Laboratoire de Psychologie des Pays de La Loire, LPPL EA 4638, SFR Confluences, UNIV Angers, Nantes Université, Maison de La Recherche Germaine Tillion, 5 Bis Boulevard Lavoisier, 49045 Angers, Cedex 01, France.
Laboratoire d'Etude des Mécanismes Cognitifs (EA 3082), Université de Lyon, France; Institut Universitaire de France, Paris, France.
Neuropsychologia. 2021 Jan 8;150:107714. doi: 10.1016/j.neuropsychologia.2020.107714. Epub 2020 Dec 4.
The aim of the present study was to compare patients with mild to moderate Alzheimer's disease (AD) or semantic dementia (SD) on their cognitive processes and the severity of their daily life activity impairments. Three types of tasks were administered to patients (SD = 15; AD = 31) and 30 healthy controls (HC): 1) informant-based scales and questionnaires, 2) a neuropsychological assessment exploring executive functions, episodic and semantic memory, and 3) a new original test featuring multi-step naturalistic actions and multitasking: the Sequential Daily Life Multitasking (SDLM). We predicted that patients with AD would mainly exhibit task perplexity, associated with episodic and executive deficits on the SDLM, while the behavior of patients with SD would mostly be characterized by object perplexity, associated with semantic memory deficits. Results showed that patients with AD or SD were impaired across all neuropsychological tests, particularly episodic memory in AD and semantic memory in SD. General performance on the SDLM also appeared dramatically impaired in both patient groups, and correlated with results of questionnaires about instrumental activities and memory impairments. However, specific qualitative measurements on the SDLM did not allow us to pinpoint different patterns of errors and behavior in patients with AD versus SD. We suggest that the inability of patients in both groups to perform the SDLM may derive from a constellation of disorders or else from more subtle impairment of cognitive and conative processes that requires further exploration.
本研究旨在比较轻度至中度阿尔茨海默病(AD)或语义性痴呆(SD)患者的认知过程和日常生活活动受损的严重程度。我们向三组患者(SD=15;AD=31)和 30 名健康对照组(HC)提供了三种类型的任务:1)基于知情者的量表和问卷,2)探索执行功能、情景和语义记忆的神经心理学评估,以及 3)一项具有多步自然动作和多任务的新原创测试:即序列日常生活多任务(SDLM)。我们预测 AD 患者主要表现出任务困惑,这与 SDLM 上的情景和执行缺陷有关,而 SD 患者的行为主要表现为对象困惑,与语义记忆缺陷有关。结果表明,AD 或 SD 患者在所有神经心理学测试中都存在障碍,尤其是 AD 的情景记忆和 SD 的语义记忆。两组患者的 SDLM 整体表现也明显受损,与关于工具性活动和记忆障碍的问卷结果相关。然而,S DLC 上的特定定性测量并不能确定 AD 与 SD 患者之间的错误和行为模式存在差异。我们认为,两组患者无法完成 SDLM 可能源于一系列障碍,或者是由于认知和意志过程的更微妙损伤所致,需要进一步探索。