Examining the Utility of a Multiple Group Membership Intervention for Alleviating the Effects of Age-Based Stereotype Threat on Older adults' Memory Performance.

This study examined the effectiveness of a multiple group membership intervention for reducing the negative effects of age-based stereotype threat (ABST) on older adults' objective memory performance and subjective memory concerns. Healthy older adults (N = 68) were randomly allocated to an ABST + threat-removal (ABST+TR) or ABST + active-control (ABST+AC) condition. After activating ABST, the ABST+TR condition completed a group-listing task and the ABST+AC condition completed a meal-listing task. Participants then completed the Rey Auditory Verbal Learning Test (RAVLT) and Everyday Memory Questionnaire - Revised. One significant difference was found in memory performance between conditions; specifically, after controlling for age, gender, and number of items listed, those in the ABST+TR condition performed significantly better on the RAVLT memory interference trial. Further, listing a greater number of group memberships was associated with better memory performance in the ABST+TR condition. No significant difference was found in subjective memory concerns between the ABST+TR condition and the ABST+AC condition. Overall, the current findings indicated that raising the salience of multiple group memberships offered limited protection for older adults' cognitive test performance in the context of ABST.

Cost-utility analysis of a telehealth psychological support intervention for people with primary brain tumor: Telehealth Making Sense of brain tumor.

OBJECTIVE: To undertake an economic evaluation of a telehealth psychological support intervention for patients with primary brain tumor (PBT). METHODS: A within-trial cost-utility analysis over 6 months was performed comparing a tailored telehealth-psychological support intervention with standard care (SC) in a randomized control trial. Data were sourced from the Telehealth Making Sense of Brain Tumor (Tele-MAST) trial survey data, project records, and administrative healthcare claims. Quality-adjusted life years (QALYs) were calculated based on the EuroQol-5D-5L. Non-parametric bootstrapping with 2000 iterations was used to determine sampling uncertainty. Multiple imputation was used for handling missing data. RESULTS: The Tele-MAST trial included 82 participants and was conducted in Queensland, Australia during 2018-2021. When all healthcare claims were included, the incremental cost savings from Tele-MAST were -AU$4,327 (95% CI: -$8637, -$18) while incremental QALY gains were small at 0.03 (95% CI: -0.02, 0.08). The likelihood of Tele-MAST being cost-effective versus SC was 87% at a willingness-to-pay threshold of AU$50,000 per QALY gain. When psychological-related healthcare costs were included only, the incremental cost per QALY gain was AU$10,685 (95% CI: dominant, $24,566) and net monetary benefits were AU$534 (95% CI: $466, $602) with a 65% likelihood of the intervention being cost-effective. CONCLUSIONS: Based on this small randomized controlled trial, the Tele-MAST intervention is a cost-effective intervention for improving the quality of life of people with PBT in Australia. Patients receiving the intervention incurred significantly lower overall healthcare costs than patients in SC. There was no significant difference in costs incurred for psychological health services.

Evaluation of the telehealth making sense of brain tumor psychological support intervention for people with primary brain tumor and their caregivers: A randomized controlled trial.

OBJECTIVE: This pragmatic randomized control trial aimed to evaluate clinical efficacy of the Making Sense of Brain Tumour program delivered via videoconferencing (Tele-MAST) for improving mental health and quality of life (QoL) relative to standard care in individuals with primary brain tumor (PBT). METHOD: Adults with PBT experiencing at least mild distress (Distress Thermometer ≥4) and caregivers were randomly allocated to the 10-session Tele-MAST program or standard care. Mental health and QoL were assessed pre-intervention, post-intervention (primary endpoint), and 6-weeks and 6-months follow-up. The primary outcome was clinician-rated depressive symptoms on the Montgomery-Asberg Depression Rating Scale. RESULTS: 82 participants with PBT (34% benign, 20% lower-grade glioma, 46% high-grade glioma) and 36 caregivers were recruited (2018-2021). Controlling for baseline functioning, Tele-MAST participants with PBT had lower depressive symptoms at post-intervention (95% CI: 10.2-14.6, vs. 15.2-19.6, p = 0.002) and 6-weeks post-intervention (95% CI: 11.5-15.8 vs. 15.6-19.9, p = 0.010) than standard care, and were almost 4 times more likely to experience clinically reduced depression (OR, 3.89; 95% CI: 1.5-9.9). Tele-MAST participants with PBT also reported significantly better global QoL, emotional QoL and lower anxiety at post-intervention and 6-weeks post-intervention than standard care. There were no significant intervention effects for caregivers. At 6-months follow-up participants with PBT who received Tele-MAST reported significantly better mental health and QoL relative to pre-intervention. CONCLUSIONS: Tele-MAST was found to be more effective for reducing depressive symptoms at post-intervention than standard care for people with PBT but not caregivers. Tailored and extended psychological support may be beneficial for people with PBT.

Health practitioner beliefs regarding the impact of age-based stereotype threat on performance in the cognitive assessment of older adults.

OBJECTIVES: Health practitioners' understanding of the impact of age-based stereotype threat (ABST) on the cognitive test performance of older adults is not well understood. This study aimed to investigate health practitioners' ability to recognize the influence of ABST in the cognitive assessment of older adults and their perceptions of its impact in practice. METHODS: One-hundred and twenty-nine health practitioners (86% female; M age = 39.75, SD = 11.50) with experience in conducting cognitive assessments with older adults (mainly psychologists and occupational therapists) completed an online survey assessing demographic and practice characteristics, aging beliefs, a hypothetical cognitive assessment scenario, and perceived impact of ABST on practice. RESULTS: Overall, health practitioners rated ABST factors in the assessment scenario as less detrimental to cognitive performance than internal and external factors. In a hierarchical regression model, lower recognition of ABST and negative aging beliefs significantly accounted for lower perceived impact of ABST on older adults' cognitive test performance in practice (R2 = .37, p < .001). CONCLUSION: Health practitioners may not recognize the influence of ABST on assessment findings, especially if they hold negative aging beliefs. The findings highlight the need to improve health practitioners' knowledge of ABST to increase the validity of cognitive testing in older adults.

Overcoming Age-Based Stereotypes to Optimize Cognitive Performance in Older Adults: A Systematic Review of Methodology and Existing Evidence.

BACKGROUND AND OBJECTIVES: Age-based stereotype threat (ABST) poses serious risks for the cognitive screening of older adults. This review aimed to identify and critically appraise the methodology and existing evidence of studies investigating the use of threat-removal (TR) strategies to overcome the effects of ABST on the cognitive performance of older adults. The types of strategies, their effectiveness in optimizing cognitive performance, and factors influencing their effectiveness were examined. RESEARCH DESIGN AND METHODS: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PsycINFO, PubMed, Embase, Web of Science, and Scopus were searched from January 1, 1995 to November 6, 2019. Two authors independently assessed article eligibility and appraised methodological quality of eligible articles using an adaptation of the Strengthening the Reporting of Observational studies in Epidemiology guidelines. Narrative synthesis was used to summarize results. RESULTS: Thirty articles, reporting on 36 studies, were eligible and included. Overall, evidence for the effectiveness of TR was mixed and varied according to the explicitness of strategies and comparison conditions used. Studies examining blatant TR strategies, and those using a combination of blatant and subtle TR strategies, provided limited support for their effectiveness in overcoming ABST. However, studies evaluating subtle TR strategies provided preliminary support for their effectiveness in overcoming ABST. DISCUSSION AND IMPLICATIONS: Existing studies provide limited evidence regarding the effectiveness of TR strategies in overcoming ABST due to methodological limitations. Recommendations are made for the design of future studies to differentiate the benefits of TR strategies from the detrimental effects of ABST, thus potentially informing their use in clinical practice.

Theory of mind correlates with clinical insight but not cognitive insight in patients with schizophrenia.

Research on the relationship between insight and social cognition, in particular Theory of Mind (ToM), in schizophrenia has yielded mixed findings to date. Very few studies, however, have assessed both clinical insight and cognitive insight when examining their relationships with ToM in schizophrenia. The current study thus investigated the relationship between clinical insight, cognitive insight, and ToM in a sample of 56 patients with schizophrenia and 30 healthy controls. Twenty-seven patients were classified as low in clinical insight according to their scores on the 'insight' item (G12) of the Positive and Negative Syndrome Scale (PANSS). Moreover, cognitive insight and ToM were assessed with the Beck Cognitive Insight Scale (BCIS) and the Yoni task, respectively. The results indicated that patients with poor clinical insight performed worse on tasks of second-order cognitive and affective ToM, while the ToM performance of patients with high clinical insight was equivalent to that of healthy controls. Furthermore, while clinical insight was correlated with ToM and clinical symptoms, cognitive insight did not correlate with clinical insight, ToM, or clinical symptoms. Clinical insight thus appears to be an important factor related to ToM in schizophrenia.