Daydreaming mentally transports people to another place or time. Many daydreams are similar in content to the thoughts that people generate when they intentionally try to forget. Thus, thoughts like those generated during daydreaming can cause forgetting of previously encoded events. We conducted two experiments to test the hypothesis that daydreams that are more different from the current moment (e.g., in distance, time, or circumstance) will result in more forgetting than daydreams that are less different from the current moment, because they result in a greater contextual shift. Daydreaming was simulated in the laboratory via instructions to engage in a diversionary thought. Participants learned a list of words, were asked to think about autobiographical memories, and then learned a second list of words. They tended to forget more words from the first list when they thought about their parents' home than when they thought about their current home (Experiment 1). They also tended to forget more when they thought about an international vacation than when they thought about a domestic vacation (Experiment 2). These results support a context-change account of the amnesic effects of daydreaming.
IntroductionSome Alzheimer’s disease (AD) patients die without ever developing cognitively impaired basic activities of daily living (basic ADL), which may reflect slower disease progression or better compensatory mechanisms. Although impaired basic ADL is related to disease severity, it may exert an independent risk for death. This study examined the association between impaired basic ADL and survival of AD patients, and proposed a multistate approach for modeling the time to death for patients who demonstrate different patterns of progression of AD that do or do not include basic ADL impairment.Methods1029 patients with probable AD at the Baylor College of Medicine Alzheimer’s Disease and Memory Disorders Center met the criteria for this study. Two complementary definitions were used to define development of basic ADL impairment using the Physical Self-Maintenance Scale score. A weighted Cox regression model, including a time-dependent covariate (development of basic ADL impairment), and a multistate survival model were applied to examine the effect of basic ADL impairment on survival.ResultsAs expected decreased ability to perform basic ADL at baseline, age at initial visit, years of education, and sex were all associated with significantly higher mortality risk. In those unimpaired at baseline, the development of basic ADL impairment was also associated with a much greater risk of death (hazard ratios 1.77–4.06) over and above the risk conferred by loss of MMSE points. A multi-state Cox model, controlling for those other variables quantified the substantive increase in hazard ratios for death conferred by the development of basic ADL impairment by two definitions and can be applied to calculate the short term risk of mortality in individual patients.ConclusionsThe current study demonstrates that the presence of basic ADL impairment or the development of such impairments are important predictors of death in AD patients, regardless of severity.
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