Test Battery Research Articles

The Association of Cerebrospinal Fluid Biomarkers of Alzheimer’s Disease with Cognitive Intra-Individual Variability

Abstract Objective Cognitive intra-individual variability (IIV) is a sensitive predictor of cognitive decline and disease severity in Alzheimer’s disease (AD). Despite its sensitivity, whether IIV is merely a psychometric artifact or disease pathology biomarker remains unknown. The present study evaluated the association between IIV and cerebrospinal fluid (CSF) biomarkers of AD. Method Participants included 422 individuals from the National Alzheimer’s Coordinating Center Unified Dataset 3.0 who completed baseline neuropsychological assessment and had CSF data. All participants were adult monolingual English speakers. Participants with vision or hearing impairments were excluded. Cases were stratified into cognitively normal (n = 267) and AD groups (n = 155; mild cognitive impairment = 50, dementia = 105). Cross-sectional IIV was calculated by obtaining the individual standard deviation (iSD) of ten cognitive tests. Finally, the coefficient of variation (CoV) was computed by dividing iSD by the participant’s overall test battery mean. Non-parametric Spearman-rank correlations were used to assess the relation between CoV and CSF biomarkers, including beta-amyloid 1–42, total tau (t-tau), and phosphorylated tau (p-tau181). Results In the AD group, CoV was positively correlated with p-tau181 (r = 0.285, p = 0.003) and t-tau (r = 0.241, p = 0.009), and negatively correlated with beta-amyloid 1–42 (r = −0.314, p < 0.001). Correlations between CoV and CSF biomarkers were not significant in the cognitively normal group for beta-amyloid 1–42 (r = 0.076, p = 0.215), p-tau181 (r = −0.014, p = 0.840), and t-tau (r = −0.046, p = 0.485). Conclusions In people with mild cognitive impairment and dementia of presumed AD etiology, cognitive IIV is associated with CSF biomarkers. These findings provide preliminary evidence that IIV is not merely a statistical artifact, but is associated with AD neuropathology.

B - 111 Community Resource Access and Neuropsychological Outcomes in a Post-SARS-CoV-2 Clinical Sample

Abstract Objective Lower access to resources, income, education, and housing quality has been linked with poorer neuropsychological outcomes. This study evaluated the relationship between community resource access and several cognitive and psychological outcomes among clinical patients with persisting cognitive concerns following SARS-CoV-2 infection. Method The sample consisted of 49 patients (30.6% male; 35.3% White; Mage = 45.3, SD = 12.1; Meducation = 15.5, SD = 3.0) referred for neuropsychological evaluation to assess for long-term cognitive changes following SARS-CoV-2 infection. All patients were administered a uniform neuropsychological test battery that included measures of working memory, processing speed, and verbal learning/memory, as well as measures of depression, anxiety, and perceived stress. Area deprivation index (ADI) was determined using the national decile of the 2021 Neighborhood Atlas. Linear regression models were conducted between ADI and each cognitive and psychological outcome. Results No significant associations were identified between ADI and cognitive (working memory [F = 3.16, p = 0.08]; processing speed [F = 0.89, p = 0.32]; total learning [F = 0.41, p = 0.52]; delayed recall [F = 0.08, p = 0.78]) nor psychological (depressive symptoms [F = 0.09, p = 0.77]; anxiety symptoms [F = 0.05, p = 0.82]; perceived stress [F = 0.49, p = 0.49]) variables. Conclusions In this preliminary study, community access to resources did not significantly predict long-term cognitive or psychological symptoms following SARS-CoV-2 infection. This unexpected result suggests that neighborhood deprivation may be one particular social determinant of health that is less impactful for post-SARS-CoV-2 neuropsychological outcomes in similar populations. Generalizability is limited by sample characteristics (highly educated; uncomplicated disease course) and small sample size. Thus, replication in a larger database and further research involving other social determinants is indicated.

The association between physical activity and delayed neurocognitive recovery in elderly patients: a mediation analysis of pro-inflammatory cytokines

BackgroundDelayed neurocognitive recovery (dNCR) can result in unfavorable outcomes in elderly surgical patients. Physical activity (PA) has been shown to improve cognitive function, potentially by reducing systemic inflammatory responses. However, there is a lack of supportive data indicating whether PA has a protective effect against dNCR.AimsTo examine the correlation between dNCR and PA, and to further analyze if pro-inflammatory cytokines mediate this relationship.MethodsThis study is a prospective nested case-control investigation of elderly patients who had knee replacement surgery. dNCR was defined as a decline in cognitive function compared with baseline by using a battery of neuropsychological tests. PA was assessed with the Physical Activity Scale for the Elderly (PASE). Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum concentrations of IL-6, IL-1β, and TNF-α. Multivariable logistic regression analysis was conducted to assess the association between PA and dNCR. Mediation analysis was employed to evaluate whether pro-inflammatory cytokines mediate the relationship between them.ResultsA cohort of 152 patients was included, resulting in an incidence rate of dNCR of 23.68%. PA was associated with dNCR after full adjustment [OR = 0.199, (95% CI, 0.061; 0.649), P = 0.007]. Mediation analysis showed that the IL-6 mediated the statistical association between PA and dNCR, with mediation proportions (%) of 77.68 (postoperative concentration of IL-6) or 27.58 (the absolute change in IL-6 before and after surgery).ConclusionsPA serves as a protective factor against dNCR, possibly through the reduction of pro-inflammatory cytokine concentrations.The Chinese Clinical Trail Registry: www.http://chictr.org.cn, Registration No. ChiCTR2300070834, Registration date: April 24, 2023.

One-year developmental changes in motor coordination and tennis skills in 10–12-year-old male and female tennis players

BackgroundTo date, no longitudinal studies of quarterly changes have been conducted on the differences in the development of motor coordination between boys and girls in relation to changes in their tennis skills level. Therefore, the aim of the study was to assess the development of motor coordination of 10–12-year-old tennis players over the course of 1 year, in the light of changes in tennis skills preparation.MethodsOne-hundred eighty male and female tennis players aged 10, 11, or 12 years old participated in the study. Each age group comprised 30 boys and 30 girls. To investigate their motor coordination development, a battery of general tests (simple reaction, complex reaction, Spalding test, spider test, hexagon jumping, Starosta’s test, hand–eye test, balance, plate tapping, jump rope) and specific tennis skills tests (wall game and 100-tennis ball tests) were performed 4 times quarterly over 1 year. Differences between sexes and the time points were assessed. The rate of development evaluation was based on beta coefficient of linear regression.ResultsBoys generally performed better in tennis skills tests than girls. The boys performed better also in one motor coordination test (Spalding test) among 10-year-olds, in two additional tests (spider and plate tapping tests) among 11-year-olds, and another three more tests (simple reaction, complex reaction and Starosta’s tests) among 12-year-olds. Jump rope test among 10-year-olds and hexagon jump test among 12-year-olds were the only tests where girls performed better than boys. On the other hand, girls showed higher rate of development in balance and complex reaction tests than boys.ConclusionsWe conclude that motor coordination and tennis skills development over 1 year is age-, sex-, and task-dependent, with the 10–12-year-old male tennis players performing better in tennis skills and overall motor coordination than females.

First Steps Toward Implementation of the Online Test Battery LITMUS-NL: A Usability and Feasibility Study

First Steps Toward Implementation of the Online Test Battery LITMUS-NL: A Usability and Feasibility Study

A new approach for GNSS spoofing detection using power and signal quality monitoring

Abstract Global Navigation Satellite System (GNSS) signals are highly susceptible to spoofing attacks. Signal Quality Monitoring (SQM) methods are simple and easy to detect spoofing. However, traditional SQM methods are only effective for matched-power cases and exhibit high detection probability only for a short time. This study introduces a new approach, exploiting anomalies in receiver correlation outputs during spoofing. It efficiently detects signal amplitude fluctuations and correlation peak distortions. The Texas Spoofing Test Battery (TEXBAT) dataset is used to evaluate the detection performance of the proposed approach. The results show that the proposed approach has excellent detection performance in various spoofing cases, including matched-power, overpowered, static, and dynamic cases. This approach surpasses traditional SQM metrics in detection probability and sensitivity to spoofing stages. Importantly, the proposed approach detects spoofing early.

International operations and corporate R&D investment: Evidence from China.

This paper presents an examination of the relationship between international operations and corporate R&D investment. Using a large sample of Chinese listed firms for the 2009-2022 period and the ordinary least squares method, we find that international operations have a positive effect on corporate R&D investment. The finding remains valid after a battery of robustness tests. Mechanism tests show that international operations increase corporate R&D investment by diversifying product demand instead of increasing firms' international knowledge acquisition. This paper provides new evidence on the role of international operations in innovation activities.

Early High-Dose Erythropoietin and Cognitive Functions of School-Aged Children Born Very Preterm

Children born very preterm are at risk for long-term neurodevelopmental sequelae. Prophylactic high-dose recombinant human erythropoietin (rhEpo) shortly after birth has not been shown to improve cognitive, motor, and behavioral development at 2 and 5 years. To investigate whether early high-dose rhEpo is associated with better executive functions and processing speed-late-maturing cognitive functions-in school-aged children born very preterm. This single-center cohort study was a prospective, observational follow-up study of a multicenter neonatal clinical trial; 365 children born very preterm (mean gestational age, 29.3 weeks [range, 26.0-31.9 weeks]) who had been enrolled in the Swiss EPO Neuroprotection Trial at birth between 2005 and 2012, and who were included in the primary outcome analyses at 2 years, were eligible to be recruited for the EpoKids study between 2017 and 2021 when they were at school age. Term-born children were additionally recruited and included in a control group. Data were analyzed between May and September 2022. Administration of rhEpo (3000 IU/kg) or placebo (saline, 0.9%) intravenously 3 times within the first 2 days of life as part of the Swiss EPO Neuroprotection Trial. A comprehensive neuropsychological test battery assessed executive functions and processing speed, and parents reported on their child's executive functions in everyday life to test the hypothesis that early high-dose rhEpo administration is associated with better cognitive outcomes at school age. In the EpoKids study, 214 children born very preterm (58.6% of 365 children in eligible cohort) were assessed at a mean age of 10.4 years (range, 6.9-13.4 years); 117 (54.7%) were boys. There was no evidence that the 117 children who had received rhEpo differed from the 97 children who had received placebo in any of the 15 executive function and processing speed tests, nor in parent-rated executive functions (estimates ranged from -0.138 to 0.084, all 95% CIs included 0). Irrespective of rhEpo or placebo allocation, children born very preterm scored lower on 11 of 15 executive function and processing speed tests than term-born peers (estimates ranged from 0.112 to 0.255, 95% CIs did not include 0). This study found no evidence for a positive association between prophylactic early high-dose rhEpo administration and long-term neurodevelopmental outcomes after very preterm birth. These results suggest that a comprehensive approach, including pharmacological and nonpharmacological prevention and intervention strategies, is needed to support these children's neurodevelopmental outcome.

Effects of Executive Functions and Cognitive Variables in Experimentally Induced Acute Pain Perception during a Distraction Task: A Study on Asymptomatic Pain-Free Individuals.

The aim of this study was to investigate the influence of executive functioning and cognitive performance on individual experimentally induced pain perception during distractor tasks in an asymptomatic pain-free population. A total of 59 healthy pain-free subjects (59.3% women, mean age: 46.5 ± 24.7 years) completed a battery test that assessed execution functions (cognitive flexibility, working memory, mental inhibition), attention level, and psychological aspects (anxiety/depressive levels-HADS, pain catastrophizing-PCS, pain anxiety symptoms-PASS 20, sleep quality-PSQI) before conducting two n-back distraction tasks. Pain was experimentally induced with a thermal stimulus that was able to induce moderate pain (70/100 points) and applied to the non-dominant forearm. The thermal stimulus was applied before and during both (one-back and two-back) distraction tasks. The analyses consisted of separated repeated-measures ANOVA that considered the functioning on each test (cognitive flexibility, working memory, mental inhibition, selective attention) and controlled for sociodemographic and psychological aspects by comparing the pain intensity at the baseline and during the one-back and two-back distractor tasks. All ANOVAs found a significant effect of the distraction task, which indicates that the perceived pain intensity scores were lower during the one-back and two-back tasks (p < 0.001) as compared with the baseline. No interaction effect between the distractor tasks and working memory (p = 0.546), mental inhibition (p = 0.16), cognitive flexibility (p = 0.069), or selective attention (p = 0.105) was identified. The current study found that a distraction task decreased the perceived intensity of experimentally induced pain in asymptomatic pain-free individuals and that this effect was not related to executive function or attention levels.

In Utero and Lactational Exposure to an Environmentally Relevant Mixture of Phthalates Alters Hypothalamic Gene Expression and Sexual Preference in Rats.

Several phthalates, mainly used as plasticizers, are known for their adverse effects on the male genital system. Previously, we demonstrated that an environmentally relevant mixture of six antiandrogenic phthalates (PMix), derived from a biomonitoring study in pregnant Brazilian women, was able to disrupt the reproductive development in male rats. Experimental groups (control, 0.1, 0.5, and 500 mg PMix/kg/day) were established starting from the extrapolated human dose (0.1 mg/kg/day), followed by doses 5 times and 5000 times higher. Pregnant rats received daily oral gavage administration of either vehicle (control) or PMix from gestational day 13 to postnatal day 10. Here, we examined male and female offspring regarding changes in gene expression of key reproductive factors in the hypothalamus and pituitary gland at adulthood and conducted a battery of behavioral tests in males, including partner preference, sexual behavior, and male attractiveness tests. PMix induced some changes in mating-related behavior in males, as demonstrated by the absence of preference for females against males and a higher number of penetrations up to ejaculation in the 0.5 dose group. PMix decreased Esr2 expression in the male hypothalamus across all three doses, and in females at mid and high doses in both the hypothalamus and pituitary. In male hypothalamus, we also observed decreased Kiss1 transcripts in these groups and a reduction in AR at the 0.5 dose group. In summary, our results provide further evidence that phthalates in a mixture, even at low doses, may exert cumulative effects on the structures underlying sexual behavior, which seems to be more sensitive than reproductive endpoints for the same experimental design.

Assessment of genotoxic potential of fragrance materials in the chicken egg assays.

The genotoxic and clastogenic/aneugeneic potentials of four α,β-unsaturated aldehydes, 2-phenyl-2-butenal, nona-2-trans-6-cis-dienal, 2-methyl-2-pentenal, and p-methoxy cinnamaldehyde, which are used as fragrance materials, were assessed using the Chicken Egg Genotoxicity Assay (CEGA) and the Hen's egg micronucleus (HET-MN) assay, respectively. Selection of materials was based on their chemical structures and the results of their previous assessment in the regulatory in vitro and/or in vivo genotoxicity test battery. Three tested materials, 2-phenyl-2-butenal, nona-2-trans-6-cis-dienal, and 2-methyl-2-pentenal, were negative in both, CEGA and HET-MN assays. These findings were congruent with the results of regulatory in vivo genotoxicity assays. In contrast, p-methoxy cinnamaldehyde, which was also negative in the in vivo genotoxicity assays, produced evidence of DNA damage, including DNA strand breaks and DNA adducts in CEGA. However, no increase in the micronucleus formation in blood was reported in the HET-MN study. Such variation in responses between the CEGA and HET-MN assay can be attributed to differences in the dosing protocols. Pretreatment with a glutathione precursor, N-acetyl cysteine, negated positive outcomes produced by p-methoxy cinnamaldehyde in CEGA, indicating that difference in response observed in the chicken egg and rodent models can be attributed to rapid glutathione depletion. Overall, our findings support the conclusion that CEGA and/or HET-MN can be considered as a potential alternative to animal testing as follow-up strategies for assessment of genotoxic potential of fragrance materials with evidence of genotoxicity in vitro.

N-acetylcysteine amide and di- N-acetylcysteine amide protect retinal cells in culture via an antioxidant action

Reactive oxygen species (ROS) play a significant role in toxicity to the retina in a variety of diseases. N-acetylcysteine (NAC), N-acetylcysteine amide (NACA) and the dimeric di-N-acetylcysteine amide (diNACA) were evaluated in terms of protecting retinal cells, in vitro, in a variety of stress models.Three types of rat retinal cell cultures were utilized in the study: macroglial-only cell cultures, neuron-only retinal ganglion cell (RGC) cultures, and mixed cultures containing retinal glia and neurons. Ability of test agents to attenuate oxidative stress in all cultures was ascertained. In addition, capability of agents to protect against a variety of alternate clinically-relevant stressors, including excitotoxins and mitochondrial electron transport chain inhibitors, was also evaluated. Capacity of test agents to elevate cellular levels of reduced glutathione under normal and compromised conditions was also determined.NAC, NACA and diNACA demonstrated concentration-dependent cytoprotection against oxidative stress in all cultures. These three compounds, however, had differing effects against a variety of alternate insults to retinal cells. The most protective agent was NACA, which was most potent against the most stressors (including oxidative stress, mitochondrial impairment by antimycin A and azide, and glutamate-induced excitotoxicity). Similar to NAC, NACA increased glutathione levels in non-injured cells, although diNACA did not, suggesting a different, unknown mechanism of antioxidant activity for the latter. In support of this, diNACA was the only agent to attenuate rotenone-induced toxicity in mitochondria.NAC, NACA and diNACA exhibited varying degrees of antioxidant activity, i.e., protected cultured rat retinal cells from a variety of stressors which were designed to mimic aspects of the pathology of different retinal diseases. A general rank order of activity was observed: NACA ≥ diNACA > NAC. These results warrant further exploration of NACA and diNACA as antioxidant therapeutics for the treatment of retinal diseases, particularly those involving oxidative stress. Furthermore, we have defined the battery of tests carried out as the “Wood, Chidlow, Wall and Casson (WCWC) Retinal Antioxidant Indices”; we believe that these are of great value for screening molecules for potential to reduce retinal oxidative stress in a range of retinal diseases.

Low Intake of Total Antioxidant Nutrients as a Risk Factor for Incident Dementia in Older Adults: The Shanghai Aging Study

Introduction: Previous longitudinal studies reported the impact of antioxidant nutrients (ANs) on cognitive impairment in the older population, but the conclusions were inconsistent. This study aimed to verify the hypothesis that dietary intake of total AN was associated with incident dementia among older individuals. Methods: Community residents without dementia aged ≥60 years were prospectively followed up for an average of 5.2 years in the Shanghai Aging Study. At baseline, daily intakes of total dietary AN (the sum of carotene, vitamin C, vitamin E, lutein, and flavonoids) and energy were calculated based on an interviewer-administered food frequency questionnaire measuring the dietary intake over the past 1 year for each participant. A battery of neuropsychological tests was used to evaluate cognitive function, and a consensus diagnosis of dementia was made according to the DSM-IV criteria at baseline and follow-up. Results: Among 1,550 dementia-free participants, 135 (8.7%) incident dementia cases were identified during the average of 5.2 years of follow-up. Participants with low AN intake (<112 mg/day) had a significantly higher risk of incident dementia than those with high AN intake (≥112 mg/day) (hazard ratio 1.87, 95% confidence interval 1.26–2.77) after adjusting for age, gender, education, obesity, APOE-ε4, hypertension, diabetes, depression, baseline Mini-Mental State Examination score, and total energy intake. The significant association of total AN intake with incident dementia was only found in individuals ≥70 years. Conclusion: Low total AN intake may be a risk factor for incident dementia among older adults. Maintaining sufficient AN intake may be beneficial against age-related cognitive decline.

Digital music and movement intervention to improve health and wellbeing in older adults in care homes: a pilot mixed methods study

BackgroundLow physical activity among older adults is related to adverse health outcomes such as depression and loneliness, poor physical function and increased risk of falls. This study was designed to increase physical activity through a digital, group-based, physical activity and music intervention and to examine its effectiveness on social, mental and physical health outcomes.MethodsParticipants were 34 older adults (65 years +) recruited across four care homes in Scotland to a pilot study. Surveys were administered at baseline and post-intervention, comprising measures of fear of falling, depression and anxiety, loneliness, sleep satisfaction and quality of life. A battery of physical function tests and saliva sampling for cortisol and dehydroepiandrosterone hormone analysis were also conducted at each time point. Additionally, process evaluation measures (recruitment, intervention fidelity, attendance, retention rates and safety) were monitored. The intervention comprised 12 weeks of three prescribed digital sessions per week: movement and music (n = 2) and music-only (n = 1), delivered by an activity coordinator in the care home. Post-intervention interviews with staff and participants were conducted to gain qualitative data on the acceptability of the intervention.ResultsAn average of 88% of prescribed sessions were delivered. Pre- to post-intervention intention-to-treat analysis across all participants revealed significant improvements in anxiety, salivary DHEA, fear of falling and loneliness. There were no significant improvements in health-related quality of life, perceived stress, sleep satisfaction or physical function tests, including handgrip strength. Qualitative analysis highlighted benefits of and barriers to the programme.ConclusionsThe digital movement and music intervention was deemed acceptable and delivered with moderate fidelity, justifying progression to a full-scale trial. Although a proper control group would have yielded more confident causal relationships, preliminary psychosocial and biological effects were evident from this trial. To show significant improvements in physical function, it is likely that a bigger sample size providing sufficient power to detect significant changes, greater adherence, longer intervention and/or higher exercise volume may be necessary.Trial registrationThe trial is registered at ClinicalTrials.gov, number NCT05601102 on 01/11/2022.

Cognitive Effects of Three β-Adrenoceptor Acting Drugs in Healthy Volunteers and Patients with Parkinson's Disease.

Noradrenergic signaling declines in Parkinson's disease (PD) following locus coeruleus neurodegeneration. Epidemiologic studies demonstrate that β-acting drugs slow PD progression. The primary objective was to compare the safety and effects of 3 β-adrenoceptor (β-AR) acting drugs on central nervous system (CNS) function after a single dose in healthy volunteers (HVs) and evaluate the effects of multiple doses of β-AR acting drugs in HVs and PD-patients. In Part A, HVs received single doses of 32 mg salbutamol, 160μg clenbuterol, 60 mg pindolol and placebo administered in a randomized, 4-way cross-over study. In Part B (randomized cross-over) and Part C (parallel, 2:1 randomized), placebo and/or clenbuterol (20μg on Day 1, 40μg on Day 2, 80μg on Days 3-7) were administered. CNS functions were assessed using the NeuroCart test battery, including pupillometry, adaptive tracking and recall tests. Twenty-seven HVs and 12 PD-patients completed the study. Clenbuterol improved and pindolol reduced the adaptive tracking and immediate verbal recall performance. Clenbuterol and salbutamol increased and pindolol decreased pupil-to-iris ratios. Clenbuterol was selected for Parts B and C. In Part B, clenbuterol significantly increased performance in adaptive tracking with a tendency toward improved performance in immediate and delayed verbal recall. In Part C trends toward improved performance in immediate and delayed verbal recall were observed in PD-patients. Typical cardiovascular peripheral β2-AR effects were observed with clenbuterol. This study demonstrates the pro-cognitive effects of clenbuterol in HVs with similar trends in PD-patients. The mechanism of action is likely activation of β2-ARs in the CNS.

Risk Factors for Postoperative Delirium Severity After Deep Brain Stimulation Surgery in Parkinson's Disease.

Postoperative delirium (POD) is a serious complication following deep brain stimulation (DBS) but only received little attention. Its main risk factors are higher age and preoperative cognitive deficits. These are also main risk factors for long-term cognitive decline after DBS in Parkinson's disease (PD). To identify risk factors for POD severity after DBS surgery in PD. 57 patients underwent DBS (21 female; age 60.2±8.2; disease duration 10.5±5.9 years). Preoperatively, general, PD- and surgery-specific predictors were recorded. Montreal Cognitive Assessment and the neuropsychological test battery CANTAB ConnectTM were used to test domain-specific cognition. Volumes of the cholinergic basal forebrain were calculated with voxel-based morphometry. POD severity was recorded with the delirium scales Confusion Assessment Method for Intensive Care Unit (CAM-ICU) and Nursing Delirium Scale (NU-DESC). Spearman correlations were calculated for univariate analysis of predictors and POD severity and linear regression with elastic net regularization and leave-one-out cross-validation was performed to fit a multivariable model. 21 patients (36.8%) showed mainly mild courses of POD following DBS. Correlation between predicted and true POD severity was significant (spearman rho = 0.365, p = 0.001). Influential predictors were age (p < 0.001), deficits in attention and motor speed (p = 0.002), visual learning (p = 0.036) as well as working memory (p < 0.001), Nucleus basalis of Meynert volumes (p = 0.003) and burst suppression (p = 0.005). General but also PD- and surgery-specific factors were predictive of POD severity. These findings underline the multifaceted etiology of POD after DBS in PD. Valid predictive models must therefore consider general, PD- and surgery-specific factors.

Comparing psychometric characteristics of a computerized cognitive test (BrainCheck Assess) against the Montreal cognitive assessment.

Previous validation studies demonstrated that BrainCheck Assess (BC-Assess), a computerized cognitive test battery, can reliably and sensitively distinguish individuals with different levels of cognitive impairment (i.e., normal cognition (NC), mild cognitive impairment (MCI), and dementia). Compared with other traditional paper-based cognitive screening instruments commonly used in clinical practice, the Montreal Cognitive Assessment (MoCA) is generally accepted to be among the most comprehensive and robust screening tools, with high sensitivity/specificity in distinguishing MCI from NC and dementia. In this study, we examined: (1) the linear relationship between BC-Assess and MoCA and their equivalent cut-off scores, and (2) the extent to which they agree on their impressions of an individual's cognitive status. A subset of participants (N = 55; age range 54-94, mean/SD = 80/9.5) from two previous studies who took both the MoCA and BC-Assess were included in this analysis. Linear regression was used to calculate equivalent cut-off scores for BC-Assess based on those originally recommended for the MoCA to differentiate MCI from NC (cut-off = 26), and dementia from MCI (cut-off = 19). Impression agreement between the two instruments were measured through overall agreement (OA), positive percent agreement (PPA), and negative percent agreement (NPA). A high Pearson correlation coefficient of 0.77 (CI = 0.63-0.86) was observed between the two scores. According to this relationship, MoCA cutoffs of 26 and 19 correspond to BC-Assess scores of 89.6 and 68.5, respectively. These scores are highly consistent with the currently recommended BC-Assess cutoffs (i.e., 85 and 70). The two instruments also show a high degree of agreement in their impressions based on their recommended cut-offs: (i) OA = 70.9%, PPA = 70.4%, NPA = 71.4% for differentiating dementia from MCI/NC; (ii) OA = 83.6%, PPA = 84.1%, NPA = 81.8% for differentiating dementia/MCI from NC. This study provides further validation of BC-Assess in a sample of older adults by showing its high correlation and agreement in impression with the widely used MoCA.

Functional fitness and physical independence in later years: cut-off values and validation

BackgroundTo establish and validate the criterion-referenced standards of functional fitness in predicting physical independence in 80 + years.MethodsA group of 2,749 older community dwellers (60–84 years) were recruited, and 2,050 were identified with moderate-to-high independent living ability according to the proposed minimum composite physical function score. The Senior Fitness Test battery was applied to measure functional fitness at five-year intervals. The declining rate for each fitness dimension was calculated based on the differences between any two adjacent age groups and was adjusted according to the reported degradation rate differences between the cross-sectional and longitudinal studies.ResultsThe age-and-sex-specific criterion-referenced standards were identified for muscle strength, cardiovascular endurance, and dynamic balance that older adults should possess at 60–79 to maintain independent living abilities. Moderate to high consistency (k = 0.622–0.650) and associations (φ = 0.641–0.694) were found between the predicted physical independence by criterion-referenced standards of functional fitness and the results from the composite physical function scale. Moreover, the predicted independent living abilities in later years from the criterion-referenced standards of functional fitness showed high test-retest reliability (Pa = 0.90–0.96).ConclusionThe criterion-referenced standards for functional fitness are valid and reliable to predict independent living abilities in later years, and provide the threshold to identify the limitations in physical fitness and detect the risks of functional disabilities among older adults in an early stage.

The effects of the 'active before school' programme on the academic skills of 8-9-year-old children: a physically and cognitively engaging intervention.

Literature underscores the significance of exercise and cognitive stimulation for achieving academic success. This study aims to investigate the effects of the technology-based "Active Before the First School Bell" programme, comparing the effects of two school-based interventions (physical activity vs. cognitive engagement) on the academic skills of 8-9-year-old children. This encompasses their school skills, visual-motor coordination, levels and attitudes towards physical activity, and fitness. The study involved 88 primary school children (age: 8.3 years, 58.0% girls). To assess the programme's distinct effects children were categorised into three groups. The first group (n = 31) participated in cognitive classes (CEG), the second (n = 27), in physical activity classes (PAEG), and the third (n = 30), was a control one (CG). A 12-week intervention, consisting of three 15-min sessions per week before school, was implemented. Self-report questionnaires gauged levels of physical activity. Academic skills were assessed using a battery of diagnostic methods for school failure in early childhood education. Fitness was measured using selected items from the Eurofit test battery. Pre- and post-test measures were collected and analysed, employing one-way ANOVA on ranks with Dunn's post-hoc tests. Significant post-test differences between the groups were observed in visual spatial function, with the PAEG outperforming the CG, and in auditory and language functions, where both experimental groups outperformed the CG. Results suggest that before school physical activities may be more effective than cognitive activities in improving the academic skills. The short-term effects obtained provide insights for implementing before-school programmes for children in the early school years.

Possible determinants of physical fitness in Japanese school children: Across-sectional study.

Physical fitness is one of the most important health indicators in children. Although appropriate body composition or certain lifestyle factors such as frequent physical activity are thought to improve physical fitness, results of previous studies are inconsistent, and most studies were from Western countries. We investigated associations of body composition and modifiable lifestyle factors such as physical activity, screen time, diet and sleep duration with physical fitness in Japanese primary school children. 2308 children (age 10-12 years old) in 12 primary schools were analysed in this cross-sectional study. Physical fitness was evaluated by sports battery tests conducted routinely and annually at schools. The total score of sports battery tests, 20-m shuttle run (laps) and grip strength (kg) were selected as outcomes. Information about lifestyle factors was collected by two questionnaires. Associations between lifestyle factors and physical fitness were assessed by multivariable linear mixed models by sex. Frequent exercise was related to better overall physical fitness. Regarding the 20-m shuttle run, many unfavourable lifestyle factors such as higher BMI in boys (β -7.37, 95% confidence interval [CI] -8.39, -6.35) and girls (β -3.54, 95% CI -4.50,-2.58), longer screen time (β -4.31, 95% CI -7.29, -1.34) in boys and girls (β -5.65, 95% CI -9.01, -2.30); shortest (reference) versus longest, breakfast skipping in boys (β -5.24, 95% CI -8.71, -1.77) and girls (β -3.57, 95% CI -6.84, -0.30); consumers (reference) versus skippers were associated with worse performance. Better quality of diet was associated with better results in the 20-m shuttle run only in girls (β 2.58, 95% CI 0.24, 4.93); lowest (reference) versus highest. Frequent exercise was related to better physical fitness. Higher BMI and unfavourable lifestyle factors such as longer screen time and breakfast skipping were associated with worse results of the 20-m shuttle run.