bluuebunny/crossref_metadata_2025_split huggingface dataset:
95 Examining the Utility of Demographically Adjusted Scores on the Community Screening Instrument for Dementia in Congolese Older Adults
Authors: Reyes Anny , De Wit Liselotte , Winston Molly R. , Hammers Dustin B. , Alonso Alvaro , Ikanga Jean 
Published: December 2023

Objective:Given the lack of comprehensive neuropsychological tools and neuropsychological services in Sub-Saharan Africa (SSA), cognitive screeners for dementia can be useful tools to screen for suspected dementia at the population level. However, most available screeners have not been developed or validated in SSA populations. The Community Screening Instrument for Dementia (CSID) was developed for cross-cultural use, and it has a cognitive testing component and informant interview. We have previously demonstrated that lower years of education and female sex are associated with lower scores on the CSID. Here, we examine the utility of demographically adjusted CSID scores in a community sample of Congolese older adults.Participants and Methods:354 participants (mean age=73.6±6.7, mean education (years) =7.3±4.7; 50% female) were randomly recruited in Kinshasa, Democratic Republic of the Congo, and completed the CSID and the Alzheimer's Questionnaire (AQ) to examine functional abilities. Raw scores were demographically adjusted for education and sex by adding 1 point for <12 years of education and 1 point for female. Cognitive impairment was classified as a total score below 25.5. Rates of impairment were compared between raw scores and demographically-adjusted scores. Demographic profiles were examined between both classificationsResults:Average raw CSID scores were 25.23 (SD=4.19) and average demographically-adjusted scores were 26.59 (SD= 4.09). Approximately 43.1% of the sample was impaired based on the raw CSID scores compared to 30.4% with the demographically-adjusted scores (x2= 12.334, p<.001). There was a higher proportion of females (n=95; 26.8%) classified as impaired with the raw SCID scores compared to the demographically-adjusted scores (n=62; 17.5%; x2= 8.87, p=0.003). Approximately 27.4% (n=97) of the participants classified as impaired with the raw SCID scores had primary education or less (i.e., 1-6 years) compared to 18.9% with the demographically-adjusted scores (n=67; (x2= 107.77, p<.001). Forty-five participants were re-classified as not impaired with the demographically-adjusted scores with the majority of these participants being female (73.3%), having primary education (66.7%), and being functionally unimpaired on the AQ (91.1% unimpaired).Conclusions:We demonstrate that raw scores on the CSID can lead to misclassification of impairment in females and in individuals with lower years of education. Demographically-adjusted scores on the CSID can help properly capture those with suspected dementia while reducing false positives. Given the effects of education and sex on performance, future studies should examine if demographically adjusted scores improve the sensitivity and specificity of the CSID in Congolese populations and compare its performance to other screening tools to determine the most appropriate screener for this population.
Symposium 06: Perioperative Neurocognitive Disorders With Considerations for Alzheimer’s Disease and Related Dementias
Authors: Price Catherine 
Published: December 2023

Summary AbstractLow- and high-risk surgical procedures are performed annually on more than half a million patients aged 65 and older. Yet, at least 20-35% of older patients undergoing surgery have undiagnosed signs of a mild to major neurocognitive disorder. These facts are alarming as older age, and preoperative memory/cognitive/affective vulnerabilities are significant predictors of postoperative cognitive complications such as delirium, cognitive decline, and mortality. Given the expected rate increase of neurodegenerative disorders in the populous, perioperative health care systems will face more significant numbers of individuals with undiagnosed Alzheimer’s disease and related dementias (ADRD) needing procedures with anesthesia due to severe health-related conditions (e.g., cardiac) or requesting surgeries for quality of life improvement (e.g., joint replacement). Through this symposium, attendees will learn from experts about the urgency of appreciating Perioperative Cognitive Disorders and the need for evidence-based perioperative ADRD assessment and intervention methods. Symposium speakers represent the International Society to Advance Alzheimer’s Research and Treatment’s “Perioperative Cognition and Delirium” Professional Interest Area. Lisbeth Evered, Ph.D., University of Melbourne, Australia, will begin the symposium by discussing the nomenclature for Perioperative Neurocognitive Disorders and the need to include neuropsychologists as part of the multidisciplinary diagnostic team. Robert Whittington, MD, University of California, Los Angeles, will present a bench-to-beside review of how tau protein is altered by perioperative factors and its potential relationship to cognition impairment after surgery and anesthesia. Miles Berger, M.D., Ph.D., Duke University, will present his team’s federally funded research showing how anesthesia is a stress test for the brain and the potential implications for incorporating intraoperative EEG monitoring into routine care. Kristin Hamlet, Ph.D., University of Florida, will round out the symposium by presenting a novel perioperative care environment where neuropsychologists identify at-risk undiagnosed ADRD patients before surgery for multidisciplinary care interventions. She will also highlight a cognitive “rescue” multidisciplinary intervention case. Attendees will leave the symposium with an improved understanding of Perioperative Neurocognitive Disorders and how neuropsychologists can work with other disciplines to advance evidence-based perioperative care for at-risk older adults electing surgery with anesthesia.
16 Does Cognitive Test Performance Upon Admission to Nursing Homes Predict Long Term Care Residents’ Psychological Functioning?
Authors: Ertle Emilee M , Mast Benjamin T , Simon Darby M , Meeks Suzanne 
Published: December 2023

Objective:The current study investigated whether older adults’ cognitive test scores at the time of long-term care nursing home admission are associated with psychological well-being over the first six months. We analyzed the link between Mattis Dementia Rating Scale (DRS-2) subscale scores and anxiety, depression, quality of life, and positive/negative affect.Participants and Methods:Participants were recently admitted long-term care residents from 13 nursing homes in the Louisville, KY area. Sixty-two older adults were administered the DRS-2 shortly after nursing home admission. Using a cutoff of less than 6 scaled score on the DRS-2, 52% of participants scored as cognitively impaired. Self-report measures of anxiety (RAID), depression (PHQ9), quality of life (QoL-AD), and positive/negative affect (Philadelphia Geriatric Center Affect Rating Scale) were collected at time of admission, and 3 and 6 months later.Results:The DRS-2 attention subscale significantly correlated with baseline depression symptoms. No other DRS-2 subscale or the DRS-2 total score correlated with anxiety, depression, quality of life, or affect ratings at admission. Baseline DRS-2 attention, initiation/perseveration, and memory had significant correlations with self-report measures at 3 and 6 months; these DRS-2 scores were selected for further analysis. Mixed ANOVAs found a significant main effect of group (impaired vs. not-impaired) for the initiation/perseveration subscale, memory subscale, and DRS-2 total score on negative affect; impairment in any of these domains was associated with lower reported negative affect at all three time points. There was no significant effect of cognitive scores on any other self-report measure. There was a significant, positive linear trend in quality of life over time. There was a significant quadratic trend in depression symptoms, with decreased depression reported at 3 months and increase at 6 months.Conclusions:Impaired performance on the DRS-2 was associated with lower negative affect over time. Cognitive impairment was not associated with anxiety, depression, quality of life, or positive affect. There appear to be reliable trends in some psychological factors regardless of cognitive scores, with an increase in quality of life over time and a temporary decrease in reported depression captured at 3 months. The relationship between cognitive impairment and negative affect should be interpreted with caution, as only 22 residents completed the affect self-report at all three time points. Overall, we found limited evidence of an association between cognitive scores at time of admission and self-reported psychological factors at 3 and 6 months.
31 Understanding Health Beliefs and Health Behaviors in Older Adults at Risk for Alzheimer’s Disease
Authors: Zakrzewski Jessica J. , Gemelli Zachary , Davis Jennifer , Korthauer Laura 
Published: December 2023

Objective:Given the aging population, there are significant public health benefits to delaying the onset of Alzheimer’s disease (AD) in individuals at risk. However, adherence to health behaviors (e.g., diet, exercise, sleep hygiene) is low in the general population. The Health Belief Model proposes that beliefs such as perceived threat of disease, perceived benefits and barriers to behavior change, and cues to action are mediators of behavior change. The aim of this study was to gain additional information on current health behaviors and beliefs for individuals at risk for developing AD. This information can then be used to inform behavioral interventions and individualized strategies to improve health behaviors that may reduce AD risk or delay symptom onset.Participants and Methods:Surveys were sent to the Rhode Island AD Prevention Registry, which is enriched for at-risk, cognitively normal adults (i.e., majority with a family history and/or an APOE e4 allele). A total of 177 individuals participated in this study. Participants were 68% female; 93% Caucasian and non-Hispanic; mean age of 69.2; 74% with family history of dementia; 40% with subjective memory decline. The survey included measures from the Science of Behavior Change (SoBC) Research Network to measure specific health belief factors, including individual AD risk, perceived future time remaining in one’s life, generalized self-efficacy, deferment of gratification, consideration of future consequences as well as dementia risk awareness and a total risk score for dementia calculated from a combination demographic, health and lifestyle behaviors.Results:Participants who were older had higher scores for dementia risk (r=0.78), lower future time perspective (r=-0.33), and lower generalized self-efficacy (r=-0.31) (all at p<0.001). Higher education correlated with higher consideration of future consequences (r=-.31, p<0.001) and lower overall dementia risk score (r=-0.23, p=0.006). Of all scales examined, only generalized self-efficacy had a significant linear relationship to both frequency (r2=0.06) and duration (r2=0.08) of weekly physical activity (p<0.001). Total dementia risk score also had significant linear relationships (r2=0.19) with future time perspective (p<0.001) and generalized self-efficacy (p=0.48).Conclusions:Overall, individuals who rated themselves higher in self-efficacy were more likely to exercise more frequently and for a longer duration. Individuals who had lower overall risk for dementia due to both demographic and behavioral factors were more likely to endorse higher self-efficacy and more perceived time remaining in their lives. Increasing self-efficacy and targeting perceived future time limitations may be key areas to increase motivation and participation in behavioral strategies to reduce AD risk. Developing individual profiles based on these scales may further allow for individually tailored intervention opportunities.
70 Childhood SES and Midlife CVD on Late-life Cognition
Authors: Adrien Tamare V. , Hirst Andrew , Tsai Ai-Lin , Chen Ruijia , Hayes-Larson Eleanor , Levy Shellie-Anne , Zahodne Laura , Crane Paul K. , Peterson Rachel , Gilsanz Paola , Turney Indira 
Published: December 2023

Objective:Cardiovascular disease (CVD) is a well-known risk factor for cognitive impairment and dementia, particularly among minoritized groups that have experienced a history of low childhood socioeconomic status (SES). Although previous literature has linked all levels of SES to varying degrees of stress exposure, children raised in higher SES households have more access to resources and services that encourage optimal growth and development than children who grow up in lower SES households. Given the disproportionate burden of dementia and cognitive deficits within minoritized groups, the present study examined whether childhood SES is associated with later life cognition among Black and White older adults and if this association persists after accounting for hypertension, a possible mediator of the relationship between childhood SES.Participants and Methods:1,184 participants were from the first wave of the STAR (n = 397 Black [Mage= 75.0 ±6.8 years]) and KHANDLE (386 Black [Mage= 76.2 ±7.2 years] and 401 White [Mage= 78.4 ±7.5 years]) cohorts. We used general linear models to examine the relationship between childhood SES and later-life executive function, semantic memory, and verbal memory scores, and midlife hypertension. Childhood SES was measured by self-reported perceived financial status (with participants given the following options: ‘pretty well off financially’, ‘about average’, ‘poor’, or ‘it varied’). These models were assessed in the full sample and also stratified by race.Results:In the full sample, childhood financial status was not associated with semantic memory, verbal episodic memory, or executive function. Financial status was associated with semantic memory in Black adults (β = -.124, t(771) = -2.52, p = .01) and this association persisted after accounting for hypertension (β = -.124, t(770) = -2.53, p = .01). There was no association between childhood financial status and later life semantic memory among White adults. There was no association between childhood financial status and later life verbal episodic memory or executive function in either Black or White adults in models with or without adjustment for hypertension.Conclusions:Our findings showed no relationship between childhood SES and cognition, except for semantic memory in Black participants; this relationship persisted after accounting for midlife CVD. Future analyses will assess both direct and indirect effects of more predictive measures of childhood SES on late-life cognition with midlife CVD as a mediator.
85 Predicting Conversion to Mild Cognitive Impairment in Parkinson’s Disease: a Random Forest Machine Learning Model Based on Parkinson’s Progression Markers Initiative Dataset.
Authors: Ronat Lucas A , Hanganu Alexandru 
Published: December 2023

Objective:Mild cognitive impairment (MCI) is common in Parkinson’s disease (PD). Recent scientific advances show that MCI in PD could also be impacted by neuropsychiatric symptoms (such as apathy, anxiety, depression), dopaminergic deficiency (more striatal denervation associated with MCI) and certain genotypes such as in APOE E4, MAPT H1 or SNCA C/C carriers. We used a python-based random forest machine-learning algorithm (scikit-learn) in order to evaluate the factors that are mostly involved in the MCI conversion over a 5-year follow-up period.Participants and Methods:Baseline data of healthy individuals and participants with Parkinson’s disease were extracted from the PPMI dataset. All participants also had the evaluations of their cognitive status, neuropsychiatric symptoms (hallucinations, anxiety, apathy, depression, sleepiness, impulse control disorders and rapid eye movement behaviors), dopaminergic uptake (DaT-Scan) and genetic status (APOE, MAPT and SNCA) at baseline and after 5 years. Baseline demographic (age, sex, education years) and clinical values (duration of disease, age of onset) were also included in the model. The algorithm defined (1) the most important variables in predicting MCI, (2) the threshold values to distinguish “converting” vs. “non-converting” subgroups.Results:The algorithm showed that (1) age onset of disease, (2) dopaminergic uptake, (3) age, (4) anxiety, and (5) years of education were the most important factors in predicting MCI over 5 years. Among the factors involved in predicting conversion to MCI, a lower number of years of education associated with lower dopaminergic uptake in the right putamen increased the risk of conversion. Individuals with more years of education are at higher risk of conversion if they have symptoms of depression, anxiety, and lower right striatal dopamine uptake. Other factors that were involved in increasing the risk, were the presence of sleepiness and the presence of rapid eye movement disorders. Interestingly, the genetic factors were of negligible importance and were not considered by the algorithm. Finally, the model showed an accuracy of classification of participants (converters vs. non-converters) of 92.53%.Conclusions:Random forest algorithm shows that (1) depression and anxiety are probably important factors for MCI conversion; (2) years of education influences the conversion; (3) presence of sleepiness and rapid eye movement increases the risk of conversion to MCI. Since the algorithm considers the disease’s age onset, but not the diagnosis of individuals, it would be necessary to generate a model for each group (Healthy on the one hand, Parkinson’s on the other).
21 Socioeconomic Influences on Instrumental Activities of Daily Living in Older Black Adults
Authors: Davis Katrail , Calamia Matthew 
Published: December 2023

Objective:Socioeconomic factors, spanning from childhood to mid-adulthood, were examined in an older adult Black cohort to better understand their influence on the ability to complete instrumental activities of daily living. Previous research with socioeconomic factors has primarily focused on cognitive changes rather than everyday functioning. Additionally, research that has been conducted examining functioning has been with predominantly White samples.Participants and Methods:Data on Black participants were obtained from Rush University’s Memory and Aging Project (MAP), Minority Aging Research Study (MARS), and the Latino CORE study (CORE). Participants (n = 1,273) were predominately female (79.9%) and ranged in age from 54 - 97 years (M = 73 years old). Participants were stratified into two groups based on their consensus diagnosis: no cognitive impairment (NCI; 76.1%) and mild cognitive impairment (MCI). Linear regression analyses were utilized on each group to examine predictors of decreased functioning in instrumental activities of daily living. Predictors included income levels during childhood, at age 40, and current income level. Additionally, sex, education level, and parental education levels were included in the models.Results:Impairment of functioning in instrumental activities of daily living was predicted by the age of the participants at the time of their visit in both NCI and MCI groups (p < 0.001). Current income levels for the NCI participants significantly predicted functioning in IADLs (p < 0.001). This relationship was not present for the MCI group, rather, total family income at age 40 better predicted functioning (p = 0.043).Conclusions:Previous research has found that early and mid-life socioeconomic circumstances have cascading and complex effects on late life cognition. These same associations may be applicable to functioning with instrumental activities of daily living as they are with cognition. In the present study, current income levels were influential on the functioning of participants without cognitive impairment. Although, when examining those with mild cognitive impairment, mid-life economic circumstances were more impactful on everyday functioning. While the economic status of both groups were predictors of functioning, these findings highlight the importance of better understanding socioeconomic factors across the lifespan and all levels of cognition.
76 More Than One Way to Skin a Cortex: A Meta-Analysis Comparing Neuroimaging and Personality Testing
Authors: Asencio-Ortiz Paola N. , Ikonomou Vasilios C. , Harrell Murphy N. , Maladkar Rhea , Hill Benjamin D. 
Published: December 2023

Objective:Neuroimaging is commonly used in medicine to identify neuropathology and is widely considered to be a reliable and valid diagnostic modality. Personality testing is commonly used to identify psychopathology but is generally perceived to have less clinical efficacy than neuroimaging. The purpose of the current study was to compare the clinical efficacy of personality tests to neuroimaging using meta-analysis.Participants and Methods:Multiple databases were searched for original research utilizing either personality tests or neuroimaging. The search interval covered articles published within the last 10 years. Studies were selected based on the criteria of having a clinical group and a healthy control sample with a reported diagnostic outcome. For this meta-analysis, neuroimaging studies focusing on diagnostic utility for Alzheimer’s dementia were included. Personality testing studies were included if they broadly reported a clinical outcome, due to fewer studies in this area. Studies were coded using a complex multi-comparison, outcome, and subgroup schema, and were analyzed under random-effects modeling.Results:Out of the 240 studies identified for the personality domain, 13 were selected for the meta-analysis. Out of 6522 studies identified for the neuroimaging domain, 21 studies were selected for the meta-analysis. Results indicated a significant difference between the neuroimaging and personality testing effect sizes. Specifically, neuroimaging [Hedge’s g = -1.623, 95% CI = -1.973 to -1.273, p<.001] yielded a greater effect size in comparison to the personality tests effect size [Hedge’s g = -0.658, 95% CI = -0.751 to -0.565, p<.001]. The effect size for clinical utility of neuroimaging was close to double that of the effect for personality tests diagnostic utility.Conclusions:Findings from this meta-analysis showed a significant difference in the effect sizes obtained from neuroimaging studies compared to the studies of personality tests. While both neuroimaging and personality testing demonstrated meaningful clinical utility, neuroimaging studied had a larger effect size.