Well- and ill-defined measures of everyday cognition: relationship to older adults' intellectual ability and functional status

Demographically adjusted normative study of everyday cognition in the ACTIVE sample

Objective: The goals of this project were to (1) provide demographically adjusted normative data for three performance-based tests of everyday cognition: The Everyday Problems Test, Observed Tasks of Daily Living-Revised, and Timed Instrumental Activities of Daily Living and (2) examine the relationships between test performance and traditional cognitive test scores and relevant self-report measures. Method: A sample of 2,767 Black (n = 726) and White (n = 2,041) older adults (aged 65-94) in the ACTIVE baseline sample were included in this study. Normed scores adjusting for age, education, gender, and race were created using multivariable fractional polynomial regressions. Adjusted scores were unrelated to age, education, gender, and race. A Poisson regression was performed to predict participants' number of demographically adjusted low (<16th percentile) test scores. Results: Higher intellectual self-efficacy (coef = -0.20), immediate memory (-0.21), reasoning (-0.25), recognition vocabulary (-0.04), and digit-symbol substitution (-0.01) significantly predicted fewer low test scores while higher physical health related QOL (0.21) and daily activity limitations (0.10) significantly predicted more low test scores (p < .01). Conclusions: Generally, persons with more widespread impairment on the tests evinced more cognitive, emotional, and functional problems. The three demographically adjusted scores fit excellently on a single factor, which uniquely accounted for 19%-36% of variance in the three test scores, in excess of what was already explained by the covariates, indicating the presence of reliable shared variance among the three tests that was not attributable to demographics nor any of the other covariates.

A systematic exposure-wide framework leveraging machine learning to identify multidomain exposure factors and their joint influence on cognitive function: Evidence from a neurological cohort

INTRODUCTION

Cognitive decline has become a growing public concern, yet large-scale exposure data identifying the contributing factors remain limited.

METHODS

We conducted an exposure-wide association study involving 1142 participants and 207 exposures, using machine learning to assess the relative contribution and joint effects of key factors. Cluster analysis and intervention simulation trials helped identify high-risk subpopulations and the potential benefits of targeted interventions.

RESULTS

In adjusted mixed models, the socioeconomic status domain emerged as the strongest predictor of longitudinal global cognitive score (β = 2.91, p < 0.0001, q < 0.0001), while the dietary domain also played an important role in memory function. The cluster analysis found that the "unfavorable lifestyle" dominated phenotype was associated with the poorest cognitive outcomes. Simulation trials indicated that cognitive scores could improve by shifting individuals from unfavorable to favorable phenotypes.

DISCUSSION

Cognitive health requires multidomain interventions, particularly in the socioeconomic and dietary fields, and necessitates collaboration between government and individuals.

HIGHLIGHTS

The exposure-wide association study design, which assesses a broad range of exposures, is used to identify novel variables and understand their contributions to cognitive function. The findings from the multidomain analysis indicate that socioeconomic status is the most significant contributor to global cognitive function, while diet plays the largest role in memory function. Increasing the proportion of favorable phenotypes through multidomain interventions can significantly enhance public cognitive health.

Structural equation modelling of the role of cognition in functional interference and treatment nonadherence among haemodialysis patients

BACKGROUND AND OBJECTIVES

Cognitive impairment is common in haemodialysis patients and associated with adverse health outcomes. This may be due to cognitive impairments interfering with daily functioning and self-care, but evidence is limited. This cross-sectional study aims to explore the interrelationships between cognition and functional outcomes in haemodialysis patients.

METHODS

Haemodialysis patients completed measures of objective cognitive function (Montreal Cognitive Assessment), everyday problem-solving skills (scenario-based task), and subjective cognitive complaints (self-report). Participants also self-reported sociodemographic information, functional interference, treatment nonadherence, and mood and fatigue symptoms. Patients' clinical data including comorbidities and lab results were extracted from medical record. Structural equation modelling was performed.

RESULTS

A total of 268 haemodialysis patients (mean age = 59.87 years; 42.5% female) participated. The final model showed satisfactory fit: CFI = 0.916, TLI = 0.905, RMSEA = 0.033 (90% confidence interval 0.024 to 0.041), SRMR = 0.066, χ2(493) = 618.573 (p < .001). There was a negative association between objective cognitive function and subjective cognitive complaints. Cognitive complaints were positively associated with both functional interference and treatment nonadherence, whereas objective performance was not. Everyday problem-solving skills emerged as a distinct aspect of cognition not associated with objective performance or subjective complaints, but had additive utility in predicting functional interference.

CONCLUSIONS

Subjective cognitive complaints and everyday problem-solving skills appear to be stronger predictors of functional variables compared to objective performance based on traditional tests. Routine screening of everyday cognitive difficulties may allow for early identification of dialysis patients at risk of cognitive impairment, functional interference, treatment nonadherence, and poor clinical outcomes.

Cognitive and neuroscientific perspectives of healthy ageing

With dementia incidence projected to escalate significantly within the next 25 years, the United Nations declared 2021-2030 the Decade of Healthy Ageing, emphasising cognition as a crucial element. As a leading discipline in cognition and ageing research, psychology is well-equipped to offer insights for translational research, clinical practice, and policy-making. In this comprehensive review, we discuss the current state of knowledge on age-related changes in cognition and psychological health. We discuss cognitive changes during ageing, including (a) heterogeneity in the rate, trajectory, and characteristics of decline experienced by older adults, (b) the role of cognitive reserve in age-related cognitive decline, and (c) the potential for cognitive training to slow this decline. We also examine ageing and cognition through multiple theoretical perspectives. We highlight critical unresolved issues, such as the disparate implications of subjective versus objective measures of cognitive decline and the insufficient evaluation of cognitive training programs. We suggest future research directions, and emphasise interdisciplinary collaboration to create a more comprehensive understanding of the factors that modulate cognitive ageing.

Need for cognition is associated with the interaction of reward and task-load on effort: A verification and extension study

Here, we work to provide nuance around the assumption that people will work for rewards. We examine whether individuals' inherent tendency to mobilize cognitive effort (need for cognition, NFC) moderates this effect. We re-analyzed our existing data to verify an effect reported by Sandra and Otto (2018) regarding the association between NFC and reward-induced cognitive effort expenditure, using a more ecological cognitive task design and adding a psychophysiological measure of effort. Specifically, distinct from their short time course visual task-switching paradigm, we used a relatively long course auditory comprehension task paradigm. We found that, consistent with the original study, increased cognitive effort in response to incentive reward depends on individual differences in cognitive motivation (need for cognition). We also found that, to observe consistent phenomena, different indices of effort (behavioral and psychophysiological) need to be considered when evaluating the relationship between the effort expenditure and cognitive motivation. Pupil dilation showed an advantage over reaction time in revealing mental effort mobilized over a prolonged cognitive task. Our results suggest that assessing cognitive motivation when planning a behavior-change program involving reward feedback for positive performance could help to optimize individuals' effort investment.

Adaptation and validation of the Spanish version of the everyday cognition battery for assessing everyday cognition in older adults

Introduction

Ageing entails a series of neuroanatomical and neurophysiological changes in some cognitive processes that directly affect the daily life and autonomy of a person. We believe it is necessary to have tools that assess the cognitive functions that are essential for carrying out daily activities in an independent manner. The aim of this study was to translate the Everyday Cognition Battery (ECB) into Spanish, adapt it to the sociocultural context of Spain, and validate it by testing the psychometric properties, i.e., the reliability and validity of the translated version.

Methods

The translation and adaptation of the ECB into Spanish was carried out following the method recommended by Beaton et al., the process concluding with a pilot test to ensure that subjects were able to understand the scale correctly. Between March and October 2019, the study population voluntarily completed the translated version of each of the four subscales that make up the battery of tests.

The translated version was validated by analysing its psychometric properties, using reliability or internal consistency tests assessed with Cronbach’s alpha coefficient and validity tests analysed using correlation tables and Spearman’s correlation coefficient. The scale considered to represent the gold standard in the assessment of cognition was the Rapid Assessment of Cognitive Functions (RACF), and to assess Instrumental Activities of Daily Living (IADL) this was the Lawton and Brody Index.

Results

The total study population included 226 subjects, of which 52 participants were excluded, resulting in a study sample size of 174 older adults. The recognition, inductive reasoning and computation span tests showed good reliability (Cronbach’s alpha coefficient of > 0.827, > 0.836, and > 0.823, respectively), while the knowledge test showed questionable reliability with a Cronbach’s alpha coefficient of > 0.615. The validity analysis demonstrated that all the combinations of correlations of the different scales were significantly and positively related to one another.

Conclusions

The Spanish version of the ECB tool is socially and culturally equivalent to the original version, and both its validity and reliability for assessing everyday cognition in older adults have been demonstrated.

Performance-Based Everyday Problem-Solving in Patients With TBI

OBJECTIVE

The present study examined whether the everyday problems test (EPT), a performance-based measure of everyday problem-solving, can be considered a useful test in assessing functional independence in patients with traumatic brain injury (TBI). The relationship between EPT, cognitive abilities (i.e., selective attention, set switching, and working memory) and self-rated measures of everyday functioning and disability in these patients was also assessed.

METHOD

In this case-control study 25 postcomatose outpatients with TBI (age M = 35.9, SD = 14.21) from a neurorehabilitation unit and 25 matched controls were enrolled. Participants were administered the EPT along with neuropsychological tests of selective attention, set switching and working memory, and self-rated measures of everyday functioning and disability.

RESULTS

Patients with TBI were less accurate and slower than controls in the EPT; the two groups were accurately classified based on EPT completion time (likelihood ratio test χ2 = 28.67, R2 = 0.72, p < .001). In the patient group education and selective attention explained a large portion of variance in EPT accuracy (R2 = 0.53, p = .001), while only selective attention explained a significant portion of variance in EPT time (R2 = 0.24, p < .01). Self-rated measures of everyday functioning and disability did not significantly contribute to EPT performance variance.

CONCLUSION

Including performance-based measures as the EPT in a multifactorial approach to assessment can be useful for unraveling cognitive factors contributing to TBI's impact on everyday functioning. Since attentional processes seem to play a significant role in determining EPT performance, rehabilitation of functional independence should target this ability first.

The effectiveness of a training programme in everyday cognition in healthy older adults: a randomised controlled trial

BACKGROUND

Everyday cognition is the application of basic cognitive skills and knowledge of the specific cognitive domain for the resolution of problems that are integrated within the instrumental domains of functioning. The main objective is to evaluate the effectiveness of a Training Programme in Everyday Cognition in order to improve the levels of everyday cognition and global cognitive performance in older adults.

METHODS

A randomised controlled trial of two groups. The sample was composed of healthy older adults. The intervention of the experimental group consisted of an Everyday Cognition Training Programme, and the intervention of the control group consisted of a Conventional Cognitive Training Programme. The Rapid Assessment of Cognitive Functions test (ERFC) and the Everyday Cognition Battery test (ECB) were used to assess the intervention.

RESULTS

Total sample (n = 237) composed of 44 men and 223 women, with a mean age of 73.45 years. Statistically significant differences (p < 0.001) were evidenced between the control group and the experimental group in both the ECB and ERFC; in the final evaluation of the study and in the follow-up.

CONCLUSION

The use of a Daily Cognition Training Programme presents greater benefits in terms of both global cognitive performance and everyday cognition than the use of a Conventional Cognitive Training Programme in elderly adults.

TRIAL REGISTRATION

ClinicalTrials.gov : NCT04041999 . Retrospectively registered. Date of trial registration: 8th July 2019.

Dynamic awareness of age-related losses predict concurrent and subsequent changes in daily inductive reasoning performance

To address gaps in previous research, we examined daily within-person associations between awareness of age-related change (AARC) and cognitive performance in older adults. One hundred twelve adults aged 60-90 participated in an online daily diary study for nine consecutive days. On Day 1, they reported demographic information. On Days 2-9, they reported daily AARC, subjective age, and stressors and completed three tasks that gauged memory (word recall), perceptual speed (number comparison), and reasoning (letter series), respectively, once per day. Unconditional multilevel models revealed significant within-person fluctuations in daily cognitive performance and daily AARC. Controlling for age, education, health, and daily stressors, daily awareness of age-related losses was negatively associated with letter series scores of the same day and changes from one day to the next. The effects held over and above AARC gains and subjective age. Dynamic, naturally occurring perceptions of ageing may influence within-person concurrent and subsequent changes in reasoning performance on a daily basis and point to a promising avenue of intervention.

Education and Cognitive Functioning Across the Life Span

Cognitive abilities are important predictors of educational and occupational performance, socioeconomic attainment, health, and longevity. Declines in cognitive abilities are linked to impairments in older adults' everyday functions, but people differ from one another in their rates of cognitive decline over the course of adulthood and old age. Hence, identifying factors that protect against compromised late-life cognition is of great societal interest. The number of years of formal education completed by individuals is positively correlated with their cognitive function throughout adulthood and predicts lower risk of dementia late in life. These observations have led to the propositions that prolonging education might (a) affect cognitive ability and (b) attenuate aging-associated declines in cognition. We evaluate these propositions by reviewing the literature on educational attainment and cognitive aging, including recent analyses of data harmonized across multiple longitudinal cohort studies and related meta-analyses. In line with the first proposition, the evidence indicates that educational attainment has positive effects on cognitive function. We also find evidence that cognitive abilities are associated with selection into longer durations of education and that there are common factors (e.g., parental socioeconomic resources) that affect both educational attainment and cognitive development. There is likely reciprocal interplay among these factors, and among cognitive abilities, during development. Education-cognitive ability associations are apparent across the entire adult life span and across the full range of education levels, including (to some degree) tertiary education. However, contrary to the second proposition, we find that associations between education and aging-associated cognitive declines are negligible and that a threshold model of dementia can account for the association between educational attainment and late-life dementia risk. We conclude that educational attainment exerts its influences on late-life cognitive function primarily by contributing to individual differences in cognitive skills that emerge in early adulthood but persist into older age. We also note that the widespread absence of educational influences on rates of cognitive decline puts constraints on theoretical notions of cognitive aging, such as the concepts of cognitive reserve and brain maintenance. Improving the conditions that shape development during the first decades of life carries great potential for improving cognitive ability in early adulthood and for reducing public-health burdens related to cognitive aging and dementia.

Episodic memory contributions to autobiographical memory and open-ended problem-solving specificity in younger and older adults

Research indicates that episodic memory processes are required to access specific autobiographical events and the details encompassed by a single event for several functions, including remembering and personal problem solving. Since healthy cognitive aging is associated with episodic memory decline, we hypothesized that older adults would be impaired at producing specific autobiographical events and details in service of these two functions. To test this hypothesis, younger and older adults completed two tasks (generation and elaboration) across two experiments (autobiographical memory and problem solving). The generation task required participants to produce multiple specific event memories or solutions to cues within a 90-s time period. The elaboration task required participants to select a single memory or solution to describe in detail. We quantified the number of specific and non-specific responses provided during the generation task and scored the descriptions from the elaboration task for the number of episodic (internal) and non-episodic (external) details. Across experiment, older adults produced fewer specific responses (generation task) and fewer internal details (elaboration task) than younger adults. In addition, older adults generated more non-specific responses and external details than younger adults for the memory but not the problem-solving experiment. A correlational analysis showed that the number of specific responses (generation) and internal details (elaboration) correlated for the memory but not for the problem-solving experiment. These results show that age-related episodic memory decline impairs access to specific autobiographical events and detail information when remembering and problem solving, but that additional cognitive factors impact how these age declines present when solving problems.

Education and age-related decline in cognitive performance: Systematic review and meta-analysis of longitudinal cohort studies

Central theories of cognitive aging propose that education is an important protective factor for decline in cognitive performance in older age. We conducted a systematic review and meta-analysis of reported estimates of an association between educational attainment and change in performance in six cognitive domains (episodic memory, processing speed, verbal fluency, crystallized intelligence, fluid intelligence, and global ability) in the general population of older individuals. The systematic search (11^th of October 2019) identified 92 eligible articles. The episodic memory domain had the highest number of estimates (37 estimates from 18 articles, n = 109,281) included in the meta-analysis. The fewest estimates (6 estimates from 6 articles, n = 5263) were included for fluid intelligence. Pooled mean estimates from an inverse-variance weighted random effects analysis were not statistically significant and indicated that any association between education and change in cognitive performance is likely of a negligible magnitude. The estimates for education's role (one additional year) for change in cognitive performance ranged from -0.019 (95 % confidence interval, CI = -0.047, 0.010) to 0.004SD (CI = -0.003, 0.012) per decade. Even if the larger positive point estimates (i.e., protective effects) are selectively considered, the influence of education on change is still at least 12 times less important for the cognitive functioning of an older individual than the association between education and level of cognitive performance. Sensitivity analyses did not substantially alter these results. However, heterogeneity was substantial, and remained largely unexplained by mean age, mean educational attainment, Gini coefficient, GDP per capita, maximum follow-up period, and publication year. Overall, education is an important factor in aging due to its robust association with level of performance, but the current base of empirical evidence is not revealing a consistent and substantial association between educational attainment and changes in cognitive performance in the general population. Theories of cognitive aging must be updated to incorporate this pattern of findings.

Cognitive Aging and Dementia: A Life Span Perspective

This article summarizes empirical findings and theoretical concepts in cognitive aging and late-life dementia research. Major emphases are placed on (1) person-to-person heterogeneity in trajectories of cognitive change over time, (2) how trajectories of child cognitive development determine peak levels of adult cognitive function from which aging-related cognitive declines occur, and (3) how lifelong trajectories of cognitive function relate to the timing of severe cognitive impairments characteristic of dementia. I consider conceptual issues surrounding categorical vs. dimensional models of late-life dementia, and how current diagnostic approaches affect inferences in the empirical study of disease progression. The incomplete current understanding of the biological foundations of aging-related cognitive declines and the continuous nature of many biomarkers commonly used in dementia diagnosis and classification together pose both opportunities and challenges in the current research landscape. Research moving forward will benefit from accurately measuring and analyzing continuous variation in longitudinal trajectories of cognitive function.

My Problems Are Solvable: Idiographic Methods Offset Age Differences in Interpersonal Problem Solving Among Young, Middle-Aged, and Older Adults

This study tested the hypothesis that older adults retain high levels of everyday problem solving performance when confronting problems of maximal ecological relevance, identified through idiographic methods. Younger, middle-aged, and older adults completed a daily challenge questionnaire (DCQ) in which they reported problems of maximal personal relevance or idiographic problems. The large majority of the problems reported were interpersonal. We then assessed performance on an everyday problem-solving task in which participants generated solutions for idiographic problems as well as problems generated by group matched research participants representing each of two other age groups (e.g., older adults received their own problems plus problems generated by matched younger and middle-aged adults). Performance was measured by computing the total number of safe and effective solutions provided. Results fully supported our hypothesis; adults of all ages showed higher performance when solving their idiographic problems.

Medication adherence in renal transplant recipients: A latent variable model of psychosocial and neurocognitive predictors

Objective

Estimates indicate that 20–70% of renal transplant recipients are medication non-adherent, significantly increasing the risk of organ rejection. Medication adherence is negatively impacted by lower everyday problem solving ability, and associations between depressive symptoms, self-efficacy, and adherence are reported in renal transplant recipients. Nonetheless, to date, these associations have not been examined concurrently. Given the relationship between non-adherence and organ rejection, it is critical to gain a better understanding of the predictors of adherence in renal transplant recipients. To this end, we modeled relationships among cognitive abilities, depressive symptoms, self-efficacy, and adherence in this group.

Methods

Participants (N = 211) underwent renal transplant at least one year prior to participation. Adherence was measured via self-report, medication possession ratio, and immunosuppressant blood-level. Traditionally-measured neurocognitive and everyday problem-solving abilities were assessed. Depressive symptoms were measured via self-report, as were general and medication adherence related self-efficacy. Structural equation modeling was used to assess the fit of the model to available data.

Results

Everyday problem solving and self-efficacy had direct positive associations with adherence. Depressive symptoms were negatively associated with self-efficacy, but not adherence. Traditionally-measured neurocognitive abilities were positively associated with self-efficacy, and negatively associated with depressive symptoms.

Conclusions

We present a comprehensive investigation of relationships between cognitive and psychosocial factors and adherence in medically stable renal transplant recipients. Findings confirm the importance of everyday problem solving and self-efficacy in predicting adherence and suggest that influences of depressive symptoms and neurocognitive abilities are indirect. Findings have important implications for future development of interventions to improve medication adherence in renal transplant recipients.

"Do it-yourself": Home blood pressure as a predictor of traditional and everyday cognition in older adults

BACKGROUND

Hypertension guidelines recommend home blood pressure (HBP) monitoring in adjunct to office blood pressure (OBP) for its greater reproducibility and prognostic utility in the prevention of cardiovascular outcomes, especially stroke. To date, the relationship between HBP and cognitive function remains unexplored.

METHODS

We examined HBP as a cognitive predictor in a multi-ethnic group of community-dwelling adults aged 60 and over (N = 133) using neuropsychological measures and analyzed the data using multiple regression analyses. We also employed "everyday cognition" measures that have been found to have higher prognostic utility for real-world functioning than traditional cognitive tasks.

RESULTS

Good to perfect HBP monitoring compliance over seven days was achieved by 88.7% of the participants with superior reliability (ICC≥.96) to office readings. Higher home systolic BP and pulse pressure predicted worse processing speed, executive function, and everyday cognitive function, whereas lower home diastolic BP predicted worse everyday cognition. Office readings were similarly associated with everyday cognitive function but with no other cognitive measures.

CONCLUSION

Our findings are the first to validate HBP as a predictor of neuropsychological function in older adults beyond cognitive screening. Differential relationships among blood pressure variables and specific cognitive domains were observed. With proper standardization and training, we demonstrated that HBP can be obtained in a multi-ethnic community-dwelling older adult cohort. Our findings emphasize the importance of employing blood pressure and cognitive measures that are adequately sensitive to detect vascular-related cognitive impairment in a relatively healthy population. Implications regarding proper HBP measurement for hypertension management, cognitive health, and everyday function are discussed.

Cognitive Predictors of Everyday Problem Solving across the Lifespan

BACKGROUND

An important aspect of successful aging is maintaining the ability to solve everyday problems encountered in daily life. The limited evidence today suggests that everyday problem solving ability increases from young adulthood to middle age, but decreases in older age.

OBJECTIVES

The present study examined age differences in the relative contributions of fluid and crystallized abilities to solving problems on the Everyday Problems Test (EPT). We hypothesized that due to diminishing fluid resources available with advanced age, crystallized knowledge would become increasingly important in predicting everyday problem solving with greater age.

METHOD

Two hundred and twenty-one healthy adults from the Dallas Lifespan Brain Study, aged 24-93 years, completed a cognitive battery that included measures of fluid ability (i.e., processing speed, working memory, inductive reasoning) and crystallized ability (i.e., multiple measures of vocabulary). These measures were used to predict performance on EPT.

RESULTS

Everyday problem solving showed an increase in performance from young to early middle age, with performance beginning to decrease at about age of 50 years. As hypothesized, fluid ability was the primary predictor of performance on everyday problem solving for young adults, but with increasing age, crystallized ability became the dominant predictor.

CONCLUSION

This study provides evidence that everyday problem solving ability differs with age, and, more importantly, that the processes underlying it differ with age as well. The findings indicate that older adults increasingly rely on knowledge to support everyday problem solving, whereas young adults rely almost exclusively on fluid intelligence.

Positive affect predicts everyday problem-solving ability in older adults

OBJECTIVES

Increased symptom endorsement on the short form of the Centre for Epidemiologic Studies Depression (CES-D) Scale has been previously associated with lower everyday problem-solving (EPS) ability in older adults. However, given the multifactorial and complex nature of depressive symptoms, it remains unclear whether certain symptoms/aspects of depression account for this relationship. We examined established factor scores on the full version of the CES-D to assess their utility as predictors of EPS in an older adult cohort.

METHODS

Community-dwelling older adults (n = 103; age: 51-91) were administered the CES-D along with a measure of EPS ability assessing both social and practical EPS. Regression analyses were used to determine the relationships between variables.

RESULTS

Analyses revealed that increased CES-D scores predicted worse EPS ability in older adults (β = -.17, p < .05) beyond the effects of age, gender, and education. Regression analyses examining each CES-D factor score revealed that decreased positive affect (loss of hope/enjoyment in life; β = -.21, p < .01) remained the only significant predictor of decreased overall EPS scores beyond demographic variables, while depressed affect, interpersonal, and somatic factors were not significant predictors. Positive affect predicted both practical, as well as social EPS scores.

CONCLUSIONS

Current results extend previous findings by showing that the relationship between increased depressive symptoms and decreased EPS ability in older age may be primarily driven by anhedonia as opposed to other depressive symptoms.

A Comparison of Collaborative and Individual Everyday Problem Solving in Younger and Older Adults

To understand the conditions under which age differences in everyday problem-solving performance occur, this study investigated individual and collaborative problem solving. Younger (24 females, 24 males; M age = 19.98, SD = 1.43) and older adults (25 females, 24 males; M age = 71.14, SD = 6.65) worked either alone or with a same-sex friend to plan a cross-country trip to attend a wedding. Age differences favoring younger adults were found on three of eight performance measures: two component completion accuracy variables (i.e., city completion, Mt. Rushmore completion) and a composite variable that assessed overall performance. Younger adults also completed the task faster than did older adults. Collaborators outperformed individuals on the composite measure of overall performance and frequency of planning errors. Females committed more planning errors than males did. Younger and older adults' performances were predicted by different variables; however, basic abilities were not consistently significant predictors of performance for either younger or older adults. The results of the study suggest that task characteristics may differentially influence older and younger adults' collaborative performance.

Everyday Problem Solving among Four Groups of Individuals with Cognitive Impairments: Examination of the Discriminant Validity of the Observed Tasks of Daily Living—Revised

To examine the discriminant validity of the Observed Tasks of Daily Living—Revised (OTDL-R) assessment test, performance was compared across four groups of participants (N = 140) expected to have different problem-solving skills and everyday competencies (community-dwelling older adults, older adults living in nursing homes or assisted living facilities, individuals with schizophrenia, and individuals with brain injuries). Analysis of variance with covariates (age and education) was used to examine differences in total OTDL-R scores across the four groups. OTDL-R performance was significantly better for community-dwelling older adults and significantly worse for participants with schizophrenia than for all other groups. No statistically significant differences were found for older adults living in nursing homes or assisted living facilities or participants with brain injuries after controlling for age and education. The OTDL-R was found to be a sensitive performance-based assessment tool of potential importance for occupational therapists in assessing instrumental activities of daily living and problem-solving skills. Additional research is needed to more fully characterize the psychometric value of the OTDL-R for appropriate use by clinicians and researchers.

No Significant Effect of Prefrontal tDCS on Working Memory Performance in Older Adults

Transcranial direct current stimulation (tDCS) has been put forward as a non-pharmacological alternative for alleviating cognitive decline in old age. Although results have shown some promise, little is known about the optimal stimulation parameters for modulation in the cognitive domain. In this study, the effects of tDCS over the dorsolateral prefrontal cortex (dlPFC) on working memory performance were investigated in thirty older adults. An N-back task assessed working memory before, during and after anodal tDCS at a current strength of 1 mA and 2 mA, in addition to sham stimulation. The study used a single-blind, cross-over design. The results revealed no significant effect of tDCS on accuracy or response times during or after stimulation, for any of the current strengths. These results suggest that a single session of tDCS over the dlPFC is unlikely to improve working memory, as assessed by an N-back task, in old age.

Daily Fluctuations in Everyday Cognition: Is It Meaningful?

OBJECTIVE

This study examined whether there are daily fluctuations in everyday cognition that are consistent with daily fluctuations often observed in traditional measures of basic cognitive abilities.

METHOD

Two hundred six independently living older adults (age range = 60-91 years) were asked to complete a computerized cognitive battery over eight occasions within a 2- to 3-week period.

RESULTS

Using multilevel model, significant within-person variability was observed across the Daily Everyday Cognition Assessment (DECA; 46%), with 54% between-person variability. At each occasion, better performance on the DECA was significantly associated with better performance on simple reaction time ( p < .01) and memory (Auditory Verbal Learning Task, p < .01) even after accounting for time, age, education, and performance on other cognitive measures.

CONCLUSION

These findings demonstrate that within-person performance fluctuations can be observed for everyday cognition tasks, and these fluctuations are consistent with daily changes in basic cognitive abilities.

Age trajectories of everyday cognition in African American and White older adults under prompted and unprompted conditions

We investigated how race and verbal prompting interacted with age to predict age trajectories on a performance-based measure of everyday cognition. African American (n = 727) and White (n = 2052) older adults from the ACTIVE clinical trial were given the Observed Tasks of Daily Living (OTDL; a performance-based measure of medication management/finances/telephone use) at baseline and 1-, 2-, 3-, 5-, and 10-year follow-ups. When participants said "I don't know" or did not respond, they received a standardised verbal prompt, which served only as a cue to initiate the first step. At each occasion, unprompted (sum of items correct without prompting) and prompted (sum of correct prompted and unprompted items) scores were derived for each participant. Mixed effects models for change were used to determine the age trajectories of OTDL performance by race. When not prompted, African Americans demonstrated more rapid decline in OTDL performance than Whites, especially after age 80. When prompted, both groups had improved performance and evinced shallower decline, although African Americans continued to demonstrate a slightly more rapid decline. Simple prompting attenuated age-related changes of African Americans and Whites on a measure of everyday cognition. Prompting may be especially helpful for older African Americans.

APOE Genotype Affects Cognitive Training Response in Healthy Shanghai Community-Dwelling Elderly Individuals

BACKGROUND

Cognitive training may contribute to the ability to maintain cognitive function in healthy elderly adults. Whether genotype modifies training effects remains unknown.

OBJECTIVE

Assess influence of APOE on cognitive function over time in community-dwelling elderly adults participating in multi-domain cognitive training.

METHODS

Healthy individuals ≥70 years of age were screened from one urban community in Shanghai. 145 healthy Chinese older adults met inclusion criteria and were assigned to intervention (n = 88) or control (n = 57) groups. Multi-domain cognitive training involved 24 sessions of different content taking place over 12 weeks. Neuropsychological testing was administered at baseline, immediately after training, six months and twelve months post-intervention; composite measures of cognitive function were identified via factor analysis.

RESULTS

Three factors explained the majority of variance in function (verbal memory, processing speed, executive function). The intervention attenuated 12-month declines in processing speed, regardless of APOE genotype (p = 0.047). Executive function declined in APOEɛ4 carriers over 12 months, regardless of intervention (p = 0.056). There was a significant interaction after 12 months where intervention ɛ4 carriers had better processing speed than ɛ4 controls (p = 0.003). Intervention ɛ2 carriers had better executive function immediately after training (p = 0.02) and had better verbal memory 6-months post-intervention (p = 0.04). These effects remained significant after false-discovery rate correction.

CONCLUSION

Multi-domain cognitive training reduces declines in processing speed over time. APOEɛ4 is associated with reductions in executive function over time, and training may attenuate ɛ4-associated declines in processing speed. APOEɛ2 carriers may also benefit from training, particularly on measures of executive function and verbal memory.

Ten-year longitudinal trajectories of older adults' basic and everyday cognitive abilities

OBJECTIVE

To examine the longitudinal trajectories of everyday cognition and longitudinal associations with basic (i.e., laboratory and experimentally measured) cognitive abilities, including verbal memory, inductive reasoning, visual processing speed, and vocabulary.

METHOD

Participants were healthy older adults drawn from the no-treatment control group (N = 698) of the Advanced Cognitive Training for the Independent and Vital Elderly (Willis et al., 2006) randomized trial and were assessed at baseline and 1, 2, 3, 5, and 10 years later. Analyses were conducted using latent growth models.

RESULTS

Modeling revealed an overall inverted-U shape (quadratic) trajectory across cognitive domains. Among basic cognitive predictors, level and slope in reasoning demonstrated the closest association to level and slope of everyday cognition, and accounted for most of the individual differences in linear gain in everyday cognition.

CONCLUSION

Everyday cognition is not buffered against decline, and is most closely related to inductive reasoning in healthy older adults. To establish the clinical utility of everyday cognitive measures, future research should examine these associations in samples with more cognitive impairment.

Reasoning training in the ACTIVE study: how much is needed and who benefits?

OBJECTIVE

To characterize change through 5-year follow-up, associated with training, booster, adherence, and other characteristics.

METHODS

Sample included all individuals randomly assigned to reasoning training (N = 699). Piecewise latent growth modeling was used to examine trajectory of performance on outcome measures.

RESULTS

Training resulted in improved reasoning performance through Year 5. A significant third annual booster effect was one-half the size of the training effect. Training adherence resulted in greater training effects. Higher education, Mini-Mental State Exam (MMSE), better health, and younger age related to higher baseline performance. Higher MMSE was related to larger training effects, larger linear slopes, and smaller booster effects. Significant functional outcomes included a training effect for complex reaction time (CRT), and first annual booster effects for the CRT and observed tasks of daily living.

DISCUSSION

Initial training gain was comparable with magnitude of age-related cognitive decline over 5 years with no training. Neither age nor gender predicted training or booster effects, indicating the generality of training effects across age (65-90 years).

Cognitive longitudinal predictors of older adults' self-reported IADL function

OBJECTIVE

To examine basic and everyday cognitive predictors of older adults' self-reported instrumental activities of daily living (IADL).

METHOD

Basic and everyday cognitive predictors of self-reported IADL were examined in a sample of healthy, community-dwelling older adults (n = 698) assessed over 5 years of measurement.

RESULTS

Multilevel longitudinal analyses revealed linear and quadratic change trends for self-reported IADL function, with steeper declines at higher ages. Within-person, when participants exhibited lower cognitive performance, they also reported more IADL impairment. Everyday cognition remained a significant unique predictor of self-reported IADL after controlling for attrition, resampling effects, temporal gradients, and baseline levels and changes in demographic, sensory, functional, and basic cognitive measures.

DISCUSSION

By itself, everyday cognition appears to be an important predictor of self-reported IADL, and maintains a unique predictive contribution after many covariates are controlled. Future research should consider the inclusion of everyday cognitive measures in functional assessment batteries.

Differential contributions of executive and episodic memory functions to problem solving in younger and older adults

The relationship of higher order problem solving to basic neuropsychological processes likely depends on the type of problems to be solved. Well-defined problems (e.g., completing a series of errands) may rely primarily on executive functions. Conversely, ill-defined problems (e.g., navigating socially awkward situations) may, in addition, rely on medial temporal lobe (MTL) mediated episodic memory processes. Healthy young (N = 18; M = 19; SD = 1.3) and old (N = 18; M = 73; SD = 5.0) adults completed a battery of neuropsychological tests of executive and episodic memory function, and experimental tests of problem solving. Correlation analyses and age group comparisons demonstrated differential contributions of executive and autobiographical episodic memory function to well-defined and ill-defined problem solving and evidence for an episodic simulation mechanism underlying ill-defined problem solving efficacy. Findings are consistent with the emerging idea that MTL-mediated episodic simulation processes support the effective solution of ill-defined problems, over and above the contribution of frontally mediated executive functions. Implications for the development of intervention strategies that target preservation of functional independence in older adults are discussed.

Decision making processes and outcomes

The primary aim of this study was to examine the contributions of individual characteristics and strategic processing to the prediction of decision quality. Data were provided by 176 adults, ages 18 to 93 years, who completed computerized decision-making vignettes and a battery of demographic and cognitive measures. We examined the relations among age, domain-specific experience, working memory, and three measures of strategic information search to the prediction of solution quality using a 4-step hierarchical linear regression analysis. Working memory and two measures of strategic processing uniquely contributed to the variance explained. Results are discussed in terms of potential advances to both theory and intervention efforts.

Understanding within-group variability of everyday cognition in aging Black/African American adults: a mimic (multiple indicators, multiple causes) model approach

BACKGROUND/STUDY CONTEXT: Everyday cognition represents the ability to solve problems within domains that are representative of issues faced by adults on a daily basis. The current study examined individual differences in everyday cognitive ability among aging Black/African American adults.

METHODS

Demographic data on age, gender, education, physical functioning, chronic illnesses, self-reported health, and depression were collected from 248 African American adults (mean age = 67.8 years, standard deviation = 8.47 years). A multiple indicators, multiple causes (MIMIC) modeling approach was used to examine the associations of individual characteristics with latent everyday cognitive ability and composite score indicators.

RESULTS

Age, depressive symptoms, and number of chronic illnesses were negatively related to latent everyday cognition. The individual characteristics of age, depressive symptoms, self-rated health, and education were directly associated with composite indicators of latent everyday cognition. This suggests that within this sample of older Black/African American adults that certain composite scores (i.e., telephone use, food preparation, and finances) may be particularly sensitive to these individual characteristics.

CONCLUSION

These results identify specific sources of variability in everyday cognitive ability among aging Blacks/African Americans. These individual differences should be accounted for when studying everyday cognition among Blacks/African Americans and when comparing the everyday cognitive ability of Blacks/African Americans with other groups.

Everyday problem solving and instrumental activities of daily living: support for domain specificity

Research suggests that performance on cognitive tasks resembling daily challenges (i.e., everyday problem-solving tasks) may be a better indicator of functional ability in old age compared to traditional measures of cognitive ability. Findings demonstrating this link, however, have yielded mixed results. The current study examined performance on the Everyday Problems Test (EPT) and self-reported ability to perform Instrumental Activities of Daily Living (IADLs) in a sample of adults over age 50. The EPT measures cognitive performance on tasks with domains consistent with IADLs (telephone use, shopping, meal preparation, housekeeping, transportation, health and finances). Although overall EPT scores and self-reported IADLs were significantly related (r_s = 0.20; p < 0.05), additional analyses revealed that domain-specific EPT performance related to IADL reports within the same domain for shopping, meal preparation, housekeeping, and financial management after accounting for other variables such as age, sex, and measures of cognitive ability including total EPT score. These findings suggest that domain-specific performance on cognitive everyday problem-solving tasks may add to the predictability of specific IADLs.

The Value of Removing Daily Obstacles via Everyday Problem-Solving Theory: Developing an Applied Novel Procedure to Increase Self-Efficacy for Exercise

The objective of the study was to develop a novel procedure to increase self-efficacy for exercise. Gains in one’s ability to resolve day-to-day obstacles for entering an exercise routine were expected to cause an increase in self-efficacy for exercise. Fifty-five sedentary participants (did not exercise regularly for at least 4 months prior to the study) who expressed an intention to exercise in the near future were selected for the study. Participants were randomly assigned to one of three conditions: (1) an Experimental Group in which they received a problem-solving training session to learn new strategies for solving day-to-day obstacles that interfere with exercise, (2) a Control Group with Problem-Solving Training which received a problem-solving training session focused on a typical day-to-day problem unrelated to exercise, or (3) a Control Group which did not receive any problem-solving training. Assessment of obstacles to exercise and perceived self-efficacy for exercise were conducted at baseline; perceived self-efficacy for exercise was reassessed post-intervention (1 week later). No differences in perceived challenges posed by obstacles to exercise or self-efficacy for exercise were observed across groups at baseline. The Experimental Group reported greater improvement in self-efficacy for exercise compared to the Control Group with Training and the Control Group. Results of this study suggest that a novel procedure that focuses on removing obstacles to intended planned fitness activities is effective in increasing self-efficacy to engage in exercise among sedentary adults. Implications of these findings for use in applied settings and treatment studies are discussed.

Age differences in everyday problem solving

Reductions in everyday problem solving (EPS) are often reported in older age, although it has been suggested that problem context may modify this effect. We evaluated the impact of two aspects of problem context: age appropriateness (age-neutral vs. older-age content) and problem type (interpersonal vs. practical) on EPS performance in 175 adults aged 18–87. Older adults generated fewer solutions to ill-structured EPS vignettes than younger and middle-aged adults. Middle-aged adults demonstrated an advantage on practical problems. While all age groups demonstrated a relative performance advantage for interpersonal content on older age problems, older adults showed the least relative benefit in this condition. Thus older adults do not exhibit relative performance gains on EPS problems designed to be most salient and relevant to this age group.

Race differences in intellectual control beliefs and cognitive functioning

BACKGROUND/STUDY CONTEXT: The current study examined the relationship between intellectual control and cognition and related the results to everyday problem solving in a mixed ethnicity sample of 35% African American and 65% Caucasian elders.

METHODS

Participants completed the Personality in Intellectual Aging Contexts Inventory (PIC; Lachman et al., 1982 , Journal of Research in Personality, 16, 485-501), Everyday Cognition Battery (ECB; Allaire & Marsiske, 1999 , Psychology & Aging, 14, 627-644; 2002 , Psychology & Aging, 17, 101-115), and a battery of basic cognitive ability tests assessing memory, inductive reasoning, and verbal meaning.

RESULTS

Results indicated that African Americans had significantly lower intellectual control beliefs relative to Caucasian older adults. Regression models suggested that relationship between control beliefs and cognition was moderated by education and race. Decomposing the interactions with simple slope analysis revealed that across cognitive abilities, better cognitive performance was related to higher control beliefs in African Americans with at least 13 years of education. A similar relationship was also found in Caucasian elders with lower education.

CONCLUSION

African American elders' reaching a higher level of education may provide a basis for which individual differences in intellectual control beliefs are activated and thereby more strongly associated with cognitive performance.

Everyday problem solving across the adult life span: solution diversity and efficacy

Everyday problem solving involves examining the solutions that individuals generate when faced with problems that take place in their everyday experiences. Problems can range from medication adherence and meal preparation to disagreeing with a physician over a recommended medical procedure or compromising with extended family members over where to host Thanksgiving dinner. Across the life span, research has demonstrated divergent patterns of change in performance based on the type of everyday problems used as well as based on the way that problem-solving efficacy is operationally defined. Advancing age is associated with worsening performance when tasks involve single-solution or fluency-based definitions of effectiveness. However, when efficacy is defined in terms of the diversity of strategies used, as well as by the social and emotional impact of solution choice on the individual, performance is remarkably stable and sometimes even improves in the latter half of life. This article discusses how both of these approaches to everyday problem solving inform research on the influence that aging has on everyday functioning.

Age-related effects of blood pressure on everyday cognitive function in community-dwelling women

OBJECTIVES

Blood pressure is an indicator of vascular health that has been associated with cognition and quality of life in older age. Few studies have examined blood pressure across everyday cognitive tasks, which may have superior predictive functional utility than traditional cognitive measures. We explored blood pressure as a predictor of everyday problem solving (EPS) performance in middle-aged and older women.

METHOD

Community-dwelling women (age: 51-91) with low-normal blood pressure to mild hypertension underwent traditional and everyday cognitive testing. EPS was determined by the number of safe/effective solutions generated for real-world scenarios.

RESULTS

Analyses revealed that lower systolic blood pressure and pulse pressure were associated with worse EPS ability after controlling for age, education, and traditional cognitive abilities.

DISCUSSION

These results support that blood pressure may be an important predictor of everyday cognitive abilities in older age. Potential implications for real-world functioning are discussed.

Cognitive correlates of functional performance in older adults: comparison of self-report, direct observation, and performance-based measures

Neuropsychologists are often asked to answer questions about the effects of cognitive deficits on everyday functioning. This study examined the relationship between and the cognitive correlates of self-report, performance-based, and direct observation measures commonly used as proxy measures for everyday functioning. Participants were 88 community-dwelling, cognitively healthy older adults (age 50-86 years). Participants completed standardized neuropsychological tests and questionnaires, and performed eight activities of daily living (e.g., water plants, fill a medication dispenser) while under direct observation in a campus apartment. All proxy measures of everyday function were sensitive to the effects of healthy cognitive aging. After controlling for age, cognitive predictors explained a unique amount of the variance for only the performance-based behavioral simulation measure (i.e., Revised Observed Tasks of Daily Living). The self-report instrumental activities of daily living (IADL) and the performance-based everyday problem-solving test (i.e., EPT) did not correlate with each other; however, both were unique predictors of the direct observation measure. These findings suggest that neuropsychologists must be cautious in making predictions about the quality of everyday activity completion in cognitively healthy older adults from specific cognitive functions. The findings further suggest that a self-report of IADLs and the performance-based EPT may be useful measures for assessing everyday functional status in cognitively healthy older adults.

Consequences of age-related cognitive declines

Adult age differences in a variety of cognitive abilities are well documented, and many of those abilities have been found to be related to success in the workplace and in everyday life. However, increased age is seldom associated with lower levels of real-world functioning, and the reasons for this lab-life discrepancy are not well understood. This article briefly reviews research concerned with relations of age to cognition, relations of cognition to successful functioning outside the laboratory, and relations of age to measures of work performance and achievement. The final section discusses several possible explanations for why there are often little or no consequences of age-related cognitive declines in everyday functioning.

Cognitive predictors of everyday functioning in older adults: results from the ACTIVE Cognitive Intervention Trial

OBJECTIVE

The present study sought to predict changes in everyday functioning using cognitive tests.

METHODS

Data from the Advanced Cognitive Training for Independent and Vital Elderly trial were used to examine the extent to which competence in different cognitive domains--memory, inductive reasoning, processing speed, and global mental status--predicts prospectively measured everyday functioning among older adults. Coefficients of determination for baseline levels and trajectories of everyday functioning were estimated using parallel process latent growth models.

RESULTS

Each cognitive domain independently predicts a significant proportion of the variance in baseline and trajectory change of everyday functioning, with inductive reasoning explaining the most variance (R2 = .175) in baseline functioning and memory explaining the most variance (R2 = .057) in changes in everyday functioning.

DISCUSSION

Inductive reasoning is an important determinant of current everyday functioning in community-dwelling older adults, suggesting that successful performance in daily tasks is critically dependent on executive cognitive function. On the other hand, baseline memory function is more important in determining change over time in everyday functioning, suggesting that some participants with low baseline memory function may reflect a subgroup with incipient progressive neurologic disease.

Neurocognitive functions and everyday functions change together in old age

OBJECTIVE

Although neurocognitive functions are known to decline normatively with adult age, there is a common belief that everyday functions (e.g., paying bills, following medication instructions, making change, looking up telephone numbers in a phone book) are unaffected by these changes.

METHOD

This hypothesis was examined by applying longitudinal growth models to data from a community-based sample of 698 adults (ages 65 to 94 years and living independently at baseline) who were repeatedly measured over five years on neurocognitive tests of executive reasoning, episodic memory, and perceptual speed, and on a number of tasks that adults should be reasonably expected to be able to perform in their day-to-day lives.

RESULTS

Individual differences in changes in neurocognitive performance were strongly correlated with individual differences in changes in performance on the everyday tasks. Alternatively, changes in self-reports of everyday functions were only weakly correlated with changes in performance on the neurocognitive tests and the everyday tasks.

CONCLUSIONS

These results together suggest that normative neurocognitive aging has substantial consequences for the daily lives of older adults and that both researchers and clinicians should be cautious when interpreting self-reports of everyday functioning.

Everyday reasoning abilities in persons with Parkinson's disease

Parkinson's disease (PD) patients develop progressive cognitive decline. The degree to which such decline impacts instrumental activities of daily living (IADL) among individuals in the early stages of PD without dementia is not well documented. The Everyday Cognitive Battery Reasoning subtest (ECB) was used to assess ability to solve everyday reasoning tasks for IADL among 19 non-demented older adults with PD in comparison to 20 older adults without PD. The two groups were similar in age, education, race and gender. Individuals with PD had significantly lower scores (M = 61.98, SD = 12.03) than the comparison group (M = 69.80, SD = 9.48). Individuals with PD, who do not have dementia, may be more likely to experience difficulties in IADL requiring reasoning including medication use, finances, and nutrition. Even more serious implications lie in the capacity to make treatment choices.

Cognitive training decreases motor vehicle collision involvement of older drivers

OBJECTIVES

To test the effects of cognitive training on subsequent motor vehicle collision (MVC) involvement of older drivers.

DESIGN

Randomized, controlled, multisite, single-blind clinical trial.

SETTING

Community-dwelling seniors at four U.S. sites: Birmingham, Alabama; Baltimore, Maryland; Indianapolis, Indiana; and State College, Pennsylvania.

PARTICIPANTS

Nine hundred eight older drivers (mean age 73.1; 18.6% African American) who were randomized to one of three cognitive interventions or a control condition.

INTERVENTIONS

Up to 10 sessions of cognitive training for memory, reasoning, or speed of processing.

MEASUREMENTS

State-recorded MVC involvement up to 6 years after study enrollment.

RESULTS

Speed-of-processing and reasoning training resulted in lower rates of at-fault collision involvement over the subsequent approximately 6-year period than controls. After adjusting for age, sex, race, education, mental status, health, vision, depressive symptoms, and testing site, participants randomized to the speed-of-processing and reasoning interventions had an approximately 50% lower rate (per person-mile) of at-fault MVCs than the control group (rate ratio (RR) = 0.57, 95% confidence interval (CI) = 0.34-0.96 for speed of processing), and (RR = 0.50, 95% CI = 0.27-0.92 for reasoning). There was no significant difference observed for the memory group.

CONCLUSION

Cognitive speed-of-processing and reasoning training resulted in a lower at-fault MVC rate in older drivers than in controls. Considering the importance of driving mobility, the costs of crashes, and the benefits of cognitive training, these interventions have great potential to sustain independence and quality of life of older adults. More research is needed to understand the effects of different types and quantities of training.

Word list memory predicts everyday function and problem-solving in the elderly: results from the ACTIVE cognitive intervention trial

Data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial (N = 2,802) were analyzed to examine whether word list learning predicts future everyday functioning. Using stepwise random effects modeling, measures from the modified administrations of the Hopkins Verbal Learning Test (HVLT) and the Auditory Verbal Learning Test (AVLT) were independently predictive of everyday IADL functioning, problem-solving, and psychomotor speed. Associations between memory scores and everyday functioning outcomes remained significant across follow-up intervals spanning 5 years. HVLT total recall score was consistently the strongest predictor of each functional outcome. Results suggest that verbal memory measures are uniquely associated with both current and future functioning and that specific verbal memory tests like the HVLT and AVLT have important clinical utility in predicting future functional ability among older adults.

Everyday challenges in context: the influence of contextual factors on everyday problem solving among young, middle-aged, and older adults

The authors examined the experimental effects of social context on everyday problem-solving performance by older, middle-aged, and younger adults. Participants were presented with six everyday problems constructed by framing two behavioral challenges in social contexts representative of the lives of older, middle-aged, and younger adults. As predicted, participants performed best when problems were situated in contexts representative of their own age group. Older adults also outperformed the other age groups on problems set in older adult contexts, suggesting that when problems are set in ecologically relevant contexts, one may not observe previously reported age-related declines in performance.