Acquisition of an instrumental activity of daily living in patients with Korsakoff's syndrome: A comparison of trial and error and errorless learning

Abstract

Patients with Korsakoff's syndrome show devastating amnesia and executive deficits. Consequently, the ability to perform instrumental activities such as making coffee is frequently diminished. It is currently unknown whether patients with Korsakoff's syndrome are able to (re)learn instrumental activities. A good candidate for an effective teaching technique in Korsakoff's syndrome is errorless learning as it is based on intact implicit memory functioning. Therefore, the aim of the current study was two-fold: to investigate whether patients with Korsakoff's syndrome are able to (re)learn instrumental activities, and to compare the effectiveness of errorless learning with trial and error learning in the acquisition and maintenance of an instrumental activity, namely using a washing machine to do the laundry. Whereas initial learning performance in the errorless learning condition was superior, both intervention techniques resulted in similar improvement over eight learning sessions. Moreover, performance in a different spatial layout showed a comparable improvement. Notably, in follow-up sessions starting after four weeks without practice, performance was still elevated in the errorless learning condition, but not in the trial and error condition. The current study demonstrates that (re)learning and maintenance of an instrumental activity is possible in patients with Korsakoff's syndrome.

Keywords:

• Korsakoff's syndrome
• Amnesia
• Errorless learning
• Neuropsychological Rehabilitaton
• Cognitive Rehabilitation

We thank Ans Oosterwechel for her welcome support during our visit at Krönnenzommer, Hellendoorn. Special thanks are extended to Lieke van Nieuwenhuijzen and Mariska de Jong, our social workers during the project. We thank Esther den Haan, Tineke Keuzenkamp, Peter Muis, Helena Smit, Gerrit Nieuwenhuis, Lidy Bezemer, Angela Lau, Marloes Olivier and Carla Weg. We thank Jackelien Hollebrandse for advice.