An edition of Early assessment of dementia: the contribution of different memory components
(2002)
Early assessment of dementia : the contribution of different memory components
thesis award 2003 0130
by Paula Elisabeth Josephine Spaan
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Early assessment of dementia : the contribution of different memory components
2002, UVA
thesis
in English
- thesis award 2003 0130
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Book Details
First Sentence
"Human memory functioning is one of the most frequently studied research topics in experimental psychology"
Table of Contents
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https://hdl.handle.net/11245/1.251976
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CONTENTS
CHAPTER I: REVIEW OF CLINICAL AND EXPERIMENTAL MEMORY
TESTING AND THEIR APPLICATION TO THE STUDY OF
AGEING AND DEMENTIA 1
I Clinical and experimental memory testing 2
1. Clinically administered memory tests in neuropsychological assessment 2
2. Memory models and experimentally administered memory tasks in
neuropsychological research 5
3. Conclusion 8
II Ageing and dementia 10
1. DSM-IV 11
2. Literature review of memory functioning in normal ageing and AD 12
2.1. Episodic memory 12
2.2. Semantic memory 14
2.3. Short-term (or working) memory 16
2.4. Implicit memory: priming effects 16
2.5. Implicit memory: procedural memory or skill learning 18
3. Focus on very early and preclinical AD 19
4. Conclusion 21
III Research purpose and questions 22
1. Aim of present research 22
2. Research questions 24
Appendix: Examples and description of clinical memory tests 27
CHAPTER II: METHOD 37
I The first administration of the memory test battery 37
1. Sample 37
2. General procedure 39
3. Material 41
3.1. Memory test battery 41
3.1.1. Ten word list-learning test 41
3.1.2. Digit span task 42
3.1.3. Word-recognition test 43
3.1.4. Paired-associate learning test 43
3.1.5. Block span task 44
3.1.6. Word stem completion task 45
3.1.7. Category fluency test 45
3.1.8. Mirror-reading task 46
3.1.9. Perceptual identification task 47
3.1.10. Two-alternative word-recognition test 48
xi
CONTENTS
3.2. Visual Association Test 48
4. Analyses - Chapter III 48
II The second administration of the memory test battery 49
1. Sample 49
2. General procedure 50
3. Material 51
4. Analyses - Chapter IV and V 52
Appendix A: MMSE group classification criteria 54
Appendix B: Selection procedure based on LASA third cycle data 55
Appendix C: Computation of the 'ultimate MMSE' score 56
Appendix D: Stimuli in each subtest 57
Appendix E: Development over time of all subjects initially tested with the memory
test battery 62
CHAPTER III: RESULTS AND DISCUSSION OF THE FIRST
ADMINISTRATION OF THE MEMORY TEST BATTERY 65
1. A first description of memory performance of the elderly subjects 66
2. Reliability of each subtest 67
3. Influence of age, education, sex and MMSE on each subtest 72
4. Differentiating between the cognitively impaired subjects and the matched normal
control subjects: results per subtest 74
4.1 Ten word list-learning test 75
4.2 Digit span task 76
4.3 Word-recognition test 76
4.4 Paired-associate learning test 78
4.4.1 Main results and learning curve in the 'Paired-associate learning test'..78
4.4.2 Difference in performance between the 'Ten word list-learning test' and
the 'Paired-associate learning test' 79
4.4.3 Nature of errors made in the 'Paired-associate learning test' 81
4.5 Block span task 82
4.5.1 Main results of the 'Block span task' 82
4.5.2 Difference in performance between the 'Digit span task' and the 'Block
span task' 82
4.6 Word stem completion task 83
4.6.1 Main results of the 'Word stem completion task' 83
4.6.2 Reaction times in the 'Word stem completion task' 84
4.7 Category fluency test 85
4.7.1 Number of correct exemplars per subcategory 85
4.7.2 Nature of incorrect responses in the 'Category fluency test' 86
4.8 Mirror-reading task 87
4.8.1 Main results of the 'Mirror-reading task' 87
4.8.2 Effects of repetition of items in the 'Mirror-reading task' 88
4.8.3 Practice effects in the 'Mirror-reading task' 89
4.9 Perceptual identification task 93
4.9.1 Main results of the 'Perceptual identification task' 93
4.9.2 Word frequency effects 94
x l i
CONTENTS
4.10 Two-altemative word-recognition test 95
4.10.1 Main results of the 'Two-alternative word-recognition test' 95
4.10.2 Difference in performance between the 'Word-recognition test' and
the 'Two-alternative word-recognition test' 96
4.11 Visual Association Test 97
5. Discriminative ability of the memory test battery 98
6. Factor analysis 101
6.1 Latent factors within the memory test battery 101
6.2 The differential value of individual subtests within the memory test battery 107
6.3 The role of implicit memory within the memory test battery 107
7. Conclusion 109
CHAPTER IV: RESULTS AND DISCUSSION OF THE SECOND
ADMINISTRATION OF THE MEMORY TEST BATTERY 113
1. Reliability analyses of the memory test battery 114
2. Influence of the demographic and the screening variables on each subtest 116
3. The effects of 'preclinical dementia' on the level of memory performance in
normal ageing 118
4. Differences in memory performance (over time) between various clinical
subgroups of elderly subjects, as defined at T2 122
4.1. Ten word list-learning test 123
4.2. Digit span task 124
4.3. Word-recognition test 125
4.4. Paired-associate learning test 126
4.5. Block span task 126
4.6. Word stem completion task 127
4.7. Category fluency test 128
4.8. Mirror-reading task 128
4.9. Perceptual identification task: 'semantic memory' 129
4.10. Perceptual identification task: 'priming' 130
4.11. Two-alternative word-recognition test 130
4.12. Visual Association Test 131
4.13. Development of performance on the Mini-Mental State Examination
(MMSE) 132
4.14. The subtests most sensitive to decline in incident dementia 133
5. The profile of memory measures best predicting dementia before the diagnosis can
be made 136
5.1. The prediction of dementia, according to the DSM-IV criteria of dementia 138
5.1.1. The prediction of dementia in the entire group of elderly subjects 138
5.1.2. The prediction of dementia in the 'Cognitively Impaired' (CI) group 141
5.2. The role of the 'minimal dementia' subjects 146
6. The profile of memory measures best discriminating between demented and
nondemented elderly subjects at the time q/'diagnosis 150
7. Identification and characterization of nondemented but memory-declined subjects
154
8. Conclusion 157
xiii
CONTENTS
CHAPTER V: NATURE OF PERFORMANCE IN THE 'CATEGORY
FLUENCY TEST': AN EXPLORATION OF THE SPECIFIC
RESPONSES 161
1. Introduction 161
2. Method 163
2.1. Switching and clustering scores 163
2.2. Frequency distribution of responses 164
3. Results and discussion of the first administration of the 'Category fluency test' - a
comparison of scores between the cognitively impaired and the normal control
subjects 165
3.1. Results 165
3.1.1. Switching and clustering in the 'Category fluency test' 165
3.1.2. Frequency distribution of responses generated in the 'Category fluency
test' 167
3.2. Discussion 168
4. Results and discussion of the second administration of the 'Category fluency test'
- the development of scores over time 169
4.1. Results 169
4.1.1. Switching and clustering over time 169
4.1.2. Frequency distributions of responses over time 172
4.2. Discussion 175
5. Predictive value of the various scores of the 'Category fluency test' regarding
dementia 176
5.1. Results 176
5.2. Discussion 179
6. Conclusion 179
Appendix A: Hierarchical model of exemplars of animals named in the 'Category
fluency test' 182
Appendix B: Hierarchical model of exemplars of occupations named in the 'Category
fluency test' 183
CHAPTER VI: SUMMARY AND GENERAL DISCUSSION 185
1. Summary of the main findings 185
1.1. General design and aim of research 185
1.2. Characteristics of the battery 185
1.3. Impact of cognitive status in nondemented subjects 186
1.4. Preclinical assessment of dementia, two years in advance 186
1.5. Differential (cross-sectional) assessment of dementia 188
2. Methodological considerations 189
3. Relevance and implications for clinical practice 191
4. Recommendations for future research 193
5. Conclusions 194
xiv
CONTENTS
SAMENVATTING 197
1. Aanleiding tot het onderzoek (Hoofdstuk 1) 197
2. Invloed van cognitieve status bij niet-demente ouderen (Hoofdstuk 3) 199
3. Predictie van dementie (Hoofdstuk 4) 200
4. Prestatiepatronen op een categorie-gebonden fluency-test (Hoofdstuk 5) 200
5. Conclusies 201
REFERENCES 203
CURRICULUM VITAE 215
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