bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 01 Association between Social Vulnerability and Susceptibility in Non-Demented Older Adults
Authors: Bodek Hannah S , Pare Nadia , Nester Caroline , Warren David E , Wilhelm Anna , Aflagah Erica , Beadle Janelle N , Rabin Laura A 
Published: October 2023

Abstract

Objective
Social vulnerability, conceptualized as an impaired ability to detect or avoid potentially harmful interpersonal interactions, has been associated with the cognitive decline characteristic of neurodegenerative diseases. Social vulnerability is not routinely assessed in clinical evaluations of older adults, despite its potential clinical utility in identifying individuals at risk for poor outcomes.

Method
Participants (age 60 and over) were cognitively unimpaired, or presented with subjective cognitive decline or mild cognitive impairment. Each participant had a knowledgeable informant (i.e., family member or friend) who completed the Social Vulnerability Scale (SVS; Pinsker et al., 2006), a 15-item measure including items such as, “Been deceived by someone who has deceived them before.” Respondents were asked to rate the likely outcome if the participant was, “placed in that situation now,” using a Likert-type scale ranging from never to always (total score range from 0–60). Point biserial correlation was applied to investigate the association between SVS scores and the response to a single item from a COVID-19 questionnaire: “Since the beginning of the Covid-19 pandemic, has your loved one fallen prey or come close to falling prey to scam?”

Results
For the 69 participants (M age = 75.6; M education = 15.7; 70% female), SVS scores were significantly associated with the report of increased susceptibility to a scam (rpb = 0.47, p &lt; 0.001) during the COVID-19 pandemic.

Conclusions
These results highlight the need for attention to social interaction patterns during clinical evaluations, to help identify and mitigate potential harmful outcomes in those most vulnerable. Additional research should clarify the relationship between social vulnerability and falling prey to scams.
A - 03 Emotion Domains and Response to Cognitive Training for Mild Cognitive Impairment
Authors: Johnson Eliza , Hosseini Hadi , Newkirk Saskia 
Published: October 2023

Abstract

Objective
The aim of this study was to examine how various emotional domains predict cognitive changes in older adults with Mild Cognitive Impairment (MCI) following a cognitive training program.

Methods
This study was a single-blind, randomized, placebo-controlled trial in which participants were recruited using mixed methods primarily from aging research registries at Stanford University School of Medicine. During the trial, some participants underwent computerized cognitive training for 20 weeks, consisting of three 20 to 30-minute sessions per week. The final analysis included 20 MCI participants who completed cognitive training with an adherence rate of at least 70% and presented for follow-up neuropsychological assessment. The NIH Toolbox Test Battery was used to evaluate cognition and socioemotional functioning at baseline and follow-up. The battery included measures of cognition, motor, sensation, and emotion, and the NIH Toolbox fluid cognition composite score was used to assess changes in cognitive functioning over the course of training.

Results
Multiple regression analyses revealed that negative emotion domains were statistically significant predictors of changes in cognition at the 0.05 level (P = 0.034), while positive emotion domains were not significantly associated (P = 0.550). Among the negative emotion domains, loneliness (P = 0.022) and perceived hostility (P = 0.005) were the most significant predictors.

Conclusions
Higher levels of negative affectivity predict improvement in response to cognitive training, suggesting that cognitive training may be a beneficial treatment for individuals with high levels of negative affectivity, who are at a higher risk of developing MCI according to the extant literature.
A - 06 Sensitivity of Remote App-Based Assessment of Cognition among Older Adults to Fatigue-Mediated Differences in Cognitive Functioning
Authors: Liebenberg Erin , Rovere Rachel , Halberstadter Kimberly , Wolk David , Mechanic-Hamilton Dawn 
Published: October 2023

Abstract

Objective
This study assesses the sensitivity of the mobile cognitive app performance platform (mCAPP), a mobile and engaging cognitive assessment tool, to participant reported fatigue.

Method
The mCAPP includes three gamified tasks: a memory task (“Concentration”), a stroop-like task (“Brick Drop”), and a digit-symbol coding-like task (“Space Imposters”). For all games, shorter reaction times and fewer guesses indicate better performance. The cohort included 55 participants (72.73% female; age = 71.60 ± 4.48; education = 16.71 ± 2.30; 49.1% white; 49.1% Black/African American, 1.8% Multiracial) without cognitive impairment who are enrolled in the Penn ADRC cohort. Performance was analyzed as a whole and grouped into days of high (7+) and low (0–3) fatigue (range 0–10).

Results
The average fatigue rating was 2.61 ± 2.51. Overall, higher reported fatigue was weakly correlated with more time spent (ρ = 0.22) and a higher number of guesses on Concentration (ρ = 0.12; p-values&lt;0.01). There was a significant difference in speed for those with high fatigue (M = 2.825) and low fatigue (M = 2.592; p = 0.018) on Space Imposters, but not on Brick Drop (p = 0.15). On Concentration, those with high fatigue needed a higher number of guesses (M = 5.356) compared to low fatigue (M = 5.095; p = 0.003) and more time was spent on individual guesses for those with high fatigue (M = 17.587) compared to low fatigue (M = 13.357; p &lt; 0.001).

Conclusion
The mCAPP can remotely detect differences in cognitive performance in self-reported high and low fatigue states. Future studies will include looking at sleep data to determine objective measures of fatigue-related behavior and in-depth analysis of performance within-subject.
A - 13 Association between Motivation and Engagement in Healthy Lifestyle Behaviors in Midlife
Authors: Simone Stephanie , Kaplan Marina , Giovannetti Tania 
Published: October 2023

Abstract

Objective
Modifiable risk factors (e.g., cognitive/physical inactivity) account for up to 40% of dementia cases. The impact of risk reduction is strongest in midlife (ages 45–64), but little is known about what motivates middle-aged adults to engage in healthy lifestyle behaviors for dementia risk reduction.

Method
347 participants (M age = 54.67, SD = 5.97; 53% women; 86.5% White; M education = 14.28, SD = 2.25) completed a 30-minute online survey that assessed demographic information, multiple facets regarding motivation to change lifestyle and behaviors for dementia risk reduction (MCLHB-DRR scale: self-efficacy, barriers, etc.), and engagement in healthy lifestyle behaviors, including physical activity (IPAQ), cognitive/leisure activity (CLAS), sleep quality (B-PSQI), and loneliness/social activity (ULS-8). Multivariate linear regressions adjusted for age, sex, and education were conducted to examine the association between motivation (MCLHB-DRR z-scored subscales) and engagement in healthy lifestyle behaviors for dementia risk reduction.

Results
Self-efficacy (B = 0.198, p = 0.003) and education (B = 0.167, p = 0.003) significantly predicted total physical activity (R2 = 0.076, F(10, 336) = 2.767, p = 0.003). Self-efficacy (B = 0.239, p &lt; 0.001) and education (B = 0.307, p &lt; 0.001) also predicted cognitive/leisure activity (R2 = 0.249, F(10, 336) = 11.131, p &lt; 0.001). Perceived barriers (B = 0.256, p &lt; 0.001), general health motivation (B = 0.144, p = 0.015), self-efficacy (B = -0.137, p = 0.030), and age (B = -0.161, p = 0.002) significantly predicted loneliness/social inactivity (R2 = 0.169, F(10, 336) = 6.851, p &lt; 0.001). Self-efficacy (B = -0.152, p = 0.030), education (B = -0.147, p = 0.012), and sex (B = 0.141, p = 0.015) significantly predicted sleep quality (R2 = 0.114, F(10, 292) = 3.753, p &lt; 0.001).

Conclusions
Self-efficacy appears to be a particularly relevant motivator for engagement in healthy lifestyle behaviors for dementia risk reduction in midlife. Empirically supported strategies to improve self-efficacy should be included in preventative lifestyle interventions.
A - 14 Sex Differences in the Associations between Age and Neuroanatomical Correlates of Alzheimer’s Disease in Congolese Older Adults
Authors: Patel Saranya , Hickle Sabrina , Ikanga Jean , Epenge Emmanuel , Gikelekele Guy , Tshengele Nathan , Kavugho Immaculee , Drane Daniel , Qiu Dequiang , Alonso Alvaro 
Published: October 2023

Abstract

Objective
Investigate sex differences in the relationships between age and brain regions typically affected in Alzheimer’s disease (ad) in healthy aging Congolese adults.

Method
76 individuals, including 40 male [age: M(SD) = 70.5(9.1)] and 36 female [age: M(SD) = 74.4(6.1)] were recruited from the Democratic Republic of Congo and underwent structural magnetic imaging on a 1.5 T scanner. Freesurfer was utilized to segment 3D T1w images. Pearson correlations were used to examine the relationship between age and brain volumes in hippocampal and superior frontal regions of interest and total gray matter and overall brain volumes.

Results
Age had moderate, statistically significant negative correlations with left and right hippocampal (r = −0.50, −0.48), left and right superior frontal (r = −0.44, −0.41) total gray matter (r = −0.49) and overall brain (r = −0.48) volumes. When separated by sex, age continued to show moderate negative correlations with all regions in males. However, in females, associations only remained significant for both hippocampal (left: r = −0.37, right: r = −0.44) hippocampal, left superior frontal (r = −0.37), and total gray matter (r = −0.40) volumes.

Conclusions
Healthy Congolese older adults demonstrate associations between age and known ad brain regions, and all associations remained significant for males, while only a few remained significant for females. Similar to Western cohorts, there are aging effects in Congolese older adults and associations between age-related brain volume loss seen in healthy male individuals. Gender stratification may be important in determining risk and progression of pre-clinical and clinical populations and understanding resilience to pathophysiological processes of ad in aging Congolese adults.
A - 16 Performance on the SDMT Predicts Functionality in Older Adults
Authors: Uy Naomi G , Stimmel Marnina , Ayers Emmeline , Verghese Joseph , Weiss Erica F 
Published: October 2023

Abstract

Objective
The Symbol Digit Modalities Test (SDMT) is a task of processing speed and executive functioning that is widely used to evaluate individuals with Multiple Sclerosis (MS) and has been shown to predict various instrumental activities of daily living. The relationship between SDMT and daily functioning has not been well explored in the aging population. The Activities of Daily Living-Prevention Instrument (ADL-PI) is a self-report measure that assesses changes in functioning and instrumental activities of daily living (IADLs). We evaluate the relationship between SDMT and ADL-PI in older adults with subjective cognitive complaints in an urban, multi-ethnic, primary care population in Bronx, New York.

Methods
300 participants (50.7% Hispanic, 43.7% non-Hispanic Black; 37% assessed in Spanish) completed the SDMT and ADL-PI as part of a larger study seeking to improve detection of cognitive impairment in primary care. The mean age of the sample was 71.35 ± 5.76 years and participants had a mean 12.26 ± 3.76 years of education. Pearson correlations were used to examine the relationship between SDMT and IADLs.

Results
SDMT performance was weakly albeit significantly correlated with self-report of functional difficulties on the ADL-PI (r = −0.312, p &lt; 0.001). The relationship between SDMT (Range = 1–51, M = 25.39) and ADL-PI was significant in both English (p &lt; 0.0011) and Spanish (p = 0.004) speaking participants and remained significant when controlling for age, education, and depression (p = 0.002).

Conclusion
Consistent with MS literature, the SDMT is a useful tool for predicting self-report of instrumental activities of daily living of older adults with cognitive concerns.
A - 17 Preliminary Neuropsychological Outcomes in a Randomized Controlled Trial of High-Definition Transcranial Direct Current Stimulation in Alzheimer’s Clinical Syndrome
Authors: Ahmed Danyah , Helphrey Jessica , Cabrera Hannah , Neaves Stephanie , Mcclintock Shawn S , Hart John , Chiang Hsueh-Sheng , Lacritz Laura , Cullum Munro C , LoBue Christian 
Published: October 2023

Abstract

Objective
The Alzheimer’s Clinical Syndrome (ACS) is marked by global cognitive decline, and neural circuit dysfunction involving the dorsal anterior cingulate cortex (dACC) has been associated with some of the episodic memory and non-memory deficits in ACS. High-definition transcranial direct current stimulation (HD-tDCS) is a promising noninvasive treatment to lessen cognitive deficits in ACS, and this preliminary double-blinded trial examined whether HD-tDCS targeting the dACC could improve cognitive performance in ACS.

Methods
Ten patients diagnosed with ACS (M age = 71.500; SD = 9.755) were randomized to receive sham (n = 2), 1 mA (n = 5), or 2 mA (n = 3) multi-electrode (4 cathodes x 1 anode) HD-tDCS for 10 daily sessions. Episodic memory, language, attention, and executive function measures were administered pre- and immediately post-treatment, and composite memory and non-memory scores were calculated. Paired samples t-tests examined significant differences (p &lt; 0.05) between pre-treatment and post-treatment scores for each HD-tDCS group.

Results
For all three HD-tDCS groups, there were no significant improvements between pre-treatment and post-treatment scores for memory or non-memory abilities (p’s &gt; 0.05).

Conclusion
This preliminary study showed that HD-tDCS applied over the dACC was unassociated with cognitive improvement in ACS. Future research with a larger sample will be needed to inform if this configuration of HD-tDCS could ameliorate cognitive deficits in ACS. Moreover, evaluation of HD-tDCS applied over other brain regions may yield additional insights, and a critical step will be to identify whether any clinical characteristics such as disease stage may influence the response to stimulation in ACS.
A - 21 Sex Differences in Cortical Thickness and Cognition in Individuals with Autosomal Dominant Alzheimer’s Disease
Authors: Giudicessi Averi , Fox-Fuller Joshua T , Chen Yinghua , Su Yi , Banea Ana , Martinez Jairo E , Pluim Celina , Angella Stephanie , Cronin-Golomb Alice , Castelar Clara Vila , Restrepo Francisco Lopera , Quiroz Yakeel T 
Published: October 2023

Abstract

Objective
Cortical thinning is a marker of neurodegeneration. Individuals with autosomal dominant Alzheimer’s disease (ADAD) develop early-onset dementia with virtually 100% certainty. Cortical thickness fluctuates across the ADAD lifespan, from early-life increased thickness to atrophy proximal to clinical onset. Females have higher cortical thickness and better cognition than males as they age. We examined sex differences in cortical thickness and cognitive performance in adults with ADAD.

Method
We assessed 85 Presenilin-1 E280A mutation carriers (74 cognitively-unimpaired, 11 mildly-impaired) from the Colombia-Boston Biomarker Study of ADAD. Mean age was 35.7 (SD = 10), education 10.2 (SD = 9), and 55 were female. Global cognition was measured using Mini-Mental State Examination (MMSE), and memory using CERAD Word List Delayed Recall. Participants underwent structural brain MRI. T-tests assessed between-group differences. Pearson correlations examined associations between cortical thickness and cognition.

Results
There were no sex differences in cortical thickness or cognitive performance (all ps &gt; =0.05). For carriers, greater cortical thickness was associated with higher MMSE (r = 0.40, p &lt; 0.001) and memory recall scores (r = 0.43, p &lt; 0.01). Female carriers drove this effect, where greater cortical thickness was associated with higher MMSE (r = 0.46, p &lt; 0.001) and memory recall scores (r = 0.47, p &lt; 0.001); these associations were non-significant in male carriers alone. In cognitively-unimpaired female carriers, increased cortical thickness was associated with worse MMSE (r = −0.44, p &lt; 0.001).

Conclusions
We found sex differences in the relation between cortical thickness and cognition in ADAD carriers, which may be relevant to the differential vulnerability and progression of ad in females and males. Future work should investigate potential underlying mechanisms contributing to this sex difference.
A - 23 Neuropsychological Assessments Are Highly Predictive of Β-Amyloid Positive Alzheimer’s Disease
Authors: Horne Lucy K , Schantell Mikki , Mansouri Amirsalar , Springer Seth D , Wiesman Alex I , Johnson Hallie J , Okelberry Hannah J , May Pamela E , Wilson Tony W 
Published: October 2023

Abstract

Objective
Alzheimer’s disease (ad) is the most common cause of dementia, but it is often difficult to accurately diagnose. The current gold standard is β-amyloid positivity on a positron emission tomography (PET) scan. However, these scans are not covered by insurance and are cost prohibitive, making them infeasible for many patients. The aim of this study was to quantitatively assess the accuracy of a neuropsychological battery in distinguishing people with biomarker-confirmed ad versus people who are amyloid-negative.

Method
In total, 60 participants completed a full neuropsychological assessment and Florbetapir-PET imaging. We then used linear discriminant analysis to assess the extent to which a neuropsychological battery could accurately distinguish the biomarker-confirmed groups. Sensitivity, specificity, positive and negative likelihood ratio, area under the curve (AUC), and accuracy were computed for each model using the classification results based on neuropsychological assessments versus Florbetapir-PET imaging.

Results
Participants between the ages of 55–84 years (M = 70.17, SD = 6.65), including 37 with amyloid-positive ad and 23 amyloid-negative participants, completed all aspects of the present study. Overall, the sensitivity of the model was 94.59% (95% CI: 81.81%–99.34%), specificity was 91.30% (95% CI: 71.96%–98.93%), the AUC was 0.93 (95% CI: 0.85–1.00), the positive likelihood ratio was 10.88 (95% CI: 2.89–40.99), and the negative likelihood ratio was 0.06 (95% CI: 0.02–0.23).

Conclusions
Assessments from a neuropsychological battery accurately discriminated β-amyloid positive participants with ad from β-amyloid negative participants. These findings represent a potential alternative, cost-effective method for confirming ad status. Further research is warranted to investigate the most optimal neuropsychological battery for ad diagnosis.
A - 27 Early-Onset Alzheimer’s Disease: Indications of Psychosis Severity and Disease Progression
Authors: Muscat Whitney M , Arleo Kayla 
Published: October 2023

Abstract

Objective
Early-onset Alzheimer’s disease (EOAD) comprises about 5% of ad cases and is associated with delays in diagnosis and aggressive course. Psychotic symptoms are frequent in ad and often include delusions of infidelity and hallucinations. When present, ad with psychosis is accompanied by elevated levels of depression and greater functional impairment. This case expands upon the existing literature on EOAD through the timeline of a complex psychosis presentation accompanied by rapid cognitive decline.

Method
63-year-old, Hispanic, woman with progressive cognitive changes (e.g., confusion, forgetfulness, word-finding difficulties, disorganization) that emerged 5 years prior to seeking neurological consultation. Psychosis symptoms (i.e., auditory/visual hallucinations, delusions), in the context of real events (i.e., husband’s previous infidelity), developed simultaneously. These pervasive symptoms have contributed to social withdrawal, persistent suicidal tendencies, and impaired IADLs. Neuroimaging suggested hypometabolism in the parietotemporal regions with precuneus and posterior cingulate gyri involvement.

Results
The evaluation revealed fairly generalized cognitive decline. Basic attention, working memory, visual abstract reasoning, and phonemic fluency were intact. Visual integration/visuoconstruction were reduced. Impairments emerged in processing speed, rapid cognitive flexibility, cognitive inhibition, conceptualization, visuospatial orientation, semantic fluency, confrontation naming, and visual and verbal encoding and retention (with rapid forgetting). She endorsed moderately elevated symptoms of depression and anxiety.

Conclusions
The pattern of cognitive and functional deficits are all suggestive of an ad process. Her age, sex, significant neuroimaging findings, report of earliest cognitive symptoms, and family history reinforce an EOAD etiology. Significant behavioral changes are often associated with increased cognitive impairment and in turn, may mark the progression/stage of the disease.
A - 28 Serial Evaluations of an Older Adult with Epilepsy and Incidental Findings of Early-Onset Alzheimer’s Disease: a Case Study
Authors: O'Hara John B , Garlinghouse Matthew 
Published: October 2023

Abstract

Objective
Patients with Temporal Lobe Epilepsy (TLE) and Alzheimer’s Disease (ad) demonstrate increased β-amyloid and tau deposition, relative to patients with either TLE or ad. Presentation of ad may be atypical and more rapid in patients with both disorders. We present four serial neuropsychological evaluations (NPE) of a 68-year-old, right-handed woman with history of epilepsy (which became treatment refractory), neurosurgical resection, and incidental neuropathological findings of early-onset ad.

Method
History included generalized tonic–clonic seizure in adolescence and numerous complex partial seizures, managed for ~20 years on valproic acid. At age 63, she reported memory changes. Neurophysiological work-up revealed right frontotemporal seizure foci, and neuroimaging studies revealed amyloid angiopathy. She underwent right anterior temporal lobectomy and amygdalohippocampectomy. Afterwards, seizure control and perceived memory function improved. Post-surgical pathological analysis detected neurofibrillary tangles, neuritic plaques, angiopathy, anoxic changes, and gliosis. Later, she and family described memory decline and behavioral disinhibition. Follow-up CSF analysis identified p-tau/β-amyloid ratio consistent with ad.

Results
Presurgical NPE was largely intact. Post-surgical NPE revealed stable/improved executive functioning (EF), visuospatial skills (VS), and memory, with variability in language. Follow-up NPE 10 months later identified general stability with some variability (e.g., source memory difficulties). Follow-up NPE 16 months after that revealed declines in several domains, with sparing of VS and language.

Conclusions
We present the cognitive trajectory of an individual with refractory TLE and early-onset ad, complicated by cognitive/neuropsychiatric sequelae of neurosurgical resection. This case highlights the potential benefits of serial re-evaluation in assessing for cognitive change suggestive of ad in aging populations with refractory TLE.