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Objective A meta-analytic review was conducted to assess the effects of healthy aging, amnestic Mild Cognitive Impairment (MCI) and Alzheimer’s Disease (AD) on naturalistic autobiographical memory using the Autobiographical Interview, a widely used, standardized assessment that derives measures of internal (episodic) and external (non-episodic) details from freely recalled autobiographical narratives. Method A comprehensive literature search identified 21 aging, 6 MCI, and 7 AD studies (total N =1556 participants). Summary statistics for internal and external details for each comparison (younger vs. older or MCI/AD vs. age-matched comparison groups) and effect size statistics were extracted and summarized using Hedges’ g (random effects model) and adjusted for the presence of publication bias. Results The pattern of reduced internal and elevated external details in aging was robust and consistent across nearly all 21 studies. MCI and – to a greater extent – AD were associated with reduced internal details, whereas the external detail elevation faded with MCI and AD. Although there was evidence of publication bias on reporting of internal detail effects, these effects remained robust after correction. Discussion The canonical changes to episodic memory observed in aging and neurodegenerative disease are mirrored in the free recall of real-life events. Our findings indicate that the onset of neuropathology overwhelms the capacity of older adults to draw upon distributed neural systems to elaborate on past experiences, including both episodic details specific to identified events and non-episodic content characteristic of healthy older adults’ autobiographical narratives.

Understanding synergies between neurodegenerative and cerebrovascular pathologies that modify dementia presentation represents an important knowledge gap.This multi-site, longitudinal, observational cohort study recruited participants across prevalent neurodegenerative diseases and cerebrovascular disease and assessed participants comprehensively across modalities. We describe univariate and multivariate baseline features of the cohort and summarize recruitment, data collection, and curation processes.We enrolled 520 participants across five neurodegenerative and cerebrovascular diseases. Median age was 69 years, median Montreal Cognitive Assessment score was 25, median independence in activities of daily living was 100% for basic and 93% for instrumental activities. Spousal study partners predominated; participants were often male, White, and more educated. Milder disease stages predominated, yet cohorts reflect clinical presentation.Data will be shared with the global scientific community. Within-disease and disease-agnostic approaches are expected to identify markers of severity, progression, and therapy targets. Sampling characteristics also provide guidance for future study design.

Background Cerebral small vessel disease is associated with higher ratios of soluble‐epoxide hydrolase derived linoleic acid diols (12,13‐dihydroxyoctadecenoic acid [DiHOME] and 9,10‐DiHOME) to their parent epoxides (12(13)‐epoxyoctadecenoic acid [EpOME] and 9(10)‐EpOME); however, the relationship has not yet been examined in stroke. Methods and Results Participants with mild to moderate small vessel stroke or large vessel stroke were selected based on clinical and imaging criteria. Metabolites were quantified by ultra‐high‐performance liquid chromatography–mass spectrometry. Volumes of stroke, lacunes, white matter hyperintensities, magnetic resonance imaging visible perivascular spaces, and free water diffusion were quantified from structural and diffusion magnetic resonance imaging (3 Tesla). Adjusted linear regression models were used for analysis. Compared with participants with large vessel stroke (n=30), participants with small vessel stroke (n=50) had a higher 12,13‐DiHOME/12(13)‐EpOME ratio (β=0.251, P =0.023). The 12,13‐DiHOME/12(13)‐EpOME ratio was associated with more lacunes (β=0.266, P =0.028) but not with large vessel stroke volumes. Ratios of 12,13‐DiHOME/12(13)‐EpOME and 9,10‐DiHOME/9(10)‐EpOME were associated with greater volumes of white matter hyperintensities (β=0.364, P P P =0.011; β=0.314, P =0.006). In small vessel stroke, the 12,13‐DiHOME/12(13)‐EpOME ratio was associated with higher white matter free water diffusion (β=0.439, P =0.016), which was specific to the temporal lobe in exploratory regional analyses. The 9,10‐DiHOME/9(10)‐EpOME ratio was associated with temporal lobe atrophy (β=−0.277, P =0.031). Conclusions Linoleic acid markers of cytochrome P450/soluble‐epoxide hydrolase activity were associated with small versus large vessel stroke, with small vessel disease markers consistent with blood brain barrier and neurovascular‐glial disruption, and temporal lobe atrophy. The findings may indicate a novel modifiable risk factor for small vessel disease and related neurodegeneration.

Mean cognitive performance is worse in amnestic mild cognitive impairment (aMCI) compared to control groups. However, studies on variability of cognitive performance in aMCI have yielded inconclusive results, with many differences in variability measures and samples from one study to another.We examined variability in aMCI using an existing older adult sample (Between-groupThe current study demonstrates that self-administered online tests can be used to remotely assess different types of variability in people at risk of Alzheimer`s. Our findings show small but significantly more interindividual differences in people with aMCI. This diversity is considered as "noise" in standard assessments of mean performance, but offers an interesting and cognitively informative "signal" in itself.

One of the greatest challenges for older, homebound patients receiving health care is accessibility, particularly following a hospitalization. The current study evaluates the effects of using voice-activated technology in the homes of recently discharged patients and its effects on health care outcomes. Voice-based software was embedded in a smart device, which allowed patients to ask questions and receive answers about their own specific care plan. A pre-post study design was used. Forty-eight patients completed the pre and post survey. There was a 63% reduction in emergency department visits and a 26% reduction in physician calls. There was no change in the number of patients requiring hospitalization. More than one half of patients used the smart device daily for their health care needs. More than 70% of patients believed the device was helpful for their general health care needs and assisted in the achievement of care goals. This is the first study of its kind to evaluate patient engagement and outcomes after the use of a smart device with embedded health care directions. [ Journal of Gerontological Nursing, 48 (12), 17–24.]

Objectives Age-related differences in cognition are typically assessed by comparing groups of older to younger participants, but little is known about the continuous trajectory of cognitive changes across age, or when a shift to older adulthood occurs. We examined the pattern of mean age differences and variability on episodic memory and executive function measures over the adult life span, in a more fine-grained way than past group or life-span comparisons. Method We used a sample of over 40,000 people aged 18–90 who completed psychometrically validated online tests measuring episodic memory and executive functions (the Cogniciti Brain Health Assessment). Results Cognitive performance declined gradually over adulthood, and rapidly later in life on spatial working memory, processing speed, facilitation (but not interference), associative recognition, and set shifting. Both polynomial and segmented regression fit the data well, indicating a nonlinear pattern. Segmented regression revealed a shift from gradual to rapid decline that occurred in the early 60s. Variability between people (interindividual variability or diversity) and variability within a person across tasks (intraindividual variability or dispersion) also increased gradually until the 60s, and rapidly after. Confirmatory factor analysis revealed a single general factor (of variance shared between tasks) offered a good fit for performance across tasks. Discussion Life-span cognitive performance shows a nonlinear pattern, with gradual decline over early and mid-adulthood, followed by a transition in the 60s to notably accelerated, but more variable, decline. Some people show less decline than others, and some cognitive abilities show less within-person decline than others.

Neurodevelopmental disorders are categorized and studied according to their manifestations as distinct syndromes. For instance, congenital prosopagnosia and dyslexia have largely non-overlapping research literatures and clinical pathways for diagnosis and intervention. On the other hand, the high incidence of neurodevelopmental comorbidities or co-existing extreme strengths and weaknesses suggest that transdiagnostic commonalities may be greater than currently appreciated. The core-periphery model holds that brain regions within the stable core perceptual and motor regions are more densely connected to one another compared to regions in the flexible periphery comprising multimodal association regions. This model provides a framework for the interpretation of neural data in normal development and clinical disorders. Considering network-level commonalities reported in studies of neurodevelopmental disorders, variability in multimodal association cortex connectivity may reflect a shared origin of seemingly distinct neurodevelopmental disorders. This framework helps to explain both comorbidities in neurodevelopmental disorders and profiles of strengths and weaknesses attributable to competitive processing between cognitive systems within an individual.

Successful treatments exist for both ADHD and tics, but minimal research has been done on treatments that treat tics in children with ADHD. The purpose of this study was to analyze data from a nationally-representative sample of children with ADHD to determine characteristics and demographic factors that maximize tic prevalence and find the most beneficial treatments for those with tics. The data used was from the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome, a follow-up to the National Survey of Children’s Health, conducted by the CDC. The focus of data analysis was to assess tic prevalence in children with ADHD and different demographic characteristics as well as treatment prevalence among demographics and their effects on children with tic disorders. Males seven years or younger and in families at or below the federal poverty level were most likely to have tics. Rates of tic decline were highest in older children and children in families with income substantially above the poverty line. Antipsychotic medications, peer intervention and dietary supplements were found to be significantly more beneficial to school performance of children with ADHD and tic disorders than children without tics. Based on the sample, a combination of antipsychotics, peer intervention and dietary supplements is likely the best option for children with ADHD and tics. Future clinical studies should prioritize treating comorbid disorders before the perceived primary disorder. Comorbid disorders are often the root cause of problems that can exacerbate symptoms and require intense treatment and care.

Objectives:Many older adults experience memory changes that can have a meaningful impact on their everyday lives, such as restrictions to lifestyle activities and negative emotions. Older adults also report a variety of positive coping responses that help them manage these changes. The purpose of this study was to determine how objective cognitive performance and self-reported memory are related to the everyday impact of memory change.Methods:We examined these associations in a sample of 94 older adults (age 60–89, 52% female) along a cognitive ability continuum from normal cognition to mild cognitive impairment.Results:Correlational analyses revealed that greater restrictions to lifestyle activities (|rs| = .36–.66), more negative emotion associated with memory change (|rs| = .27–.76), and an overall greater burden of memory change on everyday living (|rs| = .28–.61) were associated with poorer objective memory performance and lower self-reported memory ability and satisfaction. Performance on objective measures of executive attention was unrelated to the impact of memory change. Self-reported strategy use was positively related to positive coping with memory change (|r| = .26), but self-reported strategy use was associated with more negative emotions regarding memory change (|r| = .23).Conclusions:Given the prevalence of memory complaints among older adults, it is important to understand the experience of memory change and its impact on everyday functioning in order to develop services that target the specific needs of this population.

Background: The production of autobiographical narratives requires linguistic structures and the ability to access and generate both semantic information and episodic details of personal events. Ai...

Objectives: Caregiving burdens are a substantial concern in the clinical care of persons with neurodegenerative disorders. In the Ontario Neurodegenerative Disease Research Initiative, we used the Zarit's Burden Interview (ZBI) to examine: (1) the types of burdens captured by the ZBI in a cross-disorder sample of neurodegenerative conditions (2) whether there are categorical or disorder-specific effects on caregiving burdens, and (3) which demographic, clinical, and cognitive measures are related to burden(s) in neurodegenerative disorders?. Methods/Design: N = 504 participants and their study partners (e.g., family, friends) across: Alzheimer's disease/mild cognitive impairment (AD/MCI; n = 120), Parkinson's disease (PD; n = 136), amyotrophic lateral sclerosis (ALS; n = 38), frontotemporal dementia (FTD; n = 53), and cerebrovascular disease (CVD; n = 157). Study partners provided information about themselves, and information about the clinical participants (e.g., activities of daily living (ADL)). We used Correspondence Analysis to identify types of caregiving concerns in the ZBI. We then identified relationships between those concerns and demographic and clinical measures, and a cognitive battery. Results: We found three components in the ZBI. The first was “overall burden” and was (1) strongly related to increased neuropsychiatric symptoms (NPI severity r = 0.586, NPI distress r = 0.587) and decreased independence in ADL (instrumental ADLs r = −0.566, basic ADLs r = −0.43), (2) moderately related to cognition (MoCA r = −0.268), and (3) showed little-to-no differences between disorders. The second and third components together showed four types of caregiving concerns: current care of the person with the neurodegenerative disease, future care of the person with the neurodegenerative disease, personal concerns of study partners, and social concerns of study partners. Conclusions: Our results suggest that the experience of caregiving in neurodegenerative and cerebrovascular diseases is individualized and is not defined by diagnostic categories. Our findings highlight the importance of targeting ADL and neuropsychiatric symptoms with caregiver-personalized solutions.

Influential research has focused on identifying the common neural and behavioural substrates underlying episodic memory (the re-experiencing of specific details from past experiences) and spatial cognition, with some theories proposing that these are supported by the same mechanisms. However, the similarities and differences between these two forms of memory in humans require further specification. We used an individual-differences approach based on self-reported survey data collected in a large online study (n = 7,487), focusing on autobiographical episodic memory and spatial navigation and their relationship to object and spatial imagery abilities. Multivariate analyses replicated prior findings that autobiographical episodic memory abilities dissociated from spatial navigational abilities. Considering imagery, episodic autobiographical memory overlapped with imagery of objects, whereas spatial navigation overlapped with a tendency to focus on spatial schematics and manipulation. These results suggest that trait episodic autobiographical memory and spatial navigation correspond to distinct mental processes.

Background:Vascular cognitive impairment (VCI) post-stroke is frequent but may go undetected, which highlights the need to better screen cognitive functioning following a stroke.Aim:We examined the clinical utility of the Montreal Cognitive Assessment (MoCA) in detecting cognitive impairment against a gold-standard neuropsychological battery.Methods:We assessed cognitive status with a comprehensive battery of neuropsychological tests in 161 individuals who were at least 3-months post-stroke. We used receiver operating characteristic (ROC) curves to identify two cut points for the MoCA to maximize sensitivity and specificity at a minimum 90% threshold. We examined the utility of the Symbol Digit Modalities Test, a processing speed measure, to determine whether this additional metric would improve classification relative to the MoCA total score alone.Results:Using two cut points, 27% of participants scored ≤ 23 and were classified as high probability of cognitive impairment (sensitivity 92%), and 24% of participants scored ≥ 28 and were classified as low probability of cognitive impairment (specificity 91%). The remaining 48% of participants scored from 24 to 27 and were classified as indeterminate probability of cognitive impairment. The addition of a processing speed measure improved classification for the indeterminate group by correctly identifying 65% of these individuals, for an overall classification accuracy of 79%.Conclusions:The utility of the MoCA in detecting cognitive impairment post-stroke is improved when using a three-category approach. The addition of a processing speed measure provides a practical and efficient method to increase confidence in the determined outcome while minimally extending the screening routine for VCI.

This study investigates coherence of discourse in the production of autobiographical narratives by individuals with aMCI. Autobiographical interviews were analyzed to determine whether reduced episodic recall was related to deficits in discourse coherence. A coherence rating scale was used to evaluate relatedness of the autobiographical details produced by participants to the topic of discourse. Interviews were transcribed, segmented into details, and divided into sets of episodic, semantic, or supplementary information, which were subsequently analysed with the coherence rating scale. We predicted that the known episodic deficits observed in aMCI could also affect the retrieval of coherent episodic information. The results revealed deficits in coherence could be found in both episodic and semantic information in the aMCI group. These results suggest that the cognitive deficits experienced by individuals with aMCI may go beyond their known difficulty in recalling episodic details, as they also affect the controlled retrieval of both episodic and semantic information.

As large research initiatives designed to generate big data on clinical cohorts become more common, there is an increasing need to establish standard quality assurance (QA; preventing errors) and quality control (QC; identifying and correcting errors) procedures for critical outcome measures. The present article describes the QA and QC approach developed and implemented for the neuropsychology data collected as part of the Ontario Neurodegenerative Disease Research Initiative study. We report on the efficacy of our approach and provide data quality metrics. Our findings demonstrate that even with a comprehensive QA protocol, the proportion of data errors still can be high. Additionally, we show that several widely used neuropsychological measures are particularly susceptible to error. These findings highlight the need for large research programs to put into place active, comprehensive, and separate QA and QC procedures before, during, and after protocol deployment. Detailed recommendations and considerations for future studies are provided.

Autobiographical memory—memory for our personal past—is a multifaceted mnemonic activity that evolves throughout the lifespan and interacts with numerous other cognitive functions. Retrieving personal past events engages processes of cue specification, search, and elaboration of details within the specified event. The retrieved content varies from specific episodes unique in time and place to more general representations of autobiographical facts (personal semantics). As expected given this complexity, autobiographical memory is mediated by distributed brain networks, with key regions in the medial temporal lobes and their connections to both anterior and posterior cortical regions supporting different levels of specificity in memory retrieval. These patterns only partially overlap with those evoked by laboratory-based episodic memory paradigms. While most empirical work on autobiographical memory focuses on the recall of particular past events, more recent research concerns individual differences in the way that people tend to remember their past. The formal study of autobiographical memory dates to the 19th century, but research in this field is burgeoning, particularly in relation to brain network connectivity. New paradigms that bridge the gap between traditional laboratory memory tasks and rich, naturalistic autobiographical memories will enhance the understanding of memory as it operates in everyday life.

Occupations are typically characterized in nominal form, a format that limits options for hypothesis testing and data analysis. We drew upon ratings of knowledge, skills, and abilities for 966 occupations listed in the US Department of Labor’s Occupational Classification Network (O*NET) database to create an accessible, standardized multidimensional space in which occupations can be quantitatively localized and compared. Principal components analysis revealed that the occupation space comprises three main dimensions that correspond to 1) the required amount of education and training, 2) the degree to which an occupation falls within a science, technology, engineering, and mathematics (STEM) discipline versus social sciences and humanities, and 3) whether occupations are more mathematically or health-related. Additional occupational spaces reflecting cognitive versus labour-oriented categories were created for finer grained characterization of dimensions within occupational sets defined by higher or lower required educational preparation. Data-driven groupings of related occupations were obtained with hierarchical cluster analysis (HCA). Proof-of-principle was demonstrated with a real-world dataset (470 participants from the Nathan Kline Institute – Rockland Sample; NKI-RS), whereby verbal and non-verbal abilities—as assessed by standardized testing—were related to the STEM versus social sciences and humanities dimension. Visualization of Latent Components Assessed in O*Net Occupations (VOLCANO) is provided to the research community as a freely accessible tool, along with a shiny app for users to extract quantitative scores along the relevant dimensions. VOLCANO brings much-needed standardization to unwieldy occupational data. Moreover, it can be used to create new occupational spaces customized to specific research domains.

Reversible lifestyle behaviors (modifiable risk factors) can reduce dementia risk by 40%, but their prevalence and association with cognition throughout the adult lifespan is less well understood.The associations between the number of modifiable risk factors for dementia (low education, hypertension, hearing loss, traumatic brain injury, alcohol or substance abuse, diabetes, smoking, and depression) and cognition were examined in an online sample (Older adults (ages 66-89) had more risk factors than middle-aged (ages 45-65) and younger adults (ages 18-44). Polynomial regression revealed that each additional risk factor was associated with lower cognitive performance (equivalent to 3 years of aging), with a larger association as age increased. People with no risk factors in their forties to seventies showed similar cognitive performance to people 10 or 20 years younger with many risk factors.Modifiable dementia risk factors amplify lifespan age differences in cognitive performance.

Background: Modifiable lifestyle behaviours can reduce dementia risk by 40%, but their prevalence and association with cognition throughout the adult lifespan is less well understood. Methods: Associations between eight modifiable risk factors for dementia (low education, hypertension, hearing loss, traumatic brain injury, alcohol or substance abuse, diabetes, smoking, and depression) and cognition were examined in an online sample (N = 22,117, aged 18-89). Findings: Older adults (ages 66-89) had more risk factors than middle-aged (ages 45-65) and younger adults (ages 18-44). Polynomial regression revealed each additional risk factor was associated with a drop in cognitive performance (equivalent to three years of aging), with a larger association as age increased. People with no risk factors in their forties to seventies showed similar cognitive performance to people ten or twenty years younger with many risk factors. Interpretation: Modifiable dementia risk factors may be more important than age in predicting cognitive performance.

INTRODUCTION: More women than men develop Alzheimer’s disease, yet women show less age-related episodic memory decline, a contradiction that may be accounted for by modifiable risk factors for dementia. METHODS: Associations between sex, modifiable dementia risk factors, and cognition were measured in a cross-sectional online sample (n = 21,840, ages 18-89). RESULTS: Across four tests of associative memory and executive functions, only a Face-Name Association task revealed sex differences in age-related decline. Men had worse associative memory than women (the equivalent of four years of aging). Each additional risk factor had the equivalent of three and a half years of aging. Men had greater age-related decline in associative memory than women among those with no to one risk factors, but multiple risk factors eliminated the female advantage. DISCUSSION: Because the relationship between dementia risk factors and age-related memory decline differs for men and women, sex-specific dementia prevention approaches are warranted.

ObjectiveTo assess overlap and uniqueness of established behavioral markers of speed of processing for different aspects of visual information within a cerebrovascular disease cohort, and to examine the link between these speed of processing markers and functional behavior, specifically walking.MethodsA cohort of 161 participants with cerebrovascular disease recruited to the Ontario Neurodegenerative Disease Research Initiative (ONDRI) were examined with three types of assessments: neuropsychology, saccadic eye movement and gait. Principal component analysis (PCA) and canonical correlation analysis (CCA) were performed on select variables from these assessments to reveal commonalities and discrepancies among the measures.ResultsPCA analysis revealed different variable patterns between neuropsychology and saccade assessments, with the first component characterized primarily by neuropsychology, and the second and third components more influenced by the saccade assessments. CCA analysis did not reveal association between different types of assessments with the exception of a modest, but significant, positive association between speed of processing measures from the neuropsychological assessments and gait speed.DiscussionNeuropsychological tests and the pro-saccade task can be used for assessment of speed of processing for two major features of visual information, visual perception vs. spatial location. Despite a general lack of association between different types of assessments, combining gait speed as an important contributor to the models reinforces the idea of the link between speed of processing and complex function such as walking, and provides support for the importance of attending to the potential consequences of changes in speed of processing after neurologic injury.

As data collection for public transportation improves and customers’ appetite for information grows, there has been a growing interest in performance measurement systems that better reflect customer experience and quantify the impacts of service while accounting for ridership. A fair amount of research has been dedicated to developing and refining these kinds of metrics, with a particular focus on comparing customers’ expected and actual waiting time on train platforms or at bus stops. Despite this, only a limited number of transit agencies have implemented such measures. This paper presents a set of metrics developed by the Metropolitan Transportation Authority (MTA) that calculates the additional time customers spend waiting for and riding buses in excess of the schedule, termed additional bus stop time (ABST) and additional travel time (ATT) respectively. Trip time performance, termed customer journey time performance (CJTP), is also computed. The methodology leverages MTA’s origin–destination (OD) ridership model and bus location data to calculate these values for each individual passenger. Measuring at the passenger level means that impacts of service delays or changes can be weighted by the number of passengers affected, unlike past bus-level measures. This enables the design of service management techniques that benefit the most riders possible. The form of the metrics, which puts service impacts in easy-to-understand terms that reflect actual customer experience, likewise provides the opportunity to better engage with customers. MTA is among the first to make these metrics regularly available to the public, and the first to publicly report them for buses.

Clinician-led memory interventions have been shown to increase knowledge, reduce anxiety, promote memory-strategy use, and increase brain-healthy lifestyle behaviours in older adults with normal age-related memory changes. A self-guided, e-learning version of the Baycrest Memory and Aging Program® was recently developed to increase accessibility to memory interventions. The objectives of the current study were to assess program feasibility (retention rate), acceptability (satisfaction), and participant-reported impact (memory concerns, behaviour change, goal attainment). As part of a larger study, participants were 139 healthy older adults (mean age: 73±7, 73% female). Ninety-two individuals completed the program (retention rate=66%). Anonymous feedback data indicated a high level of satisfaction with the program overall (98%), the pace and clarity of the learning modules (100%), and the organization and navigation of the interface (92%). Suggested improvements included offering more interaction with others and addressing minor platform glitches. There was a decrease in the level of concern about memory change, with 64% expressing concern at a level consistent with the Jessen et al. (2014) criteria for Subjective Cognitive Decline at baseline, and 23% expressing the same at post-test. The majority of participants reported increases in using memory-strategies (63-97%) and lifestyle-promoting behaviours (40-72%). All participants reported moderate to high satisfaction with personal goal attainment. Results support feasibility, acceptability, and impact of a self-guided e-learning adaptation of memory intervention. E-learning tools may be a promising avenue to deliver accessible brain health promotion in later life, especially in the context of the shift to virtual care during and beyond COVID-19.

Objectives Recent studies suggest that interindividual genetic differences in glial-dependent CSF flow through the brain parenchyma, known as glymphatic flow, may trigger compensatory changes in human sleep physiology. In animal models, brain perivascular spaces are a critical conduit for glymphatic flow. We tested the hypothesis that MRI-visible PVS volumes, a putative marker of perivascular dysfunction, are associated with compensatory differences in real-world human sleep behavior. Methods We analyzed data from 152 cerebrovascular disease patients from the Ontario Neurodegenerative Disease Research Initiative (ONDRI). PVS volumes were measured using 3T-MRI. Self-reported total sleep time, time in bed, and daytime dysfunction were extracted from the Pittsburgh Sleep Quality Index. Results Individuals with greater PVS volumes reported longer time in bed (+0.85 h per log10 proportion of intracranial volume (ICV) occupied by PVS, SE = 0.30, p = 0.006) and longer total sleep times (+0.70 h per log10 proportion of ICV occupied by PVS volume, SE = 0.33, p = 0.04), independent of vascular risk factors, sleep apnea, nocturnal sleep disturbance, depression, and global cognitive status. Further analyses suggested that the positive association between PVS volumes and total sleep time was mediated by greater time in bed. Moreover, despite having on average greater total sleep times, individuals with greater basal ganglia PVS volumes were more likely to report daytime dysfunction (OR 5.63 per log10 proportion of ICV occupied by PVS, 95% CI: 1.38–22.26, p = 0.018). Conclusions Individuals with greater PVS volumes spend more time in bed, resulting in greater total sleep time, which may represent a behavioral compensatory response to perivascular space dysfunction.

Purpose: Dementia due to cerebrovascular disease (CVD) is common. Detecting early cognitive decline in CVD is critical because addressing risk factors may slow or prevent dementia. This study used a multidomain discourse analysis approach to determine the spoken language signature of CVD-related cognitive impairment. Method: Spoken language and neuropsychological assessment data were collected prospectively from 157 participants with CVD as part of the Ontario Neurodegenerative Disease Research Initiative, a longitudinal, observational study of neurodegenerative disease. Participants were categorized as impaired (n = 92) or cognitively normal for age (n = 65) based on neuropsychology criteria. Spoken language samples were transcribed orthographically and annotated for 13 discourse features, across five domains. Discriminant function analyses were used to determine a minimum set of discourse variables, and their estimated weights, for maximizing diagnostic group separation. Results: The optimal discriminant function that included 10 of 13 discourse measures correctly classified 78.3% of original cases (69.4% cross-validated cases) with a sensitivity of 77.2% and specificity of 80.0%. Conclusion: Spoken discourse appears to be a sensitive measure for detecting cognitive impairment in CVD with measures of productivity, information content, and information efficiency heavily weighted in the final algorithm.

How accurate is memory? Although people implicitly assume that their memories faithfully represent past events, the prevailing view in research is that memories are error prone and constructive. Yet little is known about the frequency of errors, particularly in memories for naturalistic experiences. Here, younger and older adults underwent complex real-world experiences that were nonetheless controlled and verifiable, freely recalling these experiences after days to years. As expected, memory quantity and the richness of episodic detail declined with increasing age and retention interval. Details that participants did recall, however, were highly accurate (93%–95%) across age and time. This level of accuracy far exceeded comparatively low estimations among memory scientists and other academics in a survey. These findings suggest that details freely recalled from one-time real-world experiences can retain high correspondence to the ground truth despite significant forgetting, with higher accuracy than expected given the emphasis on fallibility in the field of memory research.

Decades of memory research demonstrate the importance of temporal organization in recall dynamics, using laboratory stimuli (i.e., word lists) at seconds- to minutes-long delays. Little is known, however, about such organization in recall of richer and more remote real-world experiences, in which the focus is usually on memory content without reference to event order. Here, 119 younger and older adults freely recalled extended real-world experiences, for which the encoding sequence was controlled, after 2 days or 1 week. We paired analytical tools from the list-learning and autobiographical memory literatures to measure spontaneous contextual dynamics and details in these recall narratives. Recall dynamics were organized by temporal context (contiguity and forward asymmetry), and organization was reduced in older age, despite similar serial position effects and recall initiation across age groups. Across participants, organization was positively associated with richness of episodic detail, providing evidence for a link between reexperiencing past events and reinstating their spatiotemporal context.

Objectives Our aim was to validate the online Brain Health Assessment (BHA) for detection of amnestic mild cognitive impairment (aMCI) compared to gold-standard neuropsychological assessment. We compared the diagnostic accuracy of the BHA to the Montreal Cognitive Assessment (MoCA). Methods Using a cross-sectional design, community-dwelling older adults completed a neuropsychological assessment, were diagnosed as normal cognition (NC) or aMCI, and completed the BHA and MoCA. Both logistic regression (LR) and penalized logistic regression (PLR) analyses determined BHA and demographic variables predicting aMCI; MoCA variables were similarly modeled. Diagnostic accuracy was compared using area under the receiver operating characteristic curve (ROC AUC) analyses. Results Ninety-one participants met inclusion criteria (51 aMCI, 40 NC). PLR modeling for the BHA indicated Face–Name Association, Spatial Working Memory, and age-predicted aMCI (ROC AUC = 0.76; 95% confidence interval [CI]: 0.66–0.86). Optimal cut-points resulted in 21% classified as aMCI (positive), 23% negative, and 56% inconclusive. For the MoCA, digits, abstraction, delayed recall, orientation, and age predicted aMCI (ROC AUC = 0.71; 95% CI: 0.61–0.82). Optimal cut-points resulted in 22% classified positive, 8% negative, and 70% inconclusive (LR results presented within). The BHA model classified fewer participants into the inconclusive category and more as negative for aMCI, compared to the MoCA model (Stuart–Maxwell p = .004). Discussion The self-administered BHA provides similar detection of aMCI as a clinician-administered screener (MoCA), with fewer participants classified inconclusively. The BHA has the potential to save practitioners time and decrease unnecessary referrals for a comprehensive assessment to determine the presence of aMCI.

Background Individuals differ in how they remember the past: some richly re-experience specific details of past episodes, whereas others recall only the gist of past events. Little research has examined how such trait mnemonics, or lifelong individual differences in memory capacities, relate to cognitive aging. We specifically examined trait episodic autobiographical memory (AM, the tendency to richly re-experience episodic details of past events) in relation to complaints of everyday cognitive functioning, which are known to increase with age. Although one might predict that individuals reporting higher trait-level episodic AM would be resistant to age-related decline in everyday function, we made the opposite prediction. That is, we predicted that those with lower trait-level episodic AM would be better equipped with compensatory strategies, practiced throughout the lifespan, to cope with age-related memory decline. Those with higher trait-level episodic AM would have enhanced sensitivity to age-related cognitive changes due to their tendency to rely on their perceived above-average memory function. Methods We tested these predictions in 959 older adults aged 50–93 using online subjective and objective measures of memory and cognitive function. Our key measures of interest were the Survey of Autobiographical Memory, a measure of autobiographical memory abilities; and the Cognitive Failures Questionnaire, a measure of everyday cognitive function. Results In keeping with our prediction, we found that complaints of day-to-day memory slips and errors (normally elevated with age) remained stable or even decreased with age among those reporting lower trait-level episodic AM, whereas those reporting higher trait-level episodic AM reported the expected age-related increase in such errors. This finding was specific to episodic AM and not observed for other autobiographical memory capacities (e.g., semantic, spatial). It was further unaccounted for by response bias or objectively assessed cognitive abilities. Conclusions Congenitally low trait-level episodic AM may paradoxically confer a functional advantage in aging. This could be due to well-developed non-episodic strategies not present in those with higher abilities, who are more sensitive to age-related memory decline attributable to medial temporal lobe changes. Our findings emphasize the importance of considering individual differences when studying cognitive aging trajectories.

ObjectiveIn individuals over the age of 65, concomitant neurodegenerative pathologies contribute to cognitive and/or motor decline and can be aggravated by cerebrovascular disease, but our understanding of how these pathologies synergize to produce the decline represents an important knowledge gap. The Ontario Neurodegenerative Disease Research Initiative (ONDRI), a multi-site, longitudinal, observational cohort study, recruited participants across multiple prevalent neurodegenerative diseases and cerebrovascular disease, collecting a wide array of data and thus allowing for deep investigation into common and unique phenotypes. This paper describes baseline features of the ONDRI cohort, understanding of which is essential when conducting analyses or interpreting results.MethodsFive disease cohorts were recruited: Alzheimer’s disease/amnestic mild cognitive impairment (AD/MCI), amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), Parkinson’s disease (PD), and cerebrovascular disease (CVD). Assessment platforms included clinical, neuropsychology, eye tracking, gait and balance, neuroimaging, retinal imaging, genomics, and pathology. We describe recruitment, data collection, and data curation protocols, and provide a summary of ONDRI baseline characteristics.Results520 participants were enrolled. Most participants were in the early stages of disease progression. Participants had a median age of 69 years, a median Montreal Cognitive Assessment score of 25, a median percent of independence of 100 for basic activities of daily living, and a median of 93 for instrumental activities. Variation between disease cohorts existed for age, level of cognition, and geographic location.ConclusionONDRI data will enable exploration into unique and shared pathological mechanisms contributing to cognitive and motor decline across the spectrum of neurodegenerative diseases.

Objectives: In the Ontario Neurodegenerative Disease Research Initiative (ONDRI), we aimed to ask and answer: (1) How many and what types of burdens are captured by the Zarit’s Burden Interview (ZBI)? (2) Do we see categorical or spectrum-like effects for burden(s)? and (3) Which if any demographic, clinical, and cognitive measures are related to burden(s)?Methods: N = 504 participants and their study partners (e.g., family, friends) across: Alzheimer’s disease/mild cognitive impairment (AD/MCI; n = 120), Parkinson’s disease (PD; n = 136), amyotrophic lateral sclerosis (ALS; n = 38), frontotemporal dementia (FTD; n = 53), and cerebrovascular disease (CVD; n = 157). Study partners provided information about themselves, and information about the clinical participants (e.g., activities of daily living). We used Correspondence Analysis to identify types of caregiving concerns in the ZBI, then identified relationships between those concerns and demographic and clinical measures, and a cognitive battery.Results: We found three components in the ZBI. The first was “overall burden” and was (1) strongly related to increased neuropsychiatric symptoms and decreased independence in activities of daily living, (2) moderately related to cognition, and (3) showed little-to-no differences between disorders. The second and third components showed four types of caregiving concerns: current care of patient, future care of patient, personal concerns of study partner, and social concerns of study partner. Discussion: Caregiving concerns are individual experiences and emphasize the importance of support for management of activities of daily living and neuropsychiatric symptoms, and underscore individualized needs for caregiving assessment and education.

The ability to mentally travel to specific events from one’s past, dubbed episodic autobiographical memory (E-AM), contributes to adaptive functioning. Nonetheless, the mechanisms underlying its typical interindividual variation remain poorly understood. To address this issue, we capitalize on existing evidence that successful performance on E-AM tasks draws on the ability to visualize past episodes and reinstate their unique spatiotemporal context. Hence, here, we test whether features of the brain’s functional architecture relevant to perceptual versus conceptual processes shape individual differences in both self-rated E-AM and laboratory-based episodic memory for random visual scene sequences (visual EM). We propose that superior subjective E-AM and visual EM are associated with greater similarity in static neural organization patterns, potentially indicating greater efficiency in switching, between rest and mental states relevant to encoding perceptual information. Complementarily, we postulate that impoverished subjective E-AM and visual EM are linked to dynamic brain organization patterns implying a predisposition towards semanticizing novel perceptual information. Analyses were conducted on resting state and task-based fMRI data from 329 participants (160 women) in the Human Connectome Project who completed visual and verbal EM assessments, and an independent gender diverse sample (N = 59) who self-rated their E-AM. Interindividual differences in subjective E-AM were linked to the same neural mechanisms underlying visual, but not verbal, EM, in general agreement with the hypothesized static and dynamic brain organization patterns. Our results suggest that higher E-AM entails more efficient processing of temporally extended information sequences, whereas lower E-AM entails more efficient semantic or gist-based processing. Significance Statement The ability to revisit specific events from one’s past is key to identity formation and optimal interpersonal functioning. Nonetheless, the mechanisms underlying its typical interindividual variation are yet to be fully characterized. Here, we provide novel evidence that, among younger adults, dispositional variations in subjective mental time travel draw on the same dynamic and static features of the brain’s architecture that are uniquely implicated in memory for spatiotemporal contexts. Specifically, the subjective sense of being able to revisit one’s past relates to neural mechanisms supporting serial mental operations, whereas difficulties in accessing past experiences may be traced back to a predisposition towards gist-based processing of incoming information