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March 28, 2000; 54 (6) Articles

Testing memory for self-generated items in dementia

Method makes a difference

Anna M. Barrett, Gregory P. Crucian, Ronald L. Schwartz, Kenneth M. Heilman
First published March 28, 2000, DOI: https://doi.org/10.1212/WNL.54.6.1258
Anna M. Barrett
MD
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Gregory P. Crucian
PhD
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Ronald L. Schwartz
MD
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Kenneth M. Heilman
MD
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Citation
Testing memory for self-generated items in dementia
Method makes a difference
Anna M. Barrett, Gregory P. Crucian, Ronald L. Schwartz, Kenneth M. Heilman
Neurology Mar 2000, 54 (6) 1258-1264; DOI: 10.1212/WNL.54.6.1258

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Abstract

Objective: To learn how pAD (probable Alzheimer’s disease), PD+ (“Parkinson’s Plus” syndrome), and control subjects remember internally generated material under different conditions.

Background: “Self-discovered,” or internally generated knowledge, prized by educators and therapists, can bring about considerable behavioral change. Both parietal-temporal-limbic (pAD) and frontal-subcortical dementia (e.g. PD+) cause dysmemory, but may cause different internal-external memory bias. pAD subjects, confusing internal and external information (confabulation) and reporting internal information during memory testing (intrusions), may be biased to remember internal material. PD+ subjects, impaired at generative tests, may be externally biased.

Methods: Ten pAD, 5 PD+, and 10 control subjects generated words in a category without instruction to remember (INR), and took a list-learning test of incidental memory for internally and externally generated words. To test how INR influences memory, subjects then generated and attempted to recall four more words.

Results: All three subject groups remembered more internally generated than externally provided words without INR. Recall versus recognition of internally generated words differed by group, with PD+ subjects showing greatest improvement with recognition. The pAD subjects performed worse with INR than without INR, had the most intrusion errors, and, rather than demonstrating a release from proactive inhibition, recalled fewer words outside the category. Groups differed in overall recall/recognition improvement (p = 0.015).

Conclusions: Aged subjects preferentially retained internally generated material. However, among demented subjects, memory for internally generated words was influenced by the testing method used. PD+ subjects have poor internal recall, but excellent internal recognition. In pAD, memory for internally generated words may exceed external memory, but only when subjects are not explicitly trying to remember.

  • Received May 24, 1999.
  • Accepted January 12, 2000.
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