The decline of working memory in Alzheimer's disease. A longitudinal study

A previous study (Baddeley et al., 1986) explored the hypothesis that patients suffering from dementia of the Alzheimer type (AD) are particularly impaired in the functioning of the central executive component of working memory. It showed that, when patients are required to perform 2 concurrent tasks simultaneously, the AD patients are particularly impaired, even when level of performance on the individual tasks is equated with that of age-matched controls. Although the results were clear, interpretation was still complicated by 2 issues: first, the question of comparability of performance on the separate tests between AD and control patients; secondly, the question of whether our results could be interpreted simply in terms of a limited general processing capacity being more taxed by more difficult dual tasks than by the individual tasks performed alone. The present study followed up the AD and control patients after 6 and 12 mths. We were able to allow for the problem of comparability of performance by using patients as their own control. Under these conditions, there is a very clear tendency for dual task performance to deteriorate while single task performance is maintained. A second experiment varied difficulty within a single task in which patients and controls were required to categorize words as belonging to 1, 2 or 4 semantic categories. There was a clear effect of number of categories on performance and a systematic decline in performance over time. There was, however, no interaction between task difficulty as measured by number of alternatives and rate of deterioration, suggesting that the progressive deterioration in performance shown by AD patients is a function of whether single or dual task performance is required, and is not dependent on simple level of task difficulty. Implications for the analysis of the central executive component of working memory are discussed.