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Our aim in this study was to validate a stress-process model for Hispanic caregivers of adults with mental retardation that incorporates family functioning. The model postulates that maladaptive adult behaviors are related to poorer family relationships and higher levels of family burden, which in turn is related to caregiver psychological distress and self-reported health. The 153 Hispanic caregivers were interviewed in their homes with structured interviews and self-report measures. We analyzed cross-sectional data using structural equation modeling. The hypothesized model provided an excellent fit to the data. Also, family relationships mediated the relationship between maladaptive adult behaviors and family burden, and higher levels of family burden were related to greater caregiver distress. Acculturation was negatively related to caregiver distress.

Purpose: Dementia caregiving is a rapidly growing public health problem. Logistical problems prevent many caregivers from utilizing available interventions. This article provides a demonstration of the usefulness of technology for conducting telephone-based support groups in ethnically diverse dementia caregivers. Design and Methods: Participants were 41 White American and Cuban American dementia caregivers participating at the Miami site of the Resources for Enhancing Alzheimer's Caregiver Health (known as REACH) program. Support groups were conducted over the telephone in English and Spanish as appropriate. Results: Eighty-one percent of the participants found the group "valuable," largely because of the social and emotional support and useful information obtained from other group members. The majority of caregivers also reported that their participation had increased their knowledge and skills as caregivers. Implications: The findings demonstrate that telecommunications technology can overcome the often formidable logistical problems faced by both English- and Spanish-speaking caregivers, and it can provide benefits similar to those obtained in face-to-face support groups.

Purpose: The majority of persons with Alzheimer's disease (AD) are cared for at home by a family member such as a spouse or daughter. Caregiving places enormous demands on these caregivers, and the negative consequences associated with caregiving are well documented. This paper reports results from the Miami site of the REACH (Resources for Enhancing Alzheimer's Caregiver Health) program that examined the efficacy of a family therapy and technology-based intervention in reducing depressive symptoms (according to the Center for Epidemiological Studies Depression scale) among family caregivers of AD patients at 6 months and 18 months follow-up. Design and Methods: There were 225 White American and Cuban American caregivers that were randomized into a structural ecosystems therapy, structural ecosystems therapy + computer-telephone integrated system, or minimal support control condition. Results: Caregivers in the combined family therapy and technology intervention experienced a significant reduction in depressive symptoms at 6 months. The 18-month follow-up data indicated that the intervention was particularly beneficial for Cuban American husband and daughter caregivers. Implications: The results indicate that information technology has a promising role in alleviating distress and depression among groups of AD caregivers. The data also demonstrate that interventions have differential impacts according to ethnic group and the caregiver-patient relationship.

The aim of this study was to assess a newly developed measure for the positive aspects caregiving using a sample of dementia caregivers. The measure was developed and administered to 1,229 participants in a national collaborative Alzheimer's disease caregiver study and evaluated for validity and reliability using standard psychometric analyses. Factor analysis identified two components in this nine-item measure: Self-Affirmation and Outlook on Life. Cronbach's alphas for the components were.86 and .80, respectively. For the entire scale, Cronbach's alpha was .89. The Positive Aspects of Caregiving measure, tested with a large, diverse, and well-characterized sample shows promise as a valid and reliable instrument. With additional implementation and testing, the measure has the potential to substantially increase our understanding of basic caregiving research and the outcomes of intervention efforts. [ABSTRACT FROM AUTHOR]

This article examines predictors of depressive symptoms and caregiving burden in a sample of Cuban American and Puerto Rican caregivers of an adult child with mental retardation. Using a stress process model of caregiving, the focus of this analysis was on family role strains that result from the caregiving process, which were hypothesized to be particularly strong predictors of maternal well-being in Latino families. Findings indicate that Cuban American mothers of adults with mental retardation had higher socioeconomic status than Puerto Rican mothers, yet there was a substantial amount of within-group heterogeneity in family socio-demographic characteristics, linked closely with immigration patterns for the Cuban American mothers. However, taking into account socio-demographic diversity and ethnicity, findings demonstrate that mothers whose family had more problems had higher levels of burden and depressive symptoms, supporting the hypothesized importance of family functioning to Latina mothers with a non-normative parenting challenge. [ABSTRACT FROM AUTHOR]

Junior and senior medical students (N = 288) responded to Palmore's Facts on Aging Quiz (FAQ) 1 and 2 and the Facts on Aging and Mental Health Quiz before and after they completed a course in geriatrics. Pre- and post-comparisons of medical students' knowledge base and misconceptions about the elderly revealed a significant improvement in students' knowledge base. Students displayed considerable misconceptions about the elderly as demonstrated by the bias scores on the FAQ 1 and 2. Current findings indicate that only positive bias scores improved. This may be the result of the students' primarily being exposed to chronically ill or semi-dependent nursing home patients. To ameliorate some of their negative misconceptions, students may benefit from contact with healthy elderly or those who are treated for acute rather than chronic problems. Additional geriatric education and exposure to the elderly should be incorporated throughout the four years of the medical school training. [ABSTRACT FROM PUBLISHER]

The pervasive use of computers in work settings implies that an increased number of workers, with varying levels of skills and abilities, will be performing computerbased tasks. This study investigated the impact of age, cognitive abilities, and computer experience on the performance of a real world data entry task. One hundred and ten subjects, ranging in age from 20 - 75 years, performed the task for nine hours following task training. The results indicated that abilities such as visuo-spatial skills, motor skills and processing speed had a significant impact on performance as did age and prior computer experience. With respect to age, the older participants completed less work than the younger and middle-aged subjects. Age differences in psychomotor skills and processing speed appeared to be important factors underlying age effects. In fact, the data indicated that after controlling for differences in these abilities age was no longer a significant predictor of work output. Further, after controlling for differences in work output the older people made fewer errors than the younger people. Overall the data suggest that older people will be at a disadvantage in the performance of computer-based data entry work to the extent to which speed of responding is emphasized. However, if speed of responding is not a critical element of performance they will be able to achieve comparable levels of performance to that of younger people. [ABSTRACT FROM AUTHOR]

Intrusive or perseverative errors as evidenced on tests of memory have been found to occur with greater frequency in patients with Alzheimer's Disease (AD) relative to other disorders and are thought to reflect the cholinergic deficits associated with AD. A particular type of intrusive error, semantic intrusions, has been found to discriminate AD from multi-infarct dementia and normal elderly controls. However, it has been suggested that such errors actually reflect random responding as the result of the disinhibition often observed in AD patients. The present study compared the frequency and types of intrusive errors from a sample of mildly, moderately, and more severely impaired AD patients who had undergone the Fuld Object Memory Evaluation with the “guesses” of elderly controls. Results of this study indicate that the semantic intrusions of AD patients differ both in type and frequency from the guesses of the control subjects. [ABSTRACT FROM PUBLISHER]

Neuropsychological measures have been widely used by clinicians to assist them in making judgments regarding a cognitively impaired patient's ability to independently perform important activities of daily living. However, important questions have been raised concerning the degree to which neuropsychological instruments can predict a broad array of specific functional capacities required in the home environment. In the present study, we examined 127 English-speaking and 56 Spanish-speaking patients with Alzheimer's disease (AD) and determined the extent to which various neuropsychological measures and demographic variables were predictive of performance on functional measures administered within the clinical setting. Among English-speaking AD patients, Block Design and Digit-Span of the WAIS-R, as well as tests of language were among the strongest predictors of functional performance. For Spanish-speakers, Block Design, The Mini-Mental State Evaluation (MMSE) and Digit Span had the optimal predictive power. When stepwise regression was conducted on the entire sample of 183 subjects, ethnicity emerged as a statistically significant predictor variable on one of the seven functional tests (writing a check). Despite the predictive power of several of the neuropsychological measures for both groups, most of the variability in objective functional performance could not be explained in our regression models. As a result, it would appear prudent to include functional measures as part of a comprehensive neuropsychological evaluation for dementia. [ABSTRACT FROM PUBLISHER]

Neuropsychological test batteries are frequentlyused to assess the nature and severity of cognitive deficits among patientswith early Alzheimer’s Disease (AD) and related disorders. The NINCDS-ADRDAcriteria are among the most widely used guidelines to diagnose dementia (McKhannet al.,1984). These criteria specify eight distinct areas of neuropsychologicalfunction that should be evaluated in patients with suspected cognitive impairment. Recent studies have suggested that neuropsychological deficits observedin AD may be explained by a single general factor related to memory deficitsor to executive dysfunction. In contrast, the results of other investigationshave indicated that multiple qualitatively different factors underlie cognitiveabilities in AD. In the present study, we used confirmatory factor analysis to examine thestructure of cognitive abilities in AD and to assess the extent to which singleand multiple ability factors accurately represent neuropsychological testdata obtained from patients with AD. Results indicated that the NINCDS-ADRDAmodel fit the data better than a single factor model. However, a more parsimoniousmodel specifying memory, verbal abilities, visuospatial skills, executivefunction, and higher as well as lower functional activities of daily livingfit the data better than the NINCDS-ADRDA model. These results have importanttheoretical and practical implications for diagnostic evaluation. [ABSTRACT FROM AUTHOR]