OBJECTIVES To cross-sectionally quantify the contribution of proxy measures of cognitive reserve reflective of the lifespan, such as education, socioeconomic status (SES), reading ability, and cognitive activities, in explaining late-life cognition. DESIGN Prospective observational cohort study of aging. SETTING Retirement communities across the Chicago metropolitan area. PARTICIPANTS Nine hundred fifty-one older adults free of clinical dementia in the Rush Memory and Aging Project (aged 79 ± 8, 74% female). MEASUREMENTS Baseline data on multiple life course factors included early-, mid-, and late-life participation in cognitive activities; early-life and adult SES; education; and reading ability (National Adult Reading Test; NART). Path analysis quantified direct and indirect standardized effects of life course factors on global cognition and five cognitive domains (episodic memory, semantic memory, working memory, visuospatial ability, perceptual speed). RESULTS Adjusting for age, sex, and race, education had the strongest association with global cognition, episodic memory, semantic memory, and visuospatial ability, whereas NART (followed by education) had the strongest association with working memory. Late-life cognitive activities had the strongest association with perceptual speed, followed by education. CONCLUSIONS These cross-sectional findings suggest that education and reading ability are the most-robust proxy measures of cognitive reserve in relation to late-life cognition. Additional research leveraging path analysis is warranted to better understand how these life course factors, reflecting the latent construct of cognitive reserve, affect abnormal cognitive aging.

SummaryPurpose-Associations between rolandic epilepsy (RE) with reading disability (RD) and speech sound disorder (SSD) have not been tested in a controlled study. We conducted a case-control study to determine whether (1) RD and SSD odds are higher in RE probands than controls and (2) an RE proband predicts a family member with RD or SSD, hence suggesting a shared genetic etiology for RE, RD, and SSD.Methods-Unmatched case-control study with 55 stringently defined RE cases, 150 controls in the same age range lacking a primary brain disorder diagnosis, and their siblings and parents. Odds ratios (OR) were calculated by multiple logistic regression, adjusted for sex and age, and for relatives, also adjusted for comorbidity of RD and SSD in the proband.Results-RD was strongly associated with RE after adjustment for sex and age: OR 5.78 (95% CI: 2. 86-11.69). An RE proband predicts RD in family members: OR 2.84 (95% CI: 1.38-5.84), but not independently of the RE proband's RD status: OR 1.30 (95% CI: 0.55-12.79). SSD was also comorbid with RE: adjusted OR 2.47 (95%CI: 1. 22-4.97). An RE proband predicts SSD in relatives, even after controlling for sex, age and proband SSD comorbidity: OR 4.44 (95% CI: 1.93-10.22).Conclusions-RE is strongly comorbid with RD and SSD. Both RD and SSD are likely to be genetically influenced and may contribute to the complex genetic etiology of the RE syndrome. Siblings of RE patients are at high risk of RD and SSD and both RE patients and their younger siblings should be screened early. KeywordsPhonologic disorder; Articulation disorder; Speech delay; Developmental dysphasia; Developmental dyslexia; Centrotemporal sharp waves; Complex genetic; Familial aggregation; Comorbidity; Cognitive deficit; Family study Address correspondence and reprint requests to Tara Clarke, Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, U.S.A. E-mail: tc2226@columbia.edu. The study was conceived by DKP, LJS, BB and TC. DKP, BB, TC, PLM, JC, SF, GT, BRG, and ND designed the study. BB, TC, JC, SF, and DKP collected the data. TC, LJS, PLM and DKP analyzed the data. TC wrote the first draft. All authors contributed to redrafting. Conflict of Interest:The authors declare that they have no competing financial interests. Rolandic epilepsy (RE) is the most common epilepsy syndrome affecting children . It is a developmental epilepsy with a complex genetic inheritance that has yet to be elucidated (Bali et al., 2005). Centrotemporal spikes (CTS) are the electroencephalographic hallmark of RE. The association of RE or CTS with reading disability (RD) and language impairment has often been suggested (Staden et al., 1998;Vinayan et al., 2005), as has association with impairment in the development of speech motor control, also known as speech sound disorder (SSD) (Bladin, 1987;Doose, 1989;Lundberg et al., 2005;Park et al., 2005). Neither the association between RE and RD nor between RE and SSD has been rigorously tested in a case-control study, and thus association has not been unequivocally e...

Background The Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-Cog) is widely used in AD, but may be less responsive to change when used in people with mild cognitive impairment (MCI). Methods Participants from the Alzheimer's Disease Neuroimaging Initiative were administered a neuropsychological battery and 1.5 T MRI scans over 2–3 years. Informants were queried regarding functional impairments. Some participants had lumbar punctures to obtain cerebrospinal fluid (CSF). We added executive functioning (EF) and functional ability (FA) items to the ADAS-Cog to generate candidate augmented measures. We calibrated these candidates using baseline data (n=811) and selected the best candidate that added EF items alone and that added EF and FA items. We selected candidates based on their responsiveness over three years in a training sample of participants with MCI (n=160). We compared traditional ADAS-Cog scores with the two candidates based on their responsiveness in a validation sample of participants with MCI (n=234), ability to predict conversion to dementia (n=394), strength of association with baseline MRI (n=394) and CSF biomarkers (n=193). Results The selected EF candidate added category fluency (ADAS Plus EF), and the selected EF and FA candidate added category fluency, Digit Symbol, Trail Making, and five items from the Functional Assessment Questionnaire (ADAS Plus EF&FA). The ADAS Plus EF& FA performed as well as or better than traditional ADAS-Cog scores. Conclusion Adding EF and FA items to the ADAS-Cog may improve responsiveness among people with MCI without impairing validity.

Questions pertaining to emotional complexity in adult development are being pursued from a number of vantage points. The current studies sought to clarify the study of emotional complexity by comparing and contrasting two dominant perspectives on emotional complexity in different age groups (i.e. covariation and absolute-level approaches). Results indicate that emotional complexity is a multifaceted construct and that methodology will impact substantive findings and developmental trends that emerge from the data. Recommendations and considerations for future research are discussed, including, for example, within-versus cross-domain ideas of emotional complexity. Keywordsaging; assessment; affect; older adults; complexity Lifespan perspectives on adult development are mirroring a larger trend in psychological science to consider integrated perspectives on emotion (Reich, Zautra, & Davis, 2003). Specifically, questions pertaining to various aspects of emotional complexity are being pursued (Carstensen, Pasupathi, Mayr, & Nesselroade, 2000;Charles, 2005;Magai, Consedine, Krivoshekova, Kudadjie-Gyamfi, & McPherson, 2006;Ong & Bergeman, 2004). There is some suggestion in this work of age differences in emotional complexity favoring older adults but consensus is hard to discern because investigators use different methods to assess emotional complexity.That is, emotional complexity is multiply defined. The goal of the current studies was to integrate, compare, and contrast two dominant perspectives on emotional complexity. 1 We label these approaches the covariation and the absolute-level perspectives. According to the former, low covariation among discrete affects or between larger affect systems [i.e., positive (PA) and negative affect (NA)] indicate greater emotional complexity. Low covariation suggests the capacity to experience affects as independent yet potentially co-occurring (Carstensen et al., 2000;Ong & Bergeman, 2004;Tugade, Fredrickson, & Feldman Barrett, 2004). In the current studies, covariation was assessed across PA and NA (i.e., correlation Address Correspondence to: Rebecca E. Ready, Ph.D., The University of Massachusetts, Department of Psychology, Tobin Hall, 135 Hicks Way, Amherst, MA 01003; Phone: 413-545-1359; Fax: 413-545-0996; ready@psych.umass.edu. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/journals/pag. 1 Whereas the covariation and absolute-level approaches to emotional complexity appear frequently in the adult development literature, there are other perspectives. For example, Labouvie-Veif's...

Quality of education appears to be more important than cerebrovascular risk factors in explaining cross-sectional differences in memory and EF performance between White and AA older adults. Further investigation is needed regarding the relative contribution of education quality and cerebrovascular risk factors to cognitive decline among ethnically/racially diverse older adults.

Physicians are a major referral source for neuropsychologists, but little is known about the aspects of neuropsychological evaluation that physicians do and do not find useful. In this study, 5000 members of the American Medical Association were surveyed about their use of, and satisfaction with, neuropsychological evaluation, and reasons for not referring patients for evaluation. A total of 517 usable surveys (10.8% response rate) were returned. Results indicated that respondents referred patients most often for diagnostic purposes, and they were generally satisfied with neuropsychological services. Lack of familiarity with neuropsychology and geographic proximity to a neuropsychologist were cited as the main barriers to referral. Primary care physicians were most likely to have never referred a patient for evaluation. The results are discussed in terms of the need for future educational efforts to increase physicians' awareness of the field of neuropsychology and provide physicians with access to clinical neuropsychologists.

The Frontal Systems Behavior Scale (FrSBe) is a 46-item questionnaire that measures behaviors associated with frontal subcortical deficits (apathy, disinhibition, and executive dysfunction) in adult neurologic populations. Based on findings from a previous exploratory factor analysis on the scale, the current study used confirmatory factor analysis to explore and potentially improve on the measurement model fit of current FrSBe scores. Model fit indices and reliabilities (measured using internal consistency reliability) were compared in the original and in several alternative models. The original scale demonstrated a generally good fitting model, although the best fitting model (referred to as the reduced model) removed eight items from the original measure and modestly improved model fit over the original FrSBe. Strong reliability was found in both versions. Results from the current study provide a critical first step in a potential FrSBe scale revision.

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