The use of distraction to improve episodic memory in ageing: A review of methods and theoretical implications.

Healthy ageing is characterized by changes in several cognitive functions, including episodic memory and inhibition. While the age-related decrease in the ability to inhibit irrelevant stimuli is often associated with lower performance, especially in episodic memory, some studies have highlighted the boosting effect of distraction in several tasks in older adults, including episodic memory tasks related to recollection. The aim of this article is to review and compare previous studies according to specific study features and to consider the results in light of the dual-process model of recollection and familiarity that were used by the authors of the reviewed articles. This work led to the identification of two major points of comparison between the studies: the timeline of the distraction intervention and the implicit nature of the processes at play, which both allowed for different implications to the relationship with recollection. The use of distraction in memory tasks can enhance episodic memory, and especially recollective processes, due to specific actions at encoding and retrieval. These findings open the door to further investigations but also raise several questions concerning the role of implicit processes and the negative impact of distraction, for example. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Boosting Autobiographical Memory and the Sense of Identity of Alzheimer Patients Through Repeated Reminiscence Workshops?

Despite severe amnesia, some studies showed that Alzheimer Disease (AD) patients with moderate to severe dementia keep a consistent, but impoverished representation of themselves, showing preservation of the sense of identity even at severe stages of the illness. Some studies suggest that listening to music can facilitate the reminiscence of autobiographical memories and that stimulating autobiographical memory would be relevant to support the self of these patients. Consequently, we hypothesized that repeated participation to reminiscence workshops, using excerpts of familiar songs as prompts would participate to the enrichment of autobiographical memories, self-representation and sense of identity. We included a group of 20 AD patients with severe dementia residing in nursing homes. Their performances were compared to a control group of 20 matched (age, education, mood) healthy residents living in the same institutions. The experiment was conducted in three phases over a 2-week period. On phase 1, an individual assessment of sense of identity was proposed to each participant. On phase 2, participants joined musical reminiscence workshops (six sessions over 2 weeks for AD patients and 3 sessions over a week for controls). During the third phase (12 days after the first assessment), individual evaluation of autobiographical memory and a second assessment of sense of identity were proposed. Our results showed that, despite their massive amnesia syndrome, autobiographical memories of AD reached at the end of the 2 weeks the number and quality of those of matched controls. Moreover, we confirmed a continuity of self-representation in AD patients with a stable profile of the answers between the first and second individual assessments of sense of identity. However, the increase in number and episodic quality of autobiographical memories was not accompanied by an enrichment of the sense of identity. In a complementary study, new patients participated in the same paradigm, but using movie extracts as prompts, and showed very similar effects. We discuss all of these results with regard to the literature showing the significant impact of repetition on the reactivation of memory traces even in very amnestic AD patients at severe stages of the disease.

Do Musicians Have Better Mnemonic and Executive Performance Than Actors? Influence of Regular Musical or Theater Practice in Adults and in the Elderly.

The effects of musical practice on cognition are well established yet rarely compared with other kinds of artistic training or expertise. This study aims to compare the possible effect of musical and theater regular practice on cognition across the lifespan. Both of these artistic activities require many hours of individual or collective training in order to reach an advanced level. This process requires the interaction between higher-order cognitive functions and several sensory modalities (auditory, verbal, visual and motor), as well as regular learning of new pieces. This study included participants with musical or theater practice, and healthy controls matched for age (18-84 years old) and education. The objective was to determine whether specific practice in these activities had an effect on cognition across the lifespan, and a protective influence against undesirable cognitive outcomes associated with aging. All participants underwent a battery of cognitive tasks that evaluated processing speed, executive function, fluency, working memory, verbal and visual long-term memories, and non-verbal reasoning abilities. Results showed that music and theater artistic practices were strongly associated with cognitive enhancements. Participants with musical practice were better in executive functioning, working memory and non-verbal reasoning, whereas participants with regular acting practice had better long-term verbal memory and fluency performance. Thus, taken together, results suggest a differential effect of these artistic practices on cognition across the lifespan. Advanced age did not seem to reduce the benefit, so future studies should focus on the hypothetical protective effects of artistic practice against cognitive decline.

New Long-Term Encoding in Severely Amnesic Alzheimer's Disease Patients Revealed Through Repeated Exposure to Artistic Items.

BACKGROUND: Encoding of new information is considered to be impossible in people with Alzheimer's disease (PWAD) at a moderate to severe stage. However, a few case studies reported new learning under special circumstances, especially with music. OBJECTIVE: This article aims at clarifying PWAD's learning capacities toward unknown material under more ecological settings, which is repeated exposure without encoding instruction. METHODS: Twenty-three PWAD (Age: m = 84.6(5.2), 5≤MMSE≤19) underwent presentations of unknown artistic pieces (targets) through 8 daily individual sessions. These sessions were followed by a test session, during which their knowledge of the targets was assessed through a verbal and behavioral scale (the sense of familiarity scale) against a series of unknown items (distractors). RESULTS: Through this design, we were able to objectify encoding of three types of targets (verses, paintings, and music) against distractors the day after exposure sessions, and 2 months after the last presentation (study 1). Music and paintings were eventually well-encoded by most participants, whereas poems encoding was poorer. When compared to distractors, target items were significantly better recognized. We then compared the recognition of target paintings against two types of painting distractors, either perceptually or semantically related (study 2). The targets were better recognized than all three painting distractors, even when they were very close to the targets. CONCLUSION: Despite massive anterograde amnesia, our results clearly showed that recognition-based learning without conscious memory of the encoding context is preserved in PWAD at a severe stage, revealed through an increasing sense of familiarity following repeated exposure. These findings could open new perspective both for researchers and clinicians and improve the way we understand and care for PWAD living in healthcare facilities.

Preservation of Musical Memory Throughout the Progression of Alzheimer's Disease? Toward a Reconciliation of Theoretical, Clinical, and Neuroimaging Evidence.

Through this review of 25 clinical and experimental works on long-term musical memories in Alzheimer's disease (AD) patients, we attempt to clarify the conceptual understanding of musical memories, identify their evolution across the stages of the pathology, and propose possible explanations concerning the neural and cognitive mechanisms that underpin the preservation and impairment of certain musical memories. After clarifying the different kind of musical memories, we investigated their alterations throughout AD's progression from mild to severe stages. Both procedural and retrograde semantic memory seem relatively spared in AD, while episodic memory appears to be impaired early. Moreover, partial preservation of music encoding in AD can be revealed through paradigms that are especially designed for AD patients (relying on behavioral cues, using adapted settings, etc.). Although seldomly used, they would definitely help understanding the preserved capacities in every stage of AD. However, more research is needed to better understand this phenomenon and assess its specificity to music or other types of supports. These findings could lead to multiple applications in care settings and research designs, bringing more nuanced understanding of how long-term musical memory degrades throughout the course of AD, and should encourage us to prioritize patients' preserved cognitive abilities in current AD recreational and care programs.

Helping caregivers of people with dementia: a need to renew theoretical frameworks in France.

Research and care have improved a lot for persons with dementia (PWD) in France. However, most studies are essentially descriptive, and very few researches have focused on theoretical framework that may help understand and help their caregivers (CG). Yet, some approaches exist, and have proven to be efficient in other countries. The main interest of such approaches is the possibility to match health professionals' conception of CG and their situation, and thus allowing to better describe their situation, their difficulties and their expectations, and thus offer a caring the closest possible from their needs. Four main approaches will be discussed : 1) stress coping, the most used model in CG's care that allows to assess the principal stressors in CG's role, and to figure out the best ways to cope with these; 2) person centered care, which claims that making the CG more competent in their role decreases their burden; 3) role transition theory for which the difficulties come from the fact that CG's role is mostly unexpected, and their way of embracing it modifies their perception of themselves and their relative with dementia; 4) senses framework characterizes CG and PWD through their relationship, and offers a vision that includes difficulties and ways to cope with them, as well as satisfactions they experiment in the caregiving relationship. We will see through these theoretical frameworks which elements are the most relevant to take into account, their similarities and differences as well as the possible applications for health practitioners.