A-08 Predictors of Everyday Problem Solving in Subtypes of Mild Cognitive Impairment

Objective The Everyday Problems Test (EPT) evaluates problem solving ability needed to complete activities of daily living (ADLs), such as medication and financial management. This study assessed the contributions of executive functioning and subtypes of memory on everyday problem solving in healthy aging, amnestic mild cognitive impairment (MCI), and non-amnestic MCI. Method Participants included healthy older adults (n = 56) and individuals with MCI (amnestic MCI n = 25; non-amnestic MCI n = 36). Composite scores were derived for Executive Functioning (Trail Making Test-B and FAS), Immediate Memory (short delayed recall scores from the California Verbal Learning Test-II and the Brief Visuospatial Memory Test-Revised) and Delayed Memory (long delayed recall scores from both memory tests). The EPT was the measure of everyday problem solving. Results We found that for the control group and the entire MCI group (both amnestic and non-amnestic MCI), executive functioning, immediate memory, and delayed memory predicted problem solving. When examining the separate MCI subtypes, executive functioning and delayed memory predicted problem solving in non-amnestic-MCI, but not amnestic MCI. Conclusions Findings suggest that healthy older adults engage a range of cognitive skills (executive and memory skills) when they engage in everyday problem-solving. Executive and memory skills are also utilized for those with non-amnestic MCI when performing ADLs. Interestingly, in those exhibiting memory impairment and with increased risk for the Alzheimer’s type of dementia, memory and executive functions do not predict ADL problem solving. These findings indicate that people with amnestic-MCI may benefit from being given compensatory strategies to support their memory difficulties when they must perform everyday problem-solving.

Can functional task exercise improve executive function and contribute to functional balance in older adults with mild cognitive impairment? A pilot study

Introduction Individuals with cognitive impairment are more susceptible to falls associated with decreased executive function and balance. This pilot study investigated whether functional task exercise could improve executive function, which might further affect the functional balance in older adults with mild cognitive impairment. Method This was a single-group pre-test/post-test pilot. A total of 43 participants completed a 10-week structured functional task exercise programme, performing simulated functional tasks. Paired-samples t-test was performed to evaluate intervention effects. Associations between variables were examined using Pearson's correlation coefficient. Multiple regression analysis was performed to explore the contribution of cognitive variables to functional balance. Results Significant improvements were shown in general cognitive functions, executive function, functional balance and functional status. All executive function outcomes were significantly associated with functional balance. Everyday problem-solving ability was the only significant cognitive contributor ( β = 0.407, p < 0.05) to functional balance after controlling for the confounding factors. Conclusion This pilot showed functional task exercise using simulated functional task as a means of intervention was feasible and was associated with observed improvements in executive function and functional balance in older adults with mild cognitive impairment, whereas everyday problem-solving ability was found to be associated with functional balance. Further well-designed controlled studies are needed to draw more definitive conclusions.

The Effects of Cognitive Training on Cognitive Abilities and Everyday Function: A 10-Week Randomized Controlled Trial

With a random groups design, the current study examined whether a 10-week cognitive training could improve healthy older adult’s cognitive functions and everyday problem-solving and whether high ecological validity trainings would have greater positive impact upon everyday problem-solving than low ecological validity trainings. Eighty-six healthy Chinese older adult participants were assigned randomly to five groups, including one control group receiving no training and four groups receiving low ecological memory training, high ecological memory training, low ecological reasoning training, and high ecological reasoning training, respectively. Participants were measured pre- and posttraining on spatial working memory, numerical working memory, reasoning, and everyday problem-solving. Results of this study showed that cognitive training significantly improved targeted cognitive functions and everyday problem-solving performance in all the intervention groups. However, high ecological cognitive trainings failed to show superior impact upon everyday problem-solving compared with low ecological cognitive trainings.

Cognitive Predictors of Everyday Problem Solving across the Lifespan

Background: An important aspect of successful aging is maintaining the ability to solve everyday problems encountered in daily life. The limited evidence today suggests that everyday problem solving ability increases from young adulthood to middle age, but decreases in older age. Objectives: The present study examined age differences in the relative contributions of fluid and crystallized abilities to solving problems on the Everyday Problems Test (EPT). We hypothesized that due to diminishing fluid resources available with advanced age, crystallized knowledge would become increasingly important in predicting everyday problem solving with greater age. Method: Two hundred and twenty-one healthy adults from the Dallas Lifespan Brain Study, aged 24-93 years, completed a cognitive battery that included measures of fluid ability (i.e., processing speed, working memory, inductive reasoning) and crystallized ability (i.e., multiple measures of vocabulary). These measures were used to predict performance on EPT. Results: Everyday problem solving showed an increase in performance from young to early middle age, with performance beginning to decrease at about age of 50 years. As hypothesized, fluid ability was the primary predictor of performance on everyday problem solving for young adults, but with increasing age, crystallized ability became the dominant predictor. Conclusion: This study provides evidence that everyday problem solving ability differs with age, and, more importantly, that the processes underlying it differ with age as well. The findings indicate that older adults increasingly rely on knowledge to support everyday problem solving, whereas young adults rely almost exclusively on fluid intelligence.