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1.
Neuropsychol Rehabil ; 32(3): 429-463, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33106082

RESUMO

In neurodegenerative conditions, better memory/cognitive awareness, indexed by greater "metamemory monitoring accuracy", is linked to stronger cognitive remediation outcomes. Differences in metamemory monitoring accuracy in predementia conditions, which could inform treatment effectiveness, have not been systematically investigated. We utilized a retrospective confidence judgment (RCJ) task for general knowledge recognition in community-dwelling older adults: 106 cognitively healthy (HC), 68 subjective cognitive decline (SCD) despite intact neuropsychological function, 14 amnestic mild cognitive impairment (aMCI), and 31 non-amnestic mild cognitive impairment (naMCI). Participants gave confidence ratings after making recognition responses to general knowledge questions. Recognition accuracy, confidence levels, and absolute and relative RCJ accuracy (i.e., metamemory monitoring accuracy) were analysed. Compared to HC and SCD, absolute RCJ accuracy was significantly poorer in both MCI groups but relative RCJ accuracy was significantly poorer in naMCI, but not aMCI. This novel result may be driven by lower confidence for correct recognition responses in naMCI and suggests that poorer RCJ accuracy in naMCI may be attributable to poorer performance monitoring. We discuss results in relation to the possibility that individuals in distinct preclinical dementia conditions, who have different levels of memory/cognitive awareness, may differentially benefit from cognitive remediation strategies tailored to their levels of memory/cognitive awareness.


Assuntos
Disfunção Cognitiva , Metacognição , Idoso , Humanos , Vida Independente , Metacognição/fisiologia , Testes Neuropsicológicos , Estudos Retrospectivos , Semântica
2.
J Int Neuropsychol Soc ; 20(10): 1015-27, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25401793

RESUMO

Although prospective memory (PM) is compromised in mild cognitive impairment (MCI), it is unclear which specific cognitive processes underlie these PM difficulties. We investigated older adults' performance on a computerized event-based focal versus nonfocal PM task that made varying demands on the amount of attentional control required to support intention retrieval. Participants were nondemented individuals (mean age=81.8 years; female=66.1%) enrolled in a community-based longitudinal study, including those with amnestic MCI (aMCI), nonamnestic MCI (naMCI), subjective cognitive decline (SCD), and healthy controls (HC). Participants included in the primary analysis (n=189) completed the PM task and recalled and/or recognized both focal and nonfocal PM cues presented in the task. Participants and their informants also completed a questionnaire assessing everyday PM failures. Relative to HC, those with aMCI and naMCI were significantly impaired in focal PM accuracy (p<.05). In a follow-up analysis that included 13 additional participants who successfully recalled and/or recognized at least one of the two PM cues, the naMCI group showed deficits in nonfocal PM accuracy (p<.05). There was a significant negative correlation between informant reports of PM difficulties and nonfocal PM accuracy (p<.01). PM failures in aMCI may be primarily related to impairment of spontaneous retrieval processes associated with the medial temporal lobe system, while PM failures in naMCI potentially indicate additional deficits in executive control functions and prefrontal systems. The observed focal versus nonfocal PM performance profiles in aMCI and naMCI may constitute specific behavioral markers of PM decline that result from compromise of separate neurocognitive systems.


Assuntos
Envelhecimento/psicologia , Transtornos Cognitivos/fisiopatologia , Memória Episódica , Memória , Características de Residência , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Aprendizagem por Associação/fisiologia , Transtornos Cognitivos/diagnóstico , Feminino , Seguimentos , Humanos , Masculino , Testes Neuropsicológicos , Tempo de Reação/fisiologia , Estatística como Assunto , Vocabulário
3.
Neuropsychol Rehabil ; 24(6): 868-93, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24875614

RESUMO

Despite the relevance of prospective memory to everyday functioning and the ability to live independently, prospective memory tasks are rarely incorporated into clinical evaluations of older adults. We investigated the validity and clinical utility of a recently developed measure, the Royal Prince Alfred Prospective Memory Test (RPA-ProMem), in a demographically diverse, non-demented, community-dwelling sample of 257 older adults (mean age = 80.78 years, 67.7% female) with amnestic mild cognitive impairment (aMCI, n = 18), nonamestic mild cognitive impairment (naMCI, n = 38), subjective cognitive decline (SCD, n = 83) despite intact performance on traditional episodic memory tests, and healthy controls (HC, n = 118). Those with aMCI and naMCI performed significantly worse than controls on the RPA-ProMem and its subtasks (time-based, event-based, short-term, long-term). Also, those with SCD scored significantly lower than controls on long-term, more naturalistic subtasks. Additional results supported the validity and inter-rater reliability of the RPA-ProMem and demonstrated a relation between test scores and informant reports of real-world functioning. The RPA-ProMem may help detect subtle cognitive changes manifested by individuals in the earliest stages of dementia, which may be difficult to capture with traditional episodic memory tests. Also, assessment of prospective memory can help guide the development of cognitive interventions for older adults at risk for dementia.


Assuntos
Disfunção Cognitiva/diagnóstico , Memória Episódica , Idoso , Idoso de 80 Anos ou mais , Amnésia/complicações , Amnésia/diagnóstico , Disfunção Cognitiva/complicações , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Reprodutibilidade dos Testes
4.
Artigo em Inglês | MEDLINE | ID: mdl-33893475

RESUMO

OBJECTIVE: Metamemory tasks have been utilized to investigate anosognosia in older adults with dementia, though previous research has not systematically compared memory self-awareness in prodromal dementia groups. This represents an important oversight given that remedial and interventional efforts may be most beneficial before individuals' transition to clinical dementia. We examine differences in memory self-awareness and memory self-monitoring between cognitively healthy elderly controls and prodromal dementia groups. METHODS: Participants with subjective cognitive decline despite intact objective neuropsychological functioning (SCD; n = 82), amnestic mild cognitive impairment (aMCI; n = 18), nonamnestic mild cognitive impairment (naMCI; n = 38), and normal cognitive functioning (HC; n = 120) were recruited from the Einstein Aging Study for a cross-sectional study. Participants completed an experimental visual memory-based global metamemory prediction task and subjective assessments of memory/cognition and self-awareness. RESULTS: While, relative to HC, memory self-awareness and memory self-monitoring were preserved for delayed memory performance in SCD and aMCI, these processes were impaired in naMCI. Furthermore, results suggest that poor metamemory accuracy captured by our experimental task can be generalized to everyday memory problems. CONCLUSIONS: Within the framework of the Cognitive Awareness Model, our findings provide preliminary evidence that poor memory self-awareness/self-monitoring in naMCI may reflect an executive or primary anosognosia, with implications for tailored rehabilitative interventions.

5.
Artigo em Inglês | MEDLINE | ID: mdl-25471537

RESUMO

Although older adults typically have better performance on prospective memory (PM) tasks carried out in naturalistic settings, a paucity of research directly assesses older adults' use of compensatory strategies on such tasks. The current study investigates external memory strategy use during performance of a clinical PM test that features both short-term (in laboratory) and long-term (out of laboratory) subtasks (i.e., the Royal Prince Alfred Prospective Memory Test - RPA-ProMem. Nondemented, community-dwelling older adults (n = 214; mean age = 80.5; 68.2% female; 39.7% non-white) with mild cognitive impairment, subjective cognitive decline, and healthy controls completed the RPA-ProMem while external strategy use was permitted and recorded. Overall, participants utilized external strategies 41% of the time on the RPA-ProMem. Increased utilization of external memory strategies was significantly associated with better PM performance. Additionally, better performance on executive functioning tasks was associated with increased use of external memory strategies. Results are discussed in relation to how memory strategy use can be enhanced to improve everyday memory ability in older adults at risk for dementia.


Assuntos
Transtornos Cognitivos/psicologia , Cognição , Memória Episódica , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino
6.
Am J Hum Genet ; 72(3): 739-48, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12574987

RESUMO

The genomic evolution and causes of phenotypic variation among humans and great apes remain largely unknown, although the phylogenetic relationships among them have been extensively explored. Previous studies that focus on differences at the amino acid and nucleotide sequence levels have revealed a high degree of similarity between humans and chimpanzees, suggesting that other types of genomic change may have contributed to the relatively large phenotypic differences between them. For example, the activity of long interspersed element 1 (LINE-1) retrotransposons may impose significant changes on genomic structure and function and, consequently, on phenotype. Here we investigate the relative rates of LINE-1 amplification in the lineages leading to humans, bonobos (Pan paniscus), and chimpanzees (P. troglodytes). Our data indicate that LINE-1 insertions have accumulated at significantly greater rates in bonobos and chimpanzees than in humans, provide insights into the timing of major LINE-1 amplification events during great ape evolution, and identify a Pan-specific LINE-1 subfamily.


Assuntos
Elementos Nucleotídeos Longos e Dispersos/genética , Pan troglodytes/genética , Animais , Sequência de Bases , Mapeamento Cromossômico , Amplificação de Genes , Humanos , Dados de Sequência Molecular , Filogenia , Especificidade da Espécie
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