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The impact of chronic pain and opioid use on cognitive decline and mild cognitive impairment (MCI) is unclear. We investigated these associations in early older adulthood, considering different definitions of chronic pain.
Methods:
Men in the Vietnam Era Twin Study of Aging (VETSA; n = 1,042) underwent cognitive testing and medical history interviews at average ages 56, 62, and 68. Chronic pain was defined using pain intensity and interference ratings from the SF-36 over 2 or 3 waves (categorized as mild versus moderate-to-severe). Opioid use was determined by self-reported medication use. Amnestic and non-amnestic MCI were assessed using the Jak-Bondi approach. Mixed models and Cox proportional hazards models were used to assess associations of pain and opioid use with cognitive decline and risk for MCI.
Results:
Moderate-to-severe, but not mild, chronic pain intensity (β = −.10) and interference (β = −.23) were associated with greater declines in executive function. Moderate-to-severe chronic pain intensity (HR = 1.75) and interference (HR = 3.31) were associated with a higher risk of non-amnestic MCI. Opioid use was associated with a faster decline in verbal fluency (β = −.18) and a higher risk of amnestic MCI (HR = 1.99). There were no significant interactions between chronic pain and opioid use on cognitive decline or MCI risk (all p-values > .05).
Discussion:
Moderate-to-severe chronic pain intensity and interference related to executive function decline and greater risk of non-amnestic MCI; while opioid use related to verbal fluency decline and greater risk of amnestic MCI. Lowering chronic pain severity while reducing opioid exposure may help clinicians mitigate later cognitive decline and dementia risk.
Deficits in Executive Function (EF) and Theory of Mind (ToM) are common and significant in attention deficit hyperactivity disorder (ADHD), impacting self-regulation and social interaction. The nature of ToM deficits is believed to be partially associated with preexisting deficits in other core cognitive domains of ADHD, such as EF, which are essential for making mental inferences, especially complex ones. Evaluating these associations at a meta-analytic level is relevant.
Objective:
To conduct a systematic literature review followed by a meta-analysis to identify potential associations between EF and ToM among individuals with ADHD and their healthy counterparts, considering different developmental stages.
Method:
A systematic review was conducted in seven different databases. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale. The meta-analytic measurement was estimated with the correlation coefficient as the outcome. Due to the presence of heterogeneity, a random-effects model was adopted. Independent meta-analyses were conducted for different EF subdomains and ADHD and healthy control groups. Subgroup analyses were performed to examine the influence of age on the outcome of interest.
Results:
Fifteen studies were analyzed. Moderate associations were found when comparing EF and ToM between individuals with ADHD (0.20–0.38) and healthy subjects (0.02–0.40). No significant differences were found between child and adult samples (p > 0.20).
Conclusion:
The association between EF and ToM was significant, with a moderate effect size, although no significant differences were found according to age, the presence of ADHD, or EF subdomains. Future research is suggested to expand the age groups and overcome the methodological limitations indicated in this review.
This study explores the relationships among socioeconomic status (SES), executive function (EF), grammar comprehension (GC), and pragmatic language (PL) in children aged 8–11. By employing a structural equation modelling approach, we aimed to investigate the direct and indirect effects of these variables on PL, a crucial aspect of child development involved in the formation of social relationships and general well-being. Our final sample consisted of 128 children from a heterogeneous socioeconomic context. Participants were assessed using the APL Medea, TROG-2, and TeleFE tests to measure their PL, GC, and EF, respectively. The findings reveal that GC and EF are important predictors of PL, with GC playing an important role in mediating the effects of SES. In conclusion, this study highlights the key role of GC in connecting SES and PL, with strong practical implications for the interventions aimed at mitigating the adverse effects of socioeconomic factors.
Simultaneous interpreting (SI) is an intensive multitasking activity that requires coordination of a variety of linguistic and cognitive control mechanisms. Research has shown that interpreters perform better in tasks that require domain-general executive functions (EF), but the question remains whether such cognitive alternation is a result of interpreting experience or it reflects a selection bias that only cognitively capable people are recruited and trained to be interpreters. We examined the cognitive changes experienced by beginner-level students engaged in an intensive, two-week interpreting training programme. Our findings show that: (a) only cognitive flexibility was enhanced by training, together with improvement in SI performance; (b) the three EF subcomponents in their pre-existing forms negatively correlated with training gains; and (c) only pre-existing cognitive flexibility was positively associated with improvement in SI performance. Findings were discussed regarding the relationship between cognitive abilities and the early-stage acquisition of interpreting.
This chapter highlights several aspects of human communication that rely on brain regions outside the traditional fronto-temporal language network. Factors affecting the neural resources needed for communication include the task demands (including acoustic or linguistic aspects), and abilities of individual listeners. When speech is acoustically challenging, as may happen due to background noise or hearing loss, listeners must engage cognitive resources compared to those needed for understanding clear speech. The additional cognitive demands of acoustic challenge are seen most obviously through activity in prefrontal cortex. During conversations, talkers need to plan the content of what they are saying, as well as when to say it – processes that engage the left middle frontal gyrus. And the cerebellum, frequently overlooked in traditional neurobiological models of language, exhibits responses to processing both words and sentences. The chapter ends by concluding that many aspects of human communication rely on parts of the brain outside traditional “language regions,” and that the processes engaged depend a great deal on the specific task required and who is completing it.
Previous research indicates that strong right-hand preference predicts performance in other skills, such as vocabulary size and executive function (EF). The purpose of this study was to assess the relationship between these functions, as well as social competence (SC), in a sample of preschool children. We used parent questionnaires and/or tabletop assessments to measure hand preference, fine motor skills, language, EF, and SC in 81 three- to five-year-old children. The results strengthened the evidence of a connection between right-hand use for pointing and vocabulary performance but indicated that right-hand use was not related to EF or SC. Further, the findings revealed a reciprocal connection between vocabulary and SC as well as EF and SC, but not vocabulary and EF. We discuss the implications of these connections for early childhood development.
The present study examined several distinct indicators of regulation (i.e., task-based executive function, surveyed child effortful control, and surveyed household chaos) as moderators of longitudinal bidirectional links between developmental changes in harsh parenting (HP) and child externalizing behaviors (EXT) from age 9 to 14 years. The sample included 311 children (50.4% female; 111 White or European American; 97 Hispanic or Latino; 103 Black or African American). We conducted cross-lagged panel analyses and utilized multiple reporters (mother, father, and child). Regarding bidirectionality between HP and EXT, findings were mixed depending on informant, but overall more child effects than parent effects or bidirectional effects emerged. Child and household regulation moderated certain effects, providing initial evidence of the potential role of regulations in bidirectional links between HP and EXT. The present study adds impetus to considering child self-regulation and household chaos as critical features influencing the bidirectional link between parenting and child functioning.
Measurement error undermines the accuracy of dietary intake data. The 24-h dietary recall (24HR) is the standard data collection method in nutrition surveillance. Several neurocognitive processes underpin the act of recall, and individuals differ in their performance of these processes. This study aimed to investigate whether variation in neurocognitive processes, measured using four cognitive tasks, was associated with variation in measurement error of 24HR. Participants (n 139) completed the Trail Making Test, the Wisconsin Card Sorting Test, the Visual Digit Span and the Vividness of Visual Imagery questionnaire. During a controlled feeding study, participants completed three technology-assisted 24HR: the Automated Self-Administered Dietary Assessment Tool, Intake24 and an Interviewer-Administered Image-Assisted 24HR (IA-24HR) 1 week apart. The percentage error between reported and true energy intakes was calculated. Using linear regression, the association between cognitive task scores and absolute percentage error in estimated energy intake was assessed. Longer time spent completing the Trail Making Test, an indicator of visual attention and executive functioning, was associated with greater error in energy intake estimation using ASA24 (B 0·13, 95 % CI 0·04, 0·21) and Intake24 (B 0·10, 95 % CI 0·02, 0·19). Regression models explained 13·6 % (ASA24) and 15·8 % (Intake24) of the variance in energy estimation error. No cognitive task scores were associated with error using IA-24HR. This study demonstrates that variation between individuals in neurocognitive processes explains some of the variation in 24HR error. Further investigation into the role of neurocognitive processes in 24HR and their role in the reliability of dietary intake data is warranted.
I recount my journey to developmental resilience science, highlighting the influence of serendipity and relationships. From a childhood in the military to Smith College, then onward to the NIH and the University of Minnesota, I describe forks and barriers as well as opportunities that shaped my path, including influences of mentors, challenges faced by women in academia, and fortuitous turning points in my life trajectory. I reflect on links between my own life and my motivation to understand resilience processes in children affected by adversities such as homelessness, natural disasters, or war, as well as the protections afforded by family relationships, friends, mentors, and collaborators. Relationships played a critical role in the evolution of my ideas and research, initially as a graduate student and then as a collaborator and mentor. Passing the baton to new generations of scholars, I have great confidence that resilience science and its applications to benefit human development are in very capable hands.
This chapter reviews changes to cognition with age. This includes sections on attention, executive function, motor control, and language. After reviewing cognitive aging and these basic cognitive functions, the chapter considers the burgeoning literature on training cognitive ability with age. This section includes review of intervention programs focused on physical activity, mediation and mediation, cognitive activities, working memory training, and long-term memory training.
Neuropsychiatric symptoms (NPS) are considered diagnostic and prognostic indicators of dementia and are attributable to neurodegenerative processes. Little is known about the prognostic value of early NPS on executive functioning (EF) decline in Alzheimer’s disease and related dementias (ADRD). We examined whether baseline NPS predicted the rate of executive function (EF) decline among older adults with ADRD.
Method:
Older adults (n = 1625) with cognitive impairment were selected from the National Alzheimer’s Coordinating Center database. EF was estimated with a latent factor indicated by scores on Number Span Backward, Letter Fluency, and Trail Making-Part B. A curve of factors (CUFF) latent growth curve model was estimated to examine rate of change over four years. Baseline NPS severity was entered as a predictor in the model to examine its influence on the rate of change in EF over time.
Results:
The CUFF models exhibited good fit. EF significantly declined over four waves (slope = −.16, p < .001). Initial visit NPS severity predicted decline in EF (slope = .013, p < .001), such that those with greater baseline NPS severity demonstrated a more rapid decline in EF performance over time. Presence of 2 NPS significantly predicted EF decline, and those with medium total NPS severity (NPS score of 2–4) at baseline exhibited a sharper decline in EF.
Conclusions:
Findings underscore the importance of targeting NPS early across ADRD syndromes to minimize EF decline, offering novel insights into how early NPS treatment may alter cognitive trajectories. We provide an innovative, user-friendly web-based application that may be helpful for personalized treatment planning.
We demonstrate the use of a multidimensional extension of the latent Markov model to analyse data from studies with repeated binary responses in developmental psychology. In particular, we consider an experiment based on a battery of tests which was administered to pre-school children, at three time periods, in order to measure their inhibitory control (IC) and attentional flexibility (AF) abilities. Our model represents these abilities by two latent traits which are associated to each state of a latent Markov chain. The conditional distribution of the test outcomes given the latent process depends on these abilities through a multidimensional one-parameter or two-parameter logistic parameterisation. We outline an EM algorithm for likelihood inference on the model parameters; we also focus on likelihood ratio testing of hypotheses on the dimensionality of the model and on the transition matrices of the latent process. Through the approach based on the proposed model, we find evidence that supports that IC and AF can be conceptualised as distinct constructs. Furthermore, we outline developmental aspects of participants’ performance on these abilities based on inspection of the estimated transition matrices.
The present study sought to determine the associations between executive functioning and Big Five personality traits in an undergraduate sample.
Method:
Participants included 200 undergraduates (73% women), with a mean age of approximately 21 years. Participants completed the Big Five Inventory-44 and a psychological assessment battery, which included the Trail Making Test and the Semantic Fluency Test.
Results:
Results from multiple regression analyses suggested agreeableness was negatively associated with Semantic Fluency – Animals (β = −0.310, p < 0.001). Moreover, conscientiousness was positively associated with Trail Making Test B-A (β = 0.197, p = 0.016), but negatively associated with Trail Making Test A (β = −0.193, p = 0.017).
Conclusions:
Overall results identified that executive function association with personality varies by construct. Given conscientiousness’ differential associations within the executive function task performances, future research should examine the conscientious threshold that would result in psychological symptomatology associated with extreme lows and highs in conscientiousness.
Bipolar disorder (BD) is a leading cause of disability and is linked to cognitive and functional impairment, increased mortality from cardiometabolic disorders and bipolar disorder suicide. Few studies in sub-Saharan Africa have explored cognitive dysfunction in bipolar disorder. Our study explores the cognitive characteristics in a bipolar patient cohort in Nigeria and assesses its association with clinical and demographic variables.
40 participants from the Bipolar Disorder Longitudinal Study, at baseline, were included in the pilot study of the BiDiLos-Ng. Using a cross-sectional design, cognitive function was assessed using the Screen for Cognitive Impairment in Psychiatry. Multiple linear regression models were used to explore associations between dependent and independent variables.
Cognitive impairment was present in 41% of the bipolar cohort, it was not associated with the frequency of mood episodes, and higher educational level was associated with higher verbal fluency test scores (p = 0.02). Being in employment (p = 0.03), younger age (p = 0.00), and lower YMRS score (p = 0.006) were associated with higher working memory test scores.
The presence of mania symptoms during the euthymic phase of BD was associated with cognitive impairment. Executive function and working memory were linked to better academic and occupational attainment.
Whether speaking two or more languages (multilingualism) or dialects of one language (bidialectalism) affect executive function (EF) is controversial. Theoretically, these effects may depend on at least two conditions. First, the multilingual and bidialectal characteristics; particularly, (second) language proficiency and the sociolinguistic context of language use (e.g., Green & Abutalebi, 2013). Second, the EF aspects examined; specifically, recent accounts of the locus of the multilingual effect propose a general EF effect rather than an impact on specific processes (Bialystok, 2017). We compared 52 “monolingual” (with limited additional-language/dialect experience), 79 bidialectal and 50 multilingual young adults in the diglossic context of Cyprus, where bidialectalism is widespread and Cypriot and Standard Greek are used in different everyday situations. Three EF processes were examined via seven tasks: inhibition, switching and working memory (Miyake et al., 2000). We found better multilingual and bidialectal performance in overall EF, an effect moderated by high (second) language proficiency.
Part of a wider study of family interaction, this chapter focuses on the interactional competence of a person living with dementia and some ways in which her independence is facilitated, and personhood validated, by her interlocutors. Drawing on a corpus of 15 hours of naturally occurring conversation, the study investigates the interactional practices of a woman diagnosed with dementia (Dana) in conversation with a variety of interlocutors including family caregivers, teenage grandchildren and community service providers. This chapter examines sequences of advice-giving, shared reminiscence and occasions of confusion. Dana first draws on a lifetime of expertise as a waitress to advise her granddaughter who has recently begun her first job; second, in a sequence of reminiscence, conversational partners describe a shared experience that Dana is able to assess and engage with despite potentially being unable to remember the details for herself; finally, the analysis shows how the actions of probing and testing can lead to interactional breakdown and confusion, but then note how Dana is able to recover from the situation by moving to a familiar topic and claiming epistemic authority.
The depression, obstructive sleep apnea and cognitive impairment (DOC) screen assesses three post-stroke comorbidities, but additional information may be gained from the time to complete the screen. Cognitive screening completion time is rarely used as an outcome measure.
Objective:
To assess DOC screen completion time as a predictor of cognitive impairment in stroke/transient ischemic attack clinics.
Methods:
Consecutive English-speaking stroke prevention clinic patients consented to undergo screening and neuropsychological testing (n = 437). DOC screen scores and times were compared to scores on the NINDS-CSC battery using multiple linear regression (controlling for age, sex, education and stroke severity) and receiver operating characteristic (ROC) curve analysis.
Results:
Completion time for the DOC screen was 3.8 ± 1.3 minutes. After accounting for covariates, the completion time was a significant predictor of the speed of processing (p = 0.002, 95% CI: −0.016 to −0.004), verbal fluency (p < 0.001, CI: −0.012 to −0.006) and executive function (p = 0.004, CI: −0.006 to −0.001), but not memory. Completion time above 5.5 minutes was associated with a high likelihood of impairment on executive and speed of processing tasks (likelihood ratios 3.9–5.2).
Conclusions:
DOC screen completion time is easy to collect in routine care. People needing over 5.5 minutes to be screened likely have deficits in executive functioning and speed of processing – areas commonly impaired, but challenging to screen for, after stroke. DOC screen time provides a simple, feasible approach to assess these under-identified cognitive impairments.
Child maltreatment impacts approximately one in seven children in the United States, leading to adverse outcomes throughout life. Adolescence is a time period critical for the development of executive function, but there is little research examining how abuse and neglect may differently affect the developmental trajectories of executive function throughout adolescence and into young adulthood. In the current study, 167 adolescents participated at six time points from ages 14 to 20. At each time point, adolescents completed behavioral tasks measuring the three dimensions of executive function (working memory, inhibitory control, and cognitive flexibility). Neglect and abuse in early life (ages 1–13) were reported at ages 18–19. Unconditional growth curve models revealed age-related improvement in all three executive function dimensions. Conditional growth curve models tested the prospective effects of recalled neglect and abuse on the developmental trajectories of executive function. The results revealed that neglect was associated with developmental changes in working memory abilities, such that greater levels of neglect during ages 1–13 were associated with slower increases in working memory abilities across ages 14–20. These findings highlight the adverse consequences of early neglect experiences shown by delayed working memory development during adolescence into young adulthood.
This chapter considers neuroanatomy in terms of the way in which cognitive processes and emotions are organised. Rather than using a strict localisationist approach, with specific cognitive functions being concentrated in particular anatomical areas, emphasis is placed on a more contemporary view of the brain as organised as a series of circuits. The main areas of cognition are considered, namely perception, language, memory, executive function, and attention. Differences between common terms are explained, such as grey and white matter, cortical and subcortical. This chapter also makes use of illustrations.
3q29 deletion syndrome (3q29del) is a rare (~1:30 000) genomic disorder associated with a wide array of neurodevelopmental and psychiatric phenotypes. Prior work by our team identified clinically significant executive function (EF) deficits in 47% of individuals with 3q29del; however, the nuances of EF in this population have not been described.
Methods
We used the Behavior Rating Inventory of Executive Function (BRIEF) to perform the first in-depth assessment of real-world EF in a cohort of 32 individuals with 3q29del (62.5% male, mean age = 14.5 ± 8.3 years). All participants were also evaluated with gold-standard neuropsychiatric and cognitive assessments. High-resolution structural magnetic resonance imaging was performed on a subset of participants (n = 24).
Results
We found global deficits in EF; individuals with 3q29del scored higher than the population mean on the BRIEF global executive composite (GEC) and all subscales. In total, 81.3% of study subjects (n = 26) scored in the clinical range on at least one BRIEF subscale. BRIEF GEC T scores were higher among 3q29del participants with a diagnosis of attention deficit/hyperactivity disorder (ADHD), and BRIEF GEC T scores were associated with schizophrenia spectrum symptoms as measured by the Structured Interview for Psychosis-Risk Syndromes. BRIEF GEC T scores were not associated with cognitive ability. The BRIEF-2 ADHD form accurately (sensitivity = 86.7%) classified individuals with 3q29del based on ADHD diagnosis status. BRIEF GEC T scores were correlated with cerebellar white matter and subregional cerebellar cortex volumes.
Conclusions
Together, these data expand our understanding of the phenotypic spectrum of 3q29del and identify EF as a core feature linked to both psychiatric and neuroanatomical features of the syndrome.