Working Memory Functioning in Alzheimer's Disease and Vascular Dementia
- Conditions
- Vascular DementiaMixed DementiasAlzheimer Disease
- Interventions
- Behavioral: Complex span taskDiagnostic Test: Clinical neuropsychological assessmentDiagnostic Test: Clinical neurospychological assessement
- Registration Number
- NCT06321380
- Lead Sponsor
- University Hospital, Grenoble
- Brief Summary
The aim of the present study is to investigate potential cognitive mechanisms contributing to working memory impairment in Alzheimer's disease and vascular dementia. The investigators consider a new hypothesis suggesting that difficulties in mobilizing maintenance strategies of information could explain this working memory deficit. More specifically, the investigators assume that patient groups will have difficulties in employing both refreshing and elaborative strategies during a working memory task (i.e., complex span task), as compared to a control group.
- Detailed Description
Working memory is considered as a central hub in human cognition. Good working memory capacities are fundamental for daily life. However, previous research has indicated that patients with Alzheimer's disease or vascular dementia have significant working memory impairment. Currently, there is no consensus on the cognitive mechanisms responsible for this deficit. Prior findings have highlighted that patients with Alzheimer's disease and/or vascular dementia demonstrate specific difficulties in dual-task situations. In this context, the investigators hypothesize that the continuous alternation between maintenance and processing phases involved in working memory could be impaired for these patients. Thus, the aim of the present study is to investigate if patients with Alzheimer's disease and/or vascular dementia can use maintenance strategies of information in working memory, as typically observed in individuals without cognitive impairments.
To this end, the investigators propose a short working memory task in which they manipulate the opportunities to use refreshing strategies and elaborative strategies. The investigators expect that patients with Alzheimer's disease, vascular dementia, or mixed dementia will benefit less than healthy older adults from the increased opportunities to employ refreshing and elaboration. These difficulties could account for the impaired working memory performance associated with these diseases.
In a second step, the investigators formulate distinctive hypotheses between patient sub-groups:
* On the one hand, Alzheimer's disease is characterized by salient impairment of episodic long-term memory. Consequently, the investigators hypothesize that the working memory decline could be related to this deficit in long-term memory. Specifically, patients with Alzheimer's disease would have greater difficulty in implementing elaboration strategies. Thus, these patients' recall performance should benefit less from semantic links between the to-be-remembered items compared to patients with vascular dementia.
* On the other hand, vascular dementia is characterized by a significant impairment of executive functioning. Thus, the investigators hypothesize that the working memory decline could be related to difficulties in implementing refreshing strategies (i.e., voluntary control of attention). Thus, the recall performance of these patients should benefit less from increased free time during the task, compared to patients with Alzheimer's disease.
* Finally, very few studies have been carried out on patients with mixed dementia (from both Alzheimer's disease and vascular dementia). The investigators assume that the recall performance of these patients will benefit less from elaborative opportunities compared to patients with dementia vascular, and less from refreshing opportunities compared to patients with Alzheimer's disease.
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 120
- For patient and control groups: Adults ≥ 65 years of age
- For patient and control groups: Native French speaker
- For patient and control groups: Vision for easy reading
- For patient and control groups: Hearing for easy instruction understanding
- For patient and control groups: Back span ≥ 3 during the "Digit Span Backward" subtest (WAIS-IV)
- For patient and control groups: Formulation of the non-opposition to participate in this study
- For patient group only: Consultation in Grenoble University Hospital (Centre de Gérontologie Sud - Gerontology center) for clinical neuropsychological assessment due to suspected cognitive impairment
- For patient group only: Diagnosis of Alzheimer's disease, vascular dementia, or mixed dementia (i.e., Alzheimer's disease and vascular dementia)
- For patient group only: Have undergone a neuropsychological assessment at the day clinic, less than 6 months old.
- For patient group only: Have obtained a medical opinion stating that there is no contraindication to participate in this study and no concurrent pathology that could impair the patient's cognitive abilities.
- For patient group only: Absence of praxis and language disorders thath might prevent the carrying out of the experimental task.
- For patient group only: MMSE score between 18 and 25 included
- For control group only: External visitor/carer of a patient/resident of Grenoble University Hospital or volunteers at Grenoble University Hospital.
- For control group only: MMSE score ≥ 26
- For patient and control groups: People under guardianship or deprived of their freedom
- For patient and control groups: Diagnosis of severe psychiatric disorders
- For patient and control groups: Suspicion of pathologies related to alcohol dependence
- For patient and control groups: No French social security coverage
- For patient and control groups: Refusal to voluntarily participate in this study
- For patient and control groups: People covered by articles L1121-5 to L1121-8 of the French Public Health Code
- For patient group only: Suspicion of another neurodegenerative disease, such as fronto-temporal dementia, Parkinson's disease, Lewy body disease.
- For patient group only: Clinical neuropsychological assessment did not reveal any cognitive impairment.
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Alzheimer disease Complex span task Alzheimer's disease is define on the basis of the medical diagnostic. As part of routine care, they undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions. For the study and during the day of medical consultations, each patient will perform a working memory task, lasting approximately 30 minutes. If the patient is accompanied by a family member, the investigators ask the latter to complete a questionnaire on patient's daily executive functioning (French version of the Behavior rating inventory of executive function \[BRIEF-A\]). Alzheimer disease Clinical neuropsychological assessment Alzheimer's disease is define on the basis of the medical diagnostic. As part of routine care, they undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions. For the study and during the day of medical consultations, each patient will perform a working memory task, lasting approximately 30 minutes. If the patient is accompanied by a family member, the investigators ask the latter to complete a questionnaire on patient's daily executive functioning (French version of the Behavior rating inventory of executive function \[BRIEF-A\]). Mixed dementia Complex span task Mixed dementia (i.e., Alzheimer's disease and vascular dementia) is define on the basis of the medical diagnostic. As part of routine care, they undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions . For the study and during the day of medical consultations, each patient will perform a working memory task, lasting approximately 30 minutes. If the patient is accompanied by a family member, the investigators ask the latter to complete a questionnaire on patient's daily executive functioning (French version of the Behavior rating inventory of executive function \[BRIEF-A\]). Vascular dementia Complex span task Vascular dementia is define on the basis of the medical diagnostic. As part of routine care, they undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions. For the study and during the day of medical consultations, each patient will perform a working memory task, lasting approximately 30 minutes. If the patient is accompanied by a family member, the investigators ask the latter to complete a questionnaire on patient's daily executive functioning (French version of the Behavior rating inventory of executive function \[BRIEF-A\]). Vascular dementia Clinical neuropsychological assessment Vascular dementia is define on the basis of the medical diagnostic. As part of routine care, they undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions. For the study and during the day of medical consultations, each patient will perform a working memory task, lasting approximately 30 minutes. If the patient is accompanied by a family member, the investigators ask the latter to complete a questionnaire on patient's daily executive functioning (French version of the Behavior rating inventory of executive function \[BRIEF-A\]). Mixed dementia Clinical neuropsychological assessment Mixed dementia (i.e., Alzheimer's disease and vascular dementia) is define on the basis of the medical diagnostic. As part of routine care, they undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions . For the study and during the day of medical consultations, each patient will perform a working memory task, lasting approximately 30 minutes. If the patient is accompanied by a family member, the investigators ask the latter to complete a questionnaire on patient's daily executive functioning (French version of the Behavior rating inventory of executive function \[BRIEF-A\]). Control group Complex span task Control group includes healthy older adults (without cognitive impairment). As patient group, control group will perform the working memory task. However, control group does not undergo the clinical neuropsychological assessment. Control group Clinical neurospychological assessement Control group includes healthy older adults (without cognitive impairment). As patient group, control group will perform the working memory task. However, control group does not undergo the clinical neuropsychological assessment.
- Primary Outcome Measures
Name Time Method Reaction time 30 minutes Reaction time for each distractor (in ms) in the spatial part of working memory task
Processing performance in the Working memory task 15 minutes Percentage of correct response in the spatial part of working memory task
Memory performance in the Working memory task 15 minutes Percentage of correct immediate recall, computed with strict serial recall criterion (item identity + correct position) and computed with item recall criterion (item identity only).
- Secondary Outcome Measures
Name Time Method Stroop Test - major interference part (errors) 90 secondes this part of stroop test measures strong inhibition process number of errors is noted, from 0 to 24
Trail Making Test - Part A (time) 2 minutes This test evaluate motor speed processing Time in seconds
Trail Making Test - Part A (errors) 2 minutes This test evaluates motor speed processing Number of errors is noted
Digit span backward WAIS IV (standard note) 5 minutes This scale permitted to obtain a standard note from 0 to 19 A higher score means a better performance
Stroop Test - minor interference part (Time) 30 secondes this part of stroop test measures low inhibition process time is taken, in seconds
Stroop Test - minor interference part (errors) 30 secondes this part of stroop test measures low inhibition process number of errors is noted, from 0 to 24
Category fluences 5 minutes Number of correct words is noted
Memory evaluation (16-item Free and Cued Recall, or GERIA-12) 40 minutes These tests evaluate verbal episodic memory Scores are noted for each trail, from 0 to 16 (RL-RI/16) or 0 to 12 (Geria-12) A higher score means a better performance
Behavior rating inventory of executive function 10 minutes Questionnaire (french version) on patient's daily executive functioning, completed by a relative of the patient, if present Global score from 75 to 225, composing by several composite scores. A higher score means a more severe executive dysfonctionning in daily life
Digit span forward WAIS IV (standard note) 5 minutes This scale permitted to obtain a standard note from 0 to 19 A higher score means a better performance
Stroop Test - denomination part 30 secondes the denomination part of stroop test measures processing speed time is taken, in seconds
Mini-Mental State Examination (MMSE) 15 minutes MMSE is a test evaluate global cognitive functioning Score from 0 to 30 A higher score mean a better cognitive efficiency
Digit span backward WAIS IV (digit number) 5 minutes The participant's span is noted, corresponding to the longest number of sequential digits that can be repeated backward.
Stroop Test - major interference part (time) 90 secondes this part of stroop test measures strong inhibition process time is taken, in seconds
Trail Making Test - Part B (time) 5 minutes This test evaluates mental flexibility Time in seconds
Digit span forward WAIS IV (digit number) 5 minutes The participant's span is noted, corresponding to the longest number of sequential digits that can be repeated forward.
Activities of Daily Living 5 minutes Questionnaire completed by a professional (nurse or doctor) with the patient and an accompagniant if present Score from 0 to 6 A higher score mean a better autonomy in daily life
Trail Making Test - Part B (errors) 5 minutes This test evaluates mental flexibility Number of errors is noted
Naming task 40 minutes This test evaluate the capacity to correctly name a picture Score is noted, from 0 to 40 A higher score means a better performance
Instrumental Activities of Daily Living 5 minutes Questionnaire completed by a professional (nurse or doctor) with the patient and an accompagniant if present Score from 0 to 8 A higher score mean a better autonomy in daily life