Sample records for adults performed worse

  1. Higher Anti-CMV IgG Concentrations are Associated with Worse Neurocognitive Performance During Suppressive Antiretroviral Therapy.

    PubMed

    Letendre, Scott; Bharti, Ajay; Perez-Valero, Ignacio; Hanson, Barbara; Franklin, Donald; Woods, Steven Paul; Gianella, Sara; de Oliveira, Michelli Faria; Heaton, Robert K; Grant, Igor; Landay, Alan L; Lurain, Nell

    2018-03-01

    To determine the association of CMV infection with neurocognitive performance in HIV+ adults. Cross-sectional, observational, exploratory study. Anti-CMV IgG concentrations in blood and CMV DNA copies in blood and cerebrospinal fluid (CSF) were measured in stored specimens of 80 HIV+ adults who were previously assessed with a standardized, comprehensive neurocognitive test battery. Thirty-eight were taking suppressive antiretroviral therapy (ART, HIV RNA ≤ 50 copies/mL) and 42 were not taking ART. A panel of 7 soluble biomarkers were also measured by immunoassay in CSF. Anti-CMV IgG concentrations ranged from 5.2 to 46.1 U/mL. CMV DNA was detected in 7 (8.8%) blood plasma but in none of the CSF specimens. Higher anti-CMV IgG levels were associated with older age (p=0.0017), lower nadir CD4+ T-cell count (p<0.001), AIDS (p<0.001), and higher soluble CD163 (p=0.009). Higher anti-CMV IgG levels trended toward an association with worse neurocognitive performance overall (p=0.059). This correlation was present in those taking suppressive ART (p=0.0049) but not in those who were not taking ART (p=0.92). Worse neurocognitive performance remained associated with higher anti-CMV IgG levels after accounting for other covariates in multivariate models (Model p=0.0038). Detectable plasma CMV DNA was associated with AIDS (p=0.05) but not with neurocognitive performance. CMV may influence neurocognitive performance in HIV+ adults taking suppressive ART. Future clinical trials of anti-CMV therapy should help determine whether the observed relationships are causal.

  2. Long-Term Memory Performance in Adult ADHD.

    PubMed

    Skodzik, Timo; Holling, Heinz; Pedersen, Anya

    2017-02-01

    Memory problems are a frequently reported symptom in adult ADHD, and it is well-documented that adults with ADHD perform poorly on long-term memory tests. However, the cause of this effect is still controversial. The present meta-analysis examined underlying mechanisms that may lead to long-term memory impairments in adult ADHD. We performed separate meta-analyses of measures of memory acquisition and long-term memory using both verbal and visual memory tests. In addition, the influence of potential moderator variables was examined. Adults with ADHD performed significantly worse than controls on verbal but not on visual long-term memory and memory acquisition subtests. The long-term memory deficit was strongly statistically related to the memory acquisition deficit. In contrast, no retrieval problems were observable. Our results suggest that memory deficits in adult ADHD reflect a learning deficit induced at the stage of encoding. Implications for clinical and research settings are presented.

  3. Monocyte Activation Is Associated With Worse Cognitive Performance in HIV-Infected Women With Virologic Suppression

    PubMed Central

    Imp, Brandon M.; Rubin, Leah H.; Tien, Phyllis C.; Plankey, Michael W.; Golub, Elizabeth T.; French, Audrey L.; Valcour, Victor G.

    2017-01-01

    Background. Cognitive impairment persists despite suppression of plasma human immunodeficiency virus (HIV) RNA. Monocyte-related immune activation is a likely mechanism. We examined immune activation and cognition in a cohort of HIV-infected and uninfected women from the Women's Interagency HIV Study (WIHS). Methods. Blood levels of activation markers, soluble CD163 (sCD163), soluble CD14 (sCD14), CRP, IL-6, and a gut microbial translocation marker (intestinal fatty acid binding protein (I-FABP)) were measured in 253 women (73% HIV-infected). Markers were compared to concurrent (within ± one semiannual visit) neuropsychological testing performance. Results. Higher sCD163 levels were associated with worse overall performance and worse verbal learning, verbal memory, executive function, psychomotor speed, and fine motor skills (P < .05 for all comparisons). Higher sCD14 levels were associated with worse verbal learning, verbal memory, executive function, and psychomotor speed (P < .05 for all comparisons). Among women with virological suppression, sCD163 remained associated with overall performance, verbal memory, psychomotor speed, and fine motor skills, and sCD164 remained associated with executive function (P < .05 for all comparisons). CRP, IL-6, and I-FABP were not associated with worse cognitive performance. Conclusions. Monocyte activation was associated with worse cognitive performance, and associations persisted despite viral suppression. Persistent inflammatory mechanisms related to monocytes correlate to clinically pertinent brain outcomes. PMID:27789726

  4. Hip Symptoms, Physical Performance, and Health Status in Older Adults With Chronic Low Back Pain: A Preliminary Investigation.

    PubMed

    Hicks, Gregory E; Sions, J Megan; Velasco, Teonette O

    2017-10-27

    To determine (1) whether there are differences in the prevalence of clinical hip symptoms between older adults with and without chronic low back pain (CLBP); and (2) whether coexisting hip symptoms are associated with worse physical performance and poorer health-related quality of life (HRQOL). Case-control study. Individuals participated in a standardized evaluation in a clinical laboratory. Clinical hip symptoms, which are proposed predictors of radiographic hip osteoarthritis according to American College of Rheumatology guidelines, were evaluated in a volunteer sample of community-dwelling older adults with CLBP (n=54; aged 60-85y) and in age- and sex-matched healthy controls (n=54). Not applicable. Physical performance was measured by the repeated chair rise test and stair-climbing test. HRQOL was measured by the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Hip joint pain, morning stiffness, and pain with hip internal rotation were more common among older adults with CLBP (P<.05). Participants with CLBP and coexisting hip symptoms had worse physical performance than individuals without CLBP or hip symptoms (P<.0001). Additionally, the presence of coexisting hip symptoms was associated with worse HRQOL, particularly in the domains of social functioning, mental health, and role limitations attributable to emotional problems as measured by the SF-36 (P<.01). Given our limited understanding of CLBP among older adults, there is a definitive need to systematically explore coexisting pain conditions that may contribute to worse outcomes. Based on these data, future longitudinal studies should explore whether coexisting hip symptoms are associated with a worse prognosis in older adults with CLBP. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  5. Reading Performance of Young Adults With ADHD Diagnosed in Childhood.

    PubMed

    Miranda, Ana; Mercader, Jessica; Fernández, M Inmaculada; Colomer, Carla

    2017-02-01

    To study reading performance of young adults with ADHD and its relation with executive functioning. Thirty young adults with a childhood diagnosis of ADHD and 30 with normal development (ND) were compared on reading accuracy, fluency, and comprehension. Furthermore, ADHD with reading disabilities (ADHD+RD) and ADHD without reading disabilities (ADHD-RD) subgroups were compared using self-report and informant-report versions of the Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A). Adults with ADHD obtained significantly worse results than the ND adults on reading speed, responses to literal questions, and a cloze test. Although the comparison of the ADHD+RD and ADHD-RD groups did not show significant differences on the BRIEF-A subscales, the ADHD+RD group surpassed the critical percentile (85) on more subscales, with working memory and metacognition especially affected. The findings point out that reading should be assessed in individuals with ADHD as part of their evaluation to design effective early interventions.

  6. Replicating distinctive facial features in lineups: identification performance in young versus older adults.

    PubMed

    Badham, Stephen P; Wade, Kimberley A; Watts, Hannah J E; Woods, Natalie G; Maylor, Elizabeth A

    2013-04-01

    Criminal suspects with distinctive facial features, such as tattoos or bruising, may stand out in a police lineup. To prevent suspects from being unfairly identified on the basis of their distinctive feature, the police often manipulate lineup images to ensure that all of the members appear similar. Recent research shows that replicating a distinctive feature across lineup members enhances eyewitness identification performance, relative to removing that feature on the target. In line with this finding, the present study demonstrated that with young adults (n = 60; mean age = 20), replication resulted in more target identifications than did removal in target-present lineups and that replication did not impair performance, relative to removal, in target-absent lineups. Older adults (n = 90; mean age = 74) performed significantly worse than young adults, identifying fewer targets and more foils; moreover, older adults showed a minimal benefit from replication over removal. This pattern is consistent with the associative deficit hypothesis of aging, such that older adults form weaker links between faces and their distinctive features. Although replication did not produce much benefit over removal for older adults, it was not detrimental to their performance. Therefore, the results suggest that replication may not be as beneficial to older adults as it is to young adults and demonstrate a new practical implication of age-related associative deficits in memory.

  7. Fixation Characteristics of Severe Amblyopia Subtypes: Which One is Worse?

    PubMed

    Koylu, Mehmet Talay; Ozge, Gokhan; Kucukevcilioglu, Murat; Mutlu, Fatih Mehmet; Ceylan, Osman Melih; Akıncıoglu, Dorukcan; Ayyıldız, Onder

    2017-01-01

    To determine differences in macular sensitivity and fixation patterns in different subtypes of severe amblyopia. This case-control study enrolled a total of 73 male adults, including 18 with pure strabismic severe amblyopia, 19 with pure anisometropic severe amblyopia, 18 with mixed (strabismic plus anizometropic) severe amblyopia, and 18 healthy controls. MP-1 microperimetry was used to evaluate macular sensitivity, location of fixation, and stability of fixation. Mean macular sensitivity, stability of fixation, and location of fixation were significantly worse in all amblyopia subtypes when compared with healthy controls. Intergroup comparisons between amblyopia subtypes revealed that mean macular sensitivity, stability of fixation, and location of fixation were significantly worse in pure strabismic and mixed amblyopic eyes when compared with pure anisometropic amblyopic eyes. Strabismus seems to be a worse prognostic factor in severe amblyopia than anisometropia in terms of fixation characteristics and retinal sensitivity.

  8. Intergenerational effects of parental substance-related convictions and adult drug treatment court participation on children's school performance.

    PubMed

    Gifford, Elizabeth J; Sloan, Frank A; Eldred, Lindsey M; Evans, Kelly E

    2015-09-01

    This study examined the intergenerational effects of parental conviction of a substance-related charge on children's academic performance and, conditional on a conviction, whether completion of an adult drug treatment court (DTC) program was associated with improved school performance. State administrative data from North Carolina courts, birth records, and school records were linked for 2005-2012. Math and reading end-of-grade test scores and absenteeism were examined for 5 groups of children, those with parents who: were not convicted on any criminal charge, were convicted on a substance-related charge and not referred by a court to a DTC, were referred to a DTC but did not enroll, enrolled in a DTC but did not complete, and completed a DTC program. Accounting for demographic and socioeconomic factors, the school performance of children whose parents were convicted of a substance-related offense was worse than that of children whose parents were not convicted on any charge. These differences were statistically significant but substantially reduced after controlling for socioeconomic characteristics; for example, mother's educational attainment. We found no evidence that parent participation in an adult DTC program led to improved school performance of their children. While the children of convicted parents fared worse on average, much--but not all--of this difference was attributed to socioeconomic factors, with the result that parental conviction remained a risk factor for poorer school performance. Even though adult DTCs have been shown to have other benefits, we could detect no intergenerational benefit in improved school performance of their children. (c) 2015 APA, all rights reserved).

  9. Intergenerational effects of parental substance-related convictions and adult drug treatment court participation on children’s school performance

    PubMed Central

    Gifford, Elizabeth J.; Sloan, Frank A.; Evans, Kelly E.

    2015-01-01

    Objective This study examined the intergenerational effects of parental conviction of a substance-related charge on children’s academic performance and, conditional on a conviction, whether completion of an adult drug treatment court (DTC) program was associated with improved school performance. Method State administrative data from North Carolina courts, birth records, and school records were linked for 2005–12. Math and reading end-of-grade test scores and absenteeism were examined for 5 groups of children, those with parents who: were not convicted on any criminal charge, were convicted on a substance-related charge and not referred by a court to a DTC, were referred to a DTC but did not enroll, enrolled in a DTC but did not complete, and completed a DTC program. Results Accounting for demographic and socioeconomic factors, the school performance of children whose parents were convicted of a substance-related offense was worse than that of children whose parents were not convicted on any charge. These differences were statistically significant but substantially reduced after controlling for socioeconomic characteristics, e.g., mother’s educational attainment. We found no evidence that parent participation in an adult DTC program led to improved school performance of their children. Conclusion While the children of convicted parents fared worse on average, much—but not all—of this difference was attributed to socioeconomic factors, with the result that parental conviction remained a risk factor for poorer school performance. Even though adult DTCs have been shown to have other benefits, we could detect no intergenerational benefit in improved school performance of their children. PMID:26460705

  10. Methylphenidate enhances cognitive performance in adults with poor baseline capacities regardless of attention-deficit/hyperactivity disorder diagnosis.

    PubMed

    Agay, Nirit; Yechiam, Eldad; Carmel, Ziv; Levkovitz, Yechiel

    2014-04-01

    We compare the view that the effect of methylphenidate (MPH) is selective to individuals with attention-deficit/hyperactivity disorder (ADHD) with an alternative approach suggesting that its effect is more prominent for individuals with weak baseline capacities in relevant cognitive tasks. To evaluate theses 2 approaches, we administered sustained attention, working memory, and decision-making tasks to 20 ADHD adults and 19 control subjects, using a within-subject placebo-controlled design. The results demonstrated no main effects of MPH in the decision-making tasks. In the sustained attention and working-memory tasks, MPH enhanced performance of both ADHD and non-ADHD adults to a similar extent compared with placebo. Hence, the effect of MPH was not selective to ADHD adults. In addition, those benefitting most from MPH in all 3 task domains tended to be individuals with poor task performance. However, in most tasks, individuals whose performance was impaired by MPH were not necessarily better (or worse) performers. The findings suggest that the administration of MPH to adults with ADHD should consider not only clinical diagnosis but also their functional (performance-based) profile.

  11. The combination of dynapenia and abdominal obesity as a risk factor for worse trajectories of IADL disability among older adults.

    PubMed

    Alexandre, Tiago da Silva; Scholes, Shaun; Ferreira Santos, Jair Licio; Duarte, Yeda Aparecida de Oliveira; de Oliveira, Cesar

    2017-10-02

    The concept of dynapenic obesity has been gaining great attention recently. However, there is little epidemiological evidence demonstrating that dynapenic abdominal obese individuals have worse trajectories of disability than those with dynapenia and abdominal obesity alone. Our aim was to investigate whether dynapenia combined with abdominal obesity can result in worse trajectories of instrumental activities of daily living (IADL) among English and Brazilian older adults over eight and ten years of follow-up, respectively. We used longitudinal data from 3374 participants from the English Longitudinal Study of Ageing (ELSA) and 1040 participants from the Brazilian Health, Well-being and Aging Study (SABE) who were free from disability as assessed by IADL at baseline. IADL disability was defined herein as a difficulty to perform the following: preparing meals, managing money, using transportation, shopping, using the telephone, house cleaning, washing clothes, and taking medications according to the Lawton IADL modified scale. The study population in each country was categorized into non-dynapenic/non-abdominal obese (reference group), abdominal obese, dynapenic and dynapenic abdominal obese according to their handgrip strength (<26 kg for men and <16 kg for women) and waist circumference (>102 cm for men and >88 cm for women). We used generalized linear mixed models with IADL as the outcome. The estimated change over time in IADL disability was significantly higher for participants with dynapenic abdominal obesity compared to those with neither condition in both cohorts (ELSA: +0.023, 95% CI = 0.012-0.034, p < 0.001; SABE: +0.065, 95% CI = 0.038-0.091, p < 0.001). Abdominal obesity was also associated with changes over time in IADL disability (ELSA: +0.009, 95% CI = 0.002-0.015, p < 0.05; SABE: +0.021, 95% CI = 0.002-0.041, p < 0.05), which was not observed for dynapenia. Abdominal obesity is an important risk factor for IADL decline but

  12. Women with hypertrophic cardiomyopathy have worse survival.

    PubMed

    Geske, Jeffrey B; Ong, Kevin C; Siontis, Konstantinos C; Hebl, Virginia B; Ackerman, Michael J; Hodge, David O; Miller, Virginia M; Nishimura, Rick A; Oh, Jae K; Schaff, Hartzell V; Gersh, Bernard J; Ommen, Steve R

    2017-12-07

    Sex differences in hypertrophic cardiomyopathy (HCM) remain unclear. We sought to characterize sex differences in a large HCM referral centre population. Three thousand six hundred and seventy-three adult patients with HCM underwent evaluation between January 1975 and September 2012 with 1661 (45.2%) female. Kaplan-Meier survival curves were assessed via log-rank test. Cox proportional hazard regression analyses evaluated the relation of sex with survival. At index visit, women were older (59 ± 16 vs. 52 ± 15 years, P < 0.0001) had more symptoms [New York Heart Association (NYHA) Class III-IV 45.0% vs. 35.3%, P < 0.0001], more obstructive physiology (77.4% vs. 71.8%, P = 0.0001), more mitral regurgitation (moderate or greater in 56.1% vs. 43.9%, P < 0.0001), higher E/e' ratio (n = 1649, 20.6 vs. 15.6, P < 0.0001), higher estimated pulmonary artery systolic pressure (n = 1783, 40.8 ± 15.4 vs. 34.8 ± 10.8 mmHg, P < 0.0001), worse cardiopulmonary exercise performance (n = 1267; percent VO2 predicted 62.8 ± 20% vs. 65.8 ± 19.2%, P = 0.007), and underwent more frequent alcohol septal ablation (4.9% vs. 3.0%, P = 0.004) but similar frequency of myectomy (28% vs. 30%, P = 0.24). Median follow-up was 10.9 (IQR 7.4-16.2) years. Kaplan-Meier analysis demonstrated lower survival in women compared with men (P < 0.0001). In multivariable modelling, female sex remained independently associated with mortality (HR 1.13 [1.03-1.22], P = 0.01) when adjusted for age, NYHA Class III-IV symptoms, and cardiovascular comorbidities. Women with HCM present at more advanced age, with more symptoms, worse cardiopulmonary exercise tolerance, and different haemodynamics than men. Sex is an important determinant in HCM management as women with HCM have worse survival. Women may require more aggressive diagnostic and therapeutic approaches. Published on behalf of the European Society of Cardiology. All

  13. When we test, do we stress? Impact of the testing environment on cortisol secretion and memory performance in older adults.

    PubMed

    Sindi, Shireen; Fiocco, Alexandra J; Juster, Robert-Paul; Pruessner, Jens; Lupien, Sonia J

    2013-08-01

    The majority of studies find that older adults have worse memory performance than young adults. However, contextual features in the testing environment may be perceived as stressful by older adults, increasing their stress hormone levels. Given the evidence that older adults are highly sensitive to the effects of stress hormones (cortisol) on memory performance, it is postulated that a stressful testing environment in older adults can lead to an acute stress response and to memory impairments. The current study compared salivary cortisol levels and memory performance in young and older adults tested in environments manipulated to be stressful (unfavourable condition) or not stressful (favourable condition) for each age group. 28 young adults and 32 older adults were tested in two testing conditions: (1) a condition favouring young adults (constructed to be less stressful for young adults), and (2) a condition favouring older adults (constructed to be less stressful for older adults). The main outcome measure was salivary cortisol levels. Additionally, immediate and delayed memory performances were assessed during each condition. In older adults only, we found significantly high cortisol levels and low memory performance in the condition favouring young adults. In contrast, cortisol levels were lower and memory performance was better when older adults were tested in conditions favouring them. There was no effect of testing condition in young adults. The results demonstrate that older adults' memory performance is highly sensitive to the testing environment. These findings have important implications for both research and clinical settings in which older adults are tested for memory performance. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Consistent Performance Differences between Children and Adults Despite Manipulation of Cue-Target Variables

    PubMed Central

    Bauer, Jessie-Raye; Martinez, Joel E.; Roe, Mary Abbe; Church, Jessica A.

    2017-01-01

    Two behavioral experiments assessed the plasticity and short-term improvement of task switching in 215 children and adults. Specifically, we studied manipulations of cued attention to different features of a target stimulus as a way to assess the development of cognitive flexibility. Each experiment had multiple levels of difficulty via manipulation of number of cued features (2–4) and number of response options (2 or 4). Working memory demand was manipulated across the two experiments. Impact of memory demand and task level manipulations on task accuracy and response times were measured. There were three overall goals: First, these task manipulations (number of cued features, response choices, and working memory load) were tested to assess the stability of group differences in performance between children ages 6–16 years and adults 18–27 years, with the goal of reducing age group differences. Second, age-related transitions to adult-level performance were examined within subgroups of the child sample. Third, short-term improvement from the beginning to the end of the study session was measured to probe whether children can improve with task experience. Attempts to use task manipulations to reduce age differences in cued task switching performance were unsuccessful: children performed consistently worse and were more susceptible to task manipulations than adults. However, across both studies, adult-like performance was observed around mid-adolescence, by ages 13-16 years. Certain task manipulations, especially increasing number of response options when working memory demand was low, produced differences from adults even in the oldest children. Interestingly, there was similar performance improvement with practice for both child and adult groups. The higher memory demand version of the task (Experiment 2) prompted greater short-term improvement in accuracy and response times than the lower memory demand version (Experiment 1). These results reveal stable

  15. Physical Function, Hyperuricemia, and Gout in Older Adults.

    PubMed

    Burke, Bridget Teevan; Köttgen, Anna; Law, Andrew; Windham, Beverly Gwen; Segev, Dorry; Baer, Alan N; Coresh, Josef; McAdams-DeMarco, Mara A

    2015-12-01

    Gout prevalence is high in older adults and those affected are at risk of physical disability, yet it is unclear whether they have worse physical function. We studied gout, hyperuricemia, and physical function in 5,819 older adults (age ≥65 years) attending the 2011-2013 Atherosclerosis Risk in Communities Study visit, a prospective US population-based cohort. Differences in lower extremity function (Short Physical Performance Battery [SPPB] and 4-meter walking speed) and upper extremity function (grip strength) by gout status and by hyperuricemia prevalence were estimated in adjusted ordinal logistic regression (SPPB) and linear regression (walking speed and grip strength) models. Lower scores or times signify worse function. The prevalence of poor physical performance (first quartile) by gout and hyperuricemia was estimated using adjusted modified Poisson regression. Ten percent of participants reported a history of gout and 21% had hyperuricemia. There was no difference in grip strength by history of gout (P = 0.77). Participants with gout performed worse on the SPPB test; they had 0.77 times (95% confidence interval [95% CI] 0.65, 0.90, P = 0.001) the prevalence odds of a 1-unit increase in SPPB score and were 1.18 times (95% CI 1.07, 1.32, P = 0.002) more likely to have poor SPPB performance. Participants with a history of gout had slower walking speed (mean difference -0.03; 95% CI -0.05, -0.01, P < 0.001) and were 1.19 times (95% CI 1.06, 1.34, P = 0.003) more likely to have poor walking speed. Similarly, SPPB score and walking speed, but not grip strength, were worse in participants with hyperuricemia. Older adults with gout and hyperuricemia are more likely to have worse lower extremity, but not upper extremity, function. © 2015, American College of Rheumatology.

  16. Obese adolescents with type 2 diabetes perform worse than controls on cognitive and behavioral assessments.

    PubMed

    Brady, Cassandra C; Vannest, Jennifer J; Dolan, Lawrence M; Kadis, Darren S; Lee, Gregory R; Holland, Scott K; Khoury, Jane C; Shah, Amy S

    2017-06-01

    Children with type 1 diabetes demonstrate worse cognitive performance compared with their peers. Little is known regarding the cognitive and behavioral performance in obese adolescents with type 2 diabetes. Cross sectional evaluation of 20 obese adolescents with type 2 diabetes and 20 healthy adolescents was performed in Cincinnati, Ohio. Cognitive tests that included measures of processing speed, working memory, verbal and semantic fluency and parent reports of executive function and problem behavior were compared. Academic achievement and the relationship between cognitive/behavioral scores and diabetes duration and diabetes control (hemoglobin A1c) were assessed in the type 2 diabetes group only. The type 2 diabetes group had mean duration of diabetes of 2.8 ± 2.2 yr and hemoglobin A1c of 7.9 ± 2.2%. Adolescents with type 2 diabetes scored lower than controls on tests of working and verbal memory and processing speed (all p < 0.05) and worse for Internalizing, Externalizing, and Total Problems behaviors on the Child Behavior Checklist (all p < 0.05). Adolescents with type 2 diabetes scored below the population mean in academic achievement, most notably calculation. Working memory and processing speed were negatively correlated with duration of diabetes (r = -0.50 and -0.47, respectively, p < 0.05). Obese youth with type 2 diabetes score poorly compared with controls on multiple assessments of cognitive function and adaptive behavior. Further work is needed to determine if these effects are driven by obesity, diabetes or other demographic and socioeconomic risk factors. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Effect of recurrent severe hypoglycemia on cognitive performance in adult patients with diabetes: A meta-analysis.

    PubMed

    Chen, Yu-Xue; Liu, Zheng-Ren; Yu, Ying; Yao, En-Sheng; Liu, Xing-Hua; Liu, Lu

    2017-10-01

    The purpose of this study was to investigate the existence and extent of cognitive impairment in adult diabetes mellitus (DM) patients with episodes of recurrent severe hypoglycemia, by using meta-analysis to synthesize data across studies. PubMed, EMBASE and Cochrane library search engines were used to identify studies on cognitive performance in DM patients with recurrent severe hypoglycemia. Random-effects meta-analysis was performed on seven eligible studies using an inverse-variance method. Effect sizes, which are the standardized differences between the experimental group and the control group, were calculated. Of the 853 studies, 7 studies met the inclusion criteria. Compared with control subjects, the adult DM patients with episodes of recurrent severe hypoglycemia demonstrated a significantly lowered performance on memory in both types of DM patients, and poor performance of processing speed in type 2 DM patients. There was no significant difference between adult DM patients with and those without severe hypoglycemia in other cognitive domains such as general intelligence, executive function, processing speed and psychomotor efficiency. Our results seem to confirm the hypothesis that cognitive dysfunction is characterized by worse memory and processing speed in adult DM patients with a history of recurrent severe hypoglycemia, whereas general intelligence, executive function, and psychomotor efficiency are spared.

  18. Financial burden is associated with worse health-related quality of life in adults with multiple endocrine neoplasia type 1.

    PubMed

    Peipert, Benjamin J; Goswami, Sneha; Helenowski, Irene; Yount, Susan E; Sturgeon, Cord

    2017-12-01

    Health-related quality of life and financial burden among patients with multiple endocrine neoplasia type 1 is poorly described. It is not known how financial burden influences health-related quality of life in this population. We hypothesized that the financial burden attributable to multiple endocrine neoplasia type 1 is associated with worse health-related quality of life. United States adults (≥18 years) with multiple endocrine neoplasia type 1 were recruited from the AMENSupport MEN online support group. Patient demographics, clinical characteristics, and financial burden were assessed via an online survey. The instrument Patient-Reported Outcomes Measurement Information System 29-item profile measure was used to assess health-related quality of life. Multivariable linear regression was used to identify significant variables in each Patient-Reported Outcomes Measurement Information System domain. Out of 1,378 members in AMENSupport, our survey link was accessed 449 times (33%). Of 153 US respondents who completed our survey, 84% reported financial burden attributable to multiple endocrine neoplasia type 1. The degree of financial burden had a linear relationship with worse health-related quality of life across all Patient-Reported Outcomes Measurement Information System domains (r = 0.36-0.55, P < .001); 63% reported experiencing ≥1 negative financial event(s). Borrowing money from friends/family (30%), unemployment (13%), and spending >$100/month out-of-pocket on prescription medications (46%) were associated consistently with impaired health-related quality of life (ß = 3.75-6.77, P < .05). Respondents were 3- and 34-times more likely to be unemployed and declare bankruptcy than the US population, respectively. This study characterizes the financial burden in patients with multiple endocrine neoplasia type 1. Individuals with multiple endocrine neoplasia type 1 report a high degree of financial burden, negative financial events, and

  19. Exploration of older and younger British adults' performance on The Awareness of Social Inference Test (TASIT).

    PubMed

    Burdon, Paul; Dipper, Lucy; Cocks, Naomi

    2016-09-01

    Social perception is an important skill. One assessment that is commonly used to assess social perception abilities is The Awareness of Social Inference Test (TASIT). The only normative data available for this test are for Australian younger adults. Despite no normative data being available for British adults, the test is widely used in the UK with older and younger adults. There is a growing body of research that suggests that older adults have difficulty with skills associated with social perception. There is therefore a need to determine whether British adults, and more specifically British older adults, perform similarly to the Australian normative TASIT scores available in the manual. To explore the differences between older and younger British adults' performance on TASIT, and to determine whether younger and older British adults perform similarly to the data from Australian adults in TASIT manual. TASIT was administered to a total of 42 native British English speaking participants. The participants were split into two age groups 18-45 and 60-90 years. Comparisons were made between the two groups and the Australian data in TASIT manual. The younger British and Australian adults obtained similar scores on all parts of TASIT. The older British adults though, obtained significantly lower scores than the Australian younger adults on all parts of TASIT and when education was controlled for they obtained significantly lower scores than the British younger adults. The findings are discussed in the light of previous research that has found that older adults are worse than younger adults at social inferences. The findings of the current study suggest that caution should be used when using TASIT with older British adults to assess social perception abilities. © 2016 Royal College of Speech and Language Therapists.

  20. Effect of knowledge of APOE genotype on subjective and objective memory performance in healthy older adults.

    PubMed

    Lineweaver, Tara T; Bondi, Mark W; Galasko, Douglas; Salmon, David P

    2014-02-01

    The knowledge that one carries the apolipoprotein E (APOE) ε4 allele risk factor for Alzheimer's disease was recently found to have little short-term psychological risk. The authors investigated the impact of knowledge of carrying the risk allele on subjective ratings of memory and objective memory test performance of older adults. Using a nested case-control design, the authors administered objective verbal and visual memory tests and self-rating scales of memory function to 144 cognitively normal older adults (ages 52-89) with known APOE genotype who knew (ε4+, N=25; ε4-, N=49) or did not know (ε4+, N=25; ε4-, N=45) their genotype and genetic risk for Alzheimer's disease prior to neuropsychological evaluation. Significant genotype-by-disclosure interaction effects were observed on several memory rating scales and tests of immediate and delayed verbal recall. Older adults who knew their ε4+ genotype judged their memory more harshly and performed worse on an objective verbal memory test than did ε4+ adults who did not know. In contrast, older adults who knew their ε4- genotype judged their memory more positively than did ε4- adults who did not know, but these groups did not differ in objective memory test performance. Informing older adults that they have an APOE genotype associated with an increased risk of Alzheimer's disease can have adverse consequences on their perception of their memory abilities and their performance on objective memory tests. The patient's knowledge of his or her genotype and risk of Alzheimer's disease should be considered when evaluating cognition in the elderly.

  1. Bigger is better and worse: on the intricate relationship between hippocampal size and memory.

    PubMed

    Molnár, Katalin; Kéri, Szabolcs

    2014-04-01

    The structure-function relationship between the hippocampal region and memory is a debated topic in the literature. It has been suggested that larger hippocampi are associated with less effective memory performance in healthy young adults because of a partial synaptic pruning. Here, we tested this hypothesis in individuals with Fragile X Syndrome (FXS) with known abnormal pruning and IQ- and age-matched individuals with hypoxic brain injury, preterm birth, and obstetric complications. Results revealed larger normalized hippocampal volume in FXS compared with neurotypical controls, whereas individuals with hypoxic injury had smaller hippocampi. In neurotypical controls and individuals with hypoxic injury, better general memory, as indexed by the Wechsler Memory Scale-Revised, was associated with larger hippocampus. In contrast, in FXS we observed the opposite relationship: larger hippocampus was associated with worse general memory. Caudate volume did not correlate with memory in either group. These results suggest that incomplete pruning in young healthy adults may not contribute to less efficient memory capacity, and hippocampal size is positively associated with memory performance. However, abnormally large and poorly pruned hippocampus may indeed be less effective in FXS. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Executive performance in older Portuguese adults with low education.

    PubMed

    Pavão Martins, Isabel; Maruta, Carolina; Freitas, Vanda; Mares, Inês

    2013-01-01

    Evaluation of executive functions is essential in clinical diagnosis, yet there are limited data regarding the performance of participants with low education. We present results on several measures of executive functions obtained in community-dwelling adults with an overall low education and study the effect of this variable in each test. A sample of 479 adults (64% female, mean age 66.4 years) was assessed by a battery comprising 13 measures of executive function (Trail Making Test; Symbol Search; Matrix reasoning; Semantic and phonemic verbal fluencies; Stroop test; and digit spans). Tests' psychometric properties and the effects of age, gender, and education were studied across education levels within each age group. Tests showed good psychometric properties. Education explained more variance than age in the majority of measures, with lower educational levels being significantly associated to worse scores. Tables are presented with mean scores, standard deviation, and the value of extreme percentiles for younger (50-65, N = 232) and older (>65 years, N = 247) × education (0-3, 4, 5-9, and >9 years) subgroups. Education-adjusted norms are necessary for an adequate interpretation of test results. The present data may be useful for clinicians caring for populations with low literacy.

  3. The influence of inhibitory processes on affective theory of mind in young and old adults.

    PubMed

    Mahy, Caitlin E V; Vetter, Nora; Kühn-Popp, Nina; Löcher, Carolin; Krautschuk, Susan; Kliegel, Matthias

    2014-01-01

    The primary aim of this study was to examine the impact of an inhibition manipulation on the effect of age on theory of mind (ToM) in an ecologically valid, affective ToM task. Participants were 30 young and 30 old adults. The Cambridge Mindreading Face-Voice Battery was used to measure ToM; in addition, measures of fluid and crystallized intelligence were taken. Participants were subjected to three levels of inhibitory demand during ToM reasoning: emotional inhibition, non-emotional inhibition, and no inhibition. Old adults performed worse than young adults. The emotional and non-emotional inhibition conditions resulted in worse ToM performance compared to the no inhibition condition. There were no differences in the impact of the inhibition conditions on old and young adults. Regression analyses suggested that old adults' crystallized intelligence was a significant predictor of ToM performance, whereas it did not predict young adults' ToM performance. Results are discussed in terms of verbal ability as a possible compensatory mechanism in coping with verbal inhibitory load in ToM reasoning.

  4. Doing better (or worse) than one's parents: Social status, mobility, and performance-avoidance goals.

    PubMed

    Jury, Mickaël; Bruno, Alisée; Darnon, Céline

    2018-01-11

    Previous research has shown that, when succeeding in higher education, first-generation (FG) students endorse more performance-avoidance goals (i.e., the fear of performing poorly) than continuing-generation (CG) students. In this study, individual mobility is examined as a predictor of performance-avoidance goal endorsement. It is argued that FG students endorse more these goals than CG students because in higher education, the former (but not the latter) experience upward mobility. In addition, CG can also be at risk of endorsing these goals when they are confronted with downward mobility. Two studies were conducted with psychology students (N = 143 in Study 1; N = 176 in Study 2). In Study 1, FG and CG students' perceived upward mobility was measured. In Study 2, FG and CG students were provided with a feedback that suggested either upward or downward mobility. In both studies, participants reported their level of performance-avoidance goal endorsement. Results from Study 1 supported an indirect effect of status on performance-avoidance goals via a higher perception of upward mobility. Results from Study 2 supported that psychology students who face mobility (i.e., FG students who received better feedback than their usual level of performance, CG students who received worse feedback than their usual level of performance) increased their performance-avoidance goals the most. Taken together, the results of these studies support that one's actual social position and, even more, the social position one is about to reach are reliable predictors of performance-avoidance goals. © 2018 The British Psychological Society.

  5. Deprivation is associated with worse physical and mental health beyond income poverty: a population-based household survey among Chinese adults.

    PubMed

    Chung, Roger Yat-Nork; Chung, Gary Ka-Ki; Gordon, David; Wong, Samuel Yeung-Shan; Chan, Dicken; Lau, Maggie Ka-Wai; Tang, Vera Mun-Yu; Wong, Hung

    2018-05-14

    In studying health inequality, poverty as measured by income is frequently used; however, this omits the aspects of non-monetary resources and social barriers to achieving improved living standard. Therefore, our study aimed to examine the associations of individual-level deprivation of material and social necessities with general physical and mental health beyond that of income poverty. A territory-wide two-stage stratified random sample of 2282 community-dwelling Hong Kong adults was surveyed between 2014 and 2015. Income poverty and a Deprivation Index were used as the main independent variables. General health was assessed using the validated 12-item Short-Form Health Survey version 2, from which physical component summary and mental component summary were derived. Our results in multivariable ordinal logistic regressions consistently showed that, after adjusting for income poverty, socio-demographic and lifestyle factors, being deprived was significantly associated with worse physical (OR 1.66; CI 1.25-2.20) and mental health (OR 1.83; CI 1.43-2.35). Being income poor was also significantly associated with worse mental health (OR 1.63; CI 1.28-2.09) but only marginally with physical health (OR 1.34; CI 1.00-1.80) after adjustments. Income does not capture all aspects of poverty that are associated with adverse health outcomes. Deprivation of non-monetary resources has an independent effect on general health above and beyond the effect of income poverty. Policies should move beyond endowment and take into account the multidimensionality of poverty, in order to address the problem of health inequality.

  6. "It could have been worse": Developmental change in the use of a counterfactual consoling strategy.

    PubMed

    Payir, Ayse; Guttentag, Robert

    2016-08-01

    In two experiments, we investigated developmental change in the use of a counterfactual consoling strategy: "it could have been worse." In Experiment 1, 8-year-olds, 10-year-olds, 12-year-olds, and adults were presented with two stories in which a character feels bad as the result of an event that could have turned out better or could have turned out worse. Participants were asked what they would say or do to make the characters feel better. The results revealed that the frequency with which participants mentioned a counterfactual consoling strategy increased dramatically with age. In Experiment 2, using the same stories with similar-aged participants, we tested whether providing children with several consoling strategies (rather than asking them to create one) would prompt greater use of a counterfactual consoling strategy. Under these conditions, the 10- and 12-year-olds responded in a manner very similar to that of adults, whereas the 8-year-olds selected a counterfactual consoling strategy less often than participants at any other age. The findings from the two experiments suggest that, up through at least age 12years, children are less likely than adults to spontaneously apply counterfactual thinking when generating a consoling strategy. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Face Processing and Facial Emotion Recognition in Adults with Down Syndrome

    ERIC Educational Resources Information Center

    Barisnikov, Koviljka; Hippolyte, Loyse; Van der Linden, Martial

    2008-01-01

    Face processing and facial expression recognition was investigated in 17 adults with Down syndrome, and results were compared with those of a child control group matched for receptive vocabulary. On the tasks involving faces without emotional content, the adults with Down syndrome performed significantly worse than did the controls. However, their…

  8. Tau and Amyloid Positron Emission Tomography Imaging Predict Driving Performance Among Older Adults with and without Preclinical Alzheimer's Disease.

    PubMed

    Roe, Catherine M; Babulal, Ganesh M; Mishra, Shruti; Gordon, Brian A; Stout, Sarah H; Ott, Brian R; Carr, David B; Ances, Beau M; Morris, John C; Benzinger, Tammie L S

    2018-01-01

    Abnormal levels of Alzheimer's disease (AD) biomarkers, measured by positron emission tomography imaging using amyloid-based radiotracers and cerebrospinal fluid, are associated with impaired driving performance in older adults. We examined whether preclinical AD staging, defined using amyloid imaging and tau imaging using the radiotracer T807 (AKA flortaucipir or AV-1451), was associated with receiving a marginal/fail rating on a standardized road test (n = 42). Participants at Stage 2 (positive amyloid and tau scans) of preclinical AD were more likely to receive a marginal/fail rating compared to participants at Stage 0 or 1. Stage 2 preclinical AD may manifest in worse driving performance.

  9. Physical Performance Across the Adult Life Span: Correlates With Age and Physical Activity.

    PubMed

    Hall, Katherine S; Cohen, Harvey J; Pieper, Carl F; Fillenbaum, Gerda G; Kraus, William E; Huffman, Kim M; Cornish, Melissa A; Shiloh, Andrew; Flynn, Christy; Sloane, Richard; Newby, L Kristin; Morey, Miriam C

    2017-04-01

    A number of large-scale population studies have provided valuable information about physical performance in aged individuals; however, there is little information about trajectories of function and associations with age across the adult life span. We developed a mobility-focused physical performance screener designed to be appropriate for the adult life span. The physical performance battery includes measures of mobility, strength, endurance, and balance. Physical activity (PA) was assessed with accelerometry. We examined age-related trends in physical performance and PA, and the relationship between physical performance and PA across the age range (30-90+), by decade, in 775 participants enrolled in the study 2012-2014. Physical performance was worse with increasing age decade. Although men performed better than women across all ages, the decrement by age group was similar between genders. Worsening physical performance was observed as early as the fifth decade for chair stands and balance and in the sixth decade for gait speed and aerobic endurance. The number and strength of significant associations between physical performance and PA increased with greater age: the greatest number of significant associations was seen in the 60-79 age groups, with fewer reported in the 30-59 and 80-90+ age groups. More PA was associated with better physical function. These results emphasize the importance of a life span approach to studies of function and aging. This work points to the need for a physical performance screener that spans across adulthood as a clinical tool for identifying functional decline. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Memory performance on the Auditory Inference Span Test is independent of background noise type for young adults with normal hearing at high speech intelligibility

    PubMed Central

    Rönnberg, Niklas; Rudner, Mary; Lunner, Thomas; Stenfelt, Stefan

    2014-01-01

    Listening in noise is often perceived to be effortful. This is partly because cognitive resources are engaged in separating the target signal from background noise, leaving fewer resources for storage and processing of the content of the message in working memory. The Auditory Inference Span Test (AIST) is designed to assess listening effort by measuring the ability to maintain and process heard information. The aim of this study was to use AIST to investigate the effect of background noise types and signal-to-noise ratio (SNR) on listening effort, as a function of working memory capacity (WMC) and updating ability (UA). The AIST was administered in three types of background noise: steady-state speech-shaped noise, amplitude modulated speech-shaped noise, and unintelligible speech. Three SNRs targeting 90% speech intelligibility or better were used in each of the three noise types, giving nine different conditions. The reading span test assessed WMC, while UA was assessed with the letter memory test. Twenty young adults with normal hearing participated in the study. Results showed that AIST performance was not influenced by noise type at the same intelligibility level, but became worse with worse SNR when background noise was speech-like. Performance on AIST also decreased with increasing memory load level. Correlations between AIST performance and the cognitive measurements suggested that WMC is of more importance for listening when SNRs are worse, while UA is of more importance for listening in easier SNRs. The results indicated that in young adults with normal hearing, the effort involved in listening in noise at high intelligibility levels is independent of the noise type. However, when noise is speech-like and intelligibility decreases, listening effort increases, probably due to extra demands on cognitive resources added by the informational masking created by the speech fragments and vocal sounds in the background noise. PMID:25566159

  11. Memory performance on the Auditory Inference Span Test is independent of background noise type for young adults with normal hearing at high speech intelligibility.

    PubMed

    Rönnberg, Niklas; Rudner, Mary; Lunner, Thomas; Stenfelt, Stefan

    2014-01-01

    Listening in noise is often perceived to be effortful. This is partly because cognitive resources are engaged in separating the target signal from background noise, leaving fewer resources for storage and processing of the content of the message in working memory. The Auditory Inference Span Test (AIST) is designed to assess listening effort by measuring the ability to maintain and process heard information. The aim of this study was to use AIST to investigate the effect of background noise types and signal-to-noise ratio (SNR) on listening effort, as a function of working memory capacity (WMC) and updating ability (UA). The AIST was administered in three types of background noise: steady-state speech-shaped noise, amplitude modulated speech-shaped noise, and unintelligible speech. Three SNRs targeting 90% speech intelligibility or better were used in each of the three noise types, giving nine different conditions. The reading span test assessed WMC, while UA was assessed with the letter memory test. Twenty young adults with normal hearing participated in the study. Results showed that AIST performance was not influenced by noise type at the same intelligibility level, but became worse with worse SNR when background noise was speech-like. Performance on AIST also decreased with increasing memory load level. Correlations between AIST performance and the cognitive measurements suggested that WMC is of more importance for listening when SNRs are worse, while UA is of more importance for listening in easier SNRs. The results indicated that in young adults with normal hearing, the effort involved in listening in noise at high intelligibility levels is independent of the noise type. However, when noise is speech-like and intelligibility decreases, listening effort increases, probably due to extra demands on cognitive resources added by the informational masking created by the speech fragments and vocal sounds in the background noise.

  12. Verbal Memory Performance and Reduced Cortical Thickness of Brain Regions Along the Uncinate Fasciculus in Young Adult Cannabis Users

    PubMed Central

    Levar, Nina; Francis, Alan N.; Smith, Matthew J.; Ho, Wilson C.; Gilman, Jodi M.

    2018-01-01

    Abstract Introduction: Memory impairment is one of the most commonly reported effects of cannabis use, especially among those who initiate use earlier, perhaps due to the effects of delta-9- tetrahydrocannabinol on cannabinoid (CB1) receptors in the brain. Studies have increasingly investigated whether cannabis use is associated with impairments in verbal memory, and with alterations in brain structures underlying verbal memory. The uncinate fasciculus (UF), a long-range white matter tract, connects regions with densely localized CB1 receptors that are important in verbal memory. This study investigated the impact of cannabis use on UF structures and its association with memory performance in young adult cannabis users (CU) and non-using controls (CON). Materials and Methods: Nineteen CU and 22 CON completed a verbal memory task and a neuroimaging protocol, in which diffusion tensor imaging and structural scans were collected. We compared memory performance, diffusion and tractography measures of the UF, and cortical thickness of regions connected by the UF, between CU and CON. In regions showing a significant group effect, we also examined associations between verbal memory performance, cortical thickness, and age of onset of cannabis use. Results: Compared to non-users, CU had worse memory performance, decreased fiber bundle length in the UF, and decreased cortical thickness of brain regions along the UF such as the entorhinal cortex and fusiform gyrus. Verbal memory performance was significantly associated with age of onset of cannabis use, indicating that those who initiated cannabis use at an earlier age performed worse. Cortical thickness of the entorhinal cortex was significantly correlated with age of first use and memory performance. Conclusion: This study provides evidence that cannabis use, especially when initiated at a young age, may be associated with worse verbal memory and altered neural development along the UF. Reductions in cortical thickness in

  13. Number of rib fractures thresholds independently predict worse outcomes in older patients with blunt trauma.

    PubMed

    Shulzhenko, Nikita O; Zens, Tiffany J; Beems, Megan V; Jung, Hee Soo; O'Rourke, Ann P; Liepert, Amy E; Scarborough, John E; Agarwal, Suresh K

    2017-04-01

    There have been conflicting reports regarding whether the number of rib fractures sustained in blunt trauma is associated independently with worse patient outcomes. We sought to investigate this risk-adjusted relationship among the lesser-studied population of older adults. A retrospective review of the National Trauma Data Bank was performed for patients with blunt trauma who were ≥65 years old and had rib fractures between 2009 and 2012 (N = 67,695). Control data were collected for age, sex, injury severity score, injury mechanism, 24 comorbidities, and number of rib fractures. Outcome data included hospital mortality, hospital and intensive care unit durations of stay, duration of mechanical ventilation, and the occurrence of pneumonia. Multiple logistic and linear regression analyses were performed. Sustaining ≥5 rib fractures was associated with increased intensive care unit admission (odds ratio: 1.14, P < .001) and hospital duration of stay (relative duration: 105%, P < .001). Sustaining ≥7 rib fractures was associated with an increased incidence of pneumonia (odds ratio: 1.32, P < .001) and intensive care unit duration of stay (relative duration: 122%, P < .001). Sustaining ≥8 rib fractures was associated with increased mortality (odds ratio: 1.51, P < .001) and duration of mechanical ventilation (relative duration: 117%, P < .001). In older patients with trauma, sustaining at least 5 rib fractures is a significant predictor of worse outcomes independent of patient characteristics, comorbidities, and trauma burden. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. 5-HTTLPR Genotype Moderates the Effects of Past Ecstasy Use on Verbal Memory Performance in Adolescent and Emerging Adults: A Pilot Study.

    PubMed

    Wright, Natasha E; Strong, Judith A; Gilbart, Erika R; Shollenbarger, Skyler G; Lisdahl, Krista M

    2015-01-01

    Ecstasy use is associated with memory deficits. Serotonin transporter gene (5-HTTLPR) polymorphisms have been linked with memory function in healthy samples. The present pilot study investigated the influence of 5-HTTLPR polymorphisms on memory performance in ecstasy users, marijuana-using controls, and non-drug-using controls, after a minimum of 7 days of abstinence. Data were collected from 116 young adults (18-25 years-old), including 45 controls, 42 marijuana users, and 29 ecstasy users, and were balanced for 5-HTTLPR genotype. Participants were abstinent seven days prior to completing memory testing. Three MANCOVAs and one ANCOVA were run to examine whether drug group, 5-HTTLPR genotype, and their interactions predicted verbal and visual memory after controlling for gender, past year alcohol use, other drug use, and nicotine cotinine levels. MANCOVA and ANCOVA analysis revealed a significant interaction between drug group and genotype (p = .03) such that ecstasy users with the L/L genotype performed significantly worse on CVLT-2 total recall (p = .05), short (p = .008) and long delay free recall (p = .01), and recognition (p = .006), with the reverse pattern found in controls. Ecstasy did not significantly predict visual memory. 5-HTTLPR genotype significantly predicted memory for faces (p = .02); short allele carriers performed better than those with L/L genotype. 5-HTTLPR genotype moderated the effects of ecstasy on verbal memory, with L/L carriers performing worse compared to controls. Future research should continue to examine individual differences in ecstasy's impact on neurocognitive performance as well as relationships with neuronal structure. Additional screening and prevention efforts focused on adolescents and emerging adults are necessary to prevent ecstasy consumption.

  15. Odor Detection Thresholds in a Population of Older Adults

    PubMed Central

    Schubert, Carla R.; Fischer, Mary E.; Pinto, A. Alex; Klein, Barbara E.K.; Klein, Ronald; Cruickshanks, Karen J.

    2016-01-01

    OBJECTIVE To measure odor detection thresholds and associated nasal and behavioral factors in an older adult population. STUDY DESIGN Cross-sectional cohort study METHODS Odor detection thresholds were obtained using an automated olfactometer on 832 participants, aged 68–99 (mean age 77) years in the 21-year (2013–2016) follow-up visit of the Epidemiology of Hearing Loss Study. RESULTS The mean odor detection threshold (ODT) score was 8.2 (range: 1–13; standard deviation = 2.54), corresponding to a n-butanol concentration of slightly less than 0.03%. Older participants were significantly more likely to have lower (worse) ODT scores than younger participants (p<0.001). There were no significant differences in mean ODT scores between men and women. Older age was significantly associated with worse performance in multivariable regression models and exercising at least once a week was associated with a reduced odds of having a low (≤5) ODT score. Cognitive impairment was also associated with poor performance while a history of allergies or a deviated septum were associated with better performance. CONCLUSION Odor detection threshold scores were worse in older age groups but similar between men and women in this large population of older adults. Regular exercise was associated with better odor detection thresholds adding to the evidence that decline in olfactory function with age may be partly preventable. PMID:28000220

  16. Executive functioning in older adults with hoarding disorder.

    PubMed

    Ayers, Catherine R; Wetherell, Julie Loebach; Schiehser, Dawn; Almklov, Erin; Golshan, Shahrokh; Saxena, Sanjaya

    2013-11-01

    Hoarding disorder (HD) is a chronic and debilitating psychiatric condition. Midlife HD patients have been found to have neurocognitive impairment, particularly in areas of executive functioning, but the extent to which this is due to comorbid psychiatric disorders has not been clear. The purpose of the present investigation was to examine executive functioning in geriatric HD patients without any comorbid Axis I disorders (n = 42) compared with a healthy older adult comparison group (n = 25). We hypothesized that older adults with HD would perform significantly worse on measures of executive functioning (Wisconsin Card Sort Task [Psychological Assessment Resources, Lutz, Florida, USA] ( Psychological Assessment Resources, 2003) and the Wechsler Adult Intelligence Scale-IV digit span and letter-number sequencing tests [Pearson, San Antonio, TX, USA]). Older adults with HD showed significant differences from healthy older controls in multiple aspects of executive functioning. Compared with healthy controls, older adults with HD committed significantly more total, non-perseverative errors and conceptual level responses on the Wisconsin Card Sort Task and had significantly worse performance on the Wechsler Adult Intelligence Scale-IV digit span and letter-number sequencing tests. Hoarding symptom severity was strongly correlated with executive dysfunction in the HD group. Compared with demographically-matched controls, older adults with HD have dysfunction in several domains of executive functioning including mental control, working memory, inhibition, and set shifting. Executive dysfunction is strongly correlated with hoarding severity and is not because of comorbid psychiatric disorders in HD patients. These results have broad clinical implications suggesting that executive functioning should be assessed and taken into consideration when developing intervention strategies for older adults with HD. Copyright © 2013 John Wiley & Sons, Ltd.

  17. 5-HTTLPR Genotype Moderates the Effects of Past Ecstasy Use on Verbal Memory Performance in Adolescent and Emerging Adults: A Pilot Study

    PubMed Central

    Wright, Natasha E.; Strong, Judith A.; Gilbart, Erika R.; Shollenbarger, Skyler G.; Lisdahl, Krista M.

    2015-01-01

    Objective Ecstasy use is associated with memory deficits. Serotonin transporter gene (5-HTTLPR) polymorphisms have been linked with memory function in healthy samples. The present pilot study investigated the influence of 5-HTTLPR polymorphisms on memory performance in ecstasy users, marijuana-using controls, and non-drug-using controls, after a minimum of 7 days of abstinence. Method Data were collected from 116 young adults (18–25 years-old), including 45 controls, 42 marijuana users, and 29 ecstasy users, and were balanced for 5-HTTLPR genotype. Participants were abstinent seven days prior to completing memory testing. Three MANCOVAs and one ANCOVA were run to examine whether drug group, 5-HTTLPR genotype, and their interactions predicted verbal and visual memory after controlling for gender, past year alcohol use, other drug use, and nicotine cotinine levels. Results MANCOVA and ANCOVA analysis revealed a significant interaction between drug group and genotype (p = .03) such that ecstasy users with the L/L genotype performed significantly worse on CVLT-2 total recall (p = .05), short (p = .008) and long delay free recall (p = .01), and recognition (p = .006), with the reverse pattern found in controls. Ecstasy did not significantly predict visual memory. 5-HTTLPR genotype significantly predicted memory for faces (p = .02); short allele carriers performed better than those with L/L genotype. Conclusions 5-HTTLPR genotype moderated the effects of ecstasy on verbal memory, with L/L carriers performing worse compared to controls. Future research should continue to examine individual differences in ecstasy’s impact on neurocognitive performance as well as relationships with neuronal structure. Additional screening and prevention efforts focused on adolescents and emerging adults are necessary to prevent ecstasy consumption. PMID:26231032

  18. Testing Solutions for Adult Film Performers.

    PubMed

    Bergman, Zachary R

    2014-01-01

    The majority of the nation's adult films are produced in California, and within California, most production occurs in Los Angeles. In order to regulate that content, the County of Los Angeles passed the Safer Sex in the Adult Film Industry Act (Measure B) by way of referendum in November 2012. Measure B requires that adult film producers wishing to film in Los Angeles County obtain permits from the Los Angeles County Department of Public Health, and it also mandates that adult film performers use condoms while filming and "engaging in anal or vaginal sexual intercourse." Nevertheless, between August 2013 and January 2014, several adult film performers in California tested positive for HIV, and the threat of infection remains. Although Measure B is not the best way forward for Los Angeles County, elements of the ordinance should be incorporated into future legislative efforts. Given the economic ramifications of industry flight due to more localized regulations, this Note concludes that California should pass statewide comprehensive reform. Any such new legislation must treat "independent contractors," the classification generally used for adult film performs, as if they were regular employees. Legislation should also couple mandatory testing mechanisms with provisions granting performers the right to choose whether they use condoms. Finally, legislation must include mechanisms that ensure performers' preferences are not improperly tainted by outside forces and pressures. While there will always be risks associated with the production of adult content, if undertaken, these reforms could significantly mitigate those hazards.

  19. Physical fitness, weight, smoking, and exercise patterns in young adults.

    PubMed

    Leyk, Dieter; Rüther, Thomas; Witzki, Alexander; Sievert, Alexander; Moedl, Anne; Blettner, Maria; Hackfort, Dieter; Löllgen, Herbert

    2012-11-01

    The health and physical fitness of adolescents and young adults are important not just to the individuals concerned, but also to society as a whole. Many studies from many different countries have dealt with the prevalence of overweight, the risk factors for it, and the morbidity it causes, but no more than a few have addressed the effects of unhealthy lifestyles on physical fitness. In this study, we show that young adults' physical performance depends on the number of risk factors they possess. We also compare the young adults' physical performance with that of adolescents aged 10 to 17. We obtained cross-sectional data on the weight, smoking status, athletic activity, time to run 1 km, and ability to perform a chin-up on a horizontal bar of 8048 subjects aged 10 to 25. The young adults were divided into groups depending on the number of risk factors they possessed from the following list: overweight, smoking, and lack of exercise. 28.4% of the men and 35.4% of the women aged 18 to 25 had none of these risk factors and exhibited the best physical performance. The more risk factors were present, the worse physical performance became. The 24- and 25-year-olds performed at the same level as the 14- and 15-year-olds. Unhealthy lifestyles can impair physical fitness even before any chronic disease arises. Possession of even a single risk factor is associated with significantly worse performance. Unless comprehensive and effective interventions are introduced in school and at work, the further cementation and worsening of unhealthy lifestyles will be hard to stop.

  20. Worse self-reported outcomes but no limitations in performance-based measures in patients with long-standing hip and groin pain compared with healthy controls.

    PubMed

    Wörner, Tobias; Sigurðsson, Haraldur B; Pålsson, Anders; Kostogiannis, Ioannis; Ageberg, Eva

    2017-01-01

    This study aimed to evaluate patient-reported outcomes as well as lower extremity and trunk muscle function in patients with long-standing hip and groin pain, in comparison with matched, healthy controls. It was hypothesized that patients with long-standing hip and groin pain would report more deficiency on the Copenhagen Hip and Groin Outcome Score (HAGOS) and have worse outcomes on performance-based measures than healthy controls. Nineteen patients with long-standing hip and groin pain and 19 healthy, activity level-, age-, gender-, and weight-matched controls were assessed with the HAGOS for self-reported outcomes, and a parallel squat (w/kg), single-leg triple jump (cm), single-leg rise (n), barbell roll-out (% of height), and plank test (s) for performance-based measures. Independent sample t test was performed to assess between-group differences. The paired t test was used to analyse between-limb differences in unilateral performance tasks. The patients had worse scores than the controls in all HAGOS subscales (p ≤ 0.001), while no statistically significant differences were observed for any performance measure between groups or between symptomatic and non-symptomatic limbs. Despite significant self-reported functional limitations on the HAGOS, there were no significant differences between groups in performance-based strength or power measures. The results of this study highlight the need to identify performance-based measures, sensitive to functional deficiencies in patients with long-standing hip and groin pain in order to complement the clinical picture obtained by patient-reported outcomes such as the HAGOS. III.

  1. Reference ability neural networks and behavioral performance across the adult life span.

    PubMed

    Habeck, Christian; Eich, Teal; Razlighi, Ray; Gazes, Yunglin; Stern, Yaakov

    2018-05-15

    To better understand the impact of aging, along with other demographic and brain health variables, on the neural networks that support different aspects of cognitive performance, we applied a brute-force search technique based on Principal Components Analysis to derive 4 corresponding spatial covariance patterns (termed Reference Ability Neural Networks -RANNs) from a large sample of participants across the age range. 255 clinically healthy, community-dwelling adults, aged 20-77, underwent fMRI while performing 12 tasks, 3 tasks for each of the following cognitive reference abilities: Episodic Memory, Reasoning, Perceptual Speed, and Vocabulary. The derived RANNs (1) showed selective activation to their specific cognitive domain and (2) correlated with behavioral performance. Quasi out-of-sample replication with Monte-Carlo 5-fold cross validation was built into our approach, and all patterns indicated their corresponding reference ability and predicted performance in held-out data to a degree significantly greater than chance level. RANN-pattern expression for Episodic Memory, Reasoning and Vocabulary were associated selectively with age, while the pattern for Perceptual Speed showed no such age-related influences. For each participant we also looked at residual activity unaccounted for by the RANN-pattern derived for the cognitive reference ability. Higher residual activity was associated with poorer brain-structural health and older age, but -apart from Vocabulary-not with cognitive performance, indicating that older participants with worse brain-structural health might recruit alternative neural resources to maintain performance levels. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. Deviant white matter structure in adults with attention-deficit/hyperactivity disorder points to aberrant myelination and affects neuropsychological performance.

    PubMed

    Onnink, A Marten H; Zwiers, Marcel P; Hoogman, Martine; Mostert, Jeanette C; Dammers, Janneke; Kan, Cornelis C; Vasquez, Alejandro Arias; Schene, Aart H; Buitelaar, Jan; Franke, Barbara

    2015-12-03

    Attention-deficit/hyperactivity disorder (ADHD) in childhood is characterized by gray and white matter abnormalities in several brain areas. Considerably less is known about white matter microstructure in adults with ADHD and its relation with clinical symptoms and cognitive performance. In 107 adult ADHD patients and 109 gender-, age- and IQ-matched controls, we used diffusion tensor imaging (DTI) with tract-based spatial statistics (TBSS) to investigate whole-skeleton changes of fractional anisotropy (FA) and mean, axial, and radial diffusivity (MD, AD, RD). Additionally, we studied the relation of FA and MD values with symptom severity and cognitive performance on tasks measuring working memory, attention, inhibition, and delay discounting. In comparison to controls, participants with ADHD showed reduced FA in corpus callosum, bilateral corona radiata, and thalamic radiation. Higher MD and RD were found in overlapping and even more widespread areas in both hemispheres, also encompassing internal and external capsule, sagittal stratum, fornix, and superior lateral fasciculus. Values of FA and MD were not associated with symptom severity. However, within some white matter clusters that distinguished patients from controls, worse inhibition performance was associated with reduced FA and more impulsive decision making was associated with increased MD. This study shows widespread differences in white matter integrity between adults with persistent ADHD and healthy individuals. Changes in RD suggest aberrant myelination as a pathophysiological factor in persistent ADHD. The microstructural differences in adult ADHD may contribute to poor inhibition and greater impulsivity but appear to be independent of disease severity. Copyright © 2015. Published by Elsevier Inc.

  3. Timed Up and Go test, atrophy of medial temporal areas and cognitive functions in community-dwelling older adults with normal cognition and mild cognitive impairment.

    PubMed

    Kose, Yujiro; Ikenaga, Masahiro; Yamada, Yosuke; Morimura, Kazuhiro; Takeda, Noriko; Ouma, Shinji; Tsuboi, Yoshio; Yamada, Tatsuo; Kimura, Misaka; Kiyonaga, Akira; Higaki, Yasuki; Tanaka, Hiroaki

    2016-12-01

    This study aimed to ascertain if performance on the Timed Up and Go (TUG) test is associated with indicators of brain volume and cognitive functions among community-dwelling older adults with normal cognition or mild cognitive impairment. Participants were 80 community-dwelling older adults aged 65-89years (44 men, 36 women), including 20 with mild cognitive impairment. Participants completed the TUG and a battery of cognitive assessments, including the Mini-Mental State Examination (MMSE), the Logical Memory I and II (LM-I, LM-II) subtests of the Wechsler Memory Scale-Revised; and the Trail Making Test A and B (TMT-A, TMT-B). Bilateral, right- and left-side medial temporal area atrophy as well as whole gray and white matter indices were determined with the Voxel-based Specific Regional Analysis System for Alzheimer's Disease. We divided participants into three groups based on TUG performance: "better" (≤6.9s); "normal" (7-10s); and "poor" (≥10.1s). Worse TMT-A and TMT-B performance showed significant independent associations with worse TUG performance (P<0.05, P<0.01 for trend, respectively). After adjusting for covariates, severe atrophy of bilateral, right-, and left-side medial temporal areas were significantly independently associated with worse TUG performance (P<0.05 for trend). However, no significant associations were found between MMSE, LM-I, LM-II, whole gray and white matter indices, and TUG performance. Worse TUG performance is related to poor performance on TMT-A and TMT-B, and is independently associated with severe medial temporal area atrophy in community-dwelling older adults. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Differences Among Patients That Make Their Tinnitus Worse or Better

    PubMed Central

    Tyler, Richard S.; Ji, Haihong; Coelho, Claudia; Gogel, Stephanie A.

    2015-01-01

    Purpose Our objective was to identify activities that influence tinnitus and to determine if conditional probabilities exist among such variables. Method Two hundred fifty-eight patients were asked the following two questions: “When you have your tinnitus, which of the following makes it worse?” and “Which of the following reduces your tinnitus?” Results Things that made tinnitus better included noise (31%) and relaxation (15%). Things that made tinnitus worse included being in a quiet place (48%), stress (36%), being in a noisy place (32%), and lack of sleep (27%). Almost 6% of patients suggested coffee/tea and 4% said certain foods made their tinnitus worse. Conditional probabilities indicated that for those whose tinnitus is not worse in quiet, it is usually not reduced by noise. For those whose tinnitus is not worse in noise, it is usually not reduced in quiet. Conclusion There are dramatic differences among patients. Such differences need to be considered in planning treatments. PMID:26649850

  5. Impact of poor sleep quality and physical inactivity on cognitive function in community-dwelling older adults.

    PubMed

    Nakakubo, Sho; Makizako, Hyuma; Doi, Takehiko; Tsutsumimoto, Kota; Lee, Sangyoon; Lee, Sungchul; Hotta, Ryo; Bae, Seongryu; Suzuki, Takao; Shimada, Hiroyuki

    2017-11-01

    The purpose of the present study was to examine whether the combination of subjective sleep quality and physical activity is associated with cognitive performance among community-dwelling older adults. Cross-sectional data on 5381 older adults who participated in part of the National Center for Geriatrics and Gerontology - Study of Geriatric Syndromes were analyzed. We assessed general cognitive impairment using the Mini-Mental State Examination, and also assessed story memory, attention, executive function and processing speed using the National Center for Geriatrics and Gerontology Functional Assessment Tool. Physical activity was assessed using two questionnaires, and participants were categorized as active or inactive. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, and participants were categorized as having poor (PS) or good sleep quality (GS). Participants in the inactive + PS group had worse performances than those in the active + GS group in all cognitive measures (Mini-Mental State Examination: P = 0.008, story memory: P = 0.007, other cognitive measures: P < 0.001), and also had worse performances than those in the inactive + GS and active + PS groups in the trail-making test, part B, and the symbol digit substitution test (P < 0.001, respectively). Additionally, participants in the inactive + GS group had worse performances than in the active + GS in the trail-making test, part B, and the symbol digit substitution test (P = 0.002 and P = 0.001, respectively). Inactivity and poor sleep quality were associated with poor cognitive performance among community-dwelling older adults. The combination of poor sleep quality and physical inactivity also worsened cognitive performance. Geriatr Gerontol Int 2017; 17: 1823-1828. © 2017 Japan Geriatrics Society.

  6. Volumetric brain analysis as a predictor of a worse cognitive outcome in Parkinson's disease.

    PubMed

    Vasconcellos, Luiz Felipe; Pereira, João Santos; Adachi, Marcelo; Greca, Denise; Cruz, Manuela; Malak, Ana Lara; Charchat-Fichman, Helenice

    2018-04-27

    Cognitive impairment in Parkinson's disease (PD) results in significant morbidity and mortality being early diagnosis essential. Identification of patients who are at higher risk of developing cognitive impairment based only on clinical data is not sufficient. To this end, magnetic resonance imaging (MRI) with automatic segmentation, such as FreeSurfer, could be a useful tool with high accuracy because it has histological validation. The objective of this study was to evaluate clinical, neuropsychological and FreeSurfer variables that may be related to worse cognitive outcomes over 18 months in PD patients compared with controls. PD patients were recruited according to established inclusion and exclusion criteria as well individuals without any neurological or psychiatric diagnosis and were submitted to the same protocol: neurological, neuropsychological and neuroimaging evaluations. After 18 months, the study subjects were reassessed by neurological and neuropsychological evaluations. Of 171 individuals selected for first evaluation, 96 concluded the study during 18-month follow-up. The PD group presented worse performance in the neuropsychological assessment during both the initial and final evaluations. The results obtained by FreeSurfer revealed a significant reduction (unilateral or bilateral) in the volume of thalamus, caudate nucleus, putamen, hippocampus, amygdala, accumbens, corpus callosum and cerebral gray matter in the PD group. A worse cognitive outcome was more prevalent in the PD group. Worse cognitive performance documented by neuropsychological assessment in the PD group was correlated with reduced volume of several structures by FreeSurfer analysis and may be a biomarker of cognitive decline. Copyright © 2018. Published by Elsevier Ltd.

  7. Stereotype threat as a trigger of mind-wandering in older adults.

    PubMed

    Jordano, Megan L; Touron, Dayna R

    2017-05-01

    Older adults (OAs) report less overall mind-wandering than younger adults (YAs) but more task-related interference (TRI; mind-wandering about the task). The current study examined TRI while manipulating older adults' performance-related concerns. We compared groups for which memory-related stereotype threat (ST) was activated or relieved to a control group. Participants completed an operation span task containing mind-wandering probes. ST-activated OAs reported more TRI than ST-relieved OAs and had worse performance on the operation span task. This study illustrates that environmental context triggers current concerns and determines, in part, the frequency and content of mind-wandering. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Intraindividual variability in cognitive performance in older adults: comparison of adults with mild dementia, adults with arthritis, and healthy adults.

    PubMed

    Hultsch, D F; MacDonald, S W; Hunter, M A; Levy-Bencheton, J; Strauss, E

    2000-10-01

    Intraindividual variability in latency and accuracy of cognitive performance across both trials and occasions was examined in 3 groups of older adults: healthy adults, adults with arthritis, and adults diagnosed with mild dementia. Participants completed 2 reaction-time and 2 episodic-memory tasks on 4 occasions. Results indicated that intraindividual variability in latency was greater in individuals diagnosed with mild dementia than in adults who were neurologically intact, regardless of their health status. Individual differences in variability were stable over time and across cognitive domains. Intraindividual variability was also related to level of performance and was uniquely predictive of neurological status, independent of level of performance. Results suggest that intraindividual variability may be a behavioral indicator of compromised neurological mechanisms.

  9. Relationship between functional vision and balance and mobility performance in community-dwelling older adults.

    PubMed

    Aartolahti, Eeva; Häkkinen, Arja; Lönnroos, Eija; Kautiainen, Hannu; Sulkava, Raimo; Hartikainen, Sirpa

    2013-10-01

    Vision is an important prerequisite for balance control and mobility. The role of objectively measured visual functions has been previously studied but less is known about associations of functional vision, that refers to self-perceived vision-based ability to perform daily activities. The aim of the study was to investigate the relationship between functional vision and balance and mobility performance in a community-based sample of older adults. This study is part of a Geriatric Multidisciplinary Strategy for the Good Care of the Elderly project (GeMS). Participants (576) aged 76-100 years (mean age 81 years, 70 % women) were interviewed using a seven-item functional vision questionnaire (VF-7). Balance and mobility were measured by the Berg balance scale (BBS), timed up and go (TUG), chair stand test, and maximal walking speed. In addition, self-reported fear of falling, depressive symptoms (15-item Geriatric Depression Scale), cognition (Mini-Mental State Examination) and physical activity (Grimby) were assessed. In the analysis, participants were classified into poor, moderate, or good functional vision groups. The poor functional vision group (n = 95) had more comorbidities, depressed mood, cognition decline, fear of falling, and reduced physical activity compared to participants with moderate (n = 222) or good functional vision (n = 259). Participants with poor functional vision performed worse on all balance and mobility tests. After adjusting for gender, age, chronic conditions, and cognition, the linearity remained statistically significant between functional vision and BBS (p = 0.013), TUG (p = 0.010), and maximal walking speed (p = 0.008), but not between functional vision and chair stand (p = 0.069). Poor functional vision is related to weaker balance and mobility performance in community-dwelling older adults. This highlights the importance of widespread assessment of health, including functional vision, to prevent balance impairment and maintain

  10. A Virtual Water Maze Revisited: Two-Year Changes in Navigation Performance and their Neural Correlates in Healthy Adults

    PubMed Central

    Daugherty, Ana M.; Raz, Naftali

    2016-01-01

    Age-related declines in spatial navigation are associated with deficits in procedural and episodic memory and deterioration of their neural substrates. For the lack of longitudinal evidence, the pace and magnitude of these declines and their neural mediators remain unclear. Here we examined virtual navigation in healthy adults (N=213, age 18–77 years) tested twice, two years apart, with complementary indices of navigation performance (path length and complexity) measured over six learning trials at each occasion. Slopes of skill acquisition curves and longitudinal change therein were estimated in structural equation modeling, together with change in regional brain volumes and iron content (R2* relaxometry). Although performance on the first trial did not differ between occasions separated by two years, the slope of path length improvement over trials was shallower and end-of-session performance worse at follow-up. Advanced age, higher pulse pressure, smaller cerebellar and caudate volumes, and greater caudate iron content were associated with longer search paths, i.e. poorer navigation performance. In contrast, path complexity diminished faster over trials at follow-up, albeit less so in older adults. Improvement in path complexity after two years was predicted by lower baseline hippocampal iron content and larger parahippocampal volume. Thus, navigation path length behaves as an index of perceptual-motor skill that is vulnerable to age-related decline, whereas path complexity may reflect cognitive mapping in episodic memory that improves with repeated testing, although not enough to overcome age-related deficits. PMID:27659539

  11. People with chronic facial pain perform worse than controls at a facial emotion recognition task, but it is not all about the emotion.

    PubMed

    von Piekartz, H; Wallwork, S B; Mohr, G; Butler, D S; Moseley, G L

    2015-04-01

    Alexithymia, or a lack of emotional awareness, is prevalent in some chronic pain conditions and has been linked to poor recognition of others' emotions. Recognising others' emotions from their facial expression involves both emotional and motor processing, but the possible contribution of motor disruption has not been considered. It is possible that poor performance on emotional recognition tasks could reflect problems with emotional processing, motor processing or both. We hypothesised that people with chronic facial pain would be less accurate in recognising others' emotions from facial expressions, would be less accurate in a motor imagery task involving the face, and that performance on both tasks would be positively related. A convenience sample of 19 people (15 females) with chronic facial pain and 19 gender-matched controls participated. They undertook two tasks; in the first task, they identified the facial emotion presented in a photograph. In the second, they identified whether the person in the image had a facial feature pointed towards their left or right side, a well-recognised paradigm to induce implicit motor imagery. People with chronic facial pain performed worse than controls at both tasks (Facially Expressed Emotion Labelling (FEEL) task P < 0·001; left/right judgment task P < 0·001). Participants who were more accurate at one task were also more accurate at the other, regardless of group (P < 0·001, r(2)  = 0·523). Participants with chronic facial pain were worse than controls at both the FEEL emotion recognition task and the left/right facial expression task and performance covaried within participants. We propose that disrupted motor processing may underpin or at least contribute to the difficulty that facial pain patients have in emotion recognition and that further research that tests this proposal is warranted. © 2014 John Wiley & Sons Ltd.

  12. Performance on the Wechsler Adult Intelligence Scale-III in Japanese patients with schizophrenia.

    PubMed

    Fujino, Haruo; Sumiyoshi, Chika; Sumiyoshi, Tomiki; Yasuda, Yuka; Yamamori, Hidenaga; Ohi, Kazutaka; Fujimoto, Michiko; Umeda-Yano, Satomi; Higuchi, Arisa; Hibi, Yumiko; Matsuura, Yukako; Hashimoto, Ryota; Takeda, Masatoshi; Imura, Osamu

    2014-07-01

    Patients with schizophrenia have been reported to perform worse than non-schizophrenic populations on neuropsychological tests, which may be affected by cultural factors. The aim of this study was to examine the performance of a sizable number of patients with schizophrenia on the Japanese version of the Wechsler Adult Intelligence Scale-III (WAIS-III) compared with healthy controls. Performance on the WAIS-III was evaluated in 157 Japanese patients with schizophrenia and in 264 healthy control subjects. All IQ scores and four indices from the WAIS-III were impaired for patients with schizophrenia compared with healthy controls. Processing Speed was markedly disturbed, approximately 2 SD below that of the healthy control group. Among the 13 subtests, Comprehension (z = -1.70, d = 1.55), Digit Symbol Coding (z = -1.84, d = 1.88), and Symbol Search (z = -1.85, d = 1.77) were profoundly impaired relative to the healthy controls. These results indicate that the pattern and degree of impairment, as evaluated by the WAIS-III, in Japanese patients are similar to those previously reported in English-speaking patients and that the deficits of some neuropsychological domains relevant to functional outcomes are universally characteristic of schizophrenia. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  13. Shorter survival in adolescent and young adult patients, compared to adult patients, with stage IV colorectal cancer in Japan.

    PubMed

    Shida, Dai; Ahiko, Yuka; Tanabe, Taro; Yoshida, Takefumi; Tsukamoto, Shunsuke; Ochiai, Hiroki; Takashima, Atsuo; Boku, Narikazu; Kanemitsu, Yukihide

    2018-03-27

    The incidence of colorectal cancer in adolescent and young adult patients is increasing. However, survival and clinical features of young patients, especially those with stage IV disease, relative to adult patients remain unclear. This retrospective single-institution cohort study was conducted at a tertiary care cancer center. Subjects were 861 consecutive patients who were diagnosed with stage IV colorectal cancer at the age of 15 to 74 years and who were referred to the division of surgery or gastrointestinal oncology at the National Cancer Center Hospital from 1999 to 2013. Overall survival (OS) was investigated and clinicopathological variables were analyzed for prognostic significance. Of these, 66 (8%) were adolescent and young adult patients and 795 (92%) were adult patients. Median survival time was 13.6 months in adolescent and young adult patients and 22.4 months in adult patients, and 5-year OS rates were 17.3% and 20.3%, respectively, indicating significant worse prognosis of adolescent and young adult patients (p = 0.042). However, age itself was not an independent factor associated with prognosis by multivariate analysis. When compared with adult patients, adolescent and young adult patients consisted of higher proportion of the patients who did not undergo resection of primary tumor, which was an independent factor associated with poor prognosis in multivariate analysis. In patients who did not undergo resection (n = 349), OS of adolescent and young adult patients were significantly worse (p = 0.033). Prognoses were worse in adolescent and young adult patients with stage IV colorectal cancer compared to adult patients in Japan, due to a higher proportion of patients who did not undergo resection with more advanced and severe disease, but not due to age itself.

  14. M1 macrophage recruitment correlates with worse outcome in SHH Medulloblastomas.

    PubMed

    Lee, Chanhee; Lee, Joongyub; Choi, Seung Ah; Kim, Seung-Ki; Wang, Kyu-Chang; Park, Sung-Hye; Kim, Se Hoon; Lee, Ji Yeoun; Phi, Ji Hoon

    2018-05-08

    Recent progress in molecular analysis has advanced the understanding of medulloblastoma (MB) and is anticipated to facilitate management of the disease. MB is composed of 4 molecular subgroups: WNT, SHH, Group 3, and Group 4. Macrophages play a crucial role in the tumor microenvironment; however, the functional role of their activated phenotype (M1/M2) remains controversial. Herein, we investigate the correlation between tumor-associated macrophage (TAM) recruitment within the MB subgroups and prognosis. Molecular subgrouping was performed by a nanoString-based RNA assay on retrieved snap-frozen tissue samples. Immunohistochemistry (IHC) and immunofluorescence (IF) assays were performed on subgroup identified samples, and the number of polarized macrophages was quantified from IHC. Survival analyses were conducted on collected clinical data and quantified macrophage data. TAM (M1/M2) recruitment in SHH MB was significantly higher compared to that in other subgroups. A Kaplan-Meier survival curve and multivariate Cox regression demonstrated that high M1 expressers showed worse overall survival (OS) and progression-free survival (PFS) than low M1 expressers in SHH MB, with relative risk (RR) values of 11.918 and 6.022, respectively. M1 rather than M2 correlates more strongly with worse outcome in SHH medulloblastoma.

  15. Maternal hyperthyroidism increases the susceptibility of rat adult offspring to cardiovascular disorders.

    PubMed

    Lino, Caroline A; da Silva, Ivson Bezerra; Shibata, Caroline E R; Monteiro, Priscilla de S; Barreto-Chaves, Maria Luiza M

    2015-11-15

    Suboptimal intrauterine conditions as changed hormone levels during critical periods of the development are considered an insult and implicate in physiological adaptations which may result in pathological outcomes in later life. This study evaluated the effect of maternal hyperthyroidism (hyper) on cardiac function in adult offspring and the possible involvement of cardiac Renin-Angiotensin System (RAS) in this process. Wistar dams received orally thyroxin (12 mg/L) from gestational day 9 (GD9) until GD18. Adult offspring at postnatal day 90 (PND90) from hyper dams presented increased SBP evaluated by plethysmography and worse recovery after ischemia-reperfusion (I/R), as evidenced by decreased LVDP, +dP/dT and -dP/dT at 25 min of reperfusion and by increased infarct size. Increased cardiac Angiotensin I/II levels and AT1R in hyper offspring were verified. Herein, we provide evidences that maternal hyperthyroidism leads to altered expression of RAS components in adult offspring, which may be correlated with worse recovery of the cardiac performance after ischemic insults and hypertension. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  16. Improving older adults' memory performance using prior task success.

    PubMed

    Geraci, Lisa; Miller, Tyler M

    2013-06-01

    Holding negative aging stereotypes can lead older adults to perform poorly on memory tests. We attempted to improve older adults' memory performance by giving them task experience that would counter their negative performance expectations. Before participating in a memory experiment, younger and older adults were given a cognitive task that they could either successfully complete, not successfully complete, or they were given no prior task. For older adults, recall was significantly higher and self-reported anxiety was significantly lower for the prior task success group relative to the other groups. There was no effect of prior task experience on younger adults' memory performance. Results suggest that older adults' memory can be improved with a single successful prior task experience. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  17. Global brain atrophy is associated with physical performance and the risk of falls in older adults with cognitive impairment.

    PubMed

    Yamada, Minoru; Takechi, Hajime; Mori, Shuhei; Aoyama, Tomoki; Arai, Hidenori

    2013-04-01

    Falls are common in patients with cognitive disorder. The purpose of this study was to determine whether global brain atrophy is associated with cognitive function, physical performance and fall incidents in older adults with mild cognitive disorder. A total of 31 older adults with mild cognitive disorders (mean age 78.9 ± 7.3 years) were studied, and 10 of them had experienced falls and the others had not in the past 1 year. Cognitive function and physical performance were measured in these patients. Global brain atrophy was determined by the Voxel-Based Specific Regional Analysis System for Alzheimer's Disease software. Fallers showed significantly worse scores than the non-fallers in the Global Brain Atrophy Index, Clock Drawing Test (CDT), Verbal Fluency Test (animal), maximum walking time and Timed Up & Go (TUG) Test. The Global Brain Atrophy Index was correlated with the Verbal Fluency Test (animal; r = -0.522), the Verbal Fluency Test with letter (ka; r = -0.337), CDT (r = -0.547), TUG (r = 0.276) and Five Chair Stands Test (r = 0.303) by age-adjusted correlation analyses. Stepwise regression analysis showed that the Global Brain Atrophy Index (β = 1.265, 95% CI 1.022-1.567) was a significant and independent determinant of falls (R(2) = 0.356, P = 0.003). Global brain atrophy might be indicated as one of the risk factors for falls in older adults with mild cognitive disorders. © 2012 Japan Geriatrics Society.

  18. Onset of bell's palsy in late pregnancy and early puerperium is associated with worse long-term outcomes.

    PubMed

    Phillips, Katie M; Heiser, Alyssa; Gaudin, Robert; Hadlock, Tessa A; Jowett, Nate

    2017-12-01

    The incidence of Bell's palsy (BP) is elevated in the late phases of pregnancy. Controversy exists as to whether pregnancy is a risk factor for worse outcomes in BP, and whether such outcomes are the result of factors intrinsic to pregnancy or the tendency to withhold medical therapy in this cohort. Long-term facial function outcomes in cases of pregnancy-associated BP (PABP) were compared against outcomes in cases affecting nonpregnant adult women of child-bearing age by a blinded expert using the electronic clinician-graded facial function scale (eFACE) facial grading system. Fifty-one pregnancy-associated cases and 58 nonpregnancy-associated cases were included. Among patients who received early corticosteroid therapy, significantly worse static, synkinesis, and composite facial function eFACE scores were demonstrated among cases of PABP compared to nonpregnancy-associated cases (static median = 86 vs. 92.5, P = 0.005; synkinesis median = 79 vs. 86, P = 0.007; composite median = 78 vs. 84, P = 0.023). Among those not treated with corticosteroids, significantly worse dynamic and composite facial function eFACE scores were demonstrated in cases of PABP compared to those for nonpregnancy-associated cases (dynamic median = 74 vs. 92.5, P = 0.038; composite median = 73 vs. 86.5, P = 0.038). A trend toward improved outcomes was demonstrated within both groups for those treated with corticosteroids compared to those who were not. In comparison to cases unrelated to pregnancy, late-term PABP is associated with worse long-term outcomes to a degree that cannot solely be explained by differences in medical therapy. 4. Laryngoscope, 127:2854-2859, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  19. The Relationship of Reduced Peripheral Nerve Function and Diabetes With Physical Performance in Older White and Black Adults

    PubMed Central

    Strotmeyer, Elsa S.; de Rekeneire, Nathalie; Schwartz, Ann V.; Faulkner, Kimberly A.; Resnick, Helaine E.; Goodpaster, Bret H.; Shorr, Ronald I.; Vinik, Aaron I.; Harris, Tamara B.; Newman, Anne B.

    2008-01-01

    OBJECTIVE—Poor peripheral nerve function is prevalent in diabetes and older populations, and it has great potential to contribute to poor physical performance. RESEARCH DESIGN AND METHODS—Cross-sectional analyses were done for the Health, Aging, and Body Composition (Health ABC) Study participants (n = 2,364; 48% men; 38% black; aged 73–82 years). Sensory and motor peripheral nerve function in legs/feet was assessed by 10- and 1.4-g monofilament perception, vibration detection, and peroneal motor nerve conduction amplitude and velocity. The Health ABC lower-extremity performance battery was a supplemented version of the Established Populations for the Epidemiologic Studies of the Elderly battery (chair stands, standing balance, and 6-m walk), adding increased stand duration, single foot stand, and narrow walk. RESULTS—Diabetic participants had fewer chair stands (0.34 vs. 0.36 stands/s), shorter standing balance time (0.69 vs. 0.75 ratio), slower usual walking speed (1.11 vs. 1.14 m/s), slower narrow walking speed (0.80 vs. 0.90 m/s), and lower performance battery score (6.43 vs. 6.93) (all P < 0.05). Peripheral nerve function was associated with each physical performance measure independently. After addition of peripheral nerve function in fully adjusted models, diabetes remained significantly related to a lower performance battery score and slower narrow walking speed but not to chair stands, standing balance, or usual walking speed. CONCLUSIONS—Poor peripheral nerve function accounts for a portion of worse physical performance in diabetes and may be directly associated with physical performance in older diabetic and nondiabetic adults. The impact of peripheral nerve function on incident disability should be evaluated in older adults. PMID:18535192

  20. Evaluation of Verbal Behavior in Older Adults

    PubMed Central

    Gross, Amy C.; Fuqua, R. Wayne; Merritt, Todd A.

    2013-01-01

    Approximately 5% of older adults have a dementia diagnosis, and language deterioration is commonly associated with this disorder (Kempler, 2005). Several instruments have been developed to diagnose dementia and assess language capabilities of elderly adults. However, none of these instruments take a functional approach to language assessment as described by Skinner (1957). The purpose of this study was to develop and evaluate a function-based assessment for language deficits of older adults. Thirty-one participants were categorized into a control group (n  =  15) and a dementia group (n  =  16) based on their score on the Dementia Rating Scale-2. Individuals with dementia performed significantly worse on the tact assessment than those without dementia. Participants from both groups performed better on measures of tacts than intraverbals or mands, even though topographically identical responses were required in these assessments. The data provide support for Skinner's conceptualization of functionally independent verbal operants. PMID:23814369

  1. Cognitive deficits are associated with poorer simulated driving in older adults with heart failure

    PubMed Central

    2013-01-01

    Background Cognitive impairment is prevalent in older adults with heart failure (HF) and associated with reduced functional independence. HF patients appear at risk for reduced driving ability, as past work in other medical samples has shown cognitive dysfunction to be an important contributor to driving performance. The current study examined whether cognitive dysfunction was independently associated with reduced driving simulation performance in a sample of HF patients. Methods 18 persons with HF (67.72; SD = 8.56 year) completed echocardiogram and a brief neuropsychological test battery assessing global cognitive function, attention/executive function, memory and motor function. All participants then completed the Kent Multidimensional Assessment Driving Simulation (K-MADS), a driving simulator scenario with good psychometric properties. Results The sample exhibited an average Mini Mental State Examination (MMSE) score of 27.83 (SD = 2.09). Independent sample t-tests showed that HF patients performed worse than healthy adults on the driving simulation scenario. Finally, partial correlations showed worse attention/executive and motor function were independently associated with poorer driving simulation performance across several indices reflective of driving ability (i.e., centerline crossings, number of collisions, % of time over the speed limit, among others). Conclusion The current findings showed that reduced cognitive function was associated with poor simulated driving performance in older adults with HF. If replicated using behind-the-wheel testing, HF patients may be at elevated risk for unsafe driving and routine driving evaluations in this population may be warranted. PMID:24499466

  2. A virtual water maze revisited: Two-year changes in navigation performance and their neural correlates in healthy adults.

    PubMed

    Daugherty, Ana M; Raz, Naftali

    2017-02-01

    Age-related declines in spatial navigation are associated with deficits in procedural and episodic memory and deterioration of their neural substrates. For the lack of longitudinal evidence, the pace and magnitude of these declines and their neural mediators remain unclear. Here we examined virtual navigation in healthy adults (N=213, age 18-77 years) tested twice, two years apart, with complementary indices of navigation performance (path length and complexity) measured over six learning trials at each occasion. Slopes of skill acquisition curves and longitudinal change therein were estimated in structural equation modeling, together with change in regional brain volumes and iron content (R2* relaxometry). Although performance on the first trial did not differ between occasions separated by two years, the slope of path length improvement over trials was shallower and end-of-session performance worse at follow-up. Advanced age, higher pulse pressure, smaller cerebellar and caudate volumes, and greater caudate iron content were associated with longer search paths, i.e. poorer navigation performance. In contrast, path complexity diminished faster over trials at follow-up, albeit less so in older adults. Improvement in path complexity after two years was predicted by lower baseline hippocampal iron content and larger parahippocampal volume. Thus, navigation path length behaves as an index of perceptual-motor skill that is vulnerable to age-related decline, whereas path complexity may reflect cognitive mapping in episodic memory that improves with repeated testing, although not enough to overcome age-related deficits. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Validity of a verbal incidental learning measure from the WAIS-IV in older adults.

    PubMed

    Hammers, Dustin B; Kucera, Amanda M; Card, Stephanie J; Tolle, Kathryn A; Atkinson, Taylor J; Duff, Kevin; Spencer, Robert J

    2018-01-01

    Incidental memory may reflect a form of learning in everyday life, although it is not consistently evaluated during standard neuropsychological evaluations. Further validation of a recently created measure of verbal Incidental Learning (IL) from the Wechsler Adult Intelligence Scale-IV is necessary to understand the utility of such a measure in clinical settings. Sixty-eight adults aged 50 to 89 were recruited from a Cognitive Disorders Clinic while receiving a standard neuropsychological assessment, along with two additional measures of IL. IL-Total Score was significantly correlated with immediate and delayed memory trials from standard neuropsychological tests (rs = .43 to .73, ps < .001, ds = 0.94-2.14), with worse IL performance being associated with lower memory abilities. Participants with probable Alzheimer's disease performed worse on the IL-Total Score than participants with Mild Cognitive Impairment, t(39.997) = 5.46, p < .001, d = 1.13. Given the strong relationships between this IL task and traditional memory measures in our sample, and the discrimination of IL-Total Score performance among diagnostic groups despite its short administration time, this IL task may play a role as a measure of memory in brief cognitive evaluations.

  4. Falls Risk and Simulated Driving Performance in Older Adults

    PubMed Central

    Gaspar, John G.; Neider, Mark B.; Kramer, Arthur F.

    2013-01-01

    Declines in executive function and dual-task performance have been related to falls in older adults, and recent research suggests that older adults at risk for falls also show impairments on real-world tasks, such as crossing a street. The present study examined whether falls risk was associated with driving performance in a high-fidelity simulator. Participants were classified as high or low falls risk using the Physiological Profile Assessment and completed a number of challenging simulated driving assessments in which they responded quickly to unexpected events. High falls risk drivers had slower response times (~2.1 seconds) to unexpected events compared to low falls risk drivers (~1.7 seconds). Furthermore, when asked to perform a concurrent cognitive task while driving, high falls risk drivers showed greater costs to secondary task performance than did low falls risk drivers, and low falls risk older adults also outperformed high falls risk older adults on a computer-based measure of dual-task performance. Our results suggest that attentional differences between high and low falls risk older adults extend to simulated driving performance. PMID:23509627

  5. Mental rotation and the human body: Children's inflexible use of embodiment mirrors that of adults.

    PubMed

    Krüger, Markus; Ebersbach, Mirjam

    2017-12-25

    Adults' mental rotation performance with body-like stimuli is enhanced if these stimuli are anatomically compatible with a human body, but decreased by anatomically incompatible stimuli. In this study, we investigated these effects for kindergartners and first-graders: When asked to mentally rotate cube configurations attached with human body parts in an anatomically compatible way, allowing for the projection of a human body, children performed better than with pure cube combinations. By contrast, when body parts were attached in an anatomically incompatible way, disallowing the projection of a human body, children performed worse than with pure combinations. This experiment is of specific interest against the background of two different theoretical approaches concerning imagery and the motor system in development: One approach assumes an increasing integration of motor processes and imagery over time that enables older children and adults to requisition motor resources for imagery processes, while the other postulates that imagery stems from early sensorimotor processes in the first place, and is disentangled from it over time. The finding that children of the two age groups tested show exactly the same effects as adults when mentally rotating anatomically compatible and incompatible stimuli is interpreted in favour of the latter approach. Statement of contribution What is already known on this subject? In mental rotation, adults perform better when rotating anatomically possible stimuli as compared to rotating standard cube combinations. Performance is worse when rotating anatomically impossible stimuli. What does this study add? The present study shows that children's mental transformations mirror those of adults in these respects. In case of the anatomically impossible stimuli, this highlights an inflexible use of embodiment in both age groups. This is in line with the Piagetian assumption of imagery being based on sensorimotor processes. © 2017 The British

  6. The Association between High Neuroticism-Low Extraversion and Dual-Task Performance during Walking While Talking in Non-demented Older Adults

    PubMed Central

    LeMonda, Brittany C.; Mahoney, Jeannette R.; Verghese, Joe; Holtzer, Roee

    2016-01-01

    The Walking While Talking (WWT) dual-task paradigm is a mobility stress test that predicts major outcomes, including falls, frailty, disability, and mortality in aging. Certain personality traits, such as neuroticism, extraversion, and their combination, have been linked to both cognitive and motor outcomes. We examined whether individual differences in personality dimensions of neuroticism and extraversion predicted dual-task performance decrements (both motor and cognitive) on a WWT task in non-demented older adults. We hypothesized that the combined effect of high neuroticism-low extraversion would be related to greater dual-task costs in gait velocity and cognitive performance in non-demented older adults. Participants (N = 295; age range, = 65–95 years; female = 164) completed the Big Five Inventory and WWT task involving concurrent gait and a serial 7's subtraction task. Gait velocity was obtained using an instrumented walkway. The high neuroticism-low extraversion group incurred greater dual-task costs (i.e., worse performance) in both gait velocity {95% confidence interval (CI) [−17.68 to −3.07]} and cognitive performance (95% CI [−19.34 to −2.44]) compared to the low neuroticism-high extraversion group, suggesting that high neuroticism-low extraversion interferes with the allocation of attentional resources to competing task demands during the WWT task. Older individuals with high neuroticism-low extraversion may be at higher risk for falls, mobility decline and other adverse outcomes in aging. PMID:26527241

  7. Blood Pressure Reactivity to Psychological Stress in Young Adults and Cognition in Midlife: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

    PubMed

    Yano, Yuichiro; Ning, Hongyan; Reis, Jared P; Lewis, Cora E; Launer, Lenore J; Bryan, R Nick; Yaffe, Kristine; Sidney, Stephen; Albanese, Emiliano; Greenland, Philip; Lloyd-Jones, Donald; Liu, Kiang

    2016-01-13

    The classic view of blood pressure (BP) reactivity to psychological stress in relation to cardiovascular risks assumes that excess reactivity is worse and lower reactivity is better. Evidence addressing how stress-induced BP reactivity in young adults is associated with midlife cognitive function is sparse. We assessed BP reactivity during a star tracing task and a video game in adults aged 20 to 32 years. Twenty-three years later, cognitive function was assessed with use of the Digit Symbol Substitution Test (a psychomotor speed test), the Rey Auditory Verbal Learning Test (a verbal memory test), and the modified Stroop test (an executive function test). At the time of follow-up, participants (n=3021) had a mean age of 50.2 years; 56% were women, and 44% were black. In linear regression models adjusted for demographic and clinical characteristics including baseline and follow-up resting BP, lower systolic BP (SBP) reactivity during the star tracing and video game was associated with worse Digit Symbol Substitution Test scores (β [SE]: 0.11 [0.02] and 0.05 [0.02], respectively) and worse performance on the Stroop test (β [SE]: -0.06 [0.02] and -0.05 [0.02]; all P<0.01). SBP reactivity was more consistently associated than diastolic BP reactivity with cognitive function scores. The associations between SBP reactivity and cognitive function were mostly similar between blacks and whites. Lower psychological stress-induced SBP reactivity in younger adults was associated with lower cognitive function in midlife. BP reactivity to psychological stressors may have different associations with target organs in hypertension. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  8. Computer Technology: For Better or Worse?

    ERIC Educational Resources Information Center

    Ware, Willis H.

    Computer technology ought to be among the most helpful and useful of any technology, but if it is not treated with care, the society will be worse off for it. The Federal Privacy Act of 1974 established the Privacy Protection Study Commission whose business started in June, 1975. In examination of the private sector, the commission's…

  9. Neuropsychological Performance Patterns of Adult ADHD Subtypes.

    PubMed

    LeRoy, Amy; Jacova, Claudia; Young, Caedy

    2018-05-01

    Neuropsychological performance patterns associated with adult ADHD subtypes are unknown. The aim of the current systematic review was to identify and synthesize available literature regarding neuropsychological performance associated with adult ADHD subtypes. Searches were completed using the databases PsycINFO and PubMed for studies published before March 2017 addressing adult ADHD subtypes and neuropsychological performance. Data characterizing the neuropsychological tests utilized in each study were obtained and sorted into eight domains. To summarize the results of all comparisons (ADHD subtype compared with control, or to each other), we counted the proportion of tests within each domain with significant group differences. We deemed four domains informative in differentiating ADHD subtypes from controls. Of these, memory was the only domain that held promise in distinguishing ADHD-Inattentive and ADHD-Combined. Limitations of the available literature are highlighted and recommendations for future research are provided.

  10. Neurocognitive and executive functioning in adult survivors of congenital heart disease.

    PubMed

    Klouda, Leda; Franklin, Wayne J; Saraf, Anita; Parekh, Dhaval R; Schwartz, David D

    2017-01-01

    Congenital heart disease (CHD) can affect the developing central nervous system, resulting in neurocognitive and behavioral deficits. Preoperative neurological abnormalities as well as sequelae of the open heart operations required to correct structural abnormalities of the heart contribute to these deficits. There are few studies examining the neurocognitive functioning of adults with CHD. This study sought to investigate multiple domains of neurocognitive functioning in adult survivors of CHD who had childhood cardiac surgery with either moderate or severe disease complexity. A total of 48 adults (18-49 years of age) who had undergone cardiac surgery for CHD prior to five years of age participated in the study. CHD severity was classified as moderate or severe according to the 32nd Bethesda Guidelines. A computerized battery of standardized neurocognitive tests (CNS-Vital Signs), a validated rating scale of executive functioning, and demographic questionnaires were administered. There were no significant differences between the moderate CHD group and normative data on any cognitive measure. In contrast, the severe CHD group differed from norms in multiple domains: psychomotor speed, processing speed, complex attention, reaction time, and on the overall neurocognitive index. Number of surgeries was strongly related to worse executive functioning. There was no association between age at first surgery or time since last surgery and neuropsychological functioning. Number of surgeries was also unrelated to neurocognitive test performance. Patients with severe CHD performed significantly worse on measures of processing speed, attention, and executive functioning. These findings may be useful in the long-term care of adults with congenital heart disease. © 2016 Wiley Periodicals, Inc.

  11. Lifetime Alcohol Use & Cognitive Performance in Older Adults

    PubMed Central

    Kalapatapu, Raj K.; Ventura, Maria I.; Barnes, Deborah E.

    2016-01-01

    Background Substance use is an important clinical issue in the older adult population. As older adults are susceptible to cognitive disorders, the intersection of the fields of substance use and cognitive neuroscience is an active area of research. Prior studies of alcohol use and cognitive performance are mixed, and inconsistencies may be due to under- or over-adjustment for confounders. Aim This manuscript adds to this literature by conducting a secondary analysis of self-reported lifetime history of alcohol use and cognitive performance in older adults (n = 133). We hypothesized that current alcohol users would have poorer cognitive performance compared to never/minimal and former alcohol users. Methods Older adult participants were classified into never/minimal alcohol users, former alcohol users, and current alcohol users. A neurocognitive battery included a global cognitive measure and individual measures of attention, memory, fluency, and executive function. A directed acyclic graph (DAG)-based approach was used to select variables to be included in the multiple linear regression models. Results Though unadjusted analyses showed some significant associations between alcohol use and cognitive performance, all associations between alcohol use and cognitive performance were eliminated after adjusting for age, education, sex, race and smoking pack years. Alcohol drink years were not significantly associated with cognitive performance among current and former alcohol users. Discussion These results suggest that lifetime alcohol use is not significantly associated with cognitive performance in older adults after adjustment for key confounders. Inconsistencies in prior studies may be due to uncontrolled confounding and/or unnecessary adjustment of mediators and/or colliders. PMID:27719514

  12. Pathways to Health Risk Exposure in Adult Film Performers

    PubMed Central

    Ryan, Gery; Margold, William; Torres, Jacqueline; Gelberg, Lillian

    2008-01-01

    Despite being part of a large and legal industry in Los Angeles, little is known about adult film performers’ exposure to health risks and when and how these risks might occur. The objective was to identify exposure to physical, mental, and social health risks and the pathways to such risks among adult film performers and to determine how risks differ between different types of performers, such as men and women. Semi-structured in-depth interviews were conducted with 18 female and ten male performers as well as two key informants from the industry. Performers and key informants were recruited through Protecting Adult Welfare, adult film venues, and snowball sampling. Performers engaged in risky health behaviors that included high-risk sexual acts that are unprotected, substance abuse, and body enhancement. They are exposed to physical trauma on the film set. Many entered and left the industry with financial insecurity and suffered from mental health problems. Women were more likely than men to be exposed to health risks. Adult film performers, especially women, are exposed to health risks that accumulate over time and that are not limited to sexually transmitted diseases. PMID:18709554

  13. Diarrhea - what to ask your health care provider - adult

    MedlinePlus

    What to ask your health care provider about diarrhea - adult; Loose stools - what to ask your health care provider - adult ... you should ask: Can I eat dairy foods? What foods can make my problem worse? Can I ...

  14. A Reanalysis of Cognitive-Functional Performance in Older Adults: Investigating the Interaction Between Normal Aging, Mild Cognitive Impairment, Mild Alzheimer's Disease Dementia, and Depression

    PubMed Central

    de Paula, Jonas J.; Bicalho, Maria A.; Ávila, Rafaela T.; Cintra, Marco T. G.; Diniz, Breno S.; Romano-Silva, Marco A.; Malloy-Diniz, Leandro F.

    2016-01-01

    Depressive symptoms are associated with cognitive-functional impairment in normal aging older adults (NA). However, less is known about this effect on people with mild Cognitive Impairment (MCI) and mild Alzheimer's disease dementia (AD). We investigated this relationship along with the NA-MCI-AD continuum by reanalyzing a previously published dataset. Participants (N = 274) underwent comprehensive neuropsychological assessment including measures of Executive Function, Language/Semantic Memory, Episodic Memory, Visuospatial Abilities, Activities of Daily Living (ADL), and the Geriatric Depression Scale. MANOVA, logistic regression and chi-square tests were performed to assess the association between depression and cognitive-functional performance in each group. In the NA group, depressed participants had a lower performance compared to non-depressed participants in all cognitive and functional domains. However, the same pattern was not observed in the MCI group or in AD. The results suggest a progressive loss of association between depression and worse cognitive-functional performance along the NA-MCI-AD continuum. PMID:26858666

  15. Compensatory processing during rule-based category learning in older adults.

    PubMed

    Bharani, Krishna L; Paller, Ken A; Reber, Paul J; Weintraub, Sandra; Yanar, Jorge; Morrison, Robert G

    2016-01-01

    Healthy older adults typically perform worse than younger adults at rule-based category learning, but better than patients with Alzheimer's or Parkinson's disease. To further investigate aging's effect on rule-based category learning, we monitored event-related potentials (ERPs) while younger and neuropsychologically typical older adults performed a visual category-learning task with a rule-based category structure and trial-by-trial feedback. Using these procedures, we previously identified ERPs sensitive to categorization strategy and accuracy in young participants. In addition, previous studies have demonstrated the importance of neural processing in the prefrontal cortex and the medial temporal lobe for this task. In this study, older adults showed lower accuracy and longer response times than younger adults, but there were two distinct subgroups of older adults. One subgroup showed near-chance performance throughout the procedure, never categorizing accurately. The other subgroup reached asymptotic accuracy that was equivalent to that in younger adults, although they categorized more slowly. These two subgroups were further distinguished via ERPs. Consistent with the compensation theory of cognitive aging, older adults who successfully learned showed larger frontal ERPs when compared with younger adults. Recruitment of prefrontal resources may have improved performance while slowing response times. Additionally, correlations of feedback-locked P300 amplitudes with category-learning accuracy differentiated successful younger and older adults. Overall, the results suggest that the ability to adapt one's behavior in response to feedback during learning varies across older individuals, and that the failure of some to adapt their behavior may reflect inadequate engagement of prefrontal cortex.

  16. Compensatory Processing During Rule-Based Category Learning in Older Adults

    PubMed Central

    Bharani, Krishna L.; Paller, Ken A.; Reber, Paul J.; Weintraub, Sandra; Yanar, Jorge; Morrison, Robert G.

    2016-01-01

    Healthy older adults typically perform worse than younger adults at rule-based category learning, but better than patients with Alzheimer's or Parkinson's disease. To further investigate aging's effect on rule-based category learning, we monitored event-related potentials (ERPs) while younger and neuropsychologically typical older adults performed a visual category-learning task with a rule-based category structure and trial-by-trial feedback. Using these procedures, we previously identified ERPs sensitive to categorization strategy and accuracy in young participants. In addition, previous studies have demonstrated the importance of neural processing in the prefrontal cortex and the medial temporal lobe for this task. In this study, older adults showed lower accuracy and longer response times than younger adults, but there were two distinct subgroups of older adults. One subgroup showed near-chance performance throughout the procedure, never categorizing accurately. The other subgroup reached asymptotic accuracy that was equivalent to that in younger adults, although they categorized more slowly. These two subgroups were further distinguished via ERPs. Consistent with the compensation theory of cognitive aging, older adults who successfully learned showed larger frontal ERPs when compared with younger adults. Recruitment of prefrontal resources may have improved performance while slowing response times. Additionally, correlations of feedback-locked P300 amplitudes with category-learning accuracy differentiated successful younger and older adults. Overall, the results suggest that the ability to adapt one's behavior in response to feedback during learning varies across older individuals, and that the failure of some to adapt their behavior may reflect inadequate engagement of prefrontal cortex. PMID:26422522

  17. Can chronic multimorbidity explain the age-related differences in strength, speed and balance in older adults?

    PubMed

    Welmer, Anna-Karin; Kåreholt, Ingemar; Angleman, Sara; Rydwik, Elisabeth; Fratiglioni, Laura

    2012-10-01

    It is known that physical performance declines with age in general, however there remains much to be understood in terms of age-related differences amongst older adults across a variety of physical components (such as speed, strength and balance), and particularly in terms of the role played by multimorbidity of chronic diseases. We aimed to detect the age-related differences across four components of physical performance and to explore to what extent chronic diseases and multimorbidity may explain such differences. We analyzed cross-sectional data from a population-based sample of 3323 people, aged 60 years and older from the SNAC-K study, Stockholm, Sweden. Physical performance was assessed by trained nurses using several tests (grip strength, walking speed, balance and chair stands). Clinical diagnoses were made by the examining physician based on clinical history and examination. Censored normal regression analyses showed that the 72-90+ year-old persons had 17-40% worse grip strength, 44-86% worse balance, 30-86% worse chair stand score, and 21-59% worse walking speed, compared with the 60-66 year-old persons. Chronic diseases were strongly associated with physical impairment, and this association was particularly strong among the younger men. However, chronic diseases explained only some of the age-related differences in physical performance. When controlling for chronic diseases in the analyses, the age-related differences in physical performance changed 1-11%. In spite of the strong association between multimorbidity and physical impairment, chronic morbidities explained only a small part of the age-related differences in physical performance.

  18. The effect of inversion on face recognition in adults with autism spectrum disorder.

    PubMed

    Hedley, Darren; Brewer, Neil; Young, Robyn

    2015-05-01

    Face identity recognition has widely been shown to be impaired in individuals with autism spectrum disorders (ASD). In this study we examined the influence of inversion on face recognition in 26 adults with ASD and 33 age and IQ matched controls. Participants completed a recognition test comprising upright and inverted faces. Participants with ASD performed worse than controls on the recognition task but did not show an advantage for inverted face recognition. Both groups directed more visual attention to the eye than the mouth region and gaze patterns were not found to be associated with recognition performance. These results provide evidence of a normal effect of inversion on face recognition in adults with ASD.

  19. Temporal Dynamics of Cognitive Performance and Anxiety Across Older Adulthood

    PubMed Central

    Petkus, Andrew J.; Reynolds, Chandra A.; Wetherell, Julie Loebach; Kremen, William S.; Gatz, Margaret

    2017-01-01

    Cognitive decline and anxiety symptoms commonly co-occur in later life, but the temporal order of changes on these two attributes is unclear. Specifically, it is unknown if greater anxiety leads to subsequent declines in cognitive performance or if worse cognitive performance leads to increased anxiety. In this study, we sought to elucidate the temporal dynamics between anxiety symptoms and cognitive performance across old age, that is, the extent to which level and change in one variable influence subsequent changes in a second variable. We examined data from 721 non-demented participants from the Swedish Adoption/Twin Study of Aging. Participants completed as many as eight assessments of cognitive performance and anxiety over a 26-year period. Bivariate dual change score models were fit to examine the dynamic association between anxiety and cognitive performance. Bidirectional associations between anxiety and cognitive performance were found among measures of processing speed, attention, and memory, but not visuospatial abilities. Higher anxiety was associated with greater declines in processing speed over the duration of six years and worsening attention over a span of three years. The reverse direction was also significant in that slower processing speed, worse attention, and poorer nonverbal and working memory performance were associated with larger increases in anxiety three years later. These findings highlight that in cognitively intact older adults, the association between anxiety and worse cognitive performance is bidirectional and complex. PMID:28333502

  20. Child- or Adult-Directed Speech and Esteem: Effects on Performance and Arousal in Elderly Adults.

    ERIC Educational Resources Information Center

    Bunce, Vicki L.; Harrison, David W.

    1991-01-01

    Explored effects of speech type and esteem level on performance, physiological arousal level, and subsequent esteem in older adults (n=40). Results indicated that older adults performed difficult tasks better with clarified instructions given in attention-getting manner. Findings were contradictory to more intuitive accounts of child-directed…

  1. Making detailed predictions makes (some) predictions worse

    NASA Astrophysics Data System (ADS)

    Kelly, Theresa F.

    In this paper, we investigate whether making detailed predictions about an event makes other predictions worse. Across 19 experiments, 10,895 participants, and 415,960 predictions about 724 professional sports games, we find that people who made detailed predictions about sporting events (e.g., how many hits each baseball team would get) made worse predictions about more general outcomes (e.g., which team would win). We rule out that this effect is caused by inattention or fatigue, thinking too hard, or a differential reliance on holistic information about the teams. Instead, we find that thinking about game-relevant details before predicting winning teams causes people to give less weight to predictive information, presumably because predicting details makes information that is relatively useless for predicting the winning team more readily accessible in memory and therefore incorporated into forecasts. Furthermore, we show that this differential use of information can be used to predict what kinds of games will and will not be susceptible to the negative effect of making detailed predictions.

  2. The effect of colour on children's cognitive performance.

    PubMed

    Brooker, Alice; Franklin, Anna

    2016-06-01

    The presence of red appears to hamper adults' cognitive performance relative to other colours (see Elliot & Maier, 2014, Ann. Rev. Psychol. 65, 95). Here, we investigate whether colour affects cognitive performance in 8- and 9-year-olds. Children completed a battery of tasks once in the presence of a coloured screen that was one of eight colours and once in the presence of a grey screen. Performance was assessed for each colour relative to the grey baseline, and differences across colours were compared. We find a significant difference in performance across colours, with significantly worse performance in the presence of red than grey. The effect of colour did not significantly interact with task. The findings suggest that colour can affect children's cognitive performance and that there is a detrimental effect of red. Findings are related to the adult literature and implications for educational contexts are discussed. © 2015 The British Psychological Society.

  3. Pediatric and adult vision restoration after optic nerve sheath decompression for idiopathic intracranial hypertension.

    PubMed

    Bersani, Thomas A; Meeker, Austin R; Sismanis, Dimitrios N; Carruth, Bryant P

    2016-06-01

    To compare presentations of idiopathic intracranial hypertension and efficacy of optic nerve sheath decompression between adult and pediatric patients, a retrospective cohort study was completed All idiopathic intracranial hypertension patients undergoing optic nerve sheath decompression by one surgeon between 1991 and 2012 were included. Pre-operative and post-operative visual fields, visual acuity, color vision, and optic nerve appearance were compared between adult and pediatric (<18 years) populations. Outcome measures included percentage of patients with complications or requiring subsequent interventions. Thirty-one adults (46 eyes) and eleven pediatric patients (18 eyes) underwent optic nerve sheath decompression for vision loss from idiopathic intracranial hypertension. Mean deviation on visual field, visual acuity, color vision, and optic nerve appearance significantly improved across all subjects. Pre-operative mean deviation was significantly worse in children compared to adults (p=0.043); there was no difference in mean deviation post-operatively (p=0.838). Significantly more pediatric eyes (6) presented with light perception only or no light perception than adult eyes (0) (p=0.001). Pre-operative color vision performance in children (19%) was significantly worse than in adults (46%) (p=0.026). Percentage of patients with complications or requiring subsequent interventions did not differ between groups. The consistent improvement after surgery and low rate of complications suggest optic nerve sheath decompression is safe and effective in managing vision loss due to adult and pediatric idiopathic intracranial hypertension. Given the advanced pre-operative visual deficits seen in children, one might consider a higher index of suspicion in diagnosing, and earlier surgical intervention in treating pediatric idiopathic intracranial hypertension.

  4. Gender Differences in Adult Health: An International Comparison.

    ERIC Educational Resources Information Center

    Rahman, Omar; And Others

    1994-01-01

    Used data from United States, Jamaica, Malaysia, and Bangladesh to explore gender differences in adult health. Found that women fared worse than men across variety of self-reported health measures in all four countries. Data from Jamaica indicated that gender disparities in adult health arose early and persisted throughout the life cycle, with…

  5. Engineering Improved Balance Confidence in Older Adults With Complex Health Care Needs: Learning From the Muscling Up Against Disability Study.

    PubMed

    Hetherington, Sharon; Henwood, Tim; Swinton, Paul; Keogh, Justin; Gardiner, Paul; Tuckett, Anthony; Rouse, Kevin

    2018-04-05

    To investigate the associations of balance confidence with physical and cognitive markers of well-being in older adults receiving government-funded aged care services and whether progressive resistance plus balance training could positively influence change. Intervention study. Community-based older adult-specific exercise clinic. Older adults (N=245) with complex care needs who were receiving government-funded aged care support. Twenty-four weeks of twice weekly progressive resistance plus balance training carried out under the supervision of accredited exercise physiologists. The primary measure was the Activity-specific Balance Confidence Scale. Secondary measures included the Short Physical Performance Battery; fall history gathered as part of the health history questionnaire; hierarchical timed balance tests; Geriatric Anxiety Index; Geriatric Depression Scale; Fatigue, Resistance, Ambulation, Illness, Loss of Weight scale; and EuroQoL-5 dimension 3 level. At baseline, better physical performance (r=.54; P<.01) and quality of life (r=.52; P<.01) predicted better balance confidence. In contrast, at baseline, higher levels of frailty predicted worse balance confidence (r=-.55; P<.01). Change in balance confidence after the exercise intervention was accompanied by improved physical performance (+12%) and reduced frailty (-11%). Baseline balance confidence was identified as the most consistent negative predictor of change scores across the intervention. This study shows that reduced physical performance and quality of life and increased frailty are predictive of worse balance confidence in older adults with aged care needs. However, when a targeted intervention of resistance and balance exercise is implemented that reduces frailty and improves physical performance, balance confidence will also improve. Given the influence of balance confidence on a raft of well-being determinants, including the capacity for positive physical and cognitive change, this study offers

  6. Latent toxoplasmosis is associated with neurocognitive impairment in young adults with and without chronic HIV infection.

    PubMed

    Ene, L; Marcotte, T D; Umlauf, A; Grancea, C; Temereanca, A; Bharti, A; Achim, C L; Letendre, S; Ruta, S M

    2016-10-15

    We evaluated the impact of latent toxoplasmosis (LT) on neurocognitive (NC) and neurobehavioural functioning in young adults with and without chronic HIV infection, using a standardised NC test battery, self-reported Beck Depression Inventory, Frontal System Behavior Scale, MINI-International Neuropsychiatric Interview and risk-assessment battery. 194 young adults (median age 24years, 48.2% males) with chronic HIV infection (HIV+) since childhood and 51 HIV seronegative (HIV-) participants were included. HIV+ individuals had good current immunological status (median CD4: 479 cells/μl) despite a low CD4 nadir (median: 93 cells/μl). LT (positive anti-Toxoplasma IgG antibodies) was present in one third of participants. The impairment rates in the HIV- with and without Toxo were not significantly different (p=0.17). However, we observed an increasing trend (p<0.001) in impairment rates with HIV and LT status: HIV-/LT- (6.1%); HIV-/LT+ (22%), HIV+/LT- (31%), HIV+/LT+ (49%). In a multivariable analysis using the entire study group there were main effects on cognition for HIV and also for LT. Within the HIV+ group LT was associated with worse performance globally (p=0.006), in memory (p=0.009), speed of information processing (p=0.01), verbal (p=0.02) and learning (p=0.02) domains. LT was not associated with depressive symptoms, frontal systems dysfunction or risk behaviors in any of the groups. HIV participants with lower Toxoplasma antibody concentration had worse NC performance, with higher GDS values (p=0.03) and worse learning (p=0.002), memory (p=0.006), speed of information processing (p=0.01) T scores. Latent Toxoplasmosis may contribute to NC impairment in young adults, including those with and without chronic HIV infection. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. Association between Dietary Sodium Intake and Cognitive Function in Older Adults.

    PubMed

    Rush, T M; Kritz-Silverstein, D; Laughlin, G A; Fung, T T; Barrett-Connor, E; McEvoy, L K

    2017-01-01

    To examine the association of dietary sodium intake with cognitive function in community-dwelling older adults. Cross-sectional study. Southern California community. White men (n=373) and women (n=552), aged 50-96 years from the Rancho Bernardo Study, a longitudinal study of cardiovascular disease risk factors and healthy aging. During the 1992-1996 research clinic visit, a food frequency questionnaire was used to determine daily sodium intake; cognitive function was assessed with Trails Making Test, part B (Trails B), Mini-Mental State Exam (MMSE), and Verbal Fluency Test (VFT); and medical, clinical and demographic information was obtained. Linear regression was used to assess the association between calorie-adjusted sodium intake and cognitive test scores with adjustment for demographic, behavioral and health measures. Logistic regression examined the odds of having cognitive impairment by sodium intake. Lower sodium intake was associated with poorer performance on Trails B (p=0.008) and MMSE (p=0.003) after controlling for age, sex, and education. Associations did not differ by sex, but there was a significant interaction by age for the Trails B: older (≥80 years), but not younger, adults showed worse performance with lower sodium intake (p=0.03). Associations remained significant after additional adjustment for smoking, alcohol intake, exercise, body weight, cardiovascular risk factors, kidney function, diuretic medication use, and diet quality. Lower daily sodium intake was associated with increased odds of cognitive impairment on the MMSE (score < 26; OR per SD decrease = 1.12, 95% CI 1.08, 1.16). Concluson: Lower sodium intake was associated with worse cognitive function in older community-dwelling adults. For the maintenance of cognitive health, older adults may be advised to avoid very low sodium diets.

  8. Association between Dietary Sodium Intake and Cognitive Function in Older Adults

    PubMed Central

    Rush, Toni M; Kritz-Silverstein, Donna; Laughlin, Gail A; Fung, Teresa T; Barrett-Connor, Elizabeth L; McEvoy, Linda K

    2016-01-01

    OBJECTIVES To examine the association of dietary sodium intake with cognitive function in community-dwelling older adults. DESIGN Cross-sectional study SETTING Southern California community PARTICIPANTS White men (n=373) and women (n=552), aged 50–96 years from the Rancho Bernardo Study, a longitudinal study of cardiovascular disease risk factors and healthy aging. MEASUREMENTS During the 1992–1996 research clinic visit, a food frequency questionnaire was used to determine daily sodium intake; cognitive function was assessed with Trails Making Test, part B (Trails B), Mini-Mental State Exam (MMSE), and Verbal Fluency Test (VFT); and medical, clinical and demographic information was obtained. Linear regression was used to assess the association between calorie-adjusted sodium intake and cognitive test scores with adjustment for demographic, behavioral and health measures. Logistic regression examined the odds of having cognitive impairment by sodium intake. RESULTS Lower sodium intake was associated with poorer performance on Trails B (p=0.008) and MMSE (p=0.003) after controlling for age, sex, and education. Associations did not differ by sex, but there was a significant interaction by age for the Trails B: older (≥80 years), but not younger, adults showed worse performance with lower sodium intake (p=0.03). Associations remained significant after additional adjustment for smoking, alcohol intake, exercise, body weight, cardiovascular risk factors, kidney function, diuretic medication use, and diet quality. Lower daily sodium intake was associated with increased odds of cognitive impairment on the MMSE (score < 26; OR per SD decrease = 1.12, 95% CI 1.08, 1.16). CONCLUSION Lower sodium intake was associated with worse cognitive function in older community-dwelling adults. For the maintenance of cognitive health, older adults may be advised to avoid very low sodium diets. PMID:28244567

  9. Mixed pro and antisaccade performance in children and adults.

    PubMed

    Irving, Elizabeth L; Tajik-Parvinchi, Diana J; Lillakas, Linda; González, Esther G; Steinbach, Martin J

    2009-02-19

    Pro and antisaccades are usually presented in blocks of similar type but they can also be presented such that prosaccade and antisaccade eye movements are mixed and a cue, usually the shape/colour of the fixation target or the peripheral target, determines which type of eye movement is required in a particular trial. A mixed-saccade task theoretically equalizes the inhibitory requirements for pro and antisaccades. Using a mixed-saccade task paradigm the aims of the study were to: 1) compare pro and antisaccades of children, 2) compare performance of children and adults and 3) explore the effect of increased working memory load in adults. The eye movements of 22 children (5-12 years) and 22 adults (20-51 years) were examined using a video-based eye tracking system (El-Mar Series 2020 Eye Tracker, Toronto, Canada). The task was a mixed-saccade task of pro and antisaccades and the colour of the peripheral target was the cue for whether the required saccade was to be a pro or an antisaccade. The children performed the mixed-saccade task and 11 adults performed the same mixed-saccade task alone and in a dual-task paradigm (together with mental subtraction or number repetition). A second group of 11 adults performed the mixed-saccade task alone. Children made mainly antisaccade errors. The adults' error rates increased in the mental subtraction dual-task condition but both antisaccade and prosaccade errors were made. It was concluded that the increased error rates of these two groups are reflective of different processing dynamics.

  10. Policy to Performance Toolkit: Transitioning Adults to Opportunity

    ERIC Educational Resources Information Center

    Alamprese, Judith A.; Limardo, Chrys

    2012-01-01

    The "Policy to Performance Toolkit" is designed to provide state adult education staff and key stakeholders with guidance and tools to use in developing, implementing, and monitoring state policies and their associated practices that support an effective state adult basic education (ABE) to postsecondary education and training transition…

  11. Worse outcomes among uninsured general surgery patients: does the need for an emergency operation explain these disparities?

    PubMed

    Schwartz, Diane A; Hui, Xuan; Schneider, Eric B; Ali, Mays T; Canner, Joseph K; Leeper, William R; Efron, David T; Haut, Elliot; Haut, Elliot R; Velopulos, Catherine G; Pawlik, Timothy M; Haider, Adil H

    2014-08-01

    We hypothesize that lack of access to care results in propensity toward emergent operative management and may be an important factor in worse outcomes for the uninsured population. The objective of this study is to investigate a possible link to worse outcomes in patients without insurance who undergo an emergent operation. A retrospective cross-sectional analysis was performed using the Nationwide Inpatient Sample (NIS) 2005-2011 dataset. Patients who underwent biliary, hernia, and colorectal operations were evaluated. Multivariate analyses were performed to assess the associations between insurance status, urgency of operation, and outcome. Covariates of age, sex, race, and comorbidities were controlled. The uninsured group had greatest odds ratios of undergoing emergent operative management in biliary (OR 2.43), colorectal (3.54), and hernia (3.95) operations, P < .001. Emergent operation was most likely in the 25- to 34-year age bracket, black and Hispanic patients, men, and patients with at least one comorbidity. Postoperative complications in emergencies, however, were appreciated most frequently in the populations with government coverage. Although the uninsured more frequently underwent emergent operations, patients with coverage through the government had more complications in most categories investigated. Young patients also carried significant risk of emergent operations with increased complication rates. Patients with government insurance tended toward worse outcomes, suggesting disparity for programs such as Medicaid. Disparity related to payor status implies need for policy revisions for equivalent health care access. Copyright © 2014 Mosby, Inc. All rights reserved.

  12. Plasticity in older adults' theory of mind performance: the impact of motivation.

    PubMed

    Zhang, Xin; Lecce, Serena; Ceccato, Irene; Cavallini, Elena; Zhang, Linfang; Chen, Tianyong

    2017-09-08

    Recently, motivation has been found to attenuate the age-related decline in Theory of Mind (ToM) performance (i.e. faux pas recognition). However, whether or not this effect could be generalized to other ToM tasks is still unknown. In the present study, we investigated whether and how motivation could enhance older adults' performance and reduce age differences in ToM tasks (Faux Pas vs. Animation task) that differ in familiarity. Following a previous paradigm, 171 Chinese adults (87 younger adults and 84 older adults) were recruited, and we experimentally manipulated the level of perceived closeness between participants and the experimenter before administering the ToM tasks in order to enhance participants' motivation. Results showed that, for the Faux Pas task, we replicated previous findings such that older adults under the enhanced motivation conditions performed equally well as younger adults. Conversely, for the Animation task, younger adults outperformed older adults, regardless of motivation. These results indicate that motivation can enhance older adults' performance in ToM tasks, however, this beneficial effect cannot be generalized across ToM tasks.

  13. Testing the Limits of Optimizing Dual-Task Performance in Younger and Older Adults

    PubMed Central

    Strobach, Tilo; Frensch, Peter; Müller, Herrmann Josef; Schubert, Torsten

    2012-01-01

    Impaired dual-task performance in younger and older adults can be improved with practice. Optimal conditions even allow for a (near) elimination of this impairment in younger adults. However, it is unknown whether such (near) elimination is the limit of performance improvements in older adults. The present study tests this limit in older adults under conditions of (a) a high amount of dual-task training and (b) training with simplified component tasks in dual-task situations. The data showed that a high amount of dual-task training in older adults provided no evidence for an improvement of dual-task performance to the optimal dual-task performance level achieved by younger adults. However, training with simplified component tasks in dual-task situations exclusively in older adults provided a similar level of optimal dual-task performance in both age groups. Therefore through applying a testing the limits approach, we demonstrated that older adults improved dual-task performance to the same level as younger adults at the end of training under very specific conditions. PMID:22408613

  14. Proactive and coactive interference in age-related performance in a recognition-based operation span task.

    PubMed

    Zeintl, Melanie; Kliegel, Matthias

    2010-01-01

    Generally, older adults perform worse than younger adults in complex working memory span tasks. So far, it is unclear which processes mainly contribute to age-related differences in working memory span. The aim of the present study was to investigate age effects and the roles of proactive and coactive interference in a recognition-based version of the operation span task. Younger and older adults performed standard versions and distracter versions of the operation span task. At retrieval, participants had to recognize target words in word lists containing targets as well as proactive and/or coactive interference-related lures. Results show that, overall, younger adults outperformed older adults in the recognition of target words. Furthermore, analyses of error types indicate that, while younger adults were only affected by simultaneously presented distracter words, older adults had difficulties with both proactive and coactive interference. Results suggest that age effects in complex span tasks may not be mainly due to retrieval deficits in old age. Copyright 2009 S. Karger AG, Basel.

  15. On Realizing It's Worse than I Thought

    ERIC Educational Resources Information Center

    Entin, David

    2009-01-01

    It didn't end with an acceptance letter in the mail. That was the highlight of the high school to college transition, but it wasn't the finish line, far from it. In this essay, the author describes his feelings on transitioning from high school to college. He finally sees that the process is worse than he thought. Because it's not another step in…

  16. Influence of schooling and age on cognitive performance in healthy older adults

    PubMed Central

    Bento-Torres, N.V.O.; Bento-Torres, J.; Tomás, A.M.; Costa, V.O.; Corrêa, P.G.R.; Costa, C.N.M.; Jardim, N.Y.V.; Picanço-Diniz, C.W.

    2017-01-01

    Few studies have examined the influence of a low level of schooling on age-related cognitive decline in countries with wide social and economic inequalities by using the Cambridge Automated Neuropsychological Test Battery (CANTAB). The aim of the present study was to assess the influence of schooling on age-related cognitive decline using unbiased cognitive tests. CANTAB allows cognitive assessment across cultures and education levels with reduced interference of the examiner during data acquisition. Using two-way ANOVA, we assessed the influences of age and education on test scores of old adults (61–84 years of age). CANTAB tests included: Visual Sustained Attention, Reaction Time, Spatial Working Memory, Learning and Episodic Memory. All subjects had a minimum visual acuity of 20/30 (Snellen Test), no previous or current history of traumatic brain/head trauma, stroke, language impairment, chronic alcoholism, neurological diseases, memory problems or depressive symptoms, and normal scores on the Mini Mental State Examination (MMSE). Subjects were grouped according to education level (1 to 7 and ≥8 years of schooling) and age (60–69 and ≥70 years). Low schooling level was associated with significantly lower performance on visual sustained attention, learning and episodic memory, reaction time, and spatial working memory. Although reaction time was influenced by age, no significant results on post hoc analysis were detected. Our findings showed a significantly worse cognitive performance in volunteers with lower levels of schooling and suggested that formal education in early life must be included in the preventive public health agenda. In addition, we suggest that CANTAB may be useful to detect subtle cognitive changes in healthy aging. PMID:28355353

  17. Walking through doorways causes forgetting: Younger and older adults.

    PubMed

    Radvansky, Gabriel A; Pettijohn, Kyle A; Kim, Joonsung

    2015-06-01

    Previous research on event cognition has found that walking through doorways can cause forgetting. The explanation for this finding is that there is a competition between event models, producing interference, and depressing performance. The current study explored the degree to which this might be affected by the natural aging process. This is of interest because there is some evidence that older adults have trouble coordinating sources of interference, which is what is thought to underlie this effect. This would suggest that older adults should do worse on this task. Alternatively, there is also evidence that older adults are typically not disrupted at the event level of processing per se. This would suggest that older adults should perform similarly to younger adults on this task. In the study reported here, younger and older participants navigated through a virtual environment, and memory was tested with probes either before or after a shift and for objects that were associated with the participant (i.e., just picked up). In general, both younger and older adults had memory disrupted after walking through a doorway. Importantly, the magnitude of this disruption was similar in the 2 age groups. This is consistent with the idea that processing at the event level is relatively unaffected by the natural aging process. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  18. The Artistic Infant Directed Performance: A Mycroanalysis of the Adult's Movements and Sounds.

    PubMed

    Español, Silvia; Shifres, Favio

    2015-09-01

    Intersubjectivity experiences established between adults and infants are partially determined by the particular ways in which adults are active in front of babies. An important amount of research focuses on the "musicality" of infant-directed speech (defined melodic contours, tonal and rhythm variations, etc.) and its role in linguistic enculturation. However, researchers have recently suggested that adults also bring a multimodal performance to infants. According to this, some scholars seem to find indicators of the genesis of the performing arts (mainly music and dance) in such a multimodal stimulation. We analyze the adult performance using analytical categories and methodologies of analysis broadly validated in the fields of music performance and movement analysis in contemporary dance. We present microanalyses of an adult-7 month old infant interaction scene that evidenced structural aspects of infant directed multimodal performance compatible with music and dance structures, and suggest functions of adult performance similar to performing arts functions or related to them.

  19. Simulated Driving Performance of Adults with ADHD: Comparisons with Alcohol Intoxication

    PubMed Central

    Weafer, Jessica; Camarillo, Daniel; Fillmore, Mark T.; Milich, Richard; Marczinski, Cecile A.

    2015-01-01

    Previous research has demonstrated that adults with ADHD are more likely to experience driving-related problems, which suggests that they may exhibit poorer driving performance. However, direct experimental evidence of this hypothesis is limited. The current study involved two experiments that evaluated driving performance in adults with ADHD in terms of the types of driving decrements typically associated with alcohol intoxication. Experiment 1 compared the simulated driving performance of 15 adults with ADHD to 23 adult control participants, who performed the task both while sober and intoxicated. Results showed that sober adults with ADHD exhibited decrements in driving performance compared to sober controls, and that the profile of impairment for the sober ADHD group did in fact resemble that of intoxicated drivers at the BAC level for legally impaired driving in the United States. Driving impairment of the intoxicated individuals was characterized by greater deviation of lane position, faster and more abrupt steering maneuvers, and increased speed variability. Experiment 2 was a dose-challenge study in which 8 adults with ADHD and 8 controls performed the driving simulation task under three doses of alcohol: 0.65 g/kg, 0.45 g/kg, and 0.0 g/kg (placebo). Results showed that driving performance in both groups was impaired in response to alcohol, and that individuals with ADHD exhibited generally poorer driving performance than did controls across all dose conditions. Together the findings provide compelling evidence to suggest that the cognitive and behavioral deficits associated with ADHD might impair driving performance in such a manner as to resemble that of an alcohol intoxicated driver. Moreover, alcohol might impair the performance of drivers with ADHD in an additive fashion that could considerably compromise their driving skill even at blood alcohol concentrations below the legal limit. PMID:18540785

  20. Diabetes is Associated with Worse Executive Function in Both Eastern and Western Populations: Shanghai Aging Study and Mayo Clinic Study of Aging.

    PubMed

    Zhao, Qianhua; Roberts, Rosebud O; Ding, Ding; Cha, Ruth; Guo, Qihao; Meng, Haijiao; Luo, Jianfeng; Machulda, Mary M; Shane Pankratz, V; Wang, Bei; Christianson, Teresa J H; Aakre, Jeremiah A; Knopman, David S; Boeve, Bradley F; Hong, Zhen; Petersen, Ronald C

    2015-01-01

    It remains unknown whether the association between diabetes mellitus (DM) and cognitive function differs in Eastern and Western populations. This study aimed to elucidate whether DM is associated with worse cognitive performance in both populations. The Shanghai Aging Study (SAS) and the Mayo Clinic Study of Aging (MCSA) are two population-based studies with similar design and methodology in Shanghai, China and Rochester, MN, USA. Non-demented participants underwent cognitive testing, and DM was assessed from the medical record. Separate analyses were performed in SAS and MCSA regarding the association between DM and cognitive performance. A total of 3,348 Chinese participants in the SAS and 3,734 American subjects in the MCSA were included. Compared with MCSA subjects, SAS participants were younger, less educated, and had lower frequency of vascular disease, APOE ɛ4 carriers and obesity. Participants with DM (compared to non-DM participants) performed significantly worse on all the cognitive domains in both the SAS and MCSA. After adjustment for age, gender, education, and vascular covariates, DM was associated with worse performance in executive function (β=-0.15, p = 0.001 for SAS, and β=-0.10, p = 0.008 for MCSA) in the total sample and in the cognitively normal sub-sample. Furthermore, DM was associated with poor performance in visuospatial skills, language, and memory in the SAS, but not in the MCSA. Diabetes is associated with cognitive dysfunction and, in particular, exerts a negative impact on executive function regardless of race, age, and prevalence of vascular risk factors.

  1. Aging Ebbs the Flow of Thought: Adult Age Differences in Mind Wandering, Executive Control, and Self-Evaluation

    PubMed Central

    McVay, Jennifer C.; Meier, Matthew E.; Touron, Dayna R.; Kane, Michael J.

    2013-01-01

    Two experiments examined the relations among adult aging, mind wandering, and executive-task performance, following from surprising laboratory findings that older adults report fewer task-unrelated thoughts (TUTs) than do younger adults (e.g., Giambra, 1989; Jackson & Balota, 2011). Because older adults may experience more ability- and performance-related worry during cognitive tasks in the laboratory, and because these evaluative thoughts (known as task-related interference, “TRI”) might be sometimes misclassified by subjects as task-related, we asked subjects to distinguish task-related thoughts from TRI and TUTs when probed during ongoing tasks. In Experiment 1, younger and older adults completed either a go/no-go or a vigilance version of a sustained attention to response task (SART). Older adults reported more TRI and fewer TUTs than did younger adults while also performing more accurately. In Experiment 2, subjects completed either a 1- or 2-back version of the n-back task. Older adults again reported more TRI and fewer TUTs than younger adults in both versions, while performing better than younger adults in the 1-back and worse in the 2-back. Across experiments, older adults’ reduced TUT rates were independent of performance relative to younger adults. And, although older adults consistently reported more TRI and less mind wandering than did younger adults, overall they reported more on-task thoughts. TRI cannot, therefore, account completely for prior reports of decreasing TUTs with aging. We discuss the implications of these results for various theoretical approaches to mind-wandering. PMID:23261422

  2. Major depressive disorder, cognitive symptoms, and neuropsychological performance among ethnically diverse HIV+ men and women.

    PubMed

    Fellows, Robert P; Byrd, Desiree A; Morgello, Susan

    2013-02-01

    Major depressive disorder (MDD), cognitive symptoms, and mild cognitive deficits commonly occur in HIV-infected individuals, despite highly active antiretroviral therapies. In this study, we compared neuropsychological performance and cognitive symptoms of 191 HIV-infected participants. Results indicated that participants with a formal diagnosis of current MDD performed significantly worse than participants without MDD in all seven neuropsychological domains evaluated, with the largest effect sizes in information processing speed, learning, and memory. In addition, a brief assessment of cognitive symptoms, derived from a comprehensive neuromedical interview, correlated significantly with neurocognitive functioning. Participants with MDD reported more cognitive symptoms and showed greater neurocognitive deficits than participants without MDD. These findings indicate that HIV-infected adults with MDD have more cognitive symptoms and worse neuropsychological performance than HIV-infected individuals without MDD. The results of this study have important implications for the diagnosis of HIV-associated neurocognitive disorders (HAND).

  3. Dynamic Spectral Structure Specifies Vowels for Adults and Children

    PubMed Central

    Nittrouer, Susan; Lowenstein, Joanna H.

    2014-01-01

    The dynamic specification account of vowel recognition suggests that formant movement between vowel targets and consonant margins is used by listeners to recognize vowels. This study tested that account by measuring contributions to vowel recognition of dynamic (i.e., time-varying) spectral structure and coarticulatory effects on stationary structure. Adults and children (four-and seven-year-olds) were tested with three kinds of consonant-vowel-consonant syllables: (1) unprocessed; (2) sine waves that preserved both stationary coarticulated and dynamic spectral structure; and (3) vocoded signals that primarily preserved that stationary, but not dynamic structure. Sections of two lengths were removed from syllable middles: (1) half the vocalic portion; and (2) all but the first and last three pitch periods. Adults performed accurately with unprocessed and sine-wave signals, as long as half the syllable remained; their recognition was poorer for vocoded signals, but above chance. Seven-year-olds performed more poorly than adults with both sorts of processed signals, but disproportionately worse with vocoded than sine-wave signals. Most four-year-olds were unable to recognize vowels at all with vocoded signals. Conclusions were that both dynamic and stationary coarticulated structures support vowel recognition for adults, but children attend to dynamic spectral structure more strongly because early phonological organization favors whole words. PMID:25536845

  4. Insomnia in epilepsy is associated with continuing seizures and worse quality of life.

    PubMed

    Quigg, Mark; Gharai, Sean; Ruland, Jeff; Schroeder, Catherine; Hodges, Matthew; Ingersoll, Karen S; Thorndike, Frances P; Yan, Guofen; Ritterband, Lee M

    2016-05-01

    To evaluate how insomnia is associated with seizure control and quality of life in patients with epilepsy. Consecutive patients with epilepsy attending clinical visits were surveyed with the Insomnia Severity Index (ISI). Patients had to be treated with at least one anticonvulsant and could not have had documented psychogenic pseudoseizure. The presence or absence of seizures and quality of life (QOLIE-P-10) within the past 4 weeks was recorded. Other variables included demographic and clinical data, sleep-wake timing, the Hörne-Östberg Morningness-Eveningness Questionnaire (MEQ), sleepiness (Epworth Sleepiness Scale (ESS), and mood (Center for Epidemiologic Studies Depression Scale, CES-D). 207 patients completed surveys. 43% had clinically significant insomnia, and 51% had at least mild insomnia. 58% were seizure free. Mean ISI scores were significantly worse for those with continuing seizures, and more severe ISI scores correlated strongly with worse QOL. Younger age, shorter duration of epilepsy, use of sedative/hypnotics, medical and sleep comorbidities, delayed sleep timing and chronotype, excessive sleepiness, and depression were all associated with more severe insomnia. Those with unexpected health care visits over the most recent 4 weeks had worse insomnia. After adjustment for these covariates, more severe insomnia remained significantly associated with lack of seizure freedom and with worse QOL. Insomnia is common in epilepsy, and is associated with short term poor seizure control and worse QOL. Future studies must evaluate cause-and-effect relationships. Assessment of insomnia may be important in the comprehensive care of epilepsy and may influence control of epileptic seizures. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Cognitive outcome in adults after bacterial meningitis

    PubMed Central

    Hoogman, Martine; van de Beek, Diederik; Weisfelt, Martijn; de Gans, Jan; Schmand, Ben

    2007-01-01

    Objective To evaluate cognitive outcome in adult survivors of bacterial meningitis. Methods Data from three prospective multicentre studies were pooled and reanalysed, involving 155 adults surviving bacterial meningitis (79 after pneumococcal and 76 after meningococcal meningitis) and 72 healthy controls. Results Cognitive impairment was found in 32% of patients and this proportion was similar for survivors of pneumococcal and meningococcal meningitis. Survivors of pneumococcal meningitis performed worse on memory tasks (p<0.001) and tended to be cognitively slower than survivors of meningococcal meningitis (p = 0.08). We found a diffuse pattern of cognitive impairment in which cognitive speed played the most important role. Cognitive performance was not related to time since meningitis; however, there was a positive association between time since meningitis and self‐reported physical impairment (p<0.01). The frequency of cognitive impairment and the numbers of abnormal test results for patients with and without adjunctive dexamethasone were similar. Conclusions Adult survivors of bacterial meningitis are at risk of cognitive impairment, which consists mainly of cognitive slowness. The loss of cognitive speed is stable over time after bacterial meningitis; however, there is a significant improvement in subjective physical impairment in the years after bacterial meningitis. The use of dexamethasone was not associated with cognitive impairment. PMID:17353256

  6. Theory of mind deficit in adult patients with congenital heart disease.

    PubMed

    Chiavarino, Claudia; Bianchino, Claudia; Brach-Prever, Silvia; Riggi, Chiara; Palumbo, Luigi; Bara, Bruno G; Bosco, Francesca M

    2015-10-01

    This article provides the first assessment of theory of mind, that is, the ability to reason about mental states, in adult patients with congenital heart disease. Patients with congenital heart disease and matched healthy controls were administered classical theory of mind tasks and a semi-structured interview which provides a multidimensional evaluation of theory of mind (Theory of Mind Assessment Scale). The patients with congenital heart disease performed worse than the controls on the Theory of Mind Assessment Scale, whereas they did as well as the control group on the classical theory-of-mind tasks. These findings provide the first evidence that adults with congenital heart disease may display specific impairments in theory of mind. © The Author(s) 2013.

  7. Reading difficulties in Spanish adults with dyslexia.

    PubMed

    Suárez-Coalla, Paz; Cuetos, Fernando

    2015-04-01

    Recent studies show that dyslexia persists into adulthood, even in highly educated and well-read people. The main characteristic that adults with dyslexia present is a low speed when reading. In Spanish, a shallow orthographic system, no studies about adults with dyslexia are available; and it is possible that the consistency of the orthographic system favours the reading fluency. The aim of this study was to get an insight of the reading characteristics of Spanish adults with dyslexia and also to infer the reading strategies that they are using. For that purpose, a group of 30 dyslexics (M age = 32 years old) and an age-matched group of 30 adults without reading disabilities completed several phonological and reading tasks: phonological awareness tasks, rapid automatic naming, lexical decision, word and pseudoword reading, letter detection and text reading. The results showed that highly educated Spanish dyslexics performed significantly worse than the control group in the majority of the tasks. Specifically, they showed difficulties reading long pseudowords, indicating problems in automating the grapheme-phoneme rules, but they also seem to present difficulties reading words, which indicate problems with the lexical route. It seems that the Spanish dyslexic adults, as in deep orthographies, continue having difficulties in phonological awareness tasks, rapid naming and reading.

  8. Neurocognitive consequences of cigarette smoking in young adults--a comparison with pre-drug performance.

    PubMed

    Fried, P A; Watkinson, B; Gray, R

    2006-01-01

    The present study examined effects of current and past regular cigarette smoking in young adult subjects. One hundred and twelve 17-21-year-old subjects, assessed since infancy, were evaluated using a battery of neurocognitive tests for which commensurate measures were obtained at 9-12 years of age, prior to the initiation of regular smoking. Smokers, determined by urinalysis and self-report, were categorized as heavy (>9 cigarettes per day) and light (<9 cigarettes per day) current smokers and former smokers, the latter having smoked cigarettes regularly in the past but not for at least 6 months. A third of the subjects were currently smoking cigarettes regularly with half of these being heavy smokers. Among former smokers, the average duration of smoking was slightly less than 2 years. Overall IQ, memory, processing speed, vocabulary, attention and abstract reasoning were the primary outcomes with comparisons being made between each of the three user groups and a control group who never smoked regularly. After accounting for potentially confounding factors including clinical assessment, marihuana use and pre-drug performance in the relevant cognitive domain, current regular smokers did significantly worse than non-smokers in a variety of cognitive areas predicated upon verbal/auditory competence including receptive and expressive vocabulary, oral arithmetic, and auditory memory. This impact of current smoking appears to behave in a dose-response and duration-related fashion. In contrast, former smokers differed from the non-smokers only in the arithmetic task. These results suggest that regular smoking during early adulthood is associated with cognitive impairments in selected domains and that these deficits may be reversed upon cessation. Together, the findings add to the body of evidence to be used in persuading adolescents and young adults against the initiation of smoking and, if currently smoking, the advantages of stopping.

  9. Maternal adjustment and maternal attitudes in adolescent and adult pregnant women.

    PubMed

    Figueiredo, Bárbara; Tendais, Iva; Dias, Cláudia C

    2014-08-01

    This study analyzes differences between adolescent and adult pregnant women and the contribution of maternal age to maternal adjustment and maternal attitudes during pregnancy. A sample of 398 Portuguese pregnant women (111 younger than 19 years) was recruited in a Portuguese Maternity Hospital and completed the Maternal Adjustment and Maternal Attitudes Questionnaire between the 24(th) and 36(th) weeks of gestation. Maternal Adjustment and Maternal Attitudes Questionnaire(1) RESULTS: Adolescent pregnant women show lower maternal adjustment (poorer body image and worse marital relationship) and poorer maternal attitudes (more negative attitudes to sex) than adult pregnant women. When controlling for socio-demographics, age at pregnancy predicts poorer body image and more negative attitudes to sex, but not a worse marital relationship, more somatic symptoms or negative attitudes to pregnancy and the baby. A worse marital relationship was better predicted by living without the partner, and more somatic symptoms and negative attitudes to pregnancy and the baby was predicted by higher education. Adolescent pregnant women show lower maternal adjustment and poorer maternal attitudes than adult pregnant women according to socio-demographics and unfavorable developmental circumstances. Copyright © 2014 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  10. A review of factors that influence adult handwriting performance.

    PubMed

    van Drempt, Nadege; McCluskey, Annie; Lannin, Natasha A

    2011-10-01

    Handwriting is an important activity for people of all ages. Handwriting is frequently affected after stroke and other neurological conditions. However, research on the handwriting of healthy adults is difficult to find. This review aims to advance the development of evidence-informed handwriting assessment and retraining. The aim of this paper was to review factors that influence the handwriting performance of unimpaired adults, some of which are amenable to intervention. Searches were conducted of eight electronic databases up to April 2009 and again in November 2010. Reference lists were also used to identify potential studies of interest. No limits were placed on study design.  Age: Younger adults write more legibly and faster than older adults. Gender: Women write faster and more legibly than men. Pengrip: Grips other than the traditional dynamic tripod are functional, producing legible text in an acceptable time. Pen pressure: Pressure varies with different letters, words, text size, speed and across a page of text. Error corrections and a mixed writing style occur in healthy adult handwriting. Research was inconclusive about the association between speed, pressure and upper limb movements on handwriting performance. Other factors able to predict adult handwriting legibility have been largely unexplored. A number of knowledge and research gaps about adult handwriting were identified, including the need for more contemporary normative data. © 2011 The Authors. Australian Occupational Therapy Journal © 2011 Occupational Therapy Australia.

  11. Low socioeconomic status is associated with worse survival in children with cancer: a systematic review.

    PubMed

    Gupta, Sumit; Wilejto, Marta; Pole, Jason D; Guttmann, Astrid; Sung, Lillian

    2014-01-01

    While low socioeconomic status (SES) has been associated with inferior cancer outcome among adults, its impact in pediatric oncology is unclear. Our objective was therefore to conduct a systematic review to determine the impact of SES upon outcome in children with cancer. We searched Ovid Medline, EMBASE and CINAHL from inception to December 2012. Studies for which survival-related outcomes were reported by socioeconomic subgroups were eligible for inclusion. Two reviewers independently assessed articles and extracted data. Given anticipated heterogeneity, no quantitative meta-analyses were planned a priori. Of 7,737 publications, 527 in ten languages met criteria for full review; 36 studies met final inclusion criteria. In low- and middle-income countries (LMIC), lower SES was uniformly associated with inferior survival, regardless of the measure chosen. The majority of associations were statistically significant. Of 52 associations between socioeconomic variables and outcome among high-income country (HIC) children, 38 (73.1%) found low SES to be associated with worse survival, 15 of which were statistically significant. Of the remaining 14 (no association or high SES associated with worse survival), only one was statistically significant. Both HIC studies examining the effect of insurance found uninsured status to be statistically associated with inferior survival. Socioeconomic gradients in which low SES is associated with inferior childhood cancer survival are ubiquitous in LMIC and common in HIC. Future studies should elucidate mechanisms underlying these gradients, allowing the design of interventions mediating socioeconomic effects. Targeting the effect of low SES will allow for further improvements in childhood cancer survival.

  12. Decision-making competence in younger and older adults: which cognitive abilities contribute to the application of decision rules?

    PubMed

    Rosi, Alessia; Bruine de Bruin, Wändi; Del Missier, Fabio; Cavallini, Elena; Russo, Riccardo

    2017-12-28

    Older adults perform worse than younger adults when applying decision rules to choose between options that vary along multiple attributes. Although previous studies have shown that general fluid cognitive abilities contribute to the accurate application of decision rules, relatively little is known about which specific cognitive abilities play the most important role. We examined the independent roles of working memory, verbal fluency, semantic knowledge, and components of executive functioning. We found that age-related decline in applying decision rules was statistically mediated by age-related decline in working memory and verbal fluency. Our results have implications for theories of aging and decision-making.

  13. Visualizing the pressure and time burden of intracranial hypertension in adult and paediatric traumatic brain injury.

    PubMed

    Güiza, Fabian; Depreitere, Bart; Piper, Ian; Citerio, Giuseppe; Chambers, Iain; Jones, Patricia A; Lo, Tsz-Yan Milly; Enblad, Per; Nillson, Pelle; Feyen, Bart; Jorens, Philippe; Maas, Andrew; Schuhmann, Martin U; Donald, Rob; Moss, Laura; Van den Berghe, Greet; Meyfroidt, Geert

    2015-06-01

    To assess the impact of the duration and intensity of episodes of increased intracranial pressure on 6-month neurological outcome in adult and paediatric traumatic brain injury. Analysis of prospectively collected minute-by-minute intracranial pressure and mean arterial blood pressure data of 261 adult and 99 paediatric traumatic brain injury patients from multiple European centres. The relationship of episodes of elevated intracranial pressure (defined as a pressure above a certain threshold during a certain time) with 6-month Glasgow Outcome Scale was visualized in a colour-coded plot. The colour-coded plot illustrates the intuitive concept that episodes of higher intracranial pressure can only be tolerated for shorter durations: the curve that delineates the duration and intensity of those intracranial pressure episodes associated with worse outcome is an approximately exponential decay curve. In children, the curve resembles that of adults, but the delineation between episodes associated with worse outcome occurs at lower intracranial pressure thresholds. Intracranial pressures above 20 mmHg lasting longer than 37 min in adults, and longer than 8 min in children, are associated with worse outcomes. In a multivariate model, together with known baseline risk factors for outcome in severe traumatic brain injury, the cumulative intracranial pressure-time burden is independently associated with mortality. When cerebrovascular autoregulation, assessed with the low-frequency autoregulation index, is impaired, the ability to tolerate elevated intracranial pressures is reduced. When the cerebral perfusion pressure is below 50 mmHg, all intracranial pressure insults, regardless of duration, are associated with worse outcome. The intracranial pressure-time burden associated with worse outcome is visualised in a colour-coded plot. In children, secondary injury occurs at lower intracranial pressure thresholds as compared to adults. Impaired cerebrovascular

  14. How Japanese adults perceive memory change with age: middle-aged adults with memory performance as high as young adults evaluate their memory abilities as low as older adults.

    PubMed

    Kinjo, Hikari; Shimizu, Hiroyuki

    2014-01-01

    The characteristics of self-referent beliefs about memory change with age. The relationship between beliefs and memory performance of three age groups of Japanese adults was investigated. The beliefs measured by the Personal Beliefs about Memory Instrument (Lineweaver & Hertzog, 1998) differed among the age groups and between sexes. In most scales, the ratings by middle-aged adults were as low as those by older adults, which were lower than those by young adults. Women perceived their memory abilities as lower than men's, with no interaction between age and sex, suggesting the difference remains across the lifespan. For middle-aged adults, the better they performed in cued-recall, free recall, and recognition, the lower they evaluated their memory self-efficacy, while few relationships were found for other groups. Our results suggest that cognitive beliefs change with age and that investigating the beliefs of the middle-aged adults is indispensable to elucidate the transition of beliefs.

  15. Trajectories of suicidal ideation in depressed older adults undergoing antidepressant treatment.

    PubMed

    Kasckow, John; Youk, Ada; Anderson, Stewart J; Dew, Mary Amanda; Butters, Meryl A; Marron, Megan M; Begley, Amy E; Szanto, Katalin; Dombrovski, Alexander Y; Mulsant, Benoit H; Lenze, Eric J; Reynolds, Charles F

    2016-02-01

    Suicide is a public health concern in older adults. Recent cross sectional studies suggest that impairments in executive functioning, memory and attention are associated with suicidal ideation in older adults. It is unknown whether these neuropsychological features predict persistent suicidal ideation. We analyzed data from 468 individuals ≥ age 60 with major depression who received venlafaxine XR monotherapy for up to 16 weeks. We used latent class growth modeling to classify groups of individuals based on trajectories of suicidal ideation. We also examined whether cognitive dysfunction predicted suicidal ideation while controlling for time-dependent variables including depression severity, and age and education. The optimal model using a zero inflated Poisson link classified individuals into four groups, each with a distinct temporal trajectory of suicidal ideation: those with 'minimal suicidal ideation' across time points; those with 'low suicidal ideation'; those with 'rapidly decreasing suicidal ideation'; and those with 'high and persistent suicidal ideation'. Participants in the 'high and persistent suicidal ideation' group had worse scores relative to those in the "rapidly decreasing suicidal ideation" group on the Color-Word 'inhibition/switching' subtest from the Delis-Kaplan Executive Function Scale, worse attention index scores on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and worse total RBANS index scores. These findings suggest that individuals with poorer ability to switch between inhibitory and non-inhibitory responses as well as worse attention and worse overall cognitive status are more likely to have persistently higher levels of suicidal ideation. CLINICALTRIAL. NCT00892047. Published by Elsevier Ltd.

  16. Trajectories of Suicidal Ideation in Depressed Older Adults Undergoing Antidepressant Treatment

    PubMed Central

    Youk, Ada; Anderson, Stewart J.; Dew, Mary Amanda; Butters, Meryl A.; Marron, Megan M.; Begley, Amy E.; Szanto, Katalin; Dombrovski, Alexander Y.; Mulsant, Benoit H.; Lenze, EricJ.; Reynolds, Charles F.

    2015-01-01

    Suicide is a public health concern in older adults. Recent cross sectional studies suggest that impairments in executive functioning, memory and attention are associated with suicidal ideation in older adults. It is unknown whether these neuropsychological features predict persistent suicidal ideation. We analyzed data from 468 individuals ≥ age 60 with major depression who received venlafaxine XR monotherapy for up to 16 weeks. We used latent class growth modeling to classify groups of individuals based on trajectories of suicidal ideation. We also examined whether cognitive dysfunction predicted suicidal ideation while controlling for time-dependent variables including depression severity, and age and education. The optimal model using a zero inflated Poisson link classified individuals into four groups, each with a distinct temporal trajectory of suicidal ideation: those with ‘minimal suicidal ideation’ across time points; those with ‘low suicidal ideation’; those with ‘rapidly decreasing suicidal ideation’; and those with ‘high and persistent suicidal ideation’. Participants in the ‘high and persistent suicidal ideation’ group had worse scores relative to those in the “rapidly decreasing suicidal ideation” group on the Color-Word ‘inhibition/switching’ subtest from the Delis-Kaplan Executive Function Scale, worse attention index scores on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and worse total RBANS index scores. These findings suggest that individuals with poorer ability to switch between inhibitory and non-inhibitory responses as well as worse attention and worse overall cognitive status are more likely to have persistently higher levels of suicidal ideation. PMID:26708830

  17. Goal-setting, self-efficacy, and memory performance in older and younger adults.

    PubMed

    West, R L; Thorn, R M

    2001-01-01

    Research in field and laboratory settings has shown that goals lead to improved self-efficacy and performance, especially when individuals also receive positive feedback. The present study extended goal-setting theory to examine self-set goals and feedback in relation to younger and older adults' memory performance and self-efficacy. Following a baseline recall trial, participants completed three shopping list recall trials. Half of the participants were instructed to set goals for the three experimental trials, and half in each goal condition received performance feedback after each trial. Young adults' self-efficacy, clustering, and recall exceeded that of older adults. Goal setting increased self-efficacy for younger but not older adults, and it did not affect performance. Younger adults and participants in the feedback condition increased their goals across trials, as did participants for whom feedback indicated success. These data provide a first look at the motivational impact of feedback and self-set recall goals in memory aging. Additional study is needed to understand the interactive effects of type of feedback, memory task difficulty, and type of goal setting at different ages.

  18. Stroop performance, dissociation, and trauma exposure in a community sample of children.

    PubMed

    DePrince, Anne P; Weinzierl, Kristin M; Combs, Melody D

    2008-01-01

    Extending previous research with adults, the current study examined Stroop task performance under selective and divided attention demands in a community sample of school-age children (N = 97). Stroop interference scores in both attention conditions were calculated. Higher levels of child-reported dissociation were associated with better interference control under divided attention conditions and worse control under selective attention conditions; lower levels of dissociation were associated with the opposite pattern. Both family violence exposure and Stroop interaction scores explained unique variance in dissociation scores. Although research with adults has generally assumed or implied that cognitive correlates of dissociation are a consequence of dissociation, the current findings with school-age children suggest that future research should evaluate executive function performance (in this case, interference control) as a possible risk factor for dissociation.

  19. ABCs or 123s? The independent contributions of literacy and numeracy skills on health task performance among older adults

    PubMed Central

    Smith, Samuel G.; Curtis, Laura M.; O’Conor, Rachel; Federman, Alex D.; Wolf, Michael S.

    2015-01-01

    Objective To investigate the relationship between literacy and numeracy and their association with health task performance. Methods Older adults (n = 304) completed commonly used measures of literacy and numeracy. Single factor literacy and numeracy scores were calculated and used to predict performance on an established set of health self-management tasks, including: (i) responding to spoken information; (ii) comprehension of print and (iii) multimedia information; and (iv) organizing and dosing medication. Total and sub-scale scores were calculated. Results Literacy and numeracy measures were highly correlated (rs = 0.68; ps < 0.001). In multivariable models adjusted for age, gender, race, education, and comorbidity, lower literacy (β = 0.44, p < 0.001) and numeracy (β = 0.44, p < 0.001) were independently associated with worse overall task performance and all sub-scales (literacy range, β = 0.23–0.45, ps < 0.001; numeracy range, β = 0.31–0.41, ps < 0.001). Multivariable analyses with both constructs entered explained more variance in overall health task performance compared with separate literacy and numeracy models (8.2% and 10% respectively, ps < 0.001). Conclusion Literacy and numeracy were highly correlated, but independent predictors of health task performance. These skill sets are complementary and both are important for health self-management. Practice implications Self-management interventions may be more effective if they consider both literacy and numeracy skills rather than focusing on one specific ability. PMID:25936579

  20. Negative Staining for COL4A5 Correlates With Worse Prognosis and More Severe Ultrastructural Alterations in Males With Alport Syndrome.

    PubMed

    Said, Samar M; Fidler, Mary E; Valeri, Anthony M; McCann, Brooke; Fiedler, Wade; Cornell, Lynn D; Alexander, Mariam Priya; Alkhunaizi, Ahmed M; Sullivan, Anne; Cramer, Carl H; Hogan, Marie C; Nasr, Samih H

    2017-01-01

    Alport syndrome (AS) is a genetic disorder characterized by progressive hematuric nephropathy with or without sensorineural hearing loss and ocular lesions. Previous studies on AS included mostly children. To determine the prognostic value of loss of staining for collagen type IV alpha 5 (COL4A5) and its relationship with the ultrastructural glomerular basement membrane alterations, we performed direct immunofluorescence using a mixture of fluorescein isothiocyanate-conjugated and Texas-red conjugated antibodies against COL4A5 and COL4A2, respectively, on renal biopsies of 25 males with AS (including 16 who were diagnosed in adulthood). All patients showed normal positive staining of glomerular basement membranes and tubular basement membranes for COL4A2. Of the 25 patients, 10 (40%) patients showed loss of staining for COL4A5 (including 89% of children and 13% of adults) and the remaining 15 (60%) had intact staining for COL4A5. Compared with patients with intact staining for COL4A5, those with loss of staining had more prominent ultrastructural glomerular basement membrane alterations and were younger at the time of biopsy. By Kaplan-Meier survival analysis and Cox regression analysis, loss of staining for COL4A5 predicted earlier progression to overt proteinuria and stage 2 chronic kidney disease or worse. By multivariate Cox regression analysis, loss of staining for COL4A5 was an independent predictor of the development of overt proteinuria and stage 2 chronic kidney disease or worse. Thus, the COL4A5 expression pattern has an important prognostic value and it correlates with the severity of ultrastructural glomerular basement membrane alterations in males with AS. Loss of COL4A5 staining is uncommon in patients with AS diagnosed in their adulthood.

  1. An Exploratory Investigation of Communication Technologies to Alleviate Communicative Difficulties and Depression in Older Adults.

    PubMed

    Ruppel, Erin K; Blight, Michael G; Cherney, Maura R; Fylling, Samantha Q

    2016-06-01

    To explore associations between older adults' communicative difficulties, depressive symptoms, and e-mail and telephone use with adult children. We examined these associations using data from 1,634 participants (age M = 71.16, SD = 0.89; 54% female) in the 2011 wave of the Wisconsin Longitudinal Study. Better vision and worse speech were associated with more frequent e-mail contact with the selected child. Worse hearing was associated with more depressive symptoms for participants with low e-mail use but not for those with average or high e-mail use. Telephone use was not associated with communicative difficulties or depressive symptoms. This study provides preliminary evidence that older adults might use communication technologies such as e-mail in their close relationships to compensate for communicative difficulties. The text-based format of e-mail might also help older adults mitigate hearing impairments and associated depressive symptoms. © The Author(s) 2015.

  2. Is cyberbullying worse than traditional bullying? Examining the differential roles of medium, publicity, and anonymity for the perceived severity of bullying.

    PubMed

    Sticca, Fabio; Perren, Sonja

    2013-05-01

    Cyberbullying, a modern form of bullying performed using electronic forms of contact (e.g., SMS, MMS, Facebook, YouTube), has been considered as being worse than traditional bullying in its consequences for the victim. This difference was mainly attributed to some specific aspect that are believed to distinguish cyberbullying from traditional bullying: an increased potential for a large audience, an increased potential for anonymous bullying, lower levels of direct feedback, decreased time and space limits, and lower levels of supervision. The present studies investigated the relative importance of medium (traditional vs. cyber), publicity (public vs. private), and bully's anonymity (anonymous vs. not anonymous) for the perceived severity of hypothetical bullying scenarios among a sample of Swiss seventh- and eight-graders (study 1: 49% female, mean age = 13.7; study 2: 49% female, mean age = 14.2). Participants ranked a set of hypothetical bullying scenarios from the most severe one to the least severe one. The scenarios were experimentally manipulated based on the aspect of medium and publicity (study 1), and medium and anonymity (study 2). Results showed that public scenarios were perceived as worse than private ones, and that anonymous scenarios were perceived as worse than not anonymous ones. Cyber scenarios generally were perceived as worse than traditional ones, although effect sizes were found to be small. These results suggest that the role of medium is secondary to the role of publicity and anonymity when it comes to evaluating bullying severity. Therefore, cyberbullying is not a priori perceived as worse than traditional bullying. Implications of the results for cyberbullying prevention and intervention are discussed.

  3. Glucose regulation is associated with cognitive performance in young nondiabetic adults.

    PubMed

    Messier, Claude; Awad-Shimoon, Nesrine; Gagnon, Michèle; Desrochers, Alain; Tsiakas, Maria

    2011-09-12

    Several studies have documented an increased incidence of dementia among diabetic patients. In addition, impaired glucose regulation in both, younger and older adults, has been shown to be associated with neuropsychological deficits, particularly of episodic memory. The main purpose of this study was to examine this association in a large sample of young nondiabetic adults. All participants underwent a glucose tolerance test together with measures of insulin levels and lipids. Regression analyses revealed that glucoregulatory indices based on evoked glucose levels were significantly associated with the verbal memory performance of 122 young adults, independent of demographic and vascular risk factors. Participants were assessed after drinking glucose or saccharin, using a repeated-measures design. There was no effect of glucose on cognitive performance. Glucoregulatory indices calculated on the basis of insulin levels or fasting glucose levels explained less cognitive variability compared to indices based on evoked glucose levels. Cardiovascular risk factors were associated with hyperinsulinemia but these factors were not associated with cognitive performance in this young adult group. These findings suggest that cognitive decrements are observable in young, nondiabetic adults, prior to the onset of impaired glucose regulation and diabetes. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. Is smoking cessation associated with worse comorbid substance use outcomes among homeless adults?

    PubMed

    Reitzel, Lorraine R; Nguyen, Nga; Eischen, Sara; Thomas, Janet; Okuyemi, Kolawole S

    2014-12-01

    Smoking prevalence among homeless adults is exceedingly high, and high rates of comorbid substance use are among the barriers to abstinence experienced by this group. The extent to which smoking cessation might engender an escalation in comorbid substance use could be a concern prohibiting treatment provision and engagement. This study examined whether smoking abstinence status was associated with alcohol and substance use at 26 weeks post-randomization among homeless smokers in a smoking cessation trial. The current study was a secondary analysis of randomized smoking cessation intervention trial data. The parent study was conducted in the Minneapolis/St Paul area of Minnesota, USA. Participants were 427 homeless adult smokers interested in quitting smoking. Covariates collected at baseline included alcohol, cocaine, marijuana/hashish, heroin and 'any' drug use, age, sex, race/ethnicity, education, tobacco dependence, length of time homeless and treatment group. Biochemically verified smoking abstinence and self-reported alcohol and substance use were collected at 26 weeks post-randomization. Smoking abstinence was associated with fewer drinking days (P = 0.03), fewer drinks consumed on drinking days (P = 0.01), and lower odds of heavy drinking (P = 0.05), but not with differences in the number of days of cocaine, marijuana/hashish, heroin or any drug use. In homeless smokers, achieving smoking abstinence may be associated with a reduction in alcohol consumption but appears not to be associated with a substantial change in other drug use. © 2014 Society for the Study of Addiction.

  5. Is Smoking Cessation Associated with Worse Comorbid Substance Use Outcomes among Homeless Adults?

    PubMed Central

    Reitzel, Lorraine R.; Nguyen, Nga; Eischen, Sara; Thomas, Janet; Okuyemi, Kolawole S.

    2014-01-01

    Background and Aims Smoking prevalence among homeless adults is exceedingly high, and high rates of comorbid substance use are among the barriers to abstinence experienced by this group. The extent to which smoking cessation might engender an escalation in comorbid substance use could be a concern prohibiting treatment provision and engagement. This study examined whether smoking abstinence status was associated with alcohol and substance use at 26 weeks post-randomization among homeless smokers in a smoking cessation trial. Design The current study was a secondary analysis of randomized smoking cessation intervention trial data. Setting The parent study was conducted in the Minneapolis/St. Paul area of Minnesota, USA. Participants Participants were 427 homeless adult smokers interested in quitting smoking. Measurements Covariates collected at baseline included alcohol, cocaine, marijuana/hashish, heroin, and “any” drug use, age, sex, race/ethnicity, education, tobacco dependence, length of time homeless, and treatment group. Biochemically-verified smoking abstinence and self-reported alcohol and substance use were collected at 26 weeks post-randomization. Findings Smoking abstinence was associated with fewer drinking days (p=.03), fewer drinks consumed on drinking days (p=.01), and lower odds of heavy drinking (p=.05), but not with differences in the number of days of cocaine, marijuana/hashish, heroin, or any drug use. Conclusions In homeless smokers, achieving smoking abstinence may be associated with a reduction in alcohol consumption but appears not to be associated with a substantial change in other drug use. PMID:25041459

  6. Sexual minorities in England have poorer health and worse health care experiences: a national survey.

    PubMed

    Elliott, Marc N; Kanouse, David E; Burkhart, Q; Abel, Gary A; Lyratzopoulos, Georgios; Beckett, Megan K; Schuster, Mark A; Roland, Martin

    2015-01-01

    The health and healthcare of sexual minorities have recently been identified as priorities for health research and policy. To compare the health and healthcare experiences of sexual minorities with heterosexual people of the same gender, adjusting for age, race/ethnicity, and socioeconomic status. Multivariate analyses of observational data from the 2009/2010 English General Practice Patient Survey. The survey was mailed to 5.56 million randomly sampled adults registered with a National Health Service general practice (representing 99 % of England's adult population). In all, 2,169,718 people responded (39 % response rate), including 27,497 people who described themselves as gay, lesbian, or bisexual. Two measures of health status (fair/poor overall self-rated health and self-reported presence of a longstanding psychological condition) and four measures of poor patient experiences (no trust or confidence in the doctor, poor/very poor doctor communication, poor/very poor nurse communication, fairly/very dissatisfied with care overall). Sexual minorities were two to three times more likely to report having a longstanding psychological or emotional problem than heterosexual counterparts (age-adjusted for 5.2 % heterosexual, 10.9 % gay, 15.0 % bisexual for men; 6.0 % heterosexual, 12.3 % lesbian and 18.8 % bisexual for women; p < 0.001 for each). Sexual minorities were also more likely to report fair/poor health (adjusted 19.6 % heterosexual, 21.8 % gay, 26.4 % bisexual for men; 20.5 % heterosexual, 24.9 % lesbian and 31.6 % bisexual for women; p < 0.001 for each). Adjusted for sociodemographic characteristics and health status, sexual minorities were about one and one-half times more likely than heterosexual people to report unfavorable experiences with each of four aspects of primary care. Little of the overall disparity reflected concentration of sexual minorities in low-performing practices. Sexual minorities suffer both poorer health and worse healthcare

  7. Hypothermia and rapid rewarming is associated with worse outcome following traumatic brain injury.

    PubMed

    Thompson, Hilaire J; Kirkness, Catherine J; Mitchell, Pamela H

    2010-01-01

    The purpose of the present study was to determine (1) the prevalence and degree of hypothermia in patients on emergency department admission and (2) the effect of hypothermia and rate of rewarming on patient outcomes. Secondary data analysis was conducted on patients admitted to a level I trauma center following severe traumatic brain injury (n = 147). Patients were grouped according to temperature on admission according to hypothermia status and rate of rewarming (rapid or slow). Regression analyses were performed. Hypothermic patients were more likely to have lower postresuscitation Glasgow Coma Scale scores and a higher initial injury severity score. Hypothermia on admission was correlated with longer intensive care unit stays, a lower Glasgow Coma Scale score at discharge, higher mortality rate, and lower Glasgow outcome score-extended scores up to 6 months postinjury (P < .05). When controlling for other factors, rewarming rates more than 0.25°C/h were associated with lower Glasgow Coma Scale scores at discharge, longer intensive care unit length of stay, and higher mortality rate than patients rewarmed more slowly although these did not reach statistical significance. Hypothermia on admission is correlated with worse outcomes in brain-injured patients. Patients with traumatic brain injury who are rapidly rewarmed may be more likely to have worse outcomes. Trauma protocols may need to be reexamined to include controlled rewarming at rates 0.25°C/h or less.

  8. "Thinking about numbers is not my idea of fun": need for cognition mediates age differences in numeracy performance.

    PubMed

    Bruine de Bruin, Wändi; McNair, Simon J; Taylor, Andrea L; Summers, Barbara; Strough, JoNell

    2015-01-01

    Numeracy refers to people's ability to use numbers. Low numeracy has been associated with difficulties in understanding risk-benefit information and making health decisions. Older adults tend to perform worse than younger adults on measures of numeracy, but some theories of aging suggest that older adults may lack motivation for such tasks. We therefore test whether age differences in numeracy performance are mediated by a reduced motivation to think hard about complex problems-as measured by need for cognition. We recruited an age-diverse convenience sample of 306 UK adults. They completed measures of numeracy and need for cognition. They self-reported their educational attainment and other demographics. Older age was related to lower numeracy and lower need for cognition. The negative relationship between age and numeracy was mediated by need for cognition. These findings held after we controlled for educational attainment and other demographic factors. Older adults may show lower numeracy performance due to lack of motivation. We discuss strategies for improving people's motivation to complete numeracy measures and other numerical tasks. © The Author(s) 2014.

  9. National health surveillance of adults with disabilities, adults with intellectual and developmental disabilities, and adults with no disabilities.

    PubMed

    Havercamp, Susan M; Scott, Haleigh M

    2015-04-01

    People with disabilities experience worse health and poorer access to health care compared to people without disability. Large-scale health surveillance efforts have largely excluded adults with intellectual and developmental disability. This study expands knowledge of health status, health risks and preventative health care in a representative US sample comparing the health of adults with no disability to adults with intellectual and developmental disability and to adults with other types of disability. The purposes of this study were (1) to identify disparities between adults with intellectual and developmental disability and adults with no disability and (2) compare this pattern of disparities to the pattern between adults with other types of disability and adults without disability. This study compares health status, health risks and preventative health care in a national sample across three groups of adults: No Disability, Disability, and Intellectual and Developmental Disability. Data sources were the 2010 Behavior Risk Factor Surveillance Survey and the National Core Indicators Consumer Survey. Adults with disability and with intellectual and developmental disability were more likely to report being in poor health compared to adults without disability. Disability and intellectual and developmental disability conferred unique health risks and health care utilization patterns. Significant disparities in health and health care utilization were found for adults with disability and developmental disability relative to adults without disability. Disability training for health care providers and health promotion research that identifies disability as a demographic group is needed. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Association of serum 25-hydroxyvitamin D₃ and D₂ with academic performance in childhood: findings from a prospective birth cohort.

    PubMed

    Tolppanen, Anna-Maija; Sayers, Adrian; Fraser, William D; Lawlor, Debbie A

    2012-12-01

    Higher total serum 25-hydroxyvitamin D (25(OH)D) concentrations have been associated with better cognitive function mainly in cross-sectional studies in adults. It is unknown if the associations of different forms of 25(OH)D (25(OH)D(3) and 25(OH)D(2)) are similar. Prospective cohort study (n=3171) with serum 25(OH)D(3) and 25(OH)D(2) concentrations measured at mean age of 9.8 years and academic performance at age 13-14 years (total scores in English, mathematics and science) and 15-16 years (performance in General Certificates of Education examinations). Serum 25(OH)D(3) concentrations were not associated with any educational outcomes. Higher 25(OH)D(2) concentrations were associated with worse performance in English at age 13-14 years (adjusted SD change per doubling in 25(OH)D(2) (95% CI) -0.05 (-0.08 to -0.01)) and with worse academic performance at age 15-16 years (adjusted OR for obtaining ≥5 A*-C grades (95% CI) 0.91 (0.82 to 1.00)). The null findings with 25(OH)D(3) are in line with two previous cross-sectional studies in children. It is possible that the positive association of 25(OH)D with cognitive function seen in adults does not emerge until later in life or that the results from previous cross-sectional adult studies are due to reverse causality. The unexpected inverse association of 25(OH)D(2) with academic performance requires replication in further studies. Taken together, our findings do not support suggestions that children should have controlled exposure to sunlight, or vitamin D supplements, in order to increase academic performance.

  11. Does Central Vision Loss Impair Visual Search Performance of Adults More than Children?

    PubMed

    Satgunam, PremNandhini; Luo, Gang

    2018-05-01

    In general, young adults with normal vision show the best visual search performance when compared with children and older adults. Through our study, we show that this trend is not observed in individuals with vision impairment. An interaction effect of vision impairment with visual development and aging is observed. Performance in many visual tasks typically shows improvement with age until young adulthood and then declines with aging. Using a visual search task, this study investigated whether a similar age effect on performance is present in people with central vision loss. A total of 98 participants, 37 with normal sight (NS) and 61 with visual impairment (VI) searched for targets in 150 real-world digital images. Search performance was quantified by an integrated measure combining speed and accuracy. Participant ages ranged from 5 to 74 years, visual acuity from -0.14 (20/14.5) to 1.16 logMAR (20/290), and log contrast sensitivity (CS) from 0.48 to 2.0. Data analysis was performed with participants divided into three age groups: children (aged <14 years, n = 25), young adults (aged 14 to 45 years, n = 47), and older adults (aged >45 years, n = 26). Regression (r = 0.7) revealed CS (P < .001) and age (P = .003) were significant predictors of search performance. Performance of VI participants was normalized to the age-matched average performance of the NS group. In the VI group, it was found that children's normalized performance (52%) was better than both young (39%, P = .05) and older (40%, P = .048) adults. Unlike NS participants, young adults in the VI group may not have search ability superior to children with VI, despite having the same level of visual functions (quantified by visual acuity and CS). This could be because of vision impairment limiting the developmental acquisition of the age dividend for peak performance. Older adults in the VI group had the worst performance, indicating an interaction of aging.

  12. Smoking status and cognitive performance among vocational school students in Beijing, China.

    PubMed

    Hu, Pengjuan; Huang, Lili; Zhou, Shuang; Shi, Qiang; Xiao, Dan; Wang, Chen

    2018-02-01

    In countries where smoking is associated with lower socioeconomic status, smokers tend to perform worse on cognitive tasks than non-smokers. China is now undergoing a similar process with a recent study showing that there is a reduced cognitive performance in middle aged but not in elderly smokers. We examined the links between smoking status and cognitive functioning among vocational school students in Beijing, China. A total of 213 students aged 16-20 (98 smokers and 115 non-smokers) were recruited from three vocational schools in Beijing. Participants completed three subtests of Wechsler Adult Intelligence Scale (WAIS) (information, arithmetic, digit span) and Dysexecutive Questionnaire (DEX). Smokers also completed a cigarette smoking questionnaire and Fagerstrom Test of Nicotine Dependence (FTND). Smokers performed worse than non-smokers in tests of arithmetic and digit span forward (t = 4.25, 2.05, both P < .05). Scores on digit span backward did not differentiate smokers and non-smokers, but among smokers, the performance on this subtest was related to the age of starting smoking (r = 0.26, p < .001). Cognitive performance in smokers was not related to tobacco dependence or intensity of smoking. Compared to non-smokers, smokers had a higher total DEX score and higher scores on three of its five subscales (Inhibition, Knowing-doing dissociation and Social regulation, all p < .05). Another subscale, In-resistance, did not differentiate smokers and non-smokers, but differentiated smokers with lower and higher levels of nicotine dependence (t = -2.12, p < .05). Smokers performed worse on some cognitive tasks than non-smokers and scored higher on a questionnaire assessing executive dysfunction. Copyright © 2017. Published by Elsevier Ltd.

  13. Prevalence and causes of blindness and low vision among adults in Fiji.

    PubMed

    Ramke, Jacqueline; Brian, Garry; Maher, Louise; Qalo Qoqonokana, Mundi; Szetu, John

    2012-07-01

      To estimate the prevalence and causes of blindness and low vision among adults aged ≥40 years in Fiji.   Population-based cross-sectional study.   Adults aged ≥40 years in Viti Levu, Fiji.   A population-based cross-sectional survey used multistage cluster random sampling to identify 34 clusters of 40 people. A cause of vision loss was determined for each eye with presenting vision worse than 6/18.   Blindness (better eye presenting vision worse than 6/60), low vision (better eye presenting vision worse than 6/18, but 6/60 or better).   Of 1892 people enumerated, 1381 participated (73.0%). Adjusting sample data for ethnicity, gender, age and domicile, the prevalence of blindness was 2.6% (95% confidence interval 1.7, 3.4) and low vision was 7.2% (95% confidence interval 5.9, 8.6) among adults aged ≥40 years. On multivariate analysis, being ≥70 years was a risk factor for blindness, but ethnicity, gender and urban/rural domicile were not. Being Indo-Fijian, female and older were risk factors for vision impairment (better eye presenting vision worse than 6/18). Cataract was the most common cause of bilateral blindness (71.1%). Among participants with low vision, uncorrected refractive error caused 63.3% and cataract was responsible for 25.0%.   Strategies that provide accessible cataract and refractive error services producing good quality outcomes will likely have the greatest impact on reducing vision impairment. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

  14. Between Domain Cognitive Dispersion and Functional Abilities in Older Adults

    PubMed Central

    Fellows, Robert P.; Schmitter-Edgecombe, Maureen

    2016-01-01

    Objective Within-person variability in cognitive performance is related to neurological integrity, but the association with functional abilities is less clear. The primary aim of this study was to examine the association between cognitive dispersion, or within-person variability, and everyday multitasking and the way in which these variables may influence performance on a naturalistic assessment of functional abilities. Method Participants were 156 community-dwelling adults, age 50 or older. Cognitive dispersion was calculated by measuring within-person variability in cognitive domains, established through principal components analysis. Path analysis was used to determine the independent contribution of cognitive dispersion to functional ability, mediated by multitasking. Results Results of the path analysis revealed that the number of subtasks interweaved (i.e., multitasked) mediated the association between cognitive dispersion and task sequencing and accuracy. Although increased multitasking was associated with worse task performance in the path model, secondary analyses revealed that for individuals with low cognitive dispersion, increased multitasking was associated with better task performance, whereas for those with higher levels of dispersion multitasking was negatively correlated with task performance. Conclusion These results suggest that cognitive dispersion between domains may be a useful indicator of multitasking and daily living skills among older adults. PMID:26300441

  15. What Can We Learn about Auditory Processing from Adult Hearing Questionnaires?

    PubMed

    Bamiou, Doris-Eva; Iliadou, Vasiliki Vivian; Zanchetta, Sthella; Spyridakou, Chrysa

    2015-01-01

    Questionnaires addressing auditory disability may identify and quantify specific symptoms in adult patients with listening difficulties. (1) To assess validity of the Speech, Spatial, and Qualities of Hearing Scale (SSQ), the (Modified) Amsterdam Inventory for Auditory Disability (mAIAD), and the Hyperacusis Questionnaire (HYP) in adult patients experiencing listening difficulties in the presence of a normal audiogram. (2) To examine which individual questionnaire items give the worse scores in clinical participants with an auditory processing disorder (APD). A prospective correlational analysis study. Clinical participants (N = 58) referred for assessment because of listening difficulties in the presence of normal audiometric thresholds to audiology/ear, nose, and throat or audiovestibular medicine clinics. Normal control participants (N = 30). The mAIAD, HYP, and the SSQ were administered to a clinical population of nonneurological adults who were referred for auditory processing (AP) assessment because of hearing complaints, in the presence of normal audiogram and cochlear function, and to a sample of age-matched normal-hearing controls, before the AP testing. Clinical participants with abnormal results in at least one ear and in at least two tests of AP (and at least one of these tests to be nonspeech) were classified as clinical APD (N = 39), and the remaining (16 of whom had a single test abnormality) as clinical non-APD (N = 19). The SSQ correlated strongly with the mAIAD and the HYP, and correlation was similar within the clinical group and the normal controls. All questionnaire total scores and subscores (except sound distinction of mAIAD) were significantly worse in the clinical APD versus the normal group, while questionnaire total scores and most subscores indicated greater listening difficulties for the clinical non-APD versus the normal subgroups. Overall, the clinical non-APD group tended to give better scores than the APD in all questionnaires

  16. Gender Differences in Performance of Script Analysis by Older Adults

    ERIC Educational Resources Information Center

    Helmes, E.; Bush, J. D.; Pike, D. L.; Drake, D. G.

    2006-01-01

    Script analysis as a test of executive functions is presumed sensitive to cognitive changes seen with increasing age. Two studies evaluated if gender differences exist in performance on scripts for familiar and unfamiliar tasks in groups of cognitively intact older adults. In Study 1, 26 older adults completed male and female stereotypical…

  17. The perception of strabismus by children and adults.

    PubMed

    Mojon-Azzi, Stefania Margherita; Kunz, Andrea; Mojon, Daniel Stéphane

    2011-05-01

    Visible strabismus has been shown to have adverse psychosocial consequences. It remains controversial if esotropia or exotropia is perceived more negatively. The aim of this study was to determine if esotropia or exotropia and the eye (side) in which strabismus is present are perceived differently. We also asked our adult participants: (1) if they thought visible strabismus should be corrected by surgery, (2) if they thought that strabismus surgery should only be to improve the cosmesis, and (3) if they thought that the surgery should be paid for by health insurance. One hundred adults and 61 children rated four photographs of a digitally altered picture of a boy and four of a girl, showing a large-angle esotropia or exotropia either in the left or on the right eye. The adults were additionally asked if a squint should be operated, if they considered strabismus surgery to be a cosmetic procedure, if in their opinion strabismus surgery should be covered by compulsory health insurance, and if children with strabismus are disadvantaged. Comparisons were performed using ANOVA and regression analysis. Adults perceived a squinting right eye as more disturbing than a squinting left eye p < 0.001). The direction of strabismus, the age, gender, and the number of persons with a squint among family and friends of the respondents did not influence the perception of strabismus by adults (p > 0.1 for each). Children also found that a squinting right eye is more disturbing (p < 0.001) than a left one. Additionally, children ranked esotropia worse than exotropia (p < 0.001). Neither age nor gender had an impact on the perception of strabismus by children. Of the adults, 94% would recommend surgery for all forms of strabismus, 18% thought that surgery is only cosmetic, and 94% found that health insurance should cover strabismus surgery for everybody. Problems of squinting children named by the adults included: being made fun of by other children (53%), problems with eyesight (39

  18. Policy to Performance: State ABE Transition Systems Report. Transitioning Adults to Opportunity

    ERIC Educational Resources Information Center

    Alamprese, Judith A.

    2012-01-01

    The U.S. Department of Education's Policy to Performance project was funded in 2009 to build the capacity of state adult basic education (ABE) staff to develop and implement policies and practices that would support an ABE transition system. Policy to Performance states were selected though a competitive process. State adult education directors…

  19. Old adults perform activities of daily living near their maximal capabilities.

    PubMed

    Hortobágyi, Tibor; Mizelle, Chris; Beam, Stacey; DeVita, Paul

    2003-05-01

    Old adults' ability to execute activities of daily living (ADLs) declines with age. One possible reason for this decline is that the execution of customary motor tasks requires a substantially greater effort in old compared with young adults relative to their available maximal capacity. We tested the hypothesis that the relative effort (i.e., the percentage of joint moment relative to maximal joint moment) to execute ADLs is higher in old adults compared with young adults. Healthy young adults (n = 13; mean age, 22 years) and old adults (n = 14; mean age, 74 years) ascended and descended stairs and rose from a chair and performed maximal-effort isometric supine leg press. Using inverse dynamics analysis, we determined knee joint moments in ADLs and computed relative effort. Compared with young adults, old adults had 60% lower maximal leg press moments, 53% slower knee angular velocity at peak torque, and 27% lower knee joint moments in the ADLs (all p <.05). Relative effort in ascent was 54% (SD +/- 16%) and 78% (+/-20%) in young and old adults, respectively; in descent, it was 42% (+/-20%) and 88% (+/-43%); and in chair rise, it was 42% (+/-19%) and 80% (+/-34%) (all p <.05). The relative electromyographic activity of the vastus lateralis and the coactivity of the biceps femoris associated with this relative effort were, respectively, 2- and 1.6-fold greater in old compared with young adults in the 3 ADLs (p <.05). For healthy old adults, the difficulty that arises while performing ADLs may be due more to working at a higher level of effort relative to their maximum capability than to the absolute functional demands imposed by the task.

  20. Facial emotion recognition in childhood-onset bipolar I disorder: an evaluation of developmental differences between youths and adults

    PubMed Central

    Wegbreit, Ezra; Weissman, Alexandra B; Cushman, Grace K; Puzia, Megan E; Kim, Kerri L; Leibenluft, Ellen; Dickstein, Daniel P

    2015-01-01

    Objectives Bipolar disorder (BD) is a severe mental illness with high healthcare costs and poor outcomes. Increasing numbers of youths are diagnosed with BD, and many adults with BD report their symptoms started in childhood, suggesting BD can be a developmental disorder. Studies advancing our understanding of BD have shown alterations in facial emotion recognition in both children and adults with BD compared to healthy comparison (HC) participants, but none have evaluated the development of these deficits. To address this, we examined the effect of age on facial emotion recognition in a sample that included children and adults with confirmed childhood-onset type-I BD, with the adults having been diagnosed and followed since childhood by the Course and Outcome in Bipolar Youth study. Methods Using the Diagnostic Analysis of Non-Verbal Accuracy, we compared facial emotion recognition errors among participants with BD (n = 66; ages 7–26 years) and HC participants (n = 87; ages 7–25 years). Complementary analyses investigated errors for child and adult faces. Results A significant diagnosis-by-age interaction indicated that younger BD participants performed worse than expected relative to HC participants their own age. The deficits occurred for both child and adult faces and were particularly strong for angry child faces, which were most often mistaken as sad. Our results were not influenced by medications, comorbidities/substance use, or mood state/global functioning. Conclusions Younger individuals with BD are worse than their peers at this important social skill. This deficit may be an important developmentally salient treatment target, i.e., for cognitive remediation to improve BD youths’ emotion recognition abilities. PMID:25951752

  1. Neurobiological findings associated with high cognitive performance in older adults: a systematic review.

    PubMed

    Borelli, Wyllians Vendramini; Schilling, Lucas Porcello; Radaelli, Graciane; Ferreira, Luciana Borges; Pisani, Leonardo; Portuguez, Mirna Wetters; da Costa, Jaderson Costa

    2018-04-18

    ABSTRACTObjectives:to perform a comprehensive literature review of studies on older adults with exceptional cognitive performance. We performed a systematic review using two major databases (MEDLINE and Web of Science) from January 2002 to November 2017. Quantitative analysis included nine of 4,457 studies and revealed that high-performing older adults have global preservation of the cortex, especially the anterior cingulate region, and hippocampal volumes larger than normal agers. Histological analysis of this group also exhibited decreased amyloid burden and neurofibrillary tangles compared to cognitively normal older controls. High performers that maintained memory ability after three years showed reduced amyloid positron emission tomography at baseline compared with high performers that declined. A single study on blood plasma found a set of 12 metabolites predicting memory maintenance of this group. Structural and molecular brain preservation of older adults with high cognitive performance may be associated with brain maintenance. The operationalized definition of high-performing older adults must be carefully addressed using appropriate age cut-off and cognitive evaluation, including memory and non-memory tests. Further studies with a longitudinal approach that include a younger control group are essential.

  2. Variability in reaction time performance of younger and older adults.

    PubMed

    Hultsch, David F; MacDonald, Stuart W S; Dixon, Roger A

    2002-03-01

    Age differences in three basic types of variability were examined: variability between persons (diversity), variability within persons across tasks (dispersion), and variability within persons across time (inconsistency). Measures of variability were based on latency performance from four measures of reaction time (RT) performed by a total of 99 younger adults (ages 17--36 years) and 763 older adults (ages 54--94 years). Results indicated that all three types of variability were greater in older compared with younger participants even when group differences in speed were statistically controlled. Quantile-quantile plots showed age and task differences in the shape of the inconsistency distributions. Measures of within-person variability (dispersion and inconsistency) were positively correlated. Individual differences in RT inconsistency correlated negatively with level of performance on measures of perceptual speed, working memory, episodic memory, and crystallized abilities. Partial set correlation analyses indicated that inconsistency predicted cognitive performance independent of level of performance. The results indicate that variability of performance is an important indicator of cognitive functioning and aging.

  3. Assessing Adult Learner's Numeracy as Related to Gender and Performance in Arithmetic

    ERIC Educational Resources Information Center

    Awofala, Adeneye O. A.; Anyikwa, Blessing E.

    2014-01-01

    The study investigated adult learner numeracy as related to gender and performance in arithmetic among 32 Nigerian adult learners from one government accredited adult literacy centre in Lagos State using the quantitative research method within the blueprint of descriptive survey design. Data collected were analysed using the descriptive statistics…

  4. Is Cyberbullying Worse than Traditional Bullying? Examining the Differential Roles of Medium, Publicity, and Anonymity for the Perceived Severity of Bullying

    ERIC Educational Resources Information Center

    Sticca, Fabio; Perren, Sonja

    2013-01-01

    Cyberbullying, a modern form of bullying performed using electronic forms of contact (e.g., SMS, MMS, Facebook, YouTube), has been considered as being worse than traditional bullying in its consequences for the victim. This difference was mainly attributed to some specific aspect that are believed to distinguish cyberbullying from traditional…

  5. Effect of technological advances on cochlear implant performance in adults.

    PubMed

    Lenarz, Minoo; Joseph, Gert; Sönmez, Hasibe; Büchner, Andreas; Lenarz, Thomas

    2011-12-01

    To evaluate the effect of technological advances in the past 20 years on the hearing performance of a large cohort of adult cochlear implant (CI) patients. Individual, retrospective, cohort study. According to technological developments in electrode design and speech-processing strategies, we defined five virtual intervals on the time scale between 1984 and 2008. A cohort of 1,005 postlingually deafened adults was selected for this study, and their hearing performance with a CI was evaluated retrospectively according to these five technological intervals. The test battery was composed of four standard German speech tests: Freiburger monosyllabic test, speech tracking test, Hochmair-Schulz-Moser (HSM) sentence test in quiet, and HSM sentence test in 10 dB noise. The direct comparison of the speech perception in postlingually deafened adults, who were implanted during different technological periods, reveals an obvious improvement in the speech perception in patients who benefited from the recent electrode designs and speech-processing strategies. The major influence of technological advances on CI performance seems to be on speech perception in noise. Better speech perception in noisy surroundings is strong proof for demonstrating the success rate of new electrode designs and speech-processing strategies. Standard (internationally comparable) speech tests in noise should become an obligatory part of the postoperative test battery for adult CI patients. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  6. Biases in Children's and Adults' Moral Judgments

    ERIC Educational Resources Information Center

    Powell, Nina L.; Derbyshire, Stuart W. G.; Guttentag, Robert E.

    2012-01-01

    Two experiments examined biases in children's (5/6- and 7/8-year-olds) and adults' moral judgments. Participants at all ages judged that it was worse to produce harm when harm occurred (a) through action rather than inaction (omission bias), (b) when physical contact with the victim was involved (physical contact principle), and (c) when the harm…

  7. Conflict and performance monitoring throughout the lifespan: An event-related potential (ERP) and temporospatial component analysis.

    PubMed

    Clawson, Ann; Clayson, Peter E; Keith, Cierra M; Catron, Christina; Larson, Michael J

    2017-03-01

    Cognitive control includes higher-level cognitive processes used to evaluate environmental conflict. Given the importance of cognitive control in regulating behavior, understanding the developmental course of these processes may contribute to a greater understanding of normal and abnormal development. We examined behavioral (response times [RTs], error rates) and event-related potential data (N2, error-related negativity [ERN], correct-response negativity [CRN], error positivity [Pe]) during a flanker task in cross-sectional groups of 45 youth (ages 8-18), 52 younger adults (ages 20-28), and 58 older adults (ages 56-91). Younger adults displayed the most efficient processing, including significantly reduced CRN and N2 amplitude, increased Pe amplitude, and significantly better task performance than youth or older adults (e.g., faster RTs, fewer errors). Youth displayed larger CRN and N2, attenuated Pe, and significantly worse task performance than younger adults. Older adults fell either between youth and younger adults (e.g., CRN amplitudes, N2 amplitudes) or displayed neural and behavioral performance that was similar to youth (e.g., Pe amplitudes, error rates). These findings point to underdeveloped neural and cognitive processes early in life and reduced efficiency in older adulthood, contributing to poor implementation and modulation of cognitive control in response to conflict. Thus, cognitive control processing appears to reach peak performance and efficiency in younger adulthood, marked by improved task performance with less neural activation. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. The Sooner, the Worse? Association between Earlier Age of Sexual Initiation and Worse Adolescent Health and Well-being Outcomes

    PubMed Central

    Osorio, Alfonso; Lopez-del Burgo, Cristina; Carlos, Silvia; de Irala, Jokin

    2017-01-01

    This cross-sectional study assesses the association between age of sexual initiation during adolescence and a selection of well-being outcomes regarding that first relationship. High-school adolescents from El Salvador (2,686) and from Peru (3,399) replied to a paper-pencil questionnaire. Those who were sexually initiated replied to several questions regarding their age at sexual initiation, condom use, satisfaction and reasons/circumstances for that sexual relationship. Approximately 19% of participants were sexually initiated (n = 1,179). After retaining participants with valid responses and with sexual initiation ages between 13 and 17, the final sample for this paper consisted of 996 sexually initiated participants (526 Salvadorians and 470 Peruvians). Multiple logistic regression analyses showed that those who initiated sex at earlier ages had worse outcomes compared to those who initiated at older ages. Specifically, they had lower odds of having used a condom, of having good memories of that experience and of having had that first relationship because they were in love. Conversely, they had higher odds of having had that first sexual relationship as a result of peer pressure (“Most of my friends already had sex”), because of partner pressure (“I was afraid to lose him/her,” “My partner told me he/she would leave me” or “I did not know how to say no to a person who insisted”), or as a consequence of different forms of impaired autonomy (“I was under the influence of alcohol or drugs” or “As a consequence of seeing sexual images”). Results show that sex at earlier ages is associated with worse adolescent health and well-being outcomes. PMID:28798715

  9. Muscle performance and physical function are associated with voluntary rate of neuromuscular activation in older adults

    USDA-ARS?s Scientific Manuscript database

    Participants were recruited to three experimental groups: middle-aged healthy adults (MH), older healthy adults (OH), and older adults with mobility limitations (OML). OH and OML were primarily differentiated by performance on the Short Physical Performance Battery (SPPB). Muscle performance (accele...

  10. Maximal and submaximal endurance performance in adults with severe haemophilia.

    PubMed

    Herbsleb, M; Hilberg, T

    2009-01-01

    Maximal exercise testing, including the determination of maximal performance and maximal oxygen uptake (VO(2max)), is considered the gold standard for assessing maximal endurance performance. The effectiveness of such testing is often reduced in haemophilic adults owing to musculoskeletal impairments or pain rather than because of cardiac exertion. The measurement of submaximal performance parameters overcomes many limitations of maximal exercise testing but a testing standard is still lacking. The aim of this study was to investigate maximal and particularly submaximal endurance performance of adult patients with severe haemophilia A and B. Eleven patients and 11 matched healthy controls were tested by spiroergometry with a specific treadmill test and the power was calculated in Watts. The haemophilic group achieved lower absolute (210 +/- 63 W) and weight-related (2.94 +/- 0.98 W kg(-1)) maximal endurance performance compared with the control group (287 +/- 50 W resp. 3.82 +/- 0.53 W kg(-1); P performance at the individual anaerobic threshold (IAT = 147 +/- 56 W) and fixed lactate values (2 mmol = 98 +/- 60 W; 4 mmol = 158 +/- 56 W) compared with the healthy controls (IAT = 210 +/- 41 W; 2 mmol = 153 +/- 30 W; 4 mmol = 223 +/- 39 W; all P adults lead to a reduced maximal and submaximal endurance performance, which can be easily measured by the described test procedure.

  11. Intima-Media Thickness and Cognitive Function in Stroke-Free Middle-Aged Adults: Findings From the Coronary Artery Risk Development in Young Adults Study.

    PubMed

    Zeki Al Hazzouri, Adina; Vittinghoff, Eric; Sidney, Stephen; Reis, Jared P; Jacobs, David R; Yaffe, Kristine

    2015-08-01

    The relationship between carotid artery intima-media thickness (IMT) and cognitive function in midlife remains relatively unexplored. We examined the association between IMT and cognitive function in a middle-aged epidemiological cohort of 2618 stroke-free participants. At the year 20 visit (our study baseline), participants from the Coronary Artery Risk Development in Young Adults study had IMT measured by ultrasound at the common carotid artery. Five years later, participants completed a cognitive battery consisting of the Rey Auditory-Verbal Learning Test of verbal memory, the Digit Symbol Substitution Test of processing speed, and the Stroop test of executive function. We transformed cognitive scores into standardized z scores, with negative values indicating worse performance. Mean age at baseline was 45.3 years (SD, 3.6). Greater IMT (per 1 SD difference of 0.12 mm) was significantly associated with worse performance on all cognitive tests (z scores) in unadjusted linear regression models (verbal memory, -0.16; 95% confidence interval [CI], -0.20 to -0.13; processing speed, -0.23; 95% CI, -0.27 to -0.19; and executive function, -0.17; 95% CI, -0.20 to -0.13). In models adjusted for sociodemographics and vascular risk factors that lie earlier in the causal pathway, greater IMT remained negatively associated with processing speed (-0.06; 95% CI, -0.09 to -0.02; P, 0.003) and borderline associated with executive function (-0.03; 95% CI, -0.07 to 0.00; P, 0.07) but not with verbal memory. We observed an association between greater IMT and worse processing speed-a key component of cognitive functioning-at middle age above and beyond traditional vascular risk factors. Efforts targeted at preventing early stages of atherosclerosis may modify the course of cognitive aging. © 2015 American Heart Association, Inc.

  12. Cognitive Functioning of Adolescent and Young Adult Cannabis Users in the Philadelphia Neurodevelopmental Cohort

    PubMed Central

    Scott, J. Cobb; Wolf, Daniel H.; Calkins, Monica E.; Bach, Emily C.; Weidner, Jennifer; Ruparel, Kosha; Moore, Tyler M.; Jones, Jason D.; Jackson, Chad T.; Gur, Raquel E.; Gur, Ruben C.

    2017-01-01

    Cannabis use in youth is rising and has been linked to deficits in cognitive functioning. However, cognitive findings have primarily been based on small samples of users seeking treatment, and few studies have evaluated cognition in occasional cannabis users. Here, we examined 4,568 adolescents and young adults (ages 14–21) drawn from the Philadelphia Neurodevelopmental Cohort, a prospective, population-based study. Participants were classified as cannabis Non-Users (n=3,401), Occasional Users (twice per week or less; n=940), or Frequent Users (>3 times per week; n=227). Mixed-model analyses examined main effects of cannabis use and interactions between age and cannabis use on cognitive functioning. There was a significant interaction between cannabis group and age, such that adolescent (but not young adult) Frequent Users performed worse than Non-Users on measures of executive control (p=0.002). Earlier age of cannabis use was associated with worse performance in executive control in Occasional Users (p=0.04). Unexpectedly, Occasional Users exhibited better executive control, memory, and social cognition than Non-Users (ps<.05). Although mild executive control deficits in adolescent frequent users and a relation between early cannabis initiation and cognitive performance are partially consistent with prior research, cognitive deficits were not found in other hypothesized domains in this community-based sample. Moreover, occasional cannabis users displayed equivalent or even slightly better executive control, social cognitive, and memory abilities compared to non-users, suggesting complex relationships between cannabis use and cognition in youth. Longitudinal studies with community samples are needed to identify variables affecting risk and resilience to cognitive deficits associated with cannabis. PMID:28414475

  13. Performance variability on perceptual discrimination tasks in profoundly deaf adults with cochlear implants.

    PubMed

    Hay-McCutcheon, Marcia J; Peterson, Nathaniel R; Pisoni, David B; Kirk, Karen Iler; Yang, Xin; Parton, Jason

    The purpose of this study was to evaluate performance on two challenging listening tasks, talker and regional accent discrimination, and to assess variables that could have affected the outcomes. A prospective study using 35 adults with one cochlear implant (CI) or a CI and a contralateral hearing aid (bimodal hearing) was conducted. Adults completed talker and regional accent discrimination tasks. Two-alternative forced-choice tasks were used to assess talker and accent discrimination in a group of adults who ranged in age from 30 years old to 81 years old. A large amount of performance variability was observed across listeners for both discrimination tasks. Three listeners successfully discriminated between talkers for both listening tasks, 14 participants successfully completed one discrimination task and 18 participants were not able to discriminate between talkers for either listening task. Some adults who used bimodal hearing benefitted from the addition of acoustic cues provided through a HA but for others the HA did not help with discrimination abilities. Acoustic speech feature analysis of the test signals indicated that both the talker speaking rate and the fundamental frequency (F0) helped with talker discrimination. For accent discrimination, findings suggested that access to more salient spectral cues was important for better discrimination performance. The ability to perform challenging discrimination tasks successfully likely involves a number of complex interactions between auditory and non-auditory pre- and post-implant factors. To understand why some adults with CIs perform similarly to adults with normal hearing and others experience difficulty discriminating between talkers, further research will be required with larger populations of adults who use unilateral CIs, bilateral CIs and bimodal hearing. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Symptom distress in older adults following cancer surgery.

    PubMed

    Van Cleave, Janet H; Egleston, Brian L; Ercolano, Elizabeth; McCorkle, Ruth

    2013-01-01

    Symptom distress remains a significant health problem among older adults with cancer following surgery. Understanding factors influencing older adults' symptom distress may lead to early identification and interventions, decreasing morbidity and improving outcomes. We conducted this study to identify factors associated with symptom distress following surgery among 326 community-residing patients 65 years or older with a diagnosis of thoracic, digestive, gynecologic, and genitourinary cancers. This secondary analysis used combined subsets of data from 5 nurse-directed intervention clinical trials targeting patients after surgery at academic cancer centers in northwest and northeastern United States. Symptom distress was assessed by the Symptom Distress Scale at baseline and at 3 and 6 months. A multivariable analysis, using generalized estimating equations, showed that symptom distress was significantly less at 3 and 6 months (3 months: P < .001, 6 months: P = .002) than at baseline while controlling for demographic, biologic, psychological, treatment, and function covariates. Thoracic cancer, comorbidities, worse mental health, and decreased function were, on average, associated with increased symptom distress (all P < .05). Participants 75 years or older reported increased symptom distress over time compared with those aged 65 to 69 years (P < .05). Age, type of cancer, comorbidities, mental health, and function may influence older adults' symptom distress following cancer surgery. Older adults generally experience decreasing symptom distress after thoracic, abdominal, or pelvic cancer surgery. Symptom management over time for those with thoracic cancer, comorbidities, those with worse mental health, those with decreased function, and those 75 years or older may prevent morbidity and improve outcomes of older adults following surgery.

  15. Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study.

    PubMed

    Pua, Yong-Hao; Ong, Peck-Hoon; Clark, Ross Allan; Matcher, David B; Lim, Edwin Choon-Wyn

    2017-12-21

    Risk for falls in older adults has been associated with falls efficacy (self-perceived confidence in performing daily physical activities) and postural balance, but available evidence is limited and mixed. We examined the interaction between falls efficacy and postural balance and its association with future falls. We also investigated the association between falls efficacy and gait decline. Falls efficacy, measured by the Modified Falls Efficacy Scale (MFES), and standing postural balance, measured using computerized posturography on a balance board, were obtained from 247 older adults with a falls-related emergency department visit. Six-month prospective fall rate and habitual gait speed at 6 months post baseline assessment were also measured. In multivariable proportional odds analyses adjusted for potential confounders, falls efficacy modified the association between postural balance and fall risk (interaction P = 0.014): increasing falls efficacy accentuated the increased fall risk related to poor postural balance. Low baseline falls efficacy was strongly predictive of worse gait speed (0.11 m/s [0.06 to 0.16] slower gait speed per IQR decrease in MFES; P < 0.001). Older adults with high falls efficacy but poor postural balance were at greater risk for falls than those with low falls efficacy; however, low baseline falls efficacy was strongly associated with worse gait function at follow-up. Further research into these subgroups of older adults is warranted. ClinicalTrials.gov identifier: NCT01713543 .

  16. Chronic Low Quality Sleep Impairs Postural Control in Healthy Adults.

    PubMed

    Furtado, Fabianne; Gonçalves, Bruno da Silva B; Abranches, Isabela Lopes Laguardia; Abrantes, Ana Flávia; Forner-Cordero, Arturo

    2016-01-01

    The lack of sleep, both in quality and quantity, is an increasing problem in modern society, often related to workload and stress. A number of studies have addressed the effects of acute (total) sleep deprivation on postural control. However, up to date, the effects of chronic sleep deficits, either in quantity or quality, have not been analyzed. Thirty healthy adults participated in the study that consisted of registering activity with a wrist actigraph for more than a week before performing a series of postural control tests. Sleep and circadian rhythm variables were correlated and the sum of activity of the least active 5-h period, L5, a rhythm variable, obtained the greater coefficient value with sleep quality variables (wake after sleep onset WASO and efficiency sleep). Cluster analysis was performed to classify subjects into two groups based on L5 (low and high). The balance tests scores used to asses postural control were measured using Biodex Balance System and were compared between the two groups with different sleep quality. The postural tests were divided into dynamic (platform tilt with eyes open, closed and cursor) and static (clinical test of sensory integration). The results showed that during the tests with eyes closed, the group with worse sleep quality had also worse postural control performance. Lack of vision impairs postural balance more deeply in subjects with chronic sleep inefficiency. Chronic poor sleep quality impairs postural control similarly to total sleep deprivation.

  17. Chronic Low Quality Sleep Impairs Postural Control in Healthy Adults

    PubMed Central

    Gonçalves, Bruno da Silva B.; Abranches, Isabela Lopes Laguardia; Abrantes, Ana Flávia

    2016-01-01

    The lack of sleep, both in quality and quantity, is an increasing problem in modern society, often related to workload and stress. A number of studies have addressed the effects of acute (total) sleep deprivation on postural control. However, up to date, the effects of chronic sleep deficits, either in quantity or quality, have not been analyzed. Thirty healthy adults participated in the study that consisted of registering activity with a wrist actigraph for more than a week before performing a series of postural control tests. Sleep and circadian rhythm variables were correlated and the sum of activity of the least active 5-h period, L5, a rhythm variable, obtained the greater coefficient value with sleep quality variables (wake after sleep onset WASO and efficiency sleep). Cluster analysis was performed to classify subjects into two groups based on L5 (low and high). The balance tests scores used to asses postural control were measured using Biodex Balance System and were compared between the two groups with different sleep quality. The postural tests were divided into dynamic (platform tilt with eyes open, closed and cursor) and static (clinical test of sensory integration). The results showed that during the tests with eyes closed, the group with worse sleep quality had also worse postural control performance. Lack of vision impairs postural balance more deeply in subjects with chronic sleep inefficiency. Chronic poor sleep quality impairs postural control similarly to total sleep deprivation. PMID:27732604

  18. Is delayed surgery related to worse outcomes in native left-sided endocarditis?

    PubMed

    Tepsuwan, Thitipong; Rimsukcharoenchai, Chartaroon; Tantraworasin, Apichat; Woragidpoonpol, Surin; Schuarattanapong, Suphachai; Nawarawong, Weerachai

    2016-05-01

    Timing of surgery in the management of infective endocarditis is controversial, and there is still no definite conclusion on how early the surgery should be performed. This study focuses on the outcomes of surgery during the active period of infective endocarditis in consideration of the duration after diagnosis. One hundred and thirty-four patients with active native valve infective endocarditis who underwent surgery from January 2006 to December 2013 were reviewed retrospectively. They were divided in 2 groups based on timing of surgery: early group (first week after diagnosis, n = 37) and delayed group (2 to 6 weeks after diagnosis, n = 97). Compared to the delayed group, the early group had significantly more patients in New York Heart Association class IV (81% vs. 43.3%), more mechanically ventilated (54.1% vs. 18.6%), more on inotropic support (62.2% vs. 38.1%), and hence a worse EuroSCORE II (14.8% vs. 8.8%). Operative mortality was comparable (5.4% vs. 10.3%) and 7-year survival was similar (77.4% vs. 74.6%). On multivariable regression analysis, delayed surgery did not impact on short- and long-term outcomes. Preoperative cardiac arrest and infection with Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, or Kingella were risk factors for higher operative mortality. Predictors of poor 7-year survival were diabetes mellitus and acute renal failure. Delayed surgery is not associated with worse outcomes. Both early and delayed approaches are safe and provide acceptable results. Timing of surgery should be tailored to each patient's clinical status, not based on duration of endocarditis alone. © The Author(s) 2016.

  19. Subjective memory complaints are associated with poorer cognitive performance in adults with HIV.

    PubMed

    Kamkwalala, Asante; Hulgan, Todd; Newhouse, Paul

    2017-05-01

    With successful antiretroviral therapy in the US, HIV-positive adults now routinely survive into old age. However, increased life expectancy with HIV introduces the added complication of age-related cognitive decline. Aging with HIV has been associated with poorer cognitive outcomes compared to HIV-negative adults. While up to 50% of older HIV-positive adults will develop some degree of cognitive impairment over their lifetime, cognitive symptoms are often not consistently monitored, until those symptoms are significant enough to impair daily life. In this study we found that subjective memory complaint (SMC) ratings correlated with measurable memory performance impairments in HIV-positive adults, but not HIV-negative adults. As the HIV-positive population ages, structured subjective cognitive assessment may be beneficial to identify the early signs of cognitive impairment, and subsequently allow for earlier interventions to maintain cognitive performance as these adults continue to survive into old age.

  20. Disclosure of child sexual abuse. For better or for worse.

    PubMed

    Sauzier, M

    1989-06-01

    The data presented here offer a longitudinal perspective on sexually abused children. Disclosure data are postulated to be important variables in the short-term and long-term victim-to-patient process. Fifty-five per cent of the 156 children seen purposefully disclosed their sexual abuse, most frequently to their mothers. Children who never told, but were seen after accidental disclosures, showed less distress, whether hiding minor or major forms of sexual abuse. This finding support the clinical impression that disclosure adds extra stress on children and cannot be expected of every victim. A history of past mental health intervention did not seem to enhance the child's ability to tell. Education of all professionals is critical. Approximately 18 months after the end of the crisis intervention offered at intake, 115 of the 156 cases were re-evaluated. Overall, most children showed improvements on standardized tests, but 24 per cent got worse. Specific symptoms were found to cluster in four groups: acute anxiety, characterologic, family dynamics, and specific symptoms related to sexual abuse (sexual maladjustment, prostitution, revictimization, sexually assaultive behavior). Although the data seem to support the notion that crisis intervention by trained clinicians is helpful, it is too early to tell if the ominous findings described in adult survivors can really be decreased. The impact of disclosing child sexual abuse on entire families should not be underestimated, even in cases of extrafamilial abuse. The poor ratings parents gave law enforcement, judicial, and Child Protective Service professionals may be linked to the reluctance of victims to disclose their abuse and underscores the need to review current procedures and practices. Overall, a great majority of parents did see the sexual abuse as harmful to the child and to the family, but they were evenly divided about whether the disclosure was harmful or helpful to the child and family. A final word of

  1. The Attraction Effect in Decision Making: Superior Performance by Older Adults

    PubMed Central

    Kim, Sunghan; Hasher, Lynn

    2006-01-01

    Previous work showed that older adults’ choice performance can be wiser than that of younger adults (Tentori, Osherson, Hasher, & May, 2001). We contrasted two possible interpretations: a general expertise/wisdom view that suggests that older adults are generally more skilled at making decisions than younger adults and a domain-specific expertise view that suggests that older adults are more skilled decision makers only in domains in which they have greater knowledge. These hypotheses were contrasted using attraction effect tasks in two different domains: earning extra credit in a course and grocery shopping, domains presumed to be of different levels of knowledge to younger and older adults. Older adults showed consistent choice for both domains; younger adults showed consistent choice only for the extra credit problem. Several explanations of these findings are considered, including Damasio’s somatic marker theory and age differences in reliance on heuristic versus analytic styles. PMID:15881294

  2. Health-Related Quality of Life of Adolescent and Young Adult Patients With Cancer in the United States: The Adolescent and Young Adult Health Outcomes and Patient Experience Study

    PubMed Central

    Smith, Ashley Wilder; Bellizzi, Keith M.; Keegan, Theresa H.M.; Zebrack, Brad; Chen, Vivien W.; Neale, Anne Victoria; Hamilton, Ann S.; Shnorhavorian, Margarett; Lynch, Charles F.

    2013-01-01

    Purpose Adolescents and young adults (AYAs) diagnosed with cancer face numerous physical, psychosocial, and practical challenges. This article describes the health-related quality of life (HRQOL) and associated demographic and health-related characteristics of this developmentally diverse population. Patients and Methods Data are from the Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) study, a population-based cohort of 523 AYA patients with cancer, ages 15 to 39 years at diagnosis from 2007 to 2009. Comparisons are made by age group and with general and healthy populations. Multiple linear regression models evaluated effects of demographic, disease, health care, and symptom variables on multiple domains of HRQOL using the Pediatric Quality of Life Inventory (PedsQL) and the Short-Form Health Survey 12 (SF-12). Results Overall, respondents reported significantly worse HRQOL across both physical and mental health scales than did general and healthy populations. The greatest deficits were in limitations to physical and emotional roles, physical and social functioning, and fatigue. Teenaged patients (ages 15 to 17 years) reported worse physical and work/school functioning than patients 18 to 25 years old. Regression models showed that HRQOL was worse for those in treatment, with current/recent symptoms, or lacking health insurance at any time since diagnosis. In addition, sarcoma patients, Hispanic patients, and those with high school or lower education reported worse physical health. Unmarried patients reported worse mental health. Conclusion Results suggest that AYAs with cancer have major decrements in several physical and mental HRQOL domains. Vulnerable subgroups included Hispanic patients, those with less education, and those without health insurance. AYAs also experienced higher levels of fatigue that were influenced by current symptoms and treatment. Future research should explore ways to address poor functioning in this

  3. Health-related quality of life of adolescent and young adult patients with cancer in the United States: the Adolescent and Young Adult Health Outcomes and Patient Experience study.

    PubMed

    Smith, Ashley Wilder; Bellizzi, Keith M; Keegan, Theresa H M; Zebrack, Brad; Chen, Vivien W; Neale, Anne Victoria; Hamilton, Ann S; Shnorhavorian, Margarett; Lynch, Charles F

    2013-06-10

    Adolescents and young adults (AYAs) diagnosed with cancer face numerous physical, psychosocial, and practical challenges. This article describes the health-related quality of life (HRQOL) and associated demographic and health-related characteristics of this developmentally diverse population. Data are from the Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) study, a population-based cohort of 523 AYA patients with cancer, ages 15 to 39 years at diagnosis from 2007 to 2009. Comparisons are made by age group and with general and healthy populations. Multiple linear regression models evaluated effects of demographic, disease, health care, and symptom variables on multiple domains of HRQOL using the Pediatric Quality of Life Inventory (PedsQL) and the Short-Form Health Survey 12 (SF-12). Overall, respondents reported significantly worse HRQOL across both physical and mental health scales than did general and healthy populations. The greatest deficits were in limitations to physical and emotional roles, physical and social functioning, and fatigue. Teenaged patients (ages 15 to 17 years) reported worse physical and work/school functioning than patients 18 to 25 years old. Regression models showed that HRQOL was worse for those in treatment, with current/recent symptoms, or lacking health insurance at any time since diagnosis. In addition, sarcoma patients, Hispanic patients, and those with high school or lower education reported worse physical health. Unmarried patients reported worse mental health. Results suggest that AYAs with cancer have major decrements in several physical and mental HRQOL domains. Vulnerable subgroups included Hispanic patients, those with less education, and those without health insurance. AYAs also experienced higher levels of fatigue that were influenced by current symptoms and treatment. Future research should explore ways to address poor functioning in this understudied group.

  4. How Staff Pursue Questions to Adults with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Finlay, W. M. L.; Antaki, C.

    2012-01-01

    Background: When support staff use questions to instruct, advise or guide adults with intellectual disabilities (ID), or to solicit information from them, the interaction does not always proceed smoothly, particularly when replies are ambiguous, absent or not obviously relevant. That can lead to interactional trouble and dissatisfaction, or worse.…

  5. Smartphone Text Input Method Performance, Usability, and Preference With Younger and Older Adults.

    PubMed

    Smith, Amanda L; Chaparro, Barbara S

    2015-09-01

    User performance, perceived usability, and preference for five smartphone text input methods were compared with younger and older novice adults. Smartphones are used for a variety of functions other than phone calls, including text messaging, e-mail, and web browsing. Research comparing performance with methods of text input on smartphones reveals a high degree of variability in reported measures, procedures, and results. This study reports on a direct comparison of five of the most common input methods among a population of younger and older adults, who had no experience with any of the methods. Fifty adults (25 younger, 18-35 years; 25 older, 60-84 years) completed a text entry task using five text input methods (physical Qwerty, onscreen Qwerty, tracing, handwriting, and voice). Entry and error rates, perceived usability, and preference were recorded. Both age groups input text equally fast using voice input, but older adults were slower than younger adults using all other methods. Both age groups had low error rates when using physical Qwerty and voice, but older adults committed more errors with the other three methods. Both younger and older adults preferred voice and physical Qwerty input to the remaining methods. Handwriting consistently performed the worst and was rated lowest by both groups. Voice and physical Qwerty input methods proved to be the most effective for both younger and older adults, and handwriting input was the least effective overall. These findings have implications to the design of future smartphone text input methods and devices, particularly for older adults. © 2015, Human Factors and Ergonomics Society.

  6. Task demands moderate stereotype threat effects on memory performance.

    PubMed

    Hess, Thomas M; Emery, Lisa; Queen, Tara L

    2009-06-01

    Previous research has demonstrated that older adults' memory performance is adversely affected by the explicit activation of negative stereotypes about aging. In this study, we examined the impact of stereotype threat on recognition memory, with specific interest in (a) the generalizability of previously observed effects, (b) the subjective experience of memory, and (c) the moderating effects of task demands. Older participants subjected to threat performed worse than did those in a nonthreat condition but only when performance constraints were high (i.e., memory decisions had to be made within a limited time frame). This effect was reflected in the subjective experience of memory, with participants in this condition having a lower ratio of "remember" to "know" responses. The absence of threat effects when constraints were minimal provides important boundary information regarding stereotype influences on memory performance.

  7. Facial emotion recognition in childhood-onset bipolar I disorder: an evaluation of developmental differences between youths and adults.

    PubMed

    Wegbreit, Ezra; Weissman, Alexandra B; Cushman, Grace K; Puzia, Megan E; Kim, Kerri L; Leibenluft, Ellen; Dickstein, Daniel P

    2015-08-01

    Bipolar disorder (BD) is a severe mental illness with high healthcare costs and poor outcomes. Increasing numbers of youths are diagnosed with BD, and many adults with BD report that their symptoms started in childhood, suggesting that BD can be a developmental disorder. Studies advancing our understanding of BD have shown alterations in facial emotion recognition both in children and adults with BD compared to healthy comparison (HC) participants, but none have evaluated the development of these deficits. To address this, we examined the effect of age on facial emotion recognition in a sample that included children and adults with confirmed childhood-onset type-I BD, with the adults having been diagnosed and followed since childhood by the Course and Outcome in Bipolar Youth study. Using the Diagnostic Analysis of Non-Verbal Accuracy, we compared facial emotion recognition errors among participants with BD (n = 66; ages 7-26 years) and HC participants (n = 87; ages 7-25 years). Complementary analyses investigated errors for child and adult faces. A significant diagnosis-by-age interaction indicated that younger BD participants performed worse than expected relative to HC participants their own age. The deficits occurred both for child and adult faces and were particularly strong for angry child faces, which were most often mistaken as sad. Our results were not influenced by medications, comorbidities/substance use, or mood state/global functioning. Younger individuals with BD are worse than their peers at this important social skill. This deficit may be an important developmentally salient treatment target - that is, for cognitive remediation to improve BD youths' emotion recognition abilities. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Are older adults living in more equal counties healthier than older adults living in more unequal counties? A propensity score matching approach.

    PubMed

    Choi, HwaJung; Burgard, Sarah; Elo, Irma T; Heisler, Michele

    2015-09-01

    We assessed the potential contextual effect of income inequality on health by: 1) comparing individuals with similar socioeconomic status (SES) but who reside in counties with different levels of income inequality; and 2) examining whether the potential effect of county-level income inequality on health varies across SES groups. We used the Health and Retirement Study, a nationally representative study of Americans over the age of 50. Using propensity score matching, we selected SES-comparable individuals living in high-income inequality counties and in low-income inequality counties. We examined differences in self-rated overall health outcomes and in other specific physical/mental health outcomes between the two groups using logistic regression (n = 34,994) and imposing different sample restrictions based on residential duration in the area. We then used logistic regression with interactions to assess whether, and if so how, health outcomes differed among participants of different SES groups defined by wealth, income, and education. In bivariate analyses of the unmatched full sample, adults living in high-income inequality counties have worse health outcomes for most health measures. After propensity score matching, adults in high-income inequality counties had worse self-rated health status (AOR = 1.12; 95% CI 1.04-1.19) and were more likely to report diagnosed psychiatric problems (AOR = 1.08; 95% CI 0.99-1.19) than their matched counterparts in low-income inequality counties. These associations were stronger with longer-term residents in the area. Adverse health outcomes associated with living in high-income inequality counties were significant particularly for individuals in the 30(th) or greater percentiles of income/wealth distribution and those without a college education. In summary, after using more precise matching methods to compare individuals with similar characteristics and addressing measurement error by excluding more recently arrived county

  9. Are older adults living in more equal counties healthier than older adults living in more unequal counties? A propensity score matching approach

    PubMed Central

    Choi, HwaJung; Burgard, Sarah; Elo, Irma T.; Heisler, Michele

    2015-01-01

    We assessed the potential contextual effect of income inequality on health by: 1) comparing individuals with similar socioeconomic status (SES) but who reside in counties with different levels of income inequality; and 2) examining whether the potential effect of county-level income inequality on health varies across SES groups. We used the Health and Retirement Study, a nationally representative study of Americans over the age of 50. Using propensity score matching, we selected SES-comparable individuals living in high-income inequality counties and in low-income inequality counties. We examined differences in self-rated overall health outcomes and in other specific physical/mental health outcomes between the two groups using logistic regression (n=34,994) and imposing different sample restrictions based on residential duration in the area. We then used logistic regression with interactions to assess whether, and if so how, health outcomes differed among participants of different SES groups defined by wealth, income, and education. In bivariate analyses of the unmatched full sample, adults living in high-income inequality counties have worse health outcomes for most health measures. After propensity score matching, adults in high-income inequality counties had worse self-rated health status (AOR=1.12; 95% CI 1.04–1.19) and were more likely to report diagnosed psychiatric problems (AOR=1.08; 95% CI 0.99–1.19) than their matched counterparts in low-income inequality counties. These associations were stronger with longer-term residents in the area. Adverse health outcomes associated with living in high-income inequality counties were significant particularly for individuals in the 30th or greater percentiles of income/wealth distribution and those without a college education. In summary, after using more precise matching methods to compare individuals with similar characteristics and addressing measurement error by excluding more recently arrived county residents

  10. Iron Concentration in Deep Gray Matter Structures is Associated with Worse Visual Memory Performance in Healthy Young Adults

    PubMed Central

    Darnai, Gergely; Nagy, Szilvia Anett; Horváth, Réka; Ács, Péter; Perlaki, Gábor; Orsi, Gergely; Kovács, Norbert; Altbäcker, Anna; Plózer, Enikő; Tényi, Dalma; Weintraut, Rita; Schwarcz, Attila; John, Flóra; Varga, Eszter; Bereczkei, Tamás; Clemens, Zsófia; Komoly, Sámuel; Janszky, József

    2017-01-01

    Abnormally high deposition of iron can contribute to neurodegenerative disorders with cognitive impairment. Since previous studies investigating cognition-brain iron accumulation relationships focused on elderly people, our aim was to explore the association between iron concentration in subcortical nuclei and two types of memory performances in a healthy young population. Gender difference was found only in the globus pallidus. Our results showed that iron load characterized by R2* value on the MRI in the caudate and putamen was related to visual memory, while verbal memory was unrelated to iron concentration. PMID:28671115

  11. Relationships of Mathematics Anxiety, Mathematics Self-Efficacy and Mathematics Performance of Adult Basic Education Students

    ERIC Educational Resources Information Center

    Watts, Beverly Kinsey

    2011-01-01

    Competent mathematical skills are needed in the workplace as well as in the college setting. Adults in Adult Basic Education classes and programs generally perform below high school level competency, but very few studies have been performed investigating the predictors of mathematical success for adults. The current study contributes to the…

  12. Adult psychosocial outcome of prepubertal major depressive disorder.

    PubMed

    Geller, B; Zimerman, B; Williams, M; Bolhofner, K; Craney, J L

    2001-06-01

    To compare adult psychosocial functioning (PSF) of subjects with prepubertal major depressive disorder (PMDD) to a normal comparison (NC) group. PSF of subjects with PMDD (n = 72) and of NC subjects (n = 28) was compared after prospective follow-up to adulthood. These 100 subjects were 90.9% of the baseline 110 subjects who participated in the "Nortriptyline in Childhood Depression: Follow-up Study." Research nurses who were blind to group status conducted telephone interviews using the Longitudinal Interval Follow-up Evaluation (LIFE) to obtain PSF data. At follow-up, the PMDD group was 20.7+/-2.0 and the NC subjects were 20.9+/-2.2 years old. The PMDD subjects were 10.3+/-1.5 years old at baseline. Time between baseline and follow-up was 9.9+/-1.5 years. In the PMDD group, subjects with MDD, bipolar disorder, or substance use disorders during the previous 5 years had significantly worse PSF than NC subjects. These PSF impairments included significantly worse relationships with parents, siblings, and friends; significantly worse functioning in household, school, and work settings; and worse overall quality of life and global social adjustment. Although combined treatments for PMDD have little scientific basis, multimodality regimens seem prudent until definitive treatment data become available.

  13. Prior contralateral amputation predicts worse outcomes for lower extremity bypasses performed in the intact limb.

    PubMed

    Baril, Donald T; Goodney, Philip P; Robinson, William P; Nolan, Brian W; Stone, David H; Li, YouFu; Cronenwett, Jack L; Schanzer, Andres

    2012-08-01

    To date, history of a contralateral amputation as a potential predictor of outcomes after lower extremity bypass (LEB) for critical limb ischemia (CLI) has not been studied. We sought to determine if a prior contralateral lower extremity amputation predicts worse outcomes in patients undergoing LEB in the remaining intact limb. A retrospective analysis of all patients undergoing infrainguinal LEB for CLI between 2003 and 2010 within hospitals comprising the Vascular Study Group of New England was performed. Patients were stratified according to whether or not they had previously undergone a contralateral major or minor amputation before LEB. Primary end points included major amputation and graft occlusion at 1 year postoperatively. Secondary end points included in-hospital major adverse events, discharge status, and mortality at 1 year. Of 2636 LEB procedures, 228 (8.6%) were performed in the setting of a prior contralateral amputation. Patients with a prior amputation compared to those without were younger (66.5 vs 68.7; P = .034), more like to have congestive heart failure (CHF; 25% vs 16%; P = .002), hypertension (94% vs 85%; P = .015), renal insufficiency (26% vs 14%; P = .0002), and hemodialysis-dependent renal failure (14% vs 6%; P = .0002). They were also more likely to be nursing home residents (8.0% vs 3.6%; P = .036), less likely to ambulate without assistance (41% vs 80%; P < .0002), and more likely to have had a prior ipsilateral bypass (20% vs 12%; P = .0005). These patients experience increased in-hospital major adverse events, including myocardial infarction (MI; 8.9% vs 4.2%; P = .002), CHF (6.1% vs 3.4%; P = .044), deterioration in renal function (9.0% vs 4.7%; P = .006), and respiratory complications (4.2% vs 2.3%; P = .034). They were less likely to be discharged home (52% vs 72%; P < .0001) and less likely to be ambulatory on discharge (25% vs 55%; P < .0001). Although patients with a prior contralateral amputation experienced increased rates of

  14. Prior contralateral amputation predicts worse outcomes for lower extremity bypasses performed in the intact limb

    PubMed Central

    Baril, Donald T.; Goodney, Philip P.; Robinson, William P.; Nolan, Brian W.; Stone, David H.; Li, YouFu; Cronenwett, Jack L.; Schanzer, Andres

    2013-01-01

    Introduction To date, history of a contralateral amputation as a potential predictor of outcomes after lower extremity bypass (LEB) for critical limb ischemia (CLI) has not been studied. We sought to determine if a prior contralateral lower extremity amputation predicts worse outcomes in patients undergoing LEB in the remaining intact limb. Methods A retrospective analysis of all patients undergoing infrainguinal LEB for CLI between 2003 and 2010 within hospitals comprising the Vascular Study Group of New England was performed. Patients were stratified according to whether or not they had previously undergone a contralateral major or minor amputation before LEB. Primary end points included major amputation and graft occlusion at 1 year postoperatively. Secondary end points included in-hospital major adverse events, discharge status, and mortality at 1 year. Results Of 2636 LEB procedures, 228 (8.6%) were performed in the setting of a prior contralateral amputation. Patients with a prior amputation compared to those without were younger (66.5 vs 68.7; P = .034), more like to have congestive heart failure (CHF; 25% vs 16%; P = .002), hypertension (94% vs 85%; P = .015), renal insufficiency (26% vs 14%; P = .0002), and hemodialysis-dependent renal failure (14% vs 6%; P = .0002). They were also more likely to be nursing home residents (8.0% vs 3.6%; P = .036), less likely to ambulate without assistance (41% vs 80%; P < .0002), and more likely to have had a prior ipsilateral bypass (20% vs 12%; P = .0005). These patients experience increased in-hospital major adverse events, including myocardial infarction (MI; 8.9% vs 4.2%; P = .002), CHF (6.1% vs 3.4%; P = .044), deterioration in renal function (9.0% vs 4.7%; P = .006), and respiratory complications (4.2% vs 2.3%; P = .034). They were less likely to be discharged home (52% vs 72%; P < .0001) and less likely to be ambulatory on discharge (25% vs 55%; P < .0001). Although patients with a prior contralateral amputation

  15. Documentation of daily sit-to-stands performed by community-dwelling adults.

    PubMed

    Bohannon, Richard W; Barreca, Susan R; Shove, Megan E; Lambert, Cynthia; Masters, Lisa M; Sigouin, Christopher S

    2008-01-01

    No information exists about how many sit-to-stands (STSs) are performed daily by community-dwelling adults. We, therefore, examined the feasibility of using a tally counter to document daily STSs, documented the number of daily STSs performed, and determined if the number of STSs was influenced by demographic or health variables. Ninety-eight community-dwelling adults (19-84 years) agreed to participate. After providing demographic and health information, subjects used a tally counter to document the number of STSs performed daily for 7 consecutive days. All but two subjects judged their counter-documented STS number to be accurate. Excluding data from these and two other subjects, the mean number of STSs for subjects was 42.8 to 49.3, depending on the day. The number was significantly higher on weekdays than weekends. No demographic or health variable was significantly related to the number of STSs in univariate or multivariate analysis. In conclusion, this study suggests that a tally counter may be a practical aid to documenting STS activity. The STS repetitions recorded by the counter in this study provide an estimate of the number of STSs that community-dwelling adults perform daily.

  16. Do Concomitant Cranium and Axis Injuries Predict Worse Outcome? A Trauma Database Quantitative Analysis

    PubMed Central

    Chittiboina, Prashant; Banerjee, Anirban Deep; Nanda, Anil

    2011-01-01

    We performed a trauma database analysis to identify the effect of concomitant cranial injuries on outcome in patients with fractures of the axis. We identified patients with axis fractures over a 14-year period. A binary outcome measure was used. Univariate and multiple logistic regression analysis were performed. There were 259 cases with axis fractures. Closed head injury was noted in 57% and skull base trauma in 14%. Death occurred in 17 cases (6%). Seventy-two percent had good outcome. Presence of abnormal computed tomography head findings, skull base fractures, and visceral injury was significantly associated with poor outcome. Skull base injury in association with fractures of the axis is a significant independent predictor of worse outcomes, irrespective of the severity of the head injury. We propose that presence of concomitant cranial and upper vertebral injuries require careful evaluation in view of the associated poor prognosis. PMID:22470268

  17. Transmission Behaviors and Prevalence of Chlamydia and Gonorrhea Among Adult Film Performers.

    PubMed

    Javanbakht, Marjan; Dillavou, M Claire; Rigg, Robert W; Kerndt, Peter R; Gorbach, Pamina M

    2017-03-01

    Adult film work involves multiple sex partners, unprotected intercourse and frequent oral/rectal contact. Data on sexual networks and sexual behaviors of adult film performers (AFP) are limited. From August 2012 to May 2013, AFPs in Los Angeles, CA, seeking care at 2 clinics that provide sexually transmitted infections (STIs) testing to performers were offered urogenital, pharyngeal, and rectal chlamydia/gonorrhea testing. Participants were 18 years or older and performed in at least 1 adult film scene within the past year. A Web-based survey was used to collect sexual behavior information. A total of 360 AFPs were enrolled; 75% (n = 271) were women, and the median age was 25 years (interquartile range, 22-31 years). Most reported a main partner (73%), 23% reported non-film transactional partners, and only 6% reported always using condoms on-set. Overall, 24% (n = 86) tested positive for chlamydia or gonorrhea; 15% for chlamydia (n = 54) and 11% for gonorrhea (n = 41). Prevalence of chlamydia/gonorrhea varied by time as a performer (median, year 2 vs year 3; P = 0.06), and days of adult film-work in the past 30 days (median, 6 days vs 4 days; P = 0.02). In multivariable analyses, age (adjusted odds ratio, 0.90; 95% confidence interval, 0.85-0.96) and type of scene (adjusted odds ratio for double vaginal = 2.89; 95% confidence interval, 1.29-6.48) were associated with chlamydia/gonorrhea positivity. Adult film performers had a high prevalence of STIs and reported low levels of condom use in the context of most sexual partnerships. Targeted intervention strategies-both in and outside the workplace-are needed to limit the spread of STIs.

  18. Are Immigrants and Girls Graded Worse? Results of a Matching Approach

    ERIC Educational Resources Information Center

    Kiss, David

    2013-01-01

    Using Progress in International Reading Literacy Study 2001 and Programme for International Student Assessment 2003 data for Germany, this paper examines whether second-generation immigrants and girls are graded worse in math than comparable natives and boys, respectively. Once all grading-relevant characteristics, namely math skills and oral…

  19. Functional performance comparison between real and virtual tasks in older adults

    PubMed Central

    Bezerra, Ítalla Maria Pinheiro; Crocetta, Tânia Brusque; Massetti, Thais; da Silva, Talita Dias; Guarnieri, Regiani; Meira, Cassio de Miranda; Arab, Claudia; de Abreu, Luiz Carlos; de Araujo, Luciano Vieira; Monteiro, Carlos Bandeira de Mello

    2018-01-01

    Abstract Introduction: Ageing is usually accompanied by deterioration of physical abilities, such as muscular strength, sensory sensitivity, and functional capacity, making chronic diseases, and the well-being of older adults new challenges to global public health. Objective: The purpose of this study was to evaluate whether a task practiced in a virtual environment could promote better performance and enable transfer to the same task in a real environment. Method: The study evaluated 65 older adults of both genders, aged 60 to 82 years (M = 69.6, SD = 6.3). A timing coincident task was applied to measure the perceptual-motor ability to perform a motor response. The participants were divided into 2 groups: started in a real interface and started in a virtual interface. Results: All subjects improved their performance during the practice, but improvement was not observed for the real interface, as the participants were near maximum performance from the beginning of the task. However, there was no transfer of performance from the virtual to real environment or vice versa. Conclusions: The virtual environment was shown to provide improvement of performance with a short-term motor learning protocol in a timing coincident task. This result suggests that the practice of tasks in a virtual environment seems to be a promising tool for the assessment and training of healthy older adults, even though there was no transfer of performance to a real environment. Trial registration: ISRCTN02960165. Registered 8 November 2016. PMID:29369177

  20. Physical Fitness Performance of Young Adults with and without Cognitive Impairments

    ERIC Educational Resources Information Center

    Zhang, Jiabei; Piwowar, Nathan; Reilly, Coleen Jennifer

    2009-01-01

    The purpose of this investigation was to analyze the physical fitness performance of young adults with and without cognitive impairments. Participants were 75 young adults, including 41 without disabilities (23 females, 18 males; M of age = 21.88) and 34 with mild cognitive impairments (14 females, 20 males; M of age = 21.79). They received…

  1. Adolescent Anorexia Nervosa: cognitive performance after weight recovery.

    PubMed

    Lozano-Serra, Estefanía; Andrés-Perpiña, Susana; Lázaro-García, Luisa; Castro-Fornieles, Josefina

    2014-01-01

    Although there is no definitive consensus on the impairment of neuropsychological functions, most studies of adults with Anorexia Nervosa (AN) find impaired functioning in cognitive domains such as visual-spatial abilities. The objective of this study is to assess the cognitive functions in adolescents with AN before and after weight recovery and to explore the relationship between cognitive performance and menstruation. Twenty-five female adolescents with AN were assessed by a neuropsychological battery while underweight and then following six months of treatment and weight recovery. Twenty-six healthy female subjects of a similar age were also evaluated at both time points. Underweight patients with AN showed worse cognitive performance than control subjects in immediate recall, organization and time taken to copy the Rey's Complex Figure Test (RCFT). After weight recovery, AN patients presented significant improvements in all tests, and differences between patients and controls disappeared. Patients with AN and persistence of amenorrhea at follow-up (n=8) performed worse on Block Design, delayed recall of Visual Reproduction and Stroop Test than patients with resumed menstruation (n=14) and the control group, though the two AN groups were similar in body mass index, age and psychopathological scale scores. Weight recovery improves cognitive functioning in adolescents with AN. The normalization of neuropsychological performance is better in patients who have recovered at least one menstrual cycle. The normalization of hormonal function seems to be essential for the normalization of cognitive performance, even in adolescents with a very short recovery time. © 2013.

  2. Chronic obstructive pulmonary disease is associated with altered neuropsychological performance in young adults.

    PubMed

    De Carolis, Antonella; Giubilei, Franco; Caselli, Giulio; Casolla, Barbara; Cavallari, Michele; Vanacore, Nicola; Leonori, Rita; Scrocchia, Ilaria; Fersini, Anna; Quercia, Augusto; Orzi, Francesco

    2011-01-01

    Subjects with ischemic lesions have an increased risk of dementia. In addition, Alzheimer's disease (AD) and vascular cognitive impairment share many risk factors. These observations suggest that different diseases that cause altered blood perfusion of the brain or hypoxia promote AD neurodegeneration. In this case-control, cross-sectional study, we sought to test the hypothesis that hypoxia facilitates cognitive decline. We looked for altered neuropsychological performance in subjects with chronic obstructive pulmonary disease (COPD) without apparent cardio- or cerebrovascular diseases or risk factors for atherosclerosis. A selected, homogeneous group of workers from two ceramic factories in a small town of central Italy was enrolled in this study. The COPD patients had a slightly, but significantly worse performance than controls in a number of neuropsychological tests. The findings are consistent with the working hypothesis that chronic hypoxia facilitates cognitive decline.

  3. Metabolic syndrome correlates poorly with cognitive performance in stroke-free community-dwelling older adults: a population-based, cross-sectional study in rural Ecuador.

    PubMed

    Del Brutto, Oscar H; Mera, Robertino M; Zambrano, Mauricio

    2016-04-01

    Studies investigating a possible correlation between metabolic syndrome and cognitive decline have been inconsistent. To determine whether metabolic syndrome or each of its components correlate with cognitive performance in community-dwelling older adults in rural Ecuador. Stroke-free Atahualpa residents aged ≥60 years were identified during a door-to-door survey. Metabolic syndrome was defined according to the International Diabetes Federation criteria. Cognition was evaluated by the use of the Montreal Cognitive Assessment (MoCA). Multivariate logistic regression models estimated the association between metabolic syndrome and each of its components with cognitive performance. A total of 212 persons (mean age: 69.2 ± 7.2 years, 64 % women) were enrolled. Of these, 120 (57 %) had metabolic syndrome. Mean scores in the MoCA were 18.2 ± 4.6 for persons with and 19 ± 4.7 for those without metabolic syndrome. In fully adjusted logistic models, MoCA scores were not associated with metabolic syndrome (p = 0.101). After testing individual components of metabolic syndrome with the MoCA score, we found that only hypertriglyceridemia was independently associated with the MoCA score (p = 0.009). This population-based study showed a poor correlation of metabolic syndrome with cognitive performance after adjusting for relevant confounders. Of the individual components of metabolic syndrome, only hypertriglyceridemia correlated with worse cognitive performance.

  4. A Pilot Study of the Effects of Atomoxetine on Driving Performance in Adults with ADHD

    ERIC Educational Resources Information Center

    Barkley, Russell A.; Anderson, Deborah L.; Kruesi, Markus

    2007-01-01

    Objective: There is a high risk of vehicular crashes, traffic citations, and poorer driving performance in adults with ADHD. This pilot study examines the value of a new nonstimulant (atomoxetine) for improving the driving performance of adults with ADHD. Method: Atomoxetine (1.2 mg/kg daily for 3 weeks) and a placebo are studied on 18 adults with…

  5. Factors associated with gingival inflammation among adults with systemic sclerosis.

    PubMed

    Yuen, H K; Weng, Y; Reed, S G; Summerlin, L M; Silver, R M

    2014-02-01

    To identify factors associated with increased gingival inflammation in adults with systemic sclerosis (SSc, scleroderma). In this cross-sectional study, forty-eight adults with SSc received assessment of gingival inflammation using Löe and Silness gingival index (LSGI), measurement of oral aperture and evaluation of manual dexterity to perform oral hygiene using the Toothbrushing Ability Test, as well as completion of an oral health-related questionnaire. Three explanatory variables in the final multiple predictor models for the LSGI outcome were statistically significant--manual dexterity to perform oral hygiene, flossing in the evening and SSc subtype, with higher (i.e., worse) LSGI score among those with impaired manual dexterity, not flossing in the evening and diffuse form of SSc. In addition, posterior teeth had higher LSGI scores compared with that of the anterior teeth after adjusting for other variables. Results suggest that dental health professionals take manual dexterity into consideration when educating patients with SSc to improve their oral hygiene and educate them on paying more attention on cleaning their posterior teeth and the importance of flossing in the evening--especially those who only floss once a day or less often. © 2013 John Wiley & Sons A/S.

  6. Post-exercise pulse pressure is a better predictor of executive function than pre-exercise pulse pressure in cognitively normal older adults.

    PubMed

    Scott, Bonnie M; Maye, Jacqueline; Jones, Jacob; Thomas, Kelsey; Mangal, Paul C; Trifilio, Erin; Hass, Chris; Marsiske, Michael; Bowers, Dawn

    2016-07-01

    Exercise "stress tests" are widely used to assess cardiovascular function and to detect abnormalities. In line with the view of exercise as a stressor, the present study examined the relationship between cognitive function and cardiovascular activity before and after light physical exercise in a sample of 84 non-demented community-dwelling older adults. Based on known relationships between hypertension, executive function and cerebral white matter changes, we hypothesized that greater post-exercise reactivity, as indexed by higher pulse pressure, would be more related to worse performance on frontal-executive tasks than pre-exercise physiologic measures. All participants were administered a comprehensive neuropsychological battery and underwent a Six Minute Walk Test (6MWT), with blood pressure (BP) measures obtained immediately before and after the walk. Pulse pressure (PP) was derived from BP as an indicator of vascular auto-regulation and composite scores were computed for each cognitive domain assessed. As predicted, worse executive function scores exhibited a stronger relationship with post-exercise PP than pre-exercise PP. Results suggest that PP following system stress in the form of walking may be more reflective of the state of vascular integrity and associated executive dysfunction in older adults than baseline physiologic measures.

  7. Correlates of adverse childhood events among adults with schizophrenia spectrum disorders.

    PubMed

    Rosenberg, Stanley D; Lu, Weili; Mueser, Kim T; Jankowski, Mary Kay; Cournos, Francine

    2007-02-01

    Multiple studies have found that childhood adversity is related to a range of poor mental health, substance abuse, poor physical health, and poor social functioning outcomes in the general population of adults. However, despite the high rates of childhood adversity in schizophrenia, the clinical correlates of these events have not been systematically evaluated. This study evaluated the relationship between adverse experiences in childhood and functional, clinical, and health outcomes among adults with schizophrenia. The authors surveyed 569 adults with schizophrenia regarding adverse childhood events (including physical abuse, sexual abuse, parental mental illnesses, loss of a parent, parental separation or divorce, witnessing domestic violence, and foster or kinship care). The relationships between cumulative exposure to these events and psychiatric, physical, and functional outcomes were evaluated. Increased exposure to adverse childhood events was strongly related to psychiatric problems (suicidal thinking, hospitalizations, distress, and posttraumatic stress disorder), substance abuse, physical health problems (HIV infection), medical service utilization (physician visits), and poor social functioning (homelessness or criminal justice involvement). The findings extend the results of research in the general population by suggesting that childhood adversity contributes to worse mental health, substance abuse, worse physical health, and poor functional outcomes in schizophrenia.

  8. Impact of cytogenetic abnormalities in adults with Ph-negative B-cell precursor acute lymphoblastic leukemia.

    PubMed

    Lafage-Pochitaloff, Marina; Baranger, Laurence; Hunault, Mathilde; Cuccuini, Wendy; Lefebvre, Christine; Bidet, Audrey; Tigaud, Isabelle; Eclache, Virginie; Delabesse, Eric; Bilhou-Nabéra, Chrystèle; Terré, Christine; Chapiro, Elise; Gachard, Nathalie; Mozziconacci, Marie-Joelle; Ameye, Geneviève; Porter, Sarah; Grardel, Nathalie; Béné, Marie C; Chalandon, Yves; Graux, Carlos; Huguet, Françoise; Lhéritier, Véronique; Ifrah, Norbert; Dombret, Hervé

    2017-10-19

    Multiple cytogenetic subgroups have been described in adult Philadelphia chromosome (Ph)-negative B-cell precursor (BCP) acute lymphoblastic leukemia (ALL), often comprising small numbers of patients. In this study, we aimed to reassess the prognostic value of cytogenetic abnormalities in a large series of 617 adult patients with Ph-negative BCP-ALL (median age, 38 years), treated in the intensified Group for Research on Adult Acute Lymphoblastic Leukemia (GRAALL)-2003/2005 trials. Combined data from karyotype, DNA index, fluorescence in situ hybridization, and polymerase chain reaction screening for relevant abnormalities were centrally reviewed and were informative in 542 cases (88%), allowing classification in 10 exclusive primary cytogenetic subgroups and in secondary subgroups, including complex and monosomal karyotypes. Prognostic analyses focused on cumulative incidence of failure (including primary refractoriness and relapse), event-free survival, and overall survival. Only 2 subgroups, namely t(4;11)/ KMT2A-AFF1 and 14q32/ IGH translocations, displayed a significantly worse outcome in this context, still observed after adjustment for age and after censoring patients who received allogeneic stem cell transplantation (SCT) in first remission at SCT time. A worse outcome was also observed in patients with low hypodiploidy/near triploidy, but this was likely related to their higher age and worse tolerance to therapy. The other cytogenetic abnormalities, including complex and monosomal karyotypes, had no prognostic value in these intensive protocols designed for adult patients up to the age of 60 years. © 2017 by The American Society of Hematology.

  9. Camp Verde Adult Reading Program. Final Performance Report.

    ERIC Educational Resources Information Center

    Maynard, David A.

    This document begins with a four-page performance report describing how the Camp Verde Adult Reading Program site was relocated to the Community Center Complex, and the Town Council contracted directly with the Friends of the Camp Verde Library to provide for the requirements of the program. The U.S. Department of Education grant allowed the…

  10. Insulin sensitivity across the lifespan from obese adolescents to obese adults with impaired glucose tolerance: Who is worse off?

    USDA-ARS?s Scientific Manuscript database

    Youth type 2 diabetes mellitus (T2DM) occurs decades earlier than adult T2DM and is characterized by high therapeutic failure rates and decreased response to insulin sensitizers suggesting a more severe disease process than in adults. To explain these observations, we hypothesized that insulin resis...

  11. Future thinking improves prospective memory performance and plan enactment in older adults.

    PubMed

    Altgassen, Mareike; Rendell, Peter G; Bernhard, Anka; Henry, Julie D; Bailey, Phoebe E; Phillips, Louise H; Kliegel, Matthias

    2015-01-01

    Efficient intention formation might improve prospective memory by reducing the need for resource-demanding strategic processes during the delayed performance interval. The present study set out to test this assumption and provides the first empirical assessment of whether imagining a future action improves prospective memory performance equivalently at different stages of the adult lifespan. Thus, younger (n = 40) and older (n = 40) adults were asked to complete the Dresden Breakfast Task, which required them to prepare breakfast in accordance with a set of rules and time restrictions. All participants began by generating a plan for later enactment; however, after making this plan, half of the participants were required to imagine themselves completing the task in the future (future thinking condition), while the other half received standard instructions (control condition). As expected, overall younger adults outperformed older adults. Moreover, both older and younger adults benefited equally from future thinking instructions, as reflected in a higher proportion of prospective memory responses and more accurate plan execution. Thus, for both younger and older adults, imagining the specific visual-spatial context in which an intention will later be executed may serve as an easy-to-implement strategy that enhances prospective memory function in everyday life.

  12. Turn Off the Music! Music Impairs Visual Associative Memory Performance in Older Adults.

    PubMed

    Reaves, Sarah; Graham, Brittany; Grahn, Jessica; Rabannifard, Parissa; Duarte, Audrey

    2016-06-01

    Whether we are explicitly listening to it or not, music is prevalent in our environment. Surprisingly, little is known about the effect of environmental music on concurrent cognitive functioning and whether young and older adults are differentially affected by music. Here, we investigated the impact of background music on a concurrent paired associate learning task in healthy young and older adults. Young and older adults listened to music or to silence while simultaneously studying face-name pairs. Participants' memory for the pairs was then tested while listening to either the same or different music. Participants also made subjective ratings about how distracting they found each song to be. Despite the fact that all participants rated music as more distracting to their performance than silence, only older adults' associative memory performance was impaired by music. These results are most consistent with the theory that older adults' failure to inhibit processing of distracting task-irrelevant information, in this case background music, contributes to their memory impairments. These data have important practical implications for older adults' ability to perform cognitively demanding tasks even in what many consider to be an unobtrusive environment. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. The role of visual spatial attention in adult developmental dyslexia.

    PubMed

    Collis, Nathan L; Kohnen, Saskia; Kinoshita, Sachiko

    2013-01-01

    The present study investigated the nature of visual spatial attention deficits in adults with developmental dyslexia, using a partial report task with five-letter, digit, and symbol strings. Participants responded by a manual key press to one of nine alternatives, which included other characters in the string, allowing an assessment of position errors as well as intrusion errors. The results showed that the dyslexic adults performed significantly worse than age-matched controls with letter and digit strings but not with symbol strings. Both groups produced W-shaped serial position functions with letter and digit strings. The dyslexics' deficits with letter string stimuli were limited to position errors, specifically at the string-interior positions 2 and 4. These errors correlated with letter transposition reading errors (e.g., reading slat as "salt"), but not with the Rapid Automatized Naming (RAN) task. Overall, these results suggest that the dyslexic adults have a visual spatial attention deficit; however, the deficit does not reflect a reduced span in visual-spatial attention, but a deficit in processing a string of letters in parallel, probably due to difficulty in the coding of letter position.

  14. The structure and health correlates of trait repetitive thought in older adults.

    PubMed

    Segerstrom, Suzanne C; Roach, Abbey R; Evans, Daniel R; Schipper, Lindsey J; Darville, Audrey K

    2010-09-01

    Repetitive thought (RT) involves frequent or prolonged thoughts about oneself and one's world, encompassing discrete forms such as trait worry, rumination, processing, and reminiscing. These forms of RT can be described using 3 basic, underlying qualities: total propensity for RT of all types, valence (positive vs. negative content), and purpose (searching or uncertainty vs. solving or certainty). The adaptiveness of discrete forms with regard to health is likely to be related to these qualities, particularly valence and total propensity. The present study confirmed the model and identified the relationship of these qualities of RT to subjective psychological, physical, and cognitive health in older adults aged 60-94 (N = 179). As predicted, more negatively valenced trait RT was associated with worse psychological, physical, and cognitive health. More total propensity for RT was associated only with worse psychological health. Searching purpose was associated only with worse cognitive health. In turn, negatively valenced RT was predicted by poorer executive functions, suggesting that such functions may be important for directing this quality of RT. The valence of older adults' RT is important insofar as it may contribute to their sense of good or ill health. However, the propensity for all kinds of RT to associate with poorer psychological health may reflect the co-occurrence of negative and positive RT, such as rumination and emotional processing. Although RT has not been extensively investigated in older adults, it appears to play an important role in their subjective health. (c) 2010 APA, all rights reserved.

  15. Dual-Task Performance: Influence of Frailty, Level of Physical Activity, and Cognition.

    PubMed

    Giusti Rossi, Paulo; Pires de Andrade, Larissa; Hotta Ansai, Juliana; Silva Farche, Ana Claudia; Carnaz, Leticia; Dalpubel, Daniela; Ferriolli, Eduardo; Assis Carvalho Vale, Francisco; de Medeiros Takahashi, Anielle Cristhine

    2018-03-08

    Cognition and level of physical activity have been associated with frailty syndrome. The development of tools that assess deficits related to physical and cognitive frailties simultaneously are of common interest. However, little is known about how much these aspects influence the performance of dual-task tests. Our aims were (a) to verify the influence of frailty syndrome and objectively measured physical activity and cognition on the Timed Up and Go (TUG) test and Timed Up and Go associated with dual-task (TUG-DT) performances; and (b) to compare TUG and TUG-DT performances between older adults who develop frailty syndrome. Sixty-four community-dwelling older adults were divided into frail, prefrail, and nonfrail groups, according to frailty phenotype. Assessments included anamnesis, screening of frailty syndrome, cognitive assessment (Addenbrooke's cognitive examination), placement of a triaxial accelerometer to assess level of physical activity, and TUG and TUG-DT (TUG associated with a motor-cognitive task of calling a phone number) performances. After 7 days, the accelerometer was removed. A multiple linear regression was applied to identify which independent variables could explain performances in the TUG and TUG-DT. Subsequently, the analysis of covariance test, adjusted for age, cognition, and level of physical activity covariates, was used to compare test performances. There were no differences in cognition between groups. Significant differences in the level of physical activity were found in the frail group. Compared with the frail group, the nonfrail group required less time and fewer steps to complete the TUG. Regarding the TUG-DT, cognition and age influenced the time spent and number of steps, respectively; however, no differences were found between groups. Frail older adults presented worse performance in the TUG when compared with nonfrail older adults. The dual-task test does not differentiate older adults with frailty syndrome, regardless of

  16. [Bacterial parotitis in an immunocompromised patient in adult ICU].

    PubMed

    Vassal, O; Bernet, C; Wallet, F; Friggeri, A; Piriou, V

    2013-09-01

    Bacterial parotitis is a common childhood disease with a favorable outcome. Staphylococcus aureus is the most frequently involved pathogen. Clinical presentation in adult patients can be misleading, Onset occurs in patients with multiple comorbidities, making diagnosis difficult--particularly in ICU. Different pathogens are found in adults with worse outcomes observed. We report here the case of a critically ill patient and discuss diagnosis and management of bacterial parotitis. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  17. Psychological distress among homeless adults.

    PubMed

    Gelberg, L; Linn, L S

    1989-05-01

    Recent studies have reported a high prevalence of mental illness among the homeless. As part of a community-based survey of 529 homeless adults, we developed and tested a model to increase our understanding of the factors related to their psychological distress. Using a previously validated and reliable scale of perceived psychological distress, we found that homeless adults were more likely to report psychological distress than the general population (80% vs. 49%). Distress levels were not associated with most demographic or homeless characteristics or general appearance. However, distress was related to unemployment, greater cigarette and alcohol use, worse physical health, fewer social supports, and perceived barriers to obtaining needed medical care. Since mental, physical, and social health are strongly related among homeless adults, alleviating distress among them may be most effectively done by implementing a broad-based health services package coupled with employment programs provided in an accessible service delivery setting.

  18. Psychometric properties of the Canadian Occupational Performance Measure in home-dwelling older adults.

    PubMed

    Tuntland, Hanne; Aaslund, Mona Kristin; Langeland, Eva; Espehaug, Birgitte; Kjeken, Ingvild

    2016-01-01

    The Canadian Occupational Performance Measure (COPM) is an occupational therapy instrument designed to help participants identify, prioritize, and evaluate performance of important occupations. To investigate the validity, responsiveness, interpretability, and feasibility of the COPM when used by various health professions in home-dwelling older adults receiving reablement. Reablement is a new form of multidisciplinary home-based rehabilitation for older adults experiencing functional decline. The sample of 225 participants, mean age 80.8 years, who were in need of rehabilitation for various health conditions were included in the study. Data collection was conducted at baseline and at 10 weeks follow-up. The COSMIN guidelines and recommendations for evaluating methodological quality were followed. Content validity, construct validity, and feasibility were found to be adequate. Responsiveness, however, was moderate. Functional mobility was the most frequently prioritized occupational category of all. Regarding interpretability, the minimal important change was 3.0 points and 3.2 points for performance and satisfaction, respectively. The older adults reported that COPM was a useful and manageable instrument. The majority of the occupational therapists, physiotherapists, and nurses reported that they had the required expertise to conduct the COPM assessments. The results support the multidisciplinary use of the COPM in clinical practice and research in a home-dwelling, heterogeneous population of older adults. Based on the findings, 3 points are recommended as a cutoff point to distinguish between older adults who have a minimal important change in COPM performance and COPM satisfaction and those who have not.

  19. Event-Based Prospective Memory Is Independently Associated with Self-Report of Medication Management in Older Adults

    PubMed Central

    Woods, Steven Paul; Weinborn, Michael; Maxwell, Brenton R.; Gummery, Alice; Mo, Kevin; Ng, Amanda R. J.; Bucks, Romola S.

    2014-01-01

    Background Identifying potentially modifiable risk factors for medication non-adherence in older adults is important in order to enhance screening and intervention efforts designed to improve medication-taking behavior and health outcomes. The current study sought to determine the unique contribution of prospective memory (i.e., “remembering to remember”) to successful self-reported medication management in older adults. Methods Sixty-five older adults with current medication prescriptions completed a comprehensive research evaluation of sociodemographic, psychiatric, and neurocognitive functioning, which included the Memory for Adherence to Medication Scale (MAMS), Prospective and Retrospective Memory Questionnaire (PRMQ), and a performance-based measure of prospective memory that measured both semantically-related and semantically-unrelated cue-intention (i.e., when-what) pairings. Results A series of hierarchical regressions controlling for biopsychosocial, other neurocognitive, and medication-related factors showed that elevated complaints on the PM scale of the PRMQ and worse performance on an objective semantically-unrelated event-based prospective memory task were independent predictors of poorer medication adherence as measured by the MAMS. Conclusions Prospective memory plays an important role in self-report of successful medication management among older adults. Findings may have implications for screening for older individuals “at risk” of non-adherence, as well as the development of prospective memory-based interventions to improve medication adherence and, ultimately, long-term health outcomes in older adults. PMID:24410357

  20. The Effect of Implicit Stereotypes on the Physical Performance of Older Adults

    ERIC Educational Resources Information Center

    Moriello, Gabriele; Cotter, J. James; Shook, Nathalie; Dodd-McCue, Diane; Welleford, E. Ayn

    2013-01-01

    The purpose of this study was to explore how stereotypes affect physical performance in older adults. During Experiment 1, older adults were primed with objects representing aging stereotypes to determine whether these objects can activate stereotypes of aging. Results from the first part of this study provide evidence that certain material…

  1. Gender differences in performance of script analysis by older adults.

    PubMed

    Helmes, E; Bush, J D; Pike, D L; Drake, D G

    2006-12-01

    Script analysis as a test of executive functions is presumed sensitive to cognitive changes seen with increasing age. Two studies evaluated if gender differences exist in performance on scripts for familiar and unfamiliar tasks in groups of cognitively intact older adults. In Study 1, 26 older adults completed male and female stereotypical scripts. Results were not significant but a tendency was present, with genders making fewer impossible errors on the gender-typical script. Such an interaction was also noted in Study 2, which contrasted 50 older with 50 younger adults on three scripts, including a script with neutral familiarity. The pattern of significant interactions for errors suggested the need to use scripts that are based upon tasks that are equally familiar to both genders.

  2. Sexually transmitted infection testing of adult film performers: is disease being missed?

    PubMed

    Rodriguez-Hart, Cristina; Chitale, Rohit A; Rigg, Robert; Goldstein, Binh Y; Kerndt, Peter R; Tavrow, Paula

    2012-12-01

    Undiagnosed sexually transmitted infections (STIs) may be common in the adult film industry because performers frequently engage in unprotected oral and anal intercourse, STIs are often asymptomatic, and the industry relies on urine-based testing. Between mid-May and mid-September 2010, a consecutive sample of adult film industry performers recruited from a clinic in Los Angeles, California, that provides medical care to performers was offered oropharyngeal, rectal, and urogenital testing for Gonorrhea, and rectal and urogenital testing for Chlamydia. During the 4-month study period, 168 participants were enrolled: 112 (67%) were female and 56 (33%) were male. Of the 47 (28%) who tested positive for Gonorrhea and/or Chlamydia, 11 (23%) cases would not have been detected through urogenital testing alone. Gonorrhea was the most common STI (42/168; 25%) and the oropharynx the most common site of infection (37/47; 79%). Thirty-five (95%) oropharyngeal and 21 (91%) rectal infections were asymptomatic. Few participants reported using condoms consistently while performing or with their personal sex partners. Adult film industry performers had a high burden of STIs. Undiagnosed asymptomatic rectal and oropharyngeal STIs were common and are likely reservoirs for transmission to sexual partners inside and outside the workplace. Performers should be tested at all anatomical sites irrespective of symptoms, and condom use should be enforced to protect workers in this industry.

  3. Recognition of facial, auditory, and bodily emotions in older adults.

    PubMed

    Ruffman, Ted; Halberstadt, Jamin; Murray, Janice

    2009-11-01

    Understanding older adults' social functioning difficulties requires insight into their recognition of emotion processing in voices and bodies, not just faces, the focus of most prior research. We examined 60 young and 61 older adults' recognition of basic emotions in facial, vocal, and bodily expressions, and when matching faces and bodies to voices, using 120 emotion items. Older adults were worse than young adults in 17 of 30 comparisons, with consistent difficulties in recognizing both positive (happy) and negative (angry and sad) vocal and bodily expressions. Nearly three quarters of older adults functioned at a level similar to the lowest one fourth of young adults, suggesting that age-related changes are common. In addition, we found that older adults' difficulty in matching emotions was not explained by difficulty on the component sources (i.e., faces or voices on their own), suggesting an additional problem of integration.

  4. Comparison of masticatory performance and tongue pressure between children and young adults.

    PubMed

    Fujita, Yuko; Ichikawa, Maika; Hamaguchi, Ayako; Maki, Kenshi

    2018-04-01

    The aims of the present study were to evaluate whether there are significant differences in masticatory performance by gender and dental stage. We also determined the factors directly associated with the masticatory performance in children, and those directly associated with masticatory performance in young adults. The study included 180 subjects, ranging in age from 6 to 12 years or 20 to 33 years. The subjects were divided into three groups according to the Hellman developmental stage (III A, III B, or VA); the groups were the subdivided according to gender. The body mass index (BMI), maximum tongue pressure, and sum of decayed, missing, and filled teeth (DMFT) were determined in all subjects. To investigate masticatory performance, the total number and maximum projected area of chewed particles of the jelly materials were measured. Masticatory performance had the highest values at Stage VA in both males and females. Regarding the maximum tongue pressure in females, Stage III B had the highest value of all stages. Multiple regression analysis showed that masticatory performance was associated with DMFT index, maximum tongue pressure, and BMI in children. Among young adults, masticatory performance was associated with DMFT index and maximum tongue pressure. Better masticatory performance is directly associated with better dental status, a higher BMI, and tongue pressure in schoolchildren. Additionally, masticatory performance was well-correlated with tongue pressure in young adults, although maximum tongue pressure reached its peak before Stage VA in females. We suggest that females need training with respect to tongue pressure, by the mixed dentition stage.

  5. Information Processing Differences and Similarities in Adults with Dyslexia and Adults with Attention Deficit Hyperactivity Disorder during a Continuous Performance Test: A Study of Cortical Potentials

    ERIC Educational Resources Information Center

    Dhar, Monica; Been, Pieter H.; Minderaa, Ruud B.; Althaus, Monika

    2010-01-01

    Twenty male adults with ADHD, 16 dyslexic adults, 15 comorbid adults, and 16 normal controls were compared on performance and underlying brain responses, during a cued Continuous Performance Test (O-X CPT), with the aim of discovering features of information processing differentiating between the groups. The study evaluated both cue- and…

  6. Comparison of visual and emotional continuous performance test related to sequence of presentation, gender and age.

    PubMed

    Markovska-Simoska, S; Pop-Jordanova, N

    2009-07-01

    (Full text is available at http://www.manu.edu.mk/prilozi). Continous Performance Tests (CPTs) form a group of paradigms for the evaluation of attention and, to a lesser degree, the response inhibition (or disinhibition) component of executive control. The object of this study was to compare performance on a CPT using both visual and emotional tasks in 46 normal adult subjects. In particular, it was to examine the effects of the type of task (VCPT or ECPT), sequence of presentation, and gender/age influence on performance as measured errors of omission, errors of commission, reaction time and variation of reaction time. From the results we can assume that there are significantly worse performance parameters for ECPT than VCPT tasks, with a probable explanation of the influence of emotional stimuli on attention and information-processing and no significant effect of order of presentation and gender on performance. Significant differences with more omission errors for older groups were obtained, showing better attention in younger subjects. Key words: VCPT, ECPT, omission errors, commission errors, reaction time, variation of reaction time, normal adults.

  7. Environment learning using descriptions or navigation: The involvement of working memory in young and older adults.

    PubMed

    Meneghetti, Chiara; Borella, Erika; Carbone, Elena; Martinelli, Massimiliano; De Beni, Rossana

    2016-05-01

    This study examined age-related differences between young and older adults in the involvement of verbal and visuo-spatial components of working memory (WM) when paths are learned from verbal and visuo-spatial inputs. A sample of 60 young adults (20-30 years old) and 58 older adults (60-75 years old) learned two paths from the person's point of view, one displayed in the form of a video showing the path, the other presenting the path in a verbal description. During the learning phase, participants concurrently performed a verbal task (articulatory suppression, AS group), or a visuo-spatial task (spatial tapping, ST group), or no secondary task (control, C group). After learning each path, participants completed tasks that involved the following: (1) recalling the sequential order and the location of landmarks; and (2) judging spatial sentences as true or false (verification test). The results showed that young adults outperformed older adults in all recall tasks. In both age groups performance in all types of task was worse in the AS and ST groups than in the C group, irrespective of the type of input. Overall, these findings suggest that verbal and visuo-spatial components of WM underpin the processing of environmental information in both young and older adults. The results are discussed in terms of age-related differences and according to the spatial cognition framework. © 2015 The British Psychological Society.

  8. Clinical, Pathological, and Surgical Outcomes for Adult Pineoblastomas.

    PubMed

    Gener, Melissa A; Conger, Andrew R; Van Gompel, Jamie; Ariai, Mohammad S; Jentoft, Mark; Meyer, Fredric B; Cardinal, Jeremy S; Bonnin, José M; Cohen-Gadol, Aaron A

    2015-12-01

    Pineoblastomas are uncommon primitive neuroectodermal tumors that occur mostly in children; they are exceedingly rare in adults. Few published reports have compared the various aspects of these tumors between adults and children. The authors report a series of 12 pineoblastomas in adults from 2 institutions over 24 years. The clinical, radiologic, and pathologic features and clinical outcomes were compared with previously reported cases in children and adults. Patient age ranged from 24 to 81 years, and all but 1 patient exhibited symptoms of obstructive hydrocephalus. Three patients underwent gross total resection, and subtotal resection was performed in 3 patients. Diagnostic biopsy specimens were obtained in an additional 6 patients. Pathologically, the tumors had the classical morphologic and immunohistochemical features of pineoblastomas. Postoperatively, 10 patients received radiotherapy, and 5 patients received chemotherapy. Compared with previously reported cases, several differences were noted in clinical outcomes. Of the 12 patients, only 5 (42%) died of their disease (average length of survival, 118 months); 5 patients (42%) are alive with no evidence of disease (average length of follow-up, 92 months). One patient died of unrelated causes, and one was lost to follow-up. Patients with subtotal resections or diagnostic biopsies did not suffer a worse prognosis. Of the 9 patients with biopsy or subtotal resection, 4 are alive, 4 died of their disease, and 1 died of an unrelated hemorrhagic cerebral infarction. Although this series is small, the data suggest that pineoblastomas in adults have a less aggressive clinical course than in children. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Fatigue, Pain, and other Physical Symptoms of Living Liver Donors in the Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL-2).

    PubMed

    Butt, Zeeshan; DiMartini, Andrea F; Liu, Qian; Simpson, Mary Ann; Smith, Abigail R; Zee, Jarcy; Gillespie, Brenda W; Holtzman, Susan; Ladner, Daniela; Olthoff, Kim; Fisher, Robert A; Hafliger, Silvia; Freise, Chris E; Mandell, Mercedes Susan; Sherker, Averell H; Dew, Mary Amanda

    2018-04-26

    Little is known about living liver donors' perceptions of their physical well-being following the procedure. We collected data on donor fatigue, pain, and other relevant physical outcomes as part of the prospective, multi-center Adult-to-Adult Living Donor Liver Transplantation Cohort Study (A2ALL-2) Consortium. A total of 271 (91%) of 297 eligible donors were interviewed at least once at pre-donation and 3, 6, 12, and 24 months after donation using validated measures, when available. Repeated measures regression models were used to identify potential predictors of worse physical outcomes. We found that donors reported more fatigue immediately after surgery that were returning to pre-donation levels by two years post-donation. A similar pattern was seen across a number of other physical outcomes. Abdominal or back pain and interference from their pain were rated relatively low on average at all study points. However, 21% of donors did report clinically significant pain at some point during post-donation study follow-up. Across multiple outcomes, female donors, donors whose recipients died, donors with longer hospital stays after surgery, and those whose families discouraged donation were at risk for worse physical well-being outcomes. While not readily modifiable, we have identified risk factors that may help identify donors at risk for worse physical outcomes for targeted intervention. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

  10. Arizona Adult Education Annual Performance Report. Fiscal Year 1993.

    ERIC Educational Resources Information Center

    Arizona State Dept. of Education, Phoenix. Div. of Adult Education.

    This annual performance report on Arizona adult education begins with 3 pages of financial reports and statistical information presented in 9 tables and 19 charts. Tables and charts depict the following: participants by class type, age group, ethnic background, student progress, reason for separation before completion, and status; sites with…

  11. Dose-response effects of water supplementation on cognitive performance and mood in children and adults.

    PubMed

    Edmonds, Caroline J; Crosbie, Laura; Fatima, Fareeha; Hussain, Maryam; Jacob, Nicole; Gardner, Mark

    2017-01-01

    Water supplementation has been found to facilitate visual attention and short-term memory, but the dose required to improve performance is not yet known. We assessed the dose response effect of water on thirst, mood and cognitive performance in both adults and children. Participants were offered either no water, 25 ml or 300 ml water to drink. Study 1 assessed 96 adults and in Study 2, data are presented from 60 children aged 7-9 years. In both studies, performance was assessed at baseline and 20 min after drinking (or no drink); on thirst and mood scales, letter cancellation and a digit span test. For both children and adults, a large drink (300 ml) was necessary to reduce thirst, while a small drink (25 ml) was sufficient to improve visual attention (letter cancellation). In adults, a large drink improved digit span, but there was no such effect in children. In children, but not adults, a small drink resulted in increased thirst ratings. Both children and adults show dose-response effects of drinking on visual attention. Visual attention is enhanced by small amounts of fluid and appears not to be contingent on thirst reduction. Memory performance may be related to thirst, but differently for children and adults. These contrasting dose-response characteristics could imply cognitive enhancement by different mechanisms for these two domains. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Psychometric properties of the Canadian Occupational Performance Measure in home-dwelling older adults

    PubMed Central

    Tuntland, Hanne; Aaslund, Mona Kristin; Langeland, Eva; Espehaug, Birgitte; Kjeken, Ingvild

    2016-01-01

    Background The Canadian Occupational Performance Measure (COPM) is an occupational therapy instrument designed to help participants identify, prioritize, and evaluate performance of important occupations. Objective To investigate the validity, responsiveness, interpretability, and feasibility of the COPM when used by various health professions in home-dwelling older adults receiving reablement. Reablement is a new form of multidisciplinary home-based rehabilitation for older adults experiencing functional decline. Participants and methods The sample of 225 participants, mean age 80.8 years, who were in need of rehabilitation for various health conditions were included in the study. Data collection was conducted at baseline and at 10 weeks follow-up. The COSMIN guidelines and recommendations for evaluating methodological quality were followed. Results Content validity, construct validity, and feasibility were found to be adequate. Responsiveness, however, was moderate. Functional mobility was the most frequently prioritized occupational category of all. Regarding interpretability, the minimal important change was 3.0 points and 3.2 points for performance and satisfaction, respectively. The older adults reported that COPM was a useful and manageable instrument. The majority of the occupational therapists, physiotherapists, and nurses reported that they had the required expertise to conduct the COPM assessments. Conclusion The results support the multidisciplinary use of the COPM in clinical practice and research in a home-dwelling, heterogeneous population of older adults. Based on the findings, 3 points are recommended as a cutoff point to distinguish between older adults who have a minimal important change in COPM performance and COPM satisfaction and those who have not. PMID:27621647

  13. Adult cognitive outcomes following childhood mild traumatic brain injuries.

    PubMed

    Yumul, Joy Noelle; McKinlay, Audrey

    2017-10-01

    To investigate the adult cognitive outcomes of one versus multiple childhood mTBI and to examine the potential predictors of the outcomes. Review of neurosurgical files and hospital records, as well as community recruitment, yielded 169 participants, who were injured between ages 0-17 years and assessed between ages 18-30 years with at least five years post-injury. Each participant underwent a three-hour assessment. For data analysis, participants were grouped by type and number of injury. The mTBI group exhibited some cognitive deficits but their performance fell between the control and moderate/severe TBI groups as expected. Those with one and multiple mTBI performed comparably across all cognitive domains. Cognitive outcomes were significantly predicted by estimated IQ but not by number of mTBI and age at injury. Despite the detected cognitive deficits, those who sustained multiple mTBI did not exhibit worse or cumulative deficits compared to those with one mTBI.

  14. Neural Correlates Associated with Successful Working Memory Performance in Older Adults as Revealed by Spatial ICA

    PubMed Central

    Saliasi, Emi; Geerligs, Linda; Lorist, Monicque M.; Maurits, Natasha M.

    2014-01-01

    To investigate which neural correlates are associated with successful working memory performance, fMRI was recorded in healthy younger and older adults during performance on an n-back task with varying task demands. To identify functional networks supporting working memory processes, we used independent component analysis (ICA) decomposition of the fMRI data. Compared to younger adults, older adults showed a larger neural (BOLD) response in the more complex (2-back) than in the baseline (0-back) task condition, in the ventral lateral prefrontal cortex (VLPFC) and in the right fronto-parietal network (FPN). Our results indicated that a higher BOLD response in the VLPFC was associated with increased performance accuracy in older adults, in both the baseline and the more complex task condition. This ‘BOLD-performance’ relationship suggests that the neural correlates linked with successful performance in the older adults are not uniquely related to specific working memory processes present in the complex but not in the baseline task condition. Furthermore, the selective presence of this relationship in older but not in younger adults suggests that increased neural activity in the VLPFC serves a compensatory role in the aging brain which benefits task performance in the elderly. PMID:24911016

  15. Making Decisions about Adult Learners Based on Performances on Functional Competency Measures.

    ERIC Educational Resources Information Center

    Bunch, Michael B.

    The validity and dependability of functional competency tests for adults are examined as they relate to the information needs of instructional decision makers. Test data from the Adult Performance Level (APL) Program (funded by the U.S. Office of Education at the University of Texas at Austin) is used to illustrate key points. In the discussion of…

  16. Neuroimaging explanations of age-related differences in task performance.

    PubMed

    Steffener, Jason; Barulli, Daniel; Habeck, Christian; Stern, Yaakov

    2014-01-01

    Advancing age affects both cognitive performance and functional brain activity and interpretation of these effects has led to a variety of conceptual research models without always explicitly linking the two effects. However, to best understand the multifaceted effects of advancing age, age differences in functional brain activity need to be explicitly tied to the cognitive task performance. This work hypothesized that age-related differences in task performance are partially explained by age-related differences in functional brain activity and formally tested these causal relationships. Functional MRI data was from groups of young and old adults engaged in an executive task-switching experiment. Analyses were voxel-wise testing of moderated-mediation and simple mediation statistical path models to determine whether age group, brain activity and their interaction explained task performance in regions demonstrating an effect of age group. Results identified brain regions whose age-related differences in functional brain activity significantly explained age-related differences in task performance. In all identified locations, significant moderated-mediation relationships resulted from increasing brain activity predicting worse (slower) task performance in older but not younger adults. Findings suggest that advancing age links task performance to the level of brain activity. The overall message of this work is that in order to understand the role of functional brain activity on cognitive performance, analysis methods should respect theoretical relationships. Namely, that age affects brain activity and brain activity is related to task performance.

  17. Memory is preserved in older adults taking AT1 receptor blockers.

    PubMed

    Ho, Jean K; Nation, Daniel A

    2017-04-26

    Prior work suggests that some but not all antihypertensive treatments may benefit cognition and risk for Alzheimer's disease, independent of stroke. Angiotensin II receptor blockers (ARBs) have been highlighted as one antihypertensive drug class that may confer greatest benefit. The participants comprised 1626 nondemented adults, aged 55-91 years, recruited from Alzheimer's Disease Neuroimaging Initiative sites. Three groups were compared: ARB users (HTN-ARBs), other antihypertensive drug users (HTN-Other), and normotensives. In post hoc analyses, we also examined (1) users of ARBs and angiotensin-converting enzyme inhibitors (ACEIs), (2) users of blood-brain barrier (BBB)-crossing ARBs and users of non-BBB-crossing ARBs, and (3) users of BBB-crossing ARBs and ACEIs (BBB crossers) and users of non-BBB-crossing ARBs and ACEIs (BBB noncrossers). Groups were compared regarding cognition and magnetic resonance imaging measures of brain volume and white matter hyperintensities (WMH), using analysis of covariance and multilevel models. At baseline, the HTN-Other group performed worse than normotensives on Rey Auditory Verbal Learning Test (RAVLT) Immediate Recall (p = 0.002), Delayed Recall (p < 0.001), Recognition Memory (p = 0.001), and Trails A (p < 0.001) and B (p = 0.01). ARB users performed better than the HTN-Other group on Recognition Memory (p = 0.04) and worse than normotensives on Trails A (p = 0.04). The HTN-Other group performed worse than normotensives on Logical Memory Immediate (p = 0.02) and Delayed Recall over the 3-year follow-up (p = 0.007). Over the follow-up period, those taking BBB-crossing ARBs performed better than the HTN-Other group on AVLT Delayed Recall (p = 0.04), Logical Memory Immediate (p = 0.02), and Delayed Recall (p = 0.05). They also had fewer WMH than the HTN-Other group (p = 0.008) and those taking non-BBB-crossing ARBs (p = 0.05). There were no group differences in brain

  18. Differential involvement of knowledge representation and executive control in episodic memory performance in young and older adults.

    PubMed

    Bouazzaoui, Badiâa; Fay, Séverine; Taconnat, Laurence; Angel, Lucie; Vanneste, Sandrine; Isingrini, Michel

    2013-06-01

    Craik and Bialystok (2006, 2008) postulated that examining the evolution of knowledge representation and control processes across the life span could help in understanding age-related cognitive changes. The present study explored the hypothesis that knowledge representation and control processes are differentially involved in the episodic memory performance of young and older adults. Young and older adults were administered a cued-recall task and tests of crystallized knowledge and executive functioning to measure representation and control processes, respectively. Results replicate the classic finding that executive and cued-recall performance decline with age, but crystallized-knowledge performance does not. Factor analysis confirmed the independence of representation and control. Correlation analyses showed that the memory performance of younger adults was correlated with representation but not with control measures, whereas the memory performance of older adults was correlated with both representation and control measures. Regression analyses indicated that the control factor was the main predictor of episodic-memory performance for older adults, with the representation factor adding an independent contribution, but the representation factor was the sole predictor for young adults. This finding supports the view that factors sustaining episodic memory vary from young adulthood to old age; representation was shown to be important throughout adulthood, and control was also important for older adults. The results also indicated that control and representation modulate age-group-related variance in episodic memory.

  19. Risky Decision Making Assessed With the Gambling Task in Adults with HIV

    PubMed Central

    Hardy, David J.; Hinkin, Charles H.; Castellon, Steven A.; Levine, Andrew J.; Lam, Mona N.

    2010-01-01

    Decision making was assessed using a laboratory gambling task in 67 adults with the Human Immunodeficiency Virus (HIV+) and in 19 HIV-seronegative (HIV−) control participants. Neurocognitive test performance across several domains was also analyzed to examine potential cognitive mechanisms of gambling task performance. As predicted, the HIV+ group performed worse on the gambling task, indicating greater risky decision making. Specifically, the HIV+ group selected more cards from the “risky” or disadvantageous deck that included relatively large payoffs but infrequent large penalties. The control group also selected such risky cards but quickly learned to avoid them. Exploratory analyses also indicated that in the HIV+ group, but not in the control group, gambling task performance was correlated with Stroop Interference performance and long delay free recall on the California Verbal Learning Test, suggesting the role of inhibitory processes and verbal memory in the poorer gambling task performance in HIV. These findings indicate the usefulness of the gambling task as a laboratory tool to examine risky decision making and cognition in the HIV population. PMID:16719628

  20. Task Monotony and Performance Efficacy of Mentally Retarded Young Adults.

    ERIC Educational Resources Information Center

    Locke, Bill J.; And Others

    1982-01-01

    Thirty-six mildly mentally retarded young adults were exposed to one of three training arrangements for vigilance performance, a monitoring task that some professionals consider uniquely appropriate for such persons because they are assumed to be less susceptible to boredom. (Author)

  1. Contributions to lateral balance control in ambulatory older adults.

    PubMed

    Sparto, Patrick J; Newman, A B; Simonsick, E M; Caserotti, P; Strotmeyer, E S; Kritchevsky, S B; Yaffe, K; Rosano, C

    2018-06-01

    In older adults, impaired control of standing balance in the lateral direction is associated with the increased risk of falling. Assessing the factors that contribute to impaired standing balance control may identify areas to address to reduce falls risk. To investigate the contributions of physiological factors to standing lateral balance control. Two hundred twenty-two participants from the Pittsburgh site of the Health, Aging and Body Composition Study had lateral balance control assessed using a clinical sensory integration balance test (standing on level and foam surface with eyes open and closed) and a lateral center of pressure tracking test using visual feedback. The center of pressure was recorded from a force platform. Multiple linear regression models examined contributors of lateral control of balance performance, including concurrently measured tests of lower extremity sensation, knee extensor strength, executive function, and clinical balance tests. Models were adjusted for age, body mass index, and sex. Larger lateral sway during the sensory integration test performed on foam was associated with longer repeated chair stands time. During the lateral center of pressure tracking task, the error in tracking increased at higher frequencies; greater error was associated with worse executive function. The relationship between sway performance and physical and cognitive function differed between women and men. Contributors to control of lateral balance were task-dependent. Lateral standing performance on an unstable surface may be more dependent upon general lower extremity strength, whereas visual tracking performance may be more dependent upon cognitive factors. Lateral balance control in ambulatory older adults is associated with deficits in strength and executive function.

  2. Effect of gender on the hearing performance of adult cochlear implant patients.

    PubMed

    Lenarz, Minoo; Sönmez, Hasibe; Joseph, Gert; Büchner, Andreas; Lenarz, Thomas

    2012-05-01

    To evaluate the role of gender on the hearing performance of postlingually deafened adult patients with cochlear implants. Individual retrospective cohort study. There were 638 postlingually deafened adults (280 men and 358 women) selected for a retrospective evaluation of their hearing performance with cochlear implants. Both genders underwent the same surgical and rehabilitative procedures and benefited from the latest technological advances available. There was no significant difference in the age, duration of deafness, and preoperative hearing performance between the genders. The test battery was composed of the Freiburger Monosyllabic Test, Speech Tracking, and the Hochmair-Schulz-Moser (HSM) sentence test in quiet and in 10-dB noise. The results of 5 years of follow-up are presented here. Genders showed a similar performance in Freiburger Monosyllabic Test and Speech Tracking Test. However, in the HSM test in noise, men performed slightly better than women in all of the follow-up sessions, which was statistically significant at 2 and 4 years after implantation. Although normal-hearing women use more predictive cognitive strategies in speech comprehension and are supposed to have a more efficient declarative memory system, this may not necessarily lead to a better adaptation to the altered auditory information delivered by a cochlear implant. Our study showed that in more complex listening situations such as speech tests in noise, men tend to perform slightly better than women. Gender may have an influence on the hearing performance of postlingually deafened adults with cochlear implants. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  3. Omission bias and perceived intention in children and adults.

    PubMed

    Hayashi, Hajimu

    2015-06-01

    Omission bias refers to the tendency to judge acts of commission as morally worse than equivalent acts of omission. Children aged 7-8 and 11-12 years, as well as adults, made moral judgements about acts of commission and omission in two conditions in which the protagonist obtained a self-directed benefit. In the antisocial condition, the other person was harmed; in the selfish condition, the other person was not harmed. The results showed that adults and both age groups of children judged that the agent who did something (act of commission) was morally worse than the agent who did nothing (omission) for both antisocial and selfish conditions, although this judgement tendency was clearer in the selfish condition than in the antisocial condition. Agent intention was held constant across commission and omission, but most participants rated the intention of the agent who did something as stronger than that of the agent who did nothing. These results suggest that omission bias occurs regardless of differences in age and situation. In addition, perceived intention appears to change in conjunction with omission bias. © 2015 The British Psychological Society.

  4. Responsiveness of performance-based outcome measures for mobility, balance, muscle strength and manual dexterity in adults with myotonic dystrophy type 1.

    PubMed

    Kierkegaard, Marie; Petitclerc, Émilie; Hébert, Luc J; Mathieu, Jean; Gagnon, Cynthia

    2018-02-28

    To assess changes and responsiveness in outcome measures of mobility, balance, muscle strength and manual dexterity in adults with myotonic dystrophy type 1. A 9-year longitudinal study conducted with 113 patients. The responsiveness of the Timed Up and Go test, Berg Balance Scale, quantitative muscle testing, grip and pinch-grip strength, and Purdue Pegboard Test was assessed using criterion and construct approaches. Patient-reported perceived changes (worse/stable) in balance, walking, lower-limb weakness, stair-climbing and hand weakness were used as criteria. Predefined hypotheses about expected area under the receiver operating characteristic curves (criterion approach) and correlations between relative changes (construct approach) were explored. The direction and magnitude of median changes in outcome measures corresponded with patient-reported changes. Median changes in the Timed Up and Go test, grip strength, pinch-grip strength and Purdue Pegboard Test did not, in general, exceed known measurement errors. Most criterion (72%) and construct (70%) approach hypotheses were supported. Promising responsiveness was found for outcome measures of mobility, balance and muscle strength. Grip strength and manual dexterity measures showed poorer responsiveness. The performance-based outcome measures captured changes over the 9-year period and responsiveness was promising. Knowledge of measurement errors is needed to interpret the meaning of these longitudinal changes.

  5. Optimal control theory for non-scalar-valued performance criteria. Ph.D. Thesis

    NASA Technical Reports Server (NTRS)

    Gerring, H. P.

    1971-01-01

    The theory of optimal control for nonscalar-valued performance criteria is discussed. In the space, where the performance criterion attains its value, the relations better than, worse than, not better than, and not worse than are defined by a partial order relation. The notion of optimality splits up into superiority and non-inferiority, because worse than is not the complement of better than, in general. A superior solution is better than every other solution. A noninferior solution is not worse than any other solution. Noninferior solutions have been investigated particularly for vector-valued performance criteria. Superior solutions for non-scalar-valued performance criteria attaining their values in abstract partially ordered spaces are emphasized. The main result is the infimum principle which constitutes necessary conditions for a control to be a superior solution to an optimal control problem.

  6. Measuring Literacy: Performance Levels for Adults

    ERIC Educational Resources Information Center

    Hauser, Robert M., Ed.; Edley, Christopher F., Jr., Ed.; Koenig, Judith Anderson, Ed.; Elliott, Stuart W., Ed.

    2005-01-01

    The National Assessment of Adult Literacy (NAAL) is a household survey conducted periodically by the Department of Education that evaluates the literacy skills of a sample of adults in the United Stages ages 16 and older. NAAL results are used to characterize adults literacy skills and to inform policy and programmatic decisions. The Committee on…

  7. Assessing the driving performance of older adult drivers: on-road versus simulated driving.

    PubMed

    Lee, Hoe C; Cameron, Don; Lee, Andy H

    2003-09-01

    To validate a laboratory-based driving simulator in measuring on-road driving performance, 129 older adult drivers were assessed with both the simulator and an on-road test. The driving performance of the participants was gauged by appropriate and reliable age-specific assessment criteria, which were found to be negatively correlated with age. Using principal component analysis, two performance indices were developed from the criteria to represent the overall performance in simulated driving and the on-road assessment. There was significant positive association between the two indices, with the simulated driving performance index explaining over two-thirds of the variability of the on-road driving performance index, after adjustment for age and gender of the drivers. The results supported the validity of the driving simulator and it is a safer and more economical method than the on-road testing to assess the driving performance of older adult drivers.

  8. Assessment of Driving Safety in Older Adults with Mild Cognitive Impairment.

    PubMed

    Anstey, Kaarin J; Eramudugolla, Ranmalee; Chopra, Sidhant; Price, Jasmine; Wood, Joanne M

    2017-01-01

    With population aging, drivers with mild cognitive impairment (MCI) are increasing; however, there is little evidence available regarding their safety. We aimed to evaluate risk of unsafe on-road driving performance among older adults with MCI. The study was a cross-sectional observational study, set in Canberra, Australia. Participants were non-demented, current drivers (n = 302) aged 65 to 96 years (M = 75.7, SD = 6.18, 40% female) recruited through the community and primary and tertiary care clinics. Measures included a standardized on-road driving test (ORT), a battery of screening measures designed to evaluate older driver safety (UFOV®, DriveSafe, Multi-D), a neurocognitive test battery, and questionnaires on driving history and behavior. Using Winblad criteria, 57 participants were classified as having MCI and 245 as cognitively normal (CN). While the MCI group had a significantly lower overall safety rating on the ORT (5.61 versus 6.05, p = 0.03), there was a wide range of driving safety scores in the CN and MCI groups. The MCI group performed worse than the CN group on the off-road screening tests. The best fitting model of predictors of ORT performance across the combined sample included age, the Multi-D, and DriveSafe, classifying 90.4% of the sample correctly. Adults with MCI exhibit a similar range of driving ability to CN adults, although on average they scored lower on off-road and on-road assessments. Driving specific tests were more strongly associated with safety ratings than traditional neuropsychological tests.

  9. Assessment of Driving Safety in Older Adults with Mild Cognitive Impairment

    PubMed Central

    Anstey, Kaarin J.; Eramudugolla, Ranmalee; Chopra, Sidhant; Price, Jasmine; Wood, Joanne M.

    2017-01-01

    Background: With population aging, drivers with mild cognitive impairment (MCI) are increasing; however, there is little evidence available regarding their safety. Objective: We aimed to evaluate risk of unsafe on-road driving performance among older adults with MCI. Method: The study was a cross-sectional observational study, set in Canberra, Australia. Participants were non-demented, current drivers (n = 302) aged 65 to 96 years (M = 75.7, SD = 6.18, 40% female) recruited through the community and primary and tertiary care clinics. Measures included a standardized on-road driving test (ORT), a battery of screening measures designed to evaluate older driver safety (UFOV®, DriveSafe, Multi-D), a neurocognitive test battery, and questionnaires on driving history and behavior. Results: Using Winblad criteria, 57 participants were classified as having MCI and 245 as cognitively normal (CN). While the MCI group had a significantly lower overall safety rating on the ORT (5.61 versus 6.05, p = 0.03), there was a wide range of driving safety scores in the CN and MCI groups. The MCI group performed worse than the CN group on the off-road screening tests. The best fitting model of predictors of ORT performance across the combined sample included age, the Multi-D, and DriveSafe, classifying 90.4% of the sample correctly. Conclusion: Adults with MCI exhibit a similar range of driving ability to CN adults, although on average they scored lower on off-road and on-road assessments. Driving specific tests were more strongly associated with safety ratings than traditional neuropsychological tests. PMID:28372333

  10. Association between educational status and dual-task performance in young adults.

    PubMed

    Voos, Mariana Callil; Pimentel Piemonte, Maria Elisa; Castelli, Lilian Zanchetta; Andrade Machado, Mariane Silva; Dos Santos Teixeira, Patrícia Pereira; Caromano, Fátima Aparecida; Ribeiro Do Valle, Luiz Eduardo

    2015-04-01

    The influence of educational status on perceptual-motor performance has not been investigated. The single- and dual-task performances of 15 Low educated adults (9 men, 6 women; M age=24.1 yr.; 6-9 yr. of education) and 15 Higher educated adults (8 men, 7 women; M age=24.7 yr.; 10-13 yr. of education) were compared. The perceptual task consisted of verbally classifying two figures (equal or different). The motor task consisted of alternating steps from the floor to a stool. Tasks were assessed individually and simultaneously. Two analyses of variance (2 groups×4 blocks) compared the errors and steps. The Low education group committed more errors and had less improvement on the perceptual task than the High education group. During and after the perceptual-motor task performance, errors increased only in the Low education group. Education correlated to perceptual and motor performance. The Low education group showed more errors and less step alternations on the perceptual-motor task compared to the High education group. This difference on the number of errors was also observed after the dual-task, when the perceptual task was performed alone.

  11. Assessing Cognitive Ability and Simulator-Based Driving Performance in Poststroke Adults

    PubMed Central

    Falkmer, Torbjörn; Willstrand, Tania Dukic

    2017-01-01

    Driving is an important activity of daily living, which is increasingly relied upon as the population ages. It has been well-established that cognitive processes decline following a stroke and these processes may influence driving performance. There is much debate on the use of off-road neurological assessments and driving simulators as tools to predict driving performance; however, the majority of research uses unlicensed poststroke drivers, making the comparability of poststroke adults to that of a control group difficult. It stands to reason that in order to determine whether simulators and cognitive assessments can accurately assess driving performance, the baseline should be set by licenced drivers. Therefore, the aim of this study was to assess differences in cognitive ability and driving simulator performance in licensed community-dwelling poststroke drivers and controls. Two groups of licensed drivers (37 poststroke and 43 controls) were assessed using several cognitive tasks and using a driving simulator. The poststroke adults exhibited poorer cognitive ability; however, there were no differences in simulator performance between groups except that the poststroke drivers demonstrated less variability in driver headway. The application of these results as a prescreening toolbox for poststroke drivers is discussed. PMID:28559646

  12. Cognitive performance in childhood and early adult illness: a prospective cohort study

    PubMed Central

    Martin, L.; Fitzmaurice, G.; Kindlon, D.; Buka, S.

    2004-01-01

    Study objective: To evaluate whether cognitive performance in childhood is an early determinant of adult illness. Design: Prospective cohort study covering over 30 years. Setting: Providence, Rhode Island, USA. Participants: 633 people ages 30–39 followed up since birth as part of the Providence cohort of the national collaborative perinatal project. Main results: Higher cognitive performance at age 7 was related to a significantly reduced risk of serious illness in adulthood, OR = 0.65 (95%CI: 0.47 to 0.89) for a one standard deviation (15 point) increase in IQ score. This association was independent of both parental socioeconomic status and participant's attained level of education. Conclusions: General cognitive performance may be an important and informative early determinant of adult health. Further evaluation of this association and mechanisms linking cognitive performance and health may provide new and innovative strategies to improve disease management and reduce morbidity. PMID:15252070

  13. An Acute Bout of Exercise Improves the Cognitive Performance of Older Adults.

    PubMed

    Johnson, Liam; Addamo, Patricia K; Selva Raj, Isaac; Borkoles, Erika; Wyckelsma, Victoria; Cyarto, Elizabeth; Polman, Remco C

    2016-10-01

    There is evidence that an acute bout of exercise confers cognitive benefits, but it is largely unknown what the optimal mode and duration of exercise is and how cognitive performance changes over time after exercise. We compared the cognitive performance of 31 older adults using the Stroop test before, immediately after, and at 30 and 60 min after a 10 and 30 min aerobic or resistance exercise session. Heart rate and feelings of arousal were also measured before, during, and after exercise. We found that, independent of mode or duration of exercise, the participants improved in the Stroop Inhibition task immediately postexercise. We did not find that exercise influenced the performance of the Stroop Color or Stroop Word Interference tasks. Our findings suggest that an acute bout of exercise can improve cognitive performance and, in particular, the more complex executive functioning of older adults.

  14. Exploring Discordance between Self-Efficacy and Writing Performance among Low-Literate Adult Students

    ERIC Educational Resources Information Center

    Anastasiou, Dimitris; Michail, Domna

    2013-01-01

    The paper explores accordance or discordance between efficacy beliefs of adult students and their writing performance, using a mixed methods design. The participants are 33 students with learning disabilities (LD) and 35 low-achieving (LA) students, who were attending two Second-Chance Schools (SCSs), a specific type of adult education.…

  15. [Association between sleep and leukocyte telomere length in middle-aged and older adults].

    PubMed

    Liu, H F; Li, F; Wang, Y H; Chen, J H; Peng, D X; Chen, J; Tan, L H; Mi, X; Zhao, B H

    2017-07-10

    Objective: To understand the association between peripheral leukocytes telomere length (TL) and sleep in middle-aged and old adults. Methods: A total of 176 middle-aged and old adults were investigated by using the Pittsburgh Sleep Quality Index and questionnaire. TL was measured by fluorescence quantitative PCR. The correlation and regression analysis between sleep and telomere length was performed. Results: TL had a mean T/S ratio of 0.995±0.23. There was a negative correlation between TL and age ( r =-0.241, P =0.003). With increasing age, sleep quality became worse ( r =-0.230, P <0.01), the time to fall asleep became longer ( r =0.227, P <0.01), sleep duration was shorter ( r =-0.486, P <0.01), sleep efficiency became worse ( r =-0.226, P <0.01). After controlling for the effects of gender, age, marital status, income level, residence, smoking, drinking, physical exercise and disease status, multiple linear regression analysis indicated that sleep quality ( β =0.057, P <0.01), time to fall asleep ( β =-0.046, P <0.01), sleep duration ( β =0.086, P <0.01) were independent influencing factors of telomere length, suggesting that the people who had better sleep quality, the shorter time to fall asleep, the longer sleep time would have longer telomere length. Conclusions: Sleep is a relevant factor affecting TL in middle-aged and elderly population. Good sleep may delay aging by slowing TL. We encourage to conduct health education about the importance of sleep quality in community.

  16. Visual Memory in Post-Anterior Right Temporal Lobectomy Patients and Adult Normative Data for the Brown Location Test (BLT)

    PubMed Central

    Brown, Franklin C.; Tuttle, Erin; Westerveld, Michael; Ferraro, F. Richard; Chmielowiec, Teresa; Vandemore, Michelle; Gibson-Beverly, Gina; Bemus, Lisa; Roth, Robert M.; Blumenfeld, Hal; Spencer, Dennis D.; Spencer, Susan S

    2010-01-01

    Several large and meta-analytic studies have failed to support a consistent relationship between visual or “nonverbal” memory deficits and right mesial temporal lobe changes. However, the Brown Location Test (BLT) is a recently developed dot location learning and memory test that uses a nonsymmetrical array and provides control over many of the confounding variables (e.g., verbal influence and drawing requirements) inherent in other measures of visual memory. In the present investigation, we evaluated the clinical utility of the BLT in patients who had undergone left or right anterior mesial temporal lobectomies. We also provide adult normative data of 298 healthy adults in order to provide standardized scores. Results revealed significantly worse performance on the BLT in the right as compared to left lobectomy group and the healthy adult normative sample. The present findings support a role for the right anterior-mesial temporal lobe in dot location learning and memory. PMID:20056493

  17. The Effect of Art Therapy on Cognitive Performance among Ethnically Diverse Older Adults

    ERIC Educational Resources Information Center

    Pike, Amanda Alders

    2013-01-01

    This study examined the effect of art therapy on the cognitive performance of a multisite, ethnically diverse sample ("N" = 91) of older adults. Participants were recruited from several U.S. facilities that included a community center, a retirement center, an adult daycare, an assisted living facility, and a skilled nursing facility.…

  18. Memory performance and affect: are there gender differences in community-residing older adults?

    PubMed

    McDougall, Graham Joseph; Pituch, Keenan A; Stanton, Marietta P; Chang, Wanchen

    2014-08-01

    After age 65, the incidence of episodic memory decline in males is greater than in females. We explored the influence of anxiety and depression on objective and subjective memory performance in a diverse sample of community-residing older adults. The study was a secondary analysis of data on three samples of adults from two states, Ohio and Texas: a community sample (n = 177); a retirement community sample (n = 97); and the SeniorWISE Study (n = 265). The sample of 529 adults was 74% female, the average age was 76.58 years (range = 59-100 years), and educational attainment was 13.12 years (±3.68); 68% were Caucasian, and 17% had depressive symptoms. We found no memory performance differences by gender. Males and females were similarly classified into the four memory performance groups, with almost half of each gender in the poor memory category. Even though males had greater years of education, they used fewer compensatory memory strategies. The observed gender differences in memory were subjective evaluations, specifically metamemory. Age was not a significant predictor of cognition or memory performance, nor did males have greater memory impairment than females.

  19. The Decoy Effect as a Nudge: Boosting Hand Hygiene With a Worse Option.

    PubMed

    Li, Meng; Sun, Yan; Chen, Hui

    2018-05-01

    This article provides the first test of the decoy effect as a nudge to influence real-world behavior. The decoy effect is the phenomenon that an additional but worse option can boost the appeal of an existing option. It has been widely demonstrated in hypothetical choices, but its usefulness in real-world settings has been subject to debate. In three longitudinal experiments in food-processing factories, we tested two decoy sanitation options that were worse than the existing sanitizer spray bottle. Results showed that the presence of a decoy, but not an additional copy of the original sanitizer bottle in a different color, drastically increased food workers' hand sanitizer use from the original sanitizer bottle and, consequently, improved workers' passing rate in hand sanitary tests from 60% to 70% to above 90% for 20 days. These findings indicate that the decoy effect can be a powerful nudge technique to influence real-world behavior.

  20. Older adults utilize less efficient postural control when performing pushing task

    PubMed Central

    Lee, Yun-Ju; Chen, Bing; Aruin, Alexander S.

    2015-01-01

    The ability to maintain balance deteriorates with increasing age. The aim was to investigate the role of age in generation of anticipatory (APA) and compensatory (CPA) postural adjustments during pushing an object. Older (68.8 ± 1.0 years) and young adults (30.1 ± 1.4 years) participated in the experiment involving pushing an object (a pendulum attached to the ceiling) using both hands. Electrical activity of six leg and trunk muscles and displacements of the center of pressure (COP) were recorded and analyzed during the APA and CPA phases. The onset time, integrals of muscle activity, and COP displacements were determined. In addition, the indexes of co-activation and reciprocal activation of muscles for the shank, thigh, and trunk segments were calculated. Older adults, compared to young adults, showed less efficient postural control seen as delayed anticipatory muscle onset times and delayed COP displacements. Moreover, older adults used co-activation of muscles during the CPA phase while younger subjects utilized reciprocal activation of muscles. The observed diminished efficiency of postural control during both anticipatory and compensatory postural adjustments observed in older adults might predispose them to falls while performing tasks involving pushing. The outcome provides a background for future studies focused on the optimization of the daily activities of older adults. PMID:26403099

  1. Monaural or binaural sound deprivation in postlingual hearing loss: Cochlear implant in the worse ear.

    PubMed

    Canale, Andrea; Dalmasso, Giulia; Dagna, Federico; Lacilla, Michelangelo; Montuschi, Carla; Rosa, Rosalba Di; Albera, Roberto

    2016-08-01

    To determine whether speech recognition scores (SRS) differ between adults with long-term auditory deprivation in the implanted ear and adults who received cochlear implant (CI) in the nonsound-deprived ear, either for hearing aid-assisted or due to rapidly deteriorating hearing loss. Retrospective study. Speech recognition scores at evaluations (3 and 14 months postimplantation) conducted with CI alone at 60-dB sound pressure level intensity were compared in 15 patients (4 with bilateral severe hearing loss; 11 with asymmetric hearing loss, 7 of which had contralateral hearing aid), all with long-term auditory deprivation (mean duration 16.9 years) (group A), and in 15 other patients with postlingual hearing loss (10 symmetric, 5 asymmetric with bimodal stimulation) (controls, group B). Comparison of mean percentage of correctly recognized words on speech audiometry at 3 and 14 months showed improvement within each group (P < 0.05). Between-group comparison showed no significant difference at 3 (P = 0.17) or 14 months (P = 0.46). Comparison of SRSs in group A (bimodal stimulation [n = 7] and binaural sound deprivation [n = 4]) versus group B showed no significant differences at 3 (bimodal stimulation P = 0.16; binaural sound deprivation P = 0.19) or 14 months (bimodal stimulation P = 0.14; binaural sound deprivation P = 0.82). Speech recognition scores in monaural and binaural sound-deprived ears did not significantly differ from ears with unilateral cochlear implantation in nonsound-deprived ears when tested with CI alone. Improvement in the implanted worse ear indicates that it could be a potential candidate ear for cochlear implantation even when sound deprived. 4. Laryngoscope, 126:1905-1910, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  2. Performance pay improves engagement, progress, and satisfaction in computer-based job skills training of low-income adults

    PubMed Central

    Koffarnus, Mikhail N.; DeFulio, Anthony; Sigurdsson, Sigurdur O.; Silverman, Kenneth

    2018-01-01

    Advancing the education of low-income adults could increase employment and income, but adult education programs have not successfully engaged low-income adults. Monetary reinforcement may be effective in promoting progress in adult education. This experiment evaluated the benefits of providing incentives for performance in a job-skills training program for low-income, unemployed adults. Participants worked on Typing and Keypad programs for 7 months. Participants randomly assigned to Group A (n=23) earned hourly and productivity pay on the Typing program (Productivity Pay), but earned only equalized hourly pay on the Keypad program (Hourly Pay). Group B (n=19) participants had the opposite contingencies. Participants worked more on, advanced further on, and preferred their productivity pay program. These results show that monetary incentives can increase performance in a job-skills training program, and indicate that payment in adult education programs should be delivered contingent on performance in the training program instead of simply on attendance. PMID:24114155

  3. Performance pay improves engagement, progress, and satisfaction in computer-based job skills training of low-income adults.

    PubMed

    Koffarnus, Mikhail N; DeFulio, Anthony; Sigurdsson, Sigurdur O; Silverman, Kenneth

    2013-01-01

    Advancing the education of low-income adults could increase employment and income, but adult education programs have not successfully engaged low-income adults. Monetary reinforcement may be effective in promoting progress in adult education. This experiment evaluated the benefits of providing incentives for performance in a job-skills training program for low-income, unemployed adults. Participants worked on typing and keypad programs for 7 months. Participants randomly assigned to Group A (n = 23) earned hourly and productivity pay on the typing program (productivity pay), but earned only equalized hourly pay on the keypad program (hourly pay). Group B (n = 19) participants had the opposite contingencies. Participants worked more on, advanced further on, and preferred their productivity pay program. These results show that monetary incentives can increase performance in a job-skills training program, and indicate that payment in adult education programs should be delivered contingent on performance in the training program instead of simply on attendance. © Society for the Experimental Analysis of Behavior.

  4. High IQ May "Mask" the Diagnosis of ADHD by Compensating for Deficits in Executive Functions in Treatment-Naïve Adults With ADHD.

    PubMed

    Milioni, Ana Luiza Vidal; Chaim, Tiffany Moukbel; Cavallet, Mikael; de Oliveira, Nathalya Moleda; Annes, Marco; Dos Santos, Bernardo; Louzã, Mario; da Silva, Maria Aparecida; Miguel, Carmen Silvia; Serpa, Mauricio Henriques; Zanetti, Marcus V; Busatto, Geraldo; Cunha, Paulo Jannuzzi

    2017-04-01

    To evaluate and compare the performance of adults with ADHD with high and standard IQ in executive functions (EF) tasks. We investigated the neuropsychological performance of 51 adults with ADHD, compared with 33 healthy controls (HC) while performing a wide battery of neuropsychological tests that measure executive functioning. Adults with clinical diagnosis of ADHD were divided into two groups according to their IQ level (IQ ≥ 110-ADHD group with more elevated IQ, and IQ < 110-ADHD group with standard IQ). The ADHD group with standard IQ presented a worse executive functioning compared with the HC group in the following measures: Stroop 2 ( p = .000) and 3 ( p = .000), Trail Making Test (TMT) B ( p = .005), Wisconsin Card-Sorting Test (WCST)-perseverative errors ( p = .022) and failures to maintain set ( p = .020), Continuous Performance Test (CPT)-omission errors ( p = .005) and commission errors ( p = .000), and Frontal Assessment Battery (FAB)-conceptualization ( p = .016). The ADHD group with more elevated IQ presented only impairments in the CPT-commission errors ( p = .019) when compared with the control group. Adults with ADHD and more elevated IQ show less evidence of executive functioning deficits compared with those with ADHD and standard IQ, suggesting that a higher degree of intellectual efficiency may compensate deficits in executive functions, leading to problems in establishing a precise clinical diagnosis.

  5. Trends in the Prevalence, Awareness, Treatment, and Control of Hypertension Among Young Adults in the United States, 1999 to 2014.

    PubMed

    Zhang, Yiyi; Moran, Andrew E

    2017-10-01

    Overall hypertension prevalence has not changed in the United States in recent decades although awareness, treatment, and control improved. However, hypertension epidemiology and its temporal trends may differ in younger adults compared with older adults. Our study included 41 331 participants ≥18 years of age from 8 National Health and Nutrition Examination Surveys (1999-2014) and estimated temporal trends of hypertension, awareness, treatment, and control among young adults (age, 18-39 years) compared with middle-age (age, 40-59 years) and older adults (age, ≥60 years). In 2013 to 2014, 7.3% of the US young adults had hypertension. During 1999 to 2014, young adults saw larger increases in hypertension awareness, treatment, and control than did older adults. However, all of these components of hypertension control were lower among young adults compared with middle-aged or older adults (74.7% younger versus 81.9% middle versus 88.4% older for awareness; 50.0% versus 70.3% versus 83.0% for treatment; and 40.2% versus 56.7% versus 54.4% for control). Worse hypertension awareness, treatment, and control in young adults overall were mostly driven by worse measures in young adult men compared with young adult women. More frequent healthcare visits by young adult women explained ≈28% of the sex-related difference in awareness, 60% of the difference in treatment, and 52% of the difference in control. These findings suggest that improved access to and engagement in medical care might improve hypertension control in young adults, particularly young adult men, and reduce life-time cardiovascular risk. © 2017 American Heart Association, Inc.

  6. Disorganized Symptoms Predicted Worse Functioning Outcome in Schizophrenia Patients with Established Illness.

    PubMed

    Ortiz, Bruno Bertolucci; Gadelha, Ary; Higuchi, Cinthia Hiroko; Noto, Cristiano; Medeiros, Daiane; Pitta, José Cássio do Nascimento; de Araújo Filho, Gerardo Maria; Hallak, Jaime Eduardo Cecílio; Bressan, Rodrigo Affonseca

    Most patients with schizophrenia will have subsequent relapses of the disorder, with continuous impairments in functioning. However, evidence is lacking on how symptoms influence functioning at different phases of the disease. This study aims to investigate the relationship between symptom dimensions and functioning at different phases: acute exacerbation, nonremission and remission. Patients with schizophrenia were grouped into acutely ill (n=89), not remitted (n=89), and remitted (n=69). Three exploratory stepwise linear regression analyses were performed for each phase of schizophrenia, in which the five PANSS factors and demographic variables were entered as the independent variables and the total Global Assessment of Functioning Scale (GAF) score was entered as the dependent variable. An additional exploratory stepwise logistic regression analysis was performed to predict subsequent remission at discharge in the inpatient population. The Disorganized factor was the most significant predictor for acutely ill patients (p<0.001), while the Hostility factor was the most significant for not-remitted patients and the Negative factor was the most significant for remitted patients (p=0.001 and p<0.001, respectively). In the logistic regression, the Disorganized factor score presented a significant negative association with remission (p=0.007). Higher disorganization symptoms showed the greatest impact in functioning at acute phase, and prevented patients from achieving remission, suggesting it may be a marker of symptom severity and worse outcome in schizophrenia.

  7. Sleep-Dependent Consolidation of Procedural Motor Memories in Children and Adults: The Pre-Sleep Level of Performance Matters

    ERIC Educational Resources Information Center

    Wilhelm, Ines; Metzkow-Meszaros, Maila; Knapp, Susanne; Born, Jan

    2012-01-01

    In striking contrast to adults, in children sleep following training a motor task did not induce the expected (offline) gain in motor skill performance in previous studies. Children normally perform at distinctly lower levels than adults. Moreover, evidence in adults suggests that sleep dependent offline gains in skill essentially depend on the…

  8. Greater temperature variability is not associated with a worse neurological outcome after cardiac arrest.

    PubMed

    Nobile, Leda; Lamanna, Irene; Fontana, Vito; Donadello, Katia; Dell'anna, Antonio Maria; Creteur, Jacques; Vincent, Jean-Louis; Pappalardo, Federico; Taccone, Fabio Silvio

    2015-11-01

    Spontaneous alterations in temperature homeostasis after cardiac arrest (CA) are associated with worse outcome. However, it remains unclear the prognostic role of temperature variability (TV) during cooling procedures. We hypothesized that low TV during targeted temperature management (TTM) would be associated with a favourable neurological outcome after CA. We reviewed data from all comatose patients after in-hospital or out-of-hospital CA admitted to our Department of Intensive Care between December 2006 and January 2014 who underwent TTM (32-34°C) and survived at least 24h. We collected demographic data, CA characteristics, intensive care unit (ICU) survival and neurological outcome at three months (favourable neurological outcome was defined as cerebral performance category 1-2). TV was expressed using the standard deviation (SD) of all temperature measurements during hypothermia; high TV was defined as an SD >1°C. Of the 301 patients admitted over the study period, 72 patients were excluded and a total of 229 patients were studied; 88 had a favourable neurological outcome. The median temperature on ICU admission was 35.8 [34.9-36.9]°C and the median time to hypothermia (body temperature <34°C), was 4 [3-7] h. Median TV was 0.9 [0.6-1.0]°C and 57 patients (25%) had high TV. In multivariable logistic regression, witnessed CA, ventricular fibrillation/tachycardia and previous neurological disease were independent risk factors for high TV. Younger age, bystander cardiopulmonary resuscitation, shorter time to return of spontaneous circulation, cardiac origin of arrest, shockable rhythm and longer time to target temperature were independent predictors of favourable neurological outcome, but TV was not. Among comatose survivors treated with TTM after CA, 25% of patients had high TV; however, this was not associated with a worse neurologic outcome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Gaze Behavior Consistency among Older and Younger Adults When Looking at Emotional Faces

    PubMed Central

    Chaby, Laurence; Hupont, Isabelle; Avril, Marie; Luherne-du Boullay, Viviane; Chetouani, Mohamed

    2017-01-01

    The identification of non-verbal emotional signals, and especially of facial expressions, is essential for successful social communication among humans. Previous research has reported an age-related decline in facial emotion identification, and argued for socio-emotional or aging-brain model explanations. However, more perceptual differences in the gaze strategies that accompany facial emotional processing with advancing age have been under-explored yet. In this study, 22 young (22.2 years) and 22 older (70.4 years) adults were instructed to look at basic facial expressions while their gaze movements were recorded by an eye-tracker. Participants were then asked to identify each emotion, and the unbiased hit rate was applied as performance measure. Gaze data were first analyzed using traditional measures of fixations over two preferential regions of the face (upper and lower areas) for each emotion. Then, to better capture core gaze changes with advancing age, spatio-temporal gaze behaviors were deeper examined using data-driven analysis (dimension reduction, clustering). Results first confirmed that older adults performed worse than younger adults at identifying facial expressions, except for “joy” and “disgust,” and this was accompanied by a gaze preference toward the lower-face. Interestingly, this phenomenon was maintained during the whole time course of stimulus presentation. More importantly, trials corresponding to older adults were more tightly clustered, suggesting that the gaze behavior patterns of older adults are more consistent than those of younger adults. This study demonstrates that, confronted to emotional faces, younger and older adults do not prioritize or ignore the same facial areas. Older adults mainly adopted a focused-gaze strategy, consisting in focusing only on the lower part of the face throughout the whole stimuli display time. This consistency may constitute a robust and distinctive “social signature” of emotional

  10. Liver Fibrosis Linked to Cognitive Performance in HIV and Hepatitis C.

    PubMed

    Valcour, Victor G; Rubin, Leah H; Obasi, Mary U; Maki, Pauline M; Peters, Marion G; Levin, Susanna; Crystal, Howard A; Young, Mary A; Mack, Wendy J; Cohen, Mardge H; Pierce, Christopher B; Adimora, Adaora A; Tien, Phyllis C

    2016-07-01

    Because HIV impairs gut barriers to pathogens, HIV-infected adults may be vulnerable to minimal hepatic encephalopathy in the absence of cirrhosis. Cognitive disorders persist in up to one-half of people living with HIV despite access to combination antiretroviral therapy. Minimal hepatic encephalopathy occurs in cirrhotic patients with or without HIV infection and may be associated with inflammation. A cross-sectional investigation of liver fibrosis severity using the aspartate aminotransferase to platelet ratio index (APRI) and neuropsychological testing performance among women from the Women's Interagency HIV Study. A subset underwent liver transient elastography (FibroScan, n = 303). We evaluated 1479 women [mean (SD) age of 46 (9.3) years]: 770 (52%) only HIV infected, 73 (5%) only hepatitis C virus (HCV) infected, 235 (16%) HIV/HCV coinfected, and 401 (27%) uninfected. Of these, 1221 (83%) exhibited APRI ≤0.5 (no or only mild fibrosis), 206 (14%) exhibited APRI >0.5 and ≤1.5 (moderate fibrosis), and 52 (3%) exhibited APRI >1.5 (severe fibrosis). Having moderate or severe fibrosis (APRI >0.5) was associated with worse performance in learning, executive function, memory, psychomotor speed, fluency, and fine motor skills. In these models that adjusted for fibrosis, smaller associations were found for HIV (learning and memory) and HCV (executive functioning and attention). The severity of fibrosis, measured by FibroScan, was associated with worse performance in attention, executive functioning, and fluency. Liver fibrosis had a contribution to cognitive performance independent of HCV and HIV; however, the pattern of neuropsychological deficit associated with fibrosis was not typical of minimal hepatic encephalopathy.

  11. Older adults utilize less efficient postural control when performing pushing task.

    PubMed

    Lee, Yun-Ju; Chen, Bing; Aruin, Alexander S

    2015-12-01

    The ability to maintain balance deteriorates with increasing age. The aim was to investigate the role of age in generation of anticipatory (APA) and compensatory (CPA) postural adjustments during pushing an object. Older (68.8 ± 1.0 years) and young adults (30.1 ± 1.4 years) participated in the experiment involving pushing an object (a pendulum attached to the ceiling) using both hands. Electrical activity of six leg and trunk muscles and displacements of the center of pressure (COP) were recorded and analyzed during the APA and CPA phases. The onset time, integrals of muscle activity, and COP displacements were determined. In addition, the indexes of co-activation and reciprocal activation of muscles for the shank, thigh, and trunk segments were calculated. Older adults, compared to young adults, showed less efficient postural control seen as delayed anticipatory muscle onset times and delayed COP displacements. Moreover, older adults used co-activation of muscles during the CPA phase while younger subjects utilized reciprocal activation of muscles. The observed diminished efficiency of postural control during both anticipatory and compensatory postural adjustments observed in older adults might predispose them to falls while performing tasks involving pushing. The outcome provides a background for future studies focused on the optimization of the daily activities of older adults. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Physical performance limitations among adult survivors of childhood brain tumors

    PubMed Central

    Ness, Kirsten K.; Morris, E. Brannon; Nolan, Vikki G.; Howell, Carrie R.; Gilchrist, Laura S.; Stovall, Marilyn; Cox, Cheryl L.; Klosky, James L.; Gajjar, Amar; Neglia, Joseph P.

    2013-01-01

    Background Young adult survivors of childhood brain tumors (BT) may have late-effects that compromise physical performance and everyday task participation. Objective To evaluate muscle strength, fitness, physical performance, and task participation among adult survivors of childhood BT. Design/Method In-home evaluations and interviews were conducted for 156 participants (54% male). Results on measures of muscle strength, fitness, physical performance, and participation were compared between survivors and population-group members with chi-squared statistics and two-sample t-tests. Associations between late effects and physical performance, and physical performance and participation, were evaluated in regression models. Results BT survivors were a median age of 22 (18–58), and 14.7 (6.5–45.9) years from diagnosis. Survivors had lower estimates of grip strength (Female: 24.7±9.2 vs. 31.5±5.8, Male: 39.0±12.2 vs. 53.0±10.1 kilograms), knee extension strength (Female: 246.6±95.5 vs. 331.5±5.8, Male: 304.7±116.4 vs. 466.6±92.1 Newtons) and peak oxygen uptake (Female: 25.1±8.8 vs. 31.3±5.1, Male: 24.6±9.5 vs. 33.2±3.4 milliliters/kilogram/minute) than population-group members. Physical performance was lower among survivors and associated with not living independently (OR=5.0, 95% CI=2.0–12.2) and not attending college (OR=2.3, 95% CI 1.2–4.4). Conclusion Muscle strength and fitness values among BT survivors are similar to those among persons 60+ years, and are associated with physical performance limitations. Physical performance limitations are associated with poor outcomes in home and school environments. These data indicate an opportunity for interventions targeted at improving long-term physical function in this survivor population. PMID:20564409

  13. Updating and Not Shifting Predicts Learning Performance in Young and Middle-Aged Adults

    ERIC Educational Resources Information Center

    Gijselaers, Hieronymus J. M.; Meijs, Celeste; Neroni, Joyce; Kirschner, Paul A.; de Groot, Renate H. M.

    2017-01-01

    The goal of this study was to investigate whether single executive function (EF) tests were predictive for learning performance in mainly young and middle-aged adults. The tests measured shifting and updating. Processing speed was also measured. In an observational study, cognitive performance and learning performance were measured objectively in…

  14. Postsecondary Employment Experiences Among Young Adults With an Autism Spectrum Disorder RH: Employment in Young Adults With Autism

    PubMed Central

    Roux, Anne M.; Shattuck, Paul T.; Cooper, Benjamin P.; Anderson, Kristy A.; Wagner, Mary; Narendorf, Sarah C.

    2013-01-01

    Objective We examined postsecondary employment experiences of young adults with an autism spectrum disorder (ASD) and compared these outcomes with those of young adults with different disabilities. Method Data were from Wave 5 of the National Longitudinal Transition Study 2 (NLTS2), a nationally representative survey of young adults who had received special education services during high school. We examined the prevalence of ever having had—and currently having—a paid job at 21–25 years of age. We analyzed rates of full employment, wages earned, number of jobs held since high school, and job types. Results About half (53.4%) of young adults with an ASD had ever worked for pay outside the home since leaving high school, the lowest rate among disability groups. Young adults with an ASD earned an average of $8.10 per hour, significantly lower than average wages for young adults in the comparison groups, and held jobs that clustered within fewer occupational types. Odds of ever having had a paid job were higher for those who were older, from higher-income households, and with better conversational abilities or functional skills. Conclusions Findings of worse employment outcomes for young adults with an ASD suggest this population is experiencing particular difficulty in successfully transitioning into employment. Research is needed to determine strategies for improving outcomes as these young adults transition into adulthood. PMID:23972695

  15. Subjective Memory Complaints, Cognitive Performance, and Psychological Factors in Healthy Older Adults

    PubMed Central

    Steinberg, Susanne I.; Negash, Selamawit; Sammel, Mary D.; Bogner, Hillary; Harel, Brian T.; Livney, Melissa G.; McCoubrey, Hannah; Wolk, David A.; Kling, Mitchel A.; Arnold, Steven E.

    2015-01-01

    Objective To determine whether subjective memory complaints (SMCs) are associated with performance on objective cognitive measures and psychological factors in healthy, community-dwelling older adults. Method The cohort was composed of adults, 65 years and older with no clinical evidence of cognitive impairment (n = 125). Participants were administered: CogState computerized neurocognitive battery, Prospective Retrospective Memory Questionnaire, personality and meaning-in-life measures. Results SMCs were associated with poorer performance on measures of executive function (p = 0.001). SMCs were also associated with impaired delayed recall (p = 0.006) but this did not remain significant after statistical adjustment for multiple comparisons. SMCs were inversely associated with conscientiousness (p = 0.004) and directly associated with neuroticism (p < 0.001). Higher scores on SMCs were associated with higher perceived stress (p = 0.001), and ineffective coping styles (p = 0.001). Factors contributing to meaning-in-life were associated with fewer SMCs (p < 0.05). Conclusions SMCs may reflect early, subtle cognitive changes and are associated with personality traits and meaning-in-life in healthy, older adults. PMID:24363073

  16. Subjective memory complaints, cognitive performance, and psychological factors in healthy older adults.

    PubMed

    Steinberg, Susanne I; Negash, Selamawit; Sammel, Mary D; Bogner, Hillary; Harel, Brian T; Livney, Melissa G; McCoubrey, Hannah; Wolk, David A; Kling, Mitchel A; Arnold, Steven E

    2013-12-01

    To determine whether subjective memory complaints (SMCs) are associated with performance on objective cognitive measures and psychological factors in healthy, community-dwelling older adults. The cohort was composed of adults, 65 years and older with no clinical evidence of cognitive impairment (n = 125). Participants were administered: CogState computerized neurocognitive battery, Prospective Retrospective Memory Questionnaire, personality and meaning-in-life measures. SMCs were associated with poorer performance on measures of executive function (p = 0.001). SMCs were also associated with impaired delayed recall (p = 0.006) but this did not remain significant after statistical adjustment for multiple comparisons. SMCs were inversely associated with conscientiousness (p = 0.004) and directly associated with neuroticism (p < 0.001). Higher scores on SMCs were associated with higher perceived stress (p = 0.001), and ineffective coping styles (p = 0.001). Factors contributing to meaning-in-life were associated with fewer SMCs (p < 0.05). SMCs may reflect early, subtle cognitive changes and are associated with personality traits and meaning-in-life in healthy, older adults.

  17. Methylphenidate Reduces State Anxiety During a Continuous Performance Test That Distinguishes Adult ADHD Patients From Controls.

    PubMed

    Bloch, Yuval; Aviram, Shai; Segev, Aviv; Nitzan, Uri; Levkovitz, Yechiel; Braw, Yoram; Mimouni Bloch, Aviva

    2017-01-01

    We hypothesized that patients with ADHD were typified by distress more than by functional difficulties. Thus, a decline in state anxiety while performing a cognitive task when taking methylphenidate would discriminate between ADHD patients and controls. State anxiety and cognitive performance on a continuous performance test were assessed in ADHD patients and controls with and without taking methylphenidate. State anxiety and cognitive performance improved from baseline in 36 ADHD adults after taking methylphenidate. In 25 controls, cognitive performance improved, but state anxiety did not abate after a recess. In two additional studies, 5 controls were evaluated at baseline and after receiving methylphenidate, and showed improvement in cognitive assessment but not in state anxiety. Five ADHD adults were assessed at baseline and after a recess, and showed no improvement. Our results support the hypothesis that adult ADHD patients are characterized by distress and the relief of this distress under effective therapy as expressed by a decline in state anxiety while they perform a cognitive task.

  18. Performance Pay Improves Engagement, Progress, and Satisfaction in Computer-Based Job Skills Training of Low-Income Adults

    ERIC Educational Resources Information Center

    Koffarnus, Mikhail N.; DeFulio, Anthony; Sigurdsson, Sigurdur O.; Silverman, Kenneth

    2013-01-01

    Advancing the education of low-income adults could increase employment and income, but adult education programs have not successfully engaged low-income adults. Monetary reinforcement may be effective in promoting progress in adult education. This experiment evaluated the benefits of providing incentives for performance in a job-skills training…

  19. Doing nothing: adults with disabilities with no daily activities and their siblings.

    PubMed

    Taylor, Julie Lounds; Hodapp, Robert M

    2012-01-01

    A significant concern of parents and professionals is that adults with intellectual and developmental disabilities will go without regular educational-vocational activities. The authors examined predictors of such inactivity in individuals with intellectual and developmental disabilities, as well as how inactivity related to their sibling's well-being and the sibling relationship. Participants included 796 siblings of adults with intellectual and developmental disabilities who responded to a web-based survey. Nearly 13% of adults with intellectual and developmental disabilities were without daytime activities; these adults had more emotional-behavioral and health problems, were more underserved by the formal service system, and had parents who were less able to provide care. Although siblings of adults without activities reported more depressive symptoms, worse health, and less close sibling relationships, inactivity no longer predicted these problems after controlling for characteristics that predisposed adults with intellectual and developmental disabilities to have no activities.

  20. No Evidence for Improved Associative Memory Performance Following Process-Based Associative Memory Training in Older Adults

    PubMed Central

    Bellander, Martin; Eschen, Anne; Lövdén, Martin; Martin, Mike; Bäckman, Lars; Brehmer, Yvonne

    2017-01-01

    Studies attempting to improve episodic memory performance with strategy instructions and training have had limited success in older adults: their training gains are limited in comparison to those of younger adults and do not generalize to untrained tasks and contexts. This limited success has been partly attributed to age-related impairments in associative binding of information into coherent episodes. We therefore investigated potential training and transfer effects of process-based associative memory training (i.e., repeated practice). Thirty-nine older adults (Mage = 68.8) underwent 6 weeks of either adaptive associative memory training or item recognition training. Both groups improved performance in item memory, spatial memory (object-context binding) and reasoning. A disproportionate effect of associative memory training was only observed for item memory, whereas no training-related performance changes were observed for associative memory. Self-reported strategies showed no signs of spontaneous development of memory-enhancing associative memory strategies. Hence, the results do not support the hypothesis that process-based associative memory training leads to higher associative memory performance in older adults. PMID:28119597

  1. No Evidence for Improved Associative Memory Performance Following Process-Based Associative Memory Training in Older Adults.

    PubMed

    Bellander, Martin; Eschen, Anne; Lövdén, Martin; Martin, Mike; Bäckman, Lars; Brehmer, Yvonne

    2016-01-01

    Studies attempting to improve episodic memory performance with strategy instructions and training have had limited success in older adults: their training gains are limited in comparison to those of younger adults and do not generalize to untrained tasks and contexts. This limited success has been partly attributed to age-related impairments in associative binding of information into coherent episodes. We therefore investigated potential training and transfer effects of process-based associative memory training (i.e., repeated practice). Thirty-nine older adults ( M age = 68.8) underwent 6 weeks of either adaptive associative memory training or item recognition training. Both groups improved performance in item memory, spatial memory (object-context binding) and reasoning. A disproportionate effect of associative memory training was only observed for item memory, whereas no training-related performance changes were observed for associative memory. Self-reported strategies showed no signs of spontaneous development of memory-enhancing associative memory strategies. Hence, the results do not support the hypothesis that process-based associative memory training leads to higher associative memory performance in older adults.

  2. The 2003 National Assessment of Adult Literacy (NAAL): Performance of African Americans in a National Context

    ERIC Educational Resources Information Center

    Ngwudike, Benjamin C.

    2008-01-01

    The 2003 National Assessment of Adult Literacy (NAAL): Performance of African Americans in a National Context Sponsored by the National Center for Education Statistics (NCES) the 2003 NAAL was America's most comprehensive assessment of adult literacy since the 1992 National Adult Literacy Survey (NALS). NAAL was a nationally representative…

  3. Functional impairment and cognitive performance in mood disorders: A community sample of young adults.

    PubMed

    Reyes, Amanda N; Cardoso, Taiane A; Jansen, Karen; Mondin, Thaíse C; Souza, Luciano D M; Magalhães, Pedro V S; Kapczinski, Flavio; Silva, Ricardo A

    2017-05-01

    The aim of this study was to compare the global functioning and cognitive performance in a community sample of young adults with mood disorders versus community controls. This was a cross-sectional study nested in a cohort study with a community sample. Data was collected from February 2012 to June 2014; specifically, at a mean of five years after the first phase, all young adults were invited to participate in a re-evaluation. Mini International Neuropsychiatric Interview - PLUS (MINI-PLUS) was used for the diagnosis of mood disorders. The Functional Assessment Short Test (FAST) and the Montreal Cognitive Assessment (MoCA) were used to assess the global functioning, and cognitive performance, respectively. Were included 1258 subjects. Functional impairment was greater in subjects with bipolar disorder when compared to community controls, and there were no differences between major depressive disorder and community controls. There were no significant differences in cognitive performance between young adults with mood disorders when compared to community controls. Functional impairment is a marker for bipolar disorder in young adults; however, gross cognitive impairment assessed by a screening test is not, possibly because cognition is impaired in more advanced stages of the disorder. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  4. Effects of Stereotype Threat, Perceived Discrimination, and Examiner Race on Neuropsychological Performance: Simple as Black and White?

    PubMed Central

    Thames, April D.; Hinkin, Charles H.; Byrd, Desiree A.; Bilder, Robert M.; Duff, Kimberley J.; Mindt, Monica Rivera; Arentoft, Alyssa; Streiff, Vanessa

    2013-01-01

    The purpose of the current study was to examine the predictive roles of stereotype threat and perceived discrimination and the mediating role of examiner-examinee racial discordance on neuropsychological performance in a non-clinical sample of African American and Caucasian individuals. Ninety-two African American (n = 45) and Caucasian (n = 47) adults were randomly assigned to either a stereotype threat or non-threat condition. Within each condition, participants were randomly assigned to either a same race or different race examiner. All participants underwent neuropsychological testing and completed a measure of perceived discrimination. African Americans in the stereotype threat condition performed significantly worse on global NP (Mz = −.30, 95% confidence interval [CI] [−0.07, −0.67] than African Americans in the non-threat condition (Mz = 0.09, CI [0.15, 0.33]. African Americans who reported high levels of perceived discrimination performed significantly worse on memory tests when tested by an examiner of a different race, Mz = −1.19, 95% CI [−1.78, −.54], than African Americans who were tested by an examiner of the same race, Mz = 0.24, 95% CI [−0.24, 0.72]. The current study underscores the importance of considering the role of contextual variables in neuropsychological performance, as these variables may obscure the validity of results among certain racial/ethnic groups. PMID:23388089

  5. Age-Adjusted Percentage of Adults Aged 18 Years or Older with Diagnosed Diabetes Performing Daily Self-Monitoring of ...

    MedlinePlus

    ... Share Compartir Age-Adjusted Percentage of Adults Aged 18 Years or Older with Diagnosed Diabetes Performing Daily ... 2010, the age-adjusted percentage of adults aged 18 years or older with diagnosed diabetes performing daily ...

  6. How to gain eleven IQ points in ten minutes: thinking aloud improves Raven's Matrices performance in older adults.

    PubMed

    Fox, Mark C; Charness, Neil

    2010-03-01

    Few studies have examined the impact of age on reactivity to concurrent think-aloud (TA) verbal reports. An initial study with 30 younger and 31 older adults revealed that thinking aloud improves older adult performance on a short form of the Raven's Matrices (Bors & Stokes, 1998, Educational and Psychological Measurement, 58, p. 382) but did not affect other tasks. In the replication experiment, 30 older adults (mean age = 73.0) performed the Raven's Matrices and three other tasks to replicate and extend the findings of the initial study. Once again older adults performed significantly better only on the Raven's Matrices while thinking aloud. Performance gains on this task were substantial (d = 0.73 and 0.92 in Experiments 1 and 2, respectively), corresponding to a fluid intelligence increase of nearly one standard deviation.

  7. Does injury compensation lead to worse health after whiplash? A systematic review.

    PubMed

    Spearing, Natalie M; Connelly, Luke B; Gargett, Susan; Sterling, Michele

    2012-06-01

    One might expect that injury compensation would leave injured parties better off than they would otherwise have been, yet many believe that compensation does more harm than good. This study systematically reviews the evidence on this "compensation hypothesis" in relation to compensable whiplash injuries. PubMed, CINAHL, EMBASE, PEDro, PsycInfo, CCTR, Lexis, and EconLit were searched from the date of their inception to April 2010 to locate longitudinal studies, published in English, comparing the health outcomes of adults exposed/not exposed to compensation-related factors. Studies concerning serious neck injuries, using claimants only, or using proxy measures of health outcomes were excluded. Eleven studies were included. These examined the effect of lawyer involvement, litigation, claim submission, or previous claims on pain and other health outcomes. Among the 16 results reported were 9 statistically significant negative associations between compensation-related factors and health outcomes. Irrespective of the compensation-related factor involved and the health outcome measured, the quality of these studies was similar to studies that did not find a significant negative association: most took some measures to address selection bias, confounding, and measurement bias, and none resolved the potential for reverse causality bias that arises in the relationship between compensation-related factors and health. Unless ambiguous causal pathways are addressed, one cannot draw conclusions from statistical associations, regardless of their statistical significance and the extent of measures to address other sources of bias. Consequently, there is no clear evidence to support the idea that compensation and its related processes lead to worse health. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  8. Association between physiological falls risk and physical performance tests among community-dwelling older adults

    PubMed Central

    Singh, Devinder KA; Pillai, Sharmila GK; Tan, Sin Thien; Tai, Chu Chiau; Shahar, Suzana

    2015-01-01

    Background Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests. Methods One hundred and forty older adults from a senior citizens club in Kuala Lumpur, Malaysia (94 females, 46 males), aged 60 years and above (65.77±4.61), participated in this cross-sectional study. Participants were screened for falls risk using PPA. A battery of physical performance tests that include ten-step test (TST), short physical performance battery (SPPB), functional reach test (FRT), static balance test (SBT), TUG, dominant hand-grip strength (DHGS), and gait speed test (GST) were also performed. Spearman’s rank correlation and binomial logistic regression were performed to examine the significantly associated independent variables (physical performance tests) with falls risk (dependent variable). Results Approximately 13% older adults were at high risk of falls categorized using PPA. Significant differences (P<0.05) were demonstrated for age, TST, SPPB, FRT, SBT, TUG between high and low falls risk group. A significant (P<0.01) weak correlation was found between PPA and TST (r=0.25), TUG (r=0.27), SBT (r=0.23), SPPB (r=−0.33), and FRT (r=−0.23). Binary logistic regression results demonstrated that SBT measuring postural sways objectively using a balance board was the only significant predictor of physiological falls risk (P<0.05, odds ratio of 2.12). Conclusion The

  9. Association between physiological falls risk and physical performance tests among community-dwelling older adults.

    PubMed

    Singh, Devinder K A; Pillai, Sharmila G K; Tan, Sin Thien; Tai, Chu Chiau; Shahar, Suzana

    2015-01-01

    Physical performance and balance declines with aging and may lead to increased risk of falls. Physical performance tests may be useful for initial fall-risk screening test among community-dwelling older adults. Physiological profile assessment (PPA), a composite falls risk assessment tool is reported to have 75% accuracy to screen for physiological falls risk. PPA correlates with Timed Up and Go (TUG) test. However, the association between many other commonly used physical performance tests and PPA is not known. The aim of the present study was to examine the association between physiological falls risk measured using PPA and a battery of physical performance tests. One hundred and forty older adults from a senior citizens club in Kuala Lumpur, Malaysia (94 females, 46 males), aged 60 years and above (65.77±4.61), participated in this cross-sectional study. Participants were screened for falls risk using PPA. A battery of physical performance tests that include ten-step test (TST), short physical performance battery (SPPB), functional reach test (FRT), static balance test (SBT), TUG, dominant hand-grip strength (DHGS), and gait speed test (GST) were also performed. Spearman's rank correlation and binomial logistic regression were performed to examine the significantly associated independent variables (physical performance tests) with falls risk (dependent variable). Approximately 13% older adults were at high risk of falls categorized using PPA. Significant differences (P<0.05) were demonstrated for age, TST, SPPB, FRT, SBT, TUG between high and low falls risk group. A significant (P<0.01) weak correlation was found between PPA and TST (r=0.25), TUG (r=0.27), SBT (r=0.23), SPPB (r=-0.33), and FRT (r=-0.23). Binary logistic regression results demonstrated that SBT measuring postural sways objectively using a balance board was the only significant predictor of physiological falls risk (P<0.05, odds ratio of 2.12). The reference values of physical performance tests

  10. High Right Ventricular Stroke Work Index Is Associated with Worse Kidney Function in Patients with Heart Failure with Preserved Ejection Fraction.

    PubMed

    Kanjanahattakij, Napatt; Sirinvaravong, Natee; Aguilar, Francisco; Agrawal, Akanksha; Krishnamoorthy, Parasuram; Gupta, Shuchita

    2018-01-01

    In patients with heart failure with preserved ejection fraction (HFpEF), worse kidney function is associated with worse overall cardiac mechanics. Right ventricular stroke work index (RVSWI) is a parameter of right ventricular function. The aim of our study was to determine the relationship between RVSWI and glomerular filtration rate (GFR) in patients with HFpEF. This was a single-center cross-sectional study. HFpEF is defined as patients with documented heart failure with ejection fraction > 50% and pulmonary wedge pressure > 15 mm Hg from right heart catheterization. RVSWI (normal value 8-12 g/m/beat/m2) was calculated using the formula: RVSWI = 0.0136 × stroke volume index × (mean pulmonary artery pressure - mean right atrial pressure). Univariate and multivariate linear regression analysis was performed to study the correlation between RVSWI and GFR. Ninety-one patients were included in the study. The patients were predominantly female (n = 64, 70%) and African American (n = 61, 67%). Mean age was 66 ± 12 years. Mean GFR was 59 ± 35 mL/min/1.73 m2. Mean RVSWI was 11 ± 6 g/m/beat/m2. Linear regression analysis showed that there was a significant independent inverse relationship between RVSWI and GFR (unstandardized coefficient = -1.3, p = 0.029). In the subgroup with combined post and precapillary pulmonary hypertension (Cpc-PH) the association remained significant (unstandardized coefficient = -1.74, 95% CI -3.37 to -0.11, p = 0.04). High right ventricular workload indicated by high RVSWI is associated with worse renal function in patients with Cpc-PH. Further prospective studies are needed to better understand this association. © 2018 S. Karger AG, Basel.

  11. Mediation analysis of severity of needs, service performance and outcomes for patients with mental disorders.

    PubMed

    Roux, Paul; Passerieux, Christine; Fleury, Marie-Josée

    2016-12-01

    Needs and service performance assessment are key components in improving recovery among individuals with mental disorders. To test the role of service performance as a mediating factor between severity of patients' needs and outcomes. A total of 339 adults with mental disorders were interviewed. A mediation analysis between severity of needs, service performance (adequacy of help, continuity of care and recovery orientation of services) and outcomes (personal recovery and quality of life) was carried out using structural equation modelling. The structural equation model provided a good fit with the data. An increase in needs was associated with lower service performance and worse outcomes, whereas higher service performance was associated with better outcomes. Service performance partially mediated the effect of patient needs on outcomes. Poorer service performance has a negative impact on outcomes for patients with the highest needs. Ensuring more efficient services for patients with high needs may help improve their recovery and quality of life. © The Royal College of Psychiatrists 2016.

  12. The effect of individual differences in working memory in older adults on performance with different degrees of automated technology.

    PubMed

    Pak, Richard; McLaughlin, Anne Collins; Leidheiser, William; Rovira, Ericka

    2017-04-01

    A leading hypothesis to explain older adults' overdependence on automation is age-related declines in working memory. However, it has not been empirically examined. The purpose of the current experiment was to examine how working memory affected performance with different degrees of automation in older adults. In contrast to the well-supported idea that higher degrees of automation, when the automation is correct, benefits performance but higher degrees of automation, when the automation fails, increasingly harms performance, older adults benefited from higher degrees of automation when the automation was correct but were not differentially harmed by automation failures. Surprisingly, working memory did not interact with degree of automation but did interact with automation correctness or failure. When automation was correct, older adults with higher working memory ability had better performance than those with lower abilities. But when automation was incorrect, all older adults, regardless of working memory ability, performed poorly. Practitioner Summary: The design of automation intended for older adults should focus on ways of making the correctness of the automation apparent to the older user and suggest ways of helping them recover when it is malfunctioning.

  13. Physiological Indicators of Stress and Intellectual Performance among Anxious Older Adults.

    ERIC Educational Resources Information Center

    Kelly, Kimberly S.; And Others

    1997-01-01

    Older adults (n=27) concerned about declining cognitive functioning performed cognitive tasks, completed questionnaires, and were given measures of anxiety and physiological change. Negative correlations appeared between level of cortisol, a stress-related hormone, and self-efficacy on measures of fluid intelligence. Epstein-Barr virus levels were…

  14. Noncredible cognitive performance at clinical evaluation of adult ADHD: An embedded validity indicator in a visuospatial working memory test.

    PubMed

    Fuermaier, Anselm B M; Tucha, Oliver; Koerts, Janneke; Lange, Klaus W; Weisbrod, Matthias; Aschenbrenner, Steffen; Tucha, Lara

    2017-12-01

    The assessment of performance validity is an essential part of the neuropsychological evaluation of adults with attention-deficit/hyperactivity disorder (ADHD). Most available tools, however, are inaccurate regarding the identification of noncredible performance. This study describes the development of a visuospatial working memory test, including a validity indicator for noncredible cognitive performance of adults with ADHD. Visuospatial working memory of adults with ADHD (n = 48) was first compared to the test performance of healthy individuals (n = 48). Furthermore, a simulation design was performed including 252 individuals who were randomly assigned to either a control group (n = 48) or to 1 of 3 simulation groups who were requested to feign ADHD (n = 204). Additional samples of 27 adults with ADHD and 69 instructed simulators were included to cross-validate findings from the first samples. Adults with ADHD showed impaired visuospatial working memory performance of medium size as compared to healthy individuals. Simulation groups committed significantly more errors and had shorter response times as compared to patients with ADHD. Moreover, binary logistic regression analysis was carried out to derive a validity index that optimally differentiates between true and feigned ADHD. ROC analysis demonstrated high classification rates of the validity index, as shown in excellent specificity (95.8%) and adequate sensitivity (60.3%). The visuospatial working memory test as presented in this study therefore appears sensitive in indicating cognitive impairment of adults with ADHD. Furthermore, the embedded validity index revealed promising results concerning the detection of noncredible cognitive performance of adults with ADHD. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  15. Older Adult Multitasking Performance Using a Gaze-Contingent Useful Field of View.

    PubMed

    Ward, Nathan; Gaspar, John G; Neider, Mark B; Crowell, James; Carbonari, Ronald; Kaczmarski, Hank; Ringer, Ryan V; Johnson, Aaron P; Loschky, Lester C; Kramer, Arthur F

    2018-03-01

    Objective We implemented a gaze-contingent useful field of view paradigm to examine older adult multitasking performance in a simulated driving environment. Background Multitasking refers to the ability to manage multiple simultaneous streams of information. Recent work suggests that multitasking declines with age, yet the mechanisms supporting these declines are still debated. One possible framework to better understand this phenomenon is the useful field of view, or the area in the visual field where information can be attended and processed. In particular, the useful field of view allows for the discrimination of two competing theories of real-time multitasking, a general interference account and a tunneling account. Methods Twenty-five older adult subjects completed a useful field of view task that involved discriminating the orientation of lines in gaze-contingent Gabor patches appearing at varying eccentricities (based on distance from the fovea) as they operated a vehicle in a driving simulator. In half of the driving scenarios, subjects also completed an auditory two-back task to manipulate cognitive workload, and during some trials, wind was introduced as a means to alter general driving difficulty. Results Consistent with prior work, indices of driving performance were sensitive to both wind and workload. Interestingly, we also observed a decline in Gabor patch discrimination accuracy under high cognitive workload regardless of eccentricity, which provides support for a general interference account of multitasking. Conclusion The results showed that our gaze-contingent useful field of view paradigm was able to successfully examine older adult multitasking performance in a simulated driving environment. Application This study represents the first attempt to successfully measure dynamic changes in the useful field of view for older adults completing a multitasking scenario involving driving.

  16. Event-Related-Potential (ERP) Correlates of Performance Monitoring in Adults With Attention-Deficit Hyperactivity Disorder (ADHD)

    PubMed Central

    Marquardt, Lynn; Eichele, Heike; Lundervold, Astri J.; Haavik, Jan; Eichele, Tom

    2018-01-01

    Introduction: Attention-deficit hyperactivity disorder (ADHD) is one of the most frequent neurodevelopmental disorders in children and tends to persist into adulthood. Evidence from neuropsychological, neuroimaging, and electrophysiological studies indicates that alterations of error processing are core symptoms in children and adolescents with ADHD. To test whether adults with ADHD show persisting deficits and compensatory processes, we investigated performance monitoring during stimulus-evaluation and response-selection, with a focus on errors, as well as within-group correlations with symptom scores. Methods: Fifty-five participants (27 ADHD and 28 controls) aged 19–55 years performed a modified flanker task during EEG recording with 64 electrodes, and the ADHD and control groups were compared on measures of behavioral task performance, event-related potentials of performance monitoring (N2, P3), and error processing (ERN, Pe). Adult ADHD Self-Report Scale (ASRS) was used to assess ADHD symptom load. Results: Adults with ADHD showed higher error rates in incompatible trials, and these error rates correlated positively with the ASRS scores. Also, we observed lower P3 amplitudes in incompatible trials, which were inversely correlated with symptom load in the ADHD group. Adults with ADHD also displayed reduced error-related ERN and Pe amplitudes. There were no significant differences in reaction time (RT) and RT variability between the two groups. Conclusion: Our findings show deviations of electrophysiological measures, suggesting reduced effortful engagement of attentional and error-monitoring processes in adults with ADHD. Associations between ADHD symptom scores, event-related potential amplitudes, and poorer task performance in the ADHD group further support this notion. PMID:29706908

  17. Orthographic Processing and Visual Sequential Memory in Unexpectedly Poor Spellers

    ERIC Educational Resources Information Center

    Holmes, Virginia M.; Malone, Aisling M.; Redenbach, Holly

    2008-01-01

    Does unexpectedly poor spelling in adults result from inferior visual sequential memory? In one experiment, unexpectedly poor spellers performed significantly worse than better spellers in the immediate reproduction of sequences of visual symbols, but in a second experiment, the effect was not replicated. Poor spellers were also no worse at the…

  18. Relation of Everyday Activities of Adults to Their Prose Recall Performance.

    ERIC Educational Resources Information Center

    Rice, G. Elizabeth; And Others

    1988-01-01

    Explored connection between everyday activities of different aged adults (N=54) and their performance on prose recall task. Regression analyses showed that demographic variables of age, education, and verbal ability were best predictors of prose recall. Total time spent reading and other reading variables were also significantly correlated with…

  19. Effects of simultaneously performed cognitive and physical training in older adults

    PubMed Central

    2013-01-01

    Background While many studies confirm the positive effect of cognitive and physical training on cognitive performance of older adults, only little is known about the effects of simultaneously performed cognitive and physical training. In the current study, older adults simultaneously performed a verbal working memory and a cardiovascular training to improve cognitive and motor-cognitive dual task performance. Twenty training sessions of 30 minutes each were conducted over a period of ten weeks, with a test session before, in the middle, and after the training. Training gains were tested in measures of selective attention, paired-associates learning, executive control, reasoning, memory span, information processing speed, and motor-cognitive dual task performance in the form of walking and simultaneously performing a working memory task. Results Sixty-three participants with a mean age of 71.8 ± 4.9 years (range 65 to 84) either performed the simultaneous training (N = 21), performed a single working memory training (N = 16), or attended no training at all (N = 26). The results indicate similar training progress and larger improvements in the executive control task for both training groups when compared to the passive control group. In addition, the simultaneous training resulted in larger improvements compared to the single cognitive training in the paired-associates task and was able to reduce the step-to-step variability during the motor-cognitive dual task when compared to the single cognitive training and the passive control group. Conclusions The simultaneous training of cognitive and physical abilities presents a promising training concept to improve cognitive and motor-cognitive dual task performance, offering greater potential on daily life functioning, which usually involves the recruitment of multiple abilities and resources rather than a single one. PMID:24053148

  20. Turn Off the Music! Music Impairs Visual Associative Memory Performance in Older Adults

    PubMed Central

    Reaves, Sarah; Graham, Brittany; Grahn, Jessica; Rabannifard, Parissa; Duarte, Audrey

    2016-01-01

    Purpose of the Study: Whether we are explicitly listening to it or not, music is prevalent in our environment. Surprisingly, little is known about the effect of environmental music on concurrent cognitive functioning and whether young and older adults are differentially affected by music. Here, we investigated the impact of background music on a concurrent paired associate learning task in healthy young and older adults. Design and Methods: Young and older adults listened to music or to silence while simultaneously studying face–name pairs. Participants’ memory for the pairs was then tested while listening to either the same or different music. Participants also made subjective ratings about how distracting they found each song to be. Results: Despite the fact that all participants rated music as more distracting to their performance than silence, only older adults’ associative memory performance was impaired by music. These results are most consistent with the theory that older adults’ failure to inhibit processing of distracting task-irrelevant information, in this case background music, contributes to their memory impairments. Implications: These data have important practical implications for older adults’ ability to perform cognitively demanding tasks even in what many consider to be an unobtrusive environment. PMID:26035876

  1. Visuospatial and Attentional Abilities Predict Driving Simulator Performance Among Older HIV-infected Adults

    PubMed Central

    Foley, J. M.; Gooding, A. L.; Thames, A. D.; Ettenhofer, M. L.; Kim, M. S.; Castellon, S. A.; Marcotte, T. D.; Sadek, J. R.; Heaton, R. K.; van Gorp, W. G.; Hinkin, C. H.

    2013-01-01

    Objectives To examine the effects of aging and neuropsychological (NP) impairment on driving simulator performance within a human immunodeficiency virus (HIV)-infected cohort. Methods Participants included 79 HIV-infected adults (n = 58 > age 50, n = 21 ≤ 40) who completed a NP battery and a personnel computer-based driving simulator task. Outcome variables included total completion time (time) and number of city blocks to complete the task (blocks). Results Compared to the younger group, the older group was less efficient in their route finding (blocks over optimum: 25.9 [20.1] vs 14.4 [16.9]; P = .02) and took longer to complete the task (time: 1297.6 [577.6] vs 804.4 [458.5] seconds; P = .001). Regression models within the older adult group indicated that visuospatial abilities (blocks: b = –0.40, P < .001; time: b = –0.40, P = .001) and attention (blocks: b = –0.49, P = .001; time: b = –0.42, P = .006) independently predicted simulator performance. The NP-impaired group performed more poorly on both time and blocks, compared to the NP normal group. Conclusions Older HIV-infected adults may be at risk of driving-related functional compromise secondary to HIV-associated neurocognitive decline. PMID:23314403

  2. Functional performance and exercise of older adults in long-term care settings.

    PubMed

    Resnick, B

    2000-03-01

    Performing functional activities and exercising are important for older adults living in long-term care settings. Participation in these activities not only improves and maintains function in older adults but also can improve physical and emotional health and quality of life. The purpose of this study was to explore the variables that influence functional performance and exercise activity in a group of nursing home residents. Participants included 59 residents in a long-term care facility. The mean age of participants was 88 +/- 6.9, and the majority were women (76%), White (97%), and unmarried (76%). Residents participated in a single face-to-face interview. Chart reviews for demographic and health information also were performed. Based on stepwise multiple regression analyses, upper and lower extremity contractures and cognitive status were the only variables that significantly influenced functional performance and accounted for 49% of the variance in function. Self-efficacy and outcome expectations were the only variables to significantly influence exercise behavior and accounted for 57% of the variance in this behavior. These findings can be used to help develop and implement effective restorative nursing care programs in long-term care settings.

  3. Second Primary Malignant Neoplasms and Survival in Adolescent and Young Adult Cancer Survivors.

    PubMed

    Keegan, Theresa H M; Bleyer, Archie; Rosenberg, Aaron S; Li, Qian; Goldfarb, Melanie

    2017-11-01

    Although the increased incidence of second primary malignant neoplasms (SPMs) is a well-known late effect after cancer, few studies have compared survival after an SPM to survival of the same cancer occurring as first primary malignant neoplasm (PM) by age. To assess the survival impact of SPMs in adolescents and young adults (AYAs) (15-39 years) compared with that of pediatric (<15 years) and older adult (≥40 years) patients with the same SPMs. This was a population-based, retrospective cohort study of patients with cancer in 13 Surveillance, Epidemiology and End Results regions in the United States diagnosed from 1992 to 2008 and followed through 2013. Data analysis was performed between June 2016 and January 2017. Five-year relative survival was calculated overall and for each cancer occurring as a PM or SPM by age at diagnosis. The impact of SPM status on cancer-specific death was examined using multivariable Cox proportional hazards regression. A total of 15 954 pediatric, 125 750 AYAs, and 878 370 older adult patients diagnosed as having 14 cancers occurring as a PM or SPM were included. Overall, 5-year survival after an SPM was 33.1% lower for children, 20.2% lower for AYAs, and 8.3% lower for older adults compared with a PM at the same age. For the most common SPMs in AYAs, the absolute difference in 5-year survival was 42% lower for secondary non-Hodgkin lymphoma, 19% for secondary breast carcinoma, 15% for secondary thyroid carcinoma, and 13% for secondary soft-tissue sarcoma. Survival by SPM status was significantly worse in younger vs older patients for thyroid, Hodgkin lymphoma, non-Hodgkin lymphoma, acute myeloid leukemia, soft-tissue sarcoma, and central nervous system cancer. Adolescents and young adults with secondary Hodgkin lymphoma (hazard ratio [95% CI], 3.5 [1.7-7.1]); soft-tissue sarcoma (2.8 [2.1-3.9]); breast carcinoma (2.1 [1.8-2.4]); acute myeloid leukemia (1.9 [1.5-2.4]); and central nervous system cancer (1.8 [1

  4. Intelligence moderates the benefits of strategy instructions on memory performance: an adult-lifespan examination.

    PubMed

    Frankenmolen, Nikita L; Altgassen, Mareike; Kessels, Renée; de Waal, Marleen M; Hindriksen, Julie-Anne; Verhoeven, Barbara; Fasotti, Luciano; Scheres, Anouk; Kessels, Roy P C; Oosterman, Joukje M

    2017-01-01

    Whether older adults can compensate for their associative memory deficit by using memory strategies efficiently might depend on their general cognitive abilities. This study examined the moderating role of an IQ estimate on the beneficial effects of strategy instructions. A total of 142 participants (aged 18-85 years) received either intentional learning or strategy ("sentence generation") instructions during encoding of word pairs. Whereas young adults with a lower IQ benefited from strategy instructions, those with a higher IQ did not, presumably because they already use strategies spontaneously. Older adults showed the opposite effect: following strategy instructions, older adults with a higher IQ showed a strong increase in memory performance (approximately achieving the level of younger adults), whereas older adults with a lower IQ did not, suggesting that they have difficulties implementing the provided strategies. These results highlight the importance of the role of IQ in compensating for the aging-related memory decline.

  5. "Girls Are Worse": Drama Queens, Ghetto Girls, Tomboys, and the Meaning of Girl Fights

    ERIC Educational Resources Information Center

    Waldron, Linda M.

    2011-01-01

    This article uses a race-class-gender intersectional approach to analyze qualitative interviews with girls at two public high schools to better understand a common perception that "girls are worse" when it comes to school fights. Several different understandings of why girls fight emerged from the data. On one hand, girls' perception of…

  6. Co-Constructional Task Analysis: Moving beyond Adult-Based Models to Assess Young Children's Task Performance

    ERIC Educational Resources Information Center

    Lee, Scott Weng Fai

    2013-01-01

    The assessment of young children's thinking competence in task performances has typically followed the novice-to-expert regimen involving models of strategies that adults use when engaged in cognitive tasks such as problem-solving and decision-making. Socio-constructivists argue for a balanced pedagogical approach between the adult and child that…

  7. Correlation between nutritional status and comprehensive physical performance measures among older adults with undernourishment in residential institutions.

    PubMed

    Singh, Devinder K A; Manaf, Zahara A; Yusoff, Noor Aini M; Muhammad, Nur A; Phan, Mei Fang; Shahar, Suzana

    2014-01-01

    The consequences of combined undernourishment and decreased physical performance in older adults are debilitating and increases cost of care. To date, the information regarding the association between nutritional status and physical performance does not provide a complete picture. Most studies used limited or self-reported measures to evaluate physical performance. The objective of this study was to examine the correlation between nutritional status and comprehensive physical performance measures among undernourished older adults who reside in residential institutions. Forty-seven older adults (26 males, 21 females) aged ≥ 60 (69.23 ± 8.63) years who were identified as undernourished from two residential institutions participated in this study. A battery of physical performance tests (10 m gait speed test, dominant hand grip strength test, timed five-repetition sit-to-stand test, ten step test, arm curl test, scratch test, and respiratory muscle strength test), biochemical profiles (serum albumin, hemoglobin, serum ferritin, and prealbumin levels), and falls risk using the short-form Physiological Profile Approach were performed. The Functional Ability Questionnaire and Geriatric Depression Scale were also administered. The results demonstrated that generally older adults with undernourishment scored poorly on the physical performance tests, had depression, and a high risk of falls. Biochemical results demonstrated that 10.9% of the participants were anemic, 63% had hypoalbuminemia (<3.5 g/dL), and 21.7% were at risk of protein energy malnutrition with prealbumin level (100-170 mg/L). A significant correlation (P<0.05) was demonstrated between hand grip strength and ferritin, between self-reported mobility dependence and prealbumin levels, and between self-reported mobility tiredness and body mass index. These results confirm that older adults with undernutrition have poor physical function, higher falls risk, and depression. Clinically, overall health that

  8. State performance in pluripotent and adult stem cell research, 2009-2016.

    PubMed

    Surani, Sana H; Levine, Aaron D

    2018-04-01

    To examine how the geographic distribution of pluripotent and adult stem cell research publications within the USA differs from other areas of biomedical research. Publication count data for pluripotent stem cell research, adult stem cell research and a comparison group representative of biomedical research more broadly were collected and analyzed for each US state from 2009 to 2016. The distribution of pluripotent stem cell research differed from the other fields with overperformance in pluripotent stem cell research observed in California, as well as Wisconsin, Massachusetts, Maryland and Connecticut. Our analysis suggests that permissive state stem cell policy may be one of the several factors contributing to strong state performance in pluripotent stem cell research.

  9. Physical activity and 5-year changes in physical performance tests and bone mineral density in postmenopausal women: the Yokogoshi Study.

    PubMed

    Kitamura, Kaori; Nakamura, Kazutoshi; Kobayashi, Ryosaku; Oshiki, Rieko; Saito, Toshiko; Oyama, Mari; Takahashi, Shunsuke; Nishiwaki, Tomoko; Iwasaki, Masanori; Yoshihara, Akihiro

    2011-09-01

    The effect of physical activity on musculoskeletal health in older adults is not completely understood. The aim of this study was to determine the relationship between physical activity and 5-year changes in physical performance tests and bone mineral density (BMD) in postmenopausal women. The design was a 5-year cohort study. Subjects were 507 women (55-74 years old) living in a rural community in Japan. Physical activity assessed included housework, farm work, and moderate leisure-time physical activity within the previous week. Measurements at baseline included handgrip strength, walking time (timed "Up & Go" test) and BMD of the femoral neck and vertebrae. Five-year changes in these measures (outcome variables) were compared among groups with different levels of physical activity by analysis of covariance. Women who did not do housework performed worse in changes in handgrip strength (difference=2.22 kg, P=0.0201) and worse in changes in the walking time (difference=0.54 s, P=0.0072) than those who did housework alone. Women who spent at least 9h per week (median=24) doing farm work performed better in changes in handgrip strength (difference=0.28 kg, P=0.0334), but worse in changes in the walking time (difference=0.66 s, P<0.0001) than those who did not do farm work. However, leisure-time activity was not associated with changes in any outcome variable, and none of the physical activities predicted BMD changes. Engaging in housework and farm work are determinants of physical function in postmenopausal women, which may help them maintain independence in daily living. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Effects of Elastic Resistance Exercise on Muscle Strength and Functional Performance in Healthy Adults: A Systematic Review and Meta-Analysis.

    PubMed

    de Oliveira, Poliana Alves; Blasczyk, Juscelino Castro; Souza Junior, Gerson; Lagoa, Karina Ferreira; Soares, Milene; de Oliveira, Ricardo Jacó; Filho, Paulo José Barbosa Gutierres; Carregaro, Rodrigo Luiz; Martins, Wagner Rodrigues

    2017-04-01

    Elastic Resistance Exercise (ERE) has already demonstrated its effectiveness in older adults and, when combined with the resistance generated by fixed loads, in adults. This review summarizes the effectiveness of ERE performed as isolated method on muscle strength and functional performance in healthy adults. A database search was performed (MEDLine, Cochrane Library, PEDro and Web of Knowledge) to identify controlled clinical trials in English language. The mean difference (MD) with 95% confidence intervals (CIs) and overall effect size were calculated for all comparisons. The PEDro scale was used assess the methodological quality. From the 93 articles identified by the search strategy, 5 met the inclusion criteria, in which 3 presented high quality (PEDro > 6). Meta-analyses demonstrated that the effects of ERE were superior when compared with passive control on functional performance and muscle strength. When compared with active controls, the effect of ERE was inferior on function performance and with similar effect on muscle strength. ERE are effective to improve functional performance and muscle strength when compared with no intervention, in healthy adults. ERE are not superior to other methods of resistance training to improve functional performance and muscle strength in health adults.

  11. Cognitive profiles of older adults with a prior traumatic brain injury versus healthy controls: A meta-analysis.

    PubMed

    An, Kelly Y; Monette, Mich C E

    2018-04-20

    To determine cognitive outcomes in older adults (≥ 50 years old) having sustained a traumatic brain injury (TBI) using meta-analysis. MedLine and PsycInfo databases were searched to identify studies comparing neuropsychological profiles in older adults with and without a history of TBI across various injury severities and times post-injury. Ten studies (n = 717) meeting inclusion criteria were identified. Tests were divided into functional modalities and average effect sizes were calculated across studies on a test-by-test basis. Older adults post-TBI performed worse than the non-TBI group on all cognitive outcomes evaluated (d = -0.34 to -0.75), with naming and vocabulary having the largest effect, M -0.75 (95% CI, -0.98 to -0.52). TBI in older adults leads to moderate deficits on all measured cognitive abilities, with the largest effects observed in naming and vocabulary abilities. The findings pertain broadly to TBI of mixed injury severities and times post-injury, although the majority of participants sustained TBIs of mild uncomplicated severity within one-year post-injury. Future research must address methodological limitations such as variability in reporting injury information, inconsistency in defining older age, and lack of orthopaedic comparison groups in order to permit more nuanced conclusions for this population.

  12. White matter tract integrity predicts visual search performance in young and older adults.

    PubMed

    Bennett, Ilana J; Motes, Michael A; Rao, Neena K; Rypma, Bart

    2012-02-01

    Functional imaging research has identified frontoparietal attention networks involved in visual search, with mixed evidence regarding whether different networks are engaged when the search target differs from distracters by a single (elementary) versus multiple (conjunction) features. Neural correlates of visual search, and their potential dissociation, were examined here using integrity of white matter connecting the frontoparietal networks. The effect of aging on these brain-behavior relationships was also of interest. Younger and older adults performed a visual search task and underwent diffusion tensor imaging (DTI) to reconstruct 2 frontoparietal (superior and inferior longitudinal fasciculus; SLF and ILF) and 2 midline (genu, splenium) white matter tracts. As expected, results revealed age-related declines in conjunction, but not elementary, search performance; and in ILF and genu tract integrity. Importantly, integrity of the superior longitudinal fasciculus, ILF, and genu tracts predicted search performance (conjunction and elementary), with no significant age group differences in these relationships. Thus, integrity of white matter tracts connecting frontoparietal attention networks contributes to search performance in younger and older adults. Copyright © 2012 Elsevier Inc. All rights reserved.

  13. White Matter Tract Integrity Predicts Visual Search Performance in Young and Older Adults

    PubMed Central

    Bennett, Ilana J.; Motes, Michael A.; Rao, Neena K.; Rypma, Bart

    2011-01-01

    Functional imaging research has identified fronto-parietal attention networks involved in visual search, with mixed evidence regarding whether different networks are engaged when the search target differs from distracters by a single (elementary) versus multiple (conjunction) features. Neural correlates of visual search, and their potential dissociation, were examined here using integrity of white matter connecting the fronto-parietal networks. The effect of aging on these brain-behavior relationships was also of interest. Younger and older adults performed a visual search task and underwent diffusion tensor imaging (DTI) to reconstruct two fronto-parietal (superior and inferior longitudinal fasciculus, SLF and ILF) and two midline (genu, splenium) white matter tracts. As expected, results revealed age-related declines in conjunction, but not elementary, search performance; and in ILF and genu tract integrity. Importantly, integrity of the SLF, ILF, and genu tracts predicted search performance (conjunction and elementary), with no significant age group differences in these relationships. Thus, integrity of white matter tracts connecting fronto-parietal attention networks contributes to search performance in younger and older adults. PMID:21402431

  14. Auditory measures of selective and divided attention in young and older adults using single-talker competition.

    PubMed

    Humes, Larry E; Lee, Jae Hee; Coughlin, Maureen P

    2006-11-01

    In this study, two experiments were conducted on auditory selective and divided attention in which the listening task involved the identification of words in sentences spoken by one talker while a second talker produced a very similar competing sentence. Ten young normal-hearing (YNH) and 13 elderly hearing-impaired (EHI) listeners participated in each experiment. The type of attention cue used was the main difference between experiments. Across both experiments, several consistent trends were observed. First, in eight of the nine divided-attention tasks across both experiments, the EHI subjects performed significantly worse than the YNH subjects. By comparison, significant differences in performance between age groups were only observed on three of the nine selective-attention tasks. Finally, there were consistent individual differences in performance across both experiments. Correlational analyses performed on the data from the 13 older adults suggested that the individual differences in performance were associated with individual differences in memory (digit span). Among the elderly, differences in age or differences in hearing loss did not contribute to the individual differences observed in either experiment.

  15. The relationship between IGF-I concentration, cognitive function and quality of life in adults with Prader-Willi syndrome.

    PubMed

    van Nieuwpoort, I C; Deijen, J B; Curfs, L M G; Drent, M L

    2011-04-01

    Mental retardation is one of the clinical characteristics of Prader-Willi syndrome (PWS) and in part of the patients growth hormone deficiency is demonstrable. Cognitive function seems to be influenced by insulin-like growth factor I (IGF-I); however, little is known about cognitive function in relation to IGF-I levels in PWS adults. The aim of the present study was to evaluate cognitive function in adult PWS patients in comparison to healthy siblings and to investigate whether there is a correlation between cognitive function and IGF-I levels. Anthropometric measurements, IGF-I levels, quality of life (QoL), Appetite Assessment Score, IQ (GIT and Raven) and cognitive function (by four subtests of the Cambridge Neuropsychological Automated Testing Battery, CANTAB) were evaluated in PWS patients and their healthy siblings served as control group. PWS patients had significantly lower IGF-I levels, IQ and QoL when compared to controls. Reaction times were longer and performance was worse on CANTAB subtests in PWS adults. IGF-I on one hand and IQ, Appetite Assessment Score and cognitive performance on the other hand seem to be correlated in PWS patients. In conclusion, IGF-I levels, IQ and QoL are significantly lower in PWS subjects when compared to healthy siblings. In PWS adults, temporal as well as prefrontal cognitive functions are impaired. Higher IGF-I levels appear to be related to better intellectual skills and faster temporal memory processing in PWS patients. Copyright © 2011 Elsevier Inc. All rights reserved.

  16. Interpreting the Need for Initial Support to Perform Tandem Stance Tests of Balance

    PubMed Central

    Brach, Jennifer S.; Perera, Subashan; Wert, David M.; VanSwearingen, Jessie M.; Studenski, Stephanie A.

    2012-01-01

    Background Geriatric rehabilitation reimbursement increasingly requires documented deficits on standardized measures. Tandem stance performance can characterize balance, but protocols are not standardized. Objective The purpose of this study was to explore the impact of: (1) initial support to stabilize in position and (2) maximum hold time on tandem stance tests of balance in older adults. Design A cross-sectional secondary analysis of observational cohort data was conducted. Methods One hundred seventeen community-dwelling older adults (71% female, 12% black) were assigned to 1 of 3 groups based on the need for initial support to perform tandem stance: (1) unable even with support, (2) able only with support, and (3) able without support. The able without support group was further stratified on hold time in seconds: (1) <10 (low), (2) 10 to 29, (medium), and (3) 30 (high). Groups were compared on primary outcomes (gait speed, Timed “Up & Go” Test performance, and balance confidence) using analysis of variance. Results Twelve participants were unable to perform tandem stance, 14 performed tandem stance only with support, and 91 performed tandem stance without support. Compared with the able without support group, the able with support group had statistically or clinically worse performance and balance confidence. No significant differences were found between the able with support group and the unable even with support group on these same measures. Extending the hold time to 30 seconds in a protocol without initial support eliminated ceiling effects for 16% of the study sample. Limitations Small comparison groups, use of a secondary analysis, and lack of generalizability of results were limitations of the study. Conclusions Requiring initial support to stabilize in tandem stance appears to reflect meaningful deficits in balance-related mobility measures, so failing to consider support may inflate balance estimates and confound hold time comparisons

  17. Quality of Life, Functioning, and Depressive Symptom Severity in Older Adults With Major Depressive Disorder Treated With Citalopram in the STAR*D Study.

    PubMed

    Steiner, Alexander J; Recacho, Jennifer; Vanle, Brigitte; Dang, Jonathan; Wright, Stephanie M; Miller, Justin S; Kauzor, Kaitlyn; Reid, Mark; Bashmi, Luma E; Mirocha, James; Danovitch, Itai; IsHak, Waguih William

    2017-07-01

    Major depressive disorder (MDD) can substantially worsen patient-reported quality of life (QOL) and functioning. Prior studies have examined the role of age in MDD by comparing depressive symptom severity or remission rates between younger and older adults. This study examines these outcomes before and after SSRI treatment. On the basis of prior research, we hypothesized that older adults would have worse treatment outcomes in QOL, functioning, and depressive symptom severity and that nonremitters would have worse outcomes. A retrospective secondary data analysis was conducted from the National Institute of Mental Health-funded Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (July 2001-September 2006). We analyzed data for 2,280 nonpsychotic adults with DSM-IV-TR-defined MDD who received citalopram monotherapy. Older adults were classified as adults aged 65 years and above. All subjects completed patient-reported QOL, functioning, and depressive symptom severity measures at entry and exit. Subjects included 106 older adults and 2,174 adults < 65. MDD remission status posttreatment was also determined. Both older adults and adults < 65 experienced significant improvements and medium to large treatment responses across QOL, functioning, and depressive symptom severity (P < .001). Older adults had smaller treatment effect sizes for all outcomes, particularly functioning. Conversely, mean change scores from entry to exit were equivalent across all outcomes. Remitters at exit had significantly better responses to treatment than nonremitters for the majority of outcomes. Findings suggest that older adults and younger adults have comparable treatment responses to citalopram monotherapy, with significant improvements in patient-reported depressive symptom severity, functioning, and QOL. ClinicalTrials.gov identifier: NCT00021528. © Copyright 2017 Physicians Postgraduate Press, Inc.

  18. Preventing the cure from being worse than the disease: special issues in hospital outsourcing.

    PubMed

    Beardwood, John; Alleyne, Andrew

    2004-01-01

    Like private sector organizations, hospitals are increasingly outsourcing services from food/cafeteria and security and facilities maintenance to the consulting and training of personnel and information technology (IT) functions. Also like private sector organizations, while hospitals seek the cure that will improve services at less cost, without careful management, the cure can be worse than the disease.

  19. International consensus on preliminary definitions of improvement in adult and juvenile myositis.

    PubMed

    Rider, Lisa G; Giannini, Edward H; Brunner, Hermine I; Ruperto, Nicola; James-Newton, Laura; Reed, Ann M; Lachenbruch, Peter A; Miller, Frederick W

    2004-07-01

    To use a core set of outcome measures to develop preliminary definitions of improvement for adult and juvenile myositis as composite end points for therapeutic trials. Twenty-nine experts in the assessment of myositis achieved consensus on 102 adult and 102 juvenile paper patient profiles as clinically improved or not improved. Two hundred twenty-seven candidate definitions of improvement were developed using the experts' consensus ratings as a gold standard and their judgment of clinically meaningful change in the core set of measures. Seventeen additional candidate definitions of improvement were developed from classification and regression tree analysis, a data-mining decision tree tool analysis. Six candidate definitions specifying percentage change or raw change in the core set of measures were developed using logistic regression analysis. Adult and pediatric working groups ranked the 13 top-performing candidate definitions for face validity, clinical sensibility, and ease of use, in which the sensitivity and specificity were >/=75% in adult, pediatric, and combined data sets. Nominal group technique was used to facilitate consensus formation. The definition of improvement (common to the adult and pediatric working groups) that ranked highest was 3 of any 6 of the core set measures improved by >/=20%, with no more than 2 worse by >/=25% (which could not include manual muscle testing to assess strength). Five and 4 additional preliminary definitions of improvement for adult and juvenile myositis, respectively, were also developed, with several definitions common to both groups. Participants also agreed to prospectively test 6 logistic regression definitions of improvement in clinical trials. Consensus preliminary definitions of improvement were developed for adult and juvenile myositis, and these incorporate clinically meaningful change in all myositis core set measures in a composite end point. These definitions require prospective validation, but they are now

  20. The association between physical characteristics of the ankle joint and the mobility performance in elderly people with type 2 diabetes mellitus.

    PubMed

    Ng, Thomas Ka-Wai; Lo, Sing-Kai; Cheing, Gladys Lai-Ying

    2014-01-01

    Previous studies showed that older adults with diabetes have a worse mobility performance as compared with those without diabetes. Studies also demonstrated that older adults with diabetes have weakened ankle muscle strength, reduced joint range in ankle dorsiflexion and worsened ankle joint proprioception as compared with control population. The purpose of the present study was to examine the relationship between the physical characteristics of the ankle joint and the mobility performance in older adults with type 2 diabetes. Older adults with type 2 diabetes (n=85) were recruited, and Timed Up and Go test (TUG) for mobility assessment was performed. Active ankle joint repositioning test was used for assessing the ankle joint proprioception sense; peak torque of ankle dorsiflexors and plantar flexors were tested by using a Cybex Norm dynamometer, and weight-bearing lunge test (WBLT) was used for assessing the stiffness of ankle dorsiflexion. Our results showed that age, body mass index (BMI), normalized peak torque of plantar flexors and dorsiflexors, active ankle joint repositioning test errors and the WBLT distance were significantly correlated with the TUG (all p<0.001). These ankle characteristics, together with the demographic data of the subjects, contributed 59.9% of the variance in the TUG by multiple regression analysis. Body mass, ankle plantar flexors strength and ankle joint proprioception are important factors contributing to the physical mobility of the older adults with type 2 diabetes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Variability in common synaptic input to motor neurons modulates both force steadiness and pegboard time in young and older adults.

    PubMed

    Feeney, Daniel F; Mani, Diba; Enoka, Roger M

    2018-06-07

    We investigated the associations between grooved pegboard times, force steadiness (coefficient of variation for force), and variability in an estimate of the common synaptic input to motor neurons innervating the wrist extensor muscles during steady contractions performed by young and older adults. The discharge times of motor units were derived from recordings obtained with high-density surface electrodes while participants performed steady isometric contractions at 10% and 20% of maximal voluntary contraction (MVC) force. The steady contractions were performed with a pinch grip and wrist extension, both independently (single action) and concurrently (double action). The variance in common synaptic input to motor neurons was estimated with a state-space model of the latent common input dynamics. There was a statistically significant association between the coefficient of variation for force during the steady contractions and the estimated variance in common synaptic input in young (r 2 = 0.31) and older (r 2 = 0.39) adults, but not between either the mean or the coefficient of variation for interspike interval of single motor units with the coefficient of variation for force. Moreover, the estimated variance in common synaptic input during the double-action task with the wrist extensors at the 20% target was significantly associated with grooved pegboard time (r 2 = 0.47) for older adults, but not young adults. These findings indicate that longer pegboard times of older adults were associated with worse force steadiness and greater fluctuations in the estimated common synaptic input to motor neurons during steady contractions. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  2. Effect of Indoor Temperature on Physical Performance in Older Adults during Days with Normal Temperature and Heat Waves.

    PubMed

    Lindemann, Ulrich; Stotz, Anja; Beyer, Nina; Oksa, Juha; Skelton, Dawn A; Becker, Clemens; Rapp, Kilian; Klenk, Jochen

    2017-02-14

    Indoor temperature is relevant with regard to mortality and heat-related self-perceived health problems. The aim of this study was to describe the association between indoor temperature and physical performance in older adults. Eighty-one older adults (84% women, mean age 80.9 years, standard deviation 6.53) were visited every four weeks from May to October 2015 and additionally during two heat waves in July and August 2015. Indoor temperature, habitual gait speed, chair-rise performance and balance were assessed. Baseline assessment of gait speed was used to create two subgroups (lower versus higher gait speed) based on frailty criteria. The strongest effect of increasing temperature on habitual gait speed was observed in the subgroup of adults with higher gait speed (-0.087 m/s per increase of 10 °C; 95% confidence interval (CI): -0.136; -0.038). The strongest effects on timed chair-rise and balance performance were observed in the subgroup of adults with lower gait speed (2.03 s per increase of 10 °C (95% CI: 0.79; 3.28) and -3.92 s per increase of 10 °C (95% CI: -7.31; -0.52), respectively). Comparing results of physical performance in absentia of a heat wave and during a heat wave, habitual gait speed was negatively affected by heat in the total group and subgroup of adults with higher gait speed, chair-rise performance was negatively affected in all groups and balance was not affected. The study provides arguments for exercise interventions in general for older adults, because a better physical fitness might alleviate impediments of physical capacity and might provide resources for adequate adaptation in older adults during heat stress.

  3. Physical performance limitations among adult survivors of childhood brain tumors.

    PubMed

    Ness, Kirsten K; Morris, E Brannon; Nolan, Vikki G; Howell, Carrie R; Gilchrist, Laura S; Stovall, Marilyn; Cox, Cheryl L; Klosky, James L; Gajjar, Amar; Neglia, Joseph P

    2010-06-15

    Young adult survivors of childhood brain tumors (BTs) may have late effects that compromise physical performance and everyday task participation. The objective of this study was to evaluate muscle strength, fitness, physical performance, and task participation among adult survivors of childhood BTs. In-home evaluations and interviews were conducted for 156 participants (54% men). Results on measures of muscle strength, fitness, physical performance, and participation were compared between BT survivors and members of a population-based comparison group by using chi-square statistics and 2-sample t tests. Associations between late effects and physical performance and between physical performance and participation were evaluated in regression models. : The median age of BT survivors was 22 years (range, 18-58 years) at the time of the current evaluation, and they had survived for a median of 14.7 years (range, 6.5-45.9 years) postdiagnosis. Survivors had lower estimates of grip strength (women, 24.7 + or - 9.2 kg vs 31.5 + or - 5.8 kg; men, 39.0 + or - 12.2 kg vs 53.0 + or - 10.1 kg), knee extension strength (women, 246.6 + or - 95.5 Newtons [N] vs 331.5 + or - 5.8 N; men, 304.7 + or - 116.4 N vs 466.6 + or - 92.1 N), and peak oxygen uptake (women, 25.1 + or - 8.8 mL/kg per minute vs 31.3 + or - 5.1 mL/kg per minute; men, 24.6 + or - 9.5 mL/kg per minute vs 33.2 + or - 3.4 mL/kg per minute) than members of the population-based comparison group. Physical performance was lower among survivors and was associated with not living independently (odds ratio [OR], 5.0; 95% confidence interval [CI], 2.0-12.2) and not attending college (OR, 2.3; 95% CI 1.2-4.4). Muscle strength and fitness values among BT survivors were similar to those among individuals aged > or = 60 years and were associated with physical performance limitations. Physical performance limitations were associated with poor outcomes in home and school environments. The current data indicated an opportunity for

  4. Latent autoimmune diabetes in adults is perched between type 1 and type 2: evidence from adults in one region of Spain.

    PubMed

    Mollo, Angels; Hernandez, Marta; Marsal, Josep R; Esquerda, Aureli; Rius, Ferran; Blanco-Vaca, Francisco; Verdaguer, Joan; Pozzilli, Paolo; de Leiva, Alberto; Mauricio, Didac

    2013-09-01

    The aim of this study was to characterize the clinical characteristics and insulin secretion in adults with latent autoimmune diabetes in adults (LADA). We also compared these characteristics in subjects with antibody-negative type 2 diabetes (T2DM) or adult-onset type 1 diabetes (T1DM) to subjects with LADA. In this cross-sectional study, 82 patients with LADA, 78 with T1DM and 485 with T2DM were studied. Clinical and metabolic data, in particular those that related to metabolic syndrome, fasting C-peptide and islet-cell autoantibodies [glutamic acid decarboxylase (GADAb) and IA2 (IA2Ab)] were measured. The frequency of metabolic syndrome in patients with LADA (37.3%) was higher than in those with T1DM (15.5%; p = 0.005) and lower than in patients with T2DM (67.2%; p < 0.001). During the first 36 months of the disease, the C-peptide concentration in LADA patients was higher than in subjects with T1DM but was lower than in T2DM patients (p < 0.01 for comparisons). Glycemic control in LADA patients (HbA1c 8.1%) was worse than in patients with T2DM (HbA1c 7.6%; p =0.007). An inverse association between GADAb titers and C-peptide concentrations was found in subjects with LADA (p < 0.001). Finally, LADA patients rapidly progressed to insulin treatment. As in other European populations, patients with LADA in Spain have a distinct metabolic profile compared with patients with T1DM or T2DM. LADA is also associated with higher impairment of beta-cell function and has worse glycemic control than in T2DM. Beta cell function is related to GADAb titers in patients with LADA. Copyright © 2013 John Wiley & Sons, Ltd.

  5. Organizational and Market Influences on Physician Performance on Patient Experience Measures

    PubMed Central

    Rodriguez, Hector P; von Glahn, Ted; Rogers, William H; Safran, Dana Gelb

    2009-01-01

    Objective To examine the extent to which medical group and market factors are related to individual primary care physician (PCP) performance on patient experience measures. Data Sources This study employs Clinician and Group CAHPS survey data (n=105,663) from 2,099 adult PCPs belonging to 34 diverse medical groups across California. Medical group directors were interviewed to assess the magnitude and nature of financial incentives directed at individual physicians and the adoption of patient experience improvement strategies. Primary care services area (PCSA) data were used to characterize the market environment of physician practices. Study Design We used multilevel models to estimate the relationship between medical group and market factors and physician performance on each Clinician and Group CAHPS measure. Models statistically controlled for respondent characteristics and accounted for the clustering of respondents within physicians, physicians within medical groups, and medical groups within PCSAs using random effects. Principal Findings Compared with physicians belonging to independent practice associations, physicians belonging to integrated medical groups had better performance on the communication (p=.007) and care coordination (p=.03) measures. Physicians belonging to medical groups with greater numbers of PCPs had better performance on all measures. The use of patient experience improvement strategies was not associated with performance. Greater emphasis on productivity and efficiency criteria in individual physician financial incentive formulae was associated with worse access to care (p=.04). Physicians located in PCSAs with higher area-level deprivation had worse performance on the access to care (p=.04) and care coordination (p<.001) measures. Conclusions Physicians from integrated medical groups and groups with greater numbers of PCPs performed better on several patient experience measures, suggesting that organized care processes adopted by these

  6. Organizational and market influences on physician performance on patient experience measures.

    PubMed

    Rodriguez, Hector P; von Glahn, Ted; Rogers, William H; Safran, Dana Gelb

    2009-06-01

    To examine the extent to which medical group and market factors are related to individual primary care physician (PCP) performance on patient experience measures. This study employs Clinician and Group CAHPS survey data (n=105,663) from 2,099 adult PCPs belonging to 34 diverse medical groups across California. Medical group directors were interviewed to assess the magnitude and nature of financial incentives directed at individual physicians and the adoption of patient experience improvement strategies. Primary care services area (PCSA) data were used to characterize the market environment of physician practices. We used multilevel models to estimate the relationship between medical group and market factors and physician performance on each Clinician and Group CAHPS measure. Models statistically controlled for respondent characteristics and accounted for the clustering of respondents within physicians, physicians within medical groups, and medical groups within PCSAs using random effects. Compared with physicians belonging to independent practice associations, physicians belonging to integrated medical groups had better performance on the communication ( p=.007) and care coordination ( p=.03) measures. Physicians belonging to medical groups with greater numbers of PCPs had better performance on all measures. The use of patient experience improvement strategies was not associated with performance. Greater emphasis on productivity and efficiency criteria in individual physician financial incentive formulae was associated with worse access to care ( p=.04). Physicians located in PCSAs with higher area-level deprivation had worse performance on the access to care ( p=.04) and care coordination ( p<.001) measures. Physicians from integrated medical groups and groups with greater numbers of PCPs performed better on several patient experience measures, suggesting that organized care processes adopted by these groups may enhance patients' experiences. Physicians practicing

  7. The Impact of Age Stereotypes on Older Adults' Hazard Perception Performance and Driving Confidence.

    PubMed

    Chapman, Lyn; Sargent-Cox, Kerry; Horswill, Mark S; Anstey, Kaarin J

    2016-06-01

    This study examined the effect of age-stereotype threat on older adults' performance on a task measuring hazard perception performance in driving. The impact of age-stereotype threat in relation to the value participants placed on driving and pre- and post-task confidence in driving ability was also investigated. Eighty-six adults aged from 65 years of age completed a questionnaire measuring demographic information, driving experience, self-rated health, driving importance, and driving confidence. Prior to undertaking a timed hazard perception task, participants were exposed to either negative or positive age stereotypes. Results showed that age-stereotype threats, while not influencing hazard perception performance, significantly reduced post-driving confidence compared with pre-driving confidence for those in the negative prime condition. This finding builds on the literature that has found that stereotype-based influences cannot simply be understood in terms of performance outcomes alone and may be relevant to factors affected by confidence such as driving cessation decisions. © The Author(s) 2014.

  8. Self-reported walking ability predicts functional mobility performance in frail older adults.

    PubMed

    Alexander, N B; Guire, K E; Thelen, D G; Ashton-Miller, J A; Schultz, A B; Grunawalt, J C; Giordani, B

    2000-11-01

    To determine how self-reported physical function relates to performance in each of three mobility domains: walking, stance maintenance, and rising from chairs. Cross-sectional analysis of older adults. University-based laboratory and community-based congregate housing facilities. Two hundred twenty-one older adults (mean age, 79.9 years; range, 60-102 years) without clinical evidence of dementia (mean Folstein Mini-Mental State score, 28; range, 24-30). We compared the responses of these older adults on a questionnaire battery used by the Established Populations for the Epidemiologic Study of the Elderly (EPESE) project, to performance on mobility tasks of graded difficulty. Responses to the EPESE battery included: (1) whether assistance was required to perform seven Katz activities of daily living (ADL) items, specifically with walking and transferring; (2) three Rosow-Breslau items, including the ability to walk up stairs and walk a half mile; and (3) five Nagi items, including difficulty stooping, reaching, and lifting objects. The performance measures included the ability to perform, and time taken to perform, tasks in three summary score domains: (1) walking ("Walking," seven tasks, including walking with an assistive device, turning, stair climbing, tandem walking); (2) stance maintenance ("Stance," six tasks, including unipedal, bipedal, tandem, and maximum lean); and (3) chair rise ("Chair Rise," six tasks, including rising from a variety of seat heights with and without the use of hands for assistance). A total score combines scores in each Walking, Stance, and Chair Rise domain. We also analyzed how cognitive/ behavioral factors such as depression and self-efficacy related to the residuals from the self-report and performance-based ANOVA models. Rosow-Breslau items have the strongest relationship with the three performance domains, Walking, Stance, and Chair Rise (eta-squared ranging from 0.21 to 0.44). These three performance domains are as strongly

  9. Retrospective cues based on object features improve visual working memory performance in older adults.

    PubMed

    Gilchrist, Amanda L; Duarte, Audrey; Verhaeghen, Paul

    2016-01-01

    Research with younger adults has shown that retrospective cues can be used to orient top-down attention toward relevant items in working memory. We examined whether older adults could take advantage of these cues to improve memory performance. Younger and older adults were presented with visual arrays of five colored shapes; during maintenance, participants were presented either with an informative cue based on an object feature (here, object shape or color) that would be probed, or with an uninformative, neutral cue. Although older adults were less accurate overall, both age groups benefited from the presentation of an informative, feature-based cue relative to a neutral cue. Surprisingly, we also observed differences in the effectiveness of shape versus color cues and their effects upon post-cue memory load. These results suggest that older adults can use top-down attention to remove irrelevant items from visual working memory, provided that task-relevant features function as cues.

  10. Home Delivered Meals to Older Adults: A Critical Review of the Literature.

    PubMed

    Gualtieri, Marie C; Donley, Amy M; Wright, James D; Vega, Sara Strickhouser

    The United States is witnessing a growing aging population stemming in part from medical advancements allowing people to live decades longer than previous generations. Simultaneously, food insecurity among older adults has increased, and is projected to get worse as the Baby Boomer generation ages. This review focuses on an assistance program for older adults: home-delivered meals. Specifically, we focus on the effects of Meals on Wheels (MOW) on the physical and emotional well-being of older adults, and the wide variety of procedural and operational issues that various MOW programs around the country experience. Findings from the literature highlight the positive outcomes these programs have on their clients. Although there have been recent budget cut threats from the federal government, evidence suggests that more funding should be allocated so these programs can provide services to everyone in need, and even expand what they are able to offer to older adults.

  11. Evaluation of frailty in older adults with cardiovascular disease: incorporating physical performance measures.

    PubMed

    Gary, Rebecca

    2012-01-01

    Rapid growth in the numbers of older adults with cardiovascular disease (CVD) is raising awareness and concern of the impact that common geriatric syndromes such as frailty may have on clinical outcomes, health-related quality of life, and rising economic burden associated with healthcare. Increasingly, frailty is recognized to be a highly prevalent and important risk factor that is associated with adverse cardiovascular outcomes. A limitation of previous studies in patients with CVD has been the lack of a consistent definition and measures to evaluate frailty. In this review, building upon the work of Fried and colleagues, a definition of frailty is provided that is applicable for evaluating frailty in older adults with CVD. Simple, well-established performance-based measures widely used in comprehensive geriatric assessment are recommended that can be readily implemented by nurses in most practice settings. The limited studies conducted in older adults with CVD have shown physical performance measures to be highly predictive of clinical outcomes. Implications for practice and areas for future research are described for the growing numbers of elderly cardiac patients who are frail frailty and at risk for disability.

  12. Submaximal oxygen uptake kinetics, functional mobility, and physical activity in older adults with heart failure and reduced ejection fraction.

    PubMed

    Hummel, Scott L; Herald, John; Alpert, Craig; Gretebeck, Kimberlee A; Champoux, Wendy S; Dengel, Donald R; Vaitkevicius, Peter V; Alexander, Neil B

    2016-07-01

    Submaximal oxygen uptake measures are more feasible and may better predict clinical cardiac outcomes than maximal tests in older adults with heart failure (HF). We examined relationships between maximal oxygen uptake, submaximal oxygen kinetics, functional mobility, and physical activity in older adults with HF and reduced ejection fraction. Older adults with HF and reduced ejection fraction (n = 25, age 75 ± 7 years) were compared to 25 healthy age- and gender-matched controls. Assessments included a maximal treadmill test for peak oxygen uptake (VO2peak), oxygen uptake kinetics at onset of and on recovery from a submaximal treadmill test, functional mobility testing [Get Up and Go (GUG), Comfortable Gait Speed (CGS), Unipedal Stance (US)], and self-reported physical activity (PA). Compared to controls, HF had worse performance on GUG, CGS, and US, greater delays in submaximal oxygen uptake kinetics, and lower PA. In controls, VO2peak was more strongly associated with functional mobility and PA than submaximal oxygen uptake kinetics. In HF patients, submaximal oxygen uptake kinetics were similarly associated with GUG and CGS as VO2peak, but weakly associated with PA. Based on their mobility performance, older HF patients with reduced ejection fraction are at risk for adverse functional outcomes. In this population, submaximal oxygen uptake measures may be equivalent to VO2 peak in predicting functional mobility, and in addition to being more feasible, may provide better insight into how aerobic function relates to mobility in older adults with HF.

  13. Floating elbow injuries in adults: prognostic factors affecting clinical outcomes.

    PubMed

    Ditsios, Konstantinos; Boutsiadis, Achilleas; Papadopoulos, Pericles; Karataglis, Dimitrios; Givissis, Panagiotis; Hatzokos, Ippokratis; Christodoulou, Anastasios

    2013-01-01

    Floating elbow fractures in adults are rare and complex injuries with unpredictable outcomes. The present study was designed to assess our experience, analyze possible compilations and illustrate prognostic factors of the final outcome. Between 2002 and 2009, 19 patients with floating elbow fractures were treated in our department (mean follow-up, 26 months). The fractures were open in 10 patients (52.6%), and concomitant nerve palsy was present in 10 patients. Although the term "floating elbow" refers only to concomitant ipsilateral humeral and forearm shaft fractures, we also included injuries with intra-articular involvement. We categorized the patients into 4 groups: group I (10 patients) included shaft fractures of humerus and forearm, group IIa (5 patients) and IIb (1 patient) included partial intra-articular injuries, and group III (3 patients) involved only intra-articular comminuted fractures of the elbow region. Fracture healing was observed 14 weeks postoperatively, except in 2 patients, in which elbow arthroplasty was applied, and in 1 with brachial artery injury. Nine patients with nerve neuropraxia recovered 4 months postoperatively, and tendon transfers were necessary in 1 patient. Recovery in patients with nerve palsy was worse than in those without nerve injury (Mayo Elbow Performance Score, 73 vs 88.34; Khalfayan score, 72 vs 88.3). In addition, intra-articular involvement (groups II and III) negatively influenced the final clinical outcome compared with isolated shaft fractures (group I; Mayo Elbow Performance Score, 71.1 vs 88.5; Khalfayan score, 72.67 vs 86.1). Although the nature of floating elbow injuries is complex, the presence of nerve injury and intra-articular involvement predispose to worse clinical outcomes. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  14. A cohort study on psychosocial adjustment and psychopathology in adolescents and young adults with congenital heart disease

    PubMed Central

    Freitas, Isabela Ribeiro; Castro, Marta; Sarmento, Sofia Lourenço; Moura, Cláudia; Viana, Victor; Areias, José Carlos; Areias, Maria Emília Guimarães

    2013-01-01

    Objectives Our purpose was to study psychosocial adjustment and psychiatric morbidity of adolescents and young adults with congenital heart disease (CHD). Design All assessment measures were obtained on a single occasion. Clinical data was obtained through the patient's clinical records. Setting A teaching and tertiary care facility in Porto, Portugal. Participants We evaluated 110 CHD patients (62 male) aged from 12 to 26 years (mean=18.00±3.617), 58 cyanotic. All assessment measures were obtained on a single occasion in a tertiary hospital. Demographic information and clinical history were collected. Primary and secondary outcome measures Questionnaires regarded topics such as social support, family educational style, self-image and physical limitations, a standardised psychiatric interview Schedule for Affective Disorders and Schizophrenia—Lifetime version (SADS-L), and a self-report questionnaire on psychosocial adjustment, youth self-report or adult self-report. One of the relatives completed an observational version of the same questionnaire (child behaviour checklist (CBCL) or ABCL (adult behaviour checklist)). Results We found a 21.8% lifetime prevalence of psychopathology, 31.3%, in females, 14.5% in males, showing a somewhat increased proneness in CHD patients. Females also showed worse psychosocial adjustment, with more somatic complaints (u=260 000; p=0.011), anxiety/depression (u=984 000; p=0.002), aggressive behaviour (u=920 500; p=0.001), attention problems (u=1123 500; p=0.027), thought problems (u=1069 500; p=0.010), internalisation (u=869 000; p=0.0) and externalisation (u=1163 000; p=0.05). Patients with severe CHD (u=939 000; p=0.03) and surgical repair (u=719 000; p=0.037) showed worse psychosocial adjustment. Those with poor social support showed more withdrawal (u=557 500; p=0.0) and social problems (u=748 500; p=0.023), and patients with unsatisfactory school performance revealed more anxiety/depression (u=916

  15. Increased phosphorylation of ERK1/2 is associated with worse chemotherapeutic outcome and a poor prognosis in advanced lung adenocarcinoma.

    PubMed

    Tsujino, Ichiro; Nakanishi, Yoko; Hiranuma, Hisato; Shimizu, Tetsuo; Hirotani, Yukari; Ohni, Sumie; Ouchi, Yasushi; Takahashi, Noriaki; Nemoto, Norimichi; Hashimoto, Shu

    2016-06-01

    Constitutive activation of extracellular signal-regulated kinase (ERK)1/2 pathway, that is activated by various stimuli including growth factors and oncogenic driver mutations, is observed in various cancers. However, the difference of the activated levels of the pathway is still unclear in clinical significances. The aim of this study was to investigate the effect of different ERK1/2 pathway activation, assessed by the expression levels of phosphorylated (p) ERK1/2, on the prognosis of advanced lung adenocarcinoma patients. Paraffin-embedded lung biopsy samples were obtained from 85 lung adenocarcinoma patients. Correlation between pERK1/2 expression levels that were assessed by immunohistochemistry (IHC) analysis and oncogenic driver mutation status, clinicopathological factors, outcome from standard anticancer therapies, and prognosis was investigated. Varying levels of pERK1/2 expression were observed in 68 (80.0 %) patients. The overall survival was significantly reduced in patients with higher pERK1/2 expression in comparison to those with lower expression levels (P = 0.03). In particular, higher pERK1/2 expression levels correlated with worse performance status and worse clinical outcome. Thus, the IHC analysis of pERK1/2 expression levels may predict patient prognosis in advanced lung adenocarcinoma. Inhibition of ERK1/2 pathway activated by various signals may improve the effects of standard chemotherapies and the clinical condition of patients with advanced cancer.

  16. Motor unit activity when young and old adults perform steady contractions while supporting an inertial load

    PubMed Central

    Gould, Jeffrey R.; Enoka, Roger M.

    2013-01-01

    The purpose of the study was to compare the discharge characteristics of biceps brachii motor units of young and old adults when they performed steady, submaximal contractions while the arm supported different inertial loads. Young (28 ± 4 yr; n = 16) and old (75 ± 4 yr; n = 14) adults performed steady contractions with the elbow flexors at target forces set at either small (11.7 ± 4.4% maximum) or large (17.8 ± 6.5% maximum) differences below the recruitment threshold force of the motor unit (n = 40). The task was to maintain an elbow angle at 1.57 rad until the motor unit was recruited and discharged action potentials for ∼120 s. Time to recruitment was longer for the larger target force difference (187 ± 227 s vs. 23 ± 46 s, P < 0.001). Once recruited, motor units discharged action potentials either repetitively or intermittently, with a greater proportion of motor units exhibiting the repetitive pattern for old adults. Discharge rate at recruitment and during the steady contraction was similar for the two target force differences for old adults but was greater for the small target force difference for young adults. Discharge variability was similar at recruitment for the two age groups but less for the old adults during the steady contraction. The greatest difference between the present results and those reported previously when the arm pulled against a rigid restraint was that old adults modulated discharge rate less than young adults across the two contraction intensities for both load types. PMID:23221403

  17. White matter abnormalities and their impact on attentional performance in adult attention-deficit/hyperactivity disorder.

    PubMed

    Konrad, Andreas; Dielentheis, Thomas F; El Masri, Dschamil; Dellani, Paulo R; Stoeter, Peter; Vucurevic, Goran; Winterer, Georg

    2012-06-01

    Inattention is the most important behavioral feature of adult patients with attention-deficit/hyperactivity disorder (ADHD). Neuroimaging studies in ADHD have demonstrated abnormalities primarily in the frontostriatal circuitry and were mostly conducted in children. We investigated white matter (WM) integrity in adult ADHD patients and the correlation of WM microstructure and neuropsychological parameters in 37 (21 men) never-medicated adult ADHD patients and 34 age- and gender-matched healthy controls. All subjects underwent clinical interviews, rating scales, and neuropsychological tests of attentional performance. Diffusion tensor imaging (DTI) was acquired, and 12 WM regions-of-interest (ROIs) within the attentional network were chosen. Group differences of mean fractional anisotropy (FA) and mean diffusivity (MD) values were calculated for each ROI, and patients' DTI measures were then correlated with measures of attentional performance. FA values in ADHD patients were significantly reduced in the left inferior longitudinal fasciculus (ILF), while MD values were significantly increased in ADHD patients in the frontal portion of the left frontooccipital fasciculus (IFO). In ADHD patients, MD values were negatively correlated with attentional performance in the left ILF. Our findings provide further support for disturbed frontostriatal structural connectivity and also point to an involvement of the left temporal white matter with an impact on attentional performance.

  18. Tibial Eminence Involvement With Tibial Plateau Fracture Predicts Slower Recovery and Worse Postoperative Range of Knee Motion.

    PubMed

    Konda, Sanjit R; Driesman, Adam; Manoli, Arthur; Davidovitch, Roy I; Egol, Kenneth A

    2017-07-01

    To examine 1-year functional and clinical outcomes in patients with tibial plateau fractures with tibial eminence involvement. Retrospective analysis of prospectively collected data. Academic Medical Center. All patients who presented with a tibial plateau fracture (Orthopaedic Trauma Association (OTA) 41-B and 41-C). Patients were divided into fractures with a tibial eminence component (+TE) and those without (-TE) cohorts. All patients underwent similar surgical approaches and fixation techniques for fractures. No tibial eminence fractures received fixation specifically. Short musculoskeletal functional assessment (SMFA), pain (Visual Analogue Scale), and knee range-of-motion (ROM) were evaluated at 3, 6, and 12 months postoperatively and compared between cohorts. Two hundred ninety-three patients were included for review. Patients with OTA 41-C fractures were more likely to have an associated TE compared with 41-B fractures (63% vs. 28%, P < 0.01). At 3 months postoperatively, the +TE cohort was noted to have worse knee ROM (75.16 ± 51 vs. 86.82 ± 53 degree, P = 0.06). At 6 months, total SMFA and knee ROM was significantly worse in the +TE cohort (29 ± 17 vs. 21 ± 18, P ≤ 0.01; 115.6 ± 20 vs. 124.1 ± 15, P = 0.01). By 12 months postoperatively, only knee ROM remained significantly worse in the +TE cohort (118.7 ± 15 vs. 126.9 ± 13, P < 0.01). Multivariate analysis revealed that tibial eminence involvement was a significant predictor of ROM at 6 and 12 months and SFMA at 6 months. Body mass index was found to be a significant predictor of ROM and age was a significant predictor of total SMFA at all time points. Knee ROM remains worse throughout the postoperative period in the +TE cohort. Functional outcome improves less rapidly in the +TE cohort but achieves similar results by 1 year. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

  19. Differential working memory correlates for implicit sequence performance in young and older adults.

    PubMed

    Bo, Jin; Jennett, S; Seidler, R D

    2012-09-01

    Our recent work has revealed that visuospatial working memory (VSWM) relates to the rate of explicit motor sequence learning (Bo and Seidler in J Neurophysiol 101:3116-3125, 2009) and implicit sequence performance (Bo et al. in Exp Brain Res 214:73-81, 2011a) in young adults (YA). Although aging has a detrimental impact on many cognitive functions, including working memory, older adults (OA) still rely on their declining working memory resources in an effort to optimize explicit motor sequence learning. Here, we evaluated whether age-related differences in VSWM and/or verbal working memory (VWM) performance relates to implicit performance change in the serial reaction time (SRT) sequence task in OA. Participants performed two computerized working memory tasks adapted from change detection working memory assessments (Luck and Vogel in Nature 390:279-281, 1997), an implicit SRT task and several neuropsychological tests. We found that, although OA exhibited an overall reduction in both VSWM and VWM, both OA and YA showed similar performance in the implicit SRT task. Interestingly, while VSWM and VWM were significantly correlated with each other in YA, there was no correlation between these two working memory scores in OA. In YA, the rate of SRT performance change (exponential fit to the performance curve) was significantly correlated with both VSWM and VWM, while in contrast, OA's performance was only correlated with VWM, and not VSWM. These results demonstrate differential reliance on VSWM and VWM for SRT performance between YA and OA. OA may utilize VWM to maintain optimized performance of second-order conditional sequences.

  20. Lessons from Adult Education: Identifying and Exploring Emerging Ethical Issues in Technologically Enhanced Performance

    ERIC Educational Resources Information Center

    Mabry, Christie Knittel; O'Driscoll, Tony

    2003-01-01

    Technologically Enhanced Performance (TEP) is the application of technology to improve the performance of knowledge workers. TEP is both an intellectual and ideological complement to the field of Adult Education. As such, much can be learned about ethical issues associated with implementing TEP from the established research and literature base in…

  1. Obesity-specific neural cost of maintaining gait performance under complex conditions in community-dwelling older adults.

    PubMed

    Osofundiya, Olufunmilola; Benden, Mark E; Dowdy, Diane; Mehta, Ranjana K

    2016-06-01

    Recent evidence of obesity-related changes in the prefrontal cortex during cognitive and seated motor activities has surfaced; however, the impact of obesity on neural activity during ambulation remains unclear. The purpose of this study was to determine obesity-specific neural cost of simple and complex ambulation in older adults. Twenty non-obese and obese individuals, 65years and older, performed three tasks varying in the types of complexity of ambulation (simple walking, walking+cognitive dual-task, and precision walking). Maximum oxygenated hemoglobin, a measure of neural activity, was measured bilaterally using a portable functional near infrared spectroscopy system, and gait speed and performance on the complex tasks were also obtained. Complex ambulatory tasks were associated with ~2-3.5 times greater cerebral oxygenation levels and ~30-40% slower gait speeds when compared to the simple walking task. Additionally, obesity was associated with three times greater oxygenation levels, particularly during the precision gait task, despite obese adults demonstrating similar gait speeds and performances on the complex gait tasks as non-obese adults. Compared to existing studies that focus solely on biomechanical outcomes, the present study is one of the first to examine obesity-related differences in neural activity during ambulation in older adults. In order to maintain gait performance, obesity was associated with higher neural costs, and this was augmented during ambulatory tasks requiring greater precision control. These preliminary findings have clinical implications in identifying individuals who are at greater risk of mobility limitations, particularly when performing complex ambulatory tasks. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Dissociable neural modulation underlying lasting first impressions, changing your mind for the better, and changing it for the worse.

    PubMed

    Bhanji, Jamil P; Beer, Jennifer S

    2013-05-29

    Unattractive job candidates face a disadvantage when interviewing for a job. Employers' evaluations are colored by the candidate's physical attractiveness even when they take job interview performance into account. This example illustrates unexplored questions about the neural basis of social evaluation in humans. What neural regions support the lasting effects of initial impressions (even after getting to know someone)? How does the brain process information that changes our minds about someone? Job candidates' competence was evaluated from photographs and again after seeing snippets of job interviews. Left lateral orbitofrontal cortex modulation serves as a warning signal for initial reactions that ultimately undermine evaluations even when additional information is taken into account. The neural basis of changing one's mind about a candidate is not a simple matter of computing the amount of competence-affirming information in their job interview. Instead, seeing a candidate for the better is somewhat distinguishable at the neural level from seeing a candidate for the worse. Whereas amygdala modulation marks the extremity of evaluation change, favorable impression change additionally draws on parametric modulation of lateral prefrontal cortex and unfavorable impression change additionally draws on parametric modulation of medial prefrontal cortex, temporal cortex, and striatum. Investigating social evaluation as a dynamic process (rather than a one-time impression) paints a new picture of its neural basis and highlights the partially dissociable processes that contribute to changing your mind about someone for the better or the worse.

  3. Cognitive Expectancies for Hypnotic Use among Older Adult Veterans with Chronic Insomnia.

    PubMed

    Fung, Constance H; Martin, Jennifer L; Josephson, Karen; Fiorentino, Lavinia; Dzierzewski, Joseph M; Jouldjian, Stella; Song, Yeonsu; Rodriguez Tapia, Juan Carlos; Mitchell, Michael N; Alessi, Cathy A

    2018-01-01

    To examine relationships between cognitive expectancies about sleep and hypnotics and use of medications commonly used for insomnia (hypnotics). We analyzed baseline data from older veterans who met diagnostic criteria for insomnia and were enrolled in a trial comparing CBTI delivered by a supervised, sleep educator to an attention control condition (N = 159; 97% male, mean age 72 years). We classified individuals as hypnotic users (N = 23) vs. non-users (N = 135) based upon medication diaries. Associations between hypnotic status and Dysfunctional Beliefs and Attitudes about Sleep-16 (DBAS) total score (0-10, higher = worse) and two DBAS medication item scores (Item 1: "…better off taking a sleeping pill rather than having a poor night's sleep;" Item 2: "Medication… probably the only solution to sleeplessness"; 0-10, higher = worse) were examined in logistic regression models. Higher scores on the DBAS medication items (both odds ratios = 1.3; p-values < .001) were significantly associated with hypnotic use. DBAS-16 total score was not associated with hypnotic use. Cognitive expectancy (dysfunctional beliefs) about hypnotics was associated with hypnotic use in older adults with chronic insomnia disorder. Strategies that specifically target dysfunctional beliefs about hypnotics are needed and may impact hypnotic use in older adults.

  4. Individual, parent and social-environmental correlates of caregiving experiences among parents of adults with autism spectrum disorder.

    PubMed

    Burke, M; Heller, T

    2016-05-01

    Compared to parents of adults with other types of disabilities, parents of adults with autism spectrum disorder (ASD) experience worse well-being. Thus, it is crucial to identify the individual, parent and social-environmental correlates of caregiving experiences among parents of adults with ASD. For this study, 130 parents of adults with ASD responded to a survey about caregiving satisfaction, self-efficacy and burden. Greater future planning and community involvement related to more caregiving satisfaction and increased caregiving self-efficacy, respectively. Less choicemaking of the adult with ASD related to greater caregiving satisfaction and self-efficacy. Maladaptive behaviours and poor health of the adult with ASD related to greater caregiving burden. Implications for policymakers, practitioners and future research are discussed. © 2016 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  5. Cognition and Context: Rural-Urban Differences in Cognitive Aging Among Older Mexican Adults.

    PubMed

    Saenz, Joseph L; Downer, Brian; Garcia, Marc A; Wong, Rebeca

    2017-04-01

    To describe differences in cognitive functioning across rural and urban areas among older Mexican adults. We include respondents aged 50+ in the 2012 Mexican Health and Aging Study (MHAS). Cognitive functioning by domain is regressed as a function of community size. The role of educational attainment in explaining rural/urban differences in cognitive functioning is examined. Respondents residing in more rural areas performed worse across five cognitive domains. The majority, but not all, of the association between community size and cognitive functioning was explained by lower education in rural areas. Respondents residing in more rural areas were disadvantaged in terms of cognitive functioning compared with those residing in more urban areas. Poorer cognitive functioning in late life may be the result of historical educational disadvantage in rural areas or selection through migration from rural to urban regions for employment.

  6. Music to my ears: Age-related decline in musical and facial emotion recognition.

    PubMed

    Sutcliffe, Ryan; Rendell, Peter G; Henry, Julie D; Bailey, Phoebe E; Ruffman, Ted

    2017-12-01

    We investigated young-old differences in emotion recognition using music and face stimuli and tested explanatory hypotheses regarding older adults' typically worse emotion recognition. In Experiment 1, young and older adults labeled emotions in an established set of faces, and in classical piano stimuli that we pilot-tested on other young and older adults. Older adults were worse at detecting anger, sadness, fear, and happiness in music. Performance on the music and face emotion tasks was not correlated for either age group. Because musical expressions of fear were not equated for age groups in the pilot study of Experiment 1, we conducted a second experiment in which we created a novel set of music stimuli that included more accessible musical styles, and which we again pilot-tested on young and older adults. In this pilot study, all musical emotions were identified similarly by young and older adults. In Experiment 2, participants also made age estimations in another set of faces to examine whether potential relations between the face and music emotion tasks would be shared with the age estimation task. Older adults did worse in each of the tasks, and had specific difficulty recognizing happy, sad, peaceful, angry, and fearful music clips. Older adults' difficulties in each of the 3 tasks-music emotion, face emotion, and face age-were not correlated with each other. General cognitive decline did not appear to explain our results as increasing age predicted emotion performance even after fluid IQ was controlled for within the older adult group. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. Zoonotic bacterial meningitis in human adults.

    PubMed

    van Samkar, Anusha; Brouwer, Matthijs C; van der Ende, Arie; van de Beek, Diederik

    2016-09-13

    To describe the epidemiology, etiology, clinical characteristics, treatment, outcome, and prevention of zoonotic bacterial meningitis in human adults. We identified 16 zoonotic bacteria causing meningitis in adults. Zoonotic bacterial meningitis is uncommon compared to bacterial meningitis caused by human pathogens, and the incidence has a strong regional distribution. Zoonotic bacterial meningitis is mainly associated with animal contact, consumption of animal products, and an immunocompromised state of the patient. In a high proportion of zoonotic bacterial meningitis cases, CSF analysis showed only a mildly elevated leukocyte count. The recommended antibiotic therapy differs per pathogen, and the overall mortality is low. Zoonotic bacterial meningitis is uncommon but is associated with specific complications. The suspicion should be raised in patients with bacterial meningitis who have recreational or professional contact with animals and in patients living in regions endemic for specific zoonotic pathogens. An immunocompromised state is associated with a worse prognosis. Identification of risk factors and underlying disease is necessary to improve treatment. © 2016 American Academy of Neurology.

  8. Marital status, widowhood duration, gender and health outcomes: a cross-sectional study among older adults in India.

    PubMed

    Perkins, Jessica M; Lee, Hwa-Young; James, K S; Oh, Juhwan; Krishna, Aditi; Heo, Jongho; Lee, Jong-Koo; Subramanian, S V

    2016-09-30

    Previous research has demonstrated health benefits of marriage and the potential for worse outcomes during widowhood in some populations. However, few studies have assessed the relevance of widowhood and widowhood duration to a variety of health-related outcomes and chronic diseases among older adults in India, and even fewer have examined these relationships stratified by gender. Using a cross-sectional representative sample of 9,615 adults aged 60 years or older from 7 states in diverse regions of India, we examine the relationship between widowhood and self-rated health, psychological distress, cognitive ability, and four chronic diseases before and after adjusting for demographic characteristics, socioeconomic status, living with children, and rural-urban location for men and women, separately. We then assess these associations when widowhood accounts for duration. Being widowed as opposed to married was associated with worse health outcomes for women after adjusting for other explanatory factors. Widowhood in general was not associated with any outcomes for men except for cognitive ability, though men who were widowed within 0-4 years were at greater risk for diabetes compared to married men. Moreover, recently widowed women and women who were widowed long-term were more likely to experience psychological distress, worse self-rated health, and hypertension, even after adjusting for other explanatory variables, whereas women widowed 5-9 years were not, compared to married women. Gender, the duration of widowhood, and type of outcome are each relevant pieces of information when assessing the potential for widowhood to negatively impact health. Future research should explore how the mechanisms linking widowhood to health vary over the course of widowhood. Incorporating information about marital relationships into the design of intervention programs may help better target potential beneficiaries among older adults in India.

  9. Relationships Between Performance on Assessments of Executive Function and Fall Risk Screening Measures in Community-Dwelling Older Adults.

    PubMed

    Blackwood, Jennifer; Shubert, Tiffany; Forgarty, Kieran; Chase, Carla

    2016-01-01

    Fall-related injuries are a leading cause of institutionalization and morbidity in older adults. Limitations in cognition, including deficits in higher cognitive processes, like executive function (EF), contribute to a higher risk of falling in older adults. Specifically, declines in EF have been associated with changes in gait, limited mobility, and an increased frequency of falling. It is unknown whether associations between performance on commonly used clinical assessments of EF and performance on commonly used physical performance measures of fall risk are present. The purpose of this study was to examine the relationship between a clinical measure of EF, the Trail Making Test Part B (TMT-B), and 3 physical performance measures of fall risk: the Timed Up and Go (TUG) test, gait speed, and the Five Times Sit to Stand (FTSTS) test, in a group of community-dwelling older adults. Forty-seven community-dwelling older adults met the inclusion/exclusion criteria. Demographic information was obtained and measures of fall risk and cognition were performed. Correlations and linear regression analyses to assess relationships between measures were completed. To account for the high prevalence of mild cognitive impairment (MCI) in this population, the sample was screened and stratified for MCI in post hoc analyses. The EF performance was not significantly correlated with performance on the FTSTS test (ρ = 0.26, P > .05) but was significantly correlated with the TUG test (ρ = 0.31, P < .05) and gait speed (r = -0.36, P < .05). These relationships remained after adjusting for age and education in multivariate models. Results from post hoc analyses demonstrated that only those with MCI had significant relationships between EF and physical performance measures. TMT-B scores in the MCI group were significantly correlated with gait speed (ρ = -0.51, P < .05) and TUG test (ρ = 0.58, P < .05). A significant relationship exists between performance on clinical assessments of EF

  10. Indicators of Program Quality, Measures of Performance & Standards. Adult Basic Education and ESL Programs in NJ. Summary Report.

    ERIC Educational Resources Information Center

    Merkel-Keller, Claudia; Streeter-Scrupski, Sandra

    In 1992, adult education staff and adult literacy volunteer organizations developed 8 indicators of program quality to be used for evaluating adult basic education and English as a Second Language (ESL) programs in New Jersey. Performance standards were developed to match the standards. An evaluation was conducted to determine how the indicators…

  11. The Adult Learning Open University Determinants (ALOUD) Study: Biological and Psychological Factors Associated with Learning Performance in Adult Distance Education

    ERIC Educational Resources Information Center

    Neroni, Joyce; Gijselaers, Hieronymus J. M.; Kirschner, Paul A.; Groot, Renate H. M.

    2015-01-01

    Learning is crucial for everyone. The association between biological (eg, sleep, nutrition) and psychological factors (eg, test anxiety, goal orientation) and learning performance has been well established for children, adolescents and college students in traditional education. Evidence for these associations for adult distance students is lacking…

  12. Emotions experienced in association with agricultural work performed in childhood--in opinions of adults.

    PubMed

    Lachowski, Stanisław; Lachowska, Bogusława

    2014-01-01

    Performance of work is related with experiencing various emotions, from positive - indicating full satisfaction with work, to negative - describing failures, and even harm caused by work. Such emotions are also experienced by children engaged in work on family farms. The objective of the study is the determination of emotions experienced in association with performing agricultural work in childhood, and indication of the factors conditioning the occurrence of positive and negative emotions. The study was conducted by the method of a diagnostic survey using a questionnaire technique, and covered a group of 482 adults from agricultural families. In childhood, positive emotions related with the performance of work are more often experienced than negative emotions. The occurrence of positive emotions is positively related with willingness to perform work activities, working time, respondent's age, age at which a child started to perform work, and age at which a child discontinued helping on a farm. The occurrence of negative emotions is positively related with unwillingness to perform work, performing work activities beyond the physical capabilities of a child, neglecting school duties, missing classes at school due to work, and with working time. With work performed in childhood are associated positive and negative emotions experienced in childhood and adulthood. The performance of work in childhood shapes emotions experienced by an adult which may affect his/her quality of life and functioning in adulthood.

  13. Hemiparesis and Epilepsy Are Associated With Worse Reported Health Status Following Unilateral Stroke in Children

    PubMed Central

    Smith, Sabrina E.; Vargas, Gray; Cucchiara, Andrew J.; Zelonis, Sarah J.; Beslow, Lauren A.

    2015-01-01

    BACKGROUND Perinatal and childhood stroke result in neurological impairment in the majority of survivors, but less is known about patient and parent perception of function following stroke in children. Our aim was to characterize parent-proxy and child-reported health status in children following unilateral arterial ischemic stroke or intraparenchymal hemorrhage. METHODS Fifty-nine children 2–18 years (30 girls, 29 boys) with unilateral arterial ischemic stroke or spontaneous intraparenchymal hemorrhage at least 6 months before evaluation were enrolled from a single center. The PedsQL version 4.0 Generic Short Form and PedsQL version 3.0 Cerebral Palsy Module were administered to childhood stroke subjects and parents. Generic PedsQL Inventory scores were compared between children with stroke and published data from healthy children. Reported health status scores for children with varying degrees of hemiparesis were compared. RESULTS Children with stroke had lower reported health status scores on the Generic PedsQL Inventory than healthy children. Children with moderate-severe hemiparesis had worse scores than children without hemiparesis on several measures of the Cerebral Palsy Module as reported by both parents and children. The parents of children with epilepsy reported worse scores on several measures compared with children without epilepsy, and the parent scores were lower on several measures for children with lower intelligence quotients. Agreement between parent and child scores was better on the Cerebral Palsy Module than on the Generic Inventory. CONCLUSIONS Children with stroke have worse reported health status than healthy controls. Degree of hemiparesis, epilepsy, and lower intelligence quotient affect reported health status on some measures. Agreement between parent-proxy and child scores ranges from slight to good which suggests that both provide useful information. PMID:25559938

  14. Hemiparesis and epilepsy are associated with worse reported health status following unilateral stroke in children.

    PubMed

    Smith, Sabrina E; Vargas, Gray; Cucchiara, Andrew J; Zelonis, Sarah J; Beslow, Lauren A

    2015-04-01

    Perinatal and childhood stroke result in neurological impairment in the majority of survivors, but less is known about patient and parent perception of function following stroke in children. Our aim was to characterize parent-proxy and child-reported health status in children following unilateral arterial ischemic stroke or intraparenchymal hemorrhage. Fifty-nine children 2-18 years (30 girls, 29 boys) with unilateral arterial ischemic stroke or spontaneous intraparenchymal hemorrhage at least 6 months before evaluation were enrolled from a single center. The PedsQL version 4.0 Generic Short Form and PedsQL version 3.0 Cerebral Palsy Module were administered to childhood stroke subjects and parents. Generic PedsQL Inventory scores were compared between children with stroke and published data from healthy children. Reported health status scores for children with varying degrees of hemiparesis were compared. Children with stroke had lower reported health status scores on the Generic PedsQL Inventory than healthy children. Children with moderate-severe hemiparesis had worse scores than children without hemiparesis on several measures of the Cerebral Palsy Module as reported by both parents and children. The parents of children with epilepsy reported worse scores on several measures compared with children without epilepsy, and the parent scores were lower on several measures for children with lower intelligence quotients. Agreement between parent and child scores was better on the Cerebral Palsy Module than on the Generic Inventory. Children with stroke have worse reported health status than healthy controls. Degree of hemiparesis, epilepsy, and lower intelligence quotient affect reported health status on some measures. Agreement between parent-proxy and child scores ranges from slight to good which suggests that both provide useful information. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Performance of Activity Classification Algorithms in Free-living Older Adults

    PubMed Central

    Sasaki, Jeffer Eidi; Hickey, Amanda; Staudenmayer, John; John, Dinesh; Kent, Jane A.; Freedson, Patty S.

    2015-01-01

    Purpose To compare activity type classification rates of machine learning algorithms trained on laboratory versus free-living accelerometer data in older adults. Methods Thirty-five older adults (21F and 14M ; 70.8 ± 4.9 y) performed selected activities in the laboratory while wearing three ActiGraph GT3X+ activity monitors (dominant hip, wrist, and ankle). Monitors were initialized to collect raw acceleration data at a sampling rate of 80 Hz. Fifteen of the participants also wore the GT3X+ in free-living settings and were directly observed for 2-3 hours. Time- and frequency- domain features from acceleration signals of each monitor were used to train Random Forest (RF) and Support Vector Machine (SVM) models to classify five activity types: sedentary, standing, household, locomotion, and recreational activities. All algorithms were trained on lab data (RFLab and SVMLab) and free-living data (RFFL and SVMFL) using 20 s signal sampling windows. Classification accuracy rates of both types of algorithms were tested on free-living data using a leave-one-out technique. Results Overall classification accuracy rates for the algorithms developed from lab data were between 49% (wrist) to 55% (ankle) for the SVMLab algorithms, and 49% (wrist) to 54% (ankle) for RFLab algorithms. The classification accuracy rates for SVMFL and RFFL algorithms ranged from 58% (wrist) to 69% (ankle) and from 61% (wrist) to 67% (ankle), respectively. Conclusion Our algorithms developed on free-living accelerometer data were more accurate in classifying activity type in free-living older adults than our algorithms developed on laboratory accelerometer data. Future studies should consider using free-living accelerometer data to train machine-learning algorithms in older adults. PMID:26673129

  16. Adult age differences in predicting memory performance: the effects of normative information and task experience.

    PubMed

    McDonald-Miszczak, L; Hunter, M A; Hultsch, D F

    1994-03-01

    Two experiments addressed the effects of task information and experience on younger and older adults' ability to predict their memory for words. The first study examined the effects of normative task information on subjects' predictions for 30-word lists across three trials. The second study looked at the effects of making predictions and recalling either an easy (15) or a difficult (45) word list prior to making predictions and recalling a moderately difficult (30) word list. The results from both studies showed that task information and experience affected subjects' predictions and that elderly adults predicted their performance more accurately than younger adults.

  17. Optimizing Eating Performance for Older Adults With Dementia Living in Long-term Care: A Systematic Review.

    PubMed

    Liu, Wen; Galik, Elizabeth; Boltz, Marie; Nahm, Eun-Shim; Resnick, Barbara

    2015-08-01

    Review of research to date has been focusing on maintaining weight and nutrition with little attention on optimizing eating performance. To evaluate the effectiveness of interventions on eating performance for older adults with dementia in long-term care (LTC). A systematic review was performed. Five databases including Pubmed, Medline (OVID), EBM Reviews (OVID), PsychINFO (OVID), and CINAHL (EBSCOHost) were searched between January 1980 and June 2014. Keywords included dementia, Alzheimer, feed(ing), eat(ing), mealtime(s), oral intake, autonomy, and intervention. Intervention studies that optimize eating performance and evaluate change of self-feeding or eating performance among older adults (≥65 years) with dementia in LTC were eligible. Studies were screened by title and abstract, and full texts were reviewed for eligibility. Eligible studies were classified by intervention type. Study quality was accessed using the Quality Assessment Tool for Quantitative Studies, and level of evidence using the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence. Eleven intervention studies (five randomized controlled trials [RCTs]) were identified, and classified into four types: training program, mealtime assistance, environmental modification, and multicomponent intervention. The quality of the 11 studies was generally moderate (four studies were rated as strong, four moderate, and three weak in quality), with the main threats as weak designs, lack of blinding and control for confounders, and inadequate psychometric evidence for measures. Training programs targeting older adults (Montessori methods and spaced retrieval) demonstrated good evidence in decreasing feeding difficulty. Mealtime assistance offered by nursing staff (e.g., verbal prompts and cues, positive reinforcement, appropriate praise and encouragement) also showed effectiveness in improving eating performance. This review provided preliminary support for using training and mealtime

  18. Functional health status of adults with tetralogy of Fallot: matched comparison with healthy siblings.

    PubMed

    Knowles, Rachel; Veldtman, Gruschen; Hickey, Edward J; Bradley, Timothy; Gengsakul, Aungkana; Webb, Gary D; Williams, William G; McCrindle, Brian W

    2012-07-01

    Survival prospects for adults with repaired tetralogy of Fallot (TOF) are now excellent. Attention should therefore shift to assessing and improving functional health status and quality of life. We aimed to assess late functional health status of adults surviving TOF repair by matched comparison to their healthy siblings. All 1,693 TOF repairs performed at our institution between 1946 and 1990 were reviewed. A matched comparison was undertaken whereby presumed survivors and their healthy sibling were contacted and asked to complete the Ontario Health Survey 1990 and the 36-Item Short Form Health Survey (SF-36) questionnaire. Both questionnaires were completed by 224 adult survivors and their sibling closest in age. Adults with repaired TOF had lower scores for self-perceived general health status (p < 0.001), were less likely to rate their health as good or excellent (p < 0.001), and had lower SF-36 scores for physical functioning and general health (p = 0.001) than their siblings. However, patients reported similar satisfaction with their lives, similar levels of social participation and support, and were as likely to be in long-term partnerships. Worse physical and mental health scores were associated with older age at surgery and at time of questionnaire completion and recent requirement for noncardiac medication. Although reporting lower functional health status then their siblings, quality of life and life satisfaction for adults who underwent surgery for TOF during childhood is comparable to that of their siblings without heart defects. Follow-up of younger adults is required to understand current health outcomes attributable to improvements in the management of TOF. Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Black Hispanics have a worse cardiovascular risk profile than mixed Hispanics in Venezuela.

    PubMed

    Ryder, Elena; Silva, Eglee; Sulbarán, Tulio; Fernández, Virginia; Campos, Gilberto; Calmon, Gustavo; Clavell, Emilio; Raleigh, Xiomara; Florez, Hermes

    2007-03-01

    In order to characterize components of the metabolic syndrome (MS) in Venezuelan black Hispanics and compare these metabolic abnormalities with those found in the predominant mixed Hispanic population, 2336 mixed Hispanics (69% women) and 281 black Hispanics (60% women), aged 20-78 years, without prior history of diabetes and/or cardiovascular disease were evaluated in a population-based study in Zulia State, Venezuela. Blood pressure (BP), waist circumference, as well as fasting insulin, fasting blood glucose (FBG), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) levels were measured. The criteria proposed by the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) to identify those with metabolic abnormalities were used. We found that black Hispanics showed higher frequency of age-adjusted elevated BP than mixed Hispanics in both men (66.9% vs. 52.3%, p < 0.01) and women (39.3% vs. 30.4%, p < 0.05). In men, elevated FBG was also more frequent in black Hispanics (32.7%) than in mixed Hispanics (22.3%), despite the lack of significant differences in fasting insulin, HOMA-insulin resistance and HOMA-beta cell function values. In women low HDL-C and higher abdominal obesity were more common in black Hispanics (71.8% and 54.1%, respectively) than in mixed Hispanics (56.2% and 44.5%, respectively), despite the greater frequency of high TG in mixed Hispanics (22.6%) when compared to black Hispanics (13.3%). Furthermore, in logistic regression analysis black Hispanic race was independently associated with higher risk for hypertension, fasting hyperglycemia, and low HDL-C. These results suggest that black Hispanics have worse cardiovascular risk profile than mixed Hispanics in Zulia State, with higher BP, higher FBG, more abdominal obesity, and lower HDL-C. Identification and intervention of these high-risk subjects are important strategies for diabetes and cardiovascular disease prevention in Venezuela.

  20. Neuroanatomical and resting state EEG power correlates of central hearing loss in older adults.

    PubMed

    Giroud, Nathalie; Hirsiger, Sarah; Muri, Raphaela; Kegel, Andrea; Dillier, Norbert; Meyer, Martin

    2018-01-01

    To gain more insight into central hearing loss, we investigated the relationship between cortical thickness and surface area, speech-relevant resting state EEG power, and above-threshold auditory measures in older adults and younger controls. Twenty-three older adults and 13 younger controls were tested with an adaptive auditory test battery to measure not only traditional pure-tone thresholds, but also above individual thresholds of temporal and spectral processing. The participants' speech recognition in noise (SiN) was evaluated, and a T1-weighted MRI image obtained for each participant. We then determined the cortical thickness (CT) and mean cortical surface area (CSA) of auditory and higher speech-relevant regions of interest (ROIs) with FreeSurfer. Further, we obtained resting state EEG from all participants as well as data on the intrinsic theta and gamma power lateralization, the latter in accordance with predictions of the Asymmetric Sampling in Time hypothesis regarding speech processing (Poeppel, Speech Commun 41:245-255, 2003). Methodological steps involved the calculation of age-related differences in behavior, anatomy and EEG power lateralization, followed by multiple regressions with anatomical ROIs as predictors for auditory performance. We then determined anatomical regressors for theta and gamma lateralization, and further constructed all regressions to investigate age as a moderator variable. Behavioral results indicated that older adults performed worse in temporal and spectral auditory tasks, and in SiN, despite having normal peripheral hearing as signaled by the audiogram. These behavioral age-related distinctions were accompanied by lower CT in all ROIs, while CSA was not different between the two age groups. Age modulated the regressions specifically in right auditory areas, where a thicker cortex was associated with better auditory performance in older adults. Moreover, a thicker right supratemporal sulcus predicted more rightward theta

  1. Symptoms and socio-economic impact of ependymoma on adult patients: results of the Adult Ependymoma Outcomes Project 2.

    PubMed

    Walbert, Tobias; Mendoza, Tito R; Vera-Bolaños, Elizabeth; Acquaye, Alvina; Gilbert, Mark R; Armstrong, Terri S

    2015-01-01

    Ependymoma is a rare central nervous system tumor of adults. Reports of patient symptoms, interference patterns and costs encountered by patients and families are limited. Adult ependymoma patients completed the online Ependymoma Outcomes Questionnaire II. The survey assesses disease and functional status as well as socio-economic factors. Descriptive statistics were used to report disease characteristics as well as economic and social impact. Independent samples t test was used to test if differences exist between high- and low-income groups in terms of symptom severity. Correlations were calculated between symptoms and cost estimates. 86 international patients participated (male = 50 %). The economic analysis focused on 78 respondents from the US. 48 % were employed and 55 % earned ≥$60,000. Tumors were located in the brain (44 %), spine (44 %) or both (12 %). Spine patients compared to brain patients reported significantly worse pain (4.4 versus 2.2, p < .003), numbness (5.3 versus 2.2, p < .001), fatigue (5.1 versus 3.6, p < .03), changes in bowel patterns (3.8 versus 1.4, p < .003) and weakness (4.2 versus 2.1, p < .006). Brain patients compared with spine patients had increased lack of appetite (.4 versus 2, p < .014). Patients with lower income (≤$59,999) had more problems concentrating (p < .024) and worse cognitive module severity scores (p < .024). Estimated average monthly out-of-pocket spending was $168 for medical co-pays and $59 for prescription medication. Patients with ependymoma are highly affected by their symptoms. Spinal patients report higher severity of symptoms. Patients in the lower income group report significantly higher severity of cognitive symptoms independent of disease site.

  2. Cardiovascular risk factors and cognitive function in adults 30-59 years of age (NHANES III).

    PubMed

    Pavlik, Valory N; Hyman, David J; Doody, Rachelle

    2005-01-01

    In the Third National Health and Nutrition Examination Survey (NHANES III), three measures of cognitive function [Simple Reaction Time Test (SRTT), Symbol Digit Substitution Test (SDST), and Serial Digit Learning Test (SDLT)] were administered to a half-sample of 3,385 adult men and nonpregnant women 30-59 years of age with no history of stroke. We used multiple linear regression analysis to determine whether there was an independent association between performance on each cognitive function measure and defined hypertension (HTN) alone, type 2 diabetes mellitus (DM) alone, and coexistent HTN and DM after adjustment for demographic and socioeconomic variables and selected health behaviors. After adjustment for the sociodemographic variables, the combination of HTN + DM, but not HTN alone or DM alone, was significantly associated with worse performance on the SRTT (p = 0.031) and the SDST (p = 0.011). A similar pattern was observed for SDLT performance, but the relationship did not reach statistical significance (p = 0.101). We conclude that HTN in combination with DM is associated with detectable cognitive decrements in persons under age 60.

  3. Cognitively Elite, Cognitively Normal, and Cognitively Impaired Aging: Neurocognitive Status and Stability Moderate Memory Performance

    PubMed Central

    Dixon, Roger A.; de Frias, Cindy M.

    2014-01-01

    Objective Although recent theories of brain and cognitive aging distinguish among normal, exceptional, and impaired groups, further empirical evidence is required. We adapted and applied standard procedures for classifying groups of cognitively impaired (CI) and cognitively normal (CN) older adults to a third classification, cognitively healthy, exceptional, or elite (CE) aging. We then examined concurrent and two-wave longitudinal performance on composite variables of episodic, semantic, and working memory. Method We began with a two-wave source sample from the Victoria Longitudinal Study (VLS) (source n=570; baseline age=53–90 years). The goals were to: (a) apply standard and objective classification procedures to discriminate three cognitive status groups, (b) conduct baseline comparisons of memory performance, (c) develop two-wave status stability and change subgroups, and (d) compare of stability subgroup differences in memory performance and change. Results As expected, the CE group performed best on all three memory composites. Similarly, expected status stability effects were observed: (a) stable CE and CN groups performed memory tasks better than their unstable counterparts and (b) stable (and chronic) CI group performed worse than its unstable (variable) counterpart. These stability group differences were maintained over two waves. Conclusion New data validate the expectations that (a) objective clinical classification procedures for cognitive impairment can be adapted for detecting cognitively advantaged older adults and (b) performance in three memory systems is predictably related to the tripartite classification. PMID:24742143

  4. Atomoxetine and stroop task performance in adult attention-deficit/hyperactivity disorder.

    PubMed

    Faraone, Stephen V; Biederman, Joseph; Spencer, Thomas; Michelson, David; Adler, Lenard; Reimherr, Fred; Seidman, Larry

    2005-08-01

    The aim of this study was to assess the efficacy of atomoxetine, a new and highly selective inhibitor of the norepinephrine transporter, for executive functioning in adults with attention-deficit/hyperactivity disorder (ADHD). Two identical studies using a double-blind, placebo-controlled, parallel design were conducted. Patients were adults (Study 1, n = 280; Study 2, n = 256) with Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV)-defined ADHD recruited by referral and advertising. They were randomized to 10 weeks of treatment with atomoxetine or placebo. Executive functions were measured by the Stroop task. There was no evidence of cognitive deterioration associated with atomoxetine treatment. Atomoxetine treatment was associated with an improvement of the Stroop colorword score. Our results provide further support for Spencer et al.'s (1998) report that atomoxetine improves inhibitory capacity, as measured by the Stroop task. The absence of cognitive deterioration from atomoxetine, along with improved performance in a subgroup of patients in this large study, supports the safety of atomoxetine in this regard and its potential for improving a significant source of impairment for adults with ADHD.

  5. The Cambridge Mindreading (CAM) Face-Voice Battery: Testing complex emotion recognition in adults with and without Asperger syndrome.

    PubMed

    Golan, Ofer; Baron-Cohen, Simon; Hill, Jacqueline

    2006-02-01

    Adults with Asperger Syndrome (AS) can recognise simple emotions and pass basic theory of mind tasks, but have difficulties recognising more complex emotions and mental states. This study describes a new battery of tasks, testing recognition of 20 complex emotions and mental states from faces and voices. The battery was given to males and females with AS and matched controls. Results showed the AS group performed worse than controls overall, on emotion recognition from faces and voices and on 12/20 specific emotions. Females recognised faces better than males regardless of diagnosis, and males with AS had more difficulties recognising emotions from faces than from voices. The implications of these results are discussed in relation to social functioning in AS.

  6. Sex impacts the relation between body composition and physical function in older adults.

    PubMed

    Valentine, Rudy J; Misic, Mark M; Rosengren, Karl S; Woods, Jeffrey A; Evans, Ellen M

    2009-01-01

    To determine the sex-specific relationships between physical activity, aerobic fitness, adiposity (%Fat), mineral-free lean mass (MFLM), and balance and gait performance in older adults. Eighty-five female and 49 male sedentary, healthy, community-dwelling older adults (mean [SD] age, 69.6 [5.4] and 70.3 [4.7] years, respectively) were evaluated on habitual physical activity via questionnaire, aerobic fitness by a maximal oxygen consumption treadmill test, whole and regional body composition by dual-energy x-ray absorptiometry, and lower extremity physical function using gait tasks and computerized dynamic posturography. As expected, men had less body fat, more lean mass, and higher aerobic fitness than did women and tended to perform better on all lower extremity physical function tasks (all P 0.50, all P < 0.05). Body fat was related to gait in women (r = -0.38, P < 0.05) but not in men. Neither fitness nor body composition was related to balance in men, whereas in women, leg MFLM was positively associated (r = 0.27, P < 0.05). Women, but not men, with a greater ratio of body weight to leg MFLM performed worse on gait tasks (P < 0.001). There was an interaction with sex for %Fat on gait (P = 0.05) and for leg MFLM on balance (P < 0.05). In sedentary healthy older adults, the relation between body composition, aerobic fitness, and balance and gait differs between sexes such that women are more strongly affected by alterations in body composition. Lower %Fat and preservation of lower body lean mass have important implications for reducing the risk of physical disability, especially in older women.

  7. The health status of young adults in the United States.

    PubMed

    Park, M Jane; Paul Mulye, Tina; Adams, Sally H; Brindis, Claire D; Irwin, Charles E

    2006-09-01

    The health issues of young adulthood have received relatively little attention compared with those of adolescence, although the critical issues in young adulthood parallel those of adolescence. Young adults often fare worse than adolescents on health indicators, with many measures of negative outcomes--including rates of injury, homicide, and substance use--peaking during the young adult years. The contextual factors shaping health status and access to care in young adulthood differ significantly from the context of adolescence. This article synthesizes national data to present a health profile of young adults, reviewing social indicators that describe the context of young adulthood and presenting measures of health status. We examine mortality, morbidity, risky behaviors, and health care access and utilization, identifying the most significant gender and racial/ethnic disparities. The article also identifies limitations of existing data and offers suggestions for future research and health monitoring in this area. We conclude with a discussion of current efforts to address the health and well-being of young adults and argue for creating a national health agenda for young adults that includes research, programs and policies to address health issues during this period of the lifespan.

  8. The outcome after lateral tibial plateau fracture treated with percutaneus screw fixation show a tendency towards worse functional outcome compared with a reference population.

    PubMed

    Elsoe, R; Larsen, P; Shekhrajka, N; Ferreira, L; Ostgaard, S E; Rasmussen, S

    2016-04-01

    The objective of this study was to evaluate the functional and radiological outcome after lateral tibial plateau fractures (Müller AO classification (AO) 41-B1, B2 and B3) treated with minimal invasive bone tamp reduction and percutaneous screw fixation. Retrospective, cross-sectional study. Review and clinical examination of 37 patients treated between 2005 and 2010. The patients completed a clinical examination, Knee Injury and Osteoarthritis Outcome Score (KOOS) and questionnaire evaluating QOL (Eq5D-5L). Thirty-seven patients agreed to participate (76 %). Mean time of follow-up was 5.2 years. At final follow-up, maintained anatomical joint reduction was achieved in 34 patients. The mean KOOS score was pain = 84.4, ADL = 88.4, symptoms = 80.7, QOL = 70.3, sport = 59.6. Compared with the established KOOS reference population patients, the current study reports a tendency towards worse KOOS scores but is only significant for KOOS sport. The mean Eq5D-5L index was 0.815 and shows a tendency towards worse outcome compared with the reference population. Mean knee flexion: 125.7° (95-135). A reduced number of sit-to-stands in the mean 30-s chair stand test showed a significant negative association with KOOS. The study showed a significant association between younger age at surgery and worse KOOS outcome. At 5.2-year follow-up, the patients reported a tendency towards worse KOOS and Eq5D-5L scores compared with established reference populations. This study shows a significant association between a decrease in muscle strength and worse KOOS outcome. Furthermore, a significant association between younger age at the time of surgery and worse KOOS outcome score was observed.

  9. Neighborhood built environment and cognition in non-demented older adults: The Multi-Ethnic Study of Atherosclerosis.

    PubMed

    Besser, Lilah M; Rodriguez, Daniel A; McDonald, Noreen; Kukull, Walter A; Fitzpatrick, Annette L; Rapp, Stephen R; Seeman, Teresa

    2018-03-01

    Preliminary studies suggest that neighborhood social and built environment (BE) characteristics may affect cognition in older adults. Older adults are particularly vulnerable to the neighborhood environment due to a decreasing range of routine travel with increasing age. We examined if multiple neighborhood BE characteristics are cross-sectionally associated with cognition in a diverse sample of older adults, and if the BE-cognition associations vary by individual-level demographics. The sample included 4539 participants from the Multi-Ethnic Study of Atherosclerosis. Multivariable linear regression was used to examine the associations between five BE measures and four cognitive measures, and effect modification by individual-level education and race/ethnicity. In the overall sample, increasing social destination density, walking destination density, and intersection density were associated with worse overall cognition, whereas increasing proportion of land dedicated to retail was associated with better processing speed. Effect modification results suggest that the association between urban density and worse cognition may be limited to or strongest in those of non-white race/ethnicity. Although an increase in neighborhood retail destinations was associated with better cognition in the overall sample, these results suggest that certain BE characteristics in dense urban environments may have a disproportionately negative association with cognition in vulnerable populations. However, our findings must be replicated in longitudinal studies and other regional samples. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. From Bad to Worse: Anemia on Admission and Hospital-Acquired Anemia.

    PubMed

    Koch, Colleen G; Li, Liang; Sun, Zhiyuan; Hixson, Eric D; Tang, Anne S; Phillips, Shannon C; Blackstone, Eugene H; Henderson, J Michael

    2017-12-01

    Anemia at hospitalization is often treated as an accompaniment to an underlying illness, without active investigation, despite its association with morbidity. Development of hospital-acquired anemia (HAA) has also been associated with increased risk for poor outcomes. Together, they may further heighten morbidity risk from bad to worse. The aims of this study were to (1) examine mortality, length of stay, and total charges in patients with present-on-admission (POA) anemia and (2) determine whether these are exacerbated by development of HAA. In this cohort investigation, from January 1, 2009, to August 31, 2011, a total of 44,483 patients with POA anemia were admitted to a single health system compared with a reference group of 48,640 without POA anemia or HAA. Data sources included the University HealthSystem Consortium database and electronic medical records. Risk-adjustment methods included logistic and linear regression models for mortality, length of stay, and total charges. Present-on-admission anemia was defined by administrative coding. Hospital-acquired anemia was determined by changes in hemoglobin values from the electronic medical record. Approximately one-half of the patients experienced worsening of anemia with development of HAA. Risk for death and resource use increased with increasing severity of HAA. Those who developed severe HAA had 2-fold greater odds for death; that is, mild POA anemia with development of severe HAA resulted in greater mortality (odds ratio, 2.57; 95% confidence interval, 2.08-3.18; P < 0.001), increased length of stay (2.23; 2.16-2.31; P < 0.001), and higher charges (2.09; 2.03-2.15; P < 0.001). Present-on-admission anemia is associated with increased mortality and resource use. This risk is further increased from bad to worse when patients develop HAA. Efforts to address POA anemia and HAA deserve attention.

  11. Parental divorce and adult longevity.

    PubMed

    Larson, Kandyce; Halfon, Neal

    2013-02-01

    Life course research has established associations between adverse childhood events and later life health. We examine the relationship of experiencing parental divorce before the age of 16 and survival across 34 years of adulthood. Analysis of panel data from a USA-based survey of 6,928 adults residing in Alameda County, California in 1965. Cox regression was used to examine associations between parental divorce and longevity. Controlling for age, race/ethnicity, gender, and childhood socioeconomic position, respondents who recalled a parental divorce during childhood had increased risk of mortality compared to those with no separation. The association was stronger for premature mortality and deaths due to cardiovascular disease. Divorce in childhood was also associated with lowered adult education, fewer social network ties, more depression, and worse health practices. These factors appeared to explain the association with longevity. Parental divorce in childhood is associated with lowered well-being in adulthood and long-term survival. Early prevention and health promotion efforts may be warranted for children who experience parental divorce or discord as a means of supporting enhanced trajectories of health and well-being.

  12. [Psychosocial adjustment, psychiatric morbidity and quality of life in adolescents and young adults with congenital heart disease].

    PubMed

    Coelho, Rosália; Teixeira, Flávio; Silva, Ana Margarida; Vaz, Cláudia; Vieira, Daniela; Proença, Cidália; Moura, Cláudia; Viana, Victor; Areias, José Carlos; Areias, Maria Emília Guimarães

    2013-09-01

    We aimed to study the psychosocial adjustment (PSA), psychiatric morbidity and quality of life of adolescents and young adults with congenital heart disease (CHD) to determine which demographic and clinical variables negatively affect adjustment and which increase resilience. The study included 74 patients with CHD, 41 male and 33 female, aged between 12 and 26 years (mean 18.76±3.86). Demographic information and a complete clinical history were obtained. The participants were interviewed regarding social support, family environment, self-image and physical limitations. A standardized psychiatric interview was conducted, and self-report questionnaires were administered for assessment of PSA (Youth Self Report and Adult Self Report) and quality of life (World Health Organization Quality of Life - Short Version). A caregiver completed an observational version of the PSA questionnaire (Child Behavior Checklist or Adult Behavior Checklist). Female participants showed more feelings of anxiety and depression (U=952.500; p=0.003), thought problems (U=929.500; p=0.005) and aggressive behavior (U=999.000; p=0.000). They also showed a higher rate of psychopathology. Patients with complex forms of CHD reported more thought problems (U=442.000; p=0.027) and internalization (U=429.000; p=0.021). Compared to the Portuguese population as a whole, participants showed better quality of life in the domains of social relationships (t=2.333; p=0.022) and environment (t=3.754; p=0.000). Patients who had undergone surgery had worse quality of life in physical terms (t=-1.989; p=0.050), social relationships (t=-2.012; p=0.048) and general quality of life (U=563.000; p=0.037), compared to those who were not operated. Better social support was associated with better quality of life in physical terms (t=3.287; p=0.002) and social relationships (t=3.669; p=0.000). Better school performance was also associated with better overall quality of life (U=457.000; p=0.046), less withdrawn behavior

  13. Intensive client-centred occupational therapy in the home improves older adults' occupational performance. Results from a Danish randomized controlled trial.

    PubMed

    Nielsen, Tove Lise; Andersen, Niels Trolle; Petersen, Kirsten Schultz; Polatajko, Helene; Nielsen, Claus Vinther

    2018-01-12

    There is growing interest in enabling older adults' occupational performance. We tested whether 11 weeks of intensive client-centred occupational therapy (ICC-OT) was superior to usual practice in improving the occupational performance of home-dwelling older adults. An assessor-masked randomized controlled trial among adults 60 + with chronic health issues, who received or applied for homecare services. Recruitment took place September 2012 to April 2014. All participants received practical and personal assistance and meal delivery as needed. In addition, they were randomized to receive either a maximum 22 sessions of occupation-based ICC-OT (N = 59) or to receive usual practice with a maximum three sessions of occupational therapy (N = 60). The primary outcome was self-rated occupational performance assessed with the Canadian Occupational Performance Measure (COPM). No important adverse events occurred. ICC-OT was accepted by 46 participants (88%), usual practice by 60 (100%). After 3 months, the ICC-OT-group had improved 1.86 points on COPM performance; the Usual-Practice group had improved 0.61 points. The between-group difference was statistically significant (95% confidence interval 0.50 to 2.02), t-test: p = 0.001. ICC-OT improved older adults' occupational performance more effectively than usual practice. This result may benefit older adults and support programmatic changes.

  14. The Feasibility of performing resistance exercise with acutely ill hospitalized older adults

    PubMed Central

    Mallery, Laurie H; MacDonald, Elizabeth A; Hubley-Kozey, Cheryl L; Earl, Marie E; Rockwood, Kenneth; MacKnight, Chris

    2003-01-01

    Background For older adults, hospitalization frequently results in deterioration of mobility and function. Nevertheless, there are little data about how older adults exercise in the hospital and definitive studies are not yet available to determine what type of physical activity will prevent hospital related decline. Strengthening exercise may prevent deconditioning and Pilates exercise, which focuses on proper body mechanics and posture, may promote safety. Methods A hospital-based resistance exercise program, which incorporates principles of resistance training and Pilates exercise, was developed and administered to intervention subjects to determine whether acutely-ill older patients can perform resistance exercise while in the hospital. Exercises were designed to be reproducible and easily performed in bed. The primary outcome measures were adherence and participation. Results Thirty-nine ill patients, recently admitted to an acute care hospital, who were over age 70 [mean age of 82.0 (SD= 7.3)] and ambulatory prior to admission, were randomized to the resistance exercise group (19) or passive range of motion (ROM) group (20). For the resistance exercise group, participation was 71% (p = 0.004) and adherence was 63% (p = 0.020). Participation and adherence for ROM exercises was 96% and 95%, respectively. Conclusion Using a standardized and simple exercise regimen, selected, ill, older adults in the hospital are able to comply with resistance exercise. Further studies are needed to determine if resistance exercise can prevent or treat hospital-related deterioration in mobility and function. PMID:14531932

  15. Complex roles of myoglianin in regulating adult performance and lifespan

    PubMed Central

    2017-01-01

    ABSTRACT Myoglianin, the Drosophila homolog of the secreted vertebrate proteins Myostatin and GDF-11, is an important regulator of neuronal modeling, and synapse function and morphology. While Myoglianin suppression during development elicits positive effects on the neuromuscular system, genetic manipulations of myoglianin expression levels have a varied effect on the outcome of performance tests in aging flies. Specifically, Myoglianin preserves jumping ability, has no effect on negative geotaxis, and negatively regulates flight performance in aging flies. In addition, Myoglianin exhibits a tissue-specific effect on longevity, with myoglianin upregulation in glial cells increasing the median lifespan. These findings indicate complex role for this TGF-β-like protein in governing neuromuscular signaling and consequent behavioral outputs and lifespan in adult flies. PMID:28837401

  16. Lack of relationship between masticatory performance and nutritional status in adults with natural dentition.

    PubMed

    Flores-Orozco, Elan Ignacio; Tiznado-Orozco, Gaby Esthela; Osuna-González, Olga Dionicia; Amaro-Navarrete, Claudia Lucero; Rovira-Lastra, Bernat; Martinez-Gomis, Jordi

    2016-11-01

    This study assessed the relation among several aspects of the masticatory function and the nutritional status in adults with natural dentition. One hundred adults with natural dentition participated in this cross-sectional study. They performed one free-style masticatory test consisting of five trials of 20 silicon-chewing cycles. The preferred chewing side was determined by calculating the asymmetry index. Masticatory performance was determined by sieving the silicon particles, and the cycle duration was also recorded. Weight, body water percentage, body fat mass, muscle mass and osseous mass were measured using a portable digital weighing machine. Body mass index (BMI), waist-hip ratio, skinfold thickness and the upper-arm composition were determined. The relation between masticatory function and a nutritional variable were tested using Pearson or Spearman rank correlation coefficients or using analysis of variance or the Kruskal-Wallis H-test and the Mann-Whitney U test, as appropriate. Whereas body fat percentages for women were significantly higher than for men, the body mass index was higher in men than in women. Participants who were underweight chewed more asymmetrically and more slowly than normal weight or obese participants. A negative correlation was observed between body fat percentage and masticatory laterality. No relation between masticatory performance and any nutritional status indicator was detected. Being underweight and having a low body fat percentage seem to be related to a masticatory lateral asymmetry and to a large cycle duration in young adults with natural dentition. Masticatory performance does not seem to be related to nutritional status. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Social support and mental health among adults prior to HIV counseling and testing in Durban, South Africa.

    PubMed

    Drain, Paul K; Losina, Elena; Coleman, Sharon M; Bogart, Laura; Giddy, Janet; Ross, Douglas; Katz, Jeffrey N; Bassett, Ingrid V

    2015-01-01

    Poor social support and mental health may be important modifiable risk factors for HIV acquisition, but they have not been evaluated prior to HIV testing in South Africa. We sought to describe self-perceived mental health and social support and to characterize their independent correlates among adults who presented for voluntary HIV testing in Durban. We conducted a large cross-sectional study of adults (≥18 years of age) who presented for HIV counseling and testing between August 2010 and January 2013 in Durban, South Africa. We enrolled adults presenting for HIV testing and used the Medical Outcomes Study's Social Support Scale (0 [poor] to 100 [excellent]) and the Mental Health Inventory (MHI-3) to assess social support and mental health. We conducted independent univariate and multivariable linear regression models to determine the correlates of lower self-reported Social Support Index and lower self-reported MCH scores. Among 4874 adults surveyed prior to HIV testing, 1887 (39%) tested HIV-positive. HIV-infected participants reported less social support (mean score 66 ± 22) and worse mental health (mean score 66 ± 16), compared to HIV-negative participants (74 ± 21; 70 ± 18; p < 0.0001). In a multivariable analysis, significant correlates of less social support included presenting for HIV testing at an urban hospital, not having been tested previously, not working outside the home, and being HIV-infected. In a separate multivariable analysis, significant correlates of poor mental health were similar, but also included HIV testing at an urban hospital and being in an intimate relationship less than six months. In this study, HIV-infected adults reported poorer social support and worse mental health than HIV-negative individuals. These findings suggest that interventions to improve poor social support and mental health should be focused on adults who do not work outside the home and those with no previous HIV testing.

  18. Independence of Hot and Cold Executive Function Deficits in High-Functioning Adults with Autism Spectrum Disorder.

    PubMed

    Zimmerman, David L; Ownsworth, Tamara; O'Donovan, Analise; Roberts, Jacqueline; Gullo, Matthew J

    2016-01-01

    Individuals with autistic spectrum disorder (ASD) display diverse deficits in social, cognitive and behavioral functioning. To date, there has been mixed findings on the profile of executive function deficits for high-functioning adults (IQ > 70) with ASD. A conceptual distinction is commonly made between "cold" and "hot" executive functions. Cold executive functions refer to mechanistic higher-order cognitive operations (e.g., working memory), whereas hot executive functions entail cognitive abilities supported by emotional awareness and social perception (e.g., social cognition). This study aimed to determine the independence of deficits in hot and cold executive functions for high-functioning adults with ASD. Forty-two adults with ASD (64% male, aged 18-66 years) and 40 age and gender matched controls were administered The Awareness of Social Inference Test (TASIT; emotion recognition and social inference), Letter Number Sequencing (working memory) and Hayling Sentence Completion Test (response initiation and suppression). Between-group analyses identified that the ASD group performed significantly worse than matched controls on all measures of cold and hot executive functions (d = 0.54 - 1.5). Hierarchical multiple regression analyses revealed that the ASD sample performed more poorly on emotion recognition and social inference tasks than matched controls after controlling for cold executive functions and employment status. The findings also indicated that the ability to recognize emotions and make social inferences was supported by working memory and response initiation and suppression processes. Overall, this study supports the distinction between hot and cold executive function impairments for adults with ASD. Moreover, it advances understanding of higher-order impairments underlying social interaction difficulties for this population which, in turn, may assist with diagnosis and inform intervention programs.

  19. Performance of Activity Classification Algorithms in Free-Living Older Adults.

    PubMed

    Sasaki, Jeffer Eidi; Hickey, Amanda M; Staudenmayer, John W; John, Dinesh; Kent, Jane A; Freedson, Patty S

    2016-05-01

    The objective of this study is to compare activity type classification rates of machine learning algorithms trained on laboratory versus free-living accelerometer data in older adults. Thirty-five older adults (21 females and 14 males, 70.8 ± 4.9 yr) performed selected activities in the laboratory while wearing three ActiGraph GT3X+ activity monitors (in the dominant hip, wrist, and ankle; ActiGraph, LLC, Pensacola, FL). Monitors were initialized to collect raw acceleration data at a sampling rate of 80 Hz. Fifteen of the participants also wore GT3X+ in free-living settings and were directly observed for 2-3 h. Time- and frequency-domain features from acceleration signals of each monitor were used to train random forest (RF) and support vector machine (SVM) models to classify five activity types: sedentary, standing, household, locomotion, and recreational activities. All algorithms were trained on laboratory data (RFLab and SVMLab) and free-living data (RFFL and SVMFL) using 20-s signal sampling windows. Classification accuracy rates of both types of algorithms were tested on free-living data using a leave-one-out technique. Overall classification accuracy rates for the algorithms developed from laboratory data were between 49% (wrist) and 55% (ankle) for the SVMLab algorithms and 49% (wrist) to 54% (ankle) for the RFLab algorithms. The classification accuracy rates for SVMFL and RFFL algorithms ranged from 58% (wrist) to 69% (ankle) and from 61% (wrist) to 67% (ankle), respectively. Our algorithms developed on free-living accelerometer data were more accurate in classifying the activity type in free-living older adults than those on our algorithms developed on laboratory accelerometer data. Future studies should consider using free-living accelerometer data to train machine learning algorithms in older adults.

  20. The unmet needs of all adults with ADHD are not the same: a focus on Europe.

    PubMed

    Ginsberg, Ylva; Beusterien, Kathleen Marie; Amos, Kaitlan; Jousselin, Claude; Asherson, Philip

    2014-07-01

    This review discusses the unmet needs in adult ADHD subgroups in Europe: adolescents in transition, adult patients, employees, older adults, and those in the criminal justice system. Analysis of the literature and an ADHD web forum was conducted. The visibility of adult ADHD remains low, and finding professionals able to diagnose is difficult for both adolescents as well as adults. Many ADHD cases go undiagnosed and untreated; ADHD may be mistaken for other common mental health conditions or missed in the presence of comorbidities. Pharmacological and psychosocial treatment services are very limited. Most employers do not understand how to address ADHD, and employees fear stigmatization. Older age individuals (>60 years) may feel worse with unrecognized ADHD, and those incarcerated with ADHD are likely to cost disproportionately more than their peers, with high recidivism rates. Strategies to address unmet needs and accommodate ADHD adults need not be expensive or time consuming to implement.

  1. Gait performance and foot pressure distribution during wearable robot-assisted gait in elderly adults.

    PubMed

    Lee, Su-Hyun; Lee, Hwang-Jae; Chang, Won Hyuk; Choi, Byung-Ok; Lee, Jusuk; Kim, Jeonghun; Ryu, Gyu-Ha; Kim, Yun-Hee

    2017-11-28

    A robotic exoskeleton device is an intelligent system designed to improve gait performance and quality of life for the wearer. Robotic technology has developed rapidly in recent years, and several robot-assisted gait devices were developed to enhance gait function and activities of daily living in elderly adults and patients with gait disorders. In this study, we investigated the effects of the Gait-enhancing Mechatronic System (GEMS), a new wearable robotic hip-assist device developed by Samsung Electronics Co, Ltd., Korea, on gait performance and foot pressure distribution in elderly adults. Thirty elderly adults who had no neurological or musculoskeletal abnormalities affecting gait participated in this study. A three-dimensional (3D) motion capture system, surface electromyography and the F-Scan system were used to collect data on spatiotemporal gait parameters, muscle activity and foot pressure distribution under three conditions: free gait without robot assistance (FG), robot-assisted gait with zero torque (RAG-Z) and robot-assisted gait (RAG). We found increased gait speed, cadence, stride length and single support time in the RAG condition. Reduced rectus femoris and medial gastrocnemius muscle activity throughout the terminal stance phase and reduced effort of the medial gastrocnemius muscle throughout the pre-swing phase were also observed in the RAG condition. In addition, walking with the assistance of GEMS resulted in a significant increase in foot pressure distribution, specifically in maximum force and peak pressure of the total foot, medial masks, anterior masks and posterior masks. The results of the present study reveal that GEMS may present an alternative way of restoring age-related changes in gait such as gait instability with muscle weakness, reduced step force and lower foot pressure in elderly adults. In addition, GEMS improved gait performance by improving push-off power and walking speed and reducing muscle activity in the lower

  2. A Scoping Review of Physical Performance Outcome Measures Used in Exercise Interventions for Older Adults With Alzheimer Disease and Related Dementias.

    PubMed

    McGough, Ellen L; Lin, Shih-Yin; Belza, Basia; Becofsky, Katie M; Jones, Dina L; Liu, Minhui; Wilcox, Sara; Logsdon, Rebecca G

    2017-11-28

    There is growing evidence that exercise interventions can mitigate functional decline and reduce fall risk in older adults with Alzheimer disease and related dementias (ADRD). Although physical performance outcome measures have been successfully used in older adults without cognitive impairment, additional research is needed regarding their use with individuals who have ADRD, and who may have difficulty following instructions regarding performance of these measures. The purpose of this scoping review was to identify commonly used physical performance outcome measures, for exercise interventions, that are responsive and reliable in older adults with ADRD. Ultimately, we aimed to provide recommendations regarding the use of outcome measures for individuals with ADRD across several domains of physical performance. A scoping review was conducted to broadly assess physical performance outcome measures used in exercise interventions for older adults with ADRD. Exercise intervention studies that included at least 1 measure of physical performance were included. All physical performance outcome measures were abstracted, coded, and categorized into 5 domains of physical performance: fitness, functional mobility, gait, balance, and strength. Criteria for recommendations were based on (1) the frequency of use, (2) responsiveness, and (3) reliability. Frequency was determined by the number of studies that used the outcome measure per physical performance domain. Responsiveness was assessed via calculated effect size of the outcome measures across studies within physical performance domains. Reliability was evaluated via published studies of psychometric properties. A total of 20 physical performance outcome measures were extracted from 48 articles that met study inclusion criteria. The most frequently used outcome measures were the 6-minute walk test, Timed Up and Go, repeated chair stand tests, short-distance gait speed, the Berg Balance Scale, and isometric strength measures

  3. Latent autoimmune diabetes of the adult: current knowledge and uncertainty

    PubMed Central

    Laugesen, E; Østergaard, J A; Leslie, R D G

    2015-01-01

    Patients with adult-onset autoimmune diabetes have less Human Leucocyte Antigen (HLA)-associated genetic risk and fewer diabetes-associated autoantibodies compared with patients with childhood-onset Type 1 diabetes. Metabolic changes at diagnosis reflect a broad clinical phenotype ranging from diabetic ketoacidosis to mild non-insulin-requiring diabetes, also known as latent autoimmune diabetes of the adult (LADA). This latter phenotype is the most prevalent form of adult-onset autoimmune diabetes and probably the most prevalent form of autoimmune diabetes in general. Although LADA is associated with the same genetic and immunological features as childhood-onset Type 1 diabetes, it also shares some genetic features with Type 2 diabetes, which raises the question of genetic heterogeneity predisposing to this form of the disease. The potential value of screening patients with adult-onset diabetes for diabetes-associated autoantibodies to identify those with LADA is emphasized by their lack of clinically distinct features, their different natural history compared with Type 2 diabetes and their potential need for a dedicated management strategy. The fact that, in some studies, patients with LADA show worse glucose control than patients with Type 2 diabetes, highlights the need for further therapeutic studies. Challenges regarding classification, epidemiology, genetics, metabolism, immunology, clinical presentation and treatment of LADA were discussed at a 2014 workshop arranged by the Danish Diabetes Academy. The presentations and discussions are summarized in this review, which sets out the current ideas and controversies surrounding this form of diabetes. What’s new? Latent autoimmune diabetes of the adult (LADA) is an autoimmune diabetes defined by adult-onset, presence of diabetes associated autoantibodies, and no insulin treatment requirement for a period after diagnosis. Immunologically, glutamic acid decarboxylase 65 autoantibodies are by far the most

  4. Computerized Agility Training Improves Change-of-Direction and Balance Performance Independently of Footwear in Young Adults.

    PubMed

    Paquette, Max R; Schilling, Brian K; Bravo, Joshua D; Peel, Shelby A; Li, Yuhua; Townsend, Robert J

    2017-03-01

    Understanding the effects of training in different footwear on sporting performance would be useful to coaches and athletes. This study compared the effects of computerized agility training using 3 types of footwear on change-of-direction and balance performance in young adults. Thirty recreationally active young adults (M age  = 22.8 ± 3.1 years; M height  = 1.71 ± 0.7 m; M bodymass  = 73.4 ± 10.3 kg) were randomly assigned to a 6-week computerized agility training intervention in 1 of 3 footwear groups (n = 10/group): barefoot, minimal footwear, or traditional shoes. Participants had no previous barefoot or minimal-footwear training experience. Dependent variables included change-of-direction test time to completion, Star Excursion Balance Test, and single-leg stability evaluation. Testing was performed at the start of the training program, after 2 weeks, after 4 weeks, and at the end of the training program. No group or time interactions were found for any of the dependent variables. Time main effects were observed for the performance measures of change of direction, Star Excursion, and single-leg-with-eyes-open stability evaluation. Participants improved in all 3 tests as early as 2 weeks into the intervention, with improvements continuing through the entire 6-week intervention. The lack of interaction and footwear effects suggests that agility and balance improvements during foot agility training are independent of footwear in a recreationally active young-adult population. Computerized agility training improves change-of-direction and balance performance within 2 weeks of training implementation. Future studies should consider footwear training effects in different populations, including frail older adults and athletes.

  5. Physical examination findings and their relationship with performance-based function in adults with knee osteoarthritis.

    PubMed

    Iversen, Maura D; Price, Lori Lyn; von Heideken, Johan; Harvey, William F; Wang, Chenchen

    2016-07-12

    Many physical examination (PE) maneuvers exist to assess knee function, none of which are specific to knee osteoarthritis (KOA). The Osteoarthritis Research Society International also recommends the use of six functional performance measures to assess function in adults with KOA. While earlier studies have examined the relationship between PE findings and self-reported function or PE findings and select performance tests in adults with knee pain and KOA, few have examined the all three types of measures. This cross-sectional study specifically examines the relationships between results of PE findings, functional performance tests and self-reported function in adults with symptomatic KOA. We used baseline PE data from a prospective randomized controlled trial in 87 participants aged ≥40 years with symptomatic and radiographic KOA. The PE performed by three experienced physical therapists included: muscle assessment, function and special tests. Participants also completed functional performance tests and the Western Ontario and McMaster Osteoarthritis Index (WOMAC). Multivariate linear regression identified contributions of PE findings towards functional performance and WOMAC scores, adjusting for age and gender. Participants' mean age was 60.4 years (SD = 10.5), mean disease duration was 8.4 years (SD = 10.1) and 27 participants had varus knee alignment. Mean WOMAC pain and function scores were 211 (SD = 113) and 709 (SD = 394), respectively. Weakness was present in major hip and knee muscles. Seventy-nine participants had a positive Ely's, 65 a positive Waldron and 49 a positive Grind. Mean 6-min walk was 404 m (SD = 83) and mean Berg Balance was 53 (SD = 4). Regression analysis identified positive findings on 5 special tests (P < 0.05) as indicative of poorer 6 min walk. Positive Apley's was associated (P < 0.05) with slower 20 m walk and a positive Ober with poorer balance scores (P < 0.05). Diminished hip muscle

  6. Submaximal oxygen uptake kinetics, functional mobility, and physical activity in older adults with heart failure and reduced ejection fraction

    PubMed Central

    Hummel, Scott L; Herald, John; Alpert, Craig; Gretebeck, Kimberlee A; Champoux, Wendy S; Dengel, Donald R; Vaitkevicius, Peter V; Alexander, Neil B

    2016-01-01

    Background Submaximal oxygen uptake measures are more feasible and may better predict clinical cardiac outcomes than maximal tests in older adults with heart failure (HF). We examined relationships between maximal oxygen uptake, submaximal oxygen kinetics, functional mobility, and physical activity in older adults with HF and reduced ejection fraction. Methods Older adults with HF and reduced ejection fraction (n = 25, age 75 ± 7 years) were compared to 25 healthy age- and gender-matched controls. Assessments included a maximal treadmill test for peak oxygen uptake (VO2peak), oxygen uptake kinetics at onset of and on recovery from a submaximal treadmill test, functional mobility testing [Get Up and Go (GUG), Comfortable Gait Speed (CGS), Unipedal Stance (US)], and self-reported physical activity (PA). Results Compared to controls, HF had worse performance on GUG, CGS, and US, greater delays in submaximal oxygen uptake kinetics, and lower PA. In controls, VO2peak was more strongly associated with functional mobility and PA than submaximal oxygen uptake kinetics. In HF patients, submaximal oxygen uptake kinetics were similarly associated with GUG and CGS as VO2peak, but weakly associated with PA. Conclusions Based on their mobility performance, older HF patients with reduced ejection fraction are at risk for adverse functional outcomes. In this population, submaximal oxygen uptake measures may be equivalent to VO2 peak in predicting functional mobility, and in addition to being more feasible, may provide better insight into how aerobic function relates to mobility in older adults with HF. PMID:27594875

  7. From Grapheme to Phonological Output: Performance of Adults Who Stutter on a Word Jumble Task

    PubMed Central

    McGill, Megann; Sussman, Harvey; Byrd, Courtney T.

    2016-01-01

    Purpose The purpose of the present study was to extend previous research by analyzing the ability of adults who stutter to use phonological working memory in conjunction with lexical access to perform a word jumble task. Method Forty English words consisting of 3-, 4-, 5-, and 6-letters (n = 10 per letter length category) were randomly jumbled using a web-based application. During the experimental task, 26 participants were asked to silently manipulate the scrambled letters to form a real word. Each vocal response was coded for accuracy and speech reaction time (SRT). Results Adults who stutter attempted to solve fewer word jumble stimuli than adults who do not stutter at the 4-letter, 5-letter, and 6-letter lengths. Additionally, adults who stutter were significantly less accurate solving word jumble tasks at the 4-letter, 5-letter, and 6-letter lengths compared to adults who do not stutter. At the longest word length (6-letter), SRT was significantly slower for the adults who stutter than the fluent controls. Conclusion Results of the current study lend further support to the notion that differences in various aspects of phonological processing, including vision-to-sound conversions, sub-vocal stimulus manipulation, and/or lexical access are compromised in adults who stutter. PMID:26963917

  8. The influence of education on performance of adults on the Clock Drawing Test.

    PubMed

    de Noronha, Ísis Franci Cavalcanti; Barreto, Simone Dos Santos; Ortiz, Karin Zazo

    2018-01-01

    The Clock Drawing Test (CDT) is an important instrument for screening individuals suspected of having cognitive impairment. To determine the influence of education on the performance of healthy adults on the CDT. A total of 121 drawings by healthy adults without neurological complaints or impairments were analysed. Participants were stratified by educational level into 4 subgroups: 27 illiterate adults, 34 individuals with 1-4 years of formal education, 30 with 5-11 years, and 30 adults with >11 years' formal education. Scores on the CDT were analyzed based on a scale of 1-10 points according to the criteria of Sunderland et al. (1989).¹ The Kruskal-Wallis test was applied to compare the different education groups. Tukey's multiple comparisons test was used when a significant factor was found. Although scores were higher with greater education, statistically significant differences on the CDT were found only between the illiterate and other educated groups. The CDT proved especially difficult for illiterate individuals, who had lower scores. These results suggest that this screening test is suitable for assessing mainly visuoconstructional praxis and providing an overall impression of cognitive function among individuals, independently of years of education.

  9. Prognostic value of serum phosphate level in adult patients resuscitated from cardiac arrest.

    PubMed

    Jung, Yong Hun; Lee, Byung Kook; Jeung, Kyung Woon; Youn, Chun Song; Lee, Dong Hun; Lee, Sung Min; Heo, Tag; Min, Yong Il

    2018-07-01

    Several studies have reported increased levels of phosphate after cardiac arrest. Given the relationship between phosphate level and the severity of ischaemic injury reported in previous studies, higher phosphate levels may be associated with worse outcomes. We investigated the prognostic value of phosphate level after the restoration of spontaneous circulation (ROSC) in adult cardiac arrest patients. This study was a retrospective observational study including adult cardiac arrest survivors treated at the Chonnam National University Hospital between January 2014 and June 2017. From medical records, data regarding clinical characteristics, outcome at hospital discharge, and laboratory parameters including phosphate levels after ROSC were collected. The primary outcome was poor outcome at hospital discharge, defined as Cerebral Performance Categories 3-5. Of the 674 included patients, 465 had poor outcome at hospital discharge. Serum phosphate level was significantly higher in patients with poor outcome than in those with good outcome (p < 0.001). Phosphate level was correlated with time to ROSC (r = 0.350, p < 0.001). Receiver operating characteristic curve analysis revealed an area under the curve of 0.805 (95% confidence interval [CI], 0.777-0.838) for phosphate level. In multivariate analysis, a higher phosphate level was independently associated with poor outcome at hospital discharge (odds ratio, 1.432; 95% CI, 1.245-1.626; p < 0.001). A higher phosphate level after ROSC was independently associated with poor outcome at hospital discharge in adult cardiac arrest patients. However, given its modest prognostic performance, phosphate level should be used in combination with other prognostic indicators. Copyright © 2018 Elsevier B.V. All rights reserved.

  10. Tracking Psychosocial Health in Adults with Epilepsy—Estimates from the 2010 National Health Interview Survey

    PubMed Central

    Kobau, R; Cui, W; Kadima, N; Zack, MM; Sajatovic, M; Kaiboriboon, K; Jobst, B

    2015-01-01

    Objective This study provides population-based estimates of psychosocial health among U.S. adults with epilepsy from the 2010 National Health Interview Survey. Methods Multinomial logistic regression was used to estimate the prevalence of the following measures of psychosocial health among adults with and those without epilepsy: 1) the Kessler-6 scale of Serious Psychological Distress; 2) cognitive limitation; the extent of impairments associated with psychological problems; and work limitation; 3) Social participation; and 4) the Patient Reported Outcome Measurement Information System Global Health scale. Results Compared with adults without epilepsy, adults with epilepsy, especially those with active epilepsy, reported significantly worse psychological health, more cognitive impairment, difficulty in participating in some social activities, and reduced health-related quality of life (HRQOL). Conclusions These disparities in psychosocial health in U.S. adults with epilepsy serve as baseline national estimates of their HRQOL, consistent with Healthy People 2020 national objectives on HRQOL. PMID:25305435

  11. Psychosocial health of cochlear implant users compared to that of adults with and without hearing aids: Results of a nationwide cohort study.

    PubMed

    Bosdriesz, J R; Stam, M; Smits, C; Kramer, S E

    2018-06-01

    This study aimed to examine the psychosocial health status of adult cochlear implant (CI) users, compared to that of hearing aid (HA) users, hearing-impaired adults without hearing aids and normally hearing adults. Cross-sectional observational study, using both self-reported survey data and a speech-in-noise test. Data as collected within the Netherlands Longitudinal Study on Hearing (NL-SH) between September 2011 and June 2016 were used. Data from 1254 Dutch adults (aged 23-74), selected in a convenience sample design, were included for analyses. Psychosocial health measures included emotional and social loneliness, anxiety, depression, distress and somatisation. Psychosocial health, hearing status, use of hearing technology and covariates were measured by self-report; hearing ability was assessed through an online digit triplet speech-in-noise test. After adjusting for the degree of hearing impairment, HA users (N = 418) and hearing-impaired adults (N = 247) had significantly worse scores on emotional loneliness than CI users (N = 37). HA users had significantly higher anxiety scores than CI users in some analyses. Non-significant differences were found between normally hearing (N = 552) and CI users for all psychosocial outcomes. Psychosocial health of CI users is not worse than that of hearing-impaired adults with or without hearing aids. CI users' level of emotional loneliness is even lower than that of their hearing-impaired peers using hearing aids. A possible explanation is that CI patients receive more professional and family support, and guidance along their patient journey than adults who are fitted with hearing aids. © 2017 The Authors. Clinical Otolaryngology Published by John Wiley & Sons Ltd.

  12. An exploratory study of the effects of spatial working-memory load on prefrontal activation in low- and high-performing elderly.

    PubMed

    Vermeij, Anouk; van Beek, Arenda H E A; Reijs, Babette L R; Claassen, Jurgen A H R; Kessels, Roy P C

    2014-01-01

    Older adults show more bilateral prefrontal activation during cognitive performance than younger adults, who typically show unilateral activation. This over-recruitment has been interpreted as compensation for declining structure and function of the brain. Here we examined how the relationship between behavioral performance and prefrontal activation is modulated by different levels of working-memory load. Eighteen healthy older adults (70.8 ± 5.0 years; MMSE 29.3 ± 0.9) performed a spatial working-memory task (n-back). Oxygenated ([O2Hb]) and deoxygenated ([HHb]) hemoglobin concentration changes were registered by two functional Near-Infrared Spectroscopy (fNIRS) channels located over the left and right prefrontal cortex. Increased working-memory load resulted in worse performance compared to the control condition. [O2Hb] increased with rising working-memory load in both fNIRS channels. Based on the performance in the high working-memory load condition, the group was divided into low and high performers. A significant interaction effect of performance level and hemisphere on [O2Hb] increase was found, indicating that high performers were better able to keep the right prefrontal cortex engaged under high cognitive demand. Furthermore, in the low performers group, individuals with a larger decline in task performance from the control to the high working-memory load condition had a larger bilateral increase of [O2Hb]. The high performers did not show a correlation between performance decline and working-memory load related prefrontal activation changes. Thus, additional bilateral prefrontal activation in low performers did not necessarily result in better cognitive performance. Our study showed that bilateral prefrontal activation may not always be successfully compensatory. Individual behavioral performance should be taken into account to be able to distinguish successful and unsuccessful compensation or declined neural efficiency.

  13. Outcomes of allogeneic hematopoietic cell transplantation for adolescent and young adults compared with children and older adults with acute myeloid leukemia.

    PubMed

    Majhail, Navneet S; Brazauskas, Ruta; Hassebroek, Anna; Bredeson, Christopher N; Hahn, Theresa; Hale, Gregory A; Horowitz, Mary M; Lazarus, Hillard M; Maziarz, Richard T; Wood, William A; Parsons, Susan K; Joffe, Steven; Rizzo, J Douglas; Lee, Stephanie J; Hayes-Lattin, Brandon M

    2012-06-01

    Adolescents and young adults (AYAs) with cancer have not experienced improvements in survival to the same extent as children and older adults. We compared outcomes among children (<15 years), AYAs (15-40 years) and older adults (>40 years) receiving allogeneic hematopoietic cell transplant (HCT) for acute myeloid leukemia (AML). Our cohort consisted of 900 children, 2,708 AYA, and 2,728 older adult recipients of HLA-identical sibling or unrelated donor (URD) transplantation using myeloablative or reduced-intensity/nonmyeloablative conditioning. Outcomes were assessed over three time periods (1980-1988, 1989-1997, 1998-2005) for siblings and two time periods (1989-1997, 1998-2005) for URD HCT. Analyses were stratified by donor type. Results showed overall survival for AYAs using either siblings or URD improved over time. Although children had better and older adults had worse survival compared with AYAs, improvements in survival for AYAs did not lag behind those for children and older adults. After sibling donor HCT, 5-year adjusted survival for the three time periods was 40%, 48%, and 53% for children, 35%, 41%, and 42% for AYAs, and 22%, 30%, and 34% for older adults. Among URD HCT recipients, 5-year adjusted survival for the two time periods was 38% and 37% for children, 24% and 28% for AYAs, and 19% and 23% for older adults. Improvements in survival occurred because of a reduction in risk of treatment-related mortality. The risk of relapse did not change over time. Improvements in survival among AYAs undergoing allogeneic HCT for AML have paralleled those among children and older adults. Copyright © 2012 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  14. FGFR1 actionable mutations, molecular specificities, and outcome of adult midline gliomas.

    PubMed

    Picca, Alberto; Berzero, Giulia; Bielle, Franck; Touat, Mehdi; Savatovsky, Julien; Polivka, Marc; Trisolini, Elena; Meunier, Sheida; Schmitt, Yohann; Idbaih, Ahmed; Hoang-Xuan, Khe; Delattre, Jean-Yves; Mokhtari, Karima; Di Stefano, Anna Luisa; Sanson, Marc

    2018-06-05

    To characterize the prevalence and prognostic significance of major driver molecular alterations in adult midline diffuse gliomas (MLG). Adults with histologically proven MLG diagnosed between 1996 and 2017 were identified from our tumor bank, systematically reviewed, and reclassified according to WHO 2016. Targeted sequencing was performed, including determination of H3F3A , HIST1H3B , TERTp , IDH1/2 , FGFR1 , p16/CDKN2A , and EGFR status. A total of 116 adult patients (M/F 71/45, median age 46.5 years) with MLG (17 cerebellar, 8 spinal, 30 brainstem, 57 thalamic, and 4 diencephalic nonthalamic) were identified. Most patients had high-grade disease at presentation (grade II: 11%, grade III: 15%, grade IV: 75%). Median overall survival was 17.3 months (14.5-23.8 months). Main molecular alterations observed were TERT promoter, H3F3A , and hotspot FGFR1 (N546 and K656) mutations, in 37%, 34%, and 18% of patients, respectively. IDH1 mutations only affected brainstem gliomas (6/24 vs 0/78; p = 7.5 × 10 -5 ), were mostly non-R132H (contrasting with hemispheric gliomas, p = 0.0001), and were associated with longer survival (54 vs 12 months). TERT promoter mutation (9.1 vs 24.2 months), CDKN2A deletion (9.9 vs 23.8 months), and EGFR amplification (4.3 vs 23.8 months) were associated with shorter survival. Of interest, in contrast with pediatric MLG, H3K27M mutations were not associated with worse prognosis (23 vs 15 months). Patients with adult MLG present with unique clinical and molecular characteristics, differing from their pediatric counterparts. The identification of potentially actionable FGFR1 mutations in a subset of adult MLG highlights the importance of comprehensive genomic analysis in this rare affection. © 2018 American Academy of Neurology.

  15. Determinants of Excessive Daytime Sleepiness and Fatigue in Adults with Heart Failure

    PubMed Central

    Riegel, Barbara; Ratcliffe, Sarah J.; Sayers, Steven L.; Potashnik, Sheryl; Buck, Harleah; Jurkovitz, Claudine; Fontana, Sarah; Weaver, Terri E.; Weintraub, William S.; Goldberg, Lee R.

    2012-01-01

    Little is known about excessive daytime sleepiness (EDS) in heart failure (HF). The aim of this cross-sectional descriptive study was to describe the prevalence of EDS and factors associated with it in HF. A secondary purpose was to explore the correlates of fatigue. We enrolled a consecutive sample of 280 adults with a confirmed diagnosis of chronic HF from three outpatient settings in the northeastern US. Patients with major depressive illness were excluded. Clinical, sociodemographic, behavioral, and perceptual factors were explored as possible correlates of EDS. Using an Epworth Sleepiness Scale score >10, the prevalence of EDS was 23.6%. Significant determinants of EDS were worse sleep quality (p=0.048), worse functional class (p=0.004), not taking a diuretic (p=0.005), and lack of physical activity (p=0.04). Only sleep quality was associated with fatigue (p<0.001). Sleep disordered breathing was not significantly associated with EDS or with fatigue. These factors may be amenable to intervention. PMID:21878581

  16. Normal adult and adolescent performance on TASIT-S, a short version of The Assessment of Social Inference Test.

    PubMed

    McDonald, Skye; Honan, Cynthia; Allen, Samantha K; El-Helou, Rebecca; Kelly, Michelle; Kumfor, Fiona; Piguet, Olivier; Hazelton, Jessica L; Padgett, Christine; Keage, Hannah A D

    2018-05-01

    There is a need for short, reliable, sensitive assessment tools to measure social cognition. The Awareness of Social Inference Test (TASIT) is an ecologically valid instrument that uses videos of actors engaged in everyday conversations to assess emotion perception, the ability to detect lies, sarcasm and sincerity, and the ability to judge what others are thinking, intending, feeling, and saying. A recently developed short version of TASIT retains the structure of the original test and its clinical sensitivity. In this paper, we compare TASIT-S performance in healthy adolescents, adults, and older adults as well as the effects of country (U.S.A. and Australia), English familiarity and gender. In this study 616 Australians including 226 adolescents (13-19) and 390 adults aged 20-75 + along with 180 U.S. residents (aged 20-74) completed one, two, or three parts of TASIT-S either face to face (Australians) or on-line (US residents). Results indicated that there were minor differences in TASIT-S performance (Part 3 only) based on country of residence and no significant effects for English familiarity in adolescents (not examined in adults). There were no gender effects. Young and middle aged adults (20-59) tended to perform better than adolescents and older adults on most parts of TASIT-S. In general, TASIT-S scores decreased moderately with advancing age. In conclusion, TASIT-S is a useful screen for social cognitive impairment in English speakers that is appropriate for use from adolescence through to older age. It produces comparable scores in the U.S.A. and Australia.

  17. Circadian and Wake-Dependent Influences on Subjective Sleepiness, Cognitive Throughput, and Reaction Time Performance in Older and Young Adults

    PubMed Central

    Silva, Edward J.; Wang, Wei; Ronda, Joseph M.; Wyatt, James K.; Duffy, Jeanne F.

    2010-01-01

    Study Objectives: To assess circadian and homeostatic influences on subjective sleepiness and cognitive performance in older adults when sleep and waking are scheduled at different times of day; to assess changes in subjective sleepiness and cognitive performance across several weeks of an inpatient study; and to compare these findings with results from younger adults. Design: Three 24-h baseline days consisting of 16 h of wakefulness and an 8-h sleep opportunity followed by 3-beat cycles of a 20-h forced desynchrony (FD) condition; 18 20-h “days,” each consisting of 13.33 h of scheduled wakefulness and 6.67 h of scheduled sleep opportunity. Setting: Intensive Physiological Monitoring Unit of the Brigham and Women's Hospital General Clinical Research Center. Participants: 10 healthy older adults (age 64.00 ± 5.98 y, 5 females) and 10 healthy younger adults (age 24.50 ± 3.54 y, 5 females). Interventions: Wake episodes during FD scheduled to begin 4 h earlier each day allowing for data collection at a full range of circadian phases. Measurements and Results: Subjective sleepiness, cognitive throughput, and psychomotor vigilance assessed every 2 h throughout the study. Core body temperature (CBT) data collected throughout to assess circadian phase. Older subjects were less sleepy and performed significantly better on reaction time (RT) measures than younger subjects. Decrements among younger subjects increased in magnitude further into the experiment, while the performance of older subjects remained stable. Conclusions: Our findings demonstrate that the waking performance and alertness of healthy older subjects are less impacted by the cumulative effects of repeated exposure to adverse circadian phase than that of young adults. This suggests that there are age-related changes in the circadian promotion of alertness, in the wake-dependent decline of alertness, and/or in how these 2 regulatory systems interact in healthy aging. Citation: Silva EJ; Wang W; Ronda JM

  18. Physical Activity, Sleep, and Nutrition Do Not Predict Cognitive Performance in Young and Middle-Aged Adults.

    PubMed

    Gijselaers, Hieronymus J M; Elena, Barberà; Kirschner, Paul A; de Groot, Renate H M

    2016-01-01

    Biological lifestyle factors (BLFs) such as physical activity, sleep, and nutrition play a role in cognitive functioning. Research concerning the relation between BLFs and cognitive performance is scarce however, especially in young and middle-aged adults. Research has not yet focused on a multidisciplinary approach with respect to this relation in the abovementioned population, where lifestyle habits are more stable. The aim of this study was to examine the contribution of these BLFs to cognitive performance. Path analysis was conducted in an observational study in which 1131 adults were analyzed using a cross-validation approach. Participants provided information on physical activity, sedentary behavior, chronotype, sleep duration, sleep quality, and the consumption of breakfast, fish, and caffeine via a survey. Their cognitive performance was measured using objective digital cognitive tests. Exploration yielded a predictive cohesive model that fitted the data properly, χ(2) /df = 0.8, CFI = 1.00, RMSEA < 0.001, SRMR = 0.016. Validation of the developed model indicated that the model fitted the data satisfactorily, χ(2) /df = 2.75, CFI = 0.95, RMSEA < 0.056, SRMR = 0.035. None of the variables within the BLFs were predictive for any of the cognitive performance measures, except for sedentary behavior. Although sedentary behavior was positively predictive for processing speed its contribution was small and unclear. The results indicate that the variables within the BLFs do not predict cognitive performance in young and middle-aged adults.

  19. The impact of numeracy ability and technology skills on older adults' performance of health management tasks using a patient portal.

    PubMed

    Taha, Jessica; Sharit, Joseph; Czaja, Sara J

    2014-06-01

    Patient portals, which allow patients to access their health record via the Internet, are becoming increasingly widespread and are expected to be used by diverse consumer populations. In addition to technology skills, numeracy skills are also likely to be critical to performing health management tasks, as much of the data contained in the portal are numeric. This study examined how factors such as Internet experience, numeracy, and education impacted the performance of common tasks using a simulated patient portal among a sample of older adults. In addition, information was gathered on the ability of older adults to estimate their numeracy skills. Results indicated that numeracy and Internet experience had a significant impact on their ability to perform the tasks and that older adults tended to overestimate their numeracy skills. Results from this study can help to identify interventions that may enhance the usability of patient portals for older adults.

  20. Financial performance among adult day centers: results of a national demonstration program.

    PubMed

    Reifler, B V; Henry, R S; Rushing, J; Yates, M K; Cox, N J; Bradham, D D; McFarlane, M

    1997-02-01

    This paper describes the financial performance (defined as percent of total expenses covered by net operating revenue) of 16 adult day centers participating in a national demonstration program on day services for people with dementia, including examination of possible predictors of financial performance. Participating sites submitted quarterly financial and utilization reports to the National Program Office. Descriptive statistics summarize the factors believed to influence financial performance. Sites averaged meeting 35% of expenses from self-pay and 29% from government (mainly Medicaid) revenue, totaling 64% of all (cash plus in-kind) expenses met by operating revenue. Examination of center characteristics suggests that factors related to meeting consumer needs, such as being open a full day (i.e., 7:30 am to 6:00 pm) rather than shorter hours, and providing transportation, may be related to improved utilization and, thus, improved financial performance. Higher fees were not related to lower enrollment, census, or revenue. Adult day centers are able to achieve financial viability through a combination of operating (i.e., fee-for-service) and non-operating revenue. Operating revenue is enhanced by placing emphasis on consumer responsiveness, such as being open a full day. Because higher fees were not related to lower utilization, centers should set fees to reflect actual costs. The figure of 64% of expenses met by operating revenue is conservative inasmuch as sites included in-kind revenue as expenses in their budgeting calculations, and percent of cash expenses met by operating revenue would be higher (approximately 75% for this group of centers).

  1. Childhood Poverty, Cumulative Risk Exposure, and Mental Health in Emerging Adults

    PubMed Central

    Evans, Gary W.; Cassells, Rochelle C.

    2014-01-01

    One out of four American children are born into poverty, but little is known about the long-term, mental health implications of early deprivation. The more time in poverty from birth-age-9, the worse mental health as emerging adults (n = 196, M = 17.30 years, 53% male). These results maintain independently of concurrent, adult income levels for self-reported externalizing symptoms and a standard learned helplessness behavioral protocol, but internalizing symptoms were unaffected by childhood poverty. We then demonstrate that part of the reason why early poverty exposure is harmful to mental health among emerging adults is because of elevated cumulative risk exposure assessed at age 13. The significant, prospective, longitudinal relations between early childhood poverty and externalizing symptoms plus learned helplessness behavior are mediated, in part, by exposure to a confluence of psychosocial (violence, family turmoil, child separation from family) and physical (noise, crowding, substandard housing) risk factors during adolescence. PMID:26609499

  2. Cognitive Function and Vascular Risk Factors Among Older African American Adults

    PubMed Central

    Park, Moon Ho; Tsang, Siny; Sperling, Scott A.; Manning, Carol

    2017-01-01

    To evaluate the association between vascular risk factors and cognitive impairment among older African American (AA) adults in a primary care clinic. Participants included 96 AA adults aged 60 years or older who were evaluated for global and domain-specific cognition. Participants were interviewed using the Computerized Assessment of Memory and Cognitive Impairment (CAMCI). The relationship between CAMCI cognitive domain scores and vascular risk factors were examined using hierarchical regression models. Patients who smoked, those with higher SBP/DBP values had lower accuracy rates on CAMCI cognitive domains (attention, executive, memory).Those with higher BMI had better attention scores. Patients with higher HbA1C values had worse verbal memory. Patients with higher blood pressure were significantly faster in responding to tasks in the executive domain. Primary care providers working with older AA adults with these VRFs could implement cognitive screening earlier into their practice to reduce barriers of seeking treatment. PMID:28417319

  3. A Comprehensive Analysis of the SRS-Schwab Adult Spinal Deformity Classification and Confounding Variables: A Prospective, Non-US Cross-sectional Study in 292 Patients.

    PubMed

    Hallager, Dennis Winge; Hansen, Lars Valentin; Dragsted, Casper Rokkjær; Peytz, Nina; Gehrchen, Martin; Dahl, Benny

    2016-05-01

    Cross-sectional analyses on a consecutive, prospective cohort. To evaluate the ability of the Scoliosis Research Society (SRS)-Schwab Adult Spinal Deformity Classification to group patients by widely used health-related quality-of-life (HRQOL) scores and examine possible confounding variables. The SRS-Schwab Adult Spinal Deformity Classification includes sagittal modifiers considered important for HRQOL and the clinical impact of the classification has been validated in patients from the International Spine Study Group database; however, equivocal results were reported for the Pelvic Tilt modifier and potential confounding variables were not evaluated. Between March 2013 and May 2014, all adult spinal deformity patients from our outpatient clinic with sufficient radiographs were prospectively enrolled. Analyses of HRQOL variance and post hoc analyses were performed for each SRS-Schwab modifier. Age, history of spine surgery, and aetiology of spinal deformity were considered potential confounders and their influence on the association between SRS-Schwab modifiers and aggregated Oswestry Disability Index (ODI) scores was evaluated with multivariate proportional odds regressions. P values were adjusted for multiple testing. Two hundred ninety-two of 460 eligible patients were included for analyses. The SRS-Schwab Classification significantly discriminated HRQOL scores between normal and abnormal sagittal modifier classifications. Individual grade comparisons showed equivocal results; however, Pelvic Tilt grade + versus +  + did not discriminate patients according to any HRQOL score. All modifiers showed significant proportional odds for worse aggregated ODI scores with increasing grade levels and the effects were robust to confounding. However, age group and aetiology had individual significant effects. The SRS-Schwab sagittal modifiers reliably grouped patients graded 0 versus + / +  + according to the most widely used HRQOL scores and the

  4. Postprandial effects of breakfast glycaemic index on cognitive performance among young, healthy adults: A crossover clinical trial.

    PubMed

    Sanchez-Aguadero, Natalia; Recio-Rodriguez, Jose I; Patino-Alonso, Maria C; Mora-Simon, Sara; Alonso-Dominguez, Rosario; Sanchez-Salgado, Benigna; Gomez-Marcos, Manuel A; Garcia-Ortiz, Luis

    2018-04-12

    To evaluate the postprandial effects of high and low glycaemic index (GI) breakfasts on cognitive performance in young, healthy adults. A crossover clinical trial including 40 young, healthy adults (aged 20-40 years, 50% females) recruited from primary healthcare centres in Salamanca, Spain. Verbal memory, phonological fluency, attention, and executive functions were examined 0, 60, and 120 minutes after consuming a low GI (LGI), high GI (HGI), or water breakfast. Every subject tried each breakfast variant, in a randomized order, separated by a washout period of 7 days, for a total of 3 weeks. A significant interaction between the type of breakfast consumed and immediate verbal memory was identified (P<.05). We observed a trend towards better performance in verbal memory (delayed and immediate), attention, and phonological fluency following an LGI breakfast. Cognitive performance during the postprandial phase in young, healthy adults was minimally affected by the GI of breakfast. The potential for breakfast's GI modulation to improve short- and long-term cognitive functioning requires further research.

  5. Association between dietary fiber intake and physical performance in older adults: a nationwide study in Taiwan.

    PubMed

    Wu, I-Chien; Chang, Hsing-Yi; Hsu, Chih-Cheng; Chiu, Yen-Feng; Yu, Shu-Han; Tsai, Yi-Fen; Shen, Shi-Chen; Kuo, Ken N; Chen, Ching-Yu; Liu, Kiang; Lee, Marion M; Hsiung, Chao A

    2013-01-01

    Physical performance is a major determinant of health in older adults, and is related to lifestyle factors. Dietary fiber has multiple health benefits. It remains unclear whether fiber intake is independently linked to superior physical performance. We aimed to assess the association between dietary fiber and physical performance in older adults. This was a cross-sectional study conducted with community-dwelling adults aged 55 years and older (n=2680) from the ongoing Healthy Aging Longitudinal Study (HALST) in Taiwan 2008-2010. Daily dietary fiber intake was assessed using a validated food frequency questionnaire. Physical performance was determined objectively by measuring gait speed, 6-minute walk distance, timed "up and go" (TUG), summary performance score, hand grip strength. Adjusting for all potential confounders, participants with higher fiber intake had significantly faster gait speed, longer 6-minute walk distance, faster TUG, higher summary performance score, and higher hand grip strength (all P <.05). Comparing with the highest quartile of fiber intake, the lowest quartile of fiber intake was significantly associated with the lowest sex-specific quartile of gait speed (adjusted OR, 2.18 in men [95% CI, 1.33-3.55] and 3.65 in women [95% CI, 2.20-6.05]), 6-minute walk distance (OR, 2.40 in men [95% CI, 1.38-4.17] and 4.32 in women [95% CI, 2.37-7.89]), TUG (OR, 2.42 in men [95% CI, 1.43-4.12] and 3.27 in women [95% CI, 1.94-5.52]), summary performance score (OR, 2.12 in men [95% CI, 1.19-3.78] and 5.47 in women [95% CI, 3.20-9.35]), and hand grip strength (OR, 2.64 in men [95% CI, 1.61-4.32] and 4.43 in women [95% CI, 2.62-7.50]). Dietary fiber intake was independently associated with better physical performance.

  6. Exploratory Decision-Making as a Function of Lifelong Experience, Not Cognitive Decline

    PubMed Central

    2016-01-01

    Older adults perform worse than younger adults in some complex decision-making scenarios, which is commonly attributed to age-related declines in striatal and frontostriatal processing. Recently, this popular account has been challenged by work that considered how older adults’ performance may differ as a function of greater knowledge and experience, and by work showing that, in some cases, older adults outperform younger adults in complex decision-making tasks. In light of this controversy, we examined the performance of older and younger adults in an exploratory choice task that is amenable to model-based analyses and ostensibly not reliant on prior knowledge. Exploration is a critical aspect of decision-making poorly understood across the life span. Across 2 experiments, we addressed (a) how older and younger adults differ in exploratory choice and (b) to what extent observed differences reflect processing capacity declines. Model-based analyses suggested that the strategies used by the 2 groups were qualitatively different, resulting in relatively worse performance for older adults in 1 decision-making environment but equal performance in another. Little evidence was found that differences in processing capacity drove performance differences. Rather the results suggested that older adults’ performance might result from applying a strategy that may have been shaped by their wealth of real-word decision-making experience. While this strategy is likely to be effective in the real world, it is ill suited to some decision environments. These results underscore the importance of taking into account effects of experience in aging studies, even for tasks that do not obviously tap past experiences. PMID:26726916

  7. Liver transplant for biliary atresia is associated with a worse outcome - Myth or fact?

    PubMed

    Chung, Patrick Ho Yu; Wong, Kenneth Kak Yuen; Chan, See Ching; Tam, Paul Kwong Hang

    2015-12-01

    Liver transplant for biliary atresia (BA) has been reported to be associated with worse outcome, but this remains controversial. The objective of this study is to compare the outcomes of BA and non-BA recipients. Recipients with age <18years were reviewed except cases of retransplantation. Intratransplant and posttransplant complications as well as survivals were evaluated. 119 patients, with median follow-up period 8.5years, were studied (DDLT=33; LDLT=86/M:F=56:63), and 68% (n=81) were BA patients. While demographic data were comparable between two groups of recipients, BA patients had a worse pretransplant PELD/MELD score (15.2 vs 4.0, p=0.021). Transplantation takes a longer time in the BA group (580min vs 400min, p=0.065) with more blood loss (720ml vs 500ml, p=0.072). The incidence of transplant-related complications was 30.3% (36/119) (Table 1). There was no significant difference between incidences of vascular complication, but biliary complication was more common in the BA group. Overall, the survivals between the two groups were comparable. Liver transplant is an effective surgical treatment for BA patients. When compared to other indications, results are not inferior. Previous Kasai operation is not necessarily associated with adverse outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Unmet Support Service Needs and Health-Related Quality of Life among Adolescents and Young Adults with Cancer: The AYA HOPE Study.

    PubMed

    Smith, Ashley Wilder; Parsons, Helen M; Kent, Erin E; Bellizzi, Keith; Zebrack, Brad J; Keel, Gretchen; Lynch, Charles F; Rubenstein, Mara B; Keegan, Theresa H M

    2013-01-01

    Cancer for adolescents and young adults (AYA) differs from younger and older patients; AYA face medical challenges while navigating social and developmental transitions. Research suggests that these patients are under or inadequately served by current support services, which may affect health-related quality of life (HRQOL). We examined unmet service needs and HRQOL in the National Cancer Institute's Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) study, a population-based cohort (n = 484), age 15-39, diagnosed with cancer 6-14 months prior, in 2007-2009. Unmet service needs were psychosocial, physical, spiritual, and financial services where respondents endorsed that they needed, but did not receive, a listed service. Linear regression models tested associations between any or specific unmet service needs and HRQOL, adjusting for demographic, medical, and health insurance variables. Over one-third of respondents reported at least one unmet service need. The most common were financial (16%), mental health (15%), and support group (14%) services. Adjusted models showed that having any unmet service need was associated with worse overall HRQOL, fatigue, physical, emotional, social, and school/work functioning, and mental health (p's < 0.0001). Specific unmet services were related to particular outcomes [e.g., needing pain management was associated with worse overall HRQOL, physical and social functioning (p's < 0.001)]. Needing mental health services had the strongest associations with worse HRQOL outcomes; needing physical/occupational therapy was most consistently associated with poorer functioning across domains. Unmet service needs in AYAs recently diagnosed with cancer are associated with worse HRQOL. Research should examine developmentally appropriate, relevant practices to improve access to services demonstrated to adversely impact HRQOL, particularly physical therapy and mental health services.

  9. Unmet Support Service Needs and Health-Related Quality of Life among Adolescents and Young Adults with Cancer: The AYA HOPE Study

    PubMed Central

    Smith, Ashley Wilder; Parsons, Helen M.; Kent, Erin E.; Bellizzi, Keith; Zebrack, Brad J.; Keel, Gretchen; Lynch, Charles F.; Rubenstein, Mara B.; Keegan, Theresa H. M.

    2013-01-01

    Introduction: Cancer for adolescents and young adults (AYA) differs from younger and older patients; AYA face medical challenges while navigating social and developmental transitions. Research suggests that these patients are under or inadequately served by current support services, which may affect health-related quality of life (HRQOL). Methods: We examined unmet service needs and HRQOL in the National Cancer Institute’s Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) study, a population-based cohort (n = 484), age 15–39, diagnosed with cancer 6–14 months prior, in 2007–2009. Unmet service needs were psychosocial, physical, spiritual, and financial services where respondents endorsed that they needed, but did not receive, a listed service. Linear regression models tested associations between any or specific unmet service needs and HRQOL, adjusting for demographic, medical, and health insurance variables. Results: Over one-third of respondents reported at least one unmet service need. The most common were financial (16%), mental health (15%), and support group (14%) services. Adjusted models showed that having any unmet service need was associated with worse overall HRQOL, fatigue, physical, emotional, social, and school/work functioning, and mental health (p’s < 0.0001). Specific unmet services were related to particular outcomes [e.g., needing pain management was associated with worse overall HRQOL, physical and social functioning (p’s < 0.001)]. Needing mental health services had the strongest associations with worse HRQOL outcomes; needing physical/occupational therapy was most consistently associated with poorer functioning across domains. Discussion: Unmet service needs in AYAs recently diagnosed with cancer are associated with worse HRQOL. Research should examine developmentally appropriate, relevant practices to improve access to services demonstrated to adversely impact HRQOL, particularly physical

  10. Effects of the Addition of a Dual Task to a Supervised Physical Exercise Program on Older Adults' Cognitive Performance.

    PubMed

    Ansai, Juliana Hotta; de Andrade, Larissa Pires; de Souza Buto, Marcele Stephanie; de Vassimon Barroso, Verena; Farche, Ana Claudia Silva; Rossi, Paulo Giusti; de Medeiros Takahashi, Anielle Cristhine

    2017-04-01

    The purpose of this study was to investigate the effects of the addition of a dual task to multicomponent training on cognition of active older adults. Eighty physically active older adults were divided into an intervention group (IG) and a control group (CG). Both groups performed multicomponent training over 12 weeks. The IG simultaneously performed exercises and cognitive tasks. The Mini-Mental State Examination, the Montreal Cognitive Assessment, and the Clock Drawing Test were used for cognitive assessments. The Timed Up and Go Test associated with a cognitive task was used for dual-task assessment. Significant interactions were not observed between groups in terms of the cognitive variables or the dual-task performance. An interaction was observed only for Timed Up and Go Test performance, which was better in the CG than in the IG. Active older adults showed no improvement in cognition following the addition of the dual task to the multicomponent training.

  11. Cortisol Reactivity and Performance Abilities in Social Situations in Adults with Williams Syndrome

    PubMed Central

    Lense, Miriam D.; Dykens, Elisabeth M.

    2017-01-01

    Williams syndrome (WS) is a neurodevelopmental disorder associated with hypersociability and anxiety. However, little is known about how these salient aspects of the phenotype are related or their underlying physiology. We examined cortisol reactivity in WS because cortisol is responsive to psychosocial stress. Compared to typically developing adults, adults with WS had a significant cortisol decrease in response to a challenging cognitive battery. In contrast, cortisol levels in WS stayed stable in response to a solo musical performance, and baseline cortisol levels were significantly associated with musical skill. Results indicate that people with WS respond differentially to different socially-loaded situations. Implications for salience and arousal in cognitive and social situations are discussed. PMID:24245731

  12. From Children to Adults: Motor Performance across the Life-Span

    PubMed Central

    Leversen, Jonas S. R.; Haga, Monika; Sigmundsson, Hermundur

    2012-01-01

    The life-span approach to development provides a theoretical framework to examine the general principles of life-long development. This study aims to investigate motor performance across the life span. It also aims to investigate if the correlations between motor tasks increase with aging. A cross-sectional design was used to describe the effects of aging on motor performance across age groups representing individuals from childhood to young adult to old age. Five different motor tasks were used to study changes in motor performance within 338 participants (7–79 yrs). Results showed that motor performance increases from childhood (7–9) to young adulthood (19–25) and decreases from young adulthood (19–25) to old age (66–80). These results are mirroring results from cognitive research. Correlation increased with increasing age between two fine motor tasks and two gross motor tasks. We suggest that the findings might be explained, in part, by the structural changes that have been reported to occur in the developing and aging brain and that the theory of Neural Darwinism can be used as a framework to explain why these changes occur. PMID:22719958

  13. Compensatory Saccades Are Associated With Physical Performance in Older Adults: Data From the Baltimore Longitudinal Study of Aging.

    PubMed

    Xie, Yanjun; Anson, Eric R; Simonsick, Eleanor M; Studenski, Stephanie A; Agrawal, Yuri

    2017-03-01

    To determine whether compensatory saccade metrics observed in the video head impulse test, specifically saccade amplitude and latency, predict physical performance. Cross-sectional analysis of the Baltimore Longitudinal Study of Aging, a prospective cohort study. National Institute on Aging Intramural Research Program Clinical Research Unit in Baltimore, Maryland. Community-dwelling older adults. Video head impulse testing was performed, and compensatory saccades and horizontal vestibulo-ocular reflex (VOR) gain were measured. Physical performance was assessed using the Short Physical Performance Battery (SPPB), which included the feet side-by-side, semitandem, tandem, and single-leg stance; repeated chair stands; and usual gait speed measurements. Compensatory saccade amplitude and latency, VOR gain, and SPPB performance. In 183 participants who underwent vestibular and SPPB testing (mean age 71.8 yr; 53% females), both higher mean saccade amplitude (odds ratio [OR] =1.62, p = 0.010) and shorter mean saccade latency (OR = 0.88, p = 0.004) were associated with a higher odds of failing the tandem stand task. In contrast, VOR gain was not associated with any physical performance measure. We observed in a cohort of healthy older adults that compensatory saccade amplitude and latency were associated with tandem stance performance. Compensatory saccade metrics may provide insights into capturing the impact of vestibular loss on physical function in older adults.

  14. Persistent and Newly Developed Chronic Bronchitis Are Associated with Worse Outcomes in Chronic Obstructive Pulmonary Disease.

    PubMed

    Kim, Victor; Zhao, Huaqing; Boriek, Aladin M; Anzueto, Antonio; Soler, Xavier; Bhatt, Surya P; Rennard, Stephen I; Wise, Robert; Comellas, Alejandro; Ramsdell, Joe W; Kinney, Gregory L; Han, MeiLan K; Martinez, Carlos H; Yen, Andrew; Black-Shinn, Jennifer; Porszasz, Janos; Criner, Gerard J; Hanania, Nicola A; Sharafkhaneh, Amir; Crapo, James D; Make, Barry J; Silverman, Edwin K; Curtis, Jeffrey L

    2016-07-01

    Chronic bronchitis is, by definition, a chronic condition, but the development and remission of this condition in cigarette smokers with or without chronic obstructive pulmonary disease (COPD) are poorly understood. Also, it is unclear how the persistence or new development of chronic bronchitis affects symptoms and outcomes. To ascertain the relationship between smoking status and the presence or absence of chronic bronchitis and the subsequent effects on symptoms and outcomes. We analyzed 1,775 current or ex-smokers with GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage 0-IV COPD in phase 2 of the Genetic Epidemiology of COPD (COPDGene) Study, which included subjects after 5 years of follow-up from phase 1. We asked subjects at enrollment and at 5 years of follow-up about symptoms consistent with chronic bronchitis. We divided subjects into four groups: persistent chronic bronchitis- (negative at phase 1/negative at phase 2), resolved chronic bronchitis (positive/negative), new chronic bronchitis (negative/positive), and persistent chronic bronchitis+ (positive/positive). We analyzed respiratory symptoms, health-related quality of life, lung function, exacerbation frequency, and 6-minute walk distance. Compared with the persistent chronic bronchitis- group, members of the persistent chronic bronchitis+ group were more likely to have continued smoking (53.4%). Subjects with new chronic bronchitis were more likely to have resumed (6.6%) or continued smoking (45.6%), whereas subjects with resolved chronic bronchitis were more likely to have quit smoking (23.5%). Compared with the persistent chronic bronchitis- group, the other groups had a shorter 6-minute walk distance, worse lung function, greater exacerbation frequency, and worse respiratory symptoms. Modified Medical Research Council dyspnea and St. George's Respiratory Questionnaire scores worsened between phase 1 and phase 2 in subjects with new chronic bronchitis but improved in the resolved

  15. Attentional Lapses of Adults with Attention Deficit Hyperactivity Disorder in Tasks of Sustained Attention.

    PubMed

    Gmehlin, Dennis; Fuermaier, Anselm B M; Walther, Stephan; Tucha, Lara; Koerts, Janneke; Lange, Klaus W; Tucha, Oliver; Weisbrod, Matthias; Aschenbrenner, Steffen

    2016-06-01

    Adults with attention deficit hyperactivity disorder (ADHD) show attentional dysfunction such as distractibility and mind-wandering, especially in lengthy tasks. However, fundamentals of dysfunction are ambiguous and relationships of neuropsychological test parameters with self-report measures of ADHD symptoms are marginal. We hypothesize that basic deficits in sustaining attention explain more complex attentional dysfunction in persons with ADHD and relate to ADHD symptoms. Attentional function was analyzed by computing ex-Gaussian parameters for 3 time Blocks in a 20 min test of sustained alertness. Changes in performance across these blocks were analyzed by comparing adult persons with ADHD (n = 24) with healthy matched controls (n = 24) and correlated with neuropsychological measures of selective and divided attention as well as self-report measures of ADHD symptoms. We found a significantly steeper increase in the number of slow responses (ex-Gaussian parameter τ) in persons with ADHD with time on task in basic sustained alertness. They also performed significantly worse in tasks of sustained selective and divided attention. However, after controlling for an increase in τ during the alertness task, significant differences between groups disappeared for divided and partly selective attention. Increases in τ in the sustained alertness task correlated significantly with self-report measures of ADHD symptoms. Our results provide evidence that very basic deficits in sustaining attention in adults with ADHD are related to infrequent slow responses (=attentional lapses), with changes over time being relevant for more complex attentional function and experienced ADHD symptoms in everyday life. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  16. Superior Recognition Performance for Happy Masked and Unmasked Faces in Both Younger and Older Adults

    PubMed Central

    Svärd, Joakim; Wiens, Stefan; Fischer, Håkan

    2012-01-01

    In the aging literature it has been shown that even though emotion recognition performance decreases with age, the decrease is less for happiness than other facial expressions. Studies in younger adults have also revealed that happy faces are more strongly attended to and better recognized than other emotional facial expressions. Thus, there might be a more age independent happy face advantage in facial expression recognition. By using a backward masking paradigm and varying stimulus onset asynchronies (17–267 ms) the temporal development of a happy face advantage, on a continuum from low to high levels of visibility, was examined in younger and older adults. Results showed that across age groups, recognition performance for happy faces was better than for neutral and fearful faces at durations longer than 50 ms. Importantly, the results showed a happy face advantage already during early processing of emotional faces in both younger and older adults. This advantage is discussed in terms of processing of salient perceptual features and elaborative processing of the happy face. We also investigate the combined effect of age and neuroticism on emotional face processing. The rationale was previous findings of age-related differences in physiological arousal to emotional pictures and a relation between arousal and neuroticism. Across all durations, there was an interaction between age and neuroticism, showing that being high in neuroticism might be disadvantageous for younger, but not older adults’ emotion recognition performance during arousal enhancing tasks. These results indicate that there is a relation between aging, neuroticism, and performance, potentially related to physiological arousal. PMID:23226135

  17. Cardiorespiratory Fitness Is Associated With Cognitive Performance in Older But Not Younger Adults.

    PubMed

    Hayes, Scott M; Forman, Daniel E; Verfaellie, Mieke

    2016-05-01

    Aging is associated with declines in executive function and episodic memory. Cardiorespiratory fitness (CRF) has been associated with enhanced executive function in older adults (OA), but the relationship with episodic memory remains unclear. The purpose of the study was to examine the relationship between CRF and cognition in young and OA and whether CRF mitigates age-related cognitive decline. Participants completed exercise testing to evaluate CRF (peak VO2) and neuropsychological testing to assess cognition. In OA, peak VO2 was positively related to executive function, as well as to accuracy on an experimental face-name memory task and visual episodic memory. In young adults (YA), a relationship between peak VO2 and cognition was not evident. High-fit OA performed as well as YA on executive function measures. On episodic memory measures, YA performed better than high-fit OA, who in turn performed better than low-fit OA. CRF is positively associated with executive function and episodic memory in OA and attenuates age-related cognitive decline. We provide preliminary support for the age-dependence hypothesis, which posits that cognition and CRF relationships may be most readily observed during lifetime periods of significant neurocognitive development. Published by Oxford University Press on behalf of the Gerontological Society of America 2014.

  18. No evidence that 'fast-mapping' benefits novel learning in healthy Older adults.

    PubMed

    Greve, Andrea; Cooper, Elisa; Henson, Richard N

    2014-07-01

    Much evidence suggests that the Hippocampus is necessary for learning novel associations. Contrary to this, Sharon, Moscovitch, and Gilboa (2011) reported four amnesic patients with Hippocampal damage who maintained the capacity to learn novel object-name associations when trained with a 'fast-mapping' (FM) technique. This technique therefore potentially offers an alternative route for learning novel information in populations experiencing memory problems. We examined this potential in healthy ageing, by comparing 24 Older and 24 Young participants who completed a FM procedure very similar to Sharon et al. (2011). As expected, the Older group showed worse memory than the Young group under standard explicit encoding (EE) instructions. However, the Older group continued to show worse performance under the FM procedure, with no evidence that FM alleviated their memory deficit. Indeed, performance was worse for the FM than EE condition in both groups. Structural MRI scans confirmed reduced Hippocampal grey-matter volume in the Older group, which correlated with memory performance across both groups and both EE/FM conditions. We conclude FM does not help memory problems that occur with normal ageing, and discuss theoretical implications for memory theories. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Does dual task training improve walking performance of older adults with concern of falling?

    PubMed

    Wollesen, B; Schulz, S; Seydell, L; Delbaere, K

    2017-09-11

    Older adults with concerns of falling show decrements of gait stability under single (ST) and dual task (DT) conditions. To compare the effects of a DT training integrating task managing strategies for independent living older adults with and without concern about falling (CoF) to a non-training control group on walking performance under ST and DT conditions. Single center parallel group single blind randomized controlled trial with group-based interventions (DT-managing balance training) compared to a control group (Ninety-five independent living older adults; 71.5 ± 5.2 years). A progressive DT training (12 sessions; 60 min each; 12 weeks) including task-managing strategies was compared to a non-training control group. group based intervention for independent living elderly in a gym. ST and DT walking (visual verbal Stroop task) were measured on a treadmill. Gait parameters (step length, step width, and gait line) and cognitive performance while walking were compared with a 2x2x2 Repeated Measures Analyses of Variance. Participants in the intervention group showed an increased step length under ST and DT conditions following the intervention, for both people with and without CoF compared to their respective control groups. Foot rolling movement and cognitive performance while walking however only improved in participants without CoF. The results showed that DT managing training can improve walking performance under ST and DT conditions in people with and without CoF. Additional treatment to directly address CoF, such as cognitive behavioural therapy, should be considered to further improve the cautious gait pattern (as evidenced by reduced foot rolling movements). The study was retrospectively registered in the German Clinical Trials Register (DRKS; Identification number DRKS00012382 , 11.05.2017).

  20. The influence of education on performance of adults on the Clock Drawing Test

    PubMed Central

    de Noronha, Ísis Franci Cavalcanti; Barreto, Simone dos Santos; Ortiz, Karin Zazo

    2018-01-01

    ABSTRACT The Clock Drawing Test (CDT) is an important instrument for screening individuals suspected of having cognitive impairment. Objective: To determine the influence of education on the performance of healthy adults on the CDT. Methods: A total of 121 drawings by healthy adults without neurological complaints or impairments were analysed. Participants were stratified by educational level into 4 subgroups: 27 illiterate adults, 34 individuals with 1-4 years of formal education, 30 with 5-11 years, and 30 adults with >11 years' formal education. Scores on the CDT were analyzed based on a scale of 1-10 points according to the criteria of Sunderland et al. (1989).¹ The Kruskal-Wallis test was applied to compare the different education groups. Tukey's multiple comparisons test was used when a significant factor was found. Results: Although scores were higher with greater education, statistically significant differences on the CDT were found only between the illiterate and other educated groups. Conclusion: The CDT proved especially difficult for illiterate individuals, who had lower scores. These results suggest that this screening test is suitable for assessing mainly visuoconstructional praxis and providing an overall impression of cognitive function among individuals, independently of years of education. PMID:29682235

  1. Sex differences in adult outcomes by changes in weight status from adolescence to adulthood: results from Add Health.

    PubMed

    Chung, Arlene E; Skinner, Asheley Cockrell; Maslow, Gary R; Halpern, Carolyn T; Perrin, Eliana M

    2014-01-01

    Changes in weight status from adolescence to adulthood may be associated with varying social, vocational, economic, and educational outcomes, which may differ by sex. We studied whether there are differences in adult outcomes by sex for different weight status changes in the transition to adulthood. Using data from the National Longitudinal Study of Adolescent Health, participants were categorized by weight status from adolescence into adulthood. We examined self-reported outcomes in adulthood for living with parents, being married, being a parent, employment, receipt of public assistance, income, and college graduation by weight groupings (healthy-healthy, healthy-overweight/obese, overweight/obese-overweight/obese, overweight/obese-healthy). The effect of changes in weight status on the adult outcomes was modeled, controlling for sex, age, parental education, and race/ethnicity. There were differences by sex for many of the self-reported outcomes, especially educational and economic outcomes. Female subjects who became overweight/obese between adolescence and adulthood or remained so had worse economic and educational findings as adults compared to male subjects. Overall, for female subjects, becoming and remaining overweight/obese was associated with worse outcomes, while for male subjects, adolescent obesity was more important than isolated adult obesity. The relationship between obesity and life situations may be more negative for female subjects in the transition to adulthood. The findings emphasize that adolescent obesity, and not just obesity isolated in adulthood, is important for characteristics achieved in adulthood. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  2. Lower-limb kinematics of single-leg squat performance in young adults.

    PubMed

    Horan, Sean A; Watson, Steven L; Carty, Christopher P; Sartori, Massimo; Weeks, Benjamin K

    2014-01-01

    To determine the kinematic parameters that characterize good and poor single-leg squat (SLS) performance. A total of 22 healthy young adults free from musculoskeletal impairment were recruited for testing. For each SLS, both two-dimensional video and three-dimensional motion analysis data were collected. Pelvis, hip, and knee angles were calculated using a reliable and validated lower-limb (LL) biomechanical model. Two-dimensional video clips of SLSs were blindly assessed in random order by eight musculoskeletal physiotherapists using a 10-point ordinal scale. To facilitate between-group comparisons, SLS performances were stratified by tertiles corresponding to poor, intermediate, and good SLS performance. Mean ratings of SLS performance assessed by physiotherapists were 8.3 (SD 0.5), 6.8 (SD 0.7), and 4.0 (SD 0.8) for good, intermediate, and poor squats, respectively. Three-dimensional analysis revealed that people whose SLS performance was assessed as poor exhibited increased hip adduction, reduced knee flexion, and increased medio-lateral displacement of the knee joint centre compared to those whose SLS performance was assessed as good (p≤0.05). Overall, poor SLS performance is characterized by inadequate knee flexion and excessive frontal plane motion of the knee and hip. Future investigations of SLS performance should consider standardizing knee flexion angle to illuminate other influential kinematic parameters.

  3. Brain activation during dual-task processing is associated with cardiorespiratory fitness and performance in older adults

    PubMed Central

    Wong, Chelsea N.; Chaddock-Heyman, Laura; Voss, Michelle W.; Burzynska, Agnieszka Z.; Basak, Chandramallika; Erickson, Kirk I.; Prakash, Ruchika S.; Szabo-Reed, Amanda N.; Phillips, Siobhan M.; Wojcicki, Thomas; Mailey, Emily L.; McAuley, Edward; Kramer, Arthur F.

    2015-01-01

    Higher cardiorespiratory fitness is associated with better cognitive performance and enhanced brain activation. Yet, the extent to which cardiorespiratory fitness-related brain activation is associated with better cognitive performance is not well understood. In this cross-sectional study, we examined whether the association between cardiorespiratory fitness and executive function was mediated by greater prefrontal cortex activation in healthy older adults. Brain activation was measured during dual-task performance with functional magnetic resonance imaging in a sample of 128 healthy older adults (59–80 years). Higher cardiorespiratory fitness was associated with greater activation during dual-task processing in several brain areas including the anterior cingulate and supplementary motor cortex (ACC/SMA), thalamus and basal ganglia, right motor/somatosensory cortex and middle frontal gyrus, and left somatosensory cortex, controlling for age, sex, education, and gray matter volume. Of these regions, greater ACC/SMA activation mediated the association between cardiorespiratory fitness and dual-task performance. We provide novel evidence that cardiorespiratory fitness may support cognitive performance by facilitating brain activation in a core region critical for executive function. PMID:26321949

  4. The prone bridge test: Performance, validity, and reliability among older and younger adults.

    PubMed

    Bohannon, Richard W; Steffl, Michal; Glenney, Susan S; Green, Michelle; Cashwell, Leah; Prajerova, Kveta; Bunn, Jennifer

    2018-04-01

    The prone bridge maneuver, or plank, has been viewed as a potential alternative to curl-ups for assessing trunk muscle performance. The purpose of this study was to assess prone bridge test performance, validity, and reliability among younger and older adults. Sixty younger (20-35 years old) and 60 older (60-79 years old) participants completed this study. Groups were evenly divided by sex. Participants completed surveys regarding physical activity and abdominal exercise participation. Height, weight, body mass index (BMI), and waist circumference were measured. On two occasions, 5-9 days apart, participants held a prone bridge until volitional exhaustion or until repeated technique failure. Validity was examined using data from the first session: convergent validity by calculating correlations between survey responses, anthropometrics, and prone bridge time, known groups validity by using an ANOVA comparing bridge times of younger and older adults and of men and women. Test-retest reliability was examined by using a paired t-test to compare prone bridge times for Session1 and Session 2. Furthermore, an intraclass correlation coefficient (ICC) was used to characterize relative reliability and minimal detectable change (MDC 95% ) was used to describe absolute reliability. The mean prone bridge time was 145.3 ± 71.5 s, and was positively correlated with physical activity participation (p ≤ 0.001) and negatively correlated with BMI and waist circumference (p ≤ 0.003). Younger participants had significantly longer plank times than older participants (p = 0.003). The ICC between testing sessions was 0.915. The prone bridge test is a valid and reliable measure for evaluating abdominal performance in both younger and older adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Maternal separation decreases adult hippocampal cell proliferation and impairs cognitive performance but has little effect on stress sensitivity and anxiety in adult Wistar rats.

    PubMed

    Hulshof, Henriëtte J; Novati, Arianna; Sgoifo, Andrea; Luiten, Paul G M; den Boer, Johan A; Meerlo, Peter

    2011-01-20

    Stressful events during childhood are thought to increase the risk for the development of adult psychopathology. A widely used animal model for early life stress is maternal separation (MS), which is thought to affect development and cause alterations in neuroendocrine stress reactivity and emotionality lasting into adulthood. However, results obtained with this paradigm are inconsistent. Here we investigated whether this variation may be related to the type of stressor or the tests used to assess adult stress sensitivity and behavioral performance. Rat pups were exposed to a 3h daily MS protocol during postnatal weeks 1-2. In adulthood, animals were subjected to a wide variety of stressors and tests to obtain a better view on the effects of MS on adult hypothalamic-pituitary-adrenal (HPA) axis regulation, anxiety-like behavior, social interaction and cognition. Also, the influence of MS on adult hippocampal neurogenesis was studied because it might underlie changes in neuroendocrine regulation and behavioral performance. The results show that, independent of the nature of the stressor, MS did not affect the neuroendocrine response. MS did not influence anxiety-like behavior, explorative behavior and social interaction, but did affect cognitive function in an object recognition task. The amount of new born cells in the hippocampal dentate gyrus was significantly decreased in MS animals; yet, cell differentiation and survival were not altered. In conclusion, while interfering with the mother-infant relationship early in life did affect some aspects of adult neuroplasticity and cognitive function, it did not lead to permanent changes in stress sensitivity and emotionality. Copyright © 2010 Elsevier B.V. All rights reserved.

  6. Disentangling cognition and emotion in older adults: the role of cognitive control and mental health in emotional conflict adaptation.

    PubMed

    Hantke, Nathan C; Gyurak, Anett; Van Moorleghem, Katie; Waring, Jill D; Adamson, Maheen M; O'Hara, Ruth; Beaudreau, Sherry A

    2017-08-01

    Recent research suggests cognition has a bidirectional relationship with emotional processing in older adults, yet the relationship is still poorly understood. We aimed to examine a potential relationship between late-life cognitive function, mental health symptoms, and emotional conflict adaptation. We hypothesized that worse cognitive control abilities would be associated with poorer emotional conflict adaptation. We further hypothesized that a higher severity of mental health symptoms would be associated with poorer emotional conflict adaptation. Participants included 83 cognitively normal community-dwelling older adults who completed a targeted mental health and cognitive battery, and emotion and gender conflict-adaptation tasks. Consistent with our hypothesis, poorer performance on components of cognitive control, specifically attention and working memory, was associated with poorer emotional conflict adaptation. This association with attention and working memory was not observed in the non-affective-based gender conflict adaptation task. Mental health symptoms did not predict emotional conflict adaptation, nor did performance on other cognitive measures. Our findings suggest that emotion conflict adaptation is disrupted in older individuals who have poorer attention and working memory. Components of cognitive control may therefore be an important potential source of inter-individual differences in late-life emotion regulation and cognitive affective deficits. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Olfaction and apathy in Alzheimer's disease, mild cognitive impairment, and healthy older adults.

    PubMed

    Seligman, Sarah C; Kamath, Vidyulata; Giovannetti, Tania; Arnold, Steven E; Moberg, Paul J

    2013-01-01

    Apathy is a prevalent neuropsychiatric manifestation in individuals with Alzheimer's disease (AD) that is associated with decreased social functioning and increased caregiver burden. Olfactory deficits are also commonly observed in AD, and prior work has indicated a link between increased apathy and olfactory dysfunction in individuals with Parkinson's disease. Here, we examined odor identification performance in patients with probable AD (n = 172), individuals with mild cognitive impairment (MCI; n = 112), and neurologically and psychiatrically healthy older adults (n = 132) and its relation to apathy, depression, and overall psychopathology. Participants were administered the Sniffin' Sticks odor identification test and measures assessing severity of apathy, depression, and overall neuropsychiatric symptomatology. Consistent with previous research, AD and MCI patients were significantly worse at identifying odors than healthy older adults. Additionally, a sex by diagnosis interaction was observed. AD patients had significantly higher levels of apathy relative to MCI and control participants. Of note, across the entire sample odor identification deficits were correlated with level of apathy at the level of p < 0.01, but not with depression or neuropsychiatric symptom severity, when controlling for Mini-Mental State Examination (MMSE) score. Collectively, these data suggest that olfactory disturbance and apathy in AD may result from the progression of disease pathology in shared neural substrates.

  8. Computerized Agility Training Improves Change-of-Direction and Balance Performance Independently of Footwear in Young Adults

    ERIC Educational Resources Information Center

    Paquette, Max R.; Schilling, Brian K.; Bravo, Joshua D.; Peel, Shelby A.; Li, Yuhua; Townsend, Robert J.

    2017-01-01

    Understanding the effects of training in different footwear on sporting performance would be useful to coaches and athletes. Purpose: This study compared the effects of computerized agility training using 3 types of footwear on change-of-direction and balance performance in young adults. Method: Thirty recreationally active young adults…

  9. Association of Impaired Linear Growth and Worse Neurodevelopmental Outcome in Infants with Single Ventricle Physiology: A Report from the Pediatric Heart Network Infant Single Ventricle Trial

    PubMed Central

    Ravishankar, Chitra; Zak, Victor; Williams, Ismee A.; Bellinger, David C.; Gaynor, J. William; Ghanayem, Nancy S.; Krawczeski, Catherine D.; Licht, Daniel J.; Mahony, Lynn; Newburger, Jane W.; Pemberton, Victoria L.; Williams, Richard V.; Sananes, Renee; Cook, Amanda L.; Atz, Teresa; Khaikin, Svetlana; Hsu, Daphne T.

    2012-01-01

    Objectives To describe neurodevelopmental outcomes in infants with single ventricle (SV) physiology and determine factors associated with worse outcomes. Study design Neurodevelopmental outcomes for infants with SV enrolled in a multicenter drug trial were assessed at 14 months of age using the Bayley Scales of Infant Development-II. Multivariable regression analysis was used to identify factors associated with worse outcomes. Results Neurodevelopmental testing was performed at 14±1 months in 170/185 subjects in the trial. Hypoplastic left heart syndrome was present in 59% and 75% had undergone the Norwood operation. Mean psychomotor (PDI) and mental developmental indices (MDI) were 80±18 and 96±14 respectively (normal 100±15, P<0.001 for each). Group-based trajectory analysis provided a two-group model (high” and “low”) for height z-score trajectory and brain type natriuretic peptide (BNP) trajectory. The predicted PDI scores were 15 points higher in the “high” height z-score trajectory compared with the “low” cluster (P<.001). A higher number of serious adverse events during the trial was associated with lower PDI scores (P=.02). The predicted MDI scores were 13–17 points lower in “low height trajectory- high BNP trajectory” group compared with the other three groups (P<.001). MDI scores were also lower in subjects who required extracorporeal membrane oxygenation during the neonatal hospitalization (P=.01) or supplemental oxygen at discharge (P=.01). Conclusions Neurodevelopmental outcome at 14 months of age is impaired in infants with SV physiology. Low height trajectory and high BNP trajectory were associated with worse neurodevelopmental outcomes. Efforts to improve nutritional status alone may not improve neurodevelopmental outcomes. PMID:22939929

  10. Biofilm formation is not associated with worse outcome in Acinetobacter baumannii bacteraemic pneumonia.

    PubMed

    Wang, Yung-Chih; Huang, Tzu-Wen; Yang, Ya-Sung; Kuo, Shu-Chen; Chen, Chung-Ting; Liu, Chang-Pan; Liu, Yuag-Meng; Chen, Te-Li; Chang, Feng-Yee; Wu, Shih-Hsiung; How, Chorng-Kuang; Lee, Yi-Tzu

    2018-05-08

    The effect of biofilm formation on bacteraemic pneumonia caused by A. baumannii is unknown. We conducted a 4-year multi-center retrospective study to analyze 71 and 202 patients with A. baumannii bacteraemic pneumonia caused by biofilm-forming and non-biofilm-forming isolates, respectively. The clinical features and outcomes of patients were investigated. Biofilm formation was determined by a microtitre plate assay. The antimicrobial susceptibilities of biofilm-associated cells were assessed using the minimum biofilm eradication concentration (MBEC) assay. Whole-genome sequencing was conducted to identify biofilm-associated genes and their promoters. Quantitative reverse transcription polymerase chain reaction was performed to confirm the expression difference of biofilm-associated genes. There was no significant difference in the clinical characteristics or the outcomes between patients infected with biofilm-forming and non-biofilm-forming strains. Compared with non-biofilm-forming isolates, biofilm-forming isolates exhibited lower resistance to most antimicrobials tested, including imipenem, meropenem, ceftazidime, ciprofloxacin and gentamicin; however, the MBEC assay confirmed the increased antibiotic resistance of the biofilm-embedded bacteria. Biofilm-associated genes and their promoters were detected in most isolates, including the non-biofilm-forming strains. Biofilm-forming isolates showed higher levels of expression of the biofilm-associated genes than non-biofilm-forming isolates. The biofilm-forming ability of A. baumannii isolates might not be associated with worse outcomes in patients with bacteraemic pneumonia.

  11. Effects of two doses of methylphenidate on simulator driving performance in adults with attention deficit hyperactivity disorder.

    PubMed

    Barkley, Russell A; Murphy, Kevin R; O'Connell, Trisha; Connor, Daniel F

    2005-01-01

    Numerous studies have documented an increased frequency of vehicular crashes, traffic citations, driving performance deficits, and driving-related cognitive impairments in teens and adults with attention deficit hyperactivity disorder. The present study evaluated the effects of two single, acute doses of methylphenidate (10 and 20 mg) and a placebo on the driving performance of 53 adults with ADHD (mean age=37 years, range=18-65) using a virtual reality driving simulator, examiner and self-ratings of simulator performance, and a continuous performance test (CPT) to evaluate attention and inhibition. A double-blind, drug-placebo, within-subjects crossover design was used in which all participants were tested at baseline and then experienced all three drug conditions. A significant beneficial effect for the high dose of medication was observed on impulsiveness on CPT, variability of steering in the standard driving course, and driving speed during the obstacle course. A beneficial effect of the low dose of medication also was evident on turn signal use during the standard driving course. An apparent practice effect was noted on some of the simulator measures between the baseline and subsequent testing sessions that may have interacted with and thereby obscured drug effects on those measures. The results, when placed in the context of prior studies of stimulants on driving performance, continue to recommend their clinical use as one means of reducing the driving risks in ADHD teens and adults. Given the significantly higher risk of adverse driving outcomes associated with ADHD, industry needs to better screen for ADHD among employees who drive as part of employment so as to improve safety and reduce costs. Use of stimulants to treat the adult ADHD driver may reduce safety risks.

  12. Independence of Hot and Cold Executive Function Deficits in High-Functioning Adults with Autism Spectrum Disorder

    PubMed Central

    Zimmerman, David L.; Ownsworth, Tamara; O'Donovan, Analise; Roberts, Jacqueline; Gullo, Matthew J.

    2016-01-01

    Individuals with autistic spectrum disorder (ASD) display diverse deficits in social, cognitive and behavioral functioning. To date, there has been mixed findings on the profile of executive function deficits for high-functioning adults (IQ > 70) with ASD. A conceptual distinction is commonly made between “cold” and “hot” executive functions. Cold executive functions refer to mechanistic higher-order cognitive operations (e.g., working memory), whereas hot executive functions entail cognitive abilities supported by emotional awareness and social perception (e.g., social cognition). This study aimed to determine the independence of deficits in hot and cold executive functions for high-functioning adults with ASD. Forty-two adults with ASD (64% male, aged 18–66 years) and 40 age and gender matched controls were administered The Awareness of Social Inference Test (TASIT; emotion recognition and social inference), Letter Number Sequencing (working memory) and Hayling Sentence Completion Test (response initiation and suppression). Between-group analyses identified that the ASD group performed significantly worse than matched controls on all measures of cold and hot executive functions (d = 0.54 − 1.5). Hierarchical multiple regression analyses revealed that the ASD sample performed more poorly on emotion recognition and social inference tasks than matched controls after controlling for cold executive functions and employment status. The findings also indicated that the ability to recognize emotions and make social inferences was supported by working memory and response initiation and suppression processes. Overall, this study supports the distinction between hot and cold executive function impairments for adults with ASD. Moreover, it advances understanding of higher-order impairments underlying social interaction difficulties for this population which, in turn, may assist with diagnosis and inform intervention programs. PMID:26903836

  13. Preliminary Findings of the Brief Everyday Activities Measurement (BEAM) in Older Adults.

    PubMed

    Scharaga, E A; Holtzer, R

    2015-11-01

    Functional losses are common in healthy and cognitively impaired older adults. However, subtle declines in instrumental activities of daily living (IADLs) are not always detected in self-reports. Performance IADL measurements are financially and time burdensome, restricting their use in varied settings. To address these limitations, we developed the Brief Everyday Activities Measure (BEAM), a short (< 5 minutes) objective IADL measure that assesses medication and finance management. The BEAM was administered to 209 cognitively non-demented community-dwellers (ages 65 - 95 years). Participants completed standardized motor, neuropsychological, psychological, and self-report functional assessments. BEAM completion time ranged from 54.16 to 259.31 seconds. Interclass correlations (ICC) for total BEAM completion time was moderate (0.65, 95% CI [.43 -.78]). Accuracy for total BEAM performance was in the low-moderate range (Kappa = 0.38, p < .001, 95% CI [.18 -.54]). As predicted, lower accuracy and longer time to complete the BEAM were both associated with worse executive functions, attention, and processing speed. Medication and finance management can be efficiently assessed within five minutes. The BEAM may be a valuable screening tool to evaluate these functional abilities.

  14. Older Adults Make Less Advantageous Decisions than Younger Adults: Cognitive and Psychological Correlates

    PubMed Central

    Fein, George; McGillivray, Shannon; Finn, Peter

    2007-01-01

    This study tested the hypotheses that older adults make less advantageous decisions than younger adults on the Iowa gambling task (IGT). Less advantageous decisions, as measured by the IGT, are characterized by choices that favor larger versus smaller immediate rewards, even though such choices may result in long-term negative consequences. The IGT, and measures of neuropsychological function, personality, and psychopathology were administered to 164 healthy adults 18–85 years of age. Older adults performed less advantageously on the IGT compared with younger adults. Additionally, a greater number of older adult’s IGT performances were classified as ‘impaired’ when compared to younger adults. Less advantageous decisions were associated with obsessive symptoms in older adults and with antisocial symptoms in younger adults. Performance on the IGT was positively associated with auditory working memory and psychomotor function in young adults, and in immediate memory in older adults. PMID:17445297

  15. The Effect of Prior Task Success on Older Adults' Memory Performance: Examining the Influence of Different Types of Task Success.

    PubMed

    Geraci, Lisa; Hughes, Matthew L; Miller, Tyler M; De Forrest, Ross L

    2016-01-01

    Negative aging stereotypes can lead older adults to perform poorly on memory tests. Yet, memory performance can be improved if older adults have a single successful experience on a cognitive test prior to participating in a memory experiment (Geraci & Miller, 2013, Psychology and Aging, 28, 340-345). The current study examined the effects of different types of prior task experience on subsequent memory performance. Before participating in a verbal free recall experiment, older adults in Experiment 1 successfully completed either a verbal or a visual cognitive task or no task. In Experiment 2, they successfully completed either a motor task or no task before participating in the free recall experiment. Results from Experiment 1 showed that relative to control (no prior task), participants who had prior success, either on a verbal or a visual task, had better subsequent recall performance. Experiment 2 showed that prior success on a motor task, however, did not lead to a later memory advantage relative to control. These findings demonstrate that older adults' memory can be improved by a successful prior task experience so long as that experience is in a cognitive domain.

  16. The Role of Shifting, Updating, and Inhibition in Prospective Memory Performance in Young and Older Adults

    ERIC Educational Resources Information Center

    Schnitzspahn, Katharina M.; Stahl, Christoph; Zeintl, Melanie; Kaller, Christoph P.; Kliegel, Matthias

    2013-01-01

    Prospective memory performance shows a decline in late adulthood. The present article examines the role of 3 main executive function facets (i.e., shifting, updating, and inhibition) as possible developmental mechanisms associated with these age effects. One hundred seventy-five young and 110 older adults performed a battery of cognitive tests…

  17. The Role of the Frontal Lobe in Complex Walking Among Patients With Parkinson's Disease and Healthy Older Adults: An fNIRS Study.

    PubMed

    Maidan, Inbal; Nieuwhof, Freek; Bernad-Elazari, Hagar; Reelick, Miriam F; Bloem, Bas R; Giladi, Nir; Deutsch, Judith E; Hausdorff, Jeffery M; Claassen, Jurgen A H; Mirelman, Anat

    2016-11-01

    Gait is influenced by higher order cognitive and cortical control mechanisms. Functional near infrared spectroscopy (fNIRS) has been used to examine frontal activation during walking in healthy older adults, reporting increased oxygenated hemoglobin (HbO2) levels during dual task walking (DT), compared with usual walking. To investigate the role of the frontal lobe during DT and obstacle negotiation, in healthy older adults and patients with Parkinson's disease (PD). Thirty-eight healthy older adults (mean age 70.4 ± 0.9 years) and 68 patients with PD (mean age 71.7 ± 1.1 years,) performed 3 walking tasks: (a) usual walking, (b) DT walking, and (c) obstacles negotiation, with fNIRS and accelerometers. Linear-mix models were used to detect changes between groups and within tasks. Patients with PD had higher activation during usual walking (P < .030). During DT, HbO2 increased only in healthy older adults (P < .001). During obstacle negotiation, HbO2 increased in patients with PD (P = .001) and tended to increase in healthy older adults (P = .053). Higher DT and obstacle cost (P < .003) and worse cognitive performance were observed in patients with PD (P = .001). A different pattern of frontal activation during walking was observed between groups. The higher activation during usual walking in patients with PD suggests that the prefrontal cortex plays an important role already during simple walking. However, higher activation relative to baseline during obstacle negotiation and not during DT in the patients with PD demonstrates that prefrontal activation depends on the nature of the task. These findings may have important implications for rehabilitation of gait in patients with PD. © The Author(s) 2016.

  18. A Meta-Analysis of Adult-Rated Child Personality and Academic Performance in Primary Education

    ERIC Educational Resources Information Center

    Poropat, Arthur E.

    2014-01-01

    Background: Personality is reliably associated with academic performance, but personality measurement in primary education can be problematic. Young children find it difficult to accurately self-rate personality, and dominant models of adult personality may be inappropriate for children. Aims: This meta-analysis was conducted to determine the…

  19. Association of insulin resistance with cerebral glucose uptake in late middle-aged adults at risk for Alzheimer’s disease

    PubMed Central

    Willette, Auriel A.; Bendlin, Barbara B.; Starks, Erika J.; Birdsill, Alex C.; Johnson, Sterling C.; Christian, Bradley T.; Okonkwo, Ozioma C.; La Rue, Asenath; Hermann, Bruce P.; Koscik, Rebecca L.; Jonaitis, Erin M.; Sager, Mark A.; Asthana, Sanjay

    2015-01-01

    Importance Converging evidence suggests that Alzheimer’s disease (AD) involves insulin signaling impairment. AD patients and people at risk for AD show reduced glucose metabolism, as indexed by F18-fluorodeoxyglucose positron emission tomography ([F18]FDG-PET). Objective To determine if insulin resistance (IR) predicts AD-like global and regional glucose metabolism deficits in late middle-aged participants at risk for AD. A secondary objective was to examine if IR-predicted variation in regional glucose metabolism was associated with worse cognitive performance. Setting A general community sample enriched for AD family history. Participants Population-based, cross-sectional study of 150 cognitively normal, late middle-aged (mean=60.67 years) adults from the Wisconsin Registry for Alzheimer’s Prevention. Design Participants underwent cognitive testing, fasting blood draw, and an [F18]FDG-PET scan at baseline. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was used to assess peripheral insulin resistance. Regression analysis tested the statistical effect of HOMA-IR on global glucose metabolism. A voxel-wise analysis was used to determine if HOMA-IR predicted regional glucose metabolism. Finally, predicted variation in regional glucose metabolism was regressed against cognitive factors. Covariates included age, sex, body mass index, Apolipoprotein E genotype, AD family history status, and a reference region used to normalize regional uptake. Main Outcome Measures Regional glucose uptake determined using [F18]FDG-PET, and neuropsychological factors. Results Higher HOMA-IR was associated with lower global glucose metabolism (β=−0.29, p<.01) and lower regional glucose metabolism across large portions of frontal, lateral parietal, lateral temporal, and medial temporal lobe (MTL; p<.05, family-wise error corrected). The association was especially robust in left MTL (R2=0.178). Lower left MTL glucose metabolism predicted by HOMA-IR was significantly

  20. Postsecondary employment experiences among young adults with an autism spectrum disorder.

    PubMed

    Roux, Anne M; Shattuck, Paul T; Cooper, Benjamin P; Anderson, Kristy A; Wagner, Mary; Narendorf, Sarah C

    2013-09-01

    We examined postsecondary employment experiences of young adults with an autism spectrum disorder (ASD) and compared these outcomes with those of young adults with different disabilities. Data were from Wave 5 of the National Longitudinal Transition Study-2 (NLTS2), a nationally representative survey of young adults who had received special education services during high school. We examined the prevalence of ever having had, and currently having, a paid job at 21 to 25 years of age. We analyzed rates of full-time employment, wages earned, number of jobs held since high school, and job types. Approximately one-half (53.4%) of young adults with an ASD had ever worked for pay outside the home since leaving high school, the lowest rate among disability groups. Young adults with an ASD earned an average of $8.10 per hour, significantly lower than average wages for young adults in the comparison groups, and held jobs that clustered within fewer occupational types. Odds of ever having had a paid job were higher for those who were older, from higher-income households, and with better conversational abilities or functional skills. Findings of worse employment outcomes for young adults with an ASD suggest that this population is experiencing particular difficulty in successfully transitioning into employment. Research is needed to determine strategies for improving outcomes as these young adults transition into adulthood. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  1. Relevance of nerve conduction velocity in the assessment of balance performance in older adults with diabetes mellitus.

    PubMed

    Wang, Ting-Yun; Chen, Shih-Ching; Peng, Chih-Wei; Kang, Chun-Wei; Chen, Yu-Luen; Chen, Chun-Lung; Chou, Yi-Lin; Lai, Chien-Hung

    2017-03-01

    Purpose This study investigated the relationship between peripheral nerve conduction velocity (NCV) and balance performance in older adults with diabetes. Methods Twenty older adults with diabetes were recruited to evaluate the NCV of their lower limbs and balance performance. The balance assessments comprised the timed up and go (TUG) test, Berg balance scale (BBS), unipedal stance test (UST), multidirectional reach test (MDRT), maximum step length (MSL) test and quiet standing with eyes open and closed. The relationship between NCV and balance performance was evaluated by Pearson's correlation coefficients, and the balance performances of the diabetic patients with and without peripheral neuropathy were compared by using Mann-Whitney U tests. Results The NCV in the lower limbs exhibited a moderate to strong correlation with most of the balance tests including the TUG (r = -0.435 to -0.520, p < 0.05), BBS (r = 0.406-0.554, p < 0.05), UST (r = 0.409-0.647, p < 0.05) and MSL (r = 0.399-0.585, P < 0.05). In addition, patients with diabetic peripheral neuropathy had a poorer TUG (p < 0.05), BBS (p < 0.01), UST (p < 0.05) and MSL performance (p < 0.05) compared with those without peripheral neuropathy (p < 0.05). Conclusion Our findings revealed that a decline in peripheral nerve conduction in the lower limb is not only an indication of nerve dysfunction, but may also be related to the impairment of balance performance in patients with diabetes. Implications for Rehabilitation Nerve conduction velocity in the lower limbs of diabetic older adults showed moderate to strong correlations with most of the results of balance tests, which are commonly used in clinics. Decline in nerve conduction velocity of the lower limbs may be related to the impairment of balance control in patients with diabetes. Diabetic older adults with peripheral neuropathy exhibited greater postural instability than those without peripheral

  2. Quantitative Gait Markers and Incident Fall Risk in Older Adults

    PubMed Central

    Holtzer, Roee; Lipton, Richard B.; Wang, Cuiling

    2009-01-01

    Background Identifying quantitative gait markers of falls in older adults may improve diagnostic assessments and suggest novel intervention targets. Methods We studied 597 adults aged 70 and older (mean age 80.5 years, 62% women) enrolled in an aging study who received quantitative gait assessments at baseline. Association of speed and six other gait markers (cadence, stride length, swing, double support, stride length variability, and swing time variability) with incident fall rate was studied using generalized estimation equation procedures adjusted for age, sex, education, falls, chronic illnesses, medications, cognition, disability as well as traditional clinical tests of gait and balance. Results Over a mean follow-up period of 20 months, 226 (38%) of the 597 participants fell. Mean fall rate was 0.44 per person-year. Slower gait speed (risk ratio [RR] per 10 cm/s decrease 1.069, 95% confidence interval [CI] 1.001–1.142) was associated with higher risk of falls in the fully adjusted models. Among six other markers, worse performance on swing (RR 1.406, 95% CI 1.027–1.926), double-support phase (RR 1.165, 95% CI 1.026–1.321), swing time variability (RR 1.007, 95% CI 1.004–1.010), and stride length variability (RR 1.076, 95% CI 1.030–1.111) predicted fall risk. The associations remained significant even after accounting for cognitive impairment and disability. Conclusions Quantitative gait markers are independent predictors of falls in older adults. Gait speed and other markers, especially variability, should be further studied to improve current fall risk assessments and to develop new interventions. PMID:19349593

  3. Effects of Gait Self-Efficacy and Lower-Extremity Physical Function on Dual-Task Performance in Older Adults

    PubMed Central

    Banducci, Sarah E.; Daugherty, Ana M.; Fanning, Jason; Awick, Elizabeth A.; Porter, Gwenndolyn C.; Burzynska, Agnieszka; Shen, Sa; Kramer, Arthur F.; McAuley, Edward

    2017-01-01

    Objectives. Despite evidence of self-efficacy and physical function's influences on functional limitations in older adults, few studies have examined relationships in the context of complex, real-world tasks. The present study tested the roles of self-efficacy and physical function in predicting older adults' street-crossing performance in single- and dual-task simulations. Methods. Lower-extremity physical function, gait self-efficacy, and street-crossing success ratio were assessed in 195 older adults (60–79 years old) at baseline of a randomized exercise trial. During the street-crossing task, participants walked on a self-propelled treadmill in a virtual reality environment. Participants crossed the street without distraction (single-task trials) and conversed on a cell phone (dual-task trials). Structural equation modeling was used to test hypothesized associations independent of demographic and clinical covariates. Results. Street-crossing performance was better on single-task trials when compared with dual-task trials. Direct effects of self-efficacy and physical function on success ratio were observed in dual-task trials only. The total effect of self-efficacy was significant in both conditions. The indirect path through physical function was evident in the dual-task condition only. Conclusion. Physical function can predict older adults' performance on high fidelity simulations of complex, real-world tasks. Perceptions of function (i.e., self-efficacy) may play an even greater role. The trial is registered with United States National Institutes of Health ClinicalTrials.gov (ID: NCT01472744; Fit & Active Seniors Trial). PMID:28255557

  4. Scheduled Evening Sleep and Enhanced Lighting Improve Adaptation to Night Shift Work in Older Adults

    PubMed Central

    Chinoy, Evan D.; Harris, Michael P.; Kim, Min Ju; Wang, Wei; Duffy, Jeanne F.

    2017-01-01

    Objectives We tested whether a sleep and circadian-based treatment shown to improve circadian adaptation to night shifts and attenuate negative effects on alertness, performance, and sleep in young adults would also be effective in older adults. Methods We assessed subjective alertness, sustained attention (psychomotor vigilance task, PVT), sleep duration (actigraphy), and circadian timing (salivary dim-light melatonin onset, DLMO) in eighteen older adults (57.2±3.8 y; mean±SD) in a simulated shift work protocol. Four day shifts were followed by three night shifts in the laboratory. Participants slept at home and were randomized to either the Treatment Group (scheduled evening sleep and enhanced lighting during the latter half of night shifts), or Control Group (ad lib sleep and typical lighting during night shifts). Results Compared to day shifts, alertness and sustained attention declined on the first night shift in both groups, and was worse in the latter half of the night shifts. Alertness and attention improved on nights 2 and 3 for the Treatment Group but remained lower for the Control Group. Sleep duration in the Treatment Group remained similar to baseline (6–7 h) following night shifts, but was shorter (3–5 h) following night shifts in the Control Group. Treatment Group circadian timing advanced by 169.3±16.1 min (mean±SEM) but did not shift (−9.7±9.9 min) in the Control Group. Conclusions The combined treatment of scheduled evening sleep and enhanced lighting increased sleep duration and partially aligned circadian phase with sleep and work timing, resulting in improved night shift alertness and performance. PMID:27566781

  5. Restoration of spatial hearing in adult cochlear implant users with single-sided deafness.

    PubMed

    Litovsky, Ruth Y; Moua, Keng; Godar, Shelly; Kan, Alan; Misurelli, Sara M; Lee, Daniel J

    2018-04-14

    In recent years, cochlear implants (CIs) have been provided in growing numbers to people with not only bilateral deafness but also to people with unilateral hearing loss, at times in order to alleviate tinnitus. This study presents audiological data from 15 adult participants (ages 48 ± 12 years) with single sided deafness. Results are presented from 9/15 adults, who received a CI (SSD-CI) in the deaf ear and were tested in Acoustic or Acoustic + CI hearing modes, and 6/15 adults who are planning to receive a CI, and were tested in the unilateral condition only. Testing included (1) audiometric measures of threshold, (2) speech understanding for CNC words and AzBIO sentences, (3) tinnitus handicap inventory, (4) sound localization with stationary sound sources, and (5) perceived auditory motion. Results showed that when listening to sentences in quiet, performance was excellent in the Acoustic and Acoustic + CI conditions. In noise, performance was similar between Acoustic and Acoustic + CI conditions in 4/6 participants tested, and slightly worse in the Acoustic + CI in 2/6 participants. In some cases, the CI provided reduced tinnitus handicap scores. When testing sound localization ability, the Acoustic + CI condition resulted in improved sound localization RMS error of 29.2° (SD: ±6.7°) compared to 56.6° (SD: ±16.5°) in the Acoustic-only condition. Preliminary results suggest that the perception of motion direction, whereby subjects are required to process and compare directional cues across multiple locations, is impaired when compared with that of normal hearing subjects. Copyright © 2018 Elsevier B.V. All rights reserved.

  6. Effects of dual task difficulty in motor and cognitive performance: Differences between adults and adolescents.

    PubMed

    Bustillo-Casero, Pilar; Villarrasa-Sapiña, Israel; García-Massó, Xavier

    2017-10-01

    In the present study our aim was to compare dual-task performance in thirteen adolescents and fifteen young adults while concurrently performing a cognitive and a motor task. The postural control variables were obtained under three different conditions: i) bipedal stance, ii) tandem stance and iii) unipedal stance. The cognitive task consisted of a backward digit span test in which the participants were asked to memorize a sequence of numbers and then repeat the number in reverse order at three different difficulty levels (i.e. with 3, 4 and 5 digits). The difficulty of the cognitive task was seen to have different effects on adolescents and young adults. Adolescents seem to prioritize postural control during high difficulty postural conditions while a cross-domain competition model appeared in easy postural conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Martial Art Training and Cognitive Performance in Middle-Aged Adults.

    PubMed

    Douris, Peter; Douris, Christopher; Balder, Nicole; LaCasse, Michael; Rand, Amir; Tarapore, Freya; Zhuchkan, Aleskey; Handrakis, John

    2015-09-29

    Cognitive performance includes the processes of attention, memory, processing speed, and executive functioning, which typically declines with aging. Previous research has demonstrated that aerobic and resistance exercise improves cognitive performance immediately following exercise. However, there is limited research examining the effect that a cognitively complex exercise such as martial art training has on these cognitive processes. Our study compared the acute effects of 2 types of martial art training to aerobic exercise on cognitive performance in middle-aged adults. We utilized a repeated measures design with the order of the 3 exercise conditions randomly assigned and counterbalanced. Ten recreational middle-aged martial artists (mean age = 53.5 ± 8.6 years) participated in 3 treatment conditions: a typical martial art class, an atypical martial art class, and a one-hour walk at a self-selected speed. Cognitive performance was assessed by the Stroop Color and Word test. While all 3 exercise conditions improved attention and processing speed, only the 2 martial art conditions improved the highest order of cognitive performance, executive function. The effect of the 2 martial art conditions on executive function was not different. The improvement in executive function may be due to the increased cortical demand required by the more complex, coordinated motor tasks of martial art exercise compared to the more repetitive actions of walking.

  8. Martial Art Training and Cognitive Performance in Middle-Aged Adults

    PubMed Central

    Douris, Peter; Douris, Christopher; Balder, Nicole; LaCasse, Michael; Rand, Amir; Tarapore, Freya; Zhuchkan, Aleskey; Handrakis, John

    2015-01-01

    Cognitive performance includes the processes of attention, memory, processing speed, and executive functioning, which typically declines with aging. Previous research has demonstrated that aerobic and resistance exercise improves cognitive performance immediately following exercise. However, there is limited research examining the effect that a cognitively complex exercise such as martial art training has on these cognitive processes. Our study compared the acute effects of 2 types of martial art training to aerobic exercise on cognitive performance in middle-aged adults. We utilized a repeated measures design with the order of the 3 exercise conditions randomly assigned and counterbalanced. Ten recreational middle-aged martial artists (mean age = 53.5 ± 8.6 years) participated in 3 treatment conditions: a typical martial art class, an atypical martial art class, and a one-hour walk at a self-selected speed. Cognitive performance was assessed by the Stroop Color and Word test. While all 3 exercise conditions improved attention and processing speed, only the 2 martial art conditions improved the highest order of cognitive performance, executive function. The effect of the 2 martial art conditions on executive function was not different. The improvement in executive function may be due to the increased cortical demand required by the more complex, coordinated motor tasks of martial art exercise compared to the more repetitive actions of walking. PMID:26672872

  9. "When does making detailed predictions make predictions worse?": Correction to Kelly and Simmons (2016).

    PubMed

    2016-10-01

    Reports an error in "When Does Making Detailed Predictions Make Predictions Worse" by Theresa F. Kelly and Joseph P. Simmons ( Journal of Experimental Psychology: General , Advanced Online Publication, Aug 8, 2016, np). In the article, the symbols in Figure 2 were inadvertently altered in production. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2016-37952-001.) In this article, we investigate whether making detailed predictions about an event worsens other predictions of the event. Across 19 experiments, 10,896 participants, and 407,045 predictions about 724 professional sports games, we find that people who made detailed predictions about sporting events (e.g., how many hits each baseball team would get) made worse predictions about more general outcomes (e.g., which team would win). We rule out that this effect is caused by inattention or fatigue, thinking too hard, or a differential reliance on holistic information about the teams. Instead, we find that thinking about game-relevant details before predicting winning teams causes people to give less weight to predictive information, presumably because predicting details makes useless or redundant information more accessible and thus more likely to be incorporated into forecasts. Furthermore, we show that this differential use of information can be used to predict what kinds of events will and will not be susceptible to the negative effect of making detailed predictions. PsycINFO Database Record (c) 2016 APA, all rights reserved

  10. Student Background and Student Achievement: What Is the Right Question?

    ERIC Educational Resources Information Center

    Heyneman, Stephen P.

    2005-01-01

    For half a century there have been reports that children of the poor or of some ethnic minorities on average perform worse in school. Some have suggested that these findings demonstrate a failing of education to reduce gaps in adult income and differences in adult socioeconomic status. This article reviews the research internationally and…

  11. Is performance on the Wechsler test of adult reading affected by traumatic brain injury?

    PubMed

    Mathias, J L; Bowden, S C; Bigler, E D; Rosenfeld, J V

    2007-11-01

    The validity of the National Adult Reading Test (NART) as a predictor of premorbid IQ when used with patients who have sustained a traumatic brain injury (TBI) has been questioned in recent years. This study examined whether performance on the Wechsler Test of Adult Reading (WTAR) is similarly affected by TBI in the first year after an injury. The WTAR scores of participants who had sustained a mild TBI (N=82), moderate TBI (N=73), severe TBI (N=61) or an orthopaedic injury (N=95) were compared (cross-sectional study). A subset of 21 mild TBI, 31 moderate TBI, 26 severe TBI and 21 control group participants were additionally reassessed 6 months later to assess the impact of recovery on WTAR scores (longitudinal study). The severe TBI group had significantly lower scores on the WTAR than the mild TBI, moderate TBI and control groups in the cross-sectional study, despite being matched demographically. The findings from the longitudinal study revealed a significant group difference and a small improvement in performance over time but the interaction between group and time was not significant, suggesting that the improvements in WTAR performance over time were not restricted to more severely injured individuals whose performance was temporarily suppressed. These findings suggest that reading performance may be affected by severe TBI and that the WTAR may underestimate premorbid IQ when used in this context, which may cause clinicians to underestimate the cognitive deficits experienced by these patients.

  12. Genomic analysis of adult B-ALL identifies potential markers of shorter survival.

    PubMed

    Patel, Shiven; Mason, Clinton C; Glenn, Martha J; Paxton, Christian N; South, Sara T; Cessna, Melissa H; Asch, Julie; Cobain, Erin F; Bixby, Dale L; Smith, Lauren B; Reshmi, Shalini; Gastier-Foster, Julie M; Schiffman, Joshua D; Miles, Rodney R

    2017-05-01

    B lymphoblastic leukemia (B-ALL) in adults has a higher risk of relapse and lower long-term survival than pediatric B-ALL, but data regarding genetic prognostic biomarkers are much more limited for adult patients. We identified 70 adult B-ALL patients from three institutions and performed genome-wide analysis via single nucleotide polymorphism (SNP) arrays on DNA isolated from their initial diagnostic sample and, when available, relapse bone marrow specimens to identify recurring copy number alterations (CNA). As B-cell developmental genes play a crucial role in this leukemia, we assessed such for recurrent deletions in diagnostic and relapse samples. We confirmed previous findings that the most prevalent deletions of these genes occur in CDKN2A, IKZF1, and PAX5, with several others at lower frequencies. Of the 16 samples having paired diagnostic and relapse samples, 5 showed new deletions in these recurrent B-cell related genes and 8 showed abolishment. Deletion of EBF1 heralded a significant negative prognostic impact on relapse free survival in univariate and multivariate analyses. The combination of both a CDKN2A/B deletion and an IKZF1 alteration (26% of cases) also showed a trend toward predicting worse overall survival compared to having only one or neither of these deletions. These findings add to the understanding of genomic influences on this comparably understudied disease cohort that upon further validation may help identify patients who would benefit from upfront treatment intensification. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Differences in quality-of-life dimensions of Adult Strabismus Quality of Life and Amblyopia & Strabismus Questionnaires.

    PubMed

    van de Graaf, Elizabeth S; Borsboom, Gerard J J M; van der Sterre, Geertje W; Felius, Joost; Simonsz, Huibert J; Kelderman, Henk

    2017-09-01

    The Adult Strabismus Quality of Life Questionnaire (AS-20) and the Amblyopia & Strabismus Questionnaire (A&SQ) both measure health-related quality of life in strabismus patients. We evaluated to what extent these instruments cover similar domains by identifying the underlying quality-of-life factors of the combined questionnaires. Participants were adults from a historic cohort with available orthoptic childhood data documenting strabismus and/or amblyopia. They had previously completed the A&SQ and were now asked to complete the AS-20. Factor analysis was performed on the correlation-matrix of the combined AS-20 and A&SQ data to identify common underlying factors. The identified factors were correlated with the clinical variables of angle of strabismus, degree of binocular vision, and visual acuity of the worse eye. One hundred ten patients completed both questionnaires (mean age, 44 years; range, 38-51 years). Six factors were found that together explained 78% of the total variance. The factor structure was dominated by the first four factors. One factor contained psychosocial and social-contact items, and another factor depth-perception items from both questionnaires. A third factor contained seven items-only from the AS-20-on eye strain, stress, and difficulties with reading and with concentrating. A fourth factor contained seven items-only from the A&SQ-on fear of losing the better eye and visual disorientation, specific for amblyopia. Current visual acuity of the worse eye correlated with depth-perception items and vision-related items, whereas current binocular vision correlated with psychosocial and social-contact items, in 93 patients. Factor analysis suggests that the AS-20 and A&SQ measure a similar psychosocial quality-of-life domain. However, functional problems like avoidance of reading, difficulty in concentrating, eye stress, reading problems, inability to enjoy hobbies, and need for frequent breaks when reading are represented only in the AS-20

  14. Media multitasking is associated with distractibility and increased prefrontal activity in adolescents and young adults.

    PubMed

    Moisala, M; Salmela, V; Hietajärvi, L; Salo, E; Carlson, S; Salonen, O; Lonka, K; Hakkarainen, K; Salmela-Aro, K; Alho, K

    2016-07-01

    The current generation of young people indulges in more media multitasking behavior (e.g., instant messaging while watching videos) in their everyday lives than older generations. Concerns have been raised about how this might affect their attentional functioning, as previous studies have indicated that extensive media multitasking in everyday life may be associated with decreased attentional control. In the current study, 149 adolescents and young adults (aged 13-24years) performed speech-listening and reading tasks that required maintaining attention in the presence of distractor stimuli in the other modality or dividing attention between two concurrent tasks. Brain activity during task performance was measured using functional magnetic resonance imaging (fMRI). We studied the relationship between self-reported daily media multitasking (MMT), task performance and brain activity during task performance. The results showed that in the presence of distractor stimuli, a higher MMT score was associated with worse performance and increased brain activity in right prefrontal regions. The level of performance during divided attention did not depend on MMT. This suggests that daily media multitasking is associated with behavioral distractibility and increased recruitment of brain areas involved in attentional and inhibitory control, and that media multitasking in everyday life does not translate to performance benefits in multitasking in laboratory settings. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Occupational HIV Transmission Among Male Adult Film Performers - Multiple States, 2014.

    PubMed

    Wilken, Jason A; Ried, Christopher; Rickett, Pristeen; Arno, Janet N; Mendez, Yesenia; Harrison, Robert J; Wohlfeiler, Dan; Bauer, Heidi M; Joyce, M Patricia; Switzer, William M; Heneine, Walid; Shankar, Anupama; Mark, Karen E

    2016-02-12

    In 2014, the California Department of Public Health was notified by a local health department of a diagnosis of acute human immunodeficiency virus (HIV) infection* and rectal gonorrhea in a male adult film industry performer, aged 25 years (patient A). Patient A had a 6-day history of rash, fever, and sore throat suggestive of acute retroviral syndrome at the time of examination. He was informed of his positive HIV and gonorrhea test results 6 days after his examination. Patient A had a negative HIV-1 RNA qualitative nucleic acid amplification test (NAAT)(†) 10 days before symptom onset. This investigation found that during the 22 days between the negative NAAT and being informed of his positive HIV test results, two different production companies directed patient A to have condomless sex with a total of 12 male performers. Patient A also provided contact information for five male non-work-related sexual partners during the month before and after his symptom onset. Patient A had additional partners during this time period for which no locating information was provided. Neither patient A nor any of his interviewed sexual partners reported taking HIV preexposure prophylaxis (PrEP). Contact tracing and phylogenetic analysis of HIV sequences amplified from pretreatment plasma revealed that a non-work-related partner likely infected patient A, and that patient A likely subsequently infected both a coworker during the second film production and a non-work-related partner during the interval between his negative test and receipt of his positive HIV results. Adult film performers and production companies, medical providers, and all persons at risk for HIV should be aware that testing alone is not sufficient to prevent HIV transmission. Condom use provides additional protection from HIV and sexually transmitted infections (STIs). Performers and all persons at risk for HIV infection in their professional and personal lives should discuss the use of PrEP with their medical

  16. Real-Life Impact of Executive Function Impairments in Adults Who Were Born Very Preterm.

    PubMed

    Kroll, Jasmin; Karolis, Vyacheslav; Brittain, Philip J; Tseng, Chieh-En Jane; Froudist-Walsh, Sean; Murray, Robin M; Nosarti, Chiara

    2017-05-01

    Children and adolescents who were born very preterm (≤32 weeks' gestation) are vulnerable to experiencing cognitive problems, including in executive function. However, it remains to be established whether cognitive deficits are evident in adulthood and whether these exert a significant effect on an individual's real-lifeachievement. Using a cross-sectional design, we tested a range of neurocognitive abilities, with a focus on executive function, in a sample of 122 very preterm individuals and 89 term-born controls born between 1979 and 1984. Associations between executive function and a range of achievement measures, indicative of a successful transition to adulthood, were examined. Very preterm adults performed worse compared to controls on measures of intellectual ability and executive function with moderate to large effect sizes. They also demonstrated significantly lower achievement levels in terms of years spent in education, employment status, and on a measure of functioning in work and social domains. Results of regression analysis indicated a stronger positive association between executive function and real-life achievement in the very preterm group compared to controls. Very preterm born adults demonstrate executive function impairments compared to full-term controls, and these are associated with lower achievement in several real-life domains. (JINS, 2017, 23, 381-389).

  17. Correlates of adverse childhood experiences among adults with severe mood disorders.

    PubMed

    Lu, Weili; Mueser, Kim T; Rosenberg, Stanley D; Jankowski, Mary Kay

    2008-09-01

    Adverse childhood experiences have been found to be associated with poor physical and poor mental health, impaired functioning, and increased substance abuse in the general adult population. The purpose of this study was to examine the clinical correlates of these experiences among adults with severe mood disorders. Adverse childhood experiences (including physical abuse, sexual abuse, parental mental illness, loss of parent, parental separation or divorce, witnessing domestic violence, and placement in foster or kinship care) were assessed retrospectively in a sample of 254 adults with major mood disorders. The relationships between cumulative exposure to these experiences and psychiatric problems, health, substance use disorders, community functioning, trauma exposure in adulthood, and high-risk behaviors were examined. Increased exposure to childhood adverse experiences was related to high-risk behaviors, diagnosis of a substance use disorder, exposure to trauma in adulthood, psychiatric problems (younger age at first hospitalization, number of suicide attempts, and diagnosis of posttraumatic stress disorder), medical service utilization, and homelessness. The findings extend research in the general population by suggesting that adverse childhood experiences contribute to worse mental and physical health and functional outcomes among adults with severe mood disorders.

  18. On the Inevitability of Aging: Essentialist Beliefs Moderate the Impact of Negative Age Stereotypes on Older Adults' Memory Performance and Physiological Reactivity.

    PubMed

    Weiss, David

    2016-07-20

    The goal of this research was to investigate how individual differences in essentialist beliefs about aging affect how older adults' respond to negative age stereotypes. Essentialist beliefs about aging (EBA) define the process of aging as fixed and inevitable rather than malleable and modifiable. Two experiments including older adults tested the hypothesis that EBA moderate the effect of negative age stereotypes on older adults' memory performance and physiological reactivity. In line with predictions, results of Experiment 1 (N = 79, 61-87 years) showed that for older adults with strong EBA, the activation of negative age stereotypes (vs neutral information) led to stereotype assimilation entailing a poorer memory performance. In contrast, for older adults with non-EBA, the activation of negative age stereotypes led to stereotype reactance entailing a better memory performance. Experiment 2 (N = 41; 65-92 years) replicated this pattern and also showed that older adults who endorsed rather than rejected EBA exhibited increased systolic blood pressure reactivity when negative age stereotypes were activated. The discussion focuses on pathways through which age stereotypes impact cognitive performance and health in later adulthood, as well as ways to stimulate positive plasticity by changing EBA. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Divided Attention in Younger and Older Adults: Effects of Strategy and Relatedness on Memory Performance and Secondary Task Costs

    ERIC Educational Resources Information Center

    Naveh-Benjamin, Moshe; Craik, Fergus I. M.; Guez, Jonathan; Kreuger, Sharyn

    2005-01-01

    Divided attention at encoding leads to a significant decline in memory performance, whereas divided attention during retrieval has relatively little effect; nevertheless, retrieval carries significant secondary task costs, especially for older adults. The authors further investigated the effects of divided attention in younger and older adults by…

  20. Social support and mental health among adults prior to HIV counseling and testing in Durban, South Africa

    PubMed Central

    Drain, Paul K; Losina, Elena; Coleman, Sharon M; Bogart, Laura; Giddy, Janet; Ross, Douglas; Katz, Jeffrey N; Bassett, Ingrid V

    2015-01-01

    Poor social support and mental health may be important modifiable risk factors for HIV acquisition, but they have not been evaluated prior to HIV testing in South Africa. We sought to describe self-perceived mental health and social support and to characterize their independent correlates among adults who presented for voluntary HIV testing in Durban. We conducted a large cross-sectional study of adults (≥18 years of age) who presented for HIV counseling and testing between August 2010 and January 2013 in Durban, South Africa. We enrolled adults presenting for HIV testing and used the Medical Outcomes Study’s Social Support Scale [0 (poor) to 100 (excellent)] and the Mental Health Inventory (MHI-3) to assess social support and mental health. We conducted independent univariate and multivariable linear regression models to determine the correlates of lower self-reported SSI and lower self-reported MCH scores. Among 4,874 adults surveyed prior to HIV testing, 1,887 (39%) tested HIV-positive. HIV-infected participants reported less social support (mean score 66 ±22) and worse mental health (mean score 66 ±16), compared to HIV-negative participants (74 ±21; 70 ±18) (p-values <0.0001). In a multivariable analysis, significant correlates of less social support included presenting for HIV testing at an urban hospital, not having been tested previously, not working outside the home, and being HIV-infected. In a separate multivariable analysis, significant correlates of poor mental health were similar, but also included HIV testing at an urban hospital and being in an intimate relationship less than 6 months. In this study, HIV-infected adults reported poorer social support and worse mental health than HIV-negative individuals. These findings suggest that interventions to improve poor social support and mental health should be focused on adults who do not work outside the home and those with no previous HIV testing. PMID:26213142

  1. Prefrontal Recruitment Mitigates Risk-Taking Behavior in Human Immunodeficiency Virus-Infected Young Adults.

    PubMed

    Smith, Robert X; Guha, Anika; Vaida, Florin; Paul, Robert H; Ances, Beau

    2018-05-02

    Human immunodeficiency virus (HIV)-infected (HIV+) young adults often engage in risk-taking behavior. However, the disruptive effects of HIV on the neurobiological underpinnings of risky decision making are not well understood. Risky decision making, measured via the Iowa Gambling Task (IGT), was compared voxel-wise to resting cerebral blood flow (rCBF) acquired via arterial spin labeling. Separate topographical maps were obtained for HIV-uninfected (HIV-; n = 62) and HIV+ (n = 41) young adults (18-24 years old) and were compared to the full cohort of participants. For the HIV+ group, rCBF was compared to recent and nadir CD4. IGT performance was supported by rCBF in 3 distinct brain regions: regions I, II, and III. The relationship between IGT performance and rCBF in HIV+ individuals was most robust in region I, the ventromedial prefrontal and insular cortices. Region II contained strong relationships for both HIV- and HIV+. Region III, dorsolateral prefrontal and posterior cingulate cortices, contained relationships that were strongest for HIV- controls. IGT performance was intact among HIV+ participants with higher rCBF in either region I or region III. By contrast, performance was worse among HIV+ individuals with lower rCBF in both regions I and III when compared to HIV- controls (P = .01). rCBF in region III was reduced in HIV+ compared with HIV- individuals (P = .04), and positively associated with nadir CD4 cell count (P = .02). Recruitment of executive systems (region III) mitigates risk-taking behavior in HIV+ and HIV- individuals. Recruitment of reward systems (region I) mitigates risk-taking behavior when region III is disrupted due to immunological compromise. Identifying individual recruitment patterns may aid anatomically directed therapeutics or psychosocial interventions.

  2. Physical activity during hospitalization: Activities and preferences of adults versus older adults.

    PubMed

    Meesters, Jorit; Conijn, D; Vermeulen, H M; Vliet Vlieland, Tpm

    2018-04-16

    Inactivity during hospitalization leads to a functional decline and an increased risk of complications. To date, studies focused on older adults. This study aims to compare the physical activities performed by older adult and adult hospitalized patients. Patients hospitalized for >3 days at a university hospital completed a questionnaire regarding their physical activities (% of days on which an activity was performed divided by the length of stay) and physical activity needs during hospitalization. Crude and adjusted comparisons of older adult (>60 years) and adult (≤60 years) patients were performed using parametric testing and regression analyses. Of 524 patients, 336 (64%) completed the questionnaire, including 166 (49%) older adult patients. On average, the patients were physically active on 35% or less of the days during their hospitalization. Linear regression analysis showed no significant associations between being an older adult and performing physical activities after adjusting for gender, length of stay, surgical intervention, and meeting physical activity recommendations prior to hospitalization. Most patients were well informed regarding physical activity during hospitalization; however, the older adult patients reported a need for information regarding physical activities after hospitalization more frequently (odds ratios, 2.47) after adjusting for educational level, gender, and physical therapy during hospitalization. Both older adult and adult patients are physically inactive during hospitalization, and older adult patients express a greater need for additional information regarding physical activity after hospitalization than adult patients. Therefore, personalized strategies that inform and motivate patients to resume physical activities during hospitalization are needed regardless of age.

  3. Free and cued memory in relation to biomarker-defined abnormalities in clinically normal older adults and those at risk for Alzheimer's disease.

    PubMed

    Papp, Kathryn V; Amariglio, Rebecca E; Mormino, Elizabeth C; Hedden, Trey; Dekhytar, Maria; Johnson, Keith A; Sperling, Reisa A; Rentz, Dorene M

    2015-07-01

    Furthering our understanding of the relationship between amyloidosis (Aβ), neurodegeneration (ND), and cognition is imperative for early identification and early intervention of Alzheimer's disease (AD). However, the subtle cognitive decline differentially associated with each biomarker-defined stage of preclinical AD has yet to be fully characterized. Recent work indicates that different components of memory performance (free and cued recall) may be differentially specific to memory decline in prodromal AD. We sought to examine the relationship between free and cued recall paradigms, in addition to global composites of memory, executive functioning, and processing speed in relation to stages of preclinical AD. A total of 260 clinically normal (CN) older adults (CDR=0) from the Harvard Aging Brain study were grouped according to preclinical AD stages including Stage 0 (Aβ-/ND-), Stage 1 (Aβ+/ND-), Stage 2 (Aβ+/ND+), and suspected non-Alzheimer's associated pathology (SNAP; Aβ-/ND+). General linear models controlling for age, sex, and education were used to assess for stage-based performance differences on cognitive composites of executive functioning, processing speed, and memory in addition to free and cued delayed recall on the Selective Reminding Test (SRT) and Memory Capacity Test (MCT). Global memory performance differed between preclinical stages with Stage 2 performing worse compared with Stage 0. When examining free and cued paradigms by memory test, only the MCT (and not the SRT) revealed group differences. More specifically, Stage 1 was associated with decrements in free recall compared with Stage 0 while Stage 2 was associated with decrements in both free and cued recall. There was a trend for the SNAP group to perform worse on free recall compared with Stage 0. Finally, there was no association between preclinical stage and global composites of executive functioning or processing speed. Clinically normal older adults with underlying evidence of

  4. Altered mitochondrial genome content signals worse pathology and prognosis in prostate cancer.

    PubMed

    Kalsbeek, Anton M F; Chan, Eva K F; Grogan, Judith; Petersen, Desiree C; Jaratlerdsiri, Weerachai; Gupta, Ruta; Lyons, Ruth J; Haynes, Anne-Maree; Horvath, Lisa G; Kench, James G; Stricker, Phillip D; Hayes, Vanessa M

    2018-01-01

    Mitochondrial genome (mtDNA) content is depleted in many cancers. In prostate cancer, there is intra-glandular as well as inter-patient mtDNA copy number variation. In this study, we determine if mtDNA content can be used as a predictor for prostate cancer staging and outcomes. Fresh prostate cancer biopsies from 115 patients were obtained at time of surgery. All cores underwent pathological review, followed by isolation of cancer and normal tissue. DNA was extracted and qPCR performed to quantify the total amount of mtDNA as a ratio to genomic DNA. Differences in mtDNA content were compared for prostate cancer pathology features and disease outcomes. We showed a significantly reduced mtDNA content in prostate cancer compared with normal adjacent prostate tissue (mean difference 1.73-fold, P-value <0.001). Prostate cancer with increased mtDNA content showed unfavorable pathologic characteristics including, higher disease stage (PT2 vs PT3 P-value = 0.018), extracapsular extension (P-value = 0.02) and a trend toward an increased Gleason score (P-value = 0.064). No significant association was observed between changes in mtDNA content and biochemical recurrence (median follow up of 107 months). Contrary to other cancer types, prostate cancer tissue shows no universally depleted mtDNA content. Rather, the change in mtDNA content is highly variable, mirroring known prostate cancer genome heterogeneity. Patients with high mtDNA content have an unfavorable pathology, while a high mtDNA content in normal adjacent prostate tissue is associated with worse prognosis. © 2017 Wiley Periodicals, Inc.

  5. Persistent and Newly Developed Chronic Bronchitis Are Associated with Worse Outcomes in Chronic Obstructive Pulmonary Disease

    PubMed Central

    Zhao, Huaqing; Boriek, Aladin M.; Anzueto, Antonio; Soler, Xavier; Bhatt, Surya P.; Rennard, Stephen I.; Wise, Robert; Comellas, Alejandro; Ramsdell, Joe W.; Kinney, Gregory L.; Han, MeiLan K.; Martinez, Carlos H.; Yen, Andrew; Black-Shinn, Jennifer; Porszasz, Janos; Criner, Gerard J.; Hanania, Nicola A.; Sharafkhaneh, Amir; Crapo, James D.; Make, Barry J.; Silverman, Edwin K.; Curtis, Jeffrey L.

    2016-01-01

    Rationale: Chronic bronchitis is, by definition, a chronic condition, but the development and remission of this condition in cigarette smokers with or without chronic obstructive pulmonary disease (COPD) are poorly understood. Also, it is unclear how the persistence or new development of chronic bronchitis affects symptoms and outcomes. Objectives: To ascertain the relationship between smoking status and the presence or absence of chronic bronchitis and the subsequent effects on symptoms and outcomes. Methods: We analyzed 1,775 current or ex-smokers with GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage 0–IV COPD in phase 2 of the Genetic Epidemiology of COPD (COPDGene) Study, which included subjects after 5 years of follow-up from phase 1. We asked subjects at enrollment and at 5 years of follow-up about symptoms consistent with chronic bronchitis. We divided subjects into four groups: persistent chronic bronchitis– (negative at phase 1/negative at phase 2), resolved chronic bronchitis (positive/negative), new chronic bronchitis (negative/positive), and persistent chronic bronchitis+ (positive/positive). We analyzed respiratory symptoms, health-related quality of life, lung function, exacerbation frequency, and 6-minute walk distance. Measurements and Main Results: Compared with the persistent chronic bronchitis– group, members of the persistent chronic bronchitis+ group were more likely to have continued smoking (53.4%). Subjects with new chronic bronchitis were more likely to have resumed (6.6%) or continued smoking (45.6%), whereas subjects with resolved chronic bronchitis were more likely to have quit smoking (23.5%). Compared with the persistent chronic bronchitis– group, the other groups had a shorter 6-minute walk distance, worse lung function, greater exacerbation frequency, and worse respiratory symptoms. Modified Medical Research Council dyspnea and St. George’s Respiratory Questionnaire scores worsened between phase 1 and

  6. The Wechsler Test of Adult Reading as a Measure of Premorbid Intelligence Following Traumatic Brain Injury.

    PubMed

    Steward, Kayla A; Novack, Thomas A; Kennedy, Richard; Crowe, Michael; Marson, Daniel C; Triebel, Kristen L

    2017-02-01

    The current study sought to determine whether the Wechsler Test of Adult Reading (WTAR) provides a stable estimate of premorbid intellectual ability in acutely injured patients recovering from traumatic brain injury (TBI). A total of 135 participants (43 mild TBI [mTBI], 40 moderate/severe TBI [msevTBI], 52 healthy controls) were administered the WTAR at 1 and 12 months post-injury. Despite similar demographic profiles, participants with msevTBI performed significantly worse than controls on the WTAR at both time points. Moreover, the msevTBI group had a significant improvement in WTAR performance over the 1-year period. In contrast, those participants with mTBI did not significantly differ from healthy controls and both the mTBI and control groups demonstrated stability on the WTAR over time. Results indicate that word-reading tests may underestimate premorbid intelligence during the immediate recovery period for patients with msevTBI. Clinicians should consider alternative estimation measures in this TBI subpopulation. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Pilot age and expertise predict flight simulator performance: a 3-year longitudinal study.

    PubMed

    Taylor, Joy L; Kennedy, Quinn; Noda, Art; Yesavage, Jerome A

    2007-02-27

    Expert knowledge may compensate for age-related declines in basic cognitive and sensory-motor abilities in some skill domains. We investigated the influence of age and aviation expertise (indexed by Federal Aviation Administration pilot ratings) on longitudinal flight simulator performance. Over a 3-year period, 118 general aviation pilots aged 40 to 69 years were tested annually, in which their flight performance was scored in terms of 1) executing air-traffic controller communications; 2) traffic avoidance; 3) scanning cockpit instruments; 4) executing an approach to landing; and 5) a flight summary score. More expert pilots had better flight summary scores at baseline and showed less decline over time. Secondary analyses revealed that expertise effects were most evident in the accuracy of executing aviation communications, the measure on which performance declined most sharply over time. Regarding age, even though older pilots initially performed worse than younger pilots, over time older pilots showed less decline in flight summary scores than younger pilots. Secondary analyses revealed that the oldest pilots did well over time because their traffic avoidance performance improved more vs younger pilots. These longitudinal findings support previous cross-sectional studies in aviation as well as non-aviation domains, which demonstrated the advantageous effect of prior experience and specialized expertise on older adults' skilled cognitive performances.

  8. Adult Age Differences in Dual Information Processes: Implications for the Role of Affective and Deliberative Processes in Older Adults' Decision Making.

    PubMed

    Peters, Ellen; Hess, Thomas M; Västfjäll, Daniel; Auman, Corinne

    2007-03-01

    Age differences in affective/experiential and deliberative processes have important theoretical implications for judgment and decision theory and important pragmatic implications for older-adult decision making. Age-related declines in the efficiency of deliberative processes predict poorer-quality decisions as we age. However, age-related adaptive processes, including motivated selectivity in the use of deliberative capacity, an increased focus on emotional goals, and greater experience, predict better or worse decisions for older adults depending on the situation. The aim of the current review is to examine adult age differences in affective and deliberative information processes in order to understand their potential impact on judgments and decisions. We review evidence for the role of these dual processes in judgment and decision making and then review two representative life-span perspectives (based on aging-related changes to cognitive or motivational processes) on the interplay between these processes. We present relevant predictions for older-adult decisions and make note of contradictions and gaps that currently exist in the literature. Finally, we review the sparse evidence about age differences in decision making and how theories and findings regarding dual processes could be applied to decision theory and decision aiding. In particular, we focus on prospect theory (Kahneman & Tversky, 1979) and how prospect theory and theories regarding age differences in information processing can inform one another. © 2007 Association for Psychological Science.

  9. Is Handwriting Performance Affected by the Writing Surface? Comparing Preschoolers', Second Graders', and Adults' Writing Performance on a Tablet vs. Paper.

    PubMed

    Gerth, Sabrina; Klassert, Annegret; Dolk, Thomas; Fliesser, Michael; Fischer, Martin H; Nottbusch, Guido; Festman, Julia

    2016-01-01

    Due to their multifunctionality, tablets offer tremendous advantages for research on handwriting dynamics or for interactive use of learning apps in schools. Further, the widespread use of tablet computers has had a great impact on handwriting in the current generation. But, is it advisable to teach how to write and to assess handwriting in pre- and primary schoolchildren on tablets rather than on paper? Since handwriting is not automatized before the age of 10 years, children's handwriting movements require graphomotor and visual feedback as well as permanent control of movement execution during handwriting. Modifications in writing conditions, for instance the smoother writing surface of a tablet, might influence handwriting performance in general and in particular those of non-automatized beginning writers. In order to investigate how handwriting performance is affected by a difference in friction of the writing surface, we recruited three groups with varying levels of handwriting automaticity: 25 preschoolers, 27 second graders, and 25 adults. We administered three tasks measuring graphomotor abilities, visuomotor abilities, and handwriting performance (only second graders and adults). We evaluated two aspects of handwriting performance: the handwriting quality with a visual score and the handwriting dynamics using online handwriting measures [e.g., writing duration, writing velocity, strokes and number of inversions in velocity (NIV)]. In particular, NIVs which describe the number of velocity peaks during handwriting are directly related to the level of handwriting automaticity. In general, we found differences between writing on paper compared to the tablet. These differences were partly task-dependent. The comparison between tablet and paper revealed a faster writing velocity for all groups and all tasks on the tablet which indicates that all participants-even the experienced writers-were influenced by the lower friction of the tablet surface. Our results

  10. Is Handwriting Performance Affected by the Writing Surface? Comparing Preschoolers', Second Graders', and Adults' Writing Performance on a Tablet vs. Paper

    PubMed Central

    Gerth, Sabrina; Klassert, Annegret; Dolk, Thomas; Fliesser, Michael; Fischer, Martin H.; Nottbusch, Guido; Festman, Julia

    2016-01-01

    Due to their multifunctionality, tablets offer tremendous advantages for research on handwriting dynamics or for interactive use of learning apps in schools. Further, the widespread use of tablet computers has had a great impact on handwriting in the current generation. But, is it advisable to teach how to write and to assess handwriting in pre- and primary schoolchildren on tablets rather than on paper? Since handwriting is not automatized before the age of 10 years, children's handwriting movements require graphomotor and visual feedback as well as permanent control of movement execution during handwriting. Modifications in writing conditions, for instance the smoother writing surface of a tablet, might influence handwriting performance in general and in particular those of non-automatized beginning writers. In order to investigate how handwriting performance is affected by a difference in friction of the writing surface, we recruited three groups with varying levels of handwriting automaticity: 25 preschoolers, 27 second graders, and 25 adults. We administered three tasks measuring graphomotor abilities, visuomotor abilities, and handwriting performance (only second graders and adults). We evaluated two aspects of handwriting performance: the handwriting quality with a visual score and the handwriting dynamics using online handwriting measures [e.g., writing duration, writing velocity, strokes and number of inversions in velocity (NIV)]. In particular, NIVs which describe the number of velocity peaks during handwriting are directly related to the level of handwriting automaticity. In general, we found differences between writing on paper compared to the tablet. These differences were partly task-dependent. The comparison between tablet and paper revealed a faster writing velocity for all groups and all tasks on the tablet which indicates that all participants—even the experienced writers—were influenced by the lower friction of the tablet surface. Our

  11. Associations between cadmium exposure and neurocognitive test scores in a cross-sectional study of US adults.

    PubMed

    Ciesielski, Timothy; Bellinger, David C; Schwartz, Joel; Hauser, Russ; Wright, Robert O

    2013-02-05

    Low-level environmental cadmium exposure and neurotoxicity has not been well studied in adults. Our goal was to evaluate associations between neurocognitive exam scores and a biomarker of cumulative cadmium exposure among adults in the Third National Health and Nutrition Examination Survey (NHANES III). NHANES III is a nationally representative cross-sectional survey of the U.S. population conducted between 1988 and 1994. We analyzed data from a subset of participants, age 20-59, who participated in a computer-based neurocognitive evaluation. There were four outcome measures: the Simple Reaction Time Test (SRTT: visual motor speed), the Symbol Digit Substitution Test (SDST: attention/perception), the Serial Digit Learning Test (SDLT) trials-to-criterion, and the SDLT total-error-score (SDLT-tests: learning recall/short-term memory). We fit multivariable-adjusted models to estimate associations between urinary cadmium concentrations and test scores. 5662 participants underwent neurocognitive screening, and 5572 (98%) of these had a urinary cadmium level available. Prior to multivariable-adjustment, higher urinary cadmium concentration was associated with worse performance in each of the 4 outcomes. After multivariable-adjustment most of these relationships were not significant, and age was the most influential variable in reducing the association magnitudes. However among never-smokers with no known occupational cadmium exposure the relationship between urinary cadmium and SDST score (attention/perception) was significant: a 1 μg/L increase in urinary cadmium corresponded to a 1.93% (95%CI: 0.05, 3.81) decrement in performance. These results suggest that higher cumulative cadmium exposure in adults may be related to subtly decreased performance in tasks requiring attention and perception, particularly among those adults whose cadmium exposure is primarily though diet (no smoking or work based cadmium exposure). This association was observed among exposure levels

  12. Impact of health literacy on depressive symptoms and mental health-related: quality of life among adults with addiction.

    PubMed

    Lincoln, Alisa; Paasche-Orlow, Michael K; Cheng, Debbie M; Lloyd-Travaglini, Christine; Caruso, Christine; Saitz, Richard; Samet, Jeffrey H

    2006-08-01

    Health literacy has been linked to health status in a variety of chronic diseases. However, evidence for a relationship between health literacy and mental health outcomes is sparse. We hypothesized that low literacy would be associated with higher addiction severity, higher levels of depressive symptoms, and worse mental health functioning compared with those with higher literacy in adults with alcohol and drug dependence. The association of literacy with multiple mental health outcomes was assessed using multivariable analyses. Measurement instruments included the Rapid Estimate of Adult Literacy in Medicine (REALM), the Center for Epidemiologic Studies-Depression (CES-D) scale, the Mental Component Summary scale of the Short Form Health Survey, and the Addiction Severity Index for drug and alcohol addiction. Subjects included 380 adults recruited during detoxification treatment and followed prospectively at 6-month intervals for 2 years. Based on the REALM, subjects were classified as having either low (< or = 8th grade) or higher (> or = 9th grade) literacy levels. In longitudinal analyses, low literacy was associated with more depressive symptoms. The adjusted mean difference in CES-D scores between low and high literacy levels was 4 (P<.01). Literacy was not significantly associated with mental health-related quality of life or addiction severity. In people with alcohol and drug dependence, low literacy is associated with worse depressive symptoms. The mechanisms underlying the relationship between literacy and mental health outcomes should be explored to inform future intervention efforts.

  13. Relationship between muscle mass and physical performance: is it the same in older adults with weak muscle strength?

    PubMed

    Kim, Kyoung-Eun; Jang, Soong-Nang; Lim, Soo; Park, Young Joo; Paik, Nam-Jong; Kim, Ki Woong; Jang, Hak Chul; Lim, Jae-Young

    2012-11-01

    the relationship between muscle mass and physical performance has not been consistent among studies. to clarify the relationship between muscle mass and physical performance in older adults with weak muscle strength. cross-sectional analysis using the baseline data of 542 older men and women from the Korean Longitudinal Study on Health and Aging. dual X-ray absorptiometry, isokinetic dynamometer and the Short Physical Performance Battery (SPPB) were performed. Two muscle mass parameters, appendicular skeletal mass divided by weight (ASM/Wt) and by height squared (ASM/Ht(2)), were measured. We divided the participants into a lower-quartile (L25) group and an upper-three-quartiles (H75) group based on the knee-extensor peak torque. Correlation analysis and logistic regression models were used to assess the association between muscle mass and low physical performance, defined as SPPB scores <9, after controlling for confounders. in the L25 group, no correlation between mass and SPPB was detected, whereas the correlation between peak torque and SPPB was significant and higher than that in the H75 group. Results from the logistic models also showed no association between muscle mass and SPPB in the L25 group, whereas muscle mass was associated with SPPB in the H75 group. muscle mass was not associated with physical performance in weak older adults. Measures of muscle strength may be of greater clinical importance in weak older adults than is muscle mass per se.

  14. Henoch-schönlein purpura (HSP) in an adult

    NASA Astrophysics Data System (ADS)

    Negara, C. A.; Zubir, Z.

    2018-03-01

    Henoch-schönlein purpura (HSP) is vasculitis of the small vessels, the most common vasculitis of the childhood and is uncommon in adults. A case of HSP is reported in a 36-year-old female with ten days history of multiple palpable purpura on region antebrachii, region femoralis and cruris dextra et sinistra. Burn sensation in both legs, pain sensation on knees joint and ankles joint and bloody stools were found. History of a cough and sore throat are often to be a presentation. Laboratory examination was mild anemia, mild leukocytes, ASTO (antistreptolysin titer O): < 200, IgA: 332 mg/dL. The patient treated by giving an injection of methylprednisolone, azathioprine, and at last this treatment apparently bears good result. The account of respiratory tract stated above presumed as the factors of the kindling of the outbreak of HSP to this patient. The prognosis in the adult is worse than children due to an increased risk of disorders of the renal.

  15. Isometric Force Regulation in Children.

    ERIC Educational Resources Information Center

    Lazarus, Jo-Anne C.; And Others

    1995-01-01

    Isometric pinch force regulation was investigated in children and adults using a visuo-motor tracking paradigm. Younger children aged 5-7 years performed significantly worse than older children aged 9-11 years and adults in terms of an overall error score as well as a correlation score, which is believed to reflect the ability to predict the…

  16. Complementary cognitive capabilities, economic decision making, and aging.

    PubMed

    Li, Ye; Baldassi, Martine; Johnson, Eric J; Weber, Elke U

    2013-09-01

    Fluid intelligence decreases with age, yet evidence about age declines in decision-making quality is mixed: Depending on the study, older adults make worse, equally good, or even better decisions than younger adults. We propose a potential explanation for this puzzle, namely that age differences in decision performance result from the interplay between two sets of cognitive capabilities that impact decision making, one in which older adults fare worse (i.e., fluid intelligence) and one in which they fare better (i.e., crystallized intelligence). Specifically, we hypothesized that older adults' higher levels of crystallized intelligence can provide an alternate pathway to good decisions when the fluid intelligence pathway declines. The performance of older adults relative to younger adults therefore depends on the relative importance of each type of intelligence for the decision at hand. We tested this complementary capabilities hypothesis in a broad sample of younger and older adults, collecting a battery of standard cognitive measures and measures of economically important decision-making "traits"--including temporal discounting, loss aversion, financial literacy, and debt literacy. We found that older participants performed as well as or better than younger participants on these four decision-making measures. Structural equation modeling verified our hypothesis: Older participants' greater crystallized intelligence offset their lower levels of fluid intelligence for temporal discounting, financial literacy, and debt literacy, but not for loss aversion. These results have important implications for public policy and for the design of effective decision environments for older adults.

  17. Do patients requiring a multivisceral resection for rectal cancer have worse oncologic outcomes than patients undergoing only abdominoperineal resection?

    PubMed

    Dosokey, Eslam M G; Brady, Justin T; Neupane, Ruel; Jabir, Murad A; Stein, Sharon L; Reynolds, Harry L; Delaney, Conor P; Steele, Scott R

    2017-09-01

    Abdominoperineal Resection (APR) remains an important option for patients with advanced rectal cancer though some may require multivisceral resection (MVR) in addition to APR. We hypothesized that oncological outcomes would be worse with MVR. A retrospective review from 2006 to 2015 of 161 patients undergoing APR or MVR for rectal cancer, of whom 118 underwent curative APR or APR with MVR. Perioperative, oncologic and survival metrics were evaluated. There were 82 patients who underwent APR and 36 who underwent MVR. Surgical approach and incidence of complications were similar (All P > 0.05). There was 1 local recurrence in each of the APR and MVR groups at a mean follow-up of 34 and 32 months, respectively. Distant recurrences occurred in 3 APR patients and 4 MVR patients. APR and APR with MVR can be performed with comparable morbidity and oncologic outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Older Adults Pay an Additional Cost When Texting and Walking: Effects of Age, Environment, and Use of Mixed Reality on Dual-Task Performance.

    PubMed

    Krasovsky, Tal; Weiss, Patrice L; Kizony, Rachel

    2018-04-06

    Texting while walking (TeWW) has become common among people of all ages, and mobile phone use during gait is increasingly associated with pedestrian injury. Although dual-task walking performance is known to decline with age, data regarding the effect of age on dual-task performance in ecological settings are limited. The objective of this study was to evaluate the effect of age, environment (indoors/outdoors), and mixed reality (merging of real and virtual environments) on TeWW performance. A cross-sectional design was used. Young (N = 30; 27.8 ± 4.4 years) and older (N = 20; 68.9 ± 3.9 years) adults performed single and dual-task texting and walking indoors and outdoors, with and without a mixed reality display. Participants also completed evaluations of visual scanning and cognitive flexibility (Trail Making Test) and functional mobility (Timed Up and Go). Indoors, similar interference to walking and texting occurred for both groups, but only older adults' gait variability increased under dual task conditions. Outdoors, TeWW was associated with larger age-related differences in gait variability, texting accuracy, and gait dual-task costs. Young adults with better visual scanning and cognitive flexibility performed TeWW with lower gait costs (r = 0.52 to r = 0.65). The mixed reality display was unhelpful and did not modify walking or texting. Older adults tested in this study were relatively high-functioning. Gaze of participants was not directly monitored. Although young and older adults possess the resources necessary for TeWW, older adults pay an additional "price" when dual-tasking, especially outdoors. TeWW may have potential as an ecologically-valid assessment and/or an intervention paradigm for dual task performance among older adults as well as for clinical populations.

  19. Performance on a functional motor task is enhanced by sleep in middle-aged and older adults.

    PubMed

    Al-Sharman, Alham; Siengsukon, Catherine F

    2014-07-01

    Although sleep has been shown to enhance motor skill learning, it remains unclear whether sleep enhances learning of a functional motor task in middle-aged and older individuals. The purpose of this study was to examine whether sleep enhances motor learning of a functional motor task in middle-aged and older adults. Twenty middle-aged and 20 older individuals were randomly assigned to either the sleep condition or the no-sleep condition. Participants in the sleep condition practiced a novel walking task in the evening, and returned the following morning for retesting. Participants in the no-sleep condition practiced the walking task in the morning and returned the same day in the evening for a retest. Outcome measures included time around the walking path and spatiotemporal gait parameters. Only the middle-aged and older adults in the sleep condition demonstrated significant off-line improvement in performance, measured as a decline in time to walk around the novel path and improvement in spatiotemporal gait parameters. The middle-aged and older adults in the no-sleep condition failed to demonstrate off-line improvements in performance of this functional task. This is the first study to provide evidence that sleep facilitates learning a clinically relevant functional motor task in middle-aged and older adults. Because many neurologic conditions occur in the middle-aged and older adults and sleep issues are very prevalent in many neurologic conditions, it is imperative that physical therapists consider sleep as a factor that may impact motor learning and recovery in these individuals. (See Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A73) for more insights from the authors.

  20. Swimming Performance of Adult Asian Carp: Field Assessment Using a Mobile Swim Tunnel

    DTIC Science & Technology

    2016-08-01

    The effect of temperature on swimming performance and oxygen consumption in adult sockeye (Oncorhynchus nerka) and coho (O. kisutch) salmon stocks...tunnel to determine the critical swim speed (Ucrit), oxygen consumption (VO2), and endurance at a single velocity. Tunnel Type Tunnel Size (L...specially designed mobile swim tunnel indicated that it might be used effectively with other large, active, free-swimming planktivores, including bigheaded

  1. Box and block test in Beninese adults.

    PubMed

    Natta, Ditouah Didier Niama; Alagnidé, Etienne; Kpadonou, Toussaint Godonou; Detrembleur, Christine; Lejeune, Thierry M; Stoquart, Gaëtan G

    2015-11-01

    To determine the Box and Block Test norm in a sub-Saharan population and to compare these data with published norms for North American adults. A total of 692 healthy Beninese people, age range 20-85 years, were recruited. These subjects were asked to perform the Box and Block Test with both hands. Box and Block Test scores (mean and standard deviation (SD)) for women and men were, respectively, 81.3 (15.4) and 79 (16.6) for the dominant hand and 73.2 (13.7) and 72 (14.8) for the non-dominant hand. Mean Box and Block Test scores ranged from 89.1 (12.7) for people under the age of 25 years to 55.23 (10.5) for people over the age of 74 years. Manual dexterity was better for women than men, for dominant hand than non-dominant hand, and for younger subjects. In comparison with published results for US subjects, Beninese subjects had better dexterity below the age of 50 years in both sexes for the right hand and worse dexterity over 64 years of age in both sexes for the right hand. Developing and validating outcome scales in Africa will help to improve functional assessment of African populations in clinical practice and research.

  2. Short Physical Performance Battery in hospitalized older adults.

    PubMed

    Fisher, Steve; Ottenbacher, Kenneth J; Goodwin, James S; Graham, James E; Ostir, Glenn V

    2009-12-01

    The objectives of this study were to determine if Short Physical Performance Battery (SPPB) information could be collected in a hospitalized older patient population, and to assess associations between SPPB scores and sociodemographic characteristics and clinical measures. A cross sectional design was used that included 90 adults aged 65 years or older admitted to an Acute Care for Elders unit. Patient information was collected within 24 hours of hospitalization. SPPB was scored using established criteria in older persons living in the community and revised criteria based on older persons hospitalized with acute illness. The mean age was 75.3 (SD 7.1) years; 61% were women. The SPPB can be safely and reliably administered to hospitalized elderly patients. No injuries or adverse events occurred. Hospital SPPB scoring criteria better distributed the overall range of performance for older patients than community SPPB scoring criteria. In multivariate regression analyses, increasing age (p=0.007), length of stay (p=0.02), comorbidities (p=0.04), and cognition (p=0.02) were significantly and inversely associated with SPPB when scored using hospital based scoring criteria. Only age (p=0.02) was significantly associated with SPPB when using community based scoring criteria. This study showed that a SPPB can be reliably collected in hospitalized older patients. The study further suggests that hospital based SPPB scoring criteria may be more appropriate for an older patient population.

  3. Health Literacy and Cognitive Performance among Older Adults

    PubMed Central

    Federman, Alex D.; Sano, Mary; Wolf, Michael S.; Siu, Albert L.; Halm, Ethan A.

    2009-01-01

    Objectives Specific cognitive abilities may explain the association of health literacy with health status. We studied the relationship between health literacy and memory and verbal fluency in older adults. Design Cross-sectional cohort. Setting Twenty senior centers and apartment buildings in New York City, NY. Participants Independently living, English and Spanish-speaking adults ages 60 and older (n=414). Measurements Health literacy was measured using the Short Test of Functional Health Literacy in Adults (S-TOFHLA). The associations of S-TOFHLA scores with immediate and delayed recall (Wechsler Memory Scale II), verbal fluency (Animal Naming), and global cognitive function (Mini Mental Status Exam, MMSE), were modeled with multivariable logistic and linear regression. Results Health literacy was inadequate in 24.3%. Impairment of immediate recall occurred in 20.4%; delayed recall, 15.0%; verbal fluency, 9.9%; and MMSE, 17.4%. Abnormal cognitive function was strongly associated with inadequate health literacy: immediate recall (AOR 3.44, 95% CI 1.71 to 6.94, p<.0001); delayed recall (AOR 3.48, 95% CI 1.58 to 7.67, p = .002); and verbal fluency (AOR 3.47, 95% CI 1.44 to 8.38, p=.006). These associations persisted in subgroups that excluded individuals with normal age-adjusted MMSE scores. Conclusion Memory and verbal fluency are strongly associated with health literacy, independently of education and health status, even among those with subtle cognitive dysfunction. Reducing the cognitive burden of health information might mitigate the detrimental effects of limited health literacy in older adults. Research that examines the impact of materials tailored to older adults' cognitive limitations on health literacy and health outcomes is needed. PMID:19515101

  4. Building a Beetle: How Larval Environment Leads to Adult Performance in a Horned Beetle

    PubMed Central

    Reaney, Leeann T.; Knell, Robert J.

    2015-01-01

    The link between the expression of the signals used by male animals in contests with the traits which determine success in those contests is poorly understood. This is particularly true in holometabolous insects such as horned beetles where signal expression is determined during metamorphosis and is fixed during adulthood, whereas performance is influenced by post-eclosion feeding. We used path analysis to investigate the relationships between larval and adult nutrition, horn and body size and fitness-related traits such as strength and testes mass in the horned beetle Euoniticellus intermedius. In males weight gain post-eclosion had a central role in determining both testes mass and strength. Weight gain was unaffected by adult nutrition but was strongly correlated with by horn length, itself determined by larval resource availability, indicating strong indirect effects of larval nutrition on the adult beetle’s ability to assimilate food and grow tissues. Female strength was predicted by a simple path diagram where strength was determined by eclosion weight, itself determined by larval nutrition: weight gain post-eclosion was not a predictor of strength in this sex. Based on earlier findings we discuss the insulin-like signalling pathway as a possible mechanism by which larval nutrition could affect adult weight gain and thence traits such as strength. PMID:26244874

  5. Free and Cued Memory in relation to Biomarker-Defined Abnormalities in Clinically Normal Older Adults and Those at Risk for Alzheimer’s Disease

    PubMed Central

    Papp, Kathryn V.; Amariglio, Rebecca E.; Mormino, Elizabeth; Hedden, Trey; Dekhytar, Maria; Johnson, Keith A.; Sperling, Reisa A.; Rentz, Dorene M.

    2015-01-01

    Objectives Furthering our understanding of the relationship between amyloidosis (Aβ), neurodegeneration (ND), and cognition is imperative for early identification and early intervention of Alzheimer’s disease (AD). However, the subtle cognitive decline differentially associated with each biomarker-defined stage of preclinical AD has yet to be fully characterized. Recent work indicates that different components of memory performance (free and cued recall) may be differentially specific to memory decline in prodromal AD. We sought to examine the relationship between free and cued recall paradigms, in addition to global composites of memory, executive functioning, and processing speed in relation to stages of preclinical AD. Methods A total of 260 clinically normal (CN) older adults (CDR=0) from the Harvard Aging Brain study were grouped according to preclinical AD stages including Stage 0 (Aβ−/ND−), Stage 1 (Aβ+/ND−), Stage 2 (Aβ+/ND+), and suspected non-Alzheimer’s associated pathology (SNAP; Aβ−/ND+). General linear models controlling for age, sex, and education were used to assess for stage-based performance differences on cognitive composites of executive functioning, processing speed, and memory in addition to free and cued delayed recall on the Selective Reminding Test (SRT) and Memory Capacity Test (MCT). Results Global memory performance differed between preclinical stages with Stage 2 performing worse compared with Stage 0. When examining free and cued paradigms by memory test, only the MCT (and not the SRT) revealed group differences. More specifically, Stage 1 was associated with decrements in free recall compared with Stage 0 while Stage 2 was associated with decrements in both free and cued recall. There was a trend for the SNAP group to perform worse on free recall compared with Stage 0. Finally, there was no association between preclinical stage and global composites of executive functioning or processing speed. Conclusions Clinically

  6. Adult medulloblastoma: clinical characters, prognostic factors, outcomes and patterns of relapse.

    PubMed

    Zhang, Na; Ouyang, Taohui; Kang, Huicong; Long, Wang; Thomas, Benjamin; Zhu, Suiqiang

    2015-09-01

    To analyze the clinical characters, prognostic factors, patterns of relapse and treatment outcomes for medulloblastoma in adults. The clinical materials of 73 consecutive adult patients (age, ≥16 years) with medulloblastoma were analyzed retrospectively. Follow-up data were available in 62 patients, ranging from 10 to 142 months (median, 78.4 months). Outcome in survival was assessed by the progression-free survival (PFS) and overall survival (OS). Univariate and multivariate analysis were performed to determine the prognostic factors. Total or near-total tumor resection was achieved in 37 cases (59.7 %), subtotal in 19 cases (30.6 %), and partial resection in 6 cases (9.7 %).Twenty-two patients experienced recurrences, and 45 % percent of all recurrences occurred more than 4 years after initial surgery. The PFS rates at 5 and 8 years were 60.1 and 37.0 %, respectively. The OS rates at 5 and 8 years were 82.6 and 57.3 %, respectively. In univariate analysis, less tumor resection, non-desmoplastic pathology, and brainstem involvement were risk factors for worse PFS and OS (P < 0.05). High-risk category was associated with just lower PFS, but not OS. In multivariate analysis, complete resection and desmoplastic pathology were independently predictive factors of improved PFS and OS. In adult medulloblastoma, late relapse is common and therefore long-term follow-up is important for evaluating the real impact of treatments. Risk category had prognostic value just for PFS, but not for OS. Complete resection and desmoplastic histology are independently predictive factors for favorable outcomes.

  7. Quantifying risk and benchmarking performance in the adult intensive care unit.

    PubMed

    Higgins, Thomas L

    2007-01-01

    Morbidity, mortality, and length-of-stay outcomes in patients receiving critical care are difficult to interpret unless they are risk-stratified for diagnosis, presenting severity of illness, and other patient characteristics. Acuity adjustment systems for adults include the Acute Physiology And Chronic Health Evaluation (APACHE), the Mortality Probability Model (MPM), and the Simplified Acute Physiology Score (SAPS). All have recently been updated and recalibrated to reflect contemporary results. Specialized scores are also available for patient subpopulations where general acuity scores have drawbacks. Demand for outcomes data is likely to grow with pay-for-performance initiatives as well as for routine clinical, prognostic, administrative, and research applications. It is important for clinicians to understand how these scores are derived and how they are properly applied to quantify patient severity of illness and benchmark intensive care unit performance.

  8. Behavioral performance in adult honey bees is influenced by the temperature experienced during their pupal development.

    PubMed

    Tautz, Jurgen; Maier, Sven; Groh, Claudia; Rossler, Wolfgang; Brockmann, Axel

    2003-06-10

    To investigate the possible consequences of brood-temperature regulation in honey bee colonies on the quality of behavioral performance of adults, we placed honey bee pupae in incubators and allowed them to develop at temperatures held constant at 32 degrees C, 34.5 degrees C, and 36 degrees C. This temperature range occurs naturally within hives. On emergence, the young adult bees were marked and introduced into foster colonies housed in normal and observation hives and allowed to live out their lives. No obvious difference in within-hive behavior was noted between the temperature-treated bees and the foster-colony bees. However, when the temperature-treated bees became foragers and were trained to visit a feeder 200 m from the hive, they exhibited clear differences in dance performance that could be correlated with the temperatures at which they had been raised: bees raised at 32 degrees C completed only approximately 20% of the dance circuits when compared with bees of the higher-temperature group. Also, the variance in the duration of the waggle phase is larger in 32 degrees C-raised bees compared with 36 degrees C-raised bees. All other parameters compared across all groups were not significantly different. One-trial learning and memory consolidation in the bees raised at different temperatures was investigated 1 and 10 min after conditioning the proboscis-extension reflex. Bees raised at 36 degrees C performed as expected for bees typically classified as "good learners," whereas bees raised at 32 degrees C and 34.5 degrees C performed significantly less well. We propose that the temperature at which pupae are raised will influence their behavioral performance as adults and may determine the tasks they carry out best inside and outside the hive.

  9. Enhanced emotional interference on working memory performance in adults with ADHD.

    PubMed

    Marx, Ivo; Domes, Gregor; Havenstein, Carolin; Berger, Christoph; Schulze, Lars; Herpertz, Sabine C

    2011-09-01

    Subjects with attention-deficit/hyperactivity disorder (ADHD) suffer from both executive dysfunction and deficits in emotion regulation. However, up to now, there has been no research demonstrating a clear impact of emotional dysregulation on cognitive performance in subjects with ADHD. Male and female adults with ADHD (n=39) and gender- and IQ-matched control subjects (n=40) performed an emotional working memory task (n-back task). In the background of the task, we presented neutral and negative stimuli varied in emotional saliency (negative pictures with low saliency, negative pictures with high saliency), but subjects were instructed to ignore these pictures and to process the working memory task as quickly and as accurately as possible. Compared to control subjects, ADHD patients showed both a general working memory deficit and enhanced distractability by emotionally salient stimuli in terms of lower n-back performance accuracy. In particular, while controls showed impaired WM performance when presented with highly arousing negative background pictures, a comparable decrement was observed in the ADHD group already with lowly arousing pictures. Our results suggest that difficulties in suppressing attention towards emotionally laden stimuli might result from deficient executive control in ADHD.

  10. Can performance of daily activities discriminate between older adults with normal cognitive function and those with Mild Cognitive Impairment?

    PubMed Central

    Rodakowski, Juleen; Skidmore, Elizabeth R.; Reynolds, Charles F.; Dew, Mary Amanda; Butters, Meryl A.; Holm, Margo B.; Lopez, Oscar L.; Rogers, Joan C.

    2014-01-01

    OBJECTIVES Our primary aim was to examine whether preclinical disability in performance of cognitively-focused instrumental activities of daily living (C-IADL) tasks can discriminate between older adults with normal cognitive function and those with Mild Cognitive Impairment (MCI). The secondary purpose was to determine the two tasks with the strongest psychometric properties and assess their discriminative ability. Our goal was to generate diagnosis-relevant information about cognitive changes associated with MCI and DSM-5 Mild Neurocognitive Disorder. DESIGN Secondary analyses of cross-sectional data from a cohort of individuals diagnosed with normal cognitive function or MCI. SETTING Private home locations in Pittsburgh, PA. PARTICIPANTS Older adults with remitted major depression (N=157). MEASUREMENTS Diagnosis of cognitive status was made by the Alzheimer’s Disease Research Center at the University of Pittsburgh. Performance of 8 C-IADL was measured using the criterion-referenced, observation-based Performance Assessment of Self-Care Skills (PASS). RESULTS A total of 96 older adults with normal cognitive function (mean age=72.5, SD=5.9) and 61 older adults with MCI (mean age=75.5, SD=6.3) participated. The 8 C-IADL demonstrated 81% accuracy in discriminating cognitive status (area under curve 0.81, p<0.001). Two tasks (shopping and checkbook balancing) were the most discriminating (area under curve 0.80, p<0.001); they demonstrated similar ability, as the 8 C-IADL, to discriminate cognitive status. Assessing performance on these two C-IADL takes 10–15 minutes. CONCLUSION This is the first demonstration of the discriminative ability of preclinical disability in distinguishing MCI from cognitively normal older adults. These findings highlight potential tasks, when measured with the observation-based PASS, which demonstrate increased effort for individuals with MCI. These tasks may be considered when attempting to diagnose MCI or Mild Neurocognitive Disorder

  11. Association Between Lifetime Marijuana Use and Cognitive Function in Middle Age: The Coronary Artery Risk Development in Young Adults (CARDIA) Study.

    PubMed

    Auer, Reto; Vittinghoff, Eric; Yaffe, Kristine; Künzi, Arnaud; Kertesz, Stefan G; Levine, Deborah A; Albanese, Emiliano; Whitmer, Rachel A; Jacobs, David R; Sidney, Stephen; Glymour, M Maria; Pletcher, Mark J

    2016-03-01

    Marijuana use is increasingly common in the United States. It is unclear whether it has long-term effects on memory and other domains of cognitive function. To study the association between cumulative lifetime exposure to marijuana use and cognitive performance in middle age. We used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a cohort of 5115 black and white men and women aged 18 to 30 years at baseline from March 25, 1985, to June 7, 1986 (year 0), and followed up over 25 years from June 7, 1986, to August 31, 2011, to estimate cumulative years of exposure to marijuana (1 year = 365 days of marijuana use) using repeated measures and to assess associations with cognitive function at year 25. Linear regression was used to adjust for demographic factors, cardiovascular risk factors, tobacco smoking, use of alcohol and illicit drugs, physical activity, depression, and results of the mirror star tracing test (a measure of cognitive function) at year 2. Data analysis was conducted from June 7, 1986, to August 31, 2011. Three domains of cognitive function were assessed at year 25 using the Rey Auditory Verbal Learning Test (verbal memory), the Digit Symbol Substitution Test (processing speed), and the Stroop Interference Test (executive function). Among 3385 participants with cognitive function measurements at the year 25 visit, 2852 (84.3%) reported past marijuana use, but only 392 (11.6%) continued to use marijuana into middle age. Current use of marijuana was associated with worse verbal memory and processing speed; cumulative lifetime exposure was associated with worse performance in all 3 domains of cognitive function. After excluding current users and adjusting for potential confounders, cumulative lifetime exposure to marijuana remained significantly associated with worse verbal memory. For each 5 years of past exposure, verbal memory was 0.13 standardized units lower (95% CI, -0.24 to -0.02; P = .02), corresponding to a mean of

  12. Verbal Fluency Performance in Amnestic MCI and Older Adults with Cognitive Complaints

    PubMed Central

    Nutter-Upham, Katherine E.; Saykin, Andrew J.; Rabin, Laura A.; Roth, Robert M.; Wishart, Heather A.; Pare, Nadia; Flashman, Laura A.

    2009-01-01

    Verbal fluency tests are employed regularly during neuropsychological assessments of older adults, and deficits are a common finding in patients with Alzheimer’s disease (AD). Little extant research, however, has investigated verbal fluency ability and subtypes in preclinical stages of neurodegenerative disease. We examined verbal fluency performance in 107 older adults with amnestic mild cognitive impairment (MCI, n = 37), cognitive complaints (CC, n = 37) despite intact neuropsychological functioning, and demographically-matched healthy controls (HC, n = 33). Participants completed fluency tasks with letter, semantic category, and semantic switching constraints. Both phonemic and semantic fluency were statistically (but not clinically) reduced in amnestic MCI relative to cognitively intact older adults, indicating subtle changes in both the quality of the semantic store and retrieval slowing. Investigation of the underlying constructs of verbal fluency yielded two factors: Switching (including switching and shifting tasks) and Production (including letter, category, and action naming tasks), and both factors discriminated MCI from HC albeit to different degrees. Correlational findings further suggested that all fluency tasks involved executive control to some degree, while those with an added executive component (i.e., switching and shifting) were less dependent on semantic knowledge. Overall, our findings highlight the importance of including multiple verbal fluency tests in assessment batteries targeting preclinical dementia populations and suggest that individual fluency tasks may tap specific cognitive processes. PMID:18339515

  13. Variation in lung function is associated with worse clinical outcomes in cystic fibrosis

    PubMed Central

    Heinzmann-Filho, João Paulo; Pinto, Leonardo Araujo; Marostica, Paulo José Cauduro; Donadio, Márcio Vinícius Fagundes

    2015-01-01

    ABSTRACT OBJECTIVE: To determine whether the variation in lung function over one year is associated with worse clinical outcomes, as well as with a decline in lung function in the following years, in patients with cystic fibrosis (CF). METHODS: This was a retrospective study involving CF patients (4-19 years of age), evaluated over a three-year period. We evaluated demographic characteristics, chronic Pseudomonas aeruginosa infection, antibiotic use, hospitalization, six-minute walk distance (6MWD), and lung function. The inclusion criterion was having undergone pulmonary function testing at least three times in the first year and at least once in each of the next two years. RESULTS: We evaluated 35 CF patients. The variation in FEV1 in the first year (ΔFEV1) was greater among those who, in the third year, showed reduced FEV1, had a below-average 6MWD, or were hospitalized than among those with normal FEV1, normal 6MWD, or no hospital admissions, in that same year (p < 0.05), although no such difference was found for antibiotic use in the third year. Subjects showing a ΔFEV1 ≥ 10% also showed a greater decline in FEV1 over the two subsequent years (p = 0.04). The ΔFEV1 also showed an inverse correlation with absolute FEV1 in the third year (r = −0.340, p = 0.04) and with the rate of FEV1 decline (r = −0.52, p = 0.001). Linear regression identified ΔFEV1 as a predictor of FEV1 decline (coefficient of determination, 0.27). CONCLUSIONS: Significant variation in lung function over one year seems to be associated with a higher subsequent rate of FEV1 decline and worse clinical outcomes in CF patients. Short-term ΔFEV1 might prove useful as a predictor of CF progression in clinical practice. PMID:26785959

  14. Somatic gene mutations in African Americans may predict worse outcomes in colorectal cancer.

    PubMed

    Kang, Melissa; Shen, Xiang J; Kim, Sangmi; Araujo-Perez, Felix; Galanko, Joseph A; Martin, Chris F; Sandler, Robert S; Keku, Temitope O

    2013-01-01

    African Americans have worse outcomes in colorectal cancer (CRC) than Caucasians. We sought to determine if KRAS, BRAF and PIK3CA mutations might contribute to the racial differences in CRC outcome. DNA was extracted from tissue microarrays made from CRC samples from 67 African Americans and 237 Caucasians. Mutations in KRAS, BRAF, and PIK3CA were evaluated by PCR sequencing. We also examined microsatellite instability (MSI) status. Associations of mutation status with tumor stage and grade were examined using a logistic regression model. Cox proportional hazards models were used to estimate the all-cause mortality associated with mutational status, race and other clinicopathologic features. KRAS mutations were more common in African Americans than among Caucasians (37% vs 21%, p=0.01) and were associated with advanced stage (unadjusted odds ratio (OR)=3.31, 95% confidence interval (CI) 1.03-10.61) and grade (unadjusted OR=5.60, 95% CI 1.01-31.95) among African Americans. Presence of BRAF mutations was also positively associated with advanced tumor stage (adjusted OR=3.99, 95%CI 1.43-11.12) and grade (adjusted OR=3.93, 95%CI 1.05-14.69). PIK3CA mutations showed a trend toward an association with an increased risk of death compared to absence of those mutations (adjusted for age, sex and CRC site HR=1.89, 95% CI 0.98-3.65). Among African Americans, the association was more evident (adjusted for age, sex and CRC site HR=3.92, 95% CI 1.03-14.93) and remained significant after adjustment for MSI-H status and combined education-income level, with HR of 12.22 (95%CI 1.32-121.38). Our results suggest that African Americans may have different frequencies of somatic genetic alterations that may partially explain the worse prognosis among African Americans with CRC compared to whites.

  15. The effects of glucose ingestion and glucose regulation on memory performance in older adults with mild cognitive impairment.

    PubMed

    Riby, L M; Marriott, A; Bullock, R; Hancock, J; Smallwood, J; McLaughlin, J

    2009-04-01

    Previous research investigating the impact of glucose ingestion and/or improvements in glucose regulation has found selective cognitive facilitation on episodic memory tasks in successful ageing and dementia. The present study aimed to extend this research to mild cognitive impairment (MCI). In a repeated-measures design, 24 older adults with and 24 older adults without MCI performed a battery of memory and attention tasks after 25 g of glucose or a sweetness matched placebo. In addition, to assess the impact of individual differences in glucose regulation, blood glucose measurements were taken throughout the testing session. Consistent with previous research, cognitive facilitation was observed for episodic memory tasks only in both successful ageing and MCI. Older adults with MCI had a similar glucose regulatory response as controls but their fasting levels were elevated. Notably, higher levels of blood glucose were associated with impaired memory performance in both the glucose and placebo conditions. Importantly, both blood glucose and memory performance indices were significant predictors of MCI status. The utility of glucose supplementation and the use of glucose regulation as a biological marker are discussed in relation to these data.

  16. The effects of an exercise program on several abilities associated with driving performance in older adults.

    PubMed

    Marmeleira, José F; Godinho, Mário B; Fernandes, Orlando M

    2009-01-01

    The purpose of this study was to investigate the effects of participation in an exercise program on several abilities associated with driving performance in older adults. Thirty-two subjects were randomly assigned to either an exercise group (60-81 years, n=16) or a control group (60-82 years, n=16). The exercise program was planned to stress perceptive, cognitive, and physical abilities. It lasted 12 weeks with a periodicity of three sessions of 60 min per week. Assessments were conducted before and after the intervention on behavioral speed (in single- and dual-task conditions), visual attention, psychomotor performance, speed perception (time-to-contact), and executive functioning. Significant positive effects were found at 12-week follow-up resulting from participation in the exercise program. Behavioral speed improvements were found in reaction time, movement time, and response time (both in single- and dual-task conditions); visual attention improvements took place in speed processing and divided attention; psychomotor performance improvements occurred in lower limb mobility. These results showed that exercise is capable of enhancing several abilities relevant for driving performance and safety in older adults and, therefore, should be promoted.

  17. Spatial-Sequential Working Memory in Younger and Older Adults: Age Predicts Backward Recall Performance within Both Age Groups

    PubMed Central

    Brown, Louise A.

    2016-01-01

    Working memory is vulnerable to age-related decline, but there is debate regarding the age-sensitivity of different forms of spatial-sequential working memory task, depending on their passive or active nature. The functional architecture of spatial working memory was therefore explored in younger (18–40 years) and older (64–85 years) adults, using passive and active recall tasks. Spatial working memory was assessed using a modified version of the Spatial Span subtest of the Wechsler Memory Scale – Third Edition (WMS-III; Wechsler, 1998). Across both age groups, the effects of interference (control, visual, or spatial), and recall type (forward and backward), were investigated. There was a clear effect of age group, with younger adults demonstrating a larger spatial working memory capacity than the older adults overall. There was also a specific effect of interference, with the spatial interference task (spatial tapping) reliably reducing performance relative to both the control and visual interference (dynamic visual noise) conditions in both age groups and both recall types. This suggests that younger and older adults have similar dependence upon active spatial rehearsal, and that both forward and backward recall require this processing capacity. Linear regression analyses were then carried out within each age group, to assess the predictors of performance in each recall format (forward and backward). Specifically the backward recall task was significantly predicted by age, within both the younger and older adult groups. This finding supports previous literature showing lifespan linear declines in spatial-sequential working memory, and in working memory tasks from other domains, but contrasts with previous evidence that backward spatial span is no more sensitive to aging than forward span. The study suggests that backward spatial span is indeed more processing-intensive than forward span, even when both tasks include a retention period, and that age predicts

  18. Spatial-Sequential Working Memory in Younger and Older Adults: Age Predicts Backward Recall Performance within Both Age Groups.

    PubMed

    Brown, Louise A

    2016-01-01

    Working memory is vulnerable to age-related decline, but there is debate regarding the age-sensitivity of different forms of spatial-sequential working memory task, depending on their passive or active nature. The functional architecture of spatial working memory was therefore explored in younger (18-40 years) and older (64-85 years) adults, using passive and active recall tasks. Spatial working memory was assessed using a modified version of the Spatial Span subtest of the Wechsler Memory Scale - Third Edition (WMS-III; Wechsler, 1998). Across both age groups, the effects of interference (control, visual, or spatial), and recall type (forward and backward), were investigated. There was a clear effect of age group, with younger adults demonstrating a larger spatial working memory capacity than the older adults overall. There was also a specific effect of interference, with the spatial interference task (spatial tapping) reliably reducing performance relative to both the control and visual interference (dynamic visual noise) conditions in both age groups and both recall types. This suggests that younger and older adults have similar dependence upon active spatial rehearsal, and that both forward and backward recall require this processing capacity. Linear regression analyses were then carried out within each age group, to assess the predictors of performance in each recall format (forward and backward). Specifically the backward recall task was significantly predicted by age, within both the younger and older adult groups. This finding supports previous literature showing lifespan linear declines in spatial-sequential working memory, and in working memory tasks from other domains, but contrasts with previous evidence that backward spatial span is no more sensitive to aging than forward span. The study suggests that backward spatial span is indeed more processing-intensive than forward span, even when both tasks include a retention period, and that age predicts

  19. Does adult ADHD interact with COMT val (158) met genotype to influence working memory performance?

    PubMed

    Biehl, Stefanie C; Gschwendtner, Kathrin M; Guhn, Anne; Müller, Laura D; Reichert, Susanne; Heupel, Julia; Reif, Andreas; Deckert, Jürgen; Herrmann, Martin J; Jacob, Christian P

    2015-03-01

    Both attention-deficit/hyperactivity disorder (ADHD) and catechol-O-methyltransferase (COMT) genotype have been linked to altered dopaminergic transmission and possible impairment in frontal lobe functioning. This study offers an investigation of a possible interaction between ADHD diagnosis and COMT genotype on measures of working memory and executive function. Thirty-five adults with ADHD, who were recruited from the ADHD outpatient clinic at the Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, and thirty-five matched healthy controls completed the Digit Span test and the Stroop Color Word Test. While there were no main effects of ADHD or COMT, the two factors interacted on both Digit Span subtests with the two groups' met/met carriers showing significantly different performance on the Digit Span Forward subtest and the val/val carriers showing significantly different performance on the Digit Span Backward subtest. Findings provide preliminary support for a differential impact of COMT genotype on working memory measures in adult patients with ADHD compared to healthy controls.

  20. Understanding the Relationship between Type 2 Diabetes Mellitus and Falls in Older Adults: A Prospective Cohort Study

    PubMed Central

    Roman de Mettelinge, Tine; Cambier, Dirk; Calders, Patrick; Van Den Noortgate, Nele; Delbaere, Kim

    2013-01-01

    Background Older adults with type 2 Diabetes Mellitus are at increased risk of falling. The current study aims to identify risk factors that mediate the relationship between diabetes and falls. Methods 199 older adults (104 with diabetes and 95 healthy controls) underwent a medical screening. Gait (GAITRite®), balance (AccuGait® force plate), grip strength (Jamar®), and cognitive status (Mini-Mental State Examination and Clock Drawing Test) were assessed. Falls were prospectively recorded during a 12-month follow-up period using monthly calendars. Results Compared to controls, diabetes participants scored worse on all physical and cognitive measures. Sixty-four participants (42 diabetes vs. 22 controls) reported at least one injurious fall or two non-injurious falls (“fallers”). Univariate logistic regression identified diabetes as a risk factor for future falls (Odds Ratio 2.25, 95%CI 1.21–4.15, p = 0.010). Stepwise multiple regressions defined diabetes and poor balance as independent risk factors for falling. Taking more medications, slower walking speed, shorter stride length and poor cognitive performance were mediators that reduced the Odds Ratio of the relationship between diabetes and faller status relationship the most followed by reduced grip strength and increased stride length variability. Conclusions Diabetes is a major risk factor for falling, even after controlling for poor balance. Taking more medications, poorer walking performance and reduced cognitive functioning were mediators of the relationship between diabetes and falls. Tailored preventive programs including systematic medication reviews, specific balance exercises and cognitive training might be beneficial in reducing fall risk in older adults suffering from diabetes. PMID:23825617

  1. Adult Literacy Policy and Performance in Malawi: An Analysis.

    ERIC Educational Resources Information Center

    Bhola, H. S.

    In Malawi, adult literacy deserves immediate attention in order to promote health, family planning, and productivity. While policy commitment for adult literacy promotion has not been lacking, intensified action has been. In 1979 the government accepted the Unesco Mission Report to undertake a functional literacy program on the successful…

  2. Copolymer-1 enhances cognitive performance in young adult rats

    PubMed Central

    Meneses, Alfredo; Cruz-Martínez, Yolanda; Anaya-Jiménez, Rosa María; Liy-Salmerón, Gustavo; Carvajal, Horacio Guillermo; Ponce-López, Maria Teresa

    2018-01-01

    Cognitive impairment is a dysfunction observed as a sequel of various neurodegenerative diseases, as well as a concomitant element in the elderly stages of life. In clinical settings, this malfunction is identified as mild cognitive impairment. Previous studies have suggested that cognitive impairment could be the result of a reduction in the expression of brain-derived neurotrophic factor (BDNF) and/or immune dysfunction. Copolymer-1 (Cop-1) is an FDA-approved synthetic peptide capable of inducing the activation of Th2/3 cells, which are able to release BDNF, as well as to migrate and accumulate in the brain. In this study, we evaluated the effect of Cop-1 immunization on improvement of cognition in adult rats. For this purpose, we performed four experiments. We evaluated the effect of Cop-1 immunization on learning/memory using the Morris water maze for spatial memory and autoshaping for associative memory in 3- or 6-month-old rats. BDNF concentrations at the hippocampus were determined by ELISA. Cop-1 immunization induced a significant improvement of spatial memory and associative memory in 6-month-old rats. Likewise, Cop-1 improved spatial memory and associative memory when animals were immunized at 3 months and evaluated at 6 months old. Additionally, Cop-1 induced a significant increase in BDNF levels at the hippocampus. To our knowledge, the present investigation reports the first instance of Cop-1 treatment enhancing cognitive function in normal young adult rats, suggesting that Cop-1 may be a practical therapeutic strategy potentially useful for age- or disease-related cognitive impairment. PMID:29494605

  3. Scheduled evening sleep and enhanced lighting improve adaptation to night shift work in older adults.

    PubMed

    Chinoy, Evan D; Harris, Michael P; Kim, Min Ju; Wang, Wei; Duffy, Jeanne F

    2016-12-01

    We tested whether a sleep and circadian-based treatment shown to improve circadian adaptation to night shifts and attenuate negative effects on alertness, performance and sleep in young adults would also be effective in older adults. We assessed subjective alertness, sustained attention (psychomotor vigilance task, PVT), sleep duration (actigraphy) and circadian timing (salivary dim-light melatonin onset, DLMO) in 18 older adults (57.2±3.8 years; mean±SD) in a simulated shift work protocol. 4 day shifts were followed by 3 night shifts in the laboratory. Participants slept at home and were randomised to either the treatment group (scheduled evening sleep and enhanced lighting during the latter half of night shifts) or control group (ad-lib sleep and typical lighting during night shifts). Compared with day shifts, alertness and sustained attention declined on the first night shift in both groups, and was worse in the latter half of the night shifts. Alertness and attention improved on nights 2 and 3 for the treatment group but remained lower for the control group. Sleep duration in the treatment group remained similar to baseline (6-7 hours) following night shifts, but was shorter (3-5 hours) following night shifts in the control group. Treatment group circadian timing advanced by 169.3±16.1 min (mean±SEM) but did not shift (-9.7±9.9 min) in the control group. The combined treatment of scheduled evening sleep and enhanced lighting increased sleep duration and partially aligned circadian phase with sleep and work timing, resulting in improved night shift alertness and performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Non-Elective Paraesophageal Hernia Repair Portends Worse Outcomes in Comparable Patients: a Propensity-Adjusted Analysis.

    PubMed

    Tam, Vernissia; Luketich, James D; Winger, Daniel G; Sarkaria, Inderpal S; Levy, Ryan M; Christie, Neil A; Awais, Omar; Shende, Manisha R; Nason, Katie S

    2017-01-01

    Patients undergoing non-elective paraesophageal hernia repair (PEHR) have worse perioperative outcomes. Because they are usually older and sicker, however, these patients may be more prone to adverse events, independent of surgical urgency. Our study aimed to determine whether non-elective PEHR is associated with differential postoperative outcome compared to elective repair, using propensity-score weighting. We abstracted data for patients undergoing PEHR (n = 924; non-elective n = 171 (19 %); 1997-2010). Using boosted regression, we generated a propensity-weighted dataset. Odds of 30-day/in-hospital mortality and major complications after non-elective surgery were determined. Patients undergoing non-elective repair were significantly older, had more adverse prognostic factors, and significantly more major complications (38 versus 18 %; p < 0.001) and death (8 versus 1 %; p < 0.001). After propensity weighting, median absolute percentage bias across 28 propensity-score variables improved from 19 % (significant imbalance) to 5.6 % (well-balanced). After adjusting propensity-weighted data for age and comorbidity score, odds of major complications were still nearly two times greater (OR 1.67, CI 1.07-2.61) and mortality nearly three times greater (OR 2.74, CI 0.93-8.1) than for elective repair. Even after balancing significant differences in baseline characteristics, non-elective PEHR was associated with worse outcomes than elective repair. Symptomatic patients should be referred for elective repair by experienced surgeons.

  5. Priority for the worse-off and the social cost of carbon

    NASA Astrophysics Data System (ADS)

    Adler, Matthew; Anthoff, David; Bosetti, Valentina; Garner, Greg; Keller, Klaus; Treich, Nicolas

    2017-06-01

    The social cost of carbon (SCC) is a key tool in climate policy. The SCC expresses in monetary terms the social impact of the emission of a ton of CO2 in a given year. The SCC is calculated using a `social welfare function’ (SWF): a method for assessing social welfare. The dominant SWF in climate policy is the discounted-utilitarian SWF. Individuals’ well-being numbers (utilities) are summed, and the values for later generations are reduced (`discounted’). This SWF has been criticized for ignoring the distribution of well-being and including an arbitrary time preference. Here, we use a `prioritarian’ SWF, with no time discount, to calculate the SCC. This SWF gives extra weight (`priority’) to worse-off individuals. Prioritarianism is a well-developed concept in ethics and welfare economics, but has been rarely used in climate scholarship. We find substantial differences between the discounted-utilitarian and non-discounted prioritarian SCCs.

  6. APOE ε4 associated with preserved executive function performance and maintenance of temporal and cingulate brain volumes in younger adults

    PubMed Central

    Taylor, Warren D.; Boyd, Brian; Turner, Rachel; McQuoid, Douglas R.; Ashley-Koch, Allison; MacFall, James R.; Saleh, Ayman; Potter, Guy G.

    2016-01-01

    The APOE ε4 allele is associated with cognitive deficits and brain atrophy in older adults, but studies in younger adults are mixed. We examined APOE genotype effects on cognition and brain structure in younger adults and whether genotype effects differed by age and with presence of depression. 157 adults (32% ε4 carriers, 46% depressed) between 20–50 years of age completed neuropsychological testing, 131 of which also completed 3T cranial MRI. We did not observe a direct effect of APOE genotype on cognitive performance or structural MRI measures. A significant genotype by age interaction was observed for executive function, where age had less of an effect on executive function in ε4 carriers. Similar interactions were observed for the entorhinal cortex, rostral and caudal anterior cingulate cortex and parahippocampal gyrus, where the effect of age on regional volumes was reduced in ε4 carriers. There were no significant interactions between APOE genotype and depression diagnosis. The ε4 allele benefits younger adults by allowing them to maintain executive function performance and volumes of cingulate and temporal cortex regions with aging, at least through age fifty years. PMID:26843007

  7. Lung function, 25-hydroxyvitamin D concentrations and mortality in US adults

    PubMed Central

    Ford, ES

    2015-01-01

    OBJECTIVE To explore the associations between serum concentrations of vitamin D (25(OH)D) and all-cause mortality among US adults defined by lung function (LF) status, particularly among adults with obstructive LF (OLF). METHODS Data from 10 795 adults aged 20–79 years (685 with restrictive LF (RLF) and 1309 with OLF) who participated in the Third National Health and Nutrition Examination Survey (1988–1994), had a spirometric examination, and were followed through 2006 were included. RESULTS During 14.2 years of follow-up, 1792 participants died. Mean adjusted concentrations of 25(OH)D were 75.0 nmol/l (s.e. 0.7) for adults with normal LF (NLF), 70.4 nmol/l (s.e. 1.8) for adults with RLF, 75.5 nmol/l (s.e. 1.5) for adults with mild obstruction and 71.0 nmol/l (s.e. 1.9) among adults with moderate or worse obstruction (P = 0.030). After adjustment for sociodemographic factors, lifestyle factors, clinical variables and prevalent chronic conditions, a concentration of <25 nmol/l compared with ≥75 nmol//l was associated with mortality only among adults with NLF (hazard ratio (HR) 1.76; 95% confidence interval (CI) 1.03, 3.00). Among participants with OLF, adjusted HRs were 0.65 (95% CI 0.29, 1.48), 1.21 (95% CI 0.89, 1.66) and 0.97 (95% CI 0.78, 1.19) among those with concentrations <25, 25–<50 and 50–<75 nmol/l, respectively. CONCLUSIONS Baseline concentrations of 25(OH)D did not significantly predict mortality among US adults with impaired LF. PMID:25118000

  8. Neurobehavioral effects of ambient air pollution on cognitive performance in US adults.

    PubMed

    Chen, Jiu-Chiuan; Schwartz, Joel

    2009-03-01

    In vivo animal experiments demonstrate neurotoxicity of exposures to particulate matter (PM) and ozone, but only one small epidemiological study had linked ambient air pollution with central nervous system (CNS) functions in children. To examine the neurobehavioral effects associated with long-term exposure to ambient PM and ozone in adults. We conducted a secondary analysis of the Neurobehavioral Evaluation System-2 (NES2) data (including a simple reaction time test [SRTT] measuring motor response speed to a visual stimulus; a symbol-digit substitution test [SDST] for coding ability; and a serial-digit learning test [SDLT] for attention and short-term memory) from 1764 adult participants (aged 37.5+/-10.9 years) of the Third National Health and Nutrition Examination Survey in 1988-1991. Based on ambient PM(10) (PM with aerodynamic diameter <10microm) and ozone data from the EPA Aerometric Information Retrieval System database, estimated annual exposure prior to the examination were aggregated at the centroid of each census-block group of geocoded residences, using distance-weighted averages from all monitors in the residing and adjoining counties. Generalized linear models were constructed to examine the associations, adjusting for potential confounders. In age- and sex-adjusted models, PM(10) predicted reduced CNS functions, but the association disappeared after adjustment for sociodemographic factors. There were consistent associations between ozone and reduced performance in NES2. In models adjusting for demographics, socioeconomic status, lifestyle, household and neighborhood characteristics, and cardiovascular risk factors, ozone predicted high scores in SDST and SDLT, but not in SRTT. Each 10-ppb increase in annual ozone was associated with increased SDST and SDLT scores by 0.16 (95%CI: 0.01, 0.23) and 0.56 (95%CI: 0.07, 1.05), equivalent to 3.5 and 5.3 years of aging-related decline in cognitive performance. Our study provides the first epidemiological data

  9. Quantification of biological aging in young adults

    PubMed Central

    Belsky, Daniel W.; Caspi, Avshalom; Houts, Renate; Cohen, Harvey J.; Corcoran, David L.; Danese, Andrea; Harrington, HonaLee; Israel, Salomon; Levine, Morgan E.; Schaefer, Jonathan D.; Sugden, Karen; Williams, Ben; Yashin, Anatoli I.; Poulton, Richie; Moffitt, Terrie E.

    2015-01-01

    Antiaging therapies show promise in model organism research. Translation to humans is needed to address the challenges of an aging global population. Interventions to slow human aging will need to be applied to still-young individuals. However, most human aging research examines older adults, many with chronic disease. As a result, little is known about aging in young humans. We studied aging in 954 young humans, the Dunedin Study birth cohort, tracking multiple biomarkers across three time points spanning their third and fourth decades of life. We developed and validated two methods by which aging can be measured in young adults, one cross-sectional and one longitudinal. Our longitudinal measure allows quantification of the pace of coordinated physiological deterioration across multiple organ systems (e.g., pulmonary, periodontal, cardiovascular, renal, hepatic, and immune function). We applied these methods to assess biological aging in young humans who had not yet developed age-related diseases. Young individuals of the same chronological age varied in their “biological aging” (declining integrity of multiple organ systems). Already, before midlife, individuals who were aging more rapidly were less physically able, showed cognitive decline and brain aging, self-reported worse health, and looked older. Measured biological aging in young adults can be used to identify causes of aging and evaluate rejuvenation therapies. PMID:26150497

  10. Social comparisons in adults with type 2 diabetes: Patients' reasons for target selection.

    PubMed

    Arigo, Danielle; Cornell, Max; Smyth, Joshua M

    2018-07-01

    To examine reasons for selecting a social comparison target (i.e. a specific other for relative self-evaluation), and their influence on affect and motivation for self-care, in type 2 diabetes (T2DM). Adults with T2DM (n = 180, M A1c  = 7.6%) chose to read about one of four targets. Participants rated five reasons for their choice (strongly disagree - strongly agree), and rated affect and self-care motivation before and after reading. To boost confidence in my ability to manage diabetes was rated highest overall (ps < 0.01), though choosing worse-off (vs. better-off) targets was associated with to gain useful information about how to improve (p = 0.04, [Formula: see text] = 0.05). Selection in order to feel better worked for those who chose better-off targets; choosing worse-off targets for this purpose worsened mood and stress (ps < 0.04, [Formula: see text]s = 0.02). Choosing worse-off targets to learn about similar others reduced self-care motivation (p < 0.01, [Formula: see text] = 0.05). Selection in order to boost confidence showed increased motivation only among those who chose better-off targets (p = 0.01). Patients' reasons for a particular comparison are associated with short-term changes in affect and self-care motivation, and warrant greater empirical and clinical attention.

  11. Effects of age and auditory and visual dual tasks on closed-road driving performance.

    PubMed

    Chaparro, Alex; Wood, Joanne M; Carberry, Trent

    2005-08-01

    This study investigated how driving performance of young and old participants is affected by visual and auditory secondary tasks on a closed driving course. Twenty-eight participants comprising two age groups (younger, mean age = 27.3 years; older, mean age = 69.2 years) drove around a 5.1-km closed-road circuit under both single and dual task conditions. Measures of driving performance included detection and identification of road signs, detection and avoidance of large low-contrast road hazards, gap judgment, lane keeping, and time to complete the course. The dual task required participants to verbally report the sums of pairs of single-digit numbers presented through either a computer speaker (auditorily) or a dashboard-mounted monitor (visually) while driving. Participants also completed a vision and cognitive screening battery, including LogMAR visual acuity, Pelli-Robson letter contrast sensitivity, the Trails test, and the Digit Symbol Substitution (DSS) test. Drivers reported significantly fewer signs, hit more road hazards, misjudged more gaps, and increased their time to complete the course under the dual task (visual and auditory) conditions compared with the single task condition. The older participants also reported significantly fewer road signs and drove significantly more slowly than the younger participants, and this was exacerbated for the visual dual task condition. The results of the regression analysis revealed that cognitive aging (measured by the DSS and Trails test) rather than chronologic age was a better predictor of the declines seen in driving performance under dual task conditions. An overall z score was calculated, which took into account both driving and the secondary task (summing) performance under the two dual task conditions. Performance was significantly worse for the auditory dual task compared with the visual dual task, and the older participants performed significantly worse than the young subjects. These findings demonstrate

  12. Child incarceration and long-term adult health outcomes: a longitudinal study.

    PubMed

    Barnert, Elizabeth S; Abrams, Laura S; Tesema, Lello; Dudovitz, Rebecca; Nelson, Bergen B; Coker, Tumaini; Bath, Eraka; Biely, Christopher; Li, Ning; Chung, Paul J

    2018-03-12

    Purpose Although incarceration may have life-long negative health effects, little is known about associations between child incarceration and subsequent adult health outcomes. The paper aims to discuss this issue. Design/methodology/approach The authors analyzed data from 14,689 adult participants in the National Longitudinal Study of Adolescent to Adult Health (Add Health) to compare adult health outcomes among those first incarcerated between 7 and 13 years of age (child incarceration); first incarcerated at>or=14 years of age; and never incarcerated. Findings Compared to the other two groups, those with a history of child incarceration were disproportionately black or Hispanic, male, and from lower socio-economic strata. Additionally, individuals incarcerated as children had worse adult health outcomes, including general health, functional limitations (climbing stairs), depressive symptoms, and suicidality, than those first incarcerated at older ages or never incarcerated. Research limitations/implications Despite the limitations of the secondary database analysis, these findings suggest that incarcerated children are an especially medically vulnerable population. Practical implications Programs and policies that address these medically vulnerable children's health needs through comprehensive health and social services in place of, during, and/or after incarceration are needed. Social implications Meeting these unmet health and social service needs offers an important opportunity to achieve necessary health care and justice reform for children. Originality/value No prior studies have examined the longitudinal relationship between child incarceration and adult health outcomes.

  13. Deaf Stigma: Links Between Stigma and Well-Being Among Deaf Emerging Adults.

    PubMed

    Mousley, Victoria L; Chaudoir, Stephenie R

    2018-05-31

    Although stigma has been linked to suboptimal psychological and physical health outcomes in marginalized communities such as persons of color, sexual minorities, and people living with HIV/AIDS, no known research has examined these effects among deaf individuals. In the present research, we examine the associations between anticipated, enacted, and internalized stigma and psychological well-being (i.e., depressive symptoms, anxiety) and physical well-being (i.e., quality of life, alcohol use) among a sample of 171 deaf emerging adults. Furthermore, we consider whether trait resilience and benefit-finding moderate these effects. Enacted stigma, but not anticipated or internalized stigma, was related to worse depressive symptoms, anxiety, and quality of life. However, none of these variables predicted alcohol use and neither resilience nor benefit-finding moderated these effects. These findings are consistent with other research among marginalized populations, though they are also the first to suggest that experiences of discrimination are related to suboptimal well-being among deaf emerging adults. The discussion considers how these findings may illuminate the potential causes of disparities in well-being between hearing and deaf emerging adults.

  14. Association of Insulin Resistance With Cerebral Glucose Uptake in Late Middle-Aged Adults at Risk for Alzheimer Disease.

    PubMed

    Willette, Auriel A; Bendlin, Barbara B; Starks, Erika J; Birdsill, Alex C; Johnson, Sterling C; Christian, Bradley T; Okonkwo, Ozioma C; La Rue, Asenath; Hermann, Bruce P; Koscik, Rebecca L; Jonaitis, Erin M; Sager, Mark A; Asthana, Sanjay

    2015-09-01

    Converging evidence suggests that Alzheimer disease (AD) involves insulin signaling impairment. Patients with AD and individuals at risk for AD show reduced glucose metabolism, as indexed by fludeoxyglucose F 18-labeled positron emission tomography (FDG-PET). To determine whether insulin resistance predicts AD-like global and regional glucose metabolism deficits in late middle-aged participants at risk for AD and to examine whether insulin resistance-predicted variation in regional glucose metabolism is associated with worse cognitive performance. This population-based, cross-sectional study included 150 cognitively normal, late middle-aged (mean [SD] age, 60.7 [5.8] years) adults from the Wisconsin Registry for Alzheimer's Prevention (WRAP) study, a general community sample enriched for AD parental history. Participants underwent cognitive testing, fasting blood draw, and FDG-PET at baseline. We used the homeostatic model assessment of peripheral insulin resistance (HOMA-IR). Regression analysis tested the statistical effect of HOMA-IR on global glucose metabolism. We used a voxelwise analysis to determine whether HOMA-IR predicted regional glucose metabolism. Finally, predicted variation in regional glucose metabolism was regressed against cognitive factors. Covariates included age, sex, body mass index, apolipoprotein E ε4 genotype, AD parental history status, and a reference region used to normalize regional uptake. Regional glucose uptake determined using FDG-PET and neuropsychological factors. Higher HOMA-IR was associated with lower global glucose metabolism (β = -0.29; P < .01) and lower regional glucose metabolism across large portions of the frontal, lateral parietal, lateral temporal, and medial temporal lobes (P < .05, familywise error corrected). The association was especially robust in the left medial temporal lobe (R2 = 0.178). Lower glucose metabolism in the left medial temporal lobe predicted by HOMA-IR was significantly related

  15. Performance of Hispanics and Non-Hispanic Whites on the NIH Toolbox Cognition Battery: the roles of ethnicity and language backgrounds.

    PubMed

    Flores, Ilse; Casaletto, Kaitlin B; Marquine, Maria J; Umlauf, Anya; Moore, David J; Mungas, Dan; Gershon, Richard C; Beaumont, Jennifer L; Heaton, Robert K

    2017-05-01

    This study examined the influence of Hispanic ethnicity and language/cultural background on performance on the NIH Toolbox Cognition Battery (NIHTB-CB). Participants included healthy, primarily English-speaking Hispanic (n = 93; Hispanic-English), primarily Spanish-speaking Hispanic (n = 93; Hispanic-Spanish), and English speaking Non-Hispanic white (n = 93; NH white) adults matched on age, sex, and education levels. All participants were in the NIH Toolbox national norming project and completed the Fluid and Crystallized components of the NIHTB-CB. T-scores (demographically-unadjusted) were developed based on the current sample and were used in analyses. Spanish-speaking Hispanics performed worse than English-speaking Hispanics and NH whites on demographically unadjusted NIHTB-CB Fluid Composite scores (ps < .01). Results on individual measures comprising the Fluid Composite showed significant group differences on tests of executive inhibitory control (p = .001), processing speed (p = .003), and working memory (p < .001), but not on tests of cognitive flexibility or episodic memory. Test performances were associated with language/cultural backgrounds in the Hispanic-Spanish group: better vocabularies and reading were predicted by being born outside the U.S., having Spanish as a first language, attending school outside the U.S., and speaking more Spanish at home. However, many of these same background factors were associated with worse Fluid Composites within the Hispanic-Spanish group. On tests of Fluid cognition, the Hispanic-Spanish group performed the poorest of all groups. Socio-demographic and linguistic factors were associated with those differences. These findings highlight the importance of considering language/cultural backgrounds when interpreting neuropsychological test performances. Importantly, after applying previously published NIHTB-CB norms with demographic corrections, these language/ethnic group differences are eliminated.

  16. Performance of Hispanics and Non-Hispanic Whites on the NIH Toolbox Cognition Battery: The Roles of Ethnicity and Language Backgrounds

    PubMed Central

    Flores, Ilse; Casaletto, Kaitlin B.; Marquine, Maria J.; Umlauf, Anya; Moore, David J.; Mungas, Dan; Gershon, Richard C.; Beaumont, Jennifer L.; Heaton, Robert K.

    2017-01-01

    Objective This study examined the influence of Hispanic ethnicity and language/cultural background on performance on the NIH Toolbox Cognition Battery (NIHTB-CB). Method Participants included healthy, primarily English-speaking Hispanic (n=93; Hispanic-English), primarily Spanish-speaking Hispanic (n=93; Hispanic-Spanish), and English speaking Non-Hispanic White (n=93; NH White) adults matched on age, sex, and education levels. All participants were in the NIH Toolbox national norming project and completed the Fluid and Crystallized components of the NIHTB-CB. T-scores (demographically-unadjusted) were developed based on the current sample and were used in analyses. Results Spanish-speaking Hispanics performed worse than English-speaking Hispanics and NH Whites on demographically-unadjusted NIHTB-CB Fluid Composite scores (ps<.01). Results on individual measures comprising the Fluid Composite showed significant group differences on tests of executive inhibitory control (p=.001), processing speed (p=.003), and working memory (p<.001), but not on tests of cognitive flexibility or episodic memory. Test performances were associated with language/cultural backgrounds in the Hispanic-Spanish group: better vocabularies and reading were predicted by being born outside the U.S., having Spanish as a first language, attending school outside the U.S., and speaking more Spanish at home. However, many of these same background factors were associated with worse Fluid Composites within the Hispanic-Spanish group. Conclusions On tests of Fluid cognition, the Hispanic-Spanish group performed the poorest of all groups. Socio-demographic and linguistic factors were associated with those differences. These findings highlight the importance of considering language/cultural backgrounds when interpreting neuropsychological test performances. Importantly, after applying previously published NIHTB-CB norms with demographic corrections, these language/ethnic group differences are eliminated

  17. For the Arts To Have Meaning...A Model of Adult Education in Performing Arts Organizations.

    ERIC Educational Resources Information Center

    Kitinoja, L.; Heimlich, J. E.

    A model of adult education appears to function in the outreach programs of three Columbus (Ohio) performing arts organizations. The first tier represents the arts organization's board of trustees, and the second represents the internal administration of the company. Two administrative bodies are arbitrarily labelled as education and marketing,…

  18. A population-based study of demographical variables and ability to perform activities of daily living in adults with osteogenesis imperfecta.

    PubMed

    Wekre, Lena Lande; Frøslie, Kathrine Frey; Haugen, Lena; Falch, Jan A

    2010-01-01

    To describe demographical variables, and to study functional ability to perform activities of daily life in adults with osteogenesis imperfecta (OI). Population-based study. Ninety-seven patients aged 25 years and older, 41 men and 56 women, were included. For the demographical variables, comparison was made to a matched control-group (475 persons) from the Norwegian general population. Structured interviews concerning social conditions, employment and educational issues and clinical examination were performed. The Sunnaas Activities of Daily Living (ADL) Index was used to assess the ability to perform ADL. The prevalence of clinical manifestations according to Sillence was in accordance with other studies. Demographical variables showed that most adults with OI are married and have children. They had a higher educational level than the control group, but the employment rate was significantly lower. However, the rate of employed men was similar in both groups. Adult persons with OI achieved a high score when tested for ADL. Adults with OI are well educated compared with the general population, and most of them are employed. High scores when tested for ADL indicate that most of them are able to live their lives independently, even though there are some differences according to the severity of the disorder.

  19. Cognitive function affects trainability for physical performance in exercise intervention among older adults with mild cognitive impairment.

    PubMed

    Uemura, Kazuki; Shimada, Hiroyuki; Makizako, Hyuma; Doi, Takehiko; Yoshida, Daisuke; Tsutsumimoto, Kota; Anan, Yuya; Suzuki, Takao

    2013-01-01

    Although much evidence supports the hypothesis that cognitive function and physical function are interrelated, it is unclear whether cognitive decline with mild cognitive impairment influences trainability of physical performance in exercise intervention. The purpose of this study was to examine the association between cognitive function at baseline and change in physical performance after exercise intervention in older adults with mild cognitive impairment. Forty-four older adults diagnosed with mild cognitive impairment based on the Peterson criteria (mean age 74.8 years) consented to and completed a 6-month twice weekly exercise intervention. The Timed Up and Go (TUG) test was used as a measure of physical performance. The Mini-Mental State Examination (MMSE), Trail Making Test Part B, Geriatric Depression Scale, baseline muscle strength of knee extension, and attendance rate of intervention, were measured as factors for predicting trainability. In the correlation analysis, the change in TUG showed modest correlations with attendance rate in the exercise program (r = -0.354, P = 0.027) and MMSE at baseline (r = -0.321, P = 0.034). A multiple regression analysis revealed that change in TUG was independently associated with attendance rate (β = -0.322, P = 0.026) and MMSE score (β = -0.295, P = 0.041), controlling for age and gender. General cognitive function was associated with improvements in physical performance after exercise intervention in subjects with mild cognitive impairment. Further research is needed to examine the effects of exercise programs designed to address cognitive obstacles in older adults with mild cognitive impairment.

  20. Mechanical performance comparison between RotaFlow and CentriMag centrifugal blood pumps in an adult ECLS model.

    PubMed

    Yulong Guan; Xiaowei Su; McCoach, Robert; Kunselman, Allen; El-Banayosy, Aly; Undar, Akif

    2010-03-01

    Centrifugal blood pumps have been widely adopted in conventional adult cardiopulmonary bypass and circulatory assist procedures. Different brands of centrifugal blood pumps incorporate distinct designs which affect pump performance. In this adult extracorporeal life support (ECLS) model, the performances of two brands of centrifugal blood pump (RotaFlow blood pump and CentriMag blood pump) were compared. The simulated adult ECLS circuit used in this study included a centrifugal blood pump, Quadrox D membrane oxygenator and Sorin adult ECLS tubing package. A Sorin Cardiovascular(R) VVR(R) 4000i venous reservoir (Sorin S.p.A., Milan, Italy) with a Hoffman clamp served as a pseudo-patient. The circuit was primed with 900ml heparinized human packed red blood cells and 300ml lactated Ringer's solution (total volume 1200 ml, corrected hematocrit 40%). Trials were conducted at normothermia (36 degrees C). Performance, including circuit pressure and flow rate, was measured for every setting analyzed. The shut-off pressure of the RotaFlow was higher than the CentriMag at all measurement points given the same rotation speed (p < 0.0001). The shut-off pressure differential between the two centrifugal blood pumps was significant and increased given higher rotation speeds (p < 0.0001). The RotaFlow blood pump has higher maximal flow rate (9.08 +/- 0.01L/min) compared with the CentriMag blood pump (8.37 +/- 0.02L/min) (p < 0.0001). The blood flow rate differential between the two pumps when measured at the same revolutions per minute (RPM) ranged from 1.64L/min to 1.73L/min. The results obtained in this experiment demonstrate that the RotaFlow has a higher shut-off pressure (less retrograde flow) and maximal blood flow rate than the CentriMag blood pump. Findings support the conclusion that the RotaFlow disposable pump head has a better mechanical performance than the CentriMag. In addition, the RotaFlow disposable pump is 20-30 times less expensive than the CentriMag.