Web-based self-help interventions for coping with prolonged grief have established their efficacy. However, few programs address recent losses and investigate the effect of self-tailoring of the content. In an international project, the text-based self-help program LIVIA was adapted and complemented with an Embodied Conversational Agent, an initial risk assessment and a monitoring tool. The new program SOLENA was evaluated in three trials in Switzerland, the Netherlands and Portugal. The aim of the trials was to evaluate the clinical efficacy for reducing grief, depression and loneliness and to examine client satisfaction and technology acceptance. The talk will present the SOLENA program and report results of the Portuguese and Dutch trial as well as preliminary results of the Swiss RCT. The ongoing Swiss trial compares a standardised to a self-tailored delivery format and analyses clinical outcomes, the helpfulness of specific content and the working alliance. Finally, lessons learned in the development and evaluation of a web-based self-help intervention for older adults will be discusses.

In vision, there is, surprisingly, very little evidence of common factors. Most studies have found only weak correlations between performance in different visual tests; meaning that, a participant performing better in one test is not more likely to perform also better in another test. Likewise in ageing, cross-sectional studies have repeatedly shown that older adults show deteriorated performance in most visual tests compared to young adults. However, within the older population, there is no evidence for a common factor underlying visual abilities. To investigate further the decline of visual abilities, we performed a longitudinal study with a battery of nine visual tasks three times, with two re-tests after about 4 and 7 years. Most visual abilities are rather stable across 7 years, but not visual acuity. I will discuss possible causes of these paradoxical outcomes.

The US has an aging population. For the first time in US history, the number of older adults is projected to outnumber that of children by 2034. This combined with the fact that the prevalence of Alzheimer's Disease increases exponentially with age makes for a worrying combination. Mild cognitive impairment (MCI) is an intermediate stage of cognitive decline between being cognitively normal and having full-blown Dementia, with every third person with MCI progressing to dementia of the Alzheimer's Type (DAT). While there is no known way to reverse symptoms once they begin, early prediction of disease can help stall its progression and help with early financial planning. While grey matter volume loss in the Hippocampus and Entorhinal Cortex (EC) are characteristic biomarkers of DAT, little is known about the rates of decrease of these volumes within individuals in MCI state across time. We used longitudinal growth curve models to map individual trajectories of volume loss in subjects with MCI. We then looked at whether these rates of volume decrease could predict progression to DAT right in the MCI stage. Finally, we evaluated whether these rates of Hippocampal and EC volume loss were correlated with individual rates of decline of episodic memory, visuospatial ability, and executive function.

Identifying biomarkers that predict current and future cognition may improve estimates of Alzheimer’s disease risk among cognitively unimpaired older adults (CU). In vivo measures of amyloid and tau protein burden and task-based functional MRI measures of core memory mechanisms, such as the strength of cortical reinstatement during remembering, have each been linked to individual differences in memory in CU. This study assesses whether combining CSF biomarkers with fMRI indices of cortical reinstatement improves estimation of memory function in CU, assayed using three unique tests of hippocampal-dependent memory. Participants were 158 CU (90F, aged 60-88 years, CDR=0) enrolled in the Stanford Aging and Memory Study (SAMS). Cortical reinstatement was quantified using multivoxel pattern analysis of fMRI data collected during completion of a paired associate cued recall task. Memory was assayed by associative cued recall, a delayed recall composite, and a mnemonic discrimination task that involved discrimination between studied ‘target’ objects, novel ‘foil’ objects, and perceptually similar ‘lure’ objects. CSF Aβ42, Aβ40, and p-tau181 were measured with the automated Lumipulse G system (N=115). Regression analyses examined cross-sectional relationships between memory performance in each task and a) the strength of cortical reinstatement in the Default Network (comprised of posterior medial, medial frontal, and lateral parietal regions) during associative cued recall and b) CSF Aβ42/Aβ40 and p-tau181, controlling for age, sex, and education. For mnemonic discrimination, linear mixed effects models were used to examine the relationship between discrimination (d’) and each predictor as a function of target-lure similarity. Stronger cortical reinstatement was associated with better performance across all three memory assays. Age and higher CSF p-tau181 were each associated with poorer associative memory and a diminished improvement in mnemonic discrimination as target-lure similarity decreased. When combined in a single model, CSF p-tau181 and Default Network reinstatement strength, but not age, explained unique variance in associative memory and mnemonic discrimination performance, outperforming the single-modality models. Combining fMRI measures of core memory functions with protein biomarkers of Alzheimer’s disease significantly improved prediction of individual differences in memory performance in CU. Leveraging multimodal biomarkers may enhance future prediction of risk for cognitive decline.

Episodic memory performance decreases with advancing age. According to theoretical models, such memory decline might be a consequence of age-related reductions in the ability to form distinct neural representations of our past. In this talk, I want to present our new age-comparative fMRI study investigating age-related neural dedifferentiation across different representational levels. By combining univariate analyses and searchlight pattern similarity analyses, we found that older adults show reduced category selective processing in higher visual areas, less specific item representations in occipital regions and less stable item representations. Dedifferentiation on all these representational levels was related to memory performance, with item specificity being the strongest contributor. Overall, our results emphasize that age-related dedifferentiation can be observed across the entire cortical hierarchy which may selectively impair memory performance depending on the memory task.

In Europe, the number of people aged 65 and older is increasing dramatically, and research related to ageing is more crucial than ever. The main research dedicated to age-related changes concentrates on cognitive or sensory deficits. This is also the case in vision research. However, the majority of older adults ages without major cognitive or optical or deficits. These are foremost good news, but even in the absence of neurodegenerative or eye diseases changes in visual perception occur. It has been suggested that age-related changes are due to a general decline of cognitive, perceptual and sensory functions. However, more recent studies reveal large individual differences within the ageing population and whereas some functions show age-related deterioration, others are surprisingly unaffected. Overall, it becomes increasingly apparent that perceptual changes in healthy ageing cannot be attributed to one single underlying factor. I will present studies from various areas of visual perception that challenge the view that age-related changes are primarily related to decline. Instead, our findings suggest that age-related changes are the result of visual experience, such that the brain ages optimally given the input it receives.

The spatial patterning of each neurodegenerative disease relates closely to a distinct structural and functional network in the human brain. This talk will mainly describe how brain network-sensitive neuroimaging methods such as resting-state fMRI and diffusion MRI can shed light on brain network dysfunctions associated with pathology and cognitive decline from preclinical to clinical dementia. I will first present our findings from two independent datasets on how amyloid and cerebrovascular pathology influence brain functional networks cross-sectionally and longitudinally in individuals with mild cognitive impairment and dementia. Evidence on longitudinal functional network organizational changes in healthy older adults and the influence of APOE genotype will be presented. In the second part, I will describe our work on how different pathology influences brain structural network and white matter microstructure. I will also touch on some new data on how brain network integrity contributes to behavior and disease progression using multivariate or machine learning approaches. These findings underscore the importance of studying selective brain network vulnerability instead of individual region and longitudinal design. Further developed with machine learning approaches, multimodal network-specific imaging signatures will help reveal disease mechanisms and facilitate early detection, prognosis and treatment search of neuropsychiatric disorders.

From a developmental standpoint, it has been argued that two major complementary factors contribute to the development of analogy comprehension: world knowledge and executive functions. Here I will provide evidence in support of the second view. Beyond paradigms that manipulate task difficulty (e.g., number and types of distractors and semantic distance between domains) we will provide eye-tracking data that describes differences in the way children and adults compare the base and target domains in analogy problems. We will follow the same approach with ageing people. This latter population provides a unique opportunity to disentangle the contribution of knowledge and executive processes in analogy making since knowledge is (more than) preserved and executive control is decreasing. Using this paradigm, I will show the extent to which world knowledge (assessed through vocabulary) compensates for decreasing executive control in older populations. Our eye-tracking data suggests that, to a certain extent, differences between younger and older adults are analogous to the differences between younger adults and children in the way they compare the base and the target domains in analogy problems.