Memory and comprehension for health information among older adults: Distinguishing the effects of domain-general and domain-specific knowledge

Abstract

While there is evidence that knowledge influences understanding of health information, less is known about the processing mechanisms underlying this effect and its impact on memory. We used the moving window paradigm to examine how older adults varying in domain-general crystallized ability (verbal ability) and health knowledge allocate attention to understand health and domain-general texts. Participants (n=107, aged 60 to 88 yrs) read and recalled single sentences about hypertension and about non-health topics. Mixed-effects modeling of word-by-word reading times suggested that domain-general crystallized ability increased conceptual integration regardless of text domain, while health knowledge selectively increased resource allocation to conceptual integration at clause boundaries in health texts. These patterns of attentional allocation were related to subsequent recall performance. Although older adults with lower levels of crystallized ability were less likely to engage in integrative processing, when they did, this strategy had a compensatory effect in improving recall. These findings suggest that semantic integration during reading is an important comprehension process that supports the construction of the memory representation and is engendered by knowledge. Implications of the findings for theories of text processing and memory as well as for designing patient education materials are discussed.

The Effects of Home-Based Cognitive Training on Verbal Working Memory and Language Comprehension in Older Adulthood

“…This is not only of theoretical import in defining the cognitive architecture of language processing across the lifespan (e.g., Just and Carpenter, 1992 ; Stine-Morrow and Payne, 2016 ), but also suggests applications for improving cognitive functioning among older adults in significant ways ( Stine-Morrow and Basak, 2011 ). Because age-related declines in language comprehension and memory can have far-reaching effects as adults navigate the ordinary demands of work, family, and health (e.g., Morrow et al, 2006 ; Chin et al, 2015 ), the development of pathways to mitigate such deficits offers promise for promoting late-life well-being.…”

Cognition and Health Literacy in Older Adults’ Recall of Self-Care Information

“…General knowledge (i.e., linguistic/verbal knowledge, or crystallized ability) and domain-specific knowledge, on the other hand, often support comprehension processes. More knowledgeable readers recognize words more quickly and are better able to integrate the associated concepts into the textbase (Chin et al, 2015;Payne, Gao, Noh, Anderson, & Stine-Morrow, 2012). Although processing capacity declines with age, knowledge tends to increase or remain invariant (Horn & Cattell, 1967;Li et al, 2004), depending on literacy (Stanovich, West, & Harrison, 1995) and domain-specific (Beier & Ackerman, 2005;Chin et al, 2009) experience.…”

“…The P-K model also focuses on the potential of knowledge to offset age-related processing capacity limits in order to support health literacy, decisions, and behaviors. Knowledge improves performance on the REALM and STOFHLA tests (Chin et al, 2011) as well as comprehension of health information (Chin et al, 2015;Miller, Stine-Morrow, Kirkorian, & Conroy, 2004). Wolf and colleagues (2012) found that measures of general knowledge, as measured by vocabulary, partially contributed to the impact of health literacy on understanding and remembering health information.…”

Anticipating ageing: Older adults reading their medical records

“…To be able to act as an active agent in healthcare, people also need to be able to understand and act on health information (see e.g. Chin et al, 2015). Those who have higher levels of both health literacy (HL), that is, the ability to obtain, understand, and use health information (e.g.…”

“…Inadequate health literacy and health information literacy can therefore be barriers to engagement (see e.g. Chin et al, 2015).…”