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Neuropsychological research methods are used to evaluate cognitive functions (CF). Tests used in clinical neuropsychology, in most cases, describe one or more aspects of cognitive domains that are theoretical «constructs» in which several cognitive processes are involved. Neuropsychological tests measure CFs regardless of the medical condition of the test subject. This allows for determination of even minor changes in CFs, including in clinical trials, which is of fundamental importance in studying the efficacy and safety of a given therapy. This article deals with specific aspects of using neuropsychological and screening testing of cognitive functions in individual domains on the basis of foreign experience. It discusses the criteria for selection and application of individual tools, their features, and choice of criteria for evaluating the results of testing in clinical studies in cases of CFs deterioration in various medical conditions accompanied by cognitive impairment. When planning clinical trials, it should also be taken into account that mixed anxiety-depressive disorders are likely to cause forgetfulness, and this calls for differential diagnosis and should be registered in clinical research protocols. The use of subscales and combinations of components of different tools are encouraged based on the objectives of the clinical study, and the tools of neuropsychological research and cognitive function assessment should be validated taking into account the specificity and sensitivity of the method, using statistical analysis methods for specific purposes and tasks. Such a multifaceted approach to the study of cognitive impairments will significantly increase the level of clinical trials conducted and, consequently, will make it possible to put up for sale efficacious and safe medicines for the treatment of cognitive impairment.

We aimed to investigate cross-sectional associations between skeletal muscle density, a proxy measure for fatty infiltration into muscle, and cognition. Contributions from body fat mass, systemic inflammation and lifestyle were explored, as these factors have been identified in both muscle and cognitive deterioration. For 281 men (60–95 year) from the Geelong Osteoporosis Study, radial and tibial muscle density were measured using peripheral quantitative computed tomography. Body fat and appendicular lean mass were measured using dual-energy X-ray absorptiometry. Cognitive function was assessed for psychomotor function (DET), visual identification/attention (IDN), visual learning (OCL) and working memory (OBK) (CogState Brief Battery). Composite scores signified overall cognitive function (OCF). Higher scores represent poorer performance except for OCL and OCF. Regression analyses examined associations between muscle density and cognition; potential confounders included age, muscle cross-sectional area (CSA), body composition, lifestyle and serum markers of inflammation. Negative associations with age were evident for muscle density, all cognitive domains and OCF. Muscle density at both sites was positively associated with DET, OCL and OCF. After adjustment for age, the association persisted for DET (radius: B = − 0.006, p = 0.02; tibia: B = − 0.003, p = 0.04) and OCL (radius B = + 0.004, p = 0.02; tibia: B = + 0.005, p < 0.001). At the radius, further adjustment for serum TNF-α explained the association between muscle density (B = − 0.002, p = 0.66) and DET. Education and physical activity contributed to the model for radial muscle density and DET. There were no contributions from muscle CSA, appendicular lean mass, body fat mass, other markers of inflammation or other potential confounders. At the tibia, the association between muscle density and DET (B = − 0.003, p = 0.04) was independent of TNF-α. There was an age-adjusted association between muscle density and OCL at both sites (radius: B = + 0.004, p = 0.02; tibia: B = + 0.005, p < 0.001). None of the potential confounders contributed to the models. Muscle density was associated with cognitive function in the DET and OCL domains. However, there was little evidence that this was explained by inflammation or body fat mass. No associations were identified between muscle density and IDN or OBK. [ABSTRACT FROM AUTHOR]

Objective: Nursing instruments have the potential for daily screening of delirium; however, they have not yet been evaluated. Therefore, after assessing the functional domains of the electronic Patient Assessment - Acute Care (ePA-AC), this study evaluates the cognitive and associated domains.Methods: In this prospective cohort study in the intensive care unit, 277 patients were assessed and 118 patients were delirious. The impacts of delirium on the cognitive domains, consciousness and cognition, communication and interaction, in addition to respiration, pain, and wounds were determined with simple logistic regressions and their respective odds ratios (ORs).Results: Delirium was associated with substantial impairment throughout the evaluated domains. Delirious patients were somnolent (OR 6), their orientation (OR 8.2-10.6) and ability to acquire knowledge (OR 5.5-11.6) were substantially impaired, they lost the competence to manage daily routines (OR 8.2-22.4), and their attention was compromised (OR 12.8). In addition, these patients received psychotropics (OR 3.8), were visually impaired (OR 1.8), unable to communicate their needs (OR 5.6-7.6), displayed reduced self-initiated activities (OR 6.5-6.9) and challenging behaviors (OR 6.2), as well as sleep-wake disturbances (OR 2.2-5), Furthermore, delirium was associated with mechanical ventilation, abdominal/thoracic injuries or operations (OR 4.2-4.4), and sensory perception impairment (OR 3.9-5.8).Significance Of Results: Delirium caused substantial impairment in cognitive and associated domains. In addition to the previously described functional impairments, these findings will aid the implementation of nursing instruments in delirium screening. [ABSTRACT FROM AUTHOR]

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Objective: To determine the utility of mild cognitive impairment (MCI) subtypes and number of impaired cognitive domains on initial assessment at predicting progression to dementia in a sample of memory clinic patients over a 20-year period.Methods: A retrospective analysis was conducted of those presenting to a memory clinic with MCI from 1 January 1999 to 31 December 2018 inclusive. Those with MCI were broken down into one of the four subtypes using recommended cut-off scores on the Cambridge Cognitive Assessment (CAMCOG). Binomial logistic regression analysis was used to determine the utility of MCI subtypes and number of impaired cognitive domains as predictors for dementia.Results: Overall 1188 individuals with MCI diagnosis were identified, with 378 (32%) progressing to dementia, with median [range] time to diagnosis of 2 years [1-8.4]. Six hundred and forty-nine (55%) were identified as amnestic MCI and 539 (45%) as non-amnestic MCI. Amnestic MCI was a significant predictor of progression compared to non-amnestic MCI (OR = 1.85, df = 1, P < .001). Number of cognitive domains impaired was also a significant predictor of progression to dementia (OR = 1.07, df = 1, P = .01) but the single-/multi-domain distinction was not (OR = 1.29, df = 1, P = .36).Conclusion: This study shows that approximately 32% of those diagnosed with MCI in a memory clinic progressed to dementia, with a median time to progression of 2 years. Those with amnestic MCI are almost twice as likely to progress to dementia than non-amnestic MCI and that therefore this is a useful distinction. However, the utility of the single- and multi-domain MCI distinction is called into question by our findings. [ABSTRACT FROM AUTHOR]

Introduction: Neuropsychological test scores are limited and standard outcomes may mask the heterogeneity of cognitive impairment. This article presents the calculation and evaluation of six composite scores that quantify domain‐specific impairment. Methods: Parameters for composite scores calculation were learned by performing confirmatory factor analysis in a sample of participants from the Alzheimer's Disease Neuroimaging Initiative database. The obtained scores were evaluated with a separate sample of mild cognitive impairment (MCI) in two automated tasks: unsupervised partition in different subgroups and prediction of progression to dementia for different time windows. Results: MCI subgroups with distinctive cognitive profiles and risk of progression emerged from cluster analysis. Composite scores outperform standard neuropsychological tests when automatically predicting progression within time windows up to 5 years. Conclusions: Domain‐specific composite scores are useful to delineate profiles of impairment, stratify the MCI risk, and predict progression to dementia. [ABSTRACT FROM AUTHOR]

The Algerian English foreign language (EFL) baccalaureate is a high stake exam that assesses both students' learning and their critical thinking skills. Thus, devising appropriate and effective exam questions may be a problematic issue for tests designers. Under the requirements of the current Algerian English curriculum, the exam questions must cover the lower and higher-order thinking skills of Bloom's taxonomy. On this basis, this research paper seeks to investigate the effectiveness of the EFL baccalaureate exam papers, and aims to answer the research question: 'To what extent does the Algerian EFL Baccalaureate exam paper cover the lower and higher-order thinking skills of Bloom's taxonomy?' This research is a descriptive content analysis; the researcher analyzed the exam questions of the Algerian EFL Baccalaureate under the cognitive domains of Bloom's taxonomy. This study is significant as it helps tests' designers to design practical EFL exams that develop students' thinking skills and language competencies. The findings of this study revealed that the EFL baccalaureate exam does not establish the students' higher-order thinking skills and does not assess their communicative abilities. Accordingly, some recommendations are suggested to hopefully help test designers to improve the quality of the EFL Baccalaureate questions. [ABSTRACT FROM AUTHOR]

Background: Neuroinflammation has gained increasing attention as a potential contributing factor in the onset and progression of Alzheimer's disease (AD). The objective of this study was to examine the association of selected cerebrospinal fluid (CSF) inflammatory and neuronal degeneration markers with signature CSF AD profile and cognitive functions among subjects at the symptomatic pre- and early dementia stages. Methods: In this cross-sectional study, 52 subjects were selected from an Icelandic memory clinic cohort. Subjects were classified as having AD (n = 28, age = 70, 39% female, Mini-Mental State Examination [MMSE] = 27) or non-AD (n = 24, age = 67, 33% female, MMSE = 28) profile based on the ratio between CSF total-tau (T-tau) and amyloid-β1–42 (Aβ42) values (cut-off point chosen as 0.52). Novel CSF biomarkers included neurofilament light (NFL), YKL-40, S100 calcium-binding protein B (S100B) and glial fibrillary acidic protein (GFAP), measured with enzyme-linked immunosorbent assays (ELISAs). Subjects underwent neuropsychological assessment for evaluation of different cognitive domains, including verbal episodic memory, non-verbal episodic memory, language, processing speed, and executive functions. Results: Accuracy coefficient for distinguishing between the two CSF profiles was calculated for each CSF marker and test. Novel CSF markers performed poorly (area under curve [AUC] coefficients ranging from 0.61 to 0.64) compared to tests reflecting verbal episodic memory, which all performed fair (AUC > 70). LASSO regression with a stability approach was applied for the selection of CSF markers and demographic variables predicting performance on each cognitive domain, both among all subjects and only those with a CSF AD profile. Relationships between CSF markers and cognitive domains, where the CSF marker reached stability selection criteria of > 75%, were visualized with scatter plots. Before calculations of corresponding Pearson's correlations coefficients, composite scores for cognitive domains were adjusted for age and education. GFAP correlated with executive functions (r = − 0.37, p = 0.01) overall, while GFAP correlated with processing speed (r = − 0.68, p < 0.001) and NFL with verbal episodic memory (r = − 0.43, p = 0.02) among subjects with a CSF AD profile. Conclusions: The novel CSF markers NFL and GFAP show potential as markers for cognitive decline among individuals with core AD pathology at the symptomatic pre- and early stages of dementia. [ABSTRACT FROM AUTHOR]

Background: Post-stroke cognitive impairment (PSCI) is common, but evidence of cognitive symptom profiles, course over time, and pathogenesis is scarce. We investigated the significance of time and etiologic stroke subtype for the probability of PSCI, severity, and cognitive profile. Methods: Stroke survivors (n = 617) underwent cognitive assessments of attention, executive function, memory, language, perceptual-motor function, and the Montreal Cognitive Assessment (MoCA) after 3 and/or 18 months. PSCI was classified according to DSM-5 criteria. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS). Stroke subtype was categorized as intracerebral hemorrhage (ICH), large artery disease (LAD), cardioembolic stroke (CE), small vessel disease (SVD), or un-/other determined strokes (UD). Mixed-effects logistic or linear regression was applied with PSCI, MoCA, and z-scores of the cognitive domains as dependent variables. Independent variables were time as well as stroke subtype, time, and interaction between these. The analyses were adjusted for age, education, and sex. The effects of time and stroke subtype were analyzed by likelihood ratio tests (LR). Results: Mean age was 72 years (SD 12), 42% were females, and mean NIHSS score at admittance was 3.8 (SD 4.8). Probability (95% CI) for PSCI after 3 and 18 months was 0.59 (0.51–0.66) and 0.51 (0.52–0.60), respectively and remained constant over time. Global measures and most cognitive domains were assessed as impaired for the entire stroke population and for most stroke subtypes. Executive function and language improved for the entire stroke population (LR) = 9.05, p = 0.003, and LR = 10.38, p = 0.001, respectively). After dividing the sample according to stroke subtypes, language improved for ICH patients (LR = 18.02, p = 0.003). No significant differences were found in the severity of impairment between stroke subtypes except for attention, which was impaired for LAD and CE in contrast to no impairment for SVD (LR = 56.58, p < 0.001). Conclusions: In this study including mainly minor strokes, PSCI is common for all subtypes, both early and long-term after stroke, while executive function and language improve over time. The findings might contribute to personalizing follow-up and offer new insights into underlying mechanisms. Further research is needed on underlying mechanisms, PSCI prevention and treatment, and relevance for rehabilitation. [ABSTRACT FROM AUTHOR]

Introduction. Health problems in elderly individuals are diverse. The use of cigarettes, a potentially addictive substance, has been increasing in the elderly population age group, affecting the cognitive and elderly domains, and becoming an important global public health problem. Objective. This study aimed to investigate the relationship between tobacco consumption by the elderly, as well as different levels of nicotine dependence and cognitive domains of executive functions. Method. It is a case-control study composed by 58 individuals aged = 60 years, with 29 participants in the clinical group and 29 in the control group. The case-control sample was paired in subgroups by sex, socioeconomic status, schooling, and sample isonomy with the clinical group. We used the Shapiro-Wilk normality test, the Mann-Whitney test, the student T-test, and the Cohen d-estimator. Results. The control group performed better compared to the clinical group with the median grade in the inhibitory control of the executive domain with Cohen's d 1.00 in the five-digit test and Cohen's 1.5 in the Stroop test. The control group compared with the high-grade clinical group presented better performance with Cohen's working memory of 1.56 d, Cohen's inhibition of 1.06 d in the five-digit test, and Cohen's of 1.17 d in the Stroop test. Discussion and conclusion. The detection of the level of nicotine dependence is associated with the degree of cognitive impairment in the specific executive domain, which provides a possibility of differential diagnosis, both in the clinical and population contexts, directed at the rehabilitation of executive domains most affected by smoking in the elderly. [ABSTRACT FROM AUTHOR]

Introduction: Cystatin C (Cys C) has been found as a novel biomarker of neurodegenerative diseases, such as dementia and Alzheimer's disease. Published studies on the role of Cys C as a biomarker of mild cognitive impairment (MCI) have not been reviewed systematically. Objective: Present meta-analysis was performed to elucidate the association between Cys C and risk of MCI. Methods: A comprehensive search was performed in PubMed, EMBASE, Cochrane Library, Trip databases, Worldwide Science, and Google Scholar from January 1, 1950, to April 30, 2020. Standardized mean difference (SMD) with 95% confidence interval (CI) using fixed or random effect models were used to calculate summary estimates. Quality of evidence was also assessed using the Diagnostic Accuracy Quality Scale (DAQS) and grading quality of evidence and strength of recommendations approach. Results: In our meta-analysis, 12 studies with a total of 2,433 MCI patients and 1,034 controls were included. Our findings suggest a strong association between increased levels of Cys C and risk of MCI as compared to control subjects (SMD = 2.39, 95% CI = 0.22–4.57). Subgroup analysis based on ethnicity, a significant association for the high level of Cys C with the risk of MCI was observed in the Asian population (SMD = 1.63, 95% CI = 0.44–2.82) but not in the Caucasian population (SMD = 2.80, 95% CI = [−0.66]−6.26). Conclusion: Cys C was associated with MCI, and it could be considered as a predictor for the risk of cognitive impairment. [ABSTRACT FROM AUTHOR]

The aim of this study is to analyze learning outcomes of 2018 Turkish primary school mathematics curriculum in terms of their grade level and content domains based on cognitive qualifications of TIMSS-2019 assessment framework. As a qualitative research design this is a case study design that uses document analysis as document collection tool. In order to classify the learning outcomes descriptive analysis is used as a qualitative data analysis technique. Considering their content domains and grade levels, the cognitive requirements of 229 phrases from first to the fourth grades are analyzed. According to the findings, of all learning outcomes about 58% are in knowing, 32% are in applying, and 10% are in reasoning domains. Comparing the grade levels, while the number of learning outcomes of knowing cognitive domain reduces from 1st through 4th, learning outcomes of reasoning cognitive domain raises from 1st through fourth which is affirmative. Results are discussed in the light of findings, and some suggestions are given. [ABSTRACT FROM AUTHOR]

Study Objectives: We examined and compared cross-sectional and longitudinal associations between self-reported sleep disturbances and various cognitive domains in five separate Nordic European longitudinal aging studies (baseline N = 5631, mean age = 77.7, mean follow-up = 4.16 years)., Methods: Comparable sleep parameters across studies included reduced sleep duration/quality, insomnia symptoms (sleep latency, waking up at night, and early awakenings), short and long sleep duration, and daytime napping. The cognitive domains were episodic memory, verbal fluency, perceptual speed, executive functioning, and global cognition (aggregated measure). A series of mixed linear models were run separately in each study and then compared to assess the level and rate of change in cognitive functioning across each sleep disturbance parameter. Models were adjusted for age, sex, education, hypnotic usage, depressive symptoms, lifestyle factors, cardiovascular, and metabolic conditions. By using a coordinated analytic approach, comparable construct-level measurements were generated, and results from identical statistical models were qualitatively compared across studies., Results: While the pattern of statistically significant results varied across studies, subjective sleep disturbances were consistently associated with worse cognition and steeper cognitive decline. Insomnia symptoms were associated with poorer episodic memory and participants sleeping less or more than 7-8 hours had a steeper decline in perceptual speed. In addition, daytime napping (>2 hours) was cross-sectionally and longitudinally associated with all examined cognitive domains. Most observed associations were study-specific (except for daytime napping), and a majority of association estimates remained significant after adjusting for covariates., Conclusion: This rigorous multicenter investigation further supports the importance of sleep disturbance, including insomnia, long and short sleep duration, and daytime napping on baseline cognitive functioning and rate of change among older adults. These sleep factors may be targeted in future lifestyle interventions to reduce cognitive decline., (© The Author(s) 2023. Published by Oxford University Press on behalf of Sleep Research Society.)

Background/Aim: Studies of the associations of the metabolic syndrome (MetS) with cognitive function and decline are inconclusive. We investigated the associations of the MetS with cognitive functions in 823 Chinese >55-year-olds followed up over 4.5 years. Methods: The relationships between the MetS and baseline and follow-up z-scores of cognitive domain functions were examined using mixed model analysis. Results: There were specific inverse cross-sectional associations of single cardiometabolic risk factors with cognition, such as hyperglycemia with processing speed (p = 0.045). The MetS was negatively associated with 3 out of 4 cognitive domains (p = 0.018 to p = 0.003), and the count of cardiometabolic risk factors with all cognitive domains (p = 0.025 to p = 0.002). Longitudinally, dyslipidemia was associated with worse decline in memory and learning (p = 0.022). The count of cardiometabolic risk factors was associated with worse declines in cognition (p = 0.032 for global cognition). Conclusion: Among middle-aged and older Asians, an increased number of component cardiometabolic risk factors of the MetS was associated with a worse decline in cognitive function over time. [ABSTRACT FROM AUTHOR]

Cerebral White Matter Hyperintensity (WMH) lesions have been identified as markers of cerebrovascular diseases and they are associated with increased risk of cognitive impairment. In this study, we investigated the relationship between midlife cardiovascular risk factors and late life WMH volumes two decades later, and examined their association with cognitive performance. 135 participants from the Women's Healthy Ageing Project had completed midlife cardiovascular risk measurement in 1992 and late life brain MRI scan and cognitive assessment in 2012. In these community-dwelling normal aging women, we found that higher midlife Framingham Cardiovascular Risk Profile (FCRP) score was associated with greater WMH volume two decades later, and was predominantly driven by the impact of HDL cholesterol level, controlling for age, education and APOE ε4 status. Structural equation modelling demonstrated that the relationship between midlife FCRP score and late life executive function was mediated by WMH volume. These findings suggest intervention strategies that target major cardiovascular risk factors at midlife might be effective in reducing the development of WMH lesions and thus late life cognitive decline. [ABSTRACT FROM AUTHOR]

• Our research population was from the community of older people over the age of 60, they had no dementia, and never had cerebrovascular disease. • We explored the effects of WMH on the scores of different cognitive domains in different parts. • We discussed the pre-dementia state, to provide ideas for the prevention and treatment of dementia. • Our research was the basis for establishing a cohort study. To investigate the impact of periventricular hyperintensities and serum cystatin C on mild cognitive impairment to provide a basis for the investigation of the pathogenesis. 286 patients enrolled the study and underwent an examination in Shanghai Fifth People's Hospital from June 2017 to June 2018. The participants' cognitive function was evaluated by different cognitive domains using of mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), auditory verbal learning test, Huashan version (AVLT-H), digit span test (DST), symbol digit modalities test (SDMT), trail making test (TMT) and verbal fluency test (VFT). We measured the levels of serum cystatin C at the department of clinical laboratory in Shanghai Fifth People's Hospital and each subject took an MRI examination in the Department of Radiology of Shanghai Fifth People's Hospital. Multivariate linear regression analyses were used to assess the relationship of cognitive score and the level of cystatin C and periventricular hyperintensities severity. All statistical analyses were performed using the SPSS system. Among 286 eligible participants, 203 (71.0%) were enrolled to further analysis, including 69 male and 134 female (Mean age 67.93 ± 6.19 years). Significant predictors of severe periventricular hyperintensities (PVH) were older age and hypertension. Significant predictors of severe deep white matter hyperintensities (DWMH) were older age only. PVH severity was independently associated with mild cognitive impairment and that the primary impairment was executive function and processing speed. DWMH had no significant effect on cognitive function. Cystatin C only affected the overall cognitive level, and the relationship with WMH severity was not significant. We demonstrated that in the chinese non-demented elderly, the severity of PVH was independent and significant associated with mild cognitive impairment and that the primary impairment was executive capacity and processing speed, while cystatin C may be an independent risk factor for overall cognitive impairment. [ABSTRACT FROM AUTHOR]

Objectives: Patients requiring admission to an ICU may subsequently experience cognitive decline. Our objective was to investigate longitudinal cognitive trajectories in older adults hospitalized in ICUs. We hypothesized that individuals hospitalized for critical illness develop greater cognitive decline compared with those who do not require ICU admission.Design: A retrospective cohort study using prospectively collected cognitive scores of participants enrolled in the Mayo Clinic Study of Aging and ICU admissions retrospectively ascertained from electronic medical records. A covariate-adjusted linear mixed effects model with random intercepts and slopes assessed the relationship between ICU admissions and the slope of global cognitive z scores and domains scores (memory, attention/executive, visuospatial, and language).Setting: ICU admissions and cognitive scores in the Mayo Clinic Study of Aging from October 1, 2004, to September 11, 2017.Patients: Nondemented participants age 50 through 91 at enrollment in the Mayo Clinic Study of Aging with an initial cognitive assessment and at least one follow-up visit.Interventions: None.Measurements and Main Results: Of 3,673 participants, 372 had at least one ICU admission with median (25-75th percentile) follow-up after first ICU admission of 2.5 years (1.2-4.4 yr). For global cognitive z score, admission to an ICU was associated with greater decline in scores over time compared with participants not requiring ICU admission (difference in annual slope = -0.028; 95% CI, -0.044 to -0.012; p < 0.001). ICU admission was associated with greater declines in memory (-0.029; 95% CI, -0.047 to -0.011; p = 0.002), attention/executive (-0.020; 95% CI, -0.037 to -0.004; p = 0.016), and visuospatial (-0.013; 95% CI, -0.026 to -0.001; p = 0.041) domains. ICU admissions with delirium were associated with greater declines in memory (interaction p = 0.006) and language (interaction p = 0.002) domains than ICU admissions without delirium.Conclusions: In older adults, ICU admission was associated with greater long-term cognitive decline compared with patients without ICU admission. These findings were more pronounced in those who develop delirium while in the ICU. [ABSTRACT FROM AUTHOR]

• Children from Uruguay (n = 345), were evaluated on 16 tests of cognitive performance. • Latent profile analysis found 3 generic cognitive profiles: low, average, high. • No behavioral signature of Pb & Mn co-exposure identified among 6–8 year-olds. • Likelihood of low performance profile membership greatest at lower blood Pb levels. • Mn exposure did not modify the effect of Pb on likelihood of profile membership. Lead (Pb) and manganese (Mn) are confirmed neurotoxins but it is unclear to what extent low-level exposure produces a unique behavioral signature. The objective of this study was to investigate latent cognitive profiles among children (6–8 years) from Montevideo, Uruguay co-exposed to these metals. Among 345 children, blood Pb and hair Mn were measured using atomic absorption spectroscopy and ICP-MS, respectively. Sixteen measures, reflecting multiple domains of cognitive functioning were gathered: (1) three tests from Cambridge Neuropsychological Test Automated Battery (CANTAB): Intra-Extra Dimensional Shift (IED), Spatial Span (SSP) and Stockings of Cambridge (SOC), (2) ten tasks from Woodcock-Muñoz Achievement Battery, Revised (W M): Visual-Motor Integration, Verbal Comprehension (Vocabulary, Synonyms, Antonyms, Analogies), Visual-Auditory Comprehension, Concept Formation, Visual Spatial Thinking, Number Inversion and Spatial Relations, (3) Bender Gestalt task, and (4) Weschler block design task. Scores were modeled using latent profile analysis (LPA). Association between blood Pb and hair Mn on performance profiles was assessed using ordinal regression, controlling for confounders. An interaction between Pb and Mn was tested. Mean ± SD of blood Pb was 4.1 ± 2.1 μg/dL and 35% of children had blood Pb ≥ 5 μg/dL. Median [5%, 95%] hair Mn level was 0.8 [0.3, 4.1] ppb. Three latent cognitive performance profiles were identified: high (n = 46, 13%), average (n = 209, 61%) and low (n = 90, 26%). Each one-unit increase in blood Pb was associated with a 28% greater likelihood of belonging to a poorer-performing profile. The association was non-linear, with the effect of Pb on profile membership strongest at lower levels of exposure. There was no meaningful interaction between Pb and Mn. A behavioral signature for low-level Pb & Mn exposure was not identified, but the likelihood of membership in low-performing profile was higher at lowest levels of blood Pb. There was no effect measure modification between Pb and Mn. Future research should address how complex environments created by chemical exposures and the social context relate to cognitive performance in young children. [ABSTRACT FROM AUTHOR]

In this study, Turkish fifth-grade bursary examination mathematics items, all of which are of multiple choice, from years 1999 to 2018 are analyzed based on the cognitive and content domains of TIMSS 2019 assessment framework. According to document analysis of the data collected through official website of Ministry of National Education, the distribution of the cognitive demands of all items indicates that there is an emphasis on applying or reasoning domain with about 74%. This result leads to the conclusion that Turkish fifth-grade mathematics items require upper cognitive demands comparing with TIMSS target percentages. Also, it is observed that there are dramatic changes in cognitive demands of the items from year to year which may mean that there is no framework followed for the bursary examinations. Examining the content domains of the bursary examination, findings reveal that the majority of the items are in numbers (60%), and it is followed by measurement and geometry (34%), and data (6%), which are similar with the target percentages of TIMSS 2019 that are 50, 35, and 15 respectively. Finally, suggestions are given in the light of findings and educational reforms in Turkey. [ABSTRACT FROM AUTHOR]

Introduction: Although the benefit in motor symptoms for well-selected patients with deep brain stimulation (DBS) has been established, cognitive declines associated with DBS can produce suboptimal clinical responses. Small decrements in cognition can lead to profound effects on quality of life. The growth of indications, the expansion of surgical targets, the increasing complexity of devices, and recent changes in stimulation paradigms have all collectively drawn attention to the need for re-evaluation of DBS related cognitive outcomes. Methods: To address the impact of cognitive changes following DBS, we performed a literature review using PubMed. We searched for articles focused on DBS and cognition. We extracted information about the disease, target, number of patients, assessment of time points, cognitive battery, and clinical outcomes. Diseases included were dystonia, Tourette syndrome (TS), essential tremor (ET), and Parkinson's disease (PD). Results: DBS was associated with mild cognitive issues even when rigorous patient selection was employed. Dystonia studies reported stable or improved cognitive scores, however one study using reliable change indices indicated decrements in sustained attention. Additionally, DBS outcomes were convoluted with changes in medication dose, alleviation of motor symptoms, and learning effects. In the largest, prospective TS study, an improvement in attentional skills was noted, whereas smaller studies reported variable declines across several cognitive domains. Although, most studies reported stable cognitive outcomes. ET studies largely demonstrated deficits in verbal fluency, which had variable responses depending on stimulation setting. Recently, studies have focused beyond the ventral intermediate nucleus, including the post-subthalamic area and zona incerta. For PD, the cognitive results were heterogeneous, although deficits in verbal fluency were consistent and related to the micro-lesion effect. Conclusion: Post-DBS cognitive issues can impact both motor and quality of life outcomes. The underlying pathophysiology of cognitive changes post-DBS and the identification of pathways underpinning declines will require further investigation. Future studies should employ careful methodological designs. Patient specific analyses will be helpful to differentiate the effects of medications, DBS and the underlying disease state, including disease progression. Disease progression is often an underappreciated factor that is important to post-DBS cognitive issues. [ABSTRACT FROM AUTHOR]

Telemedicine could represent an emerging and innovative approach to support cognitive and behavioral rehabilitation reducing the overload of healthcare facilities, favoring home care therapy. The present study aimed to assess the potential efficacy of Tele-VR apps in enhancing cognitive performance and improving social skills in patients with Parkinson's disease (PD). Thirty-four patients with PD were included in the study. Patients were assigned to one of the following treatment groups: Experimental Group 1 (EG1) underwent a Tele-VR program using two cognitive rehabilitation applications (app) on smartphones (Neuronation-Brain Training and Train your Brain); Experimental Group 2 (EG2) received a Tele-VR program through one cognitive rehabilitation app (Neuronation-Brain Training) and one socio-cognitive rehabilitation App (The Sims) on smartphones; Active Control Group (aCG) performed a conventional training using pencil and paper exercises (Not-VR). At the end of the study, the aCG and EG1 presented an improvement in the executive, attentional and visuospatial cognitive domains. Mood and subjective memory also improved in the EG1. Moreover, in the EG2 group, a significant improvement was found in all cognitive domains, including social cognition skills (theory of mind). The inter-group comparison showed that both EG1 and EG2 had significantly greater improvements than aCG in MoCA score. Finally, both EG1 and EG2 showed a higher improvement in the FAB score, as compared to the aCG. Rehabilitation with smartphone apps could be more useful than conventional rehabilitation in improving cognitive and social cognition skills in patients with PD. Combining cognitive and social cognition training could improve the cognitive and affective domains, also aiding in the long-term maintenance of cognitive outcomes. • Telemedicine could represent an emerging and innovative approach in rehab. • The use of Telerehabilitation with VR Apps is a new frontier in neurorehabilitation. • Few studies on usefulness of VR app in PD patients are available. • VR app could be useful in improving cognitive and social skills. • VR app could aiding in the long-term maintenance of cognitive and social outcome. [ABSTRACT FROM AUTHOR]

Joseph Elias Ibrahim,1 Laura J Anderson,1 Aleece MacPhail,2 Janaka Jonathan Lovell,2 Marie-Claire Davis,1 Margaret Winbolt3 1Department of Forensic Medicine, Monash University, Southbank, 2Ballarat Health Services, Ballarat, 3Australian Centre for Evidence Based Aged Care, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia Abstract: The burden of chronic disease is greater in individuals with dementia, a patient group that is growing as the population is aging. The cornerstone of optimal management of chronic disease requires effective patient self-management. However, this is particularly challenging in older persons with a comorbid diagnosis of dementia. The impact of dementia on a person’s ability to self-manage his/her chronic disease (eg, diabetes mellitus or heart failure) varies according to the cognitive domain(s) affected, severity of impairment and complexity of self-care tasks. A framework is presented that describes how impairment in cognitive domains (attention and information processing, language, visuospatial ability and praxis, learning and memory and executive function) impacts on the five key processes of chronic disease self-management. Recognizing the presence of dementia in a patient with chronic disease may lead to better outcomes. Patients with dementia require individually tailored strategies that accommodate and adjust to the individual and the cognitive domains that are impaired, to optimize their capacity for self-management. Management strategies for clinicians to counter poor self-management due to differentially impaired cognitive domains are also detailed in the presented framework. Clinicians should work in collaboration with patients and care givers to assess a patient’s current capabilities, identify potential barriers to successful self-management and make efforts to adjust the provision of information according to the patient’s skill set. The increasing prevalence of age-related chronic illness along with a decline in the availability of informal caregivers calls for innovative programs to support self-management at a primary care level. Keywords: chronic disease, dementia, self-management, cognitive domains

Fiona AHM Cleutjens,1 Frits ME Franssen,1 Martijn A Spruit,1 Lowie EGW Vanfleteren,1 Candy Gijsen,1 Jeanette B Dijkstra,2 Rudolf WHM Ponds,2 Emiel FM Wouters,1,3 Daisy JA Janssen1 1Department of Research and Education, CIRO, Centre of Expertise for Chronic Organ Failure, Horn, 2Department of Medical Psychology, Maastricht UMC+/School for Mental Health and Neurosciences (MHeNS), 3Department of Respiratory Medicine, Maastricht UMC+, Maastricht, the Netherlands Abstract: Impaired cognitive function is increasingly recognized in COPD. Yet, the prevalence of cognitive impairment in specific cognitive domains in COPD has been poorly studied. The aim of this cross-sectional observational study was to compare the prevalence of domain-specific cognitive impairment between patients with COPD and non-COPD controls. A neuropsychological assessment was administered in 90 stable COPD patients and 90 non-COPD controls with comparable smoking status, age, and level of education. Six core tests from the Maastricht Aging Study were used to assess general cognitive impairment. By using Z-scores, compound scores were constructed for the following domains: psychomotor speed, planning, working memory, verbal memory, and cognitive flexibility. General cognitive impairment and domain-specific cognitive impairment were compared between COPD patients and controls after correction for comorbidities using multivariate linear and logistic regression models. General cognitive impairment was found in 56.7% of patients with COPD and in 13.3% of controls. Deficits in the following domains were more often present in patients with COPD after correction for comorbidities: psychomotor speed (17.8% vs 3.3%; P

Background. The study aimed to evaluate the correlations of cognitive function with metabolic, nutritional, hormonal and immunologic parameters in patients with type 2 diabetes (T2D), in order to identify markers of cognitive impairment.

Although past research has established a relationship between functional connectivity and cognitive function, less is known about which cognitive domains are associated with which specific functional networks. This study investigated associations between functional connectivity and global cognitive function and performance in the domains of memory, executive function and psychomotor speed in 166 older adults aged 75-91 years (mean = 80.3 ± 3.8) with minor cognitive deficits (Mini-Mental State Examination scores between 21 and 27). Functional connectivity was assessed within 10 standard large-scale resting-state networks and on a finer spatial resolution between 300 nodes in a functional connectivity matrix. No domain-specific associations with mean functional connectivity within large-scale resting-state networks were found. Node-level analysis revealed that associations between functional connectivity and cognitive performance differed across cognitive functions in strength, location and direction. Specific subnetworks of functional connections were found for each cognitive domain in which higher connectivity between some nodes but lower connectivity between other nodes were related to better cognitive performance. Our findings add to a growing body of literature showing differential sensitivity of functional connections to specific cognitive functions and may be a valuable resource for hypothesis generation of future studies aiming to investigate specific cognitive dysfunction with resting-state functional connectivity in people with beginning cognitive deficits., Competing Interests: The authors report no competing interests., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Guarantors of Brain.)

Background: Physical activity preserves cognitive function in people without dementia, but the relationship between physical activity and cognitive domains among people living with dementia is unclear., Objective: The objective of this study was to explore the association between physical activity and cognition domains among people living with dementia., Methods: Participants living with dementia in residential care facilities (complete case analysis: n = 24/42) completed a battery of cognitive tests (global cognition: Montreal Cognitive Assessment; executive function: Trail-Making Test, Digit Span Forward Test; perception and orientation: Benton Judgement of Line Orientation Test; language: Boston Naming Test; learning and memory: Rey Auditory Verbal Learning Test; complex attention: Digit Symbol Substitution Test). Participants wore an actigraphy monitor on their non-dominant wrist over seven days. We conducted a linear regression for total physical activity (independent variable) with race (white/black), fall risk (Morse Fall Scale), and the number of comorbidities (Functional Comorbidities Index) as covariates, and cognitive tests as variables of interest., Results: Participants were primarily male (75%), white (87.5%), and 50%had unspecified dementia (Alzheimer's disease: 33%). Greater physical activity was associated with poorer global cognition, better executive function, and better learning and memory (ps <  0.05). Physical activity was not related to visuospatial perception, language, or complex attention., Conclusions: Physical activity may preserve executive function and learning and memory among people living with dementia. Wandering is more common in later stages of dementia, which may explain greater physical activity observed with lower global cognition. Regularly assessing physical activity may be useful in screening and monitoring cognitive changes.

Background: Evidence on the association of Olfactory Impairment (OI) with age-related cognitive decline is inconclusive, and the potential influence of allergy remains unclear., Objective: We aimed to evaluate the cross-sectional associations of allergy-related and non-allergy- related OI to cognitive function., Methods: We included 2,499 participants from the Health and Retirement Study (HRS)-Harmonized Cognitive Assessment Protocol (HCAP) sub-study and 1,086 participants from the English Longitudinal Study of Ageing (ELSA)-HCAP. The Olfactory Function Field Exam (OFFE) using Sniffin' Stick odor pens was used to objectively assess olfactory function and an olfactory score <6/11 indicated OI. Mini-Mental Status Examination (MMSE) was used to assess global cognitive function and define cognitive impairment (<24/30). A neuropsychologic battery was used to assess five cognitive domains., Results: Compared to non-OI participants, individuals with OI had lower MMSE z-score [β HRS = -0.33, 95% Confidence Interval (CI): -0.41 to -0.24; β ELSA = -0.31, -0.43 to -0.18] and higher prevalence of cognitive impairment (Prevalence Ratio (PR)HRS = 1.46, 1.06 to 2.01; PR ELSA = 1.63, 1.26 to 2.11). The associations were stronger for non-allergy-related OI (β HRS = -0.36; β ELSA = -0.34) than for allergy-related OI (β HRS = -0.26; β ELSA = 0.13). Similar associations were observed with domain- specific cognitive function measures., Conclusion: OI, particularly non-allergy-related OI, was related to poorer cognitive function in older adults. Although the current cross-sectional study is subject to several limitations, such as reverse causality and residual confounding, the findings will provide insights into the OI-cognition association and enlighten future attention to non-allergy-related OI for the prevention of potential cognitive impairment., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background We examined the role of social frailty in the association between hearing problems and mild cognitive impairment (MCI), and investigated which cognitive impairment domains are most strongly involved. Methods Participants were 4251 older adults (mean age 72.5 ± 5.2 years, 46.1% male) who met the study inclusion criteria. Hearing problems were measured using the Hearing Handicap Inventory for the Elderly. Social frailty was identified using responses to five questions. Participants were divided into four groups depending on the presence of social frailty and hearing problems: control, social frailty, hearing problem, and co-occurrence. We assessed memory, attention, executive function, and processing speed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool. Participants were categorized into normal cognition, single- and multiple-domain MCI, depending on the number of impaired cognitive domains. Results Participants with multiple-domain MCI exhibited the highest odds ratios (OR) of the co-occurrence group (OR: 3.89, 95% confidence intervals [CI]: 1.96–7.72), followed by the social frailty (OR: 2.65, 95% CI: 1.49–4.67), and hearing problem (OR: 1.90, 95% CI: 1.08–3.34) groups, compared with the control group. However, single-domain MCI was not significantly associated with any group. Cognitive domain analysis revealed that impaired executive function and processing speed were associated with the co-occurrence, hearing problem, and social frailty groups, respectively. Conclusions Social frailty and hearing problems were independently associated with multiple-domain MCI. Comorbid conditions were more strongly associated with multiple-domain MCI. Longitudinal studies are needed to elucidate the causal role of social frailty in the association between hearing impairment and MCI. [ABSTRACT FROM AUTHOR]

Self-management is integral to effective chronic disease management. Cognitive impairments (CogImp) associated with dementia have not previously been reviewed in diabetes mellitus (DM) self-care. The aims of this study are to know (1) whether CogImp associated with dementia impact self-care and (2) whether specific CogImp affects key DM self-care processes. A systematic literature search with a narrative review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This review examined studies published from January, 2000 to February, 2016 describing the relationship between cognition and DM self-care domains in community dwelling older adults with dementia/CogImp. Eight studies met inclusion criteria. Decrements in all self-care domains were associated with CogImp. Problem solving was related to reduced disease knowledge (OR 0.87, 95% CI = 0.49-1.55), resulting in poorer glycemic control. Decision-making impairments manifested as difficulties in adjusting insulin doses, leading to more hospital admissions. People without CogImp were better able to find/utilize resources by adhering to recommended management (OR 1.03, 95% CI = 1.02-1.05). A lack of interaction with health care providers was demonstrated through reduced receipt of important routine investigation including eye examinations (ARR = 0.85, 95% CI = 0.85-0.86), HbA1c testing (ARR = 0.96, 95% CI = 0.96-0.97), and LDL-C testing (ARR = 0.91, 95% CI = 0.901-0.914). People without CogImp had better clinic attendance (OR 2.17, 95% CI = 1.30-3.70). Action taking deficits were apparent through less self-testing of blood sugar levels (20.2% vs 24.4%, P = 0.1) resulting in poorer glycemic control, self-care, and more frequent micro/macrovascular complications. Persons with diabetes and CogImp, particularly in domains of learning, memory and executive function, were significantly impaired in all self-care tasks. [ABSTRACT FROM AUTHOR]

Background: The link between exposure to general anaesthesia and surgery (exposure) and cognitive decline in older adults is debated. We hypothesised that it is associated with cognitive decline.Methods: We analysed the longitudinal cognitive function trajectory in a cohort of older adults. Models assessed the rate of change in cognition over time, and its association with exposure to anaesthesia and surgery. Analyses assessed whether exposure in the 20 yr before enrolment is associated with cognitive decline when compared with those unexposed, and whether post-enrolment exposure is associated with a change in cognition in those unexposed before enrolment.Results: We included 1819 subjects with median (25th and 75th percentiles) follow-up of 5.1 (2.7-7.6) yr and 4 (3-6) cognitive assessments. Exposure in the previous 20 yr was associated with a greater negative slope compared with not exposed (slope: -0.077 vs -0.059; difference: -0.018; 95% confidence interval: -0.032, -0.003; P=0.015). Post-enrolment exposure in those previously unexposed was associated with a change in slope after exposure (slope: -0.100 vs -0.059 for post-exposure vs pre-exposure, respectively; difference: -0.041; 95% confidence interval: -0.074, -0.008; P=0.016). Cognitive impairment could be attributed to declines in memory and attention/executive cognitive domains.Conclusions: In older adults, exposure to general anaesthesia and surgery was associated with a subtle decline in cognitive z-scores. For an individual with no prior exposure and with exposure after enrolment, the decline in cognitive function over a 5 yr period after the exposure would be 0.2 standard deviations more than the expected decline as a result of ageing. This small cognitive decline could be meaningful for individuals with already low baseline cognition. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes (T2D) is a metabolic condition associated with poor clinical and cognitive outcomes including vascular disease, depressive symptoms, cognitive impairment, and dementia. In the general elderly population, depression has been consistently identified as a risk factor for cognitive impairment/decline. However, the association between depression and cognitive function in T2D has been understudied.Objective: We investigated the association between depression and cognitive function in a large sample of cognitively normal elderly with T2D.Methods: In this cross-sectional study, we examined 738 participants, aged 65-88 years old, enrolled in the Israel Diabetes and Cognitive Decline study. For each cognitive domain (Episodic Memory, Executive Function, Attention/Working Memory, Language/Semantic Categorization) and Overall Cognition, multiple linear regressions assessed its association with depression (score greater than 5 on the 15-item version of the Geriatric Depression Scale [GDS]), adjusting for age, sex, and education.Results: Depression (n = 66, 8.9%) was associated with worse performance on tasks of Executive Function (p = 0.004), Language/Semantic Categorization (p < 0.001), and Overall Cognition (p < 0.002), but not Episodic Memory (p = 0.643) or Attention/Working Memory (p = 0.488). Secondary analyses using GDS as a continuous variable did not substantially change the results. Adjusting also for a history of antidepressant medication use slightly weakened the findings.Conclusion: Significant associations of depression with several cognitive domains and Overall Cognition even in cognitively normal elderly with T2D, suggest that depression may have a role in impaired cognitive function in T2D, which may be attenuated by antidepressants. [ABSTRACT FROM AUTHOR]

Objective: To determine cognitive outcomes in older adults (≥ 50 years old) having sustained a traumatic brain injury (TBI) using meta-analysis. Methods: MedLine and PsycInfo databases were searched to identify studies comparing neuropsychological profiles in older adults with and without a history of TBI across various injury severities and times post-injury. Ten studies (n = 717) meeting inclusion criteria were identified. Tests were divided into functional modalities and average effect sizes were calculated across studies on a test-by-test basis. Results: Older adults post-TBI performed worse than the non-TBI group on all cognitive outcomes evaluated (d = -0.34 to -0.75), with naming and vocabulary having the largest effect, M -0.75 (95% CI, -0.98 to -0.52). Conclusions: TBI in older adults leads to moderate deficits on all measured cognitive abilities, with the largest effects observed in naming and vocabulary abilities. The findings pertain broadly to TBI of mixed injury severities and times post-injury, although the majority of participants sustained TBIs of mild uncomplicated severity within one-year post-injury. Future research must address methodological limitations such as variability in reporting injury information, inconsistency in defining older age, and lack of orthopaedic comparison groups in order to permit more nuanced conclusions for this population. [ABSTRACT FROM AUTHOR]

Objectives: Intraindividual variability increases with age, but the relative strength of association with cognitive domains is still unclear. The objective of this study was to examine the relation between cognitive domains and the shape and spread of response time (RT) distributions as indexed by intraindividual standard deviation (ISD), and ex-Gaussian parameters (μ, σ, τ). Methods: Healthy adults (40 young [aged 18–30 years], 40 young-old [aged 65–74 years], and 41 old-old [aged 75–85 years]) completed neuropsychological testing and a touch-screen attention task from which ISD and ex-Gaussian parameters were derived. The relation between RT performance and cognitive domains (memory, processing speed, executive functioning) was examined with structural equation modeling (SEM), and the predictive power of RT distribution indices over age was investigated with linear regression. Results:ISD, μ, and τ, but not σ, showed a linear increase with age group. An SEM showed that independent of age, τ was most strongly associated with executive functioning, while μ exhibited less critical associations. Linear regression indicated that μ and τ explained a significant portion of variance in processing speed and executive ability in addition to age group. Memory was more parsimoniously predicted by age, without any significant contribution of ex-Gaussian parameters. Conclusions: The findings suggest that exceptionally slow responses convey attention lapses through wavering of cognitive control, which strongly correspond to executive functioning tests. General slowing and extremely slow responses predicted processing speed and executive performance beyond age group, indicating that RT metrics are sensitive to differences in cognitive ability. (JINS, 2018, 24, 456–465) [ABSTRACT FROM AUTHOR]

Background: Carbon monoxide (CO) poisoning is the leading cause of accidental poisoning worldwide. This study undertook a meta-analysis to examine differences in neuropsychological functioning in patients with CO poisoning as compared to healthy controls, and examined the longer-term neuropsychological effects of CO poisoning. Methods: Studies performed between the years 1995 and 2016 were identified through a search of the electronic databases Medline and PsycInfo. Data from the papers identified were pooled to determine standard mean differences using a random-effects model. Results: Ten studies were included in the analysis, with healthy controls performing significantly better than CO poisoned participants on the domains of divided attention, immediate memory, and processing speed. No statistically significant differences were found for sustained attention, recent memory, working memory, visuospatial/constructional ability, and expressive language. Performance by participants with CO poisoning for the domains of sustained attention, recent memory, visuospatial/constructional abilities, and working memory significantly improved over time after initial exposure, demonstrating recovery of these functions over time. No statistically significant differences were evident for divided attention or expressive language. Conclusions: This evidence indicates that healthy controls perform better than do individuals with CO poisoning on a range of neuropsychological domains; however, it also indicates that performance in some domains does improve over time. (JINS, 2018, 24, 405–415) [ABSTRACT FROM AUTHOR]

A variety of practices and specialised representational systems are required to understand, communicate and construct molecular genetics knowledge. This study describes teachers’ use of multimodal representations of molecular genetics concepts and how their strategies and choice of resources were interpreted, understood and used by students to demonstrate their conceptual understanding. Recordings of teachers’ and students’ discourse around representations, teacher interviews and student pre- and post-tests were used as data sources. Vignettes of students’ dialogue with teachers around the form and function of representations and teacher interview responses highlight higher order conceptual understanding. Coding for cognitive domains within lesson phases where different modes of representation were utilised showed classrooms operated at higher domains compared to lessons where modalities were absent. This study shows how pedagogy that focuses on representational form and function as well as students’ engagement in critical discussion around affordances and constraints of representations results in a higher cognitive engagement with molecular genetics knowledge. [ABSTRACT FROM AUTHOR]

Aging is related to a deterioration of cognitive performance and to multiple alterations in the brain. Even before the beginning of a noticeable cognitive decline, the framework which holds cognitive function experiences these alterations. From a system-vulnerability point of view of cognition, the deterioration associated with age would be the collection of repercussions during a life. Brain function and structure are modified in a multidimensional way, which could concern different aspects like structural integrity, functional activity, connectivity, or glucose metabolism. From this point of view, the effects of aging could affect the most brain systems and their functional activity. In this study, we analyze the functional development of three cognitive domains in relation to aging, educational level, and cognitive reserve (CR). A total of 172 healthy subjects were divided into two age groups (young and old), and completed a battery of classic neuropsychological tests. The tests were organized and analyzed according to three cognitive domains: working memory and flexibility, visuoconstructive functions, and declarative memory. Subjects also completed a questionnaire on CR. Results showed that the performance in all cognitive domains decreased with age. In particular, tests related to working memory, flexibility, and visuoconstructive abilities were influenced by age. Nevertheless, this effect was attenuated by effects of education, mainly in visuoconstructive domain. Surprisingly, visual as well as verbal memory tests were not affected either by aging, education, or CR. Brain plasticity plays a prominent role in the aging process, but, as other studies have shown, the plasticity mechanism is quite different in healthy vs. pathological brains. Moreover, this plasticity brain mechanism could be modulated by education and CR. Specially, cognitive domains as working memory, some executive functions and the visuoconstructive abilities seem to be modulated by education. Therefore, it seems to be crucial, to propose mechanisms of maintenance of a healthy and enriched brain, since it promotes auto-regulatory mechanisms of well-aging.

In the developed world, five to ten percent of people older than 65 years have dementia. One fifth of dementia etiologies are due to vascular brain lesions (VaD – vascular dementia). A milder form is called vascular cognitive impairment (VCI). The main clinical criteria for VaD are: 1. cognitive decline verified with standardized cognitive test/scale, 2. evidence of the associated vascular brain lesion, 3. excluded reversible causes of cognitive decline. The main risk factors for VaD are age, atherosclerosis, diabetes and hypertension. They play a key role in pathogenesis of the cognitive impairment. Depending on the damaged brain region, different cognitive domains may be affected with or without other neurological signs. These diversities in the clinical picture challenge the correct diagnosis. Unique feature of VaD is its progression, which can be stopped, if patients receive an appropriate treatment.The treatment of VCI and VaD symptoms is similar to that in Alzheimer’s disease. More importantly, VCI may be slowed down or even stopped with proper secondary stroke prevention and good rehabilitation. The most efficient is primary stroke prevention with healthy lifestyle and treatment of acquired risk factors.

Introduction: In Parkinson's disease (PD), psychosis is associated with cognitive impairment that may be more profound in particular cognitive domains. Our goal was to determine whether psychosis in non-demented PD participants is associated with domain-specific cognitive impairment on the Mini-Mental State Exam (MMSE).Methods: The Morris K. Udall Parkinson's Disease Research Center of Excellence Longitudinal Study at Johns Hopkins is a prospective study that was initiated in 1998. Clinical assessments are conducted at two-year intervals at the Johns Hopkins Hospital. We analyzed data from 137 enrolled participants with idiopathic PD. Psychosis diagnoses were established by psychiatrist interview per DSM-IV criteria. An incident dementia diagnosis resulted in exclusion from analysis for that evaluation and any future evaluations in that participant. We used logistic regression with generalized estimated equations (GEE) to model the time-varying relationship between MMSE subscale scores and psychosis, adjusting for potential confounding variables identified through univariable analysis.Results: Thirty-one unique psychosis cases were recorded among non-demented participants. Fifty total evaluations with psychosis present were analyzed. In multivariable regressions, psychosis was associated with lower scores on the orientation (relative odds ratio, rOR: 0.73; 95% CI: 0.58-0.93; p = 0.011), language (rOR: 0.64; 95% CI: 0.48-0.86; p = 0.003), and intersecting pentagon (rOR: 0.43; 95% CI: 0.20-0.92 p = 0.030) subscales of the MMSE.Conclusions: In PD, executive dysfunction, disorientation, and impaired language comprehension may be associated with psychosis. Our findings suggest that the corresponding MMSE subscales may be useful in identifying participants with a higher likelihood of developing psychosis. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Current study was designed to compare effectiveness of lecture-based and modified team-based learning in achieving cognitive skills in resident doctors. Methodology: This comparative cross sectional study was conducted on medical floor in Mayo Hospital, Lahore. Resident doctors (RDs) including house officers (HOs) and postgraduate residents (PGRs) were divided into two groups for lecture based learning (LBL) and modified team based learning (mTBL) on the topic of "health promotion and disease prevention". All RDs undertook individual readiness assurance test (IRAT) and final (FT) tests where FT pertained to six cognitive domains. Statistical testing for IRAT and FT scores and performance in early and advanced domains were performed taking p-value < 0.05 as significant. Results: A total of 53 RDs including 58.49% HOs and 41.51% PGRs participated in the study with similar distribution among mTBL and LBL groups. The mean IRAT scores for LBL and mTBL groups were 41.03±17.79 & 44.17±19.54, respectively (p-value 0.272). The overall FT scores were 40.26±15.17 & 48.02±17.57 for LBL and mTBL respectively (p-value 0.045). The FT scores in early domains were 34.81±14.93 & 56.12±15.1 for LBL and mTBL groups (p-value 0.000). The scores of advanced domains were 35.53±12.65 and 30.56±14.73 for LBL and mTBL (p-value 0.301). PGRs performed better than HOs in early domains (p-value 0.043) but not in advanced domains. There was no difference in performance of male and female RDs. Conclusion: After a single session, mTBL significantly improved performance in early cognitive domains but not in advanced cognitive domains. [ABSTRACT FROM AUTHOR]

Compulsions are repetitive, stereotyped thoughts and behaviors designed to reduce harm. Growing evidence suggests that the neurocognitive mechanisms mediating behavioral inhibition (motor inhibition, cognitive inflexibility) reversal learning and habit formation (shift from goal-directed to habitual responding) contribute toward compulsive activity in a broad range of disorders. In obsessive compulsive disorder, distributed network perturbation appears focused around the prefrontal cortex, caudate, putamen, and associated neuro-circuitry. Obsessive compulsive disorder-related attentional set-shifting deficits correlated with reduced resting state functional connectivity between the dorsal caudate and the ventrolateral prefrontal cortex on neuroimaging. In contrast, experimental provocation of obsessive compulsive disorder symptoms reduced neural activation in brain regions implicated in goal-directed behavioral control (ventromedial prefrontal cortex, caudate) with concordant increased activation in regions implicated in habit learning (presupplementary motor area, putamen). The ventromedial prefrontal cortex plays a multifaceted role, integrating affective evaluative processes, flexible behavior, and fear learning. Findings from a neuroimaging study of Pavlovian fear reversal, in which obsessive compulsive disorder patients failed to flexibly update fear responses despite normal initial fear conditioning, suggest there is an absence of ventromedial prefrontal cortex safety signaling in obsessive compulsive disorder, which potentially undermines explicit contingency knowledge and may help to explain the link between cognitive inflexibility, fear, and anxiety processing in compulsive disorders such as obsessive compulsive disorder. [ABSTRACT FROM AUTHOR]