Rey Auditory Verbal Learning Test Research Articles

Exploring the Effect of Single-Session Transcranial Direct Current Stimulation on Attention, Verbal Fluency, and Working Memory in Patients With Alzheimer's Disease-Related Dementia

Objectives Alzheimer's disease (AD) is a leading cause of morbidity and mortality among the elderly. Transcranial direct current stimulation (tDCS) applies low-intensity currents to the brain, resulting in short-term neurocognitive effects and long-term neuroplasticity enhancement. Limited research reported on the impact of tDCS on cognitive functions in dementia due to AD. This study aims to compare changes in verbal fluency and working memory following a single tDCS application to the left dorsolateral prefrontal cortex (DLPFC) in AD patients. Methods Patients with mild dementia due to AD underwent cognitive assessment using the Standardized Mini-Mental Test, Clock Drawing Test, Rey Auditory Verbal Learning Test, Functional Activities Questionnaire, Informant Questionnaire on Cognitive Decline in the Elderly, and Montreal Cognitive Assessment Scale. A single-session tDCS was administered by applying anodal tDCS to the left DLPFC for a duration of 30 minutes. Verbal fluency and working memory were evaluated before and after tDCS using the WAIS-R Digit Span Test forward and backward subscales, Trail Making Test (TMT) A and B, and Verbal Fluency Test. Results Regarding cognitive test scores before and after tDCS application, there were statistically significant reductions in the durations of TMT-A and TMT-B. However, there were no significant differences observed for TMT B-A, VFT, DST-forward, and DST-backward performances. Conclusions The findings indicate that a single anodal tDCS targeting the left DLPFC enhances attention and processing speed in AD patients but has no effect on working memory or verbal fluency.

A parallel-group randomized controlled trial of blue light versus red light for improving sleep, fatigue, and cognition following stroke: Pilot results and recommendations for further study

BackgroundDisordered sleep and fatigue are common in the acute phase of stroke and can impede recovery. ObjectiveA randomized parallel group placebo-controlled pilot study compared daily morning exposure to blue light or red light (placebo) for improving daytime sleepiness, fatigue, nocturnal sleep, and cognition in patients receiving inpatient rehabilitation for acute stroke. Methods43 patients with disordered sleep secondary to first episode stroke (n = 34 ischemic, n = 9 hemorrhagic; aged 66.2 ± 14.1 years) were randomized to receive 25 min of blue or red light for 5 or more days depending on inpatient rehabilitation length of stay (blue-light n = 21, red-light n = 22). At baseline and study discharge, daytime sleepiness was measured with the Karolinska Sleepiness Scale and Wits Pictorial Sleepiness Scale, fatigue with a visual analogue scale, and cognitive function with the Rey Auditory Verbal Learning Test and Trail Making Test (TMT). Wrist actigraphs measured nocturnal sleep parameters. Effect sizes were used to estimate sample sizes for larger studies. ResultsBlue light exposure led to significant improvements in daytime sleepiness, fatigue, auditory verbal learning, and time to sleep onset (all p < .05) relative to red light exposure (effect size range 0.75 to 1.83). Change in TMT, minutes of nocturnal sleep, and number of awakenings after sleep onset were not statistically significant (effect sizes range 0.38 to 0.57). ConclusionMorning blue light exposure for 5 or more days after acute stroke led to greater improvements than red light exposure. Effect sizes suggest a larger study is warranted to confirm generalizability of pilot findings.Trial Registration:ClinicalTrials.govNCT03125967 (Registered 01/01/2017).

Investigating Sensitivity to Auditory Cognition in Listening Effort Assessments: A Simultaneous EEG and Pupillometry Study.

It is still not fully explained what kind of cognitive sources the methods used in the assessment of listening effort are more sensitive to and how these measurement results are related to each other. The aim of the study is to ascertain which neural resources crucial for listening effort are most sensitive to objective measurement methods using differently degraded speech stimuli. A total of 49 individuals between the ages of 19 and 34 with normal hearing participated in the study. In the first stage, simultaneous pupillometry, electroencephalogram (EEG), and single-task paradigm reaction time (RT) measurements were made during the challenging listening and repetition task with noise-vocoded speech. Two speech reception thresholds (SRT) (50% and 80%) for two vocoding conditions (16 and 6 channels) were collected, resulting in 4 conditions. In the second stage, the Rey Auditory Verbal Learning Test (RAVLT) and the test of attention in listening (TAIL) were applied. Stepwise linear regression analyses were conducted to examine the predictors of listening effort measurements. A significant difference was found between 6 and 16 channel stimuli in both pupil dilation change and EEG alpha band power change. In the hardest listening condition, whereas RAVLT scores are significant predictors of pupil dilation change, TAIL scores are significant predictors of EEG alpha power. As the stimulus difficulty decreased, the factors that predicted both EEG and pupillometry results decreased. In the single-task paradigm, a significant regression model could not be obtained at all four difficulty levels. As a result of the study, it was found that the pupil dilation change was more sensitive to auditory memory skills and the EEG alpha power change was more sensitive to auditory attention skills. To our knowledge, this study is the first to investigate the sensitivity of different listening effort measurement methods to auditory cognitive skills.

Effects of video game immersion and task interference on cognitive performance: a study on immediate and delayed recall and recognition accuracy.

This study investigates the cognitive impacts of video game immersion and task interference on immediate and delayed recall as well as recognition tasks. We enrolled 160 subjects aged 18 to 29, who were regular players of "shoot-em-up" video games for at least 3 years. Participants were assigned to one of three experimental groups or a control group. The experimental conditions varied in the timing and type of tasks: the first group performed a video game session between recall tasks, the second group multitasked with video games and recall tasks simultaneously, and the third group engaged in task switching from video games to recall tasks. Using the Rey Auditory Verbal Learning Test, we measured the effects of these conditions on cognitive performance, focusing on error types and recall accuracy. Results indicated that multitasking and task switching significantly affected the subjects' performance, with notable decrements in recall and recognition accuracy in conditions of high task interference. The study highlights the cognitive costs associated with multitasking in immersive digital games and provides insights into how task similarity and interference might increase error rates and affect memory performance.

Psychosocial Impact of the COVID-19 Pandemic on Older Adults With and Without Cognitive Impairment: A Cross-Sectional Study

Objectives1) To develop and test the validity of the Psychosocial Pandemic Impact Scale (PPIS); 2) test associations between PPIS scores and demographics/cognitive performance in older adults; 3) answer whether the PPIS scores would differ between cognitively healthy (HOA) or mildly impaired older adults (MCI), and between those assessed before and after vaccines were available in Brazil. DesignCross-sectional study. SettingCommunity-dwelling older adults registered to participate in a remote randomized clinical trial of computerized cognitive training were assessed online during the COVID-19 pandemic in Brazil. ParticipantsA sample of 181 older adults (>60 years) was used for the PPIS psychometric analysis, from which 120 who completed baseline cognitive, quality of life, and mood assessments were included in the group comparisons and correlational analysis. MeasurementsThe psychosocial pandemic impact scale (PPIS); The Montreal Cognitive Assessment (MoCA; used as a brief screening tool); The verbal fluency test (to assess executive function) and the Verbal memory and learning with the Portuguese version of the rey auditory verbal learning test (RAVLT); The geriatric anxiety inventory (GAI); The Geriatric Depression Scale - Short Form (GDS); The WHOQOL-BREF and WHOQOL-OLD quality of life questionnaires; The Katz and Lawton scales and the Activities of Daily Living Questionnaire (ADLQ) to measure daily function. ResultsThe PPIS demonstrated good internal consistency (α = .84) and sampling adequacy (MSA= .85) and was significantly associated with validated measures of anxiety and depression (GAI: ρ = 0.49, p< 0.001; GDS: ρ = 0.48, p = 0.006) and quality of life (WHOQOL-Bref: ρ = -0.46, p< 0.001; WHOQOL-Old: ρ = -0.24, p = 0.03), confirming construct validity and scale reliability. HOA who were female and had more years of education and those with MCI who were younger and had better memory reported higher PPIS scores. One-way ANOVAs including age and education as covariates revealed that people with MCI reported higher PPIS scores than HOA before vaccination (p = 0.01), but not after. While HOA assessed before and after vaccines were available showed similar PPIS scores, those with MCI assessed after had a trend towards lower scores than those assessed before (p = 0.06). ConclusionsOur study provides a reliable instrument for assessing older adults' psychosocial pandemic impact and shows that people with MCI might be more vulnerable to such effects—which are mediated by memory performance, age, education, and gender. This data can help clinicians to identify and propose interventions targeting vulnerable populations during public health emergencies.

Memory compromise at extended delays in people with new-onset epilepsy.

Memory is one of the most sensitive markers of cognitive compromise in people with new-onset epilepsy. Nonetheless, around half of these cases score within the normal range on standard memory testing. Here we explore whether memory retention at a 1-week delay reveals otherwise undetected memory compromise in such individuals, and how it relates to subjective memory complaints and mood. Using a prospective design, 38 adults with new-onset epilepsy underwent baseline memory screening via telephone using an abbreviated Rey Auditory Verbal Learning Test (RAVLT). Psychological screening occurred via online questionnaires. One week later, without forewarning, participants completed three follow-up memory tasks. Of particular focus, we explored longer-term memory performances and forgetting trajectories in those individuals (n = 23) who demonstrated normal memory performances (scores >10th percentile) at baseline (30-min delay). Outcomes were compared to 32 healthy controls, matched for age, sex, and education. As a group, people with epilepsy performed worse than controls on all memory measures, with 44 percent impaired at baseline testing. Of those unimpaired at baseline, the rate and volume of information loss over 1 week was significantly greater than for controls. Contextual memory performance at 1 week was also significantly poorer for people with epilepsy. At the individual level, the prevalence of impaired forgetting was not significantly different between patients and controls. Subjective memory complaints were not related to any objective tests but were strongly related to self-reported mood and anxiety symptoms. People with new-onset epilepsy show reduced memory at short and extended intervals. For those showing normal memory at baseline, information does appear to be forgotten more quickly than in healthy controls, though the effect is not large. The findings indicate that while extended delay memory testing is not essential in all new epilepsy cases, it could provide useful information for particular individuals. Memory problems are common in people with epilepsy shortly after seizure onset, however, many individuals still show normal memory performances on standard neuropsychological testing. Through testing memory at an extended timepoint (1 week), our study found that on average, these individuals showed a slightly quicker rate of forgetting over a 1-week period than people without a brain condition. Self-reported memory complaints in people with new epilepsy were unrelated to their actual memory skills on testing at short and long timepoints but were rather linked to lower mood and quality of life.

Association of systolic blood pressure variability with cognitive decline in type 2 diabetes: A post hoc analysis of a randomized clinical trial.

We aimed to explore the association between visit-to-visit systolic blood pressure variability (BPV) and cognitive function in individuals with type 2 diabetes. We performed a post hoc analysis of the Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD-MIND) substudy. A total of 2867 diabetes patients with ≥3 BP measurements between the 4- and 20-month visits were included. Visit-to-visit systolic BPV was calculated. Cognitive decline was defined as a Mini-Mental State Exam (MMSE), Digit Symbol Substitution Test (DSST), or Rey Auditory Verbal Learning Test (RAVLT) score greater than 1 standard deviation (SD) below the baseline mean, or a Stroop test score more than 1 SD above the baseline mean. The associations of systolic BPV with risks of cognitive decline were examined using Cox proportional hazards models, and with changes in brain magnetic resonance imaging parameters were evaluated using mixed models. The risk of cognitive decline defined by the DSST score (but not by other scores) increased significantly with systolic BPV quartiles (p for trend = 0.008), and there was a 55% increased risk for BPV quartile 4 versus quartile 1 (hazard ratio = 1.55, 95% confidence interval 1.10-2.19). Furthermore, a positive correlation was observed between systolic BPV and change in white matter lesion volume (β = 0.07, 95% CI 0.01-0.13). A greater visit-to-visit systolic BPV was significantly associated with an increased risk of cognitive decline measured by DSST and an increase in white matter lesion volume in patients with type 2 diabetes.

Analyzing the relationship between processing speed impairment and Rey-15 item test performance

ABSTRACT Objective This study investigated the relationship between processing speed impairment severity and performance on the Rey 15-Item Test (RFIT) and RFIT + Recognition. Method Cross-sectional data from 285 examinees (228 valid/57 invalid) referred for neuropsychological assessment who were administered the RFIT, Weschler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Processing Speed Index (PSI), Brief Visuospatial Memory Test – Revised, Rey Auditory Verbal Learning Test, and three independent criterion PVTs were included. PSI bands were operationalized as Intact (≥85SS; n = 163), Reduced/Possibly Impaired (77-84SS; n = 36), or Impaired (≤76 SS; n = 29). Receiver operator characteristic (ROC) curve analyses tested the RFIT and RFIT + Recognition’s classification accuracy for detecting invalid performance for the overall sample and by PSI impairment status. Results Those with intact processing speed performed significantly better on the RFIT and RFIT + Recognition than those with reduced/possibly impaired and impaired processing speed. Though verbal/visual memory predicted RFIT scores independently, PSI contributed additional variance. ROC curves for RFIT and RFIT + Recognition were significant (AUC=.64-.84). Optimal cut-scores yielded modest sensitivity (30%-63%) and high specificity (89%-93%) among those with intact and reduced processing speed but yielded unacceptable accuracy in those with impaired speed (AUC=.59-.62). Conclusions Although the RFIT and RFIT + Recognition demonstrated acceptable classification accuracy in those with intact processing speed, accuracy diminished with increasing speed impairment. This finding was more pronounced for RFIT + Recognition compared to the traditional RFIT. As such, the RFIT may have limited clinical utility in examinees with more significant processing speed deficits.

Plasma biomarkers in chronic single moderate-severe traumatic brain injury.

Blood biomarkers are an emerging diagnostic and prognostic tool that reflect a range of neuropathological processes following traumatic brain injury (TBI). Their effectiveness in identifying long-term neuropathological processes after TBI is unclear. Studying biomarkers in the chronic phase is vital because elevated levels in TBI might result from distinct neuropathological mechanisms during acute and chronic phases. Here, we examine plasma biomarkers in the chronic period following TBI and their association with amyloid and tau PET, white matter microarchitecture, brain age and cognition. We recruited participants ≥40 years of age who had suffered a single moderate-severe TBI ≥10 years previously between January 2018 and March 2021. We measured plasma biomarkers using single molecule array technology [ubiquitin C-terminal hydrolase L1 (UCH-L1), neurofilament light (NfL), tau, glial fibrillary acidic protein (GFAP) and phosphorylated tau (P-tau181)]; PET tracers to measure amyloid-β (18F-NAV4694) and tau neurofibrillary tangles (18F-MK6240); MRI to assess white matter microstructure and brain age; and the Rey Auditory Verbal Learning Test to measure verbal-episodic memory. A total of 90 post-TBI participants (73% male; mean = 58.2 years) were recruited on average 22 years (range = 10-33 years) post-injury, and 32 non-TBI control participants (66% male; mean = 57.9 years) were recruited. Plasma UCH-L1 levels were 67% higher {exp(b) = 1.67, P = 0.018, adjusted P = 0.044, 95% confidence interval (CI) [10% to 155%], area under the curve = 0.616} and P-tau181 were 27% higher {exp(b) = 1.24, P = 0.011, adjusted P = 0.044, 95% CI [5% to 46%], area under the curve = 0.632} in TBI participants compared with controls. Amyloid and tau PET were not elevated in TBI participants. Higher concentrations of plasma P-tau181, UCH-L1, GFAP and NfL were significantly associated with worse white matter microstructure but not brain age in TBI participants. For TBI participants, poorer verbal-episodic memory was associated with higher concentration of P-tau181 {short delay: b = -2.17, SE = 1.06, P = 0.043, 95% CI [-4.28, -0.07]; long delay: bP-tau = -2.56, SE = 1.08, P = 0.020, 95% CI [-4.71, -0.41]}, tau {immediate memory: bTau = -6.22, SE = 2.47, P = 0.014, 95% CI [-11.14, -1.30]} and UCH-L1 {immediate memory: bUCH-L1 = -2.14, SE = 1.07, P = 0.048, 95% CI [-4.26, -0.01]}, but was not associated with functional outcome. Elevated plasma markers related to neuronal damage and accumulation of phosphorylated tau suggest the presence of ongoing neuropathology in the chronic phase following a single moderate-severe TBI. Plasma biomarkers were associated with measures of microstructural brain disruption on MRI and disordered cognition, further highlighting their utility as potential objective tools to monitor evolving neuropathology post-TBI.

Hypoxemia during rapid eye movement sleep mediates memory impairment in older adults at risk for dementia via CA1 hippocampal volume loss.

Obstructive sleep apnea is associated with increased dementia risk. Nocturnal hypoxemia, which can be more severe during rapid eye movement (REM) sleep, may be a key mechanism. This study examines how REM hypoxemia affects memory and explores whether hippocampal vulnerability to hypoxemia mediates this effect in older adults at risk for dementia. Older adults aged ≥50 years (N = 338) with subjective or mild cognitive impairment (i.e., objective impairment) underwent neuropsychological, mood, and medical assessment, magnetic resonance imaging scanning (n = 135), and overnight polysomnography. Verbal learning and memory were assessed with the Rey Auditory Verbal Learning Test. REM sleep hypoxemia was measured using the Oxygen Desaturation Index-3% (REM-ODI). Hippocampal subfield (CA1, CA3, subiculum, and dentate gyrus) volumes were derived from T1 and high-resolution hippocampus T2 scans. We determined whether the relationship between REM-ODI and learning and memory was mediated by hippocampal subfield volume. Analyses were repeated in non-REM sleep to determine whether the effects were REM-specific. Although there was not a direct effect of REM-ODI on verbal learning (p > 0.05) or memory (p > 0.05), mediation analyses showed a significant indirect effect of high REM-ODI on poorer verbal learning (β = -0.09, 95% confidence interval [CI] = -0.238 to -0.005) and memory (β = -0.100, 95% CI = -0.255 to -0.005), which was mediated by CA1 volume. These associations were absent in non-REM sleep (p > 0.05). Hypoxemia during REM sleep may impair memory in people at risk for dementia by reducing CA1 hippocampal volume. Research is needed to explore whether interventions targeting REM sleep hypoxemia are protective against memory decline.

Detecting malingered neurocognitive dysfunction: Comparative analysis of freestanding and embedded performance validity tests

Detecting malingered neurocognitive dysfunction is a major issue in forensic context, particularly in legal proceeding/insurance assessment after a traumatic brain injury (TBI), condition frequently associated with persistent cognitive impairments that may potentially be related to malingering. Consequently, research has devoted considerable efforts on developing tools to verify symptoms authenticity. This study compared two freestanding performance validity tests (PVTs) (Amsterdam Short-Term Memory Test—ASTM; Word Completion Memory Test—WCMT) and five embedded PVTs (Rey Complex Figure Test—RCFT—Copy and Recall trials; Reliable Digit Span—RDS; Rey Auditory Verbal Learning Test—RAVLT—Recognition and Total Learning trials) in a sample of 120 participants, including 15 patients with TBI (Mage = 44.40), 52 experimental simulators (Mage = 29.52) and 53 control (Mage = 29.77). Group performance was analyzed to assess tests’ discriminatory power, and Receiver Operating Characteristic (ROC) curves were used to examine tools’ sensitivity and specificity. Results indicated that experimental simulators performance on the ASTM, WCMT, and RAVLT differed significantly from TBI patients and controls. The RDS and RCFT did not discriminate experimental simulators from TBI group. ROC curves analysis reveals that the most accurate tests in this battery for detecting malingering were the ASTM and the RAVLT-Total Learning score. This study offers implications for identifying malingering in medico-legal settings, underscoring the importance of incorporating PVTs into clinical practice.

Assessment of verbal memory in Parkinson's disease utilizing a virtual reality-based Rey Auditory Verbal Learning Test

The Rey Auditory Verbal Learning Test (RAVLT) is a commonly used tool for evaluating verbal learning and memory in neuropsychological assessments. In recent years, we developed a Virtual Reality (VR) adaptation of the RAVLT (VR-RVLT), aiming for increased ecological validity compared to the traditional pen and paper gold standard (GS-RAVLT). Following validation in healthy cohorts, the VR-RAVLT was validated with thirty individuals with Parkinson's Disease (PD) that completed both the GS-RAVLT and the VR- RAVLT. Validity of the VR-RAVLT was evaluated by assessing its construct and discriminant validity, and test–retest reliability, in comparison to the GS-RAVLT. Results of the PD participants were compared to those of 46 previously recruited healthy participants with comparable age and level of education. Main outcome measures derived from the remembered items on the test lists, exhibited significant and comparable correlations between VR-RAVLT and GS-RAVLT, both among healthy participants and PD participants. Likewise, serial position effects were similar for both formats amog the PD participants. Additionally, both formats showed similar discriminatory ability between healthy controls and PD participants, as well as comparable test–retest reliability measures. Taken together, the results suggest that the VR-based RAVLT is equally effective in measuring verbal memory capabilities in individuals with PD as compared to the GS-RAVLT. Certain results indicate that the virtual reality version has the capability to encompass additional factors that might impact memory performance, thereby suggesting an enhanced ecological validity.

A new test for evaluation of marginal cognitive function deficits in idiopathic normal pressure hydrocephalus through expressing texture recognition by sound symbolic words.

The number of dementia patients is increasing with population aging. Preclinical detection of dementia in patients is essential for access to adequate treatment. In previous studies, dementia patients showed texture recognition difficulties. Onomatopoeia or sound symbolic words (SSW) are intuitively associated with texture impressions and are less likely to be affected by aphasia and description of material perception can be easily obtained. In this study, we aimed to create a test of texture recognition ability expressed by SSW to detect the presence of mild cognitive disorders. The sound symbolic words texture recognition test (SSWTRT) is constructed from 12 close-up photos of various materials and participants were to choose the best SSW out of 8 choices to describe surface texture in the images in Japanese. All 102 participants seen in Juntendo University Hospital from January to August 2023 had a diagnosis of possible iNPH (age mean 77.9, SD 6.7). The answers were scored on a comprehensive scale of 0 to 1. Neuropsychological assessments included MMSE, FAB, and the Rey Auditory Verbal Learning Test (RAVLT), Pegboard Test, and Stroop Test from the EU-iNPH Grading Scale (GS). In study 1 the correlation between SSWTRT and the neuropsychological tests were analyzed. In study 2, participants were divided into two groups: the Normal Cognition group (Group A, n = 37) with MMSE scores of 28 points or above, and the Mild Cognitive Impairment group (Group B, n = 50) with scores ranging from 22 to 27 points, and its predictability were analyzed. In study 1, the total SSWTRT score had a moderate correlation with the neuropsychological test results. In study 2, there were significant differences in the SSWTRT scores between groups A and B. ROC analysis results showed that the SSWTR test was able to predict the difference between the normal and mildly impaired cognition groups. The developed SSWTRT reflects the assessment results of neuropsychological tests in cognitive deterioration and was able to detect early cognitive deficits. This test not only relates to visual perception but is likely to have an association with verbal fluency and memory ability, which are frontal lobe functions.

Fixel-based and tensor-derived white matter abnormalities in relation to memory impairment and neurocognitive disorders.

Aging-related neurocognitive disorders, including Alzheimer's disease (AD) and mild cognitive impairment (MCI), have been characterised by altered brain white matter (WM), relying widely on diffusion tensor imaging (DTI). DTI's limited accuracy in assessing crossing fibres prompted novel methods that distinguish fibres crossing through same voxel-spaces, such as fixel-based analysis (FBA), highlighting subtle macrostructural and microstructural alterations in AD and MCI. We examined the FBA and DTI's specificity in determining WM features relevant to memory in the neurocognitive aging spectrum. Diffusion-weighted images were analysed in 560 participants with various neurocognitive diagnoses from the Alzheimer's Disease Neuroimaging Initiative (F:297; mean age: 73.2 ± 8). Verbal memory was measured in 488 participants using the Rey Auditory Verbal Learning Test. FBA-derived measures of fibre density (FD), fibre-bundle cross-section (FC), and their combination (FDC), DTI fractional anisotropy (FA) and mean diffusivity (MD) were examined in relation to diagnoses and memory scores, controlling for age, sex, and intracranial volume. MCI and AD groups significantly differed from controls, with lower FD and FDC in the fornix and bilateral fibres extending to the medial temporal lobes (MTL). Memory was positively associated with FD and FDC in the fornix and MTL fibres, and FC in theanterior commissure (AC). Widespread FA reductions and MD increases were observed in AD and MCI and widely associated with memory. Fixel-wise measures highlight fibre tracts that are altered distinctly at the macroscopic and microscopic level in neurocognitive aging, and reveals structures associated with memory performance that are more specifically located than tensor-derived measures.

A - 108 Changes in Memory and Attention Function Post-COVID-19 Infection in Older Adults with MCI

Abstract Objective Persons with mild cognitive impairment (MCI) are more likely to develop dementia due to pre-existing cognitive impairment. COVID-19 is associated with an increased risk of developing dementia one-year post-infection. The purpose of this study is to explore the impact of COVID-19 infection on memory and attention in an amnestic sample. It was hypothesized that older adults with MCI would have significantly worse cognitive function post-COVID-19 infection. Method The current sample was drawn from a larger study of late life brain health. Our sample consisted of 9 older adults (mean age = 77.89 ± 9.89) with MCI. Participants were predominately White (77.78%) and male (100%). Participants completed the Rey Auditory Verbal Learning Test (RAVLT) at baseline (T1) and 6 months (T2). All participants received the COVID-19 vaccine prior to T1 and contracted COVID-19 between T1 and T2. Paired sample t-tests evaluated cognitive change over time. Results Participants experienced non-significant change on the RAVLT Trial 6 (t = 0.00, p = 0.91), RAVLT Delayed Recall (t = 1.00, p = 0.35), RAVLT Sum Trials 1–5 (t = −1.49, p = 0.18), and RAVLT Trial 1 (t = −0.12, p = 0.91). Conclusions In our sample of older adults with MCI, contracting COVID-19 was not associated with significant worsening of learning, memory, or attention over a 6-month period. These findings suggest that the 6–12-month period post-COVID-19 infection may be a critical window for significant worsening of cognitive function. Future research should directly assess cognitive function in older at-risk groups 6–12 months post-COVID-19 infection.

B - 108 Sleep Disordered Breathing, Cognition, and Anxiety in Young Adults

Abstract Objective Sleep disordered breathing (SDB) describes abnormal breathing during sleep due to upper airway dysfunction. SDB and anxiety are associated and independently affect cognition. The purpose of this study was to examine these associations among young adults in the domains of executive function, attention, working memory (WM), and long-term memory (LTM). Method Bronx students (N = 49, Mage = 19.8 years (SD = 1.30), female = 65%) were recruited via flyers. SDB risk assessment utilized the Berlin Questionnaire. Cognitive assessment included the Modified Rey Auditory Verbal Learning Test, Trail Making Test A and B, Controlled Oral Word Association Test, and the Cogstate computerized battery (Groton Maze Learning Test, Identification Test, One Back Test, Two Back Test, and Groton Maze Learning Test Recall). Anxiety was assessed with the Depression, Anxiety, and Stress Scales. Individuals in the normal/mild ranges were categorized in the low anxiety group, and individuals in the moderate/severe/extremely severe ranges were categorized in the high anxiety group. Results Anxiety symptoms moderated the relationship between SDB risk and WM. For high anxiety individuals, as SDB risk increased, performance on WM measures decreased (F(1,45) = 6.06, p = 0.02, η2 = 0.12). There was a trend for anxiety symptoms to moderate the relationship between SDB risk and LTM – among high anxiety individuals, as SDB risk increased, performance on LTM decreased (F(1,44) = 4.04, p = 0.05, η2 = 0.084). Conclusion For young adults, anxiety symptoms moderated the relationships between SDB and WM and between SDB and LTM, suggesting that mild levels of anxiety may have a beneficial effect on the relationship between SDB and cognition, while more severe anxiety may worsen that relationship.

A - 10 Selective Serotonin Reuptake Inhibitors Do Not Alter HD-tDCS Effects on Episodic Memory in Cognitively Impaired Older Adults

Abstract Objective High-Definition Transcranial Direct Current Stimulation (HD-tDCS) is a potential new intervention for mild cognitive impairment (MCI) and Alzheimer’s Dementia (ad) involving small doses of electrical stimulation. Prior studies suggest potential interactions with Selective Serotonin Reuptake Inhibitors (SSRIs) that could alter HD-tDCS’s effectiveness on cognitive outcomes. This study evaluated if SSRIs altered HD-tDCS response to episodic memory functioning in individuals with MCI and ad. Method Eighteen individuals (M age = 70.5; 27.8% female; 8 stable on SSRIs), 9 with MCI and 9 with ad, underwent ten 20-minute HD-tDCS sessions of 1 milliampere over the medial frontal cortex. Neuropsychological testing assessed learning and delayed recall for visual (Brief Visuospatial Memory Test-Revised) and verbal (Rey Auditory Verbal Learning Test or Hopkins Verbal Learning Test-Revised) episodic memory at baseline and immediately post-treatment. Linear regressions evaluated SSRI use as a predictor of post-treatment episodic memory performance controlling for baseline scores. Results Ten participants demonstrated improvement on at least one measure by 0.5 standard deviation (SD; 5 T-score points), with 5 showing 1 SD improvement. Eleven showed a decline by 0.5 SD on at least one measure, with 7 showing 1 SD decline. SSRI use did not significantly predict better or worse verbal learning (β = −4.285, p = 0.194), verbal delayed recall (β-0.408, p = 0.883), visual learning (β = −2.788, p = 0.405), and visual delayed recall (β = −6.673, p = 0.150) performance post-HD-tDCS. Conclusion Preliminary findings suggest SSRIs may not impact HD-tDCS outcomes in cognitively impaired older adults, specifically for episodic memory. These results may not translate to other neuropsychological domains; however, larger samples are needed for further investigation.

A Novel Score to Predict Individual Risk for Future Alzheimer’s Disease: A Longitudinal Study of the ADNI Cohort

Background: Identifying high-risk individuals with mild cognitive impairment (MCI) who are likely to progress to Alzheimer’s disease (AD) is crucial for early intervention. Objective: This study aimed to develop and validate a novel clinical score for personalized estimation of MCI-to-AD conversion. Methods: The data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) study were analyzed. Two-thirds of the MCI patients were randomly assigned to a training cohort (n = 478), and the remaining one-third formed the validation cohort (n = 239). Multivariable logistic regression was performed to identify factors associated with MCI-to-AD progression within 4 years. A prediction score was developed based on the regression coefficients derived from the logistic model and tested in the validation cohort. Results: A lipidomics-signature was obtained that showed a significant association with disease progression. The MCI conversion scoring system (ranged from 0 to 14 points), consisting of the lipidomics-signature and five other significant variables (Apolipoprotein ɛ4, Rey Auditory Verbal Learning Test immediate and delayed recall, Alzheimer’s Disease Assessment Scale delayed recall test, Functional Activities Questionnaire, and cortical thickness of the AD signature), was constructed. Higher conversion scores were associated with a higher proportion of patients converting to AD. The scoring system demonstrated good discrimination and calibration in both the training cohort (AUC = 0.879, p of Hosmer-Lemeshow test = 0.597) and the validation cohort (AUC = 0.915, p of Hosmer-Lemeshow test = 0.991). The risk classification achieved excellent sensitivity (0.84) and specificity (0.75). Conclusions: The MCI-to-AD conversion score is a reliable tool for predicting the risk of disease progression in individuals with MCI.

Effectiveness of Vortioxetine Treatment on Depression and Cognitive Functions in Patients with Alzheimer's Disease: A 12-Month, Retrospective, Observational Study.

This study aimed to assess the effectiveness of vortioxetine for improving depressive symptoms, cognitive performance, daily and global functioning in patients with Alzheimer's disease (AD) and major depressive disorder (MDD) in real-world clinical practice. We retrospectively identified 46 AD patients who had received treatment for 12 months with vortioxetine. Drug effects were evaluated at baseline, 4, 8, and 12 months. The primary endpoint was change from baseline in the Hamilton Depression Rating Scale (HDRS) and in the Cornell Scale for Depression in Dementia (CSDD) to month 12. Cognitive and daily and global functioning changes were also evaluated. Significant baseline-to-endpoint improvement in depressive symptom severity was observed (p < 0.0001). At month 12, the least-square mean (standard error) change score from baseline was -10.48 (±0.42) on the HDRS and -9.04 (±0.62) on the CSDD. Significant improvements in cognitive performance were observed for the Rey Auditory Verbal Learning Test, the Symbol Digit Modalities Test, the Letter Fluency Test, the Category Fluency Test, and the Trail Making Test-A. Patients also experienced significant improvements in daily and global functioning. Vortioxetine was safe and well tolerated. Patients with AD and MDD receiving vortioxetine showed meaningful improvements in depressive symptoms, cognitive performance, and daily and global functioning over the 12-month treatment period.

Clinical correlates of obstructive sleep apnoea in idiopathic normal pressure hydrocephalus.

The pathogenesis of idiopathic normal pressure hydrocephalus (iNPH) remains controversial. Limited studies have indicated a high prevalence of obstructive sleep apnoea (OSA) amongst iNPH patients. The aim was to investigate the clinical correlates of OSA in iNPH patients. In this cross-sectional observational study, consecutive iNPH patients were prospectively enrolled. Evaluations included the iNPH Rating Scale, the Movement Disorder Society Unified Parkinson's Disease Rating Scale part III, the time and number of steps to walk 10 m, the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, a complete neuropsychological evaluation, 3-T brain MRI, full-night video-polysomnography, tap test and cerebrospinal fluid (CSF) neurodegeneration biomarkers. Fifty-one patients were screened, of whom 38 met the inclusion criteria. Amongst the recruited patients, 19/38 (50%) exhibited OSA, with 12/19 (63.2%) presenting moderate to severe disorder. OSA+ iNPH patients required more time (p = 0.02) and more steps (p = 0.04) to complete the 10-m walking test, had lower scores on the gait subitem of the iNPH Rating Scale (p = 0.04) and demonstrated poorer performance on specific neuropsychological tests (Rey Auditory Verbal Learning Test immediate recall, p = 0.03, and Rey-Osterrieth Complex Figure, p = 0.01). Additionally, OSA+ iNPH patients had higher levels of total tau (p = 0.02) and phospho-tau (p = 0.03) in their CSF but no statistically significant differences in beta-amyloid (1-42) levels compared to OSA- iNPH patients. Obstructive sleep apnoea is highly prevalent in iNPH patients, particularly at moderate to severe levels. OSA is associated with worse motor and cognitive performance in iNPH. The CSF neurodegeneration biomarker profile observed in OSA+ iNPH patients may reflect OSA-induced impairment of cerebral fluid dynamics.