Sex-related differences in the associations between diurnal cortisol pattern and social and emotional loneliness in older adults.

Introduction: Loneliness is a distressful feeling that can affect mental and physical health, particularly among older adults. Cortisol, the primary hormone of the Hypothalamic-Pituitary-Adrenal axis (HPA-axis), may act as a biological transducer through which loneliness affects health. While most previous studies have evaluated the association between loneliness, as a unidimensional construct, and diurnal cortisol pattern, no research has examined this relationship discriminating between social and emotional loneliness in older adults. As sex differences in the negative mental health outcomes of loneliness have been reported, we also investigated whether diurnal cortisol indices and loneliness associations occur in a sex-specific manner. Methods: We analyzed the diurnal cortisol- pattern in 142 community-dwelling, non-depressed, Caucasian older adults (55,6% female) aged 60-90. Social and emotional (family and romantic) loneliness scores were assessed using the Spanish version of the Social and Emotional Loneliness Scale for Adults (SELSA). Five salivary cortisol samples were used to capture key features of the diurnal cortisol pattern, including: awakening and bedtime cortisol levels, awakening response (CAR), post-awakening cortisol output (post-awakening cortisol [i.e., the area under the curve with reference to the ground: AUCG]), total diurnal cortisol release (AUCG), and diurnal cortisol slope (DCS). Results: After controlling for sociodemographic variables, the hierarchical linear multiple regression analyses revealed that in male older adults, higher scores on social and family loneliness were associated with elevated awakening cortisol levels, total diurnal cortisol output, and a steeper diurnal cortisol slope (DCS). However, these associations were not observed in female older adults. In addition, feelings of romantic loneliness were positively associated with bedtime cortisol levels and AUCG in older males. Multilevel growth curve modeling showed that experiencing more social and emotional loneliness predicted higher diurnal cortisol output throughout the day in older male adults. Discussion: The presence of sex differences in the relationship between cortisol indices and loneliness among older adults holds particular significance for diagnostic and screening procedures. Combining loneliness scales as screening tools with diurnal cortisol measures has the potential to be an effective and cost-efficient approach in identifying higher-risk individuals at early stages.

Acquisition and consolidation of verbal learning and episodic memory as predictors of the conversion from mild cognitive impairment to probable Alzheimer's disease.

Verbal episodic memory tests assess memory performance using total learning scores. The analysis of inter-trial indices such as gained (GA) and lost (LA) access can provide additional information on the acquisition and consolidation processes. The main objetive was to determine whether the GA and LA indices, derived from a word-list verbal episodic memory test are useful for predicting cognitive impairment in aging. 60 older people aged was divided into 3 groups: cognitively healthy, stable Mild Cognitive Impairment (MCI) and MCI converting to probable Alzheimer's disease (MCI-conv). The results showed that GA and LA measures are independent from the traditional measures -total score of correct answers-. Logistic regression showed that these values are predictive of the conversion over time and could be a cognitive marker of conversion from MCI to AD. This suggests that the GA index, which shows acquisition processes in word-list tests, may be a marker of cognitive impairment.

Validation of the Spanish version of the Memory Failures of Everyday questionnaire in older adults using Rasch analysis.

AIM: The Memory Failures of Everyday (MFE) is a widely used instrument for assessing memory failure. The aim of the study was to analyze the MFE items using the Rasch model in a sample of cognitively older adults in Spain. METHODS: A cross-sectional validation study in a sample of 214 healthy people aged ≥60 years who used centers for older people in Madrid (Spain). The MFE for the assessment of memory complaints was used. The following properties of the Rasch model were assessed: data fit, reliability, unidimensionality, local dependence and lack of differential item functioning by gender, age and marital status. RESULTS: The MFE showed a good fit to the Rasch model (χ2 (140) = 160.2; P = 0.116) and high reliability (person separation index = 0.808). The questionnaire was unidimensional (6.54% t-test; IC binomial = 0.036-0.095). The items showed lack of local dependence between them and differential item functioning. The MFE scores were transformed into linear interval scores with a median of 44.31 and an observed range of 17.9-89.2 (theoretical range: 0-100). CONCLUSIONS: The MFE is a unidimensional, reliable instrument to assess memory complaints in cognitively healthy older adults in Spain, with usefulness in clinical research and practice. The construct validity of the MFE linear score could not be fully confirmed and this deserves further investigation. Geriatr Gerontol Int 2022; 22: 332-337.

Normative data for the Spanish version of the California Verbal Learning Test (TAVEC) from older adults.

The aim of this study was to establish normative data for the Spanish version of the California Verbal Learning Test, the Test de Aprendizaje Verbal España-Complutense (TAVEC). Through different subtests, the TAVEC allows verbal learning and episodic memory to be evaluated, an assessment that was carried out on a sample of 382 cognitive healthy Spanish individuals aged 60-90 years old. Unlike the participant's educational level, their age and sex significantly influenced performance in the TAVEC. We provide tables that allow the scaled scores obtained with this test to be adjusted for age and other tables with the relevant adjustments for sex. The normative data obtained in this study will help more precisely interpret the performance of older Spanish adults in the TAVEC, enhancing the utility of this neuropsychological test to evaluate verbal learning and episodic memory in clinical settings and in relation to healthy aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Problems in Classifying Mild Cognitive Impairment (MCI): One or Multiple Syndromes?

As the conceptual, methodological, and technological advances applied to dementias have evolved the construct of mild cognitive impairment (MCI), one problem encountered has been its classification into subtypes. Here, we aim to revise the concept of MCI and its subtypes, addressing the problems of classification not only from the psychometric point of view or by using alternative methods, such as latent class analysis, but also considering the absence of normative data. In addition to the well-known influence of certain factors on cognitive function, such as educational level and cultural traits, recent studies highlight the relevance of other factors that may significantly affect the genesis and evolution of MCI: subjective memory complaints, loneliness, social isolation, etc. The present work will contemplate the most relevant attempts to clarify the issue of MCI categorization and classification, combining our own data with that from recent studies which suggest the role of relevant psychosocial factors in MCI.