Executive Control and the Comprehension of Medical Information by Elderly Retirees

Royall, Donald R.; Cordes, Jeffrey A.; Polk, Marsha J.

doi:10.1080/03610739708254033

Cited by 71 publications

(42 citation statements)

References 15 publications

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“…We assume that this decreasing efficiency is primarily mediated by declines in frontal lobe functioning, but the present data do not directly address the issue of the neurological locus of the effect. There is, however, other evidence suggesting that lower competence in performance of everyday tasks, such as comprehension of medical information, is associated with normative late-life changes in the brain, particularly the frontal lobes [27].…”

Section: Discussionmentioning

confidence: 96%

Off-Target Verbosity, Everyday Competence, and Subjective Well-Being

Arbuckle¹,

Pushkar²,

Bourgeois³

et al. 2004

Gerontology

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Background: Off-target verbosity (OTV), defined as prolific speech that is lacking in focus, is exhibited by relatively few older adults, but increases in prevalence with age. Objective/Methods: The hypothesis that a high level of OTV is associated with declining competence in other aspects of everyday life was examined in 142 older adults, previously screened for the level of OTV. Competence was assessed based on self-reported changes since age 50 years in quality and quantity of engagement in eleven domains of instrumental and voluntary activities of everyday life. Results: Path models indicated that a high level of OTV was associated with a decreased competence in everyday activities and was indirectly linked, through competence, with lower well-being and greater loneliness. With competence level controlled, a high level of OTV directly predicted less loneliness. Conclusions: These findings support the hypothesis that a high level of OTV is symptomatic of a more general decline in competence and of less successful aging. However, a high level of OTV also entails a strong motivation for talking to others and thus may offer protection against loneliness.

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Section: Discussionmentioning

confidence: 96%

Off-Target Verbosity, Everyday Competence, and Subjective Well-Being

Arbuckle¹,

Pushkar²,

Bourgeois³

et al. 2004

Gerontology

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“…-Older adults evaluated in long-term-care settings have high rates, between 44% and 69%, of capacity impairment (Barton, Mallik, Orr, & Janofsky, 1996;Fitten & Waite, 1990;Krynski, Tymchuk, & Ouslander, 1994;Pruchno, Smyer, Rose, Hartman-Stein, & Laribee-Henderson, 1995;Royall, Cordes, & Polk, 1997;Tymchuk, Ouslander, & Fitten, 1988). Similarly, acutely hospitalized older patients have demonstrated transient capacity impairments (Carney, Neugroschl, Morrison, Marin, & Siu, 2001;Dellasega, Frank, & Smyer, 1996;Etchells et al, 1999;Fitten & Waite;Frank, Smyer, Grisso, & Applebaum, 1999).…”

Section: Impairment Within Patient Groupsmentioning

confidence: 99%

Assessment of Decision-Making Capacity in Older Adults: An Emerging Area of Practice and Research

Moye¹,

Marson²

2007

The Journals of Gerontology: Series B

272

112

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The convergence of the aging of our society, the increase in blended families, and an enormous intergenerational transfer of wealth has greatly expanded the incidence and importance of capacity assessment of older adults. In this article we discuss the emergence of capacity assessment as a distinct field of study. We review research efforts in two domains: medical decision-making capacity and financial capacity. Existing research in these two areas provides a first pass at many key questions related to capacity assessment, but additional studies that replicate, extend, and improve on this research are urgently needed. An agenda for future is detailed that recommends studies of a wide range of capacity constructs, focusing on clinical markers of diminished capacity, methods to improve clinical assessment, and the many intersections of law and clinical practice.

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“…One study by Ruscin and Semla (1996) showed that, in a sample of elders with an average age of 80, 22% of those who were physically dependent and one third of those who had cognitive impairment were still responsible for taking their own medications. Compounding this situation, a study by Royall, Cordes, and Polk (1997) showed that half of residents in the community they studied had trouble comprehending medication information.…”

mentioning

confidence: 99%

Medication Management Assessment for Older Adults in the Community

Orwig¹,

Brandt²,

Gruber‐Baldini³

2006

The Gerontologist

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Purpose: The purpose of this study was to describe the Medication Management Instrument for Deficiencies in the Elderly (MedMaIDE) and to provide results of reliability and validity testing. Design and Methods: Participants were 50 older adults, aged 65 and older, who lived in the community, took at least one prescription medication, and were then self-medicating. Nonmedical study staff assessed participants in their homes at baseline and 1 week, and a study pharmacist conducted pill counts at baseline and 30 days. The MedMaIDE covers three domains important for ensuring medication compliance (knowledge of medications, how to take medications, and procurement) and yields a total deficiency score. We assessed test-retest and interrater reliability. We assessed validity by comparing the MedMaIDE deficiency scores to 30-day pill count compliance. Results: The sample was mostly female (72%) and White (56%), with a mean age of 78. Participants were taking an average of 7 prescription drugs, with an average pill count compliance of 70%. The MedMaIDE had very good test-retest reliability (intraclass correlation coefficient [ICC] = 0.93) and good interrater reliability (ICC = 0.74). Internal consistency was also strong (Cronbach's alpha = .71). Comparing the MedMaIDE to the pill count with those who were compliant (.80%) versus those that were not, the agreement was 75%. The MedMaIDE was more highly specific and predictive of compliance compared to the pill count. Implications: The MedMaIDE appears to be a reliable and valid instrument for determining if an older adult has deficiencies in managing medications.

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Executive Control and the Comprehension of Medical Information by Elderly Retirees

Cited by 71 publications

References 15 publications

Off-Target Verbosity, Everyday Competence, and Subjective Well-Being

Off-Target Verbosity, Everyday Competence, and Subjective Well-Being

Assessment of Decision-Making Capacity in Older Adults: An Emerging Area of Practice and Research

Medication Management Assessment for Older Adults in the Community

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