Developmental change and intraindividual variability: relating cognitive aging to cognitive plasticity, cardiovascular lability, and emotional diversity

Repeated assessments obtained over years can be used to measure individuals' developmental change, whereas repeated assessments obtained over a few weeks can be used to measure individuals' dynamic characteristics. Using data from a burst of measurement embedded in the Berlin Aging Study (BASE; Baltes & Mayer, 1999), we illustrate and examine how long-term changes in cognitive ability are related to short-term changes in cognitive performance, cardiovascular function, and emotional experience. Our findings suggest that "better" cognitive aging over approximately 13 years was associated with greater cognitive plasticity, less cardiovascular lability, and less emotional diversity over approximately 2 weeks at age 90 years. The study highlights the potential benefits of multi-time scale longitudinal designs for the study of individual function and development.     

Effects of age and ability on components of cognitive change

Prior experience with a cognitive task is often associated with higher performance on a second assessment, and these experience effects can complicate the interpretation of cognitive change. The current study was designed to investigate experience effects by obtaining measures of cognitive performance separated by days and by years. The analyses were based on data from 2017 adults with two longitudinal occasions, of whom 948 had also completed a third occasion, with each occasion consisting of three parallel versions of the tests on separate sessions. Change across short intervals was typically positive, and greater among older adults and adults with low levels of cognitive ability, whereas change over intervals of approximately three years was often negative, particularly at older ages. In contrast to the expectation that change over short intervals might be informative about change over longer intervals, relations between short-term change and long-term change were negative, as the individuals who gained the most with assessments separated by days tended to experience the greatest losses across assessments separated by years.     

A follow-up of cognitive performance and diurnal salivary cortisol changes in former burnout patients

The purpose of this study was to determine whether recovery from burnout is associated with improved cognitive functioning, and whether such improvement is associated with changes in hypothalamic-pituitary-adrenal axis activity and return to work. Forty-five former burnout patients were followed up after 1.5 years with a neuropsychological examination, diurnal salivary cortisol measurements, dexamethasone suppression test (DST), and self-ratings of cognitive problems. At follow-up, improved cognitive performance was observed on several tests of short-term memory and attention. Self-rated cognitive problems decreased considerably, but this decrease was unrelated to the improvement on neuropsychological tests. Diurnal salivary cortisol concentrations at awakening, 30?min after awakening, and in the evening, did not change from baseline to follow-up, nor did the cortisol awakening response. However, slightly, but significantly, stronger suppression of cortisol in response to the DST was observed at follow-up. Improvements in subjective or objective cognitive functioning and changes in diurnal cortisol concentration were unrelated to the extent of work resumption. However, a decreased DST response at follow-up was partially related to improved cognitive performance and work resumption. The clinical implications are that burnout seems to be associated with slight and significantly reversible cognitive impairment, and that self-rated cognitive change during recovery poorly reflects objective cognitive change.     

Activity engagement is related to level, but not change in cognitive ability across adulthood

It is unclear whether the longitudinal relation between activity participation and cognitive ability is due to preserved differentiation (active individuals have higher initial levels of cognitive ability), or differential preservation (active individuals show less negative change across time). This distinction has never been evaluated after dividing time-varying activity into its two sources of variation: between-person and within-person variability. Further, few studies have investigated how the association between activity participation and cognitive ability may differ from early to older adulthood. Using the PATH Through Life Project, we evaluated whether between- and within-person variation in activity participation was associated with cognitive ability and change within cohorts aged 20-24 years, 40-44 years, and 60-64 years at baseline (n = 7,152) assessed on three occasions over an 8-year interval. Multilevel models indicated that between-person differences in activity significantly predicted baseline cognitive ability for all age cohorts and for each assessed cognitive domain (perceptual speed, short-term memory, working memory, episodic memory, and vocabulary), even after accounting for sex, education, occupational status, and physical and mental health. In each case, greater average participation was associated with higher baseline cognitive ability. However, the size of the relationship involving average activity participation and baseline cognitive ability did not differ across adulthood. Between-person activity and within-person variation in activity level were both not significantly associated with change in cognitive test performance. Results suggest that activity participation is indeed related to cognitive ability across adulthood, but only in relation to the starting value of cognitive ability, and not change over time.     

Acute neuropsychological consequences of coronary artery bypass surgery

This study examines a series of coronary artery bypass patients (CABS) for neuropsychological and regional cerebral blood flow (RCBF) changes at 8 days and 8 weeks post surgery. Seventy-three percent were found to have moderate or severe neuropsychological deficits at 8 days post operation and 37% at 8 weeks post surgery. A comparison group of major vascular and thoracic surgery patients was also found to have a significant proportion of neuropsychological deficit following surgery. The RCBF assessments indicated a significant drop in mean RCBF at 8 days post surgery in the coronary artery bypass group which did not persist to 8 weeks. The comparison group showed no changes in RCBF following surgery. The findings suggest different patterns of recovery and origins of the neuropsychological deficit in the two groups and emphasize the need for appropriate control groups in studies examining the cortical effects of extracorporeal circulation. In addition, the project received generous support from the special trustees of the Middlesex Hospital.     

Threats to the Internal Validity of Spinal Surgery Outcome Assessment: Recalibration Response Shift or Implicit Theories of Change?

A recalibration response shift will cause the patient to think about a self-report measure’s response options differently after a health state change. Commonly assessed using the retrospective-pretest design (“then-test”), recent guidelines suggest adjusting then-test estimates for competing explanations. This prospective longitudinal study investigated recalibration response shift after adjusting for implicit theories of change in patients undergoing spinal surgery. The Oswestry Disability Index (ODI) and Short Form-36 (SF-36) were collected before surgery and at 6 weeks and 3 months after spinal decompression surgery. Then-tests of the measures were also collected at all post-tests. Recalibration response shift was operationalized as the then-minus-pre difference score on the evaluative SF-36. Implicit theories of change were operationalized as the then-minus-pre difference score on the perception-based ODI. Improved vs. No-Effect patient groups were compared using the Minimally Important Difference (±15 points) as a cut-off on the Visual Analogue Scale (VAS) items for back and leg pain. Logistic regression analyses investigated whether recalibration response shift had an independent effect distinguishing patient groups, after adjusting for implicit theories of change. The sample (baseline n?=?169, mean age 52, 39 % female) was well-educated, and 1/3 were working. All then-minus-pre difference scores were non-zero at each time point and were stable over time. In the adjusted models distinguishing Improved versus No Effect groups, then-minus-pre ODI difference scores were significant in the majority of the adjusted models at all timepoints, but only one then-minus-pre SF-36 difference score—for physical functioning recalibration—was significant and only at 6-weeks post-surgery. This suggests that implicit theories of change bias the estimation of post-surgical outcomes, but that recalibration response shift biased only the estimation of physical functioning and only at 6 weeks post-surgery. Recalibration response shift and implicit theories of change can both be sources of bias in patient-reported outcome assessment. Our findings suggest that implicit theories of change are a greater threat to validity in this patient sample. Future research using the then-test should control for implicit theories of change to minimize misspecification of effects.     

Reducing Academic Procrastination Through a Group Treatment Program: A Pilot Study

The present study assessed a short-term group treatment program using cognitive interventions focused on students’ procrastination. A structured 90-min session program was used with 10 students (5 female, 5 male; M _age = 21.8, SD = 3.2) across 5 weeks. In the first and last session of the program participants completed a two reliable and valid procrastination scales, and then 8 weeks later in the follow up sessions filled out the same questionnaires. During the group sessions, participants identified their irrational thoughts as well as cognitive distortions associated with their procrastination tendencies. Results of a non-parametric Friedman Test revealed a significant decrease in participants’ academic procrastination score and general procrastination scores from the pre-test to follow-up test suggesting that the program was deemed to be successful.     

Perception of cognitive function in older adults following coronary artery bypass surgery.

This study examined the effects of coronary artery bypass grafting (CABG) on objective and subjective measures of neurocognitive functioning. Participants were 170 older patients (127 men and 43 women; mean age = 61 years) undergoing CABG. Measures of neurocognitive function, depression, anxiety, and perceived cognitive abilities were administered immediately prior to and 6 weeks following surgery. Although objective measures of impaired cognitive performance following CABG were not related to perceived cognitive difficulties, the presence of anxiety and depression was related to the perception of cognitive functioning. Patients who reported high levels of anxiety and depression 6 weeks after surgery perceived themselves as having poorer cognitive function. Interventions designed to reduce emotional distress could improve patient's perceived cognitive abilities following CABG.     

Irrational Beliefs in Employees with an Adjustment,a Depressive,or an Anxiety Disorder: a Prospective Cohort Study

It remains unclear if patients with different types of common mental disorders, such as adjustment, anxiety and depressive disorders, have the same irrational ideas. The aim of this prospective cohort study (n = 190) is to investigate differences in level and type of irrational beliefs among these groups and to examine whether a change in irrational beliefs is related to symptom recovery. Irrational beliefs (IBI) and symptoms were measured at four points in time: at baseline, after 3, 6 and 12 months. Results showed that diagnostic groups differed in their level of irrational beliefs and this effect remained over time. Highest levels of irrationality were observed in the double diagnosis group, followed by the anxiety disorder group and the depression group. Participants with adjustment disorders showed the lowest levels of irrationality, comparable to a community sample. We did not find differences in the type of irrational beliefs between diagnostic groups. The level of irrationality declined over time for all diagnostic groups. No differences in decrease were observed between diagnostic groups. The magnitude and direction of change in irrational beliefs were related to the magnitude of recovery of depressive, anxiety and stress symptoms over time. These results support the application of general cognitive interventions, especially for patients with a depressive or an anxiety disorder.     

Depressive symptoms predict decline in perceptual speed in older adulthood

Depressive symptoms and cognitive decline are associated in older age, but research is inconsistent about whether one condition influences the development of the other. We examined the directionality of relations between depressive symptoms and perceptual speed using bivariate dual change score models. Assessments of depressive symptoms and perceptual speed were completed by 1,206 nondemented older adults at baseline, and after 2, 8, 11, and 15 years. After controlling for age, education, baseline general cognitive ability, and self-reported health, allowing depressive symptoms to predict subsequent change in perceptual speed provided the best fit. More depressive symptoms predicted subsequently stronger declines in perceptual speed over time lags of 1 year.     

No protective effects of education during normal cognitive aging: results from the 6-year follow-up of the Maastricht Aging Study

Recent large-scale longitudinal aging studies question earlier claims that higher education protects against cognitive decline in older age. In the present study, the authors addressed this issue by determining whether educational level had an attenuating effect on the rate of cognitive change assessed with a broad range of neuropsychological tests in a community sample of 872 healthy individuals aged 49 to 81 years at baseline. The participants were followed for 6 years and were tested 3 times (at baseline and at 3 and 6 years after baseline). Results of linear mixed-model analyses showed that education had no significant effect on cognitive change over time. These results are discussed in terms of the age range of the sample, definition and range of education, cognitive measures used, length of the study and number of consecutive assessments, and confounding effect of health. The findings question the extent of the presumed protective effects of higher education on cognitive decline during normal aging.     

Does Writing About Suicidal Thoughts and Feelings Reduce Them?

To assess whether writing with cognitive change or exposure instructions reduces depression or suicidality, 121 undergraduates screened for suicidality wrote for 20 minutes on 4 days over 2 weeks. They were randomly assigned to reinterpret or to write and rewrite traumatic events/emotions, or to write about innocuous topics. The three groups (N = 98) who completed pre-, post-, and 6-week follow-up were not different on suicidality or depression. All subjects reported fewer automatic negative thoughts over the 2 weeks; they also reported higher self-regard but more health center visits at follow-up. Suicidal thoughts may be more resistant than physical health to writing interventions.     

Self-Reported Cognitive Inconsistency in Older Adults

ABSTRACT

Insight into one's own cognitive abilities, or metacognition, has been widely studied in developmental psychology. Relevance to the clinician is high, as memory complaints in older adults show an association with impending dementia, even after controlling for likely confounds. Another candidate marker of impending dementia under study is inconsistency in cognitive performance over short time intervals. Although there has been a recent proliferation of studies of cognitive inconsistency in older adults, to date, no one has examined adults' self-perceptions of cognitive inconsistency. Ninety-four community-dwelling older adults (aged 70–91) were randomly selected from a parent longitudinal study of short-term inconsistency and long-term cognitive change in aging. Participants completed a novel 40-item self-report measure of everyday cognitive inconsistency, including parallel scales indexing perceived inconsistency 5 years ago and at present, yielding measures of past, present, and 5-year change in inconsistency. The questionnaire showed acceptable psychometric characteristics. The sample reported an increase in perceived inconsistency over time. Higher reported present inconsistency and greater 5-year increase in inconsistency were associated with noncognitive (e.g., older age, poorer ADLs, poorer health, higher depression), metacognitive (e.g., poorer self-rated memory) and neuropsychological (e.g., poorer performance and greater 5-year decline in global cognitive status, vocabulary, and memory) measures. Correlations between self-reported inconsistency and neuropsychological performance were attenuated, but largely persisted when self-rated memory and age were controlled. Observed relationships between self-reported inconsistency and measures of neuropsychological (including memory) status and decline suggest that self-perceived inconsistency may be an area of relevance in evaluating older adults for memory disorders.     

Incidence of depression related to isotretinoin treatment in 100 acne vulgaris patients

The incidence of depression in acne patients using isotretinoin was assessed in 100 patients with moderate and nodulocystic acne. All patients received 0.75-1.00 mg/kg/day of isotretinoin for 20-28 weeks after acne was assessed. All patients' acne lesions were improved at the end of the treatment period. Psychological state was evaluated at baseline, at Month 3, and Month 6 by a psychiatrist using a Turkish version of the Hamilton Depression Rating Scale. Only one patient's score increased to the clinical level of depression at Month 3 of treatment and declined to subclinical levels at Month 6. Although Hamilton scores increased at Month 3 over baseline scores, except for one patient, others' scores remained below the subclinical level for depression. At the end of Month 6, the mean score decreased below that at Month 3. These changes in means might be related to the onset of clinical effect of isotretinoin.     

Psychophysiological mediators of caregiver stress and differential cognitive decline

The authors examined relationships between chronic stress and cognitive decline and whether such relationships were mediated by psychophysiological factors. Ninety-six caregivers of spouses with Alzheimer's disease (AD) were compared with 95 similar noncaregiver spouses. All were free of diabetes. Although the groups started similarly, over 2 years caregivers declined by a small but significant amount (1 raw score point and 4 percentile points, each p<.05) on Shipley Vocabulary. In contrast, noncaregivers did not change. Higher hostile attribution (beta=-.09; p<.05) and metabolic risk (beta=-.10; p<.05) in caregivers mediated the cognitive decline. This is the first study of cognitive decline and mediators in caregivers. This work has implications for caregiver and care-recipient health and for research on cognition, psychophysiology, diabetes, and AD.     

The effects of haloperidol on thought disorder and IQ in schizophrenia

The impact of haloperidol treatment on the Wechsler Adult Intelligence Scale (WAIS) and the Thought Disorder Index was investigated in a group of 19 patients with schizophrenia tested both before and after 26 days of treatment with haloperidol. Thought disorder scores declined significantly over the course of treatment and fewer patients demonstrated severe forms of thought disorder at the end of the trial. WAIS performance improved significantly but the magnitude of change was consistent with the literature on expected practice effects. Thought disorder scores were negatively correlated with IQ at baseline, but not at Day 26. The results suggest a partial dissociation of thought disorder and other cognitive functions in schizophrenia.     

The Effects of Haloperidol on Thought Disorder and IQ in Schizophrenia

The impact of haloperidol treatment on the Wechsler Adult intelligence Scale (WAIS) and the Thought Disorder Index was investigated in a group of 19 patients with schizophrenia tested both before and after 26 days of treatment with haloperidol. Thought disorder scores declined significantly over the course of treatment and fewer patients demonstrated severe forms of thought disorder at the end of the trial. WAIS performance improved significantly but the magnitude of change was consistent with the literature on expected practice effects. Thought disorder scores were negatively correlated with IQ at baseline, but not at Day 26. The results suggest a partial dissociation of thought disorder and other cognitive functions in schizophrenia.     

Cognition and the development of temperament from late childhood to early adolescence

Temperament is related to cognition, but it is unclear whether reciprocal associations exist with early developmental trajectories. Children from the Longitudinal Study of Australian Children (N = 8,677) were assessed over four waves on verbal ability at ages 8/9, nonverbal ability at ages 8/9 and 10/11, and parent-rated temperament every two years from ages 8/9 to 14/15. Latent difference score analyses indicated correlated changes between ages 8/9 and 10/11. Increased nonverbal ability over the first two years was associated with declined reactivity and increased persistence. Latent growth curve models further indicated that nonverbal and verbal ability at baseline were associated with declined reactivity and increased persistence over the six years. These findings suggest bidirectional associations between childhood cognitive ability and temperament development.     

A randomized control trial to investigate the impact of the Lidcombe Program on early stuttering in German-speaking preschoolers

In order to investigate whether the Lidcombe Program effects a short-term reduction of stuttered speech beyond natural recovery, 46 German preschool children were randomly assigned to a wait-contrast group or to an experimental group which received the Lidcombe Program for 16 weeks. The children were between 3;0 and 5;11 years old, their and both of their parents’ native language was German, stuttering onset had been at least 6 months before, and their stuttering frequency was higher than 3% stuttered syllables. Spontaneous speech samples were recorded at home and in the clinic prior to treatment and after 4 months. Compared to the wait-contrast group, the treatment group showed a significantly higher decrease in stuttered syllables in home-measurements (6.9%SS vs. 1.6%SS) and clinic-measurements (6.8%SS vs. 3.6%SS), and the same increase in articulation rate. The program is considered an enrichment of currently applied early stuttering interventions in Germany.

Educational objectives: Readers will discuss and evaluate: (1) the short-term effects of the Lidcombe Program in comparison to natural recovery on stuttering; (2) the impact of the Lidcombe Program on early stuttering in German-speaking preschool children.     

Auditory feedback is necessary for the maintenance of stereotyped song in adult zebra finches.

Although songbirds rely on auditory input for normal song development, many species eventually attain adult song patterns that are thought to be maintained without reference to auditory feedback. In such species, it is believed that a central motor program for song is established when the stereotyped adult song pattern is achieved. However, we report here that in the Australian zebra finch, stereotyped song patterns gradually change in adult males following bilateral cochlear removal. By 16 weeks after surgery, deaf birds accurately reproduced only 36% of the song syllables produced prior to surgery. Moreover, on average, the phonology of over 50% of the syllables produced by deaf birds was either only slightly similar or unlike the phonology of any syllable produced prior to surgery. In contrast, control birds accurately retained over 90% of their syllables over a comparable time period and less than 5% of their syllables was unmatched or only slightly similar in phonology to previously recorded syllables. In many of the deafened birds, changes in song patterns were not evident until 6-8 weeks after surgery. These data indicate that continued auditory input is necessary to maintain the patterns of neural organization supporting learned song in zebra finches and raise questions concerning the neural sites and cellular mechanisms that mediate this feedback control.