Learning face-name associations in early-stage dementia: Comparing the effects of errorless learning and effortful processing

Some recent studies suggest that errorless learning principles may be beneficial in memory rehabilitation for people with dementia, while others indicate that effortful processing may be more important. The present study compared the effects of four different learning techniques, varying in level of effort required and number of errors elicited, on free recall, cued recall and recognition of novel and previously known associations among people with early-stage dementia. Ten participants with a diagnosis of early-stage Alzheimer's, vascular or mixed dementia learned novel and previously familiar face-name associations with each of four techniques - vanishing cues, forward cues, target selection, and paired associate learning - in a within-subjects design. All conditions produced significant learning for both novel and familiar associations. There were no significant differences between conditions, although mean scores were slightly higher for errorful conditions. Reducing errors did not produce any benefits. Enhancing level of effort had no significant effects for familiar associations, but high-effort conditions were significantly more effective than low-effort conditions in facilitating cued recall of novel associations. The results confirm that memory rehabilitation techniques can produce significant benefits, but do not support the view that error reduction during learning facilitates greater improvement in early-stage dementia. Effort enhancement may be more important, especially when learning novel associations.