Financial Incapacity of Patients with Mild Alzheimer’s Disease: What Neurologists Need to Know about Where the Impairment Lies

Research in the last decade has focused on assessing financial capacity and incapacity mainly in old age, but new research has turned to address the question of how financial incapacity can be predicted by cognitive factors. The aim of this study was to identify which cognitive domains predict financial capacity and the relevant cognitive skills of patients with mild Alzheimer’s disease (AD) in order to assist neurologists in functional assessment and further patient referral. In this study, 109 patients diagnosed with mild AD were examined with a number of neuropsychological tests: Mini-Mental State Examination (MMSE), Functional Rating Scale for Symptoms of Dementia (FRSSD), Functional Cognitive Assessment Scale (FUCAS), Trail Making Test (TMT)-Part B, Rey-Osterrieth Complex Figure Test (ROCFT)-copy condition and delayed recall condition, Rey Auditory Verbal Learning Test (RAVLT), Boston Naming Test, Rivermead Behavioural Memory Test (RBMT), digit span forward and backward, WAIS-R digit symbol substitution test, Neuropsychiatric Inventory (NPI), Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). LCPLTAS total score and relevant subdomains were best predicted only by the score of one item coming from MMSE: subtraction of serial sevens. This is the only measure of arithmetic testing in use for the Greek geriatric population. Financial capacity is severely impaired in the group of mild AD patients. In order to prevent financial exploitation cases, neurologists, neuropsychologists, psychiatrists, and geriatrists should pay close attention to the information from the relevant arithmetic question of MMSE, as it is one of the most widely administered screening tests in clinical settings.

Beta oscillations following performance feedback predict subsequent recall of task-relevant information

Reward delivery in reinforcement learning tasks elicits increased beta power in the human EEG over frontal areas of the scalp but it is unclear whether these 20–30 Hz oscillations directly facilitate reward learning. We previously proposed that frontal beta is not specific to reward processing but rather reflects the role of prefrontal cortex in maintaining and transferring task-related information to other brain areas. To test this proposal, we had subjects perform a reinforcement learning task followed by a memory recall task in which subjects were asked to recall stimuli associated either with reward feedback (Reward Recall condition) or error feedback (Error Recall condition). We trained a classifier on post-feedback beta power in the Reward Recall condition to discriminate trials associated with reward feedback from those associated with error feedback and then tested the classifier on post-feedback beta power in the Error Recall condition. Crucially, the model classified error-related beta in the Error Recall condition as reward-related. The model also predicted stimulus recall from post-feedback beta power irrespective of feedback valence and task condition. These results indicate that post-feedback beta power is not specific to reward processing but rather reflects a more general task-related process.

A-043 Preschool Children with Attention Deficit Have Weakness in Reproducing the Rey-Osterrieth Complex Figure in Delayed Recall Condition

Objectives It was known that children with attention deficit (AD) have also weakness in working memory. In our previous research we have revealed that ADHD children have deficit in visual and verbal memory in delayed recall condition in comparison to immediate condition (Kiselev, 2018). The goal of this research was to examine the hypothesis that preschool children with AD have a deficit in reproducing the Rey-Osterrieth Complex Figure in delayed recall condition. Methods The experimental group included 13 children with AD at the age of 5-6 years. The control group included 13 typically developing children. The children from groups were matched for IQ, gender and age. Children from both groups were assessed with Rey–Osterrieth complex figure test (ROCF). This test is designed to assess reproducing the complex figure in immediate and delayed recall conditions. ANOVA with repeated measures was used to reveal group differences in reproducing the figure in two conditions. Results We have not revealed significant differences between children from experimental and control group in reproducing the figure in immediate condition. However, the interaction of condition type and group was significant (p < .05). Children with AD had weakness in the accurate reproduction and placement of specific design elements of Rey-Osterieth Complex Figure in Delayed Recall condition. Conclusions In view of our previously received results in children with attention deficit, we can propose that deficit in memory in delayed recall condition can be one of the key symptoms in this disorder.

Volumetric and microstructural regional changes of the hippocampus underlying development of extended delay long-term memory

Episodic memory function improves through childhood and adolescence, in part due to structural maturation of the medial temporal cortex. Although partly different processes support long-term memory over shorter vs. longer intervals, memory is usually assessed after less than an hour. The aim of the present study was to test whether there are unique developmental changes in extended memory, and whether these are related to structural maturation of sub-regions of the hippocampus. 650 children and adolescents from 4.1 to 24.8 years were assessed in total 962 times (mean interval ≈ 1.8 years). Memory was assessed by the California Verbal Learning Test (CVLT) and the Rey Complex Figure Test (CFT). In addition to 30 min recall, an extended delay recall condition was administered ≈ 10 days after encoding. We found unique developmental effects on extended delay memory independently of 30 min recall performance. For visuo-constructive memory, this could be accounted for by visuo-constructive ability levels. Performance was modestly related to anterior and posterior hippocampal volume and mean diffusion. The relationships did not show an anterior-posterior hippocampal axis difference. In conclusion, extended delay memory shows unique development, likely due to changes in encoding depth or efficacy, or improvements of long-term consolidation processes.HighlightsUnique developmental effects on episodic memories over days rather than minutesDevelopment of visuoconstructive recall explainable by visuoconstructive abilitityDevelopment of verbal recall cannot be explained by verbal abilityModest relationships between memory and hippocampal structural features

Inhibitory Process of Collaborative Inhibition: Assessment Using an Emotional Stroop Task

This study investigated the inhibitory process of collaborative inhibition. An emotional Stroop task was manipulated three times after a group-recall task across three experiments. The results showed that, when participants performed an emotional Stroop task immediately after a group-recall task (Experiment 1) or between two subsequent individual-recall tasks after a group-recall task (Experiment 3), they were able to discriminate color information relating to studied but nonrecalled emotional stimuli more rapidly in the collaborative-recall condition than in the nominal-recall condition. This indicated that participants experienced a stronger inhibition effect in the former condition. However, when the emotional Stroop task was performed after the final individual-recall task (Experiment 2), there were no differences in discrimination between the conditions. These results suggest that the inhibition effect occurs immediately after the group-recall phase and lasts until the final individual-recall task is completed (4 minutes or longer in Experiment 3). It is therefore possible to discuss retrieval inhibition as an underlying mechanism of collaborative inhibition.

Test–Retest Reliability and Minimal Detectable Change of Randomized Dichotic Digits in Learning-Disabled Children: Implications for Dichotic Listening Training

Evaluation of dichotic listening to digits is a common part of many studies for diagnosis and managing auditory processing disorders in children. Previous researchers have verified test–retest relative reliability of dichotic digits results in normal children and adults. However, detecting intervention-related changes in the ear scores after dichotic listening training requires information regarding trial-to-trial typical variation of individual ear scores that is estimated using indices of absolute reliability. Previous studies have not addressed absolute reliability of dichotic listening results.To compare the results of the Persian randomized dichotic digits test (PRDDT) and its relative and absolute indices of reliability between typical achieving (TA) and learning-disabled (LD) children.A repeated measures observational study.Fifteen LD children were recruited from a previously performed study with age range of 7–12 yr. The control group consisted of 15 TA schoolchildren with age range of 8–11 yr.The Persian randomized dichotic digits test was administered on the children under free recall condition in two test sessions 7–12 days apart. We compared the average of the ear scores and ear advantage between TA and LD children. Relative indices of reliability included Pearson’s correlation and intraclass correlation (ICC2,1) coefficients and absolute reliability was evaluated by calculation of standard error of measurement (SEM) and minimal detectable change (MDC) using the raw ear scores.The Pearson correlation coefficient indicated that in both groups of children the ear scores of test and retest sessions were strongly and positively (greater than +0.8) correlated. The ear scores showed excellent ICC coefficient of consistency (0.78–0.82) and fair to excellent ICC coefficient of absolute agreement (0.62–0.74) in TA children and excellent ICC coefficients of consistency and absolute agreement in LD children (0.76–0.87). SEM and SEM% of the ear scores in TA children were 1.46 and 1.44% for the right ear and 4.68 and 5.47% for the left ear. SEM and SEM% of the ear scores in LD children were 4.55 and 5.88% for the right ear to 7.56 and 12.81% for the left ear. MDC and MDC% of the ear scores in TA children varied from 4.03 and 3.99% for the right ear to 12.93 and 15.13% for the left ear. MDC and MDC% of the ear scores in LD children varied from 12.57 and 16.25% for the right ear to 20.89 and 35.39% for the left ear.The LD children indicated test–retest relative reliability as high as TA children in the ear scores measured by PRDDT. However, within-subject variations of the ear scores calculated by indices of absolute reliability were considerably higher in LD children versus TA children. The results of the current study could have implications for detecting real training-related changes in the ear scores.