Cognitive Status and Nutritional Markers in a Sample of Institutionalized Elderly People.

Background: Since many of the risk factors for cognitive decline can be modified by diet, the study of nutrition and its relationships with cognitive status in aging has increased considerably in recent years. However, there are hardly any studies that have assessed cognitive status using a comprehensive set of neuropsychological tests along with measures of functional capacity and mood and that have related it to nutritional status measured from several nutritional parameters that have shown its relationships with cognitive function. Objective: To test the differences in depressive symptomatology and in several measures of nutritional status between three groups classified according to their cognitive status (CS hereafter). Method: One hundred thirteen participants from nursing homes in Galicia, Spain, underwent a comprehensive neuropsychological examination, including a general screening test (MMSE) and tests for different cognitive domains along with measures of activities of daily living (ADL) and assessment of depressive symptomatology (GDS-SF). According to established clinical criteria, participants were divided into three CS groups, Cognitively Intact (CI), Mild Cognitive Impairment (MCI), and All-Cause Dementia (ACD). Nutritional status was also examined using blood-derived measures, body mass index (BMI) and a nutritional screening test (MNA-SF). Differences between CS groups in all nutritional variables were studied by one-way ANOVAs with post-hoc Bonferroni correction or Kruskal-Wallis with Games-Howell post-hoc correction when appropriate. Multinomial logistic regression was also applied to test the association between nutritional variables and CS. Results: Differences between CS groups were statistically significant for depressive symptomatology, vitamin A and D, albumin, selenium (Se), uric acid (UA), and BMI. The results of multinomial logistic regression found positive associations between groups with better CS and higher concentrations of vitamins A and D, transthyretin (TTR), albumin, Se, and UA, while negative associations were found for BMI. Conclusion: Higher serum levels of vitamin A, vitamin D, TTR, albumin, Se, and UA could act as protective factors against cognitive decline, whereas higher BMI could act as a risk factor.

Attentional Modulation of Change Detection ERP Components by Peripheral Retro-Cueing.

Change detection is essential for visual perception and performance in our environment. However, observers often miss changes that should be easily noticed. A failure in any of the processes involved in conscious detection (encoding the pre-change display, maintenance of that information within working memory, and comparison of the pre and post change displays) can lead to change blindness. Given that unnoticed visual changes in a scene can be easily detected once attention is drawn to them, it has been suggested that attention plays an important role on visual awareness. In the present study, we used behavioral and electrophysiological (ERPs) measures to study whether the manipulation of retrospective spatial attention affects performance and modulates brain activity related to the awareness of a change. To that end, exogenous peripheral cues were presented during the delay period (retro-cues) between the first and the second array using a one-shot change detection task. Awareness of a change was associated with a posterior negative amplitude shift around 228-292 ms ("Visual Awareness Negativity"), which was independent of retrospective spatial attention, as it was elicited to both validly and invalidly cued change trials. Change detection was also associated with a larger positive deflection around 420-580 ms ("Late Positivity"), but only when the peripheral retro-cues correctly predicted the change. Present results confirm that the early and late ERP components related to change detection can be functionally dissociated through manipulations of exogenous retro-cueing using a change blindness paradigm.

Preserved Suppression of Salient Irrelevant Stimuli During Visual Search in Age-Associated Memory Impairment.

Previous studies have suggested that older adults with age-associated memory impairment (AAMI) may show a significant decline in attentional resource capacity and inhibitory processes in addition to memory impairment. In the present paper, the potential attentional capture by task-irrelevant stimuli was examined in older adults with AAMI compared to healthy older adults using scalp-recorded event-related brain potentials (ERPs). ERPs were recorded during the execution of a visual search task, in which the participants had to detect the presence of a target stimulus that differed from distractors by orientation. To explore the automatic attentional capture phenomenon, an irrelevant distractor stimulus defined by a different feature (color) was also presented without previous knowledge of the participants. A consistent N2pc, an electrophysiological indicator of attentional deployment, was present for target stimuli but not for task-irrelevant color stimuli, suggesting that these irrelevant distractors did not attract attention in AAMI older adults. Furthermore, the N2pc for targets was significantly delayed in AAMI patients compared to healthy older controls. Together, these findings suggest a specific impairment of the attentional selection process of relevant target stimuli in these individuals and indicate that the mechanism of top-down suppression of entirely task-irrelevant stimuli is preserved, at least when the target and the irrelevant stimuli are perceptually very different.

Vertical asymmetries and inhibition of return: effects of spatial and non-spatial cueing on behavior and visual ERPs.

The mechanisms underlying inhibition of return (IOR) are still under debate. Besides the probable implication of several processes in its generation, a reason for this uncertainty may be related to experimental factors affecting the presence, time course, and magnitude of IOR. Two of them may be related to the arrangement of the stimuli in the visual field that could cause possible interactions between IOR and response conflict effects (horizontal arrangements) or between IOR and perceptual asymmetries (vertical arrangement). The purpose of the present study was to explore location and color cueing effects with a vertical arrangement of stimuli, free of S-R compatibility effects. To examine this possibility, a cue-back task with stimuli in the vertical meridian was employed. Targets could randomly and equiprobably appear at cued or uncued locations, or with cued or uncued color. These cueing effects were analyzed on behavior and ERPs separately for upper and lower visual fields (UVF and LVF). Under location cueing, behavioral responses were slower (spatial IOR) in both hemifields. In the ERPs, N1 reductions were observed in both visual fields although with different modulations in their latency and scalp distribution. In the P3 rising beginning, posterior negative deflections in the LVF (Nd) and anterior positive deflections (Pd) in the UVF were observed. Under color cueing, P3 amplitude was reduced in the UVF accompanied by no behavioral effects. These results suggest that different patterns of brain activation can be obtained in upper and lower visual fields under spatial- and non-spatial cueing conditions.

Response processing during visual search in normal aging: the need for more time to prevent cross talk between spatial attention and manual response selection.

It is still not well known whether the age-related behavioural slowing observed during visual search is due to changes in the allocation of attention, in response activation patterns, or to a combination of both. To help in clarifying it, attention-related (N2 posterior contralateral; N2pc, and N2 central contralateral; N2cc) and response-related (Motor Potential; MP, and Reafferent Potential; RAP) event-related potentials (ERPs) were obtained in healthy young and older participants executing a visual search task. Age was associated with N2pc and N2cc longer latencies, earlier MP onsets and longer MP rise times. Lower N2pc, higher MP and lower RAP amplitudes were also observed. Results suggest that older participants need more time to allocate spatial attention onto the target (N2pc) and to prevent cross talk between response selection and attention direction (N2cc), and that they are slower and need higher cortical activation when preparing and executing correctly selected responses (MP).

Oscillatory brain activity in the time frequency domain associated to change blindness and change detection awareness.

Despite the importance of change detection (CD) for visual perception and for performance in our environment, observers often miss changes that should be easily noticed. In the present study, we employed time-frequency analysis to investigate the neural activity associated with CD and change blindness (CB). Observers were presented with two successive visual displays and had to look for a change in orientation in any one of four sinusoid gratings between both displays. Theta power increased widely over the scalp after the second display when a change was consciously detected. Relative to no-change and CD, CB was associated with a pronounced theta power enhancement at parietal-occipital and occipital sites and broadly distributed alpha power suppression during the processing of the prechange display. Finally, power suppressions in the beta band following the second display show that, even when a change is not consciously detected, it might be represented to a certain degree. These results show the potential of time-frequency analysis to deepen our knowledge of the temporal curse of the neural events underlying CD. The results further reveal that the process resulting in CB begins even before the occurrence of the change itself.

Neural correlates of age-related visual search decline: a combined ERP and sLORETA study.

Differences in the neural systems underlying visual search processes for young (n=17, mean age 19.6+/-1.9) and older (n=22, mean age 68.5+/-6) subjects were investigated combining the Event-Related Potential (ERP) technique with standardized Low-Resolution brain Electromagnetic Tomography (sLORETA) analyses. Behavioral results showed an increase in mean reaction times (RTs) and a reduction in hit rates with age. The ERPs were significantly different between young and older subjects at the P3 component, showing longer latencies and lower amplitudes in older subjects. These ERP results suggest an age-related decline in the intensity and speed of visual processing during visual search that imply a reduction in attentional resources with normal aging. The sLORETA data revealed a significantly reduced neural differentiation in older subjects, who recruited bilateral prefrontal regions in a nonselective manner for the different search arrays. Finally, sLORETA between-group comparisons revealed that relative to young subjects, older subjects showed significantly reduced activity in anterior cingulate cortex as well as in numerous limbic and occipitotemporal regions contributing to visual search processes. These findings provide evidence that the neural circuit supporting this cognitive process is vulnerable to normal aging. All these attentional factors could contribute to poorer performance of older compared to young subjects in visual search tasks.

Feature processing during visual search in normal aging: electrophysiological evidence.

Event-related potentials (ERPs) were recorded from healthy young and older subjects during the execution of a visual search task in which they were required to detect the presence of a target stimulus that differed from distractors in a salient feature (orientation). Apart from the orientation target, a task-irrelevant singleton defined by a different feature (color) was also presented without instruction. The effects of normal aging on the N2pc component, an electrophysiological correlate of the allocation of visuospatial attention, were evaluated for the first time. Behavioral results showed an increase in the mean reaction time (RT) and a reduction in the hit rates with age. Electrophysiological results showed a consistent N2pc for orientation target pop-outs but not for irrelevant color pop-outs in both age groups, suggesting that the irrelevant color singleton did not induce attentional capture. Furthermore, the N2pc component observed for orientation targets was significantly delayed and attenuated in older subjects compared to young subjects, suggesting a specific impairment of the allocation of visuospatial attention with advancing age.

Vertical asymmetries in pre-attentive detection of changes in motion direction.

Stimulus localization affects visual motion processing. Vertical asymmetries favouring lower visual field have been reported in event-related potentials (ERPs) and behavioural studies under different attention conditions. However, there are no studies examining such asymmetries to non-attended motion changes. The present study investigated whether the asymmetry in processing information from the upper and lower visual fields also affects the automatic detection of motion-direction changes as indexed by visual Mismatch Negativity (vMMN). We recorded vMMN to changes in sinusoidal gratings differing in motion direction presented in the periphery of visual field in three different locations: upper and lower (ULVF), upper (UVF) and lower (LVF) along the vertical meridian. The N2 component elicited to peripheral motion presented lower amplitudes when the UVF was stimulated. The vMMN elicited to infrequent motion-direction changes was present in all stimulation conditions. However, it was reduced to UVF stimulation. These results suggest that the visual system automatically detects motion-direction changes presented at both upper-lower visual fields; however they also indicate that the process is favoured when stimuli are presented in the LVF alone.

Cognitive reserve, age, and neuropsychological performance in healthy participants.

The first aim of this study was to explore the relation between cognitive reserve, age, and neuropsychological functioning in a healthy sample; and second, to determine the risk of showing cognitive deficits as a function of cognitive reserve. One hundred forty-six healthy participants between the ages of 20 and 79 were submitted to neuropsychological assessment, focusing on attention, memory, visuo-construction, conceptualization and reasoning. Premorbid IQ as measured with the Wechsler Adult Intelligence Scale Vocabulary subtest was used as a proxy of cognitive reserve. Multivariate regression analysis with age and premorbid IQ as explanatory factors revealed a significant effect in all neuropsychological tests. Logistic regression revealed that participants with low cognitive reserve were more likely to obtain deficient scores (< or =1.5 SD below the mean) in the cognitive domains of attention (odds ratio [OR], 3.13; 95% confidence interval [CI], 1.059.29), memory (OR, 6.17; 95% CI, 1.69-22.61) and global functioning (OR, 6.44; 95% CI, 2.56-16.22) than participants with high cognitive reserve. Results suggest that cognitive reserve acts as a protective factor against the expression of cognitive decline related to age in healthy individuals.

Pre-attentive detection of motion direction changes in normal aging.

Effects of normal aging on pre-attentive detection of changes in motion direction were evaluated. Young, middle-aged, and older subjects performed a visual central task while standard and deviant gratings varying in motion direction were presented outside the focus of attention. A greater negativity in the event-related potentials (ERPs) to deviants was observed in all groups at posterior sites within the N2 latency range. Visual mismatch negativity (vMMN) reached its peak between 145 and 165 ms irrespective of age. However, significant age-related changes observed in vMMN mean amplitude may suggest that the pre-attentive visual detection become less efficient in older subjects. This could lead to age-related deficits in switching attention to potentially salient visual changes.

Effects of stimulus location on automatic detection of changes in motion direction in the human brain.

We extended the results of a previous report by further exploring the underlying mechanisms of an electrophysiological index of attention-free memory-based detection mechanism to motion-direction changes in the human visual system. By means of presenting bilateral, right- and left-hemifield stimulation in separate conditions, we tried to assess whether the location of the stimuli within the peripheral visual field affected the processing of motion-direction deviations, and to identify brain regions involved in the detection of unattended infrequent changes of motion direction using low-resolution brain electromagnetic tomography (LORETA). Results indicated that the ERP component related to visual change was not affected by stimulus location, and that bilateral temporal and medial regions were activated during this deviance-related response regardless of the hemifield stimulated. The bilateral activation foci observed in this study suggest that brain generators of this deviance-related component could be located at the vicinity of motion processing areas.

Covert orienting of visuospatial attention in the early stages of aging.

Electrophysiological and behavioral responses were recorded in healthy young (19-23 years) and older (56-66 years) subjects during the execution of a visuospatial attention task. The objective was to test whether covert orienting of visuospatial attention (COVAT) is sensitive to the early stages of aging. All subjects responded faster to targets following valid than invalid cues. The amplitude of the P1 component of visual event-related potentials (ERP) was larger to targets following central valid cues at all SOAs. Subtle age-related changes were observed in P1 amplitude under peripheral cueing. Furthermore, older subjects presented longer reaction times (RTs) and lower P1 amplitudes regardless of the attention condition.