=4.789, p=.002). Balance (OLS: t=2.304, p=.024) and grip strength (t=2.207, p=.031) was significant predictors. Physical and cognitive functioning explained 36.7% of variance in quality of life after controlling for age and gender (F =5.466, p<.001). Indicators of physical functioning, TUG (t=-3.252) and grip strength (t=-2.633), were the most significant predictors of quality of life, while cognitive function explained additional 3.1% of variance in quality of life (F=3.216, p=.078). Conclusion: Physical functioning were significant predictors of cognitive functioning, subsequently to quality of life among older adults with cognitive impairment. Health promoting strategies should focus on improving physical functioning of this population to maintain or prevent cognitive declining, and to promote quality of life.

A HABLE study of the relationship of blood‐based biomarkers of AD and cognition functioning in the cognitively normal: The impact of ethnicity

AbstractBackgroundBlood‐based biomarkers of amyloid accumulation (Abeta40, Abeta 42), markers of neurodegeneration (NfL) and markers of neuronal injury (Tau) have all been proposed as biomarkers of early brain changes linked to the development of cognitive impairment and Alzheimer’s disease. The impact of ethnic differences on this relationship has received little attention. The current study examined the relationship of these blood‐based biomarkers to performance on cognitive tests in cognitively normal older Mexican Americans (MA) and Non‐Hispanic Whites (NHW) to assess the impact of ethnicity.MethodCognitively normal participants were drawn from a community‐based, longitudinal study of cognitive aging in MAs. 647 MAs (447 females, 200 males) and 644 NHWs (372 females, 272 males) were administered a neuropsychological battery to assess current level of cognitive functioning. Levels of plasma total tau, Abeta 40, Abeta 42and NfL were assayed via Single Molecule Array (Simoa) technology. Data were analyzed using t tests and linear regression.ResultMAs were significantly younger and had significantly fewer years of education than NHWs. MAs had higher levels of Abeta 40, Abeta 42 and NfL and lower levels of total tau. Regression analyses by ethnicity controlling for age and education revealed no significant relationship between any of the markers and any of the cognitive tests for MAs. Regression analyses for NHWs showed significant relationships between measures of memory, language, processing speed and Abeta 40; executive functions and NfL and attention and tau and Abeta 42.ConclusionThe results of the current research support the importance of assessing ethnic differences in the relationship of these biomarkers to cognitive functioning. It is likely that other biomarkers may be better predictors of cognitive functioning and cognitive decline for MAs. Further investigation of the nature of the relationship of specific biomarkers to specific cognitive functions in cognitively normal NHWs including neuroimaging is warranted.

Moderate to vigorous physical activity and sedentary time as predictors of cognitive function in older adults with hypertension: NHANES 2011‐2014

AbstractBackgroundHypertension is associated with increased risk for cognitive decline. Lifestyle behaviors such as moderate to vigorous physical activity (MVPA) and sedentary time (ST) may mitigate this decline, though limited research on the joint association exists. The aim of the study was to examine the joint association of MVPA and ST on cognitive function by hypertension status.MethodsAdults (n=2916, ≥60yrs) from the 2011‐2014 National Health and Nutrition Examination Survey (NHANES) were assessed for their participation in MVPA (meets recommendations: ≥150min MPA and/or ≥75min MPA vs does not meet recommendations: &lt;150min MPA and &lt;75min VPA), self‐reported ST (≤7hrs ST vs &gt;7hrs ST), hypertension, and cognitive function (Digit Symbol Substitution Test [DSST]; Animal Fluency [AF] test). Weighted linear regression analyses were conducted to assess joint association of MVPA and ST on cognitive function, and test the modifying effect of hypertension status (alpha level set at 0.1) after adjustment for demographics, cardiovascular disease, diabetes, body mass index (BMI), and depression.ResultsSee Table. There were significant main effects for combined MVPA and ST on DSST (Wald F(3,30)=3.393, p=.031) and AF (Wald F(3,30)=17.33, p&lt;.001). Participants who did not meet MVPA recommendations regardless of ST had significantly worse scores on DSST compared to participants who met MVPA recommendations and reported ≤7hr ST. Participants who did not meet MVPA recommendations and had ≤7hr ST had significantly worse scores on AF. There was a significant interaction between MVPA‐ST groups and hypertension status on AF (Wald F(3,30)=3.766, p=.021), but not on DSST. Stratified analyses indicated among individuals without hypertension significance was maintained. For participants with hypertension, not meeting MVPA recommendations regardless of ST was associated with significantly worse scores.ConclusionsIn a sample of adults, meeting recommendations for MVPA was associated with better cognitive outcomes regardless of ST. Among individuals with hypertension regular MVPA regardless of ST was significantly associated with higher scores on one measure of executive function. This research highlights the added importance for individuals with hypertension to participate in the recommended amount of MVPA.

Contribution of vascular risk factors to the relationship between ADHD symptoms and cognition in adults and seniors

Symptoms of attention-deficit/hyperactivity disorder (ADHD) in childhood have been found to be predictive of compromised cognitive function, and possibly even dementia, in later adulthood. This study aimed to test vascular risk as a hypothesized moderator or mediator of this association, because individuals with elevated ADHD symptoms frequently have comorbid vascular disease or risk factors which are recognized to contribute to later-life cognitive decline. Data from 1,092 adults aged 18–85 were drawn from the Enhanced Nathan Kline Institute Rockland Sample. Childhood ADHD symptoms (assessed using the Adult ADHD Clinical Diagnostic Scale) were assessed as predictors of cognitive functioning in adulthood (assessed using subtests from the University of Pennsylvania Computerized Neurocognitive Battery, the Delis-Kaplan Executive Functioning System, and the Wechsler Memory Scale). Vascular risk factors (including diabetes, tobacco use, obesity, hypertension, and hypercholesterolemia) were tested as both a moderator and mediator of this relationship. Childhood ADHD symptoms and vascular risk factors were both independently associated with later-life cognition, but vascular risk was not a significant moderator or mediator of relationships between ADHD symptoms and cognition in statistical models. Results from this large community sample suggest that the relationship between ADHD symptoms and cognition is not accounted for by vascular risk. This question should also be investigated in clinical samples.

Comparing Framingham risk score and cognitive performance in a Mexican American cohort

ObjectiveMexican-Americans have a higher prevalence of modifiable cardiovascular risk factors as compared to Non-Hispanic whites. This study aims to elucidate the utility of the Framingham Cardiovascular Disease Risk Score (FCVDRS) as a predictor of cognitive performance on a cohort of Mexican Americans elders. Participants and Setting429 Mexican-Americans (338 female and 91 male) from a longitudinal study conducted at The University of North Texas Health Science Center were studied. Main outcome measuresDemographic and clinical data relevant to Framingham Cardiovascular Disease 10-year Risk Score (FCVDRS) were assessed. FCVDRS was calculated based on Body Mass Index (BMI) and categorized as Low if <10, Moderate if between 10 and 20, and High if >20. Cognitive performance on Trails B, Wechsler Logical Memory I and II, Mini Mental State Examination (MMSE), and Animal Naming (AN) tests. Demographic data was analyzed using t-tests and chi-square tests as appropriate. Pearson correlation tests and ANOVAs were used to compare FCVDRS, as a continuous variable and as a categorical variable, against cognitive performance. ResultsBoth Pearson correlation tests and linear regression analysis, showed significant correlations between FCVDRS and performance on 4 of the 8 measures of cognitive performance. ANOVAs with Post-Hoc analysis also showed that the difference in cognitive performance was more pronounced between groups with greater differences in FCVDRS. In all analyses, the strength of the relationship was stronger in females. ConclusionThe results show that FCDVRS has high predictive utility in measures of cognitive function. Gender specific analysis between FCVDRS and cognitive performance indicate a stronger association in females.

The biochemical subtype is a predictor for cognitive function in glutaric aciduria type 1: a national prospective follow-up study

The aim of the study was a systematic evaluation of cognitive development in individuals with glutaric aciduria type 1 (GA1), a rare neurometabolic disorder, identified by newborn screening in Germany. This national, prospective, observational, multi-centre study includes 107 individuals with confirmed GA1 identified by newborn screening between 1999 and 2020 in Germany. Clinical status, development, and IQ were assessed using standardized tests. Impact of interventional and non-interventional parameters on cognitive outcome was evaluated. The majority of tested individuals (n = 72) showed stable IQ values with age (n = 56 with IQ test; median test age 11 years) but a significantly lower performance (median [IQR] IQ 87 [78–98]) than in general population, particularly in individuals with a biochemical high excreter phenotype (84 [75–96]) compared to the low excreter group (98 [92–105]; p = 0.0164). For all patients, IQ results were homogenous on subscale levels. Sex, clinical motor phenotype and quality of metabolic treatment had no impact on cognitive functions. Long-term neurologic outcome in GA1 involves both motor and cognitive functions. The biochemical high excreter phenotype is the major risk factor for cognitive impairment while cognitive functions do not appear to be impacted by current therapy and striatal damage. These findings implicate the necessity of new treatment concepts.

Predictors of Cognitive Functioning Among Veterans with Mild Traumatic Brain Injury

<h3>Research Objectives</h3> To investigate the relative contributions of demographic factors, behavioral health and mood symptoms, and history of mild Traumatic Brain Injury (mTBI) on neuropsychological test performance. <h3>Design</h3> Cross-sectional Study. <h3>Setting</h3> Three VA Polytrauma Network Sites. <h3>Participants</h3> Veterans aged 18 years and older who deployed to Iraq and/or Afghanistan conflicts, and had not received treatment for concussion in the preceding 30 days were eligible for enrollment. Across sites, 454 Veterans were enrolled between August 1, 2010 and September 30, 2011. After excluding Veterans with missing outcome data or with scores below study cutoffs on measures of symptom/performance validity, 250 Veterans remained. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Cognitive functioning assessed using neuropsychological measures of processing speed, executive functioning, attention, and memory. <h3>Results</h3> Using separate multiple regression models (i.e., one for each neuropsychological measure), examining specified predictor variables (estimated pre-injury IQ scores, demographics, behavioral health ratings, insomnia, alcohol use, pain, positive mTBI history, anxiety, depression, presence of Posttraumatic Stress Disorder), indicate that current mood symptoms and other behavioral health concerns (e.g., pain/sleep) predict objective cognitive performance over and above mTBI history. <h3>Conclusions</h3> Some Veterans presenting to neuropsychology clinics with subjective cognitive complaints attribute these to their prior mTBI. However, many also have commonly co-occurring mood, sleep, and pain concerns which are also known to impact cognition. Our findings suggest that these modifiable factors, rather than mTBI history, likely play a greater role in objective cognitive abilities (i.e., performance on neuropsychological tests). These findings inform ongoing efforts to improve patient education regarding the expected recovery course from mTBI and the relationship between mood and health on daily cognitive efficiency. <h3>Author(s) Disclosures</h3> N/A.

Longitudinal telomere length profile does not reflect HIV and childhood trauma impacts on cognitive function in South African women.

HIV-associated neurocognitive disorders (HAND) present a challenge in South Africa where the burden of HIV infection is the highest. Identification of biological correlates of HAND is required to improve diagnosis and inform interventions. Telomeres maintain genomic integrity and their shortening is a marker of biological aging sensitive to environmental influences. This study examined relative telomere length (rTL) as a predictor of cognitive function in the context of HIV and childhood trauma (CT), a risk factor for HAND. Two hundred and eighty-six women completed a neurocognitive assessment battery and the Childhood Trauma Questionnaire-Short Form (CTQ). Quantitative polymerase chain reaction for amplification of telomeric repeats and the reference gene human beta-globin was used to calculate rTL. Neurocognitive and rTL assessments were repeated at 1year in 110 participants. Cross-sectional and longitudinal data were assessed using linear and mixed models, respectively. Participants with HIV (n = 135 in cross-sectional and n = 62 in longitudinal study groups) reported more severe CT and had shorter baseline rTL compared to seronegative controls. Participants without HIV had a greater 1-year decline in rTL. Global cognitive and attention/working memory scores declined in participants with HIV. Our data indicate that baseline rTL in the context of CT and HIV did not predict decline in cognitive scores. HIV-associated pathophysiological processes driving cognitive decline may also engage mechanisms that protect against telomere shortening. The results highlight the importance of examining biological correlates in longitudinal studies.

Predictors of Cognitive Performance Among Infants Treated for Brain Tumors: Findings From a Multisite, Prospective, Longitudinal Trial.

Infants treated for CNS malignancies experience a significantly poorer response to treatment and are particularly at risk for neuropsychological deficits. The literature is limited and inconsistent regarding cognitive outcomes among this group. We investigated predictors of cognitive outcomes in children treated for brain tumors during infancy as part of a large, prospective, multisite, longitudinal trial. One hundred thirty-nine infants with a newly diagnosed CNS tumor were treated with chemotherapy, with or without focal proton or photon radiation therapy (RT). Cognitive assessments were conducted at baseline, 6 months, 1 year, and then annually for 5 years. The median length of follow-up was 816 days (26.8 months). Neurocognitive testing included assessment of intellectual functioning (intellectual quotient [IQ]), parent ratings of executive functioning and emotional and behavioral functioning, and socioeconomic status. At baseline, IQ, parent-reported working memory, and parent-reported adaptive functioning were worse than normative expectations. Baseline cognitive difficulties were associated with younger age at diagnosis and lower socioeconomic status. Linear mixed models did not demonstrate a decline in IQ over time. There were increased parent-reported attention and executive problems over time. Increased concerns were related to supratentorial tumor location and CSF diversion. There were no differences in cognitive outcomes based on treatment exposure (chemotherapy-only v chemotherapy with RT and proton v photon focal RT). Even before adjuvant therapy, young children with brain tumors experience cognitive difficulties that can affect quality of life. Changes in cognitive functioning over time were dependent on tumor location and surgical factors rather than adjuvant therapy. These findings may serve to guide treatment planning and indicate targets for cognitive monitoring and intervention.

745 Association of Longitudinal Sleep Profiles with Cognitive Functioning in Bipolar Disorder

Abstract Introduction Emerging evidence suggests that some cognitive deficits in bipolar disorder may be attributed to sleep disturbance. However, current findings are limited by cross sectional analyses or longitudinal studies with sparse follow up on sleep quality. The current study examined longitudinal profiles of sleep as predictors of cognitive performance across a series of domains to better understand how sleep disturbance may impact in bipolar patients. Methods 241 bipolar disorder and 103 control participants had their sleep measured at baseline, 6- and 12-months using the Pittsburgh Sleep Quality Index (PSQI). Individuals with a “poor” categorical PSQI sleep rating (PSQI total score &amp;gt;5) at all time points were categorized as “Poor Sleepers” (n = 134). Those rated “good” at each time point were “Healthy Sleepers” (n = 107), and those with at least one discrepant sleep rating at any time point were labeled “Unstable Sleepers” (n = 103). Cognitive performance was assessed at 12-months, testing domains of memory, processing speed, and executive function. ANOVAs controlling for demographics, mood symptom severity, and diagnostic group examined effects of sleep profiles on cognitive function. Results Main effects for sleep group were found for the California Verbal Learning Test across all short and long delay recall conditions (F’s 4.45 – 5.8, p &amp;lt;.02 for all). The poor sleep group performed the worst, while no main effects for diagnosis were observed. Main effects of sleep group were found for time conditions of the Trail making task (F = 4.18, p = .016), but not for errors. Conclusion Sleep quality was more strongly related to verbal and visual memory than bipolar diagnosis, with weaker effects for executive function. Some cognitive domains in bipolar disorder may be more closely related to sleep disturbance than endogenous factors. Future studies should explore how improvements in sleep functioning relate to neurocognitive outcomes, and whether cognitive performance varies as a function of sleep instability independent of mood instability. Support (if any) Support: Heinz C. Prechter Bipolar Research Fund at the University of Michigan Depression Center, the Department of Veterans Affairs (IK2-CX001501; PI: Boland), the VISN 4 MIRECC, and National Institute of Mental Health (K23MH118580; PI: Goldschmied).