Explore the relationship between a motor programming and sequencing procedure and informant rating of patients' functional abilities, especially driving. The Fist-Edge-Palm (FEP; Luria, 1970; 1980) task has previously demonstrated merit distinguishing between healthy controls and those with neurodegenerative processes (Weiner et al., 2011). However, associations between FEP performance and informant-rated functional status, particularly driving ability, have been minimally reported. This exploratory review examined the relationship between FEP, informant-rated driving ability, overall functional impairment, and neurocognitive diagnostic severity.

41 Veterans seen in a South-Central VA Memory Clinic between 08/2020 and 07/2022 served as participants. Neuropsychological assessment included gathering demographic information, chairside neurobehavioral examination (including FEP), cognitive testing, and collateral informant completed Functional Activities Questionnaire (FAQ). Diagnostic severity [no diagnosis, mild cognitive impairment (MCI), dementia (MNCD)] was determined based on the patient's cognitive and functional deficits as measured by neuropsychological testing and informant-rated functional deficits. Correlational analyses were conducted to examine the strength of possible relationships between FEP performance, diagnostic severity, informant-rated functional status including driving impairment. Linear regression analyses determined the extent to which diagnostic severity and FEP performance predict informant-reported driving and ADL impairments

Participants were 97.5% male, 78% white, 22% black. Diagnostically, 3 patients received no diagnoses, 14 with MCI, and 24 with MNCD. Spearman rank correlations were computed; FEP performance was moderately negatively correlated with diagnostic severity [rho = -.35; p < .05] and driving impairment [rho = -.31; p < .05]. Diagnostic severity was moderately positively correlated with driving [rho= .44; p < .05] and total functional [rho = .65; p < .05] impairment. Total functional impairment positively correlated with reported driving impairment [rho = .58; p < .05]. Simple linear regressions tested if FEP performance and diagnostic severity independently predicted informant-reported driving and functional impairment. FEP performance predicted diagnostic severity (R2 = .12, p < .05) and reported driving impairment severity (R2 = .10, p <.05) but did not predict total functional impairment severity (R2 = .06, p = .14). Diagnostic severity predicted both informant-reported driving impairment severity (R2 = .16, p <.05) and functional severity (R2 = .30, p < .05). Multiple regression tested if diagnostic severity and FEP performance together was more predictive of driving and functional impairment than individually; the overall model was predictive of driving (R2 = .19, p < .05) and total functional (R2 = .30, p < .05) impairment, but only diagnostic severity significantly predicted reported driving (B = .63, p < .05) and functional (B = 6.25, p < .05) impairments.

FEP performance was associated with diagnosis and collateral informant concerns of patient driving ability but not statistically related to overall functional impairment or nondriving related ADLs. FEP demonstrates utility in identification of patients demonstrating concerning driving fitness per collateral informants and diagnostic severity due to rapidity of administration, ease of instructing providers, and implementation in a wide variety of clinical settings when a caregiver or informant may not be available. Future directions include explaining the relationship between FEP and driving ability and exploring associations between FEP and other neuropsychological instruments.

Self-regulation is typically operationalized in neuropsychological assessment through self-report scales and measures of attention and executive functioning. However, there have been mixed findings on the relationships between self-report measures and physiological and performance-based measures believed to represent self-regulation. Poorer self-regulation is related to an array of negative behavioral and health-related outcomes. Therefore, it is critical to understand the process of self-regulation and the relationships between measures neuropsychologists use to assess it. The current study aims to investigate the relationships between four purported measures of self-regulation: resting-state high-frequency heart rate variability (HRV; a stable individual difference variable that reflects parasympathetic capacity for adapting to changing environmental demands), behavioral performance on the Delis-Kaplan Executive Function System (D-KEFS) and the Conners Continuous Performance Test - 3rd Edition (CPT-3), and trait self-control on the Brief Self-Control Scale (BSCS). It was hypothesized that physiological and behavioral self-regulation variables would predict the BSCS, such that higher resting HRV and better performance on the cognitive measures would predict higher self-reported self-control.

Thirty-five healthy adults (Age M = 29.80, SD =8.52, 45.7% female) recruited from the community completed the BSCS, CPT-3, and D-KEFS as part of a larger battery. Participants also completed a 10-minute eyes-open resting condition during electrocardiogram recording. High-frequency power (0.15 - 0.4 Hz) was extracted and used to operationalize resting HRV. Linear regression was used to test the predictive relationships between the BSCS total score, resting HRV, CPT-3 scores, and a residualized executive functioning score from the D-KEFS that controls for non-executive lower-order cognitive processes.

Regression analyses indicated that neither the D-KEFS composite, the CPT-3 indices, nor resting HRV were related to the BSCS. Resting HRV predicted the CPT-3 Hit Reaction Time (HRT; B = -2.97, p < .05) and HRT Standard Deviation (HRT SD; B = -4.55, p < .05). Resting HRV was unrelated to the D-KEFS executive composite score. CPT-3 performance variables and D-KEFS composite score were also unrelated to one another.

Results showed that the BSCS was unrelated to resting HRV, CPT-3, and D-KEFS performance. However, higher resting HRV was related to faster and more consistent responding on the CPT-3. These findings contradict previous research showing associations between the BSCS and performance on executive functioning measures. The relationship between resting HRV and reaction time on the CPT-3 is generally consistent with literature that suggests that higher resting HRV is associated with better cognitive performance. Although the association between resting HRV and executive functioning was not significant in this modest sample, it was comparable to that reported in a recent meta-analysis. Overall, despite limitations related to the small sample size, the results raise questions regarding the construct validity of common neuropsychological indices of self-regulation. Further research is needed to clarify the nature of the self-regulation construct and the relation of neuropsychological measures of behavioral self-regulation to physiological and self-report indices.

The Tower of London is commonly used to assess planning ability. Deficient outcomes may however have different causes: A participant may not have the ability to think a sufficient number of steps into the future, or may become, for example, impatient to evaluate different possible paths. Outcomes are thus not pure measures of the "planning" construct of primary interest, which may have contributed to findings of low reliability and low validity of these outcomes in the literature. The advent of computerized testing combined with computational modeling potentially allows to go beyond traditional outcomes such as "total number of moves" and "total time taken" and disentangle different processes that are of primary interest. The goal of the current study is to establish whether a model that consists of "planning ability" and "response inhibition" parameters can be used to describe Tower of London data.

We constructed an algorithm that produces Tower of London data, and a computational model that uses every single decision of a participant as input (e.g., whether a participant moves the red or the blue ball to the right peg in setting 15 when trying to get to setting 28). There are 210 unique decision situations that participants can encounter. Our algorithm and Bayesian hierarchical model uses two parameters for each participant as well as a guessing rule, that together determine the participant's decision at every step. The appropriateness of the model was evaluated in a simulation study, where the simulated distribution of data implied by this model is compared to the empirical distribution of total number of moves observed in real datasets. Data were simulated for 10 items with a sample size of 200 participants.

Our simulation study shows that with our model the empirical distribution of total number of moves is successfully replicated in the distribution of the simulated data.

Computational modeling provides a new window into Tower of London performance by identifying different processes. Modeling thus allows us to go beyond aspecific descriptions of planning ability. Furthermore, using the high-resolution data of computerized testing allows us to estimate these parameters reliably without requiring "big data", keeping participant burden low. This study will be followed up in three ways. First, predictions will be preregistered and tested for these new cognitive outcomes in several large oncological patient samples. Second, the model will be extended to include reaction times, to include an additional metric of cognitive computation. Third, the new cognitive process outcomes will be analyzed in conjunction with cognitive process outcomes on other tests to establish process communalities.

The behavioral assessment of executive functions has become increasingly common in clinical practice, with a self-report measure of executive functions becoming one of the most commonly administered assessment instruments of the construct in clinical practice. These subjective measurements serve as an alternative to objective tests of executive functions, which have been criticized for poor ecological validity. Many behavioral measures of executive functions are now available, but there are some issues with those currently in use, in that many are lengthy, proprietary, and/or do not measure executive functions that align with a theoretical framework of the multidimensional construct. This study aimed to examine the psychometric properties of a new short questionnaire of executive functions designed to be concise, theoretically based, and ultimately freely available for use in research and clinical practice.

Participants included 575 college undergraduate students who completed an online questionnaire to earn credit in psychology courses. They were, on average, 18.9 years-old (SD=1.0, range: 18-22), 82.4% female, and 78.8% White. All participants completed 20 self-report items on a four-point ordinal scale measuring five theorized executive function constructs of Planning, Inhibition, Working Memory, Shifting, and Emotional Control. The 20 items were analyzed using confirmatory factor analysis and factor reliabilities were estimated using omega. As a validity analysis, correlations between the total score with measures of subjective cognition and ADHD symptoms were compared to correlations between the total score with measures of anxiety and depression, hypothesizing stronger correlations of executive functions with cognition and ADHD than negative affect.

The initial 20-item model did not fit well, x2=1560.10, df=160, p<.0001, CFI=0.822, TLI=0.788, RMSEA=0.130 (90% CI: 0.1240.136). The polychoric inter-item correlations were examined for high cross-factor correlations and low intra-factor correlations. This process resulted in the removal of one item from each factor, The modified model, inclusive of 15 items, presented with adequate fit to the data, X2=470.56, df=80, p<.0001, CFI=0.936, TLI=0.916, RMSEA=0.097 (90% CI: 0.0890.106). The total score has good reliability (Q=.82), whereas estimates for each factor ranged from .56 to .79. The total score showed a stronger correlation with ADHD symptoms (r=-.59) and subjective cognition (r=.59) than depression (r=.46, z=4.05, p<.001) and anxiety symptoms (r=.38, z=6.29, p<.001).

These preliminary findings provided modest psychometric support for this short 15-item self-report questionnaire of executive functions. The questionnaire had acceptable fit and evidence for validity, in that the total executive function score had a stronger correlation with subjective cognitive complaints and ADHD symptoms than negative affect. The reliability of some individual factors fell below conventional cutoffs for acceptable reliability, indicating a need for further refinement of this new questionnaire.

Attention concerns, particularly difficulties with focusing and regulating attention, are reported in diverse clinical contexts. The Ruff 2&7 Selective Attention Test (Ruff 2&7; Ruff & Allen, 1996) is a measure of sustained and selective attention that assesses automatic detection and effortful processing. The goal of this study was to create an internal consistency metric within this test and to determine cognitive predictors by evaluating associations with executive control of attention and other cognitive skills. It was hypothesized that those who are more consistent across Ruff 2&7 performance would have more robust executive functioning skills, particularly those related to regulating and directing attention and the planning and utilization of cognitive resources.

The current study examined a clinical sample of 98 United States veterans with a history of mild traumatic brain injury. After excluding invalid cases (n=24), the final sample consisted of 74 veterans (Age=38.5 (8.9) years old; 13.9 (2.2) years of education; 78% male; 82% white, 7% Black, 8% Hispanic, 2% Asian). A consistency score was defined as the absolute value of the intertrial change in target hits plus errors across each pair of trials of the same stimulus type (Automatic Detection, AD, and Controlled Search, CS). Hierarchical linear regression modeling was used to evaluate the relative contributions of memory and executive functions (Rey Auditory Verbal Learning Test, Delis-Kaplan Executive Function System Tower Test, phonemic fluency, Trail Making Test B) and subjective symptom report (PTSD Checklist for DSM-5, Barkley Adult ADHD Rating Scale for DSM-IV).

The mean deviation scores for the two trial types were similar (AD mean=13.6, SD=5.9; CS mean=13.6, SD=5.3). In predicting consistency across AD trials, delayed recall contributed 11% unique variance (p=.013), while no other block was statistically significant. For CS trials, self-reported PTSD and inattention symptoms contributed a combined 20% of unique variance to the model (p=.007), while there were no statistically significant cognitive predictors in this model.

Contrary to expectation, executive function measures did not explain statistically significant variance in performance across either trial type. Less consistent performance on AD trials was associated with weaker verbal memory. Less consistent performance on CS trials, which theoretically require greater executive control, was not associated with any cognitive scores, but was associated with more severe self-reported psychological and inattention symptoms. These findings buttress the conceptual distinction between AD and CS trial types, and they point to both cognitive and non-cognitive underpinnings of performance consistency.

COVID-19 caused a worldwide restructuring of daily life, necessitating a sharp increase in social distancing, telecommunication, and adherence to rapidly changing public health recommendations. Coping, a response to stressors, is a protective mechanism to increase resiliency against uncertainty and decreased social connectedness. This disruption of daily life has prompted unanticipated and unique research opportunities and allowed researchers to consider whether individuals' primary coping style with the pandemic is associated with cognition. Previous research has found that problem coping, or action-oriented approaches to a stressor, is the most adaptive coping strategy. Emotion-based coping, like venting or humor, varies and depends on the stressor. Avoidant coping, like denial or ignoring the stressor, is generally considered maladaptive (Carver, 1977), which may lead to increased psychosocial disturbance. Executive functioning, responsible for planning, organizing, inhibition, and self-management are theorized to be most impacted by the social and psychological effects of COVID-19 (Pollizi et al., 2021). While some research has examined this question in working parent and older adult populations, we seek to understand this relationship in emerging adults, whose frontal lobes, responsible for executive functioning, are still developing. The present study seeks to examine the association between coping with the COVID-19 pandemic and executive functioning.

College students (N=440; M=19.30 years old, SD=1.42, 76% female) across seven US universities completed self-report questionnaires on SONA, which included Barkley's Deficits in Executive Functioning, Short Form (BDEFS-SF; Barkley, 2011) and the Brief Coping Orientation to Problems Experienced Inventory adapted for coping with the COVID-19 pandemic (Brief COPE; Carver 1989). Items on the BDEFS-SF were summed to create a global executive functioning score. Items on the Brief COPE were combined to create three factors: emotional,, avoidant,, and problem-focused (Dias et al., 2011).

Stepwise linear regression was used to assess whether coping style predicted executive functioning. Results indicate that the use of emotional coping (ß =0.19, p< .001) and avoidant coping (ß =0.33, p< .001) predicted higher scores on the BDEFS (greater deficits in executive functioning). Additionally, the use of problem coping (ß =-0.27, p< .001) predicted lower BDEFS scores (better executive functioning), with this overall model explaining 16.37% of the variance.

Results from this study confirm that COVID-19 coping styles are associated with decreased executive functioning. Specifically, emotional coping and avoidant coping predicted decreased executive functioning, which has been supported in non-pandemic samples. The use of problem-focused coping predicted increased executive functioning, indicating that this may be a protective form of coping with the pandemic. Because tasks necessary for daily life, such as planning, organizing, and judgment, rely on executive functioning, maladaptive coping with COVID-19 may impede college students' daily functioning necessary for successful engagement in schoolwork, emotion regulation, and activities of daily living. This research begins to address the gap in knowledge regarding the relationship between coping with the COVID-19 pandemic and executive functioning. This knowledge can be used in future crises in order to promote the use of problem-focused coping and mitigate the self-observed deficits in executive functioning demonstrated in this population.

Engagement in sporting activities has shown improvement in executive function among youth (Contreras-Osorio et al., 2021). Additionally, participation in specific sports such as soccer has been shown to enhance executive function in youth athletes compared to same-aged non-athletes (Yongtawee et al., 2021). The present study aimed to examine the effects of competitive participation in the United States’ four most popular sports on executive function among youth athletes. The most popular sports, as defined by viewership, revenue, and youth participation in the U.S. are American football, basketball, baseball, and soccer (Injai, 2022; Aspen Institute, 2020).

Data from the following three executive functioning subtests were analyzed in a sample of youth athletes (n=76), aged 8-18 years (mean age=11.94): Delis-Kaplan Executive Function System Trail Making Letter-Number Sequencing (cognitive flexibility), Wechsler Intelligence Scale for Children Fourth Edition Working Memory Index, and Golden Stroop Color-Word Inhibition. Participants completed these measures as part of a larger neuropsychological baseline assessment. Multivariate General Linear Model (GLM) regression was used to examine the influence of total cumulative years playing in one or more of the four most popular sports on executive functioning. A multivariate GLM regression also investigated the unique contributions of total years playing soccer (n=40; mean age=12.40) and total years playing American football (n=32; mean age=12.03) on subtest performance. The unique contributions of basketball (n=14) and baseball (n=21) were not analyzed due to small sample size.

Total cumulative years playing > one of the four most popular sports significantly predicted cognitive flexibility (p=.007) and working memory (p=.002), but not inhibition (p=0.639). Total years playing soccer also significantly predicted cognitive flexibility (p=.029) and working memory (p=0.05), but not inhibition (p=.310). Total years playing American football did not significantly predict performance on tasks requiring cognitive flexibility (p=.186), working memory (p=0.150), or inhibition (p=0.277).

In congruence with previous research, sports participation predicted enhanced cognitive flexibility and working memory on certain executive tasks. Among youth athletes, prolonged competitive participation in one or more of the four most popular sports in the U.S. predicted better performance on measures of cognitive flexibility and working memory. Furthermore, protracted participation in soccer predicted enhanced performance on measures of cognitive flexibility and working memory, whereas extended participation in American football did not. Future research should examine this effect in larger samples within all four sports. Examining the cumulative length of competitive participation in these popular sports on executive function could present a favorable developmental outcome of youth participation if competitive participation is sustained. Additionally, the present data on executive function performance between lasting soccer participation and lasting American football participation suggests that executive function development and performance may be influenced by the sport played. The direction of this possible influence is unclear. More research is needed to establish this observed difference, and to better understand its existence and directionality.

The current study had two primary objectives: 1) To assess the dose-response relationship between acute bouts of aerobic exercise intensity and performance in multiple cognitive domains (episodic memory, attention, and executive function) and 2) To replicate and extend the literature by examining the dose-response relationship between aerobic exercise intensity and pattern separation.

18 young adults (mean age = 21.6, sd = 2.6; mean education = 13.9, sd = 3.4; 50% female) were recruited from The Ohio State University and surrounding area (Columbus, OH). Participants completed control (no exercise), light intensity, and vigorous intensity exercise conditions across three counterbalanced appointments. For each participant, all three appointments occurred at approximately the same time of day with at least 2 days between appointments. Following the rest or exercise conditions and after an approximately 7 minute delay, participants completed a Mnemonic Similarity Task (MST; Stark et al., 2019) to assess pattern separation. This task was always administered first as we attempted to replicate previous studies and further clarify the relationship between acute bouts of aerobic exercise and pattern separation by implementing an exercise stimulus that varied in intensity. After the MST, three brief cognitive tasks (roughly 5 min each) were administered in a counterbalanced order: a gradual-onset continuous performance task (gradCPT; Esterman et al., 2013), the flanker task from the NIH toolbox, and a face-name episodic memory task. Here we report results from the gradCPT, which assesses sustained attention and inhibitory control. Heart rate and ratings of perceived exertion were collected to validate the rest and exercise conditions. Repeated-measures ANOVAs were used to assess the relationship between exercise condition and dependent measures of sustained attention and inhibitory control and pattern separation.

One-way repeated-measures ANOVAs revealed a main effect of exercise condition on gradCPT task performance for task discrimination ability (d') and commission error rate (p’s < .05). Pairwise comparisons revealed task discrimination ability was significantly higher following the light intensity exercise condition versus the control condition. Commission error rate was significantly lower for both the light and vigorous exercise conditions compared to the control condition. For the MST, two-way repeated-measures ANOVAs revealed an expected significant main effect of lure similarity on task performance; however, there was not a significant main effect of exercise intensity on task performance (or a significant interaction).

The current study indicated that acute bouts of exercise improve both sustained attention and inhibitory control as measured with the gradCPT. We did not replicate previous work reporting that acute bouts of exercise improve pattern separation in young adults. Our results further indicate that vigorous exercise did not detrimentally impact or improve pattern separation performance. Our results indicate that light intensity exercise is sufficient to enhance sustained attention and inhibitory control, as there were no significant differences in performance following light versus vigorous exercise.

Depression is a mood or emotional state that is characterized by feelings of sadness (i.e., a loss of interest in activities, low self-worth) for a minimum of two weeks. Executive function is a set of mental processes that are necessary for cognitive control of behavior to achieve and successfully execute a specific goal (e.g., inhibition). Researchers have reported that people with abnormal symptoms of depression (ASD) demonstrate worse executive functioning abilities (e.g., planning) compared to persons with normal symptoms of depression (NSD). Currently, there is a lack of research studies examining how depressive symptoms influence executive functioning in people that identify as Mexican. The purpose of the present study was to evaluate the influence of depression on executive functioning in a healthy Mexican Spanish speaking population. We hypothesized that participants with NSD would demonstrate better executive functioning abilities compared to participants with ASD.

The sample in the present study consisted of 87 neurologically and psychologically healthy Mexican participants all residing in Mexico. Mean age was 24.71 (SD = 9.66) and 14.78 (SD = 4.50) years of education completed. Participants completed a neuropsychological battery in Spanish and were divided into two groups: NSD (n = 61) and ASD (n = 26). The Stroop Color Word Test - Color-Word (SCWT-CW) task, phonemic verbal fluency task consisting of three trials, and semantic verbal fluency task consisting of one trial were used to evaluate executive functioning. In addition, participants completed the Hospital Anxiety and Depression Scale in Spanish to report the current level of depression. ANCOVAS, controlling for age were used to examine executive functioning performance. We used a threshold of p < .05 for statistical significance.

ANCOVAS revealed the NSD group outperformed the ASD group on the SCWT-CW task, p = .004, np2 = .10. We also found the NSD group outperformed the ASD group on the phonemic verbal fluency task, p = .045, np2 = .05. Finally, no significant differences were found between depression groups on the semantic verbal fluency task.

As we predicted, the NSD group demonstrated better executive functioning abilities compared to the ASD group, except on the semantic verbal fluency task. Our data suggests that the current level of depression have a significant influence on verbal executive functioning abilities in a Spanish speaking population. Future studies with larger sample size should evaluate if current symptoms of depression influence non-verbal executive functioning abilities in a Spanish speaking Mexican population.

Mild cognitive impairment (MCI) is characterized by subjective and objective memory concerns, though additional cognitive concerns are commonly reported, including changes in executive functions (EF). Rabin et al. (2006) showed that a sample of research participants with MCI endorsed problems with their EFs, especially working memory. Similarly, those with subjective cognitive dysfunction (SCD) also reported greater difficulty with aspects of their EF than a healthy comparison sample of older adults (HC). In the present study, we investigated subjective EF in clinical samples of older adults with MCI or SCD, which represents a more naturalistic sample relative to a research sample. Furthermore, we evaluated whether subjective EF varied in these groups depending on whether patients were "young-old" versus "old-old" given prior research indicating objective cognitive differences between these age groups.

Participants were 135 older adults (53 MCI, 52 SCD, and 30 HC) matched for age (p = .116) and education (p = .863). Dichotomous categorization of age used the sample median (72 years) as cutoff score with 72 participants in the young-old group (mean age = 65.8 ± 4.7 years) and 63 in the old-old group (mean age = 78.1 ± 3.7 years). Participants completed the Behavior Rating Inventory of Executive Function-Adult (BRIEF-A), assessing executive functions in everyday life over the past month. The BRIEF-A yields an overall score (Global Executive Composite [GEC]) composed of two index scores (Behavioral Regulation Index [BRI] and Metacognition Index [MI]) and nine clinical scales (Inhibit, Shift, Emotional Control, Self-Monitor, Initiate, Working Memory, Plan/Organize, Task Monitor, and Organization of Materials). A diagnosis by age-group multivariate analysis of variance (MANOVA) with post-hoc comparisons for diagnosis using a Tukey HSD correction was conducted using SPSS Version 24.

MCI and SCD groups endorsed worse EF on all three index scores (ps < .005) and all nine clinical scales (ps < .05) relative to the HC group, and the MCI group reported worse initiation relative to the SCD group. Additionally, worse executive functions on all three index scores (ps < .05) and four clinical scales (ps < .05; emotional control, self-monitoring, planning/organization, and task monitoring) were reported by the young-old group relative to the old-old group. No diagnosis by age-group interactions were observed.

Problems with aspects of EF were endorsed by older adults with MCI and SCD compared to HCs across all indices and clinical scales; however, only initiation was reported to be worse in MCI than those with SCD. Additionally, the young-old group endorsed having worse EF than the old-old group across BRIEF-A indices and several more specific aspects of EF, without a moderating effect of diagnosis. These findings highlight the importance of assessing subjective EF in older adults, as they may be early indicators of cognitive change, prior to objective evidence of cognitive decline. Furthermore, results also point to differences in how the young-old and old-old perceive their EF in everyday life.

This study evaluated the relation between five-factor model (FFM) personality traits and intra-individual variability (IIV) in executive functioning (EF) using both subjective self-report and objectives measures of EF.

165 university participants (M=19 years old, SD=1.3; 55.2% White, 35.2% African American, 72.7% female) completed the Barkley Deficits in Executive Functioning Scale-Long Form (BDEFS), IPIP-NEO Personality Inventory, Trail-Making Test (TMT) Parts A and B, and the Neuropsychological Assessment Battery (NAB) EF module. A participant’s IIV was calculated as the standard deviation around their own mean performance. Objective EF IIV was computed from T-scores for performance on Trails A, Trails B, and the NAB EF module. Subjective EF IIV was computed from T-scores for performance across BDEFS domains.

Pearson r correlations were used to evaluate the relation between subjective and objective IIV and FFM traits of personality. Subjective EF IIV was positively correlated with FFM neuroticism [r=.48; p<.001] and negatively correlated with FFM conscientiousness [r=-.43; p<.001], extraversion [r=-.18; p=.023] and agreeableness [r=-.22; p=.004]. There were no significant associations between FFM traits and objective EF IIV performance. There was additionally no significant relation between subjective EF IIV performance and objective EF IIV.

Personality traits were associated with individual variability on a self-reported measure of EF but not on performance-based EF measures. These results suggest that IIV for the BDEFS was influenced by personality traits, particularly neuroticism and conscientiousness, and may reflect method variance. It was notable that IIV was not correlated between subjective and objective EF measures.

Psychosocial stress has been associated with impaired cognition and risk for neurodegenerative disease. However, the intermediate pathways underlying this relationship are not yet well understood. Chronic exposure to stress causes endocrine and immune dysregulation that can lead to heightened systemic inflammation. Moreover, chronic, low-grade inflammation has been linked to neurodegeneration, impaired neurogenesis and cognitive decline. Given the strength of the individual links between stress, inflammation and cognition, the current study tested the hypothesis that inflammatory biomarkers would mediate the relationship between perceived stress and executive functions.

Data from the Midlife in the United States Study (MIDUS) (N=863; Mean age= 52.72) provided measures of perceived psychological stress, inflammatory biomarkers [C-reactive protein (CRP) and interleukin-6 (IL-6)] and executive functions. Structural equation modeling (SEM) was used to test for the mediating effect of inflammation on the relationship between perceived stress and executive functions. Exploratory analyses were conducted to investigate whether sex-differences were driving these relationships. Mediation analyses adjusted for age and history of smoking.

In the full sample of men and women, there was a significant indirect effect of perceived stress on executive functions through inflammation [ß=-0.021, z=-2.841, p=0.005]. Further examination revealed that this effect was present in women [B=-0.039, z=-2.680, p=0.007] but not men [ß=-0.003, z=-0.558, p=0.577]. While inflammation was negatively associated with executive functions in both men and women [ß=-0.126, z=-1.930, p=0.050; ß=-0.279, z=-0.558, p>0.001], pathways linking perceived stress to inflammation and executive functions were only significant in women [ß=0.014, z=-3.190, p=0.001; ß=-0.192, z=-3.355, p=0.001].

These findings suggest that inflammatory biomarkers are a viable pathway for explaining how experiencing stress can negatively affect executive functions. Results indicate that women may be particularly vulnerable to the inflammatory and cognitive consequences of stress. As such, psychosocial stress and associated inflammation may be important targets for improving cognitive health outcomes, particularly in women.

Hippocampal and medial temporal lobe structure atrophy is commonly observed in patients with mild neurocognitive disorders and dementias of various neurodegenerative conditions, with the degree of atrophy in these regions correlating with cognitive performance on memory tasks. This research has been conducted largely in western and educated countries. As cognitive aging, risk factors, clinical course, and neuropathology can differ between individuals of different races and ethnicities, our goal is to determine whether these findings also generalize to patients with suspected dementias living in the Democratic Republic of the Congo (DRC).

Neuroimaging and cognitive data have been collected on 40 subjects with probable dementia from the DRC and 40 age-, education-, and gender-matched controls. Patients were classified into groups based on scores on the Community Screening Instrument and the Alzheimer's Questionnaire. All participants completed the African Neuropsychological Battery. T1 MPRAGE images were acquired on Siemens 1.5T scanner. Freesurfer was used to derive volumes and cortical thickness of medial temporal lobe regions. Volumes of structures were divided by intracranial vault volumes to adjust for head size. T-tests were used to compare hippocampal volumes, entorhinal cortex thickness, and perirhinal cortex thickness between subjects with probable dementia compared to healthy age-, gender-, and education-matched controls. Bivariate correlations were conducted to determine whether the volumes of these structures correlate significantly with learning and memory measures on the ANB.

Results will be determined by the methods described previously.

Results from this study will demonstrate whether structural brain changes commonly seen in individuals with dementia living in western and educated countries also are observed in the DRC. Results will also demonstrate whether these brain changes coincide with the degree of impairments on tasks of memory, and whether these structures can be used to aid in clinical diagnosis of patients with dementia and support the use of the ANB and neuroimaging in clinical detection of dementias in the DRC.

Given the lack of comprehensive neuropsychological tools and neuropsychological services in Sub-Saharan Africa (SSA), cognitive screeners for dementia can be useful tools to screen for suspected dementia at the population level. However, most available screeners have not been developed or validated in SSA populations. The Community Screening Instrument for Dementia (CSID) was developed for cross-cultural use, and it has a cognitive testing component and informant interview. We have previously demonstrated that lower years of education and female sex are associated with lower scores on the CSID. Here, we examine the utility of demographically adjusted CSID scores in a community sample of Congolese older adults.

354 participants (mean age=73.6±6.7, mean education (years) =7.3±4.7; 50% female) were randomly recruited in Kinshasa, Democratic Republic of the Congo, and completed the CSID and the Alzheimer's Questionnaire (AQ) to examine functional abilities. Raw scores were demographically adjusted for education and sex by adding 1 point for <12 years of education and 1 point for female. Cognitive impairment was classified as a total score below 25.5. Rates of impairment were compared between raw scores and demographically-adjusted scores. Demographic profiles were examined between both classifications

Average raw CSID scores were 25.23 (SD=4.19) and average demographically-adjusted scores were 26.59 (SD= 4.09). Approximately 43.1% of the sample was impaired based on the raw CSID scores compared to 30.4% with the demographically-adjusted scores (x2= 12.334, p<.001). There was a higher proportion of females (n=95; 26.8%) classified as impaired with the raw SCID scores compared to the demographically-adjusted scores (n=62; 17.5%; x2= 8.87, p=0.003). Approximately 27.4% (n=97) of the participants classified as impaired with the raw SCID scores had primary education or less (i.e., 1-6 years) compared to 18.9% with the demographically-adjusted scores (n=67; (x2= 107.77, p<.001). Forty-five participants were re-classified as not impaired with the demographically-adjusted scores with the majority of these participants being female (73.3%), having primary education (66.7%), and being functionally unimpaired on the AQ (91.1% unimpaired).

We demonstrate that raw scores on the CSID can lead to misclassification of impairment in females and in individuals with lower years of education. Demographically-adjusted scores on the CSID can help properly capture those with suspected dementia while reducing false positives. Given the effects of education and sex on performance, future studies should examine if demographically adjusted scores improve the sensitivity and specificity of the CSID in Congolese populations and compare its performance to other screening tools to determine the most appropriate screener for this population.

Late-life depression is a complex condition impacted by both mental and physical health outcomes and psychosocial factors. Psychosocial predictors of depression are reliant on cultural factors including socioeconomic variables, stigmas, and cultural values. Most research on late-life depression and its effect on cognitive functioning has been completed in so-called Western, Educated, Industrialized, Rich, and Democratic (WEIRD) populations and findings may not generalize to older adults living in other areas of the world. The current study explored predictors of depressive symptoms as well as the association between depressive symptoms and neuropsychological functioning in Congolese older adults.

A total of 319 participants (mean age=72.7±6.15, mean education in years=7.6±4.56; 47% female) were randomly recruited. Depressive symptoms were assessed with the Geriatric Depression Scale. Given the exploratory nature of the current study, forward stepwise linear regression models were run to assess predictors of depressive symptoms. The independent variables assessed as potential predictors included age, years of education, gender, participant income, parental income, living arrangement (i.e., alone or with others), functional abilities (FAQ), fragility, and self-rated overall health. Analyses were run in the overall sample as well as stratified by gender. The association between depressive symptoms and performance on the Community Screening Instrument for Dementia (SCID) was also explored.

Higher depressive symptoms were found in women (ß=.228, p=0.036), those with lower parental income (ß=-.156, p=.005), higher fragility (ß=-.237, p<.001), and worse overall health (ß=-.311, p=.020). Among women, lower parental income, (ß=-.230, p=.002), higher fragility (ß=-.312, p<.001), and lower overall health (ß=-.235, p=.004) predicted higher depressive symptoms, while in men only higher fragility (ß=-.164, p=.041) and living alone (ß=-.184, p=.022) predicted higher depressive symptoms. There was also a significant association between depressive symptoms and lower scores on the CSID (ß=-.189, p=.001)

Similar to results in WEIRD populations, general health and fragility predicted depressive symptoms in Congolese older adults. However, parental income (more so than participant income) also predicted depressive symptoms in Congolese older adults, particularly in women, while living alone was a predictor in Congolese older men. It is possible that the difference in depressive symptoms between men and women is driven by underreporting of depressive symptoms among men. Our results also showed that there was an association between depressive symptoms and global cognitive functioning similar to prior findings in WEIRD populations. Our results are important for clinicians assessing depressive symptoms in patients in or from Congo or sub-Saharan Africa.

Cognitive change affecting patients after anesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7.5 yr afterward. Importantly, other studies have identified that the incidence of cognitive change is similar after non-cardiac surgery. Other than the inclusion of non-surgical control groups to calculate postoperative cognitive dysfunction, research into these cognitive changes in the perioperative period has been undertaken in isolation from cognitive studies in the general population. This study aimed to develop similar terminology to that used in cognitive classifications of the general population for use in investigations of cognitive changes after anesthesia and surgery.

A multispecialty working group followed a modified Delphi procedure with no prespecified number of rounds comprised of three face-to-face meetings followed by online editing of draft versions. Two major classification guidelines [Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5) and National Institute for Aging and the Alzheimer Association (NIA-AA)] are used outside of anesthesia and surgery and may be useful for the inclusion of biomarkers in research. For clinical purposes, it is recommended to use the DSM-5 nomenclature.

The working group recommends that 'perioperative neurocognitive disorders (PND)' be used as an overarching term for cognitive impairment identified in the preoperative or postoperative period. This includes cognitive decline diagnosed before operation (described as neurocognitive disorder); any form of the acute event (postoperative delirium) and cognitive and functional decline diagnosed up to 30 days after the procedure (delayed neurocognitive recovery (dNCR)) and up to 12 months (postoperative neurocognitive disorder (postoperative NCD).1 Further, the working group has undergone a further Delphi process to expand these recommendations for research purposes which will also be covered.

Perioperative neurocognitive disorders are the most common complication for patients aged 65y or more undergoing anesthesia and surgery. Moreover, they are associated with significant morbidity, mortality, loss of functional independence and extreme economic costs. A multi-disciplinary approach to PND, including neuropsychologists, is critical to reducing and preventing these disorders. Evered L, Silbert B, Knopman DS, et al. Recommendations for the nomenclature of cognitive change associated with anaesthesia and surgery-2018. Br J Anaesth 2018; 121: 1005-12

Postoperative neurocognitive disorder is common after all forms of surgery in older adults. The mechanisms are multifactorial, and probably require pre-existing neuropathology, whether the patient is symptomatic or not. In Alzheimer's disease (AD) and other tauopathies, the microtubule-associated protein tau can undergo aberrant hyperphosphorylation potentially leading to the development of neurofibrillary pathology, one of the neuropathological hallmarks of the disease. Preclinical and human CSF studies suggest that anesthesia and surgery elicits an increment in CNS tauopathy, which may accelerate any preexisting neuropathology and produce a risk of delirium and the commonly reported changes in cognition.

In this session, the author will present a bench to beside review of how tau protein is altered by perioperative factors and its potential relationship to the impairment of cognition after surgery and anesthesia. Published and ongoing studies will be reviewed to result in a discussion as to why changes in tau protein are concerning in perioperative disorders of cognition.

The presenter will initially review pre-clinical studies focusing on the impact of anesthetics and surgery-induced inflammation on tau pathology and how the impairment of resolution of surgery-induced inflammation, notably decreased lipoxin A4 signaling, is altered by aging, gender, or an increase in the tau pathology burden. These preclinical studies have partially informed a multi-center federally funded observational clinical study, currently in progress, involving neuroimaging to determine whether pre-operative CNS tauopathy, as reflected by PET imaging, predicts delirium and other cognitive and functional outcomes. This translational study will also examine whether anesthesia and spine surgery produces a longitudinal change in the brain tau burden in older adults, as compared to control, nonoperative patients.

Bench to bedside research is needed in order to promote evidence-based care for patients at risk for ADRD.