Episodic Memory Tests Research Articles

Exploring the sensitivity of episodic and spatial memory tests to healthy and pathological cognitive aging

IntroductionIn an increasingly aging society, testing hippocampal-dependent cognition in a quick and low resource manner will be crucial in: assessing the potential benefits of lifestyle choices and interventions affecting cognitive ageing (such as those involving exercise, diet, and sleep); detecting pathological aging, such as in Alzheimer’s disease, where hippocampal degeneration occurs relatively early on.MethodsOver 300 participants aged 18-89 completed three cognitive tests, namely the Addenbrooke’s Cognitive Examination-III (ACE-III), The Four Mountains Task (4MT), and a new task introduced here, the Spaces and Sequences Episodic Video Task (SSEVT). Hippocampal tissue is particularly vulnerable to aging, and the 4MT and SSEVT were designed to be hippocampal-dependent. Accordingly, we tested the hypothesis that 4MT and SSEVT performance would be significantly compromised by aging. As an initial proof-of-concept exploration of these tests’ ability to detect pathological aging, such as in Alzheimer’s disease, we compared 10 patients with Mild Cognitive Impairment (MCI) with matched subsamples of the older group (Healthy ageing, HA).ResultsSupporting the hippocampal-aging related hypothesis, 4MT and SSEVT scores showed appreciably stronger age-related declines than ACE-III scores. The middle-aged group (mean: ∼51 years) were significantly worse than the young group (mean: ∼21 years) on the 4MT (Cohen’s d = 0.724) and the SSEVT (Cohen’s d = 0.443); and the older group (mean: ∼71 years) were significantly worse than the middle-aged group on the SSEVT (Cohen’s d = 0.724). Neither pattern was seen for ACE-III. Suggestively, the MCI patients performed worse than the matched HA group on the 4MT (consistent with previous work), and on our novel SSEVT, but not on the ACE-III.DiscussionWe conclude that the 4MT and SSEVT may be suitable for assessing lifestyle choices and interventions affecting cognitive ageing. We also propose that these findings provide an initial proof-of-concept for these tests’ ability to detect pathological aging in its early stages and support further exploration of this with larger clinical samples.

Association of a modified body shape index with cognitive impairment in middle-aged and elderly Chinese adults: a cross-sectional analysis from CHARLS

PurposeThis study aimed to investigate the association between A Body Shape Index (ABSI) and cognitive impairment in middle-aged and elderly Chinese adults.Patients and methodsWe analyzed baseline data from the 2011 China Health and Retirement Longitudinal Study (CHARLS), including 6,762 participants aged ≥45 years. The modified ABSI of adults in China was calculated using waist circumference (WC), body mass index (BMI), and height. Cognitive function was assessed through episodic memory and cognitive status tests, with impairment defined as a composite score ≤11. Multivariate logistic regression, fitted smoothing curves, and subgroup analysis were employed to evaluate the associations and interactions. Receiver operating characteristic (ROC) curves were used to compare the diagnostic performance of ABSI, BMI, and WC.ResultsAfter full adjustment, each 0.01-unit ABSI increase conferred a 45.7% higher risk of cognitive impairment (odds ratio [OR] = 1.457). Participants in the highest ABSI quartile had a 48.3% higher risk compared to the lowest quartile (p for trend < 0.001). Dose–response analysis revealed a positive relationship (p < 0.001) between ABSI and cognitive impairment. ABSI demonstrated superior diagnostic accuracy (Area Under the Curve [AUC] = 0.603) compared to BMI (AUC = 0.570) and WC (AUC = 0.548).ConclusionElevated ABSI independently predicts cognitive impairment in Chinese middle-aged and older adults. ABSI demonstrates better diagnostic accuracy compared to BMI and WC. These findings highlight ABSI’s utility as a cost-effective anthropometric tool for cognitive risk stratification in aging populations.

Subtle inefficiencies in everyday tasks indicate early functional difficulties in older adults: Implications for clinical practice and research

Objectives: This study investigated the validity and reliability of subtle errors and slowing in simple everyday tasks (Naturalistic Action Test [NAT]) to assess mild functional difficulties in older adults with mild cognitive impairmen (MCI). Method: Older adults (N = 111, MAge= 73.45; SD= 6.53) classified as having healthy cognition (HC) or MCI completed neuropsychological testing and two NAT tasks (breakfast and lunch) twice, separated by 4–6 wk. NATs were scored for subtle, inefficient actions (i.e., micro-errors) and the average time (in sec) to complete a task step. Results: Participants with MCI made significantly more micro-errors [F (1, 109) = 8.78, p = .004, partial η 2 = 0.07] and had a significantly longer average time per step [F (1, 109) = 13.98, p < .001, partial η2 = 0.11] than participants with HC. Micro-errors correlated with tests of episodic memory (r = −0.237, p = .012) and executive functioning (r = −0.201, p = .035), whereas average time per step correlated only with episodic memory (r = −0.300, p = .0001). Test-retest reliability was good for average time per step (ICC = .872, p < .001) and moderate for micro-errors (ICC = .675, p < .001). Conclusions: Measures of inefficient actions and performance time in familiar everyday tasks demonstrated strong to adequate construct and concurrent validity, as well as test-retest- and inter-rater reliability, supporting their use for the quantifying mild functional difficulties. Future studies should explore this scoring approach to develop early markers of functional disability or dementia risk.

Psychometric Properties of MyCog 2.0: A Human‐Centered Cognitive Screening Tool for Older Adults

ABSTRACTObjectivesSelf‐administered, user‐friendly apps that can detect initial symptoms of cognitive impairment have enormous potential to improve early detection of cognitive decline. We examine the psychometric properties of the redesigned version of MyCog, MyCog 2.0, an app‐based tool for older adults that assesses executive function and episodic memory. MyCog 2.0 aims to improve usability while maintaining the psychometric validity demonstrated in the original version.MethodsFeedback from clinicians and patients on MyCog was gathered to inform the human‐centered design improvements of MyCog 2.0. To assess the psychometric properties of the improved tool, data from a community sample (n = 200; mean age = 73 years) who had completed MyCog 2.0 were compared to an age‐matched sample who had completed the original MyCog. Internal consistency and construct validity were evaluated via confirmatory factor analysis. Bayesian differential item functioning was employed to evaluate the evidence for equivalence of MyCog and MyCog 2.0.ResultsInternal consistency was high for executive function and episodic memory tests (ωt = 0.84). A two‐factor model showed excellent fit, demonstrating that tests measured two related yet distinct constructs, episodic memory and executive functioning, as expected. Differential item functioning between the two test versions was not observed for episodic memory performance or executive functioning accuracy; however, response time on five executive function items was found to differ across versions.ConclusionsFindings support MyCog 2.0 as the first reliable self‐administered cognitive screener designed specifically for ease of use among older adults. Findings support the internal consistency and construct validity of MyCog 2.0 and provide a foundation for the forthcoming clinical validation studies.

Data Uncertainty (DU)-Former: An Episodic Memory Electroencephalography Classification Model for Pre- and Post-Training Assessment.

Episodic memory training plays a crucial role in cognitive enhancement, particularly in addressing age-related memory decline and cognitive disorders. Accurately assessing the effectiveness of such training requires reliable methods to capture changes in memory function. Electroencephalography (EEG) offers an objective way of evaluating neural activity before and after training. However, EEG classification in episodic memory assessment remains challenging due to the variability in brain responses, individual differences, and the complex temporal-spatial dynamics of neural signals. Traditional EEG classification methods, such as Support Vector Machines (SVMs) and Convolutional Neural Networks (CNNs), face limitations when applied to episodic memory training assessment, struggling to extract meaningful features and handle the inherent uncertainty in EEG signals. To address these issues, this paper introduces DU-former, which improves feature extraction and enhances the model's robustness against noise. Specifically, data uncertainty (DU) explicitly handles data uncertainty by modeling input features as Gaussian distributions within the reparameterization module. One branch predicts the mean through convolution and normalization, while the other estimates the variance via average pooling and normalization. These values are then used for Gaussian reparameterization, enabling the model to learn more robust feature representations. This approach allows the model to remain stable when dealing with complex or noisy data. To validate the method, an episodic memory training experiment was designed with 17 participants who underwent 28 days of training. Behavioral data showed a significant reduction in task completion time. Object recognition accuracy also improved, as indicated by the higher proportion of correctly identified target items in the episodic memory testing game. Furthermore, EEG data collected before and after the training were used to evaluate the DU-former's performance, demonstrating significant improvements in classification accuracy. This paper contributes by introducing uncertainty learning and proposing a more efficient and robust method for EEG signal classification, demonstrating superior performance in episodic memory assessment.

Brain 18F-FDG-PET abnormalities and their associations with neuropsychological assessment in initially hospitalized patients with post-COVID-19 conditions: a prospective and longitudinal study.

This study aims to longitudinally investigate the associations between brain 18F-FDG-PET metabolism and neuropsychological assessment (NPA) in initially hospitalized patients with post-COVID-19 conditions (PCCs). Patients with PCC and confirmed neurological impairment were prospectively included and underwent both brain 18F-FDG-PET and NPA at inclusion and one year later. Brain18F-FDG-PET metabolism was correlated with NPA tests. The identified hypometabolic clusters after quantitative voxel-by-voxel group analyses were correlated with the NPA results. Twenty-three patients (51.0 ± 9.5 years; 9 women) were included. Brain 18F-FDG-PET metabolism was correlated with the results of the Hamilton Anxiety Rating Scale (HARS), episodic memory, executive function and autonomy tests (p-voxel < 0.005; p-cluster < 0.05 uncorrected). Two cerebellar hypometabolic clusters were found in patients with PCC at inclusion and one year later (n = 16, p-voxel < 0.005; p-cluster < 0.05 corrected). Cerebellar metabolism was associated with an abnormal HARS test at one year (p ≤ 0.04) but not at inclusion. At one year, no brain metabolic recovery and no significant improvement in NPA tests were observed. Brain 18F-FDG-PET metabolism is associated with the results of neuropsychological tests in initially hospitalized patients with PCC, especially the metabolism of the cerebellum, which was found to be decreased in patients, and symptoms of anxiety experienced by patients. Similarly, brain 18F-FDG-PET hypometabolism and impairment in NPA tests did not significantly improve one year later.

Delayed primacy recall in AVLT is associated with medial temporal tau PET burden in cognitively unimpaired adults.

Alzheimer's disease (AD) can be diagnosed by invivo abnormalities of amyloid-β plaques (A) and tau accumulation (T) biomarkers. Previous studies have shown that analyses of serial position performance in episodic memory tests, and especially, delayed primacy, are associated with AD pathology even in individuals who are cognitively unimpaired. The earliest signs of cortical tau pathology are observed in medial temporal lobe (MTL) regions, yet it is unknown if serial position markers are also associated with early tau load in these regions. This study of cognitively unimpaired older individuals examined whether serial position scores in word-list recall cross-sectionally predicted tau PET load in the MTL, and were able to discriminate between biomarker profiles, based on AT classification. Data from 490 participants (mean age=68.8±7.2) were extracted from two cohorts, which were merged into one sample. Linear regression analyses were carried out with regional volume-controlled tau (18F-MK-6240) PET SUVR of the entorhinal cortex (EC), parahippocampal cortex (PHC) and hippocampus (H) as outcomes, cross-sectional memory scores from the Rey Auditory Verbal Learning Test as predictors (total and delayed recall, along with serial position scores) and control variables, in separate analyses for each outcome and predictor. The sample was then stratified by biomarker profile and ANCOVAs were conducted with the strongest scores from the regression analyses, AT groups as fixed factor and the covariates. Higher delayed primacy significantly predicted lower tau PET in EC, PHC, and H, cross-sectionally. Higher total recall scores predicted lower EC tau, but delayed primacy showed the best model fit, as indicated by AICs. ANCOVAs showed that AVLT metrics did not significantly discriminate between A-T- and A+T+, after correcting for multiple comparisons. Serial position analysis of word-list recall, particularly delayed primacy, may be a valuable tool for identifying invivo tau pathology in cognitively unimpaired individuals.

Trajectories of episodic memory in midlife: Historical change from a cross-country perspective.

According to the Flynn effect, performance on cognitive ability tests has improved over the past decades. However, we know very little about whether such historical improvements generalize to middle-aged adults (aged 45-65) and differ across nations. We used harmonized data on episodic memory from nationally representative longitudinal panel surveys across a total of 16 countries (United States, Mexico, China, England, and countries in Continental, Mediterranean, and Nordic Europe). We compared historical change in age-related trajectories of episodic memory among middle-aged adults. Our sample included 117,231 participants who provided 330,390 observations. Longitudinal multilevel regression models revealed that today's middle-aged adults in the United States perform worse on episodic memory tests than their peers in the past. By contrast, today's middle-aged adults in most other countries perform better on these tests than their peers in the past. However, later-born cohorts of U.S. and Chinese middle-aged adults experienced less steep within-person decrements-or even increments-in episodic memory than earlier born cohorts. Historical change trends persisted when controlling for sociodemographic factors, as well as for indicators of physical and mental health. Differences in episodic memory by gender and education became smaller over historical time across all nations. Our findings suggest that countries differ considerably in episodic memory performance, by more than half a standard deviation, and in the direction and size of how midlife episodic memory trajectories have changed over historical time. Further factors related to historical changes in midlife episodic memory need to be identified by future research. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Only child or multiple children? The number of children and cognition in older Chinese parents.

This study aimed to investigate the relationship between the number of children and cognitive function trajectories among older Chinese parents. A total of 6723 individuals (55% men) aged 50 years and older were followed for 7 years as part of the China Health and Retirement Longitudinal Study (CHARLS). Cognitive function was assessed through episodic memory and mental status tests. The number of children was dichotomised as 'only child' and 'multiple children'. Linear mixed models were used, with the number of children at baseline as the predictor. Covariates including social-demographic factors, health behaviours and health status were adjusted. Parents with multiple children had poorer baseline cognitive functions (episodic memory: B = -.17, p < .001; mental status: B = -.25, p < .001) and experienced a faster cognitive decline during the follow-up period (episodic memory: B = -.05, p < .001; mental status: B = -.03, p = .005) compared to those with only one child. Gender-stratified analyses indicated that women were more susceptible to cognitive decline than men as the number of children increased. This study found a negative correlation between the number of children and cognitive performance among older Chinese parents, with the association being stronger in women. These findings enhance the understanding of the impact of offspring on parental well-being in non-Western societies.

Cognitive and behavioral follow-up of patients with amyotrophic lateral sclerosis type 8.

Amyotrophic Lateral Sclerosis type 8 (ALS8) is a familial motor neuron disease caused by the VAPB p.P56S mutation. There is a lack of longitudinal studies to elucidate the cognitive and behavioral progression of this disease. We aimed to investigate the progression of cognitive performance and behavioral symptoms of ALS8 patients over time. The cohort was composed of 23 ALS8 patients (12 men). They underwent neuropsychological assessments in two periods of time, ranging from 24 to 48 months (mean follow-up: 33 ± 10). There was mild motor and functional decline during the follow-up. There were no significant differences between the first and the second evaluation on tests of verbal fluency, executive functions, episodic memory, and facial emotion recognition. There was a decline in the Language subdomain from the Addenbrooke's Cognitive Examination-revised. Behavioural measures indicated decreasing stereotypic behaviours. Anxiety and depression symptoms remained stable. No patient developed dementia. Cognitive decline parallels motor degeneration in ALS8, with a slow pattern of progression.

Loss of white matter tracts and persistent microglial activation in the chronic phase of ischemic stroke in female rats and the effect of miR-20a-3p treatment.

Our previous studies showed that intravenous injections of the small non-coding RNA mir-20a-3p is neuroprotective for stroke in the acute phase and attenuates long-term cognitive impairment in middle-aged female rats. In this study, we evaluated postmortem brain pathology at 100+d after stroke in a set of behaviorally characterized animals. This included Sham (no stroke) controls or stroke animals that received either mir20a-3p at 4h, 24h and 70d iv post stroke (MCAo+mir20a-3p) or a scrambled oligo (MCAo+Scr). Brain volumetric features were analyzed with T2 weighted and Diffusion Tensor magnetic resonance imaging (MRI) followed by histological analysis. Principal component analysis of Fractional Anisotropy (FA)-diffusion tensor MRI measures showed that MCAo+Scr and MCAo+mir20a-3p groups differed significantly in the volume of white matter but not gray matter. Weil myelin-stained sections confirmed decreased volume of the corpus callosum, internal capsule and the anterior commissure in the ischemic hemisphere of MCAo+Scr animals compared to the non-ischemic hemisphere, while sham and MCAo+Mir-20a-3p showed no hemispheric asymmetries. The MCAo+Scr group also exhibited asymmetry in hemisphere and lateral ventricle volumes, with ventricular enlargement in the ischemic hemisphere as compared to the non-ischemic hemisphere. The numbers of microglia were significantly elevated in white matter tracts in the MCAo+Scr group, with a trend towards increased myelin phagocytic microglia in these tracts. Regression analysis indicated that performance on an episodic memory test (novel object recognition test; NORT) was associated with decreased white matter volume and increased microglial numbers. These data support the hypothesis that stroke-induced cognitive impairment is accompanied by white matter attrition and persistent microglial activation and is consistent with reports that cognitive deterioration resulting from vascular diseases, such as stroke, is associated with secondary neurodegeneration in regions distal from the initial infarction.

Normative data for the CERAD verbal episodic memory tests in a sample of older illiterate Korean women.

Verbal episodic memory tests in the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychological battery require literacy. While modified administrations are provided for illiterate individuals, there are no norms for evaluating the performance of illiterate subjects. Assessing the performance of illiterate individuals has limitations, since existing norms were developed on data from literate populations. The purpose of this study is to provide normative data for illiterate Korean older women. The participants analyzed in this study were all illiterate. Among a sample of 109 non-demented older adults recruited from community centers for dementia, only 9 were men. Thus, the current analysis developed norms for women. Descriptive statistics were used to summarize participants' characteristics and test scores. Linear regressions were conducted to examine the effect of age on verbal episodic memory tests. Age was found to be significantly associated with performance on all word list tests. Age was divided into two groups based on the average value for sufficient sample size and showed a significant difference in test performance: 60-75, ≥76 years. Evaluating illiterate women using existing standards has the limitation of underestimating their performance relative to their actual skills. The present normative data are expected to enable researchers and clinicians to more accurately evaluate the results of the three verbal episodic memory tests, including the Word List Memory, Word List Recall, and Word List Recognition in older illiterate Korean women.

Identifying cognitive test scores associated with early tau burden in Alzheimer's disease.

This study aimed to identify cognitive tests that optimally relate to tau positron emission tomography (PET) signal in the inferior temporal cortex (ITC), a neocortical region associated with early tau accumulation in Alzheimer's disease (AD). We analyzed cross-sectional data from the harvard aging brain study (HABS) (n=128) and the Anti-Amyloid Treatment in Asymptomatic Alzheimer's(A4) study (n=393). We used elastic net regression to identify the most robust cognitive correlates of tau PET signal in the ITC. Secondary analyses examined whether the cognitive correlates remained significantly associated with tau after adjusting for structural brain measures. Episodic memory measures, including both total and "process" scores, were the most robust correlates of ITC tau across both cohorts. These cognitive test scores remained significant after accounting for structural brain measures. These findings highlight the potential of specific episodic memory test scores to detect and monitor neuropathological changes associated with early AD. Machine learning identified cognitive correlates of early Alzheimer's disease tau burden.Both traditional and process scores predicted early tau burden.Episodic memory scores were among the strongest correlates.Cognitive scores remained significant after accounting for structural brain measures.

Instrumentos para Mensuração da Memória Episódica e suas Propriedades Psicométricas: Revisão Sistemática

Abstract There are changes in episodic memory during healthy or pathological cognitive aging. This study aimed to verify which instruments were most used to assess this cognitive domain in older adults in the last ten years, evaluating their psychometric parameters. A systematic review was conducted according to the PRISMA recommendations, and 3,203 articles were identified in Pubmed, PsycINFO, Scopus, and Web of Science databases. Forty-eight of these met the eligibility criteria for analysis. The most frequently used instruments were RAVLT, FCSRT, and EBMT. The results suggested good psychometric properties for the episodic memory tests, although there is still room for adaptation, construction, and validation of new tests appropriated for the Brazilian context.

TRAJECTORIES OF EPISODIC MEMORY IN MIDLIFE: HISTORICAL CHANGE FROM A CROSS-COUNTRY PERSPECTIVE

Abstract According to the Flynn effect, cognitive abilities have improved across the past decades. However, we know little about whether such historical improvements generalize to middle-aged adults and differ across nations. In this study, we used harmonized data on episodic memory from nationally representative longitudinal panel surveys including the U.S., Europe, Mexico, and China to compare historical change in age-related trajectories of episodic memory among middle-aged adults. Our sample included 89,775 participants aged 45 to 65 years who provided 272,876 observations over up to 20 years. Longitudinal multilevel regression models revealed that today’s middle-aged adults in the U.S. perform worse on episodic memory tests than their age peers in the past. In contrast, today’s middle-aged adults in most other countries perform better than did their peers in the past. At the same time, later-born cohorts of U.S. middle-aged adults exhibited a more favorable episodic memory trajectory than earlier-born cohorts, whereas this trend was not observed in most other countries. Cohort trends remained significant when controlling for socio-demographic indicators (gender, education) and health measures (grip strength, number of chronic diseases). Women and individuals with higher levels of education, higher grip strength and fewer chronic diseases exhibited better episodic memory performance, and the association of grip strength with episodic memory was stronger in later-born cohorts. Our findings suggest that countries differ in the extent and direction of historical change in episodic memory scores and trajectories. More research is needed to better understand why the Flynn effect in the U.S. seems to be reversed.

Dopaminergic Treatment and Episodic Memory in Parkinson's Disease: A Meta-analysis of the Literature.

To date, few studies have focused on the benefits of dopaminergic treatment on episodic memory functions in patients affected by Parkinson's disease (PD). We conducted a meta-analysis to determine the effects of pharmacological therapy with dopamine in alleviating episodic memory deficits in Parkinson's patients. A secondary aim was to evaluate the role of dopamine in episodic memory circuits and thus in different memory systems. We conducted a comprehensive literature search in PubMed (1971-2022) to find studies that met specific inclusion criteria. The studies had to provide sufficient data (means and standard deviations) to evaluate performance on neuropsychological tests of episodic memory. A total of k = 36 measures were included in the analysis. A statistically significant difference suggested better performance following dopaminergic therapy assumption (ON condition) than following dopaminergic withdrawal (OFF condition), specifically the estimated pooled effect calculated through a random-effects restricted maximum likelihood model was log ratio of means (RoM) = 0.047 (p = 0.011). The back-transformed RoM, indicating a 4.8% improvement, provides an interpretable measure of the effect size, as it reflects the multiplicative change in performance associated with the ON condition. A meta-regression analysis was also performed to assess the influence of specific memory tasks and relevant covariates/factors on the overall meta-analytic effect: four memory contrasts (verbal/visual, immediate/delayed, recall/recognition, word-list/short-story), age of participants, years of education, severity of illness, duration of illness in years, country of study, proportion of women in the sample, type of medication, counterbalancing. Word list/short story and proportion of women in the sample were the only two statistically significant predictors in the model, both associated with a positive higher pooled effect size. The present study revealed a significant overall difference between the results obtained in the ON and OFF conditions. We also found a significantly greater pharmacological effect in the recall of short stories than word lists, which supports the hypothesis of a beneficial effect of dopamine on the hippocampal circuit rather than on prefrontal cortical areas.

The virtual habits underlying the behavioural hallmarks of alloanimal episodic memory: a Peircean model

Abstract Experimental studies of animal episodic memory test the behavioural expression of a what-where-when ‘memory content’. This is to say, autobiographical memory in some species (mainly birds, rodents, and great apes) has been understood on the basis of how the subject’s actions demonstrate their long-term awareness of already enacted and yet-to-be enacted scenarios. However, such behavioural focus has come at the expense of discussing the interdependent role of two equally important episodic hallmarks: ‘memory structure’ (mental representations), and ‘memory flexibility’ (adaptive choice-making). This paper provides a semiotic characterization of those less discussed hallmarks, in terms of the Peircean concept of virtual habit or the mental enactment of non-present episodes. It is argued that the behavioural expression of a ‘memory content’ (as object in a process of semiosis) cannot be accounted for without understanding the phenomenological or experiential support of memory structure (as a representamen), and the teleological or purposeful self-control of memory flexibility (as interpretant). Based on this, a new cognitive model of animal episodic memory is proposed, consisting of interrelated modalities called Virtualiter, Habitualiter, and Actualiter. Capitalizing on multispecies evidence, possible applications and new directions of the model are suggested.

Understanding the Impact of Mild Episodic Memory Difficulties on Everyday Tasks in Older Adults

Abstract BackgroundThe Goal‐Control Model posits that episodic memory impairment leads to premature decay of everyday task goals, which contributes to task omissions (failure to accomplish task steps) in those with moderate to severe impairment. Although task omissions are not observed in those with mild episodic memory (mildEM) impairment, it has yet to be investigated if goal decay is reflected by subtle errors during task completion. We hypothesized that goal decay in mildEM impairment is reflected by imprecision in task performance at the end of everyday tasks.Method54 participants (M age = 73; 39 healthy control [HC], 15 MCI/mild dementia) were videorecorded while preparing a breakfast and a lunch according to specific instructions (Naturalistic Action Task). Performance errors were classified by two coders and another organized them into segments occurring in the beginning, middle or end of the task, all blind to participant diagnosis and study hypothesis. Analyses compared errors in each segment between those with mildEM impairment (MCI/mild dementia) and HC. Correlation analyses examined relations between errors and demographically adjusted standard scores on tests of episodic memory (HVLT and BVMT‐R delayed free recall) and executive function (Digits Backward, Trail Making Test B).ResultParticipants with mildEM impairment made significantly more errors than healthy controls only during the end task segment, t(52) = 2.83, p = .04. The groups did not differ in total errors during the beginning (p = .35) or middle task segments (p = .08). Correlations including the full sample showed significant relations between total errors during the end segment and scores on tests of episodic memory (HVLT r = ‐.33, p = .01; BVMT r = ‐.37, p &lt;.01) but not scores on tests of executive function (Digits Backward r = .01, p = .92; TMT‐B r = .01, p = .97).ConclusionConsistent with hypotheses informed by the Goal‐Control Model, older adults with mildEM impairment exhibited increased imprecision towards the end of the task, suggesting that even those with mildEM deficits can experience premature decay of task goals. Behavioral strategies to strengthen goal activations, including reminder cues and/or overt verbalization of task goals, should be investigated as an avenue to improve everyday function in older adults with mild memory difficulties.

Effects of APOE genotype on cortical atrophy in early onset Alzheimer’s disease

Abstract BackgroundAPOE‐ɛ4 is a major risk factor for Alzheimer’s disease (AD); its effects have been examined in late‐onset AD (LOAD) but less so in early‐onset AD (EOAD). In LOAD, APOE genotype has strong effects on episodic memory and medial temporal lobe (MTL) atrophy (Wolk &amp; Dickerson, 2010). However, EOAD often presents with more cognitive impairments in executive function, language, and visuospatial abilities than memory. These differences reflect more prominent atrophy in posterior lateral temporal and inferior parietal cortex that mainly constitute the EOAD‐signature of atrophy. Based on the cognitive and neuroanatomical profile of EOAD, we hypothesized that EOAD ɛ4 carriers will have relatively more atrophy in MTL regions subserving episodic memory, whereas non carriers would express more atrophy in cortical regions of the EOAD‐signature involved in executive function, language, and visuospatial abilities including inferior parietal and posterior temporal regions. We also expected worse performance on episodic memory tests in ɛ4 carriers with EOAD.MethodsWe examined the effects of APOE genotype on cortical atrophy and episodic memory of 144 ɛ4 carriers and 117 ɛ4 non‐carriers with EOAD from the Longitudinal Early‐Onset Alzheimer’s Disease Study (LEADS). Between‐group comparisons using independent T‐tests were made for morphometric measures of cortical atrophy in MTL and hippocampus localized in LOAD as well as in cortical regions within our newly developed EOAD‐Signature tool (Touroutoglou et al., 2023). ANCOVA with Bonferonni’s correction was used to evaluate for effects of age on significant differences between groups.ResultsAs predicted, ɛ4 carriers with EOAD had more atrophy in the MTL and bilateral hippocampi, whereas non‐carriers had more atrophy in regions of the EOAD‐signature including bilateral caudal temporal, parietal lobule, middle frontal gyrus, mid temporal, posterior cingulate cortex, precuneus, superior frontal gyrus, superior parietal lobule. Post hoc vertex wise cortical maps further confirmed the specificity of the results. In addition, ɛ4 carriers had worse performance on episodic memory testing (AVLT delayed recall). These results were not explained by a difference in age between the groups.ConclusionsThese results are consistent with prior work (Nemes et al. 2023) and support the hypothesis that the ɛ4 genotype modulates distinct neuroanatomic phenotypes of AD in EOAD patients.

Assessing Race Differences on Performance‐Based Assessment in Older Adults

Abstract BackgroundRace differences on cognitive tests have been widely reported and attributed to psychosocial factors. Cognitive assessment via performance‐based tests of everyday functioning may be less influenced by psychosocial factors, offering ecologically valid and less/unbiased measurement. This study examined differences between Black/African American and White older adults on traditional cognitive tests, self/informant report of everyday function, and a sensitive performance‐based test of everyday function called the Naturalistic Action Task (NAT). We predicted group differences on only traditional cognitive tests.Method100 community dwelling older adults (M age = 73±6.88; 66% Female; 65% White; M education = 16±2.69) from the Philadelphia area completed cognitive tests of episodic memory and executive functioning as well as the NAT, which requires making a breakfast and a lunch using objects on a table. Video recordings of NAT performance were scored for cognitive aspects of performance (accomplishment of task steps, completion time, and errors) as well motor imprecisions/clumsiness (motor errors). Participants and informants also completed questionnaires of the participants’ everyday functioning (Functional Activity Questionnaire, Measurement of Everyday Cognition, The Instrumental Activities of Daily Living – Compensation). Analyses of Covariance adjusting for education were used to evaluate group differences.ResultThe groups differed in education level but not age or sex distribution. As shown in Table 1, after controlling for education, the groups differed on tests of episodic memory and executive function. By contrast, there were no group differences on the NAT cognitive measures, though Black/African American participants made significantly more motor errors. Finally, there were no group differences on any of the self/informant questionnaires.ConclusionConsistent with prior literature, Black/African American older adults and White older adults differed significantly on traditional cognitive tests, even after controlling for education. Group differences were not observed on questionnaires nor on cognitive measures from the performance‐based test of everyday functioning (NAT). However, contrary to prediction Black/African American participants made more motor errors on the performance‐based test (NAT). In sum, performance‐based tests, such as the NAT, should be considered as an alternative to traditional cognitive tests in research and clinical contexts that include racially diverse older adults.