|Behavioral Approaches to Evaluate and Address Memory Deficits in Older Adults
|Monday, May 30, 2016
|11:00 AM–11:50 AM
|Michigan ABC, Hyatt Regency, Bronze East
|Area: VRB; Domain: Translational
|Chair: Claudia Drossel (Eastern Michigan University)
|Discussant: Claudia Drossel (Eastern Michigan University)
|Abstract: The U.S. Census Bureau reports that between 2000 and 2010, the U.S. population segment aged 65 years and older have increased by 15.1%, notably larger than the 9.1% growth for the total U.S. population (Werner, 2011). The growth of the older adult population segment is projected to continue in the future, and at a substantially greater rate. It is also expected that the prevalence of Major Neurocognitive Disorder (NCD) will concomitantly increase alongside this graying of america. Language and memory difficulties are hallmark diagnostic markers for NCD. Both language and memory impairments can be conceptualized as stimulus control deficits. The two presentations describe methods to assess for and address stimulus control deficits in older adults. The first presentation evaluated methodologies for testing and training stimulus equivalence performance and compared this performance to participants' scores on various cognitive and functional impairment screening measures. Participants demonstrated higher levels of accurate responding on tests of direct and emergent relations when using a linear series training structure and non-arbitrary stimuli, however, lower levels of accurate responding were observed across methodologies in comparison to previous research. The Saint Louis University Mental Status Examination (SLUMS) was more sensitive to cognitive impairment than the Mini-Mental State Exam (MMSE). The second study used multiple probe tactics throughout spaced retrieval training to assess for tacting and delayed tacting of staff members in an assisted living facility. Results indicated that spaced retrieval alone did not produce improvements across all probe measures, and that modified procedures tailored to the observed deficits resulted in improved generalization. The results of these studies are discussed in the context of previous research on stimulus equivalence and spaced retrieval, and how the presence or absence of pre-requisite verbal skills can influence performance during these procedures.
|Keyword(s): Behavioral Gerontology, Spaced Retrieval, Stimulus Equivalence
|Evaluation of Equivalence Relations: Models of Assessment and Best Practice for Older Adults
|DAWN SEEFELDT (Southern Illinois University), Jonathan C. Baker (Western Michigan University)
|Abstract: Due to changing age demographics in the United States, by 2050, an estimated 62.1 Americans will be over the age of 65 and the number of Americans with cognitive impairment, such as Alzheimer’s disease, will increase drastically as well (Alzheimer’s Association, 2014; Ortman, Velkoff, & Hogan, 2014). Once a diagnosis or behavioral indicators of cognitive impairment are present, it would be beneficial to apply a treatment package that promotes the maintenance or re-establishment of stimulus control in the environment. From a behavioral perspective, stimulus control aids in learning and memory through both respondent and operant conditioning. In the current study, stimulus equivalence training was completed and compared to cognitive and functional assessments scores with older adult participants with and without cognitive impairment as a systematic replication of Gallagher and Keenan (2009). Formation of equivalence relations after exposure to linear series (LS) training with 2 3-member stimulus classes across arbitrary, familiar, and stimuli from Gallagher and Keenan (2009) was compared via trials to criterion, accuracy per relation, and session length to scores on the Mini-Mental Status Exam (MMSE), Saint Louis University State Exam (SLUMS), and Barthel ADL Index. A classification analysis was conducted between MMSE and SLUMS scores. Several methodological changes were applied to a second study to examine the impact of increased programmed stimuli, training changes, and the use of one-to-many (OTM) and many-to-one (MTO) training structures with 3 3-member stimulus classes on equivalence formation. Composite performance scores were created for accuracy during LS, OTM, and MTO training. Non-parametric analyses were conducted between assessment and composite scores. The SLUMS and Barthel ADL Index were not correlated with any composite scores. However, MMSE scores and LS composite scores were correlated. The SLUMS was more sensitive to the detection of cognitive impairment as judged by classification and diagnoses. OTM and MTO composite scores also had a strong, positive correlation. Overall, more participants demonstrated higher levels of accurate responding during LS training than during OTM and MTO training. In contrast to previous research, only 25% of the sample demonstrated equivalence formation. Limitations and future research directions are discussed.
Memory Deficits in Older Adults: Evaluating Spaced Retrieval With Multiple Probe Techniques
|CHRISTOPHER WALMSLEY (Western Michigan University), Richard Wayne Fuqua (Western Michigan University)
Difficulties in recognizing and remembering the names of individuals are a common behavioral symptom of major neurocognitive disorder. A number of behavioral strategies have been proposed to improve memory deficits, including spaced retrieval, an intervention that emphasizes delayed recall of target information. Unfortunately, many of the studies that report beneficial effects of spaced retrieval use a very limited range of outcome measures, thus calling into question the magnitude and generality of any reported memory improvement. This study reports on the impact of spaced retrieval using four older adults with cognitive impairment living in an assisted living facility. All participants demonstrated difficulty naming and recalling names of staff members at the facility who provided care. A multiple baseline across participants design with embedded probes was used to evaluate the effects of spaced retrieval on the acquisition, delayed recall, and generalization of naming a target staff member. Probe measures included a non-identity matching-to-sample task, naming in the presence of untrained photographs of the target staff member, and naming during brief video presentations of the target staff member. Non-example presentations were also interspersed. Spaced retrieval resulted in within-session increases in delayed recall for all participants, and also resulted in minimal evidence of generalization across probe measures, including live-person probes. Modified spaced retrieval interventions were then employed to address stimulus control deficits. These modified conditions resulted in further gains in delayed recall performance, as well as improved generalization across probes. These results are discussed in the context of previous research with spaced retrieval. Future directions are also discussed.