Mean Memory Score Research Articles

Low hourly wages in middle‐age are associated with faster memory decline in older age: Evidence from the health and retirement study

AbstractBackgroundLittle research has investigated the long‐term relationship between low wages and memory decline, despite the growing share of low‐wage workers in the US labor market. We examined whether cumulative exposure to low wages over 12 years in midlife is associated with memory decline in later life.MethodWe used 1992‐2016 data from the Health and Retirement Study, a biennial longitudinal survey of nationally representative samples of Americans aged 50+. We analyzed data from 3,803 individuals born 1936‐1941 using confounder‐adjusted linear mixed‐effects models. Low‐wage was defined as hourly wage lower than two‐thirds of the federal median wage for the corresponding year. Low‐wage exposure history was categorized into ‘never’, ‘intermittent’, and ‘sustained’ based on wages earned from 1992 to 2004. Memory function was measured at each visit from 2004 to 2016 by a memory composite score; on average, participants completed 4.8 memory assessments from 2004‐2016. Estimates were obtained in the total sample and within strata of sex (Nmales = 1,913, Nfemales = 1,890).ResultAt the beginning of cognitive follow‐up (2004) our sample was on average 65 years old with a mean memory score of 1.15 standard units. The confounder‐adjusted annual rate of memory decline among workers who never earned low wages was ‐0.12 standard units, 95% CI: [‐0.14, ‐0.10]. Compared with this, memory decline among workers with sustained earning of low midlife wages was significantly faster (βtime*sustained:‐0.012, 95% CI: [‐0.02, ‐0.01]), corresponding to an annual rate of ‐0.13 standard units for this group. Put into terms of “excess cognitive aging”, the cognitive aging experienced by workers with sustained exposure to low midlife wages over a 10‐year period is what workers never earning low‐wages would experience in 11 years. Similar associations were found among males and females. No significant association between intermittent earning of low wages and memory decline was observed.ConclusionSustained earning of low wages in midlife was significantly associated with a downward trajectory of memory performance in older age. Enhancing social policies to protect low‐wage workers (e.g., increasing minimum wage) may be especially beneficial for the cognitive health of individuals with sustained low‐wage employment in midlife.

Comparing relationships between health-related behaviour clustering and episodic memory trajectories in the United States of America and England: a longitudinal study

BackgroundHealth-related behaviours (HRBs) cluster within individuals. Evidence for the association between HRB clustering and cognitive functioning is limited. We aimed to examine and compare the associations between three HRB clusters: “multi-HRB cluster”, “inactive cluster” and “(ex-)smoking cluster” (identified in previous work based on HRBs including smoking, alcohol consumption, physical activity and social activity) and episodic memory trajectories among men and women, separately, in the United States of America (USA) and England.MethodsData were from the waves 10–14 (2010–2018) of the Health and Retirement Study in the USA and the waves 5–9 (2010–2018) of the English Longitudinal Study of Ageing in England. We included 17,750 US and 8,491 English participants aged 50 years and over. The gender-specific HRB clustering was identified at the baseline wave in 2010, including the multi-HRB (multiple positive behaviours), inactive and ex-smoking clusters in both US and English women, the multi-HRB, inactive and smoking clusters in US men, and only the multi-HRB and inactive clusters in English men. Episodic memory was measured by a sum score of immediate and delayed word recall tests across waves. For within country associations, a quadratic growth curve model (age-cohort model, allowing for random intercepts and slopes) was applied to assess the gender-stratified associations between HRB clustering and episodic memory trajectories, considering a range of confounding factors. For between country comparisons, we combined country-specific data into one pooled dataset and generated a country variable (0 = USA and 1 = England), which allowed us to quantify between-country inequalities in the trajectories of episodic memory over age across the HRB clusters. This hypothesis was formally tested by examining a quadratic growth curve model with the inclusion of a three-way interaction term (age × HRB clustering × country).ResultsWe found that within countries, US and English participants within the multi-HRB cluster had higher scores of episodic memory than their counterparts within the inactive and (ex-)smoking clusters. Between countries, among both men and women within each HRB cluster, faster declines in episodic memory were observed in England than in the USA (e.g., b England versus the USA for men: multi-HRB cluster = -0.05, 95%CI: -0.06, -0.03, b England versus the USA for women: ex-smoking cluster = -0.06, 95%CI: -0.07, -0.04). Additionally, the range of mean memory scores was larger in England than in the USA when comparing means between two cluster groups, including the range of means between inactive and multi-HRB cluster for men (b England versus the USA = -0.56, 95%CI: -0.85, -0.27), and between ex-smoking and multi-HRB cluster for women (b England versus the USA = -1.73, 95%CI: -1.97, -1.49).ConclusionsHRB clustering was associated with trajectories of episodic memory in both the USA and England. The effect of HRB clustering on episodic memory seemed larger in England than in the USA. Our study highlighted the importance of being aware of the interconnections between health behaviours for a better understanding of how these behaviours affect cognitive health. Governments, particularly in England, could pay more attention to the adverse effects of health behaviours on cognitive health in the ageing population.

Abstract TMP110: Design of the BP-COG Study of Blood Pressure Over the Life Course and Later-Life Cognition in Blacks, Hispanics, and Whites: A Pooled Cohort Analysis of ARIC, CARDIA, CHS, FOS, MESA, and NOMAS

Background: High blood pressure (BP), particularly in mid-life, increases the risk for late-life cognitive impairment and dementia (CID). The extent to which Blacks’ and Hispanics’ worse BP control starting in young adulthood contributes to their greater risk of CID compared to Whites is uncertain. Objective: To describe a pooled, multi-ethnic cohort created to determine the associations between BP levels over the life course and CID risk in Blacks, Hispanics, and Whites. Methods: We pooled individual-level data from 35,473 adults (22.6% Blacks, 8.1% Hispanics, 67.3% Whites, 2% Other) with baseline age ≥18 and cognitive assessments across 6 longitudinal cohorts in the United States from 1971 to 2016: Atherosclerosis Risk in Communities Study (ARIC), Coronary Artery Risk Development in Young Adults Study (CARDIA), Cardiovascular Health Study (CHS), Framingham Offspring Study (FOS), Multi-Ethnic Study of Atherosclerosis (MESA), and Northern Manhattan Study (NOMAS). We harmonized cognitive tests across studies into 3 factors representing global cognitive performance, executive function, and memory using statistically appropriate confirmatory factor analysis. Mean (SD) follow up was 17.1 (10.9) years. Results: The mean (SD) baseline age was 54.3 (16.4) years and 19554 (55.1%) participants were female (Table). There were 3193 (9.0%) first incident strokes (2651 ischemic, 348 hemorrhagic, and 117 other or undetermined type) and 15147 (42.7%) deaths. The Table presents mean BPs at the first and last visits by cohort and the pooled sample. From the initial to the last assessment, mean global cognition decreased over time (p<0.001), as did mean executive function (p<0.001) and mean memory scores (p<0.001) in the pooled sample. Conclusion: This will be the first comprehensive, large investigation of the association of BP levels from young adulthood to late-life and CID risk in Blacks, Hispanics, and Whites.

Short-term Memory Comparison between Stunted and Non-Stunted Groups

Background : Long-term insufficient nutritional needs will directly impact on the development and maturation of brain function. Disruption of development and maturation process in the brain is associated with decreased cognitive abilities. Frequently, the effect of long-term nutritional insufficiency has also height deficits called stunting.This study aimed to compare the short-term memory between stunted and non-stunted groups. Methods : A comparative study was conducted on 30 children in a non stunted group and 30 children in a stunted group. Children in both groups were selected from one of the elementary schools in Jatinangor using the simple random sampling method toward 3–5 for grade and 8–10 for age groups. The measurement of memory aspects for short-term memory used the Digit Span Test (forward and backward) and Simbol Modality Test. Results : The collected data were in normal and not normal distribution because the statistical test used the independent-t test and Mann-Whitney. The mean memory score comparison between group 1 and group 2 on Digit Span Test Forward was 5.33:5.33 (p=0.994), Digit Span test Backward was 2.73:2.60 (p=0.440), and Symbol Modality Test was 20.90:19.60 (p=0.347). Conclusions : There is no significant difference in short-term memory between stunted and non–stunted groups, due to some confounding factors such as, environmental aspect, parent’s education level, socioeconomic, and genetic factors.

Cognitive disorders in chronic kidney disease and hemodialysis patients

Introduction Cognitive impairment (CI) is common in individuals with chronic kidney disease (CKD) and among those treated with hemodialysis (HD). It may jeopardize treatment adherence by affecting the efficiency of every-day tasks, including correct medication and dietary rules. The severity of CKD is associated with the severity of CI, independent of age, education, and other key confounders. It is important to identify those patients with CI to reduce the considerable morbidity associated with this condition and improve their quality of life. Objectives The aim of the present study is to assess cognitive functions in patients with chronic renal diseases and patients on regular HD and to identify CI in these patients. Patients and methods A total of 30 patients with CKD were recruited from the outpatient clinic of Alamerya General Hospital (group I), and 30 HD patients were enrolled in the dialysis unit of the Alamerya General Hospital (group II). Moreover, 30 sex-matched and age-matched patients were recruited as controls (group III). Montreal Cognitive Assessment (MoCA) and Depression Anxiety Stress scale-21 were used as cognitive and neurological tests. Result The mean executive functions score was significantly lower in group II (2.37±0.67) in comparison with group I (3.33±0.48), with a P value less than 0.001, and it is also significantly lower in groups I and II in comparison with the control group (3.90±0.31), with a P value of 0.002 and less than 0.001, respectively. The mean attention score was significantly lower in group I (4.20±0.81) and group II (4.23±0.94) in comparison with the control group (5.27±0.69), with a P value of less than 0.001. The mean memory score was significantly lower in group I (3.10±0.40) and group II (2.57±0.90) in comparison with the control group (4.47±0.73), with a P value of less than 0.001. The mean total MoCA test score was significantly lower in group II (22.87±1.68) in comparison with group I (24.27±1.26), with a P value of less than 0.017, and it is also significantly lower in groups I and II in comparison with the control group (28.33±1.47), with a P value of less than 0.001. Conclusion Impaired renal function affects total MoCA score in the studied groups.

The Effect of Exercise Induced Dehydration on SCAT3

Sports-related concussions are plentiful in the United States. Various diagnostic tools are utilized in order to monitor deviations from baseline in memory, reaction time, symptoms, and balance. Evidence indicates that dehydration may also alter diagnostic tests. PURPOSE: To determine the effect of exercise-induced dehydration on deviations in cognitive performance related to concussion diagnostics. METHODS: Seventeen recreationally active subjects (age = 23.1 + 3.1 years, height = 168.93 + 10.71 cm, mass = 66.16 + 7.14 kg). Subjects performed three thermoneutral, counterbalanced sessions (control, euhydrated, dehydrated). Subjects were either restricted (0.0 L/hr) or provided fluids (1.0 L/hr) while treadmill running for 60 min at an intensity equal to 65-70% age-predicted maximum heart rate (APMHR). Sport Concussion Assessment Tool 3 (SCAT3) was utilized to assess symptoms, memory, balance, and coordination. RESULTS: We found a significant difference between sessions on modified BESS. (F2,16 = 8.87, P = 0.003). The control session had a significantly lower mean symptom score (2.93 + 3.28) than the dehydrated session (10.93 + 11.46; P = .028). The control session had a significantly higher mean memory score (28.27 + 1.28) than the dehydrated session (27.60 + 1.72; P = .046). CONCLUSIONS: Mild exercise-induced dehydration results in increased self-reported symptoms associated with concussions. Similarly, adequate hydration during exercise may help maintain cognitive function and balance during sport.

Memory Impairment following Acute Tricyclic Antidepressants Overdose.

Background. Psychiatric consultation is necessary for all patients with intentional poisoning and its reliability depends on the proper function of patients' memory performance. This study aimed to determine the possible memory impairment following acute TCAs' poisoning. Materials and Methods. In this cross-sectional study, patients with acute TCAs poisoning were allocated to two groups of severe poisoning (with coma, seizures, cardiac arrhythmias, hypotension, and a wide QRS complex) and mild-to-moderate poisoning according to their clinical presentation at the time of hospital admission. All patients underwent memory performance test both immediately and 24 hours after their initial consciousness after admission, using Wechsler Memory Scale (WMS-IV). Results. During the study period, 67 TCA-poisoned patients (aged, 20–64 years) were evaluated, of which 67.2% were female. The mean memory scores of patients immediately and 24 hours after the initial consciousness were 31.43 ± 9.02 and 50.62 ± 9.12, respectively (P < 0.001). Twenty-four hours after the initial consciousness, memory score was statistically correlated with the amount of ingested drug and the intoxication severity. Conclusion. Following the recovery from somatic symptoms of acute TCA poisoning, patients may still suffer from memory impairment and it seems that this time is not suitable for performing a reliable psychiatric consultation.

Subcortical vascular cognitive impairment, no dementia: EEG global power independently predicts vascular impairment and brain symmetry index reflects severity of cognitive decline.

Vascular cognitive impairment, no dementia (vCIND) is a prevalent and potentially preventable disorder. Clinical presentation of the small-vessel subcortical subtype may be insidious, and differential difficulties can arise with mild cognitive impairment. We investigated EEG parameters in subcortical vCIND in comparison with amnestic multidomain mild cognitive impairment to determine the additional diagnostic value of quantitative EEG in this setting. Fifty-seven community-residing patients with an uneventful central neurologic history and first presentation of cognitive decline without dementia were included. Neuropsychological test results were correlated with EEG parameters. Predictive values for vCIND and amnestic multidomain mild cognitive impairment were calculated using receiver operating characteristic curves and logistic regression modeling. Vascular cognitive impairment, no dementia and amnestic multidomain mild cognitive impairment differed with regard to the EEG (delta + theta)/(alpha + beta) ratio (DTABR) and pairwise derived brain symmetry index. We found statistically significant correlations between pairwise derived brain symmetry index and immediate verbal memory, immediate global memory, verbal recognition, working memory, and mean memory score in vCIND. Verbal fluency (odds ratio: 1.54, 95% confidence interval: 1.04-2.28, P = 0.033) and (delta + theta)/(alpha + beta) ratio (odds ratio: 2.28, 95% confidence interval: 1.06-4.94, P = 0.036) emerged as independent diagnostic predictors for vCIND with an overall correct classification rate of 95.0%. Our data indicate that EEG is of additional value in the differential diagnosis and follow-up of patients presenting with cognitive decline. These findings may have an impact on memory care.

Role of the apolipoprotein E and catechol-O-methyltransferase genes in prospective and retrospective memory traits

Human memory is a complex neurocognitive process. By combining psychological and molecular genetics expertise, we examined the APOE ε4 allele, a known risk factor for Alzheimer's disease, and the COMT Val 158 polymorphism, previously implicated in schizophrenia, for association with lowered memory functioning in healthy adults. To assess memory type we used a range of memory tests of both retrospective and prospective memory. Genotypes were determined using RFLP analysis and compared with mean memory scores using univariate ANOVAs. Despite a modest sample size (n=197), our study found a significant effect of the APOE ε4 polymorphism in prospective memory. Supporting our hypothesis, a significant difference was demonstrated between genotype groups for means of the Comprehensive Assessment of Prospective Memory total score (p=0.036; ε4 alleles=1.99; all other alleles=1.86). In addition, we demonstrate a significant interactive effect between the APOE ε4 and COMT polymorphisms in semantic memory. This is the first study to investigate both APOE and COMT genotypes in relation to memory in non-pathological adults and provides important information regarding the effect of genetic determinants on human memory.

Effects of social integration on preserving memory function in a nationally representative US elderly population.

We tested whether social integration protects against memory loss and other cognitive disorders in late life in a nationally representative US sample of elderly adults, whether effects were stronger among disadvantaged individuals, and whether earlier cognitive losses explained the association (reverse causation). Using data from the Health and Retirement Study (N = 16,638), we examined whether social integration predicted memory change over 6 years. Memory was measured by immediate and delayed recall of a 10-word list. Social integration was assessed by marital status, volunteer activity, and frequency of contact with children, parents, and neighbors. We examined growth-curve models for the whole sample and within subgroups. The mean memory score declined from 11.0 in 1998 to 10.0 in 2004. Higher baseline social integration predicted slower memory decline in fully adjusted models (P<.01). Memory among the least integrated declined at twice the rate as among the most integrated. This association was largest for respondents with fewer than 12 years of education. There was no evidence of reverse causation. Our study provides evidence that social integration delays memory loss among elderly Americans. Future research should focus on identifying the specific aspects of social integration most important for preserving memory.

Memory Performance in HIV/AIDS - A Prospective Case Control Study

Memory impairment, usually impaired retrieval of information, has been described in HIV/AIDS, especially among those with severe illness. Neuro-cognitive disturbances in HIV/AIDS have been linked to poor quality of life and medication adherence. This prospective, case-control study was designed to assess the verbal and non-verbal memory as well as the attention abilities of Nigerian Africans with HIV/AIDS and correlate their performances with their CD4+ T lymphocytes (CD4+) counts. A total of 288 randomly selected subjects, comprising 96 HIV-positive symptomatic patients, 96 HIV-positive asymptomatic patients and 96 HIV-negative controls, participated in the study. The subjects were age-, sex-, and level of education matched. The Recognition Memory Test and Choice Reaction Time tasks, components of the computer-assisted neuropsychological tests battery- the Iron Psychology 'FePsy' were used for cognitive assessments. The mean memory scores of the HIV-positive asymptomatic subjects did not differ significantly from the controls (p > 0.05) but the HIV-positive symptomatic subjects' scores were significantly lower than the controls (p < 0.05). Both HIV-positive groups had psychomotor slowing and impaired attention (p < 0.05). The HIV-positive subjects with CD4+ counts < 200/microl and between 200 and 499/microl had significant memory impairment (p < 0.001 and p < 0.001 respectively) but there was no significant impairment among those with count > or = 500/microl. Impaired ability for sustained attention was however present irrespective of the CD4+ level relative to controls (p < 0.001). We concluded that there was no significant memory disturbance among HIV-positive asymptomatic subjects despite the presence of impaired attention and psychomotor slowing, and that the severity of immune suppression (as indicated by the CD4+ T lymphocytes count) is a strong determinant of cognitive decline in HIV/AIDS.

A longitudinal study of rats chronically exposed to aluminum at human dietary levels

According to the World Health Organization, oral ingestion of aluminum additives is the main form of aluminum exposure for the general public. Aluminum salts are added to a range of commercially-prepared foods and beverages: to clarify drinking water, make salt free-pouring, color snack/dessert foods, and make baked goods rise. In the present study, six Wistar rats chronically consumed aluminum from 16 months of age to the conclusion of their lifespan (averaging 29.8 months) in an amount (1.5 mg/kg bodyweight) equivalent to the high end of the total aluminum range ingested daily by humans living in contemporary urban society. The rats were memory-trained in a continuous rewarded alternation T-maze task and tested weekly from 5 months of age onwards. This longitudinal study compared their mean memory performances over 15 consecutive weeks during middle age (12–23 months) and old age (≥24 months). Four out of six rats continued to perform the memory task in old age without significant deficit. The remaining two obtained significantly lower mean memory scores in old age than in middle age and exhibited soft signs associated with dementia. Their hippocampal neurons stained for aluminum, showing some but not all features of aluminum accumulation that occur in human hippocampal neurons. In view of evidenced linkages of aluminum with β-amyloid plaque and neurofibrillary tangle formation in humans with Alzheimer's disease, the findings suggest this protocol is worth testing in larger groups of animals.

Unanticipated memory loss during superselective Wada testing for right cerebral arteriovenous malformation.

120 Background: A major concern in the treatment of cerebral AVMs is whether so-called eloquent regions occupy normal anatomic locations. Recently, we have shown with selective anesthetic injections that language has a wide and unusual distribution in patients with left cerebral AVM. Our Objective here was to determine whether superselective Wada testing in medial right-hemisphere arteries would produce verbal memory loss in patients with right cerebral AVM. Methods: Nine patients, 8 right- and 1 left-handed, had superselective injections of amobarbital sodium plus lidocaine into vessels near or feeding right medial AVMs. Five patients had AVMs supplied by PCA feeders and four had ACA feeders. Memory testing occurred in a no-anesthetic baseline, 1 minute after anesthetic injection, and 12 minutes after injection. A memory test consisted of 5 words presented on a computer screen which the patient had to read aloud. After 3 minutes, recall was tested. A maximum score was 15, with uncued recall of a word = 3 points, prompted recall = 2 points, and multiple choice = 1 point. Based on clinical considerations, various numbers of vessels were tested in each patient. Results: Superselective anesthetic testing in most vessels yielded memory scores no different than baseline, and embolization took place. In each patient, however, there was at least one vessel feeding the AVM in which significant short-term verbal memory loss took place. In these instances, the mean memory score at baseline was 14 (s.d. = 1.5). Following injection of anesthetics, the mean score fell significantly to 7.1 (t-test, p&lt;.00001). Attention was unaltered. After dissipation of the anesthesia at 12 minutes, memory returned to baseline levels in every case. Conclusions: In nine patients, superselective Wada injection into arteries feeding right medial AVMs produced unanticipated verbal memory deficits. Traditional assumptions about eloquent regions would have suggested that such testing would have been unnecessary, but embolization here would have yielded significant morbidity. Our findings also question established notions of verbal memory restricted to the left hemisphere.

Midazolam sedation for percutaneous liver biopsy.

Control of patient respiration is needed to safely perform percutaneous liver biopsy (PLB) and may be adversely affected by sedation. The purpose of this study was to evaluate the safety of PLB with intravenous midazolam and to evaluate patient acceptance of PLB with and without sedation. Two hundred seventeen consecutive patients underwent 301 percutaneous liver biopsies. One hundred fifty-one of the biopsies were done after the patients were sedated with intravenous midazolam immediately before the biopsy. The last 61 patients were questioned after the biopsy to evaluate the discomfort of the procedure, their memory of the procedure, and their willingness to undergo another PLB. The major complication rate was similar in the midazolam-treated (0.7%) and untreated (0.7%) groups. The midazolam-treated patients had a numerically lower mean pain score (1.5 +/- 0.4 vs 4.0 +/- 0.7) (mean +/- SEM) (P = 0.07) and significantly lower mean memory score (4.8 +/- 0.7 vs 9.9 +/- 0.1) (P < 0.01) than the untreated patients. The treated and untreated groups had similar mean willingness for repeat PLB scores (9.3 +/- 0.3 vs 9.1 +/- 0.6). We conclude that: (1) there is no increased risk of PLB with midazolam and (2) patients have less memory of the procedure with midazolam.