Verbal Semantic Memory Research Articles

Gender differences in the association between education and late-life cognitive function in the LifeAfter90 Study: A multiethnic cohort of the oldest-old.

Few studies have examined the relationship between education and cognition among the oldest-old. Cognitive assessments were conducted biannually for 803 participants (62.6% women) of LifeAfter90, a longitudinal study of individuals ≥90 years old. Gender differences in associations between education (<high school, high school, some college, and ≥ college) and cognition (verbal episodic memory, semantic memory, and executive function) were examined at baseline and longitudinally using linear mixed models. Higher education levels were associated with better cognitive performance at baseline for both men and women. College completion was more strongly associated with better baseline executive function among women. Education-cognition associations for baseline verbal episodic memory and baseline semantic memory did not differ by gender. Education was not associated with a decline in any domain-specific cognitive scores, regardless of gender. Education is associated with cognitive function among the oldest-old and varies by gender and cognitive domain at baseline but not over time. In the oldest-old, higher education was associated with better cognitive function. College completion was more strongly associated with executive function in women. Education was not associated with cognitive decline after age 90 regardless of gender. Improving education could decrease gaps in cognitive level among older individuals.

A modified neural circuit framework for semantic memory retrieval with implications for circuit modulation to treat verbal retrieval deficits.

Word finding difficulty is a frequent complaint in older age and disease states, but treatment options are lacking for such verbal retrieval deficits. Better understanding of the neurophysiological and neuroanatomical basis of verbal retrieval function may inform effective interventions. In this article, we review the current evidence of a neural retrieval circuit central to verbal production, including words and semantic memory, that involves the pre-supplementary motor area (pre-SMA), striatum (particularly caudate nucleus), and thalamus. We aim to offer a modified neural circuit framework expanded upon a memory retrieval model proposed in 2013 by Hart etal., as evidence from electrophysiological, functional brain imaging, and noninvasive electrical brain stimulation studies have provided additional pieces of information that converge on a shared neural circuit for retrieval of memory and words. We propose that both the left inferior frontal gyrus and fronto-polar regions should be included in the expanded circuit. All these regions have their respective functional roles during verbal retrieval, such as selection and inhibition during search, initiation and termination of search, maintenance of co-activation across cortical regions, as well as final activation of the retrieved information. We will also highlight the structural connectivity from and to the pre-SMA (e.g., frontal aslant tract and fronto-striatal tract) that facilitates communication between the regions within this circuit. Finally, we will discuss how this circuit and its correlated activity may be affected by disease states and how this circuit may serve as a novel target engagement for neuromodulatory treatment of verbal retrieval deficits.

Rural‐urban disparities in the consumption of fruits and vegetables and cognitive performance in Brazil

AbstractBackgroundAdherence to a healthy diet has been associated with lower risk of dementia and cognitive decline. Furthermore, low consumption of fruits and vegetables has been associated with lower cognitive performance. Rural Brazilians have several factors related to poor diet quality, such as low education and income.Additionally, rural residents of Latin America face a higher burden of dementia compared to urban residents. However, differences in the association of fruit and vegetable consumption with cognitive performance in urban and rural areas have not been explored. The aim of this study was to investigate the association of fruit and vegetable consumption with cognitive performance in urban and rural areas in a nationally representative sample of Brazilian older adults.MethodThe sample included 9,412 adults 50 years or older from the 2015 wave of the Brazilian Longitudinal Study of Aging. Consumption of fruits and vegetables was measured using a food frequency questionnaire. Cognitive performance was evaluated using the immediate recall, late recall, semantic verbal fluency, prospective memory, semantic memory, and temporal orientation. A global composite z‐score was derived from these tests. Association of consumption of fruits and vegetables with cognitive performance was evaluated using linear regression, adjusted for sociodemographic, lifestyle, and clinical variables.ResultIn 6,743 participants (mean age 61.3±8.9 y, 53% women, 43% White, and 15% from rural areas), the mean intake of fruits and vegetables was 2.0±1.3 portions a day (Table 1). Higher consumption of fruits and vegetables was associated with better episodic (β = 0.021, 95% CI = 0.004;0.037, p = 0.013) and semantic memory (β = 0.037, 95% CI = 0.019;0.055, p&lt;0.001), verbal fluency (β = 0.035, 95% CI = 0.018;0.053, p&lt;0.001), and global cognition (β = 0.032, 95% CI = 0.016;0.048, p&lt;0.001) performances (Table 2). There was a modifying effect of urban/rural area of residency (p for interaction &lt;0.001). Stratified analysis showed that consumption of fruits and vegetables was associated with better episodic and semantic memory, verbal fluency, and global cognition performances in participants who resided in urban, but not rural areas (Table 3).ConclusionConsumption of fruits and vegetables was associated with cognitive performance in urban, but not in rural areas in Brazil, possibly due to socioeconomic disadvantages and lower access to healthcare.

Clinical Manifestations.

Oldest old adults (90+) are the fastest growing population with high burden of cognitive impairment and depression. Though depression is a known risk factor for cognitive impairment, it is unclear how each of the predominant depression dimensions correspond with cognitive outcomes. We used baseline data from LifeAfter90 study, a racially and ethnically diverse cohort of community-dwelling adults aged 90 and above. Participants are longtime members of Kaiser Permanente Northern California Health System without a dementia diagnosis in their medical record. Verbal episodic memory, semantic memory, and executive function were assessed with the Spanish & English Neuropsychological Assessment Scale and averaged as a composite measure of global cognition. Depression was measured by the Geriatric Depression Scale (GDS) and the dimensions (Dysphoria, Withdrawal-Apathy -Vigor (WAV), Anxiety, Hopelessness and Subjective Memory Complaint) calculated based on GDS-items. Generalized linear mixed models estimated associations between global and domain-specific cognition and depression dimensions adjusting for age, sex, education, and race. Participants (n = 960, mean age = 92.4 ± 2.3 yrs, 61.56% female) were 24% Asian, 23% Black, 19% Latino, and 27% White. The most common reported GDS items were "decreased energy" (52.45%), preference to "stay home" (46.31%) and "dropped activity" (40.0%) and 25% reported memory complaints (Figure 1). Hopelessness was associated with worse executive functions (P< 0.001) but not with other cognitive domains nor with global cognition. Dysphoric mood, WAV, and anxiety were not associated with any of the cognitive outcomes (Table 1). Conversely, subjective memory complaints was associated with worse global cognition, executive function and verbal episodic memory, but not with semantic memory. Characterizing the dominant depression dimensions may be informative in predicting pattern of cognitive deficits. Perceived memory impairment in the oldest old was supported by objective deficit in episodic memory and executive functions suggesting that subjective reports should be taken as a valid early sign of impairment in this population. Further exploration of the longitudinal association of depression dimensions with cognitive domains is warranted.

Self-reported mid- to late-life physical and recreational activities: Associations with late-life cognition.

Physical and recreational activities are behaviors that may modify risk of late-life cognitive decline. We sought to examine the role of retrospectively self-reported midlife (age 40) physical and recreational activity engagement - and self-reported change in these activities from age 40 to initial study visit - in predicting late-life cognition. Data were obtained from 898 participants in a longitudinal study of cognitive aging in demographically and cognitively diverse older adults (Age: range = 49-93 years, M = 75, SD = 7.19). Self-reported physical and recreational activity participation at age 40 and at the initial study visit were quantified using the Life Experiences Assessment Form. Change in activities was modeled using latent change scores. Cognitive outcomes were obtained annually (range = 2-17 years) using the Spanish and English Neuropsychological Assessment Scales, which measure verbal episodic memory, semantic memory, visuospatial processing, and executive functioning. Physical activity engagement at age 40 was strongly associated with cognitive performance in all four domains at the initial visit and with global cognitive slope. However, change in physical activities after age 40 was not associated with cognitive outcomes. In contrast, recreational activity engagement - both at age 40 and change after 40 - was predictive of cognitive intercepts and slope. Retrospectively self-reported midlife physical and recreational activity engagement were strongly associated with late-life cognition - both level of performance and rate of future decline. However, the data suggest that maintenance of recreational activity engagement (e.g., writing, taking classes, reading) after age 40 is more strongly associated with late-life cognition than continued maintenance of physical activity levels.

Characterizing oldest‐old SuperAgers based on cognitive domains and demographic factors: The Life After 90 study

AbstractBackgroundSuperAgers are individuals who maintain superior cognitive performance despite advanced age. Most studies define SuperAgers as superior performers only in episodic memory. Our aim was to assess in a diverse oldest‐old cohort if superior performance in one domain indicates superior performance in other domains and explore demographic characteristics.MethodsThe LifeAfter90 study is a multi‐ethnic cohort of members of Kaiser Permanente Northern California aged 90 or older. Baseline verbal episodic memory (VEM), semantic memory (SM), and executive function (EF) were evaluated using the Spanish and English Neuropsychological Assessment Scale (SENAS). SuperAgers were individuals who scored above the mean of domain and race‐specific SENAS scores from a reference cohort aged 65‐70 years. The reference group were similar participants from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study. To assess the association between age, sex, education, and being a SuperAger, odds ratios (OR) and 95% confidence interval (CI) were calculated using multiple logistic regression.ResultsThe 617 study participants (236 men and 381 women) had a mean age of 92.9 years (Table1). 53.6% of individuals were SuperAgers in one domain, 22.8% in any two domains, and 7.7% in all three domains. 7.0% of individuals were SuperAgers in SM and EF, 4.5% in VEM and EF, and 3.5% in VEM and SM (Figure1). SuperAgers were younger than non‐SuperAgers. Women were more likely to be SuperAgers in VEM (OR = 2.13; 95%CI: 1.43,3.18) and EF (OR = 2.18; 95%CI: 1.44,3.30) and less likely in SM (OR = 0.49; 95%CI: 0.34,0.71) compared to men. Higher education was related to being a SuperAger in SM (OR = 1.85; 95%CI: 1.28,2.67) and EF (OR = 2.56; 95%CI: 1.74,3.78) but not VEM (Table2).ConclusionIn this diverse cohort of oldest‐old SuperAgers we found that exceptional episodic memory performance does not indicate exceptional performance in other cognitive domains. Education was not a predictor of exceptional performance in all domains. Future work should investigate predictors of exceptional cognitive aging after age 90.

Evaluation of the Effectiveness of Neurocognitive Rehabilitation of Patients with Mild Cognitive Decline under Restrictions during the COVID-19 Pandemic

Background: the development of programs for the correction of cognitive impairment in elderly patients with various types of mild cognitive decline is an urgent task of geriatric medicine and clinical psychology. The aim of the study was to conduct neuropsychological and psychometric evaluation of the results of a modified neurorehabilitation program (combination of full time and part time studies) in patients of the “Memory Clinic”. Patients and methods: a total of 114 patients (mean age 73 years) with mild cognitive impairment was studied. Neuropsychological and psychometric evaluation of the dynamics of the cognitive sphere in patients with mild cognitive decline (MCI) before and after participation (week 6) in the full-time/part-time neurorehabilitation program at the “Memory Clinic” was carried out. For psychometric assessment, the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were used. The neuropsychological study was carried out using the “Express Method for the Study of Cognitive Functions at a Late Age” (N.K. Korsakova et al.). For psychometric assessment, the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were used. The neuropsychological study was carried out using the “Express Method for the Study of Cognitive Functions at a Late Age” (N.K. Korsakova, E.Yu. Balashova, I.F. Roshchina). Results: using the method of multivariate analysis of variance (MANOVA), a statistically significant effect (p &lt; 0.05) of the neurorehabilitation program on psychometric tests (MMSE, MoCA) and on the total score of the “Express Methods for the Study of Cognitive Functions at a Late Age”, as well as on its subscales —verbal memory, visual memory, semantic memory, dynamic, spatial and regulatory praxis was detected. Conclusions: a psychometric and neuropsychological study showed the effectiveness of a full time/part-time neurocognitive rehabilitation program for patients with mild cognitive decline under conditions of limited visits to the Memory Clinic during the COVID-19 pandemic.

Rural residence across the life course and late-life cognitive decline in KHANDLE: A causal inference study.

Modifiable risks for dementia are more prevalent in rural populations, yet there is a dearth of research examining life course rural residence on late-life cognitive decline. The association of rural residence and socioeconomic status (SES) in childhood and adulthood with late-life cognitive domains (verbal episodic memory, executive function, and semantic memory) and cognitive decline in the Kaiser Healthy Aging and Diverse Life Experiences cohort was estimated using marginal structural models with stabilized inverse probability weights. After adjusting for time-varying SES, the estimated marginal effect of rural residence in childhood was harmful for both executive function (β =-0.19, 95% confidence interval [CI]=-0.32, -0.06) and verbal episodic memory (β =-0.22, 95% CI=-0.35, -0.08). Effects of adult rural residence were imprecisely estimated with beneficial point estimates for both executive function (β =0.19; 95% CI=-0.07, 0.44) and verbal episodic memory (β =0.24, 95% CI=-0.07, 0.55). Childhood rurality is associated with poorer late-life cognition independent of SES.

Immigration and Cognitive Change after age 90: findings from the LifeAfter90 Study

AbstractBackgroundPrior studies have suggested immigration may be associated with different cognitive decline; however, this has not been explored in those aged 90+ years. This study examined the association between United States (US) born vs non‐US born and cognitive decline in a diverse cohort of oldest‐old.MethodWe followed 641 participants of the LifeAfter90 study, an ongoing cohort study to evaluate aging and incident dementia in individuals aged 90+ recruited from Kaiser Permanente Northern California. Verbal episodic memory (VEM), semantic memory (SM), and executive function (EF) were measured using the Spanish and English Neuropsychological Assessment Scale every six months and domain‐specific scores were z‐scored to baseline. Self‐reported birthplace was collected at baseline or visit 2 (if previously not asked due to changes in the survey). Linear mixed models with random intercepts and slopes were adjusted for baseline age, gender, race/ethnicity, education, years since baseline, and practice effects.ResultThe sample was comprised of 60% women, 30% White, 18% Latino, 22% African American, 22% Asian, and 8% multiracial individuals (Table 1). Nineteen percent (n = 123) of the participants was born outside of the US, of those, 74% identified as Asian or Latino. Average baseline age was 93 years without differences between US‐born and non‐US born participants. Participants were followed for up to 7 waves (3.5 years with a mean of 2 visits). At baseline, participants born outside of the US had lower EF z‐scores (β = ‐0.39; 95% CI:‐0.57,‐0.21) and lower SM z‐scores (β = ‐0.69; 95% CI:‐0.87,‐0.51) than US‐born counterparts after adjustments (Table 2, Model 3). Participants had similar rates of cognitive change in the EF and VEM domains over the 7 waves. Participants born outside the US had a faster rate of decline in SM (β = ‐0.14; 95% CI:‐0.26,‐0.03) after adjusting for covariates.ConclusionIn oldest‐old individuals, we found that those born outside of the US had lower baseline EF and SM; a faster rate of decline in SM and a similar, though not quite significant, effect on VEM decline. Further comprehensive data on immigration, such as age of immigration and educational opportunities, may help explain the relationship between cognitive function and immigration

Dissociations between musical semantic memory and verbal memory in a patient with behavioral variant frontotemporal dementia

Objectives Patients with dementia show dissociations between musical semantic memory (i.e., spared musical lexicon) and other memory modalities, except in some severe cases. We aim to study, from a neuropsychological point of view, the dissociation between musical semantic memory compared to language and verbal memory in a patient with severe Behavioral Variant Frontotemporal Dementia (bvFTD). We hypothesize a single dissociation between these domains will be found, with sparing of musical semantic memory. Methods LC, a patient with severe bvFTD, and three matched controls were assessed through language, semantic, and episodic memory, and musical semantic memory tasks. The control group had similar music taste as LC: to participate as controls, tango must be one of their favorite musical genres. Results LC showed impairment in all Verbal Memory tasks, but not in musical tasks. There was a dissociation between musical semantic memory, and language and verbal semantic memory. Conclusions The musical lexicon can be preserved in advanced stages of dementia, which supports the idea that music can be a therapeutic tool in patients with severe dementia.

Long-term impact of Irradiation of Brain Structures involved in Memory: The IMPALA prospective study

<h3>Objectives</h3> Specific brain structures are involved in the different mnesic systems: hippocampus in episodic and semantic memory, striatum in sequence learning part of procedural memory and cerebellum in motor adaptation part of procedural memory and working memory. The aim of this work was to explore the impact of irradiation at brain structures involved in memory on long-term memory outcomes in children treated for posterior fossa tumor (PFT). <h3>Methods</h3> We investigated mnesicsystems, using a large battery of neuropsychological tools in 60 participants included in the prospective IMPALA study (NCT04324450) divided into three groups: 39 cured from a PFT in childhood (22 irradiated (PFT+RT group) and 17 non-irradiated (PFT group)) and 21 healthy volunteers matched on age, sex and handedness with the PFT+RT group. ANOVA and mixed models were used for statistical comparisons between groups. Mean and maximum irradiation doses at hippocampus, caudate nucleus, putamen, posterior and anterior cerebellum were collected from the initial dosimetry plan and Spearman correlations were used with neuropsychological scores in irradiated group. <h3>Results</h3> Verbal working memory, semantic memory and motor adaptation part of procedural memory were impaired in both PFT+RT and PFT groups. Visual working memory, episodic memory and sequence learning part of procedural memory were impaired in PFT+RT group. Sequence learning part of procedural memory was more impaired the higher the maximum dose to the right putamen (r:-0.493, p=0.034). Episodic memory impairment was correlated to the higher the mean dose the right and left hippocampi in three different neuropsychological tools, with a higher correlation with right hippocampus (r: -0.622; p=0.004; r:-0.595;p=0.007 and r:-0.673; p=0.002). <h3>Conclusion</h3> All mnesic systems were impaired in PFT when they were treated with radiotherapy with a dose impact at striatum and hippocampi on procedural and episodic memory. This is a step toward defining dose constraints to these structures in the future.

Association of Social Integration with Cognitive Status in a Multi-Ethnic Cohort: Results From the Kaiser Healthy Aging and Diverse Life Experiences Study.

We evaluated overall and race-specific relationships between social integration and cognition in older adults. Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) cohort participants included 1343 Asian, Black, Latino, or non-Latino White Kaiser Permanente Northern California members. We estimated the effect of social integration on verbal episodic memory, semantic memory, and executive function derived from the Spanish and English Neuropsychological Assessment (SENAS) Scales. Social integration scores included marital status; volunteer activity; and contact with children, relatives, friends, and confidants. We estimated covariate-adjusted linear mixed-effects models for baseline and 17-month follow-up cognition. Social integration was associated with higher baseline cognitive scores (average = 0.066 (95% confidence interval: 0.040, 0.092)) overall and in each racial/ethnic group. The association did not vary by race/ethnicity. Social integration was not associated with the estimated rate of cognitive change. In this cohort, more social integration was similarly associated with better late-life cognition across racial/ethnic groups.

Birth Cohorts and Cognitive Reserve Influence Cognitive Performances in Older Adults.

Evidence suggests birth cohort differences in cognitive performance of older adults. Proxies of cognitive reserve (CR), such as educational attainment and occupational complexity, could also partly account for these differences as they are influenced by the sociocultural environment of the birth cohorts. To predict cognitive performance using birth cohorts and CR and examine the moderating influence of CR on cognitive performance and structural brain health association. Using ADNI data (n = 1628), four birth cohorts were defined (1915-1928; 1929-1938; 1939-1945; 1946-1964). CR proxies were education, occupational complexity, and verbal IQ. We predicted baseline cognitive performances (verbal episodic memory; language and semantic memory; attention capacities; executive functions) using multiple linear regressions with CR, birth cohorts, age, structural brain health (total brain volume; total white matter hyperintensities volume) and vascular risk factors burden as predictors. Sex and CR interactions were also explored. Recent birth cohorts, higher CR, and healthier brain structures predicted better performance in verbal episodic memory, language and semantic memory, and attention capacities, with large effect sizes. Better performance in executive functions was predicted by a higher CR and a larger total brain volume, with a small effect size. With equal score of CR, women outperformed men in verbal episodic memory and language and semantic memory in all cohorts. Higher level of CR predicted better performance in verbal episodic memory, only when total brain volume was lower. Cohort differences in cognitive performance favor more recent birth cohorts and suggests that this association may be partly explained by proxies of CR.

A de novo truncating variant in CSDE1 in an adult-onset neuropsychiatric phenotype without intellectual disability

Variants in CSDE1, a gene encoding a constrained RNA-binding protein, have recently been associated with a spectrum of neurodevelopmental conditions encompassing autism, seizures and ocular abnormalities. According to previously reported individuals, pathogenic variants in CSDE1 are typically associated with developmental delay and intellectual disability. Here, we report one individual with normal neurodevelopment and adult-onset neuropsychiatric features (i.e., acute psychosis) due to the novel de novo truncating variant c.2272C>T, p.(Gln758*) in CSDE1 (NM_001242891.1). Neuropsychological assessment confirmed deficits regarding verbal fluency, semantic memory, executive function and processing speed. Overall, our findings expand the phenotypic spectrum of CSDE1-related disorder towards the mild end.

Examining possible gender differences in the association between education and late‐life cognitive function in the LifeAfter90 Study, a large multiethnic cohort of the oldest‐old

AbstractBackgroundEducational attainment predicts late‐life cognitive ability and dementia. Historically, women have had fewer educational opportunities than men. We examine if the association between educational attainment and cognitive level and decline differ by gender.MethodLifeAfter90 is an ongoing cohort of long‐time members of an integrated healthcare delivery system ≥90 years old without a dementia diagnosis at recruitment. Interviews and cognitive assessment occurred every six months and included self‐reported education (≤high school, some college, and ≥college graduate (reference)) and Spanish and English Neuropsychological Assessment Scales (SENAS). SENAS encompasses the domains of verbal episodic memory, semantic memory, and executive function. Mixed models with random intercepts estimated possible differences in the association between education and late‐life cognition adjusting for time (years since baseline), baseline age, race/ethnicity, and practice effects. Practice effects were accounted for by using an indicator variable for the first visit. Interactions terms allowed for possible gender differences in the association of education with baseline cognitive scores (i.e. education*male) and cognitive change (i.e., education*male*time).ResultThe 669 participants were on average 92.8 years of age, 63% were women, 34% were college graduates, and 69% were racial/ethnic minorities (Table 1 and Table 2). Lower levels of education were associated with worse performance on baseline cognitive assessment but not performance over time. Women with ≤high school or some college averaged worse baseline cognition in each domain than women who had completed college (Table 3). There was no significant gender by education interaction for verbal episodic memory (p‐value=0.22) or semantic memory (p‐value=0.26), but the disadvantage in executive function associated with lower education was significantly attenuated in men (some college*male β=0.32, 95% CI=0.08, 0.56; p‐value=0.01). There were no differences across genders in the association between education and any of the domain specific cognitive scores over time.ConclusionThe association between education and late‐life cognitive function appears to be similar across genders with the exception of college completion having a larger effect on baseline executive function scores for women than for men. We will continue to explore these differences as additional visits occur in this ongoing cohort of ethnically diverse oldest‐old individuals.

Does discrimination mediate the association between education and later‐life cognitive outcomes in a cohort of Black Americans? An example of parametric g‐estimation with latent variables in the STAR study

AbstractBackgroundIdentifying mediators between education and later‐life cognition is an important step in developing prevention measures. We evaluate everyday and major lifetime discrimination as potential mediators of the impact of education on later‐life cognition. To address bias that might occur due to either time‐varying confounding or unreliable measurement of discrimination, we use a novel parametric g‐estimation approach.MethodParticipants in the Study of Healthy Aging in African Americans (STAR, n = 764, ages 52‐90) self‐reported education (high school [HS] degree, general educational development [GED], or less [ref]; bachelor’s degree; or graduate degree). Validated measures of everyday discrimination (9‐items assessing frequency with 6‐point Likert responses) and major lifetime discrimination (9‐items, dichotomous yes‐no), were conceptualized as latent variables (Table 1). The observed cognitive outcome was the average of the verbal episodic memory, semantic memory, and executive function Spanish and English Neuropsychological Assessment Scales (SENAS). We used linear regression to estimate the total effect of education on later‐life cognition and parametric g‐estimation with latent discrimination measures to estimate the controlled direct effect (CDE) of education on cognition if the discrimination measures were set to their sample averages. Models were adjusted for measurement error in the discrimination measures using Fuller’s Method. Standard errors were bootstrapped.ResultMost participants were female (68.32%) and the average age was 69.0 (Table 2). Both bachelor’s (b=0.41[0.21,0.60]) and graduate (b=0.43[0.22,0.64]) degrees were associated with better cognition compared to HS/GED or less (Table 3). More education was associated with higher levels of major lifetime discrimination. The CDEs of a bachelor’s and graduate degree, if everyone had the average level of everyday and major life discrimination, were 0.32[0.06,0.61] and 0.55[0.24,0.82], respectively (Table 3 and as a function of different fixed averages in Figure 2).ConclusionThis study provides a novel demonstration of parametric g‐estimation methods that correct for measurement error with latent variables and allow for possible feedback between education and early and late‐life confounders. Accounting for exposure to discrimination slightly increased the magnitude of the association between graduate education and cognition in this older sample of Black American adults, because education was associated with greater exposure to major life discrimination.

The association between personality and longitudinal cognitive trajectories is independent of baseline brain variables

AbstractBackgroundPrevious work has shown that select personality and other interpersonal characteristics influence late‐life cognitive outcomes. However, it is not well understood whether these associations are dissociable from the effects of late‐life brain integrity. The current study examines whether personality characteristics are associated with cross‐sectional and longitudinal cognitive variables in a diverse cohort of older adults and whether these associations are independent of brain integrity as measured by structural MRI.Method157 participants (mean age 73.1±6.3 years) from the UC Davis ADC longitudinal Diversity Cohort were evaluated using the Spanish and English Neuropsychological Assessment Scales (SENAS) to assess verbal episodic memory, semantic memory, executive function, and spatial ability. The Big 5 personality measures were used to assess openness, conscientiousness, agreeableness, neuroticism, and extraversion as well as positive affect, sadness, meaning in life, and self‐efficacy. Baseline brain (MRI) variables including total gray matter volume, hippocampus volume and total white matter hyperintensity volume were also measured (n = 131). A parallel process, multi‐level model of the four longitudinal cognitive outcomes yielded intercept and linear slope random effects for each outcome. Slope random effects were highly correlated and summarized by a global slope second order factor. Global slope and individual intercepts were regressed on personality variables, covariates (age, gender, education, race/ethnicity, and recruitment source), and baseline brain variables.ResultPositive affect (p=0.004) and openness to new experience (p=0.009) demonstrated positive associations with longitudinal change in cognition that were independent of baseline brain variables and covariates (Table 2). Other personality variables, including conscientiousness, extraversion, neuroticism, agreeableness, sadness, meaning in life, and self‐efficacy did not demonstrate significant associations with cognitive change. Lower neuroticism and higher conscientiousness were associated with higher spatial ability intercepts, and lower sadness was associated with a higher episodic memory intercept, independent of covariates and brain variables.ConclusionPositive affect and openness are significantly associated with longitudinal cognitive trajectories, independent of demographics and cross‐sectional brain variables, including total gray matter volume, hippocampal volume, and total white matter hyperintensity volume. Future research will help to delineate how individual differences in personality and behavior relate to late‐life brain and cognitive changes.

Education, white matter hyperintensities, and cognition in diverse cohorts of older adults

AbstractBackgroundHigher education predicts better late‐life cognition among older adults, but mechanisms are poorly understood. We examined whether education modified the pathway between vascular injury and late‐life cognition.MethodAnalyses pooled imaging data from the multiethnic Kaiser Healthy Aging and Diverse Life Experience Study (KHANDLE; n=219) and the Study of Healthy Aging in African Americans (STAR; n=132), two parallel studies of older adult long‐term Kaiser Permanente members. Self‐reported education was considered as continuous years of completed education. White matter hyperintensities (WMH) were obtained through 3T MRI. Cerebral WMH volume to total cerebral volume ratio was log transformed and regressed on age; residuals were z‐standardized for measure of age‐adjusted WMH volume. Cognitive domains of verbal episodic memory (VRMEM), semantic memory (SEM), and executive function (EF) were measured using the Spanish and English Neuropsychological Assessment Scales (SENAS) and z‐standardized. Domain‐stratified regression models examined (1) independent effect of WMH adjusting for education, and (2) effect modification by education on the relationship between WMH and cognition. All models were adjusted for age, race/ethnicity, gender, and study.ResultParticipants were on average 73.2 years of age with 14.7 years of education, with 57.8% of the sample identifying as female and 49% of the sample identifying as Black. Education was significantly associated with all late‐life cognitive domains but for WMH volume (B: ‐0.02, 95% CI: ‐0.06, 0.02, p‐value: 0.38). In models adjusting for education and all covariates, effect of WMH on cognition was largest for EF (B: ‐0.09, 95% CI: ‐0.17, ‐0.01, p‐value: 0.03) followed by VRMEM (B: ‐0.06, 95% CI: ‐0.15, 0.03, p‐value: 0.18) and SEM (B: 0.00, 95% CI: ‐0.08, 0.08, p‐value: 0.97). Effect modification was suggested for VRMEM (WMH x education B: ‐0.03, 95% CI: ‐0.06, 0.00, p‐value: 0.09) but not EF (WMH x education B: ‐0.01, 95% CI: ‐0.04, 0.03, p‐value: 0.74) or SEM (WMH x education B: 0.00, 95% CI: ‐0.04, 0.03, p‐value: 0.79).ConclusionThe relationship between WMH and late‐life cognition differed by cognitive domain with the strongest effect of WMH independent of education for executive functioning, and effect modification by education for the relationship between WMH verbal episodic memory.

Association of social integration with cognitive status: results from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study

AbstractBackgroundLack of strong social ties is associated with numerous morbidities including adverse late‐life cognitive outcomes. Prior work on social integration and cognition has been conducted in predominantly White cohorts. We evaluated the relationships between social integration and cognition in diverse older adults from major racial/ethnic groups in the United States using data from the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) study.MethodKHANDLE is a multi‐ethnic study of 1712 Kaiser Permanente Northern California members age 65+. Social integration was assessed using the Berkman‐Syme Social Network Index. A score ranging from 0 to 6 was calculated by assigning 1 point for each of the following domains: being married/partnered, volunteer activity, having monthly contact with children, relatives, and friends and daily contact with confidante (Figure 1). Cognition included three domains derived from the Spanish and English Neuropsychological Assessment Scales: verbal episodic memory (for White, Black and Latino participants), semantic memory and executive function. Covariate‐adjusted linear mixed‐effects models estimated a single association of social integration with cognition applicable to all three cognitive domains for the full sample and by race/ethnicity. Core models adjusted for age, gender, race, and education (years); expanded models further adjusted for variables that could either be determinants or consequences of social integration, including weekly alcohol use, average score for combined activities of daily living (ADL) and instrumental ADL, and income. We repeated these analyses using frequency of contact with confidante as the primary exposure.ResultHigher social integration score was associated with better cognition in core covariate‐adjusted models (β=0.065 (0.039, 0.091)); the association attenuated slightly when adjusting for expanded covariates (β=0.045 (0.019, 0.071)). In race‐stratified core models, higher social integration scores were associated with better cognition among Asian, Black, Latino, and White participants. In expanded models patterns were similar, but the association remained statistically significant only for Black participants (Table 1). Seeing a confidante daily was associated with higher cognition in the pooled model and for Asian participants (Table 2).ConclusionOur findings suggest that social integration and seeing a confidante daily were associated with better cognition across the four racial/ethnic groups.

Adaptation and Validation of the Memory Alteration Test (M@T) in Greek Middle-Aged, Older, and Older-Old Population with Subjective Cognitive Decline and Mild Cognitive Impairment.

The Memory Alteration Test (M@T) is a verbal episodic and semantic memory screening test able to detect subjective cognitive decline (SCD) and Mild Cognitive Impairment (MCI). To adapt M@T, creating a Greek version of the Memory Alteration Test (M@T-GR), and to validate M@T-GR compared to the Mini-Mental State Examination (MMSE), and Subjective Cognitive Decline- Questionnaire (SCD-Q) MyCog and TheirCog. 232 people over 55 years old participated in the study and they were classified as healthy controls (HC, n = 65), SCD (n = 78), or MCI (n = 89). The ANCOVA showed that the M@T-GR's total score was significantly different in HC and SCD (I-J = 2.26, p = 0.032), HC and MCI (I-J = 6.16, p < 0.0001), and SCD compared to MCI (I-J = 3.90, p < 0.0001). In particular, a cut-off score of 46.50 points had an 81%sensitivity and 61%specificity for discriminating HC from SCD (AUC = 0.76, p < 0.0001), while a cut-off score of 45.50 had a sensitivity of 92%and a specificity of 73%for discriminating MCI (AUC = 0.88, p < 0.0001), and a cut-off score of 45.50 points had a sensitivity of 63%and a specificity of 73%for discriminating SCD from those with MCI (AUC = 0.69, p < 0.0021). Exploratory factor analysis indicated that there was one factor explaining 38.46%of the total variance. Internal consistency was adequate (α= 0.75), while convergent validity was found between M@T-GR and MMSE (r = 0.37, p < 0.0001) and SCD-Q TheirCog (r = -0.32, p < 0.0001). The M@T-GR is a good to fair screening tool with adequate discriminant validity for administration in people with SCD and MCI in Greece.