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Background A decline in the ability to perform daily intentions—known as prospective memory—is a key driver of everyday functional impairment in dementia. In the absence of effective pharmacological treatments, there is a need for developing, testing, and optimizing behavioral interventions that can bolster daily prospective memory functioning. We investigated the feasibility and efficacy of smartphone‐based strategies for prospective memory in persons with cognitive impairment. Methods Fifty‐two older adults (74.79 ± 7.20 years) meeting diagnostic criteria for mild cognitive impairment or mild dementia were enrolled in a 4‐week randomized controlled trial. Participants were trained to use a digital voice recorder app or a reminder app to off‐load prospective memory intentions. Prospective memory was assessed using experimenter‐assigned tasks (e.g., call the laboratory on assigned days), standardized questionnaires, and structured interviews. Secondary dependent measures included days of phone and app usage, acceptability ratings, quality of life, and independent activities of daily living. Results Participant ratings indicated that the intervention was acceptable and feasible. Furthermore, after the four‐week intervention, participants reported improvements in daily prospective memory functioning on standardized questionnaires (p < 0.001, ηp2 = 0.285) and the structured interview (p < 0.001, d = 1.75). Participants performed relatively well on experimenter‐assigned prospective memory tasks (51.7% ± 27.8%), with performance levels favoring the reminder app in Week 1, but reversing to favor the digital recorder app in Week 4 (p = 0.010, ηp2 = 0.079). Correlational analyses indicated that greater usage of the digital recorder or reminder app was associated with better prospective memory performance and greater improvements in instrumental activities of daily living (completed by care partners), even when controlling for condition, age, baseline cognitive functioning, and baseline smartphone experience. Conclusions Older adults with cognitive disorders can learn smartphone‐based memory strategies and doing so benefits prospective memory functioning and independence.

Wernicke encephalopathy (WE), caused by thiamine deficiency, is classically associated with alcoholism but is increasingly recognized among patients who have undergone bariatric surgery. As with other neurocognitive conditions, alternative explanations for symptoms, such as psychiatric, neurological, and motivational factors, must be considered before arriving at a diagnosis of WE. We present a patient after sleeve gastrectomy who was presumed to have WE; after detailed neuropsychological assessment, the condition was better conceptualized as a conversion disorder. The case illustrates the heretofore unrecognized role of bariatric surgery in the development of functional symptoms and demonstrates the importance of neuropsychological assessment in detecting functional symptoms.

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