Accurate Prediction of Momentary Cognition From Intensive Longitudinal Data

Hawks, Zoë; Strong, Roger; Jung, Laneé; Beck, Emorie D; Passell, Eliza; Grinspoon, Elizabeth; Singh, Shifali; Frumkin, Madelyn; Sliwinski, Martin J.; Germine, Laura

doi:10.1016/j.bpsc.2022.12.002

Cited by 11 publications

(18 citation statements)

References 93 publications

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“…Minimizing cognitive fluctuations is important for everyday safety (e.g., driving) (23), and the magnitude of cognitive fluctuations may differentiate clinical conditions (e.g., cognitively intact from mild neurocognitive disorder) (24). Clarifying influences on cognitive fluctuations holds promise to inform evidence-based guidelines that enhance momentary cognition (9). This information may also be used to time delivery of cognitively demanding interventions at moments when individuals are likely to respond (25).…”

Section: Characterizing Momentary Cognition: Historical Challenges An...mentioning

confidence: 99%

“…Intensive longitudinal designs sample participants frequently and repeatedly. Frequent, repeated sampling is necessary for hypothesis tests of cognitive fluctuations (9). Medical devices that measure timevarying physiological processes relevant to cognition have also been developed, with mixed success.…”

Section: Characterizing Momentary Cognition: Historical Challenges An...mentioning

confidence: 99%

“…) were validated for brief administration across demographic groups (9,45). Prior to EMA, participants completed onboarding with task instructions, practice trials, and corrective feedback.…”

Section: Cognitive Ema Cognitive Tasks (Digit Symbol Matching [Dsm] G...mentioning

confidence: 99%

“…Prior to EMA, participants completed onboarding with task instructions, practice trials, and corrective feedback. MOT data were not analyzed due to low within-person reliability <0.3 (9), which limits the proportion of variance that may be explained by time-varying predictors (51). Refer to (52,53) for MOT task details.…”

Section: Cognitive Ema Cognitive Tasks (Digit Symbol Matching [Dsm] G...mentioning

confidence: 99%

“…Cognitive variability may be measured across tasks (cognitive dispersion; timescale: minutes/hours) and/or across trials within a task (cognitive inconsistency; timescale: seconds/minutes) at a single timepoint (6,7), or it may be measured for a given task across multiple timepoints (cognitive fluctuations; timescale: hours/days) (8). The present paper identifies factors that influence cognitive fluctuations under naturalistic assessment conditions (momentary cognition) (9) among individuals with T1D.…”

Section: Introductionmentioning

confidence: 98%

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Dynamic associations between glucose and ecological momentary cognition in Type 1 Diabetes

Hawks¹,

Beck²,

Jung³

et al. 2023

Preprint

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Type 1 diabetes (T1D) is a chronic condition characterized by glucose variability due to autoimmune destruction of insulin-secreting pancreatic beta-cells. Prior research (linking greater glucose variability to cognitive impairment and adverse health outcomes) and recent technological innovations (continuous glucose monitoring [CGM], cognitive ecological momentary assessment [EMA]) laid a foundation for the current study, which aimed to advance understanding of between- and within-person influences on physiological and cognitive processes relevant to health in T1D. We obtained intensive longitudinal, naturalistic measurements of cognition (EMA) and glucose (CGM) in N=199 adults with T1D. Given reduced cognitive performance during periods of low (hypo) and high (hyper) glycemia, our analyses focused on the strength of within-person quadratic associations between glucose and cognition—operationalized as the rate of change in the slope of the glucose-cognition relationship, hereafter, glucose acceleration. First, we used multilevel modeling to obtain group (i.e., aggregated across participants) and individual (i.e., specific to each participant) estimates of glucose acceleration. Next, we used machine learning to identify between-person predictors of individual estimates of glucose acceleration. Finally, we built personalized models to contextualize individual estimates of glucose acceleration in relation to time-varying processes. Group estimates of glucose acceleration were significant for processing speed but not sustained attention. Specifically, processing speed was fastest at glucose concentrations slightly above individuals’ means, regardless of absolute levels of the means. Between individuals, estimates of glucose acceleration varied in relation to several clinical and demographic variables, including age, microvascular complications, and percent time in hypoglycemia (< 70 mg/dL). Within individuals, fluctuations in glucose and processing speed were related to prior night’s sleep duration, self-reported assessment context (e.g., noise), and self-reported stress. Results generate testable insights about shared (across individuals) factors that impact cognitive fluctuations. They also highlight opportunities to support personalized medicine by increasing understanding about unique (person-specific) influences on cognitive fluctuations in T1D.

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Section: Characterizing Momentary Cognition: Historical Challenges An...mentioning

confidence: 99%

Section: Characterizing Momentary Cognition: Historical Challenges An...mentioning

confidence: 99%

Section: Cognitive Ema Cognitive Tasks (Digit Symbol Matching [Dsm] G...mentioning

confidence: 99%

Section: Cognitive Ema Cognitive Tasks (Digit Symbol Matching [Dsm] G...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

See 3 more Smart Citations

Dynamic associations between glucose and ecological momentary cognition in Type 1 Diabetes

Hawks¹,

Beck²,

Jung³

et al. 2023

Preprint

View full text Add to dashboard Cite

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100 days of Adolescence: Elucidating Externalizing Behaviors Through the Daily Assessment of Inhibitory Control

Chaku

Yan

Kelly

et al. 2023

Res Child Adolesc Psychopathol

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Inhibitory control is a transdiagnostic risk factor for externalizing behaviors, particularly during adolescence. Despite advances in understanding links between inhibitory control and externalizing behaviors across youth on average, significant questions remain about how these links play out in the day-to-day lives of individual adolescents. The goals of the current study were to: (1) validate a novel 100-occasion measure of inhibitory control; (2) assess links between day-to-day fluctuations in inhibitory control and individual differences in externalizing behaviors; and (3) illustrate the potential of intensive longitudinal studies for person-specific analyses of adolescent externalizing behaviors. Participants were 106 youth (57.5% female, Mage = 13.34 years; SDage = 1.92) who completed a virtual baseline session followed by 100 daily surveys, including an adapted Stroop Color Word task designed to assess inhibitory control. Results suggested that the novel task was generally reliable and valid, and that inhibitory control fluctuated across days in ways that were meaningfully associated with individual differences in baseline impulsive behaviors. Results of illustrative personalized analyses suggested that inhibitory control had more influence in the daily networks of adolescents who used substances during the 100 days than in a matched set of adolescents who did not. This work marks a path forward in intensive longitudinal research by validating a novel inhibitory control measure, revealing that daily fluctuations in inhibitory control may be a unique construct broadly relevant to adolescent externalizing problems, and at the same time, highlighting that links between daily inhibitory control and impulsive behaviors are adolescent-specific.

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Dynamic associations between glucose and ecological momentary cognition in Type 1 Diabetes

Hawks,

Beck,

Jung

et al. 2024

npj Digit. Med.

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Type 1 diabetes (T1D) is a chronic condition characterized by glucose fluctuations. Laboratory studies suggest that cognition is reduced when glucose is very low (hypoglycemia) and very high (hyperglycemia). Until recently, technological limitations prevented researchers from understanding how naturally-occurring glucose fluctuations impact cognitive fluctuations. This study leveraged advances in continuous glucose monitoring (CGM) and cognitive ecological momentary assessment (EMA) to characterize dynamic, within-person associations between glucose and cognition in naturalistic environments. Using CGM and EMA, we obtained intensive longitudinal measurements of glucose and cognition (processing speed, sustained attention) in 200 adults with T1D. First, we used hierarchical Bayesian modeling to estimate dynamic, within-person associations between glucose and cognition. Consistent with laboratory studies, we hypothesized that cognitive performance would be reduced at low and high glucose, reflecting cognitive vulnerability to glucose fluctuations. Second, we used data-driven lasso regression to identify clinical characteristics that predicted individual differences in cognitive vulnerability to glucose fluctuations. Large glucose fluctuations were associated with slower and less accurate processing speed, although slight glucose elevations (relative to person-level means) were associated with faster processing speed. Glucose fluctuations were not related to sustained attention. Seven clinical characteristics predicted individual differences in cognitive vulnerability to glucose fluctuations: age, time in hypoglycemia, lifetime severe hypoglycemic events, microvascular complications, glucose variability, fatigue, and neck circumference. Results establish the impact of glucose on processing speed in naturalistic environments, suggest that minimizing glucose fluctuations is important for optimizing processing speed, and identify several clinical characteristics that may exacerbate cognitive vulnerability to glucose fluctuations.

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Accurate Prediction of Momentary Cognition From Intensive Longitudinal Data

Cited by 11 publications

References 93 publications

Dynamic associations between glucose and ecological momentary cognition in Type 1 Diabetes

Dynamic associations between glucose and ecological momentary cognition in Type 1 Diabetes

100 days of Adolescence: Elucidating Externalizing Behaviors Through the Daily Assessment of Inhibitory Control

Dynamic associations between glucose and ecological momentary cognition in Type 1 Diabetes

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