Prospective memory and brain metastases: a relevant target for rehabilitation in post-operative patients?

PURPOSE: The study investigated the prospective memory (PM) functioning among patients with brain metastases (BM), eligible for neurosurgy/radiosurgery, and its relationships with depression and quality of life (QoL). METHODS: This case-healthy-control, cross-sectional study, comprised 160 participants, including 49 patients with BM from various cancers treated with neurosurgery or radiosurgery. They were compared with 111 matched controls on a set of neuropsychological tests, including the MoCA global cognitive test and an experimental PM task 'PROMESSE'. Participants also completed a depression scale (BDI-II), a generic (SF-12) and a specific (QLQ-C30) QoL instrument for cancer patients. Multivariate analyses were conducted on various PM outcomes, in particular on event-based (EBPM) and time-based (TBPM) PM performances. RESULTS: After adjusting for age and socio-cultural level, patients with BM performed worse than the control on the PM task (p < .0001) [OR 1.05; 95%CI (1.01-1.08)], whatever the location of BM (frontal versus temporal lobe). Patients with infratentorial BM exhibited better TBPM performances than patients with supratentorial BM (p = .02). The global PM performance was positively correlated with the MoCA (r = .45) and the SF-12 global score (r = .34), and negatively with the BDI-II score (r = - .20), the number of BM (r = - .34) and the volumetric of the BM (r = - 29). The TBPM performance was linked to the global QoL (r = .40) in patients. CONCLUSION: The study showed a significant PM deficit in patients with BM eligible for a neurosurgy/radiosurgery, which is linked to damaged QoL and which likely maintains some depressive affects. Prospective memory rehabilitation program should especially focus on TBPM for post-operative patients with BM.

Improvement of higher brain dysfunction after brain injury by repetitive transcranial magnetic stimulation and intensive rehabilitation therapy: case report.

Repetitive transcranial magnetic stimulation (rTMS) and intensive cognitive rehabilitation (CR) were administered to two patients with cognitive dysfunction following brain injury. The first case was a 67-year-old man who presented with memory dysfunction, attention dysfunction, and decreased insight following diffuse axonal injury. High-frequency rTMS (10 Hz, 2400 pulses/day) targeting the anterior cingulate using a navigation system and CR were administered for 12 days at 1 year from the onset of injury. The patient showed improved neuropsychological performance and activities of daily living. In addition, single photon emission computer tomography with Tc-ECD showed improved perfusion in the anterior cingulate gyrus. The second case was a 68-year-old man who presented with dysfunction of memory, attention, and executive function following a cerebral infarction in the middle cerebral artery region within the right hemisphere. This patient received 12 days (except for Sundays) of low-frequency rTMS (1 Hz, 1200 pulses/day) targeting the left dorsolateral prefrontal cortex and the left posterior parietal cortex and CR. Following this intervention, the patient's neuropsychological performance and activities of daily living improved. Furthermore, single photon emission computer tomography showed changes in perfusion in the rTMS target sites and areas surrounding the targets. We have shown the safety and efficacy of rTMS therapy using a navigation system combined with intensive CR on two patients with cognitive dysfunction following brain injury. In addition, we observed changes in the areas around the rTMS target sites in brain imaging data.

Memory Rehabilitation Strategies in Nonsurgical Temporal Lobe Epilepsy: A Review.

People with temporal lobe epilepsy (TLE) who have not undergone epilepsy surgery often complain of memory deficits. Cognitive rehabilitation is employed as a remedial intervention in clinical settings, but research is limited and findings concerning efficacy and the criteria for choosing different approaches have been inconsistent. We aimed to appraise existing evidence on memory rehabilitation in nonsurgical individuals with temporal lobe epilepsy and to ascertain the effectiveness of specific strategies. A scoping review was preferred given the heterogeneous nature of the interventions. A comprehensive literature search using MEDLINE, EMBASE, CINAHL, AMED, Scholars Portal/PSYCHinfo, Proceedings First, and ProQuest Dissertations and Theses identified articles published in English before February 2016. The search retrieved 372 abstracts. Of 25 eligible studies, six were included in the final review. None included pediatric populations. Strategies included cognitive training, external memory aids, brain training, and noninvasive brain stimulation. Selection criteria tended to be general. Overall, there was insufficient evidence to make definitive conclusions regarding the efficacy of traditional memory rehabilitation strategies, brain training, and noninvasive brain stimulation. The review suggests that cognitive rehabilitation in nonsurgical TLE is underresearched and that there is a need for a systematic evaluation in this population.

Cognitive cooperation groups mediated by computers and internet present significant improvement of cognitive status in older adults with memory complaints: a controlled prospective study.

OBJECTIVE: To estimate the effect of participating in cognitive cooperation groups, mediated by computers and the internet, on the Mini-Mental State Examination (MMSE) percent variation of outpatients with memory complaints attending two memory clinics. METHODS: A prospective controlled intervention study carried out from 2006 to 2013 with 293 elders. The intervention group (n = 160) attended a cognitive cooperation group (20 sessions of 1.5 hours each). The control group (n = 133) received routine medical care. Outcome was the percent variation in the MMSE. Control variables included gender, age, marital status, schooling, hypertension, diabetes, dyslipidaemia, hypothyroidism, depression, vascular diseases, polymedication, use of benzodiazepines, exposure to tobacco, sedentary lifestyle, obesity and functional capacity. The final model was obtained by multivariate linear regression. RESULTS: The intervention group obtained an independent positive variation of 24.39% (CI 95% = 14.86/33.91) in the MMSE compared to the control group. CONCLUSION: The results suggested that cognitive cooperation groups, mediated by computers and the internet, are associated with cognitive status improvement of older adults in memory clinics.

Cognitive cooperation groups mediated by computers and internet present significant improvement of cognitive status in older adults with memory complaints: a controlled prospective study / Grupos de Cooperação Cognitiva mediados pelo uso de computadores e internet mostram uma melhora significativa no estado cognitivo em idosos com queixas de memória: estudo controlado prospectivo

ABSTRACT Objective To estimate the effect of participating in cognitive cooperation groups, mediated by computers and the internet, on the Mini-Mental State Examination (MMSE) percent variation of outpatients with memory complaints attending two memory clinics. Methods A prospective controlled intervention study carried out from 2006 to 2013 with 293 elders. The intervention group (n = 160) attended a cognitive cooperation group (20 sessions of 1.5 hours each). The control group (n = 133) received routine medical care. Outcome was the percent variation in the MMSE. Control variables included gender, age, marital status, schooling, hypertension, diabetes, dyslipidaemia, hypothyroidism, depression, vascular diseases, polymedication, use of benzodiazepines, exposure to tobacco, sedentary lifestyle, obesity and functional capacity. The final model was obtained by multivariate linear regression. Results The intervention group obtained an independent positive variation of 24.39% (CI 95% = 14.86/33.91) in the MMSE compared to the control group. Conclusion The results suggested that cognitive cooperation groups, mediated by computers and the internet, are associated with cognitive status improvement of older adults in memory clinics.

RESUMO Objetivo Avaliar o efeito da participação em Grupos de Cooperação Cognitiva mediados por computadores e internet na variação do Mini-Exame de Estado Mental (MEEM) de pacientes ambulatoriais com queixas de memória, participantes de duas clínicas de memória. Métodos Estudo prospectivo de intervenção controlada, realizado em 2006-2013 com 293 idosos. O grupo de intervenção (n = 160) participou de um Grupo de Cooperação Cognitiva (20 sessões de 1,5 horas cada). O grupo controle (n = 133) recebeu acompanhamento médico. O desfecho foi a variação percentual no MEEM. As variáveis de controle incluíram genêro, idade, estado civil, escolaridade, hipertensão, diabetes, dislipidemia, hipotiroidismo, depressão, doenças cardiovasculares, polimedicação, uso de benzodiazepínicos, exposição ao tabaco, sedentarismo, obesidade e capacidade funcional. Todas as variáveis foram coletadas antes e após a intervenção. O modelo multivariado final foi obtido por regressão linear múltipla. Resultados O grupo de intervenção obteve variação positiva independente de 24,39% (IC95% = 14.86/33.91) no MEEM em relação ao grupo controle. Conclusão Os resultados deste estudo sugerem que o grupo de intervenção, mediados por computadores e internet estão associados com melhora do status cognitivo em idosos de clínicas de memória.

Exercise training effects on memory and hippocampal viscoelasticity in multiple sclerosis: a novel application of magnetic resonance elastography.

INTRODUCTION: Cognitive impairment is common and debilitating among persons with multiple sclerosis (MS) and might be managed with exercise training. However, the effects of exercise training on viscoelastic brain properties in this population are unknown. The present pilot study adopted a single-blind randomized controlled trial (RCT) design and is the first to examine the effect of an aerobic exercise training intervention on learning and memory and hippocampal viscoelasticity using magnetic resonance elastography (MRE) in persons with MS. METHODS: Eight fully ambulatory females with MS were randomly assigned into exercise training intervention or waitlist control conditions. The intervention condition involved 12 weeks of supervised, progressive treadmill walking exercise training. All participants underwent measures of learning and memory (i.e., California Verbal Learning Test-II; CVLT-II) and further underwent MRE scans for measurement of shear stiffness (µ) and damping ratio (ξ) of the hippocampus before and after the 12-week period. RESULTS: Overall, there were small-to-moderate intervention effects on CVLT-II performance (d = 0.34) and large intervention effects on hippocampal µ (d = 0.94) and hippocampal ξ (d = -1.20). Change in CVLT-II scores was strongly associated with change in µ (r = 0.93, p < 0.01) and ξ (r = -.96, p < 0.01) of the hippocampus. CONCLUSION: This small pilot RCT provides exciting proof-of-concept data supporting progressive treadmill walking exercise training for potentially improving learning and memory and underlying hippocampal viscoelastic properties in persons with MS. This is important given the high prevalence and burden of MS-related memory impairment.

Elaborative encoding through self-generation enhances outcomes with errorless learning: Findings from the Skypekids memory study.

Errorless learning has demonstrated efficacy in the treatment of memory impairment in adults and older adults with acquired brain injury. In the same population, use of elaborative encoding through supported self-generation in errorless paradigms has been shown to further enhance memory performance. However, the evidence base relevant to application of both standard and self-generation forms of errorless learning in children is far weaker. We address this limitation in the present study to examine recall performance in children with brain injury (n = 16) who were taught novel age-appropriate science and social science facts through the medium of Skype. All participants were taught these facts under conditions of standard errorless learning, errorless learning with self-generation, and trial-and-error learning after which memory was tested at 5-minute, 30-minute, 1-hour and 24-hour delays. Analysis revealed no main effect of time, with participants retaining most information acquired over the 24-hour testing period, but a significant effect of condition. Notably, self-generation proved more effective than both standard errorless and trial-and-error learning. Further analysis of the data revealed that severity of attentional impairment was less detrimental to recall performance under errorless conditions. This study extends the literature to provide further evidence of the value of errorless learning methods in children with ABI and the first demonstration of the effectiveness of self-generation when delivered via the Internet.

Voluntary exercise rescues sevoflurane-induced memory impairment in aged male mice.

Postoperative cognitive impairment is especially common in older patients following major surgery. Although exposure to sevoflurane is known to cause memory deficits, few studies have examined the putative approaches to reduce such impairments. This study tested the hypotheses that sevoflurane exposure can decrease NR2B subunit-containing NMDA receptor activity in hippocampus of aged mice, and voluntary exercise may counteract the declining hippocampal functions. We found that long exposure (3 h/day for 3 days), but not short exposure (1 h/day for 3 days), to 3 % sevoflurane produced a long-lasting spatial memory deficits up to 3 weeks in aged mice, and such an effect was not due to the neuronal loss in the hippocampus, but was correlated with a long-term decrease in Fyn kinase expression and NR2B subunit phosphorylation in the hippocampus. Furthermore, voluntary exercise rescued sevoflurane-induced spatial memory deficits in aged mice and restored Fyn kinase expression and NR2B subunit phosphorylation in the hippocampus to a level comparable to control animals. Generally, our results suggested that Fyn-mediated NR2B subunit phosphorylation may play a critical role in sevoflurane-induced impairment in cognitive functions in aged animals, and voluntary exercise might be an important non-pharmacological approach to treatment of inhaled anesthetics-induced postoperative cognitive impairment in clinical settings.

Clinical characteristics, pathophysiology, and management of noncentral nervous system cancer-related cognitive impairment in adults.

Answer questions and earn CME/CNE Over the past few decades, a body of research has emerged confirming what many adult patients with noncentral nervous system cancer have long reported-that cancer and its treatment are frequently associated with cancer-related cognitive impairment (CRCI). The severity of CRCI varies, and symptoms can emerge early or late in the disease course. Nonetheless, CRCI is typically mild to moderate in nature and primarily involves the domains of memory, attention, executive functioning, and processing speed. Animal models and novel neuroimaging techniques have begun to unravel the pathophysiologic mechanisms underlying CRCI, including the role of inflammatory cascades, direct neurotoxic effects, damage to progenitor cells, white matter abnormalities, and reduced functional connectivity, among others. Given the paucity of research on CRCI with other cancer populations, this review synthesizes the current literature with a deliberate focus on CRCI within the context of breast cancer. A hypothetical case-study approach is used to illustrate how CRCI often presents clinically and how current science can inform practice. While the literature regarding intervention for CRCI is nascent, behavioral and pharmacologic approaches are discussed.

Remediation of a naming deficit following left temporal lobe epilepsy surgery.

Dysnomia is associated with temporal lobe epilepsy and may include a deficit in recalling the names of familiar people. The deficit can worsen following surgery to relieve refractory seizures. The following is a case report comparing implicit (errorless learning) and explicit (rote rehearsal) approaches to retraining face-name associations in a 52-year-old woman who was status post-amygdalo-hippocampectomy for refractory complex partial seizures. Although both approaches initially improved performance above baseline, only errorless learning resulted in stable gains during a 10-min delay and at 1-week follow-up. Initial improvements in naming with rote rehearsal were not maintained even during the 10-min delay. In patients with severe memory impairment and dysnomia, errorless learning may offer a viable rehabilitation strategy for improving naming performance.

Non-spatial pre-training in the water maze as a clinically relevant model for evaluating learning and memory in experimental TBI.

Explicit and implicit learning and memory networks exist where each network can facilitate or inhibit cognition. Clinical evidence suggests that implicit networks are relatively preserved after traumatic brain injury (TBI). Non-spatial pre-training (NSPT) in the Morris Water Maze (MWM) provides the necessary behavioral components to complete the task, while limiting the formation of spatial maps. Our study utilized NSPT in the MWM to assess implicit and explicit learning and memory system deficits in the controlled cortical impact (CCI) model of TBI. 76 adult male Sprague-Dawley rats were divided: CCI vs. sham surgery, NSPT vs. No-NSPT, and cued vs. non-cued groups. NSPT occurred for 4d prior to surgery (dynamic hidden platform location, extra-maze cues covered, static pool entry point). Acquisition (d14-18), Probe/Visible Platform (d19), and Reversal (d20-21) trials were conducted with or without extra-maze cues. Novel time allocation and search strategy selection metrics were utilized. Results indicated implicit and explicit learning/memory networks are distinguishable in the MWM. In the cued condition, NSPT reduced thigmotaxis, improved place learning, and largely eliminated the apparent injury-induced deficits typically observed between untrained CCI and sham rats. However, among NSPT groups, incorporation of cues into search strategy selection for CCI rats was relatively impaired compared to shams. Non-cued condition performance showed sham/NSPT and CCI/NSPT rats perform similarly, suggesting implicit memory networks are largely intact 2weeks after CCI. Place learning differences between CCI/NSPT and sham/NSPT rats more accurately reflect spatial deficits in our CCI model compared to untrained controls. These data suggest NSPT as a clinically relevant construct for evaluating potential neurorestorative and neuroprotective therapies. These findings also support development of non-spatial cognitive training paradigms for evaluating rehabilitation relevant combination therapies.

Influence of chronic moderate sleep restriction and exercise training on anxiety, spatial memory, and associated neurobiological measures in mice.

Sleep deprivation can have deleterious effects on cognitive function and mental health. Moderate exercise training has myriad beneficial effects on cognition and mental health. However, physiological and behavioral effects of chronic moderate sleep restriction and its interaction with common activities, such as moderate exercise training, have received little investigation. The aims of this study were to examine the effects of chronic moderate sleep restriction and moderate exercise training on anxiety-related behavior, spatial memory, and neurobiological correlates in mice. Male mice were randomized to one of four 11-week treatments in a 2 [sleep restriction (∼4h loss/day) vs. ad libitum sleep] × 2 [exercise (1h/day/6 d/wk) vs. sedentary activity] experimental design. Anxiety-related behavior was assessed with the elevated-plus maze, and spatial learning and memory were assessed with the Morris water maze. Chronic moderate sleep restriction did not alter anxiety-related behavior, but exercise training significantly attenuated anxiety-related behavior. Spatial learning and recall, hippocampal cell activity (i.e., number of c-Fos positive cells), and brain derived neurotrophic factor were significantly lower after chronic moderate sleep restriction, but higher after exercise training. Further, the benefit of exercise training for some memory variables was evident under normal sleep, but not chronic moderate sleep restriction conditions. These data indicate clear detrimental effects of chronic moderate sleep restriction on spatial memory and that the benefits of exercise training were impaired after chronic moderate sleep restriction.

[Impact of cancer treatments on cognitive functions: the patients' view, their expectation and their interest in participating to cognitive rehabilitation workshops]. / Impact des traitements en cancérologie sur les fonctions cognitives : le point de vue des patients, leur attente et leur souhait de participer à des ateliers de rééducation cognitive.

INTRODUCTION: Cancer and chemotherapy can have adverse effects on cognitive functions and quality of life of patients. We wanted to know the patients' view on these disorders, but also their expectations in terms of assessment and support. METHODS AND RESULTS: A survey was conducted in day care hospital among 551 patients from three cancer centers. Most of the patients were between 40 and 74 years and suffered from breast cancer. Eighty-four percent were treated with chemotherapy. Forty-one percent of patients report memory problems, 26% were affected by specific concentration disorders, and 19% of the attention. On the whole, 52% of patients report at least one of the previous cognitive impairment. Among these patients, 80% evoked that the support of these problems was essential and 70% were willing to participate in "workshops" to deal with these disorders. CONCLUSION: The cognitive impairment occurrence is a real problem for patients receiving chemotherapy and becomes a priority in the global management of their disease. Studies assessing a specific support of theses symptoms should be encouraged to help patients.

Cognitive rehabilitation reduces cognitive impairment and normalizes hippocampal CA1 architecture in a rat model of vascular dementia.

Dementia is a major cause of morbidity in the western society. Pharmacological therapies to delay the progression of cognitive impairments are modestly successful. Consequently, new therapies are urgently required to improve cognitive deficits associated with dementia. We evaluated the effects of physical and cognitive activity on learning and memory in a rat model of vascular dementia (VasD). Male Sprague-Dawley rats (6 months old) were exposed to either regular chow or a diet rich in saturated fats and sucrose and chronic bilateral common carotid artery occlusion or sham surgery. First, this model of VasD was validated using a 2 × 2 experimental design (surgery × diet) and standard cognitive outcomes. Next, using identical surgical procedures, we exposed animals to a paradigm of cognitive rehabilitation or a sedentary condition. At 16 weeks post surgery, VasD animals demonstrated significant learning and memory deficits in the Morris water maze, independent of diet. Rehabilitation significantly attenuated these cognitive deficits at this time point as well as at 24 weeks. Further, rehabilitation normalized hippocampal CA1 soma size (area and volume) to that of control animals, independent of cell number. Importantly, these findings demonstrate beneficial neuroplasticity in early middle-aged rats that promoted cognitive recovery, an area rarely explored in preclinical studies.

Semantic strategy training increases memory performance and brain activity in patients with prefrontal cortex lesions.

OBJECTIVE: Memory deficit is a frequent cognitive disorder following acquired prefrontal cortex lesions. In the present study, we investigated the brain correlates of a short semantic strategy training and memory performance of patients with distinct prefrontal cortex lesions using fMRI and cognitive tests. METHODS: Twenty-one adult patients with post-acute prefrontal cortex (PFC) lesions, twelve with left dorsolateral PFC (LPFC) and nine with bilateral orbitofrontal cortex (BOFC) were assessed before and after a short cognitive semantic training using a verbal memory encoding paradigm during scanning and neuropsychological tests outside the scanner. RESULTS: After the semantic strategy training both groups of patients showed significant behavioral improvement in verbal memory recall and use of semantic strategies. In the LPFC group, greater activity in left inferior and medial frontal gyrus, precentral gyrus and insula was found after training. For the BOFC group, a greater activation was found in the left parietal cortex, right cingulated and precuneus after training. CONCLUSION: The activation of these specific areas in the memory and executive networks following cognitive training was associated to compensatory brain mechanisms and application of the semantic strategy.

STAM protocol in dementia: a multicenter, single-blind, randomized, and controlled trial.

BACKGROUND: The Sound Training for Attention and Memory in Dementia (STAM-Dem) is a manualized music-based protocol designed to be used in the rehabilitation of cognitive functions in elderly patients with dementia (PWD). METHOD: This was a multicenter, single-blind, randomized, and controlled trial that involved 51 PWD. The objective was to test the STAM-Dem efficacy. Patients in the experimental group followed the STAM-Dem for 2 weekly sessions of 45 minutes for 12 weeks (in addition to standard care). Those in the control group continued with the normal "standard care" provided. RESULTS: In the experimental group, the instruments immediate prose memory test (MPI), deferred prose memory test (MPD), attentional matrices, activities of daily living, Music Therapy Activity Scale (SVAM) and Geriatric Music Therapy Profile (GMP) increase significantly from pre to post-test (P < .05). CONCLUSION: The protocol is feasible and data suggest that there was an effect on attentino (matrices) and prose memory skills (MPI and MPD). The effect size reveals a general improvement in the results of the experimental group.

Benefits and limitations of errorless learning after surviving pediatric brain tumors: a case study.

Survivors of childhood brain tumors often acquire complex cognitive difficulties including impairments in attention, processing speed, and different aspects of memory function. These impairments can affect their learning in the real world and in the classroom. However, the efficacy of memory rehabilitation techniques post treatment has not yet been assessed in these patients. We present the case of a 15-year-old boy, C.J., who acquired a profound episodic memory impairment due to a metastatic germ cell tumor and subsequent treatment. The focus of this study was the application of an errorless learning technique to a verbal learning task. We were interested to test whether C.J. would benefit from errorless learning as compared to errorful learning. Results of an experiment and a follow-up study indicated that C.J.'s learning was more efficient under errorless conditions, although access to the information from long-term memory remained cue dependent. Implications for learning with or without the support of episodic memory are discussed, and future directions for memory rehabilitation of brain tumor survivors are outlined.

Memory rehabilitation and brain training for surgical temporal lobe epilepsy patients: a preliminary report.

The short term impact of a memory rehabilitation programme on verbal memory test performance and subjective ratings of memory in everyday life was assessed in healthy controls and left temporal lobe epilepsy (LTLE) surgical patients. The intervention involved training in the use of external and internal memory support strategies. Half of the sample in addition undertook computerised brain training exercises as homework. LTLE patients were seen either before surgery or 3-6 months after their operation. Improvements in verbal memory were observed in both groups. An effect of brain training was recorded but this did not occur in a consistent direction. Subjective ratings of memory indicated improvements that were significant for the LTLE group but not the controls. Positive changes in the memory outcome measures were associated with improvements in mood. Pre-operative memory rehabilitation was not associated with better outcomes than post-operative intervention. Further research is needed to explore the persistence of the changes observed and to explore if pre-operative rehabilitation offsets post-operative memory decline.

The memory fitness program: cognitive effects of a healthy aging intervention.

CONTEXT: Age-related memory decline affects a large proportion of older adults. Cognitive training, physical exercise, and other lifestyle habits may help to minimize self-perception of memory loss and a decline in objective memory performance. OBJECTIVE: The purpose of this study was to determine whether a 6-week educational program on memory training, physical activity, stress reduction, and healthy diet led to improved memory performance in older adults. DESIGN: A convenience sample of 115 participants (mean age: 80.9 [SD: 6.0 years]) was recruited from two continuing care retirement communities. The intervention consisted of 60-minute classes held twice weekly with 15-20 participants per class. Testing of both objective and subjective cognitive performance occurred at baseline, preintervention, and postintervention. Objective cognitive measures evaluated changes in five domains: immediate verbal memory, delayed verbal memory, retention of verbal information, memory recognition, and verbal fluency. A standardized metamemory instrument assessed four domains of memory self-awareness: frequency and severity of forgetting, retrospective functioning, and mnemonics use. RESULTS: The intervention program resulted in significant improvements on objective measures of memory, including recognition of word pairs (t([114]) = 3.62, p <0.001) and retention of verbal information from list learning (t([114]) = 2.98, p <0.01). No improvement was found for verbal fluency. Regarding subjective memory measures, the retrospective functioning score increased significantly following the intervention (t([114]) = 4.54, p <0.0001), indicating perception of a better memory. CONCLUSIONS: These findings indicate that a 6-week healthy lifestyle program can improve both encoding and recalling of new verbal information, as well as self-perception of memory ability in older adults residing in continuing care retirement communities.