Aging and performance on laboratory and naturalistic prospective memory tasks: The mediating role of executive flexibility and retrospective memory

Comparison of lifestyle, cognitive function, mental health, and quality of life between hospitalized older adults with COVID-19 and non-COVID-19 in South Korea: a cross-sectional study

BACKGROUND

The coronavirus disease (COVID-19) pandemic has greatly impacted older adults, resulting in many deaths. The impact of lifestyle and mental health on vulnerable groups, such as older adults, can be large and long lasting. Therefore, this study aimed to investigate the effects of COVID-19 confirmation on cognition, lifestyle, mental health, and quality of life in adults aged 55 years.

METHODS

The sample consisted of 111 people in the COVID group and 189 people in the non-COVID group aged over 55 years in South Korea. An online survey was conducted between January and May 2022. Participants responded to the following assessment tools: Yonsei Lifestyle Profile, Prospective and Retrospective Memory (PRMQ), Subjective Memory Complaints Questionnaire (SMCQ), Visual Analogue Scale, Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI), Fear of COVID-19 Scale (FCV-19 S), and the World Health Organization Quality of Life Scale abbreviated version (WHOQOL-BREF). Differences in lifestyle, cognition, depression, anxiety, and quality of life were compared between the two groups.

RESULTS

There were significant differences in physical activity, diet, the total score of the PRMQ, PM (a sub-score of the PRMQ), PHQ-9, Korean version of the ISI (ISI-K), and WHOQOL-BREF scores between the COVID and non-COVID groups. However, there were no significant differences in activity participation, Self-Rating Anxiety Scale (SAS), or FCV-19 S between groups.

CONCLUSIONS

The study confirms that COVID-19 negatively affects memory, physical activity, diet, quality of life, depression, and insomnia in the older adults. Therefore, this study implicated that prevention and intervention strategies required improving the memory, lifestyle, and mental health of older adults with COVID-19.

TRIAL REGISTRATION

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of Yonsei university in Korea (Registration number: 1041849-202112-SB-226-03, Date of registration: 01042022).

Development of the Virtual Kitchen Protocol for Prospective Memory: a virtual reality-based measure of everyday prospective memory abilities

INTRODUCTION

Prospective memory is the ability to remember to accomplish a task at a specified point in the future. While this cognitive ability has a large impact on daily functioning, it is rarely assessed during neuropsychological evaluations. Furthermore, existing clinical prospective memory measures are few in number and have significant limitations, including applicability to everyday functioning and appropriate norming for older adulthood. There are also many gaps in the literature on prospective memory, such as how environmental factors affect performance across the lifespan.

METHOD

In the current study, we develop and establish a new virtual reality-based measure of prospective memory, the Virtual Kitchen Protocol for Prospective Memory. Young adults (ages 18-29; n = 56), healthy older adults (ages 60-90; n = 94), and clinical older adults (ages 62-90; n = 30) were compared on their performances on both the developed virtual reality prospective memory test and a parallel paper-and-pencil prospective memory test to investigate the impact of test environment across participant group.

RESULTS

The Virtual Kitchen Protocol for Prospective Memory was found to adequately differentiate between young adult, healthy older adult, and clinical older adult populations - suggesting baseline ability for prospective memory assessment in clinical settings with older adults and potential for future improvement of neuropsychological evaluations. Additionally, the developed virtual prospective memory task appeared to mimic environmental factors in everyday life but did not replicate the benefit previously measured in healthy older adults' prospective memory ability in naturalistic settings.

CONCLUSIONS

Overall, the current study built upon extant knowledge of prospective memory in both normal and abnormal aging, suggesting future directions in replicating familiar home environments. Findings provided additional evidence toward future validation of virtual reality assessment tools in clinical neuropsychological evaluations of cognitive abilities, such as prospective memory, with both healthy and clinical older adult populations.

Inhibition mediates the relationship between age cohort and virtual reality-based prospective memory

INTRODUCTION

Prospective memory has received relatively little attention from a clinical perspective, yet it is an important part of daily functioning. Executive functions have been linked with prospective memory abilities, and age differences are found in both executive functions and prospective memory. The purpose of this study was to investigate whether age cohort differences in prospective memory abilities are mediated by executive functions, specifically inhibition.

METHOD

Participants (N = 108) consisted of young adults (n= 53) and older adults (n= 55) without any neurocognitive impairment. Participants completed a clinical interview and a battery of neuropsychological tests that included the Mini-Mental Status Exam-2 Standard Version (MMSE-2-SV), the Wisconsin Card Sorting Test-64 (WCST-64), the Delis-Kaplan Executive Functioning System Color-Word Interference Test (D-KEFS CWIT), and the Virtual Kitchen Protocol (VKP).

RESULTS

Young adults had higher prospective memory scores than older adults. Inhibition (i.e., D-KEFS CWIT) mediated the relationship between age cohort and prospective memory, while cognitive flexibility did not mediate the relationship.

CONCLUSIONS

Older adults may have diminished inhibition abilities that may negatively affect their ability to complete prospective memory tasks.

Psychometric properties of the Actual Week test: a naturalistic prospective memory task

OBJECTIVE

Prospective memory is the ability to 'remember to remember' and a facet of memory important to everyday functioning. For older adults, prospective memory slips are a common concern. In the present study, we conducted an initial validation of a paper-and-pencil adaptation of the Actual Week test, and reported on internal consistency, inter-rater and test-retest reliability, convergent and divergent validity, as well as veridicality of the task.

METHOD

Fifty-eight healthy, community-dwelling older adults were recruited from a larger randomized controlled trial and tested at baseline. The Actual Week test was a naturalistic five-day prospective memory task where participants were assigned eight hypothetical tasks to remember per day for five days. Tasks were either time-cued or event-cued and regular (i.e. occurring daily) or irregular (i.e. varied each day). The proportion of tasks that were recorded as on time and accurate was used as the primary measure of performance.

RESULTS

The Actual Week test had good internal consistency (Kuder-Richardson: r > .8), intra-test (intraclass correlation: α > .9) and test-retest reliability (r = .76). There was also evidence for convergent and divergent validity. Task performance was associated with age, but not years of education or sex.

CONCLUSION

The Actual Week test demonstrated strong psychometric qualities and promising evidence for validity as a performance-based measure of everyday prospective memory in older adults. Avenues for future studies include extending the evidence for convergent validity and evaluating feasibility and utility with other clinical populations.

Correspondence between Subjective and Objective Cognitive Functioning Following Chemotherapy for Breast Cancer

This study examined subjective and objective cognitive functioning in 26 female breast cancer survivors (BCS) who received chemotherapy treatment that finished .5 to 5 years prior to testing and compared their results to 25 demographically matched women with no history of cancer. Participants were assessed on prospective memory (PM) tasks; neuropsychological tests of processing speed, attentional flexibility with greater cognitive load, executive function, and verbal memory; self-report measures of cognitive dysfunction and PM failures; and distress. The BCS group showed significantly slower speed of processing and reduced attentional flexibility, and reported significantly more cognitive complaints and PM failures than the control group on five of six self-report measures. The groups did not differ on other PM or neuropsychological measures or on a measure of distress. Subjective cognition correlated with some neuropsychological tests and with a virtual reality PM task. Objective cognitive impairments were associated with reduced quality of life in the BCS group. The results provide some evidence of both self-reported impairment and objective cognitive dysfunction following chemotherapy treatment.