Reduced short-term memory capacity in Alzheimer's disease: the role of phonological, lexical, and semantic processing

Individuals with Alzheimer's disease (AD) are often reported to have reduced verbal short-term memory capacity, typically attributed to their attention/executive deficits. However, these individuals also tend to show progressive impairment of semantic, lexical, and phonological processing which may underlie their low short-term memory capacity. The goals of this study were to assess the contribution of each level of representation (phonological, lexical, and semantic) to immediate serial recall performance in 18 individuals with AD, and to examine how these linguistic effects on short-term memory were modulated by their reduced capacity to manipulate information in short-term memory associated with executive dysfunction. Results showed that individuals with AD had difficulty recalling items that relied on phonological representations, which led to increased lexicality effects relative to the control group. This finding suggests that patients have a greater reliance on lexical/semantic information than controls, possibly to make up for deficits in retention and processing of phonological material. This lexical/semantic effect was not found to be significantly correlated with patients' capacity to manipulate verbal material in short-term memory, indicating that language processing and executive deficits may independently contribute to reducing verbal short-term memory capacity in AD.