Total Cognitive Score Research Articles

Assessment of Mild Cognitive Impairment Using CogEvo: A Computerized Cognitive Function Assessment Tool.

To assess the utility of the computerized cognitive function assessment tool, CogEvo, as a screening tool for mild cognitive impairment in primary care, we explored the relationship between CogEvo performance, age, and the severity of cognitive dysfunction evaluated by the Mini-Mental State Examination (MMSE). The observational cross-sectional study included 209 individuals' data (mean age 79.4 ± 8.9 years). We conducted a correlation analysis between CogEvo and MMSE scores, compared the performance among the 3 cognitive function groups (MMSE ≥ 28 group; MMSE24-27 group; MMSE ≤ 23 group) using the MMSE cut-off, and evaluated CogEvo's predictive accuracy for cognitive dysfunction through ROC analysis. Both total CogEvo and MMSE scores significantly decreased with age. A significant positive correlation was observed between total CogEvo and MMSE scores, but a ceiling effect was detected in MMSE performance. Significant differences were observed in the total CogEvo score, including orientation and spatial cognitive function scores, among the 3 groups. CogEvo showed no educational bias. ROC analyses indicated moderate discrimination between the MMSE ≥ 28 group and the MMSE24-27 and MMSE ≤ 23 groups. The computer-administered CogEvo has the advantage of not exhibiting ceiling effects or educational bias like the MMSE, and was found to be able to detect age-related cognitive decline and impairment.

Okul Müdürlerinin Bilişsel Esneklikleri ile Etkili Problem Çözme Becerileri Arasındaki İlişki: Bir Kanonik Korelasyon Analizi

Current study aims to explore the relationship among cognitive flexibility variables (alternative and control) and effective problem solving variables (impulsive, reflective, avoidant, monitoring, problem solving confidence, and planfulness) in school principals’ sample. The population of the research consists of 564 school administrators working in public schools in Siirt, Turkey, in the 2020-2021 academic year. Research data were collected from 50 female and 261 male administrators who volunteered to participate in the research among school administrators. "Cognitive Flexibility Inventory" and "Problem Solving Inventory" were used as data collection tools in the study. Two independent t-tests were conducted to examine gender differences in participants' both cognitive flexibility and overall problem-solving scores. According to the research findings, it was determined that school administrators' cognitive flexibility levels and problem solving skills did not differ significantly according to gender. The canonical correlation analyze was utilized to test interrelationship between two set of variables. The canonical correlation analyze revealed two significant canonical functions. The findings of first canonical function indicated that, when both alternative and control sub-dimension of cognitive flexibility and total cognitive flexibility scores increase impulsive and avoidant scores decrease, while reflective, monitoring, problem solving confidence, and planfulness sub-dimensions of effective problem solving and total problem solving scores increase. The results also showed that there was a high and a positive correlation between overall cognitive flexibility level of school administrations and their effective problem solving skills. The findings of second canonical function also indicated that when alternative scores increase and control scores decrease, reflecting, monitoring, and impulsive problem solving scores decrease. Overall, the results suggest that the cognitive flexibility and effective problem solving nicely complement each other. In these respect, in order to be equipped to effectively solve problems, school principals need to be also equipped with cognitive flexibility skills.

Tooth Loss as a Predictor of Long-Term Care Requirements in the Elderly: A Study in Kobe City, Japan.

The Kobe project, which utilizes prospective data from the national health insurance system, focuses on early detection and preventive strategies through the Frail Kenshin health check-up program. Previous research has underscored the correlation between tooth loss and the decline in physical and cognitive functions. In this study, using Kobe project data, we examined the link between remaining teeth and long-term care needs in individuals aged 64-65 years, with primary and secondary objectives involving various health parameters and quality of life. We analyzed baseline data from a prospective study conducted alongside the Frail Check program for generally healthy individuals aged 64-65 yearsto examine the relationship between the number of remaining teeth and various health indicators. This study focused on citizens aged 64-65 years to identify those at risk of needing long-term care by the age of 65 years. Data from 1,530 participants were obtained, excluding eight individuals for specific reasons. At the end of the follow-up period, 41 (2.7%) individuals required supportand 15 (1.0%) needed long-term care alone. The data revealed a significant association between the number of remaining teeth and the need for long-term care or support, as demonstrated by the Cochran-Armitage trend test (p<0.001). Although trends were noted for nutrition and total Cognitive Functional Instrument Self scores, they did not reach statistical significance. Additionally, a decrease in the number of remaining teeth was significantly associated with worse European Quality of Life Five Dimensions (EQ-5D-5L) visual analog scale scores, mobility, and regular activities (p<0.001). Tooth loss indicates the potential long-term care needs of older adults. Monitoring oral health is crucial for addressing care requirements.

Associations of AHA’s Life’s Essential 8 health behaviors with cognitive function among U.S. Black and White midlife adults

AbstractBackgroundLife’s Simple 7 (LS7), originally proposed as the seven most important predictors of heart health, is associated with negative cognitive outcomes (Thacker et al., 2014). The recently updated Life’s Essential 8 (LE8) includes sleep. Limited research has investigated the association between LE8 and cognition, particularly within Black and White adults. We hypothesize that higher composite LE8 scores will be associated with better cognitive performance, particularly within Black adults.MethodCross‐sectional analyses were conducted including adults from the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study conducted in Baltimore, MD. Study participants (36‐76 years old; 41% male; 61% Black) completed all LE8 (Lloyd‐Jones et al., 2022) and global cognition measurements in wave 4 data collection (2013‐2017). Cognitive performance on a computerized cognitive battery (Joggle Research) yielded a total global cognition score and individual domains (e.g., working memory, attention). Linear regression analyses were stratified by race and poverty status (below 125% Federal poverty guidelines), education attainment (high school), and reading literacy (median split) respectively. Covariates included age, sex, sleep apnea, and depression. All reported models were fully adjusted.ResultAmong Black adults, higher LE8 scores (better CVH) were associated with better working memory only among individuals living above the poverty level (all b unstandardized; b = 0.008, p = .016), or only with high school education (b = 0.009, p = .027). Among White adults, higher LE8 score was associated with better working memory, particularly among individuals living above poverty level (b = 0.014, p = .002), having an education above high school (b = 0.019, p = .002), or high literacy (b = 0.021, p&lt;.001) . Additionally, higher LE8 scores were associated with better attention, and higher global cognition score among individuals living above poverty (b = 0.015, p = .042; b = 0.039, p = .025) or with a high literacy on (b = 0.023, p = .014; b = 0.049, p = .027).ConclusionHigher score of LE8 was associated with better working memory among both U.S. Black and White adults. However, higher LE8 scores were associated with performance across a larger variety of cognitive domains within White adults from diverse socioeconomic indicators. These findings illustrate unique LE8 and cognition associations when disentangling socioeconomic heterogeneity within racial groups.

Six‐Month Consistency of NIH Toolbox Cognition Battery Scores in Healthy Older Black Women with Subjective Cognitive Decline

AbstractBackgroundInterest in the NIH Toolbox Cognition Battery (NIHTB‐CB) for the clinical assessment of older adults is burgeoning. Longitudinal neuropsychological assessments are the most sensitive way to establish cognitive decline and dementia risk of older adults. The psychometric property of measurement invariance is essential to valid interpretations of change. However, few studies have evaluated the stability of NIHTB‐CB scores in a sample of cognitively normal older adults with subjective cognitive decline (SCD). This study aims to analyze measurement consistency of NIHTB‐CB performance over 6 months.Method N = 29 cognitively normal, older Black adult women (65‐81 years of age) with SCD were administered the NIHTB‐CB at baseline and six‐month follow‐up. Diagnostic status was determined via consensus conference following NACC UDS guidelines. We evaluated the mean change by matched‐pairs t‐tests, and measurement consistency by two‐way mixed effects models of intraclass correlations coefficients and Bland‐Altman plots. Uncorrected standard scores and fully corrected T scores were analyzed from NIHTB‐CB Cognition Composites of Total Cognition, Fluid Cognition, and Crystallized Cognition.ResultThere were no significant mean differences from baseline to follow‐up for corrected and uncorrected Total Cognition Scores. The uncorrected Fluid Score significantly increased by 2.5 points at follow‐up (t(28) = 2.18, p = .04), and the corrected Crystallized Score increased by 1.8 points at follow‐up (t(28) = ‐2.25, p = .03). The uncorrected Crystallized Score and the corrected Fluid Score did not differ across assessments. Consistency for the uncorrected and corrected Total scores was good, (ICC(3,1) = 0.83 and 0.80, respectively). Similarly, consistency for uncorrected and corrected Fluid Scores was also good (ICC(3,1) = 0.77 and 0.78). Consistency was excellent for uncorrected Crystallized Scores (ICC(3,1) = .92), but good for corrected scores (ICC(3,1) = .87). Discrepancy scores (baseline vs follow‐up) derived from uncorrected scores for the three composites were unrelated to age and education. Bland‐Altman plots of uncorrected scores for the Composite Scores were consistent with the ICC analyses, showing good agreement between measures.ConclusionNIHTB‐CB corrected and uncorrected composite scores have good longitudinal psychometric properties in a sample of older Black adult women with SCD, a relatively under‐investigated examinee sample. These findings also suggest that change in fluid or crystallized cognition over six months is unlikely in persons with SCD.

USING A MIDTERM WARNING SYSTEM TO IMPROVE STUDENT PERFORMANCE AND ENGAGEMENT IN AN INTRODUCTORY STATISTICS COURSE: A RANDOMIZED CONTROLLED TRIAL

This article reports on an evaluation the effectiveness of e-mailed grade “nudges” on students’ performance and engagement in an introductory statistics course for undergraduate health science students. In 2020–2021, 358 students were randomized to an e-mail (n = 178) or no e-mail (n = 180) group. The intervention e-mail contained information on each student’s predicted final grade (grade nudge). Using two-sample t-tests, the statistical analysis of final grades in the course showed a higher compatibility with a model of no mean difference for students in the e-mail (73.5%) vs. no e-mail (72.1%) group. Comparison of the distributions of final grades between the two groups, however, suggested the e-mailed nudges may be related to slight improvements in final grades. Specifically, the median final grade was higher in the e-mail group (74.6 vs. 72.4); the Q1 value in the e-mail group was also higher, and the interquartile range was similar: no e-mail group (15.8) vs. e-mail group (14.2). Students also completed the Scale of Student Engagement in Statistics (SSE-S). Total engagement, affective and cognitive subscale scores of the SSE-S were higher in the e-mail group, resulting in low compatibility with a model of no difference in engagement scores. Overall, the results showed there is potential for our midterm warning system to be used to improve outcomes, particularly given that it is simple to implement, cost-effective, and easily scalable.

A longitudinal study of polygenic score and cognitive function decline considering baseline cognitive function, lifestyle behaviors, and diabetes among middle-aged and older US adults

BackgroundGenomic study of cognition decline while considering baseline cognition and lifestyle behaviors is scarce. We aimed to evaluate the impact of a polygenic score for general cognition on cognition decline rate, while considering baseline cognition and lifestyle behaviors, among the general population and people with diabetes, a patient group commonly affected by cognition impairment.MethodsWe tested associations of the polygenic score for general cognition with annual changing rates of cognition measures in 8 years of follow-up among 12,090 White and 3100 Black participants of the Health and Retirement Study (HRS), a nationally representative sample of adults aged 50 years and older in the USA. Cognition measures including word recall, mental status, and total cognitive score were measured biannually. To maximize sample size and length of follow-up, we treated the 2010 wave of survey as baseline, and follow-up data until 2018 were analyzed. Baseline lifestyle behaviors, APOE status, and measured cognition were sequentially adjusted. Given racial differences in polygenic score, all analyses were conducted by race.ResultsThe polygenic score was significantly associated with annual changing rates of all cognition measures independent of lifestyle behaviors and APOE status. Together with age and sex, the polygenic score explained 29.9%, 15.9%, and 26.5% variances of annual changing rates of word recall, mental status, and total cognitive scores among Whites and explained 17.2%, 13.9%, and 18.7% variance of the three traits among Blacks. Among both White and Black participants, those in the top quartile of polygenic score had the three cognition measures increased annually, while those in the bottom quartile had the three cognition measures decreased annually. After further adjusting for the average cognition assessed in 3 visits around baseline, the polygenic score was still positively associated with annual changing rates of all cognition measures for White (P ≤ 2.89E − 19) but not for Black (P ≥ 0.07) participants. In addition, among participants with diabetes, physical activity offset the genetic susceptibility to decline of mental status (interaction P ≤ 0.01) and total cognitive scores (interaction P = 0.03).ConclusionsPolygenic score predicted cognition changes in addition to measured cognition. Physical activity offset genetic risk for cognition decline among diabetes patients.

33 Depressive Symptoms Drive the Underutilization of Cognitive Reappraisal in Veterans with PTSD

Objective:Adaptive emotional regulation strategies, such as cognitive reappraisal, are related to better neuropsychological functioning in the general population. Individuals with PTSD demonstrate difficulty with both emotional regulation and cognitive performance that contribute to clinical presentation (e.g., negative mood, irritability). However the extent to which neuropsychological functioning is associated with emotion regulation, alone and in concert with common comorbid symptoms like depression, remains understudied in this population. Better understanding how specific neuropsychological functions relate to cognitive reappraisal could point to novel treatment targets given preliminary evidence that certain cognitive training techniques can improves neuropsychological and affective outcomes. The present study aims to investigate the relationship between clinical symptoms of PTSD and depression, working memory capacity, and cognitive reappraisal in Veterans with PTSD. We hypothesized that clinical symptoms and working memory capacity would interact to predict cognitive reappraisal, such that elevated depression would relate to worse cognitive reappraisal, particularly for individuals with poor working memory capacity.Participants and Methods:Measures of working memory (symmetry span task), mental health symptomatology (Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) and Beck Depression Inventory-II (BDI-II), and emotional regulation (Emotion Regulation Questionnaire (ERQ)) were collected in 38 Veterans. A regression analysis was conducted with total CAPS score, total BDI score, total symmetry span score, and the interaction between BDI score and symmetry span score as the independent variables and total ERQ cognitive reappraisal score as the dependent variable.Results:When examining each predictor independently, cognitive reappraisal was not associated with working memory (t=1.42, p=.165), but was significantly associated with PTSD (t=-3.17, p&lt;.003) and depressive (t=-4.15, p&lt;.001) symptom severity. The multiple regression model (F(4, 35)=4.45, p&lt;.005, R2=.26) did not support the hypothesized relationship between working memory and depressive symptoms (t=0.56, p=.579). Depression independently predicted utilization of cognitive reappraisal in veterans with PTSD (t=2.43, p=.020) but PTSD symptom severity and working memory scores did not. However, additional investigation revealed that independently, greater PTSD symptom severity did predict less utilization of cognitive reappraisal (t=-3.17, p&lt;.005).Conclusions:While depressive symptoms did not moderate the relationship between working memory and cognitive reappraisal, depressive symptoms did best predict utilization of cognitive reappraisal in a population with PTSD. Contrary to the hypothesized outcome, neither working memory nor PTSD symptoms were significant predictors of cognitive reappraisal when controlling for depressive symptoms. This suggests that the phenomenon of lower cognitive reappraisal rates in individuals with PTSD may be due to the presence of depressive symptoms rather than traumatic stress symptoms or neuropsychological ability. Due to the sample size and homogeneous diagnosis of the current study it is possible that the predicted relationship between working memory, PTSD severity, and cognitive reappraisal was not observed due to low power or a restricted range. Further investigation specifically in clinical populations on factors that predict utilization of cognitive reappraisal could expand on these findings in populations experiencing other stress-based disorders.

Low pre-albumin but not thiamine predicts cognitive deficits in adolescents post-Fontan and healthy controls.

Low pre-albumin, body mass index, and thiamine levels have been associated with poor nutritional status and cognitive/memory deficits in adult heart failure patients. However, the relationship of these nutritional/dietary intake biomarkers to cognition has not been assessed in adolescents post-Fontan procedure and healthy controls. This is a cross-sectional study. Adolescents (14-21 years of age) post-Fontan completion were recruited from paediatric cardiology clinics and controls from the community. The Montreal Cognitive Assessment was administered (normal ≥ 26), and blood draw (thiamine [normal 70-110 nmol/L] and pre-albumin levels [adolescent normal 23-45 mg/dL]) and the Thiamine Food Frequency Questionnaire were completed by all participants. Seventy subjects, 40 post-Fontan (mean age 16 ± 1.6, female 51%, Hispanic 44%, hypoplastic left heart syndrome 26%) and 30 controls (mean age 16.8 ± 1.9, female 52%, Hispanic 66%), were participated. Post-Fontan group had lower median total cognitive scores (23 versus 29, p < 0.001), pre-albumin levels (23 versus 27, p = 0.013), and body mass index (20 versus 24, p = 0.027) than controls. Post-Fontan group had higher thiamine levels than controls (127 versus 103, p = 0.033). Lower pre-albumin levels (< 23) and underweight body mass index were associated with abnormal total cognitive scores (p = 0.030). Low pre-albumin level (p = .038) was an independent predictor of worse cognition. Lower pre-albumin was an independent predictor for worse cognition in adolescents post-Fontan. Lower pre-albumin levels may reflect chronic liver changes or protein-losing enteropathy seen in Fontan physiology. These findings highlight the possibility for nutrition-induced cognitive changes.

Association between cognitive function and probability of prodromal Parkinson's disease in middle aged and elderly people aged 55 years and above in 4 provinces in China

Objective: To analyze probability of prodromal Parkinson's disease (pPD) and assess the association between global cognitive function and cognitive domain function and probability of pPD in ≥55 years old middle-aged and elderly people in Hebei, Zhejiang, Shaanxi and Hunan Provinces in China. Methods: Data were collected from dataset of the Community-based Cohort Study on Nervous System Disease 2020. We selected 4 634 Alzheimer disease and Parkinson's disease free persons aged ≥55 years with completed information on demographics, disease history, cognitive test, and risk factors of Parkinson's disease for this study. Cognitive function was assessed using Montreal Cognitive Assessment Scale (Chinese version). Calculation of probability of pPD and assessment of possible/probable pPD were performed according to the criteria published by the International Parkinson and Movement Disorder Society. Multivariate linear regression model was used to analyze the association between cognitive function and probability of pPD. Results: The M (Q1,Q3) of global cognitive function and cognitive domains in terms of memory, execution, visuospatial function, language, attention and orientation were 25 (20, 30), 13 (11, 15), 10 (7, 12), 6 (4, 7), 5 (4, 6), 15 (12, 18) and 6 (6, 6) points, respectively. The M(Q1,Q3) of probability of pPD was 0.42% (0.80%, 1.73%), and the proportion of the study subjects with possible/probable pPD was 0.4%. Differences in the distribution of probability of pPD were significant among groups by total cognitive score quartiles (P<0.001), and the difference in proportions of study subjects with possible/probable pPD was significant and showed decline trend (P=0.001). After adjusted for confounders, the results of multivariate linear regression analyses showed that probability of pPD in the Q2, Q3 and Q4 group decreased by 23.4%, 31.2% and 20.1% compared with Q1 group, and corresponding β values were 0.766 (95%CI: 0.702-0.836), 0.688 (95%CI: 0.631-0.751) and 0.799 (95%CI: 0.730-0.875), respectively, the trend was significant (P<0.001). Higher index scores of execution, visuospatial function, language, attention and orientation were highly related to lower probability of pPD (P<0.001). Conclusion: Declines in global cognitive function and cognitive domains of execution, visuospatial function, language, attention and orientation might increase the probability of pPD in middle-aged and elderly people, suggesting the importance of cognitive intervention in early stage for pPD prevention.

Cognitive and gait in Wilson's disease: a cognitive and motor dual-task study.

Cognitive and motor dual-tasks play important roles in daily life. Dual-task interference impacting gait performance has been observed not only in healthy subjects but also in subjects with neurological disorders. Approximately 44-75% of Wilson's disease (WD) patients have gait disturbance. According to our earlier research, 59.7% of WD patients have cognitive impairment. However, there are few studies on how cognition affects the gait in WD. Therefore, this study aims to explore the influence of cognitive impairment on gait and its neural mechanism in WD patients and to provide evidence for the clinical intervention of gait disturbance. We recruited 63 patients who were divided into two groups based on their scores on the Addenbrooke's cognitive examination III (ACE-III) scale: a non-cognitive impairment group and a cognitive impairment group. In addition to performing the timed up and go (TUG) single task and the cognitive and motor dual-task digital calculation and animal naming tests, the Tinetti Balance and Gait Assessment (POMA), Berg Balance Scale (BBS), and brain MRI severity scale of WD (bMRIsc-WD) were evaluated. The dual-task cost (DTC) was also computed. Between the two groups, the results of the enhanced POMA, BBS, and bMRIsc-WD scales, as well as gait performance measures such as TUG step size, pace speed, pace frequency, and DTC value, were compared. (1) Among the 63 patients with WD, 30 (47.6%) patients had gait disturbance, and the single task TUG time was more than 10 s. A total of 43 patients had cognitive impairment, the incidence rate is 44.4%. Furthermore, 28 (44.4%) patients had cognitive impairment, 39 (61.9%) patients had abnormal brain MRI. (2) The Tinetti gait balance scale and Berg balance scale scores of patients with cognitive impairment were lower than those of patients without cognitive impairment (p < 0.05), and the pace, step size, and pace frequency in the single task TUG were slower than those of patients without cognitive impairment (p < 0.05). There was no change in the pace frequency between the dual-task TUG and the non-cognitive impairment group, but the pace speed and step size in the dual-task TUG were smaller than non-cognitive impairment group (p < 0.05). There was no difference in DTC values between cognitive impairment group and non-cognitive impairment group when performing dt-TUG number calculation and animal naming respectively (p > 0.05). However, regardless of cognitive impairment or not, the DTC2 values of number calculation tasks is higher than DTC1 of animal naming tasks in dt-TUG (p < 0.05). (3) Pace speed and step size were related to the total cognitive score, memory, language fluency, language understanding, and visual space factor score of the ACE-III (p < 0.05), and step frequency was correlated with memory and language comprehension factors (p < 0.05). There was no correlation between the attention factor scores of the ACE-III and TUG gait parameters of different tasks (p > 0.05). Brain atrophy, the thalamus, caudate nucleus, and cerebellum were correlated with cognitive impairment (p < 0.05), the lenticular nucleus was related to the step size, brain atrophy was related to the pace speed, and the thalamus, caudate nucleus, and midbrain were involved in step frequency in WD patients (p < 0.05). WD patients had a high incidence of cognitive impairment and gait disorder, the pace speed and step size can reflect the cognitive impairment of WD patients, cognitive impairment affects the gait disorder of WD patients, and the different cognitive and motor dual-tasks were involved in affecting gait parameters. The joint participation of cognitive impairment and lesion brain area may be the principal neural mechanism of gait abnormality in WD patients.

Epigenetic associations with adolescent grey matter maturation and cognitive development.

Introduction: Adolescence, a critical phase of human neurodevelopment, is marked by a tremendous reorganization of the brain and accompanied by improved cognitive performance. This development is driven in part by gene expression, which in turn is partly regulated by DNA methylation (DNAm). Methods: We collected brain imaging, cognitive assessments, and DNAm in a longitudinal cohort of approximately 200 typically developing participants, aged 9-14. This data, from three time points roughly 1year apart, was used to explore the relationships between seven cytosine-phosphate-guanine (CpG) sites in genes highly expressed in brain tissues (GRIN2D, GABRB3, KCNC1, SLC12A9, CHD5, STXBP5, and NFASC), seven networks of grey matter (GM) volume change, and scores from seven cognitive tests. Results: The demethylation of the CpGs as well as the rates of change in DNAm were significantly related to improvements in total, crystalized, and fluid cognition scores, executive function, episodic memory, and processing speed, as well as several networks of GM volume increases and decreases that highlight typical patterns of brain maturation. Discussion: Our study provides a first look at the DNAm of genes involved in myelination, excitatory and inhibitory receptors, and connectivity, how they are related to the large-scale changes occurring in the brain structure as well as cognition during adolescence.

Associations Between Socioeconomic Status, Obesity, Cognition, and White Matter Microstructure in Children

Lower neighborhood and household socioeconomic status (SES) are associated with negative health outcomes and altered brain structure in children. It is unclear whether such findings extend to white matter and via what mechanisms. To assess whether and how neighborhood and household SES are independently associated with children's white matter microstructure and examine whether obesity and cognitive performance (reflecting environmental cognitive and sensory stimulation) are plausible mediators. This cross-sectional study used baseline data from participants in the Adolescent Brain Cognitive Development (ABCD) study. Data were collected at 21 US sites, and school-based recruitment was used to represent the US population. Children aged 9 to 11 years and their parents or caregivers completed assessments between October 1, 2016, and October 31, 2018. After exclusions, 8842 of 11 875 children in the ABCD study were included in the analyses. Data analysis was conducted from July 11 to December 19, 2022. Neighborhood disadvantage was derived from area deprivation indices at participants' primary residence. Household SES factors were total income and highest parental educational attainment. A restriction spectrum imaging (RSI) model was used to quantify restricted normalized directional (RND; reflecting oriented myelin organization) and restricted normalized isotropic (RNI; reflecting glial and neuronal cell bodies) diffusion in 31 major white matter tracts. The RSI measurements were scanner harmonized. Obesity was assessed through body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), age- and sex-adjusted BMI z scores, and waist circumference, and cognition was assessed through the National Institutes of Health Toolbox Cognition Battery. Analyses were adjusted for age, sex, pubertal development stage, intracranial volume, mean head motion, and twin or siblingship. Among 8842 children, 4543 (51.4%) were boys, and the mean (SD) age was 9.9 (0.7) years. Linear mixed-effects models revealed that greater neighborhood disadvantage was associated with lower RSI-RND in the left superior longitudinal fasciculus (β = -0.055; 95% CI, -0.081 to -0.028) and forceps major (β = -0.040; 95% CI, -0.067 to -0.013). Lower parental educational attainment was associated with lower RSI-RND in the bilateral superior longitudinal fasciculus (eg, right hemisphere: β = 0.053; 95% CI, 0.025-0.080) and bilateral corticospinal or pyramidal tract (eg, right hemisphere: β = 0.042; 95% CI, 0.015-0.069). Structural equation models revealed that lower cognitive performance (eg, lower total cognition score and higher neighborhood disadvantage: β = -0.012; 95% CI, -0.016 to -0.009) and greater obesity (eg, higher BMI and higher neighborhood disadvantage: β = -0.004; 95% CI, -0.006 to -0.001) partially accounted for the associations between SES and RSI-RND. Lower household income was associated with higher RSI-RNI in most tracts (eg, right inferior longitudinal fasciculus: β = -0.042 [95% CI, -0.073 to -0.012]; right anterior thalamic radiations: β = -0.045 [95% CI, -0.075 to -0.014]), and greater neighborhood disadvantage had similar associations in primarily frontolimbic tracts (eg, right fornix: β = 0.046 [95% CI, 0.019-0.074]; right anterior thalamic radiations: β = 0.045 [95% CI, 0.018-0.072]). Lower parental educational attainment was associated with higher RSI-RNI in the forceps major (β = -0.048; 95% CI, -0.077 to -0.020). Greater obesity partially accounted for these SES associations with RSI-RNI (eg, higher BMI and higher neighborhood disadvantage: β = 0.015; 95% CI, 0.011-0.020). Findings were robust in sensitivity analyses and were corroborated using diffusion tensor imaging. In this cross-sectional study, both neighborhood and household contexts were associated with white matter development in children, and findings suggested that obesity and cognitive performance were possible mediators in these associations. Future research on children's brain health may benefit from considering these factors from multiple socioeconomic perspectives.

The association between physical activity and cognitive function in the elderly in rural areas of northern China.

Physical activity plays an important role in cognitive function in older adults, and the threshold effect and saturation effect between physical activity and cognitive function are unclear. The purpose of this study was to explore the threshold effect and saturation effect between physical activity and cognitive function in the elderly. The International Physical Activity Questionnaire (IPAQ) was used to measure moderate-intensity physical activity and vigorous-intensity physical activity and total physical activity in older adults. Cognitive function assessment uses the Beijing version of the Montreal Cognitive Assessment Scale (MoCA). The scale consists of seven parts: visual space, naming, attention, language, abstract ability, delayed recall and orientation, for a total of 30 points. The total score of the study participants < 26 was defined as the optimum cutoff point for a definition of mild cognitive impairment (MCI). The multivariable linear regression model was used to initially explore the relationship between physical activity and total cognitive function scores. The logistic regression model was used to assess the relationship between physical activity and cognitive function dimensions and MCI. The threshold effect and saturation effect between the total physical activity and the total cognitive function scores were investigated by smoothed curve fitting. This cross-sectional survey had a total of 647 participants aged 60 years and older (mean age: 73 years, female: 53.7%). Participants' higher level of physical activity were associated with higher visual space, attention, language, abstract ability, and delayed recall scores (P < 0.05). Physical activity was not statistically associated with naming and orientation. Physical activity was a protective factor for MCI (P < 0.05). Physical activity was positively correlated with total cognitive function scores. There was a saturation effect between total physical activity and total cognitive function scores, and the saturation point was 6546 MET × min/wk. This study showed a saturation effect between physical activity and cognitive function, and determined an optimal level of physical activity to protect cognitive function. This finding will help update physical activity guidelines based on cognitive function in the elderly.

Differences in total cognition and cerebrovascular function in female breast cancer survivors and cancer-free women.

Reduced cognition is often reported by breast cancer patients and survivors, but the mechanisms for this decline are yet to be determined. We compared the differences in cerebrovascular function and cognition in breast cancer survivors (n=15) and cancer-free women (n=15) matched by age and body mass index. Participants undertook anthropometric, mood, cardiovascular, exercise performance, strength, cerebrovascular, and cognitive measurements. Transcranial Doppler ultrasound was used to measure the cerebrovascular responsiveness (CVR) to physiological (hypercapnia; 5% carbon dioxide) and psychological stimuli. Breast cancer survivors had a lower CVR to hypercapnia (21.5±12.8 vs 66.0±20.9%, P<0.001), CVR to cognitive stimuli (15.1±1.5 vs 23.7±9.0%, P<0.001) and total composite cognitive score (100±12 vs. 113±7, P=0.003) than cancer-free women. These parameters remained statistically different between the groups following adjustments for covariates using an analysis of co-variance. We observed significant correlations between multiple measures and exercise capacity the only variable positively correlated to all primary measures (CVR to hypercapnia, r=0.492, P=0.007; CVR to cognitive stimuli r=0.555, P=0.003; and total composite cognitive score, r=0.625, P<0.001). In this study, breast cancer survivors had lower cerebrovascular and cognitive function than age-matched cancer-free women, which may be attributable to the effects of cancer and cancer treatment on brain health.

0087 Associations between AHA’s Life’s Essential 8 and cognition in a sample of diverse midlife adults

Abstract Introduction Life’s Simple 7 (LS7), originally proposed as the seven most important predictors of heart health, is associated with negative cognitive outcomes. Recently an updated Life’s Essential 8 (LE8) added sleep as the new eighth component. However, limited research has investigated LE8 and cognitive outcomes. We hypothesize that a higher composite LE8 score will be associated with better cognitive performance. Methods Cross-sectional analyses were conducted including 1498 adults (36-76 years old, 41% male, 61% African American) from the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study who completed all LE8 and global cognition measurements in wave 4 data collection (2013-2017). Blood pressure, glucose, cholesterol, BMI, diet, physical activity, and smoking were calculated based on available wave 4 data per LE8 scoring guidance. The sleep component was scored based on the sleep duration question from the Pittsburgh Sleep Quality Index (“During the past month, how many hours of actual sleep did you get at night?”). LE8 score was calculated by averaging the scores from the eight components. Cognitive performance was measured from a Joggle battery to calculate a total global cognition score and individual domains (memory, attention, visual orientation, executive function, speed). A set of linear regression analyses were performed. Covariates included biological age, sex, race, poverty status, sleep apnea, education attainment (high school), reading literacy, and depression (CES-D). Results Higher scores on LE8 were significantly associated with better global cognitive performance, even after adjusting for covariates (b=0.024, p = .014). Among all cognitive domains, higher LE8 scores were significantly associated with better memory (b = 0.011, p &amp;lt; .001), attention (b=0.012, p = .007), but not visual orientation, executive function, or speed. Conclusion Better cardiovascular health, as indicated by a higher LE8 composite score, is associated with better cognitive performance among U.S. middle-aged and older adults. Future studies may further explore this relationship using longitudinal data and explore the predictive power of each LE8 component. Support (if any) UF1AG072619 (PI: Gamaldo)

Effectiveness of an Online Dementia Prevention Program on Cognitive Function and Depression in Community-Dwelling Older Adults during the COVID-19 Pandemic in Korea.

(1) Background: Continuous participation in a comprehensive dementia prevention program is important for community-dwelling older adults during the coronavirus disease (COVID-19) pandemic, as limitations on their communities and social participation have increased and participation in daily tasks has decreased. These factors can negatively affect their cognitive function and symptoms of depression. This study aimed to introduce an evidence-based online dementia prevention program in the South Korean context and to identify its effect on cognitive function and symptoms of depression in community-dwelling older adults during the COVID-19 pandemic. (2) Methods: One hundred and one community-dwelling older adults without dementia participated in twelve sessions of an online dementia prevention program designed by occupational therapists. Cognitive function and symptoms of depression were assessed before and after the program. Cognitive function was tested using the Cognitive Impairment Screening Test and symptoms of depression were assessed using the Korean version of the Short Geriatric Depression Scale. The participants' opinions were gathered using open-ended questions. (3) Results: After the program, according to the raw score, orientation was maintained and attention, visuospatial function, executive function, memory, and language function increased. The memory and total cognitive score was improved significantly. Symptoms of depression significantly decreased. The program's benefits according to the participants were participation in new activities, boredom reduction, online communication, and reminiscence. (4) Conclusions: An online dementia prevention program is effective in maintaining and increasing cognitive function and preventing depression in community-dwelling older adults. An online dementia prevention program is a useful method in providing opportunities to participate in cognitive training and continuous daily activities during the COVID-19 pandemic.

NIH Toolbox Cognitive Battery in non-Hispanic Black individuals: role of cerebral vascular function, pulse wave velocity, and psychosocial stress exposure

Non-Hispanic Black (BL) individuals are ~ 2 times more likely to develop cognitive impairment, Alzheimer’s disease, and related dementias (ADRD) relative to other populations. ADRD prevalence is expected to double by 2060, with a greater increase in BL and Hispanic populations. Reduced cerebral vascular function and large elastic artery health increases risk for cognitive decline and ADRD. In addition, psychosocial stress exposure, including at a young age, is a significant predictor of intellectual function and executive attention. However, the relationship between 1) cerebral &amp; peripheral vascular function/health and indices of cognitive function, and 2) psychosocial stress exposure and indices of cognitive function in relatively young, healthy BL individuals are incompletely understood. We tested the hypothesis that cerebral vascular function and large elastic artery health are blunted in BL individuals, which will be associated with reduced cognitive performance. We also hypothesized that psychosocial stress exposure in the BL individuals is negatively associated with cognitive performance. METHODS: Eight BL (2 males; age: 20±1 yr; BMI: 22±3 kg/m2) and 8 WH (4 males; age: 20±3 yr; BMI: 23±2 kg/m2) individuals participated. Cognitive function was indexed using the NIH Toolbox Cognitive Battery which compiles a fluid score (i.e., capacity for new learning and information processing in novel situations), a crystallized score (i.e., past learning experiences), and a total cognition score. Cerebral vascular function was assessed as the % increase in cerebral vascular conductance (CVCi = middle cerebral artery blood velocity/mean arterial pressure) during hypercapnia (6% CO2). Large elastic artery health was assessed as aortic pulse wave velocity (PWV). Psychosocial stress exposure was assessed as adverse childhood experiences (ACEs). RESULTS: The national percentile and age-adjusted fluid and total scores were lower in the BL individuals ( P&lt;0.05 for each), whereas the crystallized score was not different ( P=0.79). The % increase in CVCi during hypercapnia (BL: 32±15, WH: 54±50%, P=0.26) and PWV (BL: 5.7±0.9, WH: 5.7±0.9 m·s-1, P=0.96) was similar between groups. Within the BL individuals there was not a significant correlation between %CVCi or PWV and the fluid, crystallized, or total scores ( P&gt;0.05 for each) while ACEs tended to be negatively associated with total ( P=0.06) but not fluid or crystallized scores ( P&gt;0.05 for each). CONCLUSION: These preliminary data suggest that young, healthy BL individuals may have reduced indices of cognitive function, particularly in the fluid domain, which may be associated with ACEs. This does not appear to be related to cerebral vascular function or large elastic artery stiffness. Future work will continue to assess these relationships in a population with a wider age range and more diverse life experiences. NIH R15 (HL156128, RMB) &amp; Peanut Institute (982307, RMB) This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Genome-wide association study of population-standardised cognitive performance phenotypes in a rural South African community

Cognitive function is an indicator for global physical and mental health, and cognitive impairment has been associated with poorer life outcomes and earlier mortality. A standard cognition test, adapted to a rural-dwelling African community, and the Oxford Cognition Screen-Plus were used to capture cognitive performance as five continuous traits (total cognition score, verbal episodic memory, executive function, language, and visuospatial ability) for 2,246 adults in this population of South Africans. A novel common variant, rs73485231, reached genome-wide significance for association with episodic memory using data for ~14 million markers imputed from the H3Africa genotyping array data. Window-based replication of previously implicated variants and regions of interest support the discovery of African-specific associated variants despite the small population size and low allele frequency. This African genome-wide association study identifies suggestive associations with general cognition and domain-specific cognitive pathways and lays the groundwork for further genomic studies on cognition in Africa.

Assessing the causal effect of long-term exposure to air pollution on cognitive decline in middle-aged and older adults – Empirical evidence from a nationwide longitudinal cohort

Air pollution remains a risk factor for the global burden of disease. Middle-aged and older people are more susceptible to air pollution because of their declining physical function and are more likely to develop diseases from long-term air pollution exposure. Studies of the effects of air pollution on cognitive function in middle-aged and older adults have been inconsistent. More representative and definitive evidence is needed. This study analysed data from the Chinese Family Panel Study, an ongoing nationwide prospective cohort study, collected in waves 2014, 2016 and 2018. Rigorously tested instrument was selected for analysis and participants’ PM2.5 and instrument exposures were assessed using high-precision satellite data. The causal relationship between long-term exposure to air pollution and poor cognitive function in middle-aged and older adults was investigated using the Correlated Random Effects Control Function (CRE-CF) method within a quasi-experimental framework. This study included a total of 7042 participants aged 45 years or older. A comparison of CRE-CF with other models (OLS model, ordered probit model, and ordered probit-CRE model) demonstrated the necessity of using CRE-CF given the endogeneity of air pollution. The credibility and validity of the instrumental variable were verified. In the CRE-CF model, long-term exposure to PM2.5 was found to accelerate cognitive decline in middle-aged and older adults (coefficients of −0.159, −0.336 and −0.244 for the total cognitive, verbal and mathematical scores, respectively). Taken together, these results suggest that chronic exposure to ambient air pollution is associated with cognitive decline in middle-aged and older adults, which highlights the need for appropriate protective policies.