A 20-year tale on closing-in behavior in graphic copying tasks: Revisiting Della Sala's findings in new samples of patients with dementia and stroke

Abstract

Closing-in behavior (CIB) is characterized by the placement of the graphic copy near (Near CIB) or even on the top of (Overlap CIB) the stimulus to be reproduced. Although CIB has received little attention in the literature, Sergio Della Sala and colleagues made important contributions to the understanding of the phenomenon. They noted that CIB is often observed in Alzheimer's Disease but is also present in other forms of dementia and mild cognitive impairment and stroke; they argued that CIB may reflect a deficit in executive function, rather than working memory, and that the phenomenon occurs more frequently in dual task conditions. Importantly, they demonstrated that CIB may not be specific to copying but may instead reflect a general deficit in decoupling movement location from the focus of attention. In the present study, we explored these observations in a mixed sample of 106 participants (AD n = 37, frontal stroke n = 25, other forms of dementia n = 24, and normal controls n = 20). First, we confirmed that CIB is equally common in AD, other forms of dementia and frontal stroke. Second, we confirmed the association between CIB and executive function deficits. Third, we showed that individuals with CIB are more likely to exhibit the phenomenon in dual task situations, in which line-drawing is associated with an unrelated secondary task (tapping, counting, or counting backward). The present work supports and extends the contributions of Della Sala and colleagues demonstrating that CIB is enhanced when the general attentional load of the task increases.