Dataset Information

Pragmatic approaches to handling practice effects in longitudinal cognitive aging research.

ABSTRACT:

Introduction

The challenge of accounting for practice effects (PEs) when modeling cognitive change was amplified by the COVID-19 pandemic, which introduced period and mode effects that may bias the estimation of cognitive trajectory.

Methods

In three Kaiser Permanente Northern California prospective cohorts, we compared predicted cognitive trajectories and the association of grip strength with cognitive decline using three approaches: (1) no acknowledgment of PE, (2) inclusion of a wave indicator, and (3) constraining PE based on a preliminary model (APM) fit using a subset of the data.

Results

APM-based correction for PEs based on balanced, pre-pandemic data, and with current age as the timescale produced the smallest discrepancy between within-person and between-person estimated age effects. Estimated associations between grip strength and cognitive decline were not sensitive to the approach used.

Discussion

Constraining PEs based on a preliminary model is a flexible, pragmatic approach allowing for meaningful interpretation of cognitive change.

Highlights

The magnitude of practice effects (PEs) varied widely by study. When PEs were present, the three PE approaches resulted in divergent estimated age-related cognitive trajectories. Estimated age-related cognitive trajectories were sometimes implausible in models that did not account for PEs. The associations between grip strength and cognitive decline did not differ by the PE approach used. Constraining PEs based on estimates from a preliminary model allows for a meaningful interpretation of cognitive change.

SUBMITTER: Chen R

PROVIDER: S-EPMC10524983 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Pragmatic approaches to handling practice effects in longitudinal cognitive aging research.

Chen Ruijia R Calmasini Camilla C Swinnerton Kaitlin K Wang Jingxuan J Haneuse Sebastien S Ackley Sarah F SF Hirst Andrew K AK Hayes-Larson Eleanor E George Kristen M KM Peterson Rachel R Soh Yenee Y Barnes Lisa L LL Mayeda Elizabeth Rose ER Gilsanz Paola P Mungas Dan M DM Whitmer Rachel A RA Corrada Maria M MM Glymour M Maria MM

Alzheimer's & dementia : the journal of the Alzheimer's Association 20230518 9

<h4>Introduction</h4>The challenge of accounting for practice effects (PEs) when modeling cognitive change was amplified by the COVID-19 pandemic, which introduced period and mode effects that may bias the estimation of cognitive trajectory.<h4>Methods</h4>In three Kaiser Permanente Northern California prospective cohorts, we compared predicted cognitive trajectories and the association of grip strength with cognitive decline using three approaches: (1) no acknowledgment of PE, (2) inclusion of ...[more]

PMID: 37199336

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Project description:IntroductionAlcohol consumption is a leading global risk factor for ill-health and premature death. Alcohol screening and brief interventions (SBI) delivered in primary care is effective at reducing alcohol consumption, but routine implementation remains problematic. Screening all patients for excessive drinking (universal screening) is resource-intensive and may be at odds with general practitioners' (GPs') perceived professional role. This study aimed to develop a tailored, theory-based training intervention to strengthen GPs' ability to address alcohol and to manage alcohol-related health problems through a pragmatic approach based on clinical relevance.MethodsA qualitative study design involving focus group interviews and a structured questionnaire for free text replies with GPs in Norway. Behavioral analysis assessed factors influencing delivery of SBI according to the 'capability, opportunity, motivation and behavior' (COM-B) model to inform intervention development using the Behavior Change Wheel. Qualitative data were analyzed using framework analysis and an iterative approach was adopted to develop the training.ResultsA purposive sample of GPs attended the focus groups (n = 25) and completed the questionnaire (n = 55). Four areas required additional support including: understanding the link between alcohol use and health problems; opening up the conversation on alcohol use; addressing alcohol and dealing with obstacles; and following-up and maintaining change. Findings informed the development of a four-session interactive training intervention and a digital intervention for providing support for patients between consultations to address the identified needs.ConclusionThis work highlights the value of pragmatic, relevance-based clinical strategies, as opposed to universal screening approaches to addressing alcohol in primary care. A pragmatic approach is more in line with GPs existing sclinical skill set and holds the potential to improve widespread uptake and implementation of SBI in routine primary care.

Dataset Information

Pragmatic approaches to handling practice effects in longitudinal cognitive aging research.

Introduction

Methods

Results

Discussion

Highlights

Publications

Pragmatic approaches to handling practice effects in longitudinal cognitive aging research.

Similar Datasets

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