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Background: For over three decades, the concomitance of cortical neurodegeneration and white matter hyperintensities (WMH) has sparked discussions about their coupled temporal dynamics. Longitudinal studies supporting this hypothesis nonetheless remain scarce. Methods: We applied global and regional bivariate latent growth curve modelling to determine the extent to which WMH and cortical thickness were interrelated over a four-year period. For this purpose, we leveraged longitudinal MRI data from 451 cognitively unimpaired participants (DELCODE; median age 69.71 [IQR 65.51, 75.50] years; 52.32% female). Participants underwent MRI sessions annually over a four-year period (1815 sessions in total, with roughly four MRI sessions per participant). We adjusted all models for demographics and cardiovascular risk. Results: Our findings were three-fold. First, larger WMH volumes were linked to lower cortical thickness (σ = -0.165, SE = 0.047, Z = -3.515, P < 0.001). Second, individuals with higher WMH volumes experienced more rapid cortical thinning (σ = -0.226, SE = 0.093, Z = -2.443, P = 0.007), particularly in temporal, cingulate, and insular regions. Similarly, those with lower initial cortical thickness had faster WMH progression (σ = -0.141, SE = 0.060, Z = -2.336, P = 0.009), with this effect being most pronounced in temporal, cingulate, and insular cortices. Third, faster WMH progression was associated with accelerated cortical thinning (σ = -0.239, SE = 0.139, Z = -1.710, P = 0.044), particularly in frontal, occipital, and insular cortical regions. Conclusions: Our study suggests that cortical thinning and WMH progression could be mutually reinforcing rather than parallel, unrelated processes, which become entangled before cognitive deficits are detectable. Trial registration: German Clinical Trials Register (DRKS00007966, 04/05/2015). [ABSTRACT FROM AUTHOR]

Introduction: Cholinesterase inhibitors can enhance cognitive functions in healthy elderly and delay cognitive decline in patients with Alzheimer‘s disease (AD). However, not everyone benefits from this treatment (non-responders). Current studies show clinical meaningful improvements only in one third of AD patients treated with cholinesterase inhibitors. Methods: Here we investigate structural magnetic resonance imaging of the basal forebrain cholinergic system volume (BFvol) as a potential predictor of cognitive response to a single dose of galantamine in healthy adults (n = 18; 59 to 75 years). Results: We observed that the cognitive response to galantamine, more specifically the attention-dependent filtering performance in a delayed match-to-sample working memory task, correlated with BFvol: Only participants with high BFvol showed a significant positive effect of galantamine on the ability to filter out distracting information during the workingmemory encoding process. Discussion: Future studies need to assess whether BFvol may serve as a predictor of the galantamine response in AD patients, too. [ABSTRACT FROM AUTHOR]

Cognitive performance is often found to be lower in older adults, especially when the task requires memory, executive functions, or selective attention. But this alleged deterioration may have been overestimated in the past due to ecologically invalid testing. To verify this possible misjudgment here we compared age-related memory performance in a typical, abstract computer task to a paper-pencil test with a real-world map and to an even more realistic task that took place in a real room with everyday objects. Retention and response intervals differed between the tasks as they had to be adjusted to the different settings. Twenty-seven younger (19–29 years old) and twenty-three older participants (61–77 years old) took part in the study. As expected younger participants outperformed the older ones in the computer task. However, although older adults' performance was better in both more realistic tasks, the delta to the young remained the same as in the computer task. Hence, these results do not support the general notion that older adults would profit from more realistic test scenarios. On the other hand, performance in a clinical screening task correlated only with the performance in the real world task suggesting that this task reflected the general cognitive status of participants better than the more abstract tasks. Finally, it was observed that the presence of task-irrelevant distractor items actually helped older adults to improve their performance in the paper pencil task arguing against the assumption of a general age-related impairment of inhibition. In sum, the present results show that age-related changes in memory are neither simply explained by reduced abilities to deal with abstract computer tasks nor by disturbed inhibition processes. [ABSTRACT FROM AUTHOR]

Decision-making is an important everyday function that deteriorates during normal aging. Here, we asked whether value-based decision-making can be improved in the elderly by cognitive training. We compared the effects of two training regimens on the performance in the Iowa Gambling Task (IGT), a real-life decision-making simulation task. Elderly participants (age 62–75 years) were randomized into three matched groups. The filter training (FT) group performed a selective attention task and the memory training (MT) group performed a memory storage task on five consecutive days. The control group (CG) did not perform another task besides the IGT. Only the FT group showed an improvement in IGT performance over the five days—the overall gain rose and the prominent deck B phenomenon decreased. The latter refers to the selection of cards associated with high gains and rare losses, which are nevertheless a disadvantageous choice as the frequent losses lead to a negative net outcome. As the deck B phenomenon has been associated with impaired cognitive abilities in aging, the positive effect of FT here is of special importance. In sum, attention training seems superior in improving decision-making in the elderly. [ABSTRACT FROM AUTHOR]