The literature on repetition priming in Alzheimer’s disease (AD) is inconsistent, with some findings supporting spared priming while others do not. Several factors may explain these inconsistencies, including AD severity (e.g., dementia vs. Mild Cognitive Impairment; MCI) and priming paradigm-related characteristics. This systematic review and meta-analysis provides a quantitative summary of repetition priming in AD. We examined the between-group standard mean difference comparing repetition priming in AD dementia or amnestic MCI (aMCI; presumably due to AD) to controls. Thirty-two studies were selected, including 590 individuals with AD dementia, 267 individuals with amnestic MCI, and 703 controls. Our results indicated that both individuals with aMCI and AD dementia perform worse on repetition priming tasks than cognitively older adults. Paradigm-related moderators suggested that the effect size between studies comparing the combined aMCI or AD dementia group to cognitively healthy older adults was the highest for paradigms that required participants to produce, rather than identify, primes during the test phase. Our results further suggested that priming in AD is impaired for both conceptual and perceptual priming tasks. Lastly, while our results suggested that priming in AD is impaired for priming tasks that require deep processing, we were unable to draw firm conclusions about whether priming is less impaired in aMCI or AD dementia for paradigms that require shallow processing.
Chronotype refers to the time of day that people prefer to be active or to sleep and varies predictably across the lifespan. In younger samples, the morning-chronotype is related to greater levels of physical activity (PA) and improved health outcomes. It is unclear whether this pattern holds in older adults, a group that commonly exhibits an “early bird” preference. We investigated differences in PA patterns between chronotypes in 109 older adults (Mage = 70.45 years) using wrist-worn ActiGraphs in a free-living environment. ActiGraphs captured data about PA and sleep using a novel approach to measuring chronotype with the mid-point of the sleep interval. We categorized participants as morning-, intermediate-, or evening-chronotypes. We used ANCOVA to predict total and average peak PA from chronotype, adjusting for age, sex, education, and BMI. Total PA significantly differed between chronotypes such that evening-types engaged in less PA than both morning- and intermediate-types, F (2,102) = 4.377, p =.015. Average peak activity did not differ between chronotypes, p =.112. Consistent with findings in younger samples, our evening type participants engaged in less overall activity. A unique finding was that evening-types did not differ from their morning- and intermediate-chronotype peers in peak activity levels. This implies a key distinction between total activity and peak activity levels consistent with recent trends in PA research using a 24-hour-a-day framework instead of average or total activity levels. Future research should consider whether these differences in activity patterns translate into meaningful differences in health benefits in this age group.
Executive function (i.e., decision making, self-control, planning) is important for facilitating independent living in older adults. Physical activity may preserve executive function, but previous research has demonstrated sex differences in both physical activity and executive function among older adults. Few studies have investigated sex differences in the association between the two. We examined associations between objectively measured physical activity and executive function with attention to sex differences. We recruited N = 204 participants (Mage =71, SD=6.36; 57% women) with (n=47) and without (n=157) Alzheimer’s disease from the University of Kansas Alzheimer’s Disease Research Center. We used wrist-worn accelerometers (Actigraph GT9X) to measure physical activity 24 hours a day for 7 days in a free-living environment. We categorized physical activity as moderate to vigorous (MVPA) based on the Montoye (2020) Adult Vector Magnitude cut-points. We evaluated sex differences in the association between executive function and MVPA using multiple regression with an interaction term, adjusting for age, education, and dementia status. We used a composite score to combine tests of executive function (Digit Symbol Substitution, Stroop Interference, Trail making Part B, and Verbal Fluency). Results indicated, older age and lower education were associated with lower executive function scores (β=-2.12, p < 0.001; B=2.13, p < .05). In contrast to previous research, we did not find evidence for sex differences in the MVPA, executive function, nor the association between the two in our sample. Future research should investigate whether individualized exercise-based interventions and treatment between men and women may differentially benefit cognitive function.
Studies show that women lack knowledge about perimenopause and feel unprepared to make healthcare decisions during this life transition. Most women want to be involved in their healthcare decisions and need timely, free, and accurate information. We conducted a needs assessment in Douglas County, Kansas by systematically reviewing regional organizations that might offer services and resources related to women’s health in midlife. We compared these resources to a benchmark for menopausal care available online nationwide (Gennev.com). We documented the primary purpose of each organization (e.g., cosmetic, wellness, medical care), services and resources offered (e.g., hormone therapy, counseling, non-pharmacological treatments), methods of outreach (e.g., blogs, classes), target audience, costs, and types of service providers (e.g., physician, counselor). We surveyed 9 regional websites: 5 offered medical care, 3 cosmetic and wellness services, 2 were municipal organizations, 2 offered mental health/social support. Four organizations offered services targeted specifically towards perimenopausal women. The most commonly offered services were hormone replacement therapy (44%), nutritional supplements (33%), and weight loss programs (33%). Very few offered educational resources (1) or menopause assessments (1) and none offered tailored psychosocial support for the perimenopause transition. The services offered were expensive with no free services and very few free resources. Organizations were primarily staffed by medical providers, only 1 organization had Menopause Practitioners certified by the North American Menopause Society. Our results demonstrate a need for comprehensive educational and support services for perimenopausal women to fulfill the need for timely, accessible, and accurate information during this understudied health transition.
Physical activity may preserve cognitive functioning in older adults. This study examined associations between objectively measured physical activity and cognitive functioning. We recruited participants (Mage = 75.38 years, SD = 5.99) with (N=26) and without (N=181) cognitive impairment from the University of Kansas Alzheimer’s Disease Center (KU-ADC). We collected cognitive data representing verbal memory, attention, and executive function. Accelerometers (Actigraph GT9X) were used to measure physical activity 24 hours a day for 7 days in a free-living environment. Physical activity was categorized as moderate to vigorous physical activity (MVPA) based on the Freedson (2011) Adult Vector Magnitude cut points. The association between cognitive functioning and total MVPA was evaluated by using multiple regression. We used factor analysis to create three composite scores (verbal memory, attention, executive function) from 11 individual cognitive tests. Compared to verbal memory and attention, results indicate that total MVPA was more strongly associated with executive function (β = 0.001, p = .024). These findings are consistent with the literature suggesting that executive function in older adults may benefit from physical activity. Future research should investigate the physiological mechanisms by which MVPA benefits executive function in contrast to types of activity that might benefit verbal memory and attention.
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