Behavior-analytic research on dementia in older adults

It is estimated that 1 in 10 adults aged 65 years and older have been diagnosed with dementia, which is associated with numerous behavioral excesses and deficits. Despite the publication of a special section of the Journal of Applied Behavior Analysis (JABA) on behavioral gerontology (Iwata, 1986), there continues to be a paucity of behavior-analytic research with this population. This review compares the research published before and after the behavioral gerontology special section and evaluates the most recently published aging articles in JABA.     

Abstraction of tactile properties by individuals with autism and Down syndrome using a picture‐based communication system

The present study evaluated the efficacy of a set of procedures for bringing tact extensions of abstract tactile properties under stimulus control. Two participants with disabilities who communicated via a picture‐based communication system received reinforcement for tacts of tactile properties of four wet/dry and four hard/soft stimuli. Test trials were conducted to evaluate the extent to which the participants' correct responding generalized to novel stimuli with the same tactile properties. The results suggest that the procedures were effective in bringing tact extensions of abstract tactile properties under stimulus control. Both participants' correct responding generalized to a set of novel stimuli. Mastery level responding to training and test targets maintained for 2 weeks following training. The results provide further evidence supporting the use of DTT to teach stimulus abstraction to nonvocal verbal individuals who use augmentative forms of communication.     

Driving manoeuvre during lane maintenance in older adults: Associations with neuropsychological scores

Older drivers experience difficulties in lane maintenance under challenging driving sections due to age-related cognitive declines, yet there is little comprehensive evidence on associations between cognitive functions and the lane maintenance in this population. In this study, fifty older drivers completed an on-road driving assessment and a battery of standard neuropsychological tests. Mean Lane Position (MLP), Standard Deviation of Lane Position (SDLP) and manoeuvre time calculated from precise vehicle movement trajectories were used as the lane maintenance parameters. The GNSS tracking vehicle movement presents comprehensive and reliable vehicle position data, which is more sensitive for detecting subtle variations of lane maintenance in older drivers. Statistical analysis results showed that lower visual attention (selective and divided attention) was associated with higher MLP and SDLP; MLP was also correlated to spatial abilities, executive function, and motor speed; manoeuvre time was negatively correlated with drivers’ risk-taking personality (all p < .01). Selective attention was found to be the best predictor of MLP in lane maintenance. A combined eight variables from three neuropsychological tests, UFOV 2 and 3, BD and BJLO, D-KEFS TMT 1, 2, 3, and 4, correctly classified 80.4% of participants with good versus low-performing lane maintenance.     

Rowland Universal Dementia Assessment Scale,Mini‐Mental State Examination and General Practitioner Assessment of Cognition in a multicultural cohort of community‐dwelling older persons with early dementia

Early dementia can be difficult to diagnose in older persons from culturally and linguistically diverse (CALD) backgrounds. The Folstein Mini‐Mental State Examination (MMSE), the General Practitioner Assessment of Cognition (GPCOG) and the Rowland Universal Dementia Assessment Scale (RUDAS) were compared in 151 older, community‐dwelling persons. Receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic accuracy, while logistic regression was used to evaluate the influence of age, gender, CALD status and years of education. All three instruments were equally accurate in predicting dementia (ROC area under curve 0.92–0.97, p > 0.05 for all comparisons). At the recommended cut‐offs, the RUDAS was best for ruling in dementia (positive LR = 8.77), while the GPCOG was best for ruling out dementia (negative LR = 0.03). All three instruments were influenced by concomitant depression. Whereas the MMSE was influenced by CALD status, the RUDAS and GPCOG were not. While the GPCOG combines participant and informant data, the RUDAS is a stand‐alone measure specifically designed for, and validated in, multicultural populations.     

Judgments of blame and forgiveness: A comparison of young adults,older adults,and older adults with dementia

IntroductionAlzheimer's disease may modify moral judgment.ObjectiveIn two studies, we assessed the impact of dementia on blame and forgiveness. Study 1 compared the ways in which young adults, older adults, and older adults with dementia cognitively integrated two factors. Study 2 assessed the number of different factors that older adults with dementia were able to integrate during these moral judgments.MethodThe participants recorded their moral judgements in a blame task and in a forgiveness task. In study 1, the two questionnaires contained scenarios built from the combination of two factors. In study 2, the participants were confronted with the same tasks under three different conditions with scenarios that combined three, four or five factors.ResultsThe data from study 1 showed that the older adults with dementia did not combine the two factors in the same way as young adults did: the combination depended on the type of moral judgment. Study 2 revealed differences in moral judgment between older adults with dementia and adults without dementia in all tasks (i.e. with three, four or five factors combined).ConclusionDementia has an impact on moral judgments. Moral judgment among people with dementia is both task- and condition-dependant.     

Correlated and coupled cognitive change in older adults with and without preclinical dementia

Common factor aging theories state that correlations among cognitive age effects signify a single underlying causal process. The logic underlying this proposition was evaluated by examining correlated cognitive change in a sample of 391 initially nondemented older adults who were tested annually for up to 16 years. Between-person correlations among rates of change (range = .56-.61) were partly attributable to model misspecification and the aggregation of heterogeneous groups of individuals. Correlated within-person cognitive change was much stronger in the cases (.45-.51) than in the noncases (.07-.18). These results demonstrate that correlated change may either signify causal commonality or the cumulative effects of multiple age-related conditions that can affect multiple cognitive systems.     

Typicality effects in picture‐word interference paradigm: An evaluation of the response exclusion hypothesis

The response exclusion hypothesis suggests that the polarity of semantic effects in the picture‐word interference paradigm is determined by the response‐relevant criteria. Semantic interference effects would be observed when semantically related distractor words satisfy the response‐relevant criteria; otherwise, semantic facilitation effects should be found. The purpose of this study was to further evaluate the response exclusion hypothesis by exploring the typicality effects in pictures naming. In two experiments, pictures of objects were named either in the context of verb distractor words with different typicality of passive functions or in the context of adjective distractor words with different typicality of characteristics. Facilitation effects were observed in context of typical verbs and adjectives, while interference effects were observed in the context of atypical verbs and adjectives. Given that neither typical nor atypical distractor words satisfy the response‐relevant criteria to produce noun, these findings are problematic for the response exclusion hypothesis. Role of syntagmatic relationships in lexical retrieval was invoked to explain present findings.     

Relationship maintenance across platonic and non-platonic cross-sex friendships in emerging adults

Prior research examining maintenance in cross-sex friendships focuses heavily on platonic (i.e., nonsexually active) friendships with limited research examining sexually involved cross-sex friendships (i.e., “friends with benefits relationships”). In this study, we investigated differences in relational maintenance behaviors between sexually and nonsexually active cross-sex friendships types. In an online survey, 531 emerging adult participants from large southwestern and southeastern universities identified either a friends with benefits or platonic opposite sex friendship and then completed items asking them to report the frequency with which they enacted each of 36 relationship maintenance behaviors. Overall, participants involved in casual sex friendships engaged in the least, and those who transitioned from a friends-with-benefits relationship to a romantic relationship engaged in the most frequent relationship maintenance. Platonic friendships employed more frequent maintenance than casual-sex friendships but less than either true friends with benefits or participants who transitioned to a romantic relationship.     

Deej‐a Vu: Documentary revisits facilitated communication pseudoscience

Deej is a documentary about a young man named Deej who has autism with complex communication needs (i.e., nonverbal autism). To the uninitiated, Deej might look like a poignant story about people misperceiving Deej until he reveals the intelligence hidden inside him. The documentary uses Deej's story to suggest that other people with complex communication needs are similarly misunderstood. In actuality, the documentary is misleading and concerning. Deej demonstrates his hidden intelligence via facilitated communication. The documentary does not mention the science that discredits facilitated communication or the harm that facilitated communication has enabled. In the present paper, I use the history of facilitated communication to examine Deej. I describe how the documentary promotes facilitated communication by encouraging improper forms of scientific reasoning. Finally, I suggest that skepticism toward facilitated communication is necessary to ameliorate its harmful influence and to encourage genuine acceptance of people with complex communication needs.     

Role of face‐to‐face and computer‐mediated communication time in the cohesion and performance of mixed‐mode groups

Although the rapid development of information technology has led to the increasing use of computer‐mediated communication (CMC), few studies have examined the relational aspect of mixed‐mode groups that use both face‐to‐face (FTF) communication and CMC. A field study comprising 42 student groups was conducted to assess the relationships among communication time, cohesion, and performance in mixed‐mode groups. The findings suggest that time spent in FTF communication significantly predicted group social cohesion, but time spent in CMC did not. In contrast, group task cohesion was predicted by time spent in CMC but not by time spent in FTF communication. Time spent in CMC was also a strong predictor of group task performance. These results suggest that FTF communication contributes to the social aspect of mixed‐mode groups and that CMC is beneficial to their task‐related aspect. The findings of mediation analyses showed a significant indirect effect among time spent in FTF communication, group social cohesion, and group contextual performance. In other words, time spent in FTF communication had a positive effect on group social cohesion, which in turn positively affected group contextual performance. However, no mediating effect was found among time spent in CMC, group task cohesion, and group task performance. Theoretical and practical implications of these findings are discussed.     

Working with older adults and their families – a review

This paper discusses family work with older adults by exploring some of the related literature published since Herr and Weakland's work in 1979, and compares psychoeducational and systems-based approaches to work with later life families. Issues of bias and omissions in the existing literature, and the definition of family therapy with this client group are raised. Areas for future research are indicated.     

Psychological and socioeconomic health of community‐dwelling older adults

Different dimensions of health are intertwined. The purposes of this study were: (1) to investigate the psychological and socioeconomic health status of community‐dwelling older adults in Taiwan, and (2) to compare the psychological and socioeconomic health differences among people of different age groups, gender, marital status, and exercise habits. Using stratified random sampling, 384 Taiwanese community‐dwelling older adults were recruited for this survey research. Based on the Health Model of Older Adults, seven constructs were measured: (1) psychological health: sleep quality, emotional health, cognitive functioning, and health promotion behaviors; (2) socioeconomic health: social engagement, social support, and financial status. Results showed that most participants were in a good state of psychological and socioeconomic health, except that 38.02% of them suffered from sleep disruptions, and the majority of them were not involved in any social group, nor engaged in any volunteer work. Young‐old older adults had better psychological and socioeconomic health than middle‐old and old‐old older adults. Male older adults had better psychological health than female older adults; however, they had less social engagement and social support than female older adults. Married older adults and exercisers performed better in most of the psychological and socioeconomic health indicators than single/widowed older adults and non‐exercisers.     

Psychosocial mediators of a theory-based resistance training maintenance intervention for prediabetic adults

Objective: Examine psychosocial mediators of the effects of high vs. low-dose resistance training (RT) maintenance interventions among older (ages 50–69), overweight and pre-diabetic adults.

Design: Participants (N = 123) completed a three-month supervised RT initiation phase and were subsequently randomised (time 1) to high or low-dose six-month unsupervised RT maintenance interventions (time 2), followed by a six-month no-contact phase (time 3).

Main Outcome Measures: Online measures of putative mediators and RT behaviour.

Results: RT intervention condition (high vs. low dose) had significant effects on change from time 1 to time 2 in behavioural expectation, self-regulation and perceived satisfaction (f² = .04–.08), but not outcome expectancies, RT strategies or behavioural intentions (f² ≤ .02). Change in each of the putative mediators, except for outcome expectancies (f² ≤ .02), had significant effects on RT behaviour at times 2 (f² = .12–.27) and 3 (f² = .23–.40). In a multiple mediation model, behavioural expectation (f² = .11) and self-regulation (f² = .06) mediated the effects of RT intervention condition on time 2 RT behaviour, whereas perceived satisfaction did not (f² = .01). Self-regulation was a significant mediator of intervention effects on time 3 RT behaviour (f² = .11), but behavioural expectation and perceived satisfaction were not (f² = .04).

Conclusions: Findings suggest that behavioural expectation and self-regulation are appropriate targets for RT maintenance interventions among at-risk older adults.     

Within‐session supervision communication in the training of clinical psychologists

There is little research evaluating within‐session supervision communication in the training of clinical psychologists. This study evaluated the perception of 37 interns and 49 patients regarding communication between supervisor and intern during the therapy session. Most supervisors used such communication infrequently. While some interns and patients viewed call‐ins or walk‐ins as intrusive and unhelpful, the majority did not. Indeed, some valued the feedback. No association was found between the use of call‐ins or walk‐ins and patient reports of therapist behaviours or intern reports of supervisory style. It is concluded that within‐session communication is not deemed as necessary by most supervisors, who should remain cautious in their use of such communication, unless patient care is compromised.     

Collaborative competence,social capital,and mental health: A cross‐sectional analysis of a community‐based intervention for older adults

Social capital interventions for the mental health of older adults have been inconclusive to date, and have rarely investigated the psychological resources that are important to having social capital. This study focused on the “Neighborhoods in Solidarity” (NS), which are a series of Swiss community‐based interventions that aim to empower older adults to participate in their communities. Our goal was to understand whether the NS were associated with collaborative competence, social capital, and subsequently, symptoms of depression. Cross‐sectional data were collected from 947 individuals aged 55 and over (M_age = 68.66, SD = 9.04) in 10 Swiss neighbourhoods (five with the NS [n = 479] and five control neighbourhoods [n = 468]). Structural equation modelling was used to model the relationship between the NS intervention, collaborative competence, cognitive and structural dimensions of social capital, and symptoms of depression (measured by the CESD‐R‐10). Individual participation in the NS had total and indirect effects on symptoms of depression via collaborative competence and both social capitals. These findings suggest that existing community‐based interventions can be indirectly associated with better mental health outcomes in the ageing population.