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In the HABIT program, one of our core components is encouraging our patients with memory loss due to Mild Cognitive Impairment (MCI) to use a memory support system. We specifically recommend that system be a pencil and paper day planner rather than using technology-based organizational tools. There are a number of reasons for this recommendation, but one of those is research suggesting that initial encoding of information (getting information to stick the first place) and retrieval of that information (remembering information later) is stronger when using a paper-based system as compared to using technology. In that context, I want to share a new study that further supports this finding
Researchers at the University of Tokyo published their study in in the March 19, 2021 issue of Frontiers in Behavioral Neuroscience. If you'd like to read their paper, you can find it here. In addition, here is a news release further summarizing their research and findings.
The study
Briefly, the researchers assigned study participants keep track of scheduled appointments and related information using one of three methods: a paper calendar, a smartphone, or using an electronic stylus on a Tablet. They evaluated memory for those details one hour after a distraction task. They also evaluated how active certain areas of the brain were during a memory retrieval task using functional magnetic resonance imaging (fMRI).
Their findings
The researchers found a number of interesting findings in support of using a paper note taking system:
- Those in the paper group took a significantly SHORTER time to record/write information than the tablet or smartphone groups.
- With simpler information, the paper group was more accurate in recalling the information they recorded. When the information became more complex, the groups performed similarly.
- All three groups activated memory retrieval structures but the paper group brain activation was significantly higher than the tablet or smartphone groups.
Their conclusions
On page 8 of their paper the authors state, "These results indicate that the cognitive processes for the Note [paper] group were actually deeper and more solid." In the new article about their work, Professor Kuniyoshi L. Sakai, stated "Paper is more advanced and useful compared to electronic documents because paper contains more one-of-a-kind information for stronger memory recall."
Our conclusions
In addition to the other reasons we recommend paper (1-technology is always changing, which is not helpful for our patients living with Mild Cognitive Impairment and 2-writing is a more familiar and ingrained skill learned in childhood for most older adults. Technology is a much more recent skill development and we see that older skills are typically more resilient in patients with MCI), this study provides additional support for deeper processing of information in the first place when writing things on paper rather than using technology. One limitation is that this particular study was completed in younger adults without any memory problems. Thus, it may not generalize the same way to older adults with Mild Cognitive Impairment. In HABIT, we see our paper and pencil memory support system as an ongoing tool so that our patients don't have to worry about remembering all their important information with only their brain's memory systems. Nevertheless, increased memory system activation and increased likelihood that one will remember the information certainly doesn't hurt! It is also interesting that this study was conducted with younger adults who will have more concurrent skill building with pencil and paper and technology than our older adults. So, if anything, we might expect the difference between modalities to be even greater in older adults whose brains have even LESS experience with technology and MORE experience with paper.
Our bottom line
Our HABIT team will continue to recommend paper and pencil day planner type tools over using technology with our patients. Indeed--all our HABIT staff members use pencil and paper planners for their own needs as well!
I'd be interested in your experiences with technology vs. paper--what you like and don't like and if there is a format you like best! I personally like the system we developed which shows me just one day at a time and has sections for appointments, a to do list, and notes all in one page. I love it and I take it everywhere! How about you?
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I am impressed! Where do you learn to use all that technology? Thanks, Sandy
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1 ReactionHi @ess77! Yes, we at HABIT have designed a day planner for our patients with memory impairment. It is a checkbook size book that includes the current month with a two pages per day format combined with an additional book that shows the entire year for future planning. The month at a time book has sections each day for appointments, to dos, and notes. It is similar to other commercial systems in many ways, but a bit smaller and also a bit more simplified in many cases. We do not sell them to the public as yet, but we get this question a lot so we've been discussing how we might do so.
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1 Reaction50 years as a CPA.
@DrDonaLocke Thank you for the information. It sounds like something others might enjoy and use well. Ever thought of selling it in the gift shops? I frequent the Florida gift shop most times I go to the clinic, when walking the corridors w/my walker for exercise and I've bought some masks and other things on the gift shop web site to support Mayo. Others may do the same??? Just a thought.
You know, the masks on the gift shop site are designed by mayo staff....would you think it fun for some of your patients or staff to make the covers for your planners???? Oh, my,...here goes my mind and my old retailing self. Forgive me. I do think this might be a fun addition to the Mayo collection and perhaps make some pennies for your program?
Thanks again for your information and comments. Blessings to you, your staff and program. elizabeth
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1 ReactionI love all of these ideas @ess77 ! I will definitely look into it!
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1 ReactionI believe each person should use the method that fits them. I also believe rejecting Technology without a review is a fundamental mistake. It is obvious the study participants are pencil and paper addicts. Further, many seniors need things that are more important than a todo list. Health help, falling assist, perfect memory of a multitude of items, kids, grand kids birthdays & names, instant messaging for multitude of reasons. Also most seniors find that they they have lost much of their hand motor skills making legible writing an arduous if not impossible task. Many seniors are capable of learning basic and beneficial digital skills that go way beyond a pencil and paper. Studies like yours encourage them to not even try.
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2 ReactionsThanks for sharing this information. I use my phone and laptop which sync. I've been thinking about getting a smart watch. I have a feeling you've vetted or researched the best one for those of us with MCI. Which one do you recommend?
You are an inspiration! Such shared wisdom to use every tool available to improve life. Technologies as you mention indeed are helpful to living a full life. Like you, I could not live with my Fitbit, laptops, iphone. I going to switch to a different smart watch as a gift on my next birthday:). Change is essential to keep up. As my handwriting has changed, (I call it my shaky paw), using speech to text is a gift we are lucky to use. I wish and hope that individuals with progressive hearing loss would use it more. Thanks for sharing your story.
Laughing as I read this, "I call it my shaky paw", I am thinking I need to seriously look into speech to text because of my tremors.
I love that every topic on Cennect give me an inspiration to push myself and try something new.
Thanks!
Sue
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2 ReactionsDon’t wait for your birthday. Consider it a medical need. Do you know if you are wearing an Apple Watch series 6 and fall it will contact you to offer help if you don’t answer when it calls it will call 911. But it also tracks your blood oxygen, heart rate, and resting heart rate on continuous basis. Further, at your request will do an ECG. But has many other skills. Remembers everything you tell it and you can put a time and date on any item. Never forget another appointment. It is a perfect timer for cooking, etc. No I don’t work for Apple. So many useful items you will love it. Ask an Apple may work out a no interest payment plan. Good luck.