Memory Decline In Older Adults Research Articles

Noninvasive brain stimulations modulated brain modular interactions to ameliorate working memory in community-dwelling older adults.

Non-invasive brain stimulations have drawn attention in remediating memory decline in older adults. However, it remains unclear regarding the cognitive and neural mechanisms underpinning the neurostimulation effects on memory rehabilitation. We evaluated the intervention effects of 2-weeks of neurostimulations (high-definition transcranial direct current stimulation, HD-tDCS, and electroacupuncture, EA versus controls, CN) on brain activities and functional connectivity during a working memory task in normally cognitive older adults (age 60+, n = 60). Results showed that HD-tDCS and EA significantly improved the cognitive performance, potentiated the brain activities of overlapping neural substrates (i.e. hippocampus, dlPFC, and lingual gyrus) associated with explicit and implicit memory, and modulated the nodal topological properties and brain modular interactions manifesting as increased intramodular connection of the limbic-system dominated network, decreased intramodular connection of default-mode-like network, as well as stronger intermodular connection between frontal-dominated network and limbic-system-dominated network. Predictive model further identified the neuro-behavioral association between modular connections and working memory. This preliminary study provides evidence that noninvasive neurostimulations can improve older adults' working memory through potentiating the brain activity of working memory-related areas and mediating the modular interactions of related brain networks. These findings have important implication for remediating older adults' working memory and cognitive declines.

Tau accumulation and atrophy predict amyloid independent cognitive decline in aging.

Amyloid beta (Aβ) and tau pathology are cross-sectionally associated with atrophy and cognitive decline in aging and Alzheimer's disease (AD). We investigated relationships between concurrent longitudinal measures of Aβ (Pittsburgh compound B [PiB] positron emission tomography [PET]), tau (flortaucipir [FTP] PET), atrophy (structural magnetic resonance imaging), episodic memory (EM), and non-memory (NM) in 78 cognitively healthy older adults (OA). Entorhinal FTP change was correlated with EM decline regardless of Aβ, but meta-temporal FTP and global PiB change were only associated with EM and NM decline in Aβ+ OA. Voxel-wise analyses revealed significant associations between temporal lobe FTP change and EM decline in all groups. PiB and FTP change were not associated with structural change, suggesting a functional or microstructural mechanism linking these measures to cognitive decline. Our results show that longitudinal Aβ is linked to cognitive decline only in the presence of elevated Aβ, but longitudinal temporal lobe tau is associated with memory decline regardless of Aβ status. Entorhinal tau change was associated with memory decline in older adults (OA), regardless of amyloid beta (Aβ). Greater meta-region of interest (ROI) tau change correlated with memory decline in Aβ+ OA. Voxel-wise temporal tau change correlated with memory decline, regardless of Aβ. Meta-ROI tau and global amyloid change correlated with non-memory change in Aβ+ OA. Tau and amyloid accumulation were not associated with structural change in OA.

Music Therapy Enhances Episodic Memory in Alzheimer's and Mixed Dementia: A Double-Blind Randomized Controlled Trial.

Objective: This study aimed to assess whether a music therapy (MT) intervention could improve memory decline in older adults with and without cognitive impairment. A dual-retrieval model of episodic memory was employed to estimate memory processes. Methods: Forty-three older adults with a mean age of 76.49 years (n = 25 with Alzheimer's disease (AD) and mixed dementia, and n = 18 healthy older adults) were randomly selected for the experimental and control groups. The study design was a double-blind randomized controlled clinical trial and a certified music therapist delivered the MT. The primary outcomes were measures of working memory, episodic memory, and autobiographical memory. Results: In the primary outcome measures, MT effects were restricted to episodic memory measures like the Figure Memory Test of the BCSB and the Speech and Sing Memory Test. In both tests, the experimental group improved from pre-test to post-test in delayed recall, but in the Speech and Sing Memory Test, the improvement was restricted to the AD and mixed dementia group. MT had no effects on the secondary outcome measures. Conclusions: These findings suggest that a structured MT intervention can be promising for rehabilitating episodic memory in older adults with dementia.

9 Connecting memory and functional brain networks in older adults: a resting state fMRI study

Objective:Nonpathological aging has been linked to decline in both verbal and visuospatial memory abilities in older adults. Disruptions in resting-state functional connectivity within well-characterized, higherorder cognitive brain networks have also been coupled with poorer memory functioning in healthy older adults and in older adults with dementia. However, there is a paucity of research on the association between higherorder functional connectivity and verbal and visuospatial memory performance in the older adult population. The current study examines the association between resting-state functional connectivity within the cingulo-opercular network (CON), frontoparietal control network (FPCN), and default mode network (DMN) and verbal and visuospatial learning and memory in a large sample of healthy older adults. We hypothesized that greater within-network CON and FPCN functional connectivity would be associated with better immediate verbal and visuospatial memory recall. Additionally, we predicted that within-network DMN functional connectivity would be associated with improvements in delayed verbal and visuospatial memory recall. This study helps to glean insight into whether within-network CON, FPCN, or DMN functional connectivity is associated with verbal and visuospatial memory abilities in later life.Participants and Methods:330 healthy older adults between 65 and 89 years old (mean age = 71.6 ± 5.2) were recruited at the University of Florida (n = 222) and the University of Arizona (n = 108). Participants underwent resting-state fMRI and completed verbal memory (Hopkins Verbal Learning Test - Revised [HVLT-R]) and visuospatial memory (Brief Visuospatial Memory Test - Revised [BVMT-R]) measures. Immediate (total) and delayed recall scores on the HVLT-R and BVMT-R were calculated using each test manual’s scoring criteria. Learning ratios on the HVLT-R and BVMT-R were quantified by dividing the number of stimuli (verbal or visuospatial) learned between the first and third trials by the number of stimuli not recalled after the first learning trial. CONN Toolbox was used to extract average within-network connectivity values for CON, FPCN, and DMN. Hierarchical regressions were conducted, controlling for sex, race, ethnicity, years of education, number of invalid scans, and scanner site.Results:Greater CON connectivity was significantly associated with better HVLT-R immediate (total) recall (ß = 0.16, p = 0.01), HVLT-R learning ratio (ß = 0.16, p = 0.01), BVMT-R immediate (total) recall (ß = 0.14, p = 0.02), and BVMT-R delayed recall performance (ß = 0.15, p = 0.01). Greater FPCN connectivity was associated with better BVMT-R learning ratio (ß = 0.13, p = 0.04). HVLT-R delayed recall performance was not associated with connectivity in any network, and DMN connectivity was not significantly related to any measure.Conclusions:Connectivity within CON demonstrated a robust relationship with different components of memory function as well across verbal and visuospatial domains. In contrast, FPCN only evidenced a relationship with visuospatial learning, and DMN was not significantly associated with memory measures. These data suggest that CON may be a valuable target in longitudinal studies of age-related memory changes, but also a possible target in future non-invasive interventions to attenuate memory decline in older adults.

59 The Impact of Anxiety on Memory Performance in Older Adults with Depression

Objective:Late life depression (LLD) refers to a diagnosis of major depressive disorder in people older than 60, and has been linked to significant cognitive impairment and increased risk of Alzheimer's disease. Although anxiety and depression are highly comorbid, the impact of anxiety on cognition in LLD is far less researched. This is important given that over 20% of middle aged and older adults endorse clinically significant chronic worry. Generalized anxiety disorder in older adults with major depression is associated with poorer cognition and worse treatment outcomes compared with those without anxiety. Therefore, the purpose of the study is to examine the role of anxiety on memory in LLD. We hypothesized that presence of anxiety among older depressed adults would be associated with worse cognitive performance over time.Participants and Methods:Participants included 124 individuals (69.4% female, 90.3% Caucasian) aged 60 or above (M = 71.5, SD = 7.4) who met criteria for major depression, single episode or recurrent. They completed the State Trait Anxiety Inventory, Montgomery Asberg Depression Rating Scale, and a measure of verbal episodic memory (WMS-IV Logical Memory) as part of a larger neuropsychological battery. Data were collected from baseline to three years as part of a larger NIMH-supported longitudinal study. Two-level linear mixed-effect models were fitted to predict memory. State and trait anxiety were used as time-varying predictors. The between-person (level 2) and within-person (level 1) effects of anxiety on memory were assessed controlling for the time trend, age, education, gender, race, and change in depression over time.Results:Plot trajectories across variables revealed a negative correlation such that as anxiety decreased, memory improved over time. Hierarchical linear mixed-effect models revealed that average state anxiety was a marginally significant between-person (level2) predictor for memory [B=-0.041, t(128)=-1.8, p=0.083]. Individuals with greater average state anxiety were more likely to experience memory decline compared to those with lower average state anxiety. In addition, the within-person effect (level 1) of state anxiety was significant [B=-0.096, t(253)=-2.7, p=0.007]. As an individual's anxiety increased over time, their memory declined. Trait anxiety showed a significant within-person effect on memory [B=-0.087, t(254)=-2.0, p=0.048], but a non-significant between-person effect [B=-0.005, t(124)=-0.06, p=0.95].Conclusions:Anxiety appears to increase the risk of memory decline in older adults with major depression, a cohort who are already at risk of cognitive decline. Changes in anxiety increased risk of memory decline even when accounting for changes in depression over time. Although the causal link between anxiety and cognitive impairment remains unclear, it is possible that anxiety and worry may compete for cognitive resources necessary for demanding tasks and situations, detracting from abilities, such as attention and working memory. Older adults with depression may also have difficulty coping adaptively with anxiety, which may negatively affect cognition. Finally, presence of anxiety may represent a form of mild behavioral impairment, a prodrome of cognitive decline leading to dementia. Overall, the present study highlights the negative impact of anxiety on memory performance, indicating that treatment interventions targeting anxiety in older adults are essential to help prevent cognitive decline.

Cortical microstructural changes predict tau accumulation and episodic memory decline in older adults harboring amyloid

IntroductionNon-invasive diffusion-weighted imaging (DWI) to assess brain microstructural changes via cortical mean diffusivity (cMD) has been shown to be cross-sectionally associated with tau in cognitively normal older adults, suggesting that it might be an early marker of neuronal injury. Here, we investigated how regional cortical microstructural changes measured by cMD are related to the longitudinal accumulation of regional tau as well as to episodic memory decline in cognitively normal individuals harboring amyloid pathology.Methods122 cognitively normal participants from the Harvard Aging Brain Study underwent DWI, T1w-MRI, amyloid and tau PET imaging, and Logical Memory Delayed Recall (LMDR) assessments. We assessed whether the interaction of baseline amyloid status and cMD (in entorhinal and inferior-temporal cortices) was associated with longitudinal regional tau accumulation and with longitudinal LMDR using separate linear mixed-effects models.ResultsWe find a significant interaction effect of the amyloid status and baseline cMD in predicting longitudinal tau in the entorhinal cortex (p = 0.044) but not the inferior temporal lobe, such that greater baseline cMD values predicts the accumulation of entorhinal tau in amyloid-positive participants. Moreover, we find a significant interaction effect of the amyloid status and baseline cMD in the entorhinal cortex (but not inferior temporal cMD) in predicting longitudinal LMDR (p < 0.001), such that baseline entorhinal cMD predicts the episodic memory decline in amyloid-positive participants.ConclusionsThe combination of amyloidosis and elevated cMD in the entorhinal cortex may help identify individuals at short-term risk of tau accumulation and Alzheimer’s Disease-related episodic memory decline, suggesting utility in clinical trials.

Factors Influencing Memory Decline in Older Adults: A Comprehensive Review

This review examines the factors influencing memory decline in older adults. Biological factors, such as neurodegenerative diseases and age-related brain changes, lifestyle factors like physical inactivity and unhealthy diet, and psychological and psychosocial factors including chronic stress and social isolation, all contribute to memory decline. Understanding the interplay between these factors is crucial for developing interventions and strategies to preserve cognitive function in older adults. This review highlights the importance of longitudinal studies, targeted interventions, and personalized approaches for promoting healthy aging and addressing memory decline.

Medial Temporal Tau Predicts Memory Decline in Cognitively Unimpaired Elderly (P5-6.011)

<h3>Objective:</h3> Here, we assess the prognostic accuracy of baseline [18F]-MK-6420 tau PET for predicting longitudinal memory decline in asymptomatic elderly individuals. <h3>Background:</h3> Alzheimer’s disease (AD) can be detected in living people using in vivo biomarkers of amyloid-β (Aβ) and tau, even in the absence of cognitive impairment during the preclinical phase. [18F]-MK-6420 is a high affinity positron emission tomography (PET) tracer that quantifies tau neurofibrillary tangles, but its ability to predict cognitive changes associated with early AD symptoms, such as memory decline, is unclear. <h3>Design/Methods:</h3> In a longitudinal observational study, we evaluated a cohort of cognitively normal elderly participants from the Translational Biomarkers in Aging and Dementia (TRIAD) study (October 2017-July 2020, follow-up period of 12 months). All participants underwent tau PET with [18F]-MK-6420 and Aβ PET with [18F]-AZD-4694. <h3>Results:</h3> There were 111 eligible participants who were chosen based on the availability of Aβ PET, tau PET, magnetic resonance imaging (MRI), and APOEɛ4 genotyping. Among these participants, the mean (SD) age was 70.1 (8.6) years; 20 (18%) were tau PET positive and 71 of 111 (63.9%) were women. A significant association between baseline Braak I-II [18F]-MK-6240 SUVR positivity and change in composite memory score was observed at the 12 month follow-up, after correcting for age, sex, and years of education (Logical Memory and RAVLT, standardized beta = −0.52 (−0.82−0.21), p &lt; 0.001, for dichotomized tau PET and −1.22 (−1.84−(−0.61)), p &lt; 0.0001, for continuous tau PET). Moderate cognitive decline was observed for A+T+ over the follow-up period, whereas no significant change was observed for A-T+, A+T- and A-T−, though it should be noted that the A-T+ group was small. Our results indicate that baseline tau neurofibrillary tangle pathology is associated with longitudinal changes in memory function. <h3>Conclusions:</h3> [18F]-MK-6420 PET is a promising tool for predicting memory decline in older adults without cognitive impairment at baseline. <b>Disclosure:</b> Miss Kwan has nothing to disclose. Mr. Arfaie has nothing to disclose. Mr. Therriault has nothing to disclose. Dr. Azizi has nothing to disclose. Miss Lussier has nothing to disclose. Mrs. Tissot has nothing to disclose. Dr. Chamoun has nothing to disclose. Dr. Bezgin has nothing to disclose. Dr. Servaes has nothing to disclose. Miss Stevenson has nothing to disclose. Ms. Rahmouni has nothing to disclose. Miss Pallen has nothing to disclose. The institution of Dr. Rosa Neto has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novo Nordisk.

Association between healthy lifestyle and memory decline in older adults: 10 year, population based, prospective cohort study

ObjectiveTo identify an optimal lifestyle profile to protect against memory loss in older individuals.DesignPopulation based, prospective cohort study.SettingParticipants from areas representative of the north, south, and west of China.ParticipantsIndividuals aged...

Medial temporal tau predicts memory decline in cognitively unimpaired elderly.

Alzheimer's disease can be detected in living people using in vivo biomarkers of amyloid-β and tau, even in the absence of cognitive impairment during the preclinical phase. [18F]-MK-6420 is a high-affinity PET tracer that quantifies tau neurofibrillary tangles, but its ability to predict cognitive changes associated with early Alzheimer's disease symptoms, such as memory decline, is unclear. Here, we assess the prognostic accuracy of baseline [18F]-MK-6420 tau-PET for predicting longitudinal memory decline in asymptomatic elderly individuals. In a longitudinal observational study, we evaluated a cohort of cognitively normal elderly participants (n = 111) from the translational biomarkers in ageing and dementia study (data collected between October 2017 and July 2020, with a follow-up period of 12 months). All participants underwent tau-PET with [18F]-MK-6420 and amyloid-β PET with [18F]-AZD-4694. The exclusion criteria included the presence of head trauma, stroke or other neurological disorders. There were 111 eligible participants selected based on the availability of amyloid-β PET, tau-PET, MRI and APOEɛ4 genotyping. Among these participants, the mean standard deviation age was 70.1 (8.6) years; 20 (18%) were tau-PET-positive and 71 of 111 (63.9%) were women. A significant association between the baseline Braak Stages I-II [18F]-MK-6240 standardized uptake value ratio positivity and change in composite memory score were observed at the 12-month follow-up, after correcting for age, sex and years of education [logical memory and Rey Auditory Verbal Learning Test, standardized beta = -0.52 (-0.82-0.21), P < 0.001, for dichotomized tau-PET and -1.22 (-1.84-(-0.61)], P < 0.0001, for continuous tau-PET]. Moderate cognitive decline was observed for A + T + over the follow-up period, whereas no significant change was observed for A-T+, A + T- and A-T-, although it should be noted that the A-T + group was small. Our results indicate that baseline tau neurofibrillary tangle pathology is associated with longitudinal changes in memory function, supporting the use of [18F]-MK-6420 PET to predict the likelihood of asymptomatic elderly individuals experiencing future memory decline. Overall, [18F]-MK-6420 PET is a promising tool for predicting memory decline in older adults without cognitive impairment at baseline. This is of critical relevance as the field is shifting towards a biological model of Alzheimer's disease defined by the aggregation of pathologic tau. Therefore, early detection of tau pathology using [18F]-MK-6420 PET provides us with hope that living patients with Alzheimer's disease may be diagnosed during the preclinical phase before it is too late.

Association between multimorbidity, subjective memory decline and cognitive performance in older adults.

AbstractBackgroundHigh multimorbidity rates co‐existing with Alzheimer’s disease (AD) have been interpreted as a consequence of dementia progression. Little is known about multimorbidity’s relationship with cognition as an underlying factor capable of accelerating the progression and onset of the disease. Here we examined the relationship between multimorbidity, cognitive performance and subjective memory decline in older adults in a large representative dataset.MethodsCross‐sectional data from 1,103 individuals (60.1% female), between 60 – 97 years old, enrolled in the Health, Wellbeing and Aging Study (SABE), a Brazilian population‐cohort study, were assessed for multimorbidity and cognitive performance. Multimorbidity was defined as the co‐occurrence of at least two chronic conditions. Cognitive performance was determined using the MMSE, verbal fluency (number of animals per minute), and backward digital span. For the subjective memory performance, participants were asked whether their memory for daily activities was better, the same, or worse compared to the last ten years.ResultsMultimorbidity was present in 36.8% of the participants, with the highest rates observed in the participants with subjective memory decline (p &lt; 0.001). Multivariate analysis adjusted for age, sex, education and depression symptoms showed that the higher the multimorbidity rate, the lower the MMSE (B = ‐0.365; p = 0.025) and the digit span scores (B = ‐0.232; p = 0.003; F = 68.3; p &lt; 0.001).ConclusionIn older adults, multimorbidity was associated with higher subjective memory decline, lower short‐term memory, and global cognitive performance. These findings support future longitudinal studies investigating multimorbidity in moderating dementia pathology and progression.

The association between subjective memory complaints and objective memory performance in older adults with mood disorders

<h3>Introduction</h3> The relationship between subjective memory complaints (SMCs) and objective memory performance is not always clear-cut, which in turn can complicate the assessment of potential memory decline in older adults. Although previous research suggests that the presence of certain state-related factors, including mood and anxiety symptoms, are associated with higher SMCs, whether these factors play a mediating or moderating role in the relationship between SMCs and objective memory performance isn't as clear. In addition, scant research has explored this relationship in older adults with mood disorders. This is an important target of investigation, as accounting for mood state is critical when interpreting the clinical significance of one's SMCs and objective test performance. Thus, the current study aimed to (1) investigate the relationship between SMCs and concurrent performance on memory testing in older adults with mood disorders compared to healthy controls (HCs), and (2) determine if the relationship between SMCs and objective memory performance varies as a function of depression and/or anxiety symptom severity within the mood disorder group. <h3>Methods</h3> We conducted multilevel regression analyses of cross-sectional data from a total of 36 older adults (aged 56-89) who were enrolled in the Geriatric Mood Disorders Database study at McLean Hospital. Our sample included 21 older adults with major mood disorders (depressive and bipolar spectrum disorders) and 15 older adults without any psychiatric diagnoses (HCs). All participants completed self-report scales that assessed current mood/anxiety symptom severity (Geriatric Depression Scale, GDS; Geriatric Anxiety Scale, GAS-2) and subjective memory concerns (Multifactorial Memory Questionnaire, MMQ), as well as objective memory testing using the California Verbal Learning Test (CVLT-II). Aim 1 analyses used group (HCs vs mood), SMCs (total MMQ score), and their interaction term (group x SMCs) as predictors, with three CVLT-II metrics representing memory encoding/registration, retrieval, and storage/retention as outcome variables. Aim 2 analyses were performed within the mood group only and used SMCs (total scores from the MMQ), GDS/GAS-2, and their interaction term (SMCs x GDS and SMCs x GAS-2, respectively) as predictors, with the same CVLT-II scores as outcome variables. All analyses included age and sex as covariates. <h3>Results</h3> Mood group and control group did not significantly differ (p > 0.05) in participant's age, sex, race/ethnicity, SMCs, and three categories of objective memory testing (memory encoding/registration, retrieval, and storage/retention). As expected, the groups did differ significantly in mean severity of depressive and anxiety symptoms. For aim 1, the results from regression analyses indicated that SMCs did not significantly predict memory encoding/registration (Β = .332, <i>p</i> = .16), memory retrieval (Β = .063, <i>p</i> = .40), and memory storage/retention (Β = .189, <i>p</i> = .231). Moreover, being in a mood vs. control group did not significantly moderate any of the association between SMCs and objective memory performances (i.e., memory encoding/registration (Β = -.32, <i>p</i> = .231); retrieval (Β = -.055, <i>p</i> =.514); and storage/retention (Β =-.187, <i>p</i> = .295). For aim 2, results suggested that, within the mood disorder group, the severity of depressive symptoms did not significantly moderate the association between SMCs and each of the objective memory performance variables: encoding/registration (Β = .022, <i>p</i> =.272); retrieval (Β = .007, <i>p</i> =.336); and storage/retention (Β = .02, <i>p=</i>.212). Additionally, results demonstrated that severity of anxiety symptoms was not a significant moderator for the association between SMCs and memory performance within older adults with mood disorders (i.e., Β =.003, <i>p</i> =.583 for encoding/registration; Β = .002, <i>p</i> =.454 for retrieval; and Β = .007, <i>p=</i>.261 for storage/retention). <h3>Conclusions</h3> The current results indicate that the association between SMCs and concurrent objective memory performance did not differ between healthy older adults and those with major mood disorders. In addition, the strength of this association did not vary as a function of current depression or anxiety symptom severity within the mood disorder group. Collectively, these findings suggest that, amongst older adults, neither the presence of an endogenous mood disorder nor the severity of active depression/anxiety symptoms impacts the subjective appraisal of memory functioning in relation to objective performance on concurrent memory testing. Further, those with mood disorders did not differ significantly from HCs in their subjective appraisal of memory concerns. These findings are surprising, as prior literature suggests that those with more severe mood symptoms also have higher SMCs. Our analysis is limited by a small sample size, and further investigations should be conducted with larger samples to confirm the strength of these findings. <h3>This research was funded by</h3> This study is funded by the Rogers Family Foundation.

Late‐life social activity moderates the association between temporal lobe atrophy and episodic memory decline

AbstractBackgroundRetirement and loss of important social relationships, including spouse and friends, make older adults more vulnerable to social isolation. Therefore, social activity could be important for older adults in maintaining life satisfaction and everyday functioning. Although several studies found protective roles of social activity against cognitive decline in late life, only a few studies examined the protective effects of social activity using longitudinal data. In this study, the effects of social activity on the relationship between brain aging and cognitive decline in older adults were examined during a four‐year period.MethodThirty‐two older adults with normal cognition (mean age = 70.69, SD: 6.27, mean education = 7.75, SD: 3.94 at baseline) were recruited from the Korean Social Life, Health, and Aging Project (KSHAP). Neuropsychological and brain imaging data, and social survey, were acquired in 2015 and 2019. Elderly Verbal Learning Test (EVLT) performance and cortical volumes from Magnetic Resonance Imaging (MRI) were the main measures of interest. The participants were asked to respond either “yes” or “no” to social survey items, including participation in community senior center events, volunteering for charities, religious activities, socializing events, leisure activities, and community activities. Social activity was explored in terms of level, consistency, and types of social activities. The Computational Anatomy Toolbox (CAT) was used to calculate temporal lobe gray matter volume selected as regions of interest (ROI) for its role in episodic memory. Hierarchical regressions were conducted to examine the effects of social activity on the relationship between temporal lobe atrophy and episodic memory decline.ResultWe found that the temporal lobe atrophy was associated with the delayed recall decline (r = 0.49, p = 0.003). More involvement in social activity at baseline decreased the effects of temporal lobe atrophy on delayed recall decline, controlling for age, sex, education, and self‐rated health as covariates. Further, consistent involvement in social activity, especially volunteering, attenuated the association between temporal lobe atrophy and delayed recall decline.ConclusionThese findings suggest that social activities in late life function as cognitive reserve to buffer against the effects of temporal lobe atrophy on episodic memory decline in older adults.

Depressive symptoms as a predictor of memory decline in older adults: A longitudinal study using the dual change score model

The directionality of the longitudinal association between depressive symptoms and memory remains a topic of intense debate. A unidirectional association where depression impacts the change in memory (or vice-versa) and a bidirectional association where the trajectories of both dimensions affect each other lead to different clinical implications. Method: This study investigated the depression-memory longitudinal association in a sample of 2057 older adults aged between 60 and 99 years old from the Virginia Cognitive Aging Project. The bivariate dual change score model was used to investigate the directionality of the association between episodic memory and three dimensions of depression (somatic symptoms, depressed affect, and positive affect) throughout ten years (five measurement points), controlling for education and sex. Results: the bidirectional model showed the best fit between somatic symptoms and memory, with a significant coupling effect observed from initial somatic symptoms to subsequent changes in memory. For depressed and positive affect, the unidirectional model with initial levels of depression predicting following changes in memory showed the best fit to the data, with significant coupling effects observed. Higher initial levels of somatic symptoms and depressed affect predicted a subsequent decline in memory, and higher initial levels of positive affect predicted subsequent better memory performance. Statistical adjustments for covariates (education and sex) had no significant influence on these associations. Conclusions: Our findings support a unidirectional association with higher depressive symptoms preceding a steeper decline in memory in older adults. We discuss the clinical implications for depressive symptoms as a predictor of subsequent memory decline.

Association of Coronary Artery Bypass Grafting vs Percutaneous Coronary Intervention With Memory Decline in Older Adults Undergoing Coronary Revascularization

It is uncertain whether coronary artery bypass grafting (CABG) is associated with cognitive decline in older adults compared with a nonsurgical method of coronary revascularization (percutaneous coronary intervention [PCI]). To compare the change in the rate of memory decline after CABG vs PCI. Retrospective cohort study of community-dwelling participants in the Health and Retirement Study, who underwent CABG or PCI between 1998 and 2015 at age 65 years or older. Data were modeled for up to 5 years preceding and 10 years following revascularization or until death, drop out, or the 2016-2017 interview wave. The date of final follow-up was November 2017. CABG (including on and off pump) or PCI, ascertained from Medicare fee-for-service billing records. The primary outcome was a summary measure of cognitive test scores and proxy cognition reports that were performed biennially in the Health and Retirement Study, referred to as memory score, normalized as a z score (ie, mean of 0, SD of 1 in a reference population of adults aged ≥72 years). Memory score was analyzed using multivariable linear mixed-effects models, with a prespecified subgroup analysis of on-pump and off-pump CABG. The minimum clinically important difference was a change of 1 SD of the population-level rate of memory decline (0.048 memory units/y). Of 1680 participants (mean age at procedure, 75 years; 41% female), 665 underwent CABG (168 off pump) and 1015 underwent PCI. In the PCI group, the mean rate of memory decline was 0.064 memory units/y (95% CI, 0.052 to 0.078) before the procedure and 0.060 memory units/y (95% CI, 0.048 to 0.071) after the procedure (within-group change, 0.004 memory units/y [95% CI, -0.010 to 0.018]). In the CABG group, the mean rate of memory decline was 0.049 memory units/y (95% CI, 0.033 to 0.065) before the procedure and 0.059 memory units/y (95% CI, 0.047 to 0.072) after the procedure (within-group change, -0.011 memory units/y [95% CI, -0.029 to 0.008]). The between-group difference-in-differences estimate for memory decline for PCI vs CABG was 0.015 memory units/y (95% CI, -0.008 to 0.038; P = .21). There was statistically significant increase in the rate of memory decline after off-pump CABG compared with after PCI (difference-in-differences: mean increase in the rate of decline of 0.046 memory units/y [95% CI, 0.008 to 0.084] after off-pump CABG), but not after on-pump CABG compared with PCI (difference-in-differences: mean slowing of decline of 0.003 memory units/y [95% CI, -0.024 to 0.031] after on-pump CABG). Among older adults undergoing coronary revascularization with CABG or PCI, the type of revascularization procedure was not significantly associated with differences in the change of rate of memory decline.

Associations of Vision Impairment and Eye Diseases With Memory Decline Over 4 Years in China and the United States

To examine whether vision impairment and eye diseases are independently associated with memory decline in older adults. Cohort study. We included 8,315 participants aged 50-94 years in China Health and Retirement Longitudinal Study (CHARLS) from China and 8,939 participants aged 50-95 years in Health and Retirement Study (HRS) from the United States in our analysis. During 4.0 years' follow-up, the composite memory decreased by 0.16 points in CHARLS. During 3.9 years' follow-up, the composite memory decreased by 0.51 in HRS. Distance vision impairment was inversely associated with an annual change in composite memory (β [95% CI]: -0.07 [-0.12, -0.01]) and immediate memory (-0.04 [-0.07, -0.02]) in CHARLS, and the corresponding values in HRS were -0.19 (-0.34, -0.05) and -0.07 (-0.13, -0.00), respectively. Near vision impairment was inversely associated with an annual change in delayed memory in CHARLS and composite memory, immediate memory, and delayed memory in HRS. In HRS, the association between distance vision impairment and memory decline was observed in individuals aged <65 years (β [95% CI]: -0.54 [-0.78, -0.30]) but not in those aged ≥65 years (-0.01 [-0.20, 0.18]). Cataract surgery or glaucoma was not significantly associated with memory decline in either CHARLS or HRS. Distance vision impairment was independently associated with an accelerated rate of memory decline in both China and the United States. Near vision impairment was predictive of decline in delayed memory in China and of decline in composite, immediate, and delayed memory in the United States.

The Factor Structure of Items Assessing Subjective Memory: Between-Persons and Within-Persons across Time

Introduction: Current understanding of the psychometric properties of items intended to assess the multidimensional construct of subjective memory (SM) is limited, as longitudinal studies of aging commonly use single items or brief sets of items to assess SM. Investigating how SM items cluster within individuals over time would increase the understanding of how combining these items impacts their utility as an early indicator of cognitive change in the aging trajectory. To address this need, the current study examined the factor structure of a brief set of SM items in an existing longitudinal study focused on cognitive aging at both the within-person and between-person levels. Methods: Data were drawn from the Einstein Aging Study, a longitudinal cohort study of aging (N = 1,239, M_age = 77.51, SD = 5.03; 69.50% white; 24.27% black; 6.23% other). Community-dwelling older adults from an urban area of New York City were interviewed annually. At each wave, participants responded to 6 items intended to assess SM. Items assessed participants’ perceived memory decline as well as current memory ability. Multilevel exploratory factor analyses examined which factor solution best fit the data at between-person and within-person levels. Results: Factor structure of the SM items varied at the two levels. At the within-person level, two factors emerged, whereas at the between-person level, a single factor best represented the SM items. Items assessing perceived declines in memory functioning tended to have similar trajectories, while items assessing current memory ability were less related to change over time. Conclusion: Items appeared to assess two different dimensions of SM when examining within-person changes in SM across time; however, the item structure suggested no other items covaried systematically within persons over time. In contrast to the conceptualization of SM as a multidimensional construct, our findings suggest that when measuring SM between individuals, SM items tend to capture a single dimension underlying SM. This may be due to the long retrospection period of items assessing perceived memory ability. A single item assessing perceived memory decline in older adults without evidence of objective cognitive impairment may be sufficient to monitor memory change in clinical or research settings.

Egg intake moderates the rate of memory decline in healthy older adults.

Eggs contain important compounds related to enhanced cognition, but it is not clear if egg consumption, as a whole, has a direct impact on memory decline in older adults. This study aimed to determine whether egg intake levels predict the rate of memory decline in healthy older adults after sociodemographic and dietary controls. We conducted a secondary analysis of data from 470 participants, age 50 and over, from the Biospsychosocial Religion and Health Study. Participants completed a food frequency questionnaire, which was used to calculate egg intake and divide participants into Low (<23 g/week, about half an egg), Intermediate (24-63 g/week, half to 1½ eggs) and High (≥63 g/week, about two or more eggs) tertiles. Participants were administered the California Verbal Learning Test - 2nd Edition (CVLT-II) Short Form in 2006-2007, and 294 of them were again tested in 2010-2011. Using linear mixed model analysis, no significant cross-sectional differences were observed in CVLT-II performance between egg intake levels after controlling for age, sex, race, education, body mass index, cardiovascular risk, depression and intake of meat, fish, dairy and fruits/vegetables. Longitudinally, the Intermediate egg group exhibited significantly slower rates of decline on the CVLT-II compared to the Low egg group. The High egg group also exhibited slower rates of decline, but not statistically significant. Thus, limited consumption of eggs (about 1 egg/week) was associated with slower memory decline in late life compared to consuming little to no eggs, but a dose-response effect was not clearly evident. This study may help explain discrepancies in previous research that did not control for other dietary intakes and risk factors.

Age-related alterations in functional connectivity along the longitudinal axis of the hippocampus and its subfields.

Hippocampal circuit alterations that differentially affect hippocampal subfields are associated with age-related memory decline. Additionally, functional organization along the longitudinal axis of the hippocampus has revealed distinctions between anterior and posterior (A-P) connectivity. Here, we examined the functional connectivity (FC) differences between young and older adults at high-resolution within the medial temporal lobe network (entorhinal, perirhinal, and parahippocampal cortices), allowing us to explore how hippocampal subfield connectivity across the longitudinal axis of the hippocampus changes with age. Overall, we found reliably greater connectivity for younger adults than older adults between the hippocampus and parahippocampal cortex (PHC) and perirhinal cortex (PRC). This drop in functional connectivity was more pronounced in the anterior regions of the hippocampus than the posterior ones, consistent for each of the hippocampal subfields. Further, intra-hippocampal connectivity also reflected an age-related decrease in functional connectivity within the anterior hippocampus in older adults that was offset by an increase in posterior hippocampal functional connectivity. Interestingly, the anterior-posterior dysfunction in older adults between hippocampus and PHC was predictive of lure discrimination performance on the Mnemonic similarity task (MST), suggesting a role in memory performance. While age-related dysfunction within the hippocampal subfields has been well-documented, these results suggest that the age-related dysfunction in hippocampal connectivity across the longitudinal axis may also contribute significantly to memory decline in older adults.

Combined genetic influences on episodic memory decline in older adults without dementia.

Although heritability explains a large proportion of the variance in old-age cognition, studies on the influence of specific genes have been inconclusive. We investigated the individual and combined effects of four single polymorphisms, previously associated with episodic memory, on cognitive performance and rate of change. Participants were 2490 individuals without dementia (mean age = 72 years) from the population-based Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Genotyping was performed for APOE (rs429358, rs7412), BDNF (rs6265), KIBRA (rs17070145), and CLSTN2 (rs6439886). We used latent difference score models to estimate the effects of age and genetic variation on level and change in five latent cognitive factors: episodic and semantic memory, letter and category fluency, and perceptual speed. Of the individual genes, only APOE was associated with cognitive performance; ε4 carriers showed lower perceptual speed performance and faster category fluency decline. A cumulative score, combining APOE, BDNF, KIBRA and CLSTN2, was associated with faster cognitive decline that was specific to the episodic memory domain (regression coefficient -0.064, p < .01). Similar results were obtained for a score not including APOE. Conclusions: Results suggest a benefit of investigating the combined influence of polymorphisms related to specific mechanistic factors. (PsycInfo Database Record (c) 2020 APA, all rights reserved).