Intensive assessment of executive functions derived from performance in cognitive training games.

Traditional neuropsychological tests accurately describe the current cognitive state but fall short to characterize cognitive change over multiple short time periods. We present an innovative approach to remote monitoring of executive functions on a monthly basis, which leverages the performance indicators from self-administered computerized cognitive training games (NUP-EXE). We evaluated the measurement properties of NUP-EXE in N = 56 individuals (59% women, 60-80 years) at increased risk of Alzheimer's disease (APOE-ϵ4 carriers with subjective cognitive decline) who completed a 12-month multimodal intervention for preventing cognitive decline. NUP-EXE presented good psychometric properties and greater sensitivity to change than traditional tests. Improvements in NUP-EXE correlated with improvements in functionality and were affected by participants' age and gender. This novel data collection methodology is expected to allow a more accurate characterization of an individual's response to a cognitive decline preventive intervention and to inform development of outcome measures for a new generation of intervention trials.

Prevention of cognitive decline in subjective cognitive decline APOE ε4 carriers after EGCG and a multimodal intervention (PENSA): Study design.

INTRODUCTION: Subjects exhibiting subjective cognitive decline (SCD) are at an increased risk for mild cognitive impairment and dementia. Given the delay between risk exposure and disease onset, SCD individuals are increasingly considered a good target population for cost-effective lifestyle-based Alzheimer's disease prevention trials. METHODS: The PENSA study is a randomized, double-blind, controlled clinical trial that aims to evaluate the efficacy of a personalized multimodal intervention in lifestyle (diet counseling, physical activity, cognitive training, and social engagement) combined with the use of epigallocatechin gallate (EGCG) over 12 months, in slowing down cognitive decline and improving brain connectivity. The study population includes 200 individuals meeting SCD criteria and carrying the apolipoprotein E ε4 allele, who will be randomized into four treatment arms (multimodal intervention + EGCG/placebo, or lifestyle recommendations + EGCG/placebo). The primary efficacy outcome is change in the composite score for cognitive performance measured with the Alzheimer's Disease Cooperative Study Preclinical Alzheimer Cognitive Composite (ADCS-PACC-like) adding to the original version the Interference score from the Stroop Color and Word Test and the Five Digit Test. Secondary efficacy outcomes are (1) change in functional magnetic resonance imaging (fMRI) and structural neuronal connectivity (structural MRI) and (2) the safety assessment of the EGCG compound. This study is framed within the WW-FINGERS consortium. DISCUSSION: The use of new technologies (i.e., mobile ecological momentary assessments [EMAs], activity tracker) in the PENSA study allows the collection of continuous data on lifestyle behaviors (diet and physical activity) and mood, enabling a personalized design as well as an intensive follow-up of participants. These data will be used to give feedback to participants about their own performance along the intervention, promoting their involvement and adherence. The results of the study may aid researchers on the design of future clinical trials involving preventive lifestyle multicomponent interventions.

Effects of COVID-19 Home Confinement on Mental Health in Individuals with Increased Risk of Alzheimer's Disease.

We explored the impact of the Spanish COVID-19 strict home confinement on mental health and cognition in non-infected subjects (N = 16, 60-80 years) diagnosed with subjective cognitive decline and APOEɛ3/ɛ4 carriers. Mental health was monitored for 2 months on a daily, weekly, or monthly basis, and compared to pre-confinement values. Emotional distress, anxiety, and depression scores increased to pathological threshold values during and after confinement. Those with lower mood during confinement experienced a decline in their mood after confinement. Cognition did not change. These preliminary results suggest that mental health consequences of corona measures in preclinical stages of Alzheimer's disease should be further evaluated.

La memoria de trabajo, capacidad y procedimientos, en el trastorno específico del lenguaje: análisis visual de eventos y su expresión oral / Working memory, ability and procedures in specific language impairment: visual analysis of events and their oral expression

Objetivo. Este estudio se enmarca en la perspectiva teórica de considerar las habilidades cognitivas como factores contribuyentes al trastorno específico del lenguaje (TEL). El propósito de la investigación es clarificar si se dan diferencias en los procedimientos empleados en la memoria de trabajo (MdT) de los TEL. El experimento comparativo realizado concierne a la percepción visual, la representación y la descripción de unas imágenes que ilustran eventos de tipo mental. Método. Se estudian 2 grupos de 13 niños y niñas, de entre 5 y 8 años, uno con TEL y otro de desarrollo normal (DN) de control. La tarea experimental, registrada con eye tracker y vídeo, consiste en el análisis visual de las áreas de interés de las imágenes mentales y su descripción oral, que requiere 2 verbos. Resultados. Las diferencias esperadas en el análisis visual no se han confirmado en su conjunto. Sí lo han sido para la fluidez, la velocidad en el inicio de la descripción, el desorden de los constituyentes y el tiempo empleado hasta el inicio de los verbos. Todos ellos son informativos de diferencias en los procesos de la MdT. Entre los TEL menores las diferencias han sido más amplias que entre los mayores. Conclusión. Las diferencias halladas apuntan a la existencia de múltiples procesamientos diferenciados en el grado de habilidad (datos temporales) y solo alguno, como la planificación y el orden de los constituyentes, son distintos. Estas diferencias son mucho más claras para los TEL menores (AU)

Purpose. This study is grounded on the perspective which holds that cognitive abilities contribute to the specific language impairment (SLI). The goal of this research is to find out if distinct procedures can be measures and identified in their working memory (WM). The task employed in the comparative experiment involves the visual analysis and perception of events, its representations and description of images depicting mental events. Method. Two groups of 13 children from 5 to 8 years old, SLI and a normal developing group (ND) conform the sample. The study comprises the eye tracked visual analysis of images illustrating mental events, and their video registered oral description that requires 2 verbs. Results. The results of the visual analysis have not supported the majority of predictions. They validated only the predictions about fluency, readiness in the beginning of the oral description, the clutter of constituents, and the time elapsed until uttering the verbs. All of them are informative about the processes hold in the WM. The differences with young SLI have been much more important than those found in the older groups. Conclusion. The results reflect some differences in the non verbal WM procedures, mainly in their level of cognitive proficiency (temporal data), and only some, like planning and constituent order have been found diverse. The differences are much more evident for the young SLI group (AU)