Delayed Recall Scores Research Articles

Neighborhood environment associations with cognitive function and structural brain measures in older African Americans

BackgroundSince older adults spend significant time in their neighborhood environment, environmental factors such as neighborhood socioeconomic disadvantage, high racial segregation, low healthy food availability, low access to recreation, and minimal social engagement may have adverse effects on cognitive function and increase susceptibility to dementia. DNA methylation, which is associated with neighborhood characteristics as well as cognitive function and white matter hyperintensity (WMH), may act as a mediator between neighborhood characteristics and neurocognitive outcomes.MethodsIn this study, we examined whether DNA methylation in peripheral blood leukocytes mediates the relationship between neighborhood characteristics and cognitive function (N = 542) or WMH (N = 466) in older African American (AA) participants without preliminary evidence of dementia from the Genetic Epidemiology Network of Arteriopathy (GENOA).ResultsFor a 1-mile buffer around a participant’s residence, each additional fast food destination or unfavorable food store with alcohol per square mile was nominally associated with a 0.05 (95%CI: 0.01, 0.09) and a 0.04 (0.00, 0.08) second improvement in visual conceptual tracking score, respectively. Also, each additional alcohol drinking place per square mile was nominally associated with a 0.62 (0.05, 1.19) word increase in delayed recall score, indicating better memory function (all p < 0.05). Neighborhood characteristics were not associated with WMH. We did not find evidence that DNA methylation mediates the observed associations between neighborhood characteristics and cognitive function.ConclusionsThe presence of fast food destinations and unfavorable food stores with alcohol was associated cognitive measures, possibly due to greater social interaction provided in these venues. However, replication of these findings is necessary. Further examination of the potential pathways between the neighborhood environment and cognitive function/WMH may allow the development of potential behavioral, infrastructural, and pharmaceutical interventions to facilitate aging in place and healthy brain aging in older adults, especially in marginal populations that are most at risk.

Sleep disturbances and their correlation with memory impairment in patients with Alzheimer's disease and amnestic mild cognitive impairment

Background Episodic memory impairment is the core clinical feature of patients with typical Alzheimer's disease (AD) at an early stage. Since sleep plays a very important role in memory consolidation, the relationship between memory impairment and sleep disorders in AD patients is worthy of investigation. Objective To investigate sleep disturbances and their correlations with memory impairment in patients with AD and amnestic mild cognitive impairment (aMCI). Methods Forty-three patients with AD, 43 patients with aMCI, and 43 cognitively unimpaired controls (CUCs) were recruited and subjected to memory assessment via the Hopkins Verbal Learning Test–Revised and objective sleep evaluation via polysomnography (PSG). Results The total sleep time and the percentages of nonrapid eye movement (NREM) sleep stage 3 (N3) and the rapid eye movement (REM) were lower, while the percentages of NREM sleep stage 2 (N2) were greater in the AD and aMCI groups than in the CUC group (all p &lt; 0.01). Compared with the CUC group, the AD group also presented a longer sleep latency and higher NREM sleep stage 1 (N1) percentage, apnea-hypopnea index (AHI), periodic limb movements during sleep index (PLMSI), and arousal index (AI). Both total learning scores and delayed recall scores were positively correlated with the N3 sleep percentage and negatively correlated with the AHI and PLMSI (all p &lt; 0.01). Recognition scores were positively correlated with the N3 sleep percentage and negatively correlated with the AI (all p &lt; 0.01). Conclusions Our results suggest that sleep disturbance is correlated with learning and memory disability in AD and aMCI patients. PSG is useful for screening and monitoring AD.

Relationship among Story-retelling Ability, Naming and Memory in Healthy Elderly Adults

Objectives: Cognitive decline due to aging is known to decrease discourse production in healthy elderly adults. The purpose of this study was to analyze the correlation among story retelling, naming, and memory abilities in healthy elderly adults, and to investigate the influence of these abilities on story retelling ability. Methods: Fifty-four healthy elderly people participated in the study and performed tests of story retelling, confrontational naming, verbal fluency, subjective memory, and verbal memory. Results: First, the percentage of correct responses in the confrontational naming task and the number of correct responses in the supermarket items and letter categories of the verbal fluency task were significantly correlated with the information unit (IU) analysis scale of story retelling. Second, the score of subjective memory, as well as the immediate and delayed recall scores of the verbal memory tasks were significantly correlated with all scales of the IU analysis. Finally, the regression analysis confirmed that the number of correct responses of the supermarket items, subjective memory, and delayed recall scores had a significant effect on story retelling ability. Conclusion: The present study utilized IU analysis to identify the association between story retelling, naming and memory abilities, and these results are significant in that they provide an important basis for clinical assessment and intervention strategy development.

Cognitive improvement following endovascular embolization in patients with intracranial dural arteriovenous fistula: The Neuropsychology in dural ArterIal Fistula (NAIF) Study

BackgroundCognitive improvement after endovascular embolization of an intracranial dural arteriovenous fistula (dAVF) remains unexplored. We aim to investigate cognitive changes following endovascular embolization of dAVFs.MethodsNeuropsychology in dural ArterIal Fistula (NAIF)...

Effects of idebenone on cognitive function and serum biomarkers in patients with amnestic mild cognitive impairment

ObjectivesThis retrospective study aimed to investigate the effects of idebenone on cognitive function and serum levels of superoxide dismutase (SOD) and high-sensitivity C-reactive protein (hs-CRP) in individuals with amnestic mild cognitive impairment (aMCI).MethodsRetrospective data were collected from the Neurology outpatient department of Liaocheng People’s Hospital from January 2021 to June 2023. Patients with a newly diagnosed aMCI who received treatment were included in the idebenone treatment group. The treatment group took 30 mg of oral idebenone three times a day for 6 months. A control group of 51 MCI patients who did not receive cholinesterase inhibitors or other cognitive-enhancing drugs during the period was selected. Cognitive function assessments and serum Biomarkers were conducted before and after treatment in both groups.ResultsMoCA scores were significantly improved after 6 months of idebenone treatment, and the difference was statistically significant. The delayed recall score was significantly improved, and the difference was statistically significant; The level of SOD increased and the level of high-sensitivity C-reactive protein decreased after the treatment, but there was no significant change in the control group.ConclusionsThe results of this study demonstrate that idebenone treatment significantly improves cognitive function in individuals with aMCI, particularly in the domain of delayed memory. In addition, idebenone reduces the degree of inflammation and oxidative stress and improves antioxidant levels. These findings suggest that idebenone may be a promising intervention for the management of cognitive impairments associated with aMCI.Graphical

Which Sex- and Gender-Based Explanatory Variables are Associated with Memory Function Post-Stroke? A Cross Sectional Analysis of the National Health and Aging Trends Study.

To identify sex- and gender-based variables associated with immediate and delayed recall in individuals with stroke. This was a secondary analysis of data from the National Health and Aging Trends Study (NHATS) using general linear models with a standard stepwise approach. Community INTERVENTIONS: Not Applicable PARTICIPANTS: Participants were eligible for the current analysis if they had a self-reported history of stroke at NHATS Round 1 (2011), and data available on our variables of interest. The final analyses included 366 participants for the immediate recall model and 365 participants for the delayed recall model. Independent variables of interested included sex- (eight variables, for example biological sex, depression and anxiety, and comorbidities) and gender-related factors (fourteen variables, for example education, income, independence with banking). The dependent variables of interest were the 10-word immediate and delayed recall tests, respectively. Higher immediate recall scores were associated with younger age, female biological sex, independence with banking, higher income, giving financial gifts, not requiring assistance with ADLs, and higher education (p<0.001-0.04). Higher delayed recall scores were associated with younger age, higher BMI, higher education, placing importance in socializing, and independence with banking (p<0.001-0.04). We conducted the largest analysis to date of sex- and gender-based factors associated with cognition in individuals with stroke. Stroke rehabilitation scientists and clinicians may consider both biological and sociodemographic factors associated with cognitive function, which may guide holistic post-stroke assessments and interventions.

P035 Good quality sleep is associated with initial encoding and long-term consolidation of memory in older adults

Abstract Introduction Ageing is one of the strongest and consistent factors which affect sleep. Poor quality sleep may be one of the initial presentations of poor cognitive decline in neurodegenerative disorders. In this study, we assess the association of changes in sleep quality with cognitive function in older adults. Methods 54 participants between 50-80 years were recruited from geriatric clinic and community. Pittsburgh Sleep Quality Index Questionnaire (PSQI) and Indian Council of Medical research-Neuro Cognitive Toolbox (ICMR-NCTB) were used for assessing sleep quality and different cognitive domains. Results Mean age of the participants was 63 years (Male=49, Female=05). 25 were good sleepers (PSQI score ≤5) and 29 were poor sleepers (PSQI score &amp;gt;5). PSQI global score was found to have a negative correlation with episodic memory (immediate recall score) (r=-0.38, p=0.004) and delayed recall score (r= -0.31, p=0.024) and significant positive correlation with attention and executive function measured with trail making test-B (TMT-B) (r=0.35, p=0.01). There was a significant difference between good and poor sleepers in immediate recall score (p=0.042) and trail making test-B (TMT-B) (p=0.002) but not for delayed recall score (p=0.115). Conclusion As sleep quality decreases, episodic memory performance also declines. The impact of poor sleep might be more pronounced on the ability to recall information immediately after it is presented than on the ability to recall information after a delay. This suggests addressing sleep quality could mitigate cognitive decline risks in older adults.

A nonlinear relationship between alcohol consumption and cognitive function in elderly people: a population-based study from NHANES 2011-2014.

This study aims to explore the association between alcohol intake and cognitive function in elderly Americans, including potential nonlinear relationships and interactions across different subgroups. The study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. The sample included 2,675 Americans aged 60 or older. Multivariate regression analysis was used to evaluate the relationship between alcohol intake and cognitive function. Smooth curve fitting and threshold effect analysis were employed to explore potential nonlinear relationships. Subgroup analyses were conducted to examine the stability of the results across different subgroups. The results indicate a significant negative correlation between alcohol intake and cognitive function. In the CERAD total word recall test, for every unit increase in alcohol intake, the score decreased by 0.15 points (-0.15, 95% CI: -0.25, -0.04), and in the CERAD delayed recall test, it decreased by 0.07 points (-0.07, 95% CI: -0.12, -0.01). Compared to Non-Heavy Drinkers, Heavy Drinkers showed a reduction in their CERAD total word recall scores by-0.77 points (-0.77, 95% CI: -1.23, -0.32) and in their CERAD delayed recall scores by-0.28 points (-0.28, 95% CI: -0.52, -0.04). Smooth curve fitting analysis revealed a nonlinear relationship between alcohol intake and cognitive function, with breakpoints at 10.7 for the CERAD total word recall test, 4.7 for the Animal fluency test, and 3.85 for the Digit symbol substitution test. Additionally, subgroup analysis indicated that gender, educational level, and smoking status significantly moderated the relationship between alcohol intake and cognitive function, while marital status, race, hypertension, diabetes, and cancer status showed no significant interactions. The association between alcohol intake and cognitive function in the elderly is complex, influenced by both the amount of intake and individual subgroup characteristics.

Effects of whey-derived lactopeptide β-lactolin on cognitive performance in mild cognitive impairment: a randomized, double-blind, placebo-controlled trial

ABSTRACT Objective This study aimed to investigate the effects of a long-term intervention with β-lactolin, a tetrapeptide (sequence: glycine-threonine-tryptophan-tyrosine) derived from milk, on cognitive performance in individuals with mild cognitive impairment (MCI). Methods A randomized, double-blind, placebo-controlled trial was conducted. We recruited 48 participants aged 50 years or older with the Japanese version of the Mini-Mental State Examination (MMSE-J) score of 24–28 and a Clinical Dementia Rating (CDR) score of 0.5. Participants were administered β-lactolin (1.8 mg daily) or placebo for 24 weeks. The primary outcomes were the MMSE-J and the Japanese version of the Montreal Cognitive Assessment (MoCA-J) scores for cognitive function. Results A total of 422 individuals were screened, 48 of whom were included in this study. The MMSE-J and MoCA-J scores showed no significant differences between the groups. In the intra-group comparison of the MoCA-J delayed recall score, a significant difference was observed in the β-lactolin group after 12 and 24 weeks of intervention (p = 0.0256, p = 0.0175, respectively). Furthermore, the subgroup analysis stratified for females only showed a significant difference in MoCA-J total score in the β-lactolin group after 24 weeks of intervention (p = 0.0253). Conclusion β-lactolin intake does not significantly improve cognitive function in MCI in an inter-group comparison; nevertheless, the MoCA-J delayed recall score was significantly improved in the β-lactolin group. The number of participants was lower than planned, limiting the confirmation of the effectiveness of β-lactolin on MCI. This report demonstrated the effect size of β-lactolin intervention in MCI, contributing insights for future research.

Dietary selenium intake, hypertension and cognitive function among US adults, NHANES 2011–2014

Dietary selenium intake and hypertension were associated with cognitive function, but it was limitedly understood whether the effect of selenium intake on cognitive function in older adults was modified by hypertension status. A total of 2416 participants aged ≥ 60 years old from the National Health and Nutrition Examination Survey in 2011–2014 were involved in this study. Selenium intake from foods was estimated using two non-consecutive 24-hour dietary recalls. Blood pressure was measured by trained personnel or physicians at a mobile testing center. Cognitive function was measured by Registry for Alzheimer’s disease (CERAD), the Animal Fluency test (AFT), and Digit Symbol Substitution Test (DSST). Among 2,416 participants, we found that higher dietary intake of selenium was associated with higher score on most tests (CERAD: Total Score: P for trend = 0.01; AFT: P for trend = 0.01; DSST: P for trend = 0.02) and hypertension was associated with lower score on each test (CEARD: Total Score (β = − 0.87, P = 0.03), CERAD: Delayed Recall Score (β = − 0.37, P = 0.04), AFT (β = − 0.88, P = 0.03), and DSST (β = − 2.72, P = 0.02). The interaction of hypertension status and dietary selenium intake on CERAD-immediate (P for interaction = 0.02) and DSST (P for interaction = 0.04) were statistical significance. In addition, hypertension did not mediate the association between dietary selenium intake and the four dimensions of cognition. The findings suggest that in older adults with hypertension, higher dietary selenium intake is associated with improved cognitive function, implying a potential nutritional strategy for preventing cognitive impairment in this population.

Neutrophil percentage-to-albumin ratio is associated with cognitive function in adults aged over 60 years: An analysis of data from the NHANES 2011-2014.

The aging global population is increasing the attention to cognitive decline in older individuals. This study sought to examine the potential link between the neutrophil percentage-to-albumin ratio (NPAR) and cognitive function. We analyzed data from the National Health and Nutrition Examination Survey 2011-2014 using multivariate logistic regression and smooth curve fitting, to investigate the correlation between NPAR and cognitive performance. Restricted cubic spline analysis assessed the linear relationship with high-risk cognitive dysfunction, while piecewise linear regression identified thresholds. Subgroup analyses confirmed the consistency and reliability of our findings. Our study included data from 2759 individuals aged >60 years. NPAR showed a significant correlation with Consortium to Establish a Registry for Alzheimer's Disease (CERAD) word learning score, CERAD delayed recall score, total z-score and a high risk of cognitive dysfunction. Furthermore, there were statistically significant trends in the changes in CERAD word learning, digit symbol substitution test, and CERAD delayed recall scores as the NPAR quartile increased, these trends were inverted U-shaped. When the NPAR exceeded 14.57, there was a positive association with the likelihood of a high risk of cognitive impairment. The link between NPAR and cognitive performance was notably stronger in individuals with moderate body mass index and those aged 73-80 years. A strong link was observed between the NPAR and cognitive function. NPAR may serve as a tool to identify individuals at increased risk of cognitive decline.

Auditory Memory and Visual Memory in Typically Developing Children: Modality Dependence/ Independence.

The study aimed to determine whether there was a difference or an association between auditory memory and visual memory in typically developing children. Eighteen children, aged 8 to 12 years, with normal hearing and visual acuity, were evaluated using the Children's Memory Scale (CMS) to determine their auditory and visual memory performance. Using the core subtest battery of the CMS, auditory/verbal (immediate and delayed), visual/nonverbal (immediate and delayed), and general memory index scores were assessed. No significant difference was found between auditory/verbal memory and visual/nonverbal memory scores for both immediate and delayed recall. Likewise, no correlation between auditory/verbal memory and visual/nonverbal memory scores was found. However, there was a significant correlation between immediate and delayed recall scores within each modality. The non-significant difference between the two modalities for both immediate and delayed recall gives the impression that memory is modality independent. However, the lack of any correlation between the two suggests there was no association between them. The absence of a significant difference between modalities can be attributed to the auditory and visual test material used in CMS not being analogous. It can thus be inferred that the auditory and visual modalities are independent. While the visual material evaluates simultaneous/concurrent perception, the auditory material assesses sequential perception.

A - 11 Organizational Strategies and Delayed Recall in Older Adults: Insights from the Rey-Osterrieth Complex Figure Test

Abstract Objective The objective of this study was to investigate the factors that influence older adults’ ability to recall complex figure in the Rey-Osterrieth Complex Figure (ROCF) test. Method 172 participants (50% female; M = 74.64) between the ages of 60 and 100 were recruited through the Israel Interior Ministry. Participants were asked to complete the Rey-Osterrieth Complex Figure Test (ROCF), which involved two tasks: A) participants were first instructed to replicate the complex figure exactly as shown (copy task). Subsequently, they were asked to B) recall and redraw the figure after a 30-minute delay (delayed recall task). The evaluations were conducted at the participants’ homes. The participants were evaluated on three criteria: accuracy, continuation, and the symmetry. To analyze the relationship between participants’ scores on the accuracy, continuation, and symmetry, a linear regression analysis was performed. Results A linear regression model predicting delayed recall score was significant F(3,48) = 9.61, p &amp;lt; 0.001. Among the predictors, continuation (b = 0.75, p = 0.01) and copy scores (b = 0.39, p 0.02) displayed a significant positive relationship with delayed recall score. Conclusion(s) The ROCF test serves as a comprehensive measure of cognitive functions, such as visuospatial memory, executive and organizational abilities, and retrieval. The significant influence of organizational score underscores the important link between planning abilities and declarative memory. This supports previous findings that organizing ROCF into meaningful clusters of units during the copy task improves performance in delayed recall task.

B - 135 Wisconsin Card Sorting Test 64-Card Computer Version (WCST-64-CV) Failure to Maintain Set (FMS) as an Embedded Performance Validity Indicator in a Mixed Clinical Sample

Abstract Objective The current objective was to determine the sensitivity and specificity of the Wisconsin Card Sorting Test 64-card Computer Version (WCST-64-CV) Failure to Maintain Set (FMS) as an embedded validity indicator. Methods Data were from an archival database of an academic medical center neuropsychology service. Three hundred sixty-eight adult participants completed the WCST-64-CV and Word Memory Test (WMT). Participants were defined as noncredible if all three of their WMT Immediate Recall (IR), Delayed Recall (DR), and Consistency (CNS) scores were 82.5% or below. Participants were defined as credible if all three of IR, DR, and CNS scores were above 82.5%. Forty-seven participants with scores both above and at/below 82.5% were excluded (N = 321). The sample was mean age 45 years (standard deviation [SD] = 17), mean education 13 years (SD = 2), 50% female, and 77% Caucasian. Primary diagnoses were 56.8% epilepsy and 18.1% mild cognitive impairment. No participants had dementia or an acute stroke. Results Twenty-eight participants were noncredible (8.7%) and 293 were credible (91.3%). One hundred sixty-five participants got 0 FMS (51.4%), 95 participants got 1 (29.6%), 41 participants got 2 (12.8%), and 20 participants got 3 or more (6.2%). The lowest cut-off that achieved at least 90% specificity was failure defined as ≥3. The specificity was 93.5% and the sensitivity was 3.5%. A cut-off of ≥2 achieved 80.8% specificity and 17.8% sensitivity. A cut-off of ≥1 achieved 50.8% specificity and 42.8% sensitivity. Conclusions There is no cut-off of WCST-64-CV FMS that achieves adequate specificity and sensitivity as an embedded validity indicator in this mixed clinical sample.

Association of obesity indicators with cognitive function among US adults aged 60 years and older: Results from NHANES.

Midlife obesity is a significant risk factor for Alzheimer's disease, but the effects of obesity on cognitive function, either detrimental or beneficial, are controversial among older individuals. This study aims to assess this associations of body mass index (BMI) or waist circumference (WC) with cognitive function among United States older individuals. A cross-sectional research study was conducted utilizing data from the 2011 to 2014 National Health and Nutrition Examination Survey (NHANES). Initially, the study compared differences in cognitive function among the normal weight, overweight, and obese groups. Subsequently, we examined the relationships between BMI or WC and cognitive function using multivariate linear regression. Finally, structural equation models were constructed to assess the relationships among body shape, lifestyle, and cognitive function pathways. The study included 2254 individuals. Obese subjects had lower scores in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) word list learning tasks (CERAD-WL) (χ2=7.804, p=.020) and digit symbol substitution test (χ2=8.869, p=.012). The regression analysis showed that WC was negatively connected with the CERAD-WL score after adjusting for confounding factors (β=-.029, p=.045). Moreover, WC had a mediating effect on the path from lifestyle to cognition (CERAD-WL). However, there was no difference in the CERAD delayed recall score and the animal fluency test between the obese and the other groups. Obese older adults exhibited impaired cognitive abilities in terms of learning and working memory performance. The impact of lifestyle on cognition was mediated by obesity-related anthropometric indices. Sleep, physical activity, and diet influenced the degree of obesity, which subsequently determined cognitive function. Prioritizing weight management in elderly people is crucial for safeguarding cognitive function.

An interplay between cross-cultural and psychometric factors in the Montreal Cognitive Assessment: Experience from the language of a small nation

The present study aimed to test the hypothesis that the total word length on the Memory subtest of the Czech version of the MoCA, which is 12 syllables compared to the English version of 7 syllables, would have a significant effect on Delayed Recall scores compared to the newly created well-balanced version of the test (further MoCA-WLE). In the original Czech version of MoCA, we replaced the 12-syllable word list in the Memory subtest with a 7-syllable list (MoCA-WLE) to make it equivalent to the standard English version in this respect. We analyzed data from 83 participants in the original MoCA group (70.63 ± 7.01 years old, 14.61 ± 3.17 years of education, 30.12% males) and 83 participants in the MoCA-WLE group (70.72 ± 6.95 years old, 14.93 ± 3.48 years of education, 30.12% males). We did not find evidence for a significant word-length effect in the original MoCA versus MoCA-WLE Delayed Recall in either the Mann–Whitney U test (W = 3418.0, p = .932) or multilevel binomial regression (b = 0.10, 95% posterior probability interval [−0.46, 0.68]). The present study shows cross-cultural limits in the adaptation of the test material. The results underline the caveats of such an approach to test adaptation. Fortunately, 12-syllables in the MoCA Memory Czech version versus the original 7-syllable list did not show a detectable word-length effect. We did not find evidence for differential item functioning or cultural item bias. The original MoCA Czech version is psychometrically comparable to the original English version.

Association between Life's Essential 8 and cognitive function among older adults in the United States

The American Heart Association (AHA) recently redefined cardiovascular health (CVH) with the introduction of Life's Essential 8 (LE8), which encompasses eight areas (diet, physical activity, nicotine exposure, sleep duration body mass index, non-HDL cholesterol, blood glucose, and blood pressure). This study aimed to explore the relationships between both the aggregate and individual CVH metrics, as defined by Life's Essential 8, and cognitive function in older adults in the United States. This cross-sectional, population-based study analyzed data from the National Health and Nutrition Examination Survey conducted between 2011 and 2014, focusing on individuals aged 60 years and older. CVH was categorized as low (0–49), moderate (50–79), or high (80–100). Cognitive function was assessed through the CERAD tests, Animal Fluency test, and Digit Symbol Substitution test. Multivariable logistic models and restricted cubic spline models were employed to investigate these associations. This study included a total of 2279 older adults in the United States. Only 11% of adults achieved a high total CVH score, while 12% had a low score. After further adjustment for potential confounding factors, higher LE8 scores were significantly associated with higher scores on CERAD: delayed recall score (0.02[0.01, 0.03]; P < 0.001), CERAD: total score (3 recall trials) (0.04[0.02, 0.06]; P < 0.001), animal fluency: total score (0.09[0.05, 0.12]; P < 0.001), and digit symbol: score (0.29[0.18, 0.41]; P < 0.001), demonstrating a linear dose–response relationship. Similar patterns were also observed in the associations between health behavior and health factor scores with cognitive function tests. LE8 scores exhibited positive linear associations with cognitive function. Maintaining better levels of CVH may be associated with higher levels of cognitive function in older Americans, but further research is needed to confirm the causal and temporal relationships between LE8 and cognitive function.

Evaluating Life Simple Seven's influence on brain health outcomes: The intersection of lifestyle and dementia.

Lifestyle factors have been studied for dementia risk, but few have comprehensively assessed both Alzheimer's disease (AD) and cerebrovascular disease (CBVD) pathologies. Our research aims to determine the relationships between lifestyle and various dementia pathologies, challenging conventional research paradigms. Analyzing 1231 Wisconsin Registry for Alzheimer's Prevention (WRAP) study participants, we focused on Life Simple Seven (LS7) score calculations from questionnaire data and clinical vitals. We assessed brain health indicators including CBVD, AD, and cognition. Higher LS7 scores were associated with better CBVD outcomes, including lower percent white matter hyperintensities and higher cerebral blood flow, and higher Preclinical Alzheimer's Composite 3 and Delayed Recall scores. No significant associations were observed between LS7 scores and AD markers of amyloid and tau accumulation. This study provides evidence that the beneficial effects of LS7 on cognition are primarily mediated through cerebrovascular pathways rather than direct influences on AD pathology.

γ-Secretase activity, clinical features, and biomarkers of autosomal dominant Alzheimer's disease: cross-sectional and longitudinal analysis of the Dominantly Inherited Alzheimer Network observational study (DIAN-OBS)

Genetic variants that cause autosomal dominant Alzheimer's disease are highly penetrant but vary substantially regarding age at symptom onset (AAO), rates of cognitive decline, and biomarker changes. Most pathogenic variants that cause autosomal dominant Alzheimer's disease are in presenilin 1 (PSEN1), which encodes the catalytic core of γ-secretase, an enzyme complex that is crucial in production of amyloid β. We aimed to investigate whether the heterogeneity in AAO and biomarker trajectories in carriers of PSEN1 pathogenic variants could be predicted on the basis of the effects of individual PSEN1 variants on γ-secretase activity and amyloid β production. For this cross-sectional and longitudinal analysis, we used data from participants enrolled in the Dominantly Inherited Alzheimer Network observational study (DIAN-OBS) via the DIAN-OBS data freeze version 15 (data collected between Feb 29, 2008, and June 30, 2020). The data freeze included data from 20 study sites in research institutions, universities, hospitals, and clinics across Europe, North and South America, Asia, and Oceania. We included individuals with PSEN1 pathogenic variants for whom relevant genetic, clinical, imaging, and CSF data were available. PSEN1 pathogenic variants were characterised via genetically modified PSEN1 and PSEN2 double-knockout human embryonic kidney 293T cells and immunoassays for Aβ37, Aβ38, Aβ40, Aβ42, and Aβ43. A summary measure of γ-secretase activity (γ-secretase composite [GSC]) was calculated for each variant and compared with clinical history-derived AAO using correlation analyses. We used linear mixed-effect models to assess associations between GSC scores and multimodal-biomarker and clinical data from DIAN-OBS. We used separate models to assess associations with Clinical Dementia Rating Sum of Boxes (CDR-SB), Mini-Mental State Examination (MMSE), and Wechsler Memory Scale-Revised (WMS-R) Logical Memory Delayed Recall, [11C]Pittsburgh compound B (PiB)-PET and brain glucose metabolism using [18F] fluorodeoxyglucose (FDG)-PET, CSF Aβ42-to-Aβ40 ratio (Aβ42/40), CSF log10 (phosphorylated tau 181), CSF log10 (phosphorylated tau 217), and MRI-based hippocampal volume. Data were included from 190 people carrying PSEN1 pathogenic variants, among whom median age was 39·0 years (IQR 32·0 to 48·0) and AAO was 44·5 years (40·6 to 51·4). 109 (57%) of 190 carriers were female and 81 (43%) were male. Lower GSC values (ie, lower γ-secretase activity than wild-type PSEN1) were associated with earlier AAO (r=0·58; p<0·0001). GSC was associated with MMSE (β=0·08, SE 0·03; p=0·0043), CDR-SB (-0·05, 0·02; p=0·0027), and WMS-R Logical Memory Delayed Recall scores (0·09, 0·02; p=0·0006). Lower GSC values were associated with faster increase in PiB-PET signal (p=0·0054), more rapid decreases in hippocampal volume (4·19, 0·77; p<0·0001), MMSE (0·02, 0·01; p=0·0020), and WMS-R Logical Memory Delayed Recall (0·004, 0·001; p=0·0003). Our findings suggest that clinical heterogeneity in people with autosomal dominant Alzheimer's disease can be at least partly explained by different effects of PSEN1 variants on γ-secretase activity and amyloid β production. They support targeting γ-secretase as a therapeutic approach and suggest that cell-based models could be used to improve prediction of symptom onset. US National Institute on Aging, Alzheimer's Association, German Center for Neurodegenerative Diseases, Raul Carrea Institute for Neurological Research, Japan Agency for Medical Research and Development, Korea Health Industry Development Institute, South Korean Ministry of Health and Welfare, South Korean Ministry of Science and ICT, and Spanish Institute of Health Carlos III.

The Effects of Carotid Revascularization on 1-Year Cognitive Performance in Patients With Carotid Artery Stenosis.

The impact of carotid revascularization on cognitive function for patients with severe carotid artery stenosis remains uncertain. This study is aimed to investigate the 1-year neurocognitive outcomes of patients who accept carotid revascularization and identify the risk factors associated with postoperative cognitive decline. From April 2019 to April 2021, patients with ≥70% carotid artery stenosis who were treated with carotid endarterectomy (CEA) or carotid artery stenting (CAS) were recruited for this study. The Montreal Cognitive Assessment (MoCA) instrument was used to evaluate cognitive function preoperatively and at 3, 6, and 12 months postoperatively. Logistic regression analysis was built to identify potential risk factors for postoperative long-term cognitive decline. A total of 89 patients who met the criteria were enrolled and completed 1-year follow-up. At 3, 6, and 12 months after carotid revascularization, the total MoCA score, attention, language fluency, and delayed recall score were significantly improved compared with the baseline scores (p<0.05). At 12 months, there was also a significant improvement in cube copying compared with baseline (p=0.034). Logistic regression analysis showed that the advancing age, left side, and symptomatic carotid artery stenosis were independent risk factors for cognitive deterioration at 12 months after surgery. Overall, carotid revascularization has a beneficial effect on cognition function in patients with severe carotid artery stenosis, while advancing age, left side, and symptomatic carotid artery stenosis were significantly related to a decreased cognitive score after carotid revascularization. This study focused on the changes in cognitive function within 1 year after carotid revascularization in patients with severe carotid stenosis. Of course, carotid revascularization can improve the cognition function in these patients. On the other hand, we found the advancing age, left side and symptomatic carotid artery stenosis were significantly associated with decreased cognitive scores at 1 year after carotid revascularization, which suggests that clinicians may need to be aware of patients with these characteristics.