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系統識別號 U0026-0812200915183286
論文名稱(中文) 阿茲海默氏症患者之認知功能、學習能力與日常生活功能之相關
論文名稱(英文) The Correlates of Cognitive Ability, Learning Ability, and Daily Functioning in People with and without Alzheimer’s Disease
校院名稱 成功大學
系所名稱(中) 職能治療學系碩博士班
系所名稱(英) Department of Occupational Therapy
學年度 97
學期 2
出版年 98
研究生(中文) 郭燕君
研究生(英文) Yen-Chun Kuo
電子信箱 t7695103@mail.ncku.edu.tw
學號 t7695103
學位類別 碩士
語文別 中文
論文頁數 96頁
口試委員 指導教授-汪翠瀅
口試委員-馬慧英
口試委員-白明奇
口試委員-林克忠
中文關鍵字 日常生活功能  學習能力  認知功能  阿茲海默氏症 
英文關鍵字 Learning  Cognitive function  Alzheimer’s disease  Daily Function 
學科別分類
中文摘要 背景
研究指出阿茲海默氏症患者在疾病早期階段就會呈現認知功能的損傷,阻礙患者獨立執行日常生活,增加對他人的依賴,進而造成個案的挫折感,亦加重家屬的負擔。現今治療上鼓勵早期發現及治療,延緩功能和認知的退化與進入機構的速度,目前雖有許多文獻嘗試探討阿茲海默氏症患者的認知功能對於日常生活功能之預測程度,以及瞭解認知訓練對於個案之認知功能及日常生活功能的效果,但研究結果並不一致。
在治療與復健的過程中,不論使用代償性或恢復性策略,個案均需具備學習和資訊保留的能力,如此,才有機會將治療的效果概化至日常生活。但目前少有文獻探討阿茲海默氏症個案學習與資訊保留的能力,以及其與日常生活功能的相關性,若能增加此方面的了解,對於臨床治療者在早期促進功能維持與獨立生活的治療介入方面,可以提供重要的實證資訊,了解治療介入的策略與適用狀況。

目的及方法
本研究招募38位50歲以上阿茲海默氏症患者為實驗組,以及35位50歲以上正常成人為對照組,所有參與者皆進行一系列認知評量(聽覺注意力與工作記憶、空間注意力與工作記憶、持續性注意力、心智轉換、建構能力和語言)、評估學習能力(聽覺、物體視覺、路徑地圖)和日常生活功能(社區功能與執行功能失能評量),探討基本認知功能、學習能力與日常生活功能之相關,並且比較正常成人與阿茲海默氏症患者在各測驗表現之差異。

資料分析
以描述性統計分析、獨立t檢定、卡方檢定檢驗以及多變量變異數分析阿茲海默氏症個案和正常成人在人口學資料與測驗各變項是否有顯著差異。利用逐步迴歸分析基本認知功能對於學習能力與日常生活功能解釋變異的程度,以及學習能力對於日常生活功能測驗解釋變異的程度。以重複量數分析了解阿茲海默氏症個案和正常成人在重複學習的情境下學習能力的表現。

結果
阿茲海默氏症個案和正常成人在口人學變項上均無顯著差異,在基本認知功能、學習能力、社區功能評量與簡短式智能量表皆有顯著差異(p < .05)。以所有參與者為樣本,逐步迴歸分析發現,基本認知功能中,心智轉換為三種學習能力測驗及社區功能(IADL)的最佳預測因子,解釋的變異量皆達30%以上(p < .05)。學習能力中,路徑地圖記憶則為社區功能的最佳預測因子(R2 = .581, p = .001)。單獨以阿茲海默氏症患者為樣本進行迴歸分析,結果發現,在基本認知功能中,語言是聽覺回憶最佳的預測因子(R2 = .262, p = .001),心智轉換為物體視覺回憶(R2 = .195, p = .007)和社區功能的最佳預測因子(R2 = .351 , p <.001),持續性注意力則為路徑地圖記憶的最佳預測因子(R2 = .327, p < .001),學習能力中,路徑地圖記憶仍為社區功能的最佳預測因子(R2 = .471, p < .001)。此外,阿茲海默氏症患者在學習能力測驗中經過多次重複學習後雖有顯著進步,但訊息登入和資訊保留的效果有限。

討論與結論
對於涵蓋認知缺失和無認知缺失的研究參與者而言,心智轉換不論是對於學習能力或是社區功能而言,都是最顯著的預測因子。而學習能力測驗中的路徑地圖記憶測驗則是對於社區功能最顯著的預測因子,但此測驗需要更多的研究了解與支持其信效度。對阿茲海默氏症個案而言,不同的學習能力分別產生了不同的預測因子,然而,基本認知功能中的心智轉換與學習能力測驗中的路徑地圖記憶仍為社區功能最為顯著的預測因子。此外,研究結果發現阿茲海默氏症患者在學習能力測驗中經過多次重複學習後雖較最初的學習有顯著進步,但訊息登入與資訊保留的效果有限,學習後的結果是否延續到下次治療或社區,需要進一步探討。
英文摘要 Background
Research has indicated that patients with Alzheimer’s disease (AD) show cognitive impairments at very early stage of the disease. The aim of this study is to measure the learning capacity and other basic cognitive abilities in people with and without AD and to investigate the relationships between their cognitions and daily functioning. The findings would provide more insight to the strength and weakness in patients with AD, and the cognitive impact on their learning and adaptation.

Purpose and Method
Thirty-nine patients with Alzheimer’s disease and 35 normal controls participated in this study. Both groups completed the cognitive tests, learning tasks, daily functioning scales, depression scales, and Mini-Mental Status Exams. Chi-square, independent t-test, multivariate analysis of variance (MANOVA), and repeated measures ANOVA were used to analyze the demographic and test data between the two groups. Stepwise regression analysis was used to identify the significant predictors for learning capacity and daily functioning.

Result
The results showed that there was no difference between the AD and normal groups regarding demographic factors of sex, age, education, and depression. There were significant differences for all cognitive and functional variables between the two groups (p < .05), except for the scores on the Dysexecutive Questionnaire. Regression analysis with the whole sample of the participants shows that, among all cognitive variables, Trail Making B was the best cognitive predictor for auditory recall, objects recall, and route map memory (R2 > .30, p < .001). For daily functioning, Trail Making B was still the best predictor for IADL and accounted for 40.8% of the total variance (p < .001). The route map memory test was the best predictor for IADL among all learning variables and accounted for 58.1% of the total variance (p < .001). Regression analysis with the AD group also identified Trail Making B as the best cognitive predictor for objects recall (R2 = .195, p = .007) and daily functioning.(R2 = .351 , p <.001). The route map memory test was still the best predictor for IADL among all learning variables and explained 47.1% of the total variance (p < .001). Verbal fluency was the best cognitive predictor for auditory recall for 26.2% of the total variance (p < .001). Trail Making A was the best predictor for route map memory test among all cognitive variables and accounted for 32.7% of the total variance (p < .001). Post hoc analysis with repeated measures ANOVA showed that the information encoding and retention as learning gains were much less in the AD group.

Discussion and Conclusion
Trail Making B represents the function of cognitive flexibility and is the best predictor for learning capacity and the IADL function. The route map memory test is an important predictor for IADL in the AD group, and the finding is supported by clinical observation. However, more validity research is warranted to assure the applicability of the test for the patient group. The deficits in basic cognition and repetitive learning are evident in the participants at the early stage of AD. The minimal learning gains in the experimental conditions were observed in the AD group. Nevertheless, how much of the encoded content could be retained till the next day or the next week; or whether if the learning could be generalized to their community functions, requires further investigation.
論文目次 摘要....................................................................................................................................... i
Abstract................................................................................................................................ iv
誌謝....................................................................................................................................vii
表目錄.................................................................................................................................. x
圖目錄.................................................................................................................................xi
第一章、引言....................................................................................................................... 1
第一節、動機與重要性............................................................................................... 1
第二節、研究目的....................................................................................................... 3
第二章、文獻回顧............................................................................................................... 4
第一節、阿茲海默氏症的認知缺失和功能限制....................................................... 4
第二節、認知退化、認知訓練與學習能力之關係................................................. 13
第三節、阿茲海默氏症患者學習能力之相關研究................................................. 16
第四節、認知功能、學習能力與生活功能之相關研究......................................... 20
第三章、方法..................................................................................................................... 25
第一節、研究對象..................................................................................................... 25
第二節、研究工具..................................................................................................... 26
第三節、實驗流程與評估方式................................................................................. 35
第四節、資料收集與分析......................................................................................... 36
第四章、結果..................................................................................................................... 40
第一節、研究參與者基本資料................................................................................. 40
第二節、實驗組與對照組在各測驗表現之差異..................................................... 43
第三節、相關性及迴歸分析:基本認知功能與學習能力..................................... 46
第四節、相關性及迴歸分析:基本認知功能與日常生活功能............................. 48
第五節、相關性及迴歸分析:學習能力與日常生活功能..................................... 49
第六節、阿茲海默氏症患者之基本認知功能、學習能力與日常生活功能......... 50
第七節、參與者在重複學習情境下之表現............................................................. 52
第五章、討論..................................................................................................................... 57
第一節、參與者之基本資料與各測驗表現............................................................. 58
第二節、基本認知功能、學習能力與日常生活功能之相關................................. 60
第三節、阿茲海默氏症患者之基本認知功能、學習能力與日常生活功能......... 65
第四節、實驗組與對照組在重複學習情境下之表現............................................. 67
第五節、臨床應用與研究限制................................................................................. 71
第六章、結論..................................................................................................................... 73
參考文獻............................................................................................................................. 74
自述.................................................................................................................................... 96
參考文獻 參考文獻
1.中國行為科學社。(2005)。WMS-III魏氏記憶力量表(弟三版)。台北:久裕。
2.白明奇。(2008)。健康世界。二七四期。34-40。
3.李眉、林克能、周碧瑟、傅中玲、王署君、劉秀枝。(1994)。智能篩檢測驗和中文版初測結果。中國臨床心理學。第二卷。69-73頁。
4.林冠宏。(2006)。阿茲海默氏症。慈濟醫學,第十八卷(suppl 5)。39-48頁。
5.林青山。(2005)。心理與教育統計學。台灣東華書局股份有限公司。
6.徐榮隆、陳威宏、邱浩彰、沈幸梅。(2000)。不同時期失智症之認知功能。台灣醫學。第四卷第四期。371-378頁。
7.郭乃文、劉秀枝、王珮芳、徐道昌。(1989)。中文版「簡短式智能評估」(MMSE)之簡介。臨床醫學。第二十三卷第一期。39-42頁。
8.黃英俊。(1995)。多變量分析(第五版)。中國經濟企業研究所。
9.葉光輝。(2005)。孝道的心理與行為。於楊國樞、黃光國、揚中芳主編,華人本土心理學(上),293-329頁。台北:三民。
10.廖以誠、葉宗烈、楊延光、盧豐華、張智仁、柯慧貞、駱重鳴。(2004):台灣老年憂鬱量表之編製與信、效度研究。台灣精神醫學。第十八卷第一期。30-41頁。.
11.榮泰生。(2007)。SPSS與研究方法(第三版)。五南圖書出版公司。

1.American Psychiatric Association. (1994). Diagnostic and statistical manual of mental Disorders (4th ed.). Washington, DC: Author.
2.Andel, R., Hughes, T. F., & Crowe, M. (2005). Strategies to reduce the risk of cognitive decline and dementia. Aging Health, 1(1), 107-116.
3.Anderson, N. D., & Craik, F. M. (2006). The mnemonic mechanism of errorless learning. Neuropsychologia, 44, 2806-2813.
4.Arbuthnott, K. & Frank, J. (2000). Trail Making Test, Part B as a measure of executive control: Validation using a set-switching paradigm. Journal of Clinical and Experimental Neuropsychology, 22(4), 518-528.
5.Atkinson, R. C., & Shiffrin, R. M. (1968). A proposed system and its control processes. In K. W. Spence & J. T. Spence (Eds.), The psychology of learning and motivation: Advances in research and theory (pp. 82-90). New York: Academic Press.
6.Au, A., Chan, A. S., & Chiu, H. (2003). Verbal learning in Alzheimer’s dementia.Journal of International Neuropsychological Society, 9, 363-375.
7.Avila, R., Bottino, C. M. C., Carvalho, I. A. M., Santos, C. B., Seral, C., & Miotto, E. C. (2004). Neuropsychological rehabilitation of memory deficits and activities of daily living in patients with Alzheimer’s disease: A pilot study. Brazilian Journal of Medical and Biological Research, 37(11), 1721-1729.
8.Baddeley, A. D., Baddeley, H. A., Bucks, R. S., Wilcock, G. K. (2001). Attentional control in Alzheimer's disease. Brain, 124, 1492-1508.
9.Ball, K., Berch, D. B., Helmers, K. F., Jobe, J. B., Leveck, M. D., & Marsiske, M. (2002). Effects of cognitive training interventions with older adults. A randomized controlled trial. The American Journal of Medical Association, 288(18), 2271-2281.
10.Baudic, S., Barba , G. D., Thibaudet, M. C., Smagghe, A., Remy, P., & Traykov, L. (2006). Executive function deficits in early Alzheimer’s disease and their relations with episodic memory. Archives of Clinical Neuropsychology, 21, 15-21.
11.Bell-McGinty, S., Podell, K., Franzen, M., Baird, A. D., & Williams, M. (2002). Standard measures of executive function in predicting instrumental activities of daily living in older adults. International Journal of Geriatric Psychiatry, 17, 828-834
12.Boyle, P. A., Malloy, P. F., Salloway, S., Cahn-Weiner, D. A., Cohen, R., & Cummings, J. L. (2003). Executive dysfunction and apathy predict functional impairment in Alzheimer disease. American Journal of Geriatric Psychiatry, 11(2), 214-221.
13.Bottino, C. M., Carvalho, I. A., Alvarez, A. M., Avila, R., Zukauskas, P. R., Bustamante, S. E., et al. (2005). Cognitive rehabilitation combined with drug treatment in Alzheimer's disease patients: A pilot study. Clinical Rehabilitation, 19(8), 861-869.
14.Brink, T. L., Yesavage, J. A., Lum, O., Heersema, P. H., Adey, M., & Rose, T. L. (1982). Screening tests for geriatric depression. Clinical Gerontologist. 1(1), 37-43.
15.Burton, C. L., Strauss, E., Hultsch, D. F., & Hunter, M. A. (2006). Cognitive function and everday problem solving in older adults. The Clinical Neuropsychologist, 20, 432-452.
16.Caro, J., Ward, A., Ishak, K., Migliaccio-Walle, K., Getsios, D., Ward, A., et al. (2002). To what degree does cognitive impairment in Alzheimer’s disease predict dependence of patients on caregivers. BioMed Central Neurology, 2(1), 6-12.
17.Chan, R. C. K. (2001) Dysexcutive symptoms among the non-clinical sample: A study with the use Dysexecuitve Questionnaire. British Journal of Psychology, 92(3),
551-565.
18.Chaytor, N., Schmitter-Edgecombe, M, & Burr, R. (2006). Improving the ecological validity of executive functioning assessment. Archives of Clinical Neuropsychology, 21, 217-227.
19.Clyburn, L. D., Stones, M. J., Hadjistavropoulos, T., & Tukko, H. (2000). Predicting caregiver burden and depression in Alzheimer’s disease. The Journals of
Gerontology Series B: Psychological Sciences and Social Sciences, 55(1), S2-13.
20.Cummings, J. L., Frank, J. C., Cherry, D., Kohatsu, N. D., Kemp, B., Hewett, L. et al. (2002). Guidelines for managing Alzheimer’s disease: Part I. Assessment. American Family Physician, 65(11), 2263-2272.
21.Delis, D. C., Massman, P. J., Butters, N., Salmon, D. P., Cermark, L. S., & Kramer, J. H. (1991). Profiles of demented and amnesic patients on the California Verbal Learning Test: Implication for the assessment of memory disorders. Psychological Assessment, 3, 19-26.
22.Farias, S. T., Harrell, E., Neumann, C., & Houtz, A. (2003). The relationship between neuropsychological and daily functioning in individuals with Alzheimer’s disease: Ecological validity of neuropsychological tests. Archives of Clinical Neuropsychology, 18, 655-672.
23.Fillenbaum, G. G., Wilkinson, W. E., Welsh, K. A., & Mohs, R. C., (1994). Discrimination between stages of Alzheimer’s disease with subsets of Mini-Mental Status Examination items. An analysis of Consortium to Establish a Registry for Alzheimer’s disease data. Archives of neurology, 51(9), 916-921
24.Filley, C. M., & Cullum, C. M. (1994). Attention and vigilance functions in normal aging. Applies Neuropsychology, 1, 29-32.
25.Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatry Research, 12, 189-198.
26.Fuh, J. L., & Wang, S. J. (2006). Assessing quality of life in Taiwanese patients with Alzheimer’s disease. International Journal of Geriatric Psychiatry, 21, 103-107.
27.Fuld, P. A. (1982). Fuld Object-Memory Evaluation. Illinois: Stoelting Co
28.Gearing, M., Mirra, S. S., Hedreen, J. C., Sumi, S. M., Hansen, L. A., Heyman, A. (1995). The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part
X. Neuropathology confirmation of the clinical diagnosis of Alzheimer's disease. Neurology, 45(3 Pt 1), 461-466.
29.Greenaway, M. C., Lacritz, L. H., Binegar, D., Weiner, M. F., Lipton, A., & Cullum, C. M. (2006). Patterns of verbal memory performance in mild cognitive impairment, Alzheimer’s disease, and normal aging. Cognitive and Behavioral Neurology, 19(2), 79-84.
30.Grigsby, J., Kaye, K., Baxter, J., Shetterly, S. M., Hamman, R., F. (1998). Executive cognitive abilities and functional status among community-dwelling older persons in the San Luis Valley Health and Aging Study. Journal of American Geriatrics Society, 46(5), 590-596.
31.Grober, E., & Kawas, C. (1995). Learning and retention in preclinical and early Alzheimer’s disease. Psychology and Aging, 12(1), 183-188.
32.Gruetzner, H. (1988). Alzheimer’s: A caregiver’s guide and sourcebook. New York: Wiley.
33.Halligan, P. W., Kischka, U., & Marshall, J. C. (2003). Hankbook of clinical neurology. New York: Oxford University Press.
34.Hoffman, S. B., & Platt, C. A. (2001). Comforting the confused strategies for managing dementia (2nd ed., pp. 51-68). New York: Springer Publishing Company.
35.Hughes, C. P., Berg, L., Danziger, W. L., Coben, L.A., & Martin, R. L. (1982) A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566–572.
36.Karlawish, J. H., Casarett, D., Klocinski, J., & Clark, C. M. (2001). The relationship between caregivers' global ratings of Alzheimer's disease patients' quality of life, disease severity, and the caregiving experience. Journal of the American Geriatrics Society, 49(8), 1066-1070.
37.Kyllonen, P. C., & Christal, R. E. (1987). Cognitive modeling of learning abilities: A status report of LAMP. In R. Dillon & J. W. Pelligrino (Eds.), Testing: Theoretical and applied issue. New York: Freeman.
38.Kyllonen, P. C., & Christal, R. E. (1990). Reasoning ability is (little more than) working-memory capacity?! Intelligence, 14, 389-433.
39.Jefferson, A. L., Barakat, L. P., Giovannetti, T., Paul, R. H., & Glosser, G. (2006). Object perception impairments predict instrumental activities of daily living dependence in Alzheimer’s disease. Journal of Clinical and Experimental Neuropsychology, 28, 884-897.
40.Lafleche, G., & Albert, M. S. (1995). Executive function deficits in mild Alzheimer’s disease. Neuropsychology, 9(3), 313-320.
41.Larrabee, G, J., & Youngjohn, J., R. (1993). Accelerated forgetting in Alzheimer-type dementia. Journal of Clinical and Experimental Neuropsychology, 15, 011-712.
42.Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and Instrumental Activities of Daily Living, Gerontologist,9, 179-186.
43.Lezak, M. D. (1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.
44.Loewenstein, D. A., & Mogosky, B. J. (1999). The functional assessment of the older adult patient. In P. A. Lichtenberg (Eds), Handbook of assessment in clinical gerontology (pp. 529-554). New York: John Wiley & Sons, Inc.
45.Lin, K. N., & Liu, H. C. (2003). Clinical Dementia Rating (CDR), Chinese Version. Acta Neurological Taiwanica, 12(3), 154-165.
46.Liu, C., McDown, J., & Lin, K. (2004). Visuospatial inattention and daily life performance in people with Alzheimer’s disease. The American Journal of Occupational Therapy, 58(2), 202-210.
47.Mast, B. T., & Allaire, J. C. (2006). Verbal learning and everyday functioning in dementia: An application of latent variable growth curve model. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 3, 167-173.
48.McGuire, L. C., Ford, E. S., & Ajani, U. A. (2006). Cognitive functioning as a predictor of functional disability in later life. American Journal of Geriatric
Psychiatry, 14(1), 36-42.
49.McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology, 34, 939-944.
50.Mesulam, M. M. (Ed.). (2000). Principles of behavior and cognitive neurology (2nd ed.). New York: Oxford University Press.
51.Panza, F., Solfrizzi, V., Tommasa, L. D., Nardó, G. A., Mastroianni, F., D'Addabbo, A.,et al. (1996 ). Correlation between neuropsychometric tests and semi-quantitative evaluation of the regional cerebral blood flow (rCBF) in a
group of outpatients affected by cognitive impairment. Archives of gerontology and geriatrics, 22-23(suppl.), 57-61.
52.Perry, R. J., & Hodges, J. R. (1999). Attention and executive deficits in Alzheimer's disease. A critical review. Brain, 122(3), 383-404.
53.Perry, R. J., Watson, P., & Hodges, J. R. (2000). The nature and staging of attention dysfunction in early (minimal and mild) Alzheimer’s disease: Relationship to
episodic and semantic memory impairment. Neuropsychology, 38, 252-271.
54.Portney, L. G., & Watkins, M. P. (2000). Foundations of clinical research: Applications to practice (2nd ed.). Upper Saddle River, NJ: Prentice Hall Health.
55.Reisberg, B. (1984). Stages of cognitive decline. American Journal of Nursing, 225-228.
56.Reitan, R. M. (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271-276.
57.Ribeiro, F., Guerreiro, M., & de Mendonca, A. (2007). Verbal learning and memory deficits in Mild Cognitive Impairment. Journal of Clinical Experimental Neuropsychology, 29(2), 187-197.
58.Salthouse, T. A. (2001) General and specific age-related influences on neuropsychological variables. In F. Boller, & J. Grafman, Handbook of Neuropsychology. (2nd ed.). New York: Elsevier Science.
59.Sands, L. P., Ferreira, P., Stewart, A. L., Brod, M., & Yaffe, K. (2004). What explains differences between dementia patients' and their caregivers' ratings of patients' quality of life? The American Journal Geriatric Psychiatry, 12(3), 272-280.
60.Sitzer, D. I., Twamley, E. W., & Jeste, D. V. (2006). Cognitive training in Alzheimer's disease: A meta-analysis of the literature. Acta Psychiatrica Scandinavica, 114(2), 75-90.
61.Solfrizzi, V., Panza, F., Torres, F., Capurso, C., D’Introno, A., Colacicco, A. M., et al. (2002). Selective attention skills in differentiating between Alzheimer’s disease and normal aging. Journal of Geriatric Psychiatry and Neurology, 15, 99-109.
62.Spreen, O., & Strauss, E. (1998). A compendium of neuropsychological tests (2nd ed.). New York: Oxford University Press.
63.Squire, L. R. (1987). Memory and brain. New York: Oxford University Press.
64.Squire, L., & Butters, N. (Eds.). (1992). Neuropsychology of memory (2nd ed.). New York: Guilford Press.
65.Stout, J. C., Bondi, M. W., Jernigan, T. L., Archibald, S. L., Delis, D. C., & Salmon, d. P. (1999). Regional cerebral volume loss associated with verbal learning and
memory in dementia of the Alzheimer’s type. Neuropsychology, 13, 188-197.
66.Tacq, J. (1979). Multivariate Analysis Techniques in Social Science Research. London: SAGE.
67.Tranel, D., Anderson, S. W., & Benton, A (1994). Development of the concept of“executive function” and its relationship to the frontal lobes. In F. Boller & J.
Grafman (Eds.), Handbook of Neurology (pp. 125-148). New York: Elsevier.
68.Vestberg, S., Passant, U., Risberg, J., & Elfgren, C. (2007). Personality characteristics and affective status related to cognitive test performance and gender in patients with memory complaints. Journal of the International Neuropsychological Society, 13(6), 911-919.
69.Wechsler, D. (1997). Wechsler memory scale (3rd ed.). San Antonio, TX: The Psychological Corporation.
70.Welsh, K., Butter, N, Hughes, J., Mohs, R., & Heyman, A. (1991). Detection of abnormal memory decline in mild cases of Alzheimer’s disease using CERAD neuropsychological measures. Archives of Neurology, 48, 278-281.
71.Wicklund, A. H., Johnson, N., Rademaker, A., Weitner, B. B., & Weintraub, S. (2006). Word list versus story memory in Alzheimer disease and frontotemporal dementia. American Disease and Associated Disorder, 20(2), 86-92.
72.Willis, S. L., Tennstedt, S. L., Marsiske, M., Ball, K., Elias, J., Koepke, K. M., et al. (2006). Long-term effects of cognitive training on everyday functional outcomes in older adult. The Journal of the American Medical Association, 296(23), 2805-2814.
73.Wilson, B. A. (2002). Towards a comprehensive model of cognitive rehabilitation. Neuropsychological Rehabilitation, 12(2), 97-110.
74.Wilson, B. A., Alderman, N., Burgess, P. W., Emslie, H., & Evan, J. J., (1996). Behavior assessment of the dysexecutive syndrome. London: Harcourt Assessment
75.Wood, R. L. & Fussey, I. (Eds.) (1990). Cognitive rehabilitation in perspective. New York: Burgess Science Press.
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