Awareness of risk factors associated with any form of impairment is critical for formulating optimal prevention and treatment planning. Millions worldwide suffer from some form of cognitive impairment, with the highest rates amongst Black and Hispanic populations. The latter have also been found to achieve lower scores on standardized neurocognitive testing than other racial/ethnic groups. Understanding the socio-demographic risk factors that lead to this discrepancy in neurocognitive functioning across racial groups is crucial. Adverse childhood experiences (ACEs), are one aspect of social determinants of health. ACES have been linked to a greater risk of future memory impairment, such as dementia. Moreover, higher instances of ACEs have been found amongst racial minorities. Considering the current literature, the purpose of this exploratory research is to better understand how social determinants, more specifically, ACEs, may play a role in the development of cognitive impairment.

This cross-sectional study included data from an urban, public Midwestern academic medical center. There was a total of 64 adult clinical patients that were referred for a neuropsychological evaluation. All patients were administered a standardized neurocognitive battery that included the Montreal Cognitive Assessment (MoCA) as well as a 10-item ACE questionnaire, which measures levels of adverse childhood experiences. The sample was 73% Black and 27% White. The average age was 66 (SD=8.6) and average education was 12.6 years (SD=3.4). A two-way ANOVA was conducted to evaluate the interaction of racial identity (White; Black) and ACE score on MoCA total score. An ACE score >4 was categorized as “high”; ACE <4 was categorized as “low.”

There was not a significant interaction of race and ACE group on MoCA score (p=.929) nor a significant main effect of ACE score (p=.541). Interestingly, there was a significant main effect of Race on MoCA (p=.029). White patients had an average MoCA score of 21.82 (sd=4.77). Black patients had an average MoCA score of 17.54 (sd=5.91).

Overall, Black patients demonstrated statistically lower scores on the MoCA than White patients. There was no significant difference on MoCA score between races when also accounting for ACE scores. Given this study’s findings, one’s level of adverse childhood experiences does not appear to impact one’s cognitive ability later in life. There is a significant difference in cognitive ability between races, specifically Black and White people, which suggests there may be social determinants other than childhood experiences to be explored that influence cognitive impairment.

Understanding healthcare information is an important aspect in managing one’s own needs and navigating a complex healthcare system. Health numeracy and literacy reflect the ability to understand and apply information conveyed numerically (i.e., graphs, statistics, proportions, etc.) and written/verbally (i.e., treatment instructions, appointments, diagnostic results) to communicate with healthcare providers, understand one’s medical condition(s) and treatment plan, and participate in informed medical decision-making. Cognitive impairment has been shown to impact one’s ability to understand complex medical information. The purpose of this study is to explore the relationship between the degree of cognitive impairment and one’s ability to perform on measures of health numeracy and literacy.

This cross-sectional study included data from 38 adult clinical patients referred for neuropsychological evaluation for primary memory complaints at an urban, public Midwestern academic medical center. All patients were administered a standardized neurocognitive battery that included the Montreal Cognitive Assessment (MoCA), as well as measures of both health numeracy (Numeracy Understanding of Medicine Instrument-Short Version [NUMI-SF]) and health literacy (Short Assessment of Health Literacy-English [SAHL-E]). The sample was 58% female and 60% Black/40% White. Mean age was 65 (SD=9.4) and mean education was 14.4 years (SD=2.5). The sample was further split into three groups based on cognitive diagnosis determined by comprehensive neuropsychological assessment (i.e., No Diagnosis [34%]; Mild Cognitive Impairment [MCI; 29%]; Dementia [34%]).Groups were well matched and did not statistically differ in premorbid intellectual functioning (F=1.96, p=.157; No Diagnosis, M=100, SD=7.92; MCI, M=99, SD=8.87; Dementia, M=94, SD=7.72) ANOVAs were conducted to evaluate differences between clinical groups on the MoCA, NUMI-SF, and SAHL-E. Multiple regressions were then conducted to determine the association of MoCA scores with NUMI-SF and SAHL-E performance.

As expected, the Dementia group performed significantly below both the No Diagnosis and MCI groups on the MoCA (F=19.92, p<.001) with a large effect (ηp2=.540). Significant differences were also found on the NUM-SF (F=5.90, p>.05) and on the SAHL-E (F=6.20, p>.05) with large effects (ηp2=.258 and ηp2=.267, respectively). Regression found that MoCA performance did not predict performance on the NUMI-SF and SAHL-E in the No Diagnosis group (F=2.30, p=.809) or the MCI group (F=1.31, p=.321). Conversely, the MoCA significantly predicted performance on the NUMI-SF and SAHL-E for the Dementia (F=15.59, p=.001) group.

Degree of cognitive impairment is associated with understanding of health numeracy and literacy information, with patients diagnosed with dementia performing most poorly on these measures. Patients with normal cognitive functioning demonstrated a significantly better understanding of health numeracy and health literacy. This study supports the notion that as cognitive functioning diminishes, incremental support is necessary for patients to understand medical information pertaining to their continued care and medical decision-making, particularly as it relates to both numerical and written information.

Self-compassion (SC) describes an emotionally positive attitude extended toward ourselves when we suffer, consisting of three main components; self-kindness, common humanity, and mindfulness (Germer & Neff, 2013). SC entails being warm and understanding towards ourselves when encountering pain or personal shortcomings, rather than ignoring them or flagellating ourselves with self-criticism. SC also involves recognizing that suffering and failure are part of the shared human experience rather than isolating. In addition, SC requires taking a mindful approach to one’s feelings and thoughts, without judgment of them.

Self-compassion (SC) involves taking an emotionally positive attitude towards oneself when suffering. Although SC has positive effects on mental well-being as well as a protective role in preventing depression and anxiety in healthy individuals, few studies on white matter (WM) microstructures in neuroimaging studies of SC has been studied.

Magnetic resonance imaging data were acquired from 71 healthy participants with measured levels of SC and its six subscales. Mirroring network as WM regions of interest were analyzed using tract-based spatial statistics (TBSS). After the WM regions associated with SC were extracted, exploratory correlation analysis with the self-forgiveness scale, the coping scale, and the world health organization quality of life scale abbreviated version was performed.

We found that self-compassion scale (SCS) total scores were negatively correlated with the fractional anisotropy (FA) values of the superior longitudinal fasciculus (SLF) in healthy individuals. The self-kindness and mindfulness subscale scores of SCS were also negatively correlated with FA values of the same regions. The FA values of SLF related to SC were found to be negatively correlated with the total scores of self-forgiveness scale, and self-control coping strategy and confrontation coping strategy.

Our findings suggest that levels of SC and its self-kindness and mindfulness components may be negatively associated with DMN-related WM microstructures in healthy individuals. These less WM microstructures may be associated with positive personal attitudes, such as self-forgiveness, self-control and active confrontational strategies.

None Declared

Suicide is a complex problem in which individual, family social factors are interrelated. The 1997 Asian financial crisis caused a major economic crisis in Korea, and Korea received bailout support from the International Monetary Funds(IMF) from December 23, 1997 to August 23, 1997.

This study aimed to investigate the relationship between the suicide rate of children and adolescents who grew up during this economic crisis in Korea.

Suicide rates are calculated according to gender, region, and age of 5 years (10-14 years old, 15-19 years old, 20-24 years old) using suicide death data from the Korea National Statistical Office from 2000 to 2017. The cohort of interest in the study is the group that was in childhood and early adolescence between 1997-2000 and corresponds to 1986-1995 in terms of birth year. Cohorts are divided into 1986-1989 (G1), 1990-1992 (G2), and 1993-1995 (G3) according to birth year. These groups were 8-14 years old for G1 and 5-10 years old for G2, 2-7 years old for G3 during 1997-2000, during the economic crisis. The Age-Period-Cohort analysis and linear mixed-effects regression models are used and the moderating effect on region and age is also analyzed.

The 10-24 year-old suicide rate was higher in males than females, in older age groups, earlier in birth years in the birth cohort, and in rural than urban areas. Suicide rates between the ages of 20-24 years were particularly high among men living in rural areas. During the national economic crisis, the suicide rate was higher among adolescents than preschoolers (G3 < G1) (p<0.001), and this trend was observed for both men and women. However, the main effect of the cohort was not observed at a statistically significant level.

The national economic crisis has a negative impact on the mental health of children and adolescents, and it is more negative for adolescents than for children, which can increase the suicide rate between the ages of 20-24.

None Declared

Electronic health record (EHR) data have many quality problems that may affect the outcome of research results and decision support systems. Many methods have been used to evaluate EHR data quality. However, there has yet to be a consensus on the best practice. We used a rule-based approach to assess the variability of EHR data quality across multiple healthcare systems.

To quantify data quality concerns across healthcare systems in a PCORnet Clinical Research Network, we used a previously tested rule-based framework tailored to the PCORnet Common Data Model to perform data quality assessment at 13 clinical sites across eight states. Results were compared with the current PCORnet data curation process to explore the differences between both methods. Additional analyses of testosterone therapy prescribing were used to explore clinical care variability and quality.

The framework detected discrepancies across sites, revealing evident data quality variability between sites. The detailed requirements encoded the rules captured additional data errors with a specificity that aids in remediation of technical errors compared to the current PCORnet data curation process. Other rules designed to detect logical and clinical inconsistencies may also support clinical care variability and quality programs.

Rule-based EHR data quality methods quantify significant discrepancies across all sites. Medication and laboratory sources are causes of data errors.

Childhood trauma influences the clinical features of schizophrenia. In this study, we examined how childhood trauma and perceived stress are associated with clinical manifestations and subcortical gray matter volumes (GMVs) in patients with schizophrenia.

We recruited 127 patients with schizophrenia and 83 healthy controls for assessment of early childhood trauma, perceived stress, and clinical symptoms. With structural brain imaging, we identified the GMVs of subcortical structures and examined the relationships between childhood trauma, perceived stress, clinical symptoms, and subcortical GMVs.

Compared to controls, patients with schizophrenia showed higher levels of childhood trauma and perceived stress. Patients with schizophrenia showed significantly smaller amygdala and hippocampus GMVs as well as total cortical GMVs than age-matched controls. Childhood trauma score was significantly correlated with the severity of clinical symptoms, depression, perceived stress, and amygdala GMVs. Perceived stress was significantly correlated with clinical symptoms, depression, and hippocampus and amygdala GMVs. Further, the association between childhood trauma (emotional neglect) and stress coping ability was mediated by right amygdala GMV in patients with schizophrenia.

Patients with schizophrenia had more exposure to early-life trauma and poorer stress coping. Both childhood trauma and perceived stress were associated with smaller amygdala volumes. The relationship between early-life trauma and perceived stress was mediated by right amygdala GMV in patients with schizophrenia. These findings together suggest the long-term effects of childhood trauma on perceived stress and the subcortical volumetric correlates of the effects in schizophrenia.

(1) To examine total quality of foods consumed on the day a home-delivered meal (HDM) of the Older Americans Act Nutrition Program (OAANSP) was served, and when a HDM was not served; and (2) to estimate proportion of HDM participants and non-participants meeting the daily average recommendations for guidance-based foods and nutrients.

Cross-sectional study.

Data were obtained from the national 2015–2017 Outcomes Evaluation Study of HDM participants in the USA.

Adults aged 67 years and older (n 1227), 620 HDM recipients and 607 matching non-participants examined in three groups: (1) meal recipients who received a HDM on the day of the 24-h dietary recall; (2) no-meal recipients who did not receive a HDM on the day of the recall and (3) matching HDM non-participants.

Healthy Eating Index (HEI)-2010 scores of HDM participants were significantly lower on the day the meal was not received compared with when a meal was received (52·5 v. 63·4, P < 0·0001). There was no significant difference in the total HEI-2010 scores of HDM meal recipients and HDM non-participants. Despite the meal, less than 20 % of HDM participants and non-participants met the 2010-Diet Guidelines for Americans recommended average daily intake for fruit, vegetables, dairy, protein foods and solid fats.

HDM participants’ diet quality is poorer when they do not receive a meal putting them at increased risk of malnutrition. Expanding the OAANSP to offer meals on weekends and/or to include more than one meal/d is recommended to improve the diet of this vulnerable population.

Previous study has identified increased antithrombin III (ATIII) in patients with major depressive disorder (MDD), supporting ATIII as a potential biomarker for depression diagnosis.

This study aimed to reveal the alteration of ATIII after occipital repetitive transcranial magnetic stimulation (rTMS), and illuminate its power to evaluate and predict the curative effects in MDD treatment.

A total of 90 MDD patients were recruited and further intervened with rTMS in occipital for individualized, standard or sham treatment for five days. Those of 74 patients underwent entire detection, including clinical assessments, blood collection and protein measurement.

After treatment, decreased ATIII were detected in both the individualized and the standard group (p=0.000 and 0.001, respectively) instead of the sham one. Especially, the reduction in ATIII in the individualized group was associated with improvements in several neuropsychological assessments. Besides, ATIII at baseline in the standard group and after the individualized rTMS showed high performance to evaluate or predict the response to the 5-day treatment (AUC=0.771, 95%CI, 0.571-0.971; AUC=0.875, 95%CI, 0.714-1.000, respectively) and the remission in follow-up (AUC=0.736, 95%CI, 0.529-0.943; AUC=0.828, 95%CI, 0.656-1.000, respectively). Furthermore, both baseline ATIII and change in ATIII involved in the prediction of 24-item Hamilton Depression Rating Scale in the follow-up study with significant predictive values (p=0.0240 and 0.0233, respectively).

This study detected a reduction in ATIII after occipital rTMS, further revealed the relationships between change in ATIII and therapeutic response, and ultimately provided evidence for the potential of ATIII as a biomarker for the evaluation and prediction of antidepressive effect.

No significant relationships.