Neuropsychology最新文献

Objective: Neuropsychologists routinely use scores on traditional paper-and-pencil tests to assess capacity for independent functioning, with these assessments accounting for a moderate amount (20%-37%) of the variance in instrumental activities of daily living (IADL) performance. The field is shifting toward incorporation of computerized neuropsychological assessments such as the National Institutes of Health Toolbox Cognition Battery (NIHTB-CB). There have been no studies examining how the NIHTB-CB relates to IADL performance or whether it better predicts IADL performance compared to traditional methods.

Method: Data from 74 participants in the Lithium as a Treatment to Prevent Impairment of Cognition in Elders were analyzed. Participants completed a neuropsychological assessment battery, the NIHTB-CB, and measures of IADL capacity. Linear regression was used to determine whether NIHTB-CB performance predicted IADL performance. Hierarchical multiple regression was used to determine whether NIHTB-CB added incremental validity to the prediction of IADL performance.

Results: Select NIHTB-CB measures predicted IADL functioning as measured by a performance-based assessment of everyday functioning, but not self- or informant-reported everyday functioning. Of these subtests, two were found to add incremental validity to the prediction of IADL performance above and beyond their matched traditional measures, with effect sizes ranging from mild to moderate (FΔR² = .045-.077).

Conclusions: We found performance on individual NIHTB-CB subtests predicted approximately the same amount of variance in IADL functioning as traditional tests, with only subtests assessing processing speed and executive functioning adding a mild to moderate amount of additional variance above matched measures. It remains important for clinicians to consider additional determinants of functioning when using computerized assessments. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: The present study characterized how language dominance and language of testing affect word list learning in older bilinguals, using picture naming in the two languages as a continuous objective measure of bilingual proficiency level. No previous study examined language dominance effects on list learning in older bilinguals or provided detailed information about language dominance effects over multiple learning trials, even though these measures provide critical diagnostic information.

Method: Forty older Spanish-English bilinguals were tested on two 10-word lists in each language, with two learning trials for each list, and with language of testing order counterbalanced between participants.

Results: Bilinguals recalled fewer words in both primacy and recency regions in the nondominant than in the dominant language, especially on Trial 1 (language dominance effects were 8.5 times larger on Trial 1 than Trial 2, after adjusting proportionally for baseline recall). The extent of language dominance was significantly correlated across picture naming and list learning, but only on Trial 1. Finally, language dominance effects were proportionally weaker on list learning (even on Trial 1) than in picture naming.

Conclusions: List learning is a hybrid comprehension/production task that is less affected by bilingualism than pure production tasks. However, testing list learning in a nondominant language can distort assessment of memory, particularly on some critical measures. Use of an independent objective measure of language proficiency provides a more precise indication of the extent to which language dominance should affect list learning in older bilinguals. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Multiple sclerosis (MS) is a neurological condition that affects physical, cognitive, and emotional functions, significantly impacting quality of life (QoL) even in its early stages. Beyond the typical motor, sensory, visual, and brainstem disorders usually assessed by the Expanded Disability Status Scale, MS also impairs functional body representations and interoception, diminishing overall functioning and QoL. In this study, we aim to explore the relationships between functional body representations, interoceptive processes, and major clinical outcomes, including physical disability (Expanded Disability Status Scale), fatigue severity, and health-related QoL in people with MS.

Method: Fifty-nine people with MS were assessed with tasks assessing body representations, action-oriented and nonaction-oriented, and interoception.

Results: Action-oriented and nonaction-oriented body representation performance was significantly associated with fatigue severity (r = -.337 and r = .301, respectively; ps ≤ .021), suggesting that body representations are particularly vulnerable to perceived fatigue in MS. In addition, fatigue severity and bowel/vesical dysfunction were positively correlated with the tendency to overestimate one's own interoceptive capabilities (r = .335 and r = .311, respectively; ps ≤ .017), highlighting the role of MS-related disability in interoception.

Conclusions: These findings underscore the importance of integrating assessments of body representation and interoception into clinical practice to guide therapeutic interventions aimed at improving people with MS outcomes and QoL. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Cognitive dysfunction is a transdiagnostic feature of psychiatric disorders and a major contributor to functional and psychosocial disability. Despite its clinical importance, the structure and dynamics of cognitive dysfunction across psychiatric conditions remain unclear. Network analysis offers a promising framework to conceptualize cognition not as isolated domains, but as interdependent systems of functions that dynamically interact with clinical symptoms and behavioral outcomes. This scoping review systematically mapped and synthesized 59 empirical studies applying network analysis to cognition across psychiatric disorders, including schizophrenia, major depression, bipolar disorder, and others.

Method: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, we extracted and synthesized data on sample characteristics, cognitive assessments, network models, and key findings.

Results: Most studies employed undirected, cross-sectional Gaussian graphical models, while directed or longitudinal models remained rare. Fewer than half of the studies conducted inferential statistics, with the remainder relying on descriptive observations. Overlap between studies was weak for cognitive domains studied and very weak for cognitive instruments used. Most studies originated from Europe, followed by Asia and North America; no studies were conducted in Latin America or Africa. Across disorders, cognition typically emerged as a distinct yet highly interconnected domain within broader psychopathological networks. Processing speed and working memory were consistently featured as central nodes, particularly in schizophrenia, lending support to their role as foundational elements of cognition. However, substantial methodological heterogeneity and limited causal modeling challenges remain.

Conclusions: Future research should emphasize theory-driven frameworks, longitudinal designs, standardized cognitive assessments, and replicability to better understand the role of cognition in psychiatric disorders. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Neuropsychological testing is the standard of care in the United States for assessing functional deficits related to cognitive impairment. However, there are well-known limitations of neuropsychological testing, including issues of reliability and validity, appropriate norming, predictive and ecological validity, and cultural appropriateness. The goal of this case example is to differentiate assessment from testing and to describe how assessment of brain-behavior relationships can be conducted when testing data are not available.

Method: This case example describes a neuropsychological differential diagnosis where the individual being examined was unable to participate in any standardized testing and had no available brain imaging. By necessity, the entirety of the differential diagnosis rests on the history and behavioral observations. This case is presented as a fact-finding exercise, as it would be in a board examination to assess neuropsychological competencies.

Results: The diagnostic value of history and behavioral observations are discussed in the context of disease base rates to rule in/rule out differential diagnoses involving the peripheral and central nervous systems. Clearly, standardized neuropsychological testing would add important data to revise and refine diagnoses and to develop treatment interventions.

Conclusions: Neuropsychological competency examinations usually observe clinicians in a controlled environment with comprehensive information, similar to demonstrating swimming skills in a swimming pool. However, neuropsychologists should also be able to swim in the ocean, where the setting is not well controlled, comprehensive information may not be available, and the waters are often murky, such as when assessing patients where standardized testing is not possible. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Slower processing speed is implicated in memory impairment in both aging and multiple sclerosis (MS). Cognitive reserve serves as a buffer against memory decline and dementia, but no studies have reported on its mediating effect on the associations between processing speed and memory. Therefore, we investigated whether cognitive reserve mediated the relationship between processing speed and verbal memory in older adults and whether the presence of MS modified this association.

Method: Older adults with MS (n = 104; M_age = 64.84 ± 4.36 years) and healthy controls (HCs: n = 105; M_age = 68.33 ± 7.24 years) underwent neuropsychological testing and brain magnetic resonance imaging. Cognitive reserve was derived using residuals from a regression model predicting a modified total score of the Repeatable Battery for the Assessment of Neuropsychological Status from demographic and brain integrity variables. Processing speed was assessed via the oral Symbol Digit Modalities Test, and memory via the Hopkins Verbal Learning Test-Revised.

Results: Cognitive reserve fully mediated the association of Symbol Digit Modalities Test on Hopkins Verbal Learning Test-Revised: immediate recall when fully adjusted for covariates (indirect effect: b = 0.221, 95% bootstrap CI [0.120, 0.322]). For delayed recall, cognitive reserve partially mediated this association in adjusted models (b = 0.221, 95% bootstrap CI [0.124, 0.322]). Group status (i.e., older adults with MS vs. HC) did not significantly moderate the mediating effect of cognitive reserve on either outcome.

Conclusions: Cognitive reserve mediated associations between processing speed and memory performance in older adults with and without MS, highlighting its protective role against memory decline. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: The California Verbal Memory Learning Test, second edition (CVLT-II) is used to assess learning and memory impairment. However, CVLT psychometric validity is not established for American Indian populations, who have high risk, as well as important sociocultural considerations in standardized testing.

Method: The Strong Heart Study conducted repeated CVLT-II short form testing among American Indian Elders across 3 U.S. regions in 2010-2013 (n = 801) and 2017-2019 (N = 386), in addition to sociodemographics and other neuropsychological testing. CVLT-II short form provides four main indices of delayed memory: 30-s (short), 10-min (long), cued, and recognition-discrimination. Statistical analyses examined inferences of CVLT-II short form delayed memory score validity with confirmatory factor analysis, generalizability and test-retest reliability with Pearson correlations, and extrapolation with path analysis.

Results: Participants were generally older (age 65-95), majority female, and majority with education 12-14 years. Fewer than 5% had missing data. Unidimensional single factor model fits were adequate (RMSEA 0.07, 90% CI 0.03-0.11; comparative fit index 0.99). Within-group and within-visit raw score comparisons were statistically significant for age, sex, and education, suggesting important score differences. Primary path analysis model suggested that age, sex, education, bilingual, and depression accounted for 16% of variance in test performance.

Conclusions: Overall, these findings suggest that CVLT-II short form has good test structure in American Indian elders, but with needed contextualization by age, sex, and education. These findings offer support for CVLT in clinical and research use but also need for further research on cultural and community factors affecting standardized cognitive testing. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Evaluate the relations of left ventricular mass (LVM) and left ventricular hypertrophy (LVH) to cognitive function in midlife adults and examine potential moderating influences of self-identified race and poverty status.

Method: Participants were 1,107 African American and White urban-dwelling adults (M_age = 52.19, 60.4% female, 56.5% African American, 34% below 125% of the poverty line) from the Healthy Aging in Neighborhoods of Diversity across the Life Span study. Multivariable linear regressions examined up to three-way interactions of LVM (and LVH), race, and poverty status to tests of attention, memory, executive function, verbal abilities, and perceptuo-motor speed. Covariates included demographic variables and cardiovascular disease risk factors.

Results: There were no significant three- or two-way interactions of LVM (or LVH), race, or poverty status for any cognitive outcome. Backward elimination identified significant main effects of LVM on the Brief Test of Attention (β = -0.089, p = .010) and Trails Making Test (TMT)-B (β = 0.072, p = .021). Main effects of LVH were significant for the Brief Test of Attention (β = -0.075, p = .017), TMT-B (β = 0.071, p = .012), TMT-A (β = 0.078, p = .009), and Verbal Fluency (β = -0.067, p = .027). Both LVM and LVH were negatively associated with performance.

Conclusions: In the presence of nonsignificant interactions, those with higher LVM (and LVH) displayed poorer performance on tests of divided attention, executive function, semantic verbal fluency, and perceptuo-motor speed. Findings may reflect the early emergence of neurocognitive changes associated with elevated cardiovascular risk in this largely middle-aged sample. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: The aim of the study was to investigate the trajectories of phonemic verbal fluency (PVF) and semantic verbal fluency (SVF) across the lifespan in the Greek language and explore the effect of age, gender, and education on individuals' performance.

Method: To this end, a total of 1,426 native speakers of Greek, ranging from 4 to over 75 years old, participated in the study. The sample was organized into 25 distinct age groups to ensure a detailed analysis across developmental stages.

Results: The results indicated a similar developmental trajectory for both PVF and SVF. Moreover, a strong effect of all three variables on individuals' performance was demonstrated. More specifically, verbal fluency performance increased steadily during childhood and adolescence, reaching a peak around the age of 40 (∂SVF∂Age = 0,Age = 39.98;∂PVF∂Age = 0,Age = 40.1), and followed by a gradual decline in later adulthood. Women (∂SVF∂Age = 0,Age = 42.98;∂PVF∂Age = 0,Age = 42.07) revealed a better performance (p < .001) than men (∂SVF∂Age = 0,Age = 39.23;∂PVF∂Age = 0,Age = 38.86), especially after the age of 40-45 years, while higher levels of education were associated with better performance in adults.

Conclusions: These findings highlight the importance of demographic factors in shaping verbal fluency abilities and underscore the need for age-, gender-, and education-sensitive assessments in clinical and educational contexts. Further research, however, is needed to explore the cognitive mechanisms underlying these effects and especially the timing of the beginning of cognitive decline. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: The inhibition deficit hypothesis postulates that inhibitory functioning declines with age, which negatively impacts other cognitive abilities. Yet still, the impact of healthy aging on inhibitory functioning remains unclear, with the multifaceted nature of inhibition often an overlooked factor. Moreover, no prior study has empirically tested whether inhibitory subcomponents explain differential age effects in sustained attention-an open question that this work aimed to address.

Method: We cross-sectionally investigated the inhibition deficit hypothesis in 80 healthy older adults (M_age = 67.78 years, 44 female). We utilized the PsyToolkit platform to administer three inhibition tasks (i.e., flanker, Stroop, and go/no-go), each targeting a distinct subcomponent process, along with the Sustained Attention to Response Task.

Results: The flanker task had low internal consistency and was deemed unreliable. Semipartial correlations of the remaining inhibition measures with age resulted in significant positive relationships with task performance on the Stroop (errors: ρ = 0.337, p = .014; reaction time: ρ = 0.313, p = .028) and a negative association with the go/no-go (balanced integrated score: ρ = -0.471, p < .001), such that older individuals had more pronounced Stroop effects and worse overall go/no-go performance. Finally, go/no-go performance completely mediated the relationship between aging and sustained attention performance (t = -2.30, 95% CI [-0.05, -0.01]), while Stroop effects partially mediated this association (t = -2.16, 95% CI [-0.03, -0.002]).

Conclusions: Age-related declines were observed across reliable inhibition tasks, lending support for the inhibition deficit hypothesis. The mediation findings demonstrate that inhibitory subcomponents account for age-related declines in sustained attention, over and beyond aging itself via an indirect path, representing an important cognitive domain to maintain throughout aging. (PsycInfo Database Record (c) 2025 APA, all rights reserved).