IMPROVING EVERYDAY MEMORY IN AT RISK ELDERLY

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Older adults want to live independently in the community for as long as possible. Factors which place older adults at a high risk for institutionalization include loss of memory performance, and the need for assistance with instrumental activities of daily living. Education and cognitively demanding environments are considered important means of remaining mentally fit. Older adults are capable of improving their memory but whether a psychosocial intervention may assist them to improve or maintain their instrumental activities of daily living is not known. The aims of the study are to determine (1) the effects of the Cognitive Behavioral Model of Everyday Memory (CBMEM)-based memory training intervention with booster sessions on memory self-efficacy, metamemory, anxiety, depression, memory performance, and instrumental activities of daily living; (2) whether the CBMEM based memory intervention will affect the distal functional outcome through its effect on the mediator variables (anxiety, depression, memory self-efficacy and metamemory) and the proximal outcome of memory performance; and (3) to examine the participants' views of the most and least helpful aspects of the CBMEM intervention. The intervention is an 8-session, 1 1/2 hour classroom course designed to teach older adults the use of strategies to improve everyday memory. Strategically placed booster sessions will be provided to subjects within 3 months following the last class session. Bandura's self-efficacy theory guides this study. A sample of 240 adults, aged 65 and older and living independently in the community will be recruited from Austin Travis County, from high rise apartments and retirement facilities. Individuals scoring <23 on the Mini-Mental Status Exam will be excluded from the study. All participants will complete the MMSE, Rivermead Behavioral Memory Test, the CES-D Depression Scale, Spielberger State-Trait Anxiety Inventory, the Medical Outcome Study-36, the Direct Assessment of Functional Status, and the Metamemory and Memory Self-Efficacy scales. In this randomized clinical trial subjects will be randomly assigned to experimental and comparison groups. Data collections will occur over 27 months on five occasions with face-to-face interviews. Data analysis will include descriptive statistics, correlations, 2X5 MANOVA and hierarchical regressions.