Changes In Memory Scores Research Articles

Longitudinal study of cognitive decline among women with and without urinary incontinence

BACKGROUNDCross-sectional and short-term cohort studies have demonstrated an association between urinary incontinence and dementia as well as lower performance on cognitive testing. The Health and Retirement Study, a longitudinal study of community-dwelling older adults, offers an opportunity to assess the temporal association between these conditions, as this study included an assessment of incontinence symptoms as well as biennial assessments of cognitive function. OBJECTIVESThis study aimed to evaluate if urinary incontinence before age 70 had an effect on changes in cognitive function among women participating in the Health and Retirement Study. STUDY DESIGNThis secondary analysis included data from female respondents in the Health and Retirement Study ages 58 to 67 years with ≥2 cognitive assessments. Urinary incontinence was defined as any involuntary loss of any urine in the preceding 12 months. A control group without incontinence was reweighted for better comparability using coarsened exact matching for age and comorbidities. Validated methods, including neuropsychological test data, estimated a Memory score and DP for each participant biennially. Coprimary outcomes were the changes in Memory score and dementia probability.Linear regression models were used to estimate the association of urinary incontinence with change in Memory score and dementia probability, adjusting for baseline demographics and comorbidities. A subgroup analysis was performed to assess the effects of urinary incontinence frequency on these outcomes. The infrequent subgroup reported less than fifteen days of leakage per month and the frequent subgroup reported fifteen or more days of leakage per month. RESULTSAmong eligible female respondents, 40.6% reported urinary incontinence between ages 58 to 69 years. Baseline Memory scores and dementia probability were similar between those with urinary incontinence (n=1706) and controls (n=2507). Memory score declined significantly in both cohorts, indicating poorer memory over time -0.222 among those with incontinence (95% confidence interval (CI) -0.245, -0.199) versus -0.207 in controls (95% CI: -0.227, -0.188). The decline of Memory score was not statistically different between cases and controls (mean difference -0.015, 95% CI: -0.045, 0.015). Dementia probability increased significantly in both groups, indicating a greater probability of dementia: 0.018 among those with incontinence (95% CI: 0.015, 0.020) and by 0.020 among controls (95% CI: 0.017, 0.022). The change in DEMENTIA PROBABILITY was not significantly different between groups (mean difference -0.002, 95% CI: -0.006, 0.002).Frequent urinary incontinence was reported in 105/1706 (6%) with urinary incontinence. Memory score declined and dementia probability increased with time (p<0.001) in frequent and infrequent UI subgroups. There was no dose-response relationship. CONCLUSIONSMeasures of cognitive performance declined with approximately 10 years of observation; the changes in performance were not associated with the presence of urinary incontinence in their younger years.

10 Semantic Memory as a Predictor of Future Memory Decline

Objective:To determine if the degree of split between phonemic verbal fluency and semantic verbal fluency at initial visit is predictive of decline in memory performance between initial evaluation and follow-up.Participants and Methods:Data from a retrospective multidisciplinary memory clinic database at Spectrum Health was utilized. We examined data from 90 participants who had both an initial and follow-up evaluation completed (initial age = 77.1±4.7 years, follow-up age = 78.4±4.7 years, education = 13.9±3.1 years, race = 91% White, 7% Black, &amp; 2% Hispanic, sex = 61% female, time between evaluations = 15.2±9.9 months). Patients who returned for follow-up did not meet criteria for dementia at time one. Split between phonemic and semantic fluency, termed the semantic-phonological delta (SPD) was measured at the initial evaluation by subtracting the Controlled Oral Word Association Test (COWAT; FAS) T-score from the Animal Naming Test (ANT) T-score. Change in memory score was defined in two ways: 1) subtracting the follow-up evaluation Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) List Recognition Score (RBANS percentiles were converted to a scaled score) from the initial evaluation List Recognition Score (List Recognition Delta), and 2) computing the difference in the RBANS Delayed Memory Index Standard Score between the initial evaluation and the follow-up evaluation (RBANS Memory Delta).Results:Average semantic fluency T scores were (M = 40.3, SD = 12.3) and phonemic fluency T scores were (M = 42.7, SD = 10.3) at initial evaluation. Bivariate correlations were used to determine the relationship between the clinical variables. SPD was significantly correlated with List Recognition Delta, r(88) = .23, p = .026, with greater discrepancies in verbal fluency scores associated with higher level of decline in List Recognition at follow-up. By comparison, Semantic Fluency performance itself at initial evaluation was not significantly correlated with List Recognition Delta, r(88) = .17, p = .097. The correlation between SPD and the RBANS Memory Delta was also not significant, r(88) = .14, p = .166. At follow-up evaluation, 39% of the sample received a diagnosis of Alzheimer’s disease. Of those diagnosed with Alzheimer’s disease, 66% had a negative SPD split at time one, performing worse on semantic fluency compared to phonemic fluency.Conclusions:SPD is a better predictor of decline in RBANS List Recognition performance between evaluations than semantic fluency alone, with a larger negative SPD score (worse semantic fluency performance compared to phonemic fluency) at initial evaluation predicting decline in List Recognition performance at follow-up evaluation. SPD at initial evaluation was not significantly correlated with change in RBANS Delayed Memory Index score between evaluations. This may be because there are some patients who are similarly impaired in both semantic and phonemic verbal fluency at initial evaluation who later demonstrate progressive decline in memory retrieval due to hippocampal-sparing etiologies (e.g., vascular dementia). Overall, these findings are consistent with previous work suggesting that declines in the semantic memory system precede declines in episodic memory retention in conditions such as Alzheimer’s disease.

Relationship Between Pre-Operative Clinical Characteristics With Changes In Post-Operative Memory Scores On Temporal Lobe Epilepsy Patient

Background: Most temporal lobe epilepsy (TLE) will become seizure-free after anterior temporal lobectomy (ATL) surgery but often result in cognitive decline, specifically in verbal or visual memory. Objective: This study examined the relationship between several demographic characteristics and pre-operative clinical conditions with changes in pre-post surgical memory of TLE patients. Methods: This study used a retrospective cohort in which the subjects were TLE patients who had undergone ATL surgery at Kariadi Hospital or Telogorejo Hospital, Semarang. Demographic variables include the age of onset, duration of illness, level of education, and clinical variables include seizure frequency, EEG waveform, number of AED, lesion site, and IQ score. Results: Memory re-examination was conducted on TLE patients who had undergone surgery between 2018 and 2021, with 55 subjects who fulfilled the criteria. Characteristics of the subjects were male 31(56%) males, 38% Senior High School education, the mean age of onset was 13,87±6,899, age at surgery was 27,67±9,802, 21 (39%) normal pres-surgical EEG waveform, 31 (56%) lesion on the left and the most frequent seizures occurred in 36 subjects (65%). Statistical test results showed a significant relationship between age of onset and changes in verbal memory recognition scores (p 0.044), lesion side with changes in verbal memory task scores (p 0.018), recall (p 0.005), recognition (0.008), and IQ scores with changes in visual memory construction recall (p 0.041) Conclusion: Age of onset, lesion side, and IQ score characteristics were related to the changes in memory scores between pre- and post-operative anterior temporal lobectomy in TLE patients.

Longitudinal change in serial position scores in older adults with entorhinal and hippocampal neuropathologies.

Serial position scores on verbal memory tests are sensitive to early Alzheimer's disease (AD)-related neuropathological changes that occur in the entorhinal cortex and hippocampus. The current study examines longitudinal change in serial position scores as markers of subtle cognitive decline in older adults who may be in preclinical or at-risk states for AD. This study uses longitudinal data from the Religious Orders Study and the Rush Memory and Aging Project. Participants (n = 141) were included if they did not have dementia at enrollment, completed follow-up assessments, and died and were classified as Braak stage I or II. Memory tests were used to calculate serial position (primacy, recency), total recall, and episodic memory composite scores. A neuropathological evaluation quantified AD, vascular, and Lewy body pathologies. Mixed effects models were used to examine change in memory scores. Neuropathologies and covariates (age, sex, education, APOE e4) were examined as moderators. Primacy scores declined (β = -.032, p < .001), whereas recency scores increased (β = .021, p = .012). No change was observed in standard memory measures. Greater neurofibrillary tangle density and atherosclerosis explained 10.4% of the variance in primacy decline. Neuropathologies were not associated with recency change. In older adults with hippocampal neuropathologies, primacy score decline may be a sensitive marker of early AD-related changes. Tangle density and atherosclerosis had additive effects on decline. Recency improvement may reflect a compensatory mechanism. Monitoring for changes in serial position scores may be a useful in vivo method of tracking incipient AD.

The Long-Term Effects of Acupuncture on Hippocampal Functional Connectivity in aMCI with Hippocampal Atrophy: A Randomized Longitudinal fMRI Study

Background. Acupuncture has been used to treat amnestic mild cognitive impairment (aMCI) for many years in China. However, the long-term effects of continuous acupuncture treatment remained unclear. Objective. We aimed to explore the long-term effects of continuous acupuncture treatment on hippocampal functional connectivity (FC) in aMCI. Methods. Fifty healthy control (HC) participants and 28 aMCI patients were recruited for resting-state functional magnetic resonance imaging (fMRI) at baseline. The 28 aMCI patients were then divided into the aMCI acupuncture group, which received acupuncture treatment for 6 months, and the aMCI control group, which received no intervention. All aMCI patients completed the second resting-state fMRI scanning after 6 months of acupuncture treatment. Analysis based on the region of interest and two-way analysis of covariance were both used to explore the long-term effects of acupuncture on cognition change and hippocampal FC in aMCI. Results. Compared to HC, aMCI showed decreased right hippocampal FC with the right inferior/middle temporal gyrus (ITG/MTG), left amygdala, and the right fusiform and increased FC with bilateral caudates at baseline. After acupuncture treatment, the right hippocampal FC with right ITG/MTG enhanced significantly in the aMCI acupuncture group, but continued to decrease in the aMCI control group. Whole brain FC analysis showed enhanced right hippocampal FC with the right ITG and the left MTG in the aMCI acupuncture group relative to the aMCI control group. Furthermore, FC strength of the right hippocampus with right ITG at baseline was negatively correlated with the changes in memory scores of aMCI acupuncture patients. Conclusion. Acupuncture treatment could alleviate the progression of cognitive decline and could enhance hippocampal FC with ITG and MTG in aMCI that may be associated with resilience to resistant against neurodegeneration. The findings provided a better understanding of the long-term effects of acupuncture treatment and confirmed the therapeutic role of acupuncture in aMCI.

Modelling prognostic trajectories of cognitive decline due to Alzheimer's disease.

Alzheimer's disease (AD) is characterised by a dynamic process of neurocognitive changes from normal cognition to mild cognitive impairment (MCI) and progression to dementia. However, not all individuals with MCI develop dementia. Predicting whether individuals with MCI will decline (i.e. progressive MCI) or remain stable (i.e. stable MCI) is impeded by patient heterogeneity due to comorbidities that may lead to MCI diagnosis without progression to AD. Despite the importance of early diagnosis of AD for prognosis and personalised interventions, we still lack robust tools for predicting individual progression to dementia. Here, we propose a novel trajectory modelling approach based on metric learning (Generalised Metric Learning Vector Quantization) that mines multimodal data from MCI patients in the Alzheimer's disease Neuroimaging Initiative (ADNI) cohort to derive individualised prognostic scores of cognitive decline due to AD. We develop an integrated biomarker generation- using partial least squares regression- and classification methodology that extends beyond binary patient classification into discrete subgroups (i.e. stable vs. progressive MCI), determines individual profiles from baseline (i.e. cognitive or biological) data and predicts individual cognitive trajectories (i.e. change in memory scores from baseline). We demonstrate that a metric learning model trained on baseline cognitive data (memory, executive function, affective measurements) discriminates stable vs. progressive MCI individuals with high accuracy (81.4%), revealing an interaction between cognitive (memory, executive functions) and affective scores that may relate to MCI comorbidity (e.g. affective disturbance). Training the model to perform the same binary classification on biological data (mean cortical β-amyloid burden, grey matter density, APOE 4) results in similar prediction accuracy (81.9%). Extending beyond binary classifications, we develop and implement a trajectory modelling approach that shows significantly better performance in predicting individualised rate of future cognitive decline (i.e. change in memory scores from baseline), when the metric learning model is trained with biological (r=-0.68) compared to cognitive (r=-0.4) data. Our trajectory modelling approach reveals interpretable and interoperable markers of progression to AD and has strong potential to guide effective stratification of individuals based on prognostic disease trajectories, reducing MCI patient misclassification, that is critical for clinical practice and discovery of personalised interventions.

Episodic memory improvements due to noninvasive stimulation targeting the cortical-hippocampal network: A replication and extension experiment.

IntroductionThe distributed cortical network of the human hippocampus is important for episodic memory. In a previous experiment, noninvasive stimulation of the hippocampal‐cortical network applied for five consecutive days improved paired‐associate learning measured after the stimulation regimen via cued recall (Wang et al., Science, 2014, 345, 1054). This finding has not yet been directly replicated. Furthermore, evidence for long‐lasting effects of stimulation on paired‐associate learning was obtained by analyzing relatively small subsamples (Wang & Voss, Hippocampus, 2015, 25, 877) and requires further evaluation.MethodsSixteen healthy young adults participated in this replication study using the same experimental design as the original study. Participants received 1 week of active stimulation and 1 week of sham stimulation, with memory assessments occurring at the beginning (pre) and end (post) of each week. Assessments included the paired‐associate task used in the original study, as well as a long‐term episodic memory retention task in order to test the hypothesis that increased paired‐associate learning could come at the cost of accelerated long‐term forgetting. Change in memory scores was evaluated within (pre vs. post) and across (active vs. sham) weeks.ResultsSimilar to Wang et al., paired‐associate learning was significantly improved after 1 week of active stimulation but not after 1 week of sham stimulation. We found no evidence that stimulation increased long‐term forgetting for either week.ConclusionThese findings confirm the beneficial effects of stimulation on episodic memory that were reported previously and indicate that stimulation‐related gains in new learning ability do not come at the price of accelerated long‐term forgetting.

The Link between Estradiol and Neuroplasticity in Transgender Women after Gender-Affirming Surgery: A Bimodal Hypothesis

For transgender individuals, gender-affirming surgery (GAS) and cross-sex hormone therapy (CSHT) are part of the gender transition process. Scientific evidence supporting the maintenance of CSHT after GAS-related gonadectomy is accumulating. However, few data are available on the impact of CSHT on the brain structure following hypogonadism. Thus, we aimed to investigate links between estradiol and brain cortical thickness (CTh) and cognition in 18 post-gonadectomy transgender women using a longitudinal design. For this purpose, the participants underwent a voluntary period of CSHT washout of at least 30 days, followed by estradiol re-institution for 60 days. High-resolution T1-weighted brain images, hormonal measures, working and verbal memory were collected at 2 time points: on the last day of the washout (t1) and on the last day of the 2-month CSHT period (t2). Between these 2 time points, CTh increased within the left precentral gyrus and right precuneus but decreased within the right lateral occipital cortex. However, these findings did not survive corrections of multiple comparisons. Nevertheless, there was a significant negative correlation between changes in estradiol levels and changes in CTh. This effect was evident in the left superior frontal gyrus, the left middle temporal gyrus, the right precuneus, the right superior temporal gyrus, and the right pars opercularis. Although there was an improvement in verbal memory following hypogonadism correction, we did not observe a significant relationship between changes in memory scores and CTh. Altogether, these findings suggest that there is a link between estradiol and CTh.

Validating the Cognitive Scale for Down Syndrome (CS-DS) to Detect Longitudinal Cognitive Decline in Adults With Down Syndrome

Down syndrome (DS) is associated with intellectual disability and an ultra-high risk of developing dementia. Informant ratings are invaluable to assess abilities and related changes in adults with DS, particularly for those with more severe intellectual disabilities and/or cognitive decline. We previously developed the informant rated Cognitive Scale for Down Syndrome (CS-DS) to measure everyday cognitive abilities across memory, executive function, and language domains in adults with DS, finding CS-DS scores are a valid measure of general abilities, and are significantly lower for those with noticeable cognitive decline compared to those without decline. To further test the validity of the CS-DS in detecting changes associated with cognitive decline we collected longitudinal data across two time points, approximately 1.5–2 years apart, for 48 adults with DS aged 36 years and over. CS-DS total scores (78.83 ± 23.85 vs. 73.83 ± 25.35, p = 0.042) and executive function scores (46.40 ± 13.59 vs. 43.54 ± 13.60, p = 0.048) significantly decreased between the two time points, with scores in the memory domain trending towards a significant decrease (22.19 ± 8.03 vs. 20.81 ± 8.63, p = 0.064). Adults with noticeable cognitive decline at follow-up showed a trend to significantly greater change in total scores (7.81 ± 16.41 vs. 3.59 ± 16.79, p = 0.067) and significantly greater change in executive function scores (5.13 ± 9.22 vs. 1.72 ± 9.97, p = 0.028) compared to those without decline. Change in total scores showed significant correlations with change in scores from other informant measures of everyday adaptive abilities and symptoms associated with dementia, and participant assessment of general cognitive abilities (all p < 0.005), while change in memory scores (R2 = 0.28, p = 0.001) better predicted change in participant cognitive assessment scores than change in executive function (R2 = 0.15, p = 0.016) or language (R2 = 0.15, p = 0.018) scores. These results suggest informants may better detect changes in the executive function domain, while change in informant rated memory scores best predicts change in assessed cognitive ability. Alternatively, memory domain scores may be sensitive to changes across both early and late cognitive decline, whereas executive function domain scores are more sensitive to changes associated with later noticeable cognitive decline. Our results provide further support for the validity of the CS-DS to assess everyday cognitive abilities and to detect associated longitudinal changes in individuals with DS.

Plasma Lipids, Apolipoproteins, and Subsequent Cognitive Decline in Men with Coronary Heart Disease.

Lipid levels are associated with an increased risk of cardiovascular disease. We investigated the association between plasma lipids, apolipoproteins levels, apolipoprotein B/low-density lipoprotein cholesterol (Apo-B/LDL-C), and Apo-B/Apo-A ratios and rate of cognitive decline two decades later in men with coronary heart disease (CHD). A subset of 337 men (mean age at baseline 56.6±6.4 years) who previously participated in the Bezafibrate Infarction Prevention (BIP) trial (1990-1997) underwent cognitive evaluations 15±3 years (T1) and 19.9±1 years after baseline (T2) as part of the BIP Neurocognitive study. Lipid and apolipoprotein fractions were measured at baseline. Cognitive function for memory, executive function, visual spatial, attention domains, and composite score were assessed using the NeuroTrax Computerized Battery at T1 and T2 evaluations. Linear mixed models were used to assess change in cognitive function between the two cognitive evaluations. Controlling for confounders, the decline in composite cognitive score (β= -0.161±0.06; p = 0.013) as well as in memory (β= -0.269±0.10; p = 0.009) and visual spatial function (β= -0.304±0.12; p = 0.010) was greater among patients in the upper (≥105 mg/dL) Apo-B tertile as compared to counterparts with < 105 mg/dL. The decline in the composite cognitive score (β= -0.124±0.06; p = 0.043) was also greater among patients in the estimated LDL-C≥160 mg/dL group compared to counterparts with LDL-C<160 mg/dL. Upper tertile of Apo-B/LDL-C ratio (≥0.75) compared to the lower tertiles was significantly associated with change in memory score (β= -0.210±0.10; p = 0.041). Our findings suggest that the plasma concentrations of Apo-B, LDL-C, and Apo-B/LDL-C ratio are potential predictors of accelerated late-life cognitive decline among men with CHD.

Differential impact of Shavasana and meditation on memory scores in healthy college students

Background: Yogic relaxation techniques endow its practitioners with the relaxation of Citta (i.e., mind, intellect, and ego) and freedom from psycho-physiological fatigue. Objectives: The purpose of the present study was to compare the differential impact of the guided instructions in Shavasana and meditation in supine posture on verbal, spatial, and associate memory scores. Research Design: This was a randomized controlled trial. Method: Randomly selected 45 healthy college students were equally divided into meditation group (n = 15), Shavasana group (n= 15), and control group (n = 15), with age range of 22–30 years. All individuals were assessed for total memory through Wechsler Memory Scale before and after the 30-day intervention of yoga, consisting of two types of relaxation techniques (Shavasana and meditation in supine posture). The sessions were of 30 min each for both the intervention groups for 6 days a week. Results: Results showed significant changes in memory scores among meditation and Shavasana groups as compared to the control group. Meditation group had shown a higher magnitude of change as compared to the other groups. Within-group comparison revealed significant changes in memory scores in both meditation (P &lt; 0.001) as well as in Shavasana (P &lt; 0.01) groups. Conclusion: This study has concluded that the guided relaxation techniques of yoga could bring a deeper relaxation at the psycho-physiological level which, in turn, could bring about a deeper impact at higher psychological levels resulting into significant improvement in verbal, spatial, and associate memory scores.

Joint Modeling of Longitudinal Change and Survival

Joint longitudinal-survival models are useful when repeated measures and event time data are available and possibly associated. The application of this joint model in aging research is relatively rare, albeit particularly useful, when there is the potential for nonrandom dropout. In this article we illustrate the method and discuss some issues that may arise when fitting joint models of this type. Using prose recall scores from the Swedish OCTO-Twin Longitudinal Study of Aging, we fitted a joint longitudinal-survival model to investigate the association between risk of mortality and individual differences in rates of change in memory. A model describing change in memory scores as following an accelerating decline trajectory and a Weibull survival model was identified as the best fitting. This model adjusted for random effects representing individual variation in initial memory performance and change in rate of decline as linking terms between the longitudinal and survival models. Memory performance and change in rate of memory decline were significant predictors of proximity to death. Joint longitudinal-survival models permit researchers to gain a better understanding of the association between change functions and risk of particular events, such as disease diagnosis or death. Careful consideration of computational issues may be required because of the complexities of joint modeling methodologies.

Effect of two yoga-based relaxation techniques on memory scores and state anxiety

BackgroundA yoga practice involving cycles of yoga postures and supine rest (called cyclic meditation) was previously shown to improve performance in attention tasks more than relaxation in the corpse posture (shavasana). This was ascribed to reduced anxiety, though this was not assessed.MethodsIn fifty-seven male volunteers (group average age ± S.D., 26.6 ± 4.5 years) the immediate effect of two yoga relaxation techniques was studied on memory and state anxiety. All participants were assessed before and after (i) Cyclic meditation (CM) practiced for 22:30 minutes on one day and (ii) an equal duration of Supine rest (SR) or the corpse posture (shavasana), on another day. Sections of the Wechsler memory scale (WMS) were used to assess; (i) attention and concentration (digit span forward and backward), and (ii) associate learning. State anxiety was assessed using Spielberger's State-Trait Anxiety Inventory (STAI).ResultsThere was a significant improvement in the scores of all sections of the WMS studied after both CM and SR, but, the magnitude of change was more after CM compared to after SR. The state anxiety scores decreased after both CM and SR, with a greater magnitude of decrease after CM. There was no correlation between percentage change in memory scores and state anxiety for either session.ConclusionA cyclical combination of yoga postures and supine rest in CM improved memory scores immediately after the practice and decreased state anxiety more than rest in a classical yoga relaxation posture (shavasana).

Memory outcome 2 years after anterior temporal lobectomy in patients with drug-resistant epilepsy

Purpose Memory decline is often observed after anterior temporal lobectomy (ATL), particularly in patients with dominant hemisphere resections. However, the follow-up length has been 1 year or less in most studies. Our aims were to examine postoperative memory changes over a longer period and to identify baseline demographic and clinical predictors of memory outcome. Methods We administered material-specific memory tests at baseline, and 1 and 2 years after surgery to 82 consecutive right-handed patients (52% males) who underwent ATL for drug-resistant temporal lobe epilepsy (TLE) (35 left, 47 right) after a non-invasive presurgical protocol. Repeated measures multivariate analysis of variance (RM-MANOVA) was used to examine the relationship between changes in memory tests scores over time and side of TLE and pathology. Also, standardized residual change scores were calculated for each memory test and entered in multiple linear regression models aimed at identifying baseline predictors of better memory outcome. Results RM-MANOVA revealed a significant change in memory test scores over time, with an interaction between time and side of surgery, as 2 years after surgery patients with RTLE were improved while patients with LTLE were not worse as compared with baseline. Pathology was not associated with changes in memory scores. In multiple regression analysis, significant associations were found between right TLE and greater improvement in verbal memory, younger age and greater improvement in visuospatial memory, and male gender and greater improvement in both verbal and visuospatial memory. Conclusions Our results suggest that the long-term memory outcome of TLE patients undergoing ATL without invasive presurgical assessment may be good in most cases not only for right-sided but also for left-sided resections.