bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 3 Quantifying the Richness of the Boston Process Approach (BPA) Using a Novel Analytic Approach: the Framingham Heart Study
Authors: Gurnani Ashita , Frank Brandon , Guan Calvin , Andersen Stacy , Devine Sherral , Hurley Landon , Liu Chunyu , Lin Honghuang , Au Rhoda 
Published: October 2023

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

Conclusions
Experiences of discrimination negatively impact health outcomes and risk. Our findings provide further evidence of a relationship between PD and SCD although, this relationship was not moderated by race. Future research should aim to examine the relationship between different forms of discrimination (e.g., systemic discrimination) and SCD.