Association between neuropsychological assessment and amyloid status in a clinical setting.

OBJECTIVE: Large research cohorts show robust associations between neuropsychological tests and Alzheimer's disease (AD) biomarkers, but studies in clinical settings are limited. The increasing availability of AD biomarkers to the practicing clinician makes it important to understand the relationship between comprehensive clinical neuropsychological assessment and biomarker status. This study examined concordance between practicing clinical neuropsychologists' diagnostic impressions and AD biomarker status in patients seen at an outpatient medical center, with a secondary aim of defining the characteristics of discordant cases. METHOD: Participants (N = 79) seen for clinical neuropsychological assessment who subsequently underwent lumbar puncture or amyloid positron emission tomography imaging were identified via retrospective chart review. Concordance between clinical neuropsychological diagnosis (non-AD, indeterminate, possible/probable AD) and AD biomarker status (negative, indeterminate, positive) was determined. Individual test score data were used to examine between-group differences based on amyloid status. RESULTS: AD biomarker positive and negative patients did not differ on individual neuropsychological tests after correcting for multiple comparisons, though the small number of AD biomarker indeterminate individuals performed better than biomarker positive patients. However, there was 76.7% concordance between neuropsychologists' diagnostic impressions and AD biomarker status (88% sensitivity and 55% specificity of neuropsychological assessment in detecting AD biomarker status). AD biomarker negative patients diagnosed as possible/probable AD (discordant) versus non-AD (concordant) had significantly lower Neuropsychological Assessment Battery Story Delayed Recall, higher Wechsler Adult Intelligence Scale-Fourth Edition Coding, and higher Trail-Making A (i.e., an amnestic memory profile). CONCLUSIONS: Comprehensive neuropsychological assessment showed modest concordance with AD biomarker status in patients seen in an outpatient medical center for routine clinical care. Low specificity for the clinical diagnosis of AD could be explained by the multiplicity of etiologies that cause memory impairment (i.e., TAR DNA-binding protein 43, suspected non-AD pathology). (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Risk and Planning in Agriculture: How Planning on Dairy Farms in Ireland Is Affected by Farmers' Regulatory Focus.

This article examines how planning on dairy farms is affected by farmers' motivation. It argues that farmers' choice of expansion strategies can be specified in terms of risk decision making and understood as either prevention-focused or promotion-focused motivation. This relationship was empirically examined using mediated regression analyses where promotion/prevention focus was the independent variable and its effect on total milk production via planned expansion strategies was examined. The results indicate that promotion focus among farmers has an indirect effect on farm expansion via planning strategies that incur greater risk to the farm enterprise. Regulatory focus on the part of farmers has an influence on farmers' planning and risk management activities and must be accounted for in the design and implementation of policy and risk management tools in agriculture.

Promoting personal resources and reducing exhaustion through positive work reflection among caregivers.

The aim of this study was to test the effects of a daily positive work reflection intervention on fostering personal resources (i.e., hope and optimism) and decreasing exhaustion (i.e., emotional exhaustion and fatigue) among caregivers for the elderly and caregivers who provide services at patients' homes. Using an intervention/waitlist control group design, 46 caregivers in an intervention group were compared with 44 caregivers in a control group at 3 points of measurement: pre-intervention, post-intervention, and at a 2-week follow-up. The results show that emotional exhaustion and fatigue were reduced for the intervention group. Primarily, caregivers with a high need for recovery at baseline benefited from the intervention. The results reveal no intervention effects for personal resources; however, they reveal a trend that the intervention led to an increase in hope and optimism among caregivers with a high need for recovery. Overall, the findings show that caregivers benefit from a daily positive work reflection intervention, particularly when their baseline levels of resources and well-being are low. (PsycINFO Database Record