A Novel Game-Based Intelligent Test for Detecting Elderly Cognitive Function Impairment.

PURPOSES: This research explores the game-based intelligent test (GBIT), predicts the possibilities of Mini-Mental State Examination (MMSE) scores and the risk of cognitive impairment, and then verifies GBIT as one of the reliable and valid cognitive assessment tools. METHODS: This study recruited 117 elderly subjects in Taiwan (average age is 79.92 ± 8.68, average height is 156.91 ± 8.01, average weight is 59.14 ± 9.67, and average MMSE score is 23.33 ± 6.16). A multiple regression model was used to analyze the GBIT parameters of the elderly's reaction, attention, coordination, and memory to predict their MMSE performance. The binary logistic regression was then utilized to predict their risk of cognitive impairment. The statistical significance level was set as α = 0.05. RESULTS: Multiple regression analysis showed that gender, the correct number of reactions, and the correct number of memory have a significantly positive predictive power on MMSE of the elderly (F = 37.60, R 2 = 0.69, and p < 0.05). Binary logistic regression analysis noted that the correct average number of reactions falls by one question, and the ratio of cognitive dysfunction risk increases 1.09 times (p < 0.05); the correct average number of memory drops by one question, the ratio of cognitive dysfunction risk increases 3.76 times (p < 0.05), and the overall model predictive power is 88.20% (sensitivity: 84.00%; specificity: 92.30%). CONCLUSIONS: This study verifies that GBIT is reliable and can effectively predict the cognitive function and risk of cognitive impairment in the elderly. Therefore, GBIT can be used as one of the feasible tools for evaluating older people's cognitive function.

The secular trend of intelligence test scores: The Danish experience for young men born between 1940 and 2000.

The present study investigated the Danish secular trend of intelligence test scores among young men born between 1940 and 2000, as well as the possible associations of birth cohort changes in family size, nutrition, education, and intelligence test score variability with the increasing secular trend. The study population included all men born from 1940 to 2000 who appeared before a draft board before 2020 (N = 1,556,770). At the mandatory draft board examination, the approximately 19-year-old men underwent a medical examination and an intelligence test. In the statistical analyses, the IQ mean and standard deviation (SD) were estimated separately for each of the included annual birth cohorts based on information from birth cohorts with available total intelligence test scores for all tested individuals (i.e. 1940-1958 and 1987-2000; the mean and SD were interpolated for the intermediate birth cohorts). Moreover, the possible associations with birth cohort changes in family size, height as a proxy for nutritional status, education, and IQ variability were investigated among those birth cohorts for whom a secular increase in intelligence test scores was found. The results showed that the estimated mean IQ score increased from a baseline set to 100 (SD: 15) among individuals born in 1940 to 108.9 (SD: 12.2) among individuals born in 1980, since when it has decreased. Focusing on the birth cohorts of 1940-1980, for whom a secular increase in intelligence test scores was found, birth cohort changes in family size, height, and education explained large proportions of the birth cohort variance in mean intelligence test scores, suggesting that these factors may be important contributors to the observed Flynn effect in Denmark.

Research Involving Participants With Impaired Consent Capacity: An Examination of Methods to Determine Capacity to Consent.

OBJECTIVE: To examine methods of assessing consent capacity in research protocols involving participants with impaired consent capacity, and examine instruments used to evaluate research consent capacity. METHODS: A retrospective review of 330 active research protocols involving participants lacking capacity to consent over a 10-year period (January 1, 2009, through March 1, 2019) was conducted to collect protocol characteristics (medical specialty, level of risk and type of study, consent and assent procedures, and type of vulnerable or protected population). Methods to assess consent capacity are described, and instruments to assess consent capacity are summarized. RESULTS: The specialties most frequently involving participants with impaired consent capacity in research were Neurology (27.3%), Critical Care (16.7%), and Surgery (10%). Type of studies are observational (43.9%), clinical trials (33%), chart review (11.5%), biobank (6.1%), and biomarker (5.5%). Minimal risk (53.3%) outnumbered greater than minimal risk (46.7%) studies. Most obtained written informed consent (77%) and assent (40.9%). The most common method to assess consent capacity was direct assessment by investigators (32.7%). Only 86 (26%) studies used instruments to assess consent capacity. Of the 13 instruments used, the most common was the Evaluation of Decision-Making Capacity for Consent to Act as a Research Subject, and is the only instrument that assesses all four components of decisional capacity: understanding, appreciation, reasoning, and choice. CONCLUSION: Generally, there was lack of uniformity in determining capacity to consent to research participation. Very few studies used instruments to assess consent capacity. Institutional review boards can provide greater guidance for research consent capacity determination.

The biochemical subtype is a predictor for cognitive function in glutaric aciduria type 1: a national prospective follow-up study.

The aim of the study was a systematic evaluation of cognitive development in individuals with glutaric aciduria type 1 (GA1), a rare neurometabolic disorder, identified by newborn screening in Germany. This national, prospective, observational, multi-centre study includes 107 individuals with confirmed GA1 identified by newborn screening between 1999 and 2020 in Germany. Clinical status, development, and IQ were assessed using standardized tests. Impact of interventional and non-interventional parameters on cognitive outcome was evaluated. The majority of tested individuals (n = 72) showed stable IQ values with age (n = 56 with IQ test; median test age 11 years) but a significantly lower performance (median [IQR] IQ 87 [78-98]) than in general population, particularly in individuals with a biochemical high excreter phenotype (84 [75-96]) compared to the low excreter group (98 [92-105]; p = 0.0164). For all patients, IQ results were homogenous on subscale levels. Sex, clinical motor phenotype and quality of metabolic treatment had no impact on cognitive functions. Long-term neurologic outcome in GA1 involves both motor and cognitive functions. The biochemical high excreter phenotype is the major risk factor for cognitive impairment while cognitive functions do not appear to be impacted by current therapy and striatal damage. These findings implicate the necessity of new treatment concepts.

Atomoxetine in Attention-Deficit/Hyperactivity Disorder in Children With and Without Comorbid Mood Disorders.

Objectives: Mood disorders are commonly associated with attention-deficit/hyperactivity disorder (ADHD), adding to the clinical complexity. Some symptoms associated with ADHD are often associated with an increase in emotional disorders and depression. Hence, the management of comorbid mood symptoms in the context of ADHD represents a particularly difficult clinical challenge. Few studies in literature, and probably none in the Arab world, have investigated the impact of individual common comorbid disorders on the efficacy of atomoxetine (a nonstimulant norepinephrine reuptake inhibitor) as a monotherapy for the treatment of these comorbid mood symptoms. Therefore, our aim was to investigate the effect of atomoxetine in a sample of drug-naive Egyptian children with ADHD, with and without comorbid mood disorders. Methods: A prospective, naturalistic, open-label study. Results: Atomoxetine is an effective treatment for the symptoms of ADHD in the presence of comorbid mood disorder, but with a slower rate of improvement than if applied in the absence of mood disorder; in addition, our study showed improvement regarding the depressive symptoms in the mood group after 1 month. Conclusions: The study highlighted that atomoxetine is an effective treatment for ADHD in the presence of comorbid mood disorder, and improves depressive symptoms in the mood group. It also predicts mild resistance to the effects of atomoxetine on ADHD with slower improvement than those with ADHD only.

The relationship between premorbid intelligence and symptoms of severe anorexia nervosa restricting type.

The purposes of this study were as follows: to compare premorbid IQ with present IQ in patients with more severe anorexia nervosa restricting type (AN-R) and to investigate the relationship between decreasing IQ and symptoms in patients with severe AN-R. Twenty-two participants were recruited (12 were AN-R patients; 10 were healthy controls). The average BMI in AN-R patients and healthy controls was 12.65 and 19.82, respectively. We assessed the outcomes using the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III), the Japanese Adult Reading Test, The Eating Disorders Inventory-2 (EDI-2), Beck Depression Scale-2 (BDI-2) and State-Trait Anxiety Index. In two-way ANOVA, there were significant interactions for the FIQ and PIQ. Only in the AN-R group, a significant single main effect of time was evidenced for the FIQ and PIQ. In the AN-R group, a significantly high positive correlation was found between changes in the PIQ and the body dissatisfaction subscale of the EDI-2. These findings raise the possibility that in patients with severe AN-R, an excessive decrease in body weight induces decreased PIQ; as a result, they have worse dissatisfaction with their body shape.

Long-Term Neurocognitive Outcomes of Spring-Assisted Surgery versus Cranial Vault Remodeling for Sagittal Synostosis.

BACKGROUND: A long-term neurocognitive comparison of patients with sagittal synostosis who underwent spring-assisted surgery or cranial vault remodeling has not been performed. METHODS: Patients with sagittal synostosis who underwent spring-assisted surgery or cranial vault remodeling were recruited from Wake Forest School of Medicine and Yale School of Medicine, respectively. Cognitive tests administered included an abbreviated intelligence quotient, academic achievement, and visuomotor integration. An analysis of covariance model compared cohorts controlling for demographic variables. RESULTS: Thirty-nine spring-assisted surgery and 36 cranial vault remodeling patients were included in the study. No significant differences between cohorts were found with respect to age at surgery, sex, race, birth weight, family income, or parental education. The cranial vault cohort had significantly older parental age (p < 0.001), and mean age at testing for the spring cohort was significantly higher (p = 0.001). After adjusting for covariates, the cranial vault cohort had significantly higher verbal intelligence quotient (116.5 versus 104.3; p = 0.0024), performance intelligence quotient (109.2 versus 101.5; p = 0.041), and full-scale intelligence quotient (114.3 versus 103.2; p = 0.0032). When included patients were limited to intelligence quotients from 80 to 120, the cranial vault cohort maintained higher verbal (108.0 versus 100.4; p = 0.036), performance (104.5 versus 97.7; p = 0.016), and full-scale (107.6 versus 101.5; p = 0.038) intelligence quotients. The cranial vault cohort had higher visuomotor integration scores than the surgery group (111.1 versus 98.1; p < 0.001). There were no significant differences in academic achievement. CONCLUSIONS: Sagittal synostosis patients who underwent cranial vault remodeling had higher intelligence quotient and visuomotor integration scores. There were no differences in academic achievement. Both cohorts had intelligence quotient scores at or above the normal range. Further studies are warranted to identify factors that may contribute to cognitive outcome differences. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

Similarities and differences in psycho-educational assessments of adolescents with specific language impairments and specific learning disabilities: A challenging differential diagnosis.

Specific Language Impairment (SLI) and Specific Learning Disabilities (SLD) have been the subject of extensive research especially with respect to the connection between them. However, the manifestation of these disorders in adolescence has not been thoroughly investigated. The objective of the present study was to compare the intelligence scores and the reading, oral and written language skills of Greek adolescents with SLI and Greek adolescents with SLD, as assessed during their psycho-educational evaluation, in order to clear the path for diagnosis and intervention. 124 Greek adolescents diagnosed with Specific Learning Disabilities and 76 Greek adolescents diagnosed with Specific Language Impairment aged from 11 to 16 years took part in the study. All participants were assessed in reading, oral language and written language skills and took part in IQ testing. Independent samples t-test, chi-square test, odds ratios and their 95 percent confidence intervals were implemented to determine statistically significant differences. Analyses revealed differences in IQ scores and some differences in the skills assessed, thus indicating that SLI adolescents exhibited more difficulties across most of the basic academic skills, whereas SLD adolescents' difficulties confined to the affected written language skills. Specifically, the observed difference was statistically significant for the total and verbal IQ score, and WISC-III scores also disclosed a significant difference for the similarities and information defisub- tests. Regarding reading skills, SLI adolescents were 4.9 times more likely to exhibit line skipping, 5.8 times more likely to exhibit hesitations, 3.2 times more likely to exhibit repetitions of syllables/words/ phrases, and 8.5 times more likely to exhibit non-acknowledgement of punctuation. Regarding reading comprehension, adolescents with SLI were more likely to have difficulty in retrieving simple information questions, making inferences, and giving titles. Adolescents with SLI were also more likely to have difficulties in story reproduction, giving synonyms/opposites, oral sentence reproduction and auditory oral word reproduction. In the area of written language skills, SLI adolescents were more likely to have poor handwriting, poor content, poor structure, and poor use of punctuation. In adolescence, Specific Language Impairment can be a different manifestation of an ongoing language disorder, which finally appears as a different type of Specific Learning Disability, but with a more generalized nature of learning difficulties. This finding should be interpreted in terms of the importance of differential diagnosis, especially during the challenging period of adolescence.

High IQ in Early Adulthood Is Associated with Parkinson's Disease.

BACKGROUND: High education level and high occupational complexity have been implicated as risk factors for Parkinson's disease (PD). OBJECTIVE: The objective was to determine whether cognitive capacity, measured as IQ, in early adulthood is associated with the subsequent development of PD. METHOD: Data on IQ were retrieved from the Swedish Military Service Conscription Registry, comprising Swedish males who enlisted for military service in the period 1968-1993 (N = 1,319,235). After exclusion, 1,189,134 subjects in total were included in the present study. Individuals who later developed PD (N = 1,724) were identified using the Swedish National Patient Register and the Swedish Cause of Death Register. RESULTS: High education level was associated with PD. High IQ was associated with PD (p < 0.0001), both when analyzed as a continuous variable and when divided into three categories. The hazard ratio for the high IQ category compared to the low IQ category was 1.35 (95% confidence interval 1.17-1.55). Strong test results on the subtests, measuring verbal, logic, visuospatial and technical abilities, were also associated with PD. In a subgroup, smoking was inversely associated with PD, as well as with IQ. CONCLUSIONS: This study identifies high IQ to be a risk factor for PD.

Diffusion modeling and intelligence: Drift rates show both domain-general and domain-specific relations with intelligence.

Several previous studies reported relationships between speed of information processing as measured with the drift parameter of the diffusion model (Ratcliff, 1978) and general intelligence. Most of these studies utilized only few tasks and none of them used more complex tasks. In contrast, our study (N = 125) was based on a large battery of 18 different response time tasks that varied both in content (numeric, figural, and verbal) and complexity (fast tasks with mean RTs of ca. 600 ms vs. more complex tasks with mean RTs of ca. 3,000 ms). Structural equation models indicated a strong relationship between a domain-general drift factor and general intelligence. Beyond that, domain-specific speed of information processing factors were closely related to the respective domain scores of the intelligence test. Furthermore, speed of information processing in the more complex tasks explained additional variance in general intelligence. In addition to these theoretically relevant findings, our study also makes methodological contributions showing that there are meaningful interindividual differences in content specific drift rates and that not only fast tasks, but also more complex tasks can be modeled with the diffusion model. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Body mass index and height in relation to type 2 diabetes by levels of intelligence and education in a large cohort of Danish men.

Socioeconomic status (SES) is inversely associated with risks of type 2 diabetes (T2D). We investigated if young men's cognitive function, measured by intelligence test scores and educational level, as determinants of SES modified associations between body mass index (BMI) and height with the risk of T2D. 369 989 young men from the Danish Conscription Database born between 1939 and 1959 with information on measured height, weight, intelligence test scores, and education were linked to the Danish National Patient Register. During follow-up from 1977 through 2015, T2D was recorded in 32 188 men. Hazard ratios (HR) and 95% confidence intervals (95% CI) were estimated by Cox regressions. BMIs below-average (z-scores ≤ 0) were not related to risks of T2D. For BMIs above-average (z-scores > 0), positive associations between BMI and T2D were slightly stronger among men with higher intelligence test scores or longer educations than among men with lower levels of these factors (pinteraction-values < 0.004). Irrespective of BMI, incidence rates of T2D were higher among men with low levels of intelligence test score and education. Height was inversely associated with T2D (per z-score, HR = 0.96 (95% CI 0.95-0.97) and the association did not vary by intelligence test scores or education (all pinteraction-values > 0.59). While below-average BMI was not associated with T2D risk, above-average BMIs were and these association were stronger among men with high cognitive function. Nevertheless, T2D risk was higher at lower levels of cognitive function throughout the range of BMI. Height was inversely associated with T2D and it was not modified by cognitive function.

Metacognition across domains: Is the association between arithmetic and metacognitive monitoring domain-specific?

Metacognitive monitoring is a critical predictor of arithmetic in primary school. One outstanding question is whether this metacognitive monitoring is domain-specific or whether it reflects a more general performance monitoring process. To answer this conundrum, we investigated metacognitive monitoring in two related, yet distinct academic domains: arithmetic and spelling. This allowed us to investigate whether monitoring in one domain correlated with monitoring in the other domain, and whether monitoring in one domain was predictive of performance in the other, and vice versa. Participants were 147 typically developing 8-9-year-old children (Study 1) and 77 typically developing 7-8-year-old children (Study 2), who were in the middle of an important developmental period for both metacognitive monitoring and academic skills. Pre-registered analyses revealed that within-domain metacognitive monitoring was an important predictor of arithmetic and spelling at both ages. In 8-9-year-olds the metacognitive monitoring measures in different academic domains were predictive of each other, even after taking into account academic performance in these domains. Monitoring in arithmetic was an important predictor of spelling performance, even when arithmetic performance was controlled for. Likewise, monitoring in spelling was an important predictor of arithmetic performance, even when spelling performance was controlled for. In 7-8-year-olds metacognitive monitoring was domain-specific, with neither correlations between the monitoring measures, nor correlations between monitoring in one domain and performance in the other. Taken together, these findings indicate that more domain-general metacognitive monitoring processes emerge over the ages from 7 to 9.

Intelligence gain and social cost savings attributable to environmental lead exposure reduction strategies since the year 2000 in Flanders, Belgium.

BACKGROUND: Recent lead (Pb) exposure reduction strategies enabled to lower children's blood lead levels (B-Pb) worldwide. This study reports the estimated intelligence gain and social cost savings attributable to recent exposure reduction based on reported B-Pb levels observed in adolescents sampled within the framework of the Flemish Environment and Health Studies (FLEHS, Belgium), i.e. in 2003-2004 (FLEHSI), in 2008-2009 (FLEHSII), and in 2013-2014 (FLEHSIII). METHODS: Intelligence Quotient (IQ) loss per 100,000 individuals - attributable to B-Pb above 20 µg/L - was estimated based on widely accepted dose response functions between children's B-Pb and IQ (- 1.88 IQ points for a duplication in B-Pb from 20 µg/L onwards; 95% Confidence Interval (CI): - 1.16;-2.59) and B-Pb exposure distribution parameters of FLEHS studies. The results were translated to the Flemish population of 15-year-olds. Given a 3-year time gap between subsequent sampling periods, the exposure distribution of each study was assumed 3 years prior to the study as well. Economic impact was estimated based on expected decrease in lifetime earnings (€ 19,464 per decreasing IQ point in 2018). RESULTS: The percentage of the adolescent population exceeding a B-Pb of 20 µg/L decreased from 57% (FLEHSI) to 23% (FLEHSII), and even further to 2.5% (FLEHSIII). The estimated IQ loss per 100,000 individuals was 94,280 (95% CI: 58,427-130,138) in FLEHSI, 14,993 (95% CI: 9289-20,695) in FLEHSII, and 976 (95% CI: 604-1347) in FLEHSIII. This translates into a total loss of 378,962 (95%CI: 234,840-523,091) IQ points within the Flemish population of 15-year-olds between 2000 and 2014. Assuming that current exposure levels do not reincrease, the expected IQ loss during the subsequent period of 15 years is estimated to be maximally 10,275 (95%CI: 6363-14,182) points. CONCLUSIONS: 7176 (95%CI: 4447-9905) million € of social cost savings were achieved by Pb reduction strategies in Flanders over 15 years. If current exposure levels further reduce to B-Pb below 20 µg/L for the whole population, social cost savings may increase up to 7376 (95%CI: 4571-10,181) million €. Given the relatively low lead contamination in Flanders, the global impact of ongoing reduction strategies is expected to be tremendous.

IQ over 130 and phobia: correlation, consequences and other psychopathologies.

BACKGROUND: Nowadays, anxiety disorders are becoming more and more important in our population. And if there is one category of people more vulnerable to this problem, it is the teenagers. In addition, more and more children and teenagers are diagnosed with an IQ greater than 130, causing all the stress and questions that it generates. In this project, we are comparing two groups of adolescents, one with an IQ over 130, the other with an IQ less than 130. We are wondering if there is any difference between these groups, in terms of phobia and other psychopathologies. SUBJECTS AND METHODS: A sample of 35 teenagers, from 12 to 16 years old, separated in two groups (IQ over 130 and IQ below 130), fulfilled the following questionnaires: the School Rehabilitation Assessment Scale-Revised (SARS-R), the "Family Adaptability and Cohesiveness Evaluation Scale III" (FACES III), and the "Kiddie- SADS-lifetime" (K-SADS-PL), and a social data collection questionnaire. RESULTS: At the end of this study, we can retain the following relevant elements: adolescents with IQs greater than 130 are statistically more likely to be the eldest siblings (Cochran Test F=9.159, p=0.010). They do not develop more phobias, but are more shy (t=4.375, p=0.036) than the control population. These high-potential and shy teenagers have a whole list of commonalities, such as being easily irritable, being easily distracted, ect... They have fewer friends in real life (t=2.255, p=0.033), fewer virtual friends (t=4.346, p=0.000) and fewer virtual relationships (t=2.431, p=0.021). Their families are very cohesive (Test t=0.004). There is no significant role of the socio-professional class of parents playing in the value of the IQ of their children (t=4.667, p=0.323). CONCLUSION: To conclude, being a teenager and having an IQ greater than 130 is not always a pleasure. Our results showed us that the majority of these young people consider themselves as shy, unsure of themselves and claim to have many fears. This is evidence of an increased anxiety component compared to the control sample. It seems important to insist on the need to be able and to know how to identify these young people as soon as possible, in order to propose appropriate therapeutic management.

Intelligence Test Scores Before and After Alcohol-Related Disorders-A Longitudinal Study of Danish Male Conscripts.

BACKGROUND: Existing studies on intellectual consequences of alcohol-related disorders are primarily cross-sectional and compare intelligence test scores of individuals with and without alcohol-related disorders, hence mixing the influence of alcohol-related disorders and predisposing factors such as premorbid intelligence. In this large-scale study, the primary aim was to estimate associations of alcohol-related disorders with changes in intelligence test scores from early adulthood to late midlife. METHODS: Data were drawn from a follow-up study on middle-aged men, which included a re-examination of the same intelligence test as completed in young adulthood at military conscription (total analytic sample = 2,499). Alcohol-related hospital diagnoses were obtained from national health registries, whereas treatment for alcohol problems was self-reported at follow-up. The analyses included adjustment for year of birth, retest interval, baseline intelligence quotient (IQ) score, education, smoking, alcohol consumption, and psychiatric and somatic comorbidity. RESULTS: Individuals with alcohol-related hospital diagnoses (8%) had a significantly lower baseline IQ score (95.0 vs. 100.5, p < 0.001) and a larger decline in IQ scores from baseline to follow-up (-8.5 vs. -4.8, p < 0.001) than individuals without such diagnoses. The larger decline in IQ scores with alcohol-related hospital diagnoses remained statistically significant after adjustment for all the covariates. Similar results were revealed when IQ scores before and after self-reported treatment for alcohol problems (10%) were examined. CONCLUSIONS: Individuals with alcohol-related disorders have a lower intelligence test score both in young adulthood and in late midlife, and these disorders, moreover, seem to be associated with more age-related decline in intelligence test scores. Thus, low mean intellectual ability observed in individuals with alcohol-related disorders is probably a result of both lower premorbid intelligence and more intellectual decline.

A benchmark concentration analysis for manganese in drinking water and IQ deficits in children.

BACKGROUND: Manganese is an essential nutrient, but in excess, can be a potent neurotoxicant. We previously reported findings from two cross-sectional studies on children, showing that higher concentrations of manganese in drinking water were associated with deficits in IQ scores. Despite the common occurrence of this neurotoxic metal, its concentration in drinking water is rarely regulated. OBJECTIVE: We aimed to apply a benchmark concentration analysis to estimate water manganese levels associated with pre-defined levels of cognitive impairment in children, i.e. drop of 1%, 2% and 5% in Performance IQ scores. METHODS: Data from two studies conducted in Canada were pooled resulting in a sample of 630 children (ages 5.9-13.7 years) with data on tap water manganese concentration and cognition, as well as confounders. We used the Bayesian Benchmark Dose Analysis System to compute weight-averaged median estimates for the benchmark concentration (BMC) of manganese in water and the lower bound of the credible interval (BMCL), based on seven different exposure-response models. RESULTS: The BMC for manganese in drinking water associated with a decrease of 1% Performance IQ score was 133 µg/L (BMCL, 78 µg/L); for a decrease of 2%, this concentration was 266 µg/L (BMCL, 156 µg/L) and for a decrease of 5% it was 676 µg/L (BMCL, 406 µg/L). In sex-stratified analyses, the manganese concentrations associated with a decrease of 1%, 2% and 5% Performance IQ in boys were 185, 375 and 935 µg/L (BMCLs, 75, 153 and 386 µg/L) and 78, 95, 192 µg/L (BMCLs, 9, 21 and 74 µg/L) for girls. CONCLUSION: Studies suggest that a maximum acceptable concentration for manganese in drinking water should be set to protect children, the most vulnerable population, from manganese neurotoxicity. The present risk analysis can guide decision-makers responsible for developing these standards.

Low socioeconomic status and severe obesity are linked to poor cognitive performance in Malaysian children.

BACKGROUND: Socioeconomic factors and nutritional status have been associated with childhood cognitive development. However, previous Malaysian studies had been conducted with small populations and had inconsistent results. Thus, this present study aims to determine the association between socioeconomic and nutritional status with cognitive performance in a nationally representative sample of Malaysian children. METHODS: A total of 2406 Malaysian children aged 5 to 12 years, who had participated in the South East Asian Nutrition Surveys (SEANUTS), were included in this study. Cognitive performance [non-verbal intelligence quotient (IQ)] was measured using Raven's Progressive Matrices, while socioeconomic characteristics were determined using parent-report questionnaires. Body mass index (BMI) was calculated using measured weight and height, while BMI-for-age Z-score (BAZ) and height-for-age Z-score (HAZ) were determined using WHO 2007 growth reference. RESULTS: Overall, about a third (35.0%) of the children had above average non-verbal IQ (high average: 110-119; superior: ≥120 and above), while only 12.2% were categorized as having low/borderline IQ (< 80). Children with severe obesity (BAZ > 3SD), children from very low household income families and children whose parents had only up to primary level education had the highest prevalence of low/borderline non-verbal IQ, compared to their non-obese and higher socioeconomic counterparts. Parental lack of education was associated with low/borderline/below average IQ [paternal, OR = 2.38 (95%CI 1.22, 4.62); maternal, OR = 2.64 (95%CI 1.32, 5.30)]. Children from the lowest income group were twice as likely to have low/borderline/below average IQ [OR = 2.01 (95%CI 1.16, 3.49)]. Children with severe obesity were twice as likely to have poor non-verbal IQ than children with normal BMI [OR = 2.28 (95%CI 1.23, 4.24)]. CONCLUSIONS: Children from disadvantaged backgrounds (that is those from very low income families and those whose parents had primary education or lower) and children with severe obesity are more likely to have poor non-verbal IQ. Further studies to investigate the social and environmental factors linked to cognitive performance will provide deeper insights into the measures that can be taken to improve the cognitive performance of Malaysian children.

Evidence for subjective emotional numbing following induced acute dissociation.

The aim of the study was to examine the effects of acute dissociation on emotional responsivity in healthy individuals. We used a previously validated technique (mirror-gazing, Caputo, 2010) to experimentally induce acute dissociation in non-clinical participants and assessed post-induction subjective responsivity (ratings of valence and arousal) to standardized emotional images. Fifty non-clinical participants were randomised to either the dissociation induction (n = 25) or control conditions (n = 25). The dissociation manipulation effect was corroborated by a significant post-induction elevation in state dissociation in the dissociation-induction group relative to controls (p = .004). The dissociation-induction group rated negative (p = .028) and neutral (p = .025) stimuli as significantly less unpleasant than controls. There was also a non-significant trend for positive stimuli to be rated as less pleasant by the dissociation-induction group compared to controls (p = .060). These findings provide experimental evidence for the short-term alleviation (i.e., emotional numbing) of negative affect during dissociative states, which may serve as a coping mechanism for some individuals. However, this tendency of emotional numbing also reduced positive affective responses to pleasant stimuli to some extent. Further investigation of dissociative phenomena and their impact on emotional processing appears warranted.

Cognition level and change in cognition during adolescence are associated with cognition in midlife.

PURPOSE: Cognitive development during adolescence affects health long term. We investigated whether level of and change in language-based cognition during adolescence are associated with cognitive performance in midlife. METHODS: Participants were enrolled in the Child Health and Development Study and followed during midlife (47-52 years). Adolescent cognition was measured with the Peabody Picture Vocabulary Test at ages 9-11 years (PPVT-9) and 15-17 years (PPVT-15). We examined PPVT-9, as well as a PPVT change score (derived using the standardized regression-based method) in relation to midlife cognition measures of Wechsler Test of Adult Reading, Verbal Fluency, and Digit Symbol tests. Linear regression models were adjusted for childhood socioeconomic status, age, sex, race, and midlife marital status, education, and occupational score. RESULTS: In 357 participants (52.1% female, 25.6% African American), both PPVT-9 (ß [95% confidence interval [CI] = 0.26 [0.18, 0.34]) and PPVT change score (ß [95% CI] = 2.03 [1.27, 2.80]) were associated with Wechsler Test of Adult Reading at midlife. PPVT-9 was associated with midlife Verbal Fluency (ß [95% CI] = 0.18 [0.10, 0.25]), whereas PPVT change score was not (ß [95% CI] = -0.01 [-0.68, 0.67]). Neither PPVT-9 nor PPVT change score was associated with midlife Digit Symbol. CONCLUSIONS: Both level of and change in language-based cognition during adolescence were associated with midlife vocabulary and language function, even after controlling for midlife occupation and education.