Papers by Maureen Schmitter-Edgecombe
Journal of clinical and experimental neuropsychology, 2016
The use of compensatory strategies plays an important role in the ability of older adults to adap... more The use of compensatory strategies plays an important role in the ability of older adults to adapt to late-life memory changes. Even with the benefits associated with compensatory strategy use, little research has explored specific mechanisms associated with memory performance and compensatory strategies. Rather than an individual's objective memory performance directly predicting their use of compensatory strategies, it is possible that some other variables are indirectly influencing that relationship. The purpose of this study was to: (a) examine the moderating effects of cognitive reserve (CR) and (b) evaluate the potential mediating effects of memory self-efficacy on the relationship between objective memory performance and compensatory strategy use. Two structural equation models (SEM) were used to evaluate CR (latent moderator model) and memory self-efficacy (mediator model) in a sample of 155 community-dwelling older adults over the age of 55. The latent variable moderato...
Journal of Clinical and Experimental Neuropsychology, 2019
Objective: Planning, a higher order executive functioning ability important for accomplishing com... more Objective: Planning, a higher order executive functioning ability important for accomplishing complex everyday tasks, can be differentiated into initial and concurrent (online) planning. In this study, initial plans were codified to assess their impact on task execution. Cognitive correlates of initial planning and task execution were also examined. Method: One-hundred fifty-four community dwelling older adults completed a naturalistic task, called the Day Out Task (DOT), in either a planning or no planning condition. The DOT required participants to multitask and efficiently complete a series of eight subtasks, preparing for a hypothetical day out. Participants also completed a neuropsychological battery with the following cognitive constructs assessed: processing speed, cognitive flexibility, episodic memory, visuoconstructional abilities, and working memory and sequencing. Results: There were no significant differences between the planning and no planning conditions in DOT execution accuracy, efficiency or duration. However, efficiency of the initial plan was a significant predictor of task execution efficiency and initial plans that contained a higher amount of Task Relevant Associations predicted a shorter duration of task execution after controlling for age, processing speed and episodic memory. Furthermore, initial plans that had more Task Relevant Associations and task executions that took less time were associated with better working memory and sequencing ability. Discussion: Quality of the initial plan is important. Initial plans that organize task objectives in an efficient manner may lead to better task execution efficiency, while initial plans that demonstrate a detailed understanding of individual relational aspects of the tasks (i.e., higher rate of Task Relevant Associations) may result in faster task execution.
Archives of Clinical Neuropsychology, 2018
Objective Although medication management is a necessary daily activity for individuals with Hunti... more Objective Although medication management is a necessary daily activity for individuals with Huntington’s disease (HD), medication management abilities and their relation to cognitive functioning have not been evaluated. Method Twenty individuals with HD and 20 healthy adults (HA) completed the Medication Management Abilities Assessment (MMAA). Individuals with HD also completed a self-report medication management measure and neuropsychological tests assessing executive function, retrospective memory, and prospective memory. Results Individuals with HD performed significantly poorer and made more undertaking errors on the MMAA as compared to HA. No group differences were found in overtaking errors. In the HD group, significant associations were found between undertaking errors and perceived medication management ability as well as between MMAA task performance and measures assessing prospective memory and executive functions. Conclusions Medication management capacity was negatively ...
Archives of Clinical Neuropsychology, 2017
Gerontechnology is a multidisciplinary field that links existing and emerging technologies to the... more Gerontechnology is a multidisciplinary field that links existing and emerging technologies to the enrichment (e.g., leisure, social engagement) and needs (e.g., safety, health, aid to caregivers) of older individuals. The combination of an aging population and rapid growth in technology has made gerontechnology an important and burgeoning area of study. As gerontechnology is a relatively young field, there are currently only a handful of books on the topic. Gerontechnology: Research, Practice and Principles in the Field of Technology and Aging, edited by Sunkyo Kwon, is a sequel to his 2004 edition. One particularly nice addition to this volume is the emphasis on providing information about gerontechnology-related principles in combination with discussing research and practice issues. In compiling this edition, Kwon indicates that he sought to provide readers with a comprehensive review of the diverse facets of the field of gerontechnology. As such, this book includes 24 chapters, which cover a breadth of issues and technologies that have shaped and continue to mold the field of gerontechnology. Consistent with the multidisciplinary nature of the field and a strength of this volume, the chapters were written by faculty or teams of faculty from multiple disciplines (e.g., psychology, engineering, marketing, mathematics). The collection of chapters will provide a student or novice to this field with an introduction to the history of gerontechnology and to many significant foundational and emerging topics. Such topics include age-related changes in sensory, motor and cognitive abilities that impact technology design, the evolving use of technology in health care, methodologies (e.g., user-centered) for assisting designers in product development, and factors that may influence technology adoption by older adult users. Especially of value throughout multiple chapters in the book are the authors' accounts of challenges they faced and lessons learned through their work. Numerous authors also provided useful recommendations for conducting future technology development and research in the respective reviewed areas. For example, based on author experiences and the literature, readers will find guidelines pertaining to topics ranging from marketing (Chapter 22) to designing a tele-health system (Chapter 13) and robot (Chapter 19) for older adults to using a virtual reality platform in aging mobility studies (Chapter 6). For individuals familiar with the field of gerontechnology, the editor aptly stated that the reader "will see their expectations met by selectively probing for and perusing the parts that best match their needs" (p. xlv). The book is organized into four sections. The first section includes a diverse set of topics that describe the history of gerontechnology (Chapter 1) as well as perceptual, social, generational and privacy issues associated with the development and use of technology. Although this section provides the reader with some of the basic tenets of technology and aging, it neglects others. For example, Chapter 2 provides detailed coverage of age-related sensory changes and reinforces the importance of developing technology interfaces that can accommodate these changes and reduce barriers to use. However, age-related cognitive (e.g., memory, decision-making), physical (mobility, strength) and health-related (e.g., arthritis, dementia) issues that may also influence technology development are not introduced until later chapters (Chapters 6, 17, and 19). Similarly, the early chapters discussing technologies for enhancing social contacts (Chapter 3) and how to introduce technologies to help older individuals age in place (Chapter 4), may have benefited from being preceded by a more thorough discussion of theories relevant to factors that may influence technology acceptance and adoption among older adults, some of which was found in later chapters (Chapters 5 and 16). The first section of the book also introduces some fresh ideas, such as the "family technologist", a family member knowledgeable about technology who can install, support and encourage use of technology by older adults to promote continued independence. Although the quality and detail of information presented throughout the chapters in Section 2 varied, this section met its goal of exposing the reader to a large number of different topics, tools and, technologies being explored in the field of gerontechnology. Chapter 7, which focuses on emerging information and communication technology, along with Chapter 8 both emphasize the importance of designing with users. In Chapter 8, the authors (C.S.C. Lim and A.F. Newell) introduce the concept of "user-sensitive inclusive design," an approach they feel will best account for the dynamic diversity of older adults in design. Chapters 9-12 discuss age-related changes and provide examples of how both low-tech assistive technologies and high-tech electronic and smart technologies can be used to support independence and quality-of-life for aging adults. Chapters 13-16 cover diverse technologies including tele-health, behavioral monitoring systems and emergency transportation systems
Alzheimer's & Dementia, 2019
indicated that the recommended cut-off scores of 26 and 18 did not give acceptable specificities ... more indicated that the recommended cut-off scores of 26 and 18 did not give acceptable specificities for detecting MCI (Sensitivity: 92%; specificity: 11) and dementia (Sensitivity: 92%; specificity: 55) respectively. The results may be related to the fact that some of the items were less culturally relevant to the Tanzanian population. Conclusions: Overall, the utility of K-MoCA for detecting MCI and dementia in this population was low due to less cultural relevance of some items. Modification to those items are recommended to improve its utility.
Alzheimer's & Dementia, 2017
over time. Even among those (n¼282) we have previously identified as 'false positive' MCI diagnos... more over time. Even among those (n¼282) we have previously identified as 'false positive' MCI diagnostic errors in ADNI (Edmonds et al., 2015), only 15 of the 24 ADNI reverters were baseline 'false positives', thereby missing 94.7% of participants in whom a cognitively normal diagnosis appears better justified based on neuropsychological performance, normal biomarkers, lack of cortical thinning, and low progression rates. Additionally, compared to ADNI, the NP criteria identified more new MCI cases and greater CSF reductions in b-amyloid in normal-to-MCI individuals, consistent with their cognitive decline. We conclude that ADNI has an artificially low reversion rate (3%) even when compared to metaanalytic reversion rates (24%) based largely on conventional criteria (Malek-Ahmadi, 2016).
American journal of Alzheimer's disease and other dementias, 2018
Compensation strategies may contribute to greater resilience among older adults, even in the face... more Compensation strategies may contribute to greater resilience among older adults, even in the face of cognitive decline. This study sought to better understand how compensation strategy use among older adults with varying degrees of cognitive impairment impacts everyday functioning. In all, 125 older adults (normal cognition, mild cognitive impairment, dementia) underwent neuropsychological testing, and their informants completed questionnaires regarding everyday compensation and cognitive and functional abilities. Cognitively normal and mild cognitive impairment older adults had greater levels of compensation use than those with dementia. Higher levels of neuropsychological functioning were associated with more frequent compensation use. Most importantly, greater frequency of compensation strategy use was associated with higher levels of independence in everyday function, even after accounting for cognition. Use of compensation strategies is associated with higher levels of function...
Innovation in Aging, 2017
The dramatic growth in the world's older population will have a significant effect on healthcare,... more The dramatic growth in the world's older population will have a significant effect on healthcare, social services, communities, and families; it will require innovative interdisciplinary solutions. The emergence of gerontechnology may address many aging-related challenges in the continuum of care for older adults. Telehealth, combined with patient education, engages independent community-dwelling chronically ill older adults in their own care. Health-assistive smart homes assist independent and assisted-living older adults with safety and health via ambient motion sensors and machine learning algorithms that may identify and predict health events, as well as provide timely alerts to facilitate earlier interventions. Mindful implementation and evaluation of the efficacy of gerontechnologies will be needed as more technological solutions become available and are employed. A focus on personhood and an
ACM Transactions on Computing for Healthcare
In this study, we introduce and validate a computational method to detect lifestyle change that o... more In this study, we introduce and validate a computational method to detect lifestyle change that occurs in response to a multi-domain healthy brain aging intervention. To detect behavior change, digital behavior markers are extracted from smartwatch sensor data and a permutation-based change detection algorithm quantifies the change in marker-based behavior from a pre-intervention, 1-week baseline. To validate the method, we verify that changes are successfully detected from synthetic data with known pattern differences. Next, we employ this method to detect overall behavior change for n = 28 brain health intervention subjects and n = 17 age-matched control subjects. For these individuals, we observe a monotonic increase in behavior change from the baseline week with a slope of 0.7460 for the intervention group and a slope of 0.0230 for the control group. Finally, we utilize a random forest algorithm to perform leave-one-subject-out prediction of intervention versus control subjects ...
Cognitive Systems Research, 2018
Smart environments offer valuable technologies for activity monitoring and health assessment. Her... more Smart environments offer valuable technologies for activity monitoring and health assessment. Here, we describe an integration of robots into smart environments to provide more interactive support of individuals with functional limitations. RAS, our Robot Activity Support system, partners smart environment sensing, object detection and mapping, and robot interaction to detect and assist with activity errors that may occur in everyday settings. We describe the components of the RAS system and demonstrate its use in a smart home testbed. To evaluate the usability of RAS, we also collected and analyzed feedback from participants who received assistance from RAS in a smart home setting as they performed routine activities.
Journal of Clinical and Experimental Neuropsychology (Neuropsychology, Development and Cognition: Section A), 2003
Thirty severe closed-head injured (CHI) participants (more than 1 year postinjury) and 30 matched... more Thirty severe closed-head injured (CHI) participants (more than 1 year postinjury) and 30 matched controls completed eight different cognitive activities. Participants' free recall and recognition of the activities provided a measure of content memory. Temporal order memory was assessed with a reconstruction task. CHI participants recalled and recognized fewer activities than did controls. However, the CHI and control groups did not differ in temporal order memory. For both groups, recognition memory was not correlated with temporal order memory. These results demonstrate intact temporal order memory for performed activities in a severe CHI population, and support the notion of separate processing of content memory and order information. Issues related to automaticity and the roles of the frontal lobes in temporal order memory are also discussed.
Archives of Clinical Neuropsychology, 1998
Gerontology & geriatrics education, Jan 19, 2017
Health care professionals (HCPs) are a critical source of recommendations for older adults. Aging... more Health care professionals (HCPs) are a critical source of recommendations for older adults. Aging services technologies (ASTs), which include devices to support the health-care needs of older adults, are underutilized despite evidence for improving functional outcomes and safety and reducing caregiver burden and health costs. This study evaluated a video-based educational program aimed at improving HCP awareness of ASTs. Sixty-five HCPs viewed AST videos related to medication management, daily living, and memory. Following the program, participants' objective and perceived AST knowledge improved, as did self-efficacy and anticipated AST engagement. About 95% of participants stated they were more likely to recommend ASTs post-program. Participants benefitted equally regardless of years of experience or previous AST familiarity. Furthermore, change in self-efficacy and perceived knowledge were significant predictors of engagement change. Overall, the educational program was effect...
Gerontology & geriatrics education, Jan 19, 2017
Health care professionals (HCPs) are a critical source of recommendations for older adults. Aging... more Health care professionals (HCPs) are a critical source of recommendations for older adults. Aging services technologies (ASTs), which include devices to support the health-care needs of older adults, are underutilized despite evidence for improving functional outcomes and safety and reducing caregiver burden and health costs. This study evaluated a video-based educational program aimed at improving HCP awareness of ASTs. Sixty-five HCPs viewed AST videos related to medication management, daily living, and memory. Following the program, participants' objective and perceived AST knowledge improved, as did self-efficacy and anticipated AST engagement. About 95% of participants stated they were more likely to recommend ASTs post-program. Participants benefitted equally regardless of years of experience or previous AST familiarity. Furthermore, change in self-efficacy and perceived knowledge were significant predictors of engagement change. Overall, the educational program was effect...
Gerontechnology
Background: Older adults may require assistance completing activities of daily living (ADLs). Rob... more Background: Older adults may require assistance completing activities of daily living (ADLs). Robotic assistance can offset healthcare costs and allow older adults to preserve their autonomy. Younger adults are often involved in the design and purchase of these robotic technologies and must take into account the needs and expectations of the target population (i.e., older adults) to create a robotic system that they will adopt. Objective: This study evaluated the opinions of younger and older adults regarding the design and performance of the Robot Activity Support (RAS) system. It is important to understand points of agreement and divergence between these populations' perspectives so that effective robotic aids are created for older adults. Methods: Fifty-two younger and older adults completed three scripted tasks with the RAS system in a smart home environment. Each participant made task errors to cue the robot to offer help via three prompt modalities (guide to object, video of forgotten step, and video of a full task). After interacting with the RAS system, participants completed questionnaires to report opinions of and satisfaction with the robot. Results: There were minimal differences between younger and older adults' perceptions of the RAS system across multiple factors (e.g., likability, cognitive demand), with both groups expressing generally neutral opinions. Both groups rated the Full Video prompt as least helpful, effective, and liked. Participants recommended the robotic system's response accuracy, movement speed, alerting style and system flexibility be improved. Younger adults overestimated how much older adults would want a robot like this. Conclusions: This study underscores the importance of testing technology with target populations, as older adults were less interested in having RAS or a similar robot in their home than younger counterparts expected. Future work with robotic aids should focus first on older adults' requirements for an adoptable product, and then on optimal design to increase its usability.
Journal of Aging and Health
Objectives This study evaluated the efficacy of a multidomain brain health intervention on health... more Objectives This study evaluated the efficacy of a multidomain brain health intervention on health behavior change and sought to understand whether health literacy or brain health knowledge predicted engagement with the intervention. Methods One-hundred thirty midlife and older adults were assigned to one of three intervention conditions: brain fitness (B-Fit) utilizing education and goal setting, education-only, or waitlist. Questionnaires were completed at baseline and post-intervention. Results Both B-Fit and education-only conditions reported improvements in health behaviors over time. Although effect size for the education-only condition was moderate, only the B-Fit condition differed significantly in health behaviors from the waitlist post-intervention. Lower baseline brain health knowledge predicted improvements in health behaviors for education-only condition. Discussion The multidomain brain health intervention was successful in helping participants change their behaviors, b...
Journal of clinical and experimental neuropsychology, 2016
Everyday functioning and its executive functioning cognitive correlates (i.e., switching, inhibit... more Everyday functioning and its executive functioning cognitive correlates (i.e., switching, inhibition, and updating) were investigated in healthy older adults (HOAs) using multiple methods of functional status. In addition to whether computerized experimental tasks would better dissociate these subcomponents than neuropsychological measures of executive functioning, we were also interested in the contributions of both experimental and neuropsychological measures of executive function subcomponents to functional abilities. Seventy HOAs (45 young-old and 25 old-old) and 70 younger adults completed executive function and neuropsychological tests. In addition to self- and informant questionnaires of functional abilities, HOAs completed two performance-based measures. An aging effect was found on all executive function measures. Old-old older adults and their informants did not report more functional difficulties but demonstrated more difficulties on performance-based measures than did yo...
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Papers by Maureen Schmitter-Edgecombe