List Recall Research Articles

Voice biomarkers in middle and later adulthood as predictors of cognitive changes.

Prosody voice measures, especially jitter and shimmer, have been associated with cognitive impairment and hold potential as early indicators of risk for cognitive decline. Prior research suggests that voice measures assessed concurrently with longitudinal cognitive outcomes are associated with 10-year cognitive declines in middle-age and older adults from Midlife in the U.S. (MIDUS) study. Using a subsample from the same study, we expanded previous research to examine voice measures that were (1) collected 8 years before cognitive outcomes, (2) derived from narrative speech in logical memory tests instead of word list recall tests, and (3) independent of the cognitive outcomes. Multilevel analyses controlled for covariates of age, sex, education, neurological conditions, depressive symptoms, and chronic conditions. The results indicated that higher jitter and lower shimmer predicted greater 10-year declines in episodic memory and working memory. These findings extend previous research by highlighting prosody voice measures assessed 8 years earlier as predictors of subsequent cognitive declines over a decade.

Individualized, cross-validated prediction of future dementia using cognitive assessments in people with mild cognitive symptoms.

We aimed to develop an algorithm to predict the individualized risk of future dementia using brief cognitive tests suitable for primary care. We included 612 participants with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) study, assessed for at least 4 years or until progression to dementia. A logistic regression model, using cognitive tests as predictors and dementia progression as an outcome, stratified participants into low, intermediate, or high risk. A second model, including 1-year cognitive test changes, was applied to the intermediate group. The models were replicated in 392 SCD/MCI participants from the BioFINDER-1 study. The best two-step model for predicting dementia incorporated Trail Making Test B (attention/executive function), Animal Fluency (verbal fluency), Mini-Mental State Examination (global cognition), and 10-word list recall (memory). The model's positive predictive value in ADNI was 85.8% and negative predictive value was 92.2% versus 62.5% and 95.6%, respectively, in BioFINDER-1. This two-step model accurately predicts individualized dementia risk. To our knowledge, this is the first algorithm for predicting all-cause dementia using a novel two-step model utilizing brief cognitive tests. Applying a validated model including the Trail Making Test B, Animal Fluency, MMSE, Alzheimer's Disease Assessment Scale delayed, and immediate recall can robustly and accurately categorize individuals into low, intermediate, or high risk of dementia progression and can facilitate clinical decision-making and personalized patient care. We created an app that is available for research and educational purposes at https://brainapps.shinyapps.io/PredictAllCauseDementia to provide an individualized risk score for dementia progression.

Suspected Pseudobulbar Affect in Neurodegenerative Disease.

To investigate the association between suspected pseudobulbar affect (PBA), clinical diagnosis, cognitive testing, and self-reported mood in older adults presenting for evaluation of dementia. Patients presenting to an outpatient memory disorders clinic (N=311). We used traditional and novel network modeling approaches to examine associations between neuropsychological (NP) tests, patient and clinician rating scales, and the Center for Neurological Study-Lability Scale (CNS-LS) among patients with suspected AD (n=133) and other neurocognitive diagnosis (n=178). We then examined differences in test performance between patients with and without suspected PBA (CNS-LS cut-off of ≥ 13), while accounting for demographic and psychiatric covariates with propensity score matching. Group differences were assessed with Bayesian models. Prevalence of suspected PBA in AD was slightly less than half (44.4%) and at a similar rate in other dementias (e.g., 46.9% in CVD and 45.5% in LBD). In network models, the CNS-LS was associated with higher anxiety and better word list recall. After accounting for covariates, AD patients with suspected PBA performed better on word list recall βM=0.40, 95% CI [0.15, 0.66], and committed fewer false positive errors on recognition βM=-1.51, 95% CI [-2.34, -0.59] than AD patients without suspected PBA. There were no differences in patients with any other diagnostic impression, nor group differences on other NP measures. Patients with suspected PBA and AD diagnosis had better memory recall and recognition than those without suspected PBA, suggesting that impaired emotional regulation may be an early sign of AD in patients with less prominent memory decline. Better understanding PBA in neurodegenerative diseases, including prevalence and comorbidity with psychiatric conditions, could help with early identification, education, and initiation of treatment.

Response to A Story During Cognitive Screening – Expression of the Inherent Awareness of Survival of Fellow Human Beings

Abstract Background The comprehensive assessment of cognition should include the immediate recall of information as well as that provided after delay. The phenomenon of patients providing intrusions is well recognised in the realm of cognitive assessment. Certain intrusions have been found to recur across patient performances. Methods Retrospective analysis was undertaken of patients (n=9) screened for dementia using the Repeatable Battery for the Assessment of Neuropsychological Status (Pearson) between 2022 and 2024. Data was sourced from MDT notes cataloguing the results of memory tests undertaken whereby the patient had added information regarding loss of life for persons involved in a fire. Data were elicited regarding List Learning (LL) and Recall; Story Memory and Recall, Figure Copy and Recall. The final sheet was used to elicit scores for each category. Results Median age was 76 (range 61-84 years). Male to female was 4:5. Patients were found to make a comment regarding loss of life e.g. ‘nobody was hurt’ where the information did not exist in the original story script. This occurred equally at Story Memory Stage and Story Recall Stage (77.7%). When compared with list and figure copy elements- only one patient also had errors in both LL and memory figure. Six patients had intrusion errors across other elements. Where the story was accentuated in both immediate and delayed recall stages- pts had intrusions in list learning (n=2, 22%) list recall (n=3, 33.3%) but no intrusions on Figure Copy- immediate or delayed. Conclusion Although this cohort of patients was small- each one of them included the status of life lost when given a short story to recite and then recall. These comments occurred both on immediate episodic recall and after delay and were not always associated with a replicated intrusion phenomena across other elements. This inherent interest in the survival of other humans is worth highlighting.

B - 118 Exploration of Supplemental Recognition Measures for the RBANS

Abstract Objective RBANS is a widely used cognitive screener that lacks memory recognition measures for 2 recall tasks. Performance on verbal and visual recognition measures, relative to recall, may help inform clinical decision-making and treatment planning. Our pilot project aims to understand how individuals with valid cognitive data and normal memory functioning perform on newly developed RBANS story and figure memory recognition tests. Method Of those referred for outpatient neuropsychological assessment at a veterans hospital between 2017–2024, 89 received the newly established recognition measures as part of their clinical evaluation. Our analysis included veterans that displayed valid profiles (TOMM trial 1 ≥ 45, n = 53). Assessment occurred 30% face-to-face and 70% telehealth. In addition to key demographic factors listed in table 1, race/ethnicity breakdown included: 92% White, 4% Black, 2% Asian, 2% Hispanic. These veterans were subdivided into 3 intact memory groups: list recall (≥ 25%ile, n = 31), story recall (≥ 25%ile, n = 37), figure recall (≥ 25%ile, n = 42) to determine average recognition performances across domains. Results The individuals with valid cognitive data and normal memory recall performed as listed in table 1. Although our novel story and figure recognition measures differ from those published in Duff et al. (2021), our pilot project data largely overlapped with their reported findings despite demographic differences. Conclusion(s) These novel recognition scores can help establish normal story and figure recognition performance to assist with clinical diagnosis and treatment planning. With greater and more diverse samples, we may be able to establish relative cut points for expected recognition memory performances across intact, amnestic/cortical, and vascular/subcortical.

B - 92 Memory Rehabilitation Following Stroke and Traumatic Brain Injury

Abstract Objective Several Meta analyses suggest mixed but objective support for internal strategies. Typically, successful rehabilitation involves at least 8 hour of memory training and often results in 0.25 to 0.50 standard deviation (SD) improvements depending on how long post injury. Intervention dose, strategies, level of impairment, and patient self-awareness and motivation all appear relevant. Methods Data is taken from 21 continuous referrals. Three individuals did not want to work on memory strategies, so their data was separated from the rest. Participants: 18 individuals with acquired brain injuries, with an average age of 51.6 and about 15 years of education, who were 76.6 days post brain injury. Intervention: Each individual was involved in 8 weeks of transdisciplinary rehabilitation. Many goals were addressed and memory rehabilitation was treated via 1 or 2 weekly sessions with a neuropsychologist. Internal and external strategy use was taught. Individuals received 8 to 10 hours of memory rehabilitation involving repetitive practice of clustering, semantic clustering, organizing information into sentences or stories, rhyming, and acronyms. Results Delayed List Recall significantly improved from standard scores of 73.5 to 89.7 and the delayed Story Recall improved from 75 to 90. The mean improvement was nearly 1 standard deviation across measures. Conclusions Individuals showed significant improvement in immediate and delayed recall memory scores. These individuals showed more than 0.5 SD short-term memory (STM) gain and also self-reported improved STM. Durability of gains was not measured in follow-ups. These interventions improve memory skills, but not all patients choose to participate in this type of treatment.

A - 15 Convergent Validity between Standard Neuropsychological Assessment and Web-Based Voice-Recognition Neuropsychological Assessment (Intraneuron)

Abstract Objective The prevalence of mild cognitive impairment (MCI) remains high, and often cases may go undetected. The gold standard for detection of cognitive decline is neuropsychological assessment. However, access to neuropsychological assessment can be impacted by geographic and financial limitations. Prior research has determined that electronic-based testing is effective in detecting cognitive change. This study aimed to investigate a convergent validity between standard neuropsychological assessment (SNA) and a web-based, voice-recognition neuropsychological assessment tool (Intraneuron). Method 75 participants from a community-based neurology practice completed SNA and Intraneuron. Intraneuron is comprised of an auditory list learning/recall test and verbal fluency tests (F/A/S, animals). Pearson correlations were conducted to examine the convergent validity between SNA and Intraneuron. A McNemar cross tabulation analysis was utilized to compare the proportions of detected “normal” and “abnormal” screening for SNA (based on clinical diagnosis) and Intraneuron (utilizing 1SD and 1.5SD below the mean as cutoffs). Results There were moderate, positive correlations between the SNA and Intraneuron: animals (r = 0.43, p < 0.001), F/A/S (r = 0.67, p < 0.001), delayed word list recall (r = 0.49, p < 0.001). The McNemar test showed that the classification between SNA and Intraneuron were similar at 1SD and 1.5SD. Conclusions The study demonstrated convergent validity SNA and Intraneuron. Results suggest that the Intraneuron is equivalent in the detection of early cognitive decline compared to SNA. This data provides support for the value of a web-based screening tool and the potential to maximize utilization across multiple settings and improve early detection of cognitive decline.

Connectome-based predictive modeling of brain pathology and cognition in Autosomal Dominant Alzheimer's Disease.

Autosomal Dominant Alzheimer's Disease (ADAD) through genetic mutations can result in near complete expression of the disease. Tracking AD pathology development in an ADAD cohort of Presenilin-1 (PSEN1) E280A carriers' mutation has allowed us to observe incipient tau tangles accumulation as early as 6 years prior to symptom onset. Resting-state functional Magnetic Resonance Imaging (fMRI) and Positron-Emission Tomography (PET) scans were acquired in a group of PSEN1 carriers (n=32) and non-carrier family members (n=35). We applied Connectome-based Predictive Modeling (CPM) to examine the relationship between the participant's functional connectome and their respective tau/amyloid-β levels and cognitive scores (word list recall). CPM models strongly predicted tau concentrations and cognitive scores within the carrier group. The connectivity patterns between the temporal cortex, default mode network, and other memory networks were the most informative of tau burden. These results indicate that resting-state fMRI methods can complement PET methods in early detection and monitoring of disease progression in ADAD.

Navigating the mind's eye: Understanding gaze shifts in visuospatial bootstrapping.

Visuospatial bootstrapping refers to the well-replicated phenomena in which serial recall in a purely verbal task is boosted by presenting digits within the familiar spatial layout of a typical telephone keypad. The visuospatial bootstrapping phenomena indicates that additional support comes from long-term knowledge of a fixed spatial pattern, and prior experimentation supports the idea that access to this benefit depends on the availability of the visuospatial motor system. We investigate this by tracking participants' eye movements during encoding and retention of verbal lists to learn whether gaze patterns support verbal memory differently when verbal information is presented in the familiar visual layout. Participants' gaze was recorded during attempts to recall lists of seven digits in three formats: centre of the screen, typical telephone keypad, or a spatially identical layout with randomised number placement. Performance was better with the typical than with the novel layout. Our data show that eye movements differ when encoding and retaining verbal information that has a familiar layout compared with the same verbal information presented in a novel layout, suggesting recruitment of different spatial rehearsal strategies. However, no clear link between gaze pattern and recall accuracy was observed, which suggests that gazes play a limited role in retention, at best.

Executive functions in children with developmental language disorder: a systematic review and meta-analysis.

The purpose of the current study was to assess the differences between children with developmental language disorder (DLD) and typically developing (TD) children in their performance of executive functions from working memory, inhibitory control, and cognitive flexibility. We performed a systematical search of PubMed, Embase, Cochrane, and Web of Science for case control studies (published in English between January 1, 1950, and October 11, 2023) comparing the differences in the performance of executive functions between DLD and TD children. Forty eligible studies were included in the present study (N = 3,168 participants). In comparison with TD children, DLD children exhibited significantly poorer performances in all six verbal working memory tasks (backward digit recall task, SMD -1.4321, 95% CI -2.2692 to -0.5950; listening recall task, SMD -1.4469, 95% CI -1.7737 to -1.1202; counting recall task, SMD -0.9192, 95% CI -1.4089 to -0.4295; digit recall task, SMD -1.2321, 95% CI -1.4397 to -1.0244; word list recall task, SMD -1.1375, 95% CI -1.5579 to -0.7171; non-word recall task, SMD -1.5355, 95% CI -1.8122 to -1.2589). However, regarding inhibitory control and cognitive flexibility, the differences between DLD and TD children depended on specific circumstances. In subgroup analyses of all verbal working memory tasks, DLD children presented notably lower performance than TD children in both the monolingual English and monolingual non-English groups, and in both the preschooler and school-aged groups. This study proves that verbal working memory deficits can be seen as a marker for children with DLD and are not affected by age or language type. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=391070, CRD42023391070.

The Relationship between Story Comprehension, Story Grammar Production, and Executive Function in Preschool-Age Korean-English Bilingual Children with and without Vocabulary Delay

Objectives: This study investigated the relationship between story comprehension and story grammar abilities, as well as executive function in preschool Korean-English bilingual children with vocabulary delay (VD) compared to typically developing (TD) children and examined predictors of their narrative abilities. Methods: A total of 30 children (13 children with VD, 17 TD children) aged from 4-6 years participated in the study. Children performed non-word repetition (NWR) and word list recall for verbal working memory, matrix for non-verbal working memory, fruit stroop for inhibition, and Dimensional Change Card Sort (DCCS) for shifting. They also performed story comprehension and story grammar production tasks in both languages to assess their narrative abilities. For data analyses, one-way ANOVA, Pearson correlation, and stepwise multiple regression were conducted. Results: The VD group showed significantly lower performance in working memory, inhibition, shifting tasks. Moreover, VD group had significantly lower performance in story comprehension and story grammar production tasks in both languages. In the TD group, Korean story comprehension performance was correlated with English story comprehension, Korean story grammar production, English story grammar production performances. On the other hand, in the VD group, only Korean story comprehension showed a significant correlation with Korean story grammar production performance. Lastly, matrix significantly predicted English story comprehension abilities and word list recall significantly predicted Korean story grammar production abilities in the TD group. Conclusion: By examining the relationship between children’s ability to understand stories, produce story grammar and sub-factors of executive function, we can improve the narrative education and intervention for bilingual children’s literacy and academic achievement in the future.

The benefits of memory control processes in working memory: Comparing effects of self-reported and instructed strategy use.

Working memory performance is often assumed to benefit from different maintenance control strategies such as rehearsal, refreshing, elaboration, and grouping. In studies assessing strategy self-reports, some strategies were indeed associated with better recall. Nevertheless, experimental studies assessing the effect of instructing maintenance strategies compared to a no-instruction baseline lend no evidence for the effectiveness of these strategies for working memory. Explanations for this contradiction could be that instruction implementation engenders dual-task costs or that strategy instructions reduce adaptive strategy switching. Across two experiments, we investigated the frequency and variability of strategy use with trial-wise self-reports in serial recall of word lists. Furthermore, we examined potential instruction costs by comparing performance in trials with self-reported versus instructed use of the same strategies. Self-reported strategy use varied from trial to trial, with elaboration and rehearsal being the most frequent. Self-reported elaboration was correlated with better performance than reading and rehearsal. For the most prevalent strategies-elaboration and rehearsal-there were no costs of instructed strategy implementation. Our results speak against dual-task costs and for the advantage of adaptively choosing one's own strategy from trial to trial. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Grouping in working memory guides chunk formation in long-term memory: Evidence from the Hebb effect

The Hebb effect refers to the improvement in immediate memory performance on a repeated list compared to unrepeated lists. That is, participants create a long-term memory representation over repetitions, on which they can draw in working memory tests. These long-term memory representations are likely formed by chunk acquisition: The whole list becomes integrated into a single unified representation. Previous research suggests that the formation of such chunks is rather inflexible and only occurs when at least the beginning of the list repeats across trials. However, recent work has shown that repetition learning strongly depends on participants recognizing the repeated information. Hence, successful chunk formation may depend on the recognizability of the repeated part of a list, and not on its position in the list. Across six experiments, we compared these two alternatives. We tested immediate serial recall of eight-letter lists, some of which partially repeated across trials. We used different partial-repetition structures, such as repeating only the first half of a list, or only every second item. We manipulated the salience of the repeating structure by spatially grouping and coloring the lists according to the repetition structure. We found that chunk formation is more flexible than previously assumed: Participants learned contiguous repeated sequences regardless of their position within the list, as long as they were able to recognize the repeated structure. Even when the repeated sequence occurred at varying positions over repetitions, learning was preserved when the repeated sequence was made salient by the spatial grouping. These findings suggest that chunk formation requires recognition of which items constitute a repeating group, and demonstrate a close link between grouping of information in working memory, and chunk formation in long-term memory.

The Effect of Psychological Resilience on Cognitive Decline in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study.

Chronic stress is associated with an increased risk of cognitive impairment and Alzheimer's disease. This study aimed to assess whether better coping with stress, as assessed using the Brief Resilience Scale (BRS), is associated with slower cognitive decline in community-dwelling older adults. This study used 2018/2019 data and 2-year follow-up data from the Korean Frailty and Aging Cohort Study. Of the 3,014 total participants, we included 1,826 participants (mean age, 77.6±3.7 years, 51.9% female) who completed BRS and Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Battery and the Korean version of the Frontal Assessment Battery (FAB). Higher BRS score at baseline was associated with a lesser decline in the Mini-Mental State Examination score over 2 years after adjusting for age, sex, years of education, smoking status, hypertension, diabetes, and depression (B, 0.175; 95% confidence interval, 0.025-0.325) for 2 years, which represents global cognitive function. Other cognitive function measurements (Word List Memory, Word List Recall, Word List Recognition, Digit Span, Trail Making Test-A, and FAB) did not change significantly with the BRS score at baseline. These findings suggest that better stress-coping ability, meaning faster termination of the stress response, may limit the decline in cognitive function.

Structure-Function Interactions in the Hippocampus and Prefrontal Cortex Are Associated with Episodic Memory in Healthy Aging.

Aging comes with declines in episodic memory. Memory decline is accompanied by structural and functional alterations within key brain regions, including the hippocampus and lateral prefrontal cortex, as well as their affiliated default and frontoparietal control networks. Most studies have examined how structural or functional differences relate to memory independently. Here we implemented a multimodal, multivariate approach to investigate how interactions between individual differences in structural integrity and functional connectivity relate to episodic memory performance in healthy aging. In a sample of younger (N = 111; mean age, 22.11 years) and older (N = 78; mean age, 67.29 years) adults, we analyzed structural MRI and multiecho resting-state fMRI data. Participants completed measures of list recall (free recall of words from a list), associative memory (cued recall of paired words), and source memory (cued recall of the trial type, or the sensory modality in which a word was presented). The findings revealed that greater structural integrity of the posterior hippocampus and middle frontal gyrus were linked with a pattern of increased within-network connectivity, which together were related to better associative and source memory in older adulthood. Critically, older adults displayed better memory performance in the context of decreased hippocampal volumes when structural differences were accompanied by functional reorganization. This functional reorganization was characterized by a pruning of connections between the hippocampus and the limbic and frontoparietal control networks. Our work provides insight into the neural mechanisms that underlie age-related compensation, revealing that the functional architecture associated with better memory performance in healthy aging is tied to the structural integrity of the hippocampus and prefrontal cortex.

Research on personalized recommendation of teaching resources based on joint probability matrix decomposition model and CNN improvement algorithm

Abstract This study proposes a teaching resource recommendation method (TRRDLMF) based on deep learning and probabilistic matrix decomposition, aiming to improve teaching resource recommendation’s accuracy and personalization level. The study combines hybrid neural network feature extraction of teaching resources and user feature extraction based on extended noise-reducing self-encoder and extended probabilistic matrix decomposition-based teaching resource recommendation technique. The study validates the model’s effectiveness by conducting empirical analyses on four online learning platform datasets of different sizes. The recommendation system can effectively track learners’ knowledge mastery status and learning preferences, and provide corresponding teaching resources. Test question similarity and difficulty analysis results show that the model can accurately capture the correlation between test questions and provide complementary data in education. The personalized recommendation analysis reveals the learners’ knowledge preference states that change with learning, demonstrating the model’s ability to give explanations at the level of learners’ knowledge preferences. The analysis of the impact of data size on recommendation results shows that the recommender system can achieve up to 73.12% accuracy and 97.89% recall for different TOP-K recommendation lists, with the best F-value at TOP-6. The personalized recommendation system for teaching resources based on the joint probability matrix decomposition model and CNN improvement algorithm proposed by the research demonstrates significant effects in improving the accuracy and personalization level of teaching resources recommendation, which helps learners to acquire suitable learning resources more efficiently, and has high practical value and promotion potential.

Does semantic similarity affect immediate memory for order? Usually not, but sometimes it does.

Recall performance in working memory (WM) is strongly affected by the similarity between items. When asked to encode and recall list of items in their serial order, people confuse more often the position of similar compared to dissimilar items. Models of WM explain this deleterious effect of similarity through a problem of discriminability between WM representations. In contrast, when lists of items that are all semantically similar are compared to lists of dissimilar items, semantic similarity does not negatively impact order memory, questioning the idea that semantic information is part of the WM content. This study reports four experiments in which semantic similarity was manipulated using lists composed of multiple semantic categories. These experiments revealed two main patterns. First, semantic similarity can increase, rather than decrease, order memory. Second, semantic knowledge reliably constrains the way items migrate; when migrating, items tend to do so more often toward the position of other similar items, rather than migrating toward other dissimilar items. These results challenge the way current models of WM represent similarity. The plausibility of different theoretical accounts and mechanisms is discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

초등 1-4학년 언어발달지연 아동과 일반 아동의 이야기 산출 회상 능력과 작업기억과의 관계

This study investigated the relationship between narrative skills and working memory in
 typically developing children and children with language delay. The macrostructure of narrative was
 analyzed through story grammar scores, and the microstructure was measured using measures of
 mean length of utterance (MLU-m), number of different words (NDW), and syntactic complexity
 (T-unit). Additionally, this study aimed to identify the cognitive variables related to narrative skills,
 specifically phonological working memory, spatial working memory, and the episodic buffer.
 A total of 112 children in the age range of 6-10 years from Seoul participated in the study,
 with 81 being typically developing children and 31 having delayed language development. All
 participants completed tasks related to narrative production, recall, and working memory.
 The study’s results revealed that the typically developing children group showed significantly
 higher scores in story grammar, lexical diversity (NDW), and syntactic complexity (MLU) compared
 to the group with delayed language development. Additionally, the typically developing children
 group demonstrated a significantly higher performance in non-word repetition, the matrix task, and
 word list recall tasks compared to the language delay group. Within the typically developing
 children group, significant positive correlations were observed between the lexical diversity and
 episodic buffer, as well as between the visuospatial working memory and narrative recall task. In
 the language delay group, a significant positive correlation was found between story grammar
 scores in the narrative production task and episodic buffer. A positive correlation between mean
 length of utterance in the production task and spatial working memory was found.. Additionally,
 the episodic buffer significantly predicted lexcial diversity and story grammar.

Association Between Executive Dysfunction-Related Activities of Daily Living Disability and Clinical Dementia Rating Domain Patterns in Patients With Vascular Dementia and Age-Matched Patients With Alzheimer's Dementia.

Although the Clinical Dementia Rating (CDR) scale was originally developed to stage Alzheimer's dementia (AD), it is now used globally for various types of dementia. The aim of this study was to investigate the characteristic pattern of CDR domains and its association with neuropsychological findings and activities of daily living (ADL) in patients with vascular dementia (VaD) and patients with AD. We recruited very mild to mild VaD and AD patients who were age-matched among the first visitors to a dementia clinic. All subjects underwent a standardized clinical interview, physical and neurological examinations, and laboratory tests, including brain magnetic resonance imaging, according to the protocol of the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease assessment battery. A total of 105 pairs of VaD and AD patients participated in this study. Although the adjusted scores on Korean version of the Mini-Mental State Examination were similar between the two groups, the VaD patients performed better on the Boston Naming Test, Word List Memory, Word List Recall, Word List Recognition, and Constructional Recall Test. However, the scores on global CDR, CDR sum of boxes, and ADL-related CDR domains were higher in VaD patients than in AD patients (p<0.001). The VaD patients also showed poor performances on the Disability Assessment for Dementia Scale, Frontal Assessment Battery, Executive Clock Drawing Task, and Stroop tests. Despite similar general cognitive function and better memory function, patients with VaD tend to be staged as severer dementia on the CDR scale than patients with AD because of more impaired ADL associated with executive dysfunction.

EFFECTS OF SELF-PERCEPTIONS OF AGING ON COGNITIVE HEALTH: MEDIATING ROLE OF SOCIAL ISOLATION AND LONELINESS

Abstract Cognitive decline is one of the most common age-related stereotypes. The stereotype embodiment theory suggests that negative age stereotypes can be internalized through socialization and become negative self-perceptions of aging (SPA). However, the potential mediating role social relationships play between SPA and cognitive health remains unclear. Using three-wave data spanning eight years (2008/2010 – 2016/2018) from the Health and Retirement Study, this study aims to examine (1) SPA’s long-term effects on changes in cognitive health; and (2) the mediating role of social isolation and loneliness (N = 3,569, Mage = 72.30). SPA was measured by an 8-item scale. Cognitive health was measured by immediate and delayed word list recall. Social isolation was measured using network size, network diversity, frequency of contact with networks, and frequency of social participation. Loneliness was measured using the 11-item UCLA Loneliness scale. We controlled for baseline measures of the dependent variables and health-related and sociodemographic covariates. We found that negative SPA at baseline was associated with memory decline eight years later (b = -0.03, SE = 0.02, p &amp;lt; 0.05). The path analysis revealed that social isolation and loneliness were mediators between SPA and cognitive health, with social isolation accounting for 15% and loneliness accounting for another 32% of the total effects. The results suggest that social isolation and loneliness are pathways by which SPA exerts adverse effects on memory among older adults. Negative SPA should be a target for intervention. In addition, social relationship building could alleviate the impact of SPA on cognitive health.