@Article{info:doi/10.2196/51943,
author="Smith, Amy M
and Marin, Anna
and DeCaro, Renee E
and Feinn, Richard
and Wack, Audrey
and Hughes, Gregory I
and Rivard, Nathaniel
and Umashankar, Akshay
and Turk, Katherine W
and Budson, Andrew E",
title="Algorithmic Spaced Retrieval Enhances Long-Term Memory in Alzheimer Disease: Case-Control Pilot Study",
journal="JMIR Form Res",
year="2024",
month="Jul",
day="19",
volume="8",
pages="e51943",
keywords="Alzheimer disease; spaced retrieval; mobile app; assistive technology; episodic memory; semantic memory; mobile phone",
abstract="Background: Spaced retrieval is a learning technique that involves engaging in repeated memory testing after increasingly lengthy intervals of time. Spaced retrieval has been shown to improve long-term memory in Alzheimer disease (AD), but it has historically been difficult to implement in the everyday lives of individuals with AD. Objective: This research aims to determine, in people with mild cognitive impairment (MCI) due to AD, the efficacy and feasibility of a mobile app that combines spaced retrieval with a machine learning algorithm to enhance memory retention. Specifically, the app prompts users to answer questions during brief daily sessions, and a machine learning algorithm tracks each user's rate of forgetting to determine the optimal spacing schedule to prevent anticipated forgetting. Methods: In this pilot study, 61 participants (young adults: n=21, 34{\%}; healthy older adults: n=20, 33{\%}; people with MCI due to AD: n=20, 33{\%}) used the app for 4 weeks to learn new facts and relearn forgotten name-face associations. Participation during the 4-week period was characterized by using the app once per day to answer 15 questions about the facts and names. After the 4-week learning phase, participants completed 2 recognition memory tests approximately 1 week apart, which tested memory for information they had studied using the app as well as information they had not studied. Results: After using the mobile app for 1 month, every person with MCI due to AD demonstrated improvements in memory for new facts that they had studied via the app compared to baseline (P<.001). All but one person with MCI due to AD (19/20, 95{\%}) showed improvements of more than 10 percentage points, comparable to the improvements shown by young adults and healthy older adults. Memory for name-face associations was similarly improved for all participant groups after using the app but to a lesser degree. Furthermore, for both new facts and name-face associations, we found no memory decay for any participant group after they took a break of approximately 1 week from using the app at the end of the study. Regarding usability, of the 20 people with MCI due to AD, 16 (80{\%}) self-adhered to the app's automated practice schedule, and half of them (n=10, 50{\%}) expressed an interest in continuing to use it. Conclusions: These results demonstrate early evidence that spaced retrieval mobile apps are both feasible for people with early-stage AD to use in their everyday lives and effective for supporting memory retention of recently learned facts and name-face associations. ",
issn="2561-326X",
doi="10.2196/51943",
url="https://formative.jmir.org/2024/1/e51943",
url="https://doi.org/10.2196/51943",
url="http://www.ncbi.nlm.nih.gov/pubmed/39028554"
}