Memory deficits in Alzheimer's patients: A comprehensive review

Despite considerable experimental work on Alzheimer's disease (AD), the underlying cognitive mechanisms as well as the precise localization of neuropathological changes critical for memory loss remains undefined. A review of the neuropsychological literature on long-term memory deficits in AD patients suggests that AD patients display (a) a pervasive deficit of explicit memory, (b) a partial deficiency of implicit memory for verbal and visuoperceptual material (as measured by repetition priming procedures), and (c) a substantial sparing of implicit memory for visuomotor skills. The explicit memory loss is likely a result of encoding as well as consolidation difficulties. A faulty lexical-semantic knowledge structure appears responsible for deficient repetition priming effects. Since neuropathological changes diffusely affect the brain of AD patients, establishing a clear relationship between localization of cerebral lesions and memory deficits is particularly difficult. Nevertheless, data suggest that extensive involvement of the hippocampal-amygdala complex plays a major role in explicit memory loss. Damage to associative cortical areas likely is involved in repetition priming deficits. The relative integrity of primary motor and sensory cortical areas and of the basal ganglia likely subsume, by contrast, the normal learning of visuomotor skills.     

Immediate memory spans in dementia

Spatial span (Corsi's block-tapping test) and verbal spans for digits (Wechsler Digits Forward Test) and for words were measured in 30 normal subjects and in 51 demented patients, divided into two groups (mildly demented and severely demented) according to selective clinical and neuropsychological criteria. Statistical analysis showed significant differences among the three groups for spatial span. By contrast, controls' and mildly demented patients' performances on both verbal spans were not significantly different. These findings are discussed in the light of theory about working memory.     

Modeling age-related memory deficits: a two-parameter solution

Recent research and meta-analytic reviews suggest that 1 observed pattern of impaired and intact memory performance with advancing age is a deficit in measures of episodic but not semantic memory. The authors used computational modeling to explore a number of age-related parameters to account for this pattern. A 2-parameter solution based on lifelong experience successfully fit the pattern of results in 5 published studies of the word-frequency mirror effect and paired-associate recognition. Lifelong experience increases the strength (resting level of activation) of concepts in the network but also saturates the network with an increasing number of episodic associations to each concept. More episodic associations to each concept mean that activation spreads more diffusely, making retrieval of any newly established memory trace less likely; however, the greater strength of a concept makes recognition based on familiarity more likely. The simulations provide good quantitative fits to the extant age-related memory literature and support the plausibility of this mechanistic account.     

The role of encoding in reality monitoring: A running memory test with Alzheimer's type dementia

Reality monitoring refers to the discrimination between memories of internal and external events (e.g., Johnson & Raye, 1981). A total of 28 healthy older adults and 28 older adults with Alzheimer's type dementia (DAT) were asked to perform or to imagine performing simple action statements in a running memory test. This task required participants to tell whether the action statement had been carried out or imagined, or whether it was new at unpredictable intervals. The results indicated that older adults with DAT had greater difficulty in reality monitoring than did the healthy control group. The finding is discussed in terms of the role of working memory functions in reality monitoring.     

Virtual reality in episodic memory research: A review

Psychonomic Bulletin & Review - Although virtual reality (VR) is a promising tool for the investigation of episodic memory phenomena, to date there has been relatively little examination of how...     

Depressive deficits in memory: processing initiative and resource allocation

Hertel and Hardin investigated the effects of depressed mood states on recognition memory in three experiments. They report that mood effects on memory depend on the subjects' awareness of the task. Four issues are considered in this article: natural and induced moods, processing initiative, initiative versus resource allocation, and strategies.     

Pentoxifylline reverses age-related deficits in spatial memory

Pentoxifylline, a phosphodiesterase inhibitor, produces a marked reversal of an age-dependent spatial memory deficit in Fischer 344 strain male rats. Performance of 26-month-old animals treated chronically with pentoxifylline approached that of 3-month-old controls. The effect was not dependent upon concurrent administration of the acetylcholine precursor choline chloride. It is concluded that the pentoxifylline-induced reversal of the age-dependent memory decline is not dependent on any presumed facilitation of acetylation and utilization of exogenously supplied transmitter substrate.     

Recognition memory deficits in mild cognitive impairment

ABSTRACT There is no agreement on the pattern of recognition memory deficits characteristic of patients diagnosed with mild cognitive impairment (MCI). Whereas lower performance in recollection is the hallmark of MCI, there is a strong controversy about possible deficits in familiarity estimates when using recognition memory tasks. The aim of this research is to shed light on the pattern of responding in recollection and familiarity in MCI. Five groups of participants were tested. The main participant samples were those formed by two MCI groups differing in age and an Alzheimer's disease group (AD), which were compared with two control groups. Whereas one of the control groups served to assess the performance of the MCI and AD people, the other one, composed of young healthy participants, served the purpose of evaluating the adequacy of the experimental tasks used in the evaluation of the different components of recognition memory. We used an associative recognition task as a direct index of recollection and a choice task on a pair of stimuli, one of which was perceptually similar to those studied in the associative recognition phase, as an index of familiarity. Our results indicate that recollection decreases with age and neurological status, and familiarity remains stable in the elderly control sample but it is deficient in MCI. This research shows that a unique encoding situation generated deficits in recollective and familiarity mechanisms in mild cognitive impaired individuals, providing evidence for the existence of deficits in both retrieval processes in recognition memory in a MCI stage.     

Schizophrenic tendencies and memory deficits in normals

The report tests the hypothesis that normals who exhibit schizophrenic tendencies are likely to show verbal-memory deficits of the types observed in schizophrenics. Thirty-four middle-aged men were tested using the MMPI 2–7–8 schizophrenic-tendency scales, the Sorting Consistency Task and the Physical Anhedonia Scale. The dependent variables were four memory tests selected on the basis of their known discriminating power and their relevance. The results showed the Schizophrenia (8) and Psychasthenia (7) scales of MMPI, and the Sorting Consistency Task effectively detected memory deficits in normals. When partialling out intelligence, as a measure of general current cognitive functioning, it appeared that one of the deficits reflecting encoding difficulty disappeared. This suggests that normal ‘high-risk’ subjects for schizophrenia show a ‘generalized deficit’, which affects memory in addition to a ‘differential deficit’ in retention. Though tentative, the results can be taken as an indication that ‘high-risk’ subjects indeed show memory deficits and that detecting these deficits requires relatively sensitive tools.     

Declarative memory deficits and schizophrenia: problems and prospects

Cognitive deficits are among the most important factors leading to poor functional outcomes in schizophrenia, with deficits in declarative memory among the largest and most robust of these. Thus far, attempts to enhance cognition in schizophrenia have shown only modest success, which underlies increasing efforts to develop effective treatment strategies. This review is divided into three main parts. The first section delineates the nature and extent of the deficits in both patients with schizophrenia and in their adult, non-psychotic relatives. The second part focuses on structural and functional abnormalities in the hippocampus, both in people with schizophrenia and in animal studies that model relevant features of the illness. The third section views problems in declarative memory and hippocampal function from the perspective of elevated rates of common medical disorders in schizophrenia, with a focus on insulin insensitivity/diabetes. The likelihood that poor glucose regulation/availability contribute to declarative memory deficits and hippocampal abnormalities is considered, along with the possibility that schizophrenia and poor glucose regulation share common etiologic elements, and with clinical implications of this perspective for enhancing declarative memory.     

The psychological treatment of memory impairment: A review of empirical studies

Memory impairment is a frequent effect of many different forms of brain dysfunction. Memory impairment is also a frequent focus of treatment interventions, and there have been many different treatment methods suggested. The suggested methods include direct retraining, the use of spared skills in compensating for the impairment (alternate functional systems), and the use of behavioral strategies to circumvent the manifest memory dysfunction (behavioral prosthetics). Unfortunately, there are very few studies comparing the various suggested treatment methods. The present paper evaluates the empirical evidence related to the treatment of memory dysfunction and suggests directions for future investigations. Although the evidence is not conclusive, it appears that some forms of treatment may be helpful in remediating certain types of memory impairment. An approach likely to be productive would include some consideration of the impaired neurological and psychological mechanisms responsible for the manifest memory deficit as well as a consideration of the etiology of the injury thought to be causally related to the memory deficit. As yet, there have been no rigorous empirical evaluations of these considerations.     

Neural basis for sentence comprehension deficits in frontotemporal dementia

Many patients with frontotemporal dementia (FTD) have impaired sentence comprehension. However, the pattern of comprehension difficulty appears to vary depending on the clinical subgroup. The purpose of this study was to elucidate the neural basis for these deficits in FTD. We studied patients with two different presentations: Three patients with Progressive Non-Fluent Ahasia (PNFA), and five non-aphasic patients with a dysexecutive and social impairment (EXEC). The FTD patient subgroups were compared to a cohort of 11 healthy seniors with intact sentence comprehension. We monitored regional cerebral activity with blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) while subjects read sentences featuring both a grammatically complex object-relative center-embedded clause and a long linkage between the head noun phrase (NP) and the gap where the NP is interpreted in the center-embedded clause. Subjects decided whether the agent of the action is a male or a female. Healthy seniors activated both ventral portions of inferior frontal cortex (vIFC) and dorsal portions of IFC (dIFC) in the left hemisphere, often associated with grammatical and working memory components of these sentences, respectively. PNFA patients differed from healthy controls since they have reduced activation of left vIFC, while EXEC patients have less recruitment of left dIFC. We conclude that FTD subgroups have distinct patterns of sentence comprehension difficulty in part because of selective interruptions of a large-scale neural network for sentence processing.     

Mood congruence and depressive deficits in memory: a forced-recall analysis

Two experiments examined the contribution of reporting biases to mood-congruent recall patterns and diminished levels of recall frequently associated with depressed mood states. In Experiment 1, participants classified as dysphoric (n = 14) or nondepressed (n = 21) on the basis of scores on the Beck Depression Inventory and the Profile of Mood States made self-referential judgements regarding a series of affectively valenced words. Subsequently they were given an unexpected forced-recall test, which encouraged guessing to meet the output requirement (i.e. 40 responses) of the test. Nondepressed subjects confidently reported more positive words than dysphoric subjects, but the latter produced significantly more correct guesses of words that were positively valenced. Similar findings were obtained in Experiment 2, in which dysphoric (n = 40) and nondepressed subjects (n = 40) performed both self-referent and orthographic judgements of affectively valenced words, followed by either a free- or forced-recall test. The findings suggest that positive and negative trait words were adequately encoded in memory, but, consistent with cognitive theories of depression, their accessibility to retrieval was differentially limited. In addition, however, the results implicate an important contribution of diminished motivation and/or conservative report criterion in the manifestation of depression-related biases and deficits in recall.     

Depressive deficits in memory: focusing attention improves subsequent recall.

Ss diagnosed as depressed, recovered from depression, or without a history of depression performed an unintentional learning task, followed by tests of free and forced recall. In the learning task, Ss decided whether a series of nouns sensibly completed corresponding sentence frames that varied in decision difficulty. For half of the Ss, the focus of attention was unconstrained by the demands of this task. The others, however, were required to repeat the targeted noun at the end of the trial as a means of focusing their attention on the task. Depressed Ss in the unfocused condition subsequently recalled fewer words than did both control groups, but this deficit disappeared in the focused condition. These results suggest that depression might not fundamentally impair the resources required for good performance on such tasks. The results' relevance to resource-allocation, initiative, and inhibition accounts of depressive deficits in memory is discussed.     

Creativity and dementia: a review

In these last years, creativity was found to play an important role for dementia patients in terms of diagnosis and rehabilitation strategies. This led us to explore the relationships between dementia and creativity. At the aim, artistic creativity and divergent thinking are considered both in non-artists and artists affected by different types of dementia. In general, artistic creativity can be expressed in exceptional cases both in Alzheimer's disease and Frontotemporal dementia, whereas divergent thinking decreases in dementia. The creation of paintings or music is anyway important for expressing emotions and well-being. Yet, creativity seems to emerge when the right prefrontal cortex, posterior temporal, and parietal areas are relatively intact, whereas it declines when these areas are damaged. However, enhanced creativity in dementia is not confirmed by controlled studies conducted in non-artists, and whether artists with dementia can show creativity has to be fully addressed. Future research directions are suggested.     

Focused attention and depressive deficits in memory.

Hertel and Rude (1991) investigated the effects of depression on memory for words in a sentence completion task. They found that depressive deficits in memory can be eliminated by procedures that increase depressed Ss' focused attention to the task. Three areas are considered in this article: irrelevant thoughts, distraction, and inhibition.     

The contribution of apraxic speech to working memory deficits in Parkinson's disease

This article links two formerly separate areas of research associated with Parkinson's disease (PD): speech and memory. It is proposed that speech deficits occur in PD not merely at the level of muscular control, as is commonly termed dysarthria, but also at the level of speech planning and programming, more aptly described as a form of apraxia. It is further argued that PD patient groups exhibit small deficits in verbal span, and the link between apraxic speech and verbal span is elucidated via Baddeley's (1986) model of working memory. An experiment is described in which aspects of speech of 36 PD and 43 healthy control subjects were rated and classified, and measures of span and articulation rate for words of different syllable lengths were taken. Twenty-three PD subjects had dysarthric speech, while 14 of them had apraxic speech, which was associated with lower memory span scores for longer words. It is concluded that apraxic speech can be a source of reduced memory span in PD. In addition to implications for rehabilitation and therapeutic work with PD sufferers, these findings advance our theoretical understanding of the Parkinsonian syndrome.     

Age-related deficits in prospective memory: the influence of task complexity.

Younger and older subjects were asked to perform an action whenever target words occurred during a short-term memory task. The difficulty of this prospective memory task was manipulated by varying the delay preceding the occurrence of a target event and by varying the number of different target events. Age-related performance differences emerged when there were several different target events but not when there was one target event presented several times. Age-related performance differences, when they occurred, were associated with poorer retrospective memory for the target events. The results were interpreted in terms of a componential analysis of prospective memory, which assumes both similarities and differences between prospective and retrospective memory.     

Auditory temporal perception deficits in the reading-impaired: A critical review of the evidence

We assess evidence and arguments brought forward by Tallal (e.g., 1980) and by the target paper (Farmer & Klein, 1995) for a general deficit in auditory temporal perception as the source of phonological deficits in impaired readers. We argue that (1) errors in temporal order judgment of both syllables and tones reflect difficulty in identifying similar (and so readily confusable) stimuli rapidly, not in judging their temporal order; (2) difficulty in identifying similar syllables or tones rapidly stem from independent deficits in speech and nonspeech discriminative capacity, not from a general deficit in rate of auditory perception; and (3) the results of dichotic experiments and studies of aphasics purporting to demonstrate left-hemisphere specialization for nonspeech auditory temporal perception are inconclusive. The paper supports its arguments with data from a recent control study. We conclude that, on the available evidence, the phonological deficit of impaired readers cannot be traced to any co-occurring nonspeech deficits so far observed and is phonetic in origin, but that its full nature, origin, and extent remain to be determined.