Validation of a novel fully automated story recall task for repeated remote high-frequency administration

INTRODUCTION: Longitudinal data is key to identifying cognitive decline and treatment response in Alzheimer's disease (AD). METHODS: The Automatic Story Recall Task (ASRT) is a novel, fully automated test that can be self-administered remotely. In this longitudinal case-control observational study, 151 participants (mean age: 69.99 (range 54-82), 73 mild cognitive impairment/mild AD and 78 cognitively unimpaired) completed parallel ASRT assessments on their smart devices over 7-8 days. Responses were automatically transcribed and scored using text similarity metrics. RESULTS: Participants reported good task usability. Adherence to optional daily assessment was moderate. Parallel forms correlation coefficients between ASRTs were moderate-high. ASRTs correlated moderately with established tests of episodic memory and global cognitive function. Poorer performance was observed in participants with MCI/Mild AD. DISCUSSION: Unsupervised ASRT assessment is feasible in older and cognitively impaired people. This automated task shows good parallel forms reliability and convergent validity with established cognitive tests.

The Impact of Naturalistic Age Stereotype Activation

Almost self-fulfilling, commonly held negative stereotypes about old age and memory can impair older adults’ episodic memory performance, due to age-based stereotype threat or self-stereotyping effects. Research studies demonstrating detrimental impacts of age stereotypes on memory performance are generally conducted in research laboratories or medical settings, which often underestimate memory abilities of older adults. To better understand the “real world” impact of negative age and memory stereotypes on episodic memory, the present research tested story recall performance of late middle-aged and older adults (N = 51) following a naturalistic age stereotype manipulation, wherein every day, newspaper-style materials (comics and puzzles) were either embedded with negative age and memory stereotype stimuli (stereotype group) or neutral stimuli (control group). Furthermore, all participants were tested in favorable, familiar environments. Potential moderators of the stereotype effects, e.g., metamemory beliefs, were assessed at baseline. Current memory evaluation and subjective age, as well as perceived stereotype threat and task-related anxiety, were assessed following the stereotype manipulation as potential mechanisms of the expected stereotype effects. Results suggested a contrast effect, as the stereotype group demonstrated superior story recall performance compared to the control group. Marginally significant moderation effects by age and perceived stereotype threat indicated that stereotype rejection was present for late middle-aged adults but not older adults, indicative of stereotype lift, and for individuals who reported low and average, but not high, levels of perceived stereotype threat. Additionally, a trend suggested more positive memory evaluation for those in the stereotype group who reported awareness of the stereotype stimuli than those who did not notice the stimuli. These results are consistent with other research demonstrating benefits to memory performance in adulthood based on motivational and contextual factors, such as using relevant memory materials and testing in favorable conditions. Moreover, the results of this study contribute to our understanding of individuals’ responses to different types of stereotype stimuli, and the differential impact of stereotype manipulations that are subtle versus blatant. Individuals were motivated to counteract negative stereotype effects when conditions were supportive, stereotype presentations were naturalistic, and personal beliefs were positive.

Suicide Attempts, Neurocognitive Dysfunctions and Clinical Correlates in Middle-Aged and Elderly Chinese Schizophrenia Patients

Background: Suicide is a common and complex symptom of schizophrenia that may be related to clinical variables and neurocognitive function. This study aimed to investigate the associated correlates of suicide attempts in Chinese middle-aged and elderly inpatients with schizophrenia, including demographic and clinical characteristics and cognitive level, which has not yet been reported.Methods: A total of 426 schizophrenia inpatients were recruited for this study. Clinical symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS). Neurocognitive function was measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).Results: The prevalence of suicide attempts in middle-aged and elderly Chinese schizophrenia patients was 13.3%. Female patients had a higher suicide rate than male patients. Patients with suicide attempts had significantly higher PANSS-positive subscores, depressive subscores, and RBANS-story recall than non-attempter patients (all p < 0.05). Multiple logistic regression showed that gender, positive subscore, depressive subscore and RBANS-story recall (OR = 1.10–2.19, p < 0.05) were independently associated with suicide attempts in middle-aged and elderly schizophrenia patients.Conclusions: Our study showed that the rate of suicide attempts in Chinese middle-aged and elderly schizophrenia patients is high. Compared to non-attempters, there are less cognitive impairments, more clinical symptoms, and more female patients in the suicide attempters.

Preliminary Validation of the Triana Test: A New Story Recall Test Based on Emotional Material

Objective: To first validate the diagnostic accuracy of the “Triana Test,” a new story recall test based on emotional material. Method: A phase I study of validation. We included 55 patients with amnestic Mild Cognitive Impairment and 69 healthy controls, diagnosed according to the “Memory Associative Test of the district of Seine-Saint-Denis” (TMA-93), and matched by age, gender, and educational level. The Triana Test’s diagnostic accuracy was calculated by ROC curve analysis and Spearman correlations estimated its convergent validity with a hippocampal memory test, the Free and Cued Selective Reminding Test with Immediate Recall (FCSRT+IR). Results: The “Triana Test” immediate and delayed recalls showed adequate diagnostic accuracy (AUC ≥ 0,74). The delayed free recall showed the highest diagnostic accuracy (AUC = 0.86). Correlations with the FCSRT+IR were moderate to strong. Conclusions: The “Triana Test” demonstrated accuracy for discriminating amnestic Mild Cognitive Impairment patients from healthy controls and convergent validity with the FCSRT+IR.

Proper names from story recall are associated with beta-amyloid in cognitively unimpaired adults at risk for Alzheimer's disease

Due to advances in the early detection of Alzheimer's disease (AD) biomarkers including beta-amyloid (Aβ), neuropsychological measures that are sensitive to concurrent, subtle changes in cognition are critically needed. Story recall tasks have shown sensitivity to early memory declines in persons with Mild Cognitive Impairment and early stage dementia, as well as in persons with autosomal dominantly inherited AD up to 10 years prior to a dementia diagnosis. However, the evidence is inconclusive regarding relationships between evidence of Aβ and story recall measures. Because story recall tasks require the encoding and delayed retrieval of several lexical-semantic categories, such as proper names, verbs, and numerical expressions, and because lexical categories have been shown to be differentially impaired in persons with MCI, we focused on item-level analyses of lexical-semantic retrieval from a quintessential story recall task, Logical Memory from the Wechsler Memory Scale. Our objective was to investigate whether delayed recall of lexical categories (proper names, verbs and/or numerical expressions), as well as the traditional total score measure, was associated with 'preclinical AD,' or cognitively unimpaired adults with positive Aβ deposition on positron emission tomography (PET) neuroimaging using Pittsburgh Compound B. We developed an item-level scoring system, in which we parsed items into lexical categories and examined the immediate and delayed recall of these lexical categories from 217 cognitively unimpaired participants from the Wisconsin Registry for Alzheimer's Prevention. We performed binary logistic regression models with story recall score as predictor and Aβ status (positive/negative) as the outcome. Using baseline Logical Memory data, proper names from delayed story recall were significantly associated with Aβ status, such that participants who recalled more proper names were less likely to be classified as PiB(+) (odds ratio = .58, p=.01). None of the other story recall variables, including total score, were associated with PiB status. Secondary analyses determined that immediate recall of proper names was not significantly associated with Aβ, suggesting a retrieval deficit rather than that of encoding. The present findings suggest that lexical semantic retrieval measures from existing story recall tasks may be sensitive to Aβ deposition, and may provide added utility to a widely-used, long-standing neuropsychological test for early detection of cognitive decline on the AD continuum.

Measuring the effects of listening for leisure on outcome after stroke (MELLO): A pilot randomized controlled trial of mindful music listening

BackgroundCognitive deficits and low mood are common post-stroke. Music listening is suggested to have beneficial effects on cognition, while mindfulness may improve mood. Combining these approaches may enhance cognitive recovery and improve mood early post-stroke.AimsTo assess the feasibility and acceptability of a novel mindful music listening intervention.MethodsA parallel group randomized controlled feasibility trial with ischemic stroke patients, comparing three groups; mindful music listening, music listening and audiobook listening (control group), eight weeks intervention. Feasibility was measured using adherence to protocol and questionnaires. Cognition (including measures of verbal memory and attention) and mood (Hospital Anxiety and Depression Scale) were assessed at baseline, end of intervention and at six-months post-stroke.ResultsSeventy-two participants were randomized to mindful music listening ( n = 23), music listening ( n = 24), or audiobook listening ( n = 25). Feasibility and acceptability measures were encouraging: 94% fully consistent with protocol; 68.1% completing ≥6/8 treatment visits; 80–107% listening adherence; 83% retention to six-month endpoint. Treatment effect sizes for cognition at six month follow-up ranged from d = 0.00 ([−0.64,0.64], music alone), d = 0.31, ([0.36,0.97], mindful music) for list learning; to d = 0.58 ([0.06,1.11], music alone), d = 0.51 ([−0.07,1.09], mindful music) for immediate story recall; and d = 0.67 ([0.12,1.22], music alone), d = 0.77 ([0.16,1.38]mindful music) for attentional switching compared to audiobooks. No signal of change was seen for mood. A definitive study would require 306 participants to detect a clinically substantial difference in improvement (z-score difference = 0.66, p = 0.017, 80% power) in verbal memory (delayed story recall).ConclusionsMindful music listening is feasible and acceptable post-stroke. Music listening interventions appear to be a promising approach to improving recovery from stroke.