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

Age-based stereotype threat effects: From the laboratory to the clinical setting

Age-Based Stereotype Threat (ABST) adversely affects older adults' memory performance by inducing anxiety and interfering thoughts related to negative stereotypes about aging and memory decline. While well-documented in laboratory settings, the relevance of ABST in real-life clinical contexts remains underexplored. This narrative review examines the effects of ABST and its implications for cognitive aging, emphasizing the importance of addressing ABST in clinical settings. We review key laboratory findings and the limited studies that simulate clinical environments, highlighting their methodological limitations. The review underscores the need for further research involving actual patients, tested within real clinical setting and using appropriate interventions to reduce ABST. Proactive interventions such as educational debriefing and expressive writing, are promising methods adapted to clinical settings. By enhancing our understanding and mitigation of ABST in clinical practice, we can improve the accuracy and reliability of neuropsychological assessments, leading to better diagnostic outcomes for older adults.

Toward a New Approach to Investigate the Role of Working Memory in Stereotype Threat Effects

Stereotype threat arises when the activation of negative stereotypes about a group impairs performance of stigmatized individuals on stereotype relevant tasks. There is ample evidence that stereotype threat leads to performance detriments by consuming executive resources. Several studies indeed showed that working memory (WM) mediates stereotype threat effects among young adults. More recently, researchers have sought to understand whether the same mechanisms underlie age-based stereotype threat, but findings are mixed regarding the role of WM and some authors rather favor a motivational explanation based on regulatory fit. The present review critically appraises the empirical support for distinct forms of stereotype threat effects mediated by distinct mechanisms. We propose a novel approach based on one of the most recent WM models, the time-based resource sharing model, to evaluate the impact of stereotype threat on attentional resources in WM among both young and older adults.

Health practitioner beliefs regarding the impact of age-based stereotype threat on performance in the cognitive assessment of older adults

OBJECTIVES

Health practitioners' understanding of the impact of age-based stereotype threat (ABST) on the cognitive test performance of older adults is not well understood. This study aimed to investigate health practitioners' ability to recognize the influence of ABST in the cognitive assessment of older adults and their perceptions of its impact in practice.

METHODS

One-hundred and twenty-nine health practitioners (86% female; M age = 39.75, SD = 11.50) with experience in conducting cognitive assessments with older adults (mainly psychologists and occupational therapists) completed an online survey assessing demographic and practice characteristics, aging beliefs, a hypothetical cognitive assessment scenario, and perceived impact of ABST on practice.

RESULTS

Overall, health practitioners rated ABST factors in the assessment scenario as less detrimental to cognitive performance than internal and external factors. In a hierarchical regression model, lower recognition of ABST and negative aging beliefs significantly accounted for lower perceived impact of ABST on older adults' cognitive test performance in practice (R² = .37, p < .001).

CONCLUSION

Health practitioners may not recognize the influence of ABST on assessment findings, especially if they hold negative aging beliefs. The findings highlight the need to improve health practitioners' knowledge of ABST to increase the validity of cognitive testing in older adults.

"What if It's not Just an Item of Clothing?" - A Narrative Review and Synthesis of the White Coat in the Context of Aged Care

Although increasingly disputed, the white coat uniform is ubiquitous in geriatric care, which may reflect a phenomenon called medicalisation of ageing. This narrative review is the first attempt at integrating several theoretical approaches, such as the "white coat effect" and "enclothed cognition", in order to gain a comprehensive understanding of the use of this clothing item. Based on extensive empirical evidence, we will examine the consequences of wearing a uniform, not only on patients (in this case, older patients) and healthcare professionals, but also on their relationship. The white coat has powerful symbolic functions for healthcare professionals and is still preferred by older adults. However, the negative repercussions of wearing a uniform require us to question its use, particularly in environments where older persons live, such as nursing homes.