Beliefs about Aging and Alzheimer’s Disease in Three Domains

The assessment of views on ageing: a review of self-report measures and innovative extensions

This is a review of existing self-report measures for assessing views on ageing. It provides an overview of instruments, for which basic psychometric properties are available and describes them according to the purposes for which they are suitable. Literature search resulted in the inclusion of 89 instruments which were categorised along eight dimensions. The majority of measures focus on explicit cognitions about people's own age and ageing or other (older) people. A substantial amount of tools account for the multidimensionality and multidirectionality of views on ageing, i.e. the idea that ageing is accompanied by both gains and losses in several different domains. To some extent, measures reflect that ageing is a long-term process and that views on ageing are malleable, rather than just stable traits. Cluster analysis revealed heterogeneity in instruments regarding the dimensions of Ecosystem, Balance, Stability, Dynamics, and Complexity. It becomes apparent, however, that approaches to measure views on ageing should be extended to more specifically target the implicit level as well as affective, physiological, and behavioural manifestations. Additionally, means for capturing views on ageing on the societal level and tools with a distinct time reference are needed. This is particularly important when one wants to account for the lifelong dynamics of views on ageing.

Preference for emotionally meaningful activity in Alzheimer's disease

Objectives: Socioemotional selectivity theory (SST) contends that future time perspective is the central determinant of healthy older adults' prioritization of emotional gratification. We have shown elsewhere that individuals with Alzheimer's disease (AD) are disoriented to future time perspective. This study examined whether these same participants would prioritize emotional gratification despite having distorted time perspective. Method: Performance of individuals with Alzheimer's disease (AD) was compared against young, young-old, and old-old adults on a social activity preference card-sort task. We examined whether activity preferences differentially related to subjective wellbeing. Results: Multidimensional scaling revealed common dimensions along which groups considered social activities. The importance of these dimensions varied across healthy participant groups in ways predicted by SST. Dimensions related to knowledge acquisition were more important in youth than older age; emotional dimensions were more important to the older age groups. Despite AD, these individuals also prioritzed emotional gratification, suggesting that cognitive impairment is not a barrier to socioemotional selectivity. Preference for emotionally meaningful activities was positively associated with subjective wellbeing. Conclusion: Persons with AD are motivated towards emotionally meaningful ends and retain high levels of wellbeing. These findings have implications in the caregiving context for shaping social programs to better match goals and preferences.

Ageing stereotypes and prodromal Alzheimer's disease (AGING): study protocol for an ongoing randomised clinical study

INTRODUCTION

The number of older people diagnosed with amnestic mild cognitive impairment (aMCI), the prodromal state of Alzheimer's disease (AD), is increasing worldwide. However, some patients with aMCI never convert to the AD type of dementia, with some remaining stable and others reverting to normal. This overdiagnosis bias has been largely overlooked and gone unexplained. There is ample evidence in the laboratory that negative ageing stereotypes (eg, the culturally shared belief that ageing inescapably causes severe cognitive decline) contribute to the deteriorating cognitive performances of healthy older adults, leading them to perform below their true abilities. The study described here is intended to test for the first time whether such stereotypes also impair patients' cognitive performances during neuropsychological examinations in memory clinics, resulting in overdiagnosis of aMCI.

METHODS AND ANALYSIS

The ongoing study is a 4-year randomised clinical trial comparing patients' physiological stress and cognitive performances during neuropsychological testing in memory clinics. A total of 260 patients attending their first cognitive evaluation will be randomised to either a standard condition of test administration, assumed here to implicitly activate negative ageing stereotypes or a reduced-threat instruction condition designed to alleviate the anxiety arising from these stereotypes. Both groups will be tested with the same test battery and stress biomarkers. For 30 patients diagnosed with aMCI in each group (n=60), biomarkers of neurodegeneration and amyloidopathy will be used to distinguish between aMCI with normal versus abnormal AD biomarkers. A 9-month follow-up will be performed on all patients to identify those whose cognitive performances remain stable, deteriorate or improve.

ETHICS AND DISSEMINATION

This protocol has been approved by the French National Agency for Medicines and Health Products Safety and the Sud-Est I French Ethics Committee (2017-A00946-47). Results will be published in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

NCT03138018.

Impact of Contact With Grandparents on Children's and Adolescents' Views on the Elderly

Stereotypes, prejudice, and discrimination against the elderly (ageism) may manifest themselves in children at an early age. However, the factors influencing this phenomenon are not well known. Using both explicit and open-ended questions, this study analyzed the influence of personal and familial parameters on the views of 1,151 seven- to sixteen-year-old Belgian children and adolescents on the elderly. Four factors were found to affect these views: gender (girls had slightly more positive views than boys), age (ageism was lowest in 10- to 12-year-old, reminiscent of other forms of stereotypes and cognitive developmental theories), grandparents' health, and most importantly, quality of contact with grandparents (very good and good contacts correlated with more favorable feelings toward the elderly, especially in children with frequent contacts).

Assessing accuracy of knowledge of cognitive effects of normal ageing and mild stage of Alzheimer's disease

OBJECTIVES

This study aimed to develop and pilot the Alzheimer's Disease and Ageing Perception Scale (ADAPS), examine theory-consistent differences and convergent validity, and identify misconceptions of the cognitive effects of ageing and mild Alzheimer's disease (AD).

METHOD

After piloting a large pool of items with a panel of ageing and dementia experts (n = 6), an item analysis yielded a 25-item version of the ADAPS (α = .70), comprising a Normal Ageing subscale (α = .68) and Mild AD subscale (α = .74). Participants from the general community (n = 251) and aged care professionals (n = 59) completed the ADAPS, Knowledge of Memory Ageing Questionnaire (KMAQ), and the Alzheimer's Disease Knowledge Scale (ADKS).

RESULTS

Compared to matched controls, aged care professionals demonstrated greater accuracy of knowledge on the Mild AD subscale (p < .05), but not the Normal Ageing subscale (p > .05) of the ADAPS. The pattern of significant correlations between the ADAPS, KMAQ, and ADKS supported the convergent validity of the ADAPS. The most common misconceptions on the ADAPS indicated a tendency for participants to overgeneralise the cognitive effects of normal ageing.

CONCLUSION

This preliminary study introduces a new tool for assessing accuracy of knowledge of cognitive effects associated with normal ageing and mild AD, and may assist in identifying misconceptions of the ageing process.