title: Testing memory for self-generated items in dementia: method makes a difference.
abstract: OBJECTIVE
  To learn how pAD (probable Alzheimer's disease), PD+ ("Parkinson's Plus" syndrome), and control subjects remember internally generated material under different conditions.
  
  
  BACKGROUND
  "Self-discovered," or internally generated knowledge, prized by educators and therapists, can bring about considerable behavioral change. Both parietal-temporal-limbic (pAD) and frontal-subcortical dementia (e.g. PD+) cause dysmemory, but may cause different internal-external memory bias. pAD subjects, confusing internal and external information (confabulation) and reporting internal information during memory testing (intrusions), may be biased to remember internal material. PD+ subjects, impaired at generative tests, may be externally biased.
  
  
  METHODS
  Ten pAD, 5 PD+, and 10 control subjects generated words in a category without instruction to remember (INR), and took a list-learning test of incidental memory for internally and externally generated words. To test how INR influences memory, subjects then generated and attempted to recall four more words.
  
  
  RESULTS
  All three subject groups remembered more internally generated than externally provided words without INR. Recall versus recognition of internally generated words differed by group, with PD+ subjects showing greatest improvement with recognition. The pAD subjects performed worse with INR than without INR, had the most intrusion errors, and, rather than demonstrating a release from proactive inhibition, recalled fewer words outside the category. Groups differed in overall recall/recognition improvement (p = 0.015).
  
  
  CONCLUSIONS
  Aged subjects preferentially retained internally generated material. However, among demented subjects, memory for internally generated words was influenced by the testing method used. PD+ subjects have poor internal recall, but excellent internal recognition. In pAD, memory for internally generated words may exceed external memory, but only when subjects are not explicitly trying to remember.
authors.affiliation: Division of Neurology, Pennsylvania State University College of Medicine, Hershey 17033, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Barrett
authors.forename: G P
authors.initials: GP
authors.lastname: Crucian
authors.forename: R L
authors.initials: RL
authors.lastname: Schwartz
authors.forename: K M
authors.initials: KM
authors.lastname: Heilman
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000503:physiopathology / Q000523:psychology*; D003704:Dementia / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology*