UNASSIGNED: Cognitive impairment is known to be mediated by a variety of risk factors, with age being the most influential of these. The worldwide phenomenon of an aging population makes decoupling old age from disease through the concept of healthy aging a matter of major interest. In Spain, rural depopulated areas, where the lack of health services is an additional concern, constitute a group of particularly aged population. Community pharmacies are widely distributed throughout the territory and are in close contact with this vulnerable population group.
UNASSIGNED: We designed and piloted a methodology to assess cognitive impairment and healthy aging from a holistic point of view. Our questionnaire comprises five sections: cognitive impairment, sociodemographic factors, health problems, lifestyle and psychosocial factors.
UNASSIGNED: The estimated prevalences of cognitive impairment and healthy aging in our cohort were 28.2 % and 15.4 %, respectively. The prevalences (or the population mean values) found for well-known risk and protective factors for cognitive impairment were consistent with those described for Spanish population in the scientific literature. The results showed that our questionnaire can be an appropriate tool for collecting information in our media and suitable for researching how modifiable risk and protective factors influence cognitive status from a holistic perspective.
UNASSIGNED: The complex interrelationships between variables should be further investigated. In this respect, novel areas, such as psychosocial variables, should also be the focus of efforts to advance the cognitive impairment knowledge.

UNASSIGNED: Cognitive assessment is a key component of clinical evaluations for patients with dementia and Alzheimer\'s disease in primary health care (PHC) settings. The need for well-validated, culturally appropriate, and easy-to-use assessments is especially urgent in low- and middle-income countries (LMICs) that are experiencing rapid growth in their older adult populations.
UNASSIGNED: To examine the feasibility and demographic determinants of performance for a tablet-based cognitive assessment tool (TabCAT) battery, which includes subtests for four cognitive domains, among older PHC patients in southeastNigeria.
UNASSIGNED: A cross-sectional mixed-method descriptive study evaluating the useability and performance of TabCAT.
UNASSIGNED: We enrolled 207 participants (mean age of 64.7±13.5 years; 52% with only primary, 41% secondary, and 7% tertiary education). Most (91%) who initiated the assessment were able to complete it, requiring 10- 15 minutes to complete. More years of education was associated with better test scores across all tests (p < 0.001). Living in a rural location was also associated with better performance (p < 0.05). Male compared to female sex did not associate with performance on any of the tests (all ps > 0.05).
UNASSIGNED: Tablet-based cognitive assessment was feasible in rural and urban settings of Nigeria. Better performance on cognitive subtests linked to more education and residing in a rural area; however, sex did not predict performance. Digital cognitive assessment tools hold potential for widespread use in healthcare and educational contexts, particularly in regions with varying levels of urbanization and educational access.

BACKGROUND: Edinburgh Cognitive and Behavioral ALS Screen (ECAS) is a validated assessment designed to screen cognitive functions and behavioral disorders in amyotrophic lateral sclerosis (ALS). Objective of this study is to determine the factors associated with ECAS impairment in a cohort of ALS patients without a co-morbid diagnosis of dementia, at the time of diagnosis.
METHODS: We enrolled 71 non-demented ALS patient. We collected clinical and demographic data, ALS familiarity, analysis of the most commonly mutated genes in ALS, ALS Milano Torino Staging System and ALS Functional Rate Scale revised scores, progression rate; finally, we recorded whether symptoms onset involved spinal or bulbar area. The alteration of the ECAS was estimated based on age and education-adjusted-validated cut off for each of the items included in ECAS. A multivariable regression analysis was done.
RESULTS: The significant determinants of ECAS alterations were: bulbar onset in both ALS-specific test and total ECAS score; bulbar onset and familiarity in ALS-non-specific test; finally, familiarity and diagnosis delay in ALS-behavioral test. All the subjects carrying C9orf72 mutations had alteration of both total ECAS score and ALS-specific tests.
CONCLUSIONS: At diagnosis, bulbar-onset ALS, family history, diagnosis delay and C9orf72 hexanucleotide repeat expansion may contribute to impairment of ECAS.

Gray matter changes are thought to be closely related to cognitive decline in mild cognitive impairment (MCI) patients. The study aimed to explore cortical and subcortical structural alterations in MCI and their association with cognitive assessment. 24 MCI patients and 22 normal controls (NCs) were included. Voxel-based morphometry (VBM), vertex-based shape analysis and surface-based morphometry (SBM) analysis were applied to explore subcortical nuclei volume, shape and cortical morphology. Correlations between structural changes and cognition were explored using spearman correlation analysis. Support vector machine (SVM) classification evaluated MCI identification accuracy. MCI patients showed significant atrophy in the left thalamus, left hippocampus, left amygdala, right pallidum, right hippocampus, along with inward deformation in the left amygdala. SBM analysis revealed that MCI group exhibited shallower sulci depth in the left hemisphere and increased cortical gyrification index (GI) in the right frontal gyrus. Correlation analysis showed the positive correlation between right hippocampus volume and episodic memory, while negative correlation between the altered GI and memory performance in MCI group. SVM analysis demonstrated superior performance of sulci depth and GI derived from SBM in MCI identification. When combined with cortical and subcortical metrics, SVM achieved a peak accuracy of 89 % in distinguishing MCI from NC. The study reveals significant gray matter structural changes in MCI, suggesting their potential role in underlying functional differences and neural mechanisms behind memory impairment in MCI.

OBJECTIVE: The importance of early diagnosis of Alzheimer\'s Disease (AD) is by no means negligible because no cure has been recognized for it rather than some therapies only lowering the pace of progression. The research gap reveals information on the lack of an automatic non-invasive approach toward the diagnosis of AD, in particular with the help of Virtual Reality (VR) and Artificial Intelligence. Another perspective highlights that current VR studies fail to incorporate a comprehensive range of cognitive tests and consider design notes for elderlies, leading to unreliable results.
METHODS: This paper tried to design a VR environment suitable for older adults in which three cognitive assessments namely: ADAS-Cog, Montreal Cognitive Assessment (MoCA), and Mini Mental State Exam (MMSE), are implemented. Moreover, a 3DCNN-ML model was trained based on the corresponding cognitive tests and Magnetic Resonance Imaging (MRI) with different modalities using the Alzheimer\'s Disease Neuroimaging Initiative 2 (ADNI2) dataset and incorporated into the application to predict if the patient suffers from AD.
RESULTS: The model has undergone three experiments with different modalities (Cognitive Scores (CS), MRI images, and CS-MRI). As for the CS-MRI experiment, the trained model achieved 97%, 95%, 95%, 96%, and 94% in terms of precision, recall, F1-score, AUC, and accuracy respectively. The considered design notes were also assessed using a new proposed questionnaire based on existing ones in terms of user experience, user interface, mechanics, in-env assistance, and VR induced symptoms and effects. The designed VR system provided an acceptable level of user experience, with participants reporting an enjoyable and immersive experience. While there were areas for improvement, including graphics and sound quality, as well as comfort issues with prolonged HMD use, the user interface and mechanics of the system were generally well-received.
CONCLUSIONS: The reported results state that our method\'s comprehensive analysis of 3D brain volumes and incorporation of cognitive scores enabled earlier detection of AD progression, potentially allowing for timely interventions and improved patient outcomes. The proposed integrated system provided us with promising insights for improvements in the diagnosis of AD using technologies.

HIV infection is a multi-organ disease that involves the central nervous system (CNS). While devastating CNS complications such as HIV-associated dementia and CNS opportunistic infection typically manifest years after HIV acquisition, HIV RNA is readily detected in the cerebrospinal fluid in untreated neuroasymptomatic people with HIV, highlighting that HIV neuroinvasion predates overt clinical manifestations. Over the past two decades, increased awareness of HIV infection within the at-risk population, coupled with the accessibility of nucleic acid testing and modern HIV immunoassays, has made the detection of acute and early HIV infection readily achievable. This review aims to summarize research findings on CNS involvement during acute and early HIV infection, as well as the outcomes following the immediate initiation of antiretroviral therapy during this early stage of infection. The knowledge gap in long-term neuroprotection through early ART within the first year of infection will be discussed.

There is great interest in the development of executive function (EF) in the preschool period. Accordingly, multiple performance-based measures of EF have been developed for this age group, yet little is known about how they compare to one another. This study used a large and diverse sample of 3-to-5-year-old children (N = 846), who completed subtests of the National Institutes of Health\'s Toolbox Cognition Battery (NTCB), the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV), and the EF Touch battery. Scores across the three batteries were compared and associations with age, income, and race/ethnicity were examined. Results revealed that (1) the three tasks were moderately correlated (r = 0.44-0.51, all p < 0.001), but children had higher mean accuracy scores on EF Touch than on the NTCB or the WPPSI-IV. (2) Mean accuracy scores on all batteries were linearly associated with child age (all F > 32.68, all p < 0.0001). (3) Comparisons by income and race/ethnicity showed lower accuracy for low-income children on the WPPSI-IV and lower accuracy for White children on the NTCB. Across all batteries, there was consistently lower accuracy for Hispanic children. In conclusion, the three batteries we examined performed similarly across several metrics. EF Touch may be more appropriate for younger children, while the NTCB performed well with older children.

Cognitive screening assessments for neurological deficits are critical to the initial assessment of post-stroke patients. However, most measures are not designed for post-stroke patients and in particular not for people with aphasia (PWA), because they rely on language functions. The Cognitive Assessment for Stroke Patients (CASP) is a screening test that can also be administered to PWA, and was recently adapted into Hebrew. The current study aimed to compare the performance of post-stroke patients on the Hebrew versions of the CASP and the Montreal Cognitive Assessment (MoCA). Forty medical records of post-stroke patients were retrospectively examined: Twenty participants without aphasia and 20 PWA. The data included demographics, total CASP and MoCA scores, and scores in specific cognitive domains. Correlations were found between total CASP and MoCA scores, for all participants as well as for each group separately. Comparisons between groups revealed significantly higher performance of the participants without aphasia on the MoCA, but not on the CASP. Clinically, these findings suggest that the Hebrew version of the CASP can be implemented as a formal cognitive screening test for post-stroke patients, including PWA. It can help identifying PWA\'s cognitive state and differentiate between language and cognitive impairments, hence, contributing in planning targeted treatment.

BACKGROUND: Cognitive impairment is a critical concern in stroke care, and international guidelines recommend early cognitive screening. The aim of this study was to determine the prognostic accuracy of both the short and standard forms of the Montreal Cognitive Assessment (MoCA) in predicting long-term cognitive recovery following a stroke.
METHODS: For this study, we used data from the Efficacy of Fluoxetine - a Randomized Controlled Trial in Stroke (EFFECTS) study, which encompassed stroke patients from 35 Swedish centers over the period from 2014 to 2019. Cognitive assessments were initially conducted at 2-15 days post-stroke, with follow-up data gathered at 6 months. We used the MoCA for objective cognitive evaluation. For assessing subjective cognitive impairment, we used the memory and thinking domain of the Stroke Impact Scale. For psychometric evaluation of the short Swedish version of MoCA (s-MoCA-SWE), we used cross tables and binary logistic regression.
RESULTS: The study included 1,141 patients (62.2% men; median [interquartile range; IQR] age, 72.3 [13.2] years; median [IQR] stroke severity, 3.0 [3.0]). At baseline, the prevalence of cognitive impairment was 71.7% according to the s-MoCA-SWE (≤12) and 67.0% according to the MoCA (≤25). The s-MoCA-SWE demonstrated a sensitivity of 92.3% for correctly identifying patients with objective cognitive impairment and 81.5% for identifying those with subjective impairments at 6 months. Although the s-MoCA-SWE had higher sensitivity, the MoCA had a more balanced sensitivity and specificity in detecting both subjective and objective cognitive impairments. In both crude and multivariable models, the s-MoCA-SWE was more strongly associated than the MoCA with cognitive impairment at 6 months.
CONCLUSIONS: Both the short and standard versions of the MoCA appear to be effective in identifying individuals likely to experience persistent cognitive issues following a stroke. Considering the limited time available in an acute stroke unit, the short-form version may be more practical. Nevertheless, further prospective studies are required to validate these findings.

Cognitive impairment is one of the invisible symptoms of Multiple sclerosis (MS), which could be associated with depression, unemployment, reduced social interaction, inability to drive, and compromised quality of life. Moreover, the presence of cognitive impairment can be considered as a long-term prognostic factor and in the follow-up of disability. So, cognitive assessment is a crucial element in clinical follow-up of patients with MS (pwMS). International recommendations mention the use of the Brief International Cognitive Assessment in MS (BICAMS). The BICAMS, that has been recently validated in French is a brief non-exhaustive assessment, developed as a short screening battery, hence needing other supplemented tests. The present paper aims to propose a consensus, approved by expert French consensus from the Cognition group of the SF-SEP (http://sfsep.org [Société Francophone de la Sclérose en Plaques]), for cognitive assessment of pwMS suggesting the tools that should be used in order to apprehend the other cognitive impairments that could appear in MS.