Factor analysis of the everyday memory questionnaire in persons with traumatic brain injury

Translation, cross-cultural adaptation, and validation of the Persian version of Everyday Memory Questionnaire-Revised (EMQ-R) in patients with multiple sclerosis

PURPOSE

The present research translated and validated the Persian version of the Everyday Memory Questionnaire-Revised (EMQ-R) in patients with multiple sclerosis (MS).

METHODS

A two-step study was performed in the current work. First, the scale was translated and culturally adopted to Persian. In the second step, the translated questionnaire was presented to 150 patients with MS and 50 individuals in the control group. Then, construct validity (factor analysis and clinical validity) and reliability measures (test-retest reliability and internal consistency) were computed for this questionnaire.

RESULTS

Patients with MS obtained higher scores in EMQ-R than the control group (p < .001). The findings of the Kaiser-Meyer-Olkin and Bartlett test approved the sampling adequacy for computing the factor analysis (p < .001). The accuracy of the three-dimensional structure was confirmed by confirmatory factor analysis (CFA). Findings of test-retest (ICC = .95, 95%CI .91-.98, p < .001) and internal consistency revealed a satisfactory value (α = .95, p < .001).

CONCLUSIONS

Satisfactory findings for construct validity and high values for reliability revealed that the Persian version of EMQ-R is a reliable and valid scale to measure the everyday memory of patients with MS in the cognitive assessments of this group.

Everyday Memory Questionnaire-Revised (EMQ-R): Psychometric Validation of the European Portuguese Version in Non-Clinical Sample

The present study aimed to translate, culturally adapt, and present a psychometric validation for the Everyday Memory Questionnaire-Revised (EMQ-R) to the Portuguese population. The study involved 267 participants aged between 18 and 75 years (M = 39.32; SD = 14.8), recruited online. Self-report measures of anxiety and depression symptoms were administered to assess the instrument's convergent validity. To examine the factorial structure of the measure, a two-step validation process was employed. Given the uncertainty about the optimal measurement model, the sample was randomly divided into two independent subsamples. First, a principal component analysis (PCA) was conducted to explore the factorial structure. Next, a confirmatory factor analysis (CFA) was performed to validate the identified structure. The results supported a unidimensional structure consisting of 12 items, suggesting that perceived memory difficulties are best represented as a single overarching factor. High reliability was observed for this structure (Cronbach's alpha and McDonald's omega values ≥ 0.90). The results also indicated that general memory complaints were moderately correlated with symptoms of anxiety and depression. Furthermore, the study highlighted the promising potential of the measure as a screening tool for detecting subjective memory complaints, with an optimal cut-off score of 16 points. Future studies should focus on validating the EMQ-R with clinical samples, exploring its discriminative ability, and examining the stability of the cut-off score across different populations and contexts.

Predictors of subjective memory functioning in young adults

BACKGROUND

The characteristics of subjective memory and the underlying cause of subjective memory complaints are well-established in the older population, but less is known about memory functioning and self-perceived memory deficiency in young adults. Therefore, we aimed to investigate the potential contributing factors of subjective memory complaints in young adults, such as objective cognitive performance, negative affective state, well-being and subjective sleep quality.

METHODS

125 participants over the age of 18 years were recruited in the study (average age was 21 years (SD = 2.29), 58 males and 67 females, average education of the participants was 14.1 years (SD = 1.94). We measured subjective memory with Multifactorial Memory Questionnaire and different cognitive domains (such as short- and long-term verbal and visual memory, working memory, and executive functions), negative affective states (depression and anxiety), well-being, and subjective sleep quality.

RESULTS

Our results showed that depression had a significant predictive value on satisfaction with memory and subjective memory complaints. We failed to find a relationship between perceived subjective memory functioning and objective cognitive performance. Besides anxiety, only the executive functions predicted significantly the frequency of internal strategy use.

CONCLUSION

In conclusion, we revealed that negative affective states are more pronounced in the satisfaction with memory and subjective memory complaints in young adults than the objective cognitive ability.

Multicenter Evaluation of Memory Remediation in Traumatic Brain Injury With Donepezil: A Randomized Controlled Trial

Memory impairments are common chronic and functionally important consequences of traumatic brain injury (TBI). Among patients with persistent verbal memory impairments due to TBI-related cholinergic deficits, donepezil (an acetylcholinesterase inhibitor) may improve these and related problems. The Multicenter Evaluation of Memory Remediation in TBI with Donepezil (MEMRI-TBI-D) study, a four-site, randomized, parallel-group, double-blind, placebo-controlled, 10-week clinical trial, evaluated the efficacy of donepezil on verbal memory impairments, co-occurring cognitive and noncognitive neuropsychiatric problems, and functional status among persons with severe, persistent, and functionally limiting verbal memory problems at least 6 months after mild, moderate, or severe TBI. Efficacy, safety, and tolerability measures were assessed. Seventy-five participants were randomly assigned to donepezil (N=37) and placebo (N=38) groups. In both modified intent-to-treat and per-protocol analyses, donepezil significantly improved memory (i.e., verbal learning, as measured by the Hopkins Verbal Learning Test-Revised Total Trials 1-3, the primary outcome measure) when compared with placebo. Treatment-responder rates in the donepezil and placebo groups were 42% and 18%, respectively, yielding a number needed to treat of 3.5. Among donepezil responders, delayed recall and processing speed also improved significantly. Treatment-emergent adverse event rates for donepezil and placebo were 46% and 8%, respectively, and mild or moderate (85%); diarrhea and nausea were significantly more common in the donepezil group, yielding a number needed to harm of 6.25 and a likelihood to be helped or harmed ratio of 1.79. These results suggest that donepezil is an efficacious treatment for severe, persistent memory impairments after predominantly severe TBI, with a relatively favorable safety and tolerability profile.

Subjective memory measures: Metamemory questionnaires currently in use

Subjective memory evaluation is important for assessing memory abilities and complaints alongside objective measures. In research and clinical settings, questionnaires are used to examine perceived memory ability, memory complaints, and memory beliefs/knowledge. Although they provide a structured measure of self-reported memory, there is some debate as to whether subjective evaluation accurately reflects memory abilities. Specifically, the disconnect between subjective and objective memory measures remains a long-standing issue within the field. Thus, it is essential to evaluate the benefits and limitations of questionnaires that are currently in use. This review encompasses three categories of metamemory questionnaires: self-efficacy, complaints, and multidimensional questionnaires. Factors influencing self-evaluation of memory including knowledge and beliefs about memory, ability to evaluate memory, recent metamemory experiences, and affect are examined. The relationship between subjective and objective memory measures is explored, and considerations for future development and use of metamemory questionnaires are provided.

Duration of post-traumatic amnesia is uniquely associated with memory functioning in chronic moderate-to-severe traumatic brain injury

BACKGROUND

Disrupted memory circuitry may contribute to post-traumatic amnesia (PTA) after traumatic brain injury (TBI). It is unclear whether duration of PTA (doPTA) uniquely impacts memory functioning in the chronic post-injury stage.

OBJECTIVE

To examine the relationship between doPTA and memory functioning, independent of other cognitive abilities, in chronic moderate-to-severe TBI.

METHODS

Participants were 82 individuals (median chronicity = 10.5 years) with available doPTA estimates and neuropsychological data. Composite memory, processing speed (PS), and executive functioning (EF) performance scores, as well as data on subjective memory (SM) beliefs, were extracted. DoPTA-memory associations were evaluated via linear modeling of doPTA with memory performance and clinical memory status (impaired/unimpaired), controlling for PS, EF and demographic covariates. Interrelationships between doPTA, objective memory functioning, and SM were assessed.

RESULTS

DoPTA was significantly related to memory performance, even after covariate adjustment. Impairment in memory, but not PS or EF, was associated with a history of longer doPTA. SM was associated with memory performance, but unrelated to doPTA.

CONCLUSIONS

Findings suggest a specific association between doPTA-an acute injury phenomenon-and chronic memory deficits after TBI. Prospective studies are needed to understand how underlying mechanisms of PTA shape distinct outcome trajectories, particularly functional abilities related to memory processing.

Life satisfaction and emotional distress in people living with type 2 diabetes mellitus: The mediating effect of cognitive function

AIMS AND OBJECTIVES

To explore the relationships among emotional distress, cognitive function and life satisfaction in people living with type 2 diabetes mellitus (T2DM), and to verify the mediating role of cognitive function.

BACKGROUND

People with T2DM face cognitive decline caused by age and disease complications. Emotional distress will reduce their life satisfaction, and cognitive function will also affect the life satisfaction, but whether cognitive function mediates the effect of emotional distress on life satisfaction has not been verified.

DESIGN

A cross-sectional study.

METHODS

A total of 200 people living with T2DM in the community by convenience sampling were enrolled from November-December 2018. Data collection involved a demographic and disease characteristic questionnaire, Problem Areas in Diabetes Scale, Subjective and Objective Cognitive Function Evaluation and Life Satisfaction Questionnaire. Data analysis included descriptive statistics and structural equation modelling. This report followed the STROBE guideline.

RESULTS

The emotional distress and subjective memory complaints of cognitive function had a significant positive correlation, while both emotional distress and cognitive function showed significant negative correlations with life satisfaction. In addition, cognitive function completely mediated the relationship between emotional distress and life satisfaction.

CONCLUSION

The cognitive function played a mediating role in life satisfaction and explains how emotional distress affects life satisfaction of people with T2DM. Therefore, it is suggested that diabetes nurses should early identify the decline of cognitive function, and to intervene at an early stage.

RELEVANCE TO CLINICAL PRACTICE

This study provides opinions on the mediating factors of cognitive function. Coping strategies and supporting resources to help the T2DM people to improve their life satisfaction are suggested.

Clinical and cost effectiveness of memory rehabilitation following traumatic brain injury: a pragmatic cluster randomized controlled trial

OBJECTIVE

To evaluate the clinical and cost effectiveness of a group-based memory rehabilitation programme for people with traumatic brain injury.

DESIGN

Multicentre, pragmatic, observer-blinded, randomized controlled trial in England.

SETTING

Community.

PARTICIPANTS

People with memory problems following traumatic brain injury, aged 18-69 years, able to travel to group sessions, communicate in English, and give consent.

INTERVENTIONS

A total of 10 weekly group sessions of manualized memory rehabilitation plus usual care (intervention) vs. usual care alone (control).

MAIN MEASURES

The primary outcome was the patient-reported Everyday Memory Questionnaire (EMQ-p) at six months post randomization. Secondary outcomes were assessed at 6 and 12 months post randomization.

RESULTS

We randomized 328 participants. There were no clinically important differences in the primary outcome between arms at six-month follow-up (mean EMQ-p score: 38.8 (SD 26.1) in intervention and 44.1 (SD 24.6) in control arms, adjusted difference in means: -2.1, 95% confidence interval (CI): -6.7 to 2.5, p = 0.37) or 12-month follow-up. Objectively assessed memory ability favoured the memory rehabilitation arm at the 6-month, but not at the 12-month outcome. There were no between-arm differences in mood, experience of brain injury, or relative/friend assessment of patient's everyday memory outcomes, but goal attainment scores favoured the memory rehabilitation arm at both outcome time points. Health economic analyses suggested that the intervention was unlikely to be cost effective. No safety concerns were raised.

CONCLUSION

This memory rehabilitation programme did not lead to reduced forgetting in daily life for a heterogeneous sample of people with traumatic brain injury. Further research will need to examine who benefits most from such interventions.