The effects of healthy aging, amnestic mild cognitive impairment, and Alzheimer's disease on recollection, familiarity and false recognition, estimated by an associative process-dissociation recognition procedure

Familiarity Deficits for Words and Objects in Amnestic Mild Cognitive Impairment in a Context Minimizing the Role of Recollection

OBJECTIVES

Amnestic mild cognitive impairment (aMCI) is associated with cortical thinning in perirhinal and entorhinal cortices, key regions of the brain supporting familiarity. Individuals with aMCI demonstrate familiarity deficits in their behavior, often repeating questions in the same conversation. While familiarity deficits in healthy aging are minimal, past studies measuring familiarity in aMCI have mixed results, perhaps due to the influence of recollection. We therefore used a paradigm that minimized the influence of recollection, and hypothesized that familiarity would be impaired in aMCI relative to age-matched controls, but not in healthy older adults relative to younger adults. We also hypothesized that familiarity deficits in aMCI would be greater for objects than words because the perirhinal cortex plays a significant role in visual discrimination.

METHODS

A sample of 36 younger adults, 38 cognitively intact older adults, and 30 older adults with aMCI made absolute frequency judgments for words and objects seen a variable number of times in an incidental encoding task. Estimates of familiarity were derived from correlating participants' frequency judgments with the actual frequency of presentation.

RESULTS

Familiarity was largely spared in healthy aging, with minor deficits in familiarity for words. Familiarity deficits were evident in aMCI comparably for words and objects.

DISCUSSION

The present research underscores the need to study familiarity in contexts minimizing recollection, particularly when comparing groups with different levels of recollection, and adds to our understanding of the phenomenology of aMCI. Familiarity deficits may provide an early biomarker of dementia risk.

Cognitive Stimulation in Moderate Alzheimer's Disease

Cognitive stimulation is one of the non-pharmacological therapies recommended for dementia intervention. The present study evaluated the efficacy of an intervention based on cognitive stimulation in people with moderate Alzheimer's disease. Fifty-nine subjects with moderate dementia were randomly assigned to the stimulation group (N = 36) and the control group (N = 35). The treatment group received 16 intervention sessions cognitive tasks. All participants were evaluated with a battery of neuropsychological tests at three time points (pre, post, and follow-up). The treatment group showed significant increases in the three domains studied (memory, attention, and executive functions), although some of these effects were not maintained at follow-up. The control group progressively worsened. Cognitive stimulation was found to be an effective intervention for people with moderate Alzheimer's disease because it helped to maintain memory function, executive functions, and attention. However, the effects were minimized at the 3-month follow-up.

The dual-process perspective and the benefits of retrieval practice in younger and older adults

The testing effect is often considered a recollection-related phenomenon. However, recent work has observed a benefit of testing to both recollection and familiarity on immediate and delayed final tests. Further, although aging populations show marked declines in recollection, older and younger adults often benefit similarly from testing. This finding suggests that the testing effect in older adults may function via relatively preserved familiarity and lends further support to the hypothesis that the testing effect does not function solely via recollection-related processes. The current study builds on this work to better understand the mechanisms from the dual-process perspective that underlie the testing effect in both younger and older adults. To this end, younger (18-22 year old) and older (65-82 year old) adults studied words, took cued-recall tests on half of the words, and took a final Remember-Know recognition test on all words immediately or after a 1-day delay. At both delays, older and younger adults exhibited a testing effect in both recollection and familiarity, although the magnitude of the testing effect in recollection was reduced for older relative to younger adults. Implications for theories of the testing effect and its application in older adult populations are explored.

Social Support and Cognitive Impairment: Results from a Portuguese 4-Year Prospective Study

(1) Background: In an ageing society, social relationships may benefit cognitive performance with an impact on the health of older people. This study aims to estimate the effect of different social support sources on the risk of cognitive impairment in a sample of older Portuguese people. (2) Methods: From the Portuguese EpiPorto cohort study, we followed a sample of participants with 60 to 85 years (N = 656) between 2009 and 2015 (4.63 mean years of follow-up). The participants’ perception of social support from family, friends and significant others was evaluated. Cox’s regression models were used to investigate the association between this and sociodemographic variables. (3) Results: It was found that social support from friends reduces the risk of cognitive impairment. Men, participants aged 60 to 64 and those not married have a lower risk of cognitive impairment after adjusting for other variables. Participants between 80 and 85 years old (p = 0.021), those with less than four years of education (p < 0.001), and those with cognitive impairment (p = 0.007) have perception of less social support from friends. (4) Conclusions: A social support network from friends reduces the risk of cognitive impairment for older people.

A Longitudinal Study of Episodic and Semantic Autobiographical Memory in aMCI and Alzheimer's Disease Patients

BACKGROUND

The main objective of this study was to analyze the evolution of autobiographical memory (both episodic and semantic) in patients with mild cognitive impairment, patients with Alzheimer's disease, and a healthy control group. We compared these groups at two time points: first, at baseline, and in a follow-up after 18 months.

METHOD

Twenty-six healthy older adults, 17 patients with mild amnestic cognitive impairment, and 16 patients with Alzheimer's disease, matched on age and educational level, were evaluated at both time points with the Autobiographical Memory Interview.

RESULTS

The results showed significant longitudinal deterioration in episodic and semantic autobiographical memory in patients with mild cognitive impairment and in patients with Alzheimer's disease, but not in healthy older adults.

CONCLUSIONS

The deterioration of episodic and semantic autobiographical memory in AD is confirmed; however, although the episodic was impaired in aMCI, a pattern that evolved toward deterioration over a period of eighteen months was observed for the semantic autobiographical memory.

Dimensional and Discrete Emotional Reactivity in Alzheimer's Disease: Film Clips as a Research Tool in Dementia

BACKGROUND

No studies have been conducted to date on the dimensional and discrete classification of emotions to study the emotional reactivity of older adults with Alzheimer's disease (AD). Additionally, the presentation of film clips with affective content is currently one of the most effective and widely used Mood Induction Procedures (MIPS). However, it has been scarcely used in AD patients.

OBJECTIVE

Based on the dimensional and discrete models of emotion, this study examines the emotional reactivity of older adults with AD, using a popular set of film clips to induce emotions.

METHODS

We compared the responses of older adults aged over 65-years with mild to moderate AD (n = 15) and a healthy comparison group (n = 17) to six target emotions: disgust, fear, anger, sadness, amusement, and tenderness.

RESULTS

The results showed significant differences in the reactivity of fear, anger, and sadness between AD patients and healthy comparison group. However, the responses of the two groups to positive film clips were similar. Only in the amusement clip did the AD participants show a higher intensity response.

CONCLUSION

These findings suggest that the characteristic loss of cognitive abilities in AD is related to a reduction in the ability to react to emotional stimuli, especially negative ones. However, these abilities seem to be preserved when it comes to positive emotions. Future research is necessary to investigate whether the positivity effect is present in AD patients.

Effectiveness of tDCS at Improving Recognition and Reducing False Memories in Older Adults

BACKGROUND

False memories tend to increase in healthy and pathological aging, and their reduction could be useful in improving cognitive functioning. The objective of this study was to use an active-placebo method to verify whether the application of transcranial direct current stimulation (tDCS) improved true recognition and reduced false memories in healthy older people.

METHOD

Participants were 29 healthy older adults (65-78 years old) that were assigned to either an active or a placebo group; the active group received anodal stimulation at 2 mA for 20 min over F7. An experimental task was used to estimate true and false recognition. The procedure took place in two sessions on two consecutive days.

RESULTS

True recognition showed a significant main effect of sessions (p < 0.01), indicating an increase from before treatment to after it. False recognition showed a significant main effect of sessions (p < 0.01), indicating a decrease from before treatment to after it and a significant session × group interaction (p < 0.0001).

CONCLUSIONS

Overall, our results show that tDCS was an effective tool for increasing true recognition and reducing false recognition in healthy older people, and suggest that stimulation improved recall by increasing the number of items a participant could recall and reducing the number of memory errors.

Boundary extension as a tool for detection of cognitive change among individuals with mild cognitive impairment: A preliminary study

OBJECTIVES

Recent neuropathological research suggests that recognition memory supported by familiarity rather than recollection may be the earliest cognitive change in course of Alzheimer's disease (AD). Nonetheless, the findings on the issue of familiarity capacity in the prodromal AD remain inconsistent. Boundary extension (BE), in which the view recollected by the subject covers a wider angle than was actually observed, is a form of false memory. Given that BE occurs implicitly and automatically, it may be a candidate for assessing familiarity functioning in cases of AD. This was the issue explored in the current study.

METHODS

One-hundred and six participants comprising a younger adult group (YA, n = 40), a healthy older adult group (OA, n = 40), and a group of patients with mild cognitive impairment (MCI, n = 26) underwent testing for BE and neuropsychological functions. Parts of OA and MCI underwent analysis for plasma tau levels. Receiver-operating characteristic analysis was used to assess memory associated with familiarity and recollection among participants.

RESULTS

The OA and MCI groups could be differentiated by the degree of familiarity associated with BE, wherein the latter group displayed minimal familiarity. Among OAs, familiarity was positively associated with education level. We observed a correlation between plasma tau levels and various neuropsychological functions. Most of the associations between plasma tau levels and neuropsychological functions were mediated by education level.

CONCLUSIONS

Our findings indicate that BE could detect early decline in familiarity and assess preserved cognitive functions in aging.

Deficits in recent but not lifetime familiarity in amnestic mild cognitive impairment

People with amnestic mild cognitive impairment (aMCI) repeat questions, seemingly without any sense of familiarity (i.e., recognition of prior occurrence without recollection of episodic context). Accumulation of neurofibrillary tau in preclinical Alzheimer's disease begins in perirhinal cortex, a medial temporal lobe region linked to familiarity. Both observations would predict impaired familiarity assessment in aMCI; however, the extant evidence is mixed. To reveal familiarity impairments, it may be necessary to minimize the influence of recollection. In the current study, older adults with aMCI and healthy controls were administered two tasks on which a well-characterized patient (NB) with selective familiarity impairments due to surgical left temporal lobe excision sparing the hippocampus showed abnormal performance: frequency judgments for words exposed to in a recent study phase and judgments of cumulative lifetime familiarity for object concepts denoted by words. We also administered a process dissociation procedure (PDP) task that previously revealed spared familiarity in aMCI. We predicted that familiarity would be spared in aMCI on the PDP task, but impaired when assessed by frequency judgments for recent laboratory exposures and lifetime familiarity judgments. Familiarity was spared on the PDP task, but was impaired when probed with frequency judgments for recently exposed words in aMCI. Lifetime familiarity was also not impaired in aMCI. These results highlight the benefits of studying familiarity under conditions that minimize recollection and the value of frequency judgments in revealing familiarity deficits, and suggest that perirhinal cortex may not be necessary for accessing familiarity accumulated over a lifetime of experience.

Conflict monitoring on an emotional Stroop task. Comparison of healthy older adults and patients with major neurocognitive disorders due to probable AD

INTRODUCTION

The conflict monitoring system exerts an influence on centers responsible for cognitive control, causing them to intervene more strongly in processing when conflict occurs. These mechanisms are usually investigated through specific tasks where there is an inherent interference elicited by the congruency or incongruency between the stimuli and responses, such as the Stroop task. In studies of emotional conflict, one hypothesis related to the dorsal anterior cingulate cortex (ACC) is that it serves, in part, to signal the appearance of conflicts, thus triggering compensatory adjustments. This study aims to verify whether the conflict monitoring hypothesis is confirmed in a group with Alzheimer's disease and, therefore, whether they exhibit a reduction in their reaction times.

METHOD

A group of healthy older adults (HOA) and a group with Major Neurocognitive Disorders due to probable AD were evaluated to test the conflict monitoring hypothesis with an emotional Stroop task.

RESULTS

A significant interaction was obtained on the word and faces blocks. In the HOA group, a reduction in reaction times was observed, whereas in the AD groups, no reduction in reaction times was obtained.

CONCLUSIONS

Whereas in HOA the conflict monitoring hypothesis is confirmed, in the Major Neurocognitive Disorders due to probable AD group there is no reduction in their reaction times on the high conflict resolution trials (incongruent trials that follow incongruent trials) due to their difficulty in making compensatory adjustments to cognitive control that help them to reduce conflict and improve their success rate.

Longitudinal Patterns of the Tip-of-the-Tongue Phenomenon in People With Subjective Cognitive Complaints and Mild Cognitive Impairment

Background

The Tip-of-the-Tongue (ToTs) state is considered a universal phenomenon and is a frequent cognitive complaint in old age. Previous cross-sectional studies have found that ToT measures successfully discriminate between cognitively unimpaired adults and adults with Mild Cognitive Impairment (MCI). The aim of this study was to identify longitudinal patterns of ToTs in individuals with subjective complaints and with MCI regarding progress of their cognitive status.

Method

The study included 193 participants with subjective cognitive complaints (SCC) and 56 participants with MCI who completed a baseline and two follow-up assessments, with an interval of about 18 months between each assessment. Participants were classified into three groups by considering cognitive stability or deterioration from the baseline diagnosis: SCC-stable, MCI-stable and MCI-worsened. Participants performed a ToT task involving recognition and naming of famous people depicted in 50 photographs. Generalized Linear Mixed Models (GLMM) were used to model longitudinal changes in familiarity, feeling of knowing, semantic access, phonological access and verbal fluency.

Results

Phonological access differentiated MCI patients, stable and worsened, from adults with SCCs at all evaluation times. Phonological access declined over time in the three groups, without significant interactions between groups and time.

Discussion

This study provides the first longitudinal evidence of differences in ToT measures for adults with MCI. The findings indicate that phonological access measures successfully differentiated between the diagnostic groups. However, slopes remain irrespective of the diagnostic group and progression toward more advance stages of cognitive impairment.

Aging and recognition memory: A meta-analysis

Recognizing a stimulus as previously encountered is a crucial everyday life skill and a critical task motivating theoretical development in models of human memory. Although there are clear age-related memory deficits in tasks requiring recall or memory for context, the existence and nature of age differences in recognition memory remain unclear. The nature of any such deficits is critical to understanding the effects of age on memory because recognition tasks allow fewer strategic backdoors to supporting memory than do tasks of recall. Consequently, recognition may provide the purest measure of age-related memory deficit of all standard memory tasks. We conducted a meta-analysis of 232 prior experiments on age differences in recognition memory. As an organizing framework, we used signal-detection theory (Green & Swets, 1966; Macmillan & Creelman, 2005) to characterize recognition memory in terms of both discrimination between studied items and unstudied lures (d') and response bias or criterion (c). Relative to young adults, older adults showed reduced discrimination accuracy and a more liberal response criterion (i.e., greater tendency to term items new). Both of these effects were influenced by multiple, differing variables, with larger age deficits when studied material must be discriminated from familiar or related material, but smaller when studying semantically rich materials. These results support a view in which neither the self-initiation of mnemonic processes nor the deployment of strategic processes is the only source of age-related memory deficits, and they add to our understanding of the mechanisms underlying those changes. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Phonological false recognition produced by bottom-up automatic activation in young and older people

Two experiments explored a new procedure to implicitly induce phonological false memories in young and older people. On the study tasks, half of the words were formed from half of the letters in the alphabet, whereas the remaining words were formed from all the letters in the alphabet. On the recognition tests, there were three types of non-studied new words: critical lures formed from the same half of the letters as the studied words; distractors formed from the other half of the letters not used, and distractors formed from all the letters in the alphabet. In both experiments, the results showed that, in both young and older people, critical lures produced more false recognitions than distractors composed of all the letters in the alphabet, which, in turn, produced more false alarms than distractors composed of the letters not used during the study. These results support the predictions of the activation/monitoring models, which assume that false memories are partly due to activation spreading from items (semantically or phonologically) related to the critical words.

Impaired perceptual integration and memory for unitized representations are associated with perirhinal cortex atrophy in Alzheimer's disease

Unitization, the capacity to encode associations as one integrated entity, can enhance associative memory in populations with an associative memory deficit by promoting familiarity-based associative recognition. Patients with Alzheimer's disease (AD) are typically impaired in associative memory compared with healthy controls but do not benefit from unitization strategies. Using fragmented pictures of objects, this study aimed at assessing which of the cognitive processes that compose unitization is actually affected in AD: the retrieval of unitized representations itself, or some earlier stages of processing, such as the integration process at a perceptual or conceptual stage of representation. We also intended to relate patients' object unitization capacity to the integrity of their perirhinal cortex (PrC), as the PrC is thought to underlie unitization and is also one of the first affected regions in AD. We evaluated perceptual integration capacity and subsequent memory for those items that have supposedly been unitized in 23 mild AD patients and 20 controls. We systematically manipulated the level of perceptual integration during encoding by presenting object pictures that were either left intact, separated into 2 fragments, or separated into 4 fragments. Subjects were instructed to unitize the fragments into a single representation. Success of integration was assessed by a question requiring the identification of the object. Participants also underwent a structural magnetic resonance imaging examination, and measures of PrC, posterior cingulate cortex volume and thickness, and hippocampal volume, were extracted. The results showed that patients' perceptual integration performance decreased with the increased fragmentation level and that their memory for unitized representations was impaired whatever the demands in terms of perceptual integration at encoding. Both perceptual integration and memory for unitized representations were related to the integrity of the PrC, and memory for unitized representations was also related to the volume of the hippocampus. We argue that, globally, this supports representational theories of memory that hold that the role of the PrC is not only perceptual nor mnemonic but instead underlies complex object representation.

Motivated forgetting reduces veridical memories but slightly increases false memories in both young and healthy older people

The aim of the current study is to examine the effects of motivated forgetting and aging on true and false memory. Sixty young and 54 healthy older adults were instructed to study two lists of 18 words each. Each list was composed of three sets of six words associated with three non-presented critical words. After studying list 1, half of the participants received the instruction to forget List 1, whereas the other half received the instruction to remember List 1. Next, all the subjects studied list 2; finally, they were asked to remember the words studied in both lists. The results showed that when participants intended to forget the studied List 1, they were less likely to recall the studied words, but more likely to intrude the critical words. That is, we can intentionally forget something but this can also entail the intrusion of some related false memories.

Effects of Stimuli Repetition and Age in False Recognition

The aim of the current study is to examine the effects of stimuli repetition and age in false recognition using the Deese-Roediger-McDermott experimental paradigm. Two matched samples of 32 young adults and 32 healthy older adults studied 10 lists of six words associated with three non-presented critical words. On half of the lists, the words were presented once, and on the other five lists, the words were presented three times, always following a same sequential order. After each study list, participants performed a self-paced recognition test containing 12 words: the 6 studied words and 6 other non-studied words (the 3 critical words and 3 distractors). The results show that false recognition increases with age and declines in both samples with repetitions (although more in the young adults than in the older people). Results are discussed in relation to the dual-process theories of (false) memory.