Insight into memory and functional abilities in individuals with amnestic mild cognitive impairment

Chudoba, Lisa A.; Schmitter‐Edgecombe, Maureen

doi:10.1080/13803395.2020.1817338

Cited by 16 publications

(13 citation statements)

References 41 publications

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“…Out of a total of 20,136 studies, 20,088 were removed according to the exclusion criteria and, additionally, if they (a) assessed visuomotor abilities in patients with MCI in Parkinson's Disease (MCI-PD) because of the major motor impairment or (b) provided information about upper extremity functioning by self-report measures. The final set, therefore, consisted of 48 studies assessing the following issues: 16 studies assessed VSWM abilities [17,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39], 12 studies assessed anosognosia for memory deficits [40][41][42][43][44][45][46][47][48][49][50][51], 14 studies assessed visuomotor abilities [52][53][54][55][56][57][58][59][60][61][62][63][64][65], 2 studies investigated the relationship between VSWM and conversion [37,66], and 4 studies investigated the relationship between anosognosia for memory deficit...…”

Section: Data Extraction Results and Synthesismentioning

confidence: 99%

Neuropsychology of posteromedial parietal cortex and conversion factors from Mild Cognitive Impairment to Alzheimer’s disease: systematic search and state-of-the-art review

et al. 2021

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In the present review, we discuss the rationale and the clinical implications of assessing visuospatial working memory (VSWM), awareness of memory deficits, and visuomotor control in patients with mild cognitive impairment (MCI). These three domains are related to neural activity in the posteromedial parietal cortex (PMC) whose hypoactivation seems to be a significant predictor of conversion from MCI to Alzheimer’s disease (AD) as indicated by recent neuroimaging evidence. A systematic literature search was performed up to May 2021. Forty-eight studies were included: 42 studies provided analytical cross-sectional data and 6 studies longitudinal data on conversion rates. Overall, these studies showed that patients with MCI performed worse than healthy controls in tasks assessing VSWM, awareness of memory deficits, and visuomotor control; in some cases, MCI patients’ performance was comparable to that of patients with overt dementia. Deficits in VSWM and metamemory appear to be significant predictors of conversion. No study explored the relationship between visuomotor control and conversion. Nevertheless, it has been speculated that the assessment of visuomotor abilities in subjects at high AD risk might be useful to discriminate patients who are likely to convert from those who are not. Being able to indirectly estimate PMC functioning through quick and easy neuropsychological tasks in outpatient settings may improve diagnostic and prognostic accuracy, and therefore, the quality of the MCI patient’s management.

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Section: Data Extraction Results and Synthesismentioning

confidence: 99%

Neuropsychology of posteromedial parietal cortex and conversion factors from Mild Cognitive Impairment to Alzheimer’s disease: systematic search and state-of-the-art review

et al. 2021

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“…How very early stage symptomatic neurodegeneration impacts on metacognition is debatable. Conflicting evidence is seen across different studies, with some finding people with amnestic MCI to have intact metacognition [22], and others identifying significant deficits [23]. Vannini et al identified correlations between metacognition and FDG-PET activity in the posterior cingulate and hippocampal cortices in people with amnestic MCI, coupled with reduced functional connectivity between the posterior cingulum, orbitofrontal cortex, and the inferior parietal lobes [13].…”

Section: Discussionmentioning

confidence: 99%

Metacognitive Performance on Memory and Visuospatial Tasks in Functional Cognitive Disorder

et al. 2021

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Functional Cognitive Disorder (FCD) is a common diagnosis at the memory clinic. FCD is characterised by significant self-reported cognitive symptoms in the absence of external evidence of cognitive dysfunction. A potential explanation for this is a deficit in metacognition, the process by which we internally judge our own abilities. Here we investigated differences in accuracy, confidence, and metacognition between people with FCD (N = 20), neurodegenerative mild cognitive impairment (nMCI; N = 14), and healthy controls (N = 23). The groups were assessed on forced choice memory and perceptual tasks, with trial by trial confidence ratings. FCD and nMCI participants showed lower accuracy on the memory task (means FCD 63.65%, nMCI 63.96%, HC 71.22%), with a significant difference between the FCD and HC groups after controlling for age and sex. There were no between-group differences in memory task confidence (means FCD 3.19, nMCI 3.59, HC 3.71). The FCD group showed greater confidence when longer time was allowed on the memory task. No between group differences in perceptual task accuracy (means FCD 63.97%, nMCI 64.50%, FCD 65.86%) or confidence (means FCD 3.71, nMCI 3.43, HC 3.88) were found. No differences in metacognitive efficacy emerged between the groups, either on the memory or perceptual task (Memory Meta-d’/d’:FCD 0.63, nMCI 0.94 HC 0.85; Perceptual Meta-d’,d’: FCD 0.50, nMCI 0.51, HC 0.72). Participants showed greater metacognitive efficacy on the memory task compared to the perceptual task. The difficulties experienced by people with FCD do not appear to be due to metacognitive deficits. Their performance was similar to people with nMCI over aspects of the memory tasks, which suggests that the primary issue may lie with memory encoding or retrieval, rather than with their judgement of performance accuracy.

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“…Our study serves to complement the existing literature by expanding the understanding of awareness of task performance in older adults using an instrument that more closely approximates real-life situations. Understanding adults' perceptions of performance immediately after a task is also important as it is this assessment that can update metacognitive knowledge and influence future performance (Toglia and Kirk, 2000;Ng et al, 2018;Chudoba and Schmitter-Edgecombe, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…It may include frequency counts of spontaneous error correction and examination of discrepancies between self-appraisal and actual performance (O'Keeffe et al, 2007). The performance discrepancy method is commonly used within memory list learning tasks (Chudoba and Schmitter-Edgecombe, 2020) and within the context of functional activities as it examines a person's awareness or perceptions of specific abilities in close proximity to a related task (Goverover et al, 2014;Rotenberg-Shpigelman et al, 2014;Chen and Toglia, 2019;Chudoba and Schmitter-Edgecombe, 2020).…”

Section: Introductionmentioning

confidence: 99%

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Awareness of Performance on a Functional Cognitive Performance-Based Assessment Across the Adult Lifespan

2021

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As people age, their cognitive skills and ability to complete complex instrumental activities of daily living often decline in subtle ways. Older adults who are aware of these slight cognitive and functional changes spontaneously adapt and implement strategies to maximize performance. On the other hand, older adults with limited self-awareness are less likely to adjust performance or initiate compensatory strategies as they may not recognize the need to do so. This places them at higher risk of functional decline and loss of independence. Research on awareness of functional performance in healthy adults is, however, limited, and there is a paucity of assessment tools available to address questions of awareness and strategy use in functional tasks. We used the Weekly Calendar Planning Activity (WCPA) – a performance-based assessment of functional cognition including measures of awareness and strategy use – to investigate differences in performance, awareness, and strategy use across the adult lifespan. The WCPA requires examinees to schedule appointments into a weekly calendar while following rules designed to increase task demands. Healthy adults (n=342) from ages 18–92 were observed for strategy use and error recognition, while a post-test interview probed participants’ reported strategy use and estimation of accuracy. The discrepancy between participant estimation and actual accuracy provided a measure of online awareness of performance where a larger estimation discrepancy indicated over-estimation of performance. Performance on the WCPA declined across the adult lifespan. Older adults were less likely to use self-monitoring strategies and used less effective strategies overall. Overestimation was associated with use of fewer strategies and lower accuracy in all age groups. Importantly, twice as many older adults overestimated compared to younger adults. Furthermore, the subset of older adults who had good awareness of performance was more likely to use effective strategies, to recognize errors, and achieved accuracy on par with their younger counterparts. Our results emphasize the importance of examining self-awareness of performance and analyzing the strategies used to perform a complex functional task. This information can provide a foundation for early detection of functional decline in aging and for designing interventions to maximize functional independence in aging.

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Insight into memory and functional abilities in individuals with amnestic mild cognitive impairment

Cited by 16 publications

References 41 publications

Neuropsychology of posteromedial parietal cortex and conversion factors from Mild Cognitive Impairment to Alzheimer’s disease: systematic search and state-of-the-art review

Neuropsychology of posteromedial parietal cortex and conversion factors from Mild Cognitive Impairment to Alzheimer’s disease: systematic search and state-of-the-art review

Metacognitive Performance on Memory and Visuospatial Tasks in Functional Cognitive Disorder

Awareness of Performance on a Functional Cognitive Performance-Based Assessment Across the Adult Lifespan

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