As senior citizens use mediation, they will need mediators who understand the elderly. The two most important issues are competency and communication. Mediators should assume that the senior is competent and able to participate meaningfully in mediation. During intake and the mediation session, mediators must be prepared to accommodate for any disabilities, especially those related to communications. Successful mediators will learn to appreciate the values, needs, and interests of seniors and to be sensitive to a possible history of poor conflict resolution. Wise mediators will become part of the senior citizen network, educate about mediation, learn about seniors, and develop referral sources for the elderly. Family mediators have much to offer senior citizens if they appreciate these issues.

Objective: Examine the psychometric properties and classification accuracy of a digit symbol substitution task (DSST) to screen for mild cognitive impairment (MCI) in older adults. Methods: Twenty-seven older adults with MCI and 50 demographically-matched healthy controls (HC) over age 60 completed the MMSE, Quick MCI (Qmci), and DSST, the latter of which was administered twice to examine the added utility of practice effects. Results: Patients with MCI performed significantly worse than their HC counterparts on the MMSE (η2 = 0.191), Qmci (η2 = 0.153), and the first (η2 = 0.337) and second (η2 = 0.393) administration of the DSST. HC participants also demonstrated significantly greater practice effects than those with MCI who did not appear to benefit from task repetition (mean score increases of 7.4 and 0.5, respectively). The DSST exhibited excellent within-session test–retest reliability (R2 = 0.774) and was more strongly correlated with Qmci (R2 = 0.311) than MMSE (R2 = 0.112) scores. ROC analyses indicated that a cutoff score of 23.5 for the first administration (AUC = 0.860) and 27.5 for the second administration (AUC = 0.900) of the DSST were associated with superior classification accuracy to that of the MMSE (AUC = 0.759) and Qmci (AUC = 0.777). DSST difference scores (AUC = 0.764) reflecting within-session practice effects were slightly superior to the MMSE but not the Qmci. In logistic regression analyses, scores from the first administration of the DSST significantly predicted group membership and the addition of practice effects significantly improved model fit (p < 0.001) resulting in an overall classification accuracy of 85.1%. Conclusions: Findings suggest that the DSST is a valid and reliable rapid screening measure which may prove useful for clinicians and researchers alike.

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BackgroundDeveloping digital healthcare solutions that facilitate rapid identification and effective management of patients with Alzheimer disease and related disorders (ADRD) is an area of intense study. A critical juncture for these efforts involves the early detection of cognitive decline. Because primary care providers (PCPs) are the first line of medical care, they are often the first to hear concerns about cognitive decline. However, under‐diagnosis of ADRD in primary care settings is widely recognized, as are the many barriers to routine cognitive screening. While information about brief cognitive screening tools for detecting ADRD is plentiful, PCPs remain uncertain about which patients to assess, which tools to use and how to use them, and how to communicate results. The goal of this project was to design a risk assessment and cognitive screening (RACS) application that specifically addressed the needs and concerns of PCPs to facilitate identification of cognitive decline in primary care settings.MethodWe employed a multi‐modal assessment approach in designing the RACS app, which first assesses risk for cognitive impairment and then assesses cognitive functioning using a working memory/processing speed task in combination with four speech/language tasks. We assembled a multidisciplinary team with the following expertise to develop and test the app: biostatistics, computational linguistics, computer science, computerized cognitive assessment, gaming/app development, engineering, neurology, neuropsychology, neuroscience, primary care, psychometrics, and speech‐language pathology.ResultProgramming of app features and pilot testing with people with ADRD was completed in 3 months. Initial development of the connected speech analysis pipeline was completed in 4 months with ongoing testing. Data collection of 50 cognitively normal, 50 mild cognitive impairment, and 50 mild dementia participants is approximately 50% completed within 6 months. Preliminary results based on cognitive performance alone show good ability to discriminate groups. Reduction of speech‐language variables for inclusion in a final cognitive performance score is underway using a variety of machine learning techniques, including the elastic net and random forests.ConclusionThe RACS app shows promise as a digital health solution to facilitate early detection of cognitive decline in primary care and may prove useful in other busy clinical settings.

Environmental adaptation and species divergence often involve suites of co‐evolving traits. Pigmentation in insects presents a variable, adaptive, and well‐characterized class of phenotypes for which correlations with multiple other traits have been demonstrated. In Drosophila, the pigmentation genes ebony and tan have pleiotropic effects on flies' response to light, creating the potential for correlated evolution of pigmentation and vision. Here, we investigate differences in light preference within and between two sister species, Drosophila americana and D. novamexicana, which differ in pigmentation in part because of evolution at ebony and tan and occupy environments that differ in many variables including solar radiation. We hypothesized that lighter pigmentation would be correlated with a greater preference for environmental light and tested this hypothesis using a habitat choice experiment. In a first set of experiments, using males of D. novamexicana line N14 and D. americana line A00, the light‐bodied D. novamexicana was found slightly but significantly more often than D. americana in the light habitat. A second experiment, which included additional lines and females as well as males, failed to find any significant difference between D. novamexicana‐N14 and D. americana‐A00. Additionally, the other dark line of D. americana (A04) was found in the light habitat more often than the light‐bodied D. novamexicana‐N14, in contrast to our predictions. However, the lightest line of D. americana, A01, was found substantially and significantly more often in the light habitat than the two darker lines of D. americana, thus providing partial support for our hypothesis. Finally, across all four lines, females were found more often in the light habitat than their more darkly pigmented male counterparts. Additional replication is needed to corroborate these findings and evaluate conflicting results, with the consistent effect of sex within and between species providing an especially intriguing avenue for further research.