Memory self-efficacy and memory performance among black and white elders

Gendered racial differences and similarities in subjective cognitive decline and life satisfaction: results from a population-based sample

OBJECTIVE

The objectives of this study were to: 1) Determine the association between subjective cognitive decline (SCD) and life satisfaction; and 2) Assess the gendered racial/ethnic disparities in the association between SCD and life satisfaction.

METHOD

Data were obtained from 3,795 participants from the Behavioral Risk Factor Surveillance System survey. SCD was operationalized by "During the past 12 months, have you experienced confusion or memory loss that is happening more often or is getting worse?" Life satisfaction was operationalized by the question "In general how satisfied are you with your life?" Interaction terms of SCD*sex, SCD*race/ethnicity, and SCD*sex*race/ethnicity were used to determine potential effect measure modification. Crude and adjusted linear regression models, controlling for age, education, income and employment, were used to assess the association between SCD and life satisfaction by sex, race, and by gendered racial/ethnic groups: Black women, White women, Hispanic women, Other women; and Black men, White men, Hispanic men and Other men.

RESULTS

SCD was negatively associated with life satisfaction in the overall sample (β: -0.55; 95% CI: -0.66, -0.43). However, the negative associations seen across gender, race/ethnicity, and gendered racial/ethnic groups were statistically similar (p for interaction terms > 0.05). The highest effect estimate was seen for Other men (β: -1.22; 95% CI: -1.37, -1.09).

CONCLUSION

Interventions geared towards improving cognition may improve life satisfaction for all groups, irrespective of gender and/or race/ethnicity. Future research may include longitudinal studies to determine the temporal sequence between SCD and life satisfaction.

Differences in Subjective Memory Impairment, Depressive Symptoms, Sleep, and Physical Activity in African American and Asian American Elderly

Background: Subjective memory impairment (SMI) is associated with negative health outcomes including mild cognitive impairment and Alzheimer's disease. However, ethnic differences in SMI and disparities in risk factors associated with SMI among minority populations are understudied. The study examined the ethnic differences in SMI, whether SMI was associated with depressive symptoms, sleep, and physical activity (PA), and whether the associations vary across racial/ethnic groups. Methods: Participants included 243 African and Asian Americans (including Chinese, Vietnamese, and Korean Americans) aged 50 or older. Demographic information, SMI, depressive symptoms, daily sleeping hours, and PA levels were assessed. Results: Vietnamese Americans reported the highest SMI score. Depressive symptoms, sleeping hours, and PA levels were significantly associated with SMI. Depressive symptoms were the only significant factor across all ethnic groups. Significant interaction effects were found between ethnicity and health behaviors in predicting SMI. In particular, Vietnamese American participants with greater depressive symptoms and physical inactivity were significantly more likely to experience SMI compared to other ethnic groups Conclusions: Our findings demonstrate ethnic differences in SMI and its association with depressive symptoms, sleep, and PA, which highlight the importance of considering the unique cultural and historical backgrounds across different racial/ethnic groups when examining cognitive functioning in elderly.

Simultaneous cognitive-physical dual task training based on fairy tales in older adults with mild cognitive impairment: A pilot study

In this study, we aimed to develop a simultaneous cognitive-physical dual-task training program based on familiar cultural backgrounds using fairy tales and to explore its feasibility and preliminary effects, including effects on neurophysiological, cognitive, and physical functions. A single-group pretest-posttest design (n = 9) was employed to evaluate the effects of the cognitive-physical intervention performed for 60-90 min once a week for 12 weeks. The findings showed that perceived memory and physical self-efficacy, muscle strength, and cognitive function were significantly increased after the intervention. Although the relative beta band power measured using electroencephalography showed a tendency to increase in eight brain domains after the 12-week intervention, the changes were not significant. Findings suggested that the intervention was feasible and provided beneficial effects on cognitive and physical functions in older adults with mild cognitive impairment. Future research on larger sample sizes using randomized controlled trials is needed to determine the effectiveness of such interventions on neurophysiological functions.

Subjective memory, objective memory, and race over a 10-year period: Findings from the ACTIVE study

The longitudinal associations between subjective and objective memory functioning in later life remain unclear. This may be due, in part, to sociodemographic differences across studies, given the hypothesis that these associations differ across racial groups. Using data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE; N = 2,694; 26% African American), multiple-group, parallel-process latent growth curve models were used to explore relationships between subjective and objective memory over 10 years and assess racial differences in these associations. Across African Americans and whites, we found bidirectional associations between subjective and objective memory such that greater self-reported forgetting at baseline predicted faster subsequent verbal episodic memory declines, and higher baseline objective memory scores predicted less increase in self-reported forgetting over time. However, rates of change in self-reported frequency of forgetting were correlated with rates of change in verbal episodic memory in whites, but not in African Americans. Subjective memory complaints may be a harbinger of future memory declines across African Americans and whites but may not track with objective memory in the same way across these racial groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Subjective Memory Complaints Are an Important Surrogate for Objective Cognitive Performance in African Americans

PURPOSE

Subjective memory complaints (SMCs) have been shown to be associated with lower neuropsychological test scores cross-sectionally. However, it remains unclear whether such findings hold true for African American (AA) older adults.

METHODS

Baseline visit data from the National Alzheimer's Coordinating Center database collected from September 2005 to March 2018 were used. Generalized linear mixed models specifying binomial distributions were used to examine how neuropsychological test scores affect the likelihood of reporting SMCs.

PATIENTS

Inclusion criteria were participants who reported AA as their primary race, 60 to 80 years of age, were cognitively unimpaired, and had a Mini-Mental Status Examination score ≥26. A total of 1021 older AA adults without missing data met the criteria.

RESULTS

A total of 258 participants reported a SMC. SMCs were more likely with lower scores on measures of episodic memory and processing; however, SMCs were also more likely with higher scores on a measure of working memory. Working memory appeared to mediate reporting of SMC among participants with lower episodic memory scores.

DISCUSSION

These findings demonstrate that SMCs are associated with lower scores on objective neuropsychological measures among older AAs. Additional work is needed to determine whether SMCs are further associated with a risk for clinical transition to mild cognitive impairment or dementia among AA older adults.

Memory training for adults with probable mild cognitive impairment: a pilot study

Background & Objectives: This pilot study aimed to evaluate the efficacy of memory training and health training intervention over a 24-month period in people with probable mild cognitive impairment (MCI). Research Design & Methods: Based on the accepted criteria, and the neuropsychiatric measures used in the trial, MCI was defined as a subjective change in cognition, impairment in episodic memory, preservation of independence of functional abilities, and no dementia. Without a neurological assessment, laboratory tests, and psychometric evaluation combined, some of our participants may have had dementia that we were unable to detect through neuropsychological testing. Of the 263 total participants, 39 met criteria for a diagnosis of MCI. There were 19 adults in the memory and 20 in health training conditions. Both groups received twenty hours of classroom content that included eight hours of booster sessions at three months post intervention. Hierarchical linear models (HLM) and standardized regression-based (SBR) analyses were used to test the efficacy of the intervention on immediate recall, delayed recall, subjective memory complaints, and memory self-efficacy. Age, education, depression, racial group, ethnic group, MMSE score, and baseline performance were included as covariates. Results: Over 24 months, the MCI group in the memory training condition showed better objective and subjective memory outcomes compared with the MCI group in the health training condition. Conclusions: Senior WISE Memory training delivered to individuals with MCI was able to forestall the participants' declining cognitive ability and sustain the benefit over two years in both subjective and objective memory function.

The relationships between perceived control and episodic memory in adulthood: a review

The goal of the current paper is to review the literature on the relationships between perceived control and episodic memory throughout adulthood. More specifically, three major questions are pursued: (1) Are higher levels of perceived control related to better memory performance? (2) Is the relationship between perceived control and memory similar or different as a function of age? (3) Does perceived control moderate memory decline? Although there is a great deal of evidence that perceived control and episodic memory are positively related in adulthood, the current review showed that very few studies have investigated whether age moderated this relationship. Moreover, only a limited number of studies have explored the role of perceived control in memory decline, and the results are inconsistent. We suggest some avenues for future research that could help understand by which mechanisms, and under what circumstances, perceived control and episodic memory are related across the lifespan.

Does Self-Efficacy Affect Responsiveness to Cognitive Speed of Processing Training?

OBJECTIVE

Older adults with higher self-efficacy may be more likely to benefit from some cognitive training approaches. We examined whether self-efficacy serves as a mediator or moderator of responsiveness to cognitive speed of processing training (SOPT).

METHOD

We used data from the Staying Keen in Later Life (SKILL) study (N = 128) and the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (N = 1,400). Both studies assessed cognitive speed of processing (Useful Field of View Test-UFOV) and self-efficacy among community-dwelling older adults who were either randomized to SOPT or control conditions. We constructed regression models examining self-efficacy as a predictor of training responsiveness.

RESULTS

Analyses from both studies indicated that participants' self-efficacy scores were not predictive of training gains from SOPT, as measured by UFOV performance.

DISCUSSION

Self-efficacy does not affect older adults' ability to benefit from cognitive SOPT.

Everyday memory strategies for medication adherence

The need to manage chronic diseases and multiple medications increases for many older adults. Older adults are aware of memory declines and incorporate compensatory techniques. Everyday memory strategies used to support medication adherence were investigated. A survey distributed to 2000 households in the Atlanta metropolitan area yielded a 19.9% response rate including 354 older adults, aged 60-80 years. Older adults reported forgetting to take their medications, more so as their activity deviated from normal routines, such as unexpected activities. The majority of older adults endorsed at least two compensatory strategies, which they perceived to be more helpful in normal routines. Compensatory strategies were associated with higher education, more medications, having concern, and self-efficacy to take medications. As memory changes, older adults rely on multiple cues, and perceive reliance on multiple cues to be helpful. These data have implications for the design and successful implementation of medication reminder systems and interventions.

Memory training interventions for older adults: a meta-analysis

A systematic review and meta-analysis of memory training research was conducted to characterize the effect of memory strategies on memory performance among cognitively intact, community-dwelling older adults, and to identify characteristics of individuals and of programs associated with improved memory. The review identified 402 publications, of which 35 studies met criteria for inclusion. The overall effect size estimate, representing the mean standardized difference in pre-post change between memory-trained and control groups, was 0.31 standard deviations (SD; 95% confidence interval (CI): 0.22, 0.39). The pre-post training effect for memory-trained interventions was 0.43 SD (95% CI: 0.29, 0.57) and the practice effect for control groups was 0.06 SD (95% CI: 0.05, 0.16). Among 10 distinct memory strategies identified in studies, meta-analytic methods revealed that training multiple strategies was associated with larger training gains (p=0.04), although this association did not reach statistical significance after adjusting for multiple comparisons. Treatment gains among memory-trained individuals were not better after training in any particular strategy, or by the average age of participants, session length, or type of control condition. These findings can inform the design of future memory training programs for older adults.

Relationships among nutritional self-efficacy, health locus of control and nutritional status in older Taiwanese adults

AIM

The purpose of this study was to examine the relationships among selected demographic characteristics, nutrition self-efficacy, health locus of control and nutritional status in older Taiwanese adults.

BACKGROUND

The number of older adults in Taiwan is increasing, and they have been shown to have poor nutritional status. However, little is known about the factors that lead to poor nutritional status in this population.

DESIGN

Correlational, cross-sectional study.

METHODS

Participants were randomly selected from two district public health centres in Yilan County, Taiwan. Of 162 individuals who met the study criteria, 156 agreed to participate and provided data on demographic information, nutrition self-efficacy (Cardiac Diet Self-Efficacy scale), health locus of control (Multidimensional Health Locus of Control scale) and nutritional status (Mini-Nutritional Assessment and serum albumin levels).

RESULTS

The majority of this sample was healthy men (60.9%) with a mean age of 72.29 years. The results indicated that age, educational level, current chronic diseases and chance health locus of control all affected nutritional status in terms of Mini-Nutritional Assessment scores, but only current chronic diseases explained significant variance in nutritional status in terms of albumin levels.

CONCLUSIONS

The current study integrated self-efficacy theory and Health Locus of Control theory to better understand how background characteristics, nutrition self-efficacy and Health Locus of Control relate to nutritional status in older Taiwanese adults. However, the overall predicted variance accounted for by predictors was small, further research is therefore necessary to gain a deeper understanding of nutritional status and its factors among older Taiwanese adults.

RELEVANCE TO CLINICAL PRACTICE

Nurses can help older persons identify factors that relate to their nutritional status and plan effective interventions to maintain healthy nutrition behaviours with the following risk characteristics: (1) lower level of education, (2) more chronic diseases and (3) external control orientation.

The SeniorWISE study: improving everyday memory in older adults

We tested whether at-risk older adults receiving memory training showed better memory self-efficacy, metamemory, memory performance, and function in instrumental activities of daily living than participants receiving a health promotion training comparison condition. We followed participants for 26 months. The sample was mostly female (79%) and Caucasian (71%), with 17% Hispanics and 12% African Americans; average age was 75 years, and average education was 13 years. The memory training group made greater gains on global cognition and had fewer memory complaints, but both groups generally maintained their performance on the other cognitive measures and instrumental activities of daily living (IADLs) throughout the 24-month study period. Black and Hispanic participants made greater gains than Whites did on some memory performance measures but not on memory self-efficacy. The unexpected finding that minority elders made the largest gains merits further study. This study contributed to the knowledge base of geropsychiatric nursing by providing evidence for an effective psychosocial intervention that could be delivered by advanced practice nurses.

Differential benefits of memory training for minority older adults in the SeniorWISE study

PURPOSE

Cognitive training improves mental abilities in older adults, but the benefit to minority elders is unclear. We conducted a subgroup analysis of subjects in the SeniorWISE (Wisdom Is Simply Exploration) trial to examine this issue.

DESIGN AND METHODS

SeniorWISE was a Phase 3 randomized trial that enrolled 265 nondemented community-dwelling older adults aged 65 years and older between 2001 and 2006. Participants were randomly assigned to 12 hr of either memory or health training.

RESULTS

The sample was 79% female, 71% Caucasian, 17% Hispanic, and 12% African American. On the Rivermead Behavioural Memory Test (RBMT), 28% of the sample scored normal, 47% scored poor, and 25% impaired. Memory performance changed differently over time depending on the demographic characteristics of participants. Both Hispanics and Blacks performed better than Whites on visual memory, and Blacks performed better over time on instrumental activities of daily living. On all performance measures, lower pretest scores were associated with relatively greater improvements over time.

IMPLICATIONS

Our analyses suggested that minority participants received differential benefits from the memory training; however, this remains speculative because the 3 ethnic groups in the sample were not equivalent in size. The question of why Black and Hispanic participants often made greater improvements needs further exploration.

A framework for cognitive interventions targeting everyday memory performance and memory self-efficacy

The human brain has the potential for self-renewal through adult neurogenesis, which is the birth of new neurons. Neural plasticity implies that the nervous system can change and grow. This understanding has created new possibilities for cognitive enhancement and rehabilitation. However, as individuals age, they have decreased confidence, or memory self-efficacy, which is directly related to their everyday memory performance. In this article, a developmental account of studies about memory self-efficacy and nonpharmacologic cognitive intervention models is presented and a cognitive intervention model, called the cognitive behavioral model of everyday memory, is proposed.

Comparing the efficiency of eight-session versus four-session memory intervention for older adults

Evidence that reduced treatment achieves similar outcomes is beneficial because shorter interventions may be more cost-effective and more acceptable to participants. We examined the effects of shortening a memory intervention for elders from eight sessions to four sessions. Shortening the intervention had little impact on either self-reported or performance measures of memory and daily living activities. Small to moderate effects were associated with positive changes in both groups. When examining cost-effectiveness, an eight-session intervention produced slightly greater gains in memory performance, but at a higher cost. Future studies should systematically vary key intervention components in more diverse samples.

The link between depressive symptoms, negative cognitive bias and memory complaints in older adults

OBJECTIVES

We sought to examine the relationship between depressive symptoms and subjective memory problems. We hypothesized that the relationship between depressive symptoms and poor subjective memory functioning is mediated by negative cognitive bias that is associated with hopelessness, a wish to die and low self-esteem.

METHODS

Complete data were available for 299 older adults with and without significant depressive symptoms who were screened in primary care offices and invited to participate, completed a baseline in-home assessment. Subjective memory functioning and psychological status was assessed with commonly used, validated standard questionnaires.

RESULTS

In regression models that included terms for age, gender and cognitive measures, depressive symptoms were significantly inversely associated with the global self-assessment of memory (beta=-0.019; p=0.006). When components of negative cognitive bias were included in the model (hopelessness, low self-esteem, a wish to die), the relationship of depressive symptoms with subjective memory problems was attenuated, consistent with mediation.

CONCLUSIONS

Our results suggest that assessment and successful interventions for memory complaints in non-demented older adults need to account for negative cognitive bias as well as depressive symptoms. Longitudinal research is needed to confirm our findings before a mediator relationship can be presumed.

Elder research: filling an important gap in psychology and law

In the past few decades, psychology-law as a discipline has made great strides in understanding and guiding public policies on issues related to eyewitnesses, confessions, juries, judges, juveniles, the mentally ill, and many others. As a field, we have largely neglected the oldest subset of the population, with only a few scholars focusing specifically on elder issues or systematically including elders in their studies. The current article is a call to research. It first outlines why elders should be considered as a specific subset of the population even though they have not been an area of focus in the field. Second, the article provides suggestions for integrating elder issues into more common psychology-law research as well as some new areas for research.

Memory performance and mild cognitive impairment in Black and White community elders

BACKGROUND

Deficits in memory performance are often nonspecific predictors of cognitive decline and may portend a diagnosis of mild cognitive impairment (MCI).

OBJECTIVE

We examined age, depression, education, gender, memory complaints, and race as related to memory performance because memory is a fundamental criterion from which MCI is evaluated.

METHODS

The study recruited Black and White adults, > or = 70 years of age, who lived in the community, spoke English, and were screened for no cognitive impairment. Bivariate analyses (t tests and Pearson correlations) and multiple regressions were performed.

RESULTS

The sample consisted of 89 African Americans and 83 Caucasian Americans. Compared to their White counterparts, Blacks had lower educational attainment, had lower baseline cognition and memory performance, were more likely to report symptoms of depression, and were more likely to have impaired memory performance. In the overall sample 52% were classified as having a poor memory, and 25% of the Caucasians and 44% of the Blacks were classified as moderately or severely memory impaired; however no difference in memory complaints was observed between the groups. Sixteen percent of the sample reported clinically significant depressive symptoms. Age and race were the statistically significant predictors of memory performance in the multiple regression analysis, even accounting for education, depression, gender, and memory complaints.

CONCLUSIONS

Why race remains a unique predictor is an unresolved issue in need of future research. Finally, using the three criteria available in this data set, 44% of the Blacks and 35% of the Caucasians in this sample would qualify for a diagnosis of MCI.

Older adults in the SeniorWISE study at risk for mild cognitive impairment

As part of a larger clinical trial, SeniorWISE (Wisdom Is Simply Exploration), this study provides baseline affective, cognitive, and functional ability data and reports on the likely incidence of mild cognitive impairment (MCI) in a tri-ethnic community sample of older adults (N = 265). Seventy-eight individuals had memory complaints, whereas 105 had none. Of the complainants, 32 had normal memory function and 46 had poor memory performance. Among those without memory complaints, 42 had no memory impairment and 63 had poor memory performance. Forty-six individuals (17%) met the criteria of poor everyday memory functioning and memory complaints whereas 81 (31%) would be considered to be at risk based on other MCI criteria. This pattern of results suggests that those with declining memory are less aware of their deficits in activities of daily living that their actual performance would suggest are occurring.

Older males, cognitive function, and alcohol consumption

We investigated the question, how do older men who drink alcohol differ from those who do not drink on measures of cognitive function, memory, affect, and health? Of the nonprobability sample of male participants (N = 60), 35 (58%) of the males reported some degree of alcohol consumption. Eleven men had one or more drinks per day, 14 had one or more drinks per week, and 9 were occasional drinkers. The drinkers reported significantly less depression, had higher self-reported general health and vitality, and had higher cognitive performance, cognitive flexibility, and verbal memory, and greater knowledge of memory processes.