Performance of the Automated Neuropsychological Assessment Metrics (ANAM) in detecting cognitive impairment in heart failure patients

The Potential of Automated Assessment of Cognitive Function Using Non-Neuroimaging Data: A Systematic Review

Background/Objectives: The growing incidence of cognitive impairment among older adults has a significant impact on individuals, family members, caregivers, and society. Current conventional cognitive assessment tools are faced with some limitations. Recent evidence suggests that automating cognitive assessment holds promise, potentially resulting in earlier diagnosis, timely intervention, improved patient outcomes, and higher chances of response to treatment. Despite the advantages of automated assessment and technological advancements, automated cognitive assessment has yet to gain widespread use, especially in low and lower middle-income countries. This review highlights the potential of automated cognitive assessment tools and presents an overview of existing tools. Methods: This review includes 87 studies carried out with non-neuroimaging data alongside their performance metrics. Results: The identified articles automated the cognitive assessment process and were grouped into five categories either based on the tools' design or the data analysis approach. These categories include game-based, digital versions of conventional tools, original computerized tests and batteries, virtual reality/wearable sensors/smart home technologies, and artificial intelligence-based (AI-based) tools. These categories are further explained, and evaluation of their strengths and limitations is discussed to strengthen their adoption in clinical practice. Conclusions: The comparative metrics of both conventional and automated approaches of assessment suggest that the automated approach is a strong alternative to the conventional approach. Additionally, the results of the review show that the use of automated assessment tools is more prominent in countries ranked as high-income and upper middle-income countries. This trend merits further social and economic studies to understand the impact of this global reality.

Validation of the automated neuropsychological assessment metrics for assessing cognitive impairment in systemic lupus erythematosus

OBJECTIVE

We previously demonstrated the utility of the Automated Neuropsychological Assessment Metrics (ANAM) for screening cognitive impairment (CI) in patients with systemic lupus erythematosus (SLE) and developed composite indices for interpreting ANAM results. Our objectives here were to provide further support for the ANAM's concurrent criterion validity against the American College of Rheumatology neuropsychological battery (ACR-NB), identify the most discriminatory subtests and scores of the ANAM for predicting CI, and provide a new approach to interpret ANAM results using Classification and Regression Tree (CART) analysis.

METHODS

300 adult SLE patients completed an adapted ACR-NB and ANAM on the same day. As per objectives, six models were built using combinations of ANAM subtests and scores and submitted to CART analysis. Area under the curve (AUC) was calculated to evaluate the ANAM's criterion validity compared to the adapted ACR-NB; the most discriminatory ANAM subtests and scores in each model were selected, and performance of models with the highest AUCs were compared to our previous composite indices; decision trees were generated for models with the highest AUCs.

RESULTS

Two models had excellent AUCs of 86 and 89%. Eight most discriminatory ANAM subtests and scores were identified. Both models demonstrated higher AUCs against our previous composite indices. An adapted decision tree was created to simplify the interpretation of ANAM results.

CONCLUSION

We provide further validity evidence for the ANAM as a valid CI screening tool in SLE. The decision tree improves interpretation of ANAM results, enhancing clinical utility.

The Effects of Moderate Physical Exercise on Adult Cognition: A Systematic Review

Background: Physical exercise is a systematic sequence of movements executed with a predefined purpose. This muscular activity impacts not only on circulatory adaptations, but also neuronal integration with the potential to influence cognition. The aim of this review was to determine whether the literature supports the idea that physical exercise promotes cognitive benefits in healthy adults.

Methods: A systematic search for relevant articles was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis criteria using available databases (PubMed, LILACS, Scopus, Web of Science, The Cochrane Library, OpenGrey, Google Scholar and CENTRAL). The search terms included “humans” or “adults” or “cognition” or “awareness” or “cognitive dissonance” or “cognitive reserve” or “comprehension” or “consciousness” and “motor activity” or “exercise” or “physical fitness,” and not “aged” or “nervous system diseases,” with the purpose of finding associations between moderate physical exercise and cognition. A methodological quality and risk of bias unit assessed the eligibility of articles.

Results: A total of 7179 articles were identified. Following review and quality assessment, three articles were identified to fulfill the inclusion criteria. An association between moderate physical exercise and cognition was observed. Improvements in cognitive parameters such as reduced simple reaction time, improved response precision and working memory were identified among the included articles.

Conclusion: This systematic review found that moderate physical exercise improves cognition.

Effect of educational status on performance of older adults in digital cognitive tasks: A systematic review

As people age, cognitive abilities may decline resulting in serious disabilities. Neuropsychological instruments can provide information on the cognitive state of older adults. Researchers worldwide have been using digital cognitive tests to assess cognitive domains.

OBJECTIVE

To determine whether educational status affects the performance of older adults on digital cognitive tasks.

METHODS

A systematic review of articles in English, Portuguese, or Spanish published in the last 5 years was conducted. The databases searched were SCOPUS, PubMed, Lilacs, Scielo and PsychInfo. The PRISMA method was used.

RESULTS

A total of 7,089 articles were initially retrieved. After search and exclusion with justification, seven articles were selected for further review.

CONCLUSION

The findings revealed that researchers using digital tasks generally employed paper-based tests to compare results. Also, no association between years of education and test performance was found. Finally, a dearth of studies using digital tests published by Brazilian researchers was evident.