Aims

To assess changes in patient perceptions of speech and swallowing impairments associated with Parkinson’s disease across the first six years post-diagnosis.

Methods

Data from the Unified Parkinson’s Disease Rating Scale (UPDRS) was obtained for 269 newly diagnosed people with PD across the first six years post-diagnosis (baseline, and then annual assessments through year six). Data from UPDRS scale items associated with “speech” and “swallowing” were collated across each assessment time point. The rate of change over time was assessed using parametric and non-parametric statistical analyses.

Results

Self-perceived speech and swallowing impairments were identified as mild at the time of initial diagnosis and progressed within the mild range of impairment across six years. The rate of change over time was significant for perceived speech impairment ([F(5.5, 1158.8) = 21.1, p <.001) and perceived swallowing impairment ([F(5.2, 1082.6) = 8.6, p <.001). There were no effects of age at diagnosis or motor phenotype on the rate of change for either speech or swallowing.

Conclusions

Self-perceptions of speech and swallowing impairment changed significantly over time in newly diagnosed PWPD. The presence of self-perceived mild speech and swallowing impairments in the initial years post-diagnosis may support the need for intervention to improve and or sustain function over time.

Aims

Cognitive training may reduce dementia risk and mitigate cognitive aging. Prior research shows the connectivity of higher-order resting-state networks (RSN) of inter-network modulation (frontoparietal control network; FPCN) and executive functioning (cingulo-opercular network; CON) may improve acutely after cognitive training. It is unknown whether RSN changes maintain after cognitive training ends. This study examined FPCN and CON connectivity 1-year after cognitive training healthy older adults.

Methods

58 healthy older adults (mean age=71.2) were randomized into a cognitive training (CT; n=30) or an educational control (ET; n=28) group. Over 12-weeks, CT underwent 40-hours of 4 attention/speed-of-processing and 4 working memory tasks, and ET watched 40-hours of educational videos. Participants randomly received sham or active transcranial direct current stimulation, although this was not a variable of interest in this study. Participants underwent resting-state functional magnetic resonance imaging at baseline, 3-month, and 1-year time points. Mixed linear models assessed group differences/change in FPCN and CON connectivity from 3-month to 1-year timepoints, controlling for baseline connectivity, age, sex, education, scanner, and tDCS. There were no group differences in baseline FPCN or CON.

Results

FPCN group main effect showed higher CT 3-month connectivity maintains at 1-year timepoint [beta=-.039;p=.010;95%CI:-.070--.009). CON group main effect or group by time interactions were not significant.

Conclusions

Increased FPCN connectivity maintains at least 1-year post cognitive training, although power analysis recommends a larger sample size. The FPCN may be a neural target to strengthen cognitive training response and could be involved in reduced dementia risk. Future studies should assess this effect in a larger group.

Aims

Background: Increased education has been associated with reduced risk of Alzheimer’s disease and related dementias (ADRD). The role of neuropathies and neurovascular damage in the education-cognition relationship are poorly understood and may differ by sex.

Objective: To determine: 1) whether ADRD biomarkers mediate the relationship between education and cognitive function and 2) whether these mediating relationships differ by sex.

Methods

Methods: Participants included 537 adults (ages 55-94 years, mean=73) from the Alzheimer’s Disease Neuroimaging Initiative - 3 (ADNI 3) with complete data on education (years), cognition (episodic memory (EM), executive functioning (EF), language (LANG) composites), and neuroimaging. Neuroimaging mediators included hippocampal (HV), cortical grey matter (CGMV), and white matter hyperintensity (WMH) volumes and meta-temporal tau PET standard uptake value ratio. We performed causal mediation analyses with education as the exposure, HV, CGMV, WMH, and meta-temporal tau as separate mediating factors, and each cognitive domain score as separate outcomes, adjusting for age, race, sex, cardiovascular history, BMI, depression, and APOE4 status. Secondary analyses analyzed sex-stratified mediation models.

Results

Results: Across domains, HV mediated the largest percent of the relationship between education and cognition (EM: 15.7%, EF: 14.5%, LANG: 11.4%) compared to CGMV, WMH, and tau PET. In sex-stratified models, HV mediated education’s associations with EM and EF among women (EM: 20.2%, p=0.03; EF: 19.8%, p=0.05) but not men.

Conclusions

Conclusions: HV mediated the largest percent of the relationship between education and cognition. The neurobiological mechanisms (e.g., hippocampal and chronic vascular risk pathways) through which education impacts later-life cognition may vary between men and women.

Abstract Body