Age-Related Effects on Interoceptive Accuracy, General Interoceptive Sensibility, and Specific Interoceptive Sensibility

Abstract. Background: The current research into interoception distinguishes between interoceptive accuracy (IAcc), the accurate detection of internal sensations (e.g., heartbeats) as measured by performance on objective IAcc tasks, and interoceptive sensibility (IS), the subjective belief concerning one’s own experience of internal sensations as measured either through self-report questionnaires or through one’s confidence in the accuracy during an IAcc task. Aims: As the two measures of IS, however, are usually uncorrelated and show differential relationships to IAcc, we suggest different types of IS, a general IS and a specific IS. Further, based on a growing body of research linking IAcc and IS to physical and mental diseases, the development of interoception across the adult lifespan is of importance. Methods: Using Structural Equation Modeling the present paper investigates the relationships among IAcc assessed by a heartbeat counting task, and the two proposed dimensions of IS in 138 participants ( Mage = 42.67, SDage = 18.77). Furthermore, we examine age-related differences in IAcc, as well as in general and specific IS. Results: In terms of the relationship between the three dimensions, general and specific IS were weakly correlated and exhibited different relationships to IAcc. Further, we found different age effects on the three interoceptive dimensions. Whereas IAcc decreased with age, specific IS tend to increase with age, and general IS remained unaffected by age. Conclusion: The findings provide further empirical support for a dissociation between general and specific IS and raised important questions concerning the relation between interoceptive accuracy and the emergence of physical diseases in older age.

Intraindividual reaction time variability predicts prospective memory failures in older adults

This study investigated the relationship between intraindividual variability (IIV) in reaction time and prospective memory errors in older adults using data from the Zurich Longitudinal Study of Cognitive Aging (n = 336 individuals aged 66-81 years). The results indicated that increased IIV measured from independent tasks was associated with a greater proportion of prospective memory errors. These significant findings were not influenced by age and did not vary according to prospective memory cue type. Variability is thought to reflect fluctuations in attentional and executive control and these attentional processes may also impact on prospective memory through failure to detect the target cue. The findings suggest, therefore, that measures of variability may have some potential in the identification of older persons who are more vulnerable to everyday errors such as prospective memory failures.

Continuous subcutaneous insulin infusion leads to immediate, stable and long-term changes in metabolic control

BACKGROUND

Evaluations of continuous subcutaneous insulin infusion (CSII) usually focus on one pre- and one post-CSII measurement to assess metabolic therapy outcome.

AIM

Extending this research, the aim of the present study was to provide a more fine-grained analysis of achieved glycaemic control.

METHODS

In 52 patients with type 1 diabetes (mean age of 37.85 years at CSII begin; s.d. +/- 12.41), haemoglobin A(1c) (HbA(1c)) levels were assessed every 3 months over a period of 5 years (1 year before and 4 years after the introduction of CSII). Mixed models were utilized to describe changes in glycaemic control.

RESULTS

The pre-post course showed that already in the first quarter, a statistically significant lower HbA(1c) level was obtained [7.30%, in contrast to 8.21% at the last quarter with intensified conventional therapy (ICT)]. In the following 15 quarters, the mean HbA(1c) levels remained constantly lower than that with ICT. Overall, the aggregated mean HbA(1c) level of patients with CSII therapy was 7.19%, in contrast to 8.08% with ICT; thus, an overall decrease by 11% was achieved. In addition, individual differences in blood glucose level and age of diabetes onset as a predictor for therapy success were analysed.

CONCLUSIONS

The data show an immediate, stable and long-term effect of CSII on HbA(1c). In addition, a significant relationship between metabolic control and age of diabetes onset was found, as well as a reduction of variance in HbA(1c) levels between subjects after change to CSII.

Life-long intellectual activities mediate the predictive effect of early education on cognitive impairment in centenarians: a retrospective study

The purpose of this study was to examine the hypothesis of whether early education and/or maintaining intellectual activities over the life-course have the power to protect against cognitive impairment even in extremely old adults. Ninety centenarians from the population-based Heidelberg Centenarian Study were assessed with a modified version of the Mini Mental State Exam (MMSE). Data about education, occupational status, and life-long intellectual activities in four selected domains were obtained. Results demonstrated that 52% of the sample showed mild-to-severe cognitive impairment. Analyzing the influence of early education, occupational status, and intellectual activities on cognitive status we applied several (logistic) regression analyses. Results revealed independent, significant and strong influence of both formal school education and intellectual activities on the cognitive status in very late life, even after controlling for occupational status. However, about one fourth of the effect of early education on cognitive status was exerted indirectly via the assessed intellectual activities. In summary, the present study provides first evidence for the conclusion that even with regard to cognitive performance in very old age, both early education and life-long intellectual activities seem to be of importance.

[Subjective cognitive dysfunctions in the elderly: a change-oriented viewpoint]

The relation between subjective cognitive complaints and the actual level of cognitive performance in the elderly is of interest in both basic and applied cognitive research. However, most studies suggest a small to moderate correlation between complaints and actual performance. In contrast to previous studies, we examined the relation between changes in fluid and crystallized intelligence, changes in memory performance, and changes in subjective cognitive complaints in a sample of 465 older adults (M = 62.9 years) at two measurement occasions four years apart. The results indicate significant relationships between changes in subjective complaints and changes in memory performance and changes in fluid intelligence. The discussion focuses on the importance of a change-oriented view in examining subjective cognitive complaints from an applied perspective.

[Success and variability of success of inpatient rehabilitation of the elderly: an empirical study based on medical-psychiatric and psychosocial indicators]

This study considers findings of psychological gerontology as particularly important for geriatric rehabilitation research. Its concrete aim was to describe the course and outcome of geriatric rehabilitation based on a wide range of success criteria, to explore the influencing role of age, sex, and diagnosis as well as to describe the variability pattern of success. The data were gathered from a sample of 100 older adults who underwent treatment in a German inpatient rehabilitation unit. Participants were assessed across five measurement occasions by use of a state-of-the-art geriatric assessment and a psychological data collection part. The results underline, for one, that significant improvements of functional as well as psychological capacity were obtained. Second, age and sex played practically no role concerning the course of the success criteria, whereas diagnosis revealed some statistically meaningful effects. Third, it was found that the variability of success was characterized by a relatively homogeneous pattern of gain with regard to functional criteria; with respect to psychological variables, heterogeneity was more pronounced and some participants show loss as well, a chance for further improvement of the geriatric rehabilitation.

Everyday competence in visually impaired older adults: a case for person-environment perspectives

In this article, the need for an explicit consideration of the environment in order to address everyday competence (EC) in old age is illustrated based on an analysis of the day-to-day challenges of visually impaired older adults. Data are based on a sample of elderly adults suffering from different degrees of visual impairment (visually severely impaired vs blind, each N = 42) and a control group of visually unimpaired elderly persons (N = 42) with age means between 74.9 and 76.8 years. Findings underscore that: (a) EC, regarded as an outcome, is negatively affected by low person-environment fit in the home environment in visually impaired older adults but not in the visually unimpaired elderly population; (b) EC, understood as daily compensatory processes, is more pronounced in the visually impaired with respect to some compensation modes (e.g., use of latent skills), but not all; and (c) EC, as a predictor variable for outdoor behavior, assumes a particularly critical role when outside environmental press is high.

[Speed of information processing and fluid intelligence in advanced age. A secondary analysis of data of the Bonn Longitudinal Study of Aging based on "latent growth curve models"]

According to the "speed"-hypothesis of cognitive development, the slowing of information processing in old age is at the core of negative age differences in psychometric intelligence. The present study investigates the "speed"-hypothesis for fluid intelligence at the individual level using Latent Growth Curve Methodology. Data on 4 measurement points come from the Bonn Longitudinal Study of aging (N = 127, mean age 67.2, 53% women). Based on principal factor analysis, markers of mental speed were the WAIS Digit Symbol Test and a simple psychomotor task. As indicators of fluid intelligence the WAIS Object Assembly and Block Design were used. After separately fitting Latent Growth Curve Models for the trajectory of mental speed and fluid intelligence, a combined model showed no statistically significant improvement of fit for freeing the covariance between the two slope-factors. Interpreting this result, contrary to the "speed"-hypothesis the intraindividual change of fluid intelligence does not relate to the according change of mental speed.