Change in Cognitive Capabilities in the Oldest Old: The Effects of Proximity to Death in Genetically Related Individuals Over a 6-Year Period.

Change in cognitive abilities was assessed over a 6-year period in a sample of monozygotic and same-sex dizygotic twin pairs (N = 507 individuals), aged 80 and older (mean age = 83.3 years: SD = 3.1). who remained nondemented over the course of the study. Latent growth models (LGMs) show that chronological age and time to death are consistent predictors of decline in measures of memory, reasoning, speed, and verbal abilities. Multivariate LGM analysis resulted in weak and often negative correlations among rates of change between individuals within twin pairs, indicating greater differential change within twin pairs than occurs on average across twin pairs. These findings highlight several challenges for estimating genetic sources of variance in the context of compromised health and mortality-related change. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Change in cognitive functioning associated with ApoE genotype in a community sample of older adults.

The influence of a genetic risk factor, apolipoprotein E (apoE) ε4 variant, was assessed in older adults aged 70 to 94 on 3 occasions over 7 years. The results of latent growth curve analyses are reported for individuals genotyped for apoE at the 2nd measurement occasion (n = 601) and for a subsample of individuals without probable or definite dementia during the 1st or 2nd occasion (n = 434). ApoE-ε4 status was a significant predictor of level and change in memory performance and change in speed performance in the full sample, and of initial level and change in memory performance in the nondemented subsample. These results support previous findings that apoE-ε4 is associated with accelerated memory deterioration in individuals without clinical dementia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Socially desirable responding and the factorial stability of the NEO PI-R.

The goal of the present investigation is to compare the factor structure of the revised NEO Personality Inventory (NEO PI-R; P. T. Costa & R. R. McCrae, 1992) in samples of respondents differentially motivated to respond in a socially desirable manner. In the French sample, the authors compared the NEO PI-R structure of job applicants (N=12,631) subgrouped by relative degree of socially desirable responding with that of a normative sample (N=801). In the Belgian sample, the authors compared the NEO PI-R structure in naturally occurring groups, including job applicants (N=3,028), individuals receiving career counseling (N=221), and a normative sample (N=549). Results indicate that the NEO PI-R factor structure remained stable across all samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Individual variation for cognitive decline: Quantitative methods for describing patterns of change.

What are the best quantitative methods for studying cognitive decline? This question was investigated in a sample of 638 individuals aged 50 years and older from the Swedish Adoption/Twin Study of Aging. A battery of cognitive tests tapping multiple domains was administered to each individual from 2 to 7 times over a span of 10 years. Four methods of operationalizing cognitive decline were compared: change scores, a criterion-based method, least squares, and random effects regression (RER). The RER results were most consistent with a significant decline across measures and differences between demented and nondemented individuals. Predicted slopes from the RER model also showed the strongest interrelationships within and across cognitive domains as indicated by factor analysis results and stronger associations with demographic, health, and psychosocial predictors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects

BACKGROUND: Research on the dimensional structure and reliability of the Hospital Anxiety and Depression Scale (HADS) and its relationship with age is scarce. Moreover, its efficacy in determining the presence of depression in different patient groups has been questioned. METHODS: Psychometric properties of the HADS were assessed in six different groups of Dutch subjects (N = 6165): (1) a random sample of younger adults (age 18-65 years) (N = 199); (2) a random sample of elderly subjects of 57 to 65 years of age (N = 1901); (3) a random sample of elderly subjects of 66 years or older (N = 3293); (4) a sample of consecutive general practice patients (N = 112); (5) a sample of consecutive general medical out-patients with unexplained somatic symptoms (N = 169); and (6) a sample of consecutive psychiatric out-patients (N = 491). RESULTS: Evidence for a two-factor solution corresponding to the original two subscales of the HADS was found, although anxiety and depression subscales were strongly correlated. Homogeneity and test-retest reliability of the total scale and the subscales were good. The dimensional structure and reliability of the HADS was stable across medical settings and age groups. The correlations between HADS scores and age were small. The total HADS scale showed a better balance between sensitivity and positive predictive value (PPV) in identifying cases of psychiatric disorder as defined by the Present State Examination than the depression subscale in identifying cases of unipolar depression as defined by ICD-8. CONCLUSIONS: The moderate PPV suggests that the HADS is best used as a screening questionnaire and not as a 'case-identifier' for psychiatric disorder or depression.     

Correlated and Coupled Cognitive Change in Older Adults With and Without Preclinical Dementia.

Common factor aging theories state that correlations among cognitive age effects signify a single underlying causal process. The logic underlying this proposition was evaluated by examining correlated cognitive change in a sample of 391 initially nondemented older adults who were tested annually for up to 16 years. Between-person correlations among rates of change (range=.56-.61) were partly attributable to model misspecification and the aggregation of heterogeneous groups of individuals. Correlated within-person cognitive change was much stronger in the cases (.45-.51) than in the noncases (.07-.18). These results demonstrate that correlated change may either signify causal commonality or the cumulative effects of multiple age-related conditions that can affect multiple cognitive systems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A bifactor model of negative affectivity: Fear and distress components among younger and older youth.

The Positive and Negative Affect Schedule for Children (PANAS-C) is a 27-item youth-report measure of positive affectivity and negative affectivity. Using 2 large school-age youth samples (clinic-referred sample: N = 662; school-based sample: N = 911), in the present study, we thoroughly examined the structure of the PANAS-C NA and PA scales and fit a bifactor model to the PANAS-C NA items. Our exploratory factor analytic results demonstrated that negative affectivity is comprised of 2 main components—NA: Fear and NA: Distress—specifically among older youth. A bifactor model also evidenced the best model fit relative to a unidimensional and second-order factor structure of the PANAS-C NA items. The NA: Fear group factor evidenced significant correspondence with external criterion measures of anxiety. However, the original PANAS-C NA scale evidenced equal (and in some cases greater) correspondence with criterion measures of anxiety. We thus recommend continued usage and interpretation of the full PANAS-C NA scale despite the identification of the fear and distress group factors underlying general negative affectivity. The identification of these fear and distress group factors nonetheless suggest that negative affectivity may be comprised largely of a fear and distress component among older youth. The implications of these findings are discussed in relation to better understanding the structure of psychopathology across childhood development and informing the development of future treatments of negative emotions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Perceived experiences of anti-bisexual prejudice: Instrument development and evaluation.

This research describes the development and psychometric evaluation of the Anti-Bisexual Experiences Scale (ABES). Items were developed on the basis of prior literature, revised on the basis of expert feedback, and submitted to psychometric evaluation. Exploratory factor analysis of data from 350 bisexual participants yielded 3 factors of reported experiences of prejudicial treatment reflecting (a) Sexual Orientation Instability, (b) Sexual Irresponsibility, and (c) Interpersonal Hostility. This structure emerged with bisexual persons' reported experiences of prejudice from heterosexual people as well as from lesbian and gay people. Confirmatory factor analysis of data from a separate sample of 349 bisexual individuals supported the stability of this 3-factor structure. The data offered evidence of acceptable reliability (i.e., Cronbach's alphas of .81 to .94), convergent validity (i.e., with stigma consciousness, r = .37 to .54; with awareness of public devaluation, r = .28 to .41), and discriminant validity (i.e., for impression management, r = –.00 to .09). Relative levels of the various types of perceived experiences of anti-bisexual prejudice and the role of such experiences within the minority stress framework were also explored. With a separate sample of 176 bisexual individuals, data on the final 17-item version of the ABES yielded 2-week test–retest reliability coefficients of .77 to .89 and Cronbach's alphas of .86 to .96 across subscales. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measurement properties of the Center for Epidemiological Studies Depression Scale (CES-D) in older populations.

Two cross-sectional samples of adults were administered the 20-item Center for Epidemiological Studies-Depression Scale (CES-D). Confirmatory item factor analysis showed that L. S. Radloff's (see record 1979-10129-001) four factor model fit the data well, but that the four factors were highly intercorrelated. A simultaneous second-order factor model fitting a single second-order Depression factor also fit well. Multiple group analyses of the first-order solution yielded invariant unstandardized item factor loadings across samples and age groups. A Cohort (Age)?×?Sex ANOVA on the total and subscale scores revealed lower total CES-D and subscale (Well-Being and Depressive Affect) scores for older persons. The Somatic subscale showed no significant age differences. The results support the measurement validity of the CES-D for depression screening in older adult populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Finding the self in metacognitive evaluations: Metamemory and agency in nondemented elders.

Objective: Metacognitive methodologies are used to examine the integrity of self-referential processing in healthy adults and have been implemented to study disorders of the self-concept in neurologic and psychiatric populations. However, the extent to which metacognitive evaluations assess a uniquely self-evaluative capacity that cannot be explained fully by primary cognitive functions, demographics, or mood is not clear. The objective of the current study was to examine whether metamemory and a metacognitive test of agency shared a self-referential association that would not be explained by cognition, demographics, or mood. Method: Thirty-eight nondemented older adults (Mini Mental State Examination [MMSE] ≥24 and mean age = 68.13) participated in metacognitive testing and completed cognitive testing and mood questionnaires. Bivariate correlations were used to evaluate the association between metamemory and agency, and to determine the cognitive (memory, attention, and executive functioning), demographic (age and education), and mood (anxiety and depression) correlates of each. Correlates of metamemory and agency were then entered into linear regression models to determine whether any association between metacognitive measures remained. Results: Metamemory was associated with agency judgments (n = 27), specifically those on self-controlled rather than computer-controlled trials (r = .41, p = .03). Regression results supported a role for agency in predicting metamemory, above and beyond memory and education (β = .39, p = .034). Metamemory was also an independent predictor of agency judgments (β = .36, p = .049). Conclusions: The interrelation between metamemory and agency judgments suggests that metacognitive testing captures an important aspect of self-referential processing not otherwise assessed in a standard cognitive evaluation and may provide unique information about self-evaluative capacities in clinical populations. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Varicella vaccine in immunocompromised patients

OBJECTIVE: To determine the prevalence of depressive symptoms and their relationship to disability in older low vision patients. DESIGN: Panel study with 2-year follow-up. PARTICIPANTS: Community-residing older people (N = 31). MEASUREMENTS: Geriatric Depression Scale, Community Disability Scale, and Snellen visual acuity. RESULTS: Twelve of 31 patients (38.7%) had GDS scores > or = 11 at baseline. Two years later, 10 of these 12 patients remained depressed, and three of the 19 (15.8%) previously nondepressed patients had become depressed. Depressed patients tended to be more disabled functionally than nondepressed patients at follow-up. The correlation of disability with depression and with vision were examined for the entire sample and revealed a strong correlation between disability and depression (r = .40; P = .013) compared with that of disability and vision (r = .34; P = .032) at baseline and at follow-up: depression (r = .68; P = .001), vision (r = .45; P = .006). There was no significant correlation between depression and vision at baseline (r = .06; P = .383), but there was a trend toward correlation at follow-up (r = .28; P = .067). CONCLUSION: Depressive symptoms are prevalent and persistent among low vision patients and appear more highly related to disability than is vision. The frequent occurrence of depression and the availability of effective treatment argue for its recognition and treatment as possible ways to reduce disability in older persons with low vision.     

Constructing a short form of the Smoking Consequences Questionnaire with adolescents and young adults.

The goal of the present studies was to construct and validate a short form of the 50-item Smoking Consequences Questionnaire (SCQ; T. H. Brandon & T. B. Baker, 1991), a measure of smoking outcome expectancies. In Study 1, a 21-item short form (S-SCQ) was derived from a sample of 107 young adults previously treated for substance abuse. In Study 2, the measure was cross-validated on 125 adolescents in treatment for substance abuse. Confirmatory factor analyses revealed good model fit and factorial invariance for the 4 S-SCQ subscales across both samples. Validation analyses on each sample found that subscale scores generally correlated significantly with smoking-related variables. The present studies provide initial evidence for the utility of the S-SCQ when used with young adults and adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The dimensions of change in therapeutic community treatment instrument.

In this article, the authors describe the refinement and preliminary evaluation of the Dimensions of Change in Therapeutic Community Treatment Instrument (DCI), a measure of treatment process. In Study 1, a 99-item DCI, administered to a cross-sectional sample of substance abuse clients (N = 990), was shortened to 54 items on the basis of results from confirmatory factor analyses and item response theory invariance tests. In Study 2, confirmatory factor analyses of the 54-item DCI, completed by a longitudinal cohort of 993 clients, established and validated an 8-factor solution across 2 subpopulations (adults and adolescents) and 2 time points (treatment entry and 30-days postentry). The results of the 2 studies are encouraging and support use of the 54-item DCI as a tool to measure treatment process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Test of the Tripartite Model of Depression and Anxiety in Older Adult Psychiatric Outpatients.

This study examined the tripartite model of depression and anxiety in 131 psychiatric outpatients, ages 55-87. Confirmatory factor analyses revealed that a 3-factor model provided an adequate fit to the observed data, that the 3-factor model was empirically superior to 1- or 2-factor models, and that the 3-factor structure obtained in the current sample of older adult outpatients converged with that obtained on a separate, younger 'sample. Negative affect was significantly related to depression and anxiety symptoms and syndromes, and positive affect was more highly related to depression than anxiety symptoms and syndromes. Ways for taking into account possible age-associated differences in emotion in older adults and thus improving the conceptual model of anxiety and depression are briefly noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cervical ectopic thyroid

BACKGROUND: The apolipoprotein E (ApoE) e4 allele has been associated with an increased risk for Alzheimer's disease, whereas the e2 allele has been shown to be protective. Similar effects in Down's syndrome (DS) have been postulated but not yet demonstrated. METHODS: We obtained DNA from 221 DS individuals and from 162 population controls, and 77 DS children. Older DS subjects were evaluated for dementia and compared to age-matched DS controls. RESULTS: The DS sample with dementia (n = 31) had a significantly lower frequency of the ApoE e2 allele compared to age-matched nondemented DS controls (0% vs. 8.3%, p = .0136). The older DS population had a significantly lower frequency of ApoE e4 compared to population controls (11.7% vs. 20.6%, chi-square 8.9, p = .0028). CONCLUSIONS: The lower frequency of the e2 allele in demented DS subjects compared to age-matched nondemented DS controls suggests a protective effect for ApoE e2 in the development of dementia in DS. The lower frequency of ApoE e4 in our older DS sample compared to population controls points to a detrimental effect of the e4 allele on longevity.     

Confirming the three-factor structure of the quality of relationships inventory within couples.

The current study further validates the Quality of Relationships Inventory (QRI; G. R. Pierce, I. G. Sarason, & B. R. Sarason, 1991) by evaluating its factor structure in a sample of 572 partners from 286 couples. Confirmatory factor analysis was used to compare 3 different models of the QRI and to investigate the invariance of the factor structure of the QRI across gender and across relationship satisfaction. Analyses revealed that a 3-factor solution--consisting of 3 different but interrelated factors (a 7-item support factor, a 12-item conflict factor, and a 6-item depth factor)--best accounted for the data. The authors' findings suggest that full metric invariance holds across gender and across relationship satisfaction in the female subsample, whereas only partial metric invariance could be established for relationship satisfaction in the male subsample. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Exploring the structure of a neuropsychological battery across healthy elders and those with questionable dementia and Alzheimer's disease.

An exploratory factor analysis (EFA) and a series of confirmatory factor analyses were conducted on 17 variables designed to assess different cognitive abilities in a sample of healthy older adults. In the EFA, 4 factors emerged corresponding to language, memory, processing speed, and fluid ability constructs. The results of the confirmatory factor analyses suggested that a 5-factor model with an additional Attention factor improved the fit. The invariance of the 5-factor model was examined across 3 groups: a group of cognitively healthy older adults, a group of patients diagnosed with questionable dementia (QD), and a group of patients diagnosed with probable Alzheimer's disease (AD). Results of the invariance analysis suggest that the model may have configural invariance across the 3 groups but not metric invariance. Specifically, preliminary analyses suggest that the memory construct may represent something different in the QD and AD groups as compared to the healthy older adult group, consistent with the underlying pathology in early AD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Goal instability and later life adjustment.

A series of analyses on the goal instability personality construct, as measured by the Goal Instability Scale (GIS [S. B. Robbins and M. J. Patton; see PA, Vol 72:16362]), was conducted to establish the construct validity of goal instability as it relates to older adults. This construct was derived from Heinz Kohut's psychology of the self. The sample consisted of a total of 157 voluntary early retirees representing a cross section of worker types from a manufacturing industry. In the first analysis, a series of confirmatory factor analyses supported the hypothesis that the 10-item GIS measures a unitary construct. In the second analysis, GIS was found to be similar across age groups. These findings enhance the conceptual clarity of the goal instability construct and its relevance with regard to older adults. Goal instability may represent 1 negative aspect of a quest for self-continuity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Structure of four executive functioning tests in healthy older adults.

The authors examined the factor structure of 4 indicators of executive functioning derived from 2 new (i.e., Hayling and Brixton) and 2 traditional (i.e., Stroop and Color Trails) tests. Data were from a cross-sectional sample of 55- to 85-year-old healthy adults (N=427) from the Victoria Longitudinal Study. Confirmatory factor analysis (LISREL 8.52) tested both a 2-factor model of Inhibition (Hayling, Stroop) and Shifting (Brixton, Color Trails) and a single-factor model. The 2-factor model did not fit the data because the covariance matrix of the factors was not positive definite. The single-factor model fit the data well, χ2(2, N=427)=0.32, p=.85, root-mean-square error of approximation (RMSEA)=.00, comparative fit index (CFI)=1.00, goodness-of-fit index (GFI)=1.00. Moreover, the single-factor structure of executive functioning was invariant (configural and metric) across gender, and invariant (configural with limited metric) across age. Structural relations showed that poorer executive functioning performance was related to older age and lower fluid intelligence, χ2(11, N=418)=23.04, p=.02, RMSEA=.05, CFI=.97, GFI=.98. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor structure and measurement invariance of the Women's Health Initiative Insomnia Rating Scale.

As part of the Women's Health Initiative Study, the 5-item Women's Health Initiative Insomnia Rating Scale (WHIIRS) was developed. This article summarizes the development of the scale through the use of responses from 66,269 postmenopausal women (mean age=62.07 years, SD=7.41 years). All women completed a 10-item questionnaire concerning sleep. A novel resampling technique was introduced as part of the data analysis. Principal-axes factor analysis without iteration and rotation to a varimax solution was conducted for 120,000 random samples of 1,000 women each. Use of this strategy led to the development of a scale with a highly stable factor structure. Structural equation modeling revealed no major differences in factor structure across age and race-ethnic groups. WHIIRS norms for race-ethnicity and age subgroups are detailed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)