The present research is based on a typology of crowding experiences incorporating two main dimensions: neutral-personal thwartings and primary-secondary environments. The thwarting dimension concerns the degree to which crowding experiences are associated with spatial inconveniences, alone, or with spatial as well as social constraints. The environmental dimension relates to the type of setting in which crowding experiences occur. A major assumption of this typology is that crowding experiences involving social conflict will be more intense and disruptive to the individual than those in which interpersonal conflict is minimal. The reported study examined the relationship between college students' evaluations of the physical amenity, social climate, and crowdedness of their residential environments, on the one hand, and their sensitivity to crowding in a classroom situation, their academic performance, and the frequency of their visits to the campus health center, on the other. Results indicated that perceived residential crowding and negative perceptions of residential social climate were strongly associated with increased sensitivity to crowding in a classroom situation, impaired course performance, and visits to the student health center. The implications of these correlational findings for future field-experimental research are discussed. © 1978 Plenum Publishing Corporation.

There is increasing evidence from basic science and human epidemiological studies that inflammation, oxidative stress, and metabolic abnormalities are associated with age-related cognitive decline and impairment. This article summarizes selected research on these topics presented at the Cognitive Aging Summit II. Speakers in this session presented evidence highlighting the roles of these processes and pathways on age-related cognitive decline, pointing to possible targets for intervention in nondemented older adults. Specific areas discussed included age differences in the production of cytokines following injury or infection, mechanisms underlying oxidative stress-induced changes in memory consolidation, insulin effects on brain signaling and memory, and the association between metabolic syndrome and cognitive decline in older adults. These presentations emphasize advances in our understanding of mechanisms and modifiers of age-related cognitive decline and provide insights into potential targets to promote cognitive health in older adults.

Trail Making Test (TMT) performance was investigated in 765 elderly volunteers (age range 60 to 96 years), 58 of whom met DSM-III-R criteria for dementia and 40 dementia 'suspects,' who showed mild changes in one or two cognitive domains. Cross-sectional analyses of the 667 nondemented participants, revealed significant age effects in completion times for both Parts A and B. Prevalence of errors increased with age on Part B, but not on Part A. Two-year longitudinal changes were examined in a subset of the nondemented sample (n = 385). Significant slowing was found for Part B, but not for Part A, with older age groups showing the greatest change. Error rates did not increase. Dementia status accounted for a significant proportion of the variance in completion times after accounting for age, education, and gender. Receiver operating characteristic analyses suggest that the TMT may be useful in screening for cognitive dysfunction.

While total errors on the Benton Visual Retention Test (BVRT) are known to increase in normal aging, there is little information on changes for specific error types. We examined the differential increase in seven specific error categories for 2,000 participants in the Baltimore Longitudinal Study of Aging. Cross-sectional analyses indicated that all errors increased with age, but differences between age groups in error profiles suggested relatively greater age effects for distortions, omissions, and rotations. There were also significant gender differences in error profiles, reflecting increased rotation and omission errors in females. Longitudinal analyses of age changes for a subset of 673 participants with three BVRT assessments were consistent with the cross-sectional data and indicated intra-individual increases with age in distortions, omissions, and rotations. While women made more omission errors, men showed steeper increases in omission errors with age. These findings suggest that cerebral aging impacts all categories of BVRT errors but has differential effects on particular error types.

Objective

To examine trajectories of declines in learning and retention during the predementia phase of Alzheimer's disease (AD) using the picture version of the Free and Cued Selective Reminding Test with Immediate Recall (pFCSRT+IR).

Method

Learning was defined by the sum of free recall over three test trials. Retention was defined in two ways: by delayed free recall (DFR) and by savings; DFR adjusted for learning. The performances of 217 incident AD cases from the Baltimore Longitudinal Study of Aging (BLSA) were aligned based on the time that AD was first diagnosed. The predementia phase of learning and retention decline was assessed using change point models in which cognitive trajectories are described by a series of linear components with knots delineating times of accelerating decline.

Results

Trajectories for both learning and DFR had two change points: the first at 6.58 (95% confidence intervals (CI): 6.56, 6.60) to 7.29 (95% CI: 6.13, 8.46) years before diagnosis followed by gradual decline over the next 4 years, and a second acceleration of decline 1.89 (0.56, 3.24) to 2.93 (95% CI: 1.56, 4.30) years before diagnosis. The change points for DFR were not significantly earlier in the predementia phase than the change points for learning. Savings had one change point, 5.3 (95% CI: 3.56, 7.04) years before diagnosis.

Conclusion

Both learning and DFR showed similar profiles of decline in the years prior to the clinical diagnosis of AD. When delayed recall was adjusted for initial learning, the measure was less sensitive to early disease. (JINS, 2019, 25, 699-705).

Objective

To compare the predictive validity of learning and retention measures from the picture version of the Free and Cued Selective Reminding Test with Immediate Recall (pFCSRT + IR) for identifying incident mild cognitive impairment (MCI).

Methods

Learning was defined by the sum of free recall (FR) and retention by delayed free recall (DFR) tested 15-20 min later. Totally, 1422 Baltimore Longitudinal Study of Aging (BLSA) participants (mean age 69.6 years, 54% male, mean 16.7 years of education) without dementia or MCI received the pFCSRT + IR at baseline and were followed longitudinally. Cox proportional hazards models were used to evaluate the effect of baseline learning and retention on risk of MCI.

Results

In total, 187 participants developed MCI over a median of 8.1 years of follow-up. FR and DFR each predicted incident MCI adjusting for age, sex, and education. Also, each independently predicted incident MCI in the presence of the other with similar effect sizes: around 20% decrease in the hazard of MCI corresponding to one standard deviation increase in FR or DFR.

Conclusion

The practice of preferring retention over learning to predict incident MCI should be reconsidered. The decision to include retention should be guided by time constraints and patient burden.

In the Baltimore Longitudinal Study of Aging (BLSA), we examined the temporal unfolding of declining performance on tests of episodic memory (Free Recall on the Free and Cued Selective Reminding Test), executive function (Category Fluency, Letter Fluency, and Trails), and Verbal Intelligence (Nelson, 1982; American Version of the Nelson Adult Reading Test [AMNART]) before the diagnosis of dementia in 92 subjects with incident Alzheimer's disease (AD) followed for up to 15 years before diagnosis. To examine the preclinical onset of cognitive decline, we aligned subjects at the time of initial AD diagnosis and examined the cognitive course preceding diagnosis. We found that declines in performance on tests of episodic memory accelerated 7 years before diagnosis. Declining performance on tests of executive function accelerated 2-3 years before diagnosis, and verbal intelligence declined in close proximity to diagnosis. This cognitive profile is compatible with pathologic data suggesting that structures which mediate memory are affected earlier than frontal structures during the preclinical onset of AD. It also supports the view that VIQ as estimated by the AMNART does not decline during the preclinical onset of AD.

Performance on letter and category fluency was studied in a group of 478 healthy, highly intelligent and educated, older adults (aged 55 to 94 years). The aim of the study was to determine and contrast the effects of age, sex, and intelligence (estimated by the NAART) on letter (FAS) and category (fruits, animal, vegetables) verbal fluency performance. Significant effects were found for age and NAART error score on all fluency scores. However, these effects were small in magnitude. The NAART was found to be a better predictor of verbal fluency scores than education. The relative sensitivity of letter and category fluency to age was not significantly different. Sex was related to performance for the categories of fruits and vegetables, with women outperforming men. Separate mean values for fluency measures are provided for different ages, NAART error scores, educational level, and sex.

Alpha-synuclein (alpha-synuclein) lesions are characteristic of idiopathic Parkinson disease (PD) and other alpha-synucleinopathies. To study the frequency of alpha-synuclein lesions in normal aging and how frequently they coexist with lesions of Alzheimer disease (AD), we examined the autopsy brains from normal and demented subjects in the Baltimore Longitudinal Study of Aging (BLSA) (n = 117). We found that the overall frequency of alpha-synuclein lesions was 25%, with 100% in 7 cases of PD, 31.5% in 56 cases with AD lesions, and 8.3% among 36 older control brains. Among brains with AD lesions, the frequency of alpha-synuclein pathology was higher in those with higher scores for neuritic plaques, but not in those with higher scores for neurofibrillary tangles. Our observations indicate that alpha-synuclein lesions are uncommon in aged control subjects. Finally, the coexistence of Abeta amyloid and alpha-synuclein pathology in AD brains suggests that the pathogenic mechanism/s leading to the accumulation of Abeta and alpha-synuclein may be similar.

Background

Midlife obesity has been linked to age-related brain atrophy and risk of dementia, but the relationships are less clear for older individuals. These associations may be explained by changes in appetite or metabolism in the dementia prodrome; thus, prospective studies with adequate follow-up are needed. We examined the associations that obesity (body mass index, BMI) and change in BMI over an average of 6.6 (1.0-9.1) years have with global and regional brain and white matter lesion volumes in a sample of 1,366 women aged 65-80.

Methods

Least square means for regional brain volumes and white matter lesion loads for women grouped by BMI and changes in BMI were generated from multivariable linear models with and without adjustment for demographic and health covariates.

Results

Both global obesity and increase in BMI were associated with lower cerebrospinal fluid and higher specific brain volumes (ps < .05), after controlling for diabetes and other cerebrovascular disease risk factors. Obesity, but not change in BMI, predicted lower lesion loads for the total, parietal, and occipital white matter (ps < .05).

Conclusions

Obesity in this cohort is associated with less brain atrophy and lower ischemic lesion loads. The findings are consistent with our previous report of worse cognitive performance in association with weight loss (probably not due to frailty) in this cohort and in line with the idea of the "obesity paradox" as differences in dementia risk vary across time, whereby midlife obesity seems to be a predictor of dementia, whereas weight loss seems to be a better predictor at older ages.