Subjective Memory Complaints Research Articles

Longitudinal trajectories of self‐reported subjective cognitive decline in relation to objective cognitive performance in a population‐based cohort

AbstractBackgroundSubjective Cognitive Decline (SCD) may represent the onset of cognitive decline before impairment on standard cognitive tests occurs (Jessen et al., 2014). Previous cross‐sectional studies were shown to have limited ability to capture objective differences in cognitive performance between groups with and without SCD (Cacciamani et al., 2017). Understanding the interplay between changes in subjective memory ratings and objective cognitive function over time may have utility in identifying people at risk of dementia.Method370 cognitively normal (CN) individuals with complete cognitive data (Table 1 for characteristics) from Insight 46, a longitudinal neuroscience sub‐study of the MRC National Survey for Health and Development (the British 1946 Birth Cohort), underwent cognitive, clinical, and physical assessments, and neuroimaging (combined MRI/18F‐Florbetapir‐PET). SCD was measured using MyCog (Rami et al., 2014) a validated tool, from the SCD‐Questionnaire, where higher scores indicate greater subjective complaints. Linear regression models were used to test whether longitudinal cognitive change as measured using the Preclinical Alzheimer Cognitive Composite (PACC) and a visual short‐term memory binding task were influenced by baseline MyCog and whether there are parallel associations between rates of change in MyCog and longitudinal cognitive change. Covariates were sex, age at baseline visit, childhood cognitive ability, educational attainment, and adult socioeconomic position.ResultBaseline MyCog scores did not predict rates of change in PACC or visual short‐term memory binding outcome measures (Table 2). Rates of MyCog change alone did not predict rate of change in PACC, localisation error, total correct number of trials or proportion of misbinding errors (Table 3). However, we observed an interaction effect with baseline amyloid‐b status, whereby greater rates of subjective memory concerns predicted faster rates of decline in the proportion of misbinding errors in amyloid‐b positive participants only (Table 3; Figure 1).ConclusionThese findings suggest that higher amyloid‐b burden in CN individuals with subjective memory complaints is associated with faster rates of decline in visual working memory. Corroborating previous reports that feature binding tasks can objectify subtle cognitive deficits found in SCD (Koppara et al., 2015) and serve as a promising tool for identifying people at risk of dementia.

Quantifying AD‐related brain amyloid with linearised progression models: Model‐based vs. data‐based

AbstractBackgroundBrain amyloid‐β (Aβ) is the pathological hallmark of Alzheimer’s disease (AD). In logistic disease models, Aβ accumulation is a sigmoid function of time‐since‐disease‐onset (TSDO) (figure 1). Previous positron emission tomography (PET)‐based models vary accumulation onset(t50) and duration(r) globally; capacity(K) and baseline(NS) regionally (Whittington2018). We confirm existing approaches and propose a more powerful ICA‐based approach to quantify disease severity and estimate TSDO.MethodWe used 1071 18F‐florbetapir standard uptake value ratio (SUVR) images from the ADNI‐2 study (adni.loni.usc.edu/data‐samples/data‐types/pet). Images were mapped into MNI space. Averages were extracted using the Harvard‐Oxford brain‐atlas. Whole‐brain tracer‐specific sigmoid parameters (Jack2013) obtained from the literature were used to estimate TSDO.Of 16 models of regional Aβ accumulation (each of the 4 regional sigmoid parameters varied either regionally or globally), the optimal Bayesian information criterion was found with global t50 and r, and regional NS and K (figure 1) with global values r = 6.16y and t50 = 4.10y.Linearised maps of NS and K were obtained by regressing the SUVR maps onto the global sigmoid. We also estimated these maps as independent components, using a 2‐component ICA on the SUVR maps. Both outcomes were used to quantify Aβ accumulation from SUVR images as weighting factors of the accumulation map.We compared the weights from the logistic model and the ICA model in ADNI, using effect size measured with Hedges' g between cognitively normal (CN), subjective memory complaints (SMC), mild cognitive impairment (EMCI/MCI/LMCI) and AD groups. We compared 3 longitudinal visits (N = 112) in the OASIS‐3 study (see www.oasis‐brains.org) with both methods, global SUVR and Centiloid (Klunk2015) using 11C‐PiB PET SUVR images.ResultMaps of accumulation capacity from both models had spatial correlation of 0.86 (figure 2); baseline maps had spatial correlation of 0.95. Hedges' g between ADNI groups was 2.25 for K, and 2.42 for ICA (1.46 for global SUVR). In OASIS‐3, Hedges' g between visits was 1.24 for K, 1.46 for ICA (global SUVR 0.15, Centiloid 0.4).ConclusionWe demonstrate that linear accumulation models can be used to quantify brain Aβ with PET; maps obtained by ICA yield larger effect sizes than the logistic method for differentiating groups and measuring changes between visits.

COGNITIVE FUNCTION IS ASSOCIATED WITH LONG-TERM BENEFITS OF BLOOD PRESSURE MANAGEMENT PROGRAMME: A 4-YEAR PROSPECTIVE COHORT OF 1,151 PARTICIPANTS FROM ELDERLY CENTRES IN HONG KONG

Objective: The blood pressure (BP) trend is shown to have seasonally fluctuated, and is affected by both personal physical and cognitive conditions. This study aimed to investigate the long-term benefits of a BP management programme with adjustment for year-round BP fluctuations among the elderly in Hong Kong. Design and method: Elderly participants with ages above 55 years were recruited from 76 elderly centres and were prospectively followed up between September 2016 and January 2020. Personal interviews were conducted to assess personal health conditions. Nursing calls and social worker engagement were offered for those with suboptimal BP readings. The inclusion criteria were the participants who reported more than 80% of weekly BP records in at least 2 years of follow-up. The seasonal BP fluctuations were adjusted by time series models and the overall BP treads were tested by the Mann-Kendall test. The logistic regression models were used to investigate both the physical and cognitive conditions for good BP management. Results: A total of 1,151 elderly participants with a mean age of 79 years were included in the study. Based on the trend testing by Mann-Kendall test, 553 (48%) participants were classified as improved BP trend, i.e. downward trends of BP records, and 598 (52%) were classified as having stable or deteriorated BP levels. The multivariate model showed that improved BP trends were associated with baseline systolic BP levels, (OR 1.03, 95% CI 1.02 - 1.04), cholesterol problems, and subjective memory complaints (OR 0.64, 95% CI 0.47 - 0.85) (Table 1). Compared with eating junk food every day, eating less than once a week were good for BP management. Conclusions: Seasonal blood pressure fluctuations always influence the performance of blood pressure management programmes. Time-series modelling is possible to figure out the real trend of personal blood pressure records after adjustment for seasonal effects. This study demonstrates that the long-term benefits of our blood pressure management programme were limited by the elderly with memory complaints. When we are offering blood pressure management programme, special arrangement is required for the participants with mild cognitive impairment or even dementia.

Executive function may underlie cognitive reserve: A 3‐year follow‐up study

AbstractBackgroundThe hypothetical concept of cognitive reserve (CR) has been proposed to explain why someone can manage to function normally even in the presence of brain pathology. However, it still remains to be determined what components constitute such resilience against Alzheimer’s disease (AD) pathology. In the current study we investigated the characteristics of cognitively normal (CN) elders with high CR.MethodWe included CN participants from the Gwangju Alzheimer’s Disease and Related Dementia Cohort in Korea. We selected a group of CN individuals who showed a significant amyloid‐beta (aß) deposition at baseline and stayed CN over the follow‐up period. They were defined as high CR group. For comparison purpose, individuals with a significant aß deposition at baseline but converted to MCI at follow‐up were also included. In the final analysis, 94 high CR group and 24 control group were included. Group comparisons in socio‐demographic, clinical and cognitive variables were performed using χ2 tests and ANOVA controlling for age, education, gender, and follow‐up month.ResultMean follow‐up month were 43.37. There were no group differences in education, gender, socio‐economic status, family history of dementia or stroke, medical conditions, body mass index, subjective memory complaints, and instrumental activities of daily living. However, high CR group was younger and had shorter follow‐up period, therefore such variables were controlled when cognitive tests were compared. High CR group was more religious (p < 0.001), showed higher complexity in former job (p = 0.009), and higher level of executive functoning (Digit Dpan Backward, p = 0.012; Fluency test, p = 0.008; Boston Naming Test, p = 0.014; Trail Making Test part B, p = 0.017) than control group. There were no group differences in episodic memory tests and visuospatial abilities.ConclusionIndividuals with high CR could cope better with AD pathology. Many factors have been suggested to be associated with CR. Regarding cognitive process involved, our findings suggest that executive function plays an important role in constituting high CR. Preserved executive function may, at least in part, underlie CR.

Joint predictability of physical frailty/pre-frailty and subjective memory complaints on mortality risk among cognitively unimpaired older adults

The aim of the present study was to investigate how frailty/pre-frailty in combination with subjective memory complaints predicts all-cause mortality in community dwelling cognitively unimpaired older adults. There were 1904 community-dwelling cognitively unimpaired persons aged 65 years or older who participated in the 2013 Taiwan National Health Interview Survey with a 5-year follow-up. Frailty was determined based on the fatigue, resistance, ambulation, illness, and loss of weight (FRAIL) scale. Two questions (“Do you have difficulties with your memory or attention?” and “Do you have difficulties with your memory only or attention only or both?”) were used to screen for subjective memory complaints (SMC). In this study, 11.9% of participants had both frailty/pre-frailty and SMC. A total of 239 deaths were recorded after 9009.5 person-years of follow-up. After adjustment for other factors, compared with participants who were physically robust with no SMC, participants who reported either SMC alone (HR = 0.88, 95% CI = 0.60–1.27) or were frail/pre-frail alone (HR = 1.32, 95% CI = 0.90–1.92) had no significantly increased mortality risk. However, coexisting frailty/pre-frailty and SMC was associated with a significantly increased hazard ratio for mortality of 1.48 (95% CI = [1.02–2.16]). Our results highlight the high prevalence of co-occurring frailty/pre-frailty and SMC and that this co-occurrence is associated with an increased risk of mortality among cognitively unimpaired older adults.

Assessment of validity and comparison of two Spanish versions of the Geriatric Depression Scale.

The Geriatric Depression Scale is an instrument used to identify depression in people of an older age. The original English version of this scale has been translated into Spanish (GDS-VE); two shorter versions of 5- (GDS-5) and 15-items (GDS-15) have been developed. To assess the validity and compare the 5- and 15-item Spanish versions of the GDS among the Spanish population. 573 Galicia residents aged >50 years participated in this study. The following instruments were applied: the 19-item Control, Autonomy, Self-Realization and Pleasure scale, the Subjective Memory Complaints Questionnaire, the Mini-Mental State Examination test, the GDS-5, and the GDS-15. We found differences in total score between GDS-5 and GDS-15 regarding the variable sex. Internal reliability for GDS-5 and GDS-15 was 0.495 and 0.715, respectively. Sensitivity and specificity for GDS-5 - with a cut-off value of 1 - was 0.517 and 0.650, respectively; for GDS-15 - with a cut-off value of 3 points - sensitivity was 0.755 and specificity 0.668. GDS-5 has a ROC curve of 0.617 and GDS-15 of 0.764. GDS-15, and to a greater extent GDS-5, should be revised or even reformulated to improve their diagnostic usefulness by choosing higher discriminative ability items or even include new items with greater sensitivity that consider currently prevailing psychosocial factors.

Improved Mood Boosts Memory Training Gains in Older Adults With Subjective Memory Complaints via Enhanced Amygdala-hippocampal Connectivity

ObjectiveOlder adults with subjective memory complaints (SMC) have a higher risk of dementia and commonly demonstrate symptoms of anxiety. This study examined the neural correlates of group counseling (GC)–boosted memory training (MT) gains. DesignThis study was an active, controlled, randomized trial. SettingNeighborhoods near the Institute of Psychology of the Chinese Academy of Sciences (CAS). ParticipantsCommunity-dwelling older adults, aged 60 or above with a minimum of 6 years of education, were recruited through advertisements and flyers posted at community service stations. MeasurementsThe amplitude of low-frequency fluctuations and resting-state functional connectivity (rs-FC) analyses were used to examine the neural correlates associated with MT gains enhanced by improved mood in older adults with SMC. Participants were randomly assigned to the combined intervention (CI) or GC group. The CI group received 3 weeks of GC followed by 4 weeks of MT, and the GC group received GC and health lectures. Cognitive function and emotions were assessed before GC (T1), after GC (T2), and after MT (T3). Both groups underwent resting-state functional magnetic resonance imaging scanning at T2 and T3. ResultsAlleviated anxiety was positively correlated with rs-FC between the amygdala and left hippocampus and negatively correlated with rs-FC between the amygdala and right hippocampus. MT improvement was negatively correlated with rs-FC between the amygdala and right hippocampus in the CI group; the correlation was not significant after controlling for emotional changes. ConclusionsAmygdala–hippocampal connectivity may be associated with improved mood-enhanced MT gains in individuals with SMC.

A decade of aging in healthy older adults: longitudinal findings on cerebrovascular and cognitive health

Research suggests an association between cerebrovascular health and cognitive decline, but previous work is limited by its cross-sectional nature or short (< 1–2 years) follow-up. Our aim was to examine, across 10 years of follow-up in healthy older adults, changes in cerebrovascular health and their relationship with subjective memory complaints as an early marker of cognitive decline. Between 2008 and 2010, twenty-eight healthy older adults (69 ± 4 years) underwent baseline blood pressure and transcranial Doppler measurements to assess middle cerebral artery blood velocity (MCAv), cerebrovascular resistance index (CVRi), and measures of cerebral autoregulation (CA). After 9–12 years of follow-up, these measurements were repeated, and presence of memory complaints was evaluated. Linear mixed-model analyses explored effects of aging on cerebrovascular parameters and whether memory complaints were associated with cerebrovascular changes. Across a median follow-up of 10.9 years, no changes in MCAv, CVRi, or CA were found. At baseline, these parameters were not different between subjects with (n = 15) versus without (n = 13) memory complaints. During follow-up, subjects with memory complaints showed larger decreases in MCAv (− 10% versus + 9%, P = 0.041) and increases in CVRi (+ 26% versus − 9%, P = 0.029) compared to other peers without memory complaints, but no distinct changes in CA parameters (P > 0.05). Although a decade of aging does not lead to deterioration in cerebral blood flow or autoregulation, our findings suggest that reductions in cerebral blood flow and increases in cerebrovascular resistance are associated with early subjective cognitive decline.

Auditory Event-Related Potentials in Older Adults with Subjective Memory Complaints.

Auditory event-related potentials (AERPs) have been suggested as possible biomarkers for the early diagnosis of Alzheimer's disease (AD). However, no study has investigated AERP measures in individuals with subjective memory complaints (SMCs), who have been suggested to be at a pre-clinical stage of AD. This study investigated whether AERPs in older adults with SMC can be used to objectively identify those at high risk of developing AD. AERPs were measured in older adults. Presence of SMC was determined using the Memory Assessment Clinics Questionnaire (MAC-Q). Hearing thresholds using pure-tone audiometry, neuropsychological data, levels of amyloid-β burden and Apolipoprotein E (APOE)ɛ genotype were also obtained A classic two-tone discrimination (oddball) paradigm was used to elicit AERPs (i.e., P50, N100, P200, N200, and P300). Sixty-two individuals (14 male, mean age 71.9±5.2 years) participated in this study, of which, 43 (11 male, mean age 72.4±5.5 years) were SMC and 19 (3 male, mean age 70.8±4.3 years) were non-SMC (controls). P50 latency was weakly but significantly correlated with MAC-Q scores. In addition, P50 latencies were significantly longer in Aβ+ individuals compared to Aβ- individuals. Results suggest that P50 latencies may be a useful tool to identify individuals at higher risk (i.e., participants with high Aβ burden) of developing measurable cognitive decline. Further longitudinal and cross-sectional studies in a larger cohort on SMC individuals are warranted to determine if AERP measures could be of significance for the detection of pre-clinical AD.

Depressive Symptoms Mediate Associations between Subjective Memory Complaints, Cognitive Ability, and Instrumental Activities of Daily Living

Objectives: Cognitive ability (CA) and instrumental activities of daily living (IADL) performance are essential for productive aging. Therefore, it is important to understand if other common issues such as subjective memory complaints (SMCs) and depressive symptoms are related to CA and IADLs, and explore the nature of those relationships. This study aims to explore 1) the associations between SMCs, depressive symptoms, CA, and IADL performance and 2) the role of depressive symptoms in these associations. Method: The study sample included 1,621 community-dwelling oldest-old from the Health and Retirement Study. Results: SMCs were significantly and positively associated with cognitive decline and limitations in IADL performance. Additionally, depressive symptoms mediated the associations between SMCs and cognitive decline and between SMCs and limitations in IADL performance. Conclusion: Depressive symptoms associated with SMCs negatively affect CA and IADL performance. Therefore, healthcare providers should consider and assess SMCs and depressive symptoms in the oldest-old.

Multimodal cross enhanced fusion network for diagnosis of Alzheimer’s disease and subjective memory complaints

Deep learning methods using multimodal imagings have been proposed for the diagnosis of Alzheimer’s disease (AD) and its early stages (SMC, subjective memory complaints), which may help to slow the progression of the disease through early intervention. However, current fusion methods for multimodal imagings are generally coarse and may lead to suboptimal results through the use of shared extractors or simple downscaling stitching. Another issue with diagnosing brain diseases is that they often affect multiple areas of the brain, making it important to consider potential connections throughout the brain. However, traditional convolutional neural networks (CNNs) may struggle with this issue due to their limited local receptive fields. To address this, many researchers have turned to transformer networks, which can provide global information about the brain but can be computationally intensive and perform poorly on small datasets. In this work, we propose a novel lightweight network called MENet that adaptively recalibrates the multiscale long-range receptive field to localize discriminative brain regions in a computationally efficient manner. Based on this, the network extracts the intensity and location responses between structural magnetic resonance imagings (sMRI) and 18-Fluoro-Deoxy-Glucose Positron Emission computed Tomography (FDG-PET) as an enhancement fusion for AD and SMC diagnosis. Our method is evaluated on the publicly available ADNI datasets and achieves 97.67% accuracy in AD diagnosis tasks and 81.63% accuracy in SMC diagnosis tasks using sMRI and FDG-PET. These results achieve state-of-the-art (SOTA) performance in both tasks. To the best of our knowledge, this is one of the first deep learning research methods for SMC diagnosis with FDG-PET.

Subjective Complaints are Similar in Subjective Cognitive Decline and Early-Stage Alzheimer's Disease when Assessed in a Memory Clinic Setting.

Subjective cognitive complaints are generally poorly associated with objective memory functioning in older persons. Subjective cognitive decline (SCD) is a key feature in SCD and amnestic mild cognitive impairment (aMCI) which both can represent early Alzheimer's disease (AD). The aim of this study was to assess how memory clinic patients with SCD, MCI and mild AD dementia scored on 3 different complaint measures and if the format of assessment had an impact on the association with cognitive functioning, age, and depressive symptoms. We included 17 SCD patients, 17 aMCI patients, 17 patients with mild AD, and 30 controls. Complaints were assessed with the Cognitive Change Index (CCI), the Subjective Memory Complaints (SMC) scale, and the Memory Complaint Questionnaire (MAC-Q). There were no significant differences between the total scores in the patient groups on the questionnaires. However, significant differences were found in the number of patients classified with impairment when using the CCI, the SMC, and the MAC-Q. Scores on all questionnaires were significantly associated with depressive symptoms, and significant associations with age, gender, and Addenbrookes Cognitive Examination score were found for the SMC. In patients with cognitive dysfunction, lower memory awareness significantly predicted fewer cognitive complaints. SCD patients in a memory clinic setting report the same degree of cognitive impairment as patients with aMCI and mild dementia, and in a hospital-based cohort we extend previous findings from healthy controls, that definition of SCD may depend on the format of assessment.

New perspectives on randomized controlled trials with omega-3 fatty acid supplements and cognition: A scoping review.

Long chain polyunsaturated omega-3 fatty acids (n-3 FA), such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are known to be important components in a healthy diet and contribute to healthy functioning of the heart and the brain, among other organs. Although there are epidemiological studies on the strong relationship between fish or n-3 FA consumption and lower risk of cognitive decline, results from randomized controlled trials (RCTs) are less consistent. Here, we performed a scoping review on RCTs with n-3 FA supplementation where cognition was evaluated. Seventy-eight RCTs published before April 2022 were included in this review. Among these RCTs, 43.6% reported a positive cognitive outcome after the consumption of n-3 FA compared to the placebo. However, there was a large diversity of populations studied (age ranges and health status), wide range of doses of EPA +DHA supplemented (79mg/day - 5200mg/day) and a multitude of tests evaluating cognition, mainly diagnostic tests, that were used to assess cognitive scores and overall cognitive status. RCTs were thereafter categorized into non-cognitively impaired middle-aged adults (n=24), non-cognitively impaired older adults (n=24), adults with subjective memory complaints (n=14), adults with mild cognitive impairments (MCI, n=9) and people with diagnosed dementia or other cognitive changes (n=7). Among these categories, 66.7% of RCTs conducted with MCI adults reported a positive cognitive outcome when supplemented with n-3 FA vs. the placebo. Therefore, this scoping review provides rationale and questions to a) strengthen the design of future RCTs with n-3 FA for cognitive outcomes, and b) generate more informative data to support clinicians in their practice in assessing cognition before and after a nutritional intervention.

Latent Profile Analysis for Classification of Psychosomatic Symptoms in Perimenopausal Women.

Over 80% of perimenopausal women experience various physical and neuropsychiatric symptoms due to changes in hormones. However, accurate evaluation and treatment of menopausal symptoms are lacking due to limited evidence regarding customized treatment for each symptom type. This study aimed to identify and cluster psychosomatic symptoms in Korean perimenopausal women and to investigate the characteristics of each cluster type. This Web-based survey assessed 1060 Korean perimenopausal women recruited from nationally representative panels available from a commercial research company. Menopausal symptoms were evaluated using the Menopause Rating Scale, Patient Health Questionnaire-15, Patient Health Questionnaire-9, Insomnia Severity Index, Subjective Memory Complaints Questionnaire, and Overactive Bladder Symptom Score. Data were analyzed using latent profile analysis and multinomial logistic regression. Latent profile analysis identified 4 latent classes: "all unimpaired (class 1)," "impaired sexual function, while others are unimpaired (class 2)," "unimpaired sexual function, while others are impaired (class 3)," and "all impaired (class 4)." Classes 3 and 4 were significantly more likely to have a family history of perimenopausal syndrome and a history of other mental disorders, postpartum depression, and postpartum psychosis than classes 1 and2. Psychosomatic symptoms appear during perimenopause along with depression, somatic symptoms, insomnia, impaired memory, and overactive bladder symptoms. Individuals with these symptoms are more likely to have a history of postpartum depression, psychosis, and other psychiatric disorders. Therefore, sexual dysfunction must be independently treated. Further studies are needed to develop and verify individualized treatments according to symptom class.

Subjective memory complaints are associated with decreased cortical thickness in Veterans with histories of mild traumatic brain injury

Objective: Memory problems are frequently endorsed in Veterans following mild traumatic brain injury (mTBI), but subjective complaints are poorly associated with objective memory performance. Few studies have examined associations between subjective memory complaints and brain morphometry. We investigated whether self-reported memory problems were associated with objective memory performance and cortical thickness in Veterans with a history of mTBI. Methods: 40 Veterans with a history of remote mTBI and 29 Veterans with no history of TBI completed the Prospective-Retrospective Memory Questionnaire (PRMQ), PTSD Checklist (PCL), California Verbal Learning Test-2nd edition (CVLT-II), and 3 T T1 structural magnetic resonance imaging. Cortical thickness was estimated in 14 a priori frontal and temporal regions. Multiple regressions adjusting for age and PCL scores examined associations between PRMQ, CVLT-II scores, and cortical thickness within each Veteran group. Results: Greater subjective memory complaints on the PRMQ were associated with lower cortical thickness in the right middle temporal gyrus (β = 0.64, q = .004), right inferior temporal gyrus (β = 0.56, q = .014), right rostral middle frontal gyrus (β = 0.45, q = .046), and right rostral anterior cingulate gyrus (β = 0.58, q = .014) in the mTBI group but not the control group (q’s > .05). These associations remained significant after adjusting for CVLT-II learning. CVLT-II performance was not associated with PRMQ score or cortical thickness in either group. Conclusions: Subjective memory complaints were associated with lower cortical thickness in right frontal and temporal regions, but not with objective memory performance, in Veterans with histories of mTBI. Subjective complaints post-mTBI may indicate underlying brain morphometry independently of objective cognitive testing.

The association between cannabis use and subjective memory complaints in older adults in the United States.

The U.S. population is aging and increasing numbers of older adults are using cannabis. Cognitive decline is common in older age and subjective memory complaints (SMC) have been associated with increased risk for dementia. While residual cognitive effects of cannabis use at younger ages are well understood, the links between cannabis use and cognition in older adults is less clear. The present study represents the first population-level analysis of cannabis use and SMC in older adults in the U.S. We used the National Survey of Drug Use and Health (NSDUH) dataset to evaluate SMC in respondents over age 50 (N = 26,399) according to past-year cannabis use. Results revealed that 13.2% (95%CI: 11.5%-15.0%) of those who reported cannabis use also reported SMC, compared to 6.4% (95%CI: 6.1%-6.8%) among individuals with no cannabis use. Logistic regression revealed a two-fold increase (OR = 2.21, 95%CI: 1.88-2.60) of reporting SMC in respondents who had used cannabis in the past year, which was attenuated (OR = 1.38, 95%CI: 1.10-1.72) when controlling for additional factors. Other covariates, including physical health conditions, misuse of other substances, and mental illness also significantly contributed to SMC outcomes. Cannabis use represents a modifiable lifestyle factor that has potential for both risk and protective properties that may impact the trajectory of cognitive decline in older age. These hypothesis generating results are important for characterizing and contextualizing population-level trends related to cannabis use and SMC in older adults.

Advances in Mind/Body Therapies: Concept, Data and Delivery

Mind/body therapies, such as yoga, mindfulness, and guided imagery, are often touted in media reports as ways to slow cognitive decline, improve brain health, and ameliorate negative psychological symptoms such as stress and depression. However, the clinical and neurobiological evidence base for these uses in older adults is limited. Moreover, many older adults, particularly during the COVID-19 pandemic, have difficulty accessing these therapies due to the in-person, group formats in which they are often delivered. A major difficulty in understanding the objective benefits of mind/body therapies for subjective cognitive and psychological symptoms is infrequent measurement during clinical trials using retrospective questionnaires. Thus, increased clinical efficacy research, neurobiological research, and methodological research to identify new ways to deliver and measure the effects of mind/body therapies is urgently needed.In this general session, three presenters will discuss recent advances in mind/body therapies, including new evidence from large-scale trials, and methodological innovations enabling remote therapy delivery and the assessment of behavioral outcomes.First, Dr. Felipe Jain will discuss smartphone delivery of mind/body therapies and new technologies that use passive smartphone sensors to enable continuous measurement of behavior. The development of digital phenotypes of psychological symptoms from these fine-grained behavioral assessments will be discussed. Dr. Jain's presentation will describe a smartphone application which delivers mind/body tools, mentalizing imagery therapy (MIT), and caregiver skills, to older adult family caregivers of persons living with dementia. His talk will elucidate simultaneous capture of usage data and passive smartphone sensor data in a subset of participants in a clinical trial using the application. Statistical methods to derive individual behavioral phenotypes for symptom tracking of psychological stress and sleep will be presented.Second, Dr. Eric Lenze will share clinical and neuroimaging results of a large trial of mindfulness-based stress reduction (MBSR) with and without exercise aimed at improving cognitive function and brain health in older adults. His talk will include clinical effects of intervention on episodic memory and executive function, and structural brain markers including hippocampal volume and dorsolateral prefrontal cortex thickness and surface area. Finally, he will focus on sensitive analyses of functional brain connectivity from before to after treatment.Finally, Dr. Helen Lavretsky will discuss the recent trends in the methodology of conducting mind-body efficacy and effectiveness trials. She will also discuss the results of a recently completed trial of Kundalini yoga for prevention of cognitive decline in women with subjective memory complaints and at risk for AD. This will also cover clinical outcomes and the role of neural and peripheral biomarkers of response.The panel discussion will outline future research directions in mind-body therapies for treatment and prevention in older adults, with a focus on diversity and inclusion of underrepresented populations.

The association between metamemory, subjective memory complaints, mood, and well-being: the Hungarian validation of Multifactorial Memory Questionnaire

The current study addressed the relationship between subjective memory complaints and negative affect, well-being, and demographic variables by investigating the Hungarian version of Multifactorial Memory Questionnaire. The original factor structure showed a poor fit on our data; therefore, principal component analysis was conducted on data from 577 participants, ranging in age from 18 to 92 years. Our analysis provided a six-component solution: Satisfaction, Retrospective memory mistakes, Prospective memory mistakes, External Strategies, Internal Strategies, and Frustration. To improve the reliability and internal consistency indicators we created four subscales by combining Frustration with Satisfaction, and Retrospective and Prospective memory mistakes subscales. Thus, we were able to preserve the factor structure similar to the original. Subjective memory complaints were correlated positively with anxiety and depression and were associated negatively with well-being. We found a slight positive correlation between age and memory ability, and age was associated negatively with the frequency of external strategy use. Individuals with higher education were satisfied with their memory, used more frequent external strategies. Furthermore, men were more satisfied with their memory and reported better memory ability, while women tended to use more external and internal strategies. Women also showed a higher level of anxiety and depression than men. In conclusion, self-reported memory changes are of particular importance because of their association with perceived mental health status and implications for later disease development.

Cognitive and behavioral abnormalities in individuals with Alzheimer’s disease, mild cognitive impairment, and subjective memory complaints

AbstractIn this study, we investigated the ability of commonly used neuropsychological tests to detect cognitive and functional decline across the Alzheimer’s disease (AD) continuum. Moreover, as preclinical AD is a key area of investigation, we focused on the ability of neuropsychological tests to distinguish the early stages of the disease, such as individuals with Subjective Memory Complaints (SMC). This study included 595 participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) dataset who were cognitively normal (CN), SMC, mild cognitive impairment (MCI; early or late stage), or AD. Our cognitive measures included the Rey Auditory Verbal Learning Test (RAVLT), the Everyday Cognition Questionnaire (ECog), the Functional Abilities Questionnaire (FAQ), the Alzheimer’s Disease Assessment Scale–Cognitive Subscale (ADAS-Cog), the Montreal Cognitive Assessment scale (MoCA), and the Trail Making test (TMT-B). Overall, our results indicated that the ADAS-13, RAVLT (learning), FAQ, ECog, and MoCA were all predictive of the AD progression continuum. However, TMT-B and the RAVLT (immediate and forgetting) were not significant predictors of the AD continuum. Indeed, contrary to our expectations ECog self-report (partner and patient) were the two strongest predictors in the model to detect the progression from CN to AD. Accordingly, we suggest using the ECog (both versions), RAVLT (learning), ADAS-13, and the MoCA to screen all stages of the AD continuum. In conclusion, we infer that these tests could help clinicians effectively detect the early stages of the disease (e.g., SMC) and distinguish the different stages of AD.

Association between olfactory dysfunction and mood disturbances with objective and subjective cognitive deficits in long-COVID.

The coronavirus disease 2019 (COVID-19) has been associated with olfactory dysfunction. The persistent symptoms of anosmia or hyposmia were associated in previous studies with the development of memory impairment and mood disturbances. We aimed to investigate the association between the chronicity of reported olfactory dysfunction and subjective and objective cognitive performance in long-COVID patients and to explore whether their emotional symptoms are related to their cognition. One hundred twenty-eight long-COVID participants were recruited. Reported symptomatology, subjective memory complaints, anxiety and depression symptomatology, and trait-anxiety were assessed. Subjective memory complaints and mood disturbances were compared among groups of participants with olfactory dysfunction as an acute (AOD), persistent (POD), or nonexistent (NOD) symptom. Seventy-six of the volunteers also participated in a face-to-face session to assess their objective performance on tests of general cognitive function and verbal declarative memory. Objective cognitive performance and mood disturbances were compared among the AOD, POD, and NOD groups. The subjective memory complaints and the anxiety and depression symptoms were similar among the groups, but the score in general cognitive function was lower in the participants with symptoms of acute olfactory dysfunction than in those with no olfactory symptoms at any time. Participants' memory complaints were positively related to their emotional symptoms. The relationship between depressive symptomatology and memory complaints interacted with the olfactory dysfunction, as it only occurred in the participants without symptoms of olfactory dysfunction. Depressive symptomatology and acute olfactory symptoms were negatively associated with general cognitive function and delayed memory performance. The months elapsed from diagnosis to assessment also predicted delayed memory performance. Anxious symptomatology was negatively associated with the immediate ability to recall verbal information in participants who did not present olfactory dysfunction in the acute phase of the infection. Olfactory dysfunction in the acute phase of the infection by COVID-19 is related to cognitive deficits in objective tests, and mood disturbances are associated with self-reported and objective memory. These findings may contribute to further understanding the neuropsychological and emotional aspects of long-COVID.