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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.

Purpose: The purposes of this study were (a) to identify cognitive abilities and other factors related to successful completion of training for computer-based tasks that simulated real jobs and (b) to create a brief assessment battery useful in assessing older adults for these kinds of jobs. Design and Methods: Participants from three age groups (young, middle-aged, and older) completed a battery of cognitive measures. They then trained on one of three computer-based tasks that simulated actual jobs and were asked to perform the tasks for 3 days. We recorded whether they completed training and whether and how well they did the tasks. In a series of logistic regressions, we evaluated the ability of a subset of cognitive measures drawn from a larger battery to predict participants' ability to successfully complete training and go on to task performance. Results: Results confirmed theory-based expectations that measures of domain knowledge, crystallized intelligence, memory, and psychomotor speed would predict success in computer-based activities. A brief battery was able to predict older adults' successful completion of training for one task but was less useful for another. Implications: A brief battery of cognitive measures may be useful in evaluating individuals for job selection. Different measures are related to job-related criteria depending on task and group evaluated, although it was not possible to identify a reduced battery for one task. The specific cognitive abilities related to participants' success have implications for task and interface design for the elderly population. Key Words: Neuropsychological tests, Computers, Cognition, Older worker

The aim of this study was to assess a newly developed measure for the positive aspects of 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. Keywords: psychometric analysis; Alzheimer's disease; research measures; caregiving satisfaction

Two related hypotheses that focus upon interpersonal aspects of depression are reviewed in conjunction with a study performed on college students. The concomitant hypothesis states that interpersonal problems usually accompany depression and intensify symptoms. The antecedent hypothesis asserts that interpersonal difficulties precede the onset of depression. Both theories stress the impact of social relations in the development of depression. Social behavioral patterns of college students were recorded using a variety of rating methods; demographic data were also recorded. The total group of 119 students was broken down into three general categories: depressed individuals, students with other mental disorders, and normal controls. The results of the data showed several overlapping characteristics between the depressed group and the individuals with other disorders. The characteristics of the roommates of these students were also reported. Some features that were unique to the depressed group included reduced social contact with their roommates, little enjoyment from the social contacts that were made, and high levels of stress. The roommates of the depressed group scored low on tests that measured enjoyment levels and had strong aggressive-competitive reactions toward their depressed roommates. This supports previous research which has indicated depressed individuals have a negative impact on those around them and that their relationships, in general, are problematic. The identification of specific vulnerability factors that are common to individuals suffering from depression remains difficult. However, certain social behavioral tendencies which aggravate depression can be identified. (Consumer Summary produced by Reliance Medical Information, Inc.)

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]