Religion/Spirituality, Mental Health, and the Lifespan: Findings from a Representative Sample of Canadian Adults.

Theories of adult development and aging suggest that older adults turn towards religion and spirituality (R/S) to increase meaning and purpose in life, and to assist in coping with adverse experience. We sought to examine the relationship between R/S and positive mental health and mental illness (i.e., psychological distress) in adulthood, and to determine the potential moderating role of age. Data from the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH), a national population health study, were used. A multivariable linear regression model revealed a significant R/S by age interaction for positive mental health (p = 0.001). Although R/S was associated with positive mental health among all participants, there was a stronger relationship between R/S and positive mental health for older adults. No statistically significant relationship between R/S and psychological distress was observed. Findings highlight the importance of R/S to positive mental health across the adult lifespan. The differential relationships among R/S, positive mental health, and mental illness underscore the utility of using the dual-continua of mental health and mental illness in order to understand their respective determinants.

Using Serial Trichotomization with Neuropsychological Measures to Inform Clinical Decisions on Fitness-to-Drive among Older Adults with Cognitive Impairment.

Decisions related to driving safety and when to cease driving are complex and costly. There is an interest in developing an off-road driving test utilizing neuropsychological tests that could help assess fitness-to-drive. Serial trichotomization has demonstrated potential as it yields 100% sensitivity and specificity in retrospective test samples. The purpose of this study was to test serial trichotomization using four common neuropsychological tests (Trail Making Test Part A and B, Clock Drawing Test, and Modified Mini-Mental State Examination). Test scores from 105 patients who were seen in a memory clinic were abstracted. After applying the model, participants were classified as unfit, fit, or requiring further testing, 38.1%, 25.8%, and 36.1%, respectively. This study provides further evidence that trichotomization can facilitate the assessment of fitness-to-drive.

Comparing Cognitive Profiles of Licensed Drivers with Mild Alzheimer's Disease and Mild Dementia with Lewy Bodies.

Purpose. Alzheimer's disease (AD) and dementia with Lewy Bodies (DLB) constitute two of the most common forms of dementia in North America. Driving is a primary means of mobility among older adults and the risk of dementia increases with advanced age. The purpose of this paper is to describe the cognitive profile of licensed drivers with mild AD and mild DLB. Method. Licensed drivers with mild AD, mild DLB, and healthy controls completed neuropsychological tests measuring general cognition, attention, visuospatial/perception, language, and cognitive fluctuations. Results. The results showed differences between healthy controls and demented participants on almost all neuropsychological measures. Participants with early DLB were found to perform significantly worse on some measures of attention and visuospatial functioning in comparison with early AD. Discussion. Future research should examine the relationship between neuropsychological measures and driving outcomes among individuals with mild AD and mild DLB.

Deficits in Attention and Visual Processing but not Global Cognition Predict Simulated Driving Errors in Drivers Diagnosed With Mild Alzheimer's Disease.

This study sought to predict driving performance of drivers with Alzheimer's disease (AD) using measures of attention, visual processing, and global cognition. Simulated driving performance of individuals with mild AD (n = 20) was contrasted with performance of a group of healthy controls (n = 21). Performance on measures of global cognitive function and specific tests of attention and visual processing were examined in relation to simulated driving performance. Strong associations were observed between measures of attention, notably the Test of Everyday Attention (sustained attention; r = -.651, P = .002) and the Useful Field of View (r = .563, P = .010), and driving performance among drivers with mild AD. The Visual Object and Space Perception Test-object was significantly correlated with the occurrence of crashes (r = .652, P = .002). Tests of global cognition did not correlate with simulated driving outcomes. The results suggest that professionals exercise caution when extrapolating driving performance based on global cognitive indicators.

Assessment of Drivers with Alzheimer's Disease in High Demand Driving Situations: Coping with Intersections in a Driving Simulator.

Intersections are one of the most complex and cognitively demanding driving situations. Individuals with dementia and, more precisely, Alzheimer's disease (AD), may face additional challenges negotiating intersections given the nature of their cognitive decline, which often includes deficits of attention. We developed a comprehensive evaluation scheme to assess simulated driving performance at intersections. The evaluation scheme captured all types of errors that could occur during preparation (i.e., prior to the intersection), execution (i.e., during the intersection), and recovery (i.e., after the intersection). Using the evaluation scheme, intersection behaviour in a driving simulator among 17 drivers with mild AD was compared to that of 21 healthy controls. The results indicated that across all types of intersections, mild AD drivers exhibited a greater number of errors relative to controls. Drivers with mild AD made the most errors during the preparation period leading up to the intersection. These findings present a novel approach to analyzing intersection behaviour and contribute to the growing body of research on dementia and driving.

Driving Competence in Mild Dementia with Lewy Bodies: In Search of Cognitive Predictors Using Driving Simulation.

Driving is a multifactorial behaviour drawing on multiple cognitive, sensory, and physical systems. Dementia is a progressive and degenerative neurological condition that impacts the cognitive processes necessary for safe driving. While a number of studies have examined driving among individuals with Alzheimer's disease, less is known about the impact of Dementia with Lewy Bodies (DLB) on driving safety. The present study compared simulated driving performance of 15 older drivers with mild DLB with that of 21 neurologically healthy control drivers. DLB drivers showed poorer performance on all indicators of simulated driving including an increased number of collisions in the simulator and poorer composite indicators of overall driving performance. A measure of global cognitive function (i.e., the Mini Mental State Exam) was found to be related to the overall driving performance. In addition, measures of attention (i.e., Useful Field of View, UFOV) and space processing (Visual Object and Space Perception, VOSP, Test) correlated significantly with a rater's assessment of driving performance.

Perceptions of private market landlords who rent to tenants of a Housing First program.

The rental of housing units by landlords to participants in Housing First (HF) programs is critical to the success of these programs. Therefore, it is important to understand the experiences of landlords with having these individuals as tenants. The paper presents findings of qualitative interviews with 23 landlords who rented to tenants from a HF program located in a small city and adjoining rural area in eastern Canada and in which approximately 75 % of tenants had been housed for at least six consecutive months at 2 years in the program. Findings showed that landlords are motivated to rent to HF tenants for financial and pro-social reasons. They reported holding a range of positive, neutral, and negative perceptions of these tenants. They identified problems encountered with some HF tenants that included disruptive visitors, conflict with other tenants, constant presence in their apartments, and poor upkeep of units. On the other hand, landlords perceived HF tenants as being mostly good tenants who are similar to their other tenants. Implications for practice in the context of HF programs are discussed.

Capturing the serial nature of older drivers' responses towards challenging events: a simulator study.

Older drivers' ability to trigger simultaneous responses in reaction to simulated challenging road events was examined through crash risk and local analyses of acceleration and direction data provided by the simulator. This was achieved by segregating and averaging the simulator's primary measures according to six short time intervals, one before and five during the challenging events. Twenty healthy adults aged 25-45 years old (M=29.5+/-4.32) and 20 healthy adults aged 65 and older (M=73.4+/-5.17) were exposed to five simulated scenarios involving sudden, complex and unexpected maneuvres. Participants were also administered the Useful Field of View (UFOV), single reaction time and choice reaction time tests, a visual secondary task in the simulator, and a subjective workload evaluation (NASA-TLX). Results indicated that the challenging event that required multiple synchronized reactions led to a higher crash rate in older drivers. Acceleration and orientation data analyses confirmed that the drivers who crashed limited their reaction. The other challenging events did not generate crashes because they could be anticipated and one response (braking) was sufficient to avoid crash. Our findings support the proposal (Hakamies-Blomqvist, L., Mynttinen, S., Backman, M., Mikkonen, V., 1999. Age-related differences in driving: are older drivers more serial? International Journal of Behavioral Development 23, 575-589) that older drivers have more difficulty activating car controls simultaneously putting them at risk when facing challenging and time pressure road events.

Context-dependent effects of hippocampal damage on memory in the shock-probe test.

We assessed the role of the hippocampus in anterograde memory, using the shock-probe test. Rats with sham or neurotoxic lesions of the hippocampus were given a shock-probe acquisition session during which each time they contacted a probe they received a shock; 24 h later, the rats were given a second shock-probe session to test their retention, but in this instance the probe was not electrified. Rats were tested in either the same context as the one used during acquisition or in a different context. The hippocampal lesions impaired avoidance of the probe and burying on the retention test, suggesting that the lesions induced anterograde amnesia. However, the impairment was context dependent. The hippocampal lesions impaired avoidance only when the rats were tested in the context in which they received the conditioning. The results of the shock-probe test suggest that the anterograde amnesia following hippocampal lesions is due mainly to an inability to associate the context with the shock more than to an inability to associate the probe with shock.