Neurofilament Light Chain as a Biomarker of Global Cognition in Individuals With Possible Vascular Mild Cognitive Impairment.

BACKGROUND: Neurofilament Light Chain (NfL) is a biomarker of axonal injury elevated in mild cognitive impairment (MCI) and Alzheimer's disease dementia. Blood NfL also inversely correlates with cognitive performance in those conditions. However, few studies have assessed NfL as a biomarker of global cognition in individuals demonstrating mild cognitive deficits who are at risk for vascular-related cognitive decline. OBJECTIVE: To assess the relationship between blood NfL and global cognition in individuals with possible vascular MCI (vMCI) throughout cardiac rehabilitation (CR). Additionally, NfL levels were compared to age/sex-matched cognitively unimpaired (CU) controls. METHOD: Participants with coronary artery disease (vMCI or CU) were recruited at entry to a 24-week CR program. Global cognition was measured using the Montreal Cognitive Assessment (MoCA) and plasma NfL level (pg/ml) was quantified using a highly sensitive enzyme-linked immunosorbent assay. RESULTS: Higher plasma NfL was correlated with worse MoCA scores at baseline (ß = -.352, P = .029) in 43 individuals with vMCI after adjusting for age, sex, and education. An increase in NfL was associated with worse global cognition (b[SE] = -4.81[2.06], P = .023) over time, however baseline NfL did not predict a decline in global cognition. NfL levels did not differ between the vMCI (n = 39) and CU (n = 39) groups (F(1, 76) = 1.37, P = .245). CONCLUSION: Plasma NfL correlates with global cognition at baseline in individuals with vMCI, and is associated with decline in global cognition during CR. Our findings increase understanding of NfL and neurobiological mechanisms associated with cognitive decline in vMCI.

Comparative efficacy of seven nonpharmacological interventions on global cognition in older adults with and without mild cognitive impairment: a network meta-analysis of randomized controlled trials.

To maintain current cognitive function and access greater cognitive reserves, nonpharmacological interventions may be a viable alternative for older adults with or without cognitive impairment. This study aimed to compare different nonpharmacological interventions for enhancing global cognition, including mind-body exercise, physical exercise, non-invasive brain stimulation, cognitive training intervention (CTI), acutherapy (ACU), meditation, and music therapy, by applying a network meta-analysis (NMA). Sixty-one randomized controlled trials evaluating the efficacy of interventions on global cognition in older adults with or without mild cognitive decline were selected. An NMA was conducted to compare the efficacy of different nonpharmacological interventions. The NMA revealed that mind-body exercise (standardized mean difference, 1.384; 95% confidence interval, 0.777-1.992); ACU (1.283; 0.478-2.088); meditation (0.910; 0.097-1.724); non-invasive brain stimulation (1.242; 0.254-2.230); CTI (1.269; 0.736-1.802); and physical exercise (0.977; 0.212-1.742), showed positive effects compared to passive controls. There were no significant differences between the efficacies of other interventions. Nonpharmacological interventions may potentially enhance and maintain global cognition through various pathways, such as memorizing movements and enhancing brain plasticity by reducing stress in the older adult population. Additional studies are needed to clarify the impact of other variables, including intervention methods or psychological variables.

Cognition in older age bipolar disorder: An analysis of archival data across the globe.

BACKGROUND: Cognitive deficits in bipolar disorder (BD) impact functioning and are main contributors to disability in older age BD (OABD). We investigated the difference between OABD and age-comparable healthy comparison (HC) participants and, among those with BD, the associations between age, global cognitive performance, symptom severity and functioning using a large, cross-sectional, archival dataset harmonized from 7 international OABD studies. METHODS: Data from the Global Aging and Geriatric Experiments in Bipolar Disorder (GAGE-BD) database, spanning various standardized measures of cognition, functioning and clinical characteristics, were analyzed. The sample included 662 euthymic to mildly symptomatic participants aged minimum 50years (509 BD, 153 HC), able to undergo extensive cognitive testing. Linear mixed models estimated associations between diagnosis and global cognitive performance (g-score, harmonized across studies), and within OABD between g-score and severity of mania and depressive symptoms, duration of illness and lithium use and of global functioning. RESULTS: After adjustment for study cohort, age, gender and employment status, there was no significant difference in g-score between OABD and HC, while a significant interaction emerged between employment status and diagnostic group (better global cognition associated with working) in BD. Within OABD, better g-scores were associated with fewer manic symptoms, higher education and better functioning. LIMITATIONS: Cross-sectional design and loss of granularity due to harmonization. CONCLUSION: More research is needed to understand heterogenous longitudinal patterns of cognitive change in BD and understand whether particular cognitive domains might be affected in OABD in order to develop new therapeutic efforts for cognitive dysfunction OABD.

The Effects of Virtual Reality Training on Cognition in Older Adults: A Systematic Review, Meta-Analysis, and Meta-Regression of Randomized Controlled Trials.

The aim of this systematic review, meta-analysis, and meta-regression was to examine the effects of virtual reality-based training on global cognition and executive function compared with conventional training or information-based treatment in older adults, regardless of cognitive level. A systematic literature search was conducted using four databases. A total of 31 randomized controlled trials were identified. Pooled effect sizes were calculated, the risk of bias was assessed, and evidence was graded. The primary analyses showed a small but statistically significant effect of virtual reality-based training compared with control on global cognition (Hedges' g 0.42, 95% confidence interval [0.17, 0.68], I2 = 70.1%, n = 876, 20 randomized controlled trials, low evidence) and executive function (Hedges' g 0.35, 95% confidence interval [0.06, 0.65], I2 = 68.4%, n = 810, 16 randomized controlled trials, very low evidence). Meta-regression yielded inconclusive results. Virtual reality-based training may be more effective than control in improving cognition in older adults; however, more high-quality studies are needed.

Addressing global cognition and ineffective depressogenic discrimination strategies with clinical hypnosis.

It is a fundamental truth in living that the quality of your decisions shapes the quality of your life. One's cognitive style determines whether one is more likely to be detailed and linear in thinking or more general and impressionistic, obvious influences on the way experiences are interpreted and reactions formed. Global thinking, also referred to as over-general thinking, has been linked to depression for several reasons. These include the lack of detail in making important discriminations that would reduce or eliminate the kind of self-injurious and depressogenic decisions described in the "stress generation" model of depression. The importance of having meaningful strategies for making effective decisions on a situation-by-situation basis cannot be overstated. Cognitive psychologists and cognitive neuroscientists use the term "discrimination" to describe the process of making distinctions between different situations that give rise to one's reactions. In this article, hypnosis is described as a vehicle for teaching global thinkers to be more skilled in making important discriminations. A sample hypnosis script is provided to illustrate the process.

Transcranial direct current stimulation for global cognition in Alzheimer's disease: a systemic review and meta-analysis.

This meta-analysis was to investigate the efficacy of transcranial direct current stimulation (tDCS) for general cognitive function in Alzheimer's disease (AD) and to investigate the potential influential factors. A systematic literature retrieval until August 2023 was performed by searching the PubMed, Embase, Web of Science, and Cochrane Library. Therapeutic effects of tDCS were evaluated using standardized mean difference (SMD) and 95% confidence interval (CI). Pooled effects of tDCS on AD patients were calculated immediately after treatment and at follow-up periods. Subgroup analyses were conducted to identify the potential prognostic factors. Eleven studies with 12 trials including 451 cases were included in our systemic review, in which 9 studies with 10 trials using Mini-Mental State Examination (MMSE) scales were included in the meta-analysis. tDCS significantly improved global cognition in AD immediately after the treatment (SMD, 0.46; 95% CI, 0.25-0.66; P<0.0001), but not at the shorter or longer follow-up period. Subgroup analyses suggested significant global cognitive improvement in patients receiving stimulation on temporal lobes instead of left dorsolateral prefrontal cortex, and in cases receiving tDCS with current density ≥ 0.08 mA/cm2 rather than <0.08 mA/cm2. Compared with tDCS plus cognitive training (CT), tDCS without CT produced obvious cognitive enhancement. In addition, patients with lower education were more likely to benefit from tDCS. tDCS was effective in improving general cognition in AD after treatment. However, further randomized trials are warranted to validate its longer-term effects as well as our subgroup analyses results.

Increased perivascular space volume in white matter and basal ganglia is associated with cognition in Parkinson's Disease.

Perivascular spaces (PVS), fluid-filled compartments surrounding brain vasculature, are an essential component of the glymphatic system responsible for transport of waste and nutrients. Glymphatic system impairment may underlie cognitive deficits in Parkinson's disease (PD). Studies have focused on the role of basal ganglia PVS with cognition in PD, but the role of white matter PVS is unknown. This study examined the relationship of white matter and basal ganglia PVS with domain-specific and global cognition in individuals with PD. Fifty individuals with PD underwent 3T T1w magnetic resonance imaging (MRI) to determine PVS volume fraction, defined as PVS volume normalized to total regional volume, within (i) centrum semiovale, (ii) prefrontal white matter (medial orbitofrontal, rostral middle frontal, superior frontal), and (iii) basal ganglia. A neuropsychological battery included assessment of global cognitive function (Montreal Cognitive Assessment, and global cognitive composite score), and cognitive-specific domains (executive function, memory, visuospatial function, attention, and language). Higher white matter rostral middle frontal PVS was associated with lower scores in both global cognitive and visuospatial function. In the basal ganglia higher PVS was associated with lower scores for memory with a trend towards lower global cognitive composite score. While previous reports have shown that greater amount of PVS in the basal ganglia is associated with decline in global cognition in PD, our findings suggest that increased white matter PVS volume may also underlie changes in cognition.

Impact of the MIND Diet on Cognition in Individuals with Dementia.

BACKGROUND: Alzheimer's disease (AD) plagues 6.5 million Americans 65+, yet treatments are lacking. The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet has been developed to address the expansive impact of dementias on the general public. This systematic review evaluated the impact of the MIND diet on cognition in those with pathologies across the dementia spectrum. OBJECTIVE: To evaluate the application of the MIND diet for prevention and/or treatment of dementia. METHODS: PubMed was used to conduct a search using the MIND diet and terms related to cognition. Articles were excluded if they were published prior to 2018, studied a population without dementia or significant risk factors, or did not include those 65 + . The overall quality of each source was analyzed based on the cognitive test(s) used, the selection of subjects, and the sample size. RESULTS: The search generated 33 papers, which yielded 11 articles after screening. Of these studies, one was conducted on those with mild cognitive impairment, one with AD, two with general dementia, and seven with at-risk individuals. All the studies found a positive correlation between adherence and some form of cognitive functioning, but results were mixed for specific cognitive domains. CONCLUSIONS: These findings suggest that the MIND diet may be a useful long-term treatment option for those with various dementia pathologies. However, more research is needed on subjects with onset dementias. Additionally, there is a need for more research into the mechanisms behind the common comorbidities.

The Association Between Cognitive Domains and Postural Balance among Healthy Older Adults: A Systematic Review of Literature and Meta-Analysis.

PURPOSE OF REVIEW: This review aims to explore which cognitive domain is more closely associated with which type of balance (static or dynamic). RESENT FINDING: Based on recent reviews, inhibitory control, a part of cognition, plays a crucial role in balance performance. Previous reviews report significant links between cognition, mobility, and physical function in older adults. However, evidence regarding the relationship between cognition and balance scores remains inconclusive. The strength of association between cognition and balance appears to be domain-specific and task-specific. Executive function exhibits the strongest correlation with balance, while episodic memory shows a small link with dynamic balance. Processing speed and global cognition demonstrate moderate correlations. Additionally, there is a slight association between cognitive domains and static balance. Further research is needed to elucidate the underlying mechanisms and develop targeted interventions for managing balance-related concerns that are domain-specific and task-specific.

Association between oral health and cognitive function among Chinese older adults: the Taizhou imaging study.

BACKGROUND: We aimed to investigate the association between oral health and cognitive function in a sample of older adults from a Chinese rural community. METHODS: The cross-sectional cognitive function of 677 individuals were assessed by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). A comprehensive profile of the oral health status was evaluated by questionnaire and clinical examination. RESULTS: Multiple covariates-adjusted regression models demonstrated decayed teeth (DT) and decayed/missing/filled teeth (DMFT) were negatively associated with MoCA score (all p < 0.05). Calculus index (CI) and clinical attachment loss (CAL) were significantly associated with the lower MoCA, short-term memory and executive function score, respectively (all p < 0.05). Additionally, participants with missing teeth unrestored tend to get lower MMSE and MoCA scores (p < 0.05). The results also showed that increased DT and CI were modestly associated with higher odds of cognitive impairment (p < 0.05). CONCLUSIONS: There is an association between oral health and global cognition. Poor periodontal status was strongly associated with worse global cognition performance, especially in the short-term memory and executive domain for the aging population.

Discordant Biological and Chronological Age: Implications for Cognitive Decline and Frailty.

BACKGROUND: Older adults with discordant biological and chronological ages (BA and CA) may vary in cognitive and physical function from those with concordant BA and CA. METHODS: To make our approach clinically accessible, we created easy-to-interpret participant groups in the Health, Aging, and Body Composition Study (N = 2 458, 52% female participants, 65% White participants, age: 73.5 ±â€…2.8) based on medians of CA, and a previously validated BA index comprised of readily available clinical tests. Joint models estimated associations of BA-CA group with cognition (Modified Mini-Mental State Examination [3MS] and Digit Symbol Substitution Test [DSST]) and frailty over 10 years. RESULTS: The sample included the following: 32%, Young group (BA and CA < median); 21%, Prematurely Aging group (BA ≥ median, CA < median), 27%, Old group (BA and CA ≥ median), and 20%, Resilient group (BA < median, CA ≥ median). In education-adjusted models of cognition, among those with CA < median, the Prematurely Aging group performed worse than the Young at baseline (3MS and DSST p < .0001), but among those with CA ≥ median, the Resilient group did not outperform the Old group (3MS p = .31; DSST p = .25). For frailty, the Prematurely Aging group performed worse than the Young group at baseline (p = .0001), and the Resilient group outperformed the Old group (p = .003). For all outcomes, groups did not differ on change over time based on the same pairwise comparisons (p ≥ .40). CONCLUSIONS: Discordant BA and CA identify groups who have greater cognitive and physical functional decline or are more protected than their CA would suggest. This information can be used for risk stratification.

Vitamin D status and cognitive performance in community-dwelling adults: A dose-response meta-analysis of observational studies.

Low vitamin D status is linked with poorer cognition in adults while findings in relation to high levels are mixed.We performed a systematic review and meta-analyses to examine dose-response associations between 25-hydroxyvitamin D (25OHD) levelsand cognitive performance in community-dwelling adults. Thirty-eight observational studies were included in dose-response meta-analyses. Positive, nonlinear associations were identified between baseline25OHD levels and global cognition incross-sectional and longitudinal analyses, and for performance in memory and executive function in longitudinal analyses. When restricted to studies involving older adults, thepattern emerged forspecific domains in cross-sectional analyses. Poorer performance was associated with low 25OHD levels, while a sharp improvement was associated withlevels up to 60-70 nM/L. Further improvement was observed only for longitudinal global cognition. Our findings support the association between low vitamin D and poorer cognition and suggest levels of at least 60 nM/L are associated with better cognition during ageing.

Using network analysis to validate domains of the modified telephone interview for cognitive status.

BACKGROUND: The modified Telephone Interview for Cognitive Status (TICS-M) is a widely used tool for assessing global cognitive functions and screening for cognitive impairments. The tool was conceptualised to capture various cognitive domains, but the validity of such domains has not been investigated against comprehensive neuropsychological assessments tools. Therefore, this study aimed to explore the associations between the TICS-M domains and neuropsychological domains to evaluate the validity of the TICS-M domains using network analysis. MATERIALS AND METHODS: A longitudinal research design was used with a large sample of older adults (aged above 70 years; n = 1037 at the baseline assessment) who completed the TICS-M and comprehensive neuropsychological assessments biennially. We applied network analysis to identify unique links between the TICS-M domains and neuropsychological test scores. RESULTS: At baseline, there were weak internal links between the TICS-M domains. The TICS-M memory and language domains were significantly related to their corresponding neuropsychological domains. The TICS-M attention domain had significant associations with executive function and visuospatial abilities. The TICS-M orientation domain was not significantly associated with any of the five neuropsychological domains. Despite an attrition of almost 50% at wave four, weak internal links between the TICS-M domains and most associations between TICS-M and neuropsychological domains that were found initially, remained stable at least over two waves within the 6-year period. CONCLUSIONS: This study supports the overall structural validity of the TICS-M screener in assessing enduring global cognitive function. However, separate TICS-M cognitive domains should not be considered equivalent to the analogous neuropsychological domains.

Effects of cognitive stimulation program on cognition and mood in older adults, stratified by cognitive levels: A randomized controlled trial.

PURPOSE OF THE RESEARCH: Cognitive stimulation (CS) is defined as activities that involve cognitive processing, usually conducted in a social context and often in a group. This study aims to evaluate the effects of a personalized-adapted CS program in older adults on global cognition, neuropsychological constructs, activities of daily living (ADLs), and mood. MATERIALS AND METHODS: The randomized controlled single-blind trial involving 337 participants (235 women and 102 men) ≥ 65 years of age in a Primary Care centre classified participants into 4 groups: 101 for the no deterioration (ND) group; 100 for the subjective cognitive impairment (SCI) group; 108 for the level deterioration (LD) group and 28 for the moderate deterioration group. The intervention consisted of a personalized CS adapted program for 10 weeks. Follow-up assessments were conducted post-intervention, and at 6 and 12 months. The primary outcome was global cognition measured by the Spanish version of the Mini-Mental State Examination. The secondary outcomes were measured by the Barthel Index, the Lawton and Brody Scale, the Goldberg Questionnaire (anxiety sub-scale) and the abbreviated Yesavage Geriatric Depression Scale. RESULTS: The intervention showed a tendency of improvement on global cognition and different cognitive functions for groups with no deterioration or level deterioration. The group with moderate deterioration improved in anxiety. CONCLUSIONS: The findings demonstrated benefits in global cognition, different cognitive functions, semantic fluency, IADLs and anxiety. The most benefits are given in the intermediate groups, SCI, and LD. Moreover, the intervention works by increasing the benefits in the different phases.

Which Specific Exercise Models Are Most Effective on Global Cognition in Patients with Cognitive Impairment? A Network Meta-Analysis.

(1) Introduction: Physical exercise interventions can impart significant cognitive benefits to older adults suffering from cognitive impairment (CI). However, the efficacy of these interventions can vary widely, depending on the type, intensity, duration and frequency of exercise. (2) Aim: To systematically review the efficacy of exercise therapy on global cognition in patients with CI using a network meta-analysis (NMA). (3) Methods: The PubMed, Embase, Sport Discus (EBSCO) and Cochrane Library databases were electronically searched to collect randomized controlled trials (RCTs) on exercise for patients with CI from inception to 7 August 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. The NMA was performed using the consistency model. (4) Results: A total of 29 RCTs comprising 2458 CI patients were included. The effects of different types of exercise on patients with CI were ranked as follows: multicomponent exercise (SMD = 0.84, 95% CI 0.31 to 1.36, p = 0.002), short duration (≤45 min) (SMD = 0.83, 95% CI 0.18 to 1.19, p = 0.001), vigorous intensity (SMD = 0.77, 95% CI 0.18 to 1.36, p = 0.011) and high frequency (5-7 times/week) (SMD = 1.28, 95% CI 0.41 to 2.14, p = 0.004). (5) Conclusion: These results suggested that multicomponent, short-duration, high-intensity, and high-frequency exercise may be the most effective type of exercise in improving global cognition in CI patients. However, more RCTs based on direct comparison of the effects of different exercise interventions are needed. (6) NMA registration identifier: CRD42022354978.

Cognitive Effects of a Cognitive Stimulation Programme on Trained Domains in Older Adults with Subjective Memory Complaints: Randomised Controlled Trial.

Age-related subjective memory complaints (SMC) are a common concern among older adults. However, little is known about the effects of cognitive stimulation (CS) interventions on subjective memory complaints. The aim of this study was to analyse the effectiveness of a CS programme on global cognition and cognitive functions of older adults with SMC. A randomised clinical trial was conducted on older adults with SMC, including 308 participants ≥65 years of age assessed 6 and 12 months after the intervention. The assessment instrument was the Spanish version of the Mini-Mental State Examination (MEC-35), and all domains of the instrument were assessed. For statistical analysis, the data were analysed using robust ANOVA with means truncated at 20% utilising a two-way repeated measures model, with between (groups) and within (measurements) factors. In post hoc tests, a Wilcoxon signed-rank test of exact permutations between groups and Bonferroni correction were applied. In post hoc between-group tests, significant differences were found: (1) post-treatment in MEC-35, temporal orientation, short-term memory (STM), global language and praxis, and language and praxis (p ≤ 0.005); (2) at 6 months in MEC-35, global orientation, temporal orientation, and STM (p = 0.005); (3) at 12 months in MEC-35, global orientation, temporal orientation, STM, global language and praxis, and language (p = 0.005). This study shows benefits in global cognition and orientation, temporal orientation, STM, and language in older adults with SMC.

Early Amnestic Mild Cognitive Impairment Is Associated with Reduced Total Cerebral Blood Flow with no Brain Tissue Loss.

BACKGROUND: Lower cerebral blood flow (CBF) and excessive brain atrophy are linked to Alzheimer's disease (AD). It is still undetermined whether reduced CBF precedes or follows brain tissue loss. OBJECTIVE: We compared total CBF (tCBF), global cerebral perfusion (GCP), and volumes of AD-prone regions between cognitively normal (CN) and early amnestic mild cognitive impairment (aMCI) and tested their associations with cognitive performance to assess their predictive value for differentiation between CN and early aMCI. METHODS: A total of 74 participants (mean age 69.9±6.2 years, 47 females) were classified into two groups: 50 CN and 24 aMCI, of whom 88% were early aMCI. tCBF, GCP, and global and regional brain volumetry were measured using phase-contrast and T1-weighted MRI. Neuropsychological tests tapping global cognition and four cognitive domains (memory, executive function, language, and visuospatial) were administered. Comparisons and associations were investigated using analyses of covariance (ANCOVA) and linear regression analyses, respectively. RESULTS: Women had significantly higher GCP than men. Both, tCBF and GCP were significantly reduced in aMCI compared with CN, while differences in volumes of cerebral gray matter, white matter, and AD-prone regions were not significant. tCBF and GCP were significantly associated with global cognition (standardized beta (stß) = 0.324 and stß= 0.326) and with memory scores (stß≥0.297 and stß≥0.264) across all participants. Associations of tCBF and GCP with memory scores were also significant in CN (stß= 0.327 and stß= 0.284) and in aMCI (stß= 0.627 and stß= 0.485). CONCLUSION: Reduced tCBF and GCP are sensitive biomarkers of early aMCI that likely precede brain tissue loss.

Identifying factors influencing cognitive outcomes after anodal transcranial direct current stimulation in older adults with and without cognitive impairment: A systematic review.

Anodal transcranial direct current stimulation (tDCS) can improve cognition in healthy older adults, those with Alzheimer's disease (AD) and mild cognitive impairment (MCI), albeit with considerable variability in response. This systematic review identifies interindividual factors that may influence tDCS outcomes in older individuals with or without cognitive impairment. Peer-reviewed articles were included if they assessed whether cognitive outcomes (memory or global cognition) after tDCS were associated with pre-intervention factors in healthy older adults or individuals with AD/MCI. We identified eight factors that may affect cognitive outcomes after tDCS. Improved tDCS outcomes were predicted by lower baseline cognitive function when tDCS was combined with a co-intervention (but not when used alone). Preserved brain structure and better baseline functional connectivity, genetic polymorphisms, and the use of concomitant medications may predict better tDCS outcomes, but further research is warranted. tDCS outcomes were not consistently associated with age, cognitive reserve, sex, and AD risk factors. Accounting for individual differences in baseline cognition, particularly for combined interventions, may thus maximize the therapeutic potential of tDCS.

The relationship between objective physical activity and change in cognitive function.

INTRODUCTION: The current study investigated the association between objectively measured physical activity and cognition in older adults over approximately 8 years. METHODS: We utilized data from 199 cognitively unimpaired individuals from the Australian Imaging, Biomarkers and Lifestyle (AIBL) study, aged ≥60. Actigraphy was used to measure physical activity (intensity, total activity, and energy expenditure) at baseline. Cognition was assessed using a comprehensive cognitive battery every 18-months. RESULTS: Higher baseline energy expenditure predicted better episodic recall memory and global cognition over the follow-up period (p = 0.031; p = 0.047, respectively). Those with higher physical activity intensity and greater total activity also had better global cognition over time (both p = 0.005). Finally, higher total physical activity predicted improved episodic recall memory over time (p = 0.022). DISCUSSION: These results suggest that physical activity can preserve cognition and that activity intensity may play an important role in this association. HIGHLIGHTS: Greater total physical activity predicts preserved episodic memory and global cognition. Moderate intensity physical activity (>3.7 metabolic equivalents of task [MET]) predicts preserved global cognition. Expending > 373 kilocalories per day may benefit episodic memory and global cognition.

Association between personality and cognitive performance in middle-aged and older adults with human immunodeficiency virus (HIV).

BACKGROUND: Nearly half of adults with human immunodeficiency virus (HIV) experience HIV-Associated Neurocognitive Disorder (HAND), characterized by cognitive impairments in two or more cognitive domains, which can interfere with everyday functioning. Many factors are thought to influence such cognitive impairments in adults with HIV; one factor seldom examined is personality. OBJECTIVE: This study investigated the association between five major dimensions of personality (openness, conscientiousness, extraversion, agreeableness, and neuroticism) and cognitive function in older adults with HIV. METHODS: In this cross-sectional study, a secondary data analysis was conducted on 261 HIV + participants. Participants completed a norm-based cognitive battery covering seven cognitive domains, which yielded the following indices: global cognitive impairment, and global and domain-specific T-scores. The Big Five Inventory was used to assess personality traits. RESULTS: Higher openness, conscientiousness, and agreeableness were associated with better performance on individual cognitive domains while agreeableness and openness were also positively associated with global cognitive T-scores (p < .01). Only openness significantly predicted global cognition when adjusting for covariates (p < .01). DISCUSSION: Openness was associated with better global cognitive function in persons with HIV. This study provides a basis for further investigation of potential mechanisms for the association between personality and cognition in people with HIV in order to ultimately inform intervention strategies.