bluuebunny/crossref_metadata_2025_split huggingface dataset:
12 Traumatic Brain Injury as a Moderator on Apolipoprotein-E Risk Associated with Earlier Onset of Alzheimer's Disease
Authors: Hollman Christina M , Pyykkonen Benjamin 
Published: December 2023

Objective:Prior studies have determined the Apolipoprotein-E (ApoE) ε4 allele presents a greater risk for developing Alzheimer's disease and for earlier onset of cognitive decline compared to individuals without the gene. Research has also recognized that traumatic brain injuries (TBIs) with loss of consciousness increase the risk for earlier development of the disease. This study sought to determine the moderating factor of TBI history on ApoE-ε4 risk associated with earlier Alzheimer's disease onset.Participants and Methods:Participants included 9,585 individuals with autopsy confirmed Alzheimer's disease pathology, that had available ApoE genotype data, TBI data, and clinician determined age of cognitive decline, representing disease onset. A 2x3 factorial ANOVA was conducted to compare the main effects of ApoE-ε4 status and TBI history and the interaction effect between the two on disease onset. The analyses used three ApoE-ε4 groups and two TBI groups. The groups included: (1) no ApoE-ε4 allele; (2) one ApoE-ε4 allele; (3) two ApoE-ε4 alleles; (4) no TBI history, (5) positive TBI history.Results:Results indicated a significant interaction effect between ApoE-ε4 status and TBI history. Secondary analyses determined the driving force behind the interaction was the effect of ApoE-ε4, which had a significant impact on the age of onset in both TBI groups, while TBI history only significantly impacted onset in individuals without an ApoE-ε4 allele.Conclusions:Contrary to prior research, these findings did not indicate TBI was significant in determining earlier onset. However, it is important to consider the large variability within the TBI group from the lack of differentiation between mild, moderate, and severe TBIs. Overall, these findings underline the greater risk and stronger impact that ApoE-ε4 poses for Alzheimer's disease onset compared to TBI. The results of this study emphasize the importance of evaluating ApoE-ε4 status for determining risk of earlier onset AD. Clinicians can better determine risk by considering patients' ApoE-ε4 status alongside TBI history.
20 Global and Local Semantic Coherence of Spontaneous Speech in Persons with Alzheimer's Disease and Healthy Controls
Authors: Burke Erin M , Gunstad John , Hamrick Phillip 
Published: December 2023

Objective:Growing evidence demonstrates that subtle changes in spontaneous speech can be used to distinguish older adults with and without cognitive impairment, including those with Alzheimer's disease (AD). Recent work suggests that quantification of the meaningful connectedness of speech - termed semantic coherence - may be sensitive to cognitive dysfunction. The current study compared global coherence (GC; the degree to which individual utterances relate to the overall topic being discussed) and local coherence (LC; the degree to which adjoining utterances relate meaningfully to each other) in persons with AD and healthy controls.Participants and Methods:Speech transcripts from 81 individuals with probable AD (Mage = 72.7 years, SD = 8.8, 70.3% female) and 61 healthy controls (HC) (Mage = 63.9 years, SD = 8.5, 62.2% female) from Dementia Bank were analyzed. All participants completed the Cookie Theft and MMSE as part of that larger project. Machine learning analyses of GC and LC were conducted and models evaluated classification accuracy (i.e., AD vs HC) as well as ROC-AUC. Relationships between coherence indices and MMSE performance were also quantified.Results:Though no significant group differences emerged in LC (Estimate = 0.012, p = 0.32), persons with AD differed from healthy controls in GC (Estimate = 0.03, p = 0.006) and produced less semantically coherent speech. GC indices predicted AD diagnoses with 65% accuracy. Interestingly, coherence indices showed only modest correlation with MMSE scores (r = .19).Conclusions:GC metrics of spontaneous speech differentiated between persons with AD and controls, but did not strongly correlate with MMSE performance. Such findings support the notion that many aspects of language are impacted in persons with AD. In addition to replication, future work should evaluate whether GC is also disrupted in persons with pre-clinical AD and its potential to assist with early detection.
55 The Indirect Effect of Positive Aspects of Caregiving on the Relationship between Dementia Severity and Caregiver Burden
Authors: Cousins-Whitus Elizabeth A , Patrick Karlee , Chapman Kimberly , Drost Jennifer , Spitznagel Mary Beth 
Published: December 2023

Objective:Caregiver burden tends to worsen as severity of dementia increases, and elevated burden can lead to negative consequences for dementia caregivers. In contrast, positive aspects of caregiving, such as feelings of being useful, needed, or appreciated as a caregiver, are associated with better outcomes. Caregivers reporting fewer positive experiences robustly demonstrate greater burden, suggesting that a lack of positive aspects of caregiving could be a key component of the relationship between dementia severity and burden. This study investigated whether an indirect effect of positive aspects of caregiving would be observed on the association between dementia severity and burden.Participants and Methods:Data were extracted from the medical records of 724 patients enrolled for services at an outpatient memory clinic. Caregiver-care recipient dyads were included based on a clinically supported patient diagnosis on the dementia spectrum following a comprehensive geriatric evaluation and having fully completed assessments from an informal caregiver. Caregivers completed the Zarit Burden Interview (ZBI) and the Positive Aspects of Caregiving (PAC) measures. The Montreal Cognitive Assessment and Mini-Mental State Exam were used to estimate dementia severity, standardized to create a single variable. Multiple potential covariates (e.g., age, gender, education, nature of dyadic relationship) were considered for inclusion in the model. A cross-sectional mediation analysis using the Hayes PROCESS macro explored presence of an indirect effect of PAC on the relationship between dementia severity and ZBI using 5000 bootstrap samples.Results:Of the proposed covariates, only caregiver age was correlated with any of the primary variables; this variable was controlled in subsequent analyses. Significant relationships emerged between dementia severity and ZBI (r=-.12, p<.001), between PAC and ZBI (r=-.23, p<.001), and between dementia severity and PAC (r=-.07, p<.05). An indirect effect of positive aspects of caregiving on the relationship between dementia severity and ZBI was statistically significant (B= .0092, BC 95% CI [.0008, .0185]), accounting for 14.4% of the variance in the model.Conclusions:A small but significant indirect effect of positive aspects of caregiving was observed on the association between dementia severity and burden. Results suggest that as dementia severity worsens, a caregiver who experiences greater positive aspects of caregiving will sustain less burden. Longitudinal examination of these relationships is needed to fully understand causality. Findings may help healthcare providers tailor treatment to alleviate caregiver burden.
6 Graph Analysis of Resting State Functional Brain Networks and Associations with Cognitive Outcomes in Survivors on Pediatric Brain Tumor
Authors: Semmel Eric , Calhoun Vince , Hillary Frank , Morris Robin , King Tricia 
Published: December 2023

Objective:Adolescent and young adult survivors of pediatric brain tumors often live with long-term neuropsychological deficits, which have been found to be related to functional and structural brain changes related to the presence of the tumor itself as well as treatments such as radiation therapy. The importance of brain networks has become a central focus of research over recent decades across neurological populations. Graph theory is one way of analyzing network properties that can describe the integration, segregation, and other aspects of network organization. The existing literature using graph theory with survivors of brain tumor is small and inconsistent; therefore, more work is needed, particularly in survivors of pediatric brain tumors. The present study used graph theory to determine whether functional network properties in this population differ from healthy controls; whether graph metrics relate to core cognitive skills: attention, working memory, and processing speed; and whether they relate to a cumulative measure of neurological risk.Participants and Methods:31 survivors and 31 matched controls completed neuropsychological testing including measures of attention, working memory, and processing speed. They also underwent resting state functional magnetic resonance imaging. Resting state data were preprocessed and spatially constrained independent component analysis was completed to construct connectivity matrices. Finally, graph metrics were calculated utilizing an area under the curve method, including global efficiency, clustering coefficient, betweenness centrality, and small-worldness. Group differences and associations between graph metrics, cognitive outcomes, and neurological risk were analyzed using SPSS version 28.0.Results:Results revealed a significant difference such that brain tumor survivors exhibited less small-world properties in their functional brain networks. This was found to be related to working memory, such that less smallworldness in the network was related to poorer performance. There were no significant relationships with neurological risk, but there were nonsignificant correlations of small-moderate effect size such that lower global efficiency and clustering coefficient were associated with greater neurological risk. Comparisons to structural network analysis from a similar sample and additional post-hoc analyses are also discussed.Conclusions:These findings reveal that survivors of pediatric brain tumor indeed display significant differences in functional brain networks that are quantifiable by graph theory. It is also possible that, with further work, we might better understand how metrics such as smallworldness can be used to predict long-term cognitive outcomes and functional independence in adulthood.
5 Antihypertensive Medication Use and Cognition in Older Adults
Authors: Moll Allison C , Woodard John L 
Published: December 2023

Objective:Hypertension is a common disorder that has been inconsistently associated with worse cognition in older adults. Antihypertensive medications offer treatment for high blood pressure but previous studies on the association between blood pressure, antihypertensive use, and cognitive performance in older adults have yielded inconsistent findings. Individuals without high blood pressure may also take antihypertensive medications for other medical conditions, including migraines. It is unclear whether antihypertensive medications have any effect on cognitive performance in older adults, and whether the differences, if any, are similar in hypertensives and normotensives.Participants and Methods:4,969 participants from the National Alzheimer Coordinating Center (NACC) database were included in this study (Mage=72.4 years, SD=7.3 years). Cognitive assessment included Letter Fluency, Category Fluency (animals and vegetables), Trail Making Test A & B, Digit Ordering (forward and backward), and MoCA total score. Participants were included if they had a clinician diagnosis of hypertension or normotension and recorded history of whether they take any antihypertensive medication. Participants with a history of stroke were excluded. Cognitive differences between medication groups were investigated in hypertensive participants and normotensive participants using Bayesian Mann-Whitney tests.Results:Bayesian Mann-Whitney tests in hypertensive individuals showed no cognitive differences between those taking antihypertensive medications and those not taking antihypertensives (all BF10s < 3). Bayesian Mann-Whitney tests in normotensive individuals showed individuals taking antihypertensive medications performed worse on Trail Making Test B compared to individuals not taking antihypertensives (123.6 seconds vs 108.8 seconds; BF10 = 35.1), with a small effect size (d=-.156).Conclusions:These results suggest that antihypertensive use in older adults with normal blood pressure may be associated with worse executive functioning. Antihypertensive use in normotensive older adults may lower blood pressure and reduce cerebral perfusion, resulting in worse cognitive functioning. Future studies should investigate long-term antihypertensive use and associated cognitive changes in both hypertensive and normotensive individuals.
27 Aging Affects Cordoba Naming Test Performance
Authors: Sidhu Jasman , Sivaramakrishnan Krithika , Cervantes Raymundo , Saravia Sarah , Estrada Luz , Garcia Dulce , Barrio Alexia , Munoz Isabel D. , Lopez Enrique , Victor Tara L. , Fernandez Alberto L. , Lopez-Hernandez Daniel W. 
Published: December 2023

Objective:The Cordoba Naming Test (CNT) is a 30-item confrontation naming test developed in Argentina. A common confrontation naming task used in the United States is the Boston Naming Test (BNT). Research shows that age affects BNT performance in the 60-item long form. In fact, studies show that scores on confrontation naming tasks increase in childhood and continue to improve until approximately 40 years of age. However, after this period, scores start to subsequently decline, and especially so after 70 years of age. On the other hand, some studies have reported that older adults maintain high BNT performance despite advancing age. To our knowledge, no study has investigated the aging effects of the CNT across various age groups. We expected CNT scores to increase significantly from young adulthood to mid-adulthood and then significantly decline with advancing age.Participants and Methods:The present study sample consisted of 272 neurologically and psychologically healthy participants with a mean age of 27.06 (SD = 12.21) with 14.29 years of education completed (SD = 2.46). Participants were divided into six different age groups: 18-19-year-old group, 20-29-year-old group, 30-39-year-old group, 40-49-year-old group, 50-59-year-old group, and 60-69-year-old group. All participants consented to voluntary participation and completed the CNT and a comprehensive background questionnaire in English. The CNT consisted of 30 black and white line drawings, ranging from easy to hard difficulty. An ANCOVA, controlling for gender, was used to evaluate CNT performance between the six age groups. We used a threshold of p < .05 for statistical significance.Results:Results revealed significant group differences between the six age groups on the CNT, p = .000, ηp2 = .14. A post-hoc test revealed that the 30-39-year-old group outperformed the 18-19-year-old, 20-29-yearold, and 60-69-year-old groups on the CNT. Finally, the 40-49-year-old group outperformed the 18-19-year-old and 60-69-year-old groups on the CNT.Conclusions:As we predicted, participants demonstrated steady improvement in the CNT until the age of 40. However, we found that until the age of 60, CNT performance started to decline significantly. Our data suggests that CNT performance declines significantly at the age of 60 compared to previous research using the BNT. Research shows other demographic variables (e.g., gender, linguistic factors) influence BNT performance. Future investigations on the CNT using a healthy sample should use a multivariate statistical analysis method to help explain influencing factors across aging. This research can have the potential to improve public health to better support and understand individuals from diverse backgrounds.
43 Mood and Everyday Function in Older Adults: Analyses of Self-report and Performance-based Measures of Everyday Function
Authors: Kaplan Marina , McKniff Moira , Pinksy Emma , Tassoni Molly , Simone Stephanie M , Hackett Katherine , Mis Rachel , Vallecorsa Giuliana , Holmqvist Sophia , Giovannetti Tania 
Published: December 2023

Objective:The relation between depressed mood and functional difficulties in older adults has been demonstrated in studies using self-report measures and has been interpreted as evidence for low mood negatively impacting everyday functional abilities. However, few studies have directly examined the relation between mood and everyday function using performance-based tests. This study included a standardized, performance-based measure of everyday action (Naturalistic Action Task, NAT) to test the prediction that report of depression symptoms are associated with self-report and performance-based tests of everyday function. Associations with anxiety symptoms and motivation/grit and everyday function also were explored.Participants and Methods:68 older adults without dementia were screened and recruited (n = 55, M age = 74.21, SD= 6.80, age range = 65 to 98) from the community and completed self-report measures of depression symptoms (GDS), anxiety (GAI), motivation (Short Grit-S), and everyday functioning (FAQ). Participants also performed the NAT, which requires completion of a breakfast and lunch task and is scored for task accomplishment, errors (micro-errors, overt, motor), and total time. Additionally, an informant also reported on the participant’s everyday function. Spearman correlations were performed and results showing a medium effect size or greater are reported.Results:Participant mood (GDS) was associated with self-reported function (FAQ; r =.45) but not performance-based measures of everyday function (NAT). Self-reported anxiety and motivation were not meaningfully associated with either self-reported or performance-based everyday function. Participant self-report (FAQ) and informant report of participant’s function (IFAQ) supported the validity of performance-based assessment as both were meaningfully associated with NAT performance (FAQ x NAT overt errors r = .34; I-FAQ x NAT micro-errors r = .34; I-FAQ x NAT motor errors r = .49).Conclusions:Mood, but not anxiety or motivation, was associated with self-reported everyday function but not performance-based function. When considered alongside the meaningful relations between self/informant-report of function and everyday task performance, results suggest mood does not impact everyday function abilities in community-dwelling older adults without dementia. We suggest that frameworks to be reconceptualized to consider the potential for mild functional difficulties to negatively impact mood in older adults without dementia. Additionally, interventions and compensatory strategies designed to improve everyday function should examine the impact on mood outcomes.
52 Association Between COVID-19 Coping Strategies and Cognitive Function in Older Adults
Authors: Tallman Morgan D , Timblin Holly , Brown Lily , MacAulay Rebecca L 
Published: December 2023

Objective:Cognitive function may underlie the use of more adaptive as compared to maladaptive coping strategies to manage pandemic-related stress in older adults. As the composition of coping strategies varies with context, we investigated the factor structure of 14 established coping strategies. We then aimed to determine whether specific coping strategies were associated with cognitive function.Participants and Methods:141 adults aged 50-90 years old completed the study via Zoom. The National Alzheimer’s Coordinating Center TCog battery assessed cognitive function. The Brief Cope, adapted to evaluate COVID-19, measured 14 specific coping strategies.Results:Based on our factor analyses, Avoidant (e.g., denial and substance use) and Approach (e.g., planning, instrumental and emotional support systems) coping composite scores were formed. Regression analyses, adjusted for age and education, indicated that 12.9% of the variance in the use of Avoidance coping strategies was explained by worse performance on measures of episodic memory, executive attention/processing speed, working memory, and verbal fluency. A closer examination indicated that verbal fluency was not a statistically significant contributor to the model. 9.1% of the variance in Approach coping strategies was related to cognitive function with working memory and verbal fluency being statistically significant contributors to the model.Conclusions:Older adults with better performance on higher-order cognitive testing may utilize more effective coping strategies in older adults. These results have implications for attenuating pandemic-related stress and warrant developing brief interventions to help facilitate problem-solving and reduce emotional distress in those with lower cognitive resources.
60 The Impact of Retirement Status on Cognitive Dysfunction in Alzheimer’s Disease
Authors: Loza Sandra S , Lee Lisa J , Liu Stephanie M , Sainz Ysmara H , Tabaza Raghad , Morin Ruth , Bennett Lauren L 
Published: December 2023

Objective:Prior research supports retirement may negatively impact cognitive functioning. The current study examined the relationship between retirement status and the level of cognitive dysfunction amongst individuals with Alzheimer’s disease (AD). For the purpose of this study, it was predicted that there would be significantly higher levels of cognitive dysfunction in retired participants after controlling for age.Participants and Methods:Participants (ages 65 to 91) were drawn from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). The sample included 110 participants who were retired and 111 participants who were not retired. Cognitive dysfunction was assessed using the cognitive subscale of the modified Alzheimer’s Disease Assessment Scale (ADAS). A one-way ANCOVA analysis was conducted with cognitive dysfunction as the dependent variable and the age of the participants as a covariate.Results:The results of the one-way ANCOVA showed being retired was a significant predictor of greater cognitive dysfunction amongst individuals with AD after controlling for age (F(df=1, 218) = 231.143, p = < .001, p < .05) and accounted for 52% of the variance in the level of cognitive dysfunction.Conclusions:Being retired is associated with higher levels of cognitive dysfunction in AD after accounting for the effects of age. As such, continued cognitive activity may slow the progression of cognitive declines amongst individuals with AD who are retired. There is a need for future longitudinal research to determine how late retirement may delay the progression of cognitive decline in AD by controlling for other moderator factors such as genetics and work-related stress.