Neuropsychological mediators of the links among age, chronic illness, and everyday problem solving.

Abstract

Reductions in everyday problem solving (EPS) are often reported in older age, although the underlying mechanisms remain unclear. The authors examined the role of 2 variables predicted to mediate (neuropsychological abilities and health status) or moderate (health status) the relationship between age and EPS performance. Toward these ends, they compared EPS and neuropsychological performance in 50 functionally independent adults with chronic kidney disease (CKD) and 64 control participants matched on age and education. Both older age and CKD were associated with worse performance on measures of EPS and memory/executive abilities. Neuropsychological abilities were positively associated with EPS performance. In both the full sample and control participants only, memory/executive functioning mediated the association between presence of chronic illness and EPS. Furthermore, memory/executive functioning partially mediated the link between age and EPS. Findings indicate that relations among age, health status, and EPS are not straightforward. Although performance on neuropsychological measures appeared to underlie EPS declines in chronic illness, increasing age remained independently associated with reduced EPS. The authors discuss implications for models of adult developmental changes in everyday cognition.

Explaining individual differences in cognitive processes underlying hindsight bias

“…Participants met the following inclusion criteria: (a) English fluency as determined by an acculturation measure developed within our lab that examines language preferences (Thornton et al, 2007), (b) a minimum of grade 7 education (i.e., completion of primary school) to ensure that reading level was adequate for questionnaire completion, and (c) no vision (corrected vision ≤ 20/50), hearing or other sensory or motor impairments that might interfere with testing. In addition, the exclusion criteria included: (a) self-reported diagnosis of major psychotic illness by a physician, (b) concurrent acute illness (e.g., terminal cancer) that may affect testing, (c) neurological disorder (e.g., Parkinson's disease, Huntington's disease, multiple sclerosis, epilepsy), (c) significant head injury or stroke that affected daily living activities, (d) a self-reported diagnosis of dementia by a physician and/or a score of less than 24 on the Mini Mental Status Examination (Folstein, Folstein, & McHugh, 1975), and (e) alcohol consumption of greater than 3 ounces/day.…”

A Survey of Neuropsychologists' Practices and Perspectives Regarding the Assessment of Judgment Ability

“…1 From a neuropsychological perspective, judgment falls under the domain of executive functioning (Woods, Patterson, & Whitehouse, 2000) and includes a cognitive appraisal process (i.e., deciding what to do in a situation) and the behavioral follow-through (i.e., carrying out an effective/safe behavior; Rabin et al, 2007;Thornton et al, 2007). Judgment is an important aspect of executive functioning that is regularly assessed during neuropsychological evaluations with varied patient populations.…”

Clinical Ethics Issues in Geriatric Psychiatry

“…Increasing age, worsening health status, and cognitive impairment all correlate with lower capacity to make everyday decisions, 40 and patients who have AD in particular have been found to perform poorly on standardized measures of everyday problemsolving. 41 Lai and colleagues 42 developed the Assessment of Capacity for Everyday Decision-Making, a semi-structured interview that, like the MacCAT-T, assesses the domains of understanding, appreciation, and reasoning.…”