Interventions to improve autobiographical memory specificity in older adults:a strategy to prevent decline in wellbeing

Abstract

Autobiographical memory (AM) is related to social problem-solving, depression, and independence. However, older adults often have difficulty recalling specific AMs, and this over-general memory (OGM) style is a vulnerability factor for depression. The main aim of this thesis was to examine how useful AM training methods are for reducing OGM in non-depressed older adults. Firstly, the effect of an intervention based on improving flexibility in AM retrieval (MemFlex) was examined in healthy older adults. Next, two AM training interventions were compared in order to investigate the underlying mechanisms that would be most suitable as targets for an older population: Memory Specificity Training (MEST) which targets systematic practice in the executive control process of retrieval, and life review which focuses on enhancing positive memories more related to the concept of self. Finally, the intervention which was found to be most suitable was examined in a clinical sample of older adults with amnestic Mild Cognitive Impairment (aMCI), and acceptability of the intervention was assessed via semi-structured interviews. The results demonstrated that OGM was modifiable in healthy older adults via both MEST and life review, however it was not differentially affected by the MemFlex intervention compared to controls. Life review was considered to be the most appropriate for older adults, however, it did not have any significant quantitative effects in the aMCI sample. Qualitative analysis suggested the element of meaning-making and taking an integrative approach was particularly relevant to them. Narrative coherence should therefore be examined as a potential underlying mechanism that could be further incorporated into the life review programme to enhance its’ effectiveness. A consistent finding throughout this body of work was a relationship between change in AM specificity and change in social problem-solving ability, supporting the suggested role of specific retrieval in generating solutions to social problems.