Normative Data for a Neuropsychological Test Battery in the French Aging Population: 20-Year Follow-Up From the "PROgnostic OF Cardiovascular and Cerebrovascular Events" Study.

OBJECTIVE: The study aimed to present relevant norms for the evaluation of pathological aging in the French population over a 20-year period, utilizing the "PROgnostic OF cardiovascular and cerebrovascular events" test and questionnaire. METHODS: Three neuropsychological evaluations were administered over 20 years with 929 participants at the first cognitive evaluation (62-69 years old), 631 at the second (71-78 years old), and 293 at the third (81-88 years old). The tests and questionnaires were administered in the following order: McNair's Cognitive Complaints Questionnaire, Depression Questionnaire of Pichot, Mini Mental State Examination, Free and Cued Selective Reminding test, Benton Visual Retention Test, Digit-Symbol Substitution Test of the WAIS-III, Trail Making Test, Stroop Test, Verbal Fluency, and the Similarities subtest of the WAIS-III. RESULTS: Normative data were presented at three time points of the repeated evaluation over 20 years (62-69 years, 71-78 years, and 81-88 years) and four educational levels (no diploma, primary school certificate, certificate of professional aptitude, and baccalaureate and above). The data showed a significant effect of educational level in all neuropsychological tests regardless of age. Gender primarily affected memory, Stroop scores, and Similarities scores. CONCLUSION: This study highlights the importance of educational level and gender in the evaluation of the memory and executive function of elderly persons. Furthermore, the presented norms consider the self-report cognitive complaints and depression symptoms over a long period of life.

Modulation of maintenance and processing in working memory by negative emotions.

Previous research has shown that working memory processes are affected by emotions. However, it is not clear if both components - maintenance and processing of information - are modulated by emotion. Since emotion is intimately related to attention, we focused on attentional maintenance in working memory. In a previous study, using a complex span task, we showed that processing emotionally negative information reduced maintenance of neutral information in working memory. The objective of the present study was first to replicate the results of our previous study and second to investigate whether maintaining emotional information would affect processing of neutral information. In Experiment 1, young adults were asked to remember a series of five letters each followed by images, either negative or neutral, to be categorized. In Experiment 2, participants were required to memorize a series of five images, either negative or neutral, each followed by digits to be categorized. In order to focus on attentional maintenance, in both experiments the tasks were performed under continuous articulatory suppression. In Experiment 1, longer processing times were observed for emotional stimuli than neutral ones, and lower recall of series of letters when negative stimuli were processed. In Experiment 2, higher memory performance was observed for negative images than neutral ones and longer processing times of digits when a series of negative stimuli was maintained. Overall, our results show that emotion impacts both processing and attentional maintenance in working memory. This is consistent with models of working memory suggesting an attentional trade-off between maintenance and processing.

Processing of Facial Expressions of Emotions and Pain in Alzheimer's Disease.

BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative pathology that disrupts processing of facial expressions of emotion. The impairment was demonstrated for negative emotions in tasks of matching, discriminating, and labeling facial expressions but no study has included the expression of pain in its protocol. OBJECTIVE: The objective was to study the processing of emotional facial expressions in AD with a particular interest in pain expression. METHODS: Twenty-seven controls, 15 mild AD patients, and 15 moderate AD patients had to perform four emotional tasks: identification of facial expressions, matching pain expressions, discriminating the intensity of pain expressions, and judging pain intensity. RESULTS: Some emotions were less efficiently recognized by AD patients compared to controls (p < 0.001), specifically fear from the mild stage (p < 0.05), pain and disgust from the moderate stage (p < 0.05 and p < 0.001 respectively). The Exploratory Factor Analysis showed that recognition of pain and recognition of other discreet emotions were underpinned by two different latent factors. Performances on pain expression matching task and pain intensity discrimination task did not differ by group. (p = 0.334 and p = 0.787 respectively). Finally, moderate AD patients judged the pain less intensively than the Control group for both, moderate, and severe pain intensity (p < 0.001). CONCLUSION: Our data suggest that AD disrupts the recognition of pain expression along with recognition of fear and disgust. Additionally, AD patients seem to underestimate pain intensity compared to controls. The self-rated pain scales should be adapted to the pain processing deficit of AD patients.

Leukoaraiosis and Gray Matter Volume Alteration in Older Adults: The PROOF Study.

Background and Purpose: Leukoaraiosis, also called white matter hyperintensities (WMH), is frequently encountered in the brain of older adults. During aging, gray matter structure is also highly affected. WMH or gray matter defects are commonly associated with a higher prevalence of mild cognitive impairment. However, little is known about the relationship between WMH and gray matter. Our aim was thus to explore the relationship between leukoaraiosis severity and gray matter volume in a cohort of healthy older adults. Methods: Leukoaraiosis was rated in participants from the PROOF cohort using the Fazekas scale. Voxel-based morphometry was performed on brain scans to examine the potential link between WMH and changes of local brain volume. A neuropsychological evaluation including attentional, executive, and memory tests was also performed to explore cognition. Results: Out of 315 75-year-old subjects, 228 had punctuate foci of leukoaraiosis and 62 had begun the confluence of foci. Leukoaraiosis was associated with a decrease of gray matter in the middle temporal gyrus, in the right medial frontal gyrus, and in the left parahippocampal gyrus. It was also associated with decreased performances in memory recall, executive functioning, and depression. Conclusion: In a population of healthy older adults, leukoaraiosis was associated with gray matter defects and reduced cognitive performance. Controlling vascular risk factors and detecting early cerebrovascular disease may prevent, at least in part, dementia onset and progression.