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using imagination improves adherence for older adults

Using visualization techniques helps older adults remember to take their medications and follow medical advice. Older adults who spent a few minutes imagining how they would test their blood sugar were 50% more likely to perform the tests as directed than people who used other memory techniques, according to a study published in Psychology and Aging (2004; 19 [2], 318–25).

“This is an innovative study. It presents an unusual but apparently very effective way to use imagination as a memory tool to help older adults more successfully follow medical instructions,” says Jeffrey Elias, PhD, of the National Institute on Aging’s Behavioral and Social Research Program. “The best medical care in the world isn’t much good if a patient can’t or won’t follow through. Creative approaches such as this one need to be explored further if we are to solve difficult medication adherence problems. The genius of this method is that it requires less conscious effort than other memory methods. So it can be easily learned and applied.”

In the study, 31 volunteers ages 60–81, were divided into three groups and instructed to monitor blood sugar levels at four specific times daily. The “imagination” group spent one 3-minute session visualizing what they would do and where they would be when scheduled to test their blood sugar levels. The “rehearsal” group repeatedly recited aloud the instructions for blood testing. The “deliberation” group wrote a list of the pros and cons of testing blood sugar.

For the next 3 weeks, participants in the imagination group remembered to test their blood sugar at the right times
of the day 76% of the time, compared to 46% for each of the other groups. The researchers suggested that imagination might be more successful than other techniques because it uses a primitive part of memory that doesn’t deteriorate with age. While more studies need to be done, this points to the value and power of using visualization to improve adherence to specific behaviors.


Shirley Eichenberger-Archer, JD, MA

Shirley Eichenberger-Archer, JD, MA, is an internationally acknowledged integrative health and mindfulness specialist, best-selling author of 16 fitness and wellness books translated into multiple languages and sold worldwide, award-winning health journalist, contributing editor to Fitness Journal, media spokesperson, and IDEA's 2008 Fitness Instructor of the Year. She's a 25-year industry veteran and former health and fitness educator at the Stanford Prevention Research Center, who has served on multiple industry committees and co-authored trade books and manuals for ACE, ACSM and YMCA of the USA. She has appeared on TV worldwide and was a featured trainer on America's Next Top Model.

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