INTRODUCTION: Daily memory lapses—defined as instances of forgetfulness during routine everyday life (e.g., forgetting someone’s name, misplacing car keys)—occur on nearly 20% of days, even in healthy young-to-midlife adults without objective cognitive deficits. Further, daily memory lapses are associated with affective responsivity (e.g., higher negative affect) implicating lapses as a source of fluctuations in daily mood consistent with other daily stressors. Importantly, daily reports of memory concerns may be the earliest pre-clinical symptomatic stage in the development of more substantial cognitive decline, including dementia. Blood pressure (BP) variability (BPV; i.e., the fluctuation in BP over a period of monitoring time) may also particularly contribute to declines in cognitive function and eventual dementia regardless of BP level. Augmented resting beat-to-beat BPV may predict cardiovascular risk and target organ damage better than traditional 24 h ambulatory or home-based BP monitoring. Together, daily memory lapses and BPV may enhance risk for development of cognitive decline as well as serve as early warning signs for primary prevention efforts to ward off cognitive decline.
PURPOSE: This project examined the relationships among frequency of daily memory lapses and cardiovascular health including resting beat-to-beat BPV in depressed young adults. Depressed young adults are at a greater risk for development of dementia and we hypothesized that daily memory lapse occurrence (frequency) will be associated with markers of poorer cardiovascular health in this high risk subgroup.
METHODS: Daily memory lapses were assessed for 8 consecutive days using a web-based survey in 39 young adults (18-30 yrs) who met criteria for major depression. Each evening, participants reported whether they had forgotten anything from a list of retrospective (names, words, past events or information, where something was placed) and prospective lapses (appointments, chores, medications, finishing a task, why you entered a room). Beat-to-beat BP was continuously measured via finger photoplethysmography (Finometer) during 20 min of supine rest on Day 8 of the daily surveys. We calculated two memory lapse occurrence indicators: frequency (i.e., percentage of interview days with at least one memory lapse) and total (i.e., total number of memory lapses reported across all interview days). Resting BP was calculated as mean values over the duration of the entire 20 min period. Mean arterial pressure (MAP) was calculated as an average of automated sphygmomanometer BP values obtained during the resting period, and BP waveforms were calibrated once to the average of these systolic BP, diastolic BP, and MAP measurements.
RESULTS: Participants reported retrospective memory lapses on 13% of days and prospective memory lapses on 23% of days. The most common lapses were where something was placed and why you entered a room, respectively. Higher systolic BP and higher MAP were associated with greater frequency of retrospective lapses (rs=.41, p=.01) but not prospective lapses (ps>.12).
CONCLUSION: The results of this ongoing data analysis suggest that among younger adults with depression memory lapses are associated with higher cardiac system load significantly increasing risk for future cognitive decline. Future work will continue to explore the relationships among indicators of real-world cognitive functioning and intensive assessments of cardiovascular functioning among young adults at higher risk for dementia.
