Is the investigation on prospective memory more useful than traditional neuropsychological investigation on retrograde and anterograde memory?
The prospective memory (PM) is a cognitive function representing the ability to create, maintain and perform an intention after a delay, remembering to execute a future action. PM has a retrospective component (the content of the intention) and a prospective one (to remember that and what to do). Therefore, it implicates a large range of cognitive aspects: memory (declarative and working memory), attention, executive functions and emotional aspects such as the motivation. PM is influenced by age related decline and cognitive deterioration such as in MCI, AD and Parkinson disease.
Considering this aspect, the individuals complaining of memory deficits, could have a potential failure on PM, not evidenced by neuropsychological evaluation of retrospective memory. Therefore, PM should be evaluated more frequently than it normally happen in the neuropsychological examination. Which are the reasons of the not frequent assessment of PM in clinical practice? Is there a problem of not satisfying PM test or difficult interpretation of the test results?
"Therefore, PM should be evaluated more frequently than it normally happen in the neuropsychological examination."
Yes, in an ideal world.
"Which are the reasons of the not frequent assessment of PM in clinical practice?"
1. Many neuropsychologists do not know much about prospective memory (PM). It is a field that has developed quite recently, and so many will not have been taught about it in their training.
2. Relative to episodic/retrospective memory tests, there is a dearth of commercially available prospective memory (PM) measures. You might however consider e.g. the Cambridge Test of Prospective Memory (CAMPROMPT). There are also some subtests of other batteries (e..g the Six Element Test of the BADS; one of the RBMT measures) that given an indication of PM abilities.
3. It is typically quicker to test retrospective memory functions than prospective memory ones.
"Is there a problem of not satisfying PM test or difficult interpretation of the test results?"
Interpretation of the results from PM tests is no more difficult than it is for many other types of memory test.
There is a growing body of literature showing that PM predicts a variety of everyday functioning outcomes (e.g., medication adherence, employment, quality of life) above and beyond traditional RM measures (and executive tasks). One task that has proven particularly useful in that regard is the Memory for Intentions Screening Test, which has norms available and can be used in clinic.
"Therefore, PM should be evaluated more frequently than it normally happen in the neuropsychological examination."
Yes, in an ideal world.
"Which are the reasons of the not frequent assessment of PM in clinical practice?"
1. Many neuropsychologists do not know much about prospective memory (PM). It is a field that has developed quite recently, and so many will not have been taught about it in their training.
2. Relative to episodic/retrospective memory tests, there is a dearth of commercially available prospective memory (PM) measures. You might however consider e.g. the Cambridge Test of Prospective Memory (CAMPROMPT). There are also some subtests of other batteries (e..g the Six Element Test of the BADS; one of the RBMT measures) that given an indication of PM abilities.
3. It is typically quicker to test retrospective memory functions than prospective memory ones.
"Is there a problem of not satisfying PM test or difficult interpretation of the test results?"
Interpretation of the results from PM tests is no more difficult than it is for many other types of memory test.
The reasons were described in detail by Prof. Dr. P. Burgess. I could also suggest you to read ;The Rehabilitation of Executive Disorders. A guide to theory and practice' (2009) edited by M. Oddy and A. Worthington and especially the chapter 5 'Rehabilitation for prospective memory' written by J. Fish, T. Manly and B. Wilson. There you can find a lot of useful information about prospective memory, theoritical models, clinical tests already mentioned by Prof. Burgess for the assement of prospective memory as well as rehabilitation approaches
Prospective and retrospective memory abilities are considered distinct, and likely reliant on different neuroanatomical substrates. It is important to assess both rather than one or the other. There have been reports that people presenting at memory clinics have prospective rather than retrospective memory complaints. There is a strong theoretical rationale for assuming that with age, and potentially with disease, prospective memory may suffer more than retrospective memory. Craik indicated the ability to remember to remember as the most demanding in terms of self-initiated processing.
There is however a recognized problem with the measurement of prospective memory. Many paradigms, including some that Prof. Burgess mentions, have binary outcomes (pass/fail), which do not provide the basis for good measurement properties. Please consult Peter Graf's publications on this topic. A way around this is to embed several occurrences of the prospective memory cue in an ongoing task but often people will then deliberately watch for it (monitoring rather than prospective remembering). Another way is to make the cue increasingly intrusive, and take the size/visibility of the cue as a measure of prospective memory efficiency.
There is no reason to believe that it takes any longer to assess prospective than retrospective remembering - both require a delay where the individual is engaged in other task and unable to maintain in conscious awareness the to-be-remembered material.
Prospective memory showed to be less "pure", in a psychometric sense, than other cognitive functions. It is a mixture of other, basic, cognitive functions: retrospective memory, executive functions in a broader sense. Probably its composite nature contributes to its relatively slow development.
For instance, I remember that for a while (8-10 years ago) there was a debate about prospective memory task as a "memory" or "vigilance" matter!
Claudia Jocova makes a very good point in saying: "There is no reason to believe that it takes any longer to assess prospective than retrospective remembering - both require a delay where the individual is engaged in other task and unable to maintain in conscious awareness the to-be-remembered material".
This is however true in principle perhaps, but not usually in practice, for the reasons Claudia outlines in her paragraph preceding this quote. PM paradigms typically require that delays between encoding and remembering occur between each stimulus and the retention retrieval. This delay is usually filled with a particular ongoing task. A typical neuropsychological retrospective memory test on the other hand, often involves the presentation of many stimuli (or one complex one) in one block at encoding, and then recall or recognition of these items in one block at retrieval. There is no ongoing task. So the retention interval after the encoding block (if there is one) may be filled with administration of other neuropsychological tests in order to save examination time. But for most PM paradigms that would test prospective memory in a way that avoids an "all or nothing" one-shot observation (which everyone would agree is not psychometrically ideal) the retention interval can rarely in practice be filled with giving other tests (i.e. because of the ongoing task).
As a consequence, most of the best PM paradigms one might use, or currently in use, will take a little longer to administer than very many of the most commonly used tests of retrospective memory. Hence my remark. But I am entirely in agreement that this need not *necessarily* be the case. Indeed, each PM test that I invented for the study reported in Volle et al (2011; these are part of a battery of tests called the "Chichester Intentionality Battery" or CIB) takes only 7 minutes on average to administer, which is comparable to the administration time of several commercially available episodic memory tests. Yet the tests were sensitive enough to detect differences between different lesion groups (and controls).
Hope this makes my point clearer - in retrospect I should have spent more time on my answer the first time, so I do apologise. But I'm busy trying to create a new PM test...
Best wishes.
Volle E, Gonen-Yaacovi G, de Lacy Costello A, Gilbert SJ, Burgess PW. (2011). The role of rostral prefrontal cortex in prospective memory: A voxel-based lesion study. Neuropsychologia 49(8): 2185-98.
Dear Roberto, the CNS is a dissipative system ( it burns energy to sustain itself) this means that it goes only in one direction, it can not recover an ancient state it only can recriate it, but is always going on only one direction. I'm saying that because PM is a very good evaluation of what is going to happen, the real capacity of the CNS to work foward. PM is much more logical and agrees with simple thermodinamic principles.
Objective
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Method
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Introduction:
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Material and methods:
Cross-sectional study including 225 subject...
Introduction: Mixed dementia (DMix) refers to dementia resulting from Alzheimer disease in addition to cerebrovascular disease. The study objectives were to determine the clinical and imaging factors associated with Dmix and compare them to those associated with Alzheimer disease. Material and methods: Cross-sectional study including 225 subjects a...