High LDL and total cholesterol levels are associated with cognitive impairment, and lowering these lipoprotein levels may be a strategy for preventing impairment. The association between statin use and better cognitive function in women without dementia requires further study.

Background/Objectives Vision-based speed of processing (VSOP) training is a promising cognitive intervention for older adults. However, it is unknown whether VSOP training can affect cognitive processing in individuals at high risk for dementia. Here, we examined cognitive and neural effects of VSOP training in older adults with amnestic mild cognitive impairment (aMCI) and contrasted those effects with an active control (mental leisure activities; MLA). Design A randomized single-blinded controlled pilot trial. Setting An academic medical center. Participants Twenty-one participants with aMCI. Intervention A 6-week computerized VSOP training. Measurements Multiple cognitive processing measures, instrumental activities of daily living (IADL), and two key resting state neural networks regulating cognitive processing: central executive network (CEN) and default mode network (DMN). Results We found that, compared to MLA control, VSOP training led to significant improvements in trained (processing speed and attention: F1,19 = 6.61, Partial η2 = 0.26, p = .019) and untrained cognitive domains (working memory: F1,19 = 7.33, Partial η2 = 0.28, p = .014; IADL: F1,19 = 5.16, Partial η2 = 0.21, p = .035), and protective maintenance in DMN (F1, 9 = 14.63, Partial η2 = 0.62, p = .004). Additionally, VSOP training, but not MLA, resulted in a significant improvement in CEN connectivity (Z = −2.37, p = .018). Conclusion We identified both target and transfer effects of VSOP training and revealed links between VSOP training and two key neural networks associated with aMCI. These findings highlight the potential of VSOP training to slow cognitive decline in aMCI. Further delineation of mechanisms underlying VSOP-induced plasticity is necessary to understand in what populations and conditions such training may be most effective.

IntroductionA novel amyloid β (Aβ) synthetic peptide vaccine (UB-311) has been evaluated in a first-in-human trial with patients of mild-to-moderate Alzheimer's disease. We describe translational research covering vaccine design, preclinical characterization, and phase-I clinical trial with supportive outcome that advances UB-311 into an ongoing phase-II trial.MethodsUB-311 is constructed with two synthetic Aβ1–14–targeting peptides (B-cell epitope), each linked to different helper T-cell peptide epitopes (UBITh®) and formulated in a Th2-biased delivery system. The hAPP751 transgenic mouse model was used to perform the proof-of-concept study. Baboons and macaques were used for preclinical safety, tolerability, and immunogenicity evaluation. Patients with mild-to-moderate Alzheimer's disease (AD) were immunized by intramuscular route with 3 doses of UB-311 at weeks 0, 4, and 12, and monitored until week 48. Safety and immunogenicity were assessed per protocol, and preliminary efficacy was analyzed by Alzheimer's Disease Assessment Scale–Cognitive Subscale (ADAS-Cog), Mini–Mental State Examination (MMSE), and Alzheimer's Disease Cooperative Study–Clinician's Global Impression of Change (ADCS-CGIC).ResultsUB-311 covers a diverse genetic background and facilitates strong immune response with high responder rate. UB-311 reduced the levels of Aβ1–42 oligomers, protofibrils, and plaque load in hAPP751 transgenic mice. Safe and well-tolerated UB-311 generated considerable site-specific (Aβ1–10) antibodies across all animal species examined. In AD patients, UB-311 induced a 100% responder rate; injection site swelling and agitation were the most common adverse events (4/19 each). A slower rate of increase in ADAS-Cog from baseline to week 48 was observed in the subgroup of mild AD patients (MMSE ≥ 20) compared with the moderate AD subgroup, suggesting that UB-311 may have a potential of cognition improvement in patients with early stage of Alzheimer's dementia.DiscussionThe UBITh® platform can generate a high-precision molecular vaccine with high responder rate, strong on-target immunogenicity, and a potential of cognition improvement, which support UB-311 for active immunotherapy in early-to-mild AD patients currently enrolled in a phase-II trial (NCT02551809).

As the world population ages, primary prevention of age-related cognitive decline and disability will become increasingly important. Prevention strategies are often developed from an understanding of disease pathobiology, but models of biological success may provide additional useful insights. Here, we studied 224 older adults, some with superior memory performance (n=41), some with normal memory performance (n=109), and some with mild cognitive impairment (MCI) or Alzheimer’s disease (AD) (n=74) to understand metabolomic differences which might inform future interventions to promote cognitive health. Plasma metabolomics revealed significant differential abundance of 12 metabolites in those with superior memory relative to controls (ROC AUC = 0.89) and the inverse abundance pattern in the MCI, AD (AUC = 1.0) and even preclinical AD groups relative to controls (AUC = 0.97). The 12 metabolites are components of key metabolic pathways regulating oxidative stress, inflammation, and nitric oxide bioavailability. These findings from opposite ends of the cognitive continuum highlight the role of these pathways in superior memory abilities and whose failure may contribute to age-related memory impairment. These pathways may be targeted to promote successful cognitive aging.

Neural reserve and compensation both support cognitive reserve, with compensation more common in later stages of the cognitive aging spectrum. Longitudinal and intervention studies are needed to investigate changes between neural reserve and compensation during the transition between clinical stages, and to explore the causal relationship between cognitive reserve and potential neural substrates.

The brain is thought to combine linguistic knowledge of words and nonlinguistic knowledge of their referents to encode sentence meaning. However, functional neuroimaging studies aiming at decoding language meaning from neural activity have mostly relied on distributional models of word semantics, which are based on patterns of word co-occurrence in text corpora. Here, we present initial evidence that modeling nonlinguistic "experiential" knowledge contributes to decoding neural representations of sentence meaning. We model attributes of peoples' sensory, motor, social, emotional, and cognitive experiences with words using behavioral ratings. We demonstrate that fMRI activation elicited in sentence reading is more accurately decoded when this experiential attribute model is integrated with a text-based model than when either model is applied in isolation (participants were 5 males and 9 females). Our decoding approach exploits a representation-similarity-based framework, which benefits from being parameter free, while performing at accuracy levels comparable with those from parameter fitting approaches, such as ridge regression. We find that the text-based model contributes particularly to the decoding of sentences containing linguistically oriented "abstract" words and reveal tentative evidence that the experiential model improves decoding of more concrete sentences. Finally, we introduce a cross-participant decoding method to estimate an upper bound on model-based decoding accuracy. We demonstrate that a substantial fraction of neural signal remains unexplained, and leverage this gap to pinpoint characteristics of weakly decoded sentences and hence identify model weaknesses to guide future model development.

The parasympathetic nervous system (PNS) is critical for adaptation to environment demands. PNS can reflect an individual's regulatory capacity of frontal brain regions and has been linked to cognitive capacity. Yet, the relationship of PNS function to cognitive decline and abnormal frontal function that characterize preclinical progression toward Alzheimer's disease (AD) is unclear. Here, we aimed to elucidate the relationship between PNS function and AD-associated neurodegeneration by testing two competing hypotheses involving frontal regions' activity (neurodegeneration vs. compensation). In 38 older human adults with amnestic mild cognitive impairment (aMCI) or normative cognition, we measured AD-associated neurodegeneration (AD signature cortical thickness; ADSCT), resting-state functional magnetic resonance imaging of frontal regions' spontaneous activation, and an electrocardiography measure of PNS (high frequency heart rate variability; HF-HRV). HF-HRV was assessed at rest and during a cognitive task protocol designed to capture HF-HRV reactivity. Higher HF-HRV at rest was significantly related to both more severe AD-associated neurodegeneration (lower ADSCT scores) and worse cognitive ability. Cognitive impairments were also related to greater suppression of HF-HRV reactivity. High activities of the anterior cingulate cortex significantly mediated relationships between ADSCT and both HF-HRV at rest and HF-HRV reactivity. Notably, these relationships were not affected by the clinical phenotype. We show that AD-associated neurodegeneration is associated with altered PNS regulation and that compensatory processes linked to frontal overactivation might be responsible for those alterations. This finding provides the first line of evidence in a new framework for understanding how early-stage AD-associated neurodegeneration affects autonomic regulation.

Understanding the association between autonomic nervous system [ANS] function and brain morphology across the lifespan provides important insights into neurovisceral mechanisms underlying health and disease. Resting‐state ANS activity, indexed by measures of heart rate [HR] and its variability [HRV] has been associated with brain morphology, particularly cortical thickness [CT]. While findings have been mixed regarding the anatomical distribution and direction of the associations, these inconsistencies may be due to sex and age differences in HR/HRV and CT. Previous studies have been limited by small sample sizes, which impede the assessment of sex differences and aging effects on the association between ANS function and CT. To overcome these limitations, 20 groups worldwide contributed data collected under similar protocols of CT assessment and HR/HRV recording to be pooled in a mega‐analysis (N = 1,218 (50.5% female), mean age 36.7 years (range: 12–87)). Findings suggest a decline in HRV as well as CT with increasing age. CT, particularly in the orbitofrontal cortex, explained additional variance in HRV, beyond the effects of aging. This pattern of results may suggest that the decline in HRV with increasing age is related to a decline in orbitofrontal CT. These effects were independent of sex and specific to HRV; with no significant association between CT and HR. Greater CT across the adult lifespan may be vital for the maintenance of healthy cardiac regulation via the ANS—or greater cardiac vagal activity as indirectly reflected in HRV may slow brain atrophy. Findings reveal an important association between CT and cardiac parasympathetic activity with implications for healthy aging and longevity that should be studied further in longitudinal research.