1
|
Gupta A, Mahnken JD, Bernal J, Sharma P, Lepping RJ, Montgomery RN, Johnson DK, Parks A, Burns JM, Drew DA, Sarnak MJ, Brooks WM. Changes in Cognitive Function After Kidney Transplantation: A Longitudinal Cohort Study. Am J Kidney Dis 2024; 84:28-37.e1. [PMID: 38423160 DOI: 10.1053/j.ajkd.2023.12.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/11/2023] [Accepted: 12/23/2023] [Indexed: 03/02/2024]
Abstract
RATIONALE & OBJECTIVE Kidney disease negatively affects cognition. We assessed the effect of kidney transplantation (KT) on different cognitive domains. STUDY DESIGN Prospective cohort study. SETTING & PARTICIPANTS We examined pre- versus post-KT cognition in patients waitlisted for KT at an academic center. PREDICTORS Transplant status. We measured cognitive function before KT (n=101), 3 months after KT (n=78), and 1 year after KT (n = 83). OUTCOMES Our primary outcome was change in cognitive function before versus after KT. We used standard neuropsychological tests to assess global cognition (Mini-Mental State Exam [MMSE]), episodic/declarative memory (Logical Memory), psychomotor speed/visuospatial function (Digit Symbol Substitution Test [DSST], Trail Making Test [TMT] A), working memory/attention (Digit Span), executive function (TMT B), and semantic memory/verbal fluency/language (Category Fluency). ANALYTICAL APPROACH Using linear mixed model analysis, we evaluated the changes in neuropsychological test scores adjusted for age, sex, race, education, and number of assessments. RESULTS Before KT, Logical Memory I and II, DSST, MMSE, Category Fluency (animal naming), and Digit Span backward scores were low compared with normative values from the National Alzheimer's Coordinating Center data. Logical Memory I and II scores improved after KT (pre- vs post-KT, estimated group difference [d]=3.3, P<0.001 for Logical Memory I; d=4.27, P<0.001 for Logical Memory II), such that post-KT scores were similar to normative values (post-KT vs normative values, d = -0.37, P=0.06 for Logical Memory I; d = -0.89, P=0.08 for Logical Memory II). Category Fluency (animal naming; d=2.4, P<0.001) and DSST (d=3.12, P=0.01) scores also improved with KT, but post-KT DSST scores remained lower than normative values (post-KT vs normative values, d = -5.17, P<0.001). MMSE, Digit Span, and TMT A and B scores did not change after KT. LIMITATIONS Single-center study. CONCLUSIONS Episodic and verbal declarative memory normalize after KT. Semantic memory, verbal fluency, language, psychomotor speed, and visuospatial function show partial improvement. Cognitive impairment in kidney disease is therefore at least partly reversible with KT. PLAIN-LANGUAGE SUMMARY Cognitive impairment in kidney disease affects self-esteem, vocational abilities, quality of life, health care costs, and mortality. It is not clear whether kidney transplantation (KT) improves cognition and whether the improvement is uniform across cognitive domains. The distinction between reversible and irreversible cognitive impairment has important implications in the clinical care of patients before and after KT. We assessed cognition before KT and 3 months and 12 months after KT and discovered that episodic and verbal declarative memory normalized with KT. Semantic memory, verbal fluency, language, psychomotor speed, and visuospatial function also improved with KT but did not reach normal levels. Cognitive impairment in kidney disease is therefore at least partly reversible.
Collapse
Affiliation(s)
- Aditi Gupta
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas; Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas; University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, Kansas; Frontiers Clinical and Translational Science Institute, University of Kansas Medical Center, Kansas City, Kansas.
| | - Jonathan D Mahnken
- University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, Kansas; Frontiers Clinical and Translational Science Institute, University of Kansas Medical Center, Kansas City, Kansas; Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Joshua Bernal
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Palash Sharma
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas
| | - Rebecca J Lepping
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas; University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, Kansas; Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, Kansas
| | - Robert N Montgomery
- Department of Biostatistics and Data Science, University of Kansas Medical Center, Kansas City, Kansas
| | - David K Johnson
- Department of Neurology, University of California, Davis, Davis, California
| | - Adam Parks
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas
| | - Jeffrey M Burns
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas; University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, Kansas
| | - David A Drew
- Division of Nephrology and Hypertension, Department of Internal Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Mark J Sarnak
- Division of Nephrology and Hypertension, Department of Internal Medicine, Tufts Medical Center, Boston, Massachusetts
| | - William M Brooks
- Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas; University of Kansas Alzheimer's Disease Center, University of Kansas Medical Center, Kansas City, Kansas; Frontiers Clinical and Translational Science Institute, University of Kansas Medical Center, Kansas City, Kansas; Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, Kansas
| |
Collapse
|
2
|
Motioleslam M, Fereidooni-Moghadam M, Etemadifar M, Mohebi Z. Medication adherence and its relationship with self-esteem among patients with epilepsy in Isfahan, Iran. Epilepsy Behav 2024; 155:109776. [PMID: 38636147 DOI: 10.1016/j.yebeh.2024.109776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/20/2024]
Abstract
Medication adherence is of utmost importance in achieving the desired therapeutic outcome and effectively managing seizures in patients with epilepsy (PWE). It is imperative to recognize self-esteem as a psychological determinant that potentially influences the optimal compliance with anti-seizure medications (ASMs) among PWE. The objective of this study was to explore medication adherence and its relationship with self-esteem among individuals diagnosed with epilepsy in Isfahan, Iran. METHODS This descriptive-analytical study was conducted in the year 2021, encompassing a cohort of 250 PWE who were referred to designated medical facilities in Isfahan, Iran, and were selected by the consecutive sampling technique. A 3-part instrument including demographic components, the Rosenberg Self-Esteem Scale, and the Morissky Drug Adherence Questionnaire employed for data collection. RESULTS The mean and standard deviation of adherence to the medicinal regimen in the participants were 6.9 ± 2.02, and 46.4 % had a low level of adherence to the medication regimen (total score 0-6). At the same time, the mean and standard deviation of self-esteem in these patients was 5.11 ± 2.11. There was a statistically significant and direct correlation between adherence to the prescribed drug regimen and self-esteem (rs = 0.464, p = 0.00). CONCLUSION Based on the findings of the study that showed a statistically significant and positive correlation between self-esteem and adherence to the medication regimen, it is advisable to enhance and advocate for these factors in PWE.
Collapse
Affiliation(s)
- Moien Motioleslam
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Malek Fereidooni-Moghadam
- Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.
| | | | - Zeinab Mohebi
- Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| |
Collapse
|
3
|
Binarelli G, Lange M, Santos MD, Duivon M, Capel A, Fernette M, Boué A, Grellard JM, Tron L, Ahmed-Lecheheb D, Clarisse B, Rigal O, Le Fel J, Joly F. Digital cognitive stimulation in elderly breast cancer patients: the Cog-Tab-Age feasibility study. BMC Complement Med Ther 2024; 24:209. [PMID: 38822324 PMCID: PMC11143679 DOI: 10.1186/s12906-024-04507-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 05/20/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Elderly cancer patients often experience cognitive difficulties that can affect their quality of life and autonomy. However, they are rarely included in clinical trials, and only one study has explored the feasibility of cognitive training in this population. While digital cognitive training has been successful in improving cognition in younger patients, its feasibility in elderly patients requires evaluation. OBJECTIVES This feasibility study primarily focused on evaluating patients' ability to use digital cognitive stimulation (usability). Secondary objectives were to evaluate acceptability, adherence, and satisfaction with regard to digital cognitive stimulation in elderly breast cancer patients. METHODS Elderly breast cancer patients at least 70 years old who were receiving cancer treatment (chemotherapy, targeted therapy, and/or radiotherapy) were recruited. Cognitive complaints were evaluated at baseline using the Functional Assessment of Cancer Therapy-Cognitive Function scale (FACT-Cog). Participants were invited to attend three 20-minute sessions of digital cognitive stimulation using HappyNeuron PRESCO software App on tablets, with the first session being supervised by a neuropsychologist and the two others being performed independently either at home or at the cancer center. We hypothesized that participants would spend 10 of the 20 min of the given time with the tablet completing exercises (training time). Thus, the usability of digital cognitive stimulation was defined as completing at least three exercises during the training time (10 min) of one of the two training sessions in autonomy. The proportion of patients who agreed to participate (acceptability) and completion of planned sessions (adherence) were also estimated. Satisfaction was evaluated post-intervention through a self-report questionnaire. RESULTS 240 patients were initially screened, 60% (n = 145) were eligible and 38% agreed to participate in the study. Included patients (n = 55) had a mean age of 73 ± 3 years, 96% an ECOG score of 0-1 and were undergoing radiotherapy (64%), and/or chemotherapy (47%) and/or targeted therapy (36%) for stage I-II breast cancer (79%). Most patients reported significant cognitive complaints (82%) and 55% had previous experience with digital tools (n = 30). The usability rate was 92%, with 46 out of 50 evaluable participants completing at least three exercises during the training time. The adherence rate was 88%, with 43/50 participants completing all planned sessions. Participants were largely satisfied with the cognitive intervention format (87%). They preferred to complete sessions at the cancer center under the supervision of the neuropsychologist than alone at home (90%). CONCLUSIONS The high level of usability, adherence and satisfaction in this study shows for the first time the feasibility of digital cognitive stimulation in cancer patients older than 70 years. However, the intervention should be proposed only to patients reporting cognitive complaints and should be structured and supervised to improve acceptability and adherence. TRIAL REGISTRATION ClinicalTrials identifier: NCT04261153, registered on 07/02/2020.
Collapse
Affiliation(s)
- Giulia Binarelli
- Clinical Research Department, Centre François Baclesse, Caen, 14076, France
- ANTICIPE U1086 INSERM-UCN, Equipe Labellisée Ligue Contre le Cancer, Centre François Baclesse, Normandie Université UNICAEN, Caen, 14000, France
| | - Marie Lange
- Clinical Research Department, Centre François Baclesse, Caen, 14076, France.
- ANTICIPE U1086 INSERM-UCN, Equipe Labellisée Ligue Contre le Cancer, Centre François Baclesse, Normandie Université UNICAEN, Caen, 14000, France.
- Services Unit PLATON, Cancer and cognition Platform, University of Caen Normandy, Caen, 14000, France.
| | - Mélanie Dos Santos
- Clinical Research Department, Centre François Baclesse, Caen, 14076, France
| | - Mylène Duivon
- Clinical Research Department, Centre François Baclesse, Caen, 14076, France
- ANTICIPE U1086 INSERM-UCN, Equipe Labellisée Ligue Contre le Cancer, Centre François Baclesse, Normandie Université UNICAEN, Caen, 14000, France
| | - Aurélie Capel
- Clinical Research Department, Centre François Baclesse, Caen, 14076, France
| | - Marie Fernette
- Clinical Research Department, Centre François Baclesse, Caen, 14076, France
| | - Antoine Boué
- Clinical Research Department, Centre François Baclesse, Caen, 14076, France
- ANTICIPE U1086 INSERM-UCN, Equipe Labellisée Ligue Contre le Cancer, Centre François Baclesse, Normandie Université UNICAEN, Caen, 14000, France
| | | | - Laure Tron
- CHU Grenoble Alpes, VOIRON, 38500, France
| | - Djihane Ahmed-Lecheheb
- ANTICIPE U1086 INSERM-UCN, Equipe Labellisée Ligue Contre le Cancer, Centre François Baclesse, Normandie Université UNICAEN, Caen, 14000, France
- Services Unit PLATON, Cancer and cognition Platform, University of Caen Normandy, Caen, 14000, France
| | - Bénédicte Clarisse
- Clinical Research Department, Centre François Baclesse, Caen, 14076, France
| | - Olivier Rigal
- Care Support Department, Centre Henri Becquerel, Rouen, France
- Medical Oncology Department, Centre Henri Becquerel, Rouen, France
| | - Johan Le Fel
- Care Support Department, Centre Henri Becquerel, Rouen, France
| | - Florence Joly
- Clinical Research Department, Centre François Baclesse, Caen, 14076, France
- ANTICIPE U1086 INSERM-UCN, Equipe Labellisée Ligue Contre le Cancer, Centre François Baclesse, Normandie Université UNICAEN, Caen, 14000, France
- Services Unit PLATON, Cancer and cognition Platform, University of Caen Normandy, Caen, 14000, France
- University Hospital of Caen, Caen, 14000, France
| |
Collapse
|
4
|
Huber BN, Fulton EK. Meta-prospective memory accuracy in older adults with and without suspected Mild Cognitive Impairment (sMCI). APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-16. [PMID: 38564814 DOI: 10.1080/23279095.2024.2334892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
This study examined if the relationship between generalized and task-specific appraisals of prospective memory (PM) and actual PM performance (i.e., meta-PM accuracy) differed between healthy and suspected Mild Cognitive Impairment (sMCI) older adults. Older adults recruited included 50 healthy and 31 sMCI participants from the community and an outpatient neuropsychology clinic. Data collected consisted of self-reported appraisals and task-specific predictions/postdictions of PM performance, objective PM performance, and executive functioning (EF). The sMCI group had significantly lower scores on objective PM and EF measures related to simple and complex task-switching. Moreover, sMCI participants displayed lower task-specific meta-PM accuracy in the direction of overconfidence, but they displayed relatively equivalent generalized meta-PM accuracy when compared to the healthy group. Notably, the sMCI group's task-specific inaccuracies became non-significant in relation to the healthy group on the final long-term PM tasks after exposure to metacognitive reflection on the first two PM tasks. Despite lower scores on EF measures, EF performance did not explain task-specific meta-PM differences between groups beyond neurocognitive status. Based on these data, sMCI patients may be better assisted by metacognitive calibration strategies, EF protocols, and the implementation of general compensatory memory strategies as targets for early intervention and prevention of neurocognitive decline.
Collapse
Affiliation(s)
- Becca N Huber
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Department of Psychology, Idaho State University, Pocatello, ID, USA
| | - Erika K Fulton
- Department of Psychology, Idaho State University, Pocatello, ID, USA
| |
Collapse
|
5
|
Al-Saleh S, Conley S, Pace T, Insel KC. A Cross-Sectional Study of Cognitive Function, Illness Perceptions, and Immunosuppression Medication Adherence After Heart Transplantation. West J Nurs Res 2024; 46:164-171. [PMID: 38146266 DOI: 10.1177/01939459231220283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
BACKGROUND There are few studies that examine relationships between cognitive function, illness perceptions, and medication adherence after heart transplantation, limiting the development of effective adherence-promoting interventions. OBJECTIVE The purpose of this study was to describe relationships between cognitive function, illness perceptions, and medication adherence among heart transplant recipients. METHODS A cross-sectional, observational design was used. Measures included the telephone-Montreal Cognitive Assessment (t-MoCA©), Patient Health Questionnaire-9, Brief Test of Adult Cognition by Telephone, Basel Assessment of Adherence to Immunosuppressive Medications Scale, and the Brief Illness Perceptions Questionnaire. Descriptive statistics, point-biserial correlations, Pearson's correlations, and logistic regression were used to describe relationships. RESULTS Of the 35 participants (mean age: 61 years [SD: 10.3], 71.4% male, 71.4% white), 31.4% (n = 11) were classified as nonadherent to their immunosuppression medications. Higher immediate word recall, indicating better episodic memory (memory for autobiographical and recent events), and higher illness coherence scores were associated with not missing doses of medication. Higher t-MoCA© total scores, indicating normal cognitive function, and lower depression scores were associated with taking medications on time. More than 22% (n = 8) of participants scored less than 19 on the t-MoCA©, an indication of mild cognitive impairment. CONCLUSION Cognitive impairment may be more common among heart transplant recipients than what is currently recognized, and specific domains of cognitive function were related to medication adherence after transplantation in this study. Future studies should include longitudinal evaluations of cognitive function, depression, and medication adherence. Consideration of these relationships is needed when designing adherence-promoting interventions for this population.
Collapse
Affiliation(s)
| | | | - Thaddeus Pace
- College of Nursing, The University of Arizona, Tucson, AZ, USA
| | | |
Collapse
|
6
|
Gomez EM, Mustafa A, Beltran-Najera I, Ridgely NR, Thompson JL, Medina LD, Woods SP. Health literacy mediates the association between cognition and healthcare provider interactions among gay and bisexual men with HIV disease. Clin Neuropsychol 2024:1-22. [PMID: 38414159 DOI: 10.1080/13854046.2024.2319902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 02/09/2024] [Indexed: 02/29/2024]
Abstract
Introduction: Gay and bisexual men (GBM) account for the highest rates of incident infection with HIV in the U.S., and experience social, systemic barriers to accessing and engaging in healthcare services. Interacting with healthcare providers can be a complex process for some GBM with HIV disease. The current study examined the contributions of cognition and health literacy to perceived interactions with healthcare providers among GBM with HIV disease. Methods: The sample included 100 adults with HIV disease (ages 24-75) who identified as GBM. All participants completed the Dealing with Health Professionals subscale of the Beliefs Related to Medication Adherence survey, as well as the Cogstate neuropsychological battery, self-report measures of cognitive symptoms, and well-validated measures of health literacy. Results: Worse performance-based cognition and subjective cognitive symptoms were both associated with perceived difficulties dealing with healthcare providers, but these associations were fully mediated by lower health literacy. Conclusion: Health literacy may play a role in the association between poorer cognitive functioning and difficulties navigating healthcare interactions among GBM with HIV disease. Further studies are needed to determine whether cognitive approaches to enhancing the access, understanding, and use of health information in GBM with HIV disease improves healthcare interactions and outcomes.
Collapse
Affiliation(s)
- Elliott M Gomez
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Andrea Mustafa
- Department of Psychology, University of Houston, Houston, Texas, USA
| | | | - Natalie R Ridgely
- Department of Psychology, University of Houston, Houston, Texas, USA
| | | | - Luis D Medina
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Steven Paul Woods
- Department of Psychology, University of Houston, Houston, Texas, USA
| |
Collapse
|
7
|
Kim JS, Kim E. Subjective memory complaints and medication adherence among hypertensive Korean older adults with multimorbidity: mediating effect of depression and social support. BMC Public Health 2024; 24:585. [PMID: 38395841 PMCID: PMC10885607 DOI: 10.1186/s12889-024-18061-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND & AIM(S) Medication adherence (MA) is a key factor in maintaining adequate blood pressure and preventing complications. However, some older adults experience difficulties in taking medicine properly due to declines in cognitive function. Although subjective memory complaints (SMC) are recognized as early markers of cognitive impairment, previous studies concerning the relationship between MA and cognitive function have focused only on objective cognitive function. Furthermore, while depression has a high correlation with SMC, low MA, and social support, there is limited evidence on their relationship. This study aims to understand the effect of SMC on MA and the mediating effect of depression and social support. METHOD(S) This study is a descriptive cross-sectional investigation. A sample of 195 community-dwelling hypertensive older adults with multimorbidity from 3 community senior centers in Gwangju, South Korea were recruited through convenience sampling. Data was collected through face-to-face survey from January to March 2018. The PROCESS macro v4.2 program [Model 6] was used to analyze the mediating effect of depression and social support in the relationship between SMC and MA. Data analysis was performed using SPSS/WIN 26.0 and STATA MP 17.0. RESULTS The average MA was 6.74. There were significant differences in MA according to awareness of prescribed drugs, awareness of side effects, insomnia, and healthcare accessibility. SMC was positively correlated with depression, while social support and MA were negatively correlated. While depression was a significant mediator of the effect of SMC on MA, the mediating effect of social support was not significant. The multiple mediation effect of depression and social support was not significant. CONCLUSION The results suggest that medication management of older adults in community settings should be accompanied by a comprehensive health assessment of associated factors. Health professionals should explore strategies to improve memory as well as prevent and alleviate depression to increase MA among hypertensive older adults with multimorbidity.
Collapse
Affiliation(s)
- Jeong Sun Kim
- College of Nursing, Chonnam National University, 160, Baekseo-ro, Dong-gu, Gwangju, South Korea
| | - Eunji Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea.
| |
Collapse
|
8
|
Wright CE, Sheeran P, Voils CI, Blalock DV. A review of implementation intentions as a tool to benefit high-need patients and healthcare systems: U.S. veterans affairs as an exemplar. PATIENT EDUCATION AND COUNSELING 2023; 116:107937. [PMID: 37595504 DOI: 10.1016/j.pec.2023.107937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023]
Abstract
Implementation intentions (if-then plans) are an evidence-based behavior change strategy designed to translate behavioral intentions into habits [1]. Despite extensive evidence of its potential utility, this behavior change strategy is underutilized and under-researched in high-need healthcare contexts within the United States (U.S.) which face high rates of chronic conditions and barriers to care such as rurality, lack of resources, and cognitive strain from mental health and neurological conditions [2,3]. Implementation intentions have demonstrated efficacy in promoting many health behaviors proven to mitigate chronic conditions, namely physical activity, healthy diet, and substance use reduction [4-6]. In addition, the accessible, adaptable, and self-driven nature of implementation intentions allow the technique to meet many of the individual and system-level priorities of these high-need care contexts. By being patient-driven, proactive, and personalized, implementation intentions can help these patients cultivate healthy habits as part of their everyday lives. At the systems-level, implementation intentions' inexpensiveness, scalability, and compatibility with telemedicine platforms allow them to be integrated easily into existing healthcare system infrastructure [7,8]. This review describes these concepts in detail, and uses the Veterans Affairs (VA) healthcare system as an exemplar to provide concrete examples of how and where implementation intentions could be integrated in a healthcare system, within some existing programs, to benefit both the system and individual patients.
Collapse
Affiliation(s)
- Charles E Wright
- Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Paschal Sheeran
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Corrine I Voils
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Dan V Blalock
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| |
Collapse
|
9
|
Rao PS, Rangaswamy M, Evans J, Dutt A. Prospective memory in early and established psychosis: An Indian perspective. J Neuropsychol 2023; 17:461-476. [PMID: 37070648 DOI: 10.1111/jnp.12314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 03/12/2023] [Accepted: 03/23/2023] [Indexed: 04/19/2023]
Abstract
Individuals affected by psychosis often have deficits in several neurocognitive functions. Prospective memory (PM), the ability to remember to do things, is crucial for activities of daily living, social and occupational functioning, but very few studies have attempted to examine this domain of functioning in people with psychosis, particularly in India. A total of 71 patients with psychosis, (both early and established psychosis), and 140 age, gender and education-matched healthy controls were assessed using the Positive and Negative Symptom Scale, Hospital Anxiety and Depression scale, and Addenbrooke's Cognitive Examination. PM was assessed using the Cambridge Prospective Memory Test and the Prospective and Retrospective Memory Questionnaire (PRMQ). Group differences were evaluated using Mann-Whitney U-tests. Significantly greater cognitive deficits, higher anxiety and depression were evident in the psychosis group compared with controls. The psychosis group performed significantly poorer on both time- and event-based tests in CAMPROMPT than controls. These differences remained when controlling for age, education, general cognitive functioning and mood. The subjective measure of PM (PRMQ) did not differentiate the two groups. The PM performance of early and established psychosis patients was similar. Comparisons with cross-cultural data (PRMQ UK norms and CAMPROMPT and PRMQ Chinese data) revealed important differences in PM performance. Individuals with psychosis have significant deficits in both time- and event-based PM. CAMPROMPT emerged as a more sensitive PM measure compared with PRMQ. Results from cross-cultural comparisons underscore the need for cultural contextualization of assessments.
Collapse
Affiliation(s)
- Pulijala Sulakshana Rao
- Department of Psychology, Christ University, Bangalore, Karnataka, 560029, India
- Duttanagar Mental Health Centre, Kolkata, 700077, India
| | - Madhavi Rangaswamy
- Department of Psychology, Christ University, Bangalore, Karnataka, 560029, India
| | - Jonathan Evans
- Department of Psychology, Christ University, Bangalore, Karnataka, 560029, India
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Anirban Dutt
- Department of Psychology, Christ University, Bangalore, Karnataka, 560029, India
- Duttanagar Mental Health Centre, Kolkata, 700077, India
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
10
|
Upamali S, Rathnayake S. Perspectives of older people with uncontrolled type 2 diabetes mellitus towards medication adherence: A qualitative study. PLoS One 2023; 18:e0289834. [PMID: 37561681 PMCID: PMC10414664 DOI: 10.1371/journal.pone.0289834] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/26/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Better medication adherence among people with diabetes mellitus was found to be associated with improved glycaemic control. However, medication non-adherence is a significant concern in older people with uncontrolled type 2 diabetes mellitus. PURPOSE To explore the perspectives of older people with uncontrolled type 2 diabetes mellitus towards medication adherence. DESIGN A qualitative descriptive exploratory study. METHODOLOGY A purposive sample of older people with uncontrolled type 2 diabetes mellitus living in the community was recruited. Snowball sampling was applied in community recruitment. In-depth telephone interviews were conducted using a semi-structured interview guide. Interviews were transcribed verbatim. Thematic analysis was used in data analysis. The consolidated criteria for reporting qualitative research (COREQ) guidelines were followed. RESULTS The emerged six themes were: (a) impact of knowledge, attitudes and practices on medication adherence, (b) treatment-related barriers to medication adherence, (c) impact of age-related changes on medication adherence, (d) person-related barriers to medication adherence, (e) impact of COVID-19 on medication adherence and, (f) role of support systems in medication adherence. Knowledge of the disease process and medications, attitudes towards medication adherence, the practice of different treatment approaches, self-medication and dosing, negative experiences related to medications, polypharmacy, changes in lifestyle and roles, the influence of work-life, motivation, negligence, family support, support received from health workers, facilities available and financial capability are the main factors influence medication adherence. Age-related memory impairment, visual disturbances and physical weaknesses affect medication adherence in older people. Additionally, COVID-19-related guidelines imposed by the government and healthcare system-related issues during the COVID-19 pandemic also affected medication adherence. CONCLUSION Adherence to medications among older people is hampered by a variety of factors, including their knowledge, attitudes and practices, person and treatment-related factors and age-related changes. The COVID-19 pandemic has brought additional challenges. Individualised patient care for older people with uncontrolled type 2 diabetes mellitus to improve medication adherence is timely. Strengthening support mechanisms for the above population is essential.
Collapse
Affiliation(s)
- Sathma Upamali
- Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Sarath Rathnayake
- Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| |
Collapse
|
11
|
Barnett MD, Coldiron AM. Development of the Virtual Kitchen Protocol for Prospective Memory: a virtual reality-based measure of everyday prospective memory abilities. J Clin Exp Neuropsychol 2023; 45:618-635. [PMID: 38063062 DOI: 10.1080/13803395.2023.2287779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 11/19/2023] [Indexed: 12/30/2023]
Abstract
INTRODUCTION Prospective memory is the ability to remember to accomplish a task at a specified point in the future. While this cognitive ability has a large impact on daily functioning, it is rarely assessed during neuropsychological evaluations. Furthermore, existing clinical prospective memory measures are few in number and have significant limitations, including applicability to everyday functioning and appropriate norming for older adulthood. There are also many gaps in the literature on prospective memory, such as how environmental factors affect performance across the lifespan. METHOD In the current study, we develop and establish a new virtual reality-based measure of prospective memory, the Virtual Kitchen Protocol for Prospective Memory. Young adults (ages 18-29; n = 56), healthy older adults (ages 60-90; n = 94), and clinical older adults (ages 62-90; n = 30) were compared on their performances on both the developed virtual reality prospective memory test and a parallel paper-and-pencil prospective memory test to investigate the impact of test environment across participant group. RESULTS The Virtual Kitchen Protocol for Prospective Memory was found to adequately differentiate between young adult, healthy older adult, and clinical older adult populations - suggesting baseline ability for prospective memory assessment in clinical settings with older adults and potential for future improvement of neuropsychological evaluations. Additionally, the developed virtual prospective memory task appeared to mimic environmental factors in everyday life but did not replicate the benefit previously measured in healthy older adults' prospective memory ability in naturalistic settings. CONCLUSIONS Overall, the current study built upon extant knowledge of prospective memory in both normal and abnormal aging, suggesting future directions in replicating familiar home environments. Findings provided additional evidence toward future validation of virtual reality assessment tools in clinical neuropsychological evaluations of cognitive abilities, such as prospective memory, with both healthy and clinical older adult populations.
Collapse
Affiliation(s)
- Michael D Barnett
- Department of Psychology and Counseling, University of Texas at Tyler, Tyler, TX, USA
| | - Allyson M Coldiron
- Department of Psychology and Counseling, University of Texas at Tyler, Tyler, TX, USA
| |
Collapse
|
12
|
Vogel A, Arnett C, Blais C, Brewer GA. An assessment of learning rates in habitual prospective memory. Psychon Bull Rev 2023; 30:1513-1520. [PMID: 36526816 DOI: 10.3758/s13423-022-02214-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2022] [Indexed: 12/23/2022]
Abstract
Most laboratory research in the field of prospective memory has focused on newly formed (episodic) intentions that are carried out in the experimental context once or only a small number of times. However, many naturalistic prospective memories are carried out many times and these types of (habitual) intentions have been studied much less in the laboratory. In the current study, our aim was to extend prior work examining habitual intentions in laboratory prospective memory paradigms. Participants formed a typical prospective memory intention and then completed an ongoing task in which the intention could be executed up to 63 times. We examined changes in performance across trials in three traditionally important prospective memory metrics: cue detection, task interference, and cue interference. Across repeated performance of the prospective memory task, we observed an increase in cue detection, elimination of task interference, and elimination of cue interference. These results provide key insights into the operation of learning mechanisms in prospective memory paradigms and promote theory development by showing that many of the resource-demanding processes that are theorized to be necessary for successful prospective memory play much less of a role when intentions are repeatedly completed.
Collapse
Affiliation(s)
- Anne Vogel
- University of Mississippi, Oxford, MS, USA
| | | | | | | |
Collapse
|
13
|
van de Vijver I, Brinkhof LP, de Wit S. Age differences in routine formation: the role of automatization, motivation, and executive functions. Front Psychol 2023; 14:1140366. [PMID: 37484115 PMCID: PMC10357511 DOI: 10.3389/fpsyg.2023.1140366] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 06/16/2023] [Indexed: 07/25/2023] Open
Abstract
Medication adherence can be vital for one's health, especially in older adults. However, previous research has demonstrated that medication adherence is negatively affected by age-related cognitive decline. In the current study we investigated whether older adults are able to compensate for this decline by relying more on the formation of efficient, automatized routines. To this end, we directly compared daily (placebo) medication adherence in a healthy sample of 68 younger (18-29 years) and 63 older adults (65-86 years) over a period of 4 weeks. We show that despite an age-related decline in cognitive functions (i.e., poorer working memory, prospective memory, task switching, and goal-directed control), older adults adhered better to a daily pill intake routine than younger adults did and, in line with our hypothesis about increased routine formation, reported higher subjective automaticity of pill intake. Across age groups, automatization of pill intake was related to intake regularity and conscientiousness, but not to individual differences in habit tendency as measured in the lab nor to explicit strategic planning. Crucially, the age-related increase in pill intake adherence was mediated by experienced automatization as well as motivation. These findings demonstrate that intact habitual processes and high motivation aid older adults in successfully forming daily routines.
Collapse
Affiliation(s)
- Irene van de Vijver
- Habit Lab, Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, Netherlands
| | - Lotte P. Brinkhof
- Habit Lab, Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Sanne de Wit
- Habit Lab, Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
14
|
Gromisch ES, Raskin SA, Neto LO, Haselkorn JK, Turner AP. Appointment attendance behaviors in multiple sclerosis: Understanding the factors that differ between no shows, short notice cancellations, and attended appointments. Mult Scler Relat Disord 2023; 70:104509. [PMID: 36638769 DOI: 10.1016/j.msard.2023.104509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/28/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND There has yet to be an examination of how appointment attendance behaviors in multiple sclerosis (MS) are related to scheduling metrics and certain demographic, clinical, and behavioral factors such as cognitive functioning and personality traits. This study aimed to examine the factors that differ between no shows (NS), short notice cancellations (SNC), and attended appointments. METHODS Participants (n = 110) were persons with MS who were enrolled in a larger cross-sectional study, during which they completed a battery of neuropsychological measures. Data about their appointments in three MS-related clinics the year prior to their study evaluation were extracted from the medical record. Bivariate analyses were done, with post-hoc tests conducted with Bonferroni corrections if there was an overall group difference. RESULTS A higher number of SNC were noted during the winter, with 22.4% being due to the weather. SNC were also more common on Thursdays, but less frequent during the early morning time slots (7am to 9am). In contrast, NS were associated with lower annual income, weaker healthcare provider relationships, lower self-efficacy, higher levels of neuroticism, depressive symptom severity, and health distress, and greater cognitive difficulties, particularly with prospective memory. CONCLUSIONS While SNC are related to clinic structure and situational factors like the weather, NS may be more influenced by behavioral issues, such as difficulty remembering an appointment and high levels of distress. These findings highlight potential targets for reducing the number of missed appointments in the clinic, providing opportunities for improved healthcare efficiency and most importantly health.
Collapse
Affiliation(s)
- Elizabeth S Gromisch
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT 06112, USA; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT 06473, USA; Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT 06473, USA; Department of Neurology, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030, USA.
| | - Sarah A Raskin
- Neuroscience Program, Trinity College, 300 Summit Street, Hartford, CT 06106, USA; Department of Psychology, Trinity College, 300 Summit Street, Hartford, CT 06106, USA
| | - Lindsay O Neto
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, 490 Blue Hills Avenue, Hartford, CT 06112, USA; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, 370 Bassett Road, North Haven, CT 06473, USA
| | - Jodie K Haselkorn
- Multiple Sclerosis Center of Excellence West, Veterans Affairs, 1660 South Columbian Way, Seattle, WA 98108, USA; Rehabilitation Care Service, VA Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108, USA; Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA; Department of Epidemiology, University of Washington, 325 Ninth Avenue, Seattle, WA, 98104, USA
| | - Aaron P Turner
- Multiple Sclerosis Center of Excellence West, Veterans Affairs, 1660 South Columbian Way, Seattle, WA 98108, USA; Rehabilitation Care Service, VA Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108, USA; Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Seattle, WA 98104, USA
| |
Collapse
|
15
|
Stecher C, Palimaru AI, Odiit M, Lunkuse L, Walukaga S, Linnemayr S. Barriers and facilitators of antiretroviral therapy (ART) adherence habit formation in Sub-Saharan Africa: Evidence from a qualitative study in Kampala, Uganda. Soc Sci Med 2023; 317:115567. [PMID: 36459789 PMCID: PMC9839633 DOI: 10.1016/j.socscimed.2022.115567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 10/12/2022] [Accepted: 11/18/2022] [Indexed: 11/22/2022]
Abstract
RATIONALE In 2020, nearly 40 million people lived with HIV/AIDS (PLWHA) worldwide, of whom 70% were receiving antiretroviral therapy (ART). Two-thirds of PLWHA reside in Sub-Saharan Africa (SSA), where rates of viral load suppression are often suboptimal and frequently attributed to low ART adherence. Strong pill-taking habits are often reported as a key strategy among those who successfully maintain medication adherence, yet not enough is known about the barriers and facilitators in SSA to pill-taking in response to the same contextual cue, which is a necessary step in the habit formation process. OBJECTIVE To address this knowledge gap and to inform a subsequent intervention to promote context-dependent repetition, called anchoring, we used a formative qualitative approach to collect in-depth narratives about barriers and facilitators of the anchoring intervention for establishing ART pill-taking habits at the Mildmay Hospital in Kampala, Uganda. METHODS We conducted interviews with 25 randomly selected patients starting ART, 5 expert patients, and 10 providers at Mildmay, and performed a rapid analysis to inform the intervention in a timely manner. RESULTS We found that pill taking in response to the same contextual cue, or anchor, was threatened by stigma and food insecurity and that the COVID-19 pandemic exacerbated these barriers. We also determined that important linguistic changes were needed to the instructional materials and reminder messages in the subsequent intervention to avoid words and phrases with negative connotations for this target population. CONCLUSIONS Several important barriers and facilitators to context-dependent pill taking in Uganda were identified through our formative research that helped to inform important revisions to our subsequent intervention. These findings underscore the importance of understanding local barriers and facilitators when designing and planning interventions, particularly when implementing theory-based intervention approaches that have yet to be tested in a new setting.
Collapse
Affiliation(s)
- Chad Stecher
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
| | | | | | | | | | | |
Collapse
|
16
|
West T, Cavallero C, Ceccherini R, Foladore S, Generali D, Versace F, Scaggiante B. Impact of psychosocial, behavioral and lifestyle factors on subjective cognitive complaints and perceived quality of life in a large cohort of Italian breast cancer patients. Front Psychol 2022; 13:1015573. [DOI: 10.3389/fpsyg.2022.1015573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
The impact of psychosocial and behavioral factors on Cancer Related Cognitive Impairment manifestations is still under debate. Study’s purpose is to determine the prevalence rate of cancer related cognitive impairment in a cohort of Italian breast cancer patients and to evaluate the implication of specific behavioral factors. For these purposes, a total of 233 women (106 breast cancer patients and 127 age-matched controls without oncological diagnosis) completed a questionnaire investigating cognitive functionality (FACT-Cog v3.0), sociodemographic characteristics, clinical information, psychosocial and behavioral factors (cognitive reserve, sleep quality, dietary habits, physical activity). The results indicated a higher prevalence rate of subjective cognitive complaints in breast cancer patients (37%) compared to a representative sample of women in the same age group without an oncological diagnosis (p < 0.001). Moreover, breast cancer patients showed significantly lower levels of cognitive reserve (p < 0.05) and worse sleep quality (p < 0.01) compared to age-matched controls. Further analysis revealed that breast cancer patients reporting subjective cognitive complaints differed significantly from breast cancer patients without subjective cognitive complaints on measures of perceived cognitive abilities (p < 0.001) and on the impact of cognitive difficulties on perceived quality of life (p < 0.01). Future studies are needed to examine behavioral directed interventions to prevent subjective cognitive deficits in breast cancer patients.
Collapse
|
17
|
El Haj M, Moustafa AA, Robin F. “Remember to take your medication”: Prospective memory in Korsakoff’s syndrome. J Clin Exp Neuropsychol 2022; 44:272-280. [DOI: 10.1080/13803395.2022.2110574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Mohamad El Haj
- Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes Université, Univ Angers, Nantes, France
- Clinical Gerontology Department, CHU Nantes, Nantes, France
- Institut Universitaire de France, Paris, France
| | - Ahmed A. Moustafa
- School of Psychology, Faculty of Society and Design, Bond University, Gold Coast, Queensland, Australia
- Department of Human Anatomy and Physiology, the Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Frédérique Robin
- Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes Université, Univ Angers, Nantes, France
| |
Collapse
|
18
|
Levin JB, Moore DJ, Depp C, Montoya JL, Briggs F, Rahman M, Stange KC, Einstadter D, Weise C, Conroy C, Yala J, Radatz E, Sajatovic M. Using mHealth to improve adherence and reduce blood pressure in individuals with hypertension and bipolar disorder (iTAB-CV): study protocol for a 2-stage randomized clinical trial. Trials 2022; 23:539. [PMID: 35768875 PMCID: PMC9244195 DOI: 10.1186/s13063-022-06449-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular disease in individuals with mental health conditions such as bipolar disorder is highly prevalent and often poorly managed. Individuals with bipolar disorder face significant medication adherence barriers, especially when they are prescribed multiple medications for other health conditions including hypertension. Poor adherence puts them at a disproportionate risk for poor health outcomes. As such, there is a need for effective interventions to improve hypertension medication adherence, particularly in patients that struggle with adherence due to mental health comorbidity. METHODS This 5-year project uses a 2-stage randomized controlled trial design to evaluate a brief, practical adherence intervention delivered via interactive text messaging (iTAB-CV) along with self-monitoring of medication taking, mood, and home blood pressure (N = 100) compared to self-monitoring alone (N = 100). Prior to randomization, all participants will view an educational video that emphasizes the importance of medication for the treatment of hypertension and bipolar disorder. Those randomized to the texting intervention will receive daily text messages with predetermined content to address 11 salient domains as well as targeted customized messages for 2 months. This group will then be re-randomized to receive either a high (gradual taper from daily to weekly texts) or low booster (weekly texts) phase for an additional 2 months. All participants will be monitored for 52 weeks. The primary outcomes are systolic blood pressure and adherence to antihypertensive medication as determined by a self-reported questionnaire and validated with an automated pill-monitoring device. Secondary outcomes include adherence to bipolar disorder medications, psychiatric symptoms, health status, self-efficacy for medication-taking behavior, illness beliefs, medication attitudes, and habit strength. DISCUSSION This study specifically targets blood pressure and mental health symptom control in people with bipolar and includes implementation elements in the study design intended to inform future scale-up. Promising pilot data and a theoretical model, which views sustained medication-taking behavior in the context of habit formation, suggests that this remotely delivered intervention may help advance care for this high-risk population and is amenable to both scale up and easy adaptation for other groups with poor medication adherence. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov ( NCT04675593 ) on December 19, 2020.
Collapse
Affiliation(s)
- Jennifer B Levin
- Department of Psychiatry, Case Western Reserve University School of Medicine, 10524 Euclid Ave. 7th floor, Cleveland, OH, 44106, USA. .,Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA. .,Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - David J Moore
- HIV Neurobehavioral Research Program (HNRP), Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Colin Depp
- HIV Neurobehavioral Research Program (HNRP), Department of Psychiatry, University of California San Diego, San Diego, CA, USA.,Stein Institute for Research on Aging, Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Jessica L Montoya
- HIV Neurobehavioral Research Program (HNRP), Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Farren Briggs
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Mahboob Rahman
- Division of Nephrology and Hypertension, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Kurt C Stange
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Department of Family Medicine and Community Health, Case Western Reserve University School of Medicine, Cleveland, OH, USA.,Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Douglas Einstadter
- Center for Health Care Research and Policy, MetroHealth Medical Center, Cleveland, OH, USA.,Department of Medicine, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Celeste Weise
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Carla Conroy
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Joy Yala
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Ethan Radatz
- Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Martha Sajatovic
- Department of Psychiatry, Case Western Reserve University School of Medicine, 10524 Euclid Ave. 7th floor, Cleveland, OH, 44106, USA.,Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.,Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| |
Collapse
|
19
|
Sun J, Zhang K, Su X, Zhang Q, Wang Z, He L, Hu L. The Chinese version of the Memory for Intentions Test (MIST): development and evaluation of its reliability and concurrent validity. Clin Neuropsychol 2022:1-19. [PMID: 35266859 DOI: 10.1080/13854046.2022.2047791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study aims to develop a simplified Chinese version of the "Memory for Intentions Test" (MIST), evaluate its reliability and concurrent validity, explore the inter-relationships among the MIST variables and the relationships between the MIST variables and socio-demographic factors. Two hundred healthy, Chinese-speaking adults of the Han community participated in this study. Form A of the Chinese MIST and two prospective items of the Rivermead Behavioural Memory Test, Second Edition (RBMT-II, Chinese version) were administered to all participants to evaluate internal consistency, split-half reliability, and concurrent validity. Twenty of these participants were assessed twice on Form A with a two-week interval to examine test-retest reliability. They were also assessed on both Form A and Form B to examine alternate-form reliability. The findings of the study indicated good internal consistency (Cronbach's α = .833) and excellent split-half reliability (r = .924-.930) among the six subscales of the Chinese MIST, although the internal consistency was low (Cronbach's α = .129) for individual PM trials. We also found adequate concurrent validity (ρ = .722, p< .001), test-retest reliability (ρ = .716, p < .001), and alternate-form reliability (ρ= .828, p < .001). The Chinese MIST demonstrated suitable reliability and concurrent validity in the Chinese-speaking population. The present study provides a new standardized prospective memory test for the Chinese population, which would enhance future clinical research in this field on the Chinese mainland.
Collapse
Affiliation(s)
- Junyuan Sun
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, China
| | - Kai Zhang
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xianbiao Su
- Department of Psychiatry, Shandong Mental Health Center, Cheeloo Chollege of Medicine, Shandong University, Jinan, China
| | - Qunlei Zhang
- Department of Psychiatry, Shandong Mental Health Center, Cheeloo Chollege of Medicine, Shandong University, Jinan, China
| | - Ziyang Wang
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Long He
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lei Hu
- Department of Psychiatry, Shandong Mental Health Center, Cheeloo Chollege of Medicine, Shandong University, Jinan, China
| |
Collapse
|
20
|
Woolf-King SE, Sheinfil AZ, Ramos J, Foley JD, Moskal D, Firkey M, Kellen D, Maisto SA. A conceptual model of alcohol use and adherence to antiretroviral therapy: systematic review and theoretical implications for mechanisms of action. Health Psychol Rev 2022; 16:104-133. [PMID: 32757813 PMCID: PMC8972079 DOI: 10.1080/17437199.2020.1806722] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Alcohol consumption is one of the most prevalent correlates of antiretroviral therapy (ART) adherence, yet causal processes underlying this association remain largely unexplored. The goal of this systematic review was to develop a conceptual model that describes the causal effect of alcohol consumption on ART nonadherence. We reviewed 230 studies that examined the association between alcohol consumption and ART adherence with three primary aims: (1) to replicate and extend previous reviews of the literature, (2) to summarize and critique study designs capable of answering questions about temporal overlap and (3) to summarize potential mechanisms of action. A model of alcohol-associated ART nonadherence was proposed to guide future work, integrating general theories of ART adherence and theory on the psychological and behavioral effects of alcohol intoxication. The conceptual model describes two mechanistic processes-prospective memory impairment and interactive toxicity beliefs/avoidance behaviors-involved in alcohol-associated intentional and unintentional nonadherence, respectively. This model can be used to guide future research on the causal processes involved in the frequently observed correlation between alcohol consumption and adherence.
Collapse
Affiliation(s)
| | - Alan Z. Sheinfil
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Jeremy Ramos
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Jacklyn D. Foley
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Dezarie Moskal
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - Madison Firkey
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | - David Kellen
- Department of Psychology, Syracuse University, Syracuse, NY, USA
| | | |
Collapse
|
21
|
O'Connor C, Leyritana K, Doyle AM, Lewis JJ, Gill R, Salvaña EM. Interactive Mobile Phone HIV Adherence Support for Men Who Have Sex With Men in the Philippines Connect for Life Study: Mixed Methods Approach to Intervention Development and Pilot Testing. JMIR Form Res 2022; 6:e30811. [PMID: 35113030 PMCID: PMC8855294 DOI: 10.2196/30811] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 12/08/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The HIV epidemic in the Philippines is one of the fastest growing epidemics globally, and infections among men who have sex with men are rising at an alarming rate. The World Health Organization recommends the use of mobile health (mHealth) technologies to engage patients in care and ensure high levels of adherence to antiretroviral therapy (ART). Existing mHealth interventions can be adapted and tailored to the context and population served. OBJECTIVE This study aims to create a locally tailored intervention using a mobile phone platform to support treatment adherence for HIV patients on ART in the Philippines. METHODS A mixed methods approach guided by the Behavior Change Wheel framework was used to adapt an existing mHealth adherence support platform for the local setting and target population. A literature review, retrospective clinical record review, and focus group discussions with patients were conducted to understand the drivers of ART adherence and tailor the intervention accordingly. The resulting intervention was pilot-tested for 8 weeks, followed by focus group discussions with patients who received the intervention to assess the acceptability of the design. RESULTS Key issues contributing to nonadherence included side effects, lack of behavioral skills for pill taking, social support, mental health, and substance use. Patients identified mHealth as an acceptable mode of intervention delivery and wanted mHealth services to be highly personalizable. The study team, clinicians, and software developers integrated these findings into the intervention, which included a menu of services as follows: pill reminders, health tips, adherence feedback, appointment reminders, and symptom reporting. During the pilot phase, technical issues in the interactive voice response system (IVRS) were identified and addressed. Patients who participated in the pilot phase expressed a preference for SMS text messaging over the IVRS. Patients responded positively to the appointment reminders and health tips, whereas patient feedback on daily and weekly pill reminders and adherence feedback was mixed. CONCLUSIONS The mobile phone-based SMS text messaging and IVRS intervention was acceptable to men who have sex with men in Manila, the Philippines, and qualitative analysis suggested that the intervention helped promote ART adherence and appointment attendance.
Collapse
Affiliation(s)
- Cara O'Connor
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong, Philippines
| | - Katerina Leyritana
- Sustained Health Initiatives of the Philippines (SHIP), Mandaluyong, Philippines
| | - Aoife M Doyle
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Medical Research Council International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - James J Lewis
- Y Lab, The Public Services Innovation Lab for Wales, School of Social Sciences, Cardiff University, Cardiff, United Kingdom
| | - Randeep Gill
- Johnson & Johnson Global Public Health, London, United Kingdom
| | - Edsel Maurice Salvaña
- Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines Manila, Ermita, Philippines.,Division of Infectious Diseases (Global Health), Department of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
| |
Collapse
|
22
|
Epstein LH, Jimenez-Knight T, Honan AM, Paluch RA, Bickel WK. Imagine to Remember: An Episodic Future Thinking Intervention to Improve Medication Adherence in Patients with Type 2 Diabetes. Patient Prefer Adherence 2022; 16:95-104. [PMID: 35046645 PMCID: PMC8763258 DOI: 10.2147/ppa.s342118] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 12/15/2021] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Medication nonadherence is prevalent in diabetic populations, with "forgetting" a commonly cited reason. This issue of forgetfulness is due, in part, to a failure of prospective memory (PM). Episodic future thinking (EFT) has been shown to improve PM but has not been used to improve medication adherence. PATIENTS AND METHODS The current study used a multiple baseline design (N = 4) to test the effects of EFT on medication non-adherence for four patients with a diagnosis of type 2 diabetes or prediabetes, with comorbid high blood pressure or high cholesterol. Medication adherence was objectively measured over 15 weeks using medication event monitoring systems. RESULTS Results of visual analysis showed medication adherence was reliably improved, confirmed by mixed model analysis of variance (p < 0.001), with significant differences from baseline to treatment (Tau <0.05) for 3 of 4 participants. Improvements in two measures of PM (effect size (ES) = 0.73, 0.80) and delay discounting (ES = 1.20) were observed. CONCLUSION This study provides a feasible way to improve medication adherence in patients with prediabetes or type 2 diabetes.
Collapse
Affiliation(s)
- Leonard H Epstein
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
- Correspondence: Leonard H Epstein Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, G56, Farber Hall, Buffalo, NY, 14214, USATel +1 716-829-3400 Email
| | - Tatiana Jimenez-Knight
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Anna M Honan
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Rocco A Paluch
- Department of Pediatrics, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Warren K Bickel
- Addiction Recovery Research Center, Fralin Biomedical Research Center, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| |
Collapse
|
23
|
Sullivan KL, Neighbors C, Bucks RS, Weinborn M, Gavett BE, Woods SP. Longitudinal declines in event-based, but not time-based, prospective memory among community-dwelling older adults. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 29:70-86. [PMID: 33191839 PMCID: PMC8121895 DOI: 10.1080/13825585.2020.1849534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Age-related deficits in prospective memory (PM) are well established, but it is not known whether PM is stable over time among older adults. In this study, 271 community-dwelling older adults underwent abaseline neuropsychological evaluation and up to three follow-up visits, approximately 2.4 years apart. Mixed effects linear longitudinal models revealed small, but significant linear declines and between-subjects variability in event-based PM performance. There were no changes in performance on measures of time-based PM, retrospective memory, or executive functions. Changes in event-based PM were not associated with age, retrospective memory, executive functions, or everyday functioning. Among older adults, event-based PM appears to be more susceptible to linear declines than does time-based PM, which future research might examine with regard to the possible underlying cognitive mechanisms of cue encoding, monitoring, detection, and retrieval processes.
Collapse
Affiliation(s)
| | | | - Romola S. Bucks
- School of Psychological Science, University of Western Australia
| | - Michael Weinborn
- School of Psychological Science, University of Western Australia
| | | | - Steven Paul Woods
- Department of Psychology, University of Houston,School of Psychological Science, University of Western Australia
| |
Collapse
|
24
|
Nyamaruze P, Govender K, Cowden RG. Self-esteem and antiretroviral therapy adherence among young people living with HIV: An exploratory serial mediation analysis. S AFR J SCI 2021. [DOI: 10.17159/sajs.2021/8354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Capitalising further on the benefits of antiretroviral therapy (ART) for individual treatment requires an improved understanding of the psychological processes that may affect optimal ART adherence among people living with HIV. We examined internalised HIV/AIDS-related stigma and body appreciation as mediators of the association between self-esteem and ART adherence among young people living with HIV (YPLHIV). A sample of 76 YPLHIV (Mage = 19.36, s.d.age = 2.56; male 56.58%) residing in an HIV hyperendemic region of South Africa completed self-report measures of self-esteem, internalised HIV/AIDS-related stigma, body appreciation, and ART adherence. Path-analytic mediation modelling was performed to test for direct and indirect effects linking self-esteem with ART adherence. Results of serial mediation analyses indicated that self-esteem and ART adherence were indirectly associated through a two-step path of internalised HIV/AIDS-related stigma and then body appreciation, as well as a one-step path through internalised HIV/AIDS-related stigma. The results provide preliminary support for internalised HIV/AIDS-related stigma and body appreciation as mechanisms underlying the association between self-esteem and ART adherence. Implications of the findings for promoting ART adherence among YPLHIV are discussed.
Collapse
Affiliation(s)
- Patrick Nyamaruze
- Discipline of Psychology, School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Kaymarlin Govender
- Health Economics and HIV and AIDS Research Division, University of KwaZulu-Natal, Durban, South Africa
| | - Richard G. Cowden
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
| |
Collapse
|
25
|
Sugden N, Thomas M, Kiernan M, Wilesmith M. Validation of the Prospective Memory Concerns Questionnaire (PMCQ). Front Hum Neurosci 2021; 15:686850. [PMID: 34512292 PMCID: PMC8427764 DOI: 10.3389/fnhum.2021.686850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/30/2021] [Indexed: 11/16/2022] Open
Abstract
Prospective memory (PM), the ability to remember to complete intended tasks, is essential for successfully completing activities of daily living. PM impairments are common in people with neuropathology such as acquired brain injury and dementia. These PM impairments affect individuals’ capabilities in key aspects of daily living including their health, safety, and independence. The Prospective Memory Concerns Questionnaire (PMCQ) was designed as a self-report measure to understand individuals’ concerns about their memory. This questionnaire may help identify issues with PM which in turn may assist clinicians in the targeted implementation of memory compensation strategies. The PMCQ was developed using Rasch and classical test methodologies, with subscales measuring frequency of forgetting behaviors, memory concerns, and retrieval failures. The current study aimed to confirm the factor structure of the PMCQ for use in adults in the general population. The study also aimed to examine relationships between the PMCQ and naturalistic performance-based measures of PM to determine how the self-report PMCQ could be used in conjunction with performance-based measures. A community dwelling sample of 558 adults completed the PMCQ, an event-based naturalistic PM task, and time-based naturalistic PM task. Confirmatory factor analyses (CFAs) indicated that a higher order model with three subscales containing 35 items produced acceptable fit [RMSEA = 0.056 (90% CI 0.054, 0.060), SRMR = 0.062, CFI = 0.915, TLI = 0.909] The PMCQ demonstrated good internal consistency (total α = 0.95, subscales: α = 0.88–0.89). The Forgetting Behaviors subscale significantly correlated with performance on the event-based naturalistic PM task (r = −0.14, p < 0.01). The Memory Concerns and Retrieval Failures subscales did not correlate significantly with performance-based PM tasks. These findings suggest that the PMCQ may be best suited for assessing individuals’ concerns about their forgetting behaviors and identifying appropriate compensation strategies or support services. It is recommended that the PMCQ be used alongside performance-based PM tasks and other cognitive measures to comprehensively assess PM. It was concluded that the PMCQ is a suitable measure for use in adults in the general population. Further validation research of the PMCQ in general population and clinical samples will determine the measures’ sensitivity and specificity in identifying PM impairments.
Collapse
Affiliation(s)
- Nicole Sugden
- School of Psychology, Charles Sturt University, Bathurst, NSW, Australia
| | - Matt Thomas
- School of Psychology, Charles Sturt University, Bathurst, NSW, Australia.,Marathon Health, Bathurst, NSW, Australia.,Western New South Wales Local Health District, Bathurst, NSW, Australia
| | - Michael Kiernan
- School of Psychology, Charles Sturt University, Bathurst, NSW, Australia
| | - Michele Wilesmith
- School of Psychology, Charles Sturt University, Bathurst, NSW, Australia
| |
Collapse
|
26
|
Zhuang XM, Kuo LW, Lin SY, Yang JJ, Tu MC, Hsu YH. Prospective Memory and Regional Functional Connectivity in Subcortical Ischemic Vascular Disease. Front Aging Neurosci 2021; 13:686040. [PMID: 34489671 PMCID: PMC8417716 DOI: 10.3389/fnagi.2021.686040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/22/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives: Patients with subcortical ischemic vascular disease (SIVD) often have prominent frontal dysfunction. However, it remains unclear how SIVD affects prospective memory (PM), which strongly relies on the frontoparietal network. The present study aimed to investigate PM performance in patients with early stage SIVD as compared to those with Alzheimer's disease (AD) and to older adults with normal cognition, and to explore the neural correlates of PM deficits. Method: Patients with very-mild to mild dementia due to SIVD or AD and normal controls (NC) aged above 60 years were recruited. Seventy-three participants (20 SIVD, 22 AD, and 31 NC) underwent structural magnetic resonance imaging (MRI), cognitive screening tests, and a computerized PM test. Sixty-five of these participants (19 SIVD, 20 AD, and 26 NC) also received resting-state functional MRI. Results: The group with SIVD had significantly fewer PM hits than the control group on both time-based and non-focal event-based PM tasks. Among patients in the very early stage, only those with SIVD but not AD performed significantly worse than the controls. Correlational analyses showed that non-focal event-based PM in SIVD was positively correlated with regional homogeneity in bilateral superior and middle frontal gyri, while time-based PM was not significantly associated with regional homogeneity in any of the regions of interest within the dorsal frontoparietal regions. Conclusions: The findings of this study highlight the vulnerability of non-focal event-based PM to the disruption of regional functional connectivity in bilateral superior and middle frontal gyri in patients with SIVD.
Collapse
Affiliation(s)
- Xuan-Miao Zhuang
- Department of Psychology, National Chung Cheng University, Chiayi, Taiwan
| | - Li-Wei Kuo
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli, Taiwan.,Institute of Medical Device and Imaging, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shih-Yen Lin
- Department of Computer Science, National Chiao Tung University, Hsinchu, Taiwan
| | - Jir-Jei Yang
- Department of Medical Imaging, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Min-Chien Tu
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,Department of Neurology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yen-Hsuan Hsu
- Department of Psychology, National Chung Cheng University, Chiayi, Taiwan.,Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, Chiayi, Taiwan
| |
Collapse
|
27
|
Au RWC, Sezto HNW, Lam VWM, Wan YT, Poon LT, Pang PF, Wong JKK. Brief report: A randomized controlled trial of a compensatory cognitive training to improve prospective memory performance in people with schizophrenia or depression. Psychiatry Res 2021; 300:113914. [PMID: 33827012 DOI: 10.1016/j.psychres.2021.113914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/27/2021] [Indexed: 10/21/2022]
Abstract
People with schizophrenia or depression have prospective memory (PM) deficits, which affect their daily living. Given the paucity of research into training to correct PM deficits, we subjected a group of participants to a Chinese version of the PM module of the Cognitive Compensatory Training (CCT-C-PM) intervention to study its effect on their PM performance. Specifically, we independently randomized two diagnostic cohorts (schizophrenia and depression) into control groups (occupational therapy only) or experimental groups (CCT-C-PM and occupational therapy). The schizophrenia cohort had 17 participants in its control group and 23 participants in its experimental group. The depression cohort had 10 participants in its control group and 12 participants in its experimental group. The sociodemographic information of the participants was collected. Their symptoms and PM performances were measured at baseline and after treatment (after the completion of the CCT-C-PM intervention in the experimental group and the same timeframe in the control group). The treatment effects were examined by a repeated measure analysis of variance/analysis of covariance and a post hoc Scheffé test. The effect sizes (Cohen's d) of treatments against the controls were also calculated. There was no difference between the experimental and control groups in either cohort in terms of sociodemographic data, symptoms, and PM measures at baseline. The sex combination differed across the groups in the depression cohort. We found that the CCT-C-PM improved PM, especially event-based PM, for which large effect sizes were seen. The effect on time-based PM was unclear and requires future study. Our findings suggest that the CCT-C-PM is a viable training method for improving PM.
Collapse
Affiliation(s)
- Raymond W C Au
- Occupational Therapy Department, United Christian Hospital, Hong Kong.
| | - Helen N W Sezto
- Occupational Therapy Department, United Christian Hospital, Hong Kong
| | - Vera W M Lam
- Occupational Therapy Department, United Christian Hospital, Hong Kong
| | - Y T Wan
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - L T Poon
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - P F Pang
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - Jackson K K Wong
- Occupational Therapy Department, United Christian Hospital, Hong Kong
| |
Collapse
|
28
|
Lui SSY, Lam JPY, Lam JWS, Chui WWH, Mui JHC, Siu BWM, Cheng KM, Cheung EFC, Chan RCK. Cognitive insight is correlated with cognitive impairments and contributes to medication adherence in schizophrenia patients. Asian J Psychiatr 2021; 60:102644. [PMID: 33862475 DOI: 10.1016/j.ajp.2021.102644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/28/2021] [Accepted: 04/05/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Cognitive insight refers to the ability to distance oneself from and evaluate one's own beliefs and interpretations. Little is known about whether cognitive insight could influence medication adherence in schizophrenia patients. This study examined the role of cognitive insight in medication adherence and how it would interact with neuropsychological functions. METHODS Ninety clinically-stable schizophrenia patients completed the Beck's Cognitive Insight Scale (BCIS) and tasks measuring prospective (PM) and other neurocognitive functions. Medication adherence was estimated using a multi-axial method comprising interview, clinician-rating, pharmacy refill record and pill counting. Correlational and regression analyses were conducted to examine whether cognitive insight and PM would be associated with mediation adherence. Post-hoc mediational analysis was performed to examine the interplay between cognitive insight, PM and medication adherence. RESULTS Clinical insight and cognitive insight together significantly influenced participants' medication adherence, after neurocognitive functions and psychopathology were accounted for. Time-based PM, compared with other neurocognitive functions, affected medication adherence more strongly. CONCLUSIONS Cognitive insight complements clinical insight in affecting medication adherence in schizophrenia patients.
Collapse
Affiliation(s)
- Simon S Y Lui
- Department of Psychiatry, The University of Hong Kong, Hong Kong Special Administrative Region, China; Castle Peak Hospital, Hong Kong Special Administrative Region, China.
| | - Jessica P Y Lam
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Joanna W S Lam
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - William W H Chui
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Jolene H C Mui
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Bonnie W M Siu
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - K M Cheng
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Eric F C Cheung
- Castle Peak Hospital, Hong Kong Special Administrative Region, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
29
|
Woods SP, Morgan EE, Loft S, Matchanova A, Verduzco M, Cushman C. Enhancing cue salience improves aspects of naturalistic time-based prospective memory in older adults with HIV disease. Neuropsychology 2021; 35:111-122. [PMID: 33393805 DOI: 10.1037/neu0000644] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Older persons living with HIV (PLWH) disease commonly experience failures of time-based prospective memory (PM) in their daily lives. This study examined the benefits of providing strategic supports at encoding, monitoring, and cue detection for naturalistic time-based PM among older PLWH. METHOD Participants included 116 older PLWH and 48 seronegatives who completed a baseline neuropsychological evaluation (see Woods et al., 2020), including a laboratory PM experiment that paralleled the design of the current naturalistic study. The naturalistic time-based PM task required participants to press a button on a portable PM response box 4 times per day for 1 month. PLWH were randomly assigned to an unsupported control condition or to an experimental group in which strategic processing was supported at encoding (implementation intentions and visualization), monitoring (content-free cuing), and/or cue detection (auditory alarm). The seronegative participants were all assigned to the unsupported control group. RESULTS In a model adjusting for age and affective disorders, PLWH who received all three supports in combination demonstrated moderately better naturalistic time-based PM accuracy as compared with PLWH controls. Both the cue detection and combination conditions were associated with markedly more precise response timing on the naturalistic time-based PM task. Supported PM accuracy as measured in the laboratory was positively associated with naturalistic PM accuracy among PLWH in the experimental groups. CONCLUSIONS Providing strategic supports to enhance the cue salience of naturalistic time-based PM tasks may improve both the accuracy and timing with which older PLWH remember to perform time-based intentions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Erin E Morgan
- Department of Psychiatry, University of California, San Diego
| | - Shayne Loft
- School of Psychological Science, University of Western Australia
| | | | | | - Clint Cushman
- Department of Psychiatry, University of California, San Diego
| |
Collapse
|
30
|
Tureson K, Byrd DA, Guzman V, Summers AC, Morris EP, Mindt MR. The impact of sociocultural factors on prospective memory performance in HIV+ Latinx adults. Neuropsychology 2021; 35:411-422. [PMID: 34043391 PMCID: PMC10284210 DOI: 10.1037/neu0000732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Prospective memory (PM), a salient component of neurocognitive functioning for people living with HIV (PLH), is necessary for planning and coordinating health-related behaviors and instrumental tasks of daily living. However, little is known regarding the impact of sociocultural factors on PM in diverse populations, particularly Latinx PLH. The aim of this study was to examine ethnic group differences and sociocultural factors related to PM. METHOD The sample of 127 PLH (91 Latinx and 36 non-Latinx white) completed measures of quality of education, socioeconomic status (SES), and a validated PM measure, the Memory for Intentions Screening Test (MIST). The Latinx group also completed a bicultural acculturation measure. RESULTS Results revealed the Latinx and the non-Latinx white groups did not significantly differ in overall MIST performance (all p > .05). In the entire sample, better quality of education was associated with better MIST performance (all p < .05). Within the Latinx group, higher Latinx acculturation was associated with worse MIST performance (p = .02), whereas higher U.S. acculturation was associated with better MIST performance at a trend level (p = .07). Multivariate regressions revealed quality of education and Latinx acculturation significantly predicted MIST performance and PM errors (all p < .05). SES was not related to the MIST (all p > .10). CONCLUSIONS In sum, clinicians must take sociocultural factors into consideration when working with Latinx PLH, as these factors influence cognitive functions (i.e., PM) vital to health-related behaviors. Integrating culturally-informed psychoeducation into care plans is an imperative first step. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- Kayla Tureson
- Department of Psychology, University of Southern California, Los Angeles, CA
| | - Desiree A. Byrd
- Department of Psychology, Queens College, Queens, NY
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Vanessa Guzman
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Psychology, Fordham University, Bronx, NY
| | - Angela C. Summers
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Psychology, Fordham University, Bronx, NY
| | - Emily P. Morris
- Department of Psychology, University of Michigan, Ann Arbor, MI
| | - Monica Rivera Mindt
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Psychology, Fordham University, Bronx, NY
| |
Collapse
|
31
|
Henry JD. Prospective memory impairment in neurological disorders: implications and management. Nat Rev Neurol 2021; 17:297-307. [PMID: 33686303 DOI: 10.1038/s41582-021-00472-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 01/31/2023]
Abstract
Prospective memory is a core neurocognitive ability that refers to memory for future intentions, such as remembering to take medications and to switch off appliances. Any breakdown in prospective memory, therefore, has serious implications for the ability to function independently in everyday life. In many neurological disorders, including Parkinson disease and dementia, prospective memory deficits are common even in the earliest stages and typically become more severe with disease progression. Consequently, clinical assessment of prospective memory is of critical importance. This article provides an overview of the various manifestations and neural bases of prospective memory deficits. To facilitate clinical decision-making, validated measures of this construct are identified and their suitability for clinical practice is discussed, focusing in particular on clinical sensitivity and psychometric properties. The article concludes by reviewing the approaches that can be used to rehabilitate different types of prospective memory impairment, and algorithms to guide the evaluation and treatment of these impairments are provided.
Collapse
Affiliation(s)
- Julie D Henry
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia.
| |
Collapse
|
32
|
Stecher C, Linnemayr S. Promoting antiretroviral therapy adherence habits: a synthesis of economic and psychological theories of habit formation. AIDS 2021; 35:711-716. [PMID: 33306553 PMCID: PMC9207816 DOI: 10.1097/qad.0000000000002792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
33
|
Vandenberg AE, Drenkard C, Goldstein FC, Dunlop-Thomas C, Lim SS, Bowling CB, Plantinga LC. Cognitive problems and their clinical assessment in SLE: contrasting patient and provider views. Arthritis Care Res (Hoboken) 2021; 74:1468-1476. [PMID: 33734607 DOI: 10.1002/acr.24599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/17/2021] [Accepted: 03/16/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Systemic lupus erythematosus (SLE) is a complex chronic disease associated with reduced cognitive functioning. Patients with SLE report cognitive symptoms, but cognitive assessment is not routine and little is known about day-to-day cognitive problems and their effect on disease management. As part of a pilot exploring the use of a cognitive functioning report prototype for shared decision making in clinical encounters (Approaches to Positive Patient-Centered Experiences of Aging in Lupus study-APPEAL), we investigated the relevance of cognitive assessments performed using the NIH Toolbox among patients with SLE. METHODS We conducted four focus groups, two with SLE patients (n=18) and two with lupus providers (physicians and nurses; n=9) addressing cognitive issues and interest in communicating about cognition. We compared how NIH Toolbox cognitive domains (episodic memory; working memory; processing speed; attention and inhibitory control; cognitive flexibility) matched with patient- and provider-identified cognitive problems and needs. RESULTS Patients identified all NIH domains with rich experiential examples; providers identified fewer domains and offered less detail. An unanticipated additional domain was prospective memory, i.e., problems in remembering future actions. Use of technological aids (e.g., smart phone alerts) was mentioned by some patients, but not providers, and represent a potential opportunity for medical care. All participants expressed interest in discussing cognition in clinic. CONCLUSION Cognitive assessment using the NIH Cognitive Toolbox is relevant to this population, with the possible addition of a prospective memory assessment. Cognitive problems and indications of communication gaps suggest the appropriateness of more clinical communication about cognition in this population.
Collapse
Affiliation(s)
- Ann E Vandenberg
- Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA, United States
| | - Cristina Drenkard
- Department of Medicine, Division of Rheumatology, Emory University School of Medicine, Atlanta, GA, United States.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Felicia C Goldstein
- Department of Neurology, Division of Neuropsychology, Emory University School of Medicine, Atlanta, GA, United States
| | - Charmayne Dunlop-Thomas
- Department of Medicine, Division of Rheumatology, Emory University School of Medicine, Atlanta, GA, United States
| | - S Sam Lim
- Department of Medicine, Division of Rheumatology, Emory University School of Medicine, Atlanta, GA, United States.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - C Barrett Bowling
- Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center (VAMC), Durham, NC, United States.,Department of Medicine, Duke University School of Medicine, Durham, NC, United States
| | - Laura C Plantinga
- Department of Medicine, Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA, United States.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| |
Collapse
|
34
|
Konstantinopoulou E, Ioannidis P, Kiosseoglou G, Aretouli E. Inhibitory control is associated with medication adherence in young HIV patients without comorbidities. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1467-1475. [PMID: 33631076 DOI: 10.1080/23279095.2021.1890594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE In the present study we evaluated the incremental contribution of executive cognition (EC) subprocesses to antiretroviral medication adherence. METHOD A comprehensive EC test battery assessing updating/working memory, mental flexibility, and inhibitory control, along with measures assessing non-executive cognitive functions were completed by 100 individuals with HIV. Medication adherence was determined via a visual analogue self-report scale and the Medication Adherence Questionnaire. Potential predictors, including demographic and clinical characteristics and neuropsychological performances on EC and other cognitive tasks were regressed to medication adherence. Predictive variables related to executive processes were added in the final block of the hierarchical regression model in order to assess their incremental predictive ability on medication adherence. RESULTS 23% of the variance in the visual analogue scale was explained by treatment complexity, memory and EC performance. A measure of inhibitory control, in particular, predicted self-reported medication adherence above and beyond demographic, clinical and other cognitive factors. CONCLUSIONS The contribution of EC to self-reported medication adherence in young seropositive adults was limited, but inhibitory control was associated with proper medication management above and beyond demographic, clinical and other cognitive functions.
Collapse
Affiliation(s)
- Eleni Konstantinopoulou
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Grigoris Kiosseoglou
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Aretouli
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.,School of the Social Sciences, University of Ioannina, Ioannina, Greece
| |
Collapse
|
35
|
McBride CM, Morrissey EC, Molloy GJ. Patients' Experiences of Using Smartphone Apps to Support Self-Management and Improve Medication Adherence in Hypertension: Qualitative Study. JMIR Mhealth Uhealth 2020; 8:e17470. [PMID: 33112251 PMCID: PMC7657730 DOI: 10.2196/17470] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 06/05/2020] [Accepted: 06/21/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Worldwide, hypertension control rates remain suboptimal despite clinically effective antihypertensive drug therapy. Patient failure to take medication as prescribed (ie, nonadherence) is the most important factor contributing to poor control. Smartphone apps can facilitate the delivery of evidence-based behavior change techniques to improve adherence and may provide a scalable, usable, and feasible method to deliver self-management support. OBJECTIVE The aim of this study is to explore patients' experiences of the usability and feasibility of smartphone apps to support self-management and improve medication adherence in hypertension. METHODS A qualitative descriptive study was conducted. A total of 11 people living with hypertension from the West of Ireland were sampled purposively and interviewed about their experience of using a self-management app for a 4-week period, which included two key functionalities: self-monitoring of blood pressure (BP) and medication reminders. Thematic analysis was carried out on the semistructured interview data. RESULTS Participants' age ranged from 43 to 74 years (mean 62 years, SD 9.13). Three themes were identified: digital empowerment of self-management, human versus digital systems, and digital sustainability. Although patients' experience of using the technology to self-monitor BP was one of empowerment, characterized by an enhanced insight and understanding into their condition, control, and personal responsibility, the reminder function was only feasible for patients who reported unintentional nonadherence to treatment. Patients experienced the app as a sustainable tool to support self-management and found it easy to use, including those with limited technological competence. CONCLUSIONS The study's findings provide new insights into the experience of using apps to support medication adherence in hypertension. Overall, the data support apps as a usable and feasible method to aid self-management of hypertension and highlight the need for personalized functionality, particularly with regard to medication adherence reminder strategies. The study's findings challenge the perspective that the use of these technologies to support self-management can inevitably add to the burden of treatment experienced by patients.
Collapse
Affiliation(s)
- Ciara M McBride
- School of Psychology, National Univeristy of Ireland Galway, Galway, Ireland
| | - Eimear C Morrissey
- Health Behaviour Change Research Group, National Univiersity of Ireland Galway, Galway, Ireland
| | - Gerard J Molloy
- Medication Adherence Across the Lifespan Research Group, National University of Ireland Galway, Galway, Ireland
| |
Collapse
|
36
|
Altgassen M, Cohen A, Jansen MG. The effects of collaboration and punishment on prospective memory performance in a group setting. APPLIED COGNITIVE PSYCHOLOGY 2020. [DOI: 10.1002/acp.3748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mareike Altgassen
- Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
- Department of Psychology Johannes Gutenberg University Mainz Mainz Germany
| | - Anna‐Lisa Cohen
- Department of Psychology Yeshiva University New York New York
| | - Michelle G. Jansen
- Donders Institute for Brain, Cognition and Behaviour Radboud University Nijmegen The Netherlands
| |
Collapse
|
37
|
Massa F, Grisanti S, Brugnolo A, Doglione E, Orso B, Morbelli S, Bauckneht M, Origone P, Filippi L, Arnaldi D, De Carli F, Pardini M, Pagani M, Nobili F, Girtler N. The role of anterior prefrontal cortex in prospective memory: an exploratory FDG-PET study in early Alzheimer's disease. Neurobiol Aging 2020; 96:117-127. [PMID: 33002765 DOI: 10.1016/j.neurobiolaging.2020.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/25/2020] [Accepted: 09/01/2020] [Indexed: 12/31/2022]
Abstract
From previous studies in healthy volunteers the prefrontal regions are deeply involved in prospective memory (PM), although little is known about the functional neural basis of PM in prodromal Alzheimer's disease (AD). To this end, we retrospectively recruited 18 patients with mild cognitive impairment caused by AD and 23 matched healthy control subjects who had undergone 18F-fluorodeoxyglucose positron emission tomography and the PM-specific paradigm test. Brain metabolism was correlated with the PM score in the 2 groups separately to find those brain areas correlated with PM performance, which were then used as a hub for an inter-regional metabolic connectivity analyses (inter-regional correlation analysis). Of note, in mild cognitive impairment caused by AD, but not in healthy control subjects, PM score positively correlated with metabolic levels in the right anterior prefrontal cortex (middle and inferior frontal gyri), which disclosed a loss of interhemispheric connectivity in the inter-regional correlation analysis. According to our findings, the functioning of the right anterior prefrontal cortex and its interhemispheric metabolic connectivity is crucial in early AD to sustain PM performance, which deteriorates along with progressive metabolic failure of the interconnected areas.
Collapse
Affiliation(s)
- Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
| | - Stefano Grisanti
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Andrea Brugnolo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Beatrice Orso
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Health Science (DISSAL), University of Genoa, Italy
| | - Matteo Bauckneht
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Health Science (DISSAL), University of Genoa, Italy
| | - Paola Origone
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Laura Filippi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Dario Arnaldi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Fabrizio De Carli
- Institute of Bioimaging and Molecular Physiology, Consiglio Nazionale delle Ricerche (CNR), Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche (CNR), Rome, Italy; Department of Medical Radiation Physics and Nuclear Medicine, Karolinska Hospital, Stockholm, Sweden
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Nicola Girtler
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| |
Collapse
|
38
|
Tonetti L, Occhionero M, Boreggiani M, Conca A, Dondi P, Elbaz M, Fabbri M, Gauriau C, Giupponi G, Leger D, Martoni M, Rafanelli C, Roncuzzi R, Zoppello M, Natale V. Sleep and Prospective Memory: A Retrospective Study in Different Clinical Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6113. [PMID: 32842672 PMCID: PMC7503383 DOI: 10.3390/ijerph17176113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/30/2020] [Accepted: 08/19/2020] [Indexed: 01/28/2023]
Abstract
Prospective memory (PM) is essential in everyday life because it concerns the ability to remember to perform an intended action in the future. This ability could be influenced by poor sleep quality, the role of which, however, is still being debated. To examine the role of sleep quality in PM in depth, we decided to perform a retrospective naturalistic study examining different clinical populations with a primary sleep disorder or comorbid low sleep quality. If sleep is important for PM function, we could expect poor sleep to affect PM performance tasks both directly and indirectly. We examined a total of 3600 nights, recorded using actigraphy in participants belonging to the following groups: primary insomnia (731 nights); narcolepsy type 1 (1069 nights); attention deficit hyperactivity disorder (152 nights in children and 239 in adults); severe obesity (232 nights); essential hypertension (226 nights); menopause (143 nights); healthy controls (808 nights). In a naturalistic activity-based PM task, each participant originally wore an actigraph around the non-dominant wrist and was requested to push the event-marker button at two specific times of day: bedtime (activity 1) and get-up time (activity 2). Each clinical group showed significantly lower sleep quality in comparison to the control group. However, only narcolepsy type 1 patients presented a significantly impaired PM performance at get-up time, remembering to push the event-marker button around half the time compared not only to healthy controls but also to the other clinical groups. Overall, the present results seem to point to sleep quality having no effect on the efficiency of a naturalistic activity-based PM task. Moreover, the data indicated that narcolepsy type 1 patients may show a disease-specific cognitive deficit of PM.
Collapse
Affiliation(s)
- Lorenzo Tonetti
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (M.O.); (M.B.); (C.R.); (V.N.)
| | - Miranda Occhionero
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (M.O.); (M.B.); (C.R.); (V.N.)
| | - Michele Boreggiani
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (M.O.); (M.B.); (C.R.); (V.N.)
| | - Andreas Conca
- Division of Psychiatry, San Maurizio Hospital, 39100 Bolzano, Italy; (A.C.); (G.G.)
| | - Paola Dondi
- Division of Hospital Psychology, New Sant’Agostino-Estense Hospital, 41126 Baggiovara, Italy;
| | - Maxime Elbaz
- Université Paris Descartes, APHP, Hôtel Dieu, Centre du Sommeil et de la Vigilance, Centre de référence hypersomnies rares et EA 7330 VIFASOM, 75004 Paris, France; (M.E.); (C.G.); (D.L.)
| | - Marco Fabbri
- Department of Psychology, University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy;
| | - Caroline Gauriau
- Université Paris Descartes, APHP, Hôtel Dieu, Centre du Sommeil et de la Vigilance, Centre de référence hypersomnies rares et EA 7330 VIFASOM, 75004 Paris, France; (M.E.); (C.G.); (D.L.)
| | - Giancarlo Giupponi
- Division of Psychiatry, San Maurizio Hospital, 39100 Bolzano, Italy; (A.C.); (G.G.)
| | - Damien Leger
- Université Paris Descartes, APHP, Hôtel Dieu, Centre du Sommeil et de la Vigilance, Centre de référence hypersomnies rares et EA 7330 VIFASOM, 75004 Paris, France; (M.E.); (C.G.); (D.L.)
| | - Monica Martoni
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40127 Bologna, Italy;
| | - Chiara Rafanelli
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (M.O.); (M.B.); (C.R.); (V.N.)
| | - Renzo Roncuzzi
- Cardiology Service, Villa Erbosa Hospital, 40129 Bologna, Italy;
| | - Marina Zoppello
- Child Neuropsychiatry Unit, IRCCS Mondino Foundation, 27100 Pavia, Italy;
| | - Vincenzo Natale
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (M.O.); (M.B.); (C.R.); (V.N.)
| |
Collapse
|
39
|
Blondelle G, Hainselin M, Gounden Y, Quaglino V. Instruments Measuring Prospective Memory: A Systematic and Meta-Analytic Review. Arch Clin Neuropsychol 2020; 35:576-596. [PMID: 32239191 DOI: 10.1093/arclin/acaa009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To identify the available measures to assess prospective memory (PM) abilities, to describe their content, and to quantitatively summarize the effects of various diseases on PM depending on the type of assessment. METHOD Three databases (PsycInfo, PsycArticles and PubMed) were searched up to June 2019 to identify the existing PM measures. The identified PM measures were classified according to the type of assessment: test batteries, single-trial procedures, questionnaires, and experimental procedures. The characteristics and psychometric properties were presented. PM performances were compared between patients with various diseases and controls depending on the type of assessment. RESULTS Most of the 16 measures identified evaluated both event- and time-based tasks, were linked to functional outcomes, showed empirical evidences regarding validity and reliability, and provided parallel versions. To a slightly lesser extent, few measures provided normative data, translations/adaptation into another language, cutoff scores for diagnostic purposes, qualitative scoring, parallel version, and external aids during the test. Compared to healthy controls, patients had significantly poorer performances when PM was assessed with experimental procedures. Heterogeneous data precluded the interpretation of a summary effect for test batteries, single-trial procedures, and questionnaires. Planned subgroup analyses indicated consistent PM impairment for patients compared to controls for three test batteries. However, PM complaints did not differ between patients and controls. CONCLUSIONS These results suggest that the use of PM test batteries and experimental procedures are relevant for detecting performance variations in diverse clinical populations. Clinical implications and directions for future research are discussed.
Collapse
Affiliation(s)
- Geoffrey Blondelle
- Department of Psychology, CRP-CPO, UR 7273, Université de Picardie Jules Verne, Amiens, France
| | - Mathieu Hainselin
- Department of Psychology, CRP-CPO, UR 7273, Université de Picardie Jules Verne, Amiens, France
| | - Yannick Gounden
- Department of Psychology, CRP-CPO, UR 7273, Université de Picardie Jules Verne, Amiens, France
| | - Véronique Quaglino
- Department of Psychology, CRP-CPO, UR 7273, Université de Picardie Jules Verne, Amiens, France
| |
Collapse
|
40
|
Seixas A, Connors C, Chung A, Donley T, Jean-Louis G. A Pantheoretical Framework to Optimize Adherence to Healthy Lifestyle Behaviors and Medication Adherence: The Use of Personalized Approaches to Overcome Barriers and Optimize Facilitators to Achieve Adherence. JMIR Mhealth Uhealth 2020; 8:e16429. [PMID: 32579121 PMCID: PMC7381082 DOI: 10.2196/16429] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/16/2020] [Accepted: 01/29/2020] [Indexed: 12/26/2022] Open
Abstract
Patient nonadherence to healthy lifestyle behaviors and medical treatments (like medication adherence) accounts for a significant portion of chronic disease burden. Despite the plethora of behavioral interventions to overcome key modifiable/nonmodifiable barriers and enable facilitators to adherence, short- and long-term adherence to healthy lifestyle behaviors and medical treatments is still poor. To optimize adherence, we aimed to provide a novel mobile health solution steeped in precision and personalized population health and a pantheoretical approach that increases the likelihood of adherence. We have described the stages of a pantheoretical approach utilizing tailoring, clustering/profiling, personalizing, and optimizing interventions/strategies to obtain adherence and highlight the minimal engineering needed to build such a solution.
Collapse
Affiliation(s)
- Azizi Seixas
- NYU Grossman School of Medicine, New York, NY, United States
| | | | - Alicia Chung
- NYU Grossman School of Medicine, New York, NY, United States
| | - Tiffany Donley
- NYU Grossman School of Medicine, New York, NY, United States
| | | |
Collapse
|
41
|
Zahed K, Sasangohar F, Mehta R, Erraguntla M, Qaraqe K. Diabetes Management Experience and the State of Hypoglycemia: National Online Survey Study. JMIR Diabetes 2020; 5:e17890. [PMID: 32442145 PMCID: PMC7330735 DOI: 10.2196/17890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 03/24/2020] [Accepted: 04/03/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Hypoglycemia, or low blood sugar levels, in people with diabetes can be a serious life-threatening condition, and serious outcomes can be avoided if low levels of blood sugar are proactively detected. Although technologies exist to detect the onset of hypoglycemia, they are invasive or costly or exhibit a high incidence of false alarms. Tremors are commonly reported symptoms of hypoglycemia and may be used to detect hypoglycemic events, yet their onset is not well researched or understood. OBJECTIVE This study aimed to understand diabetic patients' perceptions of hypoglycemic tremors, as well as their user experiences with technology to manage diabetes, and expectations from a self-management tool to ultimately inform the design of a noninvasive and cost-effective technology that detects tremors associated with hypoglycemia. METHODS A cross-sectional internet panel survey was administered to adult patients with type 1 diabetes using the Qualtrics platform in May 2019. The questions focused on 3 main constructs: (1) perceived experiences of hypoglycemia, (2) experiences and expectations about a diabetes management device and mobile app, and (3) beliefs and attitudes regarding intention to use a diabetes management device. The analysis in this paper focuses on the first two constructs. Nonparametric tests were used to analyze the Likert scale data, with a Mann-Whitney U test, Kruskal-Wallis test, and Games-Howell post hoc test as applicable, for subgroup comparisons to highlight differences in perceived frequency, severity, and noticeability of hypoglycemic tremors across age, gender, years living with diabetes, and physical activity. RESULTS Data from 212 respondents (129 [60.8%] females) revealed statistically significant differences in perceived noticeability of tremors by gender, whereby males noticed their tremors more (P<.001), and age, with the older population reporting lower noticeability than the young and middle age groups (P<.001). Individuals living longer with diabetes noticed their tremors significantly less than those with diabetes for ≤1 year but not in terms of frequency or severity. Additionally, the majority of our participants (150/212, 70.7%) reported experience with diabetes-monitoring devices. CONCLUSIONS Our findings support the need for cost-efficient and noninvasive continuous monitoring technologies. Although hypoglycemic tremors were perceived to occur frequently, such tremors were not found to be severe compared with other symptoms such as sweating, which was the highest rated symptom in our study. Using a combination of tremor and galvanic skin response sensors may show promise in detecting the onset of hypoglycemic events.
Collapse
Affiliation(s)
- Karim Zahed
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Farzan Sasangohar
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
- Center for Outcomes Research, Houston Methodist Hospital, Houston, TX, United States
| | - Ranjana Mehta
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Madhav Erraguntla
- Department of Industrial and Systems Engineering, Texas A&M University, College Station, TX, United States
| | - Khalid Qaraqe
- Department of Electrical and Computer Engineering, Texas A&M University at Qatar, Doha, Qatar
| |
Collapse
|
42
|
Stawarz K, Gardner B, Cox A, Blandford A. What influences the selection of contextual cues when starting a new routine behaviour? An exploratory study. BMC Psychol 2020; 8:29. [PMID: 32228721 PMCID: PMC7106637 DOI: 10.1186/s40359-020-0394-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 03/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Contextual cues play an important role in facilitating behaviour change. They not only support memory but may also help to make the new behaviour automatic through the formation of new routines. However, previous research shows that when people start a new behaviour, they tend to select cues that lack effectiveness for prompting behaviour. Therefore, it is important to understand what influences cue selection, as this can help to identify acceptable cues, which in turn could inform future behaviour change interventions to help people select cues that best fit their context and so ensure continued repetition. METHODS We conducted a qualitative study to investigate what cues people select, how, and what influences their decisions. We recruited 39 participants and asked them to take vitamin C tablets daily for 3 weeks and later interviewed them about their experience. Quantitative habit strength and memory measures were taken for descriptive purposes. RESULTS Cue selection was primarily influenced by a desire to minimise effort, e.g. keeping related objects at hand or in a visible place; prior experience with similar behaviours (regardless of whether the cues used in the past were reliable or not); and beliefs about effective approaches. In addition, we found that suboptimal remembering strategies involved reliance on a single cue and loosely defined plans that do not specify cues. Moreover, for many participants, identifying optimal cues required trial and error, as people were rarely able to anticipate in advance what approach would work best for them. CONCLUSIONS Future behaviour change interventions that rely on routine behaviours might fruitfully include the provision of educational information regarding what approaches are suboptimal (single factors, vaguely defined plans) and what is most likely to work (combining multiple clearly defined cues). They should also assess people's existing beliefs about how to best remember specific behaviours as such beliefs can either enhance or inhibit the cues they select. Finally, interventions should account for the fact that early failures to remember are part of the process of developing a reliable remembering strategy and to be expected.
Collapse
Affiliation(s)
- Katarzyna Stawarz
- Bristol Interaction Group, University of Bristol, Queen's Building, University Walk, Bristol, BS8 1TR, UK.
| | - Benjamin Gardner
- Department of Psychology, King's College London, Denmark Hill, London, SE5 8AF, UK
| | - Anna Cox
- UCL Interaction Centre, University College London, Gower Street, London, WC1E 6EA, UK
| | - Ann Blandford
- UCL Interaction Centre, University College London, Gower Street, London, WC1E 6EA, UK
| |
Collapse
|
43
|
The Relationship Between Medication Attitudes and Medication Adherence Behavior in Adults With Bipolar Disorder. J Nerv Ment Dis 2020; 208:87-93. [PMID: 31929465 PMCID: PMC7316161 DOI: 10.1097/nmd.0000000000001083] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The relationship between medication attitudes and adherence as well as reliable measures of medication attitudes need further study. This study examined the psychometric properties of the Attitudes Toward Mood Stabilizers Questionnaire (AMSQ) in bipolar participants and the relationship between medication attitudes and adherence, measured by the self-reported Tablets Routine Questionnaire (TRQ). Inclusion criteria included mood stabilizer treatment and 20% or more medication nonadherence. Measures were given pretreatment and posttreatment. Average age was 47 years; majority were female (69%), African American (67%), and unmarried (53%). AMSQ's test-retest reliability was ρ = 0.73 (p < 0.001). AMSQ correlated with TRQ (rs = 0.20, p < 0.01) at baseline. Factor analysis identified three factors: positive/favorable attitudes, negative/critical attitudes, and unintentional nonadherence. Change in AMSQ across time correlated with change in TRQ. The AMSQ is valid psychometrically and is sensitive to change. Medication attitudes are related to adherence behavior. Interventions should include targeting specific domains of medication attitudes, such as illness knowledge.
Collapse
|
44
|
Kordovski VM, Sullivan KL, Tierney SM, Woods SP. One-year stability of prospective memory symptoms and performance in aging and HIV disease. J Clin Exp Neuropsychol 2019; 42:118-130. [PMID: 31698985 DOI: 10.1080/13803395.2019.1687651] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: HIV disease and aging can both affect prospective memory (PM), which describes the complex process of executing delayed intentions and plays an essential role in everyday functioning. The current study investigated the course of PM symptoms and performance over approximately one year in younger and older persons with and without HIV disease. Method: Participants included 77 older (>50 years) and 35 younger (<40 years) HIV+ individuals and 44 older and 27 younger seronegative adults. Participants completed the Memory for Intentions Test to measure PM in the laboratory, the Prospective and Retrospective Memory Questionnaire to measure PM symptoms in daily life, and several clinical measures of executive functions and retrospective memory as a part of a comprehensive neurocognitive evaluation at baseline and at 14-month follow-up. Results: Findings showed additive, independent main effects of HIV and aging on time- and event-based PM performance in the laboratory, but no change in PM over time. There were no interactions between time and HIV or age groups. Parallel findings were observed for clinical measures of retrospective memory and executive functions. Older HIV+ adults endorsed the greatest frequency of PM symptoms, but there was no change in PM symptom severity over time and no interactions between time and HIV or age groups. There were no effects of HIV or aging on naturalistic PM performance longitudinally. Conclusion: Overall these findings suggest that PM symptoms and performance in the laboratory are stably impaired over the course of a year in the setting of aging and HIV disease.
Collapse
Affiliation(s)
| | - Kelli L Sullivan
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | | |
Collapse
|
45
|
Ritter A, Ilakkuvan V. Reassessing health literacy best practices to improve medication adherence among patients with dyslexia. PATIENT EDUCATION AND COUNSELING 2019; 102:2122-2127. [PMID: 31174951 DOI: 10.1016/j.pec.2019.05.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/09/2019] [Accepted: 05/25/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Dyslexia is characterized as unexpected and persistent difficulty in reading. In addition to language-based deficits, evidence indicates that people with dyslexia may struggle with tasks related to memory and executive function. This discussion paper explores how these non-linguistic deficits could plausibly affect medication adherence among patients with dyslexia. DISCUSSION There is a dearth of original research literature exploring the intersection of dyslexia and health behaviors in the United States. The authors examine selected best practices from the field of health literacy with potential to improve medication adherence among patients with dyslexia and suggest areas for further research on the intersection of dyslexia, health literacy and medication adherence. CONCLUSION Dyslexia is a high-prevalence condition. Patients with dyslexia may be more likely to experience challenges when learning and implementing complex, multi-step health behaviors, such as the tasks associated with medication adherence. However, there has been no research to assess the specific needs of patients with dyslexia, or design interventions to meet those needs. Foundational research is necessary to develop a health communications framework that meets the needs of these neurodiverse patients.
Collapse
Affiliation(s)
- Ann Ritter
- George Washington University, Milken Institute School of Public Health, Washington, DC USA; LARK Consulting, New York, NY USA.
| | - Vinu Ilakkuvan
- George Washington University, Milken Institute School of Public Health, Washington, DC USA.
| |
Collapse
|
46
|
Levent A, Davelaar EJ. Illegal drug use and prospective memory: A systematic review. Drug Alcohol Depend 2019; 204:107478. [PMID: 31715546 DOI: 10.1016/j.drugalcdep.2019.04.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 03/13/2019] [Accepted: 04/09/2019] [Indexed: 10/26/2022]
Abstract
Illegal drug use is proposed to interfere with neurobiological functioning by damaging the neurotransmitter communication systems that are believed to be responsible for cognitive abilities, including perception, attention, and memory. This review specifically examined effects of illegal drug use on prospective memory (PM) - memory for future actions. Twenty- seven studies spanning 14 years were included in this review which were divided into two broad categories based on testing methods used: self-report and lab-based testing methods. The quality of the included studies was assessed across five categories: sample type, sample size, abstinence period, testing methods and control for confounding factors. The overall quality of evidence was good for six studies and moderate for sixteen studies and low for five studies. The results from the studies employing self-report were inconsistent as illegal drug users exhibited PM deficits in some studies, but not in others. However, the studies with lab-based testing methods demonstrated more consistent findings with illegal drug users scoring worse than non-users on various PM tests. There were also consistent findings on the link between the dosage of drug taken and level of PM deficit. Based on the literature, there is moderate evidence that illegal drug use impairs PM ability. We recommend that further lab-based studies be conducted to assess dose-response effects on drug-specificity.
Collapse
Affiliation(s)
- Adnan Levent
- Department of Psychological Sciences, Birkbeck, University of London, UK.
| | - Eddy J Davelaar
- Department of Psychological Sciences, Birkbeck, University of London, UK
| |
Collapse
|
47
|
Raimo S, Trojano L, Gaita M, Spitaleri D, Santangelo G. High openness and high extroversion are linked with better time-based prospective memory in multiple sclerosis. J Neurol 2019; 266:2665-2671. [PMID: 31312957 DOI: 10.1007/s00415-019-09460-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/04/2019] [Accepted: 07/08/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Prospective memory (PM) deficits are often reported in multiple sclerosis (MS), but their relationship with neuropsychological characteristics and personality traits remains to be explored. OBJECTIVE To systematically investigate both time-based and event-based PM abilities in a sample of MS without clinically relevant disability or global cognitive decline and to explore cognitive, neuropsychiatric characteristics and personality traits associated with PM deficits. METHODS Thirty-three patients with MS and 33 healthy individuals were enrolled in the study. All participants underwent a standardized measure of PM to evaluate both time-based and event-based PM. Moreover, patients with MS completed the Brief Repeatable Battery to assess cognitive functioning, the Beck Depression Inventory-II and the Dimensional Apathy Scale to assess neuropsychiatric characteristics, and the NEO Personality Inventory-3 to assess personality traits. RESULTS Individuals with MS demonstrated impaired time-based PM compared to healthy individuals. The regression analysis showed that poor performance in time-based PM was significantly related to lower extroversion and openness traits, whereas poor performance in event-based PM was significantly related to lower visuospatial memory abilities. CONCLUSIONS Low levels of openness and extroversion traits are associated with a greater risk of developing time-based PM deficit. Therefore, personality assessment and behavioural interventions should be encouraged in MS clinical practice.
Collapse
Affiliation(s)
- Simona Raimo
- Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.,Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100, Caserta, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100, Caserta, Italy
| | - Mariachiara Gaita
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100, Caserta, Italy
| | - Daniele Spitaleri
- Neurology Unit "San Giuseppe Moscati", Hospital Avellino, Avellino, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico, 31, 81100, Caserta, Italy.
| |
Collapse
|
48
|
Naar S, Spring B. Commentary: Methods and Designs for T1 Translation in Pediatric Psychology. J Pediatr Psychol 2019; 44:418-424. [PMID: 30462239 DOI: 10.1093/jpepsy/jsy083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 12/24/2022] Open
Affiliation(s)
- Sylvie Naar
- Center for Translational Behavioral Research, Department of Behavioral Sciences and Social Medicine, Florida State University
| | - Bonnie Spring
- Center for Behavior and Health, Institute for Public Health and Medicine, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| |
Collapse
|
49
|
Trawley S, Baptista S, Pouwer F, Speight J. Prospective memory slips are associated with forgetting to take glucose-lowering therapies among adults with diabetes: results from the second Diabetes MILES - Australia (MILES-2) survey. Diabet Med 2019; 36:569-577. [PMID: 30511764 DOI: 10.1111/dme.13873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2018] [Indexed: 01/21/2023]
Abstract
AIMS Prospective memory has been long considered a fundamental cognitive ability for optimal medication taking, but the role of prospective memory errors (termed 'slips') in diabetes self-care is unclear. Our aim was to examine associations between prospective memory and medication taking in adults with Type 1 and Type 2 diabetes mellitus. METHODS Some 901 adults with Type 1 diabetes and 927 with Type 2 diabetes completed a cross-sectional survey focused on the psychological and behavioural aspects of living with diabetes. Respondents reported whether they had forgotten to take their diabetes medication over the previous 14 days. RESULTS Twenty-four per cent (n = 220) of adults with Type 1 diabetes and 23% (n = 211) with Type 2 diabetes reported that they had forgotten their medication at least once over the previous 14 days. This was associated with more prospective memory slips in adults with Type 1 diabetes [odds ratio (OR) 1.09, 95% confidence interval (CI) 1.05 to 1.13; P < 0.001] and Type 2 diabetes (OR 1.10, 95% CI 1.05 to 1.15; P < 0.001); and with younger age (both groups), insulin pump use (Type 1 diabetes), insulin treatment (Type 2 diabetes), less frequent blood glucose checks (Type 1 diabetes) and higher HbA1c (Type 1 diabetes). CONCLUSIONS These findings suggest that forgetting medication is relatively common among adults with Type 1 or Type 2 diabetes, and provide preliminary evidence for its relationship with self-reported prospective memory slips.
Collapse
Affiliation(s)
- S Trawley
- The Cairnmillar Institute, Melbourne, Victoria, Australia
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
| | - S Baptista
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
- Non Communicable Disease Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - F Pouwer
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- STENO Diabeter Center Odense, Odense University Hospital, Odense, Denmark
| | - J Speight
- School of Psychology, Deakin University, Geelong, Victoria, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Victoria, Australia
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- AHP Research, Hornchurch, UK
| |
Collapse
|
50
|
Liu LL, Gan MY, Cui JF, Chen T, Tan SP, Neumann DL, Shum DHK, Wang Y, Chan RCK. The general facilitation effect of implementation intentions on prospective memory performance in patients with schizophrenia. Cogn Neuropsychiatry 2018; 23:350-363. [PMID: 30269636 DOI: 10.1080/13546805.2018.1528143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Prospective memory (PM) refers to remembering to execute a planned intention in the future. It can be divided into event- and time-based, according to the nature of the PM cue. Event-based PM cues can be classified as focal or non-focal. Patients with schizophrenia (SCZ) have been found to be impaired in both event- and time-based PM. PM has been found to be improved by implementation intentions, which is an encoding strategy in the format of "if X then Y". This study examined the effect of implementation intentions on a non-focal event-based and a time-based PM task in patients with SCZ. METHODS Forty-two patients with SCZ and 42 healthy controls were allocated to either an implementation intention or a control PM instruction condition and were asked to complete two PM tasks. RESULTS Implementation intentions was found to improve performance in both the non-focal event-based and time-based PM tasks in patients with SCZ and healthy controls, with no costs to the ongoing task. The improvement in time-based PM performance in the implementation intentions condition was partially mediated by the frequency of clock checking behaviour. CONCLUSIONS Implementation intentions can facilitate PM performance in patients with SCZ and has the potential to be used as a clinical intervention tool.
Collapse
Affiliation(s)
- Lu-Lu Liu
- a Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health , Institute of Psychology, Chinese Academy of Sciences , Beijing , China.,b Department of Psychology , University of Chinese Academy of Sciences , Beijing , China
| | | | - Ji-Fang Cui
- d Institute of Educational Information and Statistics , National Institute of Education Sciences , Beijing , China
| | - Tao Chen
- a Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health , Institute of Psychology, Chinese Academy of Sciences , Beijing , China.,b Department of Psychology , University of Chinese Academy of Sciences , Beijing , China
| | - Shu-Ping Tan
- c Beijing Huilongguan Hospital , Beijing , China
| | - David L Neumann
- e Menzies Health Institute Queensland and School of Applied Psychology , Griffith University , Gold Coast , Australia
| | - David H K Shum
- a Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health , Institute of Psychology, Chinese Academy of Sciences , Beijing , China.,e Menzies Health Institute Queensland and School of Applied Psychology , Griffith University , Gold Coast , Australia
| | - Ya Wang
- a Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health , Institute of Psychology, Chinese Academy of Sciences , Beijing , China.,b Department of Psychology , University of Chinese Academy of Sciences , Beijing , China
| | - Raymond C K Chan
- a Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health , Institute of Psychology, Chinese Academy of Sciences , Beijing , China.,b Department of Psychology , University of Chinese Academy of Sciences , Beijing , China
| |
Collapse
|