Subjective Memory Performance Research Articles

Effects of 6-Month Combined Physical Exercise and Cognitive Training on Neuropsychological and Neurophysiological Function in Older Adults with Subjective Cognitive Decline: A Randomized Controlled Trial

Background: Multidomain intervention may delay or ameliorate cognitive decline in older adults at risk of Alzheimer’s disease, particularly in the memory and inhibitory functions. However, no study systematically investigates the changes of brain function in cognitively-normal elderly with subjective cognitive decline (SCD) when they receive multidomain intervention. Objective: We aimed to examine whether a multidomain intervention could improve neuropsychological function and neurophysiological activities related to memory and inhibitory function in SCD subjects. Methods: Eight clusters with a total of 50 community-dwelling SCD older adults were single-blind, randomized into intervention group, which received physical and cognitive training, or control group, which received treatment as usual. For the neuropsychological function, a composite Z score from six cognitive tests was calculated and compared between two groups. For the neurophysiological activities, event-related potentials (ERPs) of memory function, including mismatch negativity (MMN) and memory-P3, as well as ERPs of inhibitory function, including sensory gating (SG) and inhibition-P3, were measured. Assessments were performed at baseline (T1), end of the intervention (T2), and 6 months after T2 (T3). Results: For the neuropsychological function, the effect was not observed after the intervention. For the neurophysiological activities, improved MMN responses of ΔT2–T1 were observed in the intervention group versus the control group. The multidomain intervention produced a sustained effect on memory-P3 latencies of ΔT3–T1. However, there were no significant differences in changes of SG and inhibition-P3 between intervention and control groups. Conclusions: While not impactful on neuropsychological function, multidomain intervention enhances specific neurophysiological activities associated with memory function.

Ginsenosides Decrease β-Amyloid Production via Potentiating Capacitative Calcium Entry.

Alzheimer's disease (AD) is a progressive and irreversible neurodegenerative disorder characterized by extracellular amyloid plaques composed of amyloid β-peptide (Aβ). Studies have indicated that Ca2+ dysregulation is involved in AD pathology. It is reported that decreased capacitative Ca2+ entry (CCE), a refilling mechanism of intracellular Ca2+, resulting in increased Aβ production. In contrast, constitutive activation of CCE could decrease Aβ production. Panax ginseng Meyer is known to enhance memory and cognitive functions in healthy human subjects. We have previously reported that some ginsenosides decrease Aβ levels in cultured primary neurons and AD mouse model brains. However, mechanisms involved in the Aβ-lowering effect of ginsenosides remain unclear. In this study, we investigated the relationship between CCE and Aβ production by examining the effects of various ginsenosides on CCE levels. Aβ-lowering ginsenosides such as Rk1, Rg5, and Rg3 potentiated CCE. In contrast, ginsenosides without Aβ-lowering effects (Re and Rb2) failed to potentiate CCE. The potentiating effect of ginsenosides on CCE was inhibited by the presence of 2-aminoethoxydipherryl borate (2APB), an inhibitor of CCE. 2APB alone increased Aβ42 production. Furthermore, the presence of 2APB prevented the effects of ginsenosides on Aβ42 production. Our results indicate that ginsenosides decrease Aβ production via potentiating CCE levels, confirming a close relationship between CCE levels and Aβ production. Since CCE levels are closely related to Aβ production, modulating CCE could be a novel target for AD therapeutics.

Cognitive and immunological effects of yoga compared to memory training in older women at risk for alzheimer’s disease

Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) accompanied by cerebrovascular risk factors (CVRFs) are known to increase the risk of developing dementia. Mind-body practices such as yoga and meditation, have been recognized as safe techniques with beneficial effects on cognitive functions in older adults at risk for cognitive decline. We conducted a randomized, controlled trial to assess the efficacy of Kundalini yoga training (KY) compared to memory enhancement training (MET) on mood and cognitive functioning in a group of older women with CVRFs and SCD (clinicaltrials.gov = NCT03503669). The KY intervention consisted of weekly, 60-min in-person classes with a certified instructor for 12 weeks, with a 12-min guided recording for daily homework practice at home. MET involved 12 weekly in-person group classes with 12-min daily homework exercises. Objective and subjective memory performance were the primary outcomes. Peripheral whole blood samples were collected at baseline, 12-weeks, and 24-weeks follow-up for RNA sequencing and cytokine/chemokine assays. A total of 79 patients (KY = 40; MET = 39) were randomized, and 63 completed the 24-week follow-up (KY = 65% completion rate; MET = 95%; χ2(1) = 10.9, p < 0.001). At 24-weeks follow-up, KY yielded a significant, large effect size improvement in subjective cognitive impairment measures compared to MET. KYOn a transcriptional level, at 12- and 24-week follow-up, KY uniquely altered aging-associated signatures, including interferon gamma and other psycho-neuro-immune pathways. Levels of chemokine eotaxin-1, an aging marker, increased over time in MET but not KY participants. These results suggest clinical and biological benefits to KY for SCD, linking changes in cognition to the anti-inflammatory effects of yoga.

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

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

28 Social Support, APOE Genotype, and Memory Associations in a Community-Based Sample of Older Adults in Texas

Objective:The apolipoprotein E (APOE) gene has been identified as a major risk factor for the development of Alzheimer’s disease in late life. Research has shown that APOE e4 allele carriers demonstrate poorer memory performance and accelerated cognitive decline relative to non-carriers, and there is a need to identify potential factors of resiliency against the negative effects of e4 on cognition. Social support may represent one potential mechanism given that higher levels of social support have been linked to better cognitive and functional outcomes in older adults. Thus, the current study sought to examine whether social support moderates the relationship between APOE e4 status and subjective and objective memory performance in a large community-based sample of Hispanic/Latino (H/L) and Non-Hispanic White (NHW) older adults residing in Texas.Participants and Methods:Participants included 1,564 (H/L = 808, NHW = 756) older adults (mean age = 66.36±8.68) without dementia that had enrolled in the Health and Aging Brain Study-Health Disparities. Participants completed study questionnaires and a comprehensive neuropsychological battery. Apolipoprotein e4 status (e4 carriers vs. non-carriers) was determined by possession of at least one e4 allele. Perceived social support was measured using the total score from the abbreviated 12-item version of the Interpersonal Support Evaluation List. Objective memory performance was assessed using a z-score composite of Story A and B from the Weschler Memory Scale (WMS)-III and immediate and delayed recall trials from the Spanish-English Verbal Learning Test. Subjective memory was assessed using the total score from the Subject Memory Complaints Questionnaire. Race stratified multiple linear regression models, controlling for age, sex, and years of education, examined APOE e4 positivity x social support interactions on subjective and objective memory performance.Results:There was a significant APOE e4 genotype x social support interaction on objective memory performance (ß = -1.10, p = 0.003) in H/Ls such that higher levels of social support were associated with better memory performance in non-e4 carriers (ß = 0.14, p &lt; .001), but not in e4 carriers (ß = -0.13, p = 0.9). In contrast, no significant APOE e4 status x social support interaction was observed on subjective memory (ß = -0.39, p = 0.35) in H/Ls. Finally, results revealed no significant APOE e4 genotype x social support interactions on subjective memory (ß = 0.14 p = 0.77) or objective memory (ß = 0.67, p = 0.11) performance in NHWs. Conclusions: Findings revealed that social support did not mitigate against the negative effects of e4 on subjective and objective memory performance in H/Ls or NHWs. However, results demonstrate that higher levels of social support are associated with better objective, but not subjective memory performance in H/Ls without the e4 genotype. These findings suggest that social support may protect against cognitive decline and enhance cognitive reserve in non-e4 carriers. Future studies should explore other potential factors of resiliency (e.g., diet, exercise) and examine the association between genetic risk and social support on neural markers (e.g., cortical thinning, hippocampal atrophy).

Emotional and musical factors combined with song-specific age predict the subjective autobiographical saliency of music in older adults.

Music that evokes strong emotional responses is often experienced as autobiographically salient. Through emotional experience, the musical features of songs could also contribute to their subjective autobiographical saliency. Songs which have been popular during adolescence or young adulthood (ages 10-30) are more likely to evoke stronger memories, a phenomenon known as a reminiscence bump. In the present study, we sought to determine how song-specific age, emotional responsiveness to music, musical features, and subjective memory functioning contribute to the subjective autobiographical saliency of music in older adults. In a music listening study, 112 participants rated excerpts of popular songs from the 1950s to the 1980s for autobiographical saliency. Additionally, they filled out questionnaires about emotional responsiveness to music and subjective memory functioning. The song excerpts' musical features were extracted computationally using MIRtoolbox. Results showed that autobiographical saliency was best predicted by song-specific age and emotional responsiveness to music and musical features. Newer songs that were more similar in rhythm to older songs were also rated higher in autobiographical saliency. Overall, this study contributes to autobiographical memory research by uncovering a set of factors affecting the subjective autobiographical saliency of music.

Exploring Methylene Blue and Its Derivatives in Alzheimer's Treatment: A Comprehensive Review of Randomized Control Trials.

Methylene blue (MB) and its compounds are investigated for their potential benefits in the management of Alzheimer's disease (AD). ADis a widely seen neuropathological disorder characterized by the gradual decline of cognitive abilities, ultimately leading to the development of severe dementia. It is anticipated that there will be a significant increase in the prevalence of ADdue to the agingpopulation. Histopathologically, AD is distinguished by the presence of intracellular tangles of neurofibrillary tissues (NFTs) and extracellular amyloid plaques within the brain. MB is a thiophenazine dye with FDA approval for treating several illnesses. Its ease in crossing the blood-brain barrier and potential therapeutic use in central nervous system diseases have increased interest in its application for treating AD. The literature review includes randomized clinical trials investigating MB's potential benefits in treating AD. The findings of the studies indicate that the administration of MB has demonstrated enhancements in cognitive function, reductions in the accumulation of plaques containing beta-amyloid, improvements in memory and cognitive function in animal subjects, and possesses antioxidant properties that can mitigate oxidative stress and inflammation within the brain. Thisreview evaluates the modern and latest research on the application of MB for treating AD.

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

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

Mindfulness, Subjective Cognitive Functioning, Sleep Timing and Time Expansion during COVID-19 Lockdown: A Longitudinal Study in Italy.

During the COVID-19 lockdown, a distortion of time passage has been widely reported in association with a change in daily rhythm. However, several variables related to these changes have not been considered. The purpose of the present study was to assess the changes in dispositional mindfulness, time experience, sleep timing and subjective memory functioning. A longitudinal study was conducted on 39 Italian adults (53.85% males; 35.03 ± 14.02 years) assessing mindfulness, ad hoc questions of sleep habits during workdays and free days, chronotypes, subjective time experience, and memory functioning before (December 2019-March 2020) and during (April 2020-May 2020) the first Italian COVID-19 lockdown. Participants reported delayed sleep timing, a slowdown in the perception of the present time, a decrease of time pressure, and an increase in the feeling of time expansion/boredom. In addition to correlations between mindfulness, memory functioning, and subjective sleep duration during workdays, a mediation model showed that changes in the dispositional mindfulness determined a delay of bedtime during workdays through the mediation effect of increased feeling of time expansion/boredom. This finding highlighted the role of mindfulness in reducing the feeling of time expansion/boredom for regulating the sleep timing. The theoretical and practical implications of the findings are discussed.

Use of smartphones and tablets after acquired brain injury to support cognition

Objectives To describe the use of mobile devices after acquired brain injury (ABI), from the perspectives of injured individuals and significant others, and to examine factors associated with mobile device use for cognition. Methods Cross-sectional study with 50 adults with moderate/severe traumatic brain injury or stroke (42% women; mean of 50.7 years old, 4.6 years post-ABI), and 24 significant others. Participants completed questionnaires on mobile technology, cognitive functioning and the impact of technology. Results Of 45/50 adults with ABI who owned a smartphone/tablet, 31% reported difficulties in using their device post-injury, 44% had received support, and 46% were interested in further training. Significant others reported motor/visual impairments and the fear of becoming dependent on technology as barriers for mobile device use, and 65% mentioned that their injured relative needed additional support. Mobile device use for cognition was common (64%), predicted in a regression model by lower subjective memory and more positive perception of the psychosocial impacts of technology, and also associated in univariate analyses with younger age, lower executive functioning, and greater use of memory strategies. Conclusion Using mobile devices for cognition is common post-ABI but remains challenging for a significant proportion. Developing training approaches may help supporting technology use. IMPLICATIONS FOR REHABILITATION Using mobile electronic devices (smartphones and tablets) is common after acquired brain injury (ABI) but is challenging for a significant proportion of individuals. After the ABI, close to 50% of individuals receive support in using their mobile device, mostly from family members and friends, but rarely from rehabilitation clinicians or technology specialists. In a sample of 50 adults with ABI, more frequent use of mobile devices to support cognition was associated with poorer subjective memory and executive functioning, greater use of memory strategies, more positive perception of the psychosocial impacts of technology, and younger age.

Association of Psychological distress and Physical Health with Subjective and Objective Memory in Older Adults.

ObjectivesTo investigate how indicators of psychological stress and physical health differentially influence subjective and objective memory in older adults. Methods: 404 adults aged ≥55 without cognitive impairment participated in remote assessment of physical health (PHY; multimorbidity, body-mass-index), psychological distress (PDS; perceived stress, anxiety, depression), subjective memory complaints (SM), and task-based objective memory performance (OM). Results: Separately, both PHY and PDS significantly predicted SM (p < 0.01), but only PHY was associated with OM (p = 0.05). Combined models showed that PHY and PDS maintained significant association with SM (p < 0.01, R2 = 0.30), while only PHY was associated with OM (p = .07, R2 = 0.03; for associative OM, p = 0.04). Discussion: SM is associated with participants' psychological profile, highlighting the importance of addressing these factors when assessing SM. The results also reveal that remotely-administered OM tasks are more immune to participants' psychological profile, and support previously-established links between physical health and objective and subjective memory function.

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

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

Patterned Hippocampal Stimulation Facilitates Memory in Patients With a History of Head Impact and/or Brain Injury.

Rationale: Deep brain stimulation (DBS) of the hippocampus is proposed for enhancement of memory impaired by injury or disease. Many pre-clinical DBS paradigms can be addressed in epilepsy patients undergoing intracranial monitoring for seizure localization, since they already have electrodes implanted in brain areas of interest. Even though epilepsy is usually not a memory disorder targeted by DBS, the studies can nevertheless model other memory-impacting disorders, such as Traumatic Brain Injury (TBI). Methods: Human patients undergoing Phase II invasive monitoring for intractable epilepsy were implanted with depth electrodes capable of recording neurophysiological signals. Subjects performed a delayed-match-to-sample (DMS) memory task while hippocampal ensembles from CA1 and CA3 cell layers were recorded to estimate a multi-input, multi-output (MIMO) model of CA3-to-CA1 neural encoding and a memory decoding model (MDM) to decode memory information from CA3 and CA1 neuronal signals. After model estimation, subjects again performed the DMS task while either MIMO-based or MDM-based patterned stimulation was delivered to CA1 electrode sites during the encoding phase of the DMS trials. Each subject was sorted (post hoc) by prior experience of repeated and/or mild-to-moderate brain injury (RMBI), TBI, or no history (control) and scored for percentage successful delayed recognition (DR) recall on stimulated vs. non-stimulated DMS trials. The subject’s medical history was unknown to the experimenters until after individual subject memory retention results were scored. Results: When examined compared to control subjects, both TBI and RMBI subjects showed increased memory retention in response to both MIMO and MDM-based hippocampal stimulation. Furthermore, effects of stimulation were also greater in subjects who were evaluated as having pre-existing mild-to-moderate memory impairment. Conclusion: These results show that hippocampal stimulation for memory facilitation was more beneficial for subjects who had previously suffered a brain injury (other than epilepsy), compared to control (epilepsy) subjects who had not suffered a brain injury. This study demonstrates that the epilepsy/intracranial recording model can be extended to test the ability of DBS to restore memory function in subjects who previously suffered a brain injury other than epilepsy, and support further investigation into the beneficial effect of DBS in TBI patients.

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

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

The impact of an occupational therapy group cognitive rehabilitation program for people with dementia.

IntroductionThis study was conducted to examine the impact of a group cognitive rehabilitation program for people with dementia on everyday memory function and quality of life.MethodsParticipants included in the study were community‐dwelling adults with a diagnosis of dementia. The intervention was a 5‐week occupational therapy lead group cognitive rehabilitation program delivered once a week for 1.5 h. Outcome measures included standardised memory tests, subjective everyday memory function and quality of life ratings. The measures were completed at baseline, post‐intervention and 3‐month post‐intervention.ResultsOutcome measures were completed with 58 participants. Statistically significant improvements in standardised memory scores were noted following the intervention. Similarly, self‐rated everyday memory function and quality of life scores significantly improved following the intervention. All standardised scores and subjective ratings were maintained at 3‐month follow‐up.ConclusionGroup‐based cognitive rehabilitation programs can positively impact the quality of life and everyday memory function among people with dementia.

Examining Subjective Aging through the Lens of the Caregiver Experience

Caregivers of individuals with Alzheimer’s disease and related dementia (ADRD) often experience burden that has been associated with poor physical and psychological health outcomes (Andren & Elmstahl, 2007; Zimmerman et al., 2018). However, very little research investigates how the caregiving experience may impact an individual’s subjective aging experience. Various aspects of subjective aging have been implicated in health outcomes and memory function (Brothers et al., 2017; Stephan, Sutin, Caudroit, & Terracciano, 2016). The purpose of this study was to investigate the differences in perceptions of subjective aging between caregivers and non-caregivers. Participants (N = 185) completed a survey assessing several aspects of subjective aging, including subjective age, or how old an individual feels, memory function, well-being, attitudes towards aging, and aging stereotypes. A series of independent t-tests indicated that there were significant differences between groups on subjective age (p = .013), and subjective memory function (p = .013). Caregivers (n = 93) reported feeling significantly older than their chronological age, reported significantly more subjective memory complaints, and also reported poorer subjective memory function when compared to the non-caregiver (n = 92) control group. Previous literature does suggest that older subjective age ratings are associated with poor subjective memory function, so these results are not necessarily surprising. However, these results suggest that caregiving for individuals with ADRD may negatively impact caregivers’ perceptions of their own aging experience, but not necessarily their perceptions about aging in general.

Examining Subjective Aging through the Lens of the Caregiver Experience

As people live longer, informal caregiving for family and friends is becoming increasingly common. Caregiver satisfaction with their role is now of greater importance to an increasing proportion of the U.S. population. Most research on caregivers has studied convenience samples, often restricted to caregivers of people with dementia. Various studies have examined the impact of caregiving on caregivers’ health but to our knowledge there are no qualitative studies of caregiving experiences from caregivers in population-based samples. This study investigated the impact of caregiving on participants who transitioned into a caregiving role while participating in a national population-based study. Participants were from the Caregiving Transitions Study, which is ancillary to the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. We thematically analyzed responses from 150 caregivers providing care for multiple different conditions to an open-ended question asked at the time of enrollment and designed to encourage caregivers to share additional details about their caregiving experience. Four major themes were identified: cultural/family expectations; growth opportunities and reciprocity; stressors and challenges; and recommendations. Participants shared both positive and challenging experiences in their role as a family caregiver as well as the impact that these experiences had on their lives. Caregivers shared that one of the most important motivations for taking on this role was their sense of duty toward family. Caregivers also highlighted the positive impact of caregiving on their lives such as opportunities for personal growth, acquisition of new skills, and finding a sense of fulfillment and gratitude.

Sedentary Behavior, Sleep Quality, and Subjective Memory Function in Middle-Aged Adults

The visible impact of the SDoHs on health and behavioral health as well as health disparities among minority populations is heightened due to COVID-19. One group about which little is known in relation to SDoHs is the older Korean immigrant population in the U.S. To examine the impact of SDoHs on the health, mental health, and health care utilization, a systematic review of studies focused on SDoHs for this population was conducted. Using multiple indexing terms, databases were searched for articles published in English between January 1, 2011 and December 2020. Articles were included in the search if they examined social determinants of health of older Korean immigrants defined as foreign-born Koreans aged 60 or older who live in the United States regardless of citizenship or legal immigration status. A total of 1090 articles were identified in the search. A review of abstracts for inclusion criteria resulted in 118 articles for review. Seventy-one articles were excluded during the review process. A total of 47 articles met inclusion criteria and were evaluated. The review revealed that SDoHs, including education level, financial resources, access to health insurance, level of acculturation and level of social support, influenced cognitive status, depressive symptoms, health status and quality of life. These findings validate the need for interventions to address the social care needs of older Korean immigrants and can be used to identify the role of social workers in addressing the SDoHs that result in health disparities for older Korean immigrants.

The effect of sad mood on subjective appraisal of memory performance in older people with and without subjective memory complaints: An experimental study

AbstractBackgroundSubjective memory complaints (SMC) have been identified as a possible precursor to cognitive decline and may indicate a need for an early intervention for at‐risk older adults. However, it is well‐established that low mood is associated with SMC, leading to claims that memory concerns in older people may often reflect primarily psychological symptoms. This study aimed to determine the effect of low mood on subjective memory appraisal in older adults.MethodWe used a film‐based mood induction procedure (MIP) to test the effect of sad vs. neutral mood on subjective appraisal of memory performance in an experimental 2X2 between‐subjects design. Participants were 98 cognitively unimpaired older people (n=45 with SMC), randomised to the sad MIP (n=56) or the neutral MIP (n=42). All participants completed measures of trait SMC and ruminative self‐focused attention (RSFA) as well as perceived performance and metacognitive experience (ME) following the MIP and completion of a face‐name and a maze‐learning task.ResultParticipants in the sad MIP condition (M=42.75, SD=30.97) reported significantly greater sadness than those in the neutral condition following the manipulation (M=11.57, SD=18.44). The association between objective and subjective memory performance was stronger for cued recall on the face‐name task (r=.61, p=.001) and was weaker free recall on the face‐name task (r=.26, p=0.016) as well on the maze‐learning task (r=‐.16, p=.200). Contrary to expectation, there was no significant effect of mood condition on perceived performance on Face‐Name learning task (MD=‐2.43, p=498), but sad mood was associated with better perceived performance on the maze‐learning task (MD=13.34, p=.015). Results also indicated that RSFA and ME were implicated as mechanisms in subjective memory performance appraisal.ConclusionFindings indicate that SMC is a complex multifaceted phenomenon which may be underpinned by maladaptive self‐regulation and attentional systems, suggesting that psychological interventions may be appropriate for many older adults with SMC.

Disfungsi Kognitif Post Operatif pada Geriatri

Postoperative Cognitive Dysfunction (POCD) is a neurocognitive disorder characterized by decreased cognitive performance after surgery and anesthesia. POCD is a complication characterized by memory impairment, decreased information processing and reduced attention, accompanied by changes in mood and personality. The incidence of POCD in elderly patients (&gt; 60 years) was approximately 25.8% within seven days after surgery and 10% within three months after surgery. The risk factors and etiology that lead to POCD can be reduced by good patient education, patient care and proper sanitation can prevent the tendency of POCD symptoms in these patients. Examination can be done with the learning test, the word learning test, the tracing test, the manual dexterity test, the ability test to remember a sequence of numbers. Mini Mental Status Examination (MMSE) as a screening test for dementia. MMSE is sometimes used to measure POCD. MMSE can be used in routine clinical practice to identify preoperative subclinical dementia that would put patients at a higher risk of developing POCD. Management in POCD includes two approaches, namely rapid diagnosis and prevention of POCD symptoms. Prevention by knowing the risk factors preoperative, intraoperative and postoperative. In patients with persistent POCD, it has a negative impact on quality of life, subjective memory performance, emotional symptoms, and possible health consequences such as dementia and premature death.