bluuebunny/crossref_metadata_2025 huggingface dataset:
85 Performance Consistency on a Measure of Sustained and Selective Attention
Authors: Baumann Lauren M. , Johnson Keith P. , Ashendorf Lee
Published: December 2023

Objective:

Attention concerns, particularly difficulties with focusing and regulating attention, are reported in diverse clinical contexts. The Ruff 2&7 Selective Attention Test (Ruff 2&7; Ruff & Allen, 1996) is a measure of sustained and selective attention that assesses automatic detection and effortful processing. The goal of this study was to create an internal consistency metric within this test and to determine cognitive predictors by evaluating associations with executive control of attention and other cognitive skills. It was hypothesized that those who are more consistent across Ruff 2&7 performance would have more robust executive functioning skills, particularly those related to regulating and directing attention and the planning and utilization of cognitive resources.

Participants and Methods:

The current study examined a clinical sample of 98 United States veterans with a history of mild traumatic brain injury. After excluding invalid cases (n=24), the final sample consisted of 74 veterans (Age=38.5 (8.9) years old; 13.9 (2.2) years of education; 78% male; 82% white, 7% Black, 8% Hispanic, 2% Asian). A consistency score was defined as the absolute value of the intertrial change in target hits plus errors across each pair of trials of the same stimulus type (Automatic Detection, AD, and Controlled Search, CS). Hierarchical linear regression modeling was used to evaluate the relative contributions of memory and executive functions (Rey Auditory Verbal Learning Test, Delis-Kaplan Executive Function System Tower Test, phonemic fluency, Trail Making Test B) and subjective symptom report (PTSD Checklist for DSM-5, Barkley Adult ADHD Rating Scale for DSM-IV).

Results:

The mean deviation scores for the two trial types were similar (AD mean=13.6, SD=5.9; CS mean=13.6, SD=5.3). In predicting consistency across AD trials, delayed recall contributed 11% unique variance (p=.013), while no other block was statistically significant. For CS trials, self-reported PTSD and inattention symptoms contributed a combined 20% of unique variance to the model (p=.007), while there were no statistically significant cognitive predictors in this model.

Conclusions:

Contrary to expectation, executive function measures did not explain statistically significant variance in performance across either trial type. Less consistent performance on AD trials was associated with weaker verbal memory. Less consistent performance on CS trials, which theoretically require greater executive control, was not associated with any cognitive scores, but was associated with more severe self-reported psychological and inattention symptoms. These findings buttress the conceptual distinction between AD and CS trial types, and they point to both cognitive and non-cognitive underpinnings of performance consistency.
Poster Symposium: How Well do Western Methods Used to Assess Atypical Aging in Western Countries Generalize to Sub-Saharan African Countries?
Authors: Penna Suzanne , Ikanga Jean
Published: December 2023

Summary Abstract:

Risk factors associated with development of neurodegenerative disease has been well-studied in Western and European populations. However, there has been considerably less research in the assessment of such risk factors in developing countries, notably sub-Saharan Africa. There is a paucity of data at the micro level (e.g. neuroimaging and biomarker data) and macro level (e.g. cognitive assessment and psychosocial/environmental risk factors) for development of neurodegenerative conditions in these populations.

This symposium examines Western methods of assessment of risk factors and cognitive profiles of older adults at risk for neurodegenerative disorder to determine if they are relevant to sub-Saharan African populations, specifically older Congolese adults. This symposium utilizes an older adult sample that has been comprehensively assessed both at the cellular level (via blood biomarkers and neuroimaging typically used for assessment of dementia in Western populations), to the individual functional level (via cognitive assessment), to finally, psychosocial and environmental risk factors for dementia seen at a community level. First, Dr. Ikanga will present on the association between performance on the African Neuropsychological Battery (ANB) with biomarkers specific to Alzhemer's disease and more general vascular risk factors for cognitive decline. Second, Dr. Hickle will present on structural neuroimaging data of mesial temporal lobe atrophy in comparison with performance on the ANB. Dr. Reyes will then discuss the utility of a cognitive screener developed for use in Sub-Saharan Africa on older adults from the Democratic Republic of Congo, with specific emphasis on educational corrections. Finally, Dr. De Wit will discuss health and psychosocial predictors of depressive symptoms as well as the relation between depressive symptoms and neuropsychological functioning in Congolese older adults, to determine if neurocognitive profiles are similar in Sub-Saharan Africa relative to Western populations. This "micro to macro" approach is unique in providing a comprehensive overview of risks associated with dementia in Congolese adults. This is the first study of its kind to utilize a multi-method approach for older adults at risk for dementia in Sub-Saharan Africa, and results suggest that some approaches are more valid in this population than others. Future areas of research will be discussed, as well as feasibility and validity of Western approaches in assessment of dementia to non-Western populations.
94 Associations Between African Neuropsychological Tests of Memory and Medial Temporal Lobe Structures in Older Congolese Adults with Suspected Dementia
Authors: Ikanga Jean , Hickle Sabrina D. , Schwinne Megan , Epenge Emmanuel , Gikelekele Guy , Kavugho Immaculee , Tshengele Nathan , Samuel Mampunza , Zhao Liping , Qiu Deqiang , Stringer Anthony , Saindane Amit M. , Alonso Alvaro , Drane Daniel L.
Published: December 2023

Objective:

Hippocampal and medial temporal lobe structure atrophy is commonly observed in patients with mild neurocognitive disorders and dementias of various neurodegenerative conditions, with the degree of atrophy in these regions correlating with cognitive performance on memory tasks. This research has been conducted largely in western and educated countries. As cognitive aging, risk factors, clinical course, and neuropathology can differ between individuals of different races and ethnicities, our goal is to determine whether these findings also generalize to patients with suspected dementias living in the Democratic Republic of the Congo (DRC).

Participants and Methods:

Neuroimaging and cognitive data have been collected on 40 subjects with probable dementia from the DRC and 40 age-, education-, and gender-matched controls. Patients were classified into groups based on scores on the Community Screening Instrument and the Alzheimer's Questionnaire. All participants completed the African Neuropsychological Battery. T1 MPRAGE images were acquired on Siemens 1.5T scanner. Freesurfer was used to derive volumes and cortical thickness of medial temporal lobe regions. Volumes of structures were divided by intracranial vault volumes to adjust for head size. T-tests were used to compare hippocampal volumes, entorhinal cortex thickness, and perirhinal cortex thickness between subjects with probable dementia compared to healthy age-, gender-, and education-matched controls. Bivariate correlations were conducted to determine whether the volumes of these structures correlate significantly with learning and memory measures on the ANB.

Results:

Results will be determined by the methods described previously.

Conclusions:

Results from this study will demonstrate whether structural brain changes commonly seen in individuals with dementia living in western and educated countries also are observed in the DRC. Results will also demonstrate whether these brain changes coincide with the degree of impairments on tasks of memory, and whether these structures can be used to aid in clinical diagnosis of patients with dementia and support the use of the ANB and neuroimaging in clinical detection of dementias in the DRC.
1 Perioperative Neurocognitive Disorders Defined
Authors: Evered Lisbeth
Published: December 2023

Objective:

Cognitive change affecting patients after anesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterward. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery. Other than the inclusion of non-surgical control groups to calculate postoperative cognitive dysfunction, research into these cognitive changes in the perioperative period has been undertaken in isolation from cognitive studies in the general population. This study aimed to develop similar terminology to that used in cognitive classifications of the general population for use in investigations of cognitive changes after anesthesia and surgery.

Participants and Methods:

A multispecialty working group followed a modified Delphi procedure with no prespecified number of rounds comprised of three face-to-face meetings followed by online editing of draft versions. Two major classification guidelines [Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5) and National Institute for Aging and the Alzheimer Association (NIA-AA)] are used outside of anesthesia and surgery and may be useful for the inclusion of biomarkers in research. For clinical purposes, it is recommended to use the DSM-5 nomenclature.

Results:

The working group recommends that 'perioperative neurocognitive disorders (PND)' be used as an overarching term for cognitive impairment identified in the preoperative or postoperative period. This includes cognitive decline diagnosed before operation (described as neurocognitive disorder); any form of the acute event (postoperative delirium) and cognitive and functional decline diagnosed up to 30 days after the procedure (delayed neurocognitive recovery (dNCR)) and up to 12 months (postoperative neurocognitive disorder (postoperative NCD).1 Further, the working group has undergone a further Delphi process to expand these recommendations for research purposes which will also be covered.

Conclusions:

Perioperative neurocognitive disorders are the most common complication for patients aged 65y or more undergoing anesthesia and surgery. Moreover, they are associated with significant morbidity, mortality, loss of functional independence and extreme economic costs. A multi-disciplinary approach to PND, including neuropsychologists, is critical to reducing and preventing these disorders. Evered L, Silbert B, Knopman DS, et al. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018. Br J Anaesth 2018; 121: 1005-12
2 From Bench to Bedside: How Tau Protein is Altered by Perioperative Factors
Authors: Whittington Robert
Published: December 2023

Objective:

Postoperative neurocognitive disorder is common after all forms of surgery in older adults. The mechanisms are multifactorial, and probably require pre-existing neuropathology, whether the patient is symptomatic or not. In Alzheimer's disease (AD) and other tauopathies, the microtubule-associated protein tau can undergo aberrant hyperphosphorylation potentially leading to the development of neurofibrillary pathology, one of the neuropathological hallmarks of the disease. Preclinical and human CSF studies suggest that anesthesia and surgery elicits an increment in CNS tauopathy, which may accelerate any preexisting neuropathology and produce a risk of delirium and the commonly reported changes in cognition.

Participants and Methods:

In this session, the author will present a bench to beside review of how tau protein is altered by perioperative factors and its potential relationship to the impairment of cognition after surgery and anesthesia. Published and ongoing studies will be reviewed to result in a discussion as to why changes in tau protein are concerning in perioperative disorders of cognition.

Results:

The presenter will initially review pre-clinical studies focusing on the impact of anesthetics and surgery-induced inflammation on tau pathology and how the impairment of resolution of surgery-induced inflammation, notably decreased lipoxin A4 signaling, is altered by aging, gender, or an increase in the tau pathology burden. These preclinical studies have partially informed a multi-center federally funded observational clinical study, currently in progress, involving neuroimaging to determine whether pre-operative CNS tauopathy, as reflected by PET imaging, predicts delirium and other cognitive and functional outcomes. This translational study will also examine whether anesthesia and spine surgery produces a longitudinal change in the brain tau burden in older adults, as compared to control, nonoperative patients.

Conclusions:

Bench to bedside research is needed in order to promote evidence-based care for patients at risk for ADRD.
3 Anesthesia as a Stress Test for the Aging Brain: Understanding the Implications of Unexpected Anesthetic-Induced Brain Activity Patterns for Delirium and Dementia Risk
Authors: Berger Miles
Published: December 2023

Objective:

Recent work has shown that dysfunctional brain EEG responses to anesthetic drugs can be an indicator of both preoperative cognitive impairment and postoperative delirium risk. However, since excessive anesthetic dosage can also cause abnormal EEG brain responses, it is unclear how to tell to what extent such abnormal brain EEG responses reflect latent neurocognitive impairment versus excessive anesthetic dosage. Further, it is unclear what underlying mechanisms might underlie the link between phenotypes (such as delirium and cognitive impairment) and these abnormal neurophysiologic responses to anesthetic drugs.

Participants and Methods:

Dual center prospective cohort design. 139 total older surgical patients from two academic centers underwent intraoperative EEG monitoring with the bispectral index (BIS) EEG monitor during anesthesia and surgery, and postoperative delirium screening by geriatrician interview (Duke cohort) or by trained research staff (Mt Sinai cohort). We developed the Duke Anesthesia Resistance Scale (DARS), defined as the average BIS EEG values divided by the quantity 2.5 minus the age adjusted end tidal anesthetic gas concentration). We then examined the relationship between the DARS and postoperative delirium risk using the Youden index to identify an optimal low DARS threshold for delirium risk, and we used multivariable logistic regression to control for potential confounders.

Results:

Neither BIS scores nor inhaled anesthetic dosage differed significantly between patients with vs without postoperative delirium. Yet, patients with delirium had lower DARS scores than those who did not develop delirium (27.92 vs 32.88, p=0.015). A DARS threshold of 28.7 maximized the Youden index for the association between the DARS and delirium. In multivariable models adjusting for site (Duke vs Mt Sinai) and individual patient risk factors, DARS values <28.7 were associated with a 3.79 fold increased odds ratio (95% CI 1.63-9.10; p=0.03) for postoperative delirium. These results remained unchanged after adjusting for intraoperative medications including opioids, benzodiazepines, propofol, phenylephrine and ketamine. Patients with structural/functional MRI or CSF biomarker evidence of preclinical/prodromal Alzheimer's disease and/or neurovascular pathology were more likely to show altered anesthetic-induced EEG activity patterns.

Conclusions:

Lower scores on a processed EEG-based scale of neurophysiologic resistance to anesthetic induced brain activity changes were independently associated with a nearly 4 fold increased delirium risk. The altered anesthetic-induced brain EEG patterns in patients who go on to develop postoperative delirium may reflect latent pre-clinical/pro-dromal Alzheimer's disease and/or neurovascular pathology.
4 The Effect of Age on the Relationship Between Adverse Childhood Experiences and Frailty in Late Life: A Moderation Model
Authors: Nuccio Alexandria G. , Lobo Rosario PInts , Goodman Zachary , Merritt Stacy S , Sun Xiaoyan , McInerney Katalina F. , Levin Bonnie E.
Published: December 2023

Objective:

Although relationships between Fried frailty criteria (i.e., weakness, slowness, weight loss, exhaustion and low physical activity), cognitive decline, and adverse childhood experiences (ACEs) have been examined (Brigalo et al., 2015, Brown et al., 2022, Fabricio et al., 2020, & Tani et al., 2021), the moderating effect of age on the relationship between ACEs and frailty has yet to be explored. The present study examined whether age moderates the relationship between total number of ACEs and number of frailty criteria in older age.

Participants and Methods:

137 older adults were recruited from University of Miami clinics and surrounding community care centers. Collected data included demographic information, number of frailty criteria met, and number of ACEs endorsed. Participants were primarily Hispanic-White (64.2%) and female (56.9%), with a mean age of 73.62 years (SD=6.252). Data were initially analyzed using descriptive statistics. A hierarchical linear regression was run to test the effect of ACE score on number of frailty criteria met. A simple moderation analysis using the PROCESS macro was then performed with total number of medical conditions included as a covariate to address any potentially confounding effects. To avoid multicollinearity issues, number of ACEs endorsed and age were mean centered and an interaction term between the two was produced.

Results:

Scores on the ACE did substantially effect the total number of frailty criteria met by participants in this study (f=2.37, p=0.028, ΔR2=0.023), independent of number of medical conditions. The overall moderation model was significant (f=2.99, p=0.022, R2=0.103), and the addition of the interaction effect resulted in a statistically significant change to the model (f=4.08, p=0.045, ΔR2=0.035). Taken together, support for a moderating effect was found, specifically within the lower age group (65 - 71years), but not older (greater than 72 years) with ACE score positively predicting the number of frailty criteria met (b =0.230, t=2.62, p=0.010).

Conclusions:

Results largely support the positive effect of ACE endorsement on the number of frailty criteria met in later life. Age acted as a moderating effect, for the younger old population, such that as number of ACEs endorsed increased, so too did the number of frailty criteria met. This finding highlights the importance of early intervention among those in younger late life who have experienced trauma. Given the positive relationship between frailty and cognitive decline in late life (Brigalo et al., 2015 & Fabricio et al., 2020), these findings also support the need for a better understanding of how childhood adversity impacts physical well-being over the life course.
8 Walking for Cognitive Function in Older Adults: A Systematic Review and Meta-Analysis
Authors: Gradone Andrew M , Dotson Vonetta M , Verhaeghen Paul
Published: December 2023

Objective:

The world population is rapidly aging, and consequently, cognitive decline is becoming a larger public health crisis. There is no cure for dementia, but exercise has been consistently shown to improve cognitive function and slow cognitive decline in older adults. Given the many barriers to starting an exercise routine, walking is a particularly appealing intervention because it is safe, low-impact, and highly accessible (i.e., no upfront costs, no necessary equipment, and can be done almost anywhere and by anyone, given they are ambulatory). This abstract describes a systematic review and meta-analysis on peer-reviewed studies that examined randomized walking interventions for cognitive function in older adults.

Participants and Methods:

The analyses included 1,286 older adults aged 55 and older (mean age = 73.1 years) across 19 studies that met inclusion criteria. All studies were randomized controlled trials (RCTs) of walking interventions with pre-post cognitive outcome data. A total of eight cognitive domains were identified: global cognition, attention, processing speed, working memory, language, visuospatial skills, declarative memory, and executive function. Effect sizes, measured as net treatment gain, were extracted and converted to Hedges’ g. Three-level meta-analysis was used to account for dependency of effect sizes. Meta-regression analyses were used to examine whether the following variables moderated effect sizes: (a) cognitive status, (b) baseline activity level, (c) age, (d) walking intervention duration, and (e) duration of individual walking sessions.

Results:

Participation in walking interventions significantly benefitted broad cognitive functioning (Hedges’ g = 0.19). The cognitive domains that specifically benefitted from walking were global cognition (g = 0.60), processing speed (g = 0.15), working memory (g = 0.22), declarative memory (g = 0.18), and executive functioning (g = 0.15). Cognitive status moderated this relationship, so that cognitively impaired older adults showed greater cognitive benefit from walking interventions. Baseline activity level did not moderate the effect; being sedentary at baseline yielded an effect size significantly greater than zero. The remaining moderator analyses were nonsignificant.

Conclusions:

This systematic review and meta-analysis shows that walking interventions are associated with broad improvement in cognitive function in older adults. Walking benefits global cognition, processing speed, working memory, declarative memory, and executive function— the same cognitive domains that decline with normal cognitive aging. These findings are particularly important because walking is among the safest and most universally accessible forms of exercise. This will help healthcare providers make better lifestyle recommendations to their older patients. Future research should more rigorously examine potential moderating variables, such as walking intensity.
13 Does White Matter Hyperintensity Burden Predict Antidepressant Treatment Response? A Meta-Analysis.
Authors: Egglefield Dakota A , Schiff Sophie , Bursky Mikell , Rindskopf David , Rutherford Bret R , Sneed Joel R
Published: December 2023

Objective:

Depression is a common problem among older adults and is further exacerbated by poor treatment response. The vascular depression hypothesis suggests that white matter hyperintensities (WMH) and executive dysfunction are main contributors to treatment non-response in older adults. While a previous meta-analysis has demonstrated the effects of executive dysfunction on treatment response, similar techniques have not been used to address the relationship between WMH and treatment response. Multiple commonly-cited studies demonstrate a relationship between WMH and treatment response, however, the literature on the predictive nature of the relationship is quite inconsistent. Additionally, many studies supporting this relationship are not randomized controlled studies. Critically examining data of well-controlled treatment response outcome studies using meta-analytic methods will allow for an aggregate evaluation of the relationship between WMH burden and treatment response.

Participants and Methods:

A MEDLINE search was conducted to identify regimented antidepressant treatment trials contrasting white matter hyperintensity burden between remitters and non-remitters. Only regimented treatment trials for depressed outpatients aged 50 and older that had a pre-treatment measure of WMH burden and remitter/non-remitter comparison were included. Hedge’s g was calculated for each trial’s treatment effect. A Bayesian meta-analysis was used to estimate an aggregate effect size.

Results:

Eight studies met inclusion criteria. The log odds ratios average was significantly less than zero (.25, SE=.12, p=.019), suggesting that there is a significant effect of WMH hyperintensity burden on antidepressant remission status.

Conclusions:

The purpose of this meta-analysis was to rigorously evaluate randomized controlled trials to determine the relationship between WMH burden and antidepressant treatment response. Findings revealed that WMH burden predicted antidepressant remission, that is, individuals with high WMH burden are less likely to meet remission criteria compared to individuals with low WMH burden. Results suggest that it may be important to consider vascular depression as a distinct treatment target of alternate interventions.
14 The Impact of Visual Attention and Impulsivity on Disinhibited Eating Behaviors in Older Adults
Authors: Morgan Eliza , Harper Nesha , Savettiere Adriana , Thompson Sheila Mae , Fairchild J. Kaci
Published: December 2023

Objective:

Although the relationship between visual attention, impulsivity, and cognitively restrained eating patterns has been established in previous research, less is known about the relationship of cognitive processes and disinhibited eating patterns in older adults. Research postulates that disinhibited eating behaviors may be associated with stress, limited emotional capacity, anxiety, and impulsivity. The current study investigated impulsivity as a potential mediator of the relationship between visual attention and disinhibited eating in older veterans.

Participants and Methods:

This study included 101 Veterans who were screened as part of a larger study assessing the impact of multi-modal activity-based interventions on brain health in older adulthood. The sample included largely White (76%), male (94%) Veterans aged 54 to 88 (M = 70.1, SD 8.9). The Three-Factor Eating Questionnaire was used to assess daily disinhibited eating patterns, and attentional impulsivity was assessed with the Barratt Impulsiveness Scale. Visual attention was evaluated using the Stroop Color Word Test (Color Trial). Mediation analyses were conducted using the SPSS PROCESS Macro. The outcome variable for analysis was disinhibited eating. The predictor variable was visual attention. The mediator variable was impulsivity. Body mass index (BMI) was included as a covariate as it was significantly associated with the predictor and outcome variables.

Results:

The indirect effect of visual attention on disinhibited eating was found to be statistically significant (effect = 0.06, 95%: 0.02, 0.12)

Conclusions:

Attentional impulsivity appears to mediate the relationship between visual attention and disinhibited eating behaviors. This finding extends the current literature about the relationship between visual attention, impulsivity, and other eating patterns (e.g., cognitively restrained eating) in older adults. Exploring this relationship helps us better understand the impact of eating habits through the aging process. Caregivers and older adults should be informed about the impact of increased impulsivity on disinhibited eating behaviors, especially in those with limited visual attention processes. Further understanding of the neurobiological impact of eating behaviors on cognition in older adulthood may assist in developing awareness about the importance of healthy eating patterns when considering brain health in the aging process.
25 Specific Facets of Trait Mindfulness Show Differences in Associations with Affective and Cognitive Measures in Older Adults
Authors: Brown James , Timblin Holly , Brown Lily , Tallman Morgan , MacAulay Rebecca
Published: December 2023

Objective:

Trait mindfulness is associated with reduced stress and psychological well-being. However, evidence regarding its effects on cognitive function is mixed and certain facets of trait mindfulness are associated with higher negative affect (NA). This study investigated whether specific mindfulness skills were associated with cognitive performance and affective traits.

Participants and Methods:

165 older adults from the Maine Aging Behavior Learning Enrichment (M-ABLE) Study completed the National Alzheimer’s Coordinating Center T-Cog battery, the Five Facet Mindfulness Questionnaire, and the Positive and Negative Affect Schedule-SF.

Results:

All five facets of trait mindfulness were associated with higher Positive Affect and lower NA, with the exception that Observation was not associated with trait NA. Partial correlations adjusting for age indicated that better episodic memory was associated with Observation, Describing, and Nonreactivity. Verbal fluency performance was associated with Observation, while Working Memory was associated with Nonjudgment. Executive Attention/Processing speed was associated with total mindfulness scores and showed a trend relationship with Nonreactivity.

Conclusions:

Mindfulness skills showed specific patterns with affective traits and cognitive function. These findings suggest that the ability to maintain awareness, describe, and experience internal and external states without reacting to them may partly rely on episodic memory. Mindful awareness skills also may depend on frontal and language functions, while the ability to experience emotional states without reacting may require Executive Attention. Global mindfulness and a non-judgmental stance may require auditory attention. Alternatively, mindfulness skills may serve to enhance these functions. Hence, longitudinal research is needed to determine the directionality of these findings.
35 Impact of Cardiorespiratory Fitness and White Matter Lesions on Processing Speed with Age
Authors: Baller Kelsey L , Jain Shivangi , Springer Jenna , Sodoma Matthew , Oehler Chris , Daniels Will , Armstrong Matthew , Gimblet Colin , Nuckols Virginia , Muellerleile Michael , Nagarajan Nagalakshmi , Bjarnason Thorarinn A. , Harb Nidal , Pierce Gary L , Voss Michelle W
Published: December 2023

Objective:

Processing speed declines with age and is a strong predictor of age-related cognitive decline in other domains, and in predicting who will need help with tasks of daily living in later years. Higher cardiorespiratory fitness (CRF) reflects better cardiopulmonary health and is related to maintenance of processing speed and cognition into late life. On the other hand, white matter lesions (WML) are reflective of age-related brain network disconnections from damage to white matter tracts in the brain. Lower CRF and higher WML burden have each been related to poorer cognitive performance. Although higher CRF provides a protective effect on cognition, the combined effects of CRF and WML on processing speed have yet to be determined. Specifically, whether CRF and WML independently affect processing speed or if WML moderates the effect of CRF on processing speed is yet to be established. We predicted WML may moderate CRF benefits on cognitive aging if CRF-related cognitive benefits are weakened by high WML load. Here, we test this question with the gold-standard measure of CRF, maximal exercise oxygen uptake (relative VO2 max, mL/kg/min) during a graded exercise test, and a validated neuropsychological measure of processing speed, the Digit Symbol Substitution Test (DSST).

Participants and Methods:

CRF, DSST scores, and WML volumes of cognitively normal adults (n=91) aged 55-80 years were included in this analysis. The WML data was corrected for total intracranial volume and was log transformed. A linear regression model included the number of accurately completed items on the DSST as the dependent variable and age, sex, relative VO2 max, WML volumes and the interaction between relative VO2 max and WML volume as the predictor variables.

Results:

Main effects of age, sex, VO2 max and WML volume on the DSST were observed. Greater age, higher WML volume, and lower relative VO2 max were associated with poorer performance on the DSST. In addition, females (n=55) performed better than males (n=36) on the DSST. No significant interaction was observed between VO2 max and WML volume on DSST scores.

Conclusions:

Our results show that 1) WML and relative VO2 max independently contribute to processing speed performance in older adults as measured by the DSST, and 2) WML do not moderate the relation between VO2 max and the DSST. Strengths of this study include gold-standard measurement of CRF and WML volumes as predictors of performance on the DSST in older adults. Further research is warranted to understand how vascular aging and brain health indicators interactively or interdependently impact cognition in aging.
40 Associations Between Cardiovascular Risk, White Matter, and Medication Predictors on Longitudinal Cognitive Change in the National Alzheimer’s Coordinating Center (NACC) Cohort
Authors: Rotblatt Lindsay J , Tanner Jared J , Cohen Ronald A , Horgas Ann L , Marsiske Michael
Published: December 2023

Objective:

Drawing on the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS), this study aimed to investigate the direct and indirect associations between vascular risk factors/cardiovascular disease (CVD), pharmacological treatment (of CVD), and white matter hyperintensity (WMH) burden on overall cognition and decline trajectories in a cognitively diverse sample of older adults.

Participants and Methods:

Participants were 1,049 cognitively diverse older adults drawn from a larger NACC data repository of 22,684 participants whose data was frozen as of December 2019. The subsample included only participants who were aged 60-97 (56.7% women) who completed at least one post-baseline neuropsychological evaluation, had medication data, and both T1 and FLAIR neuroimaging scans. Cognitive composites (Memory, Attention, Executive Function, Language) were derived factor analytically using harmonized data. Baseline WMH volumes were quantified using UBO Detector. Baseline health screening and medication data was used to determine overall CVD burden and total medication. Longitudinal latent growth curve models were estimated adjusting for demographics.

Results:

More CVD medication was associated with greater CVD burden; however, no direct effects of medication were found on any of the cognitive composites or WMH volume. While no direct effects of CVD burden on cognition (overall or rate of decline) were observed, instead we found that greater CVD burden had small, but significant, negative indirect effects on Memory, Attention, Executive Functioning and Language (all p’s < .01) after controlling for CVD medication use. Whole brain WMH volume served as the mediator of this relationship, as it did for an indirect effect of baseline CVD on 6-year rate of decline in Memory and Executive function.

Conclusions:

Findings from this study were generally consistent with previous literature and extend extant knowledge regarding the direct and indirect associations between CVD burden, pharmacological treatment, and neuropathology of presumed vascular origin on cognitive decline trajectories in an older adult sample. Results reveal the subtle importance of CVD risk factors on late life cognition even after accounting for treatment and WHM volume and highlight the need for additional research to determine sensitive windows of opportunity for intervention.
59 An Examination of the Moderating Effect of Self-Efficacy on the Association Between Health Literacy and Healthy Activity Engagement in Older Adults
Authors: Rahman Samina , Pagán Carolyn , Schmitter-Edgecombe Maureen
Published: December 2023

Objective:

Engagement in activities that promote overall brain health and well-being is often a key step in reducing risks to cognitive health in older adults. Given that higher health literacy has been found to be associated with healthier lifestyles, it is unsurprising that it has been the focus of many studies and programs aimed at improving the health outcomes of older adults. An equally important factor to consider when it comes to such efforts is the role of moderating variables in the relationship between health literacy and engagement in healthy behaviors. The present study examined the moderating effect of self-efficacy, a variable that has been shown to be positively associated with both health literacy and health behaviors. We hypothesized that increased self-efficacy will strengthen the relationship between health literacy and healthy activity engagement in a sample of community-living older adults.

Participants and Methods:

Forty-nine older adults (age: M = 64.35, SD = 8.00; education: M = 16.39, SD = 2.37; 87.76% female) completed a health literacy measure (Newest Vital Sign; NVS), a self-efficacy questionnaire (General Self-Efficacy Scale; GSE), and a lifestyle behaviors questionnaire (Healthy Aging Activity Engagement Scale; HAAE). The NVS is a performance-based measure in which participants are asked to interpret the verbal and numerical information of a nutrition label to make health-related decisions. The GSE is a self-report measure that evaluates one’s belief in their ability to handle challenges, solve problems, and accomplish goals. The HAAE is a self-report measure that assesses one’s engagement in healthy activities across multiple health domains.

Results:

To examine whether self-efficacy moderates the relationship between health literacy and healthy activity engagement, a moderation analysis was conducted using Hayes’ PROCESS macro for SPSS with age and education included in the model as covariates. The results revealed no significant interaction between health literacy and self-efficacy, b = 0.23, p = .59, 95% CI [-0.60 to 1.05].

Conclusions:

Contrary to expectations, in the present sample, the degree of self-efficacy was not a condition under which level of health literacy exerted its influence on healthy activity engagement in older adults. Future studies with larger and more nationally representative samples are needed to explore self-efficacy and other potential moderating factors in order to identify individual characteristics that support older adults’ adoption and engagement in health-promoting behaviors.
64 Validity and Stability of Objective Measures of Subtle Functional Difficulties in Older Adults
Authors: Holmqvist Sophia L , Mckniff Moira , Kaplan Marina , Vallecorsa Giuliana , Chaturvedi Riya , Tassoni Molly , Simone Stephanie , Hackett Katherine , Mis Rachel , Giovannetti Tania
Published: December 2023

Objective:

Self-reported mild functional difficulties are one of the most salient predictors of future cognitive decline in older adults. However, few measures of objective assessment of mild functional difficulties are available. This study explored the validity and stability of novel, performance-based measures of subtle functional difficulties in older adults without dementia using an objective and standardized test, called the Naturalistic Action Test (NAT), which has been used for people with dementia.

Participants and Methods:

40 older adults (Healthy Controls (HC), Mild Cognitive Impairment (MCI)) completed the NAT at baseline and again after one-month. The NAT requires participants to make a breakfast and a lunch using objects presented on a table. Standard cognitive tests (memory, language, etc.) also were administered at baseline only and were used to compute intraindividual cognitive variability (IIV), a sensitive measure of cognitive ability level. NAT scores reflecting micro-errors and completion time were obtained from video recordings. Micro-errors are inefficient actions that include misreaching toward the wrong object and moving objects around the table without a clear purpose. Validity of the NAT measures was evaluated in correlations with IIV, and the stability of NAT performance was evaluated using within-sample t-tests and correlations between measures at baseline and one-month.

Results:

In the full sample (N =40), greater micro errors were significantly correlated with greater IIV at baseline (r=.512, p<.001) and one month followup (r=.327, p=.039). Among HC, paired t tests showed that there were no significant differences in micro-errors over one month; however, completion time was significantly slower at baseline (Md=16.06, SD=24; t(32)=3.76, p<.001). MCI participants showed a significant decrease in micro-errors (M=3.86, SD=4.4; t(6)=2.33, p=.029), but no difference in completion time. Among HC and MCI, micro errors (r=.506, p<.001), and completion time (r=.899, p<.001) were significantly correlated across time points.

Conclusions:

Results show promise for novel NAT measures (time, micro-errors) as valid, objective indicators of subtle cognitive difficulties that affect everyday function. Analyses of stability of scores over time showed evidence of practice effects over time, which along with predictive validity, should be explored in future work.
79 Brief Subjective Memory Screener Predicts Memory Dysfunction
Authors: Joyce Jillian L , Rizer Sandra , Shagalow Shaina , Waltrip Leah , Chapman Silvia , Cosentino Stephanie
Published: December 2023

Objective:

Alzheimer’s disease (AD) is expected to affect over 7 million older Americans by 2025. Development of fast and inexpensive screening measures for routine screening is critical for identifying those suffering from the earliest stages of AD including Mild Cognitive Impairment (MCI) and Subjective Cognitive Decline (SCD). Here we assess the validity and utility of a brief, 5-item SCD screener and its associations with neuropsychological performance as compared to an existing objective cognitive screener, the Mini Mental Status Exam (MMSE).

Participants and Methods:

Development: A brief, 5-item SCD questionnaire was developed based on a more extensive 20-item version previously validated (Chapman et al. 2021). Participants: 27 cognitively diverse (MCI and cognitively normal) community dwelling older adults were recruited for this study. Mean age: 71.9 ± 7. Inclusion criteria include memory concerns. Exclusion criteria include no previous diagnoses of neurodegenerative diseases and/or major stroke. Administration: Participants completed a brief, 5-item SCD screener along with cognitive testing including the MMSE and a clinically validated list-learning test, the Selective Reminding Test (SRT). Statistical Methods: Spearman 2-tailed correlations were conducted to assess the relationship between the two screening measures, and their relationships to the SRT. Outcome measures on the SRT included total recall (max: 72) and delayed recall (max: 12). All cognitive measures were demographically adjusted with normative data.

Results:

The mean total for the SCD screener was 2.1 ±1.1, and the mean MMSE score was 29.2 ± 1.2. The SCD screener was associated with MMSE scores (r= -.39, p= .043), SRT Total Recall (r= -.43, p= .024) and Delayed Recall (r=-.42, p=.031) measures. MMSE scores did not associate with either SRT outcome (p>.05).

Conclusions:

Results support the utility and validity of a brief subjective cognitive decline screener for identifying those who may be experiencing memory dysfunction. The brief SCD screener outperformed the MMSE, an existing and widely used objective screening measure. Associations between the SCD screener and SRT outcomes support the validity and utility of the brief screener and recapitulate previous findings with the more extensive version of the SCD questionnaire (Chapman et al. 2021). Ongoing research is focusing on the utility of the screener in frontline clinical settings and translation of the screener into Spanish.
3 Emotional Expression in Infants with Agenesis of the Corpus Callosum: The Role of Callosal Connectivity in Early Temperament
Authors: Turner Jasmin , Haisley Lauren D , Hantzch Lana , Botteron Kelly , Dager Stephen , Estes Annette M , Flake Lisa , Hazlett Heather C , Schultz Robert T , Piven Joseph , Elison Jed T , Paul Lynn K
Published: December 2023

Objective:

Accumulating evidence suggests that corpus callosum development is critically involved in the emergence of behavioral and cognitive skills during the first two years of life and that structural abnormalities of the corpus callosum are associated with a variety of neurodevelopmental disorders. Indeed by adulthood ∼30% of individuals with agenesis of the corpus callosum (ACC), a congenital condition resulting in a partial or fully absent corpus callosum, exhibit phenotypic features consistent with autism spectrum disorder (ASD). However, very little is known about developmental similarities and/or differences among infants with ACC and infants who develop ASD. This study describes temperament in infants with ACC during the first year of life in comparison with a neurotypical control group. Additionally, it examines the potential contribution of disrupted callosal connectivity to early expression of temperament in ASD through comparison to children with high familial likelihood of ASD.

Participants and Methods:

Longitudinal ratings of positive and negative emotionality were acquired at 6 and 12 months on the Infant Behavior Questionnaire-Revised across four groups of infants: isolated complete and partial ACC (n=104), high familial likelihood of ASD who do and do not have a confirmed ASD diagnosis (HL+ n=81, HL- n=282), and low-likelihood controls (LL- n=152).

Results:

Overall, the ACC group demonstrated blunted affect, with significantly lower positive and negative emotionality than LL controls at both timepoints. Specifically, the ACC group exhibited lower activity and approach dimensions of positive emotionality at both timepoints, with lower high-intensity pleasure at 6 months and lower vocal reactivity at 12 months. On negative emotionality subscales, the ACC group exhibited lower distress to limitations and sadness at both timepoints, as well as lower falling reactivity at 6 months. The ACC and HL groups did not differ significantly on positive emotionality at either timepoint. However, negative emotionality was lower in the ACC group than the HL- group at both timepoints and lower than the HL+ group at 12 months, with lower distress to limitations and sadness ratings than both HL groups at both timepoints.

Conclusions:

These findings highlight the importance of interhemispheric connections in facilitating active engagement and pursuit of pleasurable activities during the first year of life, as well as expression of sadness and distress to limitations. Notably, similarities between infants with ACC and infants at elevated familial risk of ASD suggest that disrupted callosal connectivity may specifically contribute to reductions in positive emotionality.