Is Immediate Recall test scores affected by Anxiety in a memory clinic population? A clinical correlation study

Abstract Background: It is unknown if anxiety affects performance on immediate recall testing (IR) in memory clinic patients. Method: We performed a retrospective analysis of memory clinic patients in the south shore of Boston from 2010 to 2019. We correlated anxiety screen data (GAD7) to IR scores. Univariate analyses used Spearman correlation. A multivariate regression model analyzed GAD7 to covariates of IR, age, sex, and race. Hypothesis: We hypothesized a positive correlation between anxiety levels scored by GAD7 and IR. Results: 994 patients in the memory clinic between 2010-2020 had analyzable data. Patients were 58.6% female, 84.6 % White. The mean age was 70.1±14.4, IR 6.62 ± 5.4, GAD7 5.5±5.71. On univariate analysis, IR correlated significantly to age (⍴ = 0.08, p = 0.01), gender (⍴ = 0.06, p = 0.046), and race (⍴= - 0.25, p <0.001), but not to GAD7 (⍴=-0.07, p=0.14). The multivariate model confirmed the lack of association of anxiety scores to (□=-0.05, p=0.41) to GAD7 scores. IR task performance was significantly associated only to age (□= -0.04, p=0.03) and gender (□= -1.18, p=0.04) in the regression model. Conclusions: Immediate recall task performance was not significantly affected by anxiety measured by GAD7 scores in a memory clinic population. However, a negative correlation was shown on immediate recall scores in males and older subjects.

between patients and caregivers, such that caregivers' ratings of patients were lower in terms of purpose in life (t = -5.63,p < .001)and being in worse health (t = -3.41,p < .001)than patients' ratings of themselves on the same measures.Discordance between caregiver and patient in the context of a dementia diagnostic appointment and outcomes associated with this discordance are discussed.

DOES ANXIETY AFFECT THE CLOCK-DRAWING TASK IN PATIENTS IN A MEMORY CLINIC?
A CLINICAL CORRELATION STUDY Hamed Khachan, Mahak Kanjolia, and Anil Nair, Alzheimer's Disease Center, Quincy, Massachusetts, United States Background: It is unknown if anxiety levels affect performance on clock drawing test (CDT) in memory clinic patients.Method: We performed a retrospective analysis of memory clinic patients in the south shore of Boston from 2010 to 2019.We correlated anxiety screen data (GAD7) to CDT scores, based on contour, numbers, and hands placement.Univariate analyses used Spearman correlation.A multivariate regression model analzed GAD7 to covariates of CDT, age, sex, and race.Hypothesis : We hypothesized a positive correlation between anxiety levels scored by the GAD7 and CDT.Results: 994 patients in the memory clinic between 2010-2020 had analyzable data.Patients were 58.6% female, 84.6 % White.Mean age was 70.1±14.4,CDT 1.84±1.04.CDT score correlated significantly to race (⍴=-0.16,p< 0.001), age (⍴=-0.28,p<0.001), gender (⍴=0.05,p=0.16), but not GAD7 (⍴=0.05,p=0.27).Multivariate model confirmed the lack of association of anxiety scores to CDT (□= 0.08, p=0.78).GAD7 scores correlated to female gender (□= -1.16, p=0.04).Conclusions: CDT scores were not affected by anxiety as measured on GAD7 scores.However, a positive correlation was shown on anxiety scores in females to CDT completion.

IS IMMEDIATE RECALL TEST SCORES AFFECTED BY ANXIETY IN A MEMORY CLINIC POPULATION? A CLINICAL CORRELATION STUDY.
Hamed Khachan, Anil Nair, Fioralba Andrea, and Mahak Kanjolia, Alzheimer's Disease Center, Quincy, Massachusetts, United States Background: It is unknown if anxiety affects performance on immediate recall testing (IR) in memory clinic patients.Method: We performed a retrospective analysis of memory clinic patients in the south shore of Boston from 2010 to 2019.We correlated anxiety screen data (GAD7) to IR scores.Univariate analyses used Spearman correlation.A multivariate regression model analyzed GAD7 to covariates of IR, age, sex, and race.Hypothesis: We hypothesized a positive correlation between anxiety levels scored by GAD7 and IR.Results: 994 patients in the memory clinic between 2010-2020 had analyzable data.Patients were 58.6% female, 84.6 % White.The mean age was 70.1±14.4,IR 6.62 ± 5.4, GAD7 5.5±5.71.On univariate analysis, IR correlated significantly to age (⍴ = 0.08, p = 0.01), gender (⍴ = 0.06, p = 0.046), and race (⍴= -0.25, p <0.001), but not to GAD7 (⍴=-0.07,p=0.14).The multivariate model confirmed the lack of association of anxiety scores to (□=-0.05,p=0.41) to GAD7 scores.IR task performance was significantly associated only to age (□= -0.04, p=0.03) and gender (□= -1.18, p=0.04) in the regression model.Conclusions: Immediate recall task performance was not significantly affected by anxiety measured by GAD7 scores in a memory clinic population.However, a negative correlation was shown on immediate recall scores in males and older subjects.

MODERATING EFFECT OF COGNITIVE RESERVE ON BRAIN INTEGRITY AND COGNITIVE PERFORMANCE
Monica Nelson, 1 Ross Andel, 1 Julie Martinkova, 2 Kateřina Čechová, 2 Hana Marková, 2 and Jakub Hort, 2 1.University of South Florida, Tampa, Florida, United States, 2. Motol University Hospital, Prague, Czech Republic Dementia is arguably the most devastating condition of older adulthood with treatment options still elusive.Alzheimer's is the most prevalent form of dementia where cognitive deficits relate strongly to underlying brain pathology.However, there exist cases in which cognitive performance does not match the corresponding level of neuropathology.Attempts to explain this phenomenon often include the concept of cognitive reserve (CR), whereby greater CR (e.g., more education or higher occupational position) presumably results in less impairment relative to the extent of pathology early in disease progression but also greater impairment once cognitive symptoms manifest.We examined the influence of CR proxy variables (education and occupation) on the relationship between hippocampal volume and cognitive performance on tests of executive control and memory using data from the Czech Brain Aging Study (CBAS).Participants were cognitively normal/with subjective cognitive decline but without actual impairment (CN; n=115; M(age)=66.43;M(education)=15.90;37 men) or had amnestic mild cognitive impairment (aMCI; n=165; M(age)=71.37;M(education)=14.92;85 men).We found that hippocampal volume was significantly related to executive control (b=-.0001,p=.03) and memory (b=.0002, p<.001) for participants with aMCI, but only memory (b=.0002, p=.03) for CN participants.Occupational position moderated the association between memory and hippocampal volume in aMCI, with the result approaching significance (p=.07), whereby a greater link between memory problems and hippocampal atrophy was present in those previously in high occupational positions.No other moderations for occupational position or education emerged (ps>.25).We found evidence for the concept of CR using occupational position as proxy.

MUSIC AND MEMORY IN DEMENTIA CARE: COMFORT WITH HARMONY Deepa Vinoo, NYC Health+Hospitals/Coler, Roosevelt Island, New York, United States
Data show a substantial increase in the number of people with diagnosis of dementia nationally and globally.Behavioral disturbances among persons with dementia including agitation and psychosis form a constellation of symptoms referred to as behavioral and psychological symptoms of dementia (BPSD).BPSD impacts heavily on resident's quality of life, caregivers stress and management options for the team.FDA do not approve usage of psychotropic for Dementia related Behaviors.This study was conducted in six memory care units ,N-150.Prior to the project Psychotropic usage was 64% ,physical altercations, fallsand staff been out due to work related injury were high in those units.In 2014 a memory care team came together , identified gaps and created structured memory care units with memory care programs which includes , consistent trained staffing, meaningful engagement of residents, psychotropic stewardship program , shift from medical model to palliative model of care,person centered approach, music& memory program, shared governance, staff empowerment.All residents in those units were assessed for Psychotropic usage, falls, pain management.transfer to acute hospitals and 1;1 from 2014 to 2019.Results, Usage of Music& Memory increased from 4% 75%, Anti psychotic usage reduced by 18%, Falls reduced by 12%, Physical altercation decreased from 12 to 0, Improved pain Management .Significant reduction in transfer to acute hospitals.Reduced 1;1 from 6 to 1.Staff verbalized increased satisfaction and decreased stress.Improved family involvement.Increased bonding between residents, staff and families.Decresed work related injury while giving care.

SOCIAL ENGAGEMENT AND COGNITIVE HEALTH: THE MEDIATING ROLE OF COGNITIVE AND PHYSICAL ACTIVITY
Takashi Amano, 1 Nancy Morrow-Howell, 2 Sojung Park, 2 and Brian Carpenter, 2 1. Rutgers Newark,New Jersey,United States,2. Washington University in St. Louis,St. Louis,Missouri,United States This study aimed to assess the association between social engagement and conversion from Cognitive Impairment No Dementia (CIND) to dementia and to investigate the mediating role of cognitive and physical engagements on that relationship.Data from two waves (2010 and 2014) of the psychosocial and core modules of the Health and Retirement Study (HRS) were used.The sample consisted of 929 people who had CIND in 2010 and participated in the survey in 2014.Latent Class Analysis (LCA) with eight indicators of social engagement (activities with children, volunteering with youth/others, attending educational course/organization, meeting up, speaking on the phone, writing or emailing) found three groups: formal and informal social engagement (20.7%), informal social engagement only (48.9%), and low social engagement (30.5%).Binary logistic regression analysis showed sub groups with higher levels and greater variety of social engagements were associated with lower probability of conversion to dementia in four years.Path analysis with structural equation modeling (SEM) framework showed the relationship between patterns of social engagement and lower conversion to dementia was mediated by having higher engagement in cognitive activities (e.g. home maintenance, playing sports), but not by engagement in physical activities (e.g.playing games, using computer).Results from this study implied (1) promoting active social engagement may be a promising intervention to prevent or delay conversion from CIND to dementia, and (2) promoting social engagement may be a particularly effective and efficient strategy since it promotes other activity engagements that may itself prevent or delay conversion from CIND to dementia.