Retrieval practice effect refers to improved memory on a final test for information retrieved one or more times. Although past theoretical work identifies cognitive mechanisms to explain retrieval ...practice benefits, it is possible that improving self-efficacy during learning may also contribute to better memory, in line with limited past work showing a relationship between self-efficacy and memory. Across two experiments, we examine the potential relationship between retrieval practice, self-efficacy, and memory. In Experiment
1
, we examined the extent change in self-efficacy accounted for improved memory on a final test after retrieval practice compared with restudy. In Experiment
2
, we gave participants (false) feedback that was either negative (i.e., you performed worse than others), neutral (i.e., you performed the same as others), or positive (i.e., you performed better than others) to more directly assess the effects of self-efficacy on memory under retrieval practice conditions. Results of Experiment 1 showed a significant retrieval practice effect, with memory on the final test being better after retrieval practice compared with restudy. Self-efficacy did not significantly mediate the retrieval practice effect. Results of Experiment 2, however, showed that decreases in self-efficacy due to (false) negative feedback resulted in worse memory performance compared with neutral feedback. Such findings may suggest that change in self-efficacy after retrieval practice attempts, particularly negative feedback, affects memory at final test. Overall, these findings suggest a relationship between retrieval practice, self-efficacy, and memory, and imply that interventions that influence self-efficacy may be a plausible mechanism to modulate memory under some conditions.
The COVID-19 pandemic has disproportionately impacted the most vulnerable and widened the health disparity gap in both physical and mental well-being. Consequentially, it is vital to understand how ...to best support elderly individuals, particularly Black Americans and people of low socioeconomic status, in navigating stressful situations during the COVID-19 pandemic and beyond. The aim of this study was to investigate perceived levels of stress, posttraumatic growth, coping strategies, socioeconomic status, and mental health between Black and non-Hispanic, White older adults, the majority over the age of 70. Additionally, we investigated which variables, if any, were associated with posttraumatic growth in these populations.
One hundred seventy-six community dwelling older adults (mean age = 76.30 ±8.94), part of two observational studies (The Harvard Aging Brain Study and Instrumental Activities of Daily Living Study) in Massachusetts, US, were included in this cross-sectional study. The survey, conducted from March 23, 2021 to May 13, 2021, measured perceived stress, behavioral coping strategies, posttraumatic growth, and mental health during the COVID-19 pandemic. We investigated associations with post-traumatic growth in a multiple linear regression model and examined their differences by race with t-tests, Wilcoxon rank-sum tests, and Fisher's exact tests. A second multiple linear regression model was used to examine which coping strategies were associated with posttraumatic growth.
Our results indicated no significant difference between the groups in terms of mental health or stress. However, Black participants showed significantly greater posttraumatic growth compared to non-Hispanic, White participants. Additionally, the coping strategies of religion and positive reframing were found to be significantly associated with posttraumatic growth. Furthermore, even with the effects of stress and coping strategies controlled for, race remained significantly associated with posttraumatic growth.
The COVID-19 pandemic has differentially impacted Black and non-Hispanic White older adults. These results may help encourage further analysis on geriatric psychiatry as well as understanding how cultural values and adaptations impact posttraumatic growth and mental health in diverse populations.
The Harvard Aging Brain Study (HABS) has been funded by NIH-NIA P01 AG036694 (PI: Reisa Sperling). The IADL study is funded by the National Institute on Aging (R01 AG053184, PI: Gad A. Marshall).
Background Changes in everyday functioning constitute a clinically meaningful outcome, even in the early stages of Alzheimer's disease. Performance-based assessments of everyday functioning might ...help uncover these early changes. We aimed to investigate how changes over time in everyday functioning relate to tau and amyloid in cognitively unimpaired older adults. Methods Seventy-six cognitively unimpaired participants (72 ± 6 years old, 61% female) completed multiple Harvard Automated Phone Task (APT) assessments over 2.0 ± 0.9 years. The Harvard APT consists of three tasks, performed through an automated phone system, in which participants refill a prescription (APT-Script), select a new primary care physician (APT-PCP), and transfer money to pay a bill (APT-Bank). Participants underwent Pittsburgh compound-B and flortaucipir positron emission tomography scans at baseline. We computed distribution volume ratios for a cortical amyloid aggregate and standardized uptake volume ratios for medial temporal and neocortical tau regions. In separate linear mixed models, baseline amyloid by time and tau by time interactions were used to predict longitudinal changes in performance on the Harvard APT tasks. Three-way amyloid by tau by time interactions were also investigated. Lastly, we examined associations between tau and change in Harvard APT scores in exploratory voxel-wise whole-brain analyses. All models were adjusted for age, sex, and education. Results Amyloid unstandardized partial regression coefficient estimate (β) = −0.007, 95% confidence interval (95% CI) = (−0.013, −0.001), and medial temporal tau β = −0.013, 95% CI = (−0.022, −0.004) were associated with change over time in years on APT-PCP only, i.e., higher baseline amyloid and higher baseline tau were associated with steeper rate of decline of APT-PCP. Voxel-wise analyses showed widespread associations between tau and change in APT-PCP scores over time. Conclusion Even among cognitively unimpaired older adults, changes over time in the performance of cognitively complex everyday activities relate to cortical amyloid and widespread cerebral tau burden at baseline. These findings support the link between Alzheimer's disease pathology and function and highlight the importance of measuring everyday functioning in preclinical disease stages.
Decades of research has investigated the relationship between memory and future thinking. Although some of this work has shown that memory forms the basis of making predictions about the future, less ...work has investigated how the outcome of those predictions (whether consistent or inconsistent with what one predicts) is later remembered. Limited past works suggests that memory for outcomes that are consistent with what one predicts are better remembered that predictions that are inconsistent. To advance understanding of the relationship between episodic memory and future thinking, the current investigation examines how the outcome of predictions affects memory after the predicted events takes place.
In this experiment, participants first learned trait information about social targets. Then, participants imagined scenarios involving targets and the self (i.e., the participant) and made predictions about which behaviors targets would perform based on the trait information associated with targets participants learned earlier. Participants were then told the behaviors the targets actually performed (i.e., prediction outcome), which was either consistent or inconsistent with predictions, before then taking a memory test for prediction outcomes (what the social target actually did).
Results showed memory for prediction-consistent outcomes was better than for prediction-inconsistent outcomes, suggesting people exhibit enhanced memory for events that are in line with predictions based on existing contents of memory (e.g., what one knows; schemas), which is in line with the limited past work in this domain.
Overall, finding better memory for prediction-consistent outcomes may reflect an adaptive function in memory, where people show enhanced memory for episodes when they play out as predicted, and aligned with the current contents of memory.
Detecting clinically meaningful changes in instrumental activities of daily living (IADL) at the earliest stages of Alzheimer's disease (AD) is critical.
The objective of this exploratory study was ...to examine the cross-sectional relationship between a performance-based IADL test, the Harvard Automated Phone Task (APT), and cerebral tau and amyloid burden in cognitively normal (CN) older adults.
Seventy-seven CN participants underwent flortaucipir tau and Pittsburgh Compound B amyloid PET. IADL were assessed using the three Harvard APT tasks: prescription refill (APT-Script), health insurance company call (APT-PCP), and bank transaction (APT-Bank). Linear regression models were used to determine associations between each APT task and entorhinal cortex, inferior temporal, or precuneus tau with or without an interaction with amyloid.
Significant associations were found between APT-Bank task rate and interaction between amyloid and entorhinal cortex tau, and APT-PCP task and interactions between amyloid and inferior temporal and precuneus tau. No significant associations were found between the APT tasks and tau or amyloid alone.
Our preliminary findings suggest an association between a simulated real-life IADL test and interactions of amyloid and several regions of early tau accumulation in CN older adults. However, some analyses were underpowered due to the small number of participants with elevated amyloid, and findings should be interpreted with caution. Future studies will further explore these associations cross-sectionally and longitudinally in order to determine whether the Harvard APT can serve as a reliable IADL outcome measure for preclinical AD prevention trials and ultimately in the clinic setting.
Background
Previous work has shown that neuropsychiatric symptoms (NPS) such as depression in older adults are associated with cognitive decline and brain pathology related to Alzheimer’s disease ...(AD), but the constellation of NPS driving these associations is unclear. Traditionally, depressive symptoms have been assessed with the Geriatric Depression Scale (GDS), but newer NPS assessments, such as the Mild Behavioral Impairment‐Checklist (MBI‐C), have shown promise for identification of specific early features of symptomology. Here we examined the two affective domains of the MBI‐C in cognitively unimpaired older adults with moderate‐to‐severe depressive symptoms and non‐depressed older adults, and the association between these domains and neuroimaging biomarkers of AD.
Method
21 clinically normal (CN) older adults who met DSM5 criteria for major depression (MDD) (73.0±4.3 y.o., 62% female) and 25 non‐depressed older adults from related observational studies at our site (70.8±3.7 y.o., 64% female) underwent a clinical battery that included the GDS and MBI‐C self‐report domains focused on decreased interest‐motivation‐drive and increased dysphoria‐anhedonia‐anxiety (Range for each domain: 0–18). Participants completed neuroimaging consisting of MRI, amyloid‐(C11‐PiB)‐PET, and tau‐(F18‐FTP)‐PET. We focused analyses on neocortical amyloid and regional tau and atrophy in the amygdala and hippocampus. A Pearson correlation was used to assess the association between GDS total score and MBI‐C component scores. Linear regressions adjusted for age were used to investigate relationships between MBI‐C domains and ATN biomarkers.
Result
GDS total score was correlated with both MBI‐C domains across all participants (Fig.1, p<0.01). In participants with MDD, the MBI‐C decreased interest‐motivation‐drive domain was associated with elevated FTP in the amygdala and hippocampus, while the increased dysphoria‐anhedonia‐anxiety domain was not significantly related to PET signal (Table 2, Fig.2). MBI‐C domains were not related to PET signal or atrophy in non‐depressed control participants.
Conclusion
Preliminary findings with the MBI‐C suggest that the decreased interest‐motivation‐drive domain may be associated with tau pathology in older adults with moderate‐to‐severe depression. Additional work needs to be done in a larger depressed cohort to further understand the associations between specific depressive phenotypes and AD pathology.
Background
Loss of awareness of cognitive decline (a.k.a. anosognosia) is a common symptom of Alzheimer’s disease (AD) dementia and has also been observed in its predementia stages. Anosognosia is ...thought to be related not only to functional changes in individual brain regions, but also to a disturbance in functional connectivity (FC) between or within networks. This study aimed to investigate how memory awareness relates to resting‐state fMRI segregation (within‐network connectivity) and integration (between‐network connectivity) maps across the AD spectrum.
Method
We included 66 older adults divided in two groups: cognitively normal (CN, n = 49), and symptomatic (mild cognitive impairment or mild AD; n = 17). Memory awareness was measured as the discrepancy between the participant’s and study partner’s scores on the Cognitive Function Instrument. Positive values indicated heightened awareness and negative values indicated unawareness. We assessed whole‐brain connectivity with resting‐state fMRI and computed voxel‐level maps of segregation and integration. General linear models were used to relate the integration or segregation of each voxel to memory awareness (in the total sample and in the two groups separately), adjusted for age, sex, and education. Multiple comparison correction was performed using cluster‐wise Monte Carlo simulations.
Result
Demographics are presented in Table 1. Segregation maps showed that lower awareness was associated with increased connectivity within the frontoparietal network (FPN) and with decreased connectivity within the medial visual, default mode (DMN), and sensory‐motor networks (Figure 1A(i); Table 2A(i)). The relationship with the FPN persisted in the CN and symptomatic groups separately, and an additional negative association between awareness and FC in the salience network was found in the CN group (Figure 1B‐C(i); Table 2B‐C(i)). In integration maps, lower awareness was associated with increased between‐network connectivity of the dorsal attention and DMN, and decreased connectivity of the salience and sensory‐motor networks (Figure 1A(ii); Table 2A(ii)). In the CN group, the sensory‐motor relationship persisted, while the DMN relationship reversed (Figure 1B‐C(ii); Table 2B‐C(ii)).
Conclusion
Anosognosia is characterized by reduced FC patterns featuring disconnection between self‐referential networks (DMN and salience) to other networks and hyperconnectivity within the FPN. Future studies should investigate the pathological underpinnings for these functional changes.
Introduction
It is important to study apathy in Alzheimer's disease (AD) to better understand its underlying neurobiology and develop effective interventions. In the current study, we sought to ...examine the relationships between longitudinal apathy and regional tau burden in cognitively impaired older adults from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database.
Methods
Three hundred and nineteen ADNI participants with mild cognitive impairment (MCI) or AD dementia underwent flortaucipir (FTP) tau positron emission tomography (PET) imaging and clinical assessment with the Neuropsychiatric Inventory (NPI) annually. Longitudinal NPI Apathy (NPI‐A) scores were examined in relation to baseline tau PET signal in three a priori selected regions implicated in AD and AD‐related apathy (supramarginal gyrus, entorhinal cortex EC and rostral anterior cingulate cortex rACC). Secondary models were adjusted for global cognition (Mini‐Mental State Examination score) and cortical amyloid (florbetapir PET).
Results
Higher baseline supramarginal gyrus and EC tau burden were each significantly associated with greater NPI‐A over time, while rACC tau was associated with higher NPI‐A but did not predict its trajectory over time. These results were retained for supramarginal and EC tau after adjusting models for global cognition and cortical amyloid.
Discussion
Our findings suggest that baseline in vivo tau burden in parietal and temporal brain regions affected in AD, and less so in a medial frontal region involved in motivational control, is associated with increasing apathy over time in older adults with MCI and AD dementia. Future work studying emergent apathy in relation to not only core AD pathology but also circuit level dysfunction may provide additional insight into the neurobiology of apathy in AD and opportunities for intervention.
Highlights
Tau (Flortaucipir PET) in regions implicated in AD was associated with increasing apathy over time
Cortical amyloid was also found to be a robust predictor of the trajectory of apathy
Evidence of synergy between regional tau and amyloid in overall higher levels of apathy
Background
Personal and social factors have had a varied effect on older adults during the COVID‐19 pandemic. Psychosocial factors and underlying pathological changes may have influenced the mental ...health of these older adults. Understanding the drivers behind the mental health of older adults during the pandemic may help identify treatment targets. We aimed to understand this phenomenon by exploring the relationships between the psychosocial factors iand self‐reported experiences of psychological well‐being.
Method
We included 149 participants (mean age: 75.6) from the Harvard Aging Brain Study and Instrumental Activities of Daily Living Study who took a survey conducted during the Summer of 2021, to assess stress (Perceived Stress Scale), loneliness (UCLA Loneliness Scale. 3‐item version), resilience (Connor Davidson Resilience Scale) and psychological well‐being (PROMIS‐Global Mental), encompassing self‐reported quality of life, mood and thinking, satisfaction with social relationships and anxiety and depressive symptoms. Pre‐assessed measures of cortical amyloid (PiB; mean time difference = 1.8 years) and medial temporal tau (Flortaucipir; mean time difference = 1.7 years) were also included. We performed a hierarchal regression analysis to understand the relationships among the psychosocial factors, controlling for demographics, amyloid, and tau as predictors of well‐being.
Result
Demographic and survey responses are presented in Table 1. Significant negative associations were found among perceived well‐being and pathology (amyloid and tau), stress and loneliness, such that increased pathology, increased stress and increased feelings of loneliness were related to worse mental health (Figure 1). A positive association was found between resilience and well‐being, such that increased resilience was related to higher well‐being. (Figure 1). The hierarchical regression analysis results revealed that loneliness (β = −0.32, t = −5.81, p<.001), stress (β = −0.38, t = −5.48, p<.001), and resilience (β = 0.28, t = 4.34, p<.001) uniquely accounted for a significant proportion of variance in well‐being even after controlling for demographic characteristics (age, sex, education, race) and psychosocial characteristics (marital status, living alone) (Table 2).
Conclusion
Our findings suggest that measuring and quantifying loneliness, stress, and resilience can help clinicians and researchers understand the potential detrimental effects of the COVID‐19 pandemic among older adults. These findings may extend to other prolonged exposures to stressful situations and uncover much needed targets for intervention.
