Background: Little is known about the means by which older adults achieve memory-demanding goals in everyday life or alternatively about why they fail to do so. Objectives: We conducted qualitative interviews to evaluate what older people do to support everyday memory functioning. A principal focus was on understanding the ways in which individuals use internal memory strategies and external memory aids. Methods: We interviewed 25 community-dwelling older adults (mean age 70 years) in a semi-structured interview. The transcribed results were coded by extracting segments of the interviews and classifying the responses into emergent categories. All coded interview segments were reviewed by category. Memos were created and relevant themes identified. Results: The older adults reported everyday memory failures (such as forgetting names), often without nominating explicit methods for avoiding these problems. They also reported using a number of external memory aids such as calendars and lists. Our interviews indicated this use was typically a part of complex routines and habits of living that often seemed vulnerable to errors. For instance, people would report filling medication organizers or completing to-do lists without mentioning plans for how to effectively use these aids later. Furthermore, they often reported reliance on spontaneous encoding and retrieval – for example, stating that they would routinely remember to perform important actions in the future. Conclusions: Older adults’ reported everyday memory failures were linked to suboptimal use of external memory aids and to a reliance on incidental learning and remembering. There is potential value for interventions that improve procedures for managing everyday life goals that rely on memory.
Traditional memory strategy training interventions improve older adults’ performance on tests of episodic memory, but have limited transfer to episodic memory tasks, let alone to everyday memory. We argue that an alternative approach is needed to assist older adults to compensate for age-related cognitive declines and to maintain functional capacity in their own natural ecologies. We outline a set of principles regarding how interventions can successfully train older adults to increase successful goal pursuit to reduce risks of everyday memory failures. We argue that training individuals to use metacognitive self-regulatory strategies to proactively manage formulation and pursuit of daily goals can compensate for age-related cognitive changes and increase the likelihood of goal attainment. We then describe an intervention approach that instantiates these principles in a multi-modal intervention that is unique in its three-phase approach: (1) individualized assessment of an individual’s current approaches to self-regulation; (2) training memory strategies, self-management skills, and new habits of mind in a group training context; and (3) a behavioral shaping period in which individuals receive coaching and feedback on their efforts to use trained procedures to improve everyday cognition. A recently completed study conducted an initial test of the intervention, with highly encouraging results. We advocate further efforts to replicate, extend, and fine-tune this type of intervention. The ultimate goal is to be able to deliver the intervention in a way that increases its potential reach, including to subpopulations of older adults at risk for everyday cognitive impairments.
Background and Objectives The objective of this paper is to demonstrate the efficacy of an Everyday Memory and Metacognitive Intervention (EMMI) designed to improve everyday functioning of older adults. The EMMI emphasizes self-regulation as a behavioral approach to take priority over habitual behaviors that often impede everyday functioning. Research Design and Methods This study used a quasi-experimental design (intervention vs. waitlist control) to test whether the EMMI improved several aspects of everyday cognition. Thirty-three EMMI participants (M age = 70.24) were compared to 20 control participants (M age = 71.70 years). The two groups were compared on everyday memory failures and successes, measures of well-being, subjective memory, and a prospective memory task. Results Participants who received the EMMI reported more memory successes and fewer memory failures over a 10-day measurement period post-intervention. In addition, EMMI participants reported significantly higher life satisfaction and better subjective memory at post-test than the control group. Critically, the EMMI participants performed better on a laboratory contact prospective memory task. Discussion and Implications The results from this study suggest that the EMMI is a promising approach that has potential to improve everyday memory functioning and perhaps help extend functional independence. Future studies will include randomized controlled trials as well as electronic measurement of memory incidents.
We report results from a new intervention study implementing an Everyday Memory and Metacognitive Intervention (EMMI). This intervention trains older adults on self-regulatory procedures for achieving everyday life goals by implementing a metacognitive perspective where participants learn mindful control over life tasks that place demands on planning and memory (e.g., learning new names and managing prospective memory demands). Fifty-three participants, age range 65 to 83, were assigned to either the EMMI treatment group (n = 32, mean age = 70.13, SD = 3.2) or a waitlist control group (n = 21, mean age = 71.76, SD = 4.7). Individuals with probable memory impairments, as indexed by low MOCA scores, were excluded from the study. Outcomes included daily diary reports of everyday memory errors and a prospective memory telephone task. EMMI participants had fewer reported memory errors per day (M = 0.42) than controls (M = 0.64), one-tailed p = .03. EMMI participants also performed better than controls on the telephone task outcome variables: total number of phone calls completed and mean absolute deviation of call times from scheduled times for successfully completed calls (ps<.001). Subjective outcomes, including personal memory beliefs, life satisfaction, and perceived stress, showed greater pretest-posttest improvement in the EMMI group compared to the control group. This study is a successful initial demonstration of the efficacy of our intervention for improving everyday cognition in older adults and highlights the possibility of improving success in memory-demanding everyday life contexts, thereby contributing to resilient aging in an older population.
During the COVID-19 global pandemic people’s lived experiences and day-to-day lives have been tremendously impacted. This impact is believed to be more severe in people with a memory-impaired partner at home. As part of an ongoing cognitive intervention project with the Emory-Georgia Tech Cognitive Empowerment Program (CEP), we conducted interviews with dyads (one person with diagnosed amnestic mild cognitive impairment (aMCI) and one person, in this case, a spouse who is an identified care partner). To address the COVID-19 pandemic, we supplemented the existing interview about everyday cognition with several questions about the dyadic experience during the pandemic. To date, we have conducted 5 qualitative interviews with dyads. Preliminary results indicate that the COVID-19 pandemic has created additional everyday challenges and cognitive burden for care partners of people diagnosed with aMCI. Some of these challenges include the need to manage pandemic precautionary behaviors, such as mask wearing and maintaining social distancing, for both themselves and the care recipient. In contrast, some aspects of everyday remembering among these dyads have improved (e.g. more advance planning of things like grocery shopping and outings). The results of these interviews will provide additional unique insights into the everyday cognitive challenges of the pandemic on caregivers and persons with aMCI.
Qualitative interview data about everyday remembering within the context of older adults ages 62-83, (N= 27, M=69.5, SD=5.72) and younger adults ages 18-24 (N=29, M=21.2, SD= 1.77) lives were collected and analyzed using constructivist grounded theory methods. This study sought to compare the processes used by these individuals in their pursuit of everyday memory-demanding goals and their conceptualization of these methods. Older adults typically reported importance beliefs that guided memory-supportive behaviors for things like social engagements or medical appointments, whereas younger adults reported important information as being primarily school-related. There were major differences in the execution and conceptualization for remembering critical information. Younger adults engaged in a form of socially-distributed cognition, wherein they relied on and outsourced remembering to technology and other people via apps. Interestingly, younger adults relied on others to remind them about coursework, extra-curricular activities, and social obligations via social communication platforms (e.g. GroupMe), text messages, and shared calendar alerts. Very few of the younger adults sampled were responsible for reminding others, but relied on the social altruism of their peers who were responsible for disseminating mass reminders. Conversely, technological outsourcing was not as prevalent in the older adults interviewed and only a few shared that they received similar reminders via text or email. Of the few cases that did outsource, a small subset did, however, engage in these processes within small groups or pairs, wherein a friend or significant other reminded them about social gatherings or names but in a much smaller proportion, comparatively.
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