Retrospective metamemory monitoring of semantic memory in community-dwelling older adults with subjective cognitive decline and mild cognitive impairment

Susan, Y.; Chua, Elizabeth F.; Kieschnick, Dustin W

doi:10.1080/09602011.2020.1831552

Cited by 9 publications

(9 citation statements)

References 102 publications

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“…In contrast, monitoring of episodic encoding processes was previously shown to be preserved in MCI (103). Moreover, metamemory in semantic memory tasks is intact in MCI, as shown here for semantic FOK and in another study on confidence judgments for general knowledge questions (104). Therefore, converters patients appear to have a specific difficulty in making metamemory decisions about the content of episodic memory retrieval.…”

Section: Discussionmentioning

confidence: 44%

Anosognosia in Mild Cognitive Impairment: Lack of Awareness of Memory Difficulties Characterizes Prodromal Alzheimer's Disease

et al. 2021

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While anosognosia is often present in Alzheimer's disease, the degree of awareness of cognitive difficulties in the earlier stages, such as Mild Cognitive Impairment (MCI), is less clear. Using a questionnaire and Feeling-of-Knowing tasks, the aims of this study were (1) to test the hypothesis that anosognosia is present specifically in prodromal AD stage in patients that, owing to a more severe AD neuropathology, will rapidly progress to overt dementia and (2) to assess the neural bases of self-awareness for memory functioning. A group of 44 patients with amnestic MCI and a group of 29 healthy older participants (CTRL) performed two Feeling-of-Knowing tasks (episodic and semantic FOK) and responded to the Functional Memory Scale (MARS), also completed by one of their relatives. They underwent FDG-PET and structural MRI. The participants were followed clinically for 4 years. At the end of follow-up, 23 patients with MCI developed Alzheimer's disease (converters) and 21 patients still presented symptoms of MCI without progression (non-converters). The analyses focused on the data from inclusion stratified according to clinical status 4 years later (converters, non-converters, CTRL). On the episodic FOK task, converters patients overestimated their ability to later recognize unrecalled words and they showed prediction accuracy (Hamann coefficient) at the level of chance. No difficulty was observed in any group with the semantic FOK task. On the MARS, converters patients had a higher anosognosia score than non-converters patients and CTRL, which did not differ from each other. Correlations between self-awareness scores and neuroimaging data using small volume correction analyses in a priori regions of interest in converters indicated that inaccurate episodic FOK judgments was related to changes in brain areas that might support interpretation of retrieved content for judging the likelihood of recognition. For the MARS, the association between anosognosia and decreased gray matter density of the left inferior prefrontal cortex in converters might indicate poor inhibition over outdated personal knowledge. In amnestic MCI, anosognosia could be an early sign of neurodegeneration in brain areas that would support control mechanisms over memory representations.

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Section: Discussionmentioning

confidence: 44%

Anosognosia in Mild Cognitive Impairment: Lack of Awareness of Memory Difficulties Characterizes Prodromal Alzheimer's Disease

et al. 2021

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“…This result aligns with previous studies showing deficits in metacognitive monitoring skills. Specifically, although individuals with MCI might acknowledge their cognitive difficulties and consistently report lower confidence levels in their cognitive performance, their evaluations lack accuracy ( Ryals et al 2019 ; Pennington et al 2021 ; Anderson and Schmitter-Edgecombe 2010 ; Perrotin et al 2007 ; Chi et al 2022 ). In other words, their subjective assessments do not always align with their actual performance; thus, while individuals with MCI appear to be aware of their cognitive struggles to some extent, evidenced by their reported lower confidence, their ability to accurately gauge their cognitive performance was disrupted, as reflected by poorer calibration.…”

Section: Discussionmentioning

confidence: 99%

“…The findings in studies employing online measures of metacognition at the item-by-item level show considerable heterogeneity, too ( Perrotin et al 2007 ; Akhtar et al 2006 ; Ryals et al 2019 ; Chi et al 2022 ; Anderson and Schmitter-Edgecombe 2010 ; Pennington et al 2021 ). Studies examining metacognitive monitoring accuracy during memory retrieval, as indicated by FOK judgments ( Anderson and Schmitter-Edgecombe 2010 ; Perrotin et al 2007 ; Ryals et al 2019 ; Chi et al 2022 ) and FOC ratings after a given response ( Chi et al 2022 ; Ryals et al 2019 ), have found deficits in aMCI participants. However, when measuring metamemory monitoring during encoding processes using JOLs ( Ryals et al 2019 ; Akhtar et al 2006 ), aMCI participants performed equally well compared with healthy older adults.…”

Section: Introductionmentioning

confidence: 99%

“…Notably, Ryals et al ( 2019 ) found that individuals with aMCI exhibited more pronounced inaccuracies in memory awareness, as measured by FOK judgments, for verbal stimuli compared to visual stimuli. In addition, a recent study ( Chi et al 2022 ) examined differences in monitoring accuracy, as represented by FOC estimations, among healthy older adults, individuals with subjective cognitive impairment (SCI), and those with aMCI and naMCI, on a semantic memory task. The results demonstrated that both MCI groups had significantly poorer accuracy between their confidence judgments and performance than healthy controls and those with SCI.…”

Section: Introductionmentioning

confidence: 99%

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Metacognitive Differences in Amnestic Mild Cognitive Impairment and Healthy Cognition: A Cross-Sectional Study Employing Online Measures

Bampa,

Tsolaki,

Moraitou

et al. 2023

J. Intell.

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This study aimed to examine metacognitive abilities in individuals diagnosed with amnestic mild cognitive impairment (aMCI) by using online metacognitive measures during cognitive tasks. A total of 100 participants were enrolled, all aged 50 or older (mean age = 61.98; SD = 6.27), and with a minimum of six years of education (mean = 14.95; SD = 2.94). The sample included 50 individuals with aMCI (34 females) and 50 healthy controls (HC) (33 females). Both groups underwent metacognitive versions of memory tasks (Doors and People) and executive functions tasks (Wisconsin Card Sorting Test). Metacognition was assessed through confidence ratings given after each answer (referred to as metacognitive monitoring) and the accuracy of the participants’ decisions to include or exclude answers from their final scores (known as metacognitive control). The results showed that although individuals with aMCI were aware of their cognitive limitations—evidenced by their lower confidence ratings across all tasks—they still exhibited overconfidence relative to their actual performance. Moreover, they included a greater number of incorrect answers in their final scores compared to the healthy control group. These findings suggest that while individuals with aMCI retain some level of awareness, their self-evaluations appear to lack precision. This observation was consistent across both types of cognitive tasks. The results underscore the need for additional research to better understand metacognition in MCI as well as the interplay between metacognitive monitoring and control.

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“…Specifically, individuals who demonstrate good metamemory (i.e., who have good awareness of their actual memory function), may be expected to have a more accurate subjective report of cognitive decline than those who have poor metamemory. Despite its clear relevance for understanding the prognostic relevance of SCD, metamemory has rarely been examined in relation to SCD ( Buckley et al, 2016 ; Vannini et al, 2019 ; Chi et al, 2020 ; Gagliardi et al, 2020 ), perhaps because metamemory as a construct evolved primarily in the field of cognitive psychology and is not a formal component of clinical neuropsychological evaluations ( Sunderaraman and Cosentino, 2017 ; Chapman et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Subjective Cognitive Decline Is More Accurate When Metamemory Is Better

Chapman

Joyce

Barker

et al. 2022

Front. Aging Neurosci.

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ObjectiveSubjective cognitive decline (SCD) has emerged as one of the first manifestations of Alzheimer’s disease (AD). However, discrepancies in its relationship with tests of memory and other cognitive abilities have hindered SCD’s diagnostic utility. Inter-individual heterogeneity in metamemory, or memory awareness, and the use of clinical measures of cognition lacking sensitivity to early cognitive dysfunction, may contribute to these discrepancies. We aimed to assess if the relationship between SCD and markers of early cognitive dysfunction is moderated by metamemory abilities.MethodsThe sample included 79 cognitively healthy older adults (77% female, 68% White, and 32% Black participants) with a mean age of 74.4 (SD = 6.1) and 15.9 (SD = 2.7) years of education. Metamemory was assessed using an episodic Feeling of Knowing test with four 5-item trials. Outcome measures included a resolution metric defined as a gamma correlation reflecting the accuracy of item-level predictions (“Will you know the correct answer?”). Early cognitive dysfunction was measured through the Loewenstein-Acevedo Scale for Semantic Interference and Learning (LASSI-L) and the Short-Term Memory Binding Test (STMB), measures sensitive to preclinical AD. SCD was assessed with a 20-item questionnaire that asked participants to compare themselves to others their age on a 7-point Likert scale. Regression analyses examined whether a potential relation between SCD and early cognitive dysfunction was moderated by metamemory.ResultsSubjective cognitive decline was associated with susceptibility to semantic proactive interference such that greater complaints were associated with increased susceptibility to semantic proactive interference (b = −0.30, p = 0.003) only. Metamemory moderated the association between SCD and susceptibility to and recovery of semantic proactive interference such that those with more accurate metamemory showed a stronger association between increased complaints and susceptibility to semantic proactive interference (b = −0.71, p = 0.005; b = −0.62, p = 0.034). Metamemory, however, did not moderate the association of SCD with retroactive semantic interference nor short term memory binding.DiscussionThe accuracy of an individual’s metamemory, specifically their ability to adjust moment to moment predictions in line with their performance, can influence the extent to which SCD maps onto objective cognition. Such self-referential assessment should be considered when interpreting SCD.

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Retrospective metamemory monitoring of semantic memory in community-dwelling older adults with subjective cognitive decline and mild cognitive impairment

Cited by 9 publications

References 102 publications

Anosognosia in Mild Cognitive Impairment: Lack of Awareness of Memory Difficulties Characterizes Prodromal Alzheimer's Disease

Anosognosia in Mild Cognitive Impairment: Lack of Awareness of Memory Difficulties Characterizes Prodromal Alzheimer's Disease

Metacognitive Differences in Amnestic Mild Cognitive Impairment and Healthy Cognition: A Cross-Sectional Study Employing Online Measures

Subjective Cognitive Decline Is More Accurate When Metamemory Is Better

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