Denise Park - US grants

The broad, long-term objectives of this project are to understand underlying mechanisms that account for differences in how young and elderly adults utilize context present in the memory environment to facilitate or detract from memory for target information. In other words, there are certain elements of one's memory environment which are useful in helping to learn or retrieve information; at the same time there are other forces in the memory environment, such as noise or competing activities, which detract from memory function. To the extent that scientists have a clear understanding of how young and old are differentially affected by context, information can be designed which will be easier for older adults to remember. In addition, such research will provide a more complete theoretical understanding of how human memory functions with advanced age. In the present proposal, a working memory framework is adopted which suggests that older adults differ from young adults in how effectively they integrate contextual information that supports target memory, and inhibit contextual information that detracts from target memory. Thus, age differences in the effectiveness of context are largest when older adults must perform active inhibition or integration operations--both processes associated with working memory function. In the present project, tasks are developed to independently measure subjects' ability to integrate and inhibit context, and then these ability factors are related to experimental -manipulations that are hypothesized to involve integration and inhibition of context. A conceptual taxonomy varying along four dimensions is also proposed for the study of context effects. The dimensions include (a) how strongly related the memory information (target) is to context; (b) whether the context is part of the memory stimulus (target-bound or intra-task) or not (extra-task or environmental context); (c) whether the context supports or detracts from memory; and (d) type of test for context memory--direct or indirect. Most context research on aging has focused on intra-task or target bound context, using direct memory tests. The present research focuses on the other less studied areas of context, including distracting context, environmental context, and effects of context on indirect measures of memory.

There is a large and rapidly-growing body of literature in the field of changes in cognition that occur with advance age. Based on this research, cognitive aging psychologists have made substantial gains in understanding the mechanisms which account for age-related decline. As a result of this knowledge, cognitive aging psychologists are well-positioned to use this information to design interventions which will enhance the function of older adults in situations with cognitive demands. To date, however, little work in this area of applications has occurred. Thus, the primary goal of this proposal is to establish the Southeastern Center for Applied Cognitive Aging Research which will harness existing knowledge about age-related declines in cognition into applications. The center will fund a cadre of cognitive aging researchers who will work together to develop cognitive supports, training materials and programs based on cognitive principles that will enhance the ability of older adults to function in cognitively-demanding situations that are important for every-day function. The focus of the Center is on designing practical applications and interventions in domains that are critical to the older adult's ability to maintain community-dwelling status and to continue to function independently. The center is a consortium of three institutions (University of Georgia, Georgia Tech, & Memphis State) and four investigators who have a long history of collaboration in the area of cognitive aging. Senior investigators, Denise Park at the University of Georgia, and Arthur D. Fisk at Georgia Tech, are both experienced in applied and basic cognitive research and will work in concert with two of their former students (Wendy Roger at Memphis State and Roger Morrell at the University of Georgia) and with Neff Walker, an expert at Georgia Tech in motor control, to comprise the nucleus of the Southeastern Center. The goal of the Center is to not only expand the work of these primary investigators in applied cognitive aging, but also to draw upon the rich resources in cognitive aging in the area and use them to better define and develop the field of applied cognitive aging through a fellows program, a seed grant program, and through two national conferences. The Center has a core and three research component. Denise C. Park will serve as Center Director and will administer the core. Her component project is on medication adherence in a group of low-SES hypertensive elderly. Roger Morrell will examine computer training strategies and the use of the computer as a social support system for elderly. Dan Fisk and Wendy Rogers will work on the development of a taxonomic framework for understanding age-related changes in human performance to be applied to automatic teller machines, bill evaluation, public transportation usage, and others. Specific products that will result from the Southeastern Center include software tutorials, training programs for computer usage, and specific techniques and devices (all inexpensive) which have been demonstrated to improve medication adherence in older adults.

The present proposal is focused on two major issues: understanding what cognitive mechanisms account for age differences in memory function in older adults and exploring how these mechanisms relate to the ability of older adults to use supportive contextual information to enhance their memory function. We postulate that age-differences in memory function and older adults' ability to use context can be accounted for in terms of a single construct: the construct of mental effort. In the past, this has been viewed as an untestable idea by many memory theorists, as it has proven impossible to independently measure the amount of cognitive resources that a subject brought into a situation and relate this resource to the demands created by the memory task. We believe that recent work in our laboratory and in a few other labs (Salthouse; Lindenberger, Mayr, & Kliegl; Hultsch, Hertzog, & Dixon) have developed good ways to get estimates of cognitive resources. In this research, we propose to use a combination of individual differences methodologies and more traditional experimental procedures to understand the role of mental effort in accounting for patterns of age differences across many types of memory and to explain the effects of memory context on remembering. Specifically, we propose to determine the roles of processing resource (operationalized as the joint effects of perceptual speed and working memory) and existing knowledge structures to explain age differences and cases of age invariance in use of context across different types of memory. We propose to restructure the environmental support view of context and aging within a more precisely specified continuum of mental effort. In Experiments 1 and 2, we use structural equation models to examine how constructs measuring cognitive resource and world knowledge contribute to age differences across many types of memory. In Experiment 3 and 4, we examine how context which is highly effortful to use, may not only fail to support memory in older adults, but may actually be more problematic for them then receiving no contextual support at all. In Experiment 5, we examine age differences in the deliberate recollection and familiarity components of memory. We determine how these components differ in their contribution to memory depending on whether the associative context of the memory task is easy or hard to use for older adults. In Experiments 6 and 7, we look at how effort and task demands affect prospective memory, and in Experiment 8, we examine the role of environmental context as a type of memory support for older adults.

The present conference proposal is a request to develop an important area of applied cognitive aging research--the role of age an cognitive function in understanding patient behavior in medical setting. Development in this domain has substantial implications for understanding utilization of limited health care resources and for benefits for older adults. A conference and edited volume are proposed that focus on three areas: medical decision-making and aging, the human factors perspective associated with structuring medical information for older adults, and model of medication adherence. Because much progress has been made in our basic understanding of age-related changes in cognitive mechanisms, this undeveloped topic seems well-suited for emphasis at this time. The issue has been highlighted as one of importance for future research in the 1995 federal "Task Force on Aging Report."

Fibromyalgia (FM) is a rheumatic disorder characterized by the presence of widespread musculoskeletal pain and the presence of tender points. Other symptoms, including fatigue, sleep disturbance, and neuropsychological complaints, contribute significantly to the morbidity associated with FM. One of the most prominent complaints in patients with FM is impaired cognitive ability. The notion that cognitive deficits are fundamental to FM is impaired cognitive ability. The notion that cognitive deficits are fundamental to FM has some credibility, as there is growing evidence that there are subtle but important cognitive deficits associated with Chronic Fatigue Syndrome (CFS), a related disorder, that cannot be explained by psychiatric symptoms. It is possible that cognitive defects in FM patients could result from single or multiple central nervous system perturbations associated with FM. In the present proposal, we will correlate cognitive function of FM patients with measures of neuroendocrine function. A basic thesis advanced is that FM patients may have both cognitive and neuroendocrine function similar to that of controls subjects who are 20 to 30 years older. Indeed, cognitive testing in patients with CFS reveals changes similar to those seen in subjects of advanced chronological age. In two experiments, FM patients will be compared to age-and education- matched controls, as well as to education-matched older adults. Neuroendocrine function will be measured as well, as will depression, pain, fatigue, and beliefs about memory function. This approach permits us to determine whether there are differences in cognitive function of fibromyalgia patients from others, and whether cognitive agins is a good model for understanding the cognitive effects of FM. In addition and perhaps more importantly, the integration of a cognitive approach with a neuroendocrine approach will allow us to determine what mechanisms account for the cognitive differences--neurochemical, psychiatric, or experience pain and fatigue. Knowing the mechanisms underlying observed cognitive deficits, rather than merely demonstrating that there are deficits, has important implications for treatment of the disorder as well as for understanding its etiology.

behavioral /social science research tag

For the past 5 years, the Center for Applied Cognitive Research on Aging focused generally on how the negative impact of age-associated declines in cognitive function on every day behaviors can be minimized so that older adults can function with autonomy and independence. In these next five years, we propose to study how age differences in cognitive function, affect the medical decisions older adults make, the problems older adults have using medical devices, difficulties they may have understanding and implementing physician instructions, and how age stereotypes in medical environments negatively impact health behaviors. More importantly, Center researchers will determine how to remediate these negative consequences of cognitive aging associated with medical environments and medical devices. In addition to these specific research goals, the Center-wide goals include (a) maintaining and increasing the Center's visibility as an international resource for the development and dissemination of applied research on cognitive aging, (b) continuing to attract promising investigators to the study of applied cognitive aging through the Center's highly successful seed grant program; (c) continuing to develop critical but understudied areas of research by convening small, problem-focused thematic conferences that result in edited volumes; (d) effectively utilizing the synergy and rich resources among the three consortium institutions for the study of applied cognitive aging: and (e) disseminating information about effective interventions for improving older adults processing of information in medical environments. The Center staff will distribute information directly to health-care professionals through videotapes, the world-wide web, and display at appropriate professional meetings.

This proposal focuses on the development of a conference on Cognitive Neuroscience Across the Lifespan. The conference will be a satellite to the Cognitive Neuroscience Meeting in April 2002. The primary objective is to push development in this emerging area with the ultimate goal of understanding how to maintain lifelong cognitive function, and how to maintain a healthy mind. The conference will focus on understanding the link between overt cognitive behaviors and underlying neural functions across the lifespan. The conference is designed to bring together for the first time, leading researchers in the cognitive neuroscience of aging, to highlight emerging issues, methodological challenges, and the small body of existing research in this domain, and to foster the exchange of ideas.

DESCRIPTION (provided by applicant): The proposed studies are designed to yield benchmark contributions to the study of the neuroscience of culture and cognition, while simultaneously investigating critically important questions about the generality of neurocognitive aging across cultures. Although there is considerable behavioral evidence that there are differences in organization of perceptual and memory processes between Eastern and Western cultures, the neural activations and organization underlying these differences are unexplored. Briefly, behavioral evidence suggests that due to cultural norms that focus on relationships and group function, East Asians develop a bias to monitor their environment more than Westerners do, resulting in a greater reliance on context and holistic encoding on cognitive tasks. In contrast, the individualistic society of Westerners results in more attention to focal objects and analytic processing of information. Given these observed behavioral differences across cultures, the first aim of the present proposal is to evaluate how culture sculpts neural activity in young adults. Specifically, we hypothesize that young adults in East Asian cultures, when studying complex pictures, will show heightened engagement of medial temporal structures and areas specialized for relational and contextual processing, whereas Americans will engage frontal structures associated with strategic, analytic processing. A second goal of the research is to understand neurocognitive aging cross-culturally, and determine whether patterns of decreased hippocampal/increased frontal recruitment that occur in older Western samples are mirrored in Asian samples. We propose a series of studies that will allow us to assess the interplay between experience (through culture) and neurobiology (through aging) in sculpting the neurocognitive system. The proposed studies also permit a precise evaluation of key theories about compensatory neural activations in the neurocognitive aging.

The broad mission of the Dissemination Core is to distribute Center findings and recommendations to the public, other scientists, and health and government officials. Dissemination at these multiple levels will result in public awareness of life styles that facilitate healthy minds and will also heighten awareness of issues that may enhance scientific research and government investment in research on this critically important topic. Dissemination will occur to the public through (a) regular press releases about Center work to print and talk media; (b) development of a Center website with recommendations for maintenance of healthy minds; (c) regular; and wide distribution of a Center newsletter entitled "Healthy Minds" to media, public, and government officials, and (d) a public lecture by a popular speaker that is a major community event on the topic of healthy minds. Dissemination of findings to scientists will occur through (a) targeting publication of Center results in journals with high citation rates and high impact ratings, (b) convening of three international conferences (and subsequent edited publications) on focused topics central to subsets of Center researchers, (c) the Beckman Institute will support a substantial faculty travel program to assist Center researchers in disseminating findings at high profile national meetings, and (d) a regular speaker series of national experts on Healthy Minds at the Beckman Institute.

The present proposal is a plan to continue and even expand the Dallas Lifespan Brain Study (DLBS) for five additional years. The DLBS is possibly the largest and most complete cross-sectional lifespan study that currently exists that integrates structural and functional brain imaging measures, as well as amyloid imaging to understand and predict cognitive function. At the end of the first five year period, the final sample In the study Includes 425 adults from age 20 to 90, with a minimum of 50 subjects in each age decade. Because the cognitive neuroscience of aging is still a very young science, there are very few studies of longitudinal change in neural function. In fact, most large studies of brain and behavior that have a longitudinal component include only structural imaging, and many of these studies were not designed as brain/behavior studies. The Dallas Lifespan Brain Study was designed from its inception to be a longitudinal study of neurocognitive function and the present proposal is focused on adding a four year follow-up testing interval to the study. This will allow us to assess how neural structure and function change after a four-year interval at each decade of the life-span, and whether neural signatures associated with high or low performance at initial testing are predictive of negative trajectory of change in cognition and neural structure and function. At present, subjects admitted to the DLBS are highly screened and selected. The older subjects. In particular, must be optimally aging to meet the screening criteria. We propose to add an additional 180 subjects to the original sample who are typically aging and who have an exclusion factor or are of lower education than the present DLBS sample. The contrast of subjects who are perhaps more representative of the aging population with highly selected subjects will provide one of the first pictures of the neurocognitive health of these two different populations. RELEVANCE (See instructions): This project provides fundamental information about when in the lifespan the onset of cognitive dysfunction and neuropathology occurs. The findings from this project could play a key role in Identifying high-risk individuals relatively early in life for cognitive interventions and Alzheimer's Disease prevention as treatments become available.

DESCRIPTION (provided by applicant): This application is a response to RFA OD-09-003, "Recovery Act Limited Competition: NIH Challenge Grants in Health and Science Research (RC1)." This application addresses broad Challenge Area (05), Comparative Effectiveness Research, and specific Challenge Topic, 05-AG-105 "Comparative Intervention Trials for Diseases and Syndromes of Aging including Neurodegenerative Diseases." Funding of this competing revision will enable the hiring of a total of 3.25 full time people: a half-time exercise physiologist, 1.5 postdoctoral fellows and a 1.25 research assistants. Perhaps the most urgent scientific challenge for the 21st century is to develop interventions to slow the process of cognitive aging so that at the end of life, most older adults are in control of their mental faculties and they and their families can enjoy a high quality of life in this final phase of human development. The focus of the present application is to examine carefully the role of lifestyle variables that are commonly believed to be "good for the mind" in facilitating healthy cognitive aging. There is clear evidence that physical exercise improves cognitive health in late adulthood. What has not been studied is whether enhancing neural vasculature through exercise is an important condition for reaping the benefits of cognitive interventions. One of the main reasons for this gap in knowledge is the cost of implementing and studying such complex lifestyle interventions. The proposed project is one of the first attempts to study the joint effects of exercise and a cognitive intervention program by adding exercise conditions to an already-funded intervention study on cognitive engagement in the laboratory of Denise Park at the Center for Brain Health in Dallas. Synapse involves investigating the impact on cognitive function of immersing adults in a 12 week new learning challenge for 15- 20 hours each week. Subjects learn to quilt, perform digital photography, or do both. In this new application, we will add two groups to the Synapse project for the next three years: an Exercise Only group that improves cardiovascular health through a walking program that will allow us to assess the impact of exercise versus cognitive engagement. We will also add an Exercise Plus Engagement group comprised of subjects that both exercise and participate in Synapse, allowing us to assess whether exercise potentiates cognitive engagement effects. Because the infrastructure costs of the Synapse project are already funded, we can address critical scientific questions about exercise and cognitive interventions which have proven to be too expensive to easily address in previous work. The two primary goals of the project are to (a) directly compare exercise interventions and cognitive interventions to determine relative effectiveness of each domain and (b) examine the interactive effects of a joint exercise/cognitive intervention program. We hypothesize that a healthy cardiovascular system will greatly enhance cognitive intervention effects. In addition, we will utilize novel and exceptionally sensitive measures of cerebrovascular fitness by employing transcranial Doppler imaging, a method that has not yet been used in the exercise/cognition domain. Besides measuring VO2-Max, we will measure cerebral hypoperfusion, blood vessel reactivity, and arterial stiffness so that we will have careful measures of vascular health. PUBLIC HEALTH RELEVANCE: The focus of the present application is to examine carefully the role of lifestyle variables that are commonly believed to be "good for the mind" in facilitating healthy cognitive aging. There is clear evidence that physical exercise improves cognitive health in late adulthood. What has not been studied is whether enhancing neural vasculature through exercise is an important condition for reaping the benefits of cognitive interventions. The proposed project is one of the first attempts to study the joint effects of exercise and a cognitive intervention program on cognition.

  All older adults experience some degree of cognitive compromise as they age and approximately 32% of adults aged 85 and older suffer from Alzheimer's disease. The Alzheimer's Association estimates that delaying the onset of AD symptoms by only five years would reduce the rate of incidence by 50 percent! The present Phase III clinical trial builds on a wealth of observational work and more recent experimental research conducted in the PI's lab, which suggest that an important element of maintaining cognitive vitality for life is sustained engagement in mentally-challenging activities. In a U.S. sample of cognitively normal adults, we recently demonstrated that older adults who were randomly assigned to learn digital photography, quilting, or both, in fast-paced, demanding classes for 15 hours per week for three months, showed enhanced episodic memory function?both at the end of the engagement period and, importantly, one-year later. The observed memory improvements were in comparison to two active control conditions that were low in new learning: a social engagement group that had fun but did not engage in active learning, and a placebo condition where participants worked on low-effort cognitive tasks that relied on use of previous knowledge. We also found similar facilitation effects when older adults were trained to use many different applications on an iPad. We most recently reported that older participants who participated in high-effort engagement conditions showed an increase in neural efficiency, exhibiting a change in neural activity from a pre-intervention pattern characteristic of older adults to a post-intervention pattern typical of young adults. Based on these findings, which included relatively small numbers of subjects, we propose a definitive Phase III trial to determine whether mentally challenging activities facilitate memory in cognitively normal adults via changes of neural structure and function. To isolate the critical role of mental effort, we include moderate challenge conditions and we also measure the impact of the intervention on engagement in everyday life for a full year. Finally, to maximize the scientific yield from the proposed trial, it will be conducted at two culturally diverse sites (Germany and the United States) providing an exceptionally strong test of the generalizability and reliability of positive findings. The proposed project address a critical public health issue as little is known about what steps individuals can take to maintain a healthy mind. Ultimately, we expect that sustained engagement in new learning could delay both normal age-related cognitive decline and potentially even slow the onset of AD- related cognitive symptoms.