Maria Campos-Magdaleno

Learning and serial effects on verbal memory in mild cognitive impairment

ABSTRACT The objective of this study was to examine different patterns of learning and episodic memory in 3 mild cognitive impairment (MCI) groups and a control group by administering the California Verbal Learning Test (CVLT) and using serial position effect as a principal variable. The study sample included 3 groups of patients with MCI (n = 90) divided into single-domain amnestic, multiple-domain amnestic, and multiple-domain nonamnestic MCI and a group of healthy controls (n = 60). We compared the performance of each group on several CVLT measures used in previous research, and we included a new measure that provides specific information about the serial effect. Data showed a similar pattern of learning and memory impairment in both amnestic MCI groups (i.e., no differences between the multiple-domain and single-domain subtypes); the recency effect was significantly higher in both amnestic MCI groups than in all other groups, and the primacy effect was only lower in the multiple-domain amnestic MCI subtype. Verbal learning and memory profiles of patients with amnestic MCI were very similar, independent of the presence of deficits in cognitive domains other than episodic memory. Results are discussed in light of the unitary-store model of memory.

Cluster subtypes of the Spanish version of the California Verbal Learning Test in a sample of adults with subjective memory complaints

We examined subtypes of learning and memory by administering the California Verbal Learning Test (CVLT) to a sample of adults with memory complaints that included a subsample of healthy controls and another of participants with amnesic mild cognitive impairment. We performed two-stage cluster analyses for CVLT variables representing three main factors—General Verbal Learning, Inaccurate Memory, and Serial Effect. Four, three, and two reliable subtypes were differentiated in the total sample and in the two subsamples, respectively. Gender, age, education, reading habits, vocabulary, memory complaints, and general cognitive performance were meaningfully related to variability in the performance of the subtypes.

Longitudinal Assessment of Verbal Learning and Memory in Amnestic Mild Cognitive Impairment: Practice Effects and Meaningful Changes

Objectives: To identify learning effects and meaningful changes in amnestic mild cognitive impairment (aMCI) at a follow-up assessment. Method: The Spanish version of the California Verbal Learning Test (CVLT) was administered to a sample of 274 adults of age over 50 years with subjective memory complains (SMC), including single and multiple domain aMCI groups and participants with SMC but without cognitive impairment (SMC group). The Wilcoxon test was used to compare results at baseline and after 18 months in short and long recall, and standardized regression-based (SRB) methods were used to study meaningful changes. Results: Scores were significantly higher at follow-up for short and long-delayed recall in all groups indicating generalized practice effect. SRB scores indicated a significant decline in recall in a higher proportion of participants with aMCI than in SMC group. Discussion: Patients with multiple and single domain aMCI benefit from practice in a verbal learning memory test. The SRB approach revealed a higher incidence of meaningful decline in short and long-delay recall and recognition in the aMCI groups than in the SMC group. Specifically, compared to SMC participants, single-domain aMCI individuals declined in a higher proportion in all measures, and multiple-domain aMCI individuals in long delay free recall.

Assessing Everyday Activities Across the Dementia Spectrum with the Amsterdam IADL Questionnaire

BACKGROUND Instrumental activities of daily living (IADL) are complex activities which involve multiple cognitive processes, and which are expected to be susceptible to the early effects of cognitive impairment. Informant-based questionnaires are the most common tools used to assess IADL performance in dementia, but must be adjusted for use in early stages of impairment. OBJECTIVE To investigate the differences in IADL on the continuum of cognitive decline (i.e. no cognitive decline - subjective cognitive decline - mild cognitive impairment- mild dementia - moderate dementia) using the Spanish version of the Amsterdam IADL Questionnaire (A-IADL-Q). METHODS A total of 500 volunteer participants were included: 88 participants with no signs of cognitive decline, 109 participants with subjective cognitive complaints, 114 participants with mild cognitive impairment (MCI), 81 participants with mild dementia and 108 participants with moderate dementia. IADL was assessed with the A-IADL-Q, a computerized and adaptive questionnaire that calculates scores according to the specific pattern of responses of each participant. The data were examined by ANOVAs and regression analysis. Multinomial logistic regression analysis was used to evaluate the capacity of the A-IADL-Q to distinguish between diagnostic groups. RESULTS Participants with no cognitive decline and those with subjective cognitive decline obtained higher A-IADL-Q scores than MCI participants, and participants with MCI obtained higher scores than patients with dementia. The A-IADL-Q showed excellent discrimination between non-cognitive impairment and dementia, and significant but low discrimination between non-cognitive impairment and MCI. CONCLUSION A-IADL-Q can discriminate IADL functioning between groups across the dementia spectrum.

Confirmatory factor analysis of the Spanish version of the California Verbal Learning Test in a sample of middle-aged and older adults with subjective memory complaints.

ABSTRACT Introduction: Assessment of the ability to retain new information is of special interest in the second half of life because of age-related changes, especially in those individuals at risk of cognitive impairment. The California Verbal Learning Test (CVLT) is one of the most common auditory–verbal learning tests used to test episodic memory. The objective of this paper is to study the stability of the factorial structure of the Spanish version of CVLT in a sample of adults aged 50–87 years with subjective memory complaints (SMCs). Method: Performance at baseline and follow-up assessment (about 18 months later) was analyzed in 301 participants. Models including one, two, three, and four factors were tested, by comparing the results of confirmatory factor analysis and structural equation models of relations between the factors at baseline and follow-up. Results: The two-factor models (accurate and inaccurate memory) yielded the best fit. The model establishing a relationship between these two factors at baseline and follow-up provided a good fit. Conclusion: CVLT performance in a sample of middle-aged and old adults with SMCs was separated into two factors differentiating accurate recollection and errors. A structural equation modeling (SEM) model relating data from both assessments replicated these findings.

SUBJECTIVE COGNITIVE COMPLAINTS (SCCS) AS A PREDICTOR OF COGNITIVE PERFORMANCE: A LONGITUDINAL STUDY IN PEOPLE WITH SCCS

with nonlinear transformations. The SUVR parametric map was generated using cerebellar grey matter as a reference region for both images. For statistical analysis, we performed voxel-wise analysis to show the association between amyloidosis and NFTs following the model in each group using VoxelStats. [F] MK6240 SUVR w [F]AZD4694 SUVR + age + gender + APOE + education. Results: The unique association between amyloidosis and NFTs was present in entorhinal cortex and PCC in CN; precuneus, PCC, and parahippocampal gyrus in MCI; ACC, entorhinal cortex, parahippocampal gyrus, and orbitofrontal cortex in AD. All groups showed the association in lateral temporal and middle frontal gyrus. Conclusions: Our results revealed both similar and different association patterns between amyloidosis and NFTs across AD stage. Most common association pattern was present at left lateral temporal cortex across all stages while the different association pattern moved from PCC, precuneus, to orbitofrontal cortex in CN, MCI, and AD, respectively. This corroborates the two pathologies spread from the posterior to anterior regions of the brain.

DO BIOMARKERS DIFFERENTIATE COGNITIVE PROFILES IN MILD COGNITIVE IMPAIRMENT DUE TO ALZHEIMER’S DISEASE?

Sr.,, Instituto de Neurociencia Cognitiva y Traslacional (Instituto de Neurologica Cognitiva/National Scientific and Technical Research Council), Buenos Aires, Argentina; Instituto de Neurociencia Cognitiva y Traslacional, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Cient ıficas y T ecnicas, Buenos Aires, Argentina; Neuroscience Institute Favaloro Foundation, Buenos Aires, Argentina; Instituto de Neurologica Cognitiva, Buenos Aires, Argentina. Contact e-mail: mmartinez@ineco.org.ar

MILD BEHAVIORAL IMPAIRMENT CHECKLIST (MBI-C): A PRELIMINARY VALIDATION STUDY

Multiple regression analysis was used to test the predictive value of SCCs at baseline, controlling depression, age and years of schooling on general cognitive performance at follow-up. Results: SCCs correlated significantly with depression, general cognitive performance and episodic memory at baseline (Table 2). General cognitive performance at follow-up was predicted by SCCs from informants at baseline jointly with age and years of schooling explaining 46% of the variance (Model 4 in Table 3), but not by depression (Model 2 in Table 3). Conclusions:SCCs are correlated with depression, general cognitive performance and episodic memory at baseline. SCCs from informants but not depression are relevant in the prediction of cognitive performance over time.

RELATIONSHIP BETWEEN SUBJECTIVE COGNITIVE COMPLAINTS (SCCS), DEPRESSION AND COGNITIVE PERFORMANCE

Background: Neuropsychiatric syndromes have been associated with risk and earlier onset of dementia, but it is unclear whether neuropsychiatric treatment may affect clinical changes in Alzheimer’s disease dementia (AD). This study aimed to investigate whether psychotropics may affect cognitive or functional changes in AD. Methods: Consecutive outpatients with late-onset AD according to National Institute on Aging – Alzheimer’s Association criteria were screened for demographic data and prospectively assessed for psychotropic therapy, the Mini-Mental State Examination (MMSE) and a 15-item Clock Drawing Test (CDT), while caregivers were queried for the Index of Independence in Activities of Daily Living (ADL) and Lawton’s Scale for Instrumental Activities of Daily Living (IADL), and followed for one year. Genotyping for rs7412&rs429358 (APOE gene) was undertaken with TaqMan Real-Time Polymerase Chain Reactions. Baseline behavioral symptoms were assessed according to the Neuropsychiatric Inventory, whereas anti-depressants, anti-psychotics and antiepileptic drugs entered the statistical model, significance at p<0.05. Results:Overall, 193 patients were included (mean age at AD onset 73.2966.4 years-old): 130 were female (67.36%), 103 were APOEε4 carriers (53.37%), 181 used a cholinesterase inhibitor (93.78%), 143 used Memantine (74.09%), 93 used anti-depressants (48.19%), 56 used anti-psychotics (29.02%) and 25 used anti-epileptic drugs (12.95%). Baseline neuropsychiatric burden was not significantly different according to APOE-ε4 carrier status (p1⁄40.9732). Scores in the MMSE, ADL and IADL were significantly lower after one year (p<0.0001), whereas scores in the CDT were marginally significantly lower (p1⁄40.0655). For APOE-ε4 carriers: use of anti-psychotics marginally slowed the decline in IADL (p1⁄40.0611), while use of anti-depressants and anti-epileptic drugs in combination slowed the decline in the MMSE (p1⁄40.0429). For APOE-ε4 non-carriers: use of anti-epileptic drugs accelerated the decline in ADL (p1⁄40.0114), while use of anti-psychotics marginally accelerated the decline in ADL (p1⁄40.0652) and in the MMSE (p1⁄40.0557). Conclusions:The results of this study support the prospective effects of psychotropic drugs over cognitive and functional changes in AD according to APOE-ε4 carrier status, considering a sample in which almost all patients regularly used a cholinesterase inhibitor. Psychotropics differentially affect clinical changes in AD according to APOE-ε4 carrier status, possibly due to genetically-mediated variable efficiency of neural repair mechanisms. (FAPESP grant #2015/10109-5.)

ASSESSING EVERYDAY ACTIVITIES WITH THE SPANISH VERSION OF THE AMSTERDAM IADL QUESTIONNAIRE: GROUP DIFFERENCES AND RELATION WITH COGNITIVE AND PSYCHOSOCIAL MEASURES

was adequate (Pearson’s coefficient 1⁄4. 70, p<. 001) and interrater reliability, excellent (intraclass correlation1⁄4. 99, p<.001). Normative data shown in percentiles were stratified by age and education (See Table). Conclusions: This study suggests that the DCQ is a valid and reliable cognitive screening test. Application of the DCQ on populations with atypical dementias is underway to derive sensitivity and specificity values for various dementias.