The association between sleep quality and cognition is widely established, but the role of aging in this relationship is largely unknown.

To examine how age impacts the sleep–cognition relationship and determine whether there are sensitive ranges when the relationship between sleep and cognition is modified. This investigation could help identify individuals at risk for sleep-related cognitive impairment.

Sample included 711 individuals (ages 36.00–89.83, 59.66 ± 14.91, 55.7 % female) from the Human Connectome Project-Aging (HCP-A).

The association between sleep quality (Pittsburgh Sleep Quality Index, PSQI) and cognition (Crystallized Cognition Composite and Fluid Cognition Composite from the NIH Toolbox, the Trail Making Test, TMT, and the Rey Auditory Verbal Learning Test, RAVLT) was measured using linear regression models, with sex, race, use of sleep medication, hypertension, and years of education as covariates. The interaction between sleep and age on cognition was tested using the moderation analysis, with age as both continuous linear and nonlinear (quadratic) terms.

There was a significant interaction term between the PSQI and nonlinear age term (age2) on TMT-B (p = 0.02) and NIH Toolbox crystallized cognition (p = 0.02), indicating that poor sleep quality was associated with worse performance on these measures (sensitive age ranges 50–75 years for TMT-B and 66–70 years for crystallized cognition).

The sleep–cognition relationship may be modified by age. Individuals in the middle age to early older adulthood age band may be most vulnerable to sleep-related cognitive impairment.

A number of studies have compared Alzheimer’s disease (AD), the commonest form of dementia, based on their age of onset, i.e. before the age of 65 years (early-onset AD, EO-AD) to those developing after 65 years of age (late-onset AD, LO-AD), but the differences are not clear. We performed a systematic review and meta-analysis to compare clinical characteristics between EO-AD and LO-AD.

Medline, Embase, PsycINFO, and CINAHL databases were systematically searched for studies comparing time to diagnosis, cognitive scores, annual cognitive decline, activities of daily living (ADLs), neuropsychiatric symptoms (NPS), quality of life (QoL), and survival time for EO-AD and LO-AD patients.

Forty-two studies were included (EO-AD participants n = 5,544; LO-AD participants n = 16,042). An inverse variance method with random effects models was used to calculate overall effect estimates for each outcome. People with EO-AD had significantly poorer baseline cognitive performance and faster cognitive decline but longer survival times than people with LO-AD. There was no evidence that EO-AD patients differ from people with LO-AD in terms of symptom onset to diagnosis time, ADLs, and NPS. There were insufficient data to estimate overall effects of differences in QoL in EO-AD compared to LO-AD.

Our findings suggest that EO-AD differs from LO-AD in baseline cognition, cognitive decline, and survival time but otherwise has similar clinical characteristics to LO-AD. Larger studies using standardized questionnaires focusing on the clinical presentations are needed to better understand the impact of age of onset in AD.

In sub-Saharan Africa, there are no validated screening tools for delirium in older adults, despite the known vulnerability of older people to delirium and the associated adverse outcomes. This study aimed to assess the effectiveness of a brief smartphone-based assessment of arousal and attention (DelApp) in the identification of delirium amongst older adults admitted to the medical department of a tertiary referral hospital in Northern Tanzania.

Consecutive admissions were screened using the DelApp during a larger study of delirium prevalence and risk factors. All participants subsequently underwent detailed clinical assessment for delirium by a research doctor. Delirium and dementia were identified against DSM-5 criteria by consensus.

Complete data for 66 individuals were collected of whom 15 (22.7%) had delirium, 24.5% had dementia without delirium, and 10.6% had delirium superimposed on dementia. Sensitivity and specificity of the DelApp for delirium were 0.87 and 0.62, respectively (AUROC 0.77) and 0.88 and 0.73 (AUROC 0.85) for major cognitive impairment (dementia and delirium combined). Lower DelApp score was associated with age, significant visual impairment (<6/60 acuity), illness severity, reduced arousal and DSM-5 delirium on univariable analysis, but on multivariable logistic regression only arousal remained significant.

In this setting, the DelApp performed well in identifying delirium and major cognitive impairment but did not differentiate delirium and dementia. Performance is likely to have been affected by confounders including uncorrected visual impairment and reduced level of arousal without delirium. Negative predictive value was nevertheless high, indicating excellent ‘rule out’ value in this setting.

A paucity of data exists regarding the duration of post-traumatic amnesia (PTA) as a predictor of cognitive functioning among children after traumatic brain injury (TBI). The study aimed to assess the relationship between PTA duration and areas of neurocognitive function among the pediatric population in the sub-acute phase of recovery and rehabilitation.

Data were collected from medical files on 103 children aged 5.5–16.5 hospitalized at a pediatric rehabilitation department with a diagnosis of moderate–severe TBI (msTBI) between the years 2004–2019. The Children Orientation and Amnesia Test was used to evaluate PTA duration. Measures of high-order cognitive abilities of attention and executive function were collected using the Test of Everyday Attention–Child version (TEA-Ch).

Three PTA duration groups were assembled out of a cluster analysis: “Long PTA” (M = 21 days), “Very Long PTA” (M = 47 days), and “Extremely Long PTA” (M = 94 days). Analyses revealed that the “Long PTA” group preformed significantly better than the “Very Long PTA” and “Extremely Long PTA” groups on all TEA-Ch measures, that is, Selective Attention, Attentional Control Switching, and Sustained Attention.

This study is the first to demonstrate that PTA duration is a useful predictor of high-order cognitive functions among children with msTBI in the sub-acute phase of recovery and rehabilitation. The findings emphasize the importance of using a more sensitive classification of prolonged PTA durations to improve outcome prediction and allocation of resources to those who can benefit most after severe brain injuries.

Cognitive impairment is one of the most common symptoms of anti-leucine rich glioma inactivated 1 (anti-LGI-1) encephalitis, but little is known about the cognitive profile of these patients. This study characterized the cognitive profile of patients with anti-LGI-1 encephalitis and compared patterns of impairment to healthy controls and other patient groups with known temporal lobe/limbic involvement.

A retrospective analysis of adult patients with anti-LGI-1 encephalitis who underwent neuropsychological assessment was conducted. Performance patterns of anti-LGI-1 patients were compared to patients deemed cognitively healthy (HC), as well as patients with amnestic mild cognitive impairment (aMCI) and temporal lobe epilepsy (TLE).

Among 10 anti-LGI encephalitis patients (60% male, median age 67.5 years) who underwent neuropsychological testing (median = 38.5 months from symptom onset), cognitive deficits were common, with 100% of patients showing impairment (≤1.5 SD below mean) on 1+ measures and 80% on 2+ measures. Patients with anti-LGI-1 encephalitis performed worse than controls on measures of basic attention, vigilance, psychomotor speed, complex figure copy, and aspects of learning/memory. Of measures which differed from controls, there were no differences between the anti-LGI-1 and TLE patients, while the anti-LGI-1 patients exhibited higher rates of impairment in basic attention and lower rates of delayed verbal memory impairment compared to the aMCI patients.

Long-term cognitive deficits are common in patients with anti-LGI-1 encephalitis and involve multiple domains. Future research in larger samples is needed to confirm these findings.

The modified completion test (MCT) based on the stories by H. Ebbinghaus enables to assess cognitive functions in situation close to a real-life task with an affective load (Burlakova,2016,2020). MCT includes the following stages: 1) filling the gaps in the story; 2) reading and retelling; 3) making up a continuation and a title; 4) retelling the story and its continuation after 30–40 minutes.

The objective was to research diagnostical potential of the second stage of MCT for patients suffering from paranoid schizophrenia with hallucinatory syndrome.

The study included 42 patients (28 female, 14 male) with schizophrenia (disease onset at least 5–7 years ago), aged from 19 to 51 (average age 35±8), receiving treatment. Control group consisted of 44 people (average age 37±6), never sought psychiatric help, never diagnosed with any mental disorders. Groups were organized to be equal in gender proportions, age, and educational level.

In comparison to the control group, the psychiatric patients demonstrated: 1) lower connectedness in narration, lower ability to reproduce main elements of the plot; 2) unusual logic in introduction of new details, extensiveness of such details; 3) lower integrity of mnestic functions, lower ability to maintain concentration. The clinical group: 1) imposed on the text principally different logic, subjectively significant, yet far from the original context; 2) suddenly introduced of new ideas; 3) had confabulations; 4) were altiloquent.

The stage of retelling enables to assess semantic memory, regulatory functions, connectedness of the narration, cogitation and to examine cognitive functions in the context of patient’s personality.

No significant relationships.

The study demonstrates potential of the modified completion test (MCT) (text by H. Ebbinghaus) for diagnostics of patients with schizophrenia. MCT includes four stages: 1) filling the gaps in the story; 2) reading and retelling; 3) making up a continuation and a title; 4) retelling the story and its continuation after half an hour (Burlakova,2020).

The objective was to research diagnostical potential of the first stage of MCT for patients suffering from paranoid schizophrenia with hallucinatory syndrome.

The study included 42 patients (28 female, 14 male) with schizophrenia (disease onset at least 5–7 years ago), aged from 19 to 51 (average age 35±8), receiving treatment. Control group consisted of 44 people (average age 37±6), never sought psychiatric help, never diagnosed with any mental disorders. Groups were organized to be equal in gender proportions, age, and educational level.

The psychiatric patients in comparison to the control group: 1) accomplished the task slower; 2) although instructed to fill the gaps in succession, often violated the instruction and demonstrated orientation on specific fragments rather than on the whole; 3) had lower efficiency: ˜5% of the clinical group did the task without mistakes; 4) chose strategies of interacting with the text not detected in the control group: a) did not fill several gaps, b) added words outside the gaps, and c) crossed out fragments of the text; 5) filled the gaps with words inadequate emotionally, semantically and/or logically.

Comparative analysis demonstrated that already on the first stage, the method proves informative in pathopsychological assessment.

No significant relationships.

Low and middle-income countries like India anticipate rapid population aging and increases in dementia burden. In India, dementia screening scales originally developed in other contexts need to be assessed for feasibility and validity, given the number of different languages and varying levels of literacy and education.

Using data from the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (N = 4,028), we characterize the performance of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). We described patterns and correlates of missingness, evaluated the psychometric properties of the scale, and assessed criterion validity against the Hindi Mental State Examination (HMSE) using linear regression.

Several IQCODE items had high levels of missingness, which was associated with urbanicity, respondent’s gender, and informant’s generation (same vs. younger generation). Full IQCODE scores showed strong criterion validity against the HMSE; each 1-point increase in IQCODE score was associated with a 3.03-point lower score on the HMSE, controlling for age, gender, and urbanicity. The statistically significant association between IQCODE and HMSE was stronger in urban than rural settings (p-value for interaction = 0.04). Associations between IQCODE and HMSE remained unchanged after removing the three items with the highest levels of differential missingness (remembering addresses and telephone numbers, ability to work with familiar machines, ability to learn to use new gadget or machine).

Findings raise questions about the value of including items with high proportions of missingness, which may signal cultural irrelevance, while removing them did not affect criterion validity.

Schizophrenia spectrum disorders (SSD) are characterized by heterogeneity. Cognitive decline, due to recent research results, appears to be a core symptom of schizophrenia. Dimensional approach of SSDs allows the separate assessment of each psychotic symptom, as well as cognitive functioning. Thus, correlations among them and their alterations, between baseline and follow up examination, can be estimated.

The objective of this study is to correlate observed alterations in cognitive performance in patients diagnosed with schizophrenia spectrum disorders, compared with baseline measurement, with alterations in severity of psychotic symptoms.

85 Patients diagnosed with schizophrenia spectrum disorders, attended in the Outpatient Department of Early Intervention in Psychosis of University of Thessaly, Greece and its affiliated psychiatric clinics, were evaluated the last 24 months, using the CRDPSS (Clinician-Rated Dimensions of Psychosis Symptoms Severity) measure and the validated greek version of the MoCA test. 37 of them had a follow up evaluation. The relationship between the two new categorical variables [dMoCA (positive- negative) and dmCRDPSS7 (positive-negative)] was assessed with x² test.

Alterations in cognitive function, as assessed with MoCA scale and dMoCA variable, were inversely correlated with the alteration in mean severity of other dimensions of psychosis symptoms (dmCRDPSS7), x²(1, N = 37) = 9.4891, p = .0021.

Our data suggest that alterations in cognitive performance may predict an inverse effect in the severity of psychotic symptoms. Periodic follow up of cognitive functioning in patients diagnosed with schizophrenia spectrum disorders is suggested, since it can be interpreted in clinically useful information considering relapse.

No significant relationships.

To compare the administration of neuropsychological tests by teleneuropsychology (TeleNP) and face to face (F-F) in order to determine the feasibility and reliability of TeleNP.

At the inclusion visit, all participants underwent a traditional F-F neuropsychological assessment as part of their standard care. Four months after inclusion, they were randomized to undergo an additional neuropsychological assessment either by F-F administration or by TeleNP.

A total of 150 adults with cognitive complaints, but with no major cognitive or sensorial impairment were included. At 4 months, 69 participants were randomized in the F-F arm and 71 in TeleNP arm (10 lost in the follow-up). The overall satisfaction was high: 87.1% in the TeleNP arm were “very satisfied”, and 82.9% indicated no preference between F-F and TeleNP. In agreement with previous data from the literature, neuropsychological assessments gave similar results across both administration conditions for a large majority of tests [Mini-Mental State Examination (MMSE), Free and Cued Selective Reminding Test (FCSRT) French version, Mahieux gestural praxis battery, Frontal Assessment Battery (FAB), time of completion of the Trail making Test (TMT) A and B, number of errors of the TMT B, Rey complex figure test, categorical et phonological verbal fluency tests] and minor differences for others [80-picture naming test (DO-80), FAB, Digit Span forward and backward and number of errors in the TMT A].

TeleNP is a promising method to be able to test patients as an alternative to F-F condition. Before this procedure can be generalized, it is now necessary to standardize the adaptation of certain tests and to test them in populations with more significant cognitive disorders.

This study aimed to apply the generalizability theory (G-theory) to investigate dynamic and enduring patterns of subjective cognitive complaints (SCC), and reliability of two widely used SCC assessment tools.

G-theory was applied to assessment scales using longitudinal measurement design with five assessments spanning 10 years of follow-up.

Community-dwelling older adults aged 70–90 years and their informants, living in Sydney, Australia, participated in the longitudinal Sydney Memory and Ageing Study.

The sample included 232 participants aged 70 years and older, and 232 associated informants. Participants were predominantly White Europeans (97.8%). The sample of informants included 76 males (32.8%), 153 females (65.9%), and their age ranged from 27 to 86 years, with a mean age of 61.3 years (SD = 14.38).

The Memory Complaint Questionnaire (MAC-Q) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE).

The IQCODE demonstrated strong reliability in measuring enduring patterns of SCC with G = 0.86. Marginally acceptable reliability of the 6-item MAC-Q (G = 0.77–0.80) was optimized by removing one item resulting in G = 0.80–0.81. Most items of both assessments were measuring enduring SCC with exception of one dynamic MAC-Q item. The IQCODE significantly predicted global cognition scores and risk of dementia incident across all occasions, while MAC-Q scores were only significant predictors on some occasions.

While both informants’ (IQCODE) and self-reported (MAC-Q) SCC scores were generalizable across sample population and occasions, self-reported (MAC-Q) scores may be less accurate in predicting cognitive ability and diagnosis of each individual.

In diagnosing dementia, estimating premorbid functioning is critical for accurate detection of the presence and severity of cognitive decline. However, which assessments of premorbid intelligence are most suitable for use in clinical practice is not well established. Here, we systematically evaluate the validity of instruments for measuring premorbid intelligence in people living with dementia.

In this systematic review, electronic databases (EMBASE, PsycINFO, MEDLINE, CINAHL, and AMED) were searched to identify studies reporting on objective measures of premorbid intelligence in dementia. Participants from included studies were recruited from local communities and clinical settings.

A total of 1082 patients with dementia and 2587 healthy controls were included in the review.

The literature search resulted in 13 eligible studies describing 19 different instruments. The majority of instruments (n = 14) consisted of language-based measures, with versions of the National Adult Reading Test (NART) being most commonly investigated.

Preliminary evidence suggested comparable performance of patients with mild dementia and healthy controls on word reading tasks in English, Portuguese, Swedish, and Japanese. In moderate dementia, however, the performance was significantly impaired on most verbal tasks. There was a lack of reliability and validity testing of available instruments, with only one of the included studies reporting psychometric properties within the patient group.

The results demonstrate that there is a wide range of tools available for estimating premorbid intelligence in dementia, with cautious support for the potential of word reading tasks across different languages in individuals with mild dementia. However, the review highlights the urgent need for extensive assessments of the psychometric properties of these tasks in dementia. We propose that further longitudinal research and assessments of nonverbal measures are necessary to validate these instruments and enhance diagnostic procedures for people living with dementia worldwide.

To examine the psychometric properties of the Chinese version of the Relevant Outcome Scale for Alzheimer’s disease (CROSA) among persons with AD (PWAD) and their caregivers in China.

A single-arm, open-label, multi-center study.

Two tertiary general hospitals in Shanghai.

A total of 336 PWAD and their family caregivers.

The PWAD completed a 12-week treatment with memantine after a baseline assessment.

The CROSA and the Chinese versions of the Mini-Mental State Examination, the Alzheimer’s Disease Assessment Scale-Cognitive Subscale, the Disability Activity of Dementia, the Neuropsychiatric Inventory Questionnaire, the Zarit Caregiver Burden Interview and the Self-Efficacy Questionnaire for Chinese Family Caregivers.

The Cronbach’s alpha for the total scale was 0.900, and the intraclass correlation coefficient and Pearson’s correlation coefficient were 0.910 (P < 0.001) and 0.836 (P < 0.001), respectively. Confirmatory factor analysis revealed the two-factor model to be consistent with the original version. For the known-group validity, the total score of the CROSA classified the PWAD into three stages and three MMSE score groups. Moderate to large correlations with the validated scales confirmed the criteria validity of the CROSA, and the convergent validity was confirmed via testing a hypothesized caregiving model; however, only minimal responsiveness was found among the deterioration group after 12 weeks of treatment with memantine.

The reliability and validity of the CROSA was good or acceptable for use in daily clinical settings. Further studies are needed to examine the psychometric properties of the scale.