Self-report prospective memory problems in people with stroke

Subjective memory measures: Metamemory questionnaires currently in use

Subjective memory evaluation is important for assessing memory abilities and complaints alongside objective measures. In research and clinical settings, questionnaires are used to examine perceived memory ability, memory complaints, and memory beliefs/knowledge. Although they provide a structured measure of self-reported memory, there is some debate as to whether subjective evaluation accurately reflects memory abilities. Specifically, the disconnect between subjective and objective memory measures remains a long-standing issue within the field. Thus, it is essential to evaluate the benefits and limitations of questionnaires that are currently in use. This review encompasses three categories of metamemory questionnaires: self-efficacy, complaints, and multidimensional questionnaires. Factors influencing self-evaluation of memory including knowledge and beliefs about memory, ability to evaluate memory, recent metamemory experiences, and affect are examined. The relationship between subjective and objective memory measures is explored, and considerations for future development and use of metamemory questionnaires are provided.

The Assessment and Prediction of Prospective Memory after Stroke

OBJECTIVE

Prospective memory (PM) is the memory used when intentions are to be carried out in the future. Little research has been conducted examining PM after stroke. This study aimed to determine if PM is impaired after stroke through comparison of individuals with stroke to healthy controls. Additionally, it aimed to explore the predictors of PM performance post-stroke.

METHOD

Twenty-eight individuals with stroke and 27 neurologically healthy controls completed the Cambridge Prospective Memory Test (CAMPROMPT), 2 self-report PM questionnaires, and multiple cognitive measures.

RESULTS

Individuals with stroke performed significantly lower on both event- and time-based PM than controls on the CAMPROMPT, indicating PM impairment. Event-based PM after stroke was significantly predicted by age, retrospective memory (RM), and global cognitive function, whereas time-based PM was only predicted by the metacognitive skill of note-taking. Age and note-taking predicted time-based PM for controls, whereas only age predicted event-based PM for control participants.

CONCLUSIONS

The findings of this study have helped to confirm that PM impairment does exist after stroke, particularly when using a standardised PM measure. Furthermore, PM impairment may be predicted by variables, such as age, strategy use, RM, and cognitive ability.

Self-reported prospective memory after stroke

Prospective Memory (PM) is the memory for completing future intentions. This study aimed to compare self-reported PM of individuals with stroke to healthy controls, to determine if PM is impaired after stroke. Additionally, self-reported PM for individuals with stroke was compared to significant-other reports, ascertaining a level of self-awareness of PM function. Twenty-eight individuals with stroke, 25 significant-others, and 27 healthy controls completed the Brief Assessment of PM (BAPM) and the Prospective and Retrospective Memory Questionnaire (PRMQ) as part of a larger study. Individuals with stroke reported significantly more Basic Activities of Daily Living (BADL) PM failures compared to controls on Part A of the BAPM. On Part B, individuals with stroke reported BADL PM failures to be less problematic/important than controls, suggesting a lack of self-awareness into the consequences of PM failure. Individuals with stroke also reported significantly more PM and RM failures compared to controls on the PRMQ. No significant differences were found between individuals with stroke and their significant-others on both the BAPM and PRMQ. Results of this study helped to clarify the previous research and highlighted that individuals with stroke reported more PM failures than controls but underestimated the importance of such memory lapses.

Systematic review of subjective memory measures to inform assessing memory limitations after stroke and stroke-related aphasia

AIM

Primary aims of this systematic review were to: (1) identify the range of subjective memory measures used in the stroke and stroke-related aphasia literature and (2) critically appraise their psychometric properties as well as (3) the methodological qualities of studies that included them, (4) investigate whether such measures provide an accurate reflection of memory impairments (i.e., in comparison to norms from age-matched, neurotypical participants), (5) document the representation of individuals with stroke-related aphasia, and (6) examine the extent to which subjective memory measures correlate with objective memory measures.

METHODS

Systematic review of the literature from 1970 to June 2019 using a comprehensive range of relevant search terms in EMBASE, Medline, PsychINFO, SCOPUS, and Web of Science. Eligibility criteria were for studies to include adults who had suffered of clinical stroke, to report a subjective memory measure that was completed by the stroke survivors, to be reported in a peer-reviewed journal, and to be published in English or Dutch. Quality appraisal was carried out for the included studies as well as the subjective memory measures they employed.

RESULTS

A total of 7,077 titles or abstracts were screened, with 41 studies included in the quantitative and qualitative synthesis. Twenty-six subjective memory measures were used in the included studies. The critical appraisal of their psychometric properties and the methodological quality of the included studies revealed significant shortcomings; for example, neurotypical participants were included in only 14 of the 41 studies. When statistical comparisons were made, different outcomes arose. Only eight studies statistically compared subjective with objective memory measures.

CONCLUSIONS

This literature domain currently provides an unclear picture as to how memory limitations affect participation in stroke and stroke-related aphasia.IMPLICATIONS FOR REHABILITATIONA broad range of subjective memory measures have been used to determine stroke survivors' perceptions of their everyday memory issues.Because of psychometric weaknesses such as inadequate reliability and cross-cultural validity among subjective memory measures, there remains a need to carefully review a given measure's properties to determine if it is appropriate for use with a given stroke survivor.Stroke survivors with aphasia have been infrequently included or inadequately described in studies of subjective memory measures, and thus how these individuals perceive their everyday memory abilities requires further investigation.Although the relationship between subjective and objective memory measures has been infrequently investigated by stroke researchers, both types of measures should be considered as they likely offer complementary rather than redundant information about stroke survivors' memory abilities.

A review of prospective memory in individuals with acquired brain injury

OBJECTIVE

Prospective memory (PM) deficits have emerged as an important predictor of difficulty in daily life for individuals with acquired brain injury (BI). This review examines the variables that have been found to influence PM performance in this population. In addition, current methods of assessment are reviewed with a focus on clinical measures. Finally, cognitive rehabilitation therapies are reviewed, including compensatory, restorative and metacognitive approaches.

METHOD

Preferred reporting items for systematic reviews and meta-analyses guidelines were used to identify studies. Studies were added that were identified from the reference lists of these.

RESULTS

Research has begun to elucidate the contributing variables to PM deficits after BI, such as attention, executive function and retrospective memory components. Imaging studies have identified prefrontal deficits, especially in the region of BA10 as contributing to these deficits. There are now several clinical measures available with good psychometric properties. Rehabilitation techniques have mostly focused on compensatory strategies, but, in addition, some restorative and metacognitive approaches have shown preliminary promise.

CONCLUSIONS

PM deficits are a common and important deficit after BI. Clinical evaluation is recommended and further understanding of rehabilitation techniques is needed.

Prospective Memory After Stroke: A Scoping Review

The aim of this paper was to review the limited, but growing, literature on prospective memory (PM) following stroke using a scoping study methodology. Multiple databases were systematically searched and yielded 11 studies that were classified as observational (n = 7) or intervention studies (n = 4) and reviewed for quality. PM impairment after stroke was more commonly identified using behavioural measures compared to self-report measures. There were mixed findings regarding the extent and nature of PM impairment poststroke; however, more studies reported impairment for time-based PM, compared to both event- and activity-based PM. Studies examining rehabilitative techniques for PM resulted in mixed findings and were limited as most were case studies of poor methodological quality. Overall previous research in this area was limited as most studies were often underpowered due to small sample sizes, or used single-item measures which may not be robust enough to reliably measure PM impairment. Additionally, the methods used to measure PM were varied and many studies did not control for retrospective memory impairment, which could impact the results, as PM has both a retrospective (remembering both the action and when it needs to be completed) and prospective component (remembering to perform the action when appropriate). In conclusion, PM impairment is apparent poststroke, specifically for time-based PM. However, more research is needed to determine why PM impairment occurs, and how it can be improved.