bluuebunny/crossref_metadata_2025 huggingface dataset:
A study on flexible bio-based conductive foam for pressure sensing and electromagnetic interference applications
Authors: Selvaraj Vinoth Kumar , Subramanian Jeyanthi , P Krishna Rajeev
Published: October 2023

Day by day gadgets are taking an irreplaceable role in our life. Humans are now depending on electronic gadgets. This increased usage and utility of these electronic gadgets increased the radiation; hence, it is important to research materials for better absorption of these radiations. In this research work, we are developing an electromagnetic interference shielding material. We used polyurethane foam (PU foam), an insulating material that has been filled with nanofillers Polyaniline (PANi), Zinc Oxide (ZnO), and MWCNT. The PU foam used was castor oil-based instead of going with petroleum-based. This work aims to achieve a potential material for electromagnetic interference shielding and sensing material that should be bio-degradable at a low price. The samples were fabricated using the taguchi method in the design of the experiment. This helps to reduce time consumption and provides more accurate results. Once the samples were fabricated, it was subjected to morphological study SEM and EDAX. EMI and conductivity were also carried out. The EMI experiment was done using setup model N5230A PNA-L. The conductivity test is done. GRA relational statistics was utilized to find the interrelation between the two output responses in the taguchi. The experiment concludes that the samples synthesized with 2 wt% of PANi, 300 rpm mixing rotation, and 10 min. Sonication time, provide the best conductivity of 900 S m−1 and EMI SE of 34.38 dB. The best result for conductivity is for sample 8. The maximum conductivity value is 900 S m−1. The lightweight flexible conductive foams can be used in the application of biosensors.
Silicon elastomer as flexible substrate: dielectric characterization and applications for wearable antenna
Authors: Iftikhar Adnan , Naseer Noaman , Yildiz Solen Kumbay , Gokcen Dincer , Fida Adnan , Shafique Muhammad Farhan , Saka Birsen
Published: October 2023

In this paper, low-cost mold silicone and silicone elastomers are investigated as substrates for the realization of flexible antennas. A methodical dielectric characterization is carried out, followed by a detailed explanation of the manufacturing process of the silicone elastomers. The prepared silicone elastomer substrates are also subjected to mechanical tests to ensure flexibility and robustness. The mechanical tests corroborated the utilization of the prepared silicone elastomers for the flexible antennas. Silicone has limited adhesion to metal, so when producing a silicone substrate, a 0.5 mm deep cavity is created with a negative impression of the intended metal component. Consequently, the metal layer is embedded within the silicon substrate, aligning the top surface of the metal flush with the silicone substrate edges. The radio frequency (RF) structure incorporates ridges within the silicone substrate to form a gap, effectively securing the metal on the surface of the silicone. Finally, to prevent the metal from falling from the silicone substrate, Kapton tape is laminated on the substrate. The wrapping of the Kapton tape additionally provides protection from moisture since the silicone elastomer substrate is prone to moisture absorption. The proposed technique is experimentally verified by designing and prototyping a coplanar patch antenna using copper and conductive woven fiber on the silicone substrate. The simulation analysis and experimentation results authenticated the effectiveness of the proposed technique to design a flexible antenna on the silicone elastomer substrates. It is also concluded that the conductive woven fiber-based prototype offers higher flexibility as compared to the copper-based prototype. It is also clinched that there exists a trade-off in flexibility and performance characteristics due to the conductivity and texture difference between the copper and conductive woven fiber.
Decoding of imagined speech electroencephalography neural signals using transfer learning method
Authors: Mahapatra Nrushingh Charan , Bhuyan Prachet
Published: October 2023

The use of brain-computer interfaces to produce imagined speech from brain waves has the potential to assist individuals with difficulty producing speech or communicating silently. The decoding of covert speech has been observed to have limited efficacy due to the diverse nature of the associated measured brain waves and the limited number of covert speech databases. As a result, traditional machine learning algorithms for learning and inference are challenging, and one of the real alternatives could be to leverage transfer of learning. The main goals of this research were to create a new deep learning (DL) framework for decoding imagined speech electroencephalography (EEG) signals tasks using transfer learning and to transfer the model learning of the source task of an imagined speech EEG dataset to the model training on the target task of another imagined speech EEG dataset, essentially the cross-task learning transfer of discriminative characteristics of the source task to the target task of imagined speech. The experiment was carried out using two distinct open-access EEG datasets, FEIS and KaraOne, that recorded the imagined speech classes of neural signals from multiple individuals. The target FEIS model and the target KaraOne model for multiclass classification exhibit overall accuracy of 89.01% and 82.35%, respectively, according to the proposed transfer learning. The experiment results indicate that the cross-task deep transfer learning design reliably classifies the imagined speech EEG signals by applying the source task learning to the target task learning. The findings suggest the feasibility of a consistent strategy for classifying multiclass imagined speech with transfer learning, which could thereby open up the possibility of future investigation into cross-task imagined speech classification knowledge usability for generalization of new imagined speech prompts.
Bimetallic copper-based nanowires and the means to create next-generation stable transparent electrodes
Authors: Križan Anđela , Zimny Kevin , Guyonnet Alexandre , Idowu Emmanuel Opeyemi , Duguet Etienne , Plissonneau Marie , d’Alençon Lauriane , Le Mercier Thierry , Tréguer-Delapierre Mona
Published: October 2023

Metallic nanowire percolating networks are one of the promising alternatives to conventional transparent conducting electrodes. Among the conductive metals, copper appears as a relevant alternative to develop electrodes in a more sustainable and economical way (abundance of the supplies, geo-political risks regarding the supplies, environmental impact, and cost). However, Cu nanowires suffer from high instability in air, and one of the ways to increase stability as well as to boost properties related to transparent electrodes is to combine the Cu with another metal, resulting in bimetallic nanowires. Even though the field of fabrication of nanoalloys has been advancing at a rapid pace in the last two decades, binary nanowires are difficult to produce due to a wide range of parameters that must be aligned in regard to metals that are being combined, such as surface energy of the bulk metal, atomic radii, crystal lattice matching, redox potentials, etc. In this review, we present the current research landscape in making Cu-based bimetallic nanowires for the development of metal nanowire networks with high oxidation resistance. This analysis allows identifying the most promising bimetallic materials for obtaining highly efficient, robust, and cost-effective electrodes.
AGR - 1 A Case Study of Cognitive Reserve and Wernicke's Aphasia Status-Post Insular Stroke
Authors: Wright Madison E , Kinoshita Lisa M
Published: October 2023

Objective

The case is an 88-year-old, woman, formerly a successful surgeon for decades, with Wernicke’s aphasia due to dominant insular stroke. Our evaluation explored her deficits in the context of the heterogeneous presentations of insular strokes and how speech rehabilitation has impacted her language abilities given her cognitive reserve prior to her stroke.

Method

The patient sustained a left MCA embolic stroke in 2020. Neurodiagnostics revealed an infarct in the insula, dominant temporal, frontal, and parietal lobes. Baseline language assessment was completed. Results included moderate–severe receptive language impairment; intact fluency; deficits in writing and repetition; and significant paraphasias.

Results

Neuropsychological assessment demonstrated prominent deficits in repetition with paraphasias and irritability. Auditory learning, attention, and working memory were invalid due to deficits in repetition. She was diagnosed with mild vascular neurocognitive disorder and conduction aphasia.

Conclusions

Despite comprehension having improved, the patient’s paraphasias resemble the presentation of Wernicke’s aphasia. Interestingly, there were some consistencies in paraphasic errors, such as consistently swapping certain words or letters, demonstrating diminished but not absent volition of speech. Story memory was the most effective measure of auditory memory given repetition deficits. Despite repetition deficits commonly localizing to the supramarginal gyrus, her repetition difficulty is likely related to language network disruption due to her insular infarct. Rehabilitation for comprehension was successful despite age at time of injury. Consistent with previous research, results suggest despite cognitive reserve, repetition is resistant to rehabilitation; however, in this case, paraphasic errors were also resistant. Rehabilitation should include a behavioral component for insular stroke patients.
A - 1 Acculturation’s Effect on Neuropsychological Test Performance: a Systematic Review
Authors: Puente Antonio N , Deng Xinyue , Baker Melissa , Puente Antonio E
Published: October 2023

Objective

Acculturation is not thought to reflect one’s brain function; however, numerous studies have shown that less acculturated adults perform worse on neuropsychological tests. This study systematically reviews the effect of acculturation on neuropsychological tests in healthy adults.

Data Selection

This systematic review was registered in Prospero (CRD42020196578) with the defined review procedures. It included studies with healthy adults and relational data between neuropsychological test scores and acculturation. 13,945 studies were screened studies and 8 met inclusion criteria.

Data Synthesis

After accounting for demographic factors (including education), acculturation was a positive predictor of performance on tests of dementia screening, processing speed, attention, executive functioning, language, and memory. This relationship remained after accounting for both demographic factors and English Fluency, and specifically on tests of IQ, language, and visuoconstruction.

Conclusion

These results support measuring and considering acculturation when interpreting both verbal and “non-verbal” test results. At a minimum acculturation should be factored into test selection, normative selection, and clinical judgment. Looking forward it is hoped that new norms and tests will be developed to eliminate the effect of one’s culture on test performance.
A - 2 The Effect of English Language Fluency, Acculturation, and Length of Stay in the U.S. on Cognitive Functioning in Mexican Americans
Authors: Dimmick Andrew , Su Charlie , Raffiudin Hanan , Callahan Jennifer L
Published: October 2023

Objective

Evidence suggests that Hispanic and Latino individuals perform worse on some measures of cognitive functioning than non-Hispanic White individuals. Given this finding, several possible explanations have been posited, including differences in English fluency and acculturation. The purpose of this study was to investigate the effect of English fluency and acculturation on older Mexican American individuals’ cognitive testing performance.

Method

Participants (M age = 63.44; 66.1% female) were Mexican American (n = 899) community members participating in the Health and Aging Brain Study: Health Disparities study. Information gathered included demographic information, attained education level, language use/fluency, acculturation level, and estimated premorbid functioning (reading score) in addition to cognitive functioning performance (MMSE).

Results

Controlling for education and estimated premorbid functioning, both longer stay in the U.S. (β = 1.12, p = 0.006) and more acculturation (β = 1.00, p = 0.035) significantly predicted better cognitive testing performance. Furthermore, after controlling for education and estimated premorbid functioning, using English as a primary language resulted in significantly better testing performance than using Spanish as a primary language and being English fluent (p = 0.006) or non-fluent (p < 0.001). English fluent individuals that used Spanish as their primary language performed significantly better (p < 0.001) than those that were not English fluent and used Spanish as their primary language.

Conclusion

Our findings suggest that factors associated with U.S. acculturation, including stay in the U.S. and English fluency, influence cognitive testing performance. Additional cultural considerations and adaptions may be needed for current neuropsychology measures, such as cognitive testing instruments.
A - 3 Quantifying the Richness of the Boston Process Approach (BPA) Using a Novel Analytic Approach: the Framingham Heart Study
Authors: Gurnani Ashita , Frank Brandon , Guan Calvin , Andersen Stacy , Devine Sherral , Hurley Landon , Liu Chunyu , Lin Honghuang , Au Rhoda
Published: October 2023

Objective

Neuropsychological (NP) tests are often interpreted with a one test-one domain analytic approach in research, which misrepresents their clinical utility. The Boston Process Approach (BPA) allows for extraction of multi domain features within and across NP tests although its use is hampered by the data complexity and lack of objective quantification methods. In this study, we aim to develop a novel factor analytic approach that quantifies the richness of BPA data in the Framingham Heart Study (FHS).

Method

Data included BPA error scores (n = 172) derived from 10 baseline NP tests from 2238 Offspring participants. The outcome variable was dementia diagnosis. Factor analyses were conducted using Kemeny covariance matrix with maximum likelihood decomposition. Dwyer’s (1937) method was used to estimate factor loadings for demographic variables (sex, education, and age) and dementia status.

Results

Participants’ average age was 67.3 ± 9.3 years, 54.5% were female, 41.3% had education ≥ college degree, and 92.5% were without dementia. A bifactor model demonstrated adequate fit (TLI = 0.95, RMSEA = 0.03), similar to the best multi-factor model (TLI = 0.95, RMSEA = 0.03), and improved over a single factor model (TLI = 0.87, RMSEA = 0.05). Omega estimates revealed saturation in general factor versus total factor loadings (ratio: 0.90). Dementia status loaded highly on the general factor (0.82, h2 = 0.81), as did sex (0.44, h2 = 0.27).

Conclusions

BPA data fit a bifactor model, with most variation accounted for by the general factor. This study quantifies the richness of BPA measures into a single factor score that can be used as a predictor for several outcomes in clinical research.
A - 02 Performance and Usage of a Remote App-Based Cognitive Assessment among Older Adults with a Range of Technology Experience
Authors: Halberstadter Kimberly , Rovere Rachel , Liebenberg Erin , Wolk David , Mechanic-Hamilton Dawn
Published: October 2023

Objective

The mobile cognitive app performance platform (mCAPP), an app-based cognitive assessment, includes memory and executive functioning tasks to remotely detect cognitive changes associated with aging and preclinical Alzheimer’s disease. This study examines the relationship between prior experience and comfort with mobile technology and subjective experiences with mCAPP.

Method

60 older adults (73% female; age = 74 ± 4.8; education = 17 ± 2.4 years; 48% Black/African American) with normal cognition enrolled in the Penn Alzheimer’s Disease Research Center cohort completed one baseline session and two weeks of at-home mCAPP use. This study included measures of prior experience with mobile technology and games, at-home mCAPP performance and usage levels, and feedback on mCAPP usability.

Results

62% of participants reported using mobile devices to play games (“game-players”), and they did not differ from non-users in age or global cognitive status. Game-players self-reported significantly higher proficiency with specific mobile technology features (p = 0.028), but not perceived independence or confidence with technology. mCAPP performance differences were present at baseline but not by the 8th at-home session. Usability and enjoyment of mCAPP were high and increased for both groups. Non-players reported lower likelihood to play mCAPP games at baseline (p < 0.05), but in practice increased play frequency throughout at-home use and reported higher likelihood to play mCAPP games afterwards (p ≤ 0.001).

Conclusion (s)

Participants with varying mobile game experience-levels were willing and able to use mCAPP at-home. Both groups found mCAPP easy and enjoyable to use, and non-players particularly showed increased adoption of mCAPP. This pilot study shows preliminary feasibility of mobile app-based assessment regardless of prior experience with mobile games.
A - 05 Insight and Anxiety Ratings as Predictors of Mild Cognitive Impairment and Dementia
Authors: Khan Humza , Neale Alec C , Sweet Jerry J , Geary Elizabeth K , Axelrod Jenna L , Guidotti-Breting Leslie
Published: October 2023

Objective

Insight has been investigated as a predictor of mood symptoms and psychosis onset. Little research has examined insight as a predictor of diagnosis, especially given possible confounding factors such as anxiety.

Methods

This cross-sectional study included 223 adult patients diagnosed with Mild Cognitive Impairment (MCI) or Dementia as a result of outpatient neuropsychological evaluation. Patients completed either the Depression Anxiety Stress Scale (DASS-42) or the Beck Anxiety Inventory (BAI) and the Behavioral Dyscontrol Scale (BDS-II). Participants were divided into four groups (MCI, Dementia, MCI + Anxiety, or Dementia+Anxiety) utilizing DASS-42 anxiety scale ≥7, or BAI score ≥ 7 (clinical anxiety). Insight grouping (four categories: 0 [no insight] to 3 [intact insight]) was determined by the BDS-II clinician-based insight rating. Diagnosis and insight groups were compared using one-way ANOVAs. Predictive value of BDS-II insight scores was determined by logistic regression.

Results

The sample was 52.9% male and 87.9% non-Hispanic White, with mean age 75.54 (SD = 8.24) and education 16.1 years (SD = 2.9). There was a significant difference between diagnoses and insight levels for the four conditions [F(3, 219) = 6.06, p < 0.001]. The logistic regression model was significant [χ2(9, N = 223) = 25.79, p < 0.01]. The model explained 11.9% of the variance in diagnosis and correctly identified 47.1% of the cases.

Conclusion

Insight appears to affect the diagnostic outcomes in cases of MCI and dementia. Clinicians should consider insight ratings, along with clinical history, behavioral observations, and test findings when evaluating possible MCI and dementia. Future research should examine neurocognitive disorder subtypes to identify those most affected by reduced insight.
A - 07 The Role of Age and Cognitive Reserve in Moderating the Cognitive Effects of Chemotherapy
Authors: Manica Isabel , Lemos Raquel , Nunes Maria Vânia , Sousa Berta , Oliveira-Maia Albino J
Published: October 2023

Objective

The aim of this exploratory study is to assess the cognitive effects of chemotherapy (CT) in women with breast cancer and to understand the role of age and cognitive reserve (CR) in the development of these effects.

Method

A group of women with early breast cancer with indication for CT (n = 32) and a group of healthy subjects (n = 32) were recruited. Both groups performed neuropsychological assessment at two time points- at baseline (before the initiation of CT and 6 months later). Additionally, Cognitive Reserve Index questionnaire (CRIq), a comprehensive measure of CR, was applied. The cognitive tests were combined in a unique z-score for attention and executive function domain. The longitudinal cognitive assessment was analyzed using a mixed effect modeling approach with patient’s vs controls as grouping factor and adjusted for age, CR, years of education and baseline cognitive performance as fixed factors.

Results

Mean age and education years for both groups were 49 (SD ± 8) years and 17 (SD ± 3), respectively. The level of CR was equally distributed across both samples, with 75% of participants presenting a high level of CR. The mixed effects model analysis did not show a significant effect for group. For Attention, a three-way interaction among CR, age and years of education was significant (p = 0.04). For the executive functions, none of the factors were significant.

Conclusions

Our results suggest that CT did not contribute significantly for the development of cognitive decline in cancer patients. However, age, years of education and CR have a joint impact on attention, but not executive functions.
A - 09 Normative Data of Neuropsychological Tests of Attention in Older Adults from Costa Rica
Authors: Usuga Daniela Ramos , Mora-Villalobos Lara , Brown-Mata Gloriana , Smith-Castro Vanessa , Rivera Diego , Arango-Lasprill Juan Carlos
Published: October 2023

Objective

To generate normative data for the Trail Making Test (TMT) and the Target Cancellation Task for healthy older adults in Costa Rica.

Method

563 healthy Costa Rican adults aged 59–90 years (M = 67.15; SD = 7) were assessed. Each participant was administered the two attention tests as part of a more comprehensive neuropsychological battery.

Results

Multiple regression models showed a linear effect of education for TMT-A and TMT-B, as well as a linear and curvilinear effect of age for TMT-B and TMT-A, respectively. The model predictors explained between 27.4% and 30.3% of the variance. For the Target Cancellation Task scores, linear effects of education were observed for all 4 scores, as well as a linear effect of age for the TMX time and Rhombus time scores. The correct TMX score showed a curvilinear effect of age. The predictors of the model explained between 2% and 33.3% of the variance.

Conclusion

This is the first normative data generated for the TMT and the Target Cancellation Task in older adults from Costa Rica. This normative data will be used in individuals with a variety of neurological conditions that course with attention deficits to establish the neuropsychological profile of those individuals in this area.
A - 11 Normative Data of Neuropsychological Tests of Learning and Memory Tests in Older Adults from Costa Rica
Authors: Usuga Daniela Ramos , Mora-Villalobos Lara , Brown-Mata Gloriana , Smith-Castro Vanessa , Rivera Diego , Arango-Lasprilla Juan Carlos
Published: October 2023

Objective

To generate normative data of the Word Memory List (WML) and Logic Memory (LM) for healthy older adults in Costa Rica.

Method

The sample consisted of 563 healthy Costa Rican adults, aged 59–90 years (M = 67.15; SD = 7), who were assessed with a complete neuropsychological battery.

Results

Multiple regression models showed a linear effect of education on the 3 WML scores. Age had a linear effect on WML Delayed recall and WML Recognition, and a curvilinear effect on WML Total. Finally, except in WML Recognition, a sex effect was found, such that females performed better than males. The predictors of the model explained between 6% and 32.4% of the variance. In LM there was a linear effect of education on all scores except LM2 B Recognition. For age, a linear effect was found in LM B, LM RA, LM2 B scores, and a curvilinear effect in LM A. Finally, sex was significant in all scores except LM2 A Recognition, with females performing better than males. The model predictors explained between 2% and 18.1% of the variance.

Conclusion

The results of the present study constitute the first normative data for WML and LM in older adults from Costa Rica. In the near future it is expected that clinical neuropsychologists will use this data to improve the everyday practice of the profession in the country.
A - 18 Predicting Incident Amnestic Mild Cognitive Impairment and Alzheimer’s Disease with a Computerized Neuropsychological Assessment Device: Comparative Clinical Utility
Authors: Docteur Natalia , Callahan Brandy
Published: October 2023

Objective

Computerized neuropsychological assessment devices (CNADs) offer improved accessibility to screen for neurodegeneration, although their clinical utility is yet to be established. We evaluated the efficacy of a CNAD to predict incident amnestic mild cognitive impairment and Alzheimer’s disease (aMCI/ad) compared to a conventional paper-and-pencil screening tool and PET amyloid beta (AB).

Method

Data were collected from the longitudinal observational Alzheimer’s Disease Neuroimaging Initiative 3. Participants were cognitively normal at baseline (N = 315, mean age = 72.9 +/− 7.1, 59.4% female, 16.8 +/− 2.3 years of education, 91.4% White, 33.7% APOE4+). Over four years, 26 (8.3%) participants converted to aMCI and 3 (1.0%) individuals developed ad. Prognostic validity was compared between three measures assessed at baseline. Computerized visual episodic memory scores were evaluated using the One Card Learning (OCL) test. Conventional screening was conducted using the Montreal Cognitive Assessment (MoCA). PET AB+ was quantified as ≥2 SD whole cerebellum referenced region standardized uptake value ratios.

Results

Area under the curve (AUC) analyses using logistic regression were adjusted for age, sex, education, race, and APOE4+ status. OCL accuracy yielded AUC = 0.67, p = 0.003, 95% CI [0.58, 0.76]. Total MoCA score demonstrated AUC = 0.75, p < 0.001, 95% CI [0.67, 0.83]. PET AB+ produced AUC = 0.68, p = 0.001, 95% CI [0.58, 0.79].

Conclusions

When assessed at baseline, the MoCA provided the greatest clinical utility to predict incident aMCI/ad. Baseline OCL accuracy and PET AB+ were similarly effective for determining future cognitive decline. Further research is needed to examine the utility of CNADs before they are integrated into clinical practice.
A - 20 Do Alzheimer’s Disease Biomarkers Impact Normal Pressure Hydrocephalus Lumbar Drain Trial Outcomes
Authors: Fatima Hudaisa , Nguyen Trung P , Schaffert Jeff , Gonzalez Deborah , White Jonathan , Ruchinskas Robert
Published: October 2023

Objective

Distinguishing normal pressure hydrocephalus (NPH) from Alzheimer’s disease (ad) would aid patient selection for lumbar drain trials (LDT). Cerebrospinal fluid (CSF) ad biomarkers are altered in NPH, limiting interpretation. This study examines the utility of CSF ad biomarkers in predicting gait and cognitive outcomes in patients undergoing LDT.

Methods

127 patients underwent LDT. CSF ad biomarkers from Mayo Clinic Laboratories (MCL) or Athena Diagnostics were used to classify patients as ad, non-ad, or indeterminate. MCL indeterminate results were further classified as suspected ad, non-ad, or suspected NPH (sNPH) using a derived p-tau threshold (>15 pg/mL & Aß42 <=1026 pg/mL)1. Cognitive improvement was determined using reliable change indices for Trail Making Test A&B and Hopkins Verbal Learning Test-Revised. Physical therapists (PT) utilized the Berg Balance Scale and/or the Timed Up and Go to determine gait improvements. Chi-square tests investigated relationships between diagnostic groups, PT and cognitive improvements, and eventual shunting for the whole sample and then stratified by the two laboratory assays.

Results

The sNPH group had the highest percentage of PT (63%–70%) and cognitive (9% -11%) improvement (see Table 1), while the ad group had the lowest (50% and 3%, respectively). The sNPH group underwent shunting more (56%–68%) compared to the ad and non-ad groups (47%). Relationships, however, were not statistically significant (p > 0.05).

Conclusion

Patients with sNPH CSF ad biomarker profiles demonstrated clinically meaningful physical improvements and underwent shunting more frequently than those with ad or non-ad biomarker profiles. This highlights the potential for CSF ad biomarkers in predicting NPH treatment response.
A - 26 Behavioral Variant Alzheimer’s Disease: Distinctly Different from Alzheimer’s Disease and Behavioral Variant Frontotemporal Disease
Authors: Lanctot Jessica , Fink Joseph
Published: October 2023

Objective

Behavioral variant Alzheimer’s disease (bvAD) is a variant of Alzheimer’s disease (ad) and is distinctly different from behavioral variant frontotemporal disease (bvFTD). However, bvAD has many overlapping symptoms with ad (i.e., atrophy in temporal, episodic memory deficits) and bvFTD (i.e., behavioral changes, early onset, caregiver burden) that can cause diagnostic confusion.

Method

Patient was referred to outpatient tertiary neuropsychological clinic for neuropsychological evaluation. Patient was a 75-year-old, right-handed, retired Caucasian man with 18 years of formal education. He reported experiencing insidious and gradual memory loss over the last eight years. He had been previously diagnosed with ad, mild cognitive impairment due to cerebrovascular disease, and suspected frontotemporal disease by three different providers. CT scan received small vessel ischemic disease and PET scan showed hypometabolism in the bilateral anterior temporal lobes. His symptoms included difficulties with memory, attention, language, executive functioning, disinhibition, impulsivity, uncontrollable crying, and apathy.

Results

Neuropsychological testing results revealed primary deficits in memory and executive functioning. He presented with an amnestic memory profile, with reduced encoding of new information and significantly impaired consolidation and retrieval. He demonstrated difficulty with working memory, inhibition, set-shifting, problem-solving, and visuoconstruction. Repetition and naming were reduced. All other cognition was largely intact.

Conclusions

The presenting case analysis illustrates the unique presentation of bvAD when considering an ad versus bvFTD diagnosis, specifically in the context of behavioral/personality changes and memory deficits. Specifically, it draws important attention to the cognitive profile of bvAD, which can be often overlooked and lead providers to incorrect diagnoses, thus delaying proper treatment.
A - 29 Understanding the Role of Caregiver Self-Efficacy in Dementia Healthcare: Findings from the Care Ecosystem Program
Authors: Pereira-Osorio Carolina , Arredondo Beth , Brickell Emily , Sharma Sakshi , Sawyer Robert J , Boettcher Anneliese , Lee Bern
Published: October 2023

Objective

Identify changes in healthcare utilization (HCU) and admission risk scores (ARS) by caregiver self-efficacy levels (CGSE) in persons with dementia (PWD).

Methods

179 community-dwelling dyads (PWD-CG) with at least 1 emergency or hospital admission 12-months prior to enrollment in the Care Ecosystem (dementia care-management program), provided data at baseline, 6, and 12-months. Analyzed data included caregiver self-reported HCU, dementia ratings (QDRS, NPI), wellbeing (ZBI-12, NPI-Distress, PHQ9), and CGSE scales. HCU confirmation and ARS were extracted from electronic medical records. Repeated measures ANOVA and paired sample t-tests compared ARS and HCU across time points by baseline CGSE. On average, PWD and caregivers were 80 (SD:8) and 64 years-old (SD:11); predominantly female (PWD:63%, CG: 77%) and white (62%), with 12+ years of education (PWD: 84%, CG: 98%).

Results

Self-efficacy improved over time [F(1.92, 281.74 = 11.56, p < 0.001, ηp2 = 0.13]; post-hoc Bonferroni indicated increases from 19.37 to 20.62 at 6-months (95% CI, 0.59–1.92) and 20.56 at 12-months (95% CI, 0.41–1.98). Reductions in ARS [t(178) = 2.63, p = 0.009, MD = 3.34, d = 0.2] and HCU [t(177) = 5.37, p < 0.001, MD = 0.85, d = 0.4] were observed at program completion. The high-CGSE group demonstrated significant ARS [t(98) = 3.43, p = 0.001, d = 0.4] and HCU reductions [t(98) = 3.65, p < 0.001, d = 0.4]. HCU also decreased for the moderate-CGSE cohort [t(43) = 4.17, p < 0.001, d = 0.6].

Conclusion(s)

Groups with higher CGSE experienced greater reductions in ARS and HCU compared to lower CGSE. Self-reported measures and CGSE-group sample sizes may limit our findings.
A - 30 Risk Factors for Poor Sleep Quality and Subjective Cognitive Decline during the COVID-19 Pandemic in an Ethnoracially Diverse US Sample
Authors: McDowell Celina Pluim , Martinez Jairo E , Giudicessi Averi , Munera Diana , Vila-Castelar Clara , Guzmán-Vélez Edmarie , Ramirez-Gomez Liliana , Duffy Jeanne F , Cronin-Golomb Alice , Quiroz Yakeel T
Published: October 2023

Objective

Poor sleep quality is associated with subjective cognitive decline (SCD), a risk factor for developing Alzheimer’s disease and Mild Cognitive Impairment. These relationships are understudied in ethnoracially diverse groups. We examined associations between sociodemographic characteristics, sleep changes during the COVID-19 pandemic (i.e., increased problems/poorer quality), and SCD in ethnoracially diverse older individuals in the US.

Method

870 older adults (126 Latino, 74 Black, 33 Asian, and 637 White; Mage = 67.0 [7.6]) completed an online survey including sociodemographic information, the Everyday Cognition scale (ECog), which measures SCD, and a question inquiring about increased sleep problems/worsened sleep quality during the pandemic. Chi-square tests and analyses of variance assessed sociodemographic and SCD differences between groups. Regression and correlation analyses assessed relationships among sociodemographic factors, changes in sleep quality, and SCD.

Results

White participants were older (p < 0.001), and White and Asian groups had higher education levels (p = 0.009) than Latinos. There were more female (p = 0.016) and middle-income (p = 0.019) White respondents. There were no group differences in ECog ratings (p = 0.143) or the proportion of respondents endorsing changes in sleep during the pandemic (p = 0.197). Changes in sleep were associated with greater SCD (β = 0.214, p < 0.001). Younger age (p < 0.001), female sex (p = 0.001), and lower income (p = 0.016) were significant predictors of changes in sleep.

Conclusions

Poorer sleep quality resulting from the COVID-19 pandemic was associated with SCD concerns. Notably, younger, female, and lower-income adults may have been at greater risk for increased sleep problems. Future work is needed to comprehensively examine sleep quality, SCD, and objective cognitive functioning in more representative samples.
A - 31 Perceived Discrimination, Socioeconomic Factors & Subjective Cognitive Decline in Ethnoracially Diverse Older Adults Living in the United States
Authors: Pugh Erika , Martinez Jairo , McDowell Celina Plium , Munera Diana , Castelar Clara Vila , Quiroz Yakeel T
Published: October 2023

Objective

Perceived discrimination (PD) is linked to poorer well-being and a higher risk of future cognitive decline. Higher levels of PD are frequently reported by people of color. Subjective cognitive decline (SCD), the self-perceived cognitive decline, has been associated with increased risk for dementia. The present study aimed to examine the relationship among PD, race, socio-economic factors and SCD.

Method

A total of 870 community-dwelling older adults (mean age = 67.0, SD = 7.6; range = 55–94; 76% female) living in the United States who self-identified as Latino (n = 126), Black (n = 74), Asian (n = 33), and White (n = 637) completed an online survey during the COVID-19 pandemic. Socio-economic factors included access to resources and resource insecurity. PD was measured with the 7-item Everyday Discrimination Scale, and SCD was measured with the Everyday Cognition scale (ECOG).

Results

Higher levels of PD predicted higher SCD in the entire sample (p-values 0.05). There were no significant associations between PD, socio-economic factors, race, and SCD (p-values >0.05).

Conclusions

Experiences of discrimination negatively impact health outcomes and risk. Our findings provide further evidence of a relationship between PD and SCD although, this relationship was not moderated by race. Future research should aim to examine the relationship between different forms of discrimination (e.g., systemic discrimination) and SCD.
A - 35 The Relationship between Perceived Social Support and Everyday Cognition in Mild Cognitive Impairment: a Longitudinal Study
Authors: Split Molly , De Wit Liselotte , Rodriguez Amy D , Goldstein Felicia C , Vickers Kayci L
Published: October 2023

Objective

Explore the relationship between perceived social support and changes in informant-rated cognitive ability in people with mild cognitive impairment (pwMCI) enrolled in a lifestyle intervention program. Based on prior literature, we hypothesized lower levels of social support would be associated with greater declines in executive functioning (EF) over time.

Method

Forty-nine pwMCI who enrolled in a 12-month comprehensive lifestyle program completed the Multidimensional Scale of Perceived Social Support (MSPSS), and their informants completed the Everyday Cognition Scale (ECog) pre- and post-program. Change scores were calculated for the ECog Total Score and EF subscale. MCI participants were classified into three groups based on ECog change: Declined (n = 17), Stable (n = 17), and Improved (n = 15). Pearson correlations were conducted between MSPSS, ECog, and EF change scores within each group.

Results

There was no significant difference in baseline ECog ratings between groups, F(2,46) = 0.36, p = 0.70 or baseline MSPSS F(2,46) = 1.23, p = 0.30. For the Declined group, a trend emerged suggesting higher MSPSS was associated with declines in EF (r = 0.27, p = 0.07). The relationship between MSPSS and ECog total scores was not significant (p = 0.16). No trends or associations were observed in the Stable or Improved groups.

Conclusions

Findings were counter to initial hypotheses. Although further work is needed, this effect may relate to Reciprocity Theory which posits those who require more social support experience emotional distress due to feelings of unwanted dependence and a lack of perceived ability to reciprocate support. This experience may adversely affect EF through an increase in negative emotions and stress. Further exploration of moderators of this relationship is warranted.
A - 39 Diagnosing Behavioral Variant Frontotemporal Dementia in the Absence of Notable Cognitive Changes: the Value of Collateral Reports
Authors: Espinal Elizabeth , Erani Fareshte , Minniti Nancy
Published: October 2023

Objective

Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative disorder broadly characterized by insidious changes in psychosocial domains including personality/mood, behavior, and cognition. Early detection of bvFTD can be challenging in the absence of structural brain changes, cognitive deficits, and/or patient report. Collateral reports and behavioral observations become integral to diagnostic conceptualization.

Methods

The patient is a 71-year-old White male who was seen by a neurologist for semi-involuntary fidgeting. His spouse also began noticing medication mismanagement and personality changes characterized by irritability, compulsive spending, and irrational thoughts, as well as uncharacteristic lapses in judgement and difficulty with planning and organization. Additional family reports endorsed new perseverative behaviors and intermittent confusion while operating familiar devices. An MRI of the brain demonstrated mild white matter disease.

Results

The patient demonstrated superior premorbid intellectual functioning and average-to-above average scores across most neuropsychological tests. Subtle deficits in maintaining set on executive tasks were noted. Behaviorally, speech was perseverative and tangential throughout the evaluation and he demonstrated low frustration tolerance. Collateral questionnaires indicated a decline in most activities of daily living and significant elevations in apathy, personal neglect, and loss of insight.

Conclusion

While there were subtle changes in cognition, the patient’s overall cognitive profile was intact. However, collateral reports, reported functional decline, and direct behavioral observations warranted concern for early stage bvFTD. Consistent with bvFTD literature, current neuropsychological assessments lack sensitivity for capturing deficits in the presence of behavioral and functional impairment. This case highlights the continued need to develop and validate naturalistic assessments to appropriately capture bvFTD.
A - 46 Mild Neurocognitive Disorder Due to Multiple Etiologies Case Study
Authors: Felegy Katelyn , Keaveney Julie
Published: October 2023

Objective

Frank, a 68-year-old male, is seeking a neuropsychological evaluation based on a referral from the concussion legacy foundation. He wants to know if he has impairment and if so, what the cause is. He has been told by previous providers that he has Lewy Body Dementia, Alzheimer’s Disease, or CTE.

Method

Frank has had over 20 concussions from football, car accidents, and assaults. For approximately a year, Frank has noticed short-term memory loss, word-finding problems, difficulty concentrating, and forgetting things. Frank indicated his balance is poor, as he stumbles and falls 3–4 times/day. In 2022, Frank began having visual hallucinations. Frank’s medical history includes diabetes, hypertension, and high cholesterol. He is prescribed Seroquel, Aricept, Depakote DR, Zoloft, Wellbutrin, and Prazosin.

Results

A test of premorbid functioning indicated Frank’ abilities were in the Above Average range, which relative to his scores on this evaluation indicates a significant decline in cognitive functioning. There are significant impairments in Frank’ auditory working memory, verbal learning and memory, visual learning and memory, visual planning and organization, and mental flexibility.

Conclusions

Deficits are consistent with Mild Neurocognitive Disorder due to multiple etiologies. Possible etiologies include multiple concussions, vascular risk factors such as hypertension, high cholesterol, and diabetes, as well as possible degenerative brain changes. The data suggests deficits with attention, learning, retrieval, impulsivity, mental flexibility, which is consistent with frontal subcortical executive deficits. The pattern of findings is consistent with Lewy Body changes due to visual hallucinations, fluctuating cognition, motor symptoms, and dysexecutive patterns on testing.
A - 51 The Interaction of Social Cognition Deficits and Personality Change in Progressive Supranuclear Palsy
Authors: Hebron Liberty P , Callahan Patrick , Wever Leonore , Rijpma Myrthe G , Antoniou Rea , Kramer Joel H , Miller Bruce L , Rankin Katherine R
Published: October 2023

Objective

Small studies have suggested individuals with progressive supranuclear palsy (PSP) may have socioemotional deficits (i.e., poor emotion recognition and mentalizing). However, consideration has not been given to the interplay of social cognition and personality changes. The present study used multiple personality and social cognition measures to identify neurologically-driven socioemotional changes in PSP.

Method

Data was collected from 177 individuals: 77 with PSP and 100 older healthy controls (HC). The Awareness of Social Inference Test (TASIT) measures patients’ comprehension of emotional videos (Emotion Evaluation Test: EET) and everyday social interactions (Social Inference Enriched: SI-E). Premorbid and current personality was reported by informants using the Interpersonal Adjectives Scale (IAS) and the Big Five Inventory (BFI). Groups were compared controlling for age and sex; statistical significance was set at p < 0.05.

Results

PSPs displayed impairment in reading emotions on the TASIT-EET (M:9.1 ± SD:2.66) and inferring others’ intentions on the TASIT-SIE (44.8 ± 6.12) compared to HCs (11.5 ± 1.48; 53.8 ± 4.94). PSPs showed clinically (−1.5 SD) and statistically significant drops from premorbid levels in Extraversion (IAS current T: 37.0 ± 16.28; BFI: 20.1 ± 5.80) and IAS Dominance (39.9 ± 13.54).

Conclusions

PSP patients showed significant deficits at multiple levels of emotion reading and theory of mind, impairing their comprehension of social communication. This may in turn explain the observed declines in interpersonal dominance and extraversion, possibly reflecting loss of agency and sociableness with disease progression. These results reveal more clinically significant socioemotional deficits in PSP than are generally recognized, and suggest face-to-face social testing and informant reports of personality change can be valuable testing approaches.
A - 53 A Digital Health Solution for Early Detection of Cognitive Impairment in Primary Care
Authors: Hilsabeck Robin C , Keller Jeffrey , Henry Maya L , Li Jessy , Pugalenthi Lokesh , Rathouz Paul J , Toprac Paul , Chang Patrick , Chang Joshua T , Schmitz Suzanne M , Largent Avery , Foil Heather , Brouillette Robert , Lester-Smith Rosemary
Published: October 2023

Objective

To determine which task or combination of tasks provided the most effective way to differentiate cognitively impaired (CI) from cognitively normal (CN) participants in under 5 minutes and to ensure that classification accuracy was equal to or better than a traditional brief cognitive screening task, the Quick Mild Cognitive Impairment (Qmci) screen.

Method

CN (n = 53) and CI (n = 51) participants completed a risk assessment task, a symbol matching (SM) task, and four speech-language tasks, followed by a second administration of SM to examine utility of practice effects administered on an iPad. Participants also completed the Qmci. Eleven models were tested using Bayesian adaptive regression trees.

Results

The top three models all included the two SM variables: the one with SM by itself (estimated c = 0.91), one with SM and features from a personal narrative task (c = 0.94), and one with SM and a counting backwards task (c = 0.90). Models with picture description and procedural discourse tasks performed the worst. For comparison, the QMCI-only model yielded c = 0.91.

Conclusions

A combination of working memory/processing speed and acoustic and linguistic variables from recalling a personal story achieved a high level of classification accuracy, slightly exceeding that of a traditional cognitive screening task. The inclusion of both verbal and nonverbal tasks may be an important feature, allowing for cognitive screening of individuals who are not able to do one type of task or the other. Future work is planned to examine this shortened tool in a pragmatic clinical trial in two primary care clinics.