Relationship of cognitive strategy use to prospective memory performance in a diverse sample of nondemented older adults with varying degrees of cognitive complaints and impairment

Although older adults typically have better performance on prospective memory (PM) tasks carried out in naturalistic settings, a paucity of research directly assesses older adults’ use of compensatory strategies on such tasks. The current study investigates external memory strategy use during performance of a clinical PM test that features both short-term (in laboratory) and long-term (out of laboratory) subtasks (i.e., the Royal Prince Alfred Prospective Memory Test – RPA-ProMem. Nondemented, community-dwelling older adults (n = 214; mean age = 80.5; 68.2% female; 39.7% non-white) with mild cognitive impairment, subjective cognitive decline, and healthy controls completed the RPA-ProMem while external strategy use was permitted and recorded. Overall, participants utilized external strategies 41% of the time on the RPA-ProMem. Increased utilization of external memory strategies was significantly associated with better PM performance. Additionally, better performance on executive functioning tasks was associated with increased use of external memory strategies. Results are discussed in relation to how memory strategy use can be enhanced to improve everyday memory ability in older adults at risk for dementia.     

A study of mild cognitive impairment in veterans: role of hypertension and other confounding factors

Introduction: Hypertension has shown to be an important risk factor for the decline in cognitive function. Aim of our study is to investigate the presence of cognitive impairment of the elders with hypertension and other confounding factors.

Methods: This study was conducted on 400 veterans who were matched one-to-one with the confounding factors for assessing the presence of mild cognitive impairment using both MMSE and Montreal Cognitive Assessment (MoCA). The 13 related factors of patient data were studied.

Results: The prevalence rate of cognitive impairment was 29.25%. Age (OR 2.679, 95%CI 1.663–6.875), sleep impairment (OR 1.117, 95%CI 1.754–7.422), uncontrolled hypertension (OR 1.522, 95%CI 1.968–4.454), type 2 diabetes (OR 2.464, 95%CI 1.232–4.931), and hyperlipidaemia (OR 1.411, 95%CI 1.221–8.988) are the risk factors for the cognitive deterioration, while the protective factors are high level of education (OR 0.032, 95%CI 0.007–0.149) and regular exercise (OR 0.307, 95%CI 0.115–0.818).

Discussion: Because some vascular disease risk factors, such as hypertension, can be treated effectively, cognitive decline related to these risk factors, and vascular disease per se, may be prevented or its course modified through more aggressive treatment and improved compliance.     

Assessing cognitive impairment in Indigenous Australians: Re‐evaluation of the Kimberley Indigenous Cognitive Assessment in Western Australia and the Northern Territory

The Kimberley Indigenous Cognitive Assessment (KICA) was initially developed and validated as a culturally appropriate dementia screening tool for older Indigenous people living in the Kimberley. This paper describes the re‐evaluation of the psychometric properties of the cognitive section (KICA‐Cog) of this tool in two different populations, including a Northern Territory sample, and a larger population‐based cohort from the Kimberley. In both populations, participants were evaluated on the KICA‐Cog tool, and independently assessed by expert clinical raters blinded to the KICA scores, to determine validity and reliability of dementia diagnosis for both groups. Community consultation, feedback and education were integral parts of the research. for the Northern Territory sample, 52 participants were selected primarily through health services. Sensitivity was 82.4% and specificity was 87.5% for diagnosis of dementia, with area under the curve (AUC) of .95, based on a cut‐off score of 31/32 of a possible 39. for the Kimberley sample, 363 participants from multiple communities formed part of a prevalence study of dementia. Sensitivity was 93.3% and specificity was 98.4% for a cut‐off score of 33/34, with AUC = .98 (95% confidence interval: 0.97–0.99). There was no education bias found. The KICA‐Cog appears to be most reliable at a cut‐off of 33/39.     

The Feeling-Tone Questionnaire: Reliability and Validity of a Direct Patient Assessment Screening Instrument for the Detection of Depressive Symptoms in Cases of Dementia

The purpose of this study was to develop a reliable and valid measure of affective disorder in elderly demented patients. The field lacks instruments which are sensitive to detecting depressive signs in severely as well as mildly and moderately demented subjects. Two samples of subjects were chosen for study. The first sample consisted of subjects from six institutions, which were chosen for study from a probability sample of 25 long-term care institutions in New York City. This sample was part of the Cross-National Institutional Study conducted in New York and London (Gurland et al., 1979; Mann et al., 1984). Thirty patients were selected at random within each institution. The second sample consisted of 52 inpatients at Willard Psychiatric Center, a traditional state psychiatric hospital in upstate New York. All subjects had a chart diagnosis of dementia and were 60 years old or older. The mean age of the sample was 82 years and 56% of the subjects were female. The Feeling-Tone Questionnaire, which was developed for these analyses, consists of 16 dichotomous items and 16 5-point Likert ratings of affect. The reliability of this scale using Cronbach's alpha is .91 for the long-term care institutional sample and .90 for the psychiatric hospital sample. Interrater reliability for two raters on ten cases is .99. Test–retest reliability on ten cases with a 1-day to 2-day interval between trials is .81. A short mood scale was developed from the observational data as a validity measure for the Feeling-Tone Questionnaire. Evidence for the validity of the Feeling-Tone Questionnaire is provided.     

Increased sensitivity to proactive interference in amnestic mild cognitive impairment is independent of associative and semantic impairment

Episodic memory deficit is the hallmark of amnestic mild cognitive impairment (aMCI). There is, however, an overlap in performance among patients with aMCI and elderly controls (EC). The memory deficit in aMCI therefore needs to be better characterized. Studies have shown that associative memory is selectively impaired in aMCI, and recent work suggested that aMCI may be hypersensitive to semantic proactive interference (PI). It is not known whether this increased PI is related to associative or semantic impairment. EC (n = 44) and patients with aMCI (n = 30) performed two tasks presenting a gradually increasing PI effect across four lists. One task used semantic cueing, the other phonological cueing. We controlled for associative memory by introducing it as a covariate and by matching our subjects for it. Patients with aMCI had a greater PI effect than EC matched for associative memory, regardless of the type of cueing. The increased PI effect in patients with aMCI is independent of their associative and semantic impairment.     

The assessment of recognition memory using the Remember/Know procedure in amnestic mild cognitive impairment and probable Alzheimer’s disease

This study used the Remember/Know (R/K) procedure combined with signal detection analyses to assess recognition memory in 20 elders with amnestic mild cognitive impairment (aMCI), 10 patients with probable Alzheimer’s disease (AD) as well as matched healthy older adults. Signal detection analyses first indicated that aMCI and control participants were comparable on general recognition performance. As regards AD patients, they were impaired relative to both aMCI and healthy elders. When assessing Remember and Know responses the aMCI group showed diminished sensitivity for Remember responses but intact Know responses compared to healthy elders. In contrast, AD patients showed decreased sensitivity for both Remember and Know responses compared to control and aMCI participants. The response bias index revealed that AD patients were more liberal than aMCI and control participants when providing Know responses. On the other measures, response bias was comparable between the groups. Overall, this study indicates that the R/K procedure can characterize different aspects of recognition memory performance in persons with aMCI or AD.     

Implications of MDMA use for prospective memory function and substance use patterns in an Australian sample: A web‐based pilot study

The use of amphetamine type stimulants, particularly MDMA, is a global concern. Little research has been conducted on the association between MDMA use and everyday memory function—prospective memory. Twenty‐five MDMA users, 37 cannabis users, and 43 illicit substance‐naïve controls were assessed on their substance use history and reported prospective memory performance as measured by the Prospective Memory Questionnaire (PMQ) using a web‐based survey. There were significant differences between MDMA users and controls and cannabis users and controls on long‐term episodic subscale of the PMQ. However, given the high prevalence of cannabis co‐use by MDMA users, it was not possible to determine if MDMA use alone is associated with prospective memory performance. The substance use patterns of the sample were evaluated. Alcohol was the most used substance followed by tobacco, cannabis, and MDMA. The incidence of polydrug use was high, with all illicit substance use reporting having used at least two substances in their lifetime. The present study supports previous research into prospective memory deficits associated with substance use, and provides a basis for future research, particularly for elucidation of prospective memory deficits specific to MDMA use and further evaluation of substance use patterns.