RecruitingNot ApplicableNCT03991624

Lack of Decision-making in Patients With Alzheimer's Disease : Functions Involved and the Daily Consequences

Sponsor

Centre Hospitalier Universitaire de Saint Etienne

Enrollment

180 participants

Start Date

Sep 27, 2019

Study Type

INTERVENTIONAL

Conditions

Alzheimer Disease

Summary

Early in its development, Alzheimer's disease causes not only brain damage affecting different regions of the brain, such as the entorhinal cortex, the anterior cingulate cortex, and the prefrontal lobe, but also a cognitive deficit affecting several functions, such as episodic memory, executive functions, or working memory. Although these different areas and functions are involved in the decision-making process, few studies have focused their research on this subject in the context of Alzheimer's disease. However, a 2008 study showed an early decline in decision-making skills in the disease, but did not link this deficit to cognitive impairment. In addition, decision-making is generally assessed using a test called the Iowa Gambling Task (IGT), which, despite its many advantages, does not have established ecological validity. In the context of pathology, however, it seems essential to evaluate decision-making in relation to daily life, especially since a deficit in this process would have considerable repercussions on quality of life. In this study, the investigators seek to better define the disorder by decision-making in early Alzheimer's disease, to understand the links between them with the deficit of other cognitive functions, and to highlight the the consequences that this decline has on patients' daily lives.

Eligibility

Min Age: 60 Years

Inclusion Criteria5

Mini-Mental State Examination \> 23
stable treatment for at least two months
mother tongue : French
general cognitive level in the standard on the following tests : Mini-Mental State Examination and Fast Front End Efficiency Battery
mother tongue : French

Exclusion Criteria8

game addiction
uncorrected visual and hearing disorders
other neurological or psychiatric history
inability to communicate
delusional or psychotic state
game addiction
psychiatric or neurological disorders
anxiety and depression symptomatology

Interventions

DIAGNOSTIC_TESTcognitive assessment

* MMSE : Mini-Mental State Examination * 5 words of Dubois * Direct Assessment of Functional Status * Trail Making Test * BREF : Fast Front End Efficiency Battery * short battery of praxies * Quality of Life in Alzheimer's Disease

OTHERInhibition evaluation

* Stroop Victoria : This test consists of 3 sheets of 24 items, organized in 6 lines of 4 (points, neutral words or names of colours), from which the subject must identify the ink of the stimuli as quickly and precisely as possible. * Stop Signal task on the computer to give a response to the presentation of a target stimulus (Go signal) (e.g. pressing a button when a red circle appears on the screen, but doing nothing when a blue triangle appears), and prevent this response when the stimulus is followed or preceded by a beep (stop signal) (e.g. the appearance of a red circle is immediately preceded or followed by a beep, the subject should not press the button).

OTHERAssessment of mental flexibility

* a letter-number pair task. The subject sees 4 blocks of 48 letter-number pairs appear successively on a screen. When the pair appears at the top, the subject must make a parity judgment but when the pair appears at the bottom, the subject must make a consonant / vowel judgment. * a category change task, which consists in classifying a word according to one category or another according to a visual clue that appears. The task consists of 4 blocks of 48 stimuli.

OTHEREvaluation of the update

* an update span task for which letters appear on a screen sequentially, and subjects must memorize the last three, without knowing the length of the list. The task will consist of 3 tests of training and then 20 tests. After three errors consecutive, the task ends. * an n-back task that consists of a sequential presentation of letters, during which the subject must indicate when the stimulus. The task consists of 3 levels, with n = 1, n= 2 or n = 3. For level 1 (with n = 1), the subject must press a button when the same letter appears twice in a row on the screen. This task consists of 75 letters.

OTHERworking memory

* the empan baba task, which mainly involves maintaining information, and which consists in retaining a series of letters, appearing sequentially on a screen, and whose latency time between two word presentations is required for a secondary task: the repetition of baba syllables. * the task of reading operations which consists in recalling operations series of letters whose presentation is interspersed with the reading aloud of simple operations and of their results. * the ongoing operational task of recalling a list of letters, the presentation of which is interspersed with operations that are simple to read aloud and to to solve head-on.

OTHERepisodic memory

\- A recognition task with a Remember/Know paradigm