Mercedes Montenegro

Subjective memory complaints in the elderly: Prevalence and influence of temporal orientation, depression and quality of life in a population-based study in the city of Madrid

Objectives: It is still a matter of debate whether variables such as education, sex, age, personality and others underlie subjective memory complaints (SMC). Our objectives are to study: the prevalence of memory complaints in the city of Madrid, the distribution of complaints in the population according to socio-demographic variables and the related variables like cognitive performance, quality of life, perceived health status and functional ability. To our knowledge, this is the first study about the prevalence of SMC in Spain. Methods: We adopted a transversal descriptive epidemiological study. The survey sample size is 1637 persons above 64 years. SMC were obtained through questions regarding memory complaints. Results: 524 (32.4%) subjects reported SMC. The prevalence of SMC depends on age, education, sex, mood and cognitive performance. SMC rises from 24% in the 65–69 age groups to 57% in the 90 and above group. The percentage of subjects with SMC was 52.8% among persons diagnosed with depression or anxiety, and 28.7% among subjects without. Performance on cognitive tests such as orientation showed that subjects without orientation failures (81%) have a 22.2% SMC frequency and subjects who fail all the orientation items (4%) have a 93% frequency. A logistic regression analysis showed that those variables indicating a better prediction of group membership (SMC vs. controls) were orientation in time, quality of life and depression–anxiety. Conclusion: Complaints reflect various processes and are the result of various elements; however, our study highlights the importance of factors such as cognitive performance, depression–anxiety and quality of life.

Memory complaints in the elderly: quality of life and daily living activities. A population based study.

OBJECTIVES We investigate whether Subjective Memory Complaints (SMC) are associated with specific aspects of quality of life and activities of daily living. METHODS Cross-sectional descriptive epidemiological study (random sample of the non-institutionalized census population): 1637 subjects over 64 years. SMC were obtained through questions regarding memory complaints. Coop/Wonca questionnaire, Katz Index and Lawton Scale were also administrated. RESULTS A significant association between SMC with global quality of life and every dimension of quality of life is found (p<0.05). There is also a significant association with every item of Lawton Scale (p<0.001) and Katz Index (p<0.01). Variables associated with SMC identified by logistic regression are: difficulties in using telephone, in taking medication, in social activities and a low self perceived health. DISCUSSION Subjects with memory complaints are a heterogeneous group. Quality of life and activities of daily living are both associated with SMC.

Increased biomagnetic activity in healthy elderly with subjective memory complaints

OBJECTIVE Subjective memory complaints (SMCs) are frequently reported by elderly people with or without objective cognitive impairment (OMI) as assessed by neuropsychological tests. We investigate whether SMCs are associated with altered brain biomagnetic patterns even in the absence of OMI. METHODS We report spatio-temporal patterns of brain magnetic activity recorded with magnetoencephalography during a memory task in 51 elderly participants divided into the following groups: patients with mild cognitive impairment (MCI) with SMC and OMI, individuals with SMC but not OMI, and healthy controls without neither SMC nor OMI. Exclusion criteria for all three groups included a diagnosis of depression or any other psychiatric condition. RESULTS No statistically significant differences were found between MCI patients and participants with SMC. However, the SMC showed higher activation, between 200 and 900 ms after stimulus onset, than the control group in posterior ventral regions and in the dorsal pathway. MCI patients showed higher activation than the control group in the posterior part of the ventral pathway. CONCLUSIONS These findings suggest that similar physiological mechanisms may underlie SMC and MCI, which could be two stages in a cognitive continuum. SIGNIFICANCE MEG provide different neurophysiological profiles between SMC and control subjects.

Early dysfunction of functional connectivity in healthy elderly with subjective memory complaints

It is still an open question whether subjective memory complaints (SMC) can actually be considered to be clinically relevant predictors for the development of an objective memory impairment and even dementia. There is growing evidence that suggests that SMC are associated with an increased risk of dementia and with the presence of biological correlates of early Alzheimers disease. In this paper, in order to shed some light on this issue, we try to discern whether subjects with SMC showed a different profile of functional connectivity compared with subjects with mild cognitive impairment (MCI) and healthy elderly subjects. In the present study, we compare the degree of synchronization of brain signals recorded with magnetoencephalography between three groups of subjects (56 in total): 19 with MCI, 12 with SMC and 25 healthy controls during a memory task. Synchronization likelihood, an index based on the theory of nonlinear dynamical systems, was used to measure functional connectivity. Briefly, results show that subjects with SMC have a very similar pattern of connectivity to control group, but on average, they present a lower synchronization value. These results could indicate that SMC are representing an initial stage with a hypo-synchronization (in comparison with the control group) where the brain system is still not compensating for the failing memory networks, but behaving as controls when compared with the MCI subjects.

Association of perceived health and depression with older adults’ subjective memory complaints: contrasting a specific questionnaire with general complaints questions

The objectives of this paper were to evaluate the association of subjective memory complaints (SMC) with perceived state of health, mood and episodic memory (associative and everyday memory). We studied these areas using two different complaint assessment methods (three general questions and a validated scale). The study included 269 older adults (aged 65–87) with age-related memory changes, but without cognitive impairment. They were evaluated with Mini-cognitive Exam, Rivermead Behavioural Memory Test (a test of everyday memory), Paired Associates Learning Test, Memory Failures of Everyday Questionnaire, three memory complaints questions, Nottingham Health Profile and Geriatric Depression Scale. The results indicated that memory for everyday performance, mood and perceived health were independent predictors of SMC, with mood and perceived health being stronger predictors than actual memory performance. Age was not associated with subjective memory and, with regard to level of education, only the illiterate level was associated with SMC. A specific questionnaire on subjective memory was found to be preferable to an aggregate of complaints questions on self-reported memory; only health profile was found to predict the outcomes on memory complaints questions. Our conclusion is that a group of underlying factors other than everyday memory were playing a role in SMC; these SMC of subjects with age-related memory changes were mainly associated with subjective evaluations of their health.

Synchronization during an internally directed cognitive state in healthy aging and mild cognitive impairment: a MEG study

Mild cognitive impairment (MCI) is a stage between healthy aging and dementia. It is known that in this condition the connectivity patterns are altered in the resting state and during cognitive tasks, where an extra effort seems to be necessary to overcome cognitive decline. We aimed to determine the functional connectivity pattern required to deal with an internally directed cognitive state (IDICS) in healthy aging and MCI. This task differs from the most commonly employed ones in neurophysiology, since inhibition from external stimuli is needed, allowing the study of this control mechanism. To this end, magnetoencephalographic (MEG) signals were acquired from 32 healthy individuals and 38 MCI patients, both in resting state and while performing a subtraction task of two levels of difficulty. Functional connectivity was assessed with phase locking value (PLV) in five frequency bands. Compared to controls, MCIs showed higher PLV values in delta, theta, and gamma bands and an opposite pattern in alpha, beta, and gamma bands in resting state. These changes were associated with poorer neuropsychological performance. During the task, this group exhibited a hypersynchronization in delta, theta, beta, and gamma bands, which was also related to a lower cognitive performance, suggesting an abnormal functioning in this group. Contrary to controls, MCIs presented a lack of synchronization in the alpha band which may denote an inhibition deficit. Additionally, the magnitude of connectivity changes rose with the task difficulty in controls but not in MCIs, in line with the compensation-related utilization of neural circuits hypothesis (CRUNCH) model.

Alpha band disruption in the AD-continuum starts in the Subjective Cognitive Decline stage: a MEG study

The consideration of Subjective Cognitive Decline (SCD) as a preclinical stage of AD remains still a matter of debate. Alpha band alterations represent one of the most significant changes in the electrophysiological profile of AD. In particular, AD patients exhibit reduced alpha relative power and frequency. We used alpha band activity measured with MEG to study whether SCD and MCI elders present these electrophysiological changes characteristic of AD, and to determine the evolution of the observed alterations across AD spectrum. The total sample consisted of 131 participants: 39 elders without SCD, 41 elders with SCD and 51 MCI patients. All of them underwent MEG and MRI scans and neuropsychological assessment. SCD and MCI patients exhibited a similar reduction in alpha band activity compared with the no SCD group. However, only MCI patients showed a slowing in their alpha peak frequency compared with both SCD and no SCD. These changes in alpha band were related to worse cognition. Our results suggest that AD-related alterations may start in the SCD stage, with a reduction in alpha relative power. It is later, in the MCI stage, where the slowing of the spectral profile takes place, giving rise to objective deficits in cognitive functioning.

Functional Connectivity Disruption in Subjective Cognitive Decline and Mild Cognitive Impairment: A Common Pattern of Alterations

Functional connectivity (FC) alterations represent a key feature in Alzheimers Disease (AD) and provide a useful tool to characterize and predict the course of the disease. Those alterations have been also described in Mild Cognitive Impairment (MCI), a prodromal stage of AD. There is a growing interest in detecting AD pathology in the brain in the very early stages of the disorder. Subjective Cognitive Decline (SCD) could represent a preclinical asymptomatic stage of AD but very little is known about this population. In the present work we assessed whether FC disruptions are already present in this stage, and if they share any spatial distribution properties with MCI alterations (a condition known to be highly related to AD). To this end, we measured electromagnetic spontaneous activity with MEG in 39 healthy control elders, 41 elders with SCD and 51 MCI patients. The results showed FC alterations in both SCD and MCI compared to the healthy control group. Interestingly, both groups exhibited a very similar spatial pattern of altered links: a hyper-synchronized anterior network and a posterior network characterized by a decrease in FC. This decrease was more pronounced in the MCI group. These results highlight that elders with SCD present FC alterations. More importantly, those disruptions affected AD typically related areas and showed great overlap with the alterations exhibited by MCI patients. These results support the consideration of SCD as a preclinical stage of AD and may indicate that FC alterations appear very early in the course of the disease.

APOE ε4 Modulation of Training Outcomes in Several Cognitive Domains in a Sample of Cognitively Intact Older Adults

BACKGROUND Most research points to the ɛ4 allele of the apolipoprotein E (APOE) gene as the most recognizable genetic risk factor associated with Alzheimers disease pathogenesis. It has been also suggested that the APOEɛ4 allele has a negative influence on cognitive functioning, which begins long before cognitive impairment becomes manifest. However, still, little is known about the APOEɛ4 interaction with cognitive intervention programs. OBJECTIVE The main goal of this study was to explore whether there was a differential APOE genotype modulation effect after cognitive training in different domains, such as language comprehension, executive functions, and memory. Contrary to other studies, hippocampal volume was controlled for. METHODS Fifty older adults (65+ years; 30 women and 20 men) participated in a multi-domain cognitive training that involved 30 sessions taking place over 12 weeks. Half of the participants were APOEɛ4 carriers. The control group was matched in age, gender, normalized hippocampal volume, cognitive reserve, Mini-Mental State Examination score, and Geriatric Depression Scale-Short Version. RESULTS The study revealed that there were consistent treatment benefits in complex sentence comprehension (noncanonical sentences and sentences with two propositions), a domain that was not directly trained, but only in the A POEɛ4 noncarrier group. CONCLUSION Genetic profile modulates training outcomes in sentence comprehension.

Efficacy of Cognitive Training in Older Adults with and without Subjective Cognitive Decline Is Associated with Inhibition Efficiency and Working Memory Span, Not with Cognitive Reserve

The present study explores the role of cognitive reserve, executive functions, and working memory (WM) span, as factors that might explain training outcomes in cognitive status. Eighty-one older adults voluntarily participated in the study, classified either as older adults with subjective cognitive decline or cognitively intact. Each participant underwent a neuropsychological assessment that was conducted both at baseline (entailing cognitive reserve, executive functions, WM span and depressive symptomatology measures, as well as the Mini-Mental State Exam regarding initial cognitive status), and then 6 months later, once each participant had completed the training program (Mini-Mental State Exam at the endpoint). With respect to cognitive status the training program was most beneficial for subjective cognitive decline participants with low efficiency in inhibition at baseline (explaining a 33% of Mini-Mental State Exam total variance), whereas for cognitively intact participants training gains were observed for those who presented lower WM span.