seniors

Older adults' distractability can be used to help put a face to a name

  • A small study has used older adults’ inability to ignore irrelevant information to improve their memory for face-name pairs.

One important reason for the greater cognitive problems commonly experienced as we age, is our increasing difficulty in ignoring distracting and irrelevant information. But it may be that in some circumstances that propensity can be used to help memory.

The study involved 25 younger (17-23) and 32 older adults (60-86), who were shown the faces and names of 24 different people and told to learn them. The names were written in bright blue text and placed on the forehead, and each photo was shown for 3 seconds. After the learning session, participants were immediately tested on their recall of the name for each face. The test was self-paced. Following a 10 minute interval, during which they were given psychological tests, they were shown more photos of faces, but this time were told to ignore the text — their task was to push a button when they saw the same face appear twice in a row. The text was varied: sometimes names, sometimes words, and sometimes nonwords. Ten of the same faces and names from the first task were repeated in the series of 108 trials; all items were repeated three times (thus, 30 repeated face-name pairs; 30 other face-name pairs; 24 face-word pairs; 24 face-nonword pairs). The photos were each displayed for 1.5 seconds. A delayed memory test was given after another 10 minutes of psychological testing. A cued-recall test was followed by a forced-choice recognition test.

Unsurprisingly, overall younger adults remembered more names than older adults, and both groups remembered more on the second series, with younger adults improving more. But younger adults showed no benefit for the repeated face-name pairs, while — on the delayed recall task only — older adults did.

Interestingly, there was no sign, in either group, of repeated names being falsely recalled or recognized. Nor did they significantly affect familiarity.

It seems that this sort of inadvertent repetition doesn’t improve memory for items (faces, names), but, specifically, the face-name associations. The study builds on previous research indicating that older adults hyperbind distracting names and attended faces, which produces better learning of these face-name pairs.

It’s suggested that repetition as distraction might act as a sort of covert retrieval practice that relies on a nonconscious process specifically related to the priming of relational associations. Perhaps older adults’ vulnerability to distraction is not simply a sign of degeneration, but reflects a change of strategy to one that increases receptiveness to environmental regularities that have predictive value. Younger adults have narrowed attention that, while it allows them greater focus on the task, also stops them noticing information that is immediately irrelevant but helpful further down the track.

The researchers are working on a training program to help older adults with MCI use this benefit to better remember faces and names.

https://www.eurekalert.org/pub_releases/2018-03/bcfg-oad031618.php

Reference: 

Biss, Renée K., Rowe, Gillian, Weeks, Jennifer C., Hasher, Lynn, Murphy, Kelly J. 2018. Leveraging older adults’ susceptibility to distraction to improve memory for face-name associations. Psychology and Aging, 33(1), 158-164.

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Rigorous exercise does not slow dementia decline

  • A study involving nearly 500 people with dementia has found that a rigorous physical exercise program did nothing to slow their decline.

A number of studies have found that physical exercise can help delay the onset of dementia, however the ability of exercise to slow the decline once dementia has set in is a more equivocal question. A large new study answers this question in the negative.

The study involved 494 people with mild-to-moderate dementia (average age 77; 61% male), of whom 329 were randomly assigned to a four-month aerobic and strength exercise programme and 165 were assigned to usual care. The exercise program was personalized, and involved two 60-90 minute gym sessions every week, plus a further hour at home. Nearly two-thirds of the exercise group attended more than three-quarters of the gym sessions.

While the exercise group did get physically fitter, their cognitive fitness (as measured by ADAS-cog score) actually worsened slightly.

The researchers emphasize that this was a specialized and intense exercise program, and in no way should it be taken to mean that gentle exercise, which is good for dementia sufferers, should be avoided.

https://www.theguardian.com/society/2018/may/16/rigorous-exercise-makes-dementia-worse-study-concludes

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Gist memory may be why false memories are more common in older adults

  • Gist processing appears to play a strong role in false memories.
  • Older adults rely on gist memory more.
  • Older adults find it harder to recall specific sensory details that would help confirm whether a memory is true.

Do older adults forget as much as they think, or is it rather that they ‘misremember’?

A small study adds to evidence that gist memory plays an important role in false memories at any age, but older adults are more susceptible to misremembering because of their greater use of gist memory.

Gist memory is about remembering the broad story, not the details. We use schemas a lot. Schemas are concepts we build over time for events and experiences, in order to relieve the cognitive load. They allow us to respond and process faster. We build schemas for such things as going to the dentist, going to a restaurant, attending a lecture, and so on. Schemas are very useful, reminding us what to expect and what to do in situations we have experienced before. But they are also responsible for errors of perception and memory — we see and remember what we expect to see.

As we get older, we do of course build up more and firmer schemas, making it harder to really see with fresh eyes. Which means it’s harder for us to notice the details, and easier for us to misremember what we saw.

A small study involving 20 older adults (mean age 75) had participants look at 26 different pictures of common scenes (such as a farmyard, a bathroom) for about 10 seconds, and asked them to remember as much as they could about the scenes. Later, they were shown 300 pictures of objects that were either in the scene, related to the scene (but not actually in the scene), or not commonly associated to the scene, and were required to say whether or not the objects were in the picture. Brain activity was monitored during these tests. Performance was also compared with that produced in a previous identical study, involving 22 young adults (mean age 23).

As expected and as is typical, there was a higher hit rate for schematic items and a higher rate of false memories for schematically related lures (items that belong to the schema but didn’t appear in the picture). True memories activated the typical retrieval network (medial prefrontal cortex, hippocampus/parahippocampal gyrus, inferior parietal lobe, right middle temporal gyrus, and left fusiform gyrus).

Activity in some of these regions (frontal-parietal regions, left hippocampus, right MTG, and left fusiform) distinguished hits from false alarms, supporting the idea that it’s more demanding to retrieve true memories than illusory ones. This contrasts with younger adults who in this and previous research have displayed the opposite pattern. The finding is consistent, however, with the theory that older adults tend to engage frontal resources at an earlier level of difficulty.

Older adults also displayed greater activation in the medial prefrontal cortex for both schematic and non-schematic hits than young adults did.

While true memories activated the typical retrieval network, and there were different patterns of activity for schematic vs non-schematic hits, there was no distinctive pattern of activity for retrieving false memories. However, there was increased activity in the middle frontal gyrus, middle temporal gyrus, and hippocampus/parahippocampal gyrus as a function of the rate of false memories.

Imaging also revealed that, like younger adults, older adults also engage the ventromedial prefrontal cortex when retrieving schematic information, and that they do so to a greater extent. Activation patterns also support the role of the mediotemporal lobe (MTL), and the posterior hippocampus/parahippocampal gyrus in particular, in determining true memories from false. Note that schematic information is not part of this region’s concern, and there was no consistent difference in activation in this region for schematic vs non-schematic hits. But older adults showed this shift within the hippocampus, with much of the activity moving to a more posterior region.

Sensory details are also important for distinguishing between true and false memories, but, apart from activity in the left fusiform gyrus, older adults — unlike younger adults — did not show any differential activation in the occipital cortex. This finding is consistent with previous research, and supports the conclusion that older adults don’t experience the recapitulation of sensory details in the same way that younger adults do. This, of course, adds to the difficulty they have in distinguishing true and false memories.

Older adults also showed differential activation of the right MTG, involved in gist processing, for true memories. Again, this is not found in younger adults, and supports the idea that older adults depend more on schematic gist information to assess whether a memory is true.

However, in older adults, increased activation of both the MTL and the MTG is seen as rates of false alarms increase, indicating that both gist and episodic memory contribute to their false memories. This is also in line with previous research, suggesting that memories of specific events and details can (incorrectly) provide support for false memories that are consistent with such events.

Older adults, unlike young adults, failed to show differential activity in the retrieval network for targets and lures (items that fit in with the schema, but were not in fact present in the image).

What does all this mean? Here’s what’s important:

  • older adults tend to use schema information more when trying to remember
  • older adults find it harder to recall specific sensory details that would help confirm a memory’s veracity
  • at all ages, gist processing appears to play a strong role in false memories
  • memory of specific (true) details can be used to endorse related (but false) details.

What can you do about any of this? One approach would be to make an effort to recall specific sensory details of an event rather than relying on the easier generic event that comes to mind first. So, for example, if you’re asked to go to the store to pick up orange juice, tomatoes and muesli, you might end up with more familiar items — a sort of default position, as it were, because you can’t quite remember what you were asked. If you make an effort to remember the occasion of being told — where you were, how the other person looked, what time of day it was, other things you talked about, etc — you might be able to bring the actual items to mind. A lot of the time, we simply don’t make the effort, because we don’t think we can remember.

https://www.eurekalert.org/pub_releases/2018-03/ps-fdg032118.php

Reference: 

[4331] Webb, C. E., & Dennis N. A.
(Submitted).  Differentiating True and False Schematic Memories in Older Adults.
The Journals of Gerontology: Series B.

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Lifestyle changes can prevent cognitive decline even in genetically at-risk individuals

  • A large study indicates that lifestyle changes, together with advice and support for managing vascular health, can help prevent cognitive decline even in carriers of the Alzheimer's gene.

A Finnish study involving over 1000 older adults suggests that a counselling program can prevent cognitive decline even among those with the Alzheimer’s gene.

The study involved 1,109 older adults (aged 60-77) of whom 362 were carriers of the APOE4 gene. Some of the participants received regular lifestyle counselling (general health advice), while the rest received “enhanced” lifestyle counselling, involving nutrition counselling, physical and cognitive exercises, and support in managing the risk of cardiovascular diseases.

Earlier findings from the FINGER (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability) trial showed that the regular lifestyle counselling group had a significantly increased risk of cognitive and functional impairment compared to the group receiving enhanced counselling. This analysis shows that this holds true even for those with the Alzheimer's gene, and indeed, might even be more helpful for carriers of the risky gene.

The findings emphasize the importance of early prevention strategies that target multiple modifiable risk factors simultaneously.

https://www.eurekalert.org/pub_releases/2018-01/uoef-lcp012518.php

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The right diet may slow cognitive decline in stroke survivors

  • An observational study involving over 100 stroke survivors suggests the MIND diet may help substantially slow cognitive decline in those impaired by stroke.

A pilot study involving 106 participants of the Rush Memory and Aging Project who had experienced a stroke followed participants for an average of 5.9 years, testing their cognitive function and monitoring their eating habits using food journals. It was found that those whose diets scored highest on the MIND (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay) diet score had substantially slower rates of cognitive decline than those who scored lowest. The estimated effect of the diet remained strong even after taking into account participants' level of education and participation in cognitive and physical activities. Those who instead scored high on the Mediterranean or DASH diets did not show the same slower decline.

Both the Mediterranean and DASH diets have been shown to be protective against coronary artery disease and stroke, but this finding suggests the MIND diet is better for overall brain health.

The MIND diet is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. It has 15 components: 10 “brain-healthy food groups” and five unhealthy groups (red meat, butter, cheese, pastries and sweets, and fried or fast food).

To adhere to the MIND diet, you need to

  • eat at least three daily servings of whole grains
  • eat a green leafy vegetable and one other vegetable every day
  • drink a regular glass of wine
  • snack most days on nuts
  • have beans every other day or so
  • eat poultry and berries at least twice a week
  • eat fish at least once a week
  • limit butter to less than 1 1/2 teaspoons a day
  • eat less than 5 servings a week of sweets and pastries
  • eat less than one serving per week of whole fat cheese, and fried or fast food.

The researchers stress that this is a preliminary study, observational only. They are currently seeking participants for a wider, intervention study.

https://www.eurekalert.org/pub_releases/2018-01/rumc-mdm012418.php

Reference: 

Laurel J. Cherian & Martha Clare Morris: Presentation at the American Stroke Association's International Stroke Conference 2018 in Los Angeles, January 25.

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Reduced face memorization ability in those with MCI

  • A small study suggests that the ability to remember faces specifically is impaired in those with amnestic mild cognitive impairment.

A small Japanese study has found evidence that those with amnestic mild cognitive impairment (aMCI) show a specific decline in their ability to recognize faces, and this is accompanied by changes in the way they scan faces.

The study involved 18 patients with aMCI and 18 age-matched healthy controls. Participants were tested on their ability to perceive and remember images of faces and houses.

Those with aMCI showed poorer memory for faces compared to their memory for houses, while control participants showed no difference between the two. Moreover, compared with controls, those with aMCI spent less time looking at the eyes in the image, while increasing the time they spent looking at the mouths of faces.

In general, people have an excellent memory for faces compared to other visual stimuli, and the eyes are particularly useful in helping us remember the face. The researchers suggest that damage to the brain region known as the fusiform face area (FFA) is responsible for the abnormal processing of faces. It is worth noting that a case study of a patient with acquired prosopagnosia revealed the same pattern of fixating on the mouth rather than the eyes.

The finding is consistent with several other studies showing impaired face processing in those with aMCI, but there is some controversy about that conclusion.

https://www.eurekalert.org/pub_releases/2017-11/ku-pso112117.php

Full text available at https://www.nature.com/articles/s41598-017-14585-5

 

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Personality changes during transition to MCI

  • Behavioral and personality changes seen in those with Alzheimer's appear to be reflected in very early increases in neuroticism and declines in openness.

Mild cognitive impairment (MCI) is a precursor of Alzheimer's disease, although having MCI does not mean you are definitely going to progress to Alzheimer's. A new study suggests that one sign of MCI development might be personality changes.

The study involved 277 cognitively healthy residents of a U.S. County, who had the apolipoprotein E (APOE) ɛ4 gene (otherwise known as the ‘Alzheimer’s gene’). Over the study period (around 7 years), 25 developed MCI. Their performance on the Neuroticism, Extraversion, and Openness Personality Inventory—Revised (delivered at the beginning of the study, as well as at other times during the study) was compared with that of the other 252 participants.

Neuroticism increased significantly more in those developing MCI, and openness decreased more. Those developing MCI also showed significantly greater depression, somatization, irritability, anxiety, and aggressive attitude. (Somatization refers to the tendency to generate physical manifestations in response to psychological distress.)

While such personality changes may be barely noticeable at this stage, it may be that diagnosing such early personality changes could help experts develop earlier, safer, and more effective treatments — or even prevention options — for the more severe types of behavior challenges that affect people with Alzheimer's disease.

https://www.eurekalert.org/pub_releases/2018-01/ags-pcd012318.php

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Dementia trend shows later onset with fewer years of the disease

  • A large study shows that the falling rates of dementia reflect later onset coupled with shorter time spent with the dementia.

A large study using data from the famous Framingham Heart Study has compared changes in dementia onset over the last three decades. The study found that over time the age of onset has increased while the length of time spent with dementia has decreased.

The study involved 5,205 participants from the Framingham Original and Offspring cohorts. Four 5-year periods anchored to different baseline examinations (participants have been examined every four years) were compared. These baseline years are (on average, because participants’ schedules are different): 1978, 1989, 1996, 2006. Participants were those who were aged 60 or older and dementia-free at the start of a time period. There were at least 2000 participants in each time period. In total, there were 371 cases of dementia, and 43% of dementia cases survived more than 5 years after diagnosis.

It was found that the mean age of dementia onset increased by around two years per time period, while age at death increased by around one year. Length of survival after diagnosis decreased over time for everyone, taken as a whole, and also for each gender and education level, taken separately. Survival was almost 6 years in the first time period, and only three years in the last. But the mean age of onset was 80 in the first period, compared to over 86 in the last.

However, the changes haven’t been steady over the 30 years, but rather occurred mostly in those with dementia in 1986–1991 compared to 1977–1983.

Part of the reason for the changes is thought to be because of the reduced risk of stroke (largely because of better blood pressure management), and the better stroke treatments available. Stroke is a major risk factor for dementia. Other reasons might include lower burdens of multiple infections, better education, and better nutrition.

https://www.eurekalert.org/pub_releases/2018-04/uoth-dts042318.php

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Daily crosswords linked to sharper brain in later life

  • A very large online study has found that doing word puzzles regularly protects against age-related cognitive decline.

Data from more than 17,000 healthy people aged 50 and over has revealed that the more regularly participants engaged with word puzzles, the better they performed on tasks assessing attention, reasoning and memory.

Study participants took part in online cognitive tests, as well as being asked how frequently they did word puzzles such as crosswords. There was a direct relationship between the frequency of word puzzle use and the speed and accuracy of performance on nine cognitive tasks.

The effect was considerable. For example, on test measures of grammatical reasoning speed and short-term memory accuracy, performing word puzzles was associated with brain function equivalent to ten years younger than participants’ chronological age.

The next question is whether you can improve brain function by engaging in puzzles.

The study used participants in the PROTECT online platform, run by the University of Exeter and Kings College London. Currently, more than 22,000 healthy people aged between 50 and 96 are registered in the study. PROTECT is a 10 year study with participants being followed up annually to enable a better understanding of cognitive trajectories in this age range.

https://www.eurekalert.org/pub_releases/2017-07/uoe-dcl071417.php

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The Relationship Between the Frequency of Word Puzzle Use and Cognitive Function in a Large Sample of Adults Aged 50 to 96 Years, was presented at the Alzheimer's Association International Conference (AAIC) 2017 on July 17.

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How risky is surgery for older adults' cognitive function?

Several studies suggest that post-operative cognitive decline in older adults is due to several factors:

  • the stress of hospitalization, if unexpected
  • brain inflammation caused by an immune response from the brain’s microglia
  • post-operative delirium.

It also seems that higher levels of cognitive function, higher levels of engagement in certain cognitive activities, and better cerebrovascular health, all protect against such decline.

Unplanned hospitalizations accelerate cognitive decline in older adults

Data from the Rush Memory and Aging Project has found that emergency and urgent hospitalizations are associated with an increased rate of cognitive decline in older adults.

Non-elective hospitalizations were associated with an approximately 60% acceleration in the rate of cognitive decline from before hospitalization. Elective hospitalizations, however, were not associated with acceleration in the rate of decline at all.

Of the 930 participants (average age 81), 613 were hospitalized at least once over an average of almost five years of observation. Of those who were hospitalized, 260 (28%) had at least one elective hospital admission, and 553 (60%) had at least one non-elective hospital admission. These groups included 200 participants (22%) who had both types of hospitalizations.

The data was presented at the Alzheimer's Association International Conference in London on July 17.

https://www.eurekalert.org/pub_releases/2017-07/rumc-hac071717.php

Inflammation triggered by brain's own immune cells behind post-surgical decline

There is growing evidence that inflammation might be responsible for the cognitive decline seen in many older adults after surgery. Now a mouse study provides evidence that brain inflammation and cognitive decline following surgery are triggered by the brain's microglia.

When mice had their microglia temporarily depleted before surgery, they didn’t show any cognitive decline several days after surgery. They also had much lower levels of inflammatory molecules in the hippocampus. Controls — those not receiving the experimental drug to deplete microglia to around 5% of normal levels — did typically show a drop in cognitive performance.

Microglia levels returned to normal within two days after the treatment was stopped, and there was no sign of any impairment in surgical wound healing as a result of the intervention.

https://www.eurekalert.org/pub_releases/2017-04/uoc--cda040517.php

Delirium in older patients after surgery linked to long-term cognitive decline

A 3-year study looking at short-term and long-term cognitive decline in older patients following a surgery found that those who experienced delirium after the surgery showed significantly greater decline than those who didn’t suffer such post-surgical confusion.

The study involved 560 patients (70+), of whom 134 experienced delirium. Both groups showed a significant cognitive decline at one month, followed by a return to their previous level of cognitive function at two months and then a gradual decline for the next 34 months. However, the rate of decline over the three year follow-up was not significant for those who hadn’t experienced delirium.

Those who suffered delirium also had significantly lower cognitive function before surgery.

The odd finding that even the delirium group recovered their cognitive function at two months, before once again declining, suggests that something about the delirium triggers a cascade of events which leads to progressive, long-lasting effects.

http://www.eurekalert.org/pub_releases/2016-07/hsif-dio071416.php

Who’s more likely to develop delirium after surgery?

Delirium after surgery can lead to long-term cognitive decline in older adults — but not always. So what makes the difference?

A preliminary study involving 126 older adults suggests the answer lies in their cognitive function before surgery. Their global cognition score explained the most variation, with other significant factors including: IQCODE score, cognitive independent activities of daily living impairment, living alone, cerebrovascular disease, Charlson comorbidity index score, and exhaustion level. Taken together, these factors explained 32% of the variation in people’s outcome.

Delirium, an acute state of confusion, is a common condition affecting up to 50% of hospitalized older adults.

https://www.eurekalert.org/pub_releases/2017-03/hsif-plc031417.php

Certain leisure activities may reduce post-surgical delirium among older adults

A study of 142 older adults who underwent elective surgery found that greater participation in cognitive activities was linked with a lower incidence and lower severity of delirium.

Nearly a third of the patients (average age 71) developed post-operative delirium. Those who did had participated in fewer leisure activities before surgery compared with people who didn't experience delirium.

Out of all the activities, reading books, using email, and playing computer games reduced the risk of delirium. Playing computer games and singing were the only two activities that predicted lower severity of delirium.

The protection afforded was dose-dependent, with each additional leisure activity reducing post-operative delirium by 8%.

http://www.eurekalert.org/pub_releases/2016-06/ags-cla062116.php

http://www.eurekalert.org/pub_releases/2016-06/w-crm062216.php

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