To preserve or improve independent functioning in older adults and those with neurocognitive impairments, researchers and clinicians need to address prospective memory deficits. To be effective, prospective memory interventions must restore (or circumvent) the underlying attention and memory mechanisms that are impaired by aging, brain injury, and neurodegeneration. We evaluated two decades of prospective memory interventions for efficacy, time/resource costs, and ecological validity. Method: We systematically reviewed 73 prospective memory intervention studies of middle-to older-aged healthy adults and clinical groups (N ϭ 3,749). We also rated the ecological validity of each study's prospective memory assessment/task using a newly developed scale. When possible (72% of studies), we estimated effect sizes using random-effects models and Hedges' g. Results: We identified four categories of prospective memory interventions, including mnemonic strategy, cognitive training, external memory aid, and combination interventions. Mnemonic strategy (g ϭ .450) and cognitive training (g ϭ .538) interventions demonstrated efficacy. Combination interventions showed mixed results (g ϭ .254), underscoring that "more is not always better." External memory aids demonstrated very positive outcomes (g ϭ .805), though often with small-sample, case-series designs. Prospective memory assessments had high ecological validity in external memory aid studies (84%), but not in mnemonic strategy (14%), cognitive training (20%), or combination intervention (50%) studies, p Ͻ .001, p 2 ϭ .33. Conclusions: Everyday prospective memory can be meaningfully improved, perhaps particularly with external memory aids, but larger trials are required to optimize treatments, increase adherence, and broaden implementation in daily life.

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.

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Interruption interference refers to significant performance decreases that follow task interruption. Evidence has suggested that practicing interruption resumption reduces interruption interference as measured by the time required to resume the interrupted task. However, evidence has also indicated that interruption practice only improves resumption for the practiced pair of primary and interrupting tasks. If this is true, then there is little applied benefit in interruption training, because the training would be unlikely to transfer beyond the training environment. In the current studies, a transfer paradigm was utilized to determine whether interruption resumption skill practiced within a task-pair transfers to a novel task-pair. The results of Experiments 1A and 1B provide evidence that interruption resumption skill transfers to another primary task when the interrupting task is either held constant or varies. Experiment 2 manipulated the primary tasks to minimize the ability to reconstruct the next step in problem solving. When minimizing reconstruction, resumption skill that transfers is likely the ability to successfully retrieve the next planned action that was suspended when interrupted. The results support the conclusion that resumption skill does transfer and, therefore, opens up additional research avenues with applications to minimizing interruption interference. Public Significance StatementThe findings in this study demonstrate that people can learn to better recover from interruptions and that this training may generalize beyond the training environment to a limited degree. Safely training people to recover from interruptions may reduce interruption related errors and time loss in high-risk work environments.

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