Enumeration in Alzheimer's disease and other late life psychiatric syndromes

Examining aging and numerosity using an integrated diffusion model

Two experiments are presented that use tasks common in research in numerical cognition with young adults and older adults as subjects. In these tasks, one or two arrays of dots are displayed, and subjects decide whether there are more or fewer dots of one kind than another. Results show that older adults, relative to young adults, tend to rely more on the perceptual feature, area, in making numerosity judgments when area is correlated with numerosity. Also, convex hull unexpectedly shows different effects depending on the task (being either correlated with numerosity or anticorrelated). Accuracy and response time (RT) data are interpreted with the integration of the diffusion decision model with models for the representation of numerosity. One model assumes that the representation of the difference depends on the difference between the numerosities and that standard deviations (SDs) increase linearly with numerosity, and the other model assumes a log representation with constant SDs. The representational models have coefficients that are applied to differences between two numerosities to produce drift rates and SDs in drift rates in the decision process. The two tasks produce qualitatively different patterns of RTs: One model fits results from one task, but the results are mixed for the other task. The effects of age on model parameters show a modest decrease in evidence driving the decision process, an increase in the duration of processes outside the decision process (nondecision time), and an increase in the amount of evidence needed to make a decision (boundary separation). (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Individuation of object parts in aging

Research on enumeration with isolated objects has indicated that young and older adults can report up to three elements with similar efficiency (subitizing effect). Recent studies on subitizing in young adults have shown that individuation occurs over parts of an object as efficiently as over physically disconnected objects, suggesting that spatial separation is a sufficient requirement for efficient individuation. Do young and older adults share this sufficient requirement? In two experiments, we tested for the presence of subitizing in an enumeration task with a varying number of distinct objects and object parts. In Experiment 1, results indicated the presence of a bilinear function (with an inflection point between 3 and 4 elements, a proxy for subitizing) in the response speed of young and older adults, and in both stimulus conditions. In addition, the enumeration slope in older participants was steeper for object parts than for objects in the subitizing range, possibly due to perceptual degradation (e.g., in contour detection). The pattern found generalizes to other stimuli (Experiment 2), thus highlighting the robustness of the present findings. Overall, the results indicate that while some perceptual factors (such as contour detection or curvature polarity) may hamper subitizing speed of older individuals relative to young adults, the subitizing span remains at approximately three to four elements for multiple objects and object parts in both young and older adults. Thus, individuation of multiple objects and object parts is a mechanism relatively resistant to aging.

Neural Dynamics of Multiple Object Processing in Mild Cognitive Impairment and Alzheimer's Disease: Future Early Diagnostic Biomarkers?

The aim of this study was to investigate the behavioral and electrophysiological dynamics of multiple object processing (MOP) in mild cognitive impairment (MCI) and Alzheimer's disease (AD), and to test whether its neural signatures may represent reliable diagnostic biomarkers. Behavioral performance and event-related potentials [N2pc and contralateral delay activity (CDA)] were measured in AD, MCI, and healthy controls during a MOP task, which consisted in enumerating a variable number of targets presented among distractors. AD patients showed an overall decline in accuracy for both small and large target quantities, whereas in MCI patients, only enumeration of large quantities was impaired. N2pc, a neural marker of attentive individuation, was spared in both AD and MCI patients. In contrast, CDA, which indexes visual short term memory abilities, was altered in both groups of patients, with a non-linear pattern of amplitude modulation along the continuum of the disease: a reduction in AD and an increase in MCI. These results indicate that AD pathology shows a progressive decline in MOP, which is associated to the decay of visual short-term memory mechanisms. Crucially, CDA may be considered as a useful neural signature both to distinguish between healthy and pathological aging and to characterize the different stages along the AD continuum, possibly becoming a reliable candidate for an early diagnostic biomarker of AD pathology.

Understanding the world of dementia. How do people with dementia experience the world?

BACKGROUND

There is growing awareness that the subjective experience of people with dementia is important for understanding behavior and improving quality of life. This paper reviews and reflects on the currently available theories on subjective experience in dementia and it explores the possibility of a knowledge gap on the influence of neurological deficits on experience in late stage dementia.

METHODS

A literature review on current commonly used theories on experience in dementia was supplemented with a systematic review in PubMed and Psychinfo. For the systematic review, the terms used were Perception and Dementia and Behavior; and Awareness and Dementia and Long term care.

RESULTS

Current models emphasize the psychosocial factors that influence subjective experience, but the consequences of neurological deficits are not elaborated upon. The systematic literature search on the neuropsychological functioning in dementia resulted in 631 papers, of which 94 were selected for review. The current knowledge is limited to the early stages of Alzheimer's disease. Next to memory impairments, perception of the direct environment, interpretation of the environment, and inhibition of own responses to the environment seem to be altered in people with dementia.

CONCLUSIONS

Without knowledge on how perception, interpretation and the ability for response control are altered, the behavior of people with dementia can easily be misinterpreted. Research into neuropsychological functioning of people in more severe stages and different forms of dementia is needed to be able to develop a model that is truly biopsychosocial. The proposed model can be used in such research as a starting point for developing tests and theories.

Electrophysiological Advances on Multiple Object Processing in Aging

EEG research conducted in the past 5 years on multiple object processing has begun to define how the aging brain tracks the numerosity of the objects presented in the visual field for different goals. We review the recent EEG findings in healthy older individuals (age range: 65-75 years approximately) on perceptual, attentional and memory mechanisms-reflected in the N1, N2pc and contralateral delayed activity (CDA) components of the EEG, respectively-during the execution of a variety of cognitive tasks requiring simultaneous processing of multiple elements. The findings point to multiple loci of neural changes in multi-object analysis, and suggest the involvement of early perceptual mechanisms, attentive individuation and working memory (WM) operations in the neural and cognitive modification due to aging. However, the findings do not simply reflect early impairments with a cascade effect over subsequent stages of stimulus processing, but in fact highlight interesting dissociations between the effects occurring at the various stages of stimulus processing. Finally, the results on older adults indicate the occurrence of neural overactivation in association to good levels of performance in easy perceptual contexts, thus providing some hints on the existence of compensatory phenomena that are associated with the functioning of early perceptual mechanisms.

Aging and the number sense: preserved basic non-symbolic numerical processing and enhanced basic symbolic processing

Aging often leads to general cognitive decline in domains such as memory and attention. The effect of aging on numerical cognition, particularly on foundational numerical skills known as the number sense, is not well-known. Early research focused on the effect of aging on arithmetic. Recent studies have begun to investigate the impact of healthy aging on basic numerical skills, but focused on non-symbolic quantity discrimination alone. Moreover, contradictory findings have emerged. The current study aimed to further investigate the impact of aging on basic non-symbolic and symbolic numerical skills. A group of 25 younger (18-25) and 25 older adults (60-77) participated in non-symbolic and symbolic numerical comparison tasks. Mathematical and spelling abilities were also measured. Results showed that aging had no effect on foundational non-symbolic numerical skills, as both groups performed similarly [RTs, accuracy and Weber fractions (w)]. All participants showed decreased non-symbolic acuity (accuracy and w) in trials requiring inhibition. However, aging appears to be associated with a greater decline in discrimination speed in such trials. Furthermore, aging seems to have a positive impact on mathematical ability and basic symbolic numerical processing, as older participants attained significantly higher mathematical achievement scores, and performed significantly better on the symbolic comparison task than younger participants. The findings suggest that aging and its lifetime exposure to numbers may lead to better mathematical achievement and stronger basic symbolic numerical skills. Our results further support the observation that basic non-symbolic numerical skills are resilient to aging, but that aging may exacerbate poorer performance on trials requiring inhibitory processes. These findings lend further support to the notion that preserved basic numerical skills in aging may reflect the preservation of an innate, primitive, and embedded number sense.

Aging and visual counting

Background

Much previous work on how normal aging affects visual enumeration has been focused on the response time required to enumerate, with unlimited stimulus duration. There is a fundamental question, not yet addressed, of how many visual items the aging visual system can enumerate in a “single glance”, without the confounding influence of eye movements.

Methodology/Principal Findings

We recruited 104 observers with normal vision across the age span (age 21–85). They were briefly (200 ms) presented with a number of well- separated black dots against a gray background on a monitor screen, and were asked to judge the number of dots. By limiting the stimulus presentation time, we can determine the maximum number of visual items an observer can correctly enumerate at a criterion level of performance (counting threshold, defined as the number of visual items at which ≈63% correct rate on a psychometric curve), without confounding by eye movements. Our findings reveal a 30% decrease in the mean counting threshold of the oldest group (age 61–85: ∼5 dots) when compared with the youngest groups (age 21–40: 7 dots). Surprisingly, despite decreased counting threshold, on average counting accuracy function (defined as the mean number of dots reported for each number tested) is largely unaffected by age, reflecting that the threshold loss can be primarily attributed to increased random errors. We further expanded this interesting finding to show that both young and old adults tend to over-count small numbers, but older observers over-count more.

Conclusion/Significance

Here we show that age reduces the ability to correctly enumerate in a glance, but the accuracy (veridicality), on average, remains unchanged with advancing age. Control experiments indicate that the degraded performance cannot be explained by optical, retinal or other perceptual factors, but is cortical in origin.