Predictive value of somatic and functional variables for cognitive deterioration for early-stage patients with Alzheimer's Disease: Evidence from a prospective registry on dementia.

Alzheimer's disease (AD) imposes a major burden on affected individuals, their caregivers and health-care systems alike. Though quite many risk factors for disease progression have been identified, there is a lack of prospective studies investigating the interplay and predictive value of a wide variety of patient variables associated with cognitive deterioration (defined as key feature of AD progression). Study participants were patients with probable and possible AD, that were assessed at four time points over a period of two years (T1-T4). The main results were threefold: (i) over time, significant changes were observed regarding patients' cognitive functioning, activities of daily living and caregiver load (but not depression, pain, neuropsychiatric symptoms); (ii) intercorrelations between caregiver load and patients' cognitive and functional variables were high, correlation patterns remaining rather stable across time; (iii) cognitive functioning at T4 was best predicted by patients' age, sex, atrial fibrillation and activities of daily living at T1; and (iv) across all four assessment points, cognitive functioning was best predicted by time (i.e., disease duration), age, sex, activities of daily living and depression. Overall, even in early stages of AD and during a short two-year period, functional changes were significant and tightly intertwined with caregiver load, thus stressing the need to consider caregiver load when diagnosing and treating patients with AD. A novel and clinically relevant finding is that even in early stages of AD, cognitive deterioration was best predicted by a combination of patients' demographic, somatic and functional variables.

Evidence for Two Types of Task Conflict in a Color-Digit Stroop Task.

In the present study, we conducted a Stroop-like task in which the participants were required to decide whether the presented stimulus, which could be either a colored digit or a colored rectangle, consisted of more or less than five colors. Like other Stroop-like tasks, the stimuli could be congruent (the stimulus was a digit that was equal to the presented number of colors), incongruent (the stimulus was a digit that was different than the presented number of colors), or neutral (a colored rectangle). We utilized a two-to-one response setting so that in some incongruent trials the digit and the number of colors would elicit the same response (e.g., the digit 3 containing two colors; both are smaller than 5), while in some incongruent trials, the digit and the number of colors would elicit different responses (e.g., the digit 3 containing 6 colors). This enabled us to measure both conflicts arising from stimulus-stimulus and stimulus-response compatibilities. Our results indicated the existence of stimulus-stimulus compatibility (SSC), stimulus-response compatibility (SRC), and task conflict. Interestingly, these effects were in interaction with the number of colors, so that in small numbers, SSC and SRC were found, and in large numbers, SRC and task conflict were found. Moreover, the results suggest that our task includes two types of task conflict that are raised due to three different tasks: processing the meaning of the digit vs. estimating the number of colors and counting the number of colors vs. estimating the number of colors.

Effect of oxygen supplementation on cognitive performance among HEMS providers after acute exposure to altitude: the HEMS II randomized clinical trial.

IMPORTANCE: Emergency medical services (EMS) providers transiently ascend to high altitude for primary missions and secondary transports in mountainous areas in helicopters that are unpressurised and do not have facilities for oxygen supplementation. The decrease in cerebral oxygen saturation can lead to impairment in attention and reaction time as well as in quality of care during acute exposure to altitude. OBJECTIVE: The primary aim of the current study was to investigate the effect of oxygen supplementation on cognitive performance in Helicopter EMS (HEMS) providers during acute exposure to altitude. DESIGN, SETTING, AND PARTICIPANTS: This interventional, randomized, controlled, double-blind, cross-over clinical trial was conducted in October 2021. Each trial used a simulated altitude scenario equivalent to 4000 m, in which volunteers were exposed to hypobaric hypoxia with a constant rate of ascent of 4 m/s in an environmental chamber under controlled, replicable, and safe conditions. Trials could be voluntarily terminated at any time. Inclusion criteria were being members of emergency medical services and search and rescue services with an age between 18 and 60 years and an American Society of Anesthesiologists physical status class I. EXPOSURES: Each participant conducted 2 trials, one in which they were exposed to altitude with oxygen supplementation (intervention trial) and the other in which they were exposed to altitude with ambient air supplementation (control trial). MAIN OUTCOMES AND MEASURES: Measurements included peripheral oxygen saturation (SpO2), cerebral oxygenation (ScO2), breathing and heart rates, Psychomotor Vigilance Test (PVT), Digit-Symbol Substitution Test (DSST), n-Back test (2-BACK), the Grooved Pegboard test, and questionnaires on subjective performance, stress, workload, and positive and negative affect. Paired t-tests were used to compare conditions (intervention vs. control). Data were further analyzed using generalized estimating equations (GEE). RESULTS: A total of 36 volunteers (30 men; mean [SD] age, 36 [9] years; mean [SD] education, 17 [4] years) were exposed to the intervention and control trials. The intervention trials, compared with the control trials, had higher values of SpO2 (mean [SD], 97.9 [1.6] % vs. 86 [2.3] %, t-test, p = 0.004) and ScO2 (mean [SD], 69.9 [5.8] % vs. 62.1 [5.2] %, paired t-test, p = 0.004). The intervention trials compared with the control trials had a shorter reaction time (RT) on the PVT after 5 min (mean [SD], 277.8 [16.7] ms vs. 282.5 [15.3] ms, paired t-test, p = 0.006) and after 30 min (mean [SD], 276.9 [17.7] ms vs. 280.7 [15.0] ms, paired t-test, p = 0.054) at altitude. While controlling for other variables, there was a RT increase of 0.37 ms for each % of SpO2 decrease. The intervention trials showed significantly higher values for DSST number of correct responses (with a difference of mean [SD], 1.2 [3.2], paired t-test, p = 0.035). Variables in the intervention trials were otherwise similar to those in the control trials for DSST number of incorrect responses, 2-BACK, and the Grooved Pegboard test. CONCLUSIONS AND RELEVANCE: This randomized clinical trial found that oxygen supplementation improves cognitive performance among HEMS providers during acute exposure to 4000 m altitude. The use of oxygen supplementation may allow to maintain attention and timely reaction in HEMS providers. The impact of repeated altitude ascents on the same day, sleep-deprivation, and additional stressors should be investigated. Trial registration NCT05073406, ClinicalTrials.gov trial registration.

Short-Term Medication Effect on Fall Risk in Multimorbid Inpatients with Dementia.

INTRODUCTION: Dementia increases the risk of falls and fall-related injuries, which may be caused by inappropriate medication use. To date, there is little evidence on which medications are more likely to cause falls. We therefore investigated the effects of medication use and medication changes 48 h before falls in hospitalised patients with dementia. METHODS: This matched case-control study included 74 patients with a mean age of 83 years (38% women) who had been hospitalised for at least 7 days. Information on medications, diagnoses, disease severity, use of walking aids, falls, and demographics was collected from electronic medical records. The effects of the number of medications and psychotropics, equivalent daily doses of antidepressants, antipsychotics and benzodiazepines, anticholinergic burden, medication initiation, dose change, medication discontinuation, as-needed medications, opioid use and the presence of fall-increasing diseases were examined separately for the periods 0 h-24 h and 24 h-48 h before the falls using binomial logistic regression analyses. RESULTS: Falls increased significantly with higher daily antipsychotic doses 24 h before the fall. In addition, the rate of falls increased with higher anticholinergic burden and prevalence of medication discontinuation 24-48 h before the fall. Notably, the total number of medications and psychotropic medications had no effect on the incidence of falls. CONCLUSION: With regard to the short-term effects of medication on fall risk, particular attention should be paid to the daily dose of antipsychotics, anticholinergic burden and medication discontinuation. Further studies with larger samples are needed to confirm the results of this study.

Preventive Effect of a 7-Week App-Based Passive Psychoeducational Stress Management Program on Students.

Passive psychoeducation is an easily accessible and cost-effective self-guided intervention that does not use elements of active psychotherapies or require homework. The present study aimed to investigate the acceptability and efficacy of a 7-week app-based passive psychoeducation stress management program to promote adaptive emotion regulation and coping skills in university students (i.e., 80% psychology students). Participants were tested via Lime-Survey® at pre- and post-test with the Depression Anxiety Stress Scale-21 (DASS-21), the Response Styles Questionnaire (RSQ), and the Emotion Regulation Questionnaire (ERQ). A stratified permutation block randomization by age, gender, and the DASS-21 stress subscale was performed. Each week, the psychoeducation group (n = 123) received different psychoeducation modules. At the end of each module, participants answered questions about their satisfaction with each module and adherence to psychoeducation. The control group (n = 130) received no intervention. The psychoeducation program led to a significant improvement in the adaptive emotion regulation strategy: "reappraisal" (p = 0.004) and a significant reduction in the dysfunctional coping style: "symptom-related rumination" (p = 0.01) but not to a significant reduction in depression, anxiety, and stress scores compared to the control group. Thus, the present study might demonstrate a preventive effect of an app-based passive psychoeducation program in students with low clinically relevant psychopathological symptoms.

Insights from Eye Blinks into the Cognitive Processes Involved in Visual Word Recognition.

Behavioral differences in speed and accuracy between reading familiar and unfamiliar words are well-established in the empirical literature. However, these standard measures of skill proficiency are limited in their ability to capture the moment-to-moment processing involved in visual word recognition. In the present study, the effect of word familiarity was initially investigated using an eye blink rate among adults and children. The probability of eye blinking was higher for familiar (real) words than for unfamiliar (pseudo)words. This counterintuitive pattern of results suggests that the processing of unfamiliar (pseudo)words is more demanding and perhaps less rewarding than the processing of familiar (real) words, as previously observed in both behavioral and pupillometry data. Our findings suggest that the measurement of eye blinks might shed new light on the cognitive processes involved in visual word recognition and other domains of human cognition.

The contribution of difficulty of an irrelevant task to task conflict.

In the standard colour-word Stroop task, participants are presented with colour words and required to respond to their colour while ignoring their meaning. Two types of conflict might occur in such experiments: information conflict and task conflict. Information conflict reflects the processing of two contradicting pieces of information and is indicated by shorter reaction times (RTs) in congruent than in incongruent trials. Task conflict reflects the additional effort associated with performing two tasks, as opposed to one, and is indicated by shorter RTs in neutral trials than in congruent trials (termed reverse facilitation). While information conflict is commonly seen in Stroop and Stroop-like tasks, task conflict is rarely observed. In the present study, participants were presented with coloured segments that, by applying Gestalt principles, could be perceived as colour words. We found that incongruent trials were slower than congruent trials, suggesting that participants successfully perceived the colour words, which led to involuntary reading. In addition, reversed facilitation was found so that neutral trials (i.e., trials that only consist of one task) were faster than congruent trials (as well as incongruent trials; both consist of two tasks). The presence of both interference from the incongruent trials and reverse facilitation suggests that involuntary reading could also occur in scenarios requiring cognitive effort.

Learning to be inventive in the face of statistics: A positive reappraisal intervention for statistics anxiety.

BACKGROUND AND OBJECTIVES: The burden of statistics anxiety on students calls for effective interventions. This study investigated whether a cognitive reappraisal training designed to stimulate the generation of positive re-interpretations may yield behavioral changes in anxiety measures and changes in cerebral activation patterns reflecting the activation of approach/avoidance motivational tendencies (frontal EEG alpha asymmetry response). METHODS: Three groups of female psychology students (n = 45) with statistics anxiety were tested. Two groups received a guided, two-week reappraisal training with either statistics-anxiety or general anxiety situations; the control group received no intervention. RESULTS: Both training groups significantly increased their amount of positive re-interpretations from pre-to post-test compared to the control group. Increased habitual use of reappraisal in statistics situations and significant EEG changes reflecting more approach-oriented coping with anxiety occurred in the statistics-anxiety training group only. No changes in statistics anxiety and statistics attitudes were observed, suggesting that the training effects, though corroborated through neurophysiological changes, did not sufficiently translate to improving students' deep-rooted anxiety. LIMITATIONS: Effects, though robust and following the same pattern, were observed in a small sample. CONCLUSIONS: Our findings delineate a promising expandable approach for helping students' cope with statistics anxiety in a healthier way.

Humor creation during efforts to find humorous cognitive reappraisals of threatening situations.

This interdisciplinary study examined the structure of humor creation in the specific context of efforts to positively reappraise stressful situations for effective coping. In a sample of n = 101 participants, a performance test was used to assess the quantity (fluency, number of generated ideas that qualified as humor) and quality (rated funniness) of humor creation in cognitive reappraisal. Linguistic mechanisms were identified and quantified using cognitive-linguistic methods of corpus analysis, and their employment was correlated with humor production performance on the level of the individual. Almost all individuals were able to come up with reappraisal ideas that qualified as humorous. Depressive symptoms, a negative mood state, and high perceptions of threat did not compromise the participants' capability to create humor. Individuals who were more serious-minded as a trait produced ideas that were rated as less funny, but their basic ability to create humor was unaffected. Metonymy (a contiguity-based principle of meaning extension) emerged as by far the most prominent semantic mechanism in the creation of humorous re-interpretations. Furthermore, its use was related to good humor creation performance in terms of quantity and quality, which is in line with its assumed importance in the extension of meaning in general and the creation of humor in particular. Further effective linguistic mechanisms and conceptual phenomena were identified. The empirical data may be valuable for the development of interventions involving the creation of humorous ideas for cognitive reappraisal.

Impact of repeated morning bright white light exposures on attention in a simulated office environment.

Attention is essential to the work. This study investigated the effects of two different light pulses on a simple attention task. In addition, the effects of subsequent exposure to constant but different illuminance levels on the continuation of the simple attention task and a subsequent complex attention task were examined. A total of 56 subjects were assigned in random order to two white light interventions that were repeated five times during the morning. Each light intervention consisted of a brief light pulse followed by constant light exposure and differed in temporal dimming dynamics and corneal illuminance. Subjective and psychometric parameters were recorded several times during light exposure. Heart rate variability (HRV) was derived from continuous electrocardiograms. Subjects showed improved reaction speed in the simple attention task, accompanied by higher HRV under a brighter light pulse without habituation by repetition. This difference in simple attention performance disappeared when light exposure remained the same after the light pulse. In addition, higher reaction speed and HRV were observed in the complex attention task under constant bright light exposure. Intermittent bright light seems promising to acutely improve attentional performance in office workplaces. Future research is needed to investigate daytime light effects on other work-related cognitive functions.

Different Facets of Creativity in Employees Covering Non-Clinical to Clinical Manifestations of Burnout.

Empirical studies exploring the relationship between burnout and creativity are very rare. In the present study, a well-defined group of clinical burnout patients (n = 75) and two groups of working people showing high (n = 39) vs. low burnout symptoms (n = 62) were investigated. Participants completed various creativity tests including self-assessed facets of creativity, as well as psychometric measures of figural and verbal creativity. Furthermore, we examined individual and clinical characteristics that may influence creativity in burnout patients, such as depression, sleep quality, daytime fatigue, and cognitive measures (i.e., selective attention and executive control). The clinical burnout group scored lowest in all creativity tasks and cognitive tests. Additionally, they showed lower nighttime sleep quality and higher depression scores. However, creativity scores in both groups of working people were largely comparable, indicating that only more severe (i.e., clinical) manifestations of burnout are linked to creativity.

Simulated Acute Hypobaric Hypoxia Effects on Cognition in Helicopter Emergency Medical Service Personnel - A Randomized, Controlled, Single-Blind, Crossover Trial.

OBJECTIVE: To evaluate, under replicable, blinded and standardised conditions, the effect of acute exposure to hypobaric hypoxia (HH) (equivalent to 200 or 3000 or 5000 m above sea level (asl)) on selected cognitive domains and physiological parameters in personnel of helicopter emergency medical service (HEMS). METHODS: We conducted a randomized clinical trial using a single-blind crossover design in an environmental chamber (terraXcube) to induce HH in 48 HEMS personnel. Participants performed cognitive tests (CT) before the ascent, after 5 min at altitude, and after simulated cardiopulmonary resuscitation (SCR). CT evaluated: sustained attention using the psychomotor vigilance test (PVT) that included measurement of reaction time (RT); risky decision making using the balloon analogue risk task (BART), and attention and speed of processing using the digit symbol substitution test (DSST). CT performance was subjectively rated with a visual analogue scale (VAS). Physiological data were recorded with a physiological monitoring system. Data were analysed using a linear mixed model and correlation analysis. RESULTS: Mean reaction time was significantly slower (p = 0.002) at HH (5000 m asl), but there were no independent effects of HH on the other parameters of the PVT, BART or DSST. Participants did not detect subjectively the slower RT at altitude since VAS performance results showed a positive correlation with mean RT (p = 0.009). DSST results significantly improved (p = 0.001) after SCR. CONCLUSION: Acute exposure of HEMS personnel to HH induced a slower RT but no changes in any other investigated measures of cognition. The reduced RT was not detected subjectively by the participants. Trial number 3489044136, ClinicalTrials.gov trial registration.

Self-efficacy matters: Influence of students' perceived self-efficacy on statistics anxiety.

Statistical knowledge is a key competency for psychologists in order to correctly interpret assessment outcomes. Importantly, when learning statistics (and its mathematical foundations), self-efficacy (defined as an individual's belief to successfully accomplish specific performance attainments) is a central predictor of students' motivation to learn, learning engagement, and actual achievement. Therefore, it is crucial to gain a better understanding of students' self-efficacy for statistics and its interrelations with statistics anxiety and students' belief in the relevance of statistics. Here, we present results showing development and validation of a self-assessment questionnaire for examining self-efficacy for statistics in psychology students (Self-Efficacy for Learning Statistics for Psychologists, SES-Psy). Upon using different methodological approaches, we demonstrate that the SES-Psy questionnaire has (1) sound psychometric properties, and within our sample of university students, (2) a robust latent structure disclosing three clearly distinctive profiles that are characterized by a complex and nonlinear interplay between perceived self-efficacy (for basic and advanced statistics), statistics anxiety, and students' belief in the relevance of statistics. Implications for educational settings and future research are discussed.

Creative, yet not unique? Paranormal belief, but not self-rated creative ideation behavior is associated with a higher propensity to perceive unique meanings in randomness.

Apophenia, patternicity, and the experience of meaningful coincidences describe the propensity to perceive meaning in random arrangements, which is known to be linked with paranormal beliefs. Additionally, this trait of combining unrelated elements to create new meanings suggests an association with creativity. However, studies indicating a relationship between creativity and apophenia are scarce. To gain empirical evidence, the present study (n = 77) assessed the propensity to experience meaningful patterns in random arrangements by means of a questionnaire (coincidence questionnaire) and a behavioral measure. The applied figural association task allows to reliably differentiate between the perception of idiosyncratic/unique and intersubjective meaningful/non-unique patterns. Self-rated creative ideation behavior and paranormal beliefs were positively associated with the subjectively rated frequency of meaningful coincidences. Furthermore, participants high in both creative ideation behavior and paranormal beliefs perceived a higher number of non-unique meanings in the figural association task. Yet, participants high in paranormal beliefs additionally perceived a higher number of unique meanings. This divergence in findings suggests that creative ideation behavior and paranormal belief are associated with the perception of partly different meanings in random arrangements. In paranormal believers, this pattern of findings may indicate a lower threshold to detect meaning in meaninglessness, leading to more idiosyncratic/unique perceptions. Altogether, slight reductions of this threshold to detect meaningfulness may increase a persons' creativity; however, excessive pattern recognition may facilitate paranormal beliefs.

Effects of dynamic bedroom lighting on measures of sleep and circadian rest-activity rhythm in inpatients with major depressive disorder.

Bright light therapy is an effective treatment option for seasonal and non-seasonal affective disorders. However up to now, no study has investigated effects of dynamic bedroom lighting in hospitalized patients with major depression. A bedroom lighting system, which automatically delivered artificial dawn and dusk and blue-depleted nighttime lighting (DD-N lighting) was installed in a psychiatric ward. Patients with moderate to severe depression were randomly assigned to stay in bedrooms with the new lighting or standard lighting system. Patients wore wrist actimeters during the first two treatment weeks. Additionally, hospitalization duration and daily psychotropic medication were retrieved from patients' medical charts. Data from thirty patients, recorded over a period of two weeks, were analyzed. Patients under DD-N lighting generally woke up earlier (+ 20 min), slept longer (week 1: + 11 min; week 2: + 27 min) and showed higher sleep efficiency (+ 2.4%) and shorter periods of nighttime awakenings (- 15 min). In the second treatment week, patients started sleep and the most active 10-h period earlier (- 33 min and - 64 min, respectively). This pilot study gives first evidence that depressed patients' sleep and circadian rest/activity system may benefit from bedroom lighting when starting inpatient treatment.

Disorder-Specific Profiles of Self-Perceived Emotional Abilities in Schizophrenia and Major Depressive Disorder.

Deficits in social cognition are a core feature of neuropsychiatric disorders. The purpose of this study was to compare profiles of self-perceived abilities across the core domains of emotional functioning between patients with schizophrenia (n = 22), major depressive disorder (n = 31) and healthy participants (n = 43) with the Self-report Emotional Ability Scale (SEAS). Profile analyses were used to explore group differences in the overall level of self-perceived effectiveness of emotional functioning and in the patterns in which the four functions of emotion perception and regulation in the intra- and inter-personal domains are arranged to each other. Both patient groups showed significantly lower overall levels of self-perceived emotional functioning compared to healthy controls. Most importantly, we found significant differences between patient groups in their profile patterns. Patients with schizophrenia indicated experiencing difficulties in all investigated domains, but the profile pattern largely matched that of healthy individuals. Instead, the profile of patients with depression was much more accentuated, showing lower perceived effectiveness of emotion perception and regulation in the intra-personal domain compared to inter-personal functions. Our results of disorder-specific emotional deficits may have profound implications for early screening and identification of at-risk populations as well as recovery-oriented interventions.

Light Intervention Effects on Circadian Activity Rhythm Parameters and Nighttime Sleep in Dementia Assessed by Wrist Actigraphy: A Systematic Review and Meta-Analysis.

BACKGROUND AND OBJECTIVES: Persons with dementia often show circadian rhythm disturbances and sleep problems. Timed light exposure seems to be a promising nonpharmacological treatment option. In this review, meta-analyses were run on light effects on circadian activity rhythm parameters in persons with dementia measured with wrist actimetry. Furthermore, we update a Cochrane review, published in 2014, on actigraphically measured light effects in nighttime sleep parameters in persons with dementia. RESEARCH DESIGN AND METHODS: Four electronic databases were searched for randomized controlled trials. Effects in meta-analyses were summarized by using mean differences and 95% confidence intervals. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to assess the risk of bias and registered the review protocol (PROSPERO: CRD42020149001). RESULTS: Thirteen trials met inclusion criteria, and either utilized light therapy devices, ambient room lighting systems, or dawn-dusk interventions. Eleven of these studies were subjected to meta-analyses. They did not reveal significant light effects on circadian activity parameters: amplitude (p = .62; n = 313), acrophase (p = .34; n = 313), intradaily variability (p = .51; n = 354), and interdaily stability (p = .38; n = 354). Furthermore, no light effects were found on sleep parameters: total sleep duration (p = .53; n = 594), sleep efficiency (p = .63; n = 333), wake after sleep onset (p = .95; n = 212), and sleep onset latency (p = .26; n = 156). Subgroup analyses, pooling data from 3 studies including persons with Alzheimer's dementia, also did not show light effects on circadian activity and sleep parameters. The overall risk of bias of included studies was high. DISCUSSION AND IMPLICATIONS: There is insufficient evidence for actigraphically measured circadian light effects in persons with dementia. More high-quality research is needed to recommend the application of adjunctive light.

Decision Making under Risk in Patients Suffering from Schizophrenia or Depression.

Studies have reported difficulties in decision making for patients with schizophrenia or depression. Here, we investigated whether there are differences between schizophrenia patients, depressed patients, and healthy individuals (HC) when decisions are to be made under risk and cognitive flexibility is required. We were also interested in the relationships between decision making, cognitive functioning, and disease severity. Thirty HC, 28 schizophrenia patients, and 28 depressed patients underwent structured clinical assessments and were assessed by the Positive and Negative Syndrome Scale or Hamilton Rating Scale. They performed the Probability-Associated Gambling (PAG) Task and a neuropsychological test battery. Both patient groups obtained lower scores than HC in memory and executive function measures. In the PAG task, relative to HC, depressed patients made slower decisions but showed a comparable number of advantageous decisions or strategy flexibility. Schizophrenia patients were slower, riskier, and less flexible compared to HC. For them, the decision making behavior correlated with the symptom severity. In both groups, decision making scores correlated with memory and executive function scores. Patients with schizophrenia or depression may have difficulties under risk when quick and flexible decisions are required. These difficulties may be more pronounced in patients who have marked cognitive deficits or severe clinical symptoms.

A Prospective Evaluation of the Acute Effects of High Altitude on Cognitive and Physiological Functions in Lowlanders.

Cognitive function impairment due to high altitude exposure has been reported with some contradictory results regarding the possible selective cognitive domain involvement. We prospectively evaluated in 36 lowlanders, exposed for 3 consecutive days to an altitude of 3,269 m, specific cognitive abilities (attention, processing speed, and decision-making) required to safely explore the mountains, as well as to work at altitude. We simultaneously monitored the physiological parameters. Our study provides evidence of a reduced processing speed in lowlanders when exposed to altitude in the first 24 h. There was a fairly quick recovery since this impairment was no more detectable after 36 h of exposure. There were no clinically relevant effects on decision-making, while psychomotor vigilance was unaffected at altitude except for individuals with poor sleep. Significant changes were seen in physiological parameters (increased heart rate and reduced peripheral oxygen saturation). Our results may have practical implications, suggesting that individuals should practice prudence with higher ascent when performing risky activities in the first 24-36 h, even at altitudes below 3,500 m, due to an impairment of the cognitive performance that could worsen and lead to accidents.

Unaffected Memory and Inhibitory Functioning Several Weeks Postpartum in Women with Pregnancy Complicated by Preeclampsia.

Several studies reported impaired cognitive functioning after pregnancy complicated by preeclampsia. The present study examined cognitive and executive functioning in women with preeclampsia at a time at which immediate effects of gestation have resolved, brain damage due to other risk factors have not yet manifested, and impairments may thus primarily occur as a result of the huge stress induced by the potentially life threatening condition. Verbal learning/memory (California Verbal Learning Test) and inhibitory functioning (Mittenecker Pointing Test) of 35 women with preeclampsia and 38 women with uncomplicated pregnancy were followed over five measurement time points during the period from 16 to 48 weeks postpartum. A further control group comprised 40 women with no history of recent pregnancy. The groups did not differ in their verbal learning/memory performance. Higher levels of currently experienced everyday-life stress were associated with poorer inhibitory control/greater stereotypy in responding, but this effect was not directly connected with pregnancy complications. Taken together, the findings do not indicate rapid-onset cognitive impairment after preeclampsia, brought about by its extremely stressful nature or other factors that take effect during gestation. Deficits observed in later life may develop on a long-term basis through late-diagnosed hypertension and unfavorable lifestyle factors. The large time window in which exaggerated cognitive decline can be prevented or mitigated should be utilized for the control of risk factors and interventions to improve lifestyle where appropriate.