Combined therapies in family practice and hospitals. A controlled clinical study of a population of 162 patients with criteria of age-related memory disorders

OBJECTIVES: To assess the combination of drug and cognitive therapy on age-associated memory impairment (AAMI). PATIENTS AND METHODS: A double-blind randomized trial was performed involving 162 patients with age-associated memory impairment selected and followed by their general practitioners. Two intervention methods-a drug and a cognitive therapy-were assessed in combination. Three randomized parallel groups of 54 patients each, aged 55 years and over, were followed and treated for 3 months. After a placebo washout period of 10 days, one group received 2.4 g of piracetam, another group, 4.8 g and the third, a placebo. RESULTS: A total of 135 patients, 45 in each group, completed the study. Combined therapy was most effective in patients whose baseline performance on memory tests was lowest. The best results were observed with piracetam combined with memory training. This result confirmed by the global impression of the principal investigator was in agreement with findings of previous double-blind placebo-controlled trials assessing the combined effect of drug treatment and memory training. CONCLUSION: This result confirmed by the global impression of the principal investigator was in agreement with findings of previous double-blind placebo-controlled trials assessing the combined effect of drug treatment and memory training.     

Impact of working memory training on memory performance in old-old adults.

Memory impairments constitute an increasing objective and subjective problem with advancing age. The aim of the present study was to investigate the impact of working memory training on memory performance. The authors trained a sample of 80-year-old adults twice weekly over a time period of 3 months. Participants were tested on 4 different memory measures before, immediately after, and 1 year after training completion. The authors found overall increased memory performance in the experimental group compared to an active control group immediately after training completion. This increase was especially pronounced in visual working memory performance and, to a smaller degree, also in visual episodic memory. No group differences were found 1 year after training completion. The results indicate that even in old?old adults, brain plasticity is strong enough to result in transfer effects, that is, performance increases in tasks that were not trained during the intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discriminating age-associated memory impairment from Alzheimer's disease.

The authors attempt to provide a better understanding of the differences between the normal memory decline characteristic of age-associated memory impairment (AAMI) and the pathological decline typical of mild Alzheimer's disease (AD). Batteries of traditional memory tests and computer-simulated everyday-memory tests discriminated between the 2 groups, which were matched on age, gender, and education, with reasonable degrees of accuracy (87.5% and 88.4%, respectively). False positives were the most frequent classification errors when using either battery. These results indicate that it is possible to use ecologically valid memory assessment paradigms without sacrificing discriminant validity. The clinical significance of discriminating mild AD from AAMI is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term outcomes of memory retrieval under stress.

Previous studies have found impairing effects of stress hormones on memory retrieval. So far, it is unknown whether these impairments are temporary, persistent throughout time, or whether the strength of the memory trace changes after retrieval because of the effects of stress hormones on memory processes during retrieval. In the present study, delayed cued recall (6 months after initial learning) was compared between male participants who had retrieved previously learned word pairs during stress or a control condition. Retrieval (with or without stress) had taken place either 1 day or 5 weeks after initial encoding. The group that had retrieved words under stress 5 weeks after encoding performed worse on long-term recall than the comparable control group. However, when words were retrieved under stress 1 day after encoding, no long-term effect was found, although performance at 6 months in relation to performance under stress was slightly increased compared to the control group. These results support previous findings in animals that stress may affect memory during reactivation. It further suggests that time intervals between encoding and reactivation may play an important role. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhancement by an ampakine of memory encoding in humans

Acentrally active drug that enhances AMPA receptor-mediated currents was tested for its effects on memory in humans. Evidence for a positive influence on encoding was obtained in four tests: (i) visual associations, (ii) recognition of odors, (iii) acquisition of a visuospatial maze, and (iv) location and identity of playing cards. The drug did not improve scores in a task requiring cued recall of verbal information. The selectivity of drug effects on memory was confirmed using tests of visual recognition, motor performance, and general intellectual functioning. These results suggest that positive modulators of AMPA receptors selectively improve at least some aspects of memory.     

MR T2 relaxometry in Alzheimer's disease and age-associated memory impairment

A prolonged MR T2 relaxation time was proposed to mark the presence and severity of Alzheimer's disease (AD). We studied the value of T2 relaxometry in diagnosing early AD. T2 was measured from 54 patients with AD, 25 subjects with age-associated memory impairment (AAMI), 18 elderly and 16 young controls. The AD patients had longer T2 in the right hippocampal head (104 +/- 11 ms) and tail (98 +/- 10 ms) than age-matched controls (95 +/- 5 and 92 +/- 9 ms, respectively). This prolongation was not related to age. In the AD group, the T2 of the left hippocampal head also correlated with the clinical severity. The T2 of the amygdala did not differ across the groups. Increased T2 in the temporal and parietal white matter and the thalamus related to increasing age rather than to the diagnostic category. The AAMI subjects had T2 comparable with those of age-matched controls. Despite the prolongation of T2 in the AD group the possible diagnostic value was compromized by a substantial overlap between the study groups. We, thus, conclude that the T2 relaxometry is not a reliable method for diagnosing early AD.     

Adult age differences in controlled and automatic memory processing.

The memory performance of groups of younger, middle-aged, and older participants was tested on indirect and direct tests of word stem completion and on a process-dissociation task. As expected, on the direct tests of stem completion, older participants had lower scores than the younger and middle-aged groups. Age effects were also found on the indirect word completion test. The process-dissociation task allowed memory performance to be divided into controlled and automatic processing components. Estimates of automatic processing were comparable for the three groups, but there was an age effect for controlled processing, with the middle-aged and older groups differing from the younger group. These results confirm the findings of J. M. Jennings and L. L. Jacoby (1993) and suggest that the decline in conscious processing efficiency begins in middle age. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging and forgetting in prospective and retrospective memory tasks.

Ss (aged 52–83 yrs) named 30 famous people 4 times over the course of an hour and responded to 2 targets (a beard and a pipe) by marking the trial number on the response sheet. Initial performance in the prospective memory task was related only to a measure of incidental learning. Subsequent forgetting (i.e., success followed by failure) occurred more often for older Ss than for younger Ss, but there was no difference between the age groups in recovery (i.e., failure followed by success). Forgetting was predicted by age, even after a composite measure of general ability was included in the regression. Recovery was related to general ability alone. Results both replicate and extend those from a reanalysis of a previous study (E. A. Maylor, 1990). They provide a striking contrast with the effect of age on retrospective memory, namely, age-related impairment on initial performance but no effect of age on subsequent forgetting. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Variable-interval probe test as a tool for repeated measurements of spatial memory in the water maze.

Probe tests provide an important additional converging operation to identify the characteristics of cognitive processes being assessed by other behavioral measures. A new procedure is introduced using a variable interval (VI) probe test to assess spatial memory in the water maze. Three groups of rats were trained in spatial discrimination with traditional platform trials. For the probe trials, 2 groups had no-platform (NP) probe trials in which the escape platform was unavailable for the entire trial. The 3rd group had VI probe trials, in which the escape platform was available only after a VI. The VI probe trial was a more sensitive measure of spatial memory than was the NP probe trial and was useful for repeated measurements of spatial memory, a characteristic not readily attainable with the NP probe trial. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term study of chronic oral aluminum exposure and spatial working memory in rats.

The authors report an effort to advance animal models that mimic the cognitive decline of Alzheimer's disease. Rats were trained and repeatedly tested in a spatial delayed matching-to-position paradigm in the water maze, with the location of the submerged platform changing between, but not within, days. After Trial 1 (random search) and intertrial intervals of 30 s or 1 hr, memory was tested in Trial 2. Young rats quickly acquired this task and were repeatedly tested after different intervals over 7 months, with a slight increase in performance toward the end of testing, but no difference in latencies between delays. Oral long-term treatment of 1 group with 0.1 % aluminum caused no delay-dependent working memory deficit. This testing protocol may enable between- and within-subject long-term assessment of spatial working memory before and after drug treatment and may prove useful in animal models of progressive cognitive decline. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Central cholinergic involvement in working memory: Effects of scopolamine on continuous nonmatching and discrimination performance in the rat.

In 4 experiments, male Sprague-Dawley rats (N?=?37) were trained to stable baselines of leverpressing on a variable intertrial interval continuous nonmatching-to-sample schedule (CNM) or on an analogous discrimination schedule. Scopolamine HBr (0.125, 0.25, and 0.50 mg/kg) reduced the accuracy of CNM performance to a similar extent over the 3 intertrial (retention) intervals: 2.5, 5, and 10 sec, indicating that the drug did not affect the time-dependent process of retention in working memory. When baseline levels of performance accuracy were similar in the CNM and discrimination tasks (but stimulus discriminability was greater in the CNM task), scopolamine reduced accuracy equally in the 2 procedures. The effects of scopolamine on the accuracy of noncorrection trial CNM performance were simulated by reducing stimulus discriminability; however, scopolamine disrupted CNM correction trial performance much more than did reductions in stimulus discriminability. It is concluded that scopolamine's effects on working memory are not limited to the possible effects on stimulus discrimination—scopolamine may also affect the retrieval of response rules from reference memory. (52 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cortisol differentially affects memory in young and elderly men.

Nine young and 11 elderly men participated in this placebo-controlled, double-blind, crossover study (0.5 mg/kg cortisol or intravenous placebo). Participants learned a word list before cortisol administration, and delayed recall was then tested. A 2nd word list was learned and recalled after drug administration. In addition, the Paragraph Recall Test and tests measuring working memory (Digit Span), attention (timed cancellation), and response inhibition (Stroop Color and Word Test) were administered at 2 time points after drug administration. Cortisol reduced recall from the word list learned before treatment in both groups but did not influence recall of the list learned after treatment. In contrast, Digit Span performance was decreased by cortisol in young but not elderly participants. The possibility that differential age-associated brain changes might underlie the present results is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Yoga breathing through a particular nostril increases spatial memory scores without lateralized effects

Uninostril breathing facilitates the performance on spatial and verbal cognitive tasks, said to be right and left brain functions, respectively. Since hemispheric memory functions are also known to be lateralized, the present study assessed the effects of uninostril breathing on the performance in verbal and spatial memory tests. School children (N = 108 whose ages ranged from 10 to 17 years) were randomly assigned to four groups. Each group practiced a specific yoga breathing technique: (i) right nostril breathing, (ii) left nostril breathing, (iii) alternate nostril breathing, or (iv) breath awareness without manipulation of nostrils. These techniques were practiced for 10 days. Verbal and spatial memory was assessed initially and after 10 days. An age-matched control group of 27 were similarly assessed. All 4 trained groups showed a significant increase in spatial test scores at retest, but the control group showed no change. Average increase in spatial memory scores for the trained groups was 84%. It appears yoga breathing increases spatial rather than verbal scores, without a lateralized effect.     

The biology of menopause

Rats with bilateral electrolytic lesions of perirhinal cortex (PRC) or sham control (SHAM) lesions were tested in spatial reference and working memory tasks in the radial arm maze. In experiment 1, one arm of the maze was baited and always located in a fixed position relative to the extra-maze environment. PRC lesioned animals made a significantly greater number of errors than did SHAM animals during initial training in this reference memory task and exhibited a delay-dependent impairment on trial 5 in a series when a delay period of 5, 60, 120, or 240 s was inserted between trials 4 and 5. In experiment 2, when a second group of the animals was tested on the standard radial arm maze working memory task, the performance of the PRC group was markedly impaired relative to controls. These data demonstrate that electrolytic PRC lesions result in a deficit in both spatial reference and spatial working memory tasks. These effects are interpreted as being consistent with the idea that PRC plays an important role in episodic memory processes. These processes may include the storage of information, which is required for the performance of spatial tasks.     

Cognitive and consensus processes in group recognition memory performance.

This experiment applies signal detection theory and social decision schemes to investigate the potential impact of information pooling, error correction, and effective decision-making processes in the general finding that groups perform better than individuals on memory tasks. Groups and individuals completed a true/false recognition test regarding material presented in a videotaped simulated job interview. Various indexes of memory performance indicated that each of the processes contributed to the superiority of group recognition memory performance. Social decision scheme analyses indicated that the plurality-correct-wins decision scheme was the best summary of the decision process. Subsequent analyses suggested that the confidence that group members held in their initial preferences influenced the group decision process. Discussion emphasized the impact of consensus, correctness, and confidence on group memory performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships between metamemory, memory predictions, and memory task performance in adults.

A cross-sectional sample of adults recalled categorized word lists and narrative texts. Subjects gave performance predictions before each of 3 recall trials for each task. Older subjects had poorer memory performance and also predicted lower performance levels than did younger subjects. The LISREL models suggested (a) direct effects of memory self-efficacy (MSE) on initial predictions; (b) upgrading of prediction–performance correlations across trials, determined by direct effects of performance on subsequent predictions; (c) significant effects of a higher order verbal memory factor on MSE; and (d) an independent relationship of text recall ability to initial text recall performance predictions. These results lend support to the theoretical treatment of predictions as task-specific MSE judgments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The facilitation of long-term memory improvement and operative development.

J. Piaget and B. Inhelder (1973) have reported that children's memories for pictures or events improve between early (1-wk) and late (several-month) recall sessions in conjunction with operative growth. Using the concept of verticality, the present study investigated (a) if an intervening operative training task would increase memory improvements, and (b) if exposure to the memory stimulus per se would enhance later operative performance. 97 3rd graders were randomly assigned to 1 of 4 groups—with or without operative training and with or without a memory task. At the end of the school year, all Ss were tested for operative level. The trained group showed significantly more memory progressions and fewer regressions than the untrained group on 1 of 2 memory stimuli. On the 2nd stimulus, performance was consistently high across children and recall sessions, and thus no differences were found as a function of training. Participation in the memory task enhanced later operative performance. Implications for Piagetian memory research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perirhinal cortex contributions to performance in the Morris Water Maze.

Rats with bilateral, electrolytic lesions of perirhinal cortex (PRC), lateral entorhinal cortex (LEC), or combined lesions (PRLE) were impaired relative to controls (sham) during initial acquisition in the Morris water maze, although all groups were eventually able to learn to locate the platform. A further deficit in the performance of PRC and PRLE, but not LEC groups, was evident, however, when a probe trial was conducted 2 min (but not 24 hours) after training. When the performance of sham- and PRC-lesioned rats was tested with variable memory delays inserted between training and probe trials, lesioned rats displayed an increase in the rate of forgetting for information made available during the training trial. This finding suggests that the PRC normally stores information regarding the cue–platform relationship and transfers this information to related structures during water maze performance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Norepinephrine modulation of social memory: Evidence for a time-dependent functional recovery of behavior.

We tested the hypothesis that central nervous system (CNS) norepinephrine (NE) modulates the ability of an adult male rat to remember significant novel stimuli. Behavioral tests evaluated NE effects on general exploration and social memory. Results were that neither depletion nor elevation of NE impaired general exploration. Findings from the social memory setting suggested that animals tested 2 weeks after NE depletion were unable to discriminate novel from familiar juveniles in situations where untreated controls had no difficulty. Elevation of CNS NE, conversely, produced improved discrimination performance compared with control animals. Results suggest that activation of the CNS NE system is involved in the memory for novel stimuli. Performance of the NE-depleted group tested 3 months after treatment indicates a time-dependent functional recovery can occur in the presence of virtually total CNS NE depletion. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recognition memory, sleep and circadian rhythms.

Examined the effects of sleep on memory. In Exp 1, 43 Ss learned a list of words and were tested for recognition 24 hrs later. For the delayed sleep group, learning was followed by a period of wakefulness; for the immediate sleep group, it was followed by a period of sleep. Retention was significantly better for the immediate sleep group. In Exp 2, 69 Ss were tested approximately 8 hrs after learning. The normal waking group learned and was tested after a period of daytime wakefulness; the normal sleep group learned and was tested after a period of nighttime sleep; and the sleep deprivation group learned and was tested after a period of nighttime wakefulness. In agreement with previous work (e.g., J. G. Jenkins and K. M. Dallenbach, 1924), retention for the normal sleep group was superior to that of the normal waking group; however, retention was not better for the normal sleep group than for the sleep deprivation group. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)