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Rekers S, Heine J, Thöne-Otto AIT, Finke C. Neuropsychiatric symptoms and metamemory across the life span: psychometric properties of the German Multifactorial Memory Questionnaire (MMQ). J Neurol 2024; 271:4551-4565. [PMID: 38717611 PMCID: PMC11233313 DOI: 10.1007/s00415-024-12402-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVE We assessed the psychometric properties, established normative data for the German Multifactorial Memory Questionnaire (MMQ), and analyzed its association with neuropsychiatric factors across the life span to provide a validated metamemory assessment for a German-speaking population. METHODS The three MMQ scales (memory satisfaction, self-rated ability, and strategy application) were translated into German, considering cultural, linguistic, and conceptual aspects. To validate the MMQ and assess associations with neuropsychiatric factors, the Complainer Profile Identification, Geriatric Depression Scale, Beck Anxiety Inventory, Pittsburgh Sleep Quality Index, and Short-Form-Health Survey were applied in an online study in 336 healthy participants with follow-up after 8 months. RESULTS Psychometric evaluation of the German MMQ showed normal distribution of all scales and good to excellent validity, internal consistency, and retest reliability. We provide percentiles and normative data for z-score conversion. Importantly, even subclinically elevated scores in depressiveness and anxiety were associated with decreased memory satisfaction and self-rated ability. Furthermore, although the influence of age on the German MMQ scales was minimal, effects of neuropsychiatric factors such as sleep quality, anxiety, and depressiveness on MMQ Satisfaction and Ability varied across the life span. CONCLUSIONS Our study provides a validated German translation of the MMQ with normative data and reliability measures, including reliable change scores. We show the impact of neuropsychiatric factors on the MMQ scales across the life span and emphasize the relevance of a multifactorial approach to metamemory as a measure of individualized everyday functionality and the importance of including neuropsychiatric factors into both research and clinical assessments of metamemory.
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Affiliation(s)
- Sophia Rekers
- Department of Neurology, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Josephine Heine
- Department of Neurology, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Angelika I T Thöne-Otto
- Clinic for Cognitive Neurology, University of Leipzig, Max-Planck-Institute of Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Carsten Finke
- Department of Neurology, Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
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Silverberg ND, Rush BK. Neuropsychological evaluation of functional cognitive disorder: A narrative review. Clin Neuropsychol 2024; 38:302-325. [PMID: 37369579 DOI: 10.1080/13854046.2023.2228527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023]
Abstract
Objective: To critically review contemporary theoretical models, diagnostic approaches, clinical features, and assessment findings in Functional Cognitive Disorder (FCD), and make recommendations for neuropsychological evaluation of this condition. Method: Narrative review. Results: FCD is common in neuropsychological practice. It is characterized by cognitive symptoms that are not better explained by another medical or psychiatric disorder. The cognitive symptoms are associated with distress and/or limitations in daily functioning, but are potentially reversible with appropriate identification and treatment. Historically, a variety of diagnostic frameworks have attempted to capture this condition. A contemporary conceptualization of FCD positions it as a subtype of Functional Neurological Disorder, with shared and unique etiological factors. Patients with FCD tend to perform normally on neuropsychological testing or demonstrate relatively weak memory acquisition (e.g. list learning trials) in comparison to strong attention and delayed recall performance. Careful history-taking and behavioral observations are essential to support the diagnosis of FCD. Areas of ongoing controversy include operationalizing "internal inconsistencies" and the role of performance validity testing. Evidence for targeted interventions remains scarce. Conclusions: Neuropsychologists familiar with FCD can uniquely contribute to the care of patients with this condition by improving diagnostic clarity, richening case formulation, communicating effectively with referrers, and leading clinical management. Further research is needed to refine diagnosis, prognosis, and treatment.
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Affiliation(s)
- Noah D Silverberg
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada
- Djavad Mowafaghian Centre for Brain Health, Vancouver, British Columbia, Canada
| | - Beth K Rush
- Department of Psychiatry & Psychology, Mayo Clinic, Jacksonville, Florida, USA
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Hatch S, Finlayson M, Rej S, Kessler D. Virtually-Delivered Emotion Focused Mindfulness Therapy (EFMT) Group vs. Wait-List Control for Late-Life Anxiety: A Randomized Controlled Trial. Am J Geriatr Psychiatry 2023; 31:767-782. [PMID: 37169708 DOI: 10.1016/j.jagp.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND The worldwide annual prevalence of anxiety in older adults is estimated to be between 6% and 10%. Emotion Focused Mindfulness Therapy (EFMT) is a mindfulness-based group intervention that has been demonstrated to reduce symptoms of anxiety in community dwelling adults. No study has yet assessed EFMT for older adults with late-life anxiety. The aim of this study was to determine the feasibility of video-delivered group EFMT for older adults living in community settings, a novel and potentially scalable intervention. METHODS This was a feasibility randomized controlled trial (RCT) of 48 older adults (≥55 years old), recruited through primary care, community organizations and snowball methods. Participants were randomized to group EFMT delivered by Zoom vs. a wait-list control. Data were collected at baseline (T1), 9 weeks following baseline (T2, primary study endpoint) and 17 weeks following baseline (T3). Random allocation was conducted immediately after each group of 12 participants had been enrolled into the trial, with groups beginning on a rolling basis each time a block of 12 participants had been enrolled. The main efficacy outcome examined changes over time to anxiety. RESULTS Recruitment was successfully completed in 32 weeks. Enrollment was calculated at 62.3% (48 of 77 people screened). Retention (80.0%) and adherence (100.0% for intervention group participants) were excellent. The EFMT group had significant improvements in anxiety at T2 compared to the wait-list control group (-3.47 [4.12] vs.-1.22 [3.25] points, p = 0.05). CONCLUSIONS Virtually-delivered EFMT appears to be a feasible, acceptable, and efficacious group treatment to improve late-life anxiety.
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Affiliation(s)
- Stacey Hatch
- Aging and Health Program (SH, MF, DK), School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada.
| | - Marcia Finlayson
- Aging and Health Program (SH, MF, DK), School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Soham Rej
- Department of Psychiatry (SR), Lady Davis Institute/Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Dorothy Kessler
- Aging and Health Program (SH, MF, DK), School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
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Csábi E, Hallgató E, Volosin M. The association between metamemory, subjective memory complaints, mood, and well-being: the Hungarian validation of Multifactorial Memory Questionnaire. Cogn Res Princ Implic 2023; 8:15. [PMID: 36786909 PMCID: PMC9928992 DOI: 10.1186/s41235-023-00469-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 01/19/2023] [Indexed: 02/15/2023] Open
Abstract
The current study addressed the relationship between subjective memory complaints and negative affect, well-being, and demographic variables by investigating the Hungarian version of Multifactorial Memory Questionnaire. The original factor structure showed a poor fit on our data; therefore, principal component analysis was conducted on data from 577 participants, ranging in age from 18 to 92 years. Our analysis provided a six-component solution: Satisfaction, Retrospective memory mistakes, Prospective memory mistakes, External Strategies, Internal Strategies, and Frustration. To improve the reliability and internal consistency indicators we created four subscales by combining Frustration with Satisfaction, and Retrospective and Prospective memory mistakes subscales. Thus, we were able to preserve the factor structure similar to the original. Subjective memory complaints were correlated positively with anxiety and depression and were associated negatively with well-being. We found a slight positive correlation between age and memory ability, and age was associated negatively with the frequency of external strategy use. Individuals with higher education were satisfied with their memory, used more frequent external strategies. Furthermore, men were more satisfied with their memory and reported better memory ability, while women tended to use more external and internal strategies. Women also showed a higher level of anxiety and depression than men. In conclusion, self-reported memory changes are of particular importance because of their association with perceived mental health status and implications for later disease development.
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Affiliation(s)
- Eszter Csábi
- Institute of Psychology, University of Szeged, Egyetem Utca 2, Szeged, 6722, Hungary.
| | - Emese Hallgató
- grid.9008.10000 0001 1016 9625Present Address: Institute of Psychology, University of Szeged, Egyetem Utca 2, Szeged, 6722 Hungary
| | - Márta Volosin
- grid.9008.10000 0001 1016 9625Present Address: Institute of Psychology, University of Szeged, Egyetem Utca 2, Szeged, 6722 Hungary ,grid.425578.90000 0004 0512 3755Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Magyar Tudósok Körútja 2, Budapest, 1117 Hungary
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Yang HL, Chou KR, Lee SC, Lin PH, Chiang HY. Test-Retest Reliability and Random Measurement Error of the Multifactorial Memory Questionnaire in Older Adults With Subjective Memory Complaints. Gerontol Geriatr Med 2023; 9:23337214231171981. [PMID: 37361030 PMCID: PMC10286540 DOI: 10.1177/23337214231171981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/26/2023] [Accepted: 04/03/2023] [Indexed: 06/28/2023] Open
Abstract
To examine the psychometric properties of the Multifactorial Memory Questionnaire (MMQ) in older adults with subjective memory complaints. The three MMQ subscale (Satisfaction, Ability, and Strategy) was administered twice, with a 3-month interval. The test-retest reliability was examined using intraclass correlation coefficients (ICCs). The random measurement error was examined by calculating the standard error of measurement (SEM) and minimal detectable change (MDC95). The test-retest reliabilities of the three MMQ subscales were generally acceptable. The SEM of the three MMQ subscales was higher than the acceptable criterion of 10%. Despite the influence of random measurement error, the change scores of the three MMQ subscales may represent true changes if they are larger than the MDC95 of 13.2 (Satisfaction), 18.4 (Ability), and 16.9 (Strategy). The MMQ appears to be a reliable measure for use in research settings, but may not yet be suitable for clinical use.
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Affiliation(s)
| | - Kuei-Ru Chou
- Taipei Medical University
- Taipei Medical University-Shuang Ho Hospital
- Taipei Medical University Hospital
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McGarrigle R, Knight S, Hornsby BWY, Mattys S. Predictors of Listening-Related Fatigue Across the Adult Life Span. Psychol Sci 2021; 32:1937-1951. [PMID: 34751602 DOI: 10.1177/09567976211016410] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Listening-related fatigue is a potentially serious negative consequence of an aging auditory and cognitive system. However, the impact of age on listening-related fatigue and the factors underpinning any such effect remain unexplored. Using data from a large sample of adults (N = 281), we conducted a conditional process analysis to examine potential mediators and moderators of age-related changes in listening-related fatigue. Mediation analyses revealed opposing effects of age on listening-related fatigue: Older adults with greater perceived hearing impairment tended to report increased listening-related fatigue. However, aging was otherwise associated with decreased listening-related fatigue via reductions in both mood disturbance and sensory-processing sensitivity. Results suggested that the effect of auditory attention ability on listening-related fatigue was moderated by sensory-processing sensitivity; for individuals with high sensory-processing sensitivity, better auditory attention ability was associated with increased fatigue. These findings shed light on the perceptual, cognitive, and psychological factors underlying age-related changes in listening-related fatigue.
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Affiliation(s)
- Ronan McGarrigle
- Department of Psychology, University of York.,Department of Psychology, University of Bradford
| | | | - Benjamin W Y Hornsby
- Department of Hearing and Speech Sciences, Vanderbilt University School of Medicine
| | - Sven Mattys
- Department of Psychology, University of York
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The Impact of Memory Change on Everyday Life Among Older Adults: Association with Cognition and Self-Reported Memory. J Int Neuropsychol Soc 2021; 27:896-904. [PMID: 33441202 DOI: 10.1017/s1355617720001344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Many older adults experience memory changes that can have a meaningful impact on their everyday lives, such as restrictions to lifestyle activities and negative emotions. Older adults also report a variety of positive coping responses that help them manage these changes. The purpose of this study was to determine how objective cognitive performance and self-reported memory are related to the everyday impact of memory change. METHODS We examined these associations in a sample of 94 older adults (age 60-89, 52% female) along a cognitive ability continuum from normal cognition to mild cognitive impairment. RESULTS Correlational analyses revealed that greater restrictions to lifestyle activities (|rs| = .36-.66), more negative emotion associated with memory change (|rs| = .27-.76), and an overall greater burden of memory change on everyday living (|rs| = .28-.61) were associated with poorer objective memory performance and lower self-reported memory ability and satisfaction. Performance on objective measures of executive attention was unrelated to the impact of memory change. Self-reported strategy use was positively related to positive coping with memory change (|r| = .26), but self-reported strategy use was associated with more negative emotions regarding memory change (|r| = .23). CONCLUSIONS Given the prevalence of memory complaints among older adults, it is important to understand the experience of memory change and its impact on everyday functioning in order to develop services that target the specific needs of this population.
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Hatch S, Kessler D, Finlayson M, Rej S. Video-delivered emotion-focused mindfulness therapy for late- life anxiety: study protocol for a feasibility randomized controlled trial. Pilot Feasibility Stud 2021; 7:169. [PMID: 34479632 PMCID: PMC8413357 DOI: 10.1186/s40814-021-00905-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 08/20/2021] [Indexed: 12/22/2022] Open
Abstract
Background The worldwide prevalence of anxiety in older adults is estimated at between 6 and 10%. In Canada, adults 65 and older experience anxiety at a rate of 6.4%, affecting more than 300,000 people. Anxiety in older adults has been linked to difficulties retaining new information and engaging in instrumental daily activities of living. Due to COVID-19 restrictions, novel methods of delivering therapy programs remotely are needed; however, data is limited. There is some evidence that older adults prefer non-pharmacological approaches for anxiety that can be delivered in the community. Emotion-focused mindfulness therapy (EFMT) is a mindfulness-based intervention that emphasizes meditation and observing thoughts and emotions as they arise. This emphasis has been demonstrated to reduce symptoms of anxiety in general populations. This study aims to evaluate the feasibility of EFMT with older adults. Methods This pilot feasibility randomized controlled trial will use a wait list control trial design. Due to COVID-19 restrictions, we will use telehealth delivery via Zoom rather than in-person delivery. The first 48 people to meet the eligibility criteria will be randomly allocated to either receive EFMT immediately, or in approximately 8 weeks time from enrollment (1:1 allocation ratio). Data will be collected at baseline, 8 weeks following baseline, and 16 weeks following baseline. The primary outcomes will determine the feasibility of the intervention based on recruitment, enrolment, retention, and adherence to all components of the intervention. The secondary outcome will be changes to anxiety over time. Discussion The results of this trial will determine the feasibility and potential effectiveness of video-delivered EFMT for late-life anxiety compared to no treatment. If the results are promising, a larger randomized controlled trial may be conducted. Trial registration ClinicalTrials.gov, NCT04415528. Registered on June 4, 2020 Protocol version Protocol version 2, January 2, 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-021-00905-0.
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Affiliation(s)
- Stacey Hatch
- Aging and Health Program, School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, 31 George St, Kingston, Ontario, K7L 3N6, Canada.
| | - Dorothy Kessler
- Aging and Health Program, School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, 31 George St, Kingston, Ontario, K7L 3N6, Canada
| | - Marcia Finlayson
- Aging and Health Program, School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, 31 George St, Kingston, Ontario, K7L 3N6, Canada
| | - Soham Rej
- Department of Psychiatry, Lady Davis Institute /Jewish General Hospital, McGill University, 3755 Chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E2, Canada
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Shaikh KT, Tatham EL, Rich JB, Troyer AK. Examining the factor structure of the Multifactorial Memory Questionnaire. Memory 2021; 29:255-260. [PMID: 33480308 DOI: 10.1080/09658211.2021.1874995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Many adults report memory changes as they age. The Multifactorial Memory Questionnaire (MMQ) measures different aspects of self-reported memory, including satisfaction with one's memory, self-appraisal of memory ability, and compensatory strategy use. This questionnaire has been extensively used for clinical and research purposes, with studies reporting differences in the factor structure (three or four factors) underlying this measure. The current study evaluates previously reported factor configurations of the MMQ using best measurement practices. Confirmatory factor analyses were conducted on data from 560 cognitively - normal adults, ranging in age from 50 to 90 years old. Our results demonstrate support for both 3-factor model (with Satisfaction, Ability and Strategy scales) and 4-factor model structure (with Satisfaction, Ability, Internal Strategy and External Strategy scales) of this instrument. These results harmonise the existing literature which, in separate studies using exploratory analyses, supports the validity of one model or the other. The confirmation of multiple Strategy scales will provide clinicians and researchers with additional relevant information about how older adults compensate for their memory changes, enabling a broader understanding of the experience of age-related memory change. We contextualise these results within existing research identifying conceptual differences between internal and external strategy implementation.
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Affiliation(s)
- Komal T Shaikh
- Department of Psychology, York University, Toronto, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Erica L Tatham
- Department of Psychology, York University, Toronto, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Jill B Rich
- Department of Psychology, York University, Toronto, Canada.,Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada
| | - Angela K Troyer
- Neuropsychology and Cognitive Health Program, Baycrest Health Sciences, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
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