Neurocognitive Profiles Associated With Limited English Proficiency in Cognitively Intact Adults.

OBJECTIVE: The objective of the present study was to examine the neurocognitive profiles associated with limited English proficiency (LEP). METHOD: A brief neuropsychological battery including measures with high (HVM) and low verbal mediation (LVM) was administered to 80 university students: 40 native speakers of English (NSEs) and 40 with LEP. RESULTS: Consistent with previous research, individuals with LEP performed more poorly on HVM measures and equivalent to NSEs on LVM measures-with some notable exceptions. CONCLUSIONS: Low scores on HVM tests should not be interpreted as evidence of acquired cognitive impairment in individuals with LEP, because these measures may systematically underestimate cognitive ability in this population. These findings have important clinical and educational implications.

Effects of Exergaming on Physical and Cognitive Outcomes of Older Adults Living in Long-Term Care Homes: A Systematic Review.

BACKGROUND: Aging is often associated with increasing functional decline as measured by deterioration in mobility and activities of daily living. Older adults (OAs) living in residential long-term care (LTC) homes in particular may not engage in regular physical exercise, significantly increasing their risk of further cognitive and functional decline. Exergaming may hold promise for OAs by combining exercise and technology-based gaming systems, but evidence for its use in LTC is unknown. METHODS: A systematic review was conducted to summarize the effects of exergaming interventions on physical, cognitive, and quality of life (QoL) outcomes for OAs (>65 years of age) living in LTC. RESULTS: Twenty-one studies involving 657 OAs living in LTC met the inclusion criteria. Most studies were associated with a high risk of bias and many used uncontrolled designs and small samples. Across studies, exergame interventions were associated with preliminary benefits relative to control conditions on standardized measures of physical outcomes (e.g., Timed Up & Go, 5-meter gait speed). No consistent effects were found for cognitive and QoL outcomes. CONCLUSIONS: Exergames might be a promising intervention to benefit the physical health of OAs (>65 years) living in LTC, but more research is required to determine the effects of exergaming on physical health, as well as cognitive and QoL outcomes. More specifically, larger and more methodologically robust evaluations are needed.

The BNT-15 provides an accurate measure of English proficiency in cognitively intact bilinguals - a study in cross-cultural assessment.

This study was designed to replicate earlier reports of the utility of the Boston Naming Test - Short Form (BNT-15) as an index of limited English proficiency (LEP). Twenty-eight English-Arabic bilingual student volunteers were administered the BNT-15 as part of a brief battery of cognitive tests. The majority (23) were women, and half had LEP. Mean age was 21.1 years. The BNT-15 was an excellent psychometric marker of LEP status (area under the curve: .990-.995). Participants with LEP underperformed on several cognitive measures (verbal comprehension, visuomotor processing speed, single word reading, and performance validity tests). Although no participant with LEP failed the accuracy cutoff on the Word Choice Test, 35.7% of them failed the time cutoff. Overall, LEP was associated with an increased risk of failing performance validity tests. Previously published BNT-15 validity cutoffs had unacceptably low specificity (.33-.52) among participants with LEP. The BNT-15 has the potential to serve as a quick and effective objective measure of LEP. Students with LEP may need academic accommodations to compensate for slower test completion time. Likewise, LEP status should be considered for exemption from failing performance validity tests to protect against false positive errors.

Exergaming Platform for Older Adults Residing in Long-Term Care Homes: User-Centered Design, Development, and Usability Study.

BACKGROUND: Older adults (OAs) residing in long-term care (LTC) homes are often unable to engage in adequate amounts of physical activity because of multiple comorbidities, including frailty and severe cognitive impairments. This level of physical inactivity is associated with declines in cognitive and functional abilities and can be further compounded by social isolation. Exergaming, defined as a combination of exercise and gaming, has the potential to engage OAs in exercise and encourage social interaction. However, previously used systems such as the Nintendo Wii are no longer commercially available, and the physical design of other exergames is not suitable for OAs (ie, fall risks, accessibility issues, and games geared toward a younger population) with diverse physical and cognitive impairments. OBJECTIVE: This study aims to design and develop a novel, user-centered, evidence-based exergaming system for use among OAs in LTC homes. In addition, we aim to identify facilitators and barriers to the implementation of our exergaming intervention, the MouvMat, into LTC homes according to staff input. METHODS: This study used a user-centered design (UCD) process that consisted of 4 rounds of usability testing. The exergame was developed and finalized based on existing evidence, end user and stakeholder input, and user testing. Semistructured interviews and standardized and validated scales were used iteratively to evaluate the acceptability, usability, and physical activity enjoyment of the MouvMat. RESULTS: A total of 28 participants, 13 LTC residents, and 15 staff and family members participated in the UCD process for over 18 months to design and develop the novel exergaming intervention, the MouvMat. The iterative use of validated scales (System Usability Scale, 8-item Physical Activity Enjoyment Scale, and modified Treatment Evaluation Inventory) indicated an upward trend in the acceptability, usability, and enjoyment scores of MouvMat over 4 rounds of usability testing, suggesting that identified areas for refinement and improvement were appropriately addressed by the team. A qualitative analysis of semistructured interview data found that residents enjoyed engaging with the prototype and appreciated the opportunity to increase their PA. In addition, staff and stakeholders were drawn to MouvMat's ability to increase residents' autonomous PA. The intended and perceived benefits of MouvMat use, that is, improved physical and cognitive health, were the most common facilitators of its use identified by study participants. CONCLUSIONS: This study was successful in applying UCD to collaborate with LTC residents, despite the high number of physical and sensory impairments that this population experiences. By following a UCD process, an exergaming intervention that meets diverse requirements (ie, hardware design features and motivation) and considers environmental barriers and residents' physical and cognitive needs was developed. The effectiveness of MouvMat in improving physical and cognitive abilities should be explored in future multisite randomized controlled trials.

Technology Use among Family Caregivers of People with Dementia.

This study explored family caregivers' use of technology to care for people with dementia living at home. Three questions were pursued: (1) what are the important, unmet needs of family caregivers, (2) how do they use technologies to assist in care tasks, and (3) what do health care providers know about caregivers' needs and technology use? Two comprehensive surveys were developed to answer these questions: one for family caregivers (n = 33), and one for health care providers (n = 60). Descriptive and quantitative analyses showed that caregivers' important, unmet needs were in the domains of information, formal services, and emotional support. Caregivers make limited use of technology but believe in its potential usefulness. Health care providers agree that technology is useful in dementia care; however, they underestimate caregivers' willingness to adopt technologies to communicate with providers. Findings prove caregiver willingness to use technology to support their care role and provide guidance regarding the caregiver needs that these technologies should address.

An Incidental Learning Method to Improve Face-Name Memory in Older Adults With Amnestic Mild Cognitive Impairment.

OBJECTIVE: Forgetting names is a common memory concern for people with amnestic mild cognitive impairment (aMCI) and is related to explicit memory deficits and pathological changes in the medial temporal lobes at the early stages of Alzheimer's disease (AD). In the current experiment, we tested a unique method to improve memory for face-name associations in people with aMCI involving incidental rehearsal of face-name pairs. METHOD: Older adults with aMCI and age- and education-matched controls learned 24 face-name pairs and were tested via immediate cued recall with faces as cues for associated names. During a 25- to 30-min retention interval, 10 of the face-name pairs reappeared as a quarter of the items on a seemingly unrelated 1-back task on faces, with the superimposed names irrelevant to the task. After the delay, surprise delayed cued recall and forced-choice associative recognition tests were administered for the face-name pairs. RESULTS: Both groups showed reduced forgetting of the names that repeated as distraction and enhanced recollection of these pairs. CONCLUSIONS: The results demonstrate that passive methods to prompt automatic retrieval of associations may hold promise as interventions for people with early signs of AD.

Leveraging older adults' susceptibility to distraction to improve memory for face-name associations.

Forgetting people's names is a common memory complaint among older adults and one that is consistent with experimental evidence of age-related decline in memory for face-name associations. Despite this difficulty intentionally forming face-name associations, a recent study demonstrated that older adults hyperbind distracting names and attended faces, which produces better learning of these face-name pairs when they reappear on a memory test (Weeks, Biss, Murphy, & Hasher, 2016). The current study explored whether this effect could be leveraged as an intervention to reduce older adults' forgetting of face-name associations, using a method previously shown to improve older adults' retention of a word list (Biss, Ngo, Hasher, Campbell, & Rowe, 2013). Twenty-five younger and 32 older adults studied 24 face-name pairs and were tested via immediate and delayed memory tests. During the 30-min retention interval, 10 of the face-name pairs reoccurred as distraction in an ostensibly unrelated face-judgment task, providing an opportunity to implicitly rehearse these pairs. Older adults showed reduced forgetting of repeated face-name pairs as well as improved recollection. Younger adults showed no reliable benefit. These findings indicate that useful distraction benefits older adults' memory for face-name associations, suggesting its potential utility as a memory intervention technique. (PsycINFO Database Record

Face-name learning in older adults: a benefit of hyper-binding.

Difficulty remembering faces and corresponding names is a hallmark of cognitive aging, as is increased susceptibility to distraction. Given evidence that older adults spontaneously encode relationships between target pictures and simultaneously occurring distractors (a hyper-binding phenomenon), we asked whether memory for face-name pairs could be improved through prior exposure to faces presented with distractor names. In three experiments, young and older adults performed a selective attention task on faces while ignoring superimposed names. After a delay, they learned and were tested on face-name pairs that were either maintained or rearranged from the initial task but were not told of the connection between tasks. In each experiment, older but not younger participants showed better memory for maintained than for rearranged pairs, indicating that older adults' natural propensity to tacitly encode and bind relevant and irrelevant information can be employed to aid face-name memory performance.

Distraction can reduce age-related forgetting.

In three experiments, we assessed whether older adults' generally greater tendency to process distracting information can be used to minimize widely reported age-related differences in forgetting. Younger and older adults studied and recalled a list of words on an initial test and again on a surprise test after a 15-min delay. In the middle (Experiments 1a and 2) or at the end (Experiment 3) of the delay, participants completed a 1-back task in which half of the studied words appeared as distractors. Across all experiments, older adults reliably forgot unrepeated words; however, older adults rarely or never forgot the words that had appeared as distractors, whereas younger adults forgot words in both categories. Exposure to distraction may serve as a rehearsal episode for older adults, and thus as a method by which general distractibility may be co-opted to boost memory.

Interference from previous distraction disrupts older adults' memory.

OBJECTIVES: Previously relevant information can disrupt the ability of older adults to remember new information. Here, the researchers examined whether prior irrelevant information, or distraction, can also interfere with older adults' memory for new information. METHOD: Younger and older adults first completed a 1-back task on pictures that were superimposed with distracting words. After a delay, participants learned picture-word paired associates and memory was tested using picture-cued recall. In 1 condition (high interference), some pairs included pictures from the 1-back task now paired with new words. In a low-interference condition, the transfer list used all new items. RESULTS: Older adults had substantially lower cued-recall performance in the high- compared with the low-interference condition. In contrast, younger adults' performance did not vary across conditions. DISCUSSION: These findings suggest that even never-relevant information from the past can disrupt older adults' memory for new associations.

Happily distracted: mood and a benefit of attention dysregulation in older adults.

Positive mood states are believed to broaden the focus of attention in younger adults, but it is unclear whether the same is true for older adults. Here we examined one consequence of broader attention that has been shown in young adults: that memory for distraction is greater for those in a positive mood. In the current study, positive and neutral moods were induced in older adults (M = 67.9) prior to a 1-back task in which participants were instructed to attend to relevant pictures and ignore distracting words. Following a 10-min filled interval, participants performed a word fragment completion task that tested implicit memory for the distracting words from the 1-back task. Older adults in the positive mood group showed greater implicit memory for previous distraction compared to those in the neutral mood group. These findings suggest that affect influences the ability to regulate attention in a similar manner for younger and older adults.

Happy as a lark: morning-type younger and older adults are higher in positive affect.

A literature on young adults reports that morning-type individuals, or "larks," report higher levels of positive affect compared with evening-type individuals, or "owls" (Clark, Watson, & Leeka, 1989; Hasler et al., 2010). Morning types are relatively rare among young adults but frequent among older adults (May & Hasher, 1998; Mecacci et al., 1986), and here we report on the association between chronotype and affect in a large sample of healthy younger and older adults. Overall, older adults reported higher levels of positive affect than younger adults, with both younger and older morning types reporting higher levels of positive affect and subjective health than age mates who scored lower on morningness. Morningness partially mediated the association between age and positive affect, suggesting that greater morningness tendencies among older adults may contribute to their improved well-being relative to younger adults.

Delighted and distracted: positive affect increases priming for irrelevant information.

Emotional states are known to influence how people process relevant information. Here, we address the impact of emotional state on irrelevant information. In this experiment, participants were randomly assigned to a neutral or positive mood induction, and then completed a task that involved viewing a sequence of overlapping pictures and words. They were instructed to attend to the pictures and ignore the distracting words. Following a filled interval, implicit memory for the distracting words was tested using a word fragment completion task. Individuals in the positive mood group showed increased implicit memory for previously irrelevant information compared to those in the neutral mood group. These findings are consistent with the view that positive mood broadens attention to include encoding of irrelevant information in the environment, and this can impact subsequent performance.

Positive mood is associated with the implicit use of distraction.

Previous research demonstrates that individuals in a positive mood are differentially distracted by irrelevant information during an ongoing task (Rowe et al. in Proc Natl Acad Sci 104:383-388, 2007). The present study investigated whether susceptibility to distraction shown by individuals in a positive mood results in greater implicit memory for that distraction. Participants performed a similarity-judgment task on pictures that were superimposed with distracting words. When these previously distracting words could be used as solutions on a delayed implicit task administered several minutes later, performance was positively correlated with pleasantness of mood. Individuals in a positive mood are more likely than others to use previously irrelevant information to facilitate performance on a subsequent implicit task, a finding with implications for the relationship between positive mood and creativity.