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Objective:Black adults are approximately twice as likely to develop Alzheimer’s disease (AD) than non-Hispanic Whites and access diagnostic services later in their illness. This dictates the need to develop assessments that are cost-effective, easily administered, and sensitive to preclinical stages of AD, such as mild cognitive impairment (MCI). Two computerized cognitive batteries, NIH Toolbox-Cognition and Cogstate Brief Battery, have been developed. However, utility of these measures for clinical characterization remains only partially determined. We sought to determine the convergent validity of these computerized measures in relation to consensus diagnosis in a sample of MCI and healthy controls (HC).Method:Participants were community-dwelling Black adults who completed the neuropsychological battery and other Uniform Data Set (UDS) forms from the AD centers program for consensus diagnosis (HC = 61; MCI = 43) and the NIH Toolbox-Cognition and Cogstate batteries. Discriminant function analysis was used to determine which cognitive tests best differentiated the groups.Results:NIH Toolbox crystallized measures, Oral Reading and Picture Vocabulary, were the most sensitive in identifying MCI apart from HC. Secondarily, deficits in memory and executive subtests were also predictive. UDS neuropsychological test analyses showed the expected pattern of memory and executive functioning tests differentiating MCI from HC.Conclusions:Contrary to expectation, NIH Toolbox crystallized abilities appeared preferentially sensitive to diagnostic group differences. This study highlights the importance of further research into the validity and clinical utility of computerized neuropsychological tests within ethnic minority populations.

This study assessed the construct validity and clinical utility of the National Alzheimer's Coordinating Center Lewy Body Dementia (LBD) Module, consisting of the Speeded Attention and Noise Pareidolia Tasks.Participants included 459 older adults diagnosed as cognitively normal (n = 202), or with non-amnestic mild cognitive impairment (n = 61), amnestic mild cognitive impairment (n = 96), Alzheimer's disease dementia (n = 44), or LBD (n = 56).Speeded Attention demonstrated strong convergent validity and moderate discriminant validity when compared to established neuropsychological tests. Noise Pareidolia demonstrated strong discriminant validity, but limited convergent validity. Noise Pareidolia scores were significantly lower in those with reported hallucinations, delusions, or REM sleep behavior disorder symptoms. LBD Module tests discriminated well between cognitively normal adults and those with LBD.The LBD Module demonstrates promising construct validity and clinical utility, which support its use across research and clinical settings.

Existing studies of burden associated with caring for cognitively impaired older adults have centered on dementia caregivers. Characterizing burden experienced by caregivers to older adults with mild cognitive impairment (MCI) is critical as this may provide early indication of need for caregiver intervention and support. This study examined the psychometric properties of the Caregiver Burden Inventory (CBI), a multi-dimensional caregiver inventory, in a sample of caregivers to patients diagnosed with MCI. Participant recruitment occurred through collaborative partnership between the University of Michigan Alzheimer’s Disease Center and Wayne State University Institute of Gerontology. Participants included 109 caregivers (51.3% women, 62.4% spousal caregiver, Mage = 68.8 ± 11.6 years) to patients diagnosed with MCI as part of a longitudinal cohort study. Cronbach’s alpha (.778 - .858) was acceptable across CBI subscales. Principal Components Analysis with promax rotation identified a five factor structure (Emotional/Social Wellbeing, Time-Dependence, Physical Health, Expectations, Relationship Strain) which explained 72.0% of the variance and partially deviated from original CBI dimensions. Results suggest that the CBI may be a valid measure of the MCI caregiver’s experience of burden. The newly emerged constructs— “expectations of the future” and “relationship strain”—are relevant to caregivers intervening in the early phase of cognitive impairment. Future directions include additional CBI validation with confirmatory factor analysis in a separate MCI caregiver sample.

Despite the increased number of persons living with Mild Cognitive Impairment (MCI), there is a lack of information on diverse caregiving experiences within this population. This study sought to compare demographic and service utilization. Caregivers were study partners of a diverse groups of older adults participating in a longitudinal cohort study of aging and dementia recruited through a University of Michigan (UM) Memory and Aging Project partnership with Wayne State University (WSU) Institute of Gerontology and WSU/UM Michigan Center for Urban African American Aging Research. Participants included 40 AA (M(age)= 68.18, SD=10.29) and 108 Caucasian (M(age)= 67.57, SD=12.83) caregivers and individuals with MCI, AA (M(age)= 71.66, SD=9.28) and Caucasian (M(age)= 73.21, SD=8.11). Results indicate AA caregivers (M = 14.85, SD= 10.83) have less years of education than Caucasians (M = 15.81, SD= 12.83), ANOVA F(11,20)=4.692, p=.032. A higher proportion of Caucasian caregivers lived with MCI patient, X2(1, N=148)=20.176, p=

Chronic Posttraumatic stress disorder (PTSD), characterized by symptoms of re-experiencing, hyperarousal, and avoidance, is challenging to treat as a significant proportion of patients remain symptomatic following even empirically supported interventions. The current case series investigated the effects of up to 10 sessions of high definition transcranial direct current stimulation (HD-tDCS) on symptoms of PTSD. Participants received HD-tDCS that targeted the right lateral temporal cortex (LTC; center cathode placed over T8), given this region's potential involvement in symptoms of re-experiencing and, possibly, hyperarousal. Five of the six enrolled patients completed at least 8 sessions. Of these five, four showed improvement in symptoms of re-experiencing after HD-tDCS. This improvement was accompanied by connectivity change in the right LTC as well as a larger extended fear network but not a control network that consisted of visual cortex regions; however, the nature of the change varied across participants as some showed increased connectivity whereas others showed decreased connectivity. These preliminary data suggest that HD-tDCS may be beneficial for treatment of specific PTSD symptoms, in at least some individuals, and warrants further investigation.

Background Subjective memory complaints (SMCs) are incorporated into the diagnosis of mild cognitive impairment (MCI) and neurodegenerative dementias; however, the relative frequency of SMCs in cognitively intact older adults and those with different types of dementia is poorly understood. Similarly, the concordance between self- versus informant-reported SMCs has not been compared across different diagnostic groups. Objective This study aimed to evaluate the frequency of self-reported (Objective 1) and informant-reported (Objective 2) SMCs in cognitively intact adults or those diagnosed with MCI or a neurodegenerative dementia. Agreement between participant and informant complaints was also evaluated (Objective 3). Methods Baseline evaluation data were drawn from 488 participants (Mage = 70.49 years; Medu = 15.62 years) diagnosed as cognitively intact, non-amnestic MCI, amnestic single domain MCI, amnestic multi-domain MCI, possible/probable Alzheimer's disease, dementia with Lewy bodies, or frontotemporal dementia. Participants and their informants completed the Memory Assessment Clinic Questionnaire. Results One-way ANCOVAs controlling for age, education, and depression revealed no group differences in severity of self-reported SMCs. In contrast, informant memory ratings followed the expected clinical pattern, with comparable and most impaired ratings given to participants with any dementia diagnosis, followed by those with any MCI diagnosis, followed by cognitively intact participants. There was inconsistent agreement between self- and informant-reported SMC ratings in any of the impaired groups. Conclusions Given greater diagnostic specificity and internal consistency of informant report, clinicians should weigh this information more heavily than self-report in the diagnostic process.

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia frequently affecting patients with synucleinopathies, but its exact prevalence in multiple system atrophy (MSA) is unclear. Whether questionnaires alone are sufficient to diagnose RBD is also unknown. We performed a cross-sectional study of patients with probable MSA from six academic centers in the US and Europe. RBD was ascertained clinically and with polysomnography; we also performed a meta-analysis according to PRISMA guidelines for studies published before September 2014 that reported the prevalence of RBD in MSA. A random-effects model was constructed using weighted prevalence proportions. Only articles in English were included. Studies were classified into those that ascertained the presence of RBD in MSA clinically and with polysomnography. Case reports or case series (≤5 patients) were not included. Forty-two patients completed questionnaires and underwent polysomnography. Of those, 32 (76.1 %) had clinically suspected RBD and 34 (81 %) had polysomnography-confirmed RBD. Two patients reported no symptoms of RBD but had polysomnography-confirmed RBD. The primary search strategy yielded 374 articles of which 12 met the inclusion criteria. The summary prevalence of clinically suspected RBD was 73 % (95 % CI, 62–84 %) in a combined sample of 324 MSA patients. The summary prevalence of polysomnography-confirmed RBD was 88 % (95 % CI, 79–94 %) in a combined sample of 217 MSA patients. Polysomnography-confirmed RBD is present in up to 88 % of patients with MSA. RBD was present in some patients that reported no symptoms. More than half of MSA patients report symptoms of RBD before the onset of motor deficits.

NeuroQuant (NQ) is a fully-automated program that overcomes several existing limitations in the clinical translation of MRI-derived volumetry. The current study characterized differences between the original (NQ1) and an updated NQ version (NQ2) by 1) replicating previously identified relationships between neuropsychological test performance and medial temporal lobe volumes, 2) evaluating the level of agreement between NQ versions, and 3) determining if the addition of NQ2 age-/sex-based z-scores hold greater clinical utility for prediction of memory impairment than standard percent of intracranial volume (% ICV) values. Sixty-seven healthy older adults and 65 mild cognitive impairment patients underwent structural MRI and completed cognitive testing, including the Immediate and Delayed Memory indices from the Repeatable Battery for the Assessment of Neuropsychological Status. Results generally replicated previous relationships between key medial temporal lobe regions and memory test performance, though comparison of NQ regions revealed statistically different values that were biased toward one version or the other depending on the region. NQ2 hippocampal z-scores explained additional variance in memory performance relative to % ICV values. Findings indicate that NQ1/2 medial temporal lobe volumes, especially age- and sex-based z-scores, hold clinical value, though caution is warranted when directly comparing volumes across NQ versions.

Subjective cognitive complaints (SCCs) remain part of the diagnostic criteria for amnestic mild cognitive impairment (aMCI), the prodromal stage of dementia - Alzheimer’s type (DAT), despite weak relationships between self-reported and objectively-measured functioning. Most metacognitive measures focus on ratings of global retrospective memory rating only; greater subtlety in measurement of SCCs is required. Similarly, it is critical to identify the disease stage at which the clinical utility of SCCs is nullified by impaired insight. This study aims to evaluate group differences in (a) task-specific metacognitive ratings, and (b) the accuracy of these ratings in individuals diagnosed as cognitively intact (CI), with aMCI, or with DAT. 99 older adults (M-age = 69.43, SD-age = 6.98; M-edu = 15.54, SD-edu = 2.47; CI: n = 50, aMCI: n = 34, DAT: n = 15) enrolled in the University of Michigan Memory and Aging Project rated their performance on the Object Location Touchscreen Task (OLTT), an ecologically valid memory measure. One-way analysis of variance (ANOVA) revealed that individuals with aMCI-multiple domain or DAT rated their memory performance similarly to CI individuals, though the aMCI-single domain group rated themselves as more impaired. Bivariate Pearson’s r correlations demonstrated a decline in the strength of the relationship between task-specific metacognitive ratings and actual OLTT memory performance with increasing diagnostic severity. These findings suggest a decline in insight on task-specific memory ratings across the DAT spectrum, and call into question the use of self-reported SCCs as a diagnostic tool in later stages of disease progression.

Little is known about the service needs for persons caring for individuals with mild cognitive impairment (MCI). In this study, the level of support service need for caregivers of individuals diagnosed with Alzheimer disease (AD; N=55) and MCI (N=25) was compared with normal controls (N=44). Study partners (ie, caregivers) completed questionnaires about their service needs and participants' neurobehavioral symptoms, functional abilities, and frailty. Total, social, and mental health service needs were significantly different among the 3 groups (P

Researchers in a variety of disciplines have found that participants take less time and generate less diversity of responses when judging stimuli towards the ends of a scale than when judging those near the center. Three types of models, connectionist, exemplar, and anchor models, can account for these inverted-U effects. Anchor models assume that stimuli near the ends of the scale are used as anchors to compare with the other stimuli, implying that anchor representations are activated for each judgment. Therefore, participants should learn the anchors better than the other stimuli. Participants were 40 students from the Department of Psychology at McGill University (5 men; M age = 20.5 yr.; SD = 1.7). The experiment involved two tasks: first participants judged facial gender and then performed a recognition task. The results showed no correlation between the position on the gender scale and recognition accuracy. Several hypotheses were offered to explain these results.

and 100%; specificity: 82% and 87%; cut-off: 7.5 and 6.5) and AD from MCI (AUC: 0.89 and 0.91; sensitivity: 88% and 80%; specificity: 74% and 75%; cut-off 9.5 and 7.5). The test was less accurate to discriminate MCI from controls (AUC: 0.62 and 0.82; sensitivity: 75% and 95%; specificity: 54% and 50%; cut-off: 3.5 and 3.5). Conclusions: The SKT is subject to educational bias, and discriminates patients with AD from MCI and controls.