Differential Memory Test Sensitivity for Diagnosing Amnestic Mild Cognitive Impairment and Predicting Conversion to Alzheimer's Disease

ABSTRACT

Episodic memory is the first and most severely affected cognitive domain in Alzheimer's disease (AD), and it is also the key early marker in prodromal stages including amnestic mild cognitive impairment (MCI). The relative ability of memory tests to discriminate between MCI and normal aging has not been well characterized. We compared the classification value of widely used verbal memory tests in distinguishing healthy older adults (n = 51) from those with MCI (n = 38). Univariate logistic regression indicated that the total learning score from the California Verbal Learning Test-II (CVLT-II) ranked highest in terms of distinguishing MCI from normal aging (sensitivity = 90.2; specificity = 84.2). Inclusion of the delayed recall condition of a story memory task (i.e., WMS-III Logical Memory, Story A) enhanced the overall accuracy of classification (sensitivity = 92.2; specificity = 94.7). Combining Logical Memory recognition and CVLT-II long delay best predicted progression from MCI to AD over a 4-year period (accurate classification = 87.5%). Learning across multiple trials may provide the most sensitive index for initial diagnosis of MCI, but inclusion of additional variables may enhance overall accuracy and may represent the optimal strategy for identifying individuals most likely to progress to dementia.     

Individual differences in false memory from misinformation: Cognitive factors

This research investigated the cognitive correlates of false memories that are induced by the misinformation paradigm. A large sample of Chinese college students (N=436) participated in a misinformation procedure and also took a battery of cognitive tests. Results revealed sizable and systematic individual differences in false memory arising from exposure to misinformation. False memories were significantly and negatively correlated with measures of intelligence (measured with Raven's Advanced Progressive Matrices and Wechsler Adult Intelligence Scale), perception (Motor-Free Visual Perception Test, Change Blindness, and Tone Discrimination), memory (Wechsler Memory Scales and 2-back Working Memory tasks), and face judgement (Face Recognition and Facial Expression Recognition). These findings suggest that people with relatively low intelligence and poor perceptual abilities might be more susceptible to the misinformation effect.     

From pleasure and pride to the fear of decline: Exploring the emotions in older women's physical activity narratives

ObjectivesThe purpose of this study was to explore the emotion narratives in older women's ageing body and physical activity-related stories.MethodThe study was informed by narrative inquiry. We conducted two semi-structured interviews with 21 women aged 65 to 94 and asked them about their physical activity engagement, and body perceptions, experiences, and management strategies. Using thematic narrative analysis, we analysed the content of participants’ stories pertaining to physical activity, the core patterns within them, and considered the cultural context in which they were embedded.ResultsEmotion narratives of anxiety/fear, shame, guilt, pride, and pleasure permeated the women's stories. Participants feared physical and cognitive decline, and engaged in physical activity to stave off the ageing process. Body-related shame and guilt transected their stories; they were frustrated by their inabilities to engage in certain activities and with their move away from the healthy and physically fit cultural ideal. To negotiate this body-related anxiety/fear, shame, and guilt, the women drew attention to their accomplishments in the physical domain with pride, reinforcing their efforts to take personal responsibility for their health. Participants were also physically active for pleasure, gaining satisfaction from the social connections and mindfulness derived from being active, and through their participation in challenging yet rewarding activities.ConclusionsThe findings are novel as they highlight the importance of cultural age and body norms coupled with complex emotional experiences in shaping later life physical activity experiences, and draw attention to the usefulness of stories to explore emotions in the physical domain.     

Age-related differences in the elderly in a spatial recognition task

ABSTRACT

Spatial memory is a cognitive ability which declines with ageing thus showing changes in some process such as the use of allocentric strategies. These age-related changes in spatial orientation suggest that this skill could be an adequate marker of cognitive decline. Many tasks used in investigation to assess spatial memory demand a participant’s active role, which involves that the navigational experience is different for everyone. In this study, the Almeria Spatial Memory Recognition Test (ASMRT), a test based on a recognition paradigm, was used to offer the same experience with the environment. The aim of this research was to determine if the ASMRT is suitable to be applied in the elderly and detect spatial memory differences as one age. The ASMRT and other neuropsychological tests were applied in a sample aged between 50and 79 years. Results revealed a decrease in the ASMRT performance by the older group. No gender differences were found. Performance in attention and visuospatial working memory tests revealed some correlations with the ASMRT performance. In conclusion, this study demonstrates that 70–79-year-old participants clearly show age-related changes in spatial memory. Thanks to its simplicity the ASMRT could be used as a screening test in medical practice.     

No dual-task practice effect in Alzheimer's disease

Diagnosis of Alzheimer's disease (AD) requires evidence of progressive decline in cognitive function. However, many tests used to assess cognitive function suffer from considerable practice effects, reducing their reliability. Several studies have reported that the ability to do two things at once, or dual tasking, is impaired in AD, but unaffected by healthy ageing. The apparent specificity of this impairment suggests that this assessment may be particularly useful in the early diagnosis of AD, but the reliability of this assessment remains unknown. Therefore, this study investigated simultaneous performance of digit recall and tracking tasks across six testing sessions in eight people with AD, eight healthy older adults and eight healthy younger adults. The results found that dual-task performance was unaffected by healthy ageing, but significantly impaired in AD, with no effect of repeated exposure. The absence of any improvements in performance despite increased familiarity with the task's demands suggests that not only is the dual-task assessment well suited for monitoring progression over time, but also that dual tasking involves a specific cognitive function which is impaired in the AD brain.     

Ageing-related stereotypes in memory: When the beliefs come true

Age-related stereotype concerns culturally shared beliefs about the inevitable decline of memory with age. In this study, stereotype priming and stereotype threat manipulations were used to explore the impact of age-related stereotype on metamemory beliefs and episodic memory performance. Ninety-two older participants who reported the same perceived memory functioning were divided into two groups: a threatened group and a non-threatened group (control). First, the threatened group was primed with an ageing stereotype questionnaire. Then, both groups were administered memory complaints and memory self-efficacy questionnaires to measure metamemory beliefs. Finally, both groups were administered the Logical Memory task to measure episodic memory, for the threatened group the instructions were manipulated to enhance the stereotype threat. Results indicated that the threatened individuals reported more memory complaints and less memory efficacy, and had lower scores than the control group on the logical memory task. A multiple mediation analysis revealed that the stereotype threat effect on the episodic memory performance was mediated by both memory complaints and memory self-efficacy. This study revealed that stereotype threat impacts belief in one's own memory functioning, which in turn impairs episodic memory performance.     

Exploring possible neural mechanisms of intelligence differences using processing speed and working memory tasks: An fMRI study

To explore the possible neural foundations of individual differences in intelligence test scores, we examined the associations between Raven's Matrices scores and two tasks that were administered in a functional magnetic resonance imaging (fMRI) setting. The two tasks were an n-back working memory (N = 37) task and inspection time (N = 47). The subjects were members of the Aberdeen Birth Cohort 1936, aged in their mid–late 60s when tested for this study. Performance on both tasks was correlated significantly with scores on Raven's Matrices. In the inspection time task there were regions with significant correlations between the neural activity (BOLD response) and performance but not between BOLD response and scores on Raven's Matrices. In the working memory task there were no significant correlations between BOLD response and either performance or scores on Raven's Matrices. Moreover, there was almost no mediation of the Raven's Matrices versus n-back and inspection time scores correlations by the respective BOLD response. These findings partially replicate important aspects of a prominent report in this field [Gray, J.R., Chabris, C.F., & Braver, T.S. (2003). Neural mechanisms of general fluid intelligence. Nature Neuroscience, 6, 316–322.], but have also extended the those finding into both a unique population and a novel functional task.     

A ‘new life’ story or ‘delaying the inevitable’? Exploring older people's narratives during exercise uptake

ObjectivesThe purpose of this study was to examine narratives of ageing in a clinical population embarking on a physical activity/exercise programme, exploring if and how their narratives changed throughout their experiences.DesignThe study employed a longitudinal narrative approach.MethodParticipants were six sedentary individuals aged between 78 and 89 years who were enrolled on an exercise programme for older adults. During the course of the 32-week programme participants took part in multiple interviews focused on their attitudes towards physical activity and their physical self-perceptions and identity. A structural narrative analysis was used to focus on the progression of the plot outlined in each participant's story.ResultsOur results suggested the emergence of two comparative narratives, with each demonstrated in the stories told by three participants. The first narrative is one of decelerated decline, in which the exercise programme is assimilated or fitted into the existing life narrative, but little is made of the personal meaning of being active. In the second narrative, participation in exercise prompted participants to re-story their ageing narratives, changing from initially accepting the decline they associated with an ageing body, to the prospect of gaining some control. While this increased sense of control may intuitively seem positive, participants initially described a number of existential challenges and dilemmas as well as their resolution of these.ConclusionParticipants' emergent stories highlighted that while older adults may perceive exercise positively, their existing narratives of decline may be resistant to change. Where changes do occur, it is important for health professionals to recognize the associated difficulties with gaining increased responsibility for health.     

Cognitive stimulation for healthy older adults through computer-based programs: a review of the literature / Estimulación cognitiva para personas mayores sanas mediante programas computarizados: una revisión de la literatura

Abstract

Cognitive stimulation programs are widely used as a preventive tool for cognitive decline in older adults, as they can favour positive ageing by maintaining older persons’ autonomy and preserving their cognitive functions. Because of this, and due to its potentially easy application on a large scale and at a low cost, the incorporation of technologies for the cognitive stimulation of older adults has become an area of growing interest. This review outlines the advantages and disadvantages of computer-based cognitive stimulation programs aimed at healthy older adults, focusing on aspects that influence their effectiveness and future direction. Twenty-five articles were considered, including original studies, literature reviews and meta-analyses, published between 2013 and 2017. It was concluded that there is a need to generate more randomized studies with active control groups to assess the effectiveness of cognitive stimulation through computer-based programs, as well as develop designs to establish strategies that increase older adults’ adherence and ensure their motivation to carry out these activities.     

Framingham vascular age is associated with worse cognitive performance in the middle-aged and elderly

“Normal” age-related cognitive decline has been associated with cardiovascular risk factors. Framingham Vascular Age is age-normed cardiovascular risk which may help communicate risk to patients and identify those at relatively higher risk. We aim to assess the association between Framingham Vascular Age and cognition. 346 “healthy” participants (57±10 years) without neuropsychiatric disorders or clinical manifestations of cardiovascular disease were studied. Cognition was evaluated using the Brief Memory and Executive Test and Framingham Vascular Age was calculated. The association between Framingham Vascular Age and cognitive performance was determined through General Linear Models to control for covariates. Framingham Vascular age was associated with poorer Memory and Executive Function/Processing Speed indices (p= 0.019 and p<0.001, respectively). We conclude Framingham Vascular Age is associated with worse Executive Function/Processing Speed and Memory. Vascular Age may help identify patients at higher risk of age-related cognitive decline with implications for communicating the morbidity associated with cardiovascular risk.     

The indirect effect of cognitive reserve on the relationship between age and cognition in pathological ageing: A cross-sectional retrospective study in an unselected and consecutively enrolled sample

Cognitive reserve (CR) allows individuals to maintain cognitive functionality even in the presence of pathologies. The compensation hypothesis suggests that CR plays an indirect role between age and cognitive decline, contrasting the negative effect of ageing on cognition. We test this hypothesis in an unselected and consecutively enrolled sample of memory clinic attendees (n = 134) who completed the CR Index questionnaire and three neuropsychological tests assessing global cognition (MMSE, FAB, CDT). Participants were divided into two groups based on standard diagnostic criteria (DSM-5): those who were cognitively impaired (n = 92) and those who were preserved (n = 42). A principal component analysis was used to extract a composite measure of global cognitive functioning from the three neuropsychological tests, and mediation analysis was used to examine the relationship between CR, age and global cognitive functioning in the two groups. Results revealed that: (i) age had a significant direct negative effect on the global cognitive score in both groups; (ii) the three socio-behavioural proxies of CR together suppress the direct negative relationship between age and global cognitive score in cognitively impaired patients but not in cognitively preserved participants. This study confirms the association between CR, age and cognition and allows us to validate its role in a population with cognitive impairment and extend findings to a low-to-middle educated population. These results hold important implications for public health and wellness promotion, emphasising the beneficial role of maintaining healthy and active physical, cognitive and social lifestyles.     

Interpreting Direction of Anxiety Within Hanin's Individual Zone of Optimal Functioning

Abstract

The purpose of this study was to examine Jones' (1991) directionality hypothesis and Hanin's (2000) individual zone of optimal functioning model. Swimmers' performance was examined to determine if cognitive and somatic anxiety was within cognitive and somatic individual zones of optimal functioning (IZOFs). Direction of cognitive and somatic anxiety was examined to determine if anxiety within IZOFs would be reported as facilitative to performance. One 3×3 (cognitive anxiety X somatic anxiety) ANOVA was calculated using ipsative t scores as the performance dependent variable. Two separate one factor ANOVAs for cognitive anxiety and somatic anxiety were calculated using ipsatized cognitive and somatic direction scores as the dependent variables. Results indicated support for Hanin's IZOF theory relative to intensity of cognitive anxiety, however, interpretations of anxiety within IZOFs failed to provide support for the directional hypothesis. Results are explained via examination of extant anxiety-performance and directionality literature. Potential limitations and implications for future research are discussed.     

Social Anxiety is Associated with a Negatively Distorted Perception of One's Own Voice

According to cognitive models of social anxiety, negatively distorted self-images have a central role in the development and maintenance of social anxiety. In the present study, the relationship between social anxiety and the perception of one's own voice was investigated in a sample of 17 undergraduate students. The participants were asked to recount a story aloud in front of a tape recorder, and then to rate their voice characteristics on a Voice Evaluation Questionnaire. Independent observers (speech therapy students) were then asked to listen to the tape recordings and to rate the participants' voice characteristics on an equivalent version of the Voice Evaluation Questionnaire. Two hypotheses were contrasted: a skill deficits hypothesis and a cognitive distortion hypothesis. The results supported the cognitive distortion hypothesis. A high level of social performance anxiety was associated with an underestimation of one's voice qualities, compared with the independent observers. It is suggested that sound-tape feedback with cognitive preparation should be tested as a method for correcting the negatively distorted voice perception that is associated with social anxiety.     

Everyday Cognitive Functioning in Cardiac Patients: Relationships Between Self-report,Report of a Significant Other and Cognitive Test Performance

ABSTRACT

Candidates for cardiac bypass surgery often experience cognitive decline. Such decline is likely to affect their everyday cognitive functioning. The aim of the present study was to compare cardiac patients' ratings of their everyday cognitive functioning against significant others' ratings and selected neuropsychological tests. Sixty-nine patients completed a battery of standardised cognitive tests. Patients and significant others also completed the Everyday Function Questionnaire independently of each other. Patient and significant other ratings of patients' everyday cognitive difficulties were found to be similar. Despite the similarities in ratings of difficulties, some everyday cognitive tasks were attributed to different processes. Patients' and significant others' ratings were most closely associated with the neuropsychological test of visual memory. Tests of the patients' verbal memory and fluency were only related to significant others' ratings. Test scores of attention and planning were largely unrelated to ratings by either patients or their significant others.     

Early signs of memory impairment among multiple sclerosis patients with clinically isolated syndrome

The study investigates primary and secondary verbal memory and motor/executive functions (response inhibition and strategy shifting ability) in multiple sclerosis (MS) patients with clinically isolated syndrome (CIS). We studied 44 CIS patients and compared them to 49 patients with relapsing remitting MS (RR-MS) displaying mild disability and to a large cohort of age- and education level-matched healthy volunteers(n=230). Results showed that both CIS and RR-MS patients evidenced a disproportionate impairment in the immediate and delayed recall of the second (as compared to the first) of two short narratives of the Logical Memory WMS-III subtest, and reduced performance on the Memory for Digits-Forward. Performance of either group on the executive tasks was not impaired, showing evidence of a reversed speed-accuracy trade-off. Illness duration emerged as a significant predictor of memory and executive task performance. Clinical, psychoemotional, and brain imaging findings were also examined as potential correlates of memory deficits and disease progression among CIS patients. These findings may signify early-onset decline of specific cognitive functions in CIS, which merits regular follow-up assessments and monitoring of psychoemotional adaptation and everyday functioning.     

Lifespan normative data (18–89 years) for Raven's Advanced Progressive Matrices Set I

Raven's Advanced Progressive Matrices (APM) Set I is a validated and brief test of fluid intelligence, ideal for use in busy clinical settings. However, there is a dearth of normative data allowing an accurate interpretation of APM scores. To address this, we present normative data from across the adult lifespan (18–89 years) for the APM Set I. Data are presented in five age cohorts (total N = 352), including two older adult cohorts (65–79 years and 80–89 years), which allows age-standardized assessment. We also present data from a validated measure of premorbid intellectual ability, which was absent from previous standardizations of longer forms of the APM. In line with previous findings, a striking age-related decline was noted, beginning relatively early in adulthood and most marked amongst lower-scoring individuals. Older adults did not demonstrate difficulty with specific test items or make an increased proportion of specific errors. Sex was not a significant predictor of performance. The data set is of particular use in the neuropsychological assessment of older adults, given the known susceptibility of fluid intelligence to both the effects of normal ageing and acquired brain injury in older age. The results are discussed in light of theories of neurological ageing.     

Age and Flexible Thinking: An Experimental Demonstration of the Beneficial Effects of Increased Cognitively Stimulating Activity on Fluid Intelligence in Healthy Older Adults

ABSTRACT

The disuse hypothesis of cognitive aging attributes decrements in fluid intelligence in older adults to reduced cognitively stimulating activity. This study experimentally tested the hypothesis that a period of increased mentally stimulating activities thus would enhance older adults' fluid intelligence performance. Participants (N?=?44, mean age 67.82) were administered pre- and post-test measures, including the fluid intelligence measure, Cattell's Culture Fair (CCF) test. Experimental participants engaged in diverse, novel, mentally stimulating activities for 10–12 weeks and were compared to a control condition. Results supported the hypothesis; the experimental group showed greater pre- to post-CCF gain than did controls (effect size d?=?0.56), with a similar gain on a spatial-perceptual task (WAIS-R Blocks). Even brief periods of increased cognitive stimulation can improve older adults' problem solving and flexible thinking.     

Memory improvement tapes: How effective for elderly adults?

Abstract

The effectiveness of two commercially available audiocassette memory improvement programs was evaluated in a sample of 32 healthy, community-living elderly adults. Participants were given a set of either Syber Vision's Neuropsychology of Memory Power tapes (Bornstein, 1989) or Nightingale-Conant's Mega Memory tapes (Trudeau, 1992), and a portable cassette player, and instructed to complete the programs within 10 weeks. All participants received a comprehensive battery of memory tests prior to and immediately following the memory improvement programs. Participants completing the memory improvement programs showed no greater gains in memory test performance than no-treatment control participants, but did report greater confidence in their memory abilities. Participants completing the Mega Memory program thought they were less likely to develop Alzheimer's disease after having completed it compared with participants in the other two conditions. Participants reported finding both tape programs acceptable and potentially useful for improving memory; those who completed the Memory Power program reported somewhat greater satisfaction than those completing the Mega Memory program. the claims about rapid, dramatic memory improvement with use of these products were not substantiated in this group of elderly adults and appear to be grossly exaggerated.     

Intelligence and Family Marital Structure: The Case of Adolescents From Monogamous and Polygamous Families Among Bedouin Arabs in Israel

Abstract

The levels of intelligence among Bedouin Arab adolescents from monogamous and polygamous families living in the Negev region of Israel were examined. A shortened version of the Raven's Progressive Matrices (RPM) test (S. Elbedour, T. J. Bouchard, & Y. Hur, 1997; J. Raven, J. C. Raven, & J. H. Court, 1998) was used to assess intelligence. There were no significant test score differences between adolescents from monogamous families and adolescents from polygamous families. In addition, participants with 2 mothers tended to have lower RPM scores than those with 3 or 4 mothers, and participants with related parents tended to have lower RPM scores than participants with unrelated parents. One major finding of this study is that polygamous family marital structures tended not to have deleterious effects on the Bedouin Arab adolescents' RPM test scores.     

Hypermnesia in older people and its relationship with successful ageing / La hipermnesia en personas mayores y su relación con el envejecimiento exitoso

Abstract

This study analyses the phenomenon of hypermnesia and its relationship with variables associated with successful ageing such as age, sex, cognitive status and cognitive plasticity in older people. The sample consists of 124 institutionalized and non-institutionalized participants, whose ages ranged from 65 to 91. A specific task was used to evaluate hypermnesia; a cognitive screening test and a verbal fluency test were used to assess cognitive status, and the AVLT-LP test was used to measure cognitive plasticity. The results show significant improvements between the hypermnesia recall tests for the total sample and for all the groups, according to the variables studied. Participants with successful ageing characterized by a younger age, a high level of cognitive functioning and a greater cognitive plasticity showed better results than the other participants in the hypermnesia task with the exception of sex, which did not present differences between groups. This study confirms that hypermnesia occurs more significantly in older people with successful ageing regardless of whether they are male or female.