Montreal Cognitive Assessment (MoCA): An update normative study for the Portuguese population.

The Montreal Cognitive Assessment (MoCA) is a brief cognitive screening instrument that is known for its good psychometric properties and sensitivity to detect mild cognitive impairment (MCI). After ten years, it became relevant to update the previous Portuguese normative study due to changes in the population and some limitations present in the study itself. The study sample was composed of 860 cognitively healthy adults, stratified according to verified distribution of the Portuguese population across several sociodemographic variables. All participants completed a neuropsychological assessment battery, in which the MoCA was included. The analysis of the relationships between the sociodemographic variables and the MoCA show that age and educational level had a significant effect on MoCA scores, with educational level being the better predictor. These results foster the consideration of age and educational level in the development of normative data. The present study contributes to a reliable update of the normative data of MoCA. The new age groups and more stratified norms comply with the natural changes on the Portuguese population, providing an increase of power and clinical accuracy. The presented norms consider the cognitive domains subscores, consequently improving the comprehension and utility of the results obtained from the MoCA test.

A robust role for motor cortex.

The role of motor cortex in non-primate mammals remains unclear. More than a century of stimulation, anatomical and electrophysiological studies has implicated neural activity in this region with all kinds of movement. However, following the removal of motor cortex, rats retain most of their adaptive behaviors, including previously learned skilled movements. Here we revisit these two conflicting views of motor cortex and present a new behavior assay, challenging animals to respond to unexpected situations while navigating a dynamic obstacle course. Surprisingly, rats with motor cortical lesions show clear impairments facing an unexpected collapse of the obstacles, while showing no impairment with repeated trials in many motor and cognitive metrics of performance. We propose a new role for motor cortex: extending the robustness of sub-cortical movement systems, specifically to unexpected situations demanding rapid motor responses adapted to environmental context. The implications of this idea for current and future research are discussed.

The cerebellum is causally involved in episodic memory under aging.

Episodic memory decline is a major signature of both normal and pathological aging. Many neural regions have been implicated in the processes subserving both episodic memory and typical aging decline. Here, we demonstrate that the cerebellum is causally involved episodic memory under aging. We show that a 12-day neurostimulation program delivered to the right cerebellum led to improvements in episodic memory performance under healthy aging that long outlast the stimulation period - healthy elderly individuals show episodic memory improvement both immediately after the intervention program and in a 4-month follow-up. These results demonstrate the causal relevance of the cerebellum in processes associated with long-term episodic memory, potentially highlighting its role in regulating and maintaining cognitive processing. Moreover, they point to the importance of non-pharmacological interventions that prevent or diminish cognitive decline in healthy aging.

Identifying freshwater priority areas for cross-taxa interactions.

Information about biotic interactions (e.g. competition, predation, parasitism, diseases, mutualism, allelopathy) is fundamental to better understand species distribution and abundance, ecosystem functioning, and ultimately guide conservation efforts. However, conservation planning often overlooks these important interactions. Here, we aim to demonstrate a new framework to include biotic interactions into Marxan. For that, we use freshwater mussels and fish interaction (as mussels rely on fishes to complete their life cycle) in the Douro River basin (Iberian Peninsula) as a case study. While doing that, we also test the importance of including biotic interactions into conservation planning exercises, by running spatial prioritisation analysis considering either: 1) only the target species (freshwater mussels); 2) freshwater mussels and their obligatory hosts (freshwater fishes); 3) freshwater mussels, fishes and their interactions. With this framework we found that biotic interactions tend to be underrepresented when the data on both freshwater mussels and fishes is not simultaneously included in the spatial prioritisation. Overall, the priority areas selected across all scenarios are mostly located in the western part of the Douro River basin, where most freshwater mussels and fishes still occur. Given the low overlap of priority areas identified here and the current Natura 2000 network, our approach may be useful for establishing (or enlarging) protected areas, especially in light of the EU Biodiversity Strategy for 2030. Also, this work may provide guidance for future habitat restoration and management of main threats to freshwater biodiversity.

Cognitive decline complaints scale (CDCS): validation and normative studies for the adults and older adults Portuguese population.

OBJECTIVES: Subjective Cognitive Complaints, which result from the self-perception of Subjective Cognitive Decline, are frequently reported by older adults. The Cognitive Decline Complaints Scale (CDCS) assesses subjective complaints of cognitive decline in several cognitive domains through three levels of severity. This study aims to psychometrically validate this instrument considering the Classical Test Theory, and to establish preliminary normative data of the CDCS for adults and older adults of the Portuguese population. METHODS: The community-based sample consisted of 199 cognitively healthy Portuguese participants, aged 50 years or older, stratified according to several sociodemographic variables. In addition to the CDCS, all participants responded to an extensive neuropsychological assessment protocol. RESULTS: The psychometric characteristics of the CDCS were generally adequate for this community sample (e.g. Cronbach's alpha = .936). As for the sociodemographic variables analyzed, only the geographic region showed differences in the CDCS scores, which were more significant in the Azores. There were no significant correlations or differences between the CDCS scores and age and educational level and, therefore, normative data were explored considering the total sample. CONCLUSION: As a scale, the CDCS allows for the detailed assessment of subjective cognitive complaints and the determination of whether or not such complaints are considered normative, which will facilitate an empirically based understanding of this dimension of psychological functioning and also provide indications as to the need for a more extensive neuropsychological assessment.

A roadmap for the conservation of freshwater mussels in Europe.

Europe has a long history of human pressure on freshwater ecosystems. As pressure continues to grow and new threats emerge, there is an urgent need for conservation of freshwater biodiversity and its ecosystem services. However, whilst some taxonomic groups, mainly vertebrates, have received a disproportionate amount of attention and funds, other groups remain largely off the public and scientific radar. Freshwater mussels (Bivalvia, Unionida) are an alarming example of this conservation bias and here we point out six conceptual areas that need immediate and long-term attention: knowledge, threats, socioeconomics, conservation, governance and education. The proposed roadmap aims to advance research, policy and education by identifying the most pressing priorities for the short- and long-term conservation of freshwater mussels across Europe.

The Assessment of Cognitive Reserve: A Systematic Review of the Most Used Quantitative Measurement Methods of Cognitive Reserve for Aging.

The cognitive reserve (CR) is widely accepted as the active ability to cope with brain damage, using preexisting cognitive and compensatory processes. The common CR proxies used are the number of formal years of education, intelligence quotient (IQ) or premorbid functioning, occupation attainment, and participation in leisure activities. More recently, it has employed the level of literacy and engagement in high-level cognitive demand of professional activities. This study aims to identify and summarize published methodologies to assess the CR quantitatively. We searched for published studies on PubMed, ScienceDirect, and Web of Science between September 2018 and September 2021. We only included those studies that characterized the CR assessment methodology. The search strategy identified 1,285 publications, of which 25 were included. Most of the instruments targeted proxies individually. The lack of a gold standard tool that incorporates all proxies and cognitive tests highlights the need to develop a more holistic battery for the quantitative assessment of CR. Further studies should focus on a quantitative methodology that includes all these proxies supported by normative data to improve the use of CR as a valid measure in clinical contexts.

The European Portuguese version of the Oxford Cognitive Screening (OCS-Pt): a screening test for acute stroke patients.

In Portugal, there is no gold standard test to assess acute stroke patients in the hospital context. However, cognitive deficits are common after a stroke episode and are followed by a negative impact on a patient's quality of life and rehabilitation. Here, we first aimed to adapt the Oxford Cognitive Screening to European Portuguese speakers (OCS-Pt), develop normative data cut-offs, and report the psychometric properties of the OCS-Pt. The second aim was to test the incidence of impairments in acute stroke patients. We tested 137 healthy participants aged between 25 and 92 years old, and we report normative cut-offs based on the 5th and 95th percentile, and on the patterns for age and education level. Our results are similar to other European OCS versions, and results using convergent and divergent validity show satisfactory values ranged between moderate to high. Additionally, 146 acute stroke patients, in the first week after the stroke episode, performed the OCS-Pt. Results show that this is an inclusive test and allows to discriminate between impaired and preserved functions. In conclusion, OCS-Pt is a promising cognitive screening tool to assess acute stroke survivors to be used in stroke care in Portugal.

Effects of restraining measures due to COVID-19: Pre- and post-lockdown cognitive status and mental health.

The COVID-19 pandemic has prompted all countries to adopt restraining measures to mitigate the spread of the disease. Usually, large-scale disasters tend to be accompanied by significant increases of psychological distress, depression and anxiety. Confinement measures imposed during the COVID-19 pandemic are likely to have similar consequences. In the present study we aim to evaluate how COVID-19 affected the overall psychological functioning of Portuguese individuals by providing a comparison of current data with status prior to the COVID-19 pandemic. The study sample was composed of 150 cognitively healthy participants. Results show an overall maintenance of cognitive capacities, although subjective cognitive decline complaints significantly increased during the pandemic. Regarding mental health, restraining measures culminated in an aggravation of depressive and decrease of the perceived quality of life, associated with feelings of loneliness and perceived social isolation. Finally, higher levels of pre-COVID-19 quality of life seem to play a protective role against depression and anxiety and predict less difficulties in emotion regulation, feelings of solitude and cognitive complaints. In sum, confinement due to COVID-19 implied an aggravation of the mental health of the Portuguese population, which appears to have been attenuated in those with higher pre-pandemic levels of perceived quality of life.

Alarming decline of freshwater trigger species in western Mediterranean key biodiversity areas.

Theidentification of key biodiversity areas (KBA) was initiated by the International Union for Conservation of Nature in 2004 to overcome taxonomic biases in the selection of important areas for conservation, including freshwater ecosystems. Since then, several KBAs have been identified mainly based on the presence of trigger species (i.e., species that trigger either the vulnerability and or the irreplaceability criterion and thus identify a site as a KBA). However, to our knowledge, many of these KBAs have not been validated. Therefore, classical surveys of the taxa used to identify freshwater KBAs (fishes, molluscs, odonates, and aquatic plants) were conducted in Douro (Iberian Peninsula) and Sebou (Morocco) River basins in the Mediterranean Biodiversity Hotspot. Environmental DNA analyses were undertaken in the Moroccan KBAs. There was a mismatch between the supposed and actual presence of trigger species. None of the trigger species were found in 43% and 50% of all KBAs surveyed in the Douro and Sebou basins, respectively. Shortcomings of freshwater KBA identification relate to flawed or lack of distribution data for trigger species. This situation results from a misleading initial identification of KBAs based on poor (or even inaccurate) ecological information or due to increased human disturbance between initial KBA identification and the present. To improve identification of future freshwater KBAs, we suggest selecting trigger species with a more conservative approach; use of local expert knowledge and digital data (to assess habitat quality, species distribution, and potential threats); consideration of the subcatchment when delineating KBAs boundaries; thoughtful consideration of terrestrial special areas for conservation limits; and periodic field validation.

Alarming decline of freshwater trigger species in western Mediterranean Key Biodiversity Areas Resumen La identificación de las áreas clave de biodiversidad (ACB) fue iniciada por la Unión Internacional para la Conservación de la Naturaleza en 2004 con el objetivo de sobreponerse a los sesgos taxonómicos en la selección de áreas importantes para la conservación, incluyendo los ecosistemas de agua dulce. Desde entonces, varias ACB han sido identificadas principalmente con base en la presencia de especies desencadenantes (es decir, especies que desencadenan el criterio de vulnerabilidad o de carácter irremplazable y por lo tanto identifican a un sitio como una ACB). Sin embargo, a nuestro conocimiento, muchas de estas ACB no han sido validadas. Por lo tanto, los censos clásicos de taxones utilizados para identificar las ACB de agua dulce (peces, moluscos, odonatos y plantas acuáticas) fueron realizados en las cuencas de los ríos Duero (Península Ibérica) y Sebou (Marruecos) en el Punto Caliente de Biodiversidad del Mediterráneo. Realizamos análisis de ADN ambiental en las ACB de Marruecos. Hubo una discrepancia entre la supuesta presencia y la actual presencia de especies desencadenantes. Ninguna de las especies desencadenantes se encontró en 43% y 50% de las ACB censadas en las cuencas del Duero y del Sebou, respectivamente. Las deficiencias en la identificación de las ACB de agua dulce están relacionadas con la carencia de datos o datos erróneos sobre la distribución de las especies desencadenantes. Esta situación resulta en una identificación inicial engañosa de las ACB con base en información ecológica deficiente (o incluso incorrecta) o también puede deberse al incremento en las perturbaciones humanas ocurridas entre la identificación de la ACB y el presente. Para mejorar la identificación de ACB de agua dulce en el futuro, sugerimos que la selección de especies desencadenantes se realice con un enfoque más conservador; que se usen el conocimiento local de los expertos y los datos digitales (para evaluar la calidad del hábitat, la distribución de las especies y las amenazas potenciales); que se consideren las subcuencas cuando se delimiten las fronteras de las ACB; que se consideren cuidadosamente las áreas de especies terrestres para los límites de conservación; y que se realicen validaciones periódicas de campo.

Putting fire on the map of Brazilian savanna ecoregions.

The Brazilian savanna (Cerrado) is considered the most floristically diverse savanna in the world, home to more than seven thousand species. The region is a mosaic of savannas, grasslands and forests whose unique biophysical and landscape attributes are on the basis of a recent ecoregional map, paving the way to improved region-based strategies for land management actions. However, as a fire-prone ecosystem, Cerrado owes much of its distribution and ecological properties to the fire regime and contributes to an important parcel of South America burned area. Accordingly, any attempt to use ecoregion geography as a guide for management strategies should take fire into account, as an essential variable. The main aim of this study is to complement the ecoregional map of the Cerrado with information related to the fire component. Using remotely sensed information, we identify patterns and trends of fire frequency, intensity, seasonality, extent and scar size, and combine this information for each ecoregion, relying on a simple classification that summarizes the main fire characteristics over the last two decades. Results show a marked north-south fire activity gradient, with increased contributions from MATOPIBA, the latest agricultural frontier. Five ecoregions alone account for two thirds of yearly burned area. More intense fires are found in the Arc of Deforestation and eastern ecoregions, while ecoregions in MATOPIBA display decreasing fire intensity. An innovative analysis of fire scars stratified by size class shows that infrequent large fires are responsible for the majority of burned area. These large fires display positive trends over many ecoregions, whereas smaller fires, albeit more frequent, have been decreasing in number. The final fire classification scheme shows well defined spatially-aggregated groups, where trends are found to be the key factor to evaluate fire within their regional contexts. Results presented here provide new insights to improve fire management strategies under a changing climate.

The role of anthropogenic habitats in freshwater mussel conservation.

Anthropogenic freshwater habitats may provide undervalued prospects for long-term conservation as part of species conservation planning. This fundamental, but overlooked, issue requires attention considering the pace that humans have been altering natural freshwater ecosystems and the accelerated levels of biodiversity decline in recent decades. We compiled 709 records of freshwater mussels (Bivalvia, Unionida) inhabiting a broad variety of anthropogenic habitat types (from small ponds to large reservoirs and canals) and reviewed their importance as refuges for this faunal group. Most records came from Europe and North America, with a clear dominance of canals and reservoirs. The dataset covered 228 species, including 34 threatened species on the IUCN Red List. We discuss the conservation importance and provide guidance on how these anthropogenic habitats could be managed to provide optimal conservation value to freshwater mussels. This review also shows that some of these habitats may function as ecological traps owing to conflicting management practices or because they act as a sink for some populations. Therefore, anthropogenic habitats should not be seen as a panacea to resolve conservation problems. More information is necessary to better understand the trade-offs between human use and the conservation of freshwater mussels (and other biota) within anthropogenic habitats, given the low number of quantitative studies and the strong biogeographic knowledge bias that persists.

Neuropsychological profile of amyloid-positive versus amyloid-negative amnestic Mild Cognitive Impairment.

INTRODUCTION: Patients diagnosed with amnestic mild cognitive impairment (aMCI) are at high risk of progressing to dementia. It became possible, through the use of biomarkers, to diagnose those patients with aMCI who have Alzheimer's disease. However, it is presently unfeasible that all patients undergo biomarker testing. Since neuropsychological testing is required to make a formal diagnosis of aMCI, it would be interesting if it could be used to predict the amyloid status of patients with aMCI. METHODS: Participants with aMCI, known amyloid status (Aß+ or Aß-) and a comprehensive neuropsychological evaluation, were selected from the Cognitive Complaints Cohort database for this study. Neuropsychological tests were compared in Aß+ and Aß- aMCI patients. A binary logistic regression analysis was conducted to model the probability of being amyloid positive. RESULTS: Of the 216 aMCI patients studied, 117 were Aß+ and 99 were Aß-. Aß+ aMCI patients performed worse on several memory tests, namely Word Total Recall, Logical Memory Immediate and Delayed Free Recall, and Verbal Paired Associate Learning, as well as on Trail Making Test B, an executive function test. In a binary logistic regression model, only Logical Memory Delayed Free Recall retained significance, so that for each additional score point in this test, the probability of being amyloid positive decreased by 30.6%. The resulting model correctly classified 64.6% of the aMCI cases regarding their amyloid status. CONCLUSIONS: The neuropsychological assessment remains an essential step to diagnose and characterize patients with aMCI; however, neuropsychological tests have limited value to distinguish the aMCI patients who have amyloid pathology from those who might suffer from other clinical conditions.

Associations between Trace Elements and Cognitive Decline: An Exploratory 5-Year Follow-Up Study of an Elderly Cohort.

Trace elements (TE) homeostasis is crucial in normal brain functioning. Although imbalances have the potential to exacerbate events leading neurodegenerative diseases, few studies have directly addressed the eventual relationships between TE levels in the human body and future cognitive status. The present study aimed to assess how different TE body-levels relate to cognitive decline. This exploratory research included a study-group (RES) of 20 elderly individuals living in two Portuguese geographical areas of interest (Estarreja; Mértola), as well as a 20 subjects neuropsychological control-group (CTR). Participants were neuropsychologically assessed through the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) and the RES group was biomonitored for TE through fingernail analysis. After 5 years, the cognitive assessments were repeated. Analyses of the RES neuropsychological data showed an average decrease of 6.5 and 5.27 points in MMSE and MoCA, respectively, but TE contents in fingernails were generally within the referenced values for non-exposed individuals. Higher levels of Nickel and Selenium significantly predicted lesser cognitive decline within 5 years. Such preliminary results evidence an association between higher contents of these TE and higher cognitive scores at follow-up, suggesting their contribution to the maintenance of cognitive abilities. Future expansion of the present study is needed in order to comprehensively assess the potential benefits of these TE.

Time travelling through local ecological knowledge regarding an endangered species.

European freshwater pearl mussel (Margaritifera margaritifera) populations are declining despite a growing effort to conserve them. Here we used a combination of local ecological knowledge (LEK) and field sampling to assess past and current distribution and conservation status of this endangered species in Cávado and Neiva Rivers (Portugal). We performed face-to-face interviews in both rivers and sampled the entire area where the respondents confirmed the historical presence of this species. Abiotic characterization, water quality and fish diversity were also assessed in both rivers. We found that freshwater pearl mussels are now possibly extinct in Cávado River but almost 50% of the respondents confirm its presence in the past, especially elders that lived in villages near its historical distribution. To the contrary, and although the species is still present in Neiva River, only 3.8% of the respondents remembered its presence in the past. In both rivers, respondents suggested pollution as the most important explanation for the freshwater pearl mussels decline. However, nowadays both rivers present excellent water quality and trout Salmo trutta (the freshwater pearl mussel fish host) is still abundant. Since we identified the areas where the species was present in a recent past, this information is vital for possible management actions with the aim of re-introduce or increase the abundance of M. margaritifera populations and/or for the rehabilitation of habitats in both rivers. We also highlight the vital importance of getting LEK, mainly from elders, in order to avoid shifting baseline syndromes and to get qualitative accurate information of past references and/or experience with historical conditions. Results reported here reinforce concern about the conservation status of freshwater pearl mussel populations in Portugal and can be used to guide future research and management initiatives to better conserve this species.

Neuropsychological Contribution to Predict Conversion to Dementia in Patients with Mild Cognitive Impairment Due to Alzheimer's Disease.

BACKGROUND: Diagnosis of Alzheimer's disease (AD) confirmed by biomarkers allows the patient to make important life decisions. However, doubt about the fleetness of symptoms progression and future cognitive decline remains. Neuropsychological measures were extensively studied in prediction of time to conversion to dementia for mild cognitive impairment (MCI) patients in the absence of biomarker information. Similar neuropsychological measures might also be useful to predict the progression to dementia in patients with MCI due to AD. OBJECTIVE: To study the contribution of neuropsychological measures to predict time to conversion to dementia in patients with MCI due to AD. METHODS: Patients with MCI due to AD were enrolled from a clinical cohort and the effect of neuropsychological performance on time to conversion to dementia was analyzed. RESULTS: At baseline, converters scored lower than non-converters at measures of verbal initiative, non-verbal reasoning, and episodic memory. The test of non-verbal reasoning was the only statistically significant predictor in a multivariate Cox regression model. A decrease of one standard deviation was associated with 29% of increase in the risk of conversion to dementia. Approximately 50% of patients with more than one standard deviation below the mean in the z score of that test had converted to dementia after 3 years of follow-up. CONCLUSION: In MCI due to AD, lower performance in a test of non-verbal reasoning was associated with time to conversion to dementia. This test, that reveals little decline in the earlier phases of AD, appears to convey important information concerning conversion to dementia.

A tale of shells and claws: The signal crayfish as a threat to the pearl mussel Margaritifera margaritifera in Europe.

The freshwater pearl mussel Margaritifera margaritifera is a highly threatened species in Europe. Several mechanisms may be responsible for the decline in distribution and abundance of European pearl mussel populations, but almost no quantitative data exists about the possible negative impacts of invasive alien species (IAS). In this study, we clearly demonstrate that the invasive signal crayfish Pacifastacus leniusculus predates pearl mussels, using a laboratorial experiment followed by in situ validation in four rivers in the North of Portugal (Mente, Rabaçal, Tuela and Baceiro Rivers; Douro Basin). In the laboratory, the crayfish had a clear preference for small-sized pearl mussels but no differences in predation were found in mesocosms with and without sediment. In addition, we clearly demonstrated that the signal crayfish predates pearl mussels in natural conditions and detected a significant density dependent effect (i.e., sites with more crayfish presented higher number of pearl mussel shells with marks of predation). Given the recent introduction of the signal crayfish and the potential negative impacts on pearl mussel populations we also investigated its autoecology (distribution, abundance, size structure and sex-ratio) in the four studied rivers. Significant differences in average abundance and size of the crayfish were detected between sites and the sex-ratio was highly skewed to females. In view of the widespread distribution of signal crayfish (and other invasive crayfish species) in Europe, future management actions devoted to the conservation of pearl mussels should take in consideration the possible negative effects of these predators, especially on juveniles.