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Graves LV, Conaway Z, Weberg M, Lozano J, Mercer E, Larry M, Vergonia L. Sex-based dyad differences on informant reports of participants' daily functioning. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-9. [PMID: 38842328 DOI: 10.1080/23279095.2024.2362744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Functional assessment in neurocognitive evaluation is often provided via informant reports. These subjective reports can vary based on the characteristics of informants and their relationships with participants, such as informant sex. However, whether informant sex intersects with participant sex to impact subjective ratings of participants' daily functioning, and whether such effects mirror observed patterns in neuropsychological performance, has not been adequately examined with ethnoracially diverse samples. We examined differences among participant-informant sex-based dyads on subjective informant reports of participants' daily functioning (assessed via the Functional Activities Questionnaire [FAQ]), and whether any observed differences on reported functioning corresponded to differences in objective participant performance on neuropsychological performance, among middle-aged and older Hispanic/Latino (n = 543), non-Hispanic Black (NHB; n = 1030), and non-Hispanic White (NHW; n = 5356) adults in the National Alzheimer's Coordinating Center cohort (n = 6929). Analysis of covariance (ANCOVA) tests revealed significant dyad differences on FAQ scores in the NHB (p<.001) and NHW subsamples (p<.05), but not in the Hispanic/Latino subsample (p>.05). For the Hispanic/Latino and NHB subsamples, ANCOVA tests revealed no significant effects of dyad on neuropsychological performance (ps>.01), whereas for the NHW subsample, ANCOVA tests revealed significant dyad differences on performance in multiple cognitive domains (ps<.01). Nevertheless, the pattern of dyad differences on neuropsychological performance did not mirror the pattern of observed differences on FAQ scores in the NHW subsample. Findings and their implications, including potential contributions of other informant characteristics on observed dyad differences on reported functioning, are discussed.
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Affiliation(s)
- Lisa V Graves
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Zachary Conaway
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Mathilde Weberg
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Jennifer Lozano
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Elizabeth Mercer
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Maiya Larry
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
| | - Lorraine Vergonia
- Psychology Department, California State University San Marcos, San Marcos, CA, USA
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Chuang IC, Chen IC, Wu YR, Li KY. Prediction and mediation analysis for treatment responses to combined cognitive and physical training for older adults. Sci Rep 2024; 14:10571. [PMID: 38720025 PMCID: PMC11079002 DOI: 10.1038/s41598-024-61407-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024] Open
Abstract
Diminished cognitive and physical functions negatively affect the daily functions of individuals. Although combined cognitive and physical training prevents instrumental activities of daily living (IADL) disability in older adults, no predictive model or mediation analysis of IADL after combined training exists. This study aims to employ prediction and mediation analysis to identify the predictors of IADL performance and to elucidate the mediators of the association between baseline global cognition and subsequent IADL performance following combined cognitive and physical training. This study involved 177 participants aged 60 years and older who underwent combined training. Cognitive function was measured with the Montreal Cognitive Assessment (MoCA), Digit Symbol Substitution Test (DSST), Color Trails Test, Word List, and a dual task; physical function with the Timed Up and Go (TUG) test; daily function with the Lawton IADL Scale. We conducted regression analyses to identify the predictors of IADL performance, and mediation analysis to examine whether DSST and TUG mediate the relationship between MoCA and IADL. The pre-intervention DSST and TUG were significant independent predictors of post-intervention IADL. The association between the pre-intervention MoCA and post-intervention IADL was mediated by pre-intervention DSST and TUG. This study highlighted the importance of measuring and improving processing speed and functional mobility before and during interventions to enhance IADL outcomes.Trial registration: NCT03619577, 23/07/2018; NCT04689776, 29/12/2020.
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Affiliation(s)
- I-Ching Chuang
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No. 259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan
- Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - I-Chen Chen
- Department of Occupational Therapy, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan
| | - Yih-Ru Wu
- Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuan-Yi Li
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, No. 259, Wunhua 1st Rd., Gueishan Township, Taoyuan, 333, Taiwan.
- Department of Neurology, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.
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Donders J, Maher T. Clinical Utility of the Neuropsychological Assessment Battery Judgment Subtest in the Evaluation of Older Adults. Arch Clin Neuropsychol 2024:acae035. [PMID: 38712367 DOI: 10.1093/arclin/acae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 05/08/2024] Open
Abstract
OBJECTIVE The purpose of this retrospective archival study was to explore the clinical utility of the Judgment subtest of the Neuropsychological Assessment Battery (NAB) in older adults who were referred because of cognitive concerns. Specifically, we were interested in how NAB Judgment covaried with other measures of executive functioning. METHOD 226 adults, aged 61-89 years (48% dementia, 35% mild cognitive impairment, 18% cognitively intact) completed NAB Judgment. They also completed Trail Making Test (TMT) A and B. In addition, Behavior Rating Inventory of Executive Function (BRIEF-A) informant and self-reports were obtained to measure executive functioning in daily life. RESULTS Scores on NAB Judgment did not correlate significantly with BRIEF-A informant ratings. However, there was a statistically significant correlation between BRIEF-A informant ratings and TMT B. Better performance on TMT B was associated with fewer informant concerns. Furthermore, subgroups with versus without informant BRIEF-A Metacognition indices in the range of impairment demonstrated a statistically significant difference on TMT B but not on Judgment. CONCLUSIONS Executive functioning in older adults should not be assessed using NAB Judgment alone. Such an evaluation should be supplemented with other in-person tests as well as informant ratings of daily functioning.
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Affiliation(s)
- Jacobus Donders
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Tracy Maher
- Department of Psychology, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
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Suchy Y, Gereau Mora M, Brothers SL, DesRuisseaux LA. Six elements test vs D-KEFS: what does "Ecological Validity" tell us? J Int Neuropsychol Soc 2024; 30:350-359. [PMID: 38465734 DOI: 10.1017/s1355617723000723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
OBJECTIVE Extensive research shows that tests of executive functioning (EF) predict instrumental activities of daily living (IADLs) but are nevertheless often criticized for having poor ecological validity. The Modified Six Elements Test (MSET) is a pencil-and-paper test that was developed to mimic the demands of daily life, with the assumption that this would result in a more ecologically valid test. Although the MSET has been extensively validated in its ability to capture cognitive deficits in various populations, support for its ability to predict functioning in daily life is mixed. This study aimed to examine the MSET's ability to predict IADLs assessed via three different modalities relative to traditional EF measures. METHOD Participants (93 adults aged 60 - 85) completed the MSET, traditional measures of EF (Delis-Kaplan Executive Function System; D-KEFS), and self-reported and performance-based IADLs in the lab. Participants then completed three weeks of IADL tasks at home, using the Daily Assessment of Independent Living and Executive Skills (DAILIES) protocol. RESULTS The MSET predicted only IADLs completed at home, while the D-KEFS predicted IADLs across all three modalities. Further, the D-KEFS predicted home-based IADLs beyond the MSET when pitted against each other, whereas the MSET did not contribute beyond the D-KEFS. CONCLUSIONS Traditional EF tests (D-KEFS) appear to be superior to the MSET in predicting IADLs in community-dwelling older adults. The present results argue against replacing traditional measures with the MSET when addressing functional independence of generally high-functioning and cognitive healthy older adult patients.
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Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Carvallo C, Ramos-Henderson M. Trail making test - black & white (TMT B&W): Normative study for the Chilean population. J Neuropsychol 2024. [PMID: 38676338 DOI: 10.1111/jnp.12364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/02/2024] [Accepted: 03/07/2024] [Indexed: 04/28/2024]
Abstract
The trailmaking test (TMT) has an educational bias that makes it inapplicable to people with low levels of education due to its dependence on the alphabet. The TMT standardization is the only one available in Chile, and there is a need for alternative ways of using the TMT that do not depend on the level of education for its applicability. To determine the normative scores of the TMT - black & white (TMT B&W), considering sociodemographic factors in adult and elderly Chilean population. A total sample of 227 participants (133 healthy, 94 cognitively impaired) from the Ageing Mets cohort were recruited from three areas in Chile (Antofagasta, Santiago, and Puerto Montt). The TMT B&W was administered to all participants. A multiple regression model was used to generate normative data only in the cognitively healthy group, considering the effect of age, education and sex. A significant effect of age was found in the score of the TMT B&W Parts A and B. The level of education influenced the part B of the test; however, the completion rate of the TMT B&W parts A and B was over 90% in cognitively healthy people. Norms for the number of errors were obtained, and differences between groups were found after controlling for the effect of age and education. This study is the first to provide normative data for the Chilean version of the TMT B&W and will benefit clinical neuropsychologists by improving the procedures for more accurately assessing executive functions and its impairments.
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Affiliation(s)
- Claudia Carvallo
- Centro de Investigación e Innovación en Gerontología Aplicada CIGAP, Facultad de Salud, Universidad Santo Tomás, Antofagasta, Chile
| | - Miguel Ramos-Henderson
- Centro de Investigación e Innovación en Gerontología Aplicada CIGAP, Facultad de Salud, Universidad Santo Tomás, Antofagasta, Chile
- Laboratorio de Neurociencia Cognitiva, Escuela de Psicología, Facultad de Humanidades, Universidad Católica del Norte, Antofagasta, Chile
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Mora MG, Suchy Y. Know thyself: Executive functioning and sex predict self-appraisal of functional abilities in community-dwelling older adults. Clin Neuropsychol 2023; 37:1686-1709. [PMID: 36779583 DOI: 10.1080/13854046.2023.2167738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/06/2023] [Indexed: 02/14/2023]
Abstract
Objective: The capacity for accurate self-appraisals of age-related changes in cognitive and functional abilities is integral to the maintenance of independence in later life, yet there is little understanding of the factors that place nondemented older adults at risk for poor self-awareness. This study examined the potential contributions of executive functioning (EF), crystallized intelligence (IQ-Cr), and sex in predicting congruence between performance and self-appraisals of instrumental activities of daily living (IADL) in a group of community-dwelling older adults. Method: A group of 150 nondemented, community-dwelling older adults (White and majority highly educated) completed measures of EF and IQ-Cr. Participants also completed five timed IADL tasks and self-appraised their performance relative to others of similar age. Results: Sex [F(1,148) = 7.75, p = .006, ηp2 = .05] and EF [(F(1,147) = 5.30, p = .02, ηp2 = .04)], but not IQ-Cr, predicted the relationship between performance and self-appraisals, such that those with lower EF and those of male sex overestimated their performance more than those with higher EF and females. Conclusions: Findings indicate that having average to below average EF abilities and being of male sex are risk factors for less accurate self-report of IADL abilities and as such might represent important considerations when assessing IADL abilities via self-report among largely independent, community-dwelling older adults.
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Affiliation(s)
| | - Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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Hoffmeister JR, Roye S, Copeland CT, Linck JF. Adaptive Functioning Among Older Adults: The Essence of Information Processing Speed in Executive Functioning. Arch Clin Neuropsychol 2023; 38:1082-1090. [PMID: 37114743 DOI: 10.1093/arclin/acad031] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2023] [Indexed: 04/29/2023] Open
Abstract
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.
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Affiliation(s)
- Jordan R Hoffmeister
- Department of Psychiatry and Behavioral Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Scott Roye
- Department of Psychiatry and Behavioral Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Christopher T Copeland
- Department of Psychiatry and Behavioral Sciences, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Mikneviciute G, Allaert J, Pulopulos MM, De Raedt R, Kliegel M, Ballhausen N. Acute stress impacts reaction times in older but not in young adults in a flanker task. Sci Rep 2023; 13:17690. [PMID: 37848597 PMCID: PMC10582047 DOI: 10.1038/s41598-023-44356-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/06/2023] [Indexed: 10/19/2023] Open
Abstract
Acute psychosocial stress effects on inhibition have been investigated in young adults, but little is known about these effects in older adults. The present study investigated effects of the Trier Social Stress Test on cognitive inhibition (i.e., ability to ignore distracting information) using a cross-over (stress vs. control) design in healthy young (N = 50; 18-30 years; Mage = 23.06) versus older adults (N = 50; 65-84 years; Mage = 71.12). Cognitive inhibition was measured by a letter flanker task and psychophysiological measures (cortisol, heart rate, subjective stress) validated the stress induction. The results showed that while stress impaired overall accuracy across age groups and sessions, stress (vs. control) made older adults' faster in session 1 and slower in session 2. Given that session 2 effects were likely confounded by practice effects, these results suggest that acute psychosocial stress improved older adults' RTs on a novel flanker task but impaired RTs on a practiced flanker task. That is, the interaction between stress and learning effects might negatively affect response execution when testing older adults on flanker tasks. If confirmed by future research, these results might have important implications especially in settings where repeated cognitive testing is performed under acute stress.
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Affiliation(s)
- Greta Mikneviciute
- NCCR LIVES-Overcoming Vulnerability: Life Course Perspectives, Swiss National Centre of Competence in Research, University of Geneva, Geneva, Switzerland.
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Boulevard du Pont d'Arve 28, 1205, Geneva, Switzerland.
| | - Jens Allaert
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Ghent Experimental Psychiatry Lab, Department of Head and Skin, Ghent University, University Hospital Ghent (UZ Ghent), Ghent, Belgium
| | - Matias M Pulopulos
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
- Ghent Experimental Psychiatry Lab, Department of Head and Skin, Ghent University, University Hospital Ghent (UZ Ghent), Ghent, Belgium
| | - Matthias Kliegel
- NCCR LIVES-Overcoming Vulnerability: Life Course Perspectives, Swiss National Centre of Competence in Research, University of Geneva, Geneva, Switzerland
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Boulevard du Pont d'Arve 28, 1205, Geneva, Switzerland
- Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Nicola Ballhausen
- Centre for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Boulevard du Pont d'Arve 28, 1205, Geneva, Switzerland
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
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9
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Pantoja-Cardoso A, Aragão-Santos JC, Santos PDJ, Dos-Santos AC, Silva SR, Lima NBC, Vasconcelos ABS, Fortes LDS, Da Silva-Grigoletto ME. Functional Training and Dual-Task Training Improve the Executive Function of Older Women. Geriatrics (Basel) 2023; 8:83. [PMID: 37736883 PMCID: PMC10514855 DOI: 10.3390/geriatrics8050083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/13/2023] [Accepted: 08/16/2023] [Indexed: 09/23/2023] Open
Abstract
Functional training (FT) is a type of multicomponent training with emphasis on activities of daily living that stimulate different physical capacities in only one session. Dual-task training (DTT) is a type of training that simultaneously applies cognitive and motor stimuli. We investigated the effects of sixteen weeks of FT and DTT and eight weeks of detraining on older women's inhibitory control, working memory, and cognitive flexibility. Sixty-two older women (66.9 ± 5.4 years; 27.7 ± 3.9 kg/m2) completed a 16-week intervention program comprising the FT (n = 31) and DTT (n = 31), and 43 returned after the detraining period. We used the Stroop Color Word Color test to evaluate inhibitory control, the Corsi Block Test to assess working memory, and the Trail Making Test to evaluate cognitive flexibility. Only DTT reduced the congruent response time between the pre-test and post-test (d= -0.64; p < 0.001), with no difference between the post-test and the detraining values (d = 1.13; p < 0.001). Both groups reduced the incongruent response time between the pre-test and post-test (FT: d = -0.61; p = 0.002; DTT: d= -0.59; p = 0.002) without a difference between groups. There were no significant differences in working memory and cognitive flexibility. Sixteen weeks of FT and DTT increased the inhibitory control of older women but not the working memory and cognitive flexibility, and these effects persisted after eight weeks of detraining.
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Affiliation(s)
- Alan Pantoja-Cardoso
- Postgraduate Program in Physical Education, Federal University of Sergipe, São Cristovao 49100-000, Brazil;
| | - Jose Carlos Aragão-Santos
- Postgraduate Program in Health Sciences, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (J.C.A.-S.); (N.B.C.L.)
| | - Poliana de Jesus Santos
- Postgraduate Program in Physiological Science, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (P.d.J.S.); (S.R.S.)
| | - Ana Carolina Dos-Santos
- Graduation in Physiotherapy, Federal University of Sergipe, São Cristovao 49100-000, Brazil;
| | - Salviano Resende Silva
- Postgraduate Program in Physiological Science, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (P.d.J.S.); (S.R.S.)
| | - Newton Benites Carvalho Lima
- Postgraduate Program in Health Sciences, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (J.C.A.-S.); (N.B.C.L.)
| | - Alan Bruno Silva Vasconcelos
- Postgraduate Program in Physiological Science, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (P.d.J.S.); (S.R.S.)
| | - Leonardo de Sousa Fortes
- Associate Graduate Program in Physical Education, Federal University of Paraiba, João Pessoa 58051-900, Brazil;
| | - Marzo Edir Da Silva-Grigoletto
- Postgraduate Program in Physical Education, Federal University of Sergipe, São Cristovao 49100-000, Brazil;
- Postgraduate Program in Health Sciences, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (J.C.A.-S.); (N.B.C.L.)
- Postgraduate Program in Physiological Science, Federal University of Sergipe, São Cristovao 49100-000, Brazil; (P.d.J.S.); (S.R.S.)
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Jaywant A, Blunt E, Jamison K, Kim N, RoyChoudhury A, Schiff ND, Kuceyeski A, Dams-O'Connor K, Shah S. Association Between the Attention Network Test, Neuropsychological Measures, and Disability in Post-Acute Traumatic Brain Injury. Neurotrauma Rep 2023; 4:318-329. [PMID: 37771426 PMCID: PMC10523404 DOI: 10.1089/neur.2022.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
Cognitive impairment after traumatic brain injury (TBI) is persistent and disabling. Assessing cognitive function in a reliable and valid manner, using measures that are sensitive to the integrity of underlying neural substrates, is crucial in clinical research. The Attention Network Test (ANT) is one such assessment measure that has demonstrated associations with neural regions involved in attention; however, clinical utility of the ANT is limited because its relationship with neuropsychological measures of cognitive function (i.e., its construct validity) has not yet been established in TBI. We evaluated the association between the ANT and 1) a neuropsychological battery assessing executive function and memory and 2) global function assessed by the Glasgow Outcome Scale-Extended (GOSE). Forty-eight adults with complicated mild-severe TBI were evaluated ∼5 months post-injury. Using principal component analysis and multi-variate linear regression adjusted for age, gender, education, and cause of injury, we found that ANT reaction time and executive network scores predicted a principal component assessing processing speed and executive function. Conversely, the ANT did not predict a principal component assessing memory. The ANT was weakly associated with the GOSE. Among persons with TBI during the post-acute phase of recovery, the ANT has good construct validity as evidenced by its associations with neuropsychological measures of processing speed and executive function, but not memory. Given that ANT networks are known to relate to specific neuroanatomical regions, the ANT may be a useful outcome measure for evaluating novel therapeutics targeting attention and executive functions after TBI.
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Affiliation(s)
- Abhishek Jaywant
- Department of Psychiatry, Weill Cornell Medicine, New York, New York, USA
- Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, New York, USA
- NewYork-Presbyterian Hospital, New York, New York, USA
| | - Emily Blunt
- Brain Injury Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Keith Jamison
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Nayoung Kim
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
| | - Arindam RoyChoudhury
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York, USA
| | - Nicholas D. Schiff
- Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA
- Department of Neurology, Weill Cornell Medicine, New York, New York, USA
| | - Amy Kuceyeski
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
- Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA
| | - Kristen Dams-O'Connor
- Brain Injury Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sudhin Shah
- Department of Radiology, Weill Cornell Medicine, New York, New York, USA
- Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA
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Hyodo K, Kitano N, Ueno A, Yamaguchi D, Watanabe Y, Noda T, Nishida S, Kai Y, Arao T. Association between intensity or accumulating pattern of physical activity and executive function in community-dwelling older adults: A cross-sectional study with compositional data analysis. Front Hum Neurosci 2023; 16:1018087. [PMID: 36760224 PMCID: PMC9905631 DOI: 10.3389/fnhum.2022.1018087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/26/2022] [Indexed: 01/26/2023] Open
Abstract
Objective Previous studies have suggested a positive association between physical activity (PA) and executive function in older adults. However, they did not adequately consider the compositional nature of daily time use and accumulated PA patterns. Therefore, this study aimed to examine the association between intensity or accumulated PA patterns and executive functions (inhibitory control, working memory, and cognitive flexibility) in community-dwelling older adults, considering the interaction of daily time spent in PA, sedentary behavior (SB), and sleep. Method This cross-sectional study used baseline data from a randomized controlled trial on the effect of exercise on cognitive function conducted between 2021 and 2022. Data from 76 community-dwelling older adults were used in the analysis. The time spent in PA and SB was assessed using an accelerometer, and sleep duration was self-reported. The Stroop task (inhibitory control), N-back task (working memory), and task-switching task (cognitive flexibility) were conducted to evaluate the subcomponents of executive function. Considering various potential confounders, compositional multiple linear regression analysis and compositional isotemporal substitution were performed to examine the association of PA with executive function and to estimate predicted changes in executive function in response to the hypothetical time-reallocation of movement behaviors, respectively. Results A longer time spent in light-intensity PA (LPA), relative to remaining behaviors, was associated with better Stroop task performance. Moreover, this association was stronger in LPA lasting longer than 10 min than in sporadic LPA. Additionally, theoretical 30 min/day time reallocation from SB or sleep to LPA was associated with better Stroop task performance (corresponding to approximately a 5%-10% increase). On the other hand, no significant associations of time spent in moderate- to vigorous-intensity PA with any subcomponents of executive function were observed. Conclusion LPA was positively associated with inhibitory control, and this association was stronger in bouts of LPA than in sporadic LPA. Moreover, reducing the time spent in SB or sleep and increasing the time spent in LPA, especially long-bout LPA, could be important measures for managing inhibitory control in late life. Future large longitudinal and intervention studies are needed to confirm these associations and reveal the causality and underlying mechanisms.
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van Dam K, Gielissen M, Reijnders R, van der Poel A, Boon B. Experiences of Persons With Executive Dysfunction in Disability Care Using a Social Robot to Execute Daily Tasks and Increase the Feeling of Independence: Multiple-Case Study. JMIR Rehabil Assist Technol 2022; 9:e41313. [PMID: 36326800 PMCID: PMC9672999 DOI: 10.2196/41313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/06/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
Background Executive functions are essential for independently navigating nearly all of our daily activities. Executive dysfunction often occurs as a result of a neurodevelopmental disorder. Persons with executive dysfunction experience challenges regarding independent execution of daily tasks. Social robots might support persons with executive dysfunction to execute daily tasks and promote their feeling of independence. Objective This study aimed to study the impact of interacting with social robot Tessa on goal attainment in the execution of daily tasks and perceived independence of persons with executive dysfunction. Methods In this multiple-case study, 18 participant–caregiver couples were followed up while using Tessa in the home environment for 3 months. Goal attainment on independently performing a self-determined goal was measured by the Goal Attainment Scale, and participant–caregiver couples were interviewed about their experience with their interaction with Tessa and how they perceived Tessa’s impact on their independence. Results In total, 11 (61%) participants reached their goal after 6 weeks and maintained their goal after 3 months. During the study period, 2 participant–caregiver couples withdrew because of mismatch with Tessa. Participants set goals in the following domains: execution of household tasks; intake of food, water, or medication; being ready in time for an appointment; going to bed or getting out of bed on time; personal care; and exercise. Participants perceived that Tessa increased the feeling of independence by generating more structure, stimulation, and self-direction. Participant–caregiver couples reported that the auditive information provided by Tessa was more effective in coping with executive dysfunction compared to their initial approaches using visual information, and the use of Tessa had a positive impact on their relationship. Conclusions This study paid ample time and attention to the implementation of a social robot in daily care practice. The encouraging findings support the use of social robot Tessa for the execution of daily tasks and increasing independence of persons with executive dysfunction in disability care.
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Affiliation(s)
| | | | | | | | - Brigitte Boon
- Academy Het Dorp, Arnhem, Netherlands
- Siza, Arnhem, Netherlands
- Tranzo, Tilburg University, Tilburg, Netherlands
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13
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Suchy Y, Lipio Brothers S, DesRuisseaux LA, Gereau MM, Davis JR, Chilton RLC, Schmitter-Edgecombe M. Ecological validity reconsidered: the Night Out Task versus the D-KEFS. J Clin Exp Neuropsychol 2022; 44:562-579. [PMID: 36412540 DOI: 10.1080/13803395.2022.2142527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Although executive functioning (EF) correlates with execution of instrumental activities of daily living (IADLs), tests of EF have been criticized for having poor ecological validity. Attempts have been made to develop new tests that approximate naturalistic daily tasks. However, the incremental utility of such tests has not been convincingly demonstrated. The Night Out Task (NOT) is a novel measure designed to increase ecological validity. This study examined whether the NOT correlates with traditional lab- and home-based measures of EF and IADLs, and whether it outperforms traditional measures of EF in predicting IADLs. METHOD Participants (50 adults aged 60 to 95) completed (1) the Delis Kaplan Executive Function System (D-KEFS) and IADLs in the laboratory, and (2) ecological momentary assessment of EF and daily IADL tasks at home across three weeks (using the Daily Assessment of Independent Living and Executive Skills protocol; DAILIES). RESULTS The NOT correlated with a lab-based measure of EF beyond covariates, and lab-based IADLs beyond covariates and beyond the D-KEFS. However, it was unrelated to at-home variables beyond covariates. In contrast, the D-KEFS was a significant predictor of at-home IADLs, and this association was mediated by at-home EF performance. CONCLUSION This study provides a preliminary validation of the NOT as a correlate of office-based performances in a primarily college educated white sample. Despite its high face validity, the NOT does not appear to sufficiently tap EF processes needed for home-based IADLs as measured by the DAILIES, although small sample size limits the interpretability of this negative finding.
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Affiliation(s)
- Yana Suchy
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | | | | | - Michelle M Gereau
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Justin R Davis
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
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14
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Wang P, Fang Y, Qi JY, Li HJ. FISHERMAN: A Serious Game for Executive Function Assessment of Older Adults. Assessment 2022:10731911221105648. [PMID: 35762827 DOI: 10.1177/10731911221105648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Executive functions (EFs) are essential for daily living activities but decline with age. Convenient assessment and timely intervention have particular significance for older adults. However, the traditional laboratory tasks of EFs are typically monotonous and inconvenient. The current study aimed to develop an interesting and convenient supplementary tool to assess EFs for older adults. According to the theory of EFs, we developed a serious game, FISHERMAN, to assess EFs. The game includes three subgames, Cautious Fisherman, Agile Fisherman, and Wise Fisherman, targeting core components of inhibition, shifting, and working memory, respectively. The current study aims to verify the reliability and validity of the game. One hundred and eight healthy older adults participated in this study and were tested through the FISHERMAN game and a battery of cognitive tests. The results show that the FISHERMAN game has high internal consistency reliability and good construct validity as well as criterion-related validity, suggesting that the game design is valid and can be used in EFs assessment for older adults. Future studies are warranted to establish the norm of the FISHERMAN game in older adults and investigate whether the FISHERMAN game can be generalized to other populations.
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Affiliation(s)
- Ping Wang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuan Fang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jing-Yi Qi
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Hui-Jie Li
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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15
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Arentsen TJ, Stubbs WJ, Lease SH, Adler MC, Ovrebo E, Jacobson JL. The relationship of the clinician-rated Functional Status Interview with executive functioning. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-13. [PMID: 35694761 DOI: 10.1080/23279095.2022.2084619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Self/informant-report and performance-based instruments are typically used to measure activities of daily living (ADLs) and instrumental activities of daily living (IADLs). Minimal attention has focused on clinician-rated measures. Executive functioning (EF) contributes significantly to functional independence, and the validity of functional status measures has been examined through its relationship to EF scores. The current study used a clinical sample of older U.S. Veterans who completed a neurocognitive evaluation (n = 266). The psychometric properties of a novel, clinician-rated Functional Status Interview (FSI) and its relationship to EF measures, including the Frontal Assessment Battery (FAB) and Trail Making Test (TMT-A and TMT-B), were explored. Two FSI factors (IADL and ADL) emerged with all items loading strongly onto the subscales as predicted. EF correlated strongly with IADL but had small to medium correlations with ADL. In regression models that controlled for sociodemographic variables, all EF measures uniquely contributed to the IADL model, but only FAB and TMT-A contributed to the model for ADL. Notably, results may have been limited by prominent floor effects on TMT-B. Overall, the FSI is a promising measure with demonstrated content validity. Thus, there is preliminary support for clinicians to incorporate multiple sources of information to rate functional status using the FSI.
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Affiliation(s)
- Timothy J Arentsen
- VA Memphis Medical Center, Mental Health Service, Memphis, TN, USA
- The University of Tennessee Health Science Center, Department of Psychiatry, Memphis, TN, USA
| | - Whitney J Stubbs
- G V Montgomery VA Medical Center, Mental Health Service, Jackson, MS, USA
| | - Suzanne H Lease
- The University of Memphis, Department of Counseling, Educational Psychology and Research, Memphis, TN, USA
| | - Marcy C Adler
- VA Memphis Medical Center, Mental Health Service, Memphis, TN, USA
- The University of Tennessee Health Science Center, Department of Psychiatry, Memphis, TN, USA
| | - Elin Ovrebo
- The University of Memphis, Department of Counseling, Educational Psychology and Research, Memphis, TN, USA
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16
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Roye S, Linck JF, Hoffmeister J, Copeland CT. OUP accepted manuscript. Arch Clin Neuropsychol 2022; 37:1555-1563. [PMID: 35596956 PMCID: PMC9582161 DOI: 10.1093/arclin/acac029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 11/22/2022] Open
Abstract
Objective Attention, inhibition, and processing speed are related to functional decline among older adults. This study attempts to clarify the relationships between these cognitive factors and adaptive functioning. Method We examined relationships between attention, inhibition, and processing speed, with scores on the Texas Functional Living Scale (TFLS), a performance-based measure of daily functioning, in a mixed clinical sample of 530 older adults who were referred for an outpatient neuropsychological evaluation. Results The current study used a confirmatory factor analysis (CFA) to derive a three-factor cognitive model consisting of attention, inhibition, and processing speed. Results from a hierarchical regression, which included factor scores from the CFA, revealed that processing speed was the only significant predictor of TFLS performance when all three cognitive factors were included within a single model. Conclusion These results highlight the influence of processing speed as an important indicator of functional decline among a clinical population of older adults.
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Affiliation(s)
- Scott Roye
- Corresponding author at: Neuropsychology Services, Department of Psychiatry and Behavioral Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA. Tel.: (405) 271-4468; Fax: (405) 271-8802. E-mail address: (Scott Roye)
| | - John F Linck
- Neuropsychology Service, Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jordan Hoffmeister
- Neuropsychology Service, Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Christopher T Copeland
- Neuropsychology Service, Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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17
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Hergert DC, Cimino CR. Predictors of Caregiver Burden in Huntington's Disease. Arch Clin Neuropsychol 2021; 36:1426–1437. [PMID: 33723593 DOI: 10.1093/arclin/acab009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 11/19/2020] [Accepted: 02/10/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Huntington's disease (HD) is a genetic neurodegenerative condition that is characterized by cognitive, motor, and psychiatric dysfunction. The purpose of this study was to explore which disease characteristics influence caregiver burden in HD. METHODS Fifty participants with HD and 50 of their caregivers participated in the study at the University of South Florida. Participants were administered a neuropsychological battery, the Unified Huntington's Disease Rating Scale (UHDRS) motor exam, and the Frontal Systems Behavior Scale (FrSBe) self-report. Caregivers completed the Caregiving Appraisal Scale and the FrSBe family-report. RESULTS There were significant correlations between caregiver burden and caregiver age and sex, UHDRS motor scores, cognitive functioning, and self and caregiver-reported FrSBe scores. The significant variables were entered into a regression model and explained 63.1% of the variance in caregiver burden scores. Caregiver age, cognitive functioning, and caregiver-reported FrSBe scores continued to be significant predictors of caregiver burden, whereas the other variables were no longer significant. CONCLUSIONS There were significant relationships between caregiver burden, cognitive functioning, and frontally mediated behaviors, but not motor scores. The results suggest that possible interventions for caregivers may include education to caregivers on how to cope with apathy/executive dysfunction and cognitive decline. Caregiver age was associated with burden, with younger age being associated with increased burden when controlling for symptom severity. This has implications for this population in that HD typically has a younger age of onset than other neurodegenerative diseases and therefore, these caregivers may be particularly at risk for caregiver burden.
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Affiliation(s)
- Danielle C Hergert
- New Mexico Department of Health, Developmental Disabilities Supports Division, Albuquerque, NM, USA
| | - Cynthia R Cimino
- Deparment of Psychology, University of South Florida, Tampa, FL, USA
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18
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Effectiveness of tDCS at Improving Recognition and Reducing False Memories in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031317. [PMID: 33535690 PMCID: PMC7908296 DOI: 10.3390/ijerph18031317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 01/27/2021] [Accepted: 01/29/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND False memories tend to increase in healthy and pathological aging, and their reduction could be useful in improving cognitive functioning. The objective of this study was to use an active-placebo method to verify whether the application of transcranial direct current stimulation (tDCS) improved true recognition and reduced false memories in healthy older people. METHOD Participants were 29 healthy older adults (65-78 years old) that were assigned to either an active or a placebo group; the active group received anodal stimulation at 2 mA for 20 min over F7. An experimental task was used to estimate true and false recognition. The procedure took place in two sessions on two consecutive days. RESULTS True recognition showed a significant main effect of sessions (p < 0.01), indicating an increase from before treatment to after it. False recognition showed a significant main effect of sessions (p < 0.01), indicating a decrease from before treatment to after it and a significant session × group interaction (p < 0.0001). CONCLUSIONS Overall, our results show that tDCS was an effective tool for increasing true recognition and reducing false recognition in healthy older people, and suggest that stimulation improved recall by increasing the number of items a participant could recall and reducing the number of memory errors.
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19
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Mejía ST, Nielsen KE, Raichur V, Carmichael AG, Tavares E, Jarvis J, Smith J, Gonzalez R. Assessment of Cognitive-Motor Performance Costs, Task Prioritization, and Adaptation to Dishwashing Under Increased Demand in Older Women With Arthritis. Innov Aging 2020; 5:igaa059. [PMID: 33614990 PMCID: PMC7874570 DOI: 10.1093/geroni/igaa059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Indexed: 11/21/2022] Open
Abstract
Background and Objectives Hand arthritis can limit upper-limb instrumental activities of daily living (IADLs) and require the recruitment of additional cognitive and motor resources to support performance. We devised a dual-task protocol for dishwashing to examine cognitive-motor performance costs and prioritizations under increased demands, processes of adaptation, and individual differences in performance costs. Research Design and Methods Sixty women with hand arthritis (aged 60–91) completed a standardized dishwashing protocol. Motor demand was increased via the properties of the soap dispenser. Cognitive demand was increased using audial attention and response inhibition tasks. The protocol was completed twice per lab visit on 3 occasions. Response time and dishwashing time provided measures of cognitive and motor task performance. Prioritization was determined by comparing the magnitude of dual-task cost (DTC) across tasks. Adaptation to the dishwashing protocol and novel dispenser was assessed by change in DTC across lab visits. Individual differences in cognitive and physical ability were assessed with the trail making B test and gait speed. Results Estimates from linear mixed-effects models revealed that response time increased, whereas dishwashing time decreased, during the dual-task study stages. Cognitive-motor prioritization effects were most pronounced among women with lower cognitive and physical ability. Evidence of prioritization and individual differences in DTC diminished across lab visits. Discussion and Implications The pattern of results suggests that older women with arthritis prioritize the motor over cognitive components of dishwashing, a common IADL. Adaptation across lab visits resulted in improved performance, reduced evidence of prioritization, and attenuated differences in DTC across physical and cognitive abilities.
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Affiliation(s)
- Shannon T Mejía
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois, US
| | - Karen E Nielsen
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, US
| | - Vineet Raichur
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, US
| | - Alicia G Carmichael
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, US
| | | | | | - Jacqui Smith
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, US
| | - Richard Gonzalez
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, US
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20
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Hergert DC, Pulsipher DT, Haaland KY, Sadek JR. Influence of age and education on a performance-based measure of everyday functioning. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:651-661. [PMID: 32758020 DOI: 10.1080/23279095.2020.1803323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Sociodemographic variables, such as age and education, influence the determination of impairment on neuropsychological tests, but their influence on impairment determinations for tests of everyday functioning is less well defined. Existing studies suggest that older age and lower education levels are associated with worse everyday functioning when assessed by self- or collateral-report. This relationship, however, has not been thoroughly investigated with performance-based methods of everyday functioning. This study aimed to determine the influence of sociodemographic factors on the Functional Impact Assessment (FIA), a performance-based measure of everyday functioning that includes measures of both accuracy and speed. Seventy-three healthy individuals, ages 42 - 88 years, completed the FIA and an additional everyday functioning self-report questionnaire (Functional Activities Questionnaire). Using a multiple regression statistical approach, age and education predicted overall FIA accuracy, while age alone predicted FIA speed. Sociodemographic variables continued to predict FIA performance when controlling for overall cognitive functioning. Sociodemographic variables were unrelated to FAQ scores. These findings indicate that age and education are associated with scores on a performance-based test of everyday functioning. Demographic corrections may improve accuracy in determining functional impairment, but more research is needed given the complex relationships among demographic factors, healthy aging, and dementia risk.
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Affiliation(s)
| | | | - Kathleen Y Haaland
- Department of Psychiatry & Behavioral Sciences, 1 University of New Mexico Way, University of New Mexico, Albuquerque, NM, USA
| | - Joseph R Sadek
- New Mexico VA Health Care System, Albuquerque, NM, USA.,Department of Psychiatry & Behavioral Sciences, 1 University of New Mexico Way, University of New Mexico, Albuquerque, NM, USA.,Department of Neurology, 1 University of New Mexico Way, University of New Mexico, Albuquerque, NM, USA
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21
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Sheppard DP, Matchanova A, Sullivan KL, Kazimi SI, Woods SP. Prospective memory partially mediates the association between aging and everyday functioning. Clin Neuropsychol 2019; 34:755-774. [PMID: 31304859 DOI: 10.1080/13854046.2019.1637461] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: Older adults commonly experience declines in everyday functioning, the reasons for which are multifactorial. Prospective memory (PM), or remembering to carry out intended actions, can be an executively demanding cognitive process that declines with older age and is independently associated with a variety of everyday functions (e.g. taking medication). This study examined the hypothesis that PM mediates the relationship between older age and poorer everyday functioning.Method: A total of 468 community-dwelling adults (ages 18-75) with a range of medical comorbidities (e.g. viral infection) were classified as dependent on four well-validated measures of manifest everyday functioning: activities of daily living, employment status, the Karnofsky Scale of Performance Status, and self-reported cognitive symptoms. Participants completed the Memory for Intentions Test (MIsT) to measure PM, alongside clinical tests of executive functions and retrospective memory.Results: Controlling for education and comorbidities, bootstrap analysis revealed a significant direct effect of age on everyday functioning and a significant mediated effect of age on everyday functioning through the indirect effect of time-based b = .006 [.003, .010] and event-based PM (b = .005, [.002, .009]), as well as slightly smaller effects for executive functions (b = .003, [.001, .005]) and retrospective memory (b = .002, [.001, .005]).Conclusions: These cross-sectional data suggest that executively demanding aspects of declarative memory play an important partial mediating role between an individual factor (i.e. age) and daily life activities, and highlight the possible benefit of targeting PM for improving everyday functioning in older adults.
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Affiliation(s)
- David P Sheppard
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Kelli L Sullivan
- Department of Psychology, University of Houston, Houston, TX, USA
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22
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Neurofeedback aus der Perspektive der Neurowissenschaften. PSYCHOTHERAPEUT 2019. [DOI: 10.1007/s00278-019-0351-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Lowe DA, Nguyen CM, Copeland CT, Linck JF. Factor Analysis of the Texas Functional Living Scale in an Outpatient Clinical Sample. Arch Clin Neuropsychol 2019; 35:116-121. [PMID: 30796805 DOI: 10.1093/arclin/acz005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/02/2019] [Accepted: 01/24/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Prior factor analysis of the Texas Functional Living Scale (TFLS), a performance-based measure of functional abilities, in a military veteran sample supported four factors discrepant from the published subscales. This study analyzed TFLS factor structure in a non-veteran clinical sample. METHOD Two hundred seventy adult outpatients completed the TFLS during neuropsychological evaluation. Principal axis factor analysis with oblique promax rotation was conducted with age and education effects partialed out. RESULTS Parallel analysis indicated five factors for extraction that accounted for a combined 48% of the variance. The first factor independently explained 26% of the total variance. Inspection of factor loadings suggested the following factor interpretations: complex calculations/time, complex visual search, praxis, memory, and basic calculations/math concepts. Five items did not significantly load onto any of the factors. CONCLUSIONS Current results did not entirely correspond to the published subscales or prior results in a veteran sample. Further clarification of the TFLS factor structure is warranted.
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Affiliation(s)
- Deborah A Lowe
- University of Oklahoma Health Sciences Center, Department of Psychiatry & Behavioral Sciences, Oklahoma City, OK, USA
| | - Christopher M Nguyen
- The Ohio State University, Wexner Medical Center, Department of Psychiatry & Behavioral Health, Columbus, OH, USA
| | - Christopher T Copeland
- University of Oklahoma Health Sciences Center, Department of Psychiatry & Behavioral Sciences, Oklahoma City, OK, USA
| | - John F Linck
- University of Oklahoma Health Sciences Center, Department of Psychiatry & Behavioral Sciences, Oklahoma City, OK, USA
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