bluuebunny/crossref_metadata_2025_split huggingface dataset:
B - 28 Health Literacy Is a Better Predictor of Neurocognitive Performance on Verbal Fluency Tasks than Race
Authors: Finley John-Christopher , Oh Alison , Rauch Andrew , Khan Humza , Jacob Roshni , Soble Jason , Resch Zachary 
Published: October 2023

Abstract

Objective
Neuropsychologists have historically used demographically-adjusted normative data to account for race-associated differences in neurocognitive performance. Using race-based norms has become increasingly controversial, particularly following the National Football League 2014 concussion settlement, as such practices may perpetuate systemic inequities and biases. Adjusting for the effects of social determinants of brain health may be an alternative approach to race-based norms. A measurable social determinant of brain health that disproportionately affects Black, Indigenous, and People of Color (BIPOC) is health literacy, which has been well-associated with verbal fluency performance. The current study evaluated the incremental value of health literacy and race to predict neurocognitive performance on a verbal fluency measure.

Method
The sample comprised 71 BIPOC and 45 White participants (ages 18–87) who underwent an outpatient neuropsychological evaluation. Verbal fluency was measured via the F-A-S and Controlled Animal Word Association Test. Health literacy was measured via the Short Assessment of Health Literacy-English. Demographics included age, sex, race, and years of formal education. Race was categorized as White or BIPOC since binary classification is common in race-based norms.

Results
Hierarchical regression analysis revealed that the combination of race and health literacy have a significantly larger effect on verbal fluency performance than race alone (p &lt; 0.001). Including this interaction in the model explained 13.07% more variance in neurocognitive performance than race as an independent predictor (R-squared increased from 4.83% to 17.90%).

Conclusions
These findings suggest health literacy may be more helpful for accounting for group differences in neurocognitive performance than race when developing normative data.
B - 29 The Negative Impact of Health Inequity and Medical Mistrust Due to Intersecting Marginalized Identities: a Neuropsychological Case Study
Authors: Fisher Thomas , Whynot Delaney , Keniston Alyssa , Lewandowski Alan , Briggs Katelyn 
Published: October 2023

Abstract

Objective
The occurrence of delayed preventative health screening as a result of health inequities and medical mistrust resulting from intersecting marginalized identities, including race and sexual orientation, is well documented; however, this complex interplay applied to a neuropsychological profile is less established. The present case uses neuropsychological assessment to further the understanding of the brain-behavior relationship in a case with significant medical comorbidities, a history of childhood trauma, underlying psychiatric conditions, and social and cultural identities that have been historically marginalized.

Method
The patient is a 53-year-old right-handed Black, gay man with multiple cerebrovascular risk factors, a seizure disorder, two remote concussions, past kidney failure with the subsequent transplant, and HIV with prescribed antiretroviral medications who was referred for neuropsychological evaluation by neurology pursuant to a decline in mental status over the past decade.

Results
Neuropsychological testing reflects global cognitive deficits evidenced by difficulties with intellectual functioning, motor abilities, complex sequencing, problem-solving, executive functioning, verbal fluency, attention, and memory. A self-report of psychological functioning revealed emotional difficulties associated with depression, anxiety, ongoing traumatic stress, and emotional dysregulation. Findings are most consistent with major neurodegenerative disorder and suggest a diagnosis of dementia complicated by depression.

Conclusions
This neuropsychological case study provides an example of the complex effects of biological, economic, and other sociocultural factors on cognition and emotional functioning. This case further emphasizes the negative impact of medical mistrust and delayed preventative care in the Black, gay community on neuropsychological functioning and quality of life.
B - 30 A Consultation Model Approach to Working with the Deaf Community: a Neuropsychological Case Report
Authors: Hammond Jared , Isquith Peter K , Roth Robert M 
Published: October 2023

Abstract

Objective
Neuropsychological evaluation with Deaf individuals is of increasing interest in light of the recent SCOTUS decision in Perez v Sturgis. We describe an evaluation approach with a Deaf patient and his wife (who is deaf blind) using consecutive sign language interpretation and a remote consultant.

Method
A 76-year-old Deaf man with 8 years of education presented to a rural Northeastern medical center with memory concerns. An expert in neuropsychological evaluation with Deaf individuals provided remote consultation on relevant background, linguistic, and cultural questions for patient and interpreters, test battery choices that are robust to interpretation, modification of instructions as needed, functional equipment (clear masks, face shields), and optimal testing room setup with both a medical interpreter and a Certified Deaf Interpreter.

Results
Difficulties were noted with visual learning and memory in the context of estimated average perceptual intellectual ability and intact attention, executive functions, and spatial skills. Expressive language (ASL) and memory for ASL signs were intact. Processing speed was variable.

Conclusions
We present an example of neuropsychological evaluation using expert consultation and both hearing and Deaf interpreters for an individual from the Deaf community. The consultation process, decision making with respect to the test battery, testing room setup and coordination with interpreters, and issues related to interpreting findings in the context of a Deaf patient’s educational and medical history are addressed.
B - 33 Characterization of Subjective Cognitive Complaints in a Population-Based Sample
Authors: Longoria Anthony J , Kaser Alyssa N , Winiarski Holly R , Denney David A , Schaffert Jeffrey , Lacritz Laura H 
Published: October 2023

Abstract

Objective
Subjective cognitive complaints (SCCs) represent one’s perception of cognitive change that may relate to cognitive decline. This study characterized SCC endorsement and objective cognitive performance in minority populations.

Method
Participants from a population-based, multiethnic cardiovascular risk study (N = 2653; Age = (18–85); Female = 58%; Black = 51%; Hispanic = 14%) responded to questions about their subjective cognitive functioning prior to completing the Montreal Cognitive Assessment (MoCA). Participants endorsed “Yes” or “No” to the following items: 1) Do you have consistent memory problems, 2) If YES, do they interfere with everyday activities, and 3) do you have trouble figuring things out/solving problems. Descriptive and chi-squared analyses characterized endorsement among ethnoracial groups. One-way ANCOVA controlling for age, race/ethnicity, and education compared MoCA scores by endorsement pattern.

Results
Nineteen percent (N = 520) of participants endorsed SCCs, in which blacks endorsed SCCs at a higher rate (22.4%; p &lt; 0.008) than other ethnoracial groups (White = 16.3%; Hispanic = 17.8%). ANCOVA revealed significantly higher mean MoCA scores in those without cognitive complaints (MoCA = 23.4, N = 2122) than those who endorsed Item 3 (MoCA = 21.7, N = 42, p = 0.002, η2 = 0.001), Items 1&3 (MoCA = 21.8, N = 42, p = 0.004, η2 = 0.002), and Items 1,2, &3 (MoCA = 19.6, N = 100, p = &lt;0.001, η2 = 0.024), respectively.

Conclusions
Black individuals were more likely to endorse SCC’s than other ethnoracial groups. Interestingly, memory complaints alone were not associated with cognitive performance, while those with problem solving concerns (with or without memory concerns) showed poorer cognitive performance. While a self-appraisal of executive functioning produced the strongest effect, future investigations are needed to characterize and distinguish the most sensitive SCCs to enhance clinical utility of brief screeners.
B - 43 Case Study: Native Hawaiian/Pacific Islander Female Veteran with Dementia with Lewy Bodies
Authors: Smith Cassandra , Schwartz Eliezer 
Published: October 2023

Abstract

Objective
Recent research suggests there is a lack of consensus regarding current data on the racial/ethnic profiles of cognitively impaired persons with dementia with Lewy bodies (DLB) despite DLB being among the most common neurodegenerative dementias. This case study reviews a Native Hawaiian/Pacific Islander (NHPI) with probable DLB and discusses challenges encountered to emphasize the importance of appropriate normative data to help detect DLB in diverse populations.

Methods
A 78-year-old NHPI female veteran presented for repeat neuropsychological evaluation to track her cognitive symptoms. Chief complaints included concurrent cognitive and motor difficulties, fully formed visual hallucinations, nighttime confusion, and reduplicative paramnesias which have significantly impacted her instrumental activities of daily living.

Results
Neuropsychological testing is suggestive of progressive decline in several cognitive domains, including visuospatial ability, executive functioning, semantic fluency, and verbal and visual learning and memory. Consistent with a DLB diagnosis, her cognitive symptoms emerged concurrently with motor symptom onset. There is also evidence of significant visuospatial and executive difficulties, as well as previously reported reduplicative paramnesia, confusion, and weekly fully-formed hallucinations. Additionally, there is evidence of concurrent parkinsonism’s such as bradykinesia, rigidity, hypophonia, and tremor.

Conclusion
The constellation of symptoms reported by the patient, combined with the results of neuropsychological assessment, was highly congruent with prototypical DLB; however, lack of proper normative data to accurately assess for decline in her scores led to significant caution in interpretation of her neuropsychological performance. This case demonstrates the importance of proper normative data in diverse populations and the role of neuropsychological evaluations in specific cultural contexts.
B - 45 Differences in the Association between Social Activity and Neurocognition between Latino and Non-Hispanic White Older Adults with HIV
Authors: Wang Crystal X , Hussain Mariam A , Carvalho de Lize Tibiriçá , Castellanos-Ponce Valarie , Cherner Mariana , Palmer Barton W , Umlauf Anya , Heaton Robert K , Ellis Ronald J , Marquine María J 
Published: October 2023

Abstract

Objective
Older Hispanics/Latinos/as/x (henceforth Latinos) are disproportionately affected by HIV-associated neurocognitive impairment compared to their non-Hispanic White counterparts. We examined social activity as a possible protective factor against worse neurocognitive outcomes for older people with HIV (PWH). Given cultural values regarding interpersonal relationships, we also examined whether the association between social activity and neurocognition was stronger for Latino than White PWH.

Method
Community-dwelling PWH (N = 114; 50% Latino [53% Spanish-speaking]; Overall group: Age: M = 58.03 SD = 5.75; Education: M = 13.29, SD = 3.39; 82% male; 58% AIDS; 95% on antiretroviral therapy; 4% detectable plasma RNA) completed neuropsychological and neuromedical evaluations. Global neurocognition was derived from demographically adjusted T-scores on a battery of 10 tests with separate norms for English and Spanish-speakers. A questionnaire assessed participants’ engagement in 7 social activities over the past year. Covariates included physical activity, depressed mood, and HIV disease characteristics.

Results
There were no ethnic differences in degree or nature of social activity. A linear regression model revealed a significant interaction between ethnicity and social activity on global neurocognitive T-scores, (β = 0.45, SE = 0.18, p = 0.02), such that increased engagement in social activities was associated with better global neurocognition in White PWH (β = 3.40, SE = 1.13, p &lt; 0.01), but not Latino PWH (β = 0.57, SE = 1.00, p = 0.57).

Conclusions
Results indicate a possible protective influence of social activity on neurocognition in older White, but not Latino PWH, highlighting the importance of examining the generalizability of this relationship across ethnic/cultural groups. Future studies might examine the quality of social activities and their link with neurocognition in diverse older PWH.
B - 55 The Impact of Trauma on Executive Functioning
Authors: Grewal Daya , Keller Jennifer 
Published: October 2023

Abstract

Objective
Individuals seeking neuropsychological assessment frequently present with executive dysfunction and often have trauma histories. This study examines the relationship between Posttraumatic Stress symptoms measured by the Trauma Symptom Inventoy- 2 (TSI-2) and performance on the Delis- Kaplan Executive Function System (DKEFS) Tower Test, which is commonly used in clinical research settings to evaluate executive functioning. The task involves planning, considering multiple possibilities, and adjusting based on feedback.

Method
All participants (n = 54) had experienced trauma over the course of their life. Participants were classified into two groups based on the TSI-2 PTSD factor score: the control group (n = 33, T score 60). Result: While the Tower total achievement scores did not differ between clinical groups, there were effects seen on the efficiency of their performance. A one-way ANOVA indicated that the control group significantly were more efficient in their moves to complete the task compared to the PTSD group (F(1, 52) = 6.589, p = 0.013).

Conclusion
The symptomatic group performed lower on the Tower Move Accuracy ratio despite comparable overall Tower achievement, which suggests poorer planning and organization skills. While the total sample in this study presented with a trauma history, the groupings were based on the presence or absence of current PTSD symptoms. Consistent with Stricker et al. (2015), current trauma symptoms appear to influence performance on executive functioning tasks.
B - 62 The Clinical Utility of the BAI Compared to the GAI in Community Dwelling Older Adults
Authors: Kent George , Ramirez Amanda , Fawcett Maddie , Palladino Nathan , Roesner Elizabeth , Frick Lauren , Pyykkonen Benjamin 
Published: October 2023

Abstract

Objective
Given the potential impact anxiety may have on cognitive performance, the current study explored the relationship of both the Beck Anxiety inventory (BAI) and the Geriatric Anxiety Inventory (GAI) to cognitive performance in community dwelling older adults. Specifically, the correlation of anxiety and depression symptomatology to performance on measures of executive functioning and processing speed was explored (Dorekamp & Vik, 2018; Najimi et al., 2015; Vytal et al., 2012).

Methods
Archival data from a sample of 60 community dwelling older adult participants (female n = 54; White n = 52), with an average education of 13.83 years and an average age of 76 years were included. The BAI and GAI were used to determine anxiety levels. Processing speed and executive functioning were assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) Coding subtest and Trail Making Test B respectively. Data was analyzed using Pearson’s R product moment correlations.

Results
Pearson’s R product moment correlations were significant between the BAI and RBANS Coding (r = −0.328; p = 0.011), Trails B (r = 0.295; p = 0.023), and the GAI (r = 0.268; p = 0.04). However, the GAI was only significantly associated with the BAI.

Conclusions
While both the BAI and GAI are well established measures of anxiety in older adults, the BAI appears to be more sensitive to the effects of anxiety on executive functioning and processing speed in community dwelling older adults. Future directions related to exploration of severity and potential cut scores will be discussed.
B - 63 Relationship between Executive Functioning and Trauma Symptom Report in Healthy Older Adults
Authors: Lapitan-Moore Franchezka , Paxton Jessica , Thomas Adrian 
Published: October 2023

Abstract

Objective
The study investigated the relationship between trauma symptoms and executive functioning (EF) in healthy older adults, emphasizing the importance of assessing the trauma history of those with subclinical trauma and stressor-related disorders in neuropsychological evaluations. It was hypothesized that age is negatively correlated with trauma symptoms, and trauma symptoms are negatively correlated with EF performance.

Method
This cross-sectional investigation included 520 adults ages 50–85 (67.9% Female; Education: 15.95(2.31); 87.9% White, 7.7% Black, 3.3% Asian, 0.6% Native American, 0.6% Other) from the Nathan Kline Institute’s Rockland Sample. Trauma was measured by the total raw score of the Trauma Symptom Checklist-40 (TSC-40) and six subscale scores. EF was measured by performance on selected D-KEFS measures. Separate Pearson correlations were used to compare age to trauma scores, and EF performance to trauma scores.

Results
The anxiety subscale of TSC-40 showed a significant weak correlation with age, r (518) = −0.138, p = 0.001. Age was not correlated with any other TSC-40 subscales. The TSC-40 sexual abuse (SA) subscale showed a significant weak correlation with Color-Word Inhibition r(518) = −0.096, p = 0.031 and Trail Making-Switching r(518) = −0.106, p = 0.016. The remaining TSC-40 subscales were not correlated with other EF measures.

Conclusion
The study demonstrated that the overall severity of trauma symptoms is not associated with age in older adults. Older adults with fewer symptoms associated with SA showed higher EF abilities. Future investigations will assess how gender and socioeconomic status affect the association between trauma and EF in older adults.
B - 64 Association of Perceived Stress during the COVID-19 Pandemic on Cognitive Performance in HIV+ Adults
Authors: Lopez Johnny , Byrd Desiree , Gonzalez Jairo , Morgello Susan 
Published: October 2023

Abstract

Objective
Stress may impact cognitive ability, and perceived stress may be a modifiable risk factor for cognitive impairment. This study investigates the potential impact of perceived stress levels on cognitive test performance in a NYC cohort of people living with HIV (PLWH), assessed during the COVID-19 pandemic.

Method
124 racially-diverse PLWH participating in a longitudinal cohort completed comprehensive face-to-face neurocognitive test batteries between August 2020 and February 2023 (Mage = 61.22). Self-reported stress was assessed using the Perceived Stress Scale-14, and a median split (value of 18) was used to divide the sample into high and low stress groups. One-way ANOVAs were used to evaluate differences in cognitive performance based on stress grouping.

Results
Significant differences between high and low stress groups were found in: Trail Making Test-A (TMT-A), F(1,104) = 3.962,p = 0.049; Trail Making Test-B (TMT-B), F(1,80) = 7.106,p = 0.009; Paced Auditory Serial Addition Test (PASAT), F(1,80) = 7.096,p = 0.009; and Symbol Search (SS), F(1,102) = 5.280,p = 0.024. Participants in the high stress group had lower performance on TMT-A (M = 48.78, SD = 13.47), TMT-B(M = 49.56, SD = 13.92), PASAT (M = 43.07, SD = 12.57), and SS (M = 44.85, SD = 11.76) compared to the low stress group (M = 53.71, SD = 11.87; M = 57, SD = 10.72; M = 50.20, SD = 11.62; M = 49.78, SD = 9.85; respectively).

Conclusion
Individuals reporting higher levels of stress during the COVID pandemic had reduced performance on tasks assessing information processing speed, executive functioning, and attention. This suggests that higher perceived stress levels and ambient stressors (such as the pandemic) may influence cognitive functioning.
B - 67 The Temporal Influence of Emotion Regulation on the Association between Impulsivity and Internalizing Psychopathology: a Latent Path Model
Authors: Milam Alicia L , Nabulsi Yasmine B 
Published: October 2023

Abstract

Objective
Impulsivity has been found to predict the use of emotion regulation strategies as well as internalizing psychopathology. The present study aims to determine whether the timing of regulatory strategies used by those higher in impulsivity differentially impacts symptoms of internalizing psychopathology.

Method
A community sample (N&#3f783) recruited from Amazon MTurk completed an online survey. Latent factors were created for impulsivity, antecedent-focused and response-focused regulation, and internalizing psychopathology. A parallel latent path model was tested using robust maximum likelihood estimation in MPlus in which impulsivity was associated with internalizing psychopathology through antecedent and response-focused regulation.

Results
All adjusted measurement model fit indices were within standard cut-off limits (RMSEA = 0.000–0.069, CFI = 0.981–1.000, SRMR = 0.005–0.016). Impulsivity, β = 0.90, p &lt; 0.001, and response-focused, β = 0.40, p &lt; 0.001, but not antecedent-focused regulation, β = 0.03, p = 0.484, predicted internalizing psychopathology. Impulsivity was related to both antecedent-focused, β = 0.70, p &lt; 0.001, and response-focused regulation, β = 0.84, p &lt; 0.001. There was a specific indirect effect of impulsivity on internalizing psychopathology through response-focused, β = 0.34, p &lt; 0.001, but not antecedent-focused regulation, β = 0.02, p = 0.483. The direct effect of impulsivity, β = 0.54, p &lt; 0.001, remained after accounting for the total indirect effects, β = 0.36, p &lt; 0.001.

Conclusions
These findings indicate that the association between impulsivity and internalizing psychopathology can be partially explained by emotion regulation. Impulsivity related positively to both types of emotion regulation, suggesting that those high in impulsivity have the capacity for both types of strategies. Only response-focused strategies were associated with internalizing symptoms; thus, it may then be beneficial to prompt those with high impulsivity to use more antecedent-focused rather than response-focused regulatory strategies.