Memory Age-based Stereotype Threat: Role of Locus of Control and Anxiety.

Background: Age-related stereotype threat impacts episodic memory performance. This study compared the predictors of memory performance in older adults with and without exposure to age-related stereotype threat, hypothesizing that activating the stereotype threat modulates the relative weight of metamemory predictors of memory performance.Methods: Participants were 80 older adults (aged 60-84 years) divided into two groups, one with stereotype threat activation and one without; both groups performed an episodic memory task. To activate the stereotype threat, the memory component of the task was emphasized in the instruction given to the threatened group. Both groups also completed two scales of the MIA questionnaire (locus of control and anxiety) to identify potential predictors of memory performance.Results: Results indicated that the non-threatened group performed better than the threatened group on the episodic memory task. They also indicated that factors predicting episodic memory performance varied according to the group. In the non-threatened group, both control and anxiety were involved in memory performance and interacted whereas in the threatened group only anxiety was involved.Conclusion: This study confirms that aging stereotype threat impairs episodic memory performance; it also suggests that stereotype threat disrupts mechanisms underlying memory performance abolishing the role of control over memory regardless of the level of anxiety.

Clinical factors influencing the sensitivity to warfarin when restarted after surgery.

BACKGROUND AND OBJECTIVE: Resumption of oral anticoagulation after surgery may result in a different maintenance dose of warfarin than before the procedure. Knowledge of the clinical determinants of postoperative response could help avoid excessive anticoagulation in sensitive patients or avoid extended delays in achieving a therapeutic level in resistant patients. DESIGN: Retrospective review. SUBJECTS: Two hundred warfarin-treated patients who were managed by our clinic for surgery. OUTCOME: Two independent adjudicators classified the postoperative response to warfarin as Resistant, Normal or Sensitive, based on previous maintenance dose, international normalized ratio (INR) on the day of resumption, number of days until INR of >1.9 and doses of warfarin given. A third adjudicator resolved disagreements. Clinical data were extracted from the patient records and correlated with the response. RESULTS: Interobserver agreement for classification of postoperative response was moderate (weighted kappa 0.46) with 37 (18.5%) considered resistant, 135 (67.5%) normal, 27 (13.5%) sensitive and one patient was not classifiable. The main type of surgery was cardiac. In univariable analysis only addition of amiodarone after surgery was associated with a sensitive response (P = 0.04). After adjustment for all other factors with an ordered categorical response, amiodarone remained as the sole independent risk factor (P = 0.02) for a sensitive response, odds ratio 0.41 (95% confidence interval 0.19-0.89) for Normal instead of Sensitive or for Resistant instead of Normal. CONCLUSION: Altered sensitivity to warfarin occurs in about one-third of patients after surgery and can be predicted by the introduction of concomitant amiodarone therapy but not by patient factors or the nature of the procedure. Changes in concomitant medications after surgery should alert doctors of the potential for increased sensitivity to warfarin.