Search Results (162)

The main purpose of this work is to critically review the literature on neurocognitive disorders (ND) diagnosis. A critical review was conducted in PubMed, Scopus, and EBSCO. Systematic reviews and meta-analyses focusing on ND diagnosis were included. The selected studies were critically analyzed and conceptually integrated to identify relevant dimensions for the diagnosis of ND. The review included 88 studies. Most studies focused on Alzheimer’s disease and mild cognitive impairment. The literature remained predominantly centred on isolated diagnostic domains, and important limitations were consistently identified, including methodological heterogeneity, lack of standardized thresholds, and reduced clinical applicability. Based on the identified conceptual and methodological limitations, a Multidimensional Model of Neurocognitive Disorders (MOND model) for ND diagnosis was proposed. The MOND model was developed as a multidimensional, multilevel, transdiagnostic model integrating biological, neurocognitive, neuropsychiatric, motor, functional, frailty, reserve-related, and socio-environmental dimensions. The model may contribute to research, symptom classification, severity characterization, prognosis, and personalized intervention planning across different ND trajectories. Future studies using the MOND model should focus on refining algorithms to estimate the risk of ND. Full article

Background/Objectives: Apathy is among the most common neuropsychiatric features of late-life neurocognitive disorders and predicts functional decline and greater caregiver burden. As no treatment is formally established, identifying effective interventions is a priority. We systematically reviewed non-pharmacological randomized controlled trials (RCTs) targeting apathy in older adults with neurocognitive disorders. Methods: We searched PubMed/MEDLINE, PsycInfo, the Cochrane Library, and Google Scholar (final search 23 March 2026). Eligible studies were non-pharmacological RCTs reporting an apathy outcome. Evidence levels were graded with OCEBM and quality with PEDro; two reviewers mapped PEDro items onto Cochrane risk-of-bias domains. Reporting followed PRISMA 2020. Results: Sixty-two RCTs were included. Physical exercise and music-based interventions showed the most consistent benefit, whereas technology-based and brain stimulation approaches remained experimental. Only 30 trials (48%) showed a significant between-group effect on apathy—most were null, within-group, or had apathy as a secondary outcome. Marked heterogeneity precluded meta-analysis. Most trials were of moderate to high quality, though near-universal performance bias arose from the inability to blind participants and providers. Conclusions: Managing apathy in these populations remains challenging, and the certainty of the evidence is limited. Purpose-built, apathy-focused trials reporting effect sizes and durability are needed before disease-specific recommendations can be made. Full article

Background: Childhood malnutrition, manifesting as both underweight and obesity, is a global health concern with potential repercussions on neurodevelopment and metabolic health. Objective: To analyze the relationship between nutritional status, metabolic biomarkers, and cognitive performance in school-aged children. Methods: A cross-sectional study was conducted with 100 children between 6 and 12 years of age from a public elementary school in the municipality of Chiconcuac de Juárez, Mexico. Participants were categorized according to BMI: underweight (UW), normal weight (NW), overweight (OW), and obesity (OB). Anthropometric evaluation, serum biochemical markers, and three surrogate metabolic indices, namely the Triglyceride–Glucose (TyG), Triglyceride/high-density lipoprotein cholesterol (TG/HDL), and TyG-Body Mass Index (TyG-BMI), were calculated. Cognitive performance was assessed using the Wechsler Intelligence Scale for Children (WISC-IV). Results: The OB group children showed significantly higher levels of TG, TC and LDL-C, as well as elevated levels of TyG, TG/HDL and TyG-BMI indices (p < 0.05) and lower HDL-C concentration. While no significant differences were found in Full-Scale IQ (FSIQ), the NW group showed significantly higher performance in the PSI compared to all other groups outside the healthy weight range after FDR correction. Spearman’s correlation showed that surrogate metabolic indices exhibited exclusive negative correlations with the PSI in unadjusted bivariate models. Conclusions: The extremes of the nutritional status spectrum (UW and OB) are concurrently associated with early metabolic alterations and latent cardiovascular risk, while concurrently tracking with lower performance in selective fluid cognitive domains within unadjusted models. Furthermore, surrogate metabolic indices were shown to be valuable tools that co-vary with neurocognitive profiles. Full article

Background: Frequent consumption of foods high in fat and sugar (HFS) has been linked to disrupted appetite regulation (via hippocampal dysfunction) and an increased tendency to continue desiring palatable foods, even when physiologically full. While we have previously shown that motivational drive for such foods can persist when full, it remains unclear whether attentional engagement (i.e., the visual attention captured by palatable foods) shows a similar sustained desire to consume palatable foods when full. Understanding whether attention persists is critical, as attention can powerfully shape food choice and overeating. Methods: This study investigates whether habitual HFS intake was associated with the maintenance of visual attention, motivational responses, and food consumption when satiated. Twenty-four adults aged 18–30 years completed a food frequency questionnaire and a bogus taste-rating task once when hungry and again after consuming a standardised meal. Using Tobii Pro Glasses 3 wireless eye-tracking glasses, we measured fixations on real snack foods, and participants rated wanting and liking for each item. Results: Eating a meal significantly reduced total fixations to snack foods, and wanting was more sensitive than liking to physiological state. Fixations were higher for ‘healthy’ snacks compared to ‘unhealthy’ snacks, with this effect more pronounced when participants were hungry. Notably, individuals in the low-fat/low-sugar group showed strong alignment between post-meal decreases in visual attention and decreases in wanting and liking, whereas this coupling was diminished in the high-fat/high-sugar group. Discussion: Extending previous work into the domain of attention, this study reveals diet-related differences in how visual attention interacts with motivational evaluations of food. The disrupted coupling associated with high-fat/high-sugar intake suggests potential alterations in attentional and motivational processes supporting appetite regulation. Understanding how diet shapes these cognitive–motivational interactions provides a valuable foundation for future neurocognitive research on overeating and obesity risk. Full article

Background: The necessity of prophylactic cranial irradiation (PCI) for limited-stage small-cell lung cancer (LS-SCLC) is increasingly debated in the era of high-resolution magnetic resonance imaging (MRI). This meta-analysis evaluated the survival and neurocognitive effects of PCI in LS-SCLC patients confirmed negative for brain metastases (BM) by pre-PCI MRI. Methods: Following PRISMA guidelines, a systematic search of PubMed, Embase, and Cochrane Library was conducted through 23 September 2025. Pooled hazard ratios (HRs) and risk ratios (RRs) were calculated to assess overall survival (OS), progression-free survival (PFS), brain metastasis-free survival (BMFS), and BM rate. Results: Eleven studies involving 1894 patients were synthesized. PCI conferred a significant survival advantage, reducing the risk of death by 31% (HR = 0.69, 95% CI: 0.61–0.78), which translated to an absolute OS improvement of 8.5% at 2 years and 6.5% at 5 years. Substantial improvements were also observed in PFS (HR = 0.71, 95% CI: 0.60–0.84) and BMFS (HR = 0.53, 95% CI: 0.32–0.88), alongside a 36% reduction in BM rate (RR = 0.64, 95% CI: 0.53–0.77). Notably, PCI maintained its OS benefit even when compared directly against active MRI surveillance. While neurocognitive adverse events were reported, evidence suggests that these effects are predominantly transient and domain-specific, without a sustained decrease in global quality of life. Conclusions: In the MRI-staging era, PCI remains a significant therapeutic option for LS-SCLC. It offers a favorable risk–benefit profile by significantly enhancing survival while maintaining manageable neurocognitive safety. Full article

Background and Objectives: The neurocognitive sequelae of COVID-19 have attracted attention as part of post-COVID condition (PCC), yet standardized tools for screening and quantifying PCC-related cognitive impairment remain scarce. The present study aimed to develop and validate the Screening for Neurocognitive Abilities Post-COVID (SNAP-COVID), a self-report questionnaire designed to capture current symptom burden and perceived changes in cognitive functioning relative to pre-COVID status in a Greek-speaking sample. Materials and Methods: Data collection occurred in three phases between August 2024 and February 2025. Dataset A (N = 27) was used for test–retest reliability. Dataset B (N = 300) was used for exploratory factor analysis (EFA), reliability testing, and convergent validity analyses with the Brain Fog Scale (BFS). Dataset C (N = 317) was used for independent validation through confirmatory factor analysis (CFA). Results: Initial EFA of the 30-item SNAP-COVID scale suggested a four-factor model, yet further item refinement yielded a robust three-factor, 24-item solution: (1) General Cognitive Functions (17 items, α = 0.948), (2) Sensory Hypersensitivity (4 items, α = 0.829), and (3) Language and Communication (3 items, α = 0.950). The total scale demonstrated excellent internal consistency (α = 0.95). Convergent validity was evident by significant correlations between SNAP impact scores and BFS scores (r = −0.442, p < 0.001). CFA confirmed the three-factor structure with acceptable fit indices (χ²(249) = 677.29, p < 0.001; CFI = 0.882; TLI = 0.869; RMSEA = 0.074; SRMR = 0.032). Conclusions: The SNAP-COVID scale is a reliable and valid instrument. Its multidimensional structure captures global and domain-specific difficulties, addressing a critical gap in post-infectious cognitive assessment. Full article

Background/Objectives: No study has investigated the effect of the catechol-O-methyltransferase (COMT) Val158Met rs4680 polymorphism in cognitive and executive performance in migraine. The current study investigated the potential influence of the Val158Met rs4680 polymorphism in cognitive performance/executive function in women with migraine. Methods: One hundred and forty women with migraine (70 chronic and 70 episodic) and 70 healthy controls completed the following neurocognitive tests (D2 Attention test and Rey–Osterrieth Complex Figure) and executive functions (subtest “Digits D/R/I” of the Wechsler Adult Intelligence Scale WAIS-IV battery for, the 5-Digit test, the Symbol Search for and the Zoo Test) for evaluating selective attention, visual perception, working memory, mental inhibition, processing speed and planning/decision making, respectively. Thus, three genotypes (Val/Val, Val/Met, and Met/Met) of the Val158Met polymorphism were identified by polymerase chain reaction. The effect of group and Val158Met genotype in neurocognitive tests and executive functions was evaluated with multivariate analysis of covariance (MANCOVA). Results: The MANCOVA revealed a significant Val158Met polymorphism* group interaction on neurocognitive performance (Wilk’s λ = 0.393, F [76,688] = 2.425, p < 0.001, n2p = 0.208, 1 − β = 0.999), not influenced by age (Wilk’s λ = 0.920, F [19,174] = 0.743, p = 0.734, n2p = 0.035, 1 − β = 0.120), educational level (Wilk’s λ = 0.875, F [19,174] = 1.024, p = 0.440, n2p = 0.047, 1 − β = 0.190) and prophylactic medication (Wilk’s λ = 0.855, F [19,174]= 1.000, p = 0.467, n2p= 0.145, 1 − β = 0.686). Post hoc analyses revealed that women with chronic migraine with the Met/Met genotype exhibited domain-specific better performance (i.e., higher selective attention, visuospatial memory) and executive functioning (i.e., working memory, planning/decision making) than those women with chronic migraine carrying Val/Val or Val/Met genotypes. Conclusions: We found an association of the Met/Met genotype with neurocognitive performance/executive functioning, particularly in women with chronic migraine since women with chronic migraine carrying the Met/Met genotype showed domain-specific better cognitive performance/executive functioning than those with the Val allele. Future studies including large sample sizes from different geographic locations are needed to better generalizability and validity of the current results. Full article

Executive functions (EFs) are key cognitive processes for behaviour. However, there is little information about interaction with the dimensions of health-related quality of life (HRQoL), therefore the objective of this study was to analyse the association between lifestyle habits (physical activity and screen time), sleep, HRQoL and EFs in children and adolescents. Specifically, this study aimed to identify the extent to which perceived well-being dimensions are associated with EFs and to determine the potential mediating role of HRQoL in the relationships between lifestyle habits and these cognitive domains, examining whether these direct and indirect pathways remain robust after adjusting for gender and age. A total of 943 children and adolescents (51.3% female) aged 10–17 years participated. Lifestyle parameters (PA Krece Plus, sleep duration and KIDSCREEN-10 questionnaire) and EFs (CogniFit neurocognitive assessment battery) were evaluated. The analysis of the individual KIDSCREEN-10 items revealed that perception of school performance presented the most consistent association with EFs, being positively related to attention (b = 16.39, p = 0.018), cognitive flexibility (b = 30.65, p = 0.005), inhibition (b = 24.66, p = 0.022), and working Memory (b = 42.33, p < 0.001). Furthermore, parental fairness reported a significant association for three out of four domains: attention (b = 13.89, p = 0.006), flexibility (b = 22.93, p = 0.003), and working Memory (b = 25.42, p < 0.001). Having enough time for self was also significantly related to attention performance (b = 12.60, p = 0.026). Regarding lifestyle habits, the composite lifestyle index (PA + ST) showed the most consistent positive association across all cognitive domains, while sleep duration was inversely associated with attention, cognitive flexibility, and working Memory. The mediation analysis revealed that global HRQoL significantly mediated the relationship between lifestyle habits and executive functions, accounting for 9.55% of the total effect on attention, 5.45% on cognitive flexibility, and 4.14% on working memory, whereas no mediation was observed for inhibition. In conclusion personal time, parental fairness, and school adjustment were positively associated with EFs. HRQoL and physical activity levels also showed consistent links with all EFs, whereas sleep duration was inversely related. Furthermore, mediation analysis revealed that global HRQoL acts as a critical indirect pathway, explaining a significant proportion of the lifestyle habits’ total effect on attention, cognitive flexibility, and working memory. Overall, these findings highlight the multifactorial and interrelated mechanisms shaping executive functioning in children and adolescents. Full article

Background: Procrastination is a voluntary and irrational delay in taking action despite negative consequences. We aimed to conceive/suggest a definition of procrastination, assess the behavior, and determine its psychopathological features (within the contexts of attention-deficit/hyperactivity disorder and obsessive–compulsive disorder. Method: In this scoping study, we systematically reviewed original research studies with conceptual and clinical data related to procrastination. Data were extracted regarding definitions, populations, instruments used, and psychopathology. Results: A total of 387 studies were included. Only 13% utilized clinical/subclinical populations. Definitions of procrastination showed no single consensus. The most cited elements involved irrational delay, awareness of consequences, task aversiveness, and self-regulation failure. The most frequently used assessment tool was Lay’s General Procrastination Scale. A considerable number of studies identified associations between procrastination and clinical constructs such as impulsivity, perfectionism, executive dysfunction, low self-esteem, and mood instability. Few studies directly assessed procrastination in formal diagnostic categories, suggesting that procrastination shares neurocognitive and emotional regulation deficits with these disorders, especially in domains involving task initiation, inhibitory control, and intolerance of discomfort. Conclusions: Procrastination is a transdiagnostic construct rather than a unitary behavioral trait. Its multifactorial nature calls for further clinical investigation, particularly in structured diagnostic settings. A unified definition is needed to distinguish between normative delay and clinically relevant procrastination. Full article

Migraine affects over one billion individuals worldwide and is increasingly recognized as a systemic disorder with broad cardiovascular comorbidities extending beyond its neurological profile. Despite growing epidemiological evidence, the intersections of migraine with cardiovascular risk stratification, stroke mechanisms, endothelial dysfunction, neuroimaging findings, and neurocognitive profiles remain incompletely mapped. Following the PRISMA-ScR framework, we searched PubMed/MEDLINE for recent (2015–2025) English-language human studies with large sample sizes (≥400) examining cardiovascular outcomes, vascular biomarkers, neuroimaging, or endothelial function in adult migraine populations. The protocol was preregistered on OSF. Forty-three studies encompassing more than 1,500,000 participants across seven thematic domains were included. Migraine with aura was consistently associated with increased ischemic stroke risk in a non-atherosclerotic pattern, with evidence suggesting potential cardioembolic mechanisms including patent foramen ovale and atrial fibrillation. Active episodic migraine paradoxically showed inverse associations with traditional cardiovascular risk scores, while inflammatory biomarkers such as high-sensitivity C-reactive protein and fibrinogen remained interictally elevated, and white matter hyperintensity burden was substantially higher than controls, though available evidence did not indicate increased dementia risk. Cardiovascular disease may represent a clinically relevant comorbidity of migraine, warranting integrated multidisciplinary management. Future studies should prioritize sex-stratified longitudinal designs with aura-specific risk modeling and cerebral endothelial assessment. Full article

Background: People living with HIV (PLWH) are increasingly reaching older ages due to the success of antiretroviral therapy. However, aging with HIV is associated with increased risk of multimorbidity, neurocognitive impairment, frailty, psychosocial stress, and functional decline. Multidomain geriatric screening framed within an Age-Friendly 4Ms Framework (Mentation, Medication, Mobility, What Matters Most) and consideration of multi-complexity may help identify aging-related vulnerabilities and guide multidisciplinary care with greater impact on patient outcomes. However, real-world implementation of such programs within HIV clinical settings remains limited. Methods: We conducted a retrospective analysis of adults aged ≥50 years enrolled in a multidisciplinary Healthy Aging Program within a large, integrated HIV care system. Multidomain screening assessments included cognitive evaluation (Montreal Cognitive Assessment), mental health screening (PHQ-2, GAD-2), functional assessment (Katz ADL, Lawton IADL), frailty screening (Edmonton Frail Scale), and intrinsic capacity domains using the WHO Integrated Care for Older People (ICOPE) framework. Screening results, referrals, clinical interventions, and cardiometabolic risk management measures were extracted from clinical program databases and electronic medical records. Results: A total of 317 adults aged ≥50 years completed multidomain screening. Participants had well-controlled HIV infection, with viral suppression in 96.2% and a median CD4 count of 660 cells/mm³. Despite this, aging-related vulnerabilities were common. Overall, 78.4% of participants had at least one abnormal screening domain. Cognitive impairment was identified in nearly half of individuals screened, including mild impairment in 39.8% and moderate impairment in 8.7%. Functional limitations were identified in 10.1% of participants, while anxiety symptoms were present in 9.5%. Sensory impairments were common, including vision impairment in 36.5% of participants. Polypharmacy was prevalent, with 33.2% of participants prescribed five or more chronic medications. Screening frequently generated multidisciplinary referrals, including behavioral health services (42.3%), social work support (42.9%), and pharmacist-led cardiometabolic risk review (56.8%). Age-stratified analyses demonstrated similar prevalence of screening abnormalities across age groups, including individuals aged 50–59 years. Modest improvements in cardiometabolic preventive care were observed during follow-up. Statin utilization increased from 65.6% at baseline to 70.0% at 12 months, and LDL cholesterol declined modestly during the observation period. Conclusions: Multidomain screening integrated into routine HIV care identified a high prevalence of aging-related vulnerabilities among PLWH aged ≥50 years despite excellent virologic control. These findings suggest that aging-related risk in HIV is not adequately captured by chronological age alone and support early, universal implementation of multidomain screening within HIV care models. Full article

Circadian desynchronization is increasingly linked to metabolic, immune, neurocognitive, and oncological disease, but integrated clinical phenotyping across endocrine, microbiome, metabolic, and neuroimaging domains remains limited. We conducted a prospective, single-centre, observational study in 179 symptomatic patients referred for chronic multisystem features consistent with circadian dysregulation and 107 practically healthy controls. Circadian melatonin status was assessed using fractionated 24 h urinary 6-sulfatoxymelatonin (aMT6s) and standardized dim-light plasma sampling at daytime (14:00–16:00) and nocturnal (02:00–04:00) windows. Microbiome composition was assessed by 16S rRNA sequencing, urolithin A by targeted metabolomics, and putative glymphatic/perivascular clearance by MRI-derived DTI-ALPS index, perivascular space scoring, and white-matter-hyperintensity (WMH) volumetry. Patients showed markedly reduced nocturnal melatonin output and loss of day–night contrast (night aMT6s 10.2 vs. 40.6 ng/mL; urinary aMT6s day/night ratio 0.81 vs. 0.14; plasma nocturnal melatonin 12.7 vs. 54.4 pg/mL; all p < 0.0001), accompanied by altered cortisol day–night patterning. Patients also showed reduced microbiome diversity, depletion of Gordonibacter and Ellagibacter, lower plasma urolithin A, higher WMH volume and perivascular space scores, and a lower DTI-ALPS index. Age distributions broadly overlapped in the individual-level dataset, and key biomarkers were not significantly correlated with chronological age within the patient cohort; however, this finding is interpreted as an exploratory absence of detectable age gradient within the symptomatic cohort, not as proof of biological age-independence. Overall, the data support a coherent cross-sectional association among blunted nocturnal melatonin rhythmicity, dysbiosis/urolithin depletion, and MRI markers compatible with impaired perivascular clearance. The MGM axis framework should be regarded as hypothesis-generating; causal direction, melatonin receptor involvement, and AQP4-related mechanisms require longitudinal and mechanistic validation. Full article

Background/Objectives: Sleep problems, cognitive deficits, and mood disorders are prevalent in justice-involved populations, especially among individuals with a history of traumatic brain injury (TBI), though the association between these variables remains understudied. This retrospective study examined the relationship between subjective sleepiness and mood state on neuropsychological functioning in a forensic population with self-reported TBI. Methods: Data were obtained from 419 inmates and probationers with a self-reported history of TBI using the Ohio State University Traumatic Brain Injury Identification Method and Automated Neuropsychological Assessment Metrics (ANAM). Multiple linear regression models examined associations between cognitive performance across domains (i.e., reaction time, learning, attention, processing speed, working memory, delayed memory, and inhibition) and subjective sleepiness and mood states (i.e., depression, anxiety, fatigue, restlessness, anger, happiness, and vigor) measured by self-report scales embedded in the ANAM. Results: Negative mood state was most associated with impaired performance on tests of learning, delayed memory, spatial working memory, and reaction time, as well as global neurocognitive test performance. Subjective sleepiness was predictive of poorer performance on reaction time tasks, while positive mood states were related to better performance on the same task. Regression models were statistically significant (p < 0.05), with subjective sleepiness and mood accounting for approximately 1–5% of the variance in cognitive performance. Conclusions: Subjective sleepiness and mood symptoms are significantly related to cognitive performance among justice-involved individuals with self-reported TBI. While these factors can contribute to the need for rehabilitation, they may also reduce the likelihood of successful engagement. Importantly, both sleepiness and mood are modifiable treatment targets, and adapting interventions to accommodate cognitive inefficiencies can improve engagement and overall treatment benefit. Full article

Background/Objectives: Post-COVID-19 condition involves heterogeneous, multisystem symptoms with uncertain recovery. We characterized symptom trajectories from hospitalization to approximately 4 weeks and to 6–8 months and compared the 6–8-month symptom burden with season-matched controls, accounting for serology-identified, previously unrecognized infections. Methods: An individually pair-matched case–control study of adults with RT-PCR–confirmed SARS-CoV-2 and population controls from the Bialystok PLUS cohort, matched on age, sex and a two-month visit window, was performed. All participants underwent anti-nucleocapsid serology. Hospitalized cases were reassessed at approximately 4 weeks and 6–8 months. Cross-sectional outcomes used non-parametric tests and multivariable regression; longitudinal change used paired tests and generalized estimating equations. Results: We included 402 adults (201 post-COVID-19; 201 controls). In hospitalized cases, respiratory symptoms declined rapidly by approximately 4 weeks and remained low at 6–8 months; smell/taste recovered more slowly; fatigue improved modestly; anxiety changed minimally. At 6–8 months, total symptom counts were higher in post-COVID-19 than in controls (median 4 vs. 2), with serology-positive controls intermediate (median 3). Excess burden was concentrated in non-respiratory domains (fatigue, neurocognitive, cardiovascular, and dermatologic), whereas respiratory differences were not significant. In the multivariable model, female sex remained an independent predictor of higher multisystem burden, whereas age, body mass index, hospitalization, and acute biomarker severity were not associated. Conclusions: Six to eight months after symptomatic COVID-19, multisystem symptom burden remains substantial relative to season-matched controls, despite substantial resolution of respiratory complaints. Serology-based identification of previously unrecognized infections indicates an intermediate burden and can guide targeted follow-up. Full article

Background: Language impairment is a core feature of Major Neurocognitive Disorder (MND), yet the domain-specific relationship between language functioning and everyday functional status remains insufficiently characterized. Methods: We conducted a retrospective observational study in 125 older adults diagnosed with MND according to DSM-5 criteria with mild-to-moderate cognitive impairment measured with Mini-Mental State Examination (MMSE). Language performance was assessed using semantic, phonemic verbal fluency and confrontation naming. Functional status was evaluated using basic (BADL) and instrumental activities of daily living (IADL). Ordinal logistic regression models examined associations between language domains and functional outcomes, adjusting for global cognitive status (MMSE), demographic variables, multimorbidity, and depressive symptoms. Model fit was evaluated using the Akaike Information Criterion. Results: Semantic fluency emerged as the best-performing predictor of BADL across all hierarchical models, remaining statistically significant after full adjustment for MMSE and clinical covariates (β ≈ 0.60, p < 0.05). Phonemic fluency showed the most robust association with IADL, with a stable effect across models, reaching a trend toward statistical significance in the fully adjusted analyses (β ≈ 0.22–0.27, p = 0.069). Naming ability did not influence functional outcomes. All observed associations persisted after controlling for MMSE, demographic variables, multimorbidity, and depressive symptoms. Conclusions: Language abilities showed differential associations across language domains with functional status in this sample of patients with MND. Semantic fluency was associated with basic self-care, while phonemic fluency showed a trend toward association with instrumental daily activities. These relationships remained observable after adjustment for global cognitive impairment, suggesting verbal fluency as a potentially sensitive marker of functional vulnerability. Full article