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Introduction The present study explored the nature of the semantic deterioration normally displayed in the course of Alzheimer’s disease (AD). The aim was to disentangle the extent to which semantic memory problems in patients with AD are best characterized as loss of semantic knowledge rather than difficulties in accessing semantic knowledge. Method A longitudinal approach was applied. The same semantic tests as well as same items were used across three test occasions a year apart. Twelve Alzheimer patients and 20 matched control subjects, out of a total of 25 cases in each group, remained at the final test occasion. Results and Conclusions Alzheimer patients were impaired in all the semantic tasks as compared to the matched comparison group. A progressing deterioration was evident during the study period. Our findings suggest that semantic impairment is mainly due to loss of information rather than problems in accessing semantic information.

Damage to the brain can affect the core of the individual, i.e. the self. Results from a small number of studies with amnesic individuals indicate that patients' ability to show preserved knowledge of self may vary. The present study explored self-knowledge in patients with memory impairment as a result of confabulation, mild cognitive impairment, Alzheimer's disease and acquired brain damage. We found that different memory disorders differentially affected patients' self-knowledge. At least some patients showed a preserved sense of self, and were able to acquire information about another person that they had met postmorbidly. Frontal function and stability of cognitive impairments over time appear to be two variables important in determining whether patients can have a consistent and updated sense of self. We also explored the extent to which self-referential and other-referential processing might enhance memory in individuals with memory-impairment. The self-reference effect (SRE) and other-reference effect (ORE) have been consistently found in normal adults. Results indicated that patients showed a normal SRE and ORE. The SRE and ORE appeared to be at least partly dependent on degree of knowledge of the person being referenced, and were also related to general memory and frontal function. Only the SRE, however, was also related to patients' ability to improve memory as a result of emotional processing. These findings may have important implications for caregivers and healthcare professionals working with memory-impaired patients, and may pave the way to novel memory rehabilitation methods.

Our memory is prone to distortions which in everyday life can lead to mistaken memories. This thesis investigates memory distortion. In addition, one might recall (e.g. an event) correctly but misremember the source of the event (e.g. place or time of the event); this particular type of memory distortion is called source amnesia. Here, an overview of cognitive theories of memory distortion as well as the neuroscience behind memory distortion is provided. In addition, the particular memory distortion of source amnesia where one is unable to acquire when or where a fact was learned is further investigated. Results indicate that an overlap of qualities related to the information being learned causes information to be linked to wrong sources, thus creating distorted memories. Misinformation is also indicated to produce impairment in memory. In memory distortions, memory impairments are representative in various areas of the brain, including the hippocampus and the amygdala in the medial temporal lobes as well as in the frontal cortex and in the visual cortex. These key areas are also closely related to brain aging in Alzheimer´s disease and in schizophrenia, depression, posttraumatic stress disorder (PTSD) and in drug and alcohol abuse. Individuals inflicted with these disease symptoms seem to be more prone to source amnesia compared to controls. The limitations and future directions of what we can study regarding memory distortion and source amnesia are also presented in this thesis.

Memory impairment is common following traumatic brain injury (TBI). In recent years, researchers have demonstrated that the processes underlying memory formation (working memory, encoding, consolidation, and retrieval) are interrelated but dissociable events.The following study was designed to determine how these processes contribute to memory impairment following experimental TBI in the rat. Experiment 1 indicated thatTBI induces severe working memory deficits in a delayed non-matching-to-place task.Although all animals displayed intact acquisition, only injured animals displayed poor performance as the delay between the sample and choice phases was increased.Experiment 2 was designed to determine if TBI produces a transient period of posttraumatic amnesia (PTA) following TBI. During the early post-injury period, injured animals displayed intact short-term (3min) object recognition memory but impaired long-term (1 and 24hrs) memory. However, during the chronic post-injury period (days 14-17), no recognition memory deficits were observed in injured animals, indicating thatPTA resolves by 14 days post-injury. Experiment 3 was designed to determine the mechanism of anterograde memory impairment following TBI. Animals were injured and then trained to a pre-determined criterion in a 1 -day water maze procedure.Although injured animals required more trials to reach criterion, the rate of forgetting was identical among sham and injured groups up to 24hrs post-training. This suggests that the amount of information encoded into long-term memory, not more rapid forgetting, is the primary mechanism of anterograde memory impairment following TBI. InExperiment 4, animals were trained in the water maze and then injured 1 (recent memory) or 14 (recent memory) days post-training. Fourteen days post-injury, animals were given a retention probe trial followed by a reminding procedure and a second probe trial. Injured animals in both the recent and remote memory conditions displayed impaired performance on the first probe trial. However, injured animals benefited from the reminding procedure, and animals in the remote memory group were identical to shams during the second probe trial. These results indicate that retrograde memory impairment following TBI is mediated primarily by retrieval deficits at the time of testing, while the quality of the memory trace remains largely intact.

OF DIPLOMA THESIS Title of diploma thesis: Clinical Utility of Rivermead Behavioural Memory Test in Patients after Brain Damage Objective: The main goal of this diploma thesis was to monitor the relationship between memory functions measured by the Rivermead Behavioral Memory Test (RBMT-3) and their subsequent influence on occupational performance in ADL (pADL) in patients after brain damage. The partial objective was to determine whether self-sufficiency in ADL can be predicted from RBMT-3 results. The last partial goal was to create a working version of the RBMT-3 and translate it from the original English version. Methods: The research group consisted of 40 probands (22 males and 18 females) after brain damage. For data collection, the Rivermead Behavioral Memory Test (RBMT-3) for assessing the memory function level was used. FIM (version 5.2) was used for evaluating the level of occupational performance in ADL (pADL). Hypothesis verification was performed by correlation analysis and corrected Spearman's correlation coefficient and p-values. For this pre- research, the level of significance α1 < 0.05 and α2 < 0.01 was chosen. Results: The pre-research did not confirm the dependence between the RBMT-3 memory level and the level of self-sufficiency measured by FIM. The P value (p = 0.526) from the...

OF DIPLOMA THESIS Title of diploma thesis: Clinical Utility of Rivermead Behavioural Memory Test in Patients after Brain Damage Objective: The main goal of this diploma thesis was to monitor the relationship between memory functions measured by the Rivermead Behavioral Memory Test (RBMT-3) and their subsequent influence on occupational performance in ADL (pADL) in patients after brain damage. The partial objective was to determine whether self-sufficiency in ADL can be predicted from RBMT-3 results. The last partial goal was to create a working version of the RBMT-3 and translate it from the original English version. Methods: The research group consisted of 40 probands (22 males and 18 females) after brain damage. For data collection, the Rivermead Behavioral Memory Test (RBMT-3) for assessing the memory function level was used. FIM (version 5.2) was used for evaluating the level of occupational performance in ADL (pADL). Hypothesis verification was performed by correlation analysis and corrected Spearman's correlation coefficient and p-values. For this pre- research, the level of significance α1 < 0.05 and α2 < 0.01 was chosen. Results: The pre-research did not confirm the dependence between the RBMT-3 memory level and the level of self-sufficiency measured by FIM. The P value (p = 0.526) from the...

Submitted by SANDRA LUCIA PETRILLO (sandrapetrillo.longlife@gmail.com) on 2017-12-11T17:56:53Z No. of bitstreams: 1 Dissertação_Mestrado_Sandra_Petrillo.pdf: 5408729 bytes, checksum: 260301e7ac6761c455f3e28f08f23ac3 (MD5) / Submitted by SANDRA LUCIA PETRILLO (sandrapetrillo.longlife@gmail.com) on 2017-12-11T18:47:11Z No. of bitstreams: 1 Dissertação_Mestrado_Sandra_Petrillo.pdf: 5408729 bytes, checksum: 260301e7ac6761c455f3e28f08f23ac3 (MD5) / Approved for entry into archive by Luciana Pizzani null (luciana@btu.unesp.br) on 2017-12-12T16:04:58Z (GMT) No. of bitstreams: 1 petrillo_sl_me_bot.pdf: 5408729 bytes, checksum: 260301e7ac6761c455f3e28f08f23ac3 (MD5) / Made available in DSpace on 2017-12-12T16:04:58Z (GMT). No. of bitstreams: 1 petrillo_sl_me_bot.pdf: 5408729 bytes, checksum: 260301e7ac6761c455f3e28f08f23ac3 (MD5) Previous issue date: 2017-07-14 / Objetivo: Avaliar desempenho do teste de rastreio Memory Impairment Screen (MIS) para a triagem diagnóstica da Demência na Doença de Alzheimer (DDA). Casuística e método: Estudo de acurácia realizado no Ambulatório de Geriatria do Centro de Saúde Escola da Faculdade de Medicina de Botucatu – Unesp. Casuística de 126 pacientes idosos, sendo aplicado o teste de avaliação cognitiva MIS, utilizando-se como padrão ouro os critérios diagnósticos da DDA propostos por Frota. O valor diagnóstico foi analisado pelo cálculo da sensibilidade, especificidade, valores preditivos (positivo e negativo) e razão de verossimilhança positiva e negativa. A curva ROC foi traçada para contribuir na avaliação do desempenho do MIS no diagnóstico da DDA. Resultados: Foram avaliados 126 idosos com média de idade de 71,6 + 7,8 anos, maioria do sexo feminino (65,9%) e com 1 a 4 anos de estudo (40%). A presença do diagnóstico de Doença de Alzheimer foi observada em 18 (14,3%) dos idosos avaliados. O teste de rastreio cognitivo pelo MIS apresentou valor de sensibilidade de 72,2%, especificidade de 83,3%, valor preditivo positivo de 41,9% e negativo de 94,7% e razões de verossimilhanças positiva de 433 e negativa de 33,3. A área sob a curva ROC foi de 0,78 (IC 95%, 0,65-0,9). Conclusão: O presente estudo evidenciou a aplicabilidade do teste MIS e sua eficácia no diagnóstico das alterações cognitivas em pacientes idosos, com valores significativos de sensibilidade e especificidade; apresentou vantagens de rapidez, fácil aplicabilidade e interpretação; independente de cultura, linguagem e escolaridade. O MIS oferece vantagens importantes como teste de rastreio para uso em cuidados primários a saúde, sendo necessário estudos complementares que possam indicar o uso isolado deste teste para exclusão de demência. / Objective: To evaluate the performance of the Memory Impairment Screen (MIS) for the diagnostic screening of Dementia in Alzheimer's Disease (AD). Methods: Accuracy study performed at the Geriatrics Outpatient Clinic of the School Health Center of Botucatu Medical School - Unesp. A total of 126 elderly patients were enrolled, and the MIS cognitive evaluation test was applied, using the AD diagnostic criteria proposed by Frota as the gold standard. The diagnostic value was analyzed by the calculation of sensitivity, specificity, predictive values (positive and negative) and positive and negative likelihood ratio. The ROC curve was drawn to contribute to the evaluation of MIS performance in the diagnosis of AD. Results: A total of 126 elderly individuals with a mean age of 71.6 ± 7.8 years, most of them female (65.9%) and 1 to 4 years of education (40%) were evaluated. The presence of the diagnosis of Alzheimer's disease was observed in 18 (14.3%) of the elderly evaluated. The MIS cognitive screening test showed a sensitivity of 72.2%, specificity of 83.3%, positive predictive value of 41.9% and negative of 94.7% and likelihood ratio of 433 and negative of 33,3. The area under the ROC curve was 0,78 (95% CI, 0.65-0.9). Conclusion: The present study evidenced the applicability of the MIS test and its efficacy in the diagnosis of cognitive alterations in elderly patients, with significant values of sensitivity and specificity; Presented advantages of speed, easy applicability and interpretation; Independent of culture, language and schooling. MIS offers important advantages as a screening test for use in primary health care, and further studies are needed to indicate the use of this test alone to exclude dementia.

Teaching conversational strategies has been effective for a wide array of clients with acquired neurologic disorders and their caregivers. Research indicates positive results for Supported Conversation in adults with Aphasia (SCA) secondary to stroke. Applying this method to work with caregivers of persons with memory impairment could prove to be a valid intervention tool. This investigation will examine the applicability of SCA with persons with memory impairment and their familial caregivers. This pilot study is intended to create a conversation regarding SCA and its implementation with persons with memory impairment who still live in the community with their caregivers. Analysis between the pre-training and post-training scores showed a trend to wards significance for Time (F(1, 9) = 0.064), no significance for Measure (F(3, 9) = 0.558), and no significance for the interaction of Time*Measure (F(3, 9) = 0.276). The effect size for Time was 0.732, for Measure was 0.494 and for Time*Measure was 0.956.

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