Age Differences in Everyday Problem-Solving and Decision-Making Effectiveness: A Meta-Analytic Review

Exploring the Cognitive Profiles of Haemodialysis Patients using Objective and Subjective Indicators: A Cross-sectional Observational Study

BACKGROUND

Cognitive impairment is common in haemodialysis patients and associated with adverse health outcomes. Previous work focused primarily on neuropsychological tests, the gold standard measure of cognition. However, these tests reflect performance under optimal conditions rather than performance in everyday life. This study aims to assess both objective and subjective cognition in haemodialysis patients.

METHODS

Adult haemodialysis patients completed measures of objective cognitive impairment (Montreal Cognitive Assessment), subjective cognitive complaints, mood and fatigue symptoms, and provided sociodemographic information. Clinical data such as comorbidity were extracted from patients' medical record.

RESULTS

A total of 268 haemodialysis patients (mean age = 59.87 years; 42.5% female) participated. Only 25.0% of the sample had normal cognition, while the rest had either objective cognitive impairments or clinically significant cognitive complaints, or both (both objective impairments and subjective complaints: 26.1%; objective impairments without complaint: 38.4%; significant complaints without objective impairments: 10.4%). Lower education was associated with the presence of objective cognitive impairments, whereas depression was associated with the presence of clinically significant cognitive complaints. Patients who exhibited both objective cognitive impairments and significant cognitive complaints were more likely to have diabetes and higher dialysis dose (Kt/V). Patients with objective cognitive impairments but no significant complaints were significantly older.

CONCLUSIONS

The cognitive burden of haemodialysis patients can be manifested as objective impairments and/or subjective complaints. When combined the two indicators may better represent the overall cognitive well-being in this population. There is a need to screen for cognitive difficulties and develop cognitive rehabilitative strategies in dialysis settings.

Adaptive Functioning Among Older Adults: The Essence of Information Processing Speed in Executive Functioning

OBJECTIVE

The current study investigated the degree to which information processing speed mediates the association between executive functioning and adaptive functioning among older adults.

METHOD

Cases (N = 239) were selected from a clinical database of neuropsychological evaluations. Inclusion criteria were age 60+ (M = 74.0, standard deviation = 6.9) and completion of relevant study measures. Participants were majority White (93%) women (53.1%). The Texas Functional Living Scale was used as a performance-based measure of adaptive functioning. Information processing speed was measured using the Coding subtest from the Repeatable Battery for the Assessment of Neuropsychological Status. Executive functioning performance was quantified using part B of the Trail Making Test, Controlled Oral Word Association Test, and Similarities and Matrix Reasoning subtests from the Wechsler Abbreviated Scale of Intelligence, second edition. Mediation models were assessed with bootstrapped confidence intervals.

RESULTS

Information processing speed mediated all measures of executive functioning. Direct effects were significant for all models (ps < 0.03), suggesting that executive functioning maintained unique associations with adaptive functioning. Follow-up analyses indicated no evidence for moderation of the mediation models based on diagnostic group. Additional models with executive functioning mediating information processing speed and adaptive functioning revealed inconsistent mediation, with smaller effects.

CONCLUSIONS

Results highlight the importance of information processing speed in understanding real-world implications of pathological and non-pathological cognitive aging. Information processing speed mediated all relationships between executive functioning and adaptive functioning. Further investigation is warranted into the importance of processing speed in explaining associations of other cognitive domains with adaptive functioning.

The effects of typical ageing on cognitive control: recent advances and future directions

Cognitive control is one of the most fundamental aspects of human life. Its ageing is an important contemporary research area due to the needs of the growing ageing population, such as prolonged independence and quality of life. Traditional ageing research argued for a global decline in cognitive control with age, typically characterised by slowing processing speed and driven by changes in the frontal cortex. However, recent advances questioned this perspective by demonstrating high heterogeneity in the ageing data, domain-specific declines, activity changes in resting state networks, and increased functional connectivity. Moreover, improvements in neuroimaging techniques have enabled researchers to develop compensatory models of neural reorganisation that helps negate the effects of neural losses and promote cognitive control. In this article on typical ageing, we review recent behavioural and neural findings related to the decline in cognitive control among older adults. We begin by reviewing traditional perspectives and continue with how recent work challenged those perspectives. In the discussion section, we propose key areas of focus for future research in the field.

The role of subjective cognitive complaints in self-management among haemodialysis patients: a cross-sectional study

Background

Subjective cognitive complaints refer to self-experienced difficulties with everyday cognitive tasks. Although there has been a fair amount of research on cognitive impairments and cognitive complaints in end-stage renal disease, the practical implications of these complaints remain unclear. The current study aims to examine the associations of cognitive complaints with sociodemographic and clinical variables, mood, as well as key patient-reported outcomes, i.e., self-efficacy, self-management skills, and treatment adherence.

Methods

A total of 305 haemodialysis patients (mean age = 53.97 years, 42.6% female) completed the Kidney Disease Quality of Life Cognitive Function subscale, a brief measure of cognitive complaints. The recommended cut-off point of 60 was used to identify probable cognitive impairment. Measures of self-efficacy, self-management skills (i.e., symptom coping, health monitoring, health service navigation), treatment adherence, and mood symptoms were also administered. Between-group comparisons and correlational analyses were performed to examine associations of cognitive complaints with sociodemographic, clinical, and health behaviour variables. Mediation analyses were also conducted to investigate the mediating role of self-efficacy on the relationship between cognitive complaints and treatment adherence.

Results

Nearly a quarter (23.0%) of haemodialysis patients reported cognitive complaints indicative of clinical impairments. Risk of probable impairments was higher for patients with hypertension, diabetes, those diagnosed with end-stage renal disease at an older age, and those with shorter time on dialysis. Subjective cognitive complaints (both rates of probable impairments as per cut-off and continuous scores) were significantly associated with lower disease and treatment self-efficacy, poorer self-management skills, lower treatment adherence, as well as higher symptoms of distress. Mediation analysis indicated that treatment self-efficacy mediated the relationship between cognitive complaints and treatment adherence.

Conclusions

The current study demonstrated the clinical characteristics of haemodialysis patients who report cognitive complaints indicative of probable cognitive impairments and showed the associations of these complaints with self-management outcomes. Future studies should adopt more comprehensive measures of cognitive complaints and longitudinal designs to confirm the current findings.

Oxytocin Release Increases With Age and Is Associated With Life Satisfaction and Prosocial Behaviors

Helping behaviors and life satisfaction generally increase after middle-age. Identifying the neural substrates of prosocial behaviors in older adults may offer additional insights into these changes over the lifespan. The present study examines the endogenous release of the neuromodulator oxytocin (OT) in participants aged 18-99 and its relationship to prosocial behaviors. OT has been shown to influence trust, altruism, charity, and generosity, yet the effect of age on OT release has not been well-established. Blood samples before and after a video stimulus were obtained from 103 participants in order to examine the impact of OT on prosocial behaviors. We found that OT release following a social prime increased with age (r = 0.49, p = 0.001) and that OT moderated the relationship between age and donations to charity. We tested for robustness by examining three additional prosocial behaviors, money and goods donated to charity during the past year and social-sector volunteering. OT moderated the impact of age on all three prosocial behaviors (ps < 0.05). The analysis also showed that participants' change in OT was positively associated with satisfaction with life (p = 0.04), empathic concern (p = 0.015), dispositional gratitude (p = 0.019), and religious commitment (p = 0.001). Our findings indicate that the neural chemistry that helps sustain social relationships and live a fulfilled life appear to strengthen with age.

A 21st century cognitive portrait of the Himba, a remote people of Namibia

This research sketches the cognitive portrait of the Himba, a remote population from Northern Namibia living in a non-industrial society almost completely devoid of modern artefacts. We compared the Himba sample to a French sample, exploring cognitive reflection, moral judgement, cooperative behaviour, paranormal beliefs, and happiness. We looked for both differences and similarities across cultures, and for the way cognitive functioning is associated with a range of demographic variables. Results showed some important group differences, with the Himba being more intuitive, more religious, happier, and less utilitarian than the French participants. Further, the predictors of these beliefs and behaviours differed between the two groups. The present results provide additional support to the recent line of research targeting cultural variations and similarities, and call for the need to expand psychology research beyond the Western world.

Adaptation for Growth Via Learning New Skills as a Means to Long-Term Functional Independence in Older Adulthood: Insights From Emerging Adulthood

Maintenance of functional independence, or the ability to perform daily tasks independently, is a hallmark of successful aging. Healthy older adults are considered functionally independent if they pass a short survey consisting of relatively simple daily activities, including grocery shopping and managing finances. We argue that aging research often has overlooked an important factor for long-term functional independence in a dynamic environment: adaptation for growth via learning new skills. Previous research has focused primarily on compensation and mitigating decline rather than growth. Given that adaptation for growth is at the core of intelligence, resilience, and neuroplasticity, we suggest that functional independence research with older adults could integrate adaptation for growth into the construct, following research on adolescent autonomy and emerging adulthood. After briefly reviewing research on functional independence and compensation in older adulthood, we offer suggestions to push forward gerontological research linking adaptation for growth and functional independence.

Effects of initial planning on task execution performance of older adults: A naturalistic assessment paradigm

Objective: Planning, a higher order executive functioning ability important for accomplishing complex everyday tasks, can be differentiated into initial and concurrent (online) planning. In this study, initial plans were codified to assess their impact on task execution. Cognitive correlates of initial planning and task execution were also examined.Method: One-hundred fifty-four community dwelling older adults completed a naturalistic task, called the Day Out Task (DOT), in either a planning or no planning condition. The DOT required participants to multitask and efficiently complete a series of eight subtasks, preparing for a hypothetical day out. Participants also completed a neuropsychological battery with the following cognitive constructs assessed: processing speed, cognitive flexibility, episodic memory, visuoconstructional abilities, and working memory and sequencing.Results: There were no significant differences between the planning and no planning conditions in DOT execution accuracy, efficiency or duration. However, efficiency of the initial plan was a significant predictor of task execution efficiency and initial plans that contained a higher amount of Task Relevant Associations predicted a shorter duration of task execution after controlling for age, processing speed and episodic memory. Furthermore, initial plans that had more Task Relevant Associations and task executions that took less time were associated with better working memory and sequencing ability.Discussion: Quality of the initial plan is important. Initial plans that organize task objectives in an efficient manner may lead to better task execution efficiency, while initial plans that demonstrate a detailed understanding of individual relational aspects of the tasks (i.e., higher rate of Task Relevant Associations) may result in faster task execution.

My Problems Are Solvable: Idiographic Methods Offset Age Differences in Interpersonal Problem Solving Among Young, Middle-Aged, and Older Adults

This study tested the hypothesis that older adults retain high levels of everyday problem solving performance when confronting problems of maximal ecological relevance, identified through idiographic methods. Younger, middle-aged, and older adults completed a daily challenge questionnaire (DCQ) in which they reported problems of maximal personal relevance or idiographic problems. The large majority of the problems reported were interpersonal. We then assessed performance on an everyday problem-solving task in which participants generated solutions for idiographic problems as well as problems generated by group matched research participants representing each of two other age groups (e.g., older adults received their own problems plus problems generated by matched younger and middle-aged adults). Performance was measured by computing the total number of safe and effective solutions provided. Results fully supported our hypothesis; adults of all ages showed higher performance when solving their idiographic problems.

Neuropsychology of aging

All people want to age "successfully," maintaining functional capacity and quality of life as they reach advanced age. Achieving this goal depends on preserving optimal cognitive and brain functioning. Yet, significant individual differences exist in this regard. Some older adults continue to retain most cognitive abilities throughout their lifetime. Others experience declines in cognitive and functional capacity that range from mild decrements in certain cognitive functions over time to severe dementia among those with neurodegenerative diseases. Even among relatively healthy "successful agers," certain cognitive functions are reduced from earlier levels. This is particularly true for cognitive functions that are dependent on cognitive processing speed and efficiency. Working memory and executive and attentional functions tend to be most vulnerable. Learning and memory functions are also usually reduced, although in the absence of neurodegenerative disease learning and retrieval efficiency rather than memory storage are affected. Other functions, such as visual perception, language, semantics, and knowledge, are often well preserved. Structural, functional, and physiologic/metabolic brain changes correspond with age-associated cognitive decline. Physiologic and metabolic mechanisms, such as oxidative stress and neuroinflammation, may contribute to these changes, along with the contribution of comorbidities that secondarily affect the brain of older adults. Cognitive frailty often corresponds with physical frailty, both affected by multiple exogenous and endogenous factors. Neuropsychologic assessment provides a way of measuring the cognitive and functional status of older adults, which is useful for monitoring changes that may be occurring. Neuroimaging is also useful for characterizing age-associated structural, functional, physiologic, and metabolic brain changes, including alterations in cerebral blood flow and metabolite concentrations. Some interventions that may enhance cognitive function, such as cognitive training, neuromodulation, and pharmacologic approaches, exist or are being developed. Yet, preventing, slowing, and reversing the adverse effects of cognitive aging remains a challenge.

Medication adherence in renal transplant recipients: A latent variable model of psychosocial and neurocognitive predictors

Objective

Estimates indicate that 20–70% of renal transplant recipients are medication non-adherent, significantly increasing the risk of organ rejection. Medication adherence is negatively impacted by lower everyday problem solving ability, and associations between depressive symptoms, self-efficacy, and adherence are reported in renal transplant recipients. Nonetheless, to date, these associations have not been examined concurrently. Given the relationship between non-adherence and organ rejection, it is critical to gain a better understanding of the predictors of adherence in renal transplant recipients. To this end, we modeled relationships among cognitive abilities, depressive symptoms, self-efficacy, and adherence in this group.

Methods

Participants (N = 211) underwent renal transplant at least one year prior to participation. Adherence was measured via self-report, medication possession ratio, and immunosuppressant blood-level. Traditionally-measured neurocognitive and everyday problem-solving abilities were assessed. Depressive symptoms were measured via self-report, as were general and medication adherence related self-efficacy. Structural equation modeling was used to assess the fit of the model to available data.

Results

Everyday problem solving and self-efficacy had direct positive associations with adherence. Depressive symptoms were negatively associated with self-efficacy, but not adherence. Traditionally-measured neurocognitive abilities were positively associated with self-efficacy, and negatively associated with depressive symptoms.

Conclusions

We present a comprehensive investigation of relationships between cognitive and psychosocial factors and adherence in medically stable renal transplant recipients. Findings confirm the importance of everyday problem solving and self-efficacy in predicting adherence and suggest that influences of depressive symptoms and neurocognitive abilities are indirect. Findings have important implications for future development of interventions to improve medication adherence in renal transplant recipients.

Adult Intelligence: The Construct and the Criterion Problem

Over 100 years have passed since Binet and Simon proposed scales for assessment of intelligence of children to predict academic success and failure. The extension of these assessments to adults largely resulted from efforts of psychologists to provide insights for military selection in World War I. At the time, relatively little thought was given to how adult intelligence might differ from child and adolescent intelligence. Traditional approaches for assessing adult intelligence have largely survived. However, there is little reference to adult intellectual functioning outside of laboratory-based tasks and clinical assessments of pathology. The result is that there are insufficient criterion measures for adult intelligence. Moreover, researchers have shifted from treating intelligence tests as predictors to treating them as criterion measures. The result is a disconnection between basic research on one hand and understanding adult intelligence on the other hand. This lack of connection is a serious impediment for predicting individual differences in performance on tasks which adults perform in their day-to-day work and nonwork lives. This article explores how the field has come to the current situation, and what remedies might be explored. Ultimately, a fundamental reexamination of how adult intelligence is studied and applied is suggested.

Influence of Cognitive Functioning on Age-Related Performance Declines in Visuospatial Sequence Learning

Objectives: The aim of this study was to investigate how age-related performance differences in a visuospatial sequence learning task relate to age-related declines in cognitive functioning.

Method: Cognitive functioning of 18 younger and 18 older participants was assessed using a standardized test battery. Participants then undertook a perceptual visuospatial sequence learning task. Various relationships between sequence learning and participants’ cognitive functioning were examined through correlation and factor analysis.

Results: Older participants exhibited significantly lower performance than their younger counterparts in the sequence learning task as well as in multiple cognitive functions. Factor analysis revealed two independent subsets of cognitive functions associated with performance in the sequence learning task, related to either the processing and storage of sequence information (first subset) or problem solving (second subset). Age-related declines were only found for the first subset of cognitive functions, which also explained a significant degree of the performance differences in the sequence learning task between age-groups.

Discussion: The results suggest that age-related performance differences in perceptual visuospatial sequence learning can be explained by declines in the ability to process and store sequence information in older adults, while a set of cognitive functions related to problem solving mediates performance differences independent of age.

Age Differences in Information Use While Making Decisions: Resource Limitations or Processing Differences?

Recent research on the decision-making abilities of older adults has shown that they use less information than young adults. One explanation ascribes this age difference to reductions in cognitive abilities with age. The article includes three experimental studies that focused on determining the conditions in which older and young adults would display dissimilar information processing characteristics. Findings from Studies 1 and 2 demonstrated that older adults are not necessarily at greater disadvantage than young adults in decision contexts that demand more information processing resources. Findings from Study 3 indicated that older adults when faced with decisions that require greater processing are likely to use a strategy that reduces the amount of information needed, whereas younger adults rely on strategies that utilize more resources. Combined the findings indicate that older adults change their decision-making strategies based on the context and information provided. Furthermore, support is provided for processing difference.

Positive affect predicts everyday problem-solving ability in older adults

OBJECTIVES

Increased symptom endorsement on the short form of the Centre for Epidemiologic Studies Depression (CES-D) Scale has been previously associated with lower everyday problem-solving (EPS) ability in older adults. However, given the multifactorial and complex nature of depressive symptoms, it remains unclear whether certain symptoms/aspects of depression account for this relationship. We examined established factor scores on the full version of the CES-D to assess their utility as predictors of EPS in an older adult cohort.

METHODS

Community-dwelling older adults (n = 103; age: 51-91) were administered the CES-D along with a measure of EPS ability assessing both social and practical EPS. Regression analyses were used to determine the relationships between variables.

RESULTS

Analyses revealed that increased CES-D scores predicted worse EPS ability in older adults (β = -.17, p < .05) beyond the effects of age, gender, and education. Regression analyses examining each CES-D factor score revealed that decreased positive affect (loss of hope/enjoyment in life; β = -.21, p < .01) remained the only significant predictor of decreased overall EPS scores beyond demographic variables, while depressed affect, interpersonal, and somatic factors were not significant predictors. Positive affect predicted both practical, as well as social EPS scores.

CONCLUSIONS

Current results extend previous findings by showing that the relationship between increased depressive symptoms and decreased EPS ability in older age may be primarily driven by anhedonia as opposed to other depressive symptoms.

Measures of Bayesian Reasoning Performance on 'Normal' and 'Natural' Frequency Tasks

While the majority of similar studies examining Bayesian reasoning investigate how participants avoid common errors such as base-rate neglect, the current research also examines whether different formats (frequency and probability) lead to a difference in levels of absolute accuracy. In Study One, older (≥60 years) and younger (18 to 29 years) participants completed tasks in probability and normalized frequency formats. In Study 2, participants completed tasks in probability and natural frequency formats. Findings are that frequencies lead to less over-estimation, particularly in natural frequency tasks, which also reveal an interaction between age and task format whereby older adults seem unaffected by format. There was no association found between format and the avoidance of errors such as base-rate neglect. Findings are discussed in the light of dual and multi-process theories of reasoning, having failed to support the theory that frequency formats elicit System 2 reasoning processes.

Adult Age Differences in Dual Information Processes: Implications for the Role of Affective and Deliberative Processes in Older Adults' Decision Making

Age differences in affective/experiential and deliberative processes have important theoretical implications for judgment and decision theory and important pragmatic implications for older-adult decision making. Age-related declines in the efficiency of deliberative processes predict poorer-quality decisions as we age. However, age-related adaptive processes, including motivated selectivity in the use of deliberative capacity, an increased focus on emotional goals, and greater experience, predict better or worse decisions for older adults depending on the situation. The aim of the current review is to examine adult age differences in affective and deliberative information processes in order to understand their potential impact on judgments and decisions. We review evidence for the role of these dual processes in judgment and decision making and then review two representative life-span perspectives (based on aging-related changes to cognitive or motivational processes) on the interplay between these processes. We present relevant predictions for older-adult decisions and make note of contradictions and gaps that currently exist in the literature. Finally, we review the sparse evidence about age differences in decision making and how theories and findings regarding dual processes could be applied to decision theory and decision aiding. In particular, we focus on prospect theory ( Kahneman & Tversky, 1979 ) and how prospect theory and theories regarding age differences in information processing can inform one another.

Effects of Age and Initial Risk Perception on Balloon Analog Risk Task: The Mediating Role of Processing Speed and Need for Cognitive Closure

According to the dual-process theoretical perspective adopted in the presented research, the efficiency of deliberative processes in decision making declines with age, but experiential processes are relatively well-preserved. The age-related differences in deliberative and experiential processes in risky decision-making were examined in this research by applying the Balloon Analog Risk Task (BART). We analyzed the influence of age on risk acceptance and decision-making performance in two age groups of female participants (younger adults, n = 81; older adults, n = 76), with additional experimental manipulation of initial risk perception. We predicted and confirmed that aging significantly worsens performance on the behavioral BART measures due to age-related decline in deliberative processes. Older participants were found to exhibit significantly higher risk aversion and lower BART performance, and the effect of age was mediated by cognitive (processing speed) and motivational (need for cognitive closure) mechanisms. Moreover, older adults adapt to the initial failure (vs. success) similarly, as younger adults due to preserved efficiency of experiential processes. These results suggest future directions for minimizing negative effects of aging in risky decision-making and indicate compensatory processes, which are preserved during aging.

Aging and wisdom: age-related changes in economic and social decision making

World life expectancy is increasing and many populations will begin to age rapidly. The impeding prevalence of a greater number of older people living longer lives will have significant social and economic implications. It is important to understand how older people make economic and social decisions. Aging can be associated with a “phenomenon of decline” and also greater wisdom. This paper seeks to examine the relationship between wisdom and aging. It reviews and connects the behavioral sciences and neuroscience literature on age differences in the following social and economic decision making domains that represent subcomponents of wisdom: (1) prosocial behavior in experimental economic games and competitive situations; (2) resolving social conflicts; (3) emotional homeostasis; (4) self-reflection; (5) dealing effectively with uncertainty in the domains of risk, ambiguity and intertemporal choice. Overall, we find a lack of research into how older people make economic and social decisions. There is, however, some evidence that older adults outperform young adults on certain subcomponents of wisdom, but the exact relationship between old age and each subcomponent remains unclear. A better understanding of these relationships holds the potential to alleviate a wide range of mental health problems, and has broad implications for social policies aimed at the elderly.

Ten-year longitudinal trajectories of older adults' basic and everyday cognitive abilities

OBJECTIVE

To examine the longitudinal trajectories of everyday cognition and longitudinal associations with basic (i.e., laboratory and experimentally measured) cognitive abilities, including verbal memory, inductive reasoning, visual processing speed, and vocabulary.

METHOD

Participants were healthy older adults drawn from the no-treatment control group (N = 698) of the Advanced Cognitive Training for the Independent and Vital Elderly (Willis et al., 2006) randomized trial and were assessed at baseline and 1, 2, 3, 5, and 10 years later. Analyses were conducted using latent growth models.

RESULTS

Modeling revealed an overall inverted-U shape (quadratic) trajectory across cognitive domains. Among basic cognitive predictors, level and slope in reasoning demonstrated the closest association to level and slope of everyday cognition, and accounted for most of the individual differences in linear gain in everyday cognition.

CONCLUSION

Everyday cognition is not buffered against decline, and is most closely related to inductive reasoning in healthy older adults. To establish the clinical utility of everyday cognitive measures, future research should examine these associations in samples with more cognitive impairment.

Forewarning reduces fraud susceptibility in vulnerable consumers

Telemarketing fraud is pervasive and older consumers are disproportionally targeted. Given laboratory research showing that forewarning can effectively counter influence appeals, we conducted a field experiment to test whether forewarning could protect people who had been victimized in the past. A research assistant with prior experience as a telemarketer pitched a mock scam two or four weeks after participants were warned about the same scam or an entirely different scam. Both warnings reduced unequivocal acceptance of the mock scam although outright refusals (as opposed to expressions of skepticism) were more frequent with the same scam warning than the different scam warning. The same scam warning, but not the different scam warning, lost effectiveness over time. Findings demonstrate that social psychological research can inform effective protection strategies against telemarketing fraud.

Translation and validation of Chinese version of the problems in everyday living (PEDL) test in patients with mild cognitive impairment

BACKGROUND

Cognitive impairment places older adults at increased risk of functional decline, injuries, and hospitalization. Assessments to determine whether older persons are still capable of meeting the cognitive challenges of everyday living are crucial to ensure their safe and independent living in the community. The present study aims to translate and validate the Chinese version of the Problems in Everyday Living (PEDL) test for use in Chinese population with mild cognitive impairment (MCI).

METHODS

The cultural relevancy and content validity of the Chinese version of PEDL (C-PEDL) was evaluated by a seven-member expert panel. Forty patients with MCI and 40 cognitively healthy participants were recruited to examine the psychometric properties of C-PEDL.

RESULTS

Significant differences in the C-PEDL scores were found between the patients with MCI and the cognitively healthy controls in both educated (F = 9.96, p = 0.003) and illiterate (F = 10.43, p = 0.004) populations. The C-PEDL had excellent test-retest and inter-rater reliabilities, with intraclass correlation coefficient at 0.95 and 0.99 respectively. The internal consistency of C-PEDL was acceptable with Chronbach's α at 0.69. The C-PEDL had moderate correlation with the Mini-Mental State Examination (r = 0.45, p = 0.004) and the Category Verbal Fluency Test (r = 0.40, p = 0.012), and a moderate negative Spearman's correlation with the Global Deteriorating Scale (r = -0.42, p = 0.007).

CONCLUSIONS

The C-PEDL is a valid and reliable test for assessing the everyday problem-solving ability in Chinese older population with MCI.

Verbal prompting to improve everyday cognition in MCI and unimpaired older adults

OBJECTIVE

This study investigated the effect of verbal prompting on elders' 10-year longitudinal change in everyday cognition. Differential effects of prompting associated with impaired cognitive status were also examined.

METHOD

At baseline, 2,802 participants (mean age = 73.6 years, mean education = 13.5 years) from the Advanced Cognitive Training for Independent and Vital Elderly trial were classified as unimpaired, having amnestic mild cognitive impairment (MCI) or nonamnestic MCI, based on psychometric algorithm. Participants were given the Observed Tasks of Daily Living (OTDL; a behavioral measure with tasks involving medication management/finances/telephone use) at baseline and at 1-, 2-, 3-, 5-, and 10-year follow-ups. When participants said "I don't know" or did not respond to an item, they received a standardized verbal prompt. At each occasion, unprompted (sum of items correct without prompting) and prompted (sum of items correct including both prompted and unprompted) scores were derived for each participant. Multilevel modeling, adjusting for demographics/health/training group, was used to determine the trajectories of OTDL performance.

RESULTS

Persons with MCI performed at lower levels than those who were unimpaired (amnestic < nonamnestic < unimpaired), and for all groups, prompted performance exceeded unprompted in all years. There was differential performance of the prompting conditions over time; prompted performance, unlike unprompted, was relatively protected from age-related decline, and persons with MCI experienced greater improvement due to prompting.

CONCLUSIONS

Very simple prompting appears to enhance and maintain performance on a task of everyday cognition over 10 years for both unimpaired and mildly impaired older adults.

Decision making processes and outcomes

The primary aim of this study was to examine the contributions of individual characteristics and strategic processing to the prediction of decision quality. Data were provided by 176 adults, ages 18 to 93 years, who completed computerized decision-making vignettes and a battery of demographic and cognitive measures. We examined the relations among age, domain-specific experience, working memory, and three measures of strategic information search to the prediction of solution quality using a 4-step hierarchical linear regression analysis. Working memory and two measures of strategic processing uniquely contributed to the variance explained. Results are discussed in terms of potential advances to both theory and intervention efforts.

Complementary cognitive capabilities, economic decision making, and aging

Fluid intelligence decreases with age, yet evidence about age declines in decision-making quality is mixed: Depending on the study, older adults make worse, equally good, or even better decisions than younger adults. We propose a potential explanation for this puzzle, namely that age differences in decision performance result from the interplay between two sets of cognitive capabilities that impact decision making, one in which older adults fare worse (i.e., fluid intelligence) and one in which they fare better (i.e., crystallized intelligence). Specifically, we hypothesized that older adults' higher levels of crystallized intelligence can provide an alternate pathway to good decisions when the fluid intelligence pathway declines. The performance of older adults relative to younger adults therefore depends on the relative importance of each type of intelligence for the decision at hand. We tested this complementary capabilities hypothesis in a broad sample of younger and older adults, collecting a battery of standard cognitive measures and measures of economically important decision-making "traits"--including temporal discounting, loss aversion, financial literacy, and debt literacy. We found that older participants performed as well as or better than younger participants on these four decision-making measures. Structural equation modeling verified our hypothesis: Older participants' greater crystallized intelligence offset their lower levels of fluid intelligence for temporal discounting, financial literacy, and debt literacy, but not for loss aversion. These results have important implications for public policy and for the design of effective decision environments for older adults.

Everyday problem solving and instrumental activities of daily living: support for domain specificity

Research suggests that performance on cognitive tasks resembling daily challenges (i.e., everyday problem-solving tasks) may be a better indicator of functional ability in old age compared to traditional measures of cognitive ability. Findings demonstrating this link, however, have yielded mixed results. The current study examined performance on the Everyday Problems Test (EPT) and self-reported ability to perform Instrumental Activities of Daily Living (IADLs) in a sample of adults over age 50. The EPT measures cognitive performance on tasks with domains consistent with IADLs (telephone use, shopping, meal preparation, housekeeping, transportation, health and finances). Although overall EPT scores and self-reported IADLs were significantly related (r_s = 0.20; p < 0.05), additional analyses revealed that domain-specific EPT performance related to IADL reports within the same domain for shopping, meal preparation, housekeeping, and financial management after accounting for other variables such as age, sex, and measures of cognitive ability including total EPT score. These findings suggest that domain-specific performance on cognitive everyday problem-solving tasks may add to the predictability of specific IADLs.

A meta-analytical review of the relationship between emotional intelligence and leaders’ constructive conflict management

In this paper, we report the findings of a meta-analysis investigating the relationship between emotional intelligence (EI) and constructive conflict management, and the moderational role of leadership position and age. A total of 20 studies yielding 280 effect sizes and involving 5,175 participants were examined. The results supported the hypothesis that EI is positively associated with constructive conflict management, and this relationship was stronger for subordinates than leaders. Contrary to our predictions, age was not a significant moderator. The limitations and implications are discussed in terms of psychometric issues, use of EI in leadership development and facilitation of problem solving, and for the further development of a constructive organizational culture.

The role of supportive messages and distracting thoughts on everyday problem-solving performance

BACKGROUND/STUDY CONTEXT: An increasing number of studies have examined factors related to everyday problem-solving performance across adulthood. The current study examined the role of experimentally provided supportive messages intended to provide practical or emotional support on everyday problem-solving performance. Other factors such as participant age and distracting thoughts experienced during task completion were also investigated.

METHODS

Everyday problem-solving performance, verbal ability performance, inductive reasoning performance, and self-reports of distracting thoughts were obtained from 54 middle-aged and 48 older adults. Participants were also exposed to practically supportive messages, emotionally supportive messages, or no supportive messages prior to completing the everyday problem-solving task.

RESULTS

Exposure to emotionally supportive messages increased task performance and lowered levels of distracting thoughts. Distracting thoughts mediated the relation between exposure to emotionally supportive messages and everyday problem-solving performance. Distracting thoughts also mediated the relation between age and everyday problem-solving performance.

CONCLUSION

Study findings indicate that emotionally supportive messages may increase everyday problem-solving performance by decreasing the amount of distracting thoughts experienced by participants. This finding suggests that consistent administration of emotionally supportive messages could result in more optimal everyday problem-solving performance among middle-aged and older adults.

Age differences in everyday problem solving

Reductions in everyday problem solving (EPS) are often reported in older age, although it has been suggested that problem context may modify this effect. We evaluated the impact of two aspects of problem context: age appropriateness (age-neutral vs. older-age content) and problem type (interpersonal vs. practical) on EPS performance in 175 adults aged 18–87. Older adults generated fewer solutions to ill-structured EPS vignettes than younger and middle-aged adults. Middle-aged adults demonstrated an advantage on practical problems. While all age groups demonstrated a relative performance advantage for interpersonal content on older age problems, older adults showed the least relative benefit in this condition. Thus older adults do not exhibit relative performance gains on EPS problems designed to be most salient and relevant to this age group.

Age-based differences in strategy use in choice tasks

We incorporated behavioral and computational modeling techniques to examine age-based differences in strategy use in two four-choice decision-making tasks. Healthy older (aged 60-82 years) and younger adults (aged 18-23 years) performed one of two decision-making tasks that differed in the degree to which rewards for each option depended on the choices made on previous trials. In the choice-independent task rewards for each choice were not affected by the sequence of previous choices that had been made. In contrast, in the choice-dependent task rewards for each option were based on how often each option had been chosen in the past. We compared the fits of a model that assumes the use of a win-stay-lose-shift (WSLS) heuristic to make decisions, to the fits of a reinforcement-learning (RL) model that compared expected reward values for each option to make decisions. Younger adults were best fit by the RL model, while older adults showed significantly more evidence of being best fit by the WSLS heuristic model. This led older adults to perform worse than younger adults in the choice-independent task, but better in the choice-dependent task. These results coincide with previous work in our labs that also found better performance for older adults in choice-dependent tasks (Worthy et al., 2011), and the present results suggest that qualitative age-based differences in the strategies used in choice tasks may underlie older adults' advantage in choice-dependent tasks. We discuss possible factors behind these differences such as neurobiological changes associated with aging, and increased use of heuristics by older adults.

Everyday problem solving across the adult life span: solution diversity and efficacy

Everyday problem solving involves examining the solutions that individuals generate when faced with problems that take place in their everyday experiences. Problems can range from medication adherence and meal preparation to disagreeing with a physician over a recommended medical procedure or compromising with extended family members over where to host Thanksgiving dinner. Across the life span, research has demonstrated divergent patterns of change in performance based on the type of everyday problems used as well as based on the way that problem-solving efficacy is operationally defined. Advancing age is associated with worsening performance when tasks involve single-solution or fluency-based definitions of effectiveness. However, when efficacy is defined in terms of the diversity of strategies used, as well as by the social and emotional impact of solution choice on the individual, performance is remarkably stable and sometimes even improves in the latter half of life. This article discusses how both of these approaches to everyday problem solving inform research on the influence that aging has on everyday functioning.

Is there evidence of publication biases in JDM research?

It is a long known problem that the preferential publication of statistically significant results (publication bias) may lead to incorrect estimates of the true effects being investigated. Even though other research areas (e.g., medicine, biology) are aware of the problem, and have identified strong publication biases, researchers in judgment and decision making (JDM) largely ignore it. We reanalyzed two current meta-analyses in this area. Both showed evidence of publication biases that may have led to a substantial overestimation of the true effects they investigated. A review of additional JDM meta-analyses shows that most meta-analyses conducted no or insufficient analyses of publication bias. However, given our results and the rareness of non-significant effects in the literature, we suspect that biases occur quite often. These findings suggest that (a) conclusions based on meta-analyses without reported tests of publication bias should be interpreted with caution and (b) publication policies and standard research practices should be revised to overcome the problem.

Judgment in Mild Cognitive Impairment and Alzheimer's disease

Judgment is the capacity to make decisions after considering available information, contextual factors, possible solutions and probable outcomes. Our aim was to investigate previous research studies regarding assessment of judgment in older adults with different degrees of cognitive impairment. To this end, a search of Pubmed and Lilacs electronic databases for studies published from January 1990 until August 2011 in English, Spanish and Portuguese was carried out. The terms used were "judgment" combined with the terms "dementia" or "Mild Cognitive Impairment" (MCI) or "Alzheimer's disease" (AD). Some studies showed that MCI and AD patients had impaired judgment. There is a lack of specific methods to measure judgment capacity, and data on judgment abilities in older adults with MCI and dementia are scarce. No studies with specific measures of judgment capacity in other dementias were found.

Age-related effects of blood pressure on everyday cognitive function in community-dwelling women

OBJECTIVES

Blood pressure is an indicator of vascular health that has been associated with cognition and quality of life in older age. Few studies have examined blood pressure across everyday cognitive tasks, which may have superior predictive functional utility than traditional cognitive measures. We explored blood pressure as a predictor of everyday problem solving (EPS) performance in middle-aged and older women.

METHOD

Community-dwelling women (age: 51-91) with low-normal blood pressure to mild hypertension underwent traditional and everyday cognitive testing. EPS was determined by the number of safe/effective solutions generated for real-world scenarios.

RESULTS

Analyses revealed that lower systolic blood pressure and pulse pressure were associated with worse EPS ability after controlling for age, education, and traditional cognitive abilities.

DISCUSSION

These results support that blood pressure may be an important predictor of everyday cognitive abilities in older age. Potential implications for real-world functioning are discussed.

When 2 is Better Than 1 + 1

Little is known about older spousal dyads’ collaborative problem solving. Although typically collaborating dyads perform worse than nominal dyads in other dyadic cognition tasks, we assumed that older couples might profit from collaboration in a highly demanding problem-solving task requiring the sequential and complementary use of spatial memory and reasoning abilities. In this paper, we examine whether older couples profit from the dyadic situation on a computer-based problem-solving task that can most likely be optimally solved when dyads manage to distribute responsibilities between the spatial memory demands and the reasoning demands of the task. In 50 married couples consisting of N = 100 older individuals (M = 67.3 years, SD = 4.9), we tested the hypothesis that compared to their own individual performance, compared to repeated individual performance of a control group (N = 41, M = 66.0 years, SD = 3.8), and compared to nominal pairs (same 100 participants as in the experimental group), older couples would show the best performance on the task. The comparison of individual versus dyadic problem-solving performance demonstrates that dyads consisting of old spouses outperform old individuals as well as nominal pairs on the problem-solving task. Our results suggest that older familiar dyads are expert collaborators whose collaborative expertise might be able to overcome individual deficits in problem-solving skills through dyadic cognition.

Age differences in attention toward decision-relevant information: education matters

Previous studies suggested that older adults are more likely to engage in heuristic decision-making than young adults. This study used eye tracking technique to examine young adults' and highly educated older adults' attention toward two types of decision-relevant information: heuristic cue vs. factual cues. Surprisingly, highly educated older adults showed the reversed age pattern-they looked more toward factual cues than did young adults. This age difference disappeared after controlling for educational level. Additionally, education correlated with attentional pattern to decision-relevant information. We interpret this finding as an indication of the power of education: education may modify what are thought to be "typical" age differences in decision-making, and education may influence young and older people's decision-making via different paths.

Everyday challenges in context: the influence of contextual factors on everyday problem solving among young, middle-aged, and older adults

The authors examined the experimental effects of social context on everyday problem-solving performance by older, middle-aged, and younger adults. Participants were presented with six everyday problems constructed by framing two behavioral challenges in social contexts representative of the lives of older, middle-aged, and younger adults. As predicted, participants performed best when problems were situated in contexts representative of their own age group. Older adults also outperformed the other age groups on problems set in older adult contexts, suggesting that when problems are set in ecologically relevant contexts, one may not observe previously reported age-related declines in performance.