Prospective Memory Problems Research Articles

20 The Influence of Brain Injury Severity, Anxiety, and Depression on Objective and Subjective Prospective Memory Problems

Objective:Following a traumatic brain injury (TBI), the majority of patients report difficulties with prospective memory (PM). However, there is not always a significant relationship between subjective and objective PM measures. Several variables may influence the degree of severity of perceived difficulties, including the severity of the injury and psychoemotional status. The aim of this study was to determine whether the severity of the TBI and anxiety and depressive symptoms were related to objective and subjective difficulties of PM.Participants and Methods:50 patients (mean age = 31,3 years old) with a TBI (20 mild and 30 moderate/severe) in the post-acute phase of recovery and 15 matched healthy control participants (mean age = 32,3 years old) were recruited. They completed inventories assessing the presence of anxiety (BAI) and depressive (BDI) symptoms and performed the Ecological test of prospective memory (TEMP), an objective measure of PM. The Comprehensive Assessment of PM (CAPM), a subjective measure of PM, was also filled out by participants and their relatives.Results:In patients with moderate/severe TBI, significant correlations were found between the CAPM and the BDI (r =.601, p<.001) and the BAI (r =.507, p=.004). A negative correlation was also observed between the relatives’ CAPM scores and the performance of the patients on the TEMP (r= -.374, p=.042). In patients with mild TBI, there was only a strong significant correlation between the CAPM and the BAI scores (r =.574, p=.008). However, no other correlation was significant between this group of patients and their relatives. Additionally, results on the TEMP were not significantly correlated with the CAMP completed by healthy control participants or their relatives. A linear regression conducted in the group of participants with TBI showed that BAI and BDI scores are the only significant predictors of the results on the CAPM (31% of the variance), while TBI severity is the only significant predictor of the results on the TEMP (37% of the variance).Conclusions:The perception of PM difficulties in patients with a TBI does not seem to be related to their objective performance. Anxiety and depressive symptoms appear to influence their perception more than their objective performance. As suggested by their relatives, a decrease in self-awareness could explain the lack of relationship between subjective PM difficulties of patients with moderate/severe TBI and their objective performance. On the other hand, TBI severity is more strongly related to objective performance on PM tests. These results highlight the importance of using different measures to accurately assess PM and the various factors influencing this construct.

A Neuropsychological Rehabilitation Framework to Address Cognitive and Neurobehavioral Impairments After Strokes to the Anterior Communicating Artery.

Patients with strokes to the Anterior Communicating Artery (ACoA) pose an important challenge to rehabilitation teams due to a particular mix of cognitive and behavioral impairments (anosognosia, anterograde amnesia, prospective memory problems, and executive dysfunction). These deficits often compromise engagement with rehabilitation, learning and generalization. The goal of this article is to describe the long-term presentation of a patient with an ACoA stroke (Mrs. B, a 60-year-old electric engineer) as well as her rehabilitation needs and the many challenges experienced by the rehabilitation team when attempting to facilitate functional, vocational and psychosocial recovery. Based on this case, and the existing literature, a neuropsychological rehabilitation framework to understand and address the specific problems and needs of this population is proposed. This framework demands rehabilitation teams to consider: the slow pattern of recovery of this population, the interaction between cognitive and behavioral impairments, the relevance of physical and social environments, the value of personal projects and the need to include psychological and relational interventions.

The effects of lavender, rosemary and orange essential oils on memory problems and medication adherence among patients undergoing hemodialysis: A parallel randomized controlled trial

Background: hemodialysis patients’ daily use of medications is essential for the disease management. One of the causes of medication non-adherence is that they forget to take medications, and non-adherence to treatment following memory loss is a common problem in patients on hemodialysis.Objective: the current study aimed to compare the effects of Lavender, Rosemary, and Orange essential oils on memory problems (both retrospective and prospective aspects of memory) and medication adherence in hemodialysis patients.Design: this study was a parallel randomized controlled trial.Setting: the two main hemodialysis centers in Kerman, southeastern Iran.Participants: eighty-six patients under chronic hemodialysis were randomly allocated into four groups (Lavender, Rosemary, Orange, and control) by simple randomization method.Interventions: The samples of the intervention group, in addition to routine care, received Lavender or Rosemary or Orange essential oils three times a week for a month. A gauze containing with five drops of the essential oil was placed at a distance of 10 cm from the patient's nose one hour after hemodialysis, and the patient was asked to inhale it for 30 min.Main outcome measures: retrospective and prospective memory, and medication adherence were assessed before, immediately and one month after the intervention.Results: prospective memory problems in Lavender, Rosemary and Orange groups did not change significantly over time (P > 0.05). Prospective memory problems in the control group had a significant increase (P = 0.002). No significant difference was found in prospective memory problems between the four groups (P > 0.05). Retrospective memory problems in the Lavender and Rosemary groups decreased significantly over time (P <0.05). The decreasing retrospective memory problems in the Orange and control groups were not statistically significant over time (P > 0.05). There was no significant difference in retrospective memory problems between the four groups (P > 0.05). No significant difference was observed between the four groups in medication adherence score during the study (P > 0.05).Conclusion: aromatherapy with Lavender or Rosemary can reduce some memory problems in hemodialysis patients. However, the results of this study could not justify the effect of aromatherapy on the rate of medication adherence in patients on hemodialysis, so further studies are required.Trial registration: IRCT20190428043410N1

Depression involved in self-reported prospective memory problems in survivors of breast cancer who have received chemotherapy.

To investigate the relationship between depression and the self-reported prospective memory (SPM) problems in breast cancer survivors who have received chemotherapy.Sixty-three breast cancer patients were administered with self-rating depression scale (SDS) and the prospective memory questionnaire as part of extensive neuropsychological assessments before and after chemotherapy. The performance of SDS and SPM were compared, with the level of significance set at P < .05.Compared with the group before chemotherapy, there is a significant difference on the SPM score (t = 6.069, P = .000) in breast cancer patients after chemotherapy. Further, there is also a significant difference on the SPM score (t = −4.348, P = .000) between the patients with and without depression group after chemotherapy.The present result indicated that the depression in breast cancer survivors after chemotherapy may be involved in their chemotherapy-induced SPM impairment.

Self and Informant Memory Reports in FINGER: Associations with Two-Year Cognitive Change.

Subjective memory complaints (SMCs) may be the first sign of cognitive decline in aging. To examine whether SMCs reported by oneself and informant predict cognitive change over 2 years among at-risk elderly people, and to determine the relationship of different types of SMCs (prospective and retrospective memory complaints) and change in cognitive function. This investigation is part of the FINGER project, which is a multicenter randomized controlled trial aiming at preventing cognitive decline in cognitively healthy older adults with increased risk of dementia. A subsample of 303 control-group participants (aged 60-80 years) and their informants (n = 261) rated the frequency of SMCs, using the Prospective and Retrospective Memory Questionnaire (PRMQ). Cognitive performance was measured at baseline and at 1- and 2-year follow-up visits using a neuropsychological test battery. Participants who reported more SMCs improved less in global cognition, executive function, and memory during the subsequent 2 years in the fully-adjusted analyses. Self-reported retrospective memory problems predicted less improvement in all cognitive domains, whereas prospective memory problems did not. Informant-reported memory problems were not linked to subsequent change in cognition. Our results indicate that self-reported SMCs, measured with PRMQ, predict future cognitive change in several cognitive domains. By contrast, reports by informants were not linked to changes in cognition. Among cognitively healthy at-risk elderly individuals, the persons themselves observe more easily problems relevant for their future cognitive trajectories than their informants.

The implementation of web-based cognitive rehabilitation in adult cancer survivors: examining participant engagement, attrition and treatment fidelity.

Low engagement and high attrition are common challenges in web-based interventions. Typical measures of engagement reported in the literature are not meaningful for describing participant activity within the intervention and can be misleading. This research aimed to develop a more meaningful method of measuring engagement in an online cognitive rehabilitation program whilst monitoring treatment fidelity. A pilot study and randomised controlled trial (RCT) were conducted. Data from 60 participants were analysed from three intervention groups: pilot cancer group, pilot non-cancer group and RCT cancer group. Groups completed the 4-week eReCog program comprised of four online modules. Engagement scores were calculated based on activities completed in each module. Attrition, interaction with the program facilitator and correlations with outcome measures were analysed. Overall engagement in the intervention was high. The non-cancer group participated significantly less than the cancer groups (p=<0.001), whereby the percentage of activity items completed was 92, 87 and 78% in the pilot cancer, RCT cancer and pilot non-cancer groups, respectively. Attrition was higher in the pilot non-cancer group (24%) compared to the pilot cancer group (8%) and the RCT cancer group (16%). Total engagement was correlated with fewer prospective memory problems on instrumental activities of daily living (p=0.018). Measuring completed activities in online interventions appears a more meaningful measure of engagement than other conventional methods described in the literature and has the potential to increase treatment fidelity in web-based research.

Prospective memory rehabilitation using smartphones in patients with TBI

Purpose: The aim of the present study was to investigate the effectiveness of a prospective memory aid that combines smartphones with Internet-based calendars among community-dwelling patients with traumatic brain injury.Method: An uncontrolled pre- and post-assessment design was employed to study the use of unmodified, low-cost, off-the-shelf smartphones combined with Internet-calendars as a compensatory memory strategy in community-dwelling patients with traumatic brain injury. Thirteen participants received a 6-week group-based intervention with pre-, post- and 2-month follow-up-assessments by questionnaires and by daily assessment of target behaviors for 2-week periods.Results: Participants reported significantly fewer retro- and prospective memory problems on questionnaires after the intervention and at follow-up with large effect sizes. The performance of target behaviors, however, improved insignificantly with moderate effect sizes. There were no changes in quality of life or symptoms of emotional distress.Conclusions: This study adds to a growing body of evidence that smartphones are a useful compensatory aid in rehabilitation of prospective memory that should routinely be considered in rehabilitation of traumatic brain injury patients.Implication for rehabilitationSmartphones are easy-to-use and accessible assistive technology for compensatory memory rehabilitation to most traumatic brain injury patients.By using low-cost, off-the-shelf devices, the technology becomes available to a broader range of patients.By combining smartphones with Internet-based and cross-platform services (e.g., calendars, contacts) the participants are less device-dependent and less vulnerable to data loss.Smartphones should routinely be considered as compensatory aid in rehabilitation of prospective memory of traumatic brain injured patients.

Reduced memory skills and increased hair cortisol levels in recent Ecstasy/MDMA users: significant but independent neurocognitive and neurohormonal deficits.

The goals of this study were to measure the neurocognitive performance of recent users of recreational Ecstasy and investigate whether it was associated with the stress hormone cortisol. The 101 participants included 27 recent light users of Ecstasy (one to four times in the last 3 months), 23 recent heavier Ecstasy users (five or more times) and 51 non-users. Rivermead paragraph recall provided an objective measure for immediate and delayed recall. The prospective and retrospective memory questionnaire provided a subjective index of memory deficits. Cortisol levels were taken from near-scalp 3-month hair samples. Cortisol was significantly raised in recent heavy Ecstasy users compared with controls, whereas hair cortisol in light Ecstasy users was not raised. Both Ecstasy groups were significantly impaired on the Rivermead delayed word recall, and both groups reported significantly more retrospective and prospective memory problems. Stepwise regression confirmed that lifetime Ecstasy predicted the extent of these memory deficits. Recreational Ecstasy is associated with increased levels of the bio-energetic stress hormone cortisol and significant memory impairments. No significant relationship between cortisol and the cognitive deficits was observed. Ecstasy users did display evidence of a metacognitive deficit, with the strength of the correlations between objective and subjective memory performances being significantly lower in the Ecstasy users.

Self-report prospective memory problems in people with stroke

Background and purpose: Prospective memory (PM) is a common problem which can limit performance of basic and instrumental activities of daily living in patients with stroke. This study compared self-report PM failures between older and younger people with stroke, examined differences in perceptions of PM failures between people with stroke and relatives, relationships between these PM failures and functional performance.Methods: A total of 105 patients with stroke, 65 relatives and 112 healthy controls were recruited. Both the patients with stroke and controls were further divided into an older (age > 55 years) and a younger (age ≤ 55 years) group. Data for patients with stroke and relatives were obtained via the Brief Assessment of Prospective Memory (BAPM), Basic Activity of Daily Living (BADL) related Modified Barthel Index (MBI) and Lawton Instrumental Activities of Daily Living (Lawton IADL) Scale. Healthy controls’ data were also collected.Results: The older stroke group had significantly higher BAPM total scores and BADL and IADL sub-scale scores than the younger group. Difference in perceptions of the patients’ self-report of PM failures and their relatives’ report was significant for the IADL sub-scale. Self-report of PM failure was significantly related to functional BADL and IADL measures.Conclusions: Results highlight the impact of PM failures in patients with stroke and their assessment, management and rehabilitation of these patients.

Trait impulsivity and prospective memory abilities: An exploratory study

Both impulsivity and prospective memory may be related to executive functioning. This study was the first to examine if prospective memory is related to trait impulsivity.Seventy-eight undergraduate students completed one self-report and two laboratory measures of prospective memory, as well as the Barratt Impulsiveness Scale-11. Higher levels of trait impulsivity were not significantly associated with prospective memory task performance; however, impulsivity was related to self-report of prospective memory problems. Individuals with relatively worse prospective memory appeared to rely on a clock-checking tactic to improve task performance. Such compensatory behaviors may be effectively deployed over short periods by people with chronic prospective memory problems when such memory abilities are made salient, but may be difficult to maintain in day-to-day life.

Impact of the Cognitive Status on the Memory Complaints in MS Patients

Despite the evidence of cognitive deficits in Multiple Sclerosis (MS) patients, evaluation of their cognitive integrity is often limited to the use of clinical interviews and questionnaires. However, the consensus in the literature is that these patients under- or overestimate their deficits and repercussions. The objective of this study was to clarify why some patients overestimate while others underestimate their memory deficits. Fifty-four participants (30 MS, 24 controls) completed the Prospective and Retrospective Memory Questionnaire (PRMQ) and were tested on a battery of neuropsychological tests. Based on the test results, MS patients were categorized as having either mild or moderate/severe cognitive deficits. The moderate/severe MS group differed from the two other groups on the Rey Auditory Verbal Learning Test (RAVLT) but did not differ from the control group on the PRMQ. Conversely, the mild MS group did not differ from the control group on the RAVLT but did report significantly more problems than this group on the PRMQ. There was no difference between the two clinical groups on the Depression Index (Beck) but there was a significant correlation (r=.409) between the depression scores and the overestimation of prospective memory problems (PRMQ). The results explain the contradiction in the literature. It is the mild group who overestimates, maybe because they are overly concerned by their deficits, whereas the cognitive impairments of the moderate/severe group lead them to underestimate and may make their self-assessment unreliable. Formal testing or information from a significant other would be advisable.

Validation of a New Measure of Prospective Memory: The Royal Prince Alfred Prospective Memory Test

Prospective memory problems are common in patients with brain injury, but appropriate measures are limited. The reliability and validity of the newly designed Royal Prince Alfred Prospective Memory Test (RPA-ProMem), which has three alternate versions, was investigated in 20 healthy volunteers and 20 neurological patients with everyday prospective memory problems. The RPA-ProMem was found to be easy to score reliably (inter-rater reliability = .90) and its three versions were well matched (delayed alternate-form reliability = .71). Test validity and sensitivity to patient deficits were also supported. This new measure of prospective memory should be particularly useful in situations that require repeated assessments, such as evaluation of rehabilitation efforts.

A short self-report measure of problems with executive function suitable for administration via the Internet

This article describes a short self-report measure of problems with executive function designed for use in Internet-mediated research. In Study 1, participants completed the online measure (Webexec) using a browser but under laboratory conditions. They also completed a paper self-report measure of executive problems (the Dysexecutive Questionnaire; DEX) and three objective tasks involving executive function: reverse digit span, semantic fluency (unconstrained), and semantic fluency (constrained). Webexec scores correlated positively with the DEX and negatively with the three executive tasks. Further evidence of construct validity came from Study 2, in which Webexec scores correlated positively with both use of cannabis and prospective memory problems reported in an online drug questionnaire. Webexec thus appears suitable for online research with normal populations.

Evidence of Impaired Event-Based Prospective Memory in Clinical Obsessive–Compulsive Checking

AbstractBased on findings from subclinical OCD checking samples (Cuttler &amp; Graf, 2007; 2008), Cuttler and Graf (2009) suggested that checking may develop to compensate for prospective memory failures. The present study provides the first evidence of prospective memory problems in a clinical sample of OCD checkers (n = 26) compared to a group of healthy controls (n = 26). Consistent with earlier work with subclinical samples, the OCD checkers performed more poorly on an event-based, but not a time-based, prospective memory task. However, the OCD checkers did not report more subjective prospective memory failures than controls and their confidence in prospective memory accuracy was higher than that of controls. An explanation of the inconsistent findings with regard to metamemory in clinical and subclinical OCD checking is provided. Further research assessing both subjective memory performance and the strategies understood to support memory is needed to clarify the contribution of prospective memory to OCD checking.

The assessment and rehabilitation of prospective memory problems in people with neurological disorders: A review

People with neurological disorders often report difficulty with prospective memory (PM), that is, remembering to do things they had intended to do. This paper briefly reviews the literature regarding the neuropsychology of PM function, concluding that from the clinical perspective, PM is best considered in terms of its separable but interacting mnemonic and executive components. Next, the strengths and limitations in the current clinical assessment of PM, including the assessment of component processes, desktop analogues of PM tasks, and naturalistic PM tasks, are outlined. The evidence base for the rehabilitation of PM is then considered, focusing on retraining PM, using retrospective memory strategies, problem-solving training, and finally, electronic memory aids. It is proposed that further research should focus on establishing the predictive validity of PM assessment, and refining promising rehabilitation techniques.

Issues surrounding the user-centred development of a new interactive memory aid

Memory problems are often associated with the ageing process and are one of the commonest effects of brain injury. Electronic memory aids have been successfully used as a compensatory approach to provide reminders to individuals with prospective memory problems. This paper describes the usability issues surrounding the development of a new memory aid rendered on a personal digital assistant (PDA); in addition, it discusses the importance of a user-centred design process for the development of the memory aid and preliminary qualitative findings from interviews and focus groups of disabled or elderly users.