Interest of a Hospital-Based Geriatric Living Lab among Inpatients with Neurocognitive Disorders: The ALLEGRIA Cross-Sectional Study.

INTRODUCTION: The objectives of this study were to determine the participation rates, levels of engagement, and abilities to answer User eXperience (UX) questionnaires according to the presence and severity of major neurocognitive disorders (MNCD) among participants involved in gerontechnological experimentations within a hospital-based geriatric clinical living lab. METHODS: Cross-sectional analysis examining all consecutive geriatric patients involved in the Allegro living lab experimentations, separated according to the presence and severity of MNCD. Participation rates were assessed using the "Task-Based Experiment"-type User eXperience (TBE-UX). Participation was considered successful if patients fully completed the TBE-UX experimental procedure. Engagement level was characterized using a five-point scale: interactive, constructive, active, passive, and disengaged. The abilities to answer UX questionnaires were characterized using a five-point scale from "no completion" to "completion in autonomy." RESULTS: 313 patients were included. All patients without MNCD and with mild MNCD fully completed the TBE-UX procedures. Their engagement behaviors were rather active and constructive. All patients without MNCD and 88% of those with mild MNCD were able to fully complete the UX questionnaires. 96.2% of the patients with moderate MNCD fully followed the TBE-UX procedures. Their engagement behaviors were mainly active or passive. 64.2% were able to fully complete the UX questionnaires. 76.5% of the patients with severe MNCD fully followed the TBE-UX procedures. Their engagement behaviors were mainly passive or disengaged. 35.3% were able to fully complete the UX questionnaires. CONCLUSION: Living lab experimentations appear feasible with older adults, even with those with MNCD. Task support can be offered to those with severe MNCD.

Social cognition in adult survivors of brain tumors: studying the relationship between theory of mind and quality of life.

OBJECTIVE: The present study is the first to examine theory of mind (ToM) sequelae in a sample of adult survivors of primary brain tumors, and to investigate the assumed relationship between ToM and health-related quality of life (HRQoL). METHOD: Participants were 40 long-term adult survivors of primary brain tumors and 40 matched healthy controls. They completed ToM tests (Faux-Pas test and Advanced ToM task) and two questionnaires assessing HRQoL (36-Item Short-Form Health Survey and EORTC QLQ-C30/QLQ-BN20). Their relatives also completed an observer-rated version of the SF-36 questionnaire. RESULTS: Survivors performed worse than controls only on the Advanced ToM task. Overall, patients and caregivers reported more problems than healthy controls and their relatives regarding both global HRQoL and its social/emotional aspects. No relationship was found between ToM and HRQoL scores. CONCLUSION: Adult survivors of primary brain tumors may exhibit ToM deficits several years after treatment and report more problems on social/emotional HRQoL components. Our findings highlight the need to consider these late effects in survivors' long-term follow-up, even if the clinical involvement of ToM deficits still needs to be elucidated. The assessment of ToM deficits and their potential impact on survivors' everyday life is thoroughly discussed.

Memory in Social Interactions: The Effects of Introspection on Destination Memory in Traumatic Brain Injury.

Destination memory, which is the ability to remember to whom one has sent information, is intimately associated with social cognition. We assessed whether processing attributes of destinations would improve destination memory in patients with traumatic brain injury (TBI). In this cross-sectional study, we tested the destination memory of 24 patients with TBI and 25 control participants in two conditions. On the first one (control condition), we invited participants to tell proverbs to celebrities' faces in order to decide, on a subsequent recognition test, whether they previously told that proverb to that celebrity or not. On the second condition (experimental introspection condition), the same procedures were repeated. However, after telling the proverbs, we invited participants to introspect about what the destination might believe about the proverbs (e.g., "What do you think that the celebrities would think about the proverbs?"). Group comparisons demonstrated better destination memory after the introspection than when no introspection was implemented in control participants, but there were no significant differences between the two conditions in patients with TBI. However, analyses of individual profiles demonstrated that more than half (n = 13) of the patients with TBI demonstrated better destination memory after introspection. While these results demonstrate a beneficial effect of introspection on destination memory for some cases of patients with TBI, more research is needed to reveal how introspection may influence patients' memory in social interactions.

"Ten euros now" temporal discounting in Huntington disease.

BACKGROUND: When making decisions, one often faces a trade-off between immediate and long-term rewards. In these situations, people may prefer immediate over later rewards, even if immediate rewards are smaller than later ones; a phenomenon known as temporal discounting. In this study, we, for the first time, assessed temporal discounting in three populations: participants with manifest Huntington disease (HD), participants with premanifest HD, and control participants. METHODS: Using the temporal discounting task, we invited participants to choose between small immediate amount of money vs. delayed, but larger amount of money (e.g., "Which do you prefer: you get 10 euros right now or 50 euros in a month?"). We also measured inhibition in order to test if it impacts discounting performance. RESULTS: Analysis demonstrated higher temporal discounting (i.e., a preference for the immediate rewards) in participants with manifest HD compared to those with premanifest HD or control participants, but no significant differences were observed in participants with premanifest HD and control participants. Analysis also demonstrated significant correlations between temporal discounting and scores on an inhibition test in participants with manifest HD, but not in those with premanifest HD or in control participants. DISCUSSION: We suggest that, when making decisions, patients with manifest HD may have difficulties with suppressing the temptation of smaller, but immediate, rewards.

Associations between Adult Primary Brain Tumor Survivors' Behavioral Executive Functions, Health Related Quality of Life and their Caregivers' Health Related Quality : A cross-sectional study.

The present study focused on adult primary brain tumor (PBT) survivors' caregivers. The main objective was to study associations between PBT survivors' health-related quality of life (HRQOL), their behavioral executive functions (EF) and their caregivers' HRQOL. Forty PBT survivors of PBT and 37 caregivers (mostly patient's spouses 81.08%; n = 30) participated in the study. PBT survivors completed a cancer related Quality of Life (QOL) questionnaire. Caregivers completed informant rated HRQOL and behavioral EF reports relating to PBT survivors and a self-rated HRQOL questionnaire relating to themselves. Correlational and multiple regression analyses were conducted. No associations were found between caregivers' physical HRQOL and PBT survivors' HRQOL nor behavioral EF. Analyses yielded several significant correlations between caregivers' mental HRQOL and variables pertaining to PBT survivors' HRQOL and behavioral EF. Multiple regression analyses showed that caregivers' mental HRQOL is predicted by PBT survivors' mental HRQOL, global cancer-related QOL scores and global behavioral EF scores. This study provides evidence suggesting that during the survivorship phase, at an average of 3.67 (SD = 2.31) years following treatment for a PBT, caregivers mental HRQOL is linked to PBT survivors' long-term effects. These findings shed some light regarding post-cancer care for both PBT survivors and their caregivers.

"What Did I Tell This Sad Person?": Memory for Emotional Destinations in Korsakoff's Syndrome.

We investigated destination memory, defined as the ability to remember to whom a piece of information was previously transmitted, for emotional destinations (i.e., a happy or sad person) in Korsakoff's syndrome (KS). We asked patients with KS and control participants to tell facts to neutral, positive, or negative faces. On a subsequent recognition task, participants had to decide to whom they told each fact. Compared with control participants, patients with KS demonstrated lower recognition of neutral, emotionally positive, and emotionally negative destinations. Patients with KS demonstrated lower recognition of emotionally negative than for emotionally positive or neutral destinations, but there were no significant differences between recognition of neutral and emotionally positive destinations. Our study demonstrates a compromised ability to process negative destinations in KS. Our study highlights the relationship between memory decline and impaired emotional processing in KS.

Destination Memory for Self-Related Information: When I Tell Elvis Presley about My Favorite Food.

Destination memory, the ability to remember to whom information was previously delivered, has found to be influenced by social processing and social interactions. This memory has also been shown to be compromised in normal aging. Our paper investigated whether older adults would demonstrate better destination memory for self-related information than for general information. METHODS: We asked younger adults and older adults to tell self-related information (e.g., "I like Chinese food") and semantic information (e.g., "the moon is smaller than the sun") to pictures of celebrities (e.g., Elvis Presley). RESULTS: Analysis showed higher destination memory for self-related information than for semantic information in older adults and younger adults. DISCUSSION: Older adults may draw on self-related information to improve memory and social interactions.

The talking eyes: Pupillometry to index verbal fluency in normal aging.

BACKGROUND: Verbal fluency tasks are widely used to assess cognitive and linguistic abilities in older adults. In this study, we investigated whether pupillometry can be used to measure verbal fluency in healthy older adults. METHODS: We invited 45 older adults (Mean age = 66.55 years, SD = 4.32) to perform a verbal fluency task, which involves generating as many words as possible beginning with the letter "P" for a duration of one minute. We also invited participants to perform a control task, which involves counting aloud for one minute. In both tasks, we recorded pupil activity with eye-tracking glasses. RESULTS: Analysis demonstrated a larger pupil size during the verbal fluency condition than in the counting condition. Significant positive correlations were observed between pupil size and correct responses on the verbal fluency task. CONCLUSION: The larger pupil size during the verbal fluency condition can be attributed to the cognitive load inherent in the verbal fluency task and/or to the ability of older adults to produce correct answers on this task. Our study demonstrates how pupillometry can be used as an ecological physiological assessment of not only verbal fluency, but also linguistic ability in general, in normal aging.

Does Sex Matter? High Semantic Autobiographical Retrieval in Women and Men With Alzheimer's Disease.

The decline of autobiographical memory in Alzheimer's disease (AD) is mainly characterized by overgenerality. While there is a large body of research on autobiographical overgenerality in AD, this research has mainly assessed retrieval with a dichotomy between specific vs. general retrieval. To go beyond this dichotomy, we assessed several degrees of autobiographical specificity in patients with AD, namely, we assessed specific vs. categoric vs. extended vs. semantic retrieval. We also assessed sex differences regarding these degrees of autobiographical specificity. We invited patients with mild AD and control participants to complete sentences (e. g., "When I think back to/of…") with autobiographical memories. Memories were categorized into specific, categoric, extended, or semantic memories. Results demonstrated more semantic than specific, categoric or extended memories in men and women with AD. In control participants, analysis demonstrated more specific than categoric, extended, and semantic memories in men and women. Also, no significant differences were observed between women and men with AD, or between control women and men, regarding specific, categoric, extended, and semantic memoires. This study offers not only a nuanced analysis of autobiographical specificity in patients with mild AD, but also an original analysis regarding this specificity by sex.

Empathy of individuals with Alzheimer's disease (AD) toward other AD patients.

BACKGROUND: The objective of this study was twofold. We assessed whether individuals with Alzheimer's disease (AD) demonstrate higher empathy toward people with the same disorder. We also assessed whether empathy may enhance the recognition of these peoples' faces. METHOD: Twenty-seven mild AD participants and 30 healthy older adults were invited to retain faces depicting either people diagnosed with AD or healthy people. Participants were also invited to rate their empathy toward all faces. RESULTS: Although AD participants reported higher empathy for "AD-labeled" than for "healthy" faces, recognition was similar for both categories of faces. Healthy older adults also reported higher empathy for "AD-labeled" than for "healthy" faces. However, they demonstrated higher recognition for "healthy" than for "AD-labeled" faces. CONCLUSIONS: Although our paper shows no effect of empathy on face recognition in AD, it provides a clinically relevant finding: individuals with mild AD can demonstrate significant empathy toward people with the same medical condition.

L'évaluation de la capacité de consentement sexuel chez les personnes âgées souffrant de démence : quelle place et quels outils pour les psychologues ?

Résumé Les capacités décisionnelles des personnes âgées présentant une démence comptent parmi les problématiques sociétales et éthiques les plus importantes dans le champ du vieillissement. La question est particulièrement épineuse lorsqu'il s'agit d'aborder la capacité de consentement sexuel chez ces personnes. En effet, des travaux montrent que les personnes âgées institutionnalisées (atteintes ou non de démences) conservent des intérêts et besoins sexuels similaires à ceux des personnes âgées vivant à domicile. Néanmoins, les personnes âgées cognitivement ou physiquement vulnérables constituent également un groupe à risque d'agressions et/ou de victimisation sexuelles, en particulier celles atteintes de démence sévère. Cet article s'intéresse à la place du psychologue et à la démarche qu'il peut développer pour évaluer la capacité de consentement sexuel chez le sujet âgé présentant une vulnérabilité cognitive. Abstract Decision-making capacities of older people with cognitive disorders are among the most important societal and ethical issues in the field of aging. The question is particularly thorny when it comes to addressing the issue of sexual consent capacity among these people. Indeed, research shows that institutionalized elderly people (with or without dementia) maintains sexual interests and needs similar to those of elderly people living at home. Nevertheless, cognitively or physically vulnerable elderly people also constitute a group at risk of sexual assault and/or victimization, and especially with people with severe dementia. This article examines the place of the psychologist and the approach he can develop to assess the capacity of sexual consent in the elderly subject with cognitive vulnerability. Following the recommendations of the American Bar Association/American Psychological Association for the assessment of capacity in older adults with diminished capacity, we make some propositions to assess psychological and neuropsychological functions implicated in sexual consent.

"Who will I be?": The future of the self as described by Alzheimer's disease (AD) patients.

We assessed how Alzheimer's disease (AD) patients would imagine their self in the future. AD patients and healthy controls were asked to generate statements beginning with "I-will-be" to describe how they saw themselves or how they wished to be in the future. These statements were analyzed in terms of four self-dimensions, i.e., physical self, social self, psychological self and self-cessation. The latter was investigated to assess how AD patients processed the idea of their own mortality. Findings demonstrated fewer total "I-will-be" statements in AD participants than in controls, suggesting that the construction of future self-concepts becomes weaker in the disease. Our results also demonstrated fewer statements related to the physical-self, the social-self and the psychological-self, and more statements related to self-cessation in AD participants than in controls. These findings suggest that AD patients are highly preoccupied by the idea of death when thinking about the future of their self.

On Covid-19 and mental health: An observational study on depression, anxiety, and loneliness during the second lockdown in patients with Alzheimer disease.

ABSTRACT: While visiting and socialization restrictions during lockdowns were instituted to cope with the Covid-19 spread and to prolong the life of residents of retirement homes, these measures could have been expected to decrease the quality of life of their residents.We assessed longitudinal effects of the two successive lockdowns, as implemented in France, on mental health (i.e., depression, anxiety, and loneliness) in 62 retirement home residents with Alzheimer disease (AD).Analysis demonstrated higher levels of depression, anxiety, and loneliness during the second lockdown than during the first lockdown.The increased levels of depression, anxiety, and loneliness during the second lockdown can be attributed to the longer duration of the restrictive measures, especially the restriction of visits, that were implemented in retirement homes. In addition, the increased workload of geriatric healthcare workers leading to higher levels of burnout and decreased quality of care may help explain the increased loneliness, depression, and anxiety of retirement home residents with AD, which were observed during the second Covid-19 era lockdown.

Frontal lobe functions in schizophrenia: Interest of the Stuss approach.

OBJECTIVE: The term Executive Functions (EFs) refers to the higher-level skills we use every day to control and coordinate our cognitive abilities and behaviours. EFs are mainly supported by the frontal lobes and its connections. EFs are frequently impaired in schizophrenia, but the profiles of executive deficits accompanying schizophrenia remains unclear. The use of specific EFs models might help to shed new light on this issue. Stuss (Stuss & Alexander, 2007; Stuss, 2008, 2011, 2017) proposed an integrative and operant model of EFs which has never been used to explore and characterize deficits in schizophrenia. The aim of this study is to further examine EFs in schizophrenia in the light of the frontal lobe functional approach developed by Stuss (2008, 2011, 2017) in order to question EFs impairment homogeneity and heterogeneity in schizophrenia. METHODS: Forty-five patients with schizophrenia and fifty-five healthy controls were recruited. They all completed a series of neuropsychological tests selected and adapted to measure the five majors' functions of the frontal lobe described by Stuss (2017). RESULTS: Patients showed deficits in almost all the frontal functions. Inside each frontal lobe function, correlations were observed between all the corresponding measures. The study of profiles highlighted a heterogeneous functioning in schizophrenia. CONCLUSIONS: The model of Stuss (Stuss & Alexander, 2007; Stuss, 2008, 2011, 2017) allows accurate and specific measures of the frontal functions and observation. Beyond "cold" or "hot" EFs division, this integrative approach is helpful to understand links within neurocognition.

The "Sickness" Memory: Can Patients With Alzheimer Disease Remember the Diagnosis Announcement?

BACKGROUND: Diagnosis of Alzheimer disease (AD) can cause substantial psychological distress in patients. We thus assessed how patients with AD remember the announcement of diagnosis. METHODS: We recruited 47 participants with mild AD (26 women; M age=68.89 y, SD=7.37; M years of formal education=9.74, SD=3.00). We invited the participants to remember the moment when their clinicians announced their diagnosis, within 6 months of the event, as well as a control memory, over the same period. We analyzed memory retrieval regarding specificity, as well as the subjective experience of retrieval (ie, regarding mental time travel, visual imagery, emotion and importance). RESULTS: No significant differences were observed between memory of diagnosis and control memory regarding specificity, mental time travel and visual imagery. However, memory of diagnosis triggered a more intense emotional experience and feeling of importance than control memory. DISCUSSION: Retrieval of the diagnosis announcement can activate a strong emotional and personally important experience in patients with AD. When remembering the diagnosis announcement, patients with AD may re-experience some features of that turning point in which they shift from "person" to "patient."

Neuropsychological assessment of patients with alzheimer's Disease in the presence or absence of spouses.

A common question in the neuropsychological testing of patients with Alzheimer's Disease is whether or not patients should be tested in the presence of their spouses. We addressed this issue by assessing the neuropsychological performances of Alzheimer's Disease patients in the presence or absence of spouses. Results showed no significant differences between patients' performances in the presence or absence of spouses on tests assessing general cognitive abilities, episodic memory, working memory, inhibition and flexibility. No significant differences were observed regarding either anxiety or depression in patients when tested alone, compared to when spouses were attending. However, patients demonstrated higher verbal fluency when tested alone compared to when spouses attended. Clinicians may carry out neuropsychological assessment in the presence or absence of spouses, except when assessing verbal fluency. In such cases, clinicians should privilege testing patients alone or, if spouses attend the test, take into account this variable when interpreting patients' performances.

"My sympathetic clinician": perception of sympathy by patients with Alzheimer's disease increases when asked to provide autobiographical memories.

BACKGROUND AND AIMS: Autobiographical memory serves to recall past personal experiences and share them with others, promoting social bonding and communication. In this study, we investigated whether encouraging patients with Alzheimer's disease (AD) to share autobiographical memories during formal neuropsychological testing may boost the patient-clinician relationship, and more specifically, the neuropsychologist's level of sympathy as perceived by patients. METHODS: We invited patients with mild AD to perform neuropsychological testing in two conditions. In one condition, we invited patients to retrieve and share two autobiographical memories after testing, while in a control condition, the testing session ended without asking patients to retrieve and share any autobiographical memories. After the two conditions, patients were invited to rate the neuropsychologist's level of sympathy towards them. RESULTS: Analysis demonstrated that patients perceived a higher level of sympathy when their neuropsychologist invited them to retrieve and share past personal experiences. DISCUSSION: By inviting patients with AD to retrieve past personal experiences, clinicians can promote a sense of sharing, create a social bond and, consequently, enhance the therapeutic relationship. In other words, by inviting patients with AD to share autobiographical memories, clinicians can promote a "social glue" with their patients, boosting mutual sympathy and patients' well-being.

Apathy and Huntington's Disease: A Literature Review Based on PRISMA.

OBJECTIVE: Although apathy is commonly reported among patients with Huntington's disease (HD), this psychiatric symptom has not yet been clearly defined or extensively studied in HD. Most researchers have adopted descriptive approaches, showing that apathy is a multidimensional entity but leaving the processes underlying its different dimensions relatively unexplored. METHODS: A systematic review of the literature on apathy in HD, focusing on current approaches and measurement tools, was conducted. RESULTS: Searches in PubMed and PubMed Central yielded 368 articles, 25 of which were included in the present review. CONCLUSIONS: This systematic review suggests that more comprehensive research is needed to help shed light on apathy in HD, especially regarding its multidimensional aspect and underlying mechanisms.

Social commitment toward prospective memory tasks in cognitively impaired non-demented individuals.

Prospective memory, which is the ability to remember to perform an intended action in the future, has been found to be diminished in cognitively impaired non-demented individuals (CIND). This study investigated whether providing CIND with a social motive would improve their prospective memory performance. Accordingly, CIND and controls were asked to perform a prospective memory task which includes one of the following three conditions: a reward (i.e., a candy bar), no feedback, or a social motive (i.e., that performing the prospective memory task would be a favor for the experimenter). The participants also rated their commitment to achieve the three prospective conditions. Results showed lower prospective memory in CIND than in controls. Unlike controls, CIND did not benefit from the social motive; however, both populations demonstrated commitment toward this condition relative to the "reward" or "control" conditions. Although social motivation did not ameliorate prospective memory, CIND seem to demonstrate commitment to perform prospective memory tasks that involve social benefits for others.

The discounted future: Relationship between temporal discounting and future thinking in Alzheimer's disease.

Temporal discounting refers to the tendency to prefer smaller sooner rewards over larger later rewards. Prior research has reported temporal discounting in Alzheimer's disease (AD). We thus investigated, in this study, the relationship between temporal discounting and future thinking in AD. The study included 40 patients with AD and 42 control participants. We invited participants, on a temporal discounting task, to choose between an immediate but smaller or a delayed but larger amount of money (e.g. "would you prefer 10 dollars today or 50 dollars after one month?"). We also invited the participants to imagine events that may happen in the future, a task known as future thinking. Analysis demonstrated a bias toward immediate rewards (i.e. temporal discounting) as well as difficulties to imagine specific future events in patients with AD. Critically, temporal discounting and future thinking in AD were significantly correlated. Generally speaking, a lack of thinking about the future may lead to impulsive behavior. More specifically, decline in future thinking in AD may limit the ability of patients to project themselves in time to consider outcomes of their decisions, resulting in a tendency to devaluate future rewards in favor of more imminent ones (i.e. temporal discounting).