Awareness of Psychiatric Symptoms in a Mixed Clinical Sample of Older Adults.

OBJECTIVE: This study examined the neuropsychological correlates and impact on caregiver distress of reduced awareness of mood symptoms in patients with suspected neurodegenerative disease. METHOD: Records from a clinical sample of older adults were examined (N = 940). RESULTS: More than one-third of patient and caregiver ratings of mood symptoms did not agree (comparing patient and caregiver self-report measures); 27.9% of patients were unaware of depression (UoD) and 16.6% of patients were unaware of anxiety (UoA). The UoD group exhibited poorer verbal memory and executive abilities and the UoA group exhibited poorer verbal memory than those with preserved awareness. Unawareness was not associated with caregiver distress. CONCLUSIONS: These findings highlight the importance of capturing informant report in clinical practice with older adults suspected of cognitive impairment. Unawareness of mood symptoms was related to memory dysfunction and-to a lesser extent-to executive abilities and may have implications for addressing patient and caregiver needs for disorders affecting these cognitive systems.

Training in improvisation techniques helps reduce caregiver burden and depression: Innovative Practice.

This study measured outcomes of a novel pilot program designed to teach improvisation skills to caregivers of family members with dementia. Fifteen caregivers completed questionnaires measuring changes in their perception of burden (Zarit Burden Interview), depression (Beck Depression Inventory), their cared-for person's neuropsychiatric symptoms (Neuropsychiatric Inventory Questionnaire), and experiences related to caregiving. Caregivers' depressive symptoms and sense of burden significantly decreased after completing the six-week program. Caregivers reported that their loved ones' neuropsychiatric symptoms increased during the course of the intervention, though associated distress did not also increase. The Improv for Care program shows promise as an intervention for caregivers to improve stress, mood, and coping skills.

Strategy use and verbal memory in older adults: The role of intellectual functioning and the preferential impact of semantic clustering.

Objective: The relative importance of various mechanisms supporting declarative verbal memory among older adults remains uncertain. The present study examined the impact of strategy use (specifically semantic clustering) versus other variables known to impact memory performance (age, sex, education, FSIQ, processing speed, and executive functioning) on verbal memory functioning among healthy older adults.Methods: Healthy older adults from the California Verbal Learning Test, Second Edition standardization sample were selected (N = 242). Relationships between verbal memory, demographics variables, and neuropsychological factors were established, and a hierarchical regression analysis was conducted to examine the individual contributions of these variables in predicting memory performance.Results: Bivariate correlations suggested that memory was significantly related to demographic factors, IQ, executive functioning, and semantic clustering. Importantly, hierarchical regression analysis revealed that semantic clustering significantly and independently contributed to recall performance beyond the demonstrated impacts of FSIQ, speed, executive functioning, and demographic variables. Furthermore, FSIQ did not moderate the relationship between semantic clustering and memory indicating that this strategy is an important factor in bolstering recall, independent of FSIQ.Conclusions: Our results highlight the critical importance of semantic clustering utilization in enhancing memory performance among healthy older adults.

Influence of sex differences in interpreting learning and memory within a clinical sample of older adults.

Sex is an important factor to consider when evaluating memory with older adults. This present study aimed to examine sex differences in memory within a clinical sample of older adults (N = 1084). Raw learning and recall scores on the Hopkins Verbal Learning Test, Revised (HVLT-R) and Brief Visuospatial Memory Test, Revised (BVMT-R) were compared between sexes within the entire sample and cohorts stratified by age. Within the entire sample, women outperformed men in HVLT-R learning and recall, and there were no sex differences in BVMT-R performance. These sex differences, however, were absent or reversed for those with impaired HVLT-R performance and functional deficits, indicating that women retain an early advantage in verbal memory, which is lost with greater indication of disease severity. These findings indicate that women retain an advantage in verbal learning and memory, at least before significant levels of impairment, within a sample of older adults seen at an outpatient neurology clinic, which may have implications for diagnosing memory disorders.

Does informant-based reporting of cognitive symptoms predict amyloid positivity on positron emission tomography?

INTRODUCTION: Researchers are searching for clinical instruments to predict amyloid positivity for disease classification. Informant-based reports could detect disease status. This study compares subjective memory complaints captured by informant-based reports between positron emission tomography (PET)-positive and PET-negative patients and hypothesizes that amyloid PET positivity associates with increased informant-based cognitive complaints. METHODS: Ninety-eight amnestic mild cognitive impairment or mild dementia subjects were studied. Subjective report was captured by the informant-driven Alzheimer's Questionnaire (AQ) administered before PET. Differences in demographics and AQ score by diagnostic status and amyloid status were measured, and a receiver-operating characteristic curve was calculated. RESULTS: Sixty-five mild cognitive impairment/Alzheimer's disease amyloid PET-positive and 33 amyloid PET-negative subjects were included. AQ was significantly higher (12.51 ± 4.95) for amyloid PET-positive subjects (9.06 ± 3.65; P = .001). CONCLUSIONS: Amyloid PET-positive subjects with Alzheimer's disease or mild cognitive impairment have more informant-based reports of cognitive decline, indicating utility for a brief informant measure.