Are Changes in Cognitive Functioning in Older Adults Related to Changes in Subjective Complaints?

In many areas of intellectual functioning, age-related declines in older adults' performance and increases in subjective complaints about intellectual performance are observed. However, the literature mostly reports very low relations between functioning and respective complaints. This finding could be the consequence of examining the relation between subjective complaints and the perceived level of functioning. If, however, persons are sensitive to relative changes in performance, they might base their subjective judgment on changes in the level of cognitive functioning. With 202 subjects (mean age=63 years) and two measurements, the authors examine (a) the relation between functioning and complaints at each measurement point, and (b) the relation between changes in functioning and changes in complaints between the measurement points with latent difference variables. The results indicate that there is no relation between level of functioning and level of complaints, but that there is a substantial relation between changes in functioning and complaints.     

When Do Older Adults Show a Positivity Effect in Emotional Memory?

Background: Typically, positive and negative emotional items are easier to remember than neutral ones. Charles, Mather, and Carstensen (2003) reported that older adults preferentially remember positive items, but this age-related “positivity effect” has not been replicated consistently.

Methods: We conducted a close replication of Charles et al.’s study to verify that their method yields a clear positivity effect in older adults relative to the young. We also examined the role of attention, which has been argued to influence the presence of the positivity effect in older adults. We used a method similar to Charles et al. (2003). Young and older adults recalled pictures that had been encoded under full or divided attention.

Results and Conclusions: Older adults showed a positivity effect, but only under full attention. Young adults did not show any hint of a positivity effect, under either of the encoding conditions. The finding of a positivity effect in older but not young adults replicates the original report from Charles et al. (2003). The attention manipulation results suggest that when the positivity effect occurs in older adults’ memory, it is attributable at least in part to cognitive control during encoding.

Key terms: Emotional Enhancement of Memory–Divided attention–Aging     

Do Older Adults Perceive Postural Constraints for Reach Estimation?

Background/Study Context: Recent evidence indicates that older persons have difficulty mentally representing intended movements. Furthermore, in an estimation of reach paradigm using motor imagery, a form of mental representation, older persons significantly overestimated their ability compared with young adults. The authors tested the notion that older adults may also have difficulty perceiving the postural constraints associated with reach estimation.

Methods: The authors compared young (M_age = 22 years) and older (M_age = 67) adults on reach estimation while seated and in a more postural demanding standing and leaning forward position. The expectation was a significant postural effect with the standing condition, as evidenced by reduced overestimation.

Results: Whereas there was no difference between groups in the seated condition (both overestimated), older adults underestimated whereas the younger group once again overestimated in the standing condition.

Conclusion: From one perspective, these results show that older adults do perceive postural constraints in light of their own physical capabilities. That is, that group perceived greater postural demands with the standing posture and elected to program a more conservative strategy, resulting in underestimation.     

Do Health Educator Telephone Calls Reduce At-risk Drinking Among Older Adults in Primary Care?

Background  

Alcohol screening and brief intervention for unhealthy alcohol use has not been consistently delivered in primary care as part of preventive healthcare.     

Do NSAIDs Affect Longitudinal Changes in Knee Cartilage Volume and Knee Cartilage Defects in Older Adults?

Background

The effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on knee osteoarthritis progression are unclear. The aim of this longitudinal study was to determine the associations between use of NSAIDs and changes in knee cartilage volume and knee cartilage defects over 2.9 years in older adults.

Methods

T₁-weighted fat-suppressed magnetic resonance imaging on the right knee was performed in a total of 395 randomly selected subjects (mean age 62 years, range 51-80 years, and 50% female) to assess knee cartilage volume at tibial sites and knee cartilage defects (0-4 scale) at baseline and 2.9 years later. Medication use in the last month was recorded by questionnaire.

Results

Compared with nonusers of NSAIDs (n = 334), users of cyclooxygenase (COX)-2 inhibitors (n = 40) had decreased knee cartilage defect development in the medial tibiofemoral compartment (odds ratio [OR] 0.4, 95% confidence interval [CI], 0.2-0.99), whereas users of conventional NSAIDs (n = 21) had increased knee cartilage defect development in both medial (OR 3.1, 95% CI, 1.0-9.1) and lateral (OR 2.6, 95% CI, 1.0-6.7) tibiofemoral compartments. Comparing users of COX-2 inhibitors with users of conventional NSAIDs, the latter had higher knee cartilage volume loss (−5.3% vs −3.1% at medial tibia and −3.6% vs −1.1% at lateral tibia; all P <.05). All associations were adjusted for potential confounders including knee pain and radiographic osteoarthritis.

Conclusions

This study suggests that nonselective NSAIDs may have deleterious effects, while selective COX-2 inhibitors might have beneficial effects on knee cartilage. Randomized controlled trials examining knee structure to confirm this finding are warranted.     

Subjective and Objective Napping and Sleep in Older Adults: Are Evening Naps “Bad” for Nighttime Sleep?

OBJECTIVES: To compare objective and subjective measurements of napping and to examine the relationship between evening napping and nocturnal sleep in older adults. DESIGN: For 12 days, participants wore actigraphs and completed sleep diaries. SETTING: Community. PARTICIPANTS: One hundred individuals who napped, aged 60 to 89 (including good and poor sleepers with typical age‐related medical comorbidities). MEASUREMENTS: Twelve days of sleep diary and actigraphy provided subjective and objective napping and sleep data. RESULTS: Evening naps (within 2 hours of bedtime) were characteristic of the sample, with peak nap time occurring between 20:30 and 21:00 (average nap time occurred between 14:30 and 15:00). Two categories of nappers were identified: those who took daytime and evening naps and daytime‐only. No participants napped during the evening only. Day‐and‐evening nappers significantly underreported evening napping and demonstrated lower objectively measured sleep onset latencies (20.0 vs 26.5 minutes), less wake after sleep onset (51.4 vs 72.8 minutes), and higher sleep efficiencies (76.8 vs 82%) than daytime‐only nappers. CONCLUSION: Day and evening napping was prevalent in this sample of community‐dwelling good and poor sleepers but was not associated with impaired nocturnal sleep. Although the elimination or restriction of napping is a common element of cognitive‐behavioral therapy for insomnia, these results suggest that a uniform recommendation to restrict or eliminate napping (particularly evening napping) may not meet the needs of all older individuals with insomnia.     

Do Older Adults Use the Method of Loci? Results From the ACTIVE Study

Background/Study Context: The method of loci (MoL) is a complex visuospatial mnemonic strategy. Previous research suggests that older adults could potentially benefit from using the MoL, but that it is too attentionally demanding for them to use in practice. The authors evaluated the hypotheses that training can increase the use of MoL, and that MoL use is associated with better memory.

Methods: The authors analyzed skip patterns on response forms for the Auditory Verbal Learning Test (AVLT) in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE; N = 1401) trial using 5 years of longitudinal follow-up.

Results: At baseline, 2% of participants skipped spaces. Fewer than 2% of control participants skipped spaces at any visit across 5 years, but 25% of memory-trained participants, taught the MoL, did so. Participants who skipped spaces used more serial clustering, a hallmark of the MoL (p < .001). Trained participants who skipped spaces showed greater memory improvement after training than memory-trained participants who did not skip spaces (Cohen’s d = .84, p = .007), and did not differ in the subsequent rate of long-term memory decline through up to 5 years of follow-up.

Conclusion: Despite being attentionally demanding, this study suggests that after training, the MoL is used by up to 25% of older adults, and that its use is associated with immediate memory improvement that was sustained through the course of follow-up. Findings are consistent with the notion that older adults balance complexity with novelty in strategy selection, and that changes in strategies used following memory training result in observable qualitative and quantitative differences in memory performance.     

Do Factor V Leiden and Prothrombin G20210A Mutations Predict Recurrent Venous Thromboembolism in Older Patients?

Background

The value of genetic thrombophilia testing in elderly patients with an unprovoked venous thromboembolism is unclear. We assessed whether the Factor V Leiden and the prothrombin G20210A mutation are associated with recurrent venous thromboembolism in elderly patients in a prospective multicenter cohort study.

Does Social Class Predict Substance Problems in Young Adults with ADHD?

The relationship between social class and substance use problems is unclear. We aimed to clarify this association in a sample of young adult males with and without attention-deficit/hyperactivity disorder (ADHD). We included 69 ADHD and 78 control subjects. Substance use problems were measured with the Drug Use Screening Inventory-Revised (DUSI). Among ADHD subjects, we found a U-shaped association, with elevated risk for substance-related problems at both ends of the SES spectrum. No significant association was found in controls. These findings indicate that substance use risk in ADHD subjects is especially vulnerable to social class.