A Wearable System for Continuous Monitoring and Assessment of Speech, Gait, and Cognitive Decline for Early Diagnosis of ADRD.

Early detection of cognitive decline is essential to study mild cognitive impairment and Alzheimer's Disease in order to develop targeted interventions and prevent or stop the progression of dementia. This requires continuous and longitudinal assessment and tracking of the related physiological and behavioral changes during daily life. In this paper, we present a low cost and low power wearable system custom designed to track the trends in speech, gait, and cognitive stress while also considering the important human factor needs such as privacy and compliance. In the form factors of a wristband and waist-patch, this multimodal, multi-sensor system measures inertial signals, sound, heart rate, electrodermal activity and pulse transit time. A total power consumption of 2.6 mW without any duty cycling allows for more than 3 weeks of run time between charges when 1500 mAh batteries are used.Clinical Relevance- Much earlier detection of Alzheimer's disease and related dementias may be possible by continuous monitoring of physiological and behavioral state using application specific wearable sensors during the activities of daily life.

Aging attitudes and changes in the costs of cognitive engagement in older adults over 5 years.

The costs associated with performing a specific activity may play an important role in determining engagement, potentially impacting the willingness of older adults to engage in activities-particularly those with high demands-that may have benefits for physical and cognitive health. The present study examined changes in both objective (effort expenditure) and subjective (perceived task demands) costs associated with engagement in a cognitively challenging memory-scan task across a 5-year period in 163 older adults aged 64-81. Consistent with assumptions of selective engagement theory (SET; Hess, 2014), the effort associated with performing the task-as assessed by systolic blood pressure responses-was observed to increase over time. Subjective assessments of costs, as assessed by the National Aeronautics and Space Administration task load index (NASA TLX), were also observed to increase. In addition, the increases in both objective and subjective costs were greatest at high levels of task demands. We further found that both the effort and, to a lesser extent, perceived costs associated with performance were moderated by aging attitudes. Specifically, more positive attitudes were associated with greater effort expenditure and lower perceived costs. These findings suggest that negative attitudes about aging may have detrimental effects on perceived ability to perform challenging tasks. Given the importance of costs in determining activity participation, promoting positive aging attitudes along with more realistic perceptions of task demands may provide important means for promoting engagement in beneficial activities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The role of cognitive costs, attitudes about aging, and intrinsic motivation in predicting engagement in everyday activities.

Engagement in cognitively demanding everyday activities has been shown to benefit cognitive health in later life. We investigated the factors that influence engagement, with specific interest in determining the extent to which the costs of engaging cognitive resources are associated with intrinsic motivation and, ultimately, participation in everyday activities. Older adults (N = 153) aged from 65 to 81 years completed a challenging cognitive task, with the costs of cognitive engagement-operationalized as the effort required to maintain performance-assessed using systolic blood pressure responses (SBP-R). We also assessed participation in everyday activities using both 2-year retrospective reports and five daily reports over a 5-week period. Structural models revealed that lower levels of costs were associated with more positive attitudes about aging, which in turn were associated with higher levels of intrinsic motivation. Motivation was subsequently predictive of everyday activity engagement, with the effect being specific to those activities thought to place demands on cognitive resources. The measure of engagement had minimal impact on the nature of the observed effects, suggesting that the retrospective and weekly assessments were tapping into similar constructs. Taken together, the results are consistent with expectations derived from Selective Engagement Theory (Hess, 2014), which argues that engagement in demanding activities is related to the cost associated with such engagement, which in turn leads to selective participation through changes in motivation. (PsycINFO Database Record

Negative Aging Attitudes Predict Greater Reactivity to Daily Stressors in Older Adults.

Objectives: In order to understand conflicting findings regarding the emotional reactions of older adults to daily stressors, we examined the possibility that negative aging attitudes could function as an important individual differences factor related to stressor reactivity. Method: Using a daily dairy design, we examined the aging attitudes of 43 older adults reporting on 380 total days. Participants reported their aging attitudes on Day 1, followed by their stressor exposure and negative affect on Days 2-9. Covariates included age, gender, education, and personality. Results: Using multilevel modeling, our results suggest that individuals with more positive aging attitudes report consistent levels of affect across study days regardless of stressors, whereas those with more negative aging attitudes reported increased emotional reactivity to daily stressors. Discussion: Positive aging attitudes may serve as a resource that helps buffer reactions to daily stressors.

SSI/SSDI Outreach, Access, and Recovery (SOAR): Disability Application Outcomes Among Homeless Adults.

OBJECTIVE: The SSI/SSDI Outreach, Access, and Recovery (SOAR) program has been shown to increase access to Supplemental Security Income and Social Security Disability Insurance benefits among homeless adults. However, little empirical data exist on how or for whom SOAR achieves successful application outcomes. This study investigated applicant and application characteristics associated with disability application outcomes among homeless adults. METHODS: Secondary data on 6,361 SOAR-assisted applications were obtained. Multilevel models investigated between-applicant differences in application processing time and decision as a function of applicant and application characteristics. RESULTS: Older age and living in an institution were associated with greater odds of application approval. Female gender and receipt of public assistance were associated with longer processing time and lower odds of approval. Except for quality review, SOAR critical components were associated with greater odds of approval. CONCLUSIONS: Women and adults receiving public assistance appear disadvantaged in the SOAR application process. SOAR critical components promote successful disability application outcomes.

Do daily stress processes account for socioeconomic health disparities?

OBJECTIVES: The present study examined the extent to which daily stressor severity and appraisals of the stressors accounted for socioeconomic disparities in health. METHODS: Data from the National Study of Daily Experiences and the Midlife in the United States Survey were combined for the current analyses, resulting in 1,031 respondents who reported on 7,229 days. RESULTS: Respondents without a high school degree experienced more severe stressors and appraised stressors as posing greater risk to their financial situation and to their self-concept than respondents with a high school or college degree. Differences in severity and stressor appraisal accounted for education differences in psychological distress and physical health symptoms. DISCUSSION: Findings suggest the importance of considering variation across stressors, particularly implications for self-concept, in understanding sources of differential stressor vulnerability.

Socioeconomic status and health: a micro-level analysis of exposure and vulnerability to daily stressors.

This study examines the interconnections among education--as a proxy for socioeconomic status--stress, and physical and mental healthy by specifying differential exposure and vulnerability models using data from The National Study of Daily Experiences (N = 1,031). These daily diary data allowed assessment of the social distribution of a qualitatively different type of stressor than has previously been examined in sociological stress research--daily stressors, or hassles. Moreover, these data allowed a less biased assessment of stress exposure and a more micro-level examination of the connections between stress and healthy by socioeconomic status. Consistent with the broad literature describing socioeconomic inequalities in physical and mental health, the results of this study indicated that, on any given day, better-educated adults reported fewer physical symptoms and less psychological distress. Although better educated individuals reported more daily stressors, stressors reported by those with less education were more severe. Finally, neither exposure nor vulnerability explained socioeconomic differentials in daily health, but the results clearly indicate that the stressor-health association cannot be considered independent of socioeconomic status.