Clinical Utility of the Envelope Task in Mild Cognitive Impairment and Dementia.

OBJECTIVE: Prospective memory (PM) is a cognitive function defined as the ability to perform an intention at an appropriate moment in the future. In the aging population, PM is essential for maintaining independent daily living. Introduced as a simple and quick way to assess PM in clinical settings, the envelope task has to date received very limited empirical and practical interest. METHODS: The present study investigated the task's clinical utility in detecting PM impairment in a sample composed of 49 healthy older adults (OA), 41 patients with Alzheimer's disease, and 64 individuals with amnestic and nonamnestic mild cognitive impairment (MCI) of heterogeneous etiology: 17 of idiopathic nature, 20 presenting an idiopathic rapid-eye movement sleep behaviour disorder, and 27 patients diagnosed with idiopathic Parkinson's disease. RESULTS: The envelope task was highly sensitive and specific in discriminating Alzheimer's disease patients from OA. Although it was specific in distinguishing MCI individuals from OA, its sensitivity was modest, especially in patients presenting a nonamnestic MCI subtype. CONCLUSIONS: Given its high specificity and simple low-cost administration procedure, the envelope task is a promising instrument for clinicians who seek to rapidly assess PM impairment in their daily practice.

[A comparison of the performances between healthy older adults and persons with Alzheimer's disease on the Rey auditory verbal learning test and the Test de rappel libre/rappel indicé 16 items]. / Comparaison des performances à l'épreuve des 15 mots de Rey et au RL/RI 16 dans le vieillissement normal et la démence de type Alzheimer.

The aim of this research was to compare the performances of healthy elderly (n=40) and individuals with Alzheimer's disease (AD, n=40) on the RL/RI 16, a French adaptation of the Free and cued selective reminding test (FCSRT) and on the Rey auditory verbal learning test (RAVLT). These two verbal episodic memory tests are frequently used in clinical practice in French-speaking populations. Results showed that the RAVLT demonstrated a slightly better sensitivity and sensibility than the RL/RI 16. The RAVLT allowed to classify participants of the two groups without any overlap. Moreover, no floor effect was observed in the RAVLT in AD and ceiling effects were less pronounced in normal controls that in the RL/RI 16. Results observed in the RL/RI 16 showed important ceiling effects and a decline in performance on free recall throughout trials in AD patients. Nonetheless, the latter tool was less sensitive to recency effects than the RAVLT and may thus provide a more realistic view of the long-term memory performance of these patients. The semantic cues provided in the RL/RI 16 appeared to increase intrusions in AD whereas the interference list in the RAVLT was the first source of false recognitions in both healthy elderly and AD. In conclusion, this paper demonstrates both the advantages and disadvantages of these two tools in the evaluation of episodic memory in elderly with and without cognitive deficits.

Neuropsychological and activity of daily living script performance in patients with positive or negative schizophrenia.

Cognitive and psychiatric determinants of impairment of complex activities of daily living (ADLs) were investigated in 33 schizophrenic patients and 16 normal comparison subjects. The schizophrenic patients were cognitively impaired and were deficient in the ADL. However, the impairment of ADL could not be explained specifically by impairment of higher-order executive function or by negative symptoms: memory functions were more related to impairment of ADL and positive symptoms as much as the negative ones. Positive symptoms were significantly related to commissive errors in the ADL, whereas negative symptoms were nonsignificantly related to omissive errors. Negative symptoms were significantly more related to memory impairment than to impairment on measures of higher-order executive function (working memory). This investigation demonstrates that an ecologically oriented approach to test development and measurement of ADL is fruitful in understanding schizophrenia-especially if it is constrained by cognitive constructs compatible with the phenomenology of the disease.