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Gómez CS, Rodríguez EJF. The effectiveness of a training programme in everyday cognition in healthy older adults: a randomised controlled trial. BMC Geriatr 2021; 21:79. [PMID: 33509113 PMCID: PMC7842078 DOI: 10.1186/s12877-020-01998-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Everyday cognition is the application of basic cognitive skills and knowledge of the specific cognitive domain for the resolution of problems that are integrated within the instrumental domains of functioning. The main objective is to evaluate the effectiveness of a Training Programme in Everyday Cognition in order to improve the levels of everyday cognition and global cognitive performance in older adults. METHODS A randomised controlled trial of two groups. The sample was composed of healthy older adults. The intervention of the experimental group consisted of an Everyday Cognition Training Programme, and the intervention of the control group consisted of a Conventional Cognitive Training Programme. The Rapid Assessment of Cognitive Functions test (ERFC) and the Everyday Cognition Battery test (ECB) were used to assess the intervention. RESULTS Total sample (n = 237) composed of 44 men and 223 women, with a mean age of 73.45 years. Statistically significant differences (p < 0.001) were evidenced between the control group and the experimental group in both the ECB and ERFC; in the final evaluation of the study and in the follow-up. CONCLUSION The use of a Daily Cognition Training Programme presents greater benefits in terms of both global cognitive performance and everyday cognition than the use of a Conventional Cognitive Training Programme in elderly adults. TRIAL REGISTRATION ClinicalTrials.gov : NCT04041999 . Retrospectively registered. Date of trial registration: 8th July 2019.
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Affiliation(s)
- Celia Sánchez Gómez
- Department of Evolutionary and Educational Psychologyt, Faculty of Psychology. University of Salamanca, Avenida de la Merced, 109, 37005 Salamanca, Spain
| | - Eduardo José Fernández Rodríguez
- Department of Nursing and Physiotherapy, University of Salamanca, Salamanca, Spain
- Biomedical Research Institute of Salamanca, Salamanca, Spain
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Romero-Ayuso D, Castillero-Perea Á, González P, Navarro E, Molina-Massó JP, Funes MJ, Ariza-Vega P, Toledano-González A, Triviño-Juárez JM. Assessment of cognitive instrumental activities of daily living: a systematic review. Disabil Rehabil 2019; 43:1342-1358. [PMID: 31549907 DOI: 10.1080/09638288.2019.1665720] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE Cognitive instrumental activities of daily living are particularly related to executive functions, such as scheduling appointments, monthly payments, managing the household economy, shopping or taking the bus. The aim of this systematic review was to determine the available tests for the assessment of executive functions with ecological validity to predict individuals' functioning. MATERIALS AND METHODS An electronic search was conducted in MEDLINE, Cochrane Central, PsyCInfo and IEEE Xplore until May 2019, in addition to a manual search. The PRISMA criteria and the Covidence platform were used to select articles and extract data. RESULTS After applying the search selection criteria, 76 studies were identified. They referred to 110 tools to assess instrumental activities of daily living. Those that have received most attention are related to menu preparation and shopping. Performance-based measures are the most widely used traditional methods. Most tests were aimed at the adult population with acquired brain damage, cognitive impairment or dementia. There was a predominance of tests based on the Multiple Errands Test paradigm. CONCLUSIONS In recent years, it has increased the number of tools that assess the instrumental activities of daily living based on technologies such as personal or environmental sensors and serious games.IMPLICATIONS FOR REHABILITATIONAssessment of Instrumental Activities of Daily Living through performance-based measures is especially useful for the early detection of dysfunctions or preclinical disability.Difficulties in performing instrumental activities of daily living are closely associated with deficits in executive functions and prospective memory.Activities of Daily Living can be understood as multitasks.The use of virtual reality-based tests was shown to be sensitive to the detection of cognitive deficits in Activities of Daily Living.An advantage of using virtual reality in assessments is that it can help to predict the level of personal autonomy in patients who are in an institutional environment and could be a first approximation to the real environment.
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Affiliation(s)
- Dulce Romero-Ayuso
- Division of Occupational Therapy, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | | | - Pascual González
- LoUISE Research Group, Computing Systems Department, University of Castilla-La Mancha, Albacete, Spain
| | - Elena Navarro
- LoUISE Research Group, Computing Systems Department, University of Castilla-La Mancha, Albacete, Spain
| | - José Pascual Molina-Massó
- LoUISE Research Group, Computing Systems Department, University of Castilla-La Mancha, Albacete, Spain
| | - M Jesús Funes
- Mind, Brain and Behaviour Research Center (CIMCYC) and Department of Experimental Psychology, University of Granada, Granada, Spain
| | - Patrocinio Ariza-Vega
- Division of Occupational Therapy, Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Rehabilitation and Traumatology Service, Virgen de Las Nieves University Hospital of Granada, Granada, Spain
| | - Abel Toledano-González
- Department of Psychology, Faculty of Occupational Therapy, Speech Therapy and Nursing, University of Castilla-La Mancha, Ciudad Real, Spain
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Bielak AAM, Hatt CR, Diehl M. Cognitive Performance in Adults' Daily Lives: Is There a Lab-Life Gap? RESEARCH IN HUMAN DEVELOPMENT 2017; 14:219-233. [PMID: 37771386 PMCID: PMC10538579 DOI: 10.1080/15427609.2017.1340050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This article addresses the "lab-life gap" in cognitive aging research as an important issue of ecological validity in developmental research. Older adults often function competently in complex everyday situations despite age-related deficits on laboratory-based cognitive tasks. Therefore, to what extent do lab-based cognitive tasks predict real-life outcomes in older adults? Our review shows that although they are similar, measures of everyday cognitive competence predict relevant outcomes beyond basic measures. We provide our perspective on critical questions concerning the relevance of everyday cognitive tests in our ever-changing world, new methods of everyday cognitive assessment, and whether everyday cognition can be improved.
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Yeung SE, Loken Thornton W. "Do it-yourself": Home blood pressure as a predictor of traditional and everyday cognition in older adults. PLoS One 2017; 12:e0177424. [PMID: 28520751 PMCID: PMC5435167 DOI: 10.1371/journal.pone.0177424] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 04/27/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Hypertension guidelines recommend home blood pressure (HBP) monitoring in adjunct to office blood pressure (OBP) for its greater reproducibility and prognostic utility in the prevention of cardiovascular outcomes, especially stroke. To date, the relationship between HBP and cognitive function remains unexplored. METHODS We examined HBP as a cognitive predictor in a multi-ethnic group of community-dwelling adults aged 60 and over (N = 133) using neuropsychological measures and analyzed the data using multiple regression analyses. We also employed "everyday cognition" measures that have been found to have higher prognostic utility for real-world functioning than traditional cognitive tasks. RESULTS Good to perfect HBP monitoring compliance over seven days was achieved by 88.7% of the participants with superior reliability (ICC≥.96) to office readings. Higher home systolic BP and pulse pressure predicted worse processing speed, executive function, and everyday cognitive function, whereas lower home diastolic BP predicted worse everyday cognition. Office readings were similarly associated with everyday cognitive function but with no other cognitive measures. CONCLUSION Our findings are the first to validate HBP as a predictor of neuropsychological function in older adults beyond cognitive screening. Differential relationships among blood pressure variables and specific cognitive domains were observed. With proper standardization and training, we demonstrated that HBP can be obtained in a multi-ethnic community-dwelling older adult cohort. Our findings emphasize the importance of employing blood pressure and cognitive measures that are adequately sensitive to detect vascular-related cognitive impairment in a relatively healthy population. Implications regarding proper HBP measurement for hypertension management, cognitive health, and everyday function are discussed.
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Affiliation(s)
- Sophie E Yeung
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Wendy Loken Thornton
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
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Paterson TSE, Yeung SE, Thornton WL. Positive affect predicts everyday problem-solving ability in older adults. Aging Ment Health 2016; 20:871-9. [PMID: 26033072 DOI: 10.1080/13607863.2015.1043619] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
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.
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Affiliation(s)
| | - Sophie E Yeung
- a Department of Psychology , Simon Fraser University , Burnaby , Canada
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Lindbergh CA, Dishman RK, Miller LS. Functional Disability in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2016; 26:129-59. [PMID: 27393566 DOI: 10.1007/s11065-016-9321-5] [Citation(s) in RCA: 95] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 05/12/2016] [Indexed: 02/07/2023]
Abstract
Accumulating evidence suggests that the pre-dementia syndrome mild cognitive impairment (MCI) is characterized by decrements in instrumental activities of daily living (IADL). The current review was a quantitative synthesis of the available literature to objectively characterize IADL disability in MCI while clarifying inconsistencies in findings across studies. It was hypothesized that individuals with MCI would display significantly greater functional impairment relative to cognitively intact controls. Candidate moderators specified a priori included functional assessment approach, MCI subtype, depressive symptoms, and language conducted. Online databases (PubMed/MEDLINE and PsycINFO) and reference lists were searched to identify peer-reviewed publications assessing IADL in MCI compared to normal aging. A total of 151 effect sizes derived from 106 studies met inclusionary criteria (N = 62,260). Random effects models yielded a large overall summary effect size (Hedges' g = 0.76, 95 % confidence interval: 0.68 - 0.83, p < .001) confirmed in multi-level analyses adjusted for nesting of effect sizes within studies (g = 0.78, 95 % confidence interval: 0.69 - 0.87). Functional assessment strategy and MCI subtype were significant moderators of effect size, whereas depressive symptoms and language were not. Results convincingly demonstrate that MCI is associated with significant difficulties in the performance of complex everyday tasks. It appears that functional decline, like cognitive decline, exists on a continuum from healthy aging to dementia onset. Implications for clinical practice and research priorities are discussed.
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Affiliation(s)
- Cutter A Lindbergh
- Department of Psychology, University of Georgia, Athens, GA, 30602, USA.
| | - Rodney K Dishman
- Department of Kinesiology, University of Georgia, Athens, GA, 30602, USA
| | - L Stephen Miller
- Department of Psychology, University of Georgia, Athens, GA, 30602, USA.,Bio-Imaging Research Center, Paul D. Coverdell Center, University of Georgia, Athens, GA, 30602, USA
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Abstract
OBJECTIVE This study examined whether there are daily fluctuations in everyday cognition that are consistent with daily fluctuations often observed in traditional measures of basic cognitive abilities. METHOD Two hundred six independently living older adults (age range = 60-91 years) were asked to complete a computerized cognitive battery over eight occasions within a 2- to 3-week period. RESULTS Using multilevel model, significant within-person variability was observed across the Daily Everyday Cognition Assessment (DECA; 46%), with 54% between-person variability. At each occasion, better performance on the DECA was significantly associated with better performance on simple reaction time ( p < .01) and memory (Auditory Verbal Learning Task, p < .01) even after accounting for time, age, education, and performance on other cognitive measures. CONCLUSION These findings demonstrate that within-person performance fluctuations can be observed for everyday cognition tasks, and these fluctuations are consistent with daily changes in basic cognitive abilities.
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Nurse-Enhanced Computerized Cognitive Training Increases Serum Brain-Derived Neurotropic Factor Levels and Improves Working Memory in Heart Failure. J Card Fail 2015; 21:630-41. [PMID: 25982826 DOI: 10.1016/j.cardfail.2015.05.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 03/27/2015] [Accepted: 05/07/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Memory loss is common in heart failure (HF) patients, but few interventions have been tested to treat it. The objective of this study was to evaluate efficacy of a cognitive training intervention, Brain Fitness, to improve memory, serum brain-derived neurotropic factor (BDNF) levels, working memory, processing speed, executive function, instrumental activities of daily living, mobility, depressive symptoms, and health-related quality of life. METHODS AND RESULTS Twenty-seven HF patients were randomly assigned to Brain Fitness and health education active control interventions. Data were collected at baseline and 8 and 12 weeks. Linear mixed models analyses were completed. Patients in the Brain Fitness group were older with lower ejection fraction. At 12 weeks, a group by time interaction effect was found for serum BDNF levels (P = .011): serum BDNF levels increased among patients who completed Brain Fitness and decreased among patients who completed health education. No differences were found in memory, but a group by time interaction (P = .046) effect was found for working memory. CONCLUSIONS Findings support efficacy of Brain Fitness in improving working memory and serum BDNF levels as a biomarker of intervention response. A randomized controlled study is needed among a larger more diverse group of HF patients.
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Yam A, Gross A, Prindle J, Marsiske M. Ten-year longitudinal trajectories of older adults' basic and everyday cognitive abilities. Neuropsychology 2014; 28:819-28. [PMID: 24885451 PMCID: PMC4227959 DOI: 10.1037/neu0000096] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
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.
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Affiliation(s)
- Anna Yam
- Department of Clinical and Health Psychology, University of Florida
| | - Alden Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Center on Aging and Health
| | | | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida
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Thomas KR, Marsiske M. Verbal prompting to improve everyday cognition in MCI and unimpaired older adults. Neuropsychology 2013; 28:123-34. [PMID: 24219613 DOI: 10.1037/neu0000039] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
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.
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Affiliation(s)
- Kelsey R Thomas
- Department of Clinical and Health Psychology, University of Florida
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida
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Zur BM, Rudman DL, Johnson AM, Roy EA, Wells JL. Components of cognitive competence predictive of occupational competence in persons with dementia: a Delphi study. The Canadian Journal of Occupational Therapy 2013; 80:71-81. [PMID: 23926759 DOI: 10.1177/0008417413481574] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Within the area of dementia care, occupational therapists are asked to predict occupational competence in everyday living and often do so by assessing cognitive competence. Considering the cognitive changes that occur with dementia over time, the construct of cognitive competence is a key consideration. Still, a gap exists in the literature examining the relationship between cognitive competence and occupational competence. PURPOSE This study developed a consensus among participating Canadian occupational therapists regarding the components of cognitive competence they considered essential to predict occupational competence in people with dementia. METHOD A three-round Delphi study was completed with English- and French-speaking occupational therapists (n = 127; 116; 125) experienced in dementia care. FINDINGS Ten cognitive components were identified as essential to predict occupational competence in individuals with dementia. IMPLICATIONS The 10 identified components provide direction for assessment practices and education in dementia care and for development of measurement tools.
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Affiliation(s)
- Briana M Zur
- Graduate Program in Health and Rehabilitation Sciences (Occupational Science), University of Western Ontario, London, Canada.
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Zur BM, Rudman DL, Johnson AM, Roy EA, Wells JL. Examining the construct validity of the Cognitive Competency Test for occupational therapy practice / Évaluer la validité de construit du Cognitive Competency Test en fonction de la pratique de l’ergothérapie. Can J Occup Ther 2013; 80:171-80. [DOI: 10.1177/0008417413491918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Enhancing occupational therapy practice requires critical examination of assessment tools and the conclusions being drawn from their use. When working with cognitively impaired older individuals, judgments about occupational competence are often informed by an assessment of cognitive competence. Purpose. The Cognitive Competency Test (CCT) is a frequently used measure in Canada to inform predictions of occupational competence. However, there is an absence of published evidence that addresses its validity. Methods. To appraise validity of the CCT, a retrospective chart review ( n = 107) of CCT reports for inpatient and outpatient clients with cognitive impairment was conducted. Data were subjected to exploratory factor analyses to examine the factor structure, and the measure was compared with commonly used clinical variables reflecting cognitive and occupational competence. Findings. Results suggest that the CCT measures a unitary construct and provide some support for its predictive capacity. Implications. CCT scores can add incremental validity to cognitive screens, such as the Mini Mental State Exam, when evaluating occupational competence.
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Ayotte BJ, Allaire JC, Whitfield KE. Understanding within-group variability of everyday cognition in aging Black/African American adults: a mimic (multiple indicators, multiple causes) model approach. Exp Aging Res 2013; 38:488-510. [PMID: 23092220 DOI: 10.1080/0361073x.2012.726022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
UNLABELLED BACKGROUND/STUDY CONTEXT: Everyday cognition represents the ability to solve problems within domains that are representative of issues faced by adults on a daily basis. The current study examined individual differences in everyday cognitive ability among aging Black/African American adults. METHODS Demographic data on age, gender, education, physical functioning, chronic illnesses, self-reported health, and depression were collected from 248 African American adults (mean age = 67.8 years, standard deviation = 8.47 years). A multiple indicators, multiple causes (MIMIC) modeling approach was used to examine the associations of individual characteristics with latent everyday cognitive ability and composite score indicators. RESULTS Age, depressive symptoms, and number of chronic illnesses were negatively related to latent everyday cognition. The individual characteristics of age, depressive symptoms, self-rated health, and education were directly associated with composite indicators of latent everyday cognition. This suggests that within this sample of older Black/African American adults that certain composite scores (i.e., telephone use, food preparation, and finances) may be particularly sensitive to these individual characteristics. CONCLUSION These results identify specific sources of variability in everyday cognitive ability among aging Blacks/African Americans. These individual differences should be accounted for when studying everyday cognition among Blacks/African Americans and when comparing the everyday cognitive ability of Blacks/African Americans with other groups.
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Affiliation(s)
- Brian J Ayotte
- Department of Psychology, University of Massachusetts Dartmouth, North Dartmouth, MA 02747, USA.
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Thornton WL, Paterson TSE, Yeung SE. Age differences in everyday problem solving. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2012. [DOI: 10.1177/0165025412454028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Kennedy SW, Allaire JC, Gamaldo AA, Whitfield KE. Race differences in intellectual control beliefs and cognitive functioning. Exp Aging Res 2012; 38:247-64. [PMID: 22540381 DOI: 10.1080/0361073x.2012.672122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
UNLABELLED BACKGROUND/STUDY CONTEXT: The current study examined the relationship between intellectual control and cognition and related the results to everyday problem solving in a mixed ethnicity sample of 35% African American and 65% Caucasian elders. METHODS Participants completed the Personality in Intellectual Aging Contexts Inventory (PIC; Lachman et al., 1982 , Journal of Research in Personality, 16, 485-501), Everyday Cognition Battery (ECB; Allaire & Marsiske, 1999 , Psychology & Aging, 14, 627-644; 2002 , Psychology & Aging, 17, 101-115), and a battery of basic cognitive ability tests assessing memory, inductive reasoning, and verbal meaning. RESULTS Results indicated that African Americans had significantly lower intellectual control beliefs relative to Caucasian older adults. Regression models suggested that relationship between control beliefs and cognition was moderated by education and race. Decomposing the interactions with simple slope analysis revealed that across cognitive abilities, better cognitive performance was related to higher control beliefs in African Americans with at least 13 years of education. A similar relationship was also found in Caucasian elders with lower education. CONCLUSION African American elders' reaching a higher level of education may provide a basis for which individual differences in intellectual control beliefs are activated and thereby more strongly associated with cognitive performance.
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Affiliation(s)
- Sarah W Kennedy
- Department of Health and Human Services: Division of Aging and Adult Services, Raleigh, North Carolina, USA
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Law LLF, Barnett F, Yau MK, Gray MA. Measures of everyday competence in older adults with cognitive impairment: a systematic review. Age Ageing 2012; 41:9-16. [PMID: 21893502 DOI: 10.1093/ageing/afr104] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The issue of safety of the cognitively impaired elderly people living alone has been continuously raised. Traditional psychometric measures of cognitive abilities may not adequately reflect older adults' functioning in a real everyday context. OBJECTIVES To conduct a systematic review on instruments available for evaluating the everyday problem-solving or everyday competence of the elderly with cognitive impairment and to critically review the measurement properties of the identified instruments. METHODS We searched the databases such as Cinahl, Medline, PsycINFO, AARP Ageline, ProQuest and the Cochrane Library for the time period between January 1995 and December 2010. Reference lists of the included papers were also manually searched. RESULTS Five instruments were included. All the instruments focused their framework on Instrumental Activities of Daily Living (IADL) domains which meet well with suggestions from other studies on the importance of IADL in determining an elderly individual's capability to live independently in the community. No available instruments for the moderate to severe impairment group were identified under this review. CONCLUSIONS Few existing instruments to assess the ability of everyday problem-solving of the elderly with cognitive impairment can be identified in the literature. Further research validating them against functional, real-world outcomes is needed.
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Affiliation(s)
- Lawla L F Law
- Occupational Therapy Discipline, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville QLD, Australia.
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Yeung SE, Thornton WL. Age-related effects of blood pressure on everyday cognitive function in community-dwelling women. AGING NEUROPSYCHOLOGY AND COGNITION 2011; 18:733-55. [PMID: 22010841 DOI: 10.1080/13825585.2011.609882] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
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.
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Affiliation(s)
- Sophie E Yeung
- Department of Psychology, Simon Fraser University Burnaby, British Columbia, Canada. ,
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Pressler SJ, Therrien B, Riley PL, Chou CC, Ronis DL, Koelling TM, Smith DG, Sullivan BJ, Frankini AM, Giordani B. Nurse-Enhanced Memory Intervention in Heart Failure: the MEMOIR study. J Card Fail 2011; 17:832-43. [PMID: 21962422 PMCID: PMC3227743 DOI: 10.1016/j.cardfail.2011.06.650] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 06/24/2011] [Accepted: 06/27/2011] [Indexed: 12/15/2022]
Abstract
BACKGROUND Many patients with heart failure (HF) have cognitive deficits, including memory loss. OBJECTIVES The aim of this study was to evaluate the efficacy of a cognitive training intervention on memory (primary outcome), working memory, psychomotor speed, executive function, and performance of cognitive activities and instrumental activities of daily living (IADLs). METHODS AND RESULTS Forty patients with HF were randomly assigned to the computerized plasticity-based cognitive training intervention called Brain Fitness or to the health education active control intervention. Advanced practice nurses made weekly home visits to assess symptoms and monitor intervention adherence. Patients completed demographic and clinical data (baseline), neuropsychologic tests (baseline and 8 and 12 weeks), and measures of cognitive and IADLs performance (baseline and 12 weeks) and satisfaction (12 weeks). Linear mixed models analyses indicated a significant group by time interaction for delayed recall memory (P = .032) and a significant time effect for total (list learning) (P < .001) and delayed (P = .015) recall memory, psychomotor speed (P = .029), and performance of IADLs (P = .006). Intervention adherence and patient satisfaction were high. CONCLUSIONS To our knowledge, this was the first test of Brain Fitness in HF. Although it was a preliminary study with limitations, results support the need for a larger randomized controlled trial to determine whether the memory loss of HF is amenable to plasticity-based interventions.
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Affiliation(s)
- Susan J Pressler
- University of Michigan School of Nursing, Ann Arbor, Michigan 48109, USA.
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Neupert SD, Patterson TR, Davis AA, Allaire JC. Age Differences in Daily Predictors of Forgetting to Take Medication: The Importance of Context and Cognition. Exp Aging Res 2011; 37:435-48. [DOI: 10.1080/0361073x.2011.590757] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Young TL, Granic A, Yu Chen T, Haley CB, Edwards JD. Everyday reasoning abilities in persons with Parkinson's disease. Mov Disord 2011; 25:2756-61. [PMID: 20939079 DOI: 10.1002/mds.23379] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Parkinson's disease (PD) patients develop progressive cognitive decline. The degree to which such decline impacts instrumental activities of daily living (IADL) among individuals in the early stages of PD without dementia is not well documented. The Everyday Cognitive Battery Reasoning subtest (ECB) was used to assess ability to solve everyday reasoning tasks for IADL among 19 non-demented older adults with PD in comparison to 20 older adults without PD. The two groups were similar in age, education, race and gender. Individuals with PD had significantly lower scores (M = 61.98, SD = 12.03) than the comparison group (M = 69.80, SD = 9.48). Individuals with PD, who do not have dementia, may be more likely to experience difficulties in IADL requiring reasoning including medication use, finances, and nutrition. Even more serious implications lie in the capacity to make treatment choices.
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Affiliation(s)
- Tiffany L Young
- University of South Florida, School of Aging Studies, Tampa, Florida, USA
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Kalisch T, Richter J, Lenz M, Kattenstroth JC, Kolankowska I, Tegenthoff M, Dinse HR. Questionnaire-based evaluation of everyday competence in older adults. Clin Interv Aging 2011; 6:37-46. [PMID: 21472090 PMCID: PMC3066251 DOI: 10.2147/cia.s15433] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Gerontological research aims at understanding factors that are crucial for mediating "successful aging". This term denotes the absence of significant disease and disabilities, maintenance of high levels of physical and cognitive function, and preservation of social and productive activities. Preservation of an active lifestyle is considered an effective means through which everyday competence can be attained. In this context, it is crucial to obtain ratings of modern day older adults' everyday competence by means of appropriate assessments. Here, we introduce the Everyday Competence Questionnaire (ECQ), designed to assess healthy older adults' everyday competence. METHODS The ECQ includes 17 items, covering housekeeping, leisure activities, sports, daily routines, manual skills, subjective well-being, and general linguistic usage. The ECQ was administered to a population of 158 healthy subjects aged 60-91 years, who were divided into groups on the basis of their physical activity. These groups were community-dwelling subjects, those living independently and having a sedentary lifestyle, those living independently but characterized by a general lifestyle without any noteworthy physical activity, and those living independently and exercising regularly. Age, gender, and education levels were balanced between the groups. RESULTS Using the ECQ, we could identify and distinguish different everyday competence levels between the groups tested: Subjects characterized by an active lifestyle outperformed all other groups. Subjects characterized by a general lifestyle showed higher everyday competence than those with a sedentary lifestyle or subjects who needed care. Furthermore, the ECQ data showed a significant positive correlation between individual physical activity and everyday competence. CONCLUSION The ECQ is a novel tool for the questionnaire-based evaluation of everyday competence among healthy subjects. By including leisure activities, it considers the changed living conditions of modern-day older adults.
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Affiliation(s)
- Tobias Kalisch
- Department of Neurology, BG-Kliniken Bergmannsheil, Bochum, Germany.
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Thornton AE, Kristinsson H, DeFreitas VG, Thornton WL. The ecological validity of everyday cognition in hospitalized patients with serious mental illness. J Clin Exp Neuropsychol 2009; 32:299-308. [DOI: 10.1080/13803390903002209] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Allen E. Thornton
- a Department of Psychology , Simon Fraser University , Burnaby, British Columbia, Canada
- b British Columbia Mental Health and Addiction Services Research Institute , Vancouver, British Columbia, Canada
| | - Hayley Kristinsson
- a Department of Psychology , Simon Fraser University , Burnaby, British Columbia, Canada
| | - Vanessa G. DeFreitas
- a Department of Psychology , Simon Fraser University , Burnaby, British Columbia, Canada
| | - Wendy Loken Thornton
- a Department of Psychology , Simon Fraser University , Burnaby, British Columbia, Canada
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Fleischman DA, Bienias JL, Bennett DA. Repetition priming and change in functional ability in older persons without dementia. Neuropsychology 2009; 23:98-104. [PMID: 19210037 DOI: 10.1037/a0013994] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Adverse consequences such as institutionalization and death are associated with compromised activities of daily living in aging, yet there is little known about risk factors for the development and progression of functional disability. Using generalized linear models, the authors examined the association between the ability to benefit from repetition and rate of change in functional ability in 160 nondemented elders participating in the Religious Orders Study. Three single-word repetition priming tasks were administered that varied in the degree to which visual-perceptual or conceptual processing was invoked. Decline in functional ability was less rapid, during follow-up of up to 10 years, in persons with better baseline priming performance on a task known to draw on both visual-perceptual and conceptual processing (word-stem completion). By contrast, change in functional ability was not associated with priming on tasks that are known to draw primarily on either visual-perceptual (threshold word-identification) or conceptual (category exemplar production) processing. The results are discussed in terms of a common biological substrate in the inferotemporal neocortex, supporting efficient processing of meaningful visual-perceptual experience and proficient performance of activities of daily living.
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Affiliation(s)
- Debra A Fleischman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
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Allaire JC, Gamaldo A, Ayotte BJ, Sims R, Whitfield K. Mild cognitive impairment and objective instrumental everyday functioning: the everyday cognition battery memory test. J Am Geriatr Soc 2008; 57:120-5. [PMID: 19016931 DOI: 10.1111/j.1532-5415.2008.02054.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine the performance subjects with and without mild cognitive impairment (MCI) on an objective measure of everyday or real-world memory and subjective items assessing competency within the same instrumental domains; to determine whether the Everyday Cognition Battery (ECB) can uniquely predict MCI status. DESIGN Cross-sectional. SETTING Independent-living sample of urban dwelling elders in Baltimore Maryland. PARTICIPANTS The sample consisted of 555 subjects ranging in age from 50 to 95 (mean 68.8 +/- 9.6). MEASUREMENTS Objective performance in three instrumental domains (medication use, financial management, nutrition and food preparation) was assessed using the ECB Memory Test. Subjective performance within the same instrumental domains was also assessed. RESULTS No difference was found between elderly subjects with and without MCI on the subjective items of instrumental activity of daily living (IADL) competency. A significant multivariate effect for cognitive status group (F(3, 507)=21.88, P<.05, eta(2)=.12) was observed for the objective measure, with participants with MCI performing, on average, significantly worse than those without on all thee instrumental domain subscales. The medicine use (odds ratio (OR)=0.96, 95% confidence interval (CI)=0.94-0.99) and financial management (OR=0.93, 95% CI=0.91-0.96) subscales of the ECB Memory Test were unique and significant predictors of MCI. CONCLUSION This study adds to the growing body of literature suggesting that cognitively complex IADLs might be compromised in elderly people with MCI. Moreover, the ECB Memory Test might be a clinically useful tool in evaluating real-world competency.
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Affiliation(s)
- Jason C Allaire
- Department of Psychology, North Carolina State University, Raleigh, North Carolina 27695-7801, USA.
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Abstract
Regaining independence after a neurologic insult requires more than improved motor control. To assume roles and responsibilities and individual must have the executive functions of planning, organizing and self monitoring. Physical therapists are evolving their role as movement specialists by appreciating the executive function skills required to fully integrate and participate in society. Tasks trained in physical therapy provide and ideal opportunity to incorporate executive function as patients practice mobility skills and experience errors in safety and efficiency. This article will begin to bridge the gap between cognitive and motor rehabilitation by providing practical applications to integrate executive function rehabilitation into current physical therapist practice.
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Lewis MC, Nevo I, Paniagua MA, Ben-Ari A, Pretto E, Eisdorfer S, Davidson E, Matot I, Eisdorfer C. Uncomplicated general anesthesia in the elderly results in cognitive decline: does cognitive decline predict morbidity and mortality? Med Hypotheses 2006; 68:484-92. [PMID: 17141964 DOI: 10.1016/j.mehy.2006.08.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2006] [Accepted: 08/16/2006] [Indexed: 11/22/2022]
Abstract
Elderly surgical patients constitute a unique surgical group. They require special consideration in order to preempt the long term adverse effects of anesthesia. This paper examines the proposition that general anesthesia causes harm to elderly patients with its impact being felt long after the anesthetic agents are cleared from the body. One complication, Postoperative Cognitive Decline (POCD), is associated with the administration of anesthesia and deep sedation. Its' occurrence may herald an increase in morbidity and mortality. Based on both human and animal data, this paper outlines a unitary theoretical framework to explain these phenomena. If this hypothesis proves to be correct, anesthesiologist should consider regional rather than general anesthesia for equivalent surgical procedures to reduce POCD and consequently achieving superior patient outcome.
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Affiliation(s)
- M C Lewis
- Miller School of Medicine, University of Miami, Miami, FL 33101, USA.
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