Underawareness of deficit in Alzheimer's disease: Convergent validation of metamemory tasks and the relationship to risky behavior
AuthorDuke, Lisa Marie
AdvisorKaszniak, Alfred W.
MetadataShow full item record
PublisherThe University of Arizona.
RightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
AbstractUnderawareness of memory impairment in Alzheimer's disease (AD) was examined using three experimental methodologies: the feeling-of-knowing (FOK) paradigm, the performance prediction/postdiction paradigm (PPP), and patient-caregiver discrepancy on questionnaire (QD). For the FOK paradigm, thirty-two AD patients and their spouses were given an episodic (sentence) memory task, during which they were asked to recall the sentences' final words and to make retrospective confidence judgements about their recall attempts. For failed items, participants rated their future likelihood of correctly recognizing each ending (FOK). Participants' ratings were compared to actual recall or recognition scores. Results revealed that AD patients were less accurate than their non-demented spouses in making retrospective recall and prospective FOK ratings. Similarly, results from the PPP showed that AD patients overestimated their own performance relative to their caregivers' performance on a list learning and memory task, more than caregivers did. Contrary to prior research, participants' responses on questionnaires concerning their own and their spouses' memory change showed that AD patients reported less memory change for both themselves and their caregivers. The paradigms were hypothesized to differ in the extent to which they require different aspects of metamemory ability. Because both require on-line memory monitoring ability, it was hypothesized that the FOK and PPP would be most related, while the QD was predicted to be relatively independent, relying more on generalized self-memory beliefs. A principal components analysis confirmed that the questionnaire data was relatively independent from the other two methodologies. However, the prospective FOK ratings loaded on a different component than the retrospective ratings and the PPP variables. Memory monitoring may be dissociable by task, with prospective ratings relying more on inferential processes, thought to depend on frontal lobe functioning. In order to examine the relationship between underawareness and risky behavior, caregivers were administered a novel interview during which they rated the patients' propensity to attempt various activities, as well as the riskiness of each behavior. Contrary to expectation, riskiness was not significantly correlated with underawareness, but was associated with greater impairments of activities of daily living.
Degree ProgramGraduate College