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This study explored how adherence to the DASH diet relates to electrophysiological measures in individuals at varying Alzheimer's disease (AD) risk due to family history (FH). There were 179 dementia-free subjects. DASH index was calculated, and participants were classified into different DASH adherence groups. Tertiles of relative alpha power in default mode network (DMN) regions were calculated. Multivariate logistic regression models were used to examine the association. Lower DASH adherence was associated with decreased odds of higher relative alpha power in the DMN, observed across the entire sample and specifically among those without a FH of AD. Logistic regression models indicated that participants with poorer DASH adherence had a reduced likelihood of elevated DMN alpha power, potentially influenced by vascular and amyloid-beta mechanisms. These findings underscore the dietary pattern's potential role in neural activity modulation, particularly in individuals not genetically predisposed to AD., (© 2024. The Author(s), under exclusive licence to American Aging Association.)

Purpose: Study the efficacy of olfactory training in smell recovery., Methods: An extensive search was performed through different databases in order to find articles analyzing the efficacy of olfactory training as a treatment for olfactory dysfunction. Methodological quality of primary studies within the final sample was assessed following PRISMA guidelines. Standardized mean differences in pre-post olfactory training groups, and also in experimental-control and pre-follow up if possible, were computed by Hedges' g effect size statistic. Each effect size was weighted by its inverse variance., Results: Final sample was composed of 36 articles (45 pre-post effect sizes). Contrasts were performed separately for odor identification, odor discrimination, odor threshold and general olfactory function. Moderate to large and heterogeneous effect was obtained for olfactory function (g = 0.755, k = 45, SE = 0.093, CI 95% = [0.572, 0.937]), different moderators had a significant effects, such as, training duration, age and anosmia diagnosis., Conclusion: Olfactory training was found to have a positive and significant effect on rehabilitating the olfactory function., (© 2024. The Author(s).)

Purpose: This comprehensive meta-analysis investigates the association between olfactory deficits in mild cognitive impairment (MCI) and Alzheimer's disease (AD)., Methods: A thorough search across databases identified articles analyzing olfactory status in MCI or AD patients. Methodological quality assessment followed PRISMA guidelines. Hedges' g effect size statistic computed standard mean differences and 95% confidence intervals. Moderator analysis was conducted., Results: Among the included studies (65 for MCI and 61 for AD), odor identification exhibited larger effect sizes compared to odor threshold and discrimination, in both MCI and AD samples. Moderate effect size is found in OI scores in MCI (k = 65, SE = 0.078, CI 95% = [-1.151, -0.844]). Furthermore, compared to MCI, AD had moderate to large heterogeneous effects in olfactory identification (k = 61, g = -2.062, SE = 0.125, CI 95% = [-2.308, -1.816]). Global cognitive status is positively related to olfactory identification impairment in both MCI (k = 57, Z = 2.74, p = 0.006) and AD (k = 53, Z = 5.03, p < 0.0001) samples., Conclusion: Olfactory impairments exhibit a notable and substantial presence in MCI. Among these impairments, odor identification experiences the greatest decline in MCI, mirroring the primary sensory deficit observed in AD. Consequently, the incorporation of a straightforward odor identification test is advisable in the evaluation of individuals vulnerable to the onset of AD, offering a practical screening tool for early detection., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

Purpose: This study aims to highlight the feasibility of an olfactory training program entirely monitored through online media in COVID-19 patients., Methods: Classic olfactory training was performed with a sample with olfactory loss due COVID-19 ( n = 11). Participants were engaged on a weekly video call in order to improve adherence and collect information regarding the number of correct answers and the individuals' perception of olfactory function. The olfactory status after training was compared to two groups, one composed of participants who contracted COVID-19 but did not report olfactory loss ( n = 11) and a sample composed of healthy participants ( n = 11)., Results: The experimental group showed improvements throughout the training period (TDI score on week 0 was 20.3 (5.6) and 24.6 (4.3) for week 12, and on week 24 was 25.4 (6.2) (F = 5.115, df = 2, 20, p = 0.016), and post hoc tests showed that participants significantly improved their TDI score in W12 compared to W0 (SMD = 0.869, p = 0.041) and in W24 compared to W0 (SMD = 0.859, p = 0.041). The experimental group showed lower scores when compared with both groups, and the no OT COVID-19 group showed lower scores than the healthy control group, even though they did not report olfactory alterations., Conclusions: Findings suggest that the strategies applied to improve adherence were successful since 100% of the sample completed the training adherence, offering a valuable framework for future olfactory training studies.

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 (R 2  = .19). Subjects with a larger CR and a greater gray matter volume better improved their processing speed (R 2  = .18). Age was correlated with the improvement in executive functions, such that older age predicts less improvement (R 2  = .07). Subjects with a larger left hippocampal volume achieved more significant gains in general cognitive performance (R 2  = .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)., (© 2024. The Author(s), under exclusive licence to Marta Olivetti Belardinelli.)

Objective: Verbal fluency tests are quick and easy to administer neuropsychological measures and are regularly used in neuropsychological assessment. Additionally, phonological fluency is a widely used paradigm that is sensitive to cognitive impairment. This paper offers normative data of phonological verbal fluency (letters P, M, R) for Spanish middle- and older-aged adults, considering sociodemographic factors, and different measures such as the total number of words, errors (perseveration and intrusions), and 15 sec-segmented scores., Method: A total of 1165 cognitively unimpaired participants aged between 50 and 89 years old, participated in the study. Data for P were obtained for all participants. Letters M and R were also administered to a subsample of participants (852) aged 60 to 89 years. In addition, errors and words produced every 15 seconds were collected in the subsample. To verify the effect of sociodemographic variables, linear regression was used. Adjustments were calculated for variables that explained at least 5% of the variance ( R 2 ≥ .05)., Results: Means and standard deviations by age, scaled scores, and percentiles for all tests across different measures are shown. No determination coefficients equal to or greater than .05 were found for sex or age. The need to establish adjustments for the educational level was only found in some of the measures., Conclusions: The current norms provide clinically useful data to evaluate Spanish-speaking natives from Spain aged from 50 to 89 years. Specific patterns of cognitive impairment can be analyzed using these normative data and may be important in neuropsychological assessment.

Episodic memory (EM), one of the most commonly assessed cognitive domains in aging, is useful for identifying pathological processes such as mild cognitive impairment and dementia. However, EM tests must be culturally adapted, and the influence of sociodemographic variables analyzed, to provide cut-off points that enable correct diagnosis. The aim of this article is to report updated Spanish normative data for three EM tests: the California Verbal Learning Test, the Logical Memory subtest of the Wechsler Memory Test, and the Rivermead Behavioral Memory Test. Measures include immediate, short-, and long-delay free recall, intrusions, and global scores. The entire sample is comprised of 1,193 cognitively unimpaired participants aged +50, recruited from three cohort studies within the Spanish Consortium for Ageing Normative Data. Participants who subsequently developed cognitive impairment, detected at follow-up, were removed from the total sample. Data analysis included transformation of percentile ranges into scalar scores, tests for the effects of education level, age, and sex on performance, and linear regression to calculate scalar adjustments. Tables with percentile ranges and scalar scores for each measure are provided, with adjustments for age, education level, and sex, as required. The normative scores provide robust data for assessing EM in Spanish middle-aged and old populations. Effects of sex, age, and education level in each measure are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

(1) Background: Persistent COVID is characterized by the presence of fatigue, mental fog, and sleep problems, among others. We aimed to study cognitive abilities (attention, executive functions, memory, language) and psychological and emotional factors in a group of participants of the population with persistent COVID-19 and asymptomatic or non-COVID-19-infected patients; (2) Methods: A total of 86 participants aged 18 to 66 years (X = 46.76) took part in the study, with 57 individuals (66.27%) in the experimental group and 29 (33.73%) in the control group. A comprehensive assessment included neuropsychological evaluations, evaluations of anxious and depressive symptomatology, assessments of the impact of fatigue, sleep quality, memory failures in daily life, and the perceived general health status of the participants; (3) Results: significant differences between groups were found in incidental learning within the Key Numbers task (U = 462.5; p = 0.001; p = 0.022) and in the Direct Digit Span (U = 562; p = 0.022), but not in the Inverse Digit Span (U = 632.5; p = 0.105). Differences were also observed in the prospective memory task of the Rivermead Prospective Memory Tasks (from the Rivermead Behavioural Memory Test) in the recall of quotations (U = 610; p = 0.020) as well as in the recall of objects (U = 681.5; p = 0.032). Concerning the task of verbal fluency, significant differences were found for both phonological cues ( p - and s-) (t = -2.190; p = 0.031) and semantic cues (animals) (t = -2.277; p = 0.025). In terms of the psychological impact assessment, significant differences were found in the emotional impact across all variables studied (fatigue, quality of sleep, memory lapses, and the perceived general health status), except for quality of life; (4) Conclusions: Our results suggest that the sequelae derived from persistent COVID may have an impact on people's lives, with higher levels of anxiety and depression, worse sleep quality, a greater number of subjective memory complaints, and a greater feeling of fatigue and impact on quality of life. Furthermore, poorer performance was observed in memory and verbal fluency.

Objective : This paper reports normative data for different attentional tests obtained from a sample of middle-aged and older native Spanish adults and considering effects of age, educational level and sex. Method : 2,597 cognitively intact participants, aged from 50 to 98 years old, participated voluntarily in the SCAND consortium studies. The statistical procedure included conversion of percentile ranges into scaled scores. The effects of age, education and sex were taken into account. Linear regressions were used to calculate adjusted scaled scores. Results : Scaled scores and percentiles corresponding to the TMT, Digit Symbol and Letter Cancellation Task are shown. Additional tables show the values to be added to or subtracted from the scaled scores, for age and education in the case of the TMT and Letter Cancellation Task measures, and for education in the case of the Digit Symbol subtest. Conclusions : The current norms provide clinically useful data for evaluating Spanish people aged 50 to 98 years old and contribute to improving detection of initial symptoms of cognitive impairment.

Background: Mineral intake may protect against cognitive impairment (CI) and all-cause dementia, which affects a large number of adults worldwide. The aim of this study was to investigate the association between mineral intake and Montreal Cognitive Assessment (MoCA), which is a sensitive and specific test., Methods: In total, 201 adults were included in a cross-sectional study. They completed a three-day dietary record to estimate their average daily intake of minerals. Contributions to dietary reference intakes (DRIs) were also calculated. The participants were divided into tertiles according to their mineral intake. CI classifications were determined via the MoCA (score < 26). Apolipoprotein E (APOE) genotyping was carried out, and the patients' anthropometric measurements and physical activity, health and personal data were collected., Results: The prevalence of CI in this selective sample was 54.2% (34.3% females and 19.9% males). In women, being in the third tertiles of iron and manganese intake was associated with lower odds of having CI (OR [95% CI]: 0.32 [0.11 ± 0.93]; 0.33 [0.12 ± 0.93], p < 0.05). No significant differences were observed for any of the nutrients studied in men., Conclusions: These findings suggest that a low mineral intake, especially low iron and manganese intake in women, is associated with a worse cognition as assessed by MoCA.

Introduction: Alzheimer's disease (AD) is the most common form of dementia affecting the central nervous system, and alteration of several visual structures has been reported. Structural retinal changes are usually accompanied by changes in visual function in this disease. The aim of this study was to analyse the differences in visual function at different stages of the pathology (family history group (FH+), mild cognitive impairment (MCI), mild AD and moderate AD) in comparison with a control group of subjects with no cognitive decline and no family history of AD., Methods: We included 53 controls, 13 subjects with FH+, 23 patients with MCI, 25 patients with mild AD and, 21 patients with moderate AD. All were ophthalmologically healthy. Visual acuity (VA), contrast sensitivity (CS), colour perception, visual integration, and fundus examination were performed., Results: The analysis showed a statistically significant decrease in VA, CS and visual integration score between the MCI, mild AD and moderate AD groups compared to the control group. In the CS higher frequencies and in the colour perception test (total errors number), statistically significant differences were also observed in the MCI, mild AD and moderate AD groups with respect to the FH+ group and also between the control and AD groups. The FH+ group showed no statistically significant difference in visual functions compared to the control group. All the test correlated with the Mini Mental State Examination score and showed good predictive value when memory decline was present, with better values when AD was at a more advanced stage., Conclusion: Alterations in visual function appear in subjects with MCI and evolve when AD is established, being stable in the initial stages of the disease (mild AD and moderate AD). Therefore, visual psychophysical tests are a useful, simple and complementary tool to neuropsychological tests to facilitate diagnosis in the preclinical and early stages of AD., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Elvira-Hurtado, López-Cuenca, de Hoz, Salas, Sánchez-Puebla, Ramírez-Toraño, Matamoros, Fernández-Albarral, Rojas, Alfonsín, Delgado-Losada, Ramírez, Salazar, Maestu, Gil, Ramírez and Salobrar-García.)

Aging contributes to the deterioration of the olfactory system in humans. Several studies indicate that the olfactory identification test alone may function as a screening test for olfactory dysfunction and they are more feasible to apply in clinical practice. Olfactory identification may be a predictor for cognitive impairment. Multiple studies have considered the use of odor identification as a measure to identify the conversion from normality to mild cognitive impairment or dementia. The objectives were (i) to elucidate the associations between cognitive status and olfactory identification performance in aging; (ii) understand the predictive value of olfactory capacity in identifying subjects with cognitive impairment risk; and (iii) to study how cognitive status and olfactory identification relate with other variables of wellness in aging, such as functional capabilities and clinical measures. For this purpose, a group of 149 participants (77.15 ± 7.29 years; 73 women of 76.7 ± 8 years and 76 men of 77.6 ± 6.52 years) were recruited and were subjected to a sociodemographic questionnaire, a psychological screening tool of general cognitive status, an olfactory identification evaluation, and clinical measures. The participants were divided into groups based on their cutoff scores of previous scientific reports about the Spanish version of Montreal Cognitive Assessment. Our results indicate an age-associated decline in olfactory identification ability and intensity of odor perception. The predictive ability of olfactory identification scores for the risk of mild and severe impairment is around 80%. Olfactory identification decreases with cognitive function. Performance in odor identification is associated with impairment of episodic memory and executive functions. These findings further our current understanding of the association between cognition and olfaction, and support olfactory assessment in screening those at higher risk of dementia., (© 2023. The Author(s).)

Loneliness is considered a prognostic factor for poorer health status in the elderly. It is proposed to analyze the role of loneliness in health status in terms of various factors. A total of 1747 individuals from the pilot survey of the Aging in Spain Longitudinal Study (ELES-PS) were reviewed. ELES is a cross-sectional study for collecting health variables, food habits, socioeconomic data, and cognitive and functional capacities, which was carried out on a Spanish representative sample of noninstitutionalized persons of 50 years of age or older. Moreover, since telomere shortening is associated with cellular senescence, 35 telomere-related SNPs and cognitive impairments were analyzed. The results characterize the "solos" as males of 50-60 years, who were overweight and had lower levels of hemoglobin and neutrophils. There is also an association between five SNPs related to telomere length and BDNF. A group of people with loneliness and depression was identified with poorer health and cognitive status, poorer perception of their quality of life, poorer quality of sleep, and lower physical activity. Therefore, it follows that telomeres and BDNF play a role as intermediaries between loneliness and depression and their relationship with a worse state of health.

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., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s). Published by IMR Press.)

Hospital workers have increased exposure risk of healthcare-associated infections due to the frontline nature of their work. Olfactory dysfunction is highly prevalent. The objectives for this investigation are to study the prevalence of long-lasting olfactory dysfunction associated with COVID-19 infection in hospital workers during the first pandemic wave, to identify clinical characteristics and associated symptomatology, and to analyze how many patients with COVID-19 infection had developed olfactory dysfunction during infection and maintained a reduced olfactory function for approximately 10 weeks after diagnosis. Between June and July of 2020, a cross-sectional study was carried out at the Hospital Central de la Cruz Roja San José and Santa Adela in Madrid, Spain. One hundred sixty-four participants were included, of which 110 were patient-facing healthcare staff and 54 were non-patient-facing healthcare staff. Participants were split into three groups, according to COVID-19 diagnosis and presence of COVID-19 related olfactory symptomatology. Participants were asked to complete a structured online questionnaire along with Sniffin' Stick Olfactory Test measurements. In this study, 88 participants were confirmed for COVID-19 infection, 59 of those participants also reported olfactory symptomatology. The prevalence of COVID-19 infection was 11.35%, and the prevalence for olfactory dysfunction was 67.05%. Olfactory dysfunction associated with COVID-19 infection leads to long-lasting olfactory loss. Objective assessment with Sniffin' Stick Olfactory Test points to odor identification as the most affected process. Lemon, liquorice, solvent, and rose are the odors that are worst recognized. Mint, banana, solvent, garlic, coffee, and pineapple, although they are identified, are perceived with less intensity. The findings of this study confirmed a high prevalence of SARS-CoV-2 infection among the hospital workers.

Objective: Semantic verbal fluency constitutes a good candidate for identifying cognitive impairment. This paper offers normative data of different semantic verbal fluency tests for middle-aged and older adults natives from Spain considering sociodemographic factors, and different measures for each specific category (number of words produced, errors, and words evoked every 15 s)., Method: Two thousand and eighty-eight cognitively unimpaired subjects aged between 50 and 89 years old, community dwelling, participated in the study. The statistical procedure includes the conversion of percentile ranges into scalar scores. Secondly, the effects of age, education and gender were verified. Linear regressions are used to calculate the scalar adjusted scores., Results: Scalar scores and percentiles corresponding to all semantic verbal fluency tests across different measures are shown. Additional tables, which show the points that must be added or subtracted from direct scores, are provided for Education regarding the total number of "animals" and "clothes" evoked by participants, as well as for Age and Education in case of the total number of "clothes". Gender affects the number of "clothes" produced by participants in the first two 15-second segments., Conclusions: The current norms should provide clinically useful data for evaluating Spanish-speaking natives from Spain aged from 50 to 89 years., (© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permission@oup.com.)

Background: Recent studies demonstrated that brain hypersynchrony is an early sign of dysfunction in Alzheimer's disease (AD) that can represent a proxy for clinical progression. Conversely, non-pharmacological interventions, such as cognitive training (COGTR), are associated with cognitive gains that may be underpinned by a neuroprotective effect on brain synchrony., Objective: To study the potential of COGTR to modulate brain synchrony and to eventually revert the hypersynchrony phenomenon that characterizes preclinical AD., Methods: The effect of COGTR was examined in a sample of healthy controls (HC, n = 41, 22 trained) and individuals with subjective cognitive decline (SCD, n = 49, 24 trained). Magnetoencephalographic activity and neuropsychological scores were acquired before and after a ten-week COGTR intervention aimed at improving cognitive function and daily living performance. Functional connectivity (FC) was analyzed using the phase-locking value. A mixed-effects ANOVA model with factors time (pre-intervention/post-intervention), training (trained/non-trained), and diagnosis (HC/SCD) was used to investigate significant changes in FC., Results: We found an average increase in alpha-band FC over time, but the effect was different in each group (trained and non-trained). In the trained group (HC and SCD), we report a reduction in the increase in FC within temporo-parietal and temporo-occipital connections. In the trained SCD group, this reduction was stronger and showed a tentative correlation with improved performance in different cognitive tests., Conclusion: COGTR interventions could mitigate aberrant increases in FC in preclinical AD, promoting brain synchrony normalization in groups at a higher risk of developing dementia.

Introduction: Semantic verbal fluency is a useful neuropsychological tool since it involves language and executive abilities that can be impaired in patients with neurodegenerative diseases in comparison to healthy controls. The present study explores retrieve and executive control processes using traditional quantitative and qualitative raw scores and examines the utility of multidimensional scaling combined with linear regression to provide new insights about the underlying semantic network in mild cognitive impairment and in healthy older adults., Method: A total of 165 Spanish older adults, 81 patients and 84 controls, were assessed in different cognitive domains and evoked animal names in one minute. Group differences on fluency raw scores were first explored. Regressions using tests to predict groups' fluency scores were also performed. The 12 animals that had been produced more frequently were selected to perform a multidimensional scaling analysis for each group. Four features related to animal names were extracted from normative studies and then were used as predictors in linear regression to provide an interpretation of the resulting dimensions' coordinates., Results: Patients performed worse on memory and naming and produced a shorter list of animals than controls. In controls, naming and visual memory explained a small part of variance related to the total of animals produced and to the number of switches. Both groups exhibited similar semantic maps., Conclusions: Results suggest that patients' map is influenced by words with a dense associative neighborhood that were acquired at an early age, whereas in controls none of the predictors explained dimensions.

The Sniffin' Sticks Olfactory Identification Test is a tool for measurement of olfactory performance developed in Germany and validated in several countries. This research aims to develop the Spanish version of the Sniffin' Sticks Olfactory Identification Test and obtain normative values for the Spanish population. The parameters are free recall and subjective intensity of odorants are included. The influence of possible demographic covariates such as sex, age, smoking, or educational level are analyzed, and the items that best discriminate are studied. In addition, the internal structure validity of the blue and purple versions is studied as a parallel measure, and a cultural adaptation of the purple version is carried out. For this, three independent samples of normosmic healthy volunteers were studied. To obtain normative values, the sample was of 417 participants (18-89 years). For the internal structure validity study of both versions, the sample was 226 (18-70 years), and for familiarity of the purple version, the sample was 75 participants (21-79 years). Results indicated that men and women and smokers and non-smokers perform equally. However, differences were found as age progresses, being more pronounced after 60 years old in all three measurements of the identification test. This research also provides the items that best discriminate in the blue version and a cultural adaptation for the purple version. In conclusion, the Sniffin' Sticks Odor Identification Test is a suitable tool for olfactory assessment in the Spanish population. The instrument has been expanded with two new scores, and normative data as a function of age are provided. Its parallel version also seems appropriate for testing, as items have been culturally adapted and evidence of internal structure validity for both versions is reported.

Background: Detecting cognitive impairment is a priority for health systems. The aim of this study is to create normative data on screening tests (MMSE, GDS and MFE) for middle-aged and older Spanish adults, considering the effects of sociodemographic factors., Method: A total of 2,030 cognitively intact subjects who lived in the community, aged from 50 to 88 years old, participated voluntarily in SCAND consortium studies. The statistical procedure included the conversion of percentile ranges into scalar scores. Secondly, the effects of age, educational level and gender were verified. Linear regressions were used to calculate the scalar adjusted scores. Cut-off values for each test were also calculated., Results: Scalar scores and percentiles corresponding to MMSE, GDS-15 and MFE are shown. An additional table is provided which shows the points that must be added or subtracted from MMSE score depending on the subject's educational level., Conclusions: The current norms should provide clinically useful data for evaluating Spanish people aged 50 to 88 years old and should contribute to improving the detection of initial symptoms of cognitive impairment in people living in the community, taking into account the influence of gender, age and educational level.

Alzheimer's disease (AD) studies on animal models, and humans showed a tendency of the brain tissue to become hyperexcitable and hypersynchronized, causing neurodegeneration. However, we know little about either the onset of this phenomenon or its early effects on functional brain networks. We studied functional connectivity (FC) on 127 participants (92 middle-age relatives of AD patients and 35 age-matched nonrelatives) using magnetoencephalography. FC was estimated in the alpha band in areas known both for early amyloid accumulation and disrupted FC in MCI converters to AD. We found a frontoparietal network (anterior cingulate cortex, dorsal frontal, and precuneus) where relatives of AD patients showed hypersynchronization in high alpha (not modulated by APOE-ε4 genotype) in comparison to age-matched nonrelatives. These results represent the first evidence of neurophysiological events causing early network disruption in humans, opening a new perspective for intervention on the excitation/inhibition unbalance., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The assessment of olfactory function is becoming increasingly relevant, especially in cases of cognitive decline (i.e., neurodegenerative diseases), where olfactory alterations may be relevant as potential early biomarkers. The Sniffin' Sticks Olfactory Test, developed in Germany and validated in several countries, is an objective measure of olfactory performance. This study aims to validate this test in a Spanish sample. This study included 209 healthy normosmic volunteers (154 females and 55 males) aged between 20 to 79 years (mean age = 50.11 ± 15.18 years) as the normative sample. From this group, 22 participants were retested in order to obtain test-retest reliability evidence. Odor familiarity for descriptors in the olfactory identification test was also studied on an independent healthy sample ( n = 69), and required cultural modifications were applied. Results indicate that men and women, as well as smokers and non-smokers, performed equally in every test. However, significant differences were found between age groups in every score. The general trend is that olfactory function progressively decreases as a function of age, the elderly group (+60 years) being the one with the lowest scores. In conclusion, this normative data, in addition to the test's cultural modifications, allows the Sniffin' Sticks Olfactory Test to be administered on a Spanish population.

Background: Electrophysiological studies show that reductions in power within the alpha band are associated with the Alzheimer's disease (AD) continuum. Physical activity (PA) is a protective factor that has proved to reduce AD risk and pathological brain burden. Previous research has confirmed that exercise increases power in the alpha range. However, little is known regarding whether other non-modifiable risk factors for AD, such as increased age or APOE ε4 carriage, alter the association between PA and power in the alpha band., Methods: The relationship between PA and alpha band power was examined in a sample of 113 healthy adults using magnetoencephalography. Additionally, we explored whether ε4 carriage and age modulate this association. The correlations between alpha power and gray matter volumes and cognition were also investigated., Results: We detected a parieto-occipital cluster in which PA positively correlated with alpha power. The association between PA and alpha power remained following stratification of the cohort by genotype. Younger and older adults were investigated separately, and only younger adults exhibited a positive relationship between PA and alpha power. Interestingly, when four groups were created based on age (younger-older adult) and APOE (E3/E3-E3/E4), only younger E3/E3 (least predicted risk) and older E3/E4 (greatest predicted risk) had associations between greater alpha power and higher PA. Among older E3/E4, greater alpha power in these regions was associated with improved memory and preserved brain structure., Conclusion: PA could protect against the slowing of brain activity that characterizes the AD continuum, where it is of benefit for all individuals, especially E3/E4 older adults.

Background: Neuronal hyperexcitability and hypersynchrony have been described as key features of neurophysiological dysfunctions in the Alzheimer's disease (AD) continuum. Conversely, physical activity (PA) has been associated with improved brain health and reduced AD risk. However, there is controversy regarding whether AD genetic risk (in terms of APOE ε4 carriage) modulates these relationships. The utilization of multiple outcome measures within one sample may strengthen our understanding of this complex phenomenon., Method: The relationship between PA and functional connectivity (FC) was examined in a sample of 107 healthy older adults using magnetoencephalography. Additionally, we explored whether ε4 carriage modulates this association. The correlation between FC and brain structural integrity, cognition, and mood was also investigated., Results: A relationship between higher PA and decreased FC (hyposynchrony) in the left temporal lobe was observed among all individuals (across the whole sample, in ε4 carriers, and in ε4 non-carriers), but its effects manifest differently according to genetic risk. In ε4 carriers, we report an association between this region-specific FC profile and preserved brain structure (greater gray matter volumes and higher integrity of white matter tracts). In this group, decreased FC also correlated with reduced anxiety levels. In ε4 non-carriers, this profile is associated with improved cognition (working and episodic memory)., Conclusions: PA could mitigate the increase in FC (hypersynchronization) that characterizes preclinical AD, being beneficial for all individuals, especially ε4 carriers.

Poor diet quality and obesity, especially abdominal obesity, have been associated with systemic inflammation. The neutrophil-to-lymphocyte Ratio (NLR) is an available and inexpensive inflammation biomarker. The aim of the present study was to determine the association of dietary patterns and obesity with an inflammatory state. A group of 1747 Spanish noninstitutionalized older adults individuals were included, and a food-frequency questionnaire was applied. The Global Food Score (GFS) and Healthy Eating Index for Spanish population (SHEI) were calculated. Weight, height and waist (WC) and hip circumferences were measured, and BMI, waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR) determined. In addition, body-fat percentage was measured by bioimpedance. NLR was calculated (NLR ≥ p80: 2.6; 2.8 and 2.4 as inflammatory status in the entire population, men and women, respectively). The men with inflammatory status presented significative higher values of WC, WHtR, WHR, and body-fat percentage (101.82 ± 10.34 cm, 0.61 ± 0.06, 0.98 ± 0.06, and 31.68 ± 5.94%, respectively) than those with better inflammatory status (100.18 ± 10.22 cm, 0.59 ± 0.06, 0.97 ± 0.07, and 30.31 ± 6.16%, respectively). Those males with worse inflammatory state had lower scores for protein foods (OR = 0.898 (0.812-0.993); p = 0.037). The women with NLR ≥ 2.4 had higher WHtR and WHR (0.62 ± 0.09 and 0.91 ± 0.09) than those with NLR < 2.4 (0.60 ± 0.08 and 0.90 ± 0.08). In multiple linear regression analysis, NLR was positively related with WHtR and negatively related with SHEI score (β = 0.224 ± 0.094; R 2 = 0.060; p < 0.05 and β = -0.218 ± 0.101; R 2 = 0.061; p < 0.05), adjusting by sex, age, marital status, education level, smoking, hours of sleeping and inflammatory diseases. In women, the higher the SHEI and GFS scores were and the better meeting the aims of cereal and vegetable servings, the less the odds of inflammatory status (OR = 0.970 (0.948-0.992); p = 0.008; OR = 0.963 (0.932-0.995); p = 0.024; OR = 0.818 (0.688-0.974); p = 0.024 and OR = 0.829 (0.730-0.942); p = 0.004, respectively). WHtR and quality of diet is related to the inflammation status in older adults regardless to the sex.

The ability to generate memory strategies is a key factor in performance of episodic memory tests. There is evidence about the inefficient use of memory strategies in old adults. However, a question remains unresolved: Worse performance on memory test in the older people is due to an inability to mobilize cognitive strategies or to an episodic memory deficit? In this study we tried to answer it by using the Test of Memory Strategies (TMS), which parametrically reduces the need of executive functions on memory tests. The test consists of five experimental conditions (TMS1-5) where a progressive external organization of the material reduces the need to mobilize memory strategies. TMS was applied to a sample of 180 participants (n = 180) divided into three age groups (25-45; 46-65; 66-85). The results showed an increased performance in all groups groups (F(2, 177) = 14.79, p < .001) across conditions (F(3.88,674.04) = 292.48, p < .001), without group differences in those conditions with a maximum reduction of the need of executive functions (F(7.61,674.04) = 1.95, p = .053). However, middle age and older adults showed more difficulties in establishing cognitive strategies, in the initial conditions. These results lead to the conclusion that the typical pattern of low performance on episodic memory tasks in the older population may be due to the deterioration of executive functions and not mainly to a primary decline of memory process.

Cognitive reserve has been defined as the individuals' ability to tolerate age-related and neurodegenerative changes in the brain without developing clinical symptoms or signs of disease. Formal education, occupational attainment, and knowledge of other languages have been assessed as the most relevant factors determining cognitive reserve. The main objective of this study was to develop a structural equation model that reflects the direct influence of cognitive reserve on old adults' general cognitive status and executive functioning, and indirectly on sentence comprehension performance through executive functions mediation. One hundred and fifty eight Spanish-speaking older adults, cognitively intact, were assessed to obtain cognitive reserve data, general cognitive status, executive functioning (inhibitory control, working memory and cognitive flexibility), and sentence comprehension measures. High indicators of adjustment of the proposed model were obtained. The most related factors to cognitive reserve were education and occupational attainment. As we hypothesize, cognitive reserve had a higher direct significant relation to cognitive status and, in a lesser extent, to executive functioning. Participants' general cognitive status and executive function were high and directly related. Furthermore, cognitive reserve has an indirect positive relation to sentence comprehension via executive functions' mediation., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Alzheimer's disease (AD) prevalence is rapidly growing as worldwide populations grow older. Available treatments have failed to slow down disease progression, thus increasing research focus towards early or preclinical stages of the disease. Subjective cognitive decline (SCD) is known to increase the risk of developing AD and several other negative outcomes. However, it is still very scarcely characterized and there is no neurophysiological study devoted to its individual classification which could improve targeted sample recruitment for clinical trials., Methods: Two hundred fifty-two older adults (70 healthy controls, 91 SCD, and 91 MCI) underwent a magnetoencephalography scan. Alpha relative power in the source space was employed to train a LASSO classifier and applied to distinguish between healthy controls and SCD. Moreover, MCI participants were used to further validate the previously trained algorithm., Results: The classifier was significantly associated to SCD with an AUC of 0.81 in the whole sample. After randomly splitting the sample in 2/3 for discovery and 1/3 for validation, the newly trained classifier was also able to correctly classify SCD individuals with an AUC of 0.75 in the validation sample. The regions selected by the algorithm included medial frontal, temporal, and occipital areas. The algorithm trained to select SCD individuals was also significantly associated to MCI diagnostic., Conclusions: According to our results, magnetoencephalography could be a useful tool for distinguishing individuals with SCD and healthy older adults without cognitive concerns. Furthermore, our classifier showed good external validity, being not only successful for an unseen SCD sample, but also in a different population with MCI cases. This supports its utility in the context of preclinical dementia. These findings highlight the potential applications of electrophysiological techniques to improve sample recruitment at the individual level in the context of clinical trials.

Objective: Since a cure for Alzheimer's Disease (AD) is yet to be discovered, attention has shifted towards prevention. Physical activity (PA) emerged as a notorious lifestyle factor that could influence brain structure and function. The individual alpha peak frequency (IAPF) is a measure that summarizes the spectral content of brain signals and has been proven to be sensitive to both AD pathology and PA interventions. Therefore, our goal was to unravel whether chronic PA modulates IAPF and if APOE ɛ4 carriage moderates this relationship., Methods: We analyzed 4-minutes of resting-state magnetoencephalographic recordings from 100 healthy elders that provided self-reported measures of PA, and the IAPF was calculated., Results: We found that IAPF was negatively influenced by age and APOE and positively influenced by PA. The effect of PA on IAPF only remained significant for the ɛ4 non-carriers group., Conclusions: PA is positively associated to higher IAPF in healthy older adults and could potentially act as a protective factor against cognitive decline. Nevertheless, such effect is non-significant among elders who are more vulnerable to developing AD due to their genetic carriage., Significance: This investigation offers the first neurophysiological evidences on the combined effects of APOE genotype and PA in healthy elders., (Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.)

The present study explores the role of cognitive reserve, executive functions, and working memory (WM) span, as factors that might explain training outcomes in cognitive status. Eighty-one older adults voluntarily participated in the study, classified either as older adults with subjective cognitive decline or cognitively intact. Each participant underwent a neuropsychological assessment that was conducted both at baseline (entailing cognitive reserve, executive functions, WM span and depressive symptomatology measures, as well as the Mini-Mental State Exam regarding initial cognitive status), and then 6 months later, once each participant had completed the training program (Mini-Mental State Exam at the endpoint). With respect to cognitive status the training program was most beneficial for subjective cognitive decline participants with low efficiency in inhibition at baseline (explaining a 33% of Mini-Mental State Exam total variance), whereas for cognitively intact participants training gains were observed for those who presented lower WM span.

Introduction: Subjective Cognitive Decline (SCD) is a largely unknown state thought to represent a preclinical stage of Alzheimer's Disease (AD) previous to mild cognitive impairment (MCI). However, the course of network disruption in these stages is scarcely characterized., Methods: We employed resting state magnetoencephalography in the source space to calculate network smallworldness, clustering, modularity and transitivity. Nodal measures (clustering and node degree) as well as modular partitions were compared between groups., Results: The MCI group exhibited decreased smallworldness, clustering and transitivity and increased modularity in theta and beta bands. SCD showed similar but smaller changes in clustering and transitivity, while exhibiting alterations in the alpha band in opposite direction to those showed by MCI for modularity and transitivity. At the node level, MCI disrupted both clustering and nodal degree while SCD showed minor changes in the latter. Additionally, we observed an increase in modular partition variability in both SCD and MCI in theta and beta bands., Conclusion: SCD elders exhibit a significant network disruption, showing intermediate values between HC and MCI groups in multiple parameters. These results highlight the relevance of cognitive concerns in the clinical setting and suggest that network disorganization in AD could start in the preclinical stages before the onset of cognitive symptoms.

Background: Most research points to the ɛ4 allele of the apolipoprotein E (APOE) gene as the most recognizable genetic risk factor associated with Alzheimer's disease pathogenesis. It has been also suggested that the APOEɛ4 allele has a negative influence on cognitive functioning, which begins long before cognitive impairment becomes manifest. However, still, little is known about the APOEɛ4 interaction with cognitive intervention programs., Objective: The main goal of this study was to explore whether there was a differential APOE genotype modulation effect after cognitive training in different domains, such as language comprehension, executive functions, and memory. Contrary to other studies, hippocampal volume was controlled for., Methods: Fifty older adults (65+ years; 30 women and 20 men) participated in a multi-domain cognitive training that involved 30 sessions taking place over 12 weeks. Half of the participants were APOEɛ4 carriers. The control group was matched in age, gender, normalized hippocampal volume, cognitive reserve, Mini-Mental State Examination score, and Geriatric Depression Scale-Short Version., Results: The study revealed that there were consistent treatment benefits in complex sentence comprehension (noncanonical sentences and sentences with two propositions), a domain that was not directly trained, but only in the A POEɛ4 noncarrier group., Conclusion: Genetic profile modulates training outcomes in sentence comprehension.

Mild cognitive impairment (MCI) is considered a transitional stage between healthy aging and dementia, specifically Alzheimer's disease (AD). The most common cognitive impairment of MCI includes episodic memory loss and difficulties in working memory (WM). Interference can deplete WM, and an optimal WM performance requires an effective control of attentional resources between the memoranda and the incoming stimuli. Difficulties in handling interference lead to forgetting. However, the interplay between interference and WM in MCI is not well-understood and needs further investigation. The current study investigated the effect of interference during a WM task in 20 MCIs and 20 healthy elder volunteers. Participants performed a delayed match-to-sample paradigm which consisted in two interference conditions, distraction and interruption, and one control condition without any interference. Results evidenced a disproportionate impact of interference on the WM performance of MCIs, mainly in the presence of interruption. These findings demonstrate that interference, and more precisely interruption, is an important proxy for memory-related deficits in MCI. Thus, the current findings reveal novel evidence regarding the causes of WM forgetting in MCI patients, associated with difficulties in the mechanisms of attentional control.

Introduction: The Training Program in Strategies to Improve Memory arises like answer to the high percentage of complaints that older people express on their loss of memory. The main aim of this program is to intervene in those failures, trying to improve the quality of life of this population sector, more and more numerous., Development: The specific objectives of this Program are: to inform on what it is, how it works and how it is possible to improve the memory; to learn a wide range of useful strategies to obtain it; and to modify attitudes and beliefs on the memory of older people. The phases of the Program are: 1. Pre training evaluation: a battery of test, that have relation with the tasks and strategies that they are going to handle in the training sessions, is administered. 2. Training program: it consists of nine sessions of 90 minutes of duration each one, with a frequency of two sessions per week. In the sessions they deal with attention, concentration, memory, perception, language, etc., through the learning of the following strategies: association, categorization, visualization, repetition, etc. Each session has its own objectives, tasks and strategies to learn. There are 10 or 12 people in each group. 3. Posttraining evaluation: it is applied when finalizing the nine sessions of training. The same wide range of tests than in the first evaluation is administered (different forms or versions). 4. Final evaluation: it is made to the six months of the application of the training program. It tries to measure if the subjects keep on using the learnt strategies. 5. Monitoring sessions: during the six months mentioned, two monitoring sessions are carried out to fix the strategies to learnt. 6. Evaluation of the program: an evaluation of human and material resources employed and activities is made, just like the satisfaction with the program. At the present time, this program has been applied to 34 older than sixty people, and the results obtained demonstrate the existence of a clear improvement after the training, which is maintained six months after. But in addition to the mentioned improvement, the data show a reduction in the levels of anxiety and depression.

INTRODUCTION. Forensic Neuropsychology establishes an expert valuation of the brain-injured patient (or supposed), or of the law offender people (or supposed) requiring law protection due to their illness. This discipline has a fundamental role in the study of cerebral organic syndromes, particularly in the dementias. DEVELOPMENT. The demential syndrome is common to a group of diseases as degenerative or cardiovascular disorders, brain tumors, syphilis, alcoholism or toxic factors, etc. When speaking of dementia we refer to a syndrome characterized by a progressive and global deterioration of the cognitive functions (memory, language, attention, space-temporal orientation, praxis, thinking, etc.) with preservation of the level of conscience (DSM-IV). This symptomatology affects the personality of the individual as reasonable being , as well as to his behavior and social adaptation. The decrease or loss of the intellectual and volitives abilities of the affected person of a demential syndrome, if it is permanent, also implies a change in its legal situation, since its legal capacity is altered. Therefore, it will be necessary to adopt protective measures for his person and his patrimony. Even if it is necessary, to promote a process of disability, whose sentence will be emitted by a judge, who will indicate: the degree of the mentioned disability, the trusteeship regime and who is designated as a legal tutor.