Fostering Self-Management of Everyday Memory in Older Adults: A New Intervention Approach

Abstract

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.

Keywords: everyday memory; habits and behaviors; intervention – behavioral; memory training; metacognition; shaping.

FIGURE 1

Pretest–Posttest changes in Specific Memory Self-Efficacy. Significant increases were observed in the EMMI group but not in the Control group.

FIGURE 2

Group differences in completed laboratory contact within a 15-min window of scheduled time. The EMMI group completed significantly more contacts than the Control group.

FIGURE 3

Significant group differences in daily memory successes reported during the assessment window following the shaping period. The EMMI group reported more everyday memory successes than the Control group.

FIGURE 4

Group differences in daily memory failures (termed “blips”) reported during the assessment window following the shaping period, with the EMMI group reporting fewer everyday memory failures in the daily diaries than the Control group.