Contemporary review 2009: cognitive aging

Cognition and Functional Capacity: An Initial Comparison of Veteran and Non-Veteran Older Adults

INTRODUCTION

The U.S. Military Veterans aged 65 and older comprise an estimated 43% of the 22 million living Veterans in the United States. Veterans have high rates of physical, psychiatric, and social challenges, but it is not known whether Veteran status confers additional risk for cognitive or functional impairments in later life. Thus, this investigation specifically compared older Veterans with their non-Veteran peers in cognitive functioning and performance-based functional capacity.

MATERIALS AND METHODS

Participants (N = 110; 29 Veterans and 81 non-Veterans) were part of a larger longitudinal study on biopsychosocial functioning in independently living older adult residents of a Continuing Care Senior Housing Community. The University of California San Diego Institutional Review Board approved the study and all participants provided written informed consent. Participants provided demographic and mental health information and were administered a comprehensive neuropsychological battery. Functional capacity was assessed using the UCSD Performance-Based Skills Assessment-Brief (UPSA-B), which uses financial and communication role-plays to assess everyday functioning skills. Neuropsychological scores were appropriately normed prior to analysis. Multivariate Analyses of Variances with post hoc t-tests and an Analysis of Covariance were used to examine neuropsychological and functional capacity differences, respectively, between Veterans and non-Veterans.

RESULTS

Veterans did not differ from non-Veterans in educational attainment (16.4 years versus 15.5 years, P = 0.110), but they were significantly older (mean age 86.9 years ± 5.7, versus 81.74 years ± 6.53; P < 0.001) and were more likely to be male (X2 [1, N = 110] = 62.39, P < 0.001). Thus, though neuropsychological norms already accounted for demographic differences in our participants, age and sex were controlled in the Analysis of Covariance predicting UPSA-B score from Veteran status. Results suggested that, compared to non-Veterans, Veterans had significantly worse performance in the list learning portion of a test of verbal memory (Hopkins Verbal Learning Test-Revised, Total Recall; t = 2.56, P = 0.012, d = 0.56). Veterans and non-Veterans did not significantly differ in performance on the delayed recall portion of the verbal learning test and did not differ on a cognitive screening test (Montreal Cognitive Assessment) or on measures of premorbid intellectual functioning (Wide Range Achievement Test-4 Reading), language (Boston Naming Test, Verbal Fluency), visual memory (Brief Visuospatial Memory Test-Revised), attention/working memory (WAIS-IV Digit Span), processing speed (WAIS-IV Digit Symbol Coding), executive function (Delis-Kaplan Executive Function System Trails and Color-Word Test), or functional capacity (UPSA-B). Because our examination of multiple outcomes might have inflated Type I error, we performed a post hoc adjustment of P values using Benjamini-Hochberg procedures and the group difference in verbal learning remained significant.

CONCLUSIONS

Despite largely similar function in most domains, Veterans performed significantly more poorly in verbal list learning than their non-Veteran peers. Additional attention should be given to the understanding, assessment, and possible treatment of learning and memory differences in older Veterans, as this may be an area in which Veteran status confers additional risk or vulnerability to decline. This is the first study to compare objective neuropsychological and functional performance between older (age 65+) US Veterans and non-Veterans.

A comparative analysis of colour-emotion associations in 16-88-year-old adults from 31 countries

As people age, they tend to spend more time indoors, and the colours in their surroundings may significantly impact their mood and overall well-being. However, there is a lack of empirical evidence to provide informed guidance on colour choices, irrespective of age group. To work towards informed choices, we investigated whether the associations between colours and emotions observed in younger individuals also apply to older adults. We recruited 7393 participants, aged between 16 and 88 years and coming from 31 countries. Each participant associated 12 colour terms with 20 emotion concepts and rated the intensity of each associated emotion. Different age groups exhibited highly similar patterns of colour-emotion associations (average similarity coefficient of .97), with subtle yet meaningful age-related differences. Adolescents associated the greatest number but the least positively biased emotions with colours. Older participants associated a smaller number but more intense and more positive emotions with all colour terms, displaying a positivity effect. Age also predicted arousal and power biases, varying by colour. Findings suggest parallels in colour-emotion associations between younger and older adults, with subtle but significant age-related variations. Future studies should next assess whether colour-emotion associations reflect what people actually feel when exposed to colour.

Effect of Physical Exercise on Executive Functions Using the Emotional Stroop Task in Perimenopausal Women: A Pilot Study

Exercise has beneficial effects on emotional cognitive control for the majority of the population. However, the impact of exercise on cognitive processes in perimenopausal women remains unclear. Therefore, this study investigated the effect of aerobic exercise on the cognitive processes of perimenopausal women using an emotional Stroop task (EST).

METHOD

A quasi-experimental pilot study was conducted involving 14 perimenopausal women (Peri-MG) and 13 healthy young women (YG) who completed an EST before and after an aerobic cycling exercise. Mixed-effects models for repeated measures were used to analyze reaction times (RTs) and error rates (ERs) during emotional word processing (positive, negative, and neutral) for both groups.

RESULTS

Compared with the YG, the Peri-MG showed significantly shortened RTs for positive and negative emotions (p < 0.05) post-exercise, but not for neutral words. In addition, the Peri-MG exhibited significantly increased ERs for negative words at baseline compared with the YG (p < 0.05), but this difference was not observed during the post-exercise test.

CONCLUSION

The findings suggest that aerobic exercise can enhance executive control performance in perimenopausal women. The Peri-MG exhibited marked behavioral plasticity in the form of reduced bias to salient cues that were significantly more sensitive to alterations due to exercise. This new evidence enhances the understanding of emotional vulnerability and beneficial susceptibility to exercise in perimenopausal women.

Semantic impairment in aphasia: A problem of control?

PURPOSE

The relationship between cognitive processes and language ability in aphasia has recently gained increasing attention, with some authors suggesting that control impairments may underlie difficulties with semantic tasks in aphasia. This paper aims to present an overview of the current research on the involvement of cognitive processes in semantic processing tasks and discuss the proposed relationship between cognitive control and semantic processing in aphasia.

METHOD

The role of cognitive processes in semantic processing tasks commonly used in the aphasiology literature is discussed and two theoretical approaches to semantic processing that contribute to the understanding of the nature of semantic breakdown in aphasia are outlined. Finally, we examine the evidence put forward in the Controlled Semantic Cognition framework with regard to the interpretation of impaired performance on semantic processing tasks in people with aphasia.

RESULT

Non-linguistic cognitive abilities such as working memory, inhibition and control are required by semantic processing tasks, in addition to access to conceptual information, making it difficult to dissociate these abilities. Several issues exist regarding the evidence put forward for a control deficit as the underlying cause of poor performance on semantic processing tasks in aphasia.

CONCLUSION

It remains unclear whether impairment on semantic tasks in people with aphasia is related to problems with the representation and/or processing (activation/retrieval) of meaning or problems with cognitive control (or both). Further research is still needed to fully understand how non-linguistic cognitive processes interact with semantic processing, as well as clarify and consistency the definition of control.

Designing Combinations of Pictogram and Text Size for Icons: Effects of Text Size, Pictogram Size, and Familiarity on Older Adults' Visual Search Performance

OBJECTIVE

This study aimed to determine suitable combinations of text and pictogram sizes for older adults and investigated the visual prioritization of pictogram versus text.

BACKGROUND

Icons have become an indispensable part of application (app) design. Pictogram size and text size of icons influence the usability of apps, especially by aged users. However, few studies have investigated the influences of different pictogram and text size combinations on readability, legibility, and visual search performance for older adults.

METHOD

This study used eye-tracking technology to investigate the effects of different pictogram and text size combinations as well as familiarity on readability, legibility, and visual search performance for older adults. A 3 (pictogram size) × 3 (text size) × 2 (familiarity) repeated-measures experimental design was used.

RESULTS

The results of this study suggest that pictogram size and text size significantly affect visual search performance and that familiarity moderates the effect of text size on distribution of fixation duration proportion for text and pictograms.

CONCLUSION

Large pictogram and text sizes improved the readability and legibility of icons for older adults. Furthermore, the older adults fixated the area of text prior to pictograms when the pictogram size was larger than 72 × 72 px (1.38° × 1.38°) in the visual search task.

APPLICATION

The results of this study suggest using different combinations of pictogram and text sizes for older adults under different scenarios. The findings of this study act as practical support for designers and developers of mobile apps for older adults.

Brief instrument for direct complex functionality assessment: a new ecological tool

Background

The Direct Assessment of Functional Status (DAFS) is the only instrument validated in Brazil that assesses functionality directly with the patient. However, this clinical tool takes a long time to be administered. This limits its use in hospitals and outpatient clinics that require brief assessment instruments. Additionally, we need to count with a direct assessment because the number of older adults living alone is increasing and we thus lack reliable informants.

Objective

This study aimed to present the development and content validity evidence of a direct complex functionality test for older adults, the Brief Instrument for Direct Functionality Assessment (BIDFA).

Method

A total sample of 30 older adults and eight expert judges took part in the study stages. The BIDFA construction stages were: (1) literature review of functionality instruments; (2) development of seven ecological tasks to evaluate the performance of daily complex activities with the older adults; (3) content analysis by eight expert judges; (4) pilot study with 30 older adults; (5) the ecological analysis of items; (6) focus group analysis; and (7) final version of the BIDFA.

Results

The BIDFA had evidence of content validity with an agreement index of 96.5%. The final version of BIDFA was left with six domains of complex functionality divided into semantic memory and time orientation; shopping skills; executive attention, math and finance skills; organization; planning and procedural memory; and problem-solving. The complex functionality score by BIDFA ranges from 0 to 100 points.

Conclusion

The BIDFA was found to have good content validity by the expert judges and by the ecological analysis of the items by the older adults. The new instrument is expected to help assess the functional status of older adults, in an abbreviated context including complex functionality demands, with a wider range of total and subdomain scores.

Frontal adenosine triphosphate markers from 31P MRS are associated with cognitive performance in healthy older adults: preliminary findings

Aging is associated with declines in mitochondrial efficiency and energy production which directly impacts the availability of adenosine triphosphate (ATP), which contains high energy phosphates critical for a variety of cellular functions. Previous phosphorous magnetic resonance spectroscopy (31P MRS) studies demonstrate cerebral ATP declines with age. The purpose of this study was to explore the functional relationships of frontal and posterior ATP levels with cognition in healthy aging. Here, we measured frontal and posterior ATP levels using 31P MRS at 3 Tesla (3 T) and assessed cognition using the Montreal Cognitive Assessment (MoCA) in 30 healthy older adults. We found that greater frontal, but not posterior, ATP levels were significantly associated with better MoCA performance. This relationship remained significant after controlling for age, sex, years of education, and brain atrophy. In conclusion, our findings indicate that cognition is related to ATP in the frontal cortex. These preliminary findings may have important implications in the search for non-invasive markers of in vivo mitochondrial function and the impact of ATP availability on cognition. Future studies are needed to confirm the functional significance of regional ATP and cognition across the lifespan.

Age similarities in the anchoring effect in emotion intensity judgment

BACKGROUND

The anchoring effect refers to the tendency that an individual's numerical judgment would assimilate to an anchor (a numerical value) that appears before that judgment. This study investigated whether the anchoring effect exists in the emotion judgment of younger and older adults and observed the age-related characteristics. This could not only broaden the explanation of the anchoring effect but also link this classic judgment bias with daily emotion judgment to refresh our understanding of older adults' ability in emotional perspective taking.

METHOD

Participants (older adults: n = 64, age range: 60-74, 27 males; younger adults: n = 68, age range: 18-34, 34 males) read a brief emotional story and compared the protagonist's emotion intensity to a given numerical anchor (lower or higher than the anchor) and then estimated the protagonist's possible emotion intensity in that story. The task was divided into two cases according to anchor relevance (anchors are relevant or irrelevant relative to the judgment target).

RESULTS

The results showed that the estimates were higher under high-anchor than low-anchor conditions, suggesting the robust anchoring effect. Further, the anchoring effect was greater for anchor-relevant than anchor-irrelevant tasks and for negative rather than positive emotions. No age differences were found.

DISCUSSION AND CONCLUSIONS

The results indicated that the anchoring effect is robust and stable for younger and older adults, even though the anchor information seemed irrelevant. Finally, perceiving others' negative emotions is a crucial but rather difficult aspect of empathy, which could be a challenge and requires more caution for accurate interpretation.

The Purdue Pegboard Test: Normative Data From 1,355 Healthy People From Austria

IMPORTANCE

The Purdue Pegboard Test (PPT) is widely used as a measure of manual dexterity. Declining manual dexterity may predict cognitive decline among elderly people, but normative data for this population are scarce.

OBJECTIVE

To identify demographic and clinical predictors of PPT results in normal middle-aged and elderly Austrian people and to provide norms stratified by significant determinants.

DESIGN

A prospective, community-based cohort study using baseline data of participants from two study panels (1991-1994 and 1999-2003).

SETTING

Monocentric study Participants: 1,355 healthy, randomly selected, community-dwelling people ages 40 to 79 yr.

METHOD

Extensive clinical examination, including completion of the PPT.

OUTCOMES AND MEASURES

The number of pegs placed within a 30-s time limit on four subtests: using the right hand, left hand, both hands, and assembly (within 60 s), respectively. Demographic outcomes were the highest grade achieved.

RESULTS

For all four subtests, increasing age (βs = -0.400 to -0.118, SEs = 0.006 to 0.019, p < .001) and male sex (βs = -1.440 to -0.807, SEs = 0.107 to 0.325, p < .001) was related to worse test results. Among vascular risk factors, diabetes (βs = -1.577 to -0.419, SEs = 0.165 to 0.503, p < .001) was related to worse test results but explained only a small portion (0.7%-1.1%) of the variability in PPT performance.

CONCLUSIONS AND RELEVANCE

We provide age- and sex-specific norms of the PPT for a middle-aged and elderly population. The data represent useful reference values when assessing manual dexterity in older age groups. What This Article Adds: Advancing age and male sex relate to worse performance on the PPT in a community-dwelling cohort without signs and symptoms of neurological disease. Vascular risk factors explain only very little of the variance of test results in our population. Our study adds to the limited age- and sex-specific norms of the PPT among middle-aged and older people.

The knowledge domain of cognitive neuroscience of aging: A Scientometric and bibliometric analysis

Cognitive neuroscience of aging (CNA) is a relatively young field compared with other branches of cognitive aging (CA). From the beginning of this century, scholars in CNA have contributed many valuable research to explain the cognitive ability decline in aging brains in terms of functional changes, neuromechanism, and neurodegenerative diseases. However, very few studies have systematically reviewed the research in the domain of CAN, with regard to its primary research topics, theories, findings, and future development. Therefore, this study used CiteSpace to conduct a bibliometric analysis of 1,462 published articles in CNA from Web of Science (WOS) and investigated the highly influential and potential research topics and theories of CNA, as well as important brain areas involved in CAN during 2000-2021. The results revealed that: (1) the research topics of "memory" and "attention" have been the focus of most studies, progressing into a fMRI-oriented stage; (2) the scaffolding theory and hemispheric asymmetry reduction in older adults model hold a key status in CNA, characterizing aging as a dynamic process and presenting compensatory relationships between different brain areas; and (3) age-related changes always occur in temporal (especially the hippocampus), parietal, and frontal lobes and the cognitive declines establish the compensation relationship between the anterior and posterior regions.

Investigating the involvement of cognitive control processes in innovative and adaptive creativity and their age-related changes

Introduction

Based on the two-factor model of creativity, two distinct types of creative problem solving can be differentiated: innovative ("do things differently") and adaptive ("do things better"). Flexible cognitive control is a crucial concept in connection with both general and specific styles of creativity: innovative problem-solving benefits from broader attention and flexible mental set shifting; while adaptive creativity relies on focused attention and persistent goal-oriented processes. We applied an informatively cued task-switching paradigm which is suitable for measuring different cognitive control processes and mechanisms like proactive and reactive control. We hypothesized that adaptive creativity is connected to effective proactive control processes, while innovative creativity is based on reactive task-execution. As we have found no previous evidence how age-related changes in cognitive control affects creative cognition; we also examined the effect of healthy aging on different problem-solving styles in an explorative way.

Methods

Our participants, 37 younger (18-30 years) and 37 older (60-75 years) adults, were divided into innovative and adaptive creative groups according to the Torrance Test of Creative Thinking's Figural Subtest (Hungarian version).

Results

Our results showed that among younger adults the adaptively creative group had larger cue-locked CNV component (effective preparatory activity connected to proactive control), while the innovatively creative group had a larger target-locked P3b component (effective target evaluation and categorization in line with reactive control) which supports a functional difference in the two creative styles. By contrast, in older adults innovative problem-solving showed larger mixing costs (less effective maintenance and selection of task sets), and the lack of trial type effect on target-locked N2b (target-induced goal reactivation and less effective conflict resolution); while adaptive problem-solving caused them to make fewer errors (accuracy-oriented behavior).

Discussion

All in all, innovative and adaptive creativity is based on distinct cognitive control mechanisms in both age-groups, but their processing level is affected by age-related changes.

Digital literacy among Korean older adults: A scoping review of quantitative studies

Background

While digital literacy has become an essential competency for individuals across generations and sectors of society, supporting digital literacy in older adults is particularly challenging. South Korea is among the many countries undergoing rapid digitalization and population aging. Therefore, it is timely to identify the current understanding of digital literacy among older adults in South Korea.

Aim

To identify prior studies that quantitatively measure digital literacy among older adults in South Korea and to identify and evaluate how digital literacy was measured in the reviewed studies.

Methods

The study followed Arksey and O'Malley's scoping review framework, searching through four international (PubMed, CINAHL, Embase, and Cochrane Library) and four Korean (RISS, KISS, KCI, and KMBase) databases.

Results

Among 42 studies included in the final analysis, 38 were cross-sectional studies, and 21 employed primary data. Digital literacy was assessed in various scopes, including digital literacy, e-health literacy, Internet use, and smartphone use. Of the 25 identified measures, three were validated; the rest varied greatly, from using a few items from large surveys to employing investigator-developed measures. Based on the European Commission's Digital Competence Framework, the most commonly addressed components were "information and data literacy" and "communication and collaboration."

Conclusions

In recent years, attention toward digital literacy among South Korean older adults has grown rapidly. However, the level of digital literacy among older adults in South Korea remains inconclusive given measurement heterogeneity. Developing and validating more robust measures are warranted to evaluate digital literacy among older adults with diverse functions and circumstances.

Cognitive Aging: How the Brain Ages?

Cognitive aging refers to the cognitive changes or functional decline that comes with age. The relation between aging and functional declines involves various aspects of cognition, including memory, attention, processing speed, and executive function. In this chapter, we have introduced several dimensions about cognitive aging trajectories. Meanwhile, we have reviewed the history of the study of cognitive aging and expatiated two trends that are particularly noteworthy in the effort to elucidate the process of aging. One is that the differences between components of mental abilities have become gradually specified. The other one is a growing interest in the neural process, which relates changes in the brain structure to age-related changes in cognition. Lastly, as the basis of cognitive function, brain structures and functions change during aging, and these changes are reflected in a corresponding decline in cognitive function. We have discussed the patterns of reorganization of various structural and functional aging processes of the brain and their relationship with cognitive function.

Turning Point of Cognitive Decline for Chinese Older Adults from a Longitudinal Analysis: Protective Factors and Risk Factors

OBJECTIVES

To explore the turning point of cognitive decline in Chinese older adults and to explore the influencing factors including covariates.

PARTICIPANTS

Aged 65 and older whose cognitive function was normal at their first test.

METHODS

a secondary analysis that identified participants from the database of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Cohort-sequential design was used to categorize the data by age (rather than study wave), including the follow-up data of Chinese older adults aged 65-79 years and spanning 14 years. Cognitive function in 1278 participants was assessed using the Chinese Mini-Mental State Examination (CMMSE) in five waves over 14 years. Piecewise latent growth curve modeling was used to analyze the data.

RESULTS

(1) The turning point of cognitive decline in Chinese older adults occurs between the ages of 68 and 70. (2) There are statistically significant individual differences in the initial level of cognitive function and the growth rate of cognitive function before and after the transition stage. (3) Factors influencing cognitive function include residence, education level, smoking, drinking, exercise, leisure activities, social activities, Activities of Daily Living (ADL), and Instrumental Activities for Daily Living (IADL). (4) Exercise and ADL are the main protective factors, while smoking and drinking are the main risk factors.

CONCLUSIONS

There is a transition stage (68-70) in the decline of cognitive function in Chinese older adults and four main factors (such as smoking, drinking, exercise and ADL) have impacts on the cognitive decline. We should strengthen these protective factors (exercise and ADL) for the cognitive decline of older adults and avoid these risk factors (smoking, drinking). To prevent the decline of the cognitive function of older adults, the government should build more places conducive to activities for older adults and actively encourage older adults to improve their physical activity level. Given our findings, public health interventions centered on alcohol and tobacco cessation in older adults should be governmentally endorsed.

Effectiveness of feedback-based technology on physical and cognitive abilities in the elderly

Aging raises a social and health challenge because the passing of time causes changes in cognitive and physical functions that impair functionality and quality of life. In addition, advancements in technology and information technology have led to the development of new techniques for retraining based on the feedback technology provides. To solve the negative consequences of aging, a randomized clinical trial was carried out to assess the effectiveness of a protocol using feedback-based technology to improve physical and cognitive functions in older adults. For the purpose of this study, 200 patients were selected from a Social and Community Services Center in the province of Seville and only 46 of them became participants of the study (after applying the inclusion criteria). These patients were divided into two groups: control and experimental. Physical and cognitive abilities were assessed using the Miniexamen cognoscitivo Test (an adaptation of the MiniMental examination test), Yesevage's Depression Scale, Oddball Test, Attention Network Test, Berg Scale, Tinetti Scale, and Timed Up and Go Test. The intervention applied to the experimental group consisted of a supervised protocol using the Nintendo® Wii video game console and the Wii-Fit© video game during 16 sessions, 2 times a week with a duration of 30 min per session. The control group did not receive any treatment. The experimental group showed statistically significant improvements in all the physical variables (balance, gait, autonomy, and fall risk), as other authors had proven, and in memory and reaction times; there were no improvements in attention networks. The control group (placebo) even showed a decrease in their functions, with worse results on the Timed up and Go test Scale. The intervention using feedback-based technology has been proven effective in improving physical and cognitive abilities and in preventing and promoting healthy aging.

Macrostructural Aspects in Oral Narratives in Brazilian Portuguese by Left and Right Hemisphere Stroke Patients With Low Education and Low Socioeconomic Status

OBJECTIVE

Individuals with a stroke in either the left hemisphere (LH) or the right hemisphere (RH) often present macrostructural impairments in narrative abilities. Understanding the potential influence of low education and low socioeconomic status (SES) is critical to a more effective assessment of poststroke language. The first aim was to investigate macrostructural processing in low-education and low-SES individuals with stroke in the LH or RH or without brain damage. The second aim was to verify the relationships between macrolinguistic, neuropsychological, and sociodemographic variables.

METHOD

Forty-seven adults with LH (n = 15) or RH (n = 16) chronic ischemic stroke and 16 matched (age, education, and SES) healthy controls produced three oral picture-sequence narratives. The macrostructural aspects analyzed were cohesion, coherence, narrativity, macropropositions, and index of lexical informativeness and were compared among the three groups. Then, exploratory correlations were performed to assess associations between sociodemographic (such as SES), neuropsychological, and macrostructural variables.

RESULTS

Both the LH and the RH presented impairments in the local macrostructural aspect (cohesion), whereas the RH also presented impairments in more global aspects (global coherence and macropropositions). All five macrostructural variables correlated with each other, with higher correlations with narrativity. Naming was correlated with all macrostructural variables, as well as prestroke reading and writing habits (RWH), showing that higher naming accuracy and higher RWH are associated with better macrostructural skills.

CONCLUSIONS

The present results corroborate the role of the LH in more local processing and that of the RH in more global aspects of discourse. Moreover, this study highlights the importance of investigating discourse processing in healthy and clinical populations of understudied languages such as Brazilian Portuguese, with various levels of education, SES, and RWH.

Correlations between COMT polymorphism and brain structure and cognition in elderly subjects: An observational study

The catechol-O-methyltransferase (COMT) gene has been noted to play an important role in individual variations in the aging process. We investigated whether COMT polymorphism could influence cognition related to white matter networks. More specifically, we examined whether methionine (Met) allele loading is associated with better individual cognitive performance. Thirty-four healthy elderly participants were recruited; each participant's COMT genotype was determined, and Korean version of Montreal Cognitive Assessment scores and a diffusion tensor image were obtained for all participants. The Met carrier group showed significantly lower mean diffusivity, axial diffusivity, and radial diffusivity values for the right hippocampus, thalamus, uncinate fasciculus, and left caudate nucleus than the valine homozygote group. The Met carrier group also scored higher for executive function and attention on the Korean version of Montreal Cognitive Assessment. Based on these results, we can assume that the COMT Met allele has a protective effect on cognitive decline contributing to individual differences in cognitive function in late life period.

Age-related neural dedifferentiation for individual stimuli: an across-participant pattern similarity analysis

Age-related neural dedifferentiation - reductions in the regional specificity and precision of neural representations - is proposed to compromise the ability of older adults to form sufficiently distinct neural representations to support episodic memory encoding. The computational model that spurred investigations of age-related neural dedifferentiation initially characterized this phenomenon as a reduction in the specificity of neural patterns for individual items or stimuli. Most investigations have focused on reductions in neural differentiation for patterns of neural activity associated with category-level information, such as reduced neural selectivity between categories of visual stimuli (e.g., scenes, objects, and faces). Here, I report a novel across-participant pattern similarity analysis method to measure neural distinctiveness for individual stimuli that were presented to participants on a single occasion. Measures of item-level pattern similarity during encoding showed a graded positive subsequent memory effect in younger, with no significant subsequent memory effect in older adults. These results suggest that age-related reductions in the distinctiveness of neural patterns for individual stimuli during age differences in memory encoding. Moreover, a measure of category-level similarity demonstrated a significant subsequent memory effect associated with item recognition (regardless of an object source memory detail), whereas the effect in older was associated with source memory. These results converge with predictions of computational models of dedifferentiation showing age-related reductions in the distinctiveness of neural patterns across multiple levels of representation.

The impact of heavy alcohol consumption on cognitive impairment in young old and middle old persons

Background

Dementia indicates a significant disease burden worldwide with increased population aging. This study aimed to investigate the impact of alcohol consumption on the risk of cognitive impairment in older adults.

Methods

Participants ≥ 60 years were administered the Digit Symbol Substitution Test (DSST) to evaluate cognitive function in National Health and Nutrition Examination Survey (NHANES) cycles from 1999 to 2002 and 2011 to 2014 for enrollment in the present study. Participants were categorized into non-drinker, drinker, and heavy drinker groups. Logistic regression analyses were performed to explore associations between cognitive impairment and alcohol consumption.

Results

Multivariate analysis showed that older adults, men, people from minority races, persons with lower education or income levels, social difficulties, hypertension, or chronic kidney disease were significantly associated with a higher risk of cognitive impairment (all p < 0.05). In the young old (60–69 years), heavy amount of alcohol drinking was significantly associated with lower risk of cognitive impairment compared with drinkers [adjusted odds ratio (aOR): 0.280, 95% Confidence interval (CI) 0.095–0.826]. But in the middle old persons (≥ 70 years), heavy alcohol drinking was associated with higher risk of cognitive impairment (aOR: 2.929, 95% CI 0.624–13.74).

Conclusions

Our study demonstrated that light to heavy drinking was associated with lower risk of cognitive impairment in participants aged between 60 and 69 years, but caution is needed in the middle old people with heavy alcohol drinking.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12967-022-03353-3.

A Conceptual View of Cognitive Intervention in Older Adults With and Without Cognitive Decline-A Systemic Review

Background: Dementia is the one of the most common and prominent disease in the elderly person that results in the Cognitive interventions. In this study, we aim to conceptualize the cognitive intervention for older adults with and without cognitive dysfunction and to clarify the heterogeneity existing in this literature field by determining the main variables implicated. Methods: We conducted a study analysis using previous literature highlighting the significant data reporting empirical results from cognitive intervention for healthy older adults and other seniors with different types of dementia. Each paper was reviewed in terms of compensatory cognitive training, cognitive remediation, enrichment, cognitive activation, brain training, cognitive stimulation, cognitive training, and cognitive rehabilitation. The research analysis was performed following rigorous inclusion and exclusion criteria with the purpose of collecting relevant answers to our research questions. Results: We included a total of 168 studies in our review. Our findings indicated heterogeneity regarding methods, concepts, and procedures. Additionally, the values were integrated using different information existing in this field. Conclusion: In conclusion, we highlighted that this is the first review that clarify the discrepancy of various existing definitions, methods, and procedures, as well as the overlapping information in the cognitive interventions.

Overview of (f)MRI Studies of Cognitive Aging for Non-Experts: Looking through the Lens of Neuroimaging

This special issue concerning Brain Functional and Structural Connectivity and Cognition aims to expand our understanding of brain connectivity. Herein, I review related topics including the principle and concepts of functional MRI, brain activation, and functional/structural connectivity in aging for uninitiated readers. Visuospatial attention, one of the well-studied functions in aging, is discussed from the perspective of neuroimaging.

Age-related differences in bottom-up and top-down attention: Insights from EEG and MEG

Attention operates through top‐down and bottom‐up processes, and a balance between these processes is crucial for daily tasks. Imperilling such balance could explain ageing‐associated attentional problems such as exacerbated distractibility. In this study, we aimed to characterize this enhanced distractibility by investigating the impact of ageing upon event‐related components associated with top‐down and bottom‐up attentional processes. MEG and EEG data were acquired from 14 older and 14 younger healthy adults while performing a task that conjointly evaluates top‐down and bottom‐up attention. Event‐related components were analysed on sensor and source levels. In comparison with the younger group, the older mainly displayed (1) reduced target anticipation processes (reduced CMV), (2) increased early target processing (larger P50 but smaller N1) and (3) increased processing of early distracting sounds (larger N1 but reduced P3a), followed by a (4) prolonged reorientation towards the main task (larger RON). Taken together, our results suggest that the enhanced distractibility in ageing could stem from top‐down deficits, in particular from reduced inhibitory and reorientation processes.

Processing speed and working memory are predicted by components of successful aging: a HUNT study

BACKGROUND

Research has demonstrated that cognitive heterogeneity occurs with aging both within and between individuals. The purpose of this study was to explore whether the cognitive heterogeneity in aging was related to the subgroups of successful and usual aging.

METHOD

Participants were a representative sample of normal older adults (n = 65, age range 70-89 years). All subjects had participated in the third phase of the Nord-Trøndelag Health Survey (HUNT3) and completed all subtests in the Wechsler Memory Scale (WMS-III) and Wechsler Adult Intelligence Scale (WAIS-III). Successful aging was defined in four ways in the study: as (1) absence of disease, (2) high functioning, (3) active engagement with life, or (4) all three components combined. Five domains of memory and intelligence functions were investigated using linear regression analysis, with group membership (successful versus usual aging) as predictors and age, sex and education as correlates.

RESULTS

Processing speed performance was correlated with the successful aging component absence of disease, younger age and being of the female sex, while working memory performance was correlated with the successful aging component absence of disease and more years of education. Performance in other domains (verbal, visuospatial, and episodic memory) were not related to any successful aging definition. Age had a consistent negative effect on the processing speed domain for all successful aging definitions. Education was positively linked to cognitive performance on the verbal and working memory domains. Being female was positively linked to processing speed and episodic memory.

CONCLUSIONS

Processing speed and working memory were linked to successful aging when it was defined as absence of disease, but not by other components of successful aging, i.e. domain-specific. In contrast, other cognitive domains were not related to any components of successful aging.

The Effects of a Novel Non-catechol Dopamine Partial Agonist on Working Memory in the Aged Rhesus Monkey

Aged-related declines in cognition, especially working memory and executive function, begin in middle-age and these abilities are known to be mediated by the prefrontal cortex (PFC) and more specifically the dopamine (DA) system within the PFC. In both humans and monkeys, there is significant evidence that the PFC is the first cortical region to change with age and the PFC appears to be particularly vulnerable to age-related loss of dopamine (DA). Therefore, the DA system is a strong candidate for therapeutic intervention to slow or reverse age related declines in cognition. In the present study, we administered a novel selective, potent, non-catechol DA D1 R agonist PF-6294 (Pfizer, Inc.) to aged female rhesus monkeys and assessed their performance on two benchmark tasks of working memory - the Delayed Non-match to Sample Task (DNMS) and Delayed Recognition Span Task (DRST). The DNMS task was administered first with the standard 10 s delay and then with 5 min delays, with and without distractors. The DRST was administered each day with four trials with unique sequences and one trial of a repeated sequence to assess evidence learning and retention. Overall, there was no significant effect of drug on performance on any aspect of the DNMS task. In contrast, we demonstrated that a middle range dose of PF-6294 significantly increased memory span on the DRST on the first and last days of testing and by the last day of testing the increased memory span was driven by the performance on the repeated trials.

Cardiorespiratory fitness and prefrontal cortex oxygenation during Stroop task in older males

AIM

The aim of the current study was to assess whether executive function and prefrontal oxygenation are dependent on fitness level and age in older adults.

METHODS

Twenty-four healthy males aged between 55 and 69 years old were recruited for this study. They were stratified by age, leading to the creation of two groups: 55-60 years old and 61-69 years old. A median split based on CRF created higher- and lower-fit categories of participants. Cerebral oxygenation was assessed using functional near-infrared spectroscopy (fNIRS) during a computerized Stroop task. Accuracy (% of correct responses) and reaction times (ms) were used as behavioural indicators of cognitive performances. Changes in oxygenated (∆[HbO2]) and deoxygenated (∆[HHb]) hemoglobin were measured to capture neural changes. Repeated measures ANOVAs (CRF × Age × Stroop conditions) were performed to test the null hypothesis of an absence of interaction between CRF, Age and executive performance.

RESULTS

We also found an interaction between CRF and age on reaction times (p = .001), in which higher fitness levels were related to faster reaction times in the 61-69 year olds but not in the 55-60 year olds. Regarding ΔHHb, the ANOVA revealed a main effect of CRF in the right PFC (p = .04), in which higher-fit participants had a greater Δ[HHb] than the lower-fit (d = 1.5). We also found fitness by age interaction for Δ[HHb] in the right PFC (p = .04).

CONCLUSION

Our results support the positive association of CRF on cerebral oxygenation and Stroop performance in healthy older males. They indicated that high-fit individuals performed better in the 61-69 year olds group, but not in the 55-60 years old group. We also observed a greater PFC oxygenation change (as measured by Δ[HHb]) in the high-fit individuals.

Age-related changes in ongoing thought relate to external context and individual cognition

Understanding how age-related changes in cognition manifest in the real world is an important goal. One means of capturing these changes involves "experience sampling" participant's self-reported thoughts. Research has shown age-related changes in ongoing thought: e.g., older adults have fewer thoughts unrelated to the here-and-now. However, it is currently unclear how these changes reflect cognitive aging or lifestyle changes. 78 younger adults and 35 older adults rated their thought contents along 20 dimensions and the difficulty of their current activity in their daily lives. They also performed cognitive tasks in the laboratory. In a set of exploratory analyses, we found that older adults spent more time thinking positive, wanted thoughts, particularly in demanding contexts, and less time mind wandering about their future selves. Past-related thought related to episodic memory differently in older and younger adults. These findings inform the use of experience sampling to understand cognitive aging.

Transient neural network dynamics in cognitive ageing

It is important to maintain cognitive function in old age, yet the neural substrates that support successful cognitive ageing remain unclear. One factor that might be crucial, but has been overlooked due to limitations of previous data and methods, is the ability of brain networks to flexibly reorganize and coordinate over a millisecond time-scale. Magnetoencephalography (MEG) provides such temporal resolution, and can be combined with Hidden Markov Models (HMMs) to characterise transient neural states. We applied HMMs to resting-state MEG data from a large cohort (N=595) of population-based adults (aged 18-88), who also completed a range of cognitive tasks. Using multivariate analysis of neural and cognitive profiles, we found that decreased occurrence of "lower-order" brain networks, coupled with increased occurrence of "higher-order" networks, was associated with both increasing age and decreased fluid intelligence. These results favour theories of age-related reductions in neural efficiency over current theories of age-related functional compensation, and suggest that this shift might reflect a stable property of the ageing brain.

Quantifying Age-Related Changes in Brain and Behavior: A Longitudinal versus Cross-Sectional Approach

Cross-sectional versus longitudinal comparisons of age-related change have often revealed differing results. In the current study, we used within-subject task-based fMRI to investigate changes in voxel-based activations and behavioral performance across the life span in the Reference Ability Neural Network cohort, at both baseline and 5 year follow-up. We analyzed fMRI data from between 127 and 159 participants (20–80 years) on a battery of tests relating to each of four cognitive reference abilities. We applied a Gaussian age kernel to capture continuous change across the life span using a 5 year sliding window centered on each age in our participant sample, with a subsequent division into young, middle, and old age brackets. This method was applied separately to both cross-sectional approximations of change and real longitudinal changes adopting a comparative approach. We then focused on longitudinal measurements of neural change to identify regions expressing peak changes and fluctuations of sign change across our sample. Our results revealed several regions expressing divergence between cross-sectional and longitudinal measurements in each domain and age bracket; behavioral comparisons between measurements showed differences in change curves for all four domains, with processing speed displaying the steepest declines. In the longitudinal change measurement, we found lack of support for age-related frontal increases across analysis types, instead finding more posterior regions displaying peak increases in activation, particularly in the old age bracket. Our findings encourage greater focus on longitudinal measurements of age-related changes, which display appreciable differences from cross-sectional approximations.

The Aging Brain and Executive Functions Revisited: Implications from Meta-analytic and Functional-Connectivity Evidence

Healthy aging is associated with changes in cognitive performance, including executive functions (EFs) and their associated brain activation patterns. However, it has remained unclear which EF-related brain regions are affected consistently, because the results of pertinent neuroimaging studies and earlier meta-analyses vary considerably. We, therefore, conducted new rigorous meta-analyses of published age differences in EF-related brain activity. Out of a larger set of regions associated with EFs, only left inferior frontal junction and left anterior cuneus/precuneus were found to show consistent age differences. To further characterize these two age-sensitive regions, we performed seed-based resting-state functional connectivity (RS-FC) analyses using fMRI data from a large adult sample with a wide age range. We also assessed associations of the two regions' whole-brain RS-FC patterns with age and EF performance. Although our results largely point toward a domain-general role of left inferior frontal junction in EFs, the pattern of individual study contributions to the meta-analytic results suggests process-specific modulations by age. Our analyses further indicate that the left anterior cuneus/precuneus is recruited differently by older (compared with younger) adults during EF tasks, potentially reflecting inefficiencies in switching the attentional focus. Overall, our findings question earlier meta-analytic results and suggest a larger heterogeneity of age-related differences in brain activity associated with EFs. Hence, they encourage future research that pays greater attention to replicability, investigates age-related differences in deactivation, and focuses on more narrowly defined EF subprocesses, combining multiple behavioral assessments with multimodal imaging.

Effects of Cognitive Load on Pure-Tone Audiometry Thresholds in Younger and Older Adults

Supplemental Digital Content is available in the text.

Cognitive load (CL) impairs listeners’ ability to comprehend sentences, recognize words, and identify speech sounds. Recent findings suggest that this effect originates in a disruption of low-level perception of acoustic details. Here, we attempted to quantify such a disruption by measuring the effect of CL (a two-back task) on pure-tone audiometry (PTA) thresholds. We also asked whether the effect of CL on PTA was greater in older adults, on account of their reduced ability to divide cognitive resources between simultaneous tasks. To specify the mechanisms and representations underlying the interface between auditory and cognitive processes, we contrasted CL requiring visual encoding with CL requiring auditory encoding. Finally, the link between the cost of performing PTA under CL, working memory, and speech-in-noise (SiN) perception was investigated and compared between younger and older participants.

Depression, health comorbidities, cognitive symptoms and their functional impact: Not just a geriatric problem

OBJECTIVE

To compare the prevalence of cognitive symptoms and their functional impact by age group accounting for depression and number of other health conditions.

METHODS

We analyzed data from the 2011 Behavioral Risk Factor Surveillance System, a population-based, cross-sectional telephone survey of US adults. Twenty-one US states asked participants (n = 131, 273) about cognitive symptoms (worsening confusion or memory loss in the past year) and their functional impact (interference with activities and need for assistance). We analyzed the association between age, depression history and cognitive symptoms and their functional impact using logistic regression and adjusted for demographic characteristics and other health condition count.

RESULTS

There was a significant interaction between age and depression (p < 0.0001). In adults reporting depression, the adjusted odds of cognitive symptoms in younger age groups (<75 years) were comparable or greater to those in the oldest age group (≥75 years) with a peak in the middle age (45-54 years) group (OR 1.9 (95% Confidence Interval: 1.4-2.5). In adults without depression, adults <75 years had a significantly lower adjusted odds of cognitive symptoms compared to the oldest age group with the exception of the middle-aged group where the difference was not statistically significant. Over half of adults under age 65 with depression reported that cognitive symptoms interfered with life activities compared to 35.7% of adults ≥65 years.

CONCLUSIONS

Cognitive symptoms are not universally higher in older adults; middle-aged adults are also particularly vulnerable. Given the adverse functional impact associated with cognitive symptoms in younger adults, clinicians should assess cognitive symptoms and their functional impact in adults of all ages and consider treatments that impact both cognition and functional domains.

Inhibitory control training in healthy and highly educated older adults

Executive function training is considered a promising tool for delaying the natural effects of aging on cognition. However, there are still few studies that propose a unimodal intervention with a focus on inhibitory control, and none of them has studied the effect of this type of intervention on older adults (OA).

OBJECTIVE

The aim of this study is to investigate the benefits of inhibitory control training in healthy OA by comparing the two assessment time points, namely, before and after training.

METHODS

Twenty-seven participants were included after interview and checking the inclusion criteria. The training was based on the stop-signal paradigm and carried out in 21 sessions.

RESULTS

Participants performed better after training by reducing the false alarm error rate (i.e., for stop-signal trials), reducing omission error rate, showing an increase in hit rate, Go response time (i.e., for go-signal trials), stop-signal response time, and showing a decrease in the level of anxiety. The executive function training had no significant impact on the scores obtained in the complementary neuropsychological tests.

CONCLUSIONS

These results are consistent with previous studies that support the viability and effectiveness of cognitive intervention for executive functions in OA and suggest a positive effect of the intervention, which may be related to the learning experience of a new and challenging task.

Differential interactions of age and sleep deprivation in driving and spatial perception by male drivers in a virtual reality environment

We determined the effects of age and sleep deprivation on driving and spatial perception in a virtual reality environment. Twenty-two young (mean age: 22 years, range: 18-35) and 23 old (mean age: 71 years, range: 65-79) participants were tested after a normal night of sleep and a night of sleep deprivation. The participants drove a virtual car while responding to uni- and bilateral visual and auditory stimuli. Driving errors (crossing the lane borders), reaction times and accuracy to visual and auditory stimuli, performance in psychological tests, and subjective driving ability and tiredness were measured. Age had no effect on the number of driving errors, whereas sleep deprivation increased significantly especially the number of left lane border crossings. Age increased the number of stimulus detection errors, while sleep deprivation increased the number of errors particularly in the young and in the auditory modality as response omissions. Age and sleep deprivation together increased the number of response omissions in both modalities. Left side stimulus omissions suggest a bias to the right hemispace. The subjective evaluations were consistent with the objective measures. The psychological tests were more sensitive to the effects of age than to those of sleep deprivation. Driving simulation in a virtual reality setting is sensitive in detecting the effects of deteriorating factors on both driving and simultaneous spatial perception.

An evaluation of memory and attention in BRCA mutation carriers using an online cognitive assessment tool

BACKGROUND

The objective of this study was to evaluate the impact of various surgical, hormonal, and lifestyle factors on memory and attention in women with a BRCA1 or BRCA2 mutation.

METHODS

BRCA mutation carriers enrolled in a longitudinal study were invited to complete an online brain health assessment tool designed to screen for cognitive deficits. Four measures of memory and executive attention were assessed individually, and an overall score was compiled adjusting for age. Exposures, including preventive surgery, hormone use, and lifestyle factors, were captured by questionnaire. Performance on each of the 5 subtasks was analyzed according to various exposures. Analysis of covariance was used to compare overall scores.

RESULTS

In total, 880 women completed the online cognitive assessment. The average age of the participants was 54 years (range, 23-86 years). The mean overall test score was 54.4 (range, 0-93). The individual subtask scores declined with age at test completion (P < .0001) and increased with level of education (P ≤ .01). Women who underwent a preventive oophorectomy had a significantly higher overall score compared with women who did not undergo this surgery (55.5 vs 50.5; P = .01). Reconstructive breast surgery was also associated with a higher overall score (56.5 vs 52.3; P = .005). Chemotherapy and hormone-replacement therapy were not predictive of the overall score.

CONCLUSIONS

These findings are reassuring to high-risk women who undergo early surgical menopause for their cancer predisposition. Further studies are needed to evaluate cognitive function over time when memory deficits become more prevalent.

Different Modulatory Effects of Cognitive Training and Aerobic Exercise on Resting State Functional Connectivity of Entorhinal Cortex in Community-Dwelling Older Adults

The entorhinal cortex (EC) plays an essential role in age-related cognitive decline. However, the effect of functional connectivity (FC) changes between EC and other cerebral cortices on cognitive function remains unclear. The aim of this study was to explore the modulation of two interventions (cognitive training and aerobic exercise) on EC-FC in community-dwelling older adults. In total, 94 healthy older adults aged between 65 and 75 years were assigned to either the cognitive training or aerobic exercise group to receive 24 sessions over 12 weeks, or to a control group. Resting-state functional magnetic resonance imaging was performed at both baseline and 12-month follow-up. Compared to the cognitive training group, the aerobic exercise group showed greater EC-FC in the bilateral middle temporal gyrus, right supramarginal gyrus, left angular gyrus, and right postcentral gyrus. Compared to the control group, the cognitive training group had a decreased EC-FC in the right hippocampus, right middle temporal gyrus, left angular gyrus, and right postcentral gyrus and an increased EC-FC in the bilateral pallidum, while the aerobic exercise group showed increased EC-FC between the right medial prefrontal cortex(mPFC), bilateral pallidum, and right precuneus. Baseline EC-FC in the mPFC was positively correlated with the visuospatial/constructional index score of the Repeatable Battery for the Assessment of Neuropsychological Status. In the cognitive training group, EC-FC value changes in the right hippocampus were negatively correlated with changes in the RBANS delayed memory index score, while in the aerobic exercise group, EC-FC value changes in the left angular gyrus were positively correlated with changes in the RBANS attention index score. These findings support the hypothesis that both cognitive training and aerobic exercise can modulate EC-FC in aging populations but through different neural pathways.

Metabolic syndrome and cognitive performance across the adult lifespan

Metabolic Syndrome (MetS) is associated with increased rates of mortality and increased risk for developing dementia. Changes in brain structure and cognitive functioning have been reported within the literature. However, research examining cognitive performance in individuals with MetS is limited, inconclusive, and focuses primarily on older cohorts. As such, the effect of MetS on cognitive functioning earlier in the lifespan is unclear. This study aimed to investigate cognitive performance in young, middle-aged, and older adults with multiple metabolic and vascular risk factors in a sample of community dwelling participants (N = 128). Participants were administered a comprehensive neuropsychological battery and self-report measures. As expected, older adults performed more poorly than young and middle-aged adults across most assessments. Relative to controls, individuals with MetS reported greater hunger and disinhibited eating. MetS participants performed more poorly on Color-Word Interference: Inhibition. Additionally, when weight was accounted for, there was a significant relationship between MetS and select executive functioning tasks in middle-aged adults. These findings suggest that aspects of executive functioning may be impaired in MetS and could be further impacted by excess weight in middle-age. Future studies aimed at investigating potential causal relationships between metabolic and vascular risk factors, disinhibited eating, and executive dysfunction may provide insight into effective intervention targets to prevent MetS.

Aging-Sensitive Networks Within the Human Structural Connectome Are Implicated in Late-Life Cognitive Declines

BACKGROUND

Aging-related cognitive decline is a primary risk factor for Alzheimer's disease and related dementias. More precise identification of the neurobiological bases of cognitive decline in aging populations may provide critical insights into the precursors of late-life dementias.

METHODS

Using structural and diffusion brain magnetic resonance imaging data from the UK Biobank (n = 8185; age range, 45-78 years), we examined aging of regional gray matter volumes (nodes) and white matter structural connectivity (edges) within 9 well-characterized networks of interest in the human brain connectome. In the independent Lothian Birth Cohort 1936 (n = 534; all 73 years of age), we tested whether aging-sensitive connectome elements are enriched for key domains of cognitive function before and after controlling for early-life cognitive ability.

RESULTS

In the UK Biobank, age differences in individual connectome elements corresponded closely with principal component loadings reflecting connectome-wide integrity (|rnodes| = .420; |redges| = .583), suggesting that connectome aging occurs on broad dimensions of variation in brain architecture. In the Lothian Birth Cohort 1936, composite indices of node integrity were predictive of all domains of cognitive function, whereas composite indices of edge integrity were associated specifically with processing speed. Elements within the central executive network were disproportionately predictive of late-life cognitive function relative to the network's small size. Associations with processing speed and visuospatial ability remained after controlling for childhood cognitive ability.

CONCLUSIONS

These results implicate global dimensions of variation in the human structural connectome in aging-related cognitive decline. The central executive network may demarcate a constellation of elements that are centrally important to age-related cognitive impairments.

Mindfulness and Cognitive Training Interventions in Mild Cognitive Impairment: Impact on Cognition and Mood

With the lack of disease-modifying pharmacologic treatments for mild cognitive impairment and dementia, there has been an increasing clinical and research focus on nonpharmacological interventions for these disorders. Many treatment approaches, such as mindfulness and cognitive training, aim to mitigate or delay cognitive decline, particularly in early disease stages, while also offering potential benefits for mood and quality of life. In this review, we highlight the potential of mindfulness and cognitive training to improve cognition and mood in mild cognitive impairment. Emerging research suggests that these approaches are feasible and safe in this population, with preliminary evidence of positive effects on aspects of cognition (attention, psychomotor function, memory, executive function), depression, and anxiety, though some findings have been unclear or limited by methodological weaknesses. Even so, mindfulness and cognitive training warrant inclusion as current treatments for adults with mild cognitive impairment, even if there is need for additional research to clarify treatment outcomes and questions related to dose, mechanisms, and transfer and longevity of treatment effects.

Effects of foreign language learning on executive functions in healthy older adults: study protocol for a randomised controlled trial

Background

With age, most cognitive functions decline. As the number of people aged 60 years and older is expected to rise rapidly within the next decades, identifying interventions that promote healthy cognitive ageing is of utmost importance. Promising research on bilingualism has led to the notion that learning a foreign language could protect against cognitive decline. Foreign language learning likely promotes executive functions, which are higher-order cognitive abilities particularly affected by age-related cognitive decline. However, evidence is still sparse and has produced contradictory results. This study aims to investigate the effects of short and intensive foreign language learning on executive functions in healthy older adults.

Methods

In a randomised controlled trial, we will assign 60 native German-speaking monolingual healthy older adults, aged 65–80 years, to either a foreign language learning or a waiting list control group. Language learners will attend a face-to-face, group-based Spanish course for beginners for 1.5 h a day, 5 days a week, for a total of 3 weeks. Cognitive performance in executive functions will be assessed before and after the intervention or after a waiting period of 3 weeks (waiting list control group). Participants will be tested again after 3 months to evaluate longitudinal effects of foreign language learning. The waiting list control group will receive Spanish lessons only after the final assessment and will be invited to an additional voluntary evaluation after completion of the course.

Discussion

To the best of our knowledge, we are conducting the first randomised controlled trial on the effects of short and intensive foreign language learning in older adulthood on executive functions. Enhanced cognitive performance after foreign language learning would indicate that learning a foreign language could enlarge cognitive reserve and thus promote healthy cognitive ageing in older adults.

Trial registration

German Clinical Trials Register DRKS00016552. Registered on 11 February 2019.

Effects of Spices (Saffron, Rosemary, Cinnamon, Turmeric and Ginger) in Alzheimer's Disease

Alzheimer's disease (AD) is the most prevalent dementia in the elderly, causing disability, physical, psychological, social, and economic damage to the individual, their families, and caregivers. Studies have shown some spices, such as saffron, rosemary, cinnamon, turmeric, and ginger, have antioxidant and anti-inflammatory properties that act in inhibiting the aggregation of acetylcholinesterase and amyloid in AD. For this reason, spices have been studied as beneficial sources against neurodegenerative diseases, including AD. In this sense, this study aims to present a review of some spices (Saffron, Rosemary, Cinnamon, Turmeric and Ginger) and their bioactive compounds, most consumed and investigated in the world regarding AD. In this article, scientific evidence is compiled in clinical trials in adults, the elderly, animals, and in vitro, on properties considered neuroprotective, having no or negative effects on neuroprotection of these spices and their bioactive compounds. The importance of this issue is based on the pharmacological treatment for AD that is still not very effective. In addition, the recommendations and prescriptions of these spices are still permeated by questioning and lack of robust evidence of their effects on neurodegeneration. The literature search suggests all spices included in this article have bioactive compounds with anti-inflammatory and antioxidant actions associated with neuroprotection. To date, the amounts of spice ingestion in humans are not uniform, and there is no consensus on its indication and chronic consumption guarantees safety and efficacy in neuroprotection. Therefore, clinical evidence on this topic is necessary to become a formal adjuvant treatment for AD.

Prevalence and psychosocial correlates of subjectively perceived decline in five cognitive domains: Results from a population-based cohort study in Germany

OBJECTIVE

Subjective cognitive decline (SCD) was frequently investigated for memory in healthy aging or in relation to diseases like dementia. It was found to be related to sociodemographic and psychological variables as well as cognitive abilities. The prevalence of SCD in other cognitive domains and their relation to these variables is largely unknown to date. The present study aimed to fill this gap.

METHODS

A total of 807 subjects (18-85 years of age, M = 57.8 years, female: 43%) completed the Juelich Questionnaire on Subjective Cognitive Decline, to investigate SCD in memory, attention, language, motor, and executive functions. Logistic regression analyses were used to estimate association of depressive symptomatology, emotionality, and general cognitive performance as well as age, gender, and educational attainment with domain-specific SCD.

RESULTS

The highest prevalence rate was obtained for the memory domain (65.9%), followed by the attention (54.6%), motor (52.9%), executive (39.7%), and language domain (31.5%). Of the psychosocial factors, only age, depressive symptomatology and emotionality were consistently and strongly associated with domain-specific SCD prevalence.

CONCLUSIONS

SCD is prevalent not only in the memory domain, but also in other major cognitive domains. Our results also suggest that the suspicion from previous research, that subjective memory decline might be more strongly associated with depressive symptomatology and emotionality than with actual decline of cognitive performance, might also apply to the attention, motor, executive, and language domain. Further investigations using neuropsychological testing for specific cognitive functions and employing longitudinal designs are required for substantiating this suspicion.

Mind the Rhythm: ECG QT Dispersion and Cognition in Healthy Older Adults

Background

Autonomic function has been linked to cognitive abilities in aging. Even in non-clinical states, a certain variability in heart rhythm regulation can be measured with QT dispersion (QTcD), an ECG marker of ventricular repolarization which has been linked to autonomic function and cardiovascular health. QTcD has been shown to be higher in individuals with mild cognitive impairment, and the highest in individuals with Alzheimer’s disease. The goal of this study was to see if QTcD is associated with cognitive performance in healthy individuals.

Methods

Sixty-three healthy inactive older adults (> 60 years) completed an extensive cognitive assessment (including inhibition, divided attention, updating, working memory, and processing speed), a physical fitness assessment, and underwent a resting ECG.

Results

After controlling for age, sex, and education, QTcD significantly predicted global cognition (MoCA) scores (R² = 0.17, F_(4.58) = 3.00, p < 0.03, β = −0.36). Exploratory analysis on the MoCA subcomponents revealed a significant association between the visual/executive subcomponent and QTcD (R² = 0.12, F_(1.61) = 7.99, p < 0.01, β = −0.34). In individuals with high QTcD, QTcD values were linked to executive functions (R² = 0.37), processing speed (R² = 0.34), and dual-task performances (R² = 0.47). No significant associations were found within the low QTcD group.

Conclusion

This study shows an association between ventricular repolarization (QTcD) and cognitive performance, in particular speed and executive functions, in healthy older adults. The results provide further support for linking autonomic heart regulation and age-related cognitive changes, and suggest that deviations on ECG, even within-normal range, could help detect early cognitive deficits.

The effect of age on recollection is not moderated by differential estimation methods

Episodic memory performance declines with increasing age. It has sometimes been reported that this decline is more marked when episodic recollection is estimated by "objective" measures such as source memory performance than when it is estimated by "subjective" measures such as the "Remember/Know" procedure. Here, our main goal was to directly contrast recollection estimates derived from these procedures in the same samples of young and older participants (24 adults per age group, within-subjects manipulation of test procedure). Following identical study phases in which words were paired with either faces or scenes, participants' memories were assessed in separate test blocks using either Remember/Know or source memory procedures. Contrary to several prior reports, the deleterious effects of age on recollection estimates did not differ according to test type. Thus, we found no evidence that age differentially impacts subjective and objective recollection estimates. Additionally, and consistent with prior findings, effects of age on estimates of familiarity-driven recognition were small and non-significant.

Unsupervised assessment of cognition in the Healthy Brain Project: Implications for web-based registries of individuals at risk for Alzheimer's disease

INTRODUCTION

Web-based platforms are used increasingly to assess cognitive function in unsupervised settings. The utility of cognitive data arising from unsupervised assessments remains unclear. We examined the acceptability, usability, and validity of unsupervised cognitive testing in middle-aged adults enrolled in the Healthy Brain Project.

METHODS

A total of 1594 participants completed unsupervised assessments of the Cogstate Brief Battery. Acceptability was defined by the amount of missing data, and usability by examining error of test performance and the time taken to read task instructions and complete tests (learnability).

RESULTS

Overall, we observed high acceptability (98% complete data) and high usability (95% met criteria for low error rates and high learnability). Test validity was confirmed by observation of expected inverse relationships between performance and increasing test difficulty and age.

CONCLUSION

Consideration of test design paired with acceptability and usability criteria can provide valid indices of cognition in the unsupervised settings used to develop registries of individuals at risk for Alzheimer's disease.

Bipolar Disorder Among Patients Diagnosed With Frontotemporal Dementia

OBJECTIVE

Previous studies have documented manic and hypomanic symptoms in behavioral variant frontotemporal dementia (bvFTD), suggesting a relationship between bipolar disorder and bvFTD.

METHODS

The investigators conducted a literature review as well as a review of the psychiatric histories of 137 patients with bvFTD, and patients with a prior diagnosis of bipolar disorder were identified. The clinical characteristics of patients' bipolar disorder diagnosis, family history, features of bvFTD, and results from fluorodeoxyglucose positron emission tomography (FDG-PET), as well as autopsy findings, were evaluated.

RESULTS

Among the 137 patients, 14 (10.2%) had a psychiatric diagnosis of bipolar disorder, eight of whom met criteria for bipolar disorder (type I, N=6; type II, N=2) 6-12 years preceding onset of classic symptoms of progressive bvFTD. Seven of the eight patients with bipolar disorder had a family history of mood disorders, four had bitemporal predominant hypometabolism on FDG-PET, and two had a tauopathy involving temporal lobes on autopsy. Three additional patients with late-onset bipolar I disorder proved to have a nonprogressive disorder mimicking bvFTD. The remaining three patients with bvFTD had prior psychiatric symptoms that did not meet criteria for a diagnosis of bipolar disorder. The literature review and the findings for one patient further suggested a shared genetic mutation in some patients.

CONCLUSIONS

Manic or hypomanic episodes years before other symptoms of bvFTD may be a prodrome of this dementia, possibly indicating anterior temporal involvement in bvFTD. Other patients with late-onset bipolar disorder exhibit the nonprogressive frontotemporal dementia phenocopy syndrome. Finally, a few patients with bvFTD have a genetic predisposition for both disorders.

A multi-modal exercise intervention that improves cognitive function and physical performance, elderly with mobility-related disability: a randomized controlled trial

BACKGROUND

Physical exercise interventions have showed improvement on cognitive performance and mobility of old people. However, the results regarding the inclusion of cognitive activities into exercise were not evaluated simultaneously. Therefore, the aim of this study was to investigate the effect of multimodal exercise program on cognitive function and physical performance in elderly people with mobility disabilities.

METHODS

The sample of the study consisted of 70 old people randomly appointed to the exercise and control groups (35 people for each) with mobility disabilities. A new exercise program was conducted for old people in the exercise group for 6 months. Evaluation between 1st and 24th week included cognitive change, mobility, balance and walking parameters.

RESULTS

Exercise group showed better performance on orientation, memory and language point than before the intervention (P<0.05). Again, the total mental test score of the exercise group significantly increased from 18.7±3.5 to 20.1±3.5 after the intervention (P<0.001). People without a cognitive disorder increased from 8 to 11 in the exercise group (P<0.001), while the number did not change in control group. Correlation was found between exercise group and activities such as mobility, walking and balance performance (r=0.81; P<0.001).

CONCLUSIONS

A multimodal exercise program with intense mental activities enabled an improvement in both cognitive and physical performance in old people with loss of competences due to mobility.

Effect of Spectral Channels on Speech Recognition, Comprehension, and Listening Effort in Cochlear-Implant Users

In favorable listening conditions, cochlear-implant (CI) users can reach high speech recognition scores with as little as seven active electrodes. Here, we hypothesized that even when speech recognition is high, additional spectral channels may still benefit other aspects of speech perception, such as comprehension and listening effort. Twenty-five adult, postlingually deafened CI users, selected from two Dutch implant centers for high clinical word identification scores, participated in two experiments. Experimental conditions were created by varying the number of active electrodes of the CIs between 7 and 15. In Experiment 1, response times (RTs) on the secondary task in a dual-task paradigm were used as an indirect measure of listening effort, and in Experiment 2, sentence verification task (SVT) accuracy and RTs were used to measure speech comprehension and listening effort, respectively. Speech recognition was near ceiling for all conditions tested, as intended by the design. However, the dual-task paradigm failed to show the hypothesized decrease in RTs with increasing spectral channels. The SVT did show a systematic improvement in both speech comprehension and response speed across all conditions. In conclusion, the SVT revealed additional benefits in both speech comprehension and listening effort for conditions in which high speech recognition was already achieved. Hence, adding spectral channels may provide benefits for CI listeners that may not be reflected by traditional speech tests. The SVT is a relatively simple task that is easy to implement and may therefore be a good candidate for identifying such additional benefits in research or clinical settings.

Cognitive Correlates of MRI-defined Cerebral Vascular Injury and Atrophy in Elderly American Indians: The Strong Heart Study

OBJECTIVE

American Indians experience substantial health disparities relative to the US population, including vascular brain aging. Poorer cognitive test performance has been associated with cranial magnetic resonance imaging findings in aging community populations, but no study has investigated these associations in elderly American Indians.

METHODS

We examined 786 American Indians aged 64 years and older from the Cerebrovascular Disease and its Consequences in American Indians study (2010-2013). Cranial magnetic resonance images were scored for cortical and subcortical infarcts, hemorrhages, severity of white matter disease, sulcal widening, ventricle enlargement, and volumetric estimates for white matter hyperintensities (WMHs), hippocampus, and brain. Participants completed demographic, medical history, and neuropsychological assessments including testing for general cognitive functioning, verbal learning and memory, processing speed, phonemic fluency, and executive function.

RESULTS

Processing speed was independently associated with the presence of any infarcts, white matter disease, and hippocampal and brain volumes, independent of socioeconomic, language, education, and clinical factors. Other significant associations included general cognitive functioning with hippocampal volume. Nonsignificant, marginal associations included general cognition with WMH and brain volume; verbal memory with hippocampal volume; verbal fluency and executive function with brain volume; and processing speed with ventricle enlargement.

CONCLUSIONS

Brain-cognition associations found in this study of elderly American Indians are similar to those found in other racial/ethnic populations, with processing speed comprising an especially strong correlate of cerebrovascular disease. These findings may assist future efforts to define opportunities for disease prevention, to conduct research on diagnostic and normative standards, and to guide clinical evaluation of this underserved and overburdened population.

Age differences in the neural correlates of the specificity of recollection: An event-related potential study

In young adults, the neural correlates of successful recollection vary with the specificity (or amount) of information retrieved. We examined whether the neural correlates of recollection are modulated in a similar fashion in older adults. We compared event-related potential (ERP) correlates of recollection in samples of healthy young and older adults (N = 20 per age group). At study, participants were cued to make one of two judgments about each of a series of words. Subsequently, participants completed a memory test for studied and unstudied words in which they first made a Remember/Know/New (RKN) judgment, followed by a source memory judgment when a word attracted a 'Remember' (R) response. In young adults, the 'left parietal effect' - a putative ERP correlate of successful recollection - was largest for test items endorsed as recollected (R judgment) and attracting a correct source judgment, intermediate for items endorsed as recollected but attracting an incorrect or uncertain source judgment, and, relative to correct rejections, absent for items endorsed as familiar only (K judgment). In marked contrast, the left parietal effect was not detectable in older adults. Rather, regardless of source accuracy, studied items attracting an R response elicited a sustained, centrally maximum negative-going deflection relative to both correct rejections and studied items where recollection failed (K judgment). A similar retrieval-related negativity has been described previously in older adults, but the present findings are among the few to link this effect specifically to recollection. Finally, relative to correct rejections, all classes of correctly recognized old items elicited an age-invariant, late-onsetting positive deflection that was maximal over the right frontal scalp. This finding, which replicates several prior results, suggests that post-retrieval monitoring operations were engaged to an equivalent extent in the two age groups. Together, the present results suggest that there are circumstances where young and older adults engage qualitatively distinct retrieval-related processes during successful recollection.