Using memories to support the self in Alzheimer's disease.

The impact of memory loss on the self in Alzheimer's disease (AD) is poorly understood. Previous research is mixed on whether episodic or semantic memories are most important for supporting identity. The present study examined autobiographical memories cued by self-images (e.g., I am a father) and non-self-related cues in 16 AD patients and 29 healthy older adults. The AD group generated fewer self-images and memories compared to controls, but demonstrated similar temporal organization of self-cued memories. In both groups, self-images were supported by semantic memories that were temporally clustered around times of identity-formation. These self-supporting memories are proposed to form a scaffold to support the self and may persist the longest in AD, as opposed to memories from early adulthood per se. In both AD and control groups, self-images cued more semantic memories than non-self-relevant cues, further suggesting that semantic autobiographical memories play a fundamental role in supporting the self. These findings demonstrate that the self remains largely intact in AD, in spite of severe episodic memory deficits and global cognitive decline. In later stages of the disease, these self-supporting memories could provide effective tools for reminiscence therapy.

A test of the CaR-FA-X mechanisms and depression in adolescents.

People who have depression have difficulty recalling specific autobiographical information (Sumner, (2011) The mechanisms underlying overgeneral autobiographical memory: An evaluative review of evidence for the Ca R-FA-X model. Clinical Psychology Review, 3231(1), 34-48). This is called overgeneral autobiographical memory (OGM) and is associated with the development and persistence of depression. Williams, Barnhofer, Crane, Hermans, Raes, Watkins, & Dalgleish (2007 Autobiographical memory specificity and emotional disorder. Psychological Bulletin, 133(1), 122-148) proposed that OGM is maintained by three mechanisms: capture and rumination (CaR), functional avoidance (FA), and impaired executive control (X), and integrated these into the CaR-FA-X model. The aim of this study was to assess OGM and test the CaR-FA-X model in adolescents with low mood. We recruited 29 young people aged 12-17 with elevated symptoms of depression and 29 with minimal symptoms of depression, matched for gender and age. After controlling for IQ, adolescents with elevated depression retrieved fewer specific memories, ruminated more, and had poorer working memory and verbal fluency than adolescents with minimal depression. The groups did not differ on measures of inhibition or functional avoidance. The CaR-FA-X model was therefore partially supported. These results confirm that there is a relationship between low mood and OGM in young people and that OGM may arise as consequence of impaired working memory and verbal fluency and cognitive interference due to rumination.

Application of Behavior Change Techniques in a Personalized Nutrition Electronic Health Intervention Study: Protocol for the Web-Based Food4Me Randomized Controlled Trial.

BACKGROUND: To determine the efficacy of behavior change techniques applied in dietary and physical activity intervention studies, it is first necessary to record and describe techniques that have been used during such interventions. Published frameworks used in dietary and smoking cessation interventions undergo continuous development, and most are not adapted for Web-based delivery. The Food4Me study (N=1607) provided the opportunity to use existing frameworks to describe standardized Web-based techniques employed in a large-scale, internet-based intervention to change dietary behavior and physical activity. OBJECTIVE: The aims of this study were (1) to describe techniques embedded in the Food4Me study design and explain the selection rationale and (2) to demonstrate the use of behavior change technique taxonomies, develop standard operating procedures for training, and identify strengths and limitations of the Food4Me framework that will inform its use in future studies. METHODS: The 6-month randomized controlled trial took place simultaneously in seven European countries, with participants receiving one of four levels of personalized advice (generalized, intake-based, intake+phenotype-based, and intake+phenotype+gene-based). A three-phase approach was taken: (1) existing taxonomies were reviewed and techniques were identified a priori for possible inclusion in the Food4Me study, (2) a standard operating procedure was developed to maintain consistency in the use of methods and techniques across research centers, and (3) the Food4Me behavior change technique framework was reviewed and updated post intervention. An analysis of excluded techniques was also conducted. RESULTS: Of 46 techniques identified a priori as being applicable to Food4Me, 17 were embedded in the intervention design; 11 were from a dietary taxonomy, and 6 from a smoking cessation taxonomy. In addition, the four-category smoking cessation framework structure was adopted for clarity of communication. Smoking cessation texts were adapted for dietary use where necessary. A posteriori, a further 9 techniques were included. Examination of excluded items highlighted the distinction between techniques considered appropriate for face-to-face versus internet-based delivery. CONCLUSIONS: The use of existing taxonomies facilitated the description and standardization of techniques used in Food4Me. We recommend that for complex studies of this nature, technique analysis should be conducted a priori to develop standardized procedures and training and reviewed a posteriori to audit the techniques actually adopted. The present framework description makes a valuable contribution to future systematic reviews and meta-analyses that explore technique efficacy and underlying psychological constructs. This was a novel application of the behavior change taxonomies and was the first internet-based personalized nutrition intervention to use such a framework remotely. TRIAL REGISTRATION: ClinicalTrials.gov NCT01530139; https://clinicaltrials.gov/ct2/show/NCT01530139 (Archived by WebCite at http://www.webcitation.org/6y8XYUft1).

Stay calm! Regulating emotional responses by implementation intentions: Assessing the impact on physiological and subjective arousal.

Implementation intention (IMP) has recently been highlighted as an effective emotion regulatory strategy. Most studies examining the effectiveness of IMPs to regulate emotion have relied on self-report measures of emotional change. In two studies we employed electrodermal activity (EDA) and heart rate (HR) in addition to arousal ratings (AR) to assess the impact of an IMP on emotional responses. In Study 1, 60 participants viewed neutral and two types of negative pictures (weapon vs. non-weapon) under the IMP "If I see a weapon, then I will stay calm and relaxed!" or no self-regulatory instructions (Control). In Study 2, additionally to the Control and IMP conditions, participants completed the picture rating task either under goal intention (GI) to stay calm and relaxed or warning instructions highlighting that some pictures contain weapons. In both studies, participants showed lower EDA, reduced HR deceleration and lower AR to the weapon pictures compared to the non-weapon pictures. In Study 2, the IMP was associated with lower EDA compared to the GI condition for the weapon pictures, but not compared to the weapon pictures in the Warning condition. ARs were lower for IMP compared to GI and Warning conditions for the weapon pictures.

The perceived impact of the National Health Service on personalised nutrition service delivery among the UK public.

Personalised nutrition (PN) has the potential to reduce disease risk and optimise health and performance. Although previous research has shown good acceptance of the concept of PN in the UK, preferences regarding the delivery of a PN service (e.g. online v. face-to-face) are not fully understood. It is anticipated that the presence of a free at point of delivery healthcare system, the National Health Service (NHS), in the UK may have an impact on end-user preferences for deliverances. To determine this, supplementary analysis of qualitative data obtained from focus group discussions on PN service delivery, collected as part of the Food4Me project in the UK and Ireland, was undertaken. Irish data provided comparative analysis of a healthcare system that is not provided free of charge at the point of delivery to the entire population. Analyses were conducted using the 'framework approach' described by Rabiee (Focus-group interview and data analysis. Proc Nutr Soc 63, 655-660). There was a preference for services to be led by the government and delivered face-to-face, which was perceived to increase trust and transparency, and add value. Both countries associated paying for nutritional advice with increased commitment and motivation to follow guidelines. Contrary to Ireland, however, and despite the perceived benefit of paying, UK discussants still expected PN services to be delivered free of charge by the NHS. Consideration of this unique challenge of free healthcare that is embedded in the NHS culture will be crucial when introducing PN to the UK.

Chronic consumption of flavanone-rich orange juice is associated with cognitive benefits: an 8-wk, randomized, double-blind, placebo-controlled trial in healthy older adults.

BACKGROUND: Research indicates that the chronic consumption of flavonoids is associated with cognitive benefits in adults with mild cognitive impairment and neurodegenerative disease, although to our knowledge, there have been no such studies in healthy older adults. Furthermore, the effects of commonly consumed orange juice flavanones on cognitive function remain unexplored. OBJECTIVE: We investigated whether 8 wk of daily flavanone-rich orange juice consumption was beneficial for cognitive function in healthy older adults. DESIGN: High-flavanone (305 mg) 100% orange juice and an equicaloric low-flavanone (37 mg) orange-flavored cordial (500 mL) were consumed daily for 8 wk by 37 healthy older adults (mean age: 67 y) according to a crossover, double-blind, randomized design separated by a 4-wk washout. Cognitive function, mood, and blood pressure were assessed at baseline and follow-up by using standardized validated tests. RESULTS: Global cognitive function was significantly better after 8-wk consumption of flavanone-rich juice than after 8-wk consumption of the low-flavanone control. No significant effects on mood or blood pressure were observed. CONCLUSIONS: Chronic daily consumption of flavanone-rich 100% orange juice over 8 wk is beneficial for cognitive function in healthy older adults. The potential for flavanone-rich foods and drinks to attenuate cognitive decline in aging and the mechanisms that underlie these effects should be investigated.

Autobiographical memory and well-being in aging: The central role of semantic self-images.

Higher levels of well-being are associated with longer life expectancies and better physical health. Previous studies suggest that processes involving the self and autobiographical memory are related to well-being, yet these relationships are poorly understood. The present study tested 32 older and 32 younger adults using scales measuring well-being and the affective valence of two types of autobiographical memory: episodic autobiographical memories and semantic self-images. Results showed that valence of semantic self-images, but not episodic autobiographical memories, was highly correlated with well-being, particularly in older adults. In contrast, well-being in older adults was unrelated to performance across a range of standardised memory tasks. These results highlight the role of semantic self-images in well-being, and have implications for the development of therapeutic interventions for well-being in aging.

Self, memory, and imagining the future in a case of psychogenic amnesia.

We report a case of psychogenic amnesia and examine the relationships between autobiographical memory impairment, the self, and ability to imagine the future. Case study JH, a 60-year-old male, experienced a 6-year period of pervasive psychogenic amnesia covering all life events from childhood to the age of 53. JH was tested during his amnesic period and again following hypnotherapy and the recovery of his memories. JH's amnesia corresponded with deficits in self-knowledge and imagining the future. Results are discussed with reference to models of self and memory and processes involving remembering and imagining.

Neural correlates of true and false memory in mild cognitive impairment.

The goal of this research was to investigate the changes in neural processing in mild cognitive impairment. We measured phase synchrony, amplitudes, and event-related potentials in veridical and false memory to determine whether these differed in participants with mild cognitive impairment compared with typical, age-matched controls. Empirical mode decomposition phase locking analysis was used to assess synchrony, which is the first time this analysis technique has been applied in a complex cognitive task such as memory processing. The technique allowed assessment of changes in frontal and parietal cortex connectivity over time during a memory task, without a priori selection of frequency ranges, which has been shown previously to influence synchrony detection. Phase synchrony differed significantly in its timing and degree between participant groups in the theta and alpha frequency ranges. Timing differences suggested greater dependence on gist memory in the presence of mild cognitive impairment. The group with mild cognitive impairment had significantly more frontal theta phase locking than the controls in the absence of a significant behavioural difference in the task, providing new evidence for compensatory processing in the former group. Both groups showed greater frontal phase locking during false than true memory, suggesting increased searching when no actual memory trace was found. Significant inter-group differences in frontal alpha phase locking provided support for a role for lower and upper alpha oscillations in memory processing. Finally, fronto-parietal interaction was significantly reduced in the group with mild cognitive impairment, supporting the notion that mild cognitive impairment could represent an early stage in Alzheimer's disease, which has been described as a 'disconnection syndrome'.

The effects of age, enactment, and cue-action relatedness on memory for intentions in the Virtual Week task.

The current study investigated the influence of encoding modality and cue-action relatedness on prospective memory (PM) performance in young and older adults using a modified version of the Virtual Week task. Participants encoded regular and irregular intentions either verbally or by physically performing the action during encoding. For half of the intentions there was a close semantic relation between the retrieval cue and the intended action, while for the remaining intentions the cue and action were semantically unrelated. For irregular tasks, both age groups showed superior PM for related intentions compared to unrelated intentions in both encoding conditions. While older adults retrieved fewer irregular intentions than young adults after verbal encoding, there was no age difference following enactment. Possible mechanisms of enactment and relatedness effects are discussed in the context of current theories of event-based PM.

Cognitive tests used in chronic adult human randomised controlled trial micronutrient and phytochemical intervention studies.

In recent years there has been a rapid growth of interest in exploring the relationship between nutritional therapies and the maintenance of cognitive function in adulthood. Emerging evidence reveals an increasingly complex picture with respect to the benefits of various food constituents on learning, memory and psychomotor function in adults. However, to date, there has been little consensus in human studies on the range of cognitive domains to be tested or the particular tests to be employed. To illustrate the potential difficulties that this poses, we conducted a systematic review of existing human adult randomised controlled trial (RCT) studies that have investigated the effects of 24 d to 36 months of supplementation with flavonoids and micronutrients on cognitive performance. There were thirty-nine studies employing a total of 121 different cognitive tasks that met the criteria for inclusion. Results showed that less than half of these studies reported positive effects of treatment, with some important cognitive domains either under-represented or not explored at all. Although there was some evidence of sensitivity to nutritional supplementation in a number of domains (for example, executive function, spatial working memory), interpretation is currently difficult given the prevailing 'scattergun approach' for selecting cognitive tests. Specifically, the practice means that it is often difficult to distinguish between a boundary condition for a particular nutrient and a lack of task sensitivity. We argue that for significant future progress to be made, researchers need to pay much closer attention to existing human RCT and animal data, as well as to more basic issues surrounding task sensitivity, statistical power and type I error.

The impact of flavonoids on spatial memory in rodents: from behaviour to underlying hippocampal mechanisms.

Emerging evidence suggests that a group of dietary-derived phytochemicals known as flavonoids are able to induce improvements in memory, learning and cognition. Flavonoids have been shown to modulate critical neuronal signalling pathways involved in processes of memory, and therefore are likely to affect synaptic plasticity and long-term potentiation mechanisms, widely considered to provide a basis for memory. Animal dietary supplementation studies have further shown that flavonoid-rich foods are able to reverse age-related spatial memory and spatial learning impairments. A more accurate understanding of how a particular spatial memory task works and of which aspects of memory and learning can be assessed in each case, are necessary for a correct interpretation of data relating to diet-cognition experiments. Further understanding of how specific behavioural tasks relate to the functioning of hippocampal circuitry during learning processes might be also elucidative of the specific observed memory improvements. The overall goal of this review is to give an overview of how the hippocampal circuitry operates as a memory system during behavioural tasks, which we believe will provide a new insight into the underlying mechanisms of the action of flavonoids on cognition.

Flavonoids and cognitive function: a review of human randomized controlled trial studies and recommendations for future studies.

Evidence in support of the neuroprotective effects of flavonoids has increased significantly in recent years, although to date much of this evidence has emerged from animal rather than human studies. Nonetheless, with a view to making recommendations for future good practice, we review 15 existing human dietary intervention studies that have examined the effects of particular types of flavonoid on cognitive performance. The studies employed a total of 55 different cognitive tests covering a broad range of cognitive domains. Most studies incorporated at least one measure of executive function/working memory, with nine reporting significant improvements in performance as a function of flavonoid supplementation compared to a control group. However, some domains were overlooked completely (e.g. implicit memory, prospective memory), and for the most part there was little consistency in terms of the particular cognitive tests used making across study comparisons difficult. Furthermore, there was some confusion concerning what aspects of cognitive function particular tests were actually measuring. Overall, while initial results are encouraging, future studies need to pay careful attention when selecting cognitive measures, especially in terms of ensuring that tasks are actually sensitive enough to detect treatment effects.

Blueberry-induced changes in spatial working memory correlate with changes in hippocampal CREB phosphorylation and brain-derived neurotrophic factor (BDNF) levels.

Phytochemical-rich foods have been shown to be effective at reversing age-related deficits in memory in both animals and humans. We show that a supplementation with a blueberry diet (2% w/w) for 12 weeks improves the performance of aged animals in spatial working memory tasks. This improvement emerged within 3 weeks and persisted for the remainder of the testing period. Memory performance correlated well with the activation of cAMP-response element-binding protein (CREB) and increases in both pro- and mature levels of brain-derived neurotrophic factor (BDNF) in the hippocampus. Changes in CREB and BDNF in aged and blueberry-supplemented animals were accompanied by increases in the phosphorylation state of extracellular signal-related kinase (ERK1/2), rather than that of calcium calmodulin kinase (CaMKII and CaMKIV) or protein kinase A. Furthermore, age and blueberry supplementation were linked to changes in the activation state of Akt, mTOR, and the levels of Arc/Arg3.1 in the hippocampus, suggesting that pathways involved in de novo protein synthesis may be involved. Although causal relationships cannot be made among supplementation, behavior, and biochemical parameters, the measurement of anthocyanins and flavanols in the brain following blueberry supplementation may indicate that changes in spatial working memory in aged animals are linked to the effects of flavonoids on the ERK-CREB-BDNF pathway.

The representation of delayed intentions: a prospective subject-performed task?

To-be-enacted material is more accessible in tests of recognition and lexical decision than material not intended for action (T. Goschke & J. Kuhl, 1993; R. L. Marsh, J. L. Hicks, & M. L. Bink, 1998). This finding has been attributed to the superior status of intention-related information. The current article explores an alternative (action-superiority) account that draws parallels between the intended enactment effect (IEE) and the subject performed task effect. Using 2 paradigms, the authors observed faster recognition latencies for both enacted and to-be-enacted material. It is crucial to note that there was no evidence of an IEE for items that had already been executed during encoding. The IEE was also eliminated when motor processing was prevented after verbal encoding. These findings suggest an overlap between overt and intended enactment and indicate that motor information may be activated for verbal material in preparation for subsequent execution.

Conceptual and perceptual processes in prospective remembering: differential influence of attentional resources.

Does prospective remembering rely on strategic, attentionally demanding processes? We report three experiments suggesting that the extent to which attentional processes are required varies according to the character of ongoing task processing. Study-test changes in the semantic context of targets had a negative effect on prospective memory performance when participants were engaged in a conceptually focused (sentence verification) task (Experiment 1). Similarly, prospective remembering was lower following study-test changes in perceptual format (font) in the context of a perceptually focused (readability rating) ongoing task (Experiment 2). However, although dividing attention at retrieval had a negative effect during the performance of an ongoing conceptual task (Experiments 1 and 3), it had no effect during an ongoing perceptual task (Experiments 2 and 3). Thus, both perceptual and conceptual process are implicated in prospective remembering, but the processing focus of the task in which remembering should occur may mediate the requirement for strategic processes. These findings suggest that more than one retrieval route is available for prospective remembering and that selection of the route depends on the nature of the task and the processing that occurs at encoding and retrieval.