Everyday false memories in older persons with depressive disorder

The Analysis of Oxidative Stress Markers May Increase the Accuracy of the Differential Diagnosis of Alzheimer's Disease with and without Depression

Introduction

The aim of work is to assess the usefulness of oxidative stress parameters in the differential diagnosis of dementia of the Alzheimer’s type and dementia of the Alzheimer’s type with coexisting depression.

Methods

The study involved three groups of people: patients with Alzheimer’s disease (AD) (AD; N=27), patients with Alzheimer’s disease and depression (D) (AD+D; N=30), and a control group that consisted of people without dementia and without depression (C; N=24). The assessment of cognitive functioning was carried out using among alia, Auditory Verbal Learning Test and Verbal Fluency Test. Furthermore, we determined the activity of superoxide dismutase (SOD-1) and superoxide anion radical.

Results

Multiple models with different combinations of independent variables showed that SOD together with Rey delayed recall were the best significant predictors of AD with the area under curve (AUC) of 0.893 (p = 0.001) and superoxide anion radical (O2^•−) together with verbal fluency – sharp objects were the best significant predictors of AD +D diagnosis with the AUC of 0.689 (p = 0.034).

Conclusion

This study confirmed the value of neuropsychological diagnosis and analysis of oxidative stress markers in the diagnosis of AD and major depressive disorder (MDD) in the course of AD. The combination of the use of biochemical markers and neuropsychological tests seems particularly important for differential diagnosis.

Cognitive profiles in persons with depressive disorder and Alzheimer's disease

Alzheimer’s disease and depressive disorder are frequent in old age. Both may be associated with depressed mood and cognitive impairment. Therefore, finding a strategy to clarify the diagnosis underlying subjective complaints of impaired cognition and depressed mood in older persons is of utmost interest. We conducted a cross-sectional retrospective observational clinical cohort study using patient records from 2014 to 2018. From 3758 patients, we included patients aged 60 years and older with a Mini-Mental-Status Examination score of 24 and above. Final analysis included all patients in whom Alzheimer’s disease biomarker analysis was performed (cerebrospinal fluid markers of Alzheimer’s disease or positron emission tomography imaging; n = 179) and patients with depressive disorder in whom Alzheimer’s disease was ruled out by analysis of biomarkers suggestive of Alzheimer’s disease (n = 70). With case–control matching for age, education and gender, performance of patients with Alzheimer’s disease was worse in acquisition, consolidation and recall of verbal information and false-positive answers. None of the results, however, sufficed to differentially diagnose individual patients with Alzheimer’s disease or depressive disorder. With more severe symptoms of depression, patients with biomarker-verified Alzheimer’s disease performed worse in executive testing but were not additionally impaired in verbal episodic memory performance. We conclude that distinguishing between Alzheimer’s disease and depressive disorder is unreliable on clinical grounds and behavioural testing alone. Diagnosing the cause of subjective complaints about deteriorating cognitive function or depressed mood requires additional biomarker assessment, whereas cognitive assessment is needed to define appropriate targets of symptomatic treatment in patients with Alzheimer’s disease and depressive disorder.

Performances on individual neurocognitive tests by people experiencing a current major depression episode: A systematic review and meta-analysis

BACKGROUND AND PURPOSES

Previous meta-analyses on neurocognitive test performances in depression have provided effect sizes for cognitive domains. Most domain effect sizes have medium to high variance heterogeneity. Restriction to each test performance could reduce variance and clarify differing test effect sizes. This systematic review and meta-analysis were done to 1. provide effect sizes for cognitive performances (test, subtest, or multiple measures within tests), and 2. investigate age as an effect modifier.

METHODS

Inclusion criteria were: 1. active major depression episode (MD), 2. a control group, 3 reported means and standard deviations, 4. non-computerized tests previously studied at least 3 times. Meta-analyses were performed using Cochrane Review Manager. Age under versus over 45 was investigated as an effect moderator.

RESULTS

Twenty-seven studies met criteria. MD patients performed significantly poorer on 16 of 16 neurocognitive measures (random effects d = -0.47 to -0.92 across tests). Variance was heterogeneous for 11 of 16 measures. Differences between cognitive measures were largely absent based on overlapping 95% confidence intervals. Effect sizes did not differ under versus over 45 years.

LIMITATIONS

Bias risk assessment showed limited control for subject selection, comparability of depressed and control groups, pre-morbid intelligence, drug treatment, and effort in testing.

CONCLUSIONS

The depression - cognition effect was in the moderate to large range regardless of test type. Variance heterogeneity was substantial despite exclusion of inactive depression and the absence of test pooling. The size of the depression - cognition effect was not a function of age.

News and Commercials: Binding Deficits for Complex Information in Schizophrenia

Memory for complex content is severely impaired in patients with schizophrenia spectrum disorders, which might make processing of daily information such as news and commercials particularly challenging. The goal of the present study was to assess the impairment of everyday memory in patients with schizophrenia. Healthy controls (HC) and patients with schizophrenia (SZ) were asked to watch a selection of six news segments and six commercials and complete a recognition task on the content of these video clips. All participants completed a neuropsychological test battery comprising measures of attention, working and episodic memory, and executive function. The total number of correctly recognized items was significantly lower in the SZ group. In contrast, the number of false recognitions was alike in both news and commercials paradigm. We conclude that memory in patients with schizophrenia is more prone to omissions than distortions for complex everyday stimuli. The results offer further support for impaired binding in SZ patients. Memory in SZ suffices to reject false multi-feature items on grounds of identifying at least one feature as incorrect but does not suffice to recall all features of a complex item and affirm it as correct.

Everyday Memory in Healthy Aging: Porous but Not Distorted

Most studies targeting age-association of memory functions report a decline in recognition hits and an increase in false alarms. The goal of the present study was to assess these findings in tasks with day-to-day relevance. We investigated healthy young (YA; age 26.90 ± 3.55 years) and old (OA; age 69.80 ± 5.85 years) adults. Participants were asked to watch six news and six commercials and complete a recognition task relating to the information presented in the videos. OA had a lower hit rate in both news and commercials compared to YA. However, the number of false alarms (FA) was the same in both age groups. Applying signal detection theory, we found age differences in discriminability for both news and commercials paradigm. The groups showed no differences in bias and both chose a liberal answering tendency. We interpret our finding as a result of complex recognition items in an ecologically valid task. Multi-feature items offer an advantage in correct rejection—it is enough to know that at least one feature of an item is false. This benefit does not extend to hits, where all features of an item need to be recognized. This indicates that recognition memory of naturalistic stimuli in OA is porous, but not distorted.

Metacognitive Training for Depression (D-MCT) reduces false memories in depression. A randomized controlled trial

Metacognitive Training for Depression (D-MCT) is a highly standardized group program targeted at depression-related (“Beckian”) emotional as well as cognitive biases, including mood-congruent and false memory. While prior results are promising with respect to psychopathological outcomes (depression), it is unclear whether D-MCT also meets its goal of improving cognitive biases, such as false memories.

In the framework of a randomized controlled trial (registered trial, DRKS00007907), we investigated whether D-MCT is superior to an active control condition (health training, HT) in reducing the susceptibility of depressed patients for false memories. False memories were examined using parallel versions of a visual variant of the Deese-Roediger McDermott paradigm.

Both groups committed less false memories at post assessment after 4 weeks compared to baseline. Relative to HT, D-MCT led to a significant decrease in high-confident false memories over time.

The study presents first evidence that D-MCT decreases the susceptibility of depressed patients for false memories, particularly for errors made with high confidence that are presumably the most “toxic” in terms of mood-congruent memory distortions.