Word Recall Research Articles

On the Feasibility of Using Behavioral Listening Effort Test Methods to Evaluate Auditory Performance in Cochlear Implant Users.

Realistic outcome measures that reflect everyday hearing challenges are needed to assess hearing aid and cochlear implant (CI) fitting. Literature suggests that listening effort measures may be more sensitive to differences between hearing-device settings than established speech intelligibility measures when speech intelligibility is near maximum. Which method provides the most effective measurement of listening effort for this purpose is currently unclear. This study aimed to investigate the feasibility of two tests for measuring changes in listening effort in CI users due to signal-to-noise ratio (SNR) differences, as would arise from different hearing-device settings. By comparing the effect size of SNR differences on listening effort measures with test-retest differences, the study evaluated the suitability of these tests for clinical use. Nineteen CI users underwent two listening effort tests at two SNRs (+4 and +8 dB relative to individuals' 50% speech perception threshold). We employed dual-task paradigms-a sentence-final word identification and recall test (SWIRT) and a sentence verification test (SVT)-to assess listening effort at these two SNRs. Our results show a significant difference in listening effort between the SNRs for both test methods, although the effect size was comparable to the test-retest difference, and the sensitivity was not superior to speech intelligibility measures. Thus, the implementations of SVT and SWIRT used in this study are not suitable for clinical use to measure listening effort differences of this magnitude in individual CI users. However, they can be used in research involving CI users to analyze group data.

Lending a hand to speech

Abstract This study examines the effect of gestures on second language (L2) pitch measures and fluency in storytelling tasks. It is well documented that L2 learners commonly use gestures in conversations and storytelling. Research has shown that gestures benefit L2 word learning and recall, but it is still unclear to what extent gestures affect speech fluency and pitch range. We compared a series of speech fluency and pitch measures across two storytelling tasks: task repetition and explicit instruction on the use of gestures. By analysing the use of gestures in these tasks, we provide insights on how gestures can help L2 fluency and intonation.

A Cross-Sectional Study of Cognitive Function, Illness Perceptions, and Immunosuppression Medication Adherence After Heart Transplantation.

There are few studies that examine relationships between cognitive function, illness perceptions, and medication adherence after heart transplantation, limiting the development of effective adherence-promoting interventions. The purpose of this study was to describe relationships between cognitive function, illness perceptions, and medication adherence among heart transplant recipients. A cross-sectional, observational design was used. Measures included the telephone-Montreal Cognitive Assessment (t-MoCA©), Patient Health Questionnaire-9, Brief Test of Adult Cognition by Telephone, Basel Assessment of Adherence to Immunosuppressive Medications Scale, and the Brief Illness Perceptions Questionnaire. Descriptive statistics, point-biserial correlations, Pearson's correlations, and logistic regression were used to describe relationships. Of the 35 participants (mean age: 61 years [SD: 10.3], 71.4% male, 71.4% white), 31.4% (n = 11) were classified as nonadherent to their immunosuppression medications. Higher immediate word recall, indicating better episodic memory (memory for autobiographical and recent events), and higher illness coherence scores were associated with not missing doses of medication. Higher t-MoCA© total scores, indicating normal cognitive function, and lower depression scores were associated with taking medications on time. More than 22% (n = 8) of participants scored less than 19 on the t-MoCA©, an indication of mild cognitive impairment. Cognitive impairment may be more common among heart transplant recipients than what is currently recognized, and specific domains of cognitive function were related to medication adherence after transplantation in this study. Future studies should include longitudinal evaluations of cognitive function, depression, and medication adherence. Consideration of these relationships is needed when designing adherence-promoting interventions for this population.

PERSONALITY AND WORD RECALL AS INTERACTIVE PREDICTORS OF PERCEIVED MEMORY ABILITY

Abstract Cognitive gerontology research requires consideration of both actual performance and perceptions of performance. While subjective memory perceptions are positively associated with memory performance, these correlations typically are modest in magnitude. Therefore, researchers have noted the need to consider potential moderators of this association, to better understand whether certain people show weaker or stronger linkages between performance and perceptions. The current study leveraged personality (NEO Big Five), memory performance (i.e., word recall), and perceptions of memory ability (i.e., metamemory in adulthood scale and subjective memory complaints) data from the St. Louis Personality and Aging Network (SPAN) study (n = 774, mean age: 71.52 years). Personality traits were more associated with subjective than objective memory, and the most consistent associations were for extraversion (r = -.20 for complaints, r = .26 for metamemory) and conscientiousness (r = -.26 for complaints and r = .33 for metamemory). Moreover, extraversion moderated associations between word recall and both memory capacity and complaints. Results suggested that associations between word recall and the two subjective indicators were weaker for those adults higher in extraversion, relative to adults who scored lower on extraversion. One possible interpretation is that extraverted older adults may construct their cognitive self-perceptions using information from their social interactions more than objective cues. These findings highlight the need to determine how personality traits influence which sources of information older adults employ when thinking about their cognitive ability, which in turn may explain their choices for activity engagement.

FACTORS INFLUENCING COGNITIVE FUNCTION AMONG THE US OLDEST-OLDER ADULTS

Abstract Previous studies have identified factors that influence cognition in older adults (aged ≥ 65); however, the findings cannot be generalized to the oldest-old adults (aged ≥ 80), who face different physical and functional challenges. This study aimed to examine the association between potential influencing factors and cognitive function in community-dwelling oldest-older adults using the National Health Aging Trends Study (NHATS) dataset, a nationally representative sample from 2015. We conducted linear multilevel modeling (MLM) to examine the association between participation in physical activity (PA) and social activity, everyday technology use, mental health, and self-reported health with cognitive function (immediate and delayed word recall), adjusting for five sociodemographic characteristics (age, sex, race/ethnicity, and education). A total of 2779 community-dwelling oldest-old adults from the NHATS were included. Most of study participants were 80-84 years old (47%), female (61%), Non-Hispanic White (70%), not married (63%), and did not obtain a college degree (75%). In the MLM, participating in physical and social activities, using technology, and poorer mental health were significantly associated with higher word-recall scores (better cognitive function). Self-reported health was not associated with word recall. Results from our study suggest that interventions aimed at promoting physical and social activities and improving mental health may help maintain cognitive function among the oldest-old population. Our findings also suggest the potential positive impact of technology use on cognition, although further study is needed to support the evidence.

SEX AND RACE/ETHNIC DIFFERENCES IN TERMINAL COGNITIVE DECLINE

Abstract Background Cognitive decline has been documented in older adults, but sex and racial/ethnic differences among decedents have not been studied. Here we investigate the relation of mortality to change in the cognitive function of older individuals by sex and race/ethnicity. Methods The study analyzed data from the Health and Retirement Study (HRS) between 1993 and 2018, which included information on total word recall, mental status, and total cognition of individuals aged 65 and older. The study estimated the loss of cognitive function using a multilevel random coefficient model, considering sex and racial/ethnic differences in the risk of death, age, and death status. The study also approximated terminal cognitive decline using cognitive scores reported within two years before death for decedents. Results On average, older women performed better than older men in word recall and overall cognition, while older White Americans performed better than African Americans and Hispanics/Latinos in overall cognition at all ages. Decedents had a similar cognitive function to survivors at age 65, but their cognition declined quickly with age, especially among older women and White Americans. Evidence of terminal cognitive decline within two years before death was significant regardless of age but less conclusive for African Americans and Hispanics/Latinos due to smaller sample sizes. Conclusions This paper indicated evidence of sex and race/ethnic differences in cognitive decline and terminal cognitive decline among older adults, which may have critical clinical implications directly linked to the onset and duration of dementia risk.

ASSOCIATION BETWEEN LATE LIFE EDUCATION AND COGNITIVE FUNCTION AMONG U.S. OLDER ADULTS

Abstract This study assessed whether late-life education (LLE) was associated with better cognitive function and whether the benefits of LLE on cognitive decline differed by gender, race/ethnicity, and education level in a nationally-representative sample of U.S. older adults. We conducted a retrospective cohort study using six waves of data from the Health and Retirement Study ([HRS] 2008-2018) that included adults aged ≥ 65 with no baseline diagnosis of Alzheimer’s disease and related dementias (ADRD). Cognitive function was measured at baseline and over time using a summary score that included immediate/delayed word recall, serial 7’s test, objective naming test, backwards counting, recall of the current date, and naming the president/vice-president (range=0-35). LLE was measured at every wave and was categorized as “once a month or more,” and “not in the last month [or never].” Covariates included participants’ demographic background, socioeconomic status, psychosocial and behavioral factors, and health-related factors. Of 12,099 participants (median age 71 [IQR=10]), engaging in LLE at least once a month or more was associated with better cognitive function and was equivalent to a 2-4 year delay in cognitive decline than non-participation in LLE. The association was only partially attenuated after adjusting for a wide range of covariates. In addition, the benefits of LLE on cognitive function did not significantly differ by gender, race/ethnicity, or prior educational attainment. This study provides new insights into the protective role of LLE on cognitive function and underscores the importance of continued learning among older adults.

EXAMINING THE NON-LINEAR ASSOCIATION BETWEEN YEARS OF EDUCATION AND LATE-LIFE COGNITION

Abstract Dementia, a rising health concern, is expected to impact 13 million adults in the United States by 2050. Low education is a well-established risk-factor for dementia. However, few studies have investigated possible non-linearity of the association between years of education and late-life cognition, nor have investigated gender differences in this association. This study aimed to investigate whether years of education is non-linearly associated with late-life cognition, and whether the size of this association differed across men and women. To address this aim, we used data from the U.S. representative Health and Retirement Study, encompassing a sample of 32,712 respondents with episodic memory data available between 1998 and 2018 and with complete data on self-reported education (median=12, interquartile range=12-15), gender (18,509 women, 14,203 men), and confounders (ethnicity, race, parental education, childhood immigration status, and birth year). Episodic memory was measured as immediate and delayed recall using a 10-word recall test. We used confounder-adjusted linear mixed-effects models to estimate the associations between years of education and immediate recall (model 1) and delayed recall (model 2). In both models, the estimated education-recall association was non-linear based on the statistically significant squared and cubic terms (p< 0.001). Generally, an increase in education was associated with an increase in immediate and delayed recall, and these associations were more pronounced for larger education values. There were no statistically significant gender differences in the education-recall associations in both models. These findings indicate the importance of assessing non-linearity of the association between years of education and late-life cognition.

GREATER PHYSICAL ACTIVITY AND SOCIAL ENGAGEMENT OFFER PROTECTION AGAINST COGNITIVE DECLINE OVER TIME

Abstract Evidence suggests that physical activity and social engagement in later life are associated with a less pronounced and reduced risk of cognitive decline over time; however, findings are mixed and knowledge concerning the effect of these factors on cognitive functioning in older adults with mild cognitive impairment (MCI) is underdeveloped. To enhance understanding, we extracted data from eight waves (2004-2018) of the Health and Retirement Study and used hierarchical linear mixed models to investigate the impact of physical activity and social engagement on cognitive functioning in Americans aged 60 years and older with MCI (n=1462). The average cognitive score (sum of immediate and delayed word recall, serial seven subtraction test, counting backwards, range: 0 to 27) at baseline was 9.6, which decreased by 0.14 points each year. Each unit increase in physical activity (weighted sum of light, moderate, vigorous activity; range: 9 to 45) and social engagement (measure capturing social visits, volunteerism, religious participation; range: 0 to 3) reduced the effect of time on cognitive functioning by 0.01 (β=0.007, p<.0001) and 0.04 (β=0.040, p<.0001) points, respectively, while simultaneously controlling for APOE genotype and other covariates. This means, for example, that the cognitive score of someone with a physical activity score of 40 was, on average, 3.1 points higher than someone with a physical activity score of 10 after 16 years of follow-up. Findings suggest that greater physical activity and social engagement offer protection against cognitive decline and could minimize MCI progression among older adults experiencing MCI.

MEDIATING EFFECTS OF QUALITY OF LIFE IN THE ASSOCIATION OF DEBTS AND LATER MEMORY FUNCTION IN CHINA, ENGLAND, AND THE US

Abstract Non-mortgage debts were linked to negative cognitive health outcomes in later-life older adults. It is unclear how they may be associated with later-life memory function through psychosocial pathways, and whether the associations vary by health care system and policy environment. We examined the mediating effects of depressive symptoms and dissatisfaction with life in the association between non-mortgage debts and subsequent memory function among adults aged 65-101 years in the US, China, and England. Data were from harmonized, nationally representative longitudinal studies of aging in the US (Health and Retirement Study; n=8,388), China (China Health and Retirement Longitudinal Study; n=1,180), and England (English Longitudinal Study of Aging; n=3,390). Non-mortgage debt burden was defined as any pre-existing or new non-mortgage debts in two years (2010-2012 for the US and England; 2011-2013 for China). Memory function was measured by 20-point immediate and delayed word recall summary scores over a subsequent 5- or 6-year follow-up period. Within each country, we used sampling-weighted, multivariable-adjusted causal mediation analysis (product method) to estimate the total and direct effects of non-mortgage debts on memory function, and the indirect effects mediated by depressive symptoms and dissatisfaction with life. We observed significant mediating effects of depressive symptoms on the association between non-mortgage debts and memory function in China only. Dissatisfaction with life had a significant mediating effect on this association in US and China, not in England. Although more investigation is needed, the relationships between non-mortgage debts and later-life memory function through psychosocial pathways may differ across macro-level socioeconomic structures.

Lexico-syntactic constraints influence verbal working memory in sentence-like lists.

We test predictions from the language emergent perspective on verbal working memory that lexico-syntactic constraints should support both item and order memory. In natural language, long-term knowledge of lexico-syntactic patterns involving part of speech, verb biases, and noun animacy support language comprehension and production. In three experiments, participants were presented with randomly generated dative-like sentences or lists in which part of speech, verb biases, and animacy of a single word were manipulated. Participants were more likely to recall words in the correct position when presented with a verb over a noun in the verb position, a good dative verb over an intransitive verb in the verb position, and an animate noun over an inanimate noun in the subject noun position. These results demonstrate that interactions between words and their context in the form of lexico-syntactic constraints influence verbal working memory.

Evaluating Listening Effort in Unilateral, Bimodal, and Bilateral Cochlear Implant Users.

Evaluate listening effort (LE) in unilateral, bilateral, and bimodal cochlear implant (CI) users. Establish an easy-to-implement task of LE that could be useful for clinical decision making. Prospective cohort study. Tertiary neurotology center. The Sentence Final Word Identification and Recall Task, an established measure of LE, was modified to include challenging listening conditions (multitalker babble, gender, and emotional variation; test), in addition to single-talker sentences (control). Participants listened to lists of sentences in each condition and recalled the last word of each sentence. LE was quantified by percentage of words correctly recalled and was compared across conditions, across CI groups, and within subjects (best aided vsmonaural). A total of 24 adults between the ages of 37 and 82 years enrolled, including 4 unilateral CI users (CI), 10 bilateral CI users (CICI), and 10 bimodal CI users (CIHA). Task condition impacted LE (P < .001), but hearing configuration and listener group did not (P = .90). Working memory capacity and contralateral hearing contributed to individual performance. This study adds to the growing body of literature on LE in challenging listening conditions for CI users and demonstrates feasibility of a simple behavioral task that could be implemented clinically to assess LE. This study also highlights the potential benefits of bimodal hearing and individual hearing and cognitive factors in understanding individual differences in performance, which will be evaluated through further research.

A lack of retrieval practice effects in children's recognition and recall memory of novel words during storybook reading

IntroductionRetrieval practice enhances adults' long-term memory over restudying. However, it is less clear whether young children also benefit from retrieval practice. This study assessed whether retrieval practice could support children's novel word learning in the context of storybook reading.MethodIn Experiments 1–3, preschoolers (N = 167, RangeAge = 26–68 months) were presented with 10 novel word-object pairs across four consecutive storybook readings. Half of the children were read the storybook four times (i.e., SSSS), whereas the other half of the children were read the storybook once and were then asked to retrieve the novel words during the subsequent three readings (i.e., STTT). Children's recall and recognition memory for the novel words was tested after a 5-min delay.Results and discussionResults revealed that although children had high retrieval success during learning, retrieval practice did not provide an advantage over re-reading for children's recall (Experiment 1), even when additional mapping and retrieval opportunities were provided (Experiment 2); that is, children who engaged in retrieval practice did not outperform children who re-read the storybooks. A retrieval practice effect also did not emerge in children's recognition memory of novel words (Experiment 3). Taken together, this study suggests that retrieval practice may only benefit young children under specific learning conditions. Future research should therefore consider characteristics of the learner and broader learning context to explain developmental differences in retrieval practice effects.

Gestures as Scaffolding to Learn Vocabulary in a Foreign Language.

This paper investigates the influence of gestures on foreign language (FL) vocabulary learning. In this work, we first address the state of the art in the field and then delve into the research conducted in our lab (three experiments already published) in order to finally offer a unified theoretical interpretation of the role of gestures in FL vocabulary learning. In Experiments 1 and 2, we examined the impact of gestures on noun and verb learning. The results revealed that participants exhibited better learning outcomes when FL words were accompanied by congruent gestures compared to those from the no-gesture condition. Conversely, when meaningless or incongruent gestures were presented alongside new FL words, gestures had a detrimental effect on the learning process. Secondly, we addressed the question of whether or not individuals need to physically perform the gestures themselves to observe the effects of gestures on vocabulary learning (Experiment 3). Results indicated that congruent gestures improved FL word recall when learners only observed the instructor's gestures ("see" group) and when they mimicked them ("do" group). Importantly, the adverse effect associated with incongruent gestures was reduced in the "do" compared to that in the "see" experimental group. These findings suggest that iconic gestures can serve as an effective tool for learning vocabulary in an FL, particularly when the gestures align with the meaning of the words. Furthermore, the active performance of gestures helps counteract the negative effects associated with inconsistencies between gestures and word meanings. Consequently, if a choice must be made, an FL learning strategy in which learners acquire words while making gestures congruent with their meaning would be highly desirable.

Frailty, cognitive impairment, and depressive symptoms in Chinese older adults: an eight-year multi-trajectory analysis

BackgroundFrailty, cognitive impairment, and depressive symptoms are closely interrelated conditions in the aging population. However, limited research has longitudinally analyzed the concurrent trajectories of these three prominent conditions in older adults in China. This study aimed to explore the eight-year trajectories of frailty, cognitive impairment, and depressive symptoms, and to identify individual-level and structural-level factors associated with the trajectories.MethodsFour waves of data from the China Health and Retirement Longitudinal Study (2011–2018) were used to identify 6,106 eligible older adults. The main measures included frailty by the frailty index constructed using 30 indicators, cognitive impairment by the summary score of immediate and delayed word recall, figure drawing, serial subtraction, and orientation, and depressive symptoms by the Center for Epidemiologic Studies Depression Scale. Multi-trajectory models identified the trajectories of frailty, cognitive impairment, and depressive symptoms over time. Multinomial logistic regression was employed to estimate the associations between individual-level capital factors and one structural factor (hukou and geographic residency) with the identified trajectories, adjusting for demographic characteristics.ResultsFour trajectories emerged: (1) worsening frailty, worsening cognitive impairment, depression (14.0%); (2) declining pre-frailty, declining cognition, borderline depression (20.0%); (3) pre-frailty, worsening cognitive impairment, no depression (29.3%); and (4) physically robust, declining cognition, no depression (36.7%). Using the “physically robust, declining cognition, no depression” as the reference, not working, no social activity participant, worse childhood family financial situation, and poorer adult health were most strongly associated with the “worsening frailty, worsening cognitive impairment, depression” trajectory; worse health during childhood had the highest association with the “declining pre-frailty, declining cognition, borderline depression” trajectory; less education, lower household consumption, and rural hukou had the greatest association with the increased likelihood of the “pre-frailty, worsening cognitive impairment, no depression” trajectory.ConclusionsFindings could inform the understanding of the interrelationship of frailty, cognitive impairment, and depressive symptoms in older adults in China and may help practitioners detect adults at risk for adverse trajectories to implement strategies for proper care.

Impact of twice-a-day transcranial direct current stimulation intervention on cognitive function and motor cortex plasticity in patients with Alzheimer’s disease

BackgroundNon-invasive brain stimulation has improved cognitive functions in patients with Alzheimer’s disease (AD), and some studies suggest a close relationship between cognition and plasticity. However, the clinical benefits of transcranial...

Associations between aerobic fitness and subsequent memory performance in non‐demented Presenilin‐1 E280A mutation carriers: A preliminary report from the Colombia‐Boston longitudinal biomarker study

AbstractBackgroundGreater aerobic fitness, objectively measured by VO2‐max, is considered a critical component of overall health and a strong predictor of cognitive functioning. It has been associated with less neurodegeneration in Alzheimer’s disease (AD) and greater functional brain connectivity and plasticity in healthy older adults. Yet, less is known about how it relates to AD progression in people at increased risk for dementia. In this study, we examined whether VO2‐max predicted memory decline in non‐demented mutation carriers and non‐carriers from a Colombian kindred with autosomal dominant AD (ADAD), and hypothesized that those with greater VO2‐max levels would exhibit slower cognitive decline.Methods12 Presenilin‐1 E280A mutation carriers (ages: μ = 39.61 years, SD:4.18) and 14 non‐carriers (ages: μ = 37.11 years, SD:6.59) underwent a standard graded maximal exercise test performed on a treadmill to assess their VO2‐max, which is the maximal rate of oxygen consumption during exercise, measured in milliliters of oxygen per minute per kilogram body mass. Participants also completed the CERAD word list learning and delayed recall, a measure of episodic memory, at baseline and again 18‐24 months later. Group differences were tested using the Mann‐Whitney U test. Linear mixed models were used to examine associations among baseline VO2 max and changes in CERAD word list test scores.ResultsVO2‐max levels did not differ between groups (p = .16). Compared to mutation non‐carriers, mutation carriers performed worse in word list learning (p = .008) and recall (p&lt;.001) at baseline. VO2‐max levels were not associated with baseline word list learning (non‐carriers: p = .93; carriers: p = .76) or recall scores (non‐carriers: p = .82; carriers: p = .63). Baseline VO2‐max levels did not predict change in word list learning (non‐carriers: p = .47; carriers: p = .85) or recall scores (non‐carriers: p = .70; carriers: p = .87).ConclusionPreliminary findings suggest that aerobic fitness, which can be increased with exercise and is associated with greater health, does not relate to memory decline in preclinical ADAD. This is an ongoing longitudinal study, and we will continue to collect more physical activity data in this kindred to characterize these associations better. More research with larger samples is needed to elucidate whether physical activity could help delay AD progression regardless of aerobic fitness levels.

Developing Topics.

Early and accurate diagnosis is critical as disease-modifying therapies for Alzheimer's disease (AD) become available and clinical trials are moving increasingly into early disease stages. The Learning ratio (LR) has demonstrated the highest sensitivity towards changes in memory, relative to other learning slope metrics. The current study examines the performance of LR within the ADNI cognitively normal population. Our analyses included 672 participants aged 55 to 90 years, diagnosed in ADNI as cognitively intact. After applying Jak/Bondi actuarial diagnostic criteria to the sample1, 2, 56 participants met actuarial criteria for MCI (actuarial-MCI), 253 had normal cognition with subjective memory complaints (actuarial-SMC), and 363 were cognitively normal without subjective complaints (actuarial-CN). We compared LR derived from the Rey Auditory Verbal Learning Test (RAVLT)3 and the Word Recall subtest of the ADAS-Cog4 between the diagnostic groups, and studied the effects of LR, diagnosis, and the interaction between LR and diagnosis on bilateral hippocampal volume and β-amyloid pathology. Actuarial-MCI performances on RAVLT LR and Word Recall LR were significantly worse than actuarial-SMC and actuarial-CN (ps<.005). No differences were seen between LRs for actuarial-CN and actuarial-SMC (ps>.05). The association between Word Recall LR and hippocampal volume was strongest in actuarial-MCI followed by actuarial-SMC, both of which displayed a positive relationship between the two variables, while actuarial-CN displayed a negative relationship (R2 = .209, p<.001, Figure 1A). Adding the interaction term improved model performance (R2 change = .007 p = .013). Similar trends were observed between RAVLT LR and diagnostic group predicting hippocampal volume, though the interaction was not significant (R2 = .208, p<.001, Figure 1B; R2 change = .001 p = .28). No main or interaction effects were observed between LR measures, diagnostic groups, and amyloid status (ps>.05, Figure 2). A subset of ADNI cognitively intact participants displayed MCI after applying Jak/Bondi actuarial norms, suggesting that ADNI diagnostic criteria may have under-pathologized memory loss in a subset of patients. The actuarial-MCI group displayed worse learning slopes and stronger relationships with hippocampal volume than CN participants with and without SMC. Applying the actuarial criteria to AD clinical trials - in conjunction with LR - may yield greater sensitivity in detecting those in the early stages of AD.

Specific damages to olfactory‐related structures and their relation to episodic memory in Individuals at Risk of Alzheimer’s Disease.

AbstractBackgroundOne of the major challenges in the diagnosis of Alzheimer’s disease (AD) is to increase the specificity of the early diagnosis. While episodic memory impairment is a sensitive marker of AD, other markers are needed to improve diagnostic specificity. A promising biomarker might be a cerebral atrophy of the central olfactory processing areas in the early stages of the disease since an impairment of olfactory identification is present at early clinical stages of AD. Our goal was to evaluate whether reduced grey matter volume (GMV) in the central olfactory processing regions could be observed in early and preclinical stages of AD. We also aimed to verify if GMV of central olfactory processing regions is associated with episodic memory performance.Method166 participants from the Consortium for the Early Identification of Alzheimer’s Disease‐Quebec (CIMA‐Q) (92 with subjective cognitive decline ‐ SCD, 40 with mild cognitive impairment ‐ MCI and 34 cognitively healthy controls) were included. We performed regions of interest (ROI) analysis using a mask of the regions that are activated during olfactory stimulation. We also extracted GMV outside ROIs, representing non‐olfactory areas of these regions, i.e., regions which do not respond to olfactory stimulation. Verbal episodic memory was assessed using a free word recall task from Memoria Word Recall test.ResultCompared to controls (p = .019) and participants with SCD (p = .003), participants with MCI exhibited a smaller total GMV of central olfactory processing regions, with a significant interaction effect between region and group (p = .004). Specifically, the piriform cortex, amygdala, entorhinal cortex, and left hippocampus were significantly smaller in individuals with MCI (p≤.05, corrected). In contrast, when comparing GMV outside ROIs between the three groups, there was no such interaction between region and group (p = .428). Additionally, GMV in the olfactory areas of the piriform cortex, amygdala, and left hippocampal gyrus was correlated with episodic memory performance, while GMV in the non‐olfactory areas of the left hippocampus and left parahippocampal gyrus was correlated with episodic memory performance (p≤.05, corrected).ConclusionThere is a specific neurodegeneration of limbic and medial‐temporal olfactory‐structures in MCI, GMV of these regions being related to cognitive performance.

Multi‐Trajectories of Blood Pressure and Cognitive Function in U.S. Adult Population

AbstractBackgroundElevated blood pressure (BP) levels are associated with cognitive impairment and the development of Alzheimer’s disease and related dementias (ADRD). However, long‐term co‐occurring changes in BP and cognitive function are poorly characterized.MethodUsing data from the 2006‐2018 Health and Retirement Study (HRS), we identified 21,968 adults aged 50 years or older without ADRD at baseline (median follow‐up 8 years). Cognitive function was measured at each wave occurred every 2 years using a summary score that included immediate/delayed word recall, serial 7’s test, objective naming test, backwards counting, recall of the current date, and naming the president/vice‐president (score range = 0‐35). BP was measured at each wave in random half samples. We used group‐based trajectory models to identify age‐based multi‐trajectories of cognitive function and both systolic and diastolic BP from age 50 to 90.ResultFour distinct co‐occurring trajectories of systolic BP and cognitive decline were identified (Figure 1): moderately‐increasing systolic BP with moderate and accelerated cognitive decline(Group 1; 34.6%; 95% CI, 33.2%‐36.0%; n = 7,600), moderately‐increasing systolic BP with high levels of cognitive function and minimal decline (Group 2; 39.6%; 38.2%‐41.0%; n = 8,699), elevated‐increasing systolic BP with low and accelerated cognitive decline (Group 3; 14.0%; 13.3%‐14.8%; n = 3,075), and high‐stable systolic BP with moderate cognitive decline (Group 4; 11.8%; 10.5%‐13.0%; n = 2,594). Findings were similar for co‐occurring trajectories of diastolic BP and cognitive decline, but changes in diastolic BP were attenuated with age. Male, White, and more highly educated were most likely to be in Group 2 than other groups. Black adults were more likely to experience elevated BP and/or accelerated cognitive decline: Black men were most likely to be in Group 3. Among women, Black race was associated with increasing likelihood of belonging to Group1 &amp; 4.ConclusionTrajectories of systolic BP and cognitive decline varied throughout middle‐to‐late adulthood. The distinct patterns emerging that may also align with demographic differences in the prevalence of ADRD and cardiovascular risk factors. Additional research is needed to further address the underlying mechanisms contributing to age‐related changes in BP and cognitive decline.