Negative Aging Stereotypes Impair Performance on Brief Cognitive Tests Used to Screen for Predementia

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.

The Challenge of Subjective Cognitive Complaints and Executive Functions in Middle-Aged Adults as a Preclinical Stage of Dementia: A Systematic Review

Subjective cognitive complaints correspond to a heterogeneous construct that frequently occurs in the early stages of older adult life. Despite being a common source of worry for middle-aged people, it can be underestimated when clinical and neuropsychological assessments discard any underlying pathological processes. Negative age stereotyping but also self-stereotyping can contribute to doing so. Although its diagnosis is a challenge, its implication as a possible predictor of mild cognitive impairment or dementia increases the interest in its early diagnosis and intervention. The present systematic review analyzes the empirical data on the relationship between these complaints and early executive dysfunction with possible predictive value for preclinical stages of dementia. The sixteen papers obtained from the PubMed and Embase databases were exploratory, cross-sectional and prospective in scope. The studies corroborated the relationship between subjective cognitive complaints and some executive processes, which is noteworthy since many people with subjective executive complaints progress to dementia. The relational studies confirmed that impaired executive performance is associated with CSF biomarkers and reduced cortical volume in specific brain regions. However, the heterogeneity of reports in these studies demands stronger efforts in future research with specific tools applied in clinical and neuropsychological assessments and analyzed under a gender perspective.

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.

Confucian Values as a Buffer Against Age-Based Stereotype Threat for Chinese Older Adults

OBJECTIVES

Research has shown that stereotype threat can impair older adults' memory in Western cultures. We tested whether this also occurs for older adults from the East Asian Chinese culture. We also tested whether an intervention that highlighted Confucian principles would protect Chinese older adults from stereotype threat's detrimental effects.

METHOD

Culturally-Chinese older adults residing in the United States completed a memory test either under age-based stereotype threat about cognitive decline or not. Prior to this, some participants were also reminded of Confucian traditions of filial piety and were assured these values had been transmitted to the younger generation.

RESULTS

Stereotype threat impaired Chinese older adults' memory performance. However, our intervention was effective in eliminating this deficit. When the Chinese participants were reminded of the Confucian principle of filial piety they did not exhibit stereotype threat effects.

DISCUSSION

Confirming that younger adults have an obligation to respect their elders can eliminate the social-evaluative pressure of stereotype threat for Chinese older adults. These findings are noteworthy since population aging is happening at an unprecedented pace in East Asia. Although our results suggest that stereotype threat can adversely affect older adults' cognitive performance in these societies, we also identify a culturally-based intervention to alleviate this impairment.

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.

Too Old for Computers? The Longitudinal Relationship Between Stereotype Threat and Computer Use by Older Adults

Besides having lower rates of technology adoption than the general population, older adults are commonly stereotyped as lacking technological ability. Stereotype threat, the fear of confirming negative stereotypes targeting their social group, may lead individuals to distance themselves from the stereotyped domain. This suggests that older adults may underuse computer technology due to stereotype threat. A sample of 86 community-dwelling older adults (M_age = 78.47, SD_age = 7.92) participated in a two-wave longitudinal study aiming to examine the relationship between stereotype threat and computer use in this age group. An autoregressive cross-lagged panel analysis was conducted using structural equation modeling. As expected, stereotype threat predicted lower levels of computer use a year and a half later. In turn, computer use was unrelated to the later experience of stereotype threat in this domain. These findings suggest that stereotype threat may undermine computer adoption in late adulthood, thus contributing to perpetuate the digital inequalities between younger and older generations.

The effects of stereotype threat on older adults' walking performance as a function of task difficulty and resource evaluations

Stereotype threat occurs when people are concerned about confirming a negative stereotype about their social group, and this often leads people to underperform within the threatened domain. Although this is well-documented, the majority of prior studies examining stereotype threat in older adults have focused on cognitive outcomes and comparatively less research has focused on how stereotype threat affects physical outcomes. In this study, we examined whether negative age-based evaluations invoke stereotype threat and adversely affect older adults' gait, and whether this depends upon the difficulty of the gait task and upon participants' evaluations of their own resources to cope with the demands of the gait task. To test this, we recruited 163 healthy, community-dwelling older adults and asked them to complete either an "easy" gait task (i.e., walking at their own comfortable pace) or a "difficult" gait task (i.e., walking within a 15 cm narrow base of support) along a 24' temporospatial-measuring walkway. This was done in either the presence or absence of a negative age-based evaluation. Results showed that the adverse effects of stereotype threat (i.e., walking slower, with relatively more variability in speed, and with more step errors) were generally limited to participants completing the difficult gait task who were not confident that they had sufficient resources to cope with the demands of the task. Thus, stereotype threat can impair older adults' physical performance, but the magnitude of this effect depends upon the task's objective difficulty and on participants' subjective evaluations of their own resources. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Ageing stereotypes and prodromal Alzheimer's disease (AGING): study protocol for an ongoing randomised clinical study

INTRODUCTION

The number of older people diagnosed with amnestic mild cognitive impairment (aMCI), the prodromal state of Alzheimer's disease (AD), is increasing worldwide. However, some patients with aMCI never convert to the AD type of dementia, with some remaining stable and others reverting to normal. This overdiagnosis bias has been largely overlooked and gone unexplained. There is ample evidence in the laboratory that negative ageing stereotypes (eg, the culturally shared belief that ageing inescapably causes severe cognitive decline) contribute to the deteriorating cognitive performances of healthy older adults, leading them to perform below their true abilities. The study described here is intended to test for the first time whether such stereotypes also impair patients' cognitive performances during neuropsychological examinations in memory clinics, resulting in overdiagnosis of aMCI.

METHODS AND ANALYSIS

The ongoing study is a 4-year randomised clinical trial comparing patients' physiological stress and cognitive performances during neuropsychological testing in memory clinics. A total of 260 patients attending their first cognitive evaluation will be randomised to either a standard condition of test administration, assumed here to implicitly activate negative ageing stereotypes or a reduced-threat instruction condition designed to alleviate the anxiety arising from these stereotypes. Both groups will be tested with the same test battery and stress biomarkers. For 30 patients diagnosed with aMCI in each group (n=60), biomarkers of neurodegeneration and amyloidopathy will be used to distinguish between aMCI with normal versus abnormal AD biomarkers. A 9-month follow-up will be performed on all patients to identify those whose cognitive performances remain stable, deteriorate or improve.

ETHICS AND DISSEMINATION

This protocol has been approved by the French National Agency for Medicines and Health Products Safety and the Sud-Est I French Ethics Committee (2017-A00946-47). Results will be published in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

NCT03138018.

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.

Does social context impact metacognition? Evidence from stereotype threat in a visual search task

While recent studies have emphasized the role of metacognitive judgments in social interactions, whether social context might reciprocally impact individuals’ metacognition remains an open question. It has been proposed that such might be the case in situations involving stereotype threat. Here, we provide the first empirical test of this hypothesis. Using a visual search task, we asked participants, on a trial-by-trial basis, to monitor the unfolding and accuracy of their search processes, and we developed a computational model to measure the accuracy of their metacognition. Results indicated that stereotype threat enhanced metacognitive monitoring of both outcomes and processes. Our study thus shows that social context can actually affect metacognition.

Stereotype Threat Reduces the Positivity of Older Adults' Recall

OBJECTIVES

As people get older, they show a relative preference to remember positive information over negative information. In two experiments, we tested whether the positivity of older adults' memory is affected by stereotype threat about age-related cognitive declines. We also tested whether highlighting a positive aging stereotype (older adults are wise) would inoculate older adults from stereotype threat's adverse effects.

METHOD

In Experiments 1 and 2, we manipulated whether stereotypes about age-related cognitive decline were highlighted (stereotype threat) or mitigated (stereotype alleviation). In Experiment 2, we included a third condition (intervention + stereotype threat), which highlighted positive and negative aging stereotypes. Participants then saw emotionally evocative pictures and completed a memory test.

RESULTS

In both experiments, stereotype threat selectively reduced older adults' memory for positive pictures but did not affect their memory for negative pictures. This eliminated the positivity effect (i.e., the Age × Valence interaction; Experiment 1). Our positive stereotype intervention did not reduce stereotype threat's adverse effect (Experiment 2).

DISCUSSION

Our findings show that the positivity effect is more robust when testing situations minimize stereotype threat. They also suggest that health interventions designed to capitalize on the positivity effect should ensure that ageist stereotypes are mitigated in the environment.

Negative Aging Stereotypes Disrupt both the Selection and Execution of Strategies in Older Adults

BACKGROUND

Age-based cognitive deficits are exacerbated by stereotype threat effects (i.e., the threat of being judged as cognitively incapable due to aging). We tested whether age-based stereotype threat effects can occur via impair- ing older adults' ability to select the best strategy and/or to execute strategies efficiently.

METHODS

Older adults (age range: 64.3-89.5 years) were randomly assigned to a stereotype threat or control condition before taking an episodic memory task. They encoded pairs of concrete words and of abstract words, with either a repetition or an imagery strategy, and then took a cued-recall task. Whereas participants in experiment 1 could choose between these two strategies, those of experiment 2 were forced to use either the repetition or the imagery strategy.

RESULTS

Our findings showed that age-based stereotype threat disrupts both the selection and execution of the most efficient, but also most resource-demanding, imagery strategy, and that these stereotype threat effects were stronger on concrete words.

CONCLUSION

Our findings have important implications to further understand age-based (and other) stereotype threat effects, and how noncognitive factors modulate age-related changes in human cognition.

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.