[en] OBJECTIVE: Numerous studies have shown that stereotype threat (ST) reduces older people's cognitive performance, but few have studied its impact on clinical cognitive outcomes. Our study was designed to further examine the impact of ST on the clinical assessment of older subjects' cognitive functioning, as well as the moderating role of fear of Alzheimer's Disease (AD) (or 'dementia worry').
METHOD: Seventy-two neurologically normal (MMSE > 26) participants aged between 59 and 70 completed a set of neuropsychological tasks in either an ST or a positive condition (condition in which negative stereotypes were invalidated).
RESULTS: Regression-based path analyses showed that only participants who expressed moderate or high fear of AD underperformed on executive tasks in the ST condition compared to their counterparts in the positive condition. Moreover, in the ST condition, participants' performance on executive tasks was more impaired (relative to normative data) than in the positive condition. However, ST had no effect on memory and attention performance.
DISCUSSION:Our results showed that ST can cause older people to perform at pathological levels on executive tasks. Results highlight the need for clinicians to be cautious when conducting neuropsychological assessments of older people who express high levels of dementia worry.
Disciplines :
Theoretical & cognitive psychology
Author, co-author :
Fresson, Megan ; Université de Liège - ULiège > Département de Psychologie > Psychologie sociale
Dardenne, Benoît ; Université de Liège - ULiège > Département de Psychologie > Psychologie sociale
Geurten, Marie ; Université de Liège - ULiège > GIGA-Research
Meulemans, Thierry ; Université de Liège - ULiège > Département de Psychologie > Neuropsychologie
Language :
English
Title :
The Effect of Stereotype Threat on Older People’s Clinical Cognitive Outcomes: Investigating the Moderating Role of Dementia Worry
Abrams, D., Crisp, R. J., Marques, S., Fagg, E., Bedford, L., & Provias, D., (2008). Threat inoculation: Experienced and imagined intergenerational contact prevents stereotype threat effects on older people’s math performance. Psychology and Aging, 23, 934–939.10.1037/a0014293
Albert, M. S., Moss, M. B., Tanzi, R., & Jones, K., (2001). Preclinical prediction of AD using neuropsychological tests. Journal of the International Neuropsychological Society, 7, 631–639.10.1017/S1355617701755105
Alzheimer’s Association. (2008). 2008 Alzheimer’s disease facts and figures. Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association, 4, 110–133. doi:10.1016/j.jalz.2008.02.005
Andreoletti, C., & Lachman, M. E., (2004). Susceptibility and resilience to memory aging stereotypes: Education matters more than age. Experimental Aging Research, 30, 129–148. doi:10.1080/03610730490274167
Avorn, J., & Langer, E., (1982). Induced disability in nursing home patients: A controlled trial. Journal of the American Geriatrics Society, 30, 397–400.10.1111/jgs.1982.30.issue-6
Barber, S. J., & Mather, M., (2013). Stereotype threat can both enhance and impair older adults’ memory. Psychological Science, 24, 2522–2529.
Barber, S. J., Mather, M., & Gatz, M., (2015). How stereotype threat affects healthy older adults’ performance on clinical assessments of cognitive decline: The key role of regulatory fit. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 70, 891–900. doi:10.1093/geronb/gbv009
Benjamini, Y., & Hochberg, Y., (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society Series B: Methodological, 57, 289–300.
Blair, J., & Spreen, O., (1989). Predicting premorbid IQ: A revision of the national adult reading test. Clinical Neuropsychologist, 3, 129–136. doi:10.1080/13854048908403285
Bouazzaoui, B., Follenfant, A., Ric, F., Fay, S., Croizet, J. C., Atzeni, T., & Taconnat, L., (2016). Ageing-related stereotypes in memory: When the beliefs come true. Memory, 24, 659–668. doi:10.1080/09658211.2015.1040802
Burgener, S. C., Buckwalter, K., Perkhounkova, Y., & Liu, M. F., (2015). The effects of perceived stigma on quality of life outcomes in persons with early-stage dementia: Longitudinal findings: Part 2. Dementia, 14, 609–632. doi:10.1177/1471301213504202
Burgener, S. C., Buckwalter, K., Perkhounkova, Y., Liu, M. F., Riley, R., Einhorn, C. J., … Hahn-Swanson, C., (2015). Perceived stigma in persons with early-stage dementia: Longitudinal findings: Part 1. Dementia, 14, 589–608. doi:10.1177/1471301213508399
Cardebat, D., Doyon, B., Puel, M., Goulet, P., & Joanette, Y., (1990). Evocation lexicale formelle et sémantique chez des sujets normaux. Performances et dynamiques de production en fonction du sexe, de l’âge et du niveau d’étude [Formal and semantic lexical evocation in normal subjects. Performance and dynamics of production as a function of sex, age and educational level]. Acta Neurologica Belgica, 90, 207–217.
Chasteen, A., Bhattacharyya, S., Horhota, M., Tam, R., & Hasher, L., (2005). How feelings of stereotype threat influence older adults’ memory performance. Experimental Aging Research, 31, 235–260. doi:10.1080/03610730590948177
Chen, P., Ratcliff, G., Belle, S. H., Cauley, J. A., DeKosky, S. T., & Ganguli, M., (2000). Cognitive tests that best discriminate between presymptomatic AD and those who remain nondemented. Neurology, 55, 1847–1853.10.1212/WNL.55.12.1847
Cook, C. M., & Suhr, J. A., (2016). Effects of screening for postconcussive syndrome (PCS) on PCS symptom self-report and neuropsychological test performance. The Clinical Neuropsychologist, 30, 284–300.10.1080/13854046.2016.1139186
Cutler, S. J., (2015). Worries about getting Alzheimer’s: Who’s concerned? American Journal of Alzheimer’s Disease and Other Dementias, 30, 591–598.10.1177/1533317514568889
Cutler, S. J., & Brăgaru, C., (2015). Long-term and short-term predictors of worries about getting Alzheimer’s disease. European Journal of Ageing, 12, 341–351.10.1007/s10433-015-0350-3
Cutler, S. J., & Hodgson, L. G., (1996). Anticipatory dementia: A link between memory appraisals and concerns about developing Alzheimer’s disease. The Gerontologist, 36, 657–664. doi:10.1093/geront/36.5.657
Cutler, S. J., & Hodgson, L. G., (2001). Correlates of personal concerns about developing Alzheimer’s disease among middle-aged persons. American Journal of Alzheimer’s Disease and Other Dementias, 16, 335–343.10.1177/153331750101600604
Cutler, S. J., & Hodgson, L. G., (2013). Concerns about cognitive functioning, dementia worries, and psychological well-being. Revista de Asistenţă Socială, 12, 77–86.
Cutler, S. J., & Hodgson, L. G., (2014). Is health affected by dementia worries and concerns about cognitive functioning? Revista de Asistenţă Socială, 13, 7–15.
Delis, D., Kramer, J., Kaplan, E., & Ober, B., (1987). The California verbal learning test: Reliability, validity, and factor structure. New York, NY: The Psychological Corporation.
Desrichard, O., & Kopetz, C., (2005). A threat in the elder: The impact of task instructions, self-efficacy and performance expectations on memory performance in the elderly. European Journal of Social Psychology, 35, 537–552. doi:10.1002/ejsp.249
Faul, F., Erdfelder, E., Buchner, A., & Lang, A. G., (2009). Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149–1160.10.3758/BRM.41.4.1149
Fernandez-Ballesteros, R., Bustillos, A., & Huici, C., (2015). Positive perception of aging and performance in a memory task: Compensating for stereotype threat? Experimental Aging Research, 41, 410–425. doi:10.1080/0361073x.2015.1053757
Fiske, S. T., Cuddy, A. J. C., Glick, P., & Xu, J., (2002). A model of (often mixed) stereotype content: Competence and warmth respectively follow from perceived status and competition. Journal of Personality and Social Psychology, 82, 878–902. doi:10.1037/0022-3514.82.6.878
Folstein, M. F., Folstein, S. E., & McHugh, P. R., (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.10.1016/0022-3956(75)90026-6
French, S. L., Floyd, M., Wilkins, S., & Osato, S., (2012). The fear of Alzheimer’s Disease Scale: A new measure designed to assess anticipatory dementia in older adults [Executive functions and neurological and psychiatric pathologies]. International Journal of Geriatric Psychiatry, 27, 521–528. doi:10.1002/gps.2747
Godefroy, A., & GREFEX (2008). Fonctions exécutives et pathologies neurologiques et psychiatriques [Executive functions and neurological and psychiatric pathologies]. Marseille: Solal.
Grimm, L. R., Markman, A. B., Maddox, W. T., & Baldwin, G. C., (2009). Stereotype threat reinterpreted as a regulatory mismatch. Journal of Personality and Social Psychology, 96, 288–304.10.1037/a0013463
Harvard School of Public Health and Alzheimer Europe. (2011). Five-country Alzheimer’s disease survey. Retrieved from http://www.hsph.harvard.edu/news/press-releases/alzheimers-international-survey/
Haslam, C., Morton, T. A., Haslam, S. A., Varnes, L., Graham, R., & Gamaz, L., (2012). “When the age is in, the wit is out”: Age-related self-categorization and deficit expectations reduce performance on clinical tests used in dementia assessment. Psychology and Aging, 27, 778–784. doi:10.1037/a0027754
Hayes, A. F., (2013). Introduction to mediation, moderation, and conditional process analysis. A regression-based approach. New York, NY: The Guilford Press.
Hess, T. M., Auman, C., Colcombe, S. J., & Rahhal, T. A., (2003). The impact of stereotype threat on age differences in memory performance. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 58, 3–11. doi:10.1093/geronb/58.1.P3
Hess, T. M., & Hinson, J. T., (2006). Age-related variation in the influences of aging stereotypes on memory in adulthood. Psychology and Aging, 21, 621–625. doi:10.1037/0882-7974.21.3.621
Hess, T. M., Hinson, J. T., & Hodges, E. A., (2009). Moderators of and mechanisms underlying stereotype threat effects on older adults’ memory performance. Experimental Aging Research, 35, 153–177. doi:10.1080/03610730802716413
Hess, T. M., Hinson, J. T., & Statham, J. A., (2004). Explicit and implicit stereotype activation effects on memory: Do age and awareness moderate the impact of priming? Psychology and Aging, 19, 495–505. doi:10.1037/0882-7974.19.3.495
Higgins, E. T., (1997). Beyond pleasure and pain. American Psychologist, 52, 1280–1300. doi:10.1037/0003-066X.52.12.1280
Higgins, E. T., (1998). Promotion and prevention: Regulatory focus as a motivational principle. Advances in Experimental Social Psychology, 30, 1–46.10.1016/S0065-2601(08)60381-0
Horton, S., Baker, J., Pearce, W., & Deakin, J. M., (2010). Immunity to popular stereotypes of aging? Seniors and stereotype threat. Educational Gerontology, 36, 353–371. doi:10.1080/03601270903323976
Hummert, M. L., (1999). A social cognitive perspective on age stereotypes. In T. M., Hess & F., Blanchard-Fields (Eds.), Social cognition and aging (pp. 175–196). San Diego, CA: Academic Press.10.1016/B978-012345260-3/50009-4
Kang, S. K., & Chasteen, A. L., (2009). The moderating role of age-group identification and perceived threat on stereotype threat among older adults. The International Journal of Aging and Human Development, 69, 201–220. doi:10.2190/AG.69.3.c
Kessler, E.-M., Bowen, C. E., Baer, M., Froelich, L., & Wahl, H.-W., (2012). Dementia worry: A psychological examination of an unexplored phenomenon. European Journal of Ageing, 9, 275–284. doi:10.1007/s10433-012-0242-8
Kinzer, A., & Suhr, J. A., (2016). Dementia worry and its relationship to dementia exposure, psychological factors, and subjective memory concerns. Applied Neuropsychology: Adult, 23, 196–204. doi:10.1080/23279095.2015.1030669
Klenk, M. M., Strauman, T. J., & Higgins, E. T., (2011). Regulatory focus and anxiety: A self-regulatory model of GAD-depression comorbidity. Personality and Individual Differences, 50, 935–943.10.1016/j.paid.2010.12.003
Kramer, A. F., Erickson, K. I., & Colcombe, S. J., (2006). Exercise, cognition, and the aging brain. Journal of Applied Physiology, 101, 1237–1242.10.1152/japplphysiol.00500.2006
Kray, L. J., Thompson, L., & Galinsky, A., (2001). Battle of the sexes: Gender stereotype confirmation and reactance in negotiations. Journal of Personality and Social Psychology, 80, 942–958. doi:10.1037/0022-3514.80.6.942
Lamont, R. A., Swift, H. J., & Abrams, D., (2015). A review and meta-analysis of age-based stereotype threat: Negative stereotypes, not facts, do the damage. Psychology and Aging, 30, 180–193.10.1037/a0038586
Larrieu, S., Letenneur, L., Orgogozo, J. M., Fabrigoule, C., Amieva, H., Le Carret, N., … Dartigues, J. F., (2002). Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology, 59, 1594–1599.10.1212/01.WNL.0000034176.07159.F8
Leplège, A., Ecosse, E., Verdier, A., & Perneger, T. V., (1998). The French SF-36 health survey: Translation, cultural adaptation and preliminary psychometric evaluation. Journal of Clinical Epidemiology, 51, 1013–1023.10.1016/S0895-4356(98)00093-6
Levy, B., (2009). Stereotype embodiment: A psychosocial approach to aging. Current Directions in Psychological Science, 18, 332–336. doi:10.1111/j.1467-8721.2009.01662.x
Levy, B. R., & Leifheit-Limson, E., (2009). The stereotype-matching effect: Greater influence on functioning when age stereotypes correspond to outcomes. Psychology and Aging, 24, 230–233. doi:10.1037/a0014563
Lezak, M. D., Howieson, D. B., & Loring, D. W., (2012). Neuropsychological assessment (5th ed.). New York, NY: Oxford University Press.
Lineweaver, T. T., Bondi, M. W., Galasko, D., & Salmon, D. P., (2014). Effect of knowledge of APOE genotype on subjective and objective memory performance in healthy older adults. American Journal of Psychiatry, 171, 201–208. doi:10.1176/appi.ajp.2013.12121590
Mazerolle, M., Régner, I., Barber, S., Paccalin, M., Miazola, A.-C., Huguet, P., & Rigalleau, F., (2016). Negative aging stereotypes impair performance on brief cognitive tests used to screen for predementia. Journal of Gerontology Series B: Psychological Sciences. doi:10.1093/geronb/gbw083
MetLife Foundation. (2006). MetLife foundation Alzheimer’s survey: What America thinks. Retrieved from https://www.metlife.com/assets/cao/foundation/alzheimers-2011.pdf
Mitchell, A. J., (2009). A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. Journal of Psychiatric Research, 43, 411–431.10.1016/j.jpsychires.2008.04.014
Molden, J., & Maxfield, M., (2016). The impact of aging stereotypes on dementia worry. European Journal of Ageing, 14, 29–37. doi:10.1007/s10433-016-0378-z
Nguyen, H.-H. D., & Ryan, A. M., (2008). Does stereotype threat affect test performance of minorities and women? A meta-analysis of experimental evidence. Journal of Applied Psychology, 93, 1314–1334. doi:10.1037/a0012702
Peel, E., (2014). “The living death of Alzheimer’s” versus “Take a walk to keep dementia at bay”: Representations of dementia in print media and carer discourse. Sociology of Health and Illness, 36, 885–901. doi:10.1111/1467-9566.12122
Rahhal, T. A., Hasher, L., & Colcombe, S. J., (2001). Instructional manipulations and age differences in memory: Now you see them, now you don’t. Psychology and Aging, 16, 697–706. doi:10.1037/0882-7974.16.4.697
Régner, I., Mazerolle, M., Alescio-Lautier, B., Clarys, D., Michel, B., Paccalin, M., … Huguet, P., (2016). Aging stereotypes must be taken into account for the diagnosis of prodromal and early Alzheimer disease. Alzheimer Disease and Associated Disorders, 30, 77–79.10.1097/WAD.0000000000000129
Reitan, R. M., (1958). Validity of the trail making test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271–276.10.2466/pms.1958.8.3.271
Rende, B., Ramsberger, G., & Miyake, A., (2002). Commonalities and differences in the working memory components underlying letter and category fluency tasks: A dual-task investigation. Neuropsychology, 16, 309–321. doi:10.1037/0894-4105.16.3.309
Sadler, M. S., Meagor, E. L., & Kaye, K. E., (2012). Stereotypes of mental disorders differ in competence and warmth. Social Science and Medicine, 74, 915–922. doi:10.1016/j.socscimed.2011.12.019
Schmader, T., Johns, M., & Forbes, C., (2008). An integrated process model of stereotype threat effects on performance. Psychological Review, 115, 336–356. doi:10.1037/0033-295X.115.2.336
Scholl, J. M., & Sabat, S. R., (2008). Stereotypes, stereotype threat and ageing: Implications for the understanding and treatment of people with Alzheimer’s disease. Ageing and Society, 28, 103–130. doi:10.1017/S0144686X07006241
Schuster, C., Martiny, S. E., & Schmader, T., (2015). Distracted by the unthought–Suppression and reappraisal of mind wandering under stereotype threat. PLoS ONE, 10, e0122207. doi:10.1371/journal.pone.0122207
Seibt, B., & Förster, J., (2004). Stereotype threat and performance: How self-stereotypes influence processing by inducing regulatory foci. Journal of Personality and Social Psychology, 87, 38–56.10.1037/0022-3514.87.1.38
Shapiro, J. R., & Neuberg, S. L., (2007). From stereotype threat to stereotype threats: Implications of a multi-threat framework for causes, moderators, mediators, consequences, and interventions. Personality and Social Psychology Review, 11, 107–130. doi:10.1177/1088868306294790
Sosa-Ortiz, A. L., Acosta-Castillo, I., & Prince, M. J., (2012). Epidemiology of dementias and Alzheimer’s disease. Archives of Medical Research, 43, 600–608. doi:10.1016/j.arcmed.2012.11.003
Spielberger, C., Gorsuch, R., & Lushene, R., (1983). Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press.
Steele, C. M., & Aronson, J., (1995). Stereotype threat and the intellectual test performance of African Americans. Journal of Personality and Social Psychology, 69, 797–811. doi:10.1037/0022-3514.69.5.797
Stoet, G., & Geary, D. C., (2012). Can stereotype threat explain the gender gap in mathematics performance and achievement? Review of General Psychology, 16, 93–102. doi:10.1037/a0026617
Strickland-Hughes, C. M., West, R. L., Smith, K. A., & Ebner, N. C., (2016). False feedback and beliefs influence name recall in younger and older adults. Memory. doi:10.1080/09658211.2016.1260746
Stroop, J. R., (1935). Studies of interference in serial verbal reactions. Journal of Experimental Psychology, 18, 643–662. doi:10.1037/h0054651
Suhr, J. A., & Gunstad, J., (2002). “Diagnosis threat”: The effect of negative expectations on cognitive performance in head injury. Journal of Clinical and Experimental Neuropsychology, 24, 448–457. doi:10.1076/jcen.24.4.448.103912187458
Suhr, J. A., & Gunstad, J., (2005). Further exploration of the effect of “diagnosis threat” on cognitive performance in individuals with mild head injury. Journal of the International Neuropsychological Society, 11, 23–29. doi:10.1017/S1355617705050010 15686605
Sun, F., Gao, X., & Coon, D. W., (2015). Perceived threat of alzheimer’s disease among Chinese American older adults: The role of alzheimer’s disease literacy. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 70, 245–255. doi:10.1093/geronb/gbt095
Unsworth, N., Brewer, G. A., & Spillers, G. J., (2012). Working memory capacity and retrieval from long-term memory: The role of controlled search. Memory and Cognition, 41, 242–254. doi:10.3758/s13421-012-0261-x
Ware, J. E., Kosinski, M., Dewey, J. E., & Gandek, B., (2000). SF-36 health survey: Manual and interpretation guide. Lincoln, RI: QualityMetric.
Wechsler, D., (1997). Wechsler adult intelligence scale–Third edition (WAIS-III). San Antonio, TX: The Psychological Corporation.
Wechsler, D., (2008). Wechsler adult intelligence scale–Fourth edition (WAIS–IV). San Antonio, TX: NCS Pearson.
Werner, P., (2002). Assessing correlates of concern about developing Alzheimer’s dementia among adults with no family history of the disease. American Journal of Alzheimer’s Disease and Other Dementias, 17, 331–337.10.1177/153331750201700609
Winblad, B., Palmer, K., Kivipelto, M., Jelic, V., Fratiglioni, L., Wahlund, L. O., … Arai, H., (2004). Mild cognitive impairment–Beyond controversies, towards a consensus: Report of the International Working Group on mild cognitive impairment. Journal of Internal Medicine, 256, 240–246.10.1111/jim.2004.256.issue-3
Zimmermann, P., & Fimm, B., (2010). Test of attentional performance, version 2.3. Herzogenrath: Psychologische Testsysteme.
