Ageing memory:Use versus impairment

An uncued recall technique was used to compare recall of autobiographical events by two groups of elderly volunteers of equivalent general intelligence (assessed by unadjusted scores on the AH4 intelligence test). One group lived in residential care, and the other led independent lives. Residential care subjects recalled and spontaneously rehearsed more memories from their early than their recent lives, whereas the reverse was true for the independent elderly. The effects of senile confusional states were also investigated by testing a subgroup of cognitively impaired subjects, also in residential care. Although unimpaired elderly in care produced more early than recent memories, they were still able to produce substantial numbers of recent memories. Impaired subjects produced very few memories, those they did produce were mainly early ones. Frequency of rehearsal (or reminiscence) seemed to affect the probability of elicitation of a memory. People in institutions more often rehearse memories of early events. Frequency of rehearsal is thus a function of the use which people in different situations make of their memories. Cognitive impairment due to organic neurological changes in the elderly had a characteristic effect on the abundance of recall from recent life. 1991 The British Psychological Societ

Cognitive function in the Caerphilly study: Associations with age, social class, education and mood

Baseline cognitive function was established for a study of pre-symptomatic cognitive decline in 1870 men from the general population aged 55-69 years as part of the third examination of the Caerphilly Study. Cognitive assessment included the AH4, a four choice serial reaction time task, a modified CAMCOG, MMSE, NART and various memory tests. Distributions and relationships with age, social class, education and mood at time of testing are presented for a younger population than has previously been available. Multiple linear regression showed cognitive function to be independently associated with all four factors. The age effect was equivalent to one half of a standard deviation (SD) in CRT and AH4 scores. Only the NART score was not associated with age, supporting the use of NART score as an estimate of pre-morbid IQ. The largest age adjusted differences between men with low and normal mood were for the AH4 (3 points, t = 5.6, p < 0.0001) and the CAMCOG (2 points, t = 5.8, p < 0.0001). The smallest age adjusted effect of mood was for the CRT (33 ms, t = 2.14, p = 0.32) and the MMSE (0.4 points, t = 2.97, p = 0.003). Age, mood and education adjusted social class effects were very large ranging between around 0.5 SD for the CRT, and 1.0 SD for the AH4 and NART, respectively. For educational status age, mood and social class adjusted differences were also substantial with tests for trend showing the largest differences for the NART (t = 12, p < 0.0001) and modified CAMCOG (t = 10.6, p < 0.0001) with the smallest differences for the CRT (t = 2.73, p = 0.006)

Concordance of Cornell medical index self-reports to structured clinical assessment for the identification of physical health status

Self-reported questionnaires are frequently used to assess health status in epidemiological studies. The Cornell medical index is one such tool used to determine the presence of physical and psychiatric illness but its accuracy and value have been questioned. In this study we have assessed the ability of the CMI to predict health status in two separate patient populations (n=101, 88) by comparison to a structured medical assessment based on the SENIEUR protocol by two physicians. There was good agreement between medication use reported on the CMI and on medical assessment (k=0.79; CI: 0.70–0.88). Accuracy of prediction of the CMI for specific medical conditions was good 89–99%. A threshold score from the CMI was not predictive of health as determined by the SENIEUR protocol. In our older populations, we conclude that the CMI accurately predicted health status. The determination of normal health by a threshold score was poorly predictive of heath status. Self-reported medication use was the best predictor of health status