Involution of categorical thinking processes in Alzheimer's disease: Preliminary results

Mello, Claudia Berlim de; Abrisqueta-Gomez, Jacqueline; Xavier, Gilberto Fernando; Bueno, Orlando Francisco Amodeo

doi:10.1590/S1980-57642009DN20100012

Abstract

Alzheimer's disease (AD) is a degenerative brain disorder characterized by progressive losses in cognitive functions, including memory. The sequence of these losses may correspond to the inverse order of the normal sequence of ontogenetic cognitive acquisitions, a process named retrogenesis. One of the acquisitions that improve in normal development is the ability to retrieve previously acquired categorical knowledge from semantic memory in order to guide associative thinking and memory processes; consequently, children become able to associate verbal stimuli in more complex taxonomic ways and to use this knowledge to improve their recall. Objective: In this study, we investigated if AD-related deterioration of semantic memory involves a decrease in categorical thinking processes with progression of the disease, according to the retrogenesis hypothesis. Methods: We compared the performance of AD patients at mild and moderate stages, and of groups of 7, 10 and 14-year-old children in tasks of free association along with recall tasks of perceptually and semantically related stimuli. Results: ANOVAS showed a decrease in taxonomic associations and an increase in diffuse associations between mild and moderate stages, corresponding to the inverse order shown by the child groups. At the moderate AD stage, the pattern was similar to that of 7-year-old children. Both groups of patients performed worse than child groups in recall tasks. Conclusions: These results corroborate the hypothesis of an involution of the processes of categorical associative thinking in the course of the disease.

Key words:
Alzheimer's disease; neuropsychological tests; memory; thinking

Resumo

A doença de Alzheimer (DA) é uma doença degenerativa do cérebro caracterizada por perdas progressivas nas funções cognitivas, incluindo memória. A seqüência destas perdas pode corresponder à ordem inversa da seqüência normal das aquisições na ontogênese, um processo conhecido como retrogênesis. Uma das aquisições que melhoram no desenvolvimento normal é a habilidade de recuperar conhecimento categórico previamente adquirido da memória semântica de forma a organizar o pensamento associativo e a memória imediata; como conseqüência, as crianças tornam-se capazes de associar estímulos verbais de formas mais complexas, taxonômicas, e de usar este conhecimento para melhorar sua recordação. Objetivo: Neste estudo, investigamos se a deterioração cognitiva associada à DA envolve uma redução dos processos de pensamento categórico ao longo da progressão da doença, considerando a hipótese da retrogênesis. Método: Comparamos o desempenho de pacientes com DA nos estágios inicial e moderado e de grupos de crianças com 7, 10 e 14 anos de idade em tarefas de associação livre e recordação de estímulos semântica e perceptivamente associados. Resultados: ANOVAS mostraram uma redução das associações taxonômicas e um aumento de associações difusas entre os estágios inicial e moderado, correspondendo à ordem inversa mostrada pelos grupos de crianças. No estágio moderado, o padrão foi similar ao das crianças de 7 anos. Os dois grupos de pacientes apresentaram pior desempenho que as crianças nas tarefas de memória. Conclusões: Os resultados corroboram a hipótese de uma involução dos processos de pensamento associativo categórico no curso da doença.

Palavras-chave:
doença de Alzheimer; testes neuropsicológicos; memória; pensamento

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Acknowledgements

Authors acknowledge support grants from AFIP – Associação Fundo de Incentivo à Psicofarmacologia

References

¹
Reisberg B, Franssen EH, Hasan SM, et al. Retrogenesis: clinical, physiologic, and pathologic mechanisms in brain aging, Alzheimer's and other dementing processes. Eur Arch Psychiatry Clin Neurosci 1999; 249:28-36.
²
Reisberg B, Franssen EH, Souren LE, Auer SR, Akram I, Kenowsky S. Evidence and mechanisms of retrogenesis in Alzheimer's and other dementias: management and treatment import. Am J Alzheimers Dis Other Demen 2002;17:202-212.
³
Salmon DP, Butters N, Chan AS. The deterioration of semantic memory in Alzheimer's disease. Can J Exp Psychol 1999;53:108-116.
⁴
Tulving E. Organization of memory: quo vadis? In: MS Gazzaniga, editor. The cognitive neurosciences. Cambridge:Bradford Books, MIT Press, 1995.
⁵
Arriagada PV, Growdow JH, Hedley-Whyte ET, Hyman, BT. Neurofibrillary tangles but not senile plaques parallel duration and severity of Alzheimer's disease. Neurology 1992;42:631-639.
⁶
Collins AM, Loftus EF. A spreading-activation theory of semantic processing. Psychol Rev 1975;82:407-428.
⁷
Sharps MJ. Category superiority effects in young and elderly adults. J Genet Psychol., 1997;158:165-171.
⁸
Eustache F, Desgrandes B, Jacques V, Platel H. Preservation of attribute knowledge of concepts in normal aging groups. Percept Mot Skills 1998;87:1155-1162.
⁹
Wingtield A, Lindfield KC, Kahana MJ. Adult age differences in the temporal characteristics of category free recall. Psychol Aging 1998;13:256-266.
¹⁰
Miller LM. The effects of age and domain knowledge on text processing. J Gerontol B Psychol Sci Soc Sci 2003;58:217-223.
¹¹
Gomez-Arisa CJ, Bajo MT. Interference and integration: the fan effect in children and adults. Memory 2003;11:505-523.
¹²
Butters N, Granholm E, Salmon D, Grant I, Wolfe J. Episodic and semantic memory: a comparison of amnesics and demented patients. J Clin Exp Neuropsychol 1987;9:479-497.
¹³
Troster SI, Salmon DP, McCullough D, Butters N. A comparison of the category fluency deficits associated with Alzheimer's and Huntington's disease. Brain Lang 1989;37:500-513.
¹⁴
Hodges JR, Salmon DP, Butters N. Semantic memory impairment in Alzheimer's disease: failure of access or degraded knowledge? Neuropsychologia 1992;30:301-314.
¹⁵
Chan AS, Butters N, Salmon DP, McGuire KA. Dimensionality and clustering in the semantic network of patients with Alzheimer's disease. Psychol Aging 1993;8:411-419.
¹⁶
Glosser G, Friedman RB, Grugan PK, Lee JH, Grossman M. Lexical, semantic and associative priming in Alzheimer's disease. Neuropsychology 1998;12:218-224.
¹⁷
Ergis AM, Van der Linden M, Deweer B. Priming for new associations in normal aging and in mild dementia of the Alzheimer type. Cortex 1998;34:357-373.
¹⁸
Vygostky LS. An experimental study of concept formation. In: RW Rieber, AS Carton, editors. The Collected Works of LS Vygotsky, Problems of General Psychology. New York: Plenum Press; 1987;1:121-166.
¹⁹
Bjorklund DF, Douglas RN. The development of memory strategies. In: N Cowan, editor. The development of memory in childhood. New York: Psychology Press; 1997.
²⁰
Mello CB. Estratégias de memória e formação de conceitos em crianças de sete a quatorze anos de idade. Tese; Universidade de São Paulo, São Paulo, Brazil, 2003
²¹
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical Diagnosis of Alzheimer's Disease: Report of the NINCDS-ADRDA Work group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 1984;34:939-944.
²²
Folstein MF, Folstein SE, Mc Hugh PR. "Mini-Mental State" a practical method for grading the cognitive state of patients for the clinician. J Psychiatry Res 1975;12:189-198.
²³
Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto IH. Sugestões para o uso do Mini-Exame do Estado Mental no Brasil. Arq Neuropsychiatr 2003;61:777-781.
²⁴
Snodgrass JG, Vanderwart M. A standardized set of 260 pictures: norms for name agreement, familiarity, and visual complexity. J Exp Psychol [Hum Learn] 1980; 6:174-215.
²⁵
Pompéia S, Miranda MC, Bueno OFA. A set of 400 figures standardized for Portuguese: norms for name agreement, familiarity and visual complexity for children and adults. Arq Neuropsychiatr 2001;59:330-337.
²⁶
Neter J, Wasserman W, and Kutner H. Applied Linear Statistical Models. 3th ed. USA: Irwin; 1990.

Publication Dates

Publication in this collection
Jan-Mar 2008

History

Received
08 Jan 2008
Reviewed
20 Feb 2008
Accepted
20 Feb 2008

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] ¹
Reisberg B, Franssen EH, Hasan SM, et al. Retrogenesis: clinical, physiologic, and pathologic mechanisms in brain aging, Alzheimer's and other dementing processes. Eur Arch Psychiatry Clin Neurosci 1999; 249:28-36.

[2] ²
Reisberg B, Franssen EH, Souren LE, Auer SR, Akram I, Kenowsky S. Evidence and mechanisms of retrogenesis in Alzheimer's and other dementias: management and treatment import. Am J Alzheimers Dis Other Demen 2002;17:202-212.

[3] ³
Salmon DP, Butters N, Chan AS. The deterioration of semantic memory in Alzheimer's disease. Can J Exp Psychol 1999;53:108-116.

[4] ⁴
Tulving E. Organization of memory: quo vadis? In: MS Gazzaniga, editor. The cognitive neurosciences. Cambridge:Bradford Books, MIT Press, 1995.

[5] ⁵
Arriagada PV, Growdow JH, Hedley-Whyte ET, Hyman, BT. Neurofibrillary tangles but not senile plaques parallel duration and severity of Alzheimer's disease. Neurology 1992;42:631-639.

[6] ⁶
Collins AM, Loftus EF. A spreading-activation theory of semantic processing. Psychol Rev 1975;82:407-428.

[7] ⁷
Sharps MJ. Category superiority effects in young and elderly adults. J Genet Psychol., 1997;158:165-171.

[8] ⁸
Eustache F, Desgrandes B, Jacques V, Platel H. Preservation of attribute knowledge of concepts in normal aging groups. Percept Mot Skills 1998;87:1155-1162.

[9] ⁹
Wingtield A, Lindfield KC, Kahana MJ. Adult age differences in the temporal characteristics of category free recall. Psychol Aging 1998;13:256-266.

[10] ¹⁰
Miller LM. The effects of age and domain knowledge on text processing. J Gerontol B Psychol Sci Soc Sci 2003;58:217-223.

[11] ¹¹
Gomez-Arisa CJ, Bajo MT. Interference and integration: the fan effect in children and adults. Memory 2003;11:505-523.

[12] ¹²
Butters N, Granholm E, Salmon D, Grant I, Wolfe J. Episodic and semantic memory: a comparison of amnesics and demented patients. J Clin Exp Neuropsychol 1987;9:479-497.

[13] ¹³
Troster SI, Salmon DP, McCullough D, Butters N. A comparison of the category fluency deficits associated with Alzheimer's and Huntington's disease. Brain Lang 1989;37:500-513.

[14] ¹⁴
Hodges JR, Salmon DP, Butters N. Semantic memory impairment in Alzheimer's disease: failure of access or degraded knowledge? Neuropsychologia 1992;30:301-314.

[15] ¹⁵
Chan AS, Butters N, Salmon DP, McGuire KA. Dimensionality and clustering in the semantic network of patients with Alzheimer's disease. Psychol Aging 1993;8:411-419.

[16] ¹⁶
Glosser G, Friedman RB, Grugan PK, Lee JH, Grossman M. Lexical, semantic and associative priming in Alzheimer's disease. Neuropsychology 1998;12:218-224.

[17] ¹⁷
Ergis AM, Van der Linden M, Deweer B. Priming for new associations in normal aging and in mild dementia of the Alzheimer type. Cortex 1998;34:357-373.

[18] ¹⁸
Vygostky LS. An experimental study of concept formation. In: RW Rieber, AS Carton, editors. The Collected Works of LS Vygotsky, Problems of General Psychology. New York: Plenum Press; 1987;1:121-166.

[19] ¹⁹
Bjorklund DF, Douglas RN. The development of memory strategies. In: N Cowan, editor. The development of memory in childhood. New York: Psychology Press; 1997.

[20] ²⁰
Mello CB. Estratégias de memória e formação de conceitos em crianças de sete a quatorze anos de idade. Tese; Universidade de São Paulo, São Paulo, Brazil, 2003

[21] ²¹
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical Diagnosis of Alzheimer's Disease: Report of the NINCDS-ADRDA Work group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 1984;34:939-944.

[22] ²²
Folstein MF, Folstein SE, Mc Hugh PR. "Mini-Mental State" a practical method for grading the cognitive state of patients for the clinician. J Psychiatry Res 1975;12:189-198.

[23] ²³
Brucki SMD, Nitrini R, Caramelli P, Bertolucci PHF, Okamoto IH. Sugestões para o uso do Mini-Exame do Estado Mental no Brasil. Arq Neuropsychiatr 2003;61:777-781.

[24] ²⁴
Snodgrass JG, Vanderwart M. A standardized set of 260 pictures: norms for name agreement, familiarity, and visual complexity. J Exp Psychol [Hum Learn] 1980; 6:174-215.

[25] ²⁵
Pompéia S, Miranda MC, Bueno OFA. A set of 400 figures standardized for Portuguese: norms for name agreement, familiarity and visual complexity for children and adults. Arq Neuropsychiatr 2001;59:330-337.

[26] ²⁶
Neter J, Wasserman W, and Kutner H. Applied Linear Statistical Models. 3th ed. USA: Irwin; 1990.

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