Impairments in emotion recognition, a crucial component of social cognition, have been previously demonstrated in patients with behavioral variant frontotemporal dementia (bv-FTD) and Alzheimer’s disease (AD). However, to date, it is unclear whether patients with early-stage vascular dementia (VaD) display deficient emotion recognition. We investigated profiles of impairments in emotion recognition and non-social cognitive functions, comparing VaD patients to bv-FTD and AD patients, and healthy control participants (HC).

Eighty-one memory clinic patients with early-stage VaD (n = 30), bv-FTD (n = 21) and AD (n = 30), and 40 HCs were included and performed Ekman 60 Faces Test (EFT; emotion recognition), Auditory Verbal Learning Test (AVLT; memory - encoding and retrieval) and Trailmaking Test (TMT A, TMT B, TMT B/A; information processing speed, executive functions). Differences between groups were analyzed with analysis of variance (ANOVA), using age, education and sex adjusted norm Z scores.

All patient groups performed significantly worse than HCs on EFT (p < .001). Mean performance of VaD patients was in between bv-FTD and AD (only bv-FTD < AD, p < .01). All patient groups were also impaired on AVLT encoding, TMT-B and TMT B/A. Social and non-social neurocognitive functions differed between groups, with specific impairments in processing speed in VaD, emotion recognition in bv-FTD and memory retrieval in AD, and memory encoding and cognitive control impaired in all three groups.

We found significantly different profiles in VaD, bv-FTD and AD. Assessing emotion recognition has additive value in the distinction between patient groups, allowing for more timely and accurate diagnosis in clinical practice.

To document the evolution of subjective cognitive functioning over four years in adults hospitalized after traumatic brain injury (TBI), comparing mild and moderate-severe TBI, and accounting for sociodemographic and clinical factors.

This secondary analysis of a longitudinal observational cohort study includes 222 adult participants hospitalized following a TBI (mean age = 41 ± 15 years; 29% women; 65% mild, 35% moderate-severe TBI). Data were collected via in-person/telephone interview and self-report questionnaires administered 4, 8, 12, 24, 36, and 48 months post-TBI. The primary outcome measure for subjective cognitive functioning was the Medical Outcomes Study Cognitive Functioning Scale (MOS-COG).

Mixed model analyses revealed a significant Time effect, with post hoc tests showing a better perceived cognitive functioning on the MOS-COG at 4 months than at 24 and 36 months after TBI. The TBI severity effect and TBI severity*Time interaction were not significant. Secondary effects revealed that poorer subjective cognitive functioning was associated with higher levels of symptoms of depression, anxiety, insomnia, and fatigue, and lower quality of life. Overall, the MOS-Cog score was about one standard deviation below the normative mean, suggesting greater cognitive complaints than in the general population, regardless of injury severity.

The results suggest that subjective cognitive functioning is poorer than normative values and fairly stable over four years after TBI, with a slight decrease between 4 and 24–36 months, and is similar between mild and moderate-severe TBI.

The entorhinal cortex (EC) is the first cortical region affected by tau pathology in Alzheimer’s disease (AD), but its functions remain unclear. The EC is thought to support memory binding, which can be tested using the Visual Short-Term Memory Binding Test (VSTMBT). We aimed to test whether VSTMBT performance can identify individuals with preclinical AD before noticeable episodic memory impairment and whether these performances are related to amyloid (Aβ) pathology and/or EC tau burden.

Ninety-four participants underwent the VSTMBT (including a shape-only condition (SOC) and a shape-color binding condition (SCBC)), standard neuropsychological assessment including the Preclinical Alzheimer Cognitive Composite (PACC5), an Aβ status examination, a 3D-T1 MRI and a [18F]-MK-6240 tau-PET scan. Participants were classified as follows: 54 Aβ-negative cognitively normal (Aβ − CN), 22 Aβ-positive CN (Aβ + CN, preclinical AD), and 18 Aβ + individuals with Mild Cognitive Impairment (Aβ + MCI, prodromal AD).

Aβ + CN individuals performed worse than Aβ-CN participants in the SCBC while the SOC only distinguished Aβ − CN from MCI participants. The SCBC performance was predicted by tau burden in the EC after adjusting for Aβ, white matter hypointensities, inferior temporal cortex (ITC) tau burden, age, sex, and education. The SCBC was more sensitive than the PACC5 in identifying CN individuals with a positive tau-PET scan.

Impaired visual short-term memory binding performance was evident from the preclinical stage of sporadic AD and related to tau pathology in the EC, suggesting that SCBC performance could detect early tau pathology in the EC among CN individuals.

Familiarity, the sense of knowing without recalling specific details, plays a critical role in memory processing and is mediated by the perirhinal cortex (PRC), a brain region that is critical for differentiating objects with high feature overlap, and is affected first by amnestic mild cognitive impairment (aMCI). Investigating familiarity in aMCI is crucial for insights into early diagnostic markers of cognitive impairment.

We conducted two studies probing familiarity in aMCI. The first study employed a response deadline procedure (RDP) where participants were presented with pictures of objects and then completed an item recognition test under two deadlines: a long deadline of 5000 ms, indexing recollection, and a short deadline of 1200ms, indexing familiarity. The second study utilized a frequency judgment (FJ) task in which participants saw pictures of highly similar objects a variable number of times, and then were asked how many times each object was presented. Their frequency judgments were correlated with the actual presentation frequencies as a measure of familiarity.

In the RDP, individuals with aMCI had significantly lower recognition accuracy than healthy counterparts, in the long and short deadline, indicating impaired recollection and familiarity. In the FJ task, individuals with aMCI had significantly lower frequency judgment correlations, indicating impaired familiarity.

These results highlight the importance of minimizing the role of recollection when aiming to understand familiarity deficits and underscore the potential of familiarity as an early diagnostic marker of cognitive decline.

The aim of this study was to investigate sensorimotor functions that require cerebellar processing, and visuospatial perception and visuospatial abilities in adult patients with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

We included patients with unmedicated ADHD (n = 52), medicated ADHD (n = 39), ASD (n = 33), the combination of unmedicated ADHD and ASD (n = 31) and controls (n = 78). A multimodal set of neurocognitive tests and motor tasks were administrated to evaluate cognitive and motor skills.

All patient groups exhibited significantly worse performances than controls in sensorimotor functions, visuospatial perception, and visuospatial abilities. We observed significant associations between sensorimotor functions and visuospatial perception and visuospatial abilities. We conducted a regression analysis to evaluate the impact of potential confounders on neurocognitive outcomes. The results indicated that age, level of education, and insomnia, but not anxiety or depression, affected the performance on some tests.

Our results reveal deficits in sensorimotor functions, visuospatial perception, and visuospatial abilities in patients with neuropsychiatric disorders. Clear deficits emerged, despite the majority of patients showing a mild degree of severity index of ADHD/ASD across all groups (61–84%). The results are consistent with the idea that these disorders are linked to cerebellar deficits. Our results suggest that these objective tests have the potential to enhance clinical evaluations.

To examine the association of posttraumatic headache (PTH) type with postconcussive symptoms (PCS), pain intensity, and fluid cognitive function across recovery after pediatric concussion.

This prospective, longitudinal study recruited children (aged 8–16.99 years) within 24 hours of sustaining a concussion or mild orthopedic injury (OI) from two pediatric hospital emergency departments. Based on parent-proxy ratings of pre- and postinjury headache, children were classified as concussion with no PTH (n = 18), new PTH (n = 43), worse PTH (n = 58), or non-worsening chronic PTH (n = 19), and children with OI with no PTH (n = 58). Children and parents rated PCS and children rated pain intensity weekly up to 6 months. Children completed computerized testing of fluid cognition 10 days, 3 months, and 6- months postinjury. Mixed effects models compared groups across time on PCS, pain intensity, and cognition, controlling for preinjury scores and covariates.

Group differences in PCS decreased over time. Cognitive and somatic PCS were higher in new, chronic, and worse PTH relative to no PTH (up to 8 weeks postinjury; d = 0.34 to 0.87 when significant) and OI (up to 5 weeks postinjury; d = 0.30 to 1.28 when significant). Pain intensity did not differ by group but declined with time postinjury. Fluid cognition was lower across time in chronic PTH versus no PTH (d = −0.76) and OI (d = −0.61) and in new PTH versus no PTH (d = −0.51).

Onset of PTH was associated with worse PCS up to 8 weeks after pediatric concussion. Chronic PTH and new PTH were associated with moderately poorer fluid cognitive functioning up to 6 months postinjury. Pain declined over time regardless of PTH type.

Cognitive impairment is prevalent, disabling, and poorly managed in multiple sclerosis (MS). Physical activity, often expressed as steps/day, has been associated with cognitive function in this population. This brief report examined the possibility of a (1) steps/day threshold associated with absence of cognitive impairment or (2) dose-response relationship between steps/day and cognitive function in MS.

The sample included 358 persons with MS who provided demographic (age, sex, race) and clinical (MS type, disease duration, disability status) information, and completed the Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test-Second Edition (CVLT-II). Participants wore an ActiGraph GT3X+ accelerometer above the non-dominant hip during waking hours of the day over a 7-day period for measuring steps/day.

The receiver operating characteristic (ROC) curve analysis did not identify a steps/day threshold associated with cognitive impairment on SDMT (area under the curve [AUC] ranged between 0.606 and 0.691). The ROC curve analysis further did not identify a threshold of steps/day associated with cognitive impairment based on CVLT-II (AUC range 0.606 to 0.691). The regression analysis indicated significant linear relationships between steps/day and SDMT (R2 = .06; β=.251; p < .001) and CVLT-II (R2 = .06; β=.247; p < .001) z-scores.

The observed linear relationship suggests that focusing on increasing steps/day across all levels of physical activity might have benefits for cognitive function in MS.

Post-traumatic stress disorder (PTSD) and hypertension are highly prevalent among Veterans. Cognitive dispersion, indicating within-person variability across neuropsychological measures at one time point, is associated with increased risk of dementia. We examined interactive effects of PTSD symptom severity and hypertension on cognitive dispersion among older Veterans.

We included 128 Vietnam-era Veterans from the Department of Defense-Alzheimer’s Disease Neuroimaging Initiative (DoD-ADNI) with a history of PTSD. Regression models examined interactions between PTSD symptom severity and hypertension on cognitive dispersion (defined as the intraindividual standard deviation across eight cognitive measures) adjusting for demographics and comorbid vascular risk factors.

There was an interaction between PTSD symptom severity and hypertension on cognitive dispersion (p = .026) but not on mean cognitive performance (p = .543). Greater PTSD symptom severity was associated with higher cognitive dispersion among those with hypertension (p = .002), but not among those without hypertension (p = .531). Results remained similar after adjusting for mean cognitive performance.

Findings suggest, among older Veterans with PTSD, those with both hypertension and more severe PTSD symptoms may be at greater risk for cognitive difficulties. Further, cognitive dispersion may be a useful marker of subtle cognitive difficulties. Future research should examine these associations longitudinally and in a diverse sample.

Altered reinforcement learning (RL) and decision-making have been implicated in the pathophysiology of anorexia nervosa. To determine whether deficits observed in symptomatic anorexia nervosa are also present in remission, we investigated RL in women remitted from anorexia nervosa (rAN).

Participants performed a probabilistic associative learning task that involved learning from rewarding or punishing outcomes across consecutive sets of stimuli to examine generalization of learning to new stimuli over extended task exposure. We fit a hybrid RL and drift diffusion model of associative learning to model learning and decision-making processes in 24 rAN and 20 female community controls (cCN).

rAN showed better learning from negative outcomes than cCN and this was greater over extended task exposure (p < .001, ηp2 = .30). rAN demonstrated a reduction in accuracy of optimal choices (p = .007, ηp2 = .16) and rate of information extraction on reward trials from set 1 to set 2 (p = .012, ηp2 = .14), and a larger reduction of response threshold separation from set 1 to set 2 than cCN (p = .036, ηp2 = .10).

rAN extracted less information from rewarding stimuli and their learning became increasingly sensitive to negative outcomes over learning trials. This suggests rAN shifted attention to learning from negative feedback while slowing down extraction of information from rewarding stimuli. Better learning from negative over positive feedback in rAN might reflect a marker of recovery.

This study compared cognitive flexibility (CF) and emotion recognition (ER) in adolescents with eating disorders (ED) to a healthy group.

Forty healthy individuals aged 12–18 years with no psychiatric diagnosis and 46 patients diagnosed with anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED) according to DSM-5 criteria participated. CF was assessed using the Cognitive Flexibility Scale (CFS), Stroop Test, and Berg Card Sorting Test (BCST), while ER was evaluated using the test of perception of affect via nonverbal cues.

CFS scores were lower in the ED group compared to the control group. Neuropsychological test results indicated similar BCST perseverative error percentages among ED patients and controls. However, while the BED group demonstrated greater difficulties with inhibitory control, as shown in the Stroop Test, the BN and AN groups performed similarly to the control group. ER performance was similar across groups, although the AN subgroup exhibited heightened recognition of negative emotions, particularly disgust and fear.

This study highlights unique and shared neurocognitive patterns related to CF and ER profiles of ED patients. Despite self-reports of greater cognitive rigidity among ED patients, objective tests did not consistently confirm it. Notably, BED patients exhibited inhibitory control challenges, aligning with impulsive tendencies. ER abilities were similar to controls; however, the AN subgroup showed heightened sensitivity to certain negative emotions, such as disgust. These findings underscore the need for further research with larger, more balanced samples to explore how CF and ER vary across developmental stages and subtypes.

Mean levels of cognitive functioning typically do not show an association with self-reported cognitive fatigue in persons with multiple sclerosis (PwMS), but some studies indicate that cognitive variability has an association with cognitive fatigue. Additionally, coping has been shown to be a powerful moderator of some outcomes in multiple sclerosis (MS). To date, however, coping has not been considered as a possible moderator of the relationship between cognitive fatigue and cognitive variability in MS. The current study examined this relationship.

We examined 52 PwMS. All participants were administered the Fatigue Impact Scale, the Coping Orientation to Problems Experienced Questionnaire, and cognitive tests. Indices of variability for memory and attention/executive functioning tests were used as outcome variables. Avoidant coping, active coping, and composite coping indices were used as moderators.

The interaction analyses for the avoidant coping and composite coping indices were significant and accounted for 8 and 11% of the attention/executive functioning variability outcome, respectively. The interactions revealed that at low levels of cognitive fatigue, attention/executive functioning variability was comparable between the low and high avoidant and composite coping groups. However, at high levels of cognitive fatigue, PwMS using lower levels of avoidant coping (less maladaptive coping) showed less variable attention/executive functioning scores compared with those using higher levels of avoidant coping. We found a similar pattern for the composite coping groups.

At high levels of cognitive fatigue, PwMS using adaptive coping showed less attention/executive functioning variability. These findings should be considered in the context of treatment implications.

Neuropsychiatric symptoms (NPS) are considered diagnostic and prognostic indicators of dementia and are attributable to neurodegenerative processes. Little is known about the prognostic value of early NPS on executive functioning (EF) decline in Alzheimer’s disease and related dementias (ADRD). We examined whether baseline NPS predicted the rate of executive function (EF) decline among older adults with ADRD.

Older adults (n = 1625) with cognitive impairment were selected from the National Alzheimer’s Coordinating Center database. EF was estimated with a latent factor indicated by scores on Number Span Backward, Letter Fluency, and Trail Making-Part B. A curve of factors (CUFF) latent growth curve model was estimated to examine rate of change over four years. Baseline NPS severity was entered as a predictor in the model to examine its influence on the rate of change in EF over time.

The CUFF models exhibited good fit. EF significantly declined over four waves (slope = −.16, p < .001). Initial visit NPS severity predicted decline in EF (slope = .013, p < .001), such that those with greater baseline NPS severity demonstrated a more rapid decline in EF performance over time. Presence of 2 NPS significantly predicted EF decline, and those with medium total NPS severity (NPS score of 2–4) at baseline exhibited a sharper decline in EF.

Findings underscore the importance of targeting NPS early across ADRD syndromes to minimize EF decline, offering novel insights into how early NPS treatment may alter cognitive trajectories. We provide an innovative, user-friendly web-based application that may be helpful for personalized treatment planning.

Information on the time spent completing cognitive testing is often collected, but such data are not typically considered when quantifying cognition in large-scale community-based surveys. We sought to evaluate the added value of timing data over and above traditional cognitive scores for the measurement of cognition in older adults.

We used data from the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (LASI-DAD) study (N = 4,091), to assess the added value of timing data over and above traditional cognitive scores, using item-specific regression models for 36 cognitive test items. Models were adjusted for age, gender, interviewer, and item score.

Compared to Quintile 3 (median time), taking longer to complete specific items was associated (p < 0.05) with lower cognitive performance for 67% (Quintile 5) and 28% (Quintile 4) of items. Responding quickly (Quintile 1) was associated with higher cognitive performance for 25% of simpler items (e.g., orientation for year), but with lower cognitive functioning for 63% of items requiring higher-order processing (e.g., digit span test). Results were consistent in a range of different analyses adjusting for factors including education, hearing impairment, and language of administration and in models using splines rather than quintiles.

Response times from cognitive testing may contain important information on cognition not captured in traditional scoring. Incorporation of this information has the potential to improve existing estimates of cognitive functioning.

This study aimed to investigate the prevalence and nature of cognitive impairment among severely ill COVID-19 patients and the effectiveness of the Montreal Cognitive Assessment (MoCA) in detecting it.

We evaluated cognition in COVID-19 patients hospitalized during the first wave (March to June 2020) from six Dutch hospitals, nine months post-discharge, using a comprehensive multi-domain neuropsychological test battery. Test performance was corrected for sex, age, and education differences and transformed into z-scores. Scores within each cognitive domain were averaged and categorized as average and above (z-score ≥ −0.84), low average (z-score −1.28 to −0.84), below average (z-score −1.65 to −1.28), and exceptionally low (z-score < −1.65). Patients were classified with cognitive impairment if at least one domain’s z-score fell below −1.65. We assessed the MoCA’s accuracy using both the original cutoff (<26) and an “optimal” cutoff determined by Youden’s index.

Cognitive impairment was found in 12.1% (24/199) of patients, with verbal memory and mental speed most affected (6.5% and 7% below −1.65, respectively). The MoCA had an area under the curve of 0.84. The original cutoff showed sensitivity of 83% and specificity of 66%. Using the identified optimal cutoff of <24, maintained sensitivity while improving specificity to 81%.

Cognitive impairment prevalence in initially hospitalized COVID-19 patients is lower than initially expected. Verbal memory and processing speed are primarily affected. The MoCA is a valuable screening tool for these impairments and lowering the MoCA cutoff to <24 improves specificity.

Reading difficulties (RD) frequently co-occur with attention-deficit/hyperactivity disorder (ADHD), and children with both RD + ADHD often demonstrate greater challenges in reading and executive functions (EF) than those with RD-only.

This study examined the effect of a 4-week EF-based reading intervention on behavioral and neurobiological correlates of EF among 8–12 y.o. English-speaking children with RD + ADHD (n = 19), RD-only (n = 18), and typically developing children (n = 18). Behavioral and resting-state fMRI data were collected from all participants before and after 4 weeks of the EF-based reading computerized program. Group (RD + ADHD, RD-only, typical readers) x Test (pre- and post-intervention) repeated measures ANOVAs were conducted for reading, EF, and brain functional connectivity (FC) measures.

Across groups, reading (fluency, comprehension) and EF (inhibition, speed of processing) behavioral performance improved following the intervention. Exploratory subgroup comparisons revealed that children with RD + ADHD, but not RD-only, showed significant gains in reading comprehension, whereas inhibition improved in both RD groups, but not among typical readers. Furthermore, across groups, FC between the frontoparietal (FP) and cingulo-opercular (CO) networks decreased following the intervention. Exploratory subgroup comparisons revealed that children with RD + ADHD, but not RD-only, showed a significant decrease in FC of FP-CO and FP-dorsal attention network.

These results support the differential response to an EF-based reading intervention of children with RD with and without comorbid ADHD at brain and behavioral levels.

With the increased use of computer-based tests in clinical and research settings, assessing retest reliability and reliable change of NIH Toolbox-Cognition Battery (NIHTB-CB) and Cogstate Brief Battery (Cogstate) is essential. Previous studies used mostly White samples, but Black/African Americans (B/AAs) must be included in this research to ensure reliability.

Participants were B/AA consensus-confirmed healthy controls (HCs) (n = 49) or mild cognitive impairment (MCI) (n = 34) adults 60–85 years that completed NIHTB-CB and Cogstate for laptop at two timepoints within 4 months. Intraclass correlations, the Bland-Altman method, t-tests, and the Pearson correlation coefficient were used. Cut scores indicating reliable change provided.

NIHTB-CB composite reliability ranged from .81 to .93 (95% CIs [.37–.96]). The Fluid Composite demonstrated a significant difference between timepoints and was less consistent than the Crystallized Composite. Subtests were less consistent for MCIs (ICCs = .01–.89, CIs [−1.00–.95]) than for HCs (ICCs = .69–.93, CIs [.46–.92]). A moderate correlation was found for MCIs between timepoints and performance on the Total Composite (r = -.40, p = .03), Fluid Composite (r = -.38, p = .03), and Pattern Comparison Processing Speed (r = -.47, p = .006).

On Cogstate, HCs had lower reliability (ICCs = .47–.76, CIs [.05–.86]) than MCIs (ICCs = .65–.89, CIs [.29–.95]). Identification reaction time significantly improved between testing timepoints across samples.

The NIHTB-CB and Cogstate for laptop show promise for use in research with B/AAs and were reasonably stable up to 4 months. Still, differences were found between those with MCI and HCs. It is recommended that race and cognitive status be considered when using these measures.

Validated computerized assessments for cognitive functioning are crucial for older individuals and those at risk of cognitive decline. The National Institutes of Health (NIH) Toolbox Cognition Battery (NIHTB-CB) exhibits good construct validity but requires validation in diverse populations and for adults aged 85+. This study uses data from the Assessing Reliable Measurement in Alzheimer’s Disease and cognitive Aging study to explore differences in the factor structure of the NIHTB-CB for adults 85 and older, Black participants versus White participants, and those diagnosed as amnestic Mild Cognitive Impairment (aMCI) vs cognitively normal (CN).

Subtests from the NACC UDS-3 and NIHTB-CB were administered to 503 community-dwelling Black and White adults ages 55–99 (367 CN; 136 aMCI). Confirmatory factor analyses were used to investigate the original factor structure of NIHTB-CB that forms the basis for NIHTB-CD Index factor scores.

Factor analyses for all participants and some participant subsets (aMCI, White, 85+) substantiated the two anticipated factors (Fluid and Crystallized). However, while Black aMCI participants had the expected two-factor structure, for Black CN participants, the List Sorting Working Memory and Picture Sequence tests loaded on the Crystallized factor.

Findings provide psychometric support for the NIHTB-CB. Differences in factor structure between Black CN individuals and Black aMCI individuals suggest potential instability across levels of cognitive impairment. Future research should explore changes in NIHTB-CB across diagnoses in different populations.

To evaluate the impact of receptive vocabulary versus years of education on neuropsychological performance of Black and White older adults.

A community-based prospectively enrolled cohort (n = 1,007; 130 Black, 877 White) in the Emory Healthy Brain Study were administered the NIH Toolbox Picture Vocabulary Test and neuropsychological measures. Group differences were evaluated with age, sex, and education or age, sex, and Toolbox Vocabulary scores as covariates to determine whether performance differences between Black versus White participants were attenuated or eliminated.

With vocabulary as a covariate, the main effect of race was no longer significant for the MoCA, Phonemic Fluency, Rey Auditory Verbal Learning Test, and Rey Complex Figure Test immediate and delayed recall. Although still significantly different between groups, the effect sizes for Animal Fluency, Trails B-A, Symbol Digit Modalities Test, and Rey Copy were attenuated, with the greatest reductions occurring for the Multilingual Naming Test and Judgment of Line Orientation.

Findings support the value of using receptive vocabulary as a proxy for premorbid ability level when comparing the cognitive performance of Black and White older adults. The results extend investigations using measures of single word reading to encompass measures assessing word meaning.

Higher white matter hyperintensity (WMH) volume is a marker of cardiovascular disease (CVD) risk. CVD risk factors increase risk for Alzheimer’s disease and related dementias (ADRD). Mexican Americans (MA) and individuals of other Hispanic/Latino heritages have higher risk for CVD and ADRD. However, knowledge of associations between WMH volume and cognition in these groups remains limited.

We conducted a cross-sectional study of associations between WMH volume and neuropsychological performance (attention/executive functioning, memory) in MA (n = 851) and non-Hispanic White (NHW; n = 747) adults in the Health and Aging Brain Study: Health Disparities.

The MA group (mean age = 63.72 ± 7.90 years; 66.3% female) had higher rates of consensus diagnoses of hypertension and diabetes, whereas the NHW group (mean age = 69.18 ± 8.65 years; 55.2% female) had higher rates of diagnosed CVD (ps < .01). WMH volumes were higher among individuals with CVD risk factors/conditions (ps < .01). There were differential associations between WMH and neuropsychological performance across ethnoracial groups (ps < .001), wherein associations were steeper in the NHW group than in the MA group. Lower educational level was associated with higher WMH volume in the NHW group (p < .001), but no association was seen in the MA group (p > .05).

Negative effects of pathological changes in the form of WMH on cognition may be less robust or consistent for MA adults than NHW adults. Furthermore, the impact of WMH on cognition in NHW adults may be mitigated by cognitive reserve related to educational attainment.

To establish quick-reference criteria regarding the frequency of statistically rare changes in seven neuropsychological measures administered to older adults.

Data from 935 older adults examined over a two-year interval were obtained from the Alzheimer’s Disease Neuroimaging Initiative. The sample included 401 cognitively normal older adults whose scores were used to determine the natural distribution of change scores for seven cognitive measures and to set change score thresholds corresponding to the 5th percentile. The number of test scores that exceeded these thresholds were counted for the cognitively normal group, as well as 381 individuals with mild cognitive impairment (MCI) and 153 individuals with dementia. Regression analyses examined whether the number of change scores predicted diagnostic group membership beyond demographic covariates.

Only 4.2% of cognitively normal participants obtained two or more change scores that fell below the 5th percentile of change scores, compared to 10.6% of the stable MCI participants and 38.6% of those who converted to dementia. After adjusting for age, gender, race/ethnicity, and premorbid estimates, the number of change scores below the 5th percentile significantly predicted diagnostic group membership.

It was uncommon for older adults to have two or more change scores fall below the 5th percentile thresholds in a seven-test battery. Higher change counts may identify those showing atypical cognitive decline.