Neural correlates of subjective cognitive decline in adults at high risk for Alzheimer's disease.

Introduction: Recently, interest has emerged in subjective cognitive decline (SCD) as a potential precursor to Alzheimer's disease (AD) dementia. Whether individuals with SCD harbor brain alterations in midlife, when AD-related pathology begins, is yet to be elucidated. Furthermore, the role of apolipoprotein ε4 (APOE ε4) allele, a robust AD risk factor, in the relationship between SCD and brain alterations is unknown. We examined whether APOE genotype modulates the association of SCD with brain measures in individuals at high AD risk. Methods: Middle-aged adults with parental history of AD dementia underwent magnetic resonance imaging (MRI) and the Memory Functioning Questionnaire. Regression analysis tested the extent to which SCD was associated with activation during an functional MRI (fMRI) working-memory task, and white-matter microstructure. APOE ε4 genotype was tested as a moderator. Results: Among APOE ε4 carriers, but not among non-carriers, SCD was associated with higher activation in the anterior cingulate (p = 0.003), inferior, middle, and superior frontal cortices (p = 0.041, p = 0.048, p = 0.037, respectively); and with lower fractional anisotropy in the uncinate fasciculus (p = 0.002), adjusting for age, sex, and education. Conclusion: In middle aged, cognitively normal individuals at high AD risk, higher SCD was associated with greater brain alterations possibly reflecting incipient AD pathology. When accompanied by a family history of AD and an APOE ε4 allele, SCD may have important clinical value, allowing a window for early intervention and for participants' stratification in AD prevention clinical trials.

The Israel Registry for Alzheimer's Prevention (IRAP) Study: Design and Baseline Characteristics.

BACKGROUND: Family history of Alzheimer's disease (AD) is associated with increased dementia-risk. OBJECTIVE: The Israel Registry for Alzheimer's Prevention (IRAP) is a prospective longitudinal study of asymptomatic middle-aged offspring of AD patients (family history positive; FH+) and controls (whose parents have aged without dementia; FH-) aimed to unravel the contribution of midlife factors to future cognitive decline and dementia. Here we present the study design, methods, and baseline characteristics. METHODS: Participants are members of the Maccabi Health Services, 40-65 years of age, with exquisitely detailed laboratory, medical diagnoses and medication data available in the Maccabi electronic medical records since 1998. Data collected through IRAP include genetic, sociodemographic, cognitive, brain imaging, lifestyle, and health-related characteristics at baseline and every three years thereafter. RESULTS: Currently IRAP has 483 participants [mean age 54.95 (SD = 6.68) and 64.8% (n = 313) women], 379 (78.5%) FH+, and 104 (21.5%) FH-. Compared to FH-, FH+ participants were younger (p = 0.011), more often males (p = 0.003) and with a higher prevalence of the APOE E4 allele carriers (32.9% FH+, 22% FH-; p = 0.040). Adjusting for age, sex, and education, FH+ performed worse than FH-in global cognition (p = 0.027) and episodic memory (p = 0.022). CONCLUSION: Lower cognitive scores and higher rates of the APOE E4 allele carriers among the FH+ group suggest that FH ascertainment is good. The combination of long-term historical health-related data available through Maccabi with the multifactorial information collected through IRAP will potentially enable development of dementia-prevention strategies already in midlife, a critical period in terms of risk factor exposure and initiation of AD-neuropathology.

Family climate for road safety: a new concept and measure.

This research adapted the workplace concept of safety climate to the domain of safe driving, defining a new construct of "family climate for road safety". Four studies were conducted in Israel with the aim of developing and validating a multidimensional instrument to assess this construct among young drivers. Study 1 (n=632) focused on developing the Family Climate for Road Safety Scale (FCRSS), a self-report scale assessing the family climate by means of seven aspects of the parent-child relationship: Modeling, Feedback, Communication, Monitoring, Noncommitment, Messages, and Limits. Significant differences were found between young men and women on all factors. In addition, significant associations were found between the FCRSS factors on the one hand, and the reported frequency of risky driving and personal commitment to safety on the other. Studies 2-4 confirmed the factorial structure of the FCRSS and the reliability of its factors, adding to its criterion and convergent validity. Study 2 (n=178) yielded significant associations between the scale and young drivers' perception of their parents as involved, encouraging autonomy, and providing warmth; Study 3 (n=117) revealed significant associations between the scale and youngsters' reported proneness to take risks while driving, as well as significant associations between the factors and various dimensions of family functioning; and Study 4 (n=156) found associations between the FCRSS factors and both driving styles (risky, angry, anxious, careful) and family cohesion and adaptability. The discussion deals with the validity and utility of the concept of family climate for road safety and its measurement, addressing the practical implications for road safety.

The contribution of family climate for road safety and social environment to the reported driving behavior of young drivers.

Two studies examined the contribution of the new concept of "family climate for road safety" and several aspects of the social environment to the driving behavior of young drivers. Study 1 (n=120) investigated the effect of the seven dimensions of the family climate for road safety - Modeling, Feedback, Communication, Monitoring, Noncommitment, Messages, and Limits - as well as a general tendency to conform to authority, and peer pressure. Study 2 (n=154) examined the dimensions of family climate for road safety and perceived popularity of reckless driving among peers. The findings indicate associations both between the familial and the social aspects, and between these variables and driving styles, willingness to take risks while driving, reckless driving habits, and personal commitment to safe driving. Positive aspects of the parent-child relationship and high levels of conformity to authority were related to greater endorsement of the careful driving style, whereas family's noncommitment to safety, higher peer pressure, and lower conformity to authority were associated with greater endorsement of the reckless driving style. In addition, positive aspects of the family climate for road safety and lower perceived popularity of reckless driving among friends were associated with more personal commitment to safe driving and a lower tendency for risky driving. The discussion stresses the need to look at the complex set of antecedents of reckless driving among young drivers and addresses the practical implications of the findings for road safety.

Death awareness, maternal separation anxiety, and attachment style among first-time mothers--a terror management perspective.

Two studies explored the interplay between death awareness, attachment style, and maternal separation anxiety among first-time mothers of infants aged 3-12 months. In Study 1 (N = 60), a higher accessibility of death-related thoughts was found following induction of thoughts about separation from the infant. In Study 2 (N = 100), a mortality salience induction led to higher maternal separation anxiety. Contrary to expectations, these findings were not moderated by mother's attachment style. The results are explained in terms of Terror Management Theory, and demonstrate its applicability to maternal emotions and cognitions.