The Behavioral Dyscontrol Scale and Functional Status Among Elderly Medical and Surgical Rehabilitation Patients

This research was conducted in a sample of 150 older adults (mean age = 78.0) who were inpatients receiving rehabilitation services for a variety of medical and postsurgical conditions. The purpose of the study was to test the hypothesis that the Behavioral Dyscontrol Scale (BDS), a measure of the ability to use intentions to guide purposeful activity, would be strongly associated with concurrent functional status after controlling for age, sex, education, severity of pain, medical comorbidity, depression (Geriatric Depression Scale), and general mental status (Mini Mental State Exam [MMSE]). Functional status was assessed by rehabilitaion nurses' ratings of patients on 11 individual Activities of Daily Living (ADL) items and the Barthel Index. The hypothesis, tested by means of multiple regression analysis, was supported by the results. The BDS was the independent variable most strongly associated with all 11 ADL items and the Barthel Index. The MMSE contributed significantly to none of the models. Other covariates made minimal contributions to the variance shared with functional ability. Consistent with prior results in other samples, the ability to use intentions to guide purposeful behavior appears to be an important contributor to everyday functioning among older adults.     

Memory rehabilitation for older adults: preserving independent living / Rehabilitación de la memoria para adultos mayores: preservación de la autonomía de vida

Abstract

Episodic memory problems are the hallmark of cognitive ageing in normal elderly people. Learning of new material is worse in pathological cognitive ageing, such as dementia and its preliminary states (mild cognitive impairment). Because episodic learning is crucial to preserve independent living in the elderly, rehabilitation programmes for everyday memory problems are welcomed. The scope of scientific interest has switched from treatment to prevention. We claim that lifestyle interventions are the most direct way to preserve cognition. We summarize evidence for changes in nutrition and exercise. In addition, psychological interventions for elderly people with normal or pathological cognitive ageing are available. Recent meta-analyses found lacking evidence of transfer to everyday life and long-term effects. We critically assess these meta-analyses. We propose theoretically derived experimental interventions relying on spared learning mechanisms. As an example we report visual-imagery training showing positive effects in a randomized control trial, using individual memory diaries on memory improvement.     

Recurrence of Posttraumatic Stress Disorder in Late Life: A Cognitive Aging Perspective

Clinical experience with older adults shows that many will experience PTSD symptoms in older adulthood because of trauma exposure early in life. Some of these patients struggled with PTSD in the distant past and remained symptomfree for decades only to have a recurrence of PTSD in late life. This paper outlines a cognitive aging explanation for the recurrence of PTSD. It is proposed that the age-related decreases in attention make the intrusion of trauma-related memories more likely. The increase in intrusive memories, combined with age-related decreases in working memory, explicit memory, and prospective memory, increases the subjective distress associated with the memories and results in a recurrence of PTSD.     

基本心理能力老化的认知机制

基本心理能力老化机制是认知老化领域研究热点之一。横断研究与追踪研究表明, 感觉功能、加工速度、工作记忆等信息加工资源的衰退导致了基本心理能力的衰退。但由于相关研究不能进行因果推论, 基本心理能力老化的认知机制尚存在争论。因此本项目拟采用实验室研究和干预实验设计, 通过操纵感觉功能(知觉压力水平)、干预加工速度与工作记忆, 考察基本心理能力的年龄差异的变化, 以期为认知老化理论的深化和拓展提供实验依据。     

视知觉压力在基本心理能力老化中的作用

信息降格说认为, 感觉功能老化使认知系统难以获得良好的信息输入, 并必须牺牲有限的认知资源获得更好的刺激信息, 使能用于认知加工的资源不足, 造成认知老化。为探讨感觉功能对基本心理能力老化的作用, 该研究采用2(年龄组：年轻、老年组)×4(视知觉压力水平：高、中、低、无噪音)的混合设计, 考察年轻、老年组在相同视知觉压力下基本心理能力的年龄差异。结果发现和无噪音条件相比, 相同视知觉压力下基本心理能力(数字能力、归纳推理能力)的年龄差异减小, 甚至消失, 一定程度上支持信息降格说。视觉功能衰退可能是影响基本心理能力老化的重要因素, 但这种作用受认知资源的调节。     

轻度阿尔茨海默症患者的前瞻记忆

轻度阿尔茨海默症往往伴随着不同程度的前瞻记忆衰退。已有研究以轻度阿尔茨海默症与前瞻记忆衰退的关联程度为主线, 对比了这一关联与“其他认知缺陷疾病-前瞻记忆衰退”、“轻度阿尔茨海默症-回溯记忆衰退”以及“轻度阿尔茨海默症-遗传表达”这三种关联的类似程度。此外, 也有研究涉及到了如何促进轻度阿尔茨海默症患者的前瞻记忆。将来的研究应引入病情程度、前瞻记忆任务类型等变量, 深入探讨轻度阿尔茨海默症与前瞻记忆衰退的关联, 并使用ERP、fMRI等神经生理技术确定轻度阿尔茨海默症患者前瞻记忆衰退的机制。     

教育水平在认知老化中的作用

为考察教育水平在认知老化中的作用,分别使用横断数据和干预数据分析教育水平对认知老化的影响模式。对51名58～83岁的城市社区老年人实施加工速度测验和基本心理能力测验。随机选取25名被试作为干预组接受加工速度训练。被试在前测后第8周接受与前测内容相同的后测。横断分析的结果显示,在特定的认知测验中,教育水平对认知能力的年龄差异有调节作用。干预数据的分析结果显示,加工速度干预效果显著,且对词汇流畅性有迁移作用。但相关分析和回归分析的结果则表明,教育水平在促进老年人干预收益和迁移方面的作用不显著。在获取和应用新知识方面,教育水平的作用并不显著,其在认知老化中的作用可能更多地表现为对固有认知功能的保护。     

Specific effects of the Trier Social Stress Test on speech fluency in young and older adults

The notion that speech becomes less fluent during stressful speaking conditions has received little empirical test, and no research has tested this relationship in older adult participants. We analyzed speeches produced during the Trier Social Stress Test (TSST) or during a less stressful placebo (pTSST) version of the task. We measured young and older adults’ speech fillers (e.g., um), unfilled pauses (at least 1 s in duration), and other disfluencies (e.g., repetitions, repairs). Neither young nor older adult participants rated themselves as having greater stress in the TSST than pTSST condition, but behavioral effects were obtained. Participants in the TSST condition produced more mid-phrase speech fillers and unfilled pauses than participants in the pTSST condition. Young adults produced more unfilled pauses than older adults overall, and older adults produced more mid-phrase fillers than young adults. Critically, age group interacted with experimental condition, such that older speakers produced disproportionately more mid-phrase fillers than young adults in the TSST compared to the pTSST condition. In sum, the negative effects of the TSST on fluency were generally similar across age, but this specific age-related increase in mid-phrase fillers indicates that older adults’ word retrieval may have been particularly negatively affected. Findings are generally consistent with previous research and add to understanding of how factors internal to the speaker (i.e., demographic, personality, and cognitive variables) and factors external to the speaker (i.e., variables regarding the situation, context, or content of speech) combine to affect speech fluency.