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Incidental and intentional memory performance in depression and amnestic mild cognitive impairment

Dionysia Kontaxopoulou1, Stella Fragkiadaki1, Ion N. Beratis1, Dimosthenis Pavlou2, George Yannis2, Andrew C. Papanicolaou3, Alexandra Economou4 and Sokratis G. Papageorgiou1*
  • 1 Medical School University of Athens, Greece
  • 2 National and Technical University of Athens, Department of Transportation Planning and Engineering, Greece
  • 3 The University of Tennessee Health Science Center, Department of Pediatrics, United States
  • 4 National and Kapodistrian University, Department of Psychology, Greece

Introduction Mild cognitive impairment (MCI) is usually considered to be the preclinical stage of dementia. A study by Petersen (2004) proposed the diagnostic criteria of MCI subtypes. According to those criteria, amnestic MCI (aMCI) is characterized by the presence of memory complaints, the objective memory impairment for age, intact functionality in daily life and the absence of dementia. Several studies have indicated that the subtype of amnestic MCI is associated with Alzheimer Disease neuropathology (Pike, et al., 2007) and increases the risk of developing dementia. (Roberts et al., 2014) On the other hand, depression is one of the most common psychiatric disorders (Olivera et al., 2008) resulting in cognitive deficits which are very similar to those related to patients with MCI (Zihl et al., 2010). More specifically, depression has been associated with impairments in various areas of cognition such as executive functioning (Porter et al., 2007), attention (Baune et al., 2010) and episodic memory (Hickie et al., 2005). Regarding episodic memory, the encoding process can be divided into two components. Intentional memory refers to those situations where individuals are instructed to memorize presented material. It is considered an effortful procedure that engages attentional and executive resources and is believed to be an efficient way of memorizing new information (Vingerhoets, 2005; Karrasch et al., 2010). On the contrary, the encoding of information can be achieved incidentally, without the intention of memorizing. Incidental memory is an unintentional effortless procedure and is believed to be a more prominent function in everyday life (Vingerhoets, 2005). Only one study has examined incidental memory in patients with depression in comparison to patients with AD (Hart et al., 1987). The findings revealed that the patients with AD had a significantly lower performance in incidental memory as compared to the patients with depression. The aim of the present study was to investigate incidental and intentional memory performance in patients with depression and aMCI. Taking under consideration that depressive patients commonly report similar memory deficits to patients with aMCI, it is very important to find measures which could distinguish these two clinical groups from each other. Methods Participants The present study included 12 patients with depression and 12 patients with aMCI matched by age and education level. The diagnosis of aMCI was made according to the established criteria for aMCI (Petersen & Morris, 2005) while the diagnosis of depression was made according to the Geriatric Depression Scale (GDS; Yesavage et al., 1983) and the Patient Health Questionnaire (PHQ-9; Kroenke, et al., 2001). Specifically, we considered the presence of depression when a participant had a score greater than six in the GDS scale (Fountoulakis et al.,1999), as well as a score greater than 10 in PHQ9 (Kroenke & Spitzer, 2002). The participants had to meet specific inclusion and exclusion criteria: (a) a score equal to or less than 0.5 (for aMCI patients) on the Clinical Dementia Rating scale (CDR; Morris, 1993), (b) a valid driving license (c) regular car driving, (d) absence of any significant motor or visual disorder, (e) absence of alcohol or other drug addiction. Procedure (A) Neurological/Neuropsychological Assessment: The participants went through a complete medical/neurological and neuropsychological evaluation. During the medical evaluation, a detailed medical history was provided and the participants were asked to complete the depression scales. (B) Driving Simulator Experiment: The assessment of driving ability included driving in a driving simulator for about 20 minutes in two different areas, a rural and an urban area under different driving conditions. The driving simulator involved a motion base quarter-cab made by the FOERST Company, a 3 LCD wide screens 40ʼʼ (full HD: 1920x1080pixels), a driving position and also a support motion base. Measures (a) Incidental memory was evaluated right after the driving simulator assessment by the administration of an 8-item-questionnaire related to elements from the previous driving task. This questionnaire was designed by our research group and included a free recall and a recognition task. (b) Intentional memory was assessed by two neuropsychological measures: the Hopkins Verbal Learning Test (HVLT-R; Benedict et al., 1998) and the Brief Visuospatial Memory Test (BVMT-R; Benedict, 1997) which evaluates verbal and visuospatial memory irrespectively. Results Mann-Whitney analyses revealed significant differences only in the intentional verbal recognition tasks. More specifically, patients with depression outperformed patients with aMCI in the following cases: (a) HVLT–R first trial (Z= -2.58, p= 0.01); (b) HVLT-R second trial (Z= -2.35, p= 0.02); (c) HVLT-R third trial (Z= -2.04, p= 0.04); and (d) HVLT-R delayed recall (Z= -2.035, p= 0.017). No significant differences were observed between the two groups in both the incidental memory tasks as well as in the intentional visuospatial tasks. Discussion The present study investigated the incidental and intentional memory performance patterns in patients with depression in comparison to patients with aMCI. Our findings demonstrated that patients with aMCI had a significantly lower performance only in the intentional verbal memory measure, whereas no significant differences were observed in incidental memory as well as in the intentional visuospatial memory task. The advantage of the patients with depression in the intentional verbal memory task could be explained by the nature of the assessment that guides the participants to allocate their attentional resources on the encoding material. On the other hand, in the case of patients with aMCI their main difficulty is related to their capacity to learn and consolidate the information, thus the allocation of intentional resources is not enough in order to improve their distinction. In conclusion, the present findings support the usefulness of a combined memory assessment that includes both incidental and intentional encoding, in terms of differentiating patients with depression and patients with aMCI.

Acknowledgements

The current research was carried out within the framework of the Operational Program "Education and Lifelong Learning" of the National Strategic Reference Framework (NSRF), namely the Research Funding Program: THALES. Investing in knowledge society through the European Social Fund, and the Action: ARISTEIA (Action’s Beneficiary: General Secretariat for Research and Technology), co-financed by the European Union (European Social Fund -ESF) and Greek national funds.

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Keywords: incidental memory and learning, Intentional memory, Depression, Mild Cognitive Impairment, driving simulator

Conference: SAN2016 Meeting, Corfu, Greece, 6 Oct - 9 Oct, 2016.

Presentation Type: Poster Presentation in SAN2016 Conference

Topic: Posters

Citation: Kontaxopoulou D, Fragkiadaki S, Beratis IN, Pavlou D, Yannis G, Papanicolaou AC, Economou A and Papageorgiou SG (2016). Incidental and intentional memory performance in depression and amnestic mild cognitive impairment. Conference Abstract: SAN2016 Meeting. doi: 10.3389/conf.fnhum.2016.220.00119

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Received: 29 Jul 2016; Published Online: 01 Aug 2016.

* Correspondence: Prof. Sokratis G Papageorgiou, Medical School University of Athens, Athens, Greece, sokpapa@med.uoa.gr