Identifying children and/or adolescents who are at highest risk for developing chronic depression is of utmost importance, so that we can develop more effective and targeted interventions to attenuate the risk trajectory of depression. To address this, the objective of this study was to identify young people with persistent depressive symptoms across adolescence and young adulthood and examine the prospective associations between factors and persistent depressive symptoms in young people.

We used data from 6711 participants in the Avon Longitudinal Study of Parents and Children. Depressive symptoms were assessed at 12.5, 13.5, 16, 17.5, 21 and 22 years with the Short Mood and Feelings Questionnaire, and we further examined the influence of multiple biological, psychological and social factors in explaining chronic depressive symptoms.

Using latent class growth analysis, we identified four trajectories of depressive symptoms: persistent high, persistent low, persistent moderate and increasing high. After applying several logistic regression models, we found that loneliness and feeling less connected at school were the most relevant factors for chronic course of depressive symptoms.

Our findings contribute with the identification of those children who are at highest risk for developing chronic depressive symptoms.

Converging evidence across languages suggests that the word length effect (WLE; rate of number of syllables, phonemes, or pronunciation times per word) significantly contributes to estimates of verbal working memory (WM) capacity limits in the storage phase, but not in the manipulation phase (i.e., word length effect decay), of WM. Direct examination of the WLE on verbal WM performance within monolingual Spanish-speakers has not been reported. We investigated the psychophysical mechanisms of capacity consumption in Spanish-speakers across three syllabic word length rates to clarify the relative contributions of the WLE to storage (digit span forward) versus manipulation (digit span backward) memory phases within one language of monolingual speakers.

Monolingual Spanish-speaking adults (N = 84) born in Latin American countries and age 18-65 completed testing over Zoom. Inclusion criteria required proficiency in the Spanish-language; exclusion criteria were bilingualism, multilingualism, TONI-4 IQ < 85, or history of head injury/LOC. A within-group design measured the WLE across three cognitive load conditions in the forward and backward directions of the digit span test varying in Spanish syllabic word length: the Mexican WAIS-IV Digit Span Test (“Standard Load”), and two modified measures with either a ∼20% decrease (“Low Load”) or ∼20% increase (“High Load”) in total syllables/digit relative to the Standard Load.

A reverse WLE was observed on syllable accuracy percentage task performance (p < 0.01), such that longer word length led to higher capacity limits during storage WM. A WLE, not decay, was found on both raw score (p < .001) and syllable accuracy percentage (p < 0.01) task performances during manipulation WM, where longer word length led to lower capacity limits.

The reverse WLE was attributed to higher-order, executive-function cognitive strategies (such as chunking) that superseded negative word length effects. A larger syllabic discrepancy during manipulation WM could have superseded executive-function strategies, rendering a traditional WLE. Our study contributed more precise capacity estimates and clearer understanding of successful WM performance within monolingual, Latin American-born Spanish-speakers, helping to reduce cultural disparities in neurocognitive and neuropsychological research. Future studies may extend these findings to examine how WM capacity resources can be harnessed to improve memory strategies in clinically-applied settings with Spanish-speaking populations.

Older people with HIV (PWH) are at-risk for Alzheimer’s disease (AD) and its precursor, amnestic mild cognitive impairment (aMCI). Identifying aMCI among PWH is challenging because memory impairment is also common in HIV-associated neurocognitive disorders (HAND). The neuropathological hallmarks of aMCI/AD are amyloid-ß42 (Aß42) plaque and phosphorylated tau (p-tau) accumulation. Neurofilament light chain protein (NfL) is a marker of neuronal injury in AD and other neurodegenerative diseases. In this study, we assessed the prognostic value of the CSF AD pathology markers of lower Aß42, and higher p-tau, p-tau/Aß42 ratio, and NfL levels to identify an aMCI-like profile among older PWH and differentiating it from HAND. We assessed the relationship between aMCI and HAND diagnosis and AD biomarker levels

Participants included 74 PWH (Mean age=48 [SD=8.5]; 87.4% male, 56.5% White) from the National NeuroAIDS Tissue Consortium (NNTC). CSF Aß42, Aß40, p-tau and NfL were measured by commercial immunoassay. Participants completed a neurocognitive evaluation assessing the domains of learning, recall, executive function, speed of information processing, working memory, verbal fluency, and motor. Memory domains were assessed with the Hopkins Verbal Learning Test-Revised and the Brief Visuospatial Memory Test-Revised, and aMCI was defined as impairment (<1.0 SD below normative mean) on two or more memory outcomes among HVLT-R and BVMT-R learning, delayed recall and recognition with at-least one recognition impairment required. HAND was defined as impairment (<1.0 SD below normative mean) in 2 or more cognitive domains. A series of separate linear regression models were used to examine how the levels of CSF p-tau, Aß42, p-tau/Aß42 ratio, and NfL relate to aMCI and HAND status while controlling for demographic variables (age, gender, race and education). Covariates were excluded from the model if they did not reach statistical significance.

58% percent of participants were diagnosed with HAND, 50.5% were diagnosed with aMCI. PWH with aMCI had higher levels of CSF p-tau/Aß42 ratio compared to PWH without aMCI (ß=.222, SE=.001, p=.043) while controlling for age (ß=.363, p=.001). No other AD biomarker significantly differed by aMCI or HAND status.

Our results indicate that the CSF p-tau/Aß42 ratio relates specifically to an aMCI-like profile among PWH with high rates of cognitive impairment across multiple domains in this advanced HIV disease cohort. Thus, the p-tau/Aß42 ratio may have utility in disentangling aMCI from HAND and informing the need for further diagnostic procedures and intervention. Further research is needed to fully identify, among a broader group of PWH, who is at greatest risk for aMCI/AD and whether there is increased risk for aMCI/AD among PWH as compared to those without HIV.

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.

Children born to mothers infected with human immunodeficiency virus (HIV) during pregnancy experience increased risk of neurocognitive impairment. In Botswana, HIV infection is common, but standardized cognitive testing is limited. The Penn Computerized Neurocognitive Battery (PennCNB) is a widely used cognitive test battery that streamlines evaluation of neurocognitive functioning. Our group translated and culturally adapted the PennCNB for use among children and adolescents in this high-burden, low-resource setting. The current study examined the construct validity and sensitivity to HIV infection and exposure of the culturally adapted PennCNB among a cohort of HIV-affected children and adolescents in Gaborone, Botswana.

628 school-aged children aged 7-17 years (n=223 children living with HIV [HIV+]; n=204 HIV exposed, uninfected [HEU]; and 201 HIV unexposed, uninfected [HUU]) completed the PennCNB. Participants were recruited from a clinic specializing in the care and treatment of HIV+ children and adolescents in Gaborone, Botswana, as well as from local schools. Confirmatory factor analyses were performed on efficiency measures for 13 PennCNB tests. Multiple regressions examined associations between HIV and neurocognitive functioning while controlling for age and sex. Multivariate normative comparisons were used to examine rates of overall cognitive impairment by comparing individual profiles of test scores to the multivariate distribution of test scores using age-normed data from the HUU group.

Confirmatory factor analysis supported four hypothesized neurocognitive domains: executive functioning, episodic memory, complex cognition, and sensorimotor/processing speed. As expected, there were main effects of age on cognitive performance across all domains (ps < .001), and there were small sex differences, with females performing better in executive functioning and males performing better on visuospatial processing. Children and adolescents living with HIV performed significantly worse than HUU across all domains (ps < .001), with the largest effect sizes on measures of abstraction, working memory, and processing speed. HEU also performed worse than HUU across several domains, with smaller effect sizes. Multivariate normative comparisons indicated that 27% of the HIV+ group evidenced global neurocognitive impairment.

Overall, results support the validity of a neurocognitive battery adapted for use in Botswana, a non-Western, resource-limited setting. Results indicated that the adapted battery applied to children and adolescents with limited computer familiarity had a similar factor structure as in Western settings, indicating that the PennCNB appeared to assess the hypothesized neurocognitive domains. Hypothesized associations with age and sex supported the battery’s construct validity. Moreover, the battery appears to be sensitive to cognitive impairments associated with perinatally-acquired HIV and in utero HIV-related exposures, as it discriminated between the HUU, HIV+, and HEU groups. Differences were found in specific domains and in detection of overall impairment, including approximately one quarter of children and adolescents living with HIV in this cohort evidencing global neurocognitive impairment. Together, these results provide evidence that the PennCNB could serve as a useful tool for the assessment of neurocognitive functioning in school-aged children and adolescents from Botswana and, potentially, other resource-limited settings.

To assess the relationship between programme attendance in a produce prescription (PRx) programme and changes in cardiovascular risk factors.

The Georgia Food for Health (GF4H) programme provided six monthly nutrition education sessions, six weekly cooking classes and weekly produce vouchers. Participants became programme graduates attending at least 4 of the 6 of both the weekly cooking classes and monthly education sessions. We used a longitudinal, single-arm approach to estimate the association between the number of monthly programme visits attended and changes in health indicators.

GF4H was implemented in partnership with a large safety-net health system in Atlanta, GA.

Three hundred thirty-one participants living with or at-risk of chronic disease and food insecurity were recruited from primary care clinics. Over three years, 282 participants graduated from the programme.

After adjusting for programme site, year, participant sex, age, race and ethnicity, Supplemental Nutrition Assistance Program participation and household size, we estimated that each additional programme visit attended beyond four visits was associated with a 0·06 kg/m2 reduction in BMI (95 % CI –0·12, –0·01; P = 0·02), a 0·37 inch reduction in waist circumference (95 % CI –0·48, –0·27; P < 0·001), a 1·01 mmHg reduction in systolic blood pressure (95 % CI –1·45, –0·57; P < 0·001) and a 0·43 mmHg reduction in diastolic blood pressure (95 % CI –0·69, –0·17; P = 0·001).

Each additional cooking and nutrition education visit attended beyond the graduation threshold was associated with modest but significant improvements in CVD risk factors, suggesting that increased engagement in educational components of a PRx programme improves health outcomes.