We examined the relationship of cognitive and functional measures with life space (a measure of spatial mobility examining extent of movement within a person’s environment) in older adults, and investigated the potential moderating role of personal control beliefs. Internal control beliefs reflect feelings of competence and personal agency, while attributions of external control imply a more dependent or passive point of view. Participants were 2,737 adults from the ACTIVE study, with a mean age of 74 years. Females comprised 76% of the sample, with good minority representation (27% African American). In multiple regression models controlling for demographic factors, cognitive domains of memory, reasoning, and processing speed were significantly associated with life space (p<.001 for each), and reasoning ability appeared most predictive (B=.117). Measures of everyday function also showed significant associations with life space, independent from the traditional cognitive measures. Interactions between cognitive function and control beliefs were tested, and external control beliefs moderated the relationship between memory and life space, with the combination of high objective memory and low external control beliefs yielding the highest life space (t=−2.07; p=.039). In conclusion, older adults with better cognitive function have a larger overall life space. Performance-based measures of everyday function may also be useful in assessing the functional outcome of life space. Additionally, subjective external control beliefs may moderate the relationship between objective cognitive function and life space. Future studies examining the relationships between these factors longitudinally appear worthwhile to further elucidate the interrelationships of cognitive function, control beliefs, and life space.
Within the context of the ACTIVE study, the current investigation explored the relationships between objective memory and two components of subjective memory (frequency of forgetting and use of external aids) over a five-year period. Relationships were assessed using parallel process latent growth curve models. Results indicated that changes in objective memory were associated with changes in perceived frequency of forgetting, but not with use of external aids (calendars, reminder notes) over time. Findings suggest that memory complaints may accurately reflect decline in objective memory performance, but that these memory changes are not necessarily related to compensatory behaviors.
Successful destination branding strategies require the commitment and mobilization of internal stakeholders in order to reinforce the communication of the brand message to the tourist market. To this purpose, the literature suggests that adopting an inclusive and participative approach to the branding process can increase and maintain the stakeholders’ willingness to share the brand mission. However, the results of such sharing and involvement strategies in terms of internal brand equity creation are still under research. In order to fill such a gap, the article proposes to build on the established consumer-based brand equity model for assessing the internal stakeholder-based brand equity of tourist destinations. The model, comprising four dimensions – brand awareness, image, commitment, and satisfaction/loyalty – is then applied to the analysis of South Tyrol’s (Italy) regional branding strategy, through a survey of internal brand users. Findings confirm the importance of a participative approach to the branding process in order to enhance its overall internal equity. Findings also show a relevant information gap regarding brand performance that impacts the stakeholders’ commitment. This confirms the link between the internal and external performance of destination brands. Moreover, significant differences in the levels of brand awareness, commitment, and satisfaction among different categories of stakeholders suggest that the brand authorities should enact targeted internal communication efforts.
Objectives-We investigated whether factors related to health disparities -race, rural residence, education, perceived racial discrimination, vascular disease, and health care access and utilizationmay moderate the association between diabetes and cognitive decline.Methods-Participants were 624 community-dwelling older adults (49% African American, 49% rural) who completed in-home Mini-Mental State Examination at baseline and four-year follow-up.Results-Diabetes at baseline predicted cognitive decline over four years in regression models adjusted for a number of possible confounds. Only perceived discrimination and health utilization showed significant interaction effects with diabetes. Among African Americans who reported experiencing racial discrimination, there was a stronger relationship between diabetes and cognitive decline. Among participants who reported absence of visiting a physician within the past six months, the association between diabetes and cognitive decline was substantially larger.Discussion-Findings suggest that factors related to health disparities may influence cognitive outcomes among older adults with diabetes. Keywords diabetes; cognitive decline; older adults; health disparities With aging, adults are at increased risk of developing type 2 diabetes as well as cognitive impairment, and there is mounting evidence that these conditions are strongly linked (Biessels et al., 2006;Strachan, Reynolds, Frier, Mitchell, & Price, 2008). Overall prevalence of diabetes and cognitive impairment have each been rising and are substantial contributors to reduced Correspondence: Michael Crowe, PhD, Department of Psychology, University of Alabama at Birmingham, 1530 3 rd Ave. S., HMB 111, Birmingham, AL 35294-2100, Tel: 205-934-0231, Fax: 205-975-2295 (2007). The majority of diabetes cases are due to type 2 diabetes (90-95%), which has a peak prevalence around age 70 (Biessels, Deary, & Ryan, 2008). Diabetes is a well known risk factor for cardiovascular disease and stroke, which, in turn, are associated with higher rates of cognitive impairment (Hachinski, 2008). The substantial interest in understanding the role of diabetes in cognitive decline is due to the potential for modifying risk of cognitive impairment by changing or treating factors related to diabetes.Many existing studies of diabetes and cognitive aging have not included adequate numbers of African Americans, despite the fact that African Americans have substantially higher rates of diabetes compared to Caucasians (CDC, 2007;White, Beech, & Miller, 2009). African Americans also have higher rates of diabetes-related complications in terms of vision, nerve damage, kidney disease and amputations (Harris, 2001). In general, there has been little examination of the potential impact of race or other factors associated with health disparities on the relationship between diabetes and cognitive decline. One exception is for vascular disease, where it has been found that comorbid hypertension accelerates cognitive decline in those with diabete...
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