Does the Key Task Measure Prospective Memory? Cautionary Findings from Parallel Studies in HIV Disease and Older Adults

Abstract Objective Despite its brevity and face validity, little is known about the construct validity of the naturalistic “Key Task” of prospective memory (PM), in which an examinee is instructed to remind the examiner at a designated time to retrieve keys (or another belonging) placed out of sight. Method Study 1 included 162 HIV+ and 52 HIV− comparison participants who completed the Key Task alongside well-validated measures of PM and a comprehensive neuropsychological battery that included everyday functioning measures. Study 2 used broadly parallel methods in 168 older community-dwelling Australians. Results Overall, the Key Task was not reliably associated with neurocognitive functioning (including clinical and experimental measures of PM), PM symptoms, or everyday functioning in either sample. Conclusions The Key Task did not demonstrate compelling evidence of construct validity among persons living with HIV disease or older adults, which raises doubts regarding its clinical usefulness as a measure of PM.

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Factor Structure of the Memory for Intentions Test (MIsT) in Samples of Older Adults and People with HIV Disease

10.31234/osf.io/3fsxh ◽

2021 ◽

Author(s):

Kelli Sullivan ◽

Matthew Gallagher ◽

Romola S. Bucks ◽

Michael Weinborn ◽

Steven Paul Woods

Keyword(s):

Older Adults ◽

Factor Structure ◽

Prospective Memory ◽

Factor Model ◽

Factor Models ◽

Community Dwelling ◽

People Living With Hiv ◽

Hiv Disease ◽

Memory For Intentions ◽

The One

Objective: The Memory for Intentions Test (MIsT) is a clinical measure of prospective memory that has strong evidence for convergent, discriminative, and ecological validity. This study evaluates the latent structure of the MIsT among two samples who may experience prospective memory deficits: older adults and people living with HIV disease. Participants and Methods: Study participants included 303 people with HIV disease (ages 18-67) and 267 community-dwelling older adults (ages 50-91). Confirmatory factor analyses of the MIsT were conducted separately in each sample. We evaluated a one-factor model, as well as three two-factor models with the MIsT items loading onto each factor based on cue type, delay interval, or response modality, respectively. Results: The one-factor model provided the best (and most parsimonious) fit to the data in both study samples. All two-factor models also demonstrated good fit statistics, although correlations between the two factors in each model were high and none of the two-factor models provided a significantly better fit than the one-factor model. Conclusions: Results provide support for the factor structure of the MIsT in older adults and people with HIV disease. A total score for the MIsT provides the most parsimonious solution, although available evidence and theory also support the use of subscales (e.g., cue type). Future studies of the MIsT would be useful to determine its psychometrics in different clinical populations.

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Preliminary Development of a Screening Tool for Pre-Clinical Dysphagia in Community Dwelling Older Adults

Geriatrics ◽

10.3390/geriatrics3040090 ◽

2018 ◽

Vol 3 (4) ◽

pp. 90 ◽

Cited By ~ 4

Author(s):

Aarthi Madhavan ◽

Giselle Carnaby ◽

Karishma Chhabria ◽

Michael Crary

Keyword(s):

Older Adults ◽

Construct Validity ◽

Internal Consistency ◽

Screening Tool ◽

Community Dwelling ◽

Screening Tools ◽

Face Validity ◽

Psychometric Validation ◽

Patient Reported ◽

Community Dwelling Older Adults

Evidence suggests that community dwelling older adults (CDOA) are at risk for dysphagia (swallowing difficulties). Dysphagia is often unidentified until related morbidities like under nutrition or pneumonia occur. These cases of unidentified dysphagia, prior to any clinical intervention, may be termed ‘pre-clinical dysphagia’. Identifying pre-clinical dysphagia is challenged by the lack of validated tools appropriate for CDOA. This study addresses preliminary development of a novel patient reported outcome (PRO) screening tool for pre-clinical dysphagia. Initially, 34 questions were developed from literature review and expert opinion. Following pilot testing (n = 53), the questionnaire was revised and tested on 335 additional CDOA. Face validity, content validity, item analysis, reliability (internal consistency), and construct validity (exploratory factor analysis) measures were completed. Psychometric validation resulted in a 17-question PRO tool. Construct analysis identified a three-factor model that explained 67.345% of the variance. Emergent factors represented swallowing effort, physical function, and cognitive function. The results revealed strong construct validity and internal consistency (Cronbach’s α = 0.90). A novel, simple PRO incorporating multiple function domains associated with aging demonstrated strong preliminary psychometric properties. This tool is more comprehensive and aging-focused than existing dysphagia screening tools. Inclusion of multiple domains may be key in early identification of pre-clinical dysphagia.

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Neurocognitive SuperAging in Older Adults Living With HIV: Demographic, Neuromedical and Everyday Functioning Correlates

Journal of the International Neuropsychological Society ◽

10.1017/s1355617719000018 ◽

2019 ◽

Vol 25 (05) ◽

pp. 507-519 ◽

Cited By ~ 5

Author(s):

Rowan Saloner ◽

Laura M. Campbell ◽

Vanessa Serrano ◽

Jessica L. Montoya ◽

Elizabeth Pasipanodya ◽

...

Keyword(s):

Older Adults ◽

Multinomial Logistic Regression ◽

Future Research ◽

Hiv Disease ◽

Neurocognitive Performance ◽

Everyday Functioning ◽

Disease Characteristics ◽

Age Related ◽

Persons Living With Hiv ◽

Living With Hiv

Objectives:Studies of neurocognitively elite older adults, termedSuperAgers, have identified clinical predictors and neurobiological indicators of resilience against age-related neurocognitive decline. Despite rising rates of older persons living with HIV (PLWH), SuperAging (SA) in PLWH remains undefined. We aimed to establish neuropsychological criteria for SA in PLWH and examined clinically relevant correlates of SA.Methods: 734 PLWH and 123 HIV-uninfected participants between 50 and 64 years of age underwent neuropsychological and neuromedical evaluations. SA was defined as demographically corrected (i.e., sex, race/ethnicity, education) global neurocognitive performance within normal range for 25-year-olds. Remaining participants were labeled cognitively normal (CN) or impaired (CI) based on actual age. Chi-square and analysis of variance tests examined HIV group differences on neurocognitive status and demographics. Within PLWH, neurocognitive status differences were tested on HIV disease characteristics, medical comorbidities, and everyday functioning. Multinomial logistic regression explored independent predictors of neurocognitive status.Results:Neurocognitive status rates and demographic characteristics differed between PLWH (SA=17%; CN=38%; CI=45%) and HIV-uninfected participants (SA=35%; CN=55%; CI=11%). In PLWH, neurocognitive groups were comparable on demographic and HIV disease characteristics. Younger age, higher verbal IQ, absence of diabetes, fewer depressive symptoms, and lifetime cannabis use disorder increased likelihood of SA. SA reported increased independence in everyday functioning, employment, and health-related quality of life than non-SA.Conclusions:Despite combined neurological risk of aging and HIV, youthful neurocognitive performance is possible for older PLWH. SA relates to improved real-world functioning and may be better explained by cognitive reserve and maintenance of cardiometabolic and mental health than HIV disease severity. Future research investigating biomarker and lifestyle (e.g., physical activity) correlates of SA may help identify modifiable neuroprotective factors against HIV-related neurobiological aging. (JINS, 2019,25, 507–519)

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Validation of the German Life-Space Assessment (LSA-D): cross-sectional validation study in urban and rural community-dwelling older adults

BMJ Open ◽

10.1136/bmjopen-2021-049926 ◽

2021 ◽

Vol 11 (7) ◽

pp. e049926

Author(s):

Sandra Angelika Mümken ◽

Paul Gellert ◽

Malte Stollwerck ◽

Julie Lorraine O'Sullivan ◽

Joern Kiselev

Keyword(s):

Older Adults ◽

Construct Validity ◽

Outcome Measures ◽

Total Sample ◽

Community Dwelling ◽

Secondary Outcome ◽

Life Space ◽

Cross Sectional ◽

The Past ◽

Community Dwelling Older Adults

ObjectivesTo develop a German version of the original University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA-D) for measurement of community mobility in older adults within the past 4 weeks and to evaluate its construct validity for urban and rural populations of older adults.DesignCross-sectional validation study.SettingTwo study centres in urban and rural German outpatient hospital settings.ParticipantsIn total, N=83 community-dwelling older adults were recruited (n=40 from urban and n=43 from rural areas; mean age was 78.5 years (SD=5.4); 49.4% men).Primary and secondary outcome measuresThe final version of the translated LSA-D was related to limitations in activities and instrumental activities of daily living (ADL/iADL) as primary outcome measure (primary hypothesis); and with sociodemographic factors, functional mobility, self-rated health, balance confidence and history of falls as secondary outcome measures to obtain construct validity. Further descriptive measurements of health included hand grip strength, screening of cognitive function, comorbidities and use of transportation. To assess construct validity, correlations between LSA-D and the primary and secondary outcome measures were examined for the total sample, and urban and rural subsamples using bivariate regression and multiple adjusted regression models. Descriptive analyses of LSA-D included different scoring methods for each region. All parameters were estimated using non-parametric bootstrapping procedure.ResultsIn the multiple adjusted model for the total sample, number of ADL/iADL limitations (β=−0.26; 95% CI=−0.42 to −0.08), Timed Up and Go Test (β=−0.37; 95% CI=−0.68 to −0.14), shared living arrangements (β=0.22; 95% CI=0.01 to 0.44) and history of falls in the past 6 months (β=−0.22; 95% CI=−0.41 to −0.05) showed significant associations with the LSA-D composite score, while living in urban area (β=−0.19; 95% CI=−0.42 to 0.03) and male gender (β=0.15; 95% CI=−0.04 to 0.35) were not significant.ConclusionThe LSA-D is a valid tool for measuring life-space mobility in German community-dwelling older adults within the past 4 weeks in ambulant urban and rural settings.Trial registration numberDRKS00019023.

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Longitudinal validity of using digital hand photographs for assessing hand osteoarthritis progression over 7 years in community-dwelling older adults with hand pain

10.21203/rs.2.12778/v1 ◽

2019 ◽

Author(s):

Michelle Marshall ◽

Helgi Jonsson ◽

Gudrun Helgadottir ◽

Elaine Nicholls ◽

Helen L Myers ◽

...

Keyword(s):

Older Adults ◽

Construct Validity ◽

Community Dwelling ◽

Analysis Of Covariance ◽

Hand Osteoarthritis ◽

Clinical Progression ◽

Chi Square ◽

Term Change ◽

Community Dwelling Older Adults ◽

Longitudinal Construct Validity

Abstract Background: To determine the longitudinal construct validity of assessing hand OA progression on digital photographs over 7 years compared with progression determined from radiographs, clinical features and change in symptoms. Methods: Participants were community-dwelling older adults (≥50 years) in North Staffordshire, UK. Standardized digital hand photographs were taken at baseline and 7 years, and hand joints graded for OA severity using an established photographic atlas. Radiographic hand OA was assessed using the Kellgren and Lawrence grading system. Hand examination determined the presence of nodes, bony enlargement and deformity. Symptoms were reported in self-complete questionnaires. Radiographic and clinical progression and change in symptoms were compared to photographic progression. Differences were examined using analysis of covariance and Chi-Square tests. Results: Of 253 individuals (61% women, mean age 63 years) the proportion with photographic progression at the joint and joint group-level was higher, though not statistically significantly, in those with radiographic or clinical progression compared to those without. At the person-level, those with moderate photographic progression over 7 years had significantly higher summed radiographic and clinical scores after adjustment for baseline scores compared to those with no or mild photographic progression. Similar findings were observed for change in symptoms, although differences were small and not statistically significant. Conclusion: Assessing hand OA on photographs shows modest longitudinal construct validity over 7 years compared with change in radiographic and clinical hand OA at the person-level. Using hand photographs for determining long-term change may be a reasonable alternative when hand examinations and radiographs are not feasible.

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The Location Learning Test-Revised is associated with informant-reported everyday functioning in a sample of community-dwelling older adults

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa061 ◽

2020 ◽

Author(s):

Jennifer L Thompson ◽

Romola S Bucks ◽

Michael Weinborn ◽

Steven Paul Woods

Keyword(s):

Older Adults ◽

Activities Of Daily Living ◽

Daily Living ◽

Community Dwelling ◽

Object Location ◽

Everyday Functioning ◽

Ecological Relevance ◽

Learning Test ◽

Community Dwelling Older Adults ◽

Learning Trials

Abstract Objective Object location learning and memory may be important for older adults to successfully complete some everyday activities. Method This cross-sectional, correlational study investigated the ecological relevance of the Location Learning Test-Revised (LLT-R) in 195 community-dwelling, older adults in Western Australia. The LLT-R assesses object location learning and memory for everyday objects over five learning trials and after a 30-min delay. Knowledgeable informants provided structured ratings of participants’ activities of daily living and memory symptoms. Results A greater number of errors on LLT-R total learning trials were associated with mild problems in activities of daily living (particularly in travel and household domains), but not with memory symptoms. The LLT-R’s association with activities of daily living was accompanied by a small-to-medium effect size and was not better explained by demographics, global cognitive functioning, mood, or chronic medical conditions. Conclusions Findings provide some support for the ecological relevance of the LLT-R among older community-dwelling adults and suggest that object location learning may play a role in some everyday functioning problems that accompany typical aging.

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Time-Based Prospective Memory Is Associated with Functional Performance in Persons with MS

Journal of the International Neuropsychological Society ◽

10.1017/s135561771900095x ◽

2019 ◽

Vol 25 (10) ◽

pp. 1035-1043

Author(s):

Erica Weber ◽

Nancy D. Chiaravalloti ◽

John DeLuca ◽

Yael Goverover

Keyword(s):

Executive Functions ◽

Prospective Memory ◽

Functional Performance ◽

Ecological Validity ◽

Community Dwelling ◽

Everyday Functioning ◽

Significant Relationships ◽

Increased Risk ◽

Memory For Intentions ◽

Event Based

AbstractObjective:Persons with multiple sclerosis (MS) often report prospective memory (PM) failures that directly impact their everyday life. However, it is not known whether PM deficits confer an increased risk of poorer everyday functioning. The aims of this study were to: (1) compare time- (Time-PM) and event-based PM (Event-PM) performance between persons with MS and healthy controls (HCs), (2) examine the neuropsychological correlates of PM in MS, and (3) examine the relationship between PM and everyday functioning in MS.Method:A between-subjects design was used to examine 30 adults with MS and 30 community-dwelling HC. Participants were administered the Memory for Intentions Screening Test (MIST) to assess PM skills, the Actual Reality™ (AR) to assess everyday functioning, and a battery of cognitive tests.Results:The MS group performed significantly worse on Time-PM compared to HC but not on Event-PM tasks. While both Time-PM and Event-PM subscales were correlated with retrospective learning and memory, the MIST Time-PM subscale was correlated with executive functions. Significant correlations were observed between AR and the MIST Time-PM, but not Event-PM, subscales.Conclusions:The results highlight the role of executive functions on Time-PM. Furthermore, significant relationships with AR extend the ecological validity of the MIST to MS populations.

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Less SWS, REM sleep and more WASO are associated with greater depression and poorer time-based prospective memory in community-dwelling older adults

Sleep Medicine ◽

10.1016/j.sleep.2017.11.382 ◽

2017 ◽

Vol 40 ◽

pp. e131

Author(s):

E. Hodgson ◽

R. Bucks ◽

L. Fine ◽

D. Parker ◽

M. Weinborn

Keyword(s):

Older Adults ◽

Prospective Memory ◽

Rem Sleep ◽

Community Dwelling ◽

Community Dwelling Older Adults

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Factor Structure of the Dementia Mood Assessment Scale in a Cohort of Community-Dwelling Elderly

International Psychogeriatrics ◽

10.1017/s1041610297004584 ◽

1997 ◽

Vol 9 (4) ◽

pp. 449-457 ◽

Cited By ~ 5

Author(s):

Lisa L. Onega ◽

Ivo L. Abraham

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Depressive Symptoms ◽

Construct Validity ◽

Factor Structure ◽

Depressive Illness ◽

Community Dwelling ◽

Assessment Scale ◽

Diurnal Patterns ◽

Components Analysis

We examined the factor structure of the 28-item Dementia Mood Assessment Scale (DMAS), an instrument to assess depressive symptoms in older adults with cognitive impairment, in a cohort of 165 community-dwelling elderly with varying degrees of cognitive impairment. Factor analysis using principal components analysis and varimax rotation was performed to explore the presence of subscales and examine construct validity. A five-factor structure involving all 28 items accounting for 63.2% of the variance in the DMAS scores was derived. Factors were named: Depressed Affect, Environmental Interaction, Diurnal Patterns, Agitation/Suspicion, and Somatic Indicators. This factor structure reflects the often differing presentations of depressive symptoms in older adults with varying degrees of cognitive function and established the construct validity of the DMAS in this population. We conclude that the DMAS may be used for differentiated clinical assessment of depressive symptoms along major dimensions of depressive illness in this cohort of elderly.

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