Performance on the Boston Naming Test in English-Spanish Bilingual Older Adults: Some Considerations

Gollan, Fennema-Notestine, Montoya, and Jernigan (this issue) present a timely and clinically relevant study that examines the impact of bilingualism on the performance on the Boston Naming Test in older adults. In light of the methodology employed, we weigh different potential interpretations of the findings and make recommendations for future studies. (JINS, 2007, 13, 212–214.

Incentives in Health: Different Prescriptions for Physicians and Patients

Financial incentives abound in health care. They are found in the ways physicians are paid and in the ways health insurance coverage, co-payments, and deductibles are structured for patients. The effects of these incentives are often understood through conventional economic principles, with the assumption that individuals are self-interest maximizers who respond directly to changes in incentives. In contrast, behavioral economics imports insights from psychology and recognizes that individuals often do not respond to incentives as rationally as they might. In some cases, individuals lack information, but in others, they just seem to act contrary to their own known interests, for example, when they overeat, fail to take medication, or neglect to wear seat belts

Assessing Value in Health Care Programs

Many health care services provided in the United States are of low value, meaning that the cost of providing those services is high relative to the health care benefit they confer. In some cases, the care provided may have no value or even, on average, may be harmful. Examples of low- or negative-value services include unnecessary surgery or diagnostic imaging that will not change management. Given estimates that 30% of the $2.5 trillion the United States spends on health care services each year may provide little benefit,1 there is a widespread eagerness to enhance the ratio of benefits to costs

Failure to Recover from Proactive Semantic Interference Differentiates Amnestic Mild Cognitive Impairment and PreMCI from Normal Aging after Adjusting for Initial Learning Ability

Background: There is increasing evidence that the failure to recover from proactive semantic interference (frPSI) may be an early cognitive marker of preclinical Alzheimer’s disease (AD). However, it is unclear whether frPSI effects reflect deficiencies in an individual’s initial learning capacity versus the actual inability to learn new semantically related targets. Objective: The current study was designed to adjust for learning capacity and then to examine the extent to which frPSI, proactive semantic interference (PSI) and retroactive semantic interference (RSI) effects could differentiate between older adults who were cognitively normal (CN), and those diagnosed with either Pre-Mild Cognitive Impairment (PreMCI) or amnestic MCI (aMCI). Methods: We employed the LASSI-L cognitive stress test to examine frPSI, PSI and RSI effects while simultaneously controlling for the participant’s initial learning capacity among 50 CN, 35 aMCI, and 16 PreMCI participants who received an extensive diagnostic work-up. Results: aMCI and PreMCI participants showed greater frPSI deficits (50% and 43.8% respectively) compared to only 14% of CNparticipants. PSI effects were observed for aMCI but not PreMCI participants relative to their CN counterparts. RSI failed to differentiate between any of the study groups. Conclusion: By using participants as their own controls and adjusting for overall learning and memory, it is clear that frPSI deficits occur with much greater frequency in individuals at higher risk for Alzheimer’s disease (AD), and likely reflect a failure of brain compensatory mechanisms.Fil: Curiel, Rosie E.. University of Miami; Estados UnidosFil: Crocco, Elizabeth A.. University of Miami; Estados UnidosFil: Raffo, Arlene. University of Miami; Estados UnidosFil: Guinjoan, Salvador Martín. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentina. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; ArgentinaFil: Nemeroff, Charles B.. University of Miami; Estados UnidosFil: Penate, Ailyn. Mount Sinai Medical Center; Estados Unidos. University of Miami; Estados UnidosFil: Piña, Daema. University of Miami; Estados UnidosFil: Loewenstein, David A.. Mount Sinai Medical Center; Estados Unidos. University of Miami; Estados Unido

Cognitive abilities that predict success in a computer-based training program.

PURPOSE: The purposes of this study were (a) to identify cognitive abilities and other factors related to successful completion of training for computer-based tasks that simulated real jobs and (b) to create a brief assessment battery useful in assessing older adults for these kinds of jobs. DESIGN AND METHODS: Participants from three age groups (young, middle-aged, and older) completed a battery of cognitive measures. They then trained on one of three computer-based tasks that simulated actual jobs and were asked to perform the tasks for 3 days. We recorded whether they completed training and whether and how well they did the tasks. In a series of logistic regressions, we evaluated the ability of a subset of cognitive measures drawn from a larger battery to predict participants\u27 ability to successfully complete training and go on to task performance. RESULTS: Results confirmed theory-based expectations that measures of domain knowledge, crystallized intelligence, memory, and psychomotor speed would predict success in computer-based activities. A brief battery was able to predict older adults\u27 successful completion of training for one task but was less useful for another. IMPLICATIONS: A brief battery of cognitive measures may be useful in evaluating individuals for job selection. Different measures are related to job-related criteria depending on task and group evaluated, although it was not possible to identify a reduced battery for one task. The specific cognitive abilities related to participants\u27 success have implications for task and interface design for the elderly population

Do Financial Incentives Reduce Intrinsic Motivation for Weight Loss? Evidence from Two Tests of Crowding Out

Financial incentives have been used successfully to promote health behaviors, however they may be counterproductive if they crowd out pre-existing intrinsic motivation and lead to a decrease in performance once incentives are removed to a level lower than they had never been introduced. We provide new evidence that incentives do not crowd out intrinsic motivation in the case of weight loss. We measure motivation via a survey administered before and after the introduction of financial incentives in two weight loss field experiments and find no evidence that intrinsic motivation fell among participants receiving incentives compared to control participants who do not receive incentives

Semantic Interference Deficits and the Detection of Mild Alzheimer’s Disease and Mild Cognitive Impairment Without Dementia

Impairment in delayed recall has traditionally been considered a hallmark feature of Alzheimer’s disease (AD). However, vulnerability to semantic interference may reflect early manifestations of the disorder. In this study, 26 mildly demented AD patients (mild AD), 53 patients with mild cognitive impairment without dementia (MCI), and 53 normal community-dwelling elders were first presented 10 common objects that were recalled over 3 learning trials. Subjects were then presented 10 new semantically related objects followed by recall for the original targets. After controlling for the degree of overall memory impairment, mild AD patients demonstrated greater proactive but equivalent retroactive interference relative to MCI patients. Normal elderly subjects exhibited the least amount of proactive and retroactive interference effects. Recall for targets susceptible to proactive interference correctly classified 81.3% of MCI patients and 81.3% of normal elderly subjects, outperforming measures of delayed recall and rate of forgetting. Adding recognition memory scores to the model enhanced both sensitivity (84.6%) and specificity (88.5%). A combination of proactive and retroactive interference measures yielded sensitivity of 84.6% and specificity of 96.2% in differentiating mild AD patients from normal older adults. Susceptibility to proactive semantic interference may be an early cognitive feature of MCI and AD patients presenting for clinical evaluation. (JINS, 2004, 10, 91–100.

Effect of Assessment Method on the Discrepancy between Judgments of Health Disorders People Have and Do Not Have: A Web Study

Three experiments on the World Wide Web asked subjects to rate the severity of common health disorders such as acne or arthritis. People who had a disorder (“Haves”) tended to rate it as less severe than people who did not have it (“Not-haves”). Two explanations of this Have versus Not-have discrepancy were rejected. By one account, people change their reference point when they rate a disorder that they have. More precise reference points would, on this account, reduce the discrepancy, but, if anything, the discrepancy was larger. By another account, people who do not have the disorder focus on attributes that are most affected by it, and the discrepancy should decrease when people make ratings on several attributes. Again, if anything, the discrepancy increased when ratings were on separate attributes (combined by a weighted average). The discrepancy varied in size and direction across disorders. Subjects also thought that they would be less affected than others