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- New
- Research Article
- 10.3758/s13421-025-01776-z
- Jan 28, 2026
- Memory & cognition
- Katherine A Lee + 1 more
Knowledge is built through direct experiences and productive processes like self-derivation through memory integration. Prior research suggests that individual variability in self-derivation is associated with awareness of the task structure. In three experiments, half of the participants were told the task structure before participating in a self-derivation task (between-subjects manipulations). In a fourth experiment, half of participants were told the task structure before the second half of the task trials (within-subjects manipulation). Explicit instruction regarding the task structure did not facilitate self-derivation performance in any of the experiments. Additionally, neither providing the opportunity to explicitly practice the task through example trials (Experiment 2) nor implicitly practice the task by engaging in the task three (Experiment 3) or two (Experiment 4) times facilitated self-derivation performance. The interventions failed to facilitate self-derivation performance even when participants clearly encoded and remembered information about the task structure (Experiments 1B and 4). As in prior research, at the individual level, measures of verbal comprehension and working memory were positively correlated with task performance. We also measured task-based (debriefing questions) and trait-based (Metacognitive Awareness Inventory) awareness and found that only task-based awareness was positively associated with self-derivation performance. These results provide novel insights into the role (or lack thereof) of information about the task structure and suggest that self-discovery of the opportunity to self-derive new information may be the key.
- New
- Research Article
- 10.69760/jales.2026001003
- Jan 21, 2026
- Journal of Azerbaijan Language and Education Studies
- Zarifa Sadigzade
Second language (L2) processing research has predominantly focused on verbal working memory (WM), yet the potential role of visuospatial WM (VSWM) remains underexplored. This study examines how a concurrent VSWM load impacts predictive eye movements during L2 spoken word processing. Fifty adult L2 English learners completed a visual-world eye-tracking experiment in which they listened to sentences that were either predictive or non-predictive of an upcoming noun, while simultaneously performing a secondary visuospatial memory task (symmetry span) in a high-load condition. Growth curve analyses revealed that under high VSWM load, anticipatory fixations to target objects were delayed by approximately 150 ms compared to a low-load baseline, a significant effect (β = –0.22, p < 0.001). No interaction with L2 proficiency was observed. These findings suggest that VSWM capacity constrains real-time phonological prediction in L2 listening, extending theoretical models of WM in SLA and offering practical insights for multimedia language learning.
- New
- Research Article
- 10.1080/13548506.2025.2606183
- Jan 10, 2026
- Psychology, Health & Medicine
- Maddison Penson + 1 more
ABSTRACT Individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) frequently report pronounced cognitive difficulties, yet the empirical literature has not fully characterised how discrete components of working memory are affected. Given that working memory serves as a foundational system supporting complex cognitive processes, differentiating performance across verbal and visual modalities provides critical insight into which higher-order functions may be most vulnerable. This systematic review/meta-analysis aimed to synthesise current research to investigate how ME/CFS impacts working memory systems. Using PRISMA guidelines, a systematic search of 6 databases was undertaken (MEDLINE, CINAHL, Web of Science Core Collection, PubMed, EMBASE and PsycINFO). Initially, 10 574 papers were imported and following screening 34 studies of good to strong quality met the inclusion criteria. A series of random effects models were utilised to analyse working memory. Results indicated a significant difference and large effect size between ME/CFS individuals and controls on verbal working memory tasks; however, no significant difference in visual working memory performance was found between the groups. Following the breakdown of these subsystems into span/attentional control tasks and object/spatial tasks, these results remained consistent. These findings contribute to the body of ME/CFS research by articulating where specific working memory deficits lie. Specifically, they show that individuals with ME/CFS have impaired verbal memory performance. This knowledge can guide future research targeting higher-order verbal cognition and underscores the importance of recognising cognitive manifestations within ME/CFS clinical care.
- Research Article
- 10.3758/s13428-025-02905-x
- Jan 6, 2026
- Behavior research methods
- Nienke E R Van Bueren + 3 more
Electroencephalography (EEG) provides valuable insights into brain development, but collecting high-quality data can be tedious, limiting its usability with children. This study evaluates the feasibility and reliability of EEG data acquisition in children with a wireless consumer-grade EEG headset (EMOTIV EPOC X), by comparing it to a research-grade system (BioSemi ActiveTwo), with a focus on aperiodic brain activity. The portability of the EMOTIV headset allows for EEG data collection in ecologically valid, real-world settings such as schools, enabling novel insights into brain activity during learning. We recorded EEG from 93 children (aged 9-10 years) using the EMOTIV headset, beginning with a 4-min resting-state measurement, followed by assessments of mathematical ability, visuospatial working memory, and verbal working memory, in a classroom environment. Aperiodic activity, thought to reflect fundamental aspects of neural excitability and cognitive processing, was extracted and its reliability compared across the two EEG systems. We further tested whether aperiodic activity recorded with EMOTIV predicts mathematical ability, replicating earlier research using research-grade EEG equipment. Our findings reveal that, similar to earlier findings, lower aperiodic activity was associated with higher math performance, supporting its role as a neural marker of cognitive ability. These results demonstrate the feasibility and reliability of using a consumer-grade mobile EEG headset to investigate individual differences in cognitive development in naturalistic contexts. This work opens up new opportunities for large-scale, school-based neurocognitive assessments and paves the way for personalized educational approaches based on neural profiles.
- Research Article
- 10.1080/09297049.2025.2595075
- Jan 5, 2026
- Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence
- Cristian Camilo Trujillo-Trujillo + 2 more
Early interventions to enhance executive function (EF) have received growing attention; however, evidence of their effectiveness remains limited. To address this gap, we systematically reviewed and meta-analyzed studies evaluating such interventions in typically developing children aged 3 to 6 years. A database search conducted through January 2025 identified 35 eligible studies (randomized and non-randomized), including 2,367 participants in intervention groups and 1,928 in controls. Interventions comprised 27 cognitive-based, 7 multimodal, and 1 physical activity program. Seventeen randomized trials were included in the meta-analysis, examining inhibitory control, nonverbal working memory, and verbal working memory. Results showed small positive effects on verbal working memory (d = 0.13; I2 = 18%) and inhibitory control (d = 0.10; I2 = 88%), and an almost null effect on nonverbal working memory (d = 0.02; I2 = 86%). Although modest in magnitude, these patterns suggest domain-specific gains that may hold developmental relevance in preschool populations. The small effect sizes likely reflect the brief duration, methodological heterogeneity, and limited statistical power of the included studies, which were primarily conducted in non-clinical samples. Overall, these findings provide cautious yet informative evidence on the potential benefits of early EF interventions and underscore the need for larger, methodologically rigorous studies to identify which approaches yield consistent and meaningful improvements in early executive functioning.
- Research Article
- 10.1016/j.neuroimage.2026.121708
- Jan 1, 2026
- NeuroImage
- Lucie Attout + 4 more
The representation of serial order in working memory: A matter of space or time?
- Research Article
- 10.1038/s41598-025-29148-2
- Dec 29, 2025
- Scientific Reports
- Haim Raviv + 2 more
The current randomized controlled trial (RCT) examined both immediate and long-term effects of five consecutive bifrontal tACS sessions on verbal WM functioning in 30 healthy adult participants. WM performance and event-related quantitative electroencephalography (qEEG) parameters (mean power of frontal theta oscillations during three different WM events) were noted at baseline, immediately after tACS intervention, and at four-week post intervention. In comparison to the sham-tACS group, WM performance in active tACS group was improved following a four-week post-intervention period across all WM events, but not immediately after tACS intervention. Left prefrontal theta power in the active group decreased immediately after the intervention (in comparison to baseline) and remained low at four weeks, while the sham group returned to high theta-power baseline levels. Additionally, at four weeks post-intervention, participants in the active group demonstrated higher episodic memory accuracy compared to the sham group, which was associated with lower frontal theta power during WM encoding events. These findings are consistent with the hypothesized long-term plasticity effects. The current results highlight the role of event-related prefrontal theta power modulation in enhancing verbal WM and episodic memory retrieval in humans acutely, and over time.
- Research Article
- 10.1111/ejn.70371
- Dec 29, 2025
- The European Journal of Neuroscience
- Alexandra I Kosachenko + 7 more
ABSTRACTPrevious studies of verbal working memory (WM) have reported inconsistent changes in alpha power during retention, with both increases and decreases observed. We asked whether these discrepancies arise from how stimuli are presented. Thirty adults memorized seven digits presented in four modes: Simultaneous (all digits for 2800 ms) or sequential presentations at Fast (400 ms per digit), Slow (1000 ms per digit), and Fast + delay (400 ms per digit plus a 600‐ms free time in between). We analyzed EEG during encoding and a 6‐s retention period in theta (4–7 Hz), alpha (8–13 Hz), and beta (18–24 Hz) frequency bands. Encoding produced parametric load‐related theta increase and beta decrease, possibly reflecting growing executive control demands and motor program formation, respectively. Alpha power did not scale with load during encoding. Single trial models linked stronger encoding theta and deeper alpha suppression to better recall, whereas retention power did not predict accuracy. During retention, theta and beta were unaffected by presentation mode. Alpha power did not differ significantly when all sequential modes were grouped together compared to the simultaneous mode. However, the Fast + delay mode uniquely showed below‐baseline alpha in the first half of the retention. Our findings suggest that alpha dynamics are sensitive to the temporal structure of encoding and retention periods, particularly the presence or absence of free intervals between stimulus presentations. We propose that alpha modulation during WM retention may reflect processes beyond the simple gating of irrelevant sensory information.
- Research Article
- 10.1007/s00787-025-02942-z
- Dec 22, 2025
- European child & adolescent psychiatry
- Patricia Camprodon-Boadas + 13 more
Cognitive reserve (CR), referring to the brain's adaptability to maintain functioning despite pathology, has been found to positively impact the clinical manifestations in schizophrenia and bipolar disorder. Here, we aimed to explore the protective role of CR in children at familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) compared with population-based controls (PBC). This study is part of The Danish High Risk and Resilience Study, a cohort study of 522 seven-year-old children at FHR-SZ (n = 202, 45.6% females) or FHR-BP (n = 120, 46.1% females) and PBC (n = 200, 46.2% females). CR was assessed using principal component analysis including information about child IQ, school performance, peer relations, physical leisure activities, developmental milestones, parental education and occupation, and family leisure activities. Clinical outcomes included child global functioning, lifetime psychopathology, and psychotic experiences. Neurocognitive outcomes included processing speed, sustained attention, verbal memory, visuospatial memory, verbal working memory, and set-shifting. Compared with PBC, CR was lower in children at FHR-SZ (p < 0.001, d = 0.73) and FHR-BP (p < 0.001, d = 0.51). Additionally, children at FHR-SZ had lower CR than FHR-BP (p = 0.042, d = 0.24). Across groups, CR was non-differentially and positively associated with global functioning (p < 0.001) and all neurocognitive outcomes (p ≤ 0.005) and negatively associated with psychopathology (p ≤ 0.007) and delusional psychotic experiences (p = 0.019). Children at high risk have lower CR already at an early developmental stage. CR may serve as a protective factor against the development of psychopathology and neurocognitive impairments, offering a potential target in preventative interventions aiming at altering the long-term trajectories for high-risk populations.
- Research Article
- 10.1016/j.bandc.2025.106391
- Dec 20, 2025
- Brain and cognition
- Lisa Moreel + 2 more
Hemispheric specialization in mental arithmetic: Insights from functional transcranial Doppler Sonography.
- Research Article
- 10.31299/hrri.61.2.2
- Dec 19, 2025
- Hrvatska revija za rehabilitacijska istraživanja
- Ivana Šimić + 2 more
Despite early intervention with cochlear implants, children with hearing impairment often show poorer language performance than their hearing peers. Previous research has focussed primarily on language outcomes, while data on the relationship between language and cognitive function is limited. The aim of this study was to investigate and compare receptive language skills and the components of verbal working memory (storage and processing of information) in children with cochlear implants and their hearing peers, as well as to investigate the relationships between these skills within and between groups. The study involved 35 children with cochlear implants and 23 hearing children, aged 6 to 15 years, who were matched for gender and chronological age. They were assessed using the Croatian versions of the Peabody Picture Vocabulary Test (PPVTIII-HR) and the Test for Reception of Grammar (TROG-2:HR), while verbal working memory was assessed using the Digit-Span task. The results showed that children with cochlear implants had significantly lower scores in vocabulary and grammar comprehension, as well as lower verbal working memory capacity. Stronger correlations between language and cognitive variables were observed in the group of children with cochlear implants than in the hearing group. These results emphasise the importance of integrated assessment and intervention targeting both language and cognitive skills.
- Research Article
- 10.3390/app152413213
- Dec 17, 2025
- Applied Sciences
- Ilaria Pittana + 6 more
Classroom acoustics and noise exposure significantly impact students’ emotional, cognitive, and academic well-being. This study investigates how classroom noise and acoustics affect auditory and cognitive performance among 131 children in three primary schools in northeast Italy. Student performance was assessed using standardised tests evaluating working memory, verbal short and long-term memory, and visuospatial memory. Children were tested under two distinct acoustic conditions: ambient classroom noise and artificially induced noise (comprising a sequence of typical internal and external classroom sounds, intelligible speech, and unintelligible conversations). Prior to testing, hearing threshold was assessed, in order to reveal any existing impairments. Following each experimental session, children rated their perceived effort and fatigue in completing the tests. Acoustic characterisation of empty classrooms was performed using Reverberation Time (T20), Clarity (C50), and Speech Transmission Index (STI), while noise level was measured during all testing phases. Regression analysis was employed to correlate noise levels and reverberation times with class-average performance and perception scores. Results indicate that noise significantly impaired both verbal working memory and visual attention, increasing perceived effort and fatigue. Notably, both ambient and induced noise conditions exhibited comparable adverse effects on attentional and memory task performance. These findings underscore the critical importance of acoustic design in educational environments and provide empirical support for developing classroom acoustic standards.
- Research Article
- 10.1017/s1355617725101550
- Dec 15, 2025
- Journal of the International Neuropsychological Society : JINS
- Juthamas Haenjohn + 6 more
Thai researchers developed a new self-report measure of executive functions for adolescents based on Diamond's framework (the Behavioral Inventory Measure of Executive Functions [BIMEFs]). How it was developed, its psychometric properties, and norms by sex and age are reported here. An independent panel of experts evaluated the content validity of BIMEFs. Reliability was checked using Cronbach's alpha with a sample of 45 secondary students. 1,865 students, ages 12 - 18 years (65% female) from across Thailand participated in the normative study. The BIMEFs consists of 42 items that assess inhibitory control (IC), working memory (WM), and cognitive flexibility (CF), including eight subcomponents. For all items, the index of item-objective congruence was >0.5 and Cronbach's alpha was >0.7. Confirmatory factor analysis (CFA) showed the adjusted goodness of fit index to be 0.9. The strongest sex difference was for IC. Students of 13 years scored lower on EFs overall, IC, WM, CF, and all subcomponents than older students. Self-control, verbal working memory, and being able to change perspectives showed the most pronounced differences by age. The BIMEFs, which is designed to be culturally-appropriate for Thailand and cross-culturally generally, is the first EF questionnaire based on Diamond's framework. It shows good psychometric properties and sensitivity to age and sex differences. It indicates that IC development, at least in Thailand, plateaus earlier than WM and CF and that CF shows a more protracted development during adolescence than IC or WM.
- Research Article
- 10.1016/j.neuropsychologia.2025.109279
- Dec 15, 2025
- Neuropsychologia
- Maël Delem + 4 more
Unsupervised clustering reveals spatial and verbal cognitive profiles in aphantasia and typical imagery.
- Research Article
- 10.1192/bjo.2025.10918
- Dec 10, 2025
- BJPsych open
- Ahmet Mete Demir + 4 more
Cognitive impairment varies widely in bipolar disorder. Identifying cognitive subgroups and their biological correlates may improve understanding of the disorder. Brain-derived neurotrophic factor (BDNF) and C-reactive protein (CRP) are key candidates due to their roles in neuroplasticity and inflammation. The aim was to investigate cognitive subgroups in patients with bipolar disorder and their association with serum levels of BDNF and CRP. A cross-sectional study was conducted on 149 bipolar disorder patients and 48 healthy controls. Cognitive performance was assessed using a comprehensive battery of neuropsychological tests. Cluster analysis was performed to identify cognitive subgroups, followed by discriminant function analysis to validate the classification. Serum levels of BDNF and CRP were measured and compared across cognitive subgroups. Cluster analysis identified three cognitive subgroups: intact cognition, selectively impaired cognition (SIC) and globally impaired cognition (GIC). SIC exhibited the highest BDNF levels, while GIC demonstrated the highest CRP levels. CRP levels were negatively associated with performance across all cognitive domains. BDNF showed a negative correlation with verbal fluency, short-term memory and working memory. CRP levels exceeding 4.3 mg/L predicted global cognitive impairment with a sensitivity of 72.41% and specificity of 73.63%. Cognitive impairments in bipolar disorder patients can be classified into distinct subgroups, which are associated with serum levels of BDNF and CRP. These findings suggest that inflammation and neuroplasticity play key roles in the pathophysiology of cognitive decline in bipolar disorder, providing potential biomarkers for identifying patients at risk for severe cognitive impairments.
- Research Article
- 10.1016/j.actpsy.2025.106061
- Dec 8, 2025
- Acta psychologica
- David Tzuriel + 2 more
The working memory modifiability: Effects of mediation on working memory and analogical thinking.
- Research Article
- 10.64898/2025.12.04.690545
- Dec 5, 2025
- bioRxiv
- Paulina Skolasinska + 2 more
ABSTRACTPurposeThe purpose of this study was to determine if functional near-infrared spectroscopy (fNIRS), and graph theory analysis of functional connectivity measures derived from hemodynamic changes in the dorsolateral prefrontal cortex (DLPFC) can characterize spoken word processing efficiency in neurotypical listeners. Individual differences were assessed by identifying a low performing (Low-P) and a high performing (High-P) individual. Network science and psycholinguistic models of spoken word recognition predict that word frequency and sublexical phonotactic probability of the word form affects the cognitive processing effort. This novel study assesses predictors of processing efficiency directly using functional connectivity measures ofglobal efficiency, local efficiency, modularity,andhubness, derived from listener’s frontal lobe hemodynamic response function during a verbal working memory task.MethodA total of 20 neurologically typical participants (ages 18-21) completed an auditory working memory task where participants were required to hold words differing word frequency and sub lexical phonotactic probability in memory. Changes in oxygenated (HbO) and deoxygenated (HbR) hemoglobin concentration were recorded with a continuous-wave, multi-channel fNIRS system (TechEn, Inc., Milford, MA) using a 20-channel optode montage across the prefrontal cortex. Partial correlation coefficients were calculated between each channel pair to produce 20×20 functional connectivity matrices. Frontal networks were constructed as a graph where nodes in the graph are the light source and edges are connections (e.g., channels) between nodes. Functional connectivity strength and graph theory measures were examined.ResultsLF and HF words were not processed differently at the behavioral or brain level. Task performance regardless of word frequency was related to brain measures, with higher strength of prefrontal FC relating of worse accuracy (d’) regardless of task block, and with high modularity correlating with slow response times on the LF task, measured by HbR signal. Higher efficiencies tended to correspond to better accuracy but none of the tests were significant. High-P showed low FC strength and high efficiency relative to others, while Low-P had high modularity and low efficiency, in line with the direction of the brain-behavior correlations. Lastly, we characterized the centrally important regions (“hubs”). These tended to be located in the left inferior area. High-P’s hubs overlapped with those showing consistent hubs behavior at the group level, while Low-P’s hubs were uncommon.ConclusionsWe identified network properties related to efficient and inefficient language processing in typical participants, which can be used to assess language function of atypical populations in future studies.
- Research Article
- 10.3390/jintelligence13120156
- Dec 2, 2025
- Journal of Intelligence
- Daisuke Akiba
This theoretical paper introduces the Verbal-Cognitive Scaffold (VCS) Model, a cognitively inclusive framework which proposes the cognitive architectures underlying computational thinking (CT). Moving beyond monolithic theories of cognition (e.g., executive-function and metacognitive control models), the VCS Model posits inner speech (InSp) as the predominant cognitive pathway supporting CT operations in neurotypical populations. Synthesizing interdisciplinary scholarship across cognitive science, computational theory, neurodiversity research, and others, this framework articulates distinct mechanisms through which InSp supports CT. The model specifies four primary pathways linking InSp to CT components: verbal working memory supporting decomposition, symbolic representation facilitating pattern recognition and abstraction, sequential processing enabling algorithmic thinking, and dialogic self-questioning enhancing debugging processes. Crucially, the model posits these verbally mediated pathways as modal rather than universal. Although non-verbal architectures are acknowledged as possible alternative routes, their precise mechanisms remain underspecified in the existing literature and, therefore, are not the focus of the current theoretical exploration. Given this context, this manuscript focuses on the well-documented verbal support provided by InSp. The VCS Model's theoretical contributions include the following: (1) specification of nuanced cognitive support systems where distinct InSp functions selectively enable particular CT operations; (2) generation of empirically testable predictions regarding aptitude-pathway interactions in computational training and performance; and (3) compatibility with future empirical efforts to inquire into neurodivergent strategies that may diverge from verbal architectures, while acknowledging that these alternatives remain underexplored. Individual variations in InSp phenomenology are theorized to predict distinctive patterns of CT engagement. This comprehensive framework, thus, elaborates and extends existing verbal mediation theories by specifying how InSp supports and enables CT, while laying the groundwork for possible future inquiry into alternative, non-verbal cognitive pathways.
- Research Article
- 10.1037/xlm0001481
- Dec 1, 2025
- Journal of experimental psychology. Learning, memory, and cognition
- Miriam Tortajada + 4 more
We employed the retro-cue paradigm to examine performance improvements resulting from permanent versus temporary removal in verbal working memory. Permanent removal entails discarding a subset of working memory representations marked as definitively irrelevant, while temporary removal involves momentarily setting aside the uncued subset of representations from the attentional focus, preserving accessibility for later refocusing. We observed that both permanent and temporary removal led to marked progressive reductions in reaction time and errors across cue-target intervals (200, 400, 800, and 1,600 ms), reflecting the gradual simplification of the search set following informative cues. Although removal conditions did not differ in accuracy, responses were slower in the temporary removal condition, especially at the longest interval. A key finding was that performance in the temporary removal condition, but not in the permanent removal condition, was modulated by the presentation order of the target's memory set. This order effect was also observed in a nonremoval control condition where double retro-cues marked all presented information as relevant. We suggest that order effects depend on maintaining the integrity of the retrieval framework (all the contextual cues) needed to guide attentional access to specific representations, including those provisionally set aside in the temporary removal condition. We conclude that the primary distinction between permanent and temporary removal processes is that only permanent removal simplifies the retrieval framework by removing unnecessary contextual cues, resulting in a greater reduction in the complexity of the search set compared to temporary removal. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
- Abstract
- 10.1002/alz70859_100004
- Dec 1, 2025
- Alzheimer's & Dementia
- John E Harrison
Many tests have been used to study memory in Alzheimer’s disease (AD) and related dementias. At the turn of the century, these assessments included the CANTAB system, MMSE, Cognitive Drug Research (CDR), RBANS, and Cogstate, along with a large set of established paper and pencil tests. Several additional assessments have been developed and used in observational studies and clinical trials since 2000, including the mini‐cog (2000) and MOCA (2005) as well as the NIH toolbox (2004). However, since the registration of the first AD drugs, the preferred cognitive assessment has been the ADAS‐cog. This is despite several substantial criticisms levelled at this test and despite expanding options in cognitive assessments.The ADAS‐cog has issues with ceiling effects, lack of parallel forms of the praxis and language tests and generally poor content validity, and the attempt to add items to the ADAS‐cog to solve these issues has not been successful. The persistent use of the ADAS‐cog seems unaffected, despite the fact that better tests of some missing domains, such as verbal fluency, coding, attention and working memory have all demonstrated assay sensitivity in early AD.The lack of assay sensitivity of the ADAS‐cog in mild AD (MMSE 21 to 26) in the phase 2 AN1792 study, presented side‐by‐side with the newly proposed NTB showing comparable mild and moderate sensitivity, inspired development of several optimized cognitive composites for early AD stages from 2010‐2020. These included the PACC to separate amyloid positive and negative individuals, and the APCC, API‐LOAD and PACC‐5 for measuring progression in the pre‐MCI stage. Also in the late 2010s, additional composite outcomes were proposed that included both cognition and global or functional scale items, and were intended primarily for the early AD stage of disease (ADCOMS, iADRS).While the ADAS‐Cog has aided in the search for effective AD treatments, a reflection on the past 25 years of the development of cognitive assessments reveals that much effort has been spent to overcome its deficiencies and the AD world would experience more rapid advancement if we make better use of the tools we have and continue to address deficiencies.