Lise Gagnon

Improvement of Episodic Memory in Persons with Mild Cognitive Impairment and Healthy Older Adults: Evidence from a Cognitive Intervention Program

The efficacy of cognitive training was assessed in persons with mild cognitive impairment (MCI) and persons with normal cognitive aging. Forty-seven participants were included in this study: 28 with MCI and 17 controls. Twenty-one participants received intervention (20 MCI and 9 controls) and 16 participants (8 MCI and 8 controls) received no intervention (waiting-list group). The intervention focused on teaching episodic memory strategies. Three tasks of episodic memory (list recall, face-name association, text memory) were used as primary outcome measures. Results were analyzed using analyses of variance. The intervention effect (pre- and post-intervention difference) was significant on two of the primary outcome measures (delayed list recall and face-name association). A significant pre-post-effect was also found on measures of subjective memory and well-being. There was no improvement in the performance of groups of individuals with MCI and normal elderly persons who did not receive the intervention. These results suggest that persons with MCI can improve their performance on episodic memory when provided with cognitive training.

Happy, sad, scary and peaceful musical excerpts for research on emotions

Three experiments were conducted in order to validate 56 musical excerpts that conveyed four intended emotions (happiness, sadness, threat and peacefulness). In Experiment 1, the musical clips were rated in terms of how clearly the intended emotion was portrayed, and for valence and arousal. In Experiment 2, a gating paradigm was used to evaluate the course for emotion recognition. In Experiment 3, a dissimilarity judgement task and multidimensional scaling analysis were used to probe emotional content with no emotional labels. The results showed that emotions are easily recognised and discriminated on the basis of valence and arousal and with relative immediacy. Happy and sad excerpts were identified after the presentation of fewer than three musical events. With no labelling, emotion discrimination remained highly accurate and could be mapped on energetic and tense dimensions. The present study provides suitable musical material for research on emotions.Keywords.

Emotional Recognition from Face, Voice, and Music in Dementia of the Alzheimer Type

Persons with dementia of the Alzheimer type (DAT) are impaired in recognizing emotions from face and voice. Yet clinical practitioners use these mediums to communicate with DAT patients. Music is also used in clinical practice, but little is known about emotional processing from music in DAT. This study aims to assess emotional recognition in mild DAT. Seven patients with DAT and 16 healthy elderly adults were given three tasks of emotional recognition for face, prosody, and music. DAT participants were only impaired in the emotional recognition from the face. These preliminary results suggest that dynamic auditory emotions are preserved in DAT.

Face-name association learning in early Alzheimer's disease: A comparison of learning methods and their underlying mechanisms

This study compared the efficacy of five learning methods in the acquisition of face–name associations in early dementia of Alzheimer type (AD). The contribution of error production and implicit memory to the efficacy of each method was also examined. Fifteen participants with early AD and 15 matched controls were exposed to five learning methods: spaced retrieval, vanishing cues, errorless, and two trial-and-error methods, one with explicit and one with implicit memory task instructions. Under each method, participants had to learn a list of five face–name associations, followed by free recall, cued recall and recognition. Delayed recall was also assessed. For AD, results showed that all methods were efficient but there were no significant differences between them. The number of errors produced during the learning phases varied between the five methods but did not influence learning. There were no significant differences between implicit and explicit memory task instructions on test performances. For the control group, there were no differences between the five methods. Finally, no significant correlations were found between the performance of the AD participants in free recall and their cognitive profile, but generally, the best performers had better remaining episodic memory. Also, case study analyses showed that spaced retrieval was the method for which the greatest number of participants (four) obtained results as good as the controls. This study suggests that the five methods are effective for new learning of face–name associations in AD. It appears that early AD patients can learn, even in the context of error production and explicit memory conditions.

Known, lost, and recovered: Efficacy of formal‐semantic therapy and spaced retrieval method in a case of semantic dementia

Background: Few studies have addressed rehabilitation in semantic dementia. A potentially promising method is formal‐semantic therapy, which consists of tasks in which the names of concepts and their semantic characteristics are presented. It could also be enhanced by spaced retrieval, a learning method improving retention through recalling information after increasing recall intervals. Aims: This study explores the efficacy of both a formal‐semantic therapy and the spaced retrieval method to restore lost concepts in TBo, a woman with semantic dementia. Methods & Procedures: The formal‐semantic therapy consisted of giving TBo semantic feedback followed by a cueing technique to facilitate naming. Formal‐semantic therapy with simple repetition was compared to formal‐semantic therapy with spaced retrieval. TBos performance was measured throughout the study with picture naming and generation of verbal attributes. Two untrained lists were also measured for generalisation effects. Outcomes & Results: Results indicate that, after therapy, TBo could name 3/8 of the trained items, compared to no items on the untrained lists. She also showed an increase in performance for the evocation of specific semantic attributes of concepts, reaching 6/8 of correct responses. Moreover, she maintained her performance up to 5 weeks after the end of the study. Finally, when compared to simple repeated practice, spaced retrieval did not enhance learning and no generalisation was observed between trained and non‐trained categories. Conclusions: Along with recent results reported in the literature, TBos results confirm that people with semantic dementia can improve their naming performance with training but that this is limited. However, formal‐semantic therapy seems very promising for retraining specific semantic attributes. Instead of focusing on naming, we suggest that therapies used in semantic dementia should aim at restoring specific and functionally relevant concepts to enable the individuals to be more autonomous in daily living. The first author was supported by PhD awards from the Quebec Rehabilitation Research Network, the Canadian Institutes of Health Research, the Interdisciplinary Training in Research on Health and Aging, and the Ordre des ergothérapeutes du Québec. The authors also wish to thank TBo for her enthusiastic participation in this study, as well as Lindsey Nickels, Karen Croot, Kim S. Graham and two anonymous reviewers for their invaluable comments on earlier drafts of this paper.

New learning in dementia : Transfer and spontaneous use of learning in everyday life functioning. Two case studies

The purpose of these two case studies was to explore the effectiveness of learning methods in dementia when applied in real-life settings and the integration of new skills in daily life functioning. The first participant, DD, learned to look at a calendar with the spaced retrieval method to answer his repeated questions about the current date and calls made to family. Progressive cuing was used by his wife to increase spontaneous use of the calendar, but DD had difficulty integrating the calendar into his routine. The second patient, MD, relearned a leisure activity (listening to music on a cassette radio) and how to participate in a social activity (saying the rosary in a group) with a combination of learning methods. Transfer of these skills in similar contexts was difficult for MD. She never integrated the cassette radio into her daily life routine but she went regularly to the rosary activity, which was cued by an alarm clock. In sum, the learning methods used were very effective with these patients but transfer and spontaneous use were difficult. Since these aspects are essential to rehabilitation, they should be further explored in order to increase the effectiveness of cognitive interventions.

Errorless-Based Techniques Can Improve Route Finding in Early Alzheimer's Disease: A Case Study

Topographical disorientation is a common and early manifestation of dementia of Alzheimer type, which threatens independence in activities of daily living. Errorless-based techniques appear to be effective in helping patients with amnesia to learn routes, but little is known about their effectiveness in early dementia of Alzheimer type. A 77-year-old woman with dementia of Alzheimer type had difficulty in finding her way around her seniors residence, which reduced her social activities. This study used an ABA design (A is the baseline and B is the intervention) with multiple baselines across routes for going to the rosary (target), laundry, and game rooms (controls). The errorless-based technique intervention was applied to 2 of the 3 routes. Analyses showed significant improvement only for the routes learned with errorless-based techniques. Following the study, the participant increased her topographical knowledge of her surroundings. Route learning interventions based on errorless-based techniques appear to be a promising approach for improving the independence in early dementia of Alzheimer type.

Electronic organiser and Alzheimer's disease: Fact or fiction?

Alzheimers disease is a degenerative disease characterised by a progressive loss of cognitive functions and impairment of activities of daily living severe enough to interfere with normal functioning. To help persons with this disease perform a variety of activities, our research team developed AP@LZ, an electronic organiser specifically designed for them. Two participants with Alzheimers disease learned how to use AP@LZ in their daily lives by following a structured learning method. After the learning phase, the participants were able to use AP@LZ efficiently and facilitate their day-to-day activities for several months, despite the steady progression of the disease. These results suggest that persons with Alzheimers disease can learn to use new technologies to compensate for their everyday memory problems, which opens up new rehabilitation possibilities in dementia care.

Can people with Alzheimer's disease improve their day-to-day functioning with a tablet computer?

ABSTRACT New technologies, such as tablet computers, present great potential to support the day-to-day living of persons with Alzheimers disease (AD). However, whether people with AD can learn how to use a tablet properly in daily life remains to be demonstrated. A single case study was conducted with a 65-year-old woman with AD. A specific and structured intervention tailored to her needs was conceptualised for the use of a calendar application on a tablet computer according to the following learning stages: Acquisition, Application and Adaptation. In spite of her severe episodic memory deficit, she showed progressive learning of the tablet application during the intervention phase. Furthermore, data compiled over 12 months post-use show that she used the tablet successfully in her day-to-day life. She was even able to transfer her newly acquired ability to other available applications designed to monitor regular purchases, consult various recipes and play games. Tablet computers thereby offer a promising avenue for cognitive rehabilitation for persons with AD. This success was mainly achieved through a one-on-one individual programme tailored to this person. The limits and constraints of utilising tablet computers for persons with AD are discussed.

Normative data for the Dementia Rating Scale-2 in the French-Quebec population.

The Dementia Rating Scale-2 is used to measure cognitive status of adults with cognitive impairment, especially of the degenerative type, by assessing five cognitive functions, namely attention, initiation/perseveration, construction, conceptualization, and memory. The present study aimed to establish normative data for this test in the elderly French-Quebec population. A total of 432 French-speaking elders from the province of Quebec (Canada), aged 50 to 85 years, were administered the Dementia Rating Scale-2. Age and education were found to be associated with the total score on the test, while gender was not. Percentile ranks were then calculated for age- and education-stratified groups. Previous studies have shown that cultural background can affect performance on the DRS and the development of culture-specific norms for French-speaking Quebecers could be very useful to clinicians and researchers working with this population.