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).

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.

Genetic Predictors of Change in Episodic Verbal Memory by Cognitive Intervention: ACT, PICALM, BDNF, NRG1, APOE Genes and Their Interactions in Situations of Cognitive Demand.

BACKGROUND: Cognitive interventions (CIs) in the elderly are activities that seek to improve cognitive performance and delay its deterioration. Our objectives were to study potential genetic predictors of how a CI program may influence immediate and delayed episodic verbal memory (EVM). METHODS: 162 participants were elderly individuals without dementia who were randomized into parallel control and experimental groups. Participants underwent genetic testing to analyze the PICALM, ACT, NRG1, BDNF and APOE genes. We performed a broad neuropsychological assessment before and 6 months after the CI. The CI involved multifactorial training (30 sessions). The control group undertook the centre's standard activities. The main outcome measures were the genotype studied as a predictor of post-intervention changes in EVM. RESULTS: We found the CI was associated with improvements in several cognitive functions, including immediate and delayed EVM. While no individual gene was associated with any such change, the interaction between PICALM/ACT (p = 0.008; Eta2 = 0.23) and PICALM/NRG1 (p = 0.029; Eta2 = 0.19) was associated with improved immediate EVM, and the NRG1/BDNF interaction was associated with improved delayed EVM (p = 0.009; Eta2 = 0.21). The APOEε4 genotype was not associated with any change in EVM. CONCLUSIONS: Our study shows that the participants' genotype can have an impact on the results of CIs. Cognitive stress may stimulate the interaction of various genes and as such, different types of CI should be established for distinct groups of people taking into account the individual's characteristics, like genotype, to improve the results of this type of health prevention and promotion activity.

Loneliness in the elderly: association with health variables, pain, and cognitive performance. A population-based study / La soledad en personas mayores: asociación con las variables de salud, el dolor y el rendimiento cognitivo. Estudio poblacional

The aim of this population-based study is to analyze the association of loneliness and physical health, pain, health-related quality of life, mental health, cognitive performance, morbidity, and use of health services. Based on the census, a stratified random sampling was chosen. A telephone interview was conducted with 2,060 people over 65 years old, using the GHQ-12 and the COOP-Wonca. An association of loneliness with General Mental Health (GHQ-12) was found, OR = 1.43 (1.34, 1.52) and depression, OR = 2.34 (1.54, 3.53). In cognitive performance the highest effect variable was “memory problems disturb your daily life”, OR = 3.11 (1.25, 7.72); illnesses-related variables: the highest effect variables were perception of health status, OR = 1.37 (1.13, 1. 67) and quality of life (COOP-Wonca), OR = 3.03 (2.32, 3.94); pain-related variables: the highest effect variables were non-localized pain, OR = 2.67 (1.87, 3.83) and arthritis/arthrosis, OR = 1.94 (1.38, 2.72); impaired vision, OR = 2. 62 (1.84, 3.73) and hearing, OR = 1.81 (1.21, 2.72). It is concluded that loneliness is a complex phenomenon associated with variables of different nature. This fact should be taken into account at the time of planning possible solutions. (AU)

El objetivo de este estudio poblacional es analizar la asociación de la soledad no deseada (SND) con salud física, dolor, calidad de vida relacionada con la salud, salud mental, rendimiento cognitivo, morbilidad y uso de servicios de salud. Recurriendo al censo, se realizó un muestreo aleatorio estratificado en Madrid. Se llevó a cabo una entrevista telefónica a 2,060 mayores de 65 años utilizando el GHQ-12 y el COOP-Wonca. Encontramos asociación de la SND y la salud mental general (GHQ-12), OR = 1.43 (1.34, 1.52) y depresión, OR = 2.34 (1.54, 3.53). En rendimiento cognitivo, la variable de mayor efecto fue “los problemas de memoria alteran su vida cotidiana”, OR = 3.11 (1.25, 7.72); variables relacionadas con enfermedad: las de mayor efecto fueron “percepción del estado de salud”, OR = 1.37 (1.13, 1.67) y calidad de vida (COOP-Wonca), OR = 3.03 (2.32, 3.94); variables de dolor: dolor general, OR = 2.67 (1.87, 3.83) y artritis/artrosis, OR = 1.94 (1.38, 2.72); dificultades para ver, OR = 2.62 (1.84, 3.73) y oír, OR = 1.81 (1.21, 2.72). Se concluye que la SND es una situación compleja, lo que debe considerarse al programar soluciones que sean efectivas. (AU)

Subjective Memory Complaints in healthy older adults: Fewer complaints associated with depression and perceived health, more complaints also associated with lower memory performance.

OBJECTIVES: (i) To analyze if general cognitive performance, perceived health and depression are predictors of Subjective Memory Complaints (SMC) contrasting their effect sizes; (ii) to analyze the relationship between SMC and objective memory by comparing a test that measures memory in daily life and a classical test of associated pairs; (iii) to examine if different subgroups, formed according to the MFE score, might have different behaviors regarding the studied variables. METHODS: Sample: 3921 community-dwelling people (mean age 70.41±4.70) without cognitive impairment. Consecutive non-probabilistic recruitment. ASSESSMENT: Mini Cognitive Exam (MCE), daily memory Rivermead Behavioural Memory Test (RBMT), Paired Associates Learning (PAL), Geriatric Depression Scale (GDS), Nottingham Health Profile (NHP). Dependent variable: Memory Failures Everyday Questionnaire (MFE). RESULTS: Two different dimensions to explain SMC were found: One subjective (MFE, GDS, NHP) and other objective (RBMT, PAL, MCE), the first more strongly associated with SMC. SMC predictors were NHP, GDS, RBMT and PAL, in this order according to effect size. Considering MFE scores we subdivided the sample into three groups (low, medium, higher scores): low MFE group was associated with GDS; medium, with GDS, NPH and RBMT, and higher, with age as well. Effect size for every variable tended to grow as the MFE score was higher. CONCLUSION: SMC were associated with both health profile and depressive symptoms and, in a lesser degree, with memory and overall cognitive performance. In people with fewer SMC, these are only associated with depressive symptomatology. More SMC are associated with depression, poor health perception and lower memory.