Troyer Angela K, Murphy Kelly J, Anderson Nicole D, Moscovitch Morris, Craik Fergus I M
Department of Psychology, Baycrest Centre for Geriatric Care, Toronto, Canada.
Neuropsychol Rehabil. 2008 Jan;18(1):65-88. doi: 10.1080/09602010701409684.
One of the defining differences between mild cognitive impairment (MCI) and dementia is the degree of independence in everyday activities. Effecting memory-related behavioural change in MCI could help maintain daily function and prolong the time before onset of dependency. However, it is well known that changing previously well-established behaviours is difficult to achieve. We conducted a randomised controlled trial to evaluate the effectiveness of a multidisciplinary group-based intervention programme in changing everyday memory behaviour in individuals with amnestic MCI. The intervention provided evidenced-based memory training and lifestyle education to optimise memory behaviour. Fifty-four participants were randomly assigned to treatment or waitlist-control conditions. Consistent with our primary goal, treatment participants showed an increase in memory-strategy knowledge and use from pre-test to immediate post-test, and these gains were maintained at three-month post-test relative to waitlist controls. There were no group differences in memory beliefs or on laboratory tests of objective memory performance. The increase in memory-strategy knowledge and use was associated with the degree of participation in the programme. Individuals with MCI, therefore, can acquire and maintain knowledge about memory strategies and, importantly, can change their everyday memory behaviour by putting this knowledge into practice. This incorporation of practical memory strategies into daily routines could potentially provide the means for maintaining functional independence by individuals with MCI, an issue to be addressed in future research.
轻度认知障碍(MCI)与痴呆症之间的一个决定性差异在于日常活动中的独立程度。在MCI中引发与记忆相关的行为改变有助于维持日常功能,并延长出现依赖之前的时间。然而,众所周知,改变先前已确立的行为很难实现。我们进行了一项随机对照试验,以评估一项基于多学科小组的干预计划在改变遗忘型MCI个体日常记忆行为方面的有效性。该干预提供了基于证据的记忆训练和生活方式教育,以优化记忆行为。54名参与者被随机分配到治疗组或等待名单对照组。与我们的主要目标一致,治疗组参与者从测试前到测试后立即显示出记忆策略知识和使用的增加,并且相对于等待名单对照组,这些收获在测试后三个月时得以维持。在记忆信念或客观记忆表现的实验室测试方面没有组间差异。记忆策略知识和使用的增加与参与该计划的程度相关。因此,MCI个体可以获得并维持关于记忆策略的知识,重要的是,可以通过将这些知识付诸实践来改变他们的日常记忆行为。将实用记忆策略纳入日常生活可能为MCI个体维持功能独立性提供手段,这是未来研究中有待解决的一个问题。