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Scheper I, Brazil IA, Claassen JAHR, Bertens D, Geurts S, Kessels RPC. Learning capacity in early-stage Alzheimer's disease: The role of feedback during learning on memory performance. J Neuropsychol 2024; 18:100-119. [PMID: 37319104 DOI: 10.1111/jnp.12330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 04/21/2023] [Accepted: 06/01/2023] [Indexed: 06/17/2023]
Abstract
Alzheimer's disease is characterized by a decline in episodic memory and executive functioning, hampering learning ability. Insight into outcome-based learning capacity may be relevant for optimizing the learning potential of these patients. To date, mixed results have been found in studies in which cognitively impaired participants have to learn based on positive and negative outcomes. In this study, we investigated the role of negative and positive feedback on memory performance and participants' ability to adjust their behaviour accordingly in a sample of 23 early-stage AD patients and 23 matched healthy controls. We administered a novel computerized object-location memory task, in which participants were instructed to learn and memorize the locations of different everyday objects following errorless learning (EL) and trial-and-error learning (TEL). A separate probabilistic TEL task was employed in which participants had to learn how to adjust their behaviour based on positive and negative feedback. EL had a beneficial general effect on memory performance for object locations. However, this effect was not larger in early-stage AD patients compared to controls and error frequency during acquisition of object locations was unrelated to later recall performance. No group differences were found on the probabilistic learning task with respect to learning performance over time and based on positive and negative feedback. Although the error monitoring system seems intact in patients with early-stage AD, errors during learning are likely acting as a source of interference causing difficulty in storage or retrieval of object locations.
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Affiliation(s)
- Inge Scheper
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
- Center for Psychiatry, GGZ Centraal, Amersfoort, The Netherlands
| | - Inti A Brazil
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Division Diagnostics, Research, & Education, Forensic Psychiatric Centre Pompestichting, Nijmegen, The Netherlands
| | - Jurgen A H R Claassen
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Dirk Bertens
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Klimmendaal Rehabilitation Specialists, Arnhem, The Netherlands
| | - Sofie Geurts
- Department of Medical Psychology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
- Klimmendaal Rehabilitation Specialists, Arnhem, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
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Chien SC, Chang YH, Yen CM, Onthoni DD, Wu IC, Hsu CC, Chiou HY, Chung RH. Exploring concepts and trends in informal caregiver burden: systematic review using citation network and content analysis. Aging Clin Exp Res 2023; 35:2873-2885. [PMID: 37907665 DOI: 10.1007/s40520-023-02582-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/26/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND With the increase in the aging population, informal caregivers have become an essential pillar for the long-term care of older individuals. However, providing care can have a negative impact and increase the burden on caregivers, which is a cause for concern. OBJECTIVE This study aimed to comprehensively depict the concept of "informal caregiver burden" through bibliometric and content analyses. METHODS We searched the Web of Science (WoS) database to obtain bibliometric data and included only papers published between 2013 and 2022. We used content analysis to extract and identify the core concepts within the text systematically. RESULTS Altogether, 934 papers were included in the bibliometric analysis, from which we selected 19 highly impactful papers for content analysis. The results indicate that researchers have focused on exploring the factors that impact informal caregiver burden. Meanwhile, there has been a widespread discussion regarding the caregiver burden among those caring for recipients with specific illnesses, such as dementia, Alzheimer's disease, and cancer, as these illnesses can contribute to varying levels of burden on informal caregivers. In addition, questionnaires and interviews emerged as the predominant methods for data collection in the realm of informal caregiver research. Furthermore, we identified 26 distinct assessment tools specifically tailored for evaluating burden, such as caregiver strain index (CSI). CONCLUSION For future studies, we suggest considering the intersectionality of factors contributing to the burden on informal caregivers. This approach could enhance the well-being of both caregivers and older care recipients.
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Affiliation(s)
- Shuo-Chen Chien
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Yu-Hung Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Chia-Ming Yen
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, 632, Taiwan
| | - Djeane Debora Onthoni
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - I-Chien Wu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, 632, Taiwan
| | - Hung-Yi Chiou
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ren-Hua Chung
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan.
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Yamashita M, Shimokawa T, Tanemura R. Age-related learning difficulty through trial-and-error method associated with decreased default mode network integration in healthy middle-aged adults. J Clin Exp Neuropsychol 2023; 45:433-442. [PMID: 37540061 DOI: 10.1080/13803395.2023.2242106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
INTRODUCTION Efficient learning is critical to adapting to different environments. There are well-known learning principles in cognitive rehabilitation, including errorless (EL) and trial-and-error (T&E) learning; however, little is known about their underlying neural mechanisms. In the current study, to understand the age-related changes in learning benefits and neural mechanisms applying EL and T&E learning methods in healthy middle-aged adults, we conducted a graph theoretical analysis using functional magnetic resonance imaging data and analyzed the relationship between learning benefits and age, as well as functional network connectivity and age, with both learning principles. METHOD A total of 43 participants performed a color-name association task through EL and T&E learning methods. We focused on the functional connectivity patterns of the default mode network (DMN) since previous studies demonstrated this network to be more distinctive and important for the T&E learning method than EL. Within-network functional connectivity was used as the graph metric. RESULTS Age showed significant moderate negative correlations with T&E scores and within-DMN functional connectivity in the test state following T&E learning. Conversely, age was not significantly correlated with EL scores or within-DMN functional connectivity in either the EL learning or test states. CONCLUSIONS Our findings demonstrate the age-related learning decline associated with decreased DMN integration with aging, when applying the T&E method but not the EL method, even in healthy middle-aged adults. Relationships between the underlying neural network and age are different depending on the learning method. This suggests the need to take into consideration the remaining learning ability through the T&E learning method compared to normal aging and to utilize residual DMN functioning, in addition to the comparison between score differences between EL and T&E methods, when tailoring an individual learning approach.
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Affiliation(s)
- Madoka Yamashita
- Department of Rehabilitation, Kansai Medical University, Osaka, Japan
- Department of Rehabilitation Science, Graduate School of Health Sciences Discipline, Life and Medical Sciences Area, Kobe University, Hyogo, Japan
| | - Tetsuya Shimokawa
- Graduate School of Information Science and Technology, Osaka University, Osaka, Japan
| | - Rumi Tanemura
- Department of Rehabilitation, Kansai Medical University, Osaka, Japan
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Scheper I, Kessels RPC, Brazil IA, Bertens D. Errorless and trial-and-error learning of object locations in patients with executive deficits after brain injury. Neuropsychol Rehabil 2021; 33:226-238. [PMID: 34753415 DOI: 10.1080/09602011.2021.1997765] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Studies investigating the efficacy of errorless learning (EL), a rehabilitation method in which the occurrence of errors during learning are eliminated, have predominantly involved patients with memory impairment. However, the most recent perspective on the underlying mechanism of EL explicitly takes executive processes into account. The aim of this study was to investigate whether EL of object locations is beneficial for memory performance compared to trial-and-error learning (TEL) in patients with acquired brain injury (ABI) experiencing executive deficits (N = 15) and matched healthy controls (N = 15). Participants completed an EL and TEL condition of a computerized spatial learning task, in which the location of everyday objects had to be memorized. The number of errors made during learning was predetermined, varying from 0 (EL condition) to 1, 2, 3, 4 or 5 errors (TEL condition). Results showed a beneficial effect of EL on memory performance in both ABI patients and controls (p < .001), but this advantage was not larger in ABI patients compared to controls and was not moderated by the amount of errors made during learning.
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Affiliation(s)
- Inge Scheper
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Roy P C Kessels
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands.,Klimmendaal Rehabilitation Specialists, Arnhem, The Netherlands
| | - Inti A Brazil
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Division Diagnostics, Research, & Education, Forensic Psychiatric Centre Pompestichting, Nijmegen, The Netherlands
| | - Dirk Bertens
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Klimmendaal Rehabilitation Specialists, Arnhem, The Netherlands
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