Objective Memory Function Research Articles

Influence of psychological factors on the relationship between subjective and objective memory in adults with pharmacoresistant temporal lobe epilepsy

PurposeMany adults with temporal lobe epilepsy (TLE) report subjective cognitive impairment; however, prior studies have shown a discrepancy between these subjective complaints and objective cognitive deficits on neuropsychological measures. Mood disorders/symptoms are also common in TLE and have been linked to greater subjective cognitive difficulties. To further understand these relationships, this retrospective study sought to determine if symptoms of depression and anxiety moderate or mediate the relationship between subjective cognitive impairment and objective cognitive performance in adults with TLE. MethodParticipants were 345 adults (mean age = 40.7; 55 % female) with pharmacoresistant TLE who completed self-report screening measures of depression, anxiety, and subjective cognitive function along with objective memory measures as part of a pre-surgical clinical neuropsychological evaluation. A series of linear regression analyses was conducted to examine the potential moderating and mediating effects of mood on the relationship between subjective and objective memory function after adjusting for relevant covariates. ResultsConsistent with existing literature, self-reported depression and anxiety symptoms were significantly correlated with subjective memory difficulties across all scales (all p < .001). Subjective memory impairment was also significantly correlated with objective memory performance on neuropsychological measures, albeit with small effect sizes (estimate range 0.04-0.20). Contrary to our hypothesis, depression and anxiety did not moderate or mediate the relationship between subjective memory complaints and objective memory performance. ConclusionsWhile symptoms of depression and anxiety were associated with subjective memory ability in this cohort of adults with TLE, this study suggests that mood symptoms do not fully explain the relationship between subjective and objective memory function, likely reflecting the complex and multifactorial relationships among these variables. Nevertheless, our results highlight the importance of screening for depression and anxiety symptoms and assessing patients' subjective memory complaints as part of a neuropsychological evaluation as each of these factors tap into a different aspect of the patient functioning.

B - 82 Relations between Subjective and Objective Memory Functioning: Investigating Psychometric Equivalence across Race Using Structural Equation Models.

We assessed the relations between the Subjective Memory Complaints Questionnaire (SMCQ) and the Spanish English Verbal Learning Test (SEVLT) for equivalence across race. Secondary objectives include evaluating the SMCQ for measurement invariance across race. The current study accessed data from the University of North Texas Health Science Center's Health and Aging Brain Study - Health Disparities (HABS-HD). We used structural equation modeling (SEM) to test the SMCQ for measurement invariance across Black (n = 515), Hispanic (n = 1104), and White (n = 1096) Americans. We first specified a configural model to assess the fit of the underlying structure across groups, followed by a scalar model to determine whether scores reflect comparable levels of the latent construct. Next, we regressed the SEVLT on the SMCQ to test the relation between subjective and objective memory functioning. Lastly, we specified a multigroup SEM to compare unconstrained and constrained regression models across race. Full scalar invariance was tenable for the SMCQ (ΔCFI = 0.007, NCI = 0.023). There were significant negative relations between the SMCQ and the SEVLT for each group (Black: b = -2.31; Hispanic: b = -1.63; White: b = -2.72), but the relations were not equivalent across groups [χ2 diff (df) = 20.2.45 (2), p < 0.001]. Results suggest that the SMCQ can be administered to screen Black, Hispanic, and White individuals for memory functioning and that mean comparisons can be made. Differential regression coefficients suggest that clinical thresholds may need to be set independently across groups to promote clinical utility.

Discrepancy between subjective and objective memory change after epilepsy surgery: Relation with seizure outcome and depressive symptoms.

Complaints pertaining to memory functioning are among the most often reported cognitive symptoms in patients with epilepsy. However, research suggests a considerable mismatch between patients' perception of memory functioning and the objective performance as measured with standardized neuropsychological tests. Depressive mood might be an important factor in explaining this discrepancy, though other variables have also occasionally been reported as relevant. There are mixed results as to which role these factors play in determining the overall quality of life of patients with epilepsy. The present study aimed to quantify the mismatch between subjective and objective memory functioning by taking into account the dynamic change of these factors as well as depressive symptoms after epilepsy surgery. Moreover, the influencing factors of subjective and objective memory change were investigated as well as their effects on the overall quality of life. Pre- and postoperative data from 78 patients with focal epilepsy were retrospectively analyzed. The results showed that (1) patients with clinically relevant postoperative depressive symptoms underestimate their actual memory performance; (2) for non-seizure-free patients, a postoperative decrease in depressive symptoms was associated with a tendency to underestimate memory decline; (3) the relationship between objective memory change and quality of life is mediated by the factors subjective memory change and depressive mood. Our data demonstrate a quantitative approximation of a pronounced depression-related negative biased self-perception of memory functioning of roughly 1 to 1.5 standard deviations. Moreover, it seems that when patients are relieved of having recurrent epileptic seizures, they may be less influenced by depressive symptoms when judging their memory change. Taken together, our study demonstrates the clinical relevance of incorporating subjective measures of memory functioning and mood that go beyond objective memory performance for the interpretation of how changes in memory functioning may affect patients' quality of life after epilepsy surgery.

Duration of post-traumatic amnesia is uniquely associated with memory functioning in chronic moderate-to-severe traumatic brain injury

Disrupted memory circuitry may contribute to post-traumatic amnesia (PTA) after traumatic brain injury (TBI). It is unclear whether duration of PTA (doPTA) uniquely impacts memory functioning in the chronic post-injury stage. To examine the relationship between doPTA and memory functioning, independent of other cognitive abilities, in chronic moderate-to-severe TBI. Participants were 82 individuals (median chronicity = 10.5 years) with available doPTA estimates and neuropsychological data. Composite memory, processing speed (PS), and executive functioning (EF) performance scores, as well as data on subjective memory (SM) beliefs, were extracted. DoPTA-memory associations were evaluated via linear modeling of doPTA with memory performance and clinical memory status (impaired/unimpaired), controlling for PS, EF, and demographic covariates. Interrelationships between doPTA, objective memory functioning, and SM were assessed. DoPTA was significantly related to memory performance, even after covariate adjustment. Impairment in memory, but not PS or EF, was associated with a history of longer doPTA. SM was associated with memory performance, but unrelated to doPTA. Findings suggest a specific association between doPTA-an acute injury phenomenon-and chronic memory deficits after TBI. Prospective studies are needed to understand how underlying mechanisms of PTA shape distinct outcome trajectories, particularly functional abilities related to memory processing.

Subjective cognitive decline and objective cognition among diverse U.S. Hispanics/Latinos: Results from the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA).

IntroductionDespite increased risk of cognitive decline in Hispanics/Latinos, research on early risk markers of Alzheimer's disease in this group is lacking. Subjective cognitive decline (SCD) may be an early risk marker of pathological aging. We investigated associations of SCD with objective cognition among a diverse sample of Hispanics/Latinos living in the United States.MethodsSCD was measured with the Everyday Cognition Short Form (ECog‐12) and cognitive performance with a standardized battery in 6125 adults aged ≥ 50 years without mild cognitive impairment or dementia (x̄age = 63.2 years, 54.5% women). Regression models interrogated associations of SCD with objective global, memory, and executive function scores.ResultsHigher SCD was associated with lower objective global (B = −0.16, SE = 0.01), memory (B = −0.13, SE = 0.02), and executive (B = −0.13, SE = 0.02, p's < .001) function composite scores in fully adjusted models.DiscussionSelf‐reported SCD, using the ECog‐12, may be an indicator of concurrent objective cognition in diverse middle‐aged and older community‐dwelling Hispanics/Latinos.

Advances in Non-Pharmacological Interventions for Subjective Cognitive Decline: A Systematic Review and Meta-Analysis.

Subjective cognitive decline (SCD) is considered the earliest symptomatic manifestation of preclinical Alzheimer's disease (AD). Currently, given the lack of effective and curable pharmacological treatments for AD, non-pharmacological interventions (NPIs) for individuals with SCD may provide a valuable opportunity for the secondary prevention of AD. This systematic review and meta-analysis, conducted in accordance with the PRISMA guidelines, aimed to investigate the benefits of current NPIs in the population with SCD. The online electronic databases, including MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, PsycInfo, and CINAHL, were searched to identify randomized controlled trials of NPIs for SCD. Intervention strategies were psychological and health-related education interventions, mind-body therapy, lifestyle modification, cognitive training, and multidomain interventions. Outcomes included subjective memory, objective memory, global cognitive function, psychological well-being, and mood. Study quality was determined using the criteria of the Cochrane collaboration's tool. The Hedges' g of change was analyzed. Eighteen studies were included in this review and meta-analysis. Overall, psychological and health-related education interventions exhibited a medium effect on objective memory function (Hedges' g = 0.53, p = 0.01). Cognitive training led to a small effect on objective memory, which was marginal statistically (Hedges' g = 0.19, p = 0.05). In addition, cognitive training also significantly improved subjective memory performance (Hedges' g = 0.49, p = 0.0003) and psychological well-being (Hedges' g = 0.27, p = 0.03). Overall, the psychological intervention and cognitive training may be beneficial to cognitive function and psychological well-being. NPIs may be effectively implemented in older adults with SCD.

Shift-work-related sleep disruption and the risk of decline in cognitive function: The CRUISE Study.

Acute total sleep deprivation and partial sleep deprivation have negative impacts on cognitive performance. Studies in subjects who regularly experience sleep loss, however, are rare and often restricted to examination of internal sleeping disorders. To address this issue, we set up a pilot study to explore the effects of a week characterized by sleep disruption on cognitive functioning, using a case–control setting in a maritime pilot group with chronic exposure to intermittent extrinsic, work‐related sleep disruption. Twenty maritime pilots (aged 30–50 years) were compared to sex‐ and education‐matched controls with normal sleep behaviour, from the same age range. We assessed subjective and objective cognitive function, including attention, psychomotor speed, memory and executive function using the Cambridge Neuropsychological Test Automated Battery (CANTAB). Although we were able to confirm poorer sleep in maritime pilots and subjective complaints in some cognitive domains, we did not find objective cognitive deficits in the maritime pilot group compared to controls without sleep disruption. This could suggest that in this group of healthy, young maritime pilots, exposure to sleep disruption resulted in some subjective cognitive complaints, but objective deficits of cognitive function were not detected in comparison with a non‐pilot control group. However, given the small sample size, the absence of an effect does not exclude the possibility that sleep disruption could result in cognitive deficits in general. Therefore, our findings have to be confirmed in future prospective studies with a larger sample size and matched controls, regarding age, education and work history.

INVESTIGATING MODERATORS OF THE RELATIONSHIP BETWEEN SUBJECTIVE AND OBJECTIVE MEMORY

Subjective memory complaints (SMC) among older adults have been explored as an indicator of decline in objective memory functioning. While some research has found that SMC may be predictive of future cognitive impairment and dementia (Glodzik-Sobanska et al., 2007; Wang et al., 2004), others have suggested that SMC are common among healthy older adults (Cooper et al., 2011) and are not strongly related to objective memory performance. Researchers suggest that SMC may be more strongly related to affective factors (e.g., depression and anxiety; Rowell, Green, Teachman, & Salthouse, 2015). The current study examined the relationship between SMC, objective episodic memory performance (OEMP), along with depression and anxiety in a sample of 18-99 year olds (N = 5,430) from the Virginia Cognitive Aging Project (VCAP). Structural equation modeling with full information maximum likelihood estimation was used to investigate whether clinically-relevant depression and anxiety levels moderated the relationship between SMC and OEMP, controlling for age, education, gender, and health. OEMP was represented as a latent construct while the remaining variables were observed. Although depression and anxiety are significantly related to SMC (r’s = .29, .17, respectively), they are not correlated with OEMP. Furthermore, depression, but not anxiety, moderated the relationship between SMC and OEMP, such that those at risk for depression had a stronger relationship between SMC and OEMP (-.07, p<.05) compared to those not at risk (-.02, p=.31). This suggests that SMC may not be a valid indicator of OEMP as it may reflect variance from other sources, such as depression.

A-47 Self-reported Difficulties in Retrospective Memory Predict Poor Verbal Memory Performance

Abstract Objective Prospective and retrospective memory complaints are common among older adults with mixed results regarding their relationship with objective memory performance. This study investigated how subjective memory reports relate to objective memory function in a clinical sample. Method Participants (N = 139, Mage = 69.9, SD = 9.2) completed a cognitive screen at a university clinic. The assessment included the Hopkins Verbal Learning Test (verbal memory), the Brief Visuospatial Memory Test – Revised (visual memory) and the Prospective and Retrospective Memory Questionnaire, a subjective memory measure with higher scores indicating greater perceived difficulties. Correlations and linear regressions were used to evaluate the relationship between subjective and objective memory (a priori p-value = .01). Results Retrospective memory was correlated with immediate (r = -.35, p &lt; .001) and delayed verbal memory (r = -.31, p &lt; .001) but unrelated to visual memory (p &gt; .05). Prospective memory was not correlated with performance on visual or verbal memory tasks (p &gt; .05). Retrospective memory accounted for 12.3% of the variation in immediate (adjusted R2 = 11.6%; medium effect size), and 9.3% of the variation in delayed verbal memory (adjusted R2 = 8.6%; small effect size). Retrospective memory significantly predicted immediate [F(1, 132) = 18.48, p &lt; .001, 95% CI = -1.04 to -0.38] and delayed verbal memory scores [F(1, 132) = 13.51, p &lt; .001, 95% CI = -1.09 to -0.33]. Conclusions Subjective reports of retrospective memory may be a better indicator of objective verbal memory performance than prospective memory in a clinical sample of older adults.

The fear of Alzheimer’s disease: mediating effects of anxiety on subjective memory complaints

Objectives: To determine if the fear of developing Alzheimer’s disease (FDAD) construct, in combination with similar psychoemotional factors, could help elucidate the nature of older adults’ subjective memory complaints (SMCs) and subsequent objective memory performance.Methods: One hundred ninety-three healthy older adults (aged 65–93) were administered clinician and self-report measures of depression, worry, anxiety, illness attitudes, and memory, and each rated their concern with developing AD.Results: Self-reported FDAD was not associated with objective memory performance (p > .05). FDAD, trait anxiety, general anxiety, and general and illness-related worry were independently associated with subjective memory report (ps < .05). The relationship between FDAD and subjective memory report was mediated by measures of general trait and state anxiety, but not general worry or illness-specific worry.Conclusions: FDAD was not associated with objective memory functioning, suggesting AD concerns were not reflective of memory pathology. The mediating effect of anxiety on the relationship between FDAD and subjective memory report suggests that assessment of anxiety, beyond AD fear, may help identify older adults at risk for developing negative perceptions of memory and related distress.

Memory training for adults with probable mild cognitive impairment: a pilot study

Background & Objectives: This pilot study aimed to evaluate the efficacy of memory training and health training intervention over a 24-month period in people with probable mild cognitive impairment (MCI).Research Design & Methods: Based on the accepted criteria, and the neuropsychiatric measures used in the trial, MCI was defined as a subjective change in cognition, impairment in episodic memory, preservation of independence of functional abilities, and no dementia. Without a neurological assessment, laboratory tests, and psychometric evaluation combined, some of our participants may have had dementia that we were unable to detect through neuropsychological testing. Of the 263 total participants, 39 met criteria for a diagnosis of MCI. There were 19 adults in the memory and 20 in health training conditions. Both groups received twenty hours of classroom content that included eight hours of booster sessions at three months post intervention. Hierarchical linear models (HLM) and standardized regression-based (SBR) analyses were used to test the efficacy of the intervention on immediate recall, delayed recall, subjective memory complaints, and memory self-efficacy. Age, education, depression, racial group, ethnic group, MMSE score, and baseline performance were included as covariates.Results: Over 24 months, the MCI group in the memory training condition showed better objective and subjective memory outcomes compared with the MCI group in the health training condition.Conclusions: Senior WISE Memory training delivered to individuals with MCI was able to forestall the participants’ declining cognitive ability and sustain the benefit over two years in both subjective and objective memory function.

Study on the influencing factors of subjective memory complains in community elderly

Objective To explore the level of the subjective memory complaints and its influencing factors among the elderly people in the community. Methods The Memory Satisfaction of the Muti-factorial Memory Questionnaire was to evaluate the subjective memory complaints of the community elders, the objective memory function and general cognitive function were evaluated by the Auditory Verbal Learning Test (AVLT) and Mini-mental State Examination (MMSE) respectively, the depression was evaluate by the Geriatric Depression Scale (GDS-1), and the general population was collected by the general information questionnaire. Results The incidence of subjective memory complaints in the community was 76%, multiple regression analysis showed that GDS score (β=-0.522, P<0.001) , gender (β=0.137,P<0.05) and AVLT delayed recall score (β=0.136,P<0.05) were the main complaints of subjective memory in the elderly influencing factors. Conclusion Depression and objective memory are the main influencing factors of elderly subjective memory complaints, suggesting that when developing a primary preventive strategy, consideration should be given to cognitive screening of elderly people who with subjective memory complains and inclusion of prevention and management as a risk population for dementia, with a focus on providing health services and family visits. Key words: Subjective memory complain; Depression; Influencing factors; Primary prevention

Methodological Influences on the Association Between Self-Rated and Objective Memory Functioning

Methodological Influences on the Association Between Self-Rated and Objective Memory Functioning

23 Long-term follow-up in transient epileptic amnesia: prognosis over 10–20 years

Objective Transient Epileptic Amnesia (TEA) is a form of adult onset temporal lobe epilepsy characterised by ictal amnesia, which is often accompanied by interictally memory disturbances of autobiographical amnesia and accelerated long-term forgetting. Short-term follow-up studies conducted 1–2 years after commencing anticonvulsant therapy, suggest good seizure control, together with a relatively stable cognitive profile. Recent case reports, however, have raised concerns regarding a risk of developing Alzheimer’s Disease (AD). This paper reports on the clinical and cognitive outcome of TEA patients over a 10 to 20 year period. Method Two cohorts of TEA participants were studied at 10 year intervals: an initial cohort of 10 patients (C1), followed up at 10 and 20 years; and an additional 42 patients (C2), followed up at 10 years only. Information regarding clinical outcomes (mortality, seizure history and subjective reports of memory functioning) was gained via GP records and clinical interview. Objective memory function was determined at each time point via a comprehensive neuropsychological assessment, where possible. Results were compared with age-matched healthy control participants. Results Information was available for 9 patients from C1 (90%), and 37 (88%) from C2. In C1, 4 participants (40%) had died over the 20 year period, with no indication of dementia prior to death (mean age at death =82 years). One participant was diagnosed with Vascular Dementia. In C2, 15 participants (40%) had died, including one patient with AD (mean age of death =81 years). Dementia was diagnosed in a further 5 patients (3 with AD). Seizures were generally well controlled in both cohorts. Subjective memory complaints were significantly greater in TEA patients than matched controls, although reports varied in both C1 and C2, ranging from no concerns through to either stable memory difficulties, or worsening memory. Neuropsychological assessment showed no evidence of a general cognitive decline at either the 10- or the20-year follow up, with TEA participants performed similarly to healthy controls on the majority of standard neuropsychological tests. Within the memory domain, both TEA cohorts included patients with stable memory performance over time relative to healthy controls, as well as those showing impairments on one or more memory measures. Additional impairments in other cognitive domains (typically executive function) were observed in some patients. Conclusion Despite concerns raised regarding dementia, the prognosis of TEA appears relatively benign. While persistent memory difficulties are a common outcome, the prevalence of dementia in TEA does not exceed population prevalence data.

INVESTIGATING THE PROGNOSIS OF TRANSIENT EPILEPTIC AMNESIA: DOES IT LEAD TO ALZHEIMER’S DISEASE?

Transient Epileptic Amnesia (TEA) is a form of temporal lobe epilepsy characterised by seizure-induced amnesia, often accompanied by ongoing memory disturbances of autobiographical amnesia and accelerated long-term forgetting. Short-term follow-up, 1–2 years after commencing anticonvulsant therapy, suggests a relatively stable cognitive profile. Recent case reports, however, have raised concerns regarding a risk of developing Alzheimer's Disease (AD). This paper reports on the clinical and cognitive outcome of TEA patients over a 10 to 20-year period. Two cohorts of TEA participants were studied at 10-year intervals: an initial cohort of 10 patients (C1), followed up at 10 and 20- years; and an additional 42 patients (C2), followed up at 10 years only. Information regarding clinical outcomes was gained via GP records and clinical interview. Objective memory function was determined at each time point via comprehensive neuropsychological assessment, where possible. Patients were compared with age-matched healthy control participants. Clinical information was available for 9 patients from C1 (90%), and 37 (88%) from C2. In C1, there was no indication of AD in the 4 participants (40%) who had died (mean age at death = 82 years). One participant was diagnosed with Vascular Dementia. In C2, 15 participants (40%) had died, including one patient with AD (mean age of death = 81 years). Dementia was diagnosed in a further 5 patients (3 with AD). Subjective memory complaints were significantly greater in TEA patients than matched controls, although some reported no concerns or stable memory difficulties. Neuropsychological assessment showed no evidence of a general cognitive decline, with TEA participants performing similarly to healthy controls on the majority of tests. Within the memory domain, both TEA cohorts included patients with stable memory performance over time relative to healthy controls, as well as patients showing impairments on one or more memory measures. Additional impairments in other cognitive domains (typically executive function) were observed in some patients. Despite concerns raised regarding dementia, the prognosis of TEA appears relatively benign over the long term. While persistent memory difficulties are common, the prevalence of dementia in TEA does not exceed population prevalence data.

SELF-REPORTED PHYSICAL ACTIVITY IS ASSOCIATED WITH TAU BURDEN AS MEASURED BY PET

Previous reports suggest physical activity (PA) may influence cognitive function and Alzheimer's disease risk. Furthermore, numerous animal studies report wheel-running reduces the accumulation of Alzheimer's disease pathology, including brain Ab-amyloid (Ab) and tau. We previously reported a relationship between PA and lower brain Ab burden. The recent advent of tau positron emission tomography (PET) tracers enables us to extend our investigations into the evaluation of the relationship between PA and tau burden. Data from 88 cognitively healthy older adults of the Australian Imaging Biomarker and Lifestyle Study were used to evaluate the cross-sectional relationship between PA and tau burden. Self-reported PA was used to categorise participants into low-moderate PA (LMPA; n=40) or high PA (HPA; n=48). All participants also underwent Ab PET imaging with either 18F-flutemetamol or 18F-florbetapir, and tau PET imaging with one of three tau tracers: 18F-AV1451 (n=43), 18F-THK5317 (n=24), or 18F-THK5351 (n=21). Ab-negative controls were used to generate cortical tau z-scores (excluding mesial temporal lobe), allowing the combination of results from the three tracers. A linear regression was undertaken with cortical tau z-score entered as the dependent variable, and PA, age, gender, apolipoprotein E ɛ4 allele, BMI, composite memory score, Ab burden, and a Ab burden*PA interaction term entered into the model. The LMPA group had higher mean cortical tau burden (z-score:1.87±2.30), compared to the HPA group (z-score:0.57±1.64; F=5.47, p=0.02). A significant interaction was found between Ab burden*PA (F=10.24, p=0.002): Although the expected significant association between tau and Ab burden was found in the LMPA group, there was no association between tau and Ab burden in the HPA group. Our results indicate high PA is associated with lower brain tau. Given that the association between PA and tau was not altered following adjustment for objective memory function, our results suggest that higher PA alters tau aggregation or deposition. Our results also indicate high PA alters the association between brain Aβ and tau. Future longitudinal and interventional studies are vital to further investigate the relationship between tau, Aβ and PA.

Memory and Cognitive Function of Older Adults according to Subjective Memory Decline, Depression

Objectives: The present study was to examine the differences in objective memory and cognitive function between groups by classifying the groups according memory decline and depression. Methods/Statistical Analysis: One hundred and five subjects of older adult group who agreed to participate in this study were selected. One-on-one interviews were conducted using a questionnaire on subjective memory decline, depression and objective memory by researchers. Data were analyzing with ANOVA and post-hoc test with the SPSS 22. Findings: The subjects were divided into 4 groups based on the presence absence of subjective memory decline and depression. The group with subjective memory decline and depression had statistically significantly lower scores in immediate recall, delayed recall and verbal fluency than the normal group. The group with depression only had a significantly higher mean for verbal fluency than the group with both subjective memory decline and depression. The normal group had a significantly higher mean for delayed recall than the group with subjective memory decline. There was no difference between the groups in the total MMSE-K1 score measuring the relatively-generalized cognitive function and MMSE-K1 recall measuring among MMSE-K1 sub-areas. In the presence of subjective memory decline, it is important to consider depression. If depression is involved in subjective memory decline, there were notable differences in the subjective memory compared with normal persons. Improvements/Applications: In this study, only depression was considered among emotional problems and although there are many reports indicating that anxiety may affect memory, the association between anxiety and memory was not considered.

Transient Epileptic Amnesia over twenty years: Long-term follow-up of a case series with three detailed reports

PurposeTransient Epileptic Amnesia (TEA) is a form of adult onset temporal lobe epilepsy characterised by ictal amnesia. The amnesic seizures are often accompanied by interical memory disturbance, involving autobiographical amnesia and accelerated long-term forgetting. Short-term follow-up studies suggest a relatively stable cognitive profile once treated, but recent case reports raise concerns regarding the risk of developing Alzheimer’s disease (AD). The current study reports clinical and cognitive outcome in TEA patients over a 20-year period. MethodsA cohort of ten TEA patients first reported in 1998 were followed up at two time intervals, each 10 years apart. Information regarding clinical outcomes and subjective reports of memory functioning was gained via GP records and clinical interview. Objective memory function was determined at each time point via a comprehensive neuropsychological assessment, where possible. ResultsInformation was obtained for nine of the original 10 participants. Over the 20-year period, 4 participants died, with no indication of dementia prior to death. One participant was diagnosed with Vascular Dementia. Seizures were generally well controlled. Subjective reports of memory varied, including no concerns, stable memory difficulties, and worsening memory. Neuropsychological assessment at 10 years showed stable performances across most measures. At the 20-year follow up, there was no evidence of a general cognitive decline. Participants showed stability on some measures, with reductions on others. Performance was not consistent with AD. ConclusionsNo elevated risk of dementia was evident from this TEA series. Although memory difficulties persist over time, the prognosis of TEA appears generally benign.

Prevalence and predictors of subjective memory complaints in adult male carriers of the FMR1 premutation

Objective: To examine the prevalence and predictors of subjective memory complaints among a cohort of male FMR1 premutation (PM) carriers with and without fragile X-associated tremor ataxia syndrome (FXTAS). Method: Twenty-two PM males (ages 26–80, 7 with FXTAS) and 24 matched controls with normal FMR1 alleles (ages 26–77) completed cross-sectional assessments of subjective memory complaints (memory complaints questionnaire, MAC-Q), objective memory function (Logical Memory subtest from the Wechsler Memory Scale, third edition), and psychiatric symptoms (Depression, Anxiety, and Stress Scales; the Structured Clinical Interview for DSM-IV-TR Axis I Disorders). Results: Although a greater proportion of PM males (36%) endorsed subjective memory complaints compared to controls (21%), formal statistical comparisons failed to reach significance. Multiple linear regression analyses revealed that subjective memory complaints were not associated with objective memory performance, but rather were predicted by elevated psychiatric symptoms. The relationship between psychiatric symptoms and subjective complaints found in the PM group was not statistically different to that found in the control group. There were no significant relationships between FMR1 molecular measures (CGG repeat length, FMR1 mRNA level) and measures of subjective memory complaints, objective memory performance, or psychiatric symptoms. Conclusions: In keeping with findings from the general population, this study suggests that subjective ratings of memory performance in PM males are associated with underlying psychological factors rather than cross-sectional objective memory function. However, future longitudinal studies are required to determine whether subjective memory complaints may predict changes in objective memory function over time.

The Relieving Effects of BrainPower Advanced, a Dietary Supplement, in Older Adults with Subjective Memory Complaints: A Randomized, Double-Blind, Placebo-Controlled Trial.

Subjective memory complaints (SMCs) are common in older adults that can often predict further cognitive impairment. No proven effective agents are available for SMCs. The effect of BrainPower Advanced, a dietary supplement consisting of herbal extracts, nutrients, and vitamins, was evaluated in 98 volunteers with SMCs, averaging 67 years of age (47–88), in a randomized, double-blind, placebo-controlled trial. Subjective hypomnesis/memory loss (SML) and attention/concentration deficits (SAD) were evaluated before and after 12-week supplementation of BrainPower Advanced capsules (n = 47) or placebo (n = 51), using a 5-point memory questionnaire (1 = no/slight, 5 = severe). Objective memory function was evaluated using 3 subtests of visual/audio memory, abstraction, and memory recall that gave a combined total score. The BrainPower Advanced group had more cases of severe SML (severity ⩾ 3) (44/47) and severe SAD (43/47) than the placebo group (39/51 and 37/51, < 0.05, < 0.05, resp.) before the treatment. BrainPower Advanced intervention, however, improved a greater proportion of the severe SML (29.5%)(13/44) (P < 0.01) and SAD (34.9%)(15/43)(P < 0.01) than placebo (5.1% (2/39) and 13.5% (5/37), resp.). Thus, 3-month BrainPower Advanced supplementation appears to be beneficial to older adults with SMCs.