The effect of errorless learning on quality of life in patients with Korsakoff’s syndrome

Abstract

BackgroundErrorless learning (EL) is a promising rehabilitation principle for (re)learning instrumental activities in patients with amnesia, including patients with Korsakoff’s syndrome (KS). Successfully (re)learning tasks might improve the sense of competence and independence, and subsequently the quality of life. Quality of life in patients with KS has received limited attention, and no studies have been conducted to experimentally examine the effect of EL on quality of life in patients in this patient group.Materials and methodsThe QUALIDEM, an observation scale for quality of life, was completed by professional nurses before and after EL training in a group of fifty-one patients with KS. This scale was also completed for a group of thirty-one control patients receiving care as usual but no EL training.ResultsQuality of life was significantly increased on eight of the nine subscales in the Korsakoff group who participated in an EL training. There was a trend toward a significant increase in “positive affect” (ie, the ninth subscale). In contrast, no changes over time were found on any of the subscales in the control group that did not participate in any EL training.ConclusionDespite severe memory impairments, patients with KS still have the potential to (partially) (re)learn tasks using EL. This potential should be exploited, as the successes of (re)-learning might improve the quality of life of Korsakoff patients in nursing homes.

The impact of error frequency on errorless and errorful learning of object locations using a novel paradigm

“…Also, as memory capacity and learning ability decline with ageing (Park, 2000), it can be expected that the amount of errors has a more profound influence on memory performance in older adults. A similar prediction can be made for clinical populations that show impairments in memory and error-monitoring, such as mild cognitive impairment or mild-to-moderate dementia (Bettcher, Giovannetti, Macmullen, & Libon, 2008), traumatic brain injury (Bertens et al, 2016) or Korsakoff's syndrome (Rensen et al, 2017(Rensen et al, , 2019. Future research should examine whether the error-monitoring system is able to apply corrections by using the Drawer Task in individuals with an impaired error-monitoring system.…”

“…During EL, consolidation of information occurs after a single observation of an event that leads to a positive outcome, resulting in more accurate recall of information relative to TEL (Terrace, 1963). EL, compared to TEL, seems to be a more beneficial strategy to improve task performance in patients with an amnesic syndrome (Callahan & Anderson, 2019;Roberts et al, 2018;Wilson, Baddeley, Evans, & Shiel, 1994), mild to moderate dementia (de Werd, Boelen, Olde Rikkert, & Kessels, 2013;Kessels, Feijen, & Postma, 2005;Kessels & Olde Hensken, 2009), severe dementia (Ruis & Kessels, 2005), traumatic brain injury (Bertens, Kessels, Boelen, & Fasotti, 2016;Bertens, Kessels, Fiorenzato, Boelen, & Fasotti, 2015;Clare & Jones, 2008;Evans et al, 2000), alcoholic Korsakoff's syndrome (Komatsu, Mimura, Kato, Wakamatsu, & Kashima, 2000;Rensen, Egger, Westhoff, Walvoort, & Kessels, 2017, aphasia (Middleton, Schwartz, Rawson, & Garvey, 2015). Also, beneficial effects of TEL have been found in healthy older adults (Guild & Anderson, 2012;Lubinsky, Rich, & Anderson, 2009).…”

A systematic review of treatments for alcohol-related cognitive impairment: lessons from the past and gaps for future interventions

“…Moreover, cognitive deficits can be associated with increased impulsivity (Bates et al, 2002;Czapla et al, 2016;Moraleda Barreno et al, 2019) that alter decision making (Domínguez-Salas, Díaz-Batanero, Lozano-Rojas, & Verdejo-García, 2016; Moraleda Barreno et al, 2019;Stevens et al, 2015). As a consequence, patients with alcohol-related cognitive impairment (ARCI) present lower self-efficacy (Bates, Pawlak, Tonigan, & Buckman, 2006;Sachdeva et al, 2016), lower motivation and treatment compliance (Bates et al, 2013(Bates et al, , 2006Bernardin et al, 2014), as well as fewer days of abstinence (Florez et al, 2019;Sachdeva et al, 2016), more drinks per drinking day (US SDUs, 1SDU = 14 g) (Bates et al, 2006) and poorer quality of life (Horton, Duffy, & Martin, 2015;Rensen, Egger, Westhoff, Walvoort, & Kessels, 2017). Furthermore, the comorbidity of ARCI with other psychiatric disorders, depression for instance, can worsen the cognitive symptoms (Horton et al, 2015).…”

Response to Oudman

“…put this forward by himself. In addition to the neuropsychiatric symptoms referred to above, selfreported quality of life improved after our intervention (Rensen et al, 2017a;2017b). We did not find any differences in results in patients that selected the tasks themselves or those for whom the tasks were selected by the caregivers.…”