Relation between cardiovascular and metabolic disease and cognition in very old age: cross-sectional and longitudinal findings from the berlin aging study.

This study documented findings on the relation between cognitive functioning (perceptual speed, memory, fluency, and knowledge) and cardiovascular and metabolic disease in a sample of very old adults (ages 70 and older), both cross-sectionally (n=516) and longitudinally (n=206) in a 4-year follow-up. After age, SES, sex, and dementia status were controlled for, 4 diagnoses were negatively associated with cognition: congestive heart failure, stroke, coronary heart disease, and diabetes mellitus, with a joint effect of 0.47 standard deviations. The impact of disease status was largest on perceptual speed and fluency, memory was impacted only by diabetes, and knowledge was not related to any somatic diagnosis. There was no differential decline in participants diagnosed with 1 of these 4 diseases and those who were not. The only cardiovascular risk factor associated with cognitive performance was alcohol consumption.     

The relation between APOE status and neuropsychological memory test performance: an analysis of the Canadian Study of Health and Aging

This study examined the relationship between two risk factors for dementia, the apolipoprotein (APOE) epsilon4 allele and poor memory test performance. Participants were from the Canadian Study of Health and Aging, a 4-year longitudinal population-based study. Persons with no cognitive impairment who had an epsilon4 allele but whose memory was average or better were not at increased risk of developing dementia after five years. Risk was increased for those with below average memory and no epsilon4 allele, but was particularly increased for those with below average memory and an epsilon4 allele. While the APOE epsilon4 allele was associated with slightly lower memory test performance for persons without cognitive impairment at baseline, it only increased their risk of developing dementia if their memory was below average.     

高低创造性思维水平者定向遗忘效应的差异研究

采用单字法定向遗忘范式,考察远距离联想任务得分高低者在中性和负性词语定向遗忘效应上的差异,来探讨创造性思维水平高低与主动抑制的关系。实验采用2(高/低创造性思维水平)×2(中性/负性词汇)×2(记住/忘记指令)×2(2s/5s时间间隔)混合设计,发现高低创造力组,在材料不同呈现时间下,对不同情绪材料的定向遗忘效应分别不同。低创者在2s和5s以及高创者在5s时间间隔时,均对中性词语表现出定向遗忘效应,而对负性词汇没有表现出明显的定性遗忘效应。高创者在2s时间间隔下,对中性和负性词语均表现出定向遗忘效应。结果表明较短时间内高创者对负性情绪的主动抑制能力优于低创者。     

Alzheimer's Disease Patients' Cognitive Status and Course Years Prior to Symptom Recognition

This is a prospective examination of the cognitive performance and cognitive course of persons in an asymptomatic “preclinical” phase who eventually developed Alzheimer's disease (AD). We compared performances on the Mayo Cognitive Factor Scales (MCFS) of 20 persons in a neurologically normal cohort who subsequently developed AD to the performances of 60 persons who remained free of dementia symptoms. For the AD patients, exams occurred prior to the appearance of dementia symptoms (an average of 4.2 and 1.5 years prior to symptom onset). Results reveal strong group differences on learning and retention, with eventual AD patients scoring lower than controls years prior to reporting symptoms of the disease. There was no significant interaction effect (group × testing session) for memory retention, suggesting that memory decline in this preclinical period may be too slow to be a useful indicator of future AD. A significant interaction (but no group effect) was seen for verbal comprehension.     

Alzheimer's disease patients' cognitive status and course years prior to symptom recognition

This is a prospective examination of the cognitive performance and cognitive course of persons in an asymptomatic "preclinical" phase who eventually developed Alzheimer's disease (AD). We compared performances on the Mayo Cognitive Factor Scales (MCFS) of 20 persons in a neurologically normal cohort who subsequently developed AD to the performances of 60 persons who remained free of dementia symptoms. For the AD patients, exams occurred prior to the appearance of dementia symptoms (an average of 4.2 and 1.5 years prior to symptom onset). Results reveal strong group differences on learning and retention, with eventual AD patients scoring lower than controls years prior to reporting symptoms of the disease. There was no significant interaction effect (group x testing session) for memory retention, suggesting that memory decline in this preclinical period may be too slow to be a useful indicator of future AD. A significant interaction (but no group effect) was seen for verbal comprehension.     

Cognitive Functioning in Aging and Dementia: The Kungsholmen Project

The Kungsholmen Project (KP) is a community-based longitudinal study of aging and dementia targeting the 75+ population. In this article, we review empirical studies with a cognitive focus from the KP. The main findings indicate that (a) there is an age-related decline for some cognitive domains (e.g., episodic memory, verbal fluency, visuoconstructive skill, psychomotor speed), but not for others (e.g., primary memory, visuoperceptive skill, motor-hand coordination), (b) multiple individual-difference variables within demographic (e.g., sex, education) life-style (e.g., activity levels), genetic (e.g., apolipoprotein E genotype), and health-related (e.g., vitamin B deficiency, depression, diabetes) domains are related to late-life cognitive functioning, (c) a potential for improving cognitive performance – a reserve capacity – is present also among very old adults, (d) the 2 most common dementia diseases, Alzheimer’s disease (AD) and vascular dementia (VaD), affect cognition in a strikingly similar manner, (e) the role of individual-difference variables in cognitive functioning is markedly reduced in dementia – the pathogenesis itself may overshadow the influence of other variables, and (f) there is a long preclinical period in dementia during which cognitive deficits are detectable. As is true with the other projects represented in this issue, the KP portrays a rather diversified picture of cognitive aging, although systematic patterns are evident with regard to the variability of late-life cognitive functioning.     

Influences of preclinical dementia and impending death on the magnitude of age-related cognitive deficits

The authors examined the influence of preclinical dementia and impending death on the cross-sectional relationship between age and performance in tasks assessing episodic memory, visuospatial skill, and verbal fluency. Increasing age was associated with a general decrease in cognitive performance. In addition, those who were to be diagnosed with dementia or had died by a 3-year follow-up, were older, and performed at a lower level than the remaining sample across all cognitive tasks at baseline. Nevertheless, removal of the preclinical dementia and impending death groups from the original sample affected the cross-sectional age-cognition relations relatively little. This pattern of findings suggests that the biological aging process exerts negative influences on cognitive functioning beyond those resulting from disease and mortality.     

An analysis of diversity in the cognitive performance of elderly community dwellers: individual differences in change scores as a function of age.

This longitudinal study investigated whether age is associated with increases in interindividual variability across 4 ability domains using a sample of 426 elderly community dwellers followed over 3.5 years. Interindividual variability in change scores increased with age for memory, spatial functioning, and speed but not for crystallized intelligence for the full sample and in a subsample that excluded dementia or probable dementia cases. Hierarchical regression analyses indicated that being female, having weaker muscle strength, and having greater symptoms of illness and greater depression were associated with overall greater variability in cognitive scores. Having a higher level of education was associated with reduced variability. These findings are consistent with the view that there is a greater range of responses at older ages, that certain domains of intelligence are less susceptible to variation than others and that variables other than age affect cognitive performance in later life.     

A Study of Seventh Grade Children's Reading of Comic Books as Related to Certain other Variables

Developmental changes in a variety of cognitive processes as a function of age and schooling were examined in 160 rural Guatemalan children aged 5, 7, 9, and 11 years. Larger differences in test performance were seen between ages 9 and 11 than during earlier age periods on most tasks. Regression analyses of years of schooling controlling for age, sex, and socioeconomic status indicated that the effects of school were limited to memory tasks and to response time on the Matching Familiar Figures Test (MFF). Evidence for cumulative effects of additional years in school on test performance was weak. Good school performance was also most related to two memory measures. Previous studies indicating that schooling has a substantial effect on abstract cognitive processes were questioned; the suggestion that school performance is related to various memory processes was raised.     

Differential trajectories of age-related changes in components of executive and memory processes

Several studies have demonstrated age-related declines in general executive function and memory. In this study, we examined cross-sectional and longitudinal age effects in more specific cognitive processes that constitute executive function and memory. We postulated that, whereas some components of executive and memory functions would show age differences and longitudinal declines, other specific abilities would be maintained or even improve with repeated testing. In a sample of individuals ≥55 years old from the Baltimore Longitudinal Study of Aging, we found longitudinal declines in inhibition, manipulation, semantic retrieval, phonological retrieval, switching, and long-term memory over a maximum of 14 years follow-up. In contrast, abstraction, capacity, chunking, discrimination, and short-term memory were maintained or even improved longitudinally, probably due in part to repeated testing. Moreover, whereas several different abilities were correlated across participants' cross-sectional performance, longitudinal changes in performance showed more heterogeneous trajectories. Finally, compared with cross-sectional performance, longitudinal trajectories showed better distinction between participants with and those without later cognitive impairment. These results show that longitudinal cognitive aging of executive and memory functions is not a uniform process but a heterogeneous one and suggest that certain executive and memory functions remain stable despite age-related declines in other component processes. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Hippocampal memory processes are modulated by insulin and high-fat-induced insulin resistance

Insulin regulates glucose uptake and storage in peripheral tissues, and has been shown to act within the hypothalamus to acutely regulate food intake and metabolism. The machinery for transduction of insulin signaling is also present in other brain areas, particularly in the hippocampus, but a physiological role for brain insulin outside the hypothalamus has not been established. Recent studies suggest that insulin may be able to modulate cognitive functions including memory. Here we report that local delivery of insulin to the rat hippocampus enhances spatial memory, in a PI-3-kinase dependent manner, and that intrahippocampal insulin also increases local glycolytic metabolism. Selective blockade of endogenous intrahippocampal insulin signaling impairs memory performance. Further, a rodent model of type 2 diabetes mellitus produced by a high-fat diet impairs basal cognitive function and attenuates both cognitive and metabolic responses to hippocampal insulin administration. Our data demonstrate that insulin is required for optimal hippocampal memory processing. Insulin resistance within the telencephalon may underlie the cognitive deficits commonly reported to accompany type 2 diabetes.     

Self-Reported Cognitive Inconsistency in Older Adults

ABSTRACT

Insight into one's own cognitive abilities, or metacognition, has been widely studied in developmental psychology. Relevance to the clinician is high, as memory complaints in older adults show an association with impending dementia, even after controlling for likely confounds. Another candidate marker of impending dementia under study is inconsistency in cognitive performance over short time intervals. Although there has been a recent proliferation of studies of cognitive inconsistency in older adults, to date, no one has examined adults' self-perceptions of cognitive inconsistency. Ninety-four community-dwelling older adults (aged 70–91) were randomly selected from a parent longitudinal study of short-term inconsistency and long-term cognitive change in aging. Participants completed a novel 40-item self-report measure of everyday cognitive inconsistency, including parallel scales indexing perceived inconsistency 5 years ago and at present, yielding measures of past, present, and 5-year change in inconsistency. The questionnaire showed acceptable psychometric characteristics. The sample reported an increase in perceived inconsistency over time. Higher reported present inconsistency and greater 5-year increase in inconsistency were associated with noncognitive (e.g., older age, poorer ADLs, poorer health, higher depression), metacognitive (e.g., poorer self-rated memory) and neuropsychological (e.g., poorer performance and greater 5-year decline in global cognitive status, vocabulary, and memory) measures. Correlations between self-reported inconsistency and neuropsychological performance were attenuated, but largely persisted when self-rated memory and age were controlled. Observed relationships between self-reported inconsistency and measures of neuropsychological (including memory) status and decline suggest that self-perceived inconsistency may be an area of relevance in evaluating older adults for memory disorders.     

Dispersion in Cognitive Ability as a Function of Age: A Longitudinal Study of an Elderly Community Sample

This longitudinal study investigated whether age is associated with increased dispersion among major domains of cognitive ability. Three samples were examined: the full sample of 760 elderly community dwellers aged 70 years and older who were tested in 1990; a subset of the original sample who died between testing occasions; and the sample of 426 who survived with full data sets in 1994 (followed up for a mean 3.5 years). Dispersion, as measured by the within-individual standard deviation of ability scores and by the within-individual deviations from crystallized intelligence for speed, memory and spatial functioning, was significantly correlated with age in all three samples at Wave 1 and at Wave 2 (for the longitudinal sample). The rate at which dispersion increased was not significantly correlated with age. In a more detailed analysis of the 426 survivors, dispersion as a function of age was similar for demented persons within this sample, those without dementia, those with poor and excellent educational levels, and those with a physical disability. Activities of daily living was a predictor of larger-than-average changes in dispersion – but not age, education, or activity. Greater dispersion was associated with faster deterioration in memory and speed performance. Contrary to some recent reports, there was evidence for greater within-individual variability among cognitive domains in older individuals.     

Processing strategies and secondary memory in very rapid forgetting

When a memory test is unexpected, recall performance is quite poor at retention intervals as short as 2–4 seconds. Orienting tasks that change encoding conditions are known to affect forgetting in such “very rapid forgetting” paradigms where people are misled to believe that recall will not be required. We evaluated the hypothesis that differences in forgetting among orienting tasks are attributable to contributions of secondary memory during encoding in two experiments. In Experiment 1, short-term recall performance was inversely related to task demands during encoding, although long-term memory performance was not. Task demands were assessed by making the duration of stimulus presentation dependent on the time required to perform three different orienting tasks. In Experiment 2, we compared performance of that variable-length stimulus presentation to the fixed-length presentation used in most prior research. The results suggested that additional encoding or rehearsal time does not have an appreciable impact on short-term performance. Thus, differences in forgetting appeared to be a function of the contribution of secondary memory rather than a function of the time available to engage in primary memory rehearsal strategies.     

Terminal decline and cognitive performance in very old age: does cause of death matter?

Cross-sectional differences and longitudinal changes in cognitive functioning in relation to mortality across a 7-year follow-up period, with 3 times of measurement, were examined in a population-based sample of very old adults. The authors also sought to determine whether cause of death (cerebro/cardiovascular disease [CVD]; non-CVD) modified the magnitude of mortality-related cognitive deficits. Cognitive performance was indexed by tests of general cognitive ability, episodic memory, primary memory, verbal fluency, and visuospatial ability. Results indicated cross-sectional differences on all domains of functioning, with persons who would die within 3 years after baseline testing performing more poorly. Longitudinally, greater decrements were observed on all domains for persons who would die after the first follow-up period, as compared with survivors. Cause of death failed to modify the magnitude of the cross-sectional and longitudinal deficits. The pattern of results point to the general nature of this phenomenon.     

Slowing of memory-search performance in men with mild hypertension

Previous reports have associated hypertension with a slowing of cognitive performance, although the component processes involved have not been identified. Our report compares the performance of 24 men with mild hypertension and 28 age-matched normotensive men on a test of short-term memory search in which the duration of component processes could be estimated. The results indicated that the rate of search through short-term memory was slower for the hypertensive than for the normotensives, whereas the duration of encoding and response processes was equivalent for the two groups. This hypertension-related slowing of memory comparison was independent of participants' error rates and education levels.     

Recycling,evolution and the structure of human personality

Lower childhood cognitive ability may be a risk factor for greater cognitive decline in late life and progression to dementia. To assess variation in age-related cognitive change, it is helpful to have valid measures of cognitive ability from early life. Here, we examine the relation between childhood intelligence and cognitive change in later life in two samples, one born in 1921 and the other in 1936. All participants completed the same test of mental ability (one of the Moray House Test series) at age about 11 years, and were re-examined on Raven’s Progressive Matrices at age 77 (1921-born) or age 64 (1936-born). Where possible, the 1921 sample was re-tested at the age of about 80 years old and the 1936 sample re-tested at about 66 years. After taking into account various covariates, including sex, education and occupation, childhood intelligence was a significant predictor of cognitive change in later life. Results were in the direction that participants with lower childhood mental ability experienced relatively greater cognitive decline, whereas those of higher childhood mental ability showed improved performance. This result suggests that higher premorbid cognitive ability is protective of decline in later life.     

Age-associated memory impairment—pathological memory decline or normal aging?

The aim of the study was to determine whether the memory capacity of individuals with age-associated memory impairment (AAMI) over a period of approximately 3½ years declines more, if at all, than the memory capacity of persons without AAMI. Four computerized and three non-computerized memory tests, a naming test, and a test of visuo-motor speed were administered twice. Two estimates of intellectual capacity were made, one at the first examination and the other 3½ years later. One person in the AAMI group (n=44) developed vascular dementia. The group of AAMI subjects did less well on two of the seven memory tests after 3½ years than they did initially; the control group (n=18) had lower scores on one memory test at follow-up than they had previously. The data suggest that the memory capacity of subjects with AAMI is not pathologically impaired. The general intellectual level significantly influences whether an individual with memory complaints will be classified AAMI or not. People with high intelligence are less likely than people with lower intellectual capacity to fulfill the AAMI criteria. This suggests that AAMI lacks in construct validity.     

Change in cognitive functioning associated with apoE genotype in a community sample of older adults

The influence of a genetic risk factor, apolipoprotein E (apoE) epsilon4 variant, was assessed in older adults aged 70 to 94 on 3 occasions over 7 years. The results of latent growth curve analyses are reported for individuals genotyped for apoE at the 2nd measurement occasion (n = 601) and for a subsample of individuals without probable or definite dementia during the 1st or 2nd occasion (n = 434). ApoE-epsilon4 status was a significant predictor of level and change in memory performance and change in speed performance in the full sample, and of initial level and change in memory performance in the nondemented subsample. These results support previous findings that apoE-epsilon4 is associated with accelerated memory deterioration in individuals without clinical dementia.     

Exploitation in Older Adults: Personal Competence Correlates of Social Vulnerability

ABSTRACT

Clinical assessment of older people at heightened risk of financial exploitation (also termed social vulnerability) is a difficult task. There are a number of previously untested domains of personal competence which could influence social vulnerability in later life. In this study, intellectual, cognitive, and social-cognitive functioning was assessed in a combined sample of dementia patients (n = 31) and neurologically healthy individuals (n = 68) aged 50 years or over. Informants provided assessments of participants' social functioning, personality, and social vulnerability. In the combined sample, multiple regression analyses revealed significant relationships between each personal competence domain and (lower) social vulnerability, apart from personality which was non-significant. General cognitive functioning and, in particular, executive functioning showed significant overlap with social vulnerability after controlling for memory and age. Social measures were also important correlates of vulnerability, indicating that both neurocognitive and social cognitive deficits may contribute to financial exploitation in later life.