Enhancing Self-Awareness in Older Adults With Mild Cognitive Impairment: A Preliminary Randomized Controlled Trial of...

To examine whether the Feuerstein Instrumental Enrichment (FIE) program, a structured metacognitive intervention grounded in Mediated Learning Experience theory, could produce significant and durable improvements in self-awareness of memory abilities among older adults with mild cognitive impairment (MCI).

In a three-arm randomized controlled trial conducted across seven assisted-living facilities in Israel, 114 Hebrew-speaking adults aged 67-99 years diagnosed with MCI were assigned to the FIE intervention or one of two active control conditions (psychological discussion group; cultural lecture series). All conditions comprised 30 group sessions over 15 weeks. Self-awareness was operationalized as the absolute discrepancy between objective memory performance (NeuroTrax) and subjective appraisal (CogSym questionnaire), assessed at pre-intervention, post-intervention, and 2-month follow-up.

Among the 54 participants with impaired awareness at baseline, the FIE group showed significant improvement from pre- to post-intervention and from pre-intervention to follow-up, with gains fully maintained at the 2-month assessment. Control participants demonstrated only marginal improvement post-intervention that was not sustained at follow-up. Between-group differences at post-intervention were statistically significant.

The FIE program produced significant and durable improvements in self-awareness of memory abilities in older adults with MCI. Findings support the clinical utility of mediated learning approaches for addressing metacognitive deficits in this at-risk population, with implications for rehabilitation engagement and dementia prevention efforts.