Cognitive Test Results Research Articles

When Stroke Disguises as Dementia: A Case of Missed Cerebral Venous Thrombosis.

Cerebrovascular thrombosis is among the most critical medical conditions, making early diagnosis and management crucial. Although some symptoms of cerebrovascular thrombosis are typical and lead to early diagnosis, they can sometimes present with rare and unusual symptoms, complicating the diagnostic process. Given the morbidity and mortality associated with these events, it is important to be aware of unexpected symptoms to diagnose and manage these patients more accurately and rapidly. We report a 74-year-old female initially misdiagnosed with Alzheimer's because of cognitive decline and disorganized speech. Her symptoms did not improve with Alzheimer's treatment. She was reevaluated by a neurologist, and her cognitive test results were impaired. Her brain MRI revealed a previously undetected left transverse sinus cerebral venous thrombosis with subcortical white matter lesions. The patient was managed acutely with subcutaneous enoxaparin and transitioned to oral rivaroxaban, resulting in significant improvement. This case report aimed to draw attention to the pitfalls of diagnosing dementia-like syndromes in the elderly, advocating for a systematic approach to differential diagnosis. It emphasizes that a collaborative effort between psychiatrists, neurologists, radiologists, and other healthcare members is essential for accurate diagnosis and timely intervention, which can significantly alter the management and outcome for the patient.

The significance of interictal electroencephalogram analysis based on the grand total electroencephalogram score in early assessment of cognitive impairment in epilepsy patients.

Epilepsy is a widespread neurological disorder that increases the risk of cognitive impairment (CI) or dementia. We aimed to assess the relationship between cognition and interictal electroencephalogram (EEG) in epilepsy patients, using the Grand Total EEG (GTE) score. Additionally, we investigated the GTE score's utility in the early detection of CI in these patients. Data from 93 patients diagnosed with unexplained epilepsy at the Affiliated Hospital of Yangzhou University were analyzed. EEG recordings and cognitive evaluations were performed. Patients were categorized into three groups based on their Montreal Cognitive Assessment (MoCA) scores: normal cognitive (NC) group, mild cognitive impairment (MCI) group, and dementia group. The study included analysis of correlations between cognitive test results and clinical characteristics. Additionally, the influence of GTE scores and subscores on cognition was examined. Statistical analyses included one-way analysis of variance (ANOVA), Kruskal-Wallis H-test, Mann-Whitney U-test, Chi-square test, Spearman rank correlation analysis, and multiple linear regression. (1) There was a significant negative correlation between cognitive test scores and GTE scores. Strong negative correlations were found between cognition (MoCA) and the GTE score (ρ = -0.754, P < 0.001), as well as for the subscores "Diffuse Slow Activity" (ρ = -0.712, P < 0.001), "Frequency of Rhythmic Background Activity" (ρ = -0.490, P < 0.001), and "Paroxysmal Activity" (ρ = -0.565, P < 0.001). (2) Multiple linear regression analysis identified the GTE score, "Diffuse Slow Activity", "Paroxysmal Activity", age, and education as significant predictors of cognitive decline. (3) At a threshold of 4.5, the GTE score effectively differentiated between individuals with and without CI, demonstrating a sensitivity of 73.8 % and a specificity of 93.7 %. The GTE score provides clinically valuable information for the early detection of CI in patients with epilepsy. As CI worsens in epilepsy patients, the GTE score, Diffuse Slow Activity, Frequency of Rhythmic Background Activity, and Paroxysmal Activity increase. Healthcare providers should focus on managing not only seizures but also interictal EEG abnormalities to prevent or mitigate the risk of CI.

SLEEP AND CORTISOL IMPACT COGNITIVE OUTCOMES IN MIDLIFE HISPANIC/LATINE ADULTS AT RISK FOR ALZHEIMER’S DISEASE

Abstract Sleep disturbance has been associated with an increased risk of Alzheimer’s disease (AD). Repeated stressors, including ongoing sleep disturbance, trigger persistent increases in glucocorticoid levels, which affect brain function. Various cognitive domains appear to be significantly impacted by sleep. This study examined the effect of sleep and cortisol levels on cognitive test outcomes. Hispanic/Latine adults (n=39; mean age 53 yrs (SD: 5.12)) with first-degree relatives with AD were recruited from Miami-Dade and Broward counties, FL. Cortisol was measured from saliva obtained three times in one day (waking, 30 minutes post-waking, and bedtime). Cognition was measured using the NACC Neuropsychological Battery (UDS3). Sleep was measured using wrist-worn actigraphy (ActiGraph wGT3X-BT). Multiple linear regression was performed to examine correlations between sleep, cognition, and cortisol. Average sleep duration was 6.40 (SD = 1.37) hours. Average efficiency was 92% (SD = 3%). Average sleep fragmentation was 27.79 (SD = 9.59) minutes post-sleep onset. Sleep efficiency was significantly associated with executive attention after adjusting for education and income (β = -18.73, p =.046). Sleep fragmentation was significantly associated with immediate memory (β = -.045, p =.0181). The effect of cortisol at waking on episodic memory delayed was dependent on sleep efficiency (β = 211.004, p =.031). The interaction between sleep duration and cortisol at bedtime was significantly associated with nonverbal memory (β =10.37, p =.023). The identification of modifiable risk factors for AD, including poor sleep and increased stress, will inform the development of intervention efforts to prevent or delay AD onset.

Cortical and subcortical gray matter volume and cognitive impairment in Parkinson’s disease

Introduction This study investigated the cortical and subcortical gray matter volume (GMV) and cognitive impairment (CI) in patients with Parkinson’s disease (PD). Methods In this study, T1-weighted magnetic resonance imaging of the cortex and subcortex was conducted on 92 individuals diagnosed with PD and 92 healthy controls (HCs). PD patients were divided into three groups: PD with normal cognition (PD-NC, n = 21), PD with mild CI (PD-MCI, n = 43), and PD with severe CI (PD-SCI, n = 28). Differences in GMV were analyzed using voxel-based morphometry (VBM). Statistical analysis was conducted using SPSS 26. Results Compared to the HCs, the PD-NC group exhibited reduced GMV in the right middle frontal gyrus (RMFG), right precentral gyrus medial segment (RPGMS), left temporal pole, and right superior frontal gyrus medial segment (RSFGMS). In comparison to the HC and PD-NC groups, the PD-MCI and PD-SCI groups (respectively) demonstrated significant decreases in GMV in the right caudate, left hippocampus, left thalamus, RMFG, RPGMS, RSFGMS, and cerebellum (right crus I and left crus I). The regression analysis indicated that changes in the GMV of the frontal areas can predict cognitive test outcomes. Conclusion Compared to HCs, PD patients with CI presented significant volume reductions in the RC, LH, LT, RMFG, RPGMS, RSFGMS, and the right and left crus I regions. Consequently, as average GMV atrophy increased in the specified regions, PD patients exhibited more severe cognitive impairment than the HC group. This may be attributed to the initial pathological loss of frontal GMV (especially in the RMFG and RPGMS regions), which could subsequently lead to subcortical dysfunction.

Effect of carotid artery stenting on cognitive function in patients with asymptomatic carotid artery stenosis, a multimodal magnetic resonance study.

More and more evidence suggesting that internal carotid artery stenosis is not only a risk factor for ischemic stroke but also for cognitive impairments. Hypoperfusion and silent micro emboli have been reported as the pathophysiological mechanisms causing cognitive impairment. The effect of carotid artery stenting (CAS) on cognitive function varied from study to study. This study aims to explore the effect of CAS on cognition and exam the changes in cerebral perfusion and brain connectivity with pulsed arterial spin labeling (pASL) and resting-state functional MRI (R-fMRI). We conducted a controlled trial to assess alterations in cognitive performance among patients with "asymptomatic" carotid artery stenosis prior to and 3 months post-CAS intervention. Cognitive function including the Montreal Cognitive Assessment (MoCA) Beijing Version, the Minimum Mental State Examination (MMSE), the Digit Symbol Test, the Rey Auditory Verbal Learning Test (RAVLT), and the Verbal Memory Test. pASL perfusion MRI and R-fMRI were also performed prior to and 3 months post-CAS intervention. 13 patients completed all the follow-up. We observed increased perfusion in the right parietal lobe and right occipital lobe, increased amplitude of low-frequency fluctuation (ALFF) in the right precentral gyrus, increased connectivity to the posterior cingulate cortex (PCC) in the right frontal gyrus and right precuneus, and increased voxel-wise mirrored homotopic connectivity (VMHC) in the right precuneus 3 months after CAS when compared with prior to CAS. Cognitive test results showed significant improvement in the scores on the MMSE, the Verbal Memory test, and the delayed recall. CAS can partly improve the cognitive function in patients with "asymptomatic" carotid artery stenosis, and the improvement may be attributable to the increased perfusion in the right parietal lobe and right occipital lobe, increased ALFF in the right precentral gyrus, increased connectivity to the PCC in the right frontal gyrus and right precuneus, and increased VMHC in the right precuneus.

Data-driven prediction of regional brain metabolism using neuropsychological assessment in Alzheimer's disease and behavioral variant Frontotemporal dementia.

This study aimed to evaluate the capacity of neuropsychological assessment to predict the regional brain metabolism in a cohort of patients with amnestic Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) using Machine Learning algorithms. We included 360 subjects, consisting of 186 patients with AD, 87 with bvFTD, and 87 cognitively healthy controls. All participants underwent a neuropsychological assessment using the Addenbrooke's Cognitive Examination and the Neuronorma battery, in addition to [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) imaging. We trained Machine Learning algorithms, including artificial neural networks (ANN) and models that incorporate genetic algorithms (GAs), to predict the presence of regional hypometabolism in FDG-PET imaging based on cognitive testing results. The proposed models demonstrated the ability to predict hypometabolism trends with approximately 70% accuracy in key regions associated with AD and bvFTD. In addition, we showed that incorporating neuropsychological tests provided relevant information for predicting brain hypometabolism. The temporal lobe was the best-predicted region, followed by the parietal, frontal, and some areas in the occipital lobe. Diagnosis played a significant role in the estimation of hypometabolism, and several neuropsychological tests were identified as the most important predictors for different brain regions. In our experiments, classical Machine Learning models, such as support vector machines enhanced by a preliminary feature selection step using GAs outperformed ANNs. A successful prediction of regional brain metabolism of patients with AD and bvFTD was achieved based on the results of neuropsychological examination and Machine Learning algorithms. These findings support the neurobiological validity of neuropsychological examination and the feasibility of a topographical diagnosis in patients with neurodegenerative disorders.

Serum Mature and Precursor Brain-Derived Neurotrophic Factors and Their Association with Neurocognitive Function in ART-Naïve Adults Living with HIV in Sub-Saharan Africa.

This study investigates the association between serum mature brain-derived neurotrophic factor (mBDNF), its precursor proBDNF, and neurocognitive function in ART-naïve adults with HIV in sub-Saharan Africa, exploring the distinct roles of these neurotrophic factors in cognitive health. This cross-sectional analysis utilized stored baseline serum samples and neuropsychological test data from participants in the AIDS Clinical Trials Group (ACTG) A5199 study in the Johannesburg and Harare sites. Serum concentrations of mBDNF and proBDNF were quantified using ELISA. Neurocognitive function was assessed via standardized tests, with results adjusted for site-specific demographics. Linear and quantile regression models examined the relationship of mBDNF and proBDNF with a composite cognitive score (NPZ-6), and structural equation modeling (SEM) explored their association with individual cognitive test outcomes. The analysis involved 157 ART-naïve adults with HIV. Increased serum mBDNF levels showed a significant positive association with cognitive performance (β = 1.30, p = 0.02), while elevated proBDNF levels were linked to poorer outcomes, particularly affecting fine motor skills and speed (β = - 0.29 to - 0.38, p ≤ 0.01). Quantile regression analysis highlighted mBDNF's stronger positive impact at higher cognitive performance percentiles (β = 1.04 (0.01, 2.06) at the 75th percentile), while proBDNF showed significant negative association at the 75th percentile (β = - 0.26 (- 0.47, - 0.06)). The study highlights the positive association of mature BDNF and the negative association of proBDNF with cognitive function in HIV. These findings emphasize the need for longitudinal research to understand the temporal dynamics of neurotrophic factors during ART initiation and their potential as targets for neurocognitive interventions in HIV.

Cognitive Outcomes in Young Adults with Primary Arterial Hypertension: The Role of Cardiovascular Risk Factors and Hypertension-Mediated Organ Damage.

Background and Objectives: We aimed to explore the association between cognitive performance and markers of hypertension-mediated organ damage (HMOD) in young adults with hypertension. Materials and Methods: A group of adults aged 16 to 45 years with primary arterial hypertension completed a battery of paper-pencil as well as computer-based neuropsychological tests across all major cognitive domains. They also underwent office and ambulatory 24 h blood pressure, intima-media thickness measurements, heart ultrasound, and laboratory analysis of their lipid profile, blood uric acid concentration, and urine albumin-creatinine ratio. Associations between cognitive test results and markers of HMOD were explored through correlation analysis and age-, sex-, and body mass index-adjusted linear regression modeling. Results: Seventy-six individuals (62, 81.6% male) aged 36.5 years (interquartile range 18.4 to 42.0 years) were enrolled. After adjusting for age, sex, and body mass index in linear regression models, worse categorical fluency was associated with higher left ventricular mass (βst = -0.264, p = 0.043) and worse performance in a task of sustained attention-with higher left ventricular mass index (βst = -0. 304, p = 0.016). Worse phonemic fluency was related to higher pulse pressure (βst = -0.241, p = 0.049) in the respective model. Better strategy use in the task of spatial working memory was linked to higher daytime mean diastolic blood pressure (βst = -0.343 p = 0.017). Conclusions: Performance among young adults with hypertension across selected cognitive domains was inversely associated with pulse pressure, markers of left ventricular damage, and directly associated with daytime diastolic blood pressure. Our study suggests that the previously reported relationship between cognitive and cardiovascular markers in hypertension exists earlier than in middle or late adulthood.

Pelatihan Pengukuran Biomotorik bagi Atlet Tinju Tingkat Sekolah Menengah Atas

This community service (PkM) aims to apply effective biomotor measurement techniques for high school-level boxing athletes to improve performance in the ring. The method of implementing this service used lectures, demonstrations, and cognitive tests targeting 9 boxing athletes and 2 coaches at SMAN 6 Gorontalo City. Lecture sessions covered strength, endurance, speed, agility, flexibility, balance, motor skills, body composition, explosive power, and functional tests. Demonstration sessions involved practical measurements using various tests to monitor athlete progress. The cognitive test results showed good understanding from the participants with an average of 83%, indicating increased knowledge about biomotors and their applications. This activity succeeded in improving participants' skills in evaluating and improving boxing performance, facilitating a more effective and highly competitive training program. The application of appropriate biomotor techniques could improve training programs and athlete performance.

Diverging Relationships among Amyloid, Tau, and Brain Atrophy in Early-Onset and Late-Onset Alzheimer's Disease.

Alzheimer's disease (AD) dementia may not be a single disease entity. Early-onset AD (EOAD) and late-onset AD (LOAD) have been united under the same eponym of AD until now, but disentangling the heterogeneity according to the age of sonset has been a major tenet in the field of AD research. Ninety-nine patients with AD (EOAD, n=54; LOAD, n=45) and 66 cognitively normal controls completed both [18F]THK5351 and [18F]flutemetamol (FLUTE) positron emission tomography scans along with structural magnetic resonance imaging and detailed neuropsychological tests. EOAD patients had higher THK retention in the precuneus, parietal, and frontal lobe, while LOAD patients had higher THK retention in the medial temporal lobe. Intravoxel correlation analyses revealed that EOAD presented narrower territory of local FLUTE-THK correlation, while LOAD presented broader territory of correlation extending to overall parieto-occipito-temporal regions. EOAD patients had broader brain areas which showed significant negative correlations between cortical thickness and THK retention, whereas in LOAD, only limited brain areas showed significant correlation with THK retention. In EOAD, most of the cognitive test results were correlated with THK retention. However, a few cognitive test results were correlated with THK retention in LOAD. LOAD seemed to show gradual increase in tau and amyloid, and those two pathologies have association to each other. On the other hand, in EOAD, tau and amyloid may develop more abruptly and independently. These findings suggest LOAD and EOAD may have different courses of pathomechanism.

Assessment of Efficacy and Safety of Mangifera indica Extract (Stadice®) for Cognitive Function: A Randomized, Double-Blind, Placebo-Controlled Study.

Background and objectives Stadice® is a proprietary herbal ingredient preparation standardized to mangiferin, developed to support cognitive wellness in healthy adults. Mangifera indica extract and its active constituent, mangiferin were known for its positive cognitive health benefits at experimental levels. This was an attempt to evaluate the clinical efficacy and safety of Stadice® on healthy subjects. Materials and methods A randomized, double-blind, placebo-controlled clinical study was designed to study the efficacy and safety of Stadice®. Sixty healthy subjects who were regularly playing virtual/mobile/computer/laptop games online or offline were asked to consume a capsule containing 300 mg of Stadice® or placebo per day for seven days. Cognitive ability tests, that were part of the NIMHANS Neuropsychological Battery and Auditory verbal learning tests were used to assess the cognitive health effects. Psychological stress response, anxiety, mood, subjective working memory, and cortisol levels were also assessed. All assessments were carried out at the baseline and at the end of the study. Results Stadice® was found to significantly improve mental speed, attention, working memory, response inhibition, and verbal learning and memory as evidenced by the results of the multiple cognitive ability tests. Additionally, Stadice ® showed beneficial responses in managing psychological stress in terms of handling nervousness, irritability, or mood swings. No safety concerns were found in the laboratory safety test parameters as they were within the normal physiological range and no adverse events were reported in this study. Conclusion The proprietary Mangifera indica extract (Stadice®) holds promise for enhancing cognitive abilities in healthy adults, particularly those engaged in esports. Improvements in learning, memory, mental speed, attention, response inhibition, and working memory among participants supplemented with Stadice® were observed with a good safety profile. Further exploration is warranted to ascertain its broader applicability as well as to elucidate the possible mechanisms.

Markers of Biological Brain Aging Mediate Effects of Vascular Risk Factors on Cognitive and Motor Functions: A Multivariate Imaging Analysis of 40,579 Individuals.

The increasing global life expectancy brings forth challenges associated with age-related cognitive and motor declines. To better understand underlying mechanisms, we investigated the connection between markers of biological brain aging based on magnetic resonance imaging (MRI), cognitive and motor performance, as well as modifiable vascular risk factors, using a large-scale neuroimaging analysis in 40,579 individuals of the population-based UK Biobank and Hamburg City Health Study. Employing partial least squares correlation analysis (PLS), we investigated multivariate associative effects between three imaging markers of biological brain aging - relative brain age, white matter hyperintensities of presumed vascular origin, and peak-width of skeletonized mean diffusivity - and multi-domain cognitive test performances and motor test results. The PLS identified a latent dimension linking higher markers of biological brain aging to poorer cognitive and motor performances, accounting for 94.7% of shared variance. Furthermore, a mediation analysis revealed that biological brain aging mediated the relationship of vascular risk factors - including hypertension, glucose, obesity, and smoking - to cognitive and motor function. These results were replicable in both cohorts. By integrating multi-domain data with a comprehensive methodological approach, our study contributes evidence of a direct association between vascular health, biological brain aging, and functional cognitive as well as motor performance, emphasizing the need for early and targeted preventive strategies to maintain cognitive and motor independence in aging populations.

Inovasi Pembelajaran Fisika: Integrasi Problem Based Learning dan Simulasi PhET pada Materi Gelombang Bunyi

This research is motivated by the low learning outcomes of physics students, especially on sound waves material. The purpose of this research is to evaluate the effectiveness of Problem Based Learning (PBL) learning model assisted by PhET simulation in improving students' physics learning outcomes. The research method used was a pseudo experiment with a sample of 28 students of class XI IPA 2 at SMA Negeri 2 Kupang. The data obtained were analyzed by quantitative descriptive method. The results showed that after the application of PBL learning model with PhET simulation there was a significant increase in student learning outcomes. From the results of cognitive tests before treatment (pre-test), there were no students who reached the average percentage level of scores ≥ 75%, with an average score of 19. After the treatment (post-test), 25 out of 28 students were declared complete with an average percentage level of 95 or ≥ 75%. At the stage of observation and observation of affective abilities, 25 students reached an average percentage level ≥ 75%, and 3 students were still below 75%. In the follow-up observation on the psychomotor spec, 26 students reached an average percentage level ≥ 75%, and 2 students were still below 75%. The application of PBL model assisted by PhET simulation is effective in improving students' physics learning outcomes on sound wave material.

The Risk of Atrial Fibrillation and Previous Ischemic Stroke in Cognitive Decline.

Objectives: Our study investigated the inverse relationship between cognitive decline (CD) and the presence of documented atrial fibrillation (AFib), ischemic stroke, heart failure, lower extremity peripheral artery disease, and diabetes mellitus. Methods: We conducted a retrospective cross-sectional study between December 2016 and November 2019. A total of 469 patients were enrolled who underwent cognitive evaluation with three cognitive tests (Montreal Cognitive Assessment-MOCA, Mini-Mental State Examination-MMSE, and General Practitioner Assessment of Cognition-GPCOG). We used the standard cut-off values, and the optimal thresholds were obtained from the receiver operating characteristic curves. Results: The standard cut-off level of the MOCA (<26 points) was associated with the presence of AFib (OR: 1.83, 95% CI: 1.11-3.01) and the optimal cut-off level with <23 points with ischemic stroke (OR: 2.64, 95% CI: 1.47-4.74; p = 0.0011). The optimal cut-off value of the MMSE (<28 points) was associated with the presence of ischemic stroke (OR: 3.07, 95% CI: 1.56-6.07; p = 0.0012), AFib (OR: 1.65, 95% CI: 1.05-2.60; p = 0.0287), and peripheral artery disease (OR: 2.72, 95% CI: 1.38-5.36; p = 0.0039). GPCOG < 8 points were associated with ischemic stroke (OR: 2.18, 95% CI: 1.14-4.14; p = 0.0176) and heart failure (OR: 1.49, 95% CI: 1.01-2.21; p = 0.0430). Conclusions: Our research highlighted the broader utility of cognitive assessment. The MOCA and MMSE scores proved to be associated with documented AFib. Higher cognitive test results than the standard threshold for CD of the MMSE, GPCOG, and lower MOCA scores represented risk factors for the presence of previous ischemic stroke.

Plasma Neurofilament Light Chain: A Potential Biomarker for Neurological Dysfunction in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a complex disorder characterized by heterogeneous symptoms, which lack specific biomarkers for its diagnosis. This study aimed to investigate plasma neurofilament light chain (NfL) levels as a potential biomarker for ME/CFS and explore associations with cognitive, autonomic, and neuropathic symptoms. Here, 67 ME/CFS patients and 43 healthy controls (HCs) underwent comprehensive assessments, including neuropsychological evaluation, autonomic nervous system (ANS) testing, and plasma NfL level analysis. ME/CFS patients exhibited significantly higher plasma NfL levels compared to HC (F = 4.30, p < 0.05). Correlations were observed between NfL levels and cognitive impairment, particularly in visuospatial perception (r = -0.42; p ≤ 0.001), verbal memory (r = -0.35, p ≤ 0.005), and visual memory (r = -0.26; p < 0.05) in ME/CFS. Additionally, higher NfL levels were associated with worsened autonomic dysfunction in these patients, specifically in parasympathetic function (F = 9.48, p ≤ 0.003). In ME/CFS patients, NfL levels explained up to 17.2% of the results in cognitive tests. Unlike ME/CFS, in HC, NfL levels did not predict cognitive performance. Elevated plasma NfL levels in ME/CFS patients reflect neuroaxonal damage, contributing to cognitive dysfunction and autonomic impairment. These findings support the potential role of NfL as a biomarker for neurological dysfunction in ME/CFS. Further research is warranted to elucidate underlying mechanisms and clinical implications.

Transferability of Effective Consultation Skills for Decision-Making Support in the Voluntary Surrender of Older Adult Drivers' Licences in Super-Aged Japan.

Previously, we identified eight effective consultation skills to support decision-making in the voluntary surrender of older adult drivers' licences in super-aged Japan. This study aimed to clarify the transferability of these skills. We collected text data by interviewing 11 safe-driving counsellors (four police officers, four clerical staff and three nurses) in the License Division of the National Police Agency from February to March 2022. Interviews were semi-structured and conducted by telephone or email. During the interview, participants were asked to recall their experiences as counsellors providing decision-making support to older drivers and to compare their experiences with the eight consultation skills. We analysed the content of the responses by quantitative text analysis with KH Coder 3 software. As a characteristic of the words and phrases used by counsellors in their narratives about consultation skills, the most frequently extracted words from among 3147 words were think, parties and family, and promote had the highest mediation centrality. The eight subgraphs were 'Respecting the will of relevant parties from their standpoint is natural', 'Listening attentively and empathetically to relevant parties is effective', 'Presenting objective data to guide decisions is successful', 'Showing cognitive functioning test results is often effective', 'Counselors with medical expertise can elicit positive counseling outcomes', 'Intervention by medical or police counselors facilitates the decision to surrender voluntarily', 'Counseling skills need to be improved' and 'A diagram of the 8 skills is helpful for inexperienced counselors'. The results suggest that the eight consultation skills have similarities and are transferable. This transferability might contribute to practical application or cohort follow-up study research. These skills can be incorporated into counsellor training, and counsellors can be expected to use these skills in the future. Regardless of the safe-driving counsellor's years of experience, the skills can help them provide uniform and accurate support in decision-making regarding the voluntary surrender of older adult drivers' licences. These skills are a promising approach to help older adults lead safe and secure lives as they age.

Implementation of Project-Based Learning Computational Thinking Models in Mobile Programming Courses

This study focuses on investigating the integration of project-based learning with computational thinking (PjBL-CT) skills to enhance students’ proficiency in learning mobile programming. The findings of the model provide an evaluation of cognitive aspects, affective aspects in the form of 4C soft skills, and psychomotor aspects. To measure the effectiveness of the model, we will test the differences in the quality of student learning outcomes between two groups: the control group and the experimental group. The cognitive test results showed a value of 80.85 for the experimental class and 73.21 for the control class. For the assessment of soft skill 4C, student creativity aspects are superior to other aspects. Whereas for aspects of enhancing the project’s value, an important finding from the results obtained is the significant improvement in the quality of learning by incorporating computational thinking into the problem-based learning (PBL) model.

Associations Between Midlife Anticholinergic Medication Use and Subsequent Cognitive Decline: A British Birth Cohort Study.

Anticholinergic medication use is associated with cognitive decline and incident dementia. Our study, a prospective birthcohortanalysis, aimed to determine if repeated exposure to anticholinergic medicationswas associated with greater decline, and whether decline was reversed with medication reduction. From the Medical Research Council (MRC) National Survey of Health and Development, a British birth cohort with all participants born in a single week of March 1946, we quantified anticholinergic exposure between ages 53 and 69 years using the Anticholinergic Cognitive Burden Scale (ACBS). We used multinomial regression to estimate associations with global cognition, quantified bythe Addenbrooke's Cognitive Examination, 3rd Edition (ACE-III). Longitudinal associations between ACBS and cognitive test results (Verbal memory quantifiedby theWord Learning Test [WLT], and processing speed quantified by theTimed Letter Search Task [TLST]) at three time points (age 53, 60-64 and 69) were assessed using mixed and fixed effects linear regression models. Analyses were adjusted for sex, childhood cognition, education, chronic disease count and severity, and mental health symptoms. Anticholinergic exposure was associated cross-sectionally with lower ACE-III scores at age 69, with the greatest effects in those with high exposure at ages 60-64 (mean difference - 2.34, 95% confidence interval [CI] - 3.51 to - 1.17). Longitudinally, both mild-moderate and high ACBS scores were linked to lower WLT scores, again with high exposure showing larger effects (mean difference with contemporaneous exposure - 0.90, 95% CI - 1.63 to - 0.17; mean difference with lagged exposure - 1.53, 95% CI - 2.43 to - 0.64). Associations remained in fixed effects models (mean difference with contemporaneous exposure -1.78, 95% CI -2.85 to - 0.71; mean difference with lagged exposure - 2.23, 95% CI - 3.33 to - 1.13). Associations with TLST were noted only in isolated contemporaneous exposure (mean difference - 13.14, 95% CI - 19.04 to - 7.23; p<0.01). Anticholinergic exposure throughout mid and later life was associated with lower cognitive function. Reduced processing speed was associated only with contemporaneous anticholinergic medication use, and not historical use. Associations with lower verbal recall were evident with both historical and contemporaneous use of anticholinergic medication, and associations with historical use persisted in individuals even when their anticholinergic medication use decreased over the course of the study.

Association between plasma long-chain polyunsaturated n-3 fatty acids concentrations and cognitive function: findings from NHANES III.

With increased life expectancy, cognitive decline has emerged as a prevalent neurodegenerative disorder. This study aimed to examine the correlation between concentrations of Plasma long-chain n-3 polyunsaturated fatty acids (LCPUFAs) and cognitive performance in elderly Americans. Data were analyzed from older adults enrolled in two NHANES cycles. Participants completed four cognitive assessments, including the Immediate Recall Test (IRT), Delayed Recall Test (DRT), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). Linear regression and restricted cubic spline modeling examined associations between plasma LCPUFAs levels and cognitive test outcomes. The cohort included 610 adults aged 69 years on average, 300 (49.2%) males and 310 (50.8%) females. The median LCPUFAs concentration was 309.4 μmol/L, with an interquartile range of 244.7-418.9 μmol/L. In unadjusted and adjusted generalized linear regression model analyses, circulating LCPUFAs exhibited significant positive correlations with DRT performance. No relationships were detected among those with chronic conditions (chronic heart failure, stroke, diabetes). A significant association between LCPUFAs levels and DRT scores was evident in males but not females. Plasma LCPUFAs concentrations were significantly associated with DRT performance in males free of chronic illnesses, including heart failure, stroke, and diabetes.

The relationship between thermal comfort, performance, and electroencephalogram during cognitive tests at normal indoor temperatures in summer

Electroencephalograms have been proposed as potential physiological indicators to gauge the thermal comfort and cognitive performance of individuals in indoor environments, yet further experimental validation is required. In this study, a simulated experiment was conducted in a climatic room during summer, with temperatures set at 24 °C, 26 °C, 28 °C, 30 °C, and 32 °C. Twenty participants, attired in typical summer clothing (short sleeves and long pants totaling 0.39 clo), undertook cognitive tests assessing short-term memory and concentration while seated, alongside providing thermal comfort ratings. Electroencephalogram signals were continuously recorded from 14 electrode channels across the brain during the second cognitive test unit, spanning the 70th to 90th minute of experimental exposure. The relative power of electroencephalogram signals was computed and analyzed in conjunction with thermal comfort voting, revealing a significant impact of indoor temperature variations on α-band activity in the occipital lobe, with peak α-band relative power observed at 26 °C. Moreover, the whole-brain α-band relative power was significantly higher in states of thermal comfort compared to discomfort, particularly concentrated in the occipital lobe. Linear correlation analysis between cognitive test results and electroencephalogram signals indicated significant associations between the relative power of whole-brain β, δ, and θ bands and scores from the concentration-focused Flanker test. Channels O1 and P8 emerged as potential candidates for single-channel electroencephalogram signals, offering insights into thermal comfort status and cognitive performance related to concentration.