The role of autobiographical memory in mediating between underlying cognition
and outcome functional limitations and independence in older adults.
Carol Holland, Alexis Boukouvalas, Stuart Wallis, Danielle Clarkesmith, Leanne Liddell.
Introduction
Investment in the maintenance of cognition,
well-being and independence has never
been so critical, but in these financially
austere times, there are real concerns that
prevention measures will be seen as a low
priority. It is, therefore, vital to be able to
demonstrate their effectiveness on factors
that may impact actual independence and
functioning.
Results
1) Moving to an active and engaged supported living environment has an influence
on autobiographical specificity. Time x Group interaction F(1,88)=11.35, p<0.01
There is little research associating cognitive changes within the normal range
with actual function in everyday life:
“any understanding of cognition as it occurs in everyday life must
make a distinction between basic cognitive mechanisms and skills
(such as working memory capacity) and the functional use of
cognition to achieve goals in specific situations” (Hertzog et al.
(2009) p1).
Ability to recall specific detailed autobiographical memories is proposed as an
example of functional memory central to wellbeing:
• a risk factor for depression & suicide (Williams et al., 2007);
• important social functions related to intimacy (maintaining and developing
relationships), to teaching or informing (e.g. illustrating a point or giving advice)
and to eliciting or showing empathy (Alea & Bluck, 2003);
• overgeneral autobiographical retrieval associated with impaired social problem
solving (Beaman, et al, 2007; Goddard, et al, 1998);
• specificity implicated as a mediator in the relationship between chronic daily
hassles and depression (Anderson, et al., 2010).
2) Autobiographical specificity as a mediator between cognition
or depression and social functioning, independence or wellbeing?
AMT is strongly related to
these variables at Baseline
BL
-.20**
.27**
.16*
.35*
.31**
.45**
.42**
Age
Perceived health
Depression
IADL
MMSE
ACE-R
Fluency
F1
-.14
.20**
-.31**
.26**
.41**
.47**
.38**
F2
-.18*
.18
-.13
.19
.26*
.39**
.38**
Autobiographical recall specificity reduces with increasing age (Holland & Rabbitt,
1990; Holland, et al., 2012; Piolino, et al, 2002; Ros, et al., 2009).
In addition to contributing to what we know about how underlying cognition has an
influence on independence and wellbeing outcomes, given all we know about the
impact of an active and engaged lifestyle on cognitive maintenance in older age, it is
important to investigate factors that may impact ability to engage.
Hypotheses:
Moving to an active and engaged supported living environment may have an
influence on autobiographical specificity.
Autobiographical specificity may be an intermediary functional measure of
memory lying between basic cognitive function in older age and social
functioning and independence outcomes.
This would have a longitudinal influence on outcome social functioning and
independence outcomes.
The project:
In a three year longitudinal study new residents who volunteer to take part are
assessed upon moving into ExtraCare accommodation (Baseline, BL) in 14 locations
across the UK midlands and then assessed on the same measures at 3, 12 and 18
months after entry. A control group of volunteers from the same age range who are
staying in their original homes are also assessed at the same intervals.
This poster examines data on measurements at BL, 3 & 12 months available so far.
Participants: 162 new residents, mean age (SD) 75.15 (8.16) at baseline in
comparison to a control group of 33 older adults (mean age 71.81, SD = 6.30) who
remained in their original homes. Only other criterion is that participants must have
mental capacity to consent.
The measures:
i. The ACE-R (Mioshi, et al, 2006):Overall cognitive screening assessment
(attention/orientation, memory, verbal fluency, language and visuospatial awareness. The minimental state examination (MMSE) score can be calculated from results).
ii. Fluency (Categorical & Phonological)
iii. Autobiographical memory test (AMT) (Williams & Broadbent, 1986). (N specific
memories recalled out of 10 cues given).
iv. Depression (HADS, Zigmond & Snaith, 1983).
v. Instrumental activities of daily living, IADLs (as a measure of independence)
(Lawton & Brody, 1969).
vi. Functional limitations profile (Pollard & Johnstone, 2001). Only Social and
recreational limitations analysed here.
vii. Self-perceived health ‘excellent, very good, good, fair or poor’ (5 point scale)
Ability to recall specific AM acts as a mediator between..
Relationship
BL
3 months (F1)
12 months
MMSE and perceived health
√
MMSE and Instrumental ADLs
√
HADS-D and perceived health
√
√
√
HADS-D and IADLS
√
√
√
HADS-D and FL- Recreation
√
Fluency and perceived health
√
Fluency and IADLs
√
√
√
√
Fluency and FL- Social
3) So what happens when AMT changes? Longitudinal influence on
outcome social functioning and independence outcomes.
Predicting change in IADLs using regression:
• Change in all cognitive variables, perceived health and depression as
predictors: R2 (10,126) = 0.17, p<0.05,
• Change in AMT is the only significant predictor, p<0.05.
Conclusions
Demonstrating that this measure of everyday, socio-emotional, functional memory
acts as a mediator between underlying cognitive function and social and
independence functioning adds a useful predictor to our ability to relate clinic
measures to real world coping. We have shown that natural change in this
measure predicts change in an independence measure. Evidence from the
depression literature demonstrates that AM specificity can be remediated. The
next step is to examine purposeful remediation/training impact in this age group.
Key References
Beaman A, Pushkar D, Etezadi S, et al. (2007). Autobiographical memory specificity predicts problem-solving ability in old and young adults. QJEP 60, 1275-1288.
Dalgleish T, Williams JMG, Golden AMJ, et al. (2007). Reduced specificity of autobiographical memory and depression: The role of executive control. JEP-G:136, 23-42.
Hertzog C, Kramer AF, Wilson RS, Lindenberger U. (2009). Enrichment effects on adult cognitive development: Can the functional capacity of older adults be preserved and enhanced? Psychological Science in the Public Interest, 9 1-65.
Holland CA, Ridout N, Geraghty J, Walford E. (2012) Executive function and emotional focus in autobiographical specificity in older adults, Memory, 20, 779-793.
Piolino P, Coste C, Martinelli P, et al. (2010). Reduced specificity of autobiographical memory and aging: Do the executive and feature binding functions of working memory have a role? Neuropsychologia, 48, 429-440.
Ros L, Latorre JM, Serrano JP. (2010). Working memory capacity and overgeneral autobiographical memory in young and older adults. Aging, Neuropsychology and Cognition, 17, 89-107.
For further information, contact Dr. Carol Holland,
[email protected].
ARCHA website:http://www.aston.ac.uk/lhs/research/centresfacilities/archa/