Graduation Year

2019

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

School of Aging Studies

Major Professor

Ross Andel, Ph.D.

Committee Member

Aryn L. Harrison Bush, Ph.D.

Committee Member

Debra Dobbs, Ph.D.

Committee Member

Cathy McEvoy, Ph.D.

Committee Member

Brent J. Small, Ph.D.

Committee Member

John M. Ferron, Ph.D.

Keywords

aging, cognition, technology and aging, personality traits, mixed methods

Abstract

Over the last several decades, a growing awareness of the benefits of regular screening for common health conditions, such as cancer and cardiovascular diseases, has paved the way for preventative screenings to become routine in medical settings. Given that cognitive impairment is frequently reported as the number one worry of older adults, home-based cognitive monitoring may be an innovative solution that allows middle aged and older adults to take an active role in monitoring an important aspect of their health. Although several home-based cognitive monitoring programs have been validated for use in clinical and home-based settings, the Cogstate Brief Battery (CBB) may be the leading candidate based on its brevity, reliability, and lack of practice effects. Although home-based monitoring via the CBB tends to be well-received by participants, it remains unclear how participant characteristics such as personality traits may affect their performance over time. In addition, the factors related to participants’ adherence and satisfaction with regular cognitive monitoring have yet to be examined.

Addressing these unknowns are important, as they can help determine what to expect in terms of participant performance, adherence, and satisfaction, if home-based cognitive monitoring was implemented on a population-wide level in the future. This study examined how personality traits influenced cognitive performance over time on the CBB and explored participant adherence and satisfaction with regular cognitive monitoring over 60 months, using quantitative and qualitative data from a sample of cognitively healthy older adults recruited from communities in central Florida (N=158).

Statistical analyses of the quantitative data using mixed effects models showed that personality traits were associated with performance on the CBB; in particular, higher conscientiousness was related to more accurate performance at baseline and improvements in speed over time. In addition, higher openness was associated with less accurate performance at baseline and slower, yet more accurate performance over time. In general, participants’ performance was relatively stable over time and fluctuations in performance occurred mostly in the first year of the study. Intraindividual variability also decreased over time, with significant decreases in variability occurring in participants who were higher in conscientiousness and openness.

Mixed methods analyses of the data also suggested that participants liked their overall experience with the CBB, exhibited good study adherence over time, and were able to complete their monthly assessments with a high degree of independence. The themes that emerged from the qualitative analysis of participants’ study feedback suggest that most participants liked that CBB was easy, convenient to use, and provided them with a way to challenge themselves. However, some participants disliked one task in particular and felt that the CBB eventually became repetitive.

The findings from both studies are useful for future applications of cognitive monitoring programs, as they would help improve the accuracy of conclusions drawn from participants’ performance and could also lead to the development of strategies that encourage long-term participation among individuals whom low study adherence and satisfaction is likely.

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