Cognitive performance in a high-functioning community-dwelling elderly population

BACKGROUND: The purpose of this study was to examine the role of demographic factors as predictors of cognitive performance in a high-functioning, community-dwelling elderly population. METHODS: The study cohort consisted of 1,192 community-dwelling subjects, who were selected to represent the highest third of an elderly population with respect to physical and cognitive functioning. A neuropsychological battery, including 5 cognitive performance subtests (confrontation naming, delayed recognition span, similarities, figure-copying, and incidental delayed recall) was administered to the subjects in their homes. RESULTS: A summary measure of the 5 neuropsychological subtest scores, the total cognitive score, arrayed the study group across a broad range of difficulty, creating a near-normal distribution. Education, income, and race had statistically significant associations with the total score and the individual subtests. The effect of education was the most striking finding, explaining 30% of the variance in the total score. Education was most strongly related to the abstraction (partial R2 = .11) subtest, and least related to the memory subtests, delayed recognition (R2 = .02) and delayed recall (R2 = .01). CONCLUSIONS: Demographic factors are important predictors of cognitive performance in this high-functioning cohort. Education had the strongest influence on overall cognitive performance, and particularly notable associations with subtests that depended upon the use of previously learned materials. Longitudinal follow-up, now underway, will help to determine whether high levels of education help to maintain cognitive performance with age.     

The Geriatric Depression Scale and the Beck Depression Inventory as screening instruments in an older adult outpatient population.

Compared older adult outpatients with major depression (n?=?25) and healthy control Ss (n?=?25) using the Geriatric Depression Scale (GDS) and the Beck Depression Inventory (BDI). Both measures were sensitive in detecting clinical depression. Ss were, however, more likely to endorse multiple response on BDI items, suggesting that the GDS is simpler for older adults to complete. Viewed within the context of previous relevant research that used these instruments to compare older adults, the results yield additional evidence of cross-study consistency in the functional efficiency of both measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life stress, social support, and self-esteem in an elderly population.

Findings in previous studies of the stress-buffering properties of social support have been erratic. This study suggests that at least part of the reason for those inconclusive findings may be that researchers are using oversimplified models of the stress process and limited statistical approaches to assess the effects. The findings in this study indicate that social support (a) helps to reduce the deleterious effects of stress on emotional disorder primarily by bolstering the self-esteem of older adults and (b) affects psychological well-being only indirectly through self-esteem. Two distinct approaches to the statistical estimation of stress-buffering effects are also examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression in community-dwelling elders. Overcoming treatment obstacles with new antidepressants

Although depression is the most common psychiatric disorder among older adults, it continues to be misdiagnosed and undertreated in this population for a variety of reasons. The authors present an overview of the efficacy and side effects of antidepressant medications, pointing out advantages of new drugs that are especially important in older patients.     

Age differences and interindividual variation in cognition in community-dwelling elderly.

The cognitive test performance of 897 community-dwelling elderly Ss, aged 70 yrs and over, was examined for age trends and interindividual variation. Data were subjected to factor analysis, and 3 factors emerged (Crystallized Intelligence, Fluid Intelligence, and Memory). Over the age span sampled, Crystallized Intelligence, Fluid Intelligence, and Memory all decreased with the decrease being greatest for Fluid Intelligence and least for Crystallized Intelligence. Interindividual variation increased for Fluid Intelligence and Memory, but not for Crystallized Intelligence. These findings give support to the view that crystallized intelligence is lower in the very old and that there is a greater degree of variability in test performance with advancing age. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A measure of relational competence for community-dwelling elderly.

A measure of relational competence was developed to assess the skills necessary for peer friendship development among the elderly. Participants were required to respond to a series of social problem vignettes that were constructed to tap empathy, assertion, and role-taking skills. Validation data were collected as part of a larger project designed to establish indigenous, elderly peer-support telephone dyads among low-income, community-dwelling elderly women. Results indicated that the measure of relational competence was related to initial friendship formation, telephone conversational skills, and rated social competence as determined by judges' ratings of 2 telephone conversations between participants and staff members. The research illustrates the usefulness of moving away from trait conceptions of social competence to a more focused consideration of particular task demands and the skills needed to solve age-linked social problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression as measured by the DSM-III and the Beck Depression Inventory in an unselected adult population.

The National Institute of Mental Health Diagnostic Interview Schedule (DIS) and Beck Depression Inventory (BDI) were administered to 298 volunteers (average age 37.9 yrs) to determine the relation between DSM-III diagnosis of depression derived from the DIS and BDI scores of Ss. Results show that DSM-III diagnoses of depression were not associated with specific ranges of scores on the BDI, due to the heterogeneous nature of the category of dysthymic disorder. Using a cutting point of 9/10, sensitivity was 100%, specificity 86%, the proportion of false negatives 0%, and of false positives 13.7%, respectively. Upward adjustment of the cutting point on the BDI to 21/22 for research purposes reduced false positives to 1.4% but increased false negatives correspondingly to 52.4%. Upward adjustment of the cutting point on the BDI to 18/19 for epidemiologic purposes yielded an unbiased estimate of the prevalence of depression diagnosed by the DSM-III. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Satz-Mogel short form of the WAIS—R in an elderly, demented population.

Full administration of the Wechsler Adult Intelligence Scale—Revised (WAIS—R) was compared to a rescored Satz-Mogel short form of the WAIS—R (P. Satz and S. Mogel, 1962) in 51 elderly, demented individuals. The comparison revealed a high degree of association between these two forms. A smaller subset of 15 Ss was administered the Satz-Mogel short form and the full WAIS—R. Correlations between the two forms were significant for approximately half of the subtests and all of the subscales. No significant differences in means were found between forms. These findings are considered to represent some initial, positive support for the use of the Satz-Mogel short form of the WAIS—R in an elderly, demented population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression among elderly Chinese immigrants: an exploratory study

Despite an increase in the population of elderly Chinese immigrants, little is known about their mental health problems. The most prevalent mental health problem of elderly people-depression-often goes unrecognized and untreated. In an interview format, the author administered the Geriatric Depression Scale and measures of health status, living situation, stressful life events, and informal support to a community sample of 50 elderly Chinese immigrants recruited at senior centers and meal sites. Respondents who rated their health as good, who lived with others, and who were satisfied with help received from family members were least likely to be depressed. The impact of these factors on the mental health of elderly Chinese immigrants can be understood in light of their unique cultural values.     

Clinical parameters associated with falls in an elderly population

Cognitive function was investigated in a random sample of subjects on the general practitioners' registry of hypertensive patients in an inner city area and matched with normotensive controls. The response rate was 66% giving 90 matched pairs, average age 63 yrs, with 47% men. There was no difference in educational background or measures of reading ability between the two groups. Cognitive function tests showed a consistent trend of poorer performance in hypertensives, with significant differences in Verbal Learning (immediate recall and retention). Age was inversely related to cognitive function, but no additional deterioration with increasing age was shown in hypertensives.     

Psychometric evaluation of the Geriatric Depression Scale and the Zung Self-Rating Depression Scale using an elderly community sample.

In this study the psychometric properties of the Geriatric Depression Scale (GDS) and the Zung Self-Rating Depression Scale (SDS) were evaluated and compared, using a relatively large elderly community sample. The GDS generally performed well, replicating earlier findings from a different population. Also, as hypothesized, the SDS, which has a multiple-choice format, had a higher noncompletion rate than the GDS, which has a true–false format. Finally, no significant differences between the responses of young–old and old–old subjects were observed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive function in community-dwelling elderly with chronic medical conditions

OBJECTIVES: The aim of this study was to examine the effect of chronic medical conditions on cognitive function in a sample of community-dwelling elderly (N = 4528). METHODS: A checklist of 18 chronic medical conditions was used to determine whether respondents were suffering from specific disease states. The Mini Mental Status Examination (MMSE) was administered to assess cognitive functioning. RESULTS: Statistically controlling for the effects of age, education and depression, respondents with asthma/bronchitis and stroke had a tendency to perform worse on the MMSE than those without these conditions. None of the 18 medical conditions was associated with a greater proportion of respondents scoring below the cutoff for cognitive dysfunction. CONCLUSION: It appears that--with the possible exception of stroke and asthma/bronchitis-cognitive function in community-dwelling elderly is not consistently affected by specific disease states.     

Development and validation of a physical self-efficacy scale.

Conducted 6 studies, involving 861 undergraduates, to develop an individual-difference measure of physical self-efficacy with adequate psychometric properties. Factor analysis of 90 test items identified 2 underlying dimensions within a global measure of physical self-efficacy: Perceived Physical Ability and Physical Self-Presentation Confidence. Ss with positive perceptions of their physical competence outperformed Ss with poorer self-regard on 3 tasks involving the use of physical skills. Potential uses for the scale in medical, physical education, and clinical settings are discussed. (26 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Symptom representations and affect as determinants of care seeking in a community-dwelling, adult sample population.

The cognitive and emotional determinants of health-care utilization were assessed for middle-aged and older adults matched on age, gender, and health status. Both members of a pair were interviewed when either initiated a medical visit. Interviews were based on a self-regulatory model that assumed that Ss would use symptoms to create and update representations and coping procedures. Care seekers reported more symptoms than did matched controls but did not report more symptoms than did matched controls with new symptoms. The mere presence of atypical symptoms was insufficient to trigger care seeking. Care seeking is driven by well-developed representations of a serious health threat, perceptions of inability to cope with the threat, advice to seek care, and life stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression in elderly spouse pairs

Men, women, and children are subject to a number of disease conditions that have been documented over many centuries. Among the most recently described and the least understood of these conditions are autoimmune diseases. As we unfortunately have seen in recent years, the obscure nature of autoimmune disorders has allowed scientific distortion by individuals who stand to profit by claiming a cause-and-effect relationship among some types of autoimmune conditions and a number of medical products, resulting in a rapidly expanding use of "junk science" in our courtrooms. Attempts have been made recently to implicate a number of environmental factors in the development of autoimmune disorders, most notably silicone gel-filled breast implants. The controversies surrounding these alleged relationships have proved to be among the most contentious, costly, and dangerous events ever to occur in women's health care.     

Physical activity, functional limitations, and the risk of fall-related fractures in community-dwelling elderly

The ability of positron emission tomography (PET) to serve as a useful myocardial perfusion indicator is well established. We describe a methodology for obtaining reliable quantitative kinetic parameters from dynamic cardiac PET data. Reconstructed images of the myocardium are subdivided into three-dimensional volumes of interest which are used to obtain quantitative measures of myocardial perfusion over physiologically meaningful anatomical regions. The quantitation technique rigorously models the uncertainty of estimated parameters while compensating for effects such as patient motion and partial volumes to arrive at model parameters with well-established confidence intervals.     

Measuring faking in the employment interview: Development and validation of an interview faking behavior scale.

An Interview Faking Behavior (IFB) scale is developed and validated in 6 studies (N = 1,346). In Study 1, a taxonomy of faking behavior is delineated. The factor structure of a measure is evaluated and refined (Studies 2 and 3). The convergent and discriminant validity of the measure is examined (Study 4). The IFB scale consists of 4 factors (Slight Image Creation, Extensive Image Creation, Image Protection, and Ingratiation) and 11 subfactors (Embellishing, Tailoring, Fit Enhancing, Constructing, Inventing, Borrowing, Masking, Distancing, Omitting, Conforming, and Interviewer Enhancing). A study of actual interviews shows that scores on the IFB scale are related to getting a 2nd interview or a job offer (Study 5). In Study 6, an experiment is conducted to test the usefulness of the new measure for studying methods of reducing faking using structured interviews. It is found that past behavior questions are more resistant to faking than situational questions, and follow-up questioning increases faking. Finally, over 90% of undergraduate job candidates fake during employment interviews; however, fewer candidates engage in faking that is semantically closer to lying, ranging from 28% to 75%. (PsycINFO Database Record (c) 2010 APA, all rights reserved)