Adaptation to cognitive deficit? An exploration of apparent dissociations between everyday memory and test performance late after stroke

Everyday memory: self-perception and structural brain correlates in a healthy elderly population

Mapping the cerebral structural correlates of age-related cognitive decline is a growing area of research. The aim of the present study was to investigate the relationship between healthy elderly's perceived memory functioning in daily life, neuropsychological test performance on a standardized test on verbal memory, and cortical thickness and subcortical volumes in brain regions implicated in memory networks, including the medial temporal lobe (MTL). Eighty-three healthy and cognitively well-functioning volunteers aged 60-85 years underwent MRI scans, Everyday Memory Questionnaire (EMQ), and neuropsychological assessment. Both self-perceived memory in daily life related to attention and executive functions and an objective measure of verbal recall (CVLT) were, independently, associated with thickness of the left MTL. The two cognitive variables were uncorrelated, and including both measures in the model nearly doubled the amount of explained variance on MTL thickness. This suggests that measures of perceived everyday memory might substantially inform and supplement studies investigating the relationships between neuropsychological test performance and brain morphology. The results are consistent with a bigger-is-better relationship in the MTL and suggest that EMQ and neuropsychological test performance have detectable and comparable structural correlates in a region critically involved in memory functions in the well-functioning elderly.

Evaluation of a Structured Group Format Memory Rehabilitation Program For Adults Following Brain Injury

OBJECTIVE

To evaluate the impact of an 8-session structured group format memory rehabilitation program on impaired memory functioning.

PARTICIPANTS

Adults with traumatic brain injury (N = 10) or cerebral vascular accidents (N = 2).

DESIGN

A waitlist control study with pregroup, postgroup, and 1-month follow-up assessments. WECHSLER MEMORY SCALE-REVISED: Neuropsychological assessments of memory (California Verbal Learning Test, Wechsler Memory Scale-Revised logical memory, visual-paired associates, and Rey Complex Figure) and both self-report and significant other report of behaviors indicative of memory difficulties and the use of memory strategies.

RESULTS

Participation in the memory group increased participants' knowledge of memory and memory strategies as well as use of memory aids and strategies; reduced behaviors indicative of memory impairment; and had a positive effect on neuropsychological assessments of memory (eg, delayed recall for words and figures). All significant improvements exceeded change experienced by waiting-list controls and were maintained at 1-month follow-up assessment.

CONCLUSIONS

While extension of the findings is needed, the memory group has a positive impact on both neuropsychological measures of memory and everyday memory functioning.

Prevalence and correlates of face recognition impairments after acquired brain injury

Impairments of face recognition after acquired brain injury (ABI) are not restricted to prosopagnosia but commonly arise in association with other cognitive deficits and can be psychosocially debilitating. Despite this, the prevalence and cognitive concomitants of such impairments after ABI have not been systematically investigated. We tested 91 adults with ABI on a range of cognitive measures including several indices of face recognition and learning. The proportion of patients who show impaired performance varied across face learning/recognition tests between 21% and 80%. Principal components analyses indicated orthogonality between impairments of "directed facial processing", associated with memory and visuoperceptual deficits and manifest in slow learning and matching of previously unfamiliar faces, and of "face identification", associated with deficits on verbal tests and manifest in difficulty in naming famous faces. Theoretical and rehabilitative implications are considered.

Everyday memory self-assessed by adult patients with acquired brain damage and their significant others

Self-assessment of everyday memory dysfunction was examined in a sample of 48 patients with acquired brain injury. A modified version of the Everyday Memory Questionnaire (EMQ20) was used as an interview. Patients were compared to 30 persons without brain injury. EMQ20 was completed by significant others (SOs) to both patients and controls. Patients reported a higher frequency of memory problems (days per week) and more distress due to memory deficits compared to controls. A high degree of consistency was found between patient and SO ratings on these measures. No difference was found on the total usage of memory aids, but patients asked other people more for a reminder and used loose notes less than controls. Implications for rehabilitation and future research are discussed.

Cognitive impairment after transurethral resection of the prostate (TURP)

PURPOSE

It has been suggested that cognitive impairment may occur following transurethral resection of the prostate (TURP) operations due to the effects of anaesthesia or hyponatraemia or both. The aim of the study was to investigate whether TURP was associated with long-term memory complaints or cognitive impairment.

METHOD

Patients who had received a TURP or transurethral resection of a bladder tumour (TURT) in the previous 10 months were sent a questionnaire on memory problems and mood. Seventy-six TURP patients and 38 TURT patients returned the completed questionnaires. A sample of each patient group (30 TURP, 29 TURT) was assessed on standardized tests of cognitive abilities.

RESULTS

There was no significant difference between the TURP and TURT patients on the Everyday Memory Questionnaire completed by themselves or by a family member (p > 0.05). On formal cognitive testing there were no significant differences between the groups, except on the overall grading of the Kendrick Assessment Scales of Cognitive Ageing, in which TURP patients performed at a significantly lower level than TURT patients.

CONCLUSIONS

The results suggest that patients are no more likely to complain of memory problems following a TURP than with any other operative procedure. There was a slight difference in cognitive abilities but this did not indicate significant impairment of cognitive function.

Cognitive rehabilitation for memory deficits following stroke

BACKGROUND

Memory problems occur following stroke. Cognitive rehabilitation programmes are provided to retrain memory function or to teach patients strategies to cope despite memory impairment.

OBJECTIVES

To determine the effects of cognitive rehabilitation for memory problems following stroke.

SEARCH STRATEGY

We searched the Cochrane Stroke Group Trials Register, Medline, EMBASE, CINHAL and CLIN PSYCH databases and reference lists from relevant articles. Date of most recent searches: December 1998.

SELECTION CRITERIA

Controlled trials of memory retraining in stroke. Studies with mixed aetiology groups were excluded unless they had more than 75% of stroke patients or separate data were available for the stroke patients.

DATA COLLECTION AND ANALYSIS

Two reviewers extracted trial data and assessed trial quality. Reviewers contacted investigators for further details of trials.

MAIN RESULTS

One trial was identified with 12 participants. This showed memory strategy training had no significant effect on memory impairment or subjective memory complaints.

REVIEWER'S CONCLUSIONS

There is insufficient evidence to support or refute the effectiveness of cognitive rehabilitation for memory problems after stroke.

The relationship between memory performance, perceived cognitive function, and mood in patients with epilepsy

OBJECTIVE

The low correlations between memory performance and subjective memory may be attributable to disparities between tasks in neuropsychological tests and cognitive experiences of day-to-day living. This study evaluated the relationship between everyday memory performance, perceived cognitive functioning, and mood among patients with epilepsy.

METHODS

From three epilepsy centers in the USA, 138 patients were recruited. Everyday memory performance was measured using the Rivermead Behavioural Memory Test (RBMT). Questionnaires assessed perceived cognitive function (cognitive domain, Quality of Life in Epilepsy Inventory, QOLIE-89) and mood (Profile of Mood States, POMS).

RESULTS

Memory performance scores were weakly correlated with perceived cognitive functioning (r =0.22, P < 0.01). Perceived cognitive functioning was strongly correlated with mood (r = - 0.75, P < 0.0001). Multiple regression analysis indicated memory performance (RBMT) and mood (POMS) were independent predictors of perceived cognitive functioning (P < 0.02); however, the explained variance for RBMT and POMS combined (R2 = 0.58) is only slightly higher than the predictive value for the POMS score alone (R2 = 0.56).

CONCLUSIONS

Memory performance tests provide qualitatively different information than patients' self-reported cognitive difficulties, thus it is important to assess memory performance, perceived cognitive function, and mood separately because the constructs are related but not redundant.