Effectiveness of Visual Images Mnemonic Training on Memory among Alzheimer’s Disease Patients at Alzheimer’s and related Disorders society of India, Cochin, Kerala

 

Dr. Sampoornam. W¹*, Mr. Basil V. Kuriakose²

¹Associate Professor, Mental Health Nursing Department, The Tamilnadu Dr. M.G.R. Medical University, Chennai,

²Dhanvantri College of Nursing, Pallakkapalayam, Namakkal. Tamilnadu, India

 

ABSTRACT:

Visual imagery is a great way to help memorize items for some people. Imagery usually works best with smaller pieces of information. Aim: This article focus on the effectiveness of visual images mnemonic training on memory among Alzheimer’s disease patients. Methods: Pre experimental research design was selected for the present study. Purposive sampling technique was used to recruit 30 subjects. Pre test was conducted by using visual mnemonic rating scale- Alzheimer's Disease scale to assess the level of memory. Visual images mnemonic training was intervened through repeated representation of related subjects such as figures of body parts, photos, phone numbers, letters and significant places which are displayed in the chart for the duration of 30-40 minutes per day for 10 days. The mean values of all the 19 posttest scores were considered as one post test value. Results: The estimated paired ‘t’ test value showed statistical significance in all areas of memory like body parts t=7.07, significant places t=5.12 and address t=9.69 among Alzheimer’s disease patients. Memory has been enhanced after the treatment of visual images mnemonic training among Alzheimer’s disease patients.

 

 

 

INTRODUCTION:

Alzheimer's disease is an irreversible, progressive brain disorder that slowly destroys memory and thinking skills and eventually the ability to carry out the simplest tasks. In most people with Alzheimer’s symptoms first appear in their mid-60s.

 

Loss of memory is among the first symptoms reported by patients suffering from Alzheimer's disease (AD) and by their caretakers. Working memory and long-term declarative memory are affected early during the course of the disease.

 

The individual pattern of impaired memory functions correlates with parameters of structural or functional brain integrity (Holger Jahn, 2013).

 

The formation of amyloid plaques and neurofibrillary tangles are thought to contribute to the degradation of the neurons (nerve cells) in the brain and the subsequent symptoms of Alzheimer's disease. Visual mnemonics are a type of mnemonic that work by associating an image with characters or objects whose name sounds like the item that has to be memorized. Visual mnemonics include the use of visual imagery accompanying some verbal mnemonics. Interaction, vividness and bizarreness can help make visual associations effective (K.L. Higbee, 2001).

 

 

METHODS AND MATERIALS:

After obtaining informed assent, Alzheimer’s patients who were clinically diagnosed and fulfilled the inclusion criteria were enrolled in the study at Alzheimer’s and related disorders society of India, Cochin, Kerala. Pre experimental research design was selected for the present study. Purposive sampling technique was used to recruit 30 subjects. Alzheimer’s patients with mild and moderate level of memory were included in the study and subjects who had difficulty in vision, speaking, hearing and irregular visit were excluded from the research work. Demographic data like age, gender, family history of dementia, duration of illness and history of medications were collected.  Pre test was conducted by using visual mnemonic rating scale- Alzheimer's Disease scale to assess the level of memory. The time of assessment varied from 30 -40 minutes. Visual images mnemonic training was intervened through repeated representation of related subjects such as figures of body parts, photos, phone numbers, letters and significant places which are displayed in the chart for the duration of 30-40 minutes per day for 10 days. Post test was conducted by using the same assessment tools.  Post test was done right from the first day after visual images mnemonic training, subsequently every day before and after the intervention post test was conducted for 10 days. The mean values of all the 19 posttest scores were considered as one post test value. Statistical methods adopted were mean, standard deviation, paired ‘t’ test and chi square test with Yates correction. 

 

RESULTS:

Table 1: Frequency and percentage distribution of level of memory among Alzheimer’s disease patients

Level of memory disturbances	Alzheimer’s disease patients
	Pre test		Post test
	F	%	F	%
Mild	14	47	22	73
Moderate	16	53	8	27
Severe	-	-	-	-

 

In pre test 47% and 53% of the participants had mild and moderate level of memory disturbances respectively, whereas in post test 73% and 27% of the participants had mild and moderate level of memory disturbances respectively (Table- 1).

 

Table 2: Comparison of mean, standard deviation and paired ‘t’ test values on memory in course of pre and post test scores among Alzheimer’s disease patients

Areas of memory disturbances	Pre and post test scores	Mean and SD	Significance paired ‘t’ test
			Pre – Posttest
Body parts	Pretest	17.1 SD=2.5	t=7.07 P < 0.001
	Posttest	19.2 SD=2.7
Significant places	Pretest	11.1 SD=1.6	t=5.12 P < 0.001
	Posttest	12.7 SD=1.9
Address	Pretest	12.3 SD=2.3	t=9.69 P  < 0.001
	Posttest	15.5 SD=2.8

N = 30

Area wise comparison of pretest mean scores on memory of body parts showed 17.1 and posttest showed 19.2. Likewise, significant places depicted pre test mean score value as 11.1 and post test score value as 12.7. Besides address portrayed 12.3 as pre test mean scores and 15.5 as post test mean value. Parallel comparison revealed that in all areas, when compared with pre test, post test mean scores were marked up. The estimated paired ‘t’ test value showed statistical significance in all areas of memory like body parts t=7.07, significant places t=5.12 and address t=9.69 among Alzheimer’s disease patients (Table- 2). Results showed that memory has been enhanced after the treatment of visual images mnemonic training among Alzheimer’s disease patients.

 

Table 3: Association between the memory score and selected demographic variables

Demographic Variables	X2	Level of Significance
Age	6.14	Not - Significant
Sex	1.01	Not - Significant
Family history of dementia	2.1	Not - Significant
Duration of illness	1.52	Not - Significant
History of medication	0.92	Not - Significant

 

No significant association was observed between posttest memory scores for age, sex, family history of dementia, duration of illness and history of medication (Table-3).

 

DISCUSSION:

Results showed that memory has been enhanced after the treatment of visual images mnemonic training among Alzheimer’s disease patients. Another study reported that overall, neurocognitive deficits do not allow patients with Alzheimer’s disease (AD) to perform complex mental imagery, which may be most beneficial for improving memory. However, data also suggest that intact basic mental imagery and rehearsal could possibly be helpful if used in a rehabilitation multi-session intervention approach (Erin Hussey, 2012).

 

REFERENCES:

1.        Holger Jahn. Memory loss in Alzheimer's disease. Dialogues Clin Neurosci. 2013 Dec; 15(4): 445–454.

2.        K.L. Higbee, Mnemonics, Psychology of memory. International Encyclopedia of the Social and Behavioral Sciences, 2001.

3.        Erin Hussey. Using mental imagery to improve memory in patients with Alzheimer's disease: Trouble generating or remembering the mind's eye? Alzheimer Dis Assoc Disord. 2012 Apr; 26(2): 124–134.

 

 

 

 

Received on 11.01.2019         Modified on 14.02.2019

Accepted on 05.03.2019       ©A&V Publications All right reserved