Time of Day Affects Episodic Memory in Older Adults*

ABSTRACT

The neuropsychological test scores of 2,030 cognitively normal older adults were examined to evaluate performance patterns as they related to time of day (TOD) at which testing was initiated. Multiple regression analyses were used to examine the association of TOD with scores on seven neuropsychological tests used in the clinical evaluation of dementia. Episodic memory performance was significantly related to TOD, while memory span and verbal fluency were not. Best performance occurred during early morning hours and late afternoon; worst performance occurred mid-day (i.e., noon). These findings may have implications for clinical assessment, the design of research on dementia, and the daily functioning of older adults.     

Educational Opportunities for Older Adults

This paper challenges congregations to become centers for life-long learning. An experiment in educational programming conducted by Saint Olaf College at residences of the Ebenezer Society in Minneapolis, Minnesota is reported upon. The benefits derived From the program included: (1) growth in understanding of the Christian faith; (2) better understanding of political issues; (3) greater appreciation of the liberal arts; and (4) personal satisfaction. Also explored are the implications of the experiment for the educational programs of congregations. The greater interest in education by the new generation of elderly presents new opportunities to the churches.     

Spiritual Need Two: Continued Learning for Older Adults and Older Adult Organizations

SUMMARY

Age provides opportunity not only for a person to grow spiritually, but also for people to enlarge their understandings of the world about them, including God, and connect them to previous learnings and life-experiences. In older age, learning is not merely an affirmation of what has been, but a re-creation of the self in relation to everything that surrounds the person. The theories of James Fowler, Malcom Knowles, Peter Senge, and Erik Erikson provide insight as to the purpose of older adult education. The goal is for churchs to encourage and assist in each person's re-construction of their lives as they view life from the perspective of length of years. Concrete examples of re-constructive learning are provided.     

Counseling for Wellness With Older Adults

Resulting from the assumption that older adulthood is a time of decline, there is a dearth of research on the application of wellness counseling with older adults. This article reviews the literature on wellness and older adults, synthesizes wellness with adult development theory, and describes wellness counseling with older adults.     

Guided Autobiography: A Counseling Tool for Older Adults

The author describes Guided Autobiography, a course based on the life review concept, and evaluates its impact on self-concept, time competence, and purpose in life. Despite a lack of significant results on the dependent measures, informal evaluations and a follow-up study indicated that the course had resulted in some positive changes.     

Depression in Older Adults

The purpose of this article is to address selected aspects of depression in older adults. Specifically, symptoms, risk factors, diagnosis, and interventions for depression in older adults are reviewed.     

A Spiritual Screening Tool for Older Adults

Objective The purpose of this non-experimental study was to investigate the reliability and validity of a self-administered screening tool for spiritual distress in older adults. The tool was unique in that items were consistent with a conceptual definition of spirituality presented in the professional literature and supported by theories of behavioral development for older adults. Methods Questionnaires were distributed to residents of a continuing care retirement community participating in a class on spirituality. Results The split-half reliability coefficient was found to be 0.776. Construct validity was established and a cutoff value for spiritual distress was determined. Discussion Tests for reliability and validity demonstrated confidence in use of the tool to screen for spiritual distress in older adults.     

我国老年人的社会支持与服务

鉴于我国老龄化现状,简要地回顾了社会支持的定义与种类,考察了我国传统的孝顺价值观和行为;并着重分析了我国老年人的社会支持与服务,包括老年人的社会支持与幸福感,老年人的家庭支持与照料,老年组织与公共老年服务;以及我国老年人社会支持的城乡差异。     

Cognitive-Behavioral Therapy for Insomnia in Older Adults

Sleep is disturbed by a range of factors across the lifespan. However, older adults experiencing disruptions in their sleep are often simultaneously contending with a range of comorbid medical and psychiatric conditions that compound the biological changes in sleep that commonly occur with age. Cognitive behavioral therapy for insomnia (CBT-I) is the gold-standard, nonpharmacological intervention for sleep disturbances, and is a cost-effective treatment approach that can occur in either individual or group format. It has also been shown effective in older adults with medical, psychiatric, and cognitive comorbid disorders. This review highlights the success of CBT-I with older adults, as well as studies that illustrate the use of alternative delivery methods and treatment modifications for complex clinical presentations.     

Ethical Guidelines for Counselors Working With Older Adults

Counselors working with older adults may encounter situations that are not directly addressed by the ethical standards of the American Counseling Association (1995). After an extensive review of the literature, the Standards Committee of the Association for Adult Development and Aging (1998) identified 3 areas of concern: older adults with cognitive impairments, older adults who are the victims of abuse, and older adults with a terminal illness. This article examines the unique needs of older adults with these concerns and proposes guidelines for counselors working with such clients.     

Spiritual Autobiography and Older Adults

Spiritual autobiography groups constitute a form of ministry that can potentially enrich the lives of older adults, their families, and their congregations. Such groups, when competently led, provide participants with an environment in which they can make meaning out of their lives, grieve their losses, and give and receive support. The actions and interactions involved in composing, telling, and hearing life stories are salutary exercises that can increase participants’ experiences of clarity, coherence, and connection to God and to each other. The spiritual wisdom that emerges from such life stories, when shared within congregations, can enhance intergenerational relationships and lead to spiritual growth for members of diverse ages.     

Alcohol Use Among Older Adults

Alcohol use problems among older adults have been called the "invisible epidemic." As the population of older adults continues to grow, there is an increased need to reexamine alcohol use in this population. The authors provide an overview on alcohol use in the over-60 age group. The main areas of focus included research on the prevalence of drinking in that population, as well as comments on the best practices in assessment and psychological treatment. Several screening assessments have been recommended for use with older adults, such as the CAGE questionnaire, Michigan Alcohol Screening Test-Geriatric version, Alcohol-Related Problems Survey, and the Alcohol Use Disorders Identification Test. The authors note age-appropriate psychological treatment interventions that include brief interventions, family interventions, motivational counseling, and cognitive behavioral therapies. Barriers to assessment and treatment are also discussed.     

Clinical Interviewing With Older Adults

Over the next few decades the older adult population will increase dramatically, and prevalence rates of psychiatric disorders are also expected to increase in the elderly cohort. These demographic projections highlight the need for diagnostic instruments and methods that are specifically tailored to older adults. The current paper discusses the benefits and drawbacks of clinical interviewing with older adults, using two popular interview protocols as illustrative examples. Drawing upon preexisting basic research and our own observations collected in clinical and research settings over a 10-year period, we suggest procedures and suggestions for augmenting existing interview protocols to increase their usefulness with older adults in research and clinical settings. Strategies to optimize interview duration and enhance retrospective data accuracy and the pros and cons of dimensional versus dichotomous response formats, among other relevant topics, are discussed.     

Crisis Model for Older Adults: Special Considerations for an Aging Population

As the U.S. population ages, counselors must begin structuring their interactions to meet the unique needs of older adults, especially in the area of crisis intervention. The authors propose a new crisis intervention model that accounts for the needs of older adults in crisis by giving special attention to the roles of advocacy, education, and prevention.     

Cognitive Behavioral Therapy for Insomnia in Older Adults

Insomnia is associated with significant morbidity and is often a persistent problem, particularly in older adults. It is important to attend to this complaint and not assume that it will remit spontaneously. In many cases, unfortunately, insomnia remains unrecognized and untreated, often because it is presumed that insomnia is an inevitable consequence of aging. Although the sleep structure naturally changes with advancing age, these changes are not necessarily associated with complaints of poor sleep, distress, or daytime consequences, while chronic insomnia clearly is. There is increasing evidence that cognitive behavioral therapy (CBT) is effective for the management of chronic insomnia in the elderly and that it is of significant benefit for insomnia comorbid with medical and psychological conditions, also more prevalent in older age. The aim of this article is to familiarize clinicians working with older adults with the different components of CBT for insomnia and how to adapt the treatment to this population. A clinical case and session-by-session implementation of CBT for insomnia are described to illustrate information and guidelines provided in this article.     

老年人的朋友参照效应

采用自我参照效应范式探讨老年人朋友参照效应的特点。城市老年人和农村老年人各36人参加实验1, 结果表明：(1)城乡老年人都表现出朋友参照效应; (2)与农村老年人相比, 城市老年人朋友参照效应指标显著高于自我参照效应指标。城市教育程度较高与教育程度较低老年人各36人参加实验2, 结果发现, 与城市教育程度较低的老年人相比, 城市教育程度较高的老年人朋友参照效应指标高于自我参照效应指标, 表明教育程度对朋友参照效应有显著影响。由此推断, 老年人会将朋友包含于自我图式之内, 并且教育程度会影响朋友在自我图式中的地位。     

Understanding Gerotranscendence in Older Adults: A New Perspective for Counselors

The author describes gerotranscendence as a process that occurs when older adults shift from a rational focus on the present‐day, material world to a more universal and transcendent perspective. Accompanying this shift is a desire to move toward the end of life with a sense of integrity and acceptance of one's choices. By gaining an understanding of gerotranscendence, counselors can better meet the needs of their aging clients. Using existing gerotranscendence literature as a guideline, suggestions are made for appropriate counseling interventions.     

Sexuality in Older Adults: A Deconstructionist Perspective

Societal myths argue against active expression of sexuality in older adults, but these prejudices are unfounded. Using a deconstructionist framework, this article addresses issues surrounding sexuality in older adults. Implications for clinical practice are given.     

Meaningfulness in Day Centers for People With Psychiatric Disabilities: Gender and Empowerment Aspects

This study investigated the experience of meaningfulness in occupations at day centers among people with psychiatric disabilities from an empowerment and gender perspective. One hundred eight participants, from eight day centers in Sweden, completed instruments measuring experienced meaning, empowerment, psychosocial functioning, and socio-demographic factors. Mixed methods were used, combining statistical analyses and content analysis. Gender differences were found concerning principal occupations performed. These confirmed traditional gender roles. The experience of meaning in day center occupations, particularly the domain of meaning pertaining to personal development, was significantly associated with empowerment. These results may be used in the future development of day centers.