IMPROVING EVERYDAY MEMORY IN AT RISK ELDERLY

老年人希望尽可能长时间地在社区独立生活。使老年人处于机构高风险的因素包括记忆能力丧失，以及在日常生活工具活动方面需要帮助。教育和认知要求高的环境被认为是保持精神健康的重要手段。老年人有能力改善他们的记忆，但心理社会干预是否可以帮助他们改善或维持日常生活的工具性活动尚不清楚。本研究旨在探讨(1)基于日常记忆认知行为模型（CBMEM）的记忆训练干预对记忆自我效能、元记忆、焦虑、抑郁、记忆表现和日常生活工具性活动的影响；(2)基于CBMEM的记忆干预是否会通过对中介变量（焦虑、抑郁、记忆自我效能和元记忆）和记忆表现近端结果的影响影响远端功能结局；(3)考察被试对CBMEM干预最有利和最不利方面的看法。干预是一个8节，一个半小时的课堂课程，旨在教老年人使用策略来提高日常记忆。在最后一堂课结束后的3个月内，将有针对性地为受试者提供辅助课程。班杜拉的自我效能理论指导了本研究。从奥斯汀特拉维斯县的高层公寓和退休设施中招募240名年龄在65岁及以上、独立生活在社区的成年人作为样本。在迷你精神状态测试中得分低于23分的个体将被排除在研究之外。所有参与者将完成MMSE、Rivermead行为记忆测试、CES-D抑郁量表、Spielberger状态-特质焦虑量表、医疗结果研究-36、功能状态直接评估、元记忆和记忆自我效能量表。在这个随机临床试验中，受试者将被随机分配到实验组和对照组。数据收集将在27个月内进行5次面对面访谈。数据分析将包括描述性统计、相关性、2X5方差分析和层次回归。

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.