An observational study in Alzheimer Disease, Vascular Dementia and Mixed Dementias, sponsored by University Hospital, Grenoble. Not yet recruiting. Open to participants aged 65 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-03-20.
Sponsored by University Hospital, Grenoble · Observational
The aim of the present study is to investigate potential cognitive mechanisms contributing to working memory impairment in Alzheimer's disease and vascular dementia. The investigators consider a new hypothesis suggesting that difficulties in mobilizing maintenance strategies of information could explain this working memory deficit. More specifically, the investigators assume that patient groups will have difficulties in employing both refreshing and elaborative strategies during a working memory task (i.e., complex span task), as compared to a control group.
Working memory is considered as a central hub in human cognition. Good working memory capacities are fundamental for daily life. However, previous research has indicated that patients with Alzheimer's disease or vascular dementia have significant working memory impairment. Currently, there is no consensus on the cognitive mechanisms responsible for this deficit. Prior findings have highlighted that patients with Alzheimer's disease and/or vascular dementia demonstrate specific difficulties in dual-task situations. In this context, the investigators hypothesize that the continuous alternation between maintenance and processing phases involved in working memory could be impaired for these patients. Thus, the aim of the present study is to investigate if patients with Alzheimer's disease and/or vascular dementia can use maintenance strategies of information in working memory, as typically observed in individuals without cognitive impairments.
To this end, the investigators propose a short working memory task in which they manipulate the opportunities to use refreshing strategies and elaborative strategies. The investigators expect that patients with Alzheimer's disease, vascular dementia, or mixed dementia will benefit less than healthy older adults from the increased opportunities to employ refreshing and elaboration. These difficulties could account for the impaired working memory performance associated with these diseases.
In a second step, the investigators formulate distinctive hypotheses between patient sub-groups:
3,678 studies on the registry are indexed under Alzheimer Disease; 872 are open to participants now.
This study's planned enrollment of 120 is below the median of 200 across 751 observational studies indexed under Alzheimer Disease.
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The population of this study will consist of patients performing a neuropsychological assessment at Grenoble-Alpes University Hospital. These patients consult because of cognitive disorders. The patients are dividied into these three subgroups according to their medical diagnosis of Alzheimer's disease, vascular dementia, or mixed dementia (diagnostic criteria : Dubois et al. (2021) for Alzheimer's disease; VASCOG diagnostic criteria : Sachdev et al., 2015 for vascular dementia; and diagnostic criteria : DSM-V (APA, 2013) for mixed dementia due to Alzheimer and vascular etiology). The population of this study will also include healthy participants (carers/visitors of patients at the Gerontology centre or volunteers at Gerontology centre).
Exclusion Criteria:
Alzheimer's disease is define on the basis of the medical diagnostic. As part of routine care, they undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions. For the study and during the day of medical consultations, each patient will perform a working memory task, lasting approximately 30 minutes. If the patient is accompanied by a family member, the investigators ask the latter to complete a questionnaire on patient's daily executive functioning (French version of the Behavior rating inventory of executive function \[BRIEF-A\]).
Behavioral: Complex span task · Diagnostic Test: Clinical neuropsychological assessment
Vascular dementia is define on the basis of the medical diagnostic. As part of routine care, they undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions. For the study and during the day of medical consultations, each patient will perform a working memory task, lasting approximately 30 minutes. If the patient is accompanied by a family member, the investigators ask the latter to complete a questionnaire on patient's daily executive functioning (French version of the Behavior rating inventory of executive function \[BRIEF-A\]).
Behavioral: Complex span task · Diagnostic Test: Clinical neuropsychological assessment
Mixed dementia (i.e., Alzheimer's disease and vascular dementia) is define on the basis of the medical diagnostic. As part of routine care, they undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions . For the study and during the day of medical consultations, each patient will perform a working memory task, lasting approximately 30 minutes. If the patient is accompanied by a family member, the investigators ask the latter to complete a questionnaire on patient's daily executive functioning (French version of the Behavior rating inventory of executive function \[BRIEF-A\]).
Behavioral: Complex span task · Diagnostic Test: Clinical neuropsychological assessment
Control group includes healthy older adults (without cognitive impairment). As patient group, control group will perform the working memory task. However, control group does not undergo the clinical neuropsychological assessment.
Behavioral: Complex span task · Diagnostic Test: Clinical neurospychological assessement
The intervention consists in a computerized working memory task. This task follows the design of a complex span task, involving alternation between memorization and processing steps. For each trial, participants have to memorize French words. These words are sequentially displayed on the screen. Between each word, participants perform a processing task consisting in a spatial location task: They have to determine if a shape is at the top or at the bottom of the screen. After each processing episode, participants have a free time (i.e., available time to maintain information in WM). At the end of each trial, participants perform an orally immediate recall. This experimental task involves several conditions in order to manipulate the opportunities for the spontaneous use of refreshing and elaborative strategies.
Also known as: Working memory task
As part of routine care, participants in the patient group undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions. The investigators hypothesize correlations between working memory performance during the experimental task and the results of neuropsychological tests. Thus, the investigators consider the results to several French versions of neuropsychological tests: * MMSE (Mini-Mental State Examination) * "Digit Span Backward" subtest (WAIS-IV) * Stroop Test * Trail Making Test (TMT) * Rappel Libre - Rappel Indicé à 16 items or GERIA-12 * Category fluences * Instrumental Activities of Daily Living and ADL .
Participants in the control group undergo 2 tests clinical that evaluate cognitive functioning. The investigators consider the results to French versions of these neuropsychological tests: * MMSE (Mini-Mental State Examination; ) * "Digit Span Backward" subtest (WAIS-IV)
Memory performance in the Working memory task
Percentage of correct immediate recall, computed with strict serial recall criterion (item identity + correct position) and computed with item recall criterion (item identity only).
Time frame: 15 minutes
Processing performance in the Working memory task
Percentage of correct response in the spatial part of working memory task
Time frame: 15 minutes
Reaction time
Reaction time for each distractor (in ms) in the spatial part of working memory task
Time frame: 30 minutes
Mini-Mental State Examination (MMSE)
MMSE is a test evaluate global cognitive functioning Score from 0 to 30 A higher score mean a better cognitive efficiency
Time frame: 15 minutes
Digit span forward WAIS IV (digit number)
The participant's span is noted, corresponding to the longest number of sequential digits that can be repeated forward.
Time frame: 5 minutes
Digit span forward WAIS IV (standard note)
This scale permitted to obtain a standard note from 0 to 19 A higher score means a better performance
Time frame: 5 minutes
Digit span backward WAIS IV (digit number)
The participant's span is noted, corresponding to the longest number of sequential digits that can be repeated backward.
Time frame: 5 minutes
Digit span backward WAIS IV (standard note)
This scale permitted to obtain a standard note from 0 to 19 A higher score means a better performance
Time frame: 5 minutes
Stroop Test - denomination part
the denomination part of stroop test measures processing speed time is taken, in seconds
Time frame: 30 secondes
Stroop Test - minor interference part (Time)
this part of stroop test measures low inhibition process time is taken, in seconds
Time frame: 30 secondes
Stroop Test - minor interference part (errors)
this part of stroop test measures low inhibition process number of errors is noted, from 0 to 24
Time frame: 30 secondes
Stroop Test - major interference part (time)
this part of stroop test measures strong inhibition process time is taken, in seconds
Time frame: 90 secondes
Stroop Test - major interference part (errors)
this part of stroop test measures strong inhibition process number of errors is noted, from 0 to 24
Time frame: 90 secondes
Trail Making Test - Part A (time)
This test evaluate motor speed processing Time in seconds
Time frame: 2 minutes
Trail Making Test - Part A (errors)
This test evaluates motor speed processing Number of errors is noted
Time frame: 2 minutes
Trail Making Test - Part B (time)
This test evaluates mental flexibility Time in seconds
Time frame: 5 minutes
Trail Making Test - Part B (errors)
This test evaluates mental flexibility Number of errors is noted
Time frame: 5 minutes
Category fluences
Number of correct words is noted
Time frame: 5 minutes
Memory evaluation (16-item Free and Cued Recall, or GERIA-12)
These tests evaluate verbal episodic memory Scores are noted for each trail, from 0 to 16 (RL-RI/16) or 0 to 12 (Geria-12) A higher score means a better performance
Time frame: 40 minutes
Naming task
This test evaluate the capacity to correctly name a picture Score is noted, from 0 to 40 A higher score means a better performance
Time frame: 40 minutes
Behavior rating inventory of executive function
Questionnaire (french version) on patient's daily executive functioning, completed by a relative of the patient, if present Global score from 75 to 225, composing by several composite scores. A higher score means a more severe executive dysfonctionning in daily life
Time frame: 10 minutes
Instrumental Activities of Daily Living
Questionnaire completed by a professional (nurse or doctor) with the patient and an accompagniant if present Score from 0 to 8 A higher score mean a better autonomy in daily life
Time frame: 5 minutes
Activities of Daily Living
Questionnaire completed by a professional (nurse or doctor) with the patient and an accompagniant if present Score from 0 to 6 A higher score mean a better autonomy in daily life
Time frame: 5 minutes
No study locations are listed for this record.
Plan to share: No
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University Hospital, Grenoble