The effect of visual perspective on episodic memory in aging: A virtual reality study.

The possibility of flexibly retrieving our memories using a first-person or a third-person perspective (1PP or 3PP) has been extensively investigated in episodic memory research. Here, we used a Virtual Reality-based paradigm to manipulate the visual perspective used during the encoding stage to investigate age-related differences in the formation of memories experienced from 1PP vs. 3PP. 32 young adults and 32 seniors participated in the study. Participants navigated through two virtual cities to encode complex real-life virtual events, from either a 1PP (as if from their egocentric viewpoint) or a 3PP, while actively controlling an avatar. While recognition accuracy was higher in young adults after encoding in 1PP compared to 3PP, there was no benefit in memory formation in 1PP for older adults. These findings are discussed in terms of both age-related changes in episodic memory functioning and self-referencing processes.

[Long COVID : which neuropsychological intervention ? The example applied at the Leenaards Memory Centre]. / Covid Long : quelle prise en charge neuropsychologique ? La filière proposée au Centre Leenaards de la Mémoire.

A "Long COVID" care management was created at the Leenaards Memory Centre (Lausanne University Hospital) to meet the high demand for neuropsychological examinations in the patients which have persistent symptoms for several months. A multidisciplinary evaluation specifically addressing aspects of fatigue and sleep as well as cognition has been developed to receive these patients. Depending on the severity of their symptoms, they are then oriented towards a holistic group treatment, integrating cognitive remediation including psycho-education, restorative and compensatory methods to cope with their cognitive difficulties, and tools to manage the various symptoms of COVID-long (fatigue, insomnia, stress, depression and reduced quality of life).

Une filière « Covid long ¼ a vu le jour au Centre Leenaards de la mémoire du CHUV pour répondre à une importante demande d'examens neuropsychologiques chez des patients aux symptômes persistant depuis plusieurs mois. Les patients bénéficient d'une évaluation multidisciplinaire qui inclut les aspects de la fatigue et du sommeil ainsi que la cognition. Ils sont ensuite orientés, selon la sévérité de leurs symptômes, vers une prise en charge groupale holistique qui intègre de la remédiation cognitive incluant de la psychoéducation, des méthodes restauratives et compensatoires pour faire face à leurs difficultés cognitives et des outils permettant de gérer les différents symptômes caractéristiques d'un Covid long (fatigue, insomnie, stress, dépression et diminution de la qualité de vie).

[Multidisciplinary assessment and management of neurocognitive complaints in people living with HIV]. / Troubles cognitifs chez les personnes vivant avec le VIH. L'importance d'une prise en charge multidisciplinaire.

Current recommendations for the management of neurocognitive complaints in people living with HIV (PLWH) include a series of evaluations that may start with the exclusion of depression followed by a stepwise approach comprised by neurological, neuropsychological and psychiatric assessment, alongside the performance of an MRI and a lumbar puncture. This extensive evaluation is time demanding, and face PLHW with multiple medical consultations and waiting lists. As a response to these challenges, we have developed a one-day Neuro-HIV platform where PLWH undergo a state of the art multidisciplinary assessment in order to provide the necessary diagnoses and interventions to improve their quality of life.

Les recommandations actuelles pour la prise en charge des troubles neurocognitifs chez les personnes vivant avec le VIH (PVVIH) comprennent une série d'évaluations pouvant commencer par l'exclusion d'une dépression suivie d'une approche progressive comprenant une évaluation neurologique, neuropsychologique et psychiatrique, ainsi que la réalisation d'une IRM et d'une ponction lombaire. Cette évaluation approfondie est chronophage et confronte les PVVIH à de multiples consultations médicales et à des listes d'attente. En réponse à ces défis, nous avons développé une plateforme Neuro-VIH où les PVVIH bénéficient d'une évaluation multidisciplinaire sur une journée dans le but de faire un diagnostic précis et définir les interventions nécessaires pour améliorer leur qualité de vie.

Dementia prevention in memory clinics: recommendations from the European task force for brain health services.

Observational population studies indicate that prevention of dementia and cognitive decline is being accomplished, possibly as an unintended result of better vascular prevention and healthier lifestyles. Population aging in the coming decades requires deliberate efforts to further decrease its prevalence and societal burden. Increasing evidence supports the efficacy of preventive interventions on persons with intact cognition and high dementia risk. We report recommendations for the deployment of second-generation memory clinics (Brain Health Services) whose mission is evidence-based and ethical dementia prevention in at-risk individuals. The cornerstone interventions consist of (i) assessment of genetic and potentially modifiable risk factors including brain pathology, and risk stratification, (ii) risk communication with ad-hoc protocols, (iii) risk reduction with multi-domain interventions, and (iv) cognitive enhancement with cognitive and physical training. A roadmap is proposed for concept validation and ensuing clinical deployment.

Anticholinergic and Sedative Medications Are Associated With Neurocognitive Performance of Well Treated People With Human Immunodeficiency Virus.

Background: We previously showed that anticholinergic (ACH) medications contribute to self-reported neurocognitive impairment (NCI) in elderly people with human immunodeficiency virus (PWH). The current cross-sectional study further evaluated the effect of ACH and sedative drugs on neurocognitive function in PWH who underwent comprehensive neuropsychological evaluation. Methods: A medication review was performed in PWH enrolled in the prospective Neurocognitive Assessment in Metabolic and Aging Cohort within the Swiss HIV Cohort Study. Neurocognitive functions were analyzed in 5 domains (motor skills, speed of information, attention/working memory, executive functions, and verbal learning memory). The effect of ACH and sedative medications on neurocognitive functioning was evaluated using linear regression models for the continuous (mean z-score) outcome and multivariable logistic regression models for the binary (presence/absence) outcome. Results: A total of 963 PWH (80% male, 92% Caucasian, 96% virologically suppressed, median age 52) were included. Fourteen percent of participants were prescribed ≥1 ACH medication and 9% were prescribed ≥1 sedative medication. Overall, 40% of participants had NCI. Sedative medication use was associated with impaired attention/verbal learning and ACH medication use with motor skills deficits both in the continuous (mean z-score difference -0.26 to -0.14, P < .001 and P = .06) and binary (odds ratio [OR], ≥1.67; P < .05) models. Their combined use was associated with deficits in overall neurocognitive functions in both models (mean z-score difference -0.12, P = .002 and OR = 1.54, P = .03). These associations were unchanged in a subgroup analysis of participants without depression (n = 824). Conclusions: Anticholinergic and sedative medications contribute to NCI. Clinicians need to consider these drugs when assessing NCI in PWH.

Serious video games and virtual reality for prevention and neurorehabilitation of cognitive decline because of aging and neurodegeneration.

PURPOSE OF REVIEW: Cognitive decline because of aging and neurodegeneration has become increasingly prevalent. This calls for the implementation of efficacious, motivating, standardized and widely available cognitive interventions for the elderly. In this context, serious video games and virtual reality may represent promising approaches. Here, we review recent research on their potential for cognitive prevention and neurorehabilitation of age-related cognitive decline and mild cognitive impairment (MCI). RECENT FINDINGS: The majority of currently available data in this evolving domain lacks the methodological quality to draw reliable conclusions on the potential of novel technology for cognitive training in older people. However, single well designed randomized controlled trials have reported promising effects of cognitive interventions involving serious video games and virtual reality. The cognitive benefits of exergames promoting physical exercise with and without combined cognitive training remain unclear. SUMMARY: The immersion into stimulating and motivating environments along with training content based on neuroscientific and neuropsychological models may represent a significant advance as compared with conventional computerized cognitive training. Additional research with sound methodology including sufficient sample sizes, active control groups and meaningful outcome measures of everyday function is needed to elucidate the potential of serious video games and virtual reality in multifactorial neurorehabilitation of cognitive decline in aging and neurodegeneration.

Virtual Reality as a Vehicle to Empower Motor-Cognitive Neurorehabilitation.

In this paper, we advocate the combination of four key ingredients that we believe are necessary to design long-lasting effective treatments for neurorehabilitation: (i) motor-cognitive training, (ii) evidence-based neuroscience principles, in particular those related to body perception, (iii) motivational games, and (iv) empowerment techniques. Then, we propose virtual reality (VR) as the appropriate medium to encompass all the requirements mentioned above. VR is arguably one of the most suitable technologies for neurorehabilitation able to integrate evidence-based neurorehabilitation techniques and neuroscience principles into motivating training approaches that promote self-management by empowering patients to own their recovery process. We discuss the advantages and challenges of such an approach on several exemplary applications and outline directions for future developments. We strongly believe that the combination of positive psychology and positive technology mediated by VR-based interventions can heavily impact the rehabilitation outcomes of motor-cognitive functions along all the stages of the rehabilitation path.