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Objective: To measure caregivers' and clinicians' perception of false memories in the lives of patients with memory loss due to Alzheimer's disease (AD) and mild cognitive impairment (MCI) using a novel false memories questionnaire. Our hypotheses were that false memories are occurring as often as forgetting according to clinicians and family members., Method: This prospective, questionnaire-based study consisting of 20 false memory questions paired with 20 forgetting questions had two forms: one for clinicians and the other for family members of older subjects. In total, 226 clinicians and 150 family members of 49 patients with AD, 44 patients with MCI, and 57 healthy older controls (OCs) completed the questionnaire., Results: False memories occurred nearly as often as forgetting according to clinicians and family members of patients with MCI and AD. Family members of OCs and patients with MCI reported fewer false memories compared to those of the AD group. As Mini-Mental State Examination scores decreased, the mean score increased for both forgetting and false memories. Among clinicians, correlations were observed between the dementia severity of patients seen with both forgetting and false memories questionnaire scores as well as with the impact of forgetting and false memories on daily life., Conclusion: Patients with AD experience false memories almost as frequently as they do forgetting. Given how common false memories are in AD patients, additional work is needed to understand the clinical implications of these false memories on patients' daily lives. The novel false memories questionnaire developed may be a valuable tool.

Patients with amnestic mild cognitive impairment (MCI) and Alzheimer's disease (AD) often demonstrate high rates of false memories, leading to stressful and frustrating situations for both patients and caregivers in everyday life. Sometimes these false memories are due to failures in monitoring the source of the information. In the current study, we examined interventions aimed to enhance the use of the metacognitive "recall-to-reject" memory strategy. Such interventions could improve source memory and decrease false memory in patients with MCI. Because the picture superiority effect (better memory for pictures compared to words) has been shown to be present in both patients with MCI and healthy older controls, we investigated whether pictures could help patients with MCI use a recall-to-reject strategy in a simulation of real-world source memory task. In this experiment, patients with MCI and healthy older adults were asked to simulate preparing for and then taking a trip to the market. Subjects first studied 30 pictures of items in their "cupboard," followed by a list of 30 words of items on their "shopping list." At test, participants saw 90 pictures (30 cupboard, 30 list, 30 new) organized as they would be if walking down the market aisles, and are provided with either standard or metacognitive instructions. With standard instructions, they were asked if they needed to buy the item. With the metacognitive instructions, they were asked a series of questions to help guide them through a recall-to-reject strategy to highlight the different sources of memories. Results showed that the metacognitive instructions did significantly reduce the false memory rates for patients with MCI. Further studies need to investigate how to best implement these practical strategies into the everyday lives of patients., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Objectives: The present study examined the role of enactment in source memory in a cognitively impaired population. As seen in healthy older adults, it was predicted that source memory in people with mild cognitive impairment due to Alzheimer's disease (MCI-AD) would benefit from the self-reference aspect of enactment., Method: Seventeen participants with MCI-AD and 18 controls worked in small groups to pack a picnic basket and suitcase and were later tested for their source memory for each item., Results: For item memory, self-referencing improved corrected recognition scores for both MCI-AD and control participants. The MCI-AD group did not demonstrate the same benefit as controls in correct source memory for self-related items. However, those with MCI-AD were relatively less likely to misattribute new items to the self and more likely to misattribute new items to others when committing errors, compared with controls., Discussion: The enactment effect and self-referencing did not enhance accurate source memory more than other referencing for patients with MCI-AD. However, people with MCI-AD benefited in item memory and source memory, being less likely to falsely claim new items as their own, indicating some self-reference benefit occurs for people with MCI-AD., (Published by Oxford University Press on behalf of the Gerontological Society of America 2014.)

Understanding how memory breaks down in the earliest stages of Alzheimer's disease (AD) process has significant implications, both clinically and with respect to intervention development. Previous work has highlighted a robust picture superiority effect in patients with amnestic mild cognitive impairment (aMCI). However, it remains unclear as to how pictures improve memory compared to words in this patient population. In the current study, we utilized receiver operating characteristic (ROC) curves to obtain estimates of familiarity and recollection for pictures and words in patients with aMCI and healthy older controls. Analysis of accuracy shows that even when performance is matched between pictures and words in the healthy control group, patients with aMCI continue to show a significant picture superiority effect. The results of the ROC analysis showed that patients demonstrated significantly impaired recollection and familiarity for words compared controls. In contrast, patients with aMCI demonstrated impaired recollection, but intact familiarity for pictures, compared to controls. Based on previous work from our lab, we speculate that patients can utilize the rich conceptual information provided by pictures to enhance familiarity, and perceptual information may allow for post-retrieval monitoring or verification of the enhanced sense of familiarity. Alternatively, the combination of enhanced conceptual and perceptual fluency of the test item might drive a stronger or more robust sense of familiarity that can be accurately attributed to a studied item., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objective: The picture superiority effect, better memory for pictures compared to words, has been found in young adults, healthy older adults, and, most recently, in patients with Alzheimer's disease and mild cognitive impairment. Although the picture superiority effect is widely found, there is still debate over what drives this effect. One main question is whether it is enhanced perceptual or conceptual information that leads to the advantage for pictures over words. In this experiment, we examined the picture superiority effect in healthy older adults and patients with amnestic mild cognitive impairment (MCI) to better understand the role of gist-based conceptual processing., Method: We had participants study three exemplars of categories as either words or pictures. In the test phase, participants were again shown pictures or words and were asked to determine whether the item was in the same category as something they had studied earlier or whether it was from a new category., Results: We found that all participants demonstrated a robust picture superiority effect, better performance for pictures than for words., Conclusions: These results suggest that the gist-based conceptual processing of pictures is preserved in patients with MCI. While in healthy older adults preserved recollection for pictures could lead to the picture superiority effect, in patients with MCI it is most likely that the picture superiority effect is a result of spared conceptually based familiarity for pictures, perhaps combined with their intact ability to extract and use gist information.

We assessed the ability of two groups of patients with mild Alzheimer's disease (AD) and two groups of older adults to monitor the likely accuracy of recognition judgments and source identification judgments about who spoke something earlier. Alzheimer's patients showed worse performance on both memory judgments and were less able to monitor with confidence ratings the likely accuracy of both kinds of memory judgments, as compared to a group of older adults who experienced the identical study and test conditions. Critically, however, when memory performance was made comparable between the AD patients and the older adults (e.g., by giving AD patients extra exposures to the study materials), AD patients were still greatly impaired at monitoring the likely accuracy of their recognition and source judgments. This result indicates that the monitoring impairment in AD patients is actually worse than their memory impairment, as otherwise there would have been no differences between the two groups in monitoring performance when there were no differences in accuracy. We discuss the brain correlates of this memory-monitoring deficit and also propose a Remembrance-Evaluation model of memory-monitoring., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

To understand the neural correlates of the memorial power of pictures, pictures and words were systematically varied at study and test within subjects, and high-density event-related potentials (ERPs) were recorded at retrieval. Using both conventional and novel methods, the results were presented as ERP waveforms, 50 ms scalp topographies, and video clips, and analyzed using t-statistic topographic maps and nonparametric p-value maps. The authors found that a parietally-based ERP component was enhanced when pictures were presented at study or test, compared to when words were presented. An early frontally-based component was enhanced when words were presented at study compared to pictures. From these data the authors speculate that the memorial power of pictures is related to the ability of pictures to enhance recollection. Familiarity, by contrast, was enhanced when words were presented at study compared to pictures. From these results and the dynamic view of memory afforded by viewing the data as video clips, the authors propose an ERP model of recognition memory.

Alzheimer's disease (AD) reduces associative effects on false recognition in the Deese-Roediger-McDermott task, either due to impaired memory for gist or impaired use of gist in memory decisions. Gist processes were manipulated by blocking or mixing studied words according to their associations and by varying the associative strength between studied and nonstudied words at test. Both associative blocking and associative strength had smaller effects on false recognition in AD patients than in control participants, consistent with gist memory impairments. However, unlike the case with control participants, blocking influenced true and false recognition equally in AD patients, demonstrating an overdependence on gist when making memory decisions. AD also impaired item-specific recollections, relative to control participants, as true recognition of studied words was reduced even when the two groups were equated on gist-based false recognition. We propose that the overdependence on degraded gist memory in AD is caused by even larger impairments in item-specific recollections.

Within the framework of the dual process model of recognition memory, prior work with event-related potentials (ERPs) has suggested that an early component, the FN400, is a correlate of familiarity while a later component, the Late Positive Complex (LPC), is a correlate of recollection. However, other work has questioned the validity of these correlations, suggesting that the FN400 effect is too short-lived to reflect an explicit memory phenomenon and that the LPC may be influenced by decision-related factors. Using a Remember/Know paradigm we addressed these issues by (1) examining the effect of study-test delay on correctly recognized items associated with familiarity ('Know' responses) and recollection ('Remember' responses) and by (2) examining FN400 and LPC modulation associated with false alarms. Supporting the relationship of the FN400 with familiarity, attenuation of this component was present for 'Know' responses relative to correct rejections after both the short (39 min) and long (24 h) delay conditions. Attenuation of the FN400 also occurred for false alarms (responses largely driven by familiarity) relative to correct rejections. Although an increased LPC amplitude was found associated with 'Remember' responses at both delays, a decreased LPC amplitude was observed with false alarms relative to correct rejections. This latter result is discussed with regard to the possibility of an overlapping posterior negativity.

Despite their cognitive impairment, patients with mild Alzheimer's disease (AD) often make important life choices. When making choices, people frequently attempt to directly compare the features of different options, rather than evaluating each option separately. Not every feature has an analogous (or alignable) feature in the other option, however. In 2005, Mather's group found that both younger and older adults filled in such gaps when remembering, creating features in the other option to contrast with existing features. In the present study, such effects of alignability on recognition memory were not found in patients with mild AD. This finding suggests that patients with mild AD are less likely to engage in feature-by-feature comparison processes across choice options, a change that may lead them to make qualitatively different choices than healthy older adults., (Copyright (c) 2006 S. Karger AG, Basel.)

Most studies examining episodic memory in Alzheimer's disease (AD) have focused on patients' impaired ability to remember information, leading to poor discrimination between studied and unstudied items at test. Poor discrimination, however, can also be attributable to an abnormally high rate of false alarms. One cause of a high false alarm rate is an abnormally liberal response bias; that is, responding "old" too liberally to the test items. In the present study, discrimination and response bias were evaluated when participants were given a series of progressively longer study-test lists of unrelated words. As expected, patients with AD showed overall worse discrimination and a more liberal response bias compared with older adult controls. Critically, patients with AD also showed a more liberal response bias than older adults when discrimination was matched between the groups after performance was equated by giving the older adult controls a more difficult test than the patients with AD. This result confirms that the patients' abnormally liberal response bias is not simply attributable to their poor discrimination. Correlation analyses suggest that the patients' liberal response bias is related to the degree of their episodic memory deficit, which may in turn be related to the severity of their disease. Thus, our research suggests that as AD progresses two distinct abnormalities of episodic memory develop: worse discrimination and a more liberal response bias. Possible explanations of this liberal response bias in patients with AD are discussed.

Event-related potentials (ERPs) were used to investigate the neural processes underlying the distinctiveness heuristic-a response mode in which participants expect to remember vivid details of an experience and make recognition decisions based on this metacognitive expectation. One group of participants studied pictures and auditory words; another group studied visual and auditory words. Studied and novel items were presented at test as words only, with all novel items repeating after varying lags. ERP differences were seen between the word and picture groups for both studied and novel items. For the novel items, ERP differences were largest in frontal and central midline electrodes. In separate analyses, the picture group showed the greatest ERP differences between item types in a parietally based component from 550 to 1000 msec, whereas the word group showed the greatest differences in a frontally based component from 1000 to 2000 msec. The authors suggest that the distinctiveness heuristic is a retrieval orientation that facilitates reliance upon recollection to differentiate between item types. Although the picture group can use this heuristic and its retrieval orientation on the basis of recollection, the word group must engage additional postretrieval processes to distinguish between item types, reflecting the use of a different retrieval orientation.

Identifying high-functioning older individuals in preclinical phases of Alzheimer's disease (AD) may require more sensitive methods than the standard approach. The authors explored the utility of adjusting for premorbid intelligence to predict progressive cognitive decline or Mild Cognitive Impairment (MCI) in 42 highly intelligent older individuals. When scores were adjusted for baseline IQ, 9 participants had executive impairments, 11 had memory impairments, and 22 scored in the normal range. None were impaired according to standard age norms. Three and a half years later, 9 participants with IQ-adjusted memory impairment declined in naming, visuospatial functioning, and memory; 6 convened to MCI. Three participants with normal memory declined. Implications for using IQ-adjusted norms to predict preclinical AD are discussed., (((c) 2004 APA, all rights reserved))