Mental health among centenarians living in Switzerland.

BACKGROUND: Given the increasing number of people achieving exceptionally long lifespans, there is an urgent need for a better understanding of mental health in centenarians. This study aimed to understand the prevalence of mental health conditions-depressive symptoms, anxiety, sleep disturbances, disinhibition, and aberrant motor behaviour-among centenarians in Switzerland. METHODS: Data were collected from N = 169 participants via telephone interviews or paper questionnaires, either directly from centenarians or through proxy informants. Half the data were collected during a period when protective measures were imposed due to the COVID-19 pandemic, and half were collected after the measures were lifted. RESULTS: Mental health conditions were prevalent in our sample, particularly depressive symptoms (44.51%) and anxiety (42.17%). Significant positive associations were found between depressive symptoms and anxiety, and between disinhibition and aberrant motor behaviour. Furthermore, we identified statistical predictors for the occurrence of mental health conditions. Notably, institutionalised living increased the odds of depressive symptomatology, while those with higher education levels or an absence of cognitive impairment experienced more sleep disturbances. Finally, cognitive impairment was linked to increased disinhibition and aberrant motor behaviour. CONCLUSIONS: The high prevalence of mental health conditions underscores the need for proactive mental health care strategies in advanced old age. Moreover, it is vital to consider the interconnected nature of mental health conditions and to prioritise vulnerable groups, such as centenarians in institutional settings.

Profiles of centenarians' functioning: linking functional and cognitive capacity with depressive symptoms.

BACKGROUND: Despite most centenarians facing age-related declines in functional and cognitive capacities, the severity of these declines varies among individuals, as does the maintenance of good mental health (e.g., depressive symptoms) despite these declines. This study aims to examine this heterogeneity in centenarians from the Second Heidelberg Centenarian Study, which collected data from 112 centenarians living in Germany. In our study, we focus on a subsample of 73 centenarians who provided self-reports for our measures of interest (M age = 100.4, SD age = 0.55). METHODS: We examined correlations between functional capacity (i.e., PADL, IADL), cognitive capacity (i.e., MMSE), and depressive symptoms (i.e., GDS), and the existence of different profiles using hierarchical clustering. RESULTS: Higher functional capacity was related to higher cognitive capacity and to fewer depressive symptoms. Yet, higher cognitive capacity was associated with more depressive symptoms. Hierarchical clustering analysis elucidated this contradiction by identifying three profiles: low-capacity individuals (i.e., 24 individuals had low functional and cognitive capacities, with low depressive symptoms), high-capacity individuals (i.e., 33 individuals with high functional and cognitive capacities, with low depressive symptoms), and low-functional-high-cognitive-capacity individuals (i.e., 16 individuals showed low functional but high cognitive capacity, with high depressive symptoms). Our post-hoc analyses highlighted arthritis and pain as risk factors for functional dependence and depression. CONCLUSIONS: Our findings emphasize the importance of identifying centenarian subgroups with specific resource- and risk profiles to better address their needs, and of treating pain to improve functional capacity and mental health in centenarians.

Coping Patterns in Advanced Old Age: Findings from the Fordham Centenarian Study.

INTRODUCTION: Research on coping in advanced old age is scarce. In the present study, we explored coping patterns in near-centenarians and centenarians, and characteristics associated to using a specific coping pattern. METHODS: We analyzed the frequency with which participants (N = 87, MAge = 99.05; SDage = 2.6; age range 95-107) reported using specific coping strategies (i.e., coping strategy use) and the relative preference for specific strategies (i.e., relative coping preferences) in data from the Fordham Centenarian Study. Moreover, we applied cluster analysis to detect coping patterns, and we compared cluster characteristics. RESULTS: Very old individuals reported using emotion control and acceptance the most. Cluster analysis further revealed two distinct groups: The high coping group reported significantly higher coping strategy use than the low coping group (p < 0.001). The two groups also favored different strategies (p < 0.001), with the high coping group showing significantly higher relative preferences than the low coping group for active problem-solving, proactive prevention, and strategic planning (all ps < 0.05). The groups furthermore differed significantly in psychological strengths (i.e., personality, self-efficacy, ps < 0.001) and well-being outcomes (i.e., life satisfaction, p = 0.05). DISCUSSION: This study provides evidence for a general preference for acceptance and emotion control in very old individuals, supporting theories of a developmental coping shift in old age, yet our findings also document the existence of groups with different coping patterns. More frequent coping use, and particularly continued use of active problem-solving and proactive prevention, may enable well-being in very old age.

From Lab-Testing to Web-Testing in Cognitive Research: Who You Test is More Important than how You Test.

The transition to web-testing, although promising, entails many new concerns. Web-testing is harder to monitor, so researchers need to ensure that the quality of the data collected is comparable to the quality of data typically achieved by lab-testing. Our study yields a novel contribution to this issue, by being the first to distinguish between the impact of web-testing and the impact of sourcing individuals from different participant pools, including crowdsourcing platforms. We presented a fairly general working memory task to 196 MTurk participants, 300 Prolific participants, and 255 students from the University of Geneva, allowing for a comparison of data quality across different participant pools. Among university students, 215 were web-tested, and 40 were lab-tested, allowing for a comparison of testing modalities within the same participant pool. Data quality was measured by assessing multiple data characteristics (i.e., reaction time, accuracy, anomalous values) and the presence of two behavioral benchmark effects. Our results revealed that who you test (i.e., participant pool) is more important than how you test (i.e., testing modality). Concerning how you test, our results showed that web-testing incurs a small, yet acceptable loss of data quality compared to lab-testing. Concerning who you test, Prolific participants were almost indistinguishable from web-tested students, but MTurk participants differed drastically from the other pools. Our results therefore encourage the use of web-testing in the domain of cognitive psychology, even when using complex paradigms. Nevertheless, these results urge for caution regarding how researchers select web-based participant pools when conducting online research.

Managing Recurrent Clozapine-Induced Constipation in a Patient with Resistant Schizophrenia.

Clozapine is an effective antipsychotic for the treatment of resistant schizophrenia. However, clozapine can lead to serious side effects. One of the most common side effects is constipation and in rare cases ileus, which is associated with a considerable case fatality rate. Our patient exhibited repeated episodes of ileus while being treated with clozapine. We adapted the treatment of the patient in several ways to manage these severe side effects. First, we reduced clozapine dosage by opting for an augmentation strategy of clozapine through paliperidone. Then, we added linaclotide as a nonconventional laxative. We further adapted treatment after the occurrence of a volvulus prompting surgical intervention which revealed a malformation of the intestines' peritoneal attachment. A gastrostomy to facilitate the treatment of any further episode was performed and bethanechol was introduced alongside linaclotide. Follow-up revealed the efficacy of our strategy involving the use of linaclotide in managing the side effects of clozapine in this patient.

The Time-Course of the Last-Presented Benefit in Working Memory: Shifts in the Content of the Focus of Attention.

Working memory is a cognitive system responsible for maintaining information. It is often assumed to contain different states of accessibility of information, which is highest for an item held in the focus of attention. Evidence for this heightened accessibility usually comes from item-recognition tasks, in which a memory list is followed by a probe to be judged as being present in or absent from the list. Probes corresponding to the last-presented list item are usually recognized faster than probes corresponding to any other list item (i.e., the last-presented benefit), an effect that is often explained by the last-presented item being in the focus of attention. The last-presented benefit usually disappears when a long retention interval is inserted between the presentation of the list items and the probe. This raises the question of how long the last-presented item remains in the focus of attention. The present study gradually manipulates the retention interval between the presentation of the list of items and the probe in an item-recognition task in order to pinpoint when the focus of attention switches away from the last-presented list item. The results show that the last-presented benefit decreases over time when the retention interval is gradually extended from 0 ms to 200 ms, 400 ms and 500 ms, and completely disappears as of 750 ms. The cognitive mechanisms that may be involved in the time course of the last-presented benefit are discussed.

Scrutinizing patterns of solution times in alphabet-arithmetic tasks favors counting over retrieval models.

According to associationist models, initial sequential processing of algorithmic steps is replaced through learning by single-step access to a memory instance. In an alphabet-arithmetic task where equations such as C + 3 = F have to be verified, the shift from algorithmic procedures to retrieval would manifest in a transition from steep slopes relating solution times to addends at the beginning of learning to a flat function at the end (e.g., Logan & Klapp, 1991). Nevertheless, we argue that computation of the slopes at the end of training is biased by a systematic drop in solution times for the largest addend in the study set. In this paper, this drop is observed even when the longest training period in alphabet-arithmetic literature is doubled (Experiment 1) and even when the size of the largest addend is increased (Experiment 2). We demonstrate that this drop is partly due to end-term effects but remains observable even when end-term problems are not considered in the analyses. As Logan and Klapp suggested, we conclude that the drop is partly due to deliberate memorization of the problems with the largest addend. In contrast, departing from Logan and Klapp, we demonstrate that, when problems with the largest addend are excluded from the analyses, the possibility that counting is still used after learning cannot be discarded. This conclusion is reached because after this exclusion, the slopes were still significant. To conclude, our results advocate that practicing an algorithm leads to its acceleration and not to a shift from algorithmic procedures to retrieval.

The Relation Between Memory Speed and Capacity: A Domain-General Law of Human Cognition?

This study tests an important and appealing hypothesis that has been around in the fields of cognitive psychology and neuroscience for over 40 years, but that lacks a conclusive empirical test. According to this hypothesis, there is a direct relationship between speed and capacity in working memory. Working memory refers to the ability to retain a small amount of information in a highly accessible state for a short period of time. Across different fields, it has been proposed that the limited capacity of working memory can be understood in terms of time instead of space, such that the amount of information that can be actively maintained corresponds to the amount of information through which one can cycle in a constant and relatively short time-window. Here, we present a study that explicitly and directly tests the speed-capacity hypothesis. In particular, we test (1) the speed-capacity hypothesis in verbal working memory, (2) the speed-capacity hypothesis in visuospatial working memory, and most importantly, (3) whether the same speed-capacity relation holds across verbal and visuospatial working memory, reflecting a domain-general, time-based law of human working memory capacity and, as such, of the complexity of human thought. Overall, our results do not provide any evidence for the existence of a domain-general law. However, unexpected findings related to measuring memory speed (i.e., high prevalence of negative search slopes in the Sternberg task) prevent us from drawing firm conclusions.

Is working memory storage intrinsically domain-specific?

It has recently been claimed that working memory (WM) storage is intrinsically domain-specific because the concurrent maintenance of an auditory and a visuospatial memory set did not involve any dual-task cost (Fougnie, Zughni, Godwin, & Marois, 2015). Using the same paradigm, we asked participants to concurrently maintain verbal auditory memory sets of 2, 4, or 6 letters along with visuospatial memory sets of 1, 3, or 5 dots in spatial locations. Whereas using the probe-recognition procedure used by Fougnie, Zughni, Godwin, and Marois (2015) replicated the absence of dual-task cost, a recall procedure revealed systematic interference between auditory-verbal and visuospatial WM. Increasing verbal WM load had a detrimental effect on the recall of visuospatial information, and vice versa, whether or not the task was performed under concurrent articulation. These between-domain interference effects proved to be non-negligible in magnitude when compared with within-domain effects in both the verbal (letters and digits) and visuospatial (spatial locations and movements) domains. The implication of these findings for our understanding of the structure and functioning of WM as well as the potential impact of the methods used to assess WM storage (i.e., recognition vs. recall) are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

On the sources of forgetting in working memory: The test of competing hypotheses.

Whether forgetting from working memory (WM) is only due to interference or is also caused by temporal decay is still a matter of debate. In the present study, this question was examined using complex span tasks in which each memory item was followed by a series of processing episodes, the duration and number of which were varied. It is known that recall performance in these tasks depends on the cognitive load ( CL) of concurrent processing conceived as the ratio between processing time and free time, higher CL resulting in lower spans. The decay-and-refresh hypothesis accounts for this effect by assuming that memory traces decay during processing but are refreshed during free time. This hypothesis predicts lower recall performance with longer processing episodes, but no effect of their number as long as CL remains constant. The interference-only hypothesis supposes that free time is used to alleviate the interference created by processing distractors. This hypothesis is potentially compatible with an effect of the duration of processing episodes through increased interference, but predicts a detrimental effect of their number. In three experiments, the recall pattern fitted the predictions of the decay-and-refresh hypothesis for verbal WM, but that of the interference-only hypothesis for visuospatial WM. Although the entire pattern of data is more easily accommodated by the decay-and-refresh hypothesis than by its interference-only contender, our results suggest that it is unwise to aim at identifying a unique source to a complex phenomenon like WM forgetting.

Strategy difficulty effects in young and older adults' episodic memory are modulated by inter-stimulus intervals and executive control processes.

Efficient execution of strategies is crucial to memory performance and to age-related differences in this performance. Relative strategy complexity influences memory performance and aging effects on memory. Here, we aimed to further our understanding of the effects of relative strategy complexity by looking at the role of cognitive control functions and the time-course of the effects of relative strategy complexity. Thus, we manipulated inter-stimulus intervals (ISI) and assessed executive functions. Results showed that (a) performance as a function of the relative strategy difficulty of the current and previous trial was modulated by ISI, (b) these effects were modulated by inhibition capacities, and (c) significant age differences were found in the way ISI modulates relative strategy difficulty. These findings have important implications for understanding the relationships between aging, executive control, and strategy execution in episodic memory.

Fast automated counting procedures in addition problem solving: When are they used and why are they mistaken for retrieval?

Contrary to a widespread assumption, a recent study suggested that adults do not solve very small additions by directly retrieving their answer from memory, but rely instead on highly automated and fast counting procedures (Barrouillet & Thevenot, 2013). The aim of the present study was to test the hypothesis that these automated compiled procedures are restricted to small quantities that do not exceed the size of the focus of attention (i.e., 4 elements). For this purpose, we analyzed the response times of ninety adult participants when solving the 81 additions with operands from 1 to 9. Even when focusing on small problems (i.e. with sums ⩽10) reported by participants as being solved by direct retrieval, chronometric analyses revealed a strong size effect. Response times increased linearly with the magnitude of the operands testifying for the involvement of a sequential multistep procedure. However, this size effect was restricted to the problems involving operands from 1 to 4, whereas the pattern of response times for other small problems was compatible with a retrieval hypothesis. These findings suggest that very fast responses routinely interpreted as reflecting direct retrieval of the answer from memory actually subsume compiled automated procedures that are faster than retrieval and deliver their answer while the subject remains unaware of their process, mistaking them for direct retrieval from long-term memory.

Ten-year-old children strategies in mental addition: A counting model account.

For more than 30 years, it has been admitted that individuals from the age of 10 mainly retrieve the answer of simple additions from long-term memory, at least when the sum does not exceed 10. Nevertheless, recent studies challenge this assumption and suggest that expert adults use fast, compacted and unconscious procedures in order to solve very simple problems such as 3+2. If this is true, automated procedures should be rooted in earlier strategies and therefore observable in their non-compacted form in children. Thus, contrary to the dominant theoretical position, children's behaviors should not reflect retrieval. This is precisely what we observed in analyzing the responses times of a sample of 42 10-year-old children who solved additions with operands from 1 to 9. Our results converge towards the conclusion that 10-year-old children still use counting procedures in order to solve non-tie problems involving operands from 2 to 4. Moreover, these counting procedures are revealed whatever the expertise of children, who differ only in their speed of execution. Therefore and contrary to the dominant position in the literature according to which children's strategies evolve from counting to retrieval, the key change in development of mental addition solving appears to be a shift from slow to quick counting procedures.

Sequential difficulty effects during execution of memory strategies in young and older adults.

This study aimed at uncovering factors influencing execution of memory strategies and at furthering our understanding of ageing effects on memory performance. To achieve this end, we investigated strategy sequential difficulty (SSD) effects recently demonstrated by Uittenhove and Lemaire in the domain of problem solving. We found that both young and older participants correctly recalled more words using a sentence-construction strategy when this strategy followed an easier strategy (i.e., repetition strategy) or a harder strategy (i.e., mental-image strategy). These SSD effects were of equal magnitude in young and older adults, correlated significantly with Stroop performance in both young and older adults and correlated with N-back performance only in young adults. These findings have important implications for furthering our understanding of memory strategy execution and age-related variations in memory performance, as well for understanding mechanisms underlying SSD effects.

The time course of strategy sequential difficulty effects: an ERP study in arithmetic.

Uittenhove and Lemaire (Exp Psychol 59(5):295-301, 2012) found that we are slower when executing a strategy following a difficult strategy than when executing the same strategy following an easier strategy (i.e., strategy sequential difficulty effects). Uittenhove and Lemaire suggested that difficult strategies temporarily reduce available executive capacities, interfering with the next strategy execution. In this study, we used ERP to determine the time course of these effects. In a computational estimation task, we found greater cerebral activities during strategy execution following a more difficult compared to an easier strategy. Interestingly, greater cerebral activities were most apparent immediately after the encoding of the problem and not during encoding or in later stages of processing. This suggests that strategy sequential difficulty effects interfere most with the retrieval of procedures in contrast to execution of these procedures. We discuss implications of these findings for further understanding of execution of cognitive strategies.

Strategy sequential difficulty effects vary with working-memory and response-stimulus-intervals: a study in arithmetic.

Strategy sequential difficulty effects are the findings that when participants execute strategies, performance is worse after a difficult strategy than after an easy strategy (Uittenhove & Lemaire, 2012). Strategy sequential difficulty effects are hypothesized to result from decreased working-memory resources following difficult strategy execution. In the present study we found a correlation between individuals' working memory and strategy sequential difficulty effects in arithmetic, supporting a working-memory account of these effects. Furthermore, we varied response-stimulus intervals, and we found decreased strategy sequential difficulty effects with increasing response-stimulus intervals. Implications of these findings for further understanding of strategic variations in human cognition are discussed.

Strategy sequential difficulty effects in Alzheimer patients: a study in arithmetic.

OBJECTIVE: Consistent with Uittenhove and Lemaire (2012 ), we expected that strategy execution would be slower following execution of a difficult strategy than after an easy strategy (strategy sequential difficulty, SSD, effects). Moreover, we expected larger SSD effects in older adults than in young adults, and especially in Alzheimer's disease (AD) patients, a population with marked cognitive impairments. METHOD: A total of 25 young and older (41 AD and 25 healthy) adults were asked to execute rounding strategies to solve arithmetic problems (e.g., solving 43 + 68 by rounding operands down or up, e.g., 40 + 70 = 110). We measured solution latencies and percentage errors with a strategy as a function of the difficulty of the just-executed strategy. RESULTS: Solution latencies were significantly shorter following the easier rounding-down strategy than following the harder rounding-up strategy, F(2, 156) = 35.8. Moreover, this effect was significantly larger in AD patients, F(1, 78) = 117.4. CONCLUSIONS: We found comparable SSD effects in young and healthy older adults but dramatically increased SSD effects in AD patients. This has implications to further our understanding of strategic aspects underlying decreased cognitive functioning in AD patients.

Sequential difficulty effects during strategy execution.

In two experiments, we tested the hypothesis that strategy performance on a given trial is influenced by the difficulty of the strategy executed on the immediately preceding trial, an effect that we call strategy sequential difficulty effect. Participants' task was to provide approximate sums to two-digit addition problems by using cued rounding strategies. Results showed that performance was poorer after a difficult strategy than after an easy strategy. Our results have important theoretical and empirical implications for computational models of strategy choices and for furthering our understanding of strategic variations in arithmetic as well as in human cognition in general.