Cooking “Shrimp à la Créole”: A pilot study of an ecological rehabilitation in semantic dementia

Abstract

New learning in semantic dementia (SD) seems to be tied to a specific temporal and spatial context. Thus, cognitive rehabilitation could capitalise upon preserved episodic memory and focus on everyday activities which, once learned, will have an impact in everyday life. This pilot study thus explores the effectiveness of an ecological approach in one patient suffering from SD. EC, a 68-year-old woman with SD, stopped cooking complex meals due to a substantial loss of knowledge related to all food types. The therapy consisted of preparing a target recipe. She was asked to generate semantic attributes of ingredients found in one target, one control and two no-therapy recipes. The number of recipes cooked by EC between therapy sessions was computed. She was also asked to prepare a generalisation recipe combining ingredients from the target and control recipes. EC's generated semantic attributes (GSA) of ingredients pertaining to the target and control recipes increased significantly (p < .001), compared to the no-therapy recipes (ps > .79). The proportion of meals cooked also increased significantly (p = .021). For the generalisation recipe, she could not succeed without assistance. Frequent food preparation may have provided EC with new memories about the context, usage and appearance of some concepts. These memories seem very context-bound, but EC nonetheless re-introduced some recipes into her day-to-day life. The impact of these results on the relationship between semantic, episodic and procedural memory is discussed, as well as the relevance of an ecological approach in SD.

Keywords:

• Semantic memory
• Episodic memory
• Semantic dementia
• Rehabilitation
• Activities of daily living

Acknowledgments

The SemAssist Team was composed of Pierre-Yves Groussard, Céline Deschenaux, Jeremy Milhau, Patrice C. Roy, Farah Arab, Belkacem Chikhaoui, Soumaya Medini, Mohamed Firas Kammoun, and Yassine Parakh.

 Nathalie Bier is now at the École de réadaptation of the Université de Montréal, Québec, Canada, and at the Centre de recherche de l'Institut universitaire de gériatrie de Montréal.

 N. Bier and C. Bottari were supported by postdoctoral fellowship awards from the Canadian Institutes of Health Research. The authors wish to thank EC, her family and her caregiver for her participation in this study. Also, we would like to thank Jacinthe Lacombe for her help in collecting neuropsychological data.