1. Raechal Mack
05/05/2016
CDS 491 – Improving Memory in Elderly Adults
Memory is a process in which information is encoded, represented, and retrieved in the
hippocampal region of the brain. Historically, memory skill has been analyzed to determine the
type of memory associated with expanding its capabilities. The idea of improving memory is an
ancient concept that is constantly developing. Specifically, the interest in memory improvement
stems from the cognitive decline in the elderly, and the significant emergence of dementia.
Several studies show a proper diet, exercise, stress management, cognitive therapies, and
medications can help enhance memory. In particular, certain memory strategies and techniques
have been scientifically examined to determine the efficacy of each theory.
Articles from the late 19th and early 20th century divide the idea of memory into two
separate categories: natural and artificial memory. Natural memory focuses on the human mind’s
inherent qualities to attend and associate our surroundings through rational thought and the five
senses. In contrast, artificial memory relies on artificially constructed associations. (Collins,
2014) For example, using mnemonic systems to formulate and aid memory is considered an
artificial strategy. Typical efforts to enhance memory include both types of memory and have
been tested explicitly in experimental research.
The idea of acquiring a memory skill is a fundamental ability that can be learned at any
age. It has been found that distributing practice across a series of sessions can help improve
memory skills more effectively than practicing in one massed interval. In 1980, an undergraduate
student named “S.F.” engaged in a series of memory span tasks in order to analyze how a

2. memory skill is actually acquired. (Ericsson, 1980) During each session, S.F. was read random
digits at a rate of 1 digit per second. He was then immediately asked to recall the sequence of
digits he was given. If he recalled them correctly, the next sequence increased by one digit. On
the other hand, if he recalled the series of digits incorrectly, the following sequence was reduced
by one digit. At the end of each session he was asked to recall as many digits as he could and
summarize the techniques he used. Specifically, he used several mnemonic associations and
retrieval structures to help improve his ability to recall digit sequences. However, when he was
given sequences that couldn't be coded with his established techniques his performance dropped
tremendously.
Overall, “This data suggests that the reliable working capacity of short-term memory is
about 3 to 4 digits, and it’s not possible to increase the capacity without extended practice.”
(Ericsson, 1980) This hypothesis indicates that his increase in memory span was due to the
mnemonic associations that were previously stored in his long-term memory. This concludes that
long-term memory plays a major role in acquiring a memory skill and short-term memory does
not.
Now that the idea of how an individual acquires memory skills has been established,
research of how to improve memory can be appropriately conducted. Memory improvement
research is mainly focused around the elderly due to the natural decline of cognition that comes
with aging. Unfortunately, there are several disorders that affect the mental processes of older
individuals. These disorders include: Dementia, Alzheimer’s, Mild Cognitive Impairments, and
many more. A recent study proposed that dementia affects 1 in 3 people over 85 years of age,
and 1 in 6 people over 80 years of age. (Stokes, 2008) The prominence in memory related

3. disorders has placed an emphasis on remediation therapies that help to preserve memory
functions.
Over time, several techniques have been adopted that strive to improve memory in older
adults. There are several methods that have proven to be effective in training recollection skills.
Some of the most popular approaches are: spaced retrieval techniques, incremented difficulty
technique, mnemonics, and face-name association techniques.
The spaced retrieval technique is an alternative remediation approach that creates
habitual responses and promotes routines. This intervention can be used to treat a variety of
memory deficits. The technique is performed by identifying a series of functional targets that is
appropriate for the individual. Then the individual rehearses information across increasing delay
intervals, which allows the user to repeat the functional targets routinely and eventually become
stored into long-term memory.
The second technique that has proven to be effective is named the incremented difficulty
technique. This approach builds on prior work done to show the distinction for consciously
controlled memory processes and automatic influences. Research was conducted in 2003 testing
the efficacy of this intervention. The experiment asked adults to read aloud a series of words and
remember as many of the words as possible. Additionally, this experiment included an
oppositional test phase. This phase involves giving the participants a series “new words”, in
which the participants were told to not confuse them with the initial word list. After the two
series of word lists were given, a recognition test was administered to there assess recollection
skills. The participant was instructed to respond “yes” when presented one of the initial words,
and “no” when they were presented with a “new word” or any other given word. The “new

4. words” were presented in different intervals. For instance, an initial word was given, then
immediately after the “new word” was given. Then, three initial words were read and then a
“new word” was presented. (Jennings & Jacoby, 2003)
The results of this study concluded that older adults were better at recollecting the initial
words when the delays between the initial and “new words” were shorter. However, the
participants showed some improvement over the series of sessions. This deduces that “the older
adults can improve their ability to retrieve information in the form of recollecting the prior
occurrence of a repeated item across increasing delays supports the other studies that found older
adults retain a reserve capacity or cognitive plasticity that can be utilized to improve memory
function.” (Jennings & Jacoby, 2003) Essentially, this study supports the idea that the
incremented difficulty technique enhances recollection and improves memory function.
The two techniques discussed above are extremely similar. Both the spaced retrieval
technique and the incremented difficulty technique slowly increase the lag intervals across the
training sessions as the performance of the individual improves. The difference lies in the
consistency of materials across sessions. In the incremented difficulty technique the material
rehearsed is constantly changed, whereas the materials in the spaced retrieval technique remain
the same.
There are two remaining techniques that have proven to be effective. First, the idea of
mnemonics is an associative method that links unknown material with something familiar. For
instance, when trying to remember the digits 0, 5, 1, 3, 1, 5, (in that order) would be easier to
remember if the user associated it with a meaningful date or zip code. On the other hand, the
face-name association technique is generally the simplest to understand. Its main idea is that

5. remembering someone’s name is easier when associating the name of the person with his or her
face.
Throughout history, there have been several techniques that attempted improve memory,
which have proven ineffective. First, the method of loci is an older technique that uses imagery
to remember information. This method involves: choosing a series of locations that are familiar,
creating a mental image of those locations, recalling experiences to remember that coincide with
that location, then to mentally walk along the locations and recall items in a certain order.
Additionally, the technique of subliminal messages has been proven unsuccessful. This was the
idea that listening to information while sleeping would enhance your memory of that topic.
These techniques have sustained no real basis for enhancing memory and therefore were
excluded as techniques to help train a individual’s memory.
Aside from techniques that can be used to improve an individual’s memory, there are also
many memory-training strategies that have been developed to help memory performance. Data
from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) prove that
“strategies compensate for age-related declines in processing speed and other cognitive domains
by instead taking advantage of abilities that do not decline with age, thereby shifting cognitive
performance demands away from those cognitive mechanisms that do decline with age.”(Gross
& Rebok, 2011) For example, semantic memory does not decline with age. Therefore, the use of
semantic organization as a memory enhancing strategy can be very beneficial.
The use of strategies demands executive control and mechanisms that reflect cognitive
abilities. In 2011, Gross and Rebok examined the efficacy of 3 different strategies: serial
clustering, semantic clustering, and subjective clustering. Serial clustering is a measure of how

6. many correctly ordered consecutive items the participant can recall from a data set. Secondly,
semantic clustering is the measure of the amount of items the participant can recall from a certain
semantic category. The last strategy examined in the study is subjective clustering, which is also
known as pair frequency. Subjective clustering measures the amount of times the participant
clusters the same words together during the study. The results of the study indicate that memory
training had significant effects on strategy use, even years after the study was concluded. (Gross
& Rebok, 2011) This shows the effects of learning strategies are both beneficial and durable.
Another way to improve memory is by staying mentally active. “Just as physical activity
helps keep your body in shape, mentally stimulating activities help keep your brain in shape.”
(Healthy Aging, 2014) The metaphor of memory as a muscle familiarizes the idea that
stimulating the brain regularly will help cognitive functions (including memory) to remain strong.
In 2014, Collins concluded that memory resembles body parts. He claimed that combining
physiology with practical life would allow for memory improvement, based of the principles of
natural memory. Supporters of natural memory “provide accounts of memory that bridge the
determinism of bodily functions and the voluntarism of the mind by juxtaposing the natural
characteristics of memory mechanisms with the free will required to pursue exercises in a
disciplined manner and to live a healthy life.” (Collins, 2014) This analogy helps naturalize
memory, which supports the notion previously discussed, in the sense that the natural memory
has been proven to enhance memory skills.
Furthermore, an epidemiological study was conducted to test the significance that regular
mental activity has on memory. The participants in the study were provided ten 60-75 minute
group-training sessions over the course of 5-6 weeks. The sessions involved learning how to
employ cognitive strategies as well as actual physical exercise. The “results suggest that elderly

7. subjects who are group-trained in memory, reasoning, or speed of processing skills show
persistent gains in these specific domains at 2- and 5-year follow-up; training, however, results in
gains only in the domain in which the training was conducted.” (Andrade & Radhakrishnan,
2009) Therefore, this supports the claim that remaining mentally active can improve memory
functions.
Moreover, the last intervention approach that will be discussed is the notion of cognitive
therapy. This can be extremely beneficial for individuals that are interested in learning
techniques to enhance memory through a direct intervention approach. For example, in Athens,
Greece, a memory education and intervention program was developed and administered to adults
over the age of 60. (Lymperopoulou, Margioti & Sakka, 2009) The objective of this therapy was
to improve day-to-day memory functions by obtaining general knowledge about memory, aging,
and dementia. This study demonstrated that cognitive therapy in a group setting could be useful
when acquiring skills to improve ones memory.
In addition to therapeutic approaches for improving memory, there have been several
trials of prescribed medication that attempt to improve memory functions. Over time, numerous
memory supplements have been discarded due to ineptitude or unethical side effects. However,
one medication that has displayed potential in studies is called Ginkgo biloba. This drug affects
the hippocampal region of the brain and claims to be responsible for aiding certain types of
learning and memory. Ginkgo biloba has been used to treat cognitive deficits and dementia in
several experimental studies. It has shown to improve fluidity and decrease memory decline.

8. In 2009, a study conducted on animals was used to test the effects of the medication. The
study yielded positive effects on working memory in unstressed animals. (Finney-Brown, 2009)
This conclusion provided scientific evidence backing the effectiveness of the drug.
In contrast, another study conducted in 2009 tested the affects of Ginkgo biloba on 176
human patients that were diagnosed with early stages of dementia. This study is “described a
large, 5-center, randomized, double-blind, placebo-controlled study of the efficacy of Ginkgo in
reducing the incidence of AD and all-cause dementia in cognitively intact elderly subjects.”
(Andrade & Radhakrishnan, 2009) The results of this experiment indicated that there were no
benefits the drug displayed in regard to the participants in the study. It concluded that Ginkgo
biloba is unlikely to improve or preserve memory function in patients with a memory disorder.
However, the differences in outcomes of the two studies show how this medication requires
further research to determine the effectiveness explicitly.
Another medication that deals with preserving memory functions is called Donepezil.
This medication is used to treat Alzheimer’s disease in several published studies. The purpose of
the drug is to “theoretically retard neurodegeneration and slow the progression to Alzheimer's
disease by targeting very early biological changes.” (Andrade & Radhakrishnan, 2009) During a
3-year experimental study conducted to test the effectiveness of donepezil, results showed that
the drug improved memory functioning. However, the improvement was confined to the first 18
months of the study.
These experimental treatments that seek to improve memory with prescription medication
indicate that there is no definitive drug that can assistive in maintaining cognitive functions. It is

9. clear that the idea of enhancing memory through medication is a developing field. Nevertheless,
it is not an approach that is applicable at this time.
While the idea of prescribed medication doesn't help improve memory functions, it is
scientifically proven that more natural supplements (like vitamins and food) provide positive
effects on memory preservation and enhancement. “In recent years there has been emerging
evidence that a persons dietary intake influences cognitive functioning.” (Stokes, 2008) Stokes
focused on three main supplements: folate, vitamin B-12, and omega-3 fatty acids. Folate
includes foods such as green leafy vegetables, citrus fruits, fortified breads, and cereal. The
effects of folic acid supplementation have proven to directly improve cognitive functioning in
several experimental studies. Second, vitamin B-12 consists of a wide variety of food. Some
examples of good sources of B-12 are foods like salmon, cod, milk, cheese, yeast, and many
more. This supplement provides protection of the cognitive functions by reducing the levels of
homocystenine in the body. Last, omega-3’s are generally in any oily fish such as salmon, tuna,
or sardines. “Epidemiological studies have shown that a long strain of omega-3 fatty acids in
blood differ significantly between people with normal cognitive functioning and those with
impairment.” (Stokes, 2008) This proves that the consumption of this supplement has a direct
relationship with memory enhancement.
Overall, the acquisition of a memory skill has little to do with short-term memory
processes but rather is associated with long-term memory. Therefore, improving memory
through remediation approaches should target processes that strengthen long-term memory.
There are several techniques, strategies, therapies, and supplements that have proven to help
older individuals improve memory functions, although more research is necessary to explicitly

10. determine the effectiveness of each approach. The prior research has yielded positive results for
individuals looking to expand his or her memory capabilities.
References:
Andrade, C., & Radhakrishnan, R. (2009). The prevention and treatment of cognitive decline
and dementia: An overview of recent research on experimental treatments. Indian Journal
of Psychiatry, 51(1), 12-25. doi:10.4103/0019-5545.44900
Collins, A. F. (2014). Advice for Improving Memory: Exercising, Strengthening, and Cultivating
Natural Memory, 1860-1910. Journal Of The History Of The Behavioral Sciences, 50(1), 37-57.
Ericsson, K. A., Chase, W. G., & Faloon, S. (1980). Acquisition of a memory skill. Science,
208(4448), 1181-1182. doi:10.1126/science.7375930
Finney-Brown, T. (2009). Gingko biloba and memory. Australian Journal of Medical Herbalism,
21(1), 19.
Gross, A. L., & Rebok, G. W. (2011). Memory training and strategy use in older adults: Results
from the ACTIVE study. Psychology And Aging, 26(3), 503-517. doi:10.1037/a0022687
Healthy aging. (2014, March 05). Retrieved May 04, 2016, from
http://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/memory-loss/art-20046518
Jennings, J. M., & Jacoby, L. L. (2003). Improving memory in older adults: Training recollection.
Neuropsychological Rehabilitation, 13(4), 417.
Kinsella, G., Ames, D., Storey, E., Ong, B., Pike, K., Saling, M.. . Rand, E. (2016;2015;).
Strategies for improving memory: A randomized trial of memory groups for older people,
including those with mild cognitive impairment. Journal of Alzheimers Disease, 49(1), 31-43.
doi:10.3233/JAD-150378
Lymperopoulou, O., Margioti, E., & Sakka, P. (2009). Memory groups: Improving memory
knowledge, satisfaction and functioning of healthy elderly. Alzheimer's & Dementia: The
Journal of the Alzheimer's Association, 5(4), P238-P238. doi:10.1016/j.jalz.2009.04.216
Stokes, C. (2008). The role of diet on cognitive function in older adults. Nursing & Residential
Care, 10(8), 387-391 5p.