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.
Examining the role of culture and cultural perceptions of aging and dementia in the recognition, diagnosis, and treatment of age-related cognitive impairment remains an understudied area of clinical neuropsychology. This paper describes a qualitative study based on a series of key informant group interviews with an Aboriginal Grandmothers Group in the province of Saskatchewan. Thematic analysis was employed in an exploration of Aboriginal perceptions of normal aging and dementia and an investigation of issues related to the development of culturally appropriate assessment techniques. Three related themes were identified that highlighted Aboriginal experiences of aging, caregiving, and dementia within the healthcare system: (1) cognitive and behavioural changes were perceived as a normal expectation of the aging process and a circular conception of the lifespan was identified, with aging seen as going back "back to the baby stage", (2) a "big change in culture" was linked by Grandmothers to Aboriginal health, illness (including dementia), and changes in the normal aging process, and (3) the importance of culturally grounded healthcare both related to review of assessment tools, but also within the context of a more general discussion of experiences with the healthcare system. Themes of sociocultural changes leading to lifestyle changes and disruption of the family unit and community caregiving practices, and viewing memory loss and behavioural changes as a normal part of the aging process were consistent with previous work with ethnic minorities. This research points to the need to understand Aboriginal perceptions of aging and dementia in informing appropriate assessment and treatment of age-related cognitive impairment and dementia in Aboriginal seniors.
In Canada, interprofessional education (IPE) and interdisciplinary health research initiatives are beginning to transform the academic health sciences, including graduate training programs for clinical psychologists. In response to mandates and directives from national health policy and research funding bodies, academic training programs are re-structuring course offerings, practicum training experiences, and research activities to better prepare students for their future roles within interdisciplinary research groups and collaborative patient-centred clinical teams. As an example of this transformative movement in IPE, described herein are the recent training initiatives in the Graduate Program in Clinical Psychology at the University of Saskatchewan, and the role of clinical neuropsychology in an innovative interprofessional rural and remote memory clinic.
Clustering and switching strategies during phonemic and semantic verbal fluency tasks were investigated in healthy adults (n = 193, 86 males, 20-90 years) in young, middle-aged, young-old, and old-old age groups (Study 1). Older groups produced fewer total words and lower switching scores; males relied more on clustering and females on switching to produce equivalent output. In Study 2, early Alzheimer's disease participants, compared to healthy older adults, (n = 26 per group) produced fewer total words and smaller average clusters. Sex, age, and clinical differences on switching and clustering strategies support a dual processing model of verbal fluency.
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