Everyday Memory Failures in Older Adults with Amnestic Mild Cognitive Impairment

Psychometric properties of the Arabic version of the everyday memory questionnaire - revised (EMQ-R) among the Lebanese population

Objective: This study aimed to evaluate the psychometric properties of the Arabic version of the Everyday Memory Questionnaire- Revised (EMQ-R-A) in a sample of Lebanese adults. Methods: A cross-sectional study was conducted in August 2023. A diverse sample of 483 Lebanese adults aged 18 to 60 years from all Lebanese governorates was recruited. Participants completed an Arabic-language questionnaire comprising three sections: socio-demographic characteristics, health-related inquiries, the EMQ-R-A and the Arabic version of the Prospective and Retrospective Memory Questionnaire (PRMQ). Results: The study's findings indicated that the EMQ-R-A displayed strong internal consistency (Cronbach's alpha = 0.925). Convergent validity was supported by a significant correlation with PRMQ. Test-retest results demonstrated strong reliability with a Cronbach's alpha of 0.925. Confirmatory factor analysis revealed a three-factor model including retrieval related factors, attentional tracking related factors, and other factors. The factors labeled "Retrieval" and "Attentional Tracking" elucidate aspects of memory retrieval system efficacy and attention-related challenges. Higher EMQ-R-A scores were found to be associated with the female gender, lower attention, physical inactivity, lower educational levels, and higher number of comorbid disorders. Conclusion: The EMQ-R-A exhibits good validity and reliability. The identified factors associated with memory decline underscore the importance of addressing lifestyle factors, such as promoting physical activity, better educational attainment, and addressing comorbid health conditions, to potentially mitigate memory challenges.

Prospective Memory Training in Older Adults: A Systematic Review and Meta-Analysis

Prospective memory (PM), which enables one to remember to carry out delayed intentions, is crucial for everyday functioning. PM commonly deteriorates upon cognitive decline in older adults, but several studies have shown that PM in older adults can be improved by training. The current study aimed to summarise this evidence by conducting a qualitative systematic analysis and quantitative meta-analysis of the effects of PM training in older adults, for which systematic searches were conducted across seven databases (Cochrane Library, Embase, PubMed, PsycInfo, Web of Science, CINAHL and Scopus). Forty-eight studies were included in the qualitative analysis, and 43% of the assessed PM training interventions showed positive gains in enhancing PM. However, the methodological quality varied across the studies, with 41% of the non-randomised control trials (non-RCTs) rated as having either serious or critical risk of bias. Therefore, only 29 RCTs were included in the subsequent quantitative meta-analysis. We found a significant and moderate immediate efficacy (Hedges' g = 0.54) of PM training in enhancing PM performance in older adults, but no significant long-term efficacy (Hedges' g = 0.21). Two subgroup analyses also revealed a robust training efficacy across the study population (i.e., healthy and clinical population) and the number of training sessions (i.e., single session and programme-based). Overall, this study provided positive evidence to support PM training in older adults. Further studies are warranted to explore the mechanisms by which PM training exerts its effects, and better-quality RCTs are needed to provide more robust evidence supporting our findings.

A systematic review of the application of a diary for people with dementia: how to maximise the effect of diary use?

Diaries have been widely used among people with dementia as a data collection tool and memory aid. An understanding of their usage is conducive to the subsequent development of intervention measures, but comprehensive evidence is still lacking. This review synthesises the existing literature to obtain an in-depth understanding of the positive and negative effects of diary usage among people with dementia and the influencing factors. The data were collected from eight databases from the inception of each database to November 2020. A thematic synthesis method was used to sort and summarise the included studies. Ten studies were chosen for the review. The following three analytical themes were identified: (i) positive changes; (ii) factors affecting the record; and (iii) negative feelings. Diaries can cause positive changes in people with dementia, but the specific patterns of stimulation and changes over time remain to be explored. Furthermore, researchers should encourage patients and their families to have a correct understanding of the diary, improve their motivation and social support, fully use the positive effects of the diary, and reduce the occurrence of negative effects. Medical staff should help caregivers improve their awareness of the usefulness and ease of the diary and encourage them to provide support and companionship to people with dementia while exhibiting a positive attitude.

Lived experience of neuropsychiatric symptoms among females with mild cognitive impairment: A phenomenological study

AIMS

To explore the lived experience of neuropsychiatric symptoms (NPS) among females with mild cognitive impairment (MCI).

DESIGN

A phenomenological study using individual, semi-structured, telephone-based interviews was conducted to explore how the NPS are aroused, evolve, and affect the overall well-being, illness perception and the corresponding coping responses adopted by females with MCI.

METHODS

Twenty-nine participants with MCI were recruited from the community setting in Hong Kong between March and October 2020. Interviews were audio-recorded, transcribed verbatim, and analysed using an interpretative phenomenological analysis approach and constant comparison strategy.

RESULTS

Three themes were identified: (1) living vigilant lives with threats and uncertainty, (2) snowballing into further negative emotions and (3) seeking outlets for negative emotions. Our findings suggested that the participants' cognitive, functional and social challenges aroused intense emotional responses such as depression, agitation and anxiety. These noting negative emotions were further perpetuated by maladaptive coping responses, unrealistic expectations from coping strategies and overwhelming disease burden. Various internal and external strategies were adopted to enhance emotional adaptation, of which adopting a positive attitude appeared to be the most promising strategy.

CONCLUSION

This study shed light on the challenging experience of MCI. The cognitive afflictions and the resultant impacts on various life domains evoked a cluster of NPS. Support services need to enhance emotional adjustment through alleviating the various life stressors and strengthening the coping resources.

IMPACT

Elucidating the lived experience of NPS provides important insights into the development of a more effective, comprehensive and person-centred care planning for the population with MCI. Holistic care planning should extend beyond cognitive health optimization into enhancing disease knowledge, improve emotional coping, rebuild self-identity and bolstering social supports among this preclinical cohort.

Enhancing cue salience improves aspects of naturalistic time-based prospective memory in older adults with HIV disease

OBJECTIVE

Older persons living with HIV (PLWH) disease commonly experience failures of time-based prospective memory (PM) in their daily lives. This study examined the benefits of providing strategic supports at encoding, monitoring, and cue detection for naturalistic time-based PM among older PLWH.

METHOD

Participants included 116 older PLWH and 48 seronegatives who completed a baseline neuropsychological evaluation (see Woods et al., 2020), including a laboratory PM experiment that paralleled the design of the current naturalistic study. The naturalistic time-based PM task required participants to press a button on a portable PM response box 4 times per day for 1 month. PLWH were randomly assigned to an unsupported control condition or to an experimental group in which strategic processing was supported at encoding (implementation intentions and visualization), monitoring (content-free cuing), and/or cue detection (auditory alarm). The seronegative participants were all assigned to the unsupported control group.

RESULTS

In a model adjusting for age and affective disorders, PLWH who received all three supports in combination demonstrated moderately better naturalistic time-based PM accuracy as compared with PLWH controls. Both the cue detection and combination conditions were associated with markedly more precise response timing on the naturalistic time-based PM task. Supported PM accuracy as measured in the laboratory was positively associated with naturalistic PM accuracy among PLWH in the experimental groups.

CONCLUSIONS

Providing strategic supports to enhance the cue salience of naturalistic time-based PM tasks may improve both the accuracy and timing with which older PLWH remember to perform time-based intentions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Everyday memory failures across adulthood: Implications for the age prospective memory paradox

Despite the prevalence of everyday memory failures, little is known about which specific types have the strongest impact on everyday life, and whether their impact changes across adulthood. An investigation of memory failures at different ages is particularly informative to disentangle the age paradox in prospective memory, which seems to suggest that remembering to perform intended actions in everyday life improves with age. Therefore, 58 young adults, 40 middle-aged adults, and 54 elderly adults recorded their memory failures as and when they occurred during a 7-day period, and described how serious and consequential they were. Failures were coded into several subcategories of retrospective memory, prospective memory, and absent-minded lapses. It was prospective memory lapses that were overall the most common, serious and consequential ones. Young adults had substantially more prospective memory failures than the elderly and middle-aged adults who did not differ from each other. A young adult disadvantage still held up when lifestyle differences between young adults and the elderly were taken into account. Our findings support the age-related benefit previously found in naturalistic prospective memory tasks, and suggest that it is robust across various types of prospective memory tasks. The results also suggest that the benefit may result from both young adults having poor everyday prospective memory, compared to any adults of a greater age, and everyday prospective memory being spared from age-related decline between the middle and late adulthood.

Prospective memory errors in everyday life: does instruction matter?

Previous research on prospective memory (PM, the ability to remember executing an intention in the future) suggests that PM errors constitute the majority of all everyday memory errors in younger adults. However, no study so far has investigated this ratio from an ageing perspective, nor examined whether different instructions may influence PM error reporting. In the present study, 64 younger and 64 older adults completed a 5-day diary on PM, memory and cognition errors following different reporting instructions: participants had to either focus on (1) PM errors only, (2) any daily memory errors (prospective or retrospective) or (3) any kind of cognitive error. Error descriptions were coded into subcategories and analysed both quantitatively and qualitatively. Independently of given instructions, PM was the most frequent everyday error for both age groups. Overall, results confirm age differences for everyday PM (but not for retrospective memory and cognition), suggesting that everyday PM might be spared from age-related decline. From a qualitative point of view, there seem to be differences in the type of missed intentions, which correspond with existent theories of ageing. In conclusion, the present study allowed for a deeper insight into everyday PM functioning in younger and older adults.