Cognitive screening is essential for assessing mental health and identifying early cognitive vulnerability. This preliminary phase of a preregistered umbrella project (OSF: https://osf.io/8jz6k) implemented a structured cognitive assessment interview with federal public managers, representing an unprecedented initiative in Brazil. The main objective was to characterize the cognitive status of federal public leaders using a multimodal screening protocol and to examine the contributions of intellectual functioning and age to global cognitive performance. Seventy-eight leaders (Mage = 48.44, SD = 8.04) completed a standardized remote cognitive screening session including the Mini-Mental State Examination, the Brazilian version of the Montreal Cognitive Assessment, and a dyadic short form of the Wechsler Adult Intelligence Scale-III to estimate intellectual functioning. Brazilian normative data were applied for classification. Associations among age, intellectual functioning, and cognitive performance were examined using bivariate correlations, hierarchical regression, and bootstrap procedures with 5000 resamples. Mini-Mental State Examination scores were uniformly high (28.12 ± 1.74), reflecting ceiling effects typical of highly educated adults. Although most participants performed within the healthy range on the global Montreal Cognitive Assessment score (25.56 ± 2.70), the Memory Index Score identified a comparatively larger proportion of individuals within normative ranges associated with mild or more pronounced cognitive vulnerability, indicating heightened sensitivity to subtle episodic-memory changes. Intellectual functioning was a strong positive predictor of cognitive performance, whereas age emerged as a significant negative predictor only after controlling for intellectual functioning, consistent with cognitive-reserve models. Bootstrap confidence intervals supported the robustness of both predictors. The findings indicate preserved global cognition alongside meaningful heterogeneity in episodic-memory performance, underscoring the value of memory-sensitive indices for early cognitive monitoring in high-responsibility leadership contexts. Subsequent executive-function assessments from the umbrella project will further refine the identification of domain-specific cognitive profiles.
An association between hearing loss and cognitive decline has been found in many epidemiological and clinical studies but few studies have investigated if objectively measured hearing loss is associated with subjective cognitive complaints. Both factors increase with age and are linked to future cognitive decline/dementia. The aim was to investigate if the degree of subjective cognitive complaints was significantly associated with the level of hearing in older adults. Moreover, to what extent this relationship would persist if factors such as age, cognitive dysfunction, and depression were accounted for. Cognitive Function Instrument (CFI) and Cognitive Change Index (CCI) were applied in 60 community-dwelling adults and 83 audiology clinic patients. Participants were 55 years or older and were assessed with Pure Tone Audiometry (PTA), Geriatric Depression Scale, the Logical Memory Test, and Symbol Digit Modalities Test. Persons with moderate-to-severe hearing loss had significantly higher scores than persons with normal hearing on CFI and CCI. Significant group differences were also found for tests of episodic memory and processing speed. PTA results were significantly correlated to both CCI (rho = 0.21) and CFI (rho = 0.25). Regression-based models did not show an independent and significant effect of hearing on subjective cognitive complaints when age, sex, depressive symptoms, and cognitive test scores were also included in the analysis. In conclusion, subjective cognitive complaints increase with decreased hearing (as measured by tone detection) but the association seems to be moderated by other factors such as depressive symptoms and neuropsychological test performances.
The present study is an attempt to explore relationship, if any, between fat distribution and cognitive functioning among 222 perimenopausal as well as postmenopausal rural women of North India. Body composition characteristics and cognitive functioning of the participants was recorded by using DEXA scan and MMSE scale respectively. Women in cognitively normal category depicted significantly more weight, fat mass, trunk fat mass, android fat mass, gynoid fat mass, fat mass/height2, android and gynoid total mass than their cognitively impaired counterparts. Karl Pearson correlation coefficient exhibited that truncal fat mass had highest association with android fat mass in both cognitively normal and impaired women, while with FM/height2 in cognitively impaired women only. After adjusting age and menopausal status (Model 2), it was noticed that % body fat (β = -2.66) particularly % android fat (β = -3.74) exhibited greater risk for cognitive impairment, thereby indicating possible role of fat distribution in cognitive impairment.
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and hyperglycaemia, which are associated with a high risk of developing several complications, including cognitive dysfunction. Cognitive decline is particularly prevalent in T2DM, encompassing deficits in memory, executive function and information processing speed, which ultimately impact quality of life. The molecular mechanistic and cellular pathways linking T2DM and cognitive dysfunction are complex and multifactorial, involving hyperglycaemia-induced oxidative distress, chronic inflammation, vascular dysfunction and impaired insulin signalling in the brain. In this review, we examine how these interconnected pathways compromise key neuronal and vascular processes essential to maintaining brain proper functioning. Moreover, we explore how emerging evidence suggests that dietary nitrate, found abundantly in vegetables like beetroot and spinach, may offer innovative therapeutic benefits for individuals with T2DM. Finally, we discuss pre-clinical and clinical evidence, addressing challenges specific to T2DM populations that may influence the outcomes of nitrate interventions and highlighting future perspectives for leveraging dietary nitrate as a therapeutic innovative strategy to improve cognitive health in T2DM. Emerging evidence suggests that once ingested, dietary nitrate may act as a bioprecursor of nitric oxide (˙NO), playing a pivotal role in promoting glucose homeostasis, mitigating oxidative distress and inflammation and improving vascular function, mechanisms that collectively counteract the drivers of cognitive decline in T2DM. Dietary nitrate represents a promising nutritional strategy to target mechanisms underlying T2DM-associated cognitive dysfunction. Nevertheless, further studies are required to clarify its therapeutic efficacy, optimal intervention protocols and long-term impact on cognitive health in T2DM.
Hypertension, diabetes, and hyperlipidemia are common in Singapore and linked to cognitive decline. Evidence on cognitive effects of related medications is mixed, with limited multiethnic Singapore data. This study investigated associations between antihypertensive, antidiabetic, and antihyperlipidemic medications and cognitive performance. This cross-sectional (n = 1556) and longitudinal study (n = 565) utilized two datasets from a multiethnic Asian population. Medications were categorized by Anatomical Therapeutic Chemical (ATC) Classification, and analyses compared users and non-users across the full sample and within respective medical conditions. Cognitive function was assessed using a neuropsychological battery evaluating seven domains and global cognition. Linear regression and linear mixed models were used for cross-sectional and longitudinal analyses, respectively. Cross-sectional findings showed no association between antihypertensive or antihyperlipidemic use and cognition. Among diabetic patients, antidiabetic use was linked to poorer global cognition (β = -0.149 (-0.253, -0.045)), executive function (β = -0.287 (-0.468, -0.093)), and visual memory (β = -0.217 (-0.343, -0.092)). Longitudinally, antihypertensive use was associated with better global cognition (β = 0.239 (0.052, 0.426)) and visual memory (β = 0.316 (0.11, 0.522)) among hypertensive participants, while antidiabetic use was associated with poorer visuoconstruction (β = -0.514 (-0.87, -0.158)), and antihyperlipidemic use was not associated with cognition. Baseline antihypertensive use may be associated with better cognitive performance among hypertensive individuals. Poorer cognition among antidiabetic users may reflect underlying disease severity rather than drug toxicity, given the limited longitudinal evidence of consistently poorer cognitive performance. No associations were observed with antihyperlipidemic use. Further large longitudinal studies are needed.
Aging-related cognitive decline is closely associated with oxidative stress, cholinergic dysfunction and hippocampal vulnerability. Perilla seed oil (PSO), a functional food rich in α-linolenic acid and antioxidant phytochemicals, may have cognitive benefits; however, its efficacy and underlying mechanisms in experimental models of accelerated aging remain insufficiently understood. The present study aimed to investigate the effects of PSO supplementation on cognitive performance and neurobiological alterations in a D-galactose (D-Gal)-induced accelerated aging model in rats. Wistar rats were injected subcutaneously with D-Gal (300 mg/kg) daily for 8 weeks and simultaneously treated orally with PSO (100 or 500 mg/kg), fish oil (500 mg/kg) or vehicle. Cognitive function was evaluated using the Morris water maze and novel object recognition tests. Oxidative stress markers, including malondialdehyde (MDA), reduced glutathione (GSH) and superoxide dismutase (SOD), as well as acetylcholinesterase (AChE) activity, were assessed in the hippocampus. Neuronal cell density in the CA1 and CA3 regions was examined using Nissl staining. PSO supplementation significantly improved spatial memory performance and recognition memory, increased hippocampal SOD activity and reduced AChE activity compared with the D-Gal group. Although MDA and GSH levels did not differ significantly, both exhibited a tendency toward normalization. In addition, neuronal density in the CA3 region was significantly reduced in the D-Gal group compared with the control group, whereas no significant differences were observed in the CA1 region. These findings suggest that PSO attenuates D-Gal-induced cognitive impairment, which may be partially associated with enhanced antioxidant enzyme activity and modulation of cholinergic function, rather than with restoration of neuronal density. PSO may therefore represent a potential nutritional intervention for supporting cognitive function during aging-related neurobiological changes.
Alzheimer's disease (AD) is a neurodegenerative disorder characterized by progressive cognitive decline. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have shown neuroprotective potential, but the mechanisms underlying these effects remain incompletely understood. This study investigated whether semaglutide, a long-acting GLP-1RA, ameliorates AD-like phenotypes in APP/PS1 mice and explored associated changes in neuroinflammatory signaling and blood-brain barrier (BBB) integrity. Eight-month-old amyloid precursor protein/presenilin 1 (APP/PS1) transgenic mice were treated with semaglutide for 8 weeks. Cognitive performance was evaluated using the Morris water maze (MWM). AD-related neuropathology, neuroinflammation-associated protein markers, BBB integrity-related measures, and microglial ultrastructure were assessed using histological, ultrastructural, and molecular approaches. Fecal microbiota composition was profiled by 16 S rRNA amplicon sequencing. Semaglutide improved cognitive performance in APP/PS1 mice and was associated with attenuation of neuronal loss-related changes, reduced Aβ deposition, and improved synaptic ultrastructure. Semaglutide also reduced the AD-associated upregulation of inflammasome-/pyroptosis-associated proteins (including NLRP3-related and caspase-11-related markers) and TLR4/NF-κB-related inflammatory signaling proteins, accompanied by attenuation of microglial mitochondrial ultrastructural abnormalities. In addition, semaglutide improved markers of BBB integrity (tight junction proteins and brain albumin levels) and increased BBB-related Aβ clearance proteins (LRP-1 and P-gp). Gut microbiota profiling revealed genus-level differences between WT and APP/PS1 mice without significant changes in α- or β-diversity. Semaglutide was associated with improved cognition and attenuation of AD-like pathology and neuroinflammatory signaling in APP/PS1 mice, accompanied by partial preservation of BBB integrity.
We describe the reliability of remote self-administered digital cognitive measures completed via the Mayo Test Drive (MTD) web-based platform. A total of 1846 participants (mean age = 70, SD = 12, range 31-101; 48% male; 96% White; 99% non-Hispanic; 97% cognitively unimpaired) with two to four complete MTD sessions at ∼7.5-month intervals were included. Test-retest reliability was assessed using single-rating, absolute-agreement, and two-way mixed intraclass correlation coefficients (ICCs) with 95% confidence intervals. ICCs for in-person-administered traditional neuropsychological measures were compared to MTD for a subset of 244 participants. Analyses also compared reliability across demographic, residential, and session context subgroups. Reliability was good for the MTD Composite (total ICC = 0.79 [0.77, 0.80]), and moderate-to-good for the primary outcome variables for each MTD subtest (total ICCs 0.70-0.83 for Stricker Learning Span and Symbols). The reliability of the remote self-administered MTD was similar to in-person-administered cognitive measures. MTD showed moderate-to-good reliability, supporting its use in longitudinal monitoring.
Canine Cognitive Dysfunction (CCD) is a progressive neurodegenerative condition of ageing dogs, sharing pathological and clinical features with Alzheimer's disease. Despite the growing prevalence of CCD, non-pharmacological interventions for affected companion animals remain underexplored. This study evaluated the effects of structured group training classes on signs of CCD, sleep, daily activity, and caregiver burden. Forty-two dogs (≥ 8 years) with mild to moderate CCD were enrolled in either a scent-based (S; n = 21) or physical structured training (PST; n = 21) program. Each dog completed five consecutive weekly sessions, with outcomes assessed through the Canine Dementia Scale (CADES), accelerometry (FitBark), and validated caregiver burden measures at baseline, treatment, and post-treatment. CCD scores remained stable across all phases, suggesting no measurable cognitive changes. However, a significant interaction between training type and treatment phase was observed for sleep: dogs in the PST group demonstrated improved Fitbark sleep scores over time, while those in the S group declined. Daily activity followed expected bimodal patterns, with scent-trained dogs exhibiting reductions in morning and evening activity peaks. Caregiver burden decreased significantly across time in both groups, and caregivers reported high satisfaction with class participation, citing enhanced confidence and social support. These findings indicate that while structured training did not alter CCD severity scores, PST was associated with a small improvement in sleep, S was associated with reduced activity, and participation in both classes was linked to reduced caregiver burden. Further research is needed to confirm these changes and determine their effect on dog and human wellbeing. Group training classes may represent an accessible, welfare-focused intervention for managing CCD in companion dogs.
Mental health nurses now work with growing volumes of measures, documentation screens, alerts and automated scores. More information does not always mean better decisions. When key cues are hard to find, nurses may spend more time searching, checking and reconciling, with less time available for judgement, continuity and therapeutic work. How can digital information be organised so that the most important cues are easier to see and use at the point of care without adding burden? This structured debates essay draws on literature on sociotechnical safety, measurement-based care, electronic record workload and burnout, and governance for clinical decision support. A five-gate Cognitive Firewall is proposed to shape what is shown at the point of decision: Relevance, Prioritisation, Trust, Context and Actionability. Together, these gates produce a task-specific Minimum Viable Data decision view. The aim is to reduce low-value noise, searching and verification work while keeping the full record available. Cognitive safety is framed as a practical mental health nursing concern, not only a technical design issue. The framework treats information overload as a safety problem that can be reduced through clear local rules and governance that do not add further burden. The framework can support safer, clearer work in triage, handover, discharge and follow-up by making recent change, current risk and next steps easier to see. Local services should pilot the gate rules in one high-burden workflow, co-design the decision view with frontline nurses and lived-experience perspectives, and evaluate workload, usability and safety before wider adoption.
Cognitive impairment is a core feature of neuronal synuclein disease (NSD) across the Parkinson's disease (PD) continuum, emerging in prodromal states and progressing variably after diagnosis. Leveraging Parkinson's Progression Markers Initiative (PPMI) findings, we highlight that dementia risk in PD appears lower and later than historically estimated (approximately 10% at 10 years), whereas cognition is shaped by converging factors including age, education, affective symptoms, dopaminergic deficit, diffuse cortical atrophy, reduced cerebrospinal fluid (CSF) Aβ1-42, and genetic variants. These insights inform clinical research-encouraging prodromal-stage enrollment, cognition-linked functional endpoints, and platform designs-whereas myPPMI enables scalable remote phenotyping to accelerate mechanistic discovery and biologically-targeted trials of cognitive decline. ANN NEUROL 2026.
This pilot study evaluated the efficacy of a novel electronic cognitive training program aimed at alleviating anxiety in vocational college students. The intervention uniquely combined bilateral eye movements, drawing on principles of EMDR, with inhibitory control training. Fifty-four vocational college students with high anxiety symptoms were randomly assigned to the experimental group (n = 18) or the waiting control group (n = 33). The experimental group received a 1-month CogniMove program training, while the control group received no intervention for the time being. Results indicated that participants in the experimental group exhibited significantly greater reductions in anxiety compared to controls. Longitudinal analyses further revealed that improvements in self-control partially mediated the intervention's anxiolytic effects, highlighting the role of self-regulatory mechanisms. These findings suggest that combining response inhibition training with bilateral eye movements constitutes a promising and accessible approach for reducing anxiety in educational contexts.
This study investigated predictors of vowelized and unvowelized word reading efficiency among third-grade Hebrew-speaking students with reading difficulties (RD). First, it examined the contribution of rapid automatization naming (RAN), working memory (WM), phonological awareness (PA), morphological awareness (MA), and orthographic processing (OP) in explaining vowelized and unvowelized word reading efficiency among third-grade students with RD. It further explored how RAN interacts with WM, PA, MA, and OP in explaining word reading efficiency in the two scripts, and whether the contribution of RAN differs in strength between vowelized and unvowelized word reading. 270 children were assessed on the abovementioned explanatory variables as well as word reading efficiency. While RAN, WM, PA, and OP explained both vowelized and unvowelized word reading, MA contributed only to unvowelized word reading. Moreover, a significant interaction between RAN and PA was found for vowelized word reading, indicating a skill-enhancement (protective) pattern, whereby the association between RAN and reading efficiency varied as a function of phonological awareness. For unvowelized words, RAN and WM showed a significant interaction indicating a skill-enhancement pattern, in which stronger abilities in both lead to better word reading efficiency. Finally, RAN was found to play a more pronounced role in word reading efficiency of unvowelized words. These findings provide evidence that in a dual-script language, the dynamics of RAN and other cognitive-linguistic reading predictors can vary across scripts, highlighting the need for script-dependent targeted support for children with RD.
Progressive multiple sclerosis (MS) involves heterogeneous mechanisms, and primary progressive MS without inflammatory activity (PPMS-NA) is poorly understood. To characterize the immune-oxidative profile of PPMS-NA and assess plasma IL-6, IL-8, IFNα2, and cerebrospinal fluid (CSF) reactive oxygen species (ROS) as predictors of disability and cognitive decline. We conducted a multicenter longitudinal study with two cohorts. Cohort 1 included participants across MS phenotypes (n = 146 baseline; n = 36 follow-up) and other neurological disorders, measuring plasma cytokines and CSF ROS. Cohort 2 included 40 people with MS, followed for 10 years to assess associations with cognition. Outcomes were analyzed with multivariate models. PPMS-NA showed reduced IL-6 and IFNα2 but elevated CSF ROS versus RRMS and OND, reflecting low systemic inflammation and central oxidative stress. IL-8 increased, predicting disability and 10-year processing speed decline. IL-6 had time- and domain-specific effects: initially linked to attention, later inversely with visuospatial and working memory. CSF ROS correlated with atrophy, supporting oxidative stress as neurodegeneration driver. PPMS-NA is a progressive MS subtype driven by oxidative and glial processes. IL-8 and CSF ROS are biomarkers for early stratification, and IL-6 relates to cognition, supporting therapies targeting oxidative stress and glia.
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[This corrects the article DOI: 10.3389/fpubh.2026.1768848.].
Air pollution is a risk factor for dementia, but its role in early cognitive dysfunction is not clear. We aimed to investigate the association of air pollution with cognitive function, and the role of cardiovascular risk factors and greenspace in this association. The CAHHM (Canadian Alliance for Healthy Hearts and Minds Cohort Study) is a cohort of Canadian adults recruited between 2014 and 2018, for whom averages of exposures to NO2 and fine particulate matter were estimated for 5 years before recruitment. Outcomes included the Montréal Cognitive Assessment and Digit Symbol Substitution Test for cognitive function, and magnetic resonance imaging-measured covert vascular brain injury. Generalized linear mixed models assessed pollutant associations with outcomes in this cross-sectional analysis. A total of 6878 adults participated in the study, with a mean age of 57.6 years (SD=8.8), and 55.6% were women. Mean (SD; range) 5-year pollutant concentrations preceding enrollment for fine particulate matter were 6.9 μg/m3 (2.0 [1.8-11.2]), and for NO2 were 12.9 parts per billion (5.9 [0.9-33.9]). In adjusted models, a 5 μg/m3 higher fine particulate matter concentration was associated with 0.44 points lower Montréal Cognitive Assessment (95% CI, -0.62 to -0.25) and 1.31 points lower Digit Symbol Substitution Test (95% CI, -2.41 to -0.22) scores. A 5 parts per billion higher NO2 concentration was associated with 0.12 points lower Montréal Cognitive Assessment (95% CI, -0.17 to -0.07) and 0.38 points lower Digit Symbol Substitution Test (95% CI, -0.70 to -0.05) scores. A 5 parts per billion higher NO2 concentration was associated with higher odds of covert vascular brain injury (adjusted odds ratio, 1.08 [95% CI, 1.00-1.17]). Cardiovascular risk factors and greenspace did not change these associations. Fine particulate matter and NO2 were associated with lower cognitive function scores in middle-aged adults living in Canada, independent of cardiovascular risk factors. Our results warrant longitudinal follow-up to study the impact of air pollution on cognitive decline.
Postpartum depression (PPD) is a major public health concern. Despite advancements in treatment, many barriers to accessing care remain. There has been a growing interest in digital interventions for the prevention and treatment of PPD. However, for mothers with mild and moderate symptoms of depression, there is a limited offer of self-guided internet-based interventions developed with user input and with considerations on how to integrate the intervention into stepped care models for PPD. The aim of this study was (1) to describe the process of the design and development of iCARE, a self-guided digital psychological intervention for mothers with mild and moderate symptoms of PPD in Denmark, (2) present the program's theory illustrated by a logic model, and (3) explore its initial usability and prospective acceptability. Applying user-centered design methods, the intervention development followed six steps: (1) a literature review to identify evidence‑based therapeutic components of self‑guided interventions for PPD, (2) interviews with women with lived experience of PPD and group discussions with mental health experts and home‑visiting providers to identify user needs, (3) iterative design and content development with stakeholder feedback in collaboration with the Department of Digital Psychiatry, (4) prototype testing using think‑aloud usability sessions and interviews with 5 mothers, (5) a group cognitive walkthrough with mental health experts, and (6) final refinement and implementation of the iCARE program with developers and designers. Initial interviews with mothers and maternal health care providers emphasized the importance of a digital intervention offering timely psychoeducation, coping strategies, and pathways to in-person care while addressing the diversity of expressions of PPD symptoms. Stakeholders recommended a flexible program, multimodal content, and integration into maternal care systems with community health nurses supporting engagement and participation. The prototype was designed to be user-centered, engaging, and with multiple interactive features. It included components on psychoeducation, cognitive exercises grounded in cognitive behavioral therapy, acceptance and commitment principles, and mood-monitoring. The prototype was designed to be user-centered and engaging, with interactive features and components on psychoeducation, cognitive exercises grounded in cognitive behavioral and acceptance and commitment principles, and mood-monitoring. Prototype testing indicated high prospective acceptability and led to refinements across 6 themes: appropriateness of content; motivation and engagement; inclusivity and gender representation; clarity of instructions and data use; understanding of therapeutic method; and usability, layout, and navigation. iCARE is a self-guided internet-based psychological intervention for mothers with mild and moderate symptoms of PPD in Denmark. It was developed with user input by using qualitative methods, user-centered design, and psychological theory. Further research is needed to evaluate the feasibility and effectiveness of the program in a randomized controlled trial and its integration into maternal health care models such as universal PPD screening and home-visiting.
Alzheimer's disease and related dementias (ADRD) are progressive neurodegenerative conditions where early detection is critical for timely intervention and care planning. However, current diagnostic methods are often inaccessible, costly, and delayed, especially for underserved populations. There is a growing need for scalable, noninvasive tools that can support timely diagnosis. Spontaneous speech contains rich acoustic and linguistic markers that can serve as noninvasive behavioral markers for cognitive decline. Foundation models, pretrained on large-scale audio or text data, generate high-dimensional embeddings that encode rich contextual and acoustic information. This study benchmarks open-source foundation language and speech models to evaluate their effectiveness in detecting ADRD from spontaneous speech as a potential solution for early, noninvasive, and scalable ADRD detection. In this study, we used the Pioneering Research for Early Prediction of Alzheimer's and Related Dementias EUREKA (PREPARE) Challenge dataset, which consists of audio recordings from over 1600 participants with 3 distinct categories of cognitive decline: healthy control (HC), mild cognitive impairment (MCI), and Alzheimer's disease (AD). We further excluded samples that are non-English, nonspontaneous speech, or of poor quality. Our final samples included 703 (59.13%) HC, 81 (6.81%) MCI, and 405 (34.06%) AD cases. We systematically benchmarked 18 open-source foundation speech and language models to classify cognitive status into 3 categories (HC, MCI, or AD). Post hoc interpretability analysis was performed for the best-performing model using Shapley additive explanations linking high-dimensional embeddings with explainable acoustic and linguistic markers. Whisper-medium model achieved the highest performance among speech models at 0.731 accuracy and 0.802 area under the curve, while Bidirectional Encoder Representations from Transformers with pause annotation achieved the top accuracy of 0.662 and 0.744 area under the curve among language models. Overall, ADRD detection based on state-of-the-art automatic speech recognition model-generated audio-embeddings outperformed other models, and the inclusion of nonsemantic information, such as pause patterns, consistently improved the classification performance of text-embedding-based models. Our work presents a comprehensive comparative evaluation of state-of-the-art speech and language models for AD and MCI detection on a large, clinically relevant dataset. Embeddings derived from acoustic models, which capture both semantic and acoustic information, show promising performance and highlight the potential for developing a more scalable, noninvasive, and cost-effective early detection tool for ADRD.
Cannabis use initiation during adolescence has increased globally, raising concerns about neurodevelopmental consequences during this critical period when the brain undergoes extensive remodeling in cannabinoid receptor-rich regions. This systematic review examines neurodevelopmental consequences of adolescent cannabis use, focusing on structural brain changes, cognitive impacts, addiction vulnerability, and long-term outcomes. We searched PubMed, EMBASE, PsycINFO, and Web of Science (2000-2025) for studies examining cannabis effects in adolescent populations. Following PRISMA guidelines, two reviewers screened 3,421 records and assessed 156 full-text articles, including studies with neuroimaging, cognitive assessments, or longitudinal follow-up. Thirty-six studies involving 8,432 participants met criteria: 23 longitudinal cohorts (62.2%), 8 cross-sectional (22.2%), 4 RCTs (11.1%), and 1 case-control study (2.8%). Neuroimaging revealed dose-dependent alterations including reduced prefrontal cortical and hippocampal/amygdala volumes, accelerated cortical thinning in longitudinal studies, and impaired white matter connectivity correlating with initiation age. Cognitive findings were mixed - some showed persistent deficits after prolonged abstinence in adolescent-onset users, others found no effects after controlling for confounders. Epidemiological studies consistently showed elevated addiction risk (ORs 3.9-7.2) in adolescents versus adults. Long-term associations included educational difficulties, mental health problems, and functional impairment, though causal relationships remained unclear. Adolescent cannabis use associates with structural brain changes, elevated addiction risk, and variable cognitive effects, suggesting greater vulnerability versus adult-onset use. However, methodological limitations including confounders, heterogeneous definitions, and observational designs limit causal inference. Findings support age-specific prevention and specialized interventions while highlighting needs for rigorous longitudinal research establishing causality. https://www.crd.york.ac.uk/prospero/, identifierCRD420251165329.