Prospective Memory training
KATHERINE BECKS
46525760_researchproposal_2.pdf
Running head: RESEARCH PROPOSAL 1
Research Proposal
Ashleigh Barber
Australian Catholic University
RESEARCH PROPOSAL 2
Research Proposal
Background
Australia’s Ageing population
At present, Australia’s population is aged, as indicated by the large proportion of older
adult residents, and . This would at least be partially attributable to 100 years of progressively
greater longevities (Howat & Stoneham, 2011). With increasing longevity come several
challenges, for individuals and the health care sector if a number individuals later life is spent in
a state of morbidity. While normal ageing research is not without contention (e.g., about the
underpinning processes in cognitive decline), evidence suggests that the process of normal
ageing appears to involve a decline in such higher order cognitive domains as memory and
information processing REF, which are crucial for living autonomously. While many cognitive
functions are studied in relation to ageing, memory impairment topic of research in older
adulthood, as it comprises multiple cognitive abilities that are each fundamental to in successful
ageing.
The Ageing Process
A normal ageing trajectory human beings represents a latent, time-dependent biological
process (Moody & Sasser, 2014), which albeit it is not pathological, is often characterised by
functional degradation in one or more of physical, sensory, or cognitive abilities (Desjardins,
2012). Many adults experience some age-related cognitive decline (Deary et al., 2009), but the
explicit causal underpinnings of such changes are not robustly understood. The idea of negative
learning was proposed in Mahncke et al.’s (2006) framework, which argues that normal
cognitive changes stem from the combined effect of physical ageing of the cortices and negative
cortical plasticity (i.e., plasticity with negative consequences) (Mahncke, Bronstone, and
Merzenich, 2006).
Briefly outsine the scaffolding idea and negative cortical plasticity
Normal ageing
The maximum upper limit of human lifespan
RESEARCH PROPOSAL 3
The maximum human lifespan is indicated to have a fixed theoretical upper limit of 120 years
(Moody & Sasser, 2014). This upper bound has remained unchanged over time, while the life
expectancy continues to climb.
Promoting optimal development right across the lifespan is a crucial task of developmental psychology
Compression of morbidity hypothesis
Discuss briefly in conjunction: max lifespan, compression of morbidity theory in relation
to health goals and the possibility of human beings, as prevention strategies implemented with
healthy participants fosters the healthy trajectory not the one of morbidity.
“With this concept of limit in mind, compression of morbidity is attractive because
delaying dysfunction would enhance the quality of life, extend life expectancy, and reduce health
care costs (Butler, 1995). A compression-of-morbidity strategy would move life “
Prospective Memory
What is PM (related to RM, what do they encompass?)
Qualitative study: Subjective complaints of particcipants were all PM and some
RM, some really dangerous (community-dwelling older adults, focus group)
Types of PM, cued.
Cortical Plasticity
Evidence of maintaining plasticity throughout lifespan
Negative learning (NCP)
Conclusions of OA misbeliefs (negative learning)
Cognitive training programs
Extant research
Process vs. system designs
Virtual week
Original, P. R.
RESEARCH PROPOSAL 4
Computerised, 2000
VW14, computerised with graded difficulty etc.
Rationale.
Gaps in literature study aims to address
Firstly, relatively few studies include control groups when running studies with cognitive
training (REF), yet it is crucial for being able to make causal inferences about its efficacy.
Secondly, many cognitive training programs are conducted in laboratories, which limits
ecological validity. The design of the study has participants carrying out the tasks in their own
home, without the experimenter there was they play, and the tasks are relevant to functioning
outside of the study. Finally, the adherence of participants to the prescribed training program
and protocol is not a prioritised assessment in training studies.
Current Study
Aims and objectives.
The two primary objectives of this pilot study are to examine both the usability and
assess the preliminary efficacy of 6-weeks of Virtual Week Training 2014 (VWT14) program for
improving prospective memory in healthy Australian older adults. In addition, this study will aim
to analyse changes in subjective reports of memory functioning following 6-weeks of VWT14
program.
VWT14 may represent one way of decelerating normal prospective memory decline in
older adulthood, and as such, it is hypothesised that participants who have completed the training
program will have significant improvement in their prospective memory compared to waitlist
controls, based on Memory for Intentions Screening Test (MIST) (S. Raskin, Buckheit, &
RESEARCH PROPOSAL 5
Sherrod, 2010) performance. It is also hypothesised that when all participants’ posttest data are
pooled, there will significant changes from pre- to posttest performance on the MIST. Finally, it
is hypothesised that subjective reports of memory, based on the Memory Function Questionnaire
Revised (MFQ-R, Gilewski, Zelinski, & Schaie, 1990), will improve from pre- to posttest.
Research Methodology
Participants
A B C D E F
1
Recruitment phase
Prospective participants
2 Make contact (phone/email)
Pre-screen checklist
First assessment
3 Arrange in-person meeting Cog screen; BG
survey; MFQ
4 Participants
assigned to 1/2 conditions
5 Stratified by age, gender,
ACE-III score
6 Pretesting phase
Figure 1: Participant Selection Map (coordinates referred to throughout research methods section)
Study design
This pilot study will be a pre-post-test waitlist control design with both intervention and
comparison groups, so as to pilot the VWT14 program as a means of improving prospective
memory in healthy older adults.
Inclusion/exclusion criteria
Participants will be deemed eligible to partake in the study if they meet all of the criteria
examined during the screening assessment (see Appendix 1).
Measures
RESEARCH PROPOSAL 6
Addenbrooke’s Cognitive Examination III ipad version (ACEmobile) (Newman, Noad,
& Hodges, 2014)
The ACE-III (Mathuranath, Nestor, Berrios, Rakowicz, & Hodges, 2000) is a sensitive
and specific screening tool for general cognitive functioning that takes appropriately 15 minutes
to administer. Nineteen brief subtests comprise the following five dimensions:
attention/orientation, memory, verbal fluency, language, and visuo-spatial, which give five sub-
scores and a total score out of 100. The ACE-III has the capacity to screen for cognitive
impairment and diagnoses, severity and profile of cognitive functioning, and has three Australian
alternate forms for assessing change and comparing scores between groups. ACEmobile, an
electronic version of ACE-III was released for the iPad June 2014, and will be used in this study.
It enhances administration through on-screen instructions, requires no training, reduces error by
scoring automatically, and provides results instantly on-screen and via email to the researcher.
Memory Functioning Questionnaire Revised REF
DESCRIBE TEST
Memory for Intentions Screening Test
The Memory for Intentions Screening Test (MIST) (S. A. Raskin, 2009) is a standardised
tool for measuring prospective memory that takes approximately 30 minutes to administer. The
MIST is reported to have sound psychometric properties (Woods et al., 2008), and be sensitive to
mild impairment (Karantzoulis, Troyer, & Rich, 2009). Participants are provided with an eight-
task set of tests at the outset of a testing session and must remember, throughout the session, to
perform both time-based tasks (‘in exactly x minutes, please alert me that it is break time’) and
event-based tasks (‘when I pass you the blue pen, may you write your name on this sheet of
paper’). Between these PM tasks, participants solve word puzzles, while the researcher observes
RESEARCH PROPOSAL 7
whether the PM tasks are remembered and carried out. Correct and error responses are both
recorded, while variables and error scores can be combined to discern different types of
prospective memory fail
Recruitment
Participants will be sourced from the community (Catholic homes, advertisements in
relevant public locations, word-of-mouth) (A1, 2, 3). Prospective participants will be asked to
contact the researcher via either email or telephone if they are interested in partaking or to find
out more information about the study (B1, B2, 3). The researcher will then screen these
individuals over the phone using a checklist (C2).
Procedure
After eligible participants have been explained the details of the study (C2) and provided
informed consent (D2), they will then be asked to fill in a background information survey, the
Memory Functions Questionnaire (Revised), and be screened on global cognitive ability to
ensure healthy cognitive functioning on the ACE-III (D3). Both the intervention and waitlist
control groups will partake in the VWT14 program, but the immediate intervention group will
commence the 6-week training within the first two weeks of screening (C2), while the waitlist
control will commence their 6-week block around 8 weeks after screening (C2). Given the data
collection and intervention implementation procedures are conducted one participant at a time
rather than altogether in a group, so long as each participant has the appropriate intervals across
screening, pre-test, and post-test for their assigned condition (i.e., immediate intervention or
waitlist control), the waitlist control group does not necessarily have to wait until each
immediate intervention participant has completed the training. Specifically, so long as the
waitlist control has had a 6-week no-contact interval after screening, they can be pre-tested and
RESEARCH PROPOSAL 8
commence training as soon as this 6-week period is over (see Appendix 2 for visual
representation).
The Memory for Intentions Test (MIST) (S. Raskin et al., 2010) will be administered at
two time points for each participant: for the immediate intervention group, first time (pretest)
will be within two weeks following the first meeting between participant and researcher (D2, 3),
and two weeks before the start of the VWT14 program, and second time (posttest) will be within
a week of completing VWT14. For the waitlist control group, their pretest will be 6 weeks after
the first meeting between participant and researcher, and this pretest data will serve as a
comparison point for intervention effects.
Planned Statistical Analyses
The following table outlines how data will be analysed in order to address the aims and
objectives of the study. Due to the nature of a pilot study, the sample size is projected to be
relatively small so until distributions are analysed, it is unknown whether non- or parametric
statistical analyses will be more appropriate, so both are recorded below where necessary.
Table 1
Planned Statistical Analyses
Assessing By: Variables Statistics
Efficacy (a) Of VW at improving PM performance on MIST (control comparison)
Change scores on MIST from pre- to posttest: between groups difference (independent samples)
IV1 group: intervention /control IV2 time point: pretest/ posttest
DV change scores: MIST
Hodges-Lehmann estimate of median differences (estimates the median difference between the groups’ change scores from pre-post test)
Efficacy (b) Of VW at improving PM performance on MIST (pooled comparison)
Scores on MIST, difference from pre- to posttest: within groups difference (paired sample)
IV1 time point: pretest/ posttest
DV scores: MIST
Paired samples t-test or Wilcoxon test (changes in the same participants’ scores across two time points)
Efficacy (c) Of VW at Scores on MFQ IV1 time point: Paired samples t-test or Wilcoxon
RESEARCH PROPOSAL 9
improving subjective perceptions of memory (pooled comparison)
difference from pre- to posttest: within groups difference
pretest/ posttest
DV scores: MFQ test (changes in the same participants’ scores across two time points)
Usability
Of VW training program for older adults
Scores on VWUQ- 14, an adapted version of Lewis’ 1995 questionnaire
DV scores: VWUQ- 14
Descriptive statistics: means, standard deviations, confidence intervals, and % ≥ or ≤ given scoring ranges (i.e., difficulty: easy, med, hard) according to author’s recommended scoring.
Adherence/ compliance
To training program’s prescribed protocol
Rate of sessions completed per week (χ/4) (& total χ/24)
DV rate: of completed sessions out of 4
Descriptive statistics: means, SDs, CIs, n’s and % rates of completed sessions per week, total over program, and % of participants completing all prescribed sessions.
Usability of VWT14
A usability questionnaire (adapted from Lewis, 1995) will be administered via email or
post within one week of each participant’s final VWT14 session (as shown by automated data).
Participants rated how strongly they agreed with each item on a scale of 1(Strongly Disagree) to
7 (Strongly Agree) (see Appendix 3).
Efficacy of VWT14
The primary efficacy outcome measure was performance on the MIST (S. Raskin et al.,
2010) (with control comparison), which aims to objectively measure prospective memory.
The secondary efficacy outcome measures were performance on the MIST (without
control comparison), and responses on the MFQ, a self-report questionnaire that assessed
subjective perceptions of memory functioning.
RESEARCH PROPOSAL 10
Appendix 1: Pre-Screen and Screener Assessments
The following will be asked/assessed during phone calls with prospective participants (pre- screen)
Inclusion Criteria No. Question Y N 1 Are you aged 60 or older 2 Are you retired 3 Do you have a windows computer? 4 Are you comfortable using the computer 5 Are you living independently in the community (i.e. without assistance) 6 Are you comfortable reading and understanding written instructions in English Exclusion Criteria 1 Do you have any neuro/psychiatric disorders or medical conditions that could affect your ability
to play a computer game e.g., epilepsy, blindness
2 Are you involved in another research study at this time The following will be information will be collected during the first face-to-face meeting (Screener)
1. Cognitive functioning using Addenbrooke’s Cognitive Examination V.3 (ACE-III) ipad version
2. Background information using a demographic questionnaire 3. Subjective memory functioning using the MFQ
RESEARCH PROPOSAL 11
Appendix 2:
Data Collection and Intervention Timelines for Two Groups The following two hypothetical timelines are displaying one of two pathways each participant
can take depending on which group they are assigned.
1
2 ! ! 3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
In te
rv en
ti on
w ee
ks o
f as
se ss
m en
t a nd
in te
rv en
ti on
POSTTEST
In te
rv en
ti on
PRETESTPOSTTEST
N o contact
PRETEST
Immediate Intervention
Waitlist Control
SCREENER
PRESCREEN
PARTICIPANT RECRUITMENT
RESEARCH PROPOSAL 12
Appendix 3: Usability Questionnaire
The following questionnaire will be given at the completion of the 6-week training period; it is adapted from Lewis (1995).
Virtual Week 14 Usability Questionnaire (VWUQ-14) For each of the statements below, please circle the rating of your choice.
1 Overall, I am satisfied with the ease of completing the Virtual Week program Strongly AGREE 1 2 3 4 5 6 7
Strongly DISAGREE
2 I am satisfied with the availability of support information (phone calls, messages, instructions/documentation) for completing this task
Strongly AGREE 1 2 3 4 5 6 7
Strongly DISAGREE
3 I am satisfied with how clear/easy to understand instructions/documentation for completing this task was
Strongly AGREE 1 2 3 4 5 6 7
Strongly DISAGREE
4 I enjoyed playing Virtual Week Strongly AGREE 1 2 3 4 5 6 7
Strongly DISAGREE
5 It was easy to learn to play/use Virtual Week Strongly AGREE 1 2 3 4 5 6 7
Strongly DISAGREE
6 I felt comfortable using the Virtual Week program Strongly AGREE 1 2 3 4 5 6 7
Strongly DISAGREE
7 I would recommend Virtual Week to family and friends Strongly AGREE 1 2 3 4 5 6 7
Strongly DISAGREE
RESEARCH PROPOSAL 13
Appendix 4:
Memory Functioning Questionnaire-Revised
RESEARCH PROPOSAL 14
110
Se riousness of Fo rgetting
When you actually forget in these situations, how serious of a problem do you consider the memory to be?
very serious somewhat serious not serious a. names 1 2 3 4 5 6 7 b. faces 1 2 3 4 5 6 7 c. where you put things (e.g., keys) 1 2 3 4 5 6 7 d. directions to places 1 2 3 4 5 6 7 e. beginning to do something and
forgetting what you were doing 1 2 3 4 5 6 7 ______________________________________________________________________________ R et rospective F unctioning
How is your memory compared to the way is was?
much worse same much better a. 1 year ago? 1 2 3 4 5 6 7 b. 5 years ago? 1 2 3 4 5 6 7 c. 10 years ago? 1 2 3 4 5 6 7 d. 20 years ago? 1 2 3 4 5 6 7 e. when you were 18? 1 2 3 4 5 6 7 ______________________________________________________________________________
M nemonics Usage
How often do you use these techniques to remind yourself about things?
always sometimes never a. keep an appointment book 1 2 3 4 5 6 7 b. write yourself reminder notes 1 2 3 4 5 6 7 c. make lists of things to do 1 2 3 4 5 6 7 d. make grocery lists 1 2 3 4 5 6 7 e. plan your daily schedule
in advance 1 2 3 4 5 6 7 f. mental repetition 1 2 3 4 5 6 7 g. associations with other things 1 2 3 4 5 6 7 h. keep things you need to do in a
prominent place where you will notice them 1 2 3 4 5 6 7
______________________________________________________________________________
RESEARCH PROPOSAL 15
References
Deary, I. J., Corley, J., Gow, A. J., Harris, S. E., Houlihan, L. M., Marioni, R. E., . . . Starr, J. M. (2009). Age-associated cognitive decline. British Medical Bulletin, 92(1), 135-152.
Desjardins, R. (2012). Ageing and skills: a review and analysis of skill gain and skill loss over the lifespan and over time.
Gilewski, M. J., Zelinski, E. M., & Schaie, K. W. (1990). The Memory Functioning Questionnaire for assessment of memory complaints in adulthood and old age. Psychology and aging, 5(4), 482.
Howat, P., & Stoneham, M. (2011). Why sustainable population growth is a key to climate change and public health equity. Health Promotion Journal of Australia, 22(4), 34-38.
Karantzoulis, S., Troyer, A. K., & Rich, J. B. (2009). Prospective memory in amnestic mild cognitive impairment. Journal of the International Neuropsychological Society, 15(3), 407-415. doi: 10.1017/S1355617709090596
Lewis, J. R. (1995). IBM computer usability satisfaction questionnaires: Psychometric evaluation and instructions for use. International Journal of Human-Computer Interaction, 7(1), 57- 78.
Mathuranath, P. S., Nestor, P. J., Berrios, G. E., Rakowicz, W., & Hodges, J. R. (2000). A brief cognitive test battery to differentiate Alzheimer's disease and frontotemporal dementia. Neurology, 55(11), 1613-1620.
Moody, H. R., & Sasser, J. R. (2014). Aging: Concepts and Controversies: SAGE Publications. Newman, C., Noad, R., & Hodges, J. (2014). ACEmobile (Version iPad): Neuroscience
Research Australia & Plymouth University. Retrieved from http://www.acemobile.org Raskin, S., Buckheit, C., & Sherrod, C. (2010). Memory for intentions test (MIST). Lutz, FL:
Psychological Assessment Resources. Raskin, S. A. (2009). Memory for intentions screening test: Psychometric properties and clinical
evidence. Brain Impairment, 10(1), 23-33. doi: 10.1375/brim.10.1.23 Woods, S. P., Moran, L. M., Dawson, M. S., Carey, C. L., Grant, I., Atkinson, J. H., . . . Vaida,
F. (2008). Psychometric characteristics of the memory for intentions screening test. Clinical Neuropsychologist, 22(5), 864-878. doi: 10.1080/13854040701595999
