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Aging is associated with cognitive changes, even in the absence of brain pathology. This study aimed to determine if meditation training, by comparison to active and passive control groups, is linked to changes in the perception of cognitive functioning in older adults. One hundred thirty-four healthy older participants from the Age-Well Randomized Clinical Trial were included: 45 followed a meditation training, 45 a non-native language training and 44 had no intervention. Subjective cognition was assessed at baseline and following the 18-month intervention period. Perception of attentional efficiency was assessed using internal and external Attentional Style Questionnaire (ASQ) subscale scores. Perception of global cognitive capacities was measured via the total score of Cognitive Difficulties Scale (CDS). Deltas ([posttest minus pretest scores]/standard deviation at pretest) were calculated for the analyses. Generalized mixed effects models controlling for age, sex, education and baseline scores revealed that meditation training decreased the vulnerability score toward external distractors measured by the ASQ compared to non-native language training. However, no between-groups differences on ASQ internal or CDS total scores were observed. Results suggest a beneficial effect of meditation practice on perceived management of external distracting information in daily life. Meditation training may cultivate the ability to focus on specific information (e.g., breath) and ignore stimulation from other kinds of stimuli (e.g., noise). [ABSTRACT FROM AUTHOR]

Background: Non‐pharmacological interventions are a potential strategy to maintain or promote cognitive functioning in older adults. We investigated the effects of 18‐months meditation or non‐native language training versus no intervention on cognition in older adults. Method: Age‐Well was an observer‐blind, randomised, controlled clinical trial with three parallel arms. Cognitively healthy adults aged ≥ 65 years and were recruited in France. Participants were randomised (1:1:1) to a meditation training, non‐native language (English) training, or a no intervention group for 18 months. Cognition (a pre‐specified secondary outcome) was assessed pre‐ and post‐intervention via the Preclinical Alzheimer's Cognitive Composite 5 (PACC5), and composites assessing episodic memory, executive function, and attention. Linear mixed models, adjusted for age, sex, and education, evaluated cognitive changes between arms. Baseline neocortical amyloid deposition was added as a fixed effect in a sensitivity analysis. Additional sensitivity analyses assessed intervention effects for participants who attended at least 20% of intervention classes or were classified as 'responders'. Results: 137 participants were randomly assigned to meditation training (n = 45), non‐native language training (n = 46), or no intervention (n = 46). Two participants were excluded for not meeting eligibility criteria, and one died during follow‐up (Figure 1). A positive effect of non‐native language training was observed on episodic memory relative to the no intervention group (0·32 [95% CI: 0·04‐0·61], p = 0·025), and on PACC5 scores compared to meditation training (0·33 [95% CI: 0·01‐0·66], p = 0·045; Figure 2). In sensitivity analyses, neither the inclusion of amyloid as an additional covariate nor the exclusion of participants who attended <20% of intervention classes affected results. Following exclusion of 'non‐responders', evidence for beneficial effects (relative to the no intervention group) on episodic memory became significant for meditation training (0·33 [0·01, 0·66]), and was weakened for non‐native language training (0·30 [‐0·02, 0·62]). No other between‐group differences emerged. Conclusion: Among cognitively healthy older adults, there was limited evidence for positive effects of 18‐months meditation training on cognition. However, in addition to having real‐life utility, non‐native language learning in late life may have beneficial effects on cognitive domains affected early in Alzheimer's disease. Studies investigating whether these effects are long‐lasting are warranted. [ABSTRACT FROM AUTHOR]

Background: Subjective cognitive decline (SCD) denotes self‐reported cognitive concerns in the absence of objective cognitive impairment. Individuals with SCD convert to dementia at twice the annual rate of healthy controls, with relatively poorer cognition in SCD conferring additional risk. Non‐pharmacological interventions are currently undergoing intensive evaluation for promoting cognitive function in SCD. Method: This study utilized data from the SCD‐Well randomized controlled trial. One hundred forty‐seven older adults with SCD, recruited from clinics in four European countries, were randomized to one of two 8‐week non‐pharmacological interventions: the Caring Mindfulness‐Based Approach for Seniors (CMBAS), or a Health Self‐Management Program (HSMP). Participants' objective cognitive performance was assessed at baseline, post‐intervention, and 24‐weeks follow‐up using a battery of tests. Four of these (RAVLT, WAIS‐IV Coding, Mattis DRS‐2 and Category Fluency) were combined to yield an abridged version of the Preclinical Alzheimer's Cognitive Composite 5 (PACC5Abridged). Linear mixed models estimated the change in outcome measures (the PACC5Abridged and its constituents) within and between arms. All models were adjusted for country and participant demographics (sex, age, and education), as well as the time‐varying effect of participants' repeated practice with the outcome measures. Result: There was a statistically significant improvement in the PACC5Abridged in both arms of the trial (p<.001), which did not differ between groups. The mean change in PACC5Abridged from baseline to 24‐weeks was 0.28 for CMBAS, and 0.22 for HSMP (pooled baseline SD 0.72). The effect of participants' repeated practice on the PACC5Abridged was non‐significant, ruling out retest effects as a substantive explanation for results. Amongst the PACC5Abridged constituent tests, significant improvement was observed in the RAVLT and WAIS‐IV Coding. Conclusion: This clinical trial evaluated the effect of two 8‐week non‐pharmacological interventions on objective cognitive performance in SCD. Scores on a composite measure of early Alzheimer's disease related cognitive dysfunction improved in both arms, even after accounting for practice effects. These results paralleled those of the primary outcome measure (trait anxiety), for which scores also improved in both arms. This work adds to the growing body of evidence that non‐pharmacological interventions can impact cognition in individuals at increased risk of dementia. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic and the associated distancing measures dramatically affect psychoaffective health, and this is accentuated in older adults who are more vulnerable to the situation. In this study, we are interested in the predictors of emotional resilience in healthy older adults, and also on how the repetition of confinement periods could influence this resilience and its predictors. Method: 102 cognitively unimpaired older adults from the Age‐Well cohort were included. They all completed the Depression Anxiety Stress Scales (DASS‐42) during each period of national confinement (April and November 2020), used here as a measure of emotional resilience (lower scores indicating greater resilience). Baseline measures from the Age‐Well study, all acquired before the pandemic, were used as predictors, including demographics (age, sex, education), personality (Big Five Inventory), psychological (anxiety [STAI‐B], depression [GDS]), lifestyle (Lifetime of experience questionnaire), global cognitive functioning (Mattis‐DRS) and neuroimaging data (hippocampal volume, brain perfusion, amyloid burden). We ran stepwise regressions to predict emotional resilience during the first confinement. Then, we used paired t‐test to assess the evolution of emotional resilience between the two confinements. Finally, we replicated the stepwise regressions to predict changes in resilience over time ('second‐minus‐first' confinement). Result: Neuroticism was the only significant predictor of the DASS‐42 score during the first confinement (β=.48; p<.001; Figure‐1), lower neuroticism being associated with better resilience. We found the DASS‐42 score to increase significantly from the first to the second confinement, indicating decreased emotional resilience over time. Moreover, higher neuroticism (β=.53; p<.001) and higher agreeableness (β=.20; p=.03) were associated with higher DASS‐42 increase over time (Figure‐2). Conclusion: Our study suggests that lower neuroticism is the main predictor of greater emotional resilience to the COVID‐19‐related confinement. Importantly, the repetition of the confinement situation is associated with a decrease in emotional resilience in older adults, especially if they are prone to experience distress (neuroticism) or have a particularly social personality (agreeableness). Overall, these results underline the increasing need, as the crisis persists, for a psychoaffective support of older adult. [ABSTRACT FROM AUTHOR]

Background: Sleep, especially slow wave sleep (SWS), favors efficient cognitive functioning. This effect may be impaired in aging, but might be modulated by cognitive reserve. Indeed, a study reported that highly educated older adults were able to better tolerate the negative effects of subjective sleep disturbances on verbal fluency scores. Growing evidence also suggests that sleep may favor amyloid clearance. In this context, we investigated the effect of cognitive reserve and amyloid deposition on the links between SWS and cognitive performance in older adults. Methods: Baseline data of 135 cognitively unimpaired older adults (mean age ± SD: 69.3 ± 3.8 y) from the Age‐Well cohort were analysed. Participants underwent a neuropsychological assessment, a polysomnography, and a florbetapir PET scan to measure amyloid deposition. Cognitive reserve was estimated using a socio‐behavioral proxy, the Lifetime of Experiences Questionnaire. We conducted linear regressions between SWS (% of total sleep time) and 1) executive functions and 2) episodic memory composite scores. Standardized residuals were extracted so that higher values reflect a better cognition than expected (i.e., greater cognitive resilience). Then, we performed linear regressions with these residuals as dependent variables and cognitive reserve or amyloid deposition as independent variables. Analyses were repeated with age, sex and the apnea‐hypopnea index as covariates. Results: SWS (%) was positively associated with executive functions (p=0.021) and episodic memory (p=0.017) composite scores (Figure 1). For both cognitive domains, higher residuals were associated with better cognitive reserve and lower amyloid deposition (p<0.05) (Figure 2). All links with cognitive reserve remained significant after controlling for the covariates (p<0.05), while those with amyloid deposition were close to the significance threshold (p=0.085 and p=0.054 for executive functions and episodic memory respectively). Conclusions: Individuals with higher cognitive reserve or, to a lesser extent, lower amyloid deposition, were able to better tolerate the effects of low amounts of SWS on executive and episodic memory performance. Cognitive reserve may help maintaining cognitive performance even when sleep is disrupted (i.e., cognitive resilience to sleep changes), while amyloid deposition would increase the vulnerability to poor sleep quality. These findings are important to understand the factors promoting successful aging. [ABSTRACT FROM AUTHOR]

Background: Brain white matter hyperintensities (WMH) are frequent in older adults, including cognitively unimpaired individuals and are associated to decreased cognitive performances. The prevalence of WMH and their links with cognitive performance and with cortical β‐amyloid (Aβ) burden have been rarely assessed in younger adults. The aim of this study was to assess the impact of WMH in younger and older cognitively unimpaired adults on cognitive performances and the possible interaction with cortical β‐amyloid (Aβ) burden. Method: Two hundred and seventy‐two cognitively unimpaired adults from the community (from the IMAP study and the Age‐Well trial) were enrolled and age‐stratified in 86 younger adults (YA; ≤60 years old) and 187 older adults (OA; >60 years old). All participants underwent i) a comprehensive neuropsychological assessment allowing to obtain composite scores of episodic memory, processing speed, working memory, executive functions, and global cognition; ii) brain structural T1 and FLAIR MRI scans used for automatic segmentation of WMH volumes; and iii) a Florbetapir‐PET scan to measure cortical Aβ. Within each group, the relationships of total and regional WMH to age and cognition were assessed, as well as the impact of cortical Aβ on these relationships. Result: WMH increased with age in both groups but more sharply in OA than YA, particularly in the parietal lobe. Higher WMH volume was associated to worse cognitive performances in both groups. Particularly, working memory, processing speed and global cognition were negatively associated with global and regional WMH in YA and executive functions were negatively associated to occipital WMH in OA. Cortical Aβ differentially impacts the links between WMH and cognition in YA versus OA. Conclusion: WMH volume increases with age and is negatively associated to cognitive performances including in YA. This study argues for the clinical relevance of WMH even in middle age. [ABSTRACT FROM AUTHOR]

Curing Alzheimer's disease remains hampered by an incomplete understanding of its pathophysiology and progression. Exploring dysfunction in medial temporal lobe networks, particularly the anterior-temporal (AT) and posterior-medial (PM) systems, may provide key insights, as these networks exhibit functional connectivity alterations along the entire Alzheimer's continuum, potentially influencing disease propagation. However, the specific changes in each network and their clinical relevance across stages are not yet fully understood. This requires considering commonly used biomarkers, clinical progression, individual variability, and age confounds. Here, we leveraged monocentric longitudinal data from 261 participants spanning the adult lifespan and the Alzheimer's continuum. The sample included cognitively unimpaired adults aged 19 to 85 years (n = 209; eight out of 64 older adults over 60 were Aβ-positive) and Aβ-positive patients fulfilling diagnostic criteria for mild cognitive impairment (MCI, n = 26; 18 progressed to Alzheimer-dementia within seven years) or Alzheimer's type dementia (n = 26). Participants underwent structural and resting-state functional (f) MRI, florbetapir and FDG-PET, and global cognitive assessments, with up to three visits over a maximum period of 47 months. Network connectivity was assessed using seed-based analyses with the perirhinal and parahippocampal cortices as seeds, within data-driven masks reflecting the AT and PM networks. Generalized additive and linear mixed models were run to assess age-specific effects and Alzheimer's-related alterations. In this context, we explored various markers of pathological and clinical severity, including cerebral amyloid uptake, glucose metabolism, hippocampal volume, global cognition, diagnostic staging, and time to dementia onset. Our findings revealed distinct patterns of connectivity linked to normal aging or Alzheimer's disease. Advancing age throughout adulthood was associated with lower PM connectivity and more subtle changes in AT connectivity, while Alzheimer's disease was characterised by AT hyperconnectivity without global changes in PM connectivity. Specifically, AT connectivity was higher in MCI and Alzheimer-dementia patients compared to older controls and was positively associated with amyloid burden, glucose hypometabolism, hippocampal atrophy, and global cognitive deficits in older adults, ranging from unimpaired to demented. Additionally, higher AT connectivity correlated with faster progression to Alzheimer-dementia in MCI patients. This comprehensive approach allowed to reveal that excessive connectivity within the AT network is intrinsically linked to the pathological and clinical progression of Alzheimer's disease. These insights may guide future research to better understand cascading events leading to the disease and hold promise for developing prognostic tools and therapeutic interventions targeting these specific network alterations., (© The Author(s) 2025. Published by Oxford University Press on behalf of the Guarantors of Brain.)

Sleep, especially slow wave sleep (SWS), is essential for cognitive functioning and is reduced in aging. The impact of sleep quality on cognition is variable, especially in aging. Cognitive reserve (CR) may be an important modulator of these effects. We aimed at investigating this question to better identify individuals in whom sleep disturbances might have greater behavioral consequences. Polysomnography and neuropsychological assessments were performed in 135 cognitively intact older adults (mean age ± SD: 69.4 ± 3.8y) from the Age-Well randomized controlled trial (baseline data). Two measures of cognitive engagement throughout life were used as CR proxies. Linear regression analyses were performed between the proportion of SWS, and executive function and episodic memory composite scores. Then, interaction analyses between SWS and CR proxies on cognition were conducted to assess the possible impact of CR on these links. SWS was positively associated with episodic memory, but not with executive function. CR proxies modulated the associations between SWS and both executive and episodic memory performance. Specifically, individuals with higher CR were able to maintain cognitive performance despite low amounts of SWS. This study provides the first evidence that CR may protect against the deleterious effects of age-related sleep changes on cognition.