Search

Searching the internet for health-related information is a complex and dynamic goal-oriented process that ostensibly places demands on executive functions, which are higher-order cognitive abilities that can deteriorate with older age. This study examined the effects of older age on electronic health (eHealth) search behavior and the potential mediating influence of executive functions. Fifty younger adults (≤ 35 years) and 41 older adults (≥50 years) completed naturalistic eHealth search tasks involving fact-finding (Fact Search) and symptom determination (Symptom Search), a neurocognitive battery, and a series of self-report questionnaires. Multiple regression models controlling for potentially confounding psychiatric symptoms, health conditions, literacy, and demographic variables revealed that older adults were slower and less accurate than younger adults on the eHealth Fact Search task, but not on the eHealth Symptom Search task. Executive functions mediated the relationship between age and Fact and Symptom Search accuracy, independent of basic processing speed and attention. Parallel mediation models showed that episodic memory was not an independent mediator of age and search accuracy for either eHealth task once speed/attention and executive functions were included. Older adults can experience difficulty searching the internet for some health-related information, which is at least partly attributable to executive dysfunction. Future studies are needed to determine the benefits of training in the organizational and strategic aspects of internet search for older adults and whether these findings are applicable to clinical populations with executive dysfunction. [ABSTRACT FROM AUTHOR]

Introduction: The rapid development of coronavirus disease 2019 (COVID-19) into a pandemic required people to quickly acquire, evaluate, and apply novel complex health-related information about the virus and transmission risks. This study examined the potentially unique and synergistic roles of individual differences in neurocognition and health literacy in the early uptake and use of COVID-19 public health information. Method: Data were collected between April 23 and 21 May 2020, a period during which 42 out of 50 states were under a stay-at-home order. Participants were 217 healthy adults who completed a telephone-based battery that included standard tests of neurocognition, health literacy, verbal IQ, personality, and anxiety. Participants also completed measures of COVID-19 information-seeking skills, knowledge, prevention intentions, and prevention behaviors. Results: A series of hierarchical multiple regressions with data-driven covariates showed that neurocognition (viz, episodic verbal memory and executive functions) was independently related to COVID-19 knowledge (e.g. symptoms, risks) at a medium effect size, but not to information-seeking skills, prevention intentions, or prevention behaviors. Health literacy was independently related to all measured aspects of COVID-19 health information and did not interact with neurocognition in any COVID-19 health domain. Conclusions: Individual differences in neurocognition and health literacy played independent and meaningful roles in the initial acquisition of knowledge related to COVID-19, which is a novel human health condition. Future studies might examine whether neurocognitive supports (e.g. spaced retrieval practice, elaboration) can improve COVID-19-related knowledge and health behaviors in vulnerable populations. [ABSTRACT FROM AUTHOR]

Older adults with HIV-associated neurocognitive disorders (HAND) are at high risk for deficits in the resource-demanding, strategic aspects of prospective memory (PM) that can adversely affect health outcomes. This study examined the frequency and correlates of spontaneous compensatory strategy use during a laboratory-based PM task and its associations with the use of mnemonic strategies in daily life. Participants included 53 older adults with HAND, 89 older persons with HIV without HAND, and 62 seronegatives who completed the Cambridge Prospective Memory Test (CAMPROMPT), on which the type, frequency, and quality of their compensatory strategy use was quantified. Participants also completed self-report measures of PM symptoms and the frequency of mnemonic compensatory strategy use in daily life. There were no significant group-level effects on strategy use during the CAMPROMPT. Persons with HAND had moderately lower time-, but not event-based PM scores. Higher compensatory strategy use was strongly associated with better PM, particularly for time-based cues. Moreover, higher compensatory strategy use on the CAMPROMPT was associated with more frequent general mnemonic strategy use in daily life, and specifically with more frequent use of internal PM strategies (e.g., visualization) for medication adherence. Spontaneous compensatory mnemonic strategy use can support PM performance among older adults with HAND in the laboratory. Strategy use in the laboratory may be a marker for the extent to which older adults with HAND use other compensatory strategies to support memory in their daily life. Future studies may examine whether compensatory mnemonic strategies can be taught and used to support PM in the daily lives of older persons with HIV disease. [ABSTRACT FROM AUTHOR]

Introduction: There is debate about the optimal approach to diagnose neurocognitive impairment in people with HIV disease. The current "gold-standard" uses normative data to determine whether performance is below that of demographically comparable peers. This study investigated the utility of a discrepancy analysis approach, which compares normative neurocognitive performance directly to estimated premorbid intellectual functioning. Method: A total of 570 adults with and without HIV disease completed a comprehensive neurocognitive battery and the Wechsler Test of Adult Reading (WTAR), an oral word reading measure that was used to estimate premorbid verbal IQ. Normative scores for six neurocognitive domains were subtracted from the WTAR standardized score to calculate discrepancy scores where higher scores indicated greater discrepancies. Results: In models adjusting for relevant confounds, an interaction between HIV serostatus and domain discrepancy scores emerged such that persons with HIV had significantly higher discrepancy scores than seronegative participants, specifically in the domains of attention and episodic memory. Of clinical relevance, persons with HIV were two to three times more likely than their seronegative counterparts to have clinically discordant performance relative to premorbid verbal IQ in these domains. Additionally, the standard normative approach and discrepancy analysis method had fair to moderate agreement for classifying attention and episodic memory impairment in the participants with HIV disease. Conclusions: HIV disease is associated with discrepancies between premorbid IQ estimates and the domains of attention and memory, consideration of which may be a clinically useful complement to standard normative approaches to diagnosing HIV-associated neurocognitive disorders. [ABSTRACT FROM AUTHOR]