The development of a manual-based digital memory notebook intervention with case study illustrations

Abstract

There is currently a need to identify feasible and effective interventions to help older individuals suffering from memory loss maintain functional independence and quality of life. To improve upon paper and pencil memory notebook interventions, the Digital Memory Notebook (DMN) application (app) was developed iteratively with persons with cognitive impairment. In this paper we detail a manual-based intervention for training use of the DMN app. A series of three case studies are described to illustrate the clinical process of the DMN intervention, the key components of the intervention and participants' perceptions of the intervention. The Reliable Change Index was applied to pre/post intervention scores that examined everyday memory lapses, daily functioning, coping self-efficacy, satisfaction with life, and quality of life with standardized measures. Following the intervention, two of three participants self-reported a clinically significant reduction in everyday memory lapses and improved everyday functioning. One participant reported clinically significant change in quality of life. All participants demonstrated clinically significant changes in their ability to cope with problems and build self-efficacy. Furthermore, all participants scored in the normative range post-intervention on the measure of satisfaction with life. Clinical observations and participant feedback were used for refinement of the DMN intervention (ClinicalTrials.gov NCT03453554).

Compensatory strategy use improves real-world functional performance in community dwelling older adults.

“…Compensation, as measured by self- and informant-report, has been found to increase at early stages of age-related cognitive disorders (Schmitter-Edgecombe, Parsey, & Lamb, 2014) and then decrease with advanced impairment (Schmitter-Edgecombe et al, 2014; Tomaszewski Farias et al, 2018). It has also been demonstrated that individuals with mild forms of cognitive impairment can learn to use strategies to compensate for cognitive impairment suggesting a possible point of intervention (Chudoba, Church, Dahmen, Brown, & Schmitter-Edgecombe, 2019; Schmitter-Edgecombe, Howard, Pavawalla, Howell, & Rueda, 2008; Schmitter-Edgecombe & Dyck, 2014; Troyer, Murphy, Anderson, Moscovitch, & Craik, 2008). Collectively, this research may suggest that people naturally adapt to changes in cognitive ability and they have the capacity to learn and apply new strategies to improve overall daily functioning.…”

The goal-control model: An integrated neuropsychological framework to explain impaired performance of everyday activities.

“…Commission errors, which were more prominent in the PDD group, were not corrected after presentation of the goal cues (Giovannetti et al, 2015). Future studies should consider participants’ functional deficit profiles when evaluating the efficacy and effectiveness of interventions and exploit assistive technologies to reduce omissions by promoting the activation of weak task goals through the delivery of cues and prompts (Chudoba et al, 2020; Das et al, 2012; Seelye et al, 2013, 2012). Assistive technologies also should be developed specifically to reduce commissions by facilitating executive control over goal activations by increasing attention between subgoals and by explicitly instructing individuals to identify target objects and remove distractor objects before performing an everyday task (Bettcher et al, 2011; Morady & Humphreys, 2011).…”

“…delivery of cues and prompts (Chudoba et al, 2020;Das et al, 2012;Seelye et al, 2013Seelye et al, , 2012. Assistive technologies also should be developed specifically to reduce commissions by facilitating executive control over goal activations by increasing attention between subgoals and by explicitly instructing individuals to identify target objects and remove distractor objects before performing an everyday task (Bettcher et al, 2011;Morady & Humphreys, 2011).…”

Initial Evidence for the Efficacy of an Everyday Memory and Metacognitive Intervention

“…For instance, people often report using a calendar to support everyday memory but do not have a consistent habit of checking that calendar. Training people to create a new habit of consistent calendar referral can mitigate forgetting appointments ( Chudoba et al, 2019 ).…”