Memory complaints in amnestic Mild Cognitive Impairment: More prospective or retrospective?

We develop a laboratory paradigm for studying prospective memory and examine whether or not this type of memory is especially difficult for the elderly. In two experiments, young and old subjects were given a prospective memory test (they were asked to perform an action when a target event occurred) and three tests of retrospective memory (short-term memory, free recall, and recognition). From the perspective that aging disrupts mainly self-initiated retrieval processes, large age-related decrements in prospective memory were anticipated. However, despite showing reliable age differences on retrospective memory tests, both experiments showed no age deficits in prospective memory. Moreover, regression analyses produced no reliable relation between the prospective and retrospective memory tasks. Also, the experiments showed that external aids and unfamiliar target events benefit prospective memory performance. These results suggest some basic differences between prospective and retrospective memory.

Alzheimer disease (AD) is the most common cause of dementia in the elderly. Clinicopathological studies support the presence of a long preclinical phase of the disease, with the initial deposition of AD pathology estimated to begin approximately 10-15 years prior to the onset of clinical symptoms. The hallmark clinical phenotype of AD is a gradual and progressive decline in two or more cognitive domains, most commonly involving episodic memory and executive functions, that is sufficient to cause social or occupational impairment. Current diagnostic criteria can accurately identify AD in the majority of cases. As disease-modifying therapies are being developed, there is growing interest in the identification of individuals in the earliest symptomatic, as well as presymptomatic, stages of disease, because it is in this population that such therapies may have the greatest chance of success. The use of informant-based methods to establish cognitive and functional decline of an individual from previously attained levels of performance best allows for the identification of individuals in the very mildest stages of cognitive impairment.