Memory retrieval using paper vs. technology

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:

1. Those in the paper group took a significantly SHORTER time to record/write information than the tablet or smartphone groups.
2. 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.
3. 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?