Episodic autobiographical memory in normal aging and mild cognitive impairment: a population-based study

Taking stock of the past: A psychometric evaluation of the Autobiographical Interview

Autobiographical memory (AM) involves a rich phenomenological re-experiencing of a spatio-temporal event from the past, which is challenging to objectively quantify. The Autobiographical Interview (AI; Levine et al. Psychology and Aging, 17(4), 677-689, 2002) is a manualized performance-based assessment designed to quantify episodic (internal) and semantic (external) features of recalled and verbally conveyed prior experiences. The AI has been widely adopted, yet has not undergone a comprehensive psychometric validation. We investigated the reliability, validity, association to individual differences measures, and factor structure in healthy younger and older adults (N = 352). Evidence for the AI's reliability was strong: the subjective scoring protocol showed high inter-rater reliability and previously identified age effects were replicated. Internal consistency across timepoints was robust, suggesting stability in recollection. Central to our validation, internal AI scores were positively correlated with standard, performance-based measures of episodic memory, demonstrating convergent validity. The two-factor structure for the AI was not well supported by confirmatory factor analysis. Adjusting internal and external detail scores for the number of words spoken (detail density) improved trait estimation of AM performance. Overall, the AI demonstrated sound psychometric properties for inquiry into the qualities of autobiographical remembering.

Effect of acupuncture on episodic memory for amnesia-type mild cognitive impairment: study protocol of a multicenter, randomized, controlled trial

BACKGROUND

Amnesic mild cognitive impairment (aMCI) is the main subtype of mild cognitive impairment (MCI) and has the highest risk of conversion to Alzheimer's disease (AD) among all MCI subtypes. Episodic memory impairment is the early cognitive impairment of aMCI, which has become an important target for AD prevention. Previous clinical evidence has shown that acupuncture can improve the cognitive ability of MCI patients. This experiment aimed to observe the efficacy and neural mechanism of TiaoshenYizhi acupuncture on the episodic memory of patients with aMCI.

METHODS

In this multicenter, parallel-group, double-blind, randomized controlled trial, 360 aMCI participants will be recruited from six subcenters and randomly assigned to the acupuncture group, sham acupuncture group, and control group. The acupuncture group will receive TiaoshenYizhi (TSYZ) acupuncture, the sham acupuncture group will use streitberger sham acupuncture, and the control group will only receive free health education. Participants in the two acupuncture groups will receive real acupuncture treatment or placebo acupuncture three times per week, 24 sessions over 8 consecutive weeks. The primary outcome will be global cognitive ability. Secondary outcomes will be a specific cognitive domain, including episodic memory and execution ability, electroencephalogram, and functional magnetic resonance imaging data. Outcomes will be measured at baseline and the fourth and eighth weeks after randomization. Repeated measurement analysis of variance and a mixed linear model will be used to observe the intervention effect.

DISCUSSION

The protocol will give a detailed procedure to the multicenter clinical trial to further evaluate the efficacy and neural mechanism of TiaoshenYizhi acupuncture on episodic memory in patients with aMCI. From this research, we expect to provide clinical evidence for early aMCI management.

TRIAL REGISTRATION

http://www.chictr.org.cn/edit.aspx?pid=142612&htm=4 , identifier: ChiCTR2100054009.

Episodic and Semantic Autobiographical Memory in Mild Cognitive Impairment (MCI): A Systematic Review

INTRODUCTION

Mild cognitive impairment (MCI) is a syndrome defined as a decline in cognitive performance greater than expected for an individual according to age and education level, not interfering notably with daily life activities. Many studies have focused on the memory domain in the analysis of MCI and more severe cases of dementia. One specific memory system is represented by autobiographical memory (AM), which has been largely studied in Alzheimer's disease and its effect on AM; however, the impairment of AM in moderate forms of decline, such as MCI, is still controversial.

OBJECTIVE

The main aim of this systematic review is to analyze the functioning of autobiographical memory in patients with MCI, considering both the semantic and the episodic components.

MATERIALS

The review process was conducted according to the PRISMA statement. The search was conducted until 20 February 2023 in the following bibliographical databases: PubMed, Web of Science, Scopus, and PsycInfo, and twenty-one articles were included.

RESULTS

The results highlight controversial findings concerning the semantic component of AM since only seven studies have found a worse semantic AM performance in patients with MCI compared to the HC group. The results of impaired episodic AM in individuals with MCI are more consistent than those concerning semantic AM.

CONCLUSIONS

Starting from the evidence of this systematic review, further studies should detect and investigate the cognitive and emotional mechanisms that undermine AM performance, allowing the development of specific interventions targeting these mechanisms.

Autobiographical memory impairment in chronic schizophrenia: Significance and clinical correlates

Previous studies of autobiographical memory (AM) in schizophrenia yielded a reduction of specificity, richness of details and conscious recollection, which indicate both, quantitative and qualitative AM changes. However, their associations with psychopathological symptoms and neuropsychological deficits were not resolved. Therefore, we sought to investigate AM with respect to psychopathology and neuropsychology in patients with chronic schizophrenia to rule out the influence of different courses of the disease. AM of four lifetime periods was examined in 75 patients and 50 healthy controls by using a semi-structured interview. The recalled episodes were rated for memory specificity. Subsequently, one single event of each period of life was rated for details and experiential aspects of reliving (originality, vividness/visual imagery, emotional re-experiencing and emotional valence). When contrasted with healthy controls, patients recalled a significantly reduced number of episodes and personal semantic facts; moreover, memory specificity of AM was significantly lower in patients than controls. While the richness of details calculated for single events showed only minor, non-significant group differences, vividness and emotional re-experiencing were significantly less pronounced in the patient group. Along with this, AM performance correlated significantly with negative symptoms including apathy as well as verbal memory and executive functions. Our results underline the significance of overgenerality as a key feature of AM in schizophrenia as well as a dissociation between intact number of details of single events and reduced vividness and emotional re-experiencing. The extent of negative symptoms including apathy and impairments of verbal memory/executive functions may explain AM deficits in chronic schizophrenia.

Episodic Memory in Amnestic Mild Cognitive Impairment (aMCI) and Alzheimer’s Disease Dementia (ADD): Using the “Doors and People” Tool to Differentiate between Early aMCI—Late aMCI—Mild ADD Diagnostic Groups

Episodic memory is the type of memory that allows the recollection of personal experiences containing information on what has happened and, also, where and when it happened. Because of its sensitivity to neurodegenerative diseases and the aging of the brain, it is considered a hallmark of Alzheimer’s disease dementia (ADD). The objective of the present study was to examine episodic memory in amnestic mild cognitive impairment (aMCI) and ADD. Patients with the diagnosis of early aMCI, late aMCI, and mild ADD were evaluated using the Doors and People tool which consists of four subtests examining different aspects of episodic memory. The statistical analysis with receiver operating characteristic curves (ROC) showed the discriminant potential and the cutoffs of every subtest. Overall, the evaluation of episodic memory with the Doors and People tool can discriminate with great sensitivity between the different groups of people with AD and, especially, early aMCI, late aMCI, and mild ADD patients.

Age effects in autobiographical memory depend on the measure

Studies examining age effects in autobiographical memory have produced inconsistent results. This study examined whether a set of typical autobiographical memory measures produced equivalent results in a single participant sample. Five memory tests (everyday memory, autobiographical memory from the past year, autobiographical memory from age 11-17, word-cued autobiographical memory, and word-list recall) were administered in a single sample of young and older adults. There was significant variance in the tests' sensitivity to age: word-cued autobiographical memory produced the largest deficit in older adults, similar in magnitude to word-list recall. In contrast, older adults performed comparatively well on the other measures. The pattern of findings was broadly consistent with the results of previous investigations, suggesting that (1) the results of the different AM tasks are reliable, and (2) variable age effects in the autobiographical memory literature are at least partly due to the use of different tasks, which cannot be considered interchangeable measures of autobiographical memory ability. The results are also consistent with recent work dissociating measures of specificity and detail in autobiographical memory, and suggest that specificity is particularly sensitive to ageing. In contrast, detail is less sensitive to ageing, but is influenced by retention interval and event type. The extent to which retention interval and event type interact with age remains unclear; further research using specially designed autobiographical memory tasks could resolve this issue.

Association between childhood parental involvement and late-life cognitive function: A population-based cross-sectional study among cognitively intact community-dwelling older adults in Japan

AIM

Although poor childhood rearing environment is known to negatively impact late-life cognitive function, there is a scarcity of evidence on the contribution of positive parenting behaviors. The present study investigates the association between parental involvement in childhood and late-life cognitive function.

METHODS

A total of 266 older adults aged between 65 and 88 years living in Wakuya City, Miyagi Prefecture, Japan, without indication of mild cognitive impairment or dementia, participated in a survey. Parental involvement in childhood was assessed by a questionnaire, and late-life cognitive function was measured by the Japanese version of the Quick Mild Cognitive Impairment (QMCI) screening test (range: 0-100). Multiple regression analysis was performed to investigate the association, adjusting for potential confounders and mediators.

RESULTS

After adjusting for age, sex, other child-rearing environment, and academic performance in grade 6, older adults with a high level of positive parental involvement in childhood scored 6.00 (95% CI: 2.39, 9.61) points higher for the QMCI total score than those without. Parental involvement in childhood showed significant dose-response positive associations with the QMCI total score (P < 0.001), clock-drawing test score (P < 0.05), and verbal fluency score (P < 0.001). Among the six types of positive parental involvement, book reading showed a significant independent positive association with QMCI total score (P < 0.01) and logical memory score (P < 0.01).

CONCLUSIONS

Greater parental involvement in childhood, particularly book reading, was associated with better late-life cognitive function. Geriatr Gerontol Int 2021; 21: 794-801.

Memory for public events in amnestic mild cognitive impairment: The role of hippocampus and ventro-medial prefrontal cortex

BACKGROUND

Current theories assume that retrograde memory deficits for semantic information in amnestic mild cognitive impairment (aMCI) are temporally graded and partially sparing most remote memories. Moreover, these models assume a prevalent role of the hippocampus in early phases of memory consolidation and of the prefrontal mesial neocortical areas in permanent consolidation of traces.

PURPOSE

To explore the relationship between hippocampus and memory accuracy for the most recent public events and between the ventro-medial prefrontal cortex (vmPFC) and memory accuracy irrespective of the memory age, we investigated in aMCI patients the retrograde memory for public events and its relationship with grey matter volume reductions in the hippocampus and vmPFC.

METHODS

18 aMCI patients and 13 healthy subjects (HS) underwent a modified version of the Famous Events questionnaire (FEq) to assess their memory performance for public events. Patients underwent 3T-MRI scanning to assess correlations between FEq's scores and grey matter volumes.

RESULTS

aMCI showed significantly reduced performances on FEq compared to HS in the recollection of most recent events, while no significant difference was observed for more remote memories, thus demonstrating a temporal gradient. Moreover, hippocampal volumes predicted accuracy scores for most recent, but not older, public events. Finally, an area in the subcallosal portion of the vmPFC, corresponding to BA32, predicted accuracy scores on FEq irrespective of the period examined.

CONCLUSIONS

Pathological changes in a neural circuit linking hippocampal to medial prefrontal cortical regions are responsible for impaired recollection of retrograde memories in aMCI.

A Longitudinal Study of Episodic and Semantic Autobiographical Memory in aMCI and Alzheimer's Disease Patients

BACKGROUND

The main objective of this study was to analyze the evolution of autobiographical memory (both episodic and semantic) in patients with mild cognitive impairment, patients with Alzheimer's disease, and a healthy control group. We compared these groups at two time points: first, at baseline, and in a follow-up after 18 months.

METHOD

Twenty-six healthy older adults, 17 patients with mild amnestic cognitive impairment, and 16 patients with Alzheimer's disease, matched on age and educational level, were evaluated at both time points with the Autobiographical Memory Interview.

RESULTS

The results showed significant longitudinal deterioration in episodic and semantic autobiographical memory in patients with mild cognitive impairment and in patients with Alzheimer's disease, but not in healthy older adults.

CONCLUSIONS

The deterioration of episodic and semantic autobiographical memory in AD is confirmed; however, although the episodic was impaired in aMCI, a pattern that evolved toward deterioration over a period of eighteen months was observed for the semantic autobiographical memory.

The influence of emotional narrative content on the self-reference effect in memory

This study investigated how emotional language usage impacts self-referential effects in memory in healthy older adults and individuals with amnestic mild cognitive impairment (aMCI). To heighten self-focus, 37 healthy older adults and 22 aMCI participants narrated autobiographical memories and then encoded words using a self-referencing or a semantic strategy. We were interested in how narrating autobiographical memories impacted subsequent memory. We probed narrative language usage with the Linguistic Inquiry and Word Count text analysis program, testing the degree to which language from the narrated autobiographical memories contain emotional (positive and negative) words that predicted the self-reference effect across groups. Results indicated that higher levels of positive emotional language were related to larger self-reference effects in memory. In conclusion, narrating autobiographical memories using emotional language influenced the effectiveness of self-referencing as a memory strategy for both healthy older adults and aMCI participants.

Differences between episodic and semantic memory in predicting observation-based activities of daily living in mild cognitive impairment and Alzheimer's disease

Individuals with mild cognitive impairment (MCI) can often progress into Alzheimer's Disease (AD). Research suggests that decline in episodic memory and semantic memory, as well as functional abilities, can be sensitive in predicting disease progression. This study aimed to (a) investigate episodic and semantic memory performance differences between AD and MCI, (b) determine if memory performance predicts observation-based activities of daily living (ADLs), and (c) explore whether semantic memory mediates the relationship between episodic memory and ADLs. Fifty-eight AD, 53 MCI, and 72 healthy control participants were administered the Rey-O, California Verbal Learning Test, Animal Fluency Test, Boston Naming Test, and Direct Assessment of Functional Status (DAFS). The results revealed, first, that AD participants performed significantly lower than the MCI participants across semantic memory and episodic memory tasks, with the exception of the Boston Naming Test. Second, hierarchical-stepwise regression analyses found that semantic memory significantly predicted DAFS orientation, communication, and financial skills in AD, but episodic memory predicted shopping skills. Furthermore, semantic memory significantly predicted DAFS transportation skills in AD and MCI. Third, within the overall sample, semantic memory mediated the relationship between episodic memory and ADLs. Taken together, the findings suggest decline in semantic memory (as measured by confrontational naming and category fluency) and episodic memory (as measured by list and complex visual design learning and recall) may lead to decline in different and specific aspects of functional abilities in AD and MCI.

Association between positive grandparental involvement during childhood and generativity in late life among community-dwelling, cognitively intact, older adults in Japan

AIM

Generativity is increasingly being recognized as a key element of healthy aging. The present study investigated whether children who received more positive grandparental involvement would show higher generativity in late life.

METHODS

In 2017, 173 older adults living in Wakuya City (Miyagi Prefecture, Japan), and who showed normal cognition based on the Quick Mild Cognitive Impairment Screen, participated in a self-report life course survey (age range: 65-88 years). The association between positive grandparental involvement in childhood and generativity (measured by the Loyola Generativity Scale) was investigated using multiple linear regression adjusted for potential confounders.

RESULTS

Compared with older adults without or had low positive grandparental involvement in childhood, a higher level of generativity was observed among those with medium (β = 1.93, 95% confidence interval [CI]: 0.24-3.62) and high positive grandparental involvement (β = 2.09, 95% CI: 0.32-3.87), adjusting for age, gender, memory performance, depressive symptoms, childhood socio-economic status and parental involvement. The significant dose-response association remained even after further adjusting for education and current grandparental experiences.

CONCLUSION

Greater positive grandparental involvement in childhood was associated with a higher level of generativity among community-dwelling, cognitively intact, Japanese older adults. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2021; ••: ••-••.

Episodic memory decline is associated with deficits in coherence of discourse

This study investigates coherence of discourse in the production of autobiographical narratives by individuals with aMCI. Autobiographical interviews were analyzed to determine whether reduced episodic recall was related to deficits in discourse coherence. A coherence rating scale was used to evaluate relatedness of the autobiographical details produced by participants to the topic of discourse. Interviews were transcribed, segmented into details, and divided into sets of episodic, semantic, or supplementary information, which were subsequently analysed with the coherence rating scale. We predicted that the known episodic deficits observed in aMCI could also affect the retrieval of coherent episodic information. The results revealed deficits in coherence could be found in both episodic and semantic information in the aMCI group. These results suggest that the cognitive deficits experienced by individuals with aMCI may go beyond their known difficulty in recalling episodic details, as they also affect the controlled retrieval of both episodic and semantic information.

Executive Functions, Episodic Autobiographical Memory, Problem-Solving Capacity, and Depression Proposal for a Structural Equations Model

The executive functions play an important role in storing and recovering autobiographical memories, especially episodic memories. These types of memories provide information about solutions and experiences from the past that can be utilized as examples in the present when seeking solutions to any problem. In addition, a close relationship between depression and the executive functions has been widely recognized. This study aims to elaborate a structural equations model that empirically supports the relationships among the executive functions, episodic autobiographical memory, and the adaptive capacity to solve problems, taking into account the depressed mood state. In all, 32 healthy elderly people, 32 patients with Parkinson disease, 32 with amnestic mild cognitive impairment, and 32 with Alzheimer disease were evaluated. Structural equation models were estimated to test the effects among the constructs. The final model shows adequate fit indexes, thus revealing that an individual's problem-solving capacity will depend on the capacity to access the episodic autobiographical memory, which in turn will depend on the maintenance of executive functioning. In a parallel way, the mood state, and specifically depression, will play a modulator role because when there is depressive symptomatology, some capacities that depend on executive control can be diminished.

The role of hippocampus in the retrieval of autobiographical memories in patients with amnestic Mild Cognitive Impairment due to Alzheimer's disease

The role of the hippocampus and neocortical areas in the retrieval of past memories in pre-dementia Alzheimer's disease (AD) patients was investigated. The aim was to assess whether the hippocampus has a temporary role in memory trace formation, according to the Cortical Reallocation Theory (CRT), or whether it continuously updates and enriches memories, according to the Multiple Trace Theory. According to the former theory, hippocampal damage should affect more recent memories, whereas the association cortex is expected to affect memories of the entire lifespan. In the second case, damage to either the hippocampus or the association cortices should affect memories of the entire lifespan. Seventeen patients with amnestic Mild Cognitive Impairment due to AD were submitted to autobiographical (i.e., episodic and semantic personal) memory assessment. Patients underwent MRI for the acquisition of T1-weighted brain volumes. Voxel-based morphometry was used to assess correlations between grey matter (GM) volumes and autobiographical memory. Correlation analyses revealed a strict association between GM volumes in the hippocampus and patients' ability to retrieve the most recent but not the oldest autobiographical memories in both aspects, episodic and semantic. Moreover, patients' GM volumes in the pre-frontal and temporal polar areas were associated with recollection of episodic and semantic events, respectively. Finally, GM volumes in the precuneus and occipital cortex were associated with retrieval of the most recent episodic events. These findings indicate that the hippocampus has a specific time-dependent role; thus, they support the CRT.

Autobiographical memory deficits in patients with depression follow a temporal distribution

Autobiographical memory deficits are known in depression. The temporal distribution thereof across periods of life has rarely been considered yet. Autobiographical memories for 5 life periods were investigated in 27 depressed in-patients and compared to 31 matched healthy controls using the Bielefelder Autobiographisches Gedächtnis Inventar. Depressed patients reported significantly less details in memories dating from childhood to 30 years, correlating with severity of depression. Memories from childhood and recent periods were less positive in depressed patients. Thus, we found a distinct pattern of autobiographical memory deficits in depressed patients. Possible etiological factors, however, need further investigations.

Self-projection in younger and older adults: a study of episodic memory, prospection, and theory of mind

Self-projection is the ability to orient the self in different places in time and space. Episodic memory, prospection, and theory of mind (ToM) are all cognitive abilities that share an element of self-projection. Previous research has posited that each of these abilities stems from the same neural network. The current study compared performance of cognitively healthy older adults and younger adults on several self-projection tasks to examine the relatedness of these constructs behaviorally. Episodic memory and prospection were measured using an episodic interview task where the participants were asked to remember or imagine events that either had happened in the past or could happen in the future and then gave ratings describing the extent to which they were mentally experiencing the event and from what perspective they viewed it. ToM was measured by asking participants to make judgments regarding the intentions of characters described in stories that involved cognitive, affective, or ironic components. Our results demonstrate that aging influences episodic memory, prospection, and ToM similarly: older adult participants showed declines on each of these measures compared to younger adults. Further, we observed correlations between performance on the measures of episodic memory and prospection as well as between episodic memory and ToM, although no correlation between prospection and ToM was observed after controlling for chronological age. We discuss these results in the light of theories suggesting that each of these abilities is governed by a common brain system.

Self, cortical midline structures and the resting state: Implications for Alzheimer's disease

Different aspects of the self have been reported to be affected in many neurological or psychiatric diseases such as Alzheimer's disease (AD), including mainly higher-level cognitive self-unawareness. This higher sense of self-awareness is most likely related to and dependent on episodic memory, due to the proper integration of ourselves in time, with a permanent conservation of ourselves (i.e., sense of continuity across time). Reviewing studies in this field, our objective is thus to raise possible explanations, especially with the help of neuroimaging studies, for where such self-awareness deficits originate in AD patients. We describe not only episodic (and autobiographical memory) impairment in patients, but also the important role of cortical midline structures, the Default Mode Network, and the resting state (intrinsic brain activity) for the processing of self-related information.

The most frequently used tests for assessing executive functions in aging

There are numerous neuropsychological tests for assessing executive functions in aging, which vary according to the different domains assessed.

OBJECTIVE

To present a systematic review of the most frequently used instruments for assessing executive functions in older adults with different educational levels in clinical and experimental research.

METHODS

We searched for articles published in the last five years, using the PubMed database with the following terms: "neuropsychological tests", "executive functions", and "mild cognitive impairment". There was no language restriction.

RESULTS

25 articles fulfilled all the inclusion criteria. The seven neuropsychological tests most frequently used to evaluate executive functions in aging were:[1] Trail Making Test (TMT) Form B;[2] Verbal Fluency Test (VFT) - F, A and S;[3] VFT Animals category;[4] Clock Drawing Test (CDT);[5] Digits Forward and Backward subtests (WAIS-R or WAIS-III);[6] Stroop Test; and[7] Wisconsin Card Sorting Test (WCST) and its variants. The domains of executive functions most frequently assessed were: mental flexibility, verbal fluency, planning, working memory, and inhibitory control.

CONCLUSION

The study identified the tests and domains of executive functions most frequently used in the last five years by research groups worldwide to evaluate older adults. These results can direct future research and help build evaluation protocols for assessing executive functions, taking into account the different educational levels and socio-demographic profiles of older adults in Brazil.

Sleep-dependent memory consolidation in healthy aging and mild cognitive impairment

Sleep quality and architecture as well as sleep's homeostatic and circadian controls change with healthy aging. Changes include reductions in slow-wave sleep's (SWS) percent and spectral power in the sleep electroencephalogram (EEG), number and amplitude of sleep spindles, rapid eye movement (REM) density and the amplitude of circadian rhythms, as well as a phase advance (moved earlier in time) of the brain's circadian clock. With mild cognitive impairment (MCI) there are further reductions of sleep quality, SWS, spindles, and percent REM, all of which further diminish, along with a profound disruption of circadian rhythmicity, with the conversion to Alzheimer's disease (AD). Sleep disorders may represent risk factors for dementias (e.g., REM Behavior Disorder presages Parkinson's disease) and sleep disorders are themselves extremely prevalent in neurodegenerative diseases. Working memory , formation of new episodic memories, and processing speed all decline with healthy aging whereas semantic, recognition, and emotional declarative memory are spared. In MCI, episodic and working memory further decline along with declines in semantic memory. In young adults, sleep-dependent memory consolidation (SDC) is widely observed for both declarative and procedural memory tasks. However, with healthy aging, although SDC for declarative memory is preserved, certain procedural tasks, such as motor-sequence learning, do not show SDC. In younger adults, fragmentation of sleep can reduce SDC, and a normative increase in sleep fragmentation may account for reduced SDC with healthy aging. Whereas sleep disorders such as insomnia, obstructive sleep apnea, and narcolepsy can impair SDC in the absence of neurodegenerative changes, the incidence of sleep disorders increases both with normal aging and, further, with neurodegenerative disease. Specific features of sleep architecture, such as sleep spindles and SWS are strongly linked to SDC. Diminution of these features with healthy aging and their further decline with MCI may account for concomitant declines in SDC. Notably these same sleep features further markedly decline, in concert with declining cognitive function, with the progression to AD. Therefore, progressive changes in sleep quality, architecture, and neural regulation may constitute a contributing factor to cognitive decline that is seen both with healthy aging and, to a much greater extent, with neurodegenerative disease.

Is it possible to use highly realistic virtual reality in the elderly? A feasibility study with image-based rendering

BACKGROUND

Virtual reality (VR) opens up a vast number of possibilities in many domains of therapy. The primary objective of the present study was to evaluate the acceptability for elderly subjects of a VR experience using the image-based rendering virtual environment (IBVE) approach and secondly to test the hypothesis that visual cues using VR may enhance the generation of autobiographical memories.

METHODS

Eighteen healthy volunteers (mean age 68.2 years) presenting memory complaints with a Mini-Mental State Examination score higher than 27 and no history of neuropsychiatric disease were included. Participants were asked to perform an autobiographical fluency task in four conditions. The first condition was a baseline grey screen, the second was a photograph of a well-known location in the participant's home city (FamPhoto), and the last two conditions displayed VR, ie, a familiar image-based virtual environment (FamIBVE) consisting of an image-based representation of a known landmark square in the center of the city of experimentation (Nice) and an unknown image-based virtual environment (UnknoIBVE), which was captured in a public housing neighborhood containing unrecognizable building fronts. After each of the four experimental conditions, participants filled in self-report questionnaires to assess the task acceptability (levels of emotion, motivation, security, fatigue, and familiarity). CyberSickness and Presence questionnaires were also assessed after the two VR conditions. Autobiographical memory was assessed using a verbal fluency task and quality of the recollection was assessed using the "remember/know" procedure.

RESULTS

All subjects completed the experiment. Sense of security and fatigue were not significantly different between the conditions with and without VR. The FamPhoto condition yielded a higher emotion score than the other conditions (P<0.05). The CyberSickness questionnaire showed that participants did not experience sickness during the experiment across the VR conditions. VR stimulates autobiographical memory, as demonstrated by the increased total number of responses on the autobiographical fluency task and the increased number of conscious recollections of memories for familiar versus unknown scenes (P<0.01).

CONCLUSION

The study indicates that VR using the FamIBVE system is well tolerated by the elderly. VR can also stimulate recollections of autobiographical memory and convey familiarity of a given scene, which is an essential requirement for use of VR during reminiscence therapy.

Autobiographical memory: a clinical perspective

Autobiographical memory (ABM) comprises memories of one’s own past that are characterized by a sense of subjective time and autonoetic awareness. Although ABM deficits are among the primary symptoms of patients with major psychiatric conditions such as mild cognitive impairment (MCI) and Alzheimer Disease (AD) or chronic schizophrenia large clinical studies are scarce. We therefore summarize and discuss the results of our clinical studies on ABM deficits in the respective conditions. In these studies ABM was assessed by using the same instrument – i.e., the Erweitertes Autobiographisches Gedächtnis Inventar (E-AGI) – thus allowing a direct comparison between diagnostic groups. Episodic ABM, especially the richness of details was impaired already in MCI and in beginning AD. Semantic memories were spared until moderate stages, indicating a dissociation between both memory systems. A recency effect was detectable in cognitively unimpaired subjects and vanished in patients with AD. A similar pattern of deficits was found in patients with chronic schizophrenia but not in patients with major depression. These ABM deficits were not accounted for by gender, or education level and did not apply for the physiological ageing process in otherwise healthy elderly. In conclusion, ABM deficits are frequently found in AD and chronic schizophrenia and primarily involve episodic rather than semantic memories. This dissociation corresponds to the multiple trace theory which hypothesized that these memory functions refer to distinct neuronal systems. The semi-structured interview E-AGI used to discern ABM changes provided a sufficient reliability measures, moreover potential effects of a number of important confounders could be falsified so far. These findings underline the relevance of ABM-assessments in clinical practice.