Proposed Autobiographical Memory Test For Older ECT Patients, From New Zealand

 Out on PubMed, from researchers in Christchurch, New Zealand, is this paper:

Development of an autobiographical memory test for older electroconvulsive therapy candidates.

Allan D, Croucher M, Gee S, Porter R.Australas Psychiatry. 2021 Apr;29(2):214-217. doi: 10.1177/10398562211003599.PMID: 33825553

The abstract is copied below:

Objectives: To develop a test of autobiographical memory for monitoring of older people during a course of electroconvulsive therapy (ECT).

Method: A list of events commonly experienced in later life was gathered from older people (n = 26) at a psychogeriatric day clinic and from psychiatrists (n = 23) who work with older depressed patients. The most common events were chosen as question domains for an autobiographical memory interview. This was piloted with 12 severely depressed older patients.

Results: A list of 15 common life events was developed. After pilot testing, a final 30-item questionnaire covering six common life events was proposed.

Conclusion: This study developed an autobiographical memory test with good face validity and potential for clinical use. It was modelled on a well-validated scale (The Columbia University Autobiographical Memory Interview, CUAMI-SF) and represented a useful first step in the development of a test for memory loss in older patients receiving ECT. The proposed test may be particularly sensitive to autobiographical memory loss in older people undergoing ECT because it uses recent personal memories, which are relatively commonly experienced in the older depressed population.

Keywords: autobiographical memory testing; electroconvulsive therapy; life events; older people.

And from the text:

We propose that the scoring for this questionnaire would be based on consistency of answers across time, following the CUAMI-SF, and would generally be reported as a percentage of baseline. This yields a percentage loss which can easily be understood. One limitation of this system of scoring is that it only measures loss. As individuals recover from depression, they may well experience an improvement in their ability to recall events both with greater accuracy and in greater detail, which cannot be measured using this CUAMI-based approach. Future steps in the development of this questionnaire will involve validation comparing older people undergoing ECT, older people with similar levels of depression who are not being treated with ECT, and healthy older adults over time. Conclusions 

The study has developed an autobiographical memory test for older people undergoing ECT with good face validity and potential for further testing and clinical development. It has been developed to probe recent memories, which we have determined are frequent in older New Zealanders living with depression. This study represents a useful first step in the development of a test for memory loss in older patients receiving ECT. This initial piloting suggests that the approach is relatively quick and simple to use and acceptable to older people.

This is a good-faith attempt to improve/simplify autobiographical memory testing in older ECT patients. Such testing is fraught with difficulties and the literature is just plain fraught. I will leave it to the neuropsychological experts to weigh in as to whether this is an advance for the field; of course, as noted above, further testing and validation will be needed.

For those of us interested in the details of memory testing with ECT, this short paper is a must read, only ~10 minutes.