Visuospatial Memory Research Articles

Working memory and math skills in children with and without ADHD.

Children with attention-deficit/hyperactivity disorder (ADHD) frequently demonstrate deficits in working memory and in multiple domains of math skills, including underdeveloped problem-solving and computation skills. The Baddeley model of working memory posits a multicomponent system, including a domain-general central executive and two domain-specific subsystems-phonological short-term memory and visuospatial short-term memory. Extant literature indicates a strong link between neurocognitive deficits in working/short-term memory and math skills; however, the extent to which each component of working/short-term memory may account for this relation is unclear. The present study was the first to use bifactor (S·I-1) modeling to examine relations between each working/short-term memory subcomponent (i.e., central executive, phonological short-term memory, and visuospatial short-term memory), ADHD symptoms, and math skills in a clinically evaluated sample of 186 children ages 8-13 (Myears = 10.40, SD = 1.49; 62 girls; 69% White/non-Hispanic). Structural equation modeling indicated that all three working/short-term memory components exert a significant and approximately equal effect on latent math skills (β = .29-.50, all p < .05) and together explain 56% of the variance in children's math achievement (R² = .56). Exploratory analyses indicated that teacher-reported ADHD inattentive symptoms provided a small but significant contribution to predicting latent math skills (ΔR² = .07) and accounted for 24% of the central executive/math association. These findings suggest that math difficulties in children with ADHD and clinically evaluated children without ADHD are associated, in large part, with their neurocognitive vulnerabilities in working/short-term memory and, to a lesser extent, overt ADHD symptoms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The distinct and potentially conflicting effects of tDCS and tRNS on brain connectivity, cortical inhibition, and visuospatial memory.

Noninvasive brain stimulation (NIBS) techniques, including transcranial direct current stimulation (tDCS) and transcranial random noise stimulation (tRNS), are emerging as promising tools for enhancing cognitive functions by modulating brain activity and enhancing cognitive functions. Despite their potential, the specific and combined effects of tDCS and tRNS on brain functions, especially regarding functional connectivity, cortical inhibition, and memory performance, are not well-understood. This study aims to explore the distinct and combined impacts of tDCS and tRNS on these neural and cognitive parameters. Using a within-subject design, ten participants underwent four stimulation conditions: sham, tDCS, tRNS, and combined tDCS + tRNS. We assessed the impact on resting-state functional connectivity, cortical inhibition via Cortical Silent Period (CSP), and visuospatial memory performance using the Corsi Block-tapping Test (CBT). Our results indicate that while tDCS appears to induce brain lateralization, tRNS has more generalized and dispersive effects. Interestingly, the combined application of tDCS and tRNS did not amplify these effects but rather suggested a non-synergistic interaction, possibly due to divergent mechanistic pathways, as observed across fMRI, CSP, and CBT measures. These findings illuminate the complex interplay between tDCS and tRNS, highlighting their non-additive effects when used concurrently and underscoring the necessity for further research to optimize their application for cognitive enhancement.

WORKING MEMORY IN AUTISM: A REVIEW. EXECUTIVE FUNCTION OR COMPLEXITY THEORY?

Autism is a disorder of neural development characterised by social impairments, communication difficulties, and by restricted and repetitive activities, and executive function (EF) problems are often seen throughout the spectrum. Working Memory (WM) is a temporary storage system under attentional control that actively holds multiple pieces of transitory information in the mind. WM is a part of the executive functions, which is an umbrella term for cognitive processes that regulate, control, and manage other cognitive processes, for instance planning and attention. This article shows that studies supporting either executive function or complexity theory do not correlate and that attention should be oriented not to performance levels in WM tasks but to the strategies and resources employed in verbal and visuospatial memory during the life cycle.

Cognitive function and brain magnetic resonance imaging profiles in neuromyelitis optica spectrum disorder and multiple sclerosis.

The objective of this study was to investigate cognitive performance and brain volume profile in patients with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS). In a historical cohort study, 29 MS patients, 31 NMOSD patients, and 20 healthy controls (HCs) underwent neuropsychological assessment using the Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS). Patients with MS and NMOSD also underwent a 1.5-tesla magnetic resonance imaging scan and high-resolution three-dimensional T1-weighted MPRAGE sequence. The Symbol Digit Modalities Test scores were significantly lower in MS (mean [standard deviation (SD)] =44.1 [14]) and NMOSD (mean [SD] =45.5 [14.3]) patients compared to HCs (mean [SD] =57 [9.5], P < 0.001). Scores of the Controlled Oral Word Association Test were also lower in MS (mean [SD] =25.9 [9.8]) and NMOSD (mean [SD] =24.6 [10.2]) patients compared to HCs (mean [SD] =36.6 [9.8], P < 0.001). Additionally, the MS group performed worse on the Brief Visuospatial Memory Test (BVMT) compared to the NMOSD group (9.4 ± 3.4 vs. 7.1 ± 3.7 P < 0.001). In MS patients, there was a significant correlation between all cognition scores and total brain lesions, as well as between every test except BVMT-Revised with thalamic volumes. In NMOSD patients, a correlation was found between gray matter volume and the learning phase of the California Verbal Learning Test-II as well as between total lesion percentage and verbal memory and information processing speed. Both NMOSD and MS patients experienced impairment of information processing speed, working memory, and verbal fluency, whereas visuospatial memory impairment was only observed in MS patients. Despite lower total brain lesion and less thalamic atrophy, patients with NMOSD are at risk of cognitive impairment. Microscopic structural abnormalities may be a possible cause.

The MAPP Room Memory Test: Examining Contextual Memory Using a Novel Computerized Test in Cognitively-Unimpaired Individuals with Autosomal Dominant Alzheimer's Disease.

Contextual memory, the ability to remember spatial or temporal features related to an event, is affected in Alzheimer's disease (AD). There is a shortfall of tests that measure contextual memory. To evaluate visuospatial contextual memory, we developed a computerized cognitive test, the MAPP Room Memory Test, which requires participants to identify in which visual scene target items were previously presented. We hypothesized that cognitively-unimpaired carriers of an autosomal dominant AD mutation (Presenilin-1 E280A, n=15) would perform more poorly on this test than non-carrier family members (n=31). Compared to non-carriers, the carriers had significantly worse delayed room recognition. The results indicate that the MAPP Room Memory Test may be sensitive to subtle cognitive changes associated with risk of AD. Future studies with larger samples using the MAPP Room Memory Test and biomarkers are needed to examine whether this test may also be sensitive to the earliest pathological changes in preclinical AD.

Generating normative data from web-based administration of the Cambridge Neuropsychological Test Automated Battery using a Bayesian framework.

Normative cognitive data can distinguish impairment from healthy cognitive function and pathological decline from normal ageing. Traditional methods for deriving normative data typically require extremely large samples of healthy participants, stratifying test variation by pre-specified age groups and key demographic features (age, sex, education). Linear regression approaches can provide normative data from more sparsely sampled datasets, but non-normal distributions of many cognitive test results may lead to violation of model assumptions, limiting generalisability. The current study proposes a novel Bayesian framework for normative data generation. Participants (n = 728; 368 male and 360 female, age 18-75 years), completed the Cambridge Neuropsychological Test Automated Battery via the research crowdsourcing website Prolific.ac. Participants completed tests of visuospatial recognition memory (Spatial Working Memory test), visual episodic memory (Paired Associate Learning test) and sustained attention (Rapid Visual Information Processing test). Test outcomes were modelled as a function of age using Bayesian Generalised Linear Models, which were able to derive posterior distributions of the authentic data, drawing from a wide family of distributions. Markov Chain Monte Carlo algorithms generated a large synthetic dataset from posterior distributions for each outcome measure, capturing normative distributions of cognition as a function of age, sex and education. Comparison with stratified and linear regression methods showed converging results, with the Bayesian approach producing similar age, sex and education trends in the data, and similar categorisation of individual performance levels. This study documents a novel, reproducible and robust method for describing normative cognitive performance with ageing using a large dataset.

Music and Dance Training are not Uniquely Associated with Memory Skills

Music training is robustly associated with cognitive skills, and with tonal and verbal memory more specifically. However, it is unclear whether these associations reflect near or far transfer and/or whether they indicate pre-existing differences between those who do or do not take music lessons for long durations. Dance training may similarly rely on or train visuospatial memory abilities and produce exercise-induced benefits for working memory, but there is far less research on its associations with cognition. In Study 1, women with varying durations of formal music and dance experience completed measures of visual and auditory memory, general intelligence, demographics, and personality. Music training was associated with auditory immediate and delayed memory, as well as visual working memory, but all associations disappeared when other variables were held constant. Furthermore, dance training was not associated with any memory measure. Study 2 was similar but focused on visual memory and included both men and women. We replicated the simple association between duration of music training and visual working memory, which once again ceased to remain significant when controlling for other variables. Similarly, dance training failed to correlate with any visual memory measure despite the use of more valid visual memory tasks. Our findings suggest that memory advantages among musicians most likely result from pre-existing differences rather than near transfer and provide no evidence of transfer from dance training to visual memory.

Abnormal Static and Dynamic Local Functional Connectivity in First-Episode Schizophrenia: A Resting-State fMRI Study.

Dynamic functional connectivity (FC) analyses have provided ample information on the disturbances of global functional brain organization in patients with schizophrenia. However, our understanding about the dynamics of local FC in never-treated first episode schizophrenia (FES) patients is still rudimentary. Dynamic Regional Phase Synchrony (DRePS), a newly developed dynamic local FC analysis method that could quantify the instantaneous phase synchronization in local spatial scale, overcomes the limitations of commonly used sliding-window methods. The current study performed a comprehensive examination on both the static and dynamic local FC alterations in FES patients (N = 74) from healthy controls (HCs, N = 41) with resting-state functional magnetic resonance imaging using DRePS, and compared the static local FC metrics derived from DRePS with those calculated from two commonly used regional homogeneity (ReHo) analysis methods that are defined based on Kendall's coefficient of concordance (KCC-ReHo) and frequency coherence (Cohe-ReHo). Symptom severities of FES patients were assessed with a set of clinical scales. Cognitive functions of FES patients and HCs were assessed with the MATRICS consensus cognitive battery. Group-level analysis revealed that compared with HCs, FES patients exhibited increased static local FC in right superior, middle temporal gyri, hippocampus, parahippocampal gyrus, putamen, and bilateral caudate nucleus. Nonetheless, the dynamic local FC metrics did not show any significant differences between the two groups. The associations between all local FC metrics and clinical characteristics manifested scores were explored using a relevance vector machine. Results showed that the Global Assessment of Functioning score highest in past year and the Brief Visuospatial Memory Test-Revised task score were statistically significantly predicted by a combination of all static and dynamic features. The diagnostic abilities of different local FC metrics and their combinations were compared by the classification performance of linear support vector machine classifiers. Results showed that the inclusion of zero crossing ratio of DRePS, one of the dynamic local FC metrics, alongside static local FC metrics improved the classification accuracy compared to using static metrics alone. These results enrich our understanding of the neurocognitive mechanisms underlying schizophrenia, and demonstrate the potential of developing diagnostic biomarker for schizophrenia based on DRePS.

Frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico.

Between 29% and 67% of neuromyelitis optica spectrum disorder patients have cognitive alterations. To assess the frequency of cognitive impairment in patients with neuromyelitis optica spectrum disorder in Mexico using the Brief International Cognitive Assessment for Multiple Sclerosis. We evaluated 40 neuromyelitis optica spectrum disorder patients and 40 healthy controls from Mexico. 28 (70.0%) patients with neuromyelitis optica spectrum disorder had cognitive impairment in two or more cognitive domains. Student´s T test showed statistically poor performance by neuromyelitis optica spectrum disorder patients compared to healthy controls on all three neuropsychological test scores. This significant difference was observed on the Symbols Digit Modalities Test (t = 8.875; p ≤ 0.001); California Verbal Learning Test-II memory (t = 10.418; p ≤ 0.001); and Brief Visuospatial Memory Test Revised (t = 6.123; p ≤ 0.001). This study showed that 70% of neuromyelitis optica spectrum disorder patients exhibited cognitive impairment in two or more cognitive domains. Determining the frequency of cognitive impairment will guide the decision of Neuropsychologists in planning cognitive rehabilitation across various domains.

Differential Outcomes Training of Visuospatial Memory: A Gamified Approach Using a Socially Assistive Robot

This study represents the first stage of evaluating whether cognitive training interventions may be facilitated by the presence of a socially assistive robot (SAR) and gamification. Our experimental setup involves using a SAR providing feedback to a gamified visuospatial working memory task, administered according to a differential outcomes training (DOT) protocol. The study’s main objective was to investigate whether performance and attitude towards the task would be affected by different robotic setups (none, simulated or physical) and in relation to different challenge levels. We measured performance accuracy on the gamified visuospatial memory task and self-reported affective ratings, which are relevant for assessing attitude towards the task and providing indicators to the potential for using a SAR for a longer-term cognitive intervention. Additionally, we conducted exploratory analyses of eye movement strategies for memory encoding during the task. The results demonstrated a significant differential outcomes effect (DOE) on memory performance accuracy, regardless of Robot type and Challenge level, providing evidence that a DOE can still be obtained when a SAR interacts with participants. Moreover, the results from the affective ratings revealed that participants accompanied by the physical robot reported lower levels of stress and increased levels of control. Our results demonstrate, for the first time, a DOE using a SAR in a gamified context. This result, coupled with positive subjective reporting of the human–robot interactive experience of participants, demonstrates the potential for using a SAR to: (i) promote positive attitudes for a DOT-based cognitive intervention, without (ii) negatively affecting task performance.

MEDIATING ROLE OF REST–ACTIVITY RHYTHM ON THE RELATIONSHIP BETWEEN DEPRESSIVE SYMPTOM AND COGNITION IN OLDER ADULTS

Abstract Depressive symptoms and cognitive impairments are common problems in older adults. Rest-Activity Rhythm (RAR) encompasses sleep, physical activity, and rest in 24 hours. Often, individuals with depressive symptoms present altered RAR. The purpose of the study is to investigate the mediating role of RAR on the relationship between depressive symptoms and cognition in older adults using path analysis. Sixty community-dwelling older adults wore the actigraphy for two weeks (mean age ± SD=70 ±7.3, female n =32(53%)). We assessed RAR using nonparametric RAR metrics, such as interdaily stability (IS) (the similarity of one 24-hour cycle to the next), intradaily variability (IV) (the fragmentation of RAR within 24-hour periods), and relative amplitude (RA) (physical activity difference between the least active 5 hours and the most active 10 hours period). Participants completed 90 minutes’ neuropsychological assessments (11 tests) across five domains to assess cognition and the Center for Epidemiologic Studies Depression scale to assess depressive symptoms. After adjusting for age, gender, and years of education, greater depressive symptoms were directly associated with reduced cognition (β= -0.406, P= 0.0001) as well as reduced IS (β= -26.9, P= 0.022). We also found direct positive relationships between IS (β=6.68, P=0.013), IV (β= 3.36, P=0.017), RA (β=3.42, P=0.015) and visuospatial memory, as well as IS (β=1.98, P=0.005), IV (β=3.77, P=0.004) and psychomotor speed. The indirect effect of depressive symptoms on cognition through RAR was not significant . Further research should be undertaken using a large, diverse sample, and prospective design.

SUBJECTIVE COGNITIVE DECLINE MODERATES THE ASSOCIATION BETWEEN AGE AND MEMORY DECLINE IN MIDLIFE

Abstract Subjective cognitive decline (SCD) represents self-perceived worsening of memory and thinking abilities, in the absence of objective cognitive impairment, and serves as a prognostic marker of Alzheimer’s disease (AD). However, no study to date has investigated whether SCD moderates the relationship between aging and memory before older ages. We tested the hypothesis that SCD interacts with age to predict memory performance in midlife. A subset of 123 cognitively unimpaired, middle-aged adults (Mage=56.6±6.44 years; 87% females) from an ongoing clinical trial (NIH R01AG058919) were included for analyses. Multiple linear regression models tested the effects of age and SCD in predicting performance of mnemonic discrimination, auditory-verbal memory, visuospatial memory, paired associative memory, and verbal logical memory, while controlling relevant covariates (e.g., education, sex, and APOE ε4). Based on the optimal cutoff of the Everyday Cognition Scale, 28.2% of the sample were considered to have SCD and 71.8% perceived themselves to have normal cognition. After covariate adjustments, there were significant main and interaction effects of SCD and age on mnemonic discrimination performance on the Mnemonic Similarity Task (MST) but not on other memory outcomes. The negative relationship between age and mnemonic discrimination was evident in middle-aged adults who self-report cognitive concerns but not in those without such concerns. Since mnemonic discrimination is highly sensitive to hippocampal function, these findings support the utility of the MST to detect age-related hippocampal changes and ensuing memory declines in midlife as well as the importance of early interventions among middle-aged adults with SCD to prevent AD.

Vortioxetine Reverses Impairment of Visuospatial Memory and Cognitive Flexibility Induced by Degarelix as a Model of Androgen Deprivation Therapy in Rats

Introduction: Androgen deprivation therapy (ADT) is a mainstay treatment for prostate cancer, but many patients experience cognitive impairment in domains mediated by the medial prefrontal cortex (mPFC) and hippocampus. Prostate cancer typically occurs in older patients (>65 years). As age is often accompanied by cognitive decline, it may impact the efficacy of any treatment aimed at restoring cognitive impairment induced by ADT. Vortioxetine, a multimodal antidepressant that improves cognition in depression, has been shown to be efficacious in elderly patients. Therefore, vortioxetine may improve cognition in older patients who experience cognitive decline after ADT. Methods: Young (3 months) and middle-aged (13 months) rats were used to investigate the influence of age on treating ADT-induced cognitive decline. As our previous studies used surgical castration, we tested if vortioxetine would reverse cognitive deficits associated with more translationally relevant chemical castration using degarelix. Vortioxetine was given in the diet for 21 days. Animals underwent behavioral testing to assess visuospatial memory mediated by the hippocampus and cognitive flexibility mediated by the mPFC. We also investigated changes in afferent-evoked responses in these regions in middle-aged rats. Results: Degarelix induced impairments in both visuospatial memory and cognitive flexibility that were reversed by vortioxetine. Vortioxetine also rescued afferent-evoked responses in the mPFC and hippocampus. However, modest age-related reductions in baseline visuospatial memory limited our ability to detect further decreases induced by degarelix in middle-aged rats due to a floor effect. Conclusion: These results suggest that vortioxetine may be a treatment option for older prostate cancer patients who experience cognitive decline after ADT.

Potential of piperine for neuroprotection in sepsis-associated encephalopathy

AimsSepsis-associated encephalopathy (SAE) is a common complication that increases mortality and leads to long-term cognitive impairment in sepsis survivors. However, no specific or effective therapy has been identified for this complication. Piperine is an alkaloid known for its anti-inflammatory, antioxidant, and neuroprotective properties, which are important characteristics for treatment of SAE. The objective of this study was to evaluate the neuroprotective effect of piperine on SAE in C57BL/6 mice that underwent cecum ligation and perforation surgery (CLP). Main methodsC57BL/6 male mice were randomly assigned to groups that underwent SHAM surgery or CLP. Mice in the CLP group were treated with piperine at doses of 20 or 40 mg/kg for short- (5 days) or long-term (10 days) periods after CLP. Key findingsOur results revealed that untreated septic animals exhibited increased concentrations of IL-6, TNF, VEGF, MMP-9, TBARS, and NLRP3, and decreased levels of BDNF, sulfhydryl groups, and catalase in the short term. Additionally, the levels of carbonylated proteins and degenerated neuronal cells were increased at both time points. Furthermore, short-term and visuospatial memories were impaired. Piperine treatment reduced MMP-9 activity in the short term and decreased the levels of carbonylated proteins and degenerated neuronal cells in the long term. It also lowered IL-6 and TBARS levels at both time points evaluated. Moreover, piperine increased short-term catalase and long-term BDNF factor levels and improved memory at both time points. SignificanceIn conclusion, our data demonstrate that piperine exerts a neuroprotective effect on SAE in animals that have undergone CLP.

Corpus Callosum Atrophy in Alcohol-Dependent Men with Memory Disorders and Visual Attention Difficulties.

The earlier research confirm the relationship between structural changes in the corpus callosum and difficulties in attention and memory in the group of patients with alcohol use disorder (AUD). Nevertheless, the image of auditory and visual memory disorders in men with gradual atrophy of the corpus callosum and different alcohol abuse duration, it has not been explained yet. The overriding objective of this study was: (1) to determine whether there are principal and interaction effects of visuospatial and auditory-verbal memory on alcohol consumption and cross-sectional corpus callosum area in men with alcohol use disorder, (2) to assess the impact of callosal changes on the memory and visual attention processes. 97 men with alcohol use disorder were examined. T1-weighted scans were used to carry out corpus callosum segmentation and volumetric measurements. The cognition profile included two domains: attention, memory (visuospatial and auditory-verbal). The results showed that participants with visuospatial memory disorder had inferior education background, and were characterized by a longer duration of alcohol abuse, more severe alcohol use disorder, and greater alcohol consumption per day. Second, alcohol-dependent men with auditory and visual memory disorders had a smaller frontal and posterior part of the corpus callosum areas. Additionally, among the alcohol-dependent men with memory disorders the smaller rostral body of corpus callosum was determined by the longer alcohol abuse duration. On the other hand, the smaller rostral body of corpus callosum was predicted by the older age only in alcohol-dependent men with normal memory. Among all examined individuals were observed a statistically significant relationships among visual attention, visuospatial memory and corpus callosum subregions including in particular genu and isthmus. The smaller corpus callosum cross-sectional area significantly affects visual attention and memory difficulties in alcohol use disorder, especially have differentiated the patients with normal and disordered memory. Longer alcohol abuse duration plays also a significant role in the corpus callosum atrophy in alcohol-dependent men with disordered memory (visuospatial in particular).

When Failing One Performance Validity Test Matters

There appears to be a lack of consensus regarding how best to interpret cognitive test findings when there is a failure on only one Performance Validity Test (PVT). The current study examined the impact of failing one freestanding, forced-choice, memory-based (Fr-FC-MB) PVT across two memory measures in a large sample of veterans (N = 1,353). The impact of failing zero, one, or two Fr-FC-MB PVTs (Test of Memory Malingering Trial 1 or the Medical Symptom Validity Test) on subsequent memory measures was examined (California Verbal Learning Test-II [CVLT-II], Brief Visuospatial Memory Test-R [BVMT-R]). Compared to those failing zero PVTs, those failing one PVT showed significant declines across all memory indices with large average effect sizes (BVMT-R, d = −0.9, CVLT-II, d = −1.0). Those failing one PVT had memory scores more similar to those failing two PVTs. There is a need for greater nuance and flexibility when determining invalid test performance. The current findings, along with a brief review of the literature, find that failing even one Fr-FC-MB PVT dramatically (negatively) impacts memory performance. Results suggest that including individuals failing one Fr-FC-MB PVT into a credible group should be more closely scrutinized.

Design and application of a game‐based WeChat mini‐program for screening cognitive impairments in Chinese older adults

AbstractBackgroundEarly screening for mild cognitive impairment (MCI) is the key method to prevent and delay dementia. Digital screening tools are more efficient than traditional paper‐and‐pencil cognitive assessments, and gamified versions would promote engagement and completion rates. We introduced here the design and development of the Game‐based Cognitive Assessment ‐ 3 Minute Version (G3) WeChat mini‐program for MCI screening in Chinese older adults.MethodG3 is a battery of three one‐minute digital games built within the WeChat platform. Developed based on the cognitive paradigm and classic neuropsychological tests such as Trail Making Test (TMT), the Silhouettes test, the Brief Visuospatial Memory Test‐Revised (BVMT‐R) test, and California Card Sorting Tests (CCST), the G3 mini‐games, “Number Ordering”, “Species Sorting”, and “Gold finding” would measure the computational and executive function, abstractive function and visual perception, memory, and attention, respectively. In each game, the difficulty will be automatically adjusted according to performance. G3 integrates users’ game scores, age, gender, and education levels, to generate a comprehensive assessment of cognitive function with results of the six cognitive domains (Figure 2).ResultAs of August 31, 2022, more than 11 million users have completed G3 tests, 85.38% of them are aged under 40, and 2.05% of them are aged over 60 (Figure 3). Although people in all age groups have desired to know their cognitive function, the number of users decreased as people aged. Among users aged 40‐70, more females than males participated in G3 games, indicating middle‐aged and older women paid more attention to cognitive function. Among users over 45 years old, those of lower education levels (primary school or no education), middle levels (middle or high school), and university degrees accounted for 2.93%, 32.4%, and 59.65% respectively. The completion rate of users aged over 45 is 92.28%, and those over 80 years exceeded 86%.ConclusionThe G3 was a battery of three novel 1‐minute game‐based digital cognitive tests. The process is simple, efficient, and interesting. It is a promising tool for self‐administering, advancing large‐scale community screening, and social education for MCI in Chinese older adults, warranting further clinical trials to validate its feasibility, sensitivity, and diagnostic value.

Design and application of a game‐based WeChat mini‐program for screening cognitive impairments in Chinese older adults

AbstractBackgroundEarly screening for mild cognitive impairment (MCI) is the key method to prevent and delay dementia. Digital screening tools are more efficient than traditional paper‐and‐pencil cognitive assessments, and gamified versions would promote engagement and completion rates. We introduced here the design and development of the Game‐based Cognitive Assessment ‐ 3 Minute Version (G3) WeChat mini‐program for MCI screening in Chinese older adults.MethodG3 is a battery of three one‐minute digital games built within the WeChat platform. Developed based on the cognitive paradigm and classic neuropsychological tests such as Trail Making Test (TMT), the Silhouettes test, the Brief Visuospatial Memory Test‐Revised (BVMT‐R) test, and California Card Sorting Tests (CCST), the G3 mini‐games, “Number Ordering”, “Species Sorting”, and “Gold finding” would measure the computational and executive function, abstractive function and visual perception, memory, and attention, respectively. In each game, the difficulty will be automatically adjusted according to performance. G3 integrates users’ game scores, age, gender, and education levels, to generate a comprehensive assessment of cognitive function with results of the six cognitive domains (Figure 2).ResultAs of August 31, 2022, more than 11 million users have completed G3 tests, 85.38% of them are aged under 40, and 2.05% of them are aged over 60 (Figure 3). Although people in all age groups have desired to know their cognitive function, the number of users decreased as people aged. Among users aged 40‐70, more females than males participated in G3 games, indicating middle‐aged and older women paid more attention to cognitive function. Among users over 45 years old, those of lower education levels (primary school or no education), middle levels (middle or high school), and university degrees accounted for 2.93%, 32.4%, and 59.65% respectively. The completion rate of users aged over 45 is 92.28%, and those over 80 years exceeded 86%.ConclusionThe G3 was a battery of three novel 1‐minute game‐based digital cognitive tests. The process is simple, efficient, and interesting. It is a promising tool for self‐administering, advancing large‐scale community screening, and social education for MCI in Chinese older adults, warranting further clinical trials to validate its feasibility, sensitivity, and diagnostic value.

Effects of Cognitive‐motor Rhythmic Training on Executive Functions and Motor Performance in Older Adults with Mild Cognitive Impairment: A Randomized Controlled Trial

AbstractIntroductionIn recent years, prevalence of mild cognitive impairment (MCI) has increased in older adults, exacerbating the potential impact on global health. Cognitive‐motor training is an emerging treatment modality with proven benefits in enhancing both physical and cognitive functions. In recent research findings, training of musical rhythmic skills with auditory‐motor synchronization is beneficial to reactivate the brain’s sensorimotor and perceptual regions as well as to improve cognition. However, there is limited research on combining these modalities.ObjectivesThis pilot study aims to develop a pioneer program on cognitive‐motor rhythmic training (CMRT), and to investigate whether the program would improve the executive functions (EF) and hand functions of patients with MCI.MethodologyThirty patients recruited from the Hong Kong Buddhist Hospital were randomized into two groups: (i) an intervention group receiving a 6‐week training program and (ii) a waitlist control group. The program was designed with reference to the rhythm game “Taiko no Tatsujin”, in which precise timed motor responses were required to hit the circular cues against the target zone. The game was designed with progression of difficulty levels and instant feedback. Classical Cantopop songs that were familiar to Hong Kong older adults were selected. Mental flexibility, inhibitory control, working memory, visuospatial memory, verbal fluency, processing speed and problem‐solving were assessed using domain‐specific cognitive tests, while hand dexterity was measured by the Purdue Pegboard Test. Paired t‐test and ANOVA were used to examine the within group difference and the comparison between groups. The level of significance was set at P&lt;0.05.ResultsThe analysis showed significant Time x Group interaction effects in Color Trail Test (p = 0.001), Color Word Stroop Test (P = 0.002), Digit Span Test (P&lt;0.001), Corsi Block‐Tapping Test (P&lt;0.001), Verbal Fluency Test (P&lt;0.001), Symbol Digit Modalities Test (P = 0.015), Maze Test (P&lt;0.001) and the Purdue Pegboard scores (P&lt;0.001) compared to the control group after training.ConclusionsThe 6‐week CMRT program is effective in improving the executive functions and motor performance in patients with MCI. This innovation can serve as an affordable and quality intervention in early stages of cognitive decline.

A Virtual Reality Memory Test for Assessing Visuospatial Memory

AbstractBackgroundVisuospatial memory impairment is one of the common symptoms of Alzheimer’s disease. However, impairment in visuospatial and visuospatial memory function has not been focused on as much as that of episodic memory function. We developed a visuospatial memory test, the Hidden Objects Test (HOT), that was designed for people to go around the living room of a house created by virtual reality (VR) and find hidden objects.MethodThis study group comprised 17 Alzheimer’s disease dementia (ADD), 14 amnestic mild cognitive impairment (aMCI), and 15 normal controls (NC). All participants completed a sandardized neuropsychological battery and magnetic resonance imaging (MRI). Out of 46 participants, 28 received amyloid positron emission tomography (PET). Participants performed a novel visuospatial memory test in a virtual environment using VR headset HTC Vive. Walking trajectory in the virtual environment was tracked with 13Hz sampling rate. Participants’ movement path was basically assessed by the total distance, duration, and mean speed.ResultTotal HOT score and five subtests scores were differed among ADD, aMCI, and NC (p &lt;0.001). We performed walking trajectory pattern mining as well as basic trajectory feature analysis such as total distance, duration, and speed. Total duration was significantly greater in ADD than in NC (p = 0.008). The number of outliers, over 95% of estimated trajectory, was significantly higher in ADD than in NC (p = 0.002). The number of stay points, an index that participants stayed in the same position, were significantly higher in ADD and aMCI patients compared to NC (ADD vs. NC: p = 0.003, aMCI vs. NC: p = 0.019). Walking trajectory analysis suggested that ADD and aMCI patients wandered rather than going straight to the hidden objects.ConclusionOur study showed that HOT total scores differed among ADD, aMCI, and NC groups. In addition, our study provided application of trajectory data mining methods to explore the patterns of ADD and aMCI patients' walking trajectory, which could be applied to detect behavior of the patients in environments equipped with the internet of things such as future smart home or facilities.