Amnestic mild cognitive impairment (MCI) is a form of cognitive impairment that does not meet the criteria for dementia, but in which memory loss is the dominant symptom. This subtype of MCI is thought to be particularly likely to lead to Alzheimer’s Disease (AD). Although there are support services and products available for memory loss, most of the research on the effectiveness of such resources has been conducted among individuals with AD or other dementias, and not individuals diagnosed with MCI. A recent article in the International Journal of Geriatric Psychiatry reports on a randomized trial of a memory support system conducted with participants diagnosed with amnestic MCI.
The limited research base on memory support for MCI has led to some promising findings, but few research trials on memory support interventions have included randomized designs or follow-up assessments after the intervention, which is important for determining the validity and sustainability of interventions. To address this, the study provided 40 individuals (who, as part of the inclusion criteria of the study, each had a caregiver with whom they interacted at least twice a week) with the memory support system (MSS), a calendar and note-taking system designed to aid individuals with memory loss. Participants were randomly assigned to either an intervention group, which participated in 12 one-hour training sessions using the MSS, or a control group, who were provided the MSS and encouraged to use it without receiving any specific instruction.
All participants were assessed on cognition, mood, sense of self-efficacy, ability to perform activities of daily living, and quality of life. Caregiving partners were assessed for mood, care burden, and quality of life. Assessments took place at three points: baseline, or at the beginning of the trial, eight weeks after baseline, and at a six-month follow-up. Participants were also measured on their adherence to the MSS, a measure of how often they used the system. A total of five participants withdrew at various points during the study.
Participants in the control group used the MSS less frequently over the course of the trial, while individuals in the intervention group increased their adherence slightly over the same period, and continued to use the MSS more frequently than the control group at the six-month follow-up. The intervention group had significantly higher functional ability scores than the control group at the eight-week point, though this difference was no longer significant after six months. Participants in the intervention group also had significant improvements in their sense of memory self-efficacy by the end of training, which was higher than those in the control group. Caregivers in the intervention group had improved mood at the six-month follow-up, while those in the control group had a near significant statistical trend toward worsened mood and caregiver burden.
At the six-month follow-up, slightly more than half of all participants in the intervention group were still regularly using the MSS to some degree, although overall adherence did decline in this group. The authors suggest that “booster” sessions may be useful for maintaining adherence and sustaining some of the benefits of the system. Overall, within this sample, memory support training led to significant short-term (eight-week) improvements in functional ability and memory self-efficacy among participants with amnestic MCI, and led to longer-term improvements in caregiver mood and burden. These findings suggest that memory support programs may be an effective means to compensate for amnestic MCI, particularly when paired with training and support.
Greenaway MC, Duncan NL, Smith GE. The memory support system for mild cognitive impairment: randomized trial of a cognitive rehabilitation intervention. International Journal of Geriatric Psychiatry (2013); 28: 402–409.