Cognitive Performance on Piagetian Tasks by Alzheimer's Disease Patients

Abstract

The purpose of this study was to examine cognitive abilities in Alzheimer's disease (AD) patients using Piaget's child developmental theory. Thirty elderly AD patients and 30 elderly control subjects were given two traditional Piagetian measures, the Infant Psychological Development Scale and the Concrete Operations Test. Half of the AD subjects (15) were in Piaget's sensorimotor or preoperational stages, while the remaining half of the AD subjects and all elderly control subjects were in Piaget's concrete operational stage, x2 [1, N = 60] = 17.42, p <0.001. If subsequent studies confirm that AD patients' cognitive characteristics are similar to Piaget's theoretical model, nursing care might be individualized based on mental competence, thus minimizing the commonly observed caregiver overestimation and underestimation of the AD patient's ability to understand and cooperate.

Gratitude in Long Term Care

“…This is followed by impairment in long-term memory and primary memory [60]. Cognitive decline appears to follow the reverse sequence of Piagetian development [61,62].…”

“…They postulate these activities are appropriate for individuals with dementia as they are commensurate with the developmental model of cognitive development and aging. This model posits that with dementia, cognitive abilities are lost in the reverse order of which they were developed during childhood [98,62]. Thus, skills involving the earliest types of learning utilizing procedural and implicit memory and motor memory and rehearsal are the last to decline in individuals with dementia.…”

Staging: Relevance for Trial Design in Vascular Burden of the Brain

“…For example, the 16 functional stages and substages of AD charted with the FAST procedure precisely reverse the order of acquisition in normal human development (Reisberg, 1986). At the point in AD progression when MMSE assessment results in near bottom or bottom scores, tests adapted from infant and early childhood developmental literature have been shown to be just as useful in tracking residual cognition in AD as the MMSE is earlier in the AD process (Auer et al, 1994;Sclan et al, 1990;Thornbury, 1992). At the point in AD progression when MMSE assessment results in near bottom or bottom scores, tests adapted from infant and early childhood developmental literature have been shown to be just as useful in tracking residual cognition in AD as the MMSE is earlier in the AD process (Auer et al, 1994;Sclan et al, 1990;Thornbury, 1992).…”

Cognitive Developmental Approach to Dementia

“…Research correlating mental status to Piagetian tests of cognitive functions have been positive (Matteson, et al, 1993;Thornbury, 1992). People in more advanced stages of DAT appear to be in earlier preoperational and sensorimotor stages of cognitive function (Emery, 1985;Emery & Breslow, 1987;Matteson, et al, 1993;Thornbury, 1992). Changes in cognitive functioning appear to be developmentally congruent and skills are lost in reverse order of acquisition (Nolen, 1988;Reisberg, Ferris, et al, 1989).…”

“…Caregivers contend with agitation, wandering, resisting care, sleep problems, and impaired activities of daily living. Insight into behavior associated with Alzheimer's disease may help prevent unrealistic expectations (Thornbury, 1992) that include both over-and under-estimations of performance. The problem of overestimation of performance abilities usually arises in long-term relationships in which the afflicted individual had been fully functional; underestimation can lead to excess disability and exaggerated helplessness (Beck, Heacock, Mercer, Walton, & Shook, 1991).…”