Adopting a child perspective for exposome research on mental health and cognitive development - Conceptualisation and opportunities.

Mental disorders among children and adolescents pose a significant global challenge. The exposome framework covering the totality of internal, social and physical exposures over a lifetime provides opportunities to better understand the causes of and processes related to mental health, and cognitive functioning. The paper presents a conceptual framework on exposome, mental health, and cognitive development in children and adolescents, with potential mediating pathways, providing a possibility for interventions along the life course. The paper underscores the significance of adopting a child perspective to the exposome, acknowledging children's specific vulnerability, including differential exposures, susceptibility of effects and capacity to respond; their susceptibility during development and growth, highlighting neurodevelopmental processes from conception to young adulthood that are highly sensitive to external exposures. Further, critical periods when exposures may have significant effects on a child's development and future health are addressed. The paper stresses that children's behaviour, physiology, activity pattern and place for activities make them differently vulnerable to environmental pollutants, and calls for child-specific assessment methods, currently lacking within today's health frameworks. The importance of understanding the interplay between structure and agency is emphasized, where agency is guided by social structures and practices and vice-versa. An intersectional approach that acknowledges the interplay of social and physical exposures as well as a global and rural perspective on exposome is further pointed out. To advance the exposome field, interdisciplinary efforts that involve multiple scientific disciplines are crucial. By adopting a child perspective and incorporating an exposome approach, we can gain a comprehensive understanding of how exposures impact children's mental health and cognitive development leading to better outcomes.

Neural correlates of statistical learning in developmental dyslexia: An electroencephalography study.

The human brain extracts statistical regularities from the surrounding environment in a process called statistical learning. Behavioural evidence suggests that developmental dyslexia affects statistical learning. However, surprisingly few studies have assessed how developmental dyslexia affects the neural processing underlying this type of learning. We used electroencephalography to explore the neural correlates of an important aspect of statistical learning - sensitivity to transitional probabilities - in individuals with developmental dyslexia. Adults diagnosed with developmental dyslexia (n = 17) and controls (n = 19) were exposed to a continuous stream of sound triplets. Every so often, a triplet ending had a low transitional probability given the triplet's first two sounds ("statistical deviants"). Furthermore, every so often a triplet ending was presented from a deviant location ("acoustic deviants"). We examined mismatch negativity elicited by statistical deviants (sMMN), and MMN elicited by location deviants (i.e., acoustic changes). Acoustic deviants elicited a MMN which was larger in the control group than in the developmental dyslexia group. Statistical deviants elicited a small, yet significant, sMMN in the control group, but not in the developmental dyslexia group. However, the difference between the groups was not significant. Our findings indicate that the neural mechanisms underlying pre-attentive acoustic change detection and implicit statistical auditory learning are both affected in developmental dyslexia.

Protective effect of restorative possibilities on cognitive function and mental health in children and adolescents: A scoping review including the role of physical activity.

Background The exposome approach can be a powerful tool for understanding the intertwining of social, physical, and internal influences that shape mental health and cognitive development throughout childhood. To distil conceptual models for subsequent analyses, the EU-funded project Early Environmental quality and Life-course mental health effects (Equal-Life) has conducted literature reviews on potential mediators linking the exposome to these outcomes. We report on a scoping review and a conceptual model of the role of restorative possibilities and physical activity. Methods Peer-reviewed studies published since the year 2000 in English, on the association between the exposome and mental health/cognition in children/adolescents, and quantitatively investigating restoration/restorative quality as a mediating variable were considered. Database searches were last updated in December 2022. We used an unstructured expert-driven approach to fill in gaps in the reviewed literature. Results Five records of three distinct studies were identified, indicating a scarcity of empirical evidence in this newly developing research area. Not only were these studies few in numbers, but also cross-sectional, lending only tentative support to the idea that perceived restorative quality of adolescent's living environment might mediate the association between greenspace and mental health. Physical activity emerged as a mediator leading to better psychological outcomes in restorative environments. We provide a critical discussion of potential caveats when investigating the restoration mechanism in children and propose a hierarchical model including restoration, physical activity, and relational dynamics between children and their environment, including social context, as well as restorative environments other than nature. Conclusions It is justified to further explore the role of restoration and physical activity as mediators in the association between early-life exposome and mental health/cognitive development. It is important to consider the child perspective and specific methodological caveats. Given the evolving conceptual definitions/operationalizations, Equal-Life will attempt to fill in a critical gap in the literature.

Performance feedback enhances test-potentiated encoding.

Introduction: Long-term memory retention is enhanced after testing compared to restudying (testing effect). Notably, memory retrieval further improves when correct-answer feedback is provided after the retrieval attempt (test-potentiated encoding-TPE). Methods: To evaluate whether explicit positive or negative feedback further enhances memory performance beyond the effect of TPE, in two experiments additional explicit positive or negative performance-contingent feedback was presented before providing correct-answer feedback. After an initial exposure to the full material, 40 participants learned 210 weakly associated cue-target word pairs by either restudying or testing (Experiment 1). Depending on the accuracy of the retrieval attempt, the tested word pairs were followed by positive or negative performance feedback (50%) or no feedback (50%). Irrespective of the type of repetition, trials were followed by a restudy opportunity. Participants returned to perform a final cued-recall test (Day 2). Results: Final test results replicated the testing effect (better memory performance for tested compared to restudied items). Explicit performance feedback in addition to correct-answer feedback increased retrieval performance, but only on Day 2. This pattern of results was replicated in Experiment 2 in an independent sample of 25 participants. To assess the specific effects of learning history, we also examined retrieval accuracy and reaction times during repetition cycles: Explicit feedback improved retrieval for material successfully encoded in the initial study phase (consistent positive feedback) as well as for material learned during the repetition phase (mixed positive and negative feedback). Discussion: Performance feedback improves learning beyond the effects of retrieval practice and correct-answer feedback, suggesting that it strengthens memory representations and promotes re-encoding of the material.

Creativity across the lifespan: changes with age and with dementia.

BACKGROUND: It is well known that older age is associated with losses in cognitive functioning. Less is known about the extent to which creativity is changing with age or dementia. Aim of the current study was to gain more insights into psychometric aspects of creativity in younger and older people as well as people with dementia. METHOD: Our sample comprised three groups, (1) participants between age 18-30 years (n = 24), (2) participants 65 + years without cognitive impairment (n = 24), and (3) participants 65 + years with cognitive impairment / dementia (n = 23). Cognitive abilities were assessed via the Standard Progressive Matrices Test (SPM), Montreal Cognitive Assessment Test (MoCa), and Trail Making Test (TMT). Creativity was assessed via the Creative Reasoning Task (CRT), Test of Creative Thinking-Drawing Production (TCT-DP), and Alternate Uses Task (AUT). RESULTS: Compared to younger people, older people scored significantly lower in only two out of eleven creativity sub-scores (one in the CRT and one in the TCT-DP). Performance in the SPM was significantly associated with these two sub-scores and age. Cognitively impaired older people had significantly lower scores in the creativity task AUT compared to cognitively healthy older people and younger people. The associations between MoCa and AUT scores were also significant. CONCLUSION: Creativity appears relatively stable in older age, with exception of those creativity skills that are affected by abstract reasoning (SPM), which appear susceptible to aging. As our findings suggest, cognitive impairment in older age might impair only some aspects of creativity with other creativity aspects being comparable to cognitively healthy people. The age-related and the cognitive status-related effects seem to be independent. The preserved creative abilities can be used in dementia care programs.

Irrelevant speech impairs serial recall of verbal but not spatial items in children and adults.

Immediate serial recall of visually presented items is reliably impaired by task-irrelevant speech that the participants are instructed to ignore ("irrelevant speech effect," ISE). The ISE is stronger with changing speech tokens (words or syllables) when compared to repetitions of single tokens ("changing-state effect," CSE). These phenomena have been attributed to sound-induced diversions of attention away from the focal task (attention capture account), or to specific interference of obligatory, involuntary sound processing with either the integrity of phonological traces in a phonological short-term store (phonological loop account), or the efficiency of a domain-general rehearsal process employed for serial order retention (changing-state account). Aiming to further explore the role of attention, phonological coding, and serial order retention in the ISE, we analyzed the effects of steady-state and changing-state speech on serial order reconstruction of visually presented verbal and spatial items in children (n = 81) and adults (n = 80). In the verbal task, both age groups performed worse with changing-state speech (sequences of different syllables) when compared with steady-state speech (one syllable repeated) and silence. Children were more impaired than adults by both speech sounds. In the spatial task, no disruptive effect of irrelevant speech was found in either group. These results indicate that irrelevant speech evokes similarity-based interference, and thus pose difficulties for the attention-capture and the changing-state account of the ISE.

Functional underpinnings of feedback-enhanced test-potentiated encoding.

The testing effect describes the finding that retrieval practice enhances memory performance compared to restudy practice. Prior evidence demonstrates that this effect can be boosted by providing feedback after retrieval attempts (i.e. test-potentiated encoding [TPE]). The present fMRI study investigated the neural processes during successful memory retrieval underlying this beneficial effect of correct answer feedback compared with restudy and whether additional performance feedback leads to further benefits. Twenty-seven participants learned cue-target pairs by (i) restudying, (ii) standard TPE including a restudy opportunity, or (iii) TPE including a restudy opportunity immediately after a positive or negative performance feedback. One day later, a cued retrieval recognition test was performed inside the MRI scanner. Behavioral results confirmed the testing effect and that adding explicit performance feedback-enhanced memory relative to restudy and standard TPE. Stronger functional engagement while retrieving items previously restudied was found in lateral prefrontal cortex and superior parietal lobe. By contrast, lateral temporo-parietal areas were more strongly recruited while retrieving items previously tested. Performance feedback increased the hippocampal activation and resulted in stronger functional coupling between hippocampus, supramarginal gyrus, and ventral striatum with lateral temporo-parietal cortex. Our results unveil the main functional dynamics and connectivity nodes underlying memory benefits from additional performance feedback.

Differential Effects of Task-Irrelevant Monaural and Binaural Classroom Scenarios on Children's and Adults' Speech Perception, Listening Comprehension, and Visual-Verbal Short-Term Memory.

Most studies investigating the effects of environmental noise on children's cognitive performance examine the impact of monaural noise (i.e., same signal to both ears), oversimplifying multiple aspects of binaural hearing (i.e., adequately reproducing interaural differences and spatial information). In the current study, the effects of a realistic classroom-noise scenario presented either monaurally or binaurally on tasks requiring processing of auditory and visually presented information were analyzed in children and adults. In Experiment 1, across age groups, word identification was more impaired by monaural than by binaural classroom noise, whereas listening comprehension (acting out oral instructions) was equally impaired in both noise conditions. In both tasks, children were more affected than adults. Disturbance ratings were unrelated to the actual performance decrements. Experiment 2 revealed detrimental effects of classroom noise on short-term memory (serial recall of words presented pictorially), which did not differ with age or presentation mode (monaural vs. binaural). The present results add to the evidence for detrimental effects of noise on speech perception and cognitive performance, and their interactions with age, using a realistic classroom-noise scenario. Binaural simulations of real-world auditory environments can improve the external validity of studies on the impact of noise on children's and adults' learning.

Processing emotional prosody in a foreign language: the case of German and Hebrew.

This study investigated the universality of emotional prosody in perception of discrete emotions when semantics is not available. In two experiments the perception of emotional prosody in Hebrew and German by listeners who speak one of the languages but not the other was investigated. Having a parallel tool in both languages allowed to conduct controlled comparisons. In Experiment 1, 39 native German speakers with no knowledge of Hebrew and 80 native Israeli speakers rated Hebrew sentences spoken with four different emotional prosodies (anger, fear, happiness, sadness) or neutral. The Hebrew version of the Test for Rating of Emotions in Speech (T-RES) was used for this purpose. Ratings indicated participants' agreement on how much the sentence conveyed each of four discrete emotions (anger, fear, happiness and sadness). In Experient 2, 30 native speakers of German, and 24 Israeli native speakers of Hebrew who had no knowledge of German rated sentences of the German version of the T-RES. Based only on the prosody, German-speaking participants were able to accurately identify the emotions in the Hebrew sentences and Hebrew-speaking participants were able to identify the emotions in the German sentences. In both experiments ratings between the groups were similar. These findings show that individuals are able to identify emotions in a foreign language even if they do not have access to semantics. This ability goes beyond identification of target emotion; similarities between languages exist even for "wrong" perception. This adds to accumulating evidence in the literature on the universality of emotional prosody. Supplementary Information: The online version contains supplementary material available at 10.1007/s41809-022-00107-x.

Is the dolphin a fish? ERP evidence for the impact of typicality during early visual processing in ultra-rapid semantic categorization in autism spectrum disorder.

BACKGROUND: Neurotypical individuals categorize items even during ultra-rapid presentations (20 ms; see Thorpe et al. Nature 381: 520, 1996). In cognitively able autistic adults, these semantic categorization processes may be impaired and/or may require additional time, specifically for the categorization of atypical compared to typical items. Here, we investigated how typicality structures influence ultra-rapid categorization in cognitively able autistic and neurotypical male adults. METHODS: Images representing typical or atypical exemplars of two different categories (food/animals) were presented for 23.5 vs. 82.3 ms (short/long). We analyzed detection rates, reaction times, and the event-related potential components dN150, N1, P2, N2, and P3 for each group. RESULTS: Behavioral results suggest slower and less correct responses to atypical compared to typical images. This typicality effect was larger for the category with less distinct boundaries (food) and observed in both groups. However, electrophysiological data indicate a different time course of typicality effects, suggesting that neurotypical adults categorize atypical images based on simple features (P2), whereas cognitively able autistic adults categorize later, based on arbitrary features of atypical images (P3). CONCLUSIONS: We found evidence that all three factors under investigation - category, typicality, and presentation time - modulated specific aspects of semantic categorization. Additionally, we observed a qualitatively different pattern in the autistic adults, which suggests that they relied on different cognitive processes to complete the task.

Olfactory sensory and perceptual evaluation in newborn infants: A systematic review.

Fetuses are able to process olfactory stimuli present in the womb and continue to show a preference for these odors for months after birth. Despite the accumulated knowledge about their early ability to perceive odors, there is a lack of validated scales for odor response in newborns. The evaluation of reactions of the olfactory system to environmental stimuli in infants has been defined by methodological theoretical approaches of experimental and clinical assessment tools. These approaches are mainly based on psychophysical approaches and predominantly use behavioral and physiological measures. Examples can be found in studies describing early abilities of newborn babies for behaviors or heart rate variability showing memory of maternal food preferences or mother's breast milk. This systematic review aimed to determine whether validated odor assessment tools can be feasibly used in studies. Particularly in light of the current COVID-19 pandemic and evidence of associated olfactory impairment resulting from SARS-COV-2 infection, the study is also motivated by the need for tools to assess olfactory function in neonates.

Olfactory sensory evaluation in newborn children of women infected with COVID-19 during pregnancy / Avaliação sensorial olfativa em crianças recémnascidas de mulheres infectadas com COVID-19 durante a gravidez

INTRODUCTION: In adults, olfactory loss is one of the earliest and most frequent acute clinical manifestations of SARS-CoV-2 infection. The number of children infected with SARS-CoV-2 is relatively small, perhaps due to the lower expression of Angiotensin Converting Enzyme 2 (ACE2) in children compared to adults. Little is known about foetal impairment in mothers infected with SARS-CoV-2. This paper describes an ongoing scientific project on smell perception in infantsOBJECTIVE: The goal of the study is to develop and validate a behavioural evaluative scale of olfactory perception in healthy newborns and to apply this scale to newborn children of women infected with COVID-19 during pregnancy comparing to newborn children of women without COVID-19 infection history, in order to compare these groupsMETHODS: This is a retrospective comparative analytical cohort study of 300 newborns exposed and unexposed to COVID-19 during pregnancy. The data collection will follow the experimental procedure in a previous study that explored odours of the maternal breastmilk, vanilla (sweet) and distilled water (neutral). A coffee smell was implemented as an addition to this previous study in order to include acid/bitterness category to the categories of stimuliDISCUSSION: It is feasible to argue the hypothesis of the involvement of the foetus' olfactory bulb as one of the indelible pathophysiological manifestations to the clinical diagnosis of COVID-19 with neurosensory olfactory deficit in foetuses and newborns affected by intrauterine infection. This study aims to investigate if newborn children of women infected with COVID-19 during pregnancy have olfactory sensory changes. The clinical trial was registered in the Brazilian Registry of Clinical Trials (ReBEC- RBR-65qxs2

INTRODUÇÃO: Em adultos, a perda olfativa é uma das manifestações clínicas agudas mais precoces e frequentes da infecção por SARS-CoV-2. O número de crianças infectadas com SARS-CoV-2 é pequeno, talvez devido à menor expressão da Enzima Conversora da Angiotensina 2 (ACE2) em crianças em comparação com adultos. Pouco se sabe sobre o comprometimento fetal em mães infectadas com SARS-CoV-2. Este artigo descreve um projeto em andamento sobre a percepção olfativa em bebês recém-nascidosOBJETIVO: o objetivo do presente estudo é desenvolver e validar uma escala de avaliação comportamental da percepção olfativa em recém-nascidos saudáveis e aplicá-la a recém-nascidos de mulheres infectadas com COVID-19 durante a gravidez e comparar a recém-nascidos de mulheres sem histórico de infecção por COVID-19MÉTODO: Este é um estudo de coorte analítico comparativo retrospectivo de 300 recém-nascidos expostos e não expostos ao COVID-19 durante a gravidez. A coleta de dados seguirá o procedimento experimental de estudo anterior que explorou odores do leite materno, baunilha (doce) e água destilada (neutro). Um cheiro de café foi implementado como um complemento a este estudo anterior, a fim de incluir a categoria ácido / amargo nas categorias de estímulosDISCUSSÃO: É possível argumentar a hipótese do envolvimento do bulbo olfatório do feto durante a vida intrauterina como uma das manifestações fisiopatológicas indeléveis para o diagnóstico clínico de COVID-19 com déficit olfatório neurossensorial em fetos e recém-nascidos afetados por infecção intrauterina. Este estudo tem como objetivo investigar se filhos recém-nascidos de mulheres infectadas com COVID-19 durante a gravidez apresentam alterações sensoriais olfativas. O ensaio clínico foi registrado no Registro Brasileiro de Ensaios Clínicos (ReBEC- RBR-65qxs2

Do categorical representations modulate early automatic visual processing? A visual mismatch-negativity study.

Perceptual categorization is an important cognitive function. In the auditory domain, categorization already occurs within the first 200 ms of information processing, as indexed by the mismatch negativity. Here, we assessed the characteristics of the visual mismatch negativity (vMMN) elicited during the categorization of previously unknown visual stimuli. To examine this, we used five-dot patterns with characteristics that allow for the formation of categories through rotation and reflection but not through other physical properties. To assess whether or not between-category and within-category vMMN differ in amplitude, the data was analyzed with the Bayesian approach. We observed that both between-category and within-category deviants elicited a vMMN, but that both vMMNs were comparable in magnitude. This finding suggests that abstract categorical representations are not always automatically processed at early visual stages and demonstrates limitations of generalization from the auditory domain to visual domain.

Development of a Digital Video-Based Occupational Risk Assessment Method.

The development and implementation of an observational video-based risk assessment is described. Occupational risk assessment is one of the most important yet also challenging tasks for employers. Most assessment tools to date use questionnaires, expert interviews, and similar tools. Video analysis is a promising tool for risk assessment, but it needs an objective basis. A video of a plastering worker was recorded using a 360° camera. The recording was then analyzed using the developed observational matrix concerning Work Characteristics, Work Activities as well as potential risks. Risk factors present during the video of the work included lifting, fall from ladder, hazardous substances as well as occasionally bad posture. The worker had no or just one risk factor present during most of the time of the video recording, while only 16 s with more than one risk factor present according to the observational matrix. The paper presents a promising practical method to assess occupational risks on a case-by-case basis. It can help with the risk assessment process in companies which is required by law in some industrialized countries. The matrix in combination with video analysis is a first step toward digital observational risk assessment. It can also be the basis of an automated risk assessment process.

[Effects of the Computer-Based Grapho-Phonological Training Lautarium in Children with Developmental Dyslexia]. / Wirksamkeit des computergestützten grapho-phonologischen Trainingsprogramms Lautarium bei Kindern mit Lese-Rechtschreib-Störung.

Effects of the Computer-Based Grapho-Phonological Training Lautarium in Children with Developmental Dyslexia The effects of the computer-based training program Lautarium on phonological awareness and literacy skills were investigated in 41 third-grade children with developmental dyslexia who attended special dyslexia classes in a primary school in Saxony, Germany. Based on the proven efficacy of phonics-based instruction, Lautarium combines training of phoneme perception and phonological awareness with training of grapheme-phoneme-relationships and reading and spelling of transparent words. In addition, rapid access from written words to meaning is included. The children of the training group (N = 27) worked through the program during school lessons, 5 times per week for 30 minutes, for a period of 7 weeks. During the training period, the controls (N = 14) received traditional remedial reading instruction, 2-3 times per week, in small groups. Children's performance in phonological awareness, reading, and spelling was assessed at three time points (pretest, immediate posttest, and follow-up after 9 weeks). Pretest scores did not differ between groups. For spelling and subtests of phonological awareness, group comparisons of raw scores at posttest and follow-up including the respective pretest score as covariate confirmed stronger improvements in the training group when compared to the controls. Effect sizes were medium to strong. For reading, improvements did not differ between groups. In both groups, standard scores (T-scores) for reading and spelling increased significantly and substantially across the study period (from pretest to follow-up). The results confirm the efficacy of computer-based training with Lautarium in children with dyslexia, and the efficacy of school-based remedial instruction provided in the dyslexia classes.

Do categorical representations modulate early perceptual or later cognitive visual processing? An ERP study.

Encoding of perceptual categorical information has been observed in later cognitive processing like memory encoding and maintenance, starting around 300 ms after stimulus onset (P300). However, it remains open whether categorical information is also encoded in early perceptual processing steps (reflected in the mismatch negativity component; vMMN). The main goal of this study was to assess the influence of categorical information on both early perceptual (i.e., vMMN component) and later cognitive (i.e., P300 component) processing within one paradigm. Hence, we combined an oddball paradigm with a delayed memory task. We used five-dot patterns belonging to different categories even though categorical information is not mirrored in their physical characteristics. Distinct vMMNs were observed for patterns belonging to the same as compared to different categories, suggesting that abstract categorical information was encoded during early perceptual processing. However, inconsistent with prior studies, we observed no effect of categories on the P300, indicating no additional encoding of categorical information in later cognitive stages of processing. Our findings emphasize that the encoding of categorical information depends on specific task demands and hence is more flexible and dynamic than previously suggested.

Performance differences between instructions on paper vs digital glasses for a simple assembly task.

OBJECTIVE: Providing instruction for assembly tasks is essential in modern manufacturing industry, as well as in households for customers that buy products to be assembled at home. Recent technological developments might be able to assist in completing an assembly task faster and more accurately. The aim of this study was to evaluate whether performance and usability differs when instructions for an assembly task are presented on digital glasses versus paper. METHODS: Participants (n = 63) completed one of three versions of an assembly task (between-subject-design) with LEGO® bricks: (1) with paper instruction (P), (2) with text instructions presented stepwise via digital glasses (GT), (3) with stepwise text and auditory instruction (in parallel) on digital glasses (GA). Outcome measures on performance were completion time and errors. Furthermore, usability was measured by the User Experience Questionnaire, the Standardized Usability Questionnaire, the Post-Study Usability Questionnaire, and cognitive processing skills were assessed by the Trail Making Test and different versions of the Eriksen Flanker Task. Analyses were adjusted for the confounding factors age, gender, experience with glasses and LEGO, and problems with instruction. RESULTS: Findings indicate that task completion was faster with the paper instructions compared to both versions of instruction via digital glasses (GT, GA). We observed no difference in accuracy and usability between the instructions. "Novelty" was rated higher for instructions for both GT and GA, compared to P. DISCUSSION: Results show that instructions on digital glasses may not always be more effective for assembly than the traditional paper-based instructions. Further studies are necessary to investigate whether effectiveness may depend on task complexity, target group, experience of the user with task and device, and how the information is presented.

Face and word composite effects are similarly affected by priming of local and global processing.

Holistic processing has been shown with both faces and words, but it is unclear how similar their underlying mechanisms are. In this study attention to global and local features was manipulated and the consequences for holistic word and face processing were examined. On each trial participants were presented two Navon figures and told to focus on either the global or the local level. Then they performed a composite task in which they indicated whether the target halves of two sequentially presented faces or words were the same or different, ignoring the irrelevant halves. Similar stronger global priming effects were found for faces and words, indicating that holistic processing for the two types of stimuli were susceptible to attention manipulations to similar degrees, which was confirmed with Bayesian analyses. The findings add to the investigation of the similarity and differences between holistic processing and help reveal those aspects of holistic processing that are domain general and those specific to individual categories.

Systematic Review on the Impact of Intelligence on Cognitive Decline and Dementia Risk.

BACKGROUND: Previous studies have shown that an intellectually stimulating lifestyle is associated with a lower risk for cognitive decline and Alzheimer's disease and related dementia (ADRD). It is unclear so far whether higher intelligence may protect against this. The aim of this study was to conduct a systematic review on the association between intelligence and cognitive decline and ADRD risk. METHODS: We searched the PubMed, web of science, and Scopus databases following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and Population, Intervention, Comparison, and Outcome (PICO) criteria. Quality of evidence was assessed using Critical Appraisal Skills Programme (CASP) checklists. RESULTS: From an initial n=8,371 search hits, n= 14 studies met the inclusion criteria and had sufficient quality. Evidence indicates that cognitive decline in old age is not significantly associated with childhood intelligence (n=9). Evidence with regard to ADRD risk is inconclusive (n=5) with some studies showing no effects and other studies with significant effects having limitations in their design. CONCLUSIONS: Even though the majority of the studies show no significant association, we cannot exclude a possible effect that might be moderated by other, so far unknown factors. Further studies are necessary to systematically assess the influence of intelligence on ADRD risk and what factors moderate this association.