Examining the role of participant and study partner report in widely-used classification approaches of mild cognitive impairment in demographically-diverse community dwelling individuals: results from the Einstein aging study

ObjectiveThe role of subjective cognitive concerns (SCC) as a diagnostic criterion for MCI remains uncertain and limits the development of a universally (or widely)-accepted MCI definition. The optimal MCI definition should define an at-risk state and accurately predict the development of incident dementia. Questions remain about operationalization of definitions of self- and informant-reported SCCs and their individual and joint associations with incident dementia.MethodsThe present study included Einstein Aging Study participants who were non-Hispanic White or Black, free of dementia at enrollment, had follow-up, and completed neuropsychological tests and self-reported SCC at enrollment to determine MCI status. Informant-reported SCC at baseline were assessed via the CERAD clinical history questionnaire. Self-reported SCC were measured using the CERAD, items from the EAS Health Self-Assessment, and the single memory item from the Geriatric Depression Scale. Cox proportional hazards models examined the association of different operationalizations of SCC with Petersen and Jak/Bondi MCI definitions on the risk of dementia, further controlling for age, sex, education, and race/ethnicity. Time-dependent sensitivity and specificity at specific time points for each definition, and Youden’s index were calculated as an accuracy measure. Cox proportional hazards models were also used to evaluate the associations of combinations of self- and informant-reported SCC with the risk of incident dementia.Results91% of the sample endorsed at least one SCC. Youden’s index showed that not including SCC in either Jak/Bondi or Petersen classifications had the best balance between sensitivity and specificity across follow-up. A subset of individuals with informants, on average, had a lower proportion of non-Hispanic Blacks and 94% endorsed at least one self-reported SCC. Both informant-reported and self-reported SCC were significantly associated with incident dementia.ConclusionOur findings suggest that the SCC criterion may not improve the predictive validity for dementia when included in widely-employed definitions of MCI. Consistent with some prior research, informant-reported SCC was more related to risk of incident dementia than self-reported SCC. Given that requiring informant report as a diagnostic criterion may unintentionally exclude health disparate groups, additional consideration is needed to determine how best to utilize informant-report in MCI diagnosis

Improving student performance in organic chemistry: Help seeking behaviors and prior chemistry aptitude

Organic Chemistry is perceived to be one of the most challenging of undergraduate science courses, and attrition from this course may impact decisions about pursuing a professional or academic career in the biomedical and related sciences. Research suggests that chemistry students who are strategic help seekers may outperform those students who avoid seeking help, and that encouraging self-regulated learning behaviors can benefit academically at-risk students. In the current study we present the results of action research conducted in an Organic Chemistry classroom at a large, urban, public university over the course of three semesters. Results suggest that encouraging academic help seeking, a type of self-regulated learning, improves student outcomes. Implications for other science courses and for similar student populations (underrepresented minorities and first generation to attend college) are discussed

CORRELATES OF EXAM PERFORMANCE IN AN INTRODUCTORY STATISTICS COURSE: BASIC MATH SKILLS ALONG WITH SELF- REPORTED PSYCHOLOGICAL/BEHAVIORAL AND DEMOGRAPHIC VARIABLES

This study investigated whether basic mathematics skills are associated with undergraduate psychology statistics course performance while simultaneously considering self-reported psychological/behavioral and demographic variables. Participants (n = 460) completed a Math Assessment for College Students (MACS), which included questions ranging from calculating percentages to graphical interpretation. The researchers used a discriminant correspondence analysis to reveal differences in course performance evaluated as the average of three exam grades. For the variation in the average exam scores accounted for by our model, the MACS scores provided the largest contribution. Other variables associated with better exam grades included white ethnicity, non-transfer status, lower year in school, and low procrastination. The researchers discuss the implications for helping instructors identify areas of basic mathematical deficiency and strength

Frequently endorsed cognitive and physical activities among community-dwelling older adults

Background Despite the established benefits of cognitive and physical activity, a paucity of research examines the specific activities older adults favor, particularly those meeting the nationally recommended minimum duration of \u3e 30 minutes per session. Material/Methods 260 non-demented, community-dwelling participants aged 70 and above self-reported the duration of their participation in 26 cognitive and physical activities during a typical week. Overall activity engagement was investigated by sex and educational level. Results The most endorsed physical activities were walking, stretching/yoga and gardening, while the most endorsed cognitive activities were reading magazines/newspapers, reading books, and doing crosswords. Walking (p = .048), swimming (p = .008), reading magazines/ newspapers (p=.011), writing (p=.001), and attending lectures (p = .007) were more common among those with \u3e 12 years of education, while reading books (p = .039) and sewing/knitting (p = .040) were more common among those with ≤ 12 years of education. Doing crossword puzzles (p = .003), sewing/knitting (p = .001), and dancing (p = .015) were more common among females, while weight training (p = .009) and fishing (p = .003) were more common among males. Conclusions Overall, results revealed several statistically significant activity engagement differences by sex and education. Findings are discussed in relation to enhancing older adults’ participation in activities that may improve their overall functioning

Predictivos de las actitudes hacia la cirugía cosmética entre mujeres universitarias colombianas y estadounidenses: los roles de las conductas de alimentación y de las variables demográficas

Los estudios transculturales sobre las conductas re- lacionadas con la alimentación pueden identificar los factores culturales y sociales que contribuyen a la sintomatología de los trastornos alimentarios (TCA). Los TCA son causa de preocupación en los Estados Unidos, y estudios recientes en Colombia han mostrado tasas de crecimiento entre la población femenina. Además, los procedimientos de cirugía estética se han incrementado rápidamente en los Estados Unidos y Colombia, e investigaciones preliminares sugieren una relación positiva entre los TCA y el respaldo de la cirugía plástica. En muestras de mujeres universitarias de Colombia y los Estados Unidos, se han investigado los patrones de asociación entre los trastornos de la alimentación y la aceptación de la cirugía cosmética. Nuestro enfoque utilizó análisis separados para los subcomponentes del consumo alimentario desordenado (para determinar asociaciones únicas con la aceptación de cirugía estética), ajustando covariables potencialmente pertinentes y examinando patrones transculturales. Los participantes fueron estudiantes de un colegio público urbano en los Estados Unidos (n = 163) y de un colegio privado urbano de Colombia (n = 179). En general, nuestros resultados sugieren que los participantes de Colombia con valores más altos en medidas del consumo alimentario desordenado eran más propensos a apoyar la cirugía estética por razones sociales, mientras que los de los Estados Unidos eran más propensos a considerar el someterse a la cirugía estética por razones personales. Resultados divergentes entre las dos muestras puede ser debido a factores culturales y sociales, que delinearemos. Estos resultados también tienen implicaciones potenciales para el asesoramiento prequirúrgico de los candidatos de cirugía estética

Preditivos das atitudes em relação à cirurgia cosmética entre mulheres universitárias colombianas e estadunidenses: os papeis das condutas de alimentação e das variáveis demográficas

Cross-cultural studies on eating behaviors and related constructs can identify cultural and social factors that contribute to eating disorder symptomatology. Eating disorders (EDs) are a major cause for concern in the U.S., and recent studies in Colombia have shown growing rates among their female population. In addition, cosmetic surgery procedures have been increasing rapidly in both the U.S. and Colombia, and preliminary research suggests a positive relation between disordered eating and endorsement of plastic surgery. In samples of college women from Colombia and the U.S., we investigated patterns of association between disordered eating variables and cosmetic surgery acceptance. Our approach utilized separate analyses for various subcomponents of disordered eating (to determine their unique associations with cosmetic surgery acceptance) while adjusting for potentially relevant covariates and examining cross-cultural patterns. Participants were students at an urban, public college in the U.S. (n=163) and an urban, private college in Colombia (n=179). Overall, our findings suggested that participants from Colombia with greater disordered eating were more likely to endorse cosmetic surgery for social reasons, while those from the U.S. were more likely to consider undergoing cosmetic surgery for personal reasons. Differing findings between the two samples may be due to cultural and social factors, which we delineate. These findings also have potential implications for presurgical counseling of cosmetic surgery candidates.Los estudios transculturales sobre las conductas re- lacionadas con la alimentación pueden identificar los factores culturales y sociales que contribuyen a la sintomatología de los trastornos alimentarios (TCA). Los TCA son causa de preocupación en los Estados Unidos, y estudios recientes en Colombia han mostrado tasas de crecimiento entre la población femenina. Además, los procedimientos de cirugía estética se han incrementado rápidamente en los Estados Unidos y Colombia, e investigaciones preliminares sugieren una relación positiva entre los TCA y el respaldo de la cirugía plástica. En muestras de mujeres universitarias de Colombia y los Estados Unidos, se han investigado los patrones de asociación entre los trastornos de la alimentación y la aceptación de la cirugía cosmética. Nuestro enfoque utilizó análisis separados para los subcomponentes del consumo alimentario desordenado (para determinar asociaciones únicas con la aceptación de cirugía estética), ajustando covariables potencialmente pertinentes y examinando patrones transculturales. Los participantes fueron estudiantes de un colegio público urbano en los Estados Unidos (n = 163) y de un colegio privado urbano de Colombia (n = 179). En general, nuestros resultados sugieren que los participantes de Colombia con valores más altos en medidas del consumo alimentario desordenado eran más propensos a apoyar la cirugía estética por razones sociales, mientras que los de los Estados Unidos eran más propensos a considerar el someterse a la cirugía estética por razones personales. Resultados divergentes entre las dos muestras puede ser debido a factores culturales y sociales, que delinearemos. Estos resultados también tienen implicaciones potenciales para el asesoramiento prequirúrgico de los candidatos de cirugía estética.Os estudos transculturais sobre as condutas relacionadas com a alimentação podem identificar os fatores culturais e sociais que contribuem à sintomatologia dos transtornos alimentares (TCA). os TCA são causa de preocupação nos Estados Unidos, e estudos recentes Na Colômbia têm mostrado taxas de crescimento entre apopulação feminina. Além disso, os procedimentos de cirurgia estética se têm incrementado rapidamente nos Estados Unidos e na Colômbia, e pesquisadores preliminares sugerem uma relação positiva entre os TCA e o respaldo da cirurgia plástica. Em amostras de mulheres universitárias da Colômbia e dos Estados Unidos, se têm investigado os patrões de associação entre os transtornos da alimentação e a aceitação da cirurgia cosmética. Nosso enfoque utilizou análises separadas para os subcomponentes do consumo alimentar des- ordenado (para determinar associações únicas com a aceitação da cirurgia estética), ajustando covariáveis potencialmente pertinentes e examinando patrões transculturais. os participantes foram estudantes de uma escola pública urbana nos Estados Unidos (n = 163) e de uma escola privada urbana da Colômbia (n = 179). Em geral, nossos resultados sugerem que os participantes da Colômbia com valores mais altos em medidas do consumo alimentar desordenado eram mais propensos a apoiar a cirurgia estética por razões sociais, enquanto os dos Estados Unidos eram mais propensos a considerar submeterse à cirurgia estética por razões pessoais. os resultados divergentes entre as duas amostras podem ser devido a fatores culturais e sociais, que delinearemos. Estes resultados também têm implicações potenciais para o assessoramento précirúrgico dos candidatos de cirurgia estética

An approach to classifying subjective cognitive decline in community-dwelling elders

Introduction: Subjective cognitive decline (SCD) may be an early symptomatic man- ifestation of Alzheimer’s disease, though published research largely neglects how to classify SCD in community-based studies. Methods: In neuropsychologically intact Einstein Aging Study participants (n = 1115; meanage=78;63%female;30%non-White),weusedCoxmodelstoexaminetheasso- ciation between self-perceived cognitive functioning at baseline (using three different approaches) and incident amnestic mild cognitive impairment (aMCI) with covariates of age, sex, education, race/ethnicity, general (objective) cognition, depressive symp- toms, and four other SCD-related features. Results: After a median of 3 years, 198 participants developed aMCI. In models that included all the variables, self-perceived cognitive functioning was consistently asso- ciated with incident aMCI as were age, general cognition, and perceived control; apolipoprotein E (APOE) ε4 allele status was significant in one model. We set cut points that optimized the diagnostic accuracy of SCD at various time frames. Discussion: We provide an approach to SCD classification and discuss implications for cognitive aging studies

Cholinergic enhancement of brain activation in mild cognitive impairment during episodic memory encoding

Objective: To determine the physiological impact of treatment with donepezil (Aricept) on neural circuitry supporting episodic memory encoding in patients with amnestic mild cognitive impairment (MCI) using functional magnetic resonance imaging (fMRI). Methods: Eighteen patients with MCI and 20 age-matched healthy controls (HC) were scanned twice while performing an event-related verbal episodic encoding task. MCI participants were scanned before treatment and after approximately 3 months on donepezil; HCwere untreated but rescanned at the same interval.Voxel-level analyses assessed treatment effects on activation profiles in MCI patients relative to retest changes in non-treated HC. Changes in task-related connectivity in medial temporal circuitry were also evaluated, as were associations between brain activation, task-related functional connectivity, task performance, and clinical measures of cognition. Results: At baseline, the MCI group showed reduced activation during encoding relative to HC in the right medial temporal lobe (MTL; hippocampal/parahippocampal) and additional regions, as well as attenuated task-related deactivation, relative to rest, in a medial parietal lobe cluster. After treatment, the MCI group showed normalized MTL activation and improved parietal deactivation. These changes were associated with cognitive performance. After treatment, the MCI group also demonstrated increased task-related functional connectivity from the right MTL cluster seed region to a network of other sites including the basal nucleus/caudate and bilateral frontal lobes. Increased functional connectivity was associated with improved task performance. Conclusion: Pharmacologic enhancement of cholinergic function in amnestic MCI is associated with changes in brain activation and functional connectivity during episodic memory processing which are in turn related to increased cognitive performance. fMRI is a promising biomarker for assessing treatment related changes in brain function

T-MoCA: A valid phone screen for cognitive impairment in diverse community samples

Introduction: There is an urgent need to validate telephone versions of widely used general cognitive measures, such as the Montreal Cognitive Assessment (T-MoCA), for remote assessments. Methods: In the Einstein Aging Study, a diverse community cohort (n = 428; mean age = 78.1; 66% female; 54% non-White), equivalence testing was used to examine concordance between the T-MoCA and the corresponding in-person MoCA assess- ment. Receiver operating characteristic analyses examined the diagnostic ability to dis- criminate between mild cognitive impairment and normal cognition. Conversion meth- ods from T-MoCA to the MoCA are presented. Results: Education, race/ethnicity, gender, age, self-reported cognitive concerns, and telephone administration difficulties were associated with both modes of administra- tion; however, when examining the difference between modalities, these factors were not significant. Sensitivity and specificity for the T-MoCA (using Youden’s index opti- mal cut) were 72% and 59%, respectively. Discussion: The T-MoCA demonstrated sufficient psychometric properties to be use- ful for screening of MCI, especially when clinic visits are not feasible