Symptoms of depression in a large healthy population cohort are related to subjective memory complaints and memory performance in negative contexts

Development of an International Standard Set of Outcomes and Measurement Methods for Routine Practice for Adults with Epilepsy: The International Consortium for Health Outcomes Measurement Consensus Recommendations

At present, there is no internationally accepted set of core outcomes or measurement methods for epilepsy clinical practice. Therefore, the International Consortium for Health Outcomes Measurement (ICHOM) convened an international working group of experts in epilepsy, people with epilepsy and their representatives to develop minimum sets of standardized outcomes and outcomes measurement methods for clinical practice that support patient-clinician decision-making and quality improvement. Consensus methods identified 20 core outcomes. Measurement tools were recommended based on their evidence of strong clinical measurement properties, feasibility, and cross-cultural applicability. The essential outcomes included many non-seizure outcomes: anxiety, depression, suicidality, memory and attention, sleep quality, functional status, and the social impact of epilepsy. The proposed set will facilitate the implementation of the use of patient-centered outcomes in daily practice, ensuring holistic care. They also encourage harmonization of outcome measurement, and if widely implemented should reduce the heterogeneity of outcome measurement, accelerate comparative research, and facilitate quality improvement efforts.

Diffusion imaging markers of accelerated aging of the lower cingulum in subjective cognitive decline

Introduction

Alzheimer's Disease (AD) typically starts in the medial temporal lobe, then develops into a neurodegenerative cascade which spreads to other brain regions. People with subjective cognitive decline (SCD) are more likely to develop dementia, especially in the presence of amyloid pathology. Thus, we were interested in the white matter microstructure of the medial temporal lobe in SCD, specifically the lower cingulum bundle that leads into the hippocampus. Diffusion tensor imaging (DTI) has been shown to differentiate SCD participants who will progress to mild cognitive impairment from those who will not. However, the biology underlying these DTI metrics is unclear, and results in the medial temporal lobe have been inconsistent.

Methods

To better characterize the microstructure of this region, we applied DTI to cognitively normal participants in the Cam-CAN database over the age of 55 with cognitive testing and diffusion MRI available (N = 325, 127 SCD). Diffusion MRI was processed to generate regional and voxel-wise diffusion tensor values in bilateral lower cingulum white matter, while T1-weighted MRI was processed to generate regional volume and cortical thickness in the medial temporal lobe white matter, entorhinal cortex, temporal pole, and hippocampus.

Results

SCD participants had thinner cortex in bilateral entorhinal cortex and right temporal pole. No between-group differences were noted for any of the microstructural metrics of the lower cingulum. However, correlations with delayed story recall were significant for all diffusion microstructure metrics in the right lower cingulum in SCD, but not in controls, with a significant interaction effect. Additionally, the SCD group showed an accelerated aging effect in bilateral lower cingulum with MD, AxD, and RD.

Discussion

The diffusion profiles observed in both interaction effects are suggestive of a mixed neuroinflammatory and neurodegenerative pathology. Left entorhinal cortical thinning correlated with decreased FA and increased RD, suggestive of demyelination. However, right entorhinal cortical thinning also correlated with increased AxD, suggestive of a mixed pathology. This may reflect combined pathologies implicated in early AD. DTI was more sensitive than cortical thickness to the associations between SCD, memory, and age. The combined effects of mixed pathology may increase the sensitivity of DTI metrics to variations with age and cognition.

Exploring the role of neuronal-enriched extracellular vesicle miR-93 and interoception in major depressive disorder

Major depressive disorder (MDD) is associated with interoceptive processing dysfunctions, but the molecular mechanisms underlying this dysfunction are poorly understood. This study combined brain neuronal-enriched extracellular vesicle (NEEV) technology and serum markers of inflammation and metabolism with Functional Magnetic Resonance Imaging (fMRI) to identify the contribution of gene regulatory pathways, in particular micro-RNA (miR) 93, to interoceptive dysfunction in MDD. Individuals with MDD (n = 41) and healthy comparisons (HC; n = 35) provided blood samples and completed an interoceptive attention task during fMRI. EVs were separated from plasma using a precipitation method. NEEVs were enriched by magnetic streptavidin bead immunocapture utilizing a neural adhesion marker (L1CAM/CD171) biotinylated antibody. The origin of NEEVs was validated with two other neuronal markers - neuronal cell adhesion molecule (NCAM) and ATPase Na+/K+ transporting subunit alpha 3 (ATP1A3). NEEV specificities were confirmed by flow cytometry, western blot, particle size analyzer, and transmission electron microscopy. NEEV small RNAs were purified and sequenced. Results showed that: (1) MDD exhibited lower NEEV miR-93 expression than HC; (2) within MDD but not HC, those individuals with the lowest NEEV miR-93 expression had the highest serum concentrations of interleukin (IL)-1 receptor antagonist, IL-6, tumor necrosis factor, and leptin; and (3) within HC but not MDD, those participants with the highest miR-93 expression showed the strongest bilateral dorsal mid-insula activation during interoceptive versus exteroceptive attention. Since miR-93 is regulated by stress and affects epigenetic modulation by chromatin re-organization, these results suggest that healthy individuals but not MDD participants show an adaptive epigenetic regulation of insular function during interoceptive processing. Future investigations will need to delineate how specific internal and external environmental conditions contribute to miR-93 expression in MDD and what molecular mechanisms alter brain responsivity to body-relevant signals.

Research hotspots and nursing inspiration in research of older adults with subjective cognitive decline from 2003 to 2023: A bibliometric analysis

Objectives

There has been a significant increase in subjective cognitive decline (SCD) studies in older adults over the years. A bibliometric analysis was conducted to demonstrate the current hotspots and emerging trends in SCD research in older adults and provide references for further research in this field.

Methods

The study conducted a bibliometric analysis based on co-citation analysis. From the Web of Science Core Collection database, this study obtained 1,436 manuscripts regarding SCD in older adults published from 2003 to 2023. Software CiteSpace was used to analyse the results for countries, institutions, authors, journals, keywords, top-cited papers, and burst citations scientifically and intuitively.

Results

Our result showed an overall upward trend in the volume of publications on SCD in the elderly population, suggesting that the study of SCD in older adults has attracted the attention of researchers. The United States dominates this research field, followed by China and France. The top three institutions were the University of California System, Institut National de la Sante et de la Recherche Medicale (Inserm), and UDICE-French Research Universities. Frank Jessen, Han Ying, and Kathryn Ellis were the top three researchers. The top three cited journals were Neurology, Alzheimers & Dementia, and Journal of Alzheimer's Disease. The keywords clustering were "depression", "functional connectivity", "cognitive reserve", "cognitive function", "physical activity", "recommendations", "dementia prevention", " behavioral disorders", "primary care", "early diagnosis", and "community-based study". Keywords with the highest citation bursts include "physical activity", "framework", "preclinical Alzheimer's disease", "future dementia", and "late life depression".

Conclusions

Parallel to the growth trend, the range of research scopes and topics is expanding steadily, focusing on early screening and prevention, negative emotion, and symptom management, broadening researchers' perspectives, which can provide reference and guidance for nursing researchers to conduct research.

The Measurement Properties of the EQ Health and Well-being and EQ Health and Well-Being Short Form in Italian Population: A Comparative Study With EQ-5D-5L

OBJECTIVES

The EQ Health and Well-being, EQ-HWB (25-item) and the EQ-HWB-S (9-item), are new generic measures of health and well-being. The purpose of this study was to examine the measurement properties of the EQ-HWB and EQ-HWB-S measures in relation to the EQ-5D-5L among the Italian general population.

METHODS

A cross-sectional survey was conducted from October 2020 to February 2021, followed by secondary analysis of collected data from Italian adults. This analysis included response pattern distributions, correlation strength, and known-group comparison. Known-group comparison was assessed using effect sizes (ES) across health conditions, caregiver status, and social care usage. The EQ-HWB-S index-based score was based on the UK pilot value set, whereas the Italian value set was used for scoring the EQ-5D-5L index.

RESULTS

Out of the 1182 participants, 461 reported having a chronic condition, 185 identified as caregivers, and 42 were social care users. EQ-HWB items (7.5%) showed fewer ceiling effects than EQ-5D-5L items (34.7%). Strong correlations (rs > 0.5) were found between overlapping EQ-HWB and EQ-5D-5L items. EQ-HWB-S and EQ-5D-5L index scores demonstrated similar discrimination based on symptomatic chronic conditions (ES d = 0.68 vs d = 0.71), but EQ-HWB-S had slightly higher ES for social care users (ES d = 0.84 vs d = 0.74).

CONCLUSIONS

Initial evidence supports the validity of EQ-HWB/EQ-HWB-S because outcome measures in the Italian population. EQ-HWB-S performed comparably to EQ-5D-5L among patients and was better in differentiating social care users. A slight decrease in discriminative properties for caregivers was observed when transitioning from EQ-HWB to EQ-HWB-S.

Development of a Revised Version of Subjective Memory Complaints Questionnaire in Taiwan: A Preliminary Study

OBJECTIVES

Research has suggested that subjective memory complaints (SMC) are predictive of cognitive decline in cases of Alzheimer's disease; however, multidimensional characteristics of SMC make it difficult to formulate causal links. The Subjective Memory Complaints Questionnaire (SMCQ) has proven effective in capturing the nature of SMC. In this study, we developed a revised version of SMCQ (SMCQ-R) with corresponding normative data for application in Taiwan.

METHODS

This study recruited 100 cognitively normal participants (> 45 years) stratified according to demographic characteristics. Assessments were performed to evaluate test-retest reliability, criterion-related validity, and construct validity of SMCQ-R. SMCQ-R scores of 20 matched patients with mild cognitive impairment (MCI) were also compared with those of normal participants to test construct validity.

RESULTS

Reliability of SMCQ-R was satisfactory (0.81-0.95). Factor analysis revealed a three-factor structure: everyday memory problems (EMP), recent severe memory problems (RSMP), and long-term memory problems (LTMP). EMP and RSMP scores were negatively associated with objective cognitive function (r = -.20 to .39). Depressive symptoms were positively associated with all factors (r = .23-.33). Age was positively associated with total (b = 0.09, p < .05) and EMP scores (b = 0.06, p < .01). MCI patients obtained higher scores (p < .05) on all subscales. SMCQ-R scores discriminated between normal and MCI individuals (area under the curve = 0.77). This study established a norm based on scores adjusted to control for effects of age.

CONCLUSIONS

SMCQ-R has sound psychometric properties and could potentially be used as a tool to assess SMC in clinical settings.

Establishing General Working Population Norms for the Cognitive Symptom Checklist-Work

PURPOSE

The Cognitive Symptom Checklist-Work (CSC-W) is a self-report measure to assess cognitive symptoms (i.e., memory and executive function) in working adults with cancer. To date, general working population norm data are lacking worldwide. We established CSC-W norm values in the general working population, and assessed associations of CSC-W scores with work and health-related factors.

METHODS

This cross-sectional study consisted of 1,000 Dutch working adults, of whom data was collected through an online respondent panel. The sample was stratified for sex and age, and data were weighted. Summary scores of the CSC-W total scale, and memory and executive function symptoms subscales, were determined (e.g., means, percentiles). Z- and T-scores were calculated, and analysis of (co)variance has been applied.

RESULTS

Cognitive symptom scores were relatively stable across age groups, but 18-39-year-old respondents reported lower memory and executive function than respondents in other age groups. Symptom scores of memory function (mean 29.1; SD = 16.7) were higher for all age groups and in both sexes compared to executive function (mean 22.1; SD = 16.8). No sex differences in memory and executive function were observed. Higher symptom scores were associated with performing non-manual work only, manual work only, self-reported long-term illness, and higher levels of depressive symptoms and fatigue.

CONCLUSION

The CSC-W norms may enhance the interpretation and facilitate the analysis of self-reported cognitive symptoms in patients with cancer at work. Our findings may support health care professionals in identifying working adults with cancer with cognitive symptoms and in developing personalized treatment.

Predictors and prognosis of population-based subjective cognitive decline: longitudinal evidence from the Caerphilly Prospective Study (CaPS)

OBJECTIVES

To understand associations between the subjective experience of cognitive decline and objective cognition. This subjective experience is often conceptualised as an early step towards neurodegeneration, but this has not been scrutinised at the population level. An alternative explanation is poor meta-cognition, the extreme of which is seen in functional cognitive disorder (FCD).

DESIGN

Prospective cohort (Caerphilly Prospective Study).

SETTING

Population-based, South Wales, UK.

PARTICIPANTS

This men-only study began in 1979; 1225 men participated at an average age of 73 in 2002-2004, including assessments of simple subjective cognitive decline (sSCD, defined as a subjective report of worsening memory or concentration). Dementia outcomes were followed up to 2012-2014. Data on non-completers was additionally obtained from death certificates and local health records.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measure was incident dementia over 10 years. Secondary outcome measures included prospective change in objective cognition and cross-sectional cognitive internal inconsistency (the existence of a cognitive ability at some times, and its absence at other times, with no intervening explanatory factors except for focus of attention).

RESULTS

sSCD was common (30%) and only weakly associated with prior objective cognitive decline (sensitivity 36% (95% CI 30 to 42) and specificity 72% (95% CI 68 to 75)). Independent predictors of sSCD were older age, poor sleep quality and higher trait anxiety. Those with sSCD did not have excess cognitive internal inconsistency, but results suggested a mild attentional deficit. sSCD did not predict objective cognitive change (linear regression coefficient -0.01 (95% CI -0.13 to 0.15)) nor dementia (odds ratio 1.35 (0.61 to 2.99)) 10 years later.

CONCLUSIONS

sSCD is weakly associated with prior objective cognitive decline and does not predict future cognition. Prior sleep difficulties and anxiety were the most robust predictors of sSCD. sSCD in the absence of objective decline appears to be a highly prevalent example of poor meta-cognition (ie, poor self-awareness of cognitive performance), which could be a driver for later FCD.

Exploring the role of neuronal-enriched extracellular vesicle miR-93 and interoception in major depressive disorder

Major depressive disorder (MDD) is associated with interoceptive processing dysfunctions, but the molecular mechanisms underlying this dysfunction are poorly understood. This study combined brain Neuronal-Enriched Extracellular Vesicle (NEEV) technology and serum markers of inflammation and metabolism with Functional Magnetic Resonance Imaging (fMRI) to identify the contribution of gene regulatory pathways, in particular micro-RNA (miR) 93, to interoceptive dysfunction in MDD. Individuals with MDD (n = 44) and healthy comparisons (HC; n = 35) provided blood samples and completed an interoceptive attention task during fMRI. EVs were separated from plasma using a precipitation method. NEEVs were enriched by magnetic streptavidin bead immunocapture utilizing a neural adhesion marker (CD171) biotinylated antibody. NEEV specificities were confirmed by ow cytometry, western blot, particle size analyzer, and transmission electron microscopy. NEEV small RNAs were purified and sequenced. Results showed that: (1) MDD exhibited lower NEEV miR-93 expression than HC; (2) within MDD but not HC, those individuals with the lowest NEEV miR-93 expression had the highest serum concentrations of interleukin (IL)-1 receptor antagonist, IL-6, tumor necrosis factor, and leptin; and (3) within HC but not MDD, those participants with the highest miR-93 expression showed the strongest bilateral dorsal mid-insula activation. Since miR-93 is regulated by stress and affects epigenetic modulation by chromatin reorganization, these results suggest that healthy individuals but not MDD participants show an adaptive epigenetic regulation of insular function during interoceptive processing. Future investigations will need to delineate how specific internal and external environmental conditions contribute to miR-93 expression in MDD and what molecular mechanisms alter brain responsivity to body-relevant signals.

Longitudinal association between subjective and objective memory in older adults: a study with the Virginia Cognitive Aging Project sample

Using the bivariate dual change score approach, the present study investigated the directionality of the SMC-OMP association in a sample of healthy older adults (N = 2,057) from the Virginia Cognitive Aging Project. The sample was assessed throughout 10 years, five time points, and the impact of education, depressive symptoms, and low-memory functioning was tested. The Memory Functioning Questionnaire was used to assess SMC. There was a lack of longitudinal association with no significant coupling effects found between subjective and objective memory. After including depressive symptoms as a covariate, Frequency of Forgetting significantly predicted subsequent negative changes in OMP . A similar result was found for the low-memory functioning group after the inclusion of depression, with the frequency of memory complaints predicting subsequent memory decline . Our results do not support a predictive value of SMC without accounting for the influence of depressive symptoms and low-memory functioning.

Matrescence: lifetime impact of motherhood on cognition and the brain

Profound environmental, hormonal, and neurobiological changes mark the transition to motherhood as a major biosocial life event. Despite the ubiquity of motherhood, the enduring impact of caregiving on cognition and the brain across the lifespan is not well characterized and represents a unique window of opportunity to investigate human neural and cognitive development. By integrating insights from the human and animal maternal brain literatures with theories of cognitive ageing, we outline a framework for understanding maternal neural and cognitive changes across the lifespan. We suggest that the increased cognitive load of motherhood provides an initial challenge during the peripartum period, requiring continuous adaptation; yet when these demands are sustained across the lifespan, they result in increased late-life cognitive reserve.

Depressive symptoms mediate the longitudinal association between diabetes and subjective cognitive decline. Findings from a semirural multi-ethnic older population in Malaysia

The potential role of psychological distress as the pathway linking diabetes and subjective cognitive decline (SCD) is still unclear. This study aims to investigate whether depressive symptoms mediate the relationship between diabetes and SCD in older adults. Baseline data from 3428 adults (55-94 years) of the South East Asia Community Observatory (SEACO), Malaysia were utilized. Subjective cognitive complaints (SCC) were recorded at baseline and five years later. Mediation analyses with non-parametric bootstrapping methods were employed. A proportion of 20% of participants without SCC at baseline reported a decline in SCC after 5 years of follow-up. Known diabetes (β = -0.13, SE = 0.05, p = 0.02) and depressive symptoms (ß = -0.18, SE = 0.05, p = 0.001) were independently associated with SCD. Previously diagnosed diabetes was associated with depressive symptoms at baseline (ß = 0.04, SE = 0.02, p = 0.01), and greater SCD at follow-up (β = -0.19, SE = 0.06, p = 0.001). Mediation analyses revealed that 9% of the association between diabetes and SCD was attributable to an indirect effect through depressive symptoms (ß = -0.01, 95% CI 0.02-0.001, p < 0.0001). This study provides further evidence of the detrimental effects of diabetes and depression on subjective cognitive decline. Our findings also suggest that depression is an important pathway linking previously diagnosed diabetes with subjective cognitive decline in older adulthood.

Novel Multimodal Salicylamide Derivative with Antidepressant-like, Anxiolytic-like, Antipsychotic-like, and Anti-Amnesic Activity in Mice

Depression, anxiety, and schizophrenia may coexist in psychiatric patients. Moreover, these disorders are very often associated with cognitive impairments. However, pharmacotherapy of these conditions remains challenging due to limited drug effectiveness or numerous side effects. Therefore, there is an urgent need to develop novel multimodal compounds that can be used to treat depression, anxiety, and schizophrenia, as well as memory deficits. Thus, this study aimed to evaluate the potential antidepressant-like, anxiolytic-like, antipsychotic-like effects, and anti-amnesic properties, of the novel arylpiperazine derivative of salicylamide, JJGW07, with an affinity towards serotonin 5-HT1A, 5-HT2A, and 5-HT7 and dopamine D2 receptors. Firstly, we investigated the compound's affinity for 5-HT6 receptors and its functional activity by using in vitro assays. JJGW07 did not bind to 5-HT6 receptors and showed antagonistic properties for 5-HT1A, 5-HT2A, 5-HT7, and D2 receptors. Based on the receptor profile, we performed behavioral studies in mice to evaluate the antidepressant-like, anxiolytic-like, and antipsychotic-like activity of the tested compound using forced swim and tail suspension tests; four-plate, marble-burying, and elevated plus maze tests; and MK-801- and amphetamine-induced hyperlocomotion tests, respectively. JJGW07 revealed antidepressant-like properties in the tail suspension test, anxiolytic-like effects in the four-plate and marble-burying tests, and antipsychotic-like activity in the MK-801-induced hyperlocomotion test. Importantly, the tested compound did not induce catalepsy and motor impairments or influence locomotor activity in rodents. Finally, to assess the potential procognitive and anti-amnesic properties of JJGW07, we used passive avoidance and object recognition tests in mice. JJGW07 demonstrated positive effects on long-term emotional memory and also ameliorated MK-801-induced emotional memory impairments in mice, but showed no procognitive properties in the case of recognition memory. Our results encourage the search for new compounds among salicylamide derivatives, which could be model structures with multitarget mechanisms of action that could be used in psychiatric disorder therapy.

Memory performance mediates the relationship between depression and independence in instrumental activities of daily living among community-dwelling older adults: Evidence from the China Family Panel Study

Our objective was to examine the link between depression and independence in the instrumental activities of daily living (IADLs) and to explore the mediating role of memory performance through a cross-sectional analysis of a nationally representative sample of community-dwelling older adults in China. In total, 3730 respondents age ≥ 60 (51.7% males) from the 2020 survey of the China Family Panel Study (CFPS) constituted the study sample. Their depressive symptoms, memory performance, and independence in the IADLs were measured. Based on the descriptive statistics, bivariate correlation analysis and bootstrapping mediation analysis were conducted. As hypothesized, independence in the IADLs was negatively related to depression, while it was positively associated with memory performance. Moreover, after controlling for demographic factors, memory performance was demonstrated to be a partial mediator between depression and independence in the IADLs. These findings support the development of clinical interventions which prevent disability or maintain the physical functioning of older adults through alleviating depression and enhancing memory performance.

Mild behavioral impairment linked to progression to Alzheimer's disease and cortical thinning in amnestic mild cognitive impairment

Background

Mild behavioral impairment (MBI) is a neurobehavioral syndrome characterized by later life emergence of sustained neuropsychiatric symptoms, as an at-risk state for dementia. However, the associations between MBI and a risk of progression to Alzheimer's disease (AD) and its neuroanatomical correlates in mild cognitive impairment (MCI) are still unclear.

Method

A total 1,184 older adults with amnestic MCI was followed for a mean of 3.1 ± 2.0 years. MBI was approximated using a transformation algorithm for the Neuropsychiatric Inventory at baseline. A two-step cluster analysis was used to identify subgroups of individuals with amnestic MCI based on profiles of 5 MBI domain symptoms (decreased motivation, affective dysregulation, impulse dyscontrol, social inappropriateness, abnormal perception/thought content). A Cox regression analysis was applied to investigate differences in the risk of progression to AD between subgroups. A subset of participants (n = 202) underwent 3D T1-weighted MRI scans at baseline and cortical thickness was compared between the subgroups of amnestic MCI patients.

Result

The cluster analysis classified the patients into 3 groups: (1) patients without any MBI domain symptoms (47.4%, asymptomatic group); (2) those with only affective dysregulation (29.4%, affective dysregulation group); (3) those with multiple MBI domain symptoms, particularly affective dysregulation, decreased motivation and impulse dyscontrol (23.2%, complex group). Compared to the asymptomatic group, the complex group was associated with a higher risk of progression to AD (hazard ratio = 2.541 [1.904-3.392], p < 0.001), but the affective dysregulation group was not (1.214 [0.883-1.670], p = 0.232). In cortical thickness analysis, the complex group revealed cortical thinning bilaterally in the inferior parietal, lateral occipital, lateral superior temporal, and frontopolar regions compared with the affective dysregulation group.

Conclusion

The multiple co-occuring MBI domains in individuals with amnestic MCI are associated with a higher risk of progression to AD and cortical thinning in temporal, parietal and frontal areas. These results suggest that evaluation of MBI could be useful for risk stratification for AD and appropriate intervention in MCI individuals.

Test-Retest Reliability and Random Measurement Error of the Multifactorial Memory Questionnaire in Older Adults With Subjective Memory Complaints

To examine the psychometric properties of the Multifactorial Memory Questionnaire (MMQ) in older adults with subjective memory complaints. The three MMQ subscale (Satisfaction, Ability, and Strategy) was administered twice, with a 3-month interval. The test-retest reliability was examined using intraclass correlation coefficients (ICCs). The random measurement error was examined by calculating the standard error of measurement (SEM) and minimal detectable change (MDC95). The test-retest reliabilities of the three MMQ subscales were generally acceptable. The SEM of the three MMQ subscales was higher than the acceptable criterion of 10%. Despite the influence of random measurement error, the change scores of the three MMQ subscales may represent true changes if they are larger than the MDC95 of 13.2 (Satisfaction), 18.4 (Ability), and 16.9 (Strategy). The MMQ appears to be a reliable measure for use in research settings, but may not yet be suitable for clinical use.

Subjective cognitive complaints and subjective cognition following electroconvulsive therapy for depression: A systematic review and meta-analysis

BACKGROUND

Subjective cognitive complaints represent a leading reason for suboptimal prescription of electroconvulsive therapy, the most acutely effective treatment for depression. However, research findings regarding their presentation are conflicting.

OBJECTIVE

To describe, quantify and explain the variability in subjective cognitive complaints and subjective cognition following electroconvulsive therapy for depression.

METHODS

We searched systematically PubMed, Embase, PsycARTICLES, CINAHL and relevant reviews for research published from 1 January 1972 to 31 August 2020. We included all independent studies of patients whose subjective cognition was assessed following brief-pulse electroconvulsive therapy for depression. Three meta-analyses were conducted to quantify: (1) the prevalence of patients presenting with cognitive complaints following electroconvulsive therapy; (2) the pre-post electroconvulsive therapy change in subjective cognition and (3) the association between change in depressive symptoms and change in cognitive complaints. Effect sizes were calculated using random-effects models. Eight prespecified demographic and clinical moderators of between-study variability were assessed using sub-group analyses and meta-regressions.

RESULTS

Data from 72 studies including 5699 participants were meta-analysed. Weighted mean prevalence of patients with cognitive complaints was 48.1% (95% confidence interval = [42.3%, 53.9%]). The type of subjective measure used significantly impacted the pre-post electroconvulsive therapy change in subjective cognition, showing, respectively, large improvement (g = 0.81; 95% confidence interval = [0.59, 1.03]) after electroconvulsive therapy with the Squire Self-Rating Scale of Memory and small worsening (g = -0.48; 95% confidence interval = [-0.70, -0.26]) with 1-item memory scales. The strongest predictors of improved post-electroconvulsive therapy subjective cognition were increased age and larger post-electroconvulsive therapy decrease in depressive symptoms. The weighted mean correlation between pre-post electroconvulsive therapy decrease in depressive symptoms and pre-post electroconvulsive therapy decrease in cognitive complaints was 0.46 (95% confidence interval = [0.39, 0.53]).

CONCLUSION

Variability in subjective cognition following electroconvulsive therapy is mostly explained by the degree of post-treatment persisting depression and by the subjective assessment used. Scales measuring exclusively subjective worsening present limited clinical utility and instruments allowing the detection of both improvement and worsening in subjective cognition should be preferred.

Inconsistencies between Subjective Reports of Cognitive Difficulties and Performance on Cognitive Tests are Associated with Elevated Internalising and Externalising Symptoms in Children with Learning-related Problems

Children with learning difficulties are commonly assumed to have underlying cognitive deficits by health and educational professionals. However, not all children referred for psycho-educational assessment will be found to have deficits when their abilities are measured by performance on cognitive tasks. The primary aim of this study was to estimate the prevalence of this inconsistent cognitive profile (ICP) in a transdiagnostic sample of children referred by health and education service providers for problems related to attention, learning and memory (N = 715). A second aim was to explore whether elevated mental health problems were associated with ICPs. Findings suggest that approximately half of this sample could be characterised as having an ICP. Cognitive difficulties, whether identified by parent ratings or task performance, were associated with elevated internalising and externalising difficulties. Crucially, a larger discrepancy between a parent's actual ratings of a child's cognitive difficulties and the ratings that would be predicted based on the child's performance on cognitive tasks was associated greater internalising and externalising difficulties for measures of working memory, and greater externalising difficulties for measures of attention. These findings suggest that subjective cognitive difficulties occurring in the absence of any task-based performance deficits may be a functional problem arising from mental health problems.

Subjective memory complaints in young people: the role of resilience

OBJECTIVE

Little is known about the origin and associated factors of subjective memory complaints (SMCs) in the young population, although they might be closely related to the psychophysiological states produced by stress exposure, such as anxiety and depression. In this regard, resilience has been related to a reduction in these negative states, as well as to more adaptive hypothalamic-pituitary-adrenal (HPA) axis functioning. We aimed to investigate the importance of depression, anxiety, and HPA axis activity in SMCs in the young population. We also analysed the relationship between resilience and SMCs through the mediation of depression, anxiety, and the cortisol awakening response (CAR).

DESIGN

To do so, we measured SMCs, depression and anxiety states, resilience, and the CAR in 77 healthy young people.

RESULTS

Both depression and anxiety were associated with SMCs. In addition, greater resilience was related to fewer SMCs through depression and anxiety. However, the CAR was not related to SMCs, and it did not mediate the relationship between resilience and SMCs.

CONCLUSION

These results suggest that negative affective states have greater importance in SMCs than HPA functioning in this age group, and they also highlight the importance of resilience in the psychological adjustment to stressful situations.

Association between depression and subjective cognitive complaints in 47 low- and middle-income countries

People with depression and subjective cognitive complaints (SCC) may be at particularly high risk for developing dementia. However, to date, studies on depression and SCC are limited mainly to single high-income countries. Thus, the aim of the present study was to investigate the association between depression and SCC in adults from low- and middle-income countries (LMICs). Cross-sectional, community-based data were analyzed from the World Health Survey. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). ICD-10 Diagnostic Criteria for Research was used for the diagnosis of subsyndromal depression, brief depressive episode, and depressive episode. Multivariable linear regression was conducted to explore the associations. Data on 237,952 individuals aged ≥18 years [mean (SD) age 38.4 (16.0) years; females 50.8%] were analyzed. After adjustment for potential confounders (age, sex, education, anxiety), compared to no depressive disorder, subsyndromal depression (b-coefficient 7.91; 95%CI = 5.63-10.18), brief depressive episode (b-coefficient 10.37; 95%CI = 8.95-11.78), and depressive episode (b-coefficient 13.57; 95%CI = 12.33-14.81) were significantly associated with higher mean SCC scores. The association was similar in all age groups (i.e., 18-44, 45-64, and ≥65 years), and both males and females. All depression types assessed were associated with worse SCC among adults in 47 LMICs. Future longitudinal studies are needed to investigate whether older people with depression and SCC are at higher risk for dementia onset in LMICs.

Evidence of Subjective, But Not Objective, Cognitive Deficit in New Mothers at 1-Year Postpartum

Background: The experience and even existence of cognitive deficits in the postpartum period is uncertain, with only a few scientific studies, reporting inconsistent results. Methods: In this study, we investigate cognition in 86 women (43 first-time mothers 1 year postpartum and 43 non-mothers). Results: Mothers and non-mothers showed no significant differences on measures of objective cognition (verbal memory, working memory, and processing speed or theory of mind). Despite the absence of objective differences, mothers self-reported significantly worse subjective memory than non-mothers. To interpret the difference between objective and subjective measures of memory, we investigated relationships between subjective memory, objective memory, and wellbeing. Mothers, but not non-mothers, showed a positive correlation between subjective and objective measures of memory, indicating mothers are "in-tune" with their memory performance. Mothers also demonstrated a positive relationship between subjective memory and wellbeing (sleep, anxiety, and depression), where better wellbeing correlated with higher subjective memory. This relationship was not apparent in non-mothers. The results suggest that poorer sleep, higher anxiety, and higher depression are related to reports of poorer self-reported memory in mothers. Conclusion: Our results add to our growing understanding of maternal cognition at 1 year postpartum, with no evidence of cognitive differences between mothers and non-mothers.

Meta-prospective memory accuracy in young adults with and without depressive symptoms

Prospective memory (PM) is the ability to remember an intention in the future. Individuals with depression are candidates for PM failures, resulting in detrimental consequences, such as forgetting to take a medication or implement therapeutic techniques; inaccurate assessments of one's PM abilities can exacerbate these issues. The current study examined if appraisals about one's prospective memory (meta-PM) performance differs between healthy and depressed adults. Data were gathered from 137 adults and included self-reported depression, PM beliefs, objective PM, and assessment of executive functions (EFs). Participants were separated into depressed/healthy categories based on a self-report measure. There was a non-significant correlation between self-reported PM and objective PM for both depressed (r = .06, p = .61) and healthy (r = .08, p = .52) groups, suggesting both groups had inaccurate meta-PM. There were non-significant differences in meta-PM between these groups (Fisher's Z = -0.09, p = .93), but exploratory gender analyses revealed women's meta-PM was significantly less accurate than men's. Women had higher reports of depression and PM complaints compared to men. This study lends evidence that depression is not necessarily related to worse meta-PM accuracy, despite depression's association with memory complaints, and that women are at greater risk for inaccurate meta-PM.

Cognitive Test Scores and Progressive Cognitive Decline in the Aberdeen 1921 and 1936 Birth Cohorts

The Aberdeen birth cohorts of 1921 and 1936 (ABC21 and ABC36) were subjected to IQ tests in 1932 or 1947 when they were aged about 11y. They were recruited between 1997–2001 among cognitively healthy community residents and comprehensively phenotyped in a long-term study of brain aging and health up to 2017. Here, we report associations between baseline cognitive test scores and long-term cognitive outcomes. On recruitment, significant sex differences within and between the ABC21 and ABC36 cohorts supported advantages in verbal ability and learning among the ABC36 women that were not significant in ABC21. Comorbid physical disorders were self-reported in both ABC21 and ABC36 but did not contribute to differences in terms of performance in cognitive tests. When used alone without other criteria, cognitive tests scores which fell below the −1.5 SD criterion for tests of progressive matrices, namely verbal learning, digit symbol and block design, did not support the concept that Mild Cognitive Impairment (MCI) is a stable class of acquired loss of function with significant links to the later emergence of a clinical dementia syndrome. This is consistent with many previous reports. Furthermore, because childhood IQ-type data were available, we showed that a lower cognitive performance at about 64 or 78 y than that predicted by IQ at 11 ± 0.5 y did not improve the prediction of progress to MCI or greater cognitive loss. We used binary logistic regression to explore how MCI might contribute to the prediction of later progress to a clinical dementia syndrome. In a fully adjusted model using ABC21 data, we found that non-amnestic MCI, along with factors such as female sex and depressive symptoms, contributed to the prediction of later dementia. A comparable model using ABC36 data did not do so. We propose that (1) MCI criteria restricted to cognitive test scores do not improve the temporal stability of MCI classifications; (2) pathways towards dementia may differ according to age at dementia onset and (3) the concept of MCI may require measures (not captured here) that underly self-reported subjective age-related cognitive decline.

Factors That Predispose Undergraduates to Mental Issues: A Cumulative Literature Review for Future Research Perspectives

Distress and mental health issues among college students is an emerging topic of study. The aim of this research work is to illustrate academic and social risk factors and how they prove to be predictors of anxiety and depressive disorders. The methodology used is a cumulative literature review structured over 10 systematic phases, and is replicable. Showing considerable potential for cumulative research, the relevance of this study reflects the concern of the academic community and international governments. The articles selected range from categorization of disorders in relation to mental health, to reporting the condition of rhinestones and difficulties of students in university contexts. In conclusion, the research focusses upon predisposing, concurrent or protective factors relating to the mental health of university students, so that institutions can act on concrete dynamics or propose targeted research on this topic.

Association of childhood maltreatment and cortisol with the severity and stability of depression symptoms

BACKGROUND

Little is known about patterns of depression symptoms over time in older adults. This study aims to assess the association of childhood maltreatment and cortisol levels with latent classes of depression symptoms over ten years in older adults.

METHODS

A total of 752 participants (mean age 61.7±9.5, female 18%) in the Second Manifestations of ARTerial disease-Memory, depression and aging (SMART-Medea) study provided up to twenty measures of depression symptoms over ten years based on the Patient Health Questionnaire-9 (PHQ-9). At baseline, salivary cortisol was measured, and childhood maltreatment was assessed. Responses to the PHQ-9 were indicators in a latent class analysis. Multinomial regression determined associations between class membership and cortisol and maltreatment, adjusting for age, sex, and education.

RESULTS

Four distinct classes were identified; never depressed (n=275, 37%), energy/sleep difficulties (n=237, 32%), mild depression symptoms (n=152, 20%) and fluctuating severe depression (n=88, 12%). Childhood maltreatment was associated with mild depression symptoms (OR=1.95, 95% CI: 1.17-3.25) and fluctuating severe depression (OR=3.50, 95% CI: 1.99-6.15). Blunted morning cortisol was associated with energy/sleep difficulties (OR=0.98, 95% CI: 0.95-1.00) and fluctuating severe depression (OR=0.96, 95% CI: 0.92-0.99). There was no evidence for interaction between maltreatment and cortisol.

LIMITATIONS

There is limited generalizability due to the cohort consisting of participants with atherosclerosis and being mostly male. This study utilizes retrospective self-reporting of childhood maltreatment.

CONCLUSION

Childhood maltreatment and blunted morning cortisol independently contribute to a worse depression course. Blunted morning cortisol may contribute to sub-clinical depression symptoms, specifically difficulties with energy levels and sleep.

Factors that influence the emotional impact of memory problems in older adults: A qualitative descriptive study

BACKGROUND

Associations among psychological health and memory concerns in older adults are well-established, but much of this research is quantitative.

OBJECTIVES

This study examined how memory problems influence emotional well-being in older adults without dementia, and whether this differs by cognitive status and current depressive or anxiety symptoms.

METHODS

A qualitative descriptive design was used to examine our research questions. Community-dwelling older adults without dementia (n = 49, M_age  = 74.5[10.1], 63% women) completed a cognitive assessment, questionnaires and two semi-structured interviews. Content analysis was used to code and categorise the transcribed interview data, then identify themes within and across participant groups.

RESULTS

Five themes described the influence of memory problems on emotional well-being: Evoking Emotions, Fearing Future, Undermining Self, Normalising Problems and Adjusting Thinking. Memory problems' impact on emotional well-being varied by current anxiety symptoms, characteristics of the problem and personal experience with dementia.

CONCLUSION

The emotional impact of memory problems tended to differ by affective symptoms, not cognitive status. Older adults who report memory concerns without objective evidence of impairment may be at risk for negative impacts to mental health and well-being.

IMPLICATIONS FOR PRACTICE

Cognitive screening guidelines should consider best practices for responding to memory concerns when cognitive testing results are normal.

Separate neural networks of implicit emotional processing between pictures and words: A coordinate-based meta-analysis of brain imaging studies

Both pictures and words are frequently employed as experimental stimuli to investigate the neurocognitive mechanisms of emotional processing. However, it remains unclear whether emotional picture processing and emotional word processing share neural underpinnings. To address this issue, we focus on neuroimaging studies examining the implicit processing of affective words and pictures, which require participants to meet cognitive task demands under the implicit influence of emotional pictorial or verbal stimuli. A coordinate-based activation likelihood estimation meta-analysis was conducted on these studies, which revealed no common activation maximum between the picture and word conditions. Specifically, implicit negative picture processing (35 experiments, 393 foci, and 932 subjects) engages the bilateral amygdala, left hippocampus, fusiform gyri, and right insula, which are mainly located in the subcortical network and visual network associated with bottom-up emotional responses. In contrast, implicit negative word processing (34 experiments, 316 foci, and 799 subjects) engages the default mode network and fronto-parietal network including the ventrolateral prefrontal cortex, dorsolateral prefrontal cortex, and dorsomedial prefrontal cortex, indicating the involvement of top-down semantic processing and emotion regulation. Our findings indicate that affective pictures (that intrinsically have an affective valence) and affective words (that inherit the affective valence from their object) modulate implicit emotional processing in different ways, and therefore recruit distinct brain systems.

Impact of prenatal stress on amygdala anatomy in young adulthood: Timing and location matter

BACKGROUND

Exposure to maternal stress in utero has long-term implications for the developing brain and has been linked with a higher risk of depression. The amygdala, which develops during the early embryonic stage and is critical for emotion processing, might be particularly sensitive.

METHODS

Using data from a neuroimaging follow-up of the ELSPAC prenatal birth cohort (n=129, 47% men, 23-24 years old), we studied the impact of prenatal stress during the first and second half of pregnancy on the volume of the amygdala and its nuclei in young adult offspring. We further evaluated the relationship between amygdala anatomy and offspring depressive symptomatology. Amygdala nuclei were parcellated using FreeSurfer's automated segmentation pipeline. Depressive symptoms were measured via self-report using the Beck Depression Inventory (BDI).

RESULTS

Exposure to stress during the first half of pregnancy was associated with smaller accessory basal (Cohen's f²=0.27, p(FDR)=0.03) and cortical (Cohen's f²=0.29, p(FDR)=0.03) nuclei volumes. This effect remained significant after correcting for sex, stress during the second half of pregnancy, as well as maternal age at birth, birth weight, maternal education, and offspring's age at MRI. These two nuclei showed a quadratic relationship with BDI scores in young adulthood, where both smaller and larger volume was associated with more depressive symptoms (Accessory basal nucleus: Adj R²=0.05. p(FDR)=0.015; Cortical nucleus: Adj R²=0.04, p(FDR)=0.015).

CONCLUSIONS

We conclude that exposure to stress during the first half of pregnancy might have long-term implications for amygdala anatomy, which may in turn predict the experience of depressive symptoms in young adulthood.

Subclinical depression and anxiety impact verbal memory functioning differently in men and women -an fMRI study

BACKGROUND

Depressive symptoms are known to affect memory efficiency in various populations. More specifically, several studies conducted in patients suffering from schizophrenia have indicated that memory efficiency is affected by depressed mood in female patients and by anxiety in male patients. We investigated, using neuroimaging techniques, whether similar gender-specific associations with subclinical depression and anxiety could be observed in a non-clinical sample.

METHOD

Forty-five healthy Spanish-speaking individuals (23 females) were administered a verbal memory task. Lists of high- and low-frequency words were presented. Immediate free recall was requested after the learning of each list, and a yes/no recognition task was completed during the acquisition of the fMRI data.

RESULTS

Regression analyses revealed that higher depression scores in women, and higher anxiety scores in men, were associated with poorer recall. In women, higher depression scores were further associated with decreased cerebral activity in the right temporoparietal junction, left inferior occipitotemporal gyrus, bilateral thalamus, and left anterior cingulate during correct recognition of target words. In men, anxiety scores were not associated with any cerebral activity.

CONCLUSIONS

Subclinical depression in women appears to affect memory efficiency by impacting cerebral regions specifically recruited for the cognitive demands of the task, as well as cerebral regions more generally involved in arousal, decision-making, and emotional regulation. Anxiety in men might impact the encoding memory processes. The results, although preliminary, suggest that gender differences may need to be taken into account when developing strategies for the cognitive and pharmacological remediation of memory impairment.

Subjective Memory Complaints and Sensitivity of the Subjective Memory Complaint Questionnaire in Post-Stroke Dementia Patients

INTRODUCTION

Subjective memory complaints (SMCs) among stroke patients are common. To date, reports on SMCs using the Subjective Memory Complaint Questionnaire (SMCQ) are limited. We provided descriptive information on SMCs using the SMCQ alongside objective neuropsychological function assessment in stroke patients and established the sensitivity of SMCQ for post-stroke dementia.

METHODS

In total, 419 consecutive stroke patients who were admitted to a stroke unit for younger populations (age <65 years) at a rehabilitation hospital from June 1, 2014, to January 1, 2020, were reviewed. SMCs were measured using the SMCQ. Objective neuropsychological function was assessed using protocols of the Vascular Cognitive Impairment Harmonization Standards.

RESULTS

SMCs were significantly correlated with objective neuropsychological functions including memory, executive function, language, and depression. SMCs were not significantly correlated with visuospatial function. The SMCQ exhibited comparable sensitivity to that of Mini-Mental Status Examination for evaluating post-stroke dementia.

CONCLUSIONS

The SMCQ may be a valid measure of cognitive function among patients with stroke, is sensitive for post-stroke dementia, and may assume a complementary role for assessing patients with stroke.

Memory awareness in patients with Major Depressive Disorder

BACKGROUND

Subjective Memory Complaints (SMC) along with cognitive deficits are frequently observed in patients with Major Depressive Disorder (MDD). The relationship between SMC and objective memory performance in patients with MDD was evaluated, in comparison with patients with Mild Cognitive Impairment due to Alzheimer's Disease (MCI-AD) and healthy controls (HC).

METHODS

Patients with MDD (n = 47), MCI-AD (n = 43) and HC (n = 45) were assessed with a self-report memory complaints scale (SMCS) and underwent a comprehensive clinical and neuropsychological assessment. A discrepancy score between the Logical Memory delayed recall and the SMCS total score was calculated as a measure of memory awareness.

RESULTS

Patients with MDD (12.5 ± 4.4) and patients with MCI-AD (10.9 ± 4.1) had not significantly different SMCS total scores, whereas HC showed significantly lower scores (4.0 ± 3.0). As much as 74.5% of patients with MDD patients and 65.1% of patients with MCI-AD reported prominent memory complaints, whereas only 4.4% of HC did. Patients with MDD had relatively preserved memory tests, resulting in a higher discrepancy score than both patients with MCI-AD and HC. The SMCS total score correlated positively with depressive symptoms in the 3 groups of participants.

CONCLUSIONS

Patients with MDD showed inaccurate memory self-awareness as they under-estimated their memory functioning, a pattern distinct from both patients with MCI-AD and HC.

Long-term cognitive and psychiatric outcomes of acute respiratory distress syndrome managed with Extracorporeal Membrane Oxygenation

BACKGROUND

Cognitive dysfunction is often reported in patients who have experienced acute respiratory distress syndrome (ARDS). Extra Corporeal Membrane Oxygenation (ECMO) therapy is increasingly used to manage ARDS patients in ICU, transforming survival rates. However, few studies have examined cognitive outcomes.

METHODS

We examined self-reported cognitive complaints, psychiatric outcomes and neuropsychological test performance in survivors of severe hypoxaemia managed with VV-ECMO, at 18-24 month follow-up, compared with a group of healthy controls.

RESULTS

Over 70% of ECMO-treated patients (N = 46) complained of difficulty in at least one aspect of cognition on self-report measures (study 1). However, a much lower frequency of cognitive impairment was found on formal neuropsychological testing (study 2). Mean neuropsychological test scores of the ECMO group (N = 24) did not significantly differ from healthy controls (N = 23) after controlling for depression. Less than 30% of ECMO-treated patients showed impairments in anterograde memory, and deficits on general IQ or executive function were seen in <17% of patients. However, we observed high levels of self-reported anxiety and depression in the ECMO-treated patients.

CONCLUSIONS

Cognitive outcomes in ECMO-treated patients were generally good, with preserved neuropsychological function in the majority of patients, despite severe hypoxaemia and high rates of self-reported difficulties. However, we saw high levels of mental health symptoms in these patients, highlighting a need for psychological support.

Subjective Cognitive Complaints Given in Questionnaire: Relationship With Brain Structure, Cognitive Performance and Self-Reported Depressive Symptoms in a 25-Year Retrospective Cohort Study

BACKGROUND

Subjective cognitive complaints are common but it is unclear whether they indicate an underlying pathological process or reflect affective symptoms.

METHOD

800 community-dwelling older adults were drawn from the Whitehall II cohort. Subjective cognitive complaint inquiry for memory and concentration, a range of neuropsychological tests and multimodal MRI were performed in 2012-2016. Subjective complaints were again elicited after 1 year. Group differences in grey and white matter, between those with and without subjective complaints, were assessed using voxel-based morphometry and tract-based spatial statistics, respectively. Mixed effects models assessed whether cognitive decline or depressive symptoms (over a 25-year period) were associated with later subjective complaints. Analyses were controlled for potential confounders and multiple comparisons.

RESULTS

Mean age of the sample at scanning was 69.8 years (±5.1, range: 60.3-84.6). Subjective memory complaints were common (41%) and predicted further similar complaints later (mean 1.4 ± 1.4 years). There were no group differences in grey matter density or white matter integrity. Subjective complaints were not cross-sectionally or longitudinally associated with objectively assessed cognition. However, those with subjective complaints reported higher depressive symptoms ("poor concentration": odds ratio = 1.12, 95% CI 1.07-1.18; "poor memory": odds ratio = 1.18, 1.12-1.24).

CONCLUSIONS

In our sample subjective complaints were consistent over time and reflected depressive symptoms but not markers of neurodegenerative brain damage or concurrent or future objective cognitive impairment. Clinicians assessing patients presenting with memory complaints should be vigilant for affective disorders. These results question the rationale for including subjective complaints in a spectrum with Mild Cognitive Impairment diagnostic criteria.

Association between problematic social media use and memory performance in a sample of Lebanese adults: the mediating effect of anxiety, depression, stress and insomnia

BACKGROUND

Psychological factors such as depression, anxiety, stress and insomnia and problematic social media use are able to alter our memories and might have an impact on memory function and retrieval. More studies are needed to better understand the relationship between memory performance and mental health disorders, especially the ones that could be related to problematic social media use. The objective of this study was to evaluate any association between problematic social media use, depression, anxiety, stress, and insomnia vs memory performance among a representative sample of Lebanese people.

METHODS

This cross-sectional study, conducted between January and May 2019, enrolled 466 community dwelling participants using a proportionate random sample from all Lebanese governorates. The questionnaire consisted of the following measures: the Memory Awareness Rating Scale (MARS) to assesses views of memory performance, the problematic social media use scale to measure the degree of addiction to social media, the Hamilton depression rating scale and Hamilton anxiety scale to assess depression and anxiety respectively, the Beirut Distress Scale to assess stress and the Lebanese Insomnia sale to assess insomnia. The data analysis was performed using the SPSS software version 25. A linear regression was conducted, taking the memory performance scale as the dependent variable. A mediation analysis was performed to test the effect of problematic social media use on memory performance mediated by depression, anxiety, stress and insomnia.

RESULTS

Higher problematic social media use (Beta = - 0.21) and higher anxiety (Beta = - 0.25) were significantly associated with lower memory performance. The association between problematic social media use and memory performance was partially mediated by anxiety (21.19%) but not depression, stress or insomnia.

CONCLUSION

Concerning problematic social media use, a clear correlation was demonstrated in this study linking it to lower memory performances. Future studies should evaluate the possible mechanisms and methods for effective awareness especially towards the younger generation.

Effects of COVID-19 pandemic and lockdown on lifestyle and mental health of students: A retrospective study from Karachi,Pakistan

INTRODUCTION

Due to the COVID-19 pandemic, many countries imposed lockdowns on their citizens in an attempt to contain the disease. Pakistan is one of these countries. A government mandated lockdown can have mitigating psychological effects on young adults, out of which a large fraction is made up of students. This study aims to investigate the correlations between changes in sleep pattern, perception of time, and digital media usage. Furthermore, it explores the impact of these changes on the mental health of students of different educational levels.

METHODS

This cross-sectional study was conducted via a web-based questionnaire, from March 24 to April 26, 2020. The survey was targeted at students and 251 responses were obtained. It was a 5-section long questionnaire. The first section inquired about demographics of participants. Each of the other 4 section were devoted to changes in sleep pattern, perception of time flow, digital media usage and mental health status of students. Close ended questions with multiple choice responses, dichotomous, interval and 4-point Likert scales were used in the construction of the survey questionnaire. Chi square, T-tests multinomial and binary logistic regression were used as primary statistical tests. All data were analyzed using Statistical Package for Social Science (SPSS) version 23.0 (IBM Corp., Armonk, NY).

RESULTS

Out of 251 adolescents that participated in our study, the majority (70.2%) were females. The mean age of the participants was 19.40+/- 1.62 years. Two-thirds of the respondents did not have much trouble falling asleep (66.5%). The analysis found no significant association between longer sleep periods and procrastination level (p = 0.054). Nearly three-fourths (72.9%) of our participants felt that getting through quarantine would have been more difficult if they did not have any electronic gadgets. Of these, a majority (85.8%) had a general feeling of tiredness and lacked motivation (p = 0.023). Additionally, a large number of students (69.7%) had reported that time is seemingly moving faster. A significant relationship between increased usage of electronic items and longer sleep periods was also noted (p = 0.005). With respect to the level of education statistically significant values were noted for alarm use both before and after quarantine began (p = 0.021 and p = 0.004, respectively). Further analysis showed that there was a significant difference in the median difference of time spent on social media before the outbreak (3.0+/-32.46) and time spent on social media after the outbreak (6.0+/-3.52) in a single day (p=0.000).

CONCLUSIONS

Our research has revealed that due to the lockdown imposed by the government in response to COVID-19, the sleeping patterns of the students was affected the most. Our findings show that the increase in use of social media applications led to a widespread increase in the length of sleep, worsening of sleep habits (people sleeping at much later hours than usual), and a general feeling of tiredness. A general lack of recollection regarding what day of the week it was, as well as a change in the perceived flow of time were also notable. All these findings indicate the decline in mental health of students due to the lockdown. Promoting better sleep routines, minimizing the use of digital media, and encouragement of students to take up more hobbies could collectively improve the health and mood of students in self quarantine.

Risk factors associated with stress, anxiety, and depression among university undergraduate students

It is well-known that prevalence of stress, anxiety, and depression is high among university undergraduate students in developed and developing countries. Students entering university are from different socioeconomic background, which can bring a variety of mental health risk factors. The aim of this review was to investigate present literatures to identify risk factors associated with stress, anxiety, and depression among university undergraduate students in developed and developing countries. I identified and critically evaluated forty-one articles about risk factors associated with mental health of undergraduate university students in developed and developing countries from 2000 to 2020 according to the inclusion criteria. Selected papers were analyzed for risk factor themes. Six different themes of risk factors were identified: psychological, academic, biological, lifestyle, social and financial. Different risk factor groups can have different degree of impact on students' stress, anxiety, and depression. Each theme of risk factor was further divided into multiple subthemes. Risk factors associated with stress, depression and anxiety among university students should be identified early in university to provide them with additional mental health support and prevent exacerbation of risk factors.

Differences in the Associations Between Memory Complaints and Depressive Symptoms Among Black and White Older Adults

OBJECTIVE

To test whether race (specifically Black or White) moderates the relationship between memory complaints and depressive symptoms in cognitively normal older adults, and if these relationships vary by memory complaint characteristics.

METHODS

Data from Black (n = 551) and White (n = 1,158) cognitively intact participants (Mage = 77.1, SD = 7.5; 76.6% female) in the Minority Aging Research Study and the Rush Memory and Aging Project were used. Participants completed annual clinical evaluations, including the Center for Epidemiologic Studies Depression scale and two memory complaint questions, over periods of up to 18 years. Ordinal mixed effects models were used to examine within-person relationships between memory complaints and depressive symptoms over time, as well as whether race moderated these associations.

RESULTS

Reports of greater memory change over time were associated with more depressive symptoms for both Black and White older adults. However, reports of greater frequency of memory problems were related to depressive symptoms for Black older adults only.

CONCLUSION

Findings suggest differential associations between memory complaints and depressive symptoms in cognitively normal Black and White older adults and call for future research to examine the influence of race and related factors on memory complaints and depressive symptoms.

Examining the temporal associations between self-reported memory problems and depressive symptoms in older adults

Objectives: Older adults commonly report problems with their memory which can elicit sadness and worry about future development of cognitive impairment. Conversely, ongoing depressive symptoms can negatively impact older adults' perceptions of their memory performance. The current study examined the longitudinal associations between self-reported memory problems and depressive symptoms to explore which symptom tends to appear first.Method: Two datasets from ongoing observational, longitudinal studies of aging (Memory and Aging Project; Minority Aging Research Study) were used for secondary analyses. Older adults (n = 1,724; M_age = 77.03; SD = 7.54; 76.80% female; 32.26% Black) completed up to 18 annual assessments of self-reported memory (two items: perceived decline in memory and frequency of memory problems) and depressive symptoms. Multilevel models were used to examine intra-individual variability and time-lagged relationships between self-reported memory and depressive symptoms.Results: Concurrently, self-reported memory problems and depressive symptoms were significantly related; at times when older adults reported poorer memory, they also reported more depressive symptoms, regardless of the type of memory self-report. Prospectively, perceived memory decline predicted future depressive symptoms, but depressive symptoms did not predict future reports of memory decline. Self-reported frequency of memory problems did not predict future depressive symptoms or vice versa.Conclusion: The current study's findings suggest a temporal relationship between perceived memory decline and depressive symptoms, such that perceived memory decline can lead to future depressive symptoms. These findings can inform future studies focused on developing a standardized assessment of self-reported memory that is separable from depressive symptoms.

Self-rated Physical, Mental, Oral, and Cognitive Health in Older Korean Immigrants: The Role of Health Indicators and Sociocultural Factors

Objectives:

Guided by the models of health assessment and social determinants of health, we examined predictors of self-rated physical, mental, oral, and cognitive health of older Korean immigrants.

Methods:

Data came from the Study of Older Korean Americans (SOKA; N = 2,061, Mean age = 73.2). Multivariate regression models of self-ratings of health were tested with health indicators (both domain-specific and other health indicators including chronic disease, functional disability, problems with teeth or gums, and cognitive function) and sociocultural factors (acculturation, social network, and ethnic community social cohesion).

Results:

For self-rated physical, mental, and oral health, indicators specific to the targeted domain played a primary role, with those of other health domains playing a secondary role. Acculturation and social network were significant predictors of all four measures.

Discussion:

Findings highlight the importance of holistic health assessment that considers a wide range of health domains as well as sociocultural contexts.

Depressive symptoms, memory complaints, and memory test performance

The impact of emotional factors on subjective cognitive complaints and memory test performance has been a topic of extensive research, produced conflicting results. Investigators typically used self-report inventories that lack measures of response bias. Studies have also neglected to use performance validity tests (PVTs) to screen participants for incomplete effort. In the present study, 27% of the original sample of non-litigating outpatient referrals (N = 416) failed to meet self-report and performance validity criteria. Remaining participants (N = 226) were classified into high and low depression groups using their median score (66 T) on Scale D (Depression) of the MMPI-2. "High depression" subjects scored over 65 T on the D scale (MN = 77 T). "Low depression" subjects scored below 66 T (MN = 56 T). Test performances were compared across WAIS-IV Digit Span, Wechsler Memory Scale IV Logical Memory and Visual Reproduction subtests, and the Miami Selective Learning Test. High and low depressive groups exhibited no significant mean score differences on any memory measures. Cognitive Complaints on the Cognitive Difficulties Scale (CDS) were associated with level of depressive symptoms (r(226) =.42, p <.001). Complaints were predictive of delayed (30 min) list recall (r(224) =.19, p =.006, but were not related to eight other memory measures. Results suggest that, in general, depression severity is predictive of cognitive complaints yet has little, if any, relation to memory test performance.

Visuospatial/executive abilities and mood affect the reliability of a subjective memory complaints measure

BACKGROUND

Inconsistent results are reported so far in the literature on the relationship between subjective memory complaints (SMC) and objective memory performance. Mixed findings triggered the need to investigate whether other potential mediating variables, such as mood and non-memory domains, affect the relationship between SMC and memory performance.

AIMS

The present study aimed to contribute in clarifying the relation between subjective and objective memory considering the potential role of mood and visuospatial/executive functions.

METHODS

Six hundred and sixty Italian community-dwelling adults (52-91 years old) were enrolled. Italian version of Montreal Cognitive Assessment Test (MoCA), Geriatric Depression Scale and Subjective Memory Complaints Questionnaire (SMCQ) were administered. Four subsamples were composed according to the following criteria: (a) participants with high visuospatial/executive function (VSE) score at MoCA and high mood; (b) participants with high VSE score and low mood; (c) participants with low VSE score and high mood and; (d) participants with low VSE score and low mood.

RESULTS

Preliminarily, two confirmatory factor analysis have set the one-factor structure of SMCQ as the best fitting model. Diagnostic accuracy of the SMCQ in discriminating high and low memory score was assessed. ROC analyses confirmed that a low score in executive tasks was associated with poor reliability of the SMCQ. On the contrary, well-preserved executive functions and high mood levels ensured a good reliability of SMCQ in detecting memory problems.

DISCUSSION AND CONCLUSIONS

Although mood is a key mediator in the relationship between subjective and objective memory, preserving executive functions is essential for ensuring the accuracy of memory self-appraisal in adulthood and elderly.

Sources of Response Bias in Cognitive Self-Report Items: "Which Memory Are You Talking About?"

BACKGROUND AND OBJECTIVES

Self-reported cognitive difficulties are common in the years before an Alzheimer's disease (AD) diagnosis. Understanding how older adults interpret and respond to questions about their cognition is critical to recognize response biases that may limit the accuracy of cognitive self-reports in identifying AD risk. Cognitive interviewing is a systematic approach for examining sources of response bias that influence individuals' answers to specific questions. The purpose of this study was to identify features of common cognitive self-report items that contribute to (a) differing interpretations among respondents and (b) older adults' decisional processes when responding.

RESEARCH DESIGN AND METHODS

A convenience sample of community-dwelling older adults (n = 49; Mage = 74.5 years; 36.7% male) without dementia completed a demographic questionnaire, the Montreal Cognitive Assessment, and an audio-recorded cognitive interview. Twenty commonly used cognitive self-report items were evaluated using cognitive interviewing techniques. The Question Appraisal System was used to guide the analysis of interview data and identify sources of response bias within and across cognitive self-report items.

RESULTS

The most common sources of inconsistency in item interpretation and decisional processes were vague item wording, incorrect assumptions regarding consistency of cognitive problems across situations, and provocation of an emotional reaction that influenced responses.

DISCUSSION AND IMPLICATIONS

Assessment of self-reported cognition is critical to facilitate research on early AD symptoms. Findings from this study identify modifiable sources of response bias that may influence the measurement properties of currently used cognitive self-report items and can inform refinement of measures.

Motoric Cognitive Risk Syndrome Using Three-Item Recall Test and Its Associations with Fall-Related Outcomes: The Korean Frailty and Aging Cohort Study

Motoric cognitive risk (MCR) syndrome is originally defined as the presence of subjective cognitive complaints (SCCs) and slow gait (SG). MCR is well known to be useful for predicting adverse health outcomes, including falls and dementia. However, around four out of five older Korean adults reported SCCs, thereby, it may not be discriminative to define MCR in Korea. We adopted the three-item recall (3IR) test, instead of SCCs, to define MCR. This cross-sectional analysis included 2133 community-dwelling older adults aged 70-84 years, without dementia or any dependence in activities of daily living from the Korean Frailty and Aging Cohort Study. The newly attempted criteria of MCR using 3IR were met by 105 participants (4.9%). MCR using 3IR showed synergistic effects on fall-related outcomes, whereas the conventional definition of MCR using SCCs was not superior to SG only. MCR using 3IR was associated with falls (odds ratio [OR]: 1.92; 95% confidence interval (CI): 1.16-3.16), recurrent falls (OR: 2.19; 95% CI: 1.12-4.32), falls with injury (OR: 1.98; 95% CI: 1.22-3.22), falls with fracture (OR: 2.51; 95% CI: 1.09-5.79), fear of falling (OR: 3.00; 95% CI: 1.83-4.92), and low activities-specific balance confidence (OR: 3.13; 95% CI: 1.57-6.25). We found that MCR using 3IR could be useful in predicting fall-related outcomes in a cultural background reporting more SCCs, such as Korea.

On the nature of objective and perceived cognitive impairments in depressive symptoms and real-world functioning in young adults

Cognitive impairments in depression contribute to disability. According to prevailing cognitive theories, one's perception related to cognitive ability can cause and maintain depression, and related outcomes. Here, we investigate the degree to which perceived cognitive impairment predicts functional impairment above and beyond objective neurocognition. A sample of young adults (n = 123) completed a battery of tests measuring objective cognitive ability, perceived cognitive function (e.g., Perceived Deficits Questionnaire), disability (e.g., World Health Organization Disability Assessment Schedule) and depressive symptoms (Beck Depression Inventory-2). Hierarchical multiple regression analyses tested the incremental variance that perceived cognitive impairment accounts for above and beyond neuropsychological test measures and disability related to depression. Results show that perceived cognitive impairment accounts for significant incremental variance in depressive symptoms beyond neuropsychological test scores; disability measures were significantly associated with depressive symptoms, as was perceived cognitive impairment. Individuals with depression and related disorders are more likely to report cognitive impairments and experience diminished cognitive ability - relative to healthy controls - regardless of objective impairments, highlighting the importance of considering, measuring, and treating this perceived cognitive impairment, that is, Cognitive Impairment Bias (Dhillon and Zakzanis, 2019).

Associations of cardiovascular disease and depression with memory related disease: A Chinese national prospective cohort study

BACKGROUND

Association of cardiovascular disease (CVD) or depression and memory has been studied. But hardly any studies on the association of coexistence of CVD and depression and memory.

METHODS

This is a prospective cohort study of a nationally representative sample of 12,272 adults aged 45 years and more who participated in the China health and retirement longitudinal study 2011 to 2015. All variables were acquired by self-reporting questions. The associations between coexistence of CVD and depression with memory related disease (MRD) were investigated by using Cox proportional hazards regression models.

RESULTS

Among the 12,272 participants (mean age 65.69 years; 46.8% male) in this study, 56.9% no CVD or depression and 6.7% coexistence of CVD and depression. After adjustment for age, sex, marriage, living place, registered permanent residence, education level, smoking status, alcoholic intake, sleep status, nap status, social communication, health before 15 years, life satisfaction, cognitive function, and 11 chronic diseases risk factors, depression alone was significantly high risk for MRD (HR:1.64; 95% CI: 1.09-2.49); coexistence of CVD and depression increased the risk for MRD significantly higher (HR: 4.72; 95%CI: 2.91-7.64).

LIMITATIONS

Diseases were all self-reported and we couldn't adjust for all the potential confounders, which might be prone to information error and residual confounding.

CONCLUSIONS

In a nationally representative cohort with median 4 years of follow-up, depression alone and co-existence of depression and CVD could significantly increase the risk of MRD. Our study supports the idea of prevention of memory disease from a psycho-cardiology aspect.

Memory complaints and depressive symptoms over time: a construct-level replication analysis

BACKGROUND

Memory complaints and depressive symptoms are frequently associated in older adults and both serve as potential indicators of future cognitive decline. However, the temporal ordering of the development of these two symptoms remains unclear. The goal of the current study was to examine concurrent and temporal relationships between memory complaints and depressive symptoms in older adults.

METHODS

Data were drawn from two longitudinal, nationally representative datasets and included cognitively intact older adults aged 65 and over. The datasets in the current study were from the National Health and Aging Trends Study (NHATS) and the Health and Retirement Study (HRS). Using an integrative analytic framework, we tested bidirectional temporal relationships between memory complaints (memory ratings and perceived memory decline) and depressive symptoms over 6 to 9 years of data in over 5000 older adults across these two samples.

RESULTS

Across both datasets, perceived memory decline predicted future depressive symptoms whereas memory ratings did not. Additionally, results showed that at times when depressive symptoms tended to be higher, memory complaints were also higher, but depressive symptoms did not predict future memory complaints. One finding that was inconsistent across datasets was memory ratings predicting depressive symptoms. After accounting for covariates, this relationship was only significant in one dataset.

CONCLUSIONS

Cognitively intact older adults who report memory decline may be at risk for developing depressive symptoms in the future. Furthermore, our findings highlight the importance of using immediate replication of results across datasets to determine the generalizability of conclusions.

Depressive symptoms as predictors of visual memory deficits in middle-age

BACKGROUND

Depression has been known to affect memory and other cognitive domains. The objective of this longitudinal cohort study was to investigate longitudinal associations between depressive symptoms at age 31 years and visual memory and new learning at the age of 46 years. We investigated whether depressive symptoms at age 31 predicted visual memory deficits at age 46 years, and whether changes in depressive symptoms between 31 and 46 years predicted visual memory at age 46.

METHODS

Participants were members of the Northern Finland Birth Cohort 1966. Depressive symptoms were assessed with the Symptom Checklist-25 (SCL-25) on both occasions. Visual memory and new learning were assessed using Paired Associative Learning (PAL) test at the age 46 follow-up. PAL total errors adjusted and first trial memory score were used as outcomes and basic educational level, relationship status, physical activity and diet at baseline were considered as confounding factors in linear regression analysis.

RESULTS

A total of 5029 (57% female) participants were included in the main analysis. No associations were found between depressive symptoms or change in depressive symptoms and visual memory and new learning scores. The result did not change following cut-offs 1.55 and 1.75 for depression.

LIMITATIONS

SCL-25 only measures symptoms during the past week. Only one cognitive domain was assessed.

CONCLUSIONS

Contrary to our hypothesis, neither baseline depressive symptoms nor change in depressive symptoms predicted visual memory scores 15 years later. It appears that sub-clinical depressive symptoms do not effect this cognitive domain in the middle-aged population.

Cognitive functioning and lifetime major depressive disorder in UK Biobank

BACKGROUND

Cognitive impairment associated with lifetime major depressive disorder (MDD) is well-supported by meta-analytic studies, but population-based estimates remain scarce. Previous UK Biobank studies have only shown limited evidence of cognitive differences related to probable MDD. Using updated cognitive and clinical assessments in UK Biobank, this study investigated population-level differences in cognitive functioning associated with lifetime MDD.

METHODS

Associations between lifetime MDD and cognition (performance on six tasks and general cognitive functioning [g-factor]) were investigated in UK Biobank (N-range 7,457-14,836, age 45-81 years, 52% female), adjusting for demographics, education, and lifestyle. Lifetime MDD classifications were based on the Composite International Diagnostic Interview. Within the lifetime MDD group, we additionally investigated relationships between cognition and (a) recurrence, (b) current symptoms, (c) severity of psychosocial impairment (while symptomatic), and (d) concurrent psychotropic medication use.

RESULTS

Lifetime MDD was robustly associated with a lower g-factor (β = -0.10, PFDR = 4.7 × 10-5), with impairments in attention, processing speed, and executive functioning (β ≥ 0.06). Clinical characteristics revealed differential profiles of cognitive impairment among case individuals; those who reported severe psychosocial impairment and use of psychotropic medication performed worse on cognitive tests. Severe psychosocial impairment and reasoning showed the strongest association (β = -0.18, PFDR = 7.5 × 10-5).

CONCLUSIONS

Findings describe small but robust associations between lifetime MDD and lower cognitive performance within a population-based sample. Overall effects were of modest effect size, suggesting limited clinical relevance. However, deficits within specific cognitive domains were more pronounced in relation to clinical characteristics, particularly severe psychosocial impairment.

Functional cognitive disorders: a systematic review

Cognitive symptoms are common, and yet many who seek help for cognitive symptoms neither have, nor go on to develop, dementia. A proportion of these people are likely to have functional cognitive disorders, a subtype of functional neurological disorders, in which cognitive symptoms are present, associated with distress or disability, but caused by functional alterations rather than degenerative brain disease or another structural lesion. In this Review, we have systematically examined the prevalence and clinical associations of functional cognitive disorders, and related phenotypes, within the wider cognitive disorder literature. Around a quarter of patients presenting to memory clinics received diagnoses that might indicate the presence of functional cognitive disorders, which were associated with affective symptoms, negative self-evaluation, negative illness perceptions, non-progressive symptom trajectories, and linguistic and behavioural differences during clinical interactions. Those with functional cognitive disorder phenotypes are at risk of iatrogenic harm because of misdiagnosis or inaccurate prediction of future decline. Further research is imperative to improve diagnosis and identify effective treatments for functional cognitive disorders, and better understanding these phenotypes will also improve the specificity of diagnoses of prodromal degenerative brain disease.