Knowing what for, but not where: Dissociation between functional and contextual tool knowledge in healthy individuals and patients with dementia

Objective:Semantic tool knowledge underlies the ability to perform activities of daily living. Models of apraxia have emphasized the role of functional knowledge about the action performed with tools (e.g., a hammer and a mallet allow a hammering action), and contextual knowledge informing individuals about where to find tools in the social space (e.g., a hammer and a mallet can be found in a workshop). The goal of this study was to test whether contextual or functional knowledge, would be central in the organization of tool knowledge. It was assumed that contextual knowledge would be more salient than functional knowledge for healthy controls and that patients with dementia would show impaired contextual knowledge.Methods:We created an original, open-ended categorization task with ambiguity, in which the same familiar tools could be matched on either contextual or functional criteria.Results:In our findings, healthy controls prioritized a contextual, over a functional criterion. Patients with dementia had normal visual categorization skills (as demonstrated by an original picture categorization task), yet they made less contextual, but more functional associations than healthy controls.Conclusion:The findings support a dissociation between functional knowledge (what for) on the one hand, and contextual knowledge (where) on the other hand. While functional knowledge may be distributed across semantic and action-related factors, contextual knowledge may actually be the name of higher-order social norms applied to tool knowledge. These findings may encourage researchers to test both functional and contextual knowledge to diagnose semantic deficits and to use open-ended categorization tests.

Automated summary

This study aimed to test the importance of contextual and functional knowledge in the organization of tool knowledge. The findings showed that healthy controls prioritized contextual knowledge, while patients with dementia had impaired contextual knowledge. The results suggest a dissociation between functional and contextual knowledge in tool knowledge, with contextual knowledge possibly involving higher-order social norms.