Acting is the key: new directions for the stimulation of prospective memory in mild cognitive impairment

Background: The fulfillment of delayed intended actions (e.g. taking medication\ud or attending an appointment) is described in the literature as prospective\ud memory (PM), and is often pointed out as a fairly common concern for\ud healthy adults in everyday life constituting a fundamental requirement for\ud independent living across the lifespan. PM may be compromised in the\ud course of healthy aging and may be particularly disrupted very early in\ud the neurodegenerative process, namely at the stage of Mild Cognitive Impairment\ud (MCI), which usually represents an initial phase of Alzheimer’s\ud disease (AD), severely affecting a self-sufficient life-style and causing immense\ud apprehension to caregivers. Methods: We have addressed this issue\ud by investigating whether enactment at encoding could improve PM\ud performance and whether these potential benefits were dependent of the\ud relationship between the retrieval cue and its associated action. We report\ud findings that explored this hypothesis in 64 young adults aged 18-39 years\ud (M ¼ 20.41, SD ¼ 3.553) and 64 educationally matched older adults\ud aged 58-90 years (M ¼ 71.17, SD ¼ 7.204) using a behavioral PM testing\ud paradigm with a 2 X 2 X 2 between-subject factorial design. Results: Older\ud adults’ PM performance (like that of their younger counterparts) benefited\ud from enactment at encoding and from a strong semantic cue-action relation.\ud Furthermore, there were no reliable effects of encoding modality or cue-action\ud relatedness on performance accuracy or speed, despite a generalized\ud slowness associated with age. Importantly, these beneficial effects were\ud maintained across the lifespan, and even under high attentional demands.\ud Figure 1. Mean proportion of PM cues eliciting a correct response at the\ud appropriate moment in each Method of Encoding X Cue-Action Relatedness\ud X Age