The purpose of this review was to analyze the literature for potential next-day residual effects of zolpidem, a non-benzodiazepine hypnotic, following nighttime administration. Based on more than 30 international clinical trials involving more than 2,600 subjects/patients, it can be concluded that at the recommended doses of zolpidem 10 mg for adults and zolpidem 5 mg for the elderly, at single or repeated dosing, in healthy subjects or insomniac patients, zolpidem appears to induce minimal next-day residual effects. As for all sedative hypnotics, zolpidem is indicated for the short-term treatment of insomnia and is recommended to be taken only when the patient is able to get a full night's sleep before resuming usual activities.

Accurate measurement of cognitive function is critical for understanding the disease course of Alzheimer's disease (AD). Detecting cognitive change over time can be confounded by level of premorbid intellectual function or cognitive reserve and lead to under- or over-diagnosis of cognitive impairment and AD. Statistical models of cognitive performance that include cognitive reserve can improve sensitivity to change and clinical efficacy. We used confirmatory factor analysis to test a four-factor model composed of memory/language, processing speed/executive function, attention, and cognitive reserve factors in a group of cognitively healthy older adults and a group of participants along the spectrum of amnestic mild cognitive impairment to AD (aMCI-AD). The model showed excellent fit for the control group (χ2 = 100; df = 78; CFI = .962; RMSEA = .049) and adequate fit for the aMCI-AD group (χ2 = 1750; df = 78; CFI = .932; RMSEA = .085). Although strict invariance criteria were not met, invariance testing to determine if factor structures are similar across groups yielded acceptable absolute model fits and provide evidence in support of configural, metric, and scalar invariance. These results provide further support for the construct validity of cognitive reserve in healthy and memory impaired older adults. (JINS, 2012, 18, 1–10)

Studies in adults with multiple sclerosis (MS) have associated regional brain abnormalities with memory impairment. While memory problems in children with MS are often reported, little is known about the neural correlates that may contribute to these difficulties. We measured verbal and nonverbal memory using the Test of Memory and Learning (TOMAL-2) in 32 children and adolescents with MS and 26 age- and sex-matched healthy controls. Memory performance was correlated with volumetric measures of the whole brain, hippocampus, amygdala, and thalamus. Brain volumes were normalized for age and sex using magnetic resonance imaging (MRI) data from the National Institutes of Health MRI Study of Normal Brain development. With the exception of story recall, performance on memory tests was similar to that of the control group. Relative to controls, patient with MS showed reduced volume in the whole brain (p < .001), amygdala (p < .005), and thalamus (p < .001), but not the hippocampus. In the patient group, word-list learning correlated with whole brain volume (r = .53) and hippocampal volume (r = .43), whereas visual recognition memory correlated with thalamic volume (r = .48). Findings are consistent with the well-established role of the hippocampus in learning and consolidation and also highlight the importance of diffuse brain pathology on memory function. (JINS, 2012, 18, 471–480)

The immunoglobulins (IgGs) for beta amyloid (Aβ) and receptors for the advanced glycation end products (RAGE) have previously been shown to be related to memory and language measures in a mixed neurological sample of older adults. In this study, we examined group differences in Aβ and RAGE IgGs, as well as the relationship between both IgGs and cognitive performance in nondiabetic older adults with normal cognition, mild cognitive impairment (MCI), and probable Alzheimer’s disease (AD). We found RAGE and Aβ levels to be elevated in some AD participants, leading to significant AD–control group differences. While there was an overall correlation between both IgG levels and global cognition across all three groups, this relationship was largely attributable to group differences in cognition, highlighted by considerable variability within groups in the relationship between IgG levels and cognition. While findings do not support a consistent relationship between cognition and either IgG, further research with larger samples is needed to better characterize cognitive differences between AD participants with high versus low Aβ and RAGE titers. (JINS, 2010, 16, 672–678.)

Background: Patients with Alzheimer's disease (AD) and concomitant atrophy of the hippocampus may be extra vulnerable to the consequences of psychological distress, leading to greater decline in memory function. The present study investigated whether symptoms of anxiety and depression predict decline of memory function in elderly people diagnosed with early stage AD.

Methods: A sample of 44 elderly people diagnosed with early stage AD was tested on their memory function, anxiety and depression and confounding variables with one year follow-up. Episodic memory was measured with a modified Dutch version of the Auditory Verbal Learning Test (AVLT) which measures learning and recall abilities. Linear regression analyses were used to investigate the association between anxiety and depressive symptoms and decline of memory function.

Results: Anxiety symptoms predicted a smaller decline in learning on the AVLT. Anxiety symptoms did not predict decline on the recall of the AVLT. No association was found between depressive symptoms and decline in either learning or recall of the AVLT.

Conclusions: In early AD, symptoms of anxiety and depression generally seem to be mild, and do not accelerate decline of memory function over time. On the contrary, anxiety symptoms were found to predict a smaller decline in memory function.