McDougall, G.J., Jr. (2001). Memory improvement program for elderly cancer survivors. Geriatric Nursing, 22(4), 185–190.

The study was conducted to determine the effect of a rehabilitative intervention on cognitive function, depression, and functioning.

The study framework included two intervention groups and one wait-list control group. Participants were randomized into intervention group 1 (receiving eight classes and a memory book) or the wait-list control group (Group 3). Wait-list control group participants were further randomized into intervention group 2 (receiving only the memory book) or group 3.

Intervention group 1 received a memory book and classes on day 1; intervention group 2 received a memory book on day 1 and began classes four weeks later. Wait-list control group participants received a memory book on day 1. Participants from intervention group 2 and the wait-list control group were placed in classes together based on location. All classes were identical.

• The total number of participants was 78.
• The average partcipant age was 82.
• There were 58 women and 20 men in the study. 
• Participants were divided into four groups of chronic conditions for analysis: arthritis (n = 16), cancer (n = 11), heart disease (n = 32), and other (n = 19).
• On average, participants had attained 15 years of education. 

The study took place at a comprehensive retirement community in the Midwest that included independent and assisted-living dwellers.

The study utilized a randomized, controlled trial.

• Mini-Mental State Examination (MMSE) for global cognitive functioning
• Geriatric Depression Scale for depression
• Instrumental Activities of Daily Living Scale (IADL) for functional ability
• Multi-Level Assessment Instrument (MAI) as a health subscale
• Rivermead Behavioral Memory Test (RBMT)
• The Metamemory in Adulthood Questionnaire (MIA) was utilized. This 108-item assessment tool has 7 subscales assessing strategy, task, capacity, change, anxiety, achievement, and locus.

Cancer survivors showed significant improvements after the intervention in

• Memory efficacy (p = 0.05)
• Metamemory change (p = 0.0001)
• RBMT Immediate Story Recall (p = 0.006)
• RBMT Delayed Story Recall (p = 0.002)
• RBMT Belonging (p = 0.05).

The cancer survivors scored higher on managing finances (p = 0.01). They had lower total IADL scores compared with the control group, and scored lower on baseline metamemory capacity, with an average score of 2.5 (p = 0.03). They showed worsening after the intervention on the RBMT Immediate Route test (p = 0.03) and the RBMT Delayed Route test (p = 0.0001). The cancer survivors were older, with an average age of 84.12 years (p = 0.02). 

Significant associations were observed for the total sample between 

• IADL scores and memory performance on the RBMT (r = -0.44, p < 0.05)
• IADL scores and metamemory subscale of change (r = -0.33, p < 0.05)
• IADL scores and external memory strategy (r = -0.29, p < 0.05)
• Depression and memory performance on the RBMT (r = -0.31, p < 0.05).

There were no significant pre-test differences between groups on memory performance, memory self-efficacy scores, or MMSE scores. The total sample had a relatively high perception of health status and a low incidence of depression (13%). 

Post-intervention tests showed no improvements in objective memory performance, despite reported improvements in subjective memory and memory self-efficacy.

• This was not a cancer-specific study and had only a small sample of cancer survivors.
• Cancer diagnoses were not reported, and no information regarding cancer-related treatments was provided.
• Participants were assigned to the chronic illness categories by the researchers.
• No listing was provided of the medications taken between groups, which could affect cognitive performance.
• It was reported that many participants began practicing mental activities and exercises prior to the intervention's initiation, potentially affecting baseline scores for cognitive performance.
• A documentation of when the post-test was performed was not found.