Preserved word-stem-completion priming of semantically encoded information in Alzheimer's disease

Exploring why "memory loss" is a misleading descriptor of people living with dementia and can lead to dysfunctional care

Amidst goals for prevention and improved treatment for people living with dementia, much remains needed to enhance the quality of life of those currently diagnosed, especially the transfer of accurate information from professionals to the public. Although many healthcare professionals understand the various types of memory and which are likely to be more affected than others during the progression of dementia, lay persons are more frequently unaware of that important information. The terms used to describe the symptoms of dementia can have a great impact on perceptions of faculties that are absent, compromised, or preserved. Understanding the nuances of preserved memory faculties and other cognitive abilities retained by persons with dementia is important in this regard. The term "memory loss" as a descriptor of the syndrome of dementia and ascribing it to persons with dementia connotes an inability to form new memories and participate in meaningful social interactions, which is detrimental to their personhood. From a multidisciplinary approach drawn from neurology, neurobiology, psychology, and case vignettes, we aim herein to highlight the ways in which the term "memory loss" can be inaccurate, counterproductive and potentially promote dementia-related misperceptions, malignant positioning and malignant social psychology. Persons with dementia unequivocally struggle with explicit memory, or recalling on demand, but retain implicit memory, as evidenced by research and everyday actions. Therefore, we propose the use of alternative medical language to reflect accurately memory impairment and preservation of some important memory capabilities.

Repetition Priming in Individuals with Amnestic Mild Cognitive Impairment and Alzheimer's Dementia: a Systematic Review and Meta-Analysis

The literature on repetition priming in Alzheimer's disease (AD) is inconsistent, with some findings supporting spared priming while others do not. Several factors may explain these inconsistencies, including AD severity (e.g., dementia vs. Mild Cognitive Impairment; MCI) and priming paradigm-related characteristics. This systematic review and meta-analysis provides a quantitative summary of repetition priming in AD. We examined the between-group standard mean difference comparing repetition priming in AD dementia or amnestic MCI (aMCI; presumably due to AD) to controls. Thirty-two studies were selected, including 590 individuals with AD dementia, 267 individuals with amnestic MCI, and 703 controls. Our results indicated that both individuals with aMCI and AD dementia perform worse on repetition priming tasks than cognitively older adults. Paradigm-related moderators suggested that the effect size between studies comparing the combined aMCI or AD dementia group to cognitively healthy older adults was the highest for paradigms that required participants to produce, rather than identify, primes during the test phase. Our results further suggested that priming in AD is impaired for both conceptual and perceptual priming tasks. Lastly, while our results suggested that priming in AD is impaired for priming tasks that require deep processing, we were unable to draw firm conclusions about whether priming is less impaired in aMCI or AD dementia for paradigms that require shallow processing.

Neural Correlates of Repetition Priming: A Coordinate-Based Meta-Analysis of fMRI Studies

Repetition priming is a form of implicit memory, whereby classification or identification of a stimulus is improved by prior presentation of the same stimulus. Repetition priming is accompanied with a deceased fMRI signal for primed vs. unprimed stimuli in various brain regions, often called "repetition suppression," or RS. Previous studies proposed that RS in posterior regions is associated with priming of perceptual processes, whereas RS in more anterior (prefrontal) regions is associated with priming of conceptual processes. To clarify which regions exhibit reliable RS associated with perceptual and conceptual priming, we conducted a quantitative meta-analysis using coordinate-based activation likelihood estimation. This analysis included 65 fMRI studies that (i) employed visual repetition priming during either perceptual or conceptual tasks, (ii) demonstrated behavioral priming, and (iii) reported the results from whole-brain analyses. Our results showed that repetition priming was mainly associated with RS in left inferior frontal gyrus and fusiform gyrus. Importantly, RS in these regions was found for both perceptual and conceptual tasks, and no regions show RS that was selective to one of these tasks. These results question the simple distinction between conceptual and perceptual priming, and suggest consideration of other factors such as stimulus-response bindings.

Alzheimer's Disease: Prototype of Cognitive Deterioration, Valuable Lessons to Understand Human Cognition

It is important for neurologists to become more familiar with neuropsychological evaluation for Alzheimer disease. The growth of this method in research, as an available, inexpensive, and noninvasive diagnostic approach, which can be administered even by non-specialist-trained examiners, makes this knowledge more necessary than ever. Such knowledge has a basic role in planning national programs in primary health care systems for prevention and early detection of Alzheimer disease. This is more crucial in developing countries, which have higher rates of dementia prevalence along with cardiovascular risk factors, lack of public knowledge about dementia, and limited social support. In addition compared to the neurological hard signs which are tangible and measurable, the concept of cognition seems to be more difficult for the neurologists to evaluate and for the students to understand. Dementia in general and Alzheimer's disease as the prototype of cognitive disorders specifically, play an important role to explore all domains of human cognition through its symptomatology and neuropsychological deficits.

Episodic memory in normal aging and Alzheimer disease: Insights from imaging and behavioral studies

Age-related cognitive changes often include difficulties in retrieving memories, particularly those that rely on personal experiences within their temporal and spatial contexts (i.e., episodic memories). This decline may vary depending on the studied phase (i.e., encoding, storage or retrieval), according to inter-individual differences, and whether we are talking about normal or pathological (e.g., Alzheimer disease; AD) aging. Such cognitive changes are associated with different structural and functional alterations in the human neural network that underpins episodic memory. The prefrontal cortex is the first structure to be affected by age, followed by the medial temporal lobe (MTL), the parietal cortex and the cerebellum. In AD, however, the modifications occur mainly in the MTL (hippocampus and adjacent structures) before spreading to the neocortex. In this review, we will present results that attempt to characterize normal and pathological cognitive aging at multiple levels by integrating structural, behavioral, inter-individual and neuroimaging measures of episodic memory.

Lexical Priming in Alzheimer's Disease and Aphasia

Lexical priming was examined in patients with Alzheimer's disease and in aphasic patients. Control participants were divided into young and elderly [cf. Arroyo-Anlló et al.: Eur J Cogn Psychol 2004;16:535-553]. For lexical priming, a word-stem completion task was used. Normal elderly participants had lexical priming scores that were significantly lower than those of young individuals. Analysis of covariance with age and educational level as covariates showed that the control participants, aphasic and Alzheimer patients did not differ significantly on the lexical priming task. Our results suggest that performance in the lexical priming task diminishes with physiological aging, but is not significantly affected by mild or moderate Alzheimer's disease or by fluent or non-fluent aphasia.

Automatic and Controlled Uses of Memory in Alzheimer's Disease

This study used the process-dissociation procedure (Jacoby, 1991) to examine the contribution of automatic and controlled uses of memory to a stem completion task in 16 patients with Alzheimer's disease (AD) and a matched group of healthy elderly subjects (EC). In an inclusion task subjects attempted to use a studied word to complete three-letter word stems, in an exclusion task they were instructed to complete stems with unstudied words. Relative to patients with AD, EC subjects produced more target word completions under inclusion conditions, and less target word completions under exclusion conditions. The probability of the AD group using studied words to complete stems was invariant across inclusion and exclusion conditions. Estimates derived from the process-dissociation calculations, showed that the performance of the AD patients was mediated entirely by automatic uses of memory, whereas for EC subjects controlled and automatic processes codetermined task performance. Both estimates of controlled and to a lesser extent automatic uses of memory were greater for the EC than the AD subjects, indicating that the stem completion impairment in AD may not be entirely attributable to a deficiency in controlled memory processes but also due to reduced automatic processing.

Stimulus Contrast and Word Reading Speed in Alzheimer's Disease

The oral word reading speed of patients with Alzheimer's disease (AD) and healthy young and older control participants was evaluated across a broad range of stimulus contrast levels in two experiments. The impact of stimulus repetition on reading speed also was examined. It was found that the older adult participants, and particularly the AD patients, were more sensitive to contrast reductions. Each subject group was able to read repeated words more rapidly than novel words but this repetition effect emerged only at lower stimulus contrast levels. It was concluded that AD patients have feature extraction speeds comparable to non-demented older adults but only when the stimuli are presented at a relatively high contrast. These findings suggest that the automatic encoding processes involved in word recognition remain intact in mildly demented AD patients given stimuli of sufficient strength.

Capacity for decision-making in Alzheimer's disease: selfhood, positioning and semiotic people

The aim of this article is to explore some of the ethical issues surrounding the assessment and determination of capacity of people with dementia in light of their meaning-making ability as shown through discourse. Discourse analysis, two illustrative cases, social construction theory and positioning are used to highlight some of the ethical dilemmas involved in basing a determination of capacity on the diagnosis of dementia and neuropsychological tests of cognitive function. Although neuropsychological tests have their place in assessing some aspects of cognitive function, aspects cognition such as meaning-making ability and selfhood cannot be assessed in a standard format. In dementia, there can be a differential impairment of recall memory while the personality, values and substantial long-term memory remain intact, as does implicit memory for recent events. People with dementia are vulnerable to being negatively positioned, thereby unfairly undermining their rights to make decisions about aspects of their lives. Assessing the capacity of a person with dementia to engage in decision-making is presently in need of examination so as to take into account the person's meaning-making ability and selfhood. Incorrect negative positioning, based on the diagnosis and defects in recall memory, can obscure intact cognitive abilities that allow a person to make decisions about aspects of living, creating the possibility of lasting harm being inflicted on the person with dementia.

Memory processing in Alzheimer's disease

The aim of the present research was to examine automatic and controlled influences on memory processing in patients with Alzheimer's disease using the process-dissociation procedure. In Experiment 1, a source recognition procedure was used, and the patients were found to have significantly reduced estimates of automatic processing and capacity to recognise words seen during the study phase of the procedure. In Experiment 2, a detection of repetition procedure was used to determine whether automatic influences on memory decline as a dementia progressed. The patients showed the expected inability to detect repetition in their responding, but there was no evidence that estimates of automatic processing were predicted by mental status scores or by ratings of the severity of dementia. In the third study, a novel method for estimating parameters in the process-dissociation model, developed from the task used in Experiment 2, was tested in a student sample. In this procedure, participants first produce semantic associates with either high or low relatedness to a list of cue words. These responses are subsequently used in a paired associate learning paradigm to determine independent estimates of recollection and automatic processing. Evidence for the validity of this procedure was found in Experiment 3 and the procedure used to examine memory processing in a sample of persons with dementia (Experiment 4). The patient group was found to have a substantial deficit in controlled recollection and a reduced capacity for automatic memory processing.

Conceptual implicit memory performance in Alzheimer's disease

Alzheimer's disease (AD) patients often exhibit deficits on conceptual implicit memory tests such as category exemplar generation and word association. However, these tests rely on word production abilities, which are known to be disrupted by AD. The current study assessed conceptual implicit memory performance in AD patients and elderly control participants using a conceptual priming task that did not require word production (i.e., semantic decision). Memory performance was also examined using a category exemplar generation test (i.e., a conceptual priming task that required word production) and a recognition memory test. AD patients exhibited deficits on the semantic decision task, the category exemplar generation task, and the recognition memory task. The results indicate that the conceptual memory deficits observed in AD patients cannot be attributed completely to word production difficulties.

The impact of semantic impairment on word stem completion in Alzheimer's disease

Both the extent of semantic memory impairment and the level of processing attained during encoding might constitute critical factors in determining the amount of word-stem completion (WSC) priming encountered in Alzheimer's disease (AD) subjects. We investigated the impact of varying encoding level in AD and elderly normal subjects, using a set of stimuli ranked as "intact" or "degraded" in terms of each subject's semantic knowledge on probe questions. For both shallow and deep encoding conditions, overall priming in the two subject groups was equivalent. However, for the deep encoding condition, consisting of a semantic judgment task performed on each target word, the priming effect noted in AD subjects was significantly smaller for semantically degraded items than for semantically intact items. Results indicate that the degree of semantic impairment represents one important variable affecting the amount of WSC priming which results when deep encoding procedures are used at study.

On the reliability of implicit and explicit memory measures

Functional dissociations between implicit and explicit memory tests often take the form of large differences between groups or experimental conditions (e.g., amnesics and controls, elderly and younger persons, or persons learning with and without a distracting secondary task) when performance is assessed using explicit memory tests, whereas no difference is observed with implicit memory tests. We argue that the interpretation of such dissociations in terms of the memory processes or systems involved in performance is problematic because the same data pattern would emerge as a result of a mere methodological artifact, that is, the situation that implicit memory tests have low reliability whereas explicit memory tests are fairly reliable measurement instruments. We present reasons for such a reliability difference, and we demonstrate it empirically in Experiments 1a, 1b, and 2. However, our analysis also shows, and Experiment 3 confirms empirically, that implicit memory tests need not necessarily be less reliable measurement instruments than explicit memory tests.

Functional changes in brain activity during priming in Alzheimer's disease

Patients with Alzheimer's disease (AD) are often impaired on certain forms of implicit memory, such as word-stem completion priming (WSCP). Lesion data suggest that deficient WSCP may be associated with abnormal functioning in the posterior neocortex. Using positron emission tomography (PET), we here provide direct support for this view. Compared with normal old adults, AD patients showed reduced priming on a word-stem completion task. The normal old showed decreased activity in right occipital cortex (area 19), whereas the AD patients showed increased activity in this region during priming. To the extent that decreased activity during priming reflects an experience-dependent reduction of the neuronal population involved, these results indicate that shaping of the relevant neurons is slower in AD, possibly as a result of inadequate initial stimulus-processing.

Priming for new associations in normal aging and in mild dementia of the Alzheimer type

Recent data suggest that patients with Alzheimer's disease (AD) are able to show perceptual priming and, to some extent, conceptual priming for material which has preexisting representations in memory, and that normal elderly subjects are able to automatically activate pre-existing representations in both perceptual and conceptual priming tasks. An important question concerns the capacity of showing priming for materials without pre-existing representations in memory in normal and pathological aging. In order to address this issue, 20 patients with mild AD, 20 elderly controls and 20 young controls subjects were assessed with a paradigm of priming for new verbal associations. Neither the patients nor the normal elderly subjects demonstrated priming effects for new associations, while young subjects showed significant priming effects. These results suggest that the absence of priming for new verbal associations is attributable more to an effect of aging than to a specific effect of Alzheimer's disease.

Controlled and automatic memory process in Alzheimer's disease

The aim of this study was to examine the contribution of controlled (or conscious) and automatic (or unconscious) memory processes to the performance of a stem-completion recall task by persons with Alzheimer's disease and a matched group of healthy elderly individuals. The recall task made use of the process dissociation procedure of Jacoby (1991), which allows the separate estimation of conscious and unconscious influences on memory. Recollection was found to be severely impaired in the community dwelling demented patients. Further, the estimates of the automatic processing were also found to be reduced, although there was considerable overlap in the performance of the two groups on this parameter. It was found that the residual capacity of Alzheimer's patients to recall previously learned information was supported to a substantial degree by their automatic memory processes.

Automatic influences of memory in Alzheimer's disease

Automatic and controlled influences of memory were examined in 12 patients with early Alzheimer's disease (AD) and 12 control subjects. The subjects studied a list of words and then received three-letter word stems in three different retrieval tasks. In an indirect memory task (word-stem completion priming), they were asked to produce the first word that came to mind in response to each stem. In an inclusion task, they were required to produce a studied word in response to each stem, and in an exclusion task they were asked to produce a new, unstudied word for each stem. The performance of the subjects with AD was equal in the inclusion and exclusion conditions, showing no evidence of controlled recollection for the studied words, while their automatic memory as well as priming were preserved. The results provide neuropsychological support for the distinction between controlled and automatic memory processes.

Monitoring frequency of occurrence without awareness: evidence from patients with Alzheimer's disease

People are surprisingly accurate at judging how often an event occurs. Patients with Alzheimer's disease (AD), however, perform poorly on such tasks, suggesting that this ability is compromised when episodic memory is impaired. The tasks used to assess this ability in previous studies, however, placed demands on retrieval that could obscure whether frequency of occurrence was adequately encoded. We developed an indirect test of frequency monitoring based on changes in reading time as a function of item repetition. Using this procedure, patients with AD showed normal frequency monitoring for novel information (Turkish words) even though they were unable to remember the words or judge how often individual words had been presented. These findings suggest the existence of a mechanism that automatically monitors frequency of occurrence and operates outside of conscious awareness.

Word-stem completion priming for perceptually and conceptually encoded words in patients with Alzheimer's disease

This study examined whether the frequently reported word-stem completion priming deficit of Alzheimer's disease (AD) patients could be characterized as either a semantic encoding deficit or a conceptual priming deficit. AD patients and normal elderly control subjects studied words in two conditions: (1) reading visually presented words aloud, which maximizes perceptual encoding of seen words, and (2) generating words aloud from definitions, which maximizes conceptual encoding of words not seen but retrieved on the basis of semantic context. Recognition accuracy was greater for words that were generated at study, and word-stem completion priming was greater for words that were read at study. For the AD patients, recognition accuracy was impaired and word-stem completion priming was intact for words encoded in both conditions. The findings are discussed in terms of discrepant results about word-stem completion priming in AD.

Perceptual priming in Alzheimer's and Parkinson's diseases

The present study focused on perceptual identification priming (implicit memory) in early stages of dementia by studying demographically and cognitively matched patients with Alzheimer's disease (AD) and Parkinson's disease (PD). The AD and PD groups performed normally on perceptual identification priming, whereas their explicit recognition memory was equally impaired compared to normal controls. These results imply that priming in perceptual identification relies on the perceptual memory system which can resist not only impairments of explicit memory but also widespread cognitive deterioration induced by the neurodegenerative processes in AD or PD.

Stem-completion priming in Alzheimer's disease: the importance of target word articulation

Stem-completion priming performance in patients with Alzheimer's type dementia (DAT) was explored in three experiments in which both the standard repetition priming effect and a novel indirect form of priming, cohort priming, were measured. In the first experiment, in which study stimuli were words, both priming effects were found to be markedly attenuated in the DAT group. In the second experiment, the study stimuli were specially constructed nonwords, and it was found that cohort priming was present at normal levels in the DAT group. In a third experiment we tested the specific hypothesis that the requirement to overtly articulate target stimuli during the study phase was critical for the appearance of normal cohort priming in the DAT group in Experiment 2, and also for the normal levels of repetition priming which have been reported in some published studies. Two encoding conditions were compared, one in which subjects simply had to read aloud the target words and a second in which subjects were required to make evaluative (pleasantness) ratings for each of the target words (identical to that used in Experiment 1). Stem-completion priming performance following the latter condition was significantly attenuated in the DAT group relative to a healthy control group, but following the "read aloud" encoding condition, normal levels of repetition and cohort priming were observed. It is suggested that the most fruitful approach to understanding the performance of DAT subjects on lexical repetition priming tasks will involve a detailed analysis of language functions and how they interact with other, possibly mnemonic, processes in the generation of primed responses.

Cross-form priming in normal aging and in mild dementia of the Alzheimer type

Twenty patients at early stages of Alzheimer's disease (AD), 20 elderly control subjects and 20 young subjects completed a cross-form priming task, followed by a free recall task. Results show that patients with mild AD display priming effects, and that these priming effects are strictly comparable to those obtained by elderly and young control subjects. Moreover, while the patients' performances are normal in the implicit part of the task, they are massively impaired in the explicit free recall task. These results don't support the hypothesis of a dissociation of performances between identification tasks and generation tasks in Alzheimer's disease, and show that conceptual priming can be observed at early stages of the disease, despite semantic memory impairments.

Explicit memory and repetition priming in dementia: evidence for a common basic mechanism underlying conscious and unconscious retrieval deficits

The present study was designed to assess performance of Alzheimer's (AD) and Multi-infarct (MID) demented patients on the explicit and implicit versions of two memory tasks, namely Word-Stem Completion and Word-Pair Learning. Consistently with previous studies, the AD patients were deficient on the explicit and implicit versions of both tasks. In MID patients, a dissociation emerged between normal implicit and deficient explicit Word-Stem Completion. Two multiple regression analyses were performed to evaluate patients' ability on measures of lexical-semantic competence, explicit memory, and global intellective efficiency in predicting level of repetition priming. The results demonstrate a close association between explicit and implicit memory performance in AD patients but no relation between repetition priming level and measures of lexical-semantic competence or general intelligence. Overall, the results of the present study do not support previous conceptualizations suggesting that a breakdown in the structure of semantic memory is at the root of deficient priming in demented patients. Alternative interpretations of the deficient repetition priming effect in dementia, based on a common mechanism underlying conscious and unconscious retrieval deficits, are discussed.

Priming deficits in patients with dementia of the Alzheimer type

In a study that replicated the procedures used by Salmon et al. (1988), the effect on stem completion performance of two different semantic orientation tasks has been assessed in patients with Alzheimer's disease. Previously reported findings of impairment in repetition priming in Alzheimer patients were confirmed. Performance was not affected by the nature of the orientation task. No significant correlations were found between explicit and implicit memory tests. The results are discussed in the context of a hypothesized parallel decline in explicit and implicit memory systems.

Implicit verbal memory in Alzheimer's disease

Word stem completion and word identification were used in two repetition priming experiments to evaluate the implicit memory performance of Alzheimer's disease (AD) patients. This issue was also approached using various meta-analyses combining and contrasting previously reported data. While the experimental results suggested that AD patients present preserved repetition priming in both tasks, the meta-analytic approach showed an impairment in stem completion in comparison to word identification. Converging evidence cautiously suggested to accept the results of the meta-analysis. The above dissociation has been interpreted as showing differences in the specific contribution of data- and conceptually-driven processes in the two implicit tasks. A further meta-analysis on the effect of reduced perceptual availability of the study material on the same two tasks indicated that this variable affected repetition priming in word identification more heavily than in stem completion. The impact of such a dissociation on theories of implicit memory is discussed.

Dissociations between word priming effects in normal subjects and patients with memory disorders: multiple memory systems or retrieval?

Repetition priming was measured in two different tasks within a single experiment--one in which subjects named briefly (tachistoscopically) presented words, and one requiring naming of visually fragmented/degraded words. Thirteen amnesic patients, 12 patients with Alzheimer's disease (AD), and 15 normal control subjects were tested under 4 experimental conditions involving the factorial combination of two variables: delay of test (10 minutes and 24 hours), and number of prior occurrences of the primed items (1 and 4). The two tasks produced very different patterns of priming effects, despite the fact that common study phases were employed. In one task the priming effect showed no decay and virtually no effect of the number of prior occurrences of the primed items, whereas both these variables affected priming in the other task. The AD patients evidenced impaired priming in both tasks. However, in the degraded-word-naming task the deficit was only apparent under some experimental conditions. The amnesics produced priming effects that in absolute terms were similar to those produced by control subjects. However, when group differences in overall performance level were taken into account in the tachistoscopic task, these patients also showed clear evidence of impaired priming. It is argued that the complex pattern of priming effects obtained is best explained by the characteristics of the retrieval cues provided in the tasks, and, generally, that such characteristics may determine whether or not experimental variables will affect measured priming.

Priming in perceptual identification of pseudowords is normal in Alzheimer's disease

Patients with Alzheimer's disease (AD) have deficits in recall and recognition memory, and show dissociable performance in repetition priming tasks: They exhibit impaired priming in word-completion and word-generation tasks, but normal priming is perceptual identification of words. In order to examine whether AD patients can show normal priming with novel, unfamiliar stimuli, the present study examined their performance in perceptual identification of pseudowords. Despite impaired recognition memory performance, AD patients showed normal priming in perceptual identification of pseudowords. These results extend the boundaries of intact repetition priming in AD, demonstrating that such priming is not limited to stimuli that are pre-morbidly represented in long-term knowledge. Preserved repetition priming in AD may reflect the operation of perceptual processes localized to posterior visual circuits that are relatively spared in AD.

Event-related potentials (ERPs) during repetition priming in Alzheimer's patients and young and older controls

Although memory tested explicitly (e.g., recognition) is clearly deficient in the early stages of Alzheimer's disease, it is less clear if memory tested implicitly is similarly affected. To assess this, event-related potentials (ERPs) were recorded during a word-repetition priming paradigm, with semantic and orthographic orienting tasks, from 10 patients with mild probable Alzheimer's disease (PAD; mean age of 70.6), 10 young (24.1) and 10 older (69.8) controls. The extent of priming by word repetition was assessed using the new minus old ERP repetition effect. The young and older control groups showed clear ERP repetition effects that were larger during semantic than orthographic blocks. Although the PAD patients displayed the same general trends, their ERP repetition effects were not nearly as marked when compared to controls. To the extent that the ERP repetition effect recorded during this repetition priming paradigm is a measure of implicit performance, the data suggest that memory assessed in this fashion is spared in at least some Alzheimer's patients in the early stages of the disease.

Event-related potential investigations of cognitive development and aging

Comparison of the results of the studies of cognitive development and normal aging suggests a large degree of commonality in both behavioral and ERP effects across a wide age range. Whether measured in young children, adolescents, young, middle-aged or elderly adults, the size of the ERP repetition effect did not differ among the various age groups. This was true whether memory was tested directly during continuous recognition or indirectly during variants of semantic categorization tasks. Similarly, in the studies of adult aging, the degree of RT facilitation during the semantic task did not differ with age and, in both the studies of cognitive development and aging, the degree of RT prolongation during the explicit tasks did not appear to differ as a function of age. Moreover, in the studies of adult aging, the effects of three versus two exposures of a word assessed in the PM session (TABLE 1), modulated RT similarly in all three age groups. These data argue for continuity of information processing across a very wide age range during both direct and indirect memory tasks, when retention is assessed during the recognition (for explicit testing) and repetition (for implicit testing) phases of the task. Since ERP and RT modulation do not appear to differ with age during the retrieval phases of these experiments, how can the performance differential seen in young children and older adults be explained? Some evidence comes from the ERP data recorded during the study phases of our explicit tasks. During continuous recognition, both young children and elderly adults did not show the typical subsequent "memory effect." In the case of the children, the subsequently unrecognized ERP was larger than the subsequently recognized ERP, whereas for the older adults, there was no difference between these two ERPs. Moreover, during these same tasks, the young children did show the "crossover" (new greater than old) pattern for slow wave activity, whereas the older adults did not. Since these ERP findings were obtained during the acquisition phase (i.e., to new items that had to be encoded for subsequent retrieval), the data argue for encoding difficulties as one means of explaining the performance differences seen at the two ends of the age spectrum. However, since the older adults displayed a different new/old pattern for slow wave activity, the two age groups may differ qualitatively in the strategies employed to encode items for subsequent retrieval.(ABSTRACT TRUNCATED AT 400 WORDS)

Preserved implicit memory for lexical information in Alzheimer's disease

Recent studies have suggested that there is a specific impairment of implicit memory for lexical priming in Alzheimer's Disease. However, there are problems in accepting data from the word-stem completion paradigm as evidence of pure implicit-memory performance. To assess whether Alzheimer's Disease patients are relatively impaired on implicit memory for lexical information an anagram-solution task was adopted. A group of 16 early stage Alzheimer's Disease patients and a group of 16 normal elderly subjects were presented a list of 40 target words. Subsequent free recall was significantly poorer in the former group, but while both groups were significantly better at solving anagrams for words they had previously seen, there was no difference between the two groups in the amount of priming. The data are consistent with the view that previous reports of an implicit deficit in Alzheimer's Disease may not generalise to implicit tasks independent of explicit-memory performance.

Memory deficits in Alzheimer's patients: a comprehensive review

Despite considerable experimental work on Alzheimer's disease (AD), the underlying cognitive mechanisms as well as the precise localization of neuropathological changes critical for memory loss remains undefined. A review of the neuropsychological literature on long-term memory deficits in AD patients suggests that AD patients display (a) a pervasive deficit of explicit memory, (b) a partial deficiency of implicit memory for verbal and visuoperceptual material (as measured by repetition priming procedures), and (c) a substantial sparing of implicit memory for visuomotor skills. The explicit memory loss is likely a result of encoding as well as consolidation difficulties. A faulty lexical-semantic knowledge structure appears responsible for deficient repetition priming effects. Since neuropathological changes diffusely affect the brain of AD patients, establishing a clear relationship between localization of cerebral lesions and memory deficits is particularly difficult. Nevertheless, data suggest that extensive involvement of the hippocampal-amygdala complex plays a major role in explicit memory loss. Damage to associative cortical areas likely is involved in repetition priming deficits. The relative integrity of primary motor and sensory cortical areas and of the basal ganglia likely subsume, by contrast, the normal learning of visuomotor skills.