The Passion Trap: How to Right an Unbalanced Relationship

Product Information

Lange KL, Bondi MW, Galasko DG, Delis DC, Salmon DP, Thal LJ. Decline in verbal memory during preclinical Alzheimer’s disease: Examination of the effect of Apolipoprotein E genotype. Journal of the International Neuropsychological Society. 2002; 8:943–955. [ PMC free article] [ PubMed] [ Google Scholar] Partington, J. E., & Leiter, R. G. (1949). Partington’s pathway test. The Psychological Service Center Bulletin, 1, 9–20. The aim of the current study was to examine patterns of recognition memory using different testing formats, with particular interest in understanding these patterns in individuals at risk for dementia and in those at different stages of Alzheimer’s disease. This aim was investigated by comparing patterns of recognition memory performance on the yes/no and forced-choice recognition conditions of the California Verbal Learning Test-II in individuals with AD, MCI, and cognitively intact older adults. Our findings indicate a degeneration of recognition memory abilities from normal aging through moderate–severe stages of dementia, in which normal older adults demonstrated equally high recognition memory performance on both test formats, individuals with amnestic MCI performed similarly to normal controls on the forced-choice task but worse on the yes/no recognition task, and individuals with AD performed worse on both recognition memory procedures than did normal control and MCI groups.

Price CC, Garrett KD, Jefferson AL, Consentino S, Tanner JJ, Penney DL, Libon DJ. Leukoaraiosis severity and list-learning in dementia. The Clinical Neuropsychologist. 2009; 23:944–961. [ PMC free article] [ PubMed] [ Google Scholar] Dr. Delis is a Professor of Psychiatry at the UCSD School of Medicine, where he has been on the faculty since 1985. He is also an Adjunct Professor of Psychology at San Diego State University, and Director of the Psychological Assessment Unit at the San Diego V.A. Medical Center. He is a licensed clinical psychologist in California, and board certified in clinical neuropsychology from the American Board of Professional Psychology and American Board of Clinical Neuropsychology. Baker, D. A. (June 2012). "Handbook of Pediatric Neuropsychology". Archives of Clinical Neuropsychology (Review). 27 (4): 470–471. doi: 10.1093/arclin/acs037.Jak AJ, Bondi MW, Delano-Wood L, Wierenga C, Corey-Bloom J, Salmon DP, Delis DC. Quantification of five neuropsychological approaches to defining mild cognitive impairment. American Journal of Geriatric Psychiatry. 2009; 17(5):368–375. [ PMC free article] [ PubMed] [ Google Scholar] Mattis S. Dementia Rating Scale: Professional manual. Psychological Assessment Resources Inc; Odessa, FL: 1988. [ Google Scholar] Beatty, W. W., Hames, K. A., Blanco, C. R., & Paul, R. H. (1995). Verbal abstraction deficit in multiple sclerosis. Neuropsychology, 9, 198–205. Stroop, J. R. (1935). Studies of interference in serial verbal reaction. Journal of Experimental Psychology, 18, 643–662.

Delano-Wood L, Bondi MW, Sacco J, Abeles N, Jak AJ, Libon DJ, Bozoki A. Heterogeneity in mild cognitive impairment: Differences in neuropsychological profile and associated white matter lesion pathology. Journal of the International Neuropsychological Society. 2009; 15:906–914. [ PMC free article] [ PubMed] [ Google Scholar] Finally, our findings perhaps offer some diagnostic implications for MCI and its putative subtypes. For example, Petersen et al. (2009) has suggested that the amnestic subtype is approximately twice as prevelant as non-amnestic MCI, although our findings suggest that early cognitive declines in complex executive function tasks, or the confluence of difficulties in executive functions and learning, may be more prevalent than an isolated deficit in delayed free recall. The higher amnestic MCI prevalence noted by Petersen et al. may also relate to most studies over the prior decade focusing on amnestic MCI and fewer studies using comprehensive neuropsychological definitions to more broadly characterize other subtypes. Indeed, recent neuropsychological studies of empirically-derived MCI subtypes have found that the majority of MCI cases present with a more heterogeneous cognitive profile rather than a circumscribed amnesia ( Delano-Wood et al., 2009; Eppig et al., in press; Libon et al., 2010). Of course, whether these different MCI subtypes represent reliable prodromes of dementia, and of particular etiologies, will require longitudinal follow-up. Nevertheless, statistically-defined MCI subtypes derived from comprehensive neuropsychological assessments will represent improvements in profiling and characterizing MCI in older adults. Our preliminary data support that difficulties with complex executive control tasks requiring inhibition and switching may herald the onset of more global cognitive declines. Comalli, P. E., Jr., Wapner, S., & Werner, H. (1962). Interference effects of Stroop color-word test in childhood, adulthood, and aging. Journal of Genetic Psychology, 100, 47–53. Bondi MW, Salmon DP, Monsch AU, Galasko D, Butters N, Klauber MR, Saitoh T. Episodic memory changes are associated with the APOE-epsilon 4 allele in nondemented older adults. Neurology. 1995; 45:2203–2206. [ PubMed] [ Google Scholar] Baldo, J. V., Delis, D. C., Wilkins, D. P., & Shimamura, A. P. (2004). Is it bigger than a breadbox? Performance of patients with prefrontal lesions on a new executive function test. Archives of Clinical Neuropsychology, 19(3), 407–419.

The CWIT Inhibition/Switching task had the largest effect size and was the strongest predictor of subsequent DRS decline. Studies investigating executive function in individuals at risk for dementia (e.g., those with MCI) have also implicated executive function deficits in similar components such as response inhibition, divided attention, and inhibitory control ( Brandt et al., 2009; Traykov et al., 2007). Additionally, impairments in divided and sustained attention, as well as inhibition of irrelevant information on the Stroop test have been observed in mild AD ( Stokholm, Vogel, Gade, & Waldemar, 2006). The current study’s findings suggest that cognitive switching necessary for alternating between producing an automatic response (e.g., reading words) and inhibiting this automatic response to deliver a controlled response (e.g., naming colors) may be particularly sensitive to subsequent global cognitive decline in a sample of relatively healthy older adults. Our results also indicate that a decreased ability to switch between semantic categories may be useful in predicting subsequent global cognitive decline. Notably, there were no significant baseline differences between groups on the number of words generated on the fluency task, but decliners produced significantly fewer switches between semantic categories. This distinction suggests that the switching component is particularly predictive of global decline beyond the capacity to generate sufficient numbers of correct words from the categories. Nutter-Upham and colleagues (2008) showed that the D-KEFS category switching measure most strongly discriminated individuals with MCI from cognitively intact elderly compared to letter and category fluency. In a longitudinal study, Raoux and colleagues (2008) observed that individuals who developed AD within 5 years produced significantly fewer spontaneous switches between subcategories of animals on a standard fluency task compared to those who remained cognitively stable. Because similar numbers of words were produced, the authors suggested that impaired fluency performance may relate to switching deficits, rather than solely a semantic deficit. However, the latter study measured switches within a single category, whereas our VF switching task forced participants to switch categories following each word. Although switching within a category may reflect the integrity of semantic operations, rapidly switching between categories may depend both on semantic network integrity and executive function and, therefore, be particularly sensitive to impending decline. Jak AJ, Bondi MW, Delano-Wood L, Wierenga C, Corey-Bloom J, Salmon DP, Delis DC. Quantification of five neuropsychological approaches to defining mild cognitive impairment. American Journal of Geriatric Psychiatry. 2009; 17:368–375. [ PMC free article] [ PubMed] [ Google Scholar]