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Despite data showing that nutritional interventions high in antioxidant/anti-inflammatory properties (anthocyanin-rich foods, such as blueberries/elderberries) may decrease risk of memory loss and cognitive decline, evidence for such effects in mild cognitive impairment (MCI) is limited. This study examined preliminary effects of American elderberry (Sambucus nigra subsp. canadensis) juice on cognition and inflammatory markers in patients with MCI. In a randomized, double-blind, placebo–controlled trial, patients with MCI (n = 24, Mage = 76.33 ± 6.95) received American elderberry (n = 11) or placebo (n = 13) juice (5 mL orally 3 times a day) for 6 months. At baseline, 3 months, and 6 months, patients completed tasks measuring global cognition, verbal memory, language, visuospatial cognitive flexibility/problem solving, and memory. A subsample (n = 12, 7 elderberry/5 placebo) provided blood samples to measure serum inflammatory markers. Multilevel models examined effects of the condition (elderberry/placebo), time (baseline/3 months/6 months), and condition by time interactions on cognition/inflammation outcomes. Attrition rates for elderberry (18%) and placebo (15%) conditions were fairly low. The dosage compliance (elderberry—97%; placebo—97%) and completion of cognitive (elderberry—88%; placebo—87%) and blood-based (elderberry—100%; placebo—100%) assessments was high. Elderberry (not placebo) trended (p = 0.09) towards faster visuospatial problem solving performance from baseline to 6 months. For the elderberry condition, there were significant or significantly trending decreases over time across several markers of low-grade peripheral inflammation, including vasorin, prenylcysteine oxidase 1, and complement Factor D. Only one inflammatory marker showed an increase over time (alpha-2-macroglobin). In contrast, for the placebo, several inflammatory marker levels increased across time (L-lactate dehydrogenase B chain, complement Factor D), with one showing deceased levels over time (L-lactate dehydrogenase A chain). Daily elderberry juice consumption in patients with MCI is feasible and well tolerated and may provide some benefit to visuospatial cognitive flexibility. Preliminary findings suggest elderberry juice may reduce low-grade inflammation compared to a placebo–control. These promising findings support the need for larger, more definitive prospective studies with longer follow-ups to better understand mechanisms of action and the clinical utility of elderberries for potentially mitigating cognitive decline.

Purpose of Review This paper explored the under-researched bidirectional alcohol/sleep link, examining sex and gender’s impact on this relationship and treatment. Recent Findings Although men have traditionally shown higher alcohol use than women, this gap is narrowing. Regarding sleep disorders, women are more likely to have insomnia and men are more likely to have obstructive sleep apnea. Alcohol is more likely to impact self-reported insomnia symptoms in women (sleep onset latency, daytime dysfunction) and sleep duration, fragmentation, and sleep architecture in men. Sex and gender differences may depend on age, sex hormones, and alcohol/sleep disorder severity. Women are more likely to seek insomnia treatment and engage in behavior changes, but less alcohol treatment than men. Summary Biological (sex) and psychosocial (gender) factors affect alcohol’s impact on sleep (and vice versa) and treatment seeking. Adopting a sex and gender lens-based framework is a high priority for comprehensive alcohol and sleep health research and clinical care.

Environmental and genetic factors contribute to the etiology of autism spectrum disorder (ASD), but their interaction is less well understood. Mothers that are genetically more stress-susceptible have been found to be at increased risk of having a child with ASD after exposure to stress during pregnancy. Additionally, the presence of maternal antibodies for the fetal brain is associated with a diagnosis of ASD in children. However, the relationship between prenatal stress exposure and maternal antibodies in the mothers of children diagnosed with ASD has not yet been addressed. This exploratory study examined the association of maternal antibody response with prenatal stress and a diagnosis of ASD in children. Blood samples from 53 mothers with at least one child diagnosed with ASD were examined by ELISA. Maternal antibody presence, perceived stress levels during pregnancy (high or low), and maternal 5-HTTLPR polymorphisms were examined for their interrelationship in ASD. While high incidences of prenatal stress and maternal antibodies were found in the sample, they were not associated with each other (p = 0.709, Cramér’s V = 0.051). Furthermore, the results revealed no significant association between maternal antibody presence and the interaction between 5-HTTLPR genotype and stress (p = 0.729, Cramér’s V = 0.157). Prenatal stress was not found to be associated with the presence of maternal antibodies in the context of ASD, at least in this initial exploratory sample. Despite the known relationship between stress and changes in immune function, these results suggest that prenatal stress and immune dysregulation are independently associated with a diagnosis of ASD in this study population, rather than acting through a convergent mechanism. However, this would need to be confirmed in a larger sample.

Associations between subjective cognition and current objective functioning are inconclusive. Given known associations between personality and cognition, this study tested whether personality moderates associations between subjective memory and objective cognition in middle-aged and older adults. Participants (N = 62, Mage = 63.8, SD = 7.7, 33 men) completed assessments of personality (Big Five Inventory-10), subjective memory (Cognitive Failures Questionnaire [CFQ-memory]), and objective cognition (processing speed, attention, inhibition [Stroop], working memory [Sternberg], set-shifting [Wisconsin Card Sorting Task]). Multiple regressions and simple slopes analyses examined whether personality moderates associations between subjective memory and objective cognition, controlling for age, number of medical conditions, and household income. Extraversion moderated associations between processing speed and CFQ-memory. Agreeableness moderated associations between set-shifting and CFQ-memory. Among individuals with higher extraversion and lower agreeableness, objectively worse cognition was associated with the fewest memory complaints. Findings suggest personality may impact the discrepancies between subjective memory and objective cognition in mid-to-late life.

Abstract The relationship between anxiety and memory complaints is well established. Additionally, physical activity has been shown to improve anxiety symptoms and cognition. Little research, however, has examined if physical activity impacts associations between anxiety and memory complaints in cognitively healthy middle-aged and older adults. Given memory complaints are often the first indicator of subsequent cognitive decline, it is important to understand factors that impact complaints. The present study tested whether physical activity moderated associations between anxiety and memory complaints. Adults aged 50+ (N=271, Mage=64.5, SD=7.8, 124 women) completed the International Physical Activity Questionnaire, Hospital Anxiety and Depression scale (HADS), and the Cognitive Failures questionnaire (CFQ). Multiple linear regressions and simple slope analyses were conducted to examine if physical activity moderated associations between anxiety and memory complaints (CFQ-memory), covarying for age, sex, income, difficulty walking, number of medical conditions, number of medications, body mass index, and depressive symptoms (HADS-depression). Results revealed total physical activity (R2-change=.01, p=.04), vigorous activity (R2-change=.02, p=.02), and walking activity (R2-change=.01, p=.03) moderated associations between anxiety and memory complaints. Specifically, higher anxiety was associated with more memory complaints at all levels of physical activity, with the magnitude of the effect largest at highest levels of physical activity. The present findings suggest higher amounts of physical activity may exacerbate the relationship between anxiety and memory complaints. It is possible aging adults with greater perceived memory disruption experience more anxiety and engage in health enhancing behaviors, such as physical activity. Future studies should explore temporal patterns of this relationship.

Introduction How napping is associated with cognition is currently unclear with past work indicating napping benefits cognition for young adults and inconsistent findings regarding cognition in older adults. The present study improved upon previous literature by examining how age moderates associations between napping behaviors across a full week and both subjective and objective cognition across the adult lifespan. Methods Cognitively healthy adults aged 18-82 (N=134, Mage=41.43, SD=22.14, 115 females) completed assessments of napping habits across 7 days (naps per week, duration), and subjective cognition [Cognitive Failures Questionnaire (CFQ) total, sub-scores of CFQ-memory, CFQ-distractibility, and CFQ-blunders]. A sub-set of participants (N=105) also completed objective cognitive tasks: Stroop (inhibition, attention, processing speed), Posner Cueing (attentional orienting), Sternberg (working memory), and Wisconsin Card Sorting (executive function). Multiple regression and Johnson-Neyman analyses evaluated the moderating impact of age on associations between napping and cognition, controlling for sex, anxiety and depression symptoms, and sleep and pain medication usage. Results Age moderated the relationship between nap duration and CFQ-total (R2-change=.02, p=.04), CFQ-memory (R2-change=.04, p=.01), and CFQ-blunders (R2-change=.06, p=.01). Specifically, longer nap duration was associated with fewer global cognitive complaints at age 20 and below (B=-.08, SE=.04, p=.049), more memory complaints at age 69 and above (B=.08, SE=.04, p=.05), as well as more blunder complaints at age 47 and above (B=.05, SE=.02, p=.048). Conclusion Findings suggest longer naps are associated with worse subjective cognition in older adults and better subjective cognition in younger adults. Similar patterns were not observed in middle-aged adults or for objective cognition. More work is needed to understand how the potential cognitive restorative impact of napping in younger adults may be disrupted in older adults. Given known associations between subjective cognition and future cognitive impairment, prospective studies should determine if napping is a key indicator of potential future cognitive decline in aging adults and explore underlying age-related mechanisms in this relationship such as systemic inflammation and changes in Support (if any) This work was supported by the American Academy of Sleep Medicine Foundation (NCT0282642; AASM Award #: 212-FP-19 PI: Curtis, a foundation of the American Academy of Sleep Medicine).

Introduction Deviation in sleep patterns have been associated with cognitive functioning in college students, but little research has examined how deviation in bed and waketime impact next-day metacognition. Given college students have high daily variability with their bedtime and waketime, these are understudied parameter of interest in this population. Considering metacognition has been associated with academic outcomes (e.g., GPA), it is important to understand how daily bedtime and waketime patterns might impact metacognition. The present study examined how daily deviation from bedtime and waketime are associated with metacognitive ratings in college students. Methods College students (N=81, Mage=18.8, SD = 1.1, 64 females) completed seven days of sleep diaries reporting bedtime, sleep duration, and waketime. Students also provided morning metacognitive ratings regarding the perceived quality of mental functioning from very poor (0) to very good (100). Multilevel modeling analyses tested whether intraindividual patterns of associations between daily bedtime and daily waketime and daily morning metacognitive ratings, after controlling for intraindividual daily anxiety severity, interindividual levels of bed/wake time variability and sleep duration, as well as age, sex, and daily sleep medication usage. Results Daily waketime was associated with same morning metacognitive ratings (B=.02, p=0.03), in that those who woke up earlier than their typical average reported worse cognitive function. Findings did not reveal an association between bedtime variability and metacognition. Conclusion Findings suggest that regardless of how long one has slept, waking up earlier than typical may negatively impact perceptions of cognitive functioning in college students. Similar patterns are not observed at the average/interindividual level. Given younger adults typically have a delayed circadian preference, findings may reflect acute circadian disruption and associated “brain fog” in college students when waking up earlier than typical. Future studies should examine associations between daily waketime and objective cognition to better understand how regularity impacts daytime functioning. Similar to findings in adolescent populations, such evaluations could inform recommendations regarding college class start times. Support (if any)

Introduction Differences between subjective and objective sleep [subjective-objective sleep discrepancy (SOSD)] is prevalent in insomnia and older adults. Despite associations between cognition and sleep parameters, the impact of cognitive functioning on SOSD is unclear. We examined associations between various cognitive domains and SOSD in older adults and whether insomnia status moderates these associations. Methods Older adults with (N=47, Mage=68.85, 66% women) and without (N=32, Mage=67.41, 78% women) insomnia [met DSM-5 criteria plus reported >30 mins sleep onset latency (SOL) and/or wake time after sleep onset (WASO) on 3+nights/7] completed measures of subjective sleep (7-days of sleep diaries), objective sleep (one-night polysomnography, PSG), and objective cognitive tasks: Dimensional Change Card Sort (executive functioning, EF), List Sorting (working memory, WM), Auditory Verbal Learning Test (episodic memory), Flanker (inhibitory control), Pattern Comparison (processing speed). SOSD direction (average sleep diary variable – PSG variable) was computed. Moderated regressions determined independent and interactive (with insomnia status) associations between cognitive performance and SOSD for SOL, WASO, total sleep time (TST) and sleep efficiency, controlling for age, sex, apnea-hypopnea index, and sleep medication usage. Results For insomnia, longer self-reported than PSG TST was associated with better WM (b=27.90, SE=9.05, p=.003, episodic memory (b=12.83, SE=2.77, p=.01), processing speed (b=9.50, SE=2.00, p<.01), and inhibitory control (b=118.40, SE=54.09, p=.03). Similarly for insomnia, better self-reported than PSG sleep efficiency was associated with better WM (b=5.58, SE=2.12, p=.01), episodic memory (b=2.66, SE=1.08, p=.02), and processing speed (b=2.11, SE=0.47, p<.01). For non-insomnia, reports of SOSD were not associated with cognitive functioning (ps>.05). Conclusion Better diffuse cognitive functioning may be a contributing SOSD mechanism in older adults with insomnia. We speculate that better cognitive functioning may suppress cognitive arousal symptoms that are prevalent in insomnia patients, leading to better self-reported sleep relative to what is objectively measured. Prospective studies examining independent and interactive associations between cognition functioning and arousal, and insomnia on SOSD may inform underlying mechanisms of poor sleep health and the temporal impact on cognition. Support (if any) This research project was made possible by awards (PI: Curtis) from the American Academy of Sleep Medicine Foundation, a foundation of the American Academy of Sleep Medicine.