bluuebunny/crossref_metadata_2025_split huggingface dataset:
A - 33 Clock Drawing Performance Differences in World Trade Center Responders at Midlife
Authors: Santiago-Michels Stephanie , Clouston Sean , Rabin Laura A , Kritikos Minos , Pellecchia Alison , Scott Veronica , Carr Melissa , Luft Benjamin 
Published: October 2023

Abstract

Objective
World Trade Center (WTC) responders demonstrate elevated risk for cognitive impairment (CI) consistent with Alzheimer’s Disease and Related Dementias (ADRD). Neuropsychological test performance is valuable in early detection efforts and non-invasive longitudinal tracking of populations at risk of ADRD. We hypothesized that WTC-CI would be associated with a greater number of errors on the clock drawing task (CDT).

Method
The CDT was administered to responders with/without CI who participated in a case/control study. WTC-CI was diagnosed following NIA-AA guidelines for diagnosing early-onset ADRD (ages &lt;66 years). CDT performance was evaluated using subsets of clock errors derived from four existing variations in CDT evaluation measuring the number of errors. An ANOVA was conducted to compare mean differences in clock characteristics.

Results
From 99 participants, responders with CI (n = 50, Mage = 55.82) had more errors when compared to responders without CI (n = 49, Mage = 55.94) in the following CDT components: contour (p = 0.006), hands (p &lt; 0.001), hands similarity (p = 0.005), moderate graphical errors (p = 0.042), left-side number crowding (p = 0.038), time incorrectness (p &lt; 0.001), and extra marks on clock face (p = 0.006).

Conclusion
In this study, we demonstrated that CDT performance decline is associated with WTC-CI. CDT can be used as a non-invasive investigative tool that can track cognitive performance longitudinally, which can better aid in the early detection, monitoring, and intervention strategies when dealing with the emergence of encephalopathy in high-risk ADRD populations, such as the WTC cohort. Future research should evaluate additional measures that can address other comorbid issues that can arise in such populations, such as post-traumatic stress disorder (PTSD).
A - 34 A Suspected Case of Early-Onset Frontal Variant of Alzheimer’s Disease in a 64-Year-Old Male
Authors: Smith Alphonso , Bledsoe Xavier 
Published: October 2023

Abstract

Objective
Early-onset frontal variant of Alzheimer’s disease (fvAD) is characterized by apathy, disinhibition, and executive dysfunction. As such, fvAD is often difficult to clinically distinguish from behavioral variant frontotemporal dementia (bvFTD). However, research suggests that a differentiating feature among the two conditions is that fvAD typically presents with more pronounced memory impairment. Therefore, neuropsychological testing in the context of a comprehensive multidisciplinary assessment can be a valuable tool to aid with differential diagnosis.

Method
A 64-year-old male with gradually progressive difficulties in cognition and behavioral-emotional functioning over the past 8–9 years presented to a multidisciplinary neurology clinic. MRI showed mild atrophy in the frontal, temporal, and parietal lobe regions. Concerns were raised by his neurologist for early-onset ad versus bvFTD so the patient was referred for neuropsychological evaluation.

Results
Neuropsychological testing showed a largely amnestic memory profile along with deficits in executive functioning and semantic fluency. His spouse endorsed concerns for apathy and executive dysfunction on a frontal system rating questionnaire in addition to concerns for disinhibition during the clinical interview. Taken together, the patient’s profile appeared to be consistent with early-onset fvAD. Follow-up FDG-PET scan showed decreased uptake in the anteromesial temporal lobes, posterior cingulate cortices, and posterior temporoparietal regions which was consistent with an ad profile.

Conclusions
Early-onset fvAD and bvFTD are often difficult to clinically distinguish from each other. However, neuropsychological testing in conjunction with comprehensive multidisciplinary assessment can serve an important role in helping to facilitate differential diagnosis for these two neurodegenerative disorders with overlapping features.
A - 36 Neuroprotective and Resilience Factors in an Individual with Positive ad Biomarkers
Authors: Weinstein Morgan , Bradley Hannah , Martin Jane , Pereira Ana , Sutton Leah C 
Published: October 2023

Abstract

Objective
There is conflicting research on risk indicators relating to the diagnosis of early-onset Alzheimer’s disease (EOAD). We assessed an individual with numerous factors that are associated with EOAD including the presence of two APOE e4 alleles, family history of EOAD, and positive biomarkers (i.e., Amyloid PET Scan; CSF). Longitudinal neuropsychological data reflect minimal cognitive decline through age 73, suggesting substantial mediating effects of cognitive reserve and neuroprotective measures: aerobic exercise, cognitive stimulation, and psychological health.

Method
A 73-year-old man was seen for repeat neuropsychological evaluation in 2022 at an academic medical center following his baseline evaluation in 2019, which did not reveal cognitive deficits. Testing was conducted and interpreted by a clinical neuropsychologist in the context of available neuroimaging and neurodiagnostic information.

Results
Results of the neuropsychological assessment were interpreted in the context of High Average to Superior premorbid functioning, a significant family history of EOAD, a positive Amyloid PET scan and two ApoE4 alleles (4/4). Results of his 2022 evaluation remain consistent or improved from 2019 and do not suggest mild cognitive impairment (MCI). Functionally, this individual is fully independent in IADLs and does not report significant subjective cognitive concerns.

Conclusion
Phenotypic expression of ad symptoms are delayed in this individual despite his genetic risk and pathologic biomarkers; the reason is likely multifactorial but includes several resilience factors, including good cardiovascular health (i.e., aerobic exercise 5x/week), continued cognitive stimulation, and psychological health. These are areas worthy of further research.
A - 37 Measuring Experiences of Discrimination in Older Adults Enrolled in an Alzheimer’s Disease Research Cohort
Authors: Patel Nisha , Halberstadter Kimberly , Schumann Rosalie , Mechanic-Hamilton Dawn , Stites Shana D 
Published: October 2023

Abstract

Objective
Discrimination can affect healthy brain aging and Alzheimer’s disease (ad) outcomes. To advance this area of research, we characterized experiences of discrimination in a cohort of older adults, contributing data to a national research sample.

Method
An electronic survey was completed by cognitively unimpaired participants (n = 135) in the UPenn ad Research Center clinical cohort. The Everyday Discrimination Scale (EDS) asks 10 questions about lifetime experiences with discrimination. Self-report questionnaires gathered sociodemographic data, including age, race, disability, sex, sexual orientation, and gender identity. Associations between EDS items and sociodemographic characteristics were examined.

Results
The sample of 135 older adults averaged 74 years old, had 17 years of schooling, and were mostly women (61%) and white (71%). Half (49%) reported having discriminatory experiences including receiving less respect (35%), lower quality service (35%), less courtesy (34%), and being treated as inferior (35%) or less smart (22%). The most common reasons for discrimination were race (29%), gender (22%), skin color (18%), age (17%), and ancestry (16%). Black participants comprised the majority who reported receiving lower service (68%), being treated as less smart (60%), and with less courtesy (56%).

Conclusions
Our findings suggest older adults enrolled in brain aging research experience many types of discrimination, which disproportionately affect Black individuals. Their experiences make a valuable contribution to ad science, helping researchers to study how discrimination may correspond to ad outcomes. They also highlight the importance of researchers being well-trained to be culturally informed when interacting with individuals who have been, and may continue to be, impacted by discrimination.
A - 41 The Association between Education, Literacy, and Performance on the Loewenstein-Acevedo Scale for Semantic Interference and Learning (LASSI-L) in African American (AA) Older Adults
Authors: Bosworth Brooke , Neer Emory , Ramirez Sofia , Sosa Jaylene , Hincapie Diana , Ortega Alexandra , Crenshaw Kristen , Curiel Rosie , Loewenstein David 
Published: October 2023

Abstract

Objective
The LASSI-L, a cognitive challenge test, has been found to be highly discriminative between AA elders with amnestic mild cognitive impairment (aMCI) versus cognitively unimpaired (CU) counterparts. Given potentially lower levels of formal education and literacy in some AA groups, it is important to determine whether such factors might adversely influence performance.

Methods
41 AA adults (53.7% males), with a mean age of 63.9 (SD = 5.1 years, range = 54–83) were deemed to be CU after a clinical interview resulted in a CDR = 0, and scores from a neuropsychological battery were deemed normal by experienced neuropsychologists. The LASSI-L was not used in diagnosis.

Results
Level of educational attainment was 13.3 (SD = 2.3 years: range = 9–20). Level of reading literacy, as assessed by the WRAT-4, yielded an average grade equivalent (GE) of 9.6 (SD = 3.5 range = 2.0–12.9); substantially lower than reported educational attainment. Association between formal education and literacy was 0.52 which accounted for 27% of the shared variance. There were no statistically significant correlations between formal education or WRAT-4 scores in any LASSI-L variables, including initial learning (Cued Recall 2 List A), proactive semantic interference (PSI) (Cued List B1-List B2), failure to recover from PSI, or semantic intrusion errors.

Conclusions
Performance on the LASSI-L among AA-CU did not suggest biases associated with formal education or word literacy, making it a promising tool for research. Many neuropsychological measures do not have acceptable diagnostic accuracy when used among individuals that are racially diverse, have lower-education levels, and lower socioeconomic status. This is important in consideration for potential use of LASSI-L in clinical settings.
A - 42 Neuropsychological Improvement in Amnestic Mild Cognitive Impairment Following Noninvasive Transcranial Electrical Stimulation: a Case Report
Authors: Cabrera Hannah , Helphrey Jessica , Neaves Stephanie , Ahmed Danyah , Chiang Hsueh-Sheng , McClintock Shaun M , Cullum C Monroe , Hart John , Didehbani Nadeyah , LoBue Christian 
Published: October 2023

Abstract

Objective
Amnestic Mild Cognitive Impairment (aMCI) is often a prodromal stage for Alzheimer’s disease, and the few treatments available have limited efficacy in lessening the neuropsychological deficits. Transcranial direct current stimulation (tDCS) is a noninvasive electrical stimulation method with therapeutic potential found in aMCI, but high-definition tDCS (HD-tDCS) is a recent advancement allowing for improved targeting in stimulation and possibly prolonged treatment effects. We present a case report that investigates HD-tDCS-induced neuropsychological changes in aMCI.

Method
A 78-year-old male with aMCI received 10 HD-tDCS sessions at 1 mA for 20 minutes targeting the dorsal anterior cingulate cortex. He was stable on rivastigmine throughout the trial. Eight neuropsychological tests assessing episodic memory (verbal and visual), attention, executive functioning, and language were completed at baseline, after the 10th session and 3-months later. A change of +/− 10 T-score points from baseline was considered a clinically meaningful difference.

Results
Significant improvements were observed immediately after HD-tDCS on 4/8 tests, including the Brief Visuospatial Memory Test-Revised (BVMT-R; immediate recall +14; delayed recall +24), semantic fluency (Animals +17), Trail Making Test B (+14), and Stroop Color and Word Interference Trial (+21). At the 3-month follow-up, only the BVMT-R immediate recall remained higher (+16), while the rest were similar to baseline scores.

Conclusions
Clinically meaningful improvement in neuropsychological functioning was seen following HD-tDCS in this patient with aMCI. However, nearly all the enhancements were diminished 3-months later, returning to baseline. A randomized sham-controlled trial is warranted to confirm the therapeutic effects of HD- tDCS and examine how long effects may persist.
A - 43 Examining the Utility of the Adaptive Behavior Scale-3rd Edition (ABAS-3) in Capturing Age-Related Changes in Daily Functioning for Neurodiverse Populations
Authors: Colantuono Valerie , Lindgren Karen , Robins Diana L , Vivanti Giacomo 
Published: October 2023

Abstract

Objective
Current guidance for the assessment of cognitive decline for mild cognitive impairment or dementia lacks sufficient information for assessing neurodiverse populations (Janicki et. al, 2022), and standardized scores often have floor effects. This study investigated the utility of the Adaptive Behavior Scale-3rd Edition (ABAS-3) in characterizing age-related changes in daily functioning for individuals with autism and other intellectual and developmental disability (I/DD).

Method
Participants (20–76 years old) resided in community-based residential programs (CBRPs) for individuals with I/DD. Aim 1 examined mean ABAS-3 raw scores for participants with at least 1 ABAS-3 (N = 171, autism n = 115, other I/DD n = 56). Aim 2 examined changes in ABAS-3 raw scores over 2 years (N = 61, autism n = 37, other I/DD n = 24). ABAS-3 scales included “home-living” (HL), “self-care” (SC) and “health and safety” (HS).

Results
Aim 1 indicated variability within and across diagnostic groups, with lower performance for autistic versus other I/DD participants (p &lt; 0.001, large effect size across all subscales). Aim 2 found varying patterns of loss, gain, and stable scores across timepoints. HL (autism loss 24.3%, gain 16.2%, stable 59.5%; I/DD loss 16.7%, gain 33.3%, stable 50.0%), SC (autism loss 29.7%, gain 16.2%, stable 54%; I/DD loss 12.5%, gain 33.3%, stable 54.2%), HS (autism loss 24.3%, gain 16.2%, stable 59.5%; I/DD loss 16.7%, gain 33.3%, stable 50.0%).

Conclusions
This proof-of-concept study demonstrates feasibility in characterizing ADLs of individuals with autism and I/DD living in CBRPs. Future research will assess distal ABAS-3 raw score changes to track cognitive decline in individuals with autism and other I/DD.
A - 44 Social Cognition and its Neuroanatomic Correlates in Frontotemporal Dementia
Authors: Dotterer Hailey L , Morrow Christopher , Corona-Long Caitlin , Bakker Arnold , Oniyke Chiadi U , Kamath Vidyulata 
Published: October 2023

Abstract

Objective
Frontotemporal dementia (FTD) often presents with impaired social cognition in both the behavioral and language variants. Establishing reliable measures and neural correlates of social cognition may aid in staging and monitoring FTD subtypes. Here, we examined group differences in social cognitive measures between FTD subtypes and cortical thickness correlates of social cognition across groups.

Method
Participants with behavioral variant FTD (n = 53; bvFTD), semantic variant primary progressive aphasia (n = 32; svPPA) and non-fluent variant PPA (n = 32; nfPPA) were enrolled in the Frontotemporal Lobar Degeneration Neuroimaging Initiative (NIFD). In first-visit data, we examined group differences in social cognition measures [Interpersonal Reactivity Index (IRI), Revised Social-Monitoring Scale (RSMS), and Behavioral Inhibition/Activation (BIS/BAS) Scales]. We used multivariate regression adjusted for age, total intracranial volume, and CDR global score to explore associations between social cognition and cortical thickness in pre-specified regions.

Results
Reduced perspective-taking and sensitivity to socio-emotional expressiveness was observed in early-stage bvFTD and svPPA groups compared to the nfPPA group. Across FTD cohorts, increased perspective-taking was associated with reduced cortical thickness of regions within the salience and default mode networks. Increased empathic concern was associated with increased left inferior parietal cortical thickness. Increased behavioral inhibition was associated with reduced right posterior cingulate cortical thickness. Increased behavioral activation was associated with reduced right pars triangularis cortical thickness.

Conclusions
Social cognition is affected in early-stage bvFTD and svPPA to a greater extent than nfPPA. Neural correlates of social cognition are varied and warrant additional study as our findings contrast with previous literature that has typically linked lower perspective-taking with atrophy.
A - 45 Diverse Perspectives in Cognitive Reserve: Changing Theories for a Changing World
Authors: Edwards Katie , Burks Alexis , Mullins Teagan , Shendo Macaiah , Dixon Naila DeCruz , Gillezeau Christina , Hernandez-Vallant Alexandra , Schodt Kaitlin , Abrams-Silva Lynette 
Published: October 2023

Abstract

Objective
The Cognitive Reserve (CR) Theory proposes protective factors that aid in acting against cognitive decline due to factors such as dementia and head injury. Here we conduct a narrative review of diverse perspectives in CR. We provide an overview of CR models not previously highlighted, as well as how traditional models of CR may not be applicable for all populations.

Data Selection
A review of the literature on diverse perspectives of CR was carried out through PubMED, Sage Research Methods (SRM) Core, and Web of Science: All Databases. Two specific types of articles were selected. We first looked at traditional models of CR (premorbid intelligence estimates and educational or occupational attainment) tested with diverse populations not historically represented in the original models. The second category of articles included an open-ended search of CR expressions outside of these traditional understandings (i.e., resiliency).

Data Synthesis
Reviewed evidence suggests that historical models of CR are not homogeneously valid across racial and ethnic groups. Other conceptualizations expand the understanding of CR and show evidence supporting CR expressions in bilingualism, personal social networks, and protective health behaviors, among others.

Conclusion
To the best of our knowledge, this is the first attempt to provide a comprehensive review of diverse perspectives in CR. The growing body of research suggests good support for alternative understandings of CR, and indicates reconsideration of historical understandings of CR within minoritized groups. Overall, the theory of CR should continue to evolve and incorporate factors relevant to diverse populations as the world population continues to rapidly diversify.
A - 47 Characteristics and Outcomes of Older Inpatients Undergoing Neuropsychological Assessment of their Lifestyle Decision-Making Capacity
Authors: Foran Amie , Mathias Jane L , Bowden Stephen C 
Published: October 2023

Abstract

Objective
Assessments of older inpatients’ capacity to make life-style decisions (lifestyle decision-making capacity; LS-DMC) are in high demand due to the increasing prevalence of neurodegenerative disorders and cognitive decline. Few studies have compared the characteristics and outcomes of inpatients who lack LS-DMC with those that don’t.

Method
Older inpatients (≥60 years) underwent neuropsychological assessment (n = 124) and were categorized as either lacking (64%) or not-lacking (36%) LS-DMC. The two groups were compared on information available to referring medical practitioners (demographics, living supports, medical history, Mini-Mental Status Examination; MMSE, and Frontal Assessment Battery; FAB) and the QuickSort cognitive screen. Inpatients’ need for legal hearings to resolve lifestyle decisions and additional living supports, and length of hospital stay and readmissions within 1-year were also investigated.

Results
The QuickSort differentiated between inpatients who lacked/didn’t-lack LS-DMC better than the MMSE, FAB, and other demographic and medical information. Most inpatients who lacked LS-DMC needed additional living supports (92%), with 71% discharged to live in supported care or with family. Length of hospitalization (M = 49.4 SD = 37.8) and 1-year readmission rates (62%) were comparable for both groups. Of the 40% of inpatients requiring legal hearings, most lacked LS-DMC (55%), refused additional living-supports (88%), had surrogate decision-makers appointed (73%), and were hospitalized longer (M = 61.5 SD = 34.1).

Conclusions
The QuickSort provided a more accurate and briefer screen for LS-DMC than the MMSE, FAB and other patient information, suggesting it might be useful for the early detection of inpatients who may lack LS-DMC and need additional living supports, legal hearings to resolve lifestyle decisions and extended hospitalizations.
A - 48 Neuropsychiatric Symptom Severity Predicts Rate of Executive Function Decline
Authors: Goodwin Grace J , Singsank Katie T , Maloy-Robertson Myjae , Tanner Denise , Salva Christine , Briley D A , John Samantha E 
Published: October 2023

Abstract

Objective
Neuropsychiatric symptoms (NPS) are considered diagnostic and prognostic indicators of dementia and are attributable to neurodegenerative processes. NPS are distressing for patients and caregivers and are associated with accelerated functional decline, hospitalization, and institutionalization. Evaluation of NPS effects on disease course may reduce patient and caregiver distress and support development of personalized treatments. We examined whether baseline NPS predicted the rate of executive function (EF) decline among older adults with cognitive impairment.

Method
Older adults (n = 1155) with cognitive impairment and four years of data were selected from the National Alzheimer’s Coordinating Center database v3-v3.2. Overall EF was estimated with a latent factor indicated by scores on Number Span Backward, Letter Fluency, and Trail Making-Part B. Strict temporal invariance was established. A curve of factors (CUFF) latent growth curve model was estimated to examine rate of change. Baseline NPS severity was entered as a predictor to examine its influence on the rate of change in EF over time.

Results
The predicted CUFF model exhibited good fit (χ2[69] = 201.46, p &lt; 0.001; CFI = 0.98, RMSEA = 0.04). EF significantly declined over four waves (slope = −0.53). NPS severity at baseline predicted decline in EF (β = 0.164, p = 0.001), such that those with greater NPS severity demonstrated a more rapid decrease in EF performance over time.

Conclusions
Increased NPS severity at baseline predicts more rapid decline in EF over four years. Findings highlight the prognostic value of NPS on cognitive decline and underscore the importance of targeting NPS at early disease stages. Future research will examine influence of individual NPS on rate of cognitive decline.