Cognitive reserve (CR) refers to how flexibly and efficiently the individual makes use of available brain resources. Early-life education, midlife social and occupational activities, and later-life cognitive and social interactions are associated with greater CR. Years of education, premorbid intellectual (IQ) functioning, linguistic ability, and occupational complexity are often used as proxies of CR. CR theory seeks to explain discrepancies between the extent of disease pathology and clinical presentation amongst individuals with dementia. In the presence of Alzheimer’s Disease (AD) pathology, higher CR is associated with slower declines in executive functioning (EF). The current study examined the correlation between CR and EF performance across various stages of dementia severity as measured by the total score on the Clinical Dementia Rating Scale (CDRS).

The study cohort consisted of 269 individuals who had completed measures of EF and the CDRS from phase 1 of the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Individuals who scored less than 2 on the CDRS were included in the MCI group (n=197), while individuals that scored 2 or higher on the CDRS were included in the dementia group (n=73). A simple linear regression was utilized to compare the MCI group to dementia group across CR and EF performance.

There was significant correlation between CR and EF performance in the MCI group as quantified on total CDRS score (F (200) = .353, p = .0, p < .05). CR was not observed to be predictive of EF in the dementia group (F (200) = .031, p = .666, p > .05).

Findings are consistent with prior research suggesting CR is protective during early stages of dementia, but not in the later disease stages. As prior research has shown the expression of dementia is based on a complex interaction between genetic and lifestyle factors that are unique to each person, future research exploring the potentially protective role of CR amongst pre-symptomatic adults with a genetic predisposition for developing dementia may expand our understanding of the potential role of CR on dementia prevention and progression.

Persons with behavioral variant frontotemporal dementia (bvFTD) have been shown to exhibit altered morality, manifested as atypical utilitarian tendencies towards sacrificial moral dilemmas. This takes the form of endorsing harmful actions towards single individuals, including vulnerable or relationally close individuals (e.g. children, loved ones), in order to promote the greater good for the community or society as a whole. The dual process model of moral cognition interprets such tendencies as deriving from a lack of emotional engagement, whereas moral emotion theory views them as selective impairment in prosocial sentiments. We hypothesized that both the widespread neuropsychological practice of using sacrificial moral dilemmas to evaluate moral reasoning, and these tests' overreliance on quantitative results, inadequately represent how persons with bvFTD reason and feel while responding to moral dilemmas. To evaluate this hypothesis, we applied a mixed-methods approach to identify the reasoning, motivations, and emotional experiences of bvFTD persons during their deliberation about moral scenarios.

We conducted semi-structured interviews with 14 participants: 7 persons with bvFTD & 7 older healthy controls. Transcripts were coded in Atlas 5.0 to characterize the underlying reasoning, emotions, response processes, and values that emerged when responding to a structured set of moral dilemmas. Our dilemmas measured utilitarian reasoning holistically by incorporating both sacrificial and impartial/altruistic components, as suggested by the 2-dimensional model of utilitarianism.

Unexpectedly, bvFTD persons articulated a prosocial compass when asked about their values, stating they were organizing their choices predominantly around kindness and altruism, even when they were making choices to harm loved ones or vulnerable individuals to promote the greater good. During moral deliberation, persons with bvFTD showed significantly less metacognition (bvFTD = 10%, HC = 90%) but reported more positive emotions (joy; bvFTD = 83%, HC = 17%) than negative (frustration; bvFTD = 30 %, HC = 70 %) compared to controls. Qualitatively, this observed emotional outlook was typically coupled with a more rigid, simplistic viewpoint (e.g., "I felt great, it was a no brainer"), suggesting a moral understanding lacking emotional nuance and complexity.

Our data showed that bvFTD persons' utilitarian responses to moral dilemmas did not arise from an emotionally flat or antisocial cognitive perspective, but instead were guided by positive emotionality, simplistic reasoning, and prosocial values. These findings challenge the current understanding of the reasoning processes and experiences of persons with bvFTD and highlight the importance of incorporating mixed method approaches in dementia research that take into consideration the viewpoint of the cognitively compromised individual.

Decline in everyday function is a hallmark of dementia and is associated with increased caregiver burden, medical spending, and poorer quality of life. Neuropsychiatric symptoms (e.g., apathy, hallucinations) can also occur in those with dementia and have been associated with worse everyday functioning cross-sectionally. However, research on which neuropsychiatric symptoms are most associated with everyday functioning in those with dementia longitudinally has been more limited. Further, it is unknown which neuropsychiatric symptoms may add incremental validity beyond cognition in predicting everyday function longitudinally. The current study aimed to address both of these gaps in the literature by identifying which neuropsychiatric symptoms are most associated with everyday function over time and if symptoms add incremental validity in predicting everyday function beyond cognition in those with dementia.

Older adult participants (N = 4525), classified as having dementia at baseline by the National Alzheimer's Coordinating Center, were examined. Severity of neuropsychiatric symptoms were measured via the Neuropsychiatric Symptoms Questionnaire-Informant. Everyday function was assessed via the Functional Activities Questionnaire-Informant. Memory (Logical Memory immediate and delayed) and executive function (Digit Symbol Test, TMT-A and TMT-B) composites were created to assess cognition. Severity of neuropsychiatric symptoms at baseline were analyzed as predictors of everyday functioning beyond demographic factors and cognition at baseline and over the course of five years using multilevel modeling.

At baseline, severity of the majority of symptoms, excluding irritability, manic symptoms, and changes in appetite, were associated with everyday function (all p < .05). When examining everyday functioning longitudinally, only severity of hallucinations, apathy, motor dysfunction, and sleep dysfunction were associated with differences in everyday function over time (all p < .01).

There is heterogeneity in the degree to which neuropsychiatric symptoms are associated with everyday functioning over time in those with dementia. Additionally, our results show that some neuropsychiatric symptoms are associated with longitudinal changes in everyday function beyond domains of cognition show to be associated with function. Clinicians should pay particular attention to which neuropsychiatric symptoms individuals with dementia and their families are reporting to aid with treatment planning and clinical decision making related to autonomy. Future research would benefit from examining pathways through which neuropsychiatric symptoms are associated with everyday functioning over time in this population, and if treatments of neuropsychiatric symptoms may improve everyday function in this population.

In the field of neurocognitive disorders, the perspective offered by new disease-modifying therapy increases the importance of etiological diagnosis. The prescription of cerebrospinal fluid analysis (CSF) and imaging biomarkers is a common practice in the clinic but is often driven more by personal expertise and local availability of diagnostic tools than by evidence of efficacy and cost-effectiveness analysis. This leads to a widely heterogeneous dementia care across Europe. Therefore, a European initiative is currently being conducted to establish a consensus for biomarker-based diagnosis of patients with mild cognitive impairment (MCI) and mild dementia.

Since November 2020, a European multidisciplinary task force of 22 experts from 11 scientific societies have been defining a diagnostic workflow for the efficient use of biomarkers. The Delphi consensus procedure was used to bridge the gaps of incomplete scientific evidence on biomarker prioritization. The project has been in two phases. During Phase 1, we conducted a literature review on the accuracy of imaging, CSF, neurophysiological and blood biomarkers in predicting the clinical progression or in defining the underpinning aetiology of main neurocognitive disorders. Evidence was provided to support the panelists’ decisions. In phase 2, a modified Delphi procedure was implemented, and consensus was reached at a threshold of 70% agreement, or 50%+1 when a question required rediscussion.

In phase 1, 167 out of 2,200 screened papers provided validated measures of biomarker diagnostic accuracy compared with a gold standard or in predicting progression or conversion of MCI to the dementia stage (i.e., MRI, CSF, FDG-PET, DaT-imaging, amyloid-PET, tau-PET, and myocardial MIBG-scintigraphy and EEG). During phase 2, panelists agreed on the clinical workspace of the workflow, the stage of application, and the patient age window. The workflow is patient-centered and features three levels of assessment (W): W1 defines eleven clinical profiles based on integrated results of neuropsychology, MRI atrophy patterns, and blood tests; W2 describes the first-line biomarkers according to W1 versus clinical suspicion; and W3 suggests the second-line biomarkers when the results of first-line biomarkers are inconsistent with the diagnostic hypothesis, uninformative or inconclusive. CSF biomarkers are first-line in the suspect of Alzheimer’s disease (AD) and when inconsistent neuropsychological and MRI findings hinder a clear diagnostic hypothesis; dopamine SPECT/PET for those leading to suspect Lewy body spectrum. FDG-PET is first-line for the clinical profiles leading to suspect frontotemporal lobar degeneration and motor tauopathies and is followed by CSF biomarkers in the case of atypical metabolic patterns, when an underlying AD etiology is conceivable.

The workflow will promote consistency in diagnosing neurocognitive disorders across countries and rational use of resources. The initiative has some limitations, mainly linked to the Delphi procedure (e.g., kickoff questions were driven by the moderators, answers are driven by the Delphi panel composition, a subtle phrasing of the questions may drive answers, and 70% threshold for convergence is conventional). However, the diagnostic workflow will be able to help clinicians achieve an early and sustainable etiological diagnosis and enable the use of disease-modifying drugs as soon as they become available.

Assessment of learning potential in patients with cognitive disorders in individuals with alcohol-related cognitive disorders (including Korsakoff’s syndrome; KS) is highly relevant, as this may help to tailor interventions, guide treatment planning and help to optimize care. However, studies on assessing learning potential or learning ability using neuropsychological assessment in relation to changes in everyday activities during the course of treatment are scarce. In this study we examined whether verbal and visuospatial learning curves could be used as an index of learning ability in relation to everyday activities before and after a treatment program.

We examined the episodic learning ability of patients with KS (N=137), other alcohol-related cognitive impairments (ARCI; N=164), and uncomplicated alcohol use disorder (AUD; N=49). For this, we calculated the learning curves for the California Verbal Learning Test (CVLT) and the Location Learning Test - Revised (LLT-R) and examined their association with ratings of everyday activities by the patient and his/her professional caregiver using the Patient Competency Rating Scale (PCRS) before and after a 10-12 week treatment program following admission to the Korsakoff Centre.

For both verbal and visuospatial memory, the AUD group had a steeper learning curve than the ARCI patients, who in turn had a steeper learning curve than the KS group (p<.01). While the VLGT total score was related to the PCRS in all patient groups (Pearson r>.38, p<.01), this was only the case for the KS group for the LLT-R total score (r>-.29, p<.01). However, the learning curve estimates of both tests were neither related to the PCRS absolute scores (for patients and caregivers, before and after treatment) nor to the APCRS scores during the course of the treatment program.

Episodic learning ability, as measured with the learning curves of the CVLT and LLT-R, were unrelated to the patients everyday activity level as measures by the patients themselves or their professional caregiver. The results will be discussed in relation to other tools for assessing the learning potential of cognitively impaired patients, such as dynamic testing.

There is limited and inconsistent research exploring diagnosis, treatment, and prevention of dementias amongst Black Indigenous People of Color (BIPOC). By 2050, it is suspected that the White population will significantly decrease and BIPOC groups will comprise the majority of the US population yet BIPOC are historically underrepresented in dementia research. Prior research indicates apolipoprotein 4 allele (APOE-4) status is associated with a greater risk of developing Alzheimer’s disease in Black individuals when compared to non-Hispanic Whites. Investigating the racial disparities in dementia will expand our knowledgebase of risk for dementia types in the Black community to better meet the evergrowing population needs. The current study explored the impact of racial identity on global cognitive functioning, independent of age, education, and APOE e4 status.

Participants were drawn from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) study and consisted of five pairs of Black and White individuals (n = 10) matched based on age, education, and APOE status. Global cognitive performance was measured by the total Mini Mental Status Examination (MMSE) score. Notably, only five Black individuals in phase 1 of ADNI met inclusion criteria. It was hypothesized Black individuals would be more cognitively impaired than their White counterparts. A matched pairs t-test was utilized to examine the relationship between global cognitive performance and race.

Black and White individuals’ MMSE scores did not significantly differ (p > .05). The mean MMSE performance of White participants (26.40) was less robust than Black participants (27.80). Findings are inconsistent with current research, indicating that BIPOC individuals are disproportionately impacted by AD, with increased severity of cognitive impairment. There is a profound need for more research in preventative interventions and recruitment of BIPOC individuals who have been historically marginalized in cognitive research trials to help better understand diagnosis, treatment, and prevention of AD in BIPOC.

The observed commensurate global cognitive functioning performance between matched Black and White individuals is not consistent with prior research findings demonstrating increased risk of developing dementia amongst BIPOC. This study’s small sample size reflects a significant barrier to detecting clinically meaningful differences. Efforts to address the recruitment crisis, underreporting, cultural influences, and overall mistrust of research among BIPOC is warranted. Inclusive research is critical to dismantling health disparities.

Prospective memory (PM) is the ability to execute a planned action in the future (e.g., remembering to take medication before going to bed). Prior work has suggested that PM failure can account for 50-80% of reported memory problems. Research has also shown that PM becomes increasingly impaired in the Alzheimer's disease (AD) process. To our knowledge, most PM studies use PM accuracy as a measure of PM performance. However, examining the speed of the response as it relates to the AD process remains relatively unexplored. In this study, we examined both PM accuracy and speed in healthy aging, mild cognitive impairment (MCI), and AD.

Participants included healthy older controls (N=65), persons with MCI (N=70), and persons with AD (N=11). The PM task was embedded within a working memory task as PM demands often occur during an ongoing activity in everyday life. For the working memory component of the PM task, participants were shown a series of words and asked to continuously monitor the words while maintaining the last 3 in memory. All words were displayed within 1 of 6 background patterns. For the PM component, participants were asked to press "1" on the keyboard whenever they were shown a particular background pattern on the screen. PM abilities were measured using the median response time and total accuracy.

Age was correlated with PM accuracy. An ANCOVA, controlling for age, and examining the impact of diagnosis on PM accuracy, was significant. Post-hoc tests revealed a trend toward the AD and MCI groups being less accurate than healthy controls. In contrast to accuracy, age was not related to PM speed. An ANOVA examining the impact of diagnosis on PM accuracy found that the AD group responded faster than healthy controls. The MCI group did not show differences in speed from the healthy control and AD groups.

Overall, the pattern of results differed in accuracy and speed of PM performance. There was a trend for the MCI and AD groups being less accurate than the controls, with no difference in performance between the MCI and AD groups. However, the AD group responded more quickly than the controls, which may have impacted their accuracy. These findings indicate that PM performance differences among groups can be detected by examining speed and not just accuracy. As speed appears to be an essential aspect involved in PM performance, future research should consider incorporating speed as a measure of PM performance when examining PM differences in populations.

The Boston Naming Test (BNT) is a 60-item confrontation naming task requiring participants to name a series of pictures. Prior research has shown that bilingual children have smaller vocabularies than monolinguals and that this effect continues into adulthood. Numerous studies have confirmed that bilingual adults name fewer pictures correctly than monolinguals on the BNT. Research also shows that self-reported workload correlates with neuropsychological test performance and that estimates of workload provide additional information regarding cognitive outcomes. Hardy and Wright (2018) conditionally validated a measure of perceived mental workload called the NASA Task Load Index (NASA-TLX; Hart & Staveland 1988) with healthy adults on a neuropsychological test (i.e., the Tower of Hanoi). Research also shows that bilinguals report higher perceived workloads on cognitive tasks compared to monolinguals. Although this work has recently extended to other tests, to our knowledge, the workload profile of the BNT remains relatively unexplored. We evaluated BNT performance and perceived workload via the NASA-TLX in monolinguals and bilinguals. We predicted that monolinguals would outperform bilinguals on the BNT, but that bilinguals would report higher workloads.

The study sample consisted of 84 healthy participants (36 monolinguals, 48 bilinguals) with a mean age of 28.94 (SD = 10.76). Participants completed the standard 60-item BNT in English. The NASA-TLX scale was utilized to evaluate perceived workload across six subscales. The NASA-TLX was also completed in English after the completion of the BNT. ANOVAs were used to test BNT performance and perceived workload ratings between our language groups.

We found that monolinguals performed better on the BNT compared to bilinguals, p =.001, np2 = 24. However, bilinguals reported exerting more effort when completing the BNT compared to monolinguals, p =.002, np2 = .11. Additionally. bilinguals also experienced more frustration when completing the BNT compared to monolinguals, p =.034, np2 = .05.

As expected, results revealed that monolinguals outperformed bilingual participants on the BNT. However, bilinguals exerted more effort on the BNT and reported the BNT to be more frustrating. A possible reason for bilinguals underperforming and reporting higher perceived workloads on the BNT may be because correct responses were only accepted in English. This may have caused bilingual speakers to exert increased effort to complete the task in a non-native language. In turn, this increased effort likely increased cognitive load and led to higher frustration levels. Further research is needed to confirm our findings and support the idea that bilingualism leads to perceiving greater effort and frustration, and to determine whether there are subgroup differences in BNT performances among bilingual individuals (e.g., English learned as a first language compared to English learned as a second language).

Many of those who experience the trauma and abuse of sex trafficking also struggle with a variety of physical and mental health issues, a major one of those issues being posttraumatic stress disorder (PTSD). In this study, we explored the relationship between verbal comprehension and a PTSD diagnosis to see if this aspect of intelligence might be stronger for individuals without a diagnosis of PTSD.

Participants included 22 adolescent girls between the ages of 14 and 18 who had experienced sex trafficking. Participants were referred to Fuller Psychological and Family Services for learning difficulties, where they were given comprehensive clinical neuropsychological evaluations, including a Wechsler Intelligence Scale (WISC or WAIS) and a screening for PTSD. WISC or WAIS Full Scale IQ ranged from 75 to 115 (M = 85.1, SD = 11.2).

Contrary to the hypothesis that those without PTSD would have higher verbal comprehension scores than those with PTSD, the results indicated no difference between the two groups, t(23) = -.86 , p = .40. However, verbal comprehension scores across both groups were significantly below the normal range, suggesting a relationship between trauma and verbal comprehension.

The diagnosis of PTSD may impact intelligence in ways not anticipated for this population, or perhaps our method of diagnosing PTSD did not adequately nuance the varying responses to trauma. By further exploring the relationships between Verbal Comprehension Indexes and markers of resilience, we may be able to better understand the characteristics of resilience demonstrated by those who become involved in prostitution.

Health literacy is the degree to which an individual is able to attain, process, and understand information, skills, and services required to make informed decisions. Limited health literacy is a risk factor for problems understanding health information and adhering to medical instructions, underuse of preventive services, increased hospitalizations and associated medical costs, and higher mortality rates. Recognizing individuals with reduced health literacy can be difficult given demographic information such as age or years of education do not reliably reflect an individual’s health literacy level. Cross-sectional studies have identified limited health literacy as associated with lower scores on cognitive tests measuring memory, executive function (EF), and processing speed, independent from the influence of demographic variables (e.g., age, race, education). This study assessed the association of objective measures of executive functioning and health literacy when controlling for premorbid estimated intellectual functioning and relevant demographic variables.

A sample of 44 adult patients (20 Male; 24 Female) referred for neuropsychological evaluation for memory complaints who were administered the Test of Premorbid Functioning (TOPF), and multiple measures of EF including the Trail Making Test - Part B (TMT-B), Stroop Color and Word Test (SCWT), and Letter (FAS) and Semantic (Animals) Fluency as part of part of a larger standardized battery. Patients were also administered the Short Assessment of Health Literacy-English (SAHL-E). All included patients had <2 performance validity test failures. The sample was 50% non-Hispanic Black, 31.8% non-Hispanic White, 15.9% Hispanic, 2.3% Asian/Pacific Islander, and 54.5% female. Diagnostically, 50.9% of the sample were cognitively normal, 36.4% had mild cognitive impairment, and 15.9% had dementia. Two multiple regressions were conducted to evaluate (1) the predictive power of EF on the SAHL-E, and (2) the moderating impact of estimated premorbid IQ and demographics via the TOPF on the relationship between EF and SAHL-E.

The first regression was not significant (p=.168) with FAS as the only independent predictor of SAHL-E performance (ß=.387, p<.05). The overall model was significant with the addition of the TOPF (p<.001). FAS accounted for 29% (ß=.336, p<.05) of the variance in SAHL-E when controlling for TOPF and other measures of EF.

These results indicate that novel generativity is a significant predictor of health literacy beyond the influence of estimated premorbid intelligence and demographic factors. Importantly, these findings suggest that broadly speaking EF abilities have minimal impact on health literacy, although reduced verbal generativity to letter cues is associated with reduced health literacy. Identification of at-risk populations such as individuals with limited health literacy is clinically important and can make way for early intervention. Health information targeted at this at-risk population should go beyond vocabulary and more specifically reduce the burden on verbal fluency.

Brain science demonstrates that people who stutter (PWS) exhibit insufficient activation in the auditory speech area of the left hemisphere (Kikuchi, et al. 2011 ; Garnett, et al. 2018). In this study, we reported the auditory brainstem response of PWS: in PWS with moderate and severe impairment, significantly longer interpeak latencies (IPLs) between waves I and V (IPL [I-V]) of the right ear than those of the left ear were observed. However, in PWS with mild impairment, the IPLs (I-V) of the left ear were significantly longer than those of the right ear (Anzaki et al., 2020). We considered that the differences in the IPLs (I-V) between the right and left ears cause monitoring disturbance in communication, which results in developmental stuttering. It has been reported that stuttering was improved by delayed auditory feedback (DAF) (Stromsta, 1956; Sakai, 2008). Thus, we improved the DAF system and developed an application that can be used by PWS to listen to their own voices with no differences in the IPLs (I-V) between their left and right ears. We verified the effectiveness of this application.

This study included five male adults with developmental stuttering (ADSs), with a mean age and handedness index of 36 years and 84, respectively. The application was adjusted so that the IPLs (I-V) of the left and right ears were the same. For example, one ADS showed that the IPL (I-V) of their right ear was 0.5 msec longer than that of their left. Subsequently, the application was adjusted so that the IPL (I-V) of his left ear would be delayed by 0.5 msec. We asked the participants to use the application for six months when free talking and reading aloud. Using the Japanese Standardized Test for Stuttering (JSTS) (Ozawa, et al. 2013), we compared their disfluencies with and without the application.

As per the JSTS, the stuttering severity in all participants improved. Case 1, who had severe impairment (level 5), showed a moderate improvement (level 4), Cases 2 and 3, who had moderate impairment (level 4), showed a mild improvement (level 3), and Cases 4 and 5, who had mild impairment (level 3), exhibited a normal level of improvement (level 1). We calculated the z-scores of the improvement rates of the JSTS based on the standard deviations according to the severity (Anzaki, 2019). The z-scores of Case 4 and 5 were 4.01 and 2.01, respectively, indicating a significant improvement.

In our report last year, although ADSs with moderate and severe impairment showed improvement by stimulation intervention on the left hemisphere through the right ear, those with mild impairment exhibited only a slight or no improvement as per the JSTS (Anzaki, et al. 2021). The application developed in this study was found to significantly improve the disfluencies of all the participants as per the JSTS, especially those with mild impairment. Therefore, we considered that stuttering disorders are layered; ADSs have auditory monitoring disorder in the base.

As word finding or "naming" impairment is a symptom of multiple neurological conditions, naming assessment is an integral component of most neuropsychological evaluations. For decades, the Boston Naming Test (BNT) has been, and remains, the most widely used measure of naming. Although it has been shown that naming is generally stable from young adulthood through middle age, we have observed, clinically, that young adults tend to have greater difficulty on the BNT than older adults. Considering that the BNT was developed more than 50 years ago, and that language and culture change over time, we hypothesized that 1) increasing age would be associated with stronger performance on the BNT, whereas 2) there would be no association between age and naming performance on more recently developed naming measures.

Participants were healthy adults who served as normative subjects in the revision study of the Auditory (ANT) and Visual Naming (VNT) Tests. Due to known effects of education level on BNT performance, we excluded those with less than 16 years of education, targeting young adults through middle age, resulting in 118 adults, 20 through 50 years of age (mean age: 32.9 ± 9.2 years; mean education: 16.8 ± 1.2 years; mean FSIQ: 106.0 ± 12. 6). All participants were native English speakers or learned English by age 5 and were fully educated in English. Untimed accuracy (i.e., response within 20 seconds) is the standard performance measure for the BNT; the ANT and VNT additionally include tip-of-the-tongue (TOT) scores, which incorporate response time and reliance on phonemic cueing (TOT score = number of items named in > 2 seconds but < 20 seconds, plus items named correctly after 20 seconds, following a phonemic cue). Pearson correlations examined the relation between age and naming performance on the BNT, ANT and VNT.

Pearson correlations revealed a small but significant, positive correlation between age and BNT performance (r =.22, p = .017), yet no correlation between age and performance on the ANT (ANT Accuracy: r = .05, p=.60, ANT-TOT: r = -.14, p = .12) or VNT (VNT Accuracy: r = .04, p=.67, VNT-TOT; r = -.03, p = .72).

In this sample of healthy adults, naming performance improved with increasing age on the BNT; however, while vocabulary knowledge may broaden, naming efficiency should not improve with age. By contrast, we found no relation between age and naming performance on the more recently developed ANT and VNT. Results underscore the need to revise test stimuli on verbal measures, particularly those that assess naming, and suggest caution in interpreting BNT performance in young adults, as poor BNT performance might not accurately represent their true naming ability.

Working memory is a vital construct in efficient verbal memory encoding (Cotton & Ricker, 2021). Working memory is impacted by attentional capacities (Riccio, Cohen, Garrison, & Smith, 2005). Mood symptoms impact efficient information processing and consolidation of memory (Hubbard, 2016; Lukasik, 2019). This study examines self-reported symptoms of depression, anxiety, and stress as possible moderators of the relationship between working memory and a verbal list-learning task.

Archival data from 415 adults (Mage= 56.10, SD=18.05; Medu= 15.5 SD=2.2; 53% female; 73% white) were collected at an outpatient clinic. Sex and race were not available in a small percentage of cases included in analyses. The Wechsler Adult Intelligence Scale 4th Edition Digit Span subtest was given to assess attention and working memory. Although Digit Span Forward is a measure of simple attention, not working memory, it was included in initial analyses because the subtest was given as a whole. The three components of Digit Span total, Forward, Backward, and Sequencing were also investigated separately, with the two latter scores being better representations of working memory. Learning was assessed via the California Verbal Learning Test (CVLT-II) total T-Score (Trials 1-5). Mood was assessed via the Depression Anxiety and Stress Scales (DASS-42).

Results of a hierarchical linear regression showed a significant effect between total Digit Span performance and total learning on the CVLT-II in the Block 1 (F(3, 411)=14.383, p =<.001 , AR2=.095). Standardized beta weights and p-values for Digit Span Forward, Backward, and Sequencing were (ß=-.50, p=.374), (ß= .159, p=.009), and (ß=.210, p<.001) respectively. In Block 2, when the DASS variables were introduced, the model remained significant F(3,408)=2.602, p=.05 , AR2=.017). The DASS anxiety and stress subscales had significant beta weights in the model (ß=-.172, p=.015) and (ß=.144, p=.039) respectively, with depression being insignificant (ß=--.023, p=.724).

Mood symptoms have been shown to be an important consideration when assessing working memory and verbal learning performance (Massey, Meares, Batchelor, & Bryant, 2015). Present results demonstrate that when accounting for working memory, anxiety and stress were significant predictors of performance on a measure of verbal learning. Additionally, as the components best representing working memory, Digit Span Sequencing and Backward were significantly correlated with verbal learning, whereas a measure best representing simple attention, Digit Span Forward, was not significantly correlated with verbal learning.

Health numeracy is the understanding and application of information conveyed with numbers, tables and graphs, and probabilities in order to effectively manage one's own healthcare. Health numeracy is a vital aspect of communicating with healthcare providers and participating in one's own medical decision making, which is especially important in aging populations. Current literature indicates that assessing and establishing one's health numeracy abilities is among the first steps in providing necessary resources and accommodating patients' individual needs. Additionally, older adults with diffuse cognitive impairment often have issues with facets of executive functioning; however, the extant literature does not discuss the role of executive functioning in relation to health numeracy in this population. The purpose of this study was to explore the relationship between performance on tasks of executive functioning and objectively-measured health numeracy abilities in older adult patients.

This study included a sample of 42 older adult patients referred for neuropsychological evaluation for memory complaints who were administered the Test of Premorbid Functioning (TOPF), Trail Making Test - Part B (TMT-B), and Stroop Color and Word Test (SCWT Color Word Interference [CWI]) as part of a larger standardized battery. Patients were also administered the Numerical Understand in Medicine Instrument - Short Form (NUMI-SF). All included patients had <2 performance validity test failures. The sample was racially diverse (47.6% Black, 35.7% White, 14.3% Hispanic, 2.4% Asian) and 54.8% female. Average age was 62.95 (SD= 8.6) and average education was 14.1 (SD=2.7). Diagnostically, 47.6% of the sample were cognitively normal, 33.3% had mild cognitive impairment, and 19.0% had dementia. Average NUMI-SF score was 4.79 (SD= 1.7). Two multiple regressions were conducted to evaluate the extent to which executive functioning, as measured by the TMT-B and SCWT CWI predicted NUMI-SF, and the additive predictive power of premorbid IQ and demographics via the TOPF on the relationship between executive functioning and NUMI-SF.

The first regression, which measured the relationship between the TMT-B and SCWT CWI upon NUMI-SF scores, was not significant (p=.616). The model was significant with the addition of the TOPF (ß=.595, p<.001) and TOPF alone predicted ∼60% of the variance in NUMI-SF score, while TMT-B and SCWT CWI remained non-significant.

These results indicate that common measures of executive functioning are not reliable predictors of health literacy with or without the moderating of premorbid intellectual functioning taken into consideration. This suggests that health numeracy is likely to be minimally affected by deficits in executive functioning and rather may be better accounted for by premorbid intellectual functioning and/or other sociodemographic factors (e.g. socioeconomic status, education quality, occupation). Future studies will benefit from elucidating the contributions of other social determinant factors on predicting health numeracy.

The Temporal Self-Regulation Theory (Hall and Fong, 2007) proposes that initiation and maintenance of effortful health behaviors relies on executive functions (EF: cognitive abilities associated with goal-directed behavior). Alcohol harm reduction strategies are health behaviors that aim to minimize the likelihood or severity of consequences associated with alcohol use. Some drinkers have the intention to drink safely but lack the ability to effectively initiate and execute the harm reduction behaviors. Executive functions may be one mechanism that helps explain the gap between safe drinking intentions and behavior. Specific components of EF may be differentially associated with alcohol harm reduction strategy use; working memory and set-shifting may be especially important in planning and following through with alcohol harm reduction strategies, and individuals with greater working memory capacity and set-shifting abilities may be more successful in implementing strategies that require preplanning and have a focus on altering typical the manner of drinking (e.g., not mixing types of alcohol). Inhibition may be important for resisting temptations that are inconsistent with safe drinking goals, and those with stronger inhibitory control may be more likely to follow through with strategies that require withholding responses despite desire to engage in the behavior, such as stopping or limiting drinking (e.g., not exceeding a predetermined number of drinks).

Using ecological momentary assessment, the current study explored the extent to which an intention-behavior gap in harm reduction strategy use exists among college student drinkers (n=77), and investigated how potential individual differences in EF (i.e., working memory, set-shifting, and inhibition) were associated with translating intentions of drinking safely into action. Daily monitoring assessments contained brief measures of intention to use harm reduction strategies, actual strategy use, and alcohol-related behaviors, and were assessed daily for twenty-one days.

Multilevel model analyses revealed that although intention to use strategies predicted actual strategy use, measures of EF did not significantly moderate the relationship. Exploratory analyses indicated that set-shifting significantly moderated the intention-behavior gap for a subset of harm reduction strategies that relies more heavily on modifying behavior during a drinking event. Set-shifting did not significantly moderate the intention-behavior gap for a subset of strategies that relies more heavily on pre-planning before the drinking event.

Findings from the current study suggests that those who plan to use strategies typically follow through regardless of individual differences in EF. Efforts to increase intention to drink safely can be incorporated into existing alcohol prevention and intervention programs, which would likely lead to increased use of harm reduction strategies and decreased alcohol-related consequences.

The preschool children born very low birth weight(VLBW) still have executive functions(EFs) deficits even with normal early development(Ni, Huang, & Guo, 2011). Consequently, early intervention might be more important than expected. This study aims to investigate the follow-up outcome of the therapeutic effects of integrative neuropsychological training model(INTM) focused on EFs for school-age VLBW children with EFs deficits.

The VLBW children, recruited from the Regional Cohort Network for premature infants who were admitted to neonatal intensive care units, had normal scores in Bayley and Wechsler Intelligence systems before 6 years old. They also received follow-up neuropsychological assessment for EFs at 6 or 8-year-old. The deficits of EFs were defined from the result of Digit Span Subtest of WISC-IV, Knox's Cube Test(KCT), Tower of London(ToL), Wisconsin Card Sorting Test(WCST), and Comprehensive Nonverbal Attention Test Battery(CNAT). A total of 8 VLBW children with EFs deficits were recruited and received EFs training at 6 or 8-year-old. The INTM combined with Comprehensive Memory Training System(CMTS), Executive FUNction Training(EFT), and multi-ecological materials focused on enhancing the four aspects of EFs, including working memory, planning, cognitive flexibility, and inhibition ability. Then, they received follow-up neuropsychological assessment for EFs at 8 or 10-year-old.

The results showed that all children got benefits from 20 hours of INTM and most of the EF aspects remained improved at follow-up. A total of 8 VLBW children with an average of 3.4 aspects EFs deficits had an average of 1.4 aspects of EFs deficits left at the follow-up. More precisely, 5 of them had 1 aspects of EFs deficits and 3 of them had 2 aspects of EFs deficits.

This study revealed that such a short-term INTM had long-term effects in enhancing the EFs of those VLBW children who had normal early development but later grew into EFs deficits at school-age. Besides, their EFs are still improving even after two years of intervention. Further study on more subjects with longer follow-up might help VLBW children to achieve better neuropsychological function.

The process of metacognitive monitoring refers to one’s ability to incorporate rapid in-the-moment self-assessments of their cognitive performance. An area of interest within this literature concerns metacognitive accuracy (MA), or the extent to which an individual can discern when their own judgments are incorrect/correct. Much of the work in this area has either focused on school-aged samples or clinical samples, with findings of impairment in metacognitive processes associated with traumatic brain injury, Schizophrenia, cerebrovascular accidents, and Alzheimer’s disease. Notably, decreased working memory and executive functioning are frequently reported in samples with low MA, suggesting a possible reliance on basic cognitive resources in the facilitation of metacognitive processes. Thus, the goal of this investigation was to elucidate potential relationships between individual domains of cognition and higher-order MA. We hypothesized that performance on measures of working memory and executive function would be positively associated with measures of MA.

Data from 87 undergraduate students who volunteered in research for class credit were used. All participants completed a computerized metamemory task where six lists of 12 words each paired with varying point values were first presented to the participants. After each list, participants were instructed to score as many points as possible by recalling words they could remember. After a brief delay, participants completed a recognition task using the words presented earlier and provided a retrospective confidence judgement (RCJ) following each item. A metric for MA, meta d', was calculated using signal-detection theory analysis from the reported RCJs and recognition task performance. Participants also completed neuropsychological tests of attention (Trails A), working memory (WM; Backward Digits), executive function (EF; Trails B), mental flexibility (MF; Trails B/A Ratio), and processing speed (Symbol Digit Modalities). A sequential multiple regression was performed with meta d’ serving as the criterion, with education, age, and performance on neuropsychological measures entered as predictors.

The model indicated that a moderate percentage of the variability (R2 = .201) in metacognitive accuracy could be attributed to the combination of predictors in the model (F (7,79) = 2.843, p = .011). Examination of the regression coefficients indicated that only measures of attention (ß = .638, p = .01), MF (ß = .473, p = .041), and WM ß = .244, p = .024) were significantly related to MA after controlling for all other variables in the model.

The model suggests that working memory, attention, and mental flexibility increased in a linear fashion as MA increased. Our hypotheses were partially supported, while working memory predicted MA, its contribution to the overall model was the smallest among the significant predictors. While executive function was not a significant contributor to the model, MF (a component of EF) was. The largest contributor to the model was attention, which supports prior findings in the literature. This outcome would suggest that while separate from EF, metacognitive processes in neurotypical students may rely on other, more basic cognitive processes. These results may prove beneficial in guiding the development of rehabilitative interventions for MA in clinical samples.

Clinical and experimental neuropsychology patients are not always able to complete a given test due to limitations in their functioning and it can lead to frustration and time wasted, leading researchers to examine the value of metrics that can be derived earlier in a test so as to ascertain and salvage useful information. The Trail Making Test (TMT) is an oft-utilized test of executive function and has been the focus of such exploration (e.g., first error vs. time to complete Trails B which can be lengthy in dementia cases and lead to discontinuation and loss of scorable data; Christidi et al., 2013; Correia et al., 2015). The present retrospective study utilized archival chart review to examine the association between a patient's diagnosis and occurrence of the first error on Trails B (TB1err).

De-identified data was culled from adult private practice records (n=137) in the northeastern United States (the study was conducted in compliance with local IRB review). Trails A and B times, as well as Digit Span scores (for checking construct validity) were pulled from reports, and Trails B record forms were scored to extract the enumerated stimulus where any first error was observed in the patient's rendering of the trail connecting alternating numbers and letters. Paired t-tests compared the average TB1err of normative individuals (no diagnosis) with patients with a primary diagnosis of mood disorder, traumatic brain injury (TBI), mild cognitive impairment (MCI), or dementia. Additionally, Pearson's correlations were computed comparing TB1err with Trails B time, and another test of executive function (Digit Span backwards).

The order of diagnoses according to the average occurrence of the first error on Trails B (from later, to sooner occurrence) was as follows: normative (no diagnosis), mood disorder, TBI, MCI, and finally dementia. There was a significant difference on this first error metric (TB1err) when comparing normative and dementia patients (p = .03; 8.3 vs 4.2 for the average enumeration of 1st error on Trails B). Furthermore, significant correlations were found between this derived TB1err metric and Digit Span backwards (r = .31; p <.001) as well as overall TrailsB performance (r = -.39; p < .001).

The present study adds to a growing literature on the utility of deriving test metrics to maximize useful data for clinical and experimental neuropsychology. Results from this retrospective chart review indicate additional validity data to support the use of extracting the first error on Trails B as a way to salvage useful data even when a patient may not be able to complete the full TMT as designed. In this preliminary sample there was a significant difference found for normative vs. dementia patients on this derived TB1err metric and suggests it is worthy of additional research to see if it can reliably differentiate various diagnoses. We expect this finding will also be useful in experimental designs wherein time is often limited and loss of data due to incomplete testing might be avoided by extracting the first error on TrailsB.

There is increasing interest in examining a general psychopathology factor (p factor) in children and adolescents. In previous work, the relationship between the p factor and cognition in youth has largely focused on general intelligence (IQ) and executive functions (EF). Another cognitive construct, processing speed (PS), is dissociable from these cognitive constructs, but has received less research attention despite being related to many different mental health symptoms. This study aimed to examine the association between a latent processing speed factor and the p factor in youth.

The present sample included 795 youth, ages 11-16 from the Colorado Learning Disability Research Center (CLDRC) sample. Confirmatory factor analyses tested multiple p factor models, with the primary model being a novel second-order, multireporter p factor where caregivers reported on externalizing symptoms (oppositional defiant disorder and conduct disorder modules from the Diagnostic Interview for Children and Adolescents [DICA]; aggression, delinquency, and attention problems subscales from the Child Behavior Checklist; and inattentive and hyperactive/impulsive subscales from the Disruptive Behavior Rating Scale) and youth self-reported on internalizing symptoms (Child Depression Inventory, generalized anxiety module from the DICA, and withdrawn, anxious/depression, and somatic subscales from the Youth Self Report). We then tested the correlation between the p factor and a latent PS factor. The latent PS factor was composed of WISC Symbol Search, WISC Coding, Colorado Perceptual Speed Test, and Identical Pictures Test. Three secondary p factor models were examined for comparison to previous literature, including (1) a bifactor, multi-reporter model, (2) a second-order model with just caregiver-report, and (3) a bifactor model with just caregiver-report.

There was a significant, negative correlation between the p factor and PS (r=-0.42, p<.001), indicating that slower processing speed is associated with higher general mental health symptoms. This finding was robust across models that used different raters (youth and caregiver-report vs. caregiver-report only) and modeling approaches (second-order vs. bifactor). This association is stronger than previously reported associations with IQ or EF in the p factor literature. Further, in this sample, we found that the association between PS and the p factor was robust to covariation for general cognition, whereas the correlation between general cognition and the p factor was fully accounted for by PS.

Our findings indicate that PS is related to general psychopathology symptoms, expanding the existing literature relating PS to specific, distinct disorders by showing that PS is related to what is shared across psychopathology. As cognition and psychopathology both undergo significant development across childhood and adolescence, elucidating neurodevelopmental mechanisms that relate to risk for a broad range of symptoms may be critical to informing early intervention and prevention approaches. This research points to processing speed as an important transdiagnostic construct that warrants further attention and exploration across development.

The present study explored how individual differences and development of gray matter architecture in inferior frontal gyri (IFG), anterior cingulate (ACC), and inferior parietal lobe (IPL) relate to development of response inhibition as measured by both the Stop Signal Task (SST) and the Go/No-Go (GNG) task in a longitudinal sample of healthy adolescents and young adults. Reliability of behavioral and neural measures was also explored.

A total of 145 individuals contributed data from the second through fifth timepoints of an accelerated longitudinal study focused on adolescent brain and behavioral development at the University of Minnesota. At baseline, participants were 9 to 23 years of age and were typically-developing. Assessment waves were spaced approximately 2 years apart. Behavioral measures of response inhibition collected at each assessment included GNG Commission Errors (CE) and the SST Stop Signal Reaction Time (SSRT). Structural T1 MRI scans were collected on a Siemens 3 T Tim Trio and processed with the longitudinal Freesurfer 6.0 pipeline to yield cortical thickness (CT) and surface area values. Regions of interest based on the Desikan-Killiany-Tourville atlas included IFG regions (pars opercularis (PO) and pars triangularis (PT)), ACC and IPL. The cuneus and global brain measures were evaluated as control regions. Retest stability of all measures was calculated using the psych package in R. Mixed linear effects modeling using the lme4 R package identified whether age-based trajectories for SSRTs and GNG CEs best fit linear, quadratic, or inverse curve. Then, disaggregated between- and within-subjects effects of regional cortical architecture measures were added to longitudinal behavioral models to identify individual differences and developmental effects, respectively.

Both response inhibition metrics demonstrated fair reliability and were best fit by an inverse age trajectory. Neural measures demonstrated excellent retest stability (all ICCs > 0.834). Age-based analyses of regional CT identified heterogeneous patterns of development, including linear trajectories for ACC and inverse age trajectories for bilateral PT. Individuals with thinner left PO showed worse performance on both response inhibition tasks. SSRTs were related to individual differences in right PO thickness and surface area. A developmental pattern was observed for right PT cortical thickness, where thinning over time was related to better GNG performance. Lower surface area of the right PT was related to worse GNG performance. No individual differences or developmental patterns were observed for the ACC, IPL, cuneus, or global metrics.

This study examined the adolescent development of response inhibition and its association with cortical architecture in the IFG, ACC and IPL. Separate response inhibition tasks demonstrated similar developmental patterns with steepest improvements in early adolescence and relationships with left PO thickness, but each measure had unique relationships with other IFG regions. This study indicates that a region of the IFG, the par opercularis, relates to both individual difference and developmental change in response inhibition. These patterns suggest brain-behavior association that could be further explored in functional imaging studies and that may index, in vulnerable individuals, risk for psychopathology.