Training Older Adults to Use Tablet Computers: Does It Enhance Cognitive Function?

PURPOSE OF THE STUDY: Recent evidence shows that engaging in learning new skills improves episodic memory in older adults. In this study, older adults who were computer novices were trained to use a tablet computer and associated software applications. We hypothesize that sustained engagement in this mentally challenging training would yield a dual benefit of improved cognition and enhancement of everyday function by introducing useful skills. DESIGN AND METHODS: A total of 54 older adults (age 60-90) committed 15 hr/week for 3 months. Eighteen participants received extensive iPad training, learning a broad range of practical applications. The iPad group was compared with 2 separate controls: a Placebo group that engaged in passive tasks requiring little new learning; and a Social group that had regular social interaction, but no active skill acquisition. All participants completed the same cognitive battery pre- and post-engagement. RESULTS: Compared with both controls, the iPad group showed greater improvements in episodic memory and processing speed but did not differ in mental control or visuospatial processing. IMPLICATIONS: iPad training improved cognition relative to engaging in social or nonchallenging activities. Mastering relevant technological devices have the added advantage of providing older adults with technological skills useful in facilitating everyday activities (e.g., banking). This work informs the selection of targeted activities for future interventions and community programs.

Longitudinal trajectories of metabolic control across adolescence: associations with parental involvement, adolescents' psychosocial maturity, and health care utilization.

PURPOSE: To predict trajectories of metabolic control across adolescence from parental involvement and adolescent psychosocial maturity, and to link metabolic control trajectories to health care utilization. METHODS: Two hundred fifty-two adolescents (M age at study initiation = 12.5 years, SD = 1.5, range = 10-14 years) with type 1 diabetes (54.4% female, 92.8% Caucasian, length of diagnosis M = 4.7 years, SD = 3.0, range = 1-12 years) participated in a 2-year longitudinal study. Metabolic control was gathered from medical records every 3 months. Adolescents completed measures of self-reliance (functional autonomy and extreme peer orientation), self-control (self-control and externalizing behavior), and parental involvement in diabetes care (acceptance, monitoring, and frequency of help). At the end of the study, mothers reported health care utilization (diabetes-related emergency room visits and hospitalizations) over the past 6 months. RESULTS: Latent class growth analyses indicated two distinct trajectories of metabolic control across adolescence: moderate control with slight deterioration (92% of the sample; average HbA1c = 8.18%) and poor control with rapid deterioration (8% of the sample; average HbA1c of 12.09%). Adolescents with poor and rapidly deteriorating metabolic control reported lower paternal monitoring and frequency of help with diabetes management, lower functional autonomy, and lower self-control than others. Those with poor and rapidly deteriorating metabolic control were 6.4 times more likely to report diabetes-related emergency room visits, and 9.3 times more likely to report diabetes-related hospitalizations near the end of the study. CONCLUSIONS: Parental involvement and adolescents' psychosocial maturity predict patterns of deteriorating metabolic control across adolescence and could be targeted for intervention.

Depleted parental psychological resources as mediators of the association of income with adherence and metabolic control.

For adolescents with Type 1 diabetes, lower family income may be associated with poorer diabetes management through depleted parental psychological resources (i.e., higher parental depressive symptoms, lower parental acceptance). Adolescents (N = 252; 46% male) aged 10-14 years with Type 1 diabetes assessed the acceptance of their mother and father (e.g., "gives me the feeling that she likes me as I am"; "she doesn't feel she has to make me over into someone else"). Mothers provided information on family income and demographics. Both mothers and fathers reported their depressive symptoms. HbA1c scores were indexed via medical records. Lower family income was associated with higher (i.e., worse) HbA1c, more mother and father depressive symptoms, and less acceptance from both parents. Mediation analyses revealed that the relationship of lower family income with metabolic control occurred indirectly through lower maternal and paternal acceptance and lower adherence. Lower family income may impair the quality of parent--adolescent relationships that are beneficial for good diabetes management.

The mediating role of extreme peer orientation in the relationships between adolescent-parent relationship and diabetes management.

The study examined whether the quality of the adolescent-parent relationship was associated with better diabetes management in adolescents with Type 1 diabetes by decreasing adolescents' extreme peer orientation. Adolescents (n = 252; 46% male and 54% female) aged 10 to 14 years with Type 1 diabetes completed assessments of extreme peer orientation (i.e., tendency to ignore parental advice and diabetes care to fit in with friends), adolescent-parental relationship, and adherence; HbA1c scores indexed metabolic control. Adolescents with higher quality relationships with parents reported less peer orientation and better diabetes care. The mediational model revealed that adolescents' high quality relationships with their parents (mother and father) were associated with better treatment adherence and metabolic control through less peer orientation. It is likely that high quality adolescent-parent relationships may be beneficial to adolescent diabetes management through a healthy balance between peer and parental influence.

Grandparents' psychological well-being after loss of contact with their grandchildren.

This study examined how loss of contact with grandchildren due to parental separation or divorce, family feud, or a sudden event, such as relocation, affected the emotional well-being of grandparents (N = 442). Using data from the Longitudinal Study of Generations, the depressive symptoms of grandparents were tracked over 15 years. Growth curve analysis was used to compare grandparents who had lost contact with their grandchildren with those who had not and to examine preloss to postloss change in depressive symptoms. Grandparents who lost contact with their grandchildren experienced a steeper increase in depressive symptoms as they aged compared with other grandparents. Depressive symptoms of grandparents who lost contact because of a sudden event increased up to 3 years following the loss but returned to equilibrium thereafter. The authors conclude that grandparents who lost contact with their grandchildren experienced a negative impact on their emotional health.