Standardized Cognitive Assessments Research Articles

Impact of Bilingual Education on Students Linguistic Proficiency and Cognitive Development at University Level

This study investigates the impact of bilingual education on university students' linguistic proficiency and cognitive development. The research aims to explore the relationship between bilingual education and students' linguistic abilities while assessing its influence on cognitive functions such as memory, critical thinking, and problem-solving skills. The research hypothesizes that students enrolled in bilingual education programs were demonstrate higher linguistic proficiency and enhanced cognitive development compared to those in monolingual programs. The population consists of university students enrolled in bilingual education programs across various disciplines, with a sample of 200 students selected through stratified random sampling. The study employs a cross-sectional design, utilizing a quantitative research approach. Data collection is conducted through standardized language proficiency tests and cognitive assessment tools, supplemented by structured questionnaires to gather demographic and educational background information. The data were analyzed using descriptive statistics, correlation analysis, and multiple regression techniques to identify significant relationships and impacts. The findings of this study are expected to contribute valuable insights into the effectiveness of bilingual education at the university level, offering implications for curriculum development and educational policy in multilingual contexts.

Speech-related parameters are sensitive measures of acetylcholinesterase inhibitor therapy in mild Alzheimer's disease.

Our aim was to find out whether speech-related temporal parameters (SRTPs) are sensitive indicators of the clinical outcome in acetylcholinesterase (AChE) inhibitor therapy with donepezil, compared to the standard cognitive Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) used in clinical trials. In this 24-week-long, naturalistic, self-control, open-labeled, prospective pilot study with 10 mg donepezil on 20 mild AD patients, cognitive functions were evaluated using 15 different SRTPs analyzed by automatic speech recognition in the Speech-Gap Test® compared to ADAS-Cog test results. Among the SRTPs, the filled pause duration ratio significantly improved after 12 weeks of donepezil treatment. During the 24-week follow-up, additional SRTPs such as the filled pause count ratio and the filled pause frequency showed significant benefits. ADAS-Cog total scores showed a slight but not significant improvement compared to baseline after 12 and 24 weeks of donepezil treatment. Among the ADAS-Cog subtests, only orientation improved significantly after 24 weeks of donepezil treatment. Our results indicate that subtle changes in SRTPs measured by the Speech-Gap Test® could be considered as sensitive indicators of the efficacy of the pharmacotherapy in mild AD. According to our data, other cognitive domains did not show improvement in response to donepezil therapy rating by ADAS-Cog. Based on all of this, it is likely that examining and evaluating speech parameters may play an important role in determining the effects of pharmacological treatment of mild AD. The novelty of our study is that it applies the measurement of linguistic parameters as primary outcomes during a drug trial of mild AD in scientific research for the first time.

Using the RE-AIM and TDF frameworks to evaluate the implementation of a standardized cognitive assessment protocol in outpatient rehabilitation.

Impairments in cognition significantly affect patient functioning and rehabilitation outcomes. Assessment is essential to identifying at-risk individuals and guiding care plans. A cognitive assessment protocol was implemented in occupational therapy (OT) and speech-language pathology (SLP) outpatient practice. Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and Theoretical Domains Framework (TDF), this study (1) measured the reach and adoption of the cognitive assessment protocol and (2) explored determinants and strategies that may affect adoption. Sequential mixed methods. Two outpatient rehabilitation clinics (A and B) within a health care network. Medical records from 220 adult patients with neurologic diagnosis and 15 OT and SLP clinicians. Cognitive assessment protocol. Reach of the assessment protocol across patient characteristics and adoption across clinical sites were measured quantitatively via retrospective electronic medical records review. Qualitative data on effectiveness and the implementation process were collected via clinician focus groups. Protocol adoption rates were 71% and 54% at clinics A and B, respectively. Site B OT was more likely to be noncompliant with protocol adoption compared to Site A, when controlling for patient characteristics, (81% vs. 16%, respectively; odds ratio = 11.4, 95% confidence interval [3.36-38.64], p ≤ .001). Patient age was a significant factor for protocol reach; older age was associated with noncompliance of the SLP protocol adoption, p < .05. Both sites employed implementation strategies targeting the provider level (eg, education/training); Site A additionally included organization-level strategies (eg, leadership engagement). In the absence of organization-level strategies, OT and SLP clinicians at Site B identified barriers related to leadership support, resources, and workflow. Standardized practice protocols are feasible to implement within the rehabilitation setting, though multilevel implementation strategies may be needed to promote adoption. Aligning practices with the needs, values and priorities of the organization, providers, and patients and families is imperative.

Stakeholder-informed pragmatic trial protocol of the TabCAT-BHA for the detection of cognitive impairment in primary care

BackgroundCognitive impairment and dementia are frequently under-recognized. Health system strategies anchored in primary care are essential to address gaps in timely, comprehensive diagnosis. The goal of this paper is to describe the adaptation of a tablet-based brain health assessment (TabCAT-BHA) intervention and the study protocol to test its effectiveness in improving the detection of cognitive impairment, including dementia.MethodsThis mixed-methods, pragmatic, cluster randomized, hybrid effectiveness-implementation trial is being conducted in two 18-month waves with 26 Kaiser Permanente Southern California primary care clinics, with 13 serving as intervention clinics and 13 as usual care clinics. Patients 65 years and older with memory concerns (n ~ 180,000) receiving care at the 26 clinics will be included in the analyses. Primary care clinics are provided the following practice supports as part of the TabCAT-BHA intervention: brief education and training on neurocognitive disorders and study workflows; digital tools to assess cognitive function and support clinician decision making and documentation; and registered nurse support during the work-up and post-diagnosis periods for primary care providers, patients, and families. The intervention was adapted based on engagement with multiple levels of clinical and operational leaders in the healthcare system. Effectiveness outcomes include rates of cognitive impairment diagnosis in primary care and rates of completed standardized cognitive assessments and specialist referrals with incident diagnoses. Implementation outcomes include acceptability-appropriateness-feasibility, adoption, and fidelity.ResultsWe identified seven themes organized by system-, provider-, and patient-level domains that were used to adapt the TabCAT-BHA intervention. Accordingly, changes were made to the provider education, diagnostic work-up, and post-diagnostic support. Results will be reported in fall of 2027.ConclusionsOur engagement with multiple primary and specialty care clinical and operational leaders to adapt the TabCAT-BHA intervention to these primary care clinics has informed the protocol to evaluate the intervention’s effectiveness for improving the detection of cognitive impairment, including dementia, in an integrated healthcare system.Trial RegistationClinicaltrials.gov: NCT06090578 (registered 10/24/23).

The impact of premature birth on auditory-visual processes in very preterm schoolchildren

Interactions between stimuli from different sensory modalities and their integration are central to daily life, contributing to improved perception. Being born prematurely and the subsequent hospitalization can have an impact not only on sensory processes, but also on the manner in which information from different senses is combined—i.e., multisensory processes. Very preterm (VPT) children (<32 weeks gestational age) present impaired multisensory processes in early childhood persisting at least through the age of five. However, it remains largely unknown whether and how these consequences persist into later childhood. Here, we evaluated the integrity of auditory-visual multisensory processes in VPT schoolchildren. VPT children (N = 28; aged 8–10 years) received a standardized cognitive assessment and performed a simple detection task at their routine follow-up appointment. The simple detection task involved pressing a button as quickly as possible upon presentation of an auditory, visual, or simultaneous audio-visual stimulus. Compared to full-term (FT) children (N = 23; aged 6–11 years), reaction times of VPT children were generally slower and more variable, regardless of sensory modality. Nonetheless, both groups exhibited multisensory facilitation on mean reaction times and inter-quartile ranges. There was no evidence that standardized cognitive or clinical measures correlated with multisensory gains of VPT children. However, while gains in FT children exceeded predictions based on probability summation and thus forcibly invoked integrative processes, this was not the case for VPT children. Our findings provide evidence of atypical multisensory profiles in VPT children persisting into school-age. These results could help in targeting supportive interventions for this vulnerable population.

Abstract P170: Cognitive Function at Midlife by Sexual Orientation and Gender Identity in the CARDIA Cohort

Introduction: Sexual and gender minority (SGM) individuals have higher prevalence of dementia risk factors compared to non-SGM individuals. However, it is not known if differences in cognitive function appear during midlife, as prior studies lack comprehensive measures for sex, sexual orientation, and gender identity (SSOGI) or standardized cognitive assessments. We utilized Coronary Artery Risk Development in Young Adults (CARDIA) study data to assess midlife cognition by SSOGI. Hypothesis: We hypothesize that middle-aged sexual minority (SM) and transgender and non-binary (TGNB) participants demonstrate worse cognitive test scores compared to non-SM and non-TGNB participants, respectively. Methods: A total of 1,978 CARDIA participants completed cognitive assessments at Y25 and self-reported SSOGI measures at Y35. Participants with a history of brain cancer, kidney failure, or stroke prior to Y25 were excluded. Y25 examination included administration of standardized cognitive assessments of verbal memory (Rey Auditory Verbal Learning Test; RAVLT), processing speed (Digit Symbol Substitution Test; DSST), and executive function (Stroop Test). SSOGI variables are listed in Table 1 . Wilcoxon t-tests were used to compare cognitive test scores between analytic subgroups. Results: Mean age of the overall cohort at Y25 was 45 (SD = 3.6) years and 43% identified as Black. TGNB individuals performed significantly worse on a memory recall portion of the RAVLT ( p &lt;0.001) and DSST ( p &lt;0.05) compared to non-TGNB individuals. There was no significant difference in cognitive test scores between SM and non-SM and gay/lesbian and bisexual individuals. See Table 1 for statistical results. Conclusions: Preliminary findings suggest TGNB individuals may demonstrate lower midlife cognitive performance related to verbal memory and processing speed compared to non-TGNB individuals. Future studies will analyze associations of depression and chronic conditions with cognitive scores and expand to later CARDIA time points.

Occupational Therapy Practitioners’ Perceptions on Addressing Cognition in Acute Care: A National Survey

This study aimed to identify commonly used standardized cognitive screens and functional performance assessments among occupational therapy practitioners at level 1 trauma centers in the USA. A survey completed by 269 occupational therapy practitioners revealed the most common cognitive screens and the association between cognitive tool training and standardized cognitive tool implementation. Implications for practice are discussed with suggestions for improving occupational therapy practice.

A review of methods for assessment of cognitive function in high-altitude hypoxic environments.

Hypoxic environments like those present at high altitudes may negatively affect brain function. Varying levels of hypoxia, whether acute or chronic, are previously shown to impair cognitive function in humans. Assessment and prevention of such cognitive impairment require detection of cognitive changes and impairment using specific cognitive function assessment tools. This paper summarizes the findings of previous research, outlines the methods for cognitive function assessment used at a high altitude, elaborates the need to develop standardized and systematic cognitive function assessment tools for high-altitude hypoxia environments.

Topline results of INTERCEPT‐AD: A phase I trial of Aβ oligomer‐targeting ACU193 in early Alzheimer’s disease

AbstractBackgroundACU193 is a humanized IgG2 subclass monoclonal antibody targeting soluble amyloid‐beta oligomers (sAβOs). Growing evidence supports the view that sAβOs may be the most toxic and pathogenic form of Aβ relative to Aβ monomers and amyloid plaques and are one of the primary drivers of Alzheimer’s disease (AD) neurodegeneration. Thus, blocking the toxicity of sAβOs with ACU193 is a promising approach for treating AD.MethodINTERCEPT‐AD is a phase 1 randomized, placebo‐controlled, single‐ and multiple‐ ascending dose (SAD/MAD) study of the safety, tolerability, and pharmacokinetics (PK) of intravenous ACU193 in participants with early AD, i.e., mild cognitive impairment or mild dementia due to AD. Key inclusion criteria are 55‐90 years of age, confirmation of amyloid pathology with a PET scan, MMSE score of 18‐30, and CDR‐Global score (CDR‐GS) of 0.5 or 1.0. The MAD portion of the study includes three administrations of ACU193 at doses of 10, 25, or 60 mg/kg. In addition to standard safety measures, MRI is assessed periodically. Cerebrospinal fluid is collected to assess PK and evidence of target engagement. The study also includes exploratory measures such as standard cognitive and functional assessments, a computerized cognitive test battery, measures of cerebral blood flow via arterial spin labeling on MRI, and various plasma biomarkers.ResultSixty‐five participants from 17 U.S. study sites were randomized to INTERCEPT‐AD, with 53% female and baseline age of 72.1 ± 7.8 years (mean ± SD). The baseline MMSE was 24.2 ± 3.6, CDR‐GS was 0.64 ± 0.27, and CDR‐Sum of Boxes was 3.5 ± 1.8. In addition to baseline characteristics, the presentation will provide topline safety results, frequency of amyloid‐related imaging abnormalities (ARIA), PK assessments, and evidence of target engagement. Some exploratory measures including cognitive and functional assessments, computerized cognitive testing, and endpoint florbetapir PET results will also be presented.ConclusionWe will present topline results, along with key baseline demographic, clinical, and cognitive characteristics of participants in the INTERCEPT‐AD trial. The data generated from this trial will guide further development of ACU193 in a subsequent trial to test the novel mechanism of action of ACU193 in the treatment of early AD.

CSF levels of the synaptic marker Cyclase‐associated protein CAP2 in Alzheimer disease across clinical stages

AbstractBackgroundSynaptic dysfunction represent a key event in cognitive decline in Alzheimer disease. There is evidence that Cyclase‐associated protein 2 (CAP2) is involved in synaptic plasticity in AD models but its role in clinical setting has never extensively assessed. Aim of this study was to evaluate CAP2 levels in cerebrospinal fluids of AD and other neurodegenerative diseases and their relationship with amyloid and tau related biomarkers.Methodone‐hundred ten AD patients (prodromal AD n = 70; mild to moderate AD n = 40), 20 Lewy Body Dementia (LBD), 20 frontotemporal dementia (FTD) and 40 healthy controls (HC) were investigated and clinically assessed following a standardized neurological and cognitive behavioral assessment. All subjects underwent CSF analyses for h‐tau, p‐tau and Aß42 (Lumipulse) while CAP2 levels were assessed by using standard ELISA. Between‐groups differences and correlations between CSF biomarkers were evaluated using non‐parametric comparisons and partial correlation analyses adjusted for the effect of age, sex and disease duration.ResultAD patients across severity stages showed higher CAP2 levels compared to controls and non‐AD patients (p = 0.001). CAP2 levels did not correlate with disease severity and were independent of APOE genotype. In AD patients, CAP2 levels showed a positive correlation with t‐tau and p‐tau (p&lt;0.001).ConclusionCSF levels of CAP2 were significantly increased in AD patients and correlated with t‐tau and p‐tau independently of amyloid pathology. Altogether, these findings support the hypothesis that AD is specifically associated with synaptic dysfunction since early stages and that amyloid‐related synaptic changes parallels tau‐related axonal degeneration.

Effect of increasing participation in habitual intellectual activities on cognitive function in older adults without clinical dementia ‐ update on the findings of a randomized controlled trial

AbstractBackgroundThe preliminary findings of our randomized controlled trial, which aims to test whether doubling calligraphy practice leads to more cognitive benefits in older adults without clinical dementia, were presented in AAIC 2022. With the data collection near completion, we will present the latest findings of our study in AAIC 2023.MethodA total of 112 community‐living older adults without clinical dementia and with prior practice of calligraphy were recruited and randomly allocated into either the control group where they continued their usual practice of calligraphy or the intervention group where they doubled their practice. Comprehensive standardized cognitive assessments were performed before and after the 6‐month intervention.ResultChanges in global cognition and individual cognitive domains will be compared between the intervention and control groups. Compliance of intervention will also be reviewed.ConclusionOur findings will add insight to the effect of increasing the “dosage” of intellectual activities on cognitive function and the acceptability of cognitive intervention among community‐living older adults at risk of dementia.

Analysis of Convergent Validity of Performance-Based Activities of Daily Living Assessed by PA-IADL Test in Relation to Traditional (Standard) Cognitive Assessment to Identify Older Adults with Mild Cognitive Impairment.

Difficulty in performing instrumental activities of daily living (IADLs) is currently considered an important indicator of cognitive impairment in the elderly. A non-experimental case-control investigation was conducted to assess the convergent validity of the PA-IADL with traditional (standard) cognitive assessment tests in its ability to identify adults with mild cognitive impairment. The analysis of the data was carried out by means of various multivariate statistical tests, and the sequence in its execution led to the conclusion that 8 of the 12 Tasks that make up the PA-IADL allow for the identification of people with mild cognitive impairment (MCI) to the same extent as traditional cognitive assessment tests and regardless of age. Age was found to be a moderating variable in the performance of the eight tasks; however, the results allow us to hypothesize that people with MCI experience a significant decline when it happens but thereafter, the deterioration that occurs does so at the same rate as the deterioration experienced by healthy people. They also allow us to hypothesize that the difference in the cognitive skills required by the eight functional tasks, and therefore also in the cognitive skills required by the traditional (standard) tests of a person with MCI compared to a person of the same age without MCI (Healthy), is approximately 10 years. These hypotheses have remarkable relevance and should be tested via longitudinal research. In the meantime, the results highlight the importance of the IADL assessment for the diagnosis of MCI as a complement to the standard cognitive assessment.

Deliriogenic Medication Use in Older Adults Receiving CAR-T Correlates with Immune Effector Cell-Associated Neurotoxicity Syndrome (ICANS)

Background Chimeric Antigen Receptor T-Cell therapy (CAR-T) is increasingly used for older adults with hematologic malignancies. Real-world outcomes suggest chronological age alone does not have a strong impact on CAR-T outcomes or associated adverse effects, including cytokine release syndrome (CRS) and ICANS. A subset of CAR-T-eligible older adults have comorbidities managed with deliriogenic medications including opioids, benzodiazepines, and sedatives. Their effects may be exacerbated during prolonged hospitalizations for CAR-T therapy, precipitating delirium, which has clinical overlap with ICANS including inattention, altered sensorium, and reduced responsiveness. We hypothesized that exposure to high-risk deliriogenic medications may have an impact on observed ICANS incidence in older adults undergoing CAR-T therapy. Methods We performed a single-center retrospective analysis of all patients age 60 or older who received a FDA-approved CAR-T product for a hematologic malignancy at two UCLA Health hospitals from 8/2018 to 12/2022. We collected exposure to deliriogenic medications including opioids, benzodiazepines, sedatives/hypnotics, and anticholinergics prior to and during CAR-T hospitalization. Correlation with incidence of CRS and ICANS of any grade was modeled using logistic regression. If exposure to high-risk medication was found to be statistically significant, correlation with CRS and ICANS by each individual class of high-risk medications was analyzed. A multivariable logistic regression was performed including each predictor of CRS or ICANS that was statistically significant at the p&amp;lt;0.1 level in univariable regression. Results A total of 84 patients age 60 or older received an FDA-approved CAR-T product for a hematologic malignancy at our institution between 8/2018 to 12/2022. Patients ranged in age from 60 to 84 years (median 70). Baseline characteristics for all patients by cellular therapy target are shown inTable 1. The most common histology included was DLBCL (75%), followed by MCL (13%), MM (8%), ALL (2%), and FL (1%). With a median follow up of 9.6 months, CRS and ICANS of any grade were experienced by 76% and 45% of total patients with a median time to onset of 4 days and 5 days, and grade 3 or higher CRS and ICANS was experienced by 1% and 17% of patients, respectively. Most patients had exposure to a high-risk deliriogenic medication prior to and during their hospitalization for CAR-T infusions (57% and 74%, respectively). Age, performance status, and deliriogenic medication use prior to admission were not correlated with incidence of CRS or ICANS as shown in Table 2. However, exposure to high-risk medications during hospitalization was highly correlated with ICANS incidence (OR 2.64, p&amp;lt;0.001). In a multivariable model CAR-T product costimulatory domain (4-1BB vs. CD28, OR 6.21, p= 0.01), number of prior lines of therapy (OR 6.21, p=0.03), and exposure to opioids during admission (OR 10.5, p&amp;lt;0.001) were correlated with incidence of ICANS. Conclusion In our single-center real-world analysis of older adults receiving a FDA-approved CAR-T therapy, the CAR-T product infused, number of prior lines of therapy, and exposure to opioids during CAR-T hospitalization were correlated with incidence of ICANS. Increased incidence and severity of ICANS depending on CAR-T product has been well-described, but interestingly, our data suggest use of opioids in the immediate post-CAR-T infusion setting may also be a significant risk factor for ICANS. Limitations to our analysis include single-center practice patterns, unclear timing of exposure to deliriogenic medications to onset of ICANS, burden of comorbidities, and lack of baseline standardized cognitive and geriatric assessments in our elderly cohort. In addition to careful selection of CAR-T product in older adults, our findings support minimization of high-risk deliriogenic medications in the immediate post-CAR-T inpatient setting to mitigate risk of ICANS in this vulnerable patient population. Effects of ICANS and its treatments on outcomes and survival will be reported as this cohort matures.

A systematic review and meta-analysis of the effect of clozapine on cognitive functions in patients with treatment-resistant schizophrenia

BackgroundThis study aimed to conduct a systematic review and meta-analysis on cognitive performances of patients with treatment-resistant schizophrenia (TRS) after clozapine treatment and to examine the potential effect of follow-up duration and clozapine dosage. MethodsFive electronic databases were searched and studies were included if treatment-resistant schizophrenia patients were treated with clozapine and with baseline and follow-up cognitive functions assessments. Cognitive measures were categorised into six domains based on DSM-5-TR. Random-effect model analysis was used to pool the effect estimates. Moderator effects of clozapine dosage, follow up duration, duration of illness, age, years of education and change in positive symptoms severity were examined with meta-regression. FindingsNineteen articles were included with 50 cognitive measures reported. Systematic review found inconsistent results. Twelve cognitive measures were included for meta-analysis and found overall improvement of cognitive performances after clozapine treatment SMD = 0.11 [95 % CI 0.02, 0.20] (p = 0.021). Patients with younger age, more years of education and improvements in positive symptoms are more likely to improve in cognitive performances. Subgroup analysis found significant improvement in studies with follow-up periods of 6-months or longer but not for studies with shorter follow-up periods. ConclusionClozapine may improve some domains of cognitive function, particularly over a longer period. However, the overall inconsistent results suggest that more studies with larger sample size and standard cognitive function assessments would be needed to enhance our understanding of the impact of clozapine on the cognitive functions in the TRS patients.

Health economic analysis of the integrated cognitive assessment tool to aid dementia diagnosis in the United Kingdom.

The aim of this study was to develop a comprehensive economic evaluation of the integrated cognitive assessment (ICA) tool compared with standard cognitive tests when used for dementia screening in primary care and for initial patient triage in memory clinics. ICA was compared with standard of care comprising a mixture of cognitive assessment tools over a lifetime horizon and employing the UK health and social care perspective. The model combined a decision tree to capture the initial outcomes of the cognitive testing with a Markov structure that estimated long-term outcomes of people with dementia. Quality of life outcomes were quantified using quality-adjusted life years (QALYs), and the economic benefits were assessed using net monetary benefit (NMB). Both costs and QALYs were discounted at 3.5% per annum and cost-effectiveness was assessed using a threshold of £20,000 per QALY gained. ICA dominated standard cognitive assessment tools in both the primary care and memory clinic settings. Introduction of the ICA tool was estimated to result in a lifetime cost saving of approximately £123 and £226 per person in primary care and memory clinics, respectively. QALY gains associated with early diagnosis were modest (0.0016 in primary care and 0.0027 in memory clinic). The net monetary benefit (NMB) of ICA introduction was estimated at £154 in primary care and £281 in the memory clinic settings. Introduction of ICA as a tool to screen primary care patients for dementia and perform initial triage in memory clinics could be cost saving to the UK public health and social care payer.

Longitudinal study of coping strategies in first-time stroke patients: association with cognitive dysfunction, stroke site and depression

BACKGROUND. Inadequate coping strategies are associated with affective disorders and poor quality of life in stroke survivors. Although coping strategies are determined by several non-modifiable factors they have been shown to change over time.&#x0D; AIM. Longitudinal assessment of coping strategies and associated factors in patients with first-ever stroke.&#x0D; MATERIAL AND METHODS. This study was a part of prospective observational study of a cohort of patients with first-ever stroke. Patients underwent standard psychiatric, neurological and cognitive assessment and CT. Patients without aphasia, severe fatigue, eye problems fulfilled the coping strategies indicator (Amirkhan J.H., 1990): 87 patients in the first week after stroke, 45 patients in the second week, 20 patients in 3 months, 21 patients in 6 months, 33 patients in 1 year after stroke. Non-parametric statistics were used.&#x0D; RESULTS. Different coping strategies were not determined by age, gender and severity of neurological deficit; there were some correlations with educational level, work status, cognitive dysfunction, stroke volume and lesion location. There were differences in the use of coping strategies in the groups with different depression manifestations: in the group with depression manifestations in the early recovery period and later, coping strategies did not differ from the control group in the acute stroke period, but since the manifestation of depression the amount of avoidance strategies increased. In the group with pre-stroke depression, a significant increase in avoidance strategies was observed in the first week after the stroke.&#x0D; CONCLUSIONS. The longitudinal study of coping strategies revealed that the use of coping strategies is a dynamic process determined by several modifiable and non-modifiable factors in combination. Coping strategies were not predictors of depression; on the contrary, depression seems to influence the choice of coping strategies.

Frequency of cognitive dysfunction in individuals with cervicogenic headache

Background: Both primary and secondary headaches have been associated with cognitive dysfunction and depression. Objective: This study aims to investigate the effects of cervicogenic headache on cognitive function, quality of life and mood. Methods: This single-center, cross-sectional comparative study includes 30 patients diagnosed with cervicogenic headache by a neurologist and 30 healthy controls. The pain level of the participants was evaluated with the Visual Analog Scale (VAS), their mood with the Beck Depression Inventory (BDI) and the Pain Catastrophizing Scale, their quality of life with the Short Form-36 (SF-36), and their cognitive status by a psychologist with the Standard Mini Mental Test (SMMT) and Montreal Cognitive Assessment Scale (MoCA). Results: All MoCA domains except for orientation and the SMMT scores were significantly lower in the cervicogenic headache group compared to the control group (p&lt; 0,05). In addition, scores for the pain catastrophizing scale and selected SF-36 sub-parameters (physical function, physical role difficulty, social functionality, pain and general health perception) were significantly lower in the cervicogenic headache group (p&lt; 0,05). The Beck Depression Inventory score was significantly higher in patients with cervicogenic headache than in the control group (p=0.018). Conclusion: Patients with cervicogenic headache exhibit worse cognitive performance during their headache. Additionally, compared to healthy controls, they had higher rates of depression and pain catastrophizing as well as a lower quality of life.

Neurological and cognitive impairment in COVID‐19: clinical characterization andepidemiological

AbstractBackgroundCOVID‐19 neurological manifestations were demonstrated during the pandemic, including cognitive impairment. Objectives: To determine the prevalence of cognitive and behavioral complaints (such as dementia, MCI or SCD) in a outpatient sample with recent SARS‐COV2 infection. Specific: Evaluate the association of cognitive impairment with the presence of the polymorphism found in the APOE gene and with respiratory diseaseMethodObservational, longitudinal, prospective clinical study. Inclusion criteria: patients with confirmed Covid‐19. Patients are evaluated in an outpatient clinic. They are evaluated through a standardized attendance record, with somatic and cognitive neurological assessment. Cognitive assessment involves the application of cognitive (ACER, MMSE and CDR), functional (Pfeffer) and psychiatric (GDS or Beck) screening instruments, in addition to subsequent extensive neuropsychological assessment. In addition, APOE polymorphism is analysed.ResultsTo date, 200 patients were evaluated. The average age is 46.5 years, with 65.4% female, 79.16% with 8 or more years of schooling, in addition to 57.5% of the sample with cognitive complaints.ConclusionsThe results so far in our study demonstrate that cognitive complaints are frequent in patients even in the chronic phase of the disease.

Multivariate associations between cognition and neighborhood geospatial characteristics in schizophrenia.

Cognitive impairment contributes to functional impairment in schizophrenia. Yet, little is known about how environmental characteristics are related to cognition in schizophrenia. By examining how cognition and the environment are intertwined, it may be possible to identify modifiable risk and protective factors that can improve cognitive outcomes in schizophrenia. We aimed to identify multivariate associations between cognition and three geospatial characteristics (built-space density, habitable green spaces, and public spaces for social interaction) within one's immediate neighborhood among individuals with schizophrenia. We recruited participants with schizophrenia from three sites - an urban metropolitan and two towns in southern India. We administered standard cognitive assessments and performed a principal axis factoring to identify episodic memory, cognitive control, and social inference-making factors for use in further analyses. We estimated geospatial characteristics of an individual's neighborhood, i.e., up to 1km2 around the residence, by sourcing data from Google Earth. We performed unconditional and conditional (to examine the effect of clinical covariates) canonical correlation analyses to understand the multivariate relationship between cognition and geospatial characteristics. We analyzed data from 208 participants; the first canonical cognitive variate (higher social inference-making and poorer cognitive control) shared 24% of the variance (r=0.49; P<0.001) with the first geospatial variate (lower built density and poorer access to public spaces). Years of education, age at onset, and place of residence significantly modulated this relationship. We observe differential associations of the built environment with social and non-social cognition in schizophrenia, and highlight the clinical and demographic characteristics that shape these associations.

Exploring the impact of yogic intervention on cognitive abilities in visually impaired children: A systematic review

Objective: This study aimed to examine the effect of yogic intervention on cognitive abilities in visually impaired children through a secondary analysis of existing studies. The selected studies encompassed various designs and intervention durations, allowing for a comprehensive exploration of the topic. Methods: A systematic review of the literature was conducted to identify relevant studies published between 2002 and 2023. Fifteen studies met the inclusion criteria and were included in the analysis. These studies employed different yogic practices, including Hatha Yoga, Kundalini Yoga, and Iyengar Yoga, and utilized standardized cognitive assessment tools to evaluate cognitive domains such as attention, memory, problem-solving, and executive functions. The sample sizes ranged from single case studies to randomized controlled trials, and the intervention durations varied from 4 weeks to 6 months. Results: The analysis revealed promising findings regarding the effect of yogic intervention on cognitive abilities in visually impaired children. Ten out of the fifteen selected studies reported significant improvements in cognitive domains following the interventions. These improvements were observed in attention span, working memory, information processing speed, cognitive flexibility, and problem-solving skills. The modifications made to the yogic practices for visually impaired children, such as audio cues, tactile cues, and Braille instructions, were found to enhance their engagement and participation in the interventions. Conclusion: The results suggest that yogic intervention holds promise as a potential intervention for enhancing cognitive abilities in visually impaired children. The mindful and meditative nature of yogic practices, combined with the physical aspects, may contribute to the observed improvements in cognitive functioning. However, the heterogeneity of the selected studies and the limited number of high-quality randomized controlled trials highlight the need for further research to establish the efficacy and optimal implementation strategies of yogic interventions in this population. Integrating yogic practices into educational and therapeutic programs may provide additional tools to support cognitive development and overall well-being in visually impaired children.