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Esophageal cancer (EC) makes up 3.2% of all cancers but ranks sixth among cancer-related deaths worldwide. This real-world analysis determined the use of PD-1/PD-L1 (PD[L]1) inhibitors in EC patients after receiving first-line therapy. Newly diagnosed EC patients initiating first-line treatment were identified in the IBM MarketScan administrative claims databases during the study period (1 May 2015 to 31 October 2020) using ICD-9/ICD-10 codes. Patients were assigned to either the chemotherapy only, radiation only, chemotherapy plus radiation (chemoradiation), or esophageal transhiatal/transthoracic surgery cohorts. 7276 EC patients started first-line therapy (chemotherapy only = 2502, radiation only = 3355, chemoradiation = 1180, surgery = 239). The average age at diagnosis was 62 years and 23% were female. The median time from start of first-line therapy to utilization of a PD(L)1 inhibitor was 259 days. Pembrolizumab (72%) was the most frequently used PD(L)1 inhibitor across the three cohorts, followed by nivolumab (25%). Furthermore, the number of patients receiving a PD(L)1 inhibitor increased each year with the majority (73%) of use occurring between 2018 and 2020. Findings from this real-world study suggest that PD(L)1 inhibitors are increasingly used after first-line therapies in EC, especially among patients initially receiving chemotherapy only. New immunological therapies such as PD(L)1 inhibitors hold great promise for patients with solid tumors. A clearer understanding of their real-world utilization is critical. [ABSTRACT FROM AUTHOR]

Abstract: The purpose of this investigation was to examine differences in psychological functioning (e.g., well-being, affect, depression, and social functioning) between older adults who play digital games compared to those older adults that do not play digital games. Analysis was conducted on a sample of 140 independently living older adults with an average age of 77.47years (SD =7.31). Participants were divided into three groups (Regular, Occasional Gamers, and Non-gamers) – 60% of the sample was either a Regular or Occasional Gamer. Differences among the groups were found for well-being, negative affect, social functioning, and depression with Regular and Occasional Gamers performing better, on average, than Non-gaming older adults. Findings suggest that playing may serve as a positive activity associated with successful aging. [Copyright &y& Elsevier]

Social support and functional ability are related to a number of outcomes in later life among African Americans, including cognitive performance. This study examined how providing and receiving social support was related to fluid and crystallized cognitive abilities among aging African American adults after accounting for functional limitations, age, education, sex, income, and self-reported health. Data from 602 African American adults (M = 69.08,SD = 9.74; 25% male) were analyzed using latent variable modeling. Fluid ability was a second-order factor indicated by measures that assessed verbal memory, working memory, perceptual speed, and inductive reasoning. Crystallized ability was a first-order factor indicated by three measures that assessed vocabulary (Shipley Verbal Meaning Test and parts A and B of the ETS Vocabulary Test). Results indicated that the receipt of social support was negatively related to both fluid and crystallized abilities, while the provision of support was positively related to fluid and crystallized ability. Follow-up tests found that the receipt of support was more strongly related to fluid ability than crystallized ability. There was no significant difference regarding the relationship of provision of support with fluid ability compared to crystallized ability. Results discuss the importance of considering the social context of older adults when examining cognitive ability. [ABSTRACT FROM PUBLISHER]

This study examines day-to-day variability in psychometrically defined mild cognitive impairment (MCI) status and potential predictors of changes in MCI status in an independent-living sample of urban dwelling older adults in Baltimore, Maryland. The participant sample consisted of 50 older adults, ranging in age from 50 to 80 years. Participants completed health and cognitive measures (i.e., executive function, language, memory, and global cognition) over 8 occasions within a 2-3-week period. After each testing occasion, a post hoc classification of MCI status was determined using psychometrically defined criteria based on cognitive performance. Participants who classified as MCI after one assessment often did not meet MCI criteria at subsequent occasions. Daily fluctuations in sleep duration were associated with an increased risk for MCI classification. These results demonstrate that changes in sleep may explain changes in MCI status, particularly for African Americans. [ABSTRACT FROM AUTHOR]

We exaini~ied short-term intraindividual variability in control beliefs (competence and locus of control) and cognitive performance and the extent to which the constructs travel together over time. Thirty-six older adults (M = 74 years, SD = 5.51) completed questionnaires and cognitive tests twice each day for 60 consecutive days. Results indicated that control beliefs fluctuate within people across time. Multilevel models re-ealed that control and competence are coupled with concurrent and subsequent performance, but the benefit of occasion-level increases in control depends on individuals' average control. These findings underscore the importance of examining constructs using a within-person approach to identify dynamic processes in cognitive aging. [ABSTRACT FROM AUTHOR]

This study examined the within-person relationship between sleep and cognitive functioning. Fifty community-dwelling African Americans (age range 50-80 years) were asked to report their sleep duration and quality the previous evening and to complete cognitive measures over 8 occasions within a 2-3 week period. A within-person daily change in sleep duration was significantly associated with worse global cognitive performance. The greater an individual deviated away from his or her average sleep duration on a particular day, the more likely his or her performance would decline. These results demonstrate that the sleep-cognition relationship can be observed at a within-person level of analysis. [ABSTRACT FROM AUTHOR]

Objectives To examine the frequency of Mild Cognitive Impairment (MCI) in African American older adults. The study also plans to explore the specific cognitive domains of impairment as well as whether there are differences in demographics, health, and cognitive performance between MCI and normal participants. Design Cross-sectional. Setting Independent-living sample of urban dwelling elders in Baltimore, Maryland. Participants The sample consisted of 554 subjects ranging in age from 50 to 95 (Mean = 68.79 ± 9.60). Measurements Socio-demographics and health were assessed. Several cognitive measures were administered to assess inductive reasoning, declarative memory, perceptual speed, working memory, executive functioning, language and global cognitive functioning. Results Approximately 22% of participants were considered MCI (i.e. 18% non-amnestic vs. 4% amnestic). A majority of the non-amnestic MCI participants had impairment in one cognitive domain, particularly language and executive function. Individuals classified as non-amnestic MCI were significantly older and had more years of education than normal individuals. The MCI groups were not significantly different than cognitively normal individuals on health factors. Individuals classified as MCI performed significantly worse on global cognitive measures as well as across specific cognitive domains than cognitively normal individuals. Conclusion This study demonstrates that impairment in a non-memory domain may be an early indicator of cognitive impairment, particularly among African Americans. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

We examined the mediating role of health literacy in the relationships between participant demographic characteristics and health information recall. Baseline data from two studies that focused on hypertensive adults (N = 1190; M = 62.28 years, SD = 11.98; 35.5% female; 45.9% African-American) were analyzed. The final model, which adjusted for recruitment site, indicated that financial status, race, and education were indirectly related to health information recall through health literacy. Increasing education was also directly related to better health information recall. Increasing age was not related to health literacy, but was related to poorer health information recall. The final model fit the data very well, χ2(3) = 0.69, p = .36, RMSEA = .000 (90% CI = .000 to .024),CFI = 1.00. The results suggest that health literacy might be one of the mechanisms underlying the relationships between participant demographic characteristics and poor health outcomes due to inaccurate recall of instructions. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the performance subjects with and without mild cognitive impairment (MCI) on an objective measure of everyday or real-world memory and subjective items assessing competency within the same instrumental domains; to determine whether the Everyday Cognition Battery (ECB) can uniquely predict MCI status. DESIGN: Cross-sectional. SETTING: Independent-living sample of urban dwelling elders in Baltimore Maryland. PARTICIPANTS: The sample consisted of 555 subjects ranging in age from 50 to 95 (mean 68.8 ± 9.6). MEASUREMENTS: Objective performance in three instrumental domains (medication use, financial management, nutrition and food preparation) was assessed using the ECB Memory Test. Subjective performance within the same instrumental domains was also assessed. RESULTS: No difference was found between elderly subjects with and without MCI on the subjective items of instrumental activity of daily living (IADL) competency. A significant multivariate effect for cognitive status group (F3, 507=21.88, P<.05, η2=.12) was observed for the objective measure, with participants with MCI performing, on average, significantly worse than those without on all thee instrumental domain subscales. The medicine use (odds ratio (OR)=0.96, 95% confidence interval (CI)=0.94–0.99) and financial management (OR=0.93, 95% CI=0.91–0.96) subscales of the ECB Memory Test were unique and significant predictors of MCI. CONCLUSION: This study adds to the growing body of literature suggesting that cognitively complex IADLs might be compromised in elderly people with MCI. Moreover, the ECB Memory Test might be a clinically useful tool in evaluating real-world competency. [ABSTRACT FROM AUTHOR]

This study examined the relationship between elders' cognitive performance and self-reported trouble falling asleep. Analyses were conducted on 174 older independently living, community dwelling African Americans (M age = 72.74; range = 65 to 90). Cognitive performance was measured using the Mini-Mental State Examination, Forward Digit Span task, Backward Digit Span task, Alpha Span task, and California Verbal Learning Test. Results suggested that individuals who reported trouble falling asleep tended to perform significantly worse than individuals who did not report trouble falling asleep on measures tapping short-term memory and working memory after controlling for age, education, gender, depression, and current health. These results demonstrate that a self-report of sleep difficulty may be a unique predictor of cognitive performance. [ABSTRACT FROM AUTHOR]

The knowledge gained from studying diverse populations should help to address inequities and prepare us to deal with the needs of the increasing number of older minorities in this country. At the same time, research that is not properly conducted threatens to lead us astray and misconstrue relationships and outcomes related to behavioral aspects of aging. In this article, we propose that simple comparisons between groups are neither necessary nor sufficient to advance our understanding of ethnic minorities. We discuss common pitfalls conducted in group-differences research, including a specific treatment on the issue of statistical power issues. Our goal is to encourage the use of multiple methodological designs in the study of issues related to racial and ethnic minorities by demonstrating some of the advantages of lesser employed approaches. [ABSTRACT FROM AUTHOR]

Objective: Although social maladjustment appears to be common among abused children, negative outcomes are not inevitable. This investigation was designed to determine whether ethnicity and features of the parenting context predicted children's social adjustment, and whether the strength and direction of these relations differed for abused and nonabused children. Method: Participants included 78 physically abused and 75 demographically matched nonabused children and one of their parents. Observations of parenting were used to measure parental sensitivity, and parent self-reports of depression were obtained using the SCL-90-R. Children's peer social adjustment was measured by teacher report. Results: Using regression analysis, we tested whether each potential protective or vulnerability factor interacted with abuse status in prediction of social adjustment. Results indicated main effects of ethnicity and sensitivity for prosocial behavior, and a main effect of sensitivity for aggression. In addition, there was a significant interaction of ethnicity and abuse status for aggression such that there was a significant difference between abused and nonabused European American children but not between abused and nonabused African American children. Conclusions: Findings indicate that risk for aggressive behavior among abused children might be culturally specific rather than universal. In addition, results point to beneficial effects of parental sensitivity for maltreated children. [Copyright &y& Elsevier]

In this article, the authors examine the relationship between everyday cognition and mortality. Data were initially collected in 1996-1997 from 171 community-dwelling older people ranging in age from 60 to 92 years old (M = 74 years, SD = 7.38). Participants completed the Everyday Cognition Battery (ECB; J. C. Allaire & M. Marsiske, 1999, 2002) as well as basic cognitive ability tests. Results indicated that participants who died since testing (n = 56) had performed significantly worse than did still-living participants on all measures. Additionally, performance on the ECB Knowledge Test was a significant predictor of death even after controlling for basic cognitive abilities, demographics, and self-rated health. [ABSTRACT FROM AUTHOR]

This study used latent variable growth curve modeling to identify predictors and correlates of verbal learning over trials on a list-learning task in patients with dementia. Data from 116 patients evaluated at the Detroit satellite of the Michigan Alzheimer's Disease Research Center were incorporated in the present analyses. Patients were administered the Fuld Object Memory Evaluation, examined independently by a geriatrician, and, if appropriate, given a diagnosis of probable Alzheimer's disease according to criteria from the National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association. The presence of dementia significantly predicted both the intercept (i.e., level of performance) and the slope (i.e., learning over trials), with dementia patients demonstrating lower overall levels of performance and less verbal learning over trials. Rate of verbal learning over trials was a significant predictor of everyday functioning (instrumental activities of daily living) above and beyond general cognitive impairment and demographics. [ABSTRACT FROM AUTHOR]

Healthy normotensive men and women (N = 33) underwent a 60-day diary assessment of emotions and cardiovascular functioning. Individual differences in social connectedness and mood were measured in questionnaires, and positive emotions, negative emotions, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were assessed daily for 60 consecutive days. Results confirmed that the cardiovascular undoing effect of positive emotions is evident primarily in the context of negative emotional arousal. The daily associations between positive emotions and cardiovascular outcomes were linked to individual differences in social connectedness. Controlling for individual differences in mood levels, multilevel regression analyses showed that social connectedness predicted extended positive emotion, diminished SBP and DBP reactivity, and more rapid SBP recovery from daily negative emotional states. [ABSTRACT FROM AUTHOR]

This study examined consistency of performance, or intraindividual variability, in older adults' performance on 3 measures of cognitive functioning: inductive reasoning, memory, and perceptual speed. Theoretical speculation has suggested that such intraindividual variability may signal underlying vulnerability or neurologic compromise. Thirty-six participants aged 60 and older completed self-administered cognitive assessments twice a day for 60 consecutive days. Intraindividual variability was not strongly correlated among the 3 cognitive measures, but, over the course of the study, intraindividual variability was strongly intercorrelated within a task. Higher average performance on a measure was associated with greater performance variability, and follow-up analyses revealed that a higher level of intraindividual variability is positively associated with the magnitude of a person's practice-related gain on a particular measure. The authors argue that both adaptive (practice-related) and maladaptive (inconsistency-related) intraindividual variability may exist within the same individuals over time. [ABSTRACT FROM AUTHOR]

The current study sought to examine whether there were differences in the structure of specific cognitive abilities and their association with age and education in a sample of African American elders with two different early educational experiences. The study was conducted with a sample of 197 community dwelling older adults ranging in age from 50 to 79 years (mean age = 61.50 years, SD = 7.30 years). The sample included 79 individuals who attended a desegregated school at anytime during their formal education, while 118 participants completed their schooling without ever attending a desegregated school. Major results included: (1) typical patterns among cognitive abilities and age as well as years of education were found in the full sample of participants; (2) the pattern of age differences in cognition differed between the two groups. Regarding the latter, the desegregated sample exhibited significant negative age differences for some cognitive abilities, while the segregated group did not. Discussion focuses on the importance of considering the nature of the educational experience when examining cognitive aging in African American elders. [ABSTRACT FROM AUTHOR]

The present study examined 2 approaches to the measurement of everyday cognition in older adults. Measures differing in the degree of structure offered for solving problems in the domains of medication use, financial management, and food preparation and nutrition were administered to a sample of 130 community-dwelling older adults ranging in age from 60 to 90 (M = 73 years, SD = 7.02 years). Well-defined and ill-defined everyday problem-solving measures, which varied in the amount of means-end-related information provided to participants, were used. The study found that (a) well- and ill-defined measures were moderately interrelated, (b) the 2 approaches were differentially related to basic cognitive abilities, and (c) together the 2 approaches explained over half of the variance in older adults' everyday instrumental functioning and were in fact better predictors of everyday functioning than traditional psychometric cognitive measures. Discussion focuses on the differential importance of both methods for assessing older adults' everyday cognitive functioning. [ABSTRACT FROM AUTHOR]

Despite the association of neighborhood quality with poorer adult health, limited research has explored the association between neighborhood disadvantage, e.g. Area Deprivation Index (ADI), and older Black adults' health, prospectively. This observational study examined the association between ADI and changes in longitudinal physical health within older Black adults. The analytic sample (n = 317) included data from waves 1 & 2 of the Baltimore Study of Black Aging: Patterns of Cognitive Aging (BSBA-PCA). Study variables included the Area Deprivation Index (ADI), objective (e.g. average heart rate) and subjective (e.g. activities of daily living) measures of physical health. Multiple linear regression models were conducted controlling for sociodemographic and social support characteristics. Participants living in more disadvantaged neighborhoods, based on national and state ADIs, were more likely to have a decreasing heart rate even after adjusting for covariates. Likewise, participants reporting increasing levels of ADL difficulty were living in a neighborhood with greater disadvantage based on national and state ADI rankings. Significant social support received and ADI (national and state) interactions were observed for average heart rate. The findings suggest that research on the effect of neighborhood quality and social support can enhance our understanding of its impact on older Black adults' health prospectively. [ABSTRACT FROM AUTHOR]

We proposed a mediation model to examine the effects of age, education, computer knowledge, and computer anxiety on computer interest in older adults. We hypothesized that computer knowledge and computer anxiety would fully mediate the effects of age and education on computer interest. A sample of 330 older adults from local senior-citizen apartment buildings completed a survey that included an assessment of the constructs included in the model. Using structural equation modeling, we found that the results supported the hypothesized mediation model. In particular, the effect of computer knowledge operated on computer interest through computer anxiety. The effect of age was not fully mitigated by the other model variables, indicating the need for future research that identifies and models other correlates of age and computer interest. The most immediate application of this research is the finding that a simple 3-item instrument can be used to assess computer interest in older populations. This will help professionals plan and implement computer services in public-access settings for older adults. An additional application of this research is the information it provides for training program designers. [ABSTRACT FROM AUTHOR]

The primary aim of this study was to examine the relationship between a new battery of everyday cognition measures, which assessed 4 cognitive abilities within 3 familiar real-world domains, and traditional psychometric tests of the same basic cognitive abilities. Several theoreticians have argued that everyday cognition measures are somewhat distinct from traditional cognitive assessment approaches, and the authors investigated this assertion correlationally in the present study. The sample consisted of 174 community-dwelling older adults from the Detroit metropolitan area, who had an average age of 73 years. Major results of the study showed that (a) each everyday cognitive test was strongly correlated with the basic cognitive abilities; (b) several basic abilities, as well as measures of domain-specific knowledge, predicted everyday cognitive performance; and (c) everyday and basic measures were similarly related to age. The results suggest that everyday cognition is not unrelated to traditional measures, nor is it less sensitive to age-related differences. [ABSTRACT FROM AUTHOR]

This systematic literature review examines the current immune checkpoint inhibitors treatment paradigms, treatment gaps and unmet needs for treating SCLC with respect to efficacy, safety, health related quality of life (HRQoL) and cost-effectiveness. A search strategy was developed and executed using the National Library of Medicine bibliographic database (PubMed), Cochrane Library, Embase and Google Scholar. Data regarding efficacy, safety, cost-effectiveness and HRQoL were extracted and entered in a data extraction sheet created a priori. A total of 4961 patients were comprised in all the 12 studies combined. All the studies focus on extensive stage SCLC (ES-SCLC) and not limited stage SCLC (LS-SCLC). All studies used an ICI as the intervention arm and chemotherapy as the control arm. A statistically significant increase in overall survival (OS) and progression free survival (PFS) was observed when ICIs were added to chemotherapy, especially atezolizumab and durvalumab. ICIs in SCLC resulted in immune-related toxicities that have been well-documented in prior immunotherapy trials; their addition to cytotoxic chemotherapy did not worsen chemotherapy-related toxicities. Out of 12 studies, only 3 (25%) included measures to assess the impact of immunotherapy on SCLC patients' HRQoL. Although domain level scores were limited, the addition of ICIs did not seem to worsen symptoms. Two studies conducted a cost-effectiveness analysis of the combination of atezolizumab plus chemotherapy vs. chemotherapy. The addition of atezolizumab to chemotherapy was not found to be cost-effective in either study. Combining ICIs with chemotherapy enhanced OS and PFS as well as not worsening HRQoL. Among all ICIs, PD-L1 inhibitors showed better effectiveness. Future studies should focus on real-world settings and more clinical trials using ICIs for not only ES-SCLC but also LS-SCLC. [ABSTRACT FROM AUTHOR]

Objectives This study explored the association between place-based characteristics (e.g. neighborhood socioeconomic deprivation) and physical health within older Black adults, a critical gap in the literature as identified by the National Institute on Minority Health and Health Disparities. Methods The sample was from Wave 1 data of Baltimore Study of Black Aging: Patterns of Cognitive Aging (N = 450; M age = 68.34). Variables included the area deprivation index (ADI), objective (e.g. average blood pressure) and subjective (e.g. self-rated health) measures of physical health. Multiple linear regression models were conducted controlling for key sociodemographic characteristics. Results Participants reporting better self-rated health and less likely to need help with activities of daily living were significantly more likely to be living in more disadvantaged neighborhoods based on national and state ADI, respectively, even after adjusting for covariates. A significant age and ADI interaction revealed better self-rated health was associated with a more disadvantaged neighborhood particularly for individuals ≤66 years. There was no significant association between ADI and objective physical health measures. Discussion The findings suggest that national- and state-level place-based characteristics should be considered along with individual-level factors, which can enrich the scientific understanding of how neighborhood characteristics relate to varying health indicators among older Black adults. [ABSTRACT FROM AUTHOR]

Objectives This study examined engagement levels across various domains of leisure activities in community-dwelling Black adults (age range = 50–80 years) and variability in daily leisure activity engagement and positive affect (PA; positive emotions or mood) and negative affect (NA; negative emotions or mood). Additionally, we explored whether PA and NA were associated with leisure activity engagement and whether these associations varied by sociodemographics. Methods Fifty adults (78% women; mean education = 11.62 years, standard deviation = 2.4) reported affect and leisure activity engagement over 8 occasions (2–3 weeks). Results Participants averaged 3 leisure activities/day with more engagement in watching television (news), walking, reading, and visiting others. Multilevel models identified significant within-person variation across domains of leisure activity engagement. A significant main effect was observed between daily NA and reduced social activity engagement. A significant interaction between NA and education was further illustrated on those occasions when NA was higher than usual, social and total leisure activity engagement tended to be lower, particularly for adults with ≤10 years of education. A significant interaction between NA and education was observed for entertainment activities. However, results indicated adults with ≥14 years of education, and a mean NA above the sample average, tended to engage in more entertainment activities. Finally, a significant interaction between PA and age was observed indicating adults aged ≥73 had a greater social engagement, particularly when daily PA was heightened. Discussion Results demonstrate within-person changes in the types of leisure engagement among Black adults. Potential factors related to these changes may result from interconnections between affect and demographic factors (age and education). [ABSTRACT FROM AUTHOR]

Objective Vascular burden has been linked to future depression and cognitive change in predominately European American samples. This study investigated these relationships in older African Americans. Methods To examine the connection between vascular risk factors, depression, and cognitive change, this study utilized data from 435 older African Americans. Specifically, the study examined the link between vascular risk at baseline with depression and cognitive functioning at a 2.5-year follow-up visit. Results High baseline vascular risk was associated with increased odds of future depression while controlling for age and current depression. A series of path analyses demonstrated links between baseline vascular risk, increases in depression, and decreases in processing speed. Conclusions These findings suggest that African Americans with greater vascular burden are at greater risk for depression and cognitive change. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: Vascular burden has been linked to future depression and cognitive change in predominately European American samples. This study investigated these relationships in older African Americans. Methods: To examine the connection between vascular risk factors, depression, and cognitive change, this study utilized data from 435 older African Americans. Specifically, the study examined the link between vascular risk at baseline with depression and cognitive functioning at a 2.5-year follow-up visit. Results: High baseline vascular risk was associated with increased odds of future depression while controlling for age and current depression. A series of path analyses demonstrated links between baseline vascular risk, increases in depression, and decreases in processing speed. Conclusions: These findings suggest that African Americans with greater vascular burden are at greater risk for depression and cognitive change. [ABSTRACT FROM AUTHOR]

Abstract: Previous research suggests that demographic factors are important correlates of cognitive functioning in African Americans; however, less attention has been given to the influence of personality. The present study explored how dimensions and facets of personality predicted individual variability in cognition in a sample of older African Americans from the Baltimore Study of Black Aging. Cognition was assessed by verbal learning and attention/working memory measures. Personality was measured by the NEO Personality Inventory-Revised. Linear regressions controlling for demographic factors showed that Neuroticism, Openness, and Agreeableness were significant regression predictors of cognitive performance. Individual facets of all five personality dimensions were also associated with cognitive performance. These findings suggest personality is important in understanding variability in cognition among older African Americans. [Copyright &y& Elsevier]

Abstract: The effectiveness of a game-based cognitive training intervention on multiple abilities was assessed in a sample of 39 older adults aged 60–77. The intervention task was chosen based on a cognitive task analysis designed to determine the attentional and multi-modal demands of the game. Improvements on a measure of attention were found for the intervention group compared to controls. Furthermore, for the intervention group only, initial ability scores predicted improvements on both tests of attention and spatial orientation. These results suggest cognitive training may be more effective for those initially lower in ability. [Copyright &y& Elsevier]

This study examined the within-person relationship between reading vision and cognitive functioning. Analysis was conducted on 36 community-dwelling elderly (age range = 60-87) who completed a reading vision task and three cognitive tests (i.e., Rey Auditory Verbal Learning Task (AVLT), Letter Series, and Number Comparison) twice a day over 60 consecutive days. Significant within-person variability was found for the reading vision measure. Additionally, a main effect was found for reading vision and performance on the AVLT and Number Comparison task; such that on occasions when reading vision was poor, cognitive performance suffered. [ABSTRACT FROM AUTHOR]

Outliers are typically regarded as data anomalies that should be discarded. However, dynamic or “innovative” outliers can be appropriately utilized to capture unusual but substantively meaningful shifts in a system's dynamics. We extend De Jong and Penzer's 1998 approach for representing outliers in single-subject state-space models to a group-based framework. The group-based model enables model predictions concerning the group as a whole while individualized change points are incorporated to capture discrete shifts in each individual's trajectory. An illustrative example using cognitive performance data from N = 38 older adults over 60 days is presented. Results indicated that a subset of older adults showed sudden shifts in learning dynamics in several forms, including sudden jumps in level, slope, and linkage between perceived control and actual performance level. The broader implications of incorporating innovative outliers into studies of intraindividual change are discussed. [ABSTRACT FROM AUTHOR]

In this study, we examined the relationship between within-person blood pressure and cognitive functioning. We conducted an analysis on 36 community-dwelling elderly individuals (age range = 60-87 years). Participants measured their blood pressure and completed cognitive tasks (i.e., the Rey Auditory Verbal Learning Task, the Letter Series test, and the Number Comparison test) twice a day over 60 consecutive days. We observed a significant interaction between within-person change in blood pressure and average blood pressure for the Letter Series test. Individuals with high blood pressure tended to perform poorly, particularly on occasions when their blood pressure level was above their personal average. These results demonstrate that the relationship between blood pressure and cognition at the between-person level and the relationship within each individual should be further explored simultaneously. [ABSTRACT FROM AUTHOR]

Objectives The theory of selective survival suggests that possibly around 70–75 years of age, Blacks may display substantive changes in their pattern of cognitive decline. This study examined the age-graded pattern of cognitive decline within older Blacks by describing a trend that characterizes differences in the change of cognitive decline from ages 51.5 to 95.5, and hypothesized that this age-graded pattern is nonlinear. Method Utilizing 2 waves of longitudinal data from the Baltimore Study of Black Aging, this study used multilevel modeling to test whether the interaction between age and the 3-year study period (time between waves) had a positive effect on changes in inductive reasoning, declarative memory, working memory, and perceptual speed. Results A significant positive interaction between age and wave was found for inductive reasoning, demonstrating an age-grade pattern of change/decline in cognitive pattern for Blacks aged 51.5–95.4. Simple slope probing via the Johnson–Neyman Technique suggested that Black adults ~64 years and younger experienced significant decline in inductive reasoning across study time, whereas for those older than 63.71, the decline was nonsignificant. No significant age–wave interactions were found for declarative memory, working memory, or perceptual speed. Discussion Findings suggest a selective survival effect for inductive reasoning ability among Blacks. With decline evident so early, common cognitive intervention programs targeting adults 65+ may come too late for Blacks, signifying the importance and urgency for early health interventions and public policy designed to promote cognitive reserve. [ABSTRACT FROM AUTHOR]

Objectives The present study examined potential sources of intra- and inter-individual differences in older adults' control beliefs using a micro-longitudinal design. Method Older adults (n = 205) ranging in age from 60 to 94 (M = 72.70, SD = 6.72) completed 8 in-person testing sessions within 3 weeks which included assessments of control beliefs (Locus of Control and Perceived Competence), physical health (physical symptoms and sleep self-efficacy), stressors, emotional well-being (Positive Affect and Negative Affect), and cognition (basic cognition tests, everyday cognition, and memory failures). Results Multilevel models indicated that on days when older adults had higher sleep self-efficacy, more positive affect, and less negative affect, they also had more internal locus of control and higher perceived competence. Having stressors on the previous occasion was associated with lower internal locus of control on the subsequent occasion. Physical symptoms, everyday cognition, and memory failures could be predictive of locus of control for some older adults. Discussion Our findings showed the differentiated antecedents of locus of control and perceived competence, the unique role of sleep self-efficacy, positive affect, and negative affect in understanding antecedents of both, as well as the need to study well-being and cognition antecedents of control beliefs in future studies. [ABSTRACT FROM AUTHOR]

Objective The purpose of the current study is to examine the association between subjective memory complaints and sleep (quantity and quality) in African American older adults. Method Participants from the Baltimore Study of Black Aging (BSBA; n = 351; mean age = 71.99) completed a self-report sleep scale, subjective memory complaint scale, global cognitive status measure, and demographic questionnaire. Results Worse overall sleep quality was significantly associated with subjective reports of difficulty recalling the placement of objects, recalling specific facts from reading materials, and worse memory currently compared to the past. Specific sleep parameters (e.g. longer sleep latency and shorter sleep duration) were associated with negative appraisals of participants' ability to do specific tasks involving memory (e.g. difficulty recalling placement of objects). Participants classified as poor sleepers (Pittsburgh Sleep Quality Index [PSQI] total score > 5) were more likely to report worse memory now compared to the past than participants classified as good sleepers (PSQI total score ≤ 5). Conclusions Evaluation of sleep may be warranted when older adults, particularly African Americans, communicate concerns regarding their memory. Insufficient sleep may be a useful marker of acute daytime dysfunction and, perhaps, cognitive decline. Given memory problems are the hallmark of dementia, our findings support further evaluation of whether poor sleep can aid in the diagnosis of cognitive impairment. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to determine whether stability and change in cognitive status are associated with sociodemographic characteristics and health function. Design: Secondary analysis of data. Setting: Baltimore Study of Black Aging—Patterns of Cognitive Aging. Participants: Community‐dwelling black adults (N = 407; mean age 68.6 ± 9.1). Measurements: Baseline (n = 602) and 33‐month follow‐up (n = 450) assessments of cognition, health, and psychosocial function. Results: For the present analyses, participants were grouped as being cognitively normal (n = 249), having stable mild cognitive impairment (MCI) (n = 32), or being MCI converters (n = 72; normal at baseline, MCI at follow‐up) or reverters (n = 54; MCI at baseline, normal at follow‐up). Multivariate analysis of variance showed that the groups differed significantly in education and lung function (P < .010). Post hoc analyses indicated that converters had fewer years of education than the other groups, whereas those who were cognitively normal had better lung function than converters and reverters (P < .050). Conclusion: These results suggest that education and lung health are associated with patterns of cognitive status change and stability. Future research should account for sociodemographic and health factors when examining stability of cognitive status classifications. [ABSTRACT FROM AUTHOR]

Continued growth in older adults' computer and internet use has led to the need to better assess their competencies and skills. The aim of the current study was to expand on this literature by examining sources of individual differences in older adults' computer and internet proficiency. Ninety-seven adults ranging in age from 60 to 95 completed the Computer Proficiency Questionnaire (CPQ) along with a battery that measured demographic information, socio-emotional variables such as sense of control and affect, and cognitive abilities such as reasoning and speed of processing. Hierarchical regression analyses examined the predictors of CPQ Total score as well as the three CPQ subscales (e.g., Internet and Email Use, Communication and Calendaring, and Computer Basic). Age, education, affect, sense of control, inductive reasoning, perceptual speed, and psychomotor speed were associated with at least one domain of computer proficiency. Positive affect uniquely predicted Communication and Calendaring. While sense of control, inductive reasoning, and psychomotor speed uniquely predicted Computer Basic. Discussion focuses on implications for CPQ use and computer proficiency training in older adults. [ABSTRACT FROM AUTHOR]

Background. This study identified demographic and health-related characteristics that were related to mobility limitation in a sample of community-dwelling African Americans. Methods. The sample consisted of 602 community-dwelling African-American men and women ages 48–92 years at study inception. Participants who reported being limited “a lot” or “a little” in climbing one flight of stairs or walking several blocks were considered to have mobility limitation. Logistic regression was conducted to estimate the independent effect of each demographic and health-related characteristic on odds of mobility limitation. Results. African Americans who reported two or more medical conditions had higher odds of mobility limitation (women: odds ratio = 3.52; 95% confidence interval: 1.89–6.53 and men: odds ratio = 2.53; 95% confidence interval: 1.10–5.85) than those who reported one or fewer medical conditions. African Americans with major depressive symptoms had higher odds of mobility limitation (women: odds ratio = 2.98; 95% confidence interval: 1.55–5.71 and men: odds ratio = 3.19; 95% confidence interval: 1.33–7.65) than those without major depressive symptoms. Conclusions. These results highlight the importance of creating interventions particularly focused on chronic disease prevention and management for African American men and women during midlife to attempt to delay the onset or impede the progression of mobility problems that will likely become exacerbated in late life and severely affect the quality of life. [ABSTRACT FROM PUBLISHER]

The structure and organization of cognitive abilities has been examined across the life span. The current analysis had three specific aims: (1) test the factor structure of a broad cognitive ability battery across three age groups; (2) examine differences in the pattern of factor covariation across age groups; and (3) examine the pattern of factor mean differences across age groups. A sample of 512 older African Americans (mean age = 66.6 years, 25.4% male) from the Baltimore Study of Black Aging was administered a battery of cognitive tests assessing the domains of perceptual speed, verbal memory, inductive reasoning, vocabulary, and working memory. Factor models were estimated separately in middle-age adults (50-59 years, n = 107), young-old adults (60-69 years, n = 198), and old-old adults (70-79 years, n = 207). There was loading invariance across the three age groups that suggests that the selected tests measured cognition similarly across age. There was no evidence of dedifferentiation across increasingly older age groups. Factor mean differences were observed with the middle-age group having significantly higher factor means than the young-old and old-old groups; however, there was only one factor mean difference between the young-old and the old-old groups. The results suggest that a pattern of dedifferentiation of cognitive abilities does not exist within this sample of older African Americans and that the 60-69 year age range may be a critical period for cognitive decline in this population. [ABSTRACT FROM AUTHOR]

The psychometric properties of the Parenting Stress Index-Short Form (PSI-SF) were examined in a sample of 185 mothers and fathers. Factor analysis revealed 2 reasonably distinct factors involving parental distress and dysfunctional parent-child interactions. Both scales were internally consistent, and these scales were correlated with measures of parent psychopathology, parental perceptions of child adjustment, and observed parent and child behavior. PSI-SF scores were related to parent reports of child behavior 1 year later, and the Childrearing Stress subscale was a significant predictor of a parental history of abuse. [ABSTRACT FROM PUBLISHER]

Change in cognitive abilities was assessed over a 6-year period in a sample of monozygotic and same-sex dizygotic twin pairs (N = 507 individuals), aged 80 and older (mean age = 83.3 years; SD = 3.1), who remained nondemented over the course of the study. Latent growth models (LGMs) show that chronological age and time to death are consistent predictors of decline in measures of memory, reasoning, speed, and verbal abilities. Multivariate LGM analysis resulted in weak and often negative correlations among rates of change between individuals within twin pairs, indicating greater differential change within twin pairs than occurs on average across twin pairs. These findings highlight several challenges for estimating genetic sources of variance in the context of compromised health and mortality-related change. [ABSTRACT FROM AUTHOR]