Decision-making and ageing: everyday life situations under risk and under ambiguity.

Cognitive modifications during ageing can affect decision-making competence (DMC). As this ability is central to the preservation of autonomy, our study aims to investigate how it changes in elderly adults and to determine whether such changes are linked to the deterioration of executive functions and working memory. To this end, 50 young adults and 50 elderly adults were assessed with executive, working memory, and DMC tasks. The latter comprised the Iowa Gambling Task (IGT) and a scenario task based on situations inspired by everyday life, under conditions of both risk and ambiguity. The results revealed lower performances in old than in young adults for the updating, inhibition, and working memory tasks. The IGT failed to distinguish between the two age groups. However, the scenario task did permit such a distinction, with young adults seeking more risky and ambiguous choices than elderly adults. Moreover, updating and inhibition capacities appeared to influence DMC.

Modulation of maintenance and processing in working memory by negative emotions.

Previous research has shown that working memory processes are affected by emotions. However, it is not clear if both components - maintenance and processing of information - are modulated by emotion. Since emotion is intimately related to attention, we focused on attentional maintenance in working memory. In a previous study, using a complex span task, we showed that processing emotionally negative information reduced maintenance of neutral information in working memory. The objective of the present study was first to replicate the results of our previous study and second to investigate whether maintaining emotional information would affect processing of neutral information. In Experiment 1, young adults were asked to remember a series of five letters each followed by images, either negative or neutral, to be categorized. In Experiment 2, participants were required to memorize a series of five images, either negative or neutral, each followed by digits to be categorized. In order to focus on attentional maintenance, in both experiments the tasks were performed under continuous articulatory suppression. In Experiment 1, longer processing times were observed for emotional stimuli than neutral ones, and lower recall of series of letters when negative stimuli were processed. In Experiment 2, higher memory performance was observed for negative images than neutral ones and longer processing times of digits when a series of negative stimuli was maintained. Overall, our results show that emotion impacts both processing and attentional maintenance in working memory. This is consistent with models of working memory suggesting an attentional trade-off between maintenance and processing.

Decision-Making in Alzheimer's Disease: The Role of Working Memory and Executive Functions in the Iowa Gambling Task and in Tasks Inspired by Everyday Situations.

BACKGROUND: Alzheimer's disease (AD) negatively impacts patients' ability to make advantageous decisions, i.e., a core ability contributing to the preservation of autonomy. OBJECTIVE: The present study aims to analyze the changes that occur in the decision-making competence (DMC) in AD patients and to determine if these changes are related to the deterioration of executive functions and working memory. METHOD: To this end, 20 patients with AD and 20 elderly control adults were assessed using executive, working memory, and DMC tasks. The latter comprised the Iowa Gambling Task (IGT) and a scenarios task based on situations inspired by everyday life and performed under conditions of risk and ambiguity. RESULTS: Results revealed lower performances in AD patients than in elderly control adults for all the tasks assessing cognitive functions. The AD patients also made more strategy changes during the IGT. In the scenarios tasks, the two groups took as many ambiguous or risky decisions, but AD patients tended to take more risks in the context of gain than elderly control adults did. Switching and updating ability, as well as working memory, appeared to be involved in decisions in tasks inspired by everyday life, while inhibition was more related to the IGT performances. CONCLUSION: Working memory and executive functions seem to be involved in decision-making, but in different ways in gambling and daily-life situations.

Processing of Facial Expressions of Emotions and Pain in Alzheimer's Disease.

BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative pathology that disrupts processing of facial expressions of emotion. The impairment was demonstrated for negative emotions in tasks of matching, discriminating, and labeling facial expressions but no study has included the expression of pain in its protocol. OBJECTIVE: The objective was to study the processing of emotional facial expressions in AD with a particular interest in pain expression. METHODS: Twenty-seven controls, 15 mild AD patients, and 15 moderate AD patients had to perform four emotional tasks: identification of facial expressions, matching pain expressions, discriminating the intensity of pain expressions, and judging pain intensity. RESULTS: Some emotions were less efficiently recognized by AD patients compared to controls (p < 0.001), specifically fear from the mild stage (p < 0.05), pain and disgust from the moderate stage (p < 0.05 and p < 0.001 respectively). The Exploratory Factor Analysis showed that recognition of pain and recognition of other discreet emotions were underpinned by two different latent factors. Performances on pain expression matching task and pain intensity discrimination task did not differ by group. (p = 0.334 and p = 0.787 respectively). Finally, moderate AD patients judged the pain less intensively than the Control group for both, moderate, and severe pain intensity (p < 0.001). CONCLUSION: Our data suggest that AD disrupts the recognition of pain expression along with recognition of fear and disgust. Additionally, AD patients seem to underestimate pain intensity compared to controls. The self-rated pain scales should be adapted to the pain processing deficit of AD patients.

Embodied cognition and emotion, two variables improving memory abilities in Parkinson's and Alzheimer's diseases.

OBJECTIVE: This study investigated whether emotions and enactment can jointly increase memory performance in nondemented Parkinson's disease (PD) and Alzheimer's disease (AD) patients. METHOD: Actions' drawings with negative, positive, or neutral valence were presented to 17 PD patients, 17 AD patients, and 37 elderly controls, matched to age. Two conditions of intentional encoding were proposed to each participant: one verbal, in which participants had to name the represented actions; and one motor, in which they had to mime the displayed actions. Thereafter, participants were submitted to an immediate free recall task and a delayed recognition task. RESULTS: The enactment effect was found in all three groups. The effect of emotion was also observed in that all three groups recalled negative actions better than both neutral and positive (PD patients), only neutral (AD patients), or only positive actions (elderly controls). Positive actions were not recalled better than neutral actions in any group. CONCLUSIONS: These results constitute an evidence for the preservation of the enactment effect and of the emotion effect on memory in AD and PD patients. However, they do not support the hypothesis of the combined effect of emotion and enactment on memory, neither in AD and PD patients nor in normal aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Study design and protocol of a low to high intensity computer-based cognitive training at home in supplement to standard care in patients with AD.

INTRODUCTION: Recent studies on cognitive training in patients with Alzheimer's disease (AD) showed positive long-term effects on cognition and daily living, suggesting remote computer-based programmes to increase training sessions while reducing patient's travelling. The aim of this study is to examine short-term and long-term benefits of computer-based cognitive training at home in patients with mild to moderate AD, as a complement to the training in speech and language therapists' (SLT) offices. The secondary purpose is to study training frequency required to obtain noticeable effects. METHODS AND ANALYSES: This is a national multicentre study, conducted in SLT offices. The patients follow training in one of three conditions: once a week in SLT office only (regular condition) and once a week in SLT office plus one or three times per week at home. The trainings' content in SLT office and at home is identical. For all three groups near and far transfer will be compared with evaluate training frequency's effect. Our primary outcome is executive and working memory scores in experimental tasks, and the secondary is neuropsychological tests and questionnaires' scores. Linear models' analyses are considered for all measures with a random intercept for patients and another for per practice. The fixed effects will be: three modality groups and time, repeated measures, (T0-pretraining, T1-post-training, T2-long-term follow-up) and the interaction pairs. ETHICS AND DISSEMINATION: The study got ethics approval of the national ethical committee CPP Sud Méditerranée III (No 2019-A00458-49) and of the National Commission for Information Technology and Liberties (No 919217). Informed consent is obtained from each participant. Results will be disseminated in oral communications or posters in international conferences and published in scientific journals. TRIAL REGISTRATION NUMBER: NCT04010175.

Emotional modulation of episodic memory in children and adolescents with Williams-Beuren syndrome.

Children and adolescents with Williams-Beuren syndrome (WBS) have been described as having specific memory abilities and emotional reactivity. Although it is well established in the literature that emotion can enhance memory, no such studies have been undertaken in individuals with WBS. In three experiments, the present study tested whether the negative or positive emotional valence of stimuli can influence verbal, visual and visuo-spatial memory by specifically evaluating two memory components: item and associative memory. Sixteen 8- to 18-year-old individuals with WBS performed the first two experiments and, among them, twelve participated in the third. They were compared to equivalent groups of typically developing control children. Participants completed intentional-encoding tasks followed by immediate item recognition, associative recall or item recall tasks. Event-related potential measures during encoding and recognition of pictures were also added in the third experiment. Results demonstrated, for the first time, effects of emotions on visual item memory and visuo-spatial associative memory in individuals with WBS, that were similar to those observed in typically developing children. By combining behavioral and neural measures, our study provides new knowledge of the interaction between emotion and memory in WBS individuals, which seems to be unaffected by their atypical development.

Memory for a virtual reality experience in children and adults according to image quality, emotion, and sense of presence.

Numerous studies have explored the effects of virtual reality (VR) on adults' cognition. Little is known, however, of these effects in children. The aim of this study was to explore, in both children and adults, the respective roles of the specific factors of VR, such as immersion, sense of presence and emotion, on memory performance. To do so, we used a head-mounted display to present a VR experience in which we manipulated immersion by varying 3D asset quality (High and Low) and emotion by presenting negative, neutral and positive stimuli. 48 adults (M age = 20.65) and 40 children (M age = 11.63) were both divided into two experimental groups (High vs. Low 3D model quality). Valence, arousal, and sense of presence were self-assessed by means of questionnaires, while memory of the presented stimuli was assessed using a free recall task. We also performed physiological measurements to provide objective support for our data. Results showed that memory performance was better for emotional than for neutral stimuli regardless of age group, even though children seemed to avoid looking at negative stimuli compared to neutral ones. Memory was predicted by arousal and presence in adults and only by arousal in children. Memory was not impaired by using poor image quality when highly arousing content was displayed. This study revealed that, contrary to adults, the use of poor image quality did not protect children from strong emotional experiences in VR. The roles of familiarity and arousal are discussed to help explain these results. Supplementary Information: The online version contains supplementary material available at 10.1007/s10055-021-00537-y.

Emotional Modulation of Episodic Memory in School-Age Children and Adults: An Event-Related Potential Study.

The Emotional Enhancement of Memory (EEM) has been well-demonstrated in adults, but less is known about EEM in children. The present study tested the impact of emotional valence of pictures on episodic memory using behavioral and neurophysiological measures. Twenty-six 8- to 11-year-old children were tested and compared to 30 young adults. Both groups participated in pictures' intentional encoding tasks while event-related potentials (ERPs) were recorded, followed by immediate free recall tasks. Behavioral results revealed a general EEM in free recall performances in both groups, along with a negativity effect in children. ERP responses revealed a particular sensitivity to negative pictures in children with a late emotion effect at anterior clusters, as well as a greater successful encoding effect for emotional pictures compared to neutral ones. For adults, the emotion effect was more pronounced for positive pictures across all time windows from the centro-parietal to the frontal part, and localized in the left hemisphere. Positive pictures also elicited a greater successful encoding effect at anterior clusters in adults. By combining behavioral and neurophysiological measures to assess the EEM in children compared with adults, our study provides new knowledge concerning the interaction between emotional and memory processes during development.

Decision-Making Competence in Patients with Alzheimer's Disease: A Review of the Literature.

Decision-making competence (DMC) appears to be influenced by the congruency between the characteristics of the individual, the task and the context. Indeed, the ability to make decisions seems to be highly sensitive to cognitive changes as observed, in particular, in the healthy elderly. Few studies have investigated these relations in pathological ageing. In this review, we focus on DMC in patients with Alzheimer's disease (AD) and the links its impairment could have with deficits in episodic memory, working memory, and executive functions. Decision-making under risk and under ambiguity appears to be impaired early in the progress of AD, with the deficit being greater during the later stages of the disease. In addition, some studies suggest that the impairment of DMC is exacerbated by deficits in other cognitive functions, in particular working memory and executive functions. This degradation in the ability to make decisions seriously affects the quality of life of patients and their relatives, since they frequently face important decisions, especially concerning healthcare, finance or accommodation. Thus, the growing incapacity to decide for themselves increases patients' and caregivers' stress and burden. The challenge for future studies is to determine how best to help patients and their families in the decisional process.

Behavioural and ERP Effects of Cognitive and Combined Cognitive and Physical Training on Working Memory and Executive Function in Healthy Older Adults.

Cognitive and physical training have been shown to be effective in improving older adults' cognition. However, it is not yet clear whether combined cognitive and physical training offers an advantage compared to cognitive training alone. Twenty-two older adults performed cognitive or combined cognitive and physical training in order to compare their effects on working memory event-related potentials (ERPs) and on working memory and executive function performance. Before and after eight weeks of training, performance in Plus Minus, Flanker, Updated Span, and Complex Span tasks was measured, and ERPs were registered during performance of an n-back task (0-back, 2-back, and 3-back). Post-training behavioural improvement was observed in Updated Span, Complex Span, and n-back tasks. During the n-back task, the N2/P3 complex was modulated by training, with a decrease in N2 amplitude and an increase in P3 amplitude in the posttraining session compared to the pretraining session. These changes in ERP components suggest that both types of training potentially reduce the need for attentional control to perform the tasks correctly and increase working memory capacity. Thus, based on our data, no conclusion can be reached on the direct advantage of combined training, either at behavioural or at neural level. However, the present study might suggest an indirect advantage of such a combined training, because the cognitive benefit was found to be highly similar in both types of training. Using combined cognitive and physical training may produce a potential improvement in general fitness and an increased appeal of training.

How do patients with Alzheimer's disease imagine their pain?

INTRODUCTION: Pain is underdiagnosed and undertreated in patients with Alzheimer's disease (AD). Pain management is of major importance in this population to limit behavioural and functional consequences. Our study aimed to assess the capacity of AD patients to represent pain using a questionnaire exploring daily painful situations and to determine the most appropriate pain scale assessment. METHODS: Twenty-eight patients with mild AD, 21 with moderate AD and 28 matched controls underwent the Situation Pain Questionnaire (SP-Q) and assessed imaginary pain with four pain scales. Two scores were compared between the three groups: the P(A) discrimination score and the response bias ß score. P(A) reflects the degree of discrimination between high-pain and low-pain events, whereas the ß score means the degree to which situations are considered as painful. RESULTS: Our results showed that AD patients hardly discriminated the high- from low-pain events. Compared to controls, the mean P(A) score was significantly lower for Mild AD (p < 0.03) and Moderate AD (p < 0.004). In addition, the ß score indicated that the response bias is higher for AD patients (p < 0.01) in that they overestimated the level of pain. CONCLUSION: The present results suggest that patients with Mild and Moderate AD are able to recognize and assess an imagined painful situation even though their pain tolerance is lower than that of controls. The pain scales used should be chosen according to the cognitive, sensorial and personal profiles of the patients. SIGNIFICANCE: The present research is significant because it examines how patients with Alzheimer's disease understand and assess painful situations. Cognitive impairments can modify this ability. Pain is a sensory and subjective experience and to define its feeling can help us in our clinical practice.

Affective and cognitive theory of mind in Alzheimer's disease: The role of executive functions.

Introduction: Although there are plenty of studies on affective or cognitive theory of mind (ToM) in Alzheimer's Disease (AD), few have investigated both these dimensions and even fewer have examined the ability to identify an emotion from context in relation to the executive function deficit. Thus, the purpose of this study was to examine the deficit of affective and cognitive ToM in AD patients in the light of their executive function deficit. We were especially interested in the ability to attribute emotions to a character from a context and the ability to recognize facial expressions and to understand social clumsiness.Method: Twenty-eight mild AD patients and 33 healthy participants completed two sessions, one involving neuropsychological tests evaluating the executive functions, and the other comprising three tasks (Facial Expression Attribution, Facial Expression Recognition, Faux Pas test) assessing affective and cognitive ToM.Results: Compared to the healthy participants, the AD patients were impaired in the recognition of shame, anger and the neutral expression. They had difficulties in inferring surprise and disgust from visual context in situations where no facial expression was available, and were also impaired in all aspects of the Faux Pas test. Globally, and independently of the Group factor, performance in the three ToM tasks was correlated with performance in the backward span test, and the significant proportion of variance in performance in the Facial Expression Recognition and Faux Pas test was explained by the performance in backward span test. However, separate analyses did not show any significant correlations for the AD patients.Conclusions: Our results suggest an impairment of affective and cognitive ToM in AD patients. This impairment is selective as it concerns only some emotions. Considering these results with caution, it is possible that, patients' working memory difficulties explain, at least in part, their difficulties in ToM tasks.

Emotional modulation of episodic memory in school-age children and adults: Emotional items and their associated contextual details.

It is well established that emotional events are better remembered than neutral events. However, little is known about emotional enhancement of memory (EEM) in children. This is particularly the case when the main components of episodic memory are considered: core information (item memory) and its associated contextual details (associative memory). In 2 experiments, the present study tested whether the negative or positive emotional valence of words and pictures can influence item and associative memory. The contextual information to be associated with items was the gender of the voice pronouncing words and the type of frame in which pictures were displayed in Experiment 1, and the spatial location of stimuli in Experiment 2. Two groups of 8- to 11-year-old children (Experiment 1 n = 32 and Experiment 2 n = 36) performed the experiments and were compared to two groups of equivalent numbers of young adults. Participants completed an intentional-encoding task followed by immediate item recognition, associative recall and item recall tasks. Over the two experiments and in both groups, the results revealed (a) no EEM for words and pictures in recognition tasks, (b) EEM for words in item recall and associative recall tasks, and (c) mixed results for pictures, with an EEM being observed in item recall tasks but not systematically in associative recall tasks. By extending the results over two types of stimuli and their associated contextual information, our study provides new knowledge concerning the effect of emotions on episodic memory in children, which seems to be similar to that observed in young adults. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Effect of negative emotional content on attentional maintenance in working memory.

Previous research has shown that emotional stimuli may interfere with working memory (WM) processes, but little is known about the process affected. Using a complex span task, the present study investigated the influence of processing negative emotional content on attentional maintenance in WM. In two experiments conducted under articulatory suppression, participants were asked to remember a series of five letters, each of which was followed by an image to be categorised. In half of the trials, the images were negative and in the other half, they were neutral. In both experiments, our results showed longer processing times for emotional stimuli than neutral stimuli, and lower memory performance when participants processed negative stimuli. We propose that emotional stimuli direct more attentional resources towards the processing component of the WM task, thereby reducing the storage capacity available for the items that are to be remembered.

First-order Affective Theory of Mind in Persons with Alzheimer's Disease and in Healthy Older Adults.

"Theory of Mind" (ToM) is the capacity to deduce other persons' cognitive and emotional states. Studies investigating affective ToM in healthy older adults and in persons with Alzheimer's disease have reported contradictory results, although evidence indicates that advanced age (Ruffman, Henry, Livingstone, & Phillips, 2008) and Alzheimer's disease (Elferink, van Tilborg, & Kessels, 2015) do not affect the ability to identify or infer different emotions to the same extent. To evaluate affective ToM abilities in these populations, we asked 63 individuals (17 with Alzheimer's disease) to infer the emotional states of characters presented without facial details in emotional situations. We observed similar results in healthy younger and older adults, but poorer performance in persons with Alzheimer's disease for disgust, sadness, and surprise, but not for anger, fear, and joy. Results suggest that persons with Alzheimer's disease have difficulties in inferring several emotional states from contextual information without facial cues.

When Do Older Adults Show a Positivity Effect in Emotional Memory?

BACKGROUND: Typically, positive and negative emotional items are easier to remember than neutral ones. Charles, Mather, and Carstensen (2003) reported that older adults preferentially remember positive items, but this age-related "positivity effect" has not been replicated consistently. METHODS: We conducted a close replication of Charles et al.'s study to verify that their method yields a clear positivity effect in older adults relative to the young. We also examined the role of attention, which has been argued to influence the presence of the positivity effect in older adults. We used a method similar to Charles et al. (2003). Young and older adults recalled pictures that had been encoded under full or divided attention. RESULTS AND CONCLUSIONS: Older adults showed a positivity effect, but only under full attention. Young adults did not show any hint of a positivity effect, under either of the encoding conditions. The finding of a positivity effect in older but not young adults replicates the original report from Charles et al. (2003). The attention manipulation results suggest that when the positivity effect occurs in older adults' memory, it is attributable at least in part to cognitive control during encoding. Key terms: Emotional Enhancement of Memory-Divided attention-Aging.

Aging brain: the effect of combined cognitive and physical training on cognition as compared to cognitive and physical training alone - a systematic review.

This review presents a critical examination of current knowledge of the impact of combined cognitive and physical training on cognition in healthy elderly subjects. The objectives are to evaluate the contribution of cognitive and physical training to the enhancement of cognition, and to determine the interest of combining these two training types in one intervention in terms of the benefits for cognition (direct and transfer), long-term maintenance, and transfer to daily living. To do so, a systematic electronic search was conducted in PubMed and Google Scholar. Exclusion criteria were animal and pathological aging studies. We focused on the shared and different behavioral impacts of these two types of training on cognition, as well as their functional and structural impact on the brain. The review indicates that both cognitive and physical training have an impact on cognition and on the brain. However, each type of training seems to preferentially enhance different cognitive functions and specifically impact both brain structure and function. Even though some results argue in favor of a complementarity between cognitive and physical training and the superiority of combined cognitive and physical training, the current state of knowledge does not permit any definitive conclusion. Thus, the present review indicates the need for additional investigations.

Effect of Emotion and Type of Encoding on Memory for Actions: Verbal and Subject-Performed Tasks.

BACKGROUND: The present study examines whether the interaction between emotion and the enactment effect (body involvement) improves memory in people with Alzheimer disease (AD). METHODS: Two experiments with drawings of actions were conducted, in which two types of encoding were used: motor and verbal. In experiment 1, with 13 AD patients and 13 older healthy adults, the encoding was incidental. In experiment 2, with 17 mild AD patients and 21 older healthy adults, it was intentional. RESULTS: In experiment 1, no effect of enactment or emotion was observed in the AD patients. In experiment 2, effects of enactment and emotion (better recall for negative actions) were observed in the AD patients. This pattern of results was also observed in the elderly control adults in both experiments. CONCLUSION: These results confirm effects observed in normal ageing and indicate a more subtle effect on AD.

Is there a Competition between Functional and Situational Affordances during Action Initiation with Everyday Tools?

Most studies of human-tool interactions focus on the typical use of a tool (e.g., cutting in the case of a knife). However, little is known about situations requiring atypical tool use (e.g., using a knife to tighten a screw). The present study focused on a selection of atypical uses of everyday tools which might be in conflict with their typical use. Our objective was to study how tool function influences the selection of the relevant action. In Experiment 1, which involved visuomotor priming, two everyday tools (a knife and a screwdriver) and two neutral tools (two bars, with no strong functional affordance) were used as primes and targets. Participants had to use the target with the appropriate box (indicated by the color) that allowed to make an action. Longer initiation times were observed when the prime was an everyday tool, irrespective of the nature of the target. We therefore observed a conflict between functional and situational affordances. To investigate whether the priming effect is caused by the task-irrelevance of the prime, we asked the participants in Experiment 2 to perform an action associated with the prime. The results showed longer initiation times only when the prime and target were everyday tools, irrespective of their precise nature. This suggests that activation of the typical use of a tool might not be fully automatic but flexible depending on the situation.