Cognitive, Emotional, and Daily Functioning Domains Involved in Decision-Making among Patients with Mild Cognitive Impairment: A Systematic Review.

Mild cognitive impairment (MCI) is a transitional or prodromal stage of dementia in which autonomies are largely preserved (autonomies are not particularly affected). However, this condition may entail a depletion of decision-making (DM) abilities likely due to a gradual deterioration of the prefrontal cortex and subcortical brain areas underlying cognitive-emotional processing. Given the clinical implications of a decline in self-determination observed in some MCI sufferers, the present systematic review was aimed at investigating the literature addressing DM processes in patients with MCI, consistent with PRISMA guidelines. The six online databases inquired yielded 1689 research articles that were screened and then assessed based on eligibility and quality criteria. As a result, 41 studies were included and classified following the PICOS framework. Overall, patients with MCI who underwent neuropsychological assessment were found to be slightly or moderately impaired in DM abilities related to financial management, medical adherence, specific cognitive performances, risky conditions, and especially uncertain life circumstances. Comparative cross-sectional studies indicated not only mid-stage cognitive functioning in MCI but also borderline or deficit DM patterns evaluated through different tasks and procedures. Further research addressing MCI profiles suggested an association between explicit memory, executive functions, and DM performance. These findings highlight the diversity of MCI manifestations, in addition to the critical importance of DM features and correlates in patients' daily functioning. Due to a lack of consensus on both MCI and DM, this review paper sought to shed light on assessment and intervention strategies accounting for the interplay between emotion, motivation, and learning to foster DM in cognitively impaired individuals.

The flashbulb-like nature of memory for the first COVID-19 case and the impact of the emergency. A cross-national survey.

Flashbulb memories (FBMs) refer to vivid and long-lasting autobiographical memories for the circumstances in which people learned of a shocking and consequential public event. A cross-national study across eleven countries aimed to investigate FBM formation following the first COVID-19 case news in each country and test the effect of pandemic-related variables on FBM. Participants had detailed memories of the date and others present when they heard the news, and had partially detailed memories of the place, activity, and news source. China had the highest FBM specificity. All countries considered the COVID-19 emergency as highly significant at both the individual and global level. The Classification and Regression Tree Analysis revealed that FBM specificity might be influenced by participants' age, subjective severity (assessment of COVID-19 impact in each country and relative to others), residing in an area with stringent COVID-19 protection measures, and expecting the pandemic effects. Hierarchical regression models demonstrated that age and subjective severity negatively predicted FBM specificity, whereas sex, pandemic impact expectedness, and rehearsal showed positive associations in the total sample. Subjective severity negatively affected FBM specificity in Turkey, whereas pandemic impact expectedness positively influenced FBM specificity in China and negatively in Denmark.

Theory of Mind and Executive Functions in Individuals with Mild Cognitive Impairment or Healthy Aging.

Social cognition involves skills for maintaining harmonious personal and social relationships throughout life. Social cognition issues, including Theory of Mind (ToM), can significantly impact the well-being of older individuals and intensify with the onset of neurological conditions. Mild Cognitive Impairment (MCI) is a state between healthy and pathological neurocognitive aging, where monitoring social functions is crucial. Despite numerous studies on ToM challenges in older adults and cognitive disorders, the underlying mechanisms remain debated. Uncertainty exists regarding whether ToM deficits are related to other cognitive functions, such as Executive Functions (EFs). Our study examined the correlation between EF and ToM performance in 32 MCI patients and 36 healthy elderly controls. The findings revealed a link between EF and ToM performance among healthy elderly individuals. Specifically, within the assessed EFs, the role of the working memory (WM) emerged. The study also highlighted distinctions between the MCI group and the healthy elderly group, showing that despite a general reduction in cognitive performance, the condition could impact these abilities in different ways. The study contributes to the literature, fostering comprehension of the mechanisms underlying ToM difficulties, while also paving the way for targeted interventions and enhanced clinical or preventative care.

Current Challenges in the Diagnosis of Progressive Neurocognitive Disorders: A Critical Review of the Literature and Recommendations for Primary and Secondary Care.

Screening for early symptoms of cognitive impairment enables timely interventions for patients and their families. Despite the advances in dementia diagnosis, the current nosography of neurocognitive disorders (NCDs) seems to overlook some clinical manifestations and predictors that could contribute to understanding the conversion from an asymptomatic stage to a very mild one, eventually leading to obvious disease. The present review examines different diagnostic approaches in view of neurophysiological and neuropsychological evidence of NCD progression, which may be subdivided into: (1) preclinical stage; (2) transitional stage; (3) prodromal or mild stage; (4) major NCD. The absence of univocal criteria and the adoption of ambiguous or narrow labels might complicate the diagnostic process. In particular, it should be noted that: (1) only neuropathological hallmarks characterize preclinical NCD; (2) transitional NCD must be assessed through proactive neuropsychological protocols; (3) prodromal/mild NCDs are based on cognitive functional indicators; (4) major NCD requires well-established tools to evaluate its severity stage; (5) insight should be accounted for by both patient and informants. Therefore, the examination of evolving epidemiological and clinical features occurring at each NCD stage may orient primary and secondary care, allowing for more targeted prevention, diagnosis, and/or treatment of both cognitive and functional impairment.

Decision Making and Fibromyalgia: A Systematic Review.

Decision making (DM) is the ability to choose among multiple options, considering external and internal variables and identifying potential paths of action that need to be assessed. Some brain areas involved in decision making are also implicated in pain processing, such as in fibromyalgia (FM). FM is a syndrome characterized by chronic widespread musculoskeletal pain and cognitive difficulties. We conducted a systematic review with the aim of identifying articles that evaluated DM in people with fibromyalgia, highlighting the main assessment tools. This work was conducted according to the PRISMA statement by consulting six online databases and providing a quality assessment of each search that met the inclusion criteria. In line with the limited interest in this in the scientific landscape to date, we found nine studies that evaluated the performance of DM in patients with FM; furthermore, we discovered that only certain types of DM were tested. The importance of our work lies in shedding light on a cognitive ability that is often undervalued in the scientific landscape but essential in everyday life. This review can serve as a starting point for further studies to clarify the relationship between DM and FM, improving understanding of the topic.

The COVID-19 Stress Perceived on Social Distance and Gender-Based Implications.

The COVID-19 pandemic is an unprecedented event entailing long-term consequences on population health and welfare. Those who contracted the coronavirus may have suffered from both physical and mental health issues that unfold the need for tailored intervention strategies. Hence, our study aims to investigate the psychological and social consequences of COVID-19 on a sample of 86 participants, encompassing 43 patients (clinical group; 25 women; mean age = 50.4 ± 10.1 years) recruited from Bari University Hospital, 19 of whom were hospitalized due to the disease. The remaining 43 were individuals not fallen ill with COVID-19 to date (control group; 25 women; mean age = 50.4 ± 10.1 years). The investigation yielded significant gender differences in post-traumatic stress symptoms, depression, and representation of interpersonal distance (IPD), evaluated through the IES-R, the BDI-II, and the IVAS task, respectively. This pattern of results was not replicated in the control group. In general, participants who reported having experienced the most intense post-traumatic symptoms also presented a greater mood deflection and, more specifically, within the clinical group women obtained the highest scores on both scales. Women reported higher IES-R and BDI-II scores compared to men, that could indicate that women who have contracted COVID-19 are more exposed to post-traumatic and depressive symptoms. Our results also showed a significant effect of COVID-19 on IPD with a tendency of disease-experienced individuals to increase their preferred IPD from adults, children, and elderly people. Regarding gender differences in mood and proxemic behavior, a correlation between depressive symptoms and probable PTSD and a further correlation between probable PTSD and greater IPD were found in women from both clinical and control group. Overall, these findings might contribute to a better understanding of gender-based implications of the current pandemic on mental health, also leading to the development of integrated yet personalized intervention strategies.