Measuring activity engagement in old age: An exploratory factor analysis.
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ABSTRACT:
SUBMITTER: Marr C
PROVIDER: S-EPMC8648112 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:One mechanism that may allow older adults to continue to successfully perform certain cognitive tasks is to allocate more resources than their younger counterparts. Most prior studies have not included individuals beyond their 70s. Here, we investigated whether compensatory increases in neural activity previously observed in cognitively high-performing young-old adults would continue into old-old age. Event-related potentials were recorded from 72 cognitively high performing subjects, aged 18 to 96 years old, while they participated in a subject-controlled novelty oddball paradigm in which they determined viewing duration of standard, target, and novel visual stimuli. Compared to young and middle-aged subjects, both young-old and old-old subjects exhibited an impairment of preliminary mismatch/match detection operations, indexed by an attenuated anterior N2 component. This may have placed a greater burden on the subsequent controlled decision-making process, indexed by the P3, necessitating the allocation of more resources. The relationship between age and resource allocation, as measured by P3 amplitude, from midlife to very old age (45-96 years old) followed an inverted u-shaped curve (quadratic function). It peaked between the late 60s and early 70s. Thereafter, there was an inverse relationship between age and resource appropriation. This relationship remained significant after controlling for differences in task performance and MMSE. Examining the size of the P3 component across different age groups suggests that although cognitively high performing adults in their early 80s exhibit a reduction in P3 amplitude, they have a relatively well-preserved capacity to appropriate resources. However, by the late 80s, there is a robust decline (relative to young-old adults) in the size of the P3. Our results indicate that when carrying out controlled processing linked to directing attention to salient events, cognitively high performers reach the boundary of their capacity, albeit relatively late in life. This limits their ability to appropriate additional resources as compensatory activity for age-related impairments in earlier visual processing, and suggests that such a mechanism does not tend to "survive" old-old age.
| S-EPMC2962703 | biostudies-literature
Project description:Advocating continued health into old age, so called successful aging, is a growing public health goal. However, the development of tools to measure aging is limited by the lack of appropriate outcome measures, and operational definitions of successful aging. Using exploratory factor analysis, we attempted to identify distinguishable health domains with representative variables of physical function, cognitive status, social interactions, psychological status, blood biomarkers, disease history, and socioeconomic status from the InCHIANTI study. We then used logistic and mixed effect regression models to determine whether the resulting domains predicted outcomes of successful aging over a nine-year follow-up. A four-domain health model was identified: neuro-sensory function, muscle function, cardio-metabolic function and adiposity. After adjustment for age and gender, all domains contributed to the prediction of walking speed (R2=0.73). Only the muscle function domain predicted dependency (R2=0.50). None of the domains were a strong, significant predictor of self-rated health (R2=0.18) and emotional vitality (R2=0.23). Cross-sectional findings were essentially replicated in the longitudinal analysis extended to nine-year follow-up. Our results suggest a multi-domain health model can predict objective but not subjective measures of successful aging.
| S-EPMC6555461 | biostudies-literature
Project description:BackgroundStudies report various ways in which patients are involved in research design and conduct. Limited studies explore the influence of patient engagement (PE) at each research stage in qualitative research from the perspectives of all stakeholders.MethodsWe established two small research groups, a Patient Researcher-Led Group and an Academic Researcher-Led Group. We recruited patient research partners (PRP; n = 5), researchers (n = 5), and clinicians (n = 4) to design and conduct qualitative research aimed at identifying candidate attributes related to patient preferences for tapering biologic treatments in inflammatory bowel disease. We administered surveys before starting, two months into, and post-project work. The surveys contained items from three PE evaluation tools. We assessed the two groups regarding the influence and impact each stakeholder had during the different research stages.ResultsPRPs had a moderate or a great deal of influence on the critical research activities across the research stages. They indicated moderate/very/extremely meaningful engagement and agreed/strongly agreed impact of PE. PRPs helped operationalize the research question; design the study and approach; develop study materials; recruit participants; and collect and interpret the data.ConclusionThe three tools together provide deeper insight into the influence of PE at each research stage. Lessons learnt from this study suggest that PE can impact many aspects of research including the design, process, and approach in the context of qualitative research, increasing the patient-centeredness of the study. More comprehensive validated tools are required that work with a more diverse subject pool and in other contexts.
| S-EPMC10999763 | biostudies-literature
Project description:ObjectiveIn patients with cancer across the illness trajectory, treatment decisions are often influenced by one's perception of their prognosis (i.e., curability of disease, life expectancy, quality of life). However, research on how patients understand their prognosis (i.e., prognostic understanding) has been limited by simplistic measurement tools that fail to capture the complexity of the construct. This study describes the initial development of a measure of prognostic understanding: the Prognostic Understanding Perceptions Scale (PUPS) for use in patients with advanced cancer.MethodAn initial pool of 16 candidate items were developed through semi-structured interviews with 15 experts (oncology, psycho-oncology and palliative care professionals) and 30 advanced cancer patients. We investigated the dimensionality, internal item structure, item difficulty and item discrimination of the item pool using exploratory factor analysis (EFA), classical test theory (CTT) and item response theory (IRT) analyses. Convergent and divergent validity were based on correlations between PUPS, terminal illness acknowledgement, and self-report measures of depression, anxiety, hopelessness, and death acceptance.ResultsThe final measure was comprised of nine items encompassing three factors (perceived curability, illness trajectory, treatment options), yielding strong psychometric properties.ConclusionThese results provide preliminarily support for PUPS as a multifaceted measure of prognostic understanding developed for use in patients with advanced cancer. Preliminary findings also highlight the potential utility of the PUPS for clinical settings, as a means of enhancing communication between patients and physicians.
| S-EPMC9547961 | biostudies-literature
Project description:BackgroundPrevention efforts focused on parenting can prevent and reduce the rates of child internalizing and externalizing problems, and positive changes in parenting skills have been shown to mediate improvements in child behavioral problems. However, parent skills training programs remain underused, with estimates that under half of eligible parents complete treatment and even lower rates engage in preventive interventions. Moreover, there is no validated measure to assess initial engagement in parent education or skills training, which is an understudied stage of parent engagement.ObjectiveWe aimed to test a novel engagement strategy, exploring whether including information pertaining to the neuroscience of child development and parent skills training enhanced parental intent to enroll. In addition, a novel self-report measure, the 18-item Parenting Resources Acceptability Measure (PRAM), was developed and validated.MethodsIn a group of 166 parents of children aged 5 to 12 years, using an engagement strategy based on the Seductive Allure of Neuroscience Explanations, we conducted a web-based experiment to assess whether the inclusion of neuroscience information related to higher levels of engagement via self-report and behavioral measures. The PRAM was subjected to an exploratory factor analysis and examined against relevant validity measures and acceptability measurement criteria.ResultsThree PRAM factors emerged ("Acceptability of Parenting Resources," "Interest in Learning Parenting Strategies," and "Acceptability of Parenting Websites"), which explained 68.4% of the total variance. Internal consistency among the factors and the total score ranged from good to excellent. The PRAM was correlated with other relevant measures (Parental Locus of Control, Parenting Sense of Competence, Strengths and Difficulties Questionnaire, Parent Engagement in Evidence-Based Services, and behavioral outcomes) and demonstrated good criterion validity and responsiveness. Regarding the engagement manipulation, parents who did not receive the neuroscience explanation self-reported lower interest in learning new parenting skills after watching an informational video compared with parents who did receive a neuroscience explanation. However, there were no significant differences between conditions in behavioral measures of intent to enroll, including the number of mouse clicks, amount of time spent on a page of parenting resources, and requests to receive parenting resources. The effects did not persist at the 1-month follow-up, suggesting that the effects on engagement may be time-limited.ConclusionsThe findings provide preliminary evidence for the utility of theory-driven strategies to enhance initial parental engagement in parent skills training, specifically parental interest in learning new parenting skills. In addition, the study findings demonstrate the good initial psychometric properties of the PRAM, a tool to assess parental intent to enroll, which is an early stage of engagement.
| S-EPMC9568823 | biostudies-literature
Project description:This SuperSeries is composed of the SubSeries listed below.
2022-06-12 | GSE168756 | GEO
Project description:BackgroundSurvival to old ages is increasing in many African countries. While demographic tools for estimating mortality up to age 60 have improved greatly, mortality patterns above age 60 rely on models based on little or no demographic data. These estimates are important for social planning and demographic projections. We provide direct estimations of older-age mortality using survey data.MethodsSince 2005, nationally representative household surveys in ten sub-Saharan countries record counts of living and recently deceased household members: Burkina Faso, Côte d'Ivoire, Ethiopia, Namibia, Nigeria, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe. After accounting for age heaping using multiple imputation, we use this information to estimate probability of death in 5-year intervals ((5)q(x)). We then compare our (5)q(x) estimates to those provided by the World Health Organization (WHO) and the United Nations Population Division (UNPD) to estimate the differences in mortality estimates, especially among individuals older than 60 years old.FindingsWe obtained information on 505,827 individuals (18.4% over age 60, 1.64% deceased). WHO and UNPD mortality models match our estimates closely up to age 60 (mean difference in probability of death -1.1%). However, mortality probabilities above age 60 are lower using our estimations than either WHO or UNPD. The mean difference between our sample and the WHO is 5.9% (95% CI 3.8-7.9%) and between our sample is UNPD is 13.5% (95% CI 11.6-15.5%). Regardless of the comparator, the difference in mortality estimations rises monotonically above age 60.InterpretationMortality estimations above age 60 in ten African countries exhibit large variations depending on the method of estimation. The observed patterns suggest the possibility that survival in some African countries among adults older than age 60 is better than previously thought. Improving the quality and coverage of vital information in developing countries will become increasingly important with future reductions in mortality.
| S-EPMC3197519 | biostudies-literature
Project description:BackgroundEcological momentary assessment (EMA) is an in situ method of gathering self-report on behaviors using mobile devices. In typical phone-based EMAs, participants are prompted repeatedly with multiple-choice questions, often causing participation burden. Alternatively, microinteraction EMA (micro-EMA or μEMA) is a type of EMA where all the self-report prompts are single-question surveys that can be answered using a 1-tap glanceable microinteraction conveniently on a smartwatch. Prior work suggests that μEMA may permit a substantially higher prompting rate than EMA, yielding higher response rates and lower participation burden. This is achieved by ensuring μEMA prompt questions are quick and cognitively simple to answer. However, the validity of participant responses from μEMA self-report has not yet been formally assessed.ObjectiveIn this pilot study, we explored the criterion validity of μEMA self-report on a smartwatch, using physical activity (PA) assessment as an example behavior of interest.MethodsA total of 17 participants answered 72 μEMA prompts each day for 1 week using a custom-built μEMA smartwatch app. At each prompt, they self-reported whether they were doing sedentary, light/standing, moderate/walking, or vigorous activities by tapping on the smartwatch screen. Responses were compared with a research-grade activity monitor worn on the dominant ankle simultaneously (and continuously) measuring PA.ResultsParticipants had an 87.01% (5226/6006) μEMA completion rate and a 74.00% (5226/7062) compliance rate taking an average of only 5.4 (SD 1.5) seconds to answer a prompt. When comparing μEMA responses with the activity monitor, we observed significantly higher (P<.001) momentary PA levels on the activity monitor when participants self-reported engaging in moderate+vigorous activities compared with sedentary or light/standing activities. The same comparison did not yield any significant differences in momentary PA levels as recorded by the activity monitor when the μEMA responses were randomly generated (ie, simulating careless taps on the smartwatch).ConclusionsFor PA measurement, high-frequency μEMA self-report could be used to capture information that appears consistent with that of a research-grade continuous sensor for sedentary, light, and moderate+vigorous activity, suggesting criterion validity. The preliminary results show that participants were not carelessly answering μEMA prompts by randomly tapping on the smartwatch but were reporting their true behavior at that moment. However, more research is needed to examine the criterion validity of μEMA when measuring vigorous activities.
| S-EPMC7991987 | biostudies-literature
Project description:Beyond the rhetorical call for increasing patients' engagement, policy makers recognize the urgency to have an evidence-based measure of patients' engagement and capture its effect when planning and implementing initiatives aimed at sustaining the engagement of consumers in their health. In this paper, authors describe the Patient Health Engagement Scale (PHE-scale), a measure of patient engagement that is grounded in rigorous conceptualization and appropriate psychometric methods. The scale was developed based on our previous conceptualization of patient engagement (the PHE-model). In particular, the items of the PHE-scale were developed based on the findings from the literature review and from interviews with chronic patients. Initial psychometric analysis was performed to pilot test a preliminary version of the items. The items were then refined and administered to a national sample of chronic patients (N = 382) to assess the measure's psychometric performance. A final phase of test-retest reliability was performed. The analysis showed that the PHE Scale has good psychometric properties with good correlation with concurrent measures and solid reliability. Having a valid and reliable measure to assess patient engagement is the first step in understanding patient engagement and its role in health care quality, outcomes, and cost containment. The PHE Scale shows a promising clinical relevance, indicating that it can be used to tailor intervention and assess changes after patient engagement interventions.
| S-EPMC4376060 | biostudies-literature
Project description:Background: Women's status and empowerment influence health, nutrition, and socioeconomic status of women and their children. Despite its benefits, however, research on women's empowerment in Sub-Saharan Africa (SSA) is limited in scope and geography. Empowerment is variably defined and data for comparison across regions is often limited. The objective of the current study was to identify domains of empowerment from a widely available data source, Demographic and Health Surveys, across multiple regions in SSA. Methods: Demographic and Health Surveys from nineteen countries representing four African regions were used for the analysis. A total of 26 indicators across different dimensions (economic, socio-cultural, education, and health) were used to characterize women's empowerment. Pooled data from all countries were randomly divided into two datasets-one for exploratory factor analysis (EFA) and the other for Confirmatory Factor Analysis (CFA)-to verify the factor structure hypothesized during EFA. Results: Four factors including attitudes toward violence, labor force participation, education, and access to healthcare were found to define women's empowerment in Central, Southern, and West Africa. However, in East Africa, only three factors were relevant: attitudes toward violence, access to healthcare ranking, and labor force participation. There was limited evidence to support household decision-making, life course, or legal status domains as components of women's empowerment. Conclusion: This foremost study advances scholarship on women's empowerment by providing a validated measure of women's empowerment for researchers and other stakeholders in health and development.
| S-EPMC6018402 | biostudies-literature