Prior research supports retirement may negatively impact cognitive functioning. The current study examined the relationship between retirement status and the level of cognitive dysfunction amongst individuals with Alzheimer’s disease (AD). For the purpose of this study, it was predicted that there would be significantly higher levels of cognitive dysfunction in retired participants after controlling for age.

Participants (ages 65 to 91) were drawn from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). The sample included 110 participants who were retired and 111 participants who were not retired. Cognitive dysfunction was assessed using the cognitive subscale of the modified Alzheimer’s Disease Assessment Scale (ADAS). A one-way ANCOVA analysis was conducted with cognitive dysfunction as the dependent variable and the age of the participants as a covariate.

The results of the one-way ANCOVA showed being retired was a significant predictor of greater cognitive dysfunction amongst individuals with AD after controlling for age (F(df=1, 218) = 231.143, p = < .001, p < .05) and accounted for 52% of the variance in the level of cognitive dysfunction.

Being retired is associated with higher levels of cognitive dysfunction in AD after accounting for the effects of age. As such, continued cognitive activity may slow the progression of cognitive declines amongst individuals with AD who are retired. There is a need for future longitudinal research to determine how late retirement may delay the progression of cognitive decline in AD by controlling for other moderator factors such as genetics and work-related stress.

Previous research evidences men, on average, perform better than women on nonverbal tasks. Conversely, literature evidences women, on average, perform better on memory tasks. Proposed explanations for this discrepancy include, increased parietal lobe volume to hormonal differences. Some research also suggests men have greater working memory (WM) abilities than women on tasks involving holding visual information. As such, it is possible more robust WM performance in men may translate to better performance on nonverbal tasks with an immediate and delayed visual memory component. The current study examined if WM performance moderates the relationship between sex and nonverbal learning and memory in a community clinic population of older adults referred for cognitive concerns.

Data was drawn from archival medical records of patients who underwent neuropsychological assessment in an outpatient, community clinic after being referred for cognitive concerns in the context of a variety of neurodegenerative and neurological conditions. Records of patients between the ages of 65 and 91 who completed the Brief Visuospatial Memory Test (BVMT-R) and WAIS-IV Digit Span (DS) were selected from the broader clinic sample of patients seen between 2019 and 2022. The total sample consisted of 302 older adults with a mean age of 75.11 (SD=6.06) and an average of 15.54 years of education (SD=2.51); 145 (48%) were women. Hierarchical regression analyses were used to examine the effects of sex, WM, and the interaction between sex and WM on BVMT learning and memory scores, while controlling for age and education. An independent samples t-test was also computed to examine sex differences on DS working memory scores.

The optimal linear combination of sex, WM, and the interaction between sex and WM accounted for 24.7% of the variance in BVMT total learning scores (F(5, 296)=20.79, p>0.05). There were no significant main effects of sex or the interaction between sex and WM on nonverbal learning or nonverbal memory (p>0.05). However, a strong trend was observed for the effect of sex on nonverbal memory (B=-0.69, t(5)=-1.91, p=0.057). A main effect of WM on nonverbal learning (B=0.42, 95% CI [0.25, 0.59], p<0.05) and memory (B=0.21, 95% CI [0.12, 0.29], p<0.05) was observed. Sex differences on WM measures were not observed (p>0.05).

Significant main effects of sex on nonverbal learning and memory were not found, though strong trends were observed between sex and nonverbal memory performance. While the relationships between WM and nonverbal learning and memory were trending toward significance, the predicted sex differences on WM performance were not found. The trend toward significance observed between sex and nonverbal memory may be the “carryover” effect from ancillary spatial skills that prior research has shown to be more robust amongst men, including mental rotation and visual construction. Findings from the current study align with the BVMT-R technical manual, which reported no significant contribution from sex in any learning or recall scores within their normative sample.

Individuals living with HIV may experience cognitive difficulties or marked declines known as HIV-Associated Neurocognitive Disorder (HAND). Cognitive difficulties have been associated with worse outcomes for people living with HIV, therefore, accurate cognitive screening and identification is critical. One potentially sensitive marker of cognitive impairment which has been underutilized, is intra-individual variability (IIV). Cognitive IIV is the dispersion of scores across tasks in neuropsychological assessment. In individuals living with HIV, greater cognitive IIV has been associated with cortical atrophy, poorer cognitive functioning, with more rapid declines, and greater difficulties in daily functioning. Studies examining the use of IIV in clinical neuropsychological testing are limited, and few have examined IIV in the context of a single neuropsychological battery designed for culturally diverse or at-risk populations. To address these gaps, this study aimed to examine IIV profiles of individuals living with HIV and who inject drugs, utilizing the Neuropsi, a standardized neuropsychological instrument for Spanish speaking populations.

Spanish speaking adults residing in Puerto Rico (n=90) who are HIV positive and who inject drugs (HIV+I), HIV negative and who inject drugs (HIV-I), HIV positive who do not inject drugs (HIV+), or healthy controls (HC) completed the Neuropsi battery as part of a larger research protocol. The Neuropsi produces 3 index scores representing cognitive domains of memory, attention/memory, and attention/executive functioning. Total battery and within index IIV were calculated by dividing the standard deviation of T-scores by mean performance, resulting in a coefficient of variance (CoV). Group differences on overall test battery mean CoV (OTBMCoV) were investigated. To examine unique profiles of index specific IIV, a cluster analysis was performed for each group.

Results of a one-way ANOVA indicated significant between group differences on OTBMCoV (F[3,86]=6.54, p<.001). Post-hoc analyses revealed that HIV+I (M=.55, SE=.07, p=.003), HIV-I (M=.50, SE=.03, p=.001), and HIV+ (M=.48, SE=.02, p=.002) had greater OTBMCoV than the HC group (M=.30, SE=.02). To better understand sources of IIV within each group, cluster analysis of index specific IIV was conducted. For the HIV+ group, 3 distinct clusters were extracted: 1. High IIV in attention/memory and attention/executive functioning (n=3, 8%); 2. Elevated memory IIV (n=21, 52%); 3. Low IIV across all indices (n=16, 40%). For the HIV-I group, 2 distinct clusters were extracted: 1. High IIV across all 3 indices (n=7, 24%) and 2. Low IIV across all 3 indices (n=22, 76%). For the HC group, 3 distinct clusters were extracted: 1. Very low IIV across all 3 indices (n=5, 36%); 2. Elevated memory IIV (n=6, 43%); 3. Elevated attention/executive functioning IIV with very low attention/memory and memory IIV (n=3, 21%). Sample size of the HIV+I group was insufficient to extract clusters.

Current findings support IIV in the Neuropsi test battery as clinically sensitive marker for cognitive impairment in Spanish speaking individuals living with HIV or who inject drugs. Furthermore, the distinct IIV cluster types identified between groups can help to better understand specific sources of variability. Implications for clinical assessment in prognosis and etiological considerations are discussed.

Injection drug use is a significant public health crisis with adverse health outcomes, including increased risk of human immunodeficiency virus (HIV) infection. Comorbidity of HIV and injection drug use is highly prevalent in the United States and disproportionately elevated in surrounding territories such as Puerto Rico. While both HIV status and injection drug use are independently known to be associated with cognitive deficits, the interaction of these effects remains largely unknown. The aim of this study was to determine how HIV status and injection drug use are related to cognitive functioning in a group of Puerto Rican participants. Additionally, we investigated the degree to which type and frequency of substance use predict cognitive abilities.

96 Puerto Rican adults completed the Neuropsi Attention and Memory-3rd Edition battery for Spanish-speaking participants. Injection substance use over the previous 12 months was also obtained via clinical interview. Participants were categorized into four groups based on HIV status and injection substance use in the last 30 days (HIV+/injector, HIV+/non-injector, HIV/injector, HIV-/non-injector). One-way analysis of variance (ANOVA) was conducted to determine differences between groups on each index of the Neuropsi battery (Attention and Executive Function; Memory; Attention and Memory). Multiple linear regression was used to determine whether type and frequency of substance use predicted performance on these indices while considering HIV status.

The one-way ANOVAs revealed significant differences (p’s < 0.01) between the healthy control group and all other groups across all indices. No significant differences were observed between the other groups. Injection drug use, regardless of the substance, was associated with lower combined attention and memory performance compared to those who inject less than monthly (Monthly: p = 0.04; 2-3x daily: p < 0.01; 4-7x daily: p = 0.02; 8+ times daily: p < 0.01). Both minimal and heavy daily use predicted poorer memory performance (p = 0.02 and p = 0.01, respectively). Heavy heroin use predicted poorer attention and executive functioning (p = 0.04). Heroin use also predicted lower performance on tests of memory when used monthly (p = 0.049), and daily or almost daily (2-6x weekly: p = 0.04; 4-7x daily: p = 0.04). Finally, moderate injection of heroin predicted lower scores on attention and memory (Weekly: p = 0.04; 2-6x weekly: p = 0.048). Heavy combined heroin and cocaine use predicted worse memory performance (p = 0.03) and combined attention and memory (p = 0.046). HIV status was not a moderating factor in any circumstance.

As predicted, residents of Puerto Rico who do not inject substances and are HIVnegative performed better in domains of memory, attention, and executive function than those living with HIV and/or inject substances. There was no significant difference among the affected groups in cognitive ability. As expected, daily injection of substances predicted worse performance on tasks of memory. Heavy heroin use predicted worse performance on executive function and memory tasks, while heroin-only and combined heroin and cocaine use predicted worse memory performance. Overall, the type and frequency of substance is more predictive of cognitive functioning than HIV status.

With persistent incidence, incomplete vaccination rates, confounding respiratory illnesses, and few therapeutic interventions available, COVID-19 continues to be a burden on the pediatric population. During a surge, it is difficult for hospitals to direct limited healthcare resources effectively. While the overwhelming majority of pediatric infections are mild, there have been life-threatening exceptions that illuminated the need to proactively identify pediatric patients at risk of severe COVID-19 and other respiratory infectious diseases. However, a nationwide capability for developing validated computational tools to identify pediatric patients at risk using real-world data does not exist.

HHS ASPR BARDA sought, through the power of competition in a challenge, to create computational models to address two clinically important questions using the National COVID Cohort Collaborative: (1) Of pediatric patients who test positive for COVID-19 in an outpatient setting, who are at risk for hospitalization? (2) Of pediatric patients who test positive for COVID-19 and are hospitalized, who are at risk for needing mechanical ventilation or cardiovascular interventions?

This challenge was the first, multi-agency, coordinated computational challenge carried out by the federal government as a response to a public health emergency. Fifty-five computational models were evaluated across both tasks and two winners and three honorable mentions were selected.

This challenge serves as a framework for how the government, research communities, and large data repositories can be brought together to source solutions when resources are strapped during a pandemic.

Mental health problems are elevated in autistic individuals but there is limited evidence on the developmental course of problems across childhood. We compare the level and growth of anxious-depressed, behavioral and attention problems in an autistic and typically developing (TD) cohort.

Latent growth curve models were applied to repeated parent-report Child Behavior Checklist data from age 2–10 years in an inception cohort of autistic children (Pathways, N = 397; 84% boys) and a general population TD cohort (Wirral Child Health and Development Study; WCHADS; N = 884, 49% boys). Percentile plots were generated to quantify the differences between autistic and TD children.

Autistic children showed elevated levels of mental health problems, but this was substantially reduced by accounting for IQ and sex differences between the autistic and TD samples. There was small differences in growth patterns; anxious-depressed problems were particularly elevated at preschool and attention problems at late childhood. Higher family income predicted lower base-level on all three dimensions, but steeper increase of anxious-depressed problems. Higher IQ predicted lower level of attention problems and faster decline over childhood. Female sex predicted higher level of anxious-depressed and faster decline in behavioral problems. Social-affect autism symptom severity predicted elevated level of attention problems. Autistic girls' problems were particularly elevated relative to their same-sex non-autistic peers.

Autistic children, and especially girls, show elevated mental health problems compared to TD children and there are some differences in predictors. Assessment of mental health should be integrated into clinical practice for autistic children.

Face masks reduce disease transmission by protecting the wearer from inhaled pathogens and reducing the emission of infectious aerosols. Although methods quantifying efficiency for wearer protection are established, current methods for assessing face mask containment efficiency rely on measurement of a low concentration of aerosols emitted from an infected or noninfected individual.

A small port enabled the introduction of 0.05 µm sodium chloride particles at a constant rate behind the mask worn by a study participant. A condensation particle counter monitored ambient particle numbers 60 cm in front of the participant over 3-minute periods of rest, speaking, and coughing. The containment efficiency (%) for each mask and procedure was calculated as follows: 100 × (1 − average ambient concentration with face covering worn/average ambient concentration with a sham face covering in place). The protection efficiency (%) was also measured using previously published methods. The probability of transmission (%) from infected to uninfected (a function of both the containment efficiency and the protection efficiency) was calculated as follows: {1 − (containment efficiency/100)}×{1 − (protection efficiency/100)}×100.

The average containment efficiencies for each mask over all procedures and repeated measures were 94.6%, 60.9%, 38.8%, and 43.2%, respectively, for the N95 mask, the KN95 mask, the procedure face mask, and the gaiter. The corresponding protection efficiencies for each mask were 99.0%, 63.7%, 45.3%, and 24.2%, respectively. For example, the transmission probability for 1 infected and 1 uninfected individual in close proximity was ∼14.2% for KN95 masks, compared to 36%–39% when only 1 individual wore a KN95 mask.

Overall, we detected a good correlation between the protection and containment that a face covering afforded to a wearer.