Increasing Communication Among Nursing Home Residents

In this preliminary, intrasubject study (N = 8), we examined the effects of communication skills training and the use of memory books by Nursing Assistants (NAs) on the social ecology of a nursing home. Through inservice and on-the-job training, NAs were taught to use communication skills and memory books during their interactions with residents with mild to moderate cognitive impairment (Mini Mental Status Examination, M = 16.25), but relatively intact communication abilities. An abbreviated staff motivational system called Behavioral Supervision (Burgio and Burgio, 1990. Int. J. Aging Hum. Deve. 30: 287–302.) was attempted to encourage performance of these skills on the nursing units. Results showed that, regardless of sporadic implementation of the intervention by nursing staff, the intervention improved communication between staff and residents during care routines, increased the amount of time other residents and visitors spent talking with target residents, and increased the rate of positive statements made by the target residents and others in their immediate environment. Results are discussed in terms of limitations of the staff motivational system and modifications made to the system in a larger ongoing intervention trial.     

Cognitive deficits presenting as psychiatric symptoms in a patient with Moyamoya disease

The case of a middle-aged man who had intraventricular hemorrhages secondary to Moyamoya disease (MMD), and initially, presented with psychiatric symptoms which did not respond to treatment is described. Neuropsychological assessment showed underlying significant cognitive deficits, mostly of complex attention and speed of information processing, visuospatial and constructional abilities, verbal and nonverbal memory, and executive functions. These deficits remained stable or slightly improved in follow-up assessments. Cognitive dysfunction should be suspected in case of psychiatric or psychiatric-related symptoms in MMD patients. This case study in Greece highlights the range of preserved and impaired cognitive functions in adult MMD by means of repeated neuropsychological evaluations in which a broad range of cognitive abilities were assessed.     

Preservation of categorical knowledge in Alzheimer's disease: A computational account

Abstract

The distinction between knowledge of specific exemplars and knowledge of their general categories is central to much theorising on the nature of semantic memory. The dissociation between exemplar and category knowledge observed in Alzheimer's Disease (AD) would appear to support this distinction, and to suggest that different neural systems are involved in the representation of exemplar and category knowledge. We review the evidence for preserved category knowledge in the semantic memory impairment of AD, and propose an alternative interpretation, according to which category and exemplar knowledge are both represented in the same distributed neural substrate. The relative preservation of category knowledge is a consequence of the greater frequency, and hence greater robustness, of the representation of attributes shared by all or most members of a category, compared to exemplar-unique attributes. We test and confirm the computational adequacy of this hypothesis in two computer simulations.     

Memory abilities in Williams syndrome: Dissociation or developmental delay hypothesis?

Williams syndrome (WS) is a neurodevelopmental genetic disorder often described as being characterized by a dissociative cognitive architecture, in which profound impairments of visuo-spatial cognition contrast with relative preservation of linguistic, face recognition and auditory short-memory abilities. This asymmetric and dissociative cognition has been also proposed to characterize WS memory ability, with sparing of auditory short-term memory and impairment of spatial and long-term memory abilities. In this study, we explored the possibility of a double memory dissociation in WS (short- versus long-term memory; verbal versus visual memory). Thus, verbal memory abilities were assessed using California Verbal Learning Test and Digit Span and Rey-Osterrieth Complex Figure and Corsi Blocks was used to assess visual-spatial memory abilities. Overall, WS subjects were found to present a generalized significant impairment in verbal and visuo-spatial components either in short- or long-term memory. In sum, data from this study brings support for a developmental delay hypothesis, rather than a double dissociation within memory systems in WS.     

Contribution of cognitive abilities to performance and improvement on a substitution coding task

Age-related performance variance on substitution coding tests has been found to account for much of the age-related variance in tests of fluid and other abilities, leading to the conclusion that cognitive decline is due to slowing. Although it is an easy task, which could easily be performed accurately given adequate time, the substitution coding task is not a pure measure of cognitive speed. Evidence from growth curve analyses involving 3,708 volunteers (49-95 years of age) from the Manchester and Newcastle Studies of Cognitive Aging (P. Rabbitt, C. Donlan, N. Bent, L. McInnes, & V. Abson, 1993) indicates that, with practice on this task, improvement is related more to memory than to age, reasoning, vocabulary, or perceptual speed. In other words, faster performances are related primarily to memory. Operational similarities between speeded measures and measures of higher order abilities, which weaken the argument for causal relationships, are discussed.     

Sentence comprehension and memory for embedded structure

An experimental simulation technique is introduced to study memory constraints affecting comprehension of embedded sentences. Memory for embedded structure is measured in a pairing task that simulates requirements imposed by sentence comprehension. With increasing memory load (number of embeddings), the rate of performance decline is consistent across all (recall and comprehension) conditions, and reflects a loss of order (as opposed to item) information. Short-term memory overload, rather than linguistic complexity, appears sufficient to account for comprehension difficulty. Performance was imperfect even with singly embedded constructions. Recall showed no abrupt failure with multiple embeddings, indicating that memory constraints are not as discontinuous as English syntax might suggest.     

Methods for Assessing Quality of Life and Well-Being in Frail Older People

The appropriateness, reliability and convergence of differing methods and associated instruments for the assessment of quality of life and well-being in frail older people was examined in 60 ( S 65 years of age) nursing home residents. The feasibility of measuring quality of life and well-being via a variety of instruments was explored through observation (an adaptation of Dementia Care Mapping), structured interview (Schedule for the Evaluation of Individual Quality of Life - Direct Weighting), and proxy questionnaire (Pleasant Events Schedule - Alzheimer Disease; Apparent Emotion Rating Scale). The observational assessment and Pleasant Events Schedule demonstrated good reliability. Significant associations were found between well-being as assessed by observation, and active social interaction and engagement in recreation as assessed by observation, quality of life as assessed by structured interview, and enjoyment of activities as assessed by proxy questionnaire. These findings indicate the importance of social activity in later life, and the potential of different approaches for the appropriate assessment of key aspects of quality of life in frail older people.     

Effects of Age and Intentionality on Content Memory and Temporal Memory for Performed Activities

Seventy-two young (18–28), 72 young-old (ages 57–70), and 72 old-old (71–93) adults completed 10 different laboratory activities. Intention to learn the content of the activities and their temporal order was varied within each age group by manipulating type of encoding instruction given to the participant (i.e., either incidental, intentional for content, or intentional for both content and temporal order). Participants' recall, recognition, and temporal memory proficiency for the activities was then evaluated. The results revealed that both content memory and temporal order memory for the performed activities were enhanced by intentional encoding strategies. Young adults performed better on the temporal ordering task than young-old adults, with temporal memory proficiency continuing to show further decline in the old-old group. In contrast, content recall and recognition abilities were impaired only in the old-old group. The results suggest that strategic encoding processes can enhance memory for performed activities, and that age-related deficits in temporal order efficiency may occur earlier than those involved in memory for the content of performed activities.     

Memory,Print Exposure,and Metacognition: Components of Reading in Chinese Children

This study examined the relative contributions of visual and verbal memory, metacognition about reading, and print exposure to reading comprehension among 100 Chinese fifth graders. The four concurrently measured componential skills were substantially associated with reading comprehension and reliably distinguished between good and poor readers. In a hierarchical regression, after controlling for the effects of verbal intelligence, both verbal and visual memory abilities predicted unique variance in reading comprehension. The distinctness of each memory skill underscores the existence of two unique memory processes in Chinese reading. Future research should examine the longitudinal contributions of these cognitive abilities to reading comprehension.     

Cognitive reappraisal and secondary control coping: associations with working memory,positive and negative affect,and symptoms of anxiety/depression

Abstract

The current study examined the relations of measures of cognitive reappraisal and secondary control coping with working memory abilities, positive and negative affect, and symptoms of anxiety and depression in young adults (N=124). Results indicate significant relations between working memory abilities and reports of secondary control coping and between reports of secondary control coping and cognitive reappraisal. Associations were also found between measures of secondary control coping and cognitive reappraisal and positive and negative affect and symptoms of depression and anxiety. Further, the findings suggest that reports of cognitive reappraisal may be more strongly predictive of positive affect whereas secondary control coping may be more strongly predictive of negative affect and symptoms of depression and anxiety. Overall, the results suggest that current measures of secondary control coping and cognitive reappraisal capture related but distinct constructs and suggest that the assessment of working memory may be more strongly related to secondary control coping in predicting individual differences in distress.     

Selective attention in early Dementia of Alzheimer Type

This study explored possible deficits in selective attention brought about by Dementia of Alzheimer Type (DAT). In three experiments, we tested patients with early DAT, healthy elderly, and young adults under low memory demands to assess perceptual filtering, conflict resolution, and set switching abilities. We found no evidence of impaired perceptual filtering nor evidence of impaired conflict resolution in early DAT. In contrast, early DAT patients did exhibit a global cost in set switching consistent with an inability to maintain the goals of the task (mental set). We discuss these findings in relation to the DAT literature on executive attention, dual-tasking, and working memory.     

Decision-making competence in younger and older adults: which cognitive abilities contribute to the application of decision rules?

Older adults perform worse than younger adults when applying decision rules to choose between options that vary along multiple attributes. Although previous studies have shown that general fluid cognitive abilities contribute to the accurate application of decision rules, relatively little is known about which specific cognitive abilities play the most important role. We examined the independent roles of working memory, verbal fluency, semantic knowledge, and components of executive functioning. We found that age-related decline in applying decision rules was statistically mediated by age-related decline in working memory and verbal fluency. Our results have implications for theories of aging and decision-making.     

To do or not to do? Prospective memory versus response inhibition in autism spectrum disorder and attention-deficit/hyperactivity disorder

In the present research, event-based prospective memory and response inhibition (RI) abilities were investigated in children with ASD (Study 1), with ADHD (Study 2), and their matched neurotypical controls. Children engaged in a categorisation (ongoing) task and, concurrently, in either an event-based prospective memory (PM) or a Go/No-Go secondary task. Results showed that, as compared to their matched controls, ASD children's performance was more impaired in the PM task than in the Go/No-Go task, while the performance pattern of ADHD children was reversed. In the ongoing task, ASD children were as accurate as, but significantly slower than, controls, independently of conditions. ADHD children did not differ from controls in the presence of a concurrent PM task, while they were less accurate than controls in the presence of the go/no-go task. Overall, the two patterns of findings suggest important differences in the way ASD and ADHD children remember and realise intentions requiring opposite behaviours (acting vs stopping).     

Recall initiation strategies must be controlled in training studies that use immediate free recall tasks to measure the components of working memory capacity across time

There has been great interest in using working memory (WM) training regimens as an alternative treatment for ADHD, but it has recently been concluded that existing training regimens may not be optimally designed because they target the primary memory component but not the secondary component of WM capacity. This conclusion requires the ability to accurately measure changes in primary and secondary memory abilities over time. The immediate free recall task has been used in previous studies to measure these changes; however, one concern with these tasks is that the recall order required on training exercises may influence the recall strategy used during free recall, which may in turn influence the relative number of items recalled from primary and secondary memory. To address this issue, previous training studies have explicitly controlled recall strategy before and after training. However, the necessity of controlling for recall strategies has not been explicitly tested. The present study investigated the effects of forward-serial-order training on free recall performance under conditions in which recall strategy was not controlled using a sample of adolescents with ADHD. Unlike when recall order was controlled, the main findings showed selective improvement of the secondary memory component (as opposed to the primary memory component) when recall order was uncontrolled. This finding advances our understanding of WM training by highlighting the importance of controlling for recall strategies when free recall tasks are used to measure changes in the primary and secondary components of WM across time.     

Age effects shrink when motor learning is predominantly supported by nondeclarative, automatic memory processes: evidence from golf putting

Can motor learning be equivalent in younger and older adults? To address this question, 48 younger (M = 23.5 years) and 48 older (M = 65.0 years) participants learned to perform a golf-putting task in two different motor learning situations: one that resulted in infrequent errors or one that resulted in frequent errors. The results demonstrated that infrequent-error learning predominantly relied on nondeclarative, automatic memory processes whereas frequent-error learning predominantly relied on declarative, effortful memory processes: After learning, infrequent-error learners verbalized fewer strategies than frequent-error learners; at transfer, a concurrent, attention-demanding secondary task (tone counting) left motor performance of infrequent-error learners unaffected but impaired that of frequent-error learners. The results showed age-equivalent motor performance in infrequent-error learning but age deficits in frequent-error learning. Motor performance of frequent-error learners required more attention with age, as evidenced by an age deficit on the attention-demanding secondary task. The disappearance of age effects when nondeclarative, automatic memory processes predominated suggests that these processes are preserved with age and are available even early in motor learning.     

Modeling memory decline in older adults: the importance of preclinical dementia, attrition, and chronological age

This longitudinal study examined memory loss in a sample of 391 initially nondemented older adults. Analyses decomposed observed memory loss into decline associated with preclinical dementia, study attrition, terminal decline, and chronological age. Measuring memory as a function of only chronological age failed to provide an adequate representation of cognitive change. Disease progression accounted for virtually all of the memory loss in the 25% of the sample that developed diagnosable dementia. In the remainder of the sample, both chronological age and study attrition contributed to observed memory loss. These results suggest that much of memory loss in aging adults may be attributable to the progression of preclinical dementia and other nonnormative aging processes that are not captured by chronological age.     

The fate of cognition in very old age: six-year longitudinal findings in the Berlin Aging Study (BASE)

The authors report full-information longitudinal age gradients in 4 intellectual abilities on the basis of 6-year longitudinal changes in 132 individuals (mean age at T1 = 78.27, age range = 70-100) from the Berlin Aging Study. Relative to the cross-sectional parent sample (N = 516, mean age at T1 = 84.92 years), this sample was positively selected because of differential mortality and experimental attrition. Perceptual speed, memory, and fluency declined with age. In contrast, knowledge remained stable up to age 90, with evidence for decline thereafter. Age gradients were more negative in old old (n = 66, mean age at T1 = 83.04) than in old (n = 66, mean age at T1 = 73.77) participants. Rates of decline did not differ reliably between men and women or between participants with high versus low life-history status. They conclude that intellectual development after age 70 varies by distance to death, age, and intellectual ability domain.     

Depression: Psychological Referrals in Nursing Homes

Studies in nursing homes have consistently shown the presence of mental health disorders. We assessed 300 nursing home residents (referred for psychological testing) to provide preliminary data on referral patterns, assess the cognitive and affective patterns of residents with different diagnoses, and present psychometric data on depression measures, including the Beck Depression Scale (BDI) (as a bivariate index) and the Mood Scale (a shortened version of the Geriatric Depression Scale). Results show that the referrals involved a compromised group of residents, both cognitively and affectively. Despite obvious mean differences, a MANOVA revealed that Major Depressive Disorder did not differ significantly from the Adjustment Disorder and Dementia groups on the bivariate BDI and Mood Scale; the dementia group was lower than the depression and adjustment groups on the MMSE. Patterns on depression inventories also identified a correct classification score of 4 on the BDI (89%) and 3 on the Mood Scale (79%). Discussion endorsed use of the bivariate BDI and addressed depression in these facilities.     

The executive control of face memory

Patients with frontal lobe damage and cognitively normal elderly individuals demonstrate increased susceptibility to false facial recognition. In this paper we review neuropsychological evidence consistent with the notion that the common functional impairment underlying face memory distortions in both subject populations is a context recollection/source monitoring deficit, coupled with excessive reliance on relatively preserved facial familiarity signals in recognition decisions. In particular, we suggest that due to the breakdown of strategic memory retrieval, monitoring, and decision operations, individuals with frontal lobe impairment caused by focal damage or age-related functional decline do not have a reliable mechanism for attributing the experience of familiarity to the correct context or source. Memory illusions are mostly apparent under conditions of uncertainty when the face cue does not directly elicit relevant identity-specific contextual information, leaving the source of familiarity unspecified or ambiguous. Based on these findings, we propose that remembering faces is a constructive process that requires dynamic interactions between temporal lobe memory systems that operate in an automatic or bottom-up fashion and frontal executive systems that provide strategic top-down control of recollection. Executive memory control functions implemented by prefrontal cortex play a critical role in suppressing false facial recognition and related source memory misattributions.     

Active (not passive) spatial imagery primes temporal judgements

In order to identify the cognitive processes associated with target tracking, a dual-task experiment was carried out in which participants undertook a dynamic multiple-object tracking task first alone and then again, concurrently with one of several secondary tasks, in order to investigate the cognitive processes involved. The research suggests that after designated targets within the visual field have attracted preattentive indexes that point to their locations in space, conscious processes, vulnerable to secondary visual and spatial task interference, form deliberate strategies beneficial to the tracking task, before tracking commences. Target tracking itself is realized by central executive processes, which are sensitive to any other cognitive demands. The findings are discussed in the context of integrating dynamic spatial cognition within a working memory framework.