Background: Agitation is a common symptom in dementia and linked to caregiver burden, but both agitation and burden are multidimensional constructs. The current study sought to determine whether specific presentations of agitation differentially relate to aspects of caregiver burden.Methods: Medical record data from an outpatient memory clinic were extracted for 609 persons with dementia, including caregiver‐reported burden and care recipient agitation.Results: Exploratory factor analysis yielded three domains of agitation on the Cohen Mansfield Agitation Inventory (‘Physically Aggressive’, ‘Physically Non‐Aggressive’, ‘Verbally Agitated’) and four domains of burden on the Zarit Burden Interview (‘Impact on Life’, ‘Guilt/Uncertainty’, ‘Embarrassment/Frustration’, ‘Overwhelm’). Regression analyses demonstrated all domains of agitation positively predicted overall burden. Regarding specific aspects of burden, Physically Aggressive behaviours predicted Embarrassment/Frustration. Physically Non‐Aggressive behaviours predicted Impact on Life and Guilt/Uncertainty. Verbally Agitated behaviours predicted all burden dimensions.Conclusions: Results suggest specific aspects of agitation may differentially contribute to facets of caregiver burden.

Background: Research has linked increased cognitive decline in a dementia care recipient to worsening caregiver burden, but the presence of positive aspects of caregiving is associated with better outcomes. As cognitive decline worsens, a lack of positive caregiving experiences could lead to burden for the caregiver. This study investigated relationships among dementia caregiver burden, cognitive decline, and positive aspects of caregiving in dementia, predicting an indirect effect of positive aspects of caregiving.Methods: Data from 724 patients of an outpatient memory clinic in Ohio were examined and dyads included based on clinically supported patient diagnoses on the dementia spectrum. Caregivers completed the Zarit Burden Interview (ZBI) and Positive Aspects of Caregiving (PAC) measures. The Montreal Cognitive Assessment and Mini‐Mental State Examination were used to estimate cognitive decline, standardized to create a single variable. Multiple potential covariates were considered for inclusion in the model. A cross‐sectional mediation analysis using the Hayes PROCESS macro explored the presence of an indirect effect of PAC on the relationship between cognitive decline and ZBI using 5000 bootstrap samples.Results: Only the potential covariate caregiver age was correlated with any of the primary variables; this variable was controlled in analyses. Significant relationships emerged between cognitive decline and ZBI (r = −0.12, P < 0.001), between PAC and ZBI (r = −0.23, P < 0.001), and between cognitive decline and PAC (r = −0.07, P < 0.05). An indirect effect of positive aspects of caregiving on the relationship between cognitive decline and ZBI was statistically significant (B = 0.0092, 95% bias‐corrected confidence interval: 0.0008, 0.0185), accounting for 14.4% of the variance in the model.Conclusions: A lack of positive aspects of caregiving could be partially responsible for development of dementia caregiver burden as cognitive decline worsens. Longitudinal examination of these relationships is needed to understand causality fully. Findings may help healthcare providers tailor treatment to alleviate caregiver burden.

Although the most prominent symptoms of Parkinson’s disease (PD) are those impacting movement, cognitive dysfunction is prevalent and often presents early in the disease process. Individuals with cognitive symptoms of PD often complete cognitive screening, making it important to identify factors associated with cognitive screening performance to ensure prompt and accurate detection of cognitive impairments. Objective: Despite a body of research examining relationships between motor symptoms and cognitive dysfunction in PD, no prior study has undertaken a systematic review of the magnitude of the relationship between motor symptoms and cognitive screening performance in PD. Methods: This study was a systematic review and meta-analysis of the relationship between cognitive screening performance, as assessed by the Montreal Cognitive Assessment (MoCA), and motor symptoms of PD. After the systematic screening, 20 studies were included, and meta-regressions using mixed-effects models were conducted. Results: Motor symptoms across included studies were relatively mild, but average MoCA scores were at the established cutoff for risk of dementia in PD. The average disease duration was 5 years. Consistent with hypotheses, more severe motor symptoms were associated with lower MoCA scores (r=-0.22 (95%CI -0.29 to -0.16), p<0.001), indicating worse cognitive functioning. Conclusion: The results indicate a significant negative correlation between MoCA performance and motor symptoms of PD. Average MoCA scores captured early disease-stage cognitive impairment when motor symptoms remained relatively mild. Serial screening for cognitive impairment beginning early in the disease course may be of benefit to ensure that cognitive dysfunction is detected as it arises.

Introduction: Functional gastrointestinal disorders such as irritable bowel syndrome are often associated with abdominal discomfort, bloating, and cramping. There is growing evidence that gastrointestinal symptoms are also related to cognitive function, but this association has not been previously examined in young adults. Methods: We examined cross-sectional relationships between nonspecific gastrointestinal symptoms and cognition in 56 healthy young adults (41 female, 15 male) without diagnosis of gastrointestinal disorder. Results: Gastrointestinal symptoms were associated with poorer performance on objective tests of memory (p < 0.01 for all) and greater self-report of cognitive dysfunction (p < 0.01 for all). Conclusion: Results suggest that higher gastrointestinal symptoms are associated with greater subjective and objective cognitive difficulty. Future work is needed to clarify underlying mechanisms and the potential functional impact of these cognitive deficits.

Objective: Pain and cognitive impairment are prevalent and often co-occur in older adults. Because pain may negatively affect cognitive test performance, identification of pain in the context of neuropsychological evaluation is important. However, pain detection based on self-report presents challenges, and pain is often under-detected in this population. Alternative methods (e.g., video-based automatic coding of facial biomarkers of pain) may facilitate pain identification and thus enhance interpretation of neuropsychological evaluation results. Method: The current study examined pain in the context of virtual neuropsychological assessment in 111 community-dwelling older adults, first seeking to validate the use of software developed to automatically code biomarkers of pain. Measures of pain, including self-report of acute and chronic pain and automatic coding of pain, were compared while participants completed neuropsychological testing. Results: Self-reported pain was negatively associated with poorer performance on a measure of executive function (both acute and chronic pain) and a global cognitive screening measure (acute pain only). However, self-reported acute and chronic pain did not correlate significantly with most neuropsychological tests. Automatic coding of pain did not predict self-report of pain or performance on neuropsychological tests beyond the influence of demographic factors and psychological symptoms. Conclusions: Though results were largely not significant, correlations warrant further exploration of the influence of pain on neuropsychological test performance in this context to ensure that pain does not influence test performance in individuals with higher levels of pain and in other samples.