Search Results (205)

Background/Objectives: Visuospatial ability supports everyday tasks, such as judging distance and navigating, yet declines with age, especially after 70. This study presents VR RoomSpace, a virtual reality system combining immersive exploration with paper-based tasks to engage allocentric and egocentric spatial frameworks. Methods: Sixty community-dwelling older adults (aged 65–79; M = 69.8, SD = 4.4; MMSE = 29.2, SD = 1.4) trained for eight weeks. The experimental group (n = 31) received four weeks of pen-and-paper training, then four weeks of VR RoomSpace training; the control group (n = 29) received eight weeks of pen-and-paper training. The Mental Rotation Test (MRT; allocentric) and Perspective Taking Spatial Orientation Test (PTSOT; ego-centric) were assessed at baseline and evaluation. Results: Both groups improved from baseline on both measures. Analysis of covariance adjusting for baseline showed no significant between-group difference in the full sample for the MRT (adjusted difference 1.30, 95% CI [−0.31, 2.91], p = 0.113) or the PTSOT (−9.75°, 95% CI [−22.00, 2.51], p = 0.117). An exploratory subgroup analysis favored the experimental group on the MRT among participants aged 70–79 (2.29, 95% CI [0.22, 4.37], p = 0.031, d = 0.91), but this did not survive correction (Holm-adjusted p = 0.251). No differential PTSOT effect emerged in either subgroup. Conclusions: This pilot study shows that VR RoomSpace can be delivered to older adults. While primary outcomes were null, the exploratory analyses suggested a potentially greater allocentric benefit among participants aged 70–79, warranting confirmation in adequately powered studies. Full article

Matrix reasoning performance is often treated as a static indicator of cognitive ability, although it reflects a dynamic process that unfolds across items. The present study examined how reasoning ability and visuospatial working memory (vsWM) interact with item difficulty and item position to shape problem-solving behavior. Eye movements were recorded from 300 participants during a figural matrices test. Three indices of problem-solving behavior were analyzed using Bayesian multilevel models: toggle rate (ToR), proportional time on matrix (PoM), and proportional time to first fixation on response alternatives (PoFA). Results showed that higher reasoning was consistently associated with behavior indicative of constructive matching, reflected in lower ToR, higher PoM, and higher PoFA. Further, individuals with higher reasoning ability showed stronger adaptations in problem-solving behavior in response to changing task demands. Evidence regarding vsWM was more nuanced, revealing selective interactions with reasoning ability and test characteristics rather than a consistent main effect across measures. Item position revealed substantial between-person variability, which exceeded the variability associated with item difficulty. This suggests that individuals differ more strongly in how their behavior evolves across the test than in their responses to increasing difficulty. Overall, the findings highlight that problem-solving behavior in reasoning tests reflects a dynamic interplay between individual characteristics and test characteristics, emphasizing the importance of modeling both simultaneously when investigating reasoning performance. Full article

Background: Neurocognitive functioning in transgender adults remains understudied and is predominantly derived from Western samples, often treated as universally applicable. Evidence from non-Western contexts is limited, despite the potential influence of structural stigma and minority stress on cognition and research participation. Türkiye represents a sociopolitical setting where transgender individuals face significant barriers to healthcare and research. To date, no study has systematically examined the neuropsychological profile of transgender adults in Türkiye using a four-group design. Methods: This retrospective, cross-sectional study was conducted at a multidisciplinary university-based gender identity clinic. Eighty-one adults were included: transgender women (n = 14), transgender men (n = 39), cisgender women (n = 13), and cisgender men (n = 15), with cisgender groups matched for age and education. Participants completed a standardized neuropsychological battery assessing visuospatial abilities, executive functions/processing speed, working memory, and verbal fluency. Group differences were analyzed using nonparametric methods, with additional aggregated transgender–cisgender comparisons. Results: Group differences were observed in visuospatial functioning (Judgment of Line Orientation, Rey–Osterrieth Complex Figure; all p ≤ 0.05) and executive control (Trail Making Test Part B, p = 0.048; B–A difference, p = 0.014). Group-level differences were domain-specific: both transgender groups scored below both cisgender groups on the visuospatial measures, whereas the ordering on executive-control measures differed, and distributions overlapped substantially throughout. Processing speed, working memory, and verbal fluency did not differ significantly (p > 0.05). No clear association between hormone therapy status and performance was detected in this small sample. Conclusions: The observed distributions were domain-specific and substantially overlapping, and should not be interpreted as indicating correspondence between cognitive performance and either gender identity or sex assigned at birth. Differences were domain-specific, with substantial overlap across groups. Findings support a context-sensitive, non-pathologizing interpretation emphasizing sociocultural factors rather than inherent deficits. Longitudinal and cross-cultural studies incorporating psychosocial variables are needed. Full article

The relation between Attention Deficit/Hyperactivity Disorder (ADHD) and memory performance has attracted growing interest in recent years. However, one of the more complex memory abilities, object–location memory (OLM), remains scarcely studied within the context of ADHD. In this study, we examine incidental and intentional OLM performance in treated and untreated adults with ADHD and in controls. Fifty-eight adults with ADHD (26 medicated and 32 unmedicated) and 51 neurotypical individuals are assessed in a paper-and-pencil format for incidental and intentional OLM under a divided-attention condition. The results showed that all groups demonstrate higher performance in incidental OLM than in intentional OLM. Furthermore, medicated ADHD participants demonstrate reduced incidental OLM performance relative to unmedicated ADHD participants and controls. However, no group differences between unmedicated participants and controls are observed. This study reveals an overlooked aspect of visuospatial performance in ADHD under mental load and calls for further research on the impact of stimulants on incidental OLM. Full article

Background/Objectives: Chronic rhinosinusitis (CRS) is commonly accompanied by sleep disturbance and cognitive complaints, but the relationships among CRS, cognition, subjective sleep, and circulating inflammatory cytokines remain incompletely understood. Methods: In this case–control study, 80 adults with CRS and 98 controls completed validated sleep and sinonasal questionnaires and a 12-test cognitive battery assessing six domains. Plasma cytokines were measured in 101 participants with available biospecimens. Multivariable linear regression and exploratory correlation analyses were performed with false discovery rate correction. Results: Adjusted cognitive domain scores did not differ between CRS and controls. In age-by-group interaction models, CRS showed a nominally steeper age-associated decrease in episodic memory (β = −0.12, 95% CI −0.21 to −0.03; p = 0.009; q = 0.053), with weaker nominal patterns for working memory (β = −0.10, 95% CI −0.20 to −0.003; p = 0.044; q = 0.096) and visuospatial ability (β = −0.08, 95% CI −0.15 to −0.001; p = 0.048; q = 0.096). Plasma IL-6 was nominally higher in CRS after adjustment (β = 0.36, 95% CI 0.04 to 0.67; p = 0.026; q = 0.18) but did not remain significant after cytokine-level correction. Within CRS, exploratory analyses showed nominal inverse correlations between IL-6 and visuospatial ability (ρ = −0.36; p = 0.008; q = 0.236), as well as a nominal positive correlation between IL-13 and semantic memory (ρ = 0.33; p = 0.020; q = 0.236); however, none survived correction for multiple comparisons. Conclusions: Adults with CRS reported greater sleep-related burden and showed a nominally steeper age-related decrease in episodic memory. IL-6 and IL-13 showed nominal cognitive associations that did not survive correction, supporting the need for larger longitudinal studies to clarify clinical relevance. Full article

Older adults with dementia in long-term care facilities often become lost, enter unintended rooms, and develop greater dependence on care staff as a result of visuospatial impairment. However, existing dementia-friendly design studies have rarely distinguished among residents with different cognitive impairment characteristics. This exploratory cross-sectional study investigated 76 older adults with dementia and visuospatial impairment in three long-term care facilities in Xi’an, China. Neuropsychological assessment, behavior mapping, BIM-based modeling, space syntax analysis, and statistical analysis were integrated to examine the associations between environmental factors and the spatial behaviors of older adults with different research-based visuospatial impairment profiles. The results showed that the sample could be classified into three profiles: visual construction impairment, spatial disorientation, and global spatial cognitive impairment. The three groups showed different sensitivities to visual cues, path structure, and environmental stability, and exhibited distinct patterns of getting lost and spatial use. Based on these exploratory findings, this study formulates three hypothesis-generating unit-based design concepts: feature-enhanced units, path-simplified units, and stable low-load units. These concepts provide a provisional framework for examining how dementia care environments might be adapted to cognitive abilities and require validation in larger, longitudinal, and intervention-based studies. Full article

Background: Sex differences in cognitive impairment in Parkinson’s disease (PD) have been reported, with several studies suggesting greater cognitive decline in males. However, evidence on long-term trajectories across specific cognitive domains is limited, as most prior work is cross-sectional. Aim: To investigate sex-specific longitudinal changes across multiple cognitive domains over 9 years in idiopathic PD, compared to age- and sex-matched controls. Methods: We analyzed data from the prospective ParkWest study, including n = 190 persons with PD (PwPs) and n = 202 controls. Regularly assessed cognitive domains included semantic fluency, processing speed, cognitive control, memory, and visuospatial ability. Linear mixed-effect models including a three-way interaction between time, disease status, and sex, to test whether sex-specific cognitive change in PD differed from that observed in controls, were estimated. Models were adjusted for age, years of education, baseline depression, and UPDRS part II. Results: Male PwPs showed faster decline than female PwPs in most cognitive measures, resulting in gradually increasing sex differences over 9 years. However, compared with controls, the differential sex-specific decline was statistically significant only for semantic fluency (p = 0.013) and processing speed (p = 0.027 and p = 0.035). These findings remained significant after covariate adjustment. Conclusions: PD was associated with increasing sex differences in semantic fluency and processing speed, likely driven by faster decline in males. Other domains did not show sex-specific divergence over time, suggesting that sex-specific vulnerabilities in cognitive trajectories are domain-specific rather than generalized among PwPs. Full article

Background: Sensory processing differences are highly prevalent in children with autism spectrum disorder (ASD) and may shape how they interact with their environment and acquire new knowledge. The present study investigated developmental changes in learning potential and cognitive functioning in preschool children with ASD presenting a sensory seeking profile with typical sensitivity. In addition, the study examined which components of early learning potential predicted intellectual functioning two years later. Methods: A longitudinal design was employed with 44 preschool boys with ASD assessed at ages four and six. The potential for learning through dynamic assessment, intelligence and sensory processing patterns was assessed. Paired sample t-tests were conducted to examine developmental changes, and hierarchical regression analyses were used to identify predictors of intellectual functioning at age six. Results: Significant improvements were observed in general cognitive ability, classification ability, and perspective-taking skills across the two-year period. Regression analyses revealed that visual memory, sequential pattern completion, classification ability, and perspective taking significantly predicted intellectual functioning at age six, jointly explaining 51% of the variance in IQ scores. Conclusions: The findings suggest that visuospatial processing and pattern-based reasoning may play a central role in cognitive development among preschool children with ASD who exhibit active sensory engagement. Full article

Objective: Subjective cognitive complaints (SCC) and neuropsychiatric symptoms (NPS) are both recognized as early markers of dementia, but their combined predictive value is not well understood. This study investigated whether SCC and NPS, individually and jointly, predicted six-year cognitive decline and 12-year incident dementia in community-dwelling older adults. Methods: Participants were 468 dementia-free individuals aged 70–90 from the Sydney Memory and Ageing Study, followed for up to 12 years. Cognitive decline was assessed biennially via neuropsychological tests; dementia diagnoses were made by expert consensus. SCC were captured using two self-reported and one informant-reported item. NPS were assessed using the informant-rated Neuropsychiatric Inventory. SCC and NPS were each operationalised as ordinal scores ranging from 0 to 3, with higher scores reflecting more SCC items or more NPS clusters, respectively, and participants were categorized into SCC−/NPS−, SCC+/NPS−, SCC−/NPS+, SCC+/NPS+. Linear regression models assessed associations with six-year cognitive decline across domains and global cognition, and Cox proportional hazards models assessed incident dementia risk over 12 years. Results: SCC sum scores predicted dementia risk, whereas NPS sum scores were not significantly associated with dementia risk. In the combined SCC/NPS group analyses, SCC+/NPS+ participants had a 66% higher hazard of dementia (HR = 1.66, p = 0.041). For cognitive decline, the SCC−/NPS+ group showed significantly greater decline in executive function, visuospatial ability, and global cognition compared with SCC−/NPS−. Neither SCC+/NPS− nor SCC+/NPS+ predicted domain-specific decline. Discussion: SCC and NPS showed different patterns of association with later outcomes, with the combined SCC/NPS profile identifying a subgroup at elevated dementia risk. These findings support closer monitoring of older adults who present with co-occurring SCC and NPS, as this profile may help improve early identification of individuals at risk of adverse cognitive outcomes. Full article

Background/Objectives: Constructional apraxia (CA) is an impairment in combining simple elements into coherent spatial configurations without basic motor deficits. Although common in neurodegenerative disorders, the qualitative features of visuo-constructional errors and their role in differentiating dementia types remain unclear. This systematic review aimed to synthesize patterns of visuo-constructional errors in dementia and mild cognitive impairment (MCI), exploring distinctive qualitative features associated with different neurodegenerative conditions. Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science for studies published between January 1990 and January 2026, following PRISMA guidelines. Studies on adults with dementia or MCI assessing drawing/copying abilities through standardized tasks and qualitative error analysis were included. Reviews, meta-analyses, case reports, non-English articles, and studies not explicitly assessing constructional apraxia were excluded. The quality of evidence was assessed using an adapted version of the Newcastle–Ottawa Scale. Results: A total of 25 studies were included, showing heterogeneous and condition-specific visuo-constructional deficits. Spatial errors and simplifications were the most common across disorders, while perseverations, rotations, and closing-in phenomena were less frequent. Alzheimer’s disease was mainly associated with spatial disorganization, omissions, and conceptual errors linked to temporo-parietal dysfunction; frontotemporal dementia with executive deficits such as perseverations and planning impairments; Lewy body and Parkinson’s disease dementias with visuospatial and attentional alterations; and Huntington’s disease with simplifications and executive dysfunction related to fronto-striatal involvement. Conclusions: No single error pattern was pathognomonic, but qualitative assessment of constructional errors may provide clinically useful information when integrated with the broader neuropsychological profile. Full article

Introduction: Sleep disturbances are common as we age and have been linked to poor cognition and increased cognitive decline. Objective: We aimed to examine cross-sectional and longitudinal associations between objective sleep measures and cognition in middle-aged and older adults, including cognitively healthy (CH) individuals and those with mild cognitive impairment (MCI). Methods: Participants from the Aiginition Longitudinal Biomarker Investigation Of Neurodegeneration (ALBION) study (age > 40) underwent 7-day wrist actigraphy (Actiwatch 2). Sleep exposures included sleep duration, sleep efficiency, sleep variability, sleep onset latency, wake after sleep onset (WASO), and number of awakenings. A neuropsychological battery was administered examining memory, executive function, visuospatial ability, language, attention speed, and a global composite score. Cross-sectional associations were tested using generalized linear models (adjusted for age, sex, education). Longitudinal associations with cognitive trajectories were examined with linear mixed-effect models. Results: In total (N = 184; 65% women; mean age 65 years), average sleep duration was 7.2 h and mean sleep efficiency was at 80%. Cross-sectionally, more nightly awakenings were associated with poor memory and attention speed. In a 1.5-year follow-up, (n = 93), higher baseline sleep efficiency was associated with better memory and language performance, while longer WASO, more awakenings, and longer sleep onset latency showed nominal associations with less favorable cognitive trajectories, although these associations did not remain statistically significant after FDR correction. Time-varying analyses indicated that sleep variability showed robust non-linear associations with poorer memory trajectories over follow-up and remained significant after FDR adjustment; significant mean change in awakenings and variability appeared to intensify in later follow-up phases. The association between sleep characteristics and cognitive decline varied across follow-up time, with stronger adverse changes observed during later follow-up phases. Discussion: Objective indicators of sleep continuity, especially sleep variability, were most consistently related to domain-specific cognitive outcomes, with strongest evidence for memory over time. Sleep fragmentation and irregular sleep patterns may represent potentially modifiable targets for future strategies aimed at preserving cognitive health during aging. Full article

Background/Objectives: Multiple sclerosis (MS) is a chronic neurological disorder affecting more than 2.8 million individuals worldwide and is commonly associated with cognitive deficits that compromise independence and quality of life. In recent years, virtual reality (VR) has emerged as an innovative rehabilitation strategy, offering immersive and engaging environments that promote neuroplasticity and enhance patient motivation. To evaluate the effectiveness of immersive and non-immersive VR-based interventions in improving cognitive performance among adults diagnosed with MS. Methods: A systematic review was conducted following the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA 2020 guidelines (PROSPERO registration: CRD420251103762). Comprehensive searches were carried out across seven international databases up to October 2025, including only randomized controlled trials assessing cognitive outcomes after VR-based rehabilitation programs. Results: From 1948 records screened, 13 studies comprising 649 participants met the inclusion criteria. Intervention durations ranged between 6 and 17 weeks, with sessions lasting 30–60 min. The interventions involved treadmill training with VR, exergaming, and cognitive stimulation protocols. Most studies demonstrated significant improvements in processing speed, visuospatial and verbal memory, and executive functioning (p < 0.05). Adherence rates were above 80%, and no serious adverse events were reported. Conclusions: VR-based rehabilitation appears to be a safe, feasible, and effective approach for enhancing cognitive abilities in individuals with MS, particularly in processing speed and visuospatial memory. Nonetheless, the heterogeneity of methodologies underscores the need for standardized intervention frameworks and large-scale multicenter randomized trials to establish optimal parameters and confirm sustained long-term benefits. Full article

Background: Spatial cognition, a skill paramount to survival, is impaired in Parkinson’s disease (PD) but has been little researched. Spatial cognition is utilized during motor–cognitive integration, which impacts daily functioning and quality of life in PD. As PD is a unilateral-onset condition, spatial–cognitive and motor–cognitive ability may differ by side of onset. Spatial cognition is suggested to be modulated by the right hemisphere; thus, we hypothesize to observe worse spatial and motor–cognitive performance by people with left-onset PD (LOPD) than right-onset PD (ROPD). Methods: 216 participants with PD were recruited (LOPD = 107; M = 62; mean age = 69.80 ± 8.5). Spatial outcomes were collected via the body position spatial task (BPST), Reverse Corsi Blocks, and visuospatial items of the Montreal Cognitive Assessment (MoCA); motor–cognitive outcomes were collected by a Trails test, a Four Square Step Test (FSST), and a Timed Up and Go test. An independent t-test and the Mann–Whitney U test compared outcome variables between onset groups. Results: No significant differences were found between onset groups. Exploratory subgroup analyses revealed differences. Significantly worse performance by LOPD in single- and dual-task TUG was found within people with bilateral symptoms and postural instability (Hoehn & Yahr stage, >2; LOPD, N = 33; single, p = 0.001; dual, p = 0.021) and worse performance in single-task TUG in people with MoCA < 18 (LOPD, N = 5; single, p = 0.036) and people with freezing of gait (FOGQ, >0; LOPD, N = 14, p = 0.048). Significantly larger DTC by LOPD was found within frequent freezers (FOGQ, >3; LOPD, N = 9; p = 0.003). Conclusions: LOPD may tend to perform worse in motor–cognitive tasks among subgroups of those with more severe symptoms, i.e., those at later stages of disease. These findings may have implications for prognoses of those with LOPD versus ROPD and suggest that those with LOPD may have worse long-term outcomes in spatial cognition and motor–cognitive integration. Full article

Background/Objectives: This study evaluates the feasibility and preliminary effects of a short version of the Enriched Motor Program (EMP), an intervention combining aerobic and cognitive exercises, adapted to support the development of executive functioning in children with autism spectrum disorder (ASD). Executive functions are high-order cognitive abilities necessary to manage everyday social and adaptive tasks. Methods: The sample included two children with ASD (boys) with an average chronological age of eight years. The intervention was delivered once per week, over 12 weeks, and children’s executive functions were assessed before and after the intervention. Working memory was assessed using the Backward Word Span and the Mr. Cucumber tests; inhibitory control was measured via the Circle Drawing Task and the Day/Night Stroop. Results: The data for both children were analyzed using the Reliable Change Index (RCI), which indicated a reliable change in visuo-spatial working memory for the child with level 2 ASD. Conclusions: These findings provide encouraging preliminary results concerning the feasibility of a short version of the EMP. Enriched motor programs could be considered as suitable activities complementary to the main clinical therapy. Full article

Background: Parkinson’s Disease (PD) is a multisystem neurodegenerative disorder associated with cognitive and emotional disturbances, including visuospatial deficits and alexithymia, which may substantially affect quality of life (QoL). The metabolic underpinnings of non-motor and emotional features within deep basal ganglia nuclei remain poorly understood. This exploratory proof-of-concept study aimed to examine ¹H-MRS-derived metabolite ratios in the substantia nigra (SN) and globus pallidus (GP) and to explore their preliminary associations with visuospatial-attentional abilities and alexithymia. Methods: Fifteen individuals with PD and 15 healthy controls (HCs) underwent Proton Magnetic Resonance Spectroscopy (¹H-MRS) targeting the SN and GP bilaterally. Metabolite ratios were quantified with LCModel and analyzed as left, right, and hemisphere-averaged measures. PD participants completed a multidisciplinary assessment including motor severity, cognition, visuospatial abilities, mood and alexithymia. Multiple testing was controlled using false discovery rate (FDR). Given the between-group imbalance in age and education, exploratory covariate-adjusted sensitivity analyses were also performed. Results: PD participants were older, less educated, and showed lower global cognition than HCs, including significantly reduced MoCA scores (20.9 ± 6.6 vs. 28.7 ± 1.8; FDR-corrected p < 0.001). In uncorrected analyses, between-group metabolite comparisons showed lower myo-inositol (Ins) in the SN (p = 0.04) and higher glutamatergic signal in the right GP in PD relative to HCs (p = 0.03); however, these differences were not robust after adjustment for age, education and multiple testing. Within the PD group, an uncorrected right–left asymmetry was observed for pallidal Ins. Exploratory correlations suggested uncorrected associations between SN metabolites and alexithymia dimensions related to emotional awareness and verbalization, whereas GP metabolites were more frequently associated with selected visuospatial, attentional, language-related, and broader cognitive measures. None of these associations survived FDR correction. Conclusions: This exploratory proof-of-concept study provides preliminary feasibility data and effect-size estimates for future ¹H-MRS investigations of basal ganglia metabolites in PD. Given the small sample size, lack of cognitive matching, age and education imbalance, and absence of correction-surviving associations, the findings should not be interpreted as evidence of PD-specific neurometabolic markers. Larger, prospectively matched, and adequately powered studies are needed. Full article