Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing

Summary

Here, we present a protocol designed to show how negative aging stereotypes can impair memory performance of older adults during cognitive testing and how to reduce this deleterious effect. This method can help older people to perform at an optimal level during testing in both lab studies and clinical settings.

Abstract

As life expectancy increases, aging has become a major health challenge, resulting in a huge effort to better discriminate between normal and pathological cognitive decline. It is thus essential that cognitive tests and their administration are as fair as possible. However, an important source of bias during cognitive testing comes from negative aging stereotypes that can impair the memory performance of older adults and inflate age differences on cognitive tasks. The fear of confirming negative aging stereotypes creates an extra pressure among older adults which interferes with their intellectual functioning and leads them to perform below their true abilities. Here, we present a protocol that highlights simple but efficient interventions to alleviate this age-based stereotype threat effect. The first study showed that simply informing older participants about the presence of younger participants (threat condition) led older adults to underperform on a standardized memory test compared with younger participants, and that this performance difference was eliminated when the test was presented as age-fair (reduced-threat condition). The second study replicated these findings on short cognitive tests used to screen for predementia in clinical settings and showed that teaching older adults about stereotype threat inoculated them against its effects. These results provide useful recommendations about how to improve older adults' memory assessment both in Iab studies and in clinical settings.

Introduction

A growing field of laboratory research in social cognition conducted in the healthy population has demonstrated that members of groups whose abilities are negatively stereotyped typically underperform when the negative stereotypes are made relevant to the performance at hand, a phenomenon called stereotype threat (ST). In addition to the normal anxiety associated with taking cognitive tests, the fear of confirming negative stereotypes creates extra pressure that may interfere with cognitive functioning and lead to perform below one's abilities^1,2. Many findings demonstrate that negative aging stereotypes (....

Protocol

The present research was carried out in accordance with French standards, each participant provided informed consent and procedures were consistent with the guidelines of the American Psychological Association.

1. Highlighting and reducing age-based stereotype threat on a lab memory test

1. Participants screening
   1. Recruit participants in the desired age range (e.g., younger participants: 18−35 years old; older participants: 60−85 years old) for a study on general mental abilities and/or the impact of emotions on various cognitive tasks and questionnaires.
   2. Ensure that participants are native speaker....

Results

We addressed the hypothesis that stereotype threat impairs the working memory performance of older adults and that this effect can be reduced or eliminated by a simple instruction. The expected interaction between age group and threat instructions was significant, F(1, 214) = 4.85, p < 0.03, η_p² = 0.02, and is depicted in Figure 3. In the threat condition, older participants underperformed (mean [M] = 0.73, .......

Discussion

The present studies show that stereotype threat, a neglected source of stress in many testing situations, can lead older adults to perform below their true abilities on memory tests. The method presented here highlights the crucial importance of the instructions given to participants and patients before testing memory. Simply mentioning that younger adults are taking part in the study (without mentioning any expected age-related differences in performance) is sufficient to inflate by 40% (MMSE and MoCA averaged) the numb.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Table
2 chairs (one for the participant and one for experimenter)
Laptop/computer with Reading span test described in the protocol	Apple iMac (Cupertino, CA)
Software	Psyscope		http://psy.ck.sissa.it/psy_cmu_edu/index.html
Paper and pencil for MMSE, MoCA, Geriatric depression Scale, State-Trait Anxiety Inventory
Mini Mental State Examination	Folstein, M. F., Folstein, S. E., McHugh, P. R. "Mini-mental state." Journal of Psychiatric Research. 12 (3), 189–198 (1975).
Montreal Cognitive Assessment	Nasreddine, Z. S. et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society. 53, 695–699 (2005).
Geriatric depression Scale	Spielberger, C. D. Test Anxiety Inventory. The Corsini Encyclopedia of Psychology. John Wiley & Sons, Inc., Hoboken (2010).
State-Trait Anxiety Inventory	Yesavage, J. A. et al. Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research. 17 (1), 37–49 (1982).