Everyday Impact of Memory Changes Among Older Adults

Many older adults report subjective memory complaints that can impact their everyday living. The extent to which such complaints impact daily functioning are important criteria to consider when diagnosing memory conditions. In addition, as most of the research identifying the impact of memory changes is qualitative in nature, there is a need for quantitative studies that examine the impact of memory changes across the cognitive aging spectrum and how this impact is related to subjective and objective cognition. Moreover, addressing the everyday impact of memory changes is a crucial goal of memory interventions due to its implications for later disease development, and as such there is a need for instruments with strong measurement properties that assess the everyday impact of memory changes. The goal of the present research was to address these issues. In Study 1, I examine neuropsychologists practices in assessing functional abilities within the context of diagnosing memory conditions. A survey of 280 neuropsychologists revealed that neuropsychologists consider a variety of components that comprise everyday life and utilize several different instruments when assessing functioning. There was a lack of consensus among respondents when asked to diagnose individuals with different levels of impairment in daily functioning, underscoring the need for more measures that assess everyday functioning. In Study 2, I quantify the impact of memory changes across a cognitive aging spectrum ranging from normal cognition to mild cognitive impairment and describe associations between memory impact and both subjective and objective cognition. Results indicated that older adults with lower self-reported memory ability and poorer objective memory performance reported a greater burden of memory change on everyday living. In Study 3, I describe the responsiveness to intervention of a recently developed instrument that quantifies the impact of memory changes on everyday life. Results provided support for the clinical utility of this instrument in evaluating changes in memory impact. Collectively, these studies explore the impact of memory changes on everyday functioning among older adults, particularly how functioning is assessed by clinicians, the cognitive correlates of everyday functioning, and tools that can be used to assess functioning within the context of memory interventions.