Normative Data for the Logical Memory Subtest of the Wechsler Memory Scale-IV in Middle-Aged and Elderly Korean People

Effects of fruit and vegetable intake on memory and attention: a systematic review of randomized controlled trials

BACKGROUND

Memory and attention are important for daily functioning, and their function deteriorates due to aging. However, fruit and vegetable consumption are one of the protective factors against deterioration in memory and attention. This systematic review of randomized controlled trials (RCTs) aims to identify the effects of fruit and vegetable consumption on memory and attention.

METHODS

We conducted a systematic search in EBSCOhost, ProQuest, PubMed, Embase, and Web of Science from inception up to 06/09/2022. The inclusion criteria were peer-reviewed articles, fruit and vegetable intake measured using randomized controlled trials, and the outcome measures that showed the results of memory and attention scores. Two researchers independently extracted articles that met the selection criteria and evaluated the quality of each study.

RESULTS

There were 70 articles identified from the databases, of which 13 articles met the inclusion criteria and were included in this systematic review. There were 493 participants in total. The results show that consumption of fruit and vegetable intake improved memory and attention in longitudinal studies (10 to 12 weeks). Children showed improvement in immediate recall after supplementation with blueberries. Older adults required a higher dose of fruit and vegetable intake consumption to achieve significant improvement compared with children and younger adults. Furthermore, the effect of fruits and vegetables on memory showed better immediate memory recall than delayed recall.

CONCLUSION

This systematic review showed that there is an improvement in memory and attention with fruit and vegetable intake consumption. Hence, awareness of fruit and vegetable intake consumption is important to maintain cognitive health.

Effects of combined dietary intervention and physical-cognitive exercise on cognitive function and cardiometabolic health of postmenopausal women with obesity: a randomized controlled trial

BACKGROUND

Postmenopausal women with obesity are markedly at risk of cognitive impairment and several health issues. Emerging evidence demonstrated that both diet and exercise, particularly physical-cognitive exercise are involved in cognitive and health benefits. However, the comparative effect of diet, exercise, and combined interventions in postmenopausal women with obesity on cognition and cardiometabolic health is still lacking. Identifying the effective health promotion program and understanding changes in cardiometabolic health linking these interventions to cognition would have important medical implications. This RCT aimed to examine the effect of single and combined interventions of diet and exercise on cognitive function and cardiometabolic health in postmenopausal women with obesity.

METHODS

Ninety-two postmenopausal women with obesity were randomly assigned to diet group (intermittent fasting 2 days/week, 3 months), exercise group (physical-cognitive exercise 3 days/week, 3 months), combined group, or control group (n = 23/group). All cognitive outcomes and cardiometabolic outcomes were measured at baseline and post-3 months. Primary outcomes were executive functions, memory, and plasma BDNF levels. Secondary outcomes were global cognition, attention, language domain, plasma adiponectin levels, IL-6 levels, metabolic parameters, and physical function.

RESULTS

At the end of the 3-month intervention, the exercise and combined group demonstrated significant memory improvement which was accompanied by significant improvements in plasma BDNF level, insulin levels, HOMA-IR, %body fat, and muscle strength when compared to controls (p < 0.05). Only the combined intervention group demonstrated a significant improvement in executive function and increased plasma adiponectin levels when compared to control (p < 0.05). Surprisingly, no cognitive improvement was observed in the diet group (p > 0.05). Significant reduction in cholesterol levels was shown in the diet and combined groups when compared to controls (p < 0.05). Among the three intervention groups, there were no significant differences in all cognitive outcomes and cardiometabolic outcomes (p > 0.05). However, all three intervention groups showed significant improvements in plasma BDNF levels, weight, BMI, WHR, fat mass, and predicted VO2 max, when compared to control (p < 0.05).

CONCLUSION

These findings suggest that combined physical-cognitive exercise and dietary intervention are promising interventions to improve cognition and obesity-related complications of postmenopausal women with obesity.

TRIAL REGISTRATION

NCT04768725 ( https://clinicaltrials.gov ) 24th February 2021.

The Use of Verbal and Nonverbal Memory Tests for Alzheimer's Disease Screening in Taiwan Chinese

Patients with Alzheimer's disease typically have initial deficits in memory. Memory testing can be categorized as verbal or nonverbal by the modality of the stimuli used. We compared the discriminative validity of selected verbal and nonverbal memory tests between non-dementia and Alzheimer's disease in Taiwan. Ninety-eight patients with mild Alzheimer's disease and 269 non-dementia individuals underwent story recall test (immediate and delayed recall), and constructional praxis test (copy and delayed recall). The receiver-operating characteristic curve and area under the curve were evaluated to compare between tests. Patients with Alzheimer's disease performed poorly across all memory tests, and the receiver-operating characteristic curve analysis indicated that story recall immediate and relayed recall, and constructional praxis delayed recall had good classification accuracy with area under the curve of .90, .87 and .87 respectively. These results provide support that both verbal and nonverbal memory tests are reliable measure for screening patients with Alzheimer's disease.

Normative data for the story recall subtest of the BEM-144 in the Quebec-French population aged 50 years and over

OBJECTIVE

The story recall subtest of the Batterie d'Efficience Mnésique (BEM-144) is a verbal episodic memory test that assesses immediate and episodic memory. Variables such as age, sex, and education level can impact performance on this type of memory test, as can cultural differences. Therefore, the purpose of this study was to establish normative data for the story recall subtest of the BEM-144 in the elderly French-Quebec population.

METHOD

The normative sample consisted of 260 healthy individuals aged 50-90 years, all from the province of Quebec, Canada. Analyses were performed to estimate the association between age, sex, and education level on one hand, and immediate and delayed recall performance, on the other hand.

RESULTS

The results show that all sociodemographic variables are significantly associated with story recall performance. Normative data are proposed in the form of regression equations.

CONCLUSIONS

Overall, these norms will be beneficial for the evaluation and detection of episodic memory impairment in middle-aged and older adults.

Subjective Cognitive Complaints in Unaffected First-Degree Relatives of Schizophrenia Patients: Relation to Cognitive Performance, Psychotic Experiences, and Social Functioning

BACKGROUND

Neurocognitive deficits are well-documented in patients of schizophrenia and their first-degree relatives (FDRs). Metacognitive awareness of these deficits, called neurocognitive insight (NI), has been found to be poor in schizophrenia patients but has not been assessed in their FDRs. This study evaluated NI and its relationship with objective cognitive performance, a history of psychotic experiences (PEs), and social functioning in unaffected FDRs.

METHODS

This cross-sectional study was conducted at the outpatient department of a tertiary care teaching hospital. A total of 100 FDRs were assessed for PEs and evaluated for subjective cognitive complaints (SCC), objective cognitive performance, and social functioning using the Subjective Scale to Investigate Cognition in Schizophrenia, neurocognitive tests from the National Institute of Mental Health and Neurosciences battery, and SCARF Social Functioning Index, respectively.

RESULTS

Compared to normative data, episodic memory was the most commonly impaired domain (up to 72% of participants), followed by working memory, attention, and executive function. There was no correlation between SCC and neuropsychological test scores in the corresponding cognitive domains, implying poor NI. 15% of participants had a lifetime history of PEs. This group had significantly higher SCC as compared to those without PEs (U = 0.366, P = 0.009, r = 0.26). A regression analysis showed that the FDRs' social functioning reduced by 0.178 units for each unit increase in SCC [F (1,98) = 5.198, P = 0.025].

CONCLUSION

Similar to schizophrenia patients, FDRs also have poor NI. The severity and progression of SCC could be explored as a possible marker for screening and monitoring FDRs at an ultrahigh risk for psychosis. Importantly, even in unaffected FDRs, SCC could affect socio-occupational functioning and need further research.

Enhancing the Sensitivity of Memory Tests: Reference Data for the Free and Cued Selective Reminding Test and the Logical Memory Task from Cognitively Healthy Subjects with Normal Alzheimer's Disease Cerebrospinal Fluid Biomarker Levels

BACKGROUND

Cognitive performance of a given individual should be interpreted in the context of reference standards obtained in cognitively healthy populations. Recent evidence has shown that removing asymptomatic individuals with biomarker evidence of Alzheimer's disease pathology from normative samples increases the sensitivity of norms to detect memory impairments. These kind of norms may be useful for defining subtle cognitive decline, the transitional cognitive decline between normal cognition and mild cognitive impairment.

OBJECTIVE

The present study aims to provide norms for the Free and Cued Selective Reminding Test (FCSRT) and the Logical Memory subtest of the Wechsler Memory Scale-IV in a sample of individuals aged 50-70 years with normal levels of amyloid-β and tau cerebrospinal fluid (CSF) biomarkers.

METHODS

The sample was composed of 248 individuals from the ALFA+ study with negative amyloid-β and tau CSF biomarker levels. Regression-based norms were developed, including adjustments for age, education, and sex when applicable.

RESULTS

We found that education was associated with the performance in all the variables of both tests while age had a marginal effect only in the delayed free recall of the FCSRT. Sex was also related to the performance in the FCSRT, with women outperforming men. Equations to calculate z-scores and normative percentile tables were created. As compared with previously published norms the reference data presented were more sensitive but less specific, as expected.

CONCLUSION

The use of the norms provided in this work, in combination with the already published conventional norms, may contribute to detecting subtle memory impairment.

Critical Item Analysis Enhances the Classification Accuracy of the Logical Memory Recognition Trial as a Performance Validity Indicator

OBJECTIVE

: Replicate previous research on Logical Memory Recognition (LM_Recog) and perform a critical item analysis.

METHOD

: Performance validity was psychometrically operationalized in a mixed clinical sample of 213 adults. Classification of the LM_Recog and nine critical items (CR-9) was computed.

RESULTS

: LM_Recog ≤20 produced a good combination of sensitivity (.30-.35) and specificity (.89-.90). CR-9 ≥5 and ≥6 had comparable classification accuracy. CR-9 ≥5 increased sensitivity by 4% over LM_Recog ≤20; CR-9 ≥6 increased specificity by 6-8% over LM_Recog ≤20; CR-9 ≥7 increased specificity by 8-15%.

CONCLUSIONS

: Critical item analysis enhances the classification accuracy of the optimal LM_Recog cutoff (≤20).

Mitochondrial complex I abnormalities is associated with tau and clinical symptoms in mild Alzheimer's disease

Background

Mitochondrial electron transport chain abnormalities have been reported in postmortem pathological specimens of Alzheimer’s disease (AD). However, it remains unclear how amyloid and tau are associated with mitochondrial dysfunction in vivo. The purpose of this study is to assess the local relationships between mitochondrial dysfunction and AD pathophysiology in mild AD using the novel mitochondrial complex I PET imaging agent [¹⁸F]BCPP-EF.

Methods

Thirty-two amyloid and tau positive mild stage AD dementia patients (mean age ± SD: 71.1 ± 8.3 years) underwent a series of PET measurements with [¹⁸F]BCPP-EF mitochondrial function, [¹¹C]PBB3 for tau deposition, and [¹¹C] PiB for amyloid deposition. Age-matched normal control subjects were also recruited. Inter and intrasubject comparisons of levels of mitochondrial complex I activity, amyloid and tau deposition were performed.

Results

The [¹⁸F]BCPP-EF uptake was significantly lower in the medial temporal area, highlighting the importance of the mitochondrial involvement in AD pathology. [¹¹C]PBB3 uptake was greater in the temporo-parietal regions in AD. Region of interest analysis in the Braak stage I-II region showed significant negative correlation between [¹⁸F]BCPP-EF SUVR and [¹¹C]PBB3 BP_ND (R = 0.2679, p = 0.04), but not [¹¹C] PiB SUVR.

Conclusions

Our results indicated that mitochondrial complex I is closely associated with tau load evaluated by [¹¹C]PBB3, which might suffer in the presence of its off-target binding. The absence of association between mitochondrial complex I dysfunction with amyloid load suggests that mitochondrial dysfunction in the trans-entorhinal and entorhinal region is a reflection of neuronal injury occurring in the brain of mild AD.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13024-021-00448-1.

On the importance of using local tests and local norms in the assessment of memory

The current study compared the assessment of memory with a translated story recall test and its original published norms and an equivalent local test with local norms. Analyses used data from 232 individuals with memory complaints who underwent neuropsychological evaluation at an outpatient memory clinic. One group of participants completed a translated test (N = 126) and another group completed a local test (N = 106). Additionally, participants completed tasks of word list recall, picture naming, and verbal fluency, all having local norms. The results showed that raw scores on the delayed story recall test, and on all other cognitive tasks, did not differ across groups, and the cross-task correlations were significant and similar in size in both groups. Yet, there was an interaction between group and standardized tests scores, whereby the standardized scores on the translated story recall test were equivalent to population mean, whereas all other scores fell below the mean. Conversion of raw scores to the original norms indicated that the performance of individuals with memory complaints was intact, while conversion of scores on a local test to local norms revealed the expected memory impairment. The findings highlight the importance of using local tests and local norms in the assessment of memory.

A Normative Study of the Full Version of Story Memory in the Korean-Mini Mental State Examination, 2nd Edition: Expanded Version (K-MMSE-2: EV)

BACKGROUND AND PURPOSE

The Mini Mental State Examination, 2nd edition: Expanded version (MMSE-2: EV) involves an immediate recall (IR) of story memory (SM). A full version of SM has been developed and standardized; it includes delayed recall (DR) and recognition tests in addition to IR to increase its clinical utility as an independent story recall test. This study was conducted to provide norms for the full version of SM in the Korean version of MMSE-2: EV for clinical use.

METHODS

A total of 1,168 participants (496 males and 672 females) were included in the study. The ages ranged from 19 to 90 years, and the education level ranged from illiterate to post-graduate. Regression analysis was used to evaluate the relative contributions of demographic variables (age, education, and sex) on the SM measures.

RESULTS

We stratified age into 11 groups, and categorized the education level into 6 groups. It was found that the IR, DR, and recognition scores of SM were affected by age, education level, and sex. We provided corrected means and standard deviations of the IR, DR, and recognition scores of the SM for the demographic variables.

CONCLUSIONS

The results indicate the importance of considering demographic variables in interpreting the full version of SM measures. The normative data we have provided in this study should be useful in clinical and research settings for detecting the impairment in verbal memory.

Social media use while listening to new material negatively affects short-term memory in college students

Increased access to electronic devices and the ubiquity of social media has resulted in a rapid rise in the prevalence of students "multitasking" while in a classroom setting. While some data indicate the use of electronic devices in class can improve the classroom environment, other studies demonstrate the opposite finding. Moreover, it remains unclear if using social networking sites such as Instagram impacts performance on cognitive tasks when students are presented new material and, if so, what features of Instagram modulate this response. Therefore, in the current study we examined if social media use during or after being presented new information affected short-term memory in college students. Additionally, we assessed if the type or quantity of topics displayed had a modulatory impact on memory. Forty-five college-aged (18-24 years of age) students completed the Logical Memory Immediate Recall (LM I) component of the Wechsler Memory Scale IV, a measure of auditory recognition memory. Subjects were randomly divided into a group that completed the LM I without distraction (controls), a group that completed the LM I while scrolling through their Instagram feed, or a group that completed the LM I after scrolling through their Instagram feed. Subjects that used Instagram while being presented new information demonstrated worse short-term memory recall ability compared to subjects that did not use Instagram during the presentation (71.56% correct answers vs. 80.89%; p = 0.01). Recall ability in the group that used Instagram after hearing the story was not statistically different from the controls. Differences were not observed in the number of topics appearing in subjects' Instagram feeds and no correlation was found between the number of topics on a subject's Instagram feed and memory recall ability. Collectively, these results suggest that individuals who use their phones to browse Instagram during class or in social settings might have a reduced ability to retain the information given to them when compared to those that are not using their phones scrolling on social media.