The relation between cognitive functioning and activities of daily living in normal aging, mild cognitive impairment, and dementia: a meta-analysis.

Literature suggests that dementia and, more generally, cognitive impairment affect the capacity to carry out activities of daily living (ADL) in aging. However, it is important to decipher the weight of specific cognitive domains and neurodegenerative profiles mainly related to ADL difficulties. A meta-analysis was conducted to investigate the nature and strength of the association between cognitive functioning and ADL in healthy older adults, mild cognitive impairment (MCI), and dementia. A comprehensive search of the PubMed, PsycINFO (PROQUEST), and Scopus databases for cross-sectional or longitudinal studies up until December 2022. Our meta-analytic results revealed that: overall, instrumental ADL (IADL) showed a significant association with executive functioning, in particular, abstraction ability/concept formation, set-shifting, and processing speed/complex attention/working memory, regardless of type of participants (i.e., healthy older adults, MCI, and dementia); whereas ADL (both basic ADL, BADL, and IADL) significantly correlated with global cognitive functioning and long-term verbal memory, with a moderator effect of clinical condition (e.g., increasing ES based on the level of cognitive impairment). Moreover, visuospatial and language abilities significantly correlated with ADL, mainly when performance-based tasks were used for ADL assessment. These findings emphasize the importance of neuropsychological assessment in aging to early identify people most at risk of functional decline and shed light on the need to consider specific cognitive abilities in rehabilitation programs.

The Cognitive Profile of Atypical Parkinsonism: A Meta-Analysis.

Atypical Parkinsonism (AP) syndromes are characterized by a wide spectrum of non-motor symptoms including prominent attentional and executive deficits. However, the cognitive profile of AP and its differences and similarities with that of Parkinson's Disease (PD) are still a matter of debate. The present meta-analysis aimed at identifying patterns of cognitive impairment in AP by comparing global cognitive functioning, memory, executive functions, visuospatial abilities, language, non-verbal reasoning, and processing speed test performances of patients with AP relative to healthy controls and patients with PD. All investigated cognitive domains showed a substantial impairment in patients with AP compared to healthy controls. When AP syndromes were considered separately, their cognitive functioning was distributed along a continuum from Multiple Systemic Atrophy at one extreme, with the least impaired cognitive profile (similar to that observed in PD) to Progressive Supranuclear Palsy, with the greatest decline in global cognitive and executive functioning (similar to Corticobasal Syndrome). These findings indicate that widespread cognitive impairment could represent an important clinical indicator to distinguish AP from other movement disorders.

Comparing face-to-face and videoconference assessment of the Brief Repeatable Battery of Neuropsychological Tests in people with multiple sclerosis.

BACKGROUND: The COVID-19 pandemic has underlined the need to evaluate cognitive profile via videoconferencing (teleneuropsychology, TeleNP) as a suitable alternative to face-to-face assessment (F-F). OBJECTIVE: To evaluate the feasibility and the reliability of Rao's Brief Repeatable Battery of Neuropsychological Tests (R-BRB) remote administration in people with multiple sclerosis (PwMS). METHODS: Sixty PwMS underwent R-BRB in two conditions: F-F and TeleNP, 1 month apart. RESULTS: Cognitive test performance was similar, regardless of the administration type, but visuospatial test performance was better in F-F. CONCLUSION: These data suggest that TeleNP is feasible and highly reliable in MS clinical practice.

Body Representation Alterations in Patients with Unilateral Brain Damage.

OBJECTIVE: Systematic studies about the impact of unilateral brain damage on the different body representations (body schema, body structural representation, and body semantics) are still rare. Aim of this study was to evaluate body representation deficits in a relatively large sample of patients with unilateral brain damage and to investigate the impact of right or left brain damage on body representations (BRs), independently from deficits in other cognitive processes. METHOD: Sixty-four patients with unilateral stroke (22 with left brain damage, LBD; 31 with right brain damage without neglect, RBD-N; 11 with right brain damage with neglect, RBD+N) and 41 healthy individuals underwent a specific battery including BR as well as control tasks. RESULTS: In more than a third of the sample, selective (37.5%) and pure (31%) deficits of BR were presented and equally distributed among the different BRs (˜10% for each representation), with selective (27.2%) and pure (22.7%) body schema deficit mainly presented after left brain damage. As a group, patients with unilateral brain damage, independently of the side of lesion (LBD, RBD-N, RBD+N), had significantly worse performance on body structural representation with respect to healthy individuals, whereas LBD had numerically worse performance on body schema with respect to healthy individuals and RBD-N. No significant differences among groups were found on body semantics. CONCLUSION: BR deficits are not a rare consequence of unilateral brain damage and are independent of a more general cognitive dysfunction. Accordingly, the need for an accurate assessment and specific neuropsychological training in clinical settings is discussed.

Age- and gender-related differences in the evolution of psychological and cognitive status after the lockdown for the COVID-19 outbreak: a follow-up study.

OBJECTIVE: Individuals experienced psychological symptoms in response to quarantine for the COVID-19 pandemic. Therefore, we aimed to investigate the possible effect of age and gender on the evolution of mental health status after the quarantine in the Italian population and the baseline predictors of post-traumatic stress symptoms. METHODS: An online follow-up questionnaire including an assessment of depression, anxiety, anger, post-traumatic stress, subjective cognitive failures, resilience, and coping style was completed by participants 2 months after the end of the quarantine (n = 758). RESULTS: Individuals experienced psychological symptoms also 2 months after the end of the quarantine. No decrease in depression and anxiety scores emerged, but younger individuals and females experienced more severe symptoms. Anger symptoms decreased in young adults, whereas they increased in older adults. Moreover, individuals reported more cognitive failures at follow-up. No changes were observed in resilience, whereas participants reported adopting fewer coping strategies at follow-up. Finally, post-traumatic stress symptoms 2 months after the end of the lockdown were associated with more severe psychological symptoms and more fear of getting infected at baseline. CONCLUSIONS: Our findings demonstrate that the long-term psychological impact and the cognitive consequences of quarantine differ according to age and gender. The identification of more vulnerable groups allows the implementation of interventions to reduce psychological symptoms and the risk for cognitive impairment.

Subjective cognitive failures and their psychological correlates in a large Italian sample during quarantine/self-isolation for COVID-19.

OBJECTIVE: The quarantine/self-isolation measures implemented to retard the spread of the 2019 coronavirus disease (COVID-19) may negatively affect the mental health of the population. The present study aimed to explore the impact of the psychological symptoms on the occurrence of cognitive failures in a large sample of home-dwelling Italian individuals during quarantine/self-isolation for COVID-19. METHODS: We employed an online questionnaire using a virtual platform of Google Moduli. The questionnaire included an assessment of cognitive failures evaluated by the Perceived Memory and Attentional Failures Questionnaire (PerMAFaQ) and of resilience, coping style, depression, anger, and anxiety. RESULTS: The online questionnaire was completed by 4175 participants revealing that about 30% of participants complained of cognitive failures at least sometimes during quarantine/self-isolation, whereas some respondents reported very frequent cognitive failures. Moreover, resilience was found to mediate the relationships between depressive and anger symptoms and cognitive failures. Although no difference was found on PerMAFaQ among smart-workers, non-smart-workers, and those currently not at work, people not working at the moment complained of more frequent cognitive failures. CONCLUSIONS: These findings indicate the need to implement psychological support intervention, particularly for vulnerable groups, to reduce anxiety, depression, and anger, and of psychoeducational interventions to enhance resilience reducing possible long-term cognitive consequences of the quarantine.

Mental health status of Italian elderly subjects during and after quarantine for the COVID-19 pandemic: a cross-sectional and longitudinal study.

BACKGROUND: The elderly are more vulnerable to COVID-19 and therefore need to adopt long-term social distancing measures. The duration of quarantine impacts the psychological status of the general population. However, until now no study has explored the psychological impact of the pandemic and quarantine together with longitudinal changes in the mental health status of Italian elderly. METHODS: An online questionnaire including an assessment of depression, anxiety, anger, post-traumatic stress, subjective cognitive failures, resilience, coping style, and other dimensions related to the pandemic was completed by participants during (T0) and two months after the end (T1) of the quarantine. RESULTS: The sample recruited at T0 included 334 elderly participants. About 45% of the participants experienced depression, anxiety, or anger. Moreover, more fear of getting infected was related to more severe depression, anxiety, and anger, but resilience was found to mediate these relationships. More severe depressive and anger symptoms were related to more severe cognitive failures. No significant difference was observed in mental health scores between T0 and T1. Finally, more severe depression at T0 was associated with the development of post-traumatic stress symptoms at T1. CONCLUSIONS: The fear of getting infected, probably due to perceived vulnerability to disease, seems to play a crucial role in the development of psychological symptoms in the elderly, but resilience seems to mediate the impact of fear. The presence of long-term psychological consequences and the possible risk of developing PTS symptoms in the elderly suggest the need for targeted interventions to reduce possible long-term psychological and cognitive consequences.

A subjective cognitive impairments scale for migraine attacks: validation of the Italian version of the MIG-SCOG.

BACKGROUND: The MIG-SCOG is a questionnaire to assess self-reported subjective cognitive symptoms during migraine attacks, consisting of 9 items evaluating executive functions and language. The aim of the study was to evaluate the psychometric properties of the Italian version of the MIG-SCOG (I-MIG-SCOG) in patients with migraine without aura. METHODS: The I-MIG-SCOG underwent 20 Italian healthy subjects to assess its comprehensibility. Reliability and divergent validity of the I-MIG-SCOG were evaluated in a sample of 153 migraines without aura patients. They also underwent Montreal Cognitive Assessment, Beck Depression Inventory and Apathy Evaluation Scale. RESULTS: The final I-MIG-SCOG was easily comprehensible. There were no missing data, no floor and ceiling effects; mean I-MIG-SCOG score was 7.54 ± 3.98; Cronbach's alpha was 0.814. The I-MIG-SCOG score correlated poorly with Montreal Cognitive Assessment, Beck Depression Inventory and Apathy Evaluation Scale. CONCLUSION: The I-MIG-SCOG should represent a reliable and valid patient-centred and disease-related instrument to identify cognitive symptoms experienced during migraine attacks and to monitor the divergent effects of symptomatic treatments on cognitive functions also in Italian migraine patients.

Interoceptive awareness in focal brain-damaged patients.

BACKGROUND: Interoception is the basic process enabling evaluation of one's own internal state of body, but its alteration in brain-damaged patients has not been adequately investigated. Our study aimed to investigate awareness of visceral and somatosensorial sensations in brain-damaged patients with unilateral stroke. METHODS: Sixty patients (22 with left brain damage, LP; 25 with right brain damage without neglect, RPN-; and 13 with right brain-damage and extrapersonal and/or personal neglect, RPN+) and 45 healthy controls (HC) completed the Self-Awareness Questionnaire (SAQ), a self-report tool for assessing interoceptive awareness with two domains related to visceral (VD) and somatosensory feelings (SD), respectively. RESULTS: Comparing the SAQ subdomains scores between three groups of patients (LP, RPN-, and RPN+) and HC, we found that RPN+ had significantly lower scores on VD than HC and LP, whereas no significant difference was found on scores of SD between groups. CONCLUSION: Our results support the hypothesis of a right-hemispheric dominance for "interoceptive neural network" suggesting that processing of visceral sensations would be located mainly in the right hemisphere. Therefore, a careful assessment of interoceptive awareness in clinical practice would be useful to improve rehabilitation and to engage patients with deficit of interoceptive awareness in developing greater accuracy of body signals.

The Efficacy of Cognitive Training on Neuropsychological Outcomes in Mild Cognitive Impairment: A Meta-Analysis.

Mild cognitive impairment (MCI) or mild neurocognitive disorder is an intermediate stage of cognitive impairment between normal cognitive aging and dementia. Given the absence of effective pharmacological treatments for MCI, increasing numbers of studies are attempting to understand how cognitive training (CT) could benefit MCI. This meta-analysis aims to update and assess the efficacy of CT on specific neuropsychological test performance (global cognitive functioning, short-term verbal memory, long-term verbal memory, generativity, working memory, and visuospatial abilities) in individuals diagnosed with MCI, as compared to MCI control groups. After searching electronic databases for randomized controlled trials, 31 studies were found including 2496 participants. Results showed that CT significantly improved global cognitive functioning, short-term and long-term verbal memory, generativity, working memory, and visuospatial abilities. However, no significant effects were observed for shifting, abstraction ability/concept formation, processing speed, and language. The mode of CT had a moderating effect on abstraction ability/concept formation. The findings provide specific insights into the cognitive functions influenced by CT and guide the development of tailored interventions for MCI. While CT holds promise, further research is needed to address certain cognitive deficits and assess long-term effects on dementia progression.

Neural correlates of embodied action language processing: a systematic review and meta-analytic study.

The neural correlates of action language processing are still debated within embodied cognition research and little is known about the flexible involvement of modality-specific pre-motor system and multimodal high-level temporo-parietal regions as a function of explicit and implicit tasks. A systematic review and the Activation likelihood estimation (ALE) meta-analyses on functional neuroimaging studies were performed to identify neural correlates of action language processing activated during explicit and implicit tasks. The contrast ALE meta-analysis revealed activation of modality-specific premotor area and inferior frontal areas during explicit action language tasks while a greater activation of posterior temporo-occipital areas emerged for implicit tasks. The conjunction analysis revealed overlap in the temporo-parietal multimodal high-level regions for both types of tasks. Functional specialization of the middle temporal gyrus was found where the more posterior-occipital part resulted activated during implicit action language tasks whereas the antero-lateral part was involved in explicit tasks. Our findings were discussed within a conceptual flexibility perspective about the involvement of both the modality-specific and multimodal brain system during action language processing depending on different types of tasks.

Cognitive and Affective Theory of Mind across Adulthood.

BACKGROUND: Theory of mind (ToM) is a fundamental aspect of social cognition. Previous studies on age-related changes in mentalizing processes have provided conflicting results. This study aims to investigate the age-related changes in the cognitive and affective components of ToM throughout adulthood. METHODS: Two hundred and thirty-eight healthy participants divided into five age groups (18-40 years old; 41-50 years old; 51-60 years old; 61-70 years; 71-80 years old) underwent tasks assessing the cognitive (ToM Picture Sequencing Task, TMPS, and the Advanced Test of ToM, ATT) and affective (Reading the Mind in the Eyes Task, RMET, and the Emotion Attribution Task, EAT) components of ToM, in both verbal and nonverbal modality. RESULTS: Regarding affective ToM, both the youngest- and middle-old adult groups (61 to 80 years) performed worse than the young and youngest-middle adult groups (18 to 50 years) in the RMET, but no significant differences were found in the EAT. Regarding cognitive ToM, the middle-old adult group (71 to 80 years) performed worse than the young adult group (18 to 40 years) only in the TMPS, but no significant differences were found in the ATT. CONCLUSION: Rather than a general decline in ToM, our results provide evidence regarding selective changes in ToM in older adults, further confirming the dissociation of cognitive and affective ToM.

The neural basis of gambling disorder: An activation likelihood estimation meta-analysis.

Previous imaging studies suggested that impairments of prefrontal-striatal and limbic circuits are correlated to excessive gambling. However, the neural underpinnings of gambling disorder (GD) continue to be the topic of debate. The present study aimed to identify structural changes in GD and differentiate the specific brain activity patterns associated with decision-making and reward-processing. We performed a systematic review complemented by Activation likelihood estimation (ALE) meta-analyses on morphometric and functional studies on neural correlates of GD. The ALE meta-analysis on structural studies revealed that patients with GD showed significant cortical grey-matter thinning in the right ventrolateral and ventromedial prefrontal cortex compared to healthy subjects. The ALE meta-analyses on functional studies revealed that patients with GD showed a significant hyperactivation in the medial prefrontal cortex and in the right ventral striatum during decision-making and gain processing compared to healthy subjects. These findings suggest that GD is related to an alteration of brain mechanisms underlying top-down control and appraisal of gambling-related stimuli and provided indications to develop new interventions in clinical practice.

The Body Across Adulthood: On the Relation Between Interoception and Body Representations.

Interoceptive information plays a pivotal role in building body representations (BR), but the association between interoception and the different types of BR in healthy individuals has never been systematically investigated. Thus, this study aimed to explore the association between BR and interoceptive sensibility (IS) throughout adulthood. One hundred thirty-seven healthy participants (50 aged from 18 to 40 years old; 50 aged from 41 to 60 years old; and 37 over 60 years old) were given a self-report tool for assessing IS (the Self-Awareness Questionnaire; SAQ), and a specific battery including tasks evaluating three different BR (i.e., the body schema, using the Hand Laterality Task; the body structural representation, using the Frontal Body Evocation task, FBE; and body semantics, using the Object-Body Part Association Task) as well as control tasks (i.e., tasks with non-body stimuli). The older age group (aged over 60 years old) showed lower performances on the tasks probing the body schema and body structural representation than younger groups (aged 18 to 40 and 41 to 60 years old). More interestingly, worse performances on a task assessing the body schema were significantly associated with higher IS with older age, suggesting that higher awareness of one's inner body sensations would decrease the plasticity of this BR. These findings are interpreted according to the neuropsychological model of BR development and the effects of aging on the brain.

The Body across the Lifespan: On the Relation between Interoceptive Sensibility and High-Order Body Representations.

BACKGROUND: Interoceptive information plays a pivotal role in building higher-order cognitive body representations (BR) that neuropsychological and neuroimaging evidence classifies as action-oriented (i.e., body schema) or non-action-oriented (i.e., visuo-spatial body map). This study aimed to explore the development of BR, considering the association with the interoceptive sensibility throughout the lifespan. METHODS: Two hundred thirty-nine healthy participants divided into five age groups (7 to 8 years; 9 to 10 years; 18 to 40 years; 41 to 60 years; over 60 years) completed a self-report measure of interoceptive sensibility (the Self-Awareness Questionnaire; SAQ) and were given tasks assessing the two BR (action-oriented: hand laterality task; non-action-oriented: frontal body evocation task). RESULTS: Both children (7-8 and 9-10 years) and older adults (over 60 years) performed worse than young (18-40 years) and middle-aged adults (41-60 years) in action- and non-action-oriented BR tasks. Moderation analyses showed that the SAQ score significantly moderated the relationship between age and action-oriented BR. CONCLUSIONS: The current results are consistent with inverted U-shaped developmental curves for action- and non-action-oriented BR. As an innovative aspect, the ability to mentally represent one's own body parts in diverse states could be negatively affected by higher interoceptive sensibility levels in childhood and late adulthood.

Coping strategies in relapsing-remitting multiple sclerosis non-depressed patients and their associations with disease activity.

Few studies evaluated coping strategies in people with multiple sclerosis (pwMS) in relation to annualized relapse rate (ARR) and lesion load (LL). Overall, results might have been influenced by the inclusion of depressed patients. To investigate the coping strategies and their association to disease activity, we studied relapsing-remitting pwMS accurately selected to avoid the confounding effect of depression. Sixty-seven relapsing-remitting pwMS and 67 healthy subjects (HS) underwent to Coping Orientation to Problems Experienced (I-COPE) and Coping Inventory for Stressful Situation (CISS) and Beck Depression Inventory-II. Cognitive performances, ARR, physical disability and magnetic resonance imaging T2-LL were assessed for correlation with coping and depression scores. pwMS showed lower scores than HSs on social support and turning to religion subscales of I-COPE and on emotion dimension of CISS. In pwMS, higher ARR was related to higher positive attitude and lower score on the turning to religion subscale of I-COPE. The present study revealed a less employment of emotion-based coping strategies in pwMS. A scarce use of faith for support and a frequent adoption of a positive attitude were associated with an increase of MS activity in terms of ARR.

Neural bases of impulse control disorders in Parkinson's disease: A systematic review and an ALE meta-analysis.

Impulse control disorders (ICD) occur in some patients affected by Parkinson's disease (PD). Previous studies revealed an involvement of basal ganglia in ICD, but recent morphological, molecular and functional imaging studies showed that alterations of some extrastriatal regions contribute to development of ICD in PD, with mixed results. To identify the brain regions underlying ICD in PD, a systematic review of morphometric and functional studies was performed, complemented by an ALE meta-analysis of functional studies. The review of structural studies revealed no significant changes in any cortical and subcortical region in patients with ICD. The review of functional studies revealed increased activity in the Ventral Striatum and OrbitoFrontal Cortex and decreased activity in Anterior Cingulate Cortex (ACC). Clusters of hyperactivation in ventral striatum and of hypoactivation in ACC were confirmed by ALE meta-analysis. In conclusion, the present study strongly supported that ICD in PD are related to a dysfunction of limbic divisions of the striatum and of the prefrontal cortex and provided a neurofunctional basis for devising potential therapeutic interventions.