Lesson from the Nun Study

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Lesson from the Nun Study
MMSEMini Mental Status Exam NFTNeurofibrillary
tangle NPNeuritic plaque DPDiffuse plaque
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Braak stages of NFT pathology Stages I II
Transentorhinal Stages III IV Limbic Stages V
and VI Neocortical
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Memory and aging

• Memory is NOT a single ability that shows a
  unitary developmental pattern with aging

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Dissociation
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Short- vs long-term

• Short-term memory refers to recent events that
  are still in conscious awareness
• Long-term memory refers to recent or remote
  events that have left conscious awareness and
  must be retrieved from a dormant state

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Declarative vs nondeclarative

• Declarative remembering is consciously
  recollecting the past. (Memory is an object)
• Nondeclarative remembering occurs without
  awareness it facilitates current behavior
  through past experience. (Memory is a tool)

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Memory systems
Long-term Memory
Declarative
Nondeclarative
Semantic
Episodic
Priming
Skills
Classical conditioning
Retrospective
Prospective
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Memory systems memory tests

• Tests are not equal to systems
• A memory test can cross memory systems, that is,
  it can measure the functioning of more than one
  system

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Types of memory tests

• Declarative (explicit) tests
• Free recall
• Cued recall
• Recognition
• Nondeclarative (implicit) tests
• Degraded stimulus presentation
• Word-stem completion
• Fame judgments

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Apple Valley Powder Honey Elbow Angel Market
Bubble Package Story Prairie Meadow Fabric Hi
ghway Carpet Saddle Oyster Sailor Velvet Stude
nt
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Remember know as a function of age
Parkin Walter (1992). Recollective experience,
normal aging and frontal dysfunction. Psychology
and Aging, 7.
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Implications of knowing the past

• Problems with source memory (remembering the
  temporal/spatial/emotional context of an event
• Susceptibility to forming false memories
• Intense experiences may not be recollected vividly

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Measuring implicit memory

• On perceptual degradation tasks evidence of
  implicit memory is obtained if more study than
  non-study items are recognized.
• Priming percent study items recognized minus
  percent non-study items recognized.

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Types phases of memory aging
Normal Aging
Mild Cognitive Impairment
Memory function
AD
Irreversible
90
50
70
80
60
Age
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Mild Cognitive Impairment (MCI)

• Clinically significant impairment insufficient in
  severity to meet dementia criteria
• Prevalence is 16 over age 65
• AD/dementia incidence is 10-15/year
• Prediction of outcome
• Memory performance
• Neuroimaging
• Genetics
• CSF biomarkers

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Clinical course of MCI
MCI AD 12/yr
Control AD 1-2/yr
Initial
12
24
36
48
Initial
12
24
36
48
exam
exam
Months
Months