Validation of the Fear and Avoidance of Memory Loss scale in community‐based older adults

Abstract

Introduction Alzheimer's disease and related dementias (ADRD) are among the most feared conditions. However, research around ADRD‐specific fear and avoidance behaviors is lacking. Here, we validated a novel measure of fear and avoidance specific to memory loss, the Fear and Avoidance of Memory Loss (FAM) scale, and examined associations between fear avoidance and psychosocial functioning in older adults. Methods We assessed FAM Scale internal reliability and concurrent validity, and candidate subscales across two samples (total N = 813). We then examined associations between fear avoidance and memory performance, anxiety, depressive symptoms, sleep, social functioning, and quality of life. Results We identified two subscales: fear and avoidance, which yielded strong psychometric validity. Higher fear was associated with memory failures and sleep disturbance. Higher avoidance was associated with memory failures, poorer verbal memory, reduced social functioning, and quality of life. Discussion We present the first measure of fear avoidance specific to memory loss. We propose that targeting fear avoidance can promote ADRD risk reduction and resiliency.

Reducing fear and avoidance of memory loss improves mood and social engagement in community-based older adults: a randomized trial

“…Participants were recruited from the community using advertising (e.g., flyers, email outreach, postings on transit lines) and through official registries (e.g., ResearchMatch). Inclusion criteria were: ≥ 55 years of age, literate in English, resident in Illinois, elevated fear and avoidance of memory loss defined as a score of > 60 (75% percentile) on the Fear and Avoidance of Memory loss scale [ 11 , 16 ], able and willing to provide informed consent, willing to be randomized to intervention group and study measures, and access to the internet to engage with materials. Exclusion criteria were: diagnosis of Mild Cognitive Impairment or ADRD, cognitive impairment defined as a score of < 18 on the Montreal Cognitive Assessment Blind version (MoCA-Blind) [ 27 ], severe depression defined as a score of ≥ 12 on the 15-item Geriatric Depression Scale (GDS-15)” [ 28 ], history of hospitalization in the 6 weeks previous to the study or repeated emergency room visits, current psychotherapy treatment, current substance use disorder, and inadequate vision or hearing to engage with study materials.…”

“…Primary outcome. ADRD-related fear and avoidance was assessed using the FAM scale, which focuses on the symptom of memory loss [ 11 , 16 ]. The FAM is an 18-item self-report scale assessing fears and avoidance behaviors associated with memory loss, which has been validated for use in older populations [ 11 , 16 ].…”

“…ADRD-related fear and avoidance was assessed using the FAM scale, which focuses on the symptom of memory loss [ 11 , 16 ]. The FAM is an 18-item self-report scale assessing fears and avoidance behaviors associated with memory loss, which has been validated for use in older populations [ 11 , 16 ]. Items address two components: fear (e.g., “ I am afraid that I might embarrass myself by forgetting something ”) and avoidance (e.g., “ I try not to exert my brain too much as it might make my memory worse ”).…”