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In an attempt to characterize the nature of semantic memory impairment in persons with dementia of the Alzheimer type (DAT), a free association task, a definition task, and an associate rank ordering task were administered to 10 mildly and 13 moderately impaired DAT subjects, and 14 normal control subjects. The DAT subjects presented a free association response profile that was markedly different from normal controls. Further, DAT subjects provided meaningful definitions to many of the words used as stimuli in the free association task. Relative to controls, DAT subjects demonstrated a deterioration in their ability to rank order words according to the strength of their association to a stimulus noun. The presently obtained data suggest that the semantic memory impairment in DAT can be characterized, in part, as a deterioration in the associative structure between concepts and a loss of conceptual knowledge.

The purpose of this investigation was to determine the test-retest response consistency rate on a semantic memory task in persons with dementia of the Alzheimer type (DAT). Ten mildly and 13 moderately impaired DAT subjects and 14 normal controls matched for age, years of education, and estimated IQ participated in this study. The Peabody Picture Vocabulary Test (PPVT) was administered twice to each subject with a seven day inter-test interval. The mild and moderate DAT subjects responded inconsistently to significantly more PPVT items than normal controls. When the effects of guessing were considered, moderate DAT subjects gave significantly more inconsistent PPVT responses than normal controls and mild DAT subjects showed a trend towards giving more inconsistent responses. These results substantiate the conclusion that the impairment of specific conceptual knowledge in DAT subjects cannot be reliably measured with a single administration of a semantic memory task such as the PPVT.

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No description available.

Closing-in Behaviour (CIB) is the tendency observed in copying tasks, both graphic and gestural, in which the copy is made inappropriately close to or on top of the model. It is classically considered as a manifestation of Constructional Apraxia (CA) and it is often observed in patients with dementia. CIB is not only a symptom of pathology, but it is also observed in children’s first attempts at graphic copying. However, CIB shows an inverse pattern in development and dementia: while its frequency increases in severe dementia, CIB progressively decreases with development. The cognitive origins of CIB are still unclear. Two main interpretations dominate CIB literature: the compensation and the attraction hypotheses. The first hypothesis interprets CIB as a strategy specific to copying tasks that the patient adopts to overcome visuospatial and working memory deficits. In contrast, the attraction hypothesis considers CIB as a primitive behaviour, not specific to copying, and characterized by the default tendency to perform an action toward the focus of attention. This thesis aimed to study the characteristics and the cognitive origins of CIB in dementia, development and healthy adulthood. It has three main sections. The first and second sections explore CIB in patients (with Alzheimer’s disease- AD and Frontotemporal dementia) and in pre-school children, using survey and experimental studies, to investigate if CIB might have common characteristics and cognitive substrates in these different populations. The results provided converging evidence for the similar nature of CIB in development and dementia. For instance, survey studies in patients with dementia (Chapter 3) and preschool children (Chapter 6) showed that performance in attentional tasks predicted the appearance of CIB. In a similar vein, experimental studies showed support for the attraction hypothesis of CIB in a single patient with AD (Chapter 4) and pre-school children (Chapter 7 and 8). These results were not, however, replicated in a larger cohort of patients with AD due to practical reasons (Chapter 5). The last section was devoted to modelling CIB in normal participants, using complex graphic copying (Chapter 9) and dual task paradigms (Chapter 10). The results showed further support for the attraction hypothesis of CIB and underlined the difficulties of eliciting this default bias in normal adults. To conclude, this thesis radically changes the classical consideration of CIB as a manifestation of CA and demonstrates that CIB is a general default tendency, not specific to copying tasks. This work indicates avenues for new studies, which might consider the possible expression and consequences of this behaviour in patients’ daily lives.

Musik som verktyg för att lindra oro och stress är en tilltalande omvårdnadsåtgärd då den kan anpassas direkt till individen. Den är utan biverkningar samt kostnadseffektiv. Syfte: Att undersöka effekten av musikåtgärder i omvårdnad av personer med demenssjukdom. Metod: Föreliggande studie är en litteraturstudie omfattande båda kvantitativa och kvalitativa studier från databaserna Web of Science, PubMed och CINAHL. 13 artiklar skrivna på engelska utgjorde resultatunderlaget. Resultat: Resultatet är baserat på empiriska studier varav tio stycken var kvantativa studier och två stycken var kvalitativa studier. Resultatet redovisas under sammanlagt fyra teman: Musik och minskning av agitation, Musik och förbättring av kognition, Musik och ökning av välbefinnande samt Musik och höjning av socialt engagemang. Slutsats: Musik som en omvårdnadsåtgärd av personer med demenssjukdom kan med fördel användas av sjuksköterskor som ett moment i den personcentrerade omvårdnaden, som underhållning samt som ett medel att knyta samman människor. / The use of music as a tool to relieve anxiety and stress is an appealing measure of care as it can be customized directly toward the individual. It is without side-effects and it is costeffective. Aim: The aim of this study was to describe the influence of music on interventions in the daily care of persons with dementia. Method: The following study of literature spans both quantitative and qualitative studies from the databases Web of Science, PubMed and CINAHL. 13 articles that were written in English constitute the basis of data. Result: The result is based on empiric studies where ten were quantitative studies and two were qualitative studies. The result is presented in a total of four themes: Music and a decrease of agitation, Music and the improvement of cognition, Music and the rise increase of wellbeing and lastly Music and the increase of social commitment. Conclusion: Music as an intervention in the daily care of persons with dementia can with favor be used by nurses as a step in the individualized care, as entertainment and also as a medium to bring people together.

Introduktion: Mötet med personer med demens utgör en utmaning på flera nivåer för sjuksköterskor och i och med en ökande äldre befolkning kommer även antalet personer med demens öka. Syftet med litteraturstudien var att belysa etiska utmaningar som vårdpersonal möter i vård av patienter med demens Metod: Litteraturstudie. Sökord valdes ut och användes i två databaser. Artiklar som framkom i sökningen valdes ut och granskades. Totalt granskades tio artiklar, nio från databassökning och en artikel från en manuell sökning. Dataanalys: Artiklarna granskades och 3 kategorier framkom: Tvångsåtgärder, kommunikation och tolkningssvårigheter. Resultat: I de valda artiklarna beskrev vårdpersonal olika situationer och etiska utmaningar inom vården av patienter med demens. Situationerna handlade om kommunikationsproblem, etiska värderingar och kränkning av patientens rättigheter. Slutsats: Det fanns många etiska utmaningar för vårdpersonal i mötet med patienter med demens. Vårdpersonalens berättelser visade att svårigheten var att ta beslut åt patienten och genomföra en god omvårdnad utan att kränka patientens rättigheter. Personalen var ofta medvetna om felen som uppstod inom vården och det var en etisk utmaning att hitta en lösning som gjorde att alla delaktiga blev nöjda med vårdarbetet.

While some cognitive decline is part of the normal aging process, certain changes have been linked to physical health or lifestyle-related diseases and may be preventable. Hypertension and type 2 diabetes are two conditions that have been associated with a heightened risk of accelerated cognitive decline. In terms of protective factors, physical activity can positively impact a broad range of cognitive processes including memory, attention, and executive function and may also protect against or delay cognitive decline and dementia. The present study examined the extent to which physical activity moderates the impacts of hypertension and diabetes (and their interactions) on different cognitive functions. Data are from the Memory and Aging Project (MAP), a longitudinal study of older adults (N = 1400, mean age = 79). A series of multilevel models evaluated baseline differences and linear and quadratic change on four cognitive measures: mental status, perceptual speed, and immediate and delayed episodic memory. Higher levels of self-reported physical activity were associated with better perceptual speed at baseline, and significantly less linear decline across all four measures. Physical activity was not significantly associated with curvilinear change. Individuals with diabetes had significantly worse immediate episodic memory performance at baseline, but diabetes was largely unrelated to rate of change and initial performance on the other measures. Hypertension was associated with better initial mental status (linear and quadratic models) and delayed episodic memory (quadratic model). Contrary to expectations, most interactions between physical activity and the two health conditions were non-significant. However, physical activity appeared to moderate the relationship between comorbid diabetes and hypertension on immediate episodic memory, such that individuals with the two conditions who were more physically active experienced a reduced rate of linear and curvilinear decline compared to inactive individuals with diabetes and hypertension. The findings from this study suggest that physical activity may reduce the impact of comorbid conditions on certain cognitive functions, and that immediate episodic memory may be particularly susceptible. / Graduate