Brain structural changes after multi‐strategic metamemory training in older adults with subjective memory complaints: A randomized controlled trial

Abstract

Background Metamemory is the process of monitoring and controlling one's memory. Improving metamemory may reduce the memory problem in old age. We hypothesized that metamemory training (MMT) would improve cognition in older adults with subjective memory complaints and change the brain region related to metacognition. Method We recruited and randomized older adults to the multi‐strategic memory training of 10 weekly 90‐min sessions, based on the metamemory concept or usual care. Cognitive tests including the Elderly Verbal Learning Test, Simple Rey Figure Test, Digit Span, Spatial Span, Categorical Fluency, and the Boston Naming Test were done in 201 participants, together with magnetic resonance imaging (MRI) in 49 participants before and after training. Results A total of 112 in the training group and 89 in the control group participated. The training group had a significant increase in long‐term delayed free recall, categorical fluency, and the Boston Naming test. In MRI, the mean diffusivity of the bundles of axon tracts passing from the frontal lobe to the posterior end of the lateral sulcus decreased in the training group. Conclusion These results indicate that the MMT program has a positive impact on enhancing older people’ cognitive performance. Improved white matter integrity in the anterior and posterior cerebrum and increased cortical thickness of prefrontal regions, which related to metacognition, possibly suggest that the effects of the MMT would be induced via the enhancement of cognitive control.

Cognitive Improvement in Older Adults with Mild Cognitive Impairment: Evidence from a Multi-Strategic Metamemory Training

“…Visuospatial memory and attention were not significantly different between the training and control groups. The results of the current study are similar to a previous study that noted the effects of MMT in normal older adults [6]. Youn et al found that older adults who participated in the MMT (n = 112) experienced significantly greater increases in delayed free recall and language functions (i.e., fluency, BNT) compared with the control group (n = 89).…”

“…Healthy older adults who participated MMT improved more substantially compared with the wait list control group in trained areas and non-trained areas [4]. A follow up study with a larger sample size of healthy adults and brain imaging replicated the transfer effects of the MMT and brain structural changes further support the initial evidence of these effects [6]. These previous results suggest that metamemory, an understanding of how memory works and monitoring of one's memory processing, could facilitate the effects of mnemonic strategies and lead to improvement of older adults' cognitive function including memory function [7,8].…”

“…Verbal memory function is related with the left medial temporal lobe, while the function of non-verbal memory (e.g., visuo-spatial memory) is related with the right medial temporal lobe [19]. A previous study found that MMT-induced changes in the brain were more significant in the left hemisphere compared with the right [6]. For instance, they found that mean diffusivity of left superior longitudinal fasciculus, left external capsule or left corona radiata were more significantly decreased in the training group compared with the control group.…”

Advances in Non-Pharmacological Interventions for Subjective Cognitive Decline: A Systematic Review and Meta-Analysis

“…In contrast, other assessment tools, such as Memory self-efficacy (MSE), Memory Inventory for the Chinese (MIC), and Multifactorial Memory Questionnaire (MMQ)-total score, represent great subjective memory performance when the score is high. Five studies adopted former assessment tools [30,39,40,42,43], while three used the latter [32,43,44]. In five studies, the overall effect of the cognitive training intervention on subjective memory outcome was not significant (Hedges' g = -0.11, 95% CI -0.32 to 0.10, Z = 1.01, p = 0.31).…”

“…Five studies were categorized as lifestyle modification, with one as physical exercise [34] and four as functional foods or nutrients supplementation interventions [35][36][37][38]. Nine studies investigated the cognitive training [30][31][32][39][40][41][42][43][44] and two focused on the multidomain interventions (i.e., combined physical and mental activity, combined exercise and memory training) [45,46]. There was one study involving psychological and health-related education [47].…”