bluuebunny/crossref_metadata_2025 huggingface dataset:
A - 41 Serious Cognitive Difficulties Are Associated with Food Insecurity after Adjusting for Adverse Childhood Experiences among Adolescents in the United States
Authors: Iverson Ila A , Nyberg Gisela
Published: September 2024

Objective

Food insecurity, a public health problem, is associated with worse academic and mental health outcomes in adolescents. Correlates of cognitive difficulty among adolescents include neurodevelopmental disorders, psychiatric conditions, and adverse childhood experiences (ACEs). We examined the association between parent-reported food insecurity and cognitive difficulties, after statistically adjusting for neurodevelopmental disorders, psychiatric conditions, and ACEs.

Methods

The 2021 National Survey of Children’s Health is a parent-reported survey of youth in the United States that addresses their physical and emotional health. Associations between cognitive difficulty, food insecurity, neurodevelopmental and psychiatric conditions, and ACEs were examined using chi-squared tests and binary logistic regressions.

Results

Participants were 13,448 adolescents (aged 13–17; 48% girls), and 13.5% had parent-reported cognitive difficulties (14.7% of boys and 12.2% of girls). Among those with cognitive problems, 95% had a diagnosis of a neurodevelopmental or psychiatric condition. In the total sample, 21.7% were rated as having mild food insecurity and 3.4% had moderate–severe food insecurity. ACEs were associated with food insecurity and cognitive difficulties. Binary logistic regressions examined the associations between food insecurity and cognitive difficulties after statistically adjusting for sex, ACEs, and neurodevelopmental and psychiatric conditions [χ2(4) = 3941.339, p < 0.001; Nagelkerke R2 = 0.465]. Food insecurity was independently associated with cognitive difficulty (Odds Ratio = 1.28; 95% confidence interval = 1.15–1.42).

Conclusion

Food insecurity was associated with serious cognitive difficulty among adolescents in the United States after adjusting for sex, neurodevelopmental or psychiatric conditions, and ACEs. It is important to better understand the correlates of cognitive difficulties among adolescents to bolster precision care designed to support youth with these difficulties.
A - 43 Neuropsychological Profile of MED13L Syndrome: a Rare Genetic Disorder
Authors: Rowcliffe Stacey A , Culotta Vincent P , Griffith Kirk
Published: September 2024

Objective

This study examined the neuropsychological profile of a child with Mediator complex subunit 13-like gene (MED13L) syndrome, a rare developmental disorder (1 of 100,00). The MED13L gene provides protein instructions for control of cell growth and repression of cell cycle target genes. MED13L syndrome is known for intellectual disabilities, congenital heart defects, hypotonia, developmental delays, and distinctive facial features. Autism spectrum characteristics may be evident in children with MED13L.

Method

This single-subject design examines an 8-year-old, 2nd grade female referred for neuropsychological assessment secondary to significant neurodevelopmental delays related to MED13L syndrome. Assessment goals included identification of strengths and weakness, intervention guidance, educational planning, and family education.

Results

Results were consistent with a diagnosis of Autism Spectrum Disorder secondary to MED13L. Assessment results indicated intellectual impairment, language impairment, developmental coordination disorder, and restricted and repetitive behaviors. Strengths included social motivation to interact with others, a sense of humor and positive interpersonal relationships.

Conclusion

The subject’s profile revealed features consistent with literature regarding MED13L syndrome including autism spectrum features. However, notable exceptions were apparent such as preserved visuospatial skills, and preserved social motivation and social intent. This study illustrates the value of early neuropsychological assessment in identifying individual variances in rare genetic disorders and the role of testing in the development and implementation of interventions. The findings also raise research worthy interesting questions regarding the neural underpinnings of preserved social motivation, a desire for affiliation, and a pleasant disposition in genetic disorders such as Trisomy 21, Williams Syndrome, and the current presentation of MED13L.
A - 48 A Preliminary Comparison of Performance on the D-KEFS Advanced Trail Making Test across ADHD, ASD, and Math LD Clinical Groups
Authors: Ramos Mayra , Huber Ann , Holdnack James A , Drozdick Lisa W , Puig Jennifer
Published: September 2024

Objective

Exploratory analyses on executive function performance between clinical groups was conducted using the Delis-Kaplan Executive Function System Advanced (D-KEFS Advanced) Trail Making Test (TMT). Our goal was to see if TMT could detect differences in the cognitive profiles of examinees diagnosed with attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and math learning disorder (MLD) clinical groups.

Method

Participants ages of 8 and 16, diagnosed with ADHD (N = 56), ASD (N = 27), or MLD (N = 25) completed the D-KEFS Advanced TMT. DSM5 diagnostic criteria were used for diagnosis. Additionally, participants with comorbid diagnoses across the three groups were excluded from the clinical samples. Mean Correct (with errors) Connection Time for the five conditions was captured for each clinical group, as well as error rates.

Results

Multiple differences were found, but only two reached significances at the p < 0.01 level. Unpaired t-test results revealed a statistically significant difference between ADHD (M = 9.34, SD = 3.16) and ASD (M = 7.00, SD = 3.16) groups in Mean Correct (with errors) Connection Time scores for TMT Number Sequencing, t(81) = 3.16, p = 0.002, 95% CI [0.87, 3.81]. Additionally, Mean Correct (with errors) Connection Time scores for TMT Switching-Distraction condition between ADHD (M = 8.41, SD = 2.51) and ASD (M = 6.48, SD = 3.04) groups was statistically significant, t(81) = 3.06, p = 0.003, 95% CI [0.67–3.19].

Conclusion

Overall, these preliminary findings suggest good clinical utility; however, further research is needed to determine if performance differences can aid in the evaluation of patterns of cognitive difficulties between groups.
A - 51 Neuropsychological Development in Twins with Chromosome 7p14.1 Duplication
Authors: Marshall Blaine , Morton Carla
Published: September 2024

Objective

The aim of this study is to evaluate the neuropsychological development of female identical twins with a history of cognitive and language deficits as well as psychiatric symptoms. Each patient has notable genetic history for de novo chromosome 7p14.1 duplication. At this time, 7p14.1 duplication is classified as a variant of uncertain significance.

Method

Results were reviewed from neuropsychological evaluations at an outpatient neuropsychology clinic at a children’s hospital when the patients were 13, 14, and 17 years of age. The patients were evaluated across multiple neuropsychological domains.

Results

Both patients have exhibited significant deficits in numerous areas of cognitive and adaptive functioning since their initial evaluation. Across time, both patients have shown a lack of development in their overall intelligence, with current functioning between a 6- and 11-year-old level. Despite frequent exposure to English since six years of age, including several years of monolingual English academic instruction, they both continue to demonstrate severe receptive and expressive English language deficits, requiring the need for Spanish interpreters for all evaluations. In addition, both twins have exhibited symptoms of depression, anxiety, and psychosis (e.g., command hallucinations).

Conclusions

Results from this study reveal similar neuropsychological profiles across time in identical twins with an understudied chromosomal mutation. Key findings include diagnoses of Intellectual Disability and Language Disorder as well as histories of serious psychiatric symptoms. Our findings add to the limited literature on neuropsychological profiles in individuals with chromosome 7p14.1 duplication.
A - 56 Cumulative Childhood Adversity Is Linked with Reduced Cognitive Performance during Late Childhood to Adolescence
Authors: Stinson Elizabeth A , Shankula Chase A , Navarro Gabriella Y , Lisdahl Krista M
Published: September 2024

Objective

History of adverse childhood experiences (ACEs) has been linked with poorer cognitive performance in young adulthood and cognitive decline in older adults; however, few studies have examined these relationships during childhood and adolescence, which are key periods for neurocognitive development. The current study investigated the longitudinal relationships between ACEs and cognitive performance during late childhood/adolescence.

Method

10,827 participants (ages = 9–15.5 years old; 48% female) were included from the Adolescent Brain Cognitive Development Study. Cumulative ACE scores were created using annual parent and child reports of youth’s exposure to ACEs from baseline (ages 9–10) to Year 4 follow-up (ages 13–15). Cognitive performance was assessed using the NIH Toolbox (completed at baseline, Year 2, and Year 4). Separate linear mixed-effects models examined associations between ACEs and cognitive performance while accounting for time, age, sex assigned at birth, caregiver education, household income, pubertal status, internalizing and externalizing symptoms, and random effects of subject and family/twin status. Additional analyses tested for interactions with time.

Results

Greater ACEs were associated with poorer cognitive performance on tasks measuring verbal (p’s < 0.001) and visual (p < 0.001) memory, working memory (p = 0.01), cognitive flexibility (p = 0.004), processing speed (p < 0.001), and language (p’s < 0.001), above and beyond covariates. ACEs were not associated with attention (p = 0.09). Cognitive performance improved over time; however, compared to baseline, youth with greater ACE history at Year 4 demonstrated poorer attentional performance (p = 0.008).

Conclusions

Findings suggest that ACEs influence cognitive performance during key neurodevelopmental periods, and future work should assess clinical utility of targeted cognitive remediation in youth with adversity history.
A - 57 Lack of Exposure or Cognitive Disorder? Using a Flexible, Process Oriented Neuropsychological Evaluation to Clarify Etiology of Social and Academic Weakness in a 13-Year-Old Boy
Authors: Seshadri Deepak , Weiss Erica , McGinley John , Stimmel Marnina , Bronshteyn Diana , Masur David , Facchini Ronda
Published: September 2024

Objective

Inadequate socialization and lack of academic exposure are known to impact developmental and academic milestones. Attention deficit hyperactivity disorder (ADHD) is a condition with high rates of global prevalence, and comorbidity with Autism Spectrum Disorder (ASD) and Specific Learning Disorder (SLD). We present the case of a 13-year old boy with social difficulties and academic concerns in the context of atypical academic experiences to demonstrate how a flexible and process-oriented approach distinguishes lack of appropriate academic and social exposures from underlying diagnoses.

Methods

Comprehensive neuropsychological evaluation with a focus on flexibility and process of a 13-year-old boy with a history of ADHD and hypotonia who was homeschooled and is currently in an online project-based program.

Results

Overall intellectual functioning was average. Deficits observed in mathematics and visuomotor skills (fine motor control). Variable performances noted in language, visuospatial, memory, executive functioning, and behavioral/emotional functioning (anxiety). Limit testing, documentation of patient process, and considering the patient’s prior exposure to academic material through robust clinical interview helped confirm the presence of ADHD, ASD, SLD (written expression and mathematics), and developmental coordination disorder (DCD).

Conclusion

This case highlights the challenges of distinguishing overlapping clinical and neuropsychological features of comorbid ADHD, ASD, SLD, and DCD in children with atypical social and academic exposures. It emphasizes how a process oriented neuropsychological approach differentiates overlapping features and clarifies diagnoses to tailor recommendations for maximized outcomes.
A - 59 An Exploration of a Passive Decision Making Style within the Cognitive Disengagement Syndrome Population and its Contribution to Social Isolation
Authors: Lee Madeline , Castillo Brandon , Young Cara , Perry James , Alsaif Haifa , Hurt Beth
Published: September 2024

Objective

Recent research has shown that Cognitive Disengagement Syndrome (CDS) may reduce decision-making independence. In this way, CDS may include a prognosis of social disengagement due to symptoms of the disorder such as apathy, low motivation, passivity, and low energy. This poster investigates the relationship between CDS symptoms and social disengagement and explores possible treatment focuses that could increase individuals’ connection to others and the world around them.

Data Selection

Information regarding this poster was obtained through a review of the literature including peer-reviewed articles from 2019–2024. Articles were gathered from the Journal of Clinical Child and Adolescent Psychology, Journal of Attention Disorders, Journal of Pediatric Psychology, Child Neuropsychology, and Research in Developmental Disabilities. Informal analyses were used to determine themes including keywords such as sluggish cognitive tempo, cognitive disengagement syndrome, decision-making, social isolation, and apathy.

Data Synthesis

CDS is associated with lower levels of assertiveness and higher levels of passivity than in the Attention Deficit Hyperactivity Disorder Inattentive Type (ADHD-IN) population. Current research suggests CDS is associated with social isolation influenced by difficulty initiating conversations and being more likely to engage in anxious rumination during conversations. Treatment interventions for CDS should target shyness, task-unrelated thought patterns, behavioral inhibition, hyperreactivity to social stressors, socially isolating behavioral addictions, verbal inhibition, and difficulty with divided attention.

Conclusions

Based on conclusions drawn in this poster, future studies should examine the impact of loneliness on social initiation frequency within the CDS population. The development of a questionnaire that aims to differentiate ADHD-IN from CDS may also be useful.
A - 68 The Underrepresentation of Board-Certified Neuropsychologists Practicing in Rural Areas: a Diversity Issue and Call for Action
Authors: McMillen Taylor N , Woolner Kelsey
Published: September 2024

Objective

Despite the increasing growth of the discipline of clinical neuropsychology, there remains a lack of research as it pertains to the unique understanding and delivery of neuropsychological services in rural areas. The purpose of this study is to determine if there are a proportionate number of board-certified neuropsychologists practicing in rural, urbanized clusters, and urbanized areas as what would be excepted per the population according to the United States (U.S.) Census with the prediction that there will be less than expected board-certified neuropsychologists practicing in rural areas.

Methods

A database of board-certified neuropsychologists both through the American Board of Professional Psychology (ABPP) and the American Board of Professional Neuropsychology (ABN) was created for a total of 1620 board-certified neuropsychologists. Members were coded as either rural (5000 to 50,000 people). A Chi-square goodness of fit test was run comparing the proportions of board-certified neuropsychologists in rural, urbanized clusters, and urbanized areas with the expected proportions based on national population proportions.

Results

There were significantly fewer than expected board-certified neuropsychologists practicing in rural and urbanized areas as compared to the rural and urbanized area population per the U.S. Census Bureau (X^2 (2) = 7704.565, p < 0.001).

Conclusion

As predicted, rural areas have fewer board-certified neuropsychologists than would be expected. Not predicted was the finding of less board-certified neuropsychologists practicing in urbanized areas than would be expected. This finding suggests rural and urbanized areas are underserved, though tracking neuropsychologists who are not board certified is challenging.
A - 71 Cross-Cultural Comparison of Cognitive Performance between Americans and Cameroonians while Controlling for Age and Education
Authors: Heavens Brittany , Golden Charles , Stripling Ashley , Tchienga Ines
Published: September 2024

Objective

The development of cognitive abilities varies based on social and cultural factors. Given the expansion of neuropsychological measures internationally, an accurate understanding of performance across different countries is necessary to understand the appropriateness of different cognitive tests. To expand the existing knowledge base, this study explores the differences in cognitive test performance between Cameroonian and American adults.

Methods

The Cameroonian sample, 250 adults ages 22–72 (mean age = 42.91 [SD = 13.76], 52% male, mean education = 13.54 [SD = 4.58]) resided in Yaoundé, Cameroon. Participants were tested at a district center. Deidentified data from a community mental health center’s archival database comprised the American sample. A one-factor between MANCOVA examined differences in performance on selected measures between Americans and Cameroonians after controlling for age and education.

Results

Age and education statistically significantly affected scores on all selected subtests except for WMS-IV Logical Memory I. Additional analyses revealed that performance still differed between conditions while controlling for age (F (6, 749) = 33.87, p < 0.001; Wilk’s ∧ = 0.787, partial ŋ2 = 0.21), and education (F (6, 749) = 18.95, p < 0.001; Wilk’s ∧ = 0.868, partial ŋ2 = 0.13) for WAIS-IV Digit span, WAIS-IV Symbol search, WAIS-IV Coding, Stroop color word, and WMS Logical Memory I & II subtests.

Conclusion

Age and education are important predictors of performance on cognitive tests. The importance of appropriately norming new assessments and re-norming older assessments is underscored when those variables are controlled for and differences in performance are maintained between the two conditions. Current findings indicate that cultural differences and their effect on cognitive development explain performance beyond age and education level.
A - 73 The Effects of Socioeconomic Status, Depression, and Chronic Stress on Cognitive Outcomes of Latino Older Adults Enrolled in HABS-HD
Authors: Breton Jordana , Hamlin Abbey M , Ortega Nazareth , Hossain Thaha , Shirvani Mona , Medor Joshua , Pethe Ashna L , Cavazos-Reyes Estefanía , Clark Alexandra L
Published: September 2024

Objective

Although research has established that lower socioeconomic status (SES) is linked to worse cognitive functioning in Latino older adults, the precise mechanisms underlying this association remain unclear. SES has been linked to the manifestation and severity of depression and anxiety, and evidence suggests that Latinos may be more susceptible to the negative effects of these psychological factors in late life. Therefore, the present study examined the mediating role of psychological symptomatology in the relationship between SES and cognition.

Method

736 Latino older adults (mean age = 62.67) enrolled in HABS-HD were included. Mediation analysis tested the direct and indirect effects of SES (annual household income) and psychological symptomatology (depression, chronic stress) on memory and executive functioning composite scores.

Results

The direct effect of SES on memory was fully mediated by depression (β = 0.02, CI [0.01, 0.04]), and depression partially mediated the relationship between SES and executive functioning (β = 0.02, CI [0.01, 0.04]). There were no significant indirect effects of chronic stress on SES and memory (β = −0.0003, CI [−0.003, 0.002]) or executive functioning composite scores (β = 0.0004, CI [−0.002, 0.003]). However, after controlling for chronic stress, SES had a direct effect on executive functioning (β = 0.12, CI [0.03, 0.12], p = 0.001), but not memory (β = 0.03, CI [−0.03, 0.07], p = 0.48).

Conclusions

The effect of SES on cognition is mediated by depressive symptomatology but not chronic stress. Results suggest that culturally tailored treatment of depression may be an immediate intervention against long-standing resource inequalities.
A - 78 Verbal Fluency Tasks Showed Lower Performance in Hispanic Vs. Non-Hispanic White Group
Authors: Gamino Denise , Barnett Michael D , Bishop Kellee N , Boynton Harrison G , Carter Ericka , DiGiovanna Benjamin J , Langarica Ashley , Motley John E
Published: September 2024

Objective

Neuropsychological tests administered in the U.S. are primarily designed for English-speaking and White populations. Language spoken, education, age, and acculturation have been shown to impact test performance in Hispanic populations. With a growing Hispanic population in the U.S., there is a demand for greater normative efforts in neuropsychological tests, especially verbal fluency tests. The purpose of this study was to investigate differences between Hispanic and non-Hispanic Whites on verbal fluency tasks.

Methods

Adults (N = 65, age 18–81, M = 32.83) reported as either Hispanic (n = 17) or non-Hispanic White (n = 48). Verbal fluency tasks included Delis-Kaplan Executive Function System (DKEFS) Letter (LF) and Category Fluency (CF [Animals + Boys’ Names]) subtests.

Results

One-way ANOVA found that the Hispanic group showed lower correct responses in D-KEFS-CF (F(1, 63) = 4.84, p = 0.031, n2 = 0.71) than the non-Hispanic White group. Post hoc analysis showed lower performance in the Boys’ Names subtest (F(1, 63) = 4.458, p = 0.039, n2 = 0.066) and within the first interval (F(1, 63) = 4.788, p = 0.032, n2 = 0.071).

Conclusions

Results indicated that performance in verbal fluency tasks was lower in the Hispanic group –particularly in total boys’ names generation and within the first interval. This may derive from bilingual considerations and lesser cultural familiarity with American boys’ names. Although this study has limitations, further research should examine test performance differences on D-KEFS CF between Hispanics and non-Hispanic Whites to ensure accurate representation and reduce the risk of misclassifying Hispanics with language functioning deficits.
A - 80 Moderating Effect of Age on the Relationship between Mood and Executive Functioning among South Asians
Authors: Rafiuddin Hanan S , Khan Humza M , Patel-Shah Priya , Patel Hirangi , Irani Farzin , Hundal Jasdeep S , Krishnan Kamini , Sunderaraman Preeti
Published: September 2024

Objective

This study investigated whether depression and anxiety are associated with executive functioning (EF) performance among South Asians living in the United States (US). Further, we explored whether age moderated this relationship.

Method

This retrospective chart analysis study included 28 South Asians referred for a neuropsychological evaluation within multiple northeast US-based outpatient clinics. Participants completed the Beck Depression Inventory-2nd edition (BDI-II), Beck Anxiety Inventory (BAI), Stroop Color Word Test- Color-Word Trial (SCWT-CW), and Verbal Fluency (FAS). Participants were dichotomized by age threshold (age 50 cut-off). Logistic regression analysis was used to determine the moderating effect of age on mood and EF.

Results

The sample comprised 13 younger adults and 15 older adults (50+), with 60.7% male (Meducation = 16.0, SD = 2.3). Regression analysis indicated a significant overall model between age, BDI-II, and SCWT-CW (F(1,25) = 3.01, p < 0.05, ΔR2 = 0.27). Further interaction analysis showed a stronger positive interaction effect between BDI-II and SCWT-CW (β = 5.39, F(1,24) = 4.91, p < 0.05, ΔR2 = 0.15) in the younger adult group.

Conclusions

Findings suggest that South Asian older adults with lower levels of depression have worse performance on EF than younger adults. This is one of the first studies to identify links between age, mood, and EF. Interpretation is challenging given that the mean scores of depression and SCWT-CW were in the mild range. Future studies are needed to understand how factors, such as English speaking proficiency and acculturation, may moderate the association and impact clinical relevance.
A - 81 Gender Bias in Collateral Informant Ratings of the Lawton & Brody Instrumental Activities of Daily Living Scale Varies by Ethnolinguistic Group
Authors: Scott Bonnie M , Rana Amtul-noor , Ortiz Bertha K , Strutt Adriana M , Hilsabeck Robin C
Published: September 2024

Objective

Building on our prior work showing that sociocultural factors influence the nature of one’s daily activities and the degree of assistance rendered once cognitive difficulties emerge, the present study aimed to examine gender differences in the frequency of abnormal IADLS ratings [Not Applicable (N/A), Requires Assistance (R/A), Dependent] in cognitively healthy older adults from different ethnic (Hispanic vs. Non-Hispanic) and linguistic (English vs. Spanish) groups.

Method

Baseline data from 1060 healthy older adults [Non-Hispanic English-speakers (NE) = 597; Hispanic English-speakers (HE) = 249; Hispanic Spanish-speakers (HS) = 214] 50–90 years of age enrolled in the Texas Alzheimer’s Research and Care Consortium were analyzed using univariate analyses of variance and multivariate chi-squares within each ethnolinguistic group.

Results

Women obtained significantly (p < 0.001) higher IADLS total scores (indicative of greater impairment) than men in each ethnolinguistic group. A significant difference (p < 0.01) was found between gender across the sample for items related to Food Preparation, Housekeeping, and Laundry, wherein 7–25% of all men vs. < 1% of all women received “N/A” ratings. Significantly more HE men vs. women also received “N/A” ratings for Finances (4:1) and Medications (7:1), while a similar trend was observed in the NH and HS groups but did not reach statistical significance. No participants received an “N/A” rating and no significant gender differences were observed for remaining IADLs.

Conclusion(s)

Obtained findings highlight considerable gender bias on the Lawton & Brody IADLS in healthy older adults, which clearly limits the utility of this instrument in the provision of patient-centered neuropsychological services and may confound the interpretation of clinical trial outcomes.
A - 82 Differences in Cognitive Effort-Based Decision Making between Younger and Older Adults
Authors: Scott Bonnie M , Eisinger Robert , Mara Roshan , Rana Amtul-noor , Thompson Sable , Okun Michael S , Gunduz Aysegul , Bowers Dawn
Published: September 2024

Objective

Goal-directed decision-making relies on age-dependent reward processing. Current measures of motivation have yet to be validated for use among older adults (OA). This study aimed to compare the performance of younger adults (YA) and OAs on an objective effort-based decision-making behavioral task.

Method

Thirty-five YAs (21.9 ± 3.6 years of age) and thirty-five OAs (68.4 ± 8.5 years of age) completed a cognitive screening measure, self-report questionnaires assessing mood/motivation, and a computerized game in which individuals can choose to expend greater effort for larger reward that vary in magnitude and probability. Performance parameters were compared across groups.

Results

YAs displayed a greater willingness to exert effort for reward. YAs had faster decision-making time when compared to OAs, except conditions when the magnitude and probability for reward was lower. OA’s task difficulty selection was significantly influenced by the magnitude and probability for reward, as well as by previous trial outcomes. This behavior was not observed in YAs who were not sensitive to the magnitude of reward. Moreover, in OAs, lower levels of fatigue were correlated with expending greater effort in some reward probability conditions. Lower levels of apathy were also correlated with expending greater effort after following a small win.

Conclusion(s)

This study revealed preliminary evidence supporting the motivation task could recognize subtle motivational deficits and was well tolerated by YA and OAs. The measure was applicable in the context of age-related limitations. Our findings contribute to the existing body of research aimed at developing tools to accurately measure motivation levels among OAs.
A - 83 Concordance between Informant Measures, Executive Functioning, and Functional Ability in an Older Adult Population
Authors: Bodek Hannah S , Sergeyev Nicole , Krishnan Anjali , Rahman Aneela , Pare Nadia , Warren David E , Wilhelm Anna , Rabin Laura
Published: September 2024

Objective

Informant-report measures often do not correlate with neuropsychological tests measuring the same cognitive construct, yet they may offer insight into everyday difficulties not captured by objective tests. Performance-based measures of functional ability, developed to capture real-world skills, may better align with informant-report measures. Clarifying the relationship between subjective and objective assessment tools in older adults could enhance precision in selecting the most appropriate measures.

Method

As part of a comprehensive neuropsychological battery, community-dwelling older adults who were cognitively unimpaired or who presented with subjective cognitive decline or mild cognitive impairment completed tests of executive functioning (EF), (D-KEFS Trail Making Test 4, Letter Fluency, WCST, WAIS-Comprehension) and financial capacity, Financial Capacity Instrument (FCI-SF). Informants responded to measures of functional ability, Amsterdam Instrumental Activities of Daily Living Questionnaire Short Version (A-IADL-Q-SV) and Assessment of Functional Capacity Interview (AFCI) and items capturing EF on the Brief Informant Form of Neurobehavioral Symptomatology (BINS).

Results

Participants’ (N = 97, Mage = 74.64 ± 7.42 years; Meducation = 15.76 ± 2.42 years; 74.2% female) FCI-SF performance significantly correlated with higher A-IADL-Q-SV (r = 0.403, p < 0.01) and AFCI (r = −0.294, p < 0.01) scores, whereas there was no significant correlation between a composite Z-score for traditional neuropsychological tests and select EF items from the BINS, (r = −0.119, p = 0.252).

Conclusion

We found greater alignment between objective and subjective measures of functional ability than EF, possibly due to the observable nature of functional tasks. Objective and informant measures of EF do not align, potentially targeting different aspects of cognition in non-demented older adults. This should be considered when selecting instruments measuring specific constructs of interest.
A - 84 Associations between Social Vulnerability, Adaptive Functioning, and Personal Distress in Non-Demented Older Adults
Authors: Sergeyev Nicole , Krishnan Anjali , Beadle Janelle N , Warren David E , Paré Nadia , Aflagah Erica , Nester Caroline , Rabin Laura
Published: September 2024

Objective

Though social vulnerability is associated with cognitive decline in older adults, its correlation with socioemotional and functional changes, both common in neurogenerative diseases, is often overlooked. We sought to elucidate the interplay between these critical domains in older adults with varying degrees of cognitive compromise, including participants who presented with mild cognitive impairment (MCI), subjective cognitive decline (SCD), or were cognitively unimpaired (CU), with implications for enhancing risk detection in vulnerable populations.

Method

Participants (N = 97; Mage = 74.64 ± 7.42 years; Meducation = 15.76 ± 2.42 years; 74.2% female) were community-dwelling older adults, along with their informants, who underwent comprehensive neuropsychological testing and responded to the Social Vulnerability Scale (SVS15), an informant-reported assessment designed to identify potential victims of exploitation. A Kruskal-Wallis test determined group differences on SVS15 (CU, SCD, MCI). Spearman correlations tested relationships among SVS15 and adaptive functioning (Assessment of Functional Capacity Interview, Financial Capacity Instrument) and personal distress, a measure of the tendency to experience anxiety/distress in response to others’ suffering (Interpersonal Reactivity Index–Personal Distress).

Results

SVS15 scores significantly differed across diagnostic groups, H(2) = 7.060, p < 0.05, with the MCI group performing significantly worse than the CU group, H(2) = 17.703, p < 0.05. SVS15 was significantly associated with worse functional (r = 0.571, p < 0.001) and financial (r = −0.224, p = 0.027) capacity and heightened personal distress (r = 0.390, p < 0.001).

Conclusions

Increased social vulnerability is associated with functional impairment and personal distress in older adults with and without cognitive impairment. Older adults with elevated emotional reactivity in distressing situations and lower levels of functional and financial capacity may be more susceptible to exploitation.
A - 92 Association of the Grit Scale with Cognitive/Emotional Symptom Endorsement in Older Former College Athletes
Authors: Shurtz Logan , Bunt Stephen C , Schaffert Jeff , Didehbani Nyaz , LoBue Christian , Cullum C Munro
Published: September 2024

Objective

The Grit Scale is a validated measure of trait-level perseverance, often linked with resilience, and has been associated with better cognition and psychological well-being in older adults. As the ability to respond positively to setbacks is essential for a successful athlete, investigation of the Grit Scale in former athletes may prove beneficial for further understanding the effect of resilience and its relation to brain health and psychological well-being.

Method

Former college athletes (N = 678, 45.9% female) aged 50–87 (m = 61.44) from the College Level Aging Athlete Study (CLEAATS) completed the Grit Scale, Patient Health Questionnaire (PHQ-8), Generalized Anxiety Disorder Scale (GAD-7), Cognitive Function Instrument (CFI), and the Telephone Interview for Cognitive Status-Modified (TICS-m). Pearson’s partial correlations (r) were used to determine the relationship between scores on these measures, controlling for age and education.

Results

Pearson partial correlations between Grit Scale scores and scores from the other measures were modest but statistically significant: PHQ-8 (r = −0.342, p < 0.001), GAD-7 (r = −0.259, p < 0.001), CFI (r = −0.316, p < 0.001), and TICS-m (r = 0.101, p = 0.008).

Conclusions

Comparison of the Grit Scale with PHQ-8, GAD-7, CFI, and TICS-m indicated that greater trait-level perseverance correlated with better cognitive and emotional functioning in former college athletes. Results emphasize the need to further evaluate perseverance/resilience and its value for understanding brain health and psychological well-being in athletes and former athletes.
A - 101 Anticholinergic Drug Use in Older Adults with Dementia: a Systematic Review
Authors: Sacco Allegra , Monahan Kathleen , Tamlyn Autumn , Gaudet Charles
Published: September 2024

Objective

This systematic review examined the prevalence of anticholinergic medication use, a known risk factor for cognitive impairment, among older adults with dementia.

Data Selection

PubMed and Embase were searched in February 2023 and March 2024 for studies reporting on the prevalence of anticholinergic medication use in older adults (age 65+) with a pre-existing diagnosis of dementia. We appraised 560 peer-reviewed manuscripts to determine they met inclusion criteria. The systematic review was conducted, designed and reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P).

Results

Twenty-nine studies met the inclusion criteria. Anticholinergic medication use rates among adults aged 65 or older with dementia ranged from 4.4% to 63.4% across studies. The median prevalence was 23.1%. In addition to several versions of the Beers Criteria and STOPP Criteria, a range of potentially inappropriate medication criteria were used.

Conclusions

Anticholinergic medications were widely used among older adults with dementia. Compared to a prior systematic review published in 2019, the current results indicate an increase in the frequency of anticholinergic use among older adults with dementia. Given the presence of cognitive impairment in this population, healthcare providers should closely monitor anticholinergic burden in their older adult patients and consult with prescribers to consider risks and benefits associated with such medications. Future research examining the prevalence of anticholinergic use among a broader population of older adults (e.g., those with mild cognitive impairment) appears warranted.
A - 103 Exploring the Diagnostic Criteria for Alcohol-Related Dementia: a Case Study
Authors: Vazir Sheila , Klein Hannah , Kearns Kelly
Published: September 2024

Objective

Excessive and chronic alcohol use can cause structural/functional abnormalities in the brain, including cognitive impairment (CI) (Harper, 2009). Despite these established risks, alcohol-related dementia (ARD) has received little recognition, mainly due to lack of a distinct pathophysiological profile. Through a case differential approach (concussion vs. ARD), the authors aim to clarify diagnostic criteria for ARD.

Methods

A 56-year-old right-handed male presented to the emergency room after fall with head strike (no loss of consciousness) with alcohol withdrawal delirium. Symptoms of cerebellar ataxia and CI of 6-month duration were noted. Past medical history was significant for alcohol use (four standard units per day), hyperlipidemia, tobacco use, and depression/anxiety. Neuroimaging revealed cerebral atrophy and chronic small vessel ischemic disease. A neuropsychological evaluation (NPE) was conducted 18 days post-fall.

Results

NPE revealed relative weaknesses in working memory, complex attention, and visual abstraction. Impairments were noted in visuospatial organization/planning, processing speed, basic attention, verbal fluency, and verbal memory. Motor examination was evident for intention tremor.

Conclusion

Brain changes associated with ARD include volume loss, altered glucose metabolism, reduced neuronal density, changes in frontal lobe function, and white matter loss. In contrast, individuals affected by concussions may encounter challenges with attention/concentration, processing speed, and working memory. Distinguishing a clear diagnostic profile for ARD is difficult due to high rates of concomitant concussion in this population. The patient’s deficits exceed those expected due to concussion alone, with an anticipated cognitive recovery timeframe of 7–14 days (Iverson, 2006). Furthermore, neuroimaging and NPE results support the diagnostic hypothesis of ARD.
A - 105 Impact of COVID-19 on Executive Functioning and Processing Speed in Older Adults with Mild Cognitive Impairment
Authors: Torres Danna , Langdon Sarah , Savettiere Adriana , Delaney Devon , Fairchild J Kaci
Published: September 2024

Objective

COVID-19 can cause dopaminergic neuron senescence. Importantly, dopamine is instrumental in executive functioning (EF) and processing speed (PS). The current study investigated the impact of COVID-19 on EF and PS in older adults with mild cognitive impairment (MCI). It was hypothesized that older adults would have significantly worsened EF and PS post-COVID-19 infection.

Methods

Participants were drawn from a larger study of late-life brain health. The current sample included nine older males with MCI, ages 57–90 years (M = 77.78 ± 9.89). Participants were predominantly White (78%) and well-educated (55.5% had a bachelor’s degree or higher). The Stroop Color Word Test (SCWT) measured EF and PS at baseline (T1) and six months later (T2). All participants contracted COVID-19 between T1 and T2. Changes in cognition were assessed using paired sample t-tests.

Results

Post-COVID-19 infection, participants experienced a statistically significant decline on the SCWT color word trial (t = 3.15, p = 0.02). Participants evidenced nonsignificant change on the SCWT word trial (t = 1.70, p = 0.13) and the SCWT color trial (t = 1.94, p = 0.100).

Conclusions

In a sample of older adults with MCI, contracting COVID-19 potentially contributed to a significant decline in EF but not PS. Research has consistently highlighted the negative impact of Long COVID on EF. Current findings suggest that the COVID-19 infection negatively impacts EF, even in those without Long-COVID. Findings highlight the importance of monitoring cognitive function post-COVID infection in older adults with pre-existing cognitive impairment.
A - 106 Memory and Executive Functions in Everyday Problem-Solving in Mild Cognitive Impairment and Alzheimer’s Disease
Authors: Kozuki Jordan , Collins Andrea , Dadawalla Ali , Matousek Elizabeth , McEvoy Caylynn , Miller Chris , Woo Ellen
Published: September 2024

Objective

Everyday problem solving plays a meaningful role in real-world functioning. It is well-known that memory and executive skills change with age and are especially impacted by conditions such as Alzheimer’s disease (ad). This study examined the role of memory and executive functioning in the everyday problem-solving of healthy older adult, mild cognitive impairment (MCI), and ad groups.

Method

Participants included healthy older controls (n = 58), persons with MCI (n = 65), and individuals with ad (n = 18). Composite scores were calculated for Memory (CVLT-II Long Delay Free Recall and BVMT-R Delayed Recall) and Executive Functioning (Stroop Interference and Trails B) tests completed by all participants. Everyday problem-solving was measured using participants’ total scores on the Everyday Problems Test (EPT).

Results

Across the cognitive spectrum (healthy aging, MCI, and ad), the results of a regression analysis found that memory and executive functioning were predictive of everyday problem-solving. We see that when broken down by diagnostic group, this finding was driven by memory and executive functioning predicting everyday problem-solving specifically in MCI. Memory and executive functioning did not predict everyday problem-solving in healthy older adults or ad.

Conclusion

Results indicate that memory and executive functioning play an important role in everyday problem-solving skills specifically in older adults exhibiting subtle cognitive impairment. Overall, this suggests that even mild cognitive decline begins to impact real-world functioning.
A - 108 Changes in Memory and Attention Function Post-COVID-19 Infection in Older Adults with MCI
Authors: Langdon Sarah M , Torres Danna , Fairchild J Kaci
Published: September 2024

Objective

Persons with mild cognitive impairment (MCI) are more likely to develop dementia due to pre-existing cognitive impairment. COVID-19 is associated with an increased risk of developing dementia one-year post-infection. The purpose of this study is to explore the impact of COVID-19 infection on memory and attention in an amnestic sample. It was hypothesized that older adults with MCI would have significantly worse cognitive function post-COVID-19 infection.

Method

The current sample was drawn from a larger study of late life brain health. Our sample consisted of 9 older adults (mean age = 77.89 ± 9.89) with MCI. Participants were predominately White (77.78%) and male (100%). Participants completed the Rey Auditory Verbal Learning Test (RAVLT) at baseline (T1) and 6 months (T2). All participants received the COVID-19 vaccine prior to T1 and contracted COVID-19 between T1 and T2. Paired sample t-tests evaluated cognitive change over time.

Results

Participants experienced non-significant change on the RAVLT Trial 6 (t = 0.00, p = 0.91), RAVLT Delayed Recall (t = 1.00, p = 0.35), RAVLT Sum Trials 1–5 (t = −1.49, p = 0.18), and RAVLT Trial 1 (t = −0.12, p = 0.91).

Conclusions

In our sample of older adults with MCI, contracting COVID-19 was not associated with significant worsening of learning, memory, or attention over a 6-month period. These findings suggest that the 6–12-month period post-COVID-19 infection may be a critical window for significant worsening of cognitive function. Future research should directly assess cognitive function in older at-risk groups 6–12 months post-COVID-19 infection.
A - 118 Tablet-Based Cognitive Assessment Demonstrates Valid Assessment of Prodromal Huntington’s Disease
Authors: Key Abigail M , Pinto Alex , Adams William H , Possin Katherine L , Burks Deven K , Paulsen Jane S
Published: September 2024

Objectives

We analyzed performances on novel iPad-based assessments between at-risk gene-negative controls and participants carrying the gene causing Huntington’s Disease. TabCAT (UCSF) is used to detect mild cognitive impairment and dementia. We evaluated sensitivity in ten TabCAT assessments targeting memory, executive function, motor, and visuospatial abilities in 137 participants. We evaluated TabCAT’s effectiveness in detecting impairment in participants and assessed reliability of one test (Tempo) compared to a standard instrument (Paced Tapping).

Methods

Cytosine-adenine-guanine trinucleotide repeat length gene multiplied by age (CAG by age product (CAP) score) measured disease progression, based on estimated probability of manifesting motor symptoms (31 low, 41 moderate, 36 high). Controls were genetic relatives who tested negative. All statistical tests used an alpha level of 0.05.

Results

Significant differences were found for Favorites Learning, Favorites Delay, Flanker, and Match. Variables showed similar worsening trends from low to high; however, only differences with the high group were significant. The standardized Cronbach Coefficient Alphas were 0.68 for the first group of Paced Tapping variables, 0.91 for the second group, and 0.98 for Tempo. The standardized Cronbach Coefficient Alpha for variables of both tests was 0.82.

Conclusions

Grouping prodromal HD participants by disease risk compared to gene-negative controls enables cross-sectional analysis. High-risk participants performed significantly worse on tasks evaluating visual memory and executive functioning. Findings replicate previous publications showing that cognitive impairment worsens as one’s risk for motor symptom onset increases. Findings also suggest that the tablet-based assessment procedures reflect a valid representation of the insidious cognitive decline seen in traditional paper-and-pencil neuropsychological assessment.