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Biomedical subjects

Sherry L Willis

Publications and source records attributed to Sherry L Willis.

11 recordsLinked to original sources

Long-term effects of cognitive training on everyday functional outcomes in older adults.

CONTEXT: Cognitive training has been shown to improve cognitive abilities in older adults but the effects of cognitive training on everyday function have not been demonstrated. OBJECTIVE: To determine the effects of cognitive training on daily function and durability of training on cognitive abilities. DESIGN, SETTING, AND PARTICIPANTS: Five-year follow-up of a randomized controlled single-blind trial with 4 treatment groups. A volunteer sample of 2832 persons (mean age, 73.6 years; 26% black), living independently in 6 US cities, was recruited from senior housing, community centers, and hospitals and clinics. The study was conducted between April 1998 and December 2004. Five-year follow-up was completed in 67% of the sample. INTERVENTIONS: Ten-session training for memory (verbal episodic memory), reasoning (inductive reasoning), or speed of processing (visual search and identification); 4-session booster training at 11 and 35 months after training in a random sample of those who completed training. MAIN OUTCOME MEASURES: Self-reported and performance-based measures of daily function and cognitive abilities. RESULTS: The reasoning group reported significantly less difficulty in the instrumental activities of daily living (IADL) than the control group (effect size, 0.29; 99% confidence interval [CI], 0.03-0.55). Neither speed of processing training (effect size, 0.26; 99% CI, -0.002 to 0.51) nor memory training (effect size, 0.20; 99% CI, -0.06 to 0.46) had a significant effect on IADL. The booster training for the speed of processing group, but not for the other 2 groups, showed a significant effect on the performance-based functional measure of everyday speed of processing (effect size, 0.30; 99% CI, 0.08-0.52). No booster effects were seen for any of the groups for everyday problem-solving or self-reported difficulty in IADL. Each intervention maintained effects on its specific targeted cognitive ability through 5 years (memory: effect size, 0.23 [99% CI, 0.11-0.35]; reasoning: effect size, 0.26 [99% CI, 0.17-0.35]; speed of processing: effect size, 0.76 [99% CI, 0.62-0.90]). Booster training produced additional improvement with the reasoning intervention for reasoning performance (effect size, 0.28; 99% CI, 0.12-0.43) and the speed of processing intervention for speed of processing performance (effect size, 0.85; 99% CI, 0.61-1.09). CONCLUSIONS: Reasoning training resulted in less functional decline in self-reported IADL. Compared with the control group, cognitive training resulted in improved cognitive abilities specific to the abilities trained that continued 5 years after the initiation of the intervention. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00298558.

Activities of Daily Living↗

Competence in everyday activities as a predictor of cognitive risk and mortality.

This study examined the association of a performance-based measure of everyday functioning with clinically meaningful outcomes. Elderly participants in a prospective study of dementia were assessed at two occasions on the Everyday Problems Test for Cognitively Challenged Elderly (EPCCE), a performance-based measure of everyday functioning. Older adults who remained cognitively intact performed approximately 0.66 SD units higher on the EPCCE at both occasions than elders rated as impaired, when covarying on age, education, gender, and cognitive status. Relative to the nonimpaired participants, decline in EPCCE performance over a 2-year interval was significantly greater for impaired participants and those participants who transitioned from nonimpaired to impaired over the course of the study. Increased risk of mortality was associated with lower baseline scores and decline in EPCCE performance even after controlling for demographic variables and performance on the Mini-Mental State Examination. Given the clinical importance of identifying "at risk" elders for impairment, the findings from this study provide initial evidence for the predictive utility of performance-based measures of everyday functioning.

Activities of Daily Living↗

In-home cognitive training with older married couples: individual versus collaborative learning.

Research has demonstrated that older adults' cognitive performance can be enhanced via formal intervention, as well as more informal intervention including collaboration or working with a partner. The current study investigated the effects of an inductive reasoning training program adapted for in-home use among older adults assigned to individual training (n = 30), collaborative training (n = 34), or a no-treatment control group (n = 34). The training consisted of 10 sessions, and all participants completed a pretest followed by a post-test 6 weeks later. Findings suggest that older adults could effectively "train themselves" without the guidance of a formal instructor. The results, however, did not indicate immediate added benefit in reasoning performance for collaborative versus individual training using the current reasoning program.

Aged↗

Age group and health status effects on health behavior change.

The authors explored health behavior change during 5 years, considering age/cohort, health status, and gender effects. The authors divided the sample (n = 1,064) into 4 age/cohort groups: young adults (n = 139; 19-42 years), middle-aged adults (n = 386; 43-62 years), young-old adults (n = 296; 63-72 years), and old-old adults (n = 243; 73+ years) and health status: cardiovascular disease and physical disability. Smoking and seat belt behaviors remained stable, whereas alcohol, food consumption, food preparation, physical activity, dental, and medical behaviors showed change. Change in health behaviors differed by age/cohort group and health status for food consumption, food preparation, and medical care, primarily showing negative change for old-old adults and positive change for individuals with cardiovascular disease. Health behavior interventions need to focus on the old-old, individuals with physical disability, and on smoking and seat belt use. These specific populations and behaviors need to be targeted to promote positive health behavior change, to limit future onsets of disability and morbidity, and to prevent the occurrence of premature death.

Adult↗

Extending neuropsychological assessments into the primary mental ability space.

A battery of 17 neuropsychological tests (including the CERAD battery) and 17 psychometric ability tests were administered to a sample of 499 participants of the Seattle Longitudinal study who had been given the psychometric ability tests seven and 14 years earlier. The neuropsychological tests were projected into a 5-factor psychometric ability space by means of extension analysis. The concurrent regressions of the neuropsychology tests on the psychometric ability tests were then used to estimate neuropsychology test scores from the psychometric ability tests administered in 1984, 1991 and 1998. Neuropsychologists then rated the study participants as either normal, suspect or cognitively impaired in 1998. Changes in estimated test scores were computed over seven and fourteen years. Significant odds ratios between normal and cognitively impaired groups were found for all neuropsychological tests over the proximal period and for most tests over the 14-year period. Similar findings occurred for the odds ratios between the normal and suspect groups for the most proximal 7-year changes.

Journal Article↗

An Historical Framework for Cohort Differences in Intelligence.

This article reviews key issues regarding the controversy on the direction and magnitude of cohort differences in intelligence. Data from the Seattle Longitudinal Study (SLS) illustrate why differences must be studied across multiple cohorts and multiple chronological ages. Differential cohort patterns for multiple dimensions of intelligence are described. A conceptual framework is suggested for the identification of historical influences important for developmental study of cohort differences.

Journal Article↗

The Seattle longitudinal study: relationship between personality and cognition.

This article reviews the history, measures and principal findings of the Seattle Longitudinal Study. This study began in 1956 focusing upon age differences and age changes in cognitive abilities. Its sampling frame is a large HMO in the Pacific Northwest. The study has been expanded to investigate various influences on cognitive aging including, cognitive styles, personality traits, life styles, and family environment. Current interest is also in the early detection of risk for dementia. In addition, this article reports original analyses of the relation of personality dimensions to cognitive abilities (both concurrent and longitudinal). While personality remains relatively stable over the adult life span, modest proportions of variance are shared between various personality traits and the cognitive abilities.

Journal Article↗

Congruence of self-reported medications with pharmacy prescription records in low-income older adults.

PURPOSE: This study examined the congruence of self-reported medications with computerized pharmacy records. DESIGN AND METHODS: Pharmacy records and self-reported medications were obtained for 294 members of a state pharmaceutical assistance program who also participated in ACTIVE, a clinical trial on cognitive training in nondemented elderly persons. The average age of the sample participants was 74.5 years (range = 65-91); 87.8% were females. RESULTS: Congruence between self-report and pharmacy data was generally high. Self-reports omitted drug classes in the pharmacy records less often than the pharmacy records did not include self-reported drug classes. The percentage of individuals with perfect agreement between self-reports and pharmacy records varied from 49% for major drug classes to 81% for specific cardiovascular and central nervous system drugs. Within a drug class, agreement tended to be higher for individuals without a prescription in that class. Poorer health was consistently related to poorer self-report of medications. IMPLICATIONS: Self-reported medications are most likely to be congruent with pharmacy records for drugs prescribed for more serious conditions, for more specific classes of drugs, and for healthier individuals.

Aged↗

Effects of cognitive training interventions with older adults: a randomized controlled trial.

CONTEXT: Cognitive function in older adults is related to independent living and need for care. However, few studies have addressed whether improving cognitive functions might have short- or long-term effects on activities related to living independently. OBJECTIVE: To evaluate whether 3 cognitive training interventions improve mental abilities and daily functioning in older, independent-living adults. DESIGN: Randomized, controlled, single-blind trial with recruitment conducted from March 1998 to October 1999 and 2-year follow-up through December 2001. SETTING AND PARTICIPANTS: Volunteer sample of 2832 persons aged 65 to 94 years recruited from senior housing, community centers, and hospital/clinics in 6 metropolitan areas in the United States. INTERVENTIONS: Participants were randomly assigned to 1 of 4 groups: 10-session group training for memory (verbal episodic memory; n = 711), or reasoning (ability to solve problems that follow a serial pattern; n = 705), or speed of processing (visual search and identification; n = 712); or a no-contact control group (n = 704). For the 3 treatment groups, 4-session booster training was offered to a 60% random sample 11 months later. MAIN OUTCOME MEASURES: Cognitive function and cognitively demanding everyday functioning. RESULTS: Thirty participants were incorrectly randomized and were excluded from the analysis. Each intervention improved the targeted cognitive ability compared with baseline, durable to 2 years (P<.001 for all). Eighty-seven percent of speed-, 74% of reasoning-, and 26% of memory-trained participants demonstrated reliable cognitive improvement immediately after the intervention period. Booster training enhanced training gains in speed (P<.001) and reasoning (P<.001) interventions (speed booster, 92%; no booster, 68%; reasoning booster, 72%; no booster, 49%), which were maintained at 2-year follow-up (P<.001 for both). No training effects on everyday functioning were detected at 2 years. CONCLUSIONS: Results support the effectiveness and durability of the cognitive training interventions in improving targeted cognitive abilities. Training effects were of a magnitude equivalent to the amount of decline expected in elderly persons without dementia over 7- to 14-year intervals. Because of minimal functional decline across all groups, longer follow-up is likely required to observe training effects on everyday function.

Activities of Daily Living↗

Longitudinal invariance of adult psychometric ability factor structures across 7 years.

The hypothesis that psychometric ability tests retain equivalent factor structures across a 7-year interval was examined in a sample of 984 persons (disaggregated into 6 cohort groups: M ages at first test = 32, 46, 53, 60, 67, and 76), assessed in 1984 and 1991 as part of the Seattle Longitudinal Study. A best fitting measurement model was estimated for 20 psychometric tests marking the 6 primary abilities of Inductive Reasoning, Spatial Orientation, Perceptual Speed, Numeric Facility, Verbal Ability, and Verbal Recall. Gender was partialed out at the variable level by including a gender factor. Weak factorial invariance over time was demonstrated for all cohorts. Configural invariance could be demonstrated across all cohort groups. However, weak factorial invariance across groups could be accepted for all but the youngest and oldest groups. Latent means were modeled for the accepted solutions across time and cohort groups.

Adult↗

Congruence of medication information from a brown bag data collection and pharmacy records: findings from the Seattle longitudinal study.

The validity of health information obtained through participants' reports of current medications (e.g., the brown bag method) is an important, but under-studied, area. In the current study, we examined the congruence of medication reports from a brown bag data collection with the pharmacy prescription records for 1430 participants (ages 23 to 97 years) of the seventh wave of the Seattle Longitudinal Study. Overall, the congruence of the brown bag data and pharmacy records was high. Congruence was better for younger participants, healthier participants, and for medications taken for serious conditions or on a regular basis. When the focus is on assessing participants' medications at a specific point in time (e.g., on the day of testing), brown bag data may provide more complete information than pharmacy records. Age and health status of the participants as well as the type of medications of interest should be considered when determining the validity of medication information reported by participants.

Adult↗