Delayed Recall Memory Research Articles

Longitudinal Association of Changes in Metabolic Syndrome with Cognitive Function: 12-Year Follow-up of the Guangzhou Biobank Cohort Study.

The association of changes in metabolic syndrome (MetS) with cognitive function remains unclear. We explored this association using prospective and Mendelian randomization (MR) studies. MetS components including high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), waist circumference (WC), fasting plasma glucose (FPG), and triglycerides were measured at baseline and two follow-ups, constructing a MetS index. Immediate, delayed memory recall, and cognitive function along with its dimensions were assessed by immediate 10- word recall test (IWRT) and delayed 10-word recall test (DWRT), and mini-mental state examination (MMSE), respectively, at baseline and follow-ups. Linear mixed-effect model was used. Additionally, the genome-wide association study (GWAS) of MetS was conducted and one-sample MR was performed to assess the causality between MetS and cognitive function. Elevated MetS index was associated with decreasing annual change rates (decrease) in DWRT and MMSE scores, and with decreases in attention, calculation and recall dimensions. HDL-C was positively associated with an increase in DWRT scores, while SBP and FPG were negatively associated. HDL-C showed a positive association, whereas WC was negatively associated with increases in MMSE scores, including attention, calculation and recall dimensions. Interaction analysis indicated that the association of MetS index on cognitive decline was predominantly observed in low family income group. The GWAS of MetS identified some genetic variants. MR results showed a non-significant causality between MetS and decrease in DWRT, IWRT, nor MMSE scores. Our study indicated a significant association of MetS and its components with declines in memory and cognitive function, especially in delayed memory recall.

The Impact Of State Anxiety On Delayed Memory Recall In College-aged Individuals With Concussion

The Impact Of State Anxiety On Delayed Memory Recall In College-aged Individuals With Concussion

B - 92 Memory Rehabilitation Following Stroke and Traumatic Brain Injury

Abstract Objective Several Meta analyses suggest mixed but objective support for internal strategies. Typically, successful rehabilitation involves at least 8 hour of memory training and often results in 0.25 to 0.50 standard deviation (SD) improvements depending on how long post injury. Intervention dose, strategies, level of impairment, and patient self-awareness and motivation all appear relevant. Methods Data is taken from 21 continuous referrals. Three individuals did not want to work on memory strategies, so their data was separated from the rest. Participants: 18 individuals with acquired brain injuries, with an average age of 51.6 and about 15 years of education, who were 76.6 days post brain injury. Intervention: Each individual was involved in 8 weeks of transdisciplinary rehabilitation. Many goals were addressed and memory rehabilitation was treated via 1 or 2 weekly sessions with a neuropsychologist. Internal and external strategy use was taught. Individuals received 8 to 10 hours of memory rehabilitation involving repetitive practice of clustering, semantic clustering, organizing information into sentences or stories, rhyming, and acronyms. Results Delayed List Recall significantly improved from standard scores of 73.5 to 89.7 and the delayed Story Recall improved from 75 to 90. The mean improvement was nearly 1 standard deviation across measures. Conclusions Individuals showed significant improvement in immediate and delayed recall memory scores. These individuals showed more than 0.5 SD short-term memory (STM) gain and also self-reported improved STM. Durability of gains was not measured in follow-ups. These interventions improve memory skills, but not all patients choose to participate in this type of treatment.

The association between memory, COVID-19 testing, and COVID-19 incidence in middle-aged and older adults: a prospective analysis of the CLSA

ABSTRACT We investigated the association between pre-COVID-19 memory function and (a) receipt of a COVID-19 test and (b) incidence of COVID-19 using the COVID-19 Questionnaire Study (CQS) of the Canadian Longitudinal Study on Aging (CLSA). The CQS included 28,565 middle-aged and older adults. We regressed receipt of a COVID-19 test on participants’ immediate and delayed recall memory scores and re-ran the regression models with COVID-19 incidence as the outcome. All regression models were adjusted for sociodemographic, lifestyle, and health covariates. In the analytical sample (n = 21,930), higher delayed recall memory (better memory) was significantly associated with lower COVID-19 incidence. However, this association was not significant for immediate recall memory. Immediate and delayed recall memory were not associated with receipt of a COVID-19 test. Health policymakers and practitioners may viewmemory status as a potential risk for COVID-19. Memory status may not be a barrier to COVID-19 testing.

Say it out loud: Does mental context reinstatement out loud benefit immediate and delayed memory recall?

AbstractMental context reinstatement (MCR) is a key part of the cognitive interview. However, police face challenges delivering MCR in real‐life situations. Over the years, modifications have been made to make MCR more user‐friendly for officers and ensure witness engagement. The current study evaluates the impact of vocalizing MCR generations aloud on mock‐witness's immediate and delayed recollections. Participants watched a staged multiple‐car collision and were interviewed about it the next day. Half verbalized mental images aloud (aMCR), while the other half kept them silent in their minds (cMCR). After a week, participants took part in a delayed recall attempt. No significant differences in immediate recall performance were found. During the delayed recall, participants who engaged in aMCR previously recalled significantly more and more correct details than those who received cMCR. aMCR might lead to more coherent representations in working memory, resulting in improved consolidation and better future recall.

Speech patterns during memory recall relates to early tau burden across adulthood.

Early cognitive decline may manifest in subtle differences in speech. We examined 238 cognitively unimpaired adults from the Framingham Heart Study (32-75 years) who completed amyloid and tau PET imaging. Speech patterns during delayed recall of a story memory task were quantified via five speech markers, and their associations with global amyloid status and regional tau signal were examined. Total utterance time, number of between-utterance pauses, speech rate, and percentage of unique words significantly correlated with delayed recall score although the shared variance was low (2%-15%). Delayed recall score was not significantly different between β-amyoid-positive (Aβ+) and -negative (Aβ-) groups and was not associated with regional tau signal. However, longer and more between-utterance pauses, and slower speech rate were associated with increased tau signal across medial temporal and early neocortical regions. Subtle speech changes during memory recall may reflect cognitive impairment associated with early Alzheimer's disease pathology. Speech during delayed memory recall relates to tau PET signal across adulthood. Delayed memory recall score was not associated with tau PET signal. Speech shows greater sensitivity to detecting subtle cognitive changes associated with early tau accumulation. Our cohort spans adulthood, while most PET imaging studies focus on older adults.

Five-year effects of cognitive training in individuals with mild cognitive impairment.

In a 5-year follow-up study, we investigated the enduring effects of cognitive training on older adults with mild cognitive impairment (MCI). A randomized controlled single-blind trial involved 145 older adults with MCI, assigned to cognitive training (MEMO+), an active control psychosocial intervention, or a no-contact condition. Five-year effects were measured on immediate and delayed memory recall, the Montreal Cognitive Assessment screening test (MoCA), self-reported strategy use, and daily living difficulties. At follow-up, participants who received cognitive training showed a smaller decline in delayed memory and maintained MoCA scores, contrasting with greater declines in the control groups. Cognitive training participants outperformed controls in both delayed memory and MoCA scores at the 5-year time point. No significant group differences were observed in self-reported strategy use or difficulties in daily living. Cognitive training provides long-term benefits by mitigating memory decline and slowing clinical symptom progression in older adults with MCI. Cognitive training reduced the 5-year memory decline of persons with MCI.Cognitive training also reduced decline on the Montreal Cognitive Assessment (MoCA).No intervention effect was found on strategy use or activities of daily living.

NEIGHBORHOOD DISADVANTAGE, IMAGING BIOMARKERS OF ALZHEIMER’S DISEASE, AND COGNITION IN DIVERSE OLDER ADULTS

Abstract Neuroimaging biomarkers of Alzheimer’s disease (AD) are well-validated in White populations. However, it remains unclear how these biomarkers are associated with cognition in non-White populations disproportionately affected by systemic socioeconomic discrimination. We investigated whether neighborhood disadvantage modifies associations of neuroimaging biomarkers with cognition in a diverse cohort of 198 adults ≥50 years, 50% of whom are Black. Outcomes included cognitive impairment and neuropsychological test scores. Predictors were indices of neurodegeneration, vascular damage, and brain amyloid burden, quantified using MR-based measures of cortical thickness and white matter hyperintensities (WMH) and [11C]PiB PET, respectively. We measured neighborhood disadvantage using area deprivation index (ADI), a composite measurement of socioeconomic conditions in a census tract. In linear models, higher ADI, neurodegeneration, and WMH were separately associated with worse cognition. We found an ADI*neurodegeneration interaction on delayed recall memory (p=0.08). Neurodegeneration-positive participants had worse story delayed recall compared to neurodegeneration-negative regardless of ADI (β=-1.57, p=0.01). In neurodegeneration-negative participants, higher ADI is associated with worse delayed recall (β=-0.04, p=0.004): those with a high ADI exhibited low delayed recall, comparable to neurodegeneration-positive participants. ADI was not associated with cognition in neurodegeneration-positive participants. WMH and ADI interacted in models of impairment, visual memory, and visual copy (interaction p’s< 0.10). In those with high ADI, greater WMH was associated with worse cognition (β=-0.30, p=0.02) while participants with low ADI scored well regardless of WMH volume. Taken together, the relationship between neuroimaging biomarkers and cognition differs by neighborhood socioeconomic conditions, highlighting the need for clinical strategies that acknowledge structural disadvantage.

Diabetes status and cognitive function in middle-aged and older adults in the Canadian longitudinal study on aging.

Diabetes is recognized as a significant risk factor for cognitive impairment. However, this association has not been thoroughly examined using large-scale population-based datasets in the Canadian context. The objective of this study was to investigate the potential association between cognitive function and diabetes in a large population-based sample of middle-aged and older Canadians. We utilized baseline data from the Canadian Longitudinal Study on Aging (N=30,097) to test our hypotheses, using five indicators of cognitive function (animal fluency, Stroop interference, reaction time, immediate and delayed memory recall). We conducted multivariate multivariable linear regression and subsequently performed tests for moderation analysis with lifestyle factors and health status. The analysis revealed that type 2 diabetes (T2DM) was associated with lower performance on most cognitive tasks, including those assessing executive function (b=0.60, 95% CI 0.31 to 0.90), reaction time (b=16.94, 95% CI 9.18 to 24.70), immediate memory recall (b=-0.10, 95% CI -0.18 to -0.02), and delayed memory recall (b=-0.12, 95% CI -0.21 to -0.02). However, no significant association was observed between other types of diabetes and cognitive performance. Moderation effects were largely null for T2DM, with the exception of alcohol intake for reaction time, and physical activity for animal fluency. The study showed that individuals with T2DM exhibit poor performance on tasks that assess executive function, reaction time, and memory. Therefore, optimizing cognitive health among individuals with T2DM should be a priority in primary care. Additionally, further studies should examine this association using longitudinal data.

Associations between normal cognitive aging and neurodegeneration

AbstractBackgroundMultiple cognitive domains, including learning, memory and psychomotor speed, show significant reductions with age. These changes are thought to reflect normal cognitive aging. However, since cerebrospinal fluid (CSF) neurodegenerative biomarkers, such as total‐tau (t‐tau) and Neurofilament light chain (NfL), also show age‐related increases in normal aging, we aimed to investigate whether age‐associated cognitive decline may be mediated by age‐associated neurodegenerative changes.MethodWe included 114 cognitively healthy participants aged 40‐80 years from The Norwegian Dementia Disease Initiation Study. All had normal concentrations of CSF Aβ42/40 ratio. Cognitively healthy was defined as demographically adjusted T‐scores ≥35 on standardized cognitive tests. We fitted mediation models using structural equation modelling (SEM), with either CSF NfL or t‐tau as a mediator between age and CERAD learning, CERAD recall, TMT‐A and TMT‐B. All variables were standardized prior to analyses; in addition, both t‐tau and NfL were log transformed due to skewness.ResultsSee table 1 for demographic and clinical characteristics. Whilst neither NfL nor t‐tau showed statistically significant mediation of age‐related cognitive decline, our results nevertheless suggest a partial mediation of NfL on age‐related cognitive decline. Here, relationships between age and CERAD learning, CERAD Recall, and TMT‐A performance were weakened whereas higher NfL was associated with worse performance, in particular for delayed memory recall. This was not observed for t‐tau in any models. See figure 1‐2.ConclusionAge‐related decline in verbal learning, memory and psychomotor speed may be partially attributable to NfL‐associated neurodegenerative changes in cognitively healthy adults. As NfL reflects axonal degeneration, these results may reflect white matter neurodegeneration in aging.

Associations Between Longitudinal Loneliness, DNA Methylation Age Acceleration, and Cognitive Functioning.

Loneliness may influence aging biomarkers related to cognitive functioning, for example, through accelerated DNA methylation (DNAm) aging. In the present study, we tested whether six common DNAm age acceleration measures mediated the effects of baseline loneliness and five different longitudinal loneliness trajectories on general cognitive ability, immediate memory recall, delayed memory recall, and processing speed in 1,814 older adults in the Health and Retirement Study. We found that baseline loneliness and individuals who belong to the highest loneliness trajectories had poorer general cognitive ability and memory scores. Only DNAm age acceleration measures that index physiological comorbidities, unhealthy lifestyle factors (e.g., smoking), and mortality risk-mediated effects of baseline loneliness on general cognitive ability and memory functioning but not processing speed. These same DNAm measures mediated effects of the moderate-but-declining loneliness trajectory on cognitive functioning. Additionally, immediate and delayed memory scores were mediated by GrimAge Accel in the lowest and two highest loneliness trajectory groups. Total and mediated effects of loneliness on cognitive functioning outcomes were mainly accounted for by demographic, social, psychological, and physiological covariates, most notably self-rated health, depressive symptomatology, objective social isolation, and body mass index. Current findings suggest that DNAm biomarkers of aging, particularly GrimAge Accel, have promise for explaining the prospective association between loneliness and cognitive functioning outcomes.

Omega-3 Fatty Acids, Cognition, and Brain Volume in Older Adults.

The elderly population is growing at increased rates and is expected to double in size by 2050 in the United States and worldwide. The consumption of healthy foods and enriched diets have been associated with improved cognition and brain health. The key nutrients common to many healthy foods and diets are the omega-3 polyunsaturated fatty acids (omega-3 FAs), such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). We explored whether omega-3 FA levels are associated with brain volume and cognition. Forty healthy, cognitively normal, Seventh-day Adventist older adults (mean age 76.3 years at MRI scan, 22 females) completed neurocognitive testing, a blood draw, and structural neuroimaging from 2016 to 2018. EPA and an overall omega-3 index were associated with individual measures of delayed recall (RAVLT-DR) and processing speed (Stroop Color) as well as entorhinal cortex thickness. EPA, DHA, and the omega-3 index were significantly correlated with the total white matter volume. The entorhinal cortex, frontal pole, and total white matter were associated with higher scores on delayed memory recall. This exploratory study found that among healthy, cognitively older adults, increased levels of omega-3 FAs are associated with better memory, processing speed, and structural brain measures.

Association of perceived stress with memory decline in older Chinese: The Guangzhou Biobank Cohort Study

BackgroundPrevious studies on associations of perceived stress with poor memory performance in older adults showed inconsistent results. We examined the prospective associations of perceived stress with memory decline using data from Guangzhou Biobank Cohort Study (GBCS). MethodsPerceived stress was measured by the Perceived Stress Scale (PSS) at baseline (2003–2006), with greater scores indicating greater stress. Memory function was measured by delayed 10-word recall test (DWRT) and immediate 10-word recall test (IWRT), with greater scores indicating better performance, at baseline and follow-up (2008–2012) examinations, analyzed as mean annual change in scores. Results9656 participants (72 % women) with mean age 61.6 (standard deviation = 6.4) years were included. During an average of 4.4 years of follow-up, after adjusting for confounders, each one-point greater PSS score was associated with mean annual decline in DWRT scores (β (95 % CI) = −0.005 (−0.008 to −0.002)). Greater Perceived Helplessness (PH) scores, but not Perceived Self-efficacy scores, was associated with greater mean annual decline in DWRT and IWRT scores (β (95 % CI) = −0.005 (−0.009 to −0.001) and − 0.012 (−0.018 to −0.005), respectively), and similar patterns were observed in five out of seven PH items (βs from −0.02 to −0.07). Interaction analysis showed that the association of greater PSS with greater decline in DWRT scores was observed only in those with low family income (β (95 % CI) = −0.08 (−0.13 to −0.04), P for interaction = 0.03). ConclusionsGreater perceived stress was associated with a greater decline in delayed recall memory, especially in those with low family income.

Cognitive Function with PCSK9 Inhibitors: A 24-Month Follow-Up Observational Prospective Study in the Real World-MEMOGAL Study.

The cognitive safety of monoclonal antibody proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) has been established in clinical trials, but not yet in real-world observational studies. We assessed the cognitive function in patients initiating PCSK9i, and differences in cognitive function domains, to analyze subgroups by the low-density lipoprotein cholesterol (LDL-C) achieved, and differences between alirocumab and evolocumab. This has a multicenter, quasi-experimental design carried out in 12 Spanish hospitals from May 2020 to February 2023. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Among 158 patients followed for a median of 99weeks, 52% were taking evolocumab and 48% alirocumab; the mean change from baseline in MoCA score at follow-up was + 0.28 [95% CI (- 0.17 to 0.73; p = 0.216)]. There were no significant differences in the secondary endpoints-the visuospatial/executive domain + 0.04 (p = 0.651), naming domain - 0.01 (p = 0.671), attention/memory domain + 0.01 (p = 0.945); language domain - 0.10 (p = 0.145), abstraction domain + 0.03 (p = 0.624), and orientation domain - 0.05 (p = 0.224)-but for delayed recall memory the mean change was statistically significant (improvement) + 0.44 (p = 0.001). Neither were there any differences in the three stratified subgroups according to lowest attained LDL-C level-0-54mg/dL, 55-69mg/dL and ≥ 70mg/dL; p = 0.454-or between alirocumab and evolocumab arms. We did not find effect of monoclonal antibody PCSK9i on neurocognitive function over 24months of treatment, either in global MoCA score or different cognitive domains. An improvement in delayed recall memory was shown. The study showed no differences in the cognitive function between the prespecified subgroups, even among patients who achieved very low levels of LDL-C. There were no differences between alirocumab and evolocumab. ClinicalTtrials.gov Identifier number NCT04319081.

Clinical and functional correlates of parkinsonism in a population-based sample of individuals aged 75 + : the Pietà study

BackgroundParkinsonism is strongly associated with ageing, and many studies have suggested that parkinsonian signs may affect up to half of older adults and is associated with a wide range of adverse health outcomes. We compared clinical and functional characteristics of oldest-old community-dwelling individuals with parkinsonism (parkinsonian group [PG]) to individuals without parkinsonism (non-parkinsonian group [NPG].MethodsThe Pietà study is a population-based study conducted in Caeté, southeast Brazil, involving 607 individuals aged 75 + years submitted to an extensive clinical evaluation. A subset of 65 PG individuals (61.5% women, median age of 82 years) was compared to 542 NPG individuals (64.8% women, median age of 80 years).ResultsPG individuals had significantly more functional impairment, clinical comorbidities (including number of falls, loss of bladder control and dysphagia) and major depression. Multivariate analysis revealed that older age, higher UPDRSm scores, lower category fluency test (animals/minute) and delayed recall memory scores were associated with PG. This group was also more cognitively impaired, with lower performance than NPG individuals in the Mini-Mental State Examination, category fluency test (animals/minute), clock drawing and in delayed recall (p < 0.001 for all tests). UPDRSm scores were the most contributing factor to cognition that independently explained variability in functionality of the entire sample.ConclusionIndividuals aged 75 + years with parkinsonism were significantly more clinically and functionally impaired in this population-based sample. Cognitive dysfunction explained most of the loss of functionality in these patients. UPDRS-m scores contributed independently to explain variability in functionality in the whole sample.

The mechanism of impaired delayed recall verbal memory function in Parkinson's disease with orthostatic hypotension: a multiple imaging study.

Orthostatic hypotension (OH) frequently accompanies autonomic dysfunction and is an important risk factor for cognitive impairment in Parkinson's disease (PD). However, the association between different cognitive functions and OH in PD patients is not yet fully understood. This study aimed to evaluate the scores of different cognitive domains and multiple parameters using different imaging techniques on PD patients with or without OH. A total number of 31 PD patients with OH (n = 20) and without OH (n = 11) were recruited from the Department of Neurology, Beijing Xuanwu Hospital for this study. All patients underwent beat-to-beat non-invasive blood pressure recordings and an active standing test to evaluate neurogenic OH and a global neuropsychological test to assess cognitive function. All patients underwent dynamic cerebral autoregulation (dCA) measurement, brain magnetic resonance imaging (MRI), and brain 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). The results showed that OH patients had poor delayed recall verbal memory when compared with the PD patients without OH (1.75 ± 1.59 vs. 3.10 ± 1.73, p = 0.042). The dCA test indicated a significant difference in the right very low-frequency (VLF) gain between two groups (1.27 ± 0.17 vs. 1.10 ± 0.26, p = 0.045) and the brain 18F-FDG PET/CT indicated a significant difference in the SUV (right medial temporal lobe) to SUV (occipital lobe) ratio (0.60 ± 0.08 vs. 0.67 ± 0.11, p = 0.049). Meanwhile, these two imaging parameters were negatively correlated (p < 0.001). Furthermore, the score of a delayed recall verbal memory in the OH group was positively correlated with the right medial temporal lobe to occipital lobe ratio (p < 0.001) and was negatively correlated with the right VLF gain (p = 0.023). PD with OH patients had poor delayed recall memory, which might have been caused by the decreased metabolic dysfunction of specific medial temporal lobe due to the impaired dCA ability.

Episodic Memory in Amnestic Behavioral Frontotemporal Dementia and Alzheimer's Disease.

Behavioral frontotemporal dementia (bvFTD) may present with episodic memory deficits. In 38 patients with bvFTD and 61 with Alzheimer's disease (AD) specific measures of verbal memory (learning curves and serial position effects) were studied through the Rey Auditory Verbal Learning test. Forty-two percent of bvFTD showed deficits of delayed recall memory similar to that found in AD including the serial position effects. Amnestic bvFTD had more severe atrophy in the left mesial temporal lobe than non-amnestic bvFTD. AD-like memory deficits are not infrequent in bvFTD and may be in part related to mesial temporal lobe atrophy.

Longitudinal association between multimorbidity, cognitive decline and neuropsychiatric symptoms

AbstractBackgroundAlzheimer’s disease (AD) is the most common form of dementia afflicting more than 5.8 million older adults in the United States. In AD, cognitive decline and neuropsychiatric symptoms are more pronounced in those who have chronic conditions. These chronic conditions often co‐occur with other chronic conditions, known as multiple chronic conditions (MCCs). This study aimed to examine the longitudinal association between the number of chronic conditions with cognition and neuropsychiatric symptoms by cognitive status.MethodsParticipants were 21,219 community dwelling individuals from the longitudinal National Alzheimer’s Coordinating Center (NACC, U24 AG072122) database (mean age = 71.8 ± 9.8; 42.8% male). Participants completed a medical history interview, cognitive assessment, and the Neuropsychiatric Inventory (NPI), approximately every two years over a 15‐year period. Number of MCCs was characterized as the sum of clinician‐diagnosed chronic conditions (i.e., cardiovascular, metabolic, sleep, respiratory, and psychological conditions;range 0‐18). The analysis focused on memory (Craft Story 21 recall immediate and delayed), processing speed (Trails A), and executive function (Trails B, Coding, animal naming). We used mixed effect models to test whether the number of MCCs was associated with a change on each cognitive test and number neuropsychiatric symptoms by clinician diagnosed cognitive status (i.e., normal cognition, mild cognitive impairment (MCI) presumed AD etiology, MCI presumed without AD etiology, MCI with AD etiology, dementia with AD etiology, dementia with non‐AD etiology).ResultsWe found that the mean number of chronic conditions were, 2.2 ± 1.8 in cognitively normal individuals, 2.8 ± 2.0 in MCI with AD etiology, 2.8 ± 2.0 in MCI with non AD etiology, 2.7±1.9 in dementia with AD etiology, 3.0±2.1 in dementia with non‐AD etiology. Compared to cognitively normal adults, individuals with more severe cognitive impairment (i.e., groups with dementia) and a higher number of MCCs demonstrated greater decline in immediate and delayed memory recall, Trails A, animal naming, and coding (p &lt;0.05), as well as the number of neuropsychiatric symptoms (p &lt;0.05) over time accounting for age, sex, and education.ConclusionThe findings suggest that having a higher number of chronic conditions is associated with longitudinal decline in cognition and neuropsychiatric symptoms.

Non-pharmacological interventions for cognitive impairment in older adults with heart failure: A systematic review

BackgroundCognitive impairment is a prevalent issue among older adults with heart failure, and non-pharmacological approaches are recommended as the first line of treatment. However, it remains unclear which non-pharmacological interventions are the most effective for achieving optimal cognitive and physical outcomes. The aim of this study is to summarize the available evidence on the impact of non-pharmacological interventions for optimizing cognitive function in older adults with HF. MethodsA systematic research was carried out across multiple databases including PubMed, Embase, Scopus, Web of Science, PsycINFO, Cochrane Library, Chinese National Knowledge Infrastructure Database, and Wanfang Database up until May 2022. Randomized controlled trials that focused on non-pharmacological interventions for older adults with heart failure and cognitive impairment, and evaluated the impact on cognitive function were targeted. The risk bias of the selected articles was analyzed following the Cochrane handbook. Two independent reviewers were responsible for selecting the studies, extracting the data, and assessing their quality. The results were reported in a narrative format. ResultsA total of 11 studies, which involved 1,287 patients, were reviewed and showed an acceptable risk of bias. These studies evaluated various cognitive domains, including global cognition, delayed recall memory, working memory, and verbal memory. Non-pharmacological interventions that included cognitive intervention, cognitive training combined with exercise, exercise training, and self-care management, were shown to have a positive impact on cognitive function, physical performance, and depression levels in older adults with heart failure. One study explored the effects of electrical muscle stimulation therapy, but no significant improvement in cognitive abilities was observed. ConclusionThe available evidence for the effectiveness of non-pharmacological interventions for cognitive impairment in older adults with heart failure is limited, and further research with formal outcome measures and longer follow-up periods is necessary to provide more informed recommendations.

Delayed episodic memory recall after one week is associated with executive functions and divided attention in pediatric epilepsy patients

AimRecent studies suggest that although children with epilepsy may show normal learning and memory performance, accelerated long-term forgetting (ALF) may become evident over time. Our study examined associations between delayed episodic memory performance (recall 1-week after learning) and executive functions. MethodA consecutive sample of children with a diagnosis of idiopathic epilepsy with focal or generalized seizures, without morphologic or metabolic abnormalities (n = 20, mean age: 11.70 years) was compared to an IQ-matched healthy control group (n = 20, mean age: 11.55 years). We also assessed parents’ and children’s rating of forgetting in everyday life and explored its association with delayed episodic memory recall. ResultsSimilar to results from recent studies of pediatric patients with temporal lobe epilepsy or genetic generalized epilepsy, our pediatric epilepsy patients showed a significantly elevated recall loss over time, although verbal learning, immediate and 30-minute recall was comparable to the matched control group. Additionally, delayed memory recall in patients was moderately associated with their subjective rating of forgetting, as well as with executive functions (verbal fluency and switching) and divided attention. InterpretationWe assume that executive functions play a crucial role in deep memory encoding, facilitating stronger and more enduring memory traces. Given that approximately 20% of epilepsy patients – compared to a healthy reference sample – had a significantly reduced delayed recall and due to the clinical relevance of long-term memory, age-appropriate standard norms for free memory recall after 1-week are desirable.