Psychometric Concerns in the Assessment of Trauma-Related Symptoms in Older Adults

2020 ◽  
Author(s):  
Willeke H. van Zelst ◽  
Aartjan T. F. Beekman
Keyword(s):  
Older Adults ◽  
Older Individuals ◽  
Younger Adults ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Somatic Comorbidity ◽  
Multimethod Assessment ◽  
Clinician Rating ◽  
Ptsd Scale ◽  
Computerized Screening

Assessment of posttraumatic stress disorder (PTSD) in older adults is still in its infancy despite reflections on this subject in past literature. Factors that influence assessment are traumas that occurred long in the past, lower prevalence, the fact that older people complain less, more misinterpretation of avoiding and intrusion symptoms, more somatic comorbidity, and higher risk of cognitive impairment. The Clinician Administered PTSD Scale is mostly used to diagnose PTSD, but is less researched in older individuals. Only two screening instruments have been validated specifically for older adults, the PTSD Checklist (PCL) and the Self-Rating Inventory for PTSD. The PCL scale has been used more often, has been translated in various languages, and is also suitable for clinician rating, which is considered more appropriate for older adults. The PCL-5, based on the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria was researched in older veterans but needs further validation. Biological measures have not yet been adapted for assessment in the complex biological systems of older age. Multimethod assessment and computerized screening are becoming more important and can address many of the difficulties in this field. Finally, much can be learned from knowledge already acquired from younger adults.

Psychometric Concerns in the Assessment of Trauma-related Symptoms in Older Adults

2012 ◽  
pp. 281-301
Author(s):  
Willeke H. van Zelst ◽  
Aartjan T. F. Beekman
Keyword(s):  
Older Adults ◽  
Older Age ◽  
Younger Adults ◽  
The Past ◽  
Somatic Comorbidity ◽  
Multimethod Assessment ◽  
Ptsd Checklist ◽  
Clinician Rating ◽  
Ptsd Scale ◽  
Assessment Of Ptsd

Assessment of PTSD in older adults is still in its infancy despite reflections on this subject in past literature. Factors that influence assessment are: traumas that occurred long in the past, lower prevalence, the fact that older people complain less, more misinterpretation of avoiding and intrusion, more somatic comorbidity and higher risk of cognitive impairment. The Clinician Administered PTSD Scale (CAPS) is mostly used to diagnose PTSD, but less researched in older age. Only two screening instruments have been validated, the PTSD Checklist (PCL) and the Self Rating Inventory for PTSD (SRIP), but cross-validation has still to be done. The PCL scale has been used more often and is also suitable for clinician rating, which is considered more appropriate for older adults. Biological measures have not yet been adapted for assessment in the complex biological systems of older age. Multimethod assessment is becoming more important and can address many of the difficulties in this field. Finally, much can be learned from knowledge already acquired from younger adults.

Abstract P198: Clinic versus Out-of-Clinic Daytime Blood Pressure Among Older Adults: Data From the Jackson Heart Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Rikki M Tanner ◽  
Daichi Shimbo ◽  
Samantha Seals ◽  
Gbenga Ogedegbe ◽  
Paul Muntner
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Blood Pressure Monitoring ◽  
White Coat ◽  
Older Individuals ◽  
Jackson Heart Study ◽  
Large White ◽  
Younger Adults ◽  
White Coat Effect ◽  
Heart Study

In the US, antihypertensive medication treatment decisions are primarily based on blood pressure (BP) measurements obtained in the clinic setting. The optimal systolic BP (SBP) goal for adults ≥60 years is controversial and a large difference between clinic and out-of-clinic daytime BP, a white-coat effect, may be present in older individuals. We estimated the white-coat effect and calculated the percentage of untreated and treated adults <60 and ≥60 years with elevated clinic BP (defined as SBP/diastolic BP [DBP] ≥140/90 mmHg), but non-elevated out-of-clinic daytime BP (“daytime BP”, defined as SBP/DBP <135/85 mmHg) among 257 African-American participants in the Jackson Heart Study with at least 10 daytime ambulatory BP measurements. For the overall population, the white-coat effect for SBP was 12.2 mmHg (95% confidence interval [CI]: 9.2-15.1) in older adults and 8.4 mmHg (95% CI: 5.7-11.1) in younger adults (p=0.06). After multivariable (MV) adjustment, this difference was 1.3 mmHg. Among those without diabetes or chronic kidney disease (CKD), the white coat effect for SBP was 15.2 mmHg (95% CI: 10.1-20.2) and 8.6 mmHg (95% CI: 5.0-12.3) for older and younger adults, respectively (p=0.04). After MV adjustment, this difference was 5.9 mmHg. Also, SBP ≥150 mmHg versus <150 mm Hg was associated with a larger white-coat effect in the overall population after MV adjustment. Among those without CKD or diabetes, older age and SBP ≥150 mmHg were associated with a larger white-coat effect after MV adjustment. Among younger and older participants with elevated clinic BP, the prevalence of non-elevated daytime BP was 34% (95% CI: 26%-44%) and 32% (95% CI: 24%-40%), respectively (p=0.64), in the overall population and 35% (95% CI: 24%-48%) and 43% (95% CI: 31%-56%), respectively, for those without CKD or diabetes (p=0.37). In conclusion, a large white-coat effect was present among older adults. These data suggest a role for ambulatory blood pressure monitoring in preventing potential over-treatment for hypertension among older adults.

scholarly journals Aging and Sensitivity to Illusory Target Motion With or Without Secondary Tasks

2018 ◽  
Vol 31 (3-4) ◽  
pp. 227-249 ◽  
Author(s):  
Alix L. de Dieuleveult ◽  
Anne-Marie Brouwer ◽  
Petra C. Siemonsma ◽  
Jan B. F. van Erp ◽  
Eli Brenner
Keyword(s):  
Older Adults ◽  
Visual Information ◽  
Sensory Information ◽  
Older Individuals ◽  
Younger Adults ◽  
Secondary Tasks ◽  
Healthy Older Adults ◽  
The Right ◽  
Task Irrelevant ◽  
Background Motion

Older individuals seem to find it more difficult to ignore inaccurate sensory cues than younger individuals. We examined whether this could be quantified using an interception task. Twenty healthy young adults (age 18–34) and twenty-four healthy older adults (age 60–82) were asked to tap on discs that were moving downwards on a screen with their finger. Moving the background to the left made the discs appear to move more to the right. Moving the background to the right made them appear to move more to the left. The discs disappeared before the finger reached the screen, so participants had to anticipate how the target would continue to move. We examined how misjudging the disc’s motion when the background moves influenced tapping. Participants received veridical feedback about their performance, so their sensitivity to the illusory motion indicates to what extent they could ignore the task-irrelevant visual information. We expected older adults to be more sensitive to the illusion than younger adults. To investigate whether sensorimotor or cognitive load would increase this sensitivity, we also asked participants to do the task while standing on foam or counting tones. Background motion influenced older adults more than younger adults. The secondary tasks did not increase the background’s influence. Older adults might be more sensitive to the moving background because they find it more difficult to ignore irrelevant sensory information in general, but they may rely more on vision because they have less reliable proprioceptive and vestibular information.

scholarly journals Effect of Speaker Age on Speech Recognition and Perceived Listening Effort in Older Adults With Hearing Loss

2012 ◽  
Vol 55 (3) ◽  
pp. 838-847 ◽  
Author(s):  
Megan J. McAuliffe ◽  
Phillipa J. Wilding ◽  
Natalie A. Rickard ◽  
Greg A. O'Beirne
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Speech Recognition ◽  
Signal Quality ◽  
Older Individuals ◽  
Listening Effort ◽  
Younger Adults ◽  
Perceived Effort ◽  
Age Related ◽  
Significant Difference

Purpose Older adults exhibit difficulty understanding speech that has been experimentally degraded. Age-related changes to the speech mechanism lead to natural degradations in signal quality. We tested the hypothesis that older adults with hearing loss would exhibit declines in speech recognition when listening to the speech of older adults, compared with the speech of younger adults, and would report greater amounts of listening effort in this task. Method Nineteen individuals with age-related hearing loss completed speech recognition and listening effort scaling tasks. Both were conducted in quiet, when listening to high- and low-predictability phrases produced by younger and older speakers, respectively. Results No significant difference in speech recognition existed when stimuli were derived from younger or older speakers. However, perceived effort was significantly higher when listening to speech from older adults, as compared with younger adults. Conclusions For older individuals with hearing loss, natural degradations in signal quality may require greater listening effort. However, they do not interfere with speech recognition—at least in quiet. Follow-up investigation of the effect of speaker age on speech recognition and listening effort under more challenging noise conditions appears warranted.

scholarly journals Predictors of hoarding severity in older adults with hoarding disorder

2014 ◽  
Vol 27 (7) ◽  
pp. 1147-1156 ◽  
Author(s):  
Catherine R. Ayers ◽  
Mary E. Dozier
Keyword(s):  
Older Adults ◽  
Predictive Factors ◽  
Symptom Severity ◽  
Predictive Ability ◽  
Patient Characteristics ◽  
Statistical Manual ◽  
Hoarding Disorder ◽  
Diagnostic And Statistical Manual ◽  
Recent Addition ◽  
Gender Based

ABSTRACTBackground:The recent addition of hoarding disorder (HD) to the Diagnostic and Statistical Manual of Mental Health Disorders, 5th edition, has highlighted the dearth of information about the demographic, sociologic, and medical predictors of HD severity, particularly in older adults. Although there have been several previous studies examining the characteristics of older adults with HD, and one investigation of psychiatric correlates of hoarding symptom severity in non-clinical older adults, there has been little investigation about which characteristics predict hoarding symptom severity in older adults with HD.Methods:Participants were 71 older adults who were enrolled for one of the two studies of HD at the VA San Diego Healthcare System between January 2010 and January 2014.Results:There were multiple differences in the predictive ability of patient characteristics between the more cognition-related symptoms of HD and the more concrete measure of clutter, including gender-based differences and anxiety severity. Further, married participants were more likely to report lower hoarding severity, and there was no significant relationship between hoarding severity and intervention attempts or hoarding and reported falls in the past three years.Conclusions:Multiple predictive factors have been presented, which may result in further studies to investigate possible predictive differences in cognition and clutter symptoms of HD. Future studies should examine the possibility of the predictive factors also identified to be moderators of treatment outcomes.

scholarly journals Effect of Cognitive Control on Attentional Processing of Emotional Information Among Older Adults: Evidence From an Eye-Tracking Study

2021 ◽  
Vol 13 ◽  
Author(s):  
Haining Liu ◽  
Haihong Liu ◽  
Feng Li ◽  
Buxin Han ◽  
Cuili Wang
Keyword(s):  
Older Adults ◽  
Cognitive Control ◽  
Eye Tracking ◽  
Healthy Aging ◽  
Older Individuals ◽  
Younger Adults ◽  
Spatial Cueing ◽  
Age Related ◽  
Cueing Task ◽  
Engagement And Disengagement

Background: Although numerous studies have suggested that the gradually increasing selective preference for positive information over negative information in older adults depends on cognitive control processes, few have reported the characteristics of different attention stages in the emotional processing of older individuals. The present study used a real-time eye-tracking technique to disentangle the attentional engagement and disengagement processes involved in age-related positivity effect (PE).Methods: Eye movement data from a spatial-cueing task were obtained for 32 older and 32 younger healthy participants. The spatial-cueing task with varied cognitive loads appeared to be an effective way to explore the role of cognitive control during the attention engagement and disengagement stages of emotion processing.Results: Compared with younger adults, older participants showed more positive gaze preferences when cognitive resources were sufficient for face processing at the attention engagement stage. However, the age-related PE was not observed at the attention disengagement stage because older adults had more difficulty disengaging from fearful faces than did the younger adults due to the consumption of attention by the explicit target judgment.Conclusion: The present study highlights how cognitive control moderates positive gaze preferences at different attention processing stages. These findings may have far-reaching implications for understanding, preventing, and intervening in unsuccessful aging and, thus, in promoting active and healthy aging.

scholarly journals Psychological Impacts and Implications of Aging During a Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 545-545
Author(s):  
Joseph Mikels ◽  
Laura Carstensen ◽  
Susan Charles
Keyword(s):  
Older Adults ◽  
Psychological Impact ◽  
Well Being ◽  
Older Individuals ◽  
Younger Adults ◽  
Ongoing Research ◽  
Ongoing Work ◽  
Psychological Impacts ◽  
Research Findings ◽  
Mental Well Being

Abstract Despite numerous losses associated with advanced age, older adults typically fare better than their younger counterparts in terms of psychological well-being. However, the COVID-19 pandemic has disproportionately threatened the physical and mental well-being of older adults. How have older versus younger adults been doing? The goal of our symposium is to shed light on this question though presentations of intriguing research findings regarding the psychological impacts of the pandemic on older adults. Stone and Mak will describe their work examining momentary changes in affect, activities, locations, and social interactions over time during the first several months of the pandemic for older individuals. Mikels and colleagues will report on completed and ongoing work illuminating the complex ways in which certain older adults have been faring well during the pandemic, whereas others not so much, with attention to underlying factors. Jeste will discuss a diverse line of research that has examined the relationships between loneliness, social isolation, and compassion in older adults before and during the pandemic. Chi and Carstensen will report on completed and ongoing research that links work and prosocial behavior to wellbeing with consideration of associated age differences. Collectively, these presentations will describe the complex and multifaceted psychological impact that the COVID-19 pandemic has had on older individuals, revealing the multiple ways in which they are resilient as well as vulnerable.

Is V̇O2max an Appropriate Fitness Indicator for Older Adults?

1998 ◽  
Vol 6 (4) ◽  
pp. 303-309 ◽  
Author(s):  
Andrea T. White ◽  
C. Steven Fehlauer ◽  
Rita Hanover ◽  
Stephen C. Johnson ◽  
Robert E. Dustman
Keyword(s):  
Older Adults ◽  
Maximal Exercise ◽  
Cycle Ergometer ◽  
Exercise Intolerance ◽  
Older Individuals ◽  
Exercise Tests ◽  
Younger Adults ◽  
Age And Gender ◽  
And Gender ◽  
High Work

Older individuals arc more likely than younger adults to exhibit symptoms of exercise intolerance at high work rates. The risks of maximal exercise in older adults increase proportionally as the number of health difficulties increase. In this study, the effects of health status, age, and gender on older adults’ ability to attain V̇O2max are examined. Sedentary volunteers (60 women, 45 men), mean age 67 ± 5 years (range 57-78 years), participated in graded maximal exercise tests on a combined arm and leg cycle ergometer. Subjects were classified into three groups based on test termination reason: attainment of V̇O2max (MAX), symptom-limited (SX), or EKG-limited (EKG). Sixty percent of men and 40% of women were classified as MAX, while 48% of women and 27% of men were characterized as SX. Thirteen percent of men and 12% of women had EKG-limited exercise tests. Those in the EKG group reported significantly more diagnoses than subjects in the MAX group (2.7 vs. 1.4. p < .05). The number of medications reported and age of the subjects did not differ across test termination categories.

scholarly journals A Neural Signature of Regularity in Sound is Reduced in Older Adults

2021 ◽  
Author(s):  
Björn Herrmann ◽  
Burkhard Maess ◽  
Ingrid S. Johnsrude
Keyword(s):  
Older Adults ◽  
Auditory Cortex ◽  
Older Individuals ◽  
Sound Perception ◽  
Younger Adults ◽  
Sound Processing ◽  
Age Related ◽  
Increased Sensitivity ◽  
Neural Signature ◽  
Age Related Changes

AbstractSensitivity to repetitions in sound amplitude and frequency is crucial for sound perception. As with other aspects of sound processing, sensitivity to such patterns may change with age, and may help explain some age-related changes in hearing such as segregating speech from background sound. We recorded magnetoencephalography to characterize differences in the processing of sound patterns between younger and older adults. We presented tone sequences that either contained a pattern (made of a repeated set of tones) or did not contain a pattern. We show that auditory cortex in older, compared to younger, adults is hyperresponsive to sound onsets, but that sustained neural activity in auditory cortex, indexing the processing of a sound pattern, is reduced. Hence, the sensitivity of neural populations in auditory cortex fundamentally differs between younger and older individuals, overresponding to sound onsets, while underresponding to patterns in sounds. This may help to explain some age-related changes in hearing such as increased sensitivity to distracting sounds and difficulties tracking speech in the presence of other sound.

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