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Mychajliw C, Holz H, Minuth N, Dawidowsky K, Eschweiler GW, Metzger FG, Wortha F. Performance Differences of a Touch-Based Serial Reaction Time Task in Healthy Older Participants and Older Participants With Cognitive Impairment on a Tablet: Experimental Study. JMIR Aging 2024; 7:e48265. [PMID: 38512340 PMCID: PMC10995790 DOI: 10.2196/48265] [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: 04/17/2023] [Revised: 11/30/2023] [Accepted: 12/08/2023] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Digital neuropsychological tools for diagnosing neurodegenerative diseases in the older population are becoming more relevant and widely adopted because of their diagnostic capabilities. In this context, explicit memory is mainly examined. The assessment of implicit memory occurs to a lesser extent. A common measure for this assessment is the serial reaction time task (SRTT). OBJECTIVE This study aims to develop and empirically test a digital tablet-based SRTT in older participants with cognitive impairment (CoI) and healthy control (HC) participants. On the basis of the parameters of response accuracy, reaction time, and learning curve, we measure implicit learning and compare the HC and CoI groups. METHODS A total of 45 individuals (n=27, 60% HCs and n=18, 40% participants with CoI-diagnosed by an interdisciplinary team) completed a tablet-based SRTT. They were presented with 4 blocks of stimuli in sequence and a fifth block that consisted of stimuli appearing in random order. Statistical and machine learning modeling approaches were used to investigate how healthy individuals and individuals with CoI differed in their task performance and implicit learning. RESULTS Linear mixed-effects models showed that individuals with CoI had significantly higher error rates (b=-3.64, SE 0.86; z=-4.25; P<.001); higher reaction times (F1,41=22.32; P<.001); and lower implicit learning, measured via the response increase between sequence blocks and the random block (β=-0.34; SE 0.12; t=-2.81; P=.007). Furthermore, machine learning models based on these findings were able to reliably and accurately predict whether an individual was in the HC or CoI group, with an average prediction accuracy of 77.13% (95% CI 74.67%-81.33%). CONCLUSIONS Our results showed that the HC and CoI groups differed substantially in their performance in the SRTT. This highlights the promising potential of implicit learning paradigms in the detection of CoI. The short testing paradigm based on these results is easy to use in clinical practice.
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Affiliation(s)
- Christian Mychajliw
- Geriatric Center, University Hospital for Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
- TuCAN, Tübingen Cognitive Assessment for Neuropsychiatric Disorders, Tübingen, Germany
| | - Heiko Holz
- TuCAN, Tübingen Cognitive Assessment for Neuropsychiatric Disorders, Tübingen, Germany
- Institute of Computer Science, Ludwigsburg University of Education, Ludwigsburg, Germany
- LEAD Graduate School & Research Network, University of Tübingen, Tübingen, Germany
| | - Nathalie Minuth
- Geriatric Center, University Hospital for Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
- TuCAN, Tübingen Cognitive Assessment for Neuropsychiatric Disorders, Tübingen, Germany
| | - Kristina Dawidowsky
- Geriatric Center, University Hospital for Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
- TuCAN, Tübingen Cognitive Assessment for Neuropsychiatric Disorders, Tübingen, Germany
| | - Gerhard Wilhelm Eschweiler
- Geriatric Center, University Hospital for Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Florian Gerhard Metzger
- Geriatric Center, University Hospital for Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
- Vitos Hospital for Psychiatry and Psychotherapy Haina, Klinik für Psychiatrie und Psychotherapie, Vitos Haina gGmbH, Haina, Germany
| | - Franz Wortha
- TuCAN, Tübingen Cognitive Assessment for Neuropsychiatric Disorders, Tübingen, Germany
- LEAD Graduate School & Research Network, University of Tübingen, Tübingen, Germany
- Centre for Early Mathematics Learning, School of Science, Loughborough University, Loughborough, United Kingdom
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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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Markowitsch HJ, Staniloiu A. Behavioral, neurological, and psychiatric frailty of autobiographical memory. WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2023; 14:e1617. [PMID: 35970754 DOI: 10.1002/wcs.1617] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/01/2022] [Accepted: 07/03/2022] [Indexed: 05/20/2023]
Abstract
Autobiographical-episodic memory is considered to be the most complex of the five long-term memory systems. It is autonoetic, which means, self-reflective, relies on emotional colorization, and needs the features of place and time; it allows mental time traveling. Compared to the other four long-term memory systems-procedural memory, priming, perceptual, and semantic memory-it develops the latest in phylogeny and ontogeny, and is the most vulnerable of the five systems, being easily impaired by brain damage and psychiatric disorders. Furthermore, it is characterized by its fragility and proneness to distortion due to environmental influences and subsequent information. On the brain level, a distinction has to be made between memory encoding and consolidating, memory storage, and memory retrieval. For encoding, structures of the limbic system, with the hippocampus in its center, are crucial, for storage of widespread cortical networks, and for retrieval again a distributed recollection network, in which the prefrontal cortex plays a crucial role, is engaged. Brain damage and psychiatric diseases can lead to what is called "focal retrograde amnesia." In this context, the clinical picture of dissociative or functional or psychogenic amnesia is central, as it may result in autobiographical-emotional amnesia of the total past with the consequence of an impairment of the self as well. The social environment therefore can have a major impact on the brain and on autobiographical-episodic memory processing. This article is categorized under: Psychology > Memory.
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Affiliation(s)
- Hans J Markowitsch
- Department of Physiological Psychology, University of Bielefeld, Bielefeld, Germany
| | - Angelica Staniloiu
- Department of Physiological Psychology, University of Bielefeld, Bielefeld, Germany
- Oberberg Clinic, Hornberg, Germany
- Department of Psychology, University of Bucharest, Bucharest, Romania
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Almkvist O, Graff C. Practice effects in cognitive assessments three years later in non-carriers but not in symptom-free mutation carriers of autosomal-dominant Alzheimer's disease: Exemplifying procedural learning and memory? Front Aging Neurosci 2022; 14:905329. [PMID: 36275006 PMCID: PMC9580215 DOI: 10.3389/fnagi.2022.905329] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 08/15/2022] [Indexed: 11/14/2022] Open
Abstract
Practice effects (PEs) defined as an improvement of performance in cognition due to repeated assessments between sessions are well known in unimpaired individuals, while less is known about impaired cognition and particularly in latent brain disease as autosomal-dominant Alzheimer's disease. The purpose was to evaluate the general (across tests/domains) and domain-specific PE calculated as the annual rate of change (ARC) in relation to years to the estimated disease onset (YECO) and in four groups of AD: asymptomatic mutation carriers (aAD, n = 19), prodromal, i.e., symptomatic mutation carriers, criteria for AD diagnosis not fulfilled (pAD, n = 4) and mutation carriers diagnosed with AD (dAD, n = 6) as well as mutation non-carriers from the AD families serving as a healthy comparison group (HC, n = 35). Cognition was assessed at baseline and follow-up about 3 years later by 12 tests covering six domains. The aAD and HC groups were comparable at baseline in demographic characteristics (age, gender, and education), when they were in their early forties, while the pAD and dAD groups were older and cognitively impaired. The results on mean ARC for the four groups were significantly different, small, positive, and age-insensitive in the HC group, while ARC was negative and declined with time/disease advancement in AD. The differences between HC and aAD groups in mean ARC and domain-specific ARC were not significant, indicating a subtle PE in aAD in the early preclinical stage of AD. In the symptomatic stages of AD, there was no PE probably due to cognitive disease-related progression. PEs were the largest in the verbal domain in both the HC and aAD groups, indicating a relationship with cognitive vulnerability. The group-related difference in mean ARC was predominant in timekeeping tests. To conclude, the practice effect in over 3 years was suggested to be linked to procedural learning and memory.
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Affiliation(s)
- Ove Almkvist
- Divisions of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
- *Correspondence: Ove Almkvist
| | - Caroline Graff
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Divisions of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Fabiani M, Asnakew BA, Bowie DC, Chism SM, Clements GM, Gardner JC, Islam SS, Rubenstein SL, Gratton G. A healthy mind in a healthy body: Effects of arteriosclerosis and other risk factors on cognitive aging and dementia. THE PSYCHOLOGY OF LEARNING AND MOTIVATION 2022; 77:69-123. [PMID: 37139101 PMCID: PMC10153623 DOI: 10.1016/bs.plm.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In this review we start from the assumption that, to fully understand cognitive aging, it is important to embrace a holistic view, integrating changes in bodily, brain, and cognitive functions. This broad view can help explain individual differences in aging trajectories and could ultimately enable prevention and remediation strategies. As the title of this review suggests, we claim that there are not only indirect but also direct effects of various organ systems on the brain, creating cascades of phenomena that strongly contribute to age-related cognitive decline. Here we focus primarily on the cerebrovascular system, because of its direct effects on brain health and close connections with the development and progression of Alzheimer's Disease and other types of dementia. We start by reviewing the main cognitive changes that are often observed in normally aging older adults, as well as the brain systems that support them. Second, we provide a brief overview of the cerebrovascular system and its known effects on brain anatomy and function, with a focus on aging. Third, we review genetic and lifestyle risk factors that may affect the cerebrovascular system and ultimately contribute to cognitive decline. Lastly, we discuss this evidence, review limitations, and point out avenues for additional research and clinical intervention.
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Affiliation(s)
- Monica Fabiani
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Bethlehem A. Asnakew
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Daniel C. Bowie
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Sydney M. Chism
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Grace M. Clements
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Jennie C. Gardner
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Samia S. Islam
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Samantha L. Rubenstein
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Gabriele Gratton
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
- Psychology Department, University of Illinois at Urbana-Champaign, Champaign, IL, United States
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