Episodic memory impairment is a consistent, pronounced deficit in pre-clinical stages of late-onset Alzheimer's disease (AD). Individuals with risk factors for AD exhibit altered brain function several decades prior to the onset of AD-related symptoms. In the current event-related fMRI study of spatial context memory we tested the hypothesis that middle-aged adults (MA; 40–58 yrs) with a family history of late onset AD (MA+ FH), or a combined + FH and apolipoprotein E ε4 allele risk factors for AD (MA+ FH + APOE4), will exhibit differences in encoding and retrieval-related brain activity, compared to − FH − APOE4 MA controls. We also hypothesized that the two at-risk MA groups will exhibit distinct patterns of correlation between brain activity and memory performance, compared to controls. To test these hypotheses we conducted multivariate task, and behavior, partial least squares analysis of fMRI data obtained during successful context encoding and retrieval. Our results indicate that even though there were no significant group differences in context memory performance, there were significant differences in brain activity and brain-behavior correlations involving the hippocampus, inferior parietal cortex, cingulate, and precuneus cortex in MA with AD risk factors, compared to controls. In addition, we observed that brain activity and brain-behavior correlations in anterior-medial PFC and in ventral visual cortex differentiated the two MA risk groups from each other, and from MAcontrols. Our results indicate that functional differences in episodic memory-related regions are present by early midlife in adults with + FH and + APOE-4 risk factors for late onset AD, compared to middle-aged controls.

Episodic memory impairment is a consistent, pronounced deficit in pre-clinical stages of late-onset Alzheimer's disease (AD). Individuals with risk factors for AD exhibit altered brain function several decades prior to the onset of AD-related symptoms. In the current event-related fMRI study of spatial context memory we tested the hypothesis that middle-aged adults (MA; 40-58yrs) with a family history of late onset AD (MA +FH ), or a combined +FH and apolipoprotein E ε4 allele risk factors for AD (MA +FH+APOE4 ), will exhibit differences in encoding and retrieval-related brain activity , compared to -FH -APOE4 MA controls. We also hypothesized that the two at-risk MA groups will exhibit distinct patterns of correlation between brain activity and memory performance, compared to controls. To test these hypotheses we conducted multivariate task, and behavior, partial least squares analysis of fMRI data obtained during successful context encoding and retrieval. Our results indicate that even though there were no significant group differences in context memory performance, there were significant differences in brain activity and brain-behavior correlations involving hippocampus, inferior parietal cortex, cingulate, and precuneus in MA with AD risk factors, compared to controls. In addition, we observed that brain activity and brain-behavior correlations in anterior-medial PFC and in ventral visual cortex differentiated the two MA risk groups from each other, and from MA controls . Our results indicate that functional differences in episodic memory-related regions are present by early midlife in adults with +FH and +APOE-4 risk factors for late onset AD, compared to middle-aged controls.peer-reviewed)

No abstract

clinicaltrials.gov, identifier NCT00483106.

Background: In Canada, healthcare professionals often rely on ad hoc interpreters, who are untrained volunteers recruited via intercom hospital announcements to interpret for patients with language barriers. This study analyzed the frequency of ad hoc interpreter requests via intercom announcements to estimate hospital interpretation needs. Methods: A retrospective cohort analysis from intercom requests for medical interpretation collected from five hospitals of the McGill University Health Center. Requests included date, time, language requested, hospital location, and extension for who placed the request. Results: A total of 1265 intercom requests were placed for 48 languages, with the top five languages being Mandarin (17.8%), Punjabi (10.1%), Inuktitut (9.8%), Arabic (7.3%), and Cantonese (6.4%). Almost 69.8% of requests were made during working hours, 13.2% on workday evenings, and 14.8% on weekends. Requests came from urgent care (42.3%), outpatient (29.5%), and inpatient (23.3%) settings. Conclusion: This is the first published study that measures interpretation needs via intercom requests. We propose that our method can be replicated to inform implementation of professional medical interpretation services. We conclude that linguistic interpretation needs are significant in the Montreal area, and likely in Canada in general and pose a barrier to effective medical care.