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Pitfall Intention Explanation Task with Clue Questions (Pitfall task): assessment of comprehending other people's behavioral intentions in Alzheimer's disease

Published online by Cambridge University Press:  03 July 2012

Tomoharu Yamaguchi ,
Yohko Maki  and
Haruyasu Yamaguchi
Tomoharu Yamaguchi*
Affiliation:
Gunma University Graduate School of Health Sciences, Gunma, Japan Department of Rehabilitation, Gunma University of Health and Welfare, Gunma, Japan
Yohko Maki
Affiliation:
Gunma University Graduate School of Health Sciences, Gunma, Japan Geriatrics Research Institute and Hospital, Gunma, Japan
Haruyasu Yamaguchi
Affiliation:
Gunma University Graduate School of Health Sciences, Gunma, Japan
*
Correspondence should be addressed to: Tomoharu Yamaguchi, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8514, Japan. Phone: +81-27-220-8946; Fax: +81-27-220-8946. Email: [email protected].
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Abstract

Background: In Alzheimer's disease (AD) patients, deficits in contextual understanding and intentions/beliefs of other people (theory of mind; ToM) cause communication problems between patients and caregivers. To evaluate deficits of contextual understanding/ToM, we developed the Pitfall Intention Explanation Task with Clue Questions (Pitfall task).

Methods: We recruited 26 healthy older adults in clinical dementia rating (CDR) 0, and 62 outpatients: 12 with amnestic mild cognitive impairment (aMCI) in CDR 0.5; 36 mild AD in CDR 1; and 14 moderate AD in CDR 2. The Pitfall task consists of a single-frame cartoon that shows a character's intention and seven serial questions that provide clues for contextual understanding/ToM.

Results: The total score (0–7) was decreased with progression of AD (CDR 0, 5.4 ± 2.6; CDR 0.5, 3.7 ± 2.7; CDR 1, 1.9 ± 3.1; CDR 2, 0.0 ± 0.0; respectively). In CDR 0, two-third of the participants responded correctly without clue questions. In CDR 0.5, one-third of the participants responded correctly without clue questions, and half of them understood with the help of the clue questions. In CDR 1, one-fourth of the participants responded correctly without clue questions, and the clue questions did not increase the correct response. In CDR 2, none responded correctly. Additionally, the Pitfall task provided the chance for patients’ families to observe patients’ responses.

Conclusion: Contextual understanding/ToM, a kind of social cognition, was impaired with progression of AD. The Pitfall task evaluates the function quickly with low burden for memory function, and may provide helpful clues for caregivers to achieve good communication with AD patients.

Keywords

dementiacarersbehavioral and psychological symptoms of dementia (BPSD)cognitive assessmentfamily therapy
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 12 , December 2012 , pp. 1919 - 1926
Copyright
Copyright © International Psychogeriatric Association 2012

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