Trinidad Argüelles

Social marketing as a framework for recruitment: Illustrations from the REACH study

Objectives:Recruitment is often the most challenging aspect of research with older persons. Social marketing—applying marketing techniques to influence the behavior of target audiences to improve their welfare—can help researchers identify factors that influence recruitment. Methods:Illustrations of social marketing principles are provided from the Resources for Enhancing Alzheimer’s Caregiver Health project, a national Alzheimer’s caregivers study that targeted ethnic and racial minorities. Results:Social marketing principles—the six Ps of participants, product, price, place, promotion, and partners—provide a theoretical framework for organizing and planning recruitment activities, including developing varying strategies to define the target audience (participants), develop the intervention (product), manage time and trouble (price), target the audience, improve accessibility (place), promote the study, and develop and work with partners. Discussion:Strategies to enhance recruitment are often undertaken without a comprehensive plan. Asocial marketing plan provides a framework to map out the steps in recruitment that will be needed and to plan for allocations of time, staff, and resources.

Use of the Fuld Object-Memory Evaluation in the Detection of Mild Dementia Among Spanish and English-Speaking Groups

It is increasingly important that assessments for dementia do not introduce bias against different cultural/language groups. In this study the authors investigated the usefulness of the Fuld Object-Memory Evaluation (OME) as a culture-fair screen for dementia. Because the OME uses common and familiar household objects, the authors hypothesized that it would retain minimal cultural/language bias, an issue that has been addressed in few other investigations. Results indicate that the OME has a high degree of sensitivity, 95.9%, for mildly impaired Spanish-speaking patients and 95.5% for English-speaking patients diagnosed with mild Alzheimers disease. The specificity for Spanish-speaking and English-speaking control subjects was 100% and 96.7%, respectively. Sensitivities and specificities were reduced when only one trial of the OME was used. Sensitivity of the OME greatly exceeded that of the Folstein Mini-Mental State Exam in this mildly impaired dementia group. Therefore the OME may serve as a brief, reliable, culture-fair test when screening patients for possible dementia.

An Evaluation of The NINCDS-ADRDA Neuropsychological Criteria for the Assessment of Alzheimer’s Disease: A Confirmatory Factor Analysis Of Single Versus Multi-Factor Models

Neuropsychological test batteries are frequently used to assess the nature and severity of cognitive deficits among patients with early Alzheimers Disease (AD) and related disorders. The NINCDS-ADRDA criteria are among the most widely used guidelines to diagnose dementia (McKhann et al.,1984). These criteria specify eight distinct areas of neuropsychological function that should be evaluated in patients with suspected cognitive impairment. Recent studies have suggested that neuropsychological deficits observed in AD may be explained by a single general factor related to memory deficits or to executive dysfunction. In contrast, the results of other investigations have indicated that multiple qualitatively different factors underlie cognitive abilities in AD. In the present study, we used confirmatory factor analysis to examine the structure of cognitive abilities in AD and to assess the extent to which single and multiple ability factors accurately represent neuropsychological test data obtained from patients with AD. Results indicated that the NINCDS-ADRDA model fit the data better than a single factor model. However, a more parsimonious model specifying memory, verbal abilities, visuospatial skills, executive function, and higher as well as lower functional activities of daily living fit the data better than the NINCDS-ADRDA model. These results have important theoretical and practical implications for diagnostic evaluation.

The impact of the native language of Alzheimer's disease and normal elderly individuals on their ability to recall digits

Recent studies have indicated that Spanish-speaking Alzheimers disease (AD) patients perform more poorly than English-speaking patients on the Digit Span subtests of the Wechsler Adult Intelligence Scale - Revised (WAIS-R). In the current investigation, the performance of English-speaking and Spanish-speaking Alzheimers disease patients ( N = 119) and normal elderly controls ( N = 91) were compared with regards to their capacity to remember digit strings of different lengths. Subjects were administered the standard version of the Digit Span subtest of the WAIS-R as well as a modification of the test (chunking task) in which the numbers were presented in pairs (e.g. 27, 41, 46, 12, etc.). Results indicated that both English-speaking groups, AD patients as well as normal controls, had significantly higher scores on all aspects of the standard Digit Span tasks relative to their Spanish-speaking counterparts (forward, backward, and total scores). In contrast, English-speaking and Spanish-speaking AD groups did not differ with regards to their performance on the two digit chunking task forward score. Similar performance on all aspects of the chunking task was evidenced in the English-speaking and Spanish-speaking normal elderly control groups. These findings have important implications for the development of more culture and language appropriate cognitive test batteries for AD patients and the normal elderly.