This review investigates the severity and nature of post-stroke working memory deficits with reference to the multi-component model of working memory. We conducted a systematic search in PubMed up to March 2019 with search terms for stroke and memory. Studies on adult stroke patients, that included a control group, and assessed working memory function, were selected. Effect sizes (Hedges’ g) were extracted from 50 studies (in total 3,084 stroke patients) based on the sample size, mean and standard deviation of patients and controls. Performance of stroke patients was compared to healthy controls on low-load (i.e. capacity) and high-load (executively demanding) working memory tasks, grouped by modality (verbal, non-verbal). A separate analysis compared patients in the sub-acute and the chronic stage. Longitudinal studies and effects of lesion location were systematically reviewed. Stroke patients demonstrated significant deficits in working memory with a moderate effect size for both low-load (Hedges’ g = -.58 [-.82 to -.43]) and high-load (Hedges’ g = -.59 [-.73 to -.45]) tasks. The effect sizes were comparable for verbal and non-verbal material. Systematically reviewing the literature showed that working memory deficits remain prominent in the chronic stage of stroke. Lesions in a widespread fronto-parietal network are associated with working memory deficits. Stroke patients show decrements of moderate magnitude in all subsystems of working memory. This review clearly demonstrates the global nature of the impairment in working memory post-stroke.
Objective: The current study assessed the criterion validity of the Montreal Cognitive Assessment (MoCA) as a short cognitive screen for use in addiction health care. Method: Eighty-two patients were assessed with two parallel versions of the MoCA; at intake (baseline) and directly preceding an extensive neuropsychological assessment (NPA) approximately 8 weeks later (follow-up). Results: Of all included patients, 54.9% were classified as having substance-induced neurocognitive disorder. The most common primary substance of abuse was alcohol (70.7%). The criterion validity was determined predictively and concurrently, and sensitivities of .56 and .67 and specificities of .62 and .73 were found, respectively. Conclusion: While the MoCA is an adequate screen when administered at the same time as the NPA, the predictive validity of administering this cognitive screen at intake is limited. Furthermore, the relation between MoCA domain scores and the performance on their corresponding cognitive domain in the NPA is more reliable when the MoCA is administered at the same time as the NPA. While the MoCA can be used to screen for cognitive impairments in patients in addiction health care, the instrument's sensitivity is not optimal, which should be taken into account when interpreting results.
Working memory and episodic memory decline with age. However, as they are typically studied separately, it is largely unknown whether age-associated differences are similar. A task design was developed in which visual working memory and episodic memory performances were measured using the same stimuli, with both tasks involving context binding. A 2-back working memory task was followed by a surprise subsequent recognition memory task that assessed incidental encoding of object locations of the 2-back task. The study compared performance of younger (N=30; M=23.5, SD=2.9, range=20-29) and older adults (N=29; M=72.1, SD=6.8, range=62-90). Older adults performed worse than younger adults, without an interaction effect. In younger, but not in older adults, performance on the two tasks was related. We conclude that although age differences (Young>Older) are similar in the working memory and incidental associative memory tasks, the relationship between the two memory systems differs as a function of age group.
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