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Although early identification and management services for dementia have become more widespread, their efficacy and the clinical characteristics of service have yet to be fully evaluated. Therefore, the objective of this study is to clarify these issues.
The subjects were 164 Japanese users of an early identification and management program for dementia, known as the Initial-phase Intensive Support Team (IPIST), between 2013 and 2015. Nonhierarchical cluster analysis was used to derive subgroups based on cognitive status and ability in activities of daily living (ADL) and behavioral and psychological symptoms of dementia (BPSD). One-way analysis of variance was performed to evaluate differences among the groups derived by the cluster analysis. A paired t test was used to assess how the clinical status of the groups changed between baseline and follow-up.
Four groups were identified by cluster analysis, i.e. a mild group, a moderate group, a BPSD group with moderate cognitive impairment and severe BPSD, and a severe group with severe cognitive impairment and severe BPSD. Although there were no significant improvements in cognitive impairment or ADL in any group, significant improvements were found in BPSD in the BPSD and severe BPSD groups. Caregiver burden was significantly lessened in all groups. Clinical diagnosis and long-term care insurance service utilization rates were significantly improved overall.
The users of IPIST were classified into four subgroups based on their clinical characteristics. The IPIST program could improve the quality of life of people with dementia and their caregivers.
The superior memory of people with autism has been commented on for over thirty years. Kanner, in his first report on autism, mentioned the ‘excellent rote memory’ of autism children (Kanner, 1943). Clinicians who are familiar with these conditions never fail to come across examples of outstanding memory for particular subjects (such as birthdays, the academic names of fish, and so on). However, early studies that used conventional neuropsychological tests reported impairments on various measures of memory in children with autism. So, for example, Boucher and Warrington (1976; see also Boucher 1978, 1981a) found that performance in memory tasks by participants with autism was similar to that of adults with the acquired amnesic syndrome, showing impaired recall from long-term memory (LTM), combined with relatively intact cued recall from LTM as well as intact short-term memory (STM). Thus, there is a discrepancy between the clinical observations and experimental findings.
One possible explanation for this discrepancy is differences between the individuals observed or tested. The participants with autism in early psychological studies were primarily children with varying degrees of intellectual disability (low-functioning autism, or LFA). More recent studies that examined individuals without intellectual disability (high-functioning autism, or HFA) have reported basically unimpaired performance on tasks thought to measure episodic memory (Bennetto, Pennington & Rogers, 1996; Minshew et al., 1992; Minshew & Goldstein, 1993; Renner, Klinger & Klinger, 2000; Summers & Craik, 1994) (but see Bowler, Gardiner & Grice, 2000).
The main aim of the present study was to compare pictures and words with respect to access
to semantic systems in autism using a semantic priming paradigm. A word completion task
was conducted using both within-modality (word–word, WW) and cross-modality (picture–word,
PW) conditions on a group of high-functioning adolescents and adults with autism
(N = 20) and a control group (N = 20) matched on chronological age, mental age, Verbal
IQ and Performance IQ. Both groups showed semantic priming effects in both modality
conditions, generating significantly more responses for related prime-target pairs than for
unrelated pairs. Although the control group performed similarly on both priming tasks, the
autistic group performed significantly better on a PW task than on a WW task. These
findings suggest the possible advantage of pictures over words in access to semantics in
autism. The theoretical implications are discussed in terms of functional asymmetry between
verbal and pictorial semantic operations that may be specific to autism.
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