Objective To investigate the psychometric properties of the Brief Fatigue Inventory (BFI) in community-dwelling older adults. Design Cross-sectional validation study. Setting Community-based longitudinal cohort aging study in Westchester County, New York. Participants Subjects (N=302) were non-demented older adults (mean age 76.44 years, 54% female). Interventions Not applicable. Main Outcome Measures BFI total, severity, and interference summation scores. Results A Principle Component Analysis (PCA) yielded two factors: fatigue severity and interference, explaining 65.94% of the variance. Both factors had good reliability, with Cronbach’s α values of 0.867 for fatigue interference and 0.818 for fatigue severity. Higher fatigue scores were associated with older age and worse physical and cognitive functions. Conclusions Fatigue is a common and debilitating symptom in the aging population. The current study provides novel findings in validating and establishing a bi-dimensional factor structure for the BFI in older adults. Severity and interference were differentially related to important health outcomes; therefore, utilizing these subscales in addition to the total BFI scaled score is recommended with older adults. Because of its relatively short administration time and established psychometric properties, the BFI can be successfully incorporated into longitudinal studies and clinical trials.

Imagery encoding effects on source-monitoring errors were explored using the Deese-Roediger-McDermott paradigm in two experiments. While viewing thematically related lists embedded in mixed picture/word presentations, participants were asked to generate images of objects or words (Experiment 1) or to simply name the items (Experiment 2). An encoding task intended to induce spontaneous images served as a control for the explicit imagery instruction conditions (Experiment 1). On the picture/word source-monitoring tests, participants were much more likely to report "seeing" a picture of an item presented as a word than the converse particularly when images were induced spontaneously. However, this picture misattribution error was reversed after generating images of words (Experiment 1) and was eliminated after simply labelling the items (Experiment 2). Thus source misattributions were sensitive to the processes giving rise to imagery experiences (spontaneous vs deliberate), the kinds of images generated (object vs word images), and the ways in which materials were presented (as pictures vs words).

In the two experiments reported here the basis of the beneficial effects of generating images on false recognition errors is investigated. Acts of generating (descriptions, images, or both) were manipulated while examining the effects of the source of descriptions guiding imagery generations (participant vs peer). False recognition errors were relatively high across encoding conditions except when imagery generations were based on participants' own descriptions (Experiments 1 and 2). These differences in the acts of generating were not attributable to differences in the cohesiveness of descriptions themselves. Acts of generating led to greater "remember" responses than "know" responses only when participants were not the source of the descriptions used to generate images (Experiment 2). Results highlight the importance of examining the effects of the source of descriptions for guiding imagery (participant or peer) when testing predictions about the effects of imagery encoding on false recognition errors.

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Objective The risk for cognitive impairment is greater in individuals with low SES and limited education. In rural areas, distance and economic concerns preclude individuals from accessing care. In Alachua County, 23% of residents live below poverty and 16% are uninsured. The Neurocognitive Screening Initiative (NSI) attempts to reduce disparities in Alachua by offering free neurocognitive screening. NSI also aspires to promote cultural competence through unique training opportunities for clinical neuropsychology doctoral students. Method Patients learned about NSI through flyers, word of mouth, or referrals. Appointments include a clinical interview, cognitive testing, and mood questionnaires. Patients receive feedback, brain health recommendations, and referrals to community resources. Phase 1 began in November 2017 and involved selection of appropriate cognitive measures, development and dissemination of advertising materials, identification of resources, and trainee recruitment. From February 2018 to August 2018, phase 2 involved administration of cognitive screeners. Phase 3 involved continued provision of clinical services, expansion of the NSI team and increased culturally relevant outreach. Outcomes NSI’s greatest challenge is recruitment of the appropriate demographic. Since phase 2, we have evaluated 10 patients with diverse racial, socioeconomic, and clinical characteristics. NSI has recruited an ethnoracially diverse cohort of trainees comprised of 4 graduate students and 2 postdoctoral fellows supervised by a clinical neuropsychologist. Discussion Efforts to provide services to marginalized individuals have uncovered challenges in attracting patients who might benefit from these services. NSI is forging community partnerships with churches, libraries, and local organizations to reach the targeted audience. Via weekly meetings, participation in community events/outreach, and clinical work, NSI provides unique training for emerging neuropsychologists.