GROUP EXTERNAL MEMORY AID TREATMENT FOR MILD COGNITIVE IMPAIRMENT

Abstract

People with mild cognitive impairment (MCI) experience memory impairments greater than expected in normal aging, but their cognitive abilities exceed those of individuals with dementia. External memory aids (EMA) can be used to support memory impairments. The current study evaluated an intervention incorporating structured EMA training within group treatment. Specifically, the researchers examined the effects of group treatment on functional strategy use, cognitive skills and maintenance of skills following treatment. Six participants were randomly divided into two even groups (an immediate and delayed treatment group). All participants scored below the Montreal Cognitive Assessment (MoCA) cut off score of 25, lived independently, and had no previous dementia diagnosis. All participants completed six weekly, 90-minute group treatment sessions. Two non-concurrent sessions were dedicated to each EMA category (i.e., calendars, timers, and personal information). Three types of EMAs for each category were trained (e.g., monthly paper, weekly paper, and electronic calendars within the calendar category). The EMAs were taught using three phases: exploration, intensive functional practice, and home practice. To measure functional strategy use the Multifactorial Memory Questionnaire (MMQ) and a Role Play Activity were used. To measure cognitive skills the MoCA and Arizona Battery for Communication Disorders of Dementia were used. Assessments were administered at pre-treatment, post-treatment, six week follow-up and one-year follow-up. Both groups increased their functional strategy use and cognitive skills during post-treatment assessments. MMQ strategy scores and MoCA scores were significantly higher following treatment. In addition, all participants used an EMA during the Role Play Activity. During Six-week follow up, participant scores were inconsistent across all measures. One year following treatment, all participants’ strategy use and cognitive assessment scores decreased. However, some EMAs taught during treatment were maintained following treatment. Qualitative interviews described participant functional strategy use following treatment. This pilot study evaluated a small sample to describe findings from an innovative evidence-based treatment for MCI. Individuals with MCI increased their functional strategy use and memory skills provided EMA treatment. However, without treatment these gains were not maintained. Treatment is critical for maintaining and integrating daily use of memory strategies for individuals with MCI.