We propose that the earliest neuropsychological detection of Alzheimer's disease (AD) can be informed by current views about the neuropathogenesis of AD and cognitive models of memory and its neurobiological substrates. The primary impairment in early AD is encoding/consolidation, resulting from medial temporal lobe (MTL) pathology. On theoretical and empirical grounds, paired associate learning (PAL) appears to be the ideal paradigm for detecting MTL dysfunction in early AD. It has not been embraced as a test of choice, however, and this critical review discusses why the paradigm may have not fulfilled its potential. We suggest that a new PAL variant, 'associate-recognition', may prove to be clinically efficacious.
Older drivers are more likely to have difficulty wayfinding in unfamiliar areas than younger people. The present study investigated the role of cognitive functioning and age on wayfinding difficulties and driving performance whilst driving in unfamiliar areas. Forty-seven participants aged between 21 and 82 years completed a wayfinding task in a driving simulator and a battery of neuropsychological tests. Older age was related to reduced driving speed and increased time stopped during the drive. Cognitive variables associated with wayfinding difficulties and driving performance decrements included processing speed, visuospatial ability, and aspects of memory, including verbal and visual immediate and delayed recall. This research suggests that older drivers, particularly those with poorer cognitive functioning, had more difficulty with wayfinding in unfamiliar areas than younger drivers. The findings are discussed with reference to potential safety and mobility benefits of alternative wayfinding strategies.
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