Social Loneliness in Older Adults with Mild Cognitive Impairment: Predictive Factors and Associated Clinical Characteristics.

BACKGROUND: Loneliness and social isolation are considered public health problems among older individuals. In addition, both increase the risk of developing cognitive impairment and dementia. The Social Loneliness construct has been proposed to refer to these harmful social interaction-related factors. OBJECTIVE: To define the risk factors of Social Loneliness in individuals with mild cognitive impairment (MCI) and to analyze cognitive, emotional, and functional differences according to the participant's degree of Social Loneliness. METHODS: Through convenience sampling, 105 participants over 60 diagnosed with MCI were selected. The evaluation consisted of anamnesis and a comprehensive neuropsychological examination. The ESTE-II questionnaire was used to assess Social Loneliness and its three factors: perceived social support, social participation, and use of communication technologies. Personality was measured with the NEO-FFI questionnaire. RESULTS: The predictors of the Social Loneliness factors were as follows; 1) perceived social support (R2 = 0.33): Neuroticism (ß= 0.353), depression (ß= 0.205), and perceived health (ß= 0.133); 2) social participation (R2 = 0.24): Conscientiousness (ß= -0.344) and Extraversion (ß= -0.263); 3) use of communication technologies (R2 = 0.44): age (ß= 0.409), type of cohabitation (ß= 0.331), cognitive reserve (ß= -0.303), and Conscientiousness (ß= -0.247); all p < 0.05. The participants with a higher degree of Social Loneliness showed more depressive symptoms (R2 = 0.133), more memory complaints (R2 = 0.086), worse perceived health (R2 = 0.147), lower attentional performance/processing speed (R2 = 0.094), and more naming difficulties (R2 = 0.132); all p < 0.05. CONCLUSIONS: This research represents an advance in detecting individuals with MCI and an increased risk of developing Social Loneliness, which influences the configuration of the clinical profile of MCI.

Increased CAIDE dementia risk, cognition, CSF biomarkers, and vascular burden in healthy adults.

OBJECTIVE: To investigate the cognitive profile of healthy individuals with increased Cardiovascular Risk Factors, Aging and Dementia (CAIDE) dementia risk score and to explore whether this association is related to vascular burden and CSF biomarkers of amyloidosis and neurodegeneration. METHOD: Cognitively normal participants (mean age 57.6 years) from the Gipuzkoa Alzheimer Project study were classified as having high risk (HR; n = 82) or low risk (LR; n = 293) for dementia according to a CAIDE score cutoff of 9. Cognitive composites were compared between groups. We explored using generalized linear models the role of APOE genotype, MRI white matter hyperintensities (WMH), and CSF (n = 218) levels of ß-amyloid1-42 (Aß1-42), total tau (t-tau), and phosphorylated tau (p-tau) in the association between CAIDE score and cognition. RESULTS: HR participants obtained lower scores on executive function (EF) (p = 0.001) and visual perception and construction (VPC) (p < 0.001) composites. EF composite was associated with CAIDE score × p-tau (p = 0.001), CAIDE score × t-tau (p = 0.001), and WMH (p = 0.003). VPC composite was associated with APOE (p = 0.001), Aß1-42 (p = 0.004), the interaction APOE × Aß1-42 (p = 0.003), and WMH (p = 0.004). Performance on global memory was associated with Aß1-42 (p = 0.006), APOE (p = 0.008), and their interaction (p = 0.006). Analyses were adjusted for age, education, sex, premorbid intelligence, and stress. CONCLUSION: Healthy participants at increased dementia risk based on CAIDE scores show lower performance in EF and VPC. This difference is related to APOE, WMH, and Alzheimer biomarkers.

Profiles of Mild Cognitive Impairment (MCI) in the Elderly.

We applied latent class analysis (LCA) to a set of neuropsychological data with the aim of corroborating the three cognitive profiles of mild cognitive impairment (MCI) described in the literature, namely: healthy, amnestic, non-amnestic, and multidomain. The ultimate purpose of the LCA was to try to find the underlying classification of MCI and related pathologies by means of the participants' response patterns, rather than on more classical psychometric criteria, such as the standard deviation of the mean. We computed 547 neuropsychological assessments derived from 223 participants who were assessed annually for three consecutive years. The battery included tests of memory, language, executive function, and praxis. The results obtained by means of LCA, with a four-group solution and using the 40th percentile as the criterion, confirm prior classifications obtained with more questionable psychometric criteria, while providing longitudinal data on the course of MCI and the stability of group assignment over time.

Profiles of mild cognitive impairment (MCI) in the elderly

We applied latent class analysis (LCA) to a set of neuropsychological data with the aim of corroborating the three cognitive profiles of mild cognitive impairment (MCI) described in the literature, namely: healthy, amnestic, nonamnestic, and multidomain. The ultimate purpose of the LCA was to try to find the underlying classification of MCI and related pathologies by means of the participants’ response patterns, rather than on more classical psychometric criteria, such as the standard deviation of the mean. We computed 547 neuropsychological assessments derived from 223 participants who were assessed annually for three consecutive years. The battery included tests of memory, language, executive function, and praxis. The results obtained by means of LCA, with a four-group solution and using the 40th percentile as the criterion, confirm prior classifications obtained with more questionable psychometric criteria, while providing longitudinal data on the course of MCI and the stability of group assignment over time (AU)

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The characterization of biological rhythms in mild cognitive impairment.

INTRODUCTION: Patients with dementia, especially Alzheimer's disease, present several circadian impairments related to an accelerated perturbation of their biological clock that is caused by the illness itself and not merely age-related. Thus, the objective of this work was to elucidate whether these circadian system alterations were already present in patients with mild cognitive impairment (MCI), as compared to healthy age-matched subjects. METHODS: 40 subjects (21 patients diagnosed with MCI, 74.1 ± 1.5 y.o., and 19 healthy subjects, 71.7 ± 1.4 y.o.) were subjected to ambulatory monitoring, recording wrist skin temperature, motor activity, body position, and the integrated variable TAP (including temperature, activity, and position) for one week. Nonparametrical analyses were then applied. RESULTS: MCI patients exhibited a significant phase advance with respect to the healthy group for the following phase markers: temperature M5 (mean ± SEM: 04:20 ± 00:21 versus 02:52 ± 00:21) and L10 (14:35 ± 00:27 versus 13:24 ± 00:16) and TAP L5 (04:18 ± 00:14 versus 02:55 ± 00:30) and M10 (14:30 ± 00:18 versus 13:28 ± 00:23). CONCLUSIONS: These results suggest that significant advances in the biological clock begin to occur in MCI patients, evidenced by an accelerated aging of the circadian clock, as compared to a healthy population of the same age.

Increased morning salivary cortisol levels in older adults with nonamnestic and multidomain mild cognitive impairment.

Exposure to elevated glucocorticoid levels has a detrimental impact on cognitive function. In the present study, elderly individuals were classified according to their cognitive status to (i) cognitively healthy; (ii) amnestic; (iii) nonamnestic; or (iv) multidomain, with an extensive cognitive profiling. Salivary cortisol samples were taken at awakening, evening and night. We report that, compared to cognitively normal control individuals, subjects with nonamnestic or multidomain mild cognitive impairment profiles show increased salivary cortisol levels, immediately after awakening, but not in the evening or at night. Importantly, individuals with amnestic mild cognitive impairment did not show this increase in salivary cortisol levels. We also found that higher morning cortisol levels were associated with a lower global cognitive state, as well as poorer score in executive function and visuoconstructive praxes, verbal fluency, and a worse free immediate recall of items from a word list. These findings open new avenues to the use of salivary cortisol levels as a possible biomarker for nonamnestic and multidomain mild cognitive impairment in elderly subjects.

Problemas metodológicos al analizar datos de producción de ejemplares y de atributos en un estudio sobre deterioro semántico en enfermos de Alzheimer / Methodological problems when analyzing data from a research on semantic-conceptual memory in Alzheimer’s patients

El trabajo que presentamos pretende exponer desde un punto de vista metodológico una serie de problemas que han tenido que ser solventados al analizar los datos procedentes de un estudio de la memoria semántico-conceptual en enfermos de Alzheimer, así como las técnicas y métodos adoptados en cada caso. Los problemas se han generado en torno a dos tipos de pruebas: en la de fluidez verbal (o producción de ejemplares de categorías semánticas), se ha analizado además de, obviamente, el número de unidades/ejemplares producidos por unidad de tiempo, la secuencia o patrón según la cual se han ido generando, lo cual implica tratar de analizar e inferir cómo el sujeto (sano y enfermo) «busca» en su almacén conceptual. Por otra parte en la prueba de definición de categorías, y para poder analizar de manera precisa los tipos de atributos que los sujetos generan así como sus frecuencias/ocurrencias, se ha propuesto una taxonomía y un tipo de análisis específico para el tratamiento de atributos (AU)

The objective of this work is to present, from a methodological standpoint, a series of problems that had to be solved when analyzing data from a research on semantic-conceptual memory in Alzheimer’s patients or when dealing with adequate techniques or methods for specific stances. The problems have arised in two types of tests: in the verbal fluency one and in the definition of categories. The first one demanded from the subjects the production of semantic exemplars. One has analyzed not only the obvious frequency of the units/exemplars/unit of time but also the sequence or scheme generated by data. This new approach also analyzes and helps us to infer how the subject (healthy or ill) searches in his/her conceptual memory. Regarding the category definition test, for analyzing in a precise way the types of attributes that subjects generate and also their frequencies, a taxonomy and a specific analysis for attribute treatment is proposed (AU)