A pilot rating system to evaluate the quality of goal attainment scales used as outcome measures in rehabilitation.

Goal Attainment Scaling (GAS) is a method for writing person-centred approach evaluation scales that can be used as an outcome measure in clinical or research settings in rehabilitation. To be used in a research setting, it requires a high methodological quality approach. The aim of this study was to explore the feasibility and reliability of the GAS quality rating system, to ensure that GAS scales used as outcome measures are valid and reliable. Secondary objectives were: (1) to compare goal attainment scores' reliability according to how many GAS levels are described in the scale; and (2) to explore if GAS scorings are influenced by who scores goal attainment. The GAS scales analysed here were set collaboratively by 57 cognitively impaired adults clients and their occupational therapist. Goals had to be achieved within an inpatient one-month stay, during which clients participated in an intervention aimed at improving planning skills in daily life. The GAS quality rating system proved to be feasible and reliable. Regarding GAS scores, interrater reliability was higher when only three of the five GAS levels were described, i.e., "three milestone GAS" (0.74-0.92), than when all five levels were described (0.5-0.88), especially when scored by the clients (0.5 -0.88).

Interference effect of food and emotional stimuli in Stroop-like tasks for children and adults with Prader-Willi Syndrome.

Interference effect of food and emotional stimuli in Stroop-like tasks for children and adults with Prader-Willi Syndrome. The aim of this work was to study the way items related to food or emotion are processed by a population known to have difficulties with dietary restriction, namely individuals with Prader-Willi Syndrome (PWS). Given the presence of intellectual disability (ID) in PWS, our experiments were designed to examine whether these difficulties were specific to PWS or linked with their ID. Two modified Stroop tasks (i.e., a food version and an emotional version) were administered to seventy-four children (aged between 6 and 16 years old) divided into three groups (one with PWS, one with ID matched on age and Intellectual Quotient (IQ), and one healthy group matched on age) and to eighty-four adults (aged between 18 and 48 years old) distributed in the same three groups. For both tasks, a picture version was used for the children and a word version for the adults. For the food Stroop task, (Experiment 1), materials were composed of low or high-caloric food items and stimuli not related to food. The results show a food Stroop effect for children and adults with PWS that was absent in the group of healthy participants. Moreover, a food Stroop effect was also significant for adults with ID. For the emotional Stroop task (Experiment 2), materials were composed of negative, positive and neutral stimuli. The emotional Stroop effect was also obtained for children and adults with PWS as well as for the healthy group, but not for the age- and IQ-matched group. For the PWS groups, results show a preservation to process positive pictures for children and difficulties to process negative stimuli for both age-groups. These results suggest that people with PWS have difficulties in disengaging their attention when food stimuli are present in their environment and poorer abilities to process negative ones. These difficulties endure in adulthood.

Study of the deficit in planning abilities of adults with Prader-Willi Syndrome.

BACKGROUND: Prader-Willi syndrome (PWS) is a complex developmental genetic disorder associated with intellectual disability and deficits in executive functions which result in disorganisation and poor personal autonomy. AIMS: This study aimed to determine impairments in planning skills of adults with PWS, in relation with their intellectual disabilities, as well as the influence of food compulsions on their performance. METHODS AND PROCEDURES: A modified version of the Zoo Map from the Behavioural Assessment of the Dysexecutive Syndrome was used in three groups: a group of adults with PWS in comparison with two groups both matched on chronological age, one with typical development (TD) and one with intellectual disability (ID). OUTCOMES AND RESULTS: Compared to TD adults, both adults with PWS and ID showed increased planning time and lower raw scores on the planning task. The execution time and the number of errors were higher in the PWS group compared to the comparison groups. All three groups performed worse in the non-food condition only for number of errors and raw score. CONCLUSIONS AND IMPLICATIONS: Planning abilities were impaired in PWS adults. Results also showed that intellectual level plays a role in participants' performance. These findings are essential to understand the difficulties of people with PWS daily life.

Improvement of Planning Abilities in Adults with Prader-Willi Syndrome: A Randomized Controlled Trial.

Prader-Willi Syndrome (PWS) is a neurodevelopmental genetic disorder with executive deficits. Planning is one of the impaired executive functions implied in the regulation of behavior and everyday actions. We aimed to explore the feasibility and the effectiveness of a metacognitive strategy training designed to improve planning in adults with PWS using a double-blind between-group (training versus usual care) randomized controlled trial, with computerized tests and paper-pencil ecological outcome measures targeting planning, other executive functions, and achievement of personalized goal. Results showed better performances in several executive tasks and in achievement of personalized goals after both interventions, but better improvement for the experimental group (n = 27) compared to control (n = 26) only on the task assessing planning abilities. Interviews with occupational therapists demonstrated the feasibility of this training with this population. Despite a small number of sessions, the metacognitive strategy training showed encouraging results on planning abilities of patients.

Cognitive Training Targeting Planning Dysfunction in Adults with Prader-Willi Syndrome: Brief Report of a Study Protocol.

Background: Prader-Willi syndrome (PWS) is a neurodevelopmental genetic disorder involving executive deficits notably with planning. The main objective of the study is to assess the effectiveness of cognitive training on daily life planning difficulties in PWS patients. Methods/design: The study is a double-blind randomized controlled trial which will compare the effectiveness of a metacognitive strategy intervention designed to improve planning difficulties for PWS patients to usual occupational therapy. Sixty adults will be included over 20 months. The main outcome measure will be the performance on the Modified Six Elements Test from the BADS; secondary outcome measures will be computerized executive tasks and questionnaires. Daily life planning difficulties will be identified and transformed into measurable goals using Goal Attainment Scaling. Discussion: The project will provide knowledge on the difficulties experienced by PWS patients, in relation to their executive functioning in order to implement effective intervention for planning in daily life.

Exploring the contribution of executive functions to on-road driving performance during aging: A latent variable analysis.

With the aging of the population the issue of older drivers safety has gained importance in recent years. Age-related cognitive decline is frequently cited as the main cause of unsafe driving performance in older drivers. OBJECTIVE: The present study investigated how executive functions (EFs), measured as latent variables, are related to on-road driving performance during aging. METHOD: One hundred and twenty-six participants aged from twenty to eighty-two, completed a two hundred and forty-seven km on-road driving test and a set of executive tasks selected to tap three often postulated EFs: inhibition (inhibiting prepotent responses), updating (updating working memory representations), and shifting (shifting task sets). RESULTS: Confirmatory factor analysis reproduces previous results obtained by Miyake et al. (2000), Miyake and Friedman (2012) of unity and diversity of EFs in an adult life span sample. Structural equation modeling suggested that on-road driving performance was related to inhibition. Furthermore, findings indicate that the age-related driving performance decline in normal aging may be mediated by the inhibition function. CONCLUSIONS: The results highlight the importance of a proper method to assess executive functioning in a specific domain as well as emphasising the major role of those functions in driving performance while aging.

Executive functions and Prader-Willi syndrome: global deficit linked with intellectual level and syndrome-specific associations.

The aim of this study was to support the growing evidence suggesting that Prader-Willi Syndrome (PWS) might present with an impairment of executive functions (EFs) and to investigate whether this impairment is specific to patients with PWS or due to their intellectual disability (ID). Six tasks were administered to assess EFs (inhibition, switching, updating, cognitive estimation, and planning) to 17 patients with PWS and 17 age-matched healthy individuals. Performance was significantly impaired in the PWS group on all EFs and after controlling for IQ level, intergroup differences remained only for switching and cognitive estimation. In conclusion, PWS seems to be associated with a global impairment of EFs that appears to be closely linked with intellectual impairment but also with the PWS itself.

The effect of orthographic neighborhood in the reading span task.

This study aimed at examining whether and to what extent orthographic neighborhood of words influences performance in a working memory span task. Twenty-five participants performed a reading span task in which final words to be memorized had either no higher frequency orthographic neighbor or at least one. In both neighborhood conditions, each participant completed three series of two, three, four, or five sentences. Results indicated an interaction between orthographic neighborhood and list length. In particular, an inhibitory effect of orthographic neighborhood on recall appeared in list length 5. A view is presented suggesting that words with higher frequency neighbors require more resources to be memorized than words with no such neighbors. The implications of the results are discussed with regard to memory processes and current models of visual word recognition.

[An integrative model of the psychological benefits of gardening in older adults]. / Proposition d'un modèle intégratif concernant les bénéfices psychologiques du jardinage chez les personnes âgées.

This review of the literature tackles the question of the psychological benefits linked to gardening in older adults. First, the current data on these benefits are reviewed, and the findings reveal that gardening is linked to feelings of accomplishment, well-being and peace, a decrease of depressive symptoms, a protective effect on cognitive functions as well as to the development of social links for community living older adults. In institutionalized older adults, gardening promotes internal locus of control and well-being, and is related to a decrease of sadness and anxiety. Second, several explanatory theories are discussed. All of them postulate an action on the cognitive and/or emotional spheres, which were included into a integrated model that must be tested in future research. In conclusion, gardening appears to be a beneficial activity for promoting older adults' functioning but the current knowledge still has to be extended to understand the specific mechanisms of action. This deeper understanding is necessary in order to improve the future actions depending on this activity.

Investigation of age-related differences in an adapted Hayling task.

The Hayling task is traditionally used to assess activation and inhibitory processes efficiency among various populations, such as elderly adults. However, the classical design of the task may also involve the influence of strategy use and efficiency of sentence processing in the possible differences between individuals. Therefore, the present study investigated activation and inhibitory processes in aging with two formats of an adapted Hayling task designed to reduce the involvement of these alternative factors. Thirty young adults (M=20.7 years) and 31 older adults (M=69.6 years) performed an adapted Hayling task including a switching block (i.e., unblocked design) in addition to the classical task (i.e., blocked design), and the selection of the response between two propositions. The results obtained with the classical blocked design showed age-related deficits in the suppression sections of the task but also in the initiation ones. These findings can be explained by a co-impairment of both inhibition and activation processes in aging. The results of the unblocked Hayling task, in which strategy use would be reduced, confirmed this age-related decline in both activation and inhibition processes. Moreover, significant correlations between the unblocked design and the Trail Making Test revealed that flexibility is equally involved in the completion of both sections of this design. Finally, the use of a forced-response choice offers a format that is easy to administer to people with normal or pathological aging. This seems particularly relevant for these populations in whom the production of an unrelated word often poses problems.

Destination memory in mild Alzheimer's Disease.

In order to assess their destination memory, sixteen patients with probable mild Alzheimer Disease (AD), sixteen older adults and 16 young adults were asked to tell facts to pictures. On a subsequent task, they were asked to remember whether they had previously told that fact to that face or not. AD patients showed poorer destination recall than the older adults, and the older adults showed poorer destination recall than the young adults. Our results suggest that destination memory is highly impaired in AD.

Destination memory in Alzheimer's Disease: when I imagine telling Ronald Reagan about Paris.

Destination memory refers to remembering the destination of information that people output. This present paper establishes a new distinction between external and internal processes within this memory system for both normal aging and Alzheimer's Disease (AD). Young adults, older adults, and mild AD patients were asked either to tell facts (i.e., external destination memory condition) or to imagine telling facts (i.e., internal destination memory condition) to pictures of famous people. The experiment established three major findings. First, the destination memory performance of the AD patients was significantly poorer than that of older adults, which in turn was poorer than that of the young adults. Furthermore, internal destination processes were more prone to being forgotten than external destination memory processes. In other words, participants had more difficulty in remembering whether they had previously imagined telling the facts to the pictures or not (i.e., imagined condition) than in remembering whether they had previously told the facts to the pictures or not (i.e., enacted condition). Second, significant correlations were detected between performances on destination memory and several executive measures such as the Stroop, the Plus-Minus and the Binding tasks. Third, among the executive measures, regression analyses showed that performance on the Stroop task was a main factor in explaining variance in destination memory performance. Our findings reflect the difficulty in remembering the destination of internally generated information. They also demonstrate the involvement of inhibitory processes in destination memory.

Inhibition of irrelevant information is not necessary to performance of expert chess players.

Some studies on expertise have demonstrated that the difference between novices and experts can be partly due to a lack of knowledge about which information is relevant for a given situation. This lack of knowledge seems to be associated with the selection of correct information and with inhibitory processes. However, while the efficiency of inhibitory processes can lead to better performance in the normal population, it seems that experts in chess do not base their performance on this process but rather on an automatic and parallel encoding of information. Two experiments investigated the processes involved in a check detection task. The congruence of the information was manipulated in a Stroop situation similar to Reingold, Charness, Scheltetus, & Stampe (2001). The results showed that the experts did not benefit from cuing with a congruent cue and that they did not show any interference effect by the incongruent cue, contrary to less skilled chess players who benefited from cuing (Exp. 1). An attentional priming procedure confirmed the automatic encoding of chess relations in the more skilled chess players by showing no advantage from the prime in this group (Exp. 2). Taken together, the results indicate that the processing was serial for the less skilled chess players and that it was automatic and parallel for the more expert chess players. The inhibition of irrelevant information does not seem necessary to process information rapidly and efficiently.

Health and aging in elderly farmers: the AMI cohort.

BACKGROUND: The health of the agricultural population has been previously explored, particularly in relation to the farming exposures and among professionally active individuals. However, few studies specifically focused on health and aging among elders retired from agriculture. Yet, this population faces the long-term effects of occupational exposures and multiple difficulties related to living and aging in rural area (limited access to shops, services, and practitioners). However, these difficulties may be counter-balanced by advantages related to healthier lifestyle, richer social support and better living environment. The general aim of the AMI cohort was to study health and aging in elderly farmers living in rural area through a multidisciplinary approach, with a main focus on dementia. METHODS/DESIGN: The study initially included 1 002 participants, randomly selected from the Farmer Health Insurance rolls. Selection criteria were: being 65 years and older; living in rural area in Gironde (South-Western France); being retired from agriculture after at least 20 years of activity and being affiliated to the Health Insurance under own name. The study started in 2007, with two follow-up visits over 5 years. Baseline visits were conducted at home by a neuropsychologist then by a geriatrician for all cases suspected of dementia, Parkinson's disease and depression (to confirm the diagnosis), and by a nurse for others. A large panel of data were collected through standardised questionnaires: complete neuropsychological assessment, material and social living environment, psychological transition to retirement, lifestyle (smoking, alcohol and diet), medications, disability in daily living, sensory impairments and some clinical measures (blood pressure, depression symptomatology, anxiety, visual test, anthropometry...). A blood sampling was performed with biological measurements and constitution of a biological bank, including DNA. Brain MRI were also performed on 316 of the participants. Finally, the three-year data on health-related reimbursements were extracted from the Health System database (medications, medical and paramedical consultations, biological examinations and medical devices), and the registered Long-Term Diseases (30 chronic diseases 100% covered by the Insurance System). DISCUSSION: AMI is the first French longitudinal study on health and aging set up in a population of elderly farmers living in rural area through a multidisciplinary approach.

The association between routinization and cognitive resources in later life.

The aim of this study was to investigate the association between routinization of daily life activities and cognitive resources during aging. Routinization could increase excessively during aging and become maladaptative in reducing individual resources. Fifty-two young participants (M = 20.8 years) and 62 older participants (M = 66.9 years) underwent a routinization scale and cognitive tasks of working memory, speed of processing, and attention. Results revealed that older adults presented a decrease on the three cognitive measures but no change on the routinization score. While no association was observed between routinization and cognitive measures for the young adults, a high routinization was associated with lower cognitive flexibility in the older adults. These findings are interpreted in the light of theories about the positive impact of variety in daily life environment on cognitive functions.

Directed forgetting of autobiographical memory in mild Alzheimer's disease.

Using the autobiographical directed forgetting method (Barnier et al., 2007), the present paper addressed the intentional inhibitory processes of episodic and semantic autobiographical memory in Alzheimer's disease (AD). Mild AD patients and healthy elderly people were instructed to either forget or to continue remembering previously generated autobiographical events. In a later recall test they were asked to reconstruct the early-generated memories regardless of the forget/remember instruction. Autobiographical reconstruction was further distributed into episodic and semantic memories. Results showed no forget instruction effect on episodic or semantic autobiographical recall with AD patients, whereas healthy elderly people were able to inhibit only episodic autobiographical memories. The findings suggest an impairment of the intentional inhibitory processes in autobiographical memory with AD and a relative preservation of these mechanisms with normal ageing. They also demonstrate an earlier decline in the intentional inhibitory processes compared to the autobiographical deterioration in AD.

Personality traits and executive functions related to on-road driving performance among older drivers.

The present study investigated how executive functions and personality traits are related with driving performance among older drivers. Forty-two participants aged 60 and over were recruited to complete a battery of cognitive tests, measures of personality traits and an on-road driving test. Significant correlations were found between poor driving performances and low scores on tests assessing shifting and updating functions. In addition, extraversion had a negative relation with driving performance and made the only contribution, among the psychological factors, to the prediction of driving performance. Finally, gender and age emerged as the best predictors of on-road driving performance. Gender, personality traits and executive functions should be taken into account when studying safety among older drivers.

Strategy selection and aging: impact of item concreteness in paired-associate task.

The aim of this study was to examine the effect of aging on strategy selection in a paired-associate word task. Twenty-eight younger adults (mean age = 20.68 years) and 28 older adults (mean age = 68.46 years) studied 39 pairs of concrete, middle and abstract words. The concreteness level was manipulated in order to modify the benefit of imagery and sentence strategies in relation to task characteristics. The results showed an age difference in strategy selection in relation to concreteness level. Older adults showed less adaptive strategy selection for the imagery strategy but not for the sentence strategy. Change in strategy selection did not seem to be explained by better efficiency of sentence than imagery, so this study suggests a partial reduction of strategy adaptivity during aging.

Effects of depressive symptoms and routinization on metamemory during adulthood.

The purpose of this study was to investigate the impact of aging, depressive symptoms and preference for routine on metamemory. Twenty-eight young adults (of mean age=20.7 years) and 28 older adults (68.5 years) completed the metamemory in adulthood (MIA) scale for assessing various metamemory dimensions. Compared with young adults, older adults used more external strategy. They used more internal strategy but only those with high depressive symptoms or high routinization. Older adults also reported a less efficient memory than young adults, showing less capacity and more change. In addition, depressive symptoms influenced many MIA subscales: participants with high depressive symptoms reported more external strategy use, less capacity, more change and less locus than participants with low depressive symptoms. Finally, highly routinized participants reported more use of external strategy and experienced more anxiety about memory. These results confirm the impact of aging on metamemory and show that an increase in depressive symptoms even without a depressive state and routinization also influences metamemory. This study shows the need to consider variables that modify memory perception during aging.

Expertise in cognitive psychology: testing the hypothesis of long-term working memory in a study of soccer players.

This experiment compared several theories of expertise and exceptional performances in cognitive psychology. One current conception assumes that experts in a specific domain have developed a long-term working memory, which accounts for the difference in memory performance between experts and novices. The principal characteristics of this memory are the speed with which processes of storage and retrieval function and the existence of retrieval structures that allow a temporary activation of the knowledge store in long-term memory. Other authors such as Vicente and Wang argue this notion does not account for memory performance that is not intrinsic to the domain of expertise. We attempt to clarify the two viewpoints and to focus on this debate by testing the hypothesis of long-term working memory using soccer as the domain of expertise and by comparing the cognitive performance of participants who have different expertise (novices, supporters, players, and coaches). 35 male participants were administered a new version of the Reading Span test to assess their long-term working memory according to two conditions. In the first condition (structured condition), the last word of each sentence was related to the soccer domain, and these words were related to each other in such a manner that they represented a part of the game. In the second condition (unstructured condition), the last word of each sentence was related to soccer but these words did not represent part of the game. Analysis showed that the sentence span increased as a function of expertise for the structured condition but not for the unstructured condition. The results were interpreted in the framework of the constraint attunement hypothesis proposed by Vicente in 1992 and the long-term working memory hypothesis proposed by Ericsson and Kintsch in 1995.