Purpose Most health outcome measures for chronic diseases do not incorporate specific health goals of patients and caregivers. To elicit patient-centered goals for dementia care, we conducted a qualitative study using focus groups of people with early-stage dementia and dementia caregivers. Methods We conducted 5 focus groups with 43 participants (7 with early-stage dementia and 36 caregivers); 15 participants were Spanish-speaking. Verbatim transcriptions were independently analyzed line-by-line by two coders using both deductive and inductive approaches. Coded texts were grouped into domains and developed into a goal inventory for dementia care. Results Participants identified 41 goals for dementia care within five domains (medical care, physical quality of life, social and emotional quality of life, access to services and supports, and caregiver support). Caregiver goals included ensuring the safety of the person with dementia and managing caregiving stress. Participants with early-stage dementia identified engaging in meaningful activity (e.g., work, family functions) and not being a burden on family near the end of life as important goals. Participants articulated the need to readdress goals as the disease progressed and reported challenges in goal-setting when goals differed between the person with dementia and the caregiver (e.g., patient safety vs. living independently at home). While goals were similar among English and Spanish-speaking participants, Spanish-speaking participants emphasized the need to improve community education about dementia. Conclusions Patient- and caregiver-identified goals for care are different than commonly measured health outcomes for dementia. Future work should incorporate patient-centered goals into clinical settings and assess their usefulness for dementia care.

The brain regions contributing to rule-based category learning were examined using fMRI. Participants categorized single lines that varied in length and orientation into one of two categories. Category membership was based on the length of the line. Results indicated that left frontal and parietal regions were differentially activated in those participants who learned the task as compared to those who did not. Further, the head of the caudate displayed relative decreases in activation on incorrect trials relative to correct trials. The involvement of this latter structure is likely related to (1) processing an error signal, or (2) volitional switching between potential category rules. Results are consistent with theories suggesting that a frontal-striatal circuit is involved in rule-based category learning.

Parkinson's disease (PD) patients and healthy controls were administered a flanker task that consisted of the presentation of colored targets and distractors. Participants were required to attend to the center target and identify its color. The stimulus displays were either congruent (i.e., the target and flankers were the same color) or incongruent. The time between the onset of the flanker and the target color (the target onset delay) was either short or long. Results indicated that PD patients and controls did not differ in the magnitude of the flanker effect within individual trials in that both groups demonstrated a typical flanker effect at the short target onset delay and neither group demonstrated a flanker effect at the longer delay. However, when performance was examined on a trial-by-trial basis, PD patients demonstrated a slowing of reaction time relative to controls when having to make the same response across consecutive trials at longer inter-trial intervals when the flankers were incongruent across consecutive trials and the display on the second of two trials was incongruent. These results indicate that PD patients are impaired in inhibiting the distractors over an extended delay and that this deficit may impact motor responding in these patients, suggesting that the basal ganglia contribute to the interface of attention and action.

When cultural and linguistic issues in neuropsychology are raised as a topic of discussion, most U.S.-based clinicians and researchers immediately begin to think of ethnic minority groups or people with limited English proficiency. Those who are familiar with recent literature may have associations related to level of acculturation, educational experience, and other variables that, if controlled, have the potential to improve the sensitivity and specificity of neuropsychological instruments in the diagnostic setting. In this way, the dialogue is frequently framed as having to do with the impact of culture and language on cognitive testing and is thus conceptualized as being relevant only to special populations.

12 nondemented patients with Parkinson's disease (M age = 67.3) and 12 normal control participants were administered an object-based attention task that enabled examination of both negative and positive priming. Unlike previous studies in which spatial-based attention tasks were used, results of the present study indicated that the patients displayed negative and positive priming not different from those shown by controls. These results suggest that certain object-based attentional processes may not be impaired in patients with Parkinson's disease.