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Objective Multiple sclerosis (MS) is a debilitating inflammatory and neurodegenerative disease which commonly involves cognitive dysfunction. Magnetic resonance imaging (MRI) studies have shown that patients with MS (pwMS) have diffuse patterns of brain atrophy, however, the relationship between the presentation of cognitive dysfunction and brain tissue loss remains understudied. Given the integral function of thalamus as a central nervous system relay center and its involvement in various brain circuits, thalamic atrophy may play a key role in the development and progression of cognitive dysfunction. The purpose of this study is to examine the relationship between cognitive impairment in pwMS and thalamic atrophy. Methods A total of 121 pwMS who had neuropsychological testing and quantitative MRI within 1 year of each were retrospectively identified. Grouped LASSO linear regression with 10-fold cross validation was used to estimate each neuropsychological test score with thalamic volume as the focal predictor and all other demographic and MRI metrics as covariates. Results Rates of impairment ranged from 19% to 44%. Results showed notable associations between thalamic volume and Symbol Digit Modalities Test (β  = 0.11), Brief Visuospatial Memory Test, delayed (β  = 0.12), California Verbal Learning Test, delayed and total (β  = 0.24 and β  = 0.15 respectively), and Trail Making Test Part A (β  = −0.01), after adjusting for covariates. Conclusions These findings demonstrate an independent association between thalamic volumes and processing speed and memory performance, after accounting for demographic, clinical, and other MRI variables, among pwMS. [ABSTRACT FROM AUTHOR]

Objectives In the present study, we investigated the pattern of cognitive difficulties in hospitalized patients due to COVID-19 and its relation with the clinical features of the disease. Method Forty hospitalized patients with COVID-19 [mean age: 46.98 years (SD = 9.30); mean years of education: 13.65 (SD = 2.07) and 40 sex-, age- and education-matched healthy controls completed a set of neuropsychological measures administered by telephone. Participants' premorbid intellectual skills and patients' anxiety and depressive symptoms were also evaluated. The association of COVID-19-related biomarkers [oxygen saturation (SpO2), C-reactive protein (CRP), D-dimer and ferritin levels] with neuropsychological performances was examined with a series of hierarchical multiple linear regression analyses, after controlling for demographic and clinical characteristics, psychological distress and premorbid intellectual skills. Results Patients performed worse than healthy participants on measures of verbal memory, attention and working memory. SpO2 levels were associated with patients' performance on verbal and working memory, whereas CRP levels were associated with performance on verbal memory, abstract reasoning and verbal fluency, after controlling for demographic and clinical characteristics. Ferritin levels predicted performance on the verbal fluency test, whereas D-dimer levels did not predict any of the neuropsychological measures. Conclusions Cognitive difficulties in verbal memory, attention and working memory were noted in patients with COVID-19. Markers of hyperinflammation predicted patients' performance above and beyond demographic characteristics, duration of symptoms, length of hospitalization and psychological distress. [ABSTRACT FROM AUTHOR]

Objective Sustaining concussions has been linked to health issues later in life, yet evidence for associations between contact sports exposure and long-term cognitive performance is mixed. This cross-sectional study of former professional American-style football players tested the association of several measures of football exposure with later life cognitive performance, while also comparing the cognitive performance of former players to nonplayers. Methods In total, 353 former professional football players (M age = 54.3) completed both (1) an online cognitive test battery measuring objective cognitive performance and (2) a survey querying demographic information, current health conditions, and measures of past football exposure, including recollected concussion symptoms playing professional football, diagnosed concussions, years of professional play, and age of first football exposure. Testing occurred an average of 29 years after former players' final season of professional play. In addition, a comparison sample of 5,086 male participants (nonplayers) completed one or more cognitive tests. Results Former players' cognitive performance was associated with retrospectively reported football concussion symptoms (rp = −0.19, 95% CI −0.09 to −0.29; p  < 0.001), but not with diagnosed concussions, years of professional play, or age of first football exposure. This association could be due to differences in pre-concussion cognitive functioning, however, which could not be estimated based on available data. Conclusions Future investigations of the long-term outcomes of contact sports exposure should include measures of sports-related concussion symptoms, which were more sensitive to objective cognitive performance than other football exposure measures, including self-reported diagnosed concussions. [ABSTRACT FROM AUTHOR]

Objective The Benton Visual Form Discrimination Test (VFDT) is a commonly used measure of visual discrimination and visual recognition memory and has shown promise in distinguishing between different levels of cognitive impairment. We assess the predictive diagnostic utility of the VFDT in a sample of older Veterans with cognitive concerns. Method Subjects included a total of 172 mostly male Veterans over the age of 64 (mean = 76.0; SD  = 7.6) recruited from a VA clinic specializing in neuropsychological assessment of older Veterans. The clinical sample included 56 subjects diagnosed with Major Neurocognitive Disorder, 74 diagnosed with Mild Neurocognitive Disorder, and 42 with No Neurocognitive Impairment. Impairment categories were modeled in separate multinomial logistic regressions with two versions of the VFDT as predictors: the Visual Form Discrimination Test-Recognition Subtest (VFDT-Rec) test (visual recognition memory) and the Visual Form Discrimination Test-Matching Subtest VFDT-Mat test (visual form discrimination). Years of education were included as a covariate. Results After adjusting for education, higher VFDT-Rec total scores were associated with lower odds of being categorized with a greater degree of cognitive/functional impairment (OR 0.66–0.83, p  < .001). VFDT-Mat scores showed a similar pattern, but only reached statistical significance for the Major versus No Neurocognitive Impairment (OR = 0.77, p  = .0010) and Major versus Mild comparisons (OR = 0.89, p  = .0233). Conclusions The VFDT may enhance the confidence of differential diagnosis of dementia in older adult Veterans. Formal education-adjusted norms need to be established for clinical use. [ABSTRACT FROM AUTHOR]

ObjectiveRecall and recognition memory abilities are known to decline with increasing age, yet much of the evidence stems from studies that used simple measures of total target recall or recognition. The California Verbal Learning Test-Second Edition (CVLT-II) includes a new measure of recall discriminability that is analogous to recognition discriminability. These discriminability measures yield more thorough assessments of recall and recognition by accounting for intrusion and false positive errors, respectively. Research also has shown that women outperform men on verbal episodic memory tests. However, gender differences in recall and recognition discriminability and the age-by-gender interaction on these constructs have not been thoroughly examined.MethodCognitively healthy adults (N = 223) 18-91 years in age completed the CVLT-II. Multiple regression analyses were conducted to examine effects of age, gender, and the age-by-gender interaction on CVLT-II subtypes of recall and recognition discriminability.ResultsDiscriminability scores decreased with increasing age, and women outperformed men. There was an age-by-gender interaction on total, immediate, and free recall discriminability - the negative association between age and scores was stronger in men than in women. Exploratory analyses revealed an inverted U-shaped relationship between age and recall discriminability scores in women.ConclusionsThe present findings support and expand upon the extant literature on aging, gender, and verbal episodic memory, plus describe a novel age-by-gender interaction intrinsic to subtypes of recall discriminability. The findings suggest that methods traditionally used to assess recognition memory function can be used to elucidate age- and gender-related changes in recall ability across the adult lifespan.

Objective Hematopoietic stem cell transplantation (HSCT) is an effective treatment for pediatric high-risk acute lymphoblastic leukemia (ALL) survivors. Still, both the disease and treatment often impair cognitive and motor functions, and HSCT is a risk factor for long-term deficits. The study aimed at investigating the effect of HSCT on cognitive, motor, and visual-motor functions. Two groups were enrolled: The first group received HSCT treatment, and the second group did not. Method Sixty-five ALL survivors participated in the study (ages: 7–17). Twenty-one of participants who underwent HSCT comprised the first group. We implemented tests from Cambridge Neuropsychological Test Automated Battery, Wechsler Intelligence Scale for Children, and Test of Memory and Learning to estimate cognitive functions, Bruininks-Oseretsky Test of Motor Proficiency to estimate motor functions, and Beery-Buktenica Developmental Test to estimate visual perceptual and visual motor functions. As independent variables for analysis we chose group (HSCT+/−), age at diagnosis, and current age. Results MANCOVA test demonstrated significant effect of current age on cognitive functions (partial η2 = 0.55) and significant effect of HSCT treatment on motor functions (partial η2 = 0.19). Current age also had moderate effect on visual-motor functions (partial η2 = 0.11). Significant differences were found in most cognitive, motor, and visual-motor tests' results between the two groups, with HSCT+ group demonstrating poorer performance. Conclusions This study has several limitations, including small sample size, potentially mismatched groups, imbalanced gender ratio. Still, the findings underline the importance of considering late effects of HSCT, and age when designing rehabilitation programs. [ABSTRACT FROM AUTHOR]

Background Evidence suggests that select hippocampal subfields are implicated in the initial stages of Alzheimer's disease (AD) and are selectively involved in objective memory. Less is known whether subfields are associated with informant-reported memory difficulties of individuals with a diagnosis of mild cognitive impairment (MCI). Method Data from 56 participants with a diagnosis of amnestic MCI were included in the present study. To test whether FreeSurfer derived hippocampal subfields (CA1–4, subiculum, presubiculum, and dentate gyrus) were associated with objective (learning and delayed recall) and informant-reports of memory difficulties, we used multiple linear regression analysis. Subfields were adjusted for total intracranial volume, and age, sex, and years of education were included as covariates in all models. Results Larger presubiculum, subiculum, and CA4/dentate gyrus volumes were associated with higher delayed recall scores, and larger subiculum and CA4/dentate gyrus volumes were associated with fewer informant-reports of memory difficulties. There were no statistically significant associations between subfields and learning scores. Discussion Findings from the present study support the idea that difficulties with memory-dependent everyday tasks in older adults with MCI may signal a neurodegenerative process while increasing understanding of subfields correlates of these memory-specific functional difficulties. Continued investigations into identifying patterns of subfield atrophy in AD may aid early identification of those at higher risk of dementia conversion while advancing precision medicine. [ABSTRACT FROM AUTHOR]

Objective Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) frequently co-occur and are associated with neurocognitive intra-individual variability (IIV) and difficulty with prospective memory (PM). The current study aimed to examine associations between IIV and PM in this comorbid group. Method Fifty veterans with a history of blast mTBI and current comorbid PTSD completed a standardized neurocognitive battery to measure IIV, and the Memory for Intentions Screening Test measuring PM. Results Adjusting for age, education, and race, higher IIV was associated with poorer time-based PM (p  < .001, f2  = .34), but not event-based PM. In a subset of the sample with self-report data, higher IIV was associated with poorer self-reported retrospective memory, but not PM. Conclusions Cognitive variability on a standardized neuropsychological battery was associated with strategically demanding PM, which is an ecologically relevant ability and highlights the possible connection between subtle cognitive difficulties in-clinic and those experienced in daily life. [ABSTRACT FROM AUTHOR]

Objective Strict competency frameworks exist for training in, and provision of, clinical neuropsychological assessment practice. However, as in all disciplines, daily clinical practice may drift from the gold standard practice without routine monitoring and audit. A simple-to-use, but thorough and evidence-based audit tool has been developed to facilitate the tracking, maintenance, and discussion of best practice over time. Method A literature search and liaison with experienced neuropsychology colleagues did not unearth any pre-existing audit standards. Therefore, 39 new standards were generated, which were guided by best practice literature and clinical neuropsychology colleague discussions, to form the proposed self-assessment audit tool. Due to the diverse nature of services, both core and supplementary standards are proposed to enable the audit to be tailored to suit individual services' needs. Results During its development, the tool has so far been trialed in two U.K. National Health Service clinical services in different localities, on three occasions, with a total patient population of N  = 78 in order to refine the standards and to generate practice recommendations. Conclusions This audit tool is presented for services to self-assess their neuropsychological assessment practice. The authors plan to take this work forward with the British Psychological Society's Division of Neuropsychology as a policy document for self-assessment and peer review. Other potential developments include contributing to clinical neuropsychology training tools and refining audit standards for use more widely, such as in pediatric services, or internationally with diverse populations. [ABSTRACT FROM AUTHOR]

Objective There is a growing recognition that the use of conventional norms (e.g. age, sex, years of education, race) as proxies to capture a broad range of sociocultural variability on cognitive performance is suboptimal, limiting sample representativeness. The present study evaluated the incremental utility of family income, family conflict, and acculturation beyond the established associations of age, gender,maternal years of education, and race on cognitive performance. Method Hierarchical linear regressions evaluated the incremental utility of sociocultural factors on National Institutes of Health Toolbox in a nationally representative sample of pre-adolescent children (n =  11,878; M age = 10.0 years; Adolescent Brain Cognitive Development Study). A regression-based norming procedure was implemented for significant models. Paired sample t -tests were used to compare original and newly created demographically corrected T -scores. Results Nearly all regression models predicted performance on the NIH-TB subtests and composite scores (p  < .005). Greater family income and lower family conflict predicted better performance, although the effect sizes were small by traditional standards. Acculturation scores did not explain additional variance in cognitive performance. Lastly, there were no significant differences between the original and newly created demographically corrected T- scores (M diff < 0.50). Conclusions The present study highlights that, although family income, family conflict, and acculturation have been shown to routinely influence cognitive performance in preadolescent children, the NIH-TB appears to be highly robust to individual differences in sociocultural factors in children between ages 9 and 10. Contextual and temporal implications of the present results are discussed. [ABSTRACT FROM AUTHOR]

Objective The Cambridge Neuropsychological Test Automated Battery (CANTAB) is widely used in research and clinical settings. However, little is known about the use of the CANTAB in the local aging context. This study aimed to develop normative data for various CANTAB measures in community-living older adults in Singapore. Normative data were built using the regression-based approach. A secondary aim was to examine the concurrent validity of CANTAB measures with their traditional neurocognitive test counterparts. Method A total of 210 older adults (Mage = 67.27 years, SD = 5.45) from an existing cohort study completed standard neurocognitive tests and a CANTAB battery. A total of 160 were normal aging, 46 diagnosed with Mild Cognitive Impairment (MCI), and one diagnosed with Dementia. Older adults with MCI and Dementia were not included in the calculation of norms but were included in other analyses. For the CANTAB battery, regression-based norms were generated for each CANTAB measure, with age, sex, and education included as covariates. Concurrent validity was examined by correlating the CANTAB measures with their traditional neurocognitive counterparts. Results As expected, performance across most CANTAB measures declined significantly with increasing age and decreasing education levels. There were no significant effects of sex on most CANTAB measures. Our study also showed that some CANTAB measures demonstrated good concurrent validity as they significantly correlated with their traditional neurocognitive test counterparts. Conclusions We have developed age, sex, and education-specific CANTAB norms for use in the local aging context. The advantages and challenges of using the CANTAB in the local aging context are discussed. [ABSTRACT FROM AUTHOR]

Objective This study examined the degree to which verbal and visuospatial memory abilities influence performance validity test (PVT) performance in a mixed clinical pediatric sample. Method Data from 252 consecutive clinical pediatric cases (M age=11.23 years, SD =4.02; 61.9% male) seen for outpatient neuropsychological assessment were collected. Measures of learning and memory (e.g. The California Verbal Learning Test-Children's Version; Child and Adolescent Memory Profile [ChAMP]), performance validity (Test of Memory Malingering Trial 1 [TOMM T1]; Wechsler Intelligence Scale for Children-Fifth Edition [WISC-V] or Wechsler Adult Intelligence Scale-Fourth Edition Digit Span indices; ChAMP Overall Validity Index), and intellectual abilities (e.g. WISC-V) were included. Results Learning/memory abilities were not significantly correlated with TOMM T1 and accounted for relatively little variance in overall TOMM T1 performance (i.e. ≤6%). Conversely, ChAMP Validity Index scores were significantly correlated with verbal and visual learning/memory abilities, and learning/memory accounted for significant variance in PVT performance (12%–26%). Verbal learning/memory performance accounted for 5%–16% of the variance across the Digit Span PVTs. No significant differences in TOMM T1 and Digit Span PVT scores emerged between verbal/visual learning/memory impairment groups. ChAMP validity scores were lower for the visual learning/memory impairment group relative to the nonimpaired group. Conclusions Findings highlight the utility of including PVTs as standard practice for pediatric populations, particularly when memory is a concern. Consistent with the adult literature, TOMM T1 outperformed other PVTs in its utility even among the diverse clinical sample with/without learning/memory impairment. In contrast, use of Digit Span indices appear to be best suited in the presence of visuospatial (but not verbal) learning/memory concerns. Finally, the ChAMP's embedded validity measure was most strongly impacted by learning/memory performance. [ABSTRACT FROM AUTHOR]

Objective To investigate the differential ability of the "Test Relaties Abstracte Concepten" (TRACE), a Dutch test for abstract semantic knowledge, in frontotemporal dementia (FTD). Methods The TRACE was administered in patients with behavioral variant FTD (bvFTD; n  = 16), nonfluent variant (nfvPPA; n  = 10), logopenic variant (lvPPA; n  = 10), and semantic variant primary progressive aphasia (svPPA; n  = 9), and controls (n  = 59). We examined group differences, performed correlational analyses with other neuropsychological tests and investigated discriminative ability. We compared the TRACE with a semantic association test for concrete stimuli (SAT). Results All patient groups, except nfvPPA, performed worse on the TRACE than controls (p  < .01). svPPA patients performed worse than the other patient groups (p  < .05). The TRACE discriminated well between patient groups, except nfvPPA, versus controls (all p  < .01) and between svPPA versus other patient groups with high sensitivity (75–100%) and specificity (86%–92%). In bvFTD and nfvPPA the TRACE correlated with language tests (ρ  > 0.6), whereas in svPPA the concrete task correlated (ρ  ≥ 0.75) with language tests. Patients with bvFTD, nfvPPA and lvPPA performed lower on the TRACE than the SAT (p  < .05), whereas patients with svPPA were equally impaired on both tasks (p  = .2). Discussion We demonstrated impaired abstract semantic knowledge in patients with bvFTD, lvPPA, and svPPA, but not nfvPPA, with svPPA patients performing worse than the other subtypes. The TRACE was a good classifier between each patient group versus controls and between svPPA versus other patient groups. This highlights the value of incorporating semantic tests with abstract stimuli into standard neuropsychological assessment for early differential diagnosis of FTD subtypes. [ABSTRACT FROM AUTHOR]

Introduction Computerized neuropsychological testing is a cornerstone of sport-related concussion assessment. Female soccer players are at an increased risk for concussion as well as exposures to repetitive head impacts from heading a soccer ball. Our primary aim was to examine factorial validity of the Automated Neuropsychological Assessment Metrics (ANAM) neuropsychological test battery in computing the multiple neurocognitive constructs it purports to measure in a large cohort of interscholastic female soccer players. Methods Study participants included 218 interscholastic female soccer players (age = 17.0±0.7 year; mass = 55.5±6.8 kg; height = 164.7±6.6 cm) drawn from a large (850+) prospective database examining purposeful heading from four area high schools over a 10-year period. The ANAM-2001 measured neurocognitive performance. Three methods were used to identify integral constructs underlying the ANAM: (a) exploratory factor analysis (EFA), (b) first-order confirmatory factor analysis (CFA), and (c) hierarchical CFA. Results Neuropsychological phenomena measured by the ANAM-2001 were best reproduced by a hierarchical CFA organization, composed of two lower level factors (Simple Reaction Time , Mental Efficiency) and a single, general composite. Although the ANAM was multidimensional, only the composite was found to possess sufficient construct dimensionality and reliability for clinical score interpretation. Findings failed to uphold suppositions that the ANAM measures seven distinct constructs, or that any of its seven tests provide unique information independent of other constructs, or the composite, to support individual interpretation. Conclusions Outcomes infer the ANAM possesses factorial-validity evidence, but only scores from the composite appear to sufficiently internally valid, and reliable, to support applied use by practitioners. [ABSTRACT FROM AUTHOR]

Objective Mild cognitive impairment is the main risk factor of dementia. Previous evidence has claimed that subjects with memory disturbances associated with impairment of other cognitive domains (multiple domain amnesic MCI) are at the highest risk of developing dementia. To date, a shared definition of amnesic MCI multiple domain (aMCI-MD) is still lacking. Method 163 subjects with aMCI were enrolled and followed-up for 2 years. They underwent a baseline comprehensive neuropsychological battery. The cut-off point for each test was set at 1, 1.5, and 2 SD below the mean obtained in normative studies; aMCI-MD was defined as the occurrence of abnormal scores on at least one, two, or three tests not assessing memory. The Episodic Memory Score (EMS), that measures the severity of memory impairment, was determined. Logistic regressionand Cox's proportional hazard risk models were carried out. The adjunctive effect of the definitions of aMCI-MD on the severity of memory impairment was assessed. Results Fifty-four subjects progressed to dementia. Only restrictive definitions of aMCI-MD (at least three tests below 1.5 SD; at least two tests below 2 SD) predicted conversion to dementia in both logistic regression and survival analysis. None of the conditions showed a significant adjunctive effect on the EMS. Conclusions The predictive effect of impairment in tests assessing cognitive domains other than memory depends on its psychometric definition. The use of a restrictive definition would be of some usefulness, but the adjunctive effect of such a definition on an integrated analysis of memory impairment may be questionable. [ABSTRACT FROM AUTHOR]

Objective The present study explored the relationship between specific types of postconcussion symptoms and cognitive outcomes in student–athletes with chronic concussion symptoms. Method Forty student–athletes with chronic concussion symptoms were given a battery of neuropsychological tests and rated themselves on a variety of postconcussion symptoms, which included the following factors derived from prior work: Physical, Sleep, Cognitive, Affective, and Headache. Cognitive outcomes included performance on composites for the memory and attention/executive functioning speed tests, respectively. The following covariates were also explored: Sex, depression symptoms, number of previous concussions, and time since injury. Results Headache was the only individual symptom factor that significantly (p  < .05) predicted worse attention/executive functioning performance. None of the symptom factors were significantly related to memory performance over and above the variable of time since injury, such that longer time since injury was related to worse memory performance. Conclusion Comparable to work examining symptom predictors of cognitive outcomes in acutely concussed samples, headache predicted worse attention/executive functioning performance. Additionally, we found that the longer athletes had been symptomatic since injury, the "worse" their memory functioning. Understanding how headache and the length of time an individual is symptomatic are related to cognitive outcomes can help inform treatment and recommendations for athletes with prolonged symptom recovery. [ABSTRACT FROM AUTHOR]

Objective The principal goal of this study was to produce adjusted normative data for European Portuguese native speakers from Portugal on 2 neuropsychological tests widely used to assess learning and memory: the Hopkins Verbal Learning Test-Revised (HVLT-R) and the Rey–Osterrieth Complex Figure Test (ROCF). Method The study included 300 individuals aged 18–92 years (M  = 50.4, SD  = 21.2), who had educational backgrounds ranging from 3 to 25 years (M  = 10.4, SD  = 5.2). Results Age, education, and sex were significantly associated with HVLT-R and ROCF performance. These demographic variables accounted for 61% of the variance in HVLT-R total recall, 54% in HVLT-R delayed recall, 18% in HVLT-R recognition, 55% in ROCF copy, and 39% in ROCF immediate recall. Conclusions The normative data are presented as regression-based algorithms to adjust direct and derived test scores for age, education, and sex. This study provides a calculator of normative data derived from the results of the regression models. [ABSTRACT FROM AUTHOR]

Aging and HIV are both risk factors for memory deficits and declines in real-world functioning. However, we know little about the profile of memory deficits driving instrumental activities of daily living (IADL) declines across the lifespan in HIV. This study examined 145 younger (

Objective Assessment of individuals from diverse ethnic backgrounds is a major challenge in current clinical neuropsychology as most neuropsychological tests are biased by linguistic, educational, and cultural differences. The aim of this study was to examine the effects of acculturation on the newly developed European Cross-Cultural Neuropsychological Test Battery. Method The study was a cross-sectional study carried out in Copenhagen, Denmark. Neuropsychological test performances of a Danish sample were compared to a culturally and linguistically diverse sample, and the effects of a number of acculturation variables were assessed using group comparisons, correlation analyses, and regression analyses. Results A total of 152 participants were included in the study: 26 were native-born monolingual Danes and 126 had culturally and linguistically diverse backgrounds: 66 were immigrants from Turkey, 41 from Poland, and 19 from former Yugoslavia. In direct comparison, the only significant difference between the Danish and culturally and linguistically diverse samples was found on Animal Fluency. However, within the culturally and linguistically diverse sample, higher and lower acculturated groups significantly differed on several measures. The main associations between neuropsychological test performance and acculturation variables were found on measures loading on processing speed and executive function. Conclusions Overall, only limited effects of acculturation were found on the European Cross-Cultural Neuropsychological Test Battery. However, administering cross-cultural measures in the preferred language may not be sufficient to resolve challenges in cross-cultural assessment of processing speed and executive function as concept of speed and speeded performance is highly culture dependent. [ABSTRACT FROM AUTHOR]

Objectives Status epilepticus (SE) may lead to or worsen cognitive dysfunction. Few studies have evaluated magnitude and profile of cognitive dysfunction in patients after SE. Characterization of cognitive deficits may be important for rehabilitation and follow-up. We assessed cognitive function in a consecutive, non-selected group of relatively healthy survivors with a comprehensive neuropsychological test battery. Methods A total of 33 patients (24 men, 9 women; mean age 54,9 years, mean education 11,8 years) were tested 1 year after SE with Wechsler Adult Intelligence Scale Fourth edition (WAIS-IV), Rey Auditory Verbal Learning Test, subtests from the Wechsler Memory Scale–Revised, Phonemic and Semantic word list generation, and the Halstead-Reitan Battery. Premorbid IQ was estimated with a Norwegian version of the National Adult Reading Test (NART). Results were compared to published norms. Regression analyses and independent groups t -tests were performed to assess the influence of background variables. Results Mean performance generally was about one standard deviation below average. Full scale IQ (WAIS-IV) was significantly reduced compared to estimated premorbid IQ (NART). Negative influence on cognition of brain lesions visible on computed tomography or magnetic resonance imaging and duration of SE >30 min was shown by group comparisons. Conclusions SE represents a marker for possible cognitive dysfunction, and follow-up with neuropsychological assessment and cognitive rehabilitation seems warranted in most patients. Complex problem-solving abilities with high general sensitivity to brain impairment showed the most prominent reduction. Otherwise, no specific profile of domain affection was found. Structural brain lesions and duration of SE over 30 min represent risk factors for cognitive deficit. [ABSTRACT FROM AUTHOR]

Objective Neurological conditions, such as multiple sclerosis and stroke, may impair memory and language. A technique called retrieval practice (RP) may improve memory and language outcomes in such clinical populations. The RP effect refers to the finding that retrieving information from memory leads to better long-term retention than restudying the same information. Although the benefits of RP have been repeatedly observed in healthy populations, less is known about its potential applications in cognitive rehabilitation in clinical populations. Here we review the RP literature in populations with acquired memory and language impairments. Method Systematic searches for studies published before January 2020 were conducted on Elsevier, PsycARTICLES, PsycINFO, Pubmed, Web of Science, and Wiley Online Library, with the terms "retrieval practice"/"testing effect" and "cognitive rehabilitation". In addition, backward and forward snowballing were used to allow the identification of important publications missed by the initial search. Studies were included if they were peer-reviewed, empirical work in which memory or language outcome measures were compared between an RP condition and a re-exposure-control condition in patients with acquired memory or language impairments. Results Sixteen articles fulfilled the inclusion criteria. Studies from memory-impaired samples were relatively homogeneous with respect to experimental protocols and materials and favored RP over control conditions. The results were mostly positive despite short retention intervals and predominantly single-session designs. Similarly, studies from language-impaired samples focused on naming impairments in patients with aphasia and also favored RP over name repetition. Conclusion The results indicate that RP is a viable technique for cognitive rehabilitation. [ABSTRACT FROM AUTHOR]

Objective To identify the available measures to assess prospective memory (PM) abilities, to describe their content, and to quantitatively summarize the effects of various diseases on PM depending on the type of assessment Method Three databases (PsycInfo, PsycArticles and PubMed) were searched up to June 2019 to identify the existing PM measures. The identified PM measures were classified according to the type of assessment: test batteries, single-trial procedures, questionnaires, and experimental procedures. The characteristics and psychometric properties were presented. PM performances were compared between patients with various diseases and controls depending on the type of assessment. Results Most of the 16 measures identified evaluated both event- and time-based tasks, were linked to functional outcomes, showed empirical evidences regarding validity and reliability, and provided parallel versions. To a slightly lesser extent, few measures provided normative data, translations/adaptation into another language, cutoff scores for diagnostic purposes, qualitative scoring, parallel version, and external aids during the test. Compared to healthy controls, patients had significantly poorer performances when PM was assessed with experimental procedures. Heterogeneous data precluded the interpretation of a summary effect for test batteries, single-trial procedures, and questionnaires. Planned subgroup analyses indicated consistent PM impairment for patients compared to controls for three test batteries. However, PM complaints did not differ between patients and controls. Conclusions These results suggest that the use of PM test batteries and experimental procedures are relevant for detecting performance variations in diverse clinical populations. Clinical implications and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Objectives It has been challenging to identify cognitive markers to differentiate healthy brain aging from neurodegeneration due to Alzheimer's disease (AD) that are not affected by age and education. The Short-Term Memory Binding (STMB) showed not to be affected by age or education when using the change detection paradigm. However, no previous study has tested the effect of age and education using the free recall paradigm of the STMB. Therefore, the objective of this study was to investigate age and education effects on the free recall version of the STMB test under different memory loads. Methods 126 healthy volunteers completed the free recall STMB test. The sample was divided into five age bands and into five education bands for comparisons. The STMB test assessed free recall of two (or three) common objects and two (or three) primary colors presented as individual features (unbound) or integrated into unified objects (bound). Results The binding condition and the larger set size generated lower free recall scores. Performance was lower in older and less educated participants. Critically, neither age nor education modified these effects when compared across experimental conditions (unbound v. bound features). Conclusions Binding in short-term memory carries a cost in performance. Age and education do not affect such a binding cost within a memory recall paradigm. These findings suggest that this paradigm is a suitable cognitive marker to differentiate healthy brain aging from age-related disease such as AD. [ABSTRACT FROM AUTHOR]

Objective Although medication management is a necessary daily activity for individuals with Huntington's disease (HD), medication management abilities and their relation to cognitive functioning have not been evaluated. Method Twenty individuals with HD and 20 healthy adults (HA) completed the Medication Management Abilities Assessment (MMAA). Individuals with HD also completed a self-report medication management measure and neuropsychological tests assessing executive function, retrospective memory, and prospective memory. Results Individuals with HD performed significantly poorer and made more undertaking errors on the MMAA as compared to HA. No group differences were found in overtaking errors. In the HD group, significant associations were found between undertaking errors and perceived medication management ability as well as between MMAA task performance and measures assessing prospective memory and executive functions. Conclusions Medication management capacity was negatively affected in individuals with HD and may be associated with difficulty remembering to take medications in the future. [ABSTRACT FROM AUTHOR]

Objective Episodic future thinking is the ability to mentally project oneself into the future. This construct has been explored extensively in cognitive neuroscience and may be relevant for adaptive functioning. However, it has not been determined whether the measurement of episodic future thinking might be valuable in a clinical neuropsychological setting. The current study investigated (1) the relationship between episodic future thinking and instrumental activities of daily living (IADLs); and (2) whether episodic future thinking is related to IADLs over and above standard measures of cognition. Method Sixty-one older adults with heterogeneous neurological conditions and 41 healthy older adults completed a future thinking task (the adapted Autobiographical Interview), a performance-based measure of instrumental activities of daily living (the Independent Living Scales), and standard clinical measures of memory and executive functioning. Results Episodic future thinking significantly predicted IADLs after accounting for age, education, gender, and depression (increase in R 2 =.050, p =.010). Episodic future thinking significantly predicted IADLs over and above executive functioning (increase in R 2 =.025, p =.030), but was not predictive of IADLs over and above memory (p =.157). Conclusions This study suggests that episodic future thinking is significantly associated with IADLs, beyond what can be accounted for by executive functioning. However, episodic future thinking did not predict IADLs over and above memory. Overall, there is limited evidence for the clinical utility of episodic future thinking. The findings suggest that an episodic future thinking task does not provide enough valuable information about IADLs to justify its inclusion in a clinical neuropsychological setting. [ABSTRACT FROM AUTHOR]

Objective Psychiatric symptoms, including depression and apathy, may significantly impede functional and cognitive capabilities following a cerebrovascular event. This study examined the role of apathy and depression on learning and memory performance in stroke patients. Method Stroke patients (n = 140 [119 ischemic, 21 hemorrhagic], mean age = 60.6 [ SD = 15.1]) completed the Apathy Evaluation Scale (AES), the Center for Epidemiologic Studies Depression Scale (CES-D), and the California Verbal Learning Test-Second Edition (CVLT-II). Results Using a 2 × 2 MANOVA with depression (CESD ≥ 16) and apathy (AES ≥ 34) as the independent variables and cognitive performance (i.e. verbal acquisition, short-term free recall, and long-term free recall) as the dependent variables, we found a main effect for apathy (F [3,134] = 2.98, p =.034), such that apathetic stroke patients (n = 24) performed significantly worse on verbal acquisition (F [1,136] = 6.44; p =.012), short-term free recall (F [1,136] = 7.86; p =.006), and long-term free recall (F [1,136] = 8.37; p =.004) than nonapathetic stroke patients (n = 116). There was no main effect of depression on cognitive performance (F [1,136] = 1.72, p =.155). Conclusions These results suggest that apathy, not depression, is related to verbal memory performance in stroke patients. Future research should explore whether treatment of apathy (e.g. improving motivation) could be a novel target for improving cognition after stroke. Researchers should also examine whether this model can be applied to other aspects of cognition, including executive function and other areas of memory including autobiographical and working memory. [ABSTRACT FROM AUTHOR]

Objective Assessing cognitive change during a single visit requires the comparison of estimated premorbid abilities and current neuropsychological functioning. Although premorbid intellect has been widely examined, premorbid expectations for other cognitive abilities have received less attention. The current study sought to develop and validate premorbid estimates for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Method Using demographic variables and an estimate of premorbid intellect, premorbid performance on the RBANS was predicted in a sample of 143 community-dwelling, cognitively intact older adults. Results On all six Indexes of the RBANS, premorbid intellect was the best predictor of current cognitive functioning, with gender adding to one of the prediction models (R 2 = 0.04–0.16, p s <.02). These prediction formulae were then applied to a sample of 122 individuals with amnestic Mild Cognitive Impairment to look for discrepancies between premorbid and current RBANS scores. Despite minimal differences between premorbid and current RBANS scores in the intact sample, large, and statistically significant differences were observed in the impaired sample, especially on the Immediate Memory Index (discrepancy = −29.00, p <.001), Delayed Memory Index (discrepancy = −32.28, p <.001), and Total Scale score (discrepancy = −25.58, p <.001). Conclusion Although validation in larger samples is needed, the current estimates of premorbid RBANS abilities may aid clinicians in determining change across time. [ABSTRACT FROM AUTHOR]

Objective Difficulties managing medications, particularly among older adults experiencing cognitive deficits, is an important contributing factor to medication nonadherence that may have significant negative financial and health outcomes. The current study examined the performance of healthy older adults' (HOA) and individuals with amnestic mild cognitive impairment (aMCI) on the medication management abilities assessment's (MMAA, a performance-based measure of medication management) original scoring criteria and derived error process measures, assessing medication overtaking and undertaking magnitude. Exploratory correlations between performances on the MMAA and self-reported confidence in medication management skills and cognitive abilities were also examined. Method A sample of 25 HOAs with aMCI and 25 age- and education-matched HOAs completed the MMAA, a self-reported medication management confidence rating and a battery of neuropsychological tests. Results HOAs performed significantly better on the MMAA score and committed significantly less process errors than individuals with aMCI. Despite these differences in MMAA performance, the HOA and aMCI groups rated similar high levels of confidence in their ability to manage a new medication routine. Notably, while the HOA group's performance on all of the MMAA measures did not relate to cognitive measures, the aMCI group's performance on the MMAA score was significantly related to memory and executive functioning and a new process error score for overtaking was related to processing speed. Conclusions Although these results present promising potential for the MMAA as a measure of medication management in a clinical setting, further studies need to examine the validity of the MMAA against real-world adherence measures. [ABSTRACT FROM AUTHOR]

Objective Organizational strategies have been shown to improve one's ability to recall items from a list. Specifically, use of semantic clustering, the tendency to group items by category when recalling them, predicts better free recall of word lists after short and long delays. The present study utilized a healthy adult sample to examine use of efficient memory strategies as a predictor of differences in neurocognitive findings between African American and white participants. Method Participants provided demographic information and completed the California Verbal Learning Test-Second Edition (CVLT-II) and Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-2). Results Groups were matched across socioeconomic status and years of education. White participants used more semantic clustering and performed better on recall measures after short and long delays than their African American peers, and semantic clustering predicted recall in both groups. Regression analyses suggested that use of semantic clustering is a significant partial mediator of the relationship between race and free recall abilities. Intelligence scores from the WASI-2 were correlated with CVLT-II measures in white participants but not African American participants. Conclusions Despite quantitatively similar backgrounds, white and African American participants differed in recall performance. However, this study showed that African American participants' poorer recall may be partially attributed to less frequent use of semantic clustering as a strategy. These discrepancies may be rooted in inequalities in educational experiences and suggest that providing organizational strategies during early learning may be an area of intervention to mitigate racial differences seen in neuropsychological testing. [ABSTRACT FROM AUTHOR]

Objective The experimenter expectancy effect confound remains largely unexplored in neuropsychological research and has never been investigated among cannabis users. This study investigated whether examiner expectancies of cannabis user status affected examinees' neuropsychological performance. Method Participants included 41 cannabis users and 20 non-users. Before testing, examiners who were blind to participant user status privately rated whether they believed the examinee was a cannabis user or non-user. Examiners then administered a battery of neuropsychological and performance validity measures. Multiple regression analyses compared performance between examinees judged as cannabis users (n = 37) and those judged as non-users (n = 24). Results Examiners' judgments of cannabis users were 75% accurate; judgments of non-users were at chance. After controlling for age, gender, and actual user status, examiner judgments of cannabis user status predicted performance on two measures (California Verbal Learning Test-II, and Trail Making Test B; p <.05), as individuals judged as cannabis users obtained lower scores than those judged as non-users. Conclusions Examiners' judgments of cannabis user status predicted performance even after controlling for actual user status, indicating vulnerability to examiner expectancy effects. These findings have important implications for both research and clinical settings, as scores may partially reflect examiners' expectations regarding cannabis effects rather than participants' cognitive abilities. These results demonstrate the need for expectancy effect research in the neuropsychological assessment of all populations, not just cannabis users. [ABSTRACT FROM AUTHOR]

Objectives Apathy is one of the most common behavioral symptoms encountered after traumatic brain injury (TBI). However, very little is known about the longitudinal course and predictors of apathetic manifestations. The aims of the present study were to examine how apathy changes and the predictive value of cognitive factors (memory, attention/executive mechanisms, and multitasking) and personal identity factors (self-esteem and self-efficacy beliefs) for apathy over a period of 10 months. Method To this end, 68 participants (32 patients with severe TBI matched with 36 control participants) living in the community were enrolled. At Time 1, participants were given three questionnaires to assess self-esteem, self-efficacy beliefs, anxiety and depression symptoms, and five tasks to assess cognitive processes. Simultaneously, a close relative of each participant completed a questionnaire that assessed lack of initiative/initiative. At Time 2, all questionnaires were re-administered to each patient and their relatives. Results Patients displayed a significant lack of initiative/interest at all post-injury assessments. At the individual level, the results revealed that a majority of patients had no change in their apathetic symptoms over the 10-month follow-up, whereas in the others, apathetic symptoms mostly increased. Furthermore, impaired memory was the only mechanism that significantly predicted later apathetic manifestations. Complementary profile analyses indicated that patients with worsening symptoms over the follow-up period showed higher inaccurate memory at Time 1 than patients with stable symptoms. Conclusions These results provide valuable insight into the longitudinal evolution and predictors of apathy after TBI, which opens interesting prospects for psychological interventions. [ABSTRACT FROM AUTHOR]

Depressive disorders have been linked to a variety of neuropsychological deficits, including in the areas of processing speed, memory, and executive functioning. These neurocognitive disturbances may contribute to the impairments in daily functioning often experienced by those suffering with depression. Prospective memory (PM), which refers to remembering to execute a previously formed intention at some point in the future, has been shown to play a critical role in daily functioning and may be particularly relevant in the context of depression. In this review, we synthesize the literature on PM and its relation to depression. We also put forth a new five-phase model of PM through which we frame our discussion of the existing literature on PM and depression. The results of this review reveal that PM deficits emerge in those tasks that place the greatest demands on executive functioning (e.g. monitoring for a PM cue, maintaining an intention over a delay). We conclude the review by highlighting the potential clinical relevance of these findings and proposing directions for future research. [ABSTRACT FROM AUTHOR]

Objective In the weeks immediately following a stroke, impairments across multiple cognitive domains are pervasive yet there is little literature that explores cognitive recovery during this period. This paper evaluates the use of Mahalanobis distance as a means of statistically evaluating cognitive change at the individual level. Method A small battery of standardized neuropsychological tests was administered on five or six occasions across a 2-week period to the participants recovering from a stroke and a non-stroke control group. Mahalanobis distance was used to evaluate the change profile of those who were recovering from a stroke relative to the non-stroke control. Results The outcomes of three patients show that Mahalanobis distance could statistically differentiate recovery, no change, and deterioration from normal repetition effects. Discussion In the acute phase of stroke using Mahalanobis distance it is possible to distinguish between recovery, normal learning, and gerneralized learning deficits thereby identifying likely candidates for further cognitive assessment and rehabilitation. [ABSTRACT FROM AUTHOR]

Objective: The current study sought to evaluate and replicate the severe impairment profile (SIP) of the Word Memory Test (WMT) in patients referred for dementia evaluations. Method: The sample consisted of 125 patients referred for a neuropsychological evaluation at a large Veterans Affairs Medical Center. Patients were assigned a Clinical Dementia Rating (CDR) by blind raters, and were classified according to their performance on performance validity testing. Subsequent chart reviews were conducted to help in more accurately determining the presence of severe memory impairment likely due to an underlying dementing process versus poor effort/task engagement. Results: In our sample, 51% of patients failed easy WMT subtests and 93% of these patients obtained the SIP. The rates of failure on these easy subtests generally coincided with both more severely impaired CDR ratings, as well as more impaired delayed memory composite scores. Upon chart review, it was determined that there were likely a significant portion of classification errors using the SIP, with a positive posttest probability of impairment based on having the SIP being 65% as opposed to 28% for a negative result. Conclusions: Our findings suggest that the SIP does not appear to function effectively in a mixed dementia sample where there is increased potential for secondary gain. Additional concern is expressed regarding the overall likelihood of obtaining the SIP and subsequent inferential decisions related to obtaining an SIP. Future research should examine more optimal cut scores or alternative methods for more accurately classifying patients in different clinical contexts and patterns of impairment. [ABSTRACT FROM AUTHOR]

Objective: The primary aim of this study was to identify the independent and differential associations of obesity and hypertension with cognitive, physical, and directly observed functional abilities among middle age and older adults. Method: Participants were 119 adults between the ages of 51 and 89, who underwent a cross-sectional assessment of cognitive, physical, functional and relevant health-related variables. Results: Obesity predicted significantly poorer executive functions (β = -.301, t = -3.86, p < .001), mobility (β = .329, t = 3.59, p < .001), observed functional abilities (β = .220, t = 2.52, p = .013), and self-reported ability to perform activities of daily living that require physical capability (β = -.365, t = -4.23, p < .001). In contrast, hypertension was not independently associated with any of the outcome measures (ps > .05). Results from the path analysis revealed that executive functions mediated the association between obesity and poorer directly observed functional abilities. Additionally, obesity had a direct and indirect (through mobility) effect on self-reported basic activities of daily living. Conclusions: These findings suggest a link between obesity, executive functions, and limitations in physical function and instrumental activities of daily living among middle age and older adults, however, longitudinal research is needed to further delineate the trajectory of these factors. [ABSTRACT FROM AUTHOR]

Objective: Increased false memory recognition in patients with Huntington's disease (HD) has been widely reported; however, the underlying memory constructive processes remain unclear. The present study explored gist memory, item-specific memory, and monitoring ability in patients with HD. Method: Twenty-five patients (including 13 patients with mild HD and 12 patients with moderate-to-severe HD) and 30 healthy comparison participants (HC) were recruited. We used the Deese-Roediger-McDermott (DRM) paradigm to investigate participants' false recognition patterns, along with neuropsychological tests to assess general cognitive function. Results: Both mild and moderate-to-severe patients with HD showed significant executive functioning and episodic memory impairment. On the DRM tasks, both HD patient groups showed significantly impaired performance in tasks assessing unrelated false recognition and item-specific memory as compared to the HC group; moderate-to-severe patients performed more poorly than mild patients did. Only moderate-severe patients exhibited significantly poorer related false recognition index scores than HCs in the verbal DRM task; performance of HD patient groups was comparable to the HC group on the pictorial DRM task. Conclusions: It appears that diminished verbatim memory and monitoring ability are early signs of cognitive decline during the HD course. Conversely, gist memory is relatively robust, with only partial decline during advanced-stage HD. Our findings suggest that medial temporal lobe function is relatively preserved compared to that of frontal-related structures in early HD. Thus, gist-based memory rehabilitation programs might be beneficial for patients with HD. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the influence of left ventricular dysfunction type on the pattern of neuropsychological dysfunctions among heart failure (HF) subjects. Method: A sub-analysis of the data of subjects recruited in a cross-sectional survey of cognitive dysfunction among Nigerians with HF was performed. Cognitive performance on the Community Screening Interview for Dementia (CSI'D), Word List Learning Delayed Recall (WLLDR), Boston Naming Test (BNT), and Modified Token Test (MTT) were compared between heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Clinical and echocardiographic correlation analysis with cognitive performance was performed. Results: Subjects with HFpEF were impaired on the WLLDR (71.4% vs. 34.6%, p = .026). The group with HFpEF scored lower on the language domain (definition subscale) of CSI'D (p = .036), and WLLDR (p = .005). The performance on the MTT (p = .185) and BNT (p = .923) were comparable between the two groups. An inverse relationship was found between pulse pressure and delay recall (r = -.565 p = .003) among the cohort with HFpEF whereas body mass index, BMI (r = -.737, p = .023) and tricuspid valve E/A ratio, TVEA (r = -.650, p = .042) showed an inverse relationship with the total CSI'D score in the cohort with HFrEF. Conclusions: Cognitive dysfunction is largely similar between the two groups. Delay recall is however poorer among subjects with HFpEF. Regular cognitive screening is advocated among HF subjects to prevent non-adherence with therapeutic options. [ABSTRACT FROM AUTHOR]

Objective: The extent to which increasing age is associated with impairment in cognitive function, termed cognitive aging, may have been overestimated in prior studies. The inclusion of individuals with severe or uncontrolled systemic medical illness or prodromal neurodegenerative disease in normal aging samples is likely to bias estimates toward lower cognitive performance and inflate estimates of variability. Method: Unbiased estimates of cognitive aging in 658 adults aged 60-84, who underwent rigorous screening to ensure their general and cognitive health, were computed. The first study screened the psychometric properties of a battery of neuropsychological tests in order to identify those with optimal properties to evaluate cognitive aging. The second study used the selected tests to compare baseline performance within 5-year age bands from 60 to 84. Results: The first study identified a battery of 12 tests that provided reliable measures of memory, psychomotor speed, attention, and executive function and were appropriate for investigating age-related cognitive changes. The second study observed moderate to large age-related impairment for performance on tests of complex psychomotor function, category fluency, verbal learning, and verbal and visual memory. No, or only small, age effects were observed for working memory, phonemic fluency, learning of visual information, and reaction time. Conclusions: These data suggested that while increasing age is associated with impairment in cognitive function, this impairment is less severe and is evident only on more complex neuropsychological tests than estimated previously in samples selected using less rigorous criteria to ensure cognitive health. [ABSTRACT FROM AUTHOR]

Objective: We aimed to assess reliability and cross-sectional discriminative validity of the Memory Binding Test (MBT) to distinguish persons with amnestic cognitive impairment (aMCI) and dementia from cognitively normal elderly controls. Method: The MBT was administered to 20 participants with dementia, 31 with aMCI and 246 controls, who received the first administration of the MBT from May 2003 to December 2007, as a substudy of the community-based Einstein Aging Study (age range: 70+). The optimal index resulted from comparing the partial area under the receiver operating characteristic curves (ROC AUC) of four major MBT indices for specificities ≥0.70. Optimal cut-score of the optimal index was selected by maximizing the sum of sensitivity and specificity. Age and education effects were assessed using stratified cut-scores and adjusted logistic regression. Reliability was computed as intraclass correlation between scores at baseline and 1-year follow-up for participants who remained cognitively normal. Results: Total number of Items recalled in the Paired condition (TIP) was elected the optimal index. TIP cut-score was ≤22 for differentiating aMCI alone (sensitivity = 0.74, specificity = 0.73) and aMCI and dementia combined (sensitivity = 0.84, specificity = 0.73) from controls. It was ≤17 for differentiating dementia from aMCI and controls (sensitivity = 0.95, specificity = 0.87). Age and education adjustments did not materially improve discriminative validity. The reliability of TIP was 0.77. Conclusions: MBT achieved moderate to good reliability. TIP had superior cross-sectional discriminative validity than the other MBT indices. We recommend using the empirical cut-score of TIP ≤22 for discriminating aMCI and dementia and ≤17 for discriminating dementia alone. [ABSTRACT FROM AUTHOR]

Despite prior adult research regarding the influence of executive functions on memory performance, there has been inconsistent prior research on the role of executive functions on memory performance in children, particularly those children with severe psychiatric disorders. A medical chart review was conducted for 76 children (ages 6-12 years) who received a neuropsychological evaluation during children's psychiatric inpatient program hospitalization. A series of hierarchical regression analyses investigated the role of attention/executive and non-executive functions in verbal memoryperformance (immediate recall, delayed recall, and delayed recognition).Demographic and verbal measureswere entered into blocks 1 and 2 for all analyses, followed by attention and executive functions (i.e., attention span, sustained attention, verbal fluency, cognitive flexibility, inhibitory control, and planning/organization). Nearly 15% of the participants displayed memory impairment. Results of regression analyses indicated attention/executive dysfunction severity predicted overall memory performance. Attention span predicted performance on all three memory conditions. Planning/organization accounted for unique variance in immediate recall condition while inhibitory control accounted for unique variance in delayed recall condition. These results indicate that verbal memory problems frequently occur in severe childhood psychiatric disorders. Further, planning/organization deficits may influence immediate recall, while inhibitory control deficits may influence delayed recall. Alternatively, delayed recognition memory may be the most resistant to the negative influence of executive deficits on verbal memory performance in childhood psychiatric disorders. [ABSTRACT FROM AUTHOR]

Objective: Most existing tests of memory and verbal learning in adultswere created for spoken languages, and are unsuitable for assessing deaf peoplewhorelyon signed languages. In response to this need for sign language measures, the British Sign Language Verbal Learning and Memory Test (BSL-VLMT) was developed. It follows the format of the English language Hopkins Verbal Learning Test Revised, using standardized video-presentation with novel stimuli and instructions wholly in British Sign Language, and no English language requirement. Method: Data were collected from 223 cognitively healthy deaf signers aged 50-89 and 12 deaf patients diagnosed with dementia. Normative data percentiles were derived for clinical use, and receiver-operating characteristic curves computed to explore the clinical potential and diagnostic sensitivity and specificity. Results: The test showed good discrimination between the normative and clinical samples, providing preliminary evidence of clinical utility for identifying learning and memory impairment in older deaf signers with neurodegeneration. Conclusions: This innovative video testing approach transforms the ability to accurately detect memory impairments in deaf people and avoids the problems of using interpreters, with international potential for adapting similar tests into other signed languages. [ABSTRACT FROM AUTHOR]

Objective: To validate the TNI-93 test in illiterate and low-educated subjects by setting cutoff scores to discriminate non-demented and demented subjects in a clinical setting (CESILL) and verifying the adequacy of these cutoff scores in a population-based study (AMI cohort). Method: We used two study samples. First, a clinical setting (CESILL) comprising normal elderly participants and demented patients, mostly multicultural, low educated, or illiterate, was used to compute the cutoff scores of TNI-93 for the detection of dementia. Second, the AMI cohort, a population-based cohort of retired farmers living in a rural setting, was used as a replication study, to assess the detection properties of the cutoff scores in a different population composed mostly of low-educated older people. Results: When combining the two scores, that is, free recall <6 or total recall <9, TNI-93 can detect dementia with a high sensitivity (87%) and specificity (96%), in the CESILL setting. These cutoff scores were roughly similar in the AMI cohort with high sensitivity (80% sensitivity) and specificity (81% specificity). In both study samples, the level of education had no effect on performance. Conclusions: The TNI-93 appears to be a good test to detect dementia. The absence of a significant effect of education level on the performances makes the TNI-93 a tool of choice in the screening of dementia in illiterate/low-educated subjects. [ABSTRACT FROM AUTHOR]

There is a critical need for new therapeutic strategies to restore motor function in patients with spinal cord injuries (SCIs), without unwanted effects. Intermittent hypoxia (IH) induces plasticity in spared synaptic pathways to motor neurons below the level of injury, which can be harnessed to elicit motor recovery in incomplete SCI patients. However, there is conflicting evidence regarding the effects of IH on memory function. The aim of this study was to assess episodic verbal and visual memory function with the Complutense verbal learning test (TAVEC) and the Rey-Osterrieth Complex Figure Test (ROCF), respectively, before and after a 4-week protocol of repetitive IH combined with body weight-supported treadmill training (BWSTT) in incomplete ASIA C and D SCI subjects. Subjects received either IH (cycling 9%/21% FiO2 every 1.5 min, 15 cycles per day) or continued normoxia (Nx, 21% FiO2) combined with 45 min of BWSTT for 5 consecutive days, followed by 3 times per week IH and BWSTT for 3 additional weeks. ROCF Z scores between IH plus BWSTT and Nx plus BWSTT were not significantly different (p = .43). Compared with baseline, IH and BWSTT group showed a significantly greater (p < .05) verbal memory performance for immediate, short-term, and long-term recall; however, it was not different from Nx plus BWSTT group in all verbal memory components (p > .05). Our results suggest that a 4-week protocol of moderate IH does not elicit visual or verbal memory impairment. Thus, repetitive IH may be a safe therapeutic approach to incomplete spinal cord injury patients, without deleterious cognitive effects. [ABSTRACT FROM AUTHOR]

Objective. Patient-reported cognition generally exhibits poor concordance with objectively assessed cognitive performance. In this article, we introduce latent regression Rasch modeling and provide a step-by-step tutorial for applying Rasch methods as an alternative to traditional correlation to better clarify the relationship of self-report and objective cognitive performance. An example analysis using these methods is also included. Method. Introduction to latent regression Rasch modeling is provided together with a tutorial on implementing it using the JAGS programming language for the Bayesian posterior parameter estimates. In an example analysis, data from a longitudinal neurocognitive outcomes study of 132 breast cancer patients and 45 non-cancer matched controls that included self-report and objective performancemeasures pre- and post-treatment were analyzed using both conventional and latent regression Raschmodel approaches. Results. Consistent with previous research, conventional analysis and correlations between neurocognitive decline and self-reported problemswere generally near zero. In contrast, application of latent regression Rasch modeling found statistically reliable associations between objective attention and processing speed measures with self-reported Attention and Memory scores. Conclusions. Latent regression Rasch modeling, together with correlation of specific self-reported cognitive domains with neurocognitivemeasures, helps to clarify the relationship of self-report with objective performance. While themajority of patients attribute their cognitive difficulties to memory decline, the Rashmodeling suggests the importance of processing speed and initial learning. To encourage the use of thismethod, a step-by-step guide and programming language for implementation is provided. Implications of this method in cognitive outcomes research are discussed. [ABSTRACT FROM AUTHOR]

This study investigated theWord Memory Test (WMT) Free Recall (FR) subtest as a conventional memory measure. Nineteen participants with pharmacoresistant left temporal lobe epilepsy (LTLE) and 16 with right temporal lobe epilepsy (RTLE) completed theWMT, Rey Auditory Verbal Learning Test (RAVLT), and Wechsler Memory Scale-Fourth Edition Logical Memory (LM) subtest during presurgical evaluation. LTLE participants performed significantly worse on FR subtest (p, .05, h2p = 0.17) and RAVLT Trial 7 (p , .01, h2p = 0.25), but not on LM subtest. Age was a significant covariate for FR (p , .01, h2p = 0.22). Logistic regression revealed FR plus age and RAVLT age-adjusted T-scores both yielded 77.1% classification accuracy and respective diagnostic odds ratios of 11.36 and 11.84. Receiver operating characteristic curves to classify seizure laterality found that RAVLT and FR were significant (area under the curve [AUC] ¼ 0.82 and 0.74), whereasLM was nonsignificant (AUC ¼ 0.67). Cut scores and positive/negative predictive values were established for improved clinical classification. [ABSTRACT FROM AUTHOR]

This study compared the factor structure of the translated Wechsler Memory Scale-III (WMS-III), which is the latest available version in Norway, with the original U.S. version. A sample of 122 healthy, elderly Norwegians (mean age: 74; standard deviation ¼ 8.8) completed the WMS-III. The factor structure of the translated WMS-III was tested, using Confirmatory Factor Analysis, with comparison of model fit based on five a priori hypothesized models. Several model fit indices pointed to a three-factor model (working memory, visual memory, and auditory memory) providing the best fit to the data. Our study supports updated findings of the original WMS-III in nonclinical samples and suggests that the translated version is structurally equal to the original. The study supports the cross-cultural validity of the WMS-III.However, based on the present data, one might expect scores on the Family Pictures subtest to fall below scores on other WMS-III subtests in elderly Norwegians. [ABSTRACT FROM AUTHOR]

Recent research supports the utility of process variables in understanding mechanisms underlying memory impairments. The HopkinsVerbal Learning Test-Revised (HVLT-R) was administered to 84 patients with left (LTL, n ¼ 58) or right temporal lobe glioma (RTL, n ¼ 26) prior to surgical resection. Primary HVLT-R measures of learning and memory and numerous learning process indices were computed. Both groups exhibited frequent memory impairment (.30%), with greater severity in theLTLgroup. Patients withLTLglioma also exhibited lower semantic clustering scores than RTL patients, which were highly associated with Total Recall (r ¼ 0.83) and Delayed Recall (r ¼ 0.68). Learning slope and a novel measure of learning efficiency were also significantly associated with primary memory measures, though scores were similar across theLTLandRTLgroups. While lesions to either temporal lobe impact verbal memory, semantic encoding appears to depend upon the integrity of LTL structures in particular [ABSTRACT FROM AUTHOR]

This study examined the relationship between phonemic and semantic (category) verbal fluency and cognitive status in theWisconsin Registry for Alzheimer's Prevention (WRAP), a longitudinal cohort enriched for family history of Alzheimer's disease. Participants were 283 WRAP subjects (age 53.1[6.5] years at baseline); who had completed three waves of assessment, over ∼6 years and met psychometric criteria either for "cognitively healthy" (CH) or for psychometric amnestic mild cognitive impairment (aMCI) using an approach that did not consider fluency scores. CH and aMCI groups differed significantly on phonemic total scores, category total scores, phonemic switching, and category mean cluster size. These results suggest that measures of both phonemic and semantic fluency yield lower scores in persons with evidence of psychometric aMCIcompared with thosewho are CH. Differences have not previously been reported in a group this young, and provide evidence for the importance of including multiple verbal fluency tests targeting preclinical Alzheimer's disease. [ABSTRACT FROM AUTHOR]