Facial recognition memory deficits in normal aging and senile dementia

Face Recognition Characteristics in Patients with Age-Related Macular Degeneration Determined Using a Virtual Reality Headset with Eye Tracking

BACKGROUND AND OBJECTIVES

Face recognition is one of the most serious disabilities of patients with age-related macular degeneration (AMD). Our purpose was to study face recognition using a novel method incorporating virtual reality (VR) and eye tracking.

MATERIALS AND METHODS

Eighteen patients with AMD (seven male; median age 83 years; 89% with bilateral advanced AMD) and nineteen healthy controls (five male; median age 68 years) underwent the face recognition test IC FACES (Synthesius, Ljubljna, Slovenia) on a VR headset with built-in eye tracking sensors. Analysis included recognition accuracy, recognition time and fixation patterns. Additionally, a screening test for dementia and imaging with fundus autofluorescence and optical coherence tomography was performed.

RESULTS

AMD patients had significantly lower face recognition accuracy (42% vs. 92%; p < 0.001) and longer recognition time (median 4.0 vs. 2.0 s; p < 0.001) in comparison to controls. Both parameters were significantly worse in patients with lower visual acuity. In both groups, eye-tracking data revealed the two classical characteristics of the face recognition process, i.e., fixations clustering mainly in the nose-eyes-mouth triangle and starting observation in the nasal area.

CONCLUSIONS

The study demonstrates usability of a VR headset with eye tracking for studying visual perception in real-world situations which could be applicable in the design of clinical studies.

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).

Resilient memory for melodies: The number of intervening melodies does not influence novel melody recognition

In many memory domains, a decrease in recognition performance between the first and second presentation of an object is observed as the number of intervening items increases. However, this effect is not universal. Within the auditory domain, this form of interference has been demonstrated in word and single-note recognition, but has yet to be substantiated using relatively complex musical material such as a melody. Indeed, it is becoming clear that music shows intriguing properties when it comes to memory. This study investigated how the number of intervening items influences memory for melodies. In Experiments 1, 2 and 3, one melody was presented per trial in a continuous recognition paradigm. After each melody, participants indicated whether they had heard the melody in the experiment before by responding "old" or "new." In Experiment 4, participants rated perceived familiarity for every melody without being told that melodies reoccur. In four experiments using two corpora of music, two different memory tasks, transposed and untransposed melodies and up to 195 intervening melodies, no sign of a disruptive effect from the number of intervening melodies beyond the first was observed. We propose a new "regenerative multiple representations" conjecture to explain why intervening items increase interference in recognition memory for most domains but not music. This conjecture makes several testable predictions and has the potential to strengthen our understanding of domain specificity in human memory, while moving one step closer to explaining the "paradox" that is memory for melody.

Age Effects in Adaptive Criterion Learning

OBJECTIVE

Although prior work has examined age-related changes to criterion placement and flexibility, no study tested these constructs through a paradigm that employs adaptive feedback to encourage specific criterion changes. The goal of this study was to assess age differences in how young and older adults adapt and shift criteria in recognition memory decisions based on trial-by-trial feedback.

METHOD

Young and older adults completed an adaptive criterion learning paradigm. Over 3 study/test cycles, a biased feedback technique at test encouraged more liberal or strict responding by false-positive feedback toward false alarms or misses.

RESULTS

Older adults were more conservative than young, even when feedback first encouraged a liberal response bias, and older adults adaptively placed criteria in response to biased feedback, much like young adults. After first being encouraged to respond conservatively, older adults shifted criteria less than young when feedback encouraged more lenient responding.

DISCUSSION

These findings evidence labile adaptive criteria placement and criteria shifting with age. However, age-related tendencies toward conservative response biases may limit the extent to which criteria can be shifted in a lenient direction.

The impact of beliefs about face recognition ability on memory retrieval processes in young and older adults

This study examined whether beliefs about face recognition ability differentially influence memory retrieval in older compared to young adults. Participants evaluated their ability to recognise faces and were also given information about their ability to perceive and recognise faces. The information was ostensibly based on an objective measure of their ability, but in actuality, participants had been randomly assigned the information they received (high ability, low ability or no information control). Following this information, face recognition accuracy for a set of previously studied faces was measured using a remember-know memory paradigm. Older adults rated their ability to recognise faces as poorer compared to young adults. Additionally, negative information about face recognition ability improved only older adults' ability to recognise a previously seen face. Older adults were also found to engage in more familiarity than item-specific processing than young adults, but information about their face recognition ability did not affect face processing style. The role that older adults' memory beliefs have in the meta-cognitive strategies they employ is discussed.

Effects of spacing of item repetitions in continuous recognition memory: does item retrieval difficulty promote item retention in older adults?

BACKGROUND/STUDY CONTEXT: Older adults exhibit an age-related deficit in item memory as a function of the length of the retention interval, but older adults and young adults usually show roughly equivalent benefits due to the spacing of item repetitions in continuous memory tasks. The current experiment investigates the seemingly paradoxical effects of retention interval and spacing in young and older adults using a continuous recognition memory procedure.

METHODS

Fifty young adults and 52 older adults gave memory confidence ratings to words that were presented once (P1), twice (P2), or three times (P3), and the effects of the lag length and retention interval were assessed at P2 and at P3, respectively.

RESULTS

Response times at P2 were disproportionately longer for older adults than for younger adults as a function of the number of items occurring between P1 and P2, suggestive of age-related loss in item memory. Ratings of confidence in memory responses revealed that older adults remembered fewer items at P2 with a high degree of certainty. Confidence ratings given at P3 suggested that young and older adults derived equivalent benefits from the spacing between P1 and P2.

CONCLUSION

Findings of this study support theoretical accounts that suggest that recursive reminding and/or item retrieval difficulty promote item retention in older adults.

CREB regulates the expression of neuronal glucose transporter 3: a possible mechanism related to impaired brain glucose uptake in Alzheimer's disease

Impaired brain glucose uptake and metabolism precede the appearance of clinical symptoms in Alzheimer disease (AD). Neuronal glucose transporter 3 (GLUT3) is decreased in AD brain and correlates with tau pathology. However, what leads to the decreased GLUT3 is yet unknown. In this study, we found that the promoter of human GLUT3 contains three potential cAMP response element (CRE)-like elements, CRE1, CRE2 and CRE3. Overexpression of CRE-binding protein (CREB) or activation of cAMP-dependent protein kinase significantly increased GLUT3 expression. CREB bound to the CREs and promoted luciferase expression driven by human GLUT3-promoter. Among the CREs, CRE2 and CRE3 were required for the promotion of GLUT3 expression. Full-length CREB was decreased and truncation of CREB was increased in AD brain. This truncation was correlated with calpain I activation in human brain. Further study demonstrated that calpain I proteolysed CREB at Gln₂₈–Ala₂₉ and generated a 41-kDa truncated CREB, which had less activity to promote GLUT3 expression. Importantly, human brain GLUT3 was correlated with full-length CREB positively and with activation of calpain I negatively. These findings suggest that overactivation of calpain I caused by calcium overload proteolyses CREB, resulting in a reduction of GLUT3 expression and consequently impairing glucose uptake and metabolism in AD brain.

Can changes in eye movement scanning alter the age-related deficit in recognition memory?

Older adults typically exhibit poorer face recognition compared to younger adults. These recognition differences may be due to underlying age-related changes in eye movement scanning. We examined whether older adults' recognition could be improved by yoking their eye movements to those of younger adults. Participants studied younger and older faces, under free viewing conditions (bases), through a gaze-contingent moving window (own), or a moving window which replayed the eye movements of a base participant (yoked). During the recognition test, participants freely viewed the faces with no viewing restrictions. Own-age recognition biases were observed for older adults in all viewing conditions, suggesting that this effect occurs independently of scanning. Participants in the bases condition had the highest recognition accuracy, and participants in the yoked condition were more accurate than participants in the own condition. Among yoked participants, recognition did not depend on age of the base participant. These results suggest that successful encoding for all participants requires the bottom-up contribution of peripheral information, regardless of the locus of control of the viewer. Although altering the pattern of eye movements did not increase recognition, the amount of sampling of the face during encoding predicted subsequent recognition accuracy for all participants. Increased sampling may confer some advantages for subsequent recognition, particularly for people who have declining memory abilities.

Accuracy and Credibility of the Elderly Witness

Competency of witnesses depends upon the accuracy of their memory and their credibility. This paper addresses both of these factors with respect to the elderly. First, a review of the accuracy of the elderly eyewitness in recall and identification of a criminal suspect relative to that of young adults is presented. Secondly, the results of a study testing the perceptions of the legal community and the general public toward the elderly witness are given. And thirdly, the attitudes of the elderly toward police officers, trial judges, crown attorneys, and defense lawyers are discussed. Young adults were found to be seven to 20 per cent more accurate on the average than elderly subjects in recall for crime-related events and in the identification of a suspect. However, results also showed that some elderly subjects are equally as accurate as young adults in the visual identification of a suspect. Police officers, lawyers, probation officers, the general public, and elderly subjects rated the elderly witness relatively high in understandability, activity, potency, and evaluation. These judgements suggest that the credibility of the elderly witness is favorable. Finally, the study showed that elderly subjects perceive trial judges, prosecutors, and defense lawyers positively, and they are particularly supportive of the police.

Wechsler Memory Scale-III Faces test performance in patients with mild cognitive impairment and mild Alzheimer's disease

Little is known about the sensitivity of the Wechsler Memory Scale-Third Edition (WMS-III) Faces subtest to memory impairment associated with mild cognitive impairment (MCI). In this study, Faces performance was examined in 24 MCI patients, 46 mild Alzheimer's disease (AD) patients, and 98 elderly controls. We hypothesized that participants with diagnoses of MCI or AD would be impaired relative to controls on Faces. Analyses showed that AD participants performed significantly worse than MCI and intact participants, although there were no significant differences between MCI and intact participants. Data suggest that brain areas specialized for face recognition memory may be less affected by MCI and mild AD than regions specialized for verbal memory.

Age-related deficits in face recognition are related to underlying changes in scanning behavior

Previous studies demonstrating age-related impairments in recognition memory for faces are suggestive of underlying differences in face processing. To study these differences, we monitored eye movements while younger and older adults viewed younger and older faces. Compared to the younger group, older adults showed increased sampling of facial features, and more transitions. However, their scanning behavior was most similar to the younger group when looking at older faces. Moreover, while older adults exhibited worse recognition memory than younger adults overall, their memory was more accurate for older faces. These findings suggest that age-related differences in recognition memory for faces may be related to changes in scanning behavior, and that older adults may use social group status as a compensatory processing strategy.

Are faces special in Alzheimer's disease? Cognitive conceptualisation, neural correlates, and diagnostic relevance of impaired memory for faces and names

Memory for faces and names has increasingly become a focus of cognitive assessment and research in Alzheimer's disease (AD). This paper reviews evidence from cognitive and clinical neuroscience regarding the question of whether AD is associated with a specific deficit in face recognition, face-name association, and retrieval of semantic information and names. Cognitive approaches conceptualizing face recognition and face-name association have revealed that, compared to other types of visual stimuli, faces are "special" because of their complexity and high intraclass similarity, and because their association with proper names is arbitrary and unique. Neuroimaging has revealed that due to this particular status, face perception requires a complex interplay of highly specialized secondary visual areas located in the occipitotemporal cortex with a widely distributed system of cortical areas subserving further task-dependent processing. Our review of clinical research suggests that AD-related deficits in face recognition are primarily due to mnestic rather than perceptual deficits. Memory for previously studied or famous faces is closely related to mediotemporal and temporocortical brain regions subserving episodic and semantic memory in general, suggesting that AD-related impairments in this domain are due to neural degeneration in these areas. Despite limited specificity due to the apparent absence of a "genuine" domain-specific deficit of face memory in AD, testing memory for faces and names is useful in clinical contexts, as it provides highly sensitive indices of episodic and semantic memory performance. Therefore, clinical assessment of face memory can usefully contribute to early detection of memory deficits in prodromal and initial stages of AD, and represents a basis for further attempts at rehabilitation. Further advantages, such as ecological validity, high task comprehensibility and, in the case of novel face learning, independence from premorbid intelligence level, render measures of face recognition valuable for clinical assessment in early AD.

Episodic Encoding in Normal Aging: Attentional Resources Hypothesis Extended to Musical Material

The goal of the present study was to examine age-related changes in musical episodic memory for novel tunes. This was conducted by manipulating the encoding condition in a recognition paradigm. After receiving memory instructions (intentional condition), older and younger participants obtained equivalent hits. In contrast, when intentional encoding was accompanied by a dancing judgment (dancing + intentional condition), the recognition performance of the older persons was severely impaired. Impaired recognition was also found when participants only judged the excerpts without being instructed to memorize them (dancing judgment condition). Although older participants demonstrated a preserved ability to perform the dancing judgment on its own, this ability was not optimal and likely precluded the initiation of more elaborate encoding strategies. These results suggest that asking older persons to divide their attention in the study phase reduces the quality of their musical encoding. Given this extension to musical material, we discuss the notion that the age-related attentional resource decline appears to be domain-general rather than specific to verbal material.

Response bias and aging on a recognition memory task

Response bias reflects the decision rule an individual uses when faced with uncertainty on recognition memory tasks. Recent studies indicate frontal regions may mediate response bias performance. One theory of aging also implicates frontal lobe contributions in age-related cognitive changes. This suggests that frontal lobe changes may mediate response bias in older adults. Consistent with this frontal aging hypothesis, we predicted that response bias would become more liberal with age.

METHODS

Participants were 181 younger (30-49) and 112 older normal adults (75+) that were part of the California Verbal Learning Test-second edition (CVLT-2) normative sample (total n = 1078). We used parametric measures of discriminability and response bias provided by the CVLT-2 scoring program. Groups were similar in IQ and education. Multi-level regression models were created to examine the effects of moderating variables. The interaction between age and age group significantly predicted response bias. Post hoc analysis indicated that increasing age was associated with more liberal bias in the older but not in the younger group. In the light of reported relationships between frontal regions and both aging and response bias, we hypothesize that frontal changes may be the underlying mechanism explaining the increase in liberal response bias with age.

Aging and verbal memory span: a meta-analysis

Using Brinley plots, this meta-analysis provides a quantitative examination of age differences in eight verbal span tasks. The main conclusions are these: (a) there are age differences in all verbal span tasks; (b) the data support the conclusion that working memory span is more age sensitive than short-term memory span; and (c) there is a linear relationship between span of younger adults and span of older adults. A linear model indicates the presence of three distinct functions, in increasing order of size of age effects: simple storage span; backward digit span; and working memory span.

Face Recognition in the Elderly

PURPOSE

The purpose of this study was to assess face recognition ability in a large sample of elders (n=572, mean age=78.1 years) and to identify factors that affect performance.

METHODS

Face recognition was measured by presenting standardized faces of varying sizes to simulate normal-sized faces at different viewing distances. Subjects were asked to identify the name of the person and their facial expression. Threshold equivalent viewing distance (EVD) was calculated. High- and low-contrast acuity, contrast sensitivity, low-contrast/low-luminance acuity, disability glare, stereoacuity, and visual field measures (with and without an attentional task) were also measured. These vision measures, along with demographic information (age, sex, education) and cognitive status, were included in a multiple regression analysis to determine which factors predicted task performance.

RESULTS

This cross-sectional sample of elders showed significant declines in face recognition with age. Mean threshold EVD ranged from 8.0 m for participants<or=70 years of age to 2.2 meters for those over 85 years. Multiple regression analysis revealed that age, sex, years of education, spatial vision, and cognitive status were all significant predictors of face recognition, accounting for approximately 46% of the variability. Spatial vision (high-contrast acuity) and age were the best predictors. Although each spatial vision measure was significantly correlated with face recognition, adding low-contrast or contrast sensitivity measures to the regression analysis explained no more variance than age and high-contrast acuity alone.

CONCLUSIONS

The marked decline in face recognition ability in elders is related to declines in spatial vision and cognitive status. All spatial vision measures have similar predictive ability for face recognition.

Face recognition and aging: Effects of target age and memory load

In the present study, we investigated age-related decline in face recognition memory and whether this decline is moderated by the age of the target faces and by the number of faces that the participant must learn (memory load). Thirty-two participants in each of three age groups (18-39 years, 60-75 years, and 76-96 years) completed a face recognition task. Signal detection analyses confirmed that face recognition accuracy declined with age. However, this finding was qualified by an interaction between participant age and target age, which revealed that the age-related decline in face recognition accuracy occurred only for young target faces. Increased memory load was associated with comparable performance decrements across all age groups. However, memory load appears not to be the cause of these decrements. Instead, they appear to be a product of recognition load (the number of stimuli presented in the recognition phase).

Age-related changes in brain neuromagnetic responses to face perception in humans

In order to investigate the effects of ageing on face perception, we studied the magnetic responses to face images in 15 young (19-38 years) and 10 elderly (51-81 years) subjects. Face-specific responses (160mF), which originate in the inferior occipitotemporal cortices, and face non-specific responses (100m), which originate in the primary visual cortices, were evoked in all subjects. Averaged peak latency of the 160mF in the elderly group (174.0+/-9.1 ms) was significantly longer (P<0.0005) than that in the young group (161.5+/-5.1 ms), while no inter-group difference was found in the 100m latency. There was a significant correlation between age and 160mF latency (+0.35 ms/year, R=0.747) suggesting age-related decline of face perception.

Neural substrates for the recognition of newly learned faces: a functional MRI study

Face recognition is critical to the appreciation of our social and physical relations. Functional magnetic resonance imaging (fMRI) was used to identify brain regions involved in the recognition of newly learned faces. Two experiments were conducted. Experiment 1 contrasted a fixation control task with a face recognition task in which subjects were exposed solely to previously viewed faces (all-target). Experiment 2 compared a fixation control with another face recognition task in which subjects were presented with both novel and viewed faces (half-target). Compared to the fixation control, the all-target face recognition was associated with activation in the bilateral occipital and occipitotemporal regions, whereas the half-target face recognition produced activation in the right parietal and prefrontal regions, in addition to the occipital and occipitotemporal. The all-target minus half-target comparison revealed significant activation in the bilateral fusiform gyrus, suggesting stronger fusiform activity during the all-target than the half-target face recognition. The half-target minus all-target comparison showed significant activation in the superior and inferior parietal lobules and several regions in the right frontal lobe. These findings demonstrated that the bilateral fusiform gyrus is involved, not only in face perception, but in a certain aspect of face recognition memory and that this aspect is related to the actual recognition of previously viewed faces rather than the processing of novel ones, which results are consistent with previous lesion work. The right parietal and frontal regions, in contrast, are differentially more associated with the processes related to the detection of novel faces or retrieval effort.

An ERP study of famous face incongruity detection in middle age

Age-related changes in famous face incongruity detection were examined in middle-aged (mean = 50.6) and young (mean = 24.8) subjects. Behavioral and ERP responses were recorded while subjects, after a presentation of a "prime face" (a famous person with the eyes masked), had to decide whether the following "test face" was completed with its authentic eyes (congruent) or with other eyes (incongruent). The principal effects of advancing age were (1) behavioral difficulties in discriminating between incongruent and congruent faces; (2) a reduced N400 effect due to N400 enhancement for both congruent and incongruent faces; (3) a latency increase of both N400 and P600 components. ERPs to primes (face encoding) were not affected by aging. These results are interpreted in terms of early signs of aging.

Effects of age, education, and sex on response bias in a recognition task

This study examined age-related differences in decision criteria and the extent to which inconsistencies in earlier findings could be due to sampling artifacts, especially the underlying effects of educational level and sex. Male and female participants (N = 3,059) from 4 age groups (32, 42, 52, and 62 years) and a wide range of educational levels performed a word recognition task. Response bias was assessed with a nonparametric index derived from signal detection theory. The analyses revealed no age differences except for the most educated subjects, for whom increased age was associated with stricter decision criteria. Lower levels of education and men as compared with women were associated with a more conservative bias. Controlling for the level of sensitivity did not significantly change this pattern of results. This finding stresses the need for caution in generalizing age differences obtained from samples that are only partly representative or imbalanced with respect to education and sex.

Age differences in accuracy and choosing in eyewitness identification and face recognition

Studies of aging and face recognition show age-related increases in false recognitions of new faces. To explore implications of this false alarm effect, we had young and senior adults perform (1) three eye-witness identification tasks, using both target present and target absent lineups, and (2) and old/new recognition task in which a study list of faces was followed by a test including old and new faces, along with conjunctions of old faces. Compared with the young, seniors had lower accuracy and higher choosing rates on the lineups, and they also falsely recognized more new faces on the recognition test. However, after screening for perceptual processing deficits, there was no age difference in false recognition of conjunctions, or in discriminating old faces from conjunctions. We conclude that the false alarm effect generalizes to lineup identification, but does not extend to conjunction faces. The findings are consistent with age-related deficits in recollection of context and relative age invariance in perceptual integrative processes underlying the experience of familiarity.

Establishing the limits of normal cerebral ageing and senile dementias

Cognitive deterioration is so commonly observed in the elderly that it is considered by many to be an inevitable feature of the ageing process. Some researchers have proposed that the senile dementias are the inevitable end-point of this process, should the person live long enough. The differentiation of normal cerebral ageing from disease process is important in the selection of control groups for research, and also for clinical decision-making. In the latter context it is important to ask at what level of dysfunction intervention should occur, and whether this should be active or palliative. Cognitive change in the elderly is here considered from biological, neuropsychological and epidemiological viewpoints. Current research suggests that senile dementia is the result of the interplay of genetically determined disease processes, ageing-related decline which may be regulated at a cellular level, and neuronal repair and compensation mechanisms. Therefore, to debate whether dementia is simply an extension of a normal ageing process or not is probably too simplistic an approach.

Retrieving names in old age: short- and (very) long-term effects of repetition

Two experiments are reported that examine the effects of repetition on name retrieval in younger adults (in their 50s and 60s) and older adults (in their 70s and 80s). In Experiment 1, the subjects were asked to name a set of famous faces four times over the course of a 1-h session. Younger subjects produced significantly more correct responses than did older subjects. There was significant improvement with repeated attempts at naming, with younger and older subjects benefiting equally in terms of increasing numbers of correct responses across the session. In contrast, there was a highly significant age deficit in picture recognition over a similar retention interval. A qualitative analysis of naming responses (full name vs. part of the name) provided support for the view that aging and nonrecent use have equivalent effects on retrieval. In Experiment 2, younger subjects (but not older subjects) were significantly more likely to correctly name famous faces that they had seen 22 months previously than to correctly name new famous faces. In contrast, older subjects (but not younger subjects) were significantly more likely to produce erroneous names to famous faces that they had seen 22 months previously than to new famous faces. It is concluded that repetition priming may be relatively unaffected by aging over short retention intervals (Experiment 1) but not over a very long retention interval (Experiment 2).

Mood recognition across the ages

A cross-sectional study was conducted in which level of mood recognition was assessed from early childhood through old age. Asymptotic performance was obtained on facial affect recognitions tasks from ages 3-34 yrs. There was a progressive decline in facial affect recognitions beginning at age 45, with the principal problem that of recognizing angry faces. With respect to auditory prosody, there was an improvement in recognition level from ages 3-12 yrs. Performance remained asymptotic through age 43 and then began to decline increasingly beyond age 45.

Hippocampal formation size in normal human aging: a correlate of delayed secondary memory performance

Although mild progressive memory impairment is commonly associated with normal human aging, it is unclear whether this phenomenon can be explained by specific structural brain changes. In a research sample of 54 medically healthy and cognitively normal elderly persons (ages 55-87, x = 69.0 +/- 7.9), magnetic resonance imaging (MRI) was used to derive head-size-adjusted measurements of the hippocampal formation (HF) (dentate gyrus, hippocampus proper, alveus, fimbria, subiculum), the superior temporal gyrus (STG), and the subarachnoid cerebrospinal fluid (CSF) (to estimate generalized cerebral atrophy). Subjects were administered tests of primary memory (digit span) and tests of secondary memory with immediate and delayed recall components (paragraph, paired associate, list recall; facial recognition). Separate composite scores for the immediate and delayed components were created by combining, with equal weighting, the subtests of each category. The WAIS vocabulary subtest was used as a control measure for language and intelligence. A highly significant correlation (P < 0.001), independent of age, gender, and generalized cerebral atrophy was found between HF size and delayed memory performance. No significant correlations were found between HF size and primary or immediate memory performance. STG size was not significantly correlated with any of the composite memory variables. These results suggest that HF atrophy may play an important independent role in contributing to the memory loss experienced by many aging adults.

A longitudinal study of cognitive function in elderly persons with subjective memory complaints

OBJECTIVE

To assess change in cognitive function in elderly individuals with subjective memory loss over a follow-up interval of more than 3 years.

DESIGN

Prospective cohort study.

SETTING

An outpatient research clinic in aging and dementia at a university hospital.

PARTICIPANTS

A convenience sample of 59 healthy, elderly individuals (mean age 68.7 years) with memory complaints but no clinically apparent cognitive dysfunction.

MEASUREMENTS

Participants were given a full diagnostic evaluation and were administered a neuropsychological test battery at baseline and follow-up. The cognitive assessment battery included 12 tests of recent memory, immediate memory, language function, visuospatial praxis, and psychomotor speed. Most of the tests had been established to be sensitive to cross-sectional age differences.

RESULTS

Of 59 subjects, 54 (91.5%) were successfully followed up an average of 3.4 years later. Between baseline and follow-up, two tests exhibited significant improvement, two tests exhibited significant decline, and the other eight were unaffected.

CONCLUSION

Elderly individuals with subjective perceptions of cognitive decrements who fail to provide clear evidence of cognitive impairment upon clinical interview are not at high risk for progressive cognitive deterioration over the subsequent 3- to 4-year interval.

A two-year longitudinal study of cognitive function in normal aging and Alzheimer's disease

A group of 136 elderly subjects were administered a comprehensive neuropsychological test battery, which was readministered 2 years later. Among the 136 elderly subjects, 86 were assigned a diagnosis of probable Alzheimer's disease. An additional 33 young subjects were administered the assessment battery at baseline only. The normal elderly group exhibited no decline in cognitive test performance over the 2-year follow-up interval. Subjects with mild cognitive impairment, however, were as likely to deteriorate between baseline and follow-up as the more severely impaired subjects. The tests that exhibited longitudinal decline in the Alzheimer's disease patients constituted a subset of the tests that revealed cross-sectional deficits relative to the normal elderly. Differences in baseline cognitive test performance and in rate of cognitive deterioration were examined in relatively young versus relatively old Alzheimer's disease patients. Potential psychometric predictors of cognitive decline in the normal elderly were identified.

Influence of processing speed on adult age differences in working memory

Two studies are reported in which adults ranging from 18 to 80 years of age performed tasks designed to measure working memory functioning and perceptual comparison speed. The results from both studies indicated that statistical control of the measures of perceptual comparison speed greatly attenuated the age-related variance in measures of working memory even when working memory was assessed under self-paced conditions. Additional results in the second study supported the hypothesis that the speed influence was manifested in the rate of activating information rather than in the rate at which it was lost as a function of time or other processing.

The association of memory complaint with computer-simulated everyday memory performance

The relationship of memory self-report to self-rated depression and to actual performance on computer-simulated everyday memory tasks was investigated in 125 normal adults. Canonical correlation analyses demonstrated that self-rated memory performance and objective computer-simulated everyday memory performance shared from 27.9% to 29.4% of common variance. These data provide initial concurrent validity for a new memory self-report scale, the MAC-S. Results are discussed in relation to psychometric factors important in the design and validation of self-report memory scales.

Familiarity and recognition of faces in old age

Elderly persons exceed young adults in false recognitions of new faces. One account claims there are age-related deficits in memory for context of encounter with faces. Because of these deficits, elderly persons frequently recognize faces on the basis of perceived familiarity (i.e., resemblance to face representations in memory), which is high for some new faces. To test this context-recollection hypothesis, we had young adult and elderly subjects judge whether faces: (1) had been seen previously in a test (though no face was repeated), and (2) were subjectively familiar (though no face was famous). The elderly exceeded the young subjects in seen-before judgements (false recognitions), and only the elderly showed a positive correlation between false recognitions and subjective familiarity. In Experiment 2, this finding was extended from false recognitions to correct recognitions, supporting the view that elderly persons, compared to young adults, rely more on resemblance in recognizing faces.

False recency and false fame of faces in young adulthood and old age

Studies of age differences in face recognition have shown age-related increases in false-alarm errors: elderly persons exceed young adults in judging new faces to be old. To distinguish among theoretical accounts of this finding, we compared young and elderly subjects in two recognition tasks: (1) that of judging whether faces were recent or nonrecent, and (2) that of judging whether faces were famous or nonfamous. The major independent variable was prior presentation of faces-including nonrecent and nonfamous foils-1 week before the test. False recent judgments in response to nonrecent faces and false famous judgments in response to nonfamous faces were higher among the elderly. Moreover, these age-related differences in false-alarm rates were larger for faces viewed 1 week previously than for entirely new faces. The findings suggest that, compared to young adults, older individuals rely relatively more on perceived familiarity, and relatively less on recollection of context, in making recognition decisions.

Recognition memory across the adult life span: the role of prior knowledge

Two experiments were performed to investigate the effects of prior knowledge on recognition memory in young adults, younger old adults, 76-year-olds, and 85-year-olds. In Experiment 1, we examined episodic recognition of dated and contemporary famous persons presented as faces, names, and faces plus names. In Experiment 2, four types of faces were presented for later recognition: dated familiar, contemporary familiar, old unfamiliar, and young unfamiliar. The results of both experiments showed that young adults performed better with contemporary than with dated famous persons, whereas the reverse was true for all groups of older adults. In addition, the data of Experiment 2 indicated that (1) young adults showed better recognition for young than for old unfamiliar faces, (2) younger old adults performed better with old than with young unfamiliar faces, and (3) the two oldest age groups showed no effect of age of face. These results suggest that the ability to utilize rich semantic knowledge to improve episodic memory is preserved in very old age, although the aging process may be associated with deficits in the ability to utilize prior knowledge to support memory when the underlying representation lacks semantic and contextual features. The overall data pattern was discussed in relation to the notion that, with increasing adult age, there is an increase in the level of cognitive support required to enhance episodic remembering.

Diagnosis, assessment and treatment of age-associated memory impairment

We have reviewed diagnostic criteria and assessment procedures for AAMI, as well as pharmacologic and behavioral treatments for this condition. This research gives reason to hope that an important behavioral deficit associated with aging may be modified through drug and behavioral treatment.

The Misplaced Objects Test: a measure of everyday visual memory

The Misplaced Objects Test is a computerized test of object location recall. The test is structurally similar to tasks used in the evaluation of age and drug effects in preclinical animal research. Delayed recall of 20 common objects which the subject has placed using a touch sensitive screen in a computer-simulated 12-room house is evaluated with three measures. Scores include the number of objects found on the first attempt (Found 1), the number of objects found on the second attempt (Found 2), and the total number of objects found on both attempts (Found T). Performance was evaluated in relation to age, gender, education, and affective status, as well as in relation to several traditional neuropsychological measures. Misplaced Objects Test performance was most strongly associated with age and Wechsler Memory Scale Paired Associate Learning. Additional significant relationships were found with gender, education, and the WAIS Digit Symbol subtest. Potential future applications of the test were discussed.

Signal-detection analysis of nonverbal recognition memory in dementia

A signal-detection analysis was applied to performance on two non-verbal recognition memory tasks for 21 subjects with presumed dementia of the Alzheimer type, 19 subjects with presumed multi-infarct dementia, and 19 elderly depressed subjects. Performance was best for the depressed and worst for the Alzheimer subjects. Response bias did not differ significantly among groups. Within the depressed group, more impaired and older subjects were more conservative on one test. Correlations suggested that the sensitivity and response-bias measures may depend on the type of material used and so have limited generality.

Recognition memory for words and faces in primary degenerative dementia of the Alzheimer type and normal old age

The suitability of Warrington's Recognition Memory Test (RMT) for discriminating between patients with dementia of the Alzheimer type and nondemented elderly subjects was tested in a study with 44 patients (aged 59 to 94) and 45 normal elderly (aged 69 to 92). The patients showed a significant memory deficit, both in Recognition Memory for Words (RMW) and Recognition Memory for Faces (RMF), even when the scores were corrected for verbal intelligence score (WAIS Vocabulary) or a measure of visuoperceptual ability (Raven's Coloured Progressive Matrices, CPM). Word-face discrepancy scores did not differentiate between dementia and normal old age. At the 95%-specificity level, the sensitivity of RMW and RMF for the detection of memory impairment in dementia was 81% and 100% for subjects below 80, and, less satisfactory, 59% and 76% for subjects of 80 years or older. Correlational analysis showed that the patients' RMW and RMF scores were moderately correlated (r = .40). The significant correlation (r = .45) between CPM and RMF suggests that visuoperceptual deficits are involved in deficient face recognition.

Scopolamine effects on memory, language, visuospatial praxis and psychomotor speed

Scopolamine hydrobromide was administered by subcutaneous injection to 30 young subjects in a dose of 0.22 mg/70 kg, 0.43 mg/70 kg, or 0.65 mg/70 kg. Treatment effects were compared to placebo on an extensive cognitive assessment battery. Almost all tests in the battery had been previously administered to Alzheimer's disease patients and nondemented elderly subjects. Scopolamine produced deficits on tests of verbal recall, visuospatial recall, visual recognition memory, visuospatial praxis, visuoperceptual function, and psychomotor speed. Immediate memory, language function, object sorting, and frequency of intrusion errors were unaffected. The low dose of scopolamine produced some peripheral anticholinergic signs but did not affect the cognitive measures. The results support the conclusion reached in previous studies that the cognitive profile of scopolamine-injected young subjects is more similar to that of the nondemented elderly than to that of Alzheimer's disease patients.

Age differences in the vulnerability of facial recognition memory to proactive interference

A facial recognition memory task was administered to 16 young subjects (age range 18-30) and 28 elderly subjects (age range 63-83). A continuous recognition paradigm was used, in which subjects were instructed to identify the repeated faces in an ongoing series of faces presented on a video monitor screen. A signal detection analysis of the data revealed a mild recognition memory deficit in the elderly, due mainly to an increase in false positives during the second half of the test session. This age-specific increase in late-session false alarms may be a result of increased sensitivity of the aged subjects to proactive interference from previously presented faces. Increasing the length of the delay between the initial and repeat presentation of a face decreased recognition accuracy in both groups, but the young subjects were more sensitive to the delay interval effect than the elderly. Multiple presentations of faces produced a comparable improvement in the recognition accuracy of both young and old subjects. The elderly subjects exhibited a more liberal response bias than the young subjects, indicating that impaired memory task performance of the aged subjects cannot be attributed to a more conservative test-taking strategy.

Clock drawing in Alzheimer's disease. A novel measure of dementia severity

We have tested a simple and reliable measure of visuospatial ability in Alzheimer patients--the Clock Drawing Test. To determine the usefulness of this measure, we asked 67 Alzheimer patients and 83 normal controls to draw the face of a clock reading the time of 2:45. Six independent observers blindly evaluated the results with ratings from 10 (best) to 1 (worst). The mean performance score of Alzheimer subjects was 4.9 +/- 2.7 compared to 8.7 +/- 1.1 for normal controls (P less than .001). Inter-rater reliability for the clocks drawn by Alzheimer patients was highly significant (r = 0.86; P less than .001), and there was relatively little overlap between ratings for Alzheimer patients and normal controls. Furthermore, correlations were highly significant (P less than .001) between the mean score of clock drawings and three independent global measures of dementia severity. Although the Clock Drawing Test is certainly not a definitive indicator of Alzheimer's disease, the test is easy to administer and provides a useful measure of dementia severity for both research and office settings where sophisticated neuropsychological testing is not available.