Measures of letter (FAS) and category (Animal Naming) fluency were completed by community-dwelling, cognitively normal seniors (n = 635), and by individuals diagnosed with dementia of the Alzheimer type (DAT) (n = 155), or with vascular dementia (n = 39). Among normal seniors, category, but not letter fluency, declined with age, females performed better than males on letter but not on category fluency, and performance increased with education on both tasks. Among participants with DAT, letter fluency was influenced by level of education, whereas category fluency was education-, age-, and gender-invariant. Both measures differentiated normal seniors from those with dementia. Category fluency was more impaired than letter fluency at both mild and moderate stages of dementia, but neither task differentiated DAT from vascular dementia.

Atypical and early-onset dementias can be particularly problematic for family caregivers, and support groups aimed at memory loss and Alzheimer's disease are not always helpful. Unfortunately, little has been developed specifically for caregivers of individuals with atypical dementias such as the frontotemporal dementias. Compounding the lack of access to interventions targeted specifically at caregivers of individuals with atypical and early-onset dementias are the unique needs of rural caregivers. Due to the relative infrequency of these particular dementias and the large geographical distances between rural caregivers, technology-facilitation is required for any group-based intervention. This paper describes the development of a secure telehealth videoconferenced support group for rural spouses of individuals with atypical and early-onset dementias. In addition, we provide preliminary evidence of effectiveness and describe a template for future groups based on the key therapeutic aspects of this novel technology-facilitated intervention.

The availability, accessibility, and acceptability of services are critical factors in rural health service delivery. In Canada, the aging population and the consequent increase in prevalence of

Past research has been inconsistent with regard to the effects of normal aging and sex on strategy use during verbal fluency performance. In the present study, both Troyer et al.'s (1997) and Abwender et al.'s (2001) scoring methods were used to measure switching and clustering strategies in 60 young and 72 older adults, equated on verbal ability. Young adults produced more words overall and switched more often during both phonemic and semantic fluency tasks, but performed similarly to older adults on measures of clustering. Although there were no sex differences in total words produced on either fluency task, males produced larger clusters on both tasks, and females switched more frequently than males on the semantic but not on the phonemic fluency task. Although clustering strategies appear to be relatively age-insensitive, age-related changes in switching strategies resulted in fewer overall words produced by older adults. This study provides evidence of age and sex differences in strategy use during verbal fluency tests, and illustrates the utility of combining Troyer's and Abwender's scoring procedures with in-depth categorization of clustering to understand interactions between age and sex during semantic fluency tasks.

Using data from a sample of 169 patients, this study evaluates the acceptability and feasibility of telehealth videoconferencing for preclinic assessment and follow-up in an interprofessional memory clinic for rural and remote seniors. Patients and caregivers are seen via telehealth prior to the in-person clinic, and followed at 6 weeks, 12 weeks, 6 months, one year, and yearly. Patients are randomly assigned to in-person (standard care) or telehealth for the first follow-up, then alternating between the two modes of treatment, prior to 1-year follow-up. On average, telehealth appointments reduce participants' travel by 426 km per round trip. Findings show that telehealth coordinators rated 85% of patients and 92% of caregiversas comfortable or very comfortable during telehealth. Satisfaction scales completed by patient-caregiver dyads show high satisfaction with telehealth. Follow-up questionnaires reveal similar satisfaction with telehealth and in-person appointments, but telehealth is rated as significantly more convenient. Predictors of discontinuing follow-up are greater distance to telehealth, old-age patient, lower telehealth satisfaction, and lower caregiver burden.

A concurrent-task paradigm was used to investigate age-related differences in the attentional capacity of 92 right-handed adults. Young, middle-aged, and elderly Ss were compared as they performed speeded, unimanual finger tapping with and without concurrent silent reading, speaking, and maze completion. There were 2 levels of difficulty for each cognitive task. The decrement in tapping rate from the single- to dual-task condition increased linearly with age. Concurrent-task tapping was slowed more by difficult than by easy tasks, and difficult tasks had a disproportionately disruptive effect on the concurrent performance of elderly Ss. The heightened vulnerability of the elderly to concurrent-task effects cannot be attributed parsimoniously to either general slowing or diminution of a specific resource. Instead the results suggest a reduction in a general-purpose processing resource with increasing age.

Clustering and switching strategies during phonemic and semantic verbal fluency tasks as defined by Troyer et al. (1997), Abwender et al. (2001), and Lanting et al. (2009) were compared using archival data to determine which scoring procedures best differentiate healthy older adults (n = 26) from individuals with early-stage Alzheimer's disease (AD, n = 26). Total word production showed the largest group difference, especially for semantic fluency. The AD group produced fewer switches when compared to the healthy control group, whereas the groups did not differ in cluster size. The AD group also accessed fewer novel semantic subcategories, presumably due to reduced access to semantic memory storage rather than lower processing speed. Clustering and switching scores on the phonemic task did not add information above total words produced, consistent with previous research indicating these variables are most informative in relation to semantic fluency.

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