Early detection of isolated memory deficits in the elderly: the need for more sensitive neuropsychological tests

2002 ◽  
Vol 32 (3) ◽  
pp. 483-491 ◽  
Author(s):  
C. A. DE JAGER ◽  
E. MILWAIN ◽  
M. BUDGE
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Working Memory ◽  
Early Detection ◽  
Episodic Memory ◽  
Processing Speed ◽  
Neuropsychological Tests ◽  
Memory Performance ◽  
The Elderly ◽  
Memory Group

Background. Early detection of cognitive decline in the elderly is important because this may precede progression to Alzheimer's disease. The aim of this study was to see whether sensitive neuropsychological tests could identify pre-clinical cognitive deficits and to characterize the cognitive profile of a subgroup with poor memory.Methods. A neuropsychological test battery was administered to a community-dwelling sample of 155 elderly volunteers who were screened with CAMCOG at enrolment (mean age 74·7 years). The battery included tests of episodic memory, semantic and working memory, language and processing speed.Results. Episodic memory test z scores below 1 S.D. from the cohort mean identified 25 subjects with ‘non-robust’ memory performance. This group was compared to the remaining ‘robust memory’ group with a General Linear Model controlling for age, IQ, education and gender. Test performance was significantly different in all tests for episodic and semantic memory, but not in tests for working memory, processing speed and language. CANTAB paired associates learning and spatial recognition tests identified the highest percentages of those in the ‘non-robust memory’ group. Processing speed partialled out the age effect on memory performance for the whole cohort, but the ‘non-robust memory’ group's performance was not associated with age or processing speed.Conclusions. Sensitive neuropsychological tests can detect performance below the norm in elderly people whose performance on MMSE and CAMCOG tests is well within the normal range. Age-related decline in memory performance in a cohort of the elderly may be largely due to inclusion within the cohort of individuals with undetected pre-clinical Alzheimer's disease or isolated memory impairment.

Sensitivity and specificity of neuropsychological tests for mild cognitive impairment, vascular cognitive impairment and Alzheimer's disease

2003 ◽  
Vol 33 (6) ◽  
pp. 1039-1050 ◽  
Author(s):  
C. A. DE JAGER ◽  
E. HOGERVORST ◽  
M. COMBRINCK ◽  
M. M. BUDGE
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Episodic Memory ◽  
Sensitivity And Specificity ◽  
Processing Speed ◽  
Neuropsychological Tests ◽  
Verbal Learning

Background. Early diagnosis of dementia is important for those who might benefit from treatment. We designed a brief comprehensive neuropsychological test battery to help differentiate control subjects from patients with mild cognitive impairment (MCI) and dementia.Method. The battery included tests of memory, attention, executive function, speed, perception and visuospatial skills. It was administered to subjects from the OPTIMA cohort: 51 controls, 29 with MCI, 60 with ‘possible’ or ‘probable’ Alzheimer's disease (AD) (NINCDS/ADRDA) and 12 with cerebrovascular disease (CVD). Mann–Whitney U tests were used to compare performance of controls with other diagnostic groups. The sensitivity and specificity of the tests were determined using Receiver Operating Characteristic curve analyses. The effects of age, gender and years of education on test performance were determined with Spearman's rank correlations.Results. The AD group performed worse than controls on all tests except an attention task. The Hopkins Verbal Learning Test and The Placing Test for episodic memory showed significant discriminative capacity between controls and other groups. Attention and processing speed tests discriminated CVD from controls. Category fluency, episodic memory tests and the CLOX test for executive function distinguished MCI from AD. Spearman's correlations showed negative associations between age and processing speed. Years of education affected performance on all tests, except The Placing Test.Conclusions. Certain neuropsychological tests have been shown to be sensitive and specific in the differential diagnosis of various types of dementia and may prove to be useful for detection of MCI.

Impact of Comorbid Depression on Serial Position Effects in Alzheimer’s Disease

GeroPsych ◽  
2014 ◽  
Vol 27 (4) ◽  
pp. 161-169 ◽  
Author(s):  
Nienke A. Hofrichter ◽  
Sandra Dick ◽  
Thomas G. Riemer ◽  
Carsten Schleussner ◽  
Monique Goerke ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Serial Position ◽  
Episodic Memory ◽  
Memory Performance ◽  
Memory Function ◽  
Word List ◽  
Position Effects ◽  
Serial Position Effects ◽  
List Memory

Hippocampal dysfunction and deficits in episodic memory have been reported for both Alzheimer’s disease (AD) and major depressive disorder (MDD). Primacy performance has been associated with hippocampus-dependent episodic memory, while recency may reflect working memory performance. In this study, serial position profiles were examined in a total of 73 patients with MDD, AD, both AD and MDD, and healthy controls (HC) by means of CERAD-NP word list memory. Primacy performance was most impaired in AD with comorbid MDD, followed by AD, MDD, and HC. Recency performance, on the other hand, was comparable across groups. These findings indicate that primacy in AD is impaired in the presence of comorbid MDD, suggesting additive performance decrements in this specific episodic memory function.

scholarly journals Emotional Working Memory and Alzheimer’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Nicola Mammarella ◽  
Beth Fairfield
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Working Memory ◽  
Memory Performance ◽  
Memory Task ◽  
Emotional Information ◽  
Healthy Older Adults ◽  
Affective Stimuli ◽  
Age Related ◽  
Dementia Of Alzheimer’S Type

A number of recent studies have reported that working memory does not seem to show typical age-related deficits in healthy older adults when emotional information is involved. Differently, studies about the short-term ability to encode and actively manipulate emotional information in dementia of Alzheimer’s type are few and have yielded mixed results. Here, we review behavioural and neuroimaging evidence that points to a complex interaction between emotion modulation and working memory in Alzheimer’s. In fact, depending on the function involved, patients may or may not show an emotional benefit in their working memory performance. In addition, this benefit is not always clearly biased (e.g., towards negative or positive information). We interpret this complex pattern of results as a consequence of the interaction between multiple factors including the severity of Alzheimer’s disease, the nature of affective stimuli, and type of working memory task.

Apraxic and Action-Intentional Disorders Associated With Vascular and Degenerative Dementing Diseases

2020 ◽  
pp. 146-184
Author(s):  
Kenneth M. Heilman
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Working Memory ◽  
Episodic Memory ◽  
Executive Functions ◽  
Vascular Dementia ◽  
Response Inhibition ◽  
Word Fluency ◽  
Letter Word ◽  
The Brain

“Actions speak louder than words.” Although clinician’s behavioral evaluations of dementia most often include assessing episodic memory, declarative memories (e.g., naming and calculating), and executive functions (working memory, letter–word fluency), one of the most important functions of the brain is programing actions, including “how” to move and “when” to move. Patients with Alzheimer’s disease, vascular dementia, and other forms of dementia often have impairments in the systems that mediate these how-apraxic and when-intentional behaviors. Although the presence of these apraxic and action-intentional disorders may help with diagnosis and help doctors gain a better understand these patients’ disability, these functions are rarely tested and are often not well understood. The goal of this chapter is to describe the signs of the various types of apraxic disorders (limb-kinetic, ideomotor, conceptual, ideational, and dissociation) and well as action-intentional disorders (akinesia-hypokinesia, impersistence, perseveration, and defective response inhibition), how to test for these disorders, and their pathophysiology.

Effects of repetitive paired associative stimulation on brain plasticity and working memory in Alzheimer’s disease: a pilot randomized double-blind-controlled trial

2020 ◽  
pp. 1-13
Author(s):  
Sanjeev Kumar ◽  
Reza Zomorrodi ◽  
Zaid Ghazala ◽  
Michelle S. Goodman ◽  
Daniel M. Blumberger ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Working Memory ◽  
Brain Plasticity ◽  
Controlled Trial ◽  
Memory Performance ◽  
Double Blind ◽  
Paired Associative Stimulation ◽  
Post Hoc ◽  
The Impact

ABSTRACT Design: Pilot randomized double-blind-controlled trial of repetitive paired associative stimulation (rPAS), a paradigm that combines transcranial magnetic stimulation (TMS) of the dorsolateral prefrontal cortex (DLPFC) with peripheral median nerve stimulation. Objectives: To study the impact of rPAS on DLPFC plasticity and working memory performance in Alzheimer’s disease (AD). Methods: Thirty-two patients with AD (females = 16), mean (SD) age = 76.4 (6.3) years were randomized 1:1 to receive a 2-week (5 days/week) course of active or control rPAS. DLPFC plasticity was assessed using single session PAS combined with electroencephalography (EEG) at baseline and on days 1, 7, and 14 post-rPAS. Working memory and theta–gamma coupling were assessed at the same time points using the N-back task and EEG. Results: There were no significant differences between the active and control rPAS groups on DLPFC plasticity or working memory performance after the rPAS intervention. There were significant main effects of time on DLPFC plasticity, working memory, and theta–gamma coupling, only for the active rPAS group. Further, on post hoc within-group analyses done to generate hypotheses for future research, as compared to baseline, only the rPAS group improved on post-rPAS day 1 on all three indices. Finally, there was a positive correlation between working memory performance and theta–gamma coupling. Conclusions: This study did not show a beneficial effect of rPAS for DLPFC plasticity or working memory in AD. However, post hoc analyses showed promising results favoring rPAS and supporting further research on this topic. (Clinicaltrials.gov-NCT01847586)

scholarly journals Association of neuroinflammation with episodic memory: a [11C]PBR28 PET study in cognitively discordant twin pairs

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Noora Lindgren ◽  
Jouni Tuisku ◽  
Eero Vuoksimaa ◽  
Semi Helin ◽  
Mira Karrasch ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Episodic Memory ◽  
Memory Performance ◽  
Disease Process ◽  
Standardized Uptake Value ◽  
Weighted Average ◽  
Translocator Protein ◽  
Interindividual Variation ◽  
Protein Genotype

Abstract Alzheimer’s disease is associated with chronic response of innate immune system, referred as neuroinflammation. PET radioligands binding to the 18 kDa translocator protein are potential biomarkers of neuroinflammation. Translocator protein PET studies in mild cognitive impairment and Alzheimer’s disease have indicated controversial results, possibly reflecting interindividual variation and heterogeneity of study populations. We controlled for genetic and environmental effects by studying twin pairs discordant for episodic memory performance. Episodic memory impairment is a well-known cognitive hallmark of early Alzheimer’s disease process. Eleven same-sex twin pairs (four monozygotic pairs, six female pairs, age 72–77 years) underwent [11C]N-acetyl-N-(2-methoxybenzyl)-2-phenoxy-5-pyridinamine ([11C]PBR28) PET imaging, structural magnetic resonance imaging and neuropsychological testing in 2014–17. Main PET outcome was the volume-weighted average standardized uptake value of cortical regions vulnerable to Alzheimer’s disease pathology. Ten pairs were discordant for episodic memory performance. In the eight pairs with identical translocator protein genotype, twins with poorer episodic memory had ∼20% higher cortical [11C]PBR28 binding compared with their better-performing co-twins (mean intra-pair difference 0.21 standardized uptake value, 95% confidence interval 0.05–0.37, P = 0.017). The result remained the same when including all discordant pairs and controlling for translocator protein genotype. Increased translocator protein PET signal suggests that increased microglial activation is associated with poorer episodic memory performance. Twins with worse episodic memory performance compared with their co-twins had on average 20% higher uptake of the neuroinflammatory marker translocator protein PET tracer 11[11C]PBR28. The findings support a negative association between neuroinflammation and episodic memory and the use of translocator protein positron emission tomography as a useful indicator of Alzheimer’s disease process.

scholarly journals VAMP2 is a cerebrospinal fluid marker of selective hippocampal synapse loss and episodic memory performance in Alzheimer’s disease

2020 ◽  
Vol 16 (S4) ◽  
Author(s):  
Olivia Belbin ◽  
Beatriu Molina ◽  
Raúl Núñez‐Llaves ◽  
Julie Goossens ◽  
Nele Dewit ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrospinal Fluid ◽  
Episodic Memory ◽  
Memory Performance ◽  
Synapse Loss

scholarly journals Effect of cortisol levels on working memory performance in elderly subjects with Alzheimer's disease

2008 ◽  
Vol 66 (3b) ◽  
pp. 619-624 ◽  
Author(s):  
Juliana Nery de Souza-Talarico ◽  
Paulo Caramelli ◽  
Ricardo Nitrini ◽  
Eliane Corrêa Chaves
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Working Memory ◽  
Digit Span ◽  
Memory Performance ◽  
Elderly Subjects ◽  
Control Group ◽  
Acute Administration ◽  
Healthy Elderly ◽  
Cortisol Levels

BACKGROUND: Subjects with Alzheimer's disease (AD) have elevated cortisol levels as a result of hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Acute administration of hydrocortisone has been associated with working memory (WM) performance in young adults. OBJECTIVE: To investigate whether cortisol levels are associated with WM performance in subjects with AD. METHOD: Eighty subjects were included, comprising 40 patients with mild AD and 40 healthy elderly controls. WM was assessed using the Digit Span Backward test (DSB). Saliva samples were collected to determine cortisol levels. RESULTS: AD subjects had poorer performance on the DSB than controls (p=0.002) and also presented higher levels of cortisol than control group (p=0.04). No significant correlation was observed between the DSB and cortisol levels in both groups (r= -0.29). CONCLUSION: In this study, elevated cortisol levels were not associated with poorer WM performance in patients with AD or in healthy elderly subjects.

P3-348: Coping strategies may vary according to working memory performance in individuals with Alzheimer's disease

2011 ◽  
Vol 7 ◽  
pp. S626-S626
Author(s):  
Juliana Souza-Talarico ◽  
Eliane Chaves ◽  
Ricardo Nitrini ◽  
Paulo Caramelli
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Working Memory ◽  
Coping Strategies ◽  
Memory Performance
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