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Alzheimer's disease and memory-monitoring impairment: Alzheimer's patients show a monitoring deficit that is greater than their accuracy deficit

Department of Psychology, P.O. Box 400400, 102 Gilmer Hall, University of Virginia, Charlottesville, VA 22904-4400, USA.
Neuropsychologia (Impact Factor: 3.45). 05/2011; 49(9):2609-18. DOI: 10.1016/j.neuropsychologia.2011.05.008
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ABSTRACT We assessed the ability of two groups of patients with mild Alzheimer's disease (AD) and two groups of older adults to monitor the likely accuracy of recognition judgments and source identification judgments about who spoke something earlier. Alzheimer's patients showed worse performance on both memory judgments and were less able to monitor with confidence ratings the likely accuracy of both kinds of memory judgments, as compared to a group of older adults who experienced the identical study and test conditions. Critically, however, when memory performance was made comparable between the AD patients and the older adults (e.g., by giving AD patients extra exposures to the study materials), AD patients were still greatly impaired at monitoring the likely accuracy of their recognition and source judgments. This result indicates that the monitoring impairment in AD patients is actually worse than their memory impairment, as otherwise there would have been no differences between the two groups in monitoring performance when there were no differences in accuracy. We discuss the brain correlates of this memory-monitoring deficit and also propose a Remembrance-Evaluation model of memory-monitoring.

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Available from: Brandon A Ally, Sep 03, 2015
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    • "It is also notable that retrospective confidence ratings were similarly impaired in bvFTD and AD. This is consistent with prior findings from our group and others indicating that bvFTD and AD patients are impaired in retrospectively evaluating their performance (Banks & Weintraub, 2008; Dodson et al., 2011; Eslinger et al., 2005; Williamson et al., 2010), as well as studies indicating that retrospective confidence ratings, in contrast to feeling of knowing judgments, are closely associated with memory abilities and thus may be dependent on different brain structures than feeling of knowing (Modirrousta & Fellows, 2008; Shimamura & Squire, 1988). "
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    • "The first measure was the Somer's d correlation (symmetrical), which represents the extent that a participant's confidence judgments differentiated accurate from inaccurate 2AFC test trials (maximum accuracy¼ 1). Much like the Goodman–Kruskal gamma correlation often used in metamemory research (Gonzalez & Nelsons, 1996), this correlation is recommended for ordinal-scaled variables and we report it here because it was the measure used in Dodson et al. (2011). (Note that we found similar results using the gamma correlation). "
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    • "A possible concern using ROC methodology in patients with aMCI may be the ability of these patients to assess confidence for memory decisions. However, research investigating the ability to retrieve and monitor stored general knowledge in patients with aMCI and very mild AD has shown that these patients can successfully make confidence ratings regarding the certainty of their answers (Ally et al., 2009b; Dodson et al., 2011). "
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