Gunma University Graduate School of Health Sciences, Gunma, Japan.
Int Psychogeriatr. 2012 Dec;24(12):1919-26. doi: 10.1017/S1041610212001147. Epub 2012 Jul 3.
In Alzheimer's disease (AD) patients, deficits in contextual understanding and intentions/beliefs of other people (theory of mind; ToM) cause communication problems between patients and caregivers. To evaluate deficits of contextual understanding/ToM, we developed the Pitfall Intention Explanation Task with Clue Questions (Pitfall task).
We recruited 26 healthy older adults in clinical dementia rating (CDR) 0, and 62 outpatients: 12 with amnestic mild cognitive impairment (aMCI) in CDR 0.5; 36 mild AD in CDR 1; and 14 moderate AD in CDR 2. The Pitfall task consists of a single-frame cartoon that shows a character's intention and seven serial questions that provide clues for contextual understanding/ToM.
The total score (0-7) was decreased with progression of AD (CDR 0, 5.4 ± 2.6; CDR 0.5, 3.7 ± 2.7; CDR 1, 1.9 ± 3.1; CDR 2, 0.0 ± 0.0; respectively). In CDR 0, two-third of the participants responded correctly without clue questions. In CDR 0.5, one-third of the participants responded correctly without clue questions, and half of them understood with the help of the clue questions. In CDR 1, one-fourth of the participants responded correctly without clue questions, and the clue questions did not increase the correct response. In CDR 2, none responded correctly. Additionally, the Pitfall task provided the chance for patients' families to observe patients' responses.
Contextual understanding/ToM, a kind of social cognition, was impaired with progression of AD. The Pitfall task evaluates the function quickly with low burden for memory function, and may provide helpful clues for caregivers to achieve good communication with AD patients.
在阿尔茨海默病（AD）患者中，对上下文的理解和对他人意图/信念（心理理论；ToM）的缺陷导致患者和护理人员之间的沟通问题。为了评估对上下文的理解/ToM 的缺陷，我们开发了带有线索问题的陷阱意图解释任务（Pitfall 任务）。
我们招募了 26 名临床痴呆评定（CDR）为 0 的健康老年人，以及 62 名门诊患者：12 名 CDR 为 0.5 的遗忘型轻度认知障碍（aMCI）患者；36 名 CDR 为 1 的轻度 AD 患者；以及 14 名 CDR 为 2 的中度 AD 患者。Pitfall 任务由一个单帧卡通组成，显示一个角色的意图和七个连续的问题，为上下文的理解/ToM 提供线索。
随着 AD 的进展（CDR 0：5.4 ± 2.6；CDR 0.5：3.7 ± 2.7；CDR 1：1.9 ± 3.1；CDR 2：0.0 ± 0.0），总得分（0-7）逐渐降低。在 CDR 0 中，三分之二的参与者在没有线索问题的情况下回答正确。在 CDR 0.5 中，三分之一的参与者在没有线索问题的情况下回答正确，一半的参与者在线索问题的帮助下理解。在 CDR 1 中，四分之一的参与者在没有线索问题的情况下回答正确，线索问题并没有增加正确的反应。在 CDR 2 中，没有人回答正确。此外，Pitfall 任务为患者家属提供了观察患者反应的机会。
随着 AD 的进展，对上下文的理解/ToM，一种社会认知，受损。Pitfall 任务快速评估功能，对记忆功能负担低，可能为护理人员与 AD 患者进行良好沟通提供有帮助的线索。
