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Objective: This study investigated whether emotions and enactment can jointly increase memory performance in nondemented Parkinson's disease (PD) and Alzheimer's disease (AD) patients., Method: Actions' drawings with negative, positive, or neutral valence were presented to 17 PD patients, 17 AD patients, and 37 elderly controls, matched to age. Two conditions of intentional encoding were proposed to each participant: one verbal, in which participants had to name the represented actions; and one motor, in which they had to mime the displayed actions. Thereafter, participants were submitted to an immediate free recall task and a delayed recognition task., Results: The enactment effect was found in all three groups. The effect of emotion was also observed in that all three groups recalled negative actions better than both neutral and positive (PD patients), only neutral (AD patients), or only positive actions (elderly controls). Positive actions were not recalled better than neutral actions in any group., Conclusions: These results constitute an evidence for the preservation of the enactment effect and of the emotion effect on memory in AD and PD patients. However, they do not support the hypothesis of the combined effect of emotion and enactment on memory, neither in AD and PD patients nor in normal aging. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Introduction: Recent studies on cognitive training in patients with Alzheimer's disease (AD) showed positive long-term effects on cognition and daily living, suggesting remote computer-based programmes to increase training sessions while reducing patient's travelling. The aim of this study is to examine short-term and long-term benefits of computer-based cognitive training at home in patients with mild to moderate AD, as a complement to the training in speech and language therapists' (SLT) offices. The secondary purpose is to study training frequency required to obtain noticeable effects., Methods and Analyses: This is a national multicentre study, conducted in SLT offices. The patients follow training in one of three conditions: once a week in SLT office only (regular condition) and once a week in SLT office plus one or three times per week at home. The trainings' content in SLT office and at home is identical. For all three groups near and far transfer will be compared with evaluate training frequency's effect. Our primary outcome is executive and working memory scores in experimental tasks, and the secondary is neuropsychological tests and questionnaires' scores. Linear models' analyses are considered for all measures with a random intercept for patients and another for per practice. The fixed effects will be: three modality groups and time, repeated measures, (T0-pretraining, T1-post-training, T2-long-term follow-up) and the interaction pairs., Ethics and Dissemination: The study got ethics approval of the national ethical committee CPP Sud Méditerranée III (No 2019-A00458-49) and of the National Commission for Information Technology and Liberties (No 919217). Informed consent is obtained from each participant. Results will be disseminated in oral communications or posters in international conferences and published in scientific journals., Trial Registration Number: NCT04010175., Competing Interests: Competing interests: Franck Tarpin-Bernard and Bernard Croisile are cofounders and shareholders of SBT Humans Matter., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Alzheimer's disease (AD) is a neurodegenerative pathology that disrupts processing of facial expressions of emotion. The impairment was demonstrated for negative emotions in tasks of matching, discriminating, and labeling facial expressions but no study has included the expression of pain in its protocol., Objective: The objective was to study the processing of emotional facial expressions in AD with a particular interest in pain expression., Methods: Twenty-seven controls, 15 mild AD patients, and 15 moderate AD patients had to perform four emotional tasks: identification of facial expressions, matching pain expressions, discriminating the intensity of pain expressions, and judging pain intensity., Results: Some emotions were less efficiently recognized by AD patients compared to controls (p < 0.001), specifically fear from the mild stage (p < 0.05), pain and disgust from the moderate stage (p < 0.05 and p < 0.001 respectively). The Exploratory Factor Analysis showed that recognition of pain and recognition of other discreet emotions were underpinned by two different latent factors. Performances on pain expression matching task and pain intensity discrimination task did not differ by group. (p = 0.334 and p = 0.787 respectively). Finally, moderate AD patients judged the pain less intensively than the Control group for both, moderate, and severe pain intensity (p < 0.001)., Conclusion: Our data suggest that AD disrupts the recognition of pain expression along with recognition of fear and disgust. Additionally, AD patients seem to underestimate pain intensity compared to controls. The self-rated pain scales should be adapted to the pain processing deficit of AD patients.

Background: Alzheimer's disease (AD) negatively impacts patients' ability to make advantageous decisions, i.e., a core ability contributing to the preservation of autonomy., Objective: The present study aims to analyze the changes that occur in the decision-making competence (DMC) in AD patients and to determine if these changes are related to the deterioration of executive functions and working memory., Method: To this end, 20 patients with AD and 20 elderly control adults were assessed using executive, working memory, and DMC tasks. The latter comprised the Iowa Gambling Task (IGT) and a scenarios task based on situations inspired by everyday life and performed under conditions of risk and ambiguity., Results: Results revealed lower performances in AD patients than in elderly control adults for all the tasks assessing cognitive functions. The AD patients also made more strategy changes during the IGT. In the scenarios tasks, the two groups took as many ambiguous or risky decisions, but AD patients tended to take more risks in the context of gain than elderly control adults did. Switching and updating ability, as well as working memory, appeared to be involved in decisions in tasks inspired by everyday life, while inhibition was more related to the IGT performances., Conclusion: Working memory and executive functions seem to be involved in decision-making, but in different ways in gambling and daily-life situations.

Decision-making competence (DMC) appears to be influenced by the congruency between the characteristics of the individual, the task and the context. Indeed, the ability to make decisions seems to be highly sensitive to cognitive changes as observed, in particular, in the healthy elderly. Few studies have investigated these relations in pathological ageing. In this review, we focus on DMC in patients with Alzheimer's disease (AD) and the links its impairment could have with deficits in episodic memory, working memory, and executive functions. Decision-making under risk and under ambiguity appears to be impaired early in the progress of AD, with the deficit being greater during the later stages of the disease. In addition, some studies suggest that the impairment of DMC is exacerbated by deficits in other cognitive functions, in particular working memory and executive functions. This degradation in the ability to make decisions seriously affects the quality of life of patients and their relatives, since they frequently face important decisions, especially concerning healthcare, finance or accommodation. Thus, the growing incapacity to decide for themselves increases patients' and caregivers' stress and burden. The challenge for future studies is to determine how best to help patients and their families in the decisional process.

Introduction: Pain is underdiagnosed and undertreated in patients with Alzheimer's disease (AD). Pain management is of major importance in this population to limit behavioural and functional consequences. Our study aimed to assess the capacity of AD patients to represent pain using a questionnaire exploring daily painful situations and to determine the most appropriate pain scale assessment., Methods: Twenty-eight patients with mild AD, 21 with moderate AD and 28 matched controls underwent the Situation Pain Questionnaire (SP-Q) and assessed imaginary pain with four pain scales. Two scores were compared between the three groups: the P(A) discrimination score and the response bias β score. P(A) reflects the degree of discrimination between high-pain and low-pain events, whereas the β score means the degree to which situations are considered as painful., Results: Our results showed that AD patients hardly discriminated the high- from low-pain events. Compared to controls, the mean P(A) score was significantly lower for Mild AD (p < 0.03) and Moderate AD (p < 0.004). In addition, the β score indicated that the response bias is higher for AD patients (p < 0.01) in that they overestimated the level of pain., Conclusion: The present results suggest that patients with Mild and Moderate AD are able to recognize and assess an imagined painful situation even though their pain tolerance is lower than that of controls. The pain scales used should be chosen according to the cognitive, sensorial and personal profiles of the patients., Significance: The present research is significant because it examines how patients with Alzheimer's disease understand and assess painful situations. Cognitive impairments can modify this ability. Pain is a sensory and subjective experience and to define its feeling can help us in our clinical practice., (© 2020 European Pain Federation - EFIC®.)

Introduction : Although there are plenty of studies on affective or cognitive theory of mind (ToM) in Alzheimer's Disease (AD), few have investigated both these dimensions and even fewer have examined the ability to identify an emotion from context in relation to the executive function deficit. Thus, the purpose of this study was to examine the deficit of affective and cognitive ToM in AD patients in the light of their executive function deficit. We were especially interested in the ability to attribute emotions to a character from a context and the ability to recognize facial expressions and to understand social clumsiness. Method : Twenty-eight mild AD patients and 33 healthy participants completed two sessions, one involving neuropsychological tests evaluating the executive functions, and the other comprising three tasks (Facial Expression Attribution, Facial Expression Recognition, Faux Pas test) assessing affective and cognitive ToM. Results : Compared to the healthy participants, the AD patients were impaired in the recognition of shame, anger and the neutral expression. They had difficulties in inferring surprise and disgust from visual context in situations where no facial expression was available, and were also impaired in all aspects of the Faux Pas test. Globally, and independently of the Group factor, performance in the three ToM tasks was correlated with performance in the backward span test, and the significant proportion of variance in performance in the Facial Expression Recognition and Faux Pas test was explained by the performance in backward span test. However, separate analyses did not show any significant correlations for the AD patients. Conclusions : Our results suggest an impairment of affective and cognitive ToM in AD patients. This impairment is selective as it concerns only some emotions. Considering these results with caution, it is possible that, patients' working memory difficulties explain, at least in part, their difficulties in ToM tasks.

"Theory of Mind" (ToM) is the capacity to deduce other persons' cognitive and emotional states. Studies investigating affective ToM in healthy older adults and in persons with Alzheimer's disease have reported contradictory results, although evidence indicates that advanced age (Ruffman, Henry, Livingstone, & Phillips, 2008) and Alzheimer's disease (Elferink, van Tilborg, & Kessels, 2015) do not affect the ability to identify or infer different emotions to the same extent. To evaluate affective ToM abilities in these populations, we asked 63 individuals (17 with Alzheimer's disease) to infer the emotional states of characters presented without facial details in emotional situations. We observed similar results in healthy younger and older adults, but poorer performance in persons with Alzheimer's disease for disgust, sadness, and surprise, but not for anger, fear, and joy. Results suggest that persons with Alzheimer's disease have difficulties in inferring several emotional states from contextual information without facial cues.

Background: The present study examines whether the interaction between emotion and the enactment effect (body involvement) improves memory in people with Alzheimer disease (AD)., Methods: Two experiments with drawings of actions were conducted, in which two types of encoding were used: motor and verbal. In experiment 1, with 13 AD patients and 13 older healthy adults, the encoding was incidental. In experiment 2, with 17 mild AD patients and 21 older healthy adults, it was intentional., Results: In experiment 1, no effect of enactment or emotion was observed in the AD patients. In experiment 2, effects of enactment and emotion (better recall for negative actions) were observed in the AD patients. This pattern of results was also observed in the elderly control adults in both experiments., Conclusion: These results confirm effects observed in normal ageing and indicate a more subtle effect on AD., (© 2018 S. Karger AG, Basel.)

Young individuals better memorize initially seen faces with emotional rather than neutral expressions. Healthy older participants and Alzheimer's disease (AD) patients show better memory for faces with positive expressions. The socioemotional selectivity theory postulates that this positivity effect in memory reflects a general age-related preference for positive stimuli, subserving emotion regulation. Another explanation might be that older participants use compensatory strategies, often considering happy faces as previously seen. The question about the existence of this effect in tasks not permitting such compensatory strategies is still open. Thus, we compared the performance of healthy participants and AD patients for positive, neutral, and negative faces in such tasks. Healthy older participants and AD patients showed a positivity effect in memory, but there was no difference between emotional and neutral faces in young participants. Our results suggest that the positivity effect in memory is not entirely due to the sense of familiarity for smiling faces.

After short delays between encoding and retrieval, healthy young participants have better memory performance for emotional stimuli than for neutral stimuli. Divided-attention paradigms suggest that this emotional enhancement of memory (EEM) is due to different attention mechanisms involved during encoding: automatic processing for negative stimuli, and controlled processing for positive stimuli. As far as we know, no study on the influence of these factors on EEM in Alzheimer's disease (AD) and mild cognitive impairment (MCI) patients, as compared to healthy young and older controls, has been conducted. Thus, the goal of our study was to ascertain whether the EEM in these populations depends on the attention resources available at encoding. Participants completed two encoding phases: full attention (FA) and divided attention (DA), followed by two retrieval phases (recognition tasks). There was no EEM on the discrimination accuracy, independently of group and encoding condition. Nevertheless, all participants used a more liberal response criterion for the negative and positive stimuli than for neutral ones. In AD patients, larger numbers of false recognitions for negative and positive stimuli than for neutral ones were observed after both encoding conditions. In MCI patients and in healthy older and younger controls this effect was observed only for negative stimuli, and it depended on the encoding condition. Thus, this effect was observed in young controls after both encoding conditions, in older controls after the DA encoding, and in MCI patients after the FA encoding. In conclusion, our results suggest that emotional valence does not always enhance discrimination accuracy. Nevertheless, in certain conditions related to the attention resources available at encoding, emotional valence, especially the negative one, enhances the subjective feeling of familiarity and, consequently, engenders changes in response bias. This effect seems to be sensitive to the age and the pathology of participants.

Healthy participants remember emotional stimuli better than neutral stimuli. In normal, older adults this emotional enhancement of memory (EEM) was mostly seen in respect of positive stimuli (positivity bias) after rich and deep encoding. The results relating to this effect in Alzheimer's disease (AD) patients are fairly inconsistent. The goal of the present study was to ascertain whether EEM in AD patients depends on the depth and the richness of encoding. Twenty-one patients with mild-to-moderate AD and 23 age-and-education-matched controls completed two study phases, each followed by a retrieval phase. The first study phase consisted of a natural/man-made categorization task followed by a recognition task, whereas the second, which involved the stimuli used in the recognition task, allowed for richer and deeper encoding as a result of repetition and naming of the stimuli and presentation of the same semantic cues at encoding and retrieval. The second study phase was followed by free and cued recall tasks and a recognition task. After the first study phase we observed EEM in respect of negative and positive stimuli in controls, but not in AD patients. After the second study phase, the positivity bias was observed in the free recall task in controls but not in AD patients. In the cued recall and recognition tasks, however, both groups showed the positivity bias. Based on our results, AD patients present a positivity memory bias when encoding is sufficiently rich and deep, and when support is provided at the time of retrieval (cued recall or recognition tasks)., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objectives: There is some discrepancy in the results regarding emotional enhancement of memory (EEM) in Alzheimer's disease (AD). Some studies report better retrieval of emotional information, especially positive, than neutral information. This observation is similar to the positivity effect reported in healthy older adults. It was suggested that this effect is due to privileged, deeper and more controlled processing of positive information. One way of testing this is to control both the intention to encode the information and the cognitive resources involved during encoding. Studies investigating EEM in AD patients did not systematically control the nature of encoding. Consequently, the purpose of our study was to examine EEM in AD while manipulating the nature of encoding., Methods: Two experiments were conducted. In Experiment 1 the intention to encode stimuli was manipulated by giving or not giving instructions to participants about the subsequent retrieval. In Experiment 2 cognitive resources involved during encoding were varied (low vs high). In both experiments participants performed immediate recognition task of negative, positive and neutral pictures. 41 mild AD patients and 44 older healthy adults participated in Exp. 1, and 17 mild AD patients and 20 older healthy adults participated in Exp. 2., Results: AD patients did not present EEM. Positivity effect, better performance for positive than neutral and negative pictures was observed with older healthy adults., Conclusion: The data suggest that EEM is disturbed in mild AD patients, with respect to both negative and positive stimuli, at least concerning laboratory, not real-life material. They also suggest there is a positivity effect in healthy older adults and lend support to the idea that this effect is due to preferential cognitive processing of positive information in this population., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Emotional material tends to be better retrieved in memory than neutral material. This emotional enhancement of memory may be related to the attentional effects of the amygdala's response to emotional stimuli. Because early neuropathological changes in Alzheimer's disease involve the amygdala and the hippocampus, it has been suggested that this effect is impaired in patients. However inconsistent results have been reported. The goal of our study was to evaluate the effects of emotion on picture recognition in patients affected by Alzheimer's disease, and to explore the link between this effect and the degree of amygdalar and hippocampal atrophy. Mild Alzheimer's disease patients (n = 15) and control participants (n = 20) performed an Old/New recognition task using pictures of negative, neutral, and positive emotional valence. Automated segmentation of their high-resolution T1 MRI scans was performed in order to obtain amygdalar and hippocampal volumes. Correlation analyses were then performed between volumetric data, memory, and the emotional effect on memory. An effect of emotion on memory was found for control participants (with positive items being better recognized than neutral and negative ones), with no correlation between this effect and medial temporal volumes, and a significant correlation between overall recognition scores and hippocampal volumes. Conversely, no emotional effect on memory was found across the group of patients; however, significant correlations were found between the loss of this effect and amygdalar and hippocampal volumes. These results tend to confirm a link between the loss of emotional effect on memory and neuropathological change in medial temporal structures during the course of Alzheimer's disease.

We report data from a group of patients with mild Alzheimer's disease on a range of tasks requiring either stored semantic knowledge about objects (e.g., naming object use) or the execution of action to objects (e.g., miming and using objects). We found that the patients were impaired at miming in response to objects, even when they could describe the object's function. On the other hand, copying gestures was not impaired relative to naming gestures, indicating that an ideomotor deficit in action execution, per se, was unlikely to explain the impairments in object use. We suggest instead that the patients had an impairment in stored motor programmes for action, over and above their deficits in semantic knowledge. Despite this, the patients were better at using than at miming to objects, consistent with the view that proprioceptive input (when using objects) can directly constrain selection of the appropriate motor programme for action.