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Luo Y, Lin R, Yan Y, Li Y, Huang C, Chen M, Li H. Maintenance effects of short-period intensive creative expressive arts-based program (SPI-CrEAS) on cognitive function older adults with mild cognitive impairment: A pilot study. Geriatr Nurs 2024; 59:170-180. [PMID: 39018961 DOI: 10.1016/j.gerinurse.2024.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 06/16/2024] [Accepted: 06/27/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVES To assess the maintenance effectiveness of a short-period intensive creative expressive arts-based storytelling (SPI-CrEAS) program in older patients with mild cognitive impairment (MCI). METHODS This two-arm, single-blinded, pilot, randomized controlled trial was conducted at XXX and included 38 participants who had previously completed a 24-week CrEAS project. Eligible participants were randomly assigned to receive intensive CrEAS program twice weekly for an additional 12 weeks (short-period intensive [SPI]-CrEAS) or complete their daily activities (control group). Linear mixed-model regression was used to analyze baseline and intra-group and inter-group comparisons at different follow-up periods. RESULTS At the 12-week follow-up, verbal function (Verbal Fluency Test, P=0.021) improved significantly in the SPI-CrEAS group compared with the control group. The cognitive benefits of SPI-CrEAS were sustained with twice-weekly training for 3 months, lasting for up to 9 months. CONCLUSIONS The initial cognitive improvement following CrEAS was sustained at follow-up and boosted by SPI-CrEAS.
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Affiliation(s)
- Yuting Luo
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Rong Lin
- The School of Nursing, Fujian Medical University, Fuzhou, China; Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yuanjiao Yan
- The School of Nursing, Fujian Medical University, Fuzhou, China; Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yulian Li
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Chenshan Huang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Mingfeng Chen
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China; Department of Neurology, Fujian Provincial Hospital, Fuzhou, China
| | - Hong Li
- The School of Nursing, Fujian Medical University, Fuzhou, China; Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China.
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Posis AIB, Alcaraz JE, Parada H, Shadyab AH, Elman JA, Panizzon MS, Reynolds CA, Franz CE, Kremen WS, McEvoy LK. Association Between Traumatic Brain Injury and Cognitive Decline Among Middle-to-Older Aged Men in the Vietnam Era Twin Study of Aging. Neurotrauma Rep 2024; 5:563-573. [PMID: 39036434 PMCID: PMC11257108 DOI: 10.1089/neur.2024.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/23/2024] Open
Abstract
Traumatic brain injury (TBI) is associated with increased risk of dementia. However, whether TBI is associated with greater cognitive decline over time in specific cognitive domains among older adults is not well understood. This prospective cohort study used data from 1476 male Vietnam Era Twin Study of Aging participants (average age at study entry = 57.9 years, range = 51-71 years; 97.6% non-Hispanic; 92.5% White) collected from 2003 to 2019, who had complete information on prior TBI. Participants completed a comprehensive neuropsychological assessment at up to three visits over up to a 12-year follow-up period during which they also self-reported their history of TBI. Multivariable, linear mixed-effects models were used to assess associations between TBI and cognitive performance trajectories. Effect measure modification by apolipoprotein E (APOE) epsilon 4 (ε4) genotype status was assessed in a subset of participants. Thirty-one percent of participants reported a history of TBI; 29.4% were APOE ε4 carriers. There were no statistically significant associations of TBI with decline in episodic memory, executive function, or processing speed among participants overall. In models stratified by APOE ε4 carrier status, TBI was associated with a larger magnitude of decline in executive function for APOE ε4 carriers (β = -0.0181; 95% confidence interval [CI] -0.0335, -0.0027) compared to noncarriers (β = -0.0031; 95% CI -0.0128, 0.0067; P Interaction = 0.03). In sensitivity analyses, TBI earlier in life (before military induction, average age = 20 years) was associated with faster declines in executive function compared to no TBI, irrespective of APOE ε4 status. In this sample of middle-to-older aged men, TBI was associated with faster declines in executive function among APOE ε4 carriers and among those who reported TBI in early life. These findings support the importance of a life course perspective when considering factors that may influence cognitive health in aging.
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Affiliation(s)
- Alexander Ivan B. Posis
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- School of Public Health, San Diego State University, San Diego, California, USA
| | - John E. Alcaraz
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Humberto Parada
- School of Public Health, San Diego State University, San Diego, California, USA
- Moores Cancer Center, UC San Diego Health, La Jolla, California, USA
- Department of Radiation Medicine & Applied Science, University of California, San Diego, La Jolla, California, USA
| | - Aladdin H. Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
| | - Jeremy A. Elman
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, California, USA
| | - Matthew S. Panizzon
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, California, USA
| | - Chandra A. Reynolds
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
| | - Carol E. Franz
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, California, USA
| | - William S. Kremen
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, California, USA
| | - Linda K. McEvoy
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
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Duff K, Hammers DB, Koppelmans V, King JB, Hoffman JM. Short-Term Practice Effects on Cognitive Tests Across the Late Life Cognitive Spectrum and How They Compare to Biomarkers of Alzheimer's Disease. J Alzheimers Dis 2024; 99:321-332. [PMID: 38669544 DOI: 10.3233/jad-231392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Background Practice effects on cognitive testing in mild cognitive impairment (MCI) and Alzheimer's disease (AD) remain understudied, especially with how they compare to biomarkers of AD. Objective The current study sought to add to this growing literature. Methods Cognitively intact older adults (n = 68), those with amnestic MCI (n = 52), and those with mild AD (n = 45) completed a brief battery of cognitive tests at baseline and again after one week, and they also completed a baseline amyloid PET scan, a baseline MRI, and a baseline blood draw to obtain APOE ɛ4 status. Results The intact participants showed significantly larger baseline cognitive scores and practice effects than the other two groups on overall composite measures. Those with MCI showed significantly larger baseline scores and practice effects than AD participants on the composite. For amyloid deposition, the intact participants had significantly less tracer uptake, whereas MCI and AD participants were comparable. For total hippocampal volumes, all three groups were significantly different in the expected direction (intact > MCI > AD). For APOE ɛ4, the intact had significantly fewer copies of ɛ4 than MCI and AD. The effect sizes of the baseline cognitive scores and practice effects were comparable, and they were significantly larger than effect sizes of biomarkers in 7 of the 9 comparisons. Conclusion Baseline cognition and short-term practice effects appear to be sensitive markers in late life cognitive disorders, as they separated groups better than commonly-used biomarkers in AD. Further development of baseline cognition and short-term practice effects as tools for clinical diagnosis, prognostic indication, and enrichment of clinical trials seems warranted.
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Affiliation(s)
- Kevin Duff
- Department of Neurology, Layton Aging and Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
- Department of Neurology, Center for Alzheimer's Care, Imaging and Research, University of Utah, Salt Lake City, UT, USA
| | - Dustin B Hammers
- Department of Neurology, Indiana University School of Medicine, Indiana, USA
| | | | - Jace B King
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
| | - John M Hoffman
- Department of Neurology, Center for Alzheimer's Care, Imaging and Research, University of Utah, Salt Lake City, UT, USA
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT, USA
- University of Utah Center for Quantitative Cancer Imaging, Huntsman Cancer Institute, Salt Lake City, UT, USA
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Lissek VJ, Orth S, Suchan B. go4cognition: Evaluation of a Newly Developed Multicomponent Intervention in Mild Cognitive Impairment. J Alzheimers Dis 2024; 99:377-392. [PMID: 38669526 DOI: 10.3233/jad-230802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
Background Cognitive training and physical exercise show positive effects on cognitive decline in subjects with mild cognitive impairment (MCI). Multimodal interventions for MCI patients, combining physical and cognitive training in a social context seem to slow down cognitive decline. Objective Based on a previous study, a new mobile gamification tool (go4cognition; https://www.ontaris.de/go4cognition) has been developed to train cognitive and physical functions simultaneously in a group setting. It involves tasks targeting various cognitive functions (short-term memory, working memory, executive functions). The computer-based setup allows for individual performance analysis. This study evaluated the effects of this tool. Methods 30 participants with MCI, as defined by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) cut-off-score, aged between 66 and 89 years, trained for one hour two days a week for twelve weeks. Additionally, standard neuropsychological assessment of memory and attention was carried out before and after the intervention. Results The go4cognition device is highly effective in improving various cognitive functions. A significant improvement in the CERAD total score resulting in re-classification of 70% of former MCI patients into non-MCI patients was found. Additionally, an improvement of verbal fluency, verbal memory, spatial memory, and attention was observed. Furthermore, the CERAD total score was significantly correlated with performance in the go4cognition tool. Conclusions The results of the intervention support the idea of the effectiveness of a combined cognitive and motor intervention by incorporating neuropsychological paradigms in a group setting and suggest a close relation between combined cognitive and physical exercise and cognitive performance.
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Affiliation(s)
- Vanessa J Lissek
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
| | | | - Boris Suchan
- Institute of Cognitive Neuroscience, Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University Bochum, Bochum, Germany
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Rueda AV, Cabaco AS, Mejía-Ramírez MA, Afonso RM, Castillo-Riedel E. Cross-cultural effects of reminiscence therapy on life satisfaction and autobiographical memory of older adults: a pilot study across Mexico and Spain. Alzheimers Res Ther 2023; 15:204. [PMID: 37993885 PMCID: PMC10664501 DOI: 10.1186/s13195-023-01347-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/03/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND There are increasing reports on the cognitive and emotional benefits of positive reminiscence therapy in older people. The objective of this study is to assess the differential improvement of the quality of life for older people in different vital situations (three different types of aging) and from different countries by implementing a positive reminiscence therapy program (REMPOS). METHODS The participants were 144 older adults above the age of 65, 77 participants from Spain (45 experimental groups, 32 control groups) and 67 from Mexico (34 experimental groups, 33 control groups). The participants were recruited from nursing and retirement homes. A factorial randomized design with pre-post measurement with three independent variables: country (Mexico, Spain), condition (experimental, control), and types of aging (healthy aging, HA., mild cognitive impairment, MCI., Alzheimer's disease, AD). The experimental groups received REMPOS therapy and control groups received standard cognitive stimulation program. The quality of life was measured with the Life Satisfaction Inventory for adults (LSI-A) and autobiographical memory test (AMT) before and after REMPOS therapy. RESULTS The REMPOS intervention showed significantly higher positive effects than the control condition on the recall of specific positive memories across countries and types of aging, except for the Spanish MCI group. Life satisfaction in the Alzheimer's and MCI group only improved with REMPOS in the Mexican sample. CONCLUSIONS The REMPOS effects showed generalizable effects across countries, but the cross-cultural differences shown highlight the necessity of running studies to test those differential effects.
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Affiliation(s)
- Alba Villasán Rueda
- Faculty of Health Sciences, Catholic University of Ávila, Calle de los Canteros, s/n, 05005, Ávila, Spain.
| | | | | | - Rosa Marina Afonso
- Department of Psychology and Education, University of Beira Interior, 6201-001, Covilhã, Portugal
| | - Eduardo Castillo-Riedel
- School of Psychology, CETYS University, Campus Tijuana, 22210, Tijuana, Baja California, Mexico
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Chen R, Calmasini C, Swinnerton K, Wang J, Haneuse S, Ackley SF, Hirst AK, Hayes-Larson E, George KM, Peterson R, Soh Y, Barnes LL, Mayeda ER, Gilsanz P, Mungas DM, Whitmer RA, Corrada MM, Glymour MM. Pragmatic approaches to handling practice effects in longitudinal cognitive aging research. Alzheimers Dement 2023; 19:4028-4036. [PMID: 37199336 PMCID: PMC10524983 DOI: 10.1002/alz.13067] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 05/19/2023]
Abstract
INTRODUCTION The challenge of accounting for practice effects (PEs) when modeling cognitive change was amplified by the COVID-19 pandemic, which introduced period and mode effects that may bias the estimation of cognitive trajectory. METHODS In three Kaiser Permanente Northern California prospective cohorts, we compared predicted cognitive trajectories and the association of grip strength with cognitive decline using three approaches: (1) no acknowledgment of PE, (2) inclusion of a wave indicator, and (3) constraining PE based on a preliminary model (APM) fit using a subset of the data. RESULTS APM-based correction for PEs based on balanced, pre-pandemic data, and with current age as the timescale produced the smallest discrepancy between within-person and between-person estimated age effects. Estimated associations between grip strength and cognitive decline were not sensitive to the approach used. DISCUSSION Constraining PEs based on a preliminary model is a flexible, pragmatic approach allowing for meaningful interpretation of cognitive change. HIGHLIGHTS The magnitude of practice effects (PEs) varied widely by study. When PEs were present, the three PE approaches resulted in divergent estimated age-related cognitive trajectories. Estimated age-related cognitive trajectories were sometimes implausible in models that did not account for PEs. The associations between grip strength and cognitive decline did not differ by the PE approach used. Constraining PEs based on estimates from a preliminary model allows for a meaningful interpretation of cognitive change.
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Affiliation(s)
- Ruijia Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Camilla Calmasini
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Kaitlin Swinnerton
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Jingxuan Wang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Sarah F Ackley
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Andrew K Hirst
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Eleanor Hayes-Larson
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Kristen M George
- Department of Public Health Sciences, University of California, Davis, California, USA
| | - Rachel Peterson
- School of Public Health and Community Health Sciences, University of Montana, Missoula, Montana, USA
| | - Yenee Soh
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Lisa L Barnes
- Department of Neurological Sciences and Rush Alzheimer's Disease Center, Rush Medical College, Chicago, Illinois, USA
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, California, USA
| | - Paola Gilsanz
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Dan M Mungas
- Department of Neurology, University of California, Davis, California, USA
| | - Rachel A Whitmer
- Department of Public Health Sciences, University of California, Davis, California, USA
| | - Maria M Corrada
- Department of Neurology, University of California, Irvine, California, USA
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
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Sanderson-Cimino M, Chen R, Tu XM, Elman JA, Jak AJ, Kremen WS. Misinterpreting cognitive change over multiple timepoints: When practice effects meet age-related decline. Neuropsychology 2023; 37:568-581. [PMID: 37079809 PMCID: PMC10313772 DOI: 10.1037/neu0000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
OBJECTIVE Practice effects (PE) on cognitive testing have been shown to delay detection of impairment and impede our ability to assess change. When decline over time is expected, as with older adults or progressive diseases, failure to adequately address PEs may lead to inaccurate conclusions because PEs artificially boost scores while pathology- or age-related decline reduces scores. Unlike most methods, a participant-replacement approach can separate pathology- or age-related decline from PEs; however, this approach has only been used across two timepoints. More than two timepoints make it possible to determine if PEs level out after the first follow-up, but it is analytically challenging because individuals may not be assessed at every timepoint. METHOD We examined 1,190 older adults who were cognitively unimpaired (n = 809) or had mild cognitive impairment (MCI; n = 381). Participants completed six neuropsychological measures at three timepoints (baseline, 12-month, 24-month). We implemented a participant-replacement method using generalized estimating equations in comparisons of matched returnees and replacements to calculate PEs. RESULTS Without accounting for PEs, cognitive function appeared to improve or stay the same. However, with the participant-replacement method, we observed significant PEs within both groups at all timepoints. PEs did not uniformly decrease across time; some-specifically on episodic memory measures-continued to increase beyond the first follow-up. CONCLUSION A replacement method of PE adjustment revealed significant PEs across two follow-ups. As expected in these older adults, accounting for PEs revealed cognitive decline. This, in turn, means earlier detection of cognitive deficits, including progression to MCI, and more accurate characterization of longitudinal change. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Mark Sanderson-Cimino
- Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco
- Center for Behavior Genetics of Aging, University of California, San Diego
| | - Ruohui Chen
- Division of Biostatistics and Bioinformatics, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego
| | - Xin M. Tu
- School of Medicine, University of California, San Diego
- Family Medicine and Public Health, University of California San Diego
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego
| | - Jeremy A. Elman
- Center for Behavior Genetics of Aging, University of California, San Diego
- School of Medicine, University of California, San Diego
| | - Amy J. Jak
- Center for Behavior Genetics of Aging, University of California, San Diego
- Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System
| | - William S. Kremen
- Center for Behavior Genetics of Aging, University of California, San Diego
- School of Medicine, University of California, San Diego
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Young CB, Mormino EC, Poston KL, Johnson KA, Rentz DM, Sperling RA, Papp KV. Computerized cognitive practice effects in relation to amyloid and tau in preclinical Alzheimer's disease: Results from a multi-site cohort. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12414. [PMID: 36950699 PMCID: PMC10026103 DOI: 10.1002/dad2.12414] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 03/22/2023]
Abstract
Scalable cognitive paradigms that provide metrics such as the Computerized Cognitive Composite (C3) may be sensitive enough to relate to Alzheimer's disease biomarkers in the preclinical clinically unimpaired (CU) stage. We examined CU older adults (n = 3287) who completed alternate versions of the C3 approximately 51 days apart. A subset of CU with abnormal amyloid also completed tau positron emission tomography (PET) imaging. C3 initial performance and practice effects were examined in relation to amyloid status and continuous regional tau burden. Initial C3 performance was associated with amyloid status across all participants, and with tau burden in the medial temporal lobe and early cortical regions in CU with abnormal amyloid. Short-term practice effects were associated with reduced tau in these regions in CU with abnormal amyloid, but were not associated with amyloid status. Thus, computerized cognitive testing repeated over a short follow-up period provides additional insights into early Alzheimer's disease processes.
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Affiliation(s)
- Christina B. Young
- Department of Neurology and Neurological ScienceStanford University School of MedicineStanfordCaliforniaUSA
| | - Elizabeth C. Mormino
- Department of Neurology and Neurological ScienceStanford University School of MedicineStanfordCaliforniaUSA
| | - Kathleen L. Poston
- Department of Neurology and Neurological ScienceStanford University School of MedicineStanfordCaliforniaUSA
| | - Keith A. Johnson
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Dorene M. Rentz
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Reisa A. Sperling
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Kathryn V. Papp
- Center for Alzheimer Research and TreatmentDepartment of NeurologyBrigham and Women's HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
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Glisky EL, Woolverton CB, McVeigh KS, Grilli MD. Episodic Memory and Executive Function Are Differentially Affected by Retests but Similarly Affected by Age in a Longitudinal Study of Normally-Aging Older Adults. Front Aging Neurosci 2022; 14:863942. [PMID: 35493924 PMCID: PMC9043807 DOI: 10.3389/fnagi.2022.863942] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/22/2022] [Indexed: 12/26/2022] Open
Abstract
Episodic memory and executive function are two cognitive domains that have been studied extensively in older adults and have been shown to decline in normally-aging older individuals. However, one of the problems with characterizing cognitive changes in longitudinal studies has been separating effects attributable to normal aging from effects created by repeated testing or practice. In the present study, 166 people aged 65 and older were enrolled over several years and tested at least 3 times at variable intervals (M = 3.2 yrs). The cognitive measures were composite scores. Each composite was made up of five neuropsychological tests, previously identified through factor analysis. For one pair of composite scores, variance attributable to age was removed from each subtest through regression analyses before z-scores were computed, creating two age-corrected composites. A second pair of composites were not age-corrected. Using linear mixed-effects models, we first explored retest effects for each cognitive domain, independent of age, using the age-corrected composites. We then modeled aging effects using the age-uncorrected composites after subtracting out retest effects. Results indicated significant retest effects for memory but not for executive function, such that memory performance improved across the three testing sessions. When these practice effects were removed from the age-uncorrected data, effects of aging were evident for both executive and memory function with significant declines over time. We also explored several individual difference variables including sex, IQ, and age at the initial testing session and across time. Although sex and IQ affected performance on both cognitive factors at the initial test, neither was related to practice effects, although young-older adults tended to benefit from practice to a greater extent than old-older adults. In addition, people with higher IQs showed slower age-related declines in memory, but no advantages in executive function. These findings suggest that (a) aging affects both memory and executive function similarly, (b) higher IQ, possibly reflecting cognitive reserve, may slow age-related declines in memory, and (c) practice through repeated testing enhances performance in memory particularly in younger-older adults, and may therefore mask aging effects if not taken into account.
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Affiliation(s)
- Elizabeth L. Glisky
- Aging and Cognition Laboratory, Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Cindy B. Woolverton
- Aging and Cognition Laboratory, Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Katelyn S. McVeigh
- Human Memory Laboratory, Department of Psychology, University of Arizona, Tucson, AZ, United States
| | - Matthew D. Grilli
- Human Memory Laboratory, Department of Psychology, University of Arizona, Tucson, AZ, United States
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