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. 2019 Feb 12:10:241.
doi: 10.3389/fpsyg.2019.00241. eCollection 2019.

An Impairment of Prospective Memory in Mild Alzheimer's Disease: A Ride in a Virtual Town

Grégory Lecouvey  1 , Alexandrine Morand  1 , Julie Gonneaud  1 , Pascale Piolino  2 , Eric Orriols  2 , Alice Pélerin  1 , Laurence Ferreira Da Silva  1 , Vincent de La Sayette  1 , Francis Eustache  1 , Béatrice Desgranges  1
Affiliations

An Impairment of Prospective Memory in Mild Alzheimer's Disease: A Ride in a Virtual Town

Grégory Lecouvey et al. Front Psychol. .

Abstract

Objective: Research suggests that prospective memory (PM) is impaired from the very early stages of Alzheimer's disease (AD). We sought to further characterize this impairment in patients with mild AD, using a virtual reality (VR) task to provide ecological assessment of PM. Methods: Fifteen cognitively normal older individuals (76.47 years old ± 4.14, MMSE: 28.80 ± 1.21), and 17 patients with mild AD (79.29 years old ± 4.45, MMSE: 22.82 ± 2.83) were asked to recall the prospective and retrospective components of seven intentions in a virtual town task. Six intentions were event-based, where the prospective cue was either highly (three intentions) or weakly (three intentions) associated with the retrospective component. The remaining intention was time-based. All participants completed a neuropsychological assessment of episodic memory, semantic memory and executive functioning. Non-parametric tests were used to compare the two groups on the different intentions types and components. Correlations between cognition and PM scores were then realized to further understand the cognitive correlates of the PM impairment in patients with AD. Results: Overall, patients with Alzheimer disease recalled fewer intentions than controls, with the retrospective component and time-based intentions being the most challenging for them. The strength of the association between the prospective and retrospective components, however, had no effect on their performance. Event-based PM impairment, as well as deficit in the recall of prospective component correlated with memory and executive functions performance. Conclusion: PM is impaired in AD. Both automatic and controlled processes of PM retrieval are disturbed. This study also confirms the reliability of VR for assessing complex cognitive functions such as PM.

Keywords: Alzheimer’s disease; event-based; intentions; prospective component; retrospective component; time-based; virtual reality.

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Figures

FIGURE 1
FIGURE 1
Illustration of the virtual environment including a view from the virtual driving seat during the experiment (left) and a map of the city (right) showing the location of the prospective cues from Lecouvey et al. (2017).
FIGURE 2
FIGURE 2
Mean number of trials needed at encoding for each type of intentions (Link-EB vs. NoLink-EB vs. TB) in cognitively normal older adults and patients with AD. EB = event-based, TB = time-based, AD = Alzheimer’s disease. Errors bars represent standard deviation. ∗∗ p < 0.01. ∗∗∗ p < 0.001.
FIGURE 3
FIGURE 3
Percentage of correct recall for each type of intentions (Link-EB vs. NoLink-EB vs. TB) in cognitively normal older adults and patients with AD. EB = event-based, TB = time-based, AD = Alzheimer’s disease. Errors bars represent standard deviation. ∗∗∗ p < 0.001.
FIGURE 4
FIGURE 4
Percentage of correct recall of each component (prospective vs. retrospective) comparing cognitively normal older adults and patients with mild AD. EB = event-based, TB = time-based, AD = Alzheimer’s disease. Errors bars represent standard deviation. ∗∗∗ p < 0.001.
FIGURE 5
FIGURE 5
Comparison of the correct responses of the prospective vs. retrospective components of Link-EB and NoLink-EB in each group. EB = event-based, AD = Alzheimer’s disease, OA = older adults. Errors bars represent standard deviation. ∗ p < 0.05. ∗∗ p < 0.01. ns = non-significant.
FIGURE 6
FIGURE 6
Correlations between (A) shifting, (B) semantic memory and NoLink-EB intentions in AD patients.
FIGURE 7
FIGURE 7
Correlations between (A) shifting, (B) planning and prospective component in AD patients.
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