Improving older adults' memory performance using prior task success

Examining the Utility of a Multiple Group Membership Intervention for Alleviating the Effects of Age-Based Stereotype Threat on Older adults' Memory Performance

This study examined the effectiveness of a multiple group membership intervention for reducing the negative effects of age-based stereotype threat (ABST) on older adults' objective memory performance and subjective memory concerns. Healthy older adults (N = 68) were randomly allocated to an ABST + threat-removal (ABST+TR) or ABST + active-control (ABST+AC) condition. After activating ABST, the ABST+TR condition completed a group-listing task and the ABST+AC condition completed a meal-listing task. Participants then completed the Rey Auditory Verbal Learning Test (RAVLT) and Everyday Memory Questionnaire - Revised. One significant difference was found in memory performance between conditions; specifically, after controlling for age, gender, and number of items listed, those in the ABST+TR condition performed significantly better on the RAVLT memory interference trial. Further, listing a greater number of group memberships was associated with better memory performance in the ABST+TR condition. No significant difference was found in subjective memory concerns between the ABST+TR condition and the ABST+AC condition. Overall, the current findings indicated that raising the salience of multiple group memberships offered limited protection for older adults' cognitive test performance in the context of ABST.

User Interface (UI) Design and User Experience Questionnaire (UEQ) Evaluation of a To-Do List Mobile Application to Support Day-To-Day Life of Older Adults

Because of the spread of smartphones, older adults enjoy the assistance of smartphones. However, fewer mobile applications are designed for older adults. Smartphone user interface (UI) serves as an external brain to capture information, and older adults may have memory complaints that affect self-confidence and lead to memory decline. Non-declarative memory requires more effort. Therefore, this study aims to design and evaluate a to-do list application to help older adults encode, store, and retrieve non-declarative memory, such as tasks they plan to do. We recruited 15 participants (5 men and 10 women) aged 60 to 75 years old (SD = 5.32). They were asked to complete nine usability tasks, and to answer a user experience questionnaire (UEQ) and a few interview questions. Sixty percent of users completed with only one or two attempts (median = 2.80, SD = 1.63). We found three usability issues and proposed an iteration plan. The application has attractiveness, efficiency, dependability, stimulation, novelty, and good perspicuity for older adults. The product was rated excellent except for perspicuity, which met the users’ expectations. This indicates that the user is satisfied with the application prototype. The results of this measurement can be utilized as a benchmark for the next model for developing mobile to-do list applications on user experience.

Pre-Test Experience and Memory Performance in Older Adults: The Impact of Test Anxiety and Self-Efficacy

OBJECTIVE

The objective of this paper is to investigate the role of test anxiety and memory self-efficacy on memory performances in older adults.

METHOD

One hundred cognitively normal, community-dwelling older adults aged 65+ participated used in this experimental study. Participants completed baseline evaluations (including pre-test anxiety) prior to being assigned to one of two experimental conditions in which they experienced either success or failure on a verbal test. They subsequently completed post-test anxiety ratings, a measure of memory self-efficacy (Memory Self-Efficacy Questionnaire), and standardized tasks of working memory and verbal episodic memory.

RESULTS

Following experimental manipulation, participants in the pre-test failure condition demonstrated higher anxiety and lower memory performances. Hierarchical regression revealed that change in anxiety from pre-test to post-test predicted memory performances and mediation analyses demonstrated that these effects were explained by lower memory self-efficacy.

CONCLUSIONS

For older adults, experiencing test failure prior to memory testing may result in increased test anxiety and lower memory self-efficacy leading to poorer memory performance. This has implications for diagnostic cognitive assessment for older people.

The Impact of Naturalistic Age Stereotype Activation

Almost self-fulfilling, commonly held negative stereotypes about old age and memory can impair older adults' episodic memory performance, due to age-based stereotype threat or self-stereotyping effects. Research studies demonstrating detrimental impacts of age stereotypes on memory performance are generally conducted in research laboratories or medical settings, which often underestimate memory abilities of older adults. To better understand the "real world" impact of negative age and memory stereotypes on episodic memory, the present research tested story recall performance of late middle-aged and older adults (N = 51) following a naturalistic age stereotype manipulation, wherein every day, newspaper-style materials (comics and puzzles) were either embedded with negative age and memory stereotype stimuli (stereotype group) or neutral stimuli (control group). Furthermore, all participants were tested in favorable, familiar environments. Potential moderators of the stereotype effects, e.g., metamemory beliefs, were assessed at baseline. Current memory evaluation and subjective age, as well as perceived stereotype threat and task-related anxiety, were assessed following the stereotype manipulation as potential mechanisms of the expected stereotype effects. Results suggested a contrast effect, as the stereotype group demonstrated superior story recall performance compared to the control group. Marginally significant moderation effects by age and perceived stereotype threat indicated that stereotype rejection was present for late middle-aged adults but not older adults, indicative of stereotype lift, and for individuals who reported low and average, but not high, levels of perceived stereotype threat. Additionally, a trend suggested more positive memory evaluation for those in the stereotype group who reported awareness of the stereotype stimuli than those who did not notice the stimuli. These results are consistent with other research demonstrating benefits to memory performance in adulthood based on motivational and contextual factors, such as using relevant memory materials and testing in favorable conditions. Moreover, the results of this study contribute to our understanding of individuals' responses to different types of stereotype stimuli, and the differential impact of stereotype manipulations that are subtle versus blatant. Individuals were motivated to counteract negative stereotype effects when conditions were supportive, stereotype presentations were naturalistic, and personal beliefs were positive.

Understanding Older Adults' Memory Distortion in the Light of Stereotype Threat

Numerous studies have documented the detrimental impact of age-based stereotype threat (ABST) on older adults' cognitive performance and especially on veridical memory. However, far fewer studies have investigated the impact of ABST on older adults' memory distortion. Here, we review the subset of research examining memory distortion and provide evidence for the role of stereotype threat as a powerful socio-emotional factor that impacts age-related susceptibility to memory distortion. In this review we define memory distortion as errors in memory that are associated with gist-based errors or source misattributions. Whereas, some of the reviewed experiments support the conclusion that ABST should be considered in the context of age-related differences in memory distortion, others reported little or no impact of stereotype threat. These discrepancies suggest that the role of ABST, and socio-emotional processes generally, in age-related changes in memory distortion are less clear. In this review, we argue that ABST does play an important role in age-related changes in memory distortion. We present evidence suggesting that discrepancies in the reviewed literature may be reconciled when evaluated in the context of the leading theories about stereotype threat: the Executive Resource Depletion hypothesis and the Regulatory Focus theory. We also discuss how differences in methodology and participant characteristics can account for a priori contradictory results in the literature. Finally, we propose some recommendations for researchers and practitioners when assessing memory in older adults.

Effects of prior-task failure on arithmetic performance: A study in young and older adults

Effects of prior-task failure (i.e., decreased performance on a target task following failure on a prior task) were tested in young and older adults. Young and older participants (N=120) accomplished a computational estimation task (i.e., providing the best estimates to arithmetic problems) before and after accomplishing a dot comparison task in a control or in a failure condition. Both groups decreased their performance on the target computational estimation following failure on the prior dot comparison task. Also, prior-task failure led young and older adults to select the better strategy less often and to use the easier strategy more often. Our findings show, for the first time, impaired performance after experiencing failure in both young and older adults. We discuss implications of these findings for further our understanding of effects of task transitions (i.e., prior-task success and failure) on cognitive performance.

True performance: reducing stereotype threat effect in older adults' clinical assessment of memory

Empirical studies suggest that memory loss with age is based not only on biological, but also on contextual factors. In line with the stereotype threat (ST) theory, it is argued that the features of the standard clinical situation may contribute to an underestimation of memory performance in older adults (OA). To prevent these shortcomings, we proposed and tested two different interventions that are easy to implement in clinical settings: individuation and self-handicapping. Results indicate that the individuation intervention appears to be a promising solution to alleviate the ST burden in clinical assessment of memory.

Knowing What Others Know: Younger and Older Adults' Perspective-Taking and Memory for Medication Information

Health-related information can be important to communicate and remember, but we may not understand our own or others' memory abilities. In this study, younger and older adults estimated their performance before and after a cued-recall memory task in which they studied medication : side effect pairs. Participants also estimated the performance of a peer their own age, a medical student, and a person in the other age group (i.e., younger adults estimated older adults' performance and vice versa). In Experiment 1, participants completed four study-test cycles, each with new pairs. In Experiment 2, the same pairs were presented throughout. Overall, participants initially overestimated their memory performance, but after the task, several judgments were closer to participants' actual performance and that of their peers. Thus, people may not initially have accurate representations of how they and others remember health-related information, but these misconceptions may be ameliorated by testing and task experience.

Improving Medication Understanding and Adherence Using Principles of Memory and Metacognition: In Press - Policy Insights from Behavioral and Brain Sciences

More than half of older adults regularly take multiple medications. Rates of medication non-adherence are high, which undermines both patients' health and the economy. Memory and metacognitive factors (such as misplaced confidence) help explain why patients across the lifespan may not understand or follow prescribed regimens. These factors include difficulties in remembering confusing information; patients' and practitioners' potential overconfidence in memory; and misunderstandings about memory. Patients, practitioners, and the public can use these principles to improve memory, enhance understanding, and promote metacognitive accuracy with respect to complex medication information, which may increase the likelihood of adherence.

When Older Adults Outperform Young Adults: Effects of Prior-Task Success in Arithmetic

BACKGROUND

Older adults improve their cognitive performance on a target task after succeeding in a prior task. We tested whether effects of prior-task success occur via changing older adults' ability to select the better strategy and/or to execute strategies efficiently.

METHODS

Young and older participants (n = 162) accomplished a computational estimation task (i.e., providing the best estimates to arithmetic problems) after accomplishing a dot comparison task.

RESULTS

Both groups increased their performance on computational estimation following success on dot comparison. Older adults improved most and outperformed young adults following prior-task success. Prior-task success led older adults to select the better strategy more often and to repeat (or not) the same strategy more often when it was appropriate. Better strategy use mediated effects of prior-task success. Individual differences in baseline performance moderated individuals' sensitivity to effects of prior-task success.

CONCLUSION

Our findings further our understanding of mechanisms underlying effects of prior-task success and provide new perspectives on how social environment modulates age-related differences in cognitive performance.

Development and validation of a paternalism and autonomist care assessment

AIM

There is a need for a validated instrument to measure the type of care (paternalism or person-centred) provided for older adults. Since paternalism and person-centred care are the most important caregiving styles in the field of care and as they are usually opposed, the study aims to develop and establish psychometrics data of an instrument to identify paternalistic and autonomist behaviours in older adults care contexts, which can help to enhance care practice.

DESIGN

Instrument development.

METHODS

After observing and standardizing behaviours in formal care contexts in 2016, an instrument was developed and proceeding to a first validation using standard validation techniques among caregivers in two care settings during 2016-2017: senior citizen centres and older adult day care centres.

RESULTS

The Paternalist/Autonomist Care Assessment (PACA) is a 30-item, behaviour-based instrument which measures both the appraisal of caregivers on elements of care (Care Appraisal Scale- PACA-Appraisal) and the occurrence of behaviours (Occurrence of Care in Context- PACA-Occurrence). The Paternalist/Autonomist Care Assessment (PACA) was validated in 160 professional caregivers and was able to discriminate two factors: paternalistic or overprotective behaviours and autonomist behaviours. However, these factors were not fully dichotomous and were shown to coexist to some degree.

CONCLUSION

The instrument displayed good psychometric properties to measure paternalism and autonomy in older adult care. Moreover, it showed that the two types of care are not antagonistic and can coexist, with overprotective behaviours being more frequent in contexts of care for more dependent persons.

IMPACT

There are no validated instruments to measure paternalism and person-centred behaviour in care contexts. The two measures yielded by the PACA show good construct and concurrent empirical validity, internal consistency, and convergent and discriminant validity. Family caregiver, professional caregivers, nurses, older adults.

Memory for Weather Information in Younger and Older Adults: Tests of Verbatim and Gist Memory

Background/Study Context: Memory for specific, verbatim details tends to decline with age, and reliance on gist-based information increases. However, instructions that direct attention toward certain types of information can benefit memory accuracy for that information. Previous work has examined gist-based and verbatim memory for images, but little work has utilized stimuli that participants may study in their daily lives, such as a weather forecast.

METHODS

The current study examined how younger and older adults recall both general, gist-based information and specific, verbatim details of a weather forecast, and whether differences in the task instructions to focus on gist-based information may affect recall. Two study-test cycles with different forecasts were used to determine whether experience with the task may affect performance.

RESULTS

While there was no effect of additional gist-based instructions on recall of gist-based information, participants who received the additional instructions recalled fewer verbatim details than those who did not. There were no age-related differences in recall of the gist of the forecast, but younger adults correctly recalled more verbatim details than older adults did.

CONCLUSION

Environmental support and use of gist-based processing can allow both younger and older adults to remember information that can be useful in their daily lives. The current study informs future research on prospective memory and memory for everyday information.

Younger and older adults' associative memory for medication interactions of varying severity

While older adults face various deficits in binding items in memory, they are often able to remember information that is deemed important. In Experiment 1, we examined how younger and older adults remember medication interactions of varying severity. There were no age differences in overall memory accuracy, but older adults' performance depended on the severity of the interactions (such that the interactions associated with the most severe health outcomes were remembered most accurately) while younger adults' did not. In Experiment 2, a similar task was designed to create interference in memory. Even with this more difficult task there were no age differences in recall accuracy, and both age groups remembered the interactions with the severe outcomes most accurately. These findings suggest that, under certain circumstances, older adults do not face deficits in associative recognition accuracy of information that varies in importance.

Implicit motivation improves executive functions of older adults

It is widely accepted that while controlled processes (e.g., working memory and executive functions) decline with age, implicit (automatic) processes are not affected by age. In this paper we challenge this view by arguing that high-level automatic processes (e.g., recruiting motivation) decline with age, and that this decline plays an unappreciated role in cognitive aging. Specifically, we hypothesized that due to their decline, automatic motivational processes are less likely to be spontaneously activated in old age; thus, implicit external activation of them should have stronger effects on older (vs. younger) adults. In two experiments we used different methods of implicitly activating motivation, and measured executive functions of younger and older adults using the Wisconsin Card Sorting Test. In both experiments, implicit modulation of motivation resulted in improved executive functioning for older adults. The framework we propose is general and offers a new look at various aspects of cognitive aging.

Effects of Prior-Task Success on Young and Older Adults' Cognitive Performance an Evaluation of the Strategy Hypothesis

In prior-task success, older adults improve cognitive performance on target tasks after successfully accomplishing a prior task. We tested the hypothesis that effects of prior-task success occur via older adults’ selecting the better strategy more often and executing strategies more efficiently on each problem under a prior-task success condition. Young and older participants accomplished computational estimation tasks (i.e., providing the best estimates to arithmetic problems) under a success or a control condition. They successfully accomplished a Stroop task or accomplished no prior task before taking the target arithmetic task. Participants had to select the better strategy on each problem in Experiment 1 and to execute a cue strategy in Experiment 2. Consistent with the strategy hypothesis, older adults, but not young adults, (a) obtained better performance, (b) used the better strategy more often, (c) inappropriately repeated the same strategy less often across successive problems, and (d) executed strategies more efficiently, under a prior-task success condition relative to a control condition. These results highlight the role of strategic variations in effects of prior-task success. They have important implications when assessing age differences in human cognition during both normal and pathological aging.

Younger and older adults' associative memory for social information: The role of information importance

The ability to associate items in memory is critical for social interactions. Older adults show deficits in remembering associative information but can sometimes remember high-value information. In two experiments, younger and older participants studied faces, names, and occupations that were of differing social value. There were no age differences in the recall of important information in Experiment 1, but age differences were present for less important information. In Experiment 2, when younger adults' encoding time was reduced, age differences were largely absent. These findings are considered in light of value-directed strategies when remembering social associative information. (PsycINFO Database Record

An Examination of Age-Based Stereotype Threat About Cognitive Decline

"Stereotype threat" is often thought of as a singular construct, with moderators and mechanisms that are stable across groups and domains. However, this is not always true. To illustrate this, the current review focuses on the stereotype threat that older adults face about their cognitive abilities. Drawing upon the multithreat framework, I first provide evidence that this is a self-concept threat and not a group-reputation threat. Because this differs from the forms of stereotype threat experienced by other groups (e.g., the threat that minority students face about their intellectual abilities), the moderators of stereotype threat observed in other groups (i.e., group identification) do not always generalize to age-based stereotype threat about cognitive decline. Looking beyond the forms of stereotype threat elicited, this review also provides evidence that the mechanisms underlying stereotype-threat effects may vary across the adult life span. Because of age-related improvements in emotion-regulation abilities, stereotype threat does not seem to reduce older adults' executive-control resources. Overall, this review highlights the need to approach the concept of stereotype threat with more granularity, allowing researchers to design more effective stereotype-threat interventions. It will also shed light on why certain stereotype threat effects "fail to replicate" across domains or groups.

The Effect of Prior Task Success on Older Adults' Memory Performance: Examining the Influence of Different Types of Task Success

BACKGROUND/STUDY CONTEXT

Negative aging stereotypes can lead older adults to perform poorly on memory tests. Yet, memory performance can be improved if older adults have a single successful experience on a cognitive test prior to participating in a memory experiment (Geraci & Miller, 2013, Psychology and Aging, 28, 340-345). The current study examined the effects of different types of prior task experience on subsequent memory performance.

METHODS

Before participating in a verbal free recall experiment, older adults in Experiment 1 successfully completed either a verbal or a visual cognitive task or no task. In Experiment 2, they successfully completed either a motor task or no task before participating in the free recall experiment.

RESULTS

Results from Experiment 1 showed that relative to control (no prior task), participants who had prior success, either on a verbal or a visual task, had better subsequent recall performance. Experiment 2 showed that prior success on a motor task, however, did not lead to a later memory advantage relative to control.

CONCLUSION

These findings demonstrate that older adults' memory can be improved by a successful prior task experience so long as that experience is in a cognitive domain.

Memory for medication side effects in younger and older adults: the role of subjective and objective importance

Older adults often experience memory impairments, but sometimes they can use selective processing and schematic support to remember important information. In the present experiments, we investigated the degrees to which younger and healthy older adults remembered medication side effects that were subjectively or objectively important to remember. Participants studied a list of common side effects and rated how negative these effects would be if they were to experience them, and they were then given a free recall test. In Experiment 1, the severity of the side effects ranged from mild (e.g., itching) to severe (e.g., stroke), and in Experiment 2, certain side effects were indicated as being critical to remember (i.e., "contact your doctor if you experience this"). We observed no age differences in terms of free recall of the side effects, and older adults remembered more severe side effects than mild effects. However, older adults were less likely to recognize the critical side effects on a later recognition test, relative to younger adults. These findings suggest that older adults can selectively remember medication side effects but have difficulty identifying familiar but potentially critical side effects, and this has implications for monitoring medication use in older age.

False feedback and beliefs influence name recall in younger and older adults

Feedback is an important self-regulatory process that affects task effort and subsequent performance. Benefits of positive feedback for list recall have been explored in research on goals and feedback, but the effect of negative feedback on memory has rarely been studied. The current research extends knowledge of memory and feedback effects by investigating face-name association memory and by examining the potential mediation of feedback effects, in younger and older adults, through self-evaluative beliefs. Beliefs were assessed before and after name recognition and name recall testing. Repeated presentation of false positive feedback was compared to false negative feedback and a no feedback condition. Results showed that memory self-efficacy declined over time for participants in the negative and no feedback conditions but was sustained for those receiving positive feedback. Furthermore, participants who received negative feedback felt older after testing than before testing. For name recall, the positive feedback group outperformed the negative feedback and no feedback groups combined, with no age interactions. The observed feedback-related effects on memory were fully mediated by changes in memory self-efficacy. These findings advance our understanding of how beliefs are related to feedback in memory and inform future studies examining the importance of self-regulation in memory.

Gist-based memory for prices and "better buys" in younger and older adults

Ageing typically leads to various memory deficits which results in older adults' tendency to remember more general information and rely on gist memory. The current study examined if younger and older adults could remember which of two comparable grocery items (e.g., two similar but different jams) was paired with a lower price (the "better buy"). Participants studied lists of grocery items and their prices, in which the two items in each category were presented consecutively (Experiment 1), or separated by intervening items (Experiment 2). At test, participants were asked to identify the "better buy" and recall the price of both items. There were negligible age-related differences for the "better buy" in Experiment 1, but age-related differences were present in Experiment 2 when there were greater memory demands involved in comparing the two items. Together, these findings suggest that when price information of two items can be evaluated and compared within a short period of time, older adults can form stable gist-based memory for prices, but that this is impaired with longer delays. We relate the findings to age-related changes in the use of gist and verbatim memory when remembering prices, as well as the associative deficit account of cognitive ageing.