Maureen Schmitter-Edgecombe

OBJECTIVE: Compensatory strategies can be used to help mid-life and older adults successfully manage instrumental activities of daily living that rely upon prospective memory. This study compared the quality of digital and non-digital compensatory strategies in supporting accurate completion of naturalistic, real-world prospective memory tasks. METHOD: Participants included 70 community-dwelling mid-life and older adults. In this cross-sectional study, participants were tested remotely via Zoom in their homes...

Health literacy tends to decrease with age, and lower health literacy has been associated with lower levels of physical function, mental health, and medication adherence. The present study examined health literacy in relation to cognition in a sample of community-dwelling older adults. The study also examined the impact of health literacy on engagement in healthy aging lifestyle behaviors. Participants included 128 older adults (age: M  = 72.07, SD  = 6.71; education: M  = 16...

OBJECTIVE: Extraction of digital markers from passive sensors placed in homes is a promising method for understanding real-world behaviors. In this study, machine learning (ML) and multilevel modeling (MLM) are used to examine types of digital markers and whether smart home sensors can predict cognitive functioning, lifestyle behaviors, and contextual factors measured through ecological momentary assessment (EMA). METHOD: Smart home sensors were installed in the homes of 44 community-dwelling midlife and older adults for 3-4 months...

Objective: Multitasking is an essential part of everyday functioning often not formally assessed by traditional neuropsychological tests. Although individuals with Parkinson's disease (PD) experience both motor and cognitive difficulties, previous research has demonstrated more pronounced functional difficulties with the presence of mild cognitive impairment (PD-MCI). The current study compared individuals with PD-MCI, PD with normal cognition (PD-NC), and healthy controls on a naturalistic task of multitasking, the Day Out Task (DOT)...

OBJECTIVE: Prospective memory (PM), which involves remembering to execute a future action, is impacted by Alzheimer's disease. This study examined the role of PM in instrumental activities of daily living (IADLs) and the use of compensatory aids in mild cognitive impairment (MCI) and healthy aging. METHODS: Participants included 44 healthy older controls and 49 persons with MCI. Simple PM was measured by asking participants to remember to execute a single action- to request a pill after completing each of a series of neuropsychological tests...

BACKGROUND: Functional impairments are a necessary requirement for the diagnosis of a dementia along with observed cognitive impairment. Comparatively, functional abilities are often relatively intact in those with mild cognitive impairment (MCI). OBJECTIVE: The current research examined the associations between memory clinic participants classified as cognitively intact, amnestic MCI, and mixed/dysexecutive MCI, using Jak-Bondi criteria, and Instrumental Activities of Daily Living - Compensation Scale (IADL-C) abilities, an informant-based questionnaire that quantifies functional abilities...

OBJECTIVE: Traditional measures of cognitive abilities most used by neuropsychologists are generally low in ecological validity and only capture a small proportion of the variance of a person's true functional capacity. This study evaluates the association between clinic-based performance and parallel real-world completion of an everyday planning test, the Overnight Trip Task (OTT). METHOD: A cross-sectional cohort of 65 community-dwelling older adults completed a battery of cognitive assessments and two formats of the OTT: the paper-and-pencil clinic OTT, which was completed remotely through video conferencing (Zoom), and the parallel real-world OTT (RW-OTT), which was completed at home between sessions...

Objective: Older adults often spontaneously engage in compensatory strategies (CS) to support everyday task completion, but factors that influence success of chosen CS remain unclear. This study examines whether real-world prospective memory (PM) task completion is better predicted by CS count or a CS quality rating. Method: Seventy mid-life and older adult participants were presented four novel, real-world PM tasks via remote assessment and encouraged to use their typical CS. The examiner captured detailed information about planned CS at task presentation (T1) and utilized CS at follow-up testing (T2)...

OBJECTIVE: Electronic memory aids are being researched and developed widely to assist the everyday functioning of individuals experiencing cognitive decline. Although development studies show promise in the initial use of electronic memory aids, little is known about the factors that influence adoption of these aids after training ends. METHOD: We analyzed the baseline characteristics (e.g., demographics, cognitive performance) and training usage (e.g., frequency and pattern of use) of 32 older adults experiencing amnestic mild cognitive impairment who participated in a pilot clinical trial with an electronic memory and management aid (EMMA) tablet application...

OBJECTIVE: Accurate error monitoring is important for successful completion of everyday tasks and compensatory strategy use. This study examined how error awareness is impacted in amnestic mild cognitive impairment (aMCI) compared to cognitively healthy older adults (HOA). Cognitive correlates of error monitoring and relation to objective and self-reported measurement of everyday function were also evaluated. METHOD: Twenty-four individuals with aMCI and 24 cognitively HOAs completed standardized cognitive measures (domains: attention, working memory, executive functioning, memory, language, visuospatial abilities); a computerized go-no-go paradigm task that evaluated error monitoring; a naturalistic, performance-based measure of everyday functioning (day-out-task; DOT); and self- and informant-report measures of everyday dysexecutive difficulties (DEX)...

BACKGROUND: American Indians have high prevalence of risk factors for Alzheimer's disease and related dementias (ADRD) compared to the general population, yet dementia onset and frequency in this population are understudied. Intraindividual cognitive variability (IICV), a measure of variability in neuropsychological test performance within a person at a single timepoint, may be a novel, noninvasive biomarker of neurodegeneration and early dementia. OBJECTIVE: To characterize the cross-sectional associations between IICV and hippocampal, total brain volume, and white matter disease measured by magnetic resonance imaging (MRI) among older American Indians...

INTRODUCTION: Although executive functioning (EF) correlates with execution of instrumental activities of daily living (IADLs), tests of EF have been criticized for having poor ecological validity. Attempts have been made to develop new tests that approximate naturalistic daily tasks. However, the incremental utility of such tests has not been convincingly demonstrated. The Night Out Task (NOT) is a novel measure designed to increase ecological validity. This study examined whether the NOT correlates with traditional lab- and home-based measures of EF and IADLs, and whether it outperforms traditional measures of EF in predicting IADLs...

New modes of technology are offering unprecedented opportunities to unobtrusively collect data about people's behavior. While there are many use cases for such information, we explore its utility for predicting multiple clinical assessment scores. Because clinical assessments are typically used as screening tools for impairment and disease, such as mild cognitive impairment (MCI), automatically mapping behavioral data to assessment scores can help detect changes in health and behavior across time. In this paper, we aim to extract behavior markers from two modalities, a smart home environment and a custom digital memory notebook app, for mapping to ten clinical assessments that are relevant for monitoring MCI onset and changes in cognitive health...

As part of the special issue on mentoring in neuropsychology in collaboration between the Journal of Clinical and Experimental Neuropsychology (JCEN) and American Psychological Association (APA) Society for Clinical Neuropsychology (SCN; Division 40)'s Women in Neuropsychology Committee (WIN), we are excited to present a compilation of sage advice in regards to best practices in mentoring from a diverse range of well-respected clinical neuropsychologists in field. This amazing group of neuropsychologists, including: Drs...

Objective: Given the negative health outcomes associated with functional loss, there is need to better understand the trajectory of functional change and compensation use with age. Many older adults successfully age in place, and there is not a one-to-one relationship between cognitive changes and ability to live independently. This study compared healthy age cohorts' performance and approach on a functional measure, particularly examining compensatory strategy use to support task performance. Methods: 57 young adults (YAs; ages 18-39), 42 young-old adults (YOAs; ages 60-69) and 47 old-old (OOAs; ages 70+) completed the Night Out Task (NOT); an open-ended functional assessment in which participants complete eight subtasks in preparation for a night out with a friend (e...

In this study, we introduce and validate a computational method to detect lifestyle change that occurs in response to a multi-domain healthy brain aging intervention. To detect behavior change, digital behavior markers (DM) are extracted from smartwatch sensor data and a Permutation-based Change Detection (PCD) algorithm quantifies the change in marker-based behavior from a pre-intervention, one-week baseline. To validate the method, we verify that changes are successfully detected from synthetic data with known pattern differences...

BACKGROUND: Traditional paper-based calendars and to-do lists have limitations related to difficulty retrieving information and no automated way to prompt completion of activities. Such limitations may be overcome using a digital format through organized files, search functions, and alarms. This pilot project trained older adults at risk for cognitive decline to use the Digital Memory Notebook (DMN), a tablet-based application, to support everyday memory. The primary goal was to obtain preliminary information regarding a 6-week, group-based DMN training intervention in terms of acceptability and satisfaction...

BACKGROUND: The protocol for 'Brain Boosters', a novel combined compensatory training and lifestyle modification intervention aimed at Alzheimer's disease (AD) risk reduction is presented. Training in compensation will focus on a calendar and tracking system, organizational strategies, and goal setting, all aimed at supporting independent function. These same compensatory tools will be employed to facilitate adoption of lifestyle changes that support brain health (e.g., physical exercise, cognitive exercise, wellbeing exercise) through behavioral monitoring and feedback...

BACKGROUND: Compensatory aids can help mitigate the impact of progressive cognitive impairment on daily living. OBJECTIVE: We evaluate whether the learning and sustained use of an Electronic Memory and Management Aid (EMMA) application can be augmented through a partnership with real-time, activity-aware transition-based prompting delivered by a smart home. METHODS: Thirty-two adults who met criteria for amnestic mild cognitive impairment (aMCI) were randomized to learn to use the EMMA app on its own (N = 17) or when partnered with smart home prompting (N = 15)...

OBJECTIVE: This study used multiple assessment methods to examine instrumental activities of daily living (IADLs) performance in individuals with Parkinson's disease with mild cognitive impairment (PD-MCI) compared to individuals with mild cognitive impairment (MCI) and cognitively healthy older adults (HOA). Associations between functional performance and cognition were also examined. METHODS: Eighteen individuals with PD-MCI, 48 individuals with MCI, and 66 HOAs were assessed with multiple IADL measures, including direct observation, a performance-based measure, and self- and informant-report questionnaires...