Differential effects of faces and words in cognitive control in older adults with and without major depressive disorder: An emotional Stroop task study

Aging and major depressive disorders have been associated with impaired cognitive control. These deficits are also influenced by the affective valence and by the type of stimulus processed. Using an emotional Stroop task, the current study aims to examine cognitive control deficits and their association with emotion regulation in depression and the influence of the type of stimulus (words and faces) in this association. A total of 26 older patients with a major depressive disorder (MDD) (19 women; age range: 65-84 years) and 26 older healthy controls (18 women; age range: 65-80 years) participated in the study. The results showed that MDD individuals presented greater Stroop effects than their healthy controls and an absence of the conflict adaptation effect defined as a reduction of the influence of irrelevant stimulus dimensions after incongruent trials. Additionally, our results also showed that the processing of emotional words in depressed participants is more automatic than the processing of emotional faces. These findings suggest that older depressed individuals have greater difficulty in recognizing affective facial expressions than older healthy controls, while the over-learned behavior of word reading greatly reduces differences in the performance of the emotional Stroop task between groups (MDD and healthy controls).

Transcranial Direct Current Stimulation Intervention in Alzheimer's Disease and Its Follow-Up

BACKGROUND

Alzheimer's disease (AD) stands as the prevailing type of dementia, marked by gradual memory loss and cognitive decline. Transcranial direct current stimulation (tDCS) is a non-invasive method used to regulate cortical brain function and has been explored as a potential treatment for cognitive impairment.

OBJECTIVE

This study aimed to compare the effects of daily home-based active or sham tDCS on cognitive function in patients with early-stage AD and its follow-up after one month.

METHODS

The study involved a randomized, blinded, and controlled-placebo design, with 18 participants enrolled. The primary outcome measures were general cognitive function, immediate, and delayed recall, and executive function. Participants included in the study were randomly assigned to the anodal and sham tDCS groups. Participants were assessed before and after the intervention and one month after the end of treatment. The home-based intervention was applied for 5 consecutive days, daily.

RESULTS

The results showed a significant interaction between the active and sham groups; in particular, improvements in MMSE scores, immediate memory and delayed recall were observed at one-month follow-up in the active group.

CONCLUSIONS

The positive effects of tDCS on cognitive function in AD patients observed suggest that tDCS may induce long-term neuroplastic changes, leading to sustained improvements in cognitive abilities.

Genistein effect on cognition in prodromal Alzheimer's disease patients. The GENIAL clinical trial

BACKGROUND

Delaying the transition from minimal cognitive impairment to Alzheimer's dementia is a major concern in Alzheimer's disease (AD) therapeutics. Pathological signs of AD occur years before the onset of clinical dementia. Thus, long-term therapeutic approaches, with safe, minimally invasive, and yet effective substances are recommended. There is a need to develop new drugs to delay Alzheimer's dementia. We have taken a nutritional supplement approach with genistein, a chemically defined polyphenol that acts by multimodal specific mechanisms. Our group previously showed that genistein supplementation is effective to treat the double transgenic (APP/PS1) AD animal model.

METHODS

In this double-blind, placebo-controlled, bicentric clinical trial, we evaluated the effect of daily oral supplementation with 120 mg of genistein for 12 months on 24 prodromal Alzheimer's disease patients. The amyloid-beta deposition was analyzed using 18F-flutemetamol uptake. We used a battery of validated neurocognitive tests: Mini-Mental State Exam (MMSE), Memory Alteration Test (M@T), Clock Drawing Test, Complutense Verbal Learning Test (TAVEC), Barcelona Test-Revised (TBR), and Rey Complex Figure Test.

RESULTS

We report that genistein treatment results in a significant improvement in two of the tests used (dichotomized direct TAVEC, p = 0.031; dichotomized delayed Centil REY copy p = 0.002 and a tendency to improve in all the rest of them. The amyloid-beta deposition analysis showed that genistein-treated patients did not increase their uptake in the anterior cingulate gyrus after treatment (p = 0.878), while placebo-treated did increase it (p = 0.036). We did not observe significant changes in other brain areas studied.

CONCLUSIONS

This study shows that genistein may have a role in therapeutics to delay the onset of Alzheimer's dementia in patients with prodromal Alzheimer's disease. These encouraging results indicate that this should be followed up by a new study with more patients to further validate the conclusion that arises from this study.

TRIAL REGISTRATION

NCT01982578, registered on November 13, 2013.

Enhancing Immediate Memory, Potential Learning, and Working Memory with Transcranial Direct Current Stimulation in Healthy Older Adults

BACKGROUND

Transcranial direct current stimulation (tDCS) has emerged as a prevention method or minimizer of the normal cognitive deterioration that occurs during the aging process. tDCS can be used to enhance cognitive functions such as immediate memory, learning, or working memory in healthy subjects. The objective of this study was to analyze the effect of two 20-min sessions of anodal transcranial direct stimulation on immediate memory, learning potential, and working memory in healthy older adults.

METHODS

A randomized, single-blind, repeated-measures, sham-controlled design was used. The sample is made up of 31 healthy older adults, of whom 16 were in the stimulation group and 15 were in the sham group. The anode was placed on position F7, coinciding with the left dorsolateral prefrontal cortex region, and the cathode was placed on Fp2, the right supraorbital area (rSO).

RESULTS

When comparing the results of the treatment group and the sham group, differences were observed in working memory and learning potential; however, no differences in immediate memory were found.

CONCLUSION

The results showed that tDCS is a non-invasive and safe tool to enhance cognitive processes in healthy older adults interested in maintaining some cognitive function.

Comparison of Emotion Recognition in Young People, Healthy Older Adults, and Patients with Mild Cognitive Impairment

BACKGROUND

The basic discrete emotions, namely, happiness, disgust, anger, fear, surprise, and sadness, are present across different cultures and societies. Facial emotion recognition is crucial in social interactions, but normal and pathological aging seem to affect this ability. The present research aims to identify the differences in the capacity for recognition of the six basic discrete emotions between young and older healthy controls (HOC) and mildly cognitively impaired patients (MCI).

METHOD

The sample (N = 107) consisted of 47 young adults, 27 healthy older adults, and 33 MCI patients. Several neuropsychological scales were administered to assess the cognitive state of the participants, followed by the emotional labeling task on the Ekman 60 Faces test.

RESULTS

The MANOVA analysis was significant and revealed the presence of differences in the emotion recognition abilities of the groups. Compared to HOC, the MCI group obtained a significantly lower number of hits on fear, anger, disgust, sadness, and surprise. The happiness emotion recognition rate did not differ significantly among the three groups. Surprisingly, young people and HOC did not show significant differences.

CONCLUSIONS

Our results demonstrated that MCI was associated with facial emotion recognition impairment, whereas normal aging did not seem to affect this ability.

[Hopelessness as a predictor of loneliness in older adults]

BACKGROUND AND OBJECTIVE

Hopelessness is characterized by a set of negative cognitive schemas about the future, conceptualized on the basis of three dimensions: affective, motivational and cognitive. This construct is linked to loneliness, the incidence of which in older adults is increasingly high. The aim of this research is to test whether hopelessness factors predict levels of loneliness in older adults.

MATERIAL AND METHODS

138 non-institutionalized persons from Valencia city between 65-90 years old participated, with a mean age of 73.67 (SD=4.8), and 59.4% were women. The Beck Hopelessness Scale (BHS) and University of California Los Angeles Loneliness Scale (UCLA) were administered to assess participants.

RESULTS

The motivational and cognitive factors acted as statistically significant predictors of loneliness, while the affective factor was not presented as a significant factor. The final model obtained an R²adj=.442, F(3, 87)=23.97, p<.001.

CONCLUSIONS

Loneliness is a phenomenon of great concern in the field of gerontology due to its high incidence and impact. The results indicate that hopelessness, specifically loss of motivation and negative expectations about the future, are critical issues for the development of feelings of loneliness in older adults. Thus, it is relevant to pay attention to these variables in order to apply loneliness prevention programs.

The regulation of emotions: Gender differences

Introduction

Emotional regulation, understood as the emotional ability to repair emotional states, is a skill closely linked to adaptation during aging. People who are capable to manage their emotions have greater control over moods, applying adaptive regulation strategies that allow them to maintain positive moods and modify or regulate negative ones. It has been observed that gender can be a relevant variable related to emotional regulation. In this sense, it is considered that women may be more skillful than men to emotional regulation strategies, benefiting from more successful emotional management strategies.

Objectives

Verify if there are differences in the ability of emotional regulation between older men and women.

Methods

The sample consisted of 851 healthy older adults, of whom 299 were men and 554 women. The participants were recruited from elderly leisure centers in the city of Valencia (Spain). To assess emotional regulation, the regulation dimension of the Trait Meta-Mood Scale 24 (TMMS-24) was used.

Results

Significant differences were obtained in the emotional regulation dimension based on gender (F1, 851 = 0.075, p = 0.010), finding higher levels in women than in men (3.64 vs. 3.49).

Conclusions

There is an apparent advantage of women in relation to emotional regulation, showing more skill than men in the management of emotional states. This is an important finding considering the impact of emotional regulation on adaptation during aging. This adaptative advantage has a greate importance in generation pleasant emotional states that contribute to healthy aging.

Disclosure

No significant relationships.

Phonological false recognition, recollection, and familiarity in healthy aging and Alzheimer's disease

BACKGROUND

Thirty healthy older people, 20 Alzheimer's disease patients (matched on age and education level) and 33 young people, participated in an experiment to implicitly induce phonological false memories, allowing us to obtain estimates of their recollection, familiarity, and false recognition.

METHOD

In the study task, words were selected which used half of the letters in the alphabet. In the recognition test, there were three types of non-studied new words: critical lures using letters from the same half of the alphabet as the study task words; distractors formed using the unused half of the alphabet, and distractors formed using all the letters in the alphabet.

RESULTS

Results showed that: (a) in all the samples, critical lures produced more false recognitions than distractors composed of all the letters in the alphabet or distractors composed of the letters not used in the study, showing a significant phonological false recognition effect; (b) both recollection and familiarity declined with age and dementia; (c) phonological false recognition increased with age and Alzheimer's disease.

CONCLUSIONS

These results seem to support the idea that estimates of recollection, familiarity, and phonological false recognition can be used as early markers of cognitive impairment.

Dimensional and Discrete Emotional Reactivity in Alzheimer's Disease: Film Clips as a Research Tool in Dementia

BACKGROUND

No studies have been conducted to date on the dimensional and discrete classification of emotions to study the emotional reactivity of older adults with Alzheimer's disease (AD). Additionally, the presentation of film clips with affective content is currently one of the most effective and widely used Mood Induction Procedures (MIPS). However, it has been scarcely used in AD patients.

OBJECTIVE

Based on the dimensional and discrete models of emotion, this study examines the emotional reactivity of older adults with AD, using a popular set of film clips to induce emotions.

METHODS

We compared the responses of older adults aged over 65-years with mild to moderate AD (n = 15) and a healthy comparison group (n = 17) to six target emotions: disgust, fear, anger, sadness, amusement, and tenderness.

RESULTS

The results showed significant differences in the reactivity of fear, anger, and sadness between AD patients and healthy comparison group. However, the responses of the two groups to positive film clips were similar. Only in the amusement clip did the AD participants show a higher intensity response.

CONCLUSION

These findings suggest that the characteristic loss of cognitive abilities in AD is related to a reduction in the ability to react to emotional stimuli, especially negative ones. However, these abilities seem to be preserved when it comes to positive emotions. Future research is necessary to investigate whether the positivity effect is present in AD patients.

Relationship between emotional coping and depressive symptomatology

Introduction

From the life cycle perspective, the aging is described as the strengthening of adaptive resources and the capacity for recovery or compensation for losses. These skills are grounded in the coping strategies that individuals apply in order to effectively adapt to diverse situations. Emotion-focused, passive coping strategies are considered to be maladaptive in the long term. These strategies are associated with affective disorders, being these phenomena of great impact in older adults.

Objectives

Verify if there is a relationship between emotion-focused coping strategies and depressive symptoms

Methods

The sample was composed of 418 healthy older adults, aged between 60 and 89 years with an average age of 69.67 years and SD = 7.24, 63.6% of the participants are women and the remaining 36.4% are men. The Coping Stress Questionnaire was used to evaluate strategies focused on emotion (Sandín & Chorot, 2003). The Center for Epidemiological Studies-Depression Scale (Radloff & Teri, 1986) was used to evaluate depressive symptoms.

Results

Depressive symptomatology showed significant associations with all emotion-focused strategies: negative self-focus (.339), open emotional expression (.279), avoidance (.202) and religion (113) with a significance level of 0.05.

Conclusions

Emotion-focused coping strategies are associated with depressive symptomatology. Thus, it is considered that the use of these types of strategies in times of change or challenge will not benefit adaptation in the older adult. It is necessary to develop more active coping strategies for prevention in mental health during aging.

Disclosure

No significant relationships.

The enhancement of emotional skills as a resource to reduce hopelessness

Introduction

Emotional Intelligence (EI) involves a set of emotional skills (attention, clarity, and emotional regulation) for the effective use of emotional information (Mayer & Salovey, 1997). The lack of emotional skills has been associated with multiple disruptive emotional phenomena, such as hopelessness. It has been observed that EI can be a predictor of hopelessness in older adults, in such a way that we can consider that the development of EI could be a relevant resource for promoting mental health in older adults.

Objectives

Implement an EI intervention to reduce levels of hopelessness.

Methods

The sample consisted of 123 healthy older adults from Valencia (Spain), randomly distributed into two groups: treatment group (N = 57) and control group (N = 68), aged between 60 and 84 years, with a mean age of 67.62 years (SD = 6.43). Of these, 54.4% were women and the remaining 45.6% were men. The Trait Meta-Mood Sclae 24 (TMMS 24) was applied to assess EI and the Beck Hopelessness Scale (BHS) to assess hopelessness.

Results

Significant differences are observed in the treatment group after the intervention (F1, 123 = 19.86; p < 0.001, h2 = 0.142), with a decrease in scores (T1= 4.72; T2=2.88). For the control group, the effects were not significant (F1, 123 = 1.06; p = 0.305, h2 = 0,009).

Conclusions

The efficacy of the intervention in EI to manage emotional states is evidenced, reducing levels of hopelessness thanks to training in adaptive emotional processing and emotional management skills.

Disclosure

No significant relationships.

Type of memory and emotional valence in healthy aging, mild cognitive impairment, and Alzheimer's disease

BACKGROUND

Autobiographical memory (AM) presents components related to the type of memory and may present an associated emotional valence. Comparing healthy older adults, adults with mild cognitive impairment (MCI), and adults with Alzheimer's disease (AD) gives contradictory results. We examined AM in these groups to analyze differences and provide information that would contribute to the understanding of AM and associated emotional deficits in patients.

METHOD

31 AD, 32 MCI, and 32 healthy older adults were evaluated using the Autobiographical Memory Test. Taking the number of memories elicited in each category as a dependent variable, an ANOVA of three groups x 3 types of valence was applied (positive, negative, neutral, intrasubject), and another ANOVA of 3 groups x 3 types of memory (specific, general, vague, intrasubject).

RESULTS

Specific-type responses are reduced with the progression of the pathology and in addition healthy subjects have a positive valence while AD presents a mainly neutral valence.

CONCLUSIONS

Cognitive problems associated with aging tend to affect the highest level of AM specificity. Healthy subjects and MCI have memories with an emotional valence, whereas the AD group has a significant deterioration in these memories.

Resilience and Socioeconomic Status as Predictors of Life Satisfaction and Psychological Well-Being in Colombian Older Adults

Well-being is a complex construct related to sociodemographic and cultural aspects that vary across cultures. Latin America is a region with high social inequalities among population groups, although this varies significantly depending on the country. This article proposes a model that seeks to establish the relationship between psychosocial variables, psychological well-being, and life satisfaction in a sample of Colombian older adults. The model explores associations between resilience, socioeconomic status, life satisfaction, and psychological well-being. A study with a sample of 617 Colombian older adults was conducted. A structural equation modeling technique was performed. The results showed a model in which life satisfaction is positively explained by psychological well-being and resilience, whereas psychological well-being is explained by a higher socio-economic status. The results contribute to the evidence about how well-being is determined by psychosocial and cultural factors. The evidence found represents novel information about older adults in Colombia.

Phonological false recognition produced by bottom-up automatic activation in young and older people

Two experiments explored a new procedure to implicitly induce phonological false memories in young and older people. On the study tasks, half of the words were formed from half of the letters in the alphabet, whereas the remaining words were formed from all the letters in the alphabet. On the recognition tests, there were three types of non-studied new words: critical lures formed from the same half of the letters as the studied words; distractors formed from the other half of the letters not used, and distractors formed from all the letters in the alphabet. In both experiments, the results showed that, in both young and older people, critical lures produced more false recognitions than distractors composed of all the letters in the alphabet, which, in turn, produced more false alarms than distractors composed of the letters not used during the study. These results support the predictions of the activation/monitoring models, which assume that false memories are partly due to activation spreading from items (semantically or phonologically) related to the critical words.

Effectiveness of instrumental reminiscence intervention on improving coping in healthy older adults

Reminiscence is a psychological intervention that uses the recall of past events, feelings, and thoughts to facilitate pleasure, quality of life, and adjustment to present life. The main goal of this study was to investigate the effect of a reminiscence intervention programme on coping strategies. One hundred fifty healthy older adults attended the reminiscence sessions. In order to evaluate the effects of the programme and find out if its effects lasted over time, we used an experimental design with pretest, posttest, and follow-up assessments, comparing a control group to the intervention group. Repeated-measures analysis of variance showed significant differences in problem-solving coping, positive reappraisal, social support seeking, and avoidance coping with the treatment group obtaining higher scores than the control group in all cases. The effects declined after 3 months, but some differences were found in the treatment group obtaining higher scores in problem-solving coping and positive reappraisal and lower in overt emotional expression. The study suggests that reminiscence therapy contributes to mental health by enhancing coping strategies that can allow the elderly to cope successfully and overcome psychological distress.

Measuring elderly people's quality of life through the Beck Hopelessness Scale: a study with a Spanish sample

OBJECTIVES

Hopelessness is a key element of suicidal intent. It can instill a pessimistic outlook on the future, leading an individual to believe that suicide is the only answer to their problems. Hopelessness operates as a modulating variable between depression and suicidal behavior. The aim of this study was to confirm the factor structure of the Beck Hopelessness Scale (BHS) in a non-clinical sample.

METHOD

Three hundred and sixty-two Spanish individuals, aged over 60, free of cognitive impairment and depressive symptoms, completed the BHS scale. Participants were tested using confirmatory factor analysis (CFA), using one-, two- and three-factor models.

RESULTS

The one- and two-factor models presented adequate fit indices. Specifically, the indices of the two-factor models were better than those of the one-factor model. The two-factor model, without items 4, 9 and 14, provided the best fit, given that the indices obtained in the CFA and their internal consistency were better than those of the other models.

CONCLUSION

The validation of the BHS for a population of Spanish older adults provides a reliable and valid measure of hopelessness and could be useful in clinical practice and research as an effective tool for the early detection of suicidal behaviors.

Are semantic and episodic autobiographical memories influenced by the life period remembered? Comparison of young and older adults

Autobiographical memory consists of a person's personal history and contributes to building a feeling of identity and continuity. Aging affects episodic autobiographical memory negatively, whereas semantic autobiographical memory is preserved or even enhanced in older adults. The study aim was to analyze whether these hypotheses continue to find support, or if there are differences when these memories are analyzed according to the components of life cycle retrieval. The sample was composed of 151 participants: 78 young and 73 older adults. Subjects were evaluated with the Autobiographical Memory Interview. A mixed ANOVA was performed for semantic memory with two groups and three life periods (childhood, youth-adulthood, and recent life). The main group effect was not significant, but the effects of the life period and the life period × group interaction were significant. When analyzing episodic memory, the main effects of the life period and group were significant, but their interaction was not. Young people have better episodic memory than older adults, and they show a similar episodic memory pattern during the three life periods evaluated. The semantic memory of the older adults is preserved, and the reminiscence bump and recent life scores are similar in both groups.

Effects of Stimuli Repetition and Age in False Recognition

The aim of the current study is to examine the effects of stimuli repetition and age in false recognition using the Deese-Roediger-McDermott experimental paradigm. Two matched samples of 32 young adults and 32 healthy older adults studied 10 lists of six words associated with three non-presented critical words. On half of the lists, the words were presented once, and on the other five lists, the words were presented three times, always following a same sequential order. After each study list, participants performed a self-paced recognition test containing 12 words: the 6 studied words and 6 other non-studied words (the 3 critical words and 3 distractors). The results show that false recognition increases with age and declines in both samples with repetitions (although more in the young adults than in the older people). Results are discussed in relation to the dual-process theories of (false) memory.

Can there be learning potential in Parkinson's disease? A comparison with healthy older adults

Patients with Parkinson's disease may show certain cognitive impairments, although it is unclear how these deficits can affect their learning potential. The study aims to use the testing-the-limits technique to compare the potential for cognitive plasticity in a group of Patients with Parkinson's disease (N = 33) and a group of healthy older adults (N = 33). Sixty-six participants performed verbal learning test to analyze the learning potential. Repeated-measures analysis of variance showed significant main effects of time, group, and the interaction. There is a lower learning potential in subjects with Parkinson's disease; however, those still maintain a certain capacity for learning and, therefore, for cognitive plasticity.

Resilience and Coping as Predictors of Well-Being in Adults

Well-being is one of the keys to successful and optimal development across the lifespan. Based on the idea that development involves changes in individuals' adaptive capacity to meet their needs over time, the changes that occur in the second half of life require effort to adapt to the new reality. This study used a structural model to test the effects of coping strategies and resilience on well-being in a sample of 305 mid-life adults. Several constructs were measured: coping strategies, resilience, and well-being. A final model was obtained with good fit indices; psychological well-being was positively predicted by resilience and negatively by emotional coping. Moreover, positive reappraisal and avoidance form part of both coping strategies (problem-focused and emotion-focused). Considering the characteristics of the model, educational intervention programs could be developed to promote skills that favor good adaptation at this stage in the life cycle and contribute to promoting successful aging.