bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 119 Cognitive Impairment in Alzheimer’s Disease: the Impacts on Reasoning and Decision-Making in Healthcare
Authors: Navarro Etiane , Morocho Casey 
Published: September 2024

Abstract

Objective
Alzheimer’s Disease (ad) is a progressive neurodegenerative disease characterized by the presence of amyloid plaques and neurofibrillary tangles. These brain changes negatively affect inter-neuron firing, leading to memory loss and slow cognitive decline. Older adults with ad experience deficits in activities of daily living and an increased need for supervision. This systematic review investigates the cognitive impairments seen in ad patients relative to normal aging, focusing on how the neuropathology of Alzheimer’s affects their reasoning and decision-making abilities in healthcare settings.

Data Selection
Data was gathered from PubMed, PsycINFO, and Google Scholar. Terms used in the literature review included cognitive impairment in ad, executive function in ad, Alzheimer’s and its impact in decision-making, decision-making and cognitive impairment, decision-making and the elderly, caregiver burden and burnout in ad, neuropsychology in ad, neuropsychological assessment in ad, neuropathology in ad. Data search was conducted from January 15–18 and March 3–4 of 2024. Examination of 45 studies were conducted.

Data Synthesis
Patients with ad demonstrate severe brain structure deterioration, leading to cognitive impairment that impacts reasoning and decision-making. Early diagnosis and neuropsychological assessments are crucial to establish a baseline and monitor changes in cognition. Appropriate care management is key to preserving patient self-determination in healthcare decision-making and reducing the burden on caregivers.

Conclusions
ad significantly deteriorates patients’ ability to reason and make informed decisions, necessitating early and precise interventions. Future research should investigate innovative diagnostic tools and intervention strategies to enhance decision-making capabilities, improve patient quality of life, and reduce caregiver burden.
A - 124 A Case of Lewy Body Dementia and Charles Bonnet Syndrome in a Patient with Bilateral Enucleation
Authors: Jimenez Alexis , Newkirk Bailey , Fink Joseph 
Published: September 2024

Abstract

Objective
The patient presented with a history of blindness due to bilateral enucleation (age 10 and 23) and visual hallucinations for approximately 2 years. Approximately 30% of visually impaired individuals are affected by Charles Bonnet syndrome, characterized by complex visual hallucinations in visually challenged patients, possibly stemming from the brain’s attempt to fill the visual void. Additionally, she was diagnosed with Lewy Body dementia (LBD) 2 years prior by her neurologist, and she reported challenges with completing instrumental activities of daily living (IADLs).

Method
The patient was a left-handed 83-year-old woman, with a history of total blindness and bilateral enucleation, who presented with progressive memory loss 3–4 years prior, along with balance/gait disturbances for 1–1.5 years. The patient and her family sought neuropsychological testing to clarify her cognitive functioning in light of her physical and neurologic symptoms.

Results
Premorbid functioning was estimated in the low average range, with 11 years of education. Due to her total vision loss, neuropsychological evaluation was limited. Her cognitive profile was marked by impairments in immediate memory, delayed memory, recognition, executive functioning, and language.

Conclusions
In light of the patient’s marked cognitive deficits in memory, attention, and executive functioning, along with visual hallucinations (although also attributed to possible Charles Bonnet syndrome), balance/gait disturbances, fluctuating awareness, autonomic dysfunction (i.e., bladder/bowel control), and sleep changes (i.e., acting out dreams), her presentation is consistent with LBD, in the moderate stage of severity. Given the symptomatology, it raises the possibility the patient may be experiencing Charles Bonnet syndrome along with LBD.
A - 125 Exploring the Relationship between the NIH Toolbox-Cognitive Battery & the Alzheimer’s Disease Cooperative Study-Preclinical Cognitive Composite
Authors: Burger Carly N , Conley Michael , McDonald Taylor , Zhang Rong , Cullum C Munro 
Published: September 2024

Abstract

Objective
The computerized NIH Toolbox–Cognitive Battery (NIHTB-CB) is efficient but has not been widely used clinically. The Alzheimer’s Disease Cooperative Study-Preclinical Alzheimer Cognitive Composite (ADS-PACC) has good sensitivity and correlates with amyloid pathology. This study examined the relationship between the NIHTB-CB and ADS-PACC in an aging adult population.

Method
Baseline data from the Risk Reduction for Alzheimer’s Disease (rrAD) study were analyzed. Cognitively intact individuals (n = 511, M MMSE = 29) with hypertension and subjective cognitive complaints and/or a first degree relative with dementia were included (M age = 68.73, 63% female; 84% White, M education = 16.24). Multiple regression examined the relationship between the NIHTB-CB subtests and ADS-PACC composite score.

Results
NIHTB-CB subtests demonstrated small to moderate positive correlations with the ADS-PACC total score (r = 0.19–0.43, p &lt; 0.001). ADS-PACC performance explained 23.5% of the variance for NIHTB-CB Flanker Inhibitory Control/Attention [F, (4, 510) = 40.19, p &lt; 0.001], 18.1% for Pattern Comparison Processing Speed, 13.9% for List Sorting Working Memory [F, (4, 508) = 21.53, p &lt; 0.001], and 13.2% for Dimensional Change Card Sort [F, (4, 510) = 20.43, p &lt; 0.001].

Conclusions
The NIHTB-CB and ADS-PACC showed modest correlations, but PACC scores explained a sizeable amount of variance of NIHTB-CB performance. Previous research supports convergent validity of the NIHTB-CB with other commonly used neuropsychological measures; however, results of this study indicate these batteries may assess different aspects of cognitive functioning. Future research may explore the relationship between the two batteries and their components in the assessment of longitudinal changes in neurocognitive function in individuals with cognitive decline/dementia.
A - 126 Examining Five Point Test Strategy Use on Everyday Problem-Solving Abilities in Mild Cognitive Impairment and Alzheimer’s Disease
Authors: Sidhu Jasman , Baez Abril , Dadawalla Ali , Knutson Heather , Kozuki Jordan , Lent David , Miller Chris , Woo Ellen 
Published: September 2024

Abstract

Objective
Activities of daily living (ADLs) and executive functional abilities are increasingly impaired in mild cognitive impairment (MCI) and Alzheimer’s disease (ad). Impaired individuals adopt executive strategies to aid in executing executive everyday tasks. The Five Point Test measures indices of executive functioning when completing the task. The study examines the role of strategy use in everyday problem-solving in healthy older adults (HOA), MCI, and ad.

Method
Participants included HOA adults (n = 58), persons with MCI (n = 63), and individuals with ad (n = 18). Participants completed a background questionnaire, including the Everyday Problems Test (EPT). In the Five Point Test, using straight lines, participants were instructed to draw various designs in three minutes, avoiding errors across three conditions. The use of the Rotational Strategy is measured by participants generating a new design by rotating the previous spatial configuration. The use of an enumerative strategy was measured by participants generating a pattern by consecutively adding or deleting a line from the previous design.

Results
Linear regressions were conducted to determine the role of strategy use in everyday problem-solving (i.e., rotational and enumerative strategies). It was revealed that the use of the rotational strategy predicted EPT solving in the MCI group. However, problem-solving abilities did not predict EPT solving in HOA and ad.

Conclusion
Interestingly, the rotational strategy was better executed across all groups, while the ad group exhibited limited strategy use. Results suggest that those with subtle cognitive deficits adopt strategies to better execute problem-solving in real-life problems.
A - 130 Effectiveness of Beta-Amyloid Immunotherapy and Monoclonal Antibodies in Patients with Early Onset Alzheimer’s between the Ages of 45–60 Years
Authors: Cortes Edgar J , Morant Rodnie , Martinez Casiano Karla D , Ocasio-Quiñones Idanara T 
Published: September 2024

Abstract

Objective
This comprehensive systematic review examines various therapeutic approaches for Alzheimer’s Disease (ad), with a specific emphasis on immunotherapy targeting beta-amyloid and tau pathology.

Data Selection
Data were sourced from peer-reviewed journals, databases (e.g., PubMed, PsychInfo, Scielo, Google Scholar), and relevant conference proceedings from inception to present. Search terms included variations of “Alzheimer’s disease,” “clinical trials,” “monoclonal antibodies,” “beta amyloid,” “immunotherapy”. Selection criteria emphasized relevance to ad therapy, randomized controlled trials, and clinical outcomes. A total of 24 studies from 2013 to 2023 were reviewed, meeting robust study design, sample size, and therapeutic relevance were chosen. Data extraction followed standardized guidelines for abstracting key information, including study design, participant characteristics, interventions, and outcome measures.

Data Synthesis
The review synthesized recent studies on Alzheimer’s disease (ad) therapy, particularly monoclonal antibodies targeting amyloid beta oligomers. Notable studies such as Avgerinos et al. (2021) and Bateman et al. (2022), showcased significant cognitive decline reductions in ad patients. Positive outcomes were also observed with gantenerumab, lecanemab, and donanemab. Additionally, alternative approaches such as Zanthoxylum caribaeum extract and herbal extracts were explored. The synthesis underscored the complexity of ad treatment and the necessity for continued multidisciplinary research.

Conclusions
This systematic review provides valuable insights into ad therapeutics, guiding future research directions and informing clinical practice to better meet the needs of ad patients and their caregivers. Despite significant advancements, challenges persist in developing effective ad therapies, underscoring the ongoing need for research, particularly in immunotherapy and natural compounds, to address the multifaceted nature of the disease and enhance patient outcomes.
A - 131 Patterns of Functional Decline in Alzheimer Biomarker-Positive Vs. Negative Cognitive Impairment
Authors: Kostadinova Ralitsa V , Bushnell Justin , Clark David G 
Published: September 2024

Abstract

Objective
To contrast longitudinal patterns of functional decline between groups of cognitively impaired individuals with or without biomarker support for Alzheimer’s disease (ad).

Method
We requested data from the National Alzheimer’s Coordinating Center on individuals who underwent serial evaluation with the Functional Activities Questionnaire (FAQ) and those for whom cerebrospinal fluid biomarkers for ad were available. By cross-referencing the two datasets, we identified 570 subjects, 71 of whom were biomarker positive and 499 biomarker negative. Item-level FAQ item-level scores were then entered as predictor variables into lagged mixed-effects regression models with a single FAQ item as the dependent variable in each model (one model for each of the ten FAQ items). Coefficients for statistically significant predictors of follow-up FAQ items were plotted as arcs on a directed graph, with one vertex for each of the ten FAQ items. We repeated this process for biomarker positive and negative individuals and created a map depicting effect size differences, i.e., biomarker positive minus biomarker-negative regression coefficients (Δ = β + − β-) for statistically significant arcs (α = 0.05).

Results
Twelve out of 21 arcs that were significant in the biomarker-positive individuals were significant only for this group. The largest effect size difference was STOVE → STOVE (Δ = 0.233). Twenty of 29 arcs that were significant in the biomarker-negative individuals were significant only for this group. The largest effect size difference was GAMES → GAMES (Δ = −0.168).

Conclusion
ad biomarker status modulated the patterns of longitudinal functional change in this sample.
A - 134 Consistent Failed Performance on Performance Validity Tests in Early-Onset Alzheimer’s Disease Confirmed by Lumbar Puncture
Authors: Kelly Brianna , Schulze Evan 
Published: September 2024

Abstract

Objective
This case study expands the literature of failed performance validity tests (PVTs) in individuals with confirmed biomarkers for early-onset Alzheimer’s disease (ad).

Method
The case presents a 56-year-old right-handed white male with a history of depression and onset of cognitive symptoms beginning in his early 50’s. He reported difficulties remembering appointments, tasks, and events, and difficulties with orientation while driving. Brain PET-MRI displayed mild to moderate atrophy of temporal lobes, and moderate hypometabolism in the bilateral temporal and partial lobes and posterior cingulate gyri. Following neuropsychological testing, a cerebrospinal fluid (CSF) analysis was consistent with ad biomarkers.

Results
Upon neuropsychological testing, the patient obtained below cutoff scores on freestanding and embedded PVTs. The Dot Counting Test (DCT) and the TOMM yielded below cutoff scores. Embedded validity indicators on the WAIS-IV and the RBANS were also suggestive of suboptimal effort. Impaired performances were seen on test of visuomotor speed and set-shifting. In contrast, he obtained scores within normal limits on tasks of visuospatial perception, basic auditory attention, and confrontation naming.

Conclusion
Failures on multiple PVT’s were evidenced on testing with no apparent external motivating factors. While below cutoff PVT performances are concerning for suboptimal engagement, positive CSF markers for ad raise concern for possible false positive classification of suboptimal effort vs genuine cognitive impairment. This case provides further insight into PVT performance in early ad, especially with symptom onset at a younger age.
A - 137 An Item-Level Analysis of the Boston Naming Test in a Sample of Veterans as it Relates to Age and Education
Authors: Paglini Sarah A , Baldini Daniel , Moses James 
Published: September 2024

Abstract

Objective
The Boston Naming Test (Kaplan et al., 1983) is a 60-item test designed to measure confrontational naming ability. Word-finding difficulty is a prominent feature of aphasias, with picture-naming ability being a reliable predictor of lexical retrieval ability (Herbert et al., 2008). Lower performance on the BNT is found among older age groups and individuals with lower educational attainment (Zec et al., 2007). Notably, an item-level analysis of the BNT has not been analyzed in a Veteran population. There is great importance in properly accounting for demographic variables when interpreting patient test results.

Methods
An item-level confirmatory factor analysis examined mean BNT scores in a veteran sample (n = 517) ages 20–79 (M = 51) with years of educational attainment (M = 13). The purpose of this study was to conduct an item-level factor analysis of the unique cohort effects of both age and education on the Boston Naming Test within a Veteran population.

Results
The BNT solution explained 60.95% of the variance, and components reflected early and late trials. Within the rotated components matrix, education contributed to late items (36–60) whereas age contributed to early items (11–45).

Conclusions
These results indicate the importance of properly accounting for demographic variables such as age and educational attainment when interpreting test results unique to a Veteran population. Higher educational attainment is associated with increased performance on later items, whereas older age is associated with decreased performance on earlier items. It may be informative to consider item-level performance when assessing confrontational naming ability.
A - 139 A Neuropsychological Case Study of an Individual Diagnosed with Langerhans Cell Histiocytosis
Authors: Cox Nathaniel , Willis Pamelia 
Published: September 2024

Abstract

Objective
Langerhans cell histiocytosis (LCH) is a rare, idiopathic, cancer-like condition resulting from an overproduction of Langerhans cells. Disseminated LCH can spread across various anatomical systems, and prognosis is mainly dependent on organ involvement. Due to the rarity of this condition, potential neuropsychological effects are not fully understood. However, current research suggests that individuals with LCH are prone to develop various comorbid neuropsychiatric problems such as depression, anxiety, and impaired intellectual functioning.

Method
The current case is an 18-year-old, right-handed, Hispanic female who was diagnosed with LCH (brain and bone) in 2020. Cognitive symptoms began in 2016 at age 11. She was initially diagnosed with a low-grade glioma after a biopsy of a supracellular mass in 2017 but has developed various comorbid conditions since then. These include panhypopituitarism, NMDA encephalitis with behavioral disturbance, encephalomalacia, and epilepsy. She has undergone two 9-month rounds of chemotherapy and has been followed for neuroimaging with MRI and CT since 2017.

Results
Neuropsychological test findings from January 2024 indicated global deficits in intellectual functioning. Severe disruptions in sleep–wake cycle were also evident during testing. Although language abilities were relatively well preserved, abstract reasoning and executive functioning were greatly impaired. Psychological screeners also suggested anxiety and depression.

Conclusions
This case provides evidence of neurocognitive and psychiatric symptoms that can occur as a result of LCH and frequent comorbid health conditions. Neuropsychological testing can help monitor these effects on individuals with LCH across the lifespan.
A - 140 The Association between Executive Functioning and Adaptive Outcomes in Pediatric Brain Tumor Survivors
Authors: Thomas Christina , Okeke Chioma , Walsh Karen 
Published: September 2024

Abstract

Objective
Pediatric brain tumor (PBT) survivors are at high risk for cognitive and adaptive challenges. We aimed to examine the relationship between executive functioning (EF) and adaptive functioning in PBT survivors to identify critical cognitive skills that are associated with functional impact to inform intervention and transition to adulthood.

Method
Retrospective neuropsychological data was collected for 95 clinically referred PBT survivors (8–24 years). A composite EF measure was created based on the average of selected EF subtest scores. The associations between EF skills, parent-report of child adaptive functioning, and full-scale IQ were analyzed using descriptive statistics, correlations, and multiple regression.

Results
Adaptive functioning was significantly related to parent (r = −0.701, p &lt; 0.001) and teacher ratings (r = −0.372, p = 0.004) of EF, the testing composite measure of EF (r = 0.455, p = 0.033), as well as FSIQ (r = 0.386, p &lt; 0.001), general cognitive ability (r = 0.328, p = 0.003), working memory (r = 0.279, p = 0.007), and processing speed (r = 0.425, p &lt; 0.001). Parent reports of EF were not significantly related to the EF testing composite score, but both significantly predicted adaptive functioning (p &lt; 0.001). Of parent-reported domains of EF, self-monitoring was most predictive of overall adaptive functioning (B = −0.415, p = 0.017). FSIQ and age did not impact the relationship between parent reports of EF and adaptive functioning.

Conclusions
Overall, EF on both parent reports and testing, especially self-monitoring, was predictive of adaptive functioning in PBT survivors, regardless of age and overall intellectual functioning. Future research should further examine the impact of individual and treatment factors.
A - 142 Exploratory Analysis of the Cognitive Outcomes of Cognitive Behavioral Therapy for Insomnia (CBT-I) in Patients with Primary Brain Tumor
Authors: Fox Amber M , Lanoye Autumn , Zarrella Giuliana , Willis Kelcie D , Braun Sarah E , Loughan Ashlee R 
Published: September 2024

Abstract

Objective
Patients with primary brain tumor (PBT) experience declines in cognitive functioning and frequently endorse sleep disturbance. Our single-arm proof-of-concept trial of Cognitive Behavioral Therapy for Insomnia (CBT-I) in patients with PBT demonstrated clinically significant improvements in self-reported insomnia symptoms. The present study explored changes in patients’ subjective and objective cognitive functioning following completion of the six-week CBT-I intervention.

Methods
Participants with PBT and clinical insomnia (N = 35; Mage = 51.6 ± 11 years; 54.03 female) enrolled in a 6-week group-based telehealth CBT-I intervention. Participants completed pre-post-intervention subjective and objective cognitive assessments (European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC QLQ-C30]; Hopkins Verbal Learning Test–Revised [HVLT-R], Oral Trail Making Test-B [OTMT-B], and Controlled Word Association Test [COWAT]). Within-group cognitive change was examined using established minimally important differences and reliable change indices.

Results
All participants demonstrated clinically stable subjective cognitive functioning from pre-to-post intervention. Individual analyses showed that 32 participants (91.4%) demonstrated clinically stable or improved verbal memory, 30 participants (85.7%) demonstrated clinically stable or improved divided attention, and all participants (100%) demonstrated clinically stable or improved phonemic fluency. Few participants demonstrated clinically significant decline in verbal memory (n = 2, 5.7%) or divided attention (n = 5, 14.3%).

Conclusions
Changes in both subjective and objective cognitive functioning were predominantly positive following a behavioral intervention for insomnia (CBT-I) among patients with PBT; however, these results should be viewed as preliminary. We will more thoroughly examine cognitive outcomes with a longer follow-up period in an upcoming randomized pilot trial of CBT-I in PBT.