Specific Cognitive Domains Research Articles

Abstract TP106: Cognitive Impairment in Young Adult Ischaemic Stroke Survivors: a Systematic Review And Meta-analysis

Background: Post-stroke cognitive impairment is especially devastating for young adult patients, who are in their most productive years. Despite its significant impact, this remains under-studied in this growing and clinically distinct patient group. Methods: We systematically searched PubMed, Embase, Scopus, and Cochrane CENTRAL for studies including ischemic stroke patients aged 18-50 years from January 2000 to July 2024. This meta-analysis evaluated the pooled prevalence of post-stroke cognitive impairment (CogI) and specific cognitive domains, as well as the associations between baseline characteristics and CogI. Results: A total of 4 studies with 1060 patients were included in this systematic review and meta-analysis. Overall, 35.9% (95% CI 27.2-45.5; Figure 1) of patients experienced post-stroke CogI with a mean follow-up time of 11.7 months (95% CI 8.00-15.4). One study was not included in the meta-analysis of proportions of overall cognition as this information was not available. The prevalence for individual domains was: visuospatial construction (23.1%; 95% CI 14.7-34.4), episodic memory (18.5%; 95% CI 9.7- 32.5), delayed memory (16.0%; 95% CI 13.5-18.9), working memory (18.8%; 95%CI 11.8-28.6), and attention (9.3%; 95%CI 3.2-24.0) with a mean follow-up time of 8.11 months (95% CI 3.50-12.7). Male patients had significantly higher odds of CogI (OR 1.58, 95% CI 1.05-2.38, p=0.030; Figure 2). Hypertension, diabetes mellitus, current smoking and dyslipidaemia were not significantly associated with CogI. Conclusions: A significant proportion of young adult ischemic stroke survivors experience CogI. Longitudinal prospective cohort studies are needed to better characterise the post-stroke cognitive trajectory in this important group of patients.

The effectiveness of real-life cognitive and physical interventions on cognitive functioning in healthy older adults: A systematic review of the effects of education and training duration.

Physical and cognitive interventions are deemed the primary methods of improving cognitive functioning in healthy older adults. However, the effectiveness of these interventions is still debated. This systematic review, synthesised findings from the literature on four different types of interventions: physical activities, cognitive training, cognitive stimulation and a combined intervention. We searched six databases for each intervention category. Findings demonstrated that 65% of the studies across all intervention groups reported improvement in the experimental group following the intervention. Furthermore, memory, executive and global cognitive functions were the most reported improvements post-intervention. Additionally, participants with higher education benefited more from cognitive training (an intervention that targets a specific cognitive domain), while those with lower education gained more following cognitive stimulation (an intervention that targets general domains). Lastly, in sub-types of physical activity, cognitive stimulation and combined category, longer durations (more than 20 sessions) were associated with significant cognitive improvements. Conversely, in cognitive training, having less than 20 sessions led to significant results. Findings indicated an interaction of education and intervention duration with significant outcomes post-intervention. In conclusion, this review demonstrated the importance of intervention type, duration and education in understanding cognitive improvement post-intervention.

Association of post-stroke delirium with short-term trajectories of cognition.

Delirium could increase the risk of cognitive decline. We aimed to determine if changes in cognitive functions shortly after stroke differ between patients with and patients without delirium. We included patients who participated in the Prospective Observational Polish Study on post-stroke delirium and underwent the Montreal Cognitive Assessment (MoCA) at day 1, day 8 and 3months after stroke. Delirium was diagnosed using DSM-5 criteria. We used mixed linear regression models to characterize changes in mean adjusted MoCA scores over time. We included 402 patients (mean age: 68.9 ± 13.3years; mean NIHSS on admission: 6.2 ± 5.5; 48.8% female). Delirium occurred in 18.9% of them. Mean adjusted MoCA scores increased from day 1 to day 8 (20.48 vs 23.34, P<0.001) and then declined from day 8 to month 3 (23.34 vs 22.21, P<0.001). The rate of change in total MoCA scores from day 1 to day 8 (net effect: 0.65, 95%CI: -1.19; 2.49, P=0.489) and from day 8 to month 3 (net effect: -2.43, 95%CI: -4.84; -0.02, P=0.147) did not differ between patients with and patients without delirium. Compared with patients without delirium, those with delirium showed a greater improvement in naming, orientation and attention, accompanied by a worsening in memory from day 1 to day 8. They also experienced a greater decline in attention and orientation, along with a greater improvement in memory from day 8 to 3months. Post-stroke delirium is associated with short-term trajectories of specific cognitive domains, but not with changes in global cognition.

Network models of late life depression symptoms and cognitive impairments across time

Objectives Prevalence of late life depression symptoms is estimated to be up to 29%. For older adults, depression symptoms can constitute both a risk and outcome for cognitive impairment. Understanding how specific depression symptoms and cognitive impairment domains interact over time in older adults is key for prevention, early identification, and treatment. Method Using cross-sectional psychometric network models, this study aimed to explore interactions between late-life depression symptoms and cognitive impairment domains across different time points using data from waves 7–9 of the English Longitudinal Study of Ageing (ELSA). Results Across 3544 participants, ≥65 years of age, with no diagnosed dementia-related disorders, the depression symptom everything was an effort showed high expected influence across all time points. Across two time points, object naming and verbal fluency also showed high expected influence. Self-reported memory demonstrated high bridge centrality connecting depression symptom and cognitive impairment domains. Network centralities differed significantly across time points. Conclusion For older adults, fatigue appears a key depression symptom. Cognitive impairment domains become more influential over time, and perceived memory loss links cognitive impairment to depression symptoms. Practical implications are discussed in relation to targeting depression symptoms and cognitive impairment domains.

Physical activity, cathepsin B, and cognitive health.

Regular physical activity (PA) is beneficial for cognitive health, and cathepsin B (CTSB) - a protease released by skeletal muscle during PA - acts as a potential molecular mediator of this association. PA-induced metabolic and mechanical stress appears to increase plasma/serum CTSB levels. CTSB facilitates neurogenesis and synaptic plasticity in brain regions (e.g., hippocampus and prefrontal cortex) that support performance in specific cognitive domains including memory, learning, and executive function. However, the evidence regarding the role of PA-induced changes in CTSB as a mediator of PA-induced cognitive health in humans is mixed. To guide future research, this article identifies key factors that may explain the observed heterogeneity in the findings from human studies and proposes a PA-CTSB-cognition model.

The Impact of Dialysis Duration on Multidimensional Health Outcomes: A Cross-Sectional Study.

Background: Dialysis patients face multidimensional challenges that affect their quality of life. This study aimed to evaluate the association between dialysis duration and various physical, cognitive, and psychosocial parameters, including fatigue, pain, sexual satisfaction, bowel control, vision, cognitive deficits, mental health, social support, quality of life, and life satisfaction, while incorporating sociodemographic data for greater context. Methods: A cross-sectional study was conducted using validated instruments such as the Modified Fatigue Impact Scale (MFIS), Pain Effect Scale (PES), Sexual Satisfaction Scale (SSS), Bowel Control Scale (BWCS), Impact of Visual Impairment Scale (IVIS), Perceived Deficits Questionnaire (PDQ), Mental Health Inventory (MHI), Modified Social Support Survey (MSSS), WHOQOL-BREF, and Cantril Ladder. Associations between dialysis duration and these parameters were analyzed. Correlations between current and future life satisfaction were also examined. Results: Dialysis duration significantly affected sexual satisfaction, with scores worsening over time (p = 0.029). Cognitive deficits in planning and organization exhibited a near-significant trend (p = 0.072). Patients with low current life satisfaction anticipated significant future declines (p = 0.001). However, no significant associations were observed between dialysis duration and fatigue, pain, bowel control, vision, mental health, social support, overall quality of life, or life satisfaction. Conclusions: Prolonged dialysis negatively influences sexual satisfaction and may impact specific cognitive domains. The relationship between current and expected life satisfaction highlights the importance of addressing psychological health in this population. While other parameters remained unaffected, individualized care strategies focusing on sexual, cognitive, and psychological support could improve outcomes. Future research should focus on exploring these relationships further and developing targeted interventions to address vulnerable areas, such as sexual, cognitive, and psychological health.

Associations between cytokine levels and cognitive function among individuals at clinical high risk for psychosis

ObjectiveTo explore the intricate interplay among cytokines, cognitive functioning, and conversion to psychosis in individuals at clinical high-risk (CHR) for psychosis. MethodWe initially enrolled 385 individuals at CHR and 95 healthy controls (HCs). Subsequently, 102 participants at CHR completed the 1-year follow-up assessments, and 47 participants transitioned to psychosis. We assessed the levels of interleukins (IL-1β, IL-2, IL-6, IL-8, IL-10), tumor necrosis factor-α (TNF-α), granulocyte-macrophage colony-stimulating factor (GM-CSF), and vascular endothelial growth factor (VEGF). We comprehensively evaluated cognitive performance across six domains, including speed of processing (SP), attention/vigilance (AV), working memory (WM), verbal learning (VeL), visual learning (ViL), and reasoning and problem-solving (RPS). ResultsHigher baseline cognitive domain scores were associated with elevated GM-CSF and reduced VEGF levels. In the follow-up analysis, significant time effects were observed for IL-1β and IL-2. We also observed significant interaction effects between specific cognitive domains (AV, WM, VeL, and OCS) and levels of cytokine (GM-CSF, IL-1β, IL-6, and TNF-α). Changes in WM were negatively correlated with changes in TNF-α levels and positively correlated with changes in VEGF levels. Variations in VeL were inversely correlated with changes in GM-CSF and IL-10 levels, whereas changes in RPS were positively associated with changes in GM-CSF and IL-8 levels. ConclusionsOur results revealed intricate associations among cytokine levels, cognitive performance, and psychosis progression.

Health and Financial Literacy and the Acquisition of COVID-19 Knowledge in Older Adults.

Knowledge about COVID-19 enters into many aspects of decision making, especially for older people who are at increased risk of severe disease or death. Yet little is known about the resources that supported older people's uptake of COVID-19 knowledge. Here, we hypothesized that higher pre-pandemic health and financial literacy was associated with higher COVID-19 knowledge. Participants were 434 community-based older people without dementia. COVID-19 knowledge was assessed via a 5-item measure, and health and financial literacy was assessed via a 32-item measure. In an ordinal regression model adjusted for age, gender, and education, higher literacy was associated with higher COVID-19 knowledge (p < .0001), and this association persisted after further adjusting for robust measures of global cognition or one of five specific cognitive domains (all p's ≤ .0001). These findings suggest that literacy plays a key role in supporting older people's acquisition of impactful knowledge in the real world.

Two-Month Cognitive Changes Enhance Prediction of Non-Remission in Clinical High-Risk Individuals.

Longitudinal changes in cognitive function may be crucial in predicting clinical outcomes in clinical high risk (CHR) individuals. This study aims to investigate the predictive value of baseline cognitive impairment and short-term cognitive changes for non-remission and conversion to psychosis in individuals at CHR for psychosis, compared with healthy controls (HC). This study employed a multiple-group prospective design with a 3-year follow-up. CHR individuals and HCs were assessed at baseline and at a 2-month follow-up. Neuropsychological performance was evaluated using the Chinese version of the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery. The study included 310 CHR individuals and 93 HCs. Significant improvements in predicting non-remission in CHR individuals were observed when incorporating cognitive changes over 2 months (AUC for baseline cognition, 0.690; AUC for changes, 0.819; Z=3.365, p<0.001). Key predictors included the Revised Hopkins Verbal Learning Test (HVLT-R; β=0.083, p=0.003), Wechsler Memory Scale-III spatial span (WMS-3; β=0.330, p<0.001), and Revised Brief Visuospatial Memory Test (BVMT-R; β=0.127, p<0.001). Conversely, predicting conversion to psychosis showed no significant difference between baseline and 2-month cognitive changes (AUC for baseline cognition, 0.667; AUC for changes, 0.666; Z=0.021, p=0.242). The findings underscore the importance of dynamic cognitive monitoring in CHR individuals. Short-term cognitive changes significantly enhance the prediction of non-remission but do not add predictive value for conversion to psychosis beyond baseline assessments. Specific cognitive domains, such as verbal learning and working memory, are particularly valuable for predicting clinical outcomes.

The link between eye movements and cognitive function in mild to moderate Alzheimer's disease.

This study investigated the relationship between eye movement parameters and cognitive function in patients with mild to moderate Alzheimer's disease (AD). A total of 80 patients with AD (mild and moderate) and 34 normal controls (NC) participated. Neuropsychological assessments were conducted using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), while eye movements were recorded using eye-tracking technology. Comparisons of neuropsychological scores and eye movement parameters were made across the groups, and partial correlation analysis was performed to examine associations between eye movement metrics and specific cognitive domains. No significant differences were found among the groups in pursuit and fixation tasks. However, in pro-saccade tasks, patients in the moderate AD group exhibited significantly lower accuracy and longer latency compared to those in the mild AD and NC groups. Similarly, in anti-saccade tasks, the moderate AD group showed significantly lower accuracy and error correction rates compared to the other groups. Partial correlation analysis revealed that overall cognitive function was positively associated with the accuracy of pro-saccade and anti-saccade tasks, as well as the error correction rate of anti-saccade tasks, but negatively associated with pro-saccade latency. Further, orientation was negatively correlated with saccade latency and positively correlated with saccade accuracy, while visuospatial skills were positively associated with the accuracy of both saccade and anti-saccade tasks. A positive correlation was also observed between word fluency and both saccade accuracy and error correction rate. These findings indicate that eye movement parameters, particularly those related to saccade and anti-saccade tasks, are associated with various cognitive domains in mild to moderate AD patients. Eye-tracking technology may provide a convenient and non-invasive tool for assessing cognitive function and aiding in the diagnosis and evaluation of AD.

Single High-Frequency Repetitive Transcranial Magnetic Stimulation and Intermittent Theta Pulse Stimulation Promote Working Memory Behavior in Participants: An Event-Related Potential Study

ObjectiveRepetitive transcranial magnetic stimulation (rTMS) to the left dorsolateral prefrontal cortex (L-DLPFC) has an improving effect in cognitive function, but it is still not clear in what specific cognitive domains. We here combined a single session of TMS (HF-rTMS/iTBS) with electroencephalography (EEG) to clarify the effects of magnetic stimulation techniques on executive function, working memory, and visuospatial attention in healthy participants, and to investigate the underlying neurophysiological mechanisms. MethodsFifty-one healthy participants were randomly assigned to three stimulation groups (HF-rTMS, iTBS, and sham groups). Classical psychological paradigms (task-switching, 2-back with visual Oddball) and event-related potentials (ERPs) were performed to compare the behavioral indices of each paradigm before and after the two stimulations, as well as the changes in the ERP components. ResultsAnalysis of behavioral indicators showed that reaction times in the 2-back paradigm were faster after HF-rTMS and iTBS than after sham stimulation. However, no statistically significant differences were observed in the behavioral changes in the task-switching and visual Oddball paradigms. ERP analysis showed that N2 amplitude in the frontal and central regions of the participants increased during the 2-back paradigm following HF-rTMS and iTBS; however, no statistically significant differences were observed between the ERP components of the task-switching and visual Oddball paradigms. ConclusionSingle sessions of HF-rTMS and iTBS on the L-DLPFC specifically enhanced working memory performance, with no significant effects on executive function and visuospatial attention. Both true stimulations elicited more negative N2 in the frontal and central channels during the 2-back paradigm, suggesting increased recruitment of cognitive resources from these brain areas. Although iTBS and HF-rTMS improved working memory behavior, iTBS’s shorter stimulation time suggests it may have greater potential for clinical applications in terms of time-benefit costs.

Review of Associations of Diabetes and Insulin Resistance With Brain Health in Three Harmonised Cohort Studies of Ageing and Dementia.

Diabetes increases the risk of dementia, and insulin resistance (IR) has emerged as a potential unifying feature. Here, we review published findings over the past 2decades on the relation of diabetes and IR to brain health, including those related to cognition and neuropathology, in the Religious Orders Study, the Rush Memory and Aging Project, and the Minority Aging Research Study (ROS/MAP/MARS), three harmonised cohort studies of ageing and dementia at the Rush Alzheimer's Disease Center (RADC). A wide range of participant data, including information on medical conditions such as diabetes and neuropsychological tests, as well as other clinical and laboratory-based data collected annually. Neuropathology data are collected in participants who agree to autopsy at death. Recent studies have measured additional peripheral and brain IR data, including multi-omics. This review summarises findings from the RADC cohort studies that investigate the relation of diabetes and IR in older adults to cognition, neuropathology, omics in dementia, and other brain health measures. Examining the risk of clinically diagnosed dementia in older adults, our study found a 65% increased risk of Alzheimer's disease (AD) dementia in individuals with diabetes compared with those without. Regarding cognitive function, we have consistently observed associations of diabetes, as well as both peripheral and brain IR, with worse and declining performance in global cognition and specific cognitive domains, particularly semantic memory and perceptual speed. Studies utilising neuropathological data showed associations of diabetes and peripheral IR with brain infarcts, while brain IR measures, notably alpha serine/threonine-protein kinase1 (AKT1), were associated with both brain infarcts and AD pathology. Multi-omics studies suggested shared causal genes and pathways between diabetes and dementia. Recent epigenetic studies have revealed associations between IR and AD risk, along with distinct 5-hydroxymethylcytosine signatures in diabetes-associated AD. Furthermore, our studies have utilised other available data to investigate the impact of diabetes on neurological outcomes other than cognition and reported worsening of parkinsonian-like signs in diabetes. Recent studies have also explored risk factors for diabetes and have reported associations between lower literacy and decision-making abilities with elevated haemoglobin A1C levels, a peripheral IR measure. Overall, our findings, as summarised in this review, illustrate a range of mechanistic and other insights into the complex relationship of diabetes and IR with brain health. These findings may have important implications for future research on the ageing brain, including the prevention of cognitive decline and dementia in persons at risk for or with diabetes.

Multi-domain Online Therapeutic Investigation Of Neurocognition (MOTION) - A randomized comparative-effectiveness study of two remotely delivered mind-body interventions for older adults with cognitive decline.

Research suggest that mind-body movement programs have beneficial effects on cognitive outcomes for older adults with cognitive decline. However, few studies have directly compared specific approaches to mind-body movement or studied the impact of remote program delivery. In a 3-arm randomized controlled trial (RCT) for older adults with cognitive impairment, we are comparing a multidomain mind-body program that emphasizes movement, body awareness, personal meaningfulness, and social connection, and a traditional Chinese mind-body exercise (Tai Chi) to a health and wellness education control condition. All 3 interventions are delivered remotely two times per week (onehour per session) for 12weeks. The two active interventions are live-streamed. Outcomes are assessed prior to, after, and 6-months after the interventions. The co-primary outcomes are changes on the Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-cog) and brain functional connectivity in the Default Mode Network (DMN). Secondary outcomes include measures of specific cognitive domains (e.g., executive function, attention), mobility, and self-report measures of general well-being, quality of life, social engagement, self- and attention-regulation. This RCT will directly compare the effects of two mind-body movement programs versus an education control delivered remotely over 12weeks on cognitive, neuroimaging, and participant-reported outcomes. If successful, these programs may provide scalable strategies for slowing cognitive decline, which could potentially delay dementia onset in some individuals. NCT05217849.

DIRECTION MATTERS: THE ASYMMETRICAL EFFECT OF SOCIAL ISOLATION ON COGNITION

Abstract Social isolation poses significant risks to cognitive health in older adults, with isolated individuals facing higher risks of cognitive impairment. However, existing research assumes symmetrical effects of increases and decreases in social isolation. This study examines the impact of changes in social isolation on cognition using data from the National Health and Aging Trends Study (2011-2018). Social isolation was measured using a 4-item scale based on Berkman and Syme’s Social Network Index, and cognition was assessed using a dichotomous classification of dementia (no dementia vs possible or probable dementia) and domain-specific cognitive testing. Fixed-effects models with first differencing and robust standard errors were used to estimate the asymmetrical effects of variations in social isolation on cognition. Increases in social isolation increased the odds of possible or probable dementia (OR=1.13, p =.02), while decreases in isolation did not decrease odds of dementia classification. For specific cognitive domains, increased social isolation predicted decreased recall (β = -0.07, p =.02) but decreased social isolation did not predict increased recall. Both increases and decreases in social isolation were associated with changes in orientation such that decreased social isolation predicted improved orientation (β = 0.06, p &amp;lt;.001), and increased social isolation predicted lower orientation (β = - 0.06, p &amp;lt;.001). Executive function was not predicted by changes in social isolation. These findings highlight the asymmetrical nature of changes in social isolation on cognition. Social isolation primary prevention efforts may yield a greater impact in reducing adverse cognitive outcomes than secondary and tertiary interventions.

Change in transverse relaxation rates (R2) and change in cognition for older African Americans

AbstractDespite transverse relaxation rate (R2) being one of the fundamental contrasts in MRI, most investigations of brain R2 and cognition have been cross‐sectional and conducted in predominantly non‐Latino White adults. We investigated the profile of R2 as related to cognition in 212 older African Americans (~75 years of age) with longitudinal 3T MRI scans and cognitive test data to determine how changes in R2 are associated with changes in cognition. For each participant, the slopes of global cognitive and five cognitive domain scores were each separately combined with voxel‐specific slopes of R2 in whole brain voxelwise analyses. Participants with less negative rates of R2 change within left basal ganglia and centrum semiovale, bilateral hippocampal complex and temporal gyri, parietooccipital white matter, as well as posterior cingulate displayed less negative slopes in global cognition. Similar associations were seen for regional R2 change and episodic memory (most robustly within bilateral hippocampi) as well as semantic memory (left greater than right hemisphere involvement). Results suggest a relatively wide distribution of regional associations between rates of changes in R2 and changes in global cognition for older African Americans; a profile that became more regionally specific when considering individual cognitive domains. Relative preservation of tissue integrity across grey and white matter, and in key regions associated with specific cognitive domains, is associated with slower cognitive decline for older African Americans. These results may lay the foundation for more directed work to support healthy brain aging in older African Americans.

The Role of Fatty Acid Amide Hydrolase, a Key Regulatory Endocannabinoid Enzyme, in Domain-Specific Cognitive Performance in Psychosis.

Cognitive impairments are particularly disabling for patients with a psychotic disorder and often persist despite optimization of antipsychotic treatment. Thus, motivating an extension of the research focus on the endocannabinoid system. The aim of this study was to evaluate group differences in brain fatty acid amid hydrolase (FAAH), an endocannabinoid enzyme between first-episode psychosis (FEP), individuals with clinical high risk (CHR) for psychosis and healthy controls (HCs). Furthermore, to test the hypothesis that FAAH is linked with cognition using positron emission tomography (PET). We analyzed 80 PET scans with the highly selective FAAH radioligand [11C]CURB, including 30 patients with FEP (6 female), 15 CHR (5 female), and 35 HC (19 female). The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Berg Card Sorting Test (BCST) were applied to test cognitive performance. There was no difference in FAAH activity between groups (F2, 75 = 0.75, P = .48; Cohen's f = 0.141; small effect). Overall, there was a difference in the association between groups regarding FAAH activity and the domain visuospatial construction (F2, 72 = 4.67, P = .01; Cohen's f = .36; medium effect). Furthermore, across the sample, lower FAAH activity was associated with a higher percentage of perseverative responses (F1, 66 = 5.06, P = .03; Cohen's f = 0.28, medium effect). We report evidence for associations between endocannabinoid alterations in FEP and CHR with specific domains of cognition (visuospatial construction and perseverative response), not overall cognition.

Cognitive function status and its correlation with blood pressure control in patients with hypertension in China

Objective: To investigate the global cognitive function and the function of specific cognitive domains in hypertensive patients at high risk of cardiovascular disease in China, and to explore the impact of cognition function on blood pressure control. Methods: This is a cross-sectional survey. Data were obtained from the ESPRIT study. Patients with a history of hypertension who participated in the ESPRIT study from September 2019 to July 2020 were selected. Mini-mental state examination (MMSE) was used to evaluate patients' overall cognition and the function of each cognitive domain. According to the total MMSE score, patients were divided into the cognitive-intact group (MMSE total score=30 points), cognitive-declined group (MMSE total score<30 points, but did not reach the dementia screening threshold) and cognitive-impaired group (MMSE total score reached the dementia screening threshold). A multivariable logistic regression model was used to explore the effects of cognitive function and MMSE score on blood pressure control. The years of education were removed from the adjustment variables for sensitivity analysis. The interaction effect modeling of stratified variables and exposed variables was used for hierarchical analysis. Results: A total of 10 834 patients with hypertension at high risk of cardiovascular disease were enrolled, aged 65 (60, 69) years and 4 476 (41.3%) patients were female. There were 989 patients in cognitive-intact group, 8 676 patients in cognitive-declined group and 1 169 patients in cognitive-impaired group. The MMSE score of all included patients was (25.6±3.8) points. In the overall study population, 10.8% (1 169/10 834) of hypertensive patients had cognitive impairment, with an MMSE total score of (18.6±4.1) points. The cognitive domains with obvious impairment were recall memory (-80%), visuospatial function (-64%), attention and computation (-60%); 80.1% (8 676/10 834) of hypertensive patients did not meet the criteria for cognitive dysfunction, but had cognitive decline, and the cognitive domains with significant impairment were recall memory (-51%) and visuospatial structure (-23%). Multivariate logistic regression analysis showed that cognitive dysfunction (OR=0.88, 95%CI: 0.72-1.08, P=0.212) and cognitive decline (OR=0.96, 95%CI: 0.83-1.12,P=0.629) was not correlated with blood pressure control. MMSE total score and scores in each cognitive domain were not correlated with blood pressure control (P>0.05). Sensitivity analysis showed that cognitive function was not related to blood pressure control (all P>0.05). Stratified analysis according to different frequency of medication showed that cognitive function and MMSE score were not correlated with blood pressure control (P>0.05). Conclusion: One in ten hypertensive patients who were at high risk of cardiovascular disease have comorbid cognitive impairment. In patients with high risk of cardiovascular disease, the most affected cognitive domains were recall memory, visuospatial function, attention and calculation. Part of hypertensive patients have not reached the level of cognitive dysfunction, but have begun to show cognitive decline. Cognitive function is not an independent influencing factor on blood pressure control.

Effects of Ketamine and Esketamine on Cognitive Functions in Treatment-Resistant Depression

Major depressive disorder is a public health issue that negatively impacts quality of life and leads to cognitive impairments, causing significant disruptions in work, education, and social life. Treatment-resistant depression is defined as the failure to achieve improvement in depressive symptoms despite the use of at least two different antidepressant medications at adequate doses and durations. Current pharmacological approaches are inadequate for about half of treatment-resistant depression patients, and the effects of these medications on cognitive impairments are limited. Therefore, there is a need for new and effective treatment methods. This review aims to evaluate the effects of ketamine and esketamine on cognitive functions in the treatment of treatment-resistant depression patients. Relevant literature has been reviewed and recent studies have been evaluated. The results of randomized controlled trials indicate that ketamine is effective in treating treatment-resistant depression and can improve specific cognitive domains. Significant improvements in cognitive functions such as visual memory, processing speed, working memory, and attention have been recorded in patients responding to 0.5 mg/kg ketamine infusion. However, long-term use of ketamine may have negative effects on spatial working memory. Esketamine, an NMDA receptor antagonist, has shown rapid and effective antidepressant outcomes, providing stability or improvement in cognitive functions. Additionally, its intranasal administration offers practical advantages. However, findings suggest that high doses of esketamine may have neurotoxic effects and negatively impact cognitive functions. The effects of both drugs on depressive symptoms and cognitive functions vary depending on dose, duration of use, and frequency of administration. In conclusion, while ketamine and esketamine show significant potential in the treatment of treatment-resistant depression and improvement of cognitive symptoms, further research is needed regarding their long-term effects and safety.

The effectiveness of digital technology interventions for cognitive function in older adults: a systematic review and meta-analysis of randomized controlled trials.

Digital technology interventions (DTIs) are seen as promising interventions to prevent or delay cognitive decline in older adults, yet evidence from reviews is not conclusive. The aim of this study is to explore the effectiveness of DTIs in improving older adults' cognitive function while taking study design and intervention characteristics as moderators. We searched the PubMed, Embase, CINAHL, PsycINFO, and Scopus databases up to May 26, 2023. Only randomized controlled trials examined the effects of DTIs on cognitive function were included in our study. Standardized mean difference (SMD) and 95% confidence interval for outcomes were applied in meta-analyses and subgroup analyses. A risk of bias assessment was also conducted. Overall, 23 eligible studies with a total sample size of 1454 participants were included. We found that DTIs significantly improved global cognitive function (SMD = 0.479), attention and processing speed (SMD = 0.488), executive function (SMD = 0.287), immediate recall (SMD = 0.266), and working memory (SMD = 0.307). Our subgroup analyses revealed that DTIs were more effective for cognitively impaired subjects, and DTIs with specific intervention characteristics, such as the inclusion of cognitive standard tasks, virtual reality-based interventions, specialized settings, professional guidance, low/medium-density training, > 24 sessions, and sessions lasting > 30 min, were more effective for different cognitive domains. This study supported the effectiveness of DTIs in improving cognitive function in older adults aged 60 years old and over, which may be influenced by study design and intervention characteristics. These findings have important implications for clinical dementia prevention and treatment strategies targeted at specific cognitive domains.

A review of the association between in vitro fertilization and children's neurocognitive development.

This review investigated the current research on the association between in vitro fertilization and children's neurocognitive development. Twenty studies were analyzed, encompassing over 23,000 children conceived through IVF, and compared to those conceived naturally. The findings on overall cognitive function were mixed, as measured by IQ. Some studies showed no significant differences between IVF and naturally conceived children, while others suggested slight variations. There is emerging evidence that IVF might correlate with specific cognitive domains like language and motor skills, although more research is needed. Several established factors, including maternal age, education level, and birth weight, are associated with children's cognitive development, regardless of conception method. Future research should explore how these factors interact with IVF and investigate a broader range of cognitive domains. Socioeconomic background and parental involvement are essential considerations for understanding a child's developmental trajectory. The inconclusive nature of some findings highlights the need for further research with larger sample sizes, more extended follow-up periods, and robust methodologies. This research has potential implications for parents considering IVF or ICSI, healthcare professionals providing guidance, and future efforts to tailor support systems for children conceived through assisted conception techniques. Open communication about the current state of knowledge and responsible communication of research findings is crucial.