The contribution of retrospective memory, attention and executive functions to the prospective and retrospective components of prospective memory following TBI

Relationship Between Future Thinking and Prospective Memory in Alzheimer's Disease

Background

Future thinking and prospective memory are two cognitive processes oriented toward the future and reliant on the ability to envision oneself in future scenarios.

Objective

We explored the connection between future thinking and prospective memory in individuals with Alzheimer's disease (AD).

Methods

We invited both AD participants and control participants to engage in event-based prospective memory tasks (e.g., "please hand me this stopwatch when I inform you there are 10 minutes remaining") and time-based prospective memory tasks (e.g., "close the book you are working on in five minutes"). Additionally, we asked participants to engage in a future thinking task where they imagined upcoming events.

Results

Analysis revealed that AD participants exhibited lower performance in both prospective memory tasks and future thinking compared to the control group. Importantly, we identified significant positive correlations between the performance on event- and time-based prospective memory tasks and future thinking abilities among AD participants.

Conclusions

These findings underscore the connection between the decline in both prospective memory domains and the ability to envision future events in individuals with AD. Our results also shed light on the challenges AD individuals face when trying to project themselves into the future to mentally pre-experience upcoming events.

The limitations and challenges in the assessment of executive dysfunction associated with real-world functioning: The opportunity of serious games

Nowadays, there is a broad range of methods for detecting and evaluating executive dysfunction ranging from clinical interview to neuropsychological evaluation. Nevertheless, a critical issue of these assessments is the lack of correspondence of the neuropsychological test's results with real-world functioning. This paper proposes serious games as a new framework to improve the neuropsychological assessment of real-world functioning. We briefly discuss the contribution and limitations of current methods of evaluation of executive dysfunction (paper-and-pencil tests, naturalistic observation methods, and Information and Communications Technologies) to inform on daily life functioning. Then, we analyze what are the limitations of these methods to predict real-world performance: (1) A lack of appropriate instruments to investigate the complexity of real-world functioning, (2) the vast majority of neuropsychological tests assess well-structured tasks, and (3) measurement of behaviors are based on simplistic data collection and statistical analysis. This work shows how serious games offer an opportunity to develop more efficient tools to detect executive dysfunction in everyday life contexts. Serious games provide meaningful narrative stories and virtual or real environments that immerse the user in natural and social environments with social interactions. In those highly interactive game environments, the player needs to adapt his/her behavioral performance to novel and ill-structured tasks which are suited for collecting user interaction evidence. Serious games offer a novel opportunity to develop better tools to improve diagnosis of the executive dysfunction in everyday life contexts. However, more research is still needed to implement serious games in everyday clinical practice.

Virtual-Reality Performance-Based Assessment of Cognitive Functions in Adult Patients With Acquired Brain Injury: A Scoping Review

Individuals with acquired brain injury (ABI) commonly present with impairments in cognitive abilities. As these competencies seem to be predictive of patients' abilities to reintegrate into the everyday settings, it is crucial to assess them properly. However, previous research has indicated that patients may perform relatively well on standard tests of cognitive functioning, but may nonetheless encounter significant difficulties in organizing and executing everyday tasks. In order to overcome this issue, virtual reality (VR) methods have been introduced in clinical practice with the aim of creating assessments that simulate real-world activities and thus, provide a clearer picture of patients' functioning in everyday settings. This review offers an overview of VR assessment tools described in the scientific literature between 2010 and 2019. Overall, 38 relevant records describing 31 different tools were found. Among these tools, 16 assessed executive functions and prospective memory, while the other 15 assessed visuo-spatial abilities. Although promising results have been reported, our analysis indicated that about half of the tools deliver tasks that differ from everyday activities, thus limiting the generalizability of patients' performance to the real-world. Moreover, a variety of methodological shortfalls related to study Internal and External Validity have been highlighted, which hamper the possibility of drawing definite recommendations on tool choice. These limitations suggest the importance of putting considerable efforts into the improvement or development of VR tools for patients with ABI for both research and clinical purposes, considering the great potential of this form of assessment.

Validation of the Prospective Memory Concerns Questionnaire (PMCQ)

Prospective memory (PM), the ability to remember to complete intended tasks, is essential for successfully completing activities of daily living. PM impairments are common in people with neuropathology such as acquired brain injury and dementia. These PM impairments affect individuals’ capabilities in key aspects of daily living including their health, safety, and independence. The Prospective Memory Concerns Questionnaire (PMCQ) was designed as a self-report measure to understand individuals’ concerns about their memory. This questionnaire may help identify issues with PM which in turn may assist clinicians in the targeted implementation of memory compensation strategies. The PMCQ was developed using Rasch and classical test methodologies, with subscales measuring frequency of forgetting behaviors, memory concerns, and retrieval failures. The current study aimed to confirm the factor structure of the PMCQ for use in adults in the general population. The study also aimed to examine relationships between the PMCQ and naturalistic performance-based measures of PM to determine how the self-report PMCQ could be used in conjunction with performance-based measures. A community dwelling sample of 558 adults completed the PMCQ, an event-based naturalistic PM task, and time-based naturalistic PM task. Confirmatory factor analyses (CFAs) indicated that a higher order model with three subscales containing 35 items produced acceptable fit [RMSEA = 0.056 (90% CI 0.054, 0.060), SRMR = 0.062, CFI = 0.915, TLI = 0.909] The PMCQ demonstrated good internal consistency (total α = 0.95, subscales: α = 0.88–0.89). The Forgetting Behaviors subscale significantly correlated with performance on the event-based naturalistic PM task (r = −0.14, p < 0.01). The Memory Concerns and Retrieval Failures subscales did not correlate significantly with performance-based PM tasks. These findings suggest that the PMCQ may be best suited for assessing individuals’ concerns about their forgetting behaviors and identifying appropriate compensation strategies or support services. It is recommended that the PMCQ be used alongside performance-based PM tasks and other cognitive measures to comprehensively assess PM. It was concluded that the PMCQ is a suitable measure for use in adults in the general population. Further validation research of the PMCQ in general population and clinical samples will determine the measures’ sensitivity and specificity in identifying PM impairments.

Remembering to remember: prospective memory in children with epilepsy

Prospective memory, the ability to remember to perform an intended act in the future, is a complex process that involves several stages and cognitive domains. This study sought to investigate prospective memory functioning in children with idiopathic epilepsy using tasks from the Rivermead Behavioral Memory Test for Children (RBMT-C) and the Memory for Intentions Screening Test for Youth (MISTY). Performances on prospective memory task characteristics of the MISTY (i.e., cue-type, length of time delay, and response type) were also compared between and across participant groups. Healthy children (N = 26) were found to have higher overall IQ and verbal IQ scores when compared to children with epilepsy (N = 19). Group differences in prospective memory functioning were found in subtests of the RBMT-C but not on the MISTY. Lastly, while there was no significant interaction effect between the groups and MISTY task characteristics, main effects were found across participant groups; all participants performed better on event-based tasks when compared to time-based tasks and on two-minute when compared to 10-minute time delays. Overall, findings suggest potential differences in cognitive functioning, particularly in IQ and prospective memory, in children with idiopathic epilepsy, though due to differences in findings across prospective memory tasks, further research is warranted to more definitively ascertain the extent, if any, of prospective memory deficits in children with epilepsy.

Cognitive performance in older adults at three months following mild traumatic brain injury

Introduction: In the context of limited research assessing outcomes following mild traumatic brain injury (mTBI) in older adults, this study evaluated cognitive outcomes through prospective memory, and expected that performance of an older mTBI group (≥65 years) would be lower compared to orthopedic and community controls. The study also explored whether cognitive resources (retrospective memory, executive function) moderated any association between presenting Glasgow Coma Scale (GCS) and prospective memory.Method: At three-months post-injury, a mTBI group (n = 39), an orthopedic control group (n = 63), and a community control group (n = 46) completed a neuropsychological assessment, including (i) prospective memory, using a standardized paper-and-pencil task (Cambridge Prospective Memory Test), an augmented reality task and a naturalistic task, and (ii) standardized measures of retrospective memory (Hopkins Verbal Learning Test) and executive function (Trail Making Test). Group performances were compared, and bootstrapped moderation analyses evaluated the role of cognitive resources in the relationship between GCS and prospective memory outcome.Results: The mTBI group, as compared to community controls, performed significantly lower on the augmented reality task (d = -0.64 to d = -0.79), and there was a small-moderate but non-significant effect (d = -0.45) on the naturalistic task. There were no differences between the mTBI group and orthopedic controls. Retrospective memory was a unique predictor of the augmented reality task (B = 1.83) and moderated the relationship between presenting GCS and the naturalistic task (B = -5.60). Executive function moderated the association between presenting GCS and augmented reality (B = -1.13) and naturalistic task (B = -1.57).Conclusions: At three-months post-mTBI, older adults are at risk of poor cognitive performance; and the relationship between GCS and prospective memory can be moderated by cognitive resources. Further follow-up is indicated to determine whether impairments resolve or persist over time.

Assessing prospective memory in children using the Memory for Intentions Screening Test for Youth (MISTY)

OBJECTIVE

Prospective memory (PM) is defined as the ability to remember to complete an intention in the future. The first aim of this study was to address the need for clinically useful measures of PM in children, by assessing the psychometric properties of a new measure of PM in children and adolescents, the Memory for Intentions Screening Test for Youth (MISTY). The second aim was to assess the relationship between prospective memory and age, particularly the relationships between age and the impact of different PM task demands. The third aim was to examine children's performance on different aspects of PM, such as time-based versus event-based cues.

METHOD

One-hundred twenty-four children between the ages of 4 and 15 were given the MISTY.

RESULTS

Analyses revealed good internal consistency among the eight individual MISTY trials and among the six MISTY subscales which included two different cue types (event-based and time-based), two different time delays (2 minutes and 10 minutes), and two different response types (action and verbal). Results also revealed good split-half and inter-rater reliability. Findings highlighted significant correlations between age and the MISTY total score and all subscales, consistent with PM lifespan research. On the MISTY, children overall performed better on event-based cues than on time-based cues, and on shorter time delays than longer ones; there was no effect of response type (i.e. action vs. verbal response).

CONCLUSIONS

The MISTY is a promising instrument with sound psychometric properties that could be useful in both clinical and research settings. Additionally, this study highlights the age-related process of PM development in children.

One-year stability of prospective memory symptoms and performance in aging and HIV disease

Introduction: HIV disease and aging can both affect prospective memory (PM), which describes the complex process of executing delayed intentions and plays an essential role in everyday functioning. The current study investigated the course of PM symptoms and performance over approximately one year in younger and older persons with and without HIV disease. Method: Participants included 77 older (>50 years) and 35 younger (<40 years) HIV+ individuals and 44 older and 27 younger seronegative adults. Participants completed the Memory for Intentions Test to measure PM in the laboratory, the Prospective and Retrospective Memory Questionnaire to measure PM symptoms in daily life, and several clinical measures of executive functions and retrospective memory as a part of a comprehensive neurocognitive evaluation at baseline and at 14-month follow-up. Results: Findings showed additive, independent main effects of HIV and aging on time- and event-based PM performance in the laboratory, but no change in PM over time. There were no interactions between time and HIV or age groups. Parallel findings were observed for clinical measures of retrospective memory and executive functions. Older HIV+ adults endorsed the greatest frequency of PM symptoms, but there was no change in PM symptom severity over time and no interactions between time and HIV or age groups. There were no effects of HIV or aging on naturalistic PM performance longitudinally. Conclusion: Overall these findings suggest that PM symptoms and performance in the laboratory are stably impaired over the course of a year in the setting of aging and HIV disease.

Prospective memory under acute stress: The role of (output) monitoring and ongoing-task demands

Prospective memory (PM) refers to the ability to postpone retrieval and execution of intended actions until the appropriate situation (PM cue) has come, while engaging in other ongoing activities or tasks. In everyday live we often perform PM tasks in stressful situations. While it has been shown that acute stress does not impair PM-cue identification and intention retrieval, little is known about acute stress effects on PM performance and memory for having performed an action (output monitoring) under varying ongoing-task demands. Here we investigated this in eighty healthy participants who performed event-based PM tasks during low- and high-demanding ongoing working memory tasks after having undergone either a standardized stress induction (Maastricht Acute Stress Test) or a standardized control protocol. Successful stress induction in the stress group compared to the no-stress group was confirmed by increased salivary cortisol, an indicator of stress-related hypothalamus-pituitaryadrenal axis activity, throughout the event-based PM tasks. Nevertheless, not-only PM-cue identification but also output monitoring remained fully intact after stress induction. The absence of these effects was independent of ongoing-task demands. Nonetheless, we replicated recent findings of a stress-induced reduction in performance cost of monitoring for PM-cue occurrences. Taken together our findings suggest that acute stress alters PM monitoring by enhancing selective attention, decreasing PM response thresholds or by shifting performance towards more automatic processes in PM, while not affecting PM-cue identification and output monitoring.

A review of prospective memory in individuals with acquired brain injury

OBJECTIVE

Prospective memory (PM) deficits have emerged as an important predictor of difficulty in daily life for individuals with acquired brain injury (BI). This review examines the variables that have been found to influence PM performance in this population. In addition, current methods of assessment are reviewed with a focus on clinical measures. Finally, cognitive rehabilitation therapies are reviewed, including compensatory, restorative and metacognitive approaches.

METHOD

Preferred reporting items for systematic reviews and meta-analyses guidelines were used to identify studies. Studies were added that were identified from the reference lists of these.

RESULTS

Research has begun to elucidate the contributing variables to PM deficits after BI, such as attention, executive function and retrospective memory components. Imaging studies have identified prefrontal deficits, especially in the region of BA10 as contributing to these deficits. There are now several clinical measures available with good psychometric properties. Rehabilitation techniques have mostly focused on compensatory strategies, but, in addition, some restorative and metacognitive approaches have shown preliminary promise.

CONCLUSIONS

PM deficits are a common and important deficit after BI. Clinical evaluation is recommended and further understanding of rehabilitation techniques is needed.

Negative Prospective Memory in Alzheimer's Disease: "Do Not Perform That Action"

Relatively to "standard" prospective memory, i.e., remembering to perform a future action, little is known about negative prospective memory, i.e., remembering not to perform a future action. This study investigated the latter ability in Alzheimer's disease (AD). AD participants and healthy older adults were asked to click on the keyboard or not to click on it when a cue word was encountered. Results showed more omissions (i.e., forgetting to click the keyboard when the instruction was to do so) in AD participants than in healthy older adults, suggesting a prospective memory deficit. Interestingly, more commissions (i.e., clicking the keyboard when the instruction was not to do so) were also observed in AD participants than in healthy older adults. Similar levels of commissions and omissions were observed in AD participants and in healthy older adults. Also, commissions and omissions were correlated with performance on an inhibition assessment task. Our findings reveal that AD is characterized by not only difficulty in the retrieval of recent information, but also difficulty to inhibit no-longer appropriate stimulus-response associations previously learned, suggesting a specific deficit of negative prospective memory in AD.

A meta-analysis of task-related influences in prospective memory in traumatic brain injury

Prospective memory is the ability to remember to do something in the future and it is essential to every-day functional independence. Traumatic brain injury is associated with frequent and persistent prospective memory deficits. This study presents a review and meta-analysis investigating the effects of task parameters on prospective memory performance of individuals with TBI. Individual studies using continuous behavioural measures of prospective memory with a sample of adults with TBI and matched controls were included. Consistent with previous research, a random effects meta-analysis indicated that TBI groups demonstrated lower prospective memory performance than control groups (d = 1.10, SE = 0.12, 95% CI = 0.86-1.34). In addition, we found that type of prospective memory cue, saliency of cues, and complexity of the ongoing task significantly moderated the difference in prospective memory performance between TBI and control groups. These findings suggest that prospective memory task parameters should be considered in the assessment of prospective memory in individuals with cognitive impairment. In addition, considering the influence of these task parameters would be useful to develop effective compensatory strategies to reduce prospective memory failures.

Systematic Review of Neuropsychological Rehabilitation for Prospective Memory Deficits as a Consequence of Acquired Brain Injury

Objectives: Prospective memory (PM) impairments are common following acquired brain injury (ABI). PM is the ability to keep a goal in mind for future action and interventions have the potential to increase independence. This review aimed to evaluate studies examining PM rehabilitation approaches in adults and children with ABI. Methods:Relevant literature was identified using PsycARTICLES (1894 to present), PsycINFO (1880 to present), the Cochrane Library (1972 to present), MEDLINE PubMed, reference lists from relevant journal articles, and searches of key journals. Literature searches were conducted using variants of the terms brain injury, stroke, encephalitis, meningitis, and tumor, combined with variants of the terms rehabilitation and prospective memory.Results: Of the 435 papers identified, 11 were included in the review. Findings demonstrated a variety of interventions to alleviate PM deficits, including compensatory strategies (e.g., external memory aids) that provide either content-specific or content-free cueing, and remediation strategies (e.g., meta-cognitive training programs) aimed at improving the self-monitoring of personal goals. Risk of bias for individual studies was considered and the strengths and limitations of each of the included studies and the review itself were discussed. Conclusions: Interventions used with adults can be effective; PM abilities can be improved by using simple reminder systems and performance can be generalized to facilitate everyday PM functioning. There is, however, a lack of research of PM interventions conducted with children with ABI, and pediatric interventions need to consider on-going cognitive maturation. (JINS, 2017, 23, 254-265).

Frequência de déficits neuropsicológicos após traumatismo cranioencefálico

O traumatismo cranioencefálico (TCE) pode acarretar mudanças no cotidiano e prejuízos social laboral comunicativo e cognitivo (dificuldades atencionais mnemônicas e executivas). Este estudo buscou caracterizar a ocorrência de déficits neuropsicológicos após o TCE em uma amostra de adultos e verificar se há impacto do nível de severidade do trauma no desempenho cognitivo dos pacientes. Participaram 96 adultos divididos em dois grupos: TCE leve (n=39) e grave (n=57). A gravidade do trauma foi classificada pela Escala de Coma de Glasgow pela duração da perda de consciência. ou pela amnésia pós-traumática. Não houve diferença nas variáveis sociodemográficas idade e escolaridade entre os grupos. Para a comparação entre grupos quanto a ocorrência de déficits neuropsicológicos. utilizou-se o Qui-quadrado. Tarefas verbais e visuoespaciais de funções executivas habilidades linguísticas. mnemônicas verbais compuseram uma bateria neuropsicológica flexível.Os pacientes com TCE leve tiveram menos déficits comparados aos com TCE grave (erros e categorias completadas do Wisconsin Teste de Classificação de Cartas; erros da parte B do Teste Hayling; e na interferência pró e retroativa do teste de aprendizagem verbal de Rey). A severidade do trauma parece diferenciar indivíduos no desempenho de memória episódica no contexto de maior sobrecarga de informações novas e no controle da interferência entre memórias; o mesmo se aplica às funções de flexibilidade e inibição. Fazse necessário um maior investimento em ações de políticas públicas de saúde priorizando intervenção neurognitiva remediativa e métodos de prevenção para acidentes relacionados a lesões traumáticas com alta ocorrência de sequelas.

Prospective Memory After Stroke: A Scoping Review

The aim of this paper was to review the limited, but growing, literature on prospective memory (PM) following stroke using a scoping study methodology. Multiple databases were systematically searched and yielded 11 studies that were classified as observational (n = 7) or intervention studies (n = 4) and reviewed for quality. PM impairment after stroke was more commonly identified using behavioural measures compared to self-report measures. There were mixed findings regarding the extent and nature of PM impairment poststroke; however, more studies reported impairment for time-based PM, compared to both event- and activity-based PM. Studies examining rehabilitative techniques for PM resulted in mixed findings and were limited as most were case studies of poor methodological quality. Overall previous research in this area was limited as most studies were often underpowered due to small sample sizes, or used single-item measures which may not be robust enough to reliably measure PM impairment. Additionally, the methods used to measure PM were varied and many studies did not control for retrospective memory impairment, which could impact the results, as PM has both a retrospective (remembering both the action and when it needs to be completed) and prospective component (remembering to perform the action when appropriate). In conclusion, PM impairment is apparent poststroke, specifically for time-based PM. However, more research is needed to determine why PM impairment occurs, and how it can be improved.

When remembering the past suppresses memory for future actions

Remembering planned actions at the correct time in the future is an integral component of prospective cognition. Recent studies on future remembering have led to suggestions that prospective cognition might be based on past experience. To test this hypothesis, we focused on retrieval-induced forgetting (RIF), which usually indicates that remembering past events suppresses memory for related but different past events. The current study assessed RIF in two kinds of event-based prospective memory (PM) tasks using either focal or non-focal cues for ongoing tasks. Participants studied six members from each of eight taxonomic categories and then practiced recalling three of the six members from four of the eight categories using category-stem cues. This retrieval practice suppressed the detection of non-practiced members of the practiced categories during the PM task with non-focal cues (Experiment 1) but not with focal cues (Experiment 2). The results suggest that recall of certain items inhibits the function of the others as PM cues, but only if the PM task does not largely share its processing with the ongoing task.

The clinical utility of informants' appraisals on prospective and retrospective memory in patients with early Alzheimer's disease

Increasing studies suggest the importance of including prospective memory measures in clinical evaluation of dementia due to its sensitivity and functional relevance. The Prospective and Retrospective Memory Questionnaire (PRQM) is originally a self-rated memory inventory that offers a direct comparison between prospective and episodic memory. However, the informant's report has been recognized as a more valid source of cognitive complaints. We thus aimed to examine the validity of the informant-rated form of the PRMQ in assessing memory function of the patients and in detecting individuals with early dementia. The informants of 140 neurological outpatients with memory complaints completed the Taiwan version of the PRMQ. Tests of prospective memory, short-term memory, and general cognitive ability were also administered to non-demented participants and patients with early stages of Alzheimer's disease (AD). Results showed significant relationships between the PRMQ ratings and objective cognitive measures, and showed that higher ratings on the PRMQ were associated with increasing odds of greater dementia severity. Receiver operative characteristic (ROC) curves showed an adequate ability of the PRMQ to identify patients with dementia (93% sensitivity and 84% specificity). Hierarchical regression revealed that the PRMQ has additional explanatory power for dementia status after controlling for age, education and objective memory test results, and that the prospective memory subscale owns predictive value for dementia beyond the retrospective memory subscale. The present study demonstrated the external validity and diagnostic value of informants' evaluation of their respective patients' prospective and retrospective memory functioning, and highlighted the important role of prospective memory in early dementia detection. The proxy-version of the PRMQ is a useful tool that captures prospective and episodic memory problems in patients with early AD, in combination with standardized cognitive testing.

Rule monitoring ability predicts event-based prospective memory performance in individuals with TBI

Numerous studies have demonstrated that prospective memory (PM) abilities are impaired following traumatic brain injury (TBI). PM refers to the ability to remember to complete a planned action following a delay. PM post-TBI has been shown to be related to performance on neuropsychological tests of executive functioning and retrospective episodic memory (RM). However, the relative influence of impairments in RM versus executive functioning on PM performance post-TBI remains uninvestigated. In the current study, PM and neuropsychological test performance were examined in 45 persons with a history of moderate to severe TBI at least 1 year before enrollment. Regression analyses examined the relative contributions of RM and executive functioning in the prediction of PM performance on the Rivermead Behavioral Memory Test (RBMT). Results indicated that scores on tests of delayed RM and rule monitoring (i.e., ability to avoid making errors on executive measures) were the strongest predictors of PM. When the interaction between RM impairment and rule monitoring was examined, a positive relationship between PM and rule monitoring was found only in TBI participants with impaired RM. Results suggest that PM performance is dependent upon rule monitoring abilities only when RM is impaired following TBI.