In one type of association-memory paradigm, after studying pairs of the form AB, AC, participants must recall both B and C in response to A. Counterintuitively, yet often replicated, recall probabilities of B and C are typically uncorrelated ("associative independence"). This face-value independence is now understood to reflect a negative correlation due to AB and AC competing, approximately offset by a positive correlation produced by subject- and item-variability. The outcome might vary with stimulus material; for noun-pairs, and with a single study trial per pair, AB and AC have been found to be positively correlated. We replicated the positive correlation between AB and AC for noun-pairs, but this did not differ from the correlation expected for independent memory tests, suggesting that for noun pairs, AB and AC are independent on average. In Experiment 2, participants instructed to form separate images for AB and AC again produced an independence pattern, but participants instructed to combine AB and AC into an integrative image produced a facilitation pattern. Thus, the relationship between AB and AC varies, and can be influenced by study strategy. Association-memory models may need to accommodate a diverse range of AB-AC relationships, and studies that build on AB/AC learning may need to consider whether AB/AC start out with a competitive, facilitatory or independent relationship.

BackgroundNonpharmacological interventions are needed to support the function of older adults struggling with subjective cognitive impairment (SCI), mild cognitive impairment (MCI), and dementia due to Alzheimer disease (AD). Telerehabilitation aims to provide rehabilitation at a distance, but cognitive rehabilitation by videoconferencing has not been explored.ObjectiveThe objective of this study was to compare goal-oriented cognitive rehabilitation delivered in-person with videoconferencing to determine whether telehealth cognitive rehabilitation appears feasible.MethodsRandom assignment to in-person or telehealth videoconferencing cognitive rehabilitation with a combined between-subjects, multiple baseline single-case experimental design, cognitive rehabilitation was delivered by a therapist to 6 participants with SCI (n=4), MCI (n=1), or dementia due to AD (n=1).ResultsTwo of the 6 participants randomly assigned to the telehealth condition withdrew before beginning the intervention. For those who participated in the intervention, 6 out of 6 goals measured with the Canadian Occupational Performance Measure improved for those in the in-person group, and 7 out of 9 goals improved for those in the telehealth group.ConclusionsDelivery of cognitive rehabilitation by telehealth appeared feasible but required modifications such as greater reliance on caregivers and clients for manipulating materials.

Earlier research suggests that geographic location matters for informal caregivers of persons with dementia: rural caregivers tend to rely on more informal supports and may report more psychological distress and burden than urban caregivers. Differential access to services may underlie these findings, but degree of rurality is typically measured with population size. In contrast, the current article measured degree of rurality with standardized scale of access to metropolitan centers. In a large sample we found nonsignificant and trivial associations between metropolitan access with self-reported caregiver distress, (N = 272; Brief Symptom Inventory), burden (N = 234; Zarit Burden Interview), and coping (n = 46; Jalowiec Coping Scale). The null findings were likely related to the use of a proxy variable for dementia-related caregiver supports (i.e., degree of access to metropolitan centers). In future research, direct measures of access to appropriate dementia related services should be used to study caregiver outcomes.

The implications for developing cognitive rehabilitation interventions are discussed, with a recommendation for interventions for symptoms of apathy.

Caregiving in a rural context is unique, but the experience of rural caregivers is understudied. This paper describes how rural caregivers cope with caring for a loved one diagnosed with mild cognitive impairment or dementia using qualitative description to generate a low-inference summary of a response to an open-ended question. This approach allowed these rural caregivers to describe their positive experiences in addition to the more commonly explored caregiver experiences related to stress. Analyses of coping revealed use of social support, engaging in relaxing and physical activity, and cognitive reframing. In addition, caregivers reported strong faith and religiosity, and to a lesser frequency behavioral changes, checking in with the person with dementia via telephone, and joint activity. Predominantly, these methods reflect approach-based strategies. The current data suggest that these caregivers manage well and adopt adaptive coping strategies to meet the demands of the caregiving role.