Metacognitive beliefs of efficacy about daily life situations and use of cognitive strategies in amnestic mild cognitive impairment: a cross-sectional study

Metacognition, the ability to monitor and regulate cognitive processes, is essential for individuals with Mild Cognitive Impairment (MCI) to accurately identify their deficits and effectively manage them. However, previous studies primarily focused on memory awareness in MCI, neglecting other domains affected in daily life. This study aimed to investigate how individuals with MCI perceive their abilities to handle various cognitively challenging situations representing real-life scenarios and their use of compensatory strategies. Thus 100 participants were recruited, including 50 with amnestic MCI with multiple deficits (aMCI) and 50 cognitively healthy controls (HC) matched in age and education. Participants completed three metacognitive scales assessing self-perceived efficacy in everyday life scenarios and one scale evaluating use of cognitive strategies. Results indicated that aMCI participants reported significantly lower self-efficacy in memory and divided-shifted attention scenarios compared to HC. Surprisingly, no significant group differences were found in the self-reports about the use of cognitive strategies. This suggests a potential gap in understanding or applying effective strategies for compensating cognitive deficits. These findings emphasize the importance of cognitive training programs targeting metacognitive knowledge enhancement and practical use of cognitive strategies that could enhance the quality of life for individuals with MCI

Pilot intergenerational interaction program in elementary school: examining the effects on the cognitive skills of students attending the First Class of the Elementary School

Στόχο της παρούσας έρευνας αποτελεί η διερεύνηση της επίδρασης ενός διαγενεακού προγράμματος παρέμβασης στις γνωστικές δεξιότητες παιδιών μέσης παιδικής ηλικίας. Στο διαγενεακό πρόγραμμα συμμετείχαν τρεις γυναίκες ηλικίας 62-73 ετών με Ήπια Νοητική Εξασθένιση (ΗΝΕ), από την Ελληνική Εταιρία Νόσου Alzheimer και Συγγενών Διαταραχών Θεσσαλονίκης, και 25 μαθητές και μαθήτριες της Α΄ Δημοτικού, εκ των οποίων οι 15 αποτελούσαν μέλη της πειραματικής ομάδας και οι υπόλοιποι 10 μέλη της ομάδας ελέγχου. Η παρέμβαση ήταν διάρκειας έξι δίωρων εβδομαδιαίων συναντήσεων και πραγματοποιήθηκε στη σχολική αίθουσα, όπου η ομάδα των ηλικιωμένων με ΗΝΕ και των μαθητών/τριών της πειραματικής ομάδας έπαιρναν από κοινού μέρος σε δραστηριότητες με εκπαιδευτικό χαρακτήρα. Πραγματοποιήθηκαν μετρήσεις των γνωστικών δεξιοτήτων των παιδιών της πειραματικής και της ομάδας ελέγχου πριν, αμέσως μετά, και ένα μήνα μετά την παρέμβαση. Η ανάλυση διακύμανσης με επαναλαμβανόμενες μετρήσεις σε κάθε ομάδα των παιδιών έδειξε βελτίωση στη βραχύχρονη μνήμη μόνο της πειραματικής ομάδας. Συνεπώς, φαίνεται ότι η αλληλεπίδραση μεταξύ των δύο γενεών (ηλικιωμένων με HNΕ – μικρών παιδιών)  μπορεί να έχει θετικά οφέλη στη βραχύχρονη μνήμη των παιδιών και ότι η διδασκαλία των ηλικιωμένων με ΗΝΕ μπορεί να έχει  οφέλη για τα παιδιά που συμμετέχουν σε διαγενεακό πρόγραμμα διδασκαλίας.The purpose of this study is to examine the effects of an intergenerational intervention program on the cognitive skills of middle-aged children. Three older adult women diagnosed with Mild Cognitive Impairment, aged 62-73 years old, from the Greek Association of Alzheimer Disease and Related Disorders in Thessaloniki, Greece, were recruited to participate as “teachers” in the program. The sample of the study consisted of 25 children who attended the first class of the elementary school (15 pupils in the experimental group and 10 in the control group). The intervention lasted for 6 meetings and took place in the classroom, where the experimental group of older adult women and pupils (15 children) participated in activities for two hours per week. The examination of the findings, which refer to children’s short term memory, by using the method of repeated measures ANOVA, has shown that there is a significant improvement in the short term memory of experimental group, as compared to controls. In conclusion, this study suggests that the intergenerational interaction can have positive impact on young children’s short term memory and that older adults with MCI can effectively act as ‘teachers’ in interactive teaching.                                                                                    

Glucocorticoid-related genetic susceptibility for Alzheimer's disease

Because glucocorticoid excess increases neuronal vulnerability, genetic variations in the glucocorticoid system may be related to the risk for Alzheimer's disease (AD). We analyzed single-nucleotide polymorphisms in 10 glucocorticoid-related genes in a population of 814 AD patients and unrelated control subjects. Set-association analysis revealed that a rare haplotype in the 5′ regulatory region of the gene encoding 11β-hydroxysteroid dehydrogenase type 1 (HSD11B1) was associated with a 6-fold increased risk for sporadic AD. Results of a reporter-gene assay indicated that the rare risk-associated haplotype altered HSD11B1 transcription. HSD11B1 controls tissue levels of biologically active glucocorticoids and thereby influences neuronal vulnerability. Our results indicate that a functional variation in the glucocorticoid system increases the risk for AD, which may have important implications for the diagnosis and treatment of this diseas

Association study of cholesterol-related genes in Alzheimer's disease

Alzheimer's disease (AD) is a genetically complex disorder, and several genes related to cholesterol metabolism have been reported to contribute to AD risk. To identify further AD susceptibility genes, we have screened genes that map to chromosomal regions with high logarithm of the odds scores for AD in full genome scans and are related to cholesterol metabolism. In a European screening sample of 115 sporadic AD patients and 191 healthy control subjects, we analyzed single nucleotide polymorphisms in 28 cholesterol-related genes for association with AD. The genes HMGCS2, FDPS, RAFTLIN, ACAD8, NPC2, and ABCG1 were associated with AD at a significance level of P ≤ 0.05 in this sample. Replication trials in five independent European samples detected associations of variants within HMGCS2, FDPS, NPC2, or ABCG1 with AD in some samples (P = 0.05 to P = 0.005). We did not identify a marker that was significantly associated with AD in the pooled sample (n = 2864). Stratification of this sample revealed an APOE-dependent association of HMGCS2 with AD (P = 0.004). We conclude that genetic variants investigated in this study may be associated with a moderate modification of the risk for AD in some sample

Self-Awareness of Cognitive Efficiency, Cognitive Status, Insight, and Financial Capacity in Patients with Mild AD, aMCI, and Healthy Controls: An Intriguing Liaison with Clinical Implications?

Objectives: This study compares objective measures of cognitive performance with subjective perception of specific performance on neuropsychological tests examining basic cognitive domains, including, for the first time, financial capacity. Additionally, differences in assessment between single- and multiple-domain aMCI, mild AD, and healthy elderly regarding insight are examined. Methods: Participants completed a number of neuropsychological tests and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). After every test, participants were asked to complete the Clinical Insight Rating scale (CIR) and to self-evaluate their performance by comparing it to what they considered as average for people of their age and educational level. Results: These preliminary findings show significant differences in the self-assessment patterns of the four groups in measures of verbal memory, visuospatial perception and memory, executive functions, tests of attention, and financial capacity. Mild AD expressed the highest overestimations, followed by single- and multiple-domain aMCI as well as controls. Accuracy of self-report is not uniform across groups and functional areas. Conclusions: Unawareness of memory deficits in both MCI subtypes is contradictory to subjective memory complaints as being an important component for clinical diagnosis. Financial capacity is overestimated in MCI and mild AD, a finding that has a plethora of clinical and legal implications

Brain Volumes and Metacognitive Deficits in Knowledge of Self, Task and Strategies in Mathematics: A Preliminary Pilot One-Year Longitudinal Study in aMCI Patients Compared to Healthy Controls

Metacognitive knowledge has been little investigated in aMCI patients. The aim of this study is to examine whether there are specific deficits in knowledge of self, task and strategies in mathematical cognition, due its importance for everyday functioning, mainly due to its importance for financial capacity in old age. A total of 24 patients with a diagnosis of aMCI and one-to-one 24 matched individuals (similar age, education and gender) were examined at three time points in a year with a number of neuropsychological tests and a slightly modified version of the Metacognitive Knowledge in Mathematics Questionnaire (MKMQ). We analyzed longitudinal MRI data regarding various brain areas for the aMCI patients. Results indicated that the aMCI group differed in all MKMQ subscale scores at the three time points compared to healthy controls. Correlations were found only for metacognitive avoidance strategies and left and right amygdala volumes at baseline, while after twelve months correlations were found for avoidance and right and left parahippocampal volumes. These preliminary results highlight the role of specific brain regions that could be used as indices in clinical practice for the detection of metacognitive knowledge deficits that are found in aMCI

What Do Arithmetic Errors in the Financial Context Reveal? A Preliminary Study of Individuals with Neurocognitive Disorders

Objectives: Arithmetic errors in the financial context have been investigated mainly in cognitively normal Parkinson’s disease (PD) patients and mildly impaired PD (PD-MCI) individuals. The aim of this study was to examine arithmetic errors in the financial context across neurocognitive disorders. Methods: Four hundred and twenty older adults from Greece were divided into four groups (110 patients with a diagnosis of Alzheimer’s disease (AD), 107 patients with a diagnosis of mild cognitive impairment (MCI), 109 healthy controls and 94 Parkinson’s disease dementia (PDD) patients). Their ages ranged from 65 to 98 years (M = 73.96, SD = 6.68), and the sample had a mean of 8.67 (SD = 4.08) years of education. For each of the AD patients, a counterpart matched by age, educational attainment and gender was selected from a larger group of participants. Results: Overall, the results reveal that healthy older adults did not commit arithmetic errors, but AD patients reported procedural errors in their responses to both questions. A high frequency of procedural errors was found in MCI patients’ responses to the first question, while the errors in their responses to the second question cannot be categorized. Finally, in PDD patients, place value errors were reported for the first question, while more magnitude errors were made when responding to the second question. Conclusions: These findings support that arithmetic errors within financial contexts are not the same across neurocognitive disorders, and numerical representations are not impaired not only in PDD, but also in AD and MCI. This information could be useful in cognitive assessments performed by neurologists and neuropsychologists as these types of errors may be indicators of specific brain pathologies

Beneath the Top of the Iceberg: Financial Capacity Deficits in Mixed Dementia with and without Depression

Nowadays, controversy exists regarding the influence of comorbid depression on cognition in old age. Additionally, we still know little about the influence of depression in mixed dementia (MD), that is, in cases where there is the co-existence of Alzheimer’s disease and vascular dementia (VaD). Given that the assessment of financial capacity is pivotal for independent living as well as in the prevention of financial exploitation and abuse in old age, in this pilot study, we aimed to examine whether comorbid depression in MD patients can influence financial capacity performance. A total of 115 participants were recruited. They were divided into four groups: MD patients with and without depressive symptoms and healthy elderly without depression as well as older adults suffering from depression. Participants were examined with a number of neuropsychological tests, including the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), and Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). The results of this study suggested that financial capacity as measured with LCPLTAS in MD patients was severely impaired when depression co-existed compared to patients suffering only from depression and healthy controls. Deficits in financial capacity in MD and comorbid depression should be a point on which healthcare professionals should focus during neuropsychological assessment in order to prevent financial exploitation

Beneath the Top of the Iceberg: Financial Capacity Deficits in Mixed Dementia with and without Depression

Nowadays, controversy exists regarding the influence of comorbid depression on cognition in old age. Additionally, we still know little about the influence of depression in mixed dementia (MD), that is, in cases where there is the co-existence of Alzheimer’s disease and vascular dementia (VaD). Given that the assessment of financial capacity is pivotal for independent living as well as in the prevention of financial exploitation and abuse in old age, in this pilot study, we aimed to examine whether comorbid depression in MD patients can influence financial capacity performance. A total of 115 participants were recruited. They were divided into four groups: MD patients with and without depressive symptoms and healthy elderly without depression as well as older adults suffering from depression. Participants were examined with a number of neuropsychological tests, including the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS-15), and Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). The results of this study suggested that financial capacity as measured with LCPLTAS in MD patients was severely impaired when depression co-existed compared to patients suffering only from depression and healthy controls. Deficits in financial capacity in MD and comorbid depression should be a point on which healthcare professionals should focus during neuropsychological assessment in order to prevent financial exploitation