Changes In Episodic Memory Research Articles

Association of Whole Grain Consumption and Cognitive Decline: An Investigation From a Community-Based Biracial Cohort of Older Adults.

To examine the association of whole grain consumption and longitudinal change in global cognition, perceptual speed, and episodic memory by different race/ethnicity. We included 3,326 participants from the Chicago Health and Aging Project who responded to a Food Frequency Questionnaire (FFQ), with 2 or more cognitive assessments. Global cognition was assessed using a composite score of episodic memory, perceptual speed, and the Mini Mental State Examination (MMSE). Diet was assessed by a 144-item FFQ. Linear mixed-effects models were used to estimate the association of intakes of whole grains and cognitive decline. This study involved 3,326 participants (60.1% African American [AA], 63.7% female) with a mean age of 75 years at baseline and a mean follow-up of 6.1 years. Higher consumption of whole grains was associated with a slower rate of global cognitive decline. Among AA participants, those in the highest quintile of whole grain consumption had a slower rate of decline in global cognition (β = 0.024, 95% CI [0.008-0.039], p = 0.004), perceptual speed (β = 0.023, 95% CI [0.007-0.040], p = 0.005), and episodic memory (β = 0.028, 95% CI [0.005-0.050], p = 0.01) compared with those on the lowest quintile. Regarding the amount consumed, in AA participants, those who consumed >3 servings/d vs those who consumed <1 serving/d had a slower rate of decline in global cognition (β = 0.021, 95% CI [0.005-0.036], p = 0.0093). In White participants, with >3 servings/d, we found a suggestive association of whole grains with global cognitive decline when compared with those who consumed <1 serving/d (β = 0.025, 95% CI [-0.003 to 0.053], p = 0.08). Among AA participants, individuals with higher consumption of whole grains and more frequent consumption of whole grain had slower decline in global cognition, perceptual speed, and episodic memory. We did not see a similar trend in White adults.

25 Update to: The Predictive Utility of Various Subjective Cognitive Complaints Using Item Level Data from the Everyday Cognition (ECog) Scales

Objective:Early identification of individuals at risk for dementia provides an opportunity for risk reduction strategies. Many older adults (30-60%) report specific subjective cognitive complaints, which has also been shown to increase risk for dementia. The purpose of this study is to identify whether there are particular types of complaints that are associated with future: 1) progression from a clinical diagnosis of normal to impairment (either Mild Cognitive impairment or dementia) and 2) longitudinal cognitive decline.Participants and Methods:415 cognitively normal older adults were monitored annually for an average of 5 years. Subjective cognitive complaints were measured using the Everyday Cognition Scales (ECog) across multiple cognitive domains (memory, language, visuospatial abilities, planning, organization and divided attention). Cox proportional hazards models were used to assess associations between self-reported ECog items at baseline and progression to impairment. A total of 114 individuals progressed to impairment over an average of 4.9 years (SD=3.4 years, range=0.8-13.8). A subset of individuals (n=352) underwent repeat cognitive assessments for an average of 5.3 years. Mixed effects models with random intercepts and slopes were used to assess associations between baseline ECog items and change in episodic memory or executive function on the Spanish and English Neuropsychological Assessment Scales. Time in years since baseline, the ECog items, and the interaction were key terms of interest in the models. Separate models for both the progression analyses and mixed effects models were fit for each ECog item that included age at the baseline visit, gender, and years of education as covariates.Results:More complaints on five of the eight memory items, three of the nine language items, one of the seven visuospatial items, two of the five planning items, and one of the six organization items were associated with progression to impairment (HR=1.25 to 1.59, ps=0.003 to 0.03). No items from the divided attention domain were significantly associated with progression to impairment. In individuals reporting no difficulty on ECog items at the baseline visit there was no significant change over time in episodic memory(p&gt;0.4). More complaints on seven of the eight memory items, two of the nine language items, and three of the seven visuospatial items were associated with more decline in episodic memory (ps=0.003 to 0.04). No items from the planning, organization, or divided attention domains were significantly associated with episodic memory decline. Among those reporting no difficulty on ECog items at the baseline visit there was slight decline in executive function (ps=&lt;0.001 to 0.06). More complaints on three of the eight memory items and three of the nine language items were associated with decline in executive function (ps=0.002 to 0.047). No items from the visuospatial, planning, organization, or divided attention domains were significantly associated with decline in executive function.Conclusions:These findings suggest that, among cognitively normal older adults at baseline, specific complaints across several cognitive domains are associated with progression to impairment. Complaints in the domains of memory and language are associated with decline in both episodic memory and executive function.

42 Age-Related Alterations in Representational Forms of Imagination: A Novel Scoring Protocol Applied to Autobiographical Memory

Objective:Human imagination is a complex system that allows us to form images or concepts in the mind that are not present to the senses. Research on imagination has been heavily influenced by the idea that humans store two distinct types of long-term memory: episodic and semantic memory. This theoretical distinction is particularly important in the context of aging, where older adults show reduced episodic memory compared to semantic memory (Levine et al., 2002). However, recent work has shown that these two memories are not as distinct as once thought (Renoult et al., 2019; Irish &amp; Vatansever, 2020), suggesting a need to either refine the relationship between these concepts, or the concepts themselves.Here, we apply a broader framework for imagination to the autobiographical memories of older adults. Introduced by Andrews-Hanna &amp; Grilli (2021), memory and future thoughts can be understood as the outcome of the collaboration between two representational forms of imagination: the mind’s mind and the mind’s eye. The mind’s mind is described as a high-level, abstract form of imagination accompanied by a verbal representational form, and the mind’s eye is described as a contextually-specific, image-based form of imagination. In the present study, we examine whether this broader framework for understanding imaginative thought can a) explain some of the established age-related changes in episodic and semantic memory, and b) extend beyond existing research to offer new ways to conceptualize autobiographical memory in aging.Participants and Methods:In this study, we introduce a novel scoring protocol distinguishing mind’s eye from mind’s mind forms of imagination and apply this protocol to the autobiographical memories of eighty-two cognitively normal older adults. Participants were instructed to retrieve unique autobiographical events, and to focus on describing event-specific details. All data were scored both with our new scoring protocol as well as the Autobiographical Interview scoring protocol from Levine et al. (2002).Results:Our novel scoring protocol demonstrated high inter-rater reliability across two raters for both mind’s mind (0.95) and mind’s eye (0.96) details. First, we show that the proportion of mind’s mind and mind’s eye details on average are significantly different, with an increased proportion of mind’s eye details. Second, we find that both mind’s eye detail production and mind’s mind detail production is significantly reduced with age, whereas only internal details decline across age when scored with the Autobiographical Interview scoring procedure.Conclusions:The new scoring protocol suggests that both mind’s mind and mind’s eye details undergo change with age, a finding that shares similarities and differences with results from the Autobiographical Interview scoring technique. Taken together, our results hint at a more elaborate set of detail types forming autobiographical memories that change with age, with implications for understanding episodic and semantic memory.

What is the association between adverse childhood experiences and late-life cognitive decline? Study of Healthy Aging in African Americans (STAR) cohort study

ObjectivesAdverse childhood experiences (ACEs) are associated with higher risk of chronic disease, but little is known about the association with late life cognitive decline. We examined the longitudinal association between...

The effect of acute exercise on objectively measured sleep and cognition in older adults.

Exercise can improve cognition in aging, however it is unclear how exercise influences cognition, and sleep may partially explain this association. The current study aimed to investigate whether objectively measured sleep mediates the effect of an acute exercise intervention on cognition in older adults. Participants were 30 cognitively unimpaired, physically active older adults (69.2 ± 4.3 years) with poor sleep (determined via self-report). After a triple baseline cognitive assessment to account for any natural fluctuation in cognitive performance, participants completed either a single bout of 20-minutes of high intensity exercise on a cycle ergometer, or a control condition, in a cross-over trial design. Cognition was measured immediately post-intervention and the following day, and sleep (total sleep time, sleep onset latency, sleep efficiency, % of rapid eye movement sleep, light sleep and deep sleep) was characterized using WatchPAT™ at baseline (5 nights) and measured for one night after both exercise and control conditions. Results showed no effect of the exercise intervention on cognition immediately post-intervention, nor an effect of acute exercise on any sleep variable. There was no mediating effect of sleep on associations between exercise and cognition. However, a change from baseline to post-intervention in light sleep and deep sleep did predict change in episodic memory at the ~24 h post-intervention cognitive assessment, regardless of intervention condition. There was no effect of acute high intensity exercise on sleep or cognition in the current study. However, results suggest that associations between sleep and cognition may exist independently of exercise in our sample. Further research is required, and such studies may aid in informing the most effective lifestyle interventions for cognitive health.

HEPPI: a randomized controlled trial of the efficacy of a cognitive-emotional intervention for homebound older adults

Objectives This randomized controlled trial aimed to assess the efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention, among the homebound older population presenting with mild cognitive impairment and depressive or anxiety symptoms. Methods Participants were randomly assigned either to the intervention group or the treatment-as-usual group and completed baseline, post-intervention, and three-month follow-up assessments. Changes in episodic memory and symptoms of depression and anxiety were the primary outcomes. Secondary outcomes included changes in global cognition, attentional control, subjective memory complaints, functional status, and quality of life. Data were analyzed on an intention-to-treat basis employing a linear mixed models approach. ClinicalTrials.gov identifier: NCT05499767. Results Compared with the treatment-as-usual group, the HEPPI group reported significant immediate improvement in cognition, mood, and daily functional performance. Positive effects of HEPPI were maintained over the follow-up phase only in depressive symptomatology, perceived incapacity to perform advanced instrumental activities of daily living, and self-reported emotional ability. A significant impact of the intervention on the subjective memory complaints level was observed only three months after the intervention. Conclusions This study suggests that HEPPI may be a promising home-delivered cognitive-emotional intervention to help homebound older adults improve their mental health.

Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial

BackgroundMaintenance of cognitive abilities is of critical importance to older adults, yet few effective strategies to slow cognitive decline currently exist. Multivitamin supplementation is used to promote general health; it is unclear whether it favorably affects cognition in older age. ObjectivesTo examine the effect of daily multivitamin/multimineral supplementation on memory in older adults. MethodsThe COcoa Supplement and Multivitamin Outcomes Study Web (COSMOS-Web) ancillary study (NCT04582617) included 3562 older adults. Participants were randomly assigned to a daily multivitamin supplement (Centrum Silver) or placebo and evaluated annually with an Internet-based battery of neuropsychological tests for 3 y. The prespecified primary outcome measure was change in episodic memory, operationally defined as immediate recall performance on the ModRey test, after 1 y of intervention. Secondary outcome measures included changes in episodic memory over 3 y of follow-up and changes in performance on neuropsychological tasks of novel object recognition and executive function over 3 y. ResultsCompared with placebo, participants randomly assigned to multivitamin supplementation had significantly better ModRey immediate recall at 1 y, the primary endpoint (t(5889) = 2.25, P = 0.025), as well as across the 3 y of follow-up on average (t(5889) = 2.54, P = 0.011). Multivitamin supplementation had no significant effects on secondary outcomes. Based on cross-sectional analysis of the association between age and performance on the ModRey, we estimated that the effect of the multivitamin intervention improved memory performance above placebo by the equivalent of 3.1 y of age-related memory change. ConclusionsDaily multivitamin supplementation, compared with placebo, improves memory in older adults. Multivitamin supplementation holds promise as a safe and accessible approach to maintaining cognitive health in older age. This trial was registered at clinicaltrials.gov as NCT04582617.

Partial Least Squares Regression Analysis of Alzheimer's Disease Biomarkers, Modifiable Health Variables, and Cognitive Change in Older Adults with Mild Cognitive Impairment.

Prior work has shown that certain modifiable health, Alzheimer's disease (AD) biomarker, and demographic variables are associated with cognitive performance. However, less is known about the relative importance of these different domains of variables in predicting longitudinal change in cognition. Identify novel relationships between modifiable physical and health variables, AD biomarkers, and slope of cognitive change over two years in a cohort of older adults with mild cognitive impairment (MCI). Metrics of cardiometabolic risk, stress, inflammation, neurotrophic/growth factors, and AD pathology were assessed in 123 older adults with MCI at baseline from the Alzheimer's Disease Neuroimaging Initiative (mean age = 73.9; SD = 7.6; mean education = 16.0; SD = 3.0). Partial least squares regression (PLSR)-a multivariate method which creates components that best predict an outcome-was used to identify whether these physiological variables were important in predicting slope of change in episodic memory or executive function over two years. At two-year follow-up, the two PLSR models predicted, respectively, 20.0% and 19.6% of the variance in change in episodic memory and executive function. Baseline levels of AD biomarkers were important in predicting change in both episodic memory and executive function. Baseline education and neurotrophic/growth factors were important in predicting change in episodic memory, whereas cardiometabolic variables such as blood pressure and cholesterol were important in predicting change in executive function. These data-driven analyses highlight the impact of AD biomarkers on cognitive change and further clarify potential domain specific relationships with predictors of cognitive change.

Effects of Controlled Supramaximal High-Intensity Interval Training on Cardiorespiratory Fitness and Global Cognitive Function in Older Adults: The Umeå HIT Study-A Randomized Controlled Trial.

This study examined the effects of regulated and controlled supramaximal high-intensity interval training (HIT) adapted for older adults, compared to moderate-intensity training (MIT), on cardiorespiratory fitness; cognitive, cardiovascular, and muscular function; and quality of life. Sixty-eight nonexercising older adults (66-79 years, 44% males) were randomized to 3 months of twice-weekly HIT (20-minute session including 10 × 6-second intervals) or MIT (40-minute session including 3 × 8-minute intervals) on stationary bicycles in an ordinary gym setting. Individualized target intensity was watt controlled with a standardized pedaling cadence and individual adjustment of the resistance load. Primary outcomes were cardiorespiratory fitness (V̇o2peak) and global cognitive function (unit-weighted composite). V̇o2peak increased significantly (mean 1.38 mL/kg/min, 95% CI [0.77, 1.98]), with no between-group difference (mean difference 0.05 [-1.17, 1.25]). Global cognition did not improve (0.02 [-0.05, 0.09]), nor differed between groups (0.11 [-0.03, 0.24]). Significant between-group differences in change were observed for working memory (0.32 [0.01, 0.64]), and maximal isometric knee extensor muscle strength (0.07 N·m/kg [0.003, 0.137]), both in favor of HIT. Irrespective of the group, there was a negative change in episodic memory (-0.15 [-0.28, -0.02]), a positive change in visuospatial ability (0.26 [0.08, 0.44]), and a decrease in systolic (-2.09 mmHg [-3.54, -0.64]) and diastolic (-1.27 mmHg [-2.31, -0.25]) blood pressure. In nonexercising older adults, 3 months of watt-controlled supramaximal HIT improved cardiorespiratory fitness and cardiovascular function to a similar extent as MIT, despite half the training time. In favor of HIT, there was an improvement in muscular function and a potential domain-specific effect on working memory. NCT03765385.

The use of hippocampal grading as a biomarker for preclinical and prodromal Alzheimer's disease.

Hippocampal changes are associated with increased age and cognitive decline due to mild cognitive impairment (MCI) and Alzheimer's disease (AD). These associations are often observed only in the later stages of decline. This study examined if hippocampal grading, a method measuring local morphological similarity of the hippocampus to cognitively normal controls (NCs) and AD participants, is associated with cognition in NCs, subjective cognitive decline (SCD), early (eMCI), late (lMCI), and AD. A total of 1620 Alzheimer's Disease Neuroimaging Initiative participants were examined (495 NC, 262 eMCI, 545 lMCI, and 318AD) because they had baseline MRIs and Alzheimer's disease Assessment Scale (ADAS-13) and Clinical Dementia Rating-Sum of Boxes (CDR-SB) scores. In a sub-analysis, NCs with episodic memory scores (as measured by Rey Auditory Verbal Learning Test, RAVLT) were divided into those with subjective cognitive decline (SCD+; 103) and those without (SCD-; 390). Linear regressions evaluated the influence of hippocampal grading on cognition in preclinical and prodromal AD. Lower global cognition, as measured by increased ADAS-13, was associated with hippocampal grading: NC (p < .001), eMCI (p < .05), lMCI (p < .05), and AD (p=.01). Lower global cognition as measured increased CDR-SB was associated with hippocampal grading in lMCI (p <.05) and AD (p < .001). Lower RAVLT performance was associated with hippocampal grading in SCD- (p < .05) and SCD+ (p < .05). These findings suggest that hippocampal grading is associated with global cognition in NC, eMCI, lMCI, and AD. Early changes in episodic memory during pre-clinical AD are associated with changes in hippocampal grading. Hippocampal grading may be sensitive to progressive changes early in the disease course.

An empirical measure of resilience explains individual differences in the effect of tau pathology on memory change in aging.

Accurately measuring resilience to preclinical Alzheimer's disease (AD) pathology is essential to understanding an important source of variability in cognitive aging. In a cohort of cognitively normal older adults (n = 123, age 76.75 ± 6.15 yr), we built a multifactorial measure of resilience which moderated the effect of AD pathology on longitudinal cognitive change. Linear residuals-based measures of resilience, along with other proxy measures (education and vocabulary), were entered into a hierarchical partial least-squares path model defining a putative consolidated resilience latent factor (model goodness of fit = 0.77). In a set of validation analyses using linear mixed models predicting longitudinal cognitive change, there was a significant three-way interaction among consolidated resilience, tau and time on episodic memory change (P = 0.001) such that higher resilience blunted the effect of tau pathology on episodic memory decline. Interactions between consolidated resilience and amyloid pathology on non-memory cognition decline suggested that resilience moderates pathology-specific effects on different cognitive domains.

Abstract WMP78: Predictors Of Memory And Carotid Intervention-related Memory Changes

Introduction: Carotid atherosclerosis is the culprit of stroke and dementia. It has been linked to cognitive impairment in cerebrovascular diseases . A bulk of evidence suggests that carotid interventions improve cognitive functions in appropriately selected patients. We aim to investigate the factors that modulate changes in episodic memory following carotid recanalization procedures. Methods: A total of 170 subjects undergoing carotid revascularization procedures were recruited prospectively. Neuropsychometric testing was performed preoperatively, and at 1-,6-, and 12-month postoperatively. Rey Auditory Verbal Learning Test (RAVLT) was used to assess episodic memory. Changes in RAVLT sum scores at individual time points were compared to the baseline. Linear and logistic regression models were fitted to predict RAVLT sum baseline score, and postop changes at each time point compared to preop, respectively. Univariate and multivariate analyses (after adjusting for risk factors and patient demographics) were performed and variables with p &lt;0.25 were included in the multivariable analysis. Results: At baseline, having a prior stroke, and being older than 80 years of age were independent predictors of a low preop RAVLT sum score (p=0.001 and p=0.001 respectively). Interestingly, a low preop RAVLT sum score is the only independent predictor of post-intervention cognitive improvement at all three time points compared to preop (P&lt;0.01). CEA and Age &lt;80 years predicted short-term improvement at 1 and 6 months postop. Conversely, carotid artery stenting (CAS) is an independent predictor of verbal memory decline at 1-month post-intervention (p=0.039), while being older than 80 years of age predicted the decline at 1-month (p= 0.046) and 6-month (p= 0.043) postoperatively. Conclusion: Younger patients with severe atherosclerotic carotid disease and low baseline episodic memory scores benefit most from carotid intervention, specifically CEA, whereas age ≥80 years predicts poor baseline memory score and worse intervention-related memory change. Further studies with larger sample sizes are necessary to confirm the characteristics of patients with carotid occlusive disease who could benefit from revascularization procedures.

No moderating influence of education on the association between changes in hippocampus volume and memory performance in aging

Contemporary accounts of factors that may modify the risk for age-related neurocognitive disorders highlight education and its contribution to a cognitive reserve. By this view, individuals with higher educational attainment should show weaker associations between changes in brain and cognition than individuals with lower educational attainment. We tested this prediction in longitudinal data on hippocampus volume and episodic memory from 708 middle-aged and older individuals using local structural equation modeling. This technique does not require categorization of years of education and does not constrain the shape of relationships, thereby maximizing the chances of revealing an effect of education on the hippocampus-memory association. The results showed that the data were plausible under the assumption that there was no influence of education on the association between change in episodic memory and change in hippocampus volume. Restricting the sample to individuals with elevated genetic risk for dementia (APOE ε4 carriers) did not change these results. We conclude that the influence of education on changes in episodic memory and hippocampus volume is inconsistent with predictions by the cognitive reserve theory.

CHANGE IN EPISODIC MEMORY AND EXECUTIVE FUNCTIONING PREDICTS MORTALITY RISK

Abstract The current study explored whether the Brief Test of Adult Cognition via Telephone (BTACT) assessment could be used to predict longevity in a national sample of adults from the Midlife Development in the United States (MIDUS) study. Specifically, we examined whether 9-year changes in episodic memory (EM) and executive functioning (EF) predicted all-cause mortality risk (2004-2018). The sample included 2,643 participants (MAge=45.87; 92.23% white; 107 deceased) who completed the BTACT twice: between 2004-06 and between 2013-2017. Using change scores, decreases in EM (HR= 1.45 [1.09-1.93], p=.01) and EF (HR=1.585 [1.17-2.14], p&amp;lt;.001) increased the hazard of dying (controlling for age, gender, race, education, and self-rated health). Results suggest the BTACT is sensitive enough to detect health-consequential decreases in EM/EF. Future research should consider the BTACT as a viable assessment tool for older adults who may not have easy access to cognitive screenings.

LONGITUDINAL ASSOCIATIONS BETWEEN PERSONAL GROWTH AND COGNITIVE FUNCTIONING IN ADULTHOOD

Abstract While personal growth has been found to be associated with multiple aspects of health in adulthood, its associations with cognitive functioning have not been fully understood. The present study aimed to assess both directions of such longitudinal associations. Using data from the second wave (T1) and third wave (T2) of the Midlife in the United States (MIDUS) study (N = 4,206; mean age = 56.0 [SD = 12.3]), a longitudinal measurement model containing latent variables of episodic memory and executive function was first constructed. Built on the measurement model, a structural equation model was analyzed to assess cross-lagged relationships between personal growth and the two areas of cognitive functioning, in which T1 personal growth predicted residualized changes in episodic memory and executive function, and T1 episodic memory and executive function predicted change in personal growth, controlling for covariates. The results indicated that T1 personal growth significantly predicted smaller decreases in episodic memory, whereas it did not predict change in executive function. T1 episodic memory, but not T1 executive function, significantly predicted smaller decreases in personal growth. The present findings were unique, particularly implying potential longitudinal reciprocity between personal growth and episodic memory. These findings and implications can inform future research aimed at exploring approaches to promoting personal growth and cognitive functioning among aging adults.

PHYSIOLOGICAL DYSREGULATION AS A PREDICTOR OF COGNITIVE DECLINE

Abstract Preclinical indicators of disease such as inflammation, cortisol and glucose dysregulation, and multisystem dysregulation (allostatic load) are related to individual differences in the level of cognitive functioning across adulthood. This study examined whether individual biological systems and allostatic load are related to differential patterns of change in cognitive functioning over 9 years. Data are from the Midlife in the United States (MIDUS) study second (biomarker and cognitive) and third waves (cognitive). The sample includes 863 men and women who ranged in age from 35 to 85 when the data were first collected. MIDUS biomarkers include a comprehensive range of biological and anthropometric measurements reflecting cardiovascular functioning, glucose metabolism, lipid metabolism, inflammation, HPA axis function, as well as sympathetic and parasympathetic nervous system function. Summary indices of dysregulation in each of these major systems as well as an overall index of multi-system dysregulation, or allostatic load were examined in relation to 9-year changes in episodic memory and executive functioning from the Brief Test of Adult Cognition by Telephone. Regression analyses, controlling for preexisting diseases and medications, showed that higher allostatic load was associated with decreased executive functioning over time for those who started out with higher cognitive performance at baseline, after adjusting for age, gender, race, English language, education, neurological conditions, medication use and smoking. Identifying biomarkers as antecedents of cognitive changes in midlife and old age, can potentially aid in the early detection of cognitive impairments and increase the possibilities for preventive interventions.

Hippocampal grading is sensitive to changes in cognition in early MCI

AbstractBackgroundIncreased age and cognitive decline are both associated with changes in the hippocampus. These associations are often measured using hippocampal volume measurements and changes in episodic memory. Some studies have also observed a relationship between hippocampal volume and global cognition. However, these studies often only find associations in progressed stages of cognitive decline. This study examined (1) if hippocampal grading is associated with global cognition in cognitively normal controls (NC), early MCI (eMCI), late (lMCI), and Alzheimer’s disease (AD), and (2) whether these associations differ across diagnostic cohorts.MethodsParticipants for this study were selected from the Alzheimer’s Disease Neuroimaging Initiative. They were included if they completed baseline MRI scans and the Alzheimer’s disease Assessment Scale (ADAS‐13) and Clinical Dementia Rating – Sum of Boxes (CDR‐SB) cognitive tests. A total of 1620 older adults met the inclusion criteria and were included (495 CN, 262 eMCI, 545 lMCI, and 318 AD). Linear regressions examined the association between hippocampal grading and cognitive scores.ResultsLower global cognition (measured by increased ADAS‐13 scores) was associated with hippocampal grading scores in in NC, eMCI, lMCI and AD cohorts. Lower global cognition (measured by increased CDR‐SB scores) was associated with hippocampal grading scores in lMCI and AD, but not in eMCI or NC groups.ConclusionHippocampal grading was associated with changes in global cognition in healthy controls and in disease cohorts when there is sufficient dynamic range in the cognitive test. No correlation between CDR‐SB and NC was found because the NC group only had CDR‐SB scores of 0 and 1. Hippocampal grading may, thus, be a useful measure that is sensitive to progressive changes early in the disease course. Future research should determine if this method is associated with longitudinal changes in cognition.

Novel remote episodic memory assessment: An Agile development pipeline methodology for task selection

AbstractBackgroundThere is a growing need to remotely monitor episodic memory decline. Recent advances in available device technology offer an opportunity to deploy novel smart phone‐based cognitive assessments. However, candidate task design options are numerous and selecting the most clinically sensitive and usable by the target population is not a trivial task. Inspired by Agile software development, we present a case‐study of a rapid iterative process for developing and selecting candidates.MethodDesign requirements: 1) Potential for early sensitivity to episodic memory changes, defined by satisfactory performance distributions; 2) Optimized for high frequency Smart Phone deployment; 3) Acceptable user feedback.Three tasks were created: Exp 1 “Serial positioning task”, sequences of objects were memorized and recalled using a drag‐drop response (n=55). Exp 2 “Biographical association task”, AI generated faces were paired with information in a social media profile and later recalled either with questions or by clicking on probe faces (n=73). Exp 3 “Self‐generated pairing task”, where participants generated pairs of identities and later had to recall them (n=65). Each task implemented a minimum learning‐recall delay of 12 hours. Exp 4 ‐ Final versions were compared within participants and against validated CANTAB tasks using Exploratory Factor Analysis (n=155).ResultExp 1 “Serial positioning task”, identified a cognitive load of between 3‐4 items giving good performance‐based variability. Engaging stimuli using emoji and map‐backgrounds increased user ratings without negatively impacting variability. Exp 2 “Biographical association task”, demonstrated good distributions for recall, but only in a forced‐choice format. This was rated the least enjoyable. Exp 3 “Self‐generated pairing task”, showed ceiling effects. This task was rated equally enjoyable as Experiment 1. After comparing the Exp 4 results, the “Serial positioning task” was most predictive of age (tau‐b .256, Bf=113.7), as well as unique according to the factor analysis, and rated as most enjoyable.ConclusionOur agile development pipeline titrated the suitability of three candidate episodic memory tasks for future remote deployment in target clinical populations. By implementing this methodology, it was determined that the "Serial positioning task” was the best candidate for further development and testing for monitoring symptoms of memory decline.

Is episodic memory change in aging associated with level of control processes and rate of control change? A 4-year longitudinal study

En utilisant une approche longitudinale, nous avons exploré si le changement de la mémoire au cours de 4 ans est associé au niveau de contrôle de base et/ou au changement du niveau de contrôle sur la même période. Les participants ont été évalués deux fois à 4 ans d’intervalle avec une tâche de rappel indicé (mémoire épisodique) et une tâche de fluence verbale (contrôle). Un indice individuel de changement cognitif a été calculé pour chaque mesure. Les résultats ont montré que la mémoire et le contrôle ont diminué de façon significative au cours du temps et que l’indice de changement de la mémoire était corrélé significativement à l’indice de changement du contrôle mais pas au niveau de contrôle de base. Des analyses de régression indiquaient que 18 % de la variance de l’indice de changement de la mémoire était expliqué par l’indice de changement du contrôle. Ces résultats suggèrent que le niveau de changement de la mémoire au cours du temps varie en fonction du taux de changement du contrôle.

A life course approach to understanding stress exposures and cognitive function among middle-aged and older adults

BackgroundMany studies have evaluated the stress-cognition association, but few have captured the cumulative nature of stress or distinguished the influences of stressors occurring in childhood versus adulthood. Using a lifecourse approach, we investigated whether cumulative stress exposures are associated with poorer cognitive function and faster cognitive decline. MethodsWe used data from the Midlife Development in the United States Study (N = 3,954, mean baseline age: 56 years). We fit marginal structural generalized estimating equations models to estimate the difference in baseline cognitive function per SD increment in the continuous stressor score, and, separately, between persons in each life course stressor profile and those who did not experience high stress in either childhood or adulthood. We also characterized differences in cognitive decline across levels of stress exposures. ResultsHigher cumulative stress exposure was associated with lower executive function (difference per SD in continuous stressor score = −0.12 SD units, 95% CI = −0.16, −0.08) and episodic memory (difference = −0.09 SD units, 95% CI = −0.13, −0.05). Baseline executive function and episodic memory were lower among those with high stress only in childhood, only in adulthood, and both, than among those without high stress in childhood or adulthood. There was little evidence that rate of change in executive function and episodic memory differed across levels of cumulative stress exposures. ConclusionsThese findings offer support to the hypothesis that stress exposures, accumulated over the life course, worsen cognitive performance, but limited support for the hypothesis that these exposures promote cognitive decline.