Few studies examine the relationship between physical activity, multiple physical fitness domains (cardiorespiratory fitness, strength, speed), and cognition. Our objective was to investigate the association between physical activity and executive function in middle-aged and older adults and examine whether modifiable physical fitness components explain the relationship between physical activity and cognition.

Self-reported moderate-to-vigorous physical activity and objective measures of cardiorespiratory fitness (2-minute walk test), strength (grip strength), speed (4-meter walk test), and executive function were collected from 623 adults within the Human Connectome Project–Aging (ages 36 – 100 years; mean = 59.2 years; 57.8% female). Relative importance metrics, multiple regression, and conditional process analysis were used to examine relationships of age, physical activity, and physical fitness with executive function.

Greater physical fitness was related to better executive function performance (β = 0.28, p < .001). Physical activity was not associated with executive function (β = −0.04, p = .16). There was an indirect relationship between physical activity and executive function through physical fitness (ab = 0.02, 95% CI: 0.004 – 0.04). This association was explained primarily by the indirect association of cardiorespiratory fitness with physical activity and executive function. The indirect association of cardiorespiratory fitness with physical activity and executive function was significant in older study participants (mean (59 years) and + 1 SD (74 years)), but not younger (−1 SD (44 years)), although between-group comparisons were not significant.

These data highlight potential differential associations with cognition when considering physical activity and physical fitness, and the importance of considering multiple domains of physical fitness in relation to physical activity and cognitive performance.

The Stages of Objective Memory Impairment (SOMI) system, based on the Free and Cued Selective Reminding Test (FCSRT), is a potential marker of subtle cognitive impairment in cognitively normal persons defined by a Clinical Dementia Rating (CDR) = 0. We investigated SOMI’s ability to predict incident cognitive impairment (CDR >0) in combination with demographic features and neuroimaging biomarkers.

Cognitively unimpaired participants (CDR = 0) from the Harvard Aging Brain Study had baseline FCSRT scores, MRI, FDG-PET, and PiB-PET as well as follow-up CDRs for 5 years. Cox proportional hazards models with correction for multiple testing assessed the predictive validity of SOMI and neuroimaging biomarkers for progression (CDR >0). Comprehensive sensitivity analyses examined alternative outcomes and stricter screening criteria.

Participants (N = 231) were 73.7 years (SD = 6.0), 60.2% were female, 29.0% were APOE4 positive, and 54 (23.4%) progressed to CDR >0. At baseline, 67% were SOMI-0, 22% were SOMI-1, 4% were SOMI-2, and 7% were SOMI-3/4. After multiple testing correction, hazard ratios (HRs) using SOMI-0 as reference were: SOMI-1 = 2.06 (CI: 1.09 – 3.88), SOMI-2 = 2.85 (CI: 1.08 – 7.54), and SOMI-3/4 = 3.73 (CI: 1.58 – 8.79, p = 0.016). SOMI-3/4 remained significant across most biomarker models. Entorhinal thickness emerged as the most robust biomarker predictor (HR = 0.57 – 0.65, p ≤ 0.015). Sensitivity analyses confirmed robustness across alternative outcomes and stricter screening criteria.

SOMI stages predict progression to incident cognitive impairment with SOMI-3/4 maintaining significance after rigorous multiple testing correction. Entorhinal thickness provides the strongest biomarker enhancement to prediction models. SOMI demonstrates substantial incremental predictive value beyond standard demographic and biomarker predictors.

The goal of the current study was to study the contribution of source memory, more specifically, a source memory task, on the memory performance measured with a novel virtual reality (VR)-based neuropsychological assessment test, i.e., the Suite Test.

The sample included 676 subjects (49.7% female), aged from 12 to 85 years. The Suite test comprises a 360-degree VR environment designed as a furniture shop. Participants must group specific sets of furniture items (ordered by different families of customers) by clicking on the furniture to be packed, following instructions from a voice-over. All participants were administered the full version of the test, which comprises, among others, an immediate recall task, a source memory task, a short-term delayed recall task, a long-term delayed recall task, and a recognition trial.

Performance on the VR source memory task was associated with recall across age groups, with a stronger contribution in older adults, often enhancing long-term recall. In contrast, younger individuals relied more on immediate and short-term delayed recall, with weaker relationships between source memory and the other types, suggesting that it plays a more secondary role in younger participants.

The Suite Test VR-based test effectively explores source memory contributions across the lifespan. By immersing participants in a dynamic VR environment, it reveals how source memory relates to other memory types, showing age-related differences and offering valuable insights about cognitive changes, as well as about future research implications in the area of memory assessment.

Episodic memory naturally declines with age. The method of loci is an encoding strategy that has been shown to enhance episodic memory. However, it relies heavily on associative memory, as it consists in associating each item of a to-be-learnt list with a location along a familiar route, and associative memory is thought to be the source of the episodic age-related decline. However, when associative memory is supported by semantic knowledge, older adults can compensate for this decline. This study aims to explore the use of the method of loci, that we adapted to leverage pre-existing knowledge in semantic memory, to improve episodic memory in aging.

Word recall performance of young (18–30 years old) and older (60–75 years old) participants was tested after encoding word lists using the method of loci under two conditions: congruent or incongruent with pre-existing knowledge, compared to a control condition.

The results showed significant memory performance improvement in both groups when the method of loci was used with congruent associations. In contrast, in older adults, performance in the incongruent condition did not improve compared with that observed during encoding without a specific strategy, highlighting the importance of semantic links for associative memory. Furthermore, using the method of loci with congruent associations, older adults displayed recall performance equivalent to young adults, while it was not the case with incongruent associations.

The method of loci applied in conditions of semantic congruence thus appears to be a promising compensatory strategy for older adults.

We evaluated performance-based differences in neuropsychological functioning in older adults (age 65+) across the dementia continuum (cognitively intact, mild cognitive impairment, and dementia) according to recent cannabis use (past six months).

A sample of 540 older adults from a well-characterized observational cohort was included for analysis. Participants completed a standardized questionnaire assessing cannabis use in the six months prior to the study visit and completed a comprehensive neuropsychological assessment. We used traditional cross-sectional analyses (multivariate, univariate) alongside causal inference techniques (propensity score matching [PSM]) to evaluate group differences according to recent cannabis use status. We also examined whether cannabis-related problem severity, a risk factor for cannabis use disorder (CUD), was associated with cognitive outcomes among those reporting recent cannabis use.

Approximately 11% of participants reported using cannabis in the prior six months, with the median user consuming cannabis two to four times per month. Participants with recent cannabis use performed similarly across all five domains of neuropsychological functioning compared to those with no cannabis use. Among older adults reporting recent cannabis use, those with elevated risk for CUD demonstrated lower memory performance.

These preliminary results are broadly consistent with other findings indicating that low-frequency cannabis use among older adults, including those along the dementia continuum, is generally well tolerated from a cognitive perspective. However, among older adults who used cannabis, elevated symptoms of CUD may negatively impact memory performance. Future research should explore how variations in cannabis use patterns, individual characteristics, and clinical phenotypes influence cognitive outcomes.

Everyday functional capacity in older adults is influenced by several factors, with prior studies finding that cognition mediates the relationship between depression and everyday functioning. However, these studies utilized samples with low depression severity and used only one type of functional assessment. We aimed to examine whether cognition mediates the relationship between depression and functioning in older adults with a history of treatment-resistant depression.

Data from 383 participants enrolled in the OPTIMUM Neuro study were analyzed. Participants completed a neuropsychological assessment battery, depression severity interview, self-/informant-rated functioning measures and a performance-based functioning measure. Linear regression was used to determine whether depression scores predicted cognitive domain and everyday functioning scores. Cognitive domain scores predicted by depression were then tested as mediators between depression and functioning.

Higher depression symptoms predicted poorer performance on all measures of functioning as well as the cognitive domains of attention, executive functioning, and immediate memory. Immediate memory partially mediated the relationship between depression and a performance-based measure of functioning, while attention and executive functioning partially mediated the relationship between a self-report measure of functioning and depression.

The relationship between depression severity and poorer functional performance was partially mediated by attention, executive functioning, and immediate memory, with results differing based on the measure of functioning used. Our findings suggest that there may be additional non-cognitive factors influencing this relationship and highlight the importance of using multiple methods to assess functional performance.

Five-Factor Model (FFM) personality traits are associated with cognitive function, however, biological pathways accounting for these relations are not well understood. Here, we examined associations between individual FFM traits (self- and informant-reported) and cognitive function (episodic memory, executive control, and working memory), and the indirect effect of a latent index of cardiometabolic risk (composed of adiposity, glycemic control, blood pressure, blood lipids, and inflammation) in a midlife sample.

Participants included 856 volunteers (M = 44.6 ± 6.9 years, range: 30 – 54; Female 54%; Caucasian 85%) from the Adult Health and Behavior (AHAB) registry. Structural equation models were used to: (1) regress cognitive performance on FFM traits and (2) test indirect effects of cardiometabolic risk. Age, sex, and race were included as covariates in all models.

Lower Neuroticism, higher Openness, and higher Agreeableness were significantly associated with better performance in each cognitive domain, and higher Conscientiousness was associated with better working memory. Associations between these traits and executive control were accounted for by a significant indirect effect of lower cardiometabolic risk, and in component-specific analyses, by indirect effects of adiposity and systemic inflammation.

Overall, FFM personality traits were associated with multiple domains of cognitive performance, which, in the case of executive control, was partially explained by differences in cardiometabolic risk. Future investigations should examine whether these pathways account for longitudinal change in cognition.

We compare the Emory 10-item, 4-choice Rey Complex Figure (CF) Recognition task with the Meyers and Lange (M&L) 24-item yes/no CF Recognition task in a large cohort of healthy research participants and in patients with heterogeneous movement disorder diagnoses. While both tasks assess CF recognition, they differ in key aspects including the saliency of target and distractor responses, self-selection versus forced-choice formats, and the length of the item sets.

There were 1056 participants from the Emory Healthy Brain Study (EHBS; average MoCA = 26.8, SD = 2.4) and 223 movement disorder patients undergoing neuropsychological evaluation (average MoCA = 24.3, SD = 4.0).

Both recognition tasks differentiated between healthy and clinical groups; however, the Emory task demonstrated a larger effect size (Cohen’s d = 1.02) compared to the M&L task (Cohen’s d = 0.79). d-prime scoring of M&L recognition showed comparable group discrimination (Cohen’s d = 0.81). Unidimensional two-parameter logistic item response theory analysis revealed that many M&L items had low discrimination values and extreme difficulty parameters, which contributed to the task’s reduced sensitivity, particularly at lower cognitive proficiency levels relevant to clinical diagnosis. Dimensionality analyses indicated the influence of response sets as a potential contributor to poor item performance.

Emory CF Recognition task demonstrates superior psychometric properties and greater sensitivity to cognitive impairment compared to the M&L task. Its ability to more precisely measure lower levels of cognitive functioning, along with its brevity, suggests it may be more effective for diagnostic use, especially in clinical populations with cognitive decline.

Executive dysfunction is prevalent in early stroke and can predict long-term outcomes. Impairments can be subtle and undetected in cognitive stroke screens. To better assess executive functions, this study introduced a novel sentence completion test, which assesses multiple executive processes in <5 minutes (Brief Executive Language Screen – Sentence Completion; BELS-SC). The aim was to determine construct, convergent and divergent validity, sensitivity and specificity of the BELS-SC, and to explore differences between left and right hemisphere stroke patients (LHS and RHS, respectively) on the BELS-SC and standard executive function tests.

Eighty-eight acute/early sub-acute stroke patients and 116 age-matched healthy controls were included.

Principal Component Analysis (PCA) suggested four to five factors of the BELS-SC: Initiation, Selection, Inhibition (with strategy loading on Inhibition), Inhibition Response Time, and Semantic Retrieval Response Time. The BELS-SC had good sensitivity (.84) but poorer specificity (.66) differentiating controls and stroke, and good sensitivity (.83) and specificity (.80) differentiating executive function impaired versus executive function intact groups. BELS-SC Initiation and Inhibition subtests demonstrated convergent and divergent validity with corresponding Hayling subtests. LHS and RHS showed impairment across initiation, selection, inhibition and strategy; however, greatest deficits were shown by RHS on Inhibition items requiring suppression of one dominant response. More patients were impaired on BELS-SC than other executive function tests.

The BELS-SC demonstrated convergent, divergent, and construct validity, good sensitivity and specificity, taps multiple executive processes, and provides insight into strategy. Use in early stroke may aid in targeted and timely cognitive rehabilitation.

Normative data of neuropsychological tests in the Vietnamese population is considerably lacking. We aim to evaluate the effects of age, education, and sex on the performance of common neuropsychological tests, and to generate normative data for these tests in cognitively normal Vietnamese adults.

Participants were recruited from two hospitals in Ho Chi Minh City, with inclusion criteria as follows: age ≥ 40 years, normal cognition and function, and Mini-Mental State Examination (MMSE) scores ≥ 26. Neuropsychological tests were administered in a paper-and-pencil format, including the CERAD Word List, Trail Making Tests, Digit Span, Animal Naming, and Clock Drawing Test. Effects of age, education, and sex on test performance were evaluated using multiple linear regression analyses. Normed scores were reported as regression-based and discrete norms tables.

Participants included 385 cognitively normal Vietnamese, with age 61.4 ± 10.9 years (range 40 – 89), female 56%, who were relatively highly educated (42% attended college and beyond, 36% attended high school or equivalent institutions, 22% had less than high school education), and had MMSE scores 27.8 ± 1.0. Trail Making Test Part B was completed within 300 s by only 204/385 (53%) participants. Regression analyses demonstrated significant associations between age and education with performance on all or most tests, and between sex and all CERAD Word List measures and Clock Drawing Test.

The present work provides the first known normative data for a relatively comprehensive neuropsychological battery in Vietnamese adults. Performance on all tests was significantly influenced by age and education.

Remote videoconference neuropsychological assessments offer opportunities that remain under-exploited. We aimed to evaluate teleneuropsychology (TeleNP)-suitable oral and digital versions of the Symbol Digit Modalities Task (SDMT) and Trail Making Test (TMT) – widely used measures of speed and attention – by comparing them to their written counterparts.

Three-hundred and twenty-one Australian Epilepsy Project (AEP) adult participants with seizure disorders completed the written SDMT and TMT in-person. One-hundred and forty-four of these participants also completed the oral SDMT and TMT during a remote videoconference-based assessment while 177 completed a novel, examiner-administered digital SDMT analogous measure named Symbol Decoding and a novel digital TMT remotely via custom videoconference-based software.

Oral SDMT and digital Symbol Decoding strongly correlated with in-person written SDMT (r (133) = .77, p < .001 and r (126) = .76, p < .001, respectively). Oral TMT-B was only moderately associated (r (126) = .52, p < .001) with written TMT-B and, less strongly related to measures of sustained attention and spatial working memory than its written counterpart. Digital TMT better reproduced the written test’s properties with improved association with written TMT-B (r (154) = .71, p < .001).

Oral SDMT and digital Symbol Decoding are strongly correlated with in-person written SDMT. The digital TMT better captures the cognitive demands and performance characteristics of the in-person written form than does oral TMT. Videoconference-integrated digital tasks offer increased standardization and automation in administration and scoring and the potential for rich metadata, making them an attractive area for further development.

Research indicates that demographic (e.g., age, education) and sociocultural (e.g., acculturation) factors can impact neuropsychological test performance among ethnoculturally diverse adults. Some studies suggest that greater acculturation to the United States (U.S.) is associated with better neurocognitive functioning, though no meta-analysis to date has examined this relationship. This review provides a comprehensive synthesis of the literature and determines the magnitude of the relationship between acculturation and neuropsychological test performance.

A literature search explored all published articles through January 1, 2024, using three databases (i.e., PubMED/MEDLINE, PsycInfo, PsycNET). Data to calculate study effect sizes (i.e., Fisher’s z) were extracted from in-text results, tables, and figures.

Findings (k = 18 included in quantitative analyses) revealed a small to medium (r = 0.29, partial r = 0.20, p < .01), statistically significant relationship between higher U.S. acculturation and better neuropsychological test performance. Moderation analyses indicated that language of testing emerged as a significant moderator, testing in English yielded larger effect sizes compared to testing in other languages (B = 0.29, p < .05).

Neuropsychological test performance is significantly associated with U.S. acculturation, and results suggest that the magnitude may vary depending on study methodologies and samples (e.g., ethnocultural group, U.S. born vs. immigrant) examined. The current review also provides recommendations for incorporating acculturation assessment into clinical practice and highlights the need to examine the clinical utility of acculturation tools in conjunction with neuropsychological tests to assist in clinical decision-making with ethnoculturally diverse populations.