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Background: How cognition is influenced by electroconvulsive treatment (ECT) and major depressive disorder (MDD) is still debated. The development and etiology of neurocognitive impairment in MDD were examined by investigating the cognitive profile following ECT related to the state, scar, and trait perspectives, with the former predicting improvements parallel with depressive symptoms, while the two latter expected persisting impairments. Executive functions (EF) and attention are central to cognition and alterations in these functions could influence other domains like memory. The main aims of the present study were to examine the short and long-term effects of ECT on EF and attention in patients with major depressive disorder by exploiting the rapid antidepressant effect of this treatment., Methods: A case-control longitudinal follow-up design was used to investigate the effects of unilateral brief-pulse ECT on EF and attention in patients with depression (n = 36) compared to untreated healthy controls (n = 16). EF and attention were measured pre-treatment, approximately two weeks, and six months post-treatment., Results: The patient group showed significantly worse performance on most tests compared to healthy controls pre-treatment, and no short- or long-term worsening of EF and attention following ECT was found. Significant improvement was identified in patients' attention, processing speed and inhibition after ECT., Conclusions: The present study showed that there was no cognitive worsening after ECT treatment. An improvement in several of the tests measuring inhibition, attention, and processing speed was parallel to symptom reduction, with the former showing associations to symptom change, suggesting state-related effects from improved mood. Still, the patient group performed significantly worse on most measures both pre-treatment and at the short and long-term follow-ups, indicating prevailing trait or scar effects on cognitive functions and potential lack of practice effects., Clinical Trial Number: NCT04348825 (14.04.20)., Competing Interests: Declarations. Ethics approval and consent to participate: Written and informed consent from participants was collected in advance of participation. All participants consented to participation in the study. The study was approved by the Regional Committee for Medical and Health Research Ethics, South East, ID: 2013/1032 ECT and neurology. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Mild traumatic brain injury (mTBI) and posttraumatic stress are prevalent in military service members and share objective and subjective cognitive symptoms, complicating recovery. We investigated the effects of remote mTBI characteristics and current posttraumatic stress symptoms on neuropsychological performance in 152 veterans with a history of remote mTBI and current cognitive concerns. Participants completed clinical neuropsychological evaluations within a Veterans Affairs Level-II TBI/Polytrauma outpatient clinic (i.e. tertiary trauma care center for US military veterans outside of a research or teaching hospital setting). Archival data analysis of mTBI injury characteristics, clinical diagnoses, scores on the Posttraumatic Stress Disorder Checklist-Military Version (PCL-M) and performance on tests of processing speed, attention and executive function was conducted. Hierarchical linear regression demonstrated that elevated PCL-M scores were associated with slower performance on trail making test (TMT) Parts A and B (p < .016). PCL-M symptoms moderated the effect of alteration of consciousness (AOC) on TMT performance, with endorsement of AOC associated with better performance, but only when PCL-M scores were high (p < .005). Follow-up mediation analyses demonstrated that PCL-M score fully mediated the relationship between AOC and TMT-A performance and partially mediated the relationship between AOC and TMT-B performance. Post-hoc analyses meant to separate the impact of processing speed on TMT-B were all non-significant. Remote mTBI characteristics, specifically AOC, were not associated with decrements in cognitive performance. Posttraumatic symptoms were associated with worse processing speed, suggesting that psychological distress and psychopathology are contributing factors in understanding and treating persistent cognitive distress following remote mTBI., (© 2024 The British Psychological Society.)

Spoken language development after pediatric cochlear implantation requires rapid and efficient processing of novel, degraded auditory signals and linguistic information. These demands for rapid adaptation tax the information processing speed ability of children who receive cochlear implants. This study investigated the association of speed of information processing ability with spoken language outcomes after cochlear implantation in prelingually deaf children aged 4-6 years. Two domain-general (visual, non-linguistic) speed of information processing measures were administered to 21 preschool-aged children with cochlear implants and 23 normal-hearing peers. Measures of speech recognition, language (vocabulary and comprehension), nonverbal intelligence, and executive functioning skills were also obtained from each participant. Speed of information processing was positively associated with speech recognition and language skills in preschool-aged children with cochlear implants but not in normal-hearing peers. This association remained significant after controlling for hearing group, age, nonverbal intelligence, and executive functioning skills. These findings are consistent with models suggesting that domain-general, fast-efficient information processing speed underlies adaptation to speech perception and language learning following implantation. Assessment and intervention strategies targeting speed of information processing may provide better understanding and development of speech-language skills after cochlear implantation., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objective: The ability to remotely monitor cognitive skills is increasing with the ubiquity of smartphones. The Mobile Toolbox (MTB) is a new measurement system that includes measures assessing Executive Functioning (EF) and Processing Speed (PS): Arrow Matching, Shape-Color Sorting, and Number-Symbol Match. The purpose of this study was to assess their psychometric properties., Method: MTB measures were developed for smartphone administration based on constructs measured in the NIH Toolbox® (NIHTB). Psychometric properties of the resulting measures were evaluated in three studies with participants ages 18 to 90. In Study 1 ( N = 92), participants completed MTB measures in the lab and were administered both equivalent NIH TB measures and other external measures of similar cognitive constructs. In Study 2 ( N = 1,021), participants completed the equivalent NIHTB measures in the lab and then took the MTB measures on their own, remotely. In Study 3 ( N = 168), participants completed MTB measures twice remotely, two weeks apart., Results: All three measures exhibited very high internal consistency and strong test-retest reliability, as well as moderately high correlations with comparable NIHTB tests and moderate correlations with external measures of similar constructs. Phone operating system (iOS vs. Android) had a significant impact on performance for Arrow Matching and Shape-Color Sorting, but no impact on either validity or reliability., Conclusions: Results support the reliability and convergent validity of MTB EF and PS measures for use across the adult lifespan in remote, self-administered designs.

Objectives: Symptoms and cognition are both utilized as indicators of recovery following pediatric concussion, yet their interrelationship is not well understood. This study aimed to investigate: 1) the association of post-concussion symptom burden and cognitive outcomes (processing speed and executive functioning [EF]) at 4 and 12 weeks after pediatric concussion, and 2) the moderating effect of sex on this association., Methods: This prospective, multicenter cohort study included participants aged 5.00-17.99 years with acute concussion presenting to four Emergency Departments of the Pediatric Emergency Research Canada network. Five processing speed and EF tasks and the Post-Concussion Symptom Inventory (PCSI; symptom burden, defined as the difference between post-injury and retrospective [pre-injury] scores) were administered at 4 and 12 weeks post-concussion. Generalized least squares models were conducted with task performances as dependent variables and PCSI and PCSI*sex interaction as the main predictors, with important pre-injury demographic and injury characteristics as covariates., Results: 311 children (65.0% males; median age = 11.92 [IQR = 9.14-14.21 years]) were included in the analysis. After adjusting for covariates, higher symptom burden was associated with lower Backward Digit Span (χ 2 = 9.85, p = .043) and Verbal Fluency scores (χ 2 = 10.48, p = .033) across time points; these associations were not moderated by sex, ps ≥ .20. Symptom burden was not associated with performance on the Coding, Continuous Performance Test, and Color-Word Interference scores, ps ≥ .17., Conclusions: Higher symptom burden is associated with lower working memory and cognitive flexibility following pediatric concussion, yet these associations were not moderated by sex. Findings may inform concussion management by emphasizing the importance of multifaceted assessments of EF.

While previous research has linked cognitive function with resistance exercise, the nuanced links between muscle strength, mass, and neuroelectric function are less understood. Therefore, this study investigated the association of muscle strength and mass with inhibitory control (IC), working memory (WM), and related neuroelectric activity. A total of 123 18-50-year-old adults completed maximal aerobic capacity and strength tests, a body composition scan, and IC and WM tasks while the N2 and P3 components of event-related potentials were recorded. Bivariate correlations revealed aerobic fitness, strength, and mass were associated with behavioral and neuroelectric outcomes. After accounting for age, sex, and aerobic fitness, strength was associated with intra-individual response time variability, accuracy, and P3 latency during WM. Muscle mass was associated with N2 latency during IC. While relationships with behavioral outcomes did not persist after controlling for the opposite muscle outcome, greater strength and mass were related to shorter P3 latency during WM and shorter N2 latency during IC, respectively. These results provide initial evidence that muscle outcomes are associated with executive function and neuroelectric processing speed, suggesting distinct contributions of strength and mass to cognition. This work highlights the significance of maintaining muscle strength and mass alongside aerobic fitness for optimal cognitive health., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: While much is known about the effects of physical exercise in adult humans, literature on the oldest-old (≥ 85 years old) is sparse. The present study explored the relationship between self-reported engagement in physical exercise and cognition in the oldest-old., Methods: The sample included 184 cognitively healthy participants (98 females, MoCA mean score = 24.81) aged 85 to 99 years old (mean = 88.49 years). Participants completed the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire and a cognitive battery including NIH-TB, Coding, Symbol Search, Letter Fluency, and Stroop task. Three groups of participants - sedentary (n = 58; MoCA mean score = 24; 36 females; mean age = 89.03), cardio (n = 60; MoCA mean score = 25.08; 29 females; mean age = 88.62), and cardio + strength training (n = 66; MoCA mean score = 25.28; 33 females; mean age = 87.91) - were derived from responses on CHAMPS., Results: Analyses controlled for years of education, NIH-TB Crystallized Composite, and metabolic equivalent of tasks. The cardio + strength training group had the highest cognitive performances overall and scored significantly better on Coding (p < 0.001) and Symbol Search (p < 0.05) compared to the sedentary group. The cardio + strength training group scored significantly better on Symbol Search, Letter Fluency, and Stroop Color-Word compared to the cardio group (p < 0.05)., Conclusions: Our findings suggest self-reported exercise in the oldest-old is linked to better performance on cognitive measures of processing speed and executive functioning, and that there may be a synergistic effect of combining aerobic and resistance training on cognition., (© 2023. The Author(s), under exclusive licence to American Aging Association.)

Introduction: Neighborhood socioeconomic status (NSES) has been linked with overall health, and this study will evaluate whether NSES is cross-sectionally associated with cognition in non-Hispanic whites (NHWs) and Mexican Americans (MAs) from the Health and Aging Brain: Health Disparities Study (HABS-HD)., Methods: The HABS-HD is a longitudinal study conducted at the University of North Texas Health Science Center. The final sample analyzed (n = 1,312) were 50 years or older, with unimpaired cognition, and underwent an interview, neuropsychological examination, imaging, and blood draw. NSES was measured using the national area deprivation index (ADI) percentile ranking, which considered socioeconomic variables. Executive function and processing speed were assessed by the trail making tests (A and B) and the digit-symbol substitution test, respectively. Linear regression was used to assess the association of ADI and cognitive measures., Results: MAs were younger, more likely to be female, less educated, had higher ADI scores, performed worse on trails B (all p &lt; 0.05), and had lower prevalence of APOE4 + when compared to NHWs (p &lt; 0.0001). A higher percentage of MAs lived in the most deprived neighborhoods than NHWs. For NHWs, ADI did not predict trails B or DSS scores, after adjusting for demographic variables and APOE4. For MAs, ADI predicted trails A, trails B, and DSS after adjusting for demographic covariates and APOE4 status., Conclusion: Our study revealed that living in an area of higher deprivation was associated with lower cognitive function in MAs but not in NHWs, which is important to consider in future interventions to slow cognitive decline., (© 2024 S. Karger AG, Basel.)

We used data from the Comprehensive cohort of the Canadian Longitudinal Study on Aging to compare the cognitive performance of retirees and workers ( n = 1442), 45-85 years of age at baseline. Speed processing and executive functioning were assessed using standardized assessment tools at baseline and at follow-up, measured 3 years later. Retirees and workers were matched for age, sex, and education using the nearest neighbor propensity score method with a caliper of 0.02. Mixed ANOVA and post hoc analyses were conducted separately for the English- and French-speaking samples. Results for the English-speaking sample showed a significant decline on both the Stroop and the Mental Alternation tasks for retirees compared to workers from baseline to follow-up. These results support previous cross-sectional studies that have demonstrated a negative effect of retirement on executive functioning. The absence of significant results in the French-speaking sample are discussed in terms of sample size and professional occupation.

Objective: The purpose of this study was to assess how neuropsychological factors differ between general surgery interns and normative data from age-matched adults in the general population., Design: Participants completed a comprehensive neuropsychological assessment battery. Neuropsychological factors assessed included: executive function (Behavioral Rating Inventory of Executive Function, BRIEF), working memory (Wechsler Adult Intelligence Scale, or WAIS, digit span), psychomotor speed (WAIS coding, Trails A and B), selective attention (D2 Test of Attention), and problem solving (Tower of London, TOL). Data for all measures was compared to previously published normative data for age-matched, healthy adults in the general population using one-sample t-tests., Setting: This study was completed at Indiana University School of Medicine in Indianapolis, IN, which is a large academic healthcare training institution., Participants: Postgraduate year 1 general surgery residents (PGY1s) voluntarily participated in this study., Results: Twenty-six general surgery PGY1s completed all measures. We found that PGY1s had significantly better behavioral inhibition, working memory, selective attention, problem solving, and psychomotor speed than their counterparts in the general population (Table 1). Conversely, we found that PGY1s had significantly lower cognitive flexibility (p = 0.02) and ability to monitor task progress (p = 0.006) than the general population., Conclusions: The results from this study indicate that there are several neuropsychological factors that may help explain the high achievement of general surgery PGY1s. Assessment of these factors could aid general surgery programs in the selection and training of high-caliber residents. However, there are indicators that PGY1s struggle from cognitive inflexibility and task monitoring compared to the general population. These skills are needed to manage the complex and dynamic nature of surgical performance, so educators should consider methods to enhance junior residents' development of these characteristics., (Copyright © 2023 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Schoolchildren with better executive functioning skills achieve better mathematics results. It is less clear how inhibition, cognitive flexibility, and working memory combine to predict mathematics achievement and difficulty throughout primary and secondary school. This study aimed to find the best combination of executive function measures for predicting mathematical achievement in Grades 2, 6, and 10 and to test whether this combination predicts the probability of having mathematical difficulties across school grades even when fluid intelligence and processing speed were included in the models. A total of 426 students-141 2nd graders (72 girls), 143 6th graders (72 girls), and 142 10th graders (79 girls)-were cross-sectionally assessed with 12 executive tasks, one standardized mathematical task, and a standardized test of intelligence. Bayesian regression analyses found various combinations of executive predictors of mathematical achievement for each school grade spanning Grade 2 to measures of cognitive inhibition (negative priming) and cognitive flexibility (verbal fluency); Grade 6 to measures of inhibition: resistance to distractor interference (receptive attention), cognitive flexibility (local-global), and working memory (counting span); and Grade 10 to measures of inhibition: resistance to distractor interference (receptive attention) and prepotent response inhibition (stop signal) and working memory (reading span). Logistic regression showed that the executive models derived from the Bayesian analyses had a similar ability to classify students with mathematical difficulty and their peers with typical achievement to broader cognitive models that included fluid intelligence and processing speed. Measures of processing speed, cognitive flexibility (local-global), and prepotent response inhibition (stop signal) were the main risk factors in Grades 2, 6, and 10, respectively. Cognitive flexibility (verbal fluency) in Grade 2 and fluid intelligence, which was more stable in all three grades, acted as protective factors against mathematical difficulty. These findings inform practical considerations for establishing preventive and intervention proposals., (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.)

The Color Trails Test (CTT) is a neuropsychological measure assessing for frontal and executive functioning, while also minimizing the cultural and language barriers inherent in similar measures such as the Trail Making Test (TMT). This study establishes convergent validity for the CTT in the Indian population by comparing participant performance on the CTT and TMT. It also generates culturally appropriate normative data for CTT-Form A among the Indian adult population. Six-hundred and sixty-nine cognitively healthy, community-dwelling individuals between ages 18 and 69 participated in the study and were stratified based on age, gender, and educational attainment. Participant performance on the CTT and TMT were correlated to establish convergent validity. Strong correlation was found between TMT-A and CTT-1 ( r  = 0.61) and between TMT-B and CTT-2 ( r  = 0.66). An analysis of variance test was used to determine the mean and standard deviation for each stratified participant group. Further analysis found that age and educational attainment significantly impact participant performance on CTT-1 [ F (4, 649) = 4.395, p  = 0.002], whereas gender, age, and educational attainment significantly impact participant performance on CTT-2 [ F (4,649) = 2.446, p  = 0.045]. Normative data generated from this study has important clinical implications and contributes to the growing body of culturally appropriate normative data available for the Indian population.

More older adults are using cannabis for recreational and/or medical purposes, but most studies examining cognitive function and cannabis use do not include older adults. The current small pilot study sought to compare cognitive function and emotional functioning among adults age 60 and older who were regular, primarily recreational cannabis users ( n = 28) and nonusers ( n = 10). A bimodal distribution was observed among cannabis users such that they had either initiated regular use more recently ("short-term" users; ≤7 years, n = 13) or earlier in life ("long-term" users; ≥19 years, n = 15). Nonusers, short-term, and long-term users were not different in depression, anxiety, or emotion regulation, or alcohol use. Nonusers scored significantly higher than long-term users in executive function. Short-term users scored significantly higher than long-term users in executive function, processing speed, and general cognition. Additionally, greater recent cannabis use frequency was negatively associated with working memory. The current findings suggest that short-term recreational cannabis use does not result in differences in cognitive performance compared to nonusers, which may indicate that short-term use is relatively benign in older adults. However, longer duration of use is associated with poorer processing speed and executive functioning, and more recent cannabis use is associated with poorer working memory, which may impact older adults' overall cognitive functioning.

Objective: The Delis-Kaplan Executive Function System (D-KEFS) Trail Making Test (TMT) is a commonly used measure of processing speed and executive functioning that may also be useful as an embedded performance validity test (PVT). We evaluated the utility of several multi-condition indices on the D-KEFS TMT in three independent samples to determine an optimal multi-condition index and cutoff on the D-KEFS TMT., Method: Classification accuracy statistics for multiple multi-condition indices on the D-KEFS TMT were evaluated in three independent samples, including a sample with history of mild traumatic brain injury (TBI; n = 267) classified into psychometrically defined performance-valid and performance-invalid subgroups, the D-KEFS national normative sample (n = 1713), and a sample of middle- and older-aged adults diagnosed with mild cognitive impairment (MCI; n = 70)., Results: The D-KEFS TMT Conditions 1-5 summation index maximized sensitivity at .31 while maintaining adequate specificity at ≥.9. This index also had acceptable classification accuracy in both the D-KEFS national normative and MCI cross-validation samples, with the exception of the oldest subgroup of the national norming sample (i.e., individuals' ages 80-89), in which the observed failure rates for all multi-condition indices tested were greater than 10%., Conclusion: Our study provides support for the use the D-KEFS TMT Conditions 1-5 summation index as an embedded PVT among individuals younger than 80 years-old and from a range of conditions spanning from cognitively normal to mildly impaired; however, further validation is necessary.

Introduction: Executive function is responsive to exercise and predictive of subsequent falls. Minimal clinically important differences (MCIDs) are critical for understanding whether observed changes are meaningful. However, MCIDs of many cognitive measures are not established. We aimed to determine MCIDs of the Digit Symbol Substitution Test ([DSST] processing speed measure), Stroop (inhibition measure), and Trail Making Test B-A (TMT; set-shifting measure), using anchor- and distribution-based approaches in older adults who have fallen and received the Otago Exercise Program (OEP) relative to usual care only (CON). Our secondary aim was to establish construct (convergent and divergent) validity of these measures., Methods: Complete case analyses of cognitive outcomes (DSST, Stroop, TMT, and Montreal Cognitive Assessment [MoCA]) were acquired at baseline and 1 year (NCT01029171; NCT003235960); participants were randomized to the OEP (n = 114/172; Age: 80.6 ± 6.1 years; 64.9% Female) or CON (n = 128/172; Age: 82.3 ± 5.8 years; 71.9% Female)]. The MoCA was used as the anchor. We estimated MCIDs using anchor- and distribution-based approaches. Anchor-based executive function change differences ([CD] 1 year minus baseline) observed in participants with meaningful changes in the MoCA (≥3 or ≤ -3 points) receiving the OEP were subtracted from the CON. An anchor-based receiver operator characteristic (ROC) curve was employed to identify optimal cut-off scores of the 3 executive function measures. The distribution-based approach (DA) accounted for variability in baseline and follow-up data. MCID ranges were estimated using these approaches. We used Spearman's correlations to explore convergent validity between executive function measures and other measures involving the same construct (DSST, Stroop, TMT, MoCA, and Mini-Mental State Examination), and divergent validity between executive function measures and variables reflecting different constructs (Geriatric Depression Scale, Instrumental Activities of Daily Living, sex, and body mass index)., Results: Based on the 3 approaches, MCID improvement ranges were 3-5 symbols for the DSST (CD = 5; ROC = 2.5; DA = 3.3 symbols), and -11.5 to -26.0 s for the Stroop (CD = -26.0; ROC = -11.5; DA = -20.6 s). MCID decline ranges were -3 to -6 symbols for the DSST (CD = -5.2; ROC = -2.5; DA = -3.3 symbols) and 5.4-30.6 s for the Stroop (CD = 30.6; ROC = 5.4; DA = 20.6 s). MCIDs for the TMT were not meaningful due to high variability (Improvement: CD = -106.6; ROC = -18.4; DA = -69.1 s; Decline: CD = 69.1; ROC = 14.5; DA = 69.1 s). The executive function measures exhibited good convergent (r = -0.22 to r = 0.42) and divergent (r < -0.01 to r = 0.16) validity., Conclusions: These established MCIDs will allow clinicians to interpret meaningful changes in executive function following exercise amongst older adults who have fallen. The DSST, Stroop, and TMT demonstrated good construct validity, supporting their use in comprehensive fall-risk assessments in older adults who fall., (© 2021 S. Karger AG, Basel.)

This study aimed to: (1) propose a novel version of the Stroop switching test, namely the Stroop Switching Card Test (SSCT), to assess the overall efficiency of executive functions (EF) and its underlying cognitive processes (conflict resolution and conflict adaptation); (2) examine the utility of the SSCT in the assessment of EF in different age groups (age range 15-75 years), compare its results with standard neuropsychological tests (SNT), and (3) examine the contribution of both the processing speed and cognitive reserve on the performance of all used tests. The SSCT showed more sensitivity to detect subtle executive dysfunction in the middle age (~50 years). Going further, the SSCT revealed a progressive decline in conflict adaptation over two life periods. The first period of decline started at ~50 years and the second at~ 65 years. The processing speed and cognitive reserve had a prominent role in our results, notably in SSCT.

Sluggish cognitive tempo (SCT) is characterized by excessive daydreaming, slowed thinking, and mental confusion and 'fogginess'. A growing body of research supports the empirical differentiation of sluggish cognitive tempo (SCT) from the inattentive (IN) behaviors that characterize attention-deficit/hyperactivity disorder (ADHD). Further SCT and IN are uniquely associated with clinical correlates across academic, social, and emotional domains; however, there is limited understanding of how neuropsychological functioning contributes to SCT and/or IN behaviors. The two broad domains of neuropsychological functioning that have been most frequently examined in relation to SCT behaviors are processing speed and executive functions (EF). The present study tested whether EF and processing speed measured when children were on average age five years were predictive of teacher-rated IN and SCT behaviors in 1 st - 3 rd grades. Participants included 1,022 children from the Family Life Project, an ongoing prospective longitudinal study of child development in low-income, non-metropolitan communities. EF and processing speed uniquely made independent contributions to the prediction of IN and SCT. In secondary analyses that focused on specific facets of EF and processing speed, inhibitory control and working memory abilities predicted lower IN but not SCT behaviors, whereas slower processing speed significantly predicted both greater SCT and IN behaviors. These results are discussed as they inform developmental models of SCT and IN.

Objective: The Delis-Kaplan Executive Function System (D-KEFS) is a battery of tests designed to measure executive functions (EF). Additionally, the D-KEFS contains lower-order tasks, designed to control for speed of visual scanning, sequencing, and verbal and graphomotor output. The construct and criterion validities of D-KEFS scores that are time-based are well established. However, the constructs measured by the D-KEFS error scores are poorly understood, making clinical interpretations of such scores difficult. This study examined the construct validity of D-KEFS errors committed on EF tasks and tasks designed to measure lower-order processes (i.e., non-EF tasks), across the adult lifespan., Method: Participants were 427 adults (18-93 years) who completed the timed subtests of the D-KEFS. Four hundred two participants also completed the Push-Turn-Taptap (PTT; a separate measure of EF) to allow cross-validation., Results: General linear regressions showed that D-KEFS errors committed on the EF tests were associated with EF timed performance (assessed using the D-KEFS time-based scores and the PTT), but only among older adults. Importantly, errors committed on the D-KEFS tasks of lower-order processes were also associated with D-KEFS time-based EF performance, and this relationship held across the adult lifespan., Conclusions: These findings suggest that among older adults EF errors on the D-KEFS can be interpreted as indices of EF, but such interpretations are not automatically warranted for younger adults. Additionally, errors committed on non-EF tasks contained within the D-KEFS battery can be interpreted as reflecting EF weaknesses across the adult lifespan.

Background: The cognitive dysmetria theory of schizophrenia proposes that communication between the cerebellum and cerebral cortex is disrupted by structural and functional abnormalities, resulting in psychotic symptoms and cognitive deficits. Methods: Using publicly available data, resting-state functional connectivity (rsFC) was calculated from 20 hemispheric cerebellar lobules as seed regions of interest to the rest of the brain. Group differences in rsFC between individuals with schizophrenia (SZ) and healthy controls (HCs) were computed, and relationships between rsFC and symptom severity and cognitive functioning were explored. Results: HCs demonstrated stronger connectivity than SZ between several cerebellar lobules and cortical regions, most robustly between motor-related cerebellar lobules (V and VIIIa/b) and temporal and parietal cortices. In addition, seven of nine lobules in which reduced cerebellocortical connectivity was observed showed diagnosis × processing speed interactions; HC showed a positive relationship between connectivity and processing speed, whereas SZ did not show this relationship. Other cognitive domains and symptom severity did not show relationships with connectivity. Conclusions: These findings partially support the cognitive dysmetria theory, and suggest that disrupted cerebellocortical connectivity is associated with slowed processing speed in schizophrenia. Impact statement We show in this work that in chronic schizophrenia, there is weaker functional connectivity between previously unstudied inferior posterior cerebellar lobules and cortical association areas. These findings align and extend previous work showing abnormal connectivity of anterior cerebellar lobules. Further, we present a novel finding that these connectivity deficits are differentially associated with processing speed in the schizophrenia versus healthy control groups. Findings provide further evidence for cerebellocortical dysconnectivity and processing speed deficits as biomarkers of schizophrenia, which may have implications for downstream effects on higher order cognitive functions, in line with the cognitive dysmetria theory.

Selective attention is involved in multiple daily activities. Several authors state that it experiences a decline after 20 years, although there is no agreement regarding the cognitive processes that explain it. Two theories dominate the discussion: The theory of inhibitory inefficiency and the theory of processing speed. At the same time, it has been suggested that there could be complementary relations between both; however, it is not clear what the contribution of inhibition and processing speed is on the changes of selective attention. Therefore, the present study proposes to analyze this contribution, in adults between 20 and 80 years old. To assess selective attention and inhibitory control, two indices of a visual search task were obtained in which participants must identify a target stimulus among a set of distracting stimuli. To evaluate the processing speed, a response speed task was used. The main results indicate that, from the age of 60, a gradual decrease in selective attention begins and that this decline can be largely explained by a decrease in processing speed and inhibitory control. We discuss about the literature on the development of selective attention, the contribution of processing speed, and the inhibitory inefficiency hypothesis.

Children and adults with sickle cell disease (SCD) are at risk for neuropsychological deficits; however, the neurocognitive functioning of adults with SCD and related comorbidities has not been widely reported in the literature. We examined specific cognitive domains in symptomatic adults with SCD and compared them with their unaffected siblings. We also examined relationships between cognitive scores, patient-reported outcomes (PROs), and medical/laboratory values. Thirty patient-sibling pairs ( M patient age = 32.5 years, M sibling age = 32.1 years) completed evaluations as part of a medical clinical trial (NCT00061568). All patient and sibling neurocognitive test scores were within normal limits. Patients scored significantly lower ( M  = 91.0 ± 11.3) than their siblings ( M  = 100.6 ± 12.3; t  = -3.5, p  < .01) on the Wechsler Processing Speed Index. They also indicated more problems than siblings on an executive functioning questionnaire, although these differences were nonsignificant after accounting for depressive symptoms. Higher fetal hemoglobin and lower creatinine correlated with better scores on particular cognitive and PRO measures. In summary, our sample of adults with symptomatic SCD demonstrated worse processing speed and experience more executive challenges than their siblings, despite treatment with hydroxyurea. These relative weakness likely relate to disease processes but the specific physiological mechanism is unclear.

The Stroop Color and Word Test is a test of processing speed, response inhibition, and executive functioning (EF). This project examined whether extending the Stroop Color-Word trial beyond the standard time limit could more accurately assess performance on EF measures. Cognitively healthy older individuals ( n  = 198) enrolled in a study of cardiovascular health completed the Stroop as part of a neuropsychological battery. Two scores were computed for the Color-Word trial: the number of items completed within the first 45 seconds (traditional Color-Word score) and the speed of page completion beyond the first 45 seconds (Stroop-Extended score). Criterion measures included the Trail-Making Test Part B (TMT-B), Digit Span Backward, Symbol Digit Modalities Test, Short Category Test, and measures of verbal fluency. Results from hierarchical linear regression analyses indicated that the extended Stroop score accounted for small but statistically significant variance in TMT-B (additional 2.6%) and Digit Span Backwards (additional 2.6%) beyond the standard Color-Word score. These findings suggest that extending the Stroop Color-Word trial beyond the first 45 seconds provides a limited increase in predictive power within a healthy sample with restricted range of performance. The extended Stroop requires additional examination in heterogeneous samples, including clinical populations, to determine its predictive utility.

Introduction: Embedded performance validity tests (PVTs) allow for continuous and economical validity assessment during neuropsychological evaluations; however, similar to their freestanding counterparts, a limitation of well-validated embedded PVTs is that the majority are memory-based. This study cross-validated several previously identified non-memory-based PVTs derived from language, processing speed, and executive functioning tests within a single mixed clinical neuropsychiatric sample with and without cognitive impairment., Method: This cross-sectional study included data from 124 clinical patients who underwent outpatient neuropsychological evaluation. Validity groups were determined by four independent criterion PVTs (failing ≤1 or ≥2), resulting in 98 valid (68% cognitively impaired) and 26 invalid performances. In total, 23 previously identified embedded PVTs derived from Verbal Fluency (VF), Trail Making Test (TMT), Stroop (SCWT), and Wisconsin Card Sorting Test (WCST) were examined., Results: All VF, SCWT, and TMT PVTs, along with WCST Categories, significantly differed between validity groups ( η p 2  =.05-.22) with areas under the curve (AUCs) of.65-.81 and 19-54% sensitivity (≥89% specificity) at optimal cut-scores. When subdivided by impairment status, all PVTs except for WCST Failures to Maintain Set were significant (AUCs =.75-94) with 33-85% sensitivity (≥90% specificity) in the cognitively unimpaired group. Among the cognitively impaired group, most VF, TMT, and SCWT PVTs remained significant, albeit with decreased accuracy (AUCs =.65-.76) and sensitivities (19-54%) at optimal cut-scores, whereas all WCST PVTs were nonsignificant. Across groups, SCWT embedded PVTs evidenced the strongest psychometric properties., Conclusion: VF, TMT, and SCWT embedded PVTs generally demonstrated moderate accuracy for identifying invalid neuropsychological performance. However, performance on these non-memory-based PVTs from processing speed and executive functioning tests are not immune to the effects of cognitive impairment, such that alternate cut-scores (with reduced sensitivity if adequate specificity is maintained) are indicated in cases where the clinical history is consistent with cognitive impairment. In contrast, WCST indices generally had poor accuracy.

This study tested whether the bivariate association between simple reaction time (SRT) and executive function (EF) performance that has been observed in early childhood represented a between- and/or within-person association. Up to three repeated assessments (i.e., fall, winter, and spring assessments from September to May) were available for 282 preschool-aged children (M age  = 4.2 years; 54% female) who participated in the Kids Activity and Learning Study. A series of three-level hierarchical linear models (repeated measures nested in child; child nested in classroom) was used to disaggregate the observed variation in EF and SRT into between-classroom, between-person, and within-person components. EF composite scores were regressed on two indicators of SRT, which reflected between- and within-child sources of variation, along with demographic covariates (child age, gender, and parental education). Both between-person (b = -21.2, p < 0.001) and within-person (b = -13.2, p < 0.001) sources of SRT variation were uniquely related to EF performance. These results are discussed with respect to interest in using SRT as a proxy for foundational cognitive processes that contribute to EF task performance in early childhood, including the appropriateness of using SRT to refine EF task scores., (Copyright © 2019 Elsevier Inc. All rights reserved.)

This study examined working memory (WM) using complex span tasks (CSTs) to improve theoretical understanding of the relationship between WM and high-level cognition (HLC) in children. A total of 92 children aged 7 and 8 years were tested on three computer-paced CSTs and measures of nonverbal reasoning, reading, and mathematics. Processing times in the CSTs were restricted based on individually titrated processing speeds, and performance was compared with participant-led tasks with no time restrictions. Storage, processing accuracy, and both processing and recall times within the CSTs were used as performance indices to understand the effects of time restrictions at a granular level. Restricting processing times did not impair storage, challenging models that argue for a role of maintenance in WM. A task-switching account best explained the effect of time restrictions on performance indices and their interrelationships. Principal component analysis showed that a single factor with all performance indices from just one CST (counting span) was the best predictor of HLC. Storage in both the participant-led and computer-paced versions of this task explained unique and shared variance in HLC. However, the latter accounted for more variance in HLC when contributions from processing time were included in the model. Processing time in this condition also explained variance above and beyond storage. This suggests that faster processing is important to keep information active in WM; however, this is evident only when time restrictions are placed on the task and important when WM performance is applied in broader contexts that rely on this resource., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Cardiovascular disease in older people is often linked with cognitive impairment, particularly in domains of executive function and processing speed. Our aims examined whether carotid-femoral pulse wave velocity (PWV) related to subtle changes of executive function and processing speed. Fifty-six individuals with subjective mood and/or cognitive concerns underwent PWV and neuropsychological assessments of processing speed (Trail Making Test Part A) and executive functioning (Delis Kaplan Executive Function System Stroop Task; Trail Making Test Part B, TMT-B). Individuals with high PWV (≥12.0m/s) had poorer performance on TMT-B, compared to low PWV (<12.0m/s), and a moderate negative correlation (r = -0.38, p = .004) between PWV and TMT-B performance. Our results confirm that in older adults at-risk for cognitive decline, early markers of CVD are associated with subtle decrements in rapid set-shifting (executive function), supporting efforts towards early detection of CVD as a secondary prevention strategy for older individuals with cognitive decline.

Objective: To investigate the effects of methylphenidate on long-term executive and neuropsychological functioning in children with attention problems following TBI, as well as the relationship between methylphenidate associated changes in lab-based neuropsychological measures of attentional control, processing speed, and executive functioning and parent- or self-report measures of everyday executive functioning., Method: 26 children aged 6-17 years, who were hospitalized for moderate-to-severe blunt head trauma 6 or more months previously, were recruited from a large children's hospital medical center. Participants were randomized into a double-masked, placebo-controlled cross-over clinical trial. Participants completed a comprehensive neuropsychological battery and parent- and self-report ratings of everyday executive functioning at baseline, and at 4 weeks and 8 weeks following upward titration of medication to an optimal dose or while administered a placebo., Results: Methylphenidate was associated with significant improvements in processing speed, sustained attention, and both lab-based and everyday executive functioning. Significant treatment-by-period interactions were found on a task of sustained attention. Participants who were randomized to the methylphenidate condition for the first treatment period demonstrated random or erratic responding, with slower and more variable response times when given placebo during the second period., Conclusion: Results indicate that methylphenidate treatment is associated with positive outcomes in processing speed, sustained attention, and both lab-based and everyday measures of executive functioning compared to placebo group. Additionally, results suggest sustained attention worsens when discontinuing medication. (JINS, 2019, 25, 740-749).

Inattention is one of the most common neurobehavioral problems following very preterm birth. Attention problems can persist into adulthood and are associated with negative socio-emotional and educational outcomes. This study aimed to determine whether the cognitive processes associated with inattention differ between term-born and very preterm children. Sixty-five children born very preterm (<33+0 weeks' gestation) aged 8-11 years were recruited alongside 48 term-born controls (?37 20 +0 weeks' gestation). Both groups included children with a wide spectrum of parent-rated inattention (above average attention to severe inattention) measured as a continuous dimension using the Strengths and Weaknesses of ADHD and Normal-Behavior (SWAN) scale. The children completed tests to assess basic cognitive processes and executive function. A hierarchical multiple regression analysis was implemented to assess which neurocognitive processes explained variance in parent-rated inattention and whether these differed between preterm and term-born children. In both groups, poorer verbal and visuospatial short-term memory and poorer visuospatial working memory independently explained variance in parent-rated inattention. Slower motor processing speed explained variance in inattention among very preterm children only. The cognitive mechanisms associated with parent-rated inattention were predominantly overlapping between groups, but relationships between motor processing speed and inattention were unique to very preterm children. These associations may reflect risk factors for inattention in term and very preterm children. Future research should assess the efficacy of these cognitive processes as potential targets for intervention.

Background : Evidence supports that a single session of exercise has benefits for cognitive performance following exercise. Although the vast majority of research has been conducted with young adults, very few studies to date have tested these effects in adolescents (high school aged students). As executive function (EF) develops through late adolescence and into young adulthood, it is important to assess the extent to which acute exercise benefits EF in adolescents. The primary purpose of this study was to assess the effect of moderate-intensity acute exercise on subsequent EF performance in this population. Methods : Healthy high school students (N = 22; age: 15.90 [0.29] y) volunteered to participate in the study. Using a within-subjects design with order of conditions randomized and counterbalanced, participants performed the Stroop Test, the Symbol Digit Modalities Test, and the Tower of London Test following control and following exercise with sessions performed on different days. Results : Exercise resulted in significant benefits for Stroop Color, Stroop Color-Word tests, Symbol Digit Modalities Test, Tower of London total moves, and Tower of London total excess moves. Conclusions : These results provide an important extension to the literature by confirming that 20 minutes of moderate-intensity exercise benefits EF performance in high school students.

Objective: The present study aimed to investigate the factor structure of a set of neurocognitive tests theoretically assessing executive functions (EF), verbal abilities (VA), and processing speed (PS). This study extended previous research by analyzing if each test is better explained by the specific factor to which it theoretically belongs or by a more general neurocognitive factor; and also by analyzing the relations between the neurocognitive factors., Methods: Using confirmatory factor analysis (CFA) we examined the factor structure of nine neurocognitive tests (EF: Working Memory, Tower, Divided Attention, Stroop, and Verbal Fluency tests; VA: Word List and Confrontation Naming tests; PS: Coding and Telephone Search tests) in a nonclinical sample (N = 90; 18-33 years old, 76 women). We tested five factor models of neurocognitive functioning: a one-factor model; two models with two-correlated factors; and two models with three-correlated factors., Results: A three-correlated-factor model, with EF, VA, and PS factors, was the most suitable for our neuropsychological data. The Verbal Fluency test was better explained by the VA factor rather than by the EF factor. The EF factor was correlated with the PS factor, but not with the VA factor., Conclusions: Most of the neurocognitive measures used in the present study loaded in the expected factors (with the exception of the Verbal Fluency that was apparently more related to VA). EF and PS represent related but separable functions. Our results highlight the need for a careful interpretation of test scores since performance on one test usually requires multiple functions., (© The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Computerized cognitive training (CCT) has previously improved cognition and mood in people with depression. Existing research has not determined if the benefits following CCT are specific to the content of CCT or are a function of participation in an engaging activity. In this double-blind randomized controlled trial, we tested whether executive functioning and processing speed (EF/PS)-focused CCT could outperform verbal ability-focused CCT., Methods: 46 young adults with at least mild depressive symptoms (HDRS ≥ 10) were recruited from the community and randomized to either EF/PS CCT or verbal ability CCT. Participants trained on their mobile device 5 days per week for 8 weeks. Depressive severity, everyday functioning, and cognition were evaluating pre and post-training., Results: The EF/PS group had greater gains in executive functioning and processing speed than the verbal group. There were no differences between groups in mood or everyday functioning improvement, though the EF/PS obtained equivalent improvement with half the training time. Both groups saw significant improvements in self and clinician-rated depressive severity, everyday functioning, and cognition., Limitations: There was no waitlist control condition and the sample consisted of individuals with mild depressive symptoms and not diagnosed major depressive disorder., Conclusions: CCT is associated with improved mood, cognition, and everyday functioning, though the type of CCT content does not differentially impact depressive symptom change. EF/PS focused CCT has greater impact on processing speed and executive functioning and leads to equivalent mood/everyday functioning gains as verbal-focused CCT more efficiently. Common factors remain plausible drivers of CCT's therapeutic effects., (Published by Elsevier B.V.)

Background: There is a poor understanding of the dose-response relationship between years of physical activity and motor and cognitive function. We determined the dose-response effects of physical activity duration in years on motor and cognitive function and their relationship in healthy old females., Objectives: To determine the dose-effects of physical activity duration in years on motor and cognitive function and their relationship in health aging adults., Methods: We conducted a retrospective observational study with 201 old (age 69 years; SD=5.9) and 12 young (mean age 21 years; SD=1.9) females, with sub-groups based on number of years of self-reported physical activity. Aerobic capacity, mobility, functional reach, standing balance, global cognition, episodic memory, executive function, and processing speed were assessed with performance-based tests. We analyzed sub-group differences quantitatively and qualitatively and performed regression and mediation analyses to determine predictors and mediators of physical activity effects., Results: Based on physical activity of minimal (0.3 y, n=29), short (2.4 y, n=77), moderate (6.2 y, n=36) and long (16.6 y, n=59) duration, physical activity for at least 2.4 years affords old adults benefits in body mass index with peak dose-effects present in aerobic capacity and mobility at 6.2 years without additional benefits after 16.6 years of physical activity. Physical activity for any duration had no effects on functional reach, balance, executive function, episodic memory, and processing speed. Although weakly mobility predicted global cognition and executive function., Conclusion: Performing physical activity up to 6.2 years on average had favorable effects on body mass index, aerobic capacity and mobility. The data strengthen current recommendations for an active lifestyle in adulthood to prevent aging-related motor and cognitive decline., (Copyright © 2018 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.)

Neuropsychological (NP) performance has been associated with psychosocial treatment outcomes in nonpain conditions, but has never been investigated in chronic pain. We performed a secondary analysis on the association of baseline NP performance with treatment outcomes among veterans with chronic pain (N = 117) undergoing an 8-week acceptance and commitment therapy (ACT) intervention. Participants completed measures of pain interference, pain severity, quality of life, activity levels, depression, and pain-related anxiety at baseline, midtreatment, and post-treatment. Executive functioning, working memory, processing speed, learning, and verbal memory were assessed at baseline. All study measures significantly improved from baseline to post-treatment. NP performance was related to changes in depression and pain-related anxiety during treatment. Specifically, relatively lower executive functioning and processing speed was associated with greater decreases in depressive symptoms, and relatively lower processing speed was associated with greater decreases in pain-related anxiety. Consistent with research in nonpain conditions, those with relatively lower NP functioning received greater benefit from psychosocial treatment, although most study outcomes did not differ as a function of NP performance. Our results suggest relatively lower NP functioning is not contraindicated for participation in psychosocial interventions like ACT but instead may be associated with greater relief., Perspective: This study suggests that NP functioning is unrelated to changes in pain interference associated with ACT, and that those with relatively lower NP functioning may experience greater reductions in depressive symptoms and pain-related anxiety. This article contains important information for researchers and clinicians interested in cognition and chronic pain., (Published by Elsevier Inc.)

Objectives: The small body of neuropsychological research in paediatric obsessive-compulsive disorder (OCD) yields inconsistent results. A recent meta-analysis found small effect sizes, concluding that paediatric OCD may not be associated with cognitive impairments, stressing the need for more research. We investigated neuropsychological performance in a large sample of youths with OCD, while assessing potential moderators., Methods: Participants with OCD (n = 102) and matched controls (n = 161) were thoroughly screened and blindly evaluated for comorbidities, and completed a neuropsychological battery assessing processing speed, visuospatial abilities (VSA), working memory (WM), non-verbal memory (NVM), and executive functions (EF)., Results: Compared to controls, youths with OCD exhibited underperformance on tasks assessing processing speed. On tests of VSA and WM, underperformance was found only on timed tasks. There were no differences on NVM and EF tasks. Notably, the OCD group's standardised scores were in the normative range. Test performance was not associated with demographic or clinical variables., Conclusions: Youths with OCD exhibited intact performance on memory and EF tests, but slower processing speed, and underperformance only on timed VSA and WM tasks. While the OCD group performed in the normative range, these findings reveal relative weaknesses that may be overlooked. Such an oversight may be of particular importance in clinical and school settings.

The aim of this study is to investigate whether sluggish cognitive tempo (SCT) symptoms are associated with neurocognitive task performance and ratings of real-world executive functioning (EF) in preschoolers at risk for attention-deficit/hyperactivity disorder (ADHD). The associations between parent- and teacher-rated SCT symptoms and neuropsychological task performance and ratings of EF in 61 4-year-old preschool children (51 boys, 10 girls) with self-regulation difficulties were examined, with regression analyses controlling for the effects of ADHD inattention symptoms. In the study sample, higher teacher-rated SCT symptoms are significantly associated with poorer performance on tasks of visual-perceptual abilities, auditory and visual attention, sustained and selective attention, inhibitory control, pre-numerical/numerical concepts, and slower processing speed, but SCT symptoms are not significantly associated with working memory, attention shifting or cognitive flexibility when controlling for ADHD inattention. Higher parent-rated SCT symptoms are significantly associated with visual-perceptual abilities. ADHD inattention symptoms are more strongly associated than SCT with daily life EF ratings; neither parent- nor teacher-rated SCT symptoms are significantly associated with daily life ratings of inhibition, working memory, or planning/organization after controlling for ADHD inattention. This study suggests that SCT symptoms contribute to EF deficits at least on neurocognitive tasks assessing visual-perceptual/spatial abilities, attention to detail and processing speed, as observed in this sample of young children at risk for ADHD, and may be an important intervention target.

Part B of the Trail Making Test (TMT-B) is widely used as a quick and easy to administer measure of executive dysfunction. The current study investigated the relationships between TMT-B performance, brain volumes, cortical thickness and white matter water diffusion characteristics in a large sample of older participants, before and after controlling for processing speed. Four hundred and eleven healthy, community-dwelling older adults who were all born in 1936 were assessed on TMT-B, 5 tests of processing speed, and provided contemporaneous structural and diffusion MRI data. Significant relationships were found between slower TMT-B completion times and thinner cortex in the frontal, temporal and inferior parietal regions as well as the Sylvian fissure/insula. Slower TMT-B completion time was also significantly associated with poorer white matter microstructure of the left anterior thalamic radiation, and the right uncinate fasciculus. The majority of these associations were markedly attenuated when additionally controlling for processing speed. These data suggest that individual differences in processing speed contribute to the associations between TMT-B completion time and the grey and white matter structure of older adults., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Working memory is an extremely influential concept within experimental psychology, with, at the time of writing, over 90 papers with this term in their title published in this journal alone since 2000. One reason for this interest is that measures of working memory tend to be strong correlates of important indices of real-world function. In addition, at first sight working memory appears to be a relatively simple concept to understand. However, despite this apparent simplicity, explaining working memory performance is not straightforward. In this paper I address this challenge, with a particular focus on the development of working memory performance in children; both children developing typically and those experiencing atypical development. I specifically highlight the multiple constraints on working memory performance, and how these constraints inter-relate. I then consider the broader theoretical implications of each of these constraints for current accounts of working memory and its development.

Research suggests a reciprocal relationship between late-life anxiety and cognition, particularly attention and executive functions. Whereas evidence supports a conceptual distinction between cognitive and somatic dimensions of anxiety, their differential relationship with cognitive outcomes has not been examined, particularly on tests of attention/executive functions that rely on processing speed. Study goals were threefold: (a) to describe levels of overall, cognitive, and somatic anxiety in a sample of older adults without dementia, (b) to determine if overall anxiety is associated with performance on select measures of attention/executive functions that rely on processing speed, and (c) to determine if a differential relationship exists between cognitive and somatic anxiety and cognitive performance. Participants were 368 community-dwelling older adults. Results showed that elevated levels of somatic, but not cognitive anxiety were associated with poorer performance across measures. Findings suggest that the nature of anxiety symptoms may have important implications for cognitive performance in older adults.

Background and Purpose: This study examines attention, processing speed, and executive functioning in pediatric brain tumor survivors treated with proton beam radiation therapy (PBRT)., Material and Methods: We examined 39 survivors (age 6-19years) who were 3.61years post-PBRT on average. Craniospinal (CSI; n=21) and focal (n=18) subgroups were analyzed. Attention, processing speed, and executive functioning scores were compared to population norms, and clinical/demographic risk factors were examined., Results: As a group, survivors treated with focal PBRT exhibited attention, processing speed, and executive functioning that did not differ from population norms (all p>0.05). Performance in the CSI group across attention scales was normative (all p>0.05), but areas of relative weakness were identified on one executive functioning subtest and several processing speed subtests (all p<0.01)., Conclusions: Survivors treated with PBRT may exhibit relative resilience in cognitive domains traditionally associated with radiation late effects. Attention, processing speed, and executive functioning remained intact and within normal limits for survivors treated with focal PBRT. Among survivors treated with CSI, a score pattern emerged that was suggestive of difficulties in underlying component skills (i.e., processing speed) rather than true executive dysfunction. No evidence of profound cognitive impairment was found in either group., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Competent reading requires various skills beyond those for basic word reading (i.e., core language skills, rapid naming, phonological processing). Contributing "higher-level" or domain-general processes include information processing speed and executive functions (working memory, strategic problem solving, attentional switching). Research in this area has relied on largely Caucasian samples, with limited representation of children from racial or ethnic minority groups. This study examined contributions of executive skills to reading competence in 761 children of minority backgrounds. Hierarchical linear regressions examined unique contributions of executive functions (EF) to word reading, fluency, and comprehension. EF contributed uniquely to reading performance, over and above reading-related language skills; working memory contributed uniquely to all components of reading; while attentional switching, but not problem solving, contributed to isolated and contextual word reading and reading fluency. Problem solving uniquely predicted comprehension, suggesting that this skill may be especially important for reading comprehension in minority youth. Attentional switching may play a unique role in development of reading fluency in minority youth, perhaps as a result of the increased demand for switching between spoken versus written dialects. Findings have implications for educational and clinical practice with regard to reading instruction, remedial reading intervention, and assessment of individuals with reading difficulty.

Background: Childhood obesity and obesity-associated diabetes and metabolic syndrome (MetS) continue to rise. Obesity has been linked to structural and functional brain abnormalities, particularly in the frontal lobe., Methods: One hundred sixty-two adolescents (aged 19.53 ± 1.53 years) underwent medical, neurocognitive, and brain magnetic resonance imaging assessments. Participants were either healthy weight (BMI <25.0 kg/m 2 or BMI percentile <85%) or obese (BMI ≥30.0 kg/m 2 or BMI percentile ≥95%). We evaluated frontal lobe cognitive functions and the size of the corpus callosum (CC)., Results: Groups differed on four measures of processing speed contained in four different cognitive tests, but not on executive function. A confirmatory factor analysis verified that the significant processing speed variables loaded on the same factor. We also found differences between the weight groups on the area of the anterior portion of the CC, but not the overall CC. Only the Controlled Oral Word Association Test (COWAT) was significantly correlated with the area of the anterior portion of the CC. In the obese group, 32.4% met criteria for MetS. No differences were found between obese participants with or without MetS and none of the MetS factors contributed consistently to cognitive performance., Conclusions: Obese adolescents show slower cognitive processing speed while maintaining equivalent performance on executive functioning compared with their healthy weight peers. The group differences in the anterior portion of the CC, responsible for frontal lobe interhemispheric communication, may in part explain our processing speed findings. Future studies should include a longitudinal design and diffusion tensor imaging to examine the integrity of white matter.

Several studies suggest impaired executive functions (EFs) in children with externalizing behavior problems and average intelligence (e.g., IQ > 85). Even though children with mild to borderline intellectual disabilities (MBID) are at higher risk of developing externalizing behavior problems compared to children with average intelligence, it is not yet clear if impaired EFs are also associated with the occurrence of externalizing behavior problems in children with MBID. In the current study, we therefore assessed three EF components (inhibition, cognitive flexibility, and working memory) as well as processing speed in children with MBID and externalizing behavior problems (n = 71) versus children with MBID with no such problems (n = 70). This was accomplished using a well-established computerized test battery. Even after IQ was controlled for, the children with MBID and externalizing behavior problems showed more impaired working memory performance. Differences for inhibition performance and processing speed were also found but less consistent across the tasks used to measure these aspects of EF. Cognitive flexibility was not more impaired in children with both MBID and externalizing behavior problems relative to children with MBID only. Our findings highlight working memory as a potential target to enhance the treatment of children with MBID and externalizing behavior problems.

Objectives: Depression in late life has been associated with difficulties in cognitive processing, particularly in the domains of executive function, processing speed and memory, and increases the risk of developing dementia suggesting a neurodegenerative phenotype. Mitochondrial dysfunction is frequently an early event in neurodegenerative illnesses and may be operative in patients with late life depression. Phosphorus magnetic resonance spectroscopy (31P MRS) allows for the quantification of bioenergetic molecules produced by mitochondria., Methods: Ten patients with late life depression and eight normal elderly controls were studied with Stroop color and interference tests, which are widely used measures of processing speed and executive function, respectively, followed by (31P) MRS 3-dimensional chemical-shift imaging measuring levels of adenosine triphosphate, phosphocreatine, inorganic phosphate, and pH over the whole brain., Results: In all subjects, gray matter phosphocreatine was positively associated with Stroop interference. Levels of white matter adenosine triphosphate were associated with Stroop interference in subjects with late life depression but not normal elderly. There was also a complementary association between white matter inorganic phosphate and Stroop interference in late life depression patients., Conclusions: These findings suggest two independent sources of executive function dependence on bioenergetic state in the aging brain. The dependence of executive function performance in subjects with late life depression on ATP in white matter may be associated with mitochondrial impairment and is consistent with predictions of the vascular depression hypothesis. Further research with wider neuropsychological testing targeting bioenergetic markers could help clarify the scope of these effects. Copyright © 2016 John Wiley & Sons, Ltd., (Copyright © 2016 John Wiley & Sons, Ltd.)

Objectives: The present study investigated whether the performance on executive function tasks of patients with type 2 diabetes mellitus (T2DM) is as impaired as that of Alzheimer's disease (AD) patients and to compare their performance with that of a group of cognitively healthy older adults. We also investigated whether glycosylated hemoglobin levels (HbA1c, a measure of glucose regulation) are related to performance on executive control tasks., Methods: Three groups of participants (AD, T2DM, and healthy older adults) completed medical and psychological evaluations and performed a series of computerized tasks, including processing speed (simple and choice reaction time) tasks, verbal and visuospatial working memory (WM) updating (n-back) tasks, and the Wisconsin Card Sorting Test (WCST), to assess processing speed and executive functioning., Results: As expected, the results showed that AD patients performed significantly worse than the healthy older adult group in all tasks. Executive functions deteriorated in the two groups of patients but more in the AD group. The T2DM group differed from healthy older controls but not from AD patients in the percentage of perseverations and the percentage of perseverative errors (WCST)., Conclusions: These findings revealed working memory (updating and maintenance) and executive control declines in the T2DM compared to healthy older controls but smaller than that suffered by the AD patients. The impairment of executive processing of T2DM patients despite the glycosylated hemoglobin control suggests that these patients are at risk of developing AD., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Although deficits in Executive Functioning (EF) are reported frequently in young individuals with Autism Spectrum Disorders (ASD), they remain relatively unexplored later in life (>50 years). We studied objective performance on EF measures (Tower of London, Zoo map, phonetic/semantic fluency) as well as subjective complaints (self- and proxy reported BRIEF) in 36 ASD and 36 typically developed individuals (n = 72). High functioning older adults with ASD reported EF-impairments in metacognition, but did not deviate in EF task performance, except for a longer execution time of the Tower of London. The need for additional time to complete daily tasks may contribute to impairments in daily life and may be correlated to a higher level of experienced EF-difficulties in ASD.

Introduction: Although disorders of mood and cognition are frequently observed in multiple sclerosis, their relationship remains unclear. We aimed to investigate whether this mood-cognition relationship is mediated by inefficient processing speed, a deficit typically associated with mood symptomatology in the psychiatric literature and a common deficit observed in multiple sclerosis patients., Method: In this study, comprehensive cognitive data and self-reported mood data were retrospectively analyzed from 349 patients with relapsing remitting multiple sclerosis. We performed a bootstrapping analysis to examine whether processing speed provided an indirect means by which depressive symptoms influenced cognitive functioning, specifically memory and executive function., Results: We observed that processing speed mediated the relationship between depressive symptoms and measures of memory and executive function. Interestingly, exploratory analyses revealed that this mediational role of processing speed was specific to MS patients who were younger, had a lower disability level, and had fewer years since MS diagnosis., Conclusions: Together, these findings have implications for mood and cognitive intervention with multiple sclerosis patients.

This article provides a review of working memory and its application to educational settings. A discussion of the varying definitions of working memory is presented. Special attention is given to the various multidisciplinary professionals who work with students with working memory deficits, and their unique understanding of the construct. Definitions and theories of working memory are briefly summarized and provide the foundation for understanding practical applications of working memory to assessment and intervention. Although definitions and models of working memory abound, there is limited consensus regarding universally accepted definitions and models. Current research indicates that developing new models of working memory may be an appropriate paradigm shift at this time. The integration of individual practitioner's knowledge regarding academic achievement, working memory and processing speed could provide a foundation for the future development of new working memory models. Future directions for research should aim to explain how tasks and behaviors are supported by the substrates of the cortico-striatal and the cerebro-cerebellar systems. Translation of neurobiological information into educational contexts will be helpful to inform all practitioners' knowledge of working memory constructs. It will also allow for universally accepted definitions and models of working memory to arise and facilitate more effective collaboration between disciplines working in educational setting.

Adverse neurological side effects associated with childhood brain tumors and their treatments contribute to long-term neurocognitive morbidity. Measures designed to quantify tumor-related risk factors are lacking. The neurological predictor scale (NPS) is designed to assess treatment-related neurological risks. Preliminary validation established associations between the NPS and global cognitive functioning in this population, though its associations with specific neurobehavioral domains has yet to be addressed. Participants referred for outpatient neuropsychological assessment completed performance-based measures of intellectual, attentional, working memory, motor speed, and executive abilities. Caregivers completed ratings of adaptive functioning. Neuropsychological and adaptive data were available for 100 brain tumor survivors (51 % female), ages 6 to 22 years (M = 12.83, SD = 4.37). Total NPS scores were generated via retrospective medical record review. Total NPS scores were significantly associated with several neurocognitive composite scores including verbal reasoning and working memory, after controlling for years post-diagnosis (ps < .05). NPS scores also were significantly associated with performance-based measures of attention, executive functioning, and cognitive efficiency (ps < .05). No significant relationship was demonstrated between NPS scores and caregiver-reported adaptive behavior skills (ps > .05). Results indicate that the NPS is associated with performance-based neurocognitive functioning and executive skills but not with functioning in specific caregiver-reported adaptive behavior domains. The NPS offers some value as a resource for understanding associations between treatment-related neurological risks and select aspects of neurocognitive morbidity. Future studies should examine whether the NPS can aid in planning appropriate therapeutic intervention as survivors progress into early adulthood.

Objectives: Although age-related differences in planning ability are well known, their cognitive foundations remain a matter of contention. To elucidate the specific processes underlying planning decrements in older age, the relative contributions of fluid reasoning, working memory (WM) capacity, and processing speed to accuracy on the Tower of London (TOL) planning task were investigated., Method: Mediation analyses were used to relate overall and search depth-related TOL accuracy from older (N = 106; 60-89 years) and younger adults (N = 69; 18-54 years) to age and measures of fluid reasoning, WM capacity, and speed., Results: For overall planning, fluid abilities mediated the effects of age, WM capacity, and speed in older adults. By contrast, fluid abilities and WM capacity mediated each other in younger adults. For planning accuracy under low demands on the depth of search, WM capacity was specifically important in older age, whereas younger adults recruited both WM capacity and fluid reasoning. Under high search-depth-demands, fluid abilities underlay the cognitive operations critical for resolving move interdependencies in both age groups., Discussion: Fluid abilities and WM capacity undergo significant changes from younger to older age in their unique contribution to planning, which might represent a mechanism whereby planning decrements in older age are brought about., (© The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Huntington disease (HD) is a neurodegenerative condition with prominent motor (including oculomotor), cognitive, and psychiatric effects. While neuropsychological deficits are present in HD, motor impairments may impact performance on neuropsychological measures, especially those requiring a speeded response, as has been demonstrated in multiple sclerosis and schizophrenia. The current study is the first to explore associations between oculomotor functions and neuropsychological performance in HD. Participants with impaired oculomotor functioning performed worse than those with normal oculomotor functioning on cognitive tasks requiring oculomotor involvement, particularly on psychomotor speed tasks, controlling for covariates. Consideration of oculomotor dysfunction on neuropsychological performance is critical, particularly for populations with motor deficits.