Validity of Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)

Sports concussions have been recognized as significant injuries among young athletes with research demonstrating that return-to-play prior to becoming asymptomatic can have significant repercussions, including risk of sustaining cognitive deficits. In tracking and monitoring concussions during sports seasons, many programs have begun utilizing computerized testing rather than traditional neuropsychological tests to 1) determine baseline scores, 2) track symptoms, and 3) measure cognitive deficits following concussion. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) is one such instrument. The current study examined ImPACT’s convergent, discriminant, and diagnostic validity by comparing scores from post-concussion athletes (SPORT) to those from non-concussed controls (CONT). SPORT included 29 athletes, ages 12-16, referred for neuropsychological testing following sports-related concussions. CONT included 25 healthy athletes, ages 12-16, who had not sustained a concussion in the past year. Overall, results showed general support for ImPACT, when used to screen cognition. In fact, all ImPACT domains successfully differentiated between CONT and SPORT athletes; evidence supporting appropriate convergent validity was best for the Visual Memory domain. ImPACT domains demonstrated variable discriminant validity. Overall examination of validity demonstrated that ImPACT has some weaknesses but may have utility in detecting post-concussion cognitive impairment

Longitudinal Assessment of Dementia Measures in Down Syndrome

Introduction: Early detection of dementia symptoms is critical in Down syndrome (DS) but complicated by clinical assessment barriers. The current study aimed to characterize cognitive and behavioral impairment using longitudinal trajectories comparing several measures of cognitive and behavioral functioning. Methods: Measures included global cognitive status (Severe Impairment Battery [SIB]), motor praxis (Brief Praxis Test [BPT]), and clinical dementia informant ratings (Dementia Questionnaire for People with Learning Disabilities [DLD]). One-year reliability was assessed using a two-way mixed effect, consistency, single measurement intraclass correlation among non-demented participants. Longitudinal assessment of SIB, BPT, and DLD was completed using linear mixed effect models. Results: One‐year reliability (n = 52; 21 male) was moderate for DLD (0.69 to 0.75) and good for SIB (0.87) and BPT (0.80). Longitudinal analysis (n = 72) revealed significant age by diagnosis interactions for SIB (F(2, 115.02) = 6.06, P = .003), BPT (F(2, 85.59) = 4.56, P = .013), and DLD (F(2, 103.56) = 4.48, P = .014). SIB progression (PR) had a faster decline in performance versus no‐dementia (ND) (t(159) = −2.87; P = .013). Dementia had a faster decline in BPT performance versus ND (t(112) = −2.46; P = .041). PR showed quickly progressing scores compared to ND (t(128) = −2.86; P = .014). Discussion: Current measures demonstrated moderate to good reliability. Longitudinal analysis revealed that SIB, BPT, and DLD changed with age depending on diagnostic progression; no change rates were dependent on baseline cognition, indicating usefulness across a variety of severity levels in DS

Feasibility of Dual-Task Gait to Estimate Alzheimer\u27s Related Cognitive Decline in Down Syndrome

Introduction: The striatum and frontal lobes have been shown to have early Alzheimer\u27s disease (AD) neuropathology and are critical for motor and cognitive function. We hypothesized gait would be associated with early-stage dementia in Down syndrome (DS), a cohort at risk for AD. Methods: Twenty-eight participants with DS were enrolled in the study. Participants walked at their self-selected pace and while completing a dual task (counting, obstacle, or counting+obstacle). Results: All participants were able to complete the self-paced condition and 78.57-96.42% completed the dual-task conditions. There was a trend for greater dual-task effects on gait velocity based on dementia diagnosis. Gait velocity had stronger associations with clinical dementia assessments than age or diagnosis. Discussion: A dual-task gait paradigm is feasible to conduct with adults with DS and is associated with age and cognitive impairment. Dual-task gait may serve as an indicator of early stage dementia in DS