Barbara J. Cherry

Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: results of the Well Elderly 2 Randomised Controlled Trial

Background Older people are at risk for health decline and loss of independence. Lifestyle interventions offer potential for reducing such negative outcomes. The aim of this study was to determine the effectiveness and cost-effectiveness of a preventive lifestyle-based occupational therapy intervention, administered in a variety of community-based sites, in improving mental and physical well-being and cognitive functioning in ethnically diverse older people. Methods A randomised controlled trial was conducted comparing an occupational therapy intervention and a no-treatment control condition over a 6-month experimental phase. Participants included 460 men and women aged 60–95 years (mean age 74.9±7.7 years; 53% <

Fluctuations of perceptual asymmetry across time in women and men: Effects related to the menstrual cycle

12 000 annual income) recruited from 21 sites in the greater Los Angeles metropolitan area. Results Intervention participants, relative to untreated controls, showed more favourable change scores on indices of bodily pain, vitality, social functioning, mental health, composite mental functioning, life satisfaction and depressive symptomatology (ps<0.05). The intervention group had a significantly greater increment in quality-adjusted life years (p<0.02), which was achieved cost-effectively (US

Confronting challenges in intervention research with ethnically diverse older adults: the USC Well Elderly II Trial

41 218/UK £24 868 per unit). No intervention effect was found for cognitive functioning outcome measures. Conclusions A lifestyle-oriented occupational therapy intervention has beneficial effects for ethnically diverse older people recruited from a wide array of community settings. Because the intervention is cost-effective and is applicable on a wide-scale basis, it has the potential to help reduce health decline and promote well-being in older people. Trial Registration clinicaltrials.gov identifier: NCT0078634.

Age differences and similarities in patterns of cerebral hemispheric asymmetry

Women and men performed the same tachistoscopic chair identification task and free-vision face processing task during each of three test sessions. For women, the first and third sessions were performed during two successive periods of menstruation and the second session was performed during the intervening midluteal phase of the menstrual cycle. For men, the three test sessions were presented at 2-week intervals. For the chair identification task, there was no visual field (hemispheric) asymmetry for men during any of the three test sessions. For women, there was a right visual field (left-hemisphere) advantage during the second (midluteal) test session, but not during the first and third (menstrual) sessions. For the free-vision face processing task, there was a robust left-side (right-hemisphere) bias during all test sessions for both women and men and no effect of test session for either gender. Results for the nonlateralized chair identification task are consistent with the hypothesis that, in women, the left hemisphere is more activated during the midluteal phase of the menstrual cycle relative to the menstrual phase. Results for the lateralized face processing task suggest that hemispheric dominance for specific aspects of information processing are less likely to show such phase-related effects.

Lateralized cognitive dysfunction and psychotic symptoms in schizophrenia.

Background Community-dwelling older adults are at risk for declines in physical health, cognition, and psychosocial well-being. However, their enactment of active and health-promoting lifestyles can reduce such declines. Purpose The purpose of this article is to describe the USC Well Elderly II study, a randomized clinical trial designed to test the effectiveness of a healthy lifestyle program for elders, and document how various methodological challenges were addressed during the course of the trial. Methods In the study, 460 ethnically diverse elders recruited from a variety of sites in the urban Los Angeles area were enrolled in a randomized experiment involving a crossover design component. Within either the first or second 6-month phase of their study involvement, each elder received a lifestyle intervention designed to improve a variety of aging outcomes. At 4—5 time points over an 18—24 month interval, the research participants were assessed on measures of healthy activity, coping, social support, perceived control, stress-related biomarkers, perceived physical health, psychosocial well-being, and cognitive functioning to test the effectiveness of the intervention and document the process mechanisms responsible for its effects. Results The study protocol was successfully implemented, including the enrollment of study sites, the recruitment of 460 older adults, administration of the intervention, adherence to the plan for assessment, and establishment of a large computerized data base. Limitations: Methodological challenges were encountered in the areas of site recruitment, participant recruitment, testing, and intervention delivery. Conclusions The completion of clinical trials involving elders from numerous local sites requires careful oversight and anticipation of threats to the study design that stem from: (a) social situations that are particular to specific study sites; and (b) physical, functional, and social challenges pertaining to the elder population. Clinical Trials 2009; 6: 90—101. http://ctj.sagepub.com

Cognitive Dysfunctions Associated With PTSD : Evidence from World War II Prisoners of War

Younger (M age = 20.4 years) and older (M age = 70.7 years) adults participated in 3 visual half-field experiments. These were designed to examine specific aspects of hemispheric asymmetry: (a) hemispheric dominance for phonetic-linguistic processing (as measured by identification of non-word trigrams), (b) hemispheric differences in trigram processing strategy, (c) characteristic perceptual biases thought to reflect hemispheric arousal asymmetries, and (d) hemispheric dominance for processing emotions shown on faces. Patterns of left-right asymmetries were comparable for older and younger participants, and intercorrelations among the various measures of asymmetry were similar for both groups. In view of the present results, it seems unlikely that changes in hemispheric asymmetry contribute significantly to age-related changes in cognitive functioning.

Aging and Individual Variation in Interhemispheric Collaboration and Hemispheric Asymmetry

Our understanding of hemispheric asymmetries in schizophrenia can be attributed to extensive neuropsychological and neuroimaging research on this topic; however, it has yet to be determined whether lateralized cognitive dysfunction represents a single core trait in schizophrenia or whether the lateralized impairments are domain specific. To test whether lateralized deficits are core features in schizophrenia we examined performance across a wide range of lateralized cognitive domains including attention, fluency, recognition memory, perception, and arousal. We also examined the relationship between lateralized impairments and psychotic and affective symptoms to determine whether abnormal hemispheric asymmetries were possibly state-related. The sample consisted of 43 subjects with schizophrenia and 66 normal healthy comparison subjects without psychiatric illness. Schizophrenia subjects exhibited abnormal right hemisphere performance on a test of recognition memory and abnormal left hemisphere performance on a measure of arousal. These findings suggest that lateralized cognitive disturbances in schizophrenia do not represent a single core lateralized deficit. Regarding the symptom analyses, severity of positive symptoms was related to right hemisphere cognitive impairment (including fluency and recognition memory), whereas severity of negative symptoms was related to left hemisphere cognitive impairment (including fluency). Overall, our findings suggest that lateralized dysfunction can occur in both hemispheres in schizophrenia, and that the positive psychotic symptoms may relate more to right hemisphere impairment, whereas negative psychotic symptoms may related more to left hemisphere impairment.

Positive associations between physical and cognitive performance measures in fibromyalgia.

The authors aim to delineate cognitive dysfunction associated with posttraumatic stress disorder (PTSD) by evaluating a well-defined cohort of former World War II prisoners of war (POWs) with documented trauma and minimal comorbidities. The authors studied a cross-sectional assessment of neuropsychological performance in former POWs with PTSD, PTSD with other psychiatric comorbidities, and those with no PTSD or psychiatric diagnoses. Participants who developed PTSD had average IQ, while those who did not develop PTSD after similar traumatic experiences had higher IQs than average (approximately 116). Those with PTSD performed significantly less well in tests of selective frontal lobe functions and psychomotor speed. In addition, PTSD patients with co-occurring psychiatric conditions experienced impairment in recognition memory for faces. Higher IQ appears to protect individuals who undergo a traumatic experience from developing long-term PTSD, while cognitive dysfunctions appear to develop with or subsequent to PTSD. These distinctions were supported by the negative and positive correlations of these cognitive dysfunctions with quantitative markers of trauma, respectively. There is a suggestion that some cognitive decrements occur in PTSD patients only when they have comorbid psychiatric diagnoses.

The Semantic Object Retrieval Test (SORT) in amnestic mild cognitive impairment.

ABSTRACT Thirty younger (Mean Age = 19.9 years) and 20 older adults (Mean Age = 74.7 years) performed Physical and Name Identity letter-matching tasks (matches were either within or between hemispheres) to study age-related changes in 1) the efficiency with which the two hemispheres interact with each other and 2) hemispheric asymmetry. In order to determine whether age-related effects were associated with differences in cognitive resources, the same individuals completed a set of memory span tasks. Performance on the letter-matching tasks indicated that the costs of interhemispheric collaboration were greater for older than for younger participants. However, within the older group, the advantage of spreading processing across both hemispheres increased as memory span decreased, suggesting that older individuals who are challenged by cognitive complexity are more likely to show increased benefits from between-hemisphere processing than individuals who are not so challenged. There was also an overall left visual field/right hemisphere advantage for the younger but not for the older group, suggesting greater age-related declines in right- than left-hemisphere function.

Cognitive Performance in Women Aged 50 Years and Older With and Without Fibromyalgia

OBJECTIVE To investigate the associations between perceived physical function (self-report) and physical and cognitive performance (objective assessments) in persons with fibromyalgia (FM). DESIGN Correlational study. SETTING Exercise testing laboratory in Southern California. PARTICIPANTS Community-residing ambulatory adults meeting the American College of Rheumatology 1990 criteria for FM (N=68; mean age, 59.5y). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Composite Physical Function scale, Senior Fitness Test (3 items), Fullerton Advanced Balance scale, 30-foot walk, Trail Making Test parts A and B, Digit Symbol Substitution Test, a composite score of these 3 cognitive measures, attention/executive function composite, processing speed composite, problem solving, inhibition, and episodic memory composite. RESULTS Hierarchical regression analyses showed that after controlling for age and FM symptoms, better physical performance (based on assessments, not self-report) was associated with higher cognitive function in attention/executive function, processing speed, problem solving, and inhibition. CONCLUSIONS Researchers should continue to investigate the relationship between physical and cognitive function in both clinical and nonclinical populations, as well as explore changes across time. Because physical activity has been associated with neural improvements, further research may identify whether particular mechanisms, such as neurogenesis, synaptogenesis, or changes in inflammatory marker levels, are involved.