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BackgroundAge-related vision impairments and dementia both become more prevalent with increasing age. Research into the mechanisms of these conditions has proposed that some of their causes (eg, macular degeneration/glaucoma and Alzheimer’s disease) could be symptoms of an underlying common cause. Research into sensory-cognitive aging has provided data that sensory decline may be linked to the progression of dementia through reduced sensory stimulation. While hearing loss rehabilitation may have a beneficial effect on cognitive functioning, there are no data available on whether low vision rehabilitation, specifically for reading, could have a beneficial effect on cognitive health. ObjectiveThe research questions are: (1) Does low vision rehabilitation reduce reading effort? (2) If so, does reduced reading effort increase reading activity, and (3) If so, does increased reading activity improve cognitive functioning? The primary objective is to evaluate cognition before, as well as at 6 months and 12 months after, 3 weeks of low vision reading rehabilitation using magnification in individuals with age-related macular degeneration, with or without coexisting hearing impairments. We hypothesize that improvements postrehab will be observed at 6 months and maintained at 12 months for participants with vision loss and less so for those with dual sensory loss. The secondary objective is to correlate participant characteristics with all cognitive outcomes to identify which may play an important role in reading rehabilitation. MethodsWe employ a quasiexperimental approach (nonrandomized, pre-post intervention study). A 3x3 design (3 groups x 3 time points) allows us to examine whether cognitive performance will change before and after 6 months and 12 months of a low vision reading intervention, when comparing 75 low vision and 75 dual sensory impaired (vision & hearing) participants to 75 age-matched healthy controls. The study includes outcome measures of vision (eg, reading acuity and speed), cognition (eg, short-term and long-term memory, processing speed), participant descriptors, demographics, and clinical data (eg, speech perception in noise, mental health). ResultsThe study has received approval, and recruitment began on April 24, 2019. As of March 4, 2021, 38 low vision and 7 control participants have been enrolled. Lockdown forced a pause in recruitment, which will recommence once the COVID-19 crisis has reached a point where face-to-face data collection with older adults becomes feasible again. ConclusionsEvidence of protective effects caused by reading rehabilitation will have a considerable impact on the vision rehabilitation community and their clients as well as all professionals involved in the care of older adults with or without dementia. If we demonstrate that reading rehabilitation has a beneficial effect on cognition, the demand for rehabilitation services will increase, potentially preventing cognitive decline across groups of older adults at risk of developing macular degeneration. Trial RegistrationClinicalTrials.gov NCT04276610; Unique Protocol ID: CRIR-1284-1217; https://clinicaltrials.gov/ct2/show/NCT04276610 International Registered Report Identifier (IRRID)DERR1-10.2196/19931

Cognitive interventions are helpful in the non-pharmacological management of Primary progressive aphasia (PPA) and other neurodegenerative disorders of cognition, by helping patients to compensate for their cognitive deficits and improve their functional independence. In this study, we examined the effectiveness of cognitive rehabilitation based on the use of mobile device technology in PPA. The aim of this research study was to determine if BL, a patient with semantic variant PPA (svPPA) and severe anomia, was able to learn using specific smartphone functions and an application to reduce her word finding difficulties. She was trained during the intervention sessions on a list of target pictures to measure changes in picture naming performance. Errorless learning was applied during learning. BL quickly learned to use smartphone functions and the application over the course of the intervention. She significantly improved her anomia for trained pictures, and to a lesser extent for untrained semantically related pictures. Picture naming performance was maintained six months after the intervention, and she continued to use her smartphone regularly to communicate with family members and friends. This study confirms that smartphone use can be learned in PPA, which can help reduce the symptoms of anomia and improve communication skills. [ABSTRACT FROM AUTHOR]

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Semantic deficits in Alzheimer's disease have been widely documented, but little is known about the integrity of semantic memory in the prodromal stage of the illness. The aims of the present study were to: (i) investigate naming abilities and semantic memory in amnestic mild cognitive impairment (aMCI), early Alzheimer's disease (AD) compared to healthy older subjects; (ii) investigate the association between naming and semantic knowledge in aMCI and AD; (iii) examine if the semantic impairment was present in different modalities; and (iv) study the relationship between semantic performance and grey matter volume using voxel-based morphometry. Results indicate that both naming and semantic knowledge of objects and famous people were impaired in aMCI and early AD groups, when compared to healthy age- and education-matched controls. Item-by-item analyses showed that anomia in aMCI and early AD was significantly associated with underlying semantic knowledge of famous people but not with semantic knowledge of objects. Moreover, semantic knowledge of the same concepts was impaired in both the visual and the verbal modalities. Finally, voxel-based morphometry analyses revealed that semantic impairment in aMCI and AD was associated with cortical atrophy in the anterior temporal lobe (ATL) region as well as in the inferior prefrontal cortex (IPC), some of the key regions of the semantic cognition network. These findings suggest that the semantic impairment in aMCI may result from a breakdown of semantic knowledge of famous people and objects, combined with difficulties in the selection, manipulation and retrieval of this knowledge. (Contains 2 tables and 3 figures.)

Semantic dementia (SD) is a progressive condition characterized by an insidious and gradual breakdown in semantic knowledge. Patients suffering from this condition gradually lose their knowledge of objects and their attributes, concepts, famous persons, and public events. In contrast, these patients maintain a striking preservation of autobiographical memory. The aim of the present study was to examine in a patient suffering from SD the role of context in the ability to recall knowledge of familiar persons. In an experiment, patient J.M. was asked to name and identify familiar persons that appeared on family photographs from recent and remote periods of her life. In the first experimental condition, the pictures represented personally familiar persons present in a specific spatial and temporal context. In a second experimental condition, the pictures showed personally familiar persons who were presented without any specific episodic context. Results indicate that the patient was able to name and identify familiar persons irrespective of the context of presentation (with/without context) and of the time period (recent/remote). No temporal gradient was found using family photographs. Finally, in contrast with familiar persons, J.M. presented a severe anomia for celebrities. Results are discussed in light of recent research in the field.

The purpose of the present study was to compare the brain regions and systems that subserve lexical and sublexical processes in reading. In order to do so, three types of tasks were used: (i) silent reading of very high frequency regular words (lexical task); (ii) silent reading of nonwords (sublexical task); and, (iii) silent reading of very low frequency regular words (sublexical task). All three conditions were contrasted with a visual/phonological baseline condition. The lexical condition engaged primarily an area at the border of the left angular and supramarginal gyri. Activation found in this region suggests that this area may be involved in mapping orthographic-to-phonological whole word representations. Both sublexical conditions elicited significantly greater activation in the left inferior prefrontal gyrus. This region is thought to be associated with sublexical processes in reading such as grapheme-to-phoneme conversion, phoneme assembly and underlying verbal working memory processes. Activation in the left IFG was also associated with left superior and middle temporal activation. These areas are thought to be functionally correlated with the left IFG and to contribute to a phonologically based form of reading. The results as a whole demonstrate that lexical and sublexical processes in reading activate different regions within a complex network of brain structures.

Prospective memory (PM) problems in aging and, to a greater extent, in mild cognitive impairment (MCI), compromise functional independence. This study examined the effectiveness of a cognitive training program based on visual imagery to improve PM among older adults with and without MCI. Participants were older adults, 24 with MCI and 24 cognitively healthy (HOA). Half of them (12 MCI and 12 HOA) were randomly assigned to the PM training program, the other half to the no-training control group. All participants also completed a pre- and post-test evaluation, including neuropsychological tests, questionnaires, and the Ecological Test of Prospective Memory (TEMP). There was no significant effect of the intervention on the TEMP total, event-based or time-based scores for either the MCI or HOA groups. However, the trained MCI group committed fewer false alarms (i.e., more efficient identification of prospective cues) in the event-based condition of the TEMP at post-test. On the other hand, all trained participants performed better than control participants on retrospective memory tests, which suggests that visual imagery-based training is more effective to improve retrospective memory than PM. Possible explanations for these results are explored. [ABSTRACT FROM AUTHOR]

Diagonistic dyspraxia is a clinical syndrome usually characterized by involuntary and conflicting behaviors between the hands following corpus callosum lesions. In the present study, we report the case of a patient who presents such symptoms, along with a series of complex abnormal behaviors, such as carrying out an action and subsequently doing the exact opposite, or being unable to choose between two alternative decisions. The data reported in this study indicate that, at least in some patients, diagonistic dyspraxia can be associated with abnormal, antagonistic, behaviors not limited to the hands. In our view, diagonistic dyspraxia result from lesion of the posterior corpus callosum while associated complex abnormal behaviors result from concomitant anterior lesions.