Prospective memory and subjective memory decline: A neuropsychological indicator of memory difficulties in community-dwelling older people

Introduction: Prospective memory difficulties are known to occur in Alzheimer’s disease, and may provide an early indicator of cognitive decline. Older people reporting high levels of subjective memory decline (SMD) but without evidence of cognitive decline on standard neuropsychological tests are increasingly considered at increased risk for Alzheimer’s disease. Therefore, the objective of this study was to investigate whether prospective memory performance is differentially impaired in older people reporting high levels of SMD as compared to a control group. Method: A total of 195 community-dwelling older adults (M_age = 73.48 years) were assessed for self-reported complaints of memory decline and allocated to either a group reporting high levels of SMD (SMD, n = 96) or a healthy control group (HC, n = 99). Groups were assessed on neuropsychological tests, an experimental prospective memory task (focal vs. nonfocal cue conditions), and a naturalistic prospective memory task. Results: The groups did not differ in performance on standard neuropsychological tests of working memory, executive attention, and episodic retrospective memory. Furthermore, on an experimental task of prospective memory (the Supermarket Shopping Trip task), although performance of both groups was better when cues for prospective memory were focal to the ongoing activity (η² = .35), the SMD group were not impaired relative to the control group. On a naturalistic prospective memory task, however, there was a small but significant effect, with the SMD group performing more poorly than the HC group (η² = .02). Conclusions: In older adults with high levels of SMD, naturalistic measures of prospective memory provide an approach to assessing memory performance that can offer a means of investigating the memory complaints of people with SMD. Identifying prospective memory difficulties in SMD also offers a focus for intervention.     

An fMRI study of loneliness in younger and older adults

Loneliness, the subjective experience of social isolation, may reflect, in part, underlying neural processing of social signals. Aging may exacerbate loneliness due to decreased social networks and increased social isolation, or it may reduce loneliness due to preferential attentional processing of positive information and increased interactions with emotionally close partners. Here, we conducted a functional magnetic resonance imaging (fMRI) study of loneliness in younger (N = 50, 26 female, M_age = 20.4) and older (N = 49, 30 female, M_age = 62.9) adults. Compared to younger adults, older adults were less lonely and dwelled longer on faces, regardless of valence. Previous studies in younger adults found that loneliness was negatively correlated with ventral striatal (VS) activation to pleasant social pictures of strangers yet positively correlated with VS activation to faces of close others. In the present study, we observed no association between loneliness and VS activation to social pictures of strangers in either age group. Further, unlike previous studies, we observed no association between social network size and amygdala activation to social stimuli. Additional research is needed to examine the effect of loneliness and social network size on neural processing of different dimensions of social stimuli.     

Performance validity testing in a clinical sample of adults with sickle cell disease

Objective: Neuropsychologists utilize performance validity tests (PVTs) as objective means for drawing inferences about performance validity. The Test of Memory Malingering (TOMM) is a well-validated, stand-alone PVT and the Reliable Digit Span (RDS) and Reliable Digit Span-Revised (RDS-R) from the Digit Span subtest of the WAIS-IV are commonly employed, embedded PVTs. While research has demonstrated the utility of these PVTs with various clinical samples, no research has investigated their use in adults with sickle cell disease (SCD), a condition associated with multiple neurological, physical, and psychiatric symptoms. Thus, the purpose of this study was to explore PVT performance in adults with SCD. Method: Fifty-four adults with SCD (M_age = 40.61, SD = 12.35) were consecutively referred by their hematologist for a routine clinical outpatient neuropsychological evaluation. During the evaluation, participants were administered the TOMM (Trials 1 and 2), neuropsychological measures including the WAIS-IV Digit Span subtest, and mood and behavioral questionnaires. Results: The average score on the TOMM was 47.70 (SD = 3.47, range = 34–50) for Trial 1 and 49.69 (SD = 1.66, range = 38–50) for Trial 2. Only one participant failed Trial 2 of the TOMM, yielding a 98.1% pass rate for the sample. Pass rates at various RDS and RDS-R values were calculated with TOMM Trial 2 performance as an external criterion. Conclusions: Results support the use of the TOMM as a measure of performance validity for individuals with SCD, while RDS and RDS-R should be interpreted with caution in this population.     

Maternal and Paternal Parenting and Associations with School Performance in a Sample of Children with Varying Levels of Externalizing Behavior Problems

This study examined associations between parenting behaviors and school performance in children oversampled for externalizing behavior problems. Participants were 147 mothers (M _age = 36.46 years, SD = 5.66) and 110 fathers (M _age = 39.31 SD = 6.26) of 148 children (M _age = 9.64 years, SD = 1.59). The majority of children (83.7%) met diagnostic criteria for attention-deficit/hyperactivity disorder and/or oppositional defiant disorder or conduct disorder. Ratings of maternal and paternal effective control and emotional responsiveness were collected, and standardized achievement scores, teacher ratings of disruptive classroom behavior, and teacher ratings of student–teacher and student–peer relationships were used as indicators of school performance. Associations of medium size emerged between maternal parenting and school performance domains. In contrast, very few associations between paternal variables were demonstrated, with the exception of paternal reduction of child emotion being robustly associated with school performance variables. Exploratory analyses demonstrated that paternal positive involvement mitigated the negative effects of dysfunctional maternal behavior on spelling achievement and peer functioning. These findings point to the importance of considering parent functioning in the school performance of children with externalizing problems. Attention to addressing parenting difficulties common to many children with externalizing behavior problems may help to promote adaptive school functioning.     

Direct and Indirect Associations Between the Built Environment and Leisure and Utilitarian Walking in Older Women

Background

The built environment predicts walking in older adults, but the degree to which associations between the objective built environment and walking for different purposes are mediated by environmental perceptions is unknown.

Purpose

We examined associations between the neighborhood built environment and leisure and utilitarian walking and mediation by the perceived environment among older women.

Methods

Women (N = 2732, M _age = 72.8 ± 6.8 years) from Massachusetts, Pennsylvania, and California completed a neighborhood built environment and walking survey. Objective population and intersection density and density of stores and services variables were created within residential buffers. Perceived built environment variables included measures of land use mix, street connectivity, infrastructure for walking, esthetics, traffic safety, and personal safety. Regression and bootstrapping were used to test associations and indirect effects.

Results

Objective population, stores/services, and intersection density indirectly predicted leisure and utilitarian walking via perceived land use mix (odds ratios (ORs) = 1.01–1.08, 95 % bias corrected and accelerated confidence intervals do not include 1). Objective density of stores/services directly predicted ≥150 min utilitarian walking (OR = 1.11; 95% CI = 1.02, 1.22). Perceived land use mix (ORs = 1.16–1.44) and esthetics (ORs = 1.24–1.61) significantly predicted leisure and utilitarian walking,

Conclusions

Perceived built environment mediated associations between objective built environment variables and walking for leisure and utilitarian purposes. Interventions for older adults should take into account how objective built environment characteristics may influence environmental perceptions and walking.

     

The power of timing: Adding a time-to-completion cutoff to the Word Choice Test and Recognition Memory Test improves classification accuracy

Introduction: The Recognition Memory Test (RMT) and Word Choice Test (WCT) are structurally similar, but psychometrically different. Previous research demonstrated that adding a time-to-completion cutoff improved the classification accuracy of the RMT. However, the contribution of WCT time-cutoffs to improve the detection of invalid responding has not been investigated. The present study was designed to evaluate the classification accuracy of time-to-completion on the WCT compared to the accuracy score and the RMT. Method: Both tests were administered to 202 adults (M_age = 45.3 years, SD = 16.8; 54.5% female) clinically referred for neuropsychological assessment in counterbalanced order as part of a larger battery of cognitive tests. Results: Participants obtained lower and more variable scores on the RMT (M = 44.1, SD = 7.6) than on the WCT (M = 46.9, SD = 5.7). Similarly, they took longer to complete the recognition trial on the RMT (M = 157.2 s,SD = 71.8) than the WCT (M = 137.2 s, SD = 75.7). The optimal cutoff on the RMT (≤43) produced .60 sensitivity at .87 specificity. The optimal cutoff on the WCT (≤47) produced .57 sensitivity at .87 specificity. Time-cutoffs produced comparable classification accuracies for both RMT (≥192 s; .48 sensitivity at .88 specificity) and WCT (≥171 s; .49 sensitivity at .91 specificity). They also identified an additional 6–10% of the invalid profiles missed by accuracy score cutoffs, while maintaining good specificity (.93–.95). Functional equivalence was reached at accuracy scores ≤43 (RMT) and ≤47 (WCT) or time-to-completion ≥192 s (RMT) and ≥171 s (WCT). Conclusions: Time-to-completion cutoffs are valuable additions to both tests. They can function as independent validity indicators or enhance the sensitivity of accuracy scores without requiring additional measures or extending standard administration time.     

Suicidal Ideation and Interpersonal Needs: Factor Structure of a Short Version of the Interpersonal Needs Questionnaire in an At-Risk Military Sample

Objective: The interpersonal-psychological theory of suicide posits that perceived burdensomeness (PB; i.e., the belief that others would be better off if one were dead) and thwarted belongingness (TB; i.e., the belief that one lacks meaningful social connections) are both necessary risk factors for the development of suicidal ideation. To test these relations, measures are needed that are well validated, especially in samples of at-risk adults. Method: The current study was designed to examine the factor structure of an eight-item version of the Interpersonal Needs Questionnaire (INQ) in a sample of 405 U.S. past and current military personnel (M_age = 31.57 years, SD = 7.28; 90.4% male) who endorsed either current suicidal ideation and/or a past suicide attempt. Analyses were conducted using confirmatory factor analysis (CFA). Results: A bifactor model comprising a general factor, labeled interpersonal needs, and two specific factors, labeled PB and TB, fit the data best. The general factor captured a high proportion of overall variance (81.9%). In contrast, the TB factor captured only a modest amount of variance in items meant to capture this factor (59.1%) and the PB factor captured very little variance in items meant to capture this factor (13.5%). Further, only the interpersonal needs factor was associated with lifetime and past-week suicidal ideation as well as suicidal ideation frequency and duration. Conclusions: The current findings indicate that, for the INQ-8 in high-risk military personnel, a general interpersonal needs factor accounted for the relations PB and TB share with suicidal ideation.     

Understanding heterogeneity in older adults: Latent growth curve modeling of cognitive functioning

Background: Clarifying relationships between specific neurocognitive functions in cognitively intact older adults can improve our understanding of mechanisms involved in cognitive decline, which may allow identification of new opportunities for intervention and earlier detection of those at increased risk of dementia.

Method: The present study employed latent growth curve modeling to longitudinally examine the relationship between executive attention/processing speed, episodic memory, language, and working memory functioning utilizing the neuropsychological test battery from the National Alzheimer’s Disease Coordinating Center. A total of 691 relatively healthy older adults (M_age = 69.07, SD = 6.49) were assessed at baseline, and 553 individuals completed three visits spanning a two-year period.

Results: Better cognitive performance was concomitantly associated with better functioning across domains. Subtle declines in executive attention/processing speed processes were found, while, on average, memory and language performance improved with repeated testing. Lower executive attention/processing speed performance at baseline predicted less incremental growth rate in memory. In turn, higher initial memory functioning was associated with incremental improvements in language performance.

Conclusions: These results are consistent with the notion that intact executive function and attention processes are important to preserving memory functioning with advanced age, but are also the functions most susceptible to decline with age. These findings also provide further insight into the critical role of practice effects in clinical assessment practice and have implications for pharmaceutical trials. Practice effects should be routinely considered as they may give the appearance of retention of function within the cognitive domains considered to be a hallmark of Alzheimer’s disease pathology.     

Reliability and validity of a self-administered tool for online neuropsychological testing: The Amsterdam Cognition Scan

Introduction: To facilitate large-scale assessment of a variety of cognitive abilities in clinical studies, we developed a self-administered online neuropsychological test battery: the Amsterdam Cognition Scan (ACS). The current studies evaluate in a group of adult cancer patients: test–retest reliability of the ACS and the influence of test setting (home or hospital), and the relationship between our online and a traditional test battery (concurrent validity). Method: Test–retest reliability was studied in 96 cancer patients (57 female; M_age = 51.8 years) who completed the ACS twice. Intraclass correlation coefficients (ICCs) were used to assess consistency over time. The test setting was counterbalanced between home and hospital; influence on test performance was assessed by repeated measures analyses of variance. Concurrent validity was studied in 201 cancer patients (112 female; M_age = 53.5 years) who completed both the online and an equivalent traditional neuropsychological test battery. Spearman or Pearson correlations were used to assess consistency between online and traditional tests. Results: ICCs of the online tests ranged from .29 to .76, with an ICC of .78 for the ACS total score. These correlations are generally comparable with the test–retest correlations of the traditional tests as reported in the literature. Correlating online and traditional test scores, we observed medium to large concurrent validity (r/ρ = .42 to .70; total score r = .78), except for a visuospatial memory test (ρ = .36). Correlations were affected—as expected—by design differences between online tests and their offline counterparts. Conclusions: Although development and optimization of the ACS is an ongoing process, and reliability can be optimized for several tests, our results indicate that it is a highly usable tool to obtain (online) measures of various cognitive abilities. The ACS is expected to facilitate efficient gathering of data on cognitive functioning in the near future.     

Depression,Internet Gaming Disorder,and the Moderating Effect of the Gamer-Avatar Relationship: an Exploratory Longitudinal Study

Research into Internet gaming disorder (IGD) literature largely uses cross-sectional designs and seldom examines gaming context-related factors. Therefore, the present study combined a cross-sectional and longitudinal design to examine depression and the gamer-avatar relationship (GAR) as risk factors in the development of IGD among emerging adults. IGD behaviors of 125 gamers (64 online gamers, M_age = 23.3 years, SD = 3.4; 61 offline gamers, M_age = 23.0 years, SD = 3.4) were assessed using the nine-item Internet Gaming Disorder Scale Short Form (IGDS-SF9; Pontes and Griffiths Revista Argentina de Ciencias del Comportamiento, 7, 102–118, 2015a; Computers in Human Behavior, 45, 137–143, 2015b). The Self-Presence Scale (Ratan and Dawson Communication Research, 2015) and the Beck Depression Inventory (Beck et al. 1996) were also used to assess gamers’ levels of GAR and depressive symptoms, respectively. Regression and moderation analyses revealed that depression and the GAR act as individual risk factors in the development of IGD over time. Furthermore, the GAR exacerbates the IGD risk effect of depression.     

Discrepancies between crystallized and fluid ability are associated with frequency of social and physical engagement in community dwelling older adults

Objective: Age differences have been noted in the discrepancies between crystallized and fluid ability (Gc–Gf). Larger Gc–Gf discrepancies have also been shown to be associated with Alzheimer’s disease biomarkers and clinical severity. However, little is known regarding the relationship between Gc–Gf discrepancies in normal aging and functional outcomes. The aim of the present study was to examine this.

Method: Data from 104 adults (M_age = 71.70 years, SD = 9.016) were included in the present study. Measures from the NIH toolbox were used to form the discrepancy scores. Physical, cognitive, and social activities were identified using the Community Healthy Activities Model Program for Seniors activity questionnaire. Linear regression analyses, controlling for age, education, gender, health, and depressive symptoms, were used to examine the association between social, cognitive, and physical activities on Gc–Gf discrepancies.

Results: Results showed that social and physical activity were significantly associated with greater discrepancies between crystallized and fluid ability, independent of covariates. There was no association between cognitive activity and Gc–Gf discrepancies.

Conclusions: Larger discrepancies between crystallized and fluid ability are related to frequency of social and physical activity. The findings support previous research that discrepancy scores may serve as a marker of cognitive decline. In more highly educated older individuals, Gc–Gf discrepancies may be a more accurate indicator of actual cognitive status.     

Do Parents Model Gestures Differently When Children’s Gestures Differ?

Children with autism spectrum disorder (ASD) or with Down syndrome (DS) show diagnosis-specific differences from typically developing (TD) children in gesture production. We asked whether these differences reflect the differences in parental gesture input. Our systematic observations of 23 children with ASD and 23 with DS (M_ages = 2;6)—compared to 23 TD children (M_age = 1;6) similar in expressive vocabulary—showed that across groups children and parents produced similar types of gestures and gesture-speech combinations. However, only children—but not their parents—showed diagnosis-specific variability in how often they produced each type of gesture and gesture-speech combination. These findings suggest that, even though parents model gestures similarly, the amount with which children produce each type largely reflects diagnosis-specific abilities.     

Screening for neurocognitive impairment in HIV-positive adults aged 50 years and older: Montreal Cognitive Assessment relates to self-reported and clinician-rated everyday functioning

As the HIV+ population ages, the risk for and need to screen for HIV-associated neurocognitive disorders (HAND) increases. The aim of this study is to determine the utility and ecological validity of the Montreal Cognitive Assessment (MoCA) among older HIV+ adults. A total of 100 HIV+ older adults aged 50 years or over completed a comprehensive neuromedical and neurocognitive battery, including the MoCA and several everyday functioning measures. The receiver operating characteristic curve indicates ≤26 as the optimal cut-off balancing sensitivity (84.2%) and specificity (55.8%) compared to “gold standard” impairment as measured on a comprehensive neuropsychological battery. Higher MoCA total scores are significantly (p < .01) associated with better performance in all individual cognitive domains except motor abilities, with the strongest association with executive functions (r = ?0.49, p < .01). Higher MoCA total scores are also significantly (p <.01) associated with fewer instrumental activities of daily living declines (r = ?0.28), fewer everyday cognitive symptoms (r = ?0.25), and better clinician-rated functional status (i.e., Karnofsky scores; r = 0.28); these associations remain when controlling for depressive symptoms. HIV+ individuals who are neurocognitively normal demonstrate medium-to-large effect size differences in their MoCA performance compared to those with asymptomatic neurocognitive impairment (d = 0.85) or syndromic HAND (mild neurocognitive disorder or HIV-associated dementia; d = 0.78), while the latter two categories do not differ. Although limited by less than optimal specificity, the MoCA demonstrates good sensitivity and ecological validity, which lends support to its psychometric integrity as a brief cognitive screening tool among older HIV+ adults.     

Recurrent perseverations on semantic verbal fluency tasks as an early marker of cognitive impairment

Introduction: Our objective was to examine the association between perseverations produced on the semantic verbal fluency (SVF) task in asymptomatic individuals and the future diagnosis of cognitive impairment (CI).

Method: Participants were individuals participating in the Mayo Clinic Study of Aging (N = 1269, M_age = 79.3 years, SD = 5.1; 51% men). All were cognitively normal at baseline and were followed in 15-month intervals for up to 6 visits. Each neurocognitive assessment included SVF tasks (“animals,” “fruits,” and “vegetables”). Cox modeling was used to test for associations between perseverations and time to CI diagnosis.

Results: Perseverations on the “animals” SVF task were associated with incident CI (hazard ratio = 1.35; 95% confidence interval, CI [1.10, 1.66]). No significant association was found with perseverations on the “fruits” or “vegetables” SVF tasks. Mixed-effects modeling in cognitively normal participants revealed that the number of perseverations at baseline is significantly associated with decline in memory and visuospatial cognitive domains but is not associated with decline in attention.

Conclusions: Assessing perseverations together with standard SVF scores on the “animals” SVF task can help in early identification of asymptomatic individuals at an increased risk for CI. Perseverations are not associated with attention, but rather visual and verbal working memory mechanisms. In longitudinal settings aimed at early detection of signs of CI in presymptomatic individuals, SVF testing with scoring that includes counting of perseverations may potentially serve as a practical alternative to the more cumbersome memory tests.     

Promoting theory of mind in older adults: does age play a role?

Objectives: Previous research on age-related changes in Theory of Mind (ToM) showed a decline in older adults, particularly pronounced over 75 years of age. Evidence that ToM may be enhanced in healthy aging people has been demonstrated, but no study has focused on the role of age on the effects of ToM training for elderly people. The present study was designed to examine the efficacy of a ToM training on practiced (ToM Strange Stories) and transfer tasks (ToM Animations) in both young and older adults.

Method: The study involved 127 older adults belonging to two age groups: young–old (M_age = 64.41; SD = 2.49; range: 60–69 years) and old–old (M_age = 75.66; SD = 4.38; range: 70–85 years), randomly assigned to either a ToM group or a control group condition. All participants took part in two 2-hour testing sessions and four 2-hour training sessions.

Results: Results showed that both young–old and old–old adults in the ToM group condition improved their ability to reason on complex-mental states significantly more than participants in the control group condition. This positive effect of the training was evident on practiced and transfer ToM tasks. Crucially, age did not moderate the effect of the ToM training.

Conclusion: These findings demonstrate that young–old and old–old adults equally benefit from the ToM training. Implications for the positive effect of the ToM training in old–old adults are discussed.     

Vitamin D and executive functioning: Are higher levels better?

Objectives: Insufficiency of 25-hydroxyvitamin D has been associated with cognitive impairment, particularly worse executive functioning. However, it remains unclear whether supratherapeutic levels (≥100 nmol L^–1) are associated with even better performance than sufficient levels (defined as ≥50 nmol L^–1 or even ≥75 nmol L^–1). The current investigation sought to examine this question. Method: Healthy adults (n = 142) were tested on four measures of executive functioning, including verbal fluency, digit span backward, CANTAB® Spatial Working Memory, and One Touch Stockings of Cambridge. A measure of attention (digit span forward) and memory (CANTAB® Verbal Recognition) were also assessed. Based on blood 25-hydroxyvitamin D [25(OH)D] levels, participants were divided into four groups: insufficient (<50 nmol L^–1), low sufficient (50 to <75 nmol L^–1), high sufficient (75 to <100 nmol L^–1), and supratherapeutic (≥100 nmol L^–1). Relationships between vitamin D status and cognition were assessed by analyses of covariance and hierarchical multiple regression, adjusted for age, education, sex, body mass index, mood, and physical activity level. Multivariate regression spline analyses were utilized to investigate nonlinearity. Results: Performance on verbal fluency, but not other measures, differed by vitamin D status, analysis of covariance (ANCOVA), F(3, 127) = 2.70, p = .048; d = 0.50. Specifically, participants with supratherapeutic levels provided a greater number of words (M = 16.1, SE = 1.0) than those with insufficient (M = 12.0, SE = 1.0; p = .007, d = 0.78), low (M = 13.4, SE = 0.7; p = .026, d = 0.51), and high sufficient levels (M = 13.9, SE = 0.9; p = .080, d = 0.42). Similarly, vitamin D status was a significant independent predictor of verbal fluency (p = .025, d = 0.40). Spline analyses revealed that there is a positive, near-linear association between verbal fluency and 25(OH)D levels up to and exceeding 100 nmol L^–1. Discussion: Supratherapeutic levels of vitamin D were associated with significantly better performance on verbal fluency. Importantly, commonly used cutoff levels and sufficiency categories have been based on bone health and optimal levels for cognition are unknown. These findings suggest that levels exceeding 100 nmol L^–1 may be optimal for at least some aspects of executive functioning.     

Age-related differences in twitch properties and muscle activation of the first dorsal interosseous

Objective

To examine twitch force potentiation and twitch contraction duration, as well as electromyographic amplitude (EMG_RMS) and motor unit mean firing rates (MFR) at targeted forces between young and old individuals in the first dorsal interosseous (FDI). Ultrasonography was used to assess muscle quality.

Accuracy of WISC-III and WAIS-IV short forms in patients with neurological disorders

The assessment of intellectual abilities is intensive, time-consuming, and might be considered burdensome for patients. We examined psychometric qualities of short forms (SFs) of the Wechsler Intelligence Scales for Children (WISC-third edition) and for adults (WAIS-fourth edition), in children (n = 986; M_age = 10.9) and adults (n = 324; M_age = 40.9) with neurological disorders. SF estimates were compared with Full Scale IQ (FSIQ), obtained by a complete administration, for the entire sample and for the subgroups FSIQ < 80 and FSIQ ≥ 80. The FSIQ was correctly identified within ± 7 points in 86% of children and 87% of adults. There were, however, some differences regarding the optimal SF subtest combination between subgroups. Although clinical inferences should not be made, SFs may be useful in research settings to obtain a global estimate of intelligence, and in clinical settings to screen periodically for possible intellectual deterioration.     

Multicomponent analysis of a digital Trail Making Test

Objective: The purpose of the current study was to use a newly developed digital tablet-based variant of the TMT to isolate component cognitive processes underlying TMT performance.Method: Similar to the paper-based trail making test, this digital variant consists of two conditions, Part A and Part B. However, this digital version automatically collects additional data to create component subtest scores to isolate cognitive abilities. Specifically, in addition to the total time to completion and number of errors, the digital Trail Making Test (dTMT) records several unique components including the number of pauses, pause duration, lifts, lift duration, time inside each circle, and time between circles. Participants were community-dwelling older adults who completed a neuropsychological evaluation including measures of processing speed, inhibitory control, visual working memory/sequencing, and set-switching. The abilities underlying TMT performance were assessed through regression analyses of component scores from the dTMT with traditional neuropsychological measures.Results: Results revealed significant correlations between paper and digital variants of Part A (r_s = .541, p < .001) and paper and digital versions of Part B (r_s = .799, p < .001). Regression analyses with traditional neuropsychological measures revealed that Part A components were best predicted by speeded processing, while inhibitory control and visual/spatial sequencing were predictors of specific components of Part B. Exploratory analyses revealed that specific dTMT-B components were associated with a performance-based medication management task.Conclusions: Taken together, these results elucidate specific cognitive abilities underlying TMT performance, as well as the utility of isolating digital components.