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59 An Examination of the Moderating Effect of Self-Efficacy on the Association Between Health Literacy and Healthy Activity Engagement in Older Adults
- Samina Rahman, Carolyn Pagán, Maureen Schmitter-Edgecombe
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, p. 366
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Objective:
Engagement in activities that promote overall brain health and well-being is often a key step in reducing risks to cognitive health in older adults. Given that higher health literacy has been found to be associated with healthier lifestyles, it is unsurprising that it has been the focus of many studies and programs aimed at improving the health outcomes of older adults. An equally important factor to consider when it comes to such efforts is the role of moderating variables in the relationship between health literacy and engagement in healthy behaviors. The present study examined the moderating effect of self-efficacy, a variable that has been shown to be positively associated with both health literacy and health behaviors. We hypothesized that increased self-efficacy will strengthen the relationship between health literacy and healthy activity engagement in a sample of community-living older adults.
Participants and Methods:Forty-nine older adults (age: M = 64.35, SD = 8.00; education: M = 16.39, SD = 2.37; 87.76% female) completed a health literacy measure (Newest Vital Sign; NVS), a self-efficacy questionnaire (General Self-Efficacy Scale; GSE), and a lifestyle behaviors questionnaire (Healthy Aging Activity Engagement Scale; HAAE). The NVS is a performance-based measure in which participants are asked to interpret the verbal and numerical information of a nutrition label to make health-related decisions. The GSE is a self-report measure that evaluates one’s belief in their ability to handle challenges, solve problems, and accomplish goals. The HAAE is a self-report measure that assesses one’s engagement in healthy activities across multiple health domains.
Results:To examine whether self-efficacy moderates the relationship between health literacy and healthy activity engagement, a moderation analysis was conducted using Hayes’ PROCESS macro for SPSS with age and education included in the model as covariates. The results revealed no significant interaction between health literacy and self-efficacy, b = 0.23, p = .59, 95% CI [-0.60 to 1.05].
Conclusions:Contrary to expectations, in the present sample, the degree of self-efficacy was not a condition under which level of health literacy exerted its influence on healthy activity engagement in older adults. Future studies with larger and more nationally representative samples are needed to explore self-efficacy and other potential moderating factors in order to identify individual characteristics that support older adults’ adoption and engagement in health-promoting behaviors.
75 The Association Between Cognitive Function and Older Adults Performance on a Naturalistic Cooking Task in the Home Environment
- Angela Hickman, Carolyn Pagán, Catherine Luna, Maureen Schmitter-Edgecombe
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 379-380
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Objective:
Cognitive impairment can affect an individual’s ability to perform routine tasks. In this study, we investigate how cognitive abilities relate to the accuracy and efficiency of performance on a naturalistic cooking task completed in older adults’ home environments. We hypothesized a positive association between task accuracy and global cognitive status, and task efficiency and executive functioning. We further hypothesized a negative association between omission errors and immediate and delayed memory recall.
Participants and Methods:Fourteen community-dwelling older adults (Age, M = 73.92 years; Female = 9; Education, M = 16.38 years) along the continuum from normal aging to mild dementia completed a “Cooking Task” in their home environment. Specifically, participants were instructed to fry or scramble an egg, prepare slice of toast with jelly, serve side of sliced apple, pour glass of water, bring prepared items to table, and clean dishes used. Participants received ingredients necessary for task completion and a task list to reference. The task efficiency score (range 0-6) was based on multi-tasking and organizational skills (e.g., beginning the egg task early in session, plating items as prepared). Overall accuracy was computed by identifying error types (e.g., inefficiencies, substitutions, omissions, and subtasks attempted) and scaling accuracy (range 1-5) for each subtask, then summing all six subtask accuracy scores to get overall accuracy (range 6-30). Participants also completed a range of neuropsychological assessments, which included the Telephone Interview for Cognitive Status, Letter and Category Fluency from the Delis-Kaplan Executive Function System, and immediate and delayed recall measures from the Repeatable Battery for the Assessment of Neuropsychological Status. Due to the small sample size, findings are preliminary, and scatterplots were evaluated for outliers that might influence findings.
Results:Consistent with hypotheses, as overall accuracy on the Cooking Task increased so did performance on the global cognitive measure (TICS: r = 0.61, p = 0.02). Lower rates of omission errors were also associated with better performance on both immediate (r = -0.75, p < 0.01) and delayed (r = -0.55, p = 0.04) recall indices. However, these findings were not specific, as overall accuracy also significantly correlated with the memory indices and verbal fluency measures (ps < 0.05). Additionally, lower rates of omission errors significantly correlated with performance on the TICS and the D-KEFS Letter Fluency (ps < 0.05). Contrary to our hypothesis, no significant associations were found between cooking task efficiency and executive functioning (D-KEFS subtests). There were also no significant correlations between cooking task efficiency and global cognitive status or memory.
Conclusions:The present study supported our hypotheses that better overall task accuracy is associated with higher cognitive status and lower rates of omission errors correlate with better immediate and delayed recall abilities. However, the findings were not specific to these domains of functioning but rather suggest that clinical assessments measuring a range of cognitive abilities are related to the accuracy of daily task performance and omission errors on routine daily tasks. Future research will explore the validity of the efficiency measure.