Memory Questionnaires

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MEMORY QUESTIONNAIRES 1

9 Subjective memory measures: An overview of three types of memory questionnaires

10 currently in use

11

12 Yashoda Gopi† & Christopher R. Madan

13 School of Psychology, University of Nottingham, Nottingham, UK

14

15

16

17 Corresponding author.
18 Yashoda Gopi
19 School of Psychology, University Park
20 University of Nottingham

21 Nottingham, NG7 2RD, UK.


22 Email: yashoda.gopi@nottingham.ac.uk

23 Word count: 10,180

24
25
MEMORY QUESTIONNAIRES 2

26 Abstract
27 Subjective memory evaluation is important for assessing memory abilities and complaints,

28 alongside objective measures. In both research and clinical settings, questionnaires are used

29 to examine memory beliefs and knowledge, perceived memory ability, and memory

30 complaints. Although they provide a structured measure of self-reported memory, there is

31 some debate as to whether subjective evaluation accurately reflects memory abilities.

32 Specifically, the disconnect between subjective and objective memory measures remains a

33 longstanding issue within the field. Thus, it is essential to evaluate the benefits and

34 limitations of questionnaires that are currently in use. This review encompasses three

35 categories of subjective memory questionnaires: metamemory, self-efficacy, and complaints.

36 Factors influencing self-evaluation of memory including knowledge and beliefs about

37 memory, ability to evaluate memory, recent metamemory experiences, and affect are

38 examined. The relationship between subjective and objective memory measures is explored

39 and considerations for future development and use of memory questionnaires are provided.

40
41 Keywords: metamemory; memory self-efficacy; memory complaints; memory beliefs;
42 memory evaluation
43
MEMORY QUESTIONNAIRES 3

44 Subjective memory measures: An overview of three types of memory questionnaires


45 currently in use
46 Complaints of memory problems in daily life can prompt evaluation of memory abilities

47 using subjective and objective memory measures (Hendriks et al., 2002; Illman et al., 2015;

48 Schmidt et al., 2001; Sunderland et al., 1983). Objective measures include recognition or

49 recall tests that simulate memory-demanding situations to evaluate learning and memory

50 abilities, or neuropsychological test batteries designed to assess multiple aspects of cognition

51 (Beaudoin & Desrichard, 2017; Garcia et al., 1998; McMillan, 1984; Rowell et al., 2016;

52 Snitz et al., 2015). Although these measures are commonly used in examining and diagnosing

53 memory decline and deficits, objective measures alone may not sufficiently capture some

54 aspects of everyday memory demands (Illman et al., 2015; McMillan, 1984; Sander et al.,

55 2018; Sunderland et al., 1983; Troyer & Rich, 2002). Several factors such as knowledge of

56 memory processes, beliefs about memory ability and efficacy, self-awareness, recent

57 metamemory experiences, personality traits, and affect may influence motivation and

58 performance on memory tasks and contribute to memory evaluations (Berry et al., 1989;

59 Bouazzaoui et al., 2020; Cavanaugh et al., 1998; Cavuoto et al., 2021; Clare et al., 2010;

60 Gilewski & Zelinski, 1986; Hultsch et al., 1985; Sehulster, 1981; Spano et al., 2020).

61 Subjective memory measures may better capture these differences as individuals can report

62 their perceptions of memory processes and their abilities in everyday life that are not included

63 in objective measures.

64

65 Subjective memory evaluations can be obtained through self or other reports using

66 questionnaires that capture details of knowledge and beliefs about memory, perceptions of

67 memory abilities, everyday memory successes and failures, feelings about memory, and

68 complaints about memory (Crook & Larrabee, 1990; Gilewski & Zelinski, 1986; Herrmann,

69 1982; Sunderland et al., 1983). Memory questionnaires are often used in research and
MEMORY QUESTIONNAIRES 4

70 clinical settings as screening measures, to examine the relationship between beliefs and

71 objective performance, or to aid in neurological diagnosis (Burmester et al., 2015; Crook &

72 Larrabee, 1990; Helmstaedter & Elger, 2000; Herrmann, 1982; Kinsella et al., 2009; Van

73 Bergen et al., 2010). However, subjective measures remain under scrutiny for a variety of

74 reasons, including validity, length, influence on self-perceptions, and limited direct

75 connection to objective memory measures (Burmester et al., 2015, 2017; Gilewski &

76 Zelinski, 1986; Herrmann, 1982). In this review, we outline validated memory questionnaires

77 that are currently in use and explore factors that influence subjective evaluation, the

78 connection between subjective and objective measures, and future considerations for

79 development and use of memory questionnaires.

80

81 Three categories of memory ability questionnaires are examined here: metamemory, memory

82 self-efficacy, and memory complaints. Metamemory refers to an individual’s knowledge of

83 memory processes and awareness of their own memory functioning (Dixon & Hultsch, 1983;

84 Garcia et al., 1998; Hertzog et al., 1989; Hultsch et al., 1987). Memory self-efficacy is the

85 extent to which an individual believes they are capable of using memory effectively in

86 different situations (Beaudoin & Desrichard, 2011; Cavanaugh et al., 1998; Hertzog et al.,

87 1989; Lineweaver & Hertzog, 1998). Memory complaints generally involve reports of

88 forgetting instances or difficulties in remembering in everyday life (Gilewski & Zelinski,

89 1986; Hall et al., 2009; Hertzog & Pearman, 2013; Ponds & Jolles, 1996a).

90

91 Additional types of memory questionnaires include those targeted to specific patient groups

92 such as acquired brain injury and autobiographical memory questionnaires examining past

93 personal experiences (Davis et al., 1995; Man et al., 2011; Palombo et al., 2013; Vannucci et

94 al., 2020). Apart from the structured questionnaire format, subjective memory evaluation can
MEMORY QUESTIONNAIRES 5

95 be administered in interviews, open-ended questionnaires, or questionnaires designed for use

96 in specific studies (Burmester et al., 2015; Crumley et al., 2014; Kahn et al., 1975). In a

97 different capacity, individuals may be asked to make task-specific predictions of their

98 expected performance on a forthcoming memory task, or to evaluate their performance on a

99 recently completed task (Berry et al., 1989; Bruce et al., 1982; Gervasio & Blusewicz, 1988;

100 Pearman & Trujillo, 2013). While these additional subjective measures are valuable

101 assessments, they are beyond the scope of the current review, which focuses on structured

102 memory ability and complaints questionnaires currently in use across research and clinical

103 settings.

104

105 Memory Questionnaires


106 Metamemory Questionnaires

107 Metamemory encompasses knowledge about memory processes and mechanisms in addition

108 to beliefs about one’s own memory abilities, strengths and weaknesses (Bruce et al., 1982;

109 Garcia et al., 1998; Hertzog et al., 1989). Metamemory questionnaires include multiple

110 subscales to capture various characteristics of memory including remembering and forgetting,

111 evaluations of abilities, and general knowledge of memory functioning. Questionnaires

112 currently in use are shown in Table 1. See sample items in Appendix A.

113

114 One of the most widely used metamemory questionnaires is the Metamemory in Adulthood

115 Questionnaire (MIA), which was developed to capture multiple aspects of memory that are

116 relevant to activities in everyday life for adults of all ages (Dixon & Hultsch, 1983). The MIA

117 is used to examine the interrelationships between metamemory dimensions and the

118 relationship between subjective evaluations and objective memory performance with some

119 revised versions developed for different populations (Campelo et al., 2016; Hertzog et al.,
MEMORY QUESTIONNAIRES 6

120 1989; McDonough et al., 2019; Ponds & Jolles, 1996b). Another prevalent metamemory

121 questionnaire is the Memory Functioning Questionnaire (MFQ), derived from the

122 Metamemory Questionnaire, which was developed earlier by the same researchers to examine

123 awareness of memory abilities and memory failures in healthy adults (Gilewski, Zelinski, &

124 Schaie, 1990; Zelinski et al., 1980). The MFQ is frequently used in research and clinical

125 settings, with either the comprehensive test employed for metamemory analyses or individual

126 scales selected as necessary (Cavanaugh et al., 1998; Hülür et al., 2018; Payne et al., 2017;

127 Yoon et al., 2019).

128

129 In contrast to the MIA, which includes a mixture of personal and general beliefs, Lineweaver

130 and Hertzog (1998) developed two measures to separate beliefs adults hold about their own

131 memory, with the Personal Beliefs about Memory Inventory (PBMI) from beliefs they hold

132 about the memory ability of people in the general population, using the General Beliefs about

133 Memory Inventory (GBMI). Computerised versions of the PBMI and GBMI were developed

134 to increase ease-of-access and reduce response bias related to stereotypes as respondents may

135 be more truthful in anonymous responding, and are used in developmental research

136 examining age-related beliefs about memory (Cavallini et al., 2013; Hertzog et al., 2014; Irak

137 & Çapan, 2018). The most recently developed metamemory questionnaire, the Multifactorial

138 Memory Questionnaire (MMQ), was created to tap into specific aspects of metamemory such

139 as contentment, ability, and strategy use for older adults (Troyer & Rich, 2002). Use of the

140 MMQ is common across aging and patient group studies (Fort et al., 2004; Illman et al.,

141 2015; Kinsella et al., 2009; van der Werf & Vos, 2011).

142

143 Shared characteristics across metamemory questionnaires are summarised in Table 1. General

144 memory ability refers to an individual’s belief about their ‘overall’ memory and is usually a
MEMORY QUESTIONNAIRES 7

145 single question regarding general memory problems (e.g., MFQ general rating scale),

146 personal ability, or global memory ability of others (Gilewski, Zelinski, & Schaie, 1990;

147 Mogle et al., 2020). In contrast, memory self-efficacy is used to evaluate ability to effectively

148 remember in specific situations (e.g., PBMI specific memory ability scale) (Lineweaver &

149 Hertzog, 1998). Similarly, the frequency of forgetting characteristic examines the extent to

150 which memory mistakes occur in daily life situations (e.g., MMQ Ability scale) (Troyer &

151 Rich, 2002).

152

153 To examine memory change over time, questions are either in the context of retrospective

154 change in comparison to a previous timepoint (e.g., MFQ retrospective functioning scale), or

155 expected prospective change (e.g., PBMI prospective change scale) (Gilewski, Zelinski, &

156 Schaie, 1990; Lineweaver & Hertzog, 1998). Similarly, memory control questions indicate

157 the extent to which an individual believes that their memory or memory in general is

158 unchangeable or malleable (e.g., GBMI control scale) (Lachman et al., 1995; Lineweaver &

159 Hertzog, 1998). Finally, the strategy use/mnemonic characteristic refers to use of memory

160 strategies (e.g., MIA strategy scale) including internal memory aids such as mnemonics, or

161 external aids such as calendars (Bouazzaoui et al., 2010; Dixon & Hultsch, 1983). These

162 shared characteristics highlight the multidimensional nature of memory and the importance of

163 multiple scales to effectively assess knowledge and perceptions of individual ability (Dixon

164 & Hultsch, 1983; Mogle et al., 2017, 2021).

165

166 Several metamemory questionnaires include unique additional characteristics. The MIA

167 measures knowledge of basic memory processes, the reciprocal interaction between emotion

168 and memory, frequency of participating in cognitively-engaging activities, and the perceived

169 importance of good memory performance (Dixon & Hultsch, 1983). In contrast, the MFQ
MEMORY QUESTIONNAIRES 8

170 additionally examines perceived seriousness of forgetting in specific situations (Gilewski,

171 Zelinski, & Schaie, 1990). On the other hand, the PBMI includes a relative standing rating

172 where respondents are asked to compare their general memory ability to all adults of their

173 own age and all adults of all ages (Lineweaver & Hertzog, 1998). Finally, the MMQ contains

174 a contentment scale, measuring feelings about one’s own memory (Troyer & Rich, 2002).

175 These additional characteristics are important to consider when selecting a questionnaire to

176 use. For example, if the seriousness of forgetting is an essential aspect of investigation, the

177 MFQ would be appropriate whereas others that do not have this aspect may not be as

178 beneficial. Moreover, these additional characteristics support the argument that the

179 multidimensional construct of metamemory has yet to be clearly dissected into its

180 components (Clare et al., 2010; Hultsch et al., 1987; Mogle et al., 2021).

181

182 Metamemory questionnaires are valuable for addressing the multidimensional aspects of

183 memory and the variety of items may allow for better correlations with memory performance

184 on objective tasks compared to if single or open-ended questions are used (Crumley et al.,

185 2014; Dixon & Hultsch, 1983; Troyer & Rich, 2002). However, metamemory questionnaires

186 have been criticised for their length which may deter use with certain populations (Mogle et

187 al., 2021; Van Bergen et al., 2010). For example, the widely-used MIA and MFQ are time-

188 consuming which may result in fatigue and consequently incomplete or inaccurate responses

189 for older adults or individuals with memory impairments (Gilewski & Zelinski, 1986;

190 McDonough et al., 2019; Troyer & Rich, 2002; Van Bergen et al., 2010). For this reason,

191 some metamemory questionnaires have been reduced to shorter versions or specific

192 subscales, e.g., the Frequency of Forgetting-10 Scale derived from the MFQ to retain

193 essential aspects while reducing the length (McDonough et al., 2019; Zelinski & Gilewski,

194 2004). In contrast, the MMQ was designed with consideration for the length and potential
MEMORY QUESTIONNAIRES 9

195 clinical applicability and as such, has been successfully applied with clinical populations

196 (Illman et al., 2015; Troyer & Rich, 2002).

197

198 Another concern is the combination of global and specific memory questions. When

199 responding to global memory questions, respondents may rely on generalisations or

200 stereotypes about memory whereas they may consider distinct past experiences when

201 responding to questions about specific situations, resulting in different levels of specificity

202 when evaluating memory ability (Cavanaugh et al., 1998; Mogle et al., 2020). This can

203 potentially result in overgeneralisations of memory ability or inaccurate recall of past events

204 depending on the order of the questions (Cyr & Anderson, 2019). In summary, metamemory

205 questionnaires provide useful insights into the multidimensional aspects of memory but can

206 be time-consuming and include various question types and thus require consideration

207 regarding the target respondents’ ability to complete the entire measure and how question

208 types may influence self-evaluations and responses.

209

210 Self-Efficacy Questionnaires

211 Beliefs about one’s own memory ability in various situations has been labelled memory self-

212 efficacy, which is distinguished from the knowledge about memory processes by personal

213 agency in different circumstances (Beaudoin & Desrichard, 2011; Cavanaugh et al., 1998;

214 Hertzog et al., 1989). Memory self-efficacy questionnaires include ratings of one’s ability to

215 remember information in various contexts. Questionnaires currently in use are shown in

216 Table 2. See sample items in Appendix B.

217

218 One of the early established memory self-efficacy questionnaires is the Inventory of Memory

219 Experiences, which was revised by the same researchers to the Shortened Inventory of
MEMORY QUESTIONNAIRES 10

220 Memory Experiences (SIME) to assess daily forgetting and remembering instances

221 (Herrmann, 1982; Herrmann & Neisser, 1978). The SIME has subsequently been used to

222 examine memory self-efficacy beliefs in adults across all ages and in patient populations

223 (Cutler & Brăgaru, 2017; Gervasio & Blusewicz, 1988; Ryan, 1992). In contrast to the SIME,

224 the Squire Subjective Memory Questionnaire (SSMQ) was initially developed to differentiate

225 memory complaints from before and after electroconvulsive therapy to treat depression, but

226 has since been adapted for more general use (Squire et al., 1979; Van Bergen et al., 2010).

227 The SSMQ has recently been used in examining memory trust and compliance with false

228 narratives (Kuczek et al., 2018; Van Bergen et al., 2010).

229

230 A widely-used memory self-efficacy questionnaire is the Subjective Memory Questionnaire

231 (SMQ), which was created to assess self-report of memory skills regarding real-life memory

232 tasks for adults (Bennett‐Levy & Powell, 1980). The SMQ is often used across a variety of

233 studies with different populations, yet correlations with objective memory performance have

234 been mixed (Bennett‐Levy & Powell, 1980; Clark & Maguire, 2020; Gigi et al., 2020;

235 Helmstaedter & Elger, 2000). Another well-established self-efficacy questionnaire, the

236 Memory Self-Efficacy Questionnaire (MSEQ), was designed to examine developmental and

237 individual differences in self-evaluated memory ability (Berry et al., 1989; West et al., 1984).

238 The MSEQ is a common measure among studies examining age-related memory self-efficacy

239 (Beaudoin, 2018; Beaudoin & Desrichard, 2017; Cavuoto et al., 2021; Ossher et al., 2013).

240 To examine a particular aspect of memory self-efficacy, the Memory Controllability

241 Inventory (MCI) was developed to assess perceptions of memory controllability and current

242 memory ability in training studies (Lachman et al., 1995). As such, the MCI is used in

243 memory training and aging studies to examine memory control beliefs (Cherry et al., 2019;

244 Thana-Udom et al., 2021).


MEMORY QUESTIONNAIRES 11

245

246 All memory self-efficacy questionnaires include the ability to remember characteristic (Table

247 2). Ability to remember items either examine perceived memory ability for specific

248 information (e.g., phone numbers), past actions (e.g., whether someone locked the door), or

249 hypothetical questions with created scenarios (Bennett‐Levy & Powell, 1980; Berry et al.,

250 1989; Riege, 1983). However, there are differences between the target items or situations

251 across the questionnaires including variations in question framing such as I statements, e.g.,

252 “I remember conversations I had with other people”, strength of memory questions, e.g.,

253 “How good is your memory for shopping lists”, and ability to recall questions, e.g., “Can you

254 remember the price of an item in in the supermarket from one aisle to the next” (Bennett‐

255 Levy & Powell, 1980; Riege, 1983; Sehulster, 1981). There are also differences in response

256 types including agree-disagree, always-never, or for the MSEQ, yes/no responses with

257 confidence judgements (Bennett‐Levy & Powell, 1980; Berry et al., 1989; Riege, 1983).

258

259 Several questionnaires also include a frequency of forgetting characteristic, which focuses on

260 how often memory mistakes occur for specific items such as names or in situations such as

261 where someone placed an item earlier (Bennett‐Levy & Powell, 1980; Sehulster, 1981;

262 Zelinski & Gilewski, 2004). Response options to frequency of forgetting questions are

263 generally in always-never Likert format (Bennett‐Levy & Powell, 1980; Sehulster, 1981).

264 Although shared characteristics exist across self-efficacy questionnaires, they may be framed

265 differently and may therefore result in different considerations when responding (Mogle et

266 al., 2020).

267

268 Self-efficacy questionnaires differ in their current use, development, and additional

269 characteristics. Although the SSMQ was initially designed to examine memory complaints in
MEMORY QUESTIONNAIRES 12

270 relation to electroconvulsive therapy, it was transformed into a trait memory distrust measure,

271 deviating from the usual context of examining memory ability related to aging or memory

272 ability in specific situations (Squire et al., 1979; Van Bergen et al., 2010). This was based on

273 the assumption that individuals who report subjective memory problems may be more

274 suggestible and compliant with false recollections (Van Bergen et al., 2009, 2010). However,

275 the SSMQ retains questions that are comparable to those in the other self-efficacy

276 questionnaires (Appendix B). In comparing two self-efficacy questionnaires Bennett‐Levy

277 and Powell (1980) highlighted that the SMQ and SIME were developed almost concurrently

278 yet with different intentions as the SMQ was intended to bridge a gap between objective

279 memory performance in lab-based settings and everyday memory performance in clinical

280 settings whereas the SIME was intended to examine individual differences in remembering

281 and forgetting in everyday life in relation to theories of memory based on tests conducted in

282 the lab (Herrmann & Neisser, 1978). However, both questionnaires have been used in similar

283 capacities with healthy and patient populations since their initial development (Cutler &

284 Brăgaru, 2017; Gigi et al., 2020; Helmstaedter & Elger, 2000).

285

286 Another questionnaire, the MSEQ, differs from the other outlined self-efficacy measures as it

287 incorporates self-efficacy strength in addition to self-efficacy level measured by confidence

288 ratings and varying task difficulty levels, providing the advantage of separately examining

289 perceived memory ability in specific situations as well as confidence. (Berry et al., 1989). To

290 examine perceived control over and opportunity to change memory ability, the MCI includes

291 several additional such as potential improvement, effort utility, and inevitable decrement,

292 (Lachman et al., 1995). The differences across these questionnaires highlight that even

293 though they examine memory self-efficacy, they are not interchangeable as they have
MEMORY QUESTIONNAIRES 13

294 different strengths and limitations. Thus, it is essential to consider the aspects of memory

295 self-efficacy that are being examined in relation to the questionnaire being used.

296

297 Memory self-efficacy questionnaires examine self-perception of memory abilities in specific

298 situations, investigate mechanisms mediating the relationship between self-evaluation and

299 memory performance, and facilitate rapid assessment of self-efficacy in clinical settings

300 (Bennett‐Levy & Powell, 1980; Berry et al., 1989; Riege, 1983; Sehulster, 1981). They

301 provide valuable information regarding an individual’s beliefs about their own memory

302 capabilities and limitations that can aid in creating a memory profile in addition to objective

303 measures. Moreover, self-efficacy questionnaires can be helpful in examining motivation for

304 participating in memory-demanding tasks as an individual’s self-efficacy evaluation may

305 influence their decision to participate (Cavuoto et al., 2021; Hultsch et al., 1985, 1987;

306 Ossher et al., 2013). In addition, these relatively short measures can be administered to older

307 or memory-impaired individuals (Gilewski & Zelinski, 1986; Koss et al., 1993). However,

308 there are limited correlations between self-efficacy questionnaires and objective measures,

309 perhaps indicating a disconnect between what self-efficacy questionnaires and objective

310 memory tasks are measuring (Beaudoin, 2018; Herrmann, 1982). In summary, memory self-

311 efficacy questionnaires provide useful insight as to how people believe they will perform in

312 certain situations, but correlations between memory self-efficacy questionnaire responses and

313 objective memory performance are inconsistent, indicating that self-evaluations may not

314 reflect actual ability.

315

316 Complaints Questionnaires

317 Memory complaints may be the result of memory decline or impairments due to neurological

318 conditions such as stroke and should be seriously considered by clinicians as they may
MEMORY QUESTIONNAIRES 14

319 indicate onset of cognitive decline or dementia (McDonough et al., 2019; Schmand et al.,

320 1996; Vale et al., 2012; van der Werf & Vos, 2011; Youn et al., 2009). Memory complaints

321 questionnaires systematically assess complaints of memory failures or decline that can impact

322 daily living. Questionnaires currently in use are shown in Table 3. See Appendix C for

323 sample items.

324

325 One of the most widely used memory complaints questionnaires is the Everyday Memory

326 Questionnaire (EMQ), which was initially designed to assess memory failures in daily life of

327 head-injured patients (Sunderland et al., 1983). Revised versions of the EMQ are now

328 frequently used with patient groups and healthy adults as a memory complaints measure

329 (Calabria et al., 2011; Cornish, 2000; Evans et al., 2020; Royle & Lincoln, 2008; Sander et

330 al., 2018). Another well-established complaints questionnaire, the Memory Assessment

331 Clinics Self-Rating Scale (MAC-S), was initially designed for use in both clinical and

332 research settings to assess memory complaints in adults (Winterling et al., 1986). The MAC-

333 S has subsequently been used as a measure of subjective language functioning, an outcome

334 measure in memory training, and to examine memory complaints with a brief version created

335 for epilepsy patients (D’Angelo et al., 2021; Miller et al., 2019; Tarantini et al., 2021).

336

337 To specifically examine age-related memory decline rather than general memory complaints,

338 Crook et al. (1992) developed the Memory Complaint Questionnaire (MAC-Q). The MAC-Q

339 is currently used to examine severity of subjective memory complaint with patient groups and

340 healthy older adults (Buckley et al., 2013; Vogel et al., 2016). In a different approach, the

341 Subjective Memory Complaints Questionnaire (SMCQ) was developed as a brief measure of

342 memory complaints for older adults in clinical and research settings (Youn et al., 2009). The

343 SMCQ is used in screening for mild cognitive impairment and dementia in community-
MEMORY QUESTIONNAIRES 15

344 dwelling older adults but may be affected by executive functioning and mood (Spano et al.,

345 2020; Yim et al., 2017; Youn et al., 2019). Similar to the SMCQ, the Memory Complaints

346 Scale (MCS) was developed to actively and systematically search for memory complaints and

347 to distinguish between individuals with dementia and cognitively healthy older adults (Vale

348 et al., 2012). The MCS has been used with community-dwelling older adults to examine the

349 relationship between memory complaints and objective memory performance, examine the

350 effects of life factors on subjective memory complaints, and as an outcome measure in health

351 education intervention (Casemiro et al., 2018; Dalpubel et al., 2019; Hwang & Kim, 2019).

352 More recently, the Prospective Memory Concerns Questionnaire (PMCQ) was created to

353 identify prospective memory impairments in the general older adult population (Sugden,

354 Thomas, Kiernan, et al., 2021). Further examinations of the validity of this recent measure

355 are warranted.

356

357 Shared characteristics across memory complaints questionnaires include ability to remember,

358 frequency of forgetting, global/general memory ability, and comparison. Ability to remember

359 questions focus on current ability to remember in specific situations such as recalling a

360 person name (e.g., MAC-Q) or more generally, such as ability to recall things that have

361 happened in the past (e.g., MAC-S) (Crook et al., 1992; Winterling et al., 1986). On the other

362 hand, frequency of forgetting questions examine how often memory mistakes occur for

363 specific items such as faces (e.g., SMCQ) or recently learned information (e.g., EMQ)

364 (Sunderland et al., 1983; Youn et al., 2009). In a more general capacity, global items are used

365 to evaluate whether respondents or their companions believe the individual is experiencing

366 general memory problems in daily life (e.g., MCS, SMCQ) (Vale et al., 2012; Youn et al.,

367 2009).

368
MEMORY QUESTIONNAIRES 16

369 To examine memory in a comparative scope, the memory comparison characteristic examines

370 whether memory is different compared to one’s own memory at a different time point (e.g.,

371 MAC-Q) or if memory is perceived to be different from others of similar age (e.g., MCS,

372 SMCQ) (Crook et al., 1992; Vale et al., 2012; Youn et al., 2009). As memory complaints

373 questionnaires are usually administered to older adults, it is important to understand the

374 extent to which they believe their memory may have changed over time or how they examine

375 their memory in relation to others. Although complaints questionnaires share similar

376 characteristics with self-efficacy questionnaires, complaints questionnaires are more often

377 used with adults expected to have memory decline or deficits and are more often targeted to

378 older adults.

379

380 Differences across memory complaints questionnaires include design, length, and additional

381 characteristics. For example, the EMQ scale broadly differentiates between memory and

382 attention systems, which is beneficial to separately address domain-specific difficulties

383 (Royle & Lincoln, 2008; Sunderland et al., 1983, 1984). In contrast to the other

384 questionnaires, the MAC-Q examines beliefs of memory change over a specific time period

385 by asking respondents to compare their current memory ability to that of their own in high

386 school or college (Crook et al., 1992). However, affective state may influence responses on

387 the MAC-Q if aging stereotypes negatively influence emotions of respondents completing the

388 measure while comparing their current memory to their memory performance at a younger

389 age (Reid et al., 2012).

390

391 Whereas most complaints questionnaires are completed by the individual experiencing

392 memory difficulties, the MCS contains both a patient and other version to be completed by a

393 companion and includes questions regarding the impact of memory problems on daily
MEMORY QUESTIONNAIRES 17

394 activities (Vale et al., 2012). This can be particularly beneficial where it is necessary to

395 determine how memory deficits are impacting daily life and where memory deficits may

396 prevent accurate responding. Several memory complaints measures were initially targeted to

397 clinical populations but were subsequently revised to be more generally applicable (Royle &

398 Lincoln, 2008; Squire et al., 1979; Sunderland et al., 1983; Van Bergen et al., 2010).

399 Moreover, the length of memory complaints questionnaires vary, but some revisions have

400 been made to shorten them where necessary to make them appropriate for use with older

401 adults or patient populations while retaining integral aspects (Calabria et al., 2011; Miller et

402 al., 2020; Royle & Lincoln, 2008). These differences across memory complaints

403 questionnaires demonstrate strengths and limitations that warrant consideration depending on

404 the target group and purpose of assessment when selecting a questionnaire for use.

405

406 Memory complaints questionnaires examine every day remembering and forgetting, assesses

407 age-related memory decline, and detect dementia amongst older adults (Crook et al., 1992;

408 Herrmann & Neisser, 1978; Squire et al., 1979; Sunderland et al., 1983; Vale et al., 2012;

409 Winterling et al., 1986; Youn et al., 2009). Many have been designed for older adults or

410 clinical populations, and thus have been carefully constructed or revised to reduce fatigue

411 while maintaining essential aspects (Calabria et al., 2011; Crook & Larrabee, 1990; Royle &

412 Lincoln, 2008). However, one limitation is that they require the same abilities that are being

413 evaluated, thus, there is an issue of accurate reporting (McDonough et al., 2019; Spano et al.,

414 2020; van der Werf & Vos, 2011). Although it is important to consider the impact of the

415 memory problems on reporting ability of the respondents, few memory complaints

416 questionnaires include measures to address this, such as using an ‘other’ form of the

417 questionnaire that can be completed by family members (Poon et al., 1978; Vale et al., 2012).

418 Nonetheless, memory complaints should be seriously considered because they may indicate
MEMORY QUESTIONNAIRES 18

419 initial symptoms of dementia or risk factors (Vale et al., 2012; Vaskivuo et al., 2018).

420 Moreover, recent evidence suggests that healthy older adults with and without memory

421 complaints show functional differences in brain activations for memory tasks that may

422 indicate early signs of dementia and can be considered alongside subjective measures (Hayes

423 et al., 2017; Viviano & Damoiseaux, 2020). In summary, memory complaints questionnaires

424 are valuable for examining complaints in everyday life and memory decline, but the use of

425 additional measures such as other reports from family members and neuroimaging may be

426 necessary to compensate if memory problems interfere with accurate reporting.

427

428 Questionnaires Beyond the Scope of This Review

429 As previously outlined, this review encompasses metamemory, self-efficacy, and complaints

430 questionnaires. Similar questionnaires have been developed to address different aspects of

431 memory or cognition in healthy adults and clinical populations. For example, questionnaires

432 have been designed for use in educational settings, examining self-evaluated cognitive

433 failures, examining the impact of memory changes on daily life, and use in specific studies

434 (Broadbent et al., 1982; Gilewski & Zelinski, 1986; Herrmann, 1982; Kahn et al., 1975;

435 Shaikh et al., 2019; Zarit, Cole, et al., 1981). In addition, memory questionnaires have been

436 developed for specific patient groups and to examine autobiographical memory (Davis et al.,

437 1995; Palombo et al., 2013; Smith et al., 2000; Sutin & Robins, 2007). Although an extensive

438 evaluation is not within the scope of this review, a brief outline of some patient group and

439 autobiographical memory questionnaires is provided here.

440

441 Patient Groups Questionnaires

442 Several questionnaires have been developed to examine subjective memory for specific

443 groups such as dementia and acquired brain injury patients. To screen for Alzheimer’s
MEMORY QUESTIONNAIRES 19

444 disease, Koss et al. (1993) developed the Short-Memory Questionnaire (Short MQ), which

445 was derived from the Memory Self-Report Questionnaire (Riege, 1983). The Short MQ has

446 been incorporated in clinical settings to distinguish between individuals with Alzheimer’s

447 disease and healthy older adults (Garcia et al., 1998; N. Maki et al., 2000; Montgomery et al.,

448 2018). In a similar capacity, the Subjective Memory Complaints Scale was created to

449 examine the relationship between subjective memory complaints and cognitive decline or

450 dementia and has been used to examine cognitive decline in community dwelling and

451 memory clinic patient groups (Pires et al., 2012; Schmand et al., 1996; Silva et al., 2014). To

452 examine the frequency of retrospective and prospective memory errors in everyday lives of

453 Alzheimer Disease patients, their carers, and healthy adults, Smith et al. (2000) developed the

454 Prospective and Retrospective Memory Questionnaire (PRMQ). The PRMQ is widely used to

455 examine relationships between subjective memory appraisal and objective performance and

456 to prospective and retrospective memory ability across patient populations (Hogan et al.,

457 2021; Kliegel & JÄger, 2006; Vaskivuo et al., 2018).

458

459 To examine memory problems in everyday life that may impact older stroke patients, the

460 Subjective Memory Assessment Questionnaire was developed, but is now considered to have

461 poor reliability (Davis et al., 1995; Salis et al., 2019). A different questionnaire, the Brief

462 Assessment of Prospective Memory, a shortened version of the Comprehensive Assessment

463 of Prospective Memory, was created for use with traumatic brain injury patients but has been

464 expanded to use with stroke patients as well (Hogan et al., 2021; Man et al., 2011, 2015). In a

465 broader scope, the Evaluation of Everyday Memory Questionnaire was created to capture

466 everyday memory instances of acquired brain injury patients and includes a version to be

467 completed by companions (Tropp et al., 2015). These questionnaires generally differ from

468 each other as they target specific groups, but it is noteworthy that some have been extended
MEMORY QUESTIONNAIRES 20

469 for use with similar patients such as traumatic brain injury and stroke. The necessity of

470 specific patient group questionnaires indicates that memory problems vary across different

471 populations which should be considered when designing and selecting questionnaires for use.

472 In addition, patient group questionnaires tend to be relatively short as they target groups who

473 may not be able to engage with longer measures (Sugden, Thomas, & Kiernan, 2021). Thus,

474 it is essential to consider which questionnaire is appropriate in relation to the target group.

475

476 Autobiographical Memory Questionnaires

477 Autobiographical memory questionnaires examine memory for past personal events (Clark &

478 Maguire, 2020). A well-established autobiographical memory questionnaire, the Memory

479 Characteristics Questionnaire (MCQ), was designed to examine ratings of memory

480 characteristics such as visual detail, complexity, spatial and temporal information, and

481 feelings (Johnson et al., 1988). The MCQ has been used in exploring characteristics of false

482 memories and memory quality for emotional events (Mather et al., 1997; Waters et al., 2013).

483 Similar to the MCQ, the Autobiographical Memory Questionnaire (AMQ) was derived from

484 autobiographical and memory theories to examine the phenomenological characteristics of

485 autobiographical memories including recollection, vividness, and belief in the memory’s

486 accuracy (Rubin et al., 2003; Talarico et al., 2004). The AMQ is widely used in examining

487 the relationship between emotionality and the properties of autobiographical memories (Y.

488 Maki et al., 2013; Öner & Gülgöz, 2018). Another widely used questionnaire, the Memory

489 Experiences Questionnaire (MEQ), was developed to examine the dimensions of

490 autobiographical memory with a shortened version for time-limited situations (Luchetti &

491 Sutin, 2016; Sutin & Robins, 2007). The MEQ is used in examining the phenomenology of

492 intrusive memories and the relationship between aging and phenomenological aspects of

493 autobiographical memory (Newby & Moulds, 2011; Siedlecki et al., 2015).
MEMORY QUESTIONNAIRES 21

494

495 To examine individual differences in trait mnemonics, the Survey of Autobiographical

496 Memory (SAM) was created with episodic, semantic, spatial and future thinking subscales

497 and a brief version developed for epidemiological research (Palombo et al., 2013). The SAM

498 has been used in examining spatial memory and navigation as well as exploring the

499 relationship between autobiographical memory and age-related cognitive decline complaints

500 (Fan et al., 2020; Selarka et al., 2019). Another questionnaire, the Autobiographical Memory

501 Characteristics Questionnaire (AMCQ) was developed to assess characteristics of

502 autobiographical memories and consists of 14 subscales including sensory details,

503 accessibility, and observer perspective (Boyacioglu & Akfirat, 2015). The AMCQ has been

504 used in research exploring the malleability of estimated age in reported memories in relation

505 to memory quality and the relationship between psychopathic traits and recollection of

506 emotional life experiences (Lanciano et al., 2019; Wessel et al., 2019). More recently, the

507 Assessment of the Phenomenology of Autobiographical Memory (APAM) measure was

508 developed to address phenomenology of autobiographical memory with healthy adults and

509 clinical populations (Vannucci et al., 2020). A subsequent web version was created to allow

510 for online self-administration, though further research will be required to demonstrate the

511 validity and reliability of this measure for use in person and online (Vannucci et al., 2021).

512 The outlined autobiographical memory questionnaires share several characteristics and have

513 generally built upon each other to fill gaps and address different aspects of autobiographical

514 memory, which allows for targeted use depending on aims of the assessment.

515

516 Summary

517 Numerous questionnaires are available for use in research and clinical settings that contain

518 items addressing general memory ability, self-efficacy in particular situations, beliefs about
MEMORY QUESTIONNAIRES 22

519 control, memory change, comparison of memory ability, frequency of memory failures, or the

520 impact of memory failures on daily life using Likert scales, analogue sliders, or open-ended

521 questions as response options (Berry et al., 1989; Burmester et al., 2017; Crook et al., 1992;

522 Fort et al., 2004; Herrmann, 1982; Hertzog et al., 2014; Mogle et al., 2020, 2021).

523 Questionnaires can be administered during interviews with verbal responses, in pen-and-

524 paper format, and through online platforms. Three general categories of questionnaires were

525 examined here.

526

527 Metamemory questionnaires include multiple subscales to address the multidimensional

528 nature of memory but can be time-consuming and difficult to administer to special

529 populations or in time-limited situations. Memory self-efficacy questionnaires are valuable

530 for examining perceived memory ability in different situations but have limited connection to

531 objective memory performance. Memory complaints questionnaires examine potential

532 memory deficits or decline but require the use of the same abilities being evaluated that are

533 potentially impacted and thus have difficulties in reliability. Additional types of memory

534 questionnaires include those targeted to patient groups and autobiographical questionnaires to

535 examine characteristics of past personal experiences. While memory questionnaires provide

536 crucial information, individual differences that can influence self-evaluation of memory

537 should be considered.

538 Factors Influencing Self-Evaluation of Memory


539 There are individual differences in the way memory is evaluated and therefore reported on

540 questionnaires (Berry et al., 1989; Cavanaugh et al., 1998; Hultsch et al., 1987; Sehulster,

541 1981; Van Bergen et al., 2009). Several factors may interact with memory self-evaluations

542 including knowledge or beliefs about memory, ability to evaluate memory, recent
MEMORY QUESTIONNAIRES 23

543 metamemory experiences, and affect (Hertzog et al., 1989, 2014; Rowell et al., 2016; Troyer,

544 2001). These factors are considered below.

545

546 Knowledge/Beliefs About Memory

547 An individual’s conceptualisation of memory as well as beliefs about stereotypes and control

548 over memory can influence self-evaluations (Helmstaedter & Elger, 2000; Hertzog et al.,

549 2014; Troyer & Rich, 2002). For example, memory self-reports may be correlated with

550 different cognitive functions in addition to memory if individuals consider other cognitive

551 functions such as attention, language, and executive function to be part of the definition of

552 memory (Hall et al., 2009; Helmstaedter & Elger, 2000; Payne et al., 2017; Snitz et al.,

553 2015). To prevent this misconception, it may be appropriate to include a definition of

554 memory that corresponds with the questionnaire being used (Mogle et al., 2020).

555

556 In a different capacity, individuals may indicate sufficient knowledge of memory processes

557 but still rate their own memory abilities as poor or less than average based on beliefs relating

558 to generalisations or stereotypes (Hertzog et al., 1989; Troyer, 2001). For example, a

559 prominent stereotype held by adults of all ages is that memory will inevitably decline with

560 age (Cavallini et al., 2013; Dixon & Hultsch, 1983; Hertzog et al., 2014; Kahn et al., 1975;

561 Lineweaver & Hertzog, 1998; Pearman et al., 2014; Ryan, 1992; Troyer, 2001).

562 Consequently, older adults may underestimate their memory ability whereas younger adults

563 may overestimate their memory ability (Cavanaugh et al., 1998; Fort et al., 2004; Fritsch et

564 al., 2014; Irak & Çapan, 2018; Kinsella et al., 2009; Van Bergen et al., 2010). Moreover,

565 stereotypes or generalisations may influence performance on objective measures whereby

566 older adults expect themselves to perform poorly on a memory task based on age, resulting in

567 lack of motivation and subsequently poor performance (Bouazzaoui et al., 2020; Cavuoto et
MEMORY QUESTIONNAIRES 24

568 al., 2021; Hultsch et al., 1987; Irak & Çapan, 2018; Ponds & Jolles, 1996a; Poon et al., 1978;

569 Riege, 1983; Troyer & Rich, 2002).

570

571 Similar to beliefs about aging and memory, beliefs about the malleability of memory may

572 influence participation in memory tasks and responses on questionnaire items (Cavanaugh et

573 al., 1998; Dixon & Hultsch, 1983; Lineweaver & Hertzog, 1998). Perceptions that memory

574 decline is inevitable or unchangeable can lead to reduced motivation to participate in memory

575 demanding tasks whereas the belief that memory is malleable may influence motivation to

576 improve memory abilities with memory strategies and more positive reflections of ability

577 (Bouazzaoui et al., 2020; Lachman et al., 1995; Lineweaver et al., 2021; Poon et al., 1978;

578 Thana-Udom et al., 2021). In particular, older adults may believe their memory to be

579 inevitable and irreversible, whereas young adults may view their memory to be more

580 malleable, with more control over their abilities (Cavallini et al., 2013; Dixon & Hultsch,

581 1983; Hultsch et al., 1987; Irak & Çapan, 2018; Lineweaver & Hertzog, 1998). However,

582 memory training that provides education on memory processes and strategies can improve

583 memory control beliefs for older adults (Lineweaver et al., 2021; Thana-Udom et al., 2021).

584

585 Based on the influence of knowledge and beliefs about memory on self-evaluations, it has

586 been argued that memory questionnaires relate to beliefs about memory rather than actual

587 memory ability or performance on specific tasks (Cavanaugh et al., 1998; Herrmann, 1982;

588 Payne et al., 2017; Sehulster, 1981). Memory knowledge and beliefs may also relate to

589 motivation to participate in memory-demanding tasks and use memory strategies

590 (Bouazzaoui et al., 2010; Cavanaugh et al., 1998; Herrmann, 1982; Lineweaver et al., 2021).

591 Thus, knowledge, stereotypes, and beliefs about memory ability and controllability are
MEMORY QUESTIONNAIRES 25

592 important factors in evaluating one’s memory and should be considered when administering

593 memory questionnaires.

594

595 Ability to Evaluate Memory

596 Responding to questionnaires requires self-awareness of memory abilities and recent memory

597 experiences, which can be difficult for individuals with memory deficits who can

598 consequently over or under-estimate their memory abilities (Clare et al., 2010; Crook &

599 Larrabee, 1990; Davis et al., 1995; Gilewski, Zelinski, & Schaie, 1990; Man et al., 2011;

600 McDonough et al., 2019; McMillan, 1984; Spano et al., 2020; Sunderland et al., 1984).

601 Young and middle-aged adults are potentially more accurate in assessing their memory

602 abilities compared to older adults because they are regularly provided with feedback through

603 their work or education and are therefore afforded the opportunity to update their self-

604 evaluations (Van Bergen et al., 2009, 2010). On the other hand, it is possible that older adults

605 or memory-impaired individuals are more aware of their memory abilities as they are more

606 attuned to their memory failures in everyday life and may therefore be more realistic in

607 estimating memory functioning compared to healthy or young adults (Cavanaugh et al., 1998;

608 Crumley et al., 2014; Schmidt et al., 2001; Zelinski et al., 1980).

609

610 It has been suggested that young adults may not engage as frequently with memory failures if

611 they are seen as inconsequential, resulting in inaccurate evaluations (Ponds & Jolles, 1996a;

612 Sehulster, 1981; Sunderland et al., 1983; Zelinski et al., 1980). In support of this, some

613 studies have shown that older adults have better correlation between subjective and objective

614 memory measures in comparison to younger adults (Pearman & Trujillo, 2013; Riege, 1983;

615 Zelinski et al., 1980). However, further exploration is warranted to examine the factors that

616 underly the ability to accurately evaluate memory as comparing responses on subjective
MEMORY QUESTIONNAIRES 26

617 measures to performance on objective measures often has inconsistent results (Bennett‐Levy

618 & Powell, 1980; Burmester et al., 2017; Crumley et al., 2014).

619

620 Potential solutions to the difficulty of evaluating one’s own memory include questionnaires

621 for companions or using checklists and diaries that capture daily remembering instances

622 (Gilewski, Zelinski, & Anthony-Bergstone, 1990; Helmstaedter & Elger, 2000; Man et al.,

623 2011; Sugden, Thomas, & Kiernan, 2021; Sunderland et al., 1983; Vale et al., 2012; Yim et

624 al., 2017). However, memory may be assessed differently depending on whether it is being

625 assessed for oneself or for another person and discrepancies between self and other reports

626 and objective memory measures indicate a lack of reliability in determining which approach

627 best represents actual memory abilities (Clare et al., 2010; Hall et al., 2009; Helmstaedter &

628 Elger, 2000; Smith et al., 2000; Sugden, Thomas, & Kiernan, 2021). In addition, the

629 seriousness of a memory failure may vary across individuals such that the same memory

630 failure may seem inconsequential to one but serious to another (Hogan et al., 2021; Mogle et

631 al., 2019; Zelinski et al., 1980). For example, experiences such as forgetting keys or

632 misplacing one’s glasses may be seen as failing memory for older adults but for younger

633 adults may simply be ignored as inconsequential forgetting (Kahn et al., 1975; Kahn &

634 Miller, 1978; Zarit, Cole, et al., 1981).

635

636 To get accurate reporting from companions, they would need to be in contact with the patient

637 on a daily basis to observe memory successes and failures (Sugden, Thomas, & Kiernan,

638 2021). Thus, it is essential to consider the extent to which individuals can accurately judge

639 the memory ability of others through observation. In summary, ability to accurately assess

640 memory may vary depending on several factors including memory problems, confidence in
MEMORY QUESTIONNAIRES 27

641 memory, the relationship to others completing similar questionnaires, and perceived

642 seriousness of memory failures.

643

644 Recent Metamemory Experiences

645 Memory evaluations can be based on past experiences, information provided by others about

646 memory successes and failures, or comparisons of personal performance across time

647 (Cavanaugh et al., 1998; Helmstaedter & Elger, 2000; Herrmann, 1982; Mogle et al., 2017;

648 Sehulster, 1981). Recent experiences in daily life or in an experimental setting may impact

649 memory evaluations (Cavanaugh et al., 1998; Cavuoto et al., 2021; Pearman et al., 2014;

650 Sehulster, 1981; Van Bergen et al., 2010; Zelinski et al., 1980). For example, if responding to

651 a question about remembering names, an individual may recall a recent event in daily life

652 involving recalling names or past performance on a memory test (Cavanaugh et al., 1998;

653 Pearman & Trujillo, 2013; Sehulster, 1981).

654

655 In a broader capacity, forgetting incidents that cause embarrassment or frustration may lead

656 to negative perceptions of general memory ability (Hertzog et al., 1989; Poon et al., 1978).

657 Moreover, older adults who have been recently exposed to friends or family members with

658 dementia could misinterpret normal age-related memory decline as being related to dementia

659 (Kinzer & Suhr, 2016; Van Bergen et al., 2009). On the other hand, recent exposure to

660 individuals with dementia or worsening memory could result in an updated belief as to what

661 constitutes good memory and may lead to older adults evaluating their memory abilities in a

662 more positive light (Pearman et al., 2014). Moreover, older adults may evaluate recent

663 memory lapses as part of normal aging (Mogle et al., 2019; Pearman et al., 2014). Thus, it is

664 essential to consider the extent to which the questions asked on memory questionnaires

665 require reflection of recent memory experiences.


MEMORY QUESTIONNAIRES 28

666

667 Recollection of past experiences can be influenced by the question format on questionnaires.

668 Whereas some items require consideration of recent events, others require consideration of

669 events in the prior years or decades, whereas some do not include an anchor (Crook et al.,

670 1992; Hultsch et al., 1987; Kahn & Miller, 1978; Mogle et al., 2020; Rowell et al., 2016).

671 This can lead to different levels of specificity when recalling the prior events and individuals

672 might rely on generalisations to recall information or events from more remote periods

673 (Hultsch et al., 1987; Mogle et al., 2020). However, older adults indicate that remote memory

674 is better than recent memory and they may be more accurate when recalling earlier life events

675 whereas younger adults may be more accurate when retrieving recent events (Kahn et al.,

676 1975; Kahn & Miller, 1978). As such, Kahn & Miller (1978) suggest that a more apt

677 comparison of recent and remote memory experiences would be to ask about the same event

678 recently and several years prior.

679

680 It has also been demonstrated that the order of questions, e.g., having a global memory

681 question before specific memory questions may lead to more concerns about memory as

682 negative experiences are more salient and will therefore result in a negative view of general

683 memory ability (Cyr & Anderson, 2019). In a different capacity, the frequency with which

684 individuals engage with everyday remembering tasks may vary if they use memory aids or

685 rely on carers for assistance (Hogan et al., 2021; Ossher et al., 2013; Sander et al., 2018). As

686 such, when reflecting on recent memory experiences, individuals may either account for the

687 use of everyday aids if they are considered to be an extension of their own memory or they

688 may evaluate their memory based on their capability, with either case resulting in different

689 outcomes (Sander et al., 2018). Therefore, when considering responses to memory

690 questionnaires, particularly those that require recall of past information or events, it is
MEMORY QUESTIONNAIRES 29

691 important to consider how recent as well as remote metamemory experiences influence self-

692 evaluations.

693

694 Affect

695 Affective states that are either temporary or chronic including stress, concern, anxiety, and

696 depression can influence recall of affect-congruent behaviours when evaluating memory

697 (Cavanaugh et al., 1998; Lineweaver & Brolsma, 2014; Pearman et al., 2014; Rowell et al.,

698 2016; West et al., 1984; Yoon et al., 2019). Affect may also impact motivation to participate

699 in memory-demanding tasks and to seek help for memory problems (Beaudoin, 2018;

700 Bouazzaoui et al., 2020; Gigi et al., 2020; Pires et al., 2012). On the other hand, it is possible

701 that memory problems, recent memory failures, or concerns about memory decline can

702 influence anxiety and depression (Bhang et al., 2020; Cavuoto et al., 2021; Cutler & Brăgaru,

703 2017; Mogle et al., 2019; Tropp et al., 2015).

704

705 Past research has consistently demonstrated a link between affect and subjective memory

706 evaluations, even when the link between subjective memory evaluations and objective

707 memory performance is weak (Buckley et al., 2013; Kahn et al., 1975; Larrabee & Levin,

708 1986; Lineweaver & Brolsma, 2014; Pearman et al., 2014; Tropp et al., 2015; Vale et al.,

709 2012; West et al., 1984; Zarit, Gallagher, et al., 1981; Zelinski & Gilewski, 2004).

710 Specifically, scores on subjective memory questionnaires (e.g., MAC-Q, MFQ) are

711 significantly correlated with scores on anxiety and depression measures (e.g., the State-Trait

712 Anxiety Inventory and the Center for Epidemiologic Studies Depression Rating Scale) across

713 healthy adults of all ages and patient groups (Evans et al., 2020; Fort et al., 2004; Kahn et al.,

714 1975; Pearman et al., 2014; Reid et al., 2012; Rowell et al., 2016; West et al., 1984).

715 However, mixed results have been found regarding the link between affect and memory
MEMORY QUESTIONNAIRES 30

716 performance with the relationship being weak in some cases and strong in others (Crook et

717 al., 1992; Gilewski, Zelinski, & Anthony-Bergstone, 1990; Larrabee & Levin, 1986; West et

718 al., 1984; Zarit, Cole, et al., 1981).

719

720 Emotional problems appear to be a main concern when individuals are asked about memory

721 problems and anxiety and depression have been implicated as risk factors for mild cognitive

722 impairment (Gigi et al., 2020; Ma, 2020; Ponds & Jolles, 1996a). Moreover, negative feelings

723 towards oneself before performing a memory task or responding to questionnaires may result

724 in poorer outcomes on both (Bouazzaoui et al., 2020; Cavuoto et al., 2021; Poon et al., 1978).

725 In contrast, it has been suggested that anxiety or worry about memory may result in an

726 increase in motivation, resource allocation, and use of memory strategies in memory tasks to

727 compensate for negative feelings (Beaudoin, 2018; van der Werf & Vos, 2011).

728

729 Memory training or interventions and general noncognitive training have been linked to

730 reduced memory complaints and improved confidence in memory abilities even when this is

731 not reflected in objective memory performance (Sugden, Thomas, & Kiernan, 2021; Thana-

732 Udom et al., 2021; Zarit, Cole, et al., 1981; Zarit, Gallagher, et al., 1981). Evidently, affect

733 plays an important role in subjective memory evaluation and as such, should be measured

734 where memory performance is investigated (Hall et al., 2009; Rowell et al., 2016; Vaskivuo

735 et al., 2018; West et al., 1984; Yoon et al., 2019). In summary, it is possible that individuals

736 experiencing anxiety or depression may negatively evaluate their memory even without

737 objective memory deficits and judge memory to be improved following treatment for affect

738 or general cognitive training due to improved mood rather than performance (Gilewski,

739 Zelinski, & Anthony-Bergstone, 1990; Rowell et al., 2016; West et al., 1984).

740
MEMORY QUESTIONNAIRES 31

741 Summary

742 Knowledge and beliefs about memory, ability to evaluate memory, recent metamemory

743 experiences, and affect may influence self-evaluations and reports of memory abilities and

744 memory performance. It has also been demonstrated that personality traits such as

745 neuroticism and conscientousness are linked to memory evaluations and should also be

746 evaluated alongside subjective memory measures (Mogle et al., 2017; Pearman et al., 2014;

747 Rowell et al., 2016; Zelinski & Gilewski, 2004). Increased knowledge of memory processes

748 or mechanisms may reduce the influence of stereotypes or myths about memory decline with

749 aging. Similarly, increasing self-awareness of memory problems may reduce overconfident

750 responding. Recent metamemory experiences, in particular memory failures, may result in

751 negative self-evaluations but can be addressed by careful question wording and order.

752 Finally, affective states may influence self-evaluations and potentially memory performance

753 and shoud be measured alongside subjective memory measurements and addressed with

754 appropriate treatment. The influence of these individual differences on memory evaluations

755 should be considered when using memory questionnaires and evaluating memory

756 performance.

757

758 Relationship Between Subjective and Objective Memory Measures


759 There is little consistency across previous research on the relationship between subjective

760 memory evaluation and objective memory performance (Burmester et al., 2017; Calabria et

761 al., 2011; Crumley et al., 2014; Gilewski, Zelinski, & Anthony-Bergstone, 1990; Hall et al.,

762 2009; Pearman et al., 2014; Schmidt et al., 2001). Some studies have found no correlation

763 (Burmester et al., 2017; Kahn et al., 1975; Pearman et al., 2014; Schmidt et al., 2001; West et

764 al., 1984), whereas others have found only weak or moderate correlations between results on

765 memory questionnaires and objective memory measures (Beaudoin & Desrichard, 2017;
MEMORY QUESTIONNAIRES 32

766 Bennett‐Levy & Powell, 1980; Hulicka, 1982; Sehulster, 1981; Sunderland et al., 1983; Vale

767 et al., 2012; Van Bergen et al., 2009, 2010). Correlations appear to be best when memory is

768 assessed in corresponding domains, for example with face-name recall (Bennett‐Levy &

769 Powell, 1980; Ossher et al., 2013).

770

771 There are several possible reasons for the disconnect between subjective and objective

772 memory evaluation. First, subjective and objective measures may be examining different

773 aspects of memory. While objective measures such as recall or recognition tasks are mainly

774 episodic and require conscious recollection of information that was presented, subjective

775 measures often require considerations of semantic and prospective memory and can invite

776 retrieval of information about memory ability and stereotypes (Bennett‐Levy & Powell, 1980;

777 Hall et al., 2009; Schmidt et al., 2001). Moreover, objective memory tests often involve

778 learning and testing of new information, whereas subjective questionnaires often invite

779 retrieval of past experiences in addition to evaluation of general memory ability (Bennett‐

780 Levy & Powell, 1980; Helmstaedter & Elger, 2000; Reid et al., 2012; Van Bergen et al.,

781 2009). Although objective measures provide insight into learning and memory within a lab-

782 based context, this may not be representative of real-world experiences and memory

783 processes (Hultsch et al., 1985; McMillan, 1984; Ossher et al., 2013; Sander et al., 2018;

784 Vaskivuo et al., 2018). Perhaps questions about task-specific memory beliefs rather than

785 general memory performance or abilities would be more appropriate to match the type of

786 memory being examined in objective tests (Lachman et al., 1995; Troyer & Rich, 2002).

787 However, this would not provide reflections on memory in daily life.

788

789 Another potential reason for the lack of correlation is that subjective and objective memory

790 tasks are measured differently. Objective measures are often completed in lab-based settings
MEMORY QUESTIONNAIRES 33

791 with stimuli designed or selected to target a specific aspect of memory whereas self-report

792 measures may be completed in lab, clinical, or community settings with items that focus on

793 memory abilities and experiences in daily life (Bennett‐Levy & Powell, 1980; Broadbent et

794 al., 1982; Ponds & Jolles, 1996a; Schmidt et al., 2001, 2001; Sugden, Thomas, & Kiernan,

795 2021; Troyer & Rich, 2002). Moreover, objective memory tasks often involve explicit

796 instructions and guidance available to complete the task, whereas subjective measures such as

797 questionnaires rely on respondents’ interpretation of concept meanings and question

798 understanding (Mogle et al., 2021; Sunderland et al., 1983; Vogel et al., 2016). However,

799 questions on subjective measures about general memory beliefs or specific everyday

800 situations may not be easily replicated in the lab setting (Lachman et al., 1995). For example,

801 whereas individuals, particularly older adults, use compensatory strategies such as external

802 memory aids in everyday situations, memory testing in lab situations often preclude this

803 option (Bouazzaoui et al., 2010; Crumley et al., 2014; Sugden, Thomas, & Kiernan, 2021;

804 Troyer & Rich, 2002). Thus, objective memory measures may not accurately reflect everyday

805 memory tasks that are examined on memory questionnaires (Davis et al., 1995; Hall et al.,

806 2009; Man et al., 2011; McMillan, 1984; Ossher et al., 2013; Sugden, Thomas, & Kiernan,

807 2021; Sunderland et al., 1983).

808

809 Finally, it is possible that inaccurate reporting on memory questionnaires may influence the

810 discrepancy between subjective and objective measures. Individuals relying on stereotypes

811 might negatively evaluate their memory ability even if objective performance is within a

812 normal range (Kahn et al., 1975; Pearman et al., 2014; Sugden, Thomas, & Kiernan, 2021;

813 Troyer & Rich, 2002; Van Bergen et al., 2010; Zelinski et al., 1980). Similarly, some

814 individuals may underestimate or overestimate memory abilities if they are unable to

815 accurately assess their abilities due to memory impairment (Hall et al., 2009; Herrmann,
MEMORY QUESTIONNAIRES 34

816 1982; Illman et al., 2015; Snitz et al., 2015). Moreover, confounding memory with other

817 cognitive domains may result in overreporting of memory problems (Burmester et al., 2017;

818 Hall et al., 2009; Hülür et al., 2018; Snitz et al., 2015). Thus, it is essential to consider the

819 accuracy of responses on subjective measures in relation to performance on objective tasks.

820 The discrepancy between subjective and objective measures has important implications for

821 the diagnosis and treatment of memory problems and the use of memory questionnaires

822 (Bennett‐Levy & Powell, 1980; Hall et al., 2009; Illman et al., 2015). Based on the lack of

823 correlation between subjective and objective measures, it has been argued that subjective

824 reports alone should not be relied upon in clinical settings (Crumley et al., 2014; Garcia et al.,

825 1998; Herrmann, 1982; Sander et al., 2018; Schmidt et al., 2001; Sunderland et al., 1986).

826 However, it can also be argued that objective reports alone are not sufficient to reveal

827 memory problems that occur in daily life and that self-report measures reveal important

828 individual differences in memory abilities (Sander et al., 2018). Thus, it is important to

829 consider how to best combine self-report and objective measures when examining memory

830 (Gilewski, Zelinski, & Anthony-Bergstone, 1990; Sugden, Thomas, & Kiernan, 2021; Troyer

831 & Rich, 2002; Youn et al., 2019).

832

833 Conclusions and Future Considerations


834 Memory is often assessed using objective measures such as recognition or recall tests,

835 subjective measures such as memory questionnaires, or a combination of both. This review

836 focused on three types of memory questionnaires, metamemory, self-efficacy, and

837 complaints. Metamemory questionnaires address multiple dimensions of memory, self-

838 efficacy questionnaires examine evaluations of memory ability in specific situations, and

839 complaints questionnaires assess memory difficulties in everyday life. Individual differences

840 such as knowledge/beliefs about memory, ability to accurately evaluate memory, recent
MEMORY QUESTIONNAIRES 35

841 metamemory experiences, and affect can influence memory self-evaluations and therefore

842 reporting on memory questionnaires. Although memory questionnaires are useful in

843 examining self-reported memory ability and complaints, there is often discrepancies between

844 reports and objective memory performance that can lead to difficulty diagnosing and treating

845 memory problems. Thus, several considerations arise for the design and use of memory

846 questionnaires.

847

848 Some questionnaires have been criticised for being developed within research settings, with

849 limited relevance to clinical use, including items such as public speaking, driving, and

850 working that may be irrelevant to particular groups (Sander et al., 2018; Troyer & Rich,

851 2002). Moreover, many questionnaires have been developed before the commonplace use of

852 assistive technologies across healthy adults and patient populations (e.g., mobile phones to

853 store phone numbers) and therefore warrant caution when using questions that assume no use

854 of external memory aids or technology (Miller et al., 2020; Mogle et al., 2020; Sander et al.,

855 2018). Similarly, questionnaires that have been created based on suggestions from patients

856 and researchers may include items that are interpreted differently by different groups of

857 respondents (Bennett‐Levy & Powell, 1980; Cavanaugh et al., 1998; Cronholm & Ottosson,

858 1963; Helmstaedter & Elger, 2000; Sehulster, 1981; Squire et al., 1979).

859

860 It may be necessary to clearly define constructs or to ask respondents for their definitions in

861 the questionnaires to accurately interpret responses (Cavanaugh et al., 1998; Hall et al., 2009;

862 Mogle et al., 2020). In addition, it is important to examine how subjective memory measures

863 relate to actual memory ability (Vaskivuo et al., 2018). The low to moderate correlations

864 between subjective and objective measures remains an issue within the field that warrants

865 further exploration because this may influence the view that questionnaires are unreliable
MEMORY QUESTIONNAIRES 36

866 (Broadbent et al., 1982; Crumley et al., 2014; Hall et al., 2009; Hendriks et al., 2002; Hülür et

867 al., 2018; Payne et al., 2017; Poon et al., 1978; Sugden, Thomas, & Kiernan, 2021). Thus, it

868 is essential to consider the connection between memory questionnaires and actual memory

869 ability and whether subjective measures should be compared with objective measures or used

870 in combination as separate measures for evaluating different aspects of memory.

871

872 When selecting a questionnaire, it is important to consider the target group and memory

873 abilities being examined. Whereas metamemory questionnaires include multiple subscales

874 that can be used to complete a thorough evaluation, memory self-efficacy questionnaires

875 focus on ability in particular situations, and memory complaints questionnaires examine

876 every day remembering and forgetting instances. Thus, these questionnaires are not

877 interchangeable and will invite different considerations from respondents. For example, while

878 respondents may rely on schemas and stereotypes when responding to metamemory

879 questionnaires, specific past experiences may come to mind when responding to self-efficacy

880 or complaints questionnaires (Mogle et al., 2020; Ossher et al., 2013).

881

882 While memory complaints may indicate developing memory problems that are not detected

883 through objective measures alone, questionnaires designed for use with a specific population

884 may not be generalisable to others (Davis et al., 1995; Evans et al., 2020; Gilewski &

885 Zelinski, 1986; Salis et al., 2019). Moreover, lengthy questionnaires can induce fatigue,

886 particularly in older adults or individuals with memory impairments (Crook et al., 1992;

887 Davis et al., 1995; Zelinski & Gilewski, 2004). To address these concerns, shortened versions

888 or companion reports can be used (Man et al., 2011; McDonough et al., 2019; Yim et al.,

889 2017). In addition, using questionnaires with multiple subscales may not be beneficial where

890 a particular domain or aspect of memory is the focal point of the investigation (Crook et al.,
MEMORY QUESTIONNAIRES 37

891 1992; Mogle et al., 2020). Instead, matching the questionnaire to the target respondents’

892 abilities and limitations would likely provide more accurate results.

893

894 When evaluating questionnaire responses, it is worth considering how individual differences

895 influence memory evaluations and thus rehabilitation or training. Whereas some individuals

896 respond to questionnaires using implicit theories about memory, others respond based on past

897 experiences (Lineweaver & Hertzog, 1998; Pearman et al., 2014). Rather than training to

898 improve objective memory performance, perhaps training to reduce engagement with

899 stereotypes may improve accuracy of self-evaluations (Beaudoin, 2018; Ponds & Jolles,

900 1996a; Zarit, Cole, et al., 1981; Zarit, Gallagher, et al., 1981). Moreover, training to focus on

901 memory successes as well as memory failures, and increased knowledge that adults of all

902 ages encounter memory lapses may serve to reduce misconceptions regarding aging and

903 memory (Pearman & Trujillo, 2013; Zarit, Cole, et al., 1981).

904

905 As some individuals may not be able to accurately assess their own memory abilities,

906 appropriate alternatives should be put in place such as diaries or checklists to record everyday

907 memory failures (Herrmann, 1982; Sunderland et al., 1984). Similarly, it is possible to

908 include evaluations performed by companions of individuals with memory impairments

909 (Dalpubel et al., 2019; Garcia et al., 1998; Hulicka, 1982; Sunderland et al., 1983; Yim et al.,

910 2017). Finally, it is important to include measures of affect and personality traits when

911 examining subjective memory evaluations as they are consistently demonstrated to be linked

912 (Evans et al., 2020; Hall et al., 2009; Rowell et al., 2016; Tropp et al., 2015; Vaskivuo et al.,

913 2018; West et al., 1984; Yoon et al., 2019).

914
MEMORY QUESTIONNAIRES 38

915 In summary, subjective memory measures such as questionnaires are useful tools to examine

916 daily remembering and forgetting, self-efficacy, general beliefs about memory, and memory

917 complaints (Garcia et al., 1998; Hulicka, 1982; Troyer & Rich, 2002; Vale et al., 2012; van

918 der Werf & Vos, 2011). In comparison to observations or interviews, questionnaires provide

919 a standardised option to examine memory abilities, experiences, and potential for

920 improvement (Crumley et al., 2014; McDonough et al., 2019; Sugden, Thomas, & Kiernan,

921 2021). At present, the general consensus is that subjective memory questionnaires alone

922 should not be used for screening for memory problems, but subjective and objective measures

923 should be combined to provide the most accurate assessment of memory (Poon et al., 1978;

924 Sugden, Thomas, & Kiernan, 2021; Troyer & Rich, 2002; Youn et al., 2019). Memory

925 questionnaires, if selected appropriately in relation to the target audience and assessment

926 purpose, are essential tools in research and clinical settings.

927
MEMORY QUESTIONNAIRES 39

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1457
MEMORY QUESTIONNAIRES 50

1458 Tables
1459 Table 1

1460 Metamemory Questionnaires Currently in Use

Characteristics
Response
Questionnaire Reference Purpose Items General Self-
scale Forgetting Change Control Strategy Additional
ability efficacy
Metamemory in (Dixon & Examine 120 5-point X X X X Task, Anxiety,
Adulthood (MIA) Hultsch, 1983) metamemory in Activity,
adulthood Achievement

Memory (Gilewski, Examine subjective 64 7-point X X X X Seriousness of


Functioning Zelinski, & memory and forgetting
Questionnaire Schaie, 1990) objective
(MFQ) performance

Personal Beliefs (Lineweaver & Measure beliefs 57 Continuous X X X X Relative


about Memory Hertzog, 1998) about one’s own standing
Instrument (PBMI) memory

General Beliefs (Lineweaver & Measure beliefs 27 Continuous X X X


about Memory Hertzog, 1998) about memory for
Instrument (GBMI) an average healthy
adult

Multifactorial (Troyer & Rich, Assess self-reported 57 5-point X X


Memory 2002) memory for use in Contentment
Questionnaire clinical
(MMQ) assessments.

1461 Note. Revised versions of questionnaires are not included in this table.
1462
MEMORY QUESTIONNAIRES 51

1463 Table 2

1464 Memory Self-efficacy Questionnaires Currently in Use

Characteristics
Response
Questionnaire Reference Purpose Items Ability to Frequency of
scale Additional
remember forgetting
Short Inventory of (Herrmann & Examine frequency of forgetting and 12 7-point X X
Memory Experiences Neisser, 1978) clarity of remembering experiences.
(SIME) Shortened version of the IME.

Squire Subjective (Squire et al., Examine memory complaints before and 18 9-point X X
Memory Questionnaire 1979) after electroconvulsive therapy and
(SSMQ) general subjective memory evaluation.

Subjective Memory (Bennett‐Levy Measure subjective memory abilities in 43 5-point X X


Questionnaire (SMQ) & Powell, adults.
1980)

Memory Self-Efficacy (Berry et al., Measure of self-efficacy for use in 50 Yes/No & X
Questionnaire (MSEQ) 1989) developmental research and individual confidence
differences in memory ability evaluations. rating

Memory Controllability (Lachman et Measure beliefs about memory ability and 12 7-point X Potential improvement,
Inventory (MCI) al., 1995) control. effort utility, inevitable
decrement
1465 Note. Revised versions of questionnaires are not included in this table.
1466
1467
1468
1469
1470
MEMORY QUESTIONNAIRES 52

1471 Table 3

1472 Memory Complaints Questionnaires Currently in Use

Characteristics
Response
Questionnaire Reference Purpose Items Ability to Frequency of General Comparison
scale Additional
remember forgetting ability
Everyday Memory (Sunderland et Examine memory failures 35 5-point X
Questionnaire (EMQ) al., 1983) in everyday life.

Memory Assessment (Winterling et al., Assess memory complaints 49 5-point X X


Clinics, Self-Rating 1986) in adults.
Scale (MAC-S)

Memory Complaint (Crook et al., Assess age-related 6 5-point X X X


Questionnaire (MAC- 1992) memory decline as
Q) compared to high school or
college.

Subjective Memory (Youn et al., Examine subjective 14 Yes/No X X X


Complaints 2009) memory complaints in
Questionnaire (SMCQ) older adults in research
and clinical settings.

Memory Complaints (Vale et al., Actively search for 7 3-point X X X Impact on


Scale (MCS) 2012) memory complaints daily
activities

Prospective Memory (Sugden, Assess memory complaints 35 4-point X


Concerns Thomas, Kiernan, regarding prospective
Questionnaire (PMCQ) et al., 2021) memory.
1473 Note. Revised versions of questionnaires are not included in this table.
MEMORY QUESTIONNAIRES 53

1474 Appendices
1475 Appendix A

1476 Metamemory Questionnaires Sample Items

Questionnaire Sample items


MIA I am good at remembering names. (Strongly Agree – Strongly Disagree)
Do you write appointments on a calendar to help you remember them?
(Always – Never)

MFQ How often do these present a problem for you? Phone numbers you use
frequently. (Always – Never)
How is memory compared to the way it was … 10 years ago? (Much
Better – Much Worse)

PBMI Compared to all adults my age, my memory is… (Much Above Average –
Much Below Average)
My ability to remember the source of information is… (Very Good –
Very Poor)

GBMI Ability to remember in general (Very Good – Very Poor)


Ability to remember to do something at a later time. (Very Good – Very
Poor)

MMQ I have confidence in my ability to remember things. (Strongly Agree –


Strongly Disagree)
How often do you forget to take medication? (All the Time – Never)
1477
1478
MEMORY QUESTIONNAIRES 54

1479 Appendix B

1480 Self-efficacy Questionnaires Sample Items

Questionnaire Sample items


SIME Do you remember the last time you went to see a doctor? (– Not at All)
How often are you unable to find something that you put down only a few
minutes before? (Always – Never)

SSMQ My ability to recall things that happened a long time ago is (Perfect –
Disastrous)
My ability to follow what people are saying is (Perfect – Disastrous)

SMQ How good is your memory for where you’ve got to in a book? (Very
Good – Very Bad)
How often do you forget what you were going to say mid-sentence?
(Very Often – Very Rarely)

MSEQ If I heard it twice, I could remember 12 items from a grocery list without
taking the list with me. (Yes – No, 10% – 100%)
If a friend asked me to do 10 errands, 5 minutes later I could remember 2
of the errands I had to do. (Yes – No, 10% – 100%)

MCI I can find ways to improve my memory (Strongly Agree – Strongly


Disagree)
No matter how much I use my memory it is bound to get worse as I get
older (Strongly Agree – Strongly Disagree)
1481
MEMORY QUESTIONNAIRES 55

1482 Appendix C

1483 Memory Complaints Questionnaires Sample Items

Questionnaire Sample items


EMQ Finding that a word is ‘on the tip of your tongue’. You know what it is but
cannot quite find it. (Once or less in the last month – Once or more in a
day)
Repeating to someone what you have just told them or asking someone
the same question twice. (Once or less in the last month – Once or more
in a day)

MAC-S How would you describe your ability to remember where you have put
objects (such as keys) in the home or office? (Very Good – Very Poor)
How often do you go into a room to get something and forget what you
are after? (Very Often – Very Rarely)

MAC-Q Remember the name of the person just introduced


(Much Better Now – Much Poorer Now)
Remembering the item you intended to buy when you arrive at the
grocery store or pharmacy (Much Better Now – Much Poorer Now)

SMCQ Do you think you have a memory problem? (Yes – No)


Do you have difficulty in remembering to turn off the gas or light? (Yes –
No)

MCS Do you have memory problems (or forgetfulness or memory difficulties)?


(Yes – No)
Does this memory problem hamper (or impair) your daily activities? (A
lot/Frequently – No)

PMCQ I walk into a room and forget why I went there (Always – Never)
I do things twice because I forget that I have already done them, e.g., take
a tablet twice (Always – Never)
1484

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