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BACKGROUND AND OBJECTIVES: The objective of this paper is to demonstrate the efficacy of an Everyday Memory and Metacognitive Intervention (EMMI) designed to improve everyday functioning of older adults. The EMMI emphasizes self-regulation as a behavioral approach to take priority over habitual behaviors that often impede everyday functioning. RESEARCH DESIGN AND METHODS: This study used a quasi-experimental design (intervention vs waitlist control) to test whether the EMMI improved several aspects of everyday cognition. Thirty-three EMMI participants (M age = 70.24) were compared to 20 control participants (M age = 71.70 years). The 2 groups were compared on everyday memory failures and successes, measures of well-being, subjective memory, and a prospective memory task. RESULTS: Participants who received the EMMI reported more memory successes and fewer memory failures over a 10-day measurement period postintervention. In addition, EMMI participants reported significantly higher life satisfaction and better subjective memory at posttest than the control group. Critically, the EMMI participants performed better on a laboratory contact prospective memory task. DISCUSSION AND IMPLICATIONS: The results from this study suggest that the EMMI is a promising approach that has potential to improve everyday memory functioning and perhaps help extend functional independence. Future studies will include randomized controlled trials as well as electronic measurement of memory incidents.
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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.
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BACKGROUND: Little is known about the means by which older adults achieve memory-demanding goals in everyday life or alternatively about why they fail to do so. OBJECTIVES: We conducted qualitative interviews to evaluate what older people do to support everyday memory functioning. A principal focus was on understanding the ways in which individuals use internal memory strategies and external memory aids. METHODS: We interviewed 25 community-dwelling older adults (mean age 70 years) in a semi-structured interview. The transcribed results were coded by extracting segments of the interviews and classifying the responses into emergent categories. All coded interview segments were reviewed by category. Memos were created and relevant themes identified. RESULTS: The older adults reported everyday memory failures (such as forgetting names), often without nominating explicit methods for avoiding these problems. They also reported using a number of external memory aids such as calendars and lists. Our interviews indicated this use was typically a part of complex routines and habits of living that often seemed vulnerable to errors. For instance, people would report filling medication organizers or completing to-do lists without mentioning plans for how to effectively use these aids later. Furthermore, they often reported reliance on spontaneous encoding and retrieval - for example, stating that they would routinely remember to perform important actions in the future. CONCLUSIONS: Older adults' reported everyday memory failures were linked to suboptimal use of external memory aids and to a reliance on incidental learning and remembering. There is potential value for interventions that improve procedures for managing everyday life goals that rely on memory.
