APOE genotype, hippocampal volume, and cognitive reserve predict improvement by cognitive training in older adults without dementia: a randomized controlled trial.

Cognitive training (CT) programs aim to improve cognitive performance and impede its decline. Thus, defining the characteristics of individuals who can benefit from these interventions is essential. Our objectives were to assess if the cognitive reserve (CR), APOE genotype (e4 carriers/non-carriers) and/or hippocampal volume might predict the effectiveness of a CT program. Participants were older adults without dementia (n = 226), randomized into parallel experimental and control groups. The assessment consisted of a neuropsychological protocol and additional data regarding total intracranial, gray matter, left/right hippocampus volume; APOE genotype; and Cognitive Reserve (CR). The intervention involved multifactorial CT (30 sessions, 90 min each), with an evaluation pre- and post-training (at six months); the control group simply following the center's routine activities. The primary outcome measures were the change in cognitive performance and the predictors of change. The results show that APOE-e4 non-carriers (79.1%) with a larger left hippocampal volume achieved better gains in semantic verbal fluency (R2 = .19). Subjects with a larger CR and a greater gray matter volume better improved their processing speed (R2 = .18). Age was correlated with the improvement in executive functions, such that older age predicts less improvement (R2 = .07). Subjects with a larger left hippocampal volume achieved more significant gains in general cognitive performance (R2 = .087). In conclusion, besides the program itself, the effectiveness of CT depends on age, biological factors like genotype and brain volume, and CR. Thus, to achieve better results through a CT, it is essential to consider the different characteristics of the participants, including genetic factors.Trial registration: Trial retrospectively registered on January 29th, 2020-(ClinicalTrials.gov -NCT04245579).

Association between Mineral Intake and Cognition Evaluated by Montreal Cognitive Assessment (MoCA): A Cross-Sectional Study.

BACKGROUND: Mineral intake may protect against cognitive impairment (CI) and all-cause dementia, which affects a large number of adults worldwide. The aim of this study was to investigate the association between mineral intake and Montreal Cognitive Assessment (MoCA), which is a sensitive and specific test. METHODS: In total, 201 adults were included in a cross-sectional study. They completed a three-day dietary record to estimate their average daily intake of minerals. Contributions to dietary reference intakes (DRIs) were also calculated. The participants were divided into tertiles according to their mineral intake. CI classifications were determined via the MoCA (score < 26). Apolipoprotein E (APOE) genotyping was carried out, and the patients' anthropometric measurements and physical activity, health and personal data were collected. RESULTS: The prevalence of CI in this selective sample was 54.2% (34.3% females and 19.9% males). In women, being in the third tertiles of iron and manganese intake was associated with lower odds of having CI (OR [95% CI]: 0.32 [0.11 ± 0.93]; 0.33 [0.12 ± 0.93], p < 0.05). No significant differences were observed for any of the nutrients studied in men. CONCLUSIONS: These findings suggest that a low mineral intake, especially low iron and manganese intake in women, is associated with a worse cognition as assessed by MoCA.

Diffusion Tensor Imaging Measures of Brain Connectivity for the Early Diagnosis of Alzheimer's Disease.

The prognostic capacity of the diffusion tensor imaging measures fractional anisotropy (FA) and mean diffusivity (MD) to detect mild cognitive impairment (MCI) progression to Alzheimer's disease (AD) was assessed in 135 MCI patients and 72 healthy subjects over a median follow-up of 40 months. Forty-nine MCI patients (36.3%) developed AD. The factors MD left hippocampus, FA left cingulate, and FA left hippocampus emerged as predictors of progression. Age (hazard ratio [HR] 1.21), delayed text recall (HR 0.89), FA left uncinate (HR 1.90), FA left hippocampus (HR 2.21), and carrying at least one ApoE4 allele (HR 2.86) were associated with a high conversion rate. FA measures revealed the greatest discriminative capacity (Harrell's C = 0.73 versus 0.65 without FA; p = 0.034). The inclusion of FA structural connectivity data in our model improved discrimination between subjects with MCI progressing or not to dementia.

Executive control on memory test performance across life: Test of Memory Strategies

The ability to generate memory strategies is a key factor in performance of episodic memory tests. There is evidence about the inefficient use of memory strategies in old adults. However, a question remains unresolved: Worse performance on memory test in the older people is due to an inability to mobilize cognitive strategies or to an episodic memory deficit? In this study we tried to answer it by using the Test of Memory Strategies (TMS), which parametrically reduces the need of executive functions on memory tests. The test consists of five experimental conditions (TMS1-5) where a progressive external organization of the material reduces the need to mobilize memory strategies. TMS was applied to a sample of 180 participants (n = 180) divided into three age groups (25-45; 46-65; 66-85). The results showed an increased performance in all groups groups (F(2, 177) = 14.79, p < .001) across conditions (F(3.88,674.04) = 292.48, p < .001), without group differences in those conditions with a maximum reduction of the need of executive functions (F(7.61,674.04) = 1.95, p = .053). However, middle age and older adults showed more difficulties in establishing cognitive strategies, in the initial conditions. These results lead to the conclusion that the typical pattern of low performance on episodic memory tasks in the older population may be due to the deterioration of executive functions and not mainly to a primary decline of memory process

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Neuronas espejo y teoría de la mente en la explicación de la empatía / Mirror neurons and theory of mind in explaining empathy

La empatía es la capacidad de una persona para vivenciar los pensamientos y sentimientos de los otros, reaccionado adecuadamente. Diferenciamos en la empatía dos componentes; cognitivo y emocional. El componente cognitivo comprende los pensamientos y sentimientos del otro. El componente afectivo comparte el estado emocional de otra persona. Comentamos dos teorías para explicar la empatía: las neuronas espejo y la teoría de la mente. Las neuronas espejo son un tipo particular de neuronas que se activan cuando un individuo realiza una acción, pero también cuando él observa una acción similar realizada por otro individuo Para la teoría de la mente atribuir mente a otro es una actividad pero generamos hipótesis sobre lo que está pensando o sintiendo e interpretamos así su comportamiento. Argumentamos una continuidad genética entre ambas teorías, que se sitúan a nivel explicativo distinto: las neuronas espejo a nivel explicativo distinto: las neuronas espejo a nivel neuronal (neurociencia básica) y la teoría de la mente en el nivel cognitivo. Mostramos implicaciones de ambas teorías en la comprensión del autismo (AU)

Empathy is a person´s ability to experiment other people´s thoughts and feelings and to react to them in an adequate manner. There are two different components within the concept of empathy: cognitive and emotional. The former implies the ability to understand thoughts and feelings of another person; the latter allows the individual to share the mental state of another person responding to his/her demands. We comment here on two theories that explain empathy: the mirror neurons and the Theory of Mind. Mirror neurons are a particular type of neurons which are activated when an individual performs an action, but also when he/she observes a similar action performed by someone else. For theory of mind, to attribute mind to another person is a theoretical activity because we cannot what he/(she is thinking about or feeling, and, in this way, we interpret his/her behavior. We deduce a genetic continuity between both theories in a different explanatory level: mirror neurons at a neuronal level (basic neuroscience) and theory of mind at a cognitive level. Implications of both theories in the explanation of autism are discussed (AU)

Efectos del tratamiento combinado de fármaco más estimulación cognitiva en la demencia moderada: seguimiento de dos años / Effects of combined pharmacologic and cognitive treatment in the progression of moderate dementia: a two-year follow-up

Objetivos: estudiar la eficacia de un tratamiento combinado (fármaco anticolinesterásico y entrenamiento cognitivo) en los procesos cognitivos de pacientes con demencia moderada después de 2 años de tratamiento. Material y métodos: cincuenta pacientes, 64,0% mujeres, edad media ± desviación estándar de 77,9 ± 6,2 años, diagnosticados de enfermedad de Alzheimer (EA) en estadio FAST ≥ 4. Asignación aleatorizada, ciega, a 4 grupos de tratamiento: grupo 1 (n = 12 individuos) recibió estimulación cognitiva; grupo 2 (n = 13), tratamiento farmacológico; grupo 3 (n = 12), tratamiento combinado (fármaco y estimulación cognitiva), y grupo 4 (n = 13), sin tratamiento. La eficacia terapéutica se evaluó, al cabo de uno y 2 años, mediante las escalas Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale (ADAS-Cog) y Functional Staging of Dementia of the Alzheimer's Type (FAST). Se realiza comparación entre los resultados obtenidos en los distintos grupos tras el seguimiento (ANOVA para medidas repetidas), nivel de significación p < 0,05. Resultados: los grupos de tratamiento mostraron cambios significativamente positivos frente al declive del grupo control para todas las escalas estudiadas al cabo de un año (p < 0,0001). El efecto deletéreo del tratamiento al cabo de 2 años es homogéneo en estos grupos, aunque en el grupo 3 (tratamiento combinado) se aprecia una tendencia al enlentecimiento de su deterioro funcional frente al resto (p no significativa). Conclusión: el tratamiento combinado (farmacológico y cognitivo) en la EA en estadio moderado produce efectos beneficiosos durante el primer año del tratamiento y mitiga el deterioro que se produce al segundo año en relación con otras formas de tratamiento

Objectives: to study the efficacy of combined treatment (anticholinesterase drugs and cognitive stimulation) in improving cognitive function in patients with moderate dementia after a 2-year follow-up. Material and methods: fifty patients (64.0% women, mean age 77.9 years [SD 6.2]) diagnosed with Alzheimer's disease (AD) in functional assessment stage (FAST) ≥ 4 were included. The patients were randomly assigned to 4 treatment groups: group 1 (n = 12) received cognitive stimulation; group 2 (n = 13) received drug therapy; group 3 (n = 12) received combined therapy (drug therapy plus cognitive stimulation), and group 4 (n = 13) received no treatment. The evaluator was blind to treatment allocation. Therapeutic efficacy was evaluated after 1 and 2 years through the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale (ADAS-Cog) and FAST. The results obtained in the distinct study groups were compared after follow-up (repeated measures ANOVA). Statistical significance was set at p < 0.05. Results: at the end of 1 year, the two treatment groups showed significant positive changes compared with cognitive decline in the control group in all the scales studied (p < 0.0001). After 2 years, deterioration was homogeneous in these groups, although group 3 (combined therapy) showed a nonsignificant tendency toward slowing of functional deterioration compared with the remaining groups. Conclusion: combined treatment (pharmacological and cognitive) in moderate-stage AD produces beneficial effects during the first year of treatment and mitigates the deterioration produced in the second year in comparison with other forms of treatment