Imagine yourself dancing waltz: The effect of imagination on memory in Alzheimer's disease

BACKGROUND

Self-imagination refers to a mnemonic strategy of imagining oneself at a scene related to a cue.

OBJECTIVE

We tested the effect of self-imagination on memory recall in Alzheimer's disease (AD) Method: Individuals with AD and healthy controls were invited to perform two conditions. In the control (i.e., semantic elaboration) condition, participants were asked to define to which semantic category (e.g., dance) words (e.g., waltz) belong. However, in a self-imagining condition, participants were asked to imagine themselves in a scene related to the stimuli (e.g., dancing waltz). Both conditions were followed by two free memory tests with two different intervals (20 seconds vs. 20 minutes).

RESULTS

Analysis showed a beneficial effect of self-imagination for the 20-second but not for the 20- minute recall in AD participants and controls.

CONCLUSION

Clinicians can incorporate our findings when assessing, especially when trying to rehabilitate, episodic memory in AD.

The interdisciplinary science of autobiographical memory

To provide a comprehensive understanding of the characteristics of autobiographical memory, WIREs Cognitive Science is launching a special issue gathering contributions from various perspectives in the field of autobiographical memory. To introduce this special issue, I outline the philosophy of this collaborative project and summarize the knowledge gained from each of the 12 articles included. Insights into the next important steps in studying autobiographical memory are also provided. As shown in this article, research on autobiographical memory covers a wide range of disciplines (e.g., neuropsychology, cognitive psychology, social psychology, developmental psychology, neurology, psychiatry). However, there has been little interdisciplinary dialogue between autobiographical memory scholars until recently. For the first time, this special issue brings together theoretical contributions that offer different yet complementary approaches to the study of autobiographical memory. This article is categorized under: Psychology > Memory.

"Who am I?": Weakened sense of the self in patients with behavioral variant frontotemporal dementia

While research has shown a distrusted sense of the self in patients with behavioral variant frontotemporal dementia (bvFTD), little is known about how patients describe their self-image. We used the "Who am I?" task to invite patients with bvFTD and control participants to produce statements beginning with "I am…." We distinguished between statements related to physical, social, and psychological self. Analyses showed fewer statements related to physical, social, and psychological self in the patients with bvFTD than in control participants. Another result was the proportionally similar production of statements describing physical, social, and psychological self in both patients with bvFTD and control participants. Finally, the total production of "Who am I?" statements was positively correlated with verbal fluency in both patients with bvTFD and control participants. Our findings demonstrate a diminished ability of patients with bvFTD to process self-images. Our study also paves the way toward the use of the "Who am I" task as a simple and ecologically valid tool allowing for the quantitative and qualitative assessment of the sense of self in patients with bvFTD.

Work stress and motivation in psychologists in the hospital setting: the role of primary cognitive appraisal

The aim of this study was to explore in a hospital setting the relationships between work motivation and stress among psychologists working in hospitals. The second aim was to identify the respective roles of threat appraisal and challenge appraisal in this population. We expected work stress to have a motivational impact in the workplace, with primary cognitive appraisal (e.g., threat or challenge) playing a crucial role. The study included a large sample of 430 French psychologists recruited in French hospitals with a mean age of 33.68 ± 8.73 years. We assessed perceived work stress, work motivation, and primary cognitive appraisal. Analysis showed two main outcomes. First, perceived stress in the workplace impacts work motivation; specifically, the higher the perceived stress, the less motivation is self-determined. Second, threat cognitive appraisal has a direct and negative motivational impact, but also an indirect impact via perceived stress. However, appraisal of work as a cognitive challenge also directly and positively impacts motivation in the workplace, without indirect effects. Finally, work stress, work motivation and primary cognitive appraisals are significantly related with the workplace. These relationships support complementarity with the Transactional Model of Stress and SDT motivational approach in a theoretical and practical perspective in the workplace.

"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.

Effect of APOE4 Allele and Gender on the Rate of Atrophy in the Hippocampus, Entorhinal Cortex, and Fusiform Gyrus in Alzheimer's Disease

BACKGROUND

The hippocampus, entorhinal cortex, and fusiform gyrus are brain areas that deteriorate during early-stage Alzheimer's disease (AD). The ApoE4 allele has been identified as a risk factor for AD development, is linked to an increase in the aggregation of amyloid ß (Aß) plaques in the brain, and is responsible for atrophy of the hippocampal area. However, to our knowledge, the rate of deterioration over time in individuals with AD, with or without the ApoE4 allele, has not been investigated.

METHOD

In this study, we, for the first time, analyze atrophy in these brain structures in AD patients with and without the ApoE4 using the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset.

RESULTS

It was found that the rate of decrease in the volume of these brain areas over 12 months was related to the presence of ApoE4. Further, we found that neural atrophy was not different for female and male patients, unlike prior studies, suggesting that the presence of ApoE4 is not linked to the gender difference in AD.

CONCLUSION

Our results confirm and extend previous findings, showing that the ApoE4 allele gradually impacts brain regions impacted by AD.

How Do Women and Men Look at the Past? Large Scanpath in Women during Autobiographical Retrieval—A Preliminary Study

While research has consistently demonstrated how autobiographical memory triggers visual exploration, prior studies did not investigate gender differences in this domain. We thus compared eye movement between women and men while performing an autobiographical retrieval task. We invited 35 women and 35 men to retrieve autobiographical memories while their gaze was monitored by an eye tracker. We further investigated gender differences in eye movement and autobiographical specificity, that is, the ability to retrieve detailed memories. The analysis demonstrated shorter fixations, larger duration and amplitude of saccades, and higher autobiographical specificity in women than in men. The significant gender differences in eye movement disappeared after controlling for autobiographical specificity. When retrieving autobiographical memory, female participants generated a large scan with short fixation and high saccade amplitude, while male participants increased their fixation duration and showed poorer gaze scan. The large saccades in women during autobiographical retrieval may constitute an exploratory gaze behavior enabling better autobiographical memory functioning, which is reflected by the larger number of autobiographical details retrieved compared to men.

"Ten dollars today or 50 dollars after one month?" Temporal discounting in Korsakoff syndrome

OBJECTIVE

Little research has investigated decision making in patients with Korsakoff syndrome (KS). Specifically, to our knowledge, there is a lack of research investigating whether patients with KS may tend to prefer immediate over future rewards (i.e., temporal discounting). Further, we investigated the relationship between temporal discounting and inhibition.

METHODS

We, for the first time, invited patients with KS and control participants to perform a temporal discounting task, in which they answered questions probing preferences between an immediate, but smaller amount of money, and a delayed, but larger amount of money (e.g., "would you prefer 10 dollars today or 50 dollars after one month?"). Furthermore, inhibition was measured using the Stroop Colour Word Test.

RESULTS

Analysis demonstrated higher temporal discounting in patients with KS than in control participants. Temporal discounting in both populations was significantly correlated with inhibition.

CONCLUSIONS

Patients with KS may have difficulties to suppress the temptation of smaller, but immediate, rewards.

The recombined memory: associative inference in Alzheimer's disease

BACKGROUND

Associative inference refers to an adaptive ability that allows flexible recombination of information acquired during previous experiences to make new connections that they have not directly experienced. This cognitive ability has been widely associated with the hippocampus.

AIMS

We investigated associative inference in patients with Alzheimer's disease and control participants.

METHODS

The task has two phases. In the training phase, participants learned to encode overlapping pairs of objects (AB + BC). In the test phase, participants were invited to retrieve previously see associations (i.e., AB, BC) as well as novel associations between the previously exposed objects (i.e., AC). In addition, we test the relationship between associative inference and cognitive flexibility.

RESULTS

Analysis demonstrated lower associative inference in AD patients than in control participants. Interestingly, performance on the associative inference task was significantly correlated with low performance on a cognitive flexibility task in AD patients.

DISCUSSION

Our findings demonstrate a compromise of the ability to flexibly combine new representations from prior memories in AD, which is likely related to the hippocampal dysfunction in AD.

"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.

Eyes don't lie: Eye movements differ during covert and overt autobiographical recall

In everyday life, autobiographical memories are revisited silently (i.e., covert recall) or shared with others (i.e., overt recall), yet most research regarding eye movements and autobiographical recall has focused on overt recall. With that in mind, the aim of the current study was to evaluate eye movements during the retrieval of autobiographical memories (with a focus on emotion), recollected during covert and overt recall. Forty-three participants recalled personal memories out loud and silently, while wearing eye-tracking glasses, and rated these memories in terms of mental imagery and emotional intensity. Analyses showed fewer and longer fixations, fewer and shorter saccades, and fewer blinks during covert recall compared with overt recall. Participants perceived more mental images and had a more intense emotional experience during covert recall. These results are discussed considering cognitive load theories and the various functions of autobiographical recall. We theorize that fewer and longer fixations during covert recall may be due to more intense mental imagery. This study enriches the field of research on eye movements and autobiographical memory by addressing how we retrieve memories silently, a common activity of everyday life. More broadly, our results contribute to building objective tools to measure autobiographical memory, alongside already existing subjective scales.

"I Remember the Fall": Memory of Falls in Older Adults

OBJECTIVES

While there is a large body of research on falls and their consequences in older adults, little is known about how older adults remember them. We addressed this gap by inviting older adults to remember falls and control memories.

METHODS

We analyzed specificity of memories and invited participants to rate emotional valence, mental time travel, visual imagery, importance, and rehearsal, as experienced during retrieval.

RESULTS

Although analysis demonstrated no significant differences between memories of falls and control memories regarding specificity, participants rated memories of falls as more negative than control memories. Furthermore, they rated memories of falls as triggering higher mental time travel, higher visual imagery, higher importance, and higher rehearsal than control memories.

CONCLUSIONS

The negative emotional valence of memories of falls, as well as their ability to trigger significant levels of mental time travel, visual imagery, importance, and rehearsal, demonstrate how these memories are different from other memories in older adults.

CLINICAL IMPLICATIONS

The findings demonstrate how falls can modulate memory of personal events in older adults.

"I Will Be Healthy": Ideal Self in Patients with Alzheimer's Disease

Background

Within the concept of the self, a distinction can be made between ideal self (i.e., what would like to become) and feared self (i.e., what would not like to become in the future).

Objective

We investigated ideal self and feared self in patients with mild Alzheimer's disease (AD). We have also measured these self-related processes in relation to depression and anxiety.

Methods

We invited 31 patients with mild AD and 35 control participants to decide whether they would consider the statement (e.g., I will be healthy) as a representation that they would like to acquire (i.e., ideal self) or to avoid (i.e., feared self).

Results

Analysis demonstrated that more participants assigned the "I will be healthy" statement to ideal self than to feared self, and this tendency was observed in both AD participants and controls. Less depression and anxiety were observed in participants who have assigned the "I will be healthy" statement to their ideal self compared to those who assigned this statement to their feared self, and this was observed in both AD participant and control groups.

Conclusion

Our study demonstrates that AD patients tend to endorse positive health traits and to integrate these traits into their ideal self. AD patients tend to endorse health-related images that are associated with hopes when projecting into their future self. This positive projection into the self may create a motivational force (e.g., aspirations and hopes) to embody the "healthy" self that AD patients desire to be.

The fabricated past: intentionally fabricated autobiographical memories in Alzheimer's disease

OBJECTIVE

We investigated intentionally fabricated autobiographical memories in Alzheimer's Disease (AD).

METHOD

We invited AD patients and control participants to construct real events as well as fabricated events describing fictitious personal events that occurred in the past.

RESULTS

Results demonstrated slower retrieval time for intentionally fabricated memories than for real ones in both AD patients and control participants. The analysis also showed similar vividness for intentionally fabricated memories and real ones in AD patients but lower vividness for intentionally fabricated memories than for real ones in control participants.

CONCLUSIONS

The slow retrieval time of intentionally fabricated memories may be attributed to the cognitive effort required to retrieve elements from autobiographical memory and edit them to construct a new memory. We suggest that the vividness of intentionally fabricated memories observed in AD may induce confusion with real memories. In addition to the experimental approach of our study, we offer a theoretical rationale for intentionally fabricated autobiographical memories by situating them in the wider context of different facets of false memories in AD (e.g. confabulations, source monitoring errors).

Fear of COVID-19, emotional exhaustion, and care quality experience in nursing home staff during the COVID-19 pandemic

BACKGROUND

Nursing home staff have been adversely impacted throughout the COVID-19 pandemic, facing difficulties in providing patient care. The aim of this study was to explore health workers' perception regarding their own care quality experience in nursing homes during the COVID-19 pandemic. Amidst the second wave of the pandemic, we investigated the relationships between fear of COVID-19 and care quality experiences in nursing homes with emotional exhaustion (EE) as a mediating role. We hypothesized that EE is associated with fear of COVID-19 and care quality experience among nursing home staff. Furthermore, we predicted that EE would mediate the relationships between fear of COVID-19 and care quality experience.

METHODS

During the second wave of COVID-19 (October to December 2020), we administered surveys to a large sample of 129 French nursing home staff with a mean age of 38.47 ± 10.31 who were directly and repeatedly exposed to COVID-19. We assessed their emotional exhaustion (EE) and care quality experience in the workplace via subjective indicators using self-reported scales.

RESULTS

In the context of COVID-19, low to severe emotional exhaustion levels were found among nursing home staff, and these levels were associated with care quality experience as well as fear of COVID-19. The groups with low and severe levels of EE reported the highest levels of fear of COVID-19. The groups with moderate and severe levels of EE reported the lowest levels of care quality experience. Lastly, the relationships between fear of COVID-19 and care quality experience were mediated by EE.

CONCLUSIONS

The findings made by the present study focused on the role of emotional coping responses to COVID-19. EE was associated positively with fear of COVID-19 and negatively with care quality experience. Furthermore, EE was found to mediate the relationship between fear of COVID-19 and care quality experience. We discuss these findings as they relate to palliative care issues in nursing homes and the manner in which emotional exhaustion ought to be addressed among nursing home staff.

Pupillometry as an index for cognitive processing in behavioral variant FrontoTemporal Dementia: a series of case studies

We investigated whether pupil size can variate with the intensity of cognitive processing in patients with behavioral-variant-Frontotemporal-Dementia (bvFTD). We invited five bvFTD participants and 21 controls to perform forward spans and backward spans, and, in a control condition, to count aloud. We recorded pupil activity using eye-tracking-glasses during the spans and control condition. Analysis demonstrated larger pupil sizes during backward spans than during forward spans, and larger pupil sizes during forward spans than during counting in both bvFTD and control participants. These findings demonstrate how increased cognitive load triggers increased pupil size and how this connection is maintained in bvFTD.

"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.

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

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.

Pupil size as an indicator of cognitive activity in mild Alzheimer's disease

It is well established that pupil activity indexes cognitive processing. For instance, research has consistently demonstrated that the pupil reacts to working memory span task performance. However, little is known about pupil reaction to cognitive processing in Alzheimer's Disease (AD). We thus investigated whether span tasks can modulate pupil size in patients with AD. We invited 24 patients with AD and 24 healthy older adults to perform backward and forward spans, as well as to count aloud in a control condition, while their pupil activity was recorded with eye tracking glasses. In patients with AD, analysis demonstrated larger pupil size during backward spans (M = 2.12, SD = .39) than during forward spans (M = 1.98, SD = .36) [t(23) = 3.22, p = .004], larger pupil size during forward spans than during counting (M = 1.67, SD = .33) [t(23) = 4.75, p < .001], as well as larger pupil size during backward spans than during counting [t(23) = 10.60, p < .001]. In control participants, analysis demonstrated larger pupil size during backward spans (M = 3.36, SD = .49) than during forward spans (M = 2.85, SD = .68) [t(23) = 5.82, p < .001], larger pupil size during forward spans than during counting (M = 2.09, SD = .62) [t(23) = 5.42, < .001], as well as larger pupil size during backward spans than during counting [t(23) = 9.70, p < .001]. Results also demonstrated a significant interaction effect between groups and conditions [F(2,92) = 16.63, p < .001]; in other words, patients with AD have shown fewer variations on the pupil size across the conditions compared to the control participants. The larger pupil size during backward spans, compared with forward spans or counting, can be attributed to the high cognitive load of backward spans. The modulation of pupil size, as observed across backward/forward spans and counting, can possibly be attributed to sympathetic/adrenergic and parasympathetic/cholinergic activities. Our study demonstrates the value of pupillometry as a potential biomarker of cognitive processing in AD.

Increased Pupil Size during Future Thinking in a Subject with Retrograde Amnesia

Recent research has assessed pupil size during past thinking in patients with retrograde amnesia. Building on this research, we assessed pupil size during future thinking in a retrograde amnesia patient. To this end, we measured pupil size during past and future thinking in L, a 19-year-old, right-handed man free of neurological/psychiatric disorders except for retrograde amnesia that occurred after an episode of fugue. During a past thinking condition, we invited L to retrieve retrograde events (i.e., events that occurred before amnesia) and anterograde events (i.e., events that occurred after amnesia). During a future thinking condition, we invited him to imagine events that might occur the following week, the following month, and in the new year. Past and future thinking occurred while L's pupil size was monitored with eye-tracking glasses. L demonstrated higher specificity during future than during past thinking. Critically, the results demonstrated a larger pupil size during future than during past thinking. The larger pupil size during future thinking observed in L can be attributed to the high cognitive load involved in future thinking. Our study not only demonstrates preserved future thinking in a patient with dissociative retrograde amnesia, but also shows that pupillometry can be used for the physiological assessment of future thinking in retrograde amnesia patients.

Awareness for People With Alzheimer’s Disease: Profiles and Weekly Trajectories

Objective: To understand awareness and fluctuations of awareness in Alzheimer’s disease (AD), it is fruitful to consider the objects of awareness, e.g., cognitive functioning or recognition of the disease, as well as the mechanisms and modes of expression underlying awareness. With a holistic and discourse-centered approach, we aimed to identify different awareness profiles and test whether these profiles were stable or whether transitions from one profile to another occurred over short time intervals.

Methods: Twenty-eight residents of nursing homes with a diagnosis of AD participated in four semistructured interviews at biweekly intervals. These interviews were cluster analyzed to determine profiles of awareness. A Markov chain was applied to model their fluctuation.

Results: Five awareness profiles were observed that differed in terms of objects and underlying processes. Awareness proved to be quite stable for four of the five profiles. Interindividual variability in awareness was also observed through numerous different trajectories that were identified.

Discussion: Self-awareness and disease awareness are characterized by profiles that vary subtly between individuals. Fluctuations in awareness underscore the need to employ assessment intervals that closely reflect daily life in institutions.