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Objective: For decades, quantitative psychologists have recommended that authors report effect sizes to convey the magnitude and potential clinical relevance of statistical associations. However, fewer than one-third of neuropsychology articles published in the early 2000s reported effect sizes. This study re-examines the frequency and extent of effect size reporting in neuropsychology journal articles by manuscript section and over time. Methods: A sample of 326 empirical articles were drawn from 36 randomly selected issues of six neuropsychology journals at 5-year intervals between 1995 and 2020. Four raters used a novel, reliable coding system to quantify the extent to which effect sizes were included in the major sections of all 326 articles. Results: Findings showed medium-to-large increases in effect size reporting in the Methods and Results sections of neuropsychology journal articles that plateaued in recent years; however, there were only very small and nonsignificant changes in effect size reporting in the Abstract, Introduction, and Discussion sections. Conclusions: Authors in neuropsychology journals have markedly improved their effect size reporting in the core Methods and Results sections, but are still unlikely to consider these valuable metrics when motivating their study hypotheses and interpreting the conceptual and clinical implications of their findings. Recommendations are provided to encourage more widespread integration of effect sizes in neuropsychological research.

Objective: The internet serves an increasingly critical role in how older adults manage their personal health. Electronic patient portals, for example, provide a centralized platform for older adults to access lab results, manage prescriptions and appointments, and communicate with providers. This study examined whether neurocognition mediates the effect of older age on electronic patient portal navigation. Method: Forty-nine younger (18–35 years) and 35 older adults (50–75 years) completed the Test of Online Health Records Navigation (TOHRN), which is an experimenter-controlled website on which participants were asked to log-in, review laboratory results, read provider messages, and schedule an appointment. Participants also completed a neuropsychological battery, self-report questionnaires, and measures of health literacy and functional capacity. Results: Mediation analyses revealed a significant indirect effect of older age on lower TOHRN accuracy, which was fully mediated by the total cognitive composite. Conclusions: Findings indicate that neurocognition may help explain some of the variance in age-related difficulties navigating electronic patient health portals. Future studies might examine the possible benefits of both structural (e.g., human factors web design enhancement) and individual (e.g., training and compensation) cognitive supports to improve the navigability of electronic patient health portals for older adults.

Objectives: People living with HIV (PLWH) often experience deficits in the strategic/executive aspects of prospective memory (PM) that can interfere with instrumental activities of daily living. This study used a conceptual replication design to determine whether cognitive intraindividual variability, as measured by dispersion (IIV-dispersion), contributes to PM performance and symptoms among PLWH. Methods: Study 1 included 367 PLWH who completed a comprehensive clinical neuropsychological test battery, the Memory for Intentions Test (MIsT), and the Prospective and Retrospective Memory Questionnaire (PRMQ). Study 2 included 79 older PLWH who completed the Cogstate cognitive battery, the Cambridge Prospective Memory Test (CAMPROMPT), an experimental measure of time-based PM, and the PRMQ. In both studies, a mean-adjusted coefficient of variation was derived to measure IIV-dispersion using normative T-scores from the cognitive battery. Results: Higher IIV-dispersion was significantly associated with lower time-based PM performance at small-to-medium effect sizes in both studies (mean r s = −0.30). The relationship between IIV-dispersion and event-based PM performance was comparably small in magnitude in both studies (r s = −0.19, −0.20), but it was only statistically significant in Study 1. IIV-dispersion showed very small, nonsignificant relationships with self-reported PM symptoms in both samples (r s < 0.10). Conclusions: Extending prior work in healthy adults, these findings suggest that variability in performance across a cognitive battery contributes to laboratory-based PM accuracy, but not perceived PM symptoms, among PLWH. Future studies might examine whether daily fluctuations in cognition or other aspects of IIV (e.g., inconsistency) play a role in PM failures in everyday life.

Subjective cognitive decline (SCD) is a risk factor for dementia that may occur at higher rates in people with HIV (PWH). Prospective memory (PM) is an aspect of cognition that may help us better understand how SCD impacts daily life. Paricipants were 62 PWH aged ≥ 50 years and 33 seronegative individuals. SCD was operationalized as normatively elevated cognitive symptoms on standardized questionnaires, but with normatively unimpaired performance-based cognition and no current affective disorders. PM was measured with the Comprehensive Assessment of Prospective Memory (CAPM), the Cambridge Test of Prospective Memory (CAMPROMPT), and an experimental computerized time-based PM task. A logistic regression revealed that older PWH had a three-fold increased likelihood for SCD. Among the PWH, SCD was associated with more frequent PM symptoms and poorer accuracy on the time-based scale of the CAMPROMPT. These findings suggest that SCD disrupts PM in older PWH.

The Memory for Intentions Test (MIsT) is a clinical measure of prospective memory that has strong evidence for convergent, discriminative, and ecological validity. This study uses a conceptual replication design to evaluate the latent structure of the MIsT in two parallel samples who commonly experience prospective memory deficits: older adults and people living with HIV disease.Study participants included 303 people with HIV disease (ages 18-67) and 267 community-dwelling older adults (ages 50-91). Confirmatory factor analyses of the MIsT were conducted separately in each sample. We evaluated a one-factor model, as well as three two-factor models with the MIsT items loading onto each factor based on cue type, delay interval, or response modality.The one-factor model provided the best (and most parsimonious) fit to the data in both study samples. All two-factor models also demonstrated good fit statistics, although correlations between the two factors in each model were high and none of the two-factor models provided a significantly better fit than the one-factor model.Results of this conceptual replication study provide support for a robust factor structure of the MIsT across older adults and people with HIV disease. A total score for the MIsT provides the most parsimonious solution, although available evidence and theory also support the potential use of subscales (e.g., cue type). Future studies of the MIsT would be useful to determine its psychometrics in different clinical populations and across demographic factors (e.g., race/ethnicity).

Objective The COVID-19 pandemic necessitated use of remote assessments by clinical neuropsychologists. Telehealth was particularly important for vulnerable groups, including persons living with HIV (PLWH); however, limited internet access can be a serious barrier to care. This study examined the preliminary validity of a telephone-based neuropsychological assessment in a clinical sample of PLWH. Method A consecutive series of 59 PLWH were assessed via telephone at an HIV clinic in the southern U.S. between April 2020 and July 2022. The battery included auditory-verbal neuropsychological tests of memory, attention, and executive functions, and questionnaires assessing self-reported mood and activities of daily living (ADL). Results Study measures demonstrated acceptable internal consistency. PLWH demonstrated worse neuropsychological performance compared with expectations derived from the normal curve and an HIV-seronegative adult sample (N = 44). PLWH assessed via telephone demonstrated similar impairment rates to that of a consecutive series of PLWH (N = 41) assessed in-person immediately prior to the pandemic. Higher telephone-based global neuropsychological scores were related to younger age, more education, better fund of knowledge, White race/ethnicity, fewer medical conditions, and fewer depression symptoms. Global neuropsychological impairment was strongly and independently associated with greater dependence in ADL domains, particularly for instrumental activities. Conclusions Although telephone-based approaches to neuropsychological assessment are not ideal, these data provide support for the feasibility, internal consistency, and preliminary validity of this method in a consecutive clinical series of PLWH. The direct comparability of telephone-based and in-person neuropsychological assessments remains to be determined by prospective, counterbalanced study designs examining both PLWH and seronegative individuals.

Introduction: Approximately half of the people living with HIV (PLWH) experience HIV-associated neurocognitive disorders (HANDs). However, the neuropathogenesis of HAND is complex, and identifying reliable biomarkers has been challenging. Methods: This study included 132 participants aged 50 and older from greater San Diego County. The participants were divided into three groups: PLWH with HAND (n = 29), PLWH without HAND (n = 73), and seronegatives without cognitive impairment (n = 30). Peripheral blood was collected at the clinical assessment, and plasma levels of neurofilament light chain (NfL), phosphorylated Tau 181 (pTau181), and glial fibrillary acidic protein (GFAP) were measured by enzyme-linked immunosorbent assay (ELISA). Results: Plasma levels of NfL (but not pTau181 and GFAP) were significantly associated with HAND at a medium effect size (p = 0.039, Cohen’s d = 0.45 for HAND + vs. HAND−). Notably, higher levels of NfL were significantly associated with HAND diagnosis even after adjusting for sex. Discussion: Our data suggest that neuronal degeneration (as evidenced by increased levels of NfL), but not tau pathology or glial degeneration, is related to cognitive status in PLWH. Our results corroborate the view that blood NfL is a promising biomarker of cognitive impairment in PLWH.

Objective: There are many obstacles to screening for HIV-associated neurocognitive disorders (HAND), including the complexities of sociodemographic effects on screening measures. This study examined possible racial bias on the HIV Dementia Scale (HDS) in screening for HAND among Black and White persons living with HIV (PLWH). Participants and Methods: Participants included 39 Black and 84 White PLWH who completed the HDS and a comprehensive neuropsychological battery at the same study visit. Results: Black PLWH had significantly lower raw HDS scores than white PLWH, which was mediated by lower oral word reading scores. Nevertheless, HDS scores were comparably predictive of clinical HAND diagnoses for Black and White PLWH as determined by a comprehensive battery. Conclusions: Consistent with prior literature exploring race-group differences, findings suggest that lower scores among Black PLWH compared to white PLWH on a commonly-used screening measure for HAND are partly explained by reading scores, perhaps reflecting differences in educational quality and opportunities. However, race-group differences did not affect the classification accuracy of the HDS in detecting HAND, although overall diagnostic accuracy was modest in both groups. Future work is needed to determine the optimal neurocognitive screening methods for Black PLWH and other under-represented ethnoracial groups.

OBJECTIVE: The Internet serves an increasingly critical role in health behaviors for older adults with chronic medical conditions. Guided by theories of health behaviors and literacy, this study examined whether the relationship between educational attainment and online pharmacy skills in older persons with HIV disease (PWH) is mediated by health literacy. DESIGN: Participants included 98 PWH age 50 and older who completed the Test of Online Pharmacy Skills (TOPS), which required them to navigate an experimenter-controlled online pharmacy to perform several naturalistic tasks (e.g., refill an existing prescription). Participants also completed the Medication-Management Test-Revised (MMT-R). RESULTS: Mediation analyses revealed a significant indirect effect of education on both online pharmacy accuracy and MMT-R, which was fully mediated by health literacy. In contrast, there was no direct or indirect effect of education on online pharmacy speed when health literacy was included as a mediator. CONCLUSION: Health literacy plays an important role in the relationship between years of education attained and the ability of older PWH to successfully navigate online pharmacy tasks and manage their medications. Future studies might examine whether interventions to improve electronic health literacy among older PWH who have lower educational attainment have beneficial effects on online health behaviors.

Introduction Searching the internet for health-related information is a complex and dynamic goal-oriented process that ostensibly places demands on executive functions, which are higher-order cognitive abilities that can deteriorate with older age. This study examined the effects of older age on electronic health (eHealth) search behavior and the potential mediating influence of executive functions. Method Fifty younger adults (≤ 35 years) and 41 older adults (≥50 years) completed naturalistic eHealth search tasks involving fact-finding (Fact Search) and symptom determination (Symptom Search), a neurocognitive battery, and a series of self-report questionnaires. Results Multiple regression models controlling for potentially confounding psychiatric symptoms, health conditions, literacy, and demographic variables revealed that older adults were slower and less accurate than younger adults on the eHealth Fact Search task, but not on the eHealth Symptom Search task. Executive functions mediated the relationship between age and Fact and Symptom Search accuracy, independent of basic processing speed and attention. Parallel mediation models showed that episodic memory was not an independent mediator of age and search accuracy for either eHealth task once speed/attention and executive functions were included. Conclusions Older adults can experience difficulty searching the internet for some health-related information, which is at least partly attributable to executive dysfunction. Future studies are needed to determine the benefits of training in the organizational and strategic aspects of internet search for older adults and whether these findings are applicable to clinical populations with executive dysfunction.

OBJECTIVE Health disparities are evident for Black Americans with HIV disease, who are disproportionally affected by the epidemic in the United States. The current study investigated whether the higher rates of neurocognitive impairment in Black Americans with HIV disease may be at least partly attributable to health literacy, which is a potentially modifiable factor. Method: Participants were 61 White and 25 Black participants (ages 27-70) with HIV disease who were enrolled in studies at an urban academic center in Southern California. Neurocognitive function was assessed by an age-adjusted global score from the Cogstate battery. Health literacy was measured by a composite score derived from the Rapid Estimate of Adult Literacy in Medicine, Newest Vital Sign, and 3-Brief. Results: Bootstrap confidence interval mediation analyses showed that health literacy was a significant mediator of the relationship between race and neurocognition; that is, there were no direct ethnoracial differences in neurocognition after accounting for health literacy. A follow-up model to confirm the directionality of this association demonstrated that neurocognition was not a significant mediator of the relationship between race and health literacy. Conclusions: Low health literacy may contribute to the higher rates of neurocognitive impairment for Black Americans with HIV disease. Future studies might examine the possible mechanism of this mediating relationship (e.g., access to health information, health behaviors, socioeconomics) and determine whether culturally tailored interventions that improve health literacy also confer broader brain health benefits for Black Americans with HIV disease.

BACKGROUND Depression and neurocognitive impairment are highly prevalent among persons living with HIV and associated with poorer clinical outcomes; however, longitudinal studies of depression-neurocognition relationships in youth living with HIV (YLWH), and the role of antiretroviral therapy (ART), are lacking. This study tested whether (1) depressive symptomatology, across somatic, cognitive, and affective symptom domains, improved with ART and (2) more severe depressive symptoms at baseline were associated with poorer neurocognitive function and poorer HIV suppression. SETTING Data were collected from 181 YLWH (18-24 years) who were treatment-naive, a subset of whom (n = 116) initiated ART. METHODS Participants were categorized into elevated (DS) or nonelevated (non-DS) depressive symptom groups at entry (Beck Depression Inventory-II ≥14) and followed for 36 months. Neurocognition (5-domain battery) and depressive symptoms were repeatedly assessed. Longitudinal models examined depressive symptomatology, neurocognition, and odds of HIV nonsuppression by group. RESULTS Greater improvements in depressive symptoms were observed in the DS group over 36 months [beta = -0.14, (-0.24 to -0.03)], particularly within cognitive and affective domains. Verbal learning performance increased in the DS group [beta = 0.13, (0.01 to 0.24)], whereas psychomotor function improved somewhat in the non-DS group [beta = -0.10, (-0.22 to 0.00)]. Adjusted for ART adherence, odds of HIV nonsuppression did not significantly differ by group [odds ratio = 0.22, (0.04 to 1.23)]; however, greater somatic symptoms at study entry were associated with an increased risk of nonsuppression over time [odds ratio = 2.33 (1.07 to 5.68)]. CONCLUSION Depressive symptoms were associated with differential neurocognitive trajectories, and somatic depressive symptoms at baseline may predict poorer subsequent HIV suppression. Identifying and treating depressive symptoms at ART initiation may benefit neurocognitive and clinical outcomes in YLWH.

Objective:Memory symptoms and objective impairment are common in HIV disease and are associated with disability. A paradoxical issue is that objective episodic memory failures can interfere with accurate recall of memory symptoms. The present study assessed whether responses on a self-report scale of memory symptoms demonstrate measurement invariance in persons with and without objective HIV-associated memory impairment.Method:In total, 505 persons with HIV completed the Prospective and Retrospective Memory Questionnaire (PRMQ). Objective memory impairment (n = 141) was determined using a 1-SD cutoff on clinical tests of episodic memory. PRMQ measurement invariance was assessed by confirmatory factor analyses examining a one-factor model with increasing cross-group equality constraints imposed on factor loadings and item thresholds (i.e., configural, weak, and strong invariance).Results:Configural model fit indicated that identical items measured a one-factor model for both groups. Comparison to the weak model indicated that factor loadings were equivalent across groups. However, there was evidence of partial strong invariance, with two PRMQ item thresholds differing across memory impairment groups. Post hoc analyses using a 1.5-SD memory impairment cutoff (n = 77) revealed both partial weak and partial strong invariance, such that PRMQ item loadings differed across memory groups for three items.Conclusions:The PRMQ demonstrated a robust factor structure among persons with and without objective HIV-associated memory impairment. However, on select PRMQ items, individuals with memory impairment reported observed scores that were relatively higher than their latent score, while items were more strongly associated with the memory factor in a group with greater memory impairment.

OBJECTIVE. As many as 65% of people with multiple sclerosis (MS) have clinically significant memory impairment, but the nature of this deficit is controversial. Some investigations suggest that an inability to retrieve newly-learned information from memory is prominent, whereas others imply that compromised acquisition accounts for impairment. Prior research has not simultaneously evaluated acquisition and retrieval processes in MS, and fewer have attempted to account for initial acquisition when studying retrieval. The Item Specific Deficit Approach (ISDA: Wright, Woo, Schmitter-Edgecombe, Hinkin, Miller, & Gooding, 2009) offers a method of quantifying acquisition, retrieval, and retention processes, with the latter two mechanisms being adjusted for initial acquisition. To simultaneously quantify acquisition and retrieval abilities, the ISDA was applied to list learning performance in two independent samples of people with MS and corresponding healthy comparison groups. PARTICIPANTS AND METHODS. Study 1 included 85 people with MS and 47 healthy individuals. Study 2 involved a separate sample of 79 people with MS and 22 healthy people. They were administered neuropsychological batteries, and participants with MS were classified as globally impaired or unimpaired. The California Verbal Learning Test-II was administered to assess new-learning in both studies, and responses were scored using the ISDA. RESULTS. Both studies revealed that cognitively impaired people with MS manifest weaknesses involving acquisition and retrieval. Nearly identical effect sizes emerged across samples, with cognitive impairment achieving a medium effect upon acquisition and a large effect upon retrieval. CONCLUSIONS. These findings accord well with previous research showing diminished acquisition and retrieval among people with MS. The results may also reconcile contradictory findings in the extant literature by showing that memory impairment in MS is not exclusively attributable to either acquisition or retrieval. Rather, both processes may manifest across people with MS. The replication across samples with nearly identical effect sizes implies that these effects are reliable and possess external validity. These data hold implications for memory rehabilitation interventions involving people with MS, and suggest that acquisition and retrieval processes should be addressed in treatment.

The present study had two aims. First, we set out to evaluate the structure of processing speed in children by comparing five alternative models: two conceptual models (a unitary model, a complexity model) and three methodological models (a stimulus material model, an output response model, and a timing modality model). Second, we then used the resulting models to predict multiple types of reading, a highly important developmental outcome, using other well-known predictors as covariates. Participants were 844 children enrolled in third through fifth grade in urban public elementary schools who received 16 measures of processing speed that varied in the above dimensions. A two-factor complexity model that differentiated between simple and complex processing speed was the preferred model and fit the data well. Both types of PS predicted reading fluency, and complex (but not simple) PS predicted single word reading and comprehension. Results offer insight to the structure of processing speed, its relation to closely related concepts (such as executive function), and provide nuance to the understanding of the way processing speed influences reading.

Objective To examine the factor structure and sociodemographic correlates of a battery of clinical neuropsychological tests administered in-home and via telephone. Method Participants included 280 healthy adults who completed a 35–40 min battery consisting of seven auditory-verbal neuropsychological tests (i.e., 10 variables) that included digit span, list learning and memory, prospective memory, verbal fluency, and oral trail making. Results After removing oral trail making part A, a three-factor model comprised of executive functions, memory and attention demonstrated the best fit to the data. Nevertheless, the shared variance between the nine remaining neuropsychological variables was also adequately explained by a single-factor model and a two-factor model comprised of executive functions and memory. Factor scores were variably associated with education, race/ethnicity, and IQ, but not with sex or age. Conclusions Findings provide preliminary support for the feasibility and factor structure and sociodemographic correlates of a brief telephone-based screening neuropsychological battery comprised mostly of commonly administered clinical measures. Future studies are needed to determine the test–retest reliability, sensitivity, and ecological relevance of this battery, as well as equivalency to in-person assessment.

Women are becoming more prevalent in clinical neuropsychology, but gender bias and disparities persist across multiple professional domains. This study examined potential gender disparities in hist...

Symptoms of depression are common among persons with HIV (PWH) and can have a significant impact on socioeconomic and personal well-being, but little is known about their neurobiological substrates in the context of HIV disease. This study examined the possible role of brain-derived neurotrophic factor (BDNF) in symptoms of depression and other aspects of mood in 109 PWH and 43 seronegative participants aged 50 and older. Participants completed the Profile of Mood States (POMS) which measured six dimensions of mood and was normatively adjusted for sex. A model controlling for medical comorbidities and substance use diagnoses among PWH showed a significant interaction between BDNF and POMS subscales. Planned post hoc analyses revealed that lower BDNF was only associated with higher scores on Depression-Dejection and Confusion-Bewilderment POMS subscales among PWH and at small-to-medium effect sizes. Lower levels of BDNF were associated with AIDS diagnoses and CD4 count, but not with viremia or duration of infection. BDNF levels did not differ between the PWH and HIV − samples, and there were no significant correlations between BDNF and any POMS variable in the HIV − group. Findings implicate BDNF in the neuropathophysiology of specific depressive symptoms in the context of HIV disease. Future studies may examine whether BDNF levels change over time, are sensitive to other aspects of mood disorders in HIV, and are associated with markers of HIV-associated neural injury.

Creativity can help people to innovate, overcome obstacles, and successfully navigate challenges in daily life. Some aspects of creativity rely on the prefrontostriatal loops and executive functions, which can be compromised in persons with HIV (PWH). This pilot study examined whether neuropsychological functioning plays a role in creativity in PWH. A consecutive series of 41 PWH who were referred to an urban neuropsychology clinic in southeastern Texas were enrolled. Participants completed the Abbreviated Torrance Test for Adults (ATTA) to measure creativity, from which standardized creativity scores of fluency, originality, elaboration, and flexibility were derived. Participants also completed several measures of everyday functioning and a brief clinical neuropsychological battery measuring executive functions, motor skills, memory, and visuoconstruction. Global neuropsychological functioning showed a large, positive association with ATTA creativity performance that did not vary meaningfully by creativity domain and was independent of premorbid IQ. ATTA creativity scores were not associated with any measure of everyday functioning. Findings from this pilot study suggest that higher levels of neuropsychological functioning may support multiple dimensions of creativity in adults with HIV disease. Future studies might examine whether creativity moderates the association between HIV-associated neurocognitive impairment and various health behaviors (e.g., adherence, appointment attendance).

Objective Impairments in executive functions and learning are common in HIV disease and increase the risk of nonadherence to antiretroviral therapy. The mixed encoding/retrieval profile of HIV-associated deficits in learning and memory is largely driven by dysregulation of prefrontal systems and related executive dysfunction. This study tested the hypothesis that learning may be one pathway by which executive dysfunction disrupts medication management in people living with HIV (PLWH). Method A total of 195 PLWH completed a performance-based laboratory task of medication management capacity and clinical measures of executive functions, verbal learning and memory, and motor skills. Results Executive functions were significantly associated with verbal learning and medication management performance. In a model controlling for education, learning significantly mediated the relationship between executive functions and medication management, and this mediation was associated with a small effect size. In particular, executive dysfunction was associated with diminished use of higher-order learning strategies. Alternate models showed that executive functions did not mediate the relationship between learning and medication management nor did motor skills mediate the relationship between executive functions and medication management. Conclusions PLWH with executive dysfunction may demonstrate difficulty in learning new information, potentially due to ineffective strategy use, which may in turn put them at a higher risk for problems managing their medications in the laboratory. Future studies may wish to investigate whether compensatory neurocognitive training (e.g., using more effective learning strategies) may improve medication management among PLWH.

Objective Object location learning and memory may be important for older adults to successfully complete some everyday activities. Method This cross-sectional, correlational study investigated the ecological relevance of the Location Learning Test-Revised (LLT-R) in 195 community-dwelling, older adults in Western Australia. The LLT-R assesses object location learning and memory for everyday objects over five learning trials and after a 30-min delay. Knowledgeable informants provided structured ratings of participants’ activities of daily living and memory symptoms. Results A greater number of errors on LLT-R total learning trials were associated with mild problems in activities of daily living (particularly in travel and household domains), but not with memory symptoms. The LLT-R’s association with activities of daily living was accompanied by a small-to-medium effect size and was not better explained by demographics, global cognitive functioning, mood, or chronic medical conditions. Conclusions Findings provide some support for the ecological relevance of the LLT-R among older community-dwelling adults and suggest that object location learning may play a role in some everyday functioning problems that accompany typical aging.

Occurring across all southern hemisphere continents except Antarctica, old, climatically buffered, infertile landscapes (OCBILs) are centres of biological richness, often in biodiversity hotspots. Among a matrix of young, often disturbed, fertile landscapes (YODFELs), OCBILs are centres of endemism and diversity in the exceptionally rich flora of the south-west Australian global biodiversity hotspot, home to Noongar peoples for ≥ 48 000 years. We analysed contemporary traditional Noongar knowledge of adjacent OCBILs (e.g. granite outcrops) and YODFELs (e.g. creekline fringes) both at a single site and in two larger areas to test whether patterns of disturbance dictated by Noongar custom align with OCBIL theory. We found that Noongar traditional knowledge reflects a regime of concentrated YODFEL rather than OCBIL disturbance—a pattern which aligns with maximal biodiversity preservation. SIMPER testing found traditional Noongar OCBIL and YODFEL activities are 64–75% dissimilar, whereas Pearson’s chi-square tests revealed camping, burning, travelling through country and hunting as primarily YODFEL rather than OCBIL activities. We found that Noongar activities usually avoid OCBIL disturbance. This combined with high floristic diversity following enduring First Peoples’ presence, suggests that traditional Noongar knowledge is valuable and necessary for south-west Australian biodiversity conservation. Similar cultural investigations in other OCBIL-dominated global biodiversity hotspots may prove profitable.

We translated the Medication Management Ability Assessment (MMAA) from English to Spanish for use via tele-assessment and examined its reliability and validity. Following International Test Commission Guidelines for Translating and Adapting Tests, we used translation/back-translation and a small focus group (n = 6) to adapt a Spanish version of the MMAA. Eighty-six Spanish-speaking adults completed the adapted MMAA via tele-assessment at baseline and at a two-week follow-up visit. Participants also completed several self-report and performance-based cognitive and functional measures. The internal consistency of the MMAA was excellent (standardized Cronbach’s α = 0.90). Performance-based functional assessments (PBFAs) and objective cognition were positively associated with the MMAA at small to medium effect sizes. Self-report measures of daily function and cognition, measures of health literacy, and estimates of premorbid intellectual functioning were not significantly associated with MMAA performance. The test-retest reliability of the MMAA was good (CCC = 0.73, 95% CI [0.62, 0.81]; rs = 0.37, p < 0.001) and demonstrated a small practice effect (Cohen's d = 0.36, p = 0.001). Preliminary evidence for the construct validity of a Spanish-language MMAA administered via tele-assessment further expands the potential clinical utility of PBFAs in culturally diverse, Spanish-speaking populations.

OBJECTIVE: Older adults demonstrate poorer prospective memory (PM) performance compared to younger individuals, which may interfere with everyday activities such as remembering to take medications as prescribed. However, it is not known whether PM performance is stable over time or whether there are individual differences in trajectories. METHOD: Participants included 271 community-dwelling older adults (50 to 91 years of age) who underwent a baseline evaluation and up to three follow-up visits, approximately 2.4 years apart. Participants completed the time-based and event-based PM tasks of the Memory for Intentions Test (MIsT), the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), clinical measures of executive functions, and self-report measures of everyday functioning. Changes in PM performance were analyzed using mixed effects linear longitudinal models. RESULTS: Analyses revealed small, but significant linear declines in event-based PM performance over time, as well as significant between-subjects variability in event-based PM changes. Participants also reported increased difficulty with activities of daily living over time. There were no changes in performance on measures of time-based PM, retrospective memory, or executive functions, and no changes in self-reported quality of life. Changes in event-based PM were not associated with age, retrospective memory, executive functions, or everyday functioning. CONCLUSIONS: Among older adults, event-based PM appears to be more susceptible to linear declines than does time-based PM, which future research might examine with regard to the possible underlying cognitive mechanisms of cue encoding, monitoring, detection, and retrieval processes.

Objective Retrospective and prospective memory deficits are associated with lower quality of life (QoL); however, there are no validated measures that comprehensively and directly assess the impact of memory problems on QoL. The Survey of Memory-Related Quality of Life (SMRQoL) was developed as a 30-item questionnaire to measure memory-related QoL. Method Both HIV+ (n = 195) and HIV− (n = 146) participants completed the SMRQoL, a neurocognitive research battery, and validated self-report questionnaires of memory, QoL, and mood. Participants were recruited into younger (age ≤ 40 years) and older (age ≥ 50 years) groups per the parent study design. Results The SMRQoL had a unidimensional factor structure and demonstrated measurement invariance across the HIV+ and HIV− participants. Analyses of 111 clinically stable participants (e.g., persons with no incident or remitting central nervous system disorders) who returned for a 14-month follow-up visit indicated that the SMRQoL had adequate test–retest stability. There was a significant interaction of age and HIV status on the SMRQoL, such that older HIV+ participants reported the lowest memory-related QoL. SMRQoL scores were associated with validated measures of mental and physical QoL, self-reported memory and cognitive symptoms, and performance-based memory and executive functions. Conclusions The SMRQoL shows evidence of reliability and validity as a measure of memory-related QoL that can be used to assess the impact of memory problems on everyday life, but future work is needed to demonstrate the measure’s incremental value in the context of diagnosis and treatment.

Objective: The Memory for Intentions Test (MIsT) is a clinical measure of prospective memory that has strong evidence for convergent, discriminative, and ecological validity. This study evaluates the latent structure of the MIsT among two samples who may experience prospective memory deficits: older adults and people living with HIV disease. Participants and Methods: Study participants included 303 people with HIV disease (ages 18-67) and 267 community-dwelling older adults (ages 50-91). Confirmatory factor analyses of the MIsT were conducted separately in each sample. We evaluated a one-factor model, as well as three two-factor models with the MIsT items loading onto each factor based on cue type, delay interval, or response modality, respectively. Results: The one-factor model provided the best (and most parsimonious) fit to the data in both study samples. All two-factor models also demonstrated good fit statistics, although correlations between the two factors in each model were high and none of the two-factor models provided a significantly better fit than the one-factor model. Conclusions: Results provide support for the factor structure of the MIsT in older adults and people with HIV disease. A total score for the MIsT provides the most parsimonious solution, although available evidence and theory also support the use of subscales (e.g., cue type). Future studies of the MIsT would be useful to determine its psychometrics in different clinical populations.

Alcohol use is associated with memory problems in young adults with HIV, but the cognitive mechanisms of that association are not known. Sixty adults (aged 19-24 years) living with HIV were administered the Alcohol, Smoking, and Substance Involvement Screening Test to assess alcohol use, Behavior Rating Inventory of Executive Function for self-reported executive functions, and the Prospective and Retrospective Memory Questionnaire (PRMQ) for dailiy memory functioning. Controlling for mood, self-reported executive functions fully mediated the relationship between alcohol use and memory (indirect effect b=.568, 95%CI [.209,.888]). Findings suggest that self-reported executive dysregulation of memory processes (e.g., Strategic encoding and retrieval) may drive the effects of alcohol use on daily memory symptoms.

Objective Apathy is prevalent in HIV disease and can significantly impact personal well-being; however, little is known about its neurobiological substrates in persons with HIV (PWH) disease. Methods This cross-sectional, correlational study examined the association between apathy and several plasma biomarkers (tumor necrosis factor alpha, kynurenine, tryptophan, quinolinic acid, brain-derived neurotrophic factor, glial fibrillary acidic protein, neurofilament light chain, and phosphorylated tau at position threonine 181) in 109 PWH and 30 seronegative participants ages 50 and older. Apathy was measured with a composite score derived from subscales of the Frontal Systems Behavior Scale and the Profile of Mood States. Results Multiple regressions showed that PWH had significantly greater severity of apathy symptoms, independent of both data-driven and conceptually-based covariates. Pairwise correlations in the PWH sample indicated that apathy was not significantly associated with any of the measured biomarkers and all of the effect sizes were small. Conclusion Findings suggest that apathy is not strongly associated with peripheral biomarkers of inflammation, neurotrophic support, or neurodegeneration in older PWH. Limitations of this study include the cross-sectional design, the use of self-report measures of apathy, and low rates of viremia. Longitudinal studies in more representative samples of PWH that include a more comprehensive panel of fluid biomarkers, informant and behavioral indicators of apathy, and relevant psychosocial factors might help to further clarify the neurobiological substrates of this complex neuropsychiatric phenomenon.

Objective: The internet serves an increasingly critical role in how older adults manage their personal health. Electronic patient portals, for example, provide a centralized platform for older adults to access lab results, manage prescriptions and appointments, and communicate with providers. This study examined whether neurocognition mediates the effect of older age on electronic patient portal navigation. Participants and Methods: Forty-nine younger (18-35 years) and thirty-five older adults (50-75 years) completed the Test of Online Health Records Navigation (TOHRN), which is an experimenter-controlled website on which participants were asked to log-in, review laboratory results, read provider messages, and schedule an appointment. Participants also completed a neuropsychological battery, self-report questionnaires, and measures of health literacy and functional capacity. Results: Mediation analyses revealed a significant indirect effect of older age on lower TOHRN accuracy, which was fully mediated by global neurocognition and the domains of executive functions, episodic memory, and processing speed, but not attention. An exploratory follow-up model testing the inverse mediation pathway demonstrated that TOHRN accuracy was also a significant partial mediator of the relationship between older age and poorer global neurocognition. Conclusions: Findings indicate a possible bidirectional mediating relationship between age-related difficulties with neurocognition and navigating electronic patient health portals. Future studies might examine the possible benefits of both structural (e.g., human factors web design enhancement) and individual (e.g., training and compensation) cognitive supports to improve the navigability of electronic patient health portals for older adults.

The internet has become a common means by which many older adults seek out health information. The prevalence of misinformation on the internet makes the search for accurate online health information a more complex and evaluative process. This study examined the role of age and neurocognition in credibility evaluations of credible and non-credible health websites. Forty-one older adults and fifty younger adults completed a structured credibility rating task in which they evaluated a series of webpages displaying health information about migraine treatments. Participants also completed measures of neurocognition, internet use, and health literacy. Results suggested that older adults rated non-credible health websites as more credible than younger adults, but the age groups did not differ in their ratings of credible sites. Within the full sample, neurocognition was positively associated with credibility ratings for non-credible health websites, whereas health literacy was related to the ratings of credible sites. Findings indicate that older adults may be more likely to trust non-credible health websites than younger adults, which may relate to differences in higher-order neurocognitive functions. Future work might examine whether cognitive-based supports for credibility training in older adults can be used to improve the accuracy with which they evaluate online health information.

Objective: Online banking is becoming increasingly common among middle-aged and older adults, who may experience difficulties effectively navigating this sometimes complicated technology. This study examined age effects on a performance-based internet banking task and its association with neurocognitive, functional, and numerical abilities. Method: Thirty-five older adults (age 51-75) and 50 younger adults (age 18-32) completed an experimenter-controlled online banking measure in which they independently performed a series of naturalistic financial tasks (e.g., account transfers, bill paying). Participants also completed standardized tests of cognition, numeracy, and functional capacity. Results: Older adults were markedly slower and less accurate in completing the internet-based banking task, which was not confounded by other demographic, mood, or computer use factors. Higher scores on measures of neurocognition, numeracy, and financial functional capacity were both strongly associated with higher internet-based banking among older, but not younger adults. Conclusions: Findings suggest that older adults experience difficultly quickly and accurately navigating online banking platforms, which may be partly related to age-related declines in neurocognitive functions and basic financial capacity. Future studies might examine whether neurocognitive approaches to remediation and compensation can be used to improve online banking capacity in older adults. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Older age and HIV disease are independent risk factors for problems in many aspects of everyday functioning. However, less is known about how these risk factors may combine to influence everyday functioning over time. The current study examined the possible combined effects of age and HIV serostatus on change in everyday functioning over a 1-year period and its specific associations with changes in neurocognition. A repeated measures factorial design was employed. Participants included 77 older persons with HIV (PWH), 35 younger PWH, 44 older HIV-, and 27 younger HIV-adults who each completed baseline and follow-up visits approximately 14 months apart. Everyday functioning was assessed using a standardized self-report measure of activities of daily living (ADLs) at each visit. A comprehensive clinical battery assessed six domains of neurocognition. Raw scores on each neurocognitive measure were converted to sample-based z-scores, from which a global neurocognitive z-score was derived. Older PWH reported the poorest everyday functioning at baseline and follow-up visits at medium-to-large effect sizes. However, these ADL disruptions among older PWH were relatively stable over time, differing significantly from younger PWH who evidenced mild ADL improvements from baseline to follow-up. Within the entire sample, everyday functioning at baseline predicted neurocognitive performance at follow-up, but the reciprocal relationship was not significant. Older adults with HIV have high rates of ADL problems, which appear stable over 1 year, the trajectory of which differed from younger adults with HIV for whom mild improvements were observed. Importantly, the results also suggest that problems with ADLs may sometimes precede neurocognitive declines. Further examination of longitudinal data is needed to elucidate the long-term trajectory of neurocognitive and functional changes in older PWH to support early detection and proper management of clinical care.

BACKGROUND: Brain derived neurotrophic factor (BDNF) shows consistent associations with memory across many clinical populations, including dementia. Less is understood about the association between BDNF and memory functioning in people living with HIV (PWH). METHODS: A sample of 173 adults aged 50+ (n=100 HIV+ and n=73 HIV seronegative) completed a comprehensive neurobehavioral assessment and blood draw. Linear regressions predicting memory domains (learning, delayed recall, recognition) were conducted including race (White vs. Black/African American), HIV status, BDNF, and their interactions. RESULTS: For learning and delayed recall, significant (p

Introduction: The rapid development of coronavirus disease 2019 (COVID-19) into a pandemic required people to quickly acquire, evaluate, and apply novel complex health-related information about the virus and transmission risks. This study examined the potentially unique and synergistic roles of individual differences in neurocognition and health literacy in the early uptake and use of COVID-19 public health information.Method: Data were collected between April 23 and 21 May 2020, a period during which 42 out of 50 states were under a stay-at-home order. Participants were 217 healthy adults who completed a telephone-based battery that included standard tests of neurocognition, health literacy, verbal IQ, personality, and anxiety. Participants also completed measures of COVID-19 information-seeking skills, knowledge, prevention intentions, and prevention behaviors.Results: A series of hierarchical multiple regressions with data-driven covariates showed that neurocognition (viz, episodic verbal memory and executive functions) was independently related to COVID-19 knowledge (e.g. symptoms, risks) at a medium effect size, but not to information-seeking skills, prevention intentions, or prevention behaviors. Health literacy was independently related to all measured aspects of COVID-19 health information and did not interact with neurocognition in any COVID-19 health domain.Conclusions: Individual differences in neurocognition and health literacy played independent and meaningful roles in the initial acquisition of knowledge related to COVID-19, which is a novel human health condition. Future studies might examine whether neurocognitive supports (e.g. spaced retrieval practice, elaboration) can improve COVID-19-related knowledge and health behaviors in vulnerable populations.

Objective: The COVID-19 pandemic has exacerbated gender disparities in scientific output in some academic disciplines. Clinical neuropsychology has a history of gender disparities in multiple professional domains, including authorship on peer-reviewed manuscripts. This study examined the association of the COVID-19 pandemic with gender authorship disparities in clinical neuropsychology journals. Method: The author bylines of 1,018 initial manuscript submissions to four major clinical neuropsychology journals from March 15 through September 15 of both 2019 and 2020 were coded for binary gender using estimates from national databases. In addition, authorship of 40 articles published on pandemic-related topics (e.g., COVID-19, teleneuropsychology) across nine clinical neuropsychology journals were also coded for binary gender. Results: Initial submissions to clinical neuropsychology journals increased by 27.2% during the pandemic, with comparable increases in the total number of authors coded as either women (+23.0%) or men (+25.4%). Neither the average percentage of women on manuscript bylines nor the proportion of women who were lead and/or corresponding authors differed significantly across time. Moreover, the representation of women as authors of pandemic-related articles did not differ from expected frequencies in the field. Conclusions: These encouraging findings suggest that representation of women as authors of peer-reviewed manuscript submissions to clinical neuropsychology journals did not change during the initial months of the COVID-19 pandemic as compared to the prior year. Future studies might examine the roles of risk (e.g., caretaking responsibilities) and protective (e.g., sponsorship, resilience) factors that might influence individual differences in scientific productivity during the pandemic.

People living with HIV (PLWH) experience greater everyday functioning impairment. We examined frequency and correlates of successful functional aging (SFA) in PLWH. Using gold-standard questionnaires, SFA was defined in 174 HIV+ and 71 HIV− adults as absence of significant everyday cognitive symptoms and declines in instrumental activities of daily living. More HIV− (45%) than HIV+ (18%) adults met SFA criteria (p

Objective: Deficits in confrontation naming vary among persons with Alzheimer's disease (AD), including the extent to which phonemic cueing is helpful in generating the target word. This study examined neuropsychological correlates of phonemic cueing benefit and the influential effects of AD severity, estimated premorbid intellectual functioning, and apolipoprotein E genotype status.Method: Participants were 1104 individuals with mild to moderate AD who were administered the Boston Naming Test (BNT) as part of their initial neuropsychological evaluation.Results: Mild AD subjects benefited from phonemic cues significantly more than moderate AD subjects. Individuals with higher estimated premorbid IQ benefited more from phonemic cueing. Differences in phonemic cueing benefit between carriers and noncarriers of the ApoE e4 allele were accounted for by naming ability, with carriers performing better on naming tasks compared to noncarriers. Phonemic cueing benefit uniquely contributed to cognitive performance on some semantic measures, phonemic fluency, and one nonsemantic visuospatial task.Conclusion: Individuals with probable AD who benefit more from phonemic cueing during confrontation naming tend to have higher estimated premorbid IQ and are milder in dementia severity. There is a positive association between phonemic cueing benefit and performance on select semantic measures and verbal fluency. Differences in phonemic cueing benefit between carriers and noncarriers of APOE e4 allele can be explained by spontaneous naming performance. Results suggest complexity of underlying mechanisms involving confrontation naming, phonemic cueing, and lexical access and the factors that influence them.

Objective Despite its brevity and face validity, little is known about the construct validity of the naturalistic “Key Task” of prospective memory (PM), in which an examinee is instructed to remind the examiner at a designated time to retrieve keys (or another belonging) placed out of sight. Method Study 1 included 162 HIV+ and 52 HIV− comparison participants who completed the Key Task alongside well-validated measures of PM and a comprehensive neuropsychological battery that included everyday functioning measures. Study 2 used broadly parallel methods in 168 older community-dwelling Australians. Results Overall, the Key Task was not reliably associated with neurocognitive functioning (including clinical and experimental measures of PM), PM symptoms, or everyday functioning in either sample. Conclusions The Key Task did not demonstrate compelling evidence of construct validity among persons living with HIV disease or older adults, which raises doubts regarding its clinical usefulness as a measure of PM.

Objective Although medication management is a necessary daily activity for individuals with Huntington’s disease (HD), medication management abilities and their relation to cognitive functioning have not been evaluated. Method Twenty individuals with HD and 20 healthy adults (HA) completed the Medication Management Abilities Assessment (MMAA). Individuals with HD also completed a self-report medication management measure and neuropsychological tests assessing executive function, retrospective memory, and prospective memory. Results Individuals with HD performed significantly poorer and made more undertaking errors on the MMAA as compared to HA. No group differences were found in overtaking errors. In the HD group, significant associations were found between undertaking errors and perceived medication management ability as well as between MMAA task performance and measures assessing prospective memory and executive functions. Conclusions Medication management capacity was negatively affected in individuals with HD and may be associated with difficulty remembering to take medications in the future.