Denise Park - US grants

The effect of contextual information on memory function in older adults has become an issue of increasing theoretical importance in the psychology of memory and aging. Indeed, Burke and Light, in an influential review article suggest that understanding differences in the use of contextual information is one of the two major issues facing contemporary memory researchers. Craik and Simon and Rabinowitz et al. have argued that older adults are unable to encode specific contextual cues. They profit more from general cues than specific in a memory task, while young adults profit more from specific cues. Park et al. have reported findings suggesting that both old and young encode specific information, in contrast to the studies just described. In the present proposal, a series of experiments are porposed to systematically study the role that context plays in differentiating memory function of old and young adults and to resolve the conflicts present in the studies described. In Experiment 1, the role of cue relatedness and interaction with the target will be studied to determine if integration of the memory stimulus with the context is a determinant of contextual effectiveness. In Experiment 2, the role of target format (picture or word) and retrieval condition (recall or recognition) will be assessed to determine if these variables affect contextual encoding in older adults. In Experiment 3, the role of cue type vs. the cue's presence or absence will be studied. Studies finding evidence for a contextual encoding deficit in the elderly have only varied cue type while Park et al. manipulated the actual presence or absence of the cue and found no deficit. Finally, in Experiment 4, the theoretical concept of general vs. specific cues will be applied to an ecologically-valid situation. Subjects will study words in a contextually general or distinct room and the effect of remembering the different memory environments on the two ages will be studied. Since memory complaints are the primary concern of older individuals when consulting with psychologists and psychiatrists, an understanding of the interaction of the encoding context with age would be quite useful. Furthermore, Experiment 4 is an active attempt to develop a mnemonic strategy to assist in alleviating memory difficulties in older adults.

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.

Essential hypertension is a critical problem for older adults. There are 60 million or more Americans with hypertension, many of whom are aged. Hypertension is a particular problem among African American who are at much higher risk of hypertension that Caucasians. Grave consequences of uncontrolled primary hypertension include strokes, heart disease, and end stage renal disease. What is particularly tragic about hypertension is that extremely effective oral medication treatments for hypertension are readily available. Thus, a primary issue to control hypertension is ensuring that prescription medication is taken after it is dispensed. In the proposed research, a cognitive model for understanding medication adherence is applied to a sample of low- SEA African-American and Caucasian subjects who are middle aged to very old. Novel electronic devices to monitor adherence are used to provide accurate measures of medication-taking behavior. It is hypothesized that psychosocial variables, such as illness representation and depression, play a substantial role in medication adherence for younger adults, and these variables will be assessed. In older adults, however, there is growing evidence that age-related decline in cognitive function may play an important role in medication adherence, particularly for the oldest-old. In addition to assessing the magnitude of the adherence problem for hypertensive medications as well as other medications, the proposed research examines the effectiveness of different types of interventions--interventions designed to either alter an illness representation or support cognition. The interventions examined include providing patients with organizational charts and medication organizers to reduce comprehension and working memory load associated with the adherence burden, providing patients with external reminder devices to support prospective memory, or providing patient counseling to restructure the patient's illness presentation to be more consonant with a desire to adhere. The ultimate outcome of this project will be to develop profiles of individuals who are at high risk of nonadherence and provide practitioners with specific intervention strategies that are inexpensive and have been demonstrated to be effective in improving adherence.

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.

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.

DESCRIPTION (adapted from investigator's abstract): This application focuses on differences in basic cognitive processes that exist between members of Asian and Western cultures and on how these differences are magnified or moderated by the aging process. There is evidence that information processing may differ at fundamental levels as a function of culture. Data suggest that Asians process information more holistically, in a more context-bound, field-dependent manner, and that they use categorical information differently from Westerners. Although it might seem logical to assume that age will magnify these effects of culture on cognitive processes, due to increased exposure to the culture by the individual, the investigator hypothesizes that the effects of culture will not always increase with age. She believes that there are some classes of cognitive behaviors where cultural differences in cognitive function will decrease with age. There is compelling evidence that cognitive resources (as measured by speed of processing and on-line working memory capacity) decline with age--at least in Western cultures. The investigator believes that this decline is universal across cultures and that it is an important mechanism in understanding cultural differences in cognitive function. She proposes eight experiments to test our hypothesis and to characterize memory function in young and old Chinese and Americans. In Experiments 1-2, the mechanisms underlying efficient memory function --- speed of processing and working memory --- are examined. In Experiment 3, the mechanisms underlying cultural differences in memory --- field dependence, analytic processing, and categorization --- are studied. In Experiments 4-8 the investigator examines memory function, with an emphasis on understanding how different types of cues support memory in one culture but not another. It is hypothesized that visually-interacting cues facilitate Chinese more due to their bias towards holistic processing, but that categorical cues facilitate Americans more. The research is conducted under the auspices of the University of Michigan Collaborative Research Center at the Institute of Psychology in Beijing, China.

behavioral /social science research tag

In this proposal, we study how information in the medical environment that is process below a conscious awareness can affect the manner in which older adults represent their health, the medical decisions that they make, and their demonstrated physical function. The proposed work will begin to provide us with an understanding of how to design psychologically-optimal medical environments. Moreover, we also determine how e can increase the probability that compliance with medical instructions can be enhanced by strengthening the automatic aspects of everyday behavior. Automatic processes occur in situations where some aspect of the environment activates a knowledge structure and that activation continues to influence our behavior even through we are unaware of it. For example, young adults walked more slowly to the elevator at the end of an experiment after they subliminally processed words that were stereotypical of aging like "forgetful, Florida, and bingo." Research indicates that such low effort automatic processes are a pervasive aspect of our daily lives and that these automatic processes do not decline with age, unlike many other types of cognitive function. Other data have indicated that automatic processes play an important role in bridging the gulf between intention and completion of a behavior, such as wanting to exercise but then not showing up for exercise class. In these experiments, we propose to (a) understand how the decor and incidental information present in a physician's office can activate constructs of health of frailty and have a substantive impact of a range of medical behaviors in older adults; (b) determine how subliminally presenting information activating constructs of aging/frailty impacts on symptom reporting, physician-patient interactions, and hypothetical medical decisions. Finally, we develop intervention techniques that strengthen the automatic components of intentions to complete a medical behavior--in this case, compliance with an exercise program prescribed by a physician. The results of these studies will provide us with information about how to structure medical environments and interactions to minimize over-reporting of symptoms, increase patients' reliance on inexpensive but effective behavioral treatments for some health conditions, and increase the probability that compliance with physician instructions occur.

In this proposal, we study how information in the medical environment that is process below a conscious awareness can affect the manner in which older adults represent their health, the medical decisions that they make, and their demonstrated physical function. The proposed work will begin to provide us with an understanding of how to design psychologically-optimal medical environments. Moreover, we also determine how e can increase the probability that compliance with medical instructions can be enhanced by strengthening the automatic aspects of everyday behavior. Automatic processes occur in situations where some aspect of the environment activates a knowledge structure and that activation continues to influence our behavior even through we are unaware of it. For example, young adults walked more slowly to the elevator at the end of an experiment after they subliminally processed words that were stereotypical of aging like "forgetful, Florida, and bingo." Research indicates that such low effort automatic processes are a pervasive aspect of our daily lives and that these automatic processes do not decline with age, unlike many other types of cognitive function. Other data have indicated that automatic processes play an important role in bridging the gulf between intention and completion of a behavior, such as wanting to exercise but then not showing up for exercise class. In these experiments, we propose to (a) understand how the decor and incidental information present in a physician's office can activate constructs of health of frailty and have a substantive impact of a range of medical behaviors in older adults; (b) determine how subliminally presenting information activating constructs of aging/frailty impacts on symptom reporting, physician-patient interactions, and hypothetical medical decisions. Finally, we develop intervention techniques that strengthen the automatic components of intentions to complete a medical behavior--in this case, compliance with an exercise program prescribed by a physician. The results of these studies will provide us with information about how to structure medical environments and interactions to minimize over-reporting of symptoms, increase patients' reliance on inexpensive but effective behavioral treatments for some health conditions, and increase the probability that compliance with physician instructions occur.

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.

We have known for decades that older adults' memory function declines with age. In the past 15 years, we have learned much about what causes these declines by studying behavioral changes in speed of processing, working memory, and inhibitory function. In the past 15 years, we have learned much about what causes these declines by studying behavior changes in speed of processing, working memory, and inhibitory function. In the past five years, much of the focus on understanding the causes of age-related decline in memory function have shifted to understanding the brain mechanisms associated with age-related cognitive decline,, through the use of functional neuroimaging techniques. The results from this small body of literature have been startling. We now have some evidence to suggest that as we age, neural reorganization occurs so that older adults use more or different brain structures compared to young to perform the same tasks. Thus, older brains may not simply function more slowly or less efficiently, they may function differently from young brains in fundamental ways. There is simply not enough data to known. The use of event-related functional neuroimaging (fMRI) allows us to examine how old brains may work differently from young brains, while processing the same information. The focus of this proposal then is on understanding the neural circuitry associated with encoding and retrieval processes across the lifespan. We restrict our work to the study of picture memory and imagery formation, generation, and manipulation. This task domain is an excellent one to study because it involves the activation of many important brain sties (dorsolateral prefrontal, mediotemporal, and occipital cortices). Moreover, long-term memory for pictures is a task where we have demonstrated in our lab reliably that old and young demonstrate similar performance at the behavioral level. Thus, we can use picture memory tasks to understand whether differences in neural circuitry exist between young and old when they behaviorally evidence the same level of performance on a memory task. We also propose to understand neural activations on image generation and manipulation tasks, tasks where older adults perform more poorly. We also include middle-aged adults in out samples, adopting a true lifespan approach, so that we can understand where in the life-course transitions to different brain activation patterns occur. The experiments we have designed permit us to determine, as well, neural activation associated with remembered and forgotten items in young and old adults and both encoding and retrieval. This will help us understand where there are particular difficulties in memory-at the time the material is studied, at the time it is retrieved, or both. The present studies should greatly enhance our understanding of how behavioral function on cognitive tasks relates to brain organizations across the lifespan.

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): There is a unique confluence of researchers at the University of Illinois at Urbana-Champaign (UIUC) who are well-positioned to seek answers to the question of what conditions and interventions maintain or increase cognitive health with age. We propose to develop an Edward R. Roybal Center for Healthy Minds at UIUC that will have four primary goals. The first will be to organize a group of junior and senior investigators who will focus research efforts on this topic, studying social, cognitive, and physical (exercise) interventions, as well as combinations of these variables. A second goal will be to have a highly visible national Center on this topic and to make research on the topic of healthy minds a central focus at UIUC. A third goal will be to facilitate research on the topic, not only within UIUC, but to stimulate international networks of researchers to address this topic and share data through Center programs. A final goal will be to develop an ongoing set of recommendations of everyday behaviors that middle-aged and senior Americans may engage in to promote or maintain cognitive health and to disseminate these recommendations widely. Center researchers will focus efforts on six related hypotheses. There is existing expertise and some research on all of these hypotheses at UIUC. The hypotheses are: (1) Physical activity improves cognitive function; (2) Cognitive engagement and training supports a healthy mind; (3) Social engagement plays an important role in cognitive health; (4) Combinations of social/cognitive engagement may be particularly powerful in sustaining cognitive health in later adulthood; (5) Cultural context and stereotypes impact on cognitive health; and (6) Environmental supports promote and support healthy cognitive function in late adulthood.

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.

The goal of the Pilot Core is to stimulate research in both faculty members and students on the topics of healthy minds. The expectation is that these awards will result in publishable findings in their own right, but also will yield sufficiently interesting results to serve as pilot data for large-scale projects that will be submitted and funded through other mechanisms, such as RO-l's, program projects, and private initiatives. To this end, the Center will award three grants in the amount of $20,000 per year (direct costs) to faculty members at UIUC. In addition to funds budgeted for faculty awards, we also propose to make four awards of $5,000 each to postdoctoral fellows and graduate students. Such research awards will facilitate entry of young scholars into the field and also increase the amount of pilot data available for subsequent grant applications. The program is modeled after the highly successful seed grant program conducted under the auspices of the Roybal Center that Dr. Park has directed for the past two funding periods. Two model proposals are included, one by Elizabeth Stine-Morrow and Dan Morrow that proposes to develop a pilot "Odyssey of the Mind" program for senior adults, and a second project by Edward Diener that collects pilot data to understand the relationship between positive affect and cognitive flexibility and working memory function (Experiment 1) as well as social and cognitive engagement (Experiment 2).

[unreadable] DESCRIPTION (provided by applicant): There is a considerable amount of social and behavioral data that is correlational in nature suggesting that individuals who are deeply engaged in social and intellectual activities in mid and late adulthood show delays in normal age-related cognitive decline as well as in the onset of dementia. The present project entitled "Active Interventions for the Mind" is designed to provide one of the first experimental tests of the impact of sustained engagement on cognition in late adulthood. In the AIM project, we distinguish between productive engagement (engaging activities that require sustained activation of cognitive resources such as working memory, reasoning, and long-term memory, often in a social setting) and receptive engagement (engagement that relies primarily on existing knowledge and social interactions). Based on a successful pilot program, we propose to enroll older adults in intensive productive engagement conditions (e.g., learning to quilt or to use digital photography) a receptive engagement condition (e.g., participating in a primarily social program where leisure activities have low resource requirements), or control conditions (Wait-List or Placebo Control where low level cognitive activities are performed at home). All subjects except Wait-List controls will engage in activities 15 hours per week over a period of 16 weeks. We will contrast cognitive, affective and neural function in the productive engagement group with the other conditions, and hypothesize that sustained engagement in conditions that are both intellectually and socially stimulating over this time period will facilitate cognition in older adults relative to a wait-list control. Moreover, because learning a new skill and making new social contacts may permanently impact participants' daily behavior, the impact of the engagement will be assessed initially as well as a year later. Both behavioral and neural measures of cognitive change will be assessed, providing considerable insight into mechanisms of change. Subjects will be characterized thoroughly in terms of behavioral tests of cognitive function, measures of brain structure through structural imaging, and measures of brain function through functional neuroimaging, as well as in terms of psychosocial variables.. The AIM project represents one of the first systematic attempt to change and then measure older adults' lifestyle for a sustained period in an attempt to understand lifestyle factors that contribute to cognitive and neural vitality in late adulthood, much as we understand lifestyle factors that contribute to good cardiovascular health. [unreadable] [unreadable] [unreadable]

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.

The Dallas Lifespan Brain Study (DLBS) provides one of the most complete pictures of the changes that occur in brain structure and brain function, as well as their consequences for cognition, over the lifespan. The understanding of how healthy brains either maintain cognitive vitality or transition to pathology is the bedrock upon which future cures for neurological diseases will be built. We must study the entire adult lifespan to understand how early changes in brain structure and function signal future cognitive frailty. There are contrasting models of how brain function changes with age to maintain cognition (maintenance model vs. compensation model). We hypothesize that the model that best characterizes an individual is related to age and life experiences. For example, we predict that brain maintenance underlies effective cognitive function in middle-aged adults, whereas maintenance of cognitive function in old age more likely relies on a shift to compensatory brain activity. The DLBS was initially funded in 2006 by a MERIT award to Denise Park, and we have completed two waves of testing spaced four years apart. We now seek funding for Wave 3, which will occur eight years after Wave 1. This third wave is perhaps the most exciting scientifically, as the eight-year measurement period will allow us to isolate both those who are experiencing precipitous cognitive decline as well as older adults who have largely maintained cognitive vitality over eight years. The study employs a variety of neuroimaging tools that provide considerable breadth in the characterization of the brain, including structural, functional, and vascular imaging as well as a detailed cognitive and psychosocial characterization of participants. In addition, the DLBS also incorporates PET scans that measure deposits of beta amyloid and levels of tau in the brain, identifying subjects who may be in a state of preclinical AD. High levels of amyloid and tau neuropathologies are the primary diagnostic criteria for AD at autopsy, but are also commonly found in healthy, cognitively asymptomatic adults, and the DLBS seeks to disentangle this puzzle. The DLBS focuses on five important issues: (a) what neural footprint (maintenance model or compensation model) is associated with 8-year trajectories of cognitive vitality versus cognitive decline; (b) whether high amyloid accumulation in Wave 1 predicts progression at Wave 3, eight years later, to Mild Cognitive Impairment or Alzheimer's Disease; (c) how life experiences and health factors, conceptualized as neural enrichment and neural depletion factors, impact changes in brain function and cognition; (d) whether change in organization of brain networks at different ages predicts cognitive vitality or decline; and (e) whether changes in cerebrovascular health predicts cognitive trajectories. We can use these data to begin to understand the role of neural and contextual factors in explaining, not only who progresses to a pathological brain disorder like AD, but also identify brain patterns that characterize individuals who maintain cognitive function and brain health.

  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.