Using stimulus form change to understand memorial familiarity for pictures and words in patients with mild cognitive impairment and Alzheimer's disease

Although it is generally accepted that patients with amnestic mild cognitive impairment (aMCI) and patients with Alzheimer's disease (AD) have significantly impaired recollection, recent evidence has been mixed as to whether these patients demonstrate impaired memorial familiarity. Recent work suggests that familiarity may remain intact for pictures, but not for words. Further, a recent event-related potential (ERP) study suggests that enhanced conceptual processing of pictures may underlie this intact familiarity. However, to date there has been no direct comparison of perceptual and conceptual-based familiarity for pictures and words in patients with aMCI and AD. To investigate this issue, patients with aMCI, patients with AD, and healthy older adults underwent four study-test conditions of word–word, picture–picture, word–picture, and picture–word. When stimuli undergo form change, it has been suggested that only conceptual processing can help support recognition in the absence of recollection. Our results showed that patients successfully relied on perceptual and conceptual-based familiarity to improve recognition for the within format conditions over the across format conditions. Further, results suggested that patients with aMCI and AD are able to use enhanced conceptual processing of pictures compared to words to allow them to overcome the deleterious effects of form change in a similar manner as controls. These results help us begin to understand which aspects of memory are impaired and which remain relatively intact in patients with aMCI and AD. This understanding can then in turn help us to assess, conceptualize, and build behavioral interventions to help treat these patients.