Is Medical Environment Detrimental to Memory? A Test of A White Coat Effect on Older People’s Memory Performance

Schlemmer, Morgane; Desrichard, Olivier

doi:10.1080/07317115.2017.1307891

Cited by 22 publications

(17 citation statements)

References 10 publications

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“…These recommendations may help medical staff to deliver more accurate and potentially less threatening information to the patients and/or their family (thereby significantly improving their well-being and quality of life). It should be noted, however, that these recommendations may need to be adapted to consider other types of threat that could be simultaneously triggered by the clinical context (e.g., the specific threat of AD as a dramatic disease 29 , the threat of being at hospital 30 , and the threat of the white coat 31 ).…”

Section: Discussionmentioning

confidence: 99%

Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing

Mazerolle

Régner

Rigalleau

et al. 2020

JoVE

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As life expectancy increases, aging has become a major health challenge, resulting in a huge effort to better discriminate between normal and pathological cognitive decline. It is thus essential that cognitive tests and their administration are as fair as possible. However, an important source of bias during cognitive testing comes from negative aging stereotypes that can impair the memory performance of older adults and inflate age differences on cognitive tasks. The fear of confirming negative aging stereotypes creates an extra pressure among older adults which interferes with their intellectual functioning and leads them to perform below their true abilities. Here, we present a protocol that highlights simple but efficient interventions to alleviate this age-based stereotype threat effect. The first study showed that simply informing older participants about the presence of younger participants (threat condition) led older adults to underperform on a standardized memory test compared with younger participants, and that this performance difference was eliminated when the test was presented as age-fair (reduced-threat condition). The second study replicated these findings on short cognitive tests used to screen for predementia in clinical settings and showed that teaching older adults about stereotype threat inoculated them against its effects. These results provide useful recommendations about how to improve older adults' memory assessment both in Iab studies and in clinical settings.

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Section: Discussionmentioning

confidence: 99%

Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing

Mazerolle

Régner

Rigalleau

et al. 2020

JoVE

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“…While clinically valid, modern cognitive assessment is limited by the mode of administration, which is often a pen, paper, and stopwatch [5]. Such modes of administration require the continuous attention of a trained administrator, limiting the type and amount of data points captured, and making measurements vulnerable to administrator bias and white-coat effect [6, 7]. The consequent lack of accurate high-resolution data can make it difficult to make informed inferences of neuropsychological processes [5].…”

Section: Introductionmentioning

confidence: 99%

Detecting Mild Cognitive Impairment via Digital Biomarkers of Cognitive Performance Found in Klondike Solitaire: A Machine-Learning Study

Gielis¹,

Abeele²,

Verbert³

et al. 2021

Digit Biomark

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Background: Mild cognitive impairment (MCI) is a condition that entails a slight yet noticeable decline in cognition that exceeds normal age-related changes. Older adults living with MCI have a higher chance of progressing to dementia, which warrants regular cognitive follow-up at memory clinics. However, due to time and resource constraints, this follow-up is conducted at separate moments in time with large intervals in between. Casual games, embedded into the daily life of older adults, may prove to be a less resource-intensive medium that yields continuous and rich data on a patient’s cognition. Objective: To explore whether digital biomarkers of cognitive performance, found in the casual card game Klondike Solitaire, can be used to train machine-learning models to discern games played by older adults living with MCI from their healthy counterparts. Methods: Digital biomarkers of cognitive performance were captured from 23 healthy older adults and 23 older adults living with MCI, each playing 3 games of Solitaire with 3 different deck shuffles. These 3 deck shuffles were identical for each participant. Using a supervised stratified, 5-fold, cross-validated, machine-learning procedure, 19 different models were trained and optimized for F1 score. Results: The 3 best performing models, an Extra Trees model, a Gradient Boosting model, and a Nu-Support Vector Model, had a cross-validated F1 training score on the validation set of ≥0.792. The F1 score and AUC of the test set were, respectively, >0.811 and >0.877 for each of these models. These results indicate psychometric properties comparative to common cognitive screening tests. Conclusion: The results suggest that commercial card games, not developed to address specific mental processes, may be used for measuring cognition. The digital biomarkers derived from Klondike Solitaire show promise and may prove useful to fill the current blind spot between consultations.

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“…Some supporting research shows older adults might better remember characteristics about people than lists of words (Sindi et al, 2013), information of high, versus low, social importance (Hargis and Castel, 2017) or positive, rather than negative, information (Mather and Carstensen, 2005). Older adults may also underperform on memory tests compared to their true competence level when tested in unfamiliar research laboratory and medical clinic settings, compared to familiar settings, such as community centers (Hehman and Bugental, 2013;Sindi et al, 2013;Eich et al, 2014;Schlemmer and Desrichard, 2018). Ironically, pervasive negative stereotypes about memory and aging themselves might be one factor that disrupts older adults' memory performance, functioning like a science fiction "causal loop temporal paradox": Negative age and memory stereotypes, self-held or assumed to be held by others, might worsen memory performance, reinforcing the validity of the stereotypes.…”

Section: Introductionmentioning

confidence: 99%

“…Stereotype effects may also be moderated by pre-existing individual beliefs about memory and age. Evidence suggests memory self-efficacy and one's evaluation of their memory at baseline may moderate stereotype effects, and that individuals with low memory self-efficacy and higher dementia worry are the ones most susceptible to stereotype effects in clinical settings (Desrichard and Köpetz, 2005;Fresson et al, 2017;Schlemmer and Desrichard, 2018; but see Chasteen et al, 2005). Stereotype effects may also be moderated by memory achievement, or the value and importance a person places on their memory.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Naturalistic Age Stereotype Activation

Strickland-Hughes

West

2021

Front. Psychol.

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Almost self-fulfilling, commonly held negative stereotypes about old age and memory can impair older adults’ episodic memory performance, due to age-based stereotype threat or self-stereotyping effects. Research studies demonstrating detrimental impacts of age stereotypes on memory performance are generally conducted in research laboratories or medical settings, which often underestimate memory abilities of older adults. To better understand the “real world” impact of negative age and memory stereotypes on episodic memory, the present research tested story recall performance of late middle-aged and older adults (N = 51) following a naturalistic age stereotype manipulation, wherein every day, newspaper-style materials (comics and puzzles) were either embedded with negative age and memory stereotype stimuli (stereotype group) or neutral stimuli (control group). Furthermore, all participants were tested in favorable, familiar environments. Potential moderators of the stereotype effects, e.g., metamemory beliefs, were assessed at baseline. Current memory evaluation and subjective age, as well as perceived stereotype threat and task-related anxiety, were assessed following the stereotype manipulation as potential mechanisms of the expected stereotype effects. Results suggested a contrast effect, as the stereotype group demonstrated superior story recall performance compared to the control group. Marginally significant moderation effects by age and perceived stereotype threat indicated that stereotype rejection was present for late middle-aged adults but not older adults, indicative of stereotype lift, and for individuals who reported low and average, but not high, levels of perceived stereotype threat. Additionally, a trend suggested more positive memory evaluation for those in the stereotype group who reported awareness of the stereotype stimuli than those who did not notice the stimuli. These results are consistent with other research demonstrating benefits to memory performance in adulthood based on motivational and contextual factors, such as using relevant memory materials and testing in favorable conditions. Moreover, the results of this study contribute to our understanding of individuals’ responses to different types of stereotype stimuli, and the differential impact of stereotype manipulations that are subtle versus blatant. Individuals were motivated to counteract negative stereotype effects when conditions were supportive, stereotype presentations were naturalistic, and personal beliefs were positive.

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Is Medical Environment Detrimental to Memory? A Test of A White Coat Effect on Older People’s Memory Performance

Cited by 22 publications

References 10 publications

Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing

Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing

Detecting Mild Cognitive Impairment via Digital Biomarkers of Cognitive Performance Found in Klondike Solitaire: A Machine-Learning Study

The Impact of Naturalistic Age Stereotype Activation

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