Neurological Changes With a Memory Self-efficacy Training Protocol

Study Overview
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Brief Summary
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Confidence in one's ability to accomplish a task, more formally known as self-efficacy, is an important psychological variable that can influence how the investigators perform on various tasks. Previous studies have shown that self-efficacy is a modifiable trait that can be improved and bolstered with training and practice. More importantly for this study, memory self-efficacy has been shown to be modifiable for older adults, consequently improving their performance on memory tasks. While there is evidence to support the importance of memory self-efficacy for successful memory performance in older adults, the underlying neurological changes that accompany these performance changes have not been explored. The goal of this study is to examine the changes in brain activity before and after a memory self-efficacy training program to better understand the mechanisms of both memory and self-efficacy.

Official Title
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Neurological Changes With a Memory Self-efficacy Training Protocol

Conditions
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Mild Cognitive Impairment

Intervention / Treatment
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* Behavioral: Memory Self-Efficacy Training
* Behavioral: General Education


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjective memory complaints within past 5 years Objective memory impairment below age norms on standardized cognitive testing Score below 25 on Montreal Cognitive Assessment Scores 1.5 standard deviations below age norms on memory testing Unimpaired performance in Activities of Daily Living Intact general cognition Fluently read, write and speak English Right handed Exclusion Criteria: Co-morbidity that would impact cognition (depression, anxiety, stroke) Prior diagnosis of dementia of any type Use of prescription or recreational drug use that would impact cognition (excluding hormone replacement therapy) Uncorrected visual or auditory deficits/impairments Current participation in alternate study

Ages Eligible for Study
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Minimum Age: 60 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Memory Self-Efficacy Training<br>Memory self-efficacy group training classes. | Behavioral: Memory Self-Efficacy Training<br>* The intervention will consist of a six-week cognitive behavioral intervention integrating the four pillars of self-efficacy, Mastery, Social Modeling, Coaching, and Physiological Responses (West et al. 2008). Each week will comprise of a 1.5 hour session which focuses on an educational component, discussions and active learning practice activities to apply lesson material. Additionally, participants will be given take home exercises to practice outside a classroom setting. The sessions will be conducted in small groups of 4-6 people.<br>|
| Active Comparator: General Education Group<br>General education group classes (e.g., exercise, diet, sustainability, tc.) | Behavioral: General Education<br>* The active control intervention will be a general education class consisting of real world knowledge and factual information on various topics unrelated to memory. This intervention will follow the same format as the memory self-efficacy training arm. One 1.5 hours session every week for 6 weeks, in small groups.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neurological bio-markers: Regional activation | Using fMRI identify changes in activation patterns or signal change when performing an associative memory task | Pre and Post intervention - 6 weeks | 
| Neurological bio-markers: Default mode network | Using fMRI during a resting state observe changes in default mode network activation | Pre and Post intervention - 6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Story Recall - Trained memory performance task | Observe the changes in memory performance using measures that were specifically practiced in the training intervention. Recall of a short story to estimate episodic memory capacity. | Pre and Post intervention - 6 weeks | 
| List Recall - Trained memory performance tasks | Observe the changes in memory performance using measures that were specifically practiced in the training intervention. Recall of a visually presented list of unrelated words to estimate episodic memory capacity and working memory. | Pre and Post intervention - 6 weeks | 
| Face-Name Pairs - Trained memory performance tasks | Observe the changes in memory performance using measures that were specifically practiced in the training intervention. Recall of a face-name pairs to evaluate associative memory. | Pre and Post intervention - 6 weeks | 
| RAVLT - Untrained memory performance tasks | Observe the changes in memory performance using measures that were not specifically practiced in the training intervention. Participants are asked to recall a list of verbally presented words immediately after presentation and after a delay. Used to evaluate sort term verbal memory and long term memory | Pre and Post intervention - 6 weeks | 
| Visual Spatial Learning Task - Untrained memory performance tasks | Observe the changes in memory performance using measures that were not specifically practiced in the training intervention. Subjects are given time to learn the location and design of shapes on a 6 x 4 matrix. Subjects are required to correctly select the 7 correct shapes from a selection of 15 and place them on the grid. Used to measure visual spatial memory | Pre and Post intervention - 6 weeks | 
| Digit Span Task - Untrained memory performance tasks | Observe the changes in memory performance using measures that were not specifically practiced in the training intervention. A series of numbers are verbally presented, increasing in length for the participant to repeat back. Measures working memory | Pre and Post intervention - 6 weeks | 
| Face-Scene Pairs - Untrained memory performance tasks | Observe the changes in memory performance using measures that were not specifically practiced in the training intervention. An alternative form of evaluating associative memory ability. Participants will be given face and scene pairs to remember. | Pre and Post intervention - 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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memory, older adults, randomized control trial, MRI, memory education