Short term change in memory metamemory in the elderly

Issued as Progress report summary, Project no. G-42-625 (continues G-42-615; continued by G-42-604

Individual differences in adult cognitive development (RCDA)

Issued as Progress report summary, Project G-42-60

Tailored Information and Automated Reminding to Improve Medication Adherence in Spanish- and English-Speaking Elders Treated for Memory Impairment.

Medication adherence is recognized as an issue of critical importance within health care, as many patients do not take their medications as prescribed. This study evaluated two interventions targeted at improving adherence in elderly patients being treated for memory impairments. Twenty-seven participants were randomly assigned to control (n = 11), automated reminding (n = 8), or tailored information conditions (n = 8). Medication adherence was evaluated with an electronic pill bottle. Generalized estimating equation (GEE) models assessed the effects of the interventions on electronically monitored medication adherence after controlling for covariates. Results showed that individuals in both intervention groups had higher levels of medication adherence than those in the control group. The presence of a caregiver was associated with substantially higher levels of adherence. Verbal memory, but not general cognitive status, predicted better adherence. Mood, health literacy, and executive functions were not associated with adherence. Results thus suggest that both automated reminding and tailored information interventions may improve medication adherence in elders, even among those with memory impairments

Relations between cognitive status and medication adherence in patients treated for memory disorders.

Medication adherence has been increasingly recognized as an important factor in elderly persons\u27 health. Various studies have shown that medication non-adherence is associated with poor health status in this population. As part of a study of the effects of two interventions to promote medication adherence in patients treated for memory problems, information on medication adherence and cognitive status was collected at 3-month intervals. Twenty-seven participants (16 men, 11 women, age 71-92 years) were assigned to control or treatment conditions and adherence was evaluated with an electronic monitoring device. Cognitive status was evaluated at 3-month intervals beginning in April of 2003 and continuing through September of 2006. We have previously reported on the effectiveness of these interventions to promote adherence. In this paper, we examine the relations of cognitive status and adherence over time using a partial least squares path model in order to evaluate the extent to which adherence to cholinesterase medications was related to cognitive status. Adherence predicted cognitive status at later time points while cognition did not, in general, predict adherence. Results thus suggest that interventions to ensure high levels of medication adherence may be important for maintaining cognitive function in affected elderly people

Expectations about Memory Change Across the Life Span Are Impacted By Aging Stereotypes.

This study examined whether expectations about memory change with age vary for different personality types. Four adjectives from each of Hummert’s age-stereotype trait sets were selected to create 11 adjective clusters varying in both valence (positive versus negative) and relevance to memory functioning. Three hundred and seventy three participants in three age groups rated the memory abilities of target adults, defined by the adjective clusters, across the adult life span. Consistent with past studies, participants believed in age-related memory decline. However, participants rated target adults with positive personality traits as having better memory ability and less age-related memory decline than target adults with negative personality traits. This effect was larger when the traits were relevant to memory than when they were not. Finally, older participants were more strongly influenced by both the valence and the relevance of the personality descriptions than younger participants

Factors related to medication adherence in memory disorder clinic patients.

Medication adherence is a substantial problem in the elderly. It may be even more important among elderly persons with memory problems, since other factors that lead to non-adherence may be compounded with the memory problems themselves. The objective was to determine whether a model that integrates research on medication adherence from several research domains is useful in understanding adherence in elderly patients. The methodology involved a cross-sectional observational study using a convenience sample of 63 patients drawn from a university-affiliated outpatient memory disorders clinic. The primary measure of medication adherence was caregivers\u27 reports of patients\u27 medication adherence. Patients and their caregivers were asked questions assessing their beliefs about the seriousness of each condition for which a medication was prescribed and the likely outcome of that condition without treatment. Additional data collected included presence of side effects, total number of medications taken, and patients\u27 mood and cognitive status. Multilevel path analysis confirmed several model-based predictions. Caregivers\u27 reports of adherence were predicted by estimates of disease outcome, the presence of side effects, and patients\u27 relying on themselves to remember to take medications. Results partially confirm the integrative model in understanding medication adherence in these patients. Patients\u27 beliefs about the likely effect of medication treatment for their condition and the presence of side effects influence reported medication adherence. Results thus suggest that efforts to educate patients about the likely response of their medical condition to treatment and to assess and deal with medication side effects might improve patient adherence

Strategy-adaptation memory training: predictors of older adults' training gains

AbstractOver the past decades, memory training interventions have been developed in an attempt to stabilize or enhance memory functioning in aging. Only recently has attention been paid to individual differences in training gains and consequently to predictors of such gains. The aim of the present study was to identify which specific cognitive mechanisms/processes or components of the intervention were responsible for the desired change and which individuals were more responsive to memory strategic training. Eighty-one older adults (aged 55 to 82) were involved in a four-session strategy-adaptation training based on a learner-oriented approach that has previously been found to be effective in improving memory performance in practiced and untrained tasks. Results showed that baseline performance in memory tasks predicted the gains in the practiced task. Baseline performance in memory tasks and other cognitive variables, such as working memory, processing speed, and verbal knowledge predicted transfer effects. Interestingly, we found that the magnitude of training gain on the associative memory practiced task predicted the gains in the transfer tasks, suggesting those who best implemented the targeted strategies during training realized greater transfer to other tasks. Our study shows that older adults with larger cognitive resources will benefit more from interventions focused on the generalization via active processes

International approaches to protecting and retaining trees on private urban land

Most studies of urban forest management look at vegetation on public land. Yet, to meet ambitious urban forest targets, cities must attempt to maintain or increase trees and canopy cover on private urban land too. In this study, we review and evaluate international approaches to protecting and retaining trees on private urban land. Our study combines a systematic academic literature review, two empirical social science studies on the views of urban forest professionals, and a global case study review of innovative regulations and incentives aimed at protecting and retaining trees on private urban land. Case studies were evaluated for the extent they exceeded minimum standards or went beyond ?business-as-usual?. We found that the most innovative mechanisms combine many regulations, instead of relying on a single regulation, and use financial incentives to retain or plant trees in newly developed or re-developed sites, as well as private residences. We did not find any cases where appropriate monitoring was in place to determine the efficacy and efficiency of these mechanisms. We also found no single simple solution that could effectively and efficiently protect and retain trees on private land. Only by combining policies, planning schemes, local laws, and financial incentives with community engagement and stewardship will cities protect and retain trees on private land. Useful and innovative ways to protecting and retaining trees on private land involves providing solutions at multiple governments levels, embedding trees in existing strategic policy and management solutions, incentivising positive behavior, creating regulations that require payment up front, and engaging the broader community in private tree stewardship.Peer reviewe

Between fixities and flows : Navigating place attachments in an increasingly mobile world

This paper develops a theoretical argument for how place attachments are forged and become dynamically linked to increasingly common mobility practices. First, we argue that mobilities, rather than negating the importance of place, shift our understanding of place and the habitual ways we relate to and bond with places as distinct from a conception of place attachment premised on fixity and stability. Second, we document how the body of research on place attachment has both reinforced and contested 'sedentaristic' assumptions criticized within the so-called 'mobilities turn' in the social sciences. Third, we present a conceptual framework, built around different modes of interrelation between fixity and flow, as a way to re-theorize, link and balance the various studies of place attachment that have grappled with mobility. Finally, we sketch out the main research implications of this framework for advancing our understanding of place attachment in a mobile world.Peer reviewe