Age-associated memory impairment: Definition and psychometric characteristics

Abstract

The basic definition of Age-Associated Memory Impairment (AAMI) is considered, with a particular emphasis on the psychometric features of AAMI. Empirical data are presented concerning the prevalence of AAMI and demonstrating the importance of quantifying both objective age-related decline in secondary memory as well as subjective report of decline relative to young adult years. Failure to include both of these features leads to overestimation of the prevalence of AAMI. Differences in memory test performance and subjective memory ratings are presented for subjects with AAMI and Alzheimer-type dementia relative to age and education matched elderly controls. Finally, modifications to the original AAMI psychometric criteria are suggested. More precise psychometric criteria are provided for differentiation of AAMI, dementia and amnestic disorder.     

Help-seeking for AIDS-related concerns: A comparison of gay men with various HIV diagnoses

Examined help-seeking and psychological distress among four groups of gay men (30 AIDS-diagnosed, 107 HIV-seropositive, 149 HIV-seronegative, 244 untested) in the AIDS Behavioral Research Project, a longitudinal survey of San Francisco gay men. The men reported high levels of anxiety, depression, and help-seeking from their social networks. AIDS-diagnosed and HIV-positives reported the most AIDS worry and were the most likely to seek help. High percentages of AIDS-diagnosed men sought help from all sources (peers, professionals, family), whereas nondiagnosed men were more likely to seek help from peers. Regardless of the men's HIV status, peers were perceived to be the most helpful source. Family members were less likely sought and perceived as least helpful. The strengths and limitations of peers as social support providers for AIDS-related concerns are discussed, including implications for the design of community programs to enhance the abilities of peer helpers.     

Misleading postevent information and memory for events: arguments and evidence against memory impairment hypotheses

The claim that a person's memory for an event may be altered by information encountered after the event has been influential in shaping current conceptions of memory. The basis for the claim is a series of studies showing that subjects who are given false or misleading information about a previously witnessed event perform more poorly on tests of memory for the event than subjects who are not misled. In this article we argue that the available evidence does not imply that misleading postevent information impairs memory for the original event, because the procedure used in previous studies is inappropriate for assessing effects of misleading information on memory. We then introduce a more appropriate procedure and report six experiments using this procedure. We conclude from the results that misleading postevent information has no effect on memory for the original event. We then review several recent studies that seem to contradict this conclusion, showing that the studies do not pose problems for our position. Finally, we discuss the implications of our conclusions for broader issues concerning memory.     

Assessment of behavioral problems in dementia: the revised memory and behavior problems checklist.

The Revised Memory and Behavior Problems Checklist (RMBPC), a 24-item, caregiver-report measure of observable behavioral problems in dementia patients, provides 1 total score and 3 subscale scores for patient problems (memory-related, depression, and disruptive behaviors) and parallel scores for caregiver reaction. Data were obtained from 201 geriatric patients and their caregivers. Factor analysis confirmed 3 first-order factors, consistent with subscales just named, and 1 general factor of behavioral disturbance. Overall scale reliability was good, with alphas of .84 for patient behavior and .90 for caregiver reaction. Subscale alphas ranged from .67 to .89. Validity was confirmed through comparison of RMBPC scores with well-established indexes of depression, cognitive impairment, and caregiver burden. The RMBPC is recommended as a reliable and valid tool for the clinical and empirical assessment of behavior problems in dementia patients.     

Subjective memory loss in age-associated memory impairment: Family history and neuropsychological correlates

Abstract

Empiricist and rationalist approaches to data-quality control in meta-analyses are discussed, and a compromise approach advocated by Strube and Hartmann (1983) for theoretically driven meta-analyses is applied to Laver and Burke's (1993) data sets. When older adults' response times (RTs) and semantic priming effects (SPEs) are regressed on young adults' RTs and SPEs, the slopes of the regression lines are approximately 1.5 as long as the age difference is held constant and performance is reasonably accurate. Both increases and decreases in RTs following unrelated and related primes, relative to RTs following baseline primes, were analyzed. The results, like those regarding RTs and SPEs, support the hypothesis that, compared with young adults who are 50 years younger, older adults take approximately 50% longer to process lexical information     

The Collaborative Longitudinal Personality Disorders Study: reliability of axis I and II diagnoses

Both the interrater and test-retest-retest reliability of axis I and axis II disorders were assessed using the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and the Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV). Fair-good median interrater kappa (.40-.75) were found for all axis II disorders diagnosed five times or more, except antisocial personality disorder (1.0). All of the test-retest kappa for axis II disorders, except for narcissistic personality disorder (1.0) and paranoid personality disorder (.39), were also found to be fair-good. Interrater and test-retest dimensional reliability figures for axis II were generally higher than those for their categorical counterparts; most were in the excellent range (> .75). In terms of axis I, excellent median interrater kappa were found for six of the 10 disorders diagnosed five times or more, whereas fair-good median interrater kappa were found for the other four axis I disorders. In general, test-retest reliability figures for axis I disorders were somewhat lower than the interrater reliability figures. Three test-retest kappa were in the excellent range, six were in the fair-good range, and one (for dysthymia) was in the poor range (.35). Taken together, the results of this study suggest that both axis I and axis II disorders can be diagnosed reliably when using appropriate semistructured interviews. They also suggest that the reliability of axis II disorders is roughly equivalent to that reliability found for most axis I disorders.     

Understanding memory impairment with memory models and hierarchical Bayesian analysis

The study of human episodic memory is a topic that interests cognitive and mathematical psychologists as well as clinicians interested in the diagnosis and assessment of Alzheimer’s disease and related disorders (ADRD). In this paper, we use simple cognitive models for the recognition and recall tasks typically applied in clinical assessments of ADRD to study memory performance in ADRD patients. Our models make use of hierarchical Bayesian methods as a way to model individual differences in patient performance and to facilitate the modeling of performance changes that occur during multiple recall tasks. We show how the models are able to account for different aspects of patient performance, and also discuss some of the predictive capabilities of the model. We conclude with a discussion on the scope to improve on our results by discussing the link between memory theory in psychology and clinical practice.     

A computational model of semantic memory impairment: modality specificity and emergent category specificity.

It is demonstrated how a modality-specific semantic memory system can account for category-specific impairments after brain damage. In Experiment 1, the hypothesis that visual and functional knowledge play different roles in the representation of living things and nonliving things is tested and confirmed. A parallel distributed processing model of semantic memory in which knowledge is subdivided by modality into visual and functional components is described. In Experiment 2, the model is lesioned, and it is confirmed that damage to visual semantics primarily impairs knowledge of living things, and damage to functional semantics primarily impairs knowledge of nonliving things. In Experiment 3, it is demonstrated that the model accounts naturally for a finding that had appeared problematic for a modality-specific architecture, namely, impaired retrieval of functional knowledge about living things. Finally, in Experiment 4, it is shown how the model can account for a recent observation of impaired knowledge of living things only when knowledge is probed verbally.     

The selective impairment of semantic memory

The selective impairment of semantic memory is described in three patients with diffuse cerebrallesions. These patients, selected on the basis of a failure to recognize or identify common objects (agnosia for objects), were investigated in detail. In particular, their perceptual, language and memory functions were assessed, and the limits and properties of their recognition difficulties explored.

It was found that knowledge of pictorial representations of objects, and of words, was impaired or impoverished, and in both instances knowledge of subordinate categories was more vulnerable than superordinate categories. Evidence is presented that this impairment of semantic memory cannot be accounted for by intellectual impairment, sensory or perceptual deficits, or expressive language disorder. The implications of damage to the semantic memory system for the operation of other cognitive systems, in particular short and long-term memory functions, are considered. Some tentative evidence for the structural basis for a hierarchically organized modality-specific semantic memory system is discussed.     

Auditory-verbal short-term memory impairment and conduction aphasia

The specific impairment of performance on repetition tasks has classically been identified with conduction aphasia. It is argued that this impairment can be subdivided and a deficit in span performance distinguished from that of the reproduction of single words. An explanation of the span deficit in terms of auditory-verbal short-term memory is preferred to hypotheses involving disconnections or damage to order retention systems. It is shown that a short-term memory component is present in many patients previously classified as conduction aphasics.     

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.     

Sex-related impairment of memory for emotional events with beta-adrenergic blockade

On the basis of recent evidence indicating a sex-related lateralization of amygdala function in memory for emotional events, together with substantial evidence suggesting hemispheric specialization in processing global (central) versus local (detail) aspects of a situation, and the established dependence of the amygdala's memory modulating function on beta-adrenergic receptor activation, we predicted differential effects of a beta-adrenergic receptor antagonist (propranolol) on long-term memory for an emotionally arousing story in men and women. Specifically, we predicted that, relative to placebo, propranolol would impair memory for information central to the story line, but not memory for peripheral story details in men. Conversely, propranolol would impair memory for peripheral details, but not for central information in women. Here we confirm this prediction with a novel analysis of data from our two published studies of propranolol's effect on memory for an emotionally arousing story. These findings demonstrate a sex-related impairment of memory for emotional information by beta-adrenergic blockade. Additionally, they provide support for the hypothesis that, in this paradigm, emotional arousal enhances long-term memory for central information in men via activation of right amygdala/hemisphere function, and enhances long-term memory for peripheral details in women via activation of left amygdala/hemisphere function.     

Autobiographical memory impairment in chronic schizophrenia: Significance and clinical correlates

Previous studies of autobiographical memory (AM) in schizophrenia yielded a reduction of specificity, richness of details and conscious recollection, which indicate both, quantitative and qualitative AM changes. However, their associations with psychopathological symptoms and neuropsychological deficits were not resolved. Therefore, we sought to investigate AM with respect to psychopathology and neuropsychology in patients with chronic schizophrenia to rule out the influence of different courses of the disease. AM of four lifetime periods was examined in 75 patients and 50 healthy controls by using a semi-structured interview. The recalled episodes were rated for memory specificity. Subsequently, one single event of each period of life was rated for details and experiential aspects of reliving (originality, vividness/visual imagery, emotional re-experiencing and emotional valence). When contrasted with healthy controls, patients recalled a significantly reduced number of episodes and personal semantic facts; moreover, memory specificity of AM was significantly lower in patients than controls. While the richness of details calculated for single events showed only minor, non-significant group differences, vividness and emotional re-experiencing were significantly less pronounced in the patient group. Along with this, AM performance correlated significantly with negative symptoms including apathy as well as verbal memory and executive functions. Our results underline the significance of overgenerality as a key feature of AM in schizophrenia as well as a dissociation between intact number of details of single events and reduced vividness and emotional re-experiencing. The extent of negative symptoms including apathy and impairments of verbal memory/executive functions may explain AM deficits in chronic schizophrenia.     

Assessing absentmindedness: Prospective memory complaint and impairment in middle-aged adults

In two experiments, metamemorial differences between prospective and retrospective memory performance were examined. Participants in Experiment 1 were recruited through newspaper advertisements and comprised middle-aged women who experienced exceptional problems in prospective remembering. Experiment 2 involved self-reporters and nonreporters of retrospective memory problems, who were selected from a large population-based sample of middle-aged adults. In both experiments, memory performance was assessed by using a variety of tasks, including five retrospective memory tasks and three prospective memory tasks that varied in level of realism and retrieval support. In both experiments, there were selective differences in memory performance, so that participants who experienced (retrospective or prospective) memory problems showed impaired performance in prospective, but not in retrospective, memory tasks. These findings suggest that memory for future intentions provides a more sensitive task criterion than does memory for past events for assessing individual differences in self-reports of episodic memory problems. Task-specific differences in reliance on frontally mediated executive processes might underlie these differences.     

Group aggregates and individual reliability: The case of verbal short-term memory

Two experiments examined the generalizability of the effects of word length and phonological similarity with visual and auditory presentation in immediate verbal serial ordered recall. In Experiment 1, data were collected from 251 adult volunteers drawn from a broad cross-section of the normal population. Word length and phonological similarity in both presentation modes significantly influenced the group means. However, 43% of the subjects failed to show at least one of the effects, and the likelihood that effects appeared was highly correlated with verbal memory span. In Experiment 2, 40 subjects of the original sample were retested, 20 of whom had failed to show one or more effects in Experiment 1. Whether or not an effect had appeared for individual subjects on the first test session was a poor predictor of whether the effect would appear on retest. Finally, an analysis of subject reports demonstrated that the patterns of experimental data could be accounted for in part by the strategies that subjects reported using, and the effect of strategy was independent of the effect of span. The implications of these findings for theories of verbal short-term memory are discussed.     

Awareness of memory task impairment versus everyday memory difficulties in dementia

The study investigated different types of awareness of memory dysfunction in dementia, specifically judgements concerning memory task performance or appraisal of everyday memory functioning and also exploring the neuropsychological correlates of such awareness. This was investigated in 76 people with dementia, comprising 46 patients with Alzheimer's disease (AD) and 30 patients with vascular dementia (VaD). The Memory Awareness Rating Scale (Clare et al., 2002, Neuropsychol Rehabil, 12, 341–362) was used, which includes an Objective‐Judgement Discrepancy (OJD) technique involving comparison of subjective evaluation of performance on specific memory tasks with actual performance, and a Subjective Rating Discrepancy (SRD) technique, which compares self versus informant judgement of everyday memory function. The AD and VaD groups showed lower awareness than a normal control group for both types of measures, the AD group showing less awareness than the VaD group on the OJD measure. Regression analyses supported associations for both groups between memory impairment and the OJD measure and between naming impairment and the SRD measure. The findings are discussed in terms of neurocognitive theories accounting for loss of awareness in dementia.     

Autobiographical memories for the September 11th attacks: Reconstructive errors and emotional impairment of memory

College students were asked about their personal memories from September 11, 2001. Consistency in reported features over a 2-month period increased as the delay between the initial test and 9/11 increased. Central features (e.g., Where were you?) were reported with greater consistency than were peripheral features (What were you wearing?) but also contained a larger proportion of reconstructive errors. In addition, highly emotional participants demonstrated poor prospective memory and relatively inconsistent memory for peripheral details, when compared with less emotional participants. Highly emotional participants were also more likely to increase the specificity of their responses over time but did not exhibit greater consistency for central details than did less emotional participants. The results demonstrated reconstructive processes in the memory for a highly consequential and emotional event and emotional impairment of memory processing of incidental details.